Chapter 5: Time to be born!

What are the possible signs that labor has begun? Contractions: tightening and releasing of uterine muscles Braxton Hicks: false labor Lightening: baby dropping into the pelvis mother can breath easier leg cramps common urinate more often

Define SHOW Vaginal discharge prior to the beginning of birth Mucus plug is released from the cervix brownish or blood tinged 1 Tbsp. in size Labor will usually begin in 3 days

Mucus Plug

Natural Childbirth a method of delivery that does NOT use drugs developed in the 1930’s by Dr. Richard Read... he thought the pain was due to fear! woman is trained to breathe and relax during childbirth father plays an active role

Birthing Room Used for labor, delivery, and recovery Furnished like a bedroom Now offered by most hospitals

Lamaze Method invented by Dr. Fernand Lamaze mother is taught to focus on something other than the pain she uses breathing patterns to keep her mind off pain father plays the role of coach and goes to classes with her

Epidural drug given through a tiny tube placed in the small of the back mothers feel touch and pressure but not pain considered safe these days Usually in a “drip-like” form so it can be adjusted for pushing

FONTANELS “Soft Spots” Open spaces where the skull has not been joined Allows for skull to be molded during delivery & accommodate growing brain On top and towards the back of the head

1 st Stage of Labor Water breaks could lose 1 quart of amniotic fluid (4 cups) Effacement cervix prepares for delivery (softens and thins) Cervix dilates (opens) 9-10 centimeters ( 3 1/3 to 4 inches) Contractions get longer and stronger and closer together 3-5 minutes long... About 5-10 minutes apart Longest stage Hours or days

Dilation

Stage #1 Diagrams

2 nd Stage of labor Cervix completely dilated Contractions push baby down from the pelvis into the vagina and give birth! Contractions feel like a severe menstrual cramp Mother asked to “bear down” crunch and push Baby is BORN!!! Much shorter stage (30-90 min)

EPISIOTMY Surgical cut to the perineum Local anesthetic (numbing agent) Prevents possible tearing of the tissue Increases the size of the vaginal outlet (more room for baby)

Head has arrived

Forceps Pressure on baby’s head can be relieved Birth not progressing on its own Baby must be in middle or lower part of pelvis Episiotomy is first performed

Forceps being used

Vacuum Extractor Soft silicone cup attached to baby’s head Doctor then guides baby out as mother pushes

Vacuum Suction

Breech Birth Bottom/feet down in uterus May try and change baby’s position Require a c-section delivery

3 rd Stage Baby has already arrived and umbilical cord is already cut Expulsion of the placenta Contractions (less painful) minutes after the birth of baby “Afterbirth”

Caesarean Birth Over 30% of births are Caesarean Delivery of baby through a surgical incision in the abdominal wall Incision is now made horizontally and is approximately 2-3” wide Reasons for C-Section baby too big Baby is breech fetal distress medical illness (mom)

BONDING Developing a feeling of affection Important to both baby and parents What can parents do in the time after birth to help them bond with their babies?

Postpartum Care Care the mother receives during the hours following the birth of her baby. Medical staff will monitor; blood pressure, vital signs, pulse until all body functions have stabilized Being released from the hospital: Mother must be up and moving and all vital signs must be normal Baby must pass all doctor given tests Apgar, Respiratory, feeding properly and all Reflexes Baby will not be released until the mother is ready to leave – Almost always released together

After the Hospital: Mother will need to take it easy and rest as much as possible C-section will require a lot more time to heal and very little activity Mother needs to make an appointment with doctor for a 6-week check up

Mom’s Mental Health 10% of all women experience… Baby Blues - lasts a few days or weeks Postpartum depression – more severe Postpartum psychosis – most severe, not common