Chapter 9 RP

1
Chapter 9 RP

• Childbirth

2
Objectives

• Identify the signs of labor
• Explain common hospital procedures before,
  during, and after birth
• What medications are available during childbirth
• Key events at each stage of labor
• Compare different methods of childbirth
• Summarize the importance of bonding
• Routine neonatal care
• Reasons newborns may need emergency care
• Ways parents can adjust to postpartum period

3
Signs of Labor

• Lightening- babys head descends to pelvis
• Show- Passing of blood-tinged mucus
• Labor usually begins within 24 hrs
• Contractions- uterine muscles tense and cause
  pain
• Braxton hicks- if they begin a month before labor
• Pre-labor- infrequent and stop on position change
• water breaks- amnio-chorionic membrane ruptures

4
Going to the Hospital

• Gather belongings
• Take a shower
• Eat something
• Rest
• Call medical professional
• Go to the hospital if the amnio-chorionic fluid
  is leaking from the vagina or if contractions are
  5-10 minutes apart.

5
Hospital procedures

• Fill out necessary forms weeks in advance
• Taken to the appropriate room
• Woman dresses in hospital gown
• Doctor checks mother and baby, babys heart rate

6
Childbirth Medications

• Decide about medications in advance
• Medications must be safe for mother and baby
• General anesthesia
• Puts the person to sleep for a short time, cannot
  push
• Regional anesthesia (Epidural)
• Takes away feeling in one area of the body,
  difficult to determine when to push
• Local anesthesia
• Relieves the pain in the vaginal area
• Analgesics
• Dull pain but do not take it away

7
Three Stages of Labor

• Series of changes in the mothers body that allow
  the baby to be born
• Deliver requires strength, stamina, and muscle
  control
• Each stage of labor takes longer for the mothers
  first baby than other children

8
Dilation

• Stretch and expand the cervix
• Normally the cervix is less than a centimeter
  wide, the cervix will dilate to 10 centimeters
  during labor
• The longest stage of labor
• Begins with the first contraction and ends when
  the cervix is fully dilated
• Transition is the most painful part, when the
  cervix stretches from 7-8 cm to the final few
  just before delivery

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Expulsion

• Begins when the cervix is fully dilated and ends
  when the baby is born
• Lasts from half and hour to 2 hours
• Crowning
• Episiotomy
• Amniotic fluid is suctioned from babys nose and
  mouth
• Umbilical cord is cut

10
Afterbirth

• 10-20 minutes when the afterbirth is expelled
• Afterbirth is the name for the placenta and other
  tissues inside the mothers body during pregnancy
• Doctor examines the placenta
• Uterus is massaged to help it begin to shrink

11
Methods of Childbirth

• Susceptible to change at any time based on the
  mother and babys health
• Generally the couple can choose what they prefer,
  sometimes the doctor or midwife wants to delivery
  their way

12
Traditional

• Attention is focused on the health of mother and
  baby
• Woman is given anesthetics as needed
• Family members wait in the waiting room
• Usually a woman is moved to a recovery room to
  rest

13
Family-centered

• Father is encouraged to participate
• Delivery takes place in a birthing room
• Anyone who will be present at birth must attend
  childbirth classes
• After birth the family can spend as much time
  together as they wish
• Rooming in

14
Lamaze

• Prepared childbirth method
• Attend weekly classes two months before delivery
• Learn what to expect
• Learn breathing and muscle control techniques
• Medication is viewed as a tool to help the mother
  relax

15
Leboyer

• Focuses on the babys birth experience
• Make it less shocking and more comfy
• Medical staff provides quiet, cozy environment,
  dim lights, play soft music
• Immediately after birth the baby is placed on the
  mothers abdomen and then in warm water

16
Breech delivery

• A babys head should be first to come down the
  birth canal
• When the babys rear end of feet are first it is
  breech
• Risky for babys to be delivered this way
• Sometimes change positions themselves
• Sometimes the doctor can help move the baby
• Cesarean

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Cesarean delivery

• 21 of US births
• Long or difficult labor
• Babys health is in danger
• Mothers health is in danger
• Breech
• Problems with the umbilical cord or placenta
• Pelvis is too small
• Mother has an STD

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Neonatal Care

• The doctor or midwife cuts the umbilical cord
• Fluid is suctioned from the babys nose and mouth
• Washed, weighed, measured
• vernix
• Bands placed on babys wrists and ankles to
  identify baby

19
Emergency Care

• Prematurely
• Need respiratory assistance until lungs fully
  develop
• Low birth weight
• Less than 5 ½ lbs
• Born addicted to drugs
• Low Apgar test score
• Low Heart rate, breathing, reflexes
• Other serious health care

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Circumcision

• Surgical removal of a males foreskin
• Circumcision Makes the genital area easier to
  clean
• Smegma- substance that can collect under the
  foreskin and cause irritation, infection and
  cancer

21
Bonding

• Forming close ties
• Mother and baby need to be together as soon as
  possible after birth
• Father should be present too
• Room filled with relief, happiness, awe

22
Postpartum Period

• Birth six weeks
• Woman recovers
• Rests and regains strength

23
The mothers hospital stay

• Condition monitored during first hour
• Nurses continue to massage uterus
• May be encouraged to get up and walk
• Cesarean deliveries may cause woman to be in bed
  for at least first couple of days
• Get as much rest as possible
• Learn to breast feed or given hormones to dry up
  milk

24
Going home from the hospital

• Cesarean delivers keep mothers several days
  longer
• Usually stay in hospital a day or two
• At home parents face new challenges and new roles
• Mother should continue to rest

25
Adapt to physical changes

• Uterus continues to shrink
• Breastfeeding will speed this process up
• Her breasts will change
• Her abdomen returns to normal
• She will lose 10 lbs. at delivery
• Lose 5 lbs more the first month
• Should return to normal weight within 6-12 months

26
Handling emotional changes

• Postpartum depression
• Mothers feelings shortly after birth
• Hormonal changes
• Feels loss when baby leaves her body
• No longer feels fetus moving inside her
• Tired
• Letdown after excitement of delivery

27
Getting enough rest

• Avoid lifting anything but the baby
• Newborns require parents full attention
• Take advantage of time to sleep when the baby
  sleeps

28
Starting to exercise again

• Helps a woman regain weight and shape
• Walking
• Slowly build up to aerobics, swimming, bicycling,
  or jogging
• Do strength toning exercises
• Release tension, build self-confidence

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Postpartum checkup

• Usually scheduled 6 weeks after delivery
• Check blood pressure and weight
• Physical examination
• Make sure uterus is returning to shape
• Ask questions