Birth

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Story

Choosing a delivery system.

Birth is a travelogue, a mystery and a grand entrance. As the fetus exits the womb, it travels from the uterus, through the narrow passage of the cervix, down through the vagina, turns it’s head to one side to corkscrew through the pelvic circle of bones, up toward the sky and turns it’s head again to right itself. Congratulations! You made it into the world.

Here’s what is included in this lesson:

• Reflexes
• Birthing options
• Delivery process
• Delivery complications

Mind Map

Notes

• Prenatal Development
  • Prenatal Vulnerabilities
    • teratogen = causes prenatal damage
  • Teratogens
    • Environmental factor
    • Interfere with development
    • Medication & drugs
    • Substance
    • Disease
  • Harm depends on:
    • Interaction w other factors
    • Age of prenatal organism
    • Genetic predisposition
    • Dose
    • Sensitive period
      • Especially vulnerable
    • Critical period
      • Damage has big impact
      • Can be used interchangeably
• Critical Periods
  • 1. Implantation
    • 10 to14 days after conception
    • Have common blood supply
    • Whatever’s in mom’s blood crosses
  • 2. Week 3.5 to 4.5
    • Closure of the neural tube
    • Central nervous system vulnerable throughout pregnancy
  • 3. Central nervous system
    • Vulnerable throughout pregnancy
• Major Teratogens
  • Folate Deficiency
    • Lack of folic acid
    • Neural tube defects
    • Slow growth rate
    • Premature
  • Poisons
  • Radiation
  • Mercury
  • Lead
  • PCBs (polychlorinated biphenyl)
    • Coolants
  • Bacterial & Parasitic Diseases
    • Toxoplasmosis
    • Cats
  • Viruses
    • Acquired immune deficiency syndrome (AIDS)
    • Rubella (German measles)
    • Varicella (chickenpox)
      • Highly infectious disease
        • 95% of Americans have had it
        • 90% of pregnant women immune
        • 1 out of 2,000 develop during pregnancy
      • A. If in pregnancy (week 1-20)
        • 2% chance of defects
        • Congenital varicella syndrome
        • Scars
        • Malformed and paralyzed limbs
      • B. Newborn period
        • 5 days before to 2 after birth
        • About 25 % newborns become infected
        • About 30% of infected babies will die if not treated
• Parental Use Of:
  • Over The Counter Drugs
    • Aspirin
      • If used repeatedly
      • Death near birth
      • Low birth weight
      • Poor motor development
      • Lower IQ
    • Caffeine
      • 3 cups of coffee day
      • Low birth weight
      • Prematurity
      • Miscarriage
      • Newborn withdrawal symptoms
    • Smoking during pregnancy
      • Impaired breathing w. sleep
      • Cancer later in childhood
      • Infant death
      • Low birth weight
      • Prematurity
      • Miscarriage
    • Alcohol
      • Infant brains are especially sensitive to alcohol
      • Suppress release of glutamate
        • brain’s main excitatory
        • neurons receive less excitation and undergo apoptosis
      • Breaks down more slowly
        • levels remain high longer
        • immature liver
      • Worse if born to alcoholic mom
        • drink 4-5+ drinks/day
      • No amount of alcohol is safe
    • Fetal alcohol syndrome
      • Best known non-genetic cause of mental retardation (brain damage)
      • (3 in 1,000)
      • Impaired motor coordination
      • Facial abnormalities
      • Heat defects
      • ADHD
  • Prescription Drugs
    • Thalidomide
      • Anti-nausea & sedative
      • Used in 1960’s
      • Severe limb deformations
      • Sensitive period: Week 4-6
    • Phenytoin (or Dilantin)
      • Anti-convulsive (anti-seizure)
      • Used to treat epilepsy
      • 10% chance of birth defects
      • If taken in the first trimester
