Dr. Laura Jansons

1. Developmental effects
*

2. *
*On the one hand, Vaginal birth is often said to
be a “hazardous” journey on the other hand it
helps prepare the baby to meet the demands
of the world outside the womb.

3. *
*Maternal contractions provide the deepest tissue
massage a child will ever experience at any time again
in life helping to
•rid the lungs of fluid in preparation for breathing
•priming the kidneys for effective urination after birth
•awakening the sensors of the skin and proprioceptive
located in the muscles, tendons, and joints for
control of movement in a gravity-based environment
later on.

4. *
*Pressure applied to the head as a result of
squeezing from uterine contraction stimulates
the fetus to release thyroid hormones and
adrenaline, which will help the baby to
regulate temperature after birth.

5. *
*inhibits inhalation until after the head has
been born, which is important to prevent the
baby from inhaling fluid other or other
substances present in the birth canal until the
airway is clear.

6. *
*Vaginal delivery is also thought to “prime” the
immune system as the baby is exposed to
bacteria normally present in the maternal
vaginal and anal tracks, which help to confer a
natural resistance to exposure to the same or
similar bacteria in life.

7. *
*Various primitive reflexes such as the
asymmetrical tonic neck reflex (ATNR) and the
Spinal Galant assist birth and are also
reinforced by the process.
ATNR Spinal Galant
Review:

8. *
* The ATNR
• occurs in response to rotation of the head
• emerges about 18 weeks gestation at the same
time the mother starts to become aware of her
babies movements
• should be fully developed the time of birth and
a full term pregnancy ATNR helps the fetus to
move around to turn in to adjust its position
• helps to develop independent movements on
each side of the body and may help the baby
take an active role in its own normal vaginal
delivery the baby has to make to 90° turn to
pass down the birth canal.
Review:

9. *
*Mother and baby work together is cooperative partners in
the birth process
*normal vaginal delivery strengthens the reflexes for the
first few weeks of life
*cesarean section may disturb the sequence of reflex
integration which is reinforced during a normal vaginal
delivery after birth
*the ATNR is often released when baby is placed on its
tummy insuring that the head turns to one side so the
airway is free in the baby can breathe.
*ATNR is the forerunner of hand eye coordination helps
develop both central and peripheral vision activation of
the ATNR helps to train the eyes to move from peripheral
vision to focal division
*At four months, baby can focus at different distances in
the same degree as an adult
Review:

10. *
*facilitate movement in utero
*develop homolateral movements
*may assist in the birth process
*ensure free airway when placed in the prone
position by turning the head to one side
*early hand eye coordination training
*the ATN are is normally inhibited between four and
six months of post natal life
*children with retained ATNR’s have impaired motor
planning skills and lack of bilateral integration
*Retained ATNR also implications for writing and
reading: not bending the arm, trouble crossing the
midline, eyes not tracking fluidly in reading.
Review:

11. *
• The Spinal Galant reflex stimulation on the dorsal skin
of the lumbar region on one side causes outward
rotation of the hip to 45° in the same side
• Reflexes of defense or avoidance reaction
• spinal reflex, begins to be inhibited during the first 2
to 3 months of life but can remain physiologically
present until about the six month
• primitive conductor of sound
• give flexibility to the hips as well as to the shoulders
as a baby works its way down the birth
• also prime the kidneys in preparation for urination
after birth
• facilitates mobility of the trunk, initiates the later
amphibian reflex necessary for commando crawling,
creeping on hands and knees and hip rotation needed
for walking.
Review:

12. *
*persistence beyond the first year is a sign of
pathology
*the response of flexion of the hip can make it
difficult is still
*children who wriggle, squirm, and fidget in their
chairs
*sometimes prefer to do their homework or to watch
television lying on the floor because it’s avoids
aggravating the reflex
*rigid refusal to wear certain types of clothing
texture fabric or close with labels which irritate the
skin
*associated with higher incidence of nocturnal
enuresis
Review:

13. *
*facilitates mobility of the trunk initiating amphibian
reflex necessary for commando crawling, creeping on
hands and knees, and hip rotation when walking
*develops asymmetry of movement
*probably assists in the birth process
*may help to prime the kidneys for urination after birth
*may act as a primitive conductor of sound in uterine
*Retained:
 general restlessness and difficulty sitting still
 attention concentration problems
 bedwetting
 can contribute to development of scoliosis of the spine.
Review:

14. *
*Medical indications for an elective CS include:
 head to pelvic incompatibility;
 placenta previa ;
 multiple pregnancy with three or four fetuses
 Possible indications for an elective CS include:
 breech presentation
 moderate to severe pregnancy induced hypertension
 diabetes
 intrauterine growth retardation
 antepartum hemorrhage

15. *
*Indications for an emergency CS include
cord prolapse
uterine rupture
Eclampsia
failure of labor ineffective contractions which do
not improve following administration of oxytocin
fetal distress, if delivery is not imminent. Signs of
fetal distress can be meconium in the water,
changes in the fetal heart rate, and excessive
movements of the baby.

16. *
*The major risk for the baby is breathing difficulties after birth, which are four
times more likely in CS birth.
*The first task has to baby must accomplish at birth is learning how to breathe
by itself. This involves replacing the shallow episodic breathing movements
practiced before birth with regular rhythmic respirations following lung
expansion.
*At term, approximately 110 mL of lung fluid is present within the respiratory
tract.
*During delivery compression of the chest wall assists in the expulsion of some
of this fluid the remainder of which is absorbed by the pulmonary circulation
and lymphatic system after birth.
*Infants delivered by cesarean section are denied the benefits of chest
compression and therefore expression of lung fluid.
* compression and decompression of the baby’s head during delivery is thought to
stimulate the respiratory center in the brain which in turn maintains the stimulus to
respiratory effort.

17. *
*Various studies have indicated that children
born by CS experience:
higher incidence of immune related problems
 increased incidence of allergies
twice as likely to develop an allergy to cow’s
milk. None of the children out grew intolerance
to cow’s milk by their second year.
egg, fish, and nut allergies

18. *
*Cesarean delivery is associated with an
increased risk of obesity in adulthood in a
Brazilian birth cohort study1,2,3
* Helena AS Goldani, Heloisa Bettiol, Marco A Barbieri,
* Antonio AM Silva, Marilyn Agranonik, Mauro B Morais, and
* Marcelo Z Goldani

19. *
*Cesarean delivery is associated with delayed
acquisition of bifidobacteria, which might be
due to lack of contact of infants with the
maternal vaginal flora.
*A recent case-control study found that the
composition of gut flora in infancy predicted
overweight later in childhood
*cesarean delivery is associated with an
increased risk of childhood-onset type 1
diabetes mellitus.