Lesson 4: First Three Years (Birth & Physical Devt)

• Childbirth is "a struggle with death" for both mother and baby
• In the 17th and 18th century, women had a 1 in 10 chance of dying while or shortly after giving birth; thousand of babies were stillborn and 1 out of 4 born alive died during the 1st year
• At the end of the 19th century, an expectant mother was almost 50 times more likely to die in childbirth than a woman giving birth in modern times
• At the start of the 20th century, childbirth began to be professionalized in the United States; the growing use of maternity hospitals led to safer, more antiseptic conditions for childbirth
• In 1900, only 5 percent of U.S. deliveries occurred in hospitals; by 1920, in some cities 65 percent did
• In 1940, there were 47.0 infant (from birth to 1 year of age) deaths per 1,000 live births; by 2016, this rate had decreased to 5.87 infant deaths per 1,000 live births
• Labor


  An apt term for the process of giving birth
• Parturition


  The act or process of giving birth, and it typically begins about 2 weeks before delivery
• Braxton-Hicks Contraction


  False contractions at time during the final months of pregnancy, when the muscles of the uterus tighten for up to 2 minutes
• Electronic Fetal Monitoring


  Mechanical monitoring used to track the fetus's heartbeat during labor and delivery and to indicate how the fetal heart is responding to the stress of uterine contractions
• Stages of Childbirth

  1. Dilation of the Cervix

  2. Descent and Emergence of the Baby

  3. Expulsion of the Placenta

  
• Vaginal Delivery


  The usual method of childbirth that stimulates the release of oxytocin, a hormone involved in uterine contractions (maternal behavior)
• Cesarean Delivery


  Delivery of a baby by surgical removal from the uterus (incision in the mother's abdomen), performed when labor progresses too slowly, when the fetus seems to be in trouble, when the mother is bleeding vaginally, or when the fetus is in the breech or transverse position or the head is too big to pass through the mother's pelvis
• Forceps


  An instrument shaped like a large pair of salad tongs used to grasp and pull the head
• Methods of Childbirth

  • Natural Childbirth
  • Prepared Childbirth
  • Lamaze Method
  • LeBoyer Method
  • Submersion in Water
  • Bradley Method
  • Other methods using mental imagery, massage, gentle pushing, and deep breathing
• Pudendal Block


  Local (vaginal) anesthesia given during the second stage of labor
• Analgesic


  Reduces the perception of pain by depressing the activity of the central nervous system, but has side effect to labor process and baby
• Epidural


  Regional anesthesia injected into a space in the spinal cord between the vertebrae in the lumbar region
• Doula


  An experienced mentor who furnishes emotional support and information for a woman during labor
• Neonatal Period


  The first 4 weeks of life, a time of transition from intrauterine dependency to independent existence
• Anoxia or hypoxia


  Lack of oxygen which might result in permanent brain injury or damage, causing mental retardation, behavior problems, or even death
• During the first few days infants excrete meconium, a stringy, greenish-black waste matter formed in the fetal intestinal tract
• Neonatal Jaundice


  A condition, in many newborn babies, caused by immaturity of the liver and evidenced by yellowish appearance; can cause brain damage if not treated promptly
• Apgar Scale


  Standard measurement of newborn's condition, assessing Appearance, Pulse, Grimace, Activity, and Respiration, rated 0, 1, or 2 on each measure with a maximum score of 10
• Brazelton Neonatal Behavioral Assessment Scale (NBAS)


  A neurological and behavioral test to measure a neonate's responses to the environment, assessing Motor Organization, Reflexes, State Changes, Attention and Interactive Capacities, and Indications of CNS Instability
• States of Arousal

  • Regular Sleep
  • Irregular Sleep
  • Drowsiness
  • Alert Inactivity
  • Waking Activity and Crying
• Low-birth-weight babies (LBW)


  Infants with a birth weight of less than 5½ pounds (2,500 gr) due to prematurity or being small-for-date
• Risk Factors for Low Birth Weight

  • Demographic and socioeconomic factors
  • Medical factors predating the pregnancy
  • Prenatal behavioral and environmental factors
  • Medical conditions associated with the pregnancy
• The most pressing fear regarding very small babies is that they will die in infancy, given the multitude of challenges they face due to their immature immune system, nervous system, and inability to generate heat
• Respiratory distress syndrome


  Lack an adequate amount of an essential lung-coating substance called surfactant, which keeps air sacs from collapsing
• Kangaroo Care (KC)


  An intervention method of skin-to-skin contact in which a newborn is laid face down between the mother's breasts for an hour or so at a time after birth
• Preterm infants are at greater risk for high blood pressure, metabolic syndrome, adult-onset diabetes, and cardiovascular disease, but environmental factors like maternal education, two-parent family structure, and higher SES are associated with positive developmental outcomes
• Postmature


  Fetus not yet born as of 2 weeks after the due date or 42 weeks after the mother's last menstrual period
• Stillbirth


  The sudden death of a fetus at or after the 20th week of gestation
• Infant Mortality Rate


  The proportion of babies who die within the 1st year, caused by birth defects, genetic abnormalities, disorders related to prematurity or LBW, SIDS, maternal complications, accidents, and complications of the placenta, umbilical cord, and membranes
• Sudden Infant Death Syndrome (SIDS)


  The sudden death of an infant under age 1 in which the cause of death remains unexplained after a thorough investigation that includes an autopsy, involving three overlapping factors: a vulnerable infant, a critical period, and an exogenous stressor
• Vaccines


  Mobilize the body's natural defense to prevent fatal childhood illnesses such as measles, pertussis (whooping cough), and polio
• Some parents hesitate to immunize their children because of speculation that certain vaccines—particularly the diphtheria-pertussis-tetanus and measles-mumps-rubella vaccines—may cause autism or other neurodevelopmental disorders. However, there is no evidence that this is true.
• Cephalocaudal principle


  Sensory and motor development proceed from the upper parts of the body to the lower parts
• Proximodistal principle


  Growth and motor development proceed from the center of the body outward