Chapter 3: Birth and Newborn Infant

Birth

  • Newborns = Neonates

Labor

  • 1st stage
      * Longest stage
      * Contractions every 8-10 minutes for about 30 sec and increase in intensity
      * Mothers cervix fully opens
      * Stage can last for 16-24 hrs
  • 2nd Stage
      * last about 90 minutes
      * Babies emerges more and increases vaginal opening
      * The baby’s head moves through the birth canal
      * Stage ends when the baby is born
  • Epistolary________: An incision sometime made to increase the size of the opening of the vagina to allow the baby to pass
  • 3rd Stage
      * Only last a few minutes
      * The child’s umbilical cord and placenta are expelled
  • Labor and interpretations of it’s pain do vary based on cultures

Birth

  • Babies cries to clear their lungs
  • APGAR Scale - a standard measurement system that looks for a variety of indications of good health
  • Each quality is scored 0 to 2, producing an overall scale score that ranges from 0 to 10.
      * Most babies score around 7
      * Scores under 4 need immediate life-saving intervention.

APGAR Scale

  • (A)ppearance
  • (P)ulse
  • (G)rimace (reflexes and movement)
  • (A)ctivity
  • (R)espiration
      * Low Scores means Fetal Problems or Birth Defects
      * Issues during birth
      * Temporary deprivation of oxygen (anoxia)

Introducing the Neonate

  • Physical Appearance:
      * Vernix -

    a thick, greasy substance that smoothes the
    passage through the birth canal, often coats new babies.
  * Lanugo __-__A fine, dark fuzz

Initial Encounter

  • Bonding - the close psychical and emotional contact between parent and child during the period immediately following birth and argued by some to affect later parent-child relationship strength

Approach to Childbirth

  • Lamaze Birthing Techniques
      * Goal is to learn how to deal positively with pain and to relax at the onset of a contraction
  • Bradley Method
      * Principle: childbirth should be as natural as possible
  • Hypno-birthing
      * To produce a state of focused concentration in which a mother relaxes her body wile focusing inward

Child Birth Attendants

  • Child birthing center

  • Midwife - A nurse specializing in childbirth

  • Obstetrician - a physician who specializes in childbirth

  • Doula - An individual who provides emotional, psychological, and educational support

Use of Pain-Reducing Drugs

  • Epidural Anesthesia -Uses smaller needles and a system for administering continuous doses to

  reduce the pain of childbirth.

Post Delivery Hospital Stay

  • Average hospital stay in the 1970 was 3.9 days and 2 days in the 1990’s

Problems during Labor

  • Preterm Infants - Born prior to 38 weeks after conception
      * High risk for illness and heath
  • Low Birth rate - 5 pounds
  • Very Low Birth Rate - less than 2 1/4 pounds

Causes of Preterm and Low-Birth Deliveries-

  • Multiple Births
  • young mothers
  • Too closely spaced births
  • General health and nutrition of mother
  • African- American mother have double the number of low-birth weight babies

Post-mature Infants

  • Infants still not born 2 weeks after the mother’s due date
      * Blood supply deceases and cause brain damage
      * Labor and delivery become more difficult

Cesarean Delivery

  • Cesarean Delivery - Baby is surgically removed from the uterus
  • Breech Position - Baby is positioned feet first in the birth canal

Mortality and Stillbirth

  • Infant Mortality - Dead within the first year of life
  • Stillbirth - When the mother gives birth to a already dead infant

Postpartum Depression

  • A period of deep depression following the birth of a child
  • Affect about 10% of moms
      * Enduring Sleep
      * Deep feeling of sadness and unhappiness
      * Can last from a few months to years

Reflexes

  • Reflex - Unlearned, organized, and involuntary responses that occur automatically in the presence of certain stimuli
      * Meconium - a greenish-black material that is a remnant of the neonate’s day as a fetus
      * Neonatal Jaundice - a yellowish tint to their bodies and eyes. that appears when the liver isn’t working efficiently

Sensory Capabilities: Experiencing the World

  • Infants’ visual and auditory systems are not yet 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.

State of Arousal

  • State of Arousal: different degrees of sleep and wakefulness ranging from deep sleep to great agitation.