Group 1_ Section 2D.pdf

BIRTH AND PHYSICAL DEVELOPMENT DURING THE FIRST THREE YEARS Presented by group 1 CHILDBIRTH, CULTURE, AND CHANGE  Birth practices tend to be ritualized and relatively s...

BIRTH AND PHYSICAL DEVELOPMENT DURING THE FIRST THREE YEARS Presented by group 1 CHILDBIRTH, CULTURE, AND CHANGE  Birth practices tend to be ritualized and relatively standard across women within the bounds of each particular culture. Across many cultures, giving birth is viewed through a spiritual or religious lens, a perspective that can help women manage the pain of labor. In traditional societies, these others are most often family members or other well-known associates. In modern societies, this assistance is most often medicalized. Customs surrounding childbirth reflect a culture’s beliefs, values, and resources. Kung San of the Kalahari Desert Northern Thai- land Laboring women seek out The husband assists his pregnant a favorite location in the partner and her attendant, boils bush—alone—and are water, and cleans up after the birth. expected to be brave, as fear is believed to lead to a difficult and painful delivery. Ngoni in East Africa Women are assisted by attendants, men are A Mayan woman in excluded. Should the birth Yucatan prove difficult, men are Gives birth in the hammock she pressured to divulge any sleeps in every night; both the adulterous relationships, father-to-be and a midwife are expected to be present. To evade believed to be a evil spirits, mother and child contributing factor in remain at home for a week. difficult deliveries. Mende of Sierra Leone Adulterous relationships are also blamed for difficult deliveries.  THE POSTPARTUM EXPERIENCE ALSO VARIES Before the twentieth century, peasant mothers in Europe and the United States Were expected to be back at work in the fields within a few hours or days of giving birth. Southeast Thailand Traditional beliefs about the postpartum period involve rest for the new mother and "regaining heat" for the body by consuming hot drinks, taking hot baths, and lying by the fire. Tamil mothers in India Enter a birthing house for delivery and stay for 31 days before emerging for a ritual bath for the mother and shaving of the infant's head. Some areas of rural Thailand A new mother generally resumes normal activity within a few hours of giving birth. Childbirth also varies across historical time periods. Historically, childbirth has often been “a struggle with death” for both mother and baby. In seventeenth and eighteenth century France, a woman had a 1 in 10 chance of dying while or shortly after giving birth. Thousands of babies were stillborn, and 1 out of 4 born alive died during the 1st year. At the end of the nineteenth century in England and Wales, an expectant mother was almost 50 times more likely to die in childbirth than a woman giving birth in modern times.  FIGURE 2 US Infant Mortality Rates, 1940–2021 FIGURE 1 The US infant mortality rate has decreased from 47.0 infant deaths per US Maternal Mortality Rates 1,000 live births in 1940 to 5.41 in 2021. During the same period, the Since 1915, the maternal mortality rate in the United States neonatal rate decreased from 28.8 to 3.56 deaths per 1,000 live births, and has dropped from 607.9 deaths per 100,000 live births for the postneonatal rate decreased from 18.3 to 1.85 the birth registration area to 12.1 deaths per 100,000 live deaths per 1,000 live births. births in 2003. At the start of the twentieth century, childbirth In 1940, there were 47.0 infant (from birth to 1 year of age) began to be professionalized in the United States, at deaths per 1,000 live births (Figure 2); by 2020, this rate had decreased to 5.42 infant deaths per 1,000 live births. least in urban settings. The growing use of maternity Postneonatal (from 28 days to 1 year of age) survival rates hospitals led to safer, more antiseptic conditions for have also increased. In 1940, the postneonatal death rate childbirth, which reduced mortality for women. In was 18.3 infant deaths per 1,000 live births, a number that 1900, only 5 percent of US deliveries occurred in fell to 1.85 deaths in 2017. hospitals. The dramatic reductions in risks surrounding pregnancy and childbirth in industrialized countries are largely due to the availability of antibiotics, blood transfusions, safe anesthesia, improved hygiene, and drugs for inducing labor. In addition, improvements in prenatal assessment and care make it far more likely that a baby will be born healthy. Today a small but growing percentage of women in developed countries are going back to the intimate, personal experience of home birth. Home births are usually attended by a trained nurse midwife, ideally with the resources of medical science close at hand. Some studies suggest that planned home births with speedy transfer to a hospital in case of need can be as safe as hospital births for low-risk deliveries attended by skilled, certified midwives or nurse midwives.  