    • Antidepressant drugs
      • heart problems
  • Psychoactive Drugs
    • Cocaine
      • Impacts
        • Mother’s egg
        • Father’s sperm
        • Prenatal environment
      • Deformed heart, genital, kidney
      • Brain hemorrhages & seizures
      • Born drug-addicted
      • Crack worst:
        • low birth weight
      • CNS damage
      • “Crack baby”
    • Marijuana
      • Low birth weight
      • Mixed finding
  • Semi-Teratogen
    • Contributing factors
    • # of previous births
    • RH incompatibility
    • Emotional Stress
    • Maternal age
    • Nutrition
• Stages of Childbirth
  • Pre-Stage
    • Lightening
    • Fetus “drops” into pelvis
    • Bloody show
      • Small amount of bloody-mucus
    • Water breaks
      • Membrane of amniotic sac
      • Amniotic fluid
      • Feels like pop, trickle or gush
      • 400 ml (14 ounces)
  • Stage 1
    • Dilation & Cervical Effacement
      • 1st child 12-14 hours
      • 2nd child+ 4-6 hours
    • Cervix dilation & effacement
      • Starting at 3-4 cm
      • Full dilation = 10 cm
      • Fetus head = ~10 cm
    • Contraction
      • Uterine muscles
      • Upper to lower uterus
      • Shorten upper segment
      • Draw lower segment upward
  • Stage 2
    • Cervix is fully dilated
    • Ends when the baby is born
    • Timing
      • 1st child 50 minutes
      • 2nd child+ 20 minutes
    • Cervix pressure increases
    • Ferguson reflex
    • Increased uterine contractions
    • Head is fully engaged in pelvis
    • Head goes below pubic arch
    • Mother “bears down” or pushing
    • Head is down but sideways
    • Head turns face down
    • Baby moves
      • down under pelvis bone
      • then up
    • Crowning
      • Intense stretching & burning
      • See the head
    • Helping you out
      • Forceps
      • Vacuum
  • Stage 3
    • After birth before placenta
    • 10-12 minutes
    • 30+ minutes, worry
    • Separates from uterine wall
    • Clamp umbilical cord
      • 1-5 minutes
      • Shorter decreases anemia risk
      • Longer increases jaundice risk
      • Cutting is painless (no nerves)
    • Active management
      • Uterotonic drug
      • 1 min after delivery
      • Prevents postpartum hemorrhage
  • Stage 4
    • Birth to 6 weeks old
    • Postpartum period
    • AKA, puerperium
• Initiation Rites
  • Naming ceremonies
  • Eat the placenta
  • Maternal leave
  • Circumcision
  • Baptism
• Expectations
• Reality
  • Misshaped head
  • Wrinkled
  • Purple
  • Needy
  • Molding
    • As through birth canal
    • Head becomes more elongated
    • Worse in 1st child
• Birthing Options
  • Unassisted Birth
    • No professionals present
  • Partner, mother, grandparents
  • Mother & Partner Birth
  • Solo Birth
• Delivery
  • Vertex Delivery
  • Six phases of head-first delivery
    • 1. Head facing sideways
    • 2. Descent & flexing of head
    • 3. Head rotation 90-degrees
      • Face mother’s rectum
    • 4. Head extends out birth canal
      • Head tilts forward
      • Crown of head leads way
    • 5. Restitution
      • Head turn 45-degrees
      • Restore relationship w shoulders (which are angled)
    • 6. External rotation
      • Shoulders follow head; corkscrew movement
  • Water Birth
    • Reduce need for analgesia
    • Warm water tubs
    • Available in hospitals & birthing centers
• Delivery en caul
  • Born with amniotic sac in tact
  • Membranes are easily broken
  • Wiped away
  • Rare
  • Doctor breaks sac before birth
• Induction
  • Distance from hospital
  • Oxytocin: induce uterine contractions
• Vaginal Birth
  • Large head compared to pelvis
  • Not always possible
• Cesarean section
  • Indicated if:
    • maternal HIV/AIDS
    • medical conditions
    • fetal abnormality
    • breech position
    • fetal distress

