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Birth and the Newborn Baby Truth or Fiction?

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... whether the baby s belly button will be an inny or an outy. Women who give birth according to the Lamaze method do not experience pain. – PowerPoint PPT presentation

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Title: Birth and the Newborn Baby Truth or Fiction?


1
Chapter 4 Birth and the Newborn Baby In the New
World
2
Birth and the Newborn Baby Truth or Fiction?
  • The fetus signals the mother when it is ready to
    be born.
  • After birth, babies are held upside down and
    slapped on the buttocks to stimulate independent
    breathing.

3
Birth and the Newborn Baby Truth or Fiction?
  • The way that the umbilical cord is cut determines
    whether the babys belly button will be an
    inny or an outy.
  • Women who give birth according to the Lamaze
    method do not experience pain.

4
Birth and the Newborn Baby Truth or Fiction?
  • In the United States, 1 birth in 4 is by cesarean
    section.
  • It is abnormal to feel depressed following
    childbirth.

5
Birth and the Newborn Baby Truth or Fiction?
  • Parents must have extended early contact with
    their newborn children if adequate bonding is to
    take place.
  • More children die from sudden infant death
    syndrome (SIDS) than from cancer, heart disease,
    pneumonia, child abuse, AIDS, cystic fibrosis and
    muscular dystrophy combined.

6
Countdown
  • The Stages of Childbirth

7
What Events Occur just prior to the Beginning of
Childbirth?
  • Dropping or Lightening
  • Head of fetus settles in pelvis
  • Braxton-Hicks contractions
  • First uterine contractions may be experienced as
    early as 6th month
  • Blood spotting in vaginal secretions
  • Day or so before labor
  • Rush of amniotic fluid from vagina
  • Occurs in 1 woman in 10

8
What Events Occur just prior to the Beginning of
Childbirth?
  • Beginning of labor may be signaled by
    indigestion, diarrhea, ache in small or back, and
    abdominal cramps
  • Placenta and uterus secretes prostaglandins
  • excite uterus muscles causing contractions
  • As labor progresses, oxytocin is released
  • stimulates contractions powerful enough to expel
    the fetus

9
What Happens during the First Stage of Childbirth?
  • Uterine contractions efface and dilate cervix
  • First stage lasts from a few hours to more than a
    day
  • Contractions increase in strength, frequency, and
    regularity
  • Mother may be prepped
  • Shaving pubic hair
  • Administer enema

10
What Happens during the First Stage of Childbirth?
  • Fetal monitoring
  • Measure fetal heart rate and mothers
    contractions
  • If necessary to speed up delivery, forceps or
    vacuum extraction tube may be used
  • Transition (about 30 minutes)
  • Cervix is nearly fully dilated
  • Head of fetus moves into vagina
  • Frequent and strong contractions

11
Figure 4.1 The Stages of Childbirth
12
What Happens during the Second Stage of
Childbirth?
  • Begins when baby appears at opening of birth
    canal
  • Ends with birth of baby
  • Babys head crowned when it begins to emerge from
    birth canal
  • Episiotomy may be performed once crowning takes
    place
  • Used to prevent tearing of mother
  • Controversial and used less frequently

13
Lessons in Observation Birth
  • In the video, Lee had her baby in a hospital
    setting, without fetal monitoring or anesthesia.
    What are some other approaches to childbirth
    outlined in your text?
  • Lee was in labor for 9 hours with her first
    child, Carter. Is this typical?

14
Lessons in Observation Birth
15
Lessons in Observation Birth
  • Lee and Dan were worried about the size of
    Carters testicles and his somewhat flattened
    facial features. Describe the newborn babys
    appearance and explain the likely duration of
    these characteristics.
  • What does the acronym APGAR stand for?

16
Lessons in Observation Birth
  • How are each of the five areas tested by the
    APGAR rated? Appearance, Pulse, Grimace,
    Activity, Respiration
  • Explain the APGAR score ratings in connection
    with good, fair, and poor condition.

17
Lessons in Observation Birth
  • What was Carters APGAR score?
  • Why is this test performed twice, at one minute
    and at five minutes?
  • Does the APGAR score predict the future health of
    a baby?

