1. Labor and Delivery Mrs. McCann Child Development

2. Labor is the process that moves baby out of the Mom. It occurs via involuntary contractions which are the rhythmic movement of muscles in the uterus that push the baby against the cervix causing it to open. The baby then makes its way out of the Mom by traveling through the birth canal or vagina.

3. The labor contractions alternate with periods of rest for the Mom’s body. First two things that usually occur during labor are: 1. the loss of the mucus plug 2. the rupture of the amniotic sac or the breaking of Mom’s water.

4. Stages of Labor Labor is divided into 3 stages. Stage One : Dialation, or the opening of the cervix, to a full 4 inches. This stage last 12 – 24 hours. Contractions are 15 – 20 mins. apart and last less than 1 minute

5. Stage Two Delivery of the baby occurs! Baby starts to emerge through cervix and birth canal. This stage ends at birth-when baby is fully clear from mom. This stage last about 1 ½ hours. Contractions are 1 minute in duration occurring every minute.

6. Baby should exit head first, if not this is considered a breech birth. 1 out of 25 deliveries is breech. Breech babies may be manually turned, delivered breech (extremely risky!) or delivered via Cesarian section.

7. Episiotomies (surgical cut & repair by stitches after delivery) may be necessary to prevent tearing of the vaginal walls during delivery.

8. Stage two-continued The umbilical cord will stop functioning after delivery. Doctor or Dad will cut the umbilical cord.

9. Delivery Aids and Tools may be necessary. Forceps and vacuum extractors help pull the baby out.

10. The hormones Oxytocin and Pitocin are used to start and speed up contractions.

11. Stage Three Expulsion of the afterbirth The afterbirth (placenta, cord and other membranes) must be checked to make sure all was Expelled. Cord blood may be obtained and saved for future use.

12. Vernix Caseosa The baby is wiped clean after delivery. The vernix is a natural protective skin grease – similar to a wetsuit! It protects from heat loss before and during birth and too much water absorption during pregnancy.

13. Bonding Bonding between parents and child begins to occur right after birth. Mom and Dad fall in love with the infant and infant begins to identify Mom and Dad.

14. Bonding!!

15. For Baby bonding results in: increased chances of survival for the infant improvements in weight gain less crying increased language and mental development.

16. For parents, bonding results in: less child abuse faster recovery time for Mom more self-confidence less post-partum depression

17. Birth Plans Birth Plans should be made before delivery by the parents and doctor. Birth Plans include: 1. Where the birth will occur? Choices are at home with a certified nurse midwife or at the hospital with a doctor. In the hospital it can be: in the delivery room or in a birthing room.

18. Birthing room

19. Birthing rooms are a good compromise between a technological, depersonalized hospital birth (which cannot offer the emotional experience of a home birth) and a birth at home (which cannot offer the medical backup of a hospital).

20. Delivery room

21. #2 Who will be there? Doctors, delivery nurses, doulas, parents, partners, siblings, family: in- laws, aunts/uncles or your acupuncturist?

22. Side note: a Doula is a trained person that assists with physical, emotional and educational support. She is also there to help calm the “laboring Mom.” She is part of the birthing team She is similar to a midwife but does not participate in the delivery (down there!)

23. #3 Labor Style Natural childbirth –Developed by Dr. Rick Read in 1930s –Delivery without drugs –Based on educating the Mom so she knows what to expect, therefore reducing her fear factor and so pain is manageable. –Mom is trained on how to breathe and relax during delivery

24. #3 Labor Style Lamaze-developed by Dr. Fernand Lamaze Women have been conditioned to fear childbirth. So Lamaze method educates to reduce fear. Mom is taught to focus on one other thing in the room and to breath in patterns so as to keep her mind off the pain The Dad attends the Lamaze lessons with Mom and is the Coach The Mom receives medication when necessary

25. # 3 Labor Style Leboyer Method-Shhhhhh!!!!! Developed by Dr. Fredrick Leboyer The focus is on the comfort of the baby and the safety of the mom and baby This method believes delivery is painful for the baby as well. Low lights are used in the delivery room The room is quiet, soft voices, soothing music The cord is cut only after it stops functioning Baby is given a warm water bath after he has had time to bond, cuddle and suckle at Mom’s breast

26. #3 Labor Style Water Birth Uses a large bathtub for mom to sit in. It is filled with warm water and soft lighting.

27. #4 Pain Management Analgesia to reduce anxiety and pain (Demerol) Local anesthetic: a shot to numb the vaginal area Regional block: epidural, pain medication inserted into spine, mom maintains sensations but has no pain General: Mom is put out like a light!

28. # 5 Induction or Not? Will Induction be used if necessary? Hormones can be used to start and speed up labor. The manual breaking the amniotic sack or water will also start the onset of labor.

29. #6 Equipment What equipment will be used? Can parents provide and use special music? Will a vaginal mirror be used so mom can watch the birth process? Use of a video camera? Use of delivery tools can be discussed before birth too.

30. #7 Tear or Cut Episiotomy vs. natural tearing? #8 Who will cut the umbilical cord? Will it be saved? Will cord blood only be saved?

31. # 9 Length of Stay Mom often stays less than 24 hours in the hospital after delivery. Health insurance and postpartum condition of mom will determine the length of stay.

32. Cesarian Section Delivery If a C-Section is planned will Mom be awake or totally knocked-out? Who else will be present? Will a mirror be used for Mom’s viewing pleasure? Downsides: higher infection rate, longer recovery time, greater stress b/c it is surgery.