Childbirth 1. THE ROLE OF THE FAMILY 2 Today’s Fathers-to-Be First few months of pregnancy:...

ChildbirthChildbirth

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THE ROLE OF THE THE ROLE OF THE FAMILYFAMILY

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Today’s Fathers-to-BeToday’s Fathers-to-BeFirst few months of pregnancy:

Husbands reassure their wives, help select a doctor and decide other aspects about delivery.

Middle months: prepare nurseryFinal months: Husbands need to be

supportive, as the mother-to-be is very tired and anxious for delivery.

Many fathers see their babies being born.

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Fathers act as “helpers” during labor◦Labor: the process that moves the

baby out of the mother’s body◦Being involved in the delivery room

has proven to strengthen marriages, along with the bond between father and baby.

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FAMILY DECISIONS FAMILY DECISIONS CONCERNING CONCERNING CHILDBIRTHCHILDBIRTH

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Choosing a Birth Place-Choosing a Birth Place-HospitalHospitalHospital deliveries are most

common.◦Labor take place in maternity room,

and then mother is taken to delivery room shortly before baby is born.

◦After baby is born, they spend short time in recovery room before returning to maternity room.

◦If mother needs a surgical delivery, they will be taken to a surgical room.

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Hospital cont…Hospital cont…Many hospitals offer a homelike

room in the hospital for low-risk deliveries.◦Furnished like a bedroom, but with

hospital equipment.◦Nurse stay in the room during labor,

doctor only comes in for delivery.◦Parents stay here until discharged.

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Birthing CentersBirthing CentersSome families think hospital

deliveries treat childbirth as an illness rather than a natural process.

These may choose to deliver in a birth center.◦Provides health care before labor and

delivery services.Certified nurse-midwives (CNMs)

have special training in delivering babies during normal, not high-risk pregnancies

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Home BirthsHome BirthsRiskier because emergency

services are not typically nearby.

Many couples choose to have a midwife present to assist if any problems arise.

Infant death rate is higher than those born in a hospital.

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Choosing a Method of Choosing a Method of DeliveryDeliveryDelivery options may change

during labor◦May start w/out drugs, but then ask

for them to relieve pain.Some drugs may cross the

placenta causing the baby to be sluggish and not an active participant.

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Childbirth drugsChildbirth drugsSedatives: reduce anxiety and

are used in the early stages of labor.

Analgesics: reduce pain but do not take it away.

Anesthesia: blocks pain◦Has the most side effects

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Natural ChildbirthNatural ChildbirthMethod of delivery without drugsWoman is trained to breathe and

relax in a way that helps the birth process.

Father provides support.◦Some parents use a doula: female

helper who reassures and guides the mother through labor. Some use midwives.

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Lamaze MethodLamaze MethodWomen may already to conditioned

to fear childbirth, so in Lamaze training, the mother is taught to focus on something other than the pain.

Mother and her coach (usually father) attend classes that prepare her mentally and physically.◦Breathing methods and exercises are

taught.◦The woman may receive drugs.

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TIME TO BE BORNTIME TO BE BORNThe Last Weeks of Pregnancy

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ContractionsContractionsContrations: Involuntary contractions in

the uterine muscles.Lightening: a change in the baby’s

position.◦The baby settles lower into the pelvis, uterus

settles downward and forward. Baby typically rotates so the head is downward. Breech birth position: buttocks-first position.

◦When lightening takes place, the mother can breathe easier, but may get leg cramps and may need to urinate more often.

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False labor: Few irregular contractions.

Regular contractions occur at more even intervals.

As labor progresses, contractions increase in length and strength.

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Other Signs of LaborOther Signs of LaborMother may feel a boost of energy

due to an increase of adrenaline.The mucous plug in the cervix will

become loose.◦Small amount of blood in mucous is

called the show.◦This means labor will begin within 24

hours.Amniotic sac may break before

labor begins ◦Usually happens after labor starts

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SIGNS OF LABORSIGNS OF LABOR

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Stage 1: Dilation of the Stage 1: Dilation of the CervixCervixContractions start at one every 15-

20 minutes and last 30 seconds.Towards the middle of labor, they

will last 45-60 seconds and will be 2-4 minutes apart.

