Labor & Delivery

Types of Deliveries 1. Cesarean section: a small incision made in the lower

abdomen and uterus where the baby is delivered2. Natural childbirth: no medications, relax the body by

using breathing techniques3. Crouching method: squatting down and letting gravity

help deliver the baby- less chance of tearing used in more primitive societies

4. Birth in water: becoming more popular water helps mom relax and softens the shock of deliver for mom

5. Home delivery: still common use of midwife to help deliver the baby mom can be relaxed because she is at home with her family only to be used for low risk pregnancies

Stages of Labor1. First Stage

– Contractions open up the cervix to dilate and expand to 4 inches or 10 cm

– At the beginning of this stage, contractions are about 15-30 minutes apart

– Near the end of this stage, contractions are 2-4 minutes apart and are strong and frequent.

– Baby moves down into the lower pelvis and into position for birth.

2. Second Stage– Contractions move baby through birth canal– Pushing stage

3. Third Stage– Uterus continues to contract causing placenta to separate

from uterus– Placenta is birthed (afterbirth)– Shortest and least painful stage

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What does a newborn look like?

• Head is large and wobbly (1/4th the baby’s entire length) It is also pointed from the passage through the birth canal.

• Eyes are usually dark grayish-blue at birth. Baby’s permanent eye color becomes apparent within several months.

• Some are born with fine, downy hair all over their forehead, back and shoulders.

• Milia: Baby Acne (plugged oil ducts) usually disappear in 1-2 weeks.

Fontanels: open spaces where the bones of the baby’s skull have not yet permanently

joined.

Apgar Scale

• A method of evaluating a newborn’s physical condition. (rating 0-2 per category)

• Five areas: Pulse, breathing, muscle tone, reflex to stimulation, and skin color.

• A total scale of 6-10 is considered normal.

• Apgar evaluation is given at 1 minute after birth then again at 5 minutes after birth.

Bonding

• Newborn is placed on mom’s chest to facilitate lifelong emotional ties.

• Colostrum: the mother’s first breast milk is given within an hour after birth to newborn. It is rich in antibodies and sometimes thick in consistency.

What do BABIES do?

EatSleepHave dirty diapersCry

Most babies cry 2-3 hours a day for the 1st 2 -3 months of life

5 p.m. to Midnight is often a fussy time

Newborn Reflexes• Moro Reflex: When you fail to support or hold the neck and head, the arms

of your baby will thrust outward and then seem to embrace them selves as their fingers curl. This reflex disappears at about 2 months of age. It is also known as the startle reflex.

• Palmar Grasp: When you touch the palm of your baby's hand, the fingers will curl around and cling to your finger or an object.

• Plantar Grasp: This reflex occurs when you stroke the sole of your baby's foot, his toes will spread open and the foot will turn slightly inward. It is also known as the Babinski reflex. By the end of the first year this reflex is usually gone.

• Sucking: While you may not believe this to be reflexive, it is. This ensures that the baby will nurse on a breast or bottle to be fed and occurs when something is placed in the baby's mouth. It is slowly replaced by voluntary sucking around 2 months of age.

• Rooting Reflex: When you stroke your baby's cheek she will turn towards you, usually looking for food. This is very useful when learning to breastfeed your baby. This reflex is gone by about 4 months.

Reflexes Cont…• Stepping Reflex: If you take your baby and place his feet on a flat

surface he will "walk" by placing one foot in front of the other. This isn't really walking and will disappear by about 4 months of age.

• Tonic Neck Reflex: This is also called the fencing reflex, because of the position the baby assumes. When you lay your baby on her back and her head turns to one side she will extend her arm and leg on that side while the opposite arm and leg bend, assuming a "fencing" position. This reflex is present only until about the 4th month.

• Swimming: If you were to put a baby under six months of age in water, they would move their arms and legs while holding their breath.

References

• Utah State

http://www.uen.org/Lessonplan/LPview.cgi?core=20

• http://pregnancy.about.com/cs/newborns/a/aa061801a.htm