Birth

Question 1

theorically what happens

Answer 1

relese oxytocin > trigger contractions>push baby out

Question 2

stage 1 of labour

Answer 2

• the cervix expends
• the longest

Question 3

stage 2

Answer 3

• push the baby out (head first and then body)
• faster

Question 4

stage 3

Answer 4

push out the placenta, umbilical cord and fetal menbrane

Question 5

cesarean delivery

Answer 5

• Surgery to deliver the baby
• Typically used in cases where vaginal delivery may be a risk to the parent or infant
  -Complications in labour, infant health at risk, birthing parent health at risk, infant too large, mother has an infection, etc
• Around 28% of births in Canada
  Large cultural variation rate (BC/Dominican Republic)

Question 6

Vaginal vs cesarian delivery impacts

Answer 6

• Cesareans have more medical risks, longer healing time, risks with dubsquencial pregnancies, correlation between ceaserian with problems with breastfeeding
• Higher rates of childhood asthma, childhood obesity, autism, ADHD, learning disabilities
• Vaginal is inconsistent, cant hold body fluid

Question 7

Impacts in child development

Answer 7

• Randomly assigning pregnant individuals to vaginal vs cesarean delivery is typically not ethical! (ceserian is a surgery and comes with risks)
• Studies comparing children born to vaginal vs cesarean delivery typically have many confounds– other ways the children/families differ(nutrition,stress,sleep,age, in cesarian the baby or the parent already has an issue etc.)

How to get an answer then?
* Correlational studies try and control confounds
their might have confounds that are not control that seems like they are not important (ex: spicy food)

Animal studies
how much can u generalize
Situations in which less is known about delivery methods

Question 8

Reserch

Answer 8

• Term Breech Trial: randomized trial of planned cesarean vs planned vaginal delivery in infants in the breech position (feet down, instead of head down)
• Debate over best practices for delivery
• Randomly assigned to either a planned C-section or a planned vaginal delivery

Question 9

results

Answer 9

• Examined child outcomes at 2 years post-birth:
• No difference in rates of child mortality
• No differences in rates of neurodevelopmental delay

Data from experiments on breech delivery suggest no major differences in child outcomes
Same findings with twin birth studies

Question 10

limitations

Answer 10

• While planned vaginal vs cesarean delivery can be randomly assigned → in reality, not all participants follow this plan
• Analyses can underestimate differences between —-

Can the results generalize to other contexts of vaginal vs cesarean delivery?

Question 11

Pre-term birth

Answer 11

• anything before 37 weeks
• pre-term = low birth weight

Question 12

why

Answer 12

• ** sometimes by choice** (babies or parents life is in danger)
• sometimes spontaneous

Question 13

Maternal medical risks factors

Answer 13

• substance use
• bleeding,infections,teratogen exposure
• multiple gestations,high or low BMI

Question 14

Psychosocial risks

Answer 14

• social economics (probably stress)
• access to re-nate care
• margenilize racial group (social economics,exposure to recism = stress)

Question 15

**Neonatal intensive care unit **

Answer 15

• Primary goal → maintain and enhance physical well-being
• Often utilize “artificial” means
  -devices like incobeters
  -surgeries

initially they separated parents and babies for a long time to make sure the babies wouldnt develop any infections, but later it was found that babies become healthier and better if parents were involved (lessen stress?)

Question 16

Pre-term birth outcomes

Answer 16

Survivability

Question 17

Pre-term birth outcomes

Answer 17

Increased risk for developmental challenges
* Motor delays
* Lower IQ, cognitive abilities
* Social difficulties
* Neurodiversity (Autism, ADHD, learning disabilities)
* behavioural and emotional difficulties

There is more risk increases as early the preterm birth is
Even 34-36 weeks there is also some risks (even if they are moderate pre-term)

Question 18

Parents and pre-term infants:
Unique challanges

Answer 18

**Difficulty with hospital environment → separation, feelings of overwhelm/not being important **

**Parents unsure, worried, afraid, feelings of loss and guilt **

Preterm infants seen as less attractive, different quality of cries, less active

maternal distresses
- Depression
- PTSD
- Unresolved grief

Delay in reaching developmental milestones
-6 weeks > they social smile (usually) but pre-term they dont smile at 6 weeks and some more

Question 19

Pre-term birth outcomes

Answer 19

Increased risk for health problems

Immediate:
* difficulty breathing
* lung disease
* brain complications
* seizures
* feeding difficulties
* gastrointestinal issues
* infections

Long-term:
* frequent hospital stays
* continued issues with breathing
* eyesight issues
* and hearing loss

Question 20

What about attachment?

Answer 20

Prematurity per se is not a risk for insecure attachment

But prematurity and other associated risks can contribute:
* parental depression
* extra health challenges
* unresolved grief

Question 21

“Prematurity stereotype” (parents’ expectations)

Answer 21

more negative stereotypes

in a study they bring non-parents and parents

condition 1:tell them that these babies are pre-term (they actually aren’t)

condition 2 : tell them is a full term baby ( same baby as before)

results: tend to evaluate babies that are full term more positively
this then can impact how they react to the baby

they gave toys for younger age babeis to those they though were pre-term although they could have gave the ones intended for they actual age (this then can also impact development/self-fulfilling prophecy)

Question 22

Interventions for pre-term infants

Answer 22

Goal: support the best medical care for infants, while also supporting the best parent-child relationships

Evidence-supported interventions:
Kangaroo Care
Infant massage
live Music in the NICU
Parent education
Infant mental health support

Question 23

kangaroo care

Answer 23

• Parent-infant skin-to-skin contact
• Initially developed for premature infants in a hospital where there was a shortage of incubators and health-care workers
• Shown to improve survival rates and health outcomes vs care as usual
• Can be continuous (24/7) or a complement to traditional NICU care

Question 24

kangoroo care long-term benefits

Answer 24

• Improved survival and neurodevelopment
• Longer breastfeeding duration
• Stronger maternal-infant bonding
• Reduced externalizing/socially deviant behaviors in adulthood

Randomized controlled trials show
-** long-term social and behavioral benefits**
- more nurturing parenting
- better-regulated offspring

Question 25

Why is there benefits for kangoroo care

Answer 25

**Transactional model**→ kangaroo care **impacts both parent and child, who then impact each other**

Question 26

# ``` ``` other interventions

Answer 26

**NIDCAP** (Newborn Individualized Developmental Care and Assessment Program): * Individualized developmental care that enhances infant neurobehavioral organization. **Family Nurture Intervention (FNI):** -Encourages emotional exchanges and holding; shown to improve infant regulation, brain development, and reduce maternal depression. **Infant Mental Health Perspective** - Emphasizes relationship-based, reflective care to support both infants and caregivers. Infant mental health clinicians in NICUs help: - Address maternal distress and trauma - Support caregiver-infant bonding - Prepare families for the transition home - Foster resilience through nurturing early relationships