Chapter 5: Preparing for Birth

A Healthy Pregnancy
● A pregnant woman’s responsibilities grow along with her baby.
● What happens to a baby during prenatal development can affect both the baby’s and
parents’ lives.
● For her baby’s health and her own, a mother-to-be needs to eat a well-balanced diet,
exercise moderately, get plenty of sleep, and manage stress.

Early Signs of Pregnancy

● Women usually experience one or more of the following signs of pregnancy:
- A missed menstrual period (often the first indicator)
- A full feeling or mild ache in the lower abdomen
- Feeling tired or faint
- A frequent, urgent need to urinate
- Swollen breast causing discomfort or tenderness
- Nausea and/or vomiting, particularly in the morning commonly known as morning
sickness
- Doctors can conduct tests to confirm pregnancy
- Home pregnancy tests are also easy to use and very accurate
- Early detection of pregnancy is crucial to the health of the expectant mother and her baby.

Medical Care During Pregnancy

● Obstetrician - A doctor who specializes in pregnancy and childbirth - for medical care
during pregnancy.
● Most doctors schedule regular check ups during pregnancy, assist during childbirth, and
examine the newborn.
● Expectant mothers should find a doctor they like, feel comfortable with and trust.
● Nothing is more important to the health of the baby than for the mother to get regular
medical care and advice from the beginning to the end of the pregnancy.

The First Medical Examination

● With a confirmed pregnancy, the woman receives a thorough examination:
- A check for her blood pressure, pulse, respiration, and weight
- A discussion of her medical history, including existing medical conditions, such as high
blood pressure, which may require treatment or observation
- A measurement of her pelvis to determine whether it is wide enough to allow a baby of
normal size o pass through
- An analysis of her urine for signs of infection or diabetes, a condition characterized by
excessive amounts of urine
 - Blood tests to rule out anemia - a condition resulting from not having enough red blood
cells
- Symptoms include fatigue, shortness of breath, and rapid heartbeat
● Blood test also determines if mothers blood contains a certain protein known as the Rh
factor. Knowing about the presence (Rh positive) or absence (Rh negative) is important
● It is determined genetically.
● Why is this important?
- If the mothers blood doesn't have the protein and the fetus blood does, the mothers blood
builds up antibodies that attack the protein in the fetus blood, as it would an invading
germ. This can endanger later pregnancies. Once identified, the mother can receive an
injection that will prevent the antibodies from forming, thus protecting any Rh positive
fetus.
● A check of the woman's immunity to rubella, also called German measles
● “When will my baby be born?”
● Variation of up to two weeks before or after that date can be expected.
○ The approximate date is easy to calculate
○ Nine months and one week after the first day of her final period before pregnancy
is the baby due date

Later Checkups
● 1-6 months - once a month
● 7-8 months - twice a month
● 9 months - once a week
● Between the 24th and 28th week, most women take a glucose tolerance test to check for
signs for gestational diabetes, a form of diabetes that occurs only during pregnancy.
- If left untreated, this can cause the baby to be heavier than is normal or healthy
- Gestational diabetes can be controlled by a special diet or may require medication
● Preeclampsia - high blood pressure and the presence of protein in the woman’s urine.
● This can prevent the baby from getting enough blood, which provides oxygen and food.
● Treatment may include bed rest and medication for this condition.

Discomforts of Pregnancy
● If a pregnant woman experiences one or more of the following symptoms she should
report it to her doctor:
- Nausea and/or vomiting: most common complaint of pregnancy
- Sleepness: due to hormonal changes
- Heartburn: burning feeling in the upper abdomen
- Shortness of breath: pressure on the lungs from the baby
- Varicose (swollen) veins: pressure on the blood vessels in the legs
- Muscle cramps in the legs: do gentle stretches and eat a calcium rich diet
 - Lower back pain: wear low heeled shoes, exercises to strengthen the back

Possible Serious Complications

● Any of the following symptoms should be reported to a doctor immediately:
- Fever
- Vaginal bleeding
- Excessive thirst
- Severe abdominal pain
- Persistent headaches
- Severe vomiting
- Increased vaginal mucus
- Blurred vision or dizziness
- Prolonged backache
- Unusual weight gain or loss
- Swelling of face, hands or ankles
- Diminished need to urinate or pain during urination

Nutrition During Pregnancy

● Good nutrition is the single most important requirement during pregnancy.
● The baby’s growth and development, including crucial brain development, depend on
nutrients from the mother.
● Proper nutrition promotes her baby's development and maintains her own health.

