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Chapter 6: The Baby’s Arrival. Section 1: The Birth Process. Objectives. Recognize the ways in which labor may begin Outline the 3 stages of labor Describe a newborn’s physical changes and appearance at birth. The Beginning of Labor. Many changes within the last days

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chapter 6 the baby s arrival

Chapter 6:The Baby’s Arrival

Section 1: The Birth Process

objectives
Objectives
  • Recognize the ways in which labor may begin
  • Outline the 3 stages of labor
  • Describe a newborn’s physical changes and appearance at birth
the beginning of labor
The Beginning of Labor
  • Many changes within the last days
  • Different for each woman
  • One of the first signs is lightening
    • the baby “dropping”
definite signs
Definite Signs
  • Show, bloody show– “losing the mucus plug”
    • Cervix: lower part of uterus
      • Sealed with mucus throughout pregnancy
      • Prevents bacteria & infection
      • Before labor, mucus starts to liquefy
      • Woman may notice a few drops of blood
definite signs1
Definite Signs
  • Water breaking
    • Range from trickle to gush
    • The membrane holding the amniotic fluid has broken
    • For many: doesn’t happen until she is at the hospital
    • When it breaks woman should note details and tell doctor
contractions
Contractions
  • Only clear sign that labor is underway
  • Tightening and releasing of the uterine muscle
  • Follow a characteristic pattern
    • Over time they get longer, stronger, and closer together
fetal monitoring device
Fetal Monitoring Device
  • Used during labor to record infant’s heart rate & contractions
  • Medical staff determines the degree of stress on the fetus
stages of labor
Stages of Labor
  • Progresses through 3 stages:
    • Contractions open the cervix
    • Baby is born
    • Placenta is expelled
first stage
First Stage
  • During each contraction, the muscles shorten and thicken
    • Pulling open the cervix
    • Slowly thinning and opening until it is wide enough for the baby
  • Cervix dilates (widens)
    • 4 in or 10 cm
  • Cervix becomes thinner
    • ¾ in  sheet of paper
    • “Effacement”
first stage contractions
First Stage: Contractions
  • Longer= 60 seconds
  • Stronger
  • Closer together 5-6 min
  • Needs increasing support from partner
  • Should be at the hospital by this time
positioning
Positioning
  • Baby should be head down
    • If not= breech positioning
    • Doctor evaluates to determine vaginal delivery or cesarean birth
1 st stage the mother
1st stage: The Mother
  • Needs to stay relaxed
  • Fear & tension cause muscles to tighten
    • Can slow down labor
    • Make it more uncomfortable
  • Childbirth classes can help with breathing & relaxation techniques
  • Find a comfortable position
end of 1 st stage
End of 1st Stage
  • Contractions are 90 seconds and 2-3 minute apart
  • Fully dilated
  • This time is called “Transition”
  • Most difficult part of labor to cope with
health tip
Health Tip
  • If the mother finds the 1st stage difficult and very long
    • May choose to use medication
    • Dull pain or completely numb an area
  • Benefits & risks are involved
  • Possible side effects
2 nd stage
2nd Stage
  • Cervix is completely dilated
  • Baby’s head has entered the vagina
  • Contractions no longer stretch cervix they push the baby down
  • May only last several minutes and up to several hours
the pelvis
The Pelvis
  • How does a baby fit through a small opening?
  • The bones of pelvis are connected by ligaments which stretch
  • Pregnancy hormones help to stretch
2 nd stage the baby
2nd Stage: The Baby
  • Body is specially adapted for birth
  • Skull is soft and flexible
    • Becomes longer and narrower than normal
    • 5 Bones of skull can overlap to fit through the pelvis and vagina
    • If baby is not fitting properly, several procedures may occur
2 nd stage possible procedures
2nd Stage: Possible Procedures
  • Episiotomy: widening the vaginal opening with a surgical incision
  • Many doctors and midwives try to avoid this if possible
