Exam 2 Notes - Exam#2 Birth February 8 2008 Natural...

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Exam #2 Birth: February 8, 2008 Natural Childbirth Bradley, Lamaze Managed Birth Labor is controlled by a practitioner Determined by protocol of hospital/ center Analgesics: Reduce pain, Narcotics (Demoral), can cross placenta Epidurals: Spinal, epidural, walking Spinal anesthetics Needle is inserted into spinal column Medications injected Reduces pain immediately In C-Section, a general anesthetic can also be used Most common procedure Medication is inserted into epidural space Catheter is then inserted for additional doses of medication May be used as soon as somebody is in active labor Walking Epidural: o Catheter is left in place for pain management similar to epidural o Can walk and move around, only abdominal muscles are numbed o May be used later if C-Section is needed o May administer other medications Other Options: Water Birth o Helps with pain and stress. o Gentle, should be used at body temperature Coaches (Doula’s) o Not medically trained, provide emotional support for mother Birthing Centers o Nurses and midwives, doctor on call, no anesthesia, no complications, and a family approach. First Stage: Longest 8-18 hours Mild contractions (10-20 min apart) Contractions will progressively become more frequent and last longer First Stage- Active
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Cervix is completely dilated (dilate about 1 cm per hour) Contractions are longest and most intense o Lasts 60-90 seconds / 2-3 min apart Water breaks Hardest and most uncomfortable Second Stage: Delivery of the baby (top of head appears) Episiotomy Baby is checked and cleaned 20-50 min (shorter in subsequent births) Reasons for Low Birth Weight: Poverty, race/ethnicity, women over 30, multiple births, medical conditions Placenta Previa: Placenta partially or fully covers cervix Delivered first Can cause bleeding Determined by ultra sound Under 1% of pregnancies Placenta Abruption: Life threatening for baby LBW Premature Under 1% of pregnancies Breech: Baby is positioned with butt/legs, arm, or any body part other than head downward Serious and life threatening for mother and baby Complications Induction: Prostaglandin gel Pitocin Reasons for induction Water broke Medical conditions Baby is overdue Forceps Delivery: Used when fetus needs to be removed, but is not clearing the birth canal Complications associated with forceps
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Prefer vacuum delivery o Vacuum cap attached to fetal head o Removed fetus from birth canal o Fewer complications than forceps Rh Factor: Early in pregnancy, Rh factor is determined If mother is negative, and fetus is Rh positive, then a reaction may occur Subsequent pregnancies also present greater risk Me conium Stain: 1 st bowel movement in utero Suction Aspiration Respiratory problems Assessment Non-Contracting Uterus: After delivery of baby and placenta Uterus should naturally start to contract
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