1. Signs that labor is approaching:
Lightening
The show
Braxton-Hicks or prelabor contractions
Regular contractions
Rupturing of the amnio-chorionic membrane

2. What is a contraction?
A contractions is a pain that is felt during labor when the muscles of the uterus tense

3. Difference between Braxton-Hicks and real labor contractions:
As labor progresses the contractions come closer together. They continue rhythmically, an become stronger. That’s how a woman can distinguish between labor contractions and prelabor contractions. Prelabor contractions remain equal in intensity from the start. They occur irregularly, are not rhythmical, and stop if a woman changes position.

4. Why fill out hospital forms early?
A couple might fill out the admittance forms early so they can get it out of the way. This makes admittance easier when the woman is in labor.

5. What is electronic fetal monitoring?
Electronic fetal monitoring is the use of various electronic devices to measure the woman’s contractions and the baby’s response to them It is used to check how the baby is doing during labor and delivery.

6. The four types of medication for labor:
General anesthesia – puts the mom to sleep for a period of time. Do not feel pain, but miss out on birth experience. Health risks involved!
Regional anesthesia – takes away feeling in one region of the body (i.e. epidural)
Local anesthesia – takes away pain in a small area
Analgesics – dull pain, but do not take it away entirely; less side effects and risks

7. Epidural Very expensive Only administered by anesthesiologist
Continuous feed line of medication that numbs from the waist down
Not administered until at least 4 cm

8. Birth Decisions: Traditional childbirth Family-centered childbirth
Lamaze method
Prepared childbirth
Leboyer method
Breech delivery
Cesarean delivery

9. C-Section (Cesarean Section)
Delivery of a baby through a surgical incision in abdomen and uterus.
Riskier and longer recovery
Significantly high percentage (30%) in our country
Sometimes scheduled in advance; or as a response to unforeseen complications
Prolapsed cord
Poor presentation
Mother too small or baby too big
Placenta previa or abruption
Fetal distress
STDs
Previous C-section
Toxemia

10. What happens when the baby is born?
Baby is washed
Baby is weighed and measured
Apgar test is given or the Brazelton scale
Identification bands are given
Baby is given eyedrops
Baby is given tests for PKU and anemia
Circumcision

11. Test for newborn baby: Brazelton is more in depth and extensive
Apgar is done to assess the need for immediate care, Brazelton identifies problems that might not need immediate medical attention

12. Reasons a baby might need immediate medical attn:
The baby is born prematurely
The baby had a low birth weight
The baby was born addicted to illegal drugs
The baby scored very low on an Apgar test
NICU – Neonatal Intensive Care Unit

13. What is ‘postpartum’?
The postpartum period is the time in which the mother’s body recovers and heals from pregnancy. It last about six weeks.
The postpartum checkup is important because it helps the mother know how well she is recovering. It is also an opportunity for her to ask any questions she may have.

14. Water Birth Method
Mother gives birth in a tub/pool filled with warm water
Calming for mother and baby
Why don’t they drown?!
Natural Dive Reflex

15. Water Birth Conditions
Everything has to be going terrifically for the baby to be born in water.
Baby's heartbeat has to be reactive,
Do not attempt if high-risk.
More acceptable but still unconventional and considered risky; not recommended by the American College of Obstetricians and Gynecologists.
Talk to caregiver about the risks and benefits.
When the baby moves, the heart rate goes up. And there's no areas where the baby's heart rate is going down and that your blood pressure's normal and everything's good!
prenatal issues such as diabetes, high blood pressure, or preeclampsia; you plan to use any pain medication; or your labor will be induced

16. Midwifery
Midwife – low risk pregnancy; emphasis on emotional and natural support
Obstetrician – medical approach; can perform a caesarean section or other medical procedures (care of pregnant women and delivery of babies)
Pediatrician – physician who specializes in the care of infants and children

17. If no lightening….

18. Inducing Labor
Definition: To bring on (induce) contractions naturally or with medications
WHY?
You are one to two weeks past your due date
Water broke and labor did not begin
Placenta is failing to function properly
Preeclampsia
Illness threatens your health or the baby’s
Previous stillbirth

19. Stage One: Dilation Dilation – cervix opens from 0 to 10 centimeters
Effacement – cervix relaxes and thins
Transition – the fetus begins “transitioning” or moving into the birth canal
Mother starts to feel the urge to push

20. Stage Two: Delivery Begin to push
Fontanels – soft spots that overlap to fit the skull through the birth canal.
Crowning – when the widest point of the babies head is visible

21. Stage Two: Delivery cont.
Forceps or the use of a vacuum might be used to aid delivery

22. Episiotomy Incision to prevent tearing
Natural tearing takes a longer, less successful recovery

23. Stage Three: Afterbirth
Placenta detaches and is expelled
Umbilical cord, amniotic sac, and lochia also expelled
5-10 minutes of contractions and pushing
Usually not difficult or painful

24. APGAR scoring Score given at 1, 5, 10 minutes after birth of the child
Assists doctor to determine status of child
Each component is worth 2 pts

25. APGAR cont. Respiration Color Heart Rate Reflex Muscle Tone
7 + is good, normal

26. Postpartum Period 1-3 days in hospital is normal
Full recovery from pregnancy and birth can take several months, especially the first 6 weeks or postpartum period
Involution – reproductive organs return to normal size
Lochia – lining of the uterus sloughs off; bloody discharge
Afterpains – contractions that help uterus return to normal cramps

27. Postpartum cont. Walking and getting up/around usually helps recovery
Psychological effects
“Baby Blues”
Fathers’ emotions

28. Bonding
Definition:
A closeness for another person (love, caring, concern)
Day-to-day interactions and affection
Feeding, touching, playing
Can you think of other examples?

29. Bonding cont.
Having father present for birth is believed to improve his bond with the neonate
Factors that negatively affect bonding
Premature babies
Vey expensive child (hospital/doctor bills)
Colicky child
Mother’s health
Conflict within the couple
Child appearance
“Imagined Child”

30. “Failure to Thrive”
Lack of touch and bonding can lead to the actual death of a child.
Bonding is essential.
Increased healthy bonding improves mental, physical, emotional development and beyond.