Module 1:

From Birth till

Infancy
BIRTH
Birth is the process through which a baby comes
out of the mother's body and enters the world. It
usually happens about 9 months (or 266 days)
after a baby is conceived. During this time, the
baby grows inside a special organ in the mother’s
body called the uterus.

As the baby becomes fully developed and ready

to be born, the mother’s body starts to prepare
for delivery. Special hormones are released that
signal the uterus to begin contractions—
tightening and relaxing movements that help push
the baby out through the birth canal.

Birth is a natural and powerful process that marks

the beginning of a baby’s life outside the womb.
Labor: The Process
of Birth Begins
Hormonal Trigger for Labor
Around 266 days after conception, a protein
called CRH starts the birth process.

It signals the body to release important

hormones, especially oxytocin.

Oxytocin, released by the mother’s pituitary

gland, causes the uterus to start contracting.
Labor: The Process
of Birth Begins
Braxton–Hicks: Practice Contractions
During most of pregnancy, the uterus remains
relaxed.
After the fourth month, it sometimes contracts
mildly—these are called Braxton–Hicks
contractions.
Also known as “false labor”, they don’t mean
real labor has started.
They help the uterus prepare for actual
childbirth.
Labor: The Process of
Birth Begins
True Labor Begins
In real labor, the uterus has stronger, regular
contractions.
These contractions push the baby’s head downward
toward the cervix.

How the Uterus Works During Labor

The uterus tightens and relaxes rhythmically, like a vise.
This opens the cervix (the neck of the uterus) and helps
move the baby through the birth canal (vagina).
Labor: The Process
of Birth Begins
Birth and Neonatal Appearance

Eventually, the baby is pushed out and is

now called a neonate (newborn).

The pressure during birth may give the

baby a cone-shaped head—this is common
and not harmful.
Video
 Stages of Labor
Stage 1: Early Labor and Transition
In the first stage, the mother’s uterus
starts to contract (tighten and relax).
At first, these contractions happen every
8–10 minutes and last about 30 seconds.
As labor goes on, contractions get closer
together, stronger, and longer—sometimes
every 2 minutes.
The last part of this stage is called
transition, where the contractions are
most intense
 Stages of Labor
Stage 1: Early Labor and Transition

During this time, the cervix (the opening to the

uterus) slowly opens up to about 10 centimeters,
wide enough for the baby’s head to pass through.

This stage usually takes the longest time,

especially for first-time mothers—often 16 to 24
hours, but it can vary.

Mothers who have given birth before usually go

through this stage faster.
 Stages of Labor
Stage 2: Baby Is Born
In the second stage, the baby’s head starts to
move out with each contraction.

The vaginal opening stretches, and sometimes

doctors make a small cut called an episiotomy to
help the baby come out.
But this is less common now, as it's found to
sometimes cause more harm than good.

This stage ends when the baby is completely

born.It usually lasts around 90 minutes.
 Stages of Labor
Stage 3: Delivery of Placenta

In the third stage, the mother pushes

out the placenta and the umbilical
cord (which connected the baby to
her).

This stage is the quickest, often

taking just a few minutes.
 Stages of Labor
Different Reactions to Labor

All women go through similar physical changes during

labor.

But how women feel about labor, how they deal with
the pain, and what they expect can be very different
based on their culture.

Some cultures may see labor as a natural, powerful

event, while others may focus more on pain relief or
medical help.
Alternative Birthing Methods
Not all mothers give birth in hospitals or follow the usual medical process.
Some choose alternative ways of giving birth that feel more natural or personal.

1.Lamaze Method
Special way of preparing for childbirth using breathing and relaxation
techniques.

It was created by Dr. Fernand Lamaze and is very popular in countries like
the U.S. Pregnant women and their “coach” (usually the baby’s father)
attend weekly classes together.

In these classes, the mother learns how to:

Control her breathing during contractions.
Relax her muscles on command.
Stay calm by focusing on a peaceful image (like a beach or sunset).
The goal is to help the mother stay relaxed and in control, so she feels less
pain during labor.
Alternative Birthing
Methods
1.Lamaze Method

Does It Really Work?