18
What Happens during the Second Stage of
Childbirth?
  • Once babys head emerges from mother, mucus is
    suctioned from the babys mouth
  • Clears passageway for breathing
  • Umbilical cord is clamped and severed
  • Newborn may be removed
  • Baby is footprinted
  • ID bracelet is put on baby
  • Antibiotic ointment or drops are applied to
    babys eyes
  • Baby receives Vitamin K injection

19
What Happens during the Third Stage of Childbirth?
  • Also referred to as the placenta stage
  • Lasts minutes to an hour or more
  • Placenta separates from the wall of uterus and is
    expelled
  • Obstetrician sews episiotomy, if performed

20
Methods of Childbirth
21
How is Anesthesia Used in Childbirth?
  • General anesthesia
  • Puts mother to sleep
  • Negative effects of general anesthesia
  • Abnormal patterns of sleep and wakefulness
  • Decreased attention and social responsiveness for
    at least 6 weeks
  • Local anesthetics
  • Deadens pain without putting mother to sleep
  • Minor depressive effects on neonates shortly
    after birth

22
What is Prepared Childbirth?
  • Lamaze method
  • Utilize breathing and relaxation exercises to
    lessen fear and pain
  • Teaches women to associate relaxation with
    contractions
  • Coach
  • Aids the mother in the delivery room
  • Provides social support to mother during labor
  • Doula
  • Experienced female companion provides continuous
    emotional support during labor
  • Fewer cesarean deliveries, less anesthesia, and
    shorter, less painful labors

23
What is the C-section?
  • Cesarean Section
  • Delivered by abdominal surgery
  • Physicians prefer C-section to vaginal delivery
  • Mothers small pelvis
  • Maternal weakness or fatigue
  • Baby is too large
  • Baby is in distress
  • May be used to bypass infections in birth canal
    from HIV or Herpes

24
How Can a Woman Decide to Deliver Her Baby?
  • Diversity of birthing options
  • All-in-one labor, delivery, recovery, and
    postpartum rooms (LDRPs)
  • Birthing suite in hospital equipped for
    uncomplicated birth
  • Easy access to emergency facilities if needed
  • Home Birth
  • Can be fairly safe for healthy women with little
    risk of complications

25
Birth Problems
26
What are the Effects of Oxygen Deprivation at
Birth?
  • Hypoxia - Prenatal oxygen deprivation
  • can impair development of central nervous system
    and psychological disorders
  • Anoxia - Oxygen deprived at birth
  • predicted problems in learning and memory
  • can cause health problems such as early-onset
    schizophrenia and cerebral palsy

27
What is Meant by the Terms Prematurity and Low
Birth Weight?
  • Premature or preterm baby
  • Occurs before 37 weeks gestation (normal is 40
    weeks)
  • Low-birth-weight baby
  • Weighs less than 5.5 pounds
  • Small for date
  • Low-birth-weight, although born at full term

28
What Risks are Connected with being Born
Prematurely or Low in Birth Weight?
  • Infant mortality
  • Neonates weighing 3.25 to 5.5 pounds are 7 times
    more likely to die than infants of normal weight
  • Those weighing less than 3.3 pounds are nearly
    100 times as likely to die
  • Delayed neurological development
  • Lower birth weight poorer performance
    throughout school years
  • Delayed motor development, such as walking
  • Preschool experience fosters cognitive and social
    development

29
What Signs are Connected with being Born
Prematurely or Low in Birth Weight?
  • Preterm babies show signs of immaturity
  • relatively thin
  • fine, downy hair (lanugo)
  • oily, white substance on skin (vernix)
  • Preterms born six weeks or more prior to full
    term
  • nipples not yet be emerged
  • testicles of boys not yet descended into scrotum
  • Muscles immature and reflexes are weak
  • Respiratory distress syndrome
  • walls of air sacs in lungs stick together

30
How are Preterm Infants Treated Following Birth?
  • Usually remain in hospital incubators
  • Temperature-controlled environment with
    protection from infection
  • Parents often do not treat preterms as well as
    full term
  • Less attractive than full-term babies
  • High-pitched, grating cries
  • More irritable
  • Preterms and parent interaction is less even when
    they are brought home

31
How are Preterm Infants Treated Following Birth?
  • Interventions for preterm infants
  • Benefit from external stimulation
  • Massage
  • Kangaroo care
  • Preterm infants exposed to stimulation
  • Gain weight more rapidly
  • Show fewer respiratory problems
  • Make greater advances in motor, intellectual, and
    neurological development than controls

32
Developing in a World of Diversity
  • Maternal Mortality and Infant Mortality Around
    the World

33
The Postpartum Period
34
What Kinds of Problems in Mood do Women
Experience during Postpartum Period?
  • Baby blues
  • Transient about 10 days
  • Postpartum depression (PPD)
  • Begins one month after delivery and may linger
    for weeks/months
  • Major depressive disorder
  • Psychotic features

35
How Critical is Parental Interaction with
Neonates in the Formation of Bonds of Attachment?
  • Bonding
  • Formation of bonds of attachment between parent
    and child
  • Essential to survival and well being of child
  • Maternal sensitive period
  • Amount of access to newborn (Klaus Kennell,
    1978)
  • Extended early contact is not essential for
    adequate bonding

36
Characteristics of Neonates
37
How do Health Professionals Assess the Health of
Neonates?
  • Apgar scale
  • Based on five signs of health
  • Interpretation of scores
  • 7 or above no danger
  • below 4 critical condition
  • Brazelton Neonatal Behavioral Assessment Scale
  • Based on four areas of behaviors
  • Measures reflexes, motor behavior and muscle tone