Protein
● Red meat, poultry, fish, dried beans, nuts, eggs, milk, and cheese provide protein.
● This is vital to the baby’s growth and development of bones and teeth.
● It keeps the mothers body in good condition.

Vitamins
● Some birth defects such as spina bifida are linked to vitamin deficiency.
● Mothers need more vitamins during pregnancy including twice the usual amount of folic
acid for normal spinal development.
● Mothers should take vitamins and other supplements only when their doctor approves
them.
● Vitamin A - proper eye development
● Vitamin B - assist in general fetal development
● Vitamin C - helps build proper teeth and gums and helps form the connective tissue of
skin, bone, and organs
● Vitamin D - aids in the creation of bones and teeth
Minerals
● They produce strong bones and teeth and ensure regular elimination of waste from the
body.
● A doctor may instruct a woman to take mineral supplements.
● Iron is a mineral that helps prevent anemia and assists in developing the baby's own
blood supply.
● Extra iron is stored in the baby's liver and is used in the months right after birth.
● Sources of iron include dried beans, raisins, dates, red meat, and leafy green vegetables.

Carbohydrates and Fats

● Provide the body with energy.
● Whole-grain breads and cereals, fruits, and starchy vegetables such as potatoes all
provide carbohydrates.
● The body also needs some fats, although most diets contain too much.
● Foods high in fat such as those fried in oil should be avoided.

The Developing Brain

● When mothers fail to follow sensible and balanced diets, are wrongly concerned about
weight gain, or severely restrict their food intake, they put the developing fetus in serious
danger.
● Failing to supply adequate nutrition to the fetus will result in stunted brain development
which could lead to the baby being mentally challenged
● Alcohol consumption, cigarette smoking, and drug use during pregnancy can have similar
results.

Guidelines for Healthy Eating

● Focus on fruits
● Vary your veggies
● Get your calcium in rich foods
● Make half your grains whole
● Go lean with protein

Diet Guidelines for an Expectant Mother

● A pregnant woman needs to eat a variety of healthy foods everyday:
Vegetables and fruit including:
- Dark, green vegetables such as kale and bok choy each day
- Orange vegetables such as carrots and sweet potato most days
Whole grain foods, such as :
- Oats
- Wild rice
 - Whole wheat pasta
Protein foods such as:
- Eggs
- Nuts and seeds
- Fish and shellfish
- Beans, peas, and lentils
- Lean red meats, including wild game
- Lower fat dairy products
- Fortified soy beverages, tofu, soybeans, and other soy products
6 to 8 glasses of water per day

Pregnant woman should avoid:

● Supplements that contain more than the recommended daily value of vitamins and
minerals because too much Vitamin A can harm a baby.
● Raw eggs and milk or cheeses that are not pasteurized and certain fish with high mercury
content.
● Alcohol, which can lead to mental disabilities in babies.
● Smoking because mothers who smoke do not get enough oxygen, and their baby may not
develop properly.

Nutrition and Pregnant Teens

● A teen’s body has special nutritional needs because it is still developing.
● It is especially important for pregnant teens to get enough calcium and iron.
● Calcium is essential for your growing bones and the bones of your body.
● Iron helps the blood carry oxygen to every part of your body and that of your baby.

Special Diets
● One alternative to milk products is to eat larger amounts of other calcium rich foods, such
as broccoli, tofu, and leafy green vegetables.
● If milk products cause symptoms such as abdominal pain and gas, the problem isn't
usually lactose intolerance (lactose is a type of sugar found in milk) cultured yogurt
contains lactase, an enzyme that helps in the digestion of lactose.
● By eating enough tofu and other soybean products, dried beans, nuts, and nut butters such
as peanut butter, pregnant vegetarians and vegans can get the protein they need.

Weight Gain During Pregnancy

● Women typically gain about 24-30 pounds during pregnancy.
● Recommended weight gain is about 1 pound per month during the first 3 months.
● Through 4-6 months, weight gain should be about half a pound per week.
● Gaining too little weight can increase the risk of fetal death or premature birth.
 ● Women who begin a pregnancy underweight or overweight will require special
monitoring.