During the transition contractions last 90 seconds, and feel continuous.

This causes the uterus to narrow, straightening the baby’s body and pressing the head against the cervix, cause the cervix to open or dilate.

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If the amniotic sac has not broken, the doctor will break it when the cervix is fully dilated at 10 cm (about 4 inches).

When the cervix is completely open, the first stage of labor ends.

Average length of this stage is 8 hours for the first pregnancy (less for later pregnancies).

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Stage 2: Delivery of the Stage 2: Delivery of the BabyBabyBabies head enters birth canal.Sometimes an episiotomy is

needed, which is an incision made to widen the birth canal and prevent tearing.

The baby starts coming out head down, and then turns to the side as neck and shoulders come out.

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Average time is 30-90 minutes for first pregnancy.

Doctor suctions liquid out of mouth to help baby take first breath.

Umbilical cord is clipped before the third stage begins.

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Stage 3: Delivery of the Stage 3: Delivery of the PlacentaPlacentaAbout 5-10 minutes and up to 30

minutes after birth, the mother has a few irregular contractions.

These cause the placenta to detach from the uterus and descend.

Afterbirth: placenta and fetal membrane are expelled.

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COMPLICATIONS OF COMPLICATIONS OF DELIVERYDELIVERY

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Common Techniques Used to Common Techniques Used to Aid DeliveryAid DeliveryVersion: manually rotating unborn

baby into correct position for delivery.

Pitocin: a drug used to speed up labor by causing contractions to start and strengthen.

Forceps: curved instrument that fits around the sides of a baby’s head, aids in easing the baby down the birth canal during a contraction.

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Cont…Cont…Vacuum extraction: suction is

used to attach a cuplike device around the top of the baby’s head, allows the doctor to gently pull the baby down the birth canal.

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Cesarean Births (C-Cesarean Births (C-Section)Section)The mother’s abdomen and

uterus are surgically opened, and the baby is removed.

Recovery takes longer than for vaginal deliveries.

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Reasons for C-sectionsReasons for C-sectionsMother’s pelvis is small or not shape

correctlyBaby or mother is at medical riskBaby’s head is too largeContractions are weak or absentBaby is in an incorrect position for

birthMultiple birthsFear that uterine scar (from previous

c-section) will rupture. Fear of transmission of herpes

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Risks of C-sectionsRisks of C-sectionsRisks of major surgeryIncreasing need for surgical

removal of the uterus (hysterectomy) with each c-section

A low, but increased risk of stillbirth with next pregnancy

Increased risk of complications from vaginal birth after previous c-section birth

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HOSPITAL CAREHOSPITAL CARE

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Mother and baby can expect to stay in hospital for 24-60 hours.◦Complicated or c-section deliver will

stay longer

Rooming-in: if baby is healthy, baby is placed in a bassinet in the room with mother.

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BONDINGBONDING

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Bonding: developing a feeling of affection between parents and baby.◦1st hour after birth is most important◦Bonding continues for the next few

weeks as baby gets used to parents voices, touch, feel, etc.

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Benefits of BondingBenefits of Bonding

To Infant To Parents

Increased chance of survival

Better weight gainLess crying, more

smiles and laughterFewer infectionsPossibly higher IQBetter language

development

Less incidence of child abuse

Faster recovery from delivery

Longer breast-feedingMore self-confidence

as a parentLess depression after

delivery

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POSTPARTUM CAREPOSTPARTUM CARE

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Postpartum care is the care the mother receives during the 6-8 weeks following the birth of her baby.◦Body returns to prepregnancy state

unless breast feeding.

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Postpartum Mood Postpartum Mood DisordersDisordersBaby blues: mild and goes away

on its own.◦Most common

Postpartum depression (PPD): a serious form of depression

Postpartum psychosis (PPP): an extremely severe mental illness◦PPD and PPP need immediate

medical treatment

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