1. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Birth and the Newborn Chapter 4

2. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. What’s to Come? How Childbirth Has Changed The Birth Process The Newborn Baby Birth Complications and Their Aftermath Newborns and Parents

3. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. How Childbirth Has Changed Traditional and Modern Childbirth

4. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Childbirth was “a struggle with death” 20 th century Childbirth began to be professionalized Growing use of maternity hospitals Medicalization of childbirth has social and emotional costs How Childbirth Has Changed

5. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. The Birth Process Stages of Childbirth Labor and Delivery Options

6. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Labor is brought on by: Series of uterine, cervical, and other changes that begin about 2 weeks before delivery Definitive trigger for the advent of labor is unclear Likely due in part to hormones released by the placenta and fetus The Birth Process

7. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Stages in Childbirth First stage - Dilation of the cervix Longest stage Lasts 12 to 14 hours for a woman having her first child Second stage - Descent and emergence of the baby Lasts up to an hour or two Begins when the baby’s head begins to move through the cervix into the vaginal canal Ends when the baby emerges completely from the mother’s body

8. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Stages in Childbirth Third stage - Expulsion of the placenta Lasts between 10 minutes and 1 hour

9. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Surgical cut between the vagina and anus Was a standard practice Intended to: Enlarge the vaginal opening Speed up the delivery Prevent the vagina from tearing Does more harm than good Not done routinely anymore Episiotomy

10. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

11. Electronic fetal monitoring Tracks fetus’s heartbeat during labor Can help detect any serious problems Cesarean delivery Surgical removal of baby from the uterus through an incision in the mother’s abdomen Labor and Delivery Options

12. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Medicated versus nonmedicated delivery Natural or prepared childbirth Lamaze method Epidural block Being attended over by a doula Labor and Delivery Options

13. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. The Newborn Baby Size and Appearance Reflexes Body Systems Medical and Behavioral Assessment States of Arousal and Activity Levels

14. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Neonatal period First 4 weeks of life A time of transition from the uterus Fetus supported entirely by the mother to an independent existence Neonate An average newborn About 20 inches long and about 7 ½ pounds in weight in the United States Size and Appearance

15. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Special high-protein type of milk produced by mother Provides babies with important immunological substances Has laxative effects that help babies begin to eliminate toxins Contains less fat and calories than breast milk Neonates lose as much as 10 percent of their body weight in their first few days Colostrum

16. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Large head Red skin Temporary skin conditions or blotches Permanent birthmarks A receding chin Fontanels Lanugo Vernix caseosa Distinctive Features of New Babies

17. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Infants are born with the following set of newborn reflexes Rooting Sucking Moro Proper appearance and disappearance of reflexes related to neurological organization A marker of good health Reflexes

18. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Before birth Bodily functions accomplished through mother’s body After birth All systems and functions must operate on their own Neonatal jaundice Develops 3 or 4 days after birth Caused by immaturity of liver and failure to filter out bilirubin Byproduct resulting from the breakdown of red blood cells Not serious unless severe Body Systems

19. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

20. The Apgar scale Five subtests Appearance Pulse Grimace Activity Respiration Medical and Behavioral Assessment

21. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

22. The Brazelton Neonatal Behavioral Assessment Scale Assesses neonates’ responsiveness to their environment Identifies strengths and vulnerabilities in neurological functioning Predicts future development Neonatal screening for medical conditions Medical and Behavioral Assessment

23. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Infant’s state of arousal Governed by periodic cycles of wakefulness, sleep, and activity Inborn and highly individual States of Arousal and Activity Levels

24. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

25. Birth Complications and Their Aftermath Low Birth Weight Postmaturity Stillbirth

26. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. When babies weigh less than 5 ½ pounds at birth, they may be: Preterm Born before completing the 37th week of pregnancy Small-for-date Born small by comparison to other babies of the same age Both Low Birth Weight

27. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

28. Factors increasing the likelihood of having an underweight baby Demographic and socioeconomic Medical factors predating the pregnancy Prenatal behavioral and environmental factors Medical conditions Predictors of an infant’s survival and health Birth weight and length of gestation Low Birth Weight

29. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Immediate treatment and outcomes Isolette - An antiseptic, temperature-controlled crib Feeding happens through tubes Kangaroo care Method of skin-to-skin contact Seems to reduce stress on the central nervous system Helps with self-regulation of sleep and activity Low Birth Weight

30. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Common in preterm babies who lack adequate amount of surfactant Surfactant - Essential lung-coating substance that keeps air sacs from collapsing Respiratory Distress Syndrome

31. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Preterm and small-for-date infants at increased risk of adult-onset diabetes Small-for-date infants at increased risk of cardiovascular disease Environmental factors can make a difference Long Term Outcomes

32. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. When women have not gone into labor after 42 or more weeks’ gestation: Postmature babies tend to be long and thin as they continue to grow in the womb Placenta becomes less efficient as the pregnancy progresses Results in decreased levels of nutrients and oxygen that are available to the baby Doctors induce labor or perform cesarean deliveries Postmaturity

33. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Fetal death The sudden death of a fetus at or after the 20th week of gestation Sometimes diagnosed prenatally Sometimes discovered during labor or delivery There is no clear cause Stillborn fetuses are small for date Indicating malnourishment in the womb Stillbirth

34. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Newborns and Parents Childbirth and Bonding The Mother-Infant Bond The Father’s Role How Parenthood Affects Marital Satisfaction

35. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Ethological approach Considers behavior in human beings to be biologically influenced Emphasizes critical or sensitive periods for development of certain behavior A neurological basis for parental bonding Fathers, like mothers, form close bonds with their babies Childbirth and Bonding

36. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. More than feeding is involved in the mother- infant bond Mothering includes: The comfort of close bodily contact The satisfaction of an innate need to cling The Mother-Infant Bond

37. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Fathering role has different meanings in different cultures Role may be taken or shared by someone other than the biological father In some societies: Fathers more involved in their young children’s lives May change over historical time periods The Father’s Role

38. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Marital satisfaction declines during the child- raising years Probably due to restriction on mothers’ freedom and the need to adjust to a new role How Parenthood Affects Marital Satisfaction

39. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. New parents likely to experience multiple stressors Affect health and state of mind Feeling of isolation Losing sight of the fact that others parents have similar problems Division of household tasks How Parenthood Affects Marital Satisfaction

40. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Important to remember that birth of a baby is a momentous achievement Marks the start of a challenging but rewarding journey How Parenthood Affects Marital Satisfaction