Option A Introduce the - PowerPoint Presentation

Slide1

Option A

Introduce

the

Labor and Delivery Nurse who will give all of the information found in this section of

the unit

3 workbook. She will tell a lot of great stories while giving the information, show

segments

of different kinds of births from a labor and delivery video,

demonstrate an epidural, show many great visuals used for birth, and

finish off the period by showing the students a real afterbirth that she got from the hospital that morning.

 Slide2

Option B

If you do not have a speaker lined up:

MOTIVATOR:

Give each student an ice cube and have them hold it in their hand for as long as they can. Once they think that they cannot hold it any longer, tell them to hold onto it for just a little bit longer.

Discuss: how did they make it through this? (breathing, concentrating on something else…) These are all techniques that a woman would use to get through labor and delivery. You will all be fine.



Have students follow along in their workbooks with the Labor and Delivery power point as you go over each slide.Slide3

Journal

What are you doing this long Thanksgiving weekend?Slide4

Bell Quiz Slide5

LABOR & DELIVERY

For 9 months, the unborn child has been developing in the womb. Now the baby is ready to make an

exit….or an entrance. Slide6

Lightening

The baby settles deep into mom’s pelvis during the 9

th

month.

This happens weeks or days before labor begins

The hormone relaxin is released into the pelvic area.

a. helps ligaments become stretchy

b. Bones of pelvis can move to allow baby to pass through.Slide7

Reliable Indicators that labor has begun

The Show / Mucus Plug:

Keeps amniotic fluid

from leaking

out

Prevents

infection from getting

to the fetus.

Spotting of blood because of the mucus plug coming out as the cervix begins to dilate.

Water Breaks:

Rupture of amniotic sac causing fluid to leak through cervix and out the birth canal.

Does not always happen naturally.

And..Slide8
Slide9

Contractions

Contractions

are the rhythmic tightening and relaxing motions of the muscles of the uterus.

Braxton-Hicks Contractions

are called “false labor.” They can occur throughout the pregnancy and typically involve the back, not the uterus. They are not regular and can go away with exercise.Slide10

Doctors look for three signs to determine if it is false labor or real labor.

Are contractions regular & rhythmic?

Are contractions getting increasingly stronger?

Do contractions stop if mom walks around or showers?Slide11

Induced Labor

Sometimes the body just does not go into labor or the doctor needs to control when labor begins so the doctor will induce labor.

A doctor causes labor to begin by injecting Pitocin which begins the contractions.

A doctor ruptures the amniotic sac to begin contractions.

A doctor will strip the membranes (show).Slide12

U

terine

contractions begin (left) and are usually spaced from 10 to 20 minutes apart.

Initially

the contractions are gentle, but they tend to become more

powerful or stronger, sometimes uncomfortable, last longer, and become more frequent.

With

each

contraction

the

cervix

becomes larger (dilation) reaching to a 7cm

. (

right picture)

With

each

contraction

the cervix becomes thinner (effacement)

.

Longest Stage of labo

r

Average

length is two to ten

hours

Microsoft ® Encarta ® Encyclopedia 2002.

© 1993-2001

First stage of Labor (Dilation)Slide13

Fetal monitor is attached to the mom to

observe

the

baby

.

Fetal monitor is attached to the mom to observe the baby.Slide14

Labor is

the

energy and effort used to push the baby out of the

womb through a

period of irregular

uterine contractions in which the cervix thins, softens, and may begin to dilate.

As

labor progresses, the contractions increase in frequency and severity.

For

women giving birth for the first time, labor will usually last between 12 to 24 hours. However, for women who have given birth before, labor usually averages only 6 hours. Slide15

Labor is commonly divided into three stages.Slide16

Dilation

is when the cervix dilates from 0 – 10 cm.

Effacemen

t

is the thinning of the cervix.

The cervix goes from 10 saltine crackers thick to 1 saltine cracker thick.

Slide17
Slide18

Crowning

is when the head of the baby can be seen

at the outside edge of the vagina and

remains visible without slipping back in

.Slide19
Slide20
Slide21

Transition

Regular, powerful, contractions every two to three minutes that last up to 60 to 90 seconds

Last about 90 minutes

Baby’s head enters birth canal and crowns.

Cervix dilates to a complete 10 cm.Slide22

The

mother pushes, or bears down, in response to pressure against her pelvic

muscles

and the baby is

expelled

from the uterus or when the baby is born.

Contractions

continue to occur throughout this stage to help push the baby out of the mom’s body

.

Fontanels

soft spots on a baby's head which, during birth, enable the bony plates of the skull to flex,

allowing

the child's head to pass through the birth canal

.

Second stage of Labor (Expulsion)Slide23

As the head emerges entirely (

left

) the physician turns the baby’s shoulders (right), which emerge one at a time with the next contractions. The rest of the body then slides out relatively easily, and the umbilical cord is sealed and cut. Slide24

Baby is deliveredSlide25

DELIVERY & EQUIPMENT

Sometimes

extra procedures are used

if

delivery progress

is not being made and the baby is in the birth canal too long.Slide26

EPISIOTOMY

A surgical cut in the

perineum

done before delivery.

