© Goodheart-Willcox Co., Inc.

6 Childbirth

© Goodheart-Willcox Co., Inc. Key Terms labor certified nurse- midwives (CNMs) natural childbirth Lamaze method lightening breech birth position dilation episiotomy forceps vacuum extraction cesarean section bonding postpartum care baby blues postpartum depression (PPD) postpartum psychosis (PPP)

© Goodheart-Willcox Co., Inc. Objective List ways family members can be involved during pregnancy.

© Goodheart-Willcox Co., Inc. The Role of the Family Father-to-be – tend to take an active role during pregnancy education about pregnancy and childrearing prepare for baby – help during laborlabor ease anxiety of mother Children – help with preparation may ease jealousy

© Goodheart-Willcox Co., Inc. Family Decisions Concerning Childbirth Choosing a birth place – hospital most common – birth center certified nurse- midwives (CNMs) certified nurse- midwives (CNMs) – home birth higher infant death rate continued

© Goodheart-Willcox Co., Inc. Family Decisions Concerning Childbirth Using drugs for labor and delivery – sedatives reduce anxiety, used in early stages of labor – analgesics reduce pain, not take it away – anesthetics block pain general anesthesia has the most side effects continued

© Goodheart-Willcox Co., Inc. Family Decisions Concerning Childbirth Choosing a method of delivery – natural childbirth uses breathing and relaxation techniques instead of drugs natural childbirth – Lamaze method uses breathing patterns to help mother-to-be keep her mind off pain, medication is used when necessary Lamaze method

© Goodheart-Willcox Co., Inc. Objective Describe the birth process and some of the possible complications of delivery.

© Goodheart-Willcox Co., Inc. Time to Be Born Muscle contractions at regular intervals push baby out of mother’s body Lightening is a change in the baby’s position Lightening – settles downward – body rotates into position breech birth position Irregular contractions, or false labor

© Goodheart-Willcox Co., Inc. Other Signs of Labor Contractions at regular intervals Burst of energy, increased adrenaline Loss of cervical mucus plug Breaking of amniotic sac, leaking fluid

© Goodheart-Willcox Co., Inc. Stages of Labor

© Goodheart-Willcox Co., Inc. Stage One—Dilation of Cervix Contractions are regular – early labor, every 15–20 minutes, last about 30 seconds – late labor, very close together, last about 90 seconds called the transition Cervix flattens and opens (dilation)dilation – 4 inches (10 centimeters) Averages eight hours for first baby

© Goodheart-Willcox Co., Inc. Stage Two—Delivery of Baby Baby’s head enters birth canal Episiotomy is an incision to widen birth canal and prevent tearing Episiotomy – often performed Baby changes position – faces downward as head emerges – rotates as shoulders and body emerge Averages 30–90 minutes

© Goodheart-Willcox Co., Inc. Stage Three—Delivery of Placenta Averages 5–30 minutes Irregular contractions Placenta detaches from uterus and is delivered – afterbirth

© Goodheart-Willcox Co., Inc. Complications of Delivery Premature delivery Premature rupture of membranes (PROM) Prolonged delivery Abnormal position for delivery Cephalopelvic disproportion Umbilical cord compression or prolapse Asphyxia Meconium aspiration Postpartum bleeding continued

© Goodheart-Willcox Co., Inc. Complications of Delivery Delivery-aid techniques – version, manually rotating the unborn baby into correct position – picotin, a drug, can speed up labor by causing contractions – forceps, curved instrument that fits around the baby’s head to help ease down the birth canal during contraction forceps – vacuum extraction, suction instrument vacuum extraction

© Goodheart-Willcox Co., Inc. Cesarean Births In the cesarean section, the mother’s abdomen and uterus are surgically opened to remove babycesarean section – mother’s pelvis is small or misshapen – baby or mother is at medical risk – baby’s head is large – contractions are weak or absent – baby in incorrect position for birth continued

© Goodheart-Willcox Co., Inc. Cesarean Births – multiple birth – previous uterine scar(s) could rupture Risks for mother and baby – procedure is major surgery – increasing need for hysterectomy – low, but increased risk of stillbirth next pregnancy – increased risk in vaginal birth after cesarean

© Goodheart-Willcox Co., Inc. Objective Describe physical and emotional changes in the mother during the postpartum period.

© Goodheart-Willcox Co., Inc. Hospital Care Mother and baby generally remain in hospital for 24–60 hours – longer for C-section Nurseries care for babies – may room-in with mother Nurses available to help mothers Visitors limited – siblings can sometimes visit

© Goodheart-Willcox Co., Inc. Bonding Bonding is important for parents and baby Bonding First hour after birth crucial Especially important for preterm or ill infants

© Goodheart-Willcox Co., Inc. Postpartum Care Postpartum care is the care the mother receives during the six to eight weeks after childbirth Postpartum care First hour critical to restoring body stability – pulse, respiration, other body functions Nursing mothers should not diet continued

© Goodheart-Willcox Co., Inc. Postpartum Care Rest is crucial Return to employment only under doctor’s care

© Goodheart-Willcox Co., Inc. Postpartum Mood Disorders Possible causes – inherited tendency for mood disorders – dramatic changes in body chemistry after giving birth that affects the brain – stress of caring for a new baby while recovering from pregnancy and delivery continued

© Goodheart-Willcox Co., Inc. Postpartum Mood Disorders Some women are at an increased risk – over 40 years of age – family history of mood disorders and thyroid problems – mood swings during menstrual cycle – migraines when taking hormones – fertility problems – family stress and lack of support – previous mood disorders continued

© Goodheart-Willcox Co., Inc. Postpartum Mood Disorders Baby blues is a mild disorder that goes away on its own Baby blues Postpartum depression (PPT) is a serious form of depression Postpartum depression (PPT) Postpartum psychosis (PPP) is a severe mental illness Postpartum psychosis (PPP)

© Goodheart-Willcox Co., Inc. What Do You Think? Do you believe that postpartum mood disorders receive enough attention? How could the media highlight postpartum mood disorders in order to bring attention to those that suffer?

© Goodheart-Willcox Co., Inc. baby blues. Mild postpartum mood disorder that goes away on its own. bonding. Developing a feeling of affection. breech birth position. Buttocks-first position in which some babies enter the birth canal. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. certified nurse-midwives (CNMs). Nurses who have special training in delivering babies during normal pregnancies. cesarean section. Delivery method in which the mother’s abdomen and uterus are surgically opened and the baby is removed. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. dilation. First stage of labor during which the cervix opens. episiotomy. Incision made to widen the birth canal and prevent tearing. forceps. Curved instrument that fits around the sides of a baby’s head and is used to help the doctor ease the baby down the birth canal during a contraction. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. labor. Process that moves the baby out of the mother’s body. Lamaze method. Delivery method in which the pregnant woman is trained to use breathing patterns to keep her mind off pain. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. lightening. Change in the baby’s position in which the uterus settles downward and forward, and the baby descends lower into the pelvis. natural childbirth. Delivery method in which the pregnant woman learns about the birth process and uses breathing and relaxation techniques to reduce fear and pain. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. postpartum care. Care the mother receives during the six to eight weeks following the birth of her baby. postpartum depression (PPD). Less frequent, but serious form of depression that may occur after giving birth. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. postpartum psychosis (PPP). Rare and extremely severe mental illness that may result after giving birth. vacuum extraction. Technique that uses suction to help the doctor move the baby down the birth canal as the mother pushes. Glossary of Key Terms