3 - Lecture notes 3 PDF

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Taught by Franziska Kintzel. Notes from lecture 3....

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Stages of childbirth o Countdown  Last month of pregnancy dropping or lightning happens known as feet is settling in mothers pelvis Head down  Thirsty during contraction is called Braxton Hicks contractions or false labour contractions.Early as six months into pregnancy and increasing as pregnancy progresses also tones delivery muscles true labour contractions are more painful and regular and intensified by walking.  Blood may appear in Vaginal secretions two days before labour  Signs that labour is beginning including indigestion diarrhoea taking the small of the back and cramps.  To a Terry gland will release oxytocin stimulating contractions Powerful enough to expel the baby prostaglandins are produced before when the baby is ready o Childbirth  Regular uterine contraction signal beginning.  Three stages  1:Uterine contractions eface and dilate cervix. Dilation causes the most pain first stage is the longest and it may last hours to more than a day. First contractions are about 10 to 20 minutes apart from 20 to 40 seconds each they become more painful frequent and regular when contractions are 45 minutes apart until the end of the first stage of labour the mother is usually in labour room normally measuring foetal heart rate and mothers contractions.  2:Cervix is almost fully dilated head of penis moves to the vagina this is called transition this stage last 30 minutes or less contractions are frequent and strong it begins when baby appears at the opening of the vagina.Last minute or a few hours.Contractions stretch skin surrounding birth canal and propel baby forward after crowning baby emerges within minutes.Either tearing happens or an incision is made called in episiotomy to prevent random tearing.And breathing on on umbilical cord is clamped and

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severed the stump will dry and fall off in 7 to 10 days.Nurse now gets foot prints supplies and ID band and ministers antibiotic ointment or silver nitrate to prevent bacterial infection inject vitamin K help blood clot. 3:Third stage last minutes or hours placenta separates from Eden wall and expel to birth canal some bleeding is normal sows episiotomy if part of placenta is not expelled haemorrhaging could occur.

Methods of childbirth o Are used to be very intimate involving mothers home a midwife and female members. o Natural vaginal delivery with no medication, medically assisted vaginal birth and caesarean section. o Midwives  Means with mother.  Regulated and publicly funded healthcare professionals to receive specialized training and birth and care of infants and their mothers using natural birth methods including relaxation and breathing techniques.  Can provide induction anaesthesia and use of antibiotics to treat infection when required.  The woman must be low risk for complications  Deliver in Homer Hospital  Women with midwives receive fewer medical interventions and have experienced more satisfaction with prenatal in maternity care  Prepared childbirth  Lamaze method: women engage in breathing and relaxation exercises reducing fear and pain and distract him from discomfort primarily use with mother and labour.  Other methods include education Hypno birthing and the Bradley method. o Hospital delivery with medical intervention  98.5% of births. 28% of births are C-section.  Anaesthesia  General anaesthesia and cheese affect by putting woman to sleep by injected barbiturate or tranquilizers oral barbiturate and narcotics this reduces responsiveness of baby shortly after birth but no long-term negative effects.

Regional or local anaesthetics reduce anxiety and perception of pain without putting mother to sleep external genitals are numb by local injection with an epidural block in spinal block it is injected into the spinal cord or Kanell temporarily numbing below the waist minor depressive effect on newborns. Caesarean section  Position delivers baby by abdominal surgery they may cut through the mothers admin and neither is to physically remove the baby in then The incisions are then sewn.  Are used when they believe normal delivery may threaten mother or child or may be difficult than desired.  Reasons include issues with umbilical cord baby in breach position and size of infant maternal heart disease high blood pressure placenta previa and other conditions. 

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Birth problems o Oxygen deprivation  Anoxia Derives from roots meeting without oxygen  Hypoxia drives from roots meaning under and oxygen.  Impair development of foetus is central nervous system leading to cognitive problems especially in memory and special relations motor problems and psychological disorders.  Prolonged deprivation during delivery can cause schizophrenia and cerebral palsy  Can be caused by maternal disorders like diabetes immaturity of babies respiratory system and accidents involving umbilical cord pressure.  Prolong constriction of the umbilical cord is more likely during the breach position. o Preterm and near term infants  Baby is considered preterm or premature when birth occurs at or before 37 weeks of gestation compared with a normal 40 weeks.  Near term is born between 34 and 36 weeks gestation or late preterm one and 12 babies are born prematurely.  Prematurity is more common with multiple births.

