BIRTH

1. BIRTH

2. DUE DATE... By taking the first day of the woman’s last menstrual cycle and adding 280 days, you can calculate when baby is due to be born. As the mother nears full term, several things happen: Baby loses the lanugo covering (much vernix remains) and reaches an average size of 20 inches in length and 7 pounds. Eye color is slate-blue or black, and will not be fixed until after exposure to light for some time. Baby drops down several inches in the abdomen. This is called lightening. and The head becomes “engaged”. This means it presses firmly against the cervix. The birth is close at hand.

3. PARTURITION... This is the correct term for the process of childbirth…the emergence of a child from its mother’s uterus. It starts with a signal from the pituitary gland. The hormone oxytocin is secreted into the bloodstream of the mother, and the process begins. (pitocin and syntocinonare common synthetic forms of this hormone, used to induce labor) There are 3 stages of childbirth: • LABOR • BIRTH OF THE BABY • BIRTH OF THE PLACENTA

4. 3 signals indicate that labor has begun… • Contractions begin • Mucous plug is dispelled • Amniotic sac breaks LABOR 3. Before labor begins, or in the early stages, the amniotic sac ruptures under pressure and fluid trickles or gushes out. Sometimes the sac must be broken manually. 2. The mucous plug falls out as cervix dilates; it is accompanied by a tinge of blood, and is referred to as “bloody show” 1. Initial uterine contractions are short and mild, but frequency, intensity, duration increase. During transition stage, the cervix completes dilation and stretches over baby's head. The entire process usually lasts from 4-18 hours

5. DILATION & EFFACEMENT Prior to the beginning of labor, the thick cartilage walls of the cervix begin to thin out and lengthen. This process is called effacement. The cervix must be completely effaced in order to fully dilate. The purpose of “labor” is for the muscles to contract, pulling open the cervix. It must open (or dilate) to 10 cm. (approximately 4 inches) to allow for the birth of the baby. This is hard and painful work for the mother. LABOR The red arrows point to the cervical area and various stages in becoming fully effaced and dilated.

6. LABOR Aptly named, labor is hard work. Contractions/dilation can be very painful. There are several methods that can help the mother manage the pain. Although medications can control pain, there is risk that the baby will be affected and become groggy. A regional anesthetic can be injected through the vagina into a nerve to relieve pain, but an epidural block is now the method of preference. An injection into the spinal column blocks pain. The mother remains awake.

7. LABOR The mother will need to attempt to control this pushing movement. A slow expulsion of the baby from the vagina causes less damage to sensitive skin.

8. In the second stage of parturition, the baby is expelled from the womb through the vagina by both the uterine contractions and by the additional maternal efforts of pushing or "bearing down". When the head is first visible, it is called “crowning”. DELIVERY

9. EPISIOTOMY An episiotomy is an incision through the skin and muscles in the perineum, made during a vaginal delivery. This procedure is performed in 2/3 of US births, and allows extra room for baby to pass out of the birth canal. The incision prevents tearing. It stitches easier and heals faster than a tear.

10. DELIVERY Vaginal delivery accounts for 3 out of every 4 births in the United States. Most remaining vernix caseosa is rubbed off during delivery. A cephalic birth position is one that is head-first!

11. DELIVERY OF THE BABY The mother may stand with her legs apart, squat, lean over, recline backward or lie down with legs supported to facilitate the delivery.

12. When the amniotic sac has not ruptured during labor or pushing, the infant can be born with the membranes intact. This is referred to as “being born in the caul”. The caul is harmless and it’s membranes are easily broken and wiped away. In medieval times, and in some cultures still today, a caul was seen as a sign of good fortune for the baby, in some cultures was seen as protection against drowning, and the caul was often impressed onto paper and stored away as an heirloom for the child. With the advent of modern interventive obstetrics, premature artificial rupture of the membranes has become common and it is rare for infants to be born in the caul in Western births. DELIVERY OF THE BABY

13. DELIVERY The "sutures" or anatomical lines where the bony plates of the skull join together can be easily felt in the newborn infant. The diamond shaped spaces on the top, top back, and sides of the skull are often referred to as the "soft spot" in young infants…correctly known as fontanelles (fontanels).

14. DELIVERY OF THE BABY The fontanelles actually allow the skull to change to a new shape, so it can emerge through the small cervical opening. This is called “molding” of the head. This change in the shape of the skull will go back to it’s original appearance in a few hours up to a few days.

15. DELIVERY OF THE BABY Immediately following delivery, if not during, a bulb syringe is used tosuction mucous from the throat and nasal passages. It’s important that those first breaths be deep and clear. Healthy, loud cries assure that!

16. POST-DELIVERY OF THE BABY The umbilical cord is connected at baby’s navel. The cord must be clamped and cut. (or tied off) Then another small plastic clamp is used, placed close to baby’s tummy.

17. DELIVERY OF THE PLACENTA Stage 3 of childbirth follows delivery of the baby…it is the delivery of the afterbirth. After the placenta is delivered, it should be inspected for size, shape, consistency, and completeness. A one minute, thorough examination to detect normalcy or abnormalities may be critical in the management of mother and baby. An abnormal placenta may be one of the first indications that mother or baby has a problem.

18. A suctioning method or vacuum is sometimes used to assist in difficult deliveries. It can turn the baby to a better position or perhaps just quicken the descent down the birth canal. SPECIAL DELIVERIES... A breech birth position is sometimes more difficult. It means that the baby is in the birth canal feet or buttocks first. An instrument called a forceps is sometimes used during delivery also. The cushioned tongs are used to hold, guide, or pull baby through the birth canal to hasten delivery.

19. CAESARIAN SECTION birth position SPECIAL DELIVERIES... Also known as C-section or spelled cesarean section, 1. fetus is delivered through a horizontal incision in abdominal and uterine walls 2. advisable when: fetus in improperly aligned (such as a sideways position called transverse position), multiple fetuses, fetal distress, mother is worn out, or mother has a transferable genital condition or infection

20. IDENTIFICATION Soon after birth, information will be gathered for baby’s official birth certificate. This becomes a matter of permanent public record; make sure it is correct, including spellings! It’s time to name the baby! Identification wrist or ankle bands are secured, as well as foot prints.

21. The hormone oxytocin that started the process of childbirth has several other effects on the body. • Research indicates that it plays a major role in establishing maternal behaviors in the mother. • Stimulates the muscles of the cervix, vagina, and uterus, helping them contract after delivery • Works in conjunction with a second hormone secretion from the pituitary gland, prolactin, to make and secrete milk from the mammary gland of the breast. This process is called lactation. LACTATION The first secretion from the breast is called colostrum. It is sticky, and a milky-yellow color. It not only provides baby with perfect nutrition and is easily digestible, but also contains immunities from the mother.

22. THE END

23. Preparing individuals for life and work • Strengthening families • Empowering communities Created by Barbara L. Swarthout, Family & Consumer Sciences teacher at Elkhorn High School