The Stages and Impact of Childbirth: From Labor to Brain Development - Prof. Abengózar, Apuntes de Psicología

¡Descarga The Stages and Impact of Childbirth: From Labor to Brain Development - Prof. Abengózar y más Apuntes en PDF de Psicología solo en Docsity! 1. The Birth Process Labor is an apt term for the process of giving birth. Parturition is a process of uterine, cervical, and other changes, usually lasting about two weeks, preceding the labor. It begins when the levels of estrogen rise and stimulate the uterus to contract and the cervix to become more flexible. A woman may feel false contractions known as Braxton-Hicks contractions, during the last months of pregnancy or in the second trimester. This contractions are relatively mild and irregular while the “real” ones are more frequent, rhythmic and painful, and they increase in frequency and intensity. 2. Stages of Childbirth First stage → it last 12 or 14 hours for a woman having her first baby. During this stage regular and increasingly uterine contractions cause the cervix to dilate, or widen, in preparation for the delivery. Second stage → it last up to an hour or two. The contractions become stronger and closer together. It begins when the baby’s head move though the cervix into the vaginal canal, and it ends up when the baby emerges from the mother’s body. The baby is still attached to the umbilical cord. If it last more than two hours, the baby needs help. Third stage → it last from 10 to 60 minutes. The placenta and the remainder of the umbilical cord are expelled from the mother’s body. 3. Electronic Fetal Monitoring Electronic fetal monitoring → it tracks the fetus heartbeat during labor and delivery to indicate how the fetal heart is responding to stress of uterine contractions. It can detect any problem and alert attending physician or midwife that a fetus needs help. Pros: it provides valuable information in high-risk deliveries such us if the fetus is very small, is premature, or is in a breech position, if it’s in distress, or in which labor is induced trough administration of drugs. Contras: it restricts the mother’s movements during labor, it has an extremely high false-positive rate, suggesting that foetuses are in trouble when they are not. 4. Vaginal Delivery versus Cesarean Delivery Cesarean delivery → It is the delivery of a baby by surgical removal from the uterus by an incision on the mother’s abdomen. It is commonly performed when labor progress is too slow, when the fetus seems to be in trouble, or when the mother is bleeding vaginally. Also it can be used when the fetus is breech position or when the head is too big to past though the mother’s pelvis. The increase of cesarean deliveries is due to rising proportions of heavy, premature and low-birth children, multiple births and older first-time mothers. Risks → complications for the mother such as bleeding, infection, damage to pelvic organs, and postoperative pain. It also deprives the baby’s benefits from vaginal deliveries such us the hormones that clear the lungs of excess of fluid, mobilized stored fuel to nourish cells and send blood to the heart and brain. Vaginal deliveries after caesareans deliveries (VBAC’s) may be attempted with caution because the can produce a uterine rupture and brain damage in infant deaths. 5. Medicated versus Nonmedicated Delivery Natural childbirth → method of childbirth that seeks to prevent pain by eliminating the mother’s fear through education about the physiology of reproduction and training in breathing and relaxation during delivery. • Lamazed method: expectant mother works actively with their bodies through controlling breathing. The woman is trained to breathe rapidly when her contractions’ intensity increase and to concentrate in other sensation to ease the pain. She learns to relax the muscles as a response of her coach’s voice who attends classes with her and takes part in the delivery, helping with exercises. • LeBoyer method: the woman gives birth in a quiet room, with low lights, reduce stress, and the newborn is gently massage to ease crying. • Bradley Method: rejects all obstetrical procedures and medical interventions. Prepared childbirth → method of childbirth that uses instruction, breathing exercise, and social support to induce controlled physical responses to uterine contractions and reduce fear and pain. Both methods minimize or eliminate the use of drugs that may pose risks for babies and enables both parents to participate fully in a natural, empowering experience. • Medical treatments: -Pedunal block: local anesthesia, usually during the second stage of labor or if forceps are used. -Analgesic: painkiller that reduces the perception of any pain by depressing the activity of the central nervous system. These may slow labor, cause maternal complications and make the baby less alert after birth. -Regional anesthesia: epidural o spinal. Regional anesthesia that is injected into a space in the spinal cord between the vertebrae in the lumbar region, block the It takes about 30 minutes. It assesses: -Motor Organization: activity level and the ability to bring a hand to the mouth. -Reflexes -State changes: irritability, excitability, and ability to quiet down after being upset. -Attention and interactive capacities: general alertness and response to visual and auditory stimuli -Indicators of the central nervous system instability: tremors and changes in the skin color. • Neonatal Screening for Medical Conditions Children who inherit the enzyme disorder phenylketonuria or PKU will become mentally retarded unless they are fed a special diet beginning in the first three to six weeks of life. Screenings after births may discover abnormalities such as this one and others which are correctables. 