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Discovering the Life Span

Fourth Edition

Chapter 2

The Start of Life

Module 2.3

Birth and the Newborn Infant

Sections in Module 2.3

Birth

Birth Complications

The Competent Newborn

Learning Objectives (1 of 3)

2.10: Describe the normal process of labor and the events that occur in the first few hours of a newborn’s life.

2.11: Describe the major current approaches to childbirth.

2.12: Describe the causes of, consequences of, and treatments for preterm births and the risks that postmature babies face.

Learning Objectives (2 of 3)

2.13: Describe the process of cesarean delivery, and explain the reasons for its increase in use.

2.14: Explain the factors that lead to stillbirth, infant mortality, and postpartum depression.

2.15: Describe the physical capabilities of the newborn.

Learning Objectives (3 of 3)

2.16: Describe the sensory capabilities of the newborn.

2.17: Describe the learning capabilities of the newborn.

2.18: Describe the social competencies of newborns.

Birth

Module 2.3 Birth and the Newborn Infant

From Labor to Delivery (1 of 6)

LO 2.10 Describe the normal process of labor and the events that occur in the first few hours of a newborn’s life.

266 days after conception corticotropin-releasing hormone triggers birth

Oxytocin is delivered from mother’s pituitary

When level high enough, uterine contractions begin

Labor: The Process of Birth Begins

Braxton-Hicks contractions: “false labor”

Contractions force head against the cervix

Figure 2-13: The Three Stages of Labor

From Labor to Delivery (2 of 6)

LO 2.10 Describe the normal process of labor and the events that occur in the first few hours of a newborn’s life.

Labor: The Process of Birth Begins

Labor proceeds in three stages:

First stage: Longest

Contractions every 8-10 minutes lasting 30 seconds

Contractions increase to their greatest intensity “transition”

Mother’s cervix opens

Labor can last 16-24 hours for first babies: shorter for subsequent children

Second stage: Baby’s head moves through birth canal

Typically lasts 90 minutes

Episiotomy is performed if needed

Stage ends when baby is born

From Labor to Delivery (3 of 6)

LO 2.10 Describe the normal process of labor and the events that occur in the first few hours of a newborn’s life.

Labor: The Process of Birth Begins

Labor proceeds in three stages:

Third stage: Occurs when umbilical cord and placenta are expelled

Shortest stage

Lasts only minutes

From Labor to Delivery (4 of 6)

LO 2.10 Describe the normal process of labor and the events that occur in the first few hours of a newborn’s life.

Birth: From Fetus to Neonate

Birth occurs when fetus emerges from mother’s body

Most babies cry immediately to clear lungs and breathe

The APGAR Scale

Standard measurement system that looks for a variety of indications of good health in newborns

Developed in 1953 by Virginia Apgar, measures five qualities

Each quality scored on 0–2 scale with final numbers 0–10

Most babies score 7

Scores under 4 need immediate intervention

Dangers of anoxia

Appearance (color)

Pulse (heart rate)

Grimace (reflex irritability)

Activity (muscle tone)

Respiration (respiratory effort)

Table 2-3: Apgar Scale

	Sign	0 points	1 point	2 points
A	Appearance (skin color)	Blue-gray, pale all over	Normal, except for extremities	Normal over entire body
P	Pulse	Absent	Below 100 bpm	Above 100 bpm
G	Grimace (reflex irritability)	No response	Grimace	Sneezes, coughs, pulls away
A	Activity (muscle tone)	Absent	Arms and legs flexed	Active movement
R	Respiration	Absent	Slow, irregular	Good, crying

A score is given for each sign at 1 minute and 5 minutes after the birth. If there are problems with the baby, an additional score is given at 10 minutes. A score of 7-10 is considered normal, whereas 4-7 might require some resuscitative measures, and a baby with an Apgar score less than 4 requires immediate resuscitation.

Source: Apgar, 1953; Rozance & Rosenberg, 2012.

From Labor to Delivery (5 of 6)

LO 2.10 Describe the normal process of labor and the events that occur in the first few hours of a newborn’s life.

Newborn Medical Screening

Recommended tests for 29 disorders that vary from state to state

Benefits include early treatment

Research continues to determine value of these tests

From Labor to Delivery (6 of 6)

LO 2.10 Describe the normal process of labor and the events that occur in the first few hours of a newborn’s life.

