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Chapter 5

Chapter 5 - Physical Development.docx

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David Collins

PSY 2105 F Chapter 5 Physical Development: Birth, Motor Skills & Growth October 3 2012 Birth and the Perinatal Period  The perinatal period begins with birth o Birth typically occurs at 38 weeks o Birth process lasts about 16 hours (first child) o The fetus initiates the birth process by secreting chemical messages that induce rhythmic contractions of the uterus o Three stages of birth process  Uterine dilation  Fetus passes through the cervix  Delivery of the placenta and other membranes Labour and Delivery Figure 5.1 The three stages of labour: (a) the neck of the uterus dilates; (b) the baby is delivered; and (c) the placenta is expelled. Approaches to Childbirth  Childbirth classes provide information about pregnancy and childbirth  Childbirth classes teach pain control through deep breathing, imagery, and supportive coaching  Mothers who attend classes use less medication during labor  Many women see doulas and midwives as an antidote to the ‘medicalization’ of childbirth  Doula o Acts like a ‘coach’ during labour and delivery o Non-medical services (birth assistant)  Midwife o Registered health care professional who provides primary care to low-risk women throughout their pregnancy, labour and birth and provides care to both mother and baby during the first six weeks following the birth. 1 PSY 2105 F Chapter 5 o 500 in Ontario Cesareans  A "C-section" as it is commonly called, occurs when the baby needs to be delivered through a surgical incision in the mother's abdomen and uterus. o Sometimes, this is planned. Other times, it happens due to unforeseen situations. o Studies suggest that cesareans occur about 25-30% of the time in North America.  Cesarean section rate in Canada in 2005 was 23.7%  Major abdominal surgery o Riskier than a vaginal delivery (?) o Complications are the same as those involved in other surgeries  Infection, bleeding, pain, a longer hospital stay, and a longer recovery  Potential reasons o Previous C-section o Baby in breech position o Placenta problems (e.g., rupture) o Baby’s heart rate a concern o Lack of oxygen (hypoxia) concern  U T Article o http://www.windsorstar.com/health/women/Almost+half+obstetricians+back+section+request/201972 3/story.html  No Evidence of long term negative effects o Do we care?  Maternity Program – C-sections Cultural Attitudes toward Birth  Cultural variations exist in attitudes towards pregnancy and birth o Western society treats pregnancy as an illness; follows medical model of regular doctor visits, birth in hospital, and drugs for pain relief o Other cultures view pregnancy as an everyday occurrence; follows natural model where there is little, if any, medical interventions and employs alternative pain relief Infant Mortality Rates  http://www40.statcan.gc.ca/l01/cst01/health21a-eng.htm?sdi=infant%20mortality 2 PSY 2105 F Chapter 5 The Concept of Risk  Babies may face two different risks: o Risk for major physical malformations  3% of all Canadian babies  Risk for developmental delays, and for cognitive and social problems; those who have a higher likelihood of this risk are referred to as “at risk”  Indicators of at risk status: o Maternal and family characteristics  Poor prenatal care  Low SES  Maternal nutrition and drug use  10% of Canadian babies at risk  http://www.phac-aspc.gc.ca/dca-dea/programs-mes/cpnp_main-eng.php o Physical compromise of the newborn  5-6% babies born in Canada Low Birth Weight (LBW)  Higher mortality rates (x25)  But rates lowering  NICUs  Morbidity vs. mortality issue  Preterm vs. SGA o Newborn performance on behavioural assessment tests  Newborn Assessments  APGAR o Exam  Focuses on five vital functions  heart rate, respiration, muscle tone, pain response, and skin color o Scoring  Appearance  2: Completely Pink  1: Hands and Feet are blue  0: Paleness and blue color over entire body  Pulse  2: Greater than 100 BPM  1: Detectable rate below 100 BPM  0: No heart rate detected  Grimace (response to flicking of foot)  2: Infant cries in response to flick  1: Weak cry or head movement in response  0: No response  Activity (flexing and muscle tone of limbs and resistance to straightening) 3 PSY 2105 F Chapter 5  2: Normal muscle tone  1: Limp to normal muscle tone  0: No resistance to straightening  Respirations (Second most important)  2: Regular respirations and vigorous cry  1: Weak cry  0: No respiratory response  Scoring  7 to 10 generally normal  4 to 6 indicates moderate depression  < 4 requires aggressive resuscitation o Taken at 1 minute and 5 minutes after delivery o Score of zero to two is given for each category o The higher the score, the more vigorous and “healthy” the child is considered to be  Brazelton Neonatal Behavioral Assessment Scale (NBAS) o Babies possess organized behaviours to deal with attractive vs. offensive stimuli o Assesses  Attention and social responsiveness  Muscle tone and physical movement  Control of alertness  Physiological responses to stress o Key Assumptions  Infants, even ones that seem vulnerable, are highly capable when they are born  Babies "communicate" through their behavior, which, although it may not always seem like it, is a rational language.  Infants are social organisms, individuals with their own unique qualities, ready to shape as well as be shaped by the caregiving environment 4 PSY 2105 F Chapter 5 o Sample Items Response decrement to While infant is asleep, shine light in eyes and light o observe response; after response disappears, wait 5 seconds and re-present; continue for
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