Given to enlarge the vaginal opening and to prevent the

skin

from

tearing

.

C. Stitched after the

3

rd

stage of labor.Slide27

FORCEPS

Specialized

tongs

made of surgical steel, made to fit the baby's head.

Helps baby emerge more

quickly

or

slowly

if needed. Slide28

VACUUM EXTRACTOR

A vacuum hose that first on the baby’s

head

.

Used to guide the

baby

during delivery. Slide29

BRAIN

When making a decision, we need to ask the right questions so that we can see our options clearly. This is a little acronym to remind you to use your brain when making decisions. It is useful in labor, but can be used for making all kinds of decisions along life's journey!

B

enefits--

what are the benefits of doing this?

R

isks--

what are the risks involved in doing this?

A

lternatives--

what are the alternatives to doing this? Are there other options?

I

nstinct or intuition--

what is my intuition telling me to do?N

ow what will happen?--

what will change if I do this?

Slide30

VAGINAL DELIVERY

Vaginal

Delivery – Baby is delivered vaginally through the birth canal.

Preferred

because it helps the baby expel the amniotic

fluid from its lungs which helps to

clear

away any blockages in the lungs and nasal areas naturally rather than with extra medical attention.

Babies

ingests

protective

bacteria as

they

pass through your birth canal. This bacteria colonizes in their intestines and forms a balanced immune system as they develop from childhood into adulthood.Slide31

Positions for Giving Birth

Lie on back

Squatting

Lie on side

Sitting

Kneeling

In waterSlide32

CAESAREAN Section Delivery

A major

surgical

procedure in which one or more

incisions

are made through a mother's

abdomen

and

uterus

and then the baby is delivered

through the incision in the abdomen and uterus.

Cesar is said to have been born this way

Takes 6 weeks or more to fully

recover.Slide33
Slide34

http://www.babycenter.com/2_live-birth-c-section-surgery_3656510.bcSlide35
Slide36

Cesarean Delivery Used When:

The labor is long and difficult and the life or the baby or mother is threatened.

Umbilical

wrapped

around baby’s

neck.

The fetal monitor shows a drop in heart rate. Fetal distress.

Placenta Previa =

placenta is covering the opening to the cervix.

The woman’s bone structure is too small to allow vaginal delivery or the baby is too big.

Prolapsed cord =

the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the babyPoor

presentation =

breech, transverse, posterior

Placenta abruption =

placenta peels away from the inner wall of the uterus before delivery

either

partially or completely

STDs

Previous C-section

ToxemiaSlide37
Slide38

Vaginal Birth After Cesarean

Focus on good nutrition and exercise

Take a refresher birth class that supports VBAC

Find caregiver/hospital who believes in VBACS ~ know their policies!

Hire a doula

Practice relaxation, visualization, and affirmations

Write a birth plan

Establish safe supportive environment

Work on left-over negative emotions

Learn to trust, cooperate with and listen

to

your body and baby

Try variety of

birth positionsContinue calorie and fluid intake

Avoid medical intervention

Avoid artificial induction

Avoid an epidural – try natural pain reliefSlide39

Birthing room

Option A: Labor and deliver in one room and then moved to another room to recover.

Option B: Labor,

delivery, and recovery all occur in the

same room

.Slide40

Operating Room

Operating

room – used for cesarean

deliveries or other complicationsSlide41

Delivery Stations or PresentationsSlide42

BIRTH POSITIONS

Normal

Head first,

face down

, looking to the back of mom.

Delivered

vaginallySlide43

BIRTH POSITIONS

Posterior

Head first,

face up

, looking to the front of mom.

Delivered

vaginally.Slide44

BIRTH POSITIONS

Breech

Feet or buttocks is

first

Delivered

caesareanSlide45

BIRTH POSITIONS

Transverse

Fetus laying

sideways

Delivered

caesareanSlide46

Stations

When

your provider tells you about your baby’s station, she is referring to how far down your baby’s head has come into your pelvis.

If

your baby has

dropped (lightening / engaged),

but has not yet settled into your pelvis to begin his or her decent, it is measured in centimeters as a negative station. This negative measurement goes from -3 to -1.

Once

your baby has settled into your pelvis, but before he starts his descent to the birth canal, it is referred to as a zero (0) station.

Once

your baby starts heading towards the cervix, it is referred to as a positive station from 1 to 3. During this time it is likely that you will feel an increase of pressure and pain in your pelvic bone and vaginal area.

 Slide47

Last part of the bell quiz!!!Slide48

Common Choices of Anesthesia

Most women prefer some kind of anesthesia.

An epidural is given in the spinal sheath and deadens the patient from the waist down.

A saddle block deadens the area where you ride a saddle.

A

paracervical

block, also known as a cervical block deadens the cervix.

A

pudendal

block is given in the

pudendal

nerve and will numb the whole bottom and legs.

