User:Atcovi/Spring2024/Child Psychology/Ch. 4

Exploring the neonate, or the world of a "new born child". When the head of the fetus settles in the mother's pelvis, its called dropping.

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4.1 - Describe the three stages of childbirth

Intro

As early as in the 6th month of pregnancy, the mother will feel Braxton-Hicks contractions - painless contractions of childbirth. Day before labor, vaginal bleeding, mucous tissue becomes disloged, and 1/10 women "break water". The fetus' hormones get the placenta 'going' and the mother secretes prostaglandins, which essentially get the mother ready for labor!!! As the labor stage goes on, the pituitary gland releases oxytocin, which are the 'stronger hormones' that get contractions so powerful, it will EXPEL THE BABY.

First Stage (few hours - 24+ hours)

The uterine contractions efface (thin) and dilate (widen) the cervix. The pain in childbirth comes from the dilation of the cervix.
Pubic hair is shaved, getting ready for episiotomy (cut in vulva to widen vagina).
Could do an enema, but its degrading, so we skip this.
An electronic sensing device may be attached to the woman's abdomen to track the fetus' heart rate (for example, observing fetal distress via. fasten heart rate).
The transition is the initial movement of the head of the fetus into the birth canal once the cervix has dilated fully.

Second Stage (<1 hour - >2+ hours)

Contractions of 2nd stage stretch skin surrounding vagina (or birth canal) and push the baby further. Baby's out within minutes.
Episiotomy TAKES PLACE. May take place if physician regularly does it.
Mucus sucked up from newborn so that they can breath comfortably.
Umbilical cord is removed once the baby is breathing on its own.

Third Stage (placental stage: few minutes - 1 hour)

While the baby is getting an ID bracelet & artificial vitamin K, the mother enters the third stage of labor

Fetal membranes and placenta are expelled, bleeding takes place, uterine starts shrinking.
Cleaning up the episiotomy.

4.2 - Methods of Childbirth

Childbirth, at a certain time in life, only required the family home, her family, and a midwife (what some may constitute as a natural childbirth). Some people are ok with the "mute" childbirth experience (probably the mothers for obvious reasons) while others get hella' angry over this, saying that childbirth has became 'impersonal' and modern medicine contributes to a lack of control over a woman's own body.

A homebirth isn't bad if the woman knows they'll have little to no risk of complications and if they've had experience. They may choose a homebirth to put the notion of a birth in a positive regard/less expensive route.

Anesthesia

Anesthesia is a substance that renders a procedure almost painless. Generally done by putting the woman to sleep. Could have negative effects on the child, however, so anesthesia should be used cautiously.

Regional anesthesia could be used to reduce pain and not put the mom to sleep. This minimizes the effects on the neonate.

Hypnosis and Biofeedback

An excerpt from a hypnobirthing session. The woman is putting effort into relaxing her body. She is receiving help from a doula, or an experienced yet non-professional female companion. Women with doulas appear to have shorter labors than women without doulas (Hartocollis, 2015)

Hypnobirthing has been used to reduce pain by focusing on relaxing scenes/decreasing muscle tension. It's sort of a "part-time job" for the mother while the baby is coming through.

Biofeedback assists women in regulating heart rates/muscle tension so they can reduce the discomfort they going through.

Prepared Childbirth

Lamaze actually proves that the movie depiction of pregnancy isn't really the case. The Lamaze method (or prepared childbirth) is a method of "prepared" childbirth involving relaxation and controlled breathing whilst being in the presence of a "coach" (the father, in most cases in rural Russia) or doula.

Cesarean Section

A cesarean section is a method of childbirth where the neonate is delivered through the abdomen.

+ = threaten mom or child, difficult than vaginal delivery (small pelvis, fatigue due to prolonged labor, baby is massive), prevent circulatory systems of baby and mom from mixing (prevent transmission of AIDS), or baby is tryna come feet out instead of head.

But you know what the biggest factor is behind if a woman will have a C-section or not? If they had one already. Doctors fear that the tear from the C-section will rupture during a vaginal delivery.

4.3 - Birth Problems

Discussing effects of oxygen deprivation and the problems of preterm/low-birth weight nenonates.

Anoxia [without oxygen] - A condition where there is a lack of oxygen.
Hypoxia [under + oxygen] - A condition where there is less oxygen than is needed.

A lack of oxygen in the prenatal stage can cause harm for the central nervous system (which is not good). A lot of research has been focused on the hippocampus, so oxygen deprivation leads to memory problems/problems in motor development and spatial relations. Prolonged cutoff of oxygen leads to schizophrenia and cerebral palsy.

If the baby enters the birth canal butt first, also known as breech presentation, this may constrict the umbilical cord, causing prolonged oxygen deprivation. A moment of oxygen deprivation is normal at birth since the baby is adjusting to breathing on its own.

What are the risks in being born preterm or low in birth weight?

A baby is considered premature, or preterm, when birth takes place before 37 weeks (9 months) in comparison to the normal 40 weeks (9.20 months). A baby is considered of low birth weight if they weigh less than 5.50 pounds/2,500 grams. Neonates that are really small for their age are known as small for dates.

Low birth weight poses a risk of poor neurological/cognitive functioning throughout school and delayed motor development.

Because of their physical frailty, preterm infants usually remain in the hospital and are placed in incubators.

