The Birth Process
Chapter 4
The Baby Book
1. What do future parents learn in
prepared childbirth classes?
•
•
•
•
How to make labor and delivery easier
How to relax
How to breathe
Exercises to help the mother get in shape
for delivery
2. What is recommended for the new
mother to take to the hospital or birthing
center?
• Nightgowns
• Robe
• Nursing bra
• Sanitary napkins
• Toiletries
• Baby clothes
• Car Seat
• Clothes for the new mother to wear home
Traditional Childbirth
• Used in most hospitals
• Very protective of both the mother and baby
• Mother is given local or general anesthetics as
needed to reduce the discomfort
• Monitoring equipment checks on the baby’s
progress
• Husbands may or may not be in the labor and
delivery room
• After the birth the mother is taken to a recovery
room and the baby is taken to the nursery
Family
FamilyCentered
Centered
• Based on the belief that the birth affects
the family as a unit as well as each
individual
• Birthing rooms
• Husband is encouraged to remain with the
mother throughout the entire labor and
delivery
• Other support people may also be present
Family Centered, cont.
• The mother and father participate in the
labor and delivery and are accompanied
by an OB nurse or midwife. The doctor
may be present for the delivery or may be
called if complications arise.
• After the birth the mother, father and baby
spend as much time together as they like
• Brothers and sisters may visit throughout
the day
Lamaze
• Developed in France
• Based on the theory that the pain of
childbirth can be controlled by the woman
– not eliminated, but tolerated
• Couple attends classes that last 2 months
of the pregnancy preparing to work as a
team, learning exercises that will help in
breathing and muscle control so that she
can relax more during delivery
Lamaze cont.
• Focus on breathing techniques
• Husband is the labor coach, encouraging
the woman to relax
• Most often goes into the delivery room
• Women who have the Lamaze training
usually need less medication during labor
or no medication
Leboyer
• Focuses on the birth experience of the
baby
• Goal is to make the birth process less
shocking and more comfortable
• Prior to birth the environment for the baby
is dark, quiet, and warm surrounded by
fluid
• A similar environment is provided during
this method of childbirth
Leboyer cont.
• Lights are dimmed, soft music is played, low
voices are used
• Immediately after birth the baby is placed on the
mother’s abdomen, the umbilical cord is not cut
until it has stopped pulsating
• The baby is placed in warm water as soon as it
is removed from skin to skin contact with the
mother
• Many doctors use parts of this method even if
they do not use it in it’s entirety
Cesarean Section
• Surgical procedure that is faster
than a normal delivery
• It is major surgery and the
recovery time for the mother is
longer with greater risk of
infection
There are several reasons for a
cesarean section:
•The pelvic area may not be large enough for
the baby to pass through
•There may be an emergency reason where
the baby needs to be born quickly
•The labor and delivery may be prolonged
and/or difficult because of the size, position,
or condition of the baby
4. What is labor?
The process by which the baby
gradually moves out of the
uterus and into the vagina to
be born
5. What is “false labor”?
•False labor is often mistaken for
labor
•The difference is that false labor
pains remain constant in intensity
and do not increase with time
•They are irregular and not
rhythmical
6. Why do so many fathers want to
participate in the birth of their child?
•Some consider it to be the most
important event of their lives
•They feel their families will be
closer if they are there
•To support their wife
7. What is “lightening”?
•It is when the baby’s head drops
into the pelvic area about 6 weeks
prior to the birth
8. What is Breech birth?
•When the baby presents itself
bottom or feet first rather than
head first
8. What is Pre-term baby?
•A baby born weighing less than
5.5 pounds
9. List indications for the onset of
labor
• Low backache
• Sudden cramping
• Breaking of the “bag of water” – amniotic
sac
• Slight red or pink discharge
• Evenly spaced contractions
10. What is “dilation of the
cervix”?
•Stretching of the cervix so that the
baby’s head can come through
•The cervix eventually dilates to 10
cm or about 4 inches
11. What is an episiotomy?
•An incision made by the doctor or
midwife between the vagina and
anus to make it easier for the baby
to come out without tearing the
mother
12. Explain why most babies are
born headfirst.
•It is more comfortable for the baby and
the fit is better for the baby to be
headfirst the last few weeks before
delivery.
13. What happens to the baby
immediately after the birth?
• Baby must be kept warm – laid on mothers
abdomen and covered with a warm towel
or blanket which also begins the bonding
process, or
• Placed in radiant warmer if needed
• Mucous is cleared from the throat and
nose
• A brief examination
• APGAR test
14. STAGES OF LABOR:
•Dilation Stage (12 – 18 hours)
– Begins with the first uterine contraction
– Ends when the baby’s head is in the vagina or birth
canal
• Pains are slight and far apart in the beginning
• Time of contractions lengthen with shorter intervals
between contractions as they become more intense
• Cervix must dilate before the baby can be born
• The cervix opens more with each contraction
• At the end of this stage the water usually breaks
14. Stages of Labor
• Expulsion Stage (5 – 45 minutes)
– Begins when the cervix is fully dilated and the
baby’s head is in the birth canal
– Ends with the birth of the baby
• Contractions continue and the pain is most severe
at this point
• Crowning takes place: the doctor can see the
baby’s head
• Episiotomy is performed if needed
14. Stages of Labor
• Expulsion, continued
•After the head is born, the doctor gently turns the
baby so the shoulders can be born more easily
•The baby is helped to breathe and the umbilical cord
is cut
•The baby is thoroughly examined and weighed
15. Stages of Labor
• Afterbirth Stage (10 – 15 minutes)
– Uterine contractions continue
– Placenta is expelled
•Placenta separates from the uterine wall
•Placenta is expelled
•Placenta examined to make sure that none of the
tissue has torn and remains in the uterus.
APGAR
• A measurement of the newborn's response to
birth and life outside the womb. The ratings,
APGAR, are based on
• Appearance (color),
• Pulse (heartbeat),
• Grimace (reflex),
• Activity (muscle tone), and
• Respiration (breathing).
• The scores, which are taken at 1 & 5 minutes
following birth, range from a high 10 to a low 1.
APGAR Score Chart
0
Heart Rate
Absent
Breathing
Absent
Muscle Tone
1
2
Less than 100
beats per minute
Slow or irregular
100 + beats
per minute
Regular
Limp
Some motion of
extremities
Active motion
Skin Color
Blue
Pink body – blue
extremities
Pink all over
Reflex
Response
Absent
Grimace
Cry
The baby is born. Now what?
• If the baby is doing well and is considered
stable, then it can spend time with its mother
• If mother chooses to breastfeed, she may feed
the baby now – baby may be especially alert
immediately following birth
• The baby will be kept warm at all times – with a
hat, wrapped in a blanket and under a radiant
warmer when not being cuddled by its parents
• At the nursery the baby will be cleaned more
thoroughly, as well as evaluated once again.