6.4. States of Arousal An infant’s physiological and behavioural status at a given moment in the periodic daily cycle of wakefulness, sleep and activity. Most newborns sleep 75% of the time - up to 18 hours - and wake up every three or four for feeding. Newborn’s alternate active sleep or REM sleep in which adults in associated with dreaming and last about 1 hour. The periods of sleep are lengthen gradually. A 3 months baby sleeps 6 hours a night, and a 2-year-old sleeps about 13 hours including a single nap. 7. Complications of Childbirth. 7.1. Low Birth Weight Preterm (premature) infants → infants born before completing the 37th week of gestation. Small-for-date infants → infants whose birth weight is less than that of 90 percent of babies of the same gestational age, as a result of slow fetal growth. Low birth weight babies → babies who weigh less than 1,500g Moderately low weight babies → babies who weigh between 1,500 to 2,499 g at birth. Both are likely to die. Premature births have increased due to induced caesarian, delayed childbearing, fertility drugs and multiple births. There are factors that make the woman more likely to have a low-weight baby: 1. Demographic and socioeconomic factors 2. Medical factors predating the pregnancy 3. Prenatal behavioural and environmental factors 4. Medical conditions associated with the pregnancy Small babies are more likely to suffer infections, slower growth and developmental delays. They are also unable to perform basic functions to survival such as sucking, so they need to be fed by intravenous methods. It is also very difficult to stay warm for them because they not produce enough fat, so they are placed in an issolete and fed thorugh tubes. Doctors and parents are encouraged to give them special handling. Kangaroo care → a method of skin-to-skin contact in which a newborn is laid face down between the mother’s breasts for an hour or so at a time after birth. This can help preemies and full-times make the adjustment from fetal life to the jumble of sensory stimuli in the outside world. This seems to reduce stress of the central nervous system and help with self-regulation of sleep and activity. Respiratory distress syndrome is common in preterms babies who lack an adequate amount of an essential lung-coating called surfactant, which keep sacs air for collapsing. These babies may breathe irregularly or stop breathing. The future of theses babies is not concerned. They may have circulatory problems or diabetes. They may also have cognitive, neurological, sensory, educational and behavioural problems. 7.2. Postmaturity Postmature → referring to a fetus not yet born as of 2 weeks after the due date or 42 weeks after the mother’s last menstrual period. The reason may be that the placenta is aged and becomes less efficient as it may provide less oxygen. The baby’s greater size also complicates labour because the mother has to deliver a baby of 1-month-old. The baby could suffer brain damage or even die. 7.3. Stillbirth It is the death of a fetus at or after the week 20 of gestation. Fetal death is diagnosed prenatally, in other cases, during labour. Boys are more likely to be stillborn and the cause is not known, but it may be due to a malnourishment in the womb. 7.4. Can Supportive Environments Overcome Effects of Birth Complications? It has been found that a supportive environment can overcome effects of birth complications. Protective factors are those influences that reduce the impact of potentially negative influences and tend to predict positive outcomes. These protective factors are classified in three groups: 1. Individual attributes such as energy, sociability and intelligence 2. Affectionate ties with at least one parent 3. Rewards at school, work or place of worship that provides a sense of meaning and control of one’s life. 8. Sudden Infant Death Syndrome (SIDS) Also called crib death is a sudden death of an infant under age 1 in which the cause of the death remain unexplained after an investigation that includes an autopsy. SIDS often result of a combination of factors such a underlying biological defects that can make infants vulnerables to some external factors. Also, at least 6 mutations affecting the heart have been linked with SIDS. There is also a relationship between SIDS and sleeping. Normal children sleeping in their stomachs is dangerous. Doctors recommend the children not to sleep in soft surfaces 9. Early Physical Development 9.1. Principles of Development • Cephalocaudal principle: growth occurs from the top down. Because the brain grows rapidly, a newborn baby’s head is disproportionately large. The head becomes smaller as the child grows in height and the lower parts of the body develop. Sensory and motor development proceed according to the same principle: infants learn to use upper parts of the body before the lower parts. • Proximodistal principle: growth and motor development proceed from the center of the body outward. In