Labor and Childbirth

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Labor and Childbirth• The last few weeks of pregnancy are a time

of mixed emotions.• The mother tired from physical demands

placed on her body by the developing child, may be excited to give birth yet fearful and anxious of the actual birthing process.

• The father may be excited to meet the new baby yet fearful of the new responsibilities of fatherhood.

• Birth is a common experience, occurring thousands of times each day, yet each birth is unique and challenging to the people involved.

• Different methods of childbirth and anesthetic procedures are chosen to facilitate optimum childbirth conditions in each situation.

Birth plan….

• Natural Child Birth: No medication

• Medications: Epidural, local anesthetic, IV

• Birthing Exercises: Lamaze, Leboyer method

• Location: Hospital, Birth Center, Home

• A document that that lets your medical team know your preferences for things like how to manage labor pain.

Labor

• Each woman’s labor will vary and may be as short as three hours or last 24 hours or more.

• Refers to the energy and effort used to move the baby out of the mother’s body.

• Accomplished through a series of contractions in the uterine muscles.

• Hormones inside the mother control the onset, length, and strength of these contractions.

• Average length of labor for a first baby is between 12 and 14 hours.

Signs of the Beginning of Labor

• Lightening▫ Change in the position of the baby. Baby drops lower in the pelvis

• Contractions of the uterus▫ Usually begin as weak cramps and a backache, gradually increasing in

intensity and becoming more frequent and consistent.▫ Braxton Hicks contractions are false labor pains that prepare the

uterus for labor and help circulate maternal blood.

• Rupturing of the amniotic sac. (“breaking your water”)▫ Membrane ruptures▫ Could be a small trickle or a gush of fluid

• Passage of the mucous plug from the CervixReferred to as ‘the show’

Three Stages of Labor

• Stage 1: Dilation of the cervix

Early labor…cervix dilates from 0-4 cm in diameter. Contractions may be 5-10 minutes apart

Active labor…cervix dilates from 4-8 cm. Uterine contractions will be longer, and more regular

Transition… During this period the baby’s head moves from the uterus into the birth canal. Cervix dilates from 8-10 cm. Contractions become more frequent and much stronger. Transition is the most difficult period of childbirth.

▫ Further broken down into three categories

▫ The dilation stage lasts the longest, the average is about 8 hours. During this time, most hospitals will use a monitor to record the strength and duration of contractions, as well as the baby’s heartbeat.

▫ If the amniotic sac has not ruptured by this time, the physician will break it.

▫ Baby’s head is pushed against the cervix causing it to widen. This is effacement.

▫ In order for the baby to pass from the uterus to the vagina, the cervix must first stretch and expand. This is referred to a dilation.

▫ Cervix starts at ¼ inch in diameter

• Stage 2: Expulsion – Baby is born

The physician or midwife will decide whether or not to perform an episiotomy; a small incision in the vagina prevent tearing. The incision will be stitched closed.

▫ Forceps

▫ Vacuum Extraction

▫ The birth process places a great strain on the baby. It’s heartbeat will dramatically increase.

▫ Crowning is when the baby’s head is first seen.

▫ Contractions become more frequent and longer▫ Contractions occur 1-3 minutes apart and last about 1 to 1 ½ minutes.▫ Contractions push the baby out through the pelvis and the birth canal.

▫ Begins when the babies head is in the birth canal and ends when the baby is born.▫ Usually lasts 5-10 minutes.

• Stage 3: Afterbirth is expelled

▫ The contractions of the uterus continue, causing the placenta to separate from the wall of the uterus and be expelled

▫ The afterbirth which is expelled, consists of placenta, umbilical cord, amniotic sac, and lochia- bleeding tissue.

▫ Childbirth, although a natural process, is difficult for both the mother and the baby. Nature makes this easier. The unborn baby’s skull has fontanels; soft and flexible skull bones, so it can become longer and more narrow, allowing it to pass through the pelvis more easily.

Birth Process

• In most instances, the baby’s face is looking downward as the head emerges. This is called the posterior position.

• Some babies are born breech▫ The baby will emerge buttocks, feet, or shoulders

first▫ More difficult for both the mother and the child▫ The doctor will try to turn the baby or a c-section

may be performed

• Some babies are born in the anterior position▫ The head will is rotated to the side▫ The shoulders come out one at a time▫ Followed by the abdomen and legs

Birth Process• Complications may arise…

Baby experiences great pressure as it is pushed out of the uterus and through the birth canal.▫ The umbilical cord may be constricted, which restricts blood flow to the baby.▫ The mother’s pelvis may not be large enough to allow passage of the baby.▫ Baby is in a breech position.▫ The placenta may be positioned close to or covering the cervix and must be

delivered before the baby which is called Placenta Previa

• In these instances, the doctor may decide to perform a cesarean section to avoid danger to the mother or baby.▫ A C-section is performed by making an incision in the mother’s abdomen and uterus. ▫ The baby is removed from the uterus before it enters the birth canal.

• Vaginal birth is best for the infant for a fewreasons▫ It helps expel any fluid out of the lungs▫ The baby must fight more▫ This develops strength in the baby

Cesarean Birth

The Newborns Health..

Newborns are evaluated on a rating system to determine their health and general condition after birth called the Apgar Scale.

AppearancePulseGrimaceActivityRespiration

The obstetrician will test for:Heart RateBreathingMuscle ToneResponsivenessColor