Labor and Delivery STAGES OF LABOR Stage 1stage

*Labor and Delivery STAGES OF LABOR • *Stage 1—stage of dilation (lasts about 14 hours) • Contractions begin—regular, 4 -5 minutes apart • *Cervix dilates to 10 centimeters • *Effacement—process of cervix thinning and opening • Baby moves into birth canal (head down) • http: //www. youtube. com/watch? v=_hlyo 6 DV 5 UI start at 35 seconds in—shows dilation and effacement with sock and ball • *Transition- hard labor • Contractions last about 90 seconds, 2 -3 minutes apart

*Labor and Delivery STAGES OF LABOR • *Stage 2—stage of delivery (lasts 25 -45 minutes) • *Crowning—presentation of the head

*Labor and Delivery • Episiotomy—incision to prevent tearing

Labor and Delivery Cesarean Section—delivery through incision in abdomen Video 2 B and 3 B

Labor and Delivery • Forceps—tongs used to assist in delivery • Vacuum extractor—suction on baby’s head to assist in delivery.

Labor and Delivery

*Labor and Delivery STAGES OF LABOR • *Stage 3—delivery of the placenta (lasts 15 -20 minutes) • *Placenta delivered (afterbirth) Following birth… • Stitch episiotomy • Begin newborn care

Labor and Delivery NEWBORN CARE • During development in uterus, baby’s lungs are filled with fluid. Pressure of being squeezed through the birth canal forces much of the fluid out. • When the baby emerges, pressure is released and the lungs automatically expand. This is when the baby takes its first breath! • Within a few minutes after birth, the umbilical cord stops pulsing and is clamped, and cut.

Meconium • Meconium is the earliest stools of an infant. It is composed of materials ingested during the time the infant spends in the uterus: intestinal cells, lanugo, mucus, amniotic fluid, bile, and water. This makes up the first “tar” like stools of the infant.

Meconium • If the fetus becomes distressed sometimes the Meconium (normally stored in the infant's bowel until after birth) is expelled into the amniotic fluid prior to birth or during labor and delivery • This is called Meconium aspiration syndrome --is a medical condition affecting newborn infants. It occurs when meconium is present in babies lungs during or before delivery • Baby story 1 B

Labor and Delivery NEWBORN CARE • Apgar Scale- shortly after delivery, the newborn’s physical condition is checked • Infant is given a rating in each of these five areas: • • • 1. heart rate 2. breathing 3. muscle tone 4. reflex to stimulation 5. skin color • A score of 6 to 10 is considered normal. A lower score is a sign that the baby is in need of special medical attention. • Apgar Scale is used 1 minute after birth and again 5 minutes after birth.

Labor and Delivery NEWBORN CARE • The baby is weighed, measured and cleaned up. • About 60 minutes after delivery, *silver nitrate drops are put in the baby’s eyes. This is to protect them from infection from STDs. • Permanent copies of footprints are made. • Identification bands are attached to wrist or ankle. Mom and Dad have a bracelet with same information. This is done before leaving the delivery area.

Labor and Delivery NEWBORN CHARACTERISTICS • Wobbly large head that is ¼ of the baby’s length. • Lopsided, pointed head –this is temporary • Fontanels- open spaces where bones have not fused • Fat cheeks • Short, flat nose

Labor and Delivery NEWBORN CHARACTERISTICS • Receding chin • Eyes are nearly adult size—usually grayish blue—permanent color will be apparent within several months • Lanugo—fine downy hair that covers forehead, back and shoulders. This disappears as baby grows • Vernix—creamy substance that protects the skin in the amniotic fluid • Milia—white bumps on nose and cheeks (baby acne)

Labor and Delivery Milia--This is my son Cameron about a week after he was born!!!

Labor and Delivery HOSPITAL STAY • You will want to spend as much time with your baby as possible. • Bonding- forming a strong emotional tie between child and parents. • Rooming-In- the baby stays in the mothers room day and night rather than the hospital nursery. • If you are going to breastfeed, you want to get the baby to the breast as soon as possible. • Colostrum- first breast milk, high in antibodies, yellow/clear in color • Milk usually comes in by the third day after birth.

Breast Feeding Advantages: • Best source of nutrition for the baby • Gives baby immunity against diseases • Creates a bond through physical closeness with the mother • Reduces baby’s risk of allergies • Causes fewer digestive upsets • Speeds return of mother’s uterus to normal size • Convenient • Free, although a nursing mother needs additional food

Breast Feeding Disadvantages: • Prevents father from participating in feeding • Baby needs to be fed more often • Less convenient • Uncomfortable

Labor and Delivery

Bottle Feeding Advantages: • Allows father to participate in feeding • Convenient • Baby needs feeding less often Disadvantages: • Can be expensive • No natural immunities • Creates chance for baby to develop allergies

Labor and Delivery POSTNATAL CARE OF MOTHER • Postnatal—the period after birth. • Mothers Need: • • Rest—try to sleep whenever the baby does. Exercise—mild exercise when you feel up to it Nutrition—eating right is as important now as it was during the pregnancy. Pain management—ibuprofen; Percocet Stool softeners—senna; a natural vegetable laxative Simethicone—anti-gas medication Medical check-up—about 4 -6 weeks after birth the mother should have a postnatal check up.

Labor and Delivery EMOTIONAL NEEDS • What kinds of emotions would new parent’s feel? Why? • What kinds of support would new parent’s need?

The Amazing Newborn Babies are born with remarkable abilities!! • Reflexes- instinctive automatic responses. • Babies have some important reflexes:

REFLEXES l 1. Rooting reflex —automatic response when touched on the cheek or lips to turn toward the source and open his mouth in search of food. l 2. Sucking reflex - Put your (clean) finger in baby’s mouth and he will suck on it. This reflex ensures he will be able to feed. Replaced by voluntary sucking at 2 months.

Reflexes • 3. Startle or Moro reflex —automatic response to a loud noise or touch on the stomach. The legs are thrown up, fingers are spread, and arms are extended and brought back rapidly while the fingers are closed in a grasping motion. Disappears by about 2 months.

Reflexes • 4. Stepping - If you hold baby in an upright position with his feet touching the floor, his legs will seem to be trying to walk. This reflex will last about 4 months and he won’t actually walk until around 12 months. l 5. Palmar Grasp - touch the palm of babies hand his finger will curl around yours. Replaced at 5 – 6 months with hand eye coordination.

Reflexes • 6. Plantar grasp (Babinski reflex) - stroke the sole of baby’s foot and his toes will spread open. Disappears by 12 months. • 7. Swimming - If baby is placed in water his throat will close so he does not swallow water. This reflex disappears by 2 -6 months. Not recommended to test for obvious safety reasons.

The Amazing Newborn WHAT DO BABIES NEED? • Food—they will get restless, start to root, and eventually cry when hungry • Sleep—most take short naps at all times during the day. Sleep 15 hours in a 24 hour period. Typically 6 -8 different sleep periods. • Exercise—wave arms, kick.

The Amazing Newborn • Kept safe, warm and clean. • Medical care—well baby check-ups for immunizations. • Stimulation—they need things to look at, listen to, and touch. • Love—need close contact with people around them. • You cannot spoil a baby!!!!

What Do Parents Need? WHAT DO PARENTS NEED? • Knowledge of how to care for infant. • Resources that can provide answers to their questions. • Time to fill their many roles. • Emotional support from family and friends. • Financial planning. • Agreement on parenting and household responsibilities. • Privacy and time alone.