Ch. 6 and 7 Childbirth and the Newborn

•  Childbirth ends the prenatal period and begins the baby’s life as a separate person. Through labor and delivery, the mother’s body works to bring the baby into the world.

Ch. 6 - Childbirth

•  Studies show that fathers-to-be who become involved with pregnancy and childbirth are more involved in parenting

FAMILY INVOLVEMENT •  In the past, fathers had little to no involvement in

the birthing process. •  When babies were delivered at home, it was typically

the female members of the mothers family who helped.

•  When hospital deliveries became more common, the fathers job was to call the hospital. –  Once there, he was sent to the “Pacing room”

to pace the floor, nap, and talk with other fathers.

The Role of the Family

Today’s Fathers-to-Be Their role changes throughout pregnancy and childbirth. Couples often become educated about childbirth by reading books and attending classes Many see their babies being born. •  Some research shows that it is good for mothers to have help during

labor, which is the process that moves the baby out of the mothers body

•  Mother with helpers have shorter and more enjoyable labors •  Helpers tend to calm mothers and reduce their feelings of anxiety

–  Anxiety can be a problem in labor because it causes change in the blood chemistry. These changes:

•  Decrease the flow of blood to the baby, which can harm the baby

•  Slow contractions, which results in a longer labor

The Role of the Family

•  Parents have many decisions to make before their baby is born.

•  They must choose: •  Where the birth will take place •  A method of delivering the baby with their doctor’s

advice •  About cord-blood banking

FAMILY DECISIONS CONCERNING CHILDBIRTH

Parents have several options about where their baby will be born. Sometimes their options are limited by: •  Where they live •  Who will deliver the baby •  The conditions of mom and baby •  Hospital deliveries are the most common •  Here, mothers labor in a delivery room and them move to a maternity

room afterwards. •  Some deliver in a surgical room. •  Many hospitals offer the option of a homelike room for low -risk

deliveries. •  The birthing room is furnished like a bedroom with needed hospital

equipment •  A nurse stays with the parents during labor and the doctor and delivery

nurses are present for delivery or if problems arise.

CHOOSING A BIRTHPLACE

•  Some mothers may opt for a birth center. This provides health care before labor and delivery services.

•  These employ CNMs or certified nurse-midwives who have special training in delivering babies during normal, low-risk pregnancies. –  Many work out of hospitals where they can call for help if

needed. •  Others opt for a home birth, which was the norm before hospital

deliveries. •  These are risky because emergency services are not always

nearby. •  Many parents lessen the risk by having a CNM for the delivery •  Infant death rate is higher for home births than for hospital births

CHOOSING A BIRTHPLACE

•  All methods try to make labor and delivery safer and more comfortable for the mother and baby

•  Labor requires the use of many muscles •  Pain is a part of labor, but if muscles are

tense the mother has even more pain •  Labor may range from quick and easy to long

and painful, and this cannot be predicted - and people react to these differently.

CHOOSING A METHOD OF DELIVERY

•  Some mothers choose to be totally alert without drugs during delivery

•  They cope with pain by using breathing and relaxation techniques •  Many drugs can cross the placenta and make the baby sluggish •  Newer drugs and the way they’re given have made their use safer

for mom and baby and can make labor shorter. •  Drugs used for childbirths can be grouped in three ways: •  Sedatives : These reduce anxiety and are used in the early stages

of labor •  Analgesics: Reduce anxiety but do not take it away •  Anesthesia: (also called anesthetics) block pain

–  These may be used separately or in combination and all have side effects

•  General anesthesia has the most side effects

CHOOSING A METHOD OF DELIVERY

•  SEDATION – Drug given by injection or intravenously (IV) to help reduce

pain and ease anxiety •  LOCAL ANESTHESIA

– Drug injected to numb the vaginal area when birth is near, an incision will be made, or sutures are needed

COMMONLY USED DRUGS FOR LABOR AND DELIVERY

•  REGIONAL ANESTHESIA – Drug injected to numb one area (region) of the body

•  EPIDURAL – Drug given through a tiny tube (catheter) placed in the

small of the back, just outside the spinal canal. Mothers feel tough and pressure, but not pain

•  SPINAL – Drug administered into spinal canal. Side effects are

similar to those of epidural, but may be more dangerous. Epidural has almost replaced this drug

COMMONLY USED DRUGS FOR LABOR AND DELIVERY

•  COMBINED SPINAL EPIDURAL (CSE ANESTHESIA); also called Walking Epidural –  A low does is injected below the spinal cord into the spinal fluid. A

combined diluted analgesic and anesthesia are given as an epidural. The low dose allows the mother to move and walk as desired.

