Chapter 3_ Birth and the Newborn Infant

Chapter 3: Birth and the Newborn Infant

Overview

  • Focus on the stages of labor, newborn testing, and early infant development.

The Three Stages of Labor

Stage 1: Early Labor

  • Uterine contractions initially every 8 to 10 minutes, lasting about 30 seconds.

  • As labor progresses, contractions occur every 2 minutes and last up to 2 minutes.

  • Cervix must widen, ultimately allowing the baby to pass through.

Stage 2: Delivery

  • Baby's head moves through the cervix and birth canal, lasting around 90 minutes.

  • Episiotomy may be performed to enlarge vaginal opening for the baby.

Stage 3: Post-Delivery

  • Umbilical cord and placenta expelled from mother, marking the completion of delivery.

  • This stage is the quickest, usually taking just a few minutes.

Baby’s First Test: APGAR

APGAR Score Components

  1. Appearance (Skin Color)

    • 0: Blue-gray, pale all over.

    • 1: Normal except for extremities.

    • 2: Normal over entire body.

  2. Pulse

    • 0: Absent.

    • 1: Below 100 bpm.

    • 2: Above 100 bpm.

  3. Grimace (Reflex Irritability)

    • 0: No response.

    • 1: Grimace.

    • 2: Sneezes, coughs, pulls away.

Newborn Medical Screening

  • Screen for 29 disorders (e.g., hearing difficulties, sickle cell disease).

  • Benefits and potential challenges involved in screening.

Birth Plan Considerations

Key Elements

  • Birth Plan: Location, personnel, treatment options (e.g., Lamaze, hypnobirthing, water birthing).

  • Considerations regarding pain management and length of hospitalization.

Preterm Infants

Statistics and Definitions

  • Preterm Infants: Born before 38 weeks.

  • Low Birth-weight Infants: Weigh around 5 ½ pounds.

  • Small-for-Gestational-Age Infants: Weigh 90% (or less) of average weight for age.

  • Responsive and organized care leads to positive outcomes; however, many face developmental challenges.

Survival Rates and Care

  • Age of viability at 22 weeks.

  • Babies born before 25 weeks have a 50-50 chance of survival.

  • Significant expenses for medical care of very-low-birthweight infants.

Postmature Babies

  • Postmature Infants: Born 2 weeks or more overdue.

  • Risks: Insufficient blood supply from placenta, potential brain damage.

Cesarean Delivery

Overview

  • Baby surgically removed via C-section.

  • Common indications: fetal stress, breech position.

  • Use of fetal monitors significantly increased C-section rates since the 1970s.

Criticisms

  • Major surgery with extended recovery for mothers.

  • Potential risks include infection and lack of emotional satisfaction.

  • An increase in breathing problems for C-section babies.

Stillbirth and Infant Mortality

  • Stillbirth: Delivery of a child who did not survive gestation; < 1 in 100 occurrences in U.S.

  • Infant Mortality: Death within the first year; current rate = 6.17 per 1,000 births.

  • Grieving process similar to that of losing an older loved one; potential for depression and PTSD.

Postpartum Depression

  • Affects about 10% of new mothers.

  • Symptoms include prolonged sadness and emotional turmoil.

  • Triggered by hormonal changes post-birth.

The Competent Newborn

Physical Competence

  • Reflexes: Unlearned and involuntary responses (e.g., sucking, rooting).

  • Digestive system adaptations to consume milk; neonatal jaundice common in newborns.

Sensory Capabilities

  • Visual and auditory acuity developing; preferences for colors and familiar sounds.

  • Other senses (touch, smell, taste) are present and sophisticated at birth.

Early Learning

Conditioning Techniques

  • Classical Conditioning: Learning through association (like Pavlov's Dogs).

  • Operant Conditioning: Responses altered based on consequences.

  • Habituation observed as decreased response to repeated stimuli.

Social Competence

  • Infants imitate and respond to facial expressions.

  • Interaction capabilities lay groundwork for future social relationships.