the womb, the head and trunk develop before the arms and legs, then the hands and feet, and then the fingers and toes. During infancy, the limbs continue to grow faster than the hands and feet. Childs, develop first the upper arms and legs, then the forearms, the forelegs, then the hands and feet, and finally fingers and toes. 9.2. Patterns of Growth numbers of neurons increases most rapidly between the 25th week of gestation and the first few months after birth. Originally, neurons are simply cell bodies with nucleus, or center, composed by DNA, which contains genetic material. Most neurons are placed in the cortex in the 20 week of gestation, during the next 12 weeks. Once they are in place, they develop axons and dendrites. Axons send signals to other neurons and dendrites receive incoming messages from them, through synapses, the nervous system’s communication links. The synapses are tiny gaps which are bridge with the help of chemicals called neurotransmitters that are released by the neurons. The multiplication of theses neurons allows the development of new cognitive, perceptual and motor abilities. They undergo the complementary processes of integration and differentiation. Integration → process by which neurons coordinate the activities of muscle group. Differentiation → process by which cells acquire specialized structures and functions. The brain produces more neurons and synapses that it needs. Those that are not used or do not function well die out. This process of cell death, or pruning of excess cells, begins during the prenatal period and continues after birth, helping to create an efficient nervous system. 10.4. Myelination Process of coating neural pathways with a fatty substance, myelin, that enables faster communication between cells. It begins about halfway through gestation in some parts of the brain and continues into adulthood in others. Patterns of touch → by birth Patterns of visual → from birth to five months of life Patterns of hearing → fifth months until 4 years Patterns of attention and memory → young adulthood Hippocampus → until age 70 Sensory and motor pathways → before birth in the spinal cord, after birth in the cerebral cortex may account for the appearance and disappearance of early reflexes. 10.5. Early Reflexes Reflex behaviours → automatic, involuntary, innate responses to stimulation. These behaviours are controlled by lower brain centers that govern other involuntary processes such as breathing and heart rate. A baby has 27 major reflexes, many of which are presented at birth or soon after. • Primitive Reflexes → sucking, rooting for the nipple and the Moro reflex are related to instinctive needs for survival and protection or may support the early connection to the caregiver. • Postural Reflexes → changes in position or balance, controlled by the higher brain center at the first two to four months. • Locomotor Reflexes → such as walking and swimming reflexes, resemble voluntary movements that do not appear until months after the reflexes have disappear We can evaluate a baby’s neurological development by seeing whether certain reflexes are present or absent. EARLY HUMAN REFLEXES Reflex Stimulation Baby’s Behaviour Typical age of Appearance Typical Age of Disappearance Moro Baby is dropped or hears loud noise Extended legs, arms, and fingers arches back, draws back head 7th month of gestation 3 month Darwinian (grasping) Palm of baby’s hand is stroked Makes strong fist;can be raised to standing position if both fists are closed around a stick 7th month of gestation 4 month Tonic neck Baby is laid down on back Turns head to one side, assumes fencer position, extends arm and leg on preferred side, flexes opposite limbs 7th month of gestation 5 month Babkin Both of baby’s palms are stocked at once Mouth opens, eyes close, neck flexes, head tilts forward Birth 3 months Babinski Sole of baby’s foot is stroked Toes fan out; foot twists in Birth 4 months Rooting Baby’s cheek or lower lip is stroked with finger or nipple Head turns, mouth opens, sucking begin Birth 9 months Walking Baby is held under arms, with bare feet touching flat surface Makes steplike motions that look like well-coordinated 1 month 4 months walking Swimming Baby is put into water face down Makes well- coordinated swimming movements 1 month 4 month 10.5. Molding the Brain: The Role Of Experience The brain is positively and negatively modified by environmental experience. The technical term for this malleability is plasticity (modifiability or “molding”, of the brain through experience). Plasticity enables learning: • Individual differences in intelligence may reflect differences in the brain’s ability to develop neural connections in response to experience. Early experience can have lasting effects on the capacity of the CNS to learn and store information. • Drugs, toxins, maternal stress, malnutrition, early abuse or sensory impoverishment may leave an imprint on the brain because is especially vulnerable. • Enriched experience spur brain development and make up for past deprivation. Plasticity continues throughout life in response to environmental experience. 11. Early Sensory Capacities 11.1. Touch and Pain • It is the first sense to develop. • By 32 weeks of gestation, all body parts are sensitive to touch, and this sensitivity increases during the first five days of life.