Chapter 4 Birth And The Newborn Baby

Front 1

Stages of Childbirth

Back 1

Three stages of childbirth.

Front 2

First Stage

Back 2

Before actual birth.

Front 3

Uterine contractions

Back 3

Uterine contractions efface and dilate the cervix. Passageway needs to widen to about 4 inches to allow baby to pass. Women advised to go to hospital when contractions are 4 to 5 minutes apart.

Front 4

"Prep"

Back 4

Women are to be "prepped" if her pubic hair needs to be shaved to avoid infection during delivery and to facilitate performance of episotomy.

Front 5

Episotomy

Back 5

When an incision is made between the birth canal and anus to avoid random tearing when fetus is moving through.

Front 6

Fetal monitoring

Back 6

Fetal monitoring may be used. Electronic sensing device strapped around women's abdomen to measure fetal heart rate and mother's contractions.

Front 7

Transition

Back 7

Transition (30 min) - when cervix is almost fully dilated, head of fetus begins to move into vagina, or birth canal. Contractions usually frequent and strong.

Front 8

Second Stage

Back 8

-May last minutes or few hours.

-Contractions of second stage stretch skin and push baby farther along.

-Crowning occurs when head begins to emerge from birth canal. Once crowning occurs baby normally emerges.

-Episotomy may take place.

- Doctor may adjust child's shoulders to avoid tearing or dislocated shoulders.

-When baby is taken out, baby's nose and mouth are suctioned.

- Belly button is cut

Front 9

Third Stage

Back 9

-As contractions continue the placenta is ejected.

-Placenta is examined; if there is a tear, the mother's uteran wall is ruptured

-Sew episotomy up

-Need normal bowel movements to be discharged.

Front 10

Assessing neonatal health

Back 10

APGAR scale, Brazelton Neonatal Behavioral Assessment Scale

Front 11

APGAR Scale

Back 11

A-Appearance

P-Pulse or heart rate

G-Grimace (reflex irritability)

A-Activity of muscle tone (clench fist,etc)

R-Respiration - if baby can breathe right

Front 12

Brazelton Neonatal Behavioral Assessment Scale

Back 12

Evaluate neurological problems.

Babinski reflex -

Front 13

Reflexes

Back 13

Many reflexes are natural

Front 14

Neural

Back 14

neural relations like nervous system

Front 15

Rooting reflex

Back 15

When you stimulate anything near baby's mouth the baby will go towards it.

Front 16

Moro reflex

Back 16

Baby frails arms and legs when they hearing something sudden

Front 17

Grasping reflex

Back 17

When you touch palm or put something in front of baby and baby grasps it. Once they are aware of motion, grasping becomes voluntary.

Front 18

Stepping reflex

Back 18

Baby will mimic walking when you hold them

Front 19

Babinski reflex

Back 19

Baby opens toes up when its touched. Later on baby curls toes inward.

Front 20

Tonic-neck reflex

Back 20

When you lay baby flat, face facing left, the baby's left arm sticks out in same direction

Front 21

Senses of Neonates

Back 21

Vision - can see objects that are 7 to 9 inches away from their eyes. Prefer movement rather than stationary things.

Hearing - Can respond to sound months before they are born although myelination of auditory pathways is not complete, middle and inner ears normally reach mature shape and size before they are born.

Smell - Can discriminate distinct odors.

Taste - Can taste but are sensitive to diff tastes.

Touch and pain - Sensitive to touch. Not cognitively equipped to react to pain but can shriek if they've experienced it before.