•  GENERAL ANESTHESIA –  Drug given intravenously (by IV) or by breathing a gas that puts the

mother to sleep. General anesthesia is reserved for when complications arise, such as when an emergency c-section must be done. General anesthesia has more side effects for both mom and baby than other types.

COMMONLY USED DRUGS FOR LABOR AND DELIVERY

•  Natural Childbirth is a delivery method in which the pregnant woman learns about the birth process and uses breathing and relacation techniques to reduce fear and pain

•  Some parents use a doula (Female helper) who reassures and guides the mother through labor. – They cannot deliver babies.

•  Other parents use a CNM or nurses to aid the mother.

•  Some doctors use natural childbirth in hospitals and CNMs use only this approach at birth center as well as home births.

CHOOSING A METHOD OF DELIVERY

•  Lamaze Method is a method in which the pregnant woman is trained to use breathing patterns to keep her mind off of the pain. It is named for Dr. Fernand Lamaze, who is the French doctor that made it popular.

•  Mother is trained to focus on something other than pain.

•  Very similar to natural childbirth - but unlike natural childbirth, it is not fully against pain relief drugs.

LAMAZE METHOD

•  In this method, mom and coach (usually the dad) attend Lamaze classes. With the Lamaze Method: –  The woman’s coach learns the breathing patterns

and helps her through labor –  The woman receives medication when necessary.

Not all women can deliver without drugs, even when they are informed.

•  Training in childbirth is given in small classes - usually no more than 10 women and their coaches. Typically, classes are held weekly for 8 to 12 weeks before the delivery date. The instructor provides information about childbirth. He or she teaches physical exercise needed for delivery. The instructor also teaches breathing patterns

LAMAZE METHOD

•  Final natural preparations are taking place during the end of pregnancy

•  The mother’s body makes hormonal changes needed for labor to begin

•  The baby is moving into position for birth •  The doctor checks these preparations and keeps the

parents informed •  First natural preparations are usually so mild that

parents don’t actually know the time has come •  Once begun, labor and delivery are completed within

hours. •  Many adjustments occur immediately following childbirth

and throughout life

TIME TO BE BORN

•  Birth occurs about 266 days after conception (or about 280 days from the last menstrual cycle

•  For baby to enter the world, a series of contractions in the uterine muscles move the baby out of the mothers body.

•  These contractions are involuntary , which means that the mother cannot make these happen

•  Natural signals from the body control when they begin, how long they last, and how strong they are

•  They happen in intervals separated by periods that allow mom’s muscles to relax.

LAST WEEKS OF PREGNANCY

•  During the last few weeks of pregnancy, mom experiences lightening, which is a change in the baby’s position in which the uterus settles downward and forward, and the baby descends lower into the pelvis

•  In most cases, the baby’s body rotates so the head is towards the birth canal. In about 2% of cases, the baby is in breech birth position, which is where the baby enters feet or buttocks first into the birth canal.

•  Because mom’s body is preparing for birth, she may feel irregular contractions, also called false labor. These contractions do not signal the beginning of labor.

•  Parents should time the length and frequency of contractions to tell when mom is truly in labor (The closer to labor, the stronger and more frequent contractions will be).

CONTRACTIONS

•  Mother may feel a burst of energy due to increased adrenaline

•  The mucous plug in the cervix will become loose •  There will be a small amount of blood in the mucous

called the show . This means labor should start within 24 hours

•  Part of the amniotic sac may break before labor begins

OTHER SIGNS OF LABOR