What Canada's Food Guide Says

Women of childbearing age
● All women who could become pregnant and those who are pregnant or breastfeeding
need a multivitamin containing folic acid everyday. Pregnant women need to ensure that
their multivitamin also contains iron. A health care professional can help you find the
multivitamin that's right for you. Pregnant and breastfeeding women need more calories,
include an extra 2 to 3 Food Guide Servings each day:
- Have fruit and yogurt for a snack, or
- Have an extra slice of toast at breakfast and an extra glass of milk at supper

Making Wise Food Choices

● Instructions:
- On your own, create a 1 day meal plan for a pregnant woman.
It must include:
- 3 meals: breakfast, lunch, and dinner
- 3 snacks: one after each meal
- Food, food group and serving size

Baby Safety and Making a Budget

Safety
Crib Safety
● Babies spend many hours alone in a crib and this means that safety is important.
● Mattress should be firm, flat and fit tight within the crib frame. It should be no thicker
than 15 cm.
● Do not use soft pillows, comforters, lambskins, quilts, stuffed toys, and bumper pads in
your baby's crib.
● Keep baby’s crib away from the nursery windows; blind cords, lamps, heaters, wall
decorations, and shelving.
● Baby should sleep on his/her back to decrease the risk of sudden infant death (SIDS).
Safety Tips:
● Ensure the baby’s crib has a label with manufacturing information.
● Do not use a crib made before September 1986.
● Take the time to make sure that your crib has all its bars and make sure they are not more
than 6 cm apart.
● Corner posts shouldnt be higher than 3 mm above the end panels.
 ● Consult Consumer Products Recalls Database to be sure that your c ribs is not on the
recall list

Car Safety
Safety Tips:
● Starting from your baby's first ride home from the hospital, you must always use a car
seat that meets Transport Canada car safety regulations.
● In fact, many hospitals won't let you leave until they see that you have your baby secured
in a car seat properly.
● Infants require a rear-facing seat that fits the baby’s weight and height because babies
have weak neck and back muscles that need extra support when travelling in a vehicle.
● Be cautious about buying or borrowing a used car seat that could be missing parts or
instructions
● Never use a car seat that is more than 5 years old or past the manufacturer's expiration
date.
● Keep updated on any product recalls or notices.

Making a Budget
● Raising a child is expensive.
● It is estimated that to raise a child until he/she is eighteen years of age, will cost
$270,000.00 (2022) for goods and services. This calculator does not include “extras,” or
high-end purchase of goods/services.
● Depending on the family wage, having one or more children can be economically
challenging.
● Good planning can help parents meet the expenses of prenatal and postnatal care.
● A budget is a spending plan that people use to help estimate their present and future
income and expenses
● A budget will allow people to set goals for saving and develop a spending plan that meets
their needs.
- Step One: Identify income.
- Step Two: list where that income currently goes towards by assessing your expenses.
Fixed expenses: car payments, housing payments, taxes, cell phone - expenses that do not
change
Flexible expenses: food costs, household items, clothes, entertainment - expensive that can be
reduced if necessary
- Step Three: If your monthly income is less than your projected monthly expenses, it is
necessary to cut back or explore other sources of income.
● Canadian mothers are entitled to 15 weeks of pregnancy leave after giving birth.
● This benefit is only offered to biological (and surrogate) mothers.
 ● A further 35 weeks of parental benefits are available to biological, adoptive or legally
recognized parents. These can be shared between two parents.
● At the same time, your household income drops and your expenses are rising.
● Maternity leave pay in Ontario is 55% of your insurable earnings. That works out to a
total of up to $650 a week.
● The first year of a child’s life is usually one of the priciest, costing the average parents
upwards of $8,000 in extra expenses.

Reducing Expenses
● Buy second hand maternity clothing and clothing for the baby.
● Use coupons.
● Borrow baby equipment if you can.
● Access tax benefits.
● Make a plan of action and budget.

Prepared Childbirth
What Is It?*
● Prepared childbirth - involves reducing pain and fear during the birth process through
education and breathing and conditioning exercise.
● Labour - the process by which the baby gradually moves out of the uterus into the vagina
to be born.
● Delivery - the birth itself.

