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First3years
Physicaldevelopment

Methodsofdelivery
Parturi;onprocessofuterine,cervical& otherchanges.Usuallylas;ngabout2weeks precedingbirth. (sharplyrisingestrogenlevelss;mulatethe uterustocontract&thecervixtobecome moreexible) Vaginalvs.cesareandelivery Medicatedvs.unmedicateddelivery

Thenewborn
Neonatalperiod1st4weeksoflife,wherethe fetustransi;onsfromlifeintheuterusto independentexistence.

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Medical/behavioralassessment
Fontanelstheplacesontheheadwherethebones havenotyetgrowntogetherthesoOspotsare coveredbyatoughmembrane.Willnotbecompletely joinedfor1years. Ifbreathinghasnotbegunwithin5minsofdelivery, thebabymaysuerpermanentbraininjurycausedby lackofoxygen(anoxia). MeconiumastringygreenishblackwastemaUer formedinbabysintes;naltract. Abouthalfofbabiesborn(moresoinpremature delivery)developneonataljaundice:theirskin& eyeballslookyellow.

StatesofArousalandAc;vityLevels
Apgarscale1minaOerdelivery&again,5minsaOer birth. TheBrazeltonscale(NBAS)usedinhighrisksitua;ons. Toassesstheneonatesresponsivenesstotheir motororganiza;on reexes statechanges aUen;on&interac;vecapaci;es CNSinstability Neonatalscreeningformedicalcondi;ons

Stateofarousalisinborn Mostnewbabiesspend75%oftheir;me asleep Alternatesbetweenquietandac;vesleep Asthechildgrowsintotoddlerhooditssleep ;medecreases Sleepschedulesvaryacrosscultures

Complica;onsofchildbirth&their aOermath
Birthtrauma2inevery1000births. Causedbyanoxia,diseases/infec;onsor physicalinjury. ElectronicFetalMonitoringprovidesvaluable inforinhighriskdeliveries. DrawbacksofEFMcostly,restrictsmothers movementsduringlaborandhighfalse posi;verates.(sugges;ngthatfetusesarein trouble,whentheyarenot).

SURVIVAL&HEALTH

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Postmaturitymasnotgoneintolabor2weeksfrom duedate.(or42ormoreweeksofgesta;on). 37weeks42weeks Lowbirthweight.premature/smallforgesta;onalage infants. Inadequateprenatalnutri;on Uterineinfec;on Maternal/fetalstress Placentalhemorrhaging Overstretchingoftheuterus. S;llbirthtragicunionofoppositesbirth&death. Deathsthatoccurduring/within24hrsofbirth. Majorfactorfetalgrowthrestric;on ReducedduetoElectronicFetalMonitoring+ ultrasound.

LowBirthWeight Factorsconcerninghavingalowbirthweight baby Demographicandsocioeconomicfactors 13.7percentofAfricanAmericanbabieshavelow birthweight edicalfactorspreda;ngthepregnancy M renatalbehavioralandenvironmentalfactors P edicalcondi;onsassociatedwithpregnancy M

WhoisLikelytoHaveaLow BirthWeightBaby?
Factorsincludedemographicandsocioeconomic factors Suggestedreasonsfordiscrepanciesamong AfricanAmericanbabies HealthbehaviorsandSES HigherstresslevelsofAfricanAmericanwomen Greatersuscep;bilitytostress ImpactsofracismEthicdierencesinstress relatedbodyprocesses

TRENDSININFANTMORTALITY

Riskfactorsforinfantmortality
Boybabies Babiesbornpreterm/lowbirthweight Motherswhoareteenager/in40s Mothersthatdidntnishschool/unmarried/ smokedduringpregnancy Late/noprenatalcare Mul;plebirths

Whatcausesinfantmortality?
Birthdefects Premature/lowbirthweight/SIDS Maternalcomplica;onsofpregnancy Complica;onsofplacenta/umbilicalcord/ membranes

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Earlyphysicaldevelopment

Cephalocaudalprinciple Growthoccursfromtop down

Proximodecimalprinciple Growth&motor developmentproceedfrom centerofthebodyoutward.

Earlysensorycapabili;es
Touch&pain Smell&taste Hearing Sight

REFLEXES

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