1. Labor and Childbirth Stages of Labor

2. What happens during labor? Each woman will have a different labor Many parts of labor are the same There are different stages of labor There are different phases in each stage of labor There will be some variation of labor for each woman

3. Labor Rooms

4. Stages

5. First Stage Usually the longest Begin having contractions Cervix is dilating Broken down into 3 phases Early, Active and Transition phase

6. Effacement and Dilation

7. Early/Latent Phase: “Yippy! I’m in labor!” Usually spent wondering whether or not you are really in labor. Contractions are very light and about 20 minutes apart and last 30-45 seconds. They will gradually become closer (possibly 5 min. apart) Key to this phase: go about your normal schedule or if it is the middle of the night, go back to sleep Most woman will be very comfortable during this phase Not in the hospital at this point unless water breaks Can last 8 hours…sometimes more and sometimes less Should not be in a lot of pain 3 centimeters dilated at this point

8. Active Phase “This is hard work!” Cervix will dilate between 4-7 centimeters Contractions will be 2-5 minutes apart and last up to a minute More discomfort and more pain Can last 3-4 hours Most will go to hospital especially for pain medication If water hasn’t broken, it usually will during this phase

9. Epidural The anaesthetic is injected into the epidural space around the membranes surrounding the spinal cord. It results in a loss of sensation and pain in the chest and the lower half of the body. The catheter allows for additional doses of drugs to be given. Epidural anaesthesia is widely used to relieve the pain of childbirth.

10. Transition Phase “OUCH!!!!” Shortest part of labor…but definitely the hardest and most painful Contractions 2-3 minutes apart and last for a minute and a half This phase is pushing baby down further thru the cervix allowing head to enter the vagina Phase can last ten minutes, or an hour or two Partners support is crucial during this phase At end of this phase you will be completely dilated (10 centimeters)

11. Stage 2: “I can push now?” The delivery of the baby Pushing usually feels better for most women Can last minutes or up to 3 hours Length of this stage is usually determined by positioning of mother (upright=faster), positioning and size of the baby and if pain medications were used

12. New born baby

13. Water Births

14. Stage 3: The placenta After your baby is born the placenta will naturally detach from uterine wall and follow the baby through the birth canal Doctor will check placenta to look for tears or problems that can lead to your uterus not contracting properly after birth. Contractions after birth of baby will slow bleeding down and heal the area where the placenta was attached

15. Postpartum After baby is born your body will go through many changes Hormones take time to get back to pre- pregnancy days Ask for help if needed…many woman will feel depressed and helpless

16. Baby Blues The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression. Many new moms experience the baby blues after childbirth. An estimated 10 percent of new moms experience a more severe form of emotional distress known as postpartum depression. Rarely, an extreme form of postpartum depression known as postpartum psychosis develops after childbirth. Postpartum depression isn't a character flaw or a weakness. Sometimes postpartum depression is simply part of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms — and enjoy your baby.

17. Signs and Symptoms Baby blues Signs and symptoms of the baby blues — which last only a few days or weeks — may include: Mood swings Anxiety Sadness Irritability Crying Decreased concentration Trouble sleeping

18. Treatment Baby blues The baby blues usually fade on their own within a few days to weeks. In the meantime, get as much rest as you can. Accept help from family and friends. Connect with other new moms. Avoid alcohol, which can make mood swings worse. If you have an underactive thyroid, your doctor may prescribe thyroid medication.

19. Postpartum Depression Postpartum depression Postpartum depression may appear to be the baby blues at first — but the signs and symptoms are more intense and longer lasting, eventually interfering with your ability to care for your baby and handle other daily tasks. Signs and symptoms of postpartum depression may include: Loss of appetite Insomnia Intense irritability and anger Overwhelming fatigue Loss of interest in sex Lack of joy in life Feelings of shame, guilt or inadequacy Severe mood swings Difficulty bonding with the baby Withdrawal from family and friends Thoughts of harming yourself or the baby

20. Treatment Counseling. It may help to talk through your concerns with a psychiatrist, psychologist or other mental health professional. Through counseling, you can find better ways to cope with your feelings, solve problems and set realistic goals. Sometimes, family or marital therapy also is helpful. Antidepressants. Antidepressants are a proven treatment for postpartum depression. Hormone therapy. Estrogen replacement may help counteract the rapid drop in estrogen that accompanies childbirth, which may ease the signs and symptoms of postpartum depression in some women. Hormone therapy. Estrogen replacement may help counteract the rapid drop in estrogen that accompanies childbirth, which may ease the signs and symptoms of postpartum depression in some women..

21. Postpartum Psychosis With postpartum psychosis — a rare condition that typically develops within the first two weeks after delivery — the signs and symptoms are even more severe. Signs and symptoms of postpartum psychosis may include: Confusion and disorientation Hallucinations and delusions Paranoia Attempts to harm yourself or the baby

22. Treatment Postpartum psychosis requires immediate treatment, often in the hospital. When your safety is assured, a combination of medications — such as antidepressants, antipsychotic medications and mood stabilizers — may be used to control your signs and symptoms. Sometimes electroconvulsive therapy (ECT) is recommended as well. During ECT, a small amount of electrical current is applied to your brain to produce brain waves similar to those that occur during a seizure. The chemical changes triggered by the electrical currents can reduce the symptoms of depression, especially when other treatments have failed or when you need immediate results.

23. ENJOY YOUR LABOR It is the hardest work you will ever do, but it yields the most rewards!

24. Final Tomorrow Open Notebook If you DO NOT have your own handwritten notebook, you will receive a “zero” for a notebook grade 5 XTRA credit points if you have your course grading and procedures and course proficiency sheets. If you do not have them, copy someone's. You must have them both to receive credit 5 XTRA credit points if EVERYONE is present to take the test If you have any missed work or makeup tests, they must be completed by Friday for credit