Who Delivers The Baby?*

● Midwife - parents experiencing a healthy and low-risk pregnancy may use a midwife as
an alternative to a family doctor or obstetrician. A midwife provides care for the
expectant mother throughout her pregnancy and delivery either at home or at the hospital.
The services of a midwife are provided free of charge to Onatrio residents.
● Doctor - some doctors provide prenatal care and deliver babies, however if complications
arise they may call in an obstetrician.
● Obstetrician - a doctor who specializes in the care of mothers and babies both before and
right after birth. They are qualified to handle any emergency or complication.

Prepared Childbirth
● Being prepared for childbirth is a responsibility that is placed on both the expectant
mother and father.

11 Ways to Prepare for Baby’s Birth

1. Learn about the birth process
- Glade Curtis, obstetrician and author of Your Baby’s First Year: Week by Week, advises
expectant parents to do this. “In my experience, women who learn about birth ahead of
time are more active participants in their own birth process, which leads to better
outcomes,” he says.
2. Find a doctor for your baby
- Look for a pediatrician or family doctor for your baby.
3. Get on the same page with your partner
- Couples should discuss how the expectant father can assist during labour and what they
will need from each other during the newborn period.
- Differing expectations can create big conflicts, so it’s best to work this out ahead of time
(ex: diving up the housework).
4. Talk to veteran moms about birth and baby care
- Not every experience will happen to every mother, but becoming informed ahead of time
can reduce the shock factor. Asking mom friends questions may help. “For example,
there's a myth that binding should happen right away. That’s not true for everyone,” says
Patricia O’Laughlin.
5. Prepare older siblings
- Many parents use a baby doll and story books to help their child understand that there is a
baby on the way.
6. Line up help for after birth
- For many new moms and dads, help is essential (ex: cleaning, cooking, shopping,
laundry, childcare for other children, etc).
- “Moms who get help will be better equipped to help their babies - which is infinitely
more valuable than trying to be some superhero mom who does it all herself,” says
O’Laughlin, the marriage and family therapist.
7. Know what to do when labour starts
- Long before the first contractions expectant mothers should have a firm plan for who to
call, where to go and when
- The doctor or midwife should give a clear set of guidelines on what to do when you go
into labour.
8. Decide who will attend the birth
- This is a very personal decision. Some moms like a full room, with their partner, a friend
or two, their mom, and even their mother-in-law present to witness the miracle and
provide support.
9. Pack a bag
- Expectant mothers should pick important items, such as a toothbrush, clothing, etc.
10. Stock up on essentials (but don't go overboard)
- A new baby requires an installed car seat, diapers, wipes, some clothing, etc.
11. Prenatal Classes
- Prenatal classes are an important part of prenatal care.
 - They help parents understand what is happening during the pregnancy and prepare for
what is to come.
- Some of the specific topics covered include labour and delivery, newborn care and
breastfeedings.
- Prenatal classes are offered in some hospitals or by private childbirth educators.

Prenatal Classes York Region

● York Region Public Health offers classes to all expectant parents.
● York Region Public Health also provides telephone and home visiting support free of
charge to expectant parents through the Healthy Babies Healthy Children (HBHC)
program.
● Topics Include:
- Physical and emotional changes in pregnancy
- Healthy lifestyle choices and pregnancy care
- Labour and delivery
- Comfort measures during labour
- Breastfeeding
- Newborn care
- Adjusting to parenthood
- Communication and parenting skills
- Community resources for new parents
- Perinatal mood disorder
● Parents may sign up for childbirth preparation classes which usually teach either the
Lamaze or the Bradley method.
● Both methods encourage an expectant mother to work with her body through the birthing
process, instead of fighting or working against her body and encourage walking,
massage, breathing patterns and relaxation.

What About the Dads

● How Can They Be Supportive Throughout This Process?
- Ask the expectant mother or health care provider how they can help
- Going to the health care provider with expectant mother
- Take prenatal classes
- Learn about pregnancy
- Talk about how the child will be parented
- Talk about breastfeeding
- If a smoker, try to cut down or quit
- Encourage repentant mother to be active
- Understand that she may be moody at times
- Help her rest when she is tried
 - Carry things that are top heavy for her
- Learn how to take care of your new baby
- Think about things the baby will need. Get your home ready for the baby
- Find out about class or groups for new parents in your community

Types of Birth
● Today, expectant mothers are afforded the option to choose what type of birth they’d like
to have.
● Birth options include: the place of birth; and a vaginal birth, water birth or a cesarean
section.

