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Family Relations and Human Development
FRHD 1020
Susan Chuang

Stephanie Oliveira 1 Chapter 3: Birth and Newborn Child The birth process  Oxytocin: Hormone released by pituitary gland that causes labour to begin. Stage of the Birth Process  Stage 1: Labour- Longest and most taxing stage, averaging about 12 hours for first births and 6 hours for subsequent births. Contractions increase in duration, frequency, and intensity, causing the cervix to dilate.  Stage 2: Delivery. Usually takes half and hour to an hour, but there is a wide variation. The mother pushes, and the baby crowns and then exits the birth canal and enters the world.  Stage 3: Expelling of Placenta and Umbilical Cord. Contractions continue as the placenta and umbilical cord is expelled. The process usually takes a few minutes. - episiotomy: incision to make the vaginal opening larger during birth process. Birth Complications - Failure to progress and breech presentation o Failure to progress means that the woman has begun the birth process but it is taking longer than normal. o Breech presentation- positioning of the fetus so that feet or buttocks, rather than the head, is positioned to come first out of the birth canal. o Cesarean Delivery: (C-section) type of birth in which mother’s abdomen is cut open and fetus is retrieved directly from uterus. o Some of the countries that have the lowest rates of C-sections also have very low rates of birth complications, which seem to indicate that many C-sections performed in other countries are unnecessary. o For women who have had a C-section, there is a possibility of having a vaginal birth with the next baby, a procedure known as a VBAC (vaginal birth after caesarean section). Cultural and Historical Variations in Birth Beliefs and Practices Cultural Variations in Birth Beliefs Beliefs and Rituals Surrounding Birth  Many traditional cultures have developed beliefs that it puts a woman in a state of being spiritually unclean  In some cultures, birth must take place away from where most people reside, so that others will not be contaminated by it.  Many cultures have beliefs that the mother remains unclean long after the birth and must be kept away from others, for her own sake as well as teirs.  In Traditional Vietnam, the mother as to avoid going out for at least 30 days after birth, in order not to contaminate the rest of the village or endanger herself or her infant.  Some cultures have rituals for women to purify themselves after birth and not just non-Western cultures Meanings of the Placenta.  The placenta is a component of the birth process that has often carried its own special cultural beliefs.  In some cultures, the methods for disposing the placenta are clear and simple: burial, burning, or throwing it in a river, or keeping it in a special place reserved for placentas.  In developed countries the placenta is recognized as having special value as a course of hormones and nutrients. Hospitals give their placentas to researchers, or to cosmetic manufacturers who use them to make products such as hair conditioner.  The placenta is full of nutrients that can provide a boost to an exhausted new mother about to begin nursing. Cultural Variations in Birth Practices  Midwives are usually the main birth assistants in rural areas of developing countries.  Who helps? o The women who are charged with managing the birth process usually have a special status as midwives. o Midwives tend to be older women who have had children themselves but are now beyond childbearing age. o In some cultures, she receives what she believes to be a supernatural calling in a dream or a vision. In other culture, the position of midwife is inherited from mother to daughter. o Some cultures allow women to volunteer as midwives. o Typically, the woman who is to be a midwife spend several years in apprenticeship to be a more experienced midwife before taking the lead in addicting with birth. o Most often, the midwife was a highly respected status in her culture, and is help in high regard for her knowledge and skills. o In other cultures, midwives have been regarded with contempt or fear. o In India, Midwives come from the castes that have the lowest status.  Easing the Birth o When visiting the prospective mother, the midwife typically gives her and abdominal massage. This is believed to make the birth easier and it also allows the midwife to determine the position of the fetus. o The midwife often gives the mother herbal tea, intended to prevent miscarriage and promote healthy development of the fetus. o In many cultures in Asia and South America, foods are classified as “hot” or “cold” and the mother is forbidden from eating “hot” foods. Stephanie Oliveira 3 Chapter 3: Birth and Newborn Child This helps reassure the expectant mother and enhance her confidence going into birth process. o When the women begins to go into labour, the midwife is called, and the expectant mother’s female relative gather around her. o During the early part of labour, the midwife may use the intervals between contractions to explain to the expectant mother what is to come—how the contractions will come more and more frequently, how the woman will eventually have to push the baby out, and what the women’s position should be during the birth. o The longer the labour, the more exhausted the mother and the greater the potential danger to mother and child. Consequently, cultures have created a wide variety of practices intended to speed it up. o Epidural: the injection of an aesthetic drug into the spinal fluid to help the mother manage the pain while also remaining alert. o Another important part of the strategy for easing the birth in many cultures is the physical position of the mother. In nearly all cultures some kind of upright position is used, most commonly kneeling or sitting, followed in prevalence by squatting or standing. o After birth, typically the baby is laid on the mother’s abdomen until the placenta an umbilical cord expelled from her uterus. o A variety of strategies are used to promote delivering the placenta, such as massage, medication, and rituals involving opening or expelling, or attempts to make the woman sneeze or vomit. o After the placenta is expelled, the umbilical cord is cut. Usually the cord is ties with thread, string, or plant fibre.  