The document provides an overview of the birth process and caring for a newborn baby. It describes the stages of labor from the beginning signs through delivery. It then covers what happens immediately after birth, including how the baby looks and tests done. The document outlines caring for the mother and baby in the hospital and adjustments needed after returning home, such as feeding, medical care, and understanding the baby's needs and cries.

1. The Baby’s Arrival Chapter 7

2. The Birth Process A. The beginning of Labor 1. lightening – baby drops into pelvis area 2. mucus plug of cervix exits a). Prevents bacteria from entering uterus b). Mucus liquefies and exits as blood 3. water breaks a). Gush of warm fluid from vagina b). Amniotic sac is broken c). Usually doesn’t happen until in the hospital in active labor d). Want to deliver within 24-48 hours of water breaking

3. 4. Contractions – tightening and releasing of uterine muscle a). Just like any other muscle contracts, very strong b). Over time they get patterned – longer, stronger, and closer together C). Braxton-Hicks False contractions

4. Stages of Labor A. 1 st stage – contractions open the cervix 1. cervix dilates, widens, to about 10 cm (4 inches) 2. cervix becomes as thin as a piece of paper – effacement 3. contractions 60 seconds long, 5-6 minutes apart 4. Head drops lower in pelvis 5. If butt, feet first = breech a). Dr will evaluate if vaginal birth is possible 6. End of 1 st – contractions 90 sec, 3-4 minutes apart 7. Fully dilated

5. B. 2 nd Stage – baby is born 1. head slips into vagina from uterus 2. contractions work to move baby down, rather than stretch cervix 3. stage may last a few minutes or several hours 4. culminates into birth of baby 5. ligaments stretch like rubber bands so baby can fit through bones of pelvis 6. hormones make ligaments and vagina stretchy

6. 7. baby’s skull is soft and flexible, bones overlap each other so they can fit 8. episiotomy – cut opening of vagina so baby can fit through – sometimes this happens without cutting – results in tearing which can cause complications after recovery 9. forceps – guide baby’s head out 10. vacuum – “sucks” baby out by attaching it to head of baby

7. C. 3 rd Stage – placenta is expelled 1. uterus gives birth to placenta 2. 2-30 minutes

8. Cesarean Birth A. needed if there is complications 1. breech 2. complications during pregnancy 3. has had a C-section before 4. V-back = have vaginal birth after a c-section 5. usually stay 4 days after birth 6. may be awake during procedure

9. The Newborn at Birth A. Lungs 1. fluid is squeezed out of them during the birthing process as it goes through canal 2. pressure releases and baby’s lungs expand = 1 st breath = cry 3. fluid suctioned out 4. if need help to keep breathing – nurse will rub baby’s back

10. B. Heart 1. once lungs take in air, CS changes 2. valve in the heart closes and over the next few days become permanently sealed 3. blood now circulates through lungs rather than bypassing them 4. umbilical cord stops pulsing, shrinks minutes after birth and is clamped, tied, and cut off

11. C. How does a newborn look? 1. head is wobbly and large A. accounts for ¼ of baby’s length 2. may be lopsided from going through canal 3. soft spots – fontanels – skull hasn’t joined together to allow for movement 4. 6-18 months grow together 5. very tough skin on top to protect brain until the bones grow together

12. 6. fat cheeks 7. short, flat nose 8. receding chin ** the above make it easier for baby to suck b/c nose and chin are out of the way 9. baby’s eyes are nearly adult size 10. eyes dark-grayish blue at birth – permanent color apparent within several months

13. 11. skin – grayish – changes as baby’s CS starts working 12. born early – hair on back, shoulder, forehead – goes away as baby grows 13. vernix – rich, creamy substance to protect skin Some is still present after birth – white Can wash off with warm water 14. milia – white bumps, baby acne Plugged oil ducts from maternal hormones Disappears in a week or two

14. The Postnatal Period A. Apgar scale – a method of evaluating a newborn’s physical condition Appearance, pulse, grimace, activity, respiration 1. Gives a rating from 0-2 in each of these 5 areas: A. pulse B. breathing C. muscle tone D. reflex to stimulation E. skin color

15. Score of 6-10 is normal Anything less needs special medical attention Apgar is given 1 minute after birth and then again at 5 minutes Baby is also given a brief exam to check for any conditions that might require speical care

16. Within 60 minutes of delivery, drops of silver nitrate or an antiseptic ointment are put into the baby’s eyes to guard against infection Baby is weighed, measured, cleaned up Permanent copy of footprints is made for public record 2 bands giving baby’s family name are clamped to ankle or wrist

