Vaginal Natural Or Caesarean C Section

Published Date: 02 Nov 2017

At nine months the foetus should have turned itself upside down getting ready to leave the mother’s body and enter the world. There are two types of delivery; vaginal (natural) or caesarean (C-section).

If a woman is giving birth by vaginal delivery she will go through these stages of labor. The first stage is early labor and active labor. Early labor is the mild contractions of the cervix until it dilates to 3cm which is normally the longest stage of delivery. Contractions is when the uterus wall muscles contract and retract to push the baby down towards the birth canal. Contractions are caused by hormone chemicals sent from the mother and from the baby’s pituitary gland. The hormones released from the foetus are oxytoxin and prostaglandins which are responsible for the increase of contractions. Hormones released from the mother are oxytoxin for contractions and relaxin which helps dilates the cervix. These hormones operate on a positive feedback mechanism.

The next stage is active labor when the cervix dilates from 3cm to 7cm and the contractions are stronger, longer and closer together in time. The transition phase is between the first and second stage of labor. This is when the cervix fully dilates to 10cm and contractions are at their strongest.

The second stage often referred as the pushing stage. It’s important that the baby is in the correct position, head first facing downwards with the smallest part of the baby’s head first. The uterus is still contracting at this stage to push the baby out also with the help of the woman pushing. When the contractions stop and the uterus relaxes the baby normally moves back a little. It’s important to relax and not push during contractions as this could cause damage and ripping to the perineum tissue. During the second stage the woman should not be lying down because this makes descend of the baby more difficult. She should take up a position which is comfortable to her. There are a few positions which help the baby on its journey e.g. squatting, sitting, and kneeling on all fours.

The first sign of the baby is when the baby ‘crowns’. This is when the widest part of the head is visible and it puts a lot of pressure and strain on the perineum. This is when controlling pushing is vital so not to rip the skin. Once the head is fully out and checked that no umbilical cord is around the neck then the baby will then turn to the side and the shoulders will rotate and will be ready to exit. Once the baby is out the umbilical cord will be checked, clamped and cut.

The third stage is the delivery of placenta. The uterus is still contracting to expel the placenta from the uterus wall and leave the body. When the placenta comes away from the uterus wall the blood vessels close themselves to prevent any bleeding.

The woman may still have to give a couple of more pushes to get the placenta fully out of her body.

L1.1 Each stage of delivery is explained

L1.2 Stages of delivery are explained, including strategies for safe delivery of the foetus

Post partum means the period shortly after giving birth. Post partum can have many complications such as discomfort, infections, haemorrhage, thrombophlebitis and depression.

"Post partum haemorrhage is responsible for around 25% of maternal deaths, in some countries 60% mostly developing". This is a quote from the Postpartum Haemorrhage Prevention and Treatment Organization. No need to say this is a quote from you just need to state PHPTO (year) and put the full reference in the bibliography

Their website provides information, forums, sharing and learning from other organizations.

You do not need to include this information

They say PPH can be considerably prevented by skilled carers and facilities during childbirth. They claim possible reasons for excessive/severe bleeding such as the uterus not contracting properly after delivery, clotting disorders, anemia, placenta not completely expelled. They also list some prevention measures that should be taken such as having skilled birth attendants present with proper facilities, injections of oxytocin and fundal massage to help expel all the placenta; having antenatal care which can detect and treat anemia; during labor not to push before fully dilated and after delivery of placenta that it should be inspected. The PPH prevention and treatment organization also claim treatment of PPH can depend on how healthy the woman is, especially depending on her haemoglobin level when the diagnosis is made and treatment given and continued management. Some surgical treatments, when non-surgical has not helped, are hysterectomy as this will stop all bleeding, uterine artery embolisation or sutures inserted.

There are many factors that could also cause PPH or the lack of knowledge around such as poverty, social isolation, debts, depression, no support unit, age related (teenager), awareness, training, money cut backs in hospital etc.

I know there is a restricted word count but I feel that some of these claims need to be substantiated by academic evidence. Academic evidence from one web site is insufficient for this to be a proper analysis as a simple description it is evidence for a pass grade but nothing beyond this.

L1.3 Postpartum challenge is described

When babies are born the first test performed on them is the Apgar Test. There are five factors that are checked with a scoring rate between 0 to 2. Zero is the lowest which ultimately means death and two is well and healthy. An average score for a new born should be between 7 – 10. If the child falls below this range the child will need extra help to reach an average score. The factors that are checked are heart rate, colour of skin, respiratory, muscle tone and reflexes. The Apgar test is also repeated at regular intervals of time. Before a new born leaves the hospital the following checks that are made are the Apgar Test, measurement of head circumference, weight and length recorded, heart beat, sounds and breathing, internal organ check by external examination, hearing, check of all limbs, fingers and toes and reflexes. A urine and stools check to rule out any elimination problems and finally blood from the heel of foot for screening. This blood screening checks metabolic and/or inherited disorders.

