The Babys Arrival

The Babys ArrivalPreparing for the Babys ArrivalMaternity leave time off from a job allowing a woman to give birth, recuperate, and care for her new baby.Paternity leave time off from a job allowing a father to care for his new baby.Breast Feeding vs. Bottle FeedingFormula A mixture of milk or milk substitutes, water, and essential nutrients.

Write a persuasive paper explaining to soon to be mothers the advantages and disadvantages of breast-feeding or bottle feeding. Your goal is to persuade a new mother to use one or the other based on what you think is best. Disposable diapers or clothDiaper pinsWaterproof pants for cloth diapersWashclothsDiaper rash ointmentCover diaper pailBasket or hamperWipes6-8 undershirts4-6 one-piece footed sleepers4-6 gowns6 cotton receiving blankets1 warm outer wrapping blanket1 sweater and cap set1 dress-up outfitCoat and mittensLarge bottles Cleaning brushBreast pump and padsBibsPlastic bottles for storing milkHigh chairSmall bottles for water or juiceNipples and Bottle capsFitted crib sheetWaterproof mattressAbsorbent padsHeavier crib blanketBumper padsStorage spaceWastebasketBathtub or containerCotton ballsMild, pure soapNail scissorsBaby shampoothermometerSoft washclothsCombSoft bath towelsBaby oil and lotion

Car seatTote bagStroller, carriage, or infant carrierMaking a BudgetA spending planFixed expenses the costs of items that cannot be changed, such as rent, mortgage payment, taxes, insurance payments, and loan payments.Flexible expenses costs for items over which people have some control and which can be cut back if necessary.

Added expenses medical expenses will be covered by insurance, income lost if one of the parents plans to take time off from a paying job.Prepared ChildbirthPrepared childbirth a method of giving birth in which pain is reduced through the elimination of fear and the use of special conditioning exercises.Labor the process by which the baby gradually moves out of the uterus into the vagina to be born.Delivery the birth itself.Who Will Deliver the Baby?ObstetriciansDoctors who specialize in prenatal and postnatal care of the mother and baby.Family DoctorsGeneral practice doctors, deliver babies and provide prenatal and postnatal care.Licensed midwivesNurse-midwife a registered nurse with advanced training in the care of normal, uncomplicated pregnancy and birth.Lay-midwife a person who has special training in the care of pregnant women and uncomplicated deliveries but does not have a nursing degree.Childbirth OptionsPlacesHomeUnexpected problems may ariseMidwife usually presentHospitalUsually spend 2 to 3 days in the hospital after a routine delivery, or up to one week if there are complications.Many staff availableHigh tech equipment if a problem should happen.May offer several types of servicesInsurance only pays for two days of hospital stay.Can be very expensiveAlternative Birth CenterA facility that provides a more homelike environment for labor and delivery. Emphasize natural childbirth, and do not offer pain medicationsWater birth optionFamily and friends are welcomeMidwives generally handle births in the centers. Most only accept mothers with a low risk of complications. Charge less than hospitals

History of Delivery

Early 1647 Forceps developed many babies died in the early years of their useBefore 19th century was uneventful - life went on as normal no pain reliefMid 19th century women feared childbirth - painful or even fatal higher social status less children you had1800 Chloroform was used to relieve women of any pain it was harmful and even fatal to mother and baby

Mid1882 First successful Cesarean delivery death rate remained high until 20th century1898: German doctor August Bier injected cocaine into his assistants spinal column (the forerunner of the modern day epidural). It numbed the fellows lower body, but the next morning he woke with horrible vomiting and headaches.1900 Middle class women would be confined until well after the baby was bornIntroduction of Maternity clothes (Lane Bryant)

1920 Twilight labormorphine and scopolamine (general anesthetic) (These drugs proved to be harmful to baby and mother)Use of stirrups to prevent any tearing or ripping The medical profession won stronger licensing laws and helped shape the medical system so that its structure supported, rather than undermined, professional dominion. Dr. Joseph DeLee proposed that childbirth is a pathological process.sedate women at the beginning of labor, allow the cervix to dilate, give ether during the pushing stage, cut an episiotomy, deliver the baby with forceps, extract the placenta, give medications for the uterus to contract, and repair the episiotomy1930s1930: The American Board of Obstetricians and Gynecology was established.1950s1950 Use of drugs in assisted childbirth becomes popular

1960s1965: On July 30 U.S. President Lyndon B. Johnson signed into effect Medicaid and Medicare.1968: Continuous electronic fetal monitoring was introduced, only used on 510 percent of women, those considered high risk.