Birth Center or Home

● In a low-risk pregnancy, expectant mothers might be interested in having a more natural
type of birth at home or at a birthing center.
● These types of births employ the help of licensed midwives who will help you have a
healthy and natural birth experience. Obstetricians and other professional medical staff
should be on-call should an emergency arise.
● Birthing Center: they are not mini hospitals and labour will never be induced or
stimulated with oxygen (Pitocin) and c-sections are not done. But such
But such centers are equipped with IVs, oxygen, and medication. Mom is cared for by a
licensed professional, usually a midwife and a nurse, with a backup hospital and a doctor
on call in case of an emergency.

Hospital Births
● Hospital births give mom the option of having a natural birth without medication or an
epidural.
● Epidurals can relieve harsh labour pains and help mom in order to focus on her breathing
and prepare for delivery.
● Choice of having a vaginal birth or a cesarean section.

Chapter 6: Beginning of Labour and Stages of Labour - The Birth of a Baby

The Beginning of Labour
● Labour - the process by which the baby gradually moves out of the uterus and into the
vagina to be born.
● During the last few weeks of pregnancy, women feel what is called lightning.
● Lightening occurs when the baby settles deep in the pelvis near the time of birth.
● The pressure on the woman’s upper abdomen is reduced.
Early Signs of Labour
● There are many signals that the baby is on its way
1. One sign is called the “show” or “bloody show”, which refers to a few drops of blood or
a pinkish rain that occurs when the mucus that plugs the uterus during pregnancy
dissolves.
● This plug seals the cervix - which is the lower part of the uterus - and prevents bacteria
from moving into the uterus.
● This may occur a few days prior to birth.

2. Another sign is when women feel a trickle or even a gush of fluid from the vagina.
● This happens when the membrane, or amniotic sac, holding the amniotic fluid
surrounding the baby has broken, “water has broken”.
● If the mother experiences this, she should note the time, the amount, and the colour.
● Next, she should call her doctor or midwife and report this information.
● Once the membrane is broken, birth usually happens within 24-48 hours.

3. In addition, contractions - the tightening and releasing of the muscles of the uterus - can
be another sign of labour.
● When the uterus contracts, it shortens and closes, pushing the fetus against the cervix and
then relaxes.
● The time between contractions get shorter as labour advances.
● Contractions are painful, but bearable.
● During contractions it is important that the baby is monitored using an ultrasound device
to watch for indicators of stress in the baby’s heartbeat.
● Fetal monitoring - watching an unborn baby’s heart rate for indications of stress during
labour.

Premature Labour
● Occurs when the fetus has been developing in the womb for 37 weeks or less.
● Indicators of premature labour are:
- Contractions every 10 minutes
- Dull backache
- Leaking fluid or blood

False Labour
● Can occur hours or days before labour starts.
● Three signs of false labour:
○ Contractions aren't regular or rhythmic
○ Contractions don't become stronger over time
○ Contractions end with light exercise, such as walking
Stages of Labour
● The porches of labour and birth are divided into 3 stages.

Before Labour Begins

● The cervix is its normal size and shape.

First Stage
● Begins when you start having contractions that cause progressive changes in your cervix
and ends when your cervix is fully dilated.
● Dilate: to open wider.
● Contractions are about 60 seconds in length and occur 5 to 6 minutes apart.
● This stage is divided into two phases:
○ Early Labour: The cervix gradually effaces (thins out) and dilates (opens).
○ Active Labour: The cervix begins to dilate more rapidly, and contractions are
loner, stronger, and closer together.
○ People often refer to the last part of active labour as transition because it
completes the work of the first stage.

Transition Stage
● The cervix becomes fully dilated to a size of 10cm and the baby’s head slips out of the
uterus into the birth canal. Contractions begin to last about 90 seconds and are more
frequent (2-3 minutes apart).
● This is the most difficult time of labour and the woman needs encouragement and
reassurance.
● Most babies come into the world headfirst but some enter their feet or buttocks. This is
known as the breech position making it more difficult to move through the pelvis.
- In some cases, a doctor may decide that a normal delivery is not possible.
● The first stage and transition last to 6 to 18 hours for a mothers first child and 2 to 5 hours
for her second child.