Many mothers and fathers say Lamaze made their

childbirth experience more positive and empowering.

They feel more in control, less fearful, and more involved

in the birth process.

However, researchers say it’s hard to know if Lamaze

itself causes this or if it's because these parents were
already excited and motivated about childbirth from the
start.
Alternative Birthing Methods
1.Lamaze Method

Access and Inequality

Lower-income families and some ethnic minority groups are less likely to use Lamaze or
other natural childbirth classes.

This may be because they can’t afford classes, don’t have transportation, or lack free
time.

As a result, these mothers may go into labor less prepared and experience more pain
during childbirth.
Alternative Birthing
Methods
2. Bradley Method

Known as “husband coached childbirth,” is based on the

principle that childbirth should be as natural as possible and
involve no medication or medical interventions.

Women are taught to “tune into” their bodies in order to deal

with the pain of childbirth.

To prepare for childbirth, mothers-to-be are taught muscle

relaxation techniques, similar to Lamaze procedures, and
good nutrition and exercise during pregnancy are seen as
important to prepare for delivery.

Parents are urged to take responsibility for childbirth, and the

use of physicians is viewed as unnecessary and sometimes
even dangerous.
Alternative Birthing
Methods
3.Hypnobirthing

Hypnobirthing is a new, but increasingly

popular, technique. It involves a form of self-
hypnosis during delivery that produces a
sense of peace and calm, thereby reducing
pain.

The basic concept is to produce a state of

focused concentration in which a mother
relaxes her body while focusing inward.
Increasing research evidence shows the
technique can be effective in reducing pain
Alternative Birthing Methods
4. Water Birthing

Still relatively uncommon in the United States, water birthing is

a practice in which a woman enters a pool of warm water to
give birth.

The theory is that the warmth and buoyancy of the water is

soothing, easing the length and pain of labor and childbirth, and
the entry into the world is soothed for the infant, who moves
from the watery environment of the womb to the birthing pool.

Although there is some evidence that water birthing reduces

pain and the length of labor, there is a risk of infection from the
unsterile water.
Birth complications
Why is infant survival in the U.S. worse than in some other countries?

Even though the United States is a rich country, its infant mortality rate
(number of babies who die before their first birthday) is higher than in
many other developed countries, including Japan.

This may seem surprising, but several reasons contribute to it—one

major reason is complications during labor and delivery, especially when
babies are born too early.
 Birth complications
Preterm Infants: Born Too Soon, Too Small
Preterm or premature babies are born before 38 weeks of
pregnancy.
Being born early means the baby doesn’t get enough time
to fully develop in the mother’s womb.
This increases their risk of health problems and even death.

Why does birth weight matter?

A healthy newborn weighs around 3,400 grams (7½
pounds).
Low-birthweight babies weigh less than 2,500 grams
(about 5½ pounds).
Although only 7% of babies in the U.S. are low birthweight,
they account for most infant deaths.
Birth complications
Two types of low birthweight:

Preterm babies: Born early, before full development.

Small-for-gestational-age babies: These babies might be born on time, but they are
too small for their age—usually because of poor nutrition during pregnancy.

How are these babies treated?

If their condition isn’t too severe, they are just kept in the hospital to gain weight.

Gaining weight helps with temperature control, since babies don’t have enough fat to
stay warm.
Birth complications
Simple care that helps:

Kangaroo Care: Holding the baby skin-to-skin on a parent’s chest.

This helps with:
Bonding
Weight gain
Better breathing and heart rate

Massage therapy also helps babies gain weight and handle stress
better.
Birth complications
Challenges for very premature or very small babies:
They may have trouble breathing due to underdeveloped lungs.

They might suffer from Respiratory Distress Syndrome (RDS)—a

condition that can be fatal without proper care.

These babies are often placed in incubators—machines that control

temperature and oxygen levels.
But the oxygen has to be just right—too little can be harmful, and
too much can cause blindness.
Birth complications
Why is it tough for them?

Their senses are very sensitive.

