1. The Birth Process

2. False Labor?
False labor is defined as cramps and backaches that may occur several days before labor starts.
The two reliable indicators of real labor are:
1. “The Show”-pink spotting of blood discharged from vagina as mucous plug of the cervix loosens.
2. “Water Breaks”-the amniotic sac around the fetus ruptures causing fluid to trickle or gush from the vagina.
The loss of protective fluids increase the changes for infection.

3. The Beginning of Labor…

4. Three Stages of Childbirth…
1st-Labor
(14 hours is average)
2nd-Pushing and Delivery of the Baby
( 2 hours for first births)
3rd-Delivery of the Placenta
(10-30 minutes)

5. First Stage: Labor
A Woman in labor experiences contractions, a tightening and relaxing of the muscles of the uterus.
Contractions help dilate or widen the cervix and push the baby from the uterus through the vagina.
These early contractions resemble menstrual cramps.
Back Labor is felt in the lower back.
Contractions grow stronger, longer and more frequent as labor progresses.

6. Early Labor
Women may experience nausea, leg cramps, shakiness, or hiccups.
Women need to save their strength at this time.
Women may distract themselves with a quiet activity to keep their minds off labor.
A light nutritious snack helps keep up her energy.
The bladder should be emptied every hour or so during labor.
Contractions are mild, coming every 20 to 30 minutes.

7. What’s Next?
When contractions are 1 minute in length and occur every 5 minutes or less you should call your doctor or nurse-midwife to let them know you are in labor & going to the hospital.

8. Active Labor
Contractions grow more intense, coming every 3-4 minutes apart and lasting seconds.
Cervix dilates up to 7 cm.
Women walk, sit in a rocker or chair, or can be lying on one side between contractions.
Coaches need to encourage women to keep spirits and energy up during this time period, as well as breathing techniques.

9. Transition
The transitional stage rapidly moves childbirth from labor to the stage of pushing and delivery.
Transition commonly takes about 90 minutes, compare to the 14 hour average of early & active labor.
Contractions are regular and extremely powerful, lasting from seconds and coming every 2-4 minutes.
Cervix dilates fully to 10 cm, approximately 4 inches.
Transition is the most difficult part of labor.

10. Continuing Transition
Medications are more likely to be given during transition than any other time.
A woman may feel nauseous, drowsy, or feverish, and then chilled.
She starts to feel like pushing as the baby’s head presses on her lower back and pelvic area, but is told to wait.
Coaches need to stay supportive and encourage the women’s progress.
Panting exercises learned in childbirth class help the woman avoid putting pressure on the cervix (pushing) before the cervix has fully opened.

11. Bill Cosby—“Natural Childbirth”

12. Second Stage: Pushing & Delivery
A woman “turns the corner” is the second stage of the birth process.
The stage lasts about 2 hours for the first birth and 1 hour or less for subsequent births
With the cervix full dilated at 10 centimeters, the mom–to-be is allowed to push down with her abdominal muscles.
If she has had no medication up to this point, she probably will not need it now.

13. Preparing for Delivery
The women’s pelvic and vaginal area is scrubbed, and painted with an antiseptic solution.
Her body is covered with a sterile cloth.
She may lie on her back or lean forward.
The women’s coach, scrubbed and dressed in a sterile gown and mask, takes an active role as delivery nears.
Along with the doctor and nurses, the coach helps women respond to her body’s clues to breathe, bear down and relax.

14. Women need to relax between contractions.
The Delivery
Contractions are very strong during delivery, coming every minute or two and lasting almost as long.
During contractions, the woman takes in a deep breath, pushes to the count of 10, then repeats.
Women need to relax between contractions.
Aided by this forceful pushing, the baby travels down the birth canal, facing backwards, with the head down.
The skull is made of flexibly joined plates of bone, allowing it to be temporarily molded into an odd shape as it descends the narrow passageway.

15. Delivery… An episiotomy is made at this time, if needed.
As the head begins to emerge, called crowning, the baby turns upward.
Mucous is sucked from the baby’s mouth and nose.
After the head emerges it expands the birth canal so the rest of the body can pass through it easily.
The baby’s body rotates to one side, gently guided by the doctor, enabling the shoulders to emerge one at a time.

17. Delivery…
A few more contractions complete the baby’s exit…the child has been born.
The umbilical cord is then clamped and cut.
Neither the mother or baby can feel the cut.
The delivery process ends with mother and baby being wrapped in warm blankets.

