journal

Birth and the Newborn

The Stages of Childbirth

False Labor

• False labor or pre labor occurs when the uterus sporadically contracts for several weeks before the actual birth.

Lightening

• About 2 weeks before birth an event called lightening occurs.

• The baby’s head drops low into the uterus and the cervix softens in preparation for delivery.

• The bloody show is the reddish discharge release when the cervix widens.

The Stages of Childbirth

• Dilation and Effacement of the Cervix

• Deliver of the Baby

• Birth of the Placenta

Dilation and Effacement of the Cervix

• Widening and thinning of the cervix resulting in a clear pathway from the uterus into the birth canal.

• Uterine contractions are forceful and regular, getting closer together (every 2-3 minutes) lasting as long as 60 seconds.

• Transition is reached when the frequency and strength of contraction are at their peak and the cervix opens completely (10 centimeters).

• The longest stage of labor – lasting on average from

12 –14 hours (4-6 hours for later births).

Delivery of the Baby

• Lasts approximately 50 minutes for a first baby and 20 minutes for later births.

• Strong contractions continue and the mother feels a natural urge to push with her abdominal muscles, forcing the baby down and out.

• An episiotomy is a small incision that increase the size of the vaginal opening and permits the baby to pass with out damaging the mother’s tissue.

Delivery of the Placenta

• The final stage of labor last about 5-10 minutes

• Final contractions and pushes cause the placenta to separate from the uterine wall and be delivered.

• The placenta is inspected.

Instrument Delivery

• Forceps – metal clamps place around the baby’s head to pull the infant from the birth canal

• Vacuum extractor – is a suction tube that is attached to a plastic cup placed on the baby’s head.

Natural or Prepared Childbirth

• Rewarding experience for parents

• No drug support (local for the episiotomy)

• Breathing and relaxing techniques

• Labor coaches

• Positions for Delivery

Cesarean Delivery

• A surgical birth in which the doctor makes an incision in the mother’s abdomen and lifts the baby out of the uterus

• Cesarean rates in the U.S. are the highest in the world.

When is a Cesarean Delivery Needed?

Complications Can Make A Vaginal Birth

Risky For The Mother:

•The baby is too big to fit safely through

the birth canal (macrosomia), often a

complication of gestational diabetes.

•The baby's head is too large to pass

through mother's pelvis (cephalopelvic

disproportion).

•The baby is positioned buttocks-first

(breech) or crosswise (transverse),

rather than head-down.

•Medical conditions such as

hypertension, preeclampsia, or

eclampsia.

Assessing the Newborn

• The Apgar Scale –

• Infants who have difficulty making the transition to life outside the uterus must be given help at once.

• The Apgar Scale is used to assess the infant’s physical condition on 5 criteria, each of which is rated from 0 to 2

• Two Apgar ratings are given, at 1 and 5 minutes after birth, since some babies have trouble adjusting at first but do quite well after a few minutes.

The APGAR Scale

Signs 0 Score 1 Score 2 1 minute

2 minute

Heart Rate

Absent Less than 100

Over 100

2 2

Respiratory Effort

Absent Slow Irregular

Good Cry

1 2

Muscle Tone

Limp Some Flexion

Active Motion

1 2

Reflect Irritability

No Response

Grimace Cry 1 2

Color

Pale

Body Pink, Blue

Extremities

Body all Pink

1 2

Total Score - - - 6 10

The Newborn Baby’s Appearance

• Length is about 20 inches long

• Weight is about 7.5 pounds

• Large head, large foreheads

• Short bowed legs

• Round faces with chubby cheeks

• Big eyes – make adults want to pick up the new born and cuddle them

The Newborn Baby’s Capacities

• A Relex is an inborn, automatic response to a particular form of stimulation and help assess the health of the baby’s nervous system.

• States of Arousal are different degrees of sleep (about 16-18 hours/day) and wakefulness)

• Crying is the first way the baby communicates physical needs and later emotional needs.

Sensory Capacities

• Touch helps stimulate physical and emotional development, sensitive to pain

• Taste – infants have taste preferences

• Smell – research suggests that some odor preferences are innate

• Hearing – prefer expressive, high pitched voices

• Vision – limited visual acuity, prefers colored rather than gray stimuli later.

Berk, Laura E., (2016). Infants, Children, and Adolescents. Boston, MA: Pearson. EIGHTH EDITION