Labor and Delivery

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Labor and Delivery

• Mrs. McCann
• Child Development

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• Labor is the process that moves baby out of the
  Mom. It occurs via involuntary contractions
  which are the rhythmic movement of muscles in the
  uterus that push the baby against the cervix
  causing it to open.
• The baby then makes its way out of the Mom by
  traveling through the birth canal or vagina.

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• The labor contractions alternate with periods of
  rest for the Moms body.

• First two things that usually occur during labor
  are
• the loss of the mucus plug
• 2. the rupture of the amniotic sac or the
• breaking of Moms water.

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Stages of Labor

• Labor is divided into 3 stages.
• Stage One Dialation, or the
• opening of the cervix, to a full 4 inches. This
  stage last 12 24 hours. Contractions are 15
  20 mins. apart and last less than 1 minute

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Stage Two

• Delivery of the baby occurs!
• Baby starts to emerge through cervix and
  birth canal. This stage ends at birth-when baby
  is fully clear from mom. This stage last about 1
  ½ hours. Contractions are 1 minute in duration
  occurring every minute.

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Baby should exit head first, if not this is
considered a breech birth. 1 out of 25
deliveries is breech. Breech babies may be
manually turned, delivered breech (extremely
risky!) or delivered via Cesarian section.
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• Episiotomies (surgical cut repair by
  stitches after delivery) may be necessary to
  prevent tearing of the vaginal walls during
  delivery.

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Stage two-continued

• The umbilical cord will stop functioning after
  delivery.
• Doctor or Dad
• will cut the
• umbilical cord.

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• Delivery Aids and Tools may be necessary.
  Forceps and vacuum extractors help pull the baby
  out.

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• The hormones Oxytocin and Pitocin are used to
  start and speed up contractions.

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Stage Three

• Expulsion of the afterbirth
• The afterbirth (placenta, cord and other
  membranes) must be checked to
• make sure all was
• Expelled. Cord
• blood may be
• obtained and
• saved for future
• use.

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Vernix Caseosa

• The baby is wiped clean after delivery. The
  vernix is a natural protective skin grease
  similar to a wetsuit! It protects from heat loss
  before and during birth and too much water
  absorption during pregnancy.

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Bonding

• Bonding between parents and child begins to
  occur right after birth. Mom and Dad fall in
  love with the infant and infant begins to
  identify Mom and Dad.

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Bonding!!
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For Baby bonding results in

• increased chances of survival for the infant
• improvements in weight gain
• less crying
• increased language and mental development.

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For parents, bonding results in

• less child abuse
• faster recovery time for Mom
• more self-confidence
• less post-partum depression

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Birth Plans

• Birth Plans should be made before delivery by the
  parents and doctor.
• Birth Plans include
• 1. Where the birth will occur? Choices are at
  home with a certified nurse midwife or at the
  hospital with a doctor. In the hospital it can
  be in the delivery room or in a birthing room.

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Birthing room
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• Birthing rooms are a good compromise between a
  technological, depersonalized hospital birth
  (which cannot offer the emotional experience of a
  home birth) and a birth at home (which cannot
  offer the medical backup of a hospital).

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Delivery room
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2 Who will be there?

• Doctors, delivery nurses, doulas, parents,
  partners, siblings, family in-laws, aunts/uncles
  or your acupuncturist?

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• Side note a Doula is a trained person that
  assists with physical, emotional and educational
  support. She is also there to help calm the
  laboring Mom. She is part of the birthing team
  She is similar to a midwife but does not
  participate in the delivery (down there!)

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3 Labor Style

• Natural childbirth
• Developed by Dr. Rick Read in 1930s
• Delivery without drugs
• Based on educating the Mom so she knows what to
  expect, therefore reducing her fear factor and so
  pain is manageable.
• Mom is trained on how to breathe and relax during
  delivery

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3 Labor Style

• Lamaze-developed by Dr. Fernand Lamaze
• Women have been conditioned to fear childbirth.
  So Lamaze method educates to reduce fear.
• Mom is taught to focus on one other thing in the
  room and to breath in patterns so as to keep her
  mind off the pain
• The Dad attends the Lamaze lessons with Mom and
  is the Coach
• The Mom receives medication when necessary

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3 Labor Style

• Leboyer Method-Shhhhhh!!!!!
• Developed by Dr. Fredrick Leboyer
• The focus is on the comfort of the baby and the
  safety of the mom and baby
• This method believes delivery is painful for the
  baby as well.
• Low lights are used in the delivery room
• The room is quiet, soft voices, soothing music
• The cord is cut only after it stops functioning
• Baby is given a warm water bath after he has had
  time to bond, cuddle and suckle at Moms breast

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3 Labor Style

• Water Birth
• Uses a large bathtub for mom to sit in. It is
  filled with warm water and soft lighting.

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4 Pain Management

• Analgesia to reduce anxiety and pain (Demerol)
• Local anesthetic a shot to numb the vaginal area
• Regional block epidural, pain medication
  inserted into spine, mom maintains sensations but
  has no pain
• General Mom is put out like a light!

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5 Induction or Not?

• Will Induction be used if necessary?
• Hormones can be used to start and speed up labor.
  
• The manual breaking the amniotic sack or water
  will also start the onset of labor.

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6 Equipment

• What equipment will be used?
• Can parents provide and use special music?
• Will a vaginal mirror be used so mom can watch
  the birth process?
• Use of a video camera?
• Use of delivery tools can be discussed before
  birth too.

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7 Tear or Cut

• Episiotomy vs. natural tearing?
• 8 Who will cut the umbilical cord?
• Will it be saved?
• Will cord blood only be saved?

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9 Length of Stay

• Mom often stays less than 24 hours in the
  hospital after delivery.
• Health insurance and postpartum condition of mom
  will determine the length of stay.

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Cesarian Section Delivery

• If a C-Section is planned will Mom be awake or
  totally knocked-out?
• Who else will be present?
• Will a mirror be used for Moms viewing pleasure?
• Downsides higher infection rate, longer recovery
  time, greater stress b/c it is surgery.