Published on February 24, 2014
2 Children Birth & the Neonate 2.4
Birthing Methods & Delivery Options What Happens During Birth? 99% of U.S. births in hospitals Other options – Freestanding birth center – Home delivery
Birthing Methods & Delivery Options Who helps varies across cultures – 91% U.S. births physicians – Some exclude fathers – Some family members – Open to community
What Happens During Birth? Birthing Methods & Delivery Options Midwives – Norm, most of world – U.S. Attend 8% births – U.S. certified nurse midwives Deliver babies – More time with patient in prenatal visits – Counseling, education – Emotional support
Birthing Methods & Delivery Options What Happens During Birth? Doulas – No medical care Do not deliver babies – Support before, during, & after childbirth Physical Emotional Educational – Most in U.S. work independently, typically function as part of ‘birthing team’
Birthing Methods & Delivery Options What Happens During Birth? Natural childbirth – Goal: reduce pain by reducing fear Education Breathing techniques Relaxation techniques Prepared childbirth (Lamaze method) – Similar to natural childbirth – Special breathing technique in final stages of labor
Birthing Methods & Delivery Options What Happens During Birth? Other methods to reduce pain & stress during labor & childbirth – Waterbirth – Massage – Acupuncture – Hypnosis – Music therapy
Stages of Birth 3 stages of birth – Stage 1 @ 12 - 24 hrs. – Stage 2 @ 45 min’s - 1 hour – Stage 3 Lasts only minutes
Effacement of the Cervix Becomes – Thinner – Shorter Starts – Couple weeks before delivery
What Happens During Birth? Stages of Birth 1st stage: Dilation & Effacement of the Cervix – @ 12 - 24 hrs. Longest stage – Contractions @ 15 – 20 min’s apart Closer together as birth nears – Contractions dilate cervix to open @ 4 inches . Allows baby to move into birth canal
What Happens During Birth? Stages of Birth 2nd stage : Delivery of the Baby – @ 45 min’s - 1 hour – Begins when: baby’s head moves through cervix & birth canal – Ends when: baby completely emerges – Mother pushes down, contractions come @ every minute
Stages of Birth 3rd stage: Placenta (afterbirth) – Placenta, umbilical cord, & other membranes detached & expelled – Fastest stage minutes
What Happens During Birth? Cesarean Section Cesarean Delivery – Baby removed from uterus through incision in abdomen when Baby is in breech or crosswise position Head too large for mother’s pelvis Vaginal bleeding has occurred in pregnancy – U.S. births by C-sections increased since 2002 – http://www.youtube.com/watch?v=vjgxKcjnimY
PRETERM, LOW BIRTH WEIGHT, SMALL-FOR DATE
Preterm & Small-for-Date Infants Low-birth-weight infant under 5.5 lbs – Very low - under 3 lbs – Extremely low - under 2 lbs Preterm – Born 3 or more weeks early
Preterm & Small-for-Date Infants Small for date – May be preterm/full term – Birth weight below normal Increased use of progestin to prevent preterm births – Lowered preterm births 1/3
Preterm & Small-for-Date Infants Consequences of preterm & LBW Most low birth weight infants – normal & healthy As a group – – • More developmental & health problems Risk increases as gestation age decreases Potential problems include • • • • brain injuries lung & liver diseases learning disabilities breathing problems
Consequences of Preterm & LBW • Norwegian study – Preterm-birth adolescents higher risk for: language delays learning problems behavior problems/delinquency involvement
2.5 INFANT CARE
The Postpartum Period Bonding Close connection, especially physical bond, between parents & newborn in period shortly after birth – Doctors suggest: “rooming in” – Newborn kept in mother's hospital room Immediate bonding – Not necessary for emotional health Adoption?
The Postpartum Period Postpartum Depression Period after childbirth – Mother adjusts physically & psychologically to process of childbearing – Lasts about @ 6 weeks Involution – Process by which uterus returns to pre-pregnant size – 5 - 6 weeks
8. Postpartum Period
The Postpartum Period Postpartum Depression Emotional & Psychological Adjustments – Emotional fluctuations due to: Hormonal changes Fatigue Inadequate rest Inexperience or lack of confidence Extensive demands may cause – Anxiety, depression, coping difficulties
Emotional & Psychological Adjustments Postpartum depression – Strong feelings of Sadness Anxiety Despair – Gets worse without treatment
Emotional and Psychological Adjustments The Postpartum Period Postpartum depression treatments – Antidepressants – Psychotherapy; cognitive therapy is best Postpartum depression affects – Mother-infant interaction – Risk of additional psychological disorders
Emotional and Psychological Adjustments The Postpartum Period Father’s adjustment – Considerable adjustment & stress Attention on infant decreases couple’s time May feel unneeded – Father’s postpartum reactions Prenatal involvement can lessen feelings of depression
Infant Nutrition & Health • Infants in 1 yr. Triple weight – Increase length 50% – 50 calories per day per lb. of weight – High-calorie, highenergy foods & fats very important NO NONFAT FOODS
Infant Nutrition & Health Healthy infants need: – Loving, supportive feeding environment – Breast milk – Gradual increase of chew-&-swallow – More fruits & vegetables, less junk food – Demand feeding becoming more popular – Poor dietary patterns can cause overweight
How Do Infants Grow and Develop Physically? Co-sleeping Culture and Sleeping Arrangements – Sharing bed common in many cultures – American Academy of Pediatrics – Discourages co-sleeping because of Stress SIDS risk
Sudden Infant Death Syndrome (SIDS) How Do Infants Grow and Develop Physically? Infant stops breathing, usually during night, and dies without apparent cause – – – – – – Highest cause of infant death in U.S. Highest risk is 2 - 4 mo.'s of age Sleeping on back reduces risk Less common in: bedroom with fan infant who sleeps with pacifier
Sudden Infant Death Syndrome (SIDS) Thoughts?
Sudden Infant Death Syndrome (SIDS) How Do Infants Grow and Develop Physically? Highest risks – – – – – – – – Lower birth weight Siblings with SIDS Sleep apnea Lower SES groups Exposure to cigarette smoke Placement in soft bedding Abnormal brain stem functioning African American & Inuit infants
How Do Infants Grow and Develop Physically? Breast Versus Bottle Feeding Breast milk – – – – – – – – Fewer gastrointestinal infections Lower respiratory tract infections Reduces effects of asthma in first 3 mo’s Reduce risk of skin inflammation May lessen likelihood of obesity Lowers risk of childhood & adult diabetes Less risk of experiencing SIDS Claims of no link to allergy prevention
How Do Infants Grow and Develop Physically? Malnutrition in Infancy Early weaning can cause deficiencies Can develop: – Marasmus – Wasting away of body tissues infant’s 1st yr.
Malnutrition in Infancy Kwashiorkor Deficiency in protein Abdomen, feet swollen with water If not fatal, effects detrimental Lowest SES Aided by supplementary feeding
Nonorganic Failure to Thrive Child may die Occurs before 18 mo.'s. Denied – – – Affection Emotional Support Stimulation Harry Harlow experiment
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