Chapter 3 Flashcards
(38 cards)
Birth process
3 stages w
1) labor: 12 hours 1St Bebe, 6 after Cervix dilates Push fetus to vagina Cervix displayed to 10 cm Pain: contractions increase in frequency and intense to dialate cervix
2)delivery: 1/2 to 1 hour
Moms effort to push fetus through cervix and out of uterus
Less frequent contraction (60-90sec)
Crowning:babies head appears at putter opening of vag
3) delivery of placenta and uterus
Contract until placenta and Umb cord are out
Few min to half hour
Whole placenta must be out or continue to bleed
Breast feed can expel it quicker or oxytocin injection
Oxytocin
Hormone released by the pituitary gland it causes labor to begin
When hits a certain threshold
Triggers uterine contractions
Episiotomy
Incision to make vag bigger
Shorten by 15 to 30 min
Critics say unnecessary
1970 90%
2000 20%
Birth complications
1) failure to progress and breech
- longer than normal so they walk nap or get an enema meds oxytocin to stim the contractions
Breech presentation: feet/butt in breech position
Dangerous because Umb cord can restrict
Midwifes massage while using medicine by 37th week
2) c-section, cesarean delivery Can't breech progress or any problems this is the answer Cut baby from uterus 2000 year practice but babes would die or mothers Until sterile and antibiotics Help with stds Cost more and dr get payed more But not higher rates Vbac vag birth after csection
Low birth prob rates in north Europe India abs Africa
Culture and birth
Spiritually unclean
Stay away from leoe
New Guinea- outskirts of village where excretion and menstruation occur
Vietnam- x go out for 30 days talk to husband via door
Cleanse ceremonies
Why? To help control pain and peril of birth
Placenta and culture
Danger
Harmful
Burial or burn then bury
Like twin of fetus or “spirit”
Has nutrients and hormones
Consuming
Has oxytocin to prevent hemroids
China- milk production or in meds
Birth practices
Older women
Midwifes
Anyone with on call availability
Spirit calling
Volunteer
Apprentice
Highly respected
Feared in India lowest status unclean and pollut
Us docs and midwifes assist
Developing- husbands can’t be there for birth
And traditional men need to be there Mexican and Philippines
Ease preg
Midwife massage
Tea
Meds
Ukraine whiskey
Walk or lay during contractions
Birth talk- encourage or scold if too loud scream or complaining
Longer labor more danger
Key and comb given as luck
Ropes bottles/corks flowers animals
To do: Rocking chair Birth ball Steady breathing Shower
Epidural- inject amnesia in spinal fluid to decrease pain but keep consciousness
After birth baby lay on abdomen
Until Umb cord and placenta are expelled via massage meds rituals try to sneeze or vomit or synth oxytocin
Cut chord: tie cut bamboo she’ll broken glass sickles razor not clean baby have disease
India ash from burnt cow poop causes tetanus
Variations in birth
Midwifes - 15th century
18th-med school dr. With little experience
Obstetrics birth field and prenatal care
18 and 19th forceps
50% of births used it in us in 19
Then4 via 20rh
20th
50% use Midwifes
1930- 15%
1973-10%
1940s gloves and hand washing introduced
20th Twilight sleeping Inject with narcotics 1930-1960 Felt pain can't remember
Natural birth proposed in 1930 popular by 1960
Today 90% U.S. births in hospitals Epidurals Efm elect fetal monitor fetus heart beat Increase (can) csection
More use of midwives
Dads now included
80% of work pop in ing countries birth is pain and peril
Neonatal mortality 2x high for Africans
Fontanels
Two soft spots on back and top of head
Shift during birth to assist passage through birth canal
Neonate
Newb baby
Up to 4 weeks
Neonatal jaundice
Yellow skin of baby in first days due to immature liver
If like after few days problem
Fix via phototherapy (expose to blue light)
Cause brain damage
Anoxia
Can’t breath when hit oxygen
Minutes can cause perm damage
Apagar scale
0-3- life threatening
4-6- req assist to breath
7-10- good to excellence condition
Appearance blue- pink
Pulse absent to fast
Grimace ( reflex) none to cough sneeze cry
Activity limp and flaccid to strong active
Respiration no breath more than 1 min to good breath with cry
98% us babes fall in 7-10
Two times
Minute after birth
Then 5
Rates determine risk of death in first month
Brazelton scale
27 items Reflex Phys state Stun response Cent nervous system stability
Day after birth
Then two months
Decrease develop probe
Increase parent confidence
Low birth weight
Preterm
Small for date
<2500g 5.5lbs
Preterm- babes born at 37 weeks or less
Small for date: term for neonates who weigh less than 90% of other babes born at same age
World rate: 14%
As and af highest rates euro lowest
About low birth and effect on neonate
Very low birth weight less than 3.3 at birth
Extreme low birth less than 2.2 lbs
Born preteen
Us 50% survive if born pre 25 weeks
Why?
Malnutrition illness disease teratogens
Physical systems not good immature infection vulnerable
Lack Fat to insulate
Lungs
Surfactant
Helps them breath and keeps air sacs from collapsing
Preterm haven’t developed this
Fatal consequences
Breath tube help
Treatment of low birth weight
Kangaroo care moms and dad place preterm infant on skin on chest 2-3 hours a day during early weeks of life
Highly beneficial breath body temp heart rate sleep cycles
More likely to survive
Infant massage
Isolette- sterile chamber with oxy and control temp
Weight gain
Though low weight later problems
Physical cognitive allergies
Language delays poor school performance
Sleep of neonates
Avg 16-17
Reality 10-21
Periods of sleep sleep deprived parents
4months sleep longer at once, 14 per day
Rem sleep Re Adults 20% 50% on neonates 3 months 40%
Sleep wake state in babes
Trad babes always with moms
Us sleep 8 hours by 8 months
Baby reflexes
Rooting
Auto response to stimulation
Moro- arch backs fling out arms bring in arms in embrace - response to fall back or loud noise
Fade after a few months measure neuro development
Cough sneeze blink shiver avoid enviro factors
Babkin response
Stroke palms close it eyes open eyes tilt head forward
Babinski reflex
Stroke foot twist it inward as fans out toes
Neonatal senses
Touch 1st feel pain or will sleep recover quickly and be normal after
Cry from pain releases pain killer hormone
Taste/smell: prewomb jazz prefer
Amniotic fluid prefer merms- soothing
Prefer sweet taste (add sugar to amn fluid eat faster)
2 days no mom breast pref, but at 4 prefer mom
Hearing- rec distinctive sounds Nipple experiment-suck harder at preference prefer mom and native over foreign language Can tell when sound changes Syllable changes Music sensitivity Prefer prebirth mom songs
Limit- amniotic fluid drain from ears improve by two years
Sound localization- can’t tell where sound comes from worsens in first two months improve by one
Sight- lens retina cells cones and optic nerve not strong yet 20/200 or 20/600 Best at 8-14 inch Binocular vision- happens at 3-4 Visual preferences
