PSYC 2450 Chapter Notes - Chapter 5: Postpartum Depression, Umbilical Cord, Hemolytic Disease Of The Newborn
27 Jun 2018
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Chapter 5
Birth and the Newborns’ Readiness for Life
Chapter 5 Outline and Summary
Childbirth and the Perinatal Environment
1. The Birth Process
Childbirth consists of three separate stages. During the first stage the mother experiences
uterine contractions that dilate the cervix so the head of the fetus can pass through. The
second stage begins when the head of the fetus passes through the cervix and ends when the
baby is born. During the third stage the placenta is expelled from the mother’s body.
2. The Baby’s Experience
Although stressful for the fetus, the stress response is adaptive and assists them to withstand
oxygen deprivation during the birth, as well as to increase alertness after birth.
The Baby’s Appearance
Full-term newborns are typically about 51 cm long and weigh about 3.2 to 3.4 kg.
1. Assessing the Baby’s Condition
In the first minutes after the baby is born his or her physical condition is assessed using the
Apgar test. This test measures five characteristics: heart rate, respiratory effort, muscle tone,
colour, and reflex irritability. A newborn can score 0, 1, or 2 points on each characteristic,
and the total score indicates the newborn’s overall condition. A score of 7 or higher indicates
the newborn is in good physical condition; a score of 4 or lower often indicates the newborn
requires immediate medical attention.
In contrast to the Apgar test, which measures physical well-being, the Neonatal Behavioural
Assessment Scale (NBAS) provides a more sensitive measure of a baby’s neurological well-
being. This test is generally administered a few days after birth, and it assesses the strength
of 20 inborn reflexes, as well as changes in state and reactions to social stimuli. Several
studies suggest that parents who are educated about the NBAS may become more responsive
to their infants’ needs and behaviours.
2. Labour and Delivery Medication
Labour and delivery medications can cross the placenta and, in heavy doses, can make
babies lethargic and inattentive. Some researchers fear that parents could fail to become
involved with a sluggish, inattentive baby. Anaesthetics given to the mother can interfere
with effective pushing during delivery, thus necessitating further interventions to pull the
Chapter 5 Birth and the Newborns’ Readiness for Life 1
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baby from the birth canal. In light of the uncertainties about the long-term consequences of
medications used during labour and delivery, women and their doctors should carefully
weigh the pros and cons of their use and seek to limit the use of these medications whenever
possible.
a. Natural and Prepared Childbirth
Natural, or prepared, childbirth is based on the philosophy that childbirth is a normal and
natural part of living. The founders of this approach to childbirth claim that childbirth can be
comfortable without the need for medication if women are taught to associate childbirth with
pleasant feelings and ready themselves for the process by learning relaxation techniques that
make childbirth easier. Research reveals there are many benefits to natural childbirth; one of
the most important benefits is the social support mothers receive from their spouses and
other close companions.
b. Home Births
While the majority of Canadian births take place in hospitals, a small but growing number of
families are opting to deliver their babies at home, with the aid of a certified nurse-midwife
or doula. Women who deliver at home have shorter labours and use less medication than
those who deliver in hospitals. Many hospitals now provide birthing rooms, or alternative
birth centres, that create a home-like atmosphere, but still make medical technology
available. The evidence suggests that giving birth in a well-run alternative birth centre is no
more risky than a standard hospital delivery.
3. The Social Environment Surrounding Birth
The social environment surrounding a birth has changed significantly over the past 30 years.
Many hospitals have altered their routines to allow extended early contact between the
mother and her infant, which may help promote emotional bonding.
a. The Mother’s Experience
Some mothers find themselves depressed, irritable, and even resentful of their babies shortly
after birth. Mild forms of this condition are called the maternity blues; this mild depression
is probably linked to hormonal changes following childbirth along with the stresses
associated with being a new parent. However, slightly more than 10 percent of new mothers
experience a more serious reaction called postpartum depression. Mothers who experience
more than the maternity blues should seek professional help in overcoming their depression.
a. The Father’s Experience
New fathers often display a sense of engrossment with their baby, and some studies have
found that fathers who handle and help care for their babies in the hospital later spend more
time with them at home. Other studies have not found these long-term effects but do suggest
that early contact with a newborn can make fathers feel closer to their partners and more a
part of the family.
2Chapter 5
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Document Summary
Childbirth and the perinatal environment: the birth process. During the first stage the mother experiences uterine contractions that dilate the cervix so the head of the fetus can pass through. The second stage begins when the head of the fetus passes through the cervix and ends when the baby is born. During the third stage the placenta is expelled from the mother"s body: the baby"s experience. Although stressful for the fetus, the stress response is adaptive and assists them to withstand oxygen deprivation during the birth, as well as to increase alertness after birth. Full-term newborns are typically about 51 cm long and weigh about 3. 2 to 3. 4 kg: assessing the baby"s condition. In the first minutes after the baby is born his or her physical condition is assessed using the. This test measures five characteristics: heart rate, respiratory effort, muscle tone, colour, and reflex irritability.
