The Birth Process Chapter 4 The Baby Book

1. What do future parents learn in prepared childbirth classes? How to make labor and delivery easier How to relax How to breathe Exercises to help the mother get in shape for delivery

2. What is recommended for the new mother to take to the hospital or birthing center? Nightgowns Robe Nursing bra Sanitary napkins Toiletries Baby clothes Car Seat Clothes for the new mother to wear home

Traditional Childbirth Used in most hospitals Very protective of both the mother and baby Mother is given local or general anesthetics as needed to reduce the discomfort Monitoring equipment checks on the baby’s progress Husbands may or may not be in the labor and delivery room After the birth the mother is taken to a recovery room and the baby is taken to the nursery Traditional

Family Centered Based on the belief that the birth affects the family as a unit as well as each individual Birthing rooms Husband is encouraged to remain with the mother throughout the entire labor and delivery Other support people may also be present

Family Centered, cont. The mother and father participate in the labor and delivery and are accompanied by an OB nurse or midwife. The doctor may be present for the delivery or may be called if complications arise. After the birth the mother, father and baby spend as much time together as they like Brothers and sisters may visit throughout the day

Lamaze Developed in France Based on the theory that the pain of childbirth can be controlled by the woman – not eliminated, but tolerated Couple attends classes that last 2 months of the pregnancy preparing to work as a team, learning exercises that will help in breathing and muscle control so that she can relax more during delivery

Lamaze cont. Focus on breathing techniques Husband is the labor coach, encouraging the woman to relax Most often goes into the delivery room Women who have the Lamaze training usually need less medication during labor or no medication

Leboyer Focuses on the birth experience of the baby Goal is to make the birth process less shocking and more comfortable Prior to birth the environment for the baby is dark, quiet, and warm surrounded by fluid A similar environment is provided during this method of childbirth

Leboyer cont. Lights are dimmed, soft music is played, low voices are used Immediately after birth the baby is placed on the mother’s abdomen, the umbilical cord is not cut until it has stopped pulsating The baby is placed in warm water as soon as it is removed from skin to skin contact with the mother Many doctors use parts of this method even if they do not use it in it’s entirety

Cesarean Section Surgical procedure that is faster than a normal delivery It is major surgery and the recovery time for the mother is longer with greater risk of infection

There are several reasons for a cesarean section: The pelvic area may not be large enough for the baby to pass through There may be an emergency reason where the baby needs to be born quickly The labor and delivery may be prolonged and/or difficult because of the size, position, or condition of the baby

4. What is labor? The process by which the baby gradually moves out of the uterus and into the vagina to be born

5. What is “false labor”? False labor is often mistaken for labor The difference is that false labor pains remain constant in intensity and do not increase with time They are irregular and not rhythmical

6. Why do so many fathers want to participate in the birth of their child? Some consider it to be the most important event of their lives They feel their families will be closer if they are there To support their wife

7. What is “lightening”? It is when the baby’s head drops into the pelvic area about 6 weeks prior to the birth

8. What is Breech birth? When the baby presents itself bottom or feet first rather than head first

8. What is Pre-term baby? A baby born weighing less than 5.5 pounds

9. List indications for the onset of labor Low backache Sudden cramping Breaking of the “bag of water” – amniotic sac Slight red or pink discharge Evenly spaced contractions

10. What is “dilation of the cervix”? Stretching of the cervix so that the baby’s head can come through The cervix eventually dilates to 10 cm or about 4 inches

11. What is an episiotomy? An incision made by the doctor or midwife between the vagina and anus to make it easier for the baby to come out without tearing the mother

12. Explain why most babies are born headfirst. It is more comfortable for the baby and the fit is better for the baby to be headfirst the last few weeks before delivery.

13. What happens to the baby immediately after the birth? Baby must be kept warm – laid on mothers abdomen and covered with a warm towel or blanket which also begins the bonding process, or Placed in radiant warmer if needed Mucous is cleared from the throat and nose A brief examination APGAR test

What happens to the baby immediately after birth – cont. Drops are put in the eyes, to prevent infection or blindness in case the mother has an infection or an STD Baby is tagged with a wrist and ankle band that matches the mother’s Footprints are taken The baby is weighed and measured and cleaned up

14. STAGES OF LABOR: Dilation Stage (12 – 18 hours) –Begins with the first uterine contraction –Ends when the baby’s head is in the vagina or birth canal Pains are slight and far apart in the beginning Time of contractions lengthen with shorter intervals between contractions as they become more intense Cervix must dilate before the baby can be born The cervix opens more with each contraction At the end of this stage the water usually breaks

14. Stages of Labor Expulsion Stage (5 – 45 minutes) –Begins when the cervix is fully dilated and the baby’s head is in the birth canal –Ends with the birth of the baby Contractions continue and the pain is most severe at this point Crowning takes place: the doctor can see the baby’s head Episiotomy is performed if needed

14. Stages of Labor Expulsion, continued After the head is born, the doctor gently turns the baby so the shoulders can be born more easily The baby is helped to breathe and the umbilical cord is cut The baby is thoroughly examined and weighed

15. Stages of Labor Afterbirth Stage (10 – 15 minutes) –Uterine contractions continue –Placenta is expelled Placenta separates from the uterine wall Placenta is expelled Placenta examined to make sure that none of the tissue has torn and remains in the uterus.

APGAR A measurement of the newborn's response to birth and life outside the womb. The ratings, APGAR, are based on Appearance (color), Pulse (heartbeat), Grimace (reflex), Activity (muscle tone), and Respiration (breathing). The scores, which are taken at 1 & 5 minutes following birth, range from a high 10 to a low 1.

APGAR Score Chart 012 Heart RateAbsentLess than 100 beats per minute beats per minute BreathingAbsentSlow or irregularRegular Muscle ToneLimpSome motion of extremities Active motion Skin ColorBluePink body – blue extremities Pink all over Reflex Response AbsentGrimaceCry

The baby is born. Now what? If the baby is doing well and is considered stable, then it can spend time with its mother If mother chooses to breastfeed, she may feed the baby now – baby may be especially alert immediately following birth The baby will be kept warm at all times – with a hat, wrapped in a blanket and under a radiant warmer when not being cuddled by its parents At the nursery the baby will be cleaned more thoroughly, as well as evaluated once again.