1970s1970 Natural childbirth is newly popularMidwife becomes popular1980s1980 Back toward hospital birthsLate 1980s:Hospitals introduced LDR rooms (Labor, Delivery and Recovery rooms, where you labored, gave birth in, and recovered all in the same room rather than moving to different rooms for each of those stages).

2000s2006: 22 percent of women have their labors induced.2008: 33 percent Cesarean rate. An average 80 percent of women elect for an epidural for vaginal delivery.

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The Birth Process

The Beginning of LaborOne sign that labor is approaching occurs when the baby settles deep into the mothers pelvis, preparing for their journey into the world. Settling is often called lightening.Bloody showLosing the mucus plug. The cervix(lower part of the uterus) serves as a kind of door, it is closed and sealed with a mucus. It helps prevent bacteria from moving up and causing an infection. As the body prepares the mucus begins to liquefy.Water breaksA trickle or gush of warm fluid from the vagina. The membrane holding the amniotic fluid surrounding the baby has broken. For most women the membrane does not rupture until at the hospital.ContractionsThe tightening and releasing of the uterine muscle. Over time, they get longer, stronger, and closer together. Stages of Labor1st stage Dilation of the Cervixcontraction open the cervix2nd stage Delivery of the Babythe baby is born.3rd stage Delivery of the Placenta the placenta is expelled.

1st StageEach time the uterus contracts during this stage, the muscles gently pull up on the cervix, slowly thinning and opening it unit it is wide enough for the babys head to slip out. The cervix dilates, or widens, to form an opening about 4 inches din diameter and becomes as thin as a sheet of paper(effacement).Contractions get longerCervix opens, baby moves to lower pelvis. Most cases baby should be head down, if feet or butt is first it is called breech, these babies may have trouble moving pelvis. Fear and tension can cause the labor to slow down and make it more uncomfortable. End of the stage contractions become very strong, last for up to 90 seconds and occur about 2 to 3 minutes apart. Cervix is fully dilated to 4 inches or 10cm.

2nd StageBabys head has slipped out of the uterus into the vagina. Contractions now work to move the baby down. Can be as short as three minutes or as long as 3 hours.Bones of the pelvis are joined together by ligaments, allowing it stretch open.The babys skull is soft and flexible. So it becomes longer and narrower than normal. If the mothers cervix does not open enough, there is a procedure to assist in the delivery. A surgical incision called an episiotomy. This will prevent tearing of the womans tissue. Forceps specialized tongs made from band of surgical steel that are molded to fit the shape of a babys head.

Birth

As the head emerges entirely (left) the physician turns the babys shoulders (right), which emerge one at a time with the next contractions. The rest of the body then slides out relatively easily, and the umbilical cord is sealed and cut. 3rd - StageThe placentaLasts for 2 minutes or half an hour.Contractions help the placenta separate from the wall of the uterus. The placenta is soft and comes away easily. The birth process is complete after the placenta.

Other Types of Delivery Cesarean section: a small incision made in the lower abdomen and uterus where the baby is deliveredEpidural:a type of block used to deaden pain during labor and delivery mom can still push and participate in the laborNatural childbirth: no medications, relax the body by using breathing techniquesLeboyer method: gentle childbirth reduce the pain and shock of delivery quiet delivery room, dim lights, soft music playingCrouching method: squatting down and letting gravity help deliver the baby. less chance of tearing used in more primitive societiesBirth in water: becoming more popular water helps mom relax and softens the shock of deliver for momHome delivery:still common use of midwife to help deliver the baby mom can be relaxed because she is at home with her family only to be used for low risk pregnancies

Prolapsed cordPoor presentationMother too smallBaby too bigPlacenta praeviaPlacenta abruptionFetal distressMother or child cannot tolerate laborSTDsPrevious C-sectionToxemiaWhy a C-Section?Cesarean BirthsAbout 22% of children born in the US are by C-section. Names after Julius Caesar.Why have a C-sectionMothers pelvis is too smallBaby or mother at medical riskBabys head is too largeBaby is in an incorrect positionPrevious C-section scars could rupture

