Research paper
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DEP2004-7BirthSP20.pptxAn Orientation to Lifespan Development
Lesson #6
Birth
Module 2.3 Birth and the Newborn Infant
From Labor to Delivery
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: When the Process of Birth Begins:
Braxton-Hicks contractions: “false labor”
Contractions force head against the cervix
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The Three Stages of Labor
From Labor to Delivery
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: When 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
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From Labor to Delivery
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: When 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
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From Labor to Delivery
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 to 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)
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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.
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From Labor to Delivery
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 of screening include early treatment
Research continues to determine value of these tests
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From Labor to Delivery
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
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Approaches to Childbirth: Where Medicine and Attitudes Meet
LO 2.11 Describe the major current approaches to childbirth.
Alternative Birthing Procedures
Lamaze (exercising and breathing control)
Bradley (breathing and relaxation)
Hypnobirthing (natural birth/self-hypnosis)
Water birthing (part of labor/delivery happens in water)
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.
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Approaches to Childbirth: Where Medicine and Attitudes Meet
LO 2.11 Describe the major current approaches to childbirth.
Childbirth Attendants: Who Delivers?
Obstetricians
Midwife
Doula
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Approaches to Childbirth: Where Medicine and Attitudes Meet
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
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Approaches to Childbirth: Where Medicine and Attitudes Meet
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
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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
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Review: Birth
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
Parents have many choices about the birth:
Setting
Medical attendants
Whether to use pain-reducing medications
Cesarean, if necessary
Birth Complications
Module 2.3 Birth and the Newborn Infant
Preterm Infants and Postmature Babies
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
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Preterm Infants and Postmature Babies
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
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
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
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
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
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
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.
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Stillbirth, Infant Mortality, and Postpartem Depression
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
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
Review: Birth Complications
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
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.
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 (dark/green material in the intestine at birth and passed in the feces after birth)
Neonatal jaundice: More likely to occur in preterm and low-birthweight babies
Sensory Capabilities: Experiencing the World
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
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
Watson – (Little Albert experiment)
Operant Conditioning
B.F. skinner (the rat in the box)
Habituation (Observational Learning)
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.
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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.
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?