Terms

• 200 words  & walking
• 4000 words & share
• accommodation = Piaget, adding to schema categories
• adaptation = adjusting to environment
• all-nothing
• arousal
• assimilation = Piaget, adding information to current schema
• attention
• autobiographical memory = episodic memory, what you did on summer vacation
• babbling = repetitive consonant sounds, goes with sitting up, 6 months
• Babinski’s reflex
• Bauer’s reflex
• central executive = cognitive process that coordinates all mental activity
• child-directed speech (CDS) = parents give clear, exaggerated speech, helps learn language
• circular reaction = repeat event on purpose, drop bottle accidently, do again on purpose
• cognition
• color vision
• consciousness
• contrast & complexity
• cooing = first language-like sounds, goes with rolling over, 3 months old
• core knowledge perspective = hypothetical innate knowledge systems
• crawl & say “dada”
• curves & patterns
• deferred imitation = can recall & model behavior of model not there
• developmental quotient (DQ) = infant intelligence tests, unreliable
• developmentally appropriate practice = guidelines of proper child care services
• doll eyes
• expressive style of language = use language to talk about feelings
• faces
• fencing reflex
• grasping reflex
• habituation
• hallmarks
• Home Observation for Measurement of the Environment (HOME) = checklist for home eval.
• imprinting
• inattention blindness
• infant perception
• infantile amnesia = inability to recall pre-verbal phase of life
• infantile reflexes
• intelligence quotient (IQ) = widely used predictor of school success
• intentional behavior (goal-directed) = reaching-touching, solving simple problems
• irreversible coma
• joint attention = child & parent attend to same object
• language acquisition device (LAD) = hypothetical innate language processor
• laugh out loud
• life-long reflexes
• long-term memory = unknown capacity, less permanent than thought
• Lorenz, Konrad
• make-believe play = act out scenes, dress up, pretend cooking, being a monkey
• mental representation = internal symbols that can be manipulated
• mental strategies = well-practiced plans of how to achieve goals
• Moro reflex
• normal distribution = symmetrical distribution of population scores, chance
• object permanence = Piaget, learning out of sight is not out of existence
• organization = Piaget, development of cognitive representations
• overextension = using Dog for all animals
• parachute reflex
• perception
• prune sounds
• recall = recollection from a cue; listing items
• recognition = selecting from available choices; multiple choice items
• referential style of language = use language to get objects
• reflexes
• reticular formation
• rollover & coo
• rooting reflex
• scheme = Piaget, mental representation
• sensorimotor stage = Piaget’s 1st stage of development, coordination of motor skills
• sensory register = separate buffers for vision and hearing, disappears if not attended to
• sit up & babble
• sleep thru night
• stand up & single words
• standardization = basing test interpretation on the normal curve
• startle response
• stepping reflex
• sucking reflex
• telegraphic speech
• underextension = use Dog for family pet but not other dogs
• vestibulo-ocular reflex (VOR)
• violation-of-expectation method = facial expressions as dependent variable to surprise stimuli
• visual acuity
• working memory (short-term) = things currently focused on, keep active with rehearsal
• zone of proximal development = Vygotsky, what can do without help & what can do with help

Quiz

• 1. Environmental factors that interfere with development are called:
  • a.           teratogens
  • b.           restituions
  • c.           mutations
  • d.           all of the above
•  2. When your “water breaks” what comes out:
  • a.           amniotic fluid
  • b.           cerebral fluid
  • c.           uterine wall
  • d.           cervical wall
•  3. If both parents are users, cocaine can impact:
  • a.           mother’s egg
  • b.           father’s sperm
  • c.           prenatal environment
  • d.           all of the above
•  4. Head-down delivery is called:
  • a.           unassisted birth
  • b.           rotational birth
  • c.           breech birth
  • d.           vertex birth
•  5. Seeing the top of the baby’s head is called:
  • a.           corkscrewing
  • b.           crowning
  • c.           cesarean
  • d.           ventral

Answers

• 1. Environmental factors that interfere with development are called:
  • a.           teratogens
  • b.           restituions
  • c.           mutations
  • d.           all of the above
•  2. When your “water breaks” what comes out:
  • a.           amniotic fluid
  • b.           cerebral fluid
  • c.           uterine wall
  • d.           cervical wall
•  3. If both parents are users, cocaine can impact:
  • a.           mother’s egg
  • b.           father’s sperm
  • c.           prenatal environment
  • d.           all of the above
•  4. Head-down delivery is called:
  • a.           unassisted birth
  • b.           rotational birth
  • c.           breech birth
  • d.           vertex birth
•  5. Seeing the top of the baby’s head is called:
  • a.           corkscrewing
  • b.           crowning
  • c.           cesarean
  • d.           ventral

Summary

Bonus

Photo credit

Saga of Dave

Dave, our fictional character, does not exist…yet. When he does, there are a lot of things we are going to want to know about him. All of the following characteristics will be a part of understanding Dave.

Before we get to Dave, let’s discuss development itself. There are five things you should know.

Five Things To Remember

There are five major things we are going to look at:

• Mendel
• Dominant & Recessive Genes
• Autosomal Traits

 

Foto von Dylan Gillis auf Unsplash

 

Foto von Carlo Navarro auf Unsplash