THE BIRTH PROCESS Labor - this is an apt term for the process of giving birth. Parturition - the act or the process of giving birth, and it typically begins about 2 weeks before delivery. It brings series of uttering, cervical, and other changes. Constructions typically starts 266 days after conception Braxton-Hicks Constructions - false constructions during the final month and relatively mild irregular  STAGES OF CHILDBIRTH Dilation of the Cervix (12 to 14 hrs) During this stage, regular and increasingly frequent uterine constructions-15 to 20 minutes apart at first-cause the cervix to shorten and dilate, or widen, in preparation for delivery. Descent and Emergence of the Baby (1 to 2 hrs) It begins when the baby’s head begins to move through the cervix into the vaginal canal, and it ends when the baby emerges completely from the mother’s body. Expulsion of the placenta (10 mins to 1 hr) In this stage, the placenta and the remainder of the umbilical cord are expelled from the mother. ELECTRONIC FETAL MONITORING Mechanical monitoring of fetal heartbeat during labor and delivery. The sensors monitor heart rate and alert medical personnel of potentially problematic changes. It can provide valuable information in high-risk deliveries. Vaginal delivery vs Cesarean delivery Delivery of a baby by surgical The natural method of removal from the uterus. childbirth, preferred for its physiological benefits for both Most common during late evenings mother and child. and early mornings. Most common between 8:00 AM – 12:00 PM. Reasons for Cesarean Delivery Labor progresses too slowly Fetus is in the breech or transverse Mother is bleeding vaginally Physicians fear of malpractice suits and; Women's preferences U.S. Cesarean Rate: Peaked at 32.9% in 2009, slightly decreased to 31.8% in 2020. Global Rate: 21.1%, with the highest in Latin America and the Caribbean (42.8%) and the lowest in sub-Saharan Africa (5%). Risks & Benefits Vaginal Delivery Benefits: Health benefits for babies: better lung function, hormone surge, stress response. Fewer complications for future pregnancies. Cesarean Benefits: Reduces risk of urinary incontinence and pelvic organ prolapse.  Cesarean Risks: Increased risk of uterine rupture, bleeding, and complications in future pregnancies (e.g., placental abnormalities). Newborn Risks: Higher chances of obesity and asthma. Risks associated with repeat cesarean deliveries: Postpartum endometriosis (a painful VBAC (Vaginal Birth After Cesarean) condition in which uterine cells are found Success Rate: 80% in low-risk situations. outside of the uterus) Risks: Complications related to the use of Uterine rupture anesthesia Unplanned hysterectomy Bladder or bowel injury, or hysterectomy Maternal death. Not recommended for high-risk patients or home births.  Medicated Delivery VS Nonmedicated Delivery Local Anesthesia (Pudendal Block): Natural Childbirth Methods: Lamaze method, mental imagery, massage, gentle pushing, deep breathing. Administered during the second stage of labor. Aim to minimize or eliminate drug use. Provides pain relief in the vaginal area. Emphasize the woman's ability to cope with pain through training and Analgesics: techniques. Reduce pain perception by depressing the central nervous Doula Support: Experienced mentor, coach, and helper. system. Provides emotional support, information, and assistance throughout labor. May slow labor, cause maternal complications, and make the Associated with decreased likelihood of birth complications, cesarean delivery, baby less alert after birth. Regional and preterm birth. Anesthesia (Epidural): Cost-effective strategy. Challenges: Injected into the spinal cord to block nerve pathways. Doula support often not covered by insurance. Widely used, with approximately 71% of women receiving them. Cost is a significant barrier for many women. May slow the rate of labor, especially at higher doses. BIPOC women are more likely to benefit from doula support but may face greater challenges in accessing it.  CHILDBIRTH AND THE COVID-19 PANDEMIC Early research: COVID-19 infection was initially thought not to pose significant risks to pregnant women or their fetuses. Later studies: Recent evidence suggests that infected pregnant women may have higher risks of complications like preterm birth, preeclampsia, and other adverse outcomes. Hospital policies: Hospitals implemented changes during the pandemic to protect pregnant women and newborns from COVID-19. Online prenatal visits and limited visitors during delivery. Physical separation of mothers and babies. Rooming-in for COVID-positive mothers with safety measures. Impact on women: COVID-19 infection during pregnancy can lead to increased stress, reduced social support, and higher risk of adverse outcomes like low birth weight.  Thank You For Listening