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Questions and Answers
What is the primary purpose of contractions during dilation?
What is the primary purpose of contractions during dilation?
What is indicated by a deceleration in fetal heart rate during labor?
What is indicated by a deceleration in fetal heart rate during labor?
Which condition is NOT a reason for inducing labor?
Which condition is NOT a reason for inducing labor?
What is a common risk associated with a cesarean section?
What is a common risk associated with a cesarean section?
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What happens in the post-birth phase shortly after delivery?
What happens in the post-birth phase shortly after delivery?
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What is considered a low birth weight (LBW)?
What is considered a low birth weight (LBW)?
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What are the lifelong effects associated with preterm birth?
What are the lifelong effects associated with preterm birth?
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Which method involves teaching muscle relaxation and controlled breathing during childbirth?
Which method involves teaching muscle relaxation and controlled breathing during childbirth?
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What is a characteristic of the Leboyer Method?
What is a characteristic of the Leboyer Method?
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Which type of birth is characterized by leaving the umbilical cord uncut for several days?
Which type of birth is characterized by leaving the umbilical cord uncut for several days?
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Which birth location option is most suitable for low-risk women?
Which birth location option is most suitable for low-risk women?
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What effect does Low Birth Weight (LBW) have at 9 months to 2 years of age?
What effect does Low Birth Weight (LBW) have at 9 months to 2 years of age?
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Which childbirth approach emphasizes family support and relaxation techniques to alleviate fear of childbirth?
Which childbirth approach emphasizes family support and relaxation techniques to alleviate fear of childbirth?
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What begins the onset of labour?
What begins the onset of labour?
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What is an effect that seems to lessen over time for individuals who were born with Low Birth Weight?
What is an effect that seems to lessen over time for individuals who were born with Low Birth Weight?
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What is the primary focus of the Alexander Technique in childbirth?
What is the primary focus of the Alexander Technique in childbirth?
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What percentage of first-time mothers give birth at home in the provided statistics?
What percentage of first-time mothers give birth at home in the provided statistics?
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Which effect of preterm birth is NOT mentioned?
Which effect of preterm birth is NOT mentioned?
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What is a primary benefit attributed to home births for low-risk mothers?
What is a primary benefit attributed to home births for low-risk mothers?
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What does a score of 5 or less on the Apgar assessment indicate?
What does a score of 5 or less on the Apgar assessment indicate?
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What does the Neonatal Behavioural Assessment Style (NBAS) primarily assess?
What does the Neonatal Behavioural Assessment Style (NBAS) primarily assess?
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What can anoxia during birth lead to?
What can anoxia during birth lead to?
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What does Low Birth Weight (LBW) indicate?
What does Low Birth Weight (LBW) indicate?
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What is a common complication for preterm infants?
What is a common complication for preterm infants?
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What characterizes small-for-date infants?
What characterizes small-for-date infants?
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What does being postmature refer to?
What does being postmature refer to?
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What is the significance of lanugo on a newborn?
What is the significance of lanugo on a newborn?
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Which sensory ability is the least developed at birth?
Which sensory ability is the least developed at birth?
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What does a newborn's inability to regulate their own body temperature often indicate?
What does a newborn's inability to regulate their own body temperature often indicate?
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How much sleep do newborns typically need per day?
How much sleep do newborns typically need per day?
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What does a newborn exhibiting a grayish-dusky blue skin color typically indicate?
What does a newborn exhibiting a grayish-dusky blue skin color typically indicate?
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Which of the following conditions can lead to infants being at higher risk for infections?
Which of the following conditions can lead to infants being at higher risk for infections?
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What is indicated by the presence of Mongolian spots?
What is indicated by the presence of Mongolian spots?
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Study Notes
Age of Viability
- 23 weeks in Ontario, 24 weeks in London
- Chance of survival is low
- Increasing due to advancements in medicine and technology
- Leading to increased children with complex care needs, which burdens the healthcare system
Preterm Birth
- Effects vary greatly
- Can have lifelong consequences including:
- Cerebral palsy
- Cognitive impairment
- Visual and hearing impairment
- Poor health and growth
- Behavioural and social-emotional problems
Low Birth Weight (LBW)
- Impacts mental and motor development, and growth at 9 months to 2 years
- Effects on physical and mental development generally lessen over time but growth effects persist
- LBW is defined as 5 pounds 8 ounces
- Very Low Birth Weight (VLBW) is less than 3.9 lbs
