CHAPTER 3: Birthing and Newborns
Chapter Preview
This chapter focuses on birthing, including the onset and stages of labor, factors that
influence labor, delivery methods, as well as complications that can occur during the
process. It discusses the transitions that occur for parents and newborns during the first
month, including the newborn’s physical, motor, sensory, cognitive, social, and
emotional development and issues affecting premature and at-risk newborns.
Learning Objectives
After reading this chapter, you should be able to:

Highlight the labor and delivery process from onset to delivery.

Discuss various delivery methods and childbirth practices.

Review possible complications that can occur during childbirth.

Review the changes that occur for parents as they transition to caregivers during the
first month after birth.

Describe the newborn and his senses, reflexes, and states of arousal.

Discuss the changes that infants experience in terms of physical, motor, sensory,
motor, cognitive, social, and emotional development.

Describe the differences and complications affecting newborns who are at risk.
Key Terms and Concepts
Abruptio placenta is the separation of the placenta from where it is implanted in the
uterine wall before the delivery of the baby.
Apgar scale is a simple, clear classification for newborns with five areas—heart rate,
respiratory effort, reflex irritability, muscle tone, and color
Apnea is a pause in breathing for up to 20 seconds.
Behavioral states describe levels of consciousness that range from quiet sleep to
active crying.
Bilirubin is a product of the breakdown of the hemoglobin in red blood cells.
Birth weight is the weight of a newborn. It is used in determining neonatal risk.
Bradycardia is a drop in heart rate to below 80 to 100 beats per minute.
Cesarean section is the delivery of the fetus through an incision in the abdominal wall
and uterus.
Colic is a condition in newborns indicated by a high-pitched cry accompanied by
grimacing, clenched fists, knees that are either pulled up or rigid and extended, the
passing of gas, and inconsolable crying. A colicky baby cries for more than three hours a
day, for three days a week, for three weeks during the first three months of life.
Contractions are the movements of the muscles in the wall of the uterus that push the
fetus through the birth canal.
Engagement is when the largest part of the fetal head has passed through the mother’s
pelvic rim and into the true pelvis.
Extremely low birth weight is when newborns weigh less than 1,500 grams (about 3
1/3 pounds).
Fetal distress occurs when the fetus is not getting oxygen or is experiencing some
other complications.
First stage of labor begins with contractions and ends when the cervix is dilated and
effaced.
Habituation is a form of learning where the infant quits responding after repeated
exposure to a stimulus.
Intensive care nurseries are designed for high-volume, short-term acute care of
newborns. They focus on medical concerns and are used in specially designated
hospitals with highly trained staff (neonatologists and neonatal nurses) and very
advanced technological equipment.
Intraventricular hemorrhage (IVH) is bleeding into or near the normal fluid spaces
(ventricles) of the brain.
Labor is the process of regular uterine contractions that result in child birth.
Lactation is the process of secreting milk from the mammary glands to feed infants.
Low birth weight is when newborns weigh less than 2,500 grams (or about 5½
pounds).
Neonatal Behavioral Assessment Scale is designed to provide an assessment of the
neonate’s neurological responses and behavioral repertoire. It evaluates the infant’s
potential for self-organization and his ability to control the state of arousal (alertness) as
a response to the environment.
Neonatal jaundice is an excess of bilirubin, which causes a yellow coloration of the skin
and whites of the eyes of newborns.
Neonate is the designation for the newborn for the first 28 days of life.
Placenta previa is a condition where the placenta is implanted low in the uterine wall
near or over the opening to the birth canal.
Postpartum blues are short-term mood swings that are caused by hormonal
fluctuations after childbirth.
Postpartum depression (PPD) is a major form of depression that occurs following
childbirth.
Postural reactions help the infant keep his head upright and later to extend his arms to
provide some protection when falling.
