NSC Chapter 22 - websites.rcc.eduwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-22.pdfChapter 22 • Pregnancy and Childbirth • Childbirth is normal, natural process. • Usually

© 2016 National Safety Council

CHAPTER 22

Pregnancy and Childbirth

Chapter 22 • Pregnancy and Childbirth

1. List healthy behaviors during pregnancy to prevent problems for the woman and fetus.

2. Describe the stages of pregnancy and the stages of labor and delivery.

3. Explain the first aid to give for vaginal bleeding during pregnancy and for possible miscarriage.

22-2© 2016 National Safety Council

Lesson Objectives


4. Describe how to assist during childbirth and care for the mother and newborn after birth.

5. Explain actions to take in case of complications: breech presentation, prolapsed cord, the cord wrapped around the infant’s head and bleeding after delivery.


Lesson Objectives continued


• Childbirth is normal, natural process.

• Usually occurs without problems or complications.• Occasionally health problems may occur:

• e.g., Childbirth outside planned setting


Pregnancy and Childbirth


• Regular prenatal care• folic acid

• Follow health care provider’s instructions

• Healthy diet with normal weight gain – 25 to 35 pounds

• Minimize caffeine

• Avoid alcohol22-5


Prevention of Problems in Pregnancy• Avoid smoking

• Avoid illicit drugs

• 30 minutes moderate exercise a day

• Rest

• Prevent injury


• Embryo – term used for first eight weeks after implantation

• Fetus – term used thereafter


Pregnancy and Labor


• Embryo develops inside amniotic sac, which contains amniotic fluid.

• Embryo attached to placenta

• By eight weeks, embryo has developed all major organ systems.

Pregnancy and Labor continued



• First trimester• Few visible changes• HR increases by about 8 beats/min• Nausea, breast tenderness


Stages of Pregnancy


• Second trimester• Fetus grows to 12 inches.• Abdomen gradually swells.• At 18-20 weeks, may feel fetus moving.


Stages of Pregnancy continued


• Third trimester• Fetus grows rapidly.• By week 36, weighs 6½ lbs. and fully formed• Uterus is high on abdomen and presses on lungs

causing shortness of breath.• May experience backache, heartburn, constipation,

frequent urination.


Stages of Pregnancy continued


• “Show” or “bloody show”:• When mucus plug from cervix released• Can occur up to 10 days before contractions begin.

• Occurs in three stages, beginning with contractions.


Stages of Labor and Delivery


• Amniotic sac ruptures before or during first stage.

• Uterine contractions begin and eventually push infant’s head into cervix:• 10-15 minutes apart initially• 2-3 minutes apart shortly before birth

• May last few hours to a day.


First Stage


• Typically lasts 1-2 hours

• Cervix fully dilated

• Contractions powerful and painful

• Infant’s head presses on floor of pelvis – urge to push down.

• Vagina stretches open.

• Head emerges (crowning).

• Rest of body pushed out

Second Stage



• Placenta separates from uterus and delivered:• Usually within 30 minutes of birth

• Uterus contracts and seals off blood vessels.


Third Stage


• Although rare, problems may occur:• Vaginal bleeding• Miscarriage• Other problems


First Aid in Pregnancy


• May be caused by cervical growths or erosion, problem with placenta or miscarriage.

• May be sign of preterm birth in third trimester.

• See health care provider immediately.


Vaginal Bleeding


• Heavy bleeding – call 9-1-1.

• Calm woman, help into comfortable position.• Give towel or sanitary napkins to absorb blood.

• Do not try to pack vagina.

• Save blood and any expelled material.


Vaginal Bleeding continued


• Loss of fetus – usually in first 14 weeks

• 10-25% of pregnancies end in miscarriage.• Natural way body manages problem in pregnancy

• Does not usually cause problems with later pregnancies.


Miscarriage


• Early signs include vaginal bleeding, abdominal pain, cramping.

• Woman needs immediate medical attention:• Give first aid for bleeding.• Call 9-1-1.• Minimize shock.


Miscarriage continued


See health care provider for:

• Abdominal pain

• Persistent or severe headache

• Sudden leaking of water

• Persistent vomiting, chills and fever, convulsions, difficulty breathing


Other Signs of Possible Problems


• Remember, it is a natural process.

• Woman may be fearful or distressed.

• Remain calm.

Childbirth



• Contractions are less than 5 minutes apart and last 45-60 seconds.

• If previous births, more likely to have short labor

• Amniotic sac has ruptured.

• Strong urge to push or have bowel movement

• Crowning occurs during contraction – the top of the infant’s head can now be seen


Is Delivery Imminent?


• Ensure plan for transport.

• Help woman rest.

• Provide comfort measures.

• Do not let woman have bath if amniotic sac has ruptured.

• Write down contraction intervals and length.

• Help remind woman to control breathing.