Second Stage
● This is sometimes referred to as the “pushing” stage where the baby’s head appears at the
opening of the birth canal.
● This is also called crowning because the baby’s head emerges first.
○ The head has changed its shape to ease passage through the birth canal. It will
return to normal. After the head emerges, the shoulders follow and the rest of the
baby slips out easily.
● Pushing at the right time is important because earlier pushing may tear delicate tissues or
cause other types of injury.
 ● Doctors may use surgical tongs, called forceps, or a vacuum extractor to help move the
baby through the birth canal more quickly.

How Can A Baby Fit Through Such a Narrow Space?

● During labour, a hormone called relaxin allows this tissue to stretch like rubber bands,
moving apart the pelvis and pelvic bones.
● Relaxin also makes it possible for the walls of the vagina to stretch so that the baby can
safely pass through.
● If the opening of the vagina is too small to accommodate the baby’s passage, the doctor
may widen it with a surgical cut called episiotomy.
● The second stage may last 1 to 2 hours for a mother’s first child and 15 to 30 minutes for
her second child. .

Third Stage
● Begins right after the birth of your baby and ends with the delivery of the placenta, which
is no longer needed by the baby (which provided the baby with oxygen).
● Shortest age, lasting anywhere from 10 to 30 minutes.

After Labour
● Parents may choose to have the cord blood from the umbilical cord and the placenta
stored for later use in case of medical need. The stem cells found in the blood are capable
of producing all types of blood cells and can treat blood-related illnesses in the baby or
family members.
● Every pregnancy is different, and there is wide variation in the length and experience of
labour.

*Not all births progress through these stages of labour.*

Cesarean Birth (C-Section)

● Occurs when complications arise during pregnancy or labour.
● For instance:
○ Baby is distressed
○ Baby is turned the wrong direction
○ Multiple babies
● The baby is delivered through a surgical incision in the mother’s abdomen.
● Women are usually awake during the cesarean and are given pain medication like
epidural.
● Up to a six week recovery.
Premature Birth
● 5-6% of all babies are born premature.
● Premature babies are babies who are born before reaching 37 weeks and weigh less than
5 pounds 8 ounces (organs which comprise much of the baby's weight, are not developed
enough).
● Babies require extra care as they are not ready to live outside their mother’s body.
● To control breathing, feeding, and temperature the baby is placed in an incubator - which
is a special enclosed crib where oxygen supply is given and temperature is controlled.

The Newborn
A Newborn Baby Arrives
● A newborn baby is no longer reliant on the mother for basic needs, like oxygen.
● During pregnancy the baby’s lungs are collapsed and oxygen is delivered through the
mother’s blood.
○ During delivery, the lungs fill with the amniotic fluid and whatever amniotic fluid
that remains is suctioned out immediately after birth from the baby’s mouth.
● The umbilical cord, which provided the baby with nourishment and oxygen, is clamped
and cut off.

How Does the Newborn Look?

● Limbs are skinny The
● Features are flattened
● Head is wobbly and looks to large for the body
● Swollen or puffy face
● Eyes are nearly adult size
● Eye colour may change from a dark greyish-blue at birth to their permanent colour
● Fingers and toes are slightly a different colour than the rest of the body
● Premature babies have fine, downy hair called lanugo growing on their backs, shoulders,
and foreheads which soon disappears.
● Babies are born covered with vernix, which is a thick, white pasty substance
● Vernix is made up of fetus’s shed skin cells and secretion of skin glands
● Baby acne, which is called milia
● The skull can appear pointed or lopsided due to the passage through the birth canal
○ Fontanels, which are the open spaces between the baby’s skull bones that are not
fully fused, are located just above the forehead and behind the head

Examining the Newborn

● When born, the newborn's condition is evaluated using the Apgar scale, which is a
system of rating the physical conditions of the newborn baby.
● 5 factors are checked at one minute, and again 5 minutes after birth.
 ● Rating is 0-2
○ Heart rate
○ Breathing
○ Muscle tone
○ Response to simulation
○ Clear skin
● Normal scale is 6-10 range.
● 10 is a perfect score and a lower score indicates the baby may need medical assistance.
● Nurses check the baby’s weight, measurement, dry the baby off, apply eye drops to
prevent infection, and an injection of vitamin K to prevent a rare bleeding disorder.
● Records taken
○ Baby’s footprint
○ A band with the baby’s last name and matching numbers on it is fastened to the
mother’s wrist and the baby’s wrist

The Postnatal Period

What is it?
● Parents quickly begin forming emotional ties with their newborn
● This process not only plays an important role in the emotional and physical development
of the baby but also helps the parents.
● Mothers experience emotional changes, and it’s important that they receive support from
their family, friends, and health care professionals.

