Birth and Neonatal Development

Question 1

birth process

Answer 1

• Triggered by fetus itself (not mom)
• Fetus’s maturing lungs release 2 proteins that cause an inflammation of the mother’s uterus and begin the labour process
• Mother produces hormones (oxytocin, endorphins, adrenaline, and prolactin) that aid in birth process

Question 2

“typical” birth

Answer 2

• 38-40 weeks gestational age
• Baby’s head down -> facing birth canal
• Physically painful for the mother (“labour”), but not for the baby
• Squeezing of the neonate’s head, which:
• Allows it to pass through mother’s pelvic bones
• Causes release of hormones to prevent oxygen deprivation during birth
• Squeezes amniotic fluid from neonate’s lungs in preparation for its first breath

Question 3

3 stages of birth

Answer 3

• Stage 1: effacement and dilation of cervix
• Effacement: shortening/thinning of cervix
• Stage 2: emergence of the baby
• Usually begins with “crowning” of head in a typical birth
• Stage 3: delivery of the placenta
• Can happen actively (taken out physically or chemically) or passively (naturally comes out)

Question 4

Cesarean delivery

Answer 4

• Sometimes medically necessary to protect mother and/or infant
• Can happen because of “breeched” babies (babies whose heads aren’t facing down)
• Carries some respiratory risks for the infant and surgery-related risks for mother
• Babies still have fluid in lungs because their heads don’t get squeezed
• Cultural differences???

Question 5

neonates and sleep

Answer 5

• Sleeping more in this time than they will throughout lifespan
• Neonate spends the majority (approximately 2/3 of time) sleeping (16 hours) -> this declines throughout rest of life to about 20%
• Half quiet sleep (non-REM)
• Half active sleep (REM)
• Infants spend more time in REM sleep than we do
• Provides endogenous visual experience -> may allow visual systems to catch up

Question 6

neonates and crying

Answer 6

• neonates spend about 2 hours per day crying -> increases after birth until 6 weeks
• mostly non-communicative until they’re older, but can also be due to hunger, discomfort, pain, or overstimulation
• peaks in late afternoon and evening

Question 7

PURPLE crying

Answer 7

• normal period that all infants progress through, starting at birth and peaking at 5-6 weeks after birth
• this period coincides with increases in shaken baby syndrome

Question 8

What does PURPLE stand for?

Answer 8

• P: PEAK of crying -> babies cry more each weak, mostly in month 2, a bit less in months 3-5
• U: UNEXPECTED -> crying comes and goes, you don’t know why
• R: RESISTS soothing -> won’t stop crying no matter what
• P: PAIN-like face -> may look in pain, but not
• L: LONG-LASTING -> can last 5+ hours a day
• E: EVENING -> peaks in late afternoon and evening

Question 9

negative outcomes at birth

Answer 9

• infant mortality (death after first year of birth)

- low birth weight

Question 10

infant mortality

Answer 10

• death after first year of birth
• declining due to increases in public health
• Canada is still relatively bad compared to other industrialized countries because our Northern territories have infant mortality rates similar to non-industrialized countries

Question 11

low birth weight

Answer 11

• when infants weigh less than 2500 grams
• can be due to prematurity (being born at 35 weeks or earlier)
• can also simply be small for gestational age (weigh a lot less than other babies born at the same time - whether preemie or full-term)
• medical complications and neurosensory defecits, illness, lower IQ and educational achievement
• can be due to twin/triplet/multiple births
• intervention programs: infant massage

Question 12

birth varies cross-culturally

Answer 12

• North America: medical model -> survival and health -> doulas also increasing in popularity to assist women in terms of emotional and physical comfort
• Brazil: more social -> whole family is present, at home, assisted by midwife -> social integration of baby