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labor and delivery

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by

Jessica Chapman

on 13 August 2015

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Transcript of labor and delivery

BIRTH
The Chemical Process
At about 38 weeks, the fetal brain signals the release of the hormone oxytocin which prepares the fetal brain for delivery and initiates labor.
Contractions are weak and irregular initially but eventually become strong and regular.
Time to Deliver
The average baby is born after 12 hours of active labor for first births and 7 hours for subsequent births, although labor can take twice as long or half as long.
Normal Uncomplicated Birth
STAGE 1
TRANSITION
Stage 3
STAGE 2
The baby positions as the birth process begins
The cervix
dilates
to allow passage of the baby’s head
The baby moves into, and through the “birth canal”, AKA, the vagina
The baby’s head moves through the opening of the vagina – this is referred to as “
crowning

TERMS YOU NEED TO KNOW:
Labor
: the process in which the baby gradually moves out of the uterus and into the vagina to be born.

Delivery
: is the birth of the baby.

progression of labor
During the last couple weeks of pregnancy the mother will feel something called a "
lightening
"
This occurs when the baby settles deep in the pelvis near the time of birth.
Because the baby has moved down the pressure on the woman's upper abdomen is reduced or lightened.
early signs of labor
"show" or "
bloody show
": refers to the few drops of blood or pinkish vaginal stain that occurs when the mucus that plugs the uterus during pregnancy dissolves.
mucus plug
: seals the cervix and prevents bacteria from moving into the uterus.
The
cervix
is the lower part of the uterus.
Some women realize that they are in labor when they feel a trickle or gush of warm fluid from the vagina.
This indicates that the membrane, or amniotic sac, holding the fluid around the baby has broken.
Once the water has broken the mother should be within 24-48 hours of delivery.
Contractions
: the tightening and releasing of the muscles of the uterus. (Also a sign of labor)
When the uterus contracts, it shortens and closes, pushing the fetus against the cervix.
The uterus relaxes before the next contraction.
Earlier in labor the relaxation period is longer between contractions
But as time progresses the relaxation time decreases.
Contractions are painful, but bearable. After the baby is born and the placenta is also pushed out, contractions end and there is no longer lingering pain
.
premature labor:
false labor:
inducing labor:
when labor occurs at 37 weeks or less.
Warning signs: contractions every 10 minutes or less, feeling a constant dull back ache, leaking fluid, or blood.

sometimes doctors can give medication is stop premature labor.
women begin to feel strong contractions, and believe that their labor has begun. Doctors look for three signs that indicate false labor:
contractions are not regular or rhythmic
contractions DO NOT get stronger over time
contractions end with light exercise such as walking or stretching.
Starting labor by artificial means.
This can be done by using medication or puncturing the amniotic sac.

Labor is often induced for medical reasons or emergencies. If the baby has been slow to develop or is still in the womb at 42 weeks., the doctor may decide to induce labor.
This is also the case if the amniotic sac has broken and labor does not begin on its own.
Dilate = widen or open
The head of the baby is turned slightly to allow the shoulders to come out more easily
The baby emerges
AFTER BIRTH
The mother may feel a few contractions and desire to push after the baby is birthed.
These contractions are usually not painful
They help the placenta separate from the uterine wall.
Once the mother pushes the placenta out, the birth process is complete.

If needed the doctor will stitch up the episiotomy or tears that may have occurred during birth.
STEM CELL
CORD Blood
: is the blood left behind in the umbilical cord and placenta following birth.
STEM Cells
: are cells capable of producing all types of blood cells.
The stem cells can be used to treat many serious blood related illnesses in the baby or other family members.

Parents can arrange to have the cord blood stored in case there is a future medical need. It may also be donated for use by others
Cesarean Delivery
also known as a C-section — is a surgical procedure used to deliver a baby through an incision in the mother's abdomen and a second incision in the mother's uterus.
C-sections account for as many as 33% of births in the U.S. annually.
Cesarean delivery possible if:
A woman’s labor isn't progressing

The baby is not getting enough oxygen

The umbilical cord is wrapped around the neck

The baby is in an abnormal position

The woman is carrying multiples

Cephalopelvic Disproportion, when the child's head is too large or the mother's pelvis too small
RISKS and DISADVANTAGES
Increased bleeding
Blood Clots
Inflammation and infection of the membrane lining the uterus, known as Endometriosis
Mom is not able to bond with baby immediately after birth since she is just recovering from major surgery
Recovery time is much longer than a vaginal birth (6 weeks)
DOULA
Doula
is a woman who helps with the birth process
Traditionally in Latin America, a doula was like a midwife
In North America, doulas are now likely to work alongside a hospital's medical staff to help mothers through labor, delivery, breast-feeding, and new-born
Newborns First Minutes
Breath and cry on their own
•oxygen to Lungs : Color change from bluish to pinkish
•Color Change due to blood flow beneath the skin, regardless of skin hue.
•Mucus removed from throat. It can cause shallow/strained breathing.
•Umbilical Cord cut from Placenta becomes “Belly Button”.
•Examined, weighed, and given to Mother to preserve body heat.
•Eyes open, fingers grab, toes stretch and retract-Ready for life!
Apgar Scale
Color 1.
A
ppearance
Heart rate 2.
P
ulse
Cry 3.
G
rimace
Muscle Tone 4.
A
ctivity
Breathing 5.
R
espiration
Quick assessment of a newborn's health on a scale from 0-10
Most newborns score an 8 or 9. A score of 10 is rare.
•Below 7 = newborn needs help
•Below 4 = Neonatal Pediatrician is alerted for emergency care
• World Wide use
Hospital Births
Advantages
Disadvantages
Safer for mother and child
Only place available to do cesarean section if necessary
Has people to look over mother and baby at all times to make sure they are in good health
Pain medications available to making birthing easier
Allowed to have family around for comfort
More sanitary than birthing at home
Parents may feel more comfortable at home
Lack of privacy
Baby and mother are usually separated for awhile after birth
More expensive than a natural home birth
Intimidating environment may cause stress or panic
Not allowed to have many people visit you at one time
Home Births
Advantages
Disadvantages
- Can birth in the privacy of her own home
- Some feel more comfortable having special loved ones around them while giving birth
- Bond between mother and child could possibly be stronger since the baby is not taken away
Mothers who choose this method must accept a greater responsibility of their own health.
The possibility of a delay time to transfer the newborn or mother is prominent if a complication arises.
Less than 1% of births occur in home; and in some jurisdiction home birthing is illegal.
The option of home birthing is strictly recommended solely under the supervision of a certified midwife and ObGyn
Home births are more common in European countries: 2% in England & 30% in Netherlands.
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