Physical Appearance and Initial Encounters

Babies covered with vernix to aid passage through birth canal

May be covered with fine, dark fuzz called lanugo

Eyelids may be swollen and puffy from accumulation of liquids

Controversy of bonding

Approaches to Childbirth: Where Medicine and Attitudes Meet (1 of 4)

LO 2.11 Describe the major current approaches to childbirth.

Alternative Birthing Procedures

Lamaze

Bradley

Hynobirthing

Water birthing

Lamaze birthing techniques (Dr. Fernand Lamaze)

The goal is to learn how to deal positively with pain and to relax at the onset of a contraction.

While research does not support significant benefit to Lamaze, it is one of the most popular methods.

Bradley Method

Known as “husband-coached childbirth.”

Principle: Childbirth should be as natural as possible.

Involves no medication or medical interventions.

Teach mom muscle-relaxation, breathing techniques, and maintaining healthy bodies

Controversial because it teaches that physicians are unnecessary and may be dangerous

Hypnobirthing

Involves a self-hypnosis during delivery, which produces peace and calm, thereby reducing pain

Water Birthing

Water birthing is a practice in which a woman enters a pool of warm water to give birth.

Theoretically, the warmth and buoyancy of the water is soothing, easing the pain of labor and childbirth, and the entry into the world is soothed for the infant.

The disadvantage is that there is a risk of infection from the unsterile water.

Approaches to Childbirth: Where Medicine and Attitudes Meet (2 of 4)

LO 2.11 Describe the major current approaches to childbirth.

Childbirth Attendants: Who Delivers?

Obstetricians

Midwife

Doula

Approaches to Childbirth: Where Medicine and Attitudes Meet (3 of 4)

LO 2.11 Describe the major current approaches to childbirth.

Use of Anesthesia and Pain-reducing Drugs

Benefits and disadvantages

Reduces pain

Epidural

Walking epidural or dual spinal-epidural

May depress the flow of oxygen to the fetus, slowing labor, and causing harm to fetus

Not all studies suggest harmful effects for fetus

Approaches to Childbirth: Where Medicine and Attitudes Meet (4 of 4)

LO 2.11 Describe the major current approaches to childbirth.

Postdelivery Hospital Stay: Deliver, Then Depart?

1970: Average hospital stay was 3.9 days

1990: Average hospital stay dropped to 2 days

American Academy of Pediatrics states that women should stay 2 days

U.S. Congress passed legislation for insurance to cover 2 days for childbirth

Becoming an Informed Consumer of Development: Dealing With Labor

Strategies to help make labor a positive experience

Be flexible

Communicate with healthcare providers

Remember that labor is . . . laborious

Accept your partner’s support

Be realistic and honest about your reactions to pain

Focus on the big picture

Review: Birth (1 of 2)

Labor occurs in three stages:

First stage contractions occur every 8-10 minutes.

Second stage lasts about 90 minutes and baby moves through the cervix and birth canal.

Third stage lasts only a few minutes and includes expelling the umbilical cord and placenta.

The infant is assessed and returned to mother and father.

Newborns experience screening tests to identify potential problems.

Review: Birth (2 of 2)

Parents have many choices about the birth:

Setting

Medical attendants

Whether to use pain-reducing medications

Cesarean, if necessary

Check Yourself: Birth (1 of 3)

Labor proceeds in three stages. The longest stage of labor is __________.

A) the first stage

B) the second stage

C) the third stage

D) hard to determine

Answer: A

Check Yourself: Birth (2 of 3)

The _________ scale measures infant health by assessing appearance (color), pulse (heart rate), grimace (reflex irritability), activity (muscle tone), and respiration (respiratory effort).

A) Bronfenbrenner

B) Brazelton

C) Anoxia

D) Apgar

Answer: D

Check Yourself: Birth (3 of 3)

Which of the following factors influences a woman’s delivery?

A) Her preparation for childbirth

B) The support she has before and during delivery

C) Her culture’s view of pregnancy and delivery

D) All of the above

Answer: D

Birth Complications

Module 2.3 Birth and the Newborn Infant

Preterm Infants and Postmature Babies (1 of 5)

LO 2.12 Describe the causes of, consequences of, and treatments for preterm births and the risks that postmature babies face.

Preterm infants are born before 38 weeks and at risk for illness and death

Low-birthweight infants: Weigh less than 2,500 grams

Some are small-for-gestational-age infants: 90 percent or less of average weight of infants of same gestational age

Preterm infants benefit from responsive, stimulating, and organized care

Infant massage is beneficial

Susceptible to respiratory distress syndrome (RDS)

May be placed in an incubator

Figure 2-14: International Infant Mortality

Infant mortality rates in selected countries. Although the United States has greatly reduced the infant mortality rate in the past 25 years, it still ranks behind numerous other industrialized countries. What are some of the reasons for this?