18. The Try Guys Try Labor Pain Simulation
On the index card
What questions do you have about the real care babies?

19. Breech delivery: A baby is born with feet or buttocks first.
Complications
If a woman cannot push the baby out by herself the doctor may use forceps, a pincer like instrument to reach into the birth canal and pull the baby out.
Breech delivery: A baby is born with feet or buttocks first.
Cesarean Sections: A surgical delivery where child is delivered through an opening cut in the abdominal wall and uterus. Requires longer recovery period.

20. “I didn’t know I was pregnant”

21. Third Stage: Delivery Of Placenta
Occupied with her newborn, a new mother may barely notice this final stage of childbirth.
Mild contractions expel the placenta and other membranes through the birth canal.
A nurse massages the abdomen to assist the process, which takes 10 to 30 minutes.
If an episiotomy was performed, it is now stitched under local anesthetic.
The stitches will be absorbed into the body and need not be removed.

22. After Delivery…
Following delivery, the uterus shrinks, accompanied by contractions and strong cramps.
A bloody discharge is normal, and may continue for several days to as much as six weeks.

23. Do Now Identify and list what happens during each stage of labor.

24. Surgery Squad Interactive

25. The Newborn’s Appearance
After floating in the amniotic fluid for nine months and squeezing through the birth canal, the newly born infant appears far different from the little bundle that parents take home a little later.

26. The Skin…
The newborn’s skin is covered with vernix that is washed away by a birth attendant.
The skin may appear grayish-blue, but that changes with the cries and deep breaths.
The skin may look transparent or slightly wrinkled, or be covered with fine hair, called lanugo.
Newborn acne, if present, disappears within day.
Birthmarks may or may not fade over the years.

27. The Head…
The head is slightly pointed from its passage through the mother’s pelvis.
It takes a round shape within a few days.
The journey down the birth canal can produce a lump on the head called caput.
A scalp monitor used during labor may leave a swollen red mark.
Any hair present at birth may fall out, replaced by new hair in a few months.

28. Shape of Head…

29. The Eyes…
Light skinned babies almost always have slate blue eyes at birth.
The eyes of darker skinned infants are brown.
Individual eye color develops over several weeks or months.
Eyes may at first appear crossed because the newborn is unable to focus on a single object.
The drops given at birth to prevent infections sometimes cause swelling.

30. Pretend you are a baby who was just born
Pretend you are a baby who was just born. Imagine what it must feel like for a newborn to find itself outside the dark, warm, confined space of the mother’s uterus. Imagine the journey you just went through and what your reactions would be to the outside world. Write 2 paragraphs about the experience of birth from a baby’s perspective

31. One Born Every Minute

32. Review the Stages of Labor
The cervix dilates fully to 10 cm. (about 4 inches)
First Stage
An episiotomy may be performed.
Second Stage

33. Review the Stages of Labor
Medication may be given to reduce discomfort.
First Stage
Labor contractions are about minutes apart at the beginning of this stage.

34. Review the Stages of Labor
Uterus Shrinks.
Third Stage
Relaxation is important to prevent muscles from tightening.
First Stage

35. Review the Stages of Labor
Mother may be asked to push down with her abdominal muscles to help baby.
Second Stage
Lasts from 10 to 30 minutes.
Third Stage

36. Review the Stages of Labor
Woman may be encouraged to walk.
First Stage
Uterus continues to contract, causing strong cramps.
Third Stage

37. Review the Stages of Labor
Baby is born.
Second Stage
Near the end of this stage, contractions are strong and frequent.
First Stage

38. Review the Stages of Labor
Longest stage of labor.
First Stage
Mother may be moved from the labor room to a separate delivery room.
Second Stage

39. Review the Stages of Labor
Uterus contracts to expel placenta.
Third Stage
Cervix dilates and becomes thinner.
First Stage

40. Review the Stages of Labor
Forceps may be used if necessary.
Second Stage
Crowing of the baby’s head occurs.

41. Review the Stages of Labor
Stitching of the episiotomy takes place.
Third Stage
Contractions occur every 1 to 2 minutes and last 1 to 2 minutes.
Second Stage

42. Review the Stages of Labor
The umbilical cord is clamped or tied and cut.
Second Stage
A cesarean section may be performed.