Guiding Questions Chapter 4 Study Guide 1 How has childbirth changed in developed countries Began to be professionalized more births in hospitals but a growing percentage of women are going back to home birth There have been dramatic reductions in risks surrounding pregnancy childbirth due to the availability of antibiotics blood transfusions safe anesthesia improved hygiene and drugs for inducing labor Mortality rates for both mothers and children have reduced dramatically 2 How does labor begin what happens during each of the three stages of childbirth and what alternative methods of delivery are available Labor begins with a series of uterine cervical and other changes called parturition begin about 2 weeks before delivery During parturition rising estrogen levels stimulate the uterus to contract and the cervix to become more flexible Stages of childbirth 1 Longest 12 14 hours frequent contractions cervix dilates widens 2 1 2 hours babies head begins to move through the cervix born but still attached to the placenta 3 10 60 minutes placenta and umbilical cord are expelled Methods of delivery 1 Vaginal usual method 2 Cesarean used to surgically remove the baby from the uterus through an incision in the mother s abdomen usually needed when the baby is in the breech feet or buttocks first or transverse position lying crosswise 3 How do newborn infants adjust to life outside the womb and how can we tell whether a new baby is healthy and is developing normally Newborn infants instinctively suck to take in milk During the last two months of pregnancy the baby develops layers of fat that keep their body temperature constant after birth They also maintain body temperature by increasing their activity when air temperature drops Three ways to determine if a baby is healthy and developing normally 1 Apgar scale Activity muscle tone Respiration breathing organization reflexes state changes irritability excitability ability to quiet down attention and interactive capacities and central nervous system instability tremors or change sin skin color 2 Brazelton Neonatal Behavioral Assessment Scale NBAS 3 Neonatal Screening for Medical Conditions Appearance color Pulse heart rate Grimace reflex irritability assesses motor 4 What complications of childbirth can endanger newborn babies What are the prospects for infants with complicated births Some babies are born prematurely or very small some remain in the womb too long and some are born die or die soon after birth A low birth weight baby or at risk preterm baby is placed in an isolette an antiseptic temperature controlled crib and fed through tubes Gentle massage seems to foster growth weight gain motor activity alertness and behavioral organization The physical and psychological development of children who had suffered low birth weight or other birth complication were seriously impaired only when the children grew up in persistently poor environmental circumstances 5 What factors affect babies chances of survival and health The two most important predictors of infant s survival and health are birth weight 60 80 of deaths and length of gestation Severe infections account for 86 of all neonatal deaths Sepsis pneumonia tetanus and diarrhea 36 Preterm delivery 27 Asphyxia at birth difficultly breathing 23 6 What influences physical and motor development growth How do the senses develop Proper nutrition is essential to healthy growth Motor development is not something that is taught but is marked by a series of milestones Physical growth and development follow the cephalocaudal principle and the proximodistal principle Cephalocaudal principle principle that development proceeds in a head to tail direction the upper parts of the body develop before the lower parts Proximodistal principle principle that development proceeds from within to without that parts of the body near the center develop before the extremities All senses develop in the womb Touch first sense to develop By 14 weeks much of the baby s head is sensitive to touch when a newborn s cheek is stroked near the mouth the baby responds by trying to find the nipple Smell Taste a preference of pleasant odors is learned in utero and during the first few days after birth newborns prefer sweet to sour bitter or salty Hearing fetuses respond to sounds and seem to learn to recognize them early recognition of voices and language heard in the womb may lay the foundation for the relationship with the mother Sight least developed sense at birth neonates eyes focus best from about 1 foot away eyes of a newborn are smaller than adults retinal structures are incomplete and the optic nerve is underdeveloped 7 What are some early milestones in motor development What are some influences on it Motor development is marked by a series of milestones achievements that develop systematically each newly mastered ability preparing a baby to tackle the next Rolling over grasping rattle sitting without support standing while holding on grasping thumb and finger standing alone well walking well etc see table 4 5 pg 129 in book 8 What are the benefits of breast feeding and bottle feeding What factors contribute to mothers decisions about feeding their babies A Breast feeding 1 Benefits babies are less likely to contract infectious illnesses they have better visual acuity are less likely to develop obesity asthma diabetes score higher on cognitive tests have fewer cavities 2 Factors the benefits of breastfeeding mothers recover quicker report feeling more confident sleep better and are more likely to return to pre pregnancy weight 1 Benefits either parents can fed the baby because formula is less digestible than breast milk formula fed babies usually need to eat less often 2 Factors Women who opt to formula feed don t have to worry about the things they eat or drink that could affect their babies B Bottle feeding Vocabulary Parturition series of uterine cervical and other changes that bring on labor usually starts 2 weeks before birth rising estrogen levels stimulate the uterus to contract and the cervix to become more flexible Electronic fetal monitoring used to track a fetus s heartbeat during labor and delivery to indicate how the fetal heart is responding to the stress of uterine contractions cant detect any serious problems and provide valuable info in high risk deliveries However it is costly and has an extremely high false positive rate suggesting fetuses are in trouble when they re not Cesarean delivery used
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