Source: The World Factbook, 2016.

Preterm Infants and Postmature Babies (2 of 5)

LO 2.12 Describe the causes of, consequences of, and treatments for preterm births and the risks that postmature babies face.

Development for preterm infants slower; sometimes subtle problems emerge after birth

38 percent have mild problems (such as learning disabilities or low IQ scores) that call for educational interventions

Might be at greater risk for mental illness

Others have difficulties with physical coordination

Around 60 percent are free of even minor problems

Preterm Infants and Postmature Babies (3 of 5)

LO 2.12 Describe the causes of, consequences of, and treatments for preterm births and the risks that postmature babies face.

Very-low-birthweight Infants: The Smallest of the small

Weigh less than 2¼ pounds and have been in gestation for less than 30 weeks

In grave danger due to immature organs

Age of viability is about 22 weeks

Babies born earlier than 25 weeks have 50-50 change of survival

Costs to care for very-low-birthweight infants is high

Preterm Infants and Postmature Babies (4 of 5)

LO 2.12 Describe the causes of, consequences of, and treatments for preterm births and the risks that postmature babies face.

What Causes Preterm and Low-birthweight Deliveries?

Multiple births

Young mothers

Too closely spaced together births

General health and nutrition of mother

African American mothers have double the chance of having a low-birthweight baby

Preterm Infants and Postmature Babies (5 of 5)

LO 2.12 Describe the causes of, consequences of, and treatments for preterm births and the risks that postmature babies face.

Postmature Babies: Later, Larger

Postmature babies are still unborn 2 weeks after mother’s due date

They face health risks

Blood supply may be decreased to the brain

Labor and delivery is more difficult

Cesarean Delivery: Intervening in the Process of Birth (1 of 2)

LO 2.13 Describe the process of cesarean delivery, and explain the reasons for its increase in use.

More than a million cesarean deliveries each year

Cesarean delivery: Baby surgically removed from the uterus

Several difficulties can lead to cesarean delivery:

Fetus appears to be in danger

Mothers over age 40

Used for breech position

Used for transverse position

When the baby’s head is large

Cesarean Delivery: Intervening in the Process of Birth (2 of 2)

LO 2.13 Describe the process of cesarean delivery, and explain the reasons for its increase in use.

Use of fetal monitors during delivery have contributed to increased cesarean rates.

Some criticisms of fetal monitoring

No association between cesarean and successful birth consequences

Major surgery that requires prolonged recovery

Risk of infection

May deter release of stress hormones, which may impair infant later in dealing with stress

Babies more prone to breathing problems

Medical authorities recommend avoiding routine use

Figure 2-16: Cesarean Deliveries

The rate at which cesarean deliveries are performed varies substantially from one country to another. Why do you think the United States has such a high rate?

Source: Organization for Economic Cooperation and Development (OECD), 2015.

Stillbirth, Infant Mortality, and Postpartem Depression (1 of 2)

LO 2.14 Explain the factors that lead to stillbirth, infant mortality, and postpartem depression.

Stillbirth and Infant Mortality: The Tragedy of Premature Death

Infant mortality: Death in the first year of life

Rate is declining

Stillbirth: Delivery of a child who is not alive (1 in 100)

Parents grieve in the same manner as if an older loved one had died

Depression often occurs

African American babies twice as likely to die in the first year

Stillbirth, Infant Mortality, and Postpartem Depression (2 of 2)

LO 2.14 Explain the factors that lead to stillbirth, infant mortality, and postpartem depression.

Postpartem Depression: Moving from the Heights of Joy to the Depths of Despair

Period of depression following childbirth

Affects about 10 percent of new mothers

Depression can last for months or even years

May be triggered by hormones

May lead to detachment and lack of responsiveness to infant’s needs

Cultural Dimensions: Overcoming Racial and Cultural Differences in Infant Mortality

African American babies twice as likely to die in first year

May be due to socioeconomic factors

Overall infant mortality rate is higher in United States than in many countries

Higher rate of low-birthweight and preterm deliveries

More people living in poverty without medical care

Other countries provide prenatal care at low cost or free

Percentage of pregnant women in the United States with no prenatal care has increased since 1990

Free or inexpensive health care could help

Review: Birth Complications (1 of 2)

Preterm, premature infants are born less than 38 weeks gestation.