Loud sounds, bright lights, or strong touches can stress them out.

They may jerk or move in an uncoordinated way, which worries

parents.
Birth complications
How do they develop later in life?

Most preterm babies grow up just fine.

But their development may be slower than full-term babies.
Some may have:
Learning difficulties
Behavioral problems
Lower IQ
Trouble with coordination
Greater risk of mental illness
By age 6, about 38% of preterm kids need some kind of extra support in school.
Still, 60% of them develop normally, without any serious issues.
Birth complications
Who are Very-Low-Birthweight Infants?
These are extremely tiny babies who:
Weigh less than 1,250 grams (about 2¼ pounds),
OR
Are born before 30 weeks of pregnancy (a full-
term pregnancy is about 40 weeks).

How small are they?

These babies are so small they can fit in the palm of
your hand.
Their bodies look very different from full-term babies:
Eyes may be shut
Ears may look like flat skin flaps
Skin appears red, no matter their race
Birth complications
What are the dangers?
These babies are in serious danger because their organs (like lungs, brain, heart)
are not developed enough.
Before the 1980s, most of them wouldn’t survive.
But today, due to medical advances, some of them can survive if they are born as
early as 22 weeks (that’s 4 months before the normal due date).

What is the "age of viability"?

It’s the earliest point at which a baby can possibly survive outside the womb with
medical help.
Right now, it’s around 22 weeks, but chances of survival are still very low if born
before 25 weeks.
Why do some babies come early
or weigh less?
1. Problems with the mother’s reproductive system
Some women’s bodies have difficulties that can trigger early labor.
For example:
Mothers carrying twins or triplets are under more physical stress, which
can lead to early delivery.
In fact, most multiple births happen before full term.

2. Young mothers are more at risk

Girls under 15 years old are more likely to deliver early because their
bodies aren’t fully mature yet
Why do some babies come early
or weigh less?
4. Father’s age also matters
Older fathers are linked to a higher risk of preterm birth in their partners.

5. Overall health, stress, and living conditions

A mother’s general health and lifestyle play a huge role:
Poor nutrition
Not enough medical care
High stress levels
Low income or lack of financial support
All of these can increase the risk of giving birth too early or having a small baby.
Postmature Babies: Too Late, Too
Large:
What is a postmature baby?

A postmature baby is a baby who is still in the womb two weeks after the due date.

While it might seem like staying longer in the womb is good for growth, it actually
brings serious risks.

What are the risks?

🩸Placenta stops working well
The placenta (which supplies food and oxygen to the baby) may not function properly if
the baby stays in too long.
This can reduce blood flow to the baby’s brain, increasing the risk of brain damage.
Postmature Babies: Too Late, Too
Large:
2.The baby becomes too big

The baby keeps growing and can become as big as a one-month-old by the time
of delivery.
A larger baby can make labor more difficult and dangerous for both the baby and
the mother during normal vaginal birth.

Can postmature births be prevented?

Yes! Luckily, doctors can take steps to prevent complications:
They can induce labor using medications if the baby doesn’t come on time.
If natural delivery seems risky, they can perform a Cesarean section (C-section) to
safely deliver the baby.
Cesarean Delivery:
Intervening in the Process
of Birth
A Cesarean delivery, or C-section, is when a baby is
born through surgery instead of coming out through
the birth canal.

When is a C-section done?

Doctors usually do a C-section when there's a problem
during labor. Some common reasons include:

The baby is in distress, such as a very fast heart rate.

Bleeding from the mother’s vagina.
The mother is over 40 years old (they are more likely
to need a C-section).
The baby is in a breech position (feet first), which can
block oxygen if the umbilical cord gets pressed.
The baby is in a transverse position (lying sideways).
The baby’s head is too big to pass through the birth
canal.
 Cesarean Delivery
Role of fetal monitors
Fetal monitors check the baby's heartbeat during labor. They are helpful in high-risk cases, like premature or overdue
babies.

But using them too often has led to a huge increase in C-sections—sometimes unnecessarily.
Why? Because the monitors can give false alarms, showing problems when everything is fine.