Anesthesia

Mostwomenprefersome kind of anesthesia.Natural (unmedicated) childbirth is becoming more popular because the anesthesia can make the newborn baby less alert after birth.An epidural is given in the spinal sheath and deadens the patient from the waist down. A saddle block deadens the area where you ride a saddle.A paracervical block, also known as a cervical block deadens the cervix.A pudendal block is given in the pudendal nerve and will numb the whole bottom and legs.The cervix must dilate to some degree before any anesthesia is given. For this reason, a mother needs to learn some breathing and relaxation techniques.The Newborn at BirthThe babys lungs are filled with fluid. The pressure of being squeezed down the birth canal forces much of the fluid out. When the baby finally emerges, the pressure is released and the babys lungs automatically expand. Taking their first breath.The umbilical cord is cut; within a few minutes the cord stops pulsing and begins to shrink. It is clamped, tied, and cut off.Newborns have a unique appearance.Heads are large and wobbly, accounts for of entire length. May be lopsided or pointed from the passage. Fontanels open space where the bones of the babys skull have not yet permanently joined. soft spotFat cheeks; a short, flat nose; and a receding chin. Eyes are nearly adult-sized. Usually dark grayish-blue the permanent eye color becomes apparent within several months.Dusky color, improves after breathing.Babys are covered in a rich, creamy substance called vernix.Many babies have tiny white bumps scattered over their nose and cheeks, called milia or baby acne. Will disappear in a week or two.

Examining the NewbornApgar Scale, a method of evaluating a newborns physical condition. the infant is given a rating from 0 to 2 in each of these five areas:PulseBreathingMuscle toneReflex to stimulationSkin colorA total score of 6 to 10 is considered normal. A lower score is a sign that the baby needs special attention. Usually given one minute after birth and then again at five minutes after birth. With in 60 minutes of delivery, antiseptic ointment are put into the babys eyes to guard against infection. The baby is weighed, measured, and cleaned up. A permanent copy of the babys footprint. Identification bandsThe Postnatal PeriodBonding and AttachmentBonding the process of forming lifelong emotional ties. Breast-feeding: the first breast milk, is called colostrum. It is easy for the newborn to digest and rich in antibodies to protect against disease. Sometimes thick in consistency; it may be clear or yellow in color.

Birth CertificateIssued free of charge after the baby is born.Simple process, fill out the form provided by the hospital.Considered the most important piece of personal identification anyone has.

Premature BabiesBorn before prenatal development is complete. Weight is less than 5 pounds or born before 36 weeks. Occurs between 8 & 10% of all pregnanciesUsually placed in an incubator a special enclosed crib in which the oxygen supply, temperature and humidity can be closely controlled. Heart and lungs are electronically monitored. They may have health problems because their organs did not have enough time to develop, more likely to have jaundice and breathing problems.Jaundice - a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells. Jaundice can be a symptom of other health problems.Postnatal CarePostpartum Care the care mother receives during the six to eight weeks following the birth. On average a women loses 11 pounds during birth and another 7 pounds during the few weeks after birth. Physical NeedsRestExerciseNutritionMedical checkupPostpartum Mood Disorders very common affecting 15 to 25% of all people. EmotionsStress baby blues unsure why they occur but are very common. A mild postpartum mood disorder.Postpartum depression serious for of depression.Try to take some time away from the baby for short periodsA new Family MemberThe Amazing NewbornReflexesInstinctive, automatic responses, such as sneezing and yawning. Three of a newborns temporary reflexes are the rooting reflex, the grasp reflex, and the startle reflex.RootingAutomatic response, when touched on lips or cheek, of turning toward the touch and beginning to suck. Helps baby find foodGraspAutomatic response of a newborns hand to close over anything that comes in contact with the palm. At 3 months the baby beings to reach for objects.StartleAutomatic physical response legs thrown up, fingers spread, arms extended and then brought rapidly back to the midline while the fingers close in a grasping action to a loud noise or to a touch on the stomach. Care for newbornsWhat do babies need?Food- crying is the most effective way for a newborn to signal hunger. They want food immediately and it is important to give it to them. This helps babies learn to trust the world.Sleep wake at night between one and three times for feeding. A newborn sleeps on average of 15 hours a day, typically in six to eight separate periods. Exercise waving their arms and legs, this helps their muscles and nervous system develop. Safe, clean and warm diapering and bathing, watchful eye while awake, keep harmful objects away.Medical care Things to look at, touch, listen to, and play with stimulating surroundings to help them learn. Love

What do Parents Need?Knowledge of how to care for an infant.Resources to turn to for answers to their questions.Information about normal occurrences and emotions they experienceTime to fill their many rolesEmotional supportFinancial planningReassurance and confidenceAgreement about parenting and household responsibilitiesPersonal health, rest, nutritionPrivacy and time alone.Understanding baby languageHunger is the #1 reason babies cry. Hot or coldLying in an uncomfortable positionFatigue LonelinessNo reason at all

Early TemperamentTemperament style of reacting to the world and of relating to others.Be sensitive to the babys own style, babys also learn to adapt to a parents style.