17. Mother wears same bracelet Need identification to leave room later

18. Heart rate 0 – absent 1 – under 100 2 – over 100

19. breathing 0 – absent 1 – slow, irregular 2 – good, crying

20. Muscle tone 0 – limp 1 – some movement 2 – active motion

21. Responsiveness When nose irritated 0 – no response 1 – grimace, distortion of face expressing pain 2 – cough or sneeze

22. color 0 – blue or pale 1 – body limbs pink, not blue 2 – completely pink

23. Bonding and Attachment Bonding – the process of forming lifelong emotional ties Delay cutting umbilical cord, cleaning, and giving eyedrops so that parents have the opportunity to begin bonding right away Placed in mother’s arms or on stomach to feel skin, hear heartbeat and mother’s familiar voice Newborn focuses on mother’s face

24. Breast feed within minutes of birth Baby knows instinctively what to do Colostrum – the first breast milk Easy for newborn to digest Rich in mother’s antibodies Yellowish or clear, thick

25. The Hospital Stay Monitor mother and baby very close as both have gone through drastic changes Mother Pulse, BP, and other vital signs until all body functions have stabilized Stay for 12 hours – bath, eat, rest, medically checked Or 2-3 days to recuperate

26. Rooming - in Rooming-in program Arrangement in which the baby stays in the mother’s room, rather than in a hospital nursery, after birth Natural beginning to family and bonding Homelike atmosphere where visitors can hold baby Set a schedule Practice caring for baby before going home Babies seem more content

27. Birth certificate free of charge soon after baby is born Parents fill out a form, temporary certificate is given Most important piece of identification

28. Postnatal care of mother Physical needs Rest Sleep whenever baby does Get help to come so mother can sleep Exercise Simple stretches Helps return to normal figure and posture

29. Nutrition Breast feeding – very important to eat correct amount of recommended servings Eat right to regain energy Drink plenty of water Medical checkup 4-6 weeks after birth Dr checks if uterus is returning to normal size Mother can discuss any questions or concerns about parenthood or birth control

30. Emotional needs “baby blues” Few days of mild depression due to hormonal changes Loneliness, resentment Make time for just eachother together

31. Caring for premature babies Weigh less than 5 ½ lbs Born before 36 weeks Incubator – special enclosed crib in which the O2 supply, temperature, and humidity can be closely controlled Baby’s body is not yet ready for heat regulation, sucking, breathing, swallowing Baby’s heart and lungs are electronically monitored Special meds to combat infection Many less than 1 lb now are able to live

32. Can’t leave hospital until the baby can control his/her body temp and gain weight at the same time Detected early, the process can be stopped/prolonged

33. Journal What do you fear in taking care of a newborn? What do you have questions about? What do you not know how to do?

34. A new family member The AMAZING newborn Born with remarkable capabilities Focus their eyes, hear, smell, vocalize to communicate Selectively respond to human voice Breathe independently Cry for needs Prefer human faces to other shapes Can follow an object

35. reflexes Reflex – instinctive, automatic responses, such as sneezing and yawning Coordinated behavior helps the baby function Some are temporary, some continue throughout life

36. Types of reflexes 1. rooting When touched on lips or cheek, the baby will turn toward the touch and begin to suck Helps baby find food Around 4 months this reflex stops – use eyes and become aware of surroundings

37. 2. grasp Response of a newborn’s hand to close over anything that comes into contact with the palm 3 months baby’s start to reach for object Disappears by age of 1

38. 3. startle Response to a loud noise or touch on the stomach Legs thrown up, fingers spread, arms extended, then bring back to midline with clenched fists Lasts about 5 months

39. Learning to care for newborn What do babies need Food Get to them right away so they learn to trust those around them Sleep Sleep throughout the day Wake up 1-3 times/night to feed Average of 15/day

40. Exercise Helps develop muscle tone and nervous system Splashing during bath Kicking while diaper changing Kept safe, clean, and warm Make your house baby safe

41. Medical care Periodic check-ups Check if developing normal Immunizations Need things to look at, touch, listen to, and play with Need to be stimulated to learn Love Close contact touched

42. What do parents need Knowledge to care for infant Resources for any ?’s Time Emotional support Financial planning Reassurance and confidence Agreement about responsibilities Personal health/rest Privacy, time alone

43. Adjusting to new routines Trial and error Cannot spoil too much in the first months Make a routine, schedule Good for babies and kids to know what to expect

44. Understanding the Baby’s language Hunger is usually the reason they cry Fatigue, loneliness, uncomfortable Average is 1 hr/day Recognize different cries

45. Journal What was your temperament as a child? Assignment – ask your mom or dad what you were like as an infant.

46. Early Temperament Temperament – style of reacting to the world and of relating to others Baby will have own style to reacting to situations and their personality