1. Child Birth and the Newborn Baby

2. The Three Stages of Labor
Figure 4.1

3. Copyright © 2012 Pearson Education, Inc. All Rights Reserved.
The Apgar Scale
Appearance
Pulse
Grimace
Activity
Respiration
© Photomak | Dreamstime.com
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

4. The Apgar Scale
Table 4.1
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

5. Approaches to Childbirth
Attitudes and practices molded by society
Western society:
Before late 1800s→home births
Post-industrial revolution→hospital births
1950s–1960s→movement toward natural childbirth
Today→birth centers (& some home births)

6. Elements of Natural, or Prepared, Childbirth
Classes
Relaxation and
breathing techniques
Labor coach
Social support
Difference between midwife and
Doula?
© Frank Boston | Dreamstime.com
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

7. Other Natural Childbirth Practices
Positions for delivery might include sitting upright or using a birthing stool.
Water births are associated with shorter labors and a greater likelihood of a medication-free delivery than other approaches.
North American women choosing home delivery remain a small percentage (1%).
Figure 4.2

8. Medical Interventions in Childbirth
Fetal monitoring
Medication
Analgesics
Anesthetics
Instrument delivery
Induced labor
Cesarean delivery
© Alvera | Dreamstime.com
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

9. Instrument Delivery
Figure 4.3
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

10. Cesarean Delivery
Cesarean deliveries, rare 40 years ago, now account for 31% of births in the United States
Cesareans are warranted in medical emergencies such as
Rh incompatibility.
premature separation of the placenta from the uterus.
infection.
baby in breech position.

11. Cesarean Delivery Many are ELECTIVE Cesarean deliveries Why have them?
--doctor and family convenience
Higher risk of complications; infant death
due date may have been inaccurate
brain, heart, lungs and immune system mature at different rates

12. The Business of Being Born
2008 documentary

13. Anoxia Oxygen deprivation at birth
Can lead to brain damage or later cognitive, language problems
Cerebral palsy
Causes include:
Squeezing by umbilical cord
Placenta abruptio, placenta previa
Failing to breathe after birth
Respiratory distress syndrome in preterm infants

14. Preventing Brain Cell Death from Anoxia
Researchers are experimenting with ways to prevent this secondary damage.
Anoxic newborns placed in a head-cooling device shortly after birth for 72 hours substantially reduced brain injury and increased their assessment scores.
Precooled water blankets are also being used to reduce the rates of death and severe disabilities.

15. Rates of Infant Survival and Disability by Length of Pregnancy
Figure 4.4
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

16. Preterm and Small-for-Date Babies
Born weeks before their due date (< 37 wks)
May be appropriate weight for length of pregnancy
Small-for-Date
May be born at due date or preterm
Below expected weight for length of pregnancy
Some small-for-date babies have weakened abilities to manage stress.
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

17. Interventions for Preterm Infants
Isolette
Respirator
Feeding tube
Intravenous medication
Special infant stimulation
Kangaroo skin-to-skin contact
Parent training in caregiving
© Juan Carlos Herrera Arango | Dreamstime.com
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

18. Influence of Early Intervention for Low-Income, Preterm Babies
on Intellectual
Functioning
at Age 8
Figure 4.5
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

19. Health Care for Parents and Newborn Babies
Infant mortality: In spite of the most up- to-date technology in the world, the United States has made little progress in reducing infant death rates.
Neonatal mortality: Low birth weight is the second highest contributor to infant mortality, and it is largely preventable.

20. Infant Mortality Around the World
Figure 4.6
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

21. Precious Moments After Birth
Oxytocin causes the breasts to “let down” milk, heightens the mother’s response to baby
First-time fathers also show hormonal changes that are associated with positive emotional reactions to infants.
But parent–infant relationship not dependent upon immediate bonding
© Jkha | Dreamstime.com
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

22. Newborn Reflexes Eye blink Withdrawal Rooting Sucking Swimming Moro
Palmar grasp
Tonic neck
Stepping
Babinski

23. Infant States of Arousal
Regular sleep
Irregular sleep
Drowsiness
Quiet alertness
Waking activity and crying
© Atm2003 | Dreamstime.com

24. The Mysterious Tragedy of Sudden Infant Death Syndrome
SIDS is the leading cause of infant mortality between 1 week and 12 months in industrialized nations.
Its occurrence tends to peak between 2 and 4 months of age.
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

25. Reducing Incidence of SIDS
Quit smoking and taking drugs.
Put babies to sleep on their backs.
Remove bedclothes.
Pacifiers are another protective measure.

26. Ways to Soothe a Crying Baby
Hold on shoulder and rock or walk
Swaddle
Pacifier
Soothing sounds
Ride in carriage, car, swing
Massage
Combine methods
Let cry for short time
© Jperagine | Dreamstime.com
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

27. Newborn Sense of Touch
Reflexive response to touch on mouth, palms, soles, genitals
Sensitive to pain
Pain can affect later behavior.
Relieve pain with anesthetics, sugar, gentle holding

28. Newborn Senses of Taste and Smell
Prefer sweet tastes at birth
Quickly learn to like new tastes
Have odor preferences from birth
Can locate odors and identify mother by smell from birth
Figure 4.7
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

29. Newborn Sense of Hearing
Can hear a wide variety of sounds at birth
Prefer complex sounds to pure tones
Learn sound patterns within days
Sensitive to voices and biologically prepared to learn language
© Lihui | Dreamstime.com
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

30. Newborn Sense of Vision
Least developed of senses at birth
Unable to see long distances, focus clearly
Scan environment and try to track interesting objects
Color vision improves in first two months.
© Aaron Belford | Dreamstime.com
Copyright © 2012 Pearson Education, Inc. All Rights Reserved.

31. Neonatal Behavioral Assessment
Neonatal Behavioral Assessment Scale (NBAS) evaluates a baby’s reflexes, muscle tone, state changes, responsiveness to physical and social stimuli (developed by T. Berry Brazelton).
Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) is specially designed for use with newborns at risk for developmental problems.

32. Single Mother Families
39% of babies in United States born to single mothers
Most nonmarital births are unplanned.
Unprepared, adolescent teens
Low-income women in 20s
Exception is financially secure women ages 30–45
© Crystal Craig | Dreamstime.com

33. Parental Depression and Child Development
Eight to 10% of first-time mothers experience postpartum depression after the birth of their baby.
Three to 5% of fathers also report depression after the birth of a child.
Parental depression can have a negative effect on a child’s world view.
Early treatment/pre-birth intervention is vital.