WOMEN S FINAL HEALTH NOTES 04 25 2012 Childbirth Terms support today Obstetrician physician who delivers babies and is in the practice of obstetricians art and science of managing pregnancy labor and time immediately after pregnancy Midwives professional supports women to maintain health birth education and counseling works with woman and family identify unique physical social and emotional attend less than 8 of births in the US attend 70 80 in the other developed countries in the world Japan and Europe In 1900 95 of births took place in the home By 1955 less than 1 of births took place in the home and that number remains nurse midwife educated in nursing and midwifery labor and delivery nurse works with doctor provide care to women in labor and recently doula not licensed to perform medical interventions natural births physical emotional given birth support and postpartum BIRTH I STAGE 1 a Active labor contractions last 1 min more intense occur 1 3 minutes Cervix must be 8 cm dilated b Transition very intense long frequent contractions Cervix for 10 cm and fetus moves to pelvic base creates urge to push c Pain meds may be given relaxing techniques II STAGE 2 a Contractions less intense last 60 seconds every 1 3 minutes b Episiotomy may be performed c Head appears when face does mucus fluid removed from mouth and nostrils d Umbilical cord cut after first breath e Eye drops put in baby s eyes prevent bacterial infection f Apgar test well being of the infant g Newborn placed on mothers chest for bonding III STAGE 3 a Contractions continue after birth b Placenta expelled approx 30 min after birth all must be c Woman sewn up if episiotomy tearing C section delivered through incision in abdominal wall hug inc necessary when dystocia baby takes too long placenta previa placenta in the way of birth fetal distress and other procedure occurs in operating room general anesthesial epidural which requires a 3 5 day stay and can deliver vaginally in the future Fear of malpractice if not doing a C section cause C section is all in their hands It is also efficient for providers because they can decide when it happens Most likely time for unplanned C section is 4PM so they can be home for dinner or 11PM so doctor doesn t have to stay the night It is also more expensive so hospital makes more money More informed about the fetus health in all ways It is safer now because of medication Medical mode low priority on vagial births Attitudes are fear around birth and trust in Feat of malpractice efficient for providers convenience informed about fetus health safer repeat c sections medical model low priority on vaginal births side effects of medicine DECESION MAKING for a C section drugs attitudes fear and trust INFERTILITY The US have one of the highest maternal mortality rates in the world In the 70s is when we started having what is known as a test tube baby used in 3 of all live births in developed countries In order to get pregnant a womans body must release an egg from one of her ovaries the egg must go through a fallopian tube toward the uterus sperm must join with the egg along the way the fertilized egg must attach to the inside of the uterus Definition of Infertility not being able to get pregnant after one year of trying or six months if a woman is 35 or older women who can get pregnant but are unable to stay pregnant may also be infertile How common pregnant or staying pregnant about 10 percent of women 6 1 million in the US ages 15 44 have difficulty getting What causes infertility in women most cases of female infertility are caused by problems with ovulation Can be caused by PCOS s the most common cause of female infertility hormone imblanace problem which can interfere with normal ovulation Less common causes of fertility problems in women include Blocked fallopian tubes due to pelvic inflammatory disease endometriosis or surgery for an ectopic pregnancy Physical probems with the uterus Uterine fibroids which are non cancerous clumps of tissue What can increase woman s risk of infertility Age Smoking stress poor diet excess alcohol use athletic training Aging decreases a woman s chances of having a baby because Ovaries becomes less able to release eggs smaller number of eggs left eggs are not as healthy More likely to have health conditions that can cause fertility problems How can a woman tell if she is ovulating writing don changes in her morning body temp for several months writing down how her cervical mucus looks for several months if always the same may be that she is not ovulating using a home ovulation test kit available at drug or grocery store Common Medicines Used to treat infertility in women Follicle stimulating hormone or FSH causes the ovaries to begin the process of ovulation use hormones to help a woman be able to ovulate know FSH is the common one and that what they usually do is fix hormone balance so According to the 2006 CDC report on ART the average percentage of ART cycles that she is able to ovulate How effective is ART led to a live birth were 39 percent in women under the age of 35 30 percent in women aged 35 37 21 percent in women aged 37 40 11 percent in women aged 41 42 In Vitro Fertilization IVF IVF is the most effective ART Used when woman s fallopian tubes are blocked when a man produces too few sperm Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs Once mature the eggs are removed from the women They are out in a dish in the lab along with the man s sperm for fertilization After 3 to 5 days healthy embryos are implanted in the woman s uterus some times they have to take eggs from another person Egg Donation process can last up to a few months comprehensive questionnaire asking the donor about her medical history physical attributes and personal characteristics complete physical exam including blood genetic and psycholigcal testing After a donor Process of Egg Donation weeks ultrasound examd retreived Unlike sperm donation which is relatively quick and easy egg donation requires medications and an invasive procedure to retrieve the eggs Gives herself daily injections of medications and fertility drugs FSH and LH for 3 to 5 stimulate multiple eggs to develop and their maturation is monitored by once the eggs are ready to be harvested a fertility specialist identifies the eggs to be a needle is passed through the top wall of the vagina and is inserted into the ovary women usually need to schedule a day off from work or