Are C-sections always better?

Not really. Many other countries have lower C-section rates, and their babies still do just as well.
In fact, C-sections have some risks:

For the mother:

It’s a major surgery, so recovery takes longer.
There is a higher chance of infection.

For the baby:

Since the baby skips going through the birth canal, it misses stress hormones (like catecholamines) that help it adjust to life
outside the womb.
This can cause breathing problems right after birth.
Also, mothers who have C-sections often feel less happy about the birth, though this doesn’t affect how they bond with their
baby.
 Cesarean Delivery
Social differences in C-sections
Research shows racial and economic differences:

Black mothers are more likely to have unnecessary C-sections than white
mothers.

Poorer mothers (those on Medicare) also face more unnecessary C-sections

than wealthier mothers.

In short:
While C-sections can be life-saving in emergencies, using them too often—
especially when not truly needed—can lead to extra risks for both mother and
baby.

Doctors now advise not to use fetal monitors routinely unless really necessary.
 Stillbirth and Infant Mortality:
Stillbirth

A stillbirth means the baby dies before or during

birth.

This is rare, happening in less than 1 out of every

100 births.

Sometimes, doctors find out the baby has died

before labor starts. In such cases:
Labor is induced (started by medicine), or
A C-section is done to remove the baby.

In other cases, the baby dies during the birth

process.
 Stillbirth and Infant Mortality:
Infant Mortality
This refers to a baby dying within
the first year after birth.

In the U.S., the rate is about 6.17

deaths for every 1,000 live births.

Thankfully, this number has gone

down a lot since the 1960s.

From 2005 to 2011, it dropped by

12%.
 Stillbirth and Infant Mortality:
Emotional Impact on Parents

Losing a baby—whether before or after birth—is

extremely painful.

Parents often go through deep grief, just like when

an older family member dies.

It’s especially heartbreaking because it comes at a

time when parents are expecting new life and joy.

Many parents experience depression, and

sometimes even PTSD (post-traumatic stress
disorder).

The grief may feel worse if they don’t have enough

emotional support from others.
 Stillbirth and Infant Mortality:
📊 Differences in Infant Mortality
Infant deaths are not the same for everyone:
Race, income level, and cultural background all affect how often this happens.

For example, in some communities, infant death rates are higher due to less
access to healthcare or other social factors.

In short:
Stillbirth and infant death are rare but heartbreaking. They deeply affect parents
emotionally, and the loss can lead to depression and trauma.

While infant mortality rates have gone down over the years, factors like race and
socioeconomic status still play a role in how often these tragedies occur.
Video
 Postpartum Depression
Postpartum depression is a serious kind of deep
sadness that some women feel after giving birth.

It affects about 1 in 10 new mothers.

For some, it lasts months or even years.
In very rare cases, it becomes so severe that
the mother may lose touch with reality
(psychosis).

One tragic example is Andrea Yates, a woman in

Texas who drowned her five children. She said it
was because of her severe postpartum
depression.
 Postpartum Depression
What causes it?

There are many reasons a new mother might get postpartum

depression:
1.Hormone changes:
During pregnancy, levels of estrogen and progesterone
(female hormones) are very high.
But right after birth, these hormones drop quickly, which can
cause mood swings or depression.

2.Mental health history:

A woman is more at risk if she or her family members have
had depression before.

3.Emotional stress:
Some new mothers are not emotionally prepared for all the
ups and downs that come after childbirth.
 Postpartum Depression
How does it affect the baby?

Postpartum depression doesn’t just affect the mother—it can affect the
baby too.

Depressed mothers may seem emotionless, tired, or disconnected from

their babies.

As a result, babies may become sad, quiet, or withdrawn.These babies

might also avoid other people, not just their moms.

Later on, they may be more likely to show behavior problems, like being
aggressive or violent.

Summary: Postpartum depression is a real and serious condition. It can

happen to any new mother, especially those with a history of depression or
who go through sudden hormone changes after birth. It’s important to
recognize it early and get help, because it can affect both the mother’s and
the baby’s well-being.