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This includes difficulty breathing sucking and swallowing as well as jaundice poor weight gain and difficulty fighting infections also twice as likely to die from SIDS Signs of prematurity  Premature babies are relatively thin because they haven't developed the layer of fat.  Find downy hair referred to as when you go and oily white substance known as the vernix.  If babies are born six weeks or more before term their nipples will not emerge and testicles will not yet descend into scrotum surgery may be required one infant is older to correct the condition.  Immature muscles make sucking and breathing weak in the walls of the tiny air sacs in lungs may stick together because they do not secrete the lubrication supplements.  May have respiratory distress syndrome  In preterm babies with respiratory distress syndrome they show poor development and cognitive language and motor skills over the first two years of development.  Injecting pregnant women at risk for delivering preterm babies with corticosteroids increases babies chance of survival Treatment for preterm babies Usually remain in the hospital placed an incubator is maintaining a temperature controlled environment in afford some protection from disease maybe give an oxygen although excessive amounts can cause permanent eye injury. Parents in preterm newborns  Parents don't treat them as the same time as regular newborns  Five or higher pitch and more grading and they are more irritable.Also less appealing to the eye.  Can lead to depression and mothers.  Mothers tend to feel alienated from babies in harbour feelings of failure guilt and low self-esteem.

Skin to skin contact can counteract developmental challenges that arise later in life  Skin to skin holding a rocking a baby seems to regulate heartbeat improve weight gain communication and reciprocal city and improve long-term health.  Intervention programs  Preterm infants benefit from early stimulation by being cuddled rocks talk to and sung to,Mobile's in view and by hearing live and recorded music in their environment. o Low birth weight infants  .Less than 2.5 kg or 5.5 pounds.  When an infant is low birth weight despite being at full term it is called small for date.  Mothers who smoke abuse drugs or are malnourished place babies at risk for small for dateOr are abused.  Delays in learning and problems with attention.  Risks associated with low birth weight  Seven times more likely to die than infants have normal birthweight.Less than 1.5 kg are 100 times more likely to die.  More likely to develop chronic health problems in dying first year of life.  Greater risk of ADHD Postpartum period. o Weeks following delivery no specific time limit. o MSensory capabilities  Vision  Newborns are near sighted 18 to 23 cm in front of their eyes no peripheral vision  Visually detect movement and can visually follow her track movement.  Prefer moving objects  Visual accommodation refers to self adjustments made by the eyes lenses to bring object into focus newborn show little or no visual accommodation.  No muscle control to converge to see something close to them  Convergence for nearby objects doesn't occur until seven or eight weeks  Hearing  Respond to sound months before birth. 

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Smell    

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Preferences suggested by facial expression

Touch

Most advanced of all sences at birthday  Physical contact between mother and baby is very important for healthy development of skin against again contacts provide infant with feeling of comfort and security that has major factors information of bonds of attachment between infants and caregivers  Infants were not touched me die as a result of a lack of touch because they become so depressed they stop eating  Cuddling can make them feel more safe and protected swallowing is soothing as well as baby massage Sleeping in waking  Newborn spend 2/3 or 16 hours a day sleepingThis is necessary for brain development that is not fully developed at birth  Longest nap normally approaches 4 1/2 hours and are awake for little more than one hour at a time.  Between six months and one year infants start sleeping through the night.  REM and non-REM sleep  REM is rapid eye movement observed beneath close the lids.Most adults report dreaming during this time.  Development sleeping during this time declines. 

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Discriminate distinct odours Show more rapid breathing patterns and increase bodily movement to powerful odours Turn away from unpleasant ones Smell may provide vehicle for mother infant attachment and recognition.

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myelination of auditory pathway isn't complete before birth Normally here as well unless clogged with amniotic fluid I likely to respond to high pitch instead of low pitch

About 30% of babies sleep is REM by 2 to 3 years it is 20 to 25%.  Brain requires certain amount of stimulation for creation proteins involved in development of neurons and synapses newborns create this by REM sleep parallelling with waking state in terms of brain waves. Sudden infant death syndrome SIDS  Death while sleeping of apparently healthy babies who stop breathing.  Baby sleeping on their back prevents this more Crying  For hunger pain sleepiness and discomfort.  Pitch of a cry provides information for it.  High pitch is more urgent distressing and six sounding  Sudden loud and insistence didn't cry is associated with flexing and kicking of legs may indicate colic which is pain resulting from gas or other sources of distress.  Polic tends to disappear by third of six months when the G.I. system matures  Patterns of crying may be indicative of chromosome all abnormalities infections foetal malnutrition and exposure to narcotics  Crying peaks at 5 to 6 weeks normally going away by three months.  Crying is a very normal development stage  Soothing  Sucking is one of the best method  Sucking is an autonomic reflex they do it in utero so they can self sooth 

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