Child Development From Infancy to Adolescence. Laura E. Levine
& de Vries, 2013). Doctors only intervene if there are complications or it is a high-risk delivery. All expectant mothers are required to pick up a packet containing the medical supplies necessary for a home birth. If a woman chooses to give birth in a hospital rather than at home, her midwife makes a home visit to determine when it is time to go to the hospital. If a hospital birth occurs early in the day and without complications, mother and baby may go home in as little as two hours (Schalken, n.d.).
In remote rural areas of Nepal, many women prefer to give birth in a goth, a small outbuilding near the main house or in the lower section of the house used for animals. In preparation, the floor of the goth is covered with clean straw. Giving birth there avoids bringing birth pollution into the house which would offend the God in the house. It is meant to ensure the health and safety of the mother and the newborn, and also allows the woman to manage and control her own birth process (Kaphle, Hancock, & Newman, 2013).
Despite the availability of trained medical specialists and an array of medical technology in modern hospitals, maternal mortality rates have actually increased in the United States in recent years, a trend that is counter to what is happening in most countries around the world (Tavernise, 2016). In 2013, the rate in the United States was 28 maternal deaths per 100,000 births, an increase from 17 deaths per 100,000 births in 2005 (World Health Organization, 2014). Failure to receive adequate prenatal care, the greater number of pregnant women who suffer from chronic conditions, increased maternal age, and higher rates of obesity among U.S. women all may contribute to this disturbing trend. Some critics have charged that another contributing factor may be our focus on fetal and infant safety in recent years, which diverts attention from the medical needs of the mother and places her at an increased risk (Hogan, 2017; National Public Radio, 2017).
T/F #7
The rate of maternal mortality in the United States is increasing. True
Within the United States, disturbing disparities exist in the rates of maternal mortality during pregnancy or within one year of the birth. Between 2011 and 2013, the rate for Black women (43.5 per 100,000 pregnancies) was more than 3 times as high as the rate for White women (12.7 per 100,000 pregnancies; CDC, 2017p). And although Black women develop life-threatening conditions such as hemorrhage at the same rate as White women, they are two to three times as likely to die from them (Tucker, Berg, Callaghan, & Hsia, 2007). The reasons for the extreme racial disparities in maternal mortality have not yet been explained.
The Baby’s Birth Experience
You probably have heard stories about labor and delivery from the perspective of the mother, but have you ever wondered how the baby experiences birth? It might seem pretty traumatic. The baby is pushed through the birth canal, with uterine contractions intermittently causing oxygen deprivation. The newborn rapidly goes from a warm, quiet, and dark prenatal environment into a bright, noisy, and cold postnatal world. Fortunately, babies are physiologically well prepared to handle the stress of being born. For one thing, the skull of a baby is composed of separate plates that can overlap and compress during the birth process, allowing the head to elongate so it can fit through the birth canal. The mother’s production of stress hormones during labor triggers the production of stress hormones in the baby, which prepares the lungs to begin breathing, sends additional blood to the baby’s brain and vital organs, and makes the baby alert right after the birth (Weiss, 2014).
As soon as the baby’s head is delivered, the doctor or midwife uses a rubber syringe to clear the mouth and air passages. After the baby’s body emerges, the umbilical cord is clamped and cut after it stops pulsing. The baby’s weight, head circumference, and length are measured, and a few drops of an antibiotic are placed in the baby’s eyes to prevent infection from any organisms that were in the birth canal (Ben-Joseph, 2014).
The baby’s overall condition is assessed using the Apgar Scale at 1 minute and again at 5 minutes after birth. The newborn receives 0, 1, or 2 points each for its Activity level, Pulse, Grimace (a reflexive response to stimulation such as a mild pinch), Appearance, and Respiration. Newborns in the range of 7 to 10 points receive routine care and are reassessed at 5 minutes. The baby will be kept warm and placed on the mother’s stomach for some skin-to-skin contact or in her arms so mother and baby can meet for the first time. An Apgar score in the range of 4 to 6 indicates that some intervention is needed. This might be some additional suction to help the baby breathe, massage, or the administration of oxygen. A score of 3 or less means some immediate lifesaving intervention is needed (Bregman, 2005).
Apgar Scale: An assessment of a newborn’s overall condition at 1 minute and 5 minutes after birth that is based on the newborn’s activity level, pulse, grimace, appearance, and respiration.
After they are given a bath and wrapped in a blanket, newborns receive a vitamin K shot to help their blood clot properly. Before they leave the hospital, a few drops of blood will be drawn to test for PKU and other genetic and biochemical disorders (March of Dimes, 2008).
Check Your Understanding
Knowledge Questions
1 What happens during each of the three stages of labor?
2 How do the roles of a doula and a midwife differ?
3 What does the baby typically experience during birth?
Critical Thinking
In the Netherlands, a woman is more likely to give birth at home with a midwife’s help than in most other western countries. What effects do you think this might have on her birth experiences and her experiences with her newborn?
The Newborn
>> LQ 4.4 How do newborns function, and what threatens their well-being?
In this section, we examine the capabilities newborns possess from birth, and some of the challenges they face in the early months of life. Babies enter the world equipped in many ways to begin their journey of development and to interact with the people who will love and care for them along the way. As you will see, the journey is easier for some newborns than others.
Newborn Capabilities
In the early days of the field of psychology, William James (1890/1990) described the world of the infant as “one great blooming, buzzing confusion” (p. 462), but today we know this statement seriously underestimates the ability of newborns to receive information about the world in an organized way and to respond to that information. As we said earlier in this chapter, all the senses begin developing during the prenatal period and become functional before birth. Some are more advanced in their development than others when the infant is born, but there is no doubt the newborn can hear, see, taste, smell, and respond to touch.
Infant States
Although newborn senses are all functioning, they have a limited capacity to process information from the environment, so they have a set of infant states that helps them regulate the level of stimulation they receive and keeps the sensory input at a level they can process. Infant states are organized into two sleep states (quiet sleep and active sleep) and four awake states (drowsy, quiet alert, active alert, and crying) that reflect different levels of activity and alertness (March of Dimes, 2003).
Infant states: Different levels of consciousness used to regulate the amount of stimulation an infant receives, ranging from crying to deep sleep.