Birth and the Newborn Baby Truth or Fiction

Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Chapter 4 Birth and the Newborn Baby: In the New World Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Countdown… The Stages of Childbirth Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Events Occur just prior to the Beginning of Childbirth? • Dropping or Lightening – Head of fetus settles in pelvis • Braxton-Hicks contractions – First uterine contractions may be experienced as early as 6th month • Blood spotting in vaginal secretions – Day or so before labor • Rush of amniotic fluid from vagina – Occurs in 1 woman in 10 Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Events Occur just prior to the Beginning of Childbirth? • Beginning of labor may be signaled by indigestion, diarrhea, ache in small or back, and abdominal cramps • Placenta and uterus secretes prostaglandins – excite uterus muscles causing contractions • As labor progresses, oxytocin is released – stimulates contractions powerful enough to expel the fetus Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Happens during the First Stage of Childbirth? • • • • Uterine contractions efface and dilate cervix First stage lasts from a few hours to more than a day Contractions increase in strength, frequency, and regularity Mother may be prepped – Shaving pubic hair – Administer enema Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Happens during the First Stage of Childbirth? • Fetal monitoring – Measure fetal heart rate and mother’s contractions • If necessary to speed up delivery, forceps or vacuum extraction tube may be used • Transition (about 30 minutes) – Cervix is nearly fully dilated – Head of fetus moves into vagina – Frequent and strong contractions Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Figure 4.1 The Stages of Childbirth Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Happens during the Second Stage of Childbirth? • • • • Begins when baby appears at opening of birth canal Ends with birth of baby Baby’s head crowned when it begins to emerge from birth canal Episiotomy may be performed once crowning takes place – Used to prevent tearing of mother – Controversial and used less frequently Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Happens during the Second Stage of Childbirth? • Once baby’s head emerges from mother, mucus is suctioned from the baby’s mouth – Clears passageway for breathing • Umbilical cord is clamped and severed • Newborn may be removed – – – – Baby is footprinted ID bracelet is put on baby Antibiotic ointment or drops are applied to baby’s eyes Baby receives Vitamin K injection Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Happens during the Third Stage of Childbirth? • • • • Also referred to as the placenta stage Lasts minutes to an hour or more Placenta separates from the wall of uterus and is expelled Obstetrician sews episiotomy, if performed Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Methods of Childbirth Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 How is Anesthesia Used in Childbirth? • General anesthesia – Puts mother to sleep • Negative effects of general anesthesia – Abnormal patterns of sleep and wakefulness – Decreased attention and social responsiveness for at least 6 weeks • Local anesthetics – Deadens pain without putting mother to sleep – Minor depressive effects on neonates shortly after birth Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What is Prepared Childbirth? • Lamaze method – Utilize breathing and relaxation exercises to lessen fear and pain – Teaches women to associate relaxation with contractions • Coach – Aids the mother in the delivery room – Provides social support to mother during labor • Doula – Experienced female companion provides continuous emotional support during labor – Fewer cesarean deliveries, less anesthesia, and shorter, less painful labors Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What is the C-section? • Cesarean Section – Delivered by abdominal surgery • Physicians prefer C-section to vaginal delivery – – – – Mother’s small pelvis Maternal weakness or fatigue Baby is too large Baby is in distress • May be used to bypass infections in birth canal from HIV or Herpes Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 How Can a Woman Decide to Deliver Her Baby? • Diversity of birthing options • All-in-one labor, delivery, recovery, and postpartum rooms (LDRPs) – Birthing suite in hospital equipped for uncomplicated birth – Easy access to emergency facilities if needed • Home Birth – Can be fairly safe for healthy women with little risk of complications Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Birth Problems Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What are the Effects of Oxygen Deprivation at Birth? • Hypoxia - Prenatal oxygen deprivation – can impair development of central nervous system and psychological disorders • Anoxia - Oxygen deprived at birth – predicted problems in learning and memory – can cause health problems such as early-onset schizophrenia and cerebral palsy Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What is Meant by the Terms Prematurity and Low Birth Weight? • Premature or preterm baby – Occurs before 37 weeks gestation (normal is 40 weeks) • Low-birth-weight baby – Weighs less than 5.5 pounds • Small for date – Low-birth-weight, although born at full term Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Risks are Connected with being Born Prematurely or Low in Birth Weight? • Infant mortality – Neonates weighing 3.25 to 5.5 pounds are 7 times more likely to die than infants of normal weight – Those weighing less than 3.3 pounds are nearly 100 times as likely to die • Delayed neurological development – Lower birth weight – poorer performance throughout school years • Delayed motor development, such as walking • Preschool experience fosters cognitive and social development Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Signs are Connected with being Born Prematurely or Low in Birth Weight? • Preterm babies show signs of immaturity – relatively thin – fine, downy hair (lanugo) – oily, white substance on skin (vernix) • Preterms born six weeks or more prior to full term – nipples not yet be emerged – testicles of boys not yet descended into scrotum • Muscles immature and reflexes are weak • Respiratory distress syndrome – walls of air sacs in lungs stick together Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 How are Preterm Infants Treated Following Birth? • Usually remain in hospital incubators – Temperature-controlled environment with protection from infection • Parents often do not treat preterms as well as full term – Less attractive than full-term babies – High-pitched, grating cries – More irritable • Preterms and parent interaction is less even when they are brought home Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 How are Preterm Infants Treated Following Birth? • Interventions for preterm infants – Benefit from external