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Chapter 5

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PSYC 2450
Anneke Olthof

Chapter 5:  Childbirth and the perinatal environment - Perinatal environment: environment surrounding birth; it includes influences such as medications given to the mother during delivery, delivery practices and social environment shortly after the baby is born - Can affect well-being of the baby and the course of their development  The birth process Childbirth has 3 stages (see figure 5.1 p.141) 1. First stage of labour: the period of the birth process lasting from the first regular uterine contractions until the cervix is fully dilated (10-15 mins interval) 2. Second stage of labour: the period of the birth process during which the fetus moves through the birth canal (cervix) and emerges from the mother’s body (delivery) 3. Third stage of labour: expulsion of the placenta (afterbirth; takes 5-10 mins)  The baby’s experience - Fetuses stressed by birth; production of activating stress hormones is adaptive which helps them to withstand oxygen deprivation by increasing their heart rate and flow of oxygenated blood to the brain  The baby’s appearance - Color bluish from oxygen deprivation during birth process - Flattened nose due to passage through narrow cervix and birth canal, misshapen foreheads, assortment of bumps and bruises  Assessing the baby’s condition - Apgar test: A quick assessment of the newborn’s heart rate, respiration, colour, muscle tone, and reflexes that is used to gauge perinatal stress and to determine whether a neonate requires immediate medical assistance (range from 0-2; see table 5.1) (A baby’s score on this can range from 0-10. If 7 or +, good physical condition. If 4 or –, are in distress) - Neonatal behavioral assessment scale (NBAS): a test that assesses a neonate’s neurological integrity and responsiveness to environmental stimuli (more extensive  Labour and delivery medication - Use to make the birth process easier. However, a strong dose of birth medications can have some undesirable consequences - Too much anesthesia= less sensible to uterine contractions and do not push effectively during delivery (baby may have to be pulled from birth canal with obstetrical forceps- can cause brain damage) - Medication can cross the placenta and too much of it can make the baby lethargic and inattentive 1  Natural and prepared childbirth Natural and prepared childbirth: each involves a delivery in which physical and psychological preparations for the birth are stressed and medical assistance is minimized - Cesarean section: surgical delivery of a baby through an incision made in the mother’s abdomen and uterus  Home births - Home deliveries= reduce the mother’s fear and offer maximum social support and use of medications. Relaxed atmosphere: shorter labour and less medications used - Alternative birth center: a hospital birthing room or other independent facility that provides a homelike atmosphere for childbirth but still makes medical technology available - Home births are just as safe as hospital deliveries, provided that the mother is healthy and is attended by a competent doctor or midwife  The social environment surrounding birth  The mother’s experience - Emotional bounding: term used to describe the strong affectionate ties that parents may feel toward their infant; some theorists believe that the strongest bonding occurs shortly after birth, during a sensitive period (6-12 hours after birth) - Study made by Klaus and Kennell  Postpartum depression: strong feelings of sadness resentment and despair that may appear shortly after childbirth and can linger for months o Maternity blues: passes within a matter of week or two, linked to hormonal changes and stress associated with new responsibilities of parenthood. May affect 40-60 % of new mothers and 10% more serious depressive reaction o Philip Dunham; approach to lowering one contributor to postpartum depression, parenting stress  The father’s experience - Engrossment: paternal analogue of maternal emotional bonding; term used to describe father’s fascination with their neonates, including their desire to touch, hold, caress and talk to the newborn baby  Birth complications 1. Anoxia - Anoxia: a lack of sufficient oxygen to the brain; may result in neurological damage or death (umbilical cord become tangled during birth, placenta separates prematurely and if sedatives given to the mother cross placental barrier and interfere with breathing) - Breach birth: a delivery in which the fetus emerges feet first or buttocks first rather than head first (often delivered by cesarean to avoid anoxia) - RH factor: a blood protein hat when present in a fetus but not the mother can cause the mother to produce antibodies. These antibodies may then attack the red blood cells of subsequent fetuses who have the protein in their blood 2 2. Low birth weight Two types: 1. Preterm infants: infants born more than 3 weeks before their normal due date - Small in size, but body weights is appropriate for the amount of time they spent in womb 2. Small-for-date (or small for gestational-age) babies: infants whose birth weight is far below normal, even when born clos
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