What is Bonding?
● Bonding is the forming of emotional ties between parents and child.
● It is encouraged by researchers because it is very important for the baby and the mother/
parents.

How is Bonding Promoted?

● Immediately following birth, the nurse may place the baby on the mother’s abdomen to
feel the warmth of her skin and to hear her voice and heartbeat.
● Many fathers will examine their newborns' tiny toes and fingers.
● Parents usually begin touching and talking to the baby, looking into the baby’s eyes, and
stroking the baby’s cheeks.
● The newborn instinctively focuses on the human face, which in turn, helps the newborn
bond.

Breastfeeding and Bonding

● If the baby will be breastfed, the mother may begin nursing the baby right away.
 ● Newborns are born with a strong sucking reflex and are usually alert immediately after
delivery.
● Breastfeeding is also important because:
○ It stimulates the mothers body to continue to produce milk
○ Helps the uterus contract after birth, stopping any bleeding
○ High-Calorie and high-protein early breast milk called colostrum satisfies the
baby's appetite and provides protection from illness

Bonding and Brain Development

● Parents’ efforts to bond with their baby helps build connections to the brain.
● Simple bonding interactions such as holding, rocking, or singing to the baby strengthen
the development of that baby's brain.

The Hospital Stay

● The neonatal period refers to the first month after the baby is born.
● A healthy mother and her baby may go home as soon as 12 hours after birth.
● Jaundice is a condition that occurs in over 50% of newborns, causing the baby’s skin and
eyes to look slightly yellow.
● Jaundice occurs when the liver cannot remove bilirubin, a substance produced by the
breakdown of red blood cells.
● Untreated jaundice can damage the nervous system.
● Jaundice can be treated with phototherapy, the use of ultraviolet lights to help the liver do
its job.

Help With Feeding

● All babies lose weight during the first few days of life, but quickly gain it back later.
● Parents can get help with breast or bottle feeding their newborn while in the hospital.
● Mothers having difficulty breastfeeding can consult a lactation consultant, a
professional breastfeeding specialist who shows breastfeeding mothers how to encourage
adequate milk and how to position a baby properly so that they can nurse.

Rooming-In
● Hospitals offer the option of full or partial rooming-in.
● Full rooming-in means that the baby remains with the mother in her room during the
entire hospital stay.
● Partial rooming-in means that the baby stays in the nursery part of the time, such as
during night.

Caring for Premature Babies

● Premature babies are those that are born before 37 weeks of development.
 ● Premature babies may spend time in a hospital’s neonatal intensive care unit (NICU),
which has special equipment and highly trained nurses.
● Premature babies stay in the hospital until their internal organs develop enough to
function independently.
● How well a premature baby thrives depends upon how close the baby was born to the
original due date.
● Those babies born between 23-26 weeks have the highest risk of complications and
decreases for those born between 28-30 weeks.
● When premature babies are able to breathe without a machine, drink, and maintain a
steady body temperature, and maintain a steady weight of 5 pounds or more, they can
leave the hospital unless other problems require a longer stay.

Postnatal Care of the Mother

● The time following the baby’s birth is called the postnatal period.
● The nurse will explain how the new mother should care for herself and also meet the
needs of her baby.

1. Physical Needs
- Rest: the mother should try to sleep whenever the baby does.
- Exercise: with a doctor's approval, the mother can generally begin exercising gently.
- Good nutrition: as during pregnancy, eating right is important for new mothers.
- Medical checkup: a new mother should have a postnatal check-up 4-6 weeks after birth.

2. Emotional Needs
- Many women feel confused a few days after giving birth and develop mood swings or
the baby blues which is very common.
- Joining a support group for new mothers or talking with other mothers often helps.
- A small group of mothers experience these symptoms to a greater degree and the blues
develop into postpartum depression: feeling sad or crying a lot, having no energy, being
overly anxious about the baby, having little interest in the baby or thoughts of causing the
baby harm.
● Treatment is available for postpartum depression and it is very important for women who
have these.
● Talking to a therapist can help, as can medication.