1. Labor and Delivery

2. Delivery There are 2 types of delivery Cesarean section (C section)
Vaginal birth

3. Cesarean Section
A surgical procedure to remove the baby from the mother’s uterus through a cut in her abdomen in case of complications prohibiting a vaginal delivery
Pain medication is used during a C section. The mother either has an epidural, where she will remain awake, or anesthesia, where she will be put to sleep, for the delivery
Up to 6 weeks of recovery

4. Reasons for Cesarean delivery
When the labor is not progressing fast enough and a problem develops
Baby in distress or turned in the wrong direction (breech birth)
Multiple births (twins or more)

6. Stages of Labor
There is pre-labor and then 3 stages of labor after that.
Each stage has distinct factors

7. Pre-labor Watch for signs of labor
Lightening when the baby drops lower into the pelvis
During effacement the cervix becomes thinner
The cervix dilates or widens
A pinkish discharge called “show” comes from the vagina
Amniotic sac ruptures
Contractions begin by tightening and relaxing of the uterus muscles

8. First stage of labor Cervix dilates
Contractions with pain come every 15 or 20 minutes
Full dilation will measure 10 centimeters (4 inches) in width

9. Second stage of labor: Crowning
Lasts from 20 minutes to two hours
Typical birth, baby travels down the birth canal head first and facing toward the mother’s back
Doctor may make a surgical cut called an episiotomy to widen the opening
Cuts the umbilical cord when the baby is delivered
Can use forceps to guide baby out if it becomes lodged in birth canal
The baby is born

10. Third stage of labor Placenta is delivered
Mild contractions separate the placenta from the uterine wall and it moves into the vagina
Nurse massages the abdomen of the mother, usually takes 10 to 30 minutes
Mother pushes to expel the placenta

11. Examining the Newborn
Apgar Scale – scale from 0 to 2, checked at one minute, and again at five minutes
Normal total score is 6-10 range. 10 is a perfect score.
Appearance
Pulse
Grimace
(Reflex irritability)
Activity
Respiration

12. Nurse’s check Weight Measurement Dry off
Apply antibacterial drops or ointment
Injection of vitamin K to prevent bleeding disorder

13. Cord blood
The blood left behind in the umbilical cord contains stem cells
The stem cells are capable of producing all types of blood cells and can be used to treat serious blood-related illnesses in the baby or other family members
It will be stored at the hospital or another medical area

14. Advantages and disadvantages of natural childbirth
Less sedation, can run into unexpected complications
The Lamaze method---can control pain, have to take time to go to classes
The Leboyer method---makes the birth less shocking and more comfortable for the baby, fit classes into schedule

15. Controlling Pain
Lamaze- A woman is physically and psychologically prepared through prenatal training in the use of controlled breathing and coached by a partner to facilitate the process of natural childbirth
Leboyer- A method of childbirth where delivery occurs in a quiet, dimly lit room and the infant's head is not pulled, minimizing the trauma for the newborn and allowing for immediate bonding between mother and child

16. Delivery location options
Home delivery---only for uncomplicated births, might run into complications
Birthing room delivery---more home-like atmosphere, have to go home within 24 hours
Standard hospital delivery---insurance companies cover at least 2 days, high cost

17. Advantages and disadvantages of personnel to assist with deliveries
Obstetricians specialize in the care of mothers and babies both before, during and right after birth; expensive
Family doctors provide prenatal care and deliver babies; complications can be above the doctor’s skills
Licensed midwives assist women in childbirth; complications can be above midwife skills

18. History of Delivery

19. Early
1647
Forceps were developed
Many babies died in the early years of their use
Before 19th century was uneventful – delivery and life went on as normal with no pain relief
Mid-19th century
Women feared childbirth - painful or even fatal
Higher social status, less children you had
1800
Chloroform was used to relieve women of any pain
Harmful, even fatal, to mother and baby

20. Mid 1882 1900 First successful Cesarean delivery
Death rate remained high until 20th century
1900
Middle class women were confined to bed rest until well after the baby was born
Introduction of maternity clothes (Lane Bryant)

21. 1920 “Twilight labor” 1920-Morphine and scopolamine
General anesthesia
Proved harmful to baby and mother
Use of stirrups to prevent any tearing or ripping

22. 1950 and Beyond
1950-Use of drugs in “assisted” childbirth became popular
1970-“Natural” childbirth and midwives became popular
1980-Back toward hospital births
1990 and beyond-Both mother and father take a more active role in childbirth