- Extremely Low Birth Weight (ELBW) is less than 2.3 lbs
- Normal birth weight is 5.8 to 8.23 lbs
- Average birth weight in Canada is 8.7 lbs
Birth Location
- Two options in London (fully covered by healthcare):
- Hospital - OB or midwife in birth suites
- Home - Midwife
- 9% of first-time moms, 21% for second-time moms
- Only offered to women with no risk factors and spontaneous labor
- Low-risk women experience comparable or better outcomes in home births compared to hospital births
- Less stress, decreased risk of infection, and focus on low-risk babies
Childbirth Approaches
-
Lamaze Method
- Focus on empowering women to be in control during delivery
- Techniques include muscle relaxation, breathing exercises, and having a support person present
-
Leboyer Method
- Delivery in a quiet, dimly lit room
- Allows newborn to rest on the mother's stomach with umbilical cord intact for several minutes
- Warm bath for the newborn
-
Dick-Read Method/Mongan Method/Hypnobirthing
- Fear of childbirth can impact tension and pain perception
- Emphasizes relaxation, proper breathing techniques, and familiar support
-
Bradley Method
- Preparing mothers for natural childbirth with coaching by their partner
-
Alexander Technique
- Modifying habitual reactions to pain
- Enhances conscious awareness and control of posture and movement
- Promotes free movement, upright posture, and beneficial bodily positioning during labor
-
Waterbirth
- Immersion in water during labor and delivery
-
Lotus Birth (Umbilical cord nonseverance UCNS)
- Leaving the umbilical cord uncut after birth allowing the baby to remain attached to the placenta until natural separation (3-10 days after birth)
- Often practiced for spiritual reasons
-
Silent Birth
- Attendees refrain from spoken words as much as possible
-
Medicated Childbirth
- Pain relief medications
- Epidurals, spinal blocks, combined spinal-epidurals, systemic and local analgesia
- 50% of women in hospitals use epidurals
- Minimal effect on babies
- Medications given through injections may cause negative side effects on the newborns
- Pain relief medications
Stages of Labor
-
Onset of labor
- Mucus plug expulsion
- Oxytocin production
- Cervical stretching
-
Stage 1: Dilation
- Uterine muscles contract and relax
- Contractions thin (efface) and open (dilate) the cervix for baby's passage
- Longest stage
-
Stage 2: Birth
- Cervix is completely dilated (10cm)
- Baby is born
- Contractions occur every 2-3 minutes
-
Stage 3: Afterbirth Delivery
- Contractions continue until the placenta is delivered
- Typically within 20 minutes after delivery
-
Stage 4: Post-birth
- First few hours after birth
- Breastfeeding
- Hormone surge
- Shaking
- Feeling cold
- First few hours after birth
Medical Interventions in Childbirth
-
Fetal distress
- Sudden change in fetal heart rate
- Deceleration in fetal heart rate is the first indication
- Monitoring is crucial, C-section if necessary
-
Anoxia (Oxygen deprivation)
- Can cause brain death or damage
-
Induction of labor
- Performed due to:
- Mother approaching 2 weeks beyond due date
- Water breaking without contractions
- Baby's growth has stopped
- Insufficient amniotic fluid surrounding the baby
- Placenta peeling away from the uterus
- Mother having a medical condition
- Performed due to:
-
Cesarean Section
- Approximately 1 in 3 births
- Relatively safe, but longer recovery
- Incision may create a weak spot in the uterine wall, potentially causing complications with vaginal births later
- Performed in cases of:
- Unexpected problems during delivery
- Maternal health issues
- Signs of fetal distress
- Insufficient space for baby to pass through the vagina
- Baby's position preventing vaginal birth
Assessing the Newborn
-
Apgar Assessment
- Conducted 1 and 5 minutes after birth
- Assesses 5 measures:
- Heart rate
- Respiration
- Muscle tone
- Reflex response
- Color
- Score range for each measure is 0-2
- Score of 5 or less is concerning
- Second Apgar should show improvement
-
Neonatal Behavioural Assessment Style (NBAS)
- Further assessment of the newborn
- Evaluates motor development, muscle tone, and stress response
Problems of the Newborn
-
Anoxia
- Temporary lack of oxygen to the brain
- Can lead to brain damage, death, and increased risk of learning disabilities
- Caused by difficulties during delivery
-
Low Birth Weight
- Difficulty maintaining body temperature
- Increased risk of infection
- VLBW (under 2lbs) have a greater risk of cerebral palsy
- Many causes are preventable through proper prenatal care
-
Preterm Birth
- Born before 37 weeks
- Triggered by disruptions to the mother's system
- Can cause respiratory distress syndrome and jaundice
- Difficulty regulating temperature and heart rate, inability to feed through nursing or bottles
- Often requires intensive care in the Neonatal Intensive Care Unit (NICU)
-
Small-for-date infants
- May be full term or preterm
- Growth was adversely affected
- Experience death rates 4 times higher than other infants
-
Postmature
- Baby not born by 42 weeks
- Concern about the placenta's ability to function for extended periods
- Doctors may induce labor
-
Stillborn
- Fetus dies in the womb after 20-24 weeks gestation, or during delivery
- Causes are often unknown
Characteristics of the Newborn
-
Size
- Lose 5% of body weight in the first few days (temporary)
- Followed by rapid growth
-
Body Proportions
- Head accounts for 50% of body length during development
- At birth, the head is 25% of body length
-
Brain Development
- Brain is about 25% of adult weight at birth
- Neurons aren't fully mature
-
Appearance
- Lanugo: Fine, downy body hair (normal and disappears)
- Skull may change shape due to birth canal passage (reverts to normal)
- Skin is grayish-dusky blue (returns to normal with breathing)
- Scalp may be bruised or swollen
- Wet, coated in blood streaks, and covered in vernix (white substance)
- May have Mongolian spots (blue or black birthmark on lower back)
- Genitals are enlarged and reddened
- Appearance varies significantly in older babies
-
Sleep
- 16.5 hours per day, in multiple periods
-
Reflexes
- Numerous reflexes present
-
Sensory
- Visual: Least developed at birth
-
Hearing: Ability to hear develops around the 7th month of prenatal development
- Prefer infant-directed speech and mother's voice
- Touch/Pain: Sensitive to touch, temperature, and pain immediately after birth
-
Taste/Smell: Respond with different facial expressions
- Innate taste preferences
- Can distinguish between sour, bitter, sweet, and salty (preference for sweet)
- Show preference for mother's face
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