1. Labor and Birth

2. First Stage of Labor Early sign of labor: Early sign of labor: –Lose the mucus plug – water may break Contractions are the tightening and loosening of the muscles of the uterus. Contractions are the tightening and loosening of the muscles of the uterus. –Contractions get stronger and closer together as labor progresses. –Braxton – Hicks contractions are –never get stronger, not regular, end if walk around. –Braxton – Hicks contractions are FALSE LABOR –never get stronger, not regular, end if walk around.

3. First Stage Each contraction pulls up on the cervix, thinning it out – Effacement Each contraction pulls up on the cervix, thinning it out – Effacement Cervix will dilate – get wider. Cervix will dilate – get wider. Transition – fully dilated (about 4 in/10 cm), baby’s head it engaged in birth canal Transition – fully dilated (about 4 in/10 cm), baby’s head it engaged in birth canal –Contractions 2-3 minutes apart – last up to 90 seconds –First child first stage will last 6-18 hours –Later children first stage will last 2-5 hours

4. Second Stage Widest part of baby’s head appears: Crowning Widest part of baby’s head appears: Crowning –Head emerges: Skull bones are soft and pliable to fit through birth canal. Head may be a funny shape. (Fontanels) –Shoulders come out next and rest of body will slip out. –Mother produces hormone “relaxin.” Doctor may do an “episiotomy” so woman does not tear. Doctor may do an “episiotomy” so woman does not tear.

5. Third stage of Labor Woman will give birth to the placenta Woman will give birth to the placenta –“afterbirth” Episiotomy is stitched up Episiotomy is stitched up http://www.babycenter.com/2_inside- pregnancy-labor-and-birth_3658872.bc http://www.babycenter.com/2_inside- pregnancy-labor-and-birth_3658872.bc http://www.babycenter.com/2_inside- pregnancy-labor-and-birth_3658872.bc http://www.babycenter.com/2_inside- pregnancy-labor-and-birth_3658872.bc

6. Interventions Breech – feet or buttocks first Breech – feet or buttocks first May need forceps May need forceps Cesarean Birth (C-section) – incision in abdomen to get to uterus. Cesarean Birth (C-section) – incision in abdomen to get to uterus. http://www.babycenter.com/2_inside-pregnancy-labor-and- birth_3658872.bc http://www.babycenter.com/2_inside-pregnancy-labor-and- birth_3658872.bc http://www.babycenter.com/2_inside-pregnancy-labor-and- birth_3658872.bc http://www.babycenter.com/2_inside-pregnancy-labor-and- birth_3658872.bc

7. After Birth Pressure of the birth squeezes fluid out of the lungs and the baby starts to breath naturally. Pressure of the birth squeezes fluid out of the lungs and the baby starts to breath naturally. Valves in the heart close and blood circulation begins. Valves in the heart close and blood circulation begins.

8. Newborn appearance at birth Head wobbly and large compared to body Head wobbly and large compared to body Head misshapen. Head misshapen. Face may be swollen and puffy. Face may be swollen and puffy. Eyes are nearly adult size. Eyes are nearly adult size. Skin may be covered with lanugo (soft hair) or vernix (creamy substance) or milia (white bumps on the nose and cheeks. Skin may be covered with lanugo (soft hair) or vernix (creamy substance) or milia (white bumps on the nose and cheeks. http://www.babycenter.com/2_inside-pregnancy-labor-and- birth_3658872.bc http://www.babycenter.com/2_inside-pregnancy-labor-and- birth_3658872.bc http://www.babycenter.com/2_inside-pregnancy-labor-and- birth_3658872.bc http://www.babycenter.com/2_inside-pregnancy-labor-and- birth_3658872.bc

9. Vernix

10. After Baby is Born ID bracelets on both Baby and mother ID bracelets on both Baby and mother Baby’s footprints are taken Baby’s footprints are taken Birth certificate is filled out Birth certificate is filled out Hearing test Hearing test Blood test for blood type and other diseases. Blood test for blood type and other diseases.