Midwives Versus Doctors o In the west, as in other cultures, most births throughout most of history were administered by midwives. The role of midwife was widely valued and respected. Most did their work for little or no pay, although families often present them with a gift after birth. o This began to change in the 15 century, as a witch-hunting fervor swept over Europe. In 1486 an influential witch-hunting manual was published by two monks, declaring that “No one does more harm to the Catholic faith than midwives.” o In the early 18 century a new challenge arose to the status of midwives. Medical schools were established throughout Europe, and many of the new doctors considered delivering babies to be the domain of physicians. o Forceps: pair of tongs used to extract the baby’s head from the womb during delivery. o Obstetrics: field of medicine that focuses on prenatal care and birth.  The 20 Century Slow Progress o Natural childbirth: approach to childbirth that avoids medical technologies and interventions o Electronic fetal monitoring (EFM): method that tracks the fetus’s heartbeat, either externally through the mother’s abdomen or directly by running a wire through the cervix and placing a sensor on the fetus’s scalp. SECTION 2 The Neonate’s Health  Fontanels: soft spots on the skill between loosely joined pieces of the skill that shift during birth process to assist passage through the birth canal.  Neonate: newborn baby, up to 4 weeks old  Neonatal jaundice: yellowish pallor common in the first few days of life due to immaturity of the liver. o The most effective treatment is a simple one, phototherapy, which incolves exposing the neonate to coloured light; blue works best. Measuring Neonatal Health  Anoxia: deprivation of oxygen during birth process and soon after that can result in serious neurological damage within minutes. The Apgar Scale: neonatal assessment scale with five subsets: Score 0 1 2 Appearance (body Blue and pale Body pink, but Entire body pink colour) extremities blue Pulse( Heart rate) Absent Slow—less than 100 Fast—100-140 beats beats per minute per minute Grimace (Reflex No response Grimace Coughing, sneezing, irritability) and crying Activity (Muscle Limp and Flaccid Week, inactive, but Strong, active motion tone) some flexion of extremities Respiration No breathing for Irregular and slow Good breathing with (breathing) more than 1 minute normal crying. The Brazelton Scale  Brazelton Neonatal Behavioural Assessment Scale (NBAS): 27 item scale of neonatal functioning with overall ratings “worrisome,” “normal,” and “superior”  Usually performed about a day after birth but can be given any time in the first 2 months.  Predicts future development if it is given a day after birth and then a week after.  For at risk nenates as well as others, the NBAs can help inform parents about the abilities and characteristics of their infants.  The NBAs has also been used in research to examine differences among neonates across cultures and how those differences interact with parenting practices. Stephanie Oliveira 5 Chapter 3: Birth and Newborn Child Low Birth Rate  Low birth weight: term for neonates weighing less than 2,500 grams (5.5 lbs)  Preterm: babies born at 37 weeks gestation or less  Small for date: term applied to neonates who weigh less than 90% of other neonates who were born at the same gestational age.  In developing countries, the main cause for low birth weight is that mothers are frequently malnourished, in poor health, and receive little or no prenatal care.  In developed countries, the primary cause of low weight is the mothers cigarette smoking. Consequences of Low Birth Rate  Very low birth weight: term for neonates who weigh less than 1,500 grams (3.3 lbs) at birth.  Extremely low birth weight: term for neonates who weigh less than 1,000 grams (about 2.2 lbs) at birth.  Surfactant: substance in lungs that promotes breathing and keeps the air sacs in the lungs from collapsing. Treatment for Low birth Weight Babies.  Kangaroo care: recommended care for preterm and low birth weight neonates, in which mothers or fathers are advised to place the baby skin to skin on their chests for 2-3 hours a day for early weeks of life.  It helps newborns stabilize and regulate bodily functions such as heart rate, breathing, body temperature and sleep-wake cycles.  Preterm infants treated with kangaroo care are more likely to survive their first year, and they have longer periods of sleep, cry less, and gain weight faster than other preterm infants.  The other traditional method of infant care that is helpful for low-birth weight babies is infant massage. In the West, infant massage developed because low birth weight babies are often placed in an isolette, a covered, sterile chamber that provides oxygen and a controlled temperature.  The isolette protects neonates from infection but also cuts them off from sensory and social stimulation.  Preterms neonates who receive 3 15-minute massages a day in their first days of life gain weight faster than other preterm babies, and they are more active and alert.  In adolescence, low birth weight predicts relatively low intelligence-test scores and greater likelihood of repeating a grade.  In adulthood, low birth weight predicts brain abnormalities, attention deficits, and low educational attainment. Physical Functioning of the Neonate Neonatal sleeping patterns  Rapid eye movement (REM) sleep: phase of the sleep cycle in which a persons eyes move back and fourth rapidly under the eyelids; persons in REM sleep experience other physiological changes as well.  In adults, REM sleep is the time when dreams take place.  Neonates brain wave’s look similar to waking brain waves, but for infants the REM br
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