• Continue to provide reassurance.22-23


Assisting During Labor


Items Needed for Delivery


• Clean blanket or coverlet

• Several pillows

• Plastic sheet, or stack of newspapers

• Clean towels and washcloths

• Sanitary napkins or pads of clean cloth

• Medical examination gloves (or clean kitchen gloves)

• Plastic bags


• Bowl of hot water

• Empty bowl

• Clean handkerchief for face mask

• Eye/face protection

• Clean, soft towel, sheet or blanket for newborn

• Bulb syringe


Items Needed for Delivery continued


If help may be delayed:

• Clean strong string, shoelaces or cloth strips (to tie cord)

• Sharp scissors or knife (to cut cord)• Sterilize in boiling water for five minutes or hold over flame for

30 seconds.


Items Needed for Delivery continued


• Prepare birthing bed with clean sheets over plastic sheet:

• If no bed, prepare clean place on floor or ground.

• Make padded area of newspapers, clothes or blankets.

• Roll up sleeves, wash hands thoroughly for five minutes, put on medical examination gloves.


If Help May Be Delayed


• If possible, protect eyes, mouth, nose from splashes of blood or other body fluid.

• If telephone available, call health care provider or 9-1-1 for instructions during or after childbirth.


If Help May Be Delayed continued


CHAPTER 22

First Aid: Assisting With Delivery


1. Help woman lie on back with knees bent and apart and feet flat.


First Aid: Assisting With Delivery


As infant’s head appears, have gloved hands ready to receive and support the head.


First Aid: Assisting With Delivery continued


As head emerges, check thatumbilical cord is not wrappedaround infant’s neck.

Support infant’s head and body as it emerges.




Hold with head lower than feet. Suction mouth and nose with bulb syringe.




Dry and wrap infant. Place infant on mother’s abdomen.

Stay with mother and infant while placenta delivers.




• Support and comfort:• Ensure warm.

• Give water to drink.

• Wipe face with cool water.

• Ensure they see a health care provider.


Care of the Mother After Delivery


• Ensure newborn breathing well – normal respiratory rate of 40 breaths/minute or higher.

• Dry, but do not wash newborn.

• Ensure newborn stays wrapped, including head, to stay warm.

• Support head if newborn must be moved.

• Continue to check breathing.22-36


Care of the Newborn


• Most deliveries occur without problems.

• Possible problems involve presentation of infant or maternal bleeding after delivery.


Childbirth Problems


Breech Birth


• Occurs when buttocks or feet appear in birth canal

• Umbilical cord squeezed and blood flow may stop

• If infant’s head becomes lodged in birth canal and it tries to breathe, it may suffocate.


• Medical attention urgently needed

• Move woman to kneeling position with head and chest down.

Breech Birth continued



• Support infant’s body as it emerges, do not try to pull head out.

• If head does not emerge soon, create breathing space for infant.

• Check infant immediately, and give CPR if needed.


Breech Birth continued


• Rarely, arm or leg may emerge first.

• Emergency requiring immediate medical assistance.

• Put woman in knee-chest position while waiting for help.

• Do not try to pull infant out or push arm or leg back in.


Limb Presentation


• Segment of cord protrudes through birth canal before childbirth:• Cord will be compressed as

infant moves through canal

Prolapsed Cord



• Put woman in knee-chest position to reduce pressure on cord.

• Do not try to push cord back inside mother.

• When infant begins to emerge, insert hand into birth canal and try to separate cord and presenting part while allowing birth to continue.

• Check infant immediately and give CPR if needed.


Prolapsed Cord continued


• Umbilical cord may be around neck when infant emerges.

• Slip it over head or shoulder to allow infant to emerge without strangling on cord.


Cord Around Neck


• If it is too tight and you cannot release head, it is a life-threatening emergency.

• Tie off cord in two places and cut in between.


Cord Around Neck continued


• Bleeding normally occurs with childbirth and delivery of placenta.• Usually stops after placenta delivered

• Use sanitary pads or clean folded cloths to absorb blood.

• To help stop bleeding, massage the abdomen with kneading motion.


Bleeding After Delivery


• Bleeding that persists can become an emergency.

• Keep mother still and calm while waiting for help to arrive.

• Give first aid to treat shock.


Bleeding After Delivery continued


CHAPTER 22

Learning Checkpoint



Melanie is almost 9 months pregnant with her first baby, but stilla week away from her due date. You have just trimmed her hairand are blowing it dry when she suddenly gets a funny look onher face and says, “Oh, no!” Then she tells you, “My water just broke.”

What do you do?

Chapter – Opening Scenario

22-51


CHAPTER 22

Discussion and Questions

NSC Chapter 22 - websites.rcc.eduwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-22.pdfChapter 22 • Pregnancy and Childbirth • Childbirth is normal, natural process. • Usually

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