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Birth

Birth. Labor. Labor Signals WHAT IS THE FIRST EVENT THAT SIGNALS LABOR IS COMING??? Onset First event: engagement/lightening Baby “drops” (head down, feet up position) ~ 3 weeks prior to delivery Braxton-Hicks contractions Preliminary contractions, “practice”

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Birth

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  1. Birth

  2. Labor • Labor Signals WHAT IS THE FIRST EVENT THAT SIGNALS LABOR IS COMING??? • Onset • First event: engagement/lightening • Baby “drops” (head down, feet up position) • ~ 3 weeks prior to delivery • Braxton-Hicks contractions • Preliminary contractions, “practice” • Usually not consistent, not very strong

  3. Labor WHAT TRIGGERS THE ONSET OF LABOR?? • Maturation of the infant’s lungs sends a signal to infant endocrine system • hormone cascade • Endocrine change signals an estrogen surge in the mother • Contractions and dilation of the cervix • cramps, back pain, gas • Irregular (about 15 minutes apart) • Eventually regularly spaced, close together, & stronger • Mucus plug is dislodged • Water breaks (caused by the infant’s head) • Forced delivery within 24 hours

  4. Labor • 1st Stage (most of labor) • purpose: to dilate the cervix • Contractions • Increased intensity and frequency • ~5 min apart • Transition (usually lasts 1-2 hours) (pushing babies head) • intense contractions (2 min apart, 90s long) • vaginal opening is fully dilated (10 cm) Medicated delivery?

  5. Labor • 2nd Stage (30-90 minutes, purpose is to expel the baby) • Urge to push (hard not to push) • Baby started labor in head down sideways position • During this phase, baby rotates, looking at mothers spinal chord • Head crowns, pushed out, one shoulder, then the other- BIRTH!!! • 3rd Stage (very short duration -5-10 minutes) • Delivery of placenta (afterbirth)

  6. Stress? • Stress of delivery (good or bad???) • During delivery, high levels of adrenaline and noradrenaline • clears lungs of fluid • sends blood to heart and brain • sends stored fuel to cells • increases alertness in infant

  7. Prepared Child Birth • Birth Plan- Discuss with doctor, sig other, birth coach • Who do you want to deliver the baby? (Dr? Midwife?) • Where do you want to have the baby? (home, hospital, birth center) • Who do you want to be present? (Sig oth? Doctor? Other children?) • What medications (if any) and when do you want them?

  8. Prepared Childbirth • Lamaze • Information • knowledge reduces fear • Breathing technique • Different types of breathing depending on stage of labor • Visual distraction • Establish something to focus on (like meditation) • Conditioned relaxation • Use breathing and visual distraction to learn to relax during contractions • Support (coaching) • Usually the father • Often significant female friend

  9. Prepared Childbirth • Fathers in the delivery room • Now the norm in western culture • Began in mid 70s • Pregnancy is mom’s job- having dad there helps keep him in the loop • Different experience of child’s birth • Doula • Usually experienced mother • Often trained in massage techniques- relaxation • Benefits • less anesthesia • fewer instruments/ surgical deliveries

  10. Prepared Childbirth • Outcomes with prepared childbirth • Experience less pain • Take less pain medication • Lower rates of assisted delivery (instruments, surgery) • More positive attitude about birth • Father feels more part of the process

  11. Prepared Childbirth • Medicated delivery • Primary Benefit: less pain, but only at the end of labor. • Drugs cross placenta to infant • Weakens contractions- Why is this not good? • Infant responses • less active alertness • slowed social response • poor motor control • Mother-infant bonding • infant slow response • mothers felt different QUESTION: IS that due to medicated delivery or mom’s who chose non-medicated delivery were different with respect to their attitudes regarding infants, mothering, etc

  12. Prepared Childbirth • C-section • Many of the same issues as medicated delivery • Bypass stress response hormones • So tend to see: • more fluid in lungs • lower heart rate, slower circulatory flow throughout body • decreased alertness than infants born vaginally • Solution: wait for labor to get process going, then C-Sec

  13. Assessment • APGAR (@1 and 5 minutes) 5 items, 0-2 pt scale • Heart rate (over 100) • Respiration (regular, infant crying) • Muscle tone (strong, active motion • Color (pink overall, not blue or grey) • Reflexive activity (cries, coughs, sneezes, blinks) • If 5 or less at 5 minutes we are concerned

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