Pregnancy, Birth, and the Newborn

This post has many interesting facts and/or tidbits of information … not necessarily focused on one thing or another.  These notes are taken from Human Behavior in the Social Environment:  A Multidimensional Perspective written by Jose B. Ashford, Craig Winston LeCroy and Kathy L. Lortie.  This is a textbook that social workers use for guidance in assessing where their clients’ current problems may have stemmed from … you’d think that if it is known where the problems may be coming from, we’d be doing everything we could to prevent them from happening in the future.  Right?

–  “One example of a cultural practice that has served to establish the man as the father of the baby is couvade.  In certain indigenous communities, the father is expected to behave as if he, like the mother, must avoid certain foods and engage in restraint in performing some physical activities.  Also, a common feature of couvade is that while his wife is delivering the infant, the father goes to bed and may even complain of labor pains.  This custom symbolically establishes the man as the father of the baby and gives him legal rights as the parent.  In modern societies, up to 65% of men report symptoms of pregnancy during their partner’s gestation, including nausea, fatigue, back pain, and even abdominal pain.  Some research suggests that couvade brings the father into a “paternal state” and that this might reduce the risk of the father abusing the child.  Although there are no definitive answers about this syndrome, research indicates that men have psychological, emotional, and physical needs related to fatherhood that should be addressed.”

–  “The postdelivery process also includes an additional set of adaptations that are heavily determined by the health status of the mother and the availability of appropriate supports.”

–  “In addition to role changes, mothers confront many postpartum physical changes, including, “discomfort from an episiotomy or Cesarean section incision, uterine cramps, breast engorgement or infection, nipple irritation, poor appetite, fatigue, anemia, thyroid disorders, hot flashes, increased sweating, dizziness, acne, sleep disturbances, carpal tunnel syndrome, hand numbness or tingling, excessive vaginal bleeding … and sexual concerns.””

–  “The fetus is full term and ready for life outside the uterine environment between thirty-eight and forty-one weeks.”  Isn’t it amazing how the number of weeks varies from source to source?  Doctors say thirty-seven weeks is full term and forty weeks is overdue.  Midwives range from thirty-nine weeks to forty-three weeks.

–  “As labor progresses, toward the end of the first stage, the contractions may come one right after another and last up to two minutes.  During this phase, a laboring woman needs a lot of support and encouragement.”

–  “The most popular method of prepared childbirth was developed by a French obstetrician, Fernand Lamaze.  In the Lamaze method, the father or other support person attend classes where they learn about the birth process and specific relaxation techniques.  Knowledge and relaxation help reduce fear and thereby reduce pain.  The woman is taught to replace the normal responses to pain of fear and tension with more useful and distracting responses, such as patterned breathing and relaxation.”  If I am reading about this in a textbook, why then are doctors not encouraging childbirth education classes more emphatically?

–  “More recently, studies have shown that women who walk and move around during labor have shorter labors, experience less discomfort, and need less medication than women who lie down.”  Again, why are doctors not encouraging a more “active” labor?  “Studies have also shown that the presence of a supportive female birth attendant, or doula, during labor results in less medication, less medical intervention, fewer birth complications, and a shorter labor.”  I am so glad to be reading this in a textbook.  However, why are some doctors banning doulas from the births they attend?  Who wouldn’t want less medication and less intervention?  It would certainly help to cut the costs of healthcare.

–  “There is a marked increase in the use of midwives in some areas of the United States.  In 1975, midwives attended to about 1% of births, 5.5% in 1994, and 9% in 1998.  Yet, 80% of the world’s babies are born with midwives, who often provide much better prenatal care than is achieved in the United States.”

–  “Regional anesthesias include the epidural.  In the epidural, an anesthetic is injected into the mother’s lower spine.  Though little of this drug reaches the baby, its long-term effects on the baby are still unknown.”

–  “Although most women who are prepared for childbirth use less medication than those who are not, the use of medication in labor in many hospitals remains quite high.  In fact, in some hospitals the rate of epidural use approaches 85-90%.”  Hmmm … could this be because doctors are not recommending childbirth education as highly as they should be?

–  “A woman with gonorrhea can pass the infection to her newborn during birth, resulting in blindness in the infant.  As a safeguard, most hospitals treat a newborn’s eyes with erythromycin ointment or silver nitrate.”  Okay, so at the beginning of the pregnancy, you are tested for everything under the sun, including all STDs.  How many ‘safeguards’ are really needed?

–  “Though the media have given much attention to “crack babies,” the leading known preventable cause of irreversible mental retardation in the Western world is a common legal drug:  alcohol.”

–  “Smoking also has been suspected of causing a higher risk of sudden infant death syndrome (SIDS).  Other research suggests that maternal smoking decreases in-utero fetal responsiveness to external stimuli.  A growing number of studies now are showing that the effects of smoking during pregnancy may be long-term.  Children of smokers are smaller and show problems with cognitive development and educational achievement;  Drews, Murphy, Yeargin-Allsopp, and Decofle (1996) have suggested that smoking during pregnancy increases the risk of mental retardation by 50% compared with nonsmoking mothers.  Infants of smokers show differences in responsiveness by 1 week of age.  Through the preschool years, these children scored lower on verbal tests than did children of non-smokers.”  Why, then, would anybody even consider smoking during pregnancy?

–  “In the New England Journal of Medicine, Davidson stated that we need to assess the role of stress in pregnancy as a contributing factor to premature and low-birth-weight infants.”

–  “A prolonged labor is one lasting more than twenty-four hours for a first-time mother or more than twelve hours for a woman who has previously given birth.”  Why then are doctors in such a rush to move things along?  There is no need for a mother to dilate at the rate of 1cm per hour or face medical intervention.

–  “Though a c-section can be a life-saving solution to a birth complication, the procedure itself carries increased risks for the mother and the baby.  A cesarean birth increases the mother’s risk of pain, trauma, and surgical complications and has two to four times the risk of maternal mortality as a vaginal birth.  In addition, some studies have shown that women who give birth by cesarean suffer from depression more than do women who give birth vaginally.  Depression is a common consequence of major surgery, and a c-section is major surgery.  A woman who gives birth by cesarean not only must recover from surgery but also much care for a newborn infant.  This experience may leave her feeling tired and drained, and her fatigue and depression may interfere with mother-infant interactions.”  Why are we willingly taking THESE chances with our life?

–  “Another breathing problem of premature infants that can cause distress to new parents is apnea, or periods when the baby stops breathing.  Apnea is common among premature babies after periods of exertion, such as following a feeding.  Babies experiencing apnea may need to be on a monitor to signal when breathing has stopped, so the baby can then be stimulated to resume respiration.”

–  “The combination of an immature nervous system and a lengthy stay in an overstimulating hospital environment may make the baby irritable and difficult to parent.”

~ by cmb0414 on August 13, 2010.

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