  • Women need to be able to relax all muscles to allow for stretching
  • Doctors may need to use forceps
    • Specialized tongs that are molded to fit the shape of the baby’s head
end of the 2 nd stage
End of the 2nd Stage
  • Women can give birth in a variety of positions
    • Most common: semisitting position with legs apart and knees bent
    • Usually a special delivery bed is used
  • As the baby moves down the birth canal, the head appears first, then one shoulder, and then the other, then:
    • The baby is born!
3 rd stage of labor
3rd Stage of Labor
  • Uterus gives birth to the placenta
  • May be as brief as 2 minutes or may last up to half an hour
  • After a period of rest, mother may feel more contractions
    • Help the placenta separate from wall of uterus
  • Placenta is soft and comes away easily
  • Once placenta is delivered, the process is complete!
cesarean birth
Cesarean Birth
  • Not all births progress through the 3 stages
  • Cesarean birth: delivery of a baby through a surgical incision in the mother’s abdomen
  • Mother may remain awake, father may be present
  • If known beforehand, special childbirth class may be recommended
  • After surgery, mother and baby usually stay for 4 days
cultural exchange
Cultural Exchange
  • Julius Caesar’s doctor realized Julius’ mother was dying during childbirth
    • Performed a radical surgery
      • Now called Caesarean Section!
past vs present
Past Vs. Present
  • Past: if a woman had a C-section generally would always have C-sections
    • Due to scar
      • Concern would rupture the uterine wall
  • Present: improvement in surgery increases safety
    • Incision is made very low
    • Receives little stress during contractions
    • Physicians will encourage vaginal births for the 2nd child unless medical reasons prohibit
newborn at birth
Newborn at Birth
  • First several hours, the baby goes through amazing changes
  • Throughout pregnancy the baby’s lungs are filled with fluid
    • Oxygen through blood in umbilical cord
  • Pressure through birth canal expels the fluid
    • When baby is delivered the lungs expand and the baby takes first breath
breathing at birth
Breathing at Birth
  • Breathing reflex continues on own
    • May need help from doctor or nurse
      • Suctioned out
      • Rub baby’s back
  • Baby takes in oxygen from air & circulatory system changes
    • A valve in the heart closes and becomes permanently sealed
    • Blood now circulates to and from the lungs, rather than bypassing the lungs
umbilical cord
Umbilical Cord
  • No longer needed
  • Within a few minutes, the cord stops pulsing and begins to shrink
  • The cord is clamped, tied, and cut off
how does the newborn look
How Does the Newborn Look?
  • Head: wobbly & large
    • Accounts for ¼ of the body length
    • May be lopsided or pointed
      • Temporary
    • 2 fontanels: open spaces where the bones of baby’s skull have not permanently joined
fontanels
Fontanels
  • “Soft spots”
  • Largest is just above the baby’s forehead
  • Second is toward the back
  • Spaces allow for the bones to move together
  • 6-18 months the bone covers the spaces completely
other features
Other Features
  • Fat cheeks
  • Short, flat nose
  • Receding chin
  • These features make the baby’s face well adapted for sucking
    • Nose & chin are out of the way
  • Eyes are near adult sized
    • Dark graying-blue
    • Permanent eye color within several months
skin coloring
Skin coloring
  • At time of birth
    • Dusky color
    • After breathing skin color improves
    • Circulatory system takes time to adjust
      • Fingers and toes may remain bluish, cooler
  • Baby needs to stay warm
    • Wrapping in blanket
    • Cap on head
hair skin
Hair & skin
  • Soft, fine hair may cover babies skin
  • Baby is covered in vernix
    • Rich, creamy substance
    • Protects skin from amniotic fluid
    • At birth, some may be left in the skin folds
  • Tiny white bumps
    • “Milia” plugged oil ducts
    • Disappears after week or two
kangaroo care
Kangaroo Care
  • Research into immediate skin-to-skin contact
    • Mother & baby
  • Debate between benefits & risks
  • Kangaroo Care