Birth and Birth Trauma PDF

Birth and Birth Trauma  Kinds of birth Natural and spontaneous birth The position of the fetus and its size in relation to the mother reproductive organs allow it to emerge in the normal, head first position Breech Birth In the breech birth, the buttocks appear first ,fol...

Birth and Birth Trauma  Kinds of birth Natural and spontaneous birth The position of the fetus and its size in relation to the mother reproductive organs allow it to emerge in the normal, head first position Breech Birth In the breech birth, the buttocks appear first ,followed by the legs and finally the head  Kinds of birth Transverse Birth The fetus is positioned crosswise in the mother uterus. Instrument must be used for delivery unless the position can be changed before the birth process begins Instrument Birth When the fetus is too large to emerge spontaneously or when the position makes normal birth impossible, instrument must be used to aid in delivery.  Kinds of Birth Caesarean Birth Baby brought into the world through a slit made surgically in the mother abdominal wall.  Stages of Birth Stage one DILATION Stage two EXPULSION Stage three AFTER BIRTH  STAGE ONE DILATION It is the process responsible for labor pains. During which THE CERVIX DILATES ,  Stage 2 EXPULSION Period from maximal cervical dilation until the birth of the baby Lasts minutes to an hour Contractions become more intense and frequent. In stage two of the birth process the baby passes through the birth canal Psychologically this is a significant stage  Stage 3 Placenta and other membranes are discharged Usually occurs within 15 minutes after the birth of the baby, but can range from 5 to 50 minutes.  Stress on the Infant Researches have revealed that the stress of birth process releases large amount of adrenaline and nonadrenaline in the baby blood. These hormones prepare the adult to flee or fight in situations of danger or emergency. Hormones in the infant have stimulating affects on breathing, heart action, and all organs of the body. As a consequence, baby is usually born alert.  Birth trauma Fetus was living in: Calm Warmth Dark Peaceful environment All vital functioning done through placenta For nine months he was attached with mother’s womb  Birth Trauma During the birth process fetus has to move from Calm to apprehensive environment Warm to cold and extremely warm environment Dark to flashy lights environment Peaceful to noisy environment He has to breath ,suck, and perform many organic functioning like sucking,  Birth trauma More significant change Passing trough a birth canal which is stress full for fetus and at this stage fetus experiences anxiety Fetus also experiences feelings of apprehension because of separation from Mother’s womb (body)  Otto Rank 1884 to 1939  Otto Rank 1884 to 1939 Psychoanalyst Gave the concept of birth trauma (psychological trauma of birth) A person who experiences anxiety while passing through the birth canal and experiences separation anxiety, may experience this in his later life in the form of phobia and other manifestations of anxiety  Otto rank E.g Claustrophobia Separation anxiety in childhood and adult life , Fetus birth experiences during the birth process may effect their emotional health in later life. Kinds of Birth and Birth Trauma According to researches caesarean and instrumental birth effects the emotional health of individual. Due to Chance of brain damage Hypoxia , anoxia (oxygen deficiency) Extreme anxiety due to pain resulting from instrument In case of caesarean birth ,hormones which prepare to deal with stress are not produced.  APGAR SCALE A standard measurement system that looks for a variety of indications of good health in newborns. Developed by Virginia Apgar in 1953  The APGAR Directs Attention to Five Qualities: appearance (color) pulse (heart rate) grimace (reflex irritability) activity (muscle tone) respiration (respiratory effort)  The Apgar Scale Score 0 1 2 Blue, pale Body pink, extremities Entire body pink Body Color blue Absent Slow – less than 100 Fast – 100 to 140 Heartbeat beats per min. beats per min. Reflex Irritability No response Grimace Coughing, sneezing, crying Limp and Inactive, weak, some Strong, active Muscle Tone flaccid flexion of extremities motion Respiratory Breathing for Irregular and slow Breathing good with Effort no more than 1 normal crying min. ©2008 The McGraw-Hill Companies, Inc. All rights reserved. Each quality is scored 0-2 producing an overall scale score that ranges from 0-10. Most babies score around 7. – Scores under 7 require help to start breathing – Scores under 4 need immediate life- saving intervention – Scores that stay between 0 and 3 after 20 minutes are an indicator that severe problems are likely to be present.  The Brazelton Neonatal Behavioral Assessment Scale Performed within 24-36 hours after birth to evaluate neurological development, reflexes, and reactions to people. The newborn is rated on each of 27 items, contributing to four categories: physiological, motoric, state, and interaction. Babies are also given global classification such as “worrisome,” “normal,” “superior.”  The Brazelton Neonatal Behavioral Assessment NEUROLOGICAL ITEMS (Elicited reflexes and movements) [These neurological items are rated on a 3-point scale for low, medium, and high intensity of response - Asymmetry and absence are also noted.] The Brazelton Neonatal Behavioral Assessment Plantar grasp Hand grasp Ankle clonus Babiinski (Flexing toes in response to stimulus bottom of foot) Standing Automatic Walking Crawling Tonic Neck Reflex Moro Rooting Sucking Passive Movements of Both Legs and Both Arms BEHAVORIAL ITEMS (Specific behaviors observed or elicited) [These behavioral items are rated on a 9-point scale; the midpoint of the scale denotes the expected behavior of a 3-day-old normal baby. Specific Behaviors observed or elicited: Focusing and following an object Reaction to an auditory stimulus Reaction to persons Reaction to a voice Reaction to a person's face and voice  The Brazelton Neonatal Behavioral Assessment General Behaviors Observed Degree of alertness Motor maturity Cuddliness Consolability with intervention Peak of excitement Irritability Amount of startles Self-quieting activity Hand-to-mouth facility Number of smiles