Preterm infants are born before 37 weeks gestational age.
Preterm delivery occurs before 37 weeks.
Primitive reflexes are inborn behavior patterns that develop during uterine life, are
present at birth, and have survival value.
Reflexes are involuntary specific muscular responses to sensory stimuli.
Second stage of labor begins when the cervix is dilated and effaced and ends with the
birth of the infant.
Sensory development is the development of senses of hearing, seeing, feeling,
smelling, and tasting.
Supine is lying on the back with the face upward.
Surfactant is a chemical that keeps the air sacs in the lungs open during breathing.
Term is the average length of a pregnancy (40 weeks). An infant born between 37 and
42 weeks is considered to be born at term.
Third stage of labor is the expulsion of the placenta.
Transition to parenthood is the change involved in becoming a parent, characterized
by a lot of adjustments to make and challenges to deal with.
Vaginal delivery is when a baby is delivered by passing though the birth canal.
Very low birth weight is when newborns weigh less than 1,500 grams (about 3 1/3
pounds).
Chapter Outline
Labor and Delivery
Birthing Patterns
Transition from the Womb
Newborns
Newborn Assessment
Newborns at Risk
Newborn Senses
Newborn Development
Transition to Parenthood
Recommended Reading
American Academy of Pediatrics (2005). AAP policy statement of breastfeeding feeding
and the use of human milk. Pediatrics, 115(2), 486–506.
Brown, J. E., & Satin, A. J. (2007). Having a baby: The birth process. In M. L. Batshaw,
L. Pellegrino, & N. J. Rosen (Eds.), Children with disabilities (6th ed. pp. 35–45).
Baltimore, MD: Paul H. Brookes Publishing.
Dick-Read, G. (1959). Childbirth without fear: The principles and practices of natural
childbirth. New York: Harper and Row.
Gaitatzes, C., Chang, T., & Baumgart, S. (2007). The first weeks of life. In M. L.
Batshaw, L. Pellegrino, & N. J. Rosen (Eds.), Children with disabilities (6th ed., pp.
47–69). Baltimore, MD: Paul H. Brookes.
Karmel, M. (1965). Thank you Dr. Lamaze. New York: Dolphin Books.
Lamaze, F. (1956). Painless childbirth: The Lamaze method. New York: Pocket Books.
Leboyer, F. (1975). Birth without violence. New York: Knopf.
Rais-Bahrami, J., & Short, B. L. (2007). Premature and small-for-dates infants. In M. L.
Batshaw, L. Pellegrino, & N. J. Rosen (Eds.), Children with disabilities (6th ed., pp.
107–122). Baltimore, MD: Paul H. Brookes.
Relevant Web Sites
About.com: Pregnancy and Childbirth Web site offers 24 articles about labor and
delivery, including what happens for mother and child during labor and how labor
impacts a baby’s immune system. Navigate to the page on Labor Basics.
http://pregnancy.about.com/
Encyclopedia of Children’s Health provides information about various medical
conditions, disorders, and pediatric diseases. It is structured into five main sections,
which include immunizations, drugs, procedures, diseases and disorders, and
development. http://www.healthofchildren.com/
Essortment offers hundreds of tip and information pages covering parenting issues,
newborn and infant concerns, child development issues, and activities for infants and
toddlers. Navigate to the page on Infant and Toddler Feeding, Diapering, Potty Training,
Sleep, and Socialization: Information for new parents of infants and toddlers.
http://www.essortment.com/
March of Dimes is a major resource of information about birth defects and related
newborn health problems. http://www.modimes.org/
MedLine Plus, a service of the U.S. National Library of Medicine and the National
Institutes of Health, offers dozens of tip pages and links that focus on caring for infants
and newborns. Topics range from treating diaper rash and nutrition information to coping
strategies and organizations that serve parents and families. Navigate to the page on
Infant and Newborn Care. http://www.nlm.nih.gov/medlineplus/
National Center on Birth Defects and Developmental Disabilities (NCBDDD)
provides detailed information on the causes and prevention of birth defects and
developmental disabilities. Its goal is to help children develop and reach their full
potential and to promote health and well-being among people of all ages with
disabilities. http://www.cdc.gov/ncbddd/
The Brazelton Institute is a good source for learning more about the Newborn
Behavioral Observations System developed by Dr. T. Barry Brazelton.
http://www.brazelton-institute.com/clnbas.html