They generally have low birthweight, which can cause chilling, vulnerability to infection, respiratory distress, and hypersensitivity.

Adverse effects may include slowed development, below average IQ, and problems with physical coordination.

Very-low-birthweight infants have difficulties due to immature organs

The age of viability is 22 weeks.

Postmature babies are also at risk.

Review: Birth Complications (2 of 2)

Cesarean deliveries are performed when a fetus is in distress, in the wrong position, or unable to advance in birth canal.

Fetal monitoring has contributed to soaring rate of cesarean births.

Infant mortality rate in the United States is higher than in many countries.

Infant mortality is greater for low-income families.

Postpartum depression affects about 10 percent of new mothers.

In severe cases, aggressive treatment is needed.

Check Yourself: Birth Complications (1 of 2)

The amount of danger facing preterm infants largely depends on the child’s ________ at birth.

A) weight

B) intelligence

C) eye color

D) movements

Answer: A

Check Yourself: Birth Complications (2 of 2)

__________, defined as death within the first year of life, has been declining since the 1960s.

A) Infant decline

B) Infant mortality

C) Life expectancy

D) Age of viability

Answer: B

The Competent Newborn

Module 2.3 Birth and the Newborn Infant

Physical Competence: Meeting the Demands of a New Environment

LO 2.15 Describe the physical capabilities of the newborn.

Reflexes are unlearned, organized involuntary responses

Sucking and swallowing

Rooting reflex

Digestive system produces meconium

Neonatal jaundice: More likely to occur in preterm and low-birthweight babies

Sensory Capabilities: Experiencing the World (1 of 2)

LO 2.16 Describe the sensory capabilities of the newborn.

Infant’s visual and auditory systems are not fully developed

They can see levels of contrast and brightness

They can tell size consistency and distinguish colors

They react to sudden sounds and recognize familiar sounds

They are sensitive to touch

Their senses of taste and smell are well developed

Sensory Capabilities: Experiencing the World (2 of 2)

LO 2.16 Describe the sensory capabilities of the newborn.

Circumcision of Newborn Male Infants

Debate on medical necessity

May protect against sexually transmitted disease

Can come with complications (bleeding and infection)

Some believe it can reduce sensation and pleasure later on in life

The pain and stress of the procedure are not treated

Early Learning Capabilities

LO 2.17 Describe the learning capabilities of the newborn.

Classical conditioning

Little Albert

Operant Conditioning

Habituation

Orienting response

CLASSICAL CONDITIONING, a type of learning in which an organism responds in a particular way to a neutral stimulus that normally does not bring about that type of response, underlies the learning of both pleasurable and undesired responses in the newborn.

Little Albert

OPERANT CONDITIONING, a form of learning in which a voluntary response is strengthened or weakened, depending on its association with positive or negative consequences, functions from the earliest days of life.

HABITUATION, the decrease in the response to a stimulus that occurs after repeated presentations of the same stimulus, is probably the most primitive form of learning and occurs in every sensory system of the infant.

Habituation produces an orienting response, in which infants become quiet and attentive to new stimuli.

Social Competence: Responding to Others

LO 2.18 Describe the social competencies of newborns.

Infants can imitate others

Infants can differentiate basic facial expressions

Infants cycle through various states of arousal

Different degrees of sleep and wakefulness

Review: The Competent Newborn

Infants are able to breathe, demonstrate reflexes, find food, swallow, and avoid unpleasant stimuli.

Newborns’ sensory competence include seeing color differences, distinguishing objects in the visual field, hearing, and sensitivity to touch, colors, and tastes.

Infants learn through habituation, classical conditioning, and operant conditioning.

Newborns can imitate others, which helps them form relationships and develop social competence.

Check Yourself: The Competent Newborn (1 of 2)

To survive the first few minutes or even days, infants are born with _________, or unlearned, organized, involuntary responses that occur automatically in the presence of certain stimuli.

A) sensory capabilities

B) acute hearing

C) narrow vision

D) reflexes

Answer: D

Check Yourself: The Competent Newborn (2 of 2)

An infant learning through __________ learns to respond in a particular way to a neutral stimulus that normally does not bring about that type of response.

A) reward

B) classical conditioning

C) operant conditioning

D) social learning

Answer: B

Applying Lifespan Development

Can you think of examples of the use of classical conditioning on adults in everyday life, in such areas as entertainment, advertising, or politics?

Photo Credits

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