stimulation – Massage – Kangaroo care • Preterm infants exposed to stimulation – Gain weight more rapidly – Show fewer respiratory problems – Make greater advances in motor, intellectual, and neurological development than controls Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Developing in a World of Diversity Maternal Mortality and Infant Mortality Around the World Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 The Postpartum Period Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Kinds of Problems in Mood do Women Experience during Postpartum Period? • Baby blues – Transient – about 10 days • Postpartum depression (PPD) – Begins one month after delivery and may linger for weeks/months – Major depressive disorder – Psychotic features Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 How Critical is Parental Interaction with Neonates in the Formation of Bonds of Attachment? • Bonding – Formation of bonds of attachment between parent and child – Essential to survival and well being of child • “Maternal sensitive” period – Amount of access to newborn (Klaus & Kennell, 1978) – Extended early contact is not essential for adequate bonding Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Characteristics of Neonates Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 How do Health Professionals Assess the Health of Neonates? • Apgar scale – Based on five signs of health – Interpretation of scores • 7 or above – no danger • below 4 – critical condition • Brazelton Neonatal Behavioral Assessment Scale – Based on four areas of behaviors – Measures reflexes, motor behavior and muscle tone Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What are Reflexes? • Reflexes – Simple, unlearned stereotypical responses, elicited by certain types of stimulation – Survival value – Neural functioning is determined by testing reflex Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Kinds of Reflexes are Shown by Neonates? • Rooting – Baby turns head and mouth toward stimulus that strokes the cheek, chin, or corner of mouth – Facilities finding mother’s nipple for sucking • Sucking – Babies will suck almost any object that touches the lips – Will become replaced by voluntary sucking Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Kinds of Reflexes are Shown by Neonates? • Moro or startle reflex – Back arches, legs and arms are flung out and then brought back toward chest into a hugging motion – Occurs when baby’s position is suddenly changes or health and neck support is lost – Elicited by loud noises or bumping baby – Usually lost 6 to 7 months after birth Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Kinds of Reflexes are Shown by Neonates? • Grasping or palmar reflex – Using four fingers, babies grasp fingers/objects pressed against the palms of their hands – Most babies can support their own weight – Usually lost by 3 to 4 months – Replaced by voluntary grasping at 5 to 6 months Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Kinds of Reflexes are Shown by Neonates? • Stepping reflex – Mimic walk when held under arms – Usually disappears by 3 or 4 months Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Kinds of Reflexes are Shown by Neonates? • Babinski reflex – Fans or spreads toes in response to stroking foot – Usually disappears at end of first year • Tonic-neck reflex – While lying on back, baby turns head to one side. Arm and leg on that side extend, while opposite side flex. Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Vision • Visual acuity – – – – Estimate of 20/600 Best see objects 7 to 9 inches from eyes Lack peripheral vision of older child Able to track movement within one day of birth • preference for moving objects Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 A Closer Look Studying Visual Acuity in Neonates: How Well Can They See? Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Vision • Visual accommodation – Self-adjustments made by eye lens to bring objects into focus – Neonates show little or no visual accommodation • Focus on objects 7 to 9 inches away • Convergence – Does not occur until 7 or 8 weeks Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Hearing • • • • Fetuses respond to sound Neonates respond to amplitude and pitch Show preference for mothers’ voice Responsive to sounds and rhythms of speech – Show no preference for specific languages Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Smell and Taste • Smell – Well developed at birth – Demonstrate aversion for noxious and preference for pleasant odors – Recognize familiar odors • Taste – Sensitive to different tastes – Demonstrate facial expressions to basic tastes – Prefer sweet tastes Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Touch and Pain • Touch – Sensitive to touch – Touch elicits many reflex behaviors • Pain – Less sensitive to pain Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Learning Or Really Early Childhood “Education” Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Can Neonates Learn? • Classical Conditioning – Involuntary responses are conditioned to a new stimuli • Operant Conditioning – Behavior (reflexes) are modified through reinforcement Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Patterns of Sleep are Found among Neonates? • Neonates spend about 16 hours per day in sleep – Typical infants has six cycles of waking and sleeping • REM Sleep – Neonates spend 50% time in REM sleep – Decreases in percentage of REM • 6 months – 30% • 2 to 3 years – 20 to 25% • NREM Sleep Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Figure 4.15 REM Sleep and Non-REM Sleep Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 Why do Babies Cry? • Pain and discomfort • Universal, expressive and functional communication – expressive response to unpleasant feelings – stimulates caregiver response • Distinct causes and patterns of cries – Hunger, anger, pain – Peaks of crying in late afternoon and early evening • Crying produces physiological response in others Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What Can I do to Stop an Infant from Crying? • Sucking serves as a built-in tranquilizer – Pacifier, sweet solutions • Soothing processes – Pick baby up, patting, caressing, rocking them – Speaking to them in low voice Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What is SIDS? • Sudden Infant Death Syndrome – crib death – Strikes while the baby is sleeping – Most common cause of death in infants between 1 and 12 months – Most likely to occur between 2 and 5 months • Period when reflexive behavior is weakening – Causes of SIDS remains obscure Childhood and Adolescence: Voyages in Development, Second Edition, Spencer A. Rathus Chapter 4 What are the Risk Factors for SIDS? • SIDS is most common among – – – – – – – – babies aged 2 to 4 months babies put to sleep on their stomach premature and low-birth-weight babies males lower SES African Americans babies of teenage mothers babies of mothers who smoked or used narcotics during pregnancy