38
What are Reflexes?
  • Reflexes
  • Simple, unlearned stereotypical responses,
    elicited by certain types of stimulation
  • Survival value
  • Neural functioning is determined by testing
    reflex

39
What Kinds of Reflexes are Shown by Neonates?
  • Rooting
  • Baby turns head and mouth toward stimulus that
    strokes the cheek, chin, or corner of mouth
  • Facilities finding mothers nipple for sucking
  • Sucking
  • Babies will suck almost any object that touches
    the lips
  • Will become replaced by voluntary sucking

40
What Kinds of Reflexes are Shown by Neonates?
  • Moro or startle reflex
  • Back arches, legs and arms are flung out and then
    brought back toward chest into a hugging motion
  • Occurs when babys position is suddenly changes
    or health and neck support is lost
  • Elicited by loud noises or bumping baby
  • Usually lost 6 to 7 months after birth

41
What Kinds of Reflexes are Shown by Neonates?
  • Grasping or palmar reflex
  • Using four fingers, babies grasp fingers/objects
    pressed against the palms of their hands
  • Most babies can support their own weight
  • Usually lost by 3 to 4 months
  • Replaced by voluntary grasping at 5 to 6 months

42
What Kinds of Reflexes are Shown by Neonates?
  • Stepping reflex
  • Mimic walk when held under arms
  • Usually disappears by 3 or 4 months

43
What Kinds of Reflexes are Shown by Neonates?
  • Babinski reflex
  • Fans or spreads toes in response to stroking foot
  • Usually disappears at end of first year
  • Tonic-neck reflex
  • While lying on back, baby turns head to one side.
    Arm and leg on that side extend, while opposite
    side flex.

44
Vision
  • Visual acuity
  • Estimate of 20/600
  • Best see objects 7 to 9 inches from eyes
  • Lack peripheral vision of older child
  • Able to track movement within one day of birth
  • preference for moving objects

45
A Closer Look
  • Studying Visual Acuity in Neonates How Well Can
    They See?

46
Vision
  • Visual accommodation
  • Self-adjustments made by eye lens to bring
    objects into focus
  • Neonates show little or no visual accommodation
  • Focus on objects 7 to 9 inches away
  • Convergence
  • Does not occur until 7 or 8 weeks

47
Hearing
  • Fetuses respond to sound
  • Neonates respond to amplitude and pitch
  • Show preference for mothers voice
  • Responsive to sounds and rhythms of speech
  • Show no preference for specific languages

48
Smell and Taste
  • Smell
  • Well developed at birth
  • Demonstrate aversion for noxious and preference
    for pleasant odors
  • Recognize familiar odors
  • Taste
  • Sensitive to different tastes
  • Demonstrate facial expressions to basic tastes
  • Prefer sweet tastes

49
Touch and Pain
  • Touch
  • Sensitive to touch
  • Touch elicits many reflex behaviors
  • Pain
  • Less sensitive to pain

50
Learning
  • Or Really Early Childhood Education

51
Can Neonates Learn?
  • Classical Conditioning
  • Involuntary responses are conditioned to a new
    stimuli
  • Operant Conditioning
  • Behavior (reflexes) are modified through
    reinforcement

52
What Patterns of Sleep are Found among Neonates?
  • Neonates spend about 16 hours per day in sleep
  • Typical infants has six cycles of waking and
    sleeping
  • REM Sleep
  • Neonates spend 50 time in REM sleep
  • Decreases in percentage of REM
  • 6 months 30
  • 2 to 3 years 20 to 25
  • NREM Sleep

53
Figure 4.15 REM Sleep and Non-REM Sleep
54
Why do Babies Cry?
  • Pain and discomfort
  • Universal, expressive and functional
    communication
  • expressive response to unpleasant feelings
  • stimulates caregiver response
  • Distinct causes and patterns of cries
  • Hunger, anger, pain
  • Peaks of crying in late afternoon and early
    evening
  • Crying produces physiological response in others

55
What Can I do to Stop an Infant from Crying?
  • Sucking serves as a built-in tranquilizer
  • Pacifier, sweet solutions
  • Soothing processes
  • Pick baby up, patting, caressing, rocking them
  • Speaking to them in low voice

56
What is SIDS?
  • Sudden Infant Death Syndrome crib death
  • Strikes while the baby is sleeping
  • Most common cause of death in infants between 1
    and 12 months
  • Most likely to occur between 2 and 5 months
  • Period when reflexive behavior is weakening
  • Causes of SIDS remains obscure

57
What are the Risk Factors for SIDS?
  • SIDS is most common among
  • babies aged 2 to 4 months
  • babies put to sleep on their stomach
  • premature and low-birth-weight babies
  • males
  • lower SES
  • African Americans
  • babies of teenage mothers
  • babies of mothers who smoked or used narcotics
    during pregnancy
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