CHAPTER 3: Birthing and Newborns

CHAPTER 3: Birthing and Newborns

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This chapter focuses on birthing, including the onset and stages of labor, factors that influence labor, delivery methods, as well as complications that can occur during the process. It discusses the transitions that occur for parents and newborns during the first month, including the newborn’s physical, motor, sensory, cognitive, social, and emotional development and issues affecting premature and at-risk newborns.

Learning Objectives

After reading this chapter, you should be able to:

· Highlight the labor and delivery process from onset to delivery.

· Discuss various delivery methods and childbirth practices.

· Review possible complications that can occur during childbirth.

· Review the changes that occur for parents as they transition to caregivers during the first month after birth.

· Describe the newborn and his senses, reflexes, and states of arousal.

· Discuss the changes that infants experience in terms of physical, motor, sensory, motor, cognitive, social, and emotional development.

· Describe the differences and complications affecting newborns who are at risk.

Key Terms and Concepts

Abruptio placenta is the separation of the placenta from where it is implanted in the uterine wall before the delivery of the baby.

Apgar scale is a simple, clear classification for newborns with five areas—heart rate, respiratory effort, reflex irritability, muscle tone, and color

Apnea is a pause in breathing for up to 20 seconds.

Behavioral states describe levels of consciousness that range from quiet sleep to active crying.

Bilirubin is a product of the breakdown of the hemoglobin in red blood cells.

Birth weight is the weight of a newborn. It is used in determining neonatal risk.

Bradycardia is a drop in heart rate to below 80 to 100 beats per minute.

Cesarean section is the delivery of the fetus through an incision in the abdominal wall and uterus.

Colic is a condition in newborns indicated by a high-pitched cry accompanied by grimacing, clenched fists, knees that are either pulled up or rigid and extended, the passing of gas, and inconsolable crying. A colicky baby cries for more than three hours a day, for three days a week, for three weeks during the first three months of life.

Contractions are the movements of the muscles in the wall of the uterus that push the fetus through the birth canal.

Engagement is when the largest part of the fetal head has passed through the mother’s pelvic rim and into the true pelvis.

Extremely low birth weight is when newborns weigh less than 1,500 grams (about 3 1/3 pounds).

Fetal distress occurs when the fetus is not getting oxygen or is experiencing some other complications.

First stage of labor begins with contractions and ends when the cervix is dilated and effaced.

Habituation is a form of learning where the infant quits responding after repeated exposure to a stimulus.

Intensive care nurseries are designed for high-volume, short-term acute care of newborns. They focus on medical concerns and are used in specially designated hospitals with highly trained staff (neonatologists and neonatal nurses) and very advanced technological equipment.

Intraventricular hemorrhage (IVH) is bleeding into or near the normal fluid spaces (ventricles) of the brain.

Labor is the process of regular uterine contractions that result in child birth.

Lactation is the process of secreting milk from the mammary glands to feed infants.

Low birth weight is when newborns weigh less than 2,500 grams (or about 5½ pounds).

Neonatal Behavioral Assessment Scale is designed to provide an assessment of the neonate’s neurological responses and behavioral repertoire. It evaluates the infant’s potential for self-organization and his ability to control the state of arousal (alertness) as a response to the environment.

Neonatal jaundice is an excess of bilirubin, which causes a yellow coloration of the skin and whites of the eyes of newborns.

Neonate is the designation for the newborn for the first 28 days of life.

Placenta previa is a condition where the placenta is implanted low in the uterine wall near or over the opening to the birth canal.

Postpartum blues are short-term mood swings that are caused by hormonal fluctuations after childbirth.

Postpartum depression (PPD) is a major form of depression that occurs following childbirth.

Postural reactions help the infant keep his head upright and later to extend his arms to provide some protection when falling.

Preterm infants are born before 37 weeks gestational age.

Preterm delivery occurs before 37 weeks.

Primitive reflexes are inborn behavior patterns that develop during uterine life, are present at birth, and have survival value.

Reflexes are involuntary specific muscular responses to sensory stimuli.

Second stage of labor begins when the cervix is dilated and effaced and ends with the birth of the infant.

Sensory development is the development of senses of hearing, seeing, feeling, smelling, and tasting.

Supine is lying on the back with the face upward.

Surfactant is a chemical that keeps the air sacs in the lungs open during breathing.

Term is the average length of a pregnancy (40 weeks). An infant born between 37 and 42 weeks is considered to be born at term.

Third stage of labor is the expulsion of the placenta.

Transition to parenthood is the change involved in becoming a parent, characterized by a lot of adjustments to make and challenges to deal with.

Vaginal delivery is when a baby is delivered by passing though the birth canal.

Very low birth weight is when newborns weigh less than 1,500 grams (about 3 1/3 pounds).

Chapter Outline

Labor and Delivery

Birthing Patterns

Transition from the Womb

Newborns

Newborn Assessment

Newborns at Risk

Newborn Senses

Newborn Development

Transition to Parenthood