A newborn should receive monthly check ups to monitor development milestones of brain growth, height and weight, eyes and ears and also to receive immunization injections.

During the first month of a baby’s life outside the uterus they should be able to suck and swallow. This reflex is a survival skill which is important for breastfeeding. The suckling involved also is a developmental milestone of reflexes. Breast milk is important for the baby’s immune system as the colostrums and the breast milk contain important antibodies.

From birth to one years old a baby learns many skills that are all part of their development. They learn to play, socialise, walk, crawl, observe and much more. Also in the first year they will grow in height and weight and internally systems will grow and mature. Children’s progress of motor, cognitive, visual, language, social and emotional development are recorded and compared by developmental milestone charts. All children develop at different rates and these milestones are only guidelines. It’s important to look at the child holistically because a child may be on the lower scale in one area of development but could also be higher on another. A lower achiever may just need more time, encouragement and opportunities to build on a specific area but if a child shows no improvement over time then further investigations need to be made as in why the required developments are not being met.

Children are unique and grow and develop at their own individual rate but there are patterns all children follow in their development which are called milestones which show a general guideline of findings found in most children without major disabilities. With growth it is visually obvious that the child’s weight and height will increase. Percentile charts monitor growth and weight compared with children of the same age. One chart is for boys and another for girls this is because boys are generally a little bit heavier than girls. These percentile charts show weight and height normal ranges and also underweight, overweight and obese weights and also for height. Charts can help follow a child’s progress and if there is a problem that is can be identified and followed up by a professional. Who monitors this growth process?

Development in a child is regarding the skills they gain though physical, social and emotional, intellectual and communication and speech. Physical development is the skills and performance of gross motor development of arms and legs e.g. walking, kicking etc and fine motor skills of hands and fingers such as picking things up, writing etc.

Social and emotional development is the child’s identity and self image, relationships with family and others, feelings and generally living in a society with others.

Intellectual development is the skills of understanding, memory and concentration. Jean Piaget (1896 – 1980) a French psychologist is well known for the Piaget’s Theory on intellectual development in children. His theory was that a child develops ‘schemas’ the basic building block of intelligent behavior which is a way for them to organize and solve problems.

Communication and speech development is communicating with others.

All the above areas actually link together so if one area falls short so another area cannot develop. Where is the academic evidence for this statement?

In the BTEC First Children’s Care, Learning and Development pdf pages 3 – 4 it explains there are three basic principles of development for everyone wchih starts from the head e.g. a baby holding their head up for the first time which is controlled by the CNS, then moving down the body to arms then legs. The next principle development will follow the same order, but at different rates which is a baby learning to crawl before they can walk.

Finally the last basic principle is that all areas of development are linked together so without one development the child cannot move onto the next developmental stage. Not sure what you mean by this and this statement requires more evidence and explanation at this level of study

Children need love, support, opportunities, encouragement and guidance to meet their goals to the best to their potential. Parents and environments can help improve development. Why? What is the evidence for this statement?

Development during childhood is monitored by health professionals, families, teachers and early year practitioners. In the Practice Guidance for Early Years Foundation Stage, May 2008 Section 2: Learning and Development pg 11, their subtitle/slogan is Look, Listen and Note is the requirements for practitioners to observe or monitor a child or children in their care. Who are the practitioners? In what context are the assessments made?

Look means observe the child, listen to them when they talk and by getting to know them better and finally note down all observations made. From there planning and assessment can be made to suit the child’s interests and learning styles. There are different types of monitoring or observations that can be made. There are checklists, tick charts, photo evidence, video or tape recordings, written formal and information and tests. When observations are being made they should be honest, non-biased, eligible, dated and signed this is because this information will be shared with other practitioners and parents. Where is the evidence for this and how does this work within multi-disciplinary practice? There is a lack of academic evidence within your assignment

Monitoring social and emotional development can be done by observing planned or spontaneously play this way it’s easy to see how children play together and sharing or if they prefer to play alone. Monitoring of this development can be done at any time so formal notes can be taken so that a situation will not be forgotten about. Continuous bad behavior needs to be noted and shared with the parents and discussed why this is happening and how to solve the problem. Where is the evidence for this and who might be planning and carrying out the observations and for what purpose?

