Birth Day

Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth by Mark Sloan. Ballantine Books (2009) 

APGAR Score

The author is a pediatrician who specializes in taking care of newborn babies who have problems after childbirth