childbirth and parturition

1. Parturition and
child birth

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3. 1. PARTURITION

4. “Also called child birth.
Is a process during which the fetus ,
placenta and fetal membranes are
expelled from the mothers
reproductive part.

5. Labor
sequence of involuntary uterine
contractions that results in
-Dilation of uterine cervix.
-Expulsion of fetus and placenta.
 Stages of labor:
1.DILATION
2.EXPULSION.
3.THE PLACENTAL STAGE.

6. 1.DILATION
Regular painful contractions of the uterus
occurs less than 10 minutes apart.
Contraction begin @ the upper portion of
uterus and sweep downward.
Increase in frequency and intensity of
contraction.
Cervical canal forced to open to maximum
diameter of approx. 10cm.

7. Dilation is divided into 2 phases-
• LATENT PHASE-Cervix 0-4 cm dilated.
• ACTIVE PHASE –Cervix 4-10 cm dilated.
 Latent phase
-6 Hour-For a women who is giving birth for
the first time.
-Around 5 Hours-For a women who’s given
birth previously.
-For some it may last up to 8-12 Hours.

8. Active phase
-Cervix will dilate at a rate of 1 cm per hour:
for a women who’s giving birth for the first time.
-Cervix will dilate at a rate of 2 cm per hour:
for a women who previously had a vaginal birth.

9. 2.Expulsion
 Begins when cervix is fully dilated.
 Ends with delivery of the baby.
 During this stage fetus descends through
the cervix and vagina.
 Fetal membranes rupture.
 Amniotic fluid is lost through the vagina.
 Contraction of abdominal muscles—
powerful contraction of fetus’s head into
the birth canal.

10.  Baby is pushed out of the uterus and down the
vagina , usually head first.
(leg first : BREECH BIRTH)
 Once the head is born , rest of the body
follows much more easily.
 2 Phases
-PASSIVE PHASE-Baby’s head moves
through the vagina.
-ACTIVE PHASE-The mothers feels a
need to push , or contract the abdominal
muscles in time with uterine contractions.

11.  Active phase
-Last about 45 minutes for a women who’s
having her first baby.
-Lasts about 30 minutes for women who’ve had
vaginal delivery.
 Passive phase
-End with the birth of the baby.
-Newborn baby is called NEWBORN INFANT
or NEONATE.
-Umbilical cord is clamped.
-Breastfeeding is encouraged.

12. 3.THE PLACENTAL STAGE
10-45 minutes after the birth—Uterus continues to
contract to a smaller and smaller size-causes a
shearing effect b/w the walls of placenta and uterus.
Placenta is separated from implantation site-causes
bleeding.
Average blood loss-350 ml-500ml.
(POSTPARTUM HEMORRHAGE).

13.  If Doctor plays an
active role including
gently pulling on the
placenta
-Around 5 minutes.
 Without assistance
-30 minutes.

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15. Corticotropin
Releasing
Hormone
CRH
Adreno
Cortico
tropin
Hormone
ACTH

16. HORMONAL ACTION
 Fetal hypothalamus—CRH—Stimulates the anterior
Pituitary —ACTH—Stimulates adrenal cortex—Cortisol—
Involved in the synthesis of Estrogen—Stimulate uterine
contraction.
 OXYTOCIN
-Released by posterior pituitary.
-Stimulate myometrial contraction.
-contraction of muscles of uterus , helping to
recover its normal tone after birth.

17. ESTROGEN
-Increase Myometrium contractile activity.
-Release of oxytocin and prostaglandins.
RELAXIN
-Believed to soften pubic symphysis.

18. 2.LACTATION(NURSING)

19.  LACTATION-Secretion of milk by breasts or
mammary gland.
 Contain ducts(LACTIFEROUS DUCT) that branch all
through the tissue and converge at nipples.
 Ducts arise from sac like glands called ALVEOLI—
Secretes milk.
 Alveoli--surrounded by Smooth muscle
fibers(myoepithelial fibers).
 Contraction of muscles-release of milk.
 Sinus-Expanded portion of each duct.
FUNCTION : Storage of milk.

21.  Onset of puberty—Estrogen—marked
enhancement of duct growth and branching ,
relatively little development of alveoli.
 Pregnancy period
-Breast size increases due to the development
of milk glands[PROGESTERONE].
-Development of ducts[ESTROGEN].
 Anterior pituitary—Prolactin—Milk production.
 Through out pregnancy—presence of Estrogen
and Progesterone inhibits Prolactin secretion.

22.  Birth—Loss of Placenta—fall in Estrogen and
Progesterone level—Prolactin no longer inhibited—
Production of milk.
 Placental lactogen(Chorionic somatomammotropin)
Plays an important role in breast development.
 MILK EJECTION REFLEX
-Is caused by the combined neurogenic and
hormonal reflex(Posterior pituitary hormone
-OXYTOCIN).
-Reflexly released in response to suckling.

23. COLOSTRUM
o First secretion following birth.
o Yellow color.
o Rich in protein globulin.
o Low fat content.
o Means of passing antibody IgA from
mother to baby.

24. Constituents of milk
4 major constituents.
 Water
 Proteins(Lactalbumin & casein)
 Fat
 Carbohydrate lactose(Milk sugar)
 Made from the nutrients circulating in
the blood with the help of PROLACTIN ,
INSULIN , GROWTH HORMONE ,
CORTISOL Etc.
 Significance : Reduces infant sickness
and mortality.

25. FACTS!!!
 Breast feeding reduces the risk of:
Type I and II diabetes.
Leukemia.
Obesity.
High blood pressure.
High cholesterol levels.
Asthma.
 Breastfeeding reduces mama’s risk of ovarian and
breast cancer, heart disease, and
osteoporosis. The longer she breastfeeds, the
higher the benefit.
 Breastfed infants are at lower risk for sudden
infant death syndrome (SIDS)