Communication and speech development can be monitored by verbal communication, tests, speaking and listening games etc. It’s important to remember that all children develop intellectually at different rates so frequent tests and assessments will help find out how much the child has develop and what needs improvement with encouragement. You are implying here that all a child needs is encouragement and yet you are not explaining the type of assessment being carried out.

If a child is not improving over time even after planning to their needs there may be an underlying reason for this such as dyslexic, autism, lack of concentration due to diet or sleep deprivation or a number of other reasons. Communication and speech can be improved by speaking to a child more, finding out their interests and discussing them and encouraging them to ask questions. This is not an appropriate explanation of how speech therapy works in practice

Recorded data and information can be discussed with parents and other practitioners about improving the child’s development.

L3.1 The monitoring processes used during childhood are not explained appropriately and to the academic standard expected at HND Level 5. The information provided is too general and non specific.

A few early milestone developments of a newly born are touching of the cheek and baby turns their head to the hand and the grasp reflex and the startle reflex, reacting to noise.

The baby should also be raising head when on stomach, right fists and staring at objects. Not sure what this means?

A one month to three month old baby should be able to follow objects within sight, be able to hold their head up for a period of time and begin to recognise faces. During this time muscles are becoming stronger with every movement and motor skills are also developing. Baby should be able to support head and upper body, stretch, kick legs, wave arms, grab and shake objects and also bring objects to mouth. Language skills are also developing by making cooing and gurgling sounds.

Babies four to six months old grow very quickly so does their motor skills. They should be able to roll over, move objects, sit without any support. They also have more language by imitating noises and laughing. The social/emotional development of recognizing faces and surroundings, sounds, smells and their own name.

Seven to nine month old babies are gaining more control over muscles and body movement. They are now able to control fingers and pick up smaller objects and of course bring them to the mouth for further investigation. Other milestones they should reach are crawling, waving, searching for objects, attempting to speak mama and papa. During this time the child may also suffer from separation anxiety.

By age ten to twelve months old the standard milestones are crawling and standing and attempting to walk, interaction with other children, imitates others, first words, able to understand yes and no and simple instructions.

At the end of the first year baby is more mobile and curious.

This is a time when they can get themselves into a lot of trouble so safety measures are needed to secure their safety in the world. This is not the language of academia where is the evidence for this?

Within the first year baby will need immunization jags to protect from many dangerous illnesses such as the measles, mumps and rubella (MMR).

During year one to four years cognitive and language skills really start to develop. The child develops in different areas which are physical, intellectual, communication, emotional and social. Development is always continuous as the child’s body and brain continues to grow.

Physical development

2 years able to walk alone and on tiptoes, starts to run and potty training begins.

3 years can go up and down stairs using alternating feet, kick and climb, ride a tricycle and can turn pages in a book.

4 years are able to stand on one foot for 5 seconds, throw balls, dress and undresses themselves and use scissors safely.

Emotional/social development

2 years are aware of their own identity, wants to play with others, may become defiant, have temper tantrums and separation anxiety begins to fade. Temper tantrums are very common in this age because they have problems controlling their emotions and unable to express how they feel by words due to limited vocabulary thus the child ends up frustrated and upset.

3 years will imitates others, understand sharing and show affection.

4 years stary problem solving, have friends and show some independence.

Language development

2 year olds can speak about 50 words but understands more, start linking words and use simple adjectives.

3 year olds can speak 250 - 500 words, 3 – 4 word sentences and use pronouns.

4 year olds can ask and answer simple questions, speak full sentences, use prepositions and speak clearly enough to be understood by others.

Making points within assignments is not appropriate as it does not allow you to engage in discursive debate about what can happen if a 4 year old does not reach this standard of development

If a child has not reached all these milestones,

but is showing improvement then there is no big problem to be concerned about. Why?

A speech therapist may be able to offer help on improving language skills and also reading can develop this skill too. This is too general and you need to be very specific about who will refer the child to a speech therapist and why this might be necessary.

Cognitive skills

2 years can use imagination when playing, categorise by shapes and colours, look and find hidden objects.

3 years start to ask many why questions, able to name colours, copy shapes, understand same and different.

4 years start to recognise numbers/letters and print them, draw people with body parts, know morning, afternoon and night time.

So why does this happen? You are including lists and lists are not description and are not acceptable at this level of study

To develop the above skills playing games will have a benefit. Why?

It’s also vital for a child to have healthy eating habits as this will help growth and development. Also a good regular sleeping pattern will benefit the child’s development. Where is the evidence for this?