Natural (

unmedicated

) childbirth is becoming more popular because the anesthesia can make the newborn baby less alert after birth.

The cervix must dilate to some degree before any anesthesia is given. For this reason, a mother needs to learn some breathing and relaxation techniques.Slide49

Childbirth without

medication

.

If

you choose to go this route, you accept the potential for pain and discomfort as part of giving birth. But with the right preparation and support, women often feel empowered and deeply satisfied by natural childbirth.

Here are the pros:

Most natural childbirth techniques are not invasive, so there's little potential for harm or side effects for you or your baby.

Many women have a strong feeling of empowerment during labor and a sense of accomplishment afterward. Despite having to endure pain, many report that they'll choose an

unmedicated

birth again the next time. For some women, being in charge helps lessen their perception of pain.

There's no loss of sensation or alertness. You can move around more freely and find positions that help you stay comfortable during labor. And you'll remain able to participate in the delivery process when it's time to push your baby out.

Your

partner can be involved in the process as you work together to manage your pain.

You can use the breathing exercises, visualization, and self-hypnosis you learn both during labor and later on. Many new mothers find themselves drawing on their relaxation techniques in the early days of breastfeeding, while coping with postpartum discomfort, or during those times when caring for a newborn feels especially stressful

.

Natural

Childbirth

http

://

www.babycenter.com/natural-childbirth Slide50

Epidural

Injection in back next to spinal canal.

Numbs the lower half of the body

Given when mother is dilated to about 4 cm.

Mother remains awake and the epidural does not affect her state of mind

Usually takes away the pain of labor

Very little of the medication enters the baby’s blood stream

.Slide51

EPIDURAL

Injection LocationSlide52

EpiduralSlide53

Epidural Disadvantages

Mother and baby must be constantly monitored

Can slow labor

Pushing stage may be prolonged

Increased risk for instrumental delivery (forceps or suction)

May cause maternal fever, requiring possible separation of mother and baby and additional testing on baby

Must have IV fluids before epidural

Must be in bed for remainder of labor

No use of gravity

Pitocin may be needed to speed labor

Mother must be catheterized

Increased risk of additional interventions and cesarean section

May cause itching and shaking

Risk of severe headacheSlide54

The third stage occurs within ten minutes of the baby’s birth.

The

uterus continues to

contract.

The p

lacenta

pulls away from

the uterus

and is

expelled (delivered)

with

the amniotic

sac and remaining umbilical

cord

. This is called

the afterbirth.

Lochia

is

vaginal

discharge after giving birth

containing

blood, mucus

, and uterine tissue. 

Lochia discharge

typically continues for 4 to 6 weeks after childbirth.

Third Stage of LaborSlide55

Amniotic Sac

Amniotic Fluid

Holds

the amniotic fluid.

Is a

clear

transparent

membrane

.

Is very

strong

until broken.

Guards against

jolts

Keeps the fetus at a constant

temperature

.

Keeps the fetus from forming

adhesions

to the uterine

wall.

Fluid volume increases as the

fetus growsSlide56

Umbilical Cord

The Placenta

Passes

oxygen

, and

n

utrients

from

the mother

to the child.

Returns

waste

products back

to the mother.

Connection

between the

the

Umbilical

Cord fetus

& the placenta.

Is an

organ

that develops

between the embryo

and the uterus during pregnancy.

It filters nutrients and oxygen to the fetus.Slide57

Who are these People?

Obstetrician

- pregnancy doctor who delivers the baby.

Ob/

Gyn

– Obstetrician (pregnancy doctor) and Gynecology (female

doctor that specializes in females)

Midw

ife

–

A midwife is a trained health professional who helps 

healthy women

 during labor, delivery, and after the birth of their babies. 

Midwives may deliver babies at birthing centers or at home, but most can also deliver babies at a

hospital. Women

who choose midwives usually want very little medical intervention and have had no complications during their 

pregnancy

.

Labor and Delivery Nurse

-

They care for women during labor and 

childbirth

, monitoring the baby and the mother, coaching mothers and assisting doctors. As a Labor and Delivery Nurse, you'll prepare women, and their families, for the stages of giving birth and help patients

with breastfeeding

after the baby is born.Slide58

Now what?

Most

full-term babies (born between 37 and 40 weeks) weigh somewhere between 

5 pounds 8 ounces

 (

2,500 grams

) and 

8 pounds, 13

ounces

The average total price charged for pregnancy and newborn care is about 

$30,000

 for a vaginal delivery and 

$50,000

 for a C-section, with insurers paying out an average of $18,329 and $27,866, according to a recent report by Truven Health Analytics. Jul 1, 2013

The new mom will need rest (giving birth is like running a marathon), food because she has eaten since labor started, understanding of her needs and new role, and time out of bed to get up and move around.Slide59

Problems of Premature Infants 37

weeks

Low birth weight

Underdeveloped lungs

Infections

Slow development later in life

Little or no sucking reflex

https://www.youtube.com/watch?v=w-oIbeSlF9QSlide60

Baby’s Arrival