Signs of Prematurity

Pretty thin.
They have a lot of lanugo (fine, downy hair).
Covered in this white stuff called vernix.
Immature muscles.
Respiratory distress syndrome: Breathign problems (weak/irregular) which are evident in pre-term babies. This is because their air sacs stick together because they cannot secrete surfacants to lubricate the sacs. Pregnant women can recieve corticosteroids, which can increase the babies' survival rate.

4.4 - Postpartum Period

The postpartum period is the time that's right after childbirth. Although the physical pain is over (the mom's 'load' has been lightened and eased), the mental pain may start for majority of our new moms.

What Kinds of Psychological Problems Do Women Encounter During the Postpartum Period?

Baby blues, possibly due to hormonal changes: steroid levels, estrogen & progesterone levels go down severely. Last about 10 days are so, not too bad (they are common/mild). Treated with social support.
Postpartum anxiety
Postpartum depression: Severe depression that lasts for a decent bit. 10-20% of women are affected. It consists of sad feelings, change in appetite/sleep patterns, odd obession with the baby, and worthlessness. Coud last weeks/months. Treated with psychotherapy, especially cognitive-behavioral therapy (CBT).
Postpartum psychosis: An emergency situation where the mother is hallucinated with insane ideas, such as their infant is a 'devil' that 'must be killed'. Women with this usually have a tailored history of psychological disorders/substance abuse.

How Critical Is Parental Interaction with Neonates in the Formation of Bonds of Attachment?

Bonding is defined as the process of developing a sustainable, healthy relationship between the parent and the child. This is ESSENTIAL to a child's survival.

Marshall Klaus and John Kennell in 1978 had a crazy theory where the first couple of hours after the baby is born, the maternal-sensitive period, is crucial for the mother and baby to be together so they could bond and develop a good relationship. But this obviously can be contradicted by adoptions.

The concept of parent-child bonding is a lot more complicated than how Klaus & Kennell made it out to be. You have to factor parental care and a parent's raw desire to have the child.

4.5 - Characteristics of Neonates

We study neonates using the Apgar scale, a numerical scale measuring a newborn's health that looks at...

Appearance
Pulse
Grimace
Activity Level
Respiratory Effort

Each level is rated from 0-2 and the total score can be 0-10.

The Breazelton Neonatal Behavioral Assessment Scale, or NBAS, measures a neonates' reflexes and other behavior patterns (motor behavior, response to people/stress, physiological control, etc.). A low score may allude to brain damage.

The NNNS is designed to consult and comfort parents of infants who've been exposed to parental substance abuse.

What Are Reflexes? What Reflexes Are Shown by Newborns?

Reflexes are basic and innate responses elicited by certain types of stimulation. They occur without us thinking. An example of this is the swimming reflex, which is seen in neonates.

Rooting reflex is where an infant turns their mouths and heads into the direction where they feel something on their cheek/corner of mouth. The sucking reflex is also needed and very much will be replaced by voluntary sucking as the months go on.
The Moro reflex, or a startle reflex, is when the baby flings their arms and legs out and redraws them to their original position.
The grasping reflex is where babies grasp objects that are pressuring their palms.
The stepping reflex is when the baby starts taking their first walks when they are held under their arms.
The Babinski reflex is where infants fan their toes in response to stroking of the foot from heel to toes.
The tonic-neck reflex is seen where they look like a fencer, basically.

The absence or weakness of a reflex may indicate immaturity (as in prematurity), slowed responsiveness (which can result from anesthetics used during childbirth), brain injury, or intellectual disability.

How Well Can Neonates Percieve The World?

The neonates can see, but do not have great visual acuity (20/600). The Looking Chamber, or the chamber that observed the baby's eye movements and measured how much the baby spends looking at visual stimuli, was founded in the 1900s by Robert Fantz.

Visual accommodation is when the lens of the eyes are changed to bring objects in a great focus. Convergence is the inward movement of the eyes as they focus on an object that is drawing nearer.

We are not sure if neonates can respond to intesity, saturation, and hue. Cones are less developed than the rods in terms of structure. Neonates can hear well & prefer their mother's voices. When it comes to smell, babies have shown to have a preference to the odor of their mothers' milk and armpits.

Neonates can discriminate between various tastes, including sweet, bitter, and sour. Neonates can slowly eat sweet foods to prevent overeating (wow!).

Neonates can 100% feel pain, they just may not have the ability to express it.

How Well Can Neonates Learn?

Classical conditioning - A neonate was conditioned to blink at the sound of a tone.
Operant conditioning - A neonate sucks on a pacifier so they can hear their mother read a fictional book out loud.

Sleeping Patterns?

Neonates spend 16 hours a day, or 2/3rds of the time, sleeping. Sleep can be divided into

REM [rapid eye movement] sleep - Sleep where we dream, rapid eye movement. We need this, as neonates, so our neurons and synapses can be developed through protein.
Non-REM sleep - Don't dream, no rapid eye movement.

Why Do Babies Cry?

As a form of communication (to want their mothers near them, as maternal comfort is the best remedy).

Pro-longed high-pitch cries could lead to Cri du Chat.

4.6 - Sudden Unexpected Infant Death & SIDS

Sudden unexpected infant death - The random death of a baby <1 yrs old. Includes sudden infant death syndrome, which is where babies die for no reason/accidental suffocation.

Studies relating to SIDS focus on the medulla, the stem of the brain which controls breathing and the sleep-wake cycle.

How To Prevent?

Have the baby sleep on his back
Have the baby sleep on a firm sleep surface.
Have the baby sleep in the same room.
Remove any objects that could contribute to suffocation.