Children aged 4 – 5 years will start school and all areas of development should improve Why?

also children this age should gain weight at about 4 -5 pounds and grow 2-3inches per year. Genetic background also have influences on physical development e.g. short, tall, fat and thin. What is the relationship between genetic background and outcome?

Aged 6 – 9 children are able to talk about their feelings and experiences, shows concern over others and friendships are important, have own opinions, thoughts and views and becoming more independent. Physically they are stronger and better controlled.

Intellectually they are improving, understanding concept of time and of natural phenomenon’s. Not sure what is meant by this?

Their language skills show improvement with reading and writing.

From the age 9 – 11 friendships of the same sex are important, they may experience peer pressure, want to be accepted by others, responsibility of themselves and others, can make choices and body changing awareness. School work and homework requires the child to discipline themselves, concentrate for longer and their views and opinions are acknowledged. Sports, activities/hobbies will development the child’s interests and independence.

Teenagers 12 – 15 years old are going through a transitional stage which means changing from a child to teenager. There are many changes happening within and outside the body. Outside their physical appearance is changing. Boys and girls may be prone of acne/oily skin due to an increase of hormones. Girls develop breasts, hips and pubic hair and develop earlier than boys. Boys voices become deeper, pubic and facial hair appear.

Emotionally they become self obsessed with themselves and their looks, clothing and body image. This is a generalisation

Their thinking and learning development improves with more complex thoughts, language skills increase and memory improves, able to think about the future goals academically and have values.

Teenagers 15 -17 years should now have adjusted somewhat to their growing and changing bodies, but are still very much worried about self image which can cause eating disorders especially in girls. Boys and girls are becoming sexually active and interested in forming relationships. They want responsibility and to fend for themself e.g getting a job for extra money. They are more sociable with friends and spend less time with their family and they know right and wrong but still can be easily influenced into bad choices.

Privacy is important and are embarrassed easily. Where is the evidence for this?

L2.1 Developmental milestones have been identified

L2.2 Stages are described but this is not linked to academic research material and is overgeneral

L2.3 No attempt has been made to review the measurement processes used by professionals although there has been a limited attempt to describe them.

L3.1 The monitoring processes used by professionals are not referred to within an academic context

One of the ways that scientists have searched for the causes of mental illness is by studying the development of the brain from birth to adulthood. Powerful new technologies have enabled them to track the growth of the brain and to investigate the connections between brain function, development the behavior." quote from The National Institute of Mental Health article "The Teen Brain: Under Construction".

In this article it mentions that after research that many changes take place during the adolescence stage which is called the transitional stage. The brain develops at two basic stages; growth spurts and pruning. The changes that take place is very complex its as though the brain is rewiring itself or updating its system. on scans it shows parts of the brain growing and developing and also pruning is when a part is not used to its full potential then it is cut back. A popular phase I came across for this was "use it or lose it". It’s the neurons and synapses are growing and being cut back but if a neuron is not being cut back it is then covered with white matter called myelin for strengthening.

The brain develops and matures at different stages which may be responsible for the typical teenager behavior. The prefrontal cortex (PFC), the front part of the brain that is responsible for the rest of the brain. The PFC organizes thoughts, plans and ideas, memories and organising and controls impulses. It is also found is research that the PFC is the last area to mature at around 24 years of age. The amygdale (AMG) matures earlier which is the area that experiences emotions such as fear and danger.

The World Health Organisation (WHO) provides leadership on global health matters and quote "Gathering best expertise from key partners in national and international institutions, and analyzing date and the research results to propose evidence based public health interventions". The WHO Multicentre Growth Reference Study (1997 – 2003) conducted studies of the six fundamental milestones on children who were healthy, breast fed with non-smoking mothers. Breast fed children were chose because of the nutrition, immunological and growth the mother’s milk provides. Also smoking mothers tend to have children with a low birth weight so hence the reason for chosen children whose mother’s are non-smokers. Developmental data was collected from different countries e.g. Ghana, India, Norway, Oman and USA. Then all the data was analysed to set the standards for every child worldwide.

It’s important when taking data that they are truthful results and they have been recorded within set ranges. Data should be current and accurate.

L3.2 No relevant statistical evidence is evaluated in relation to growth and development.

L3.3 Challenges and resolutions in growth and development are not explained appropriately.

L4.1 The physiological changes at adolescence are not described to the standard expected to this level of study.

L4.2 The challenges of adolescence are not related to appropriate academic sources.

L4.3 There is a limited attempt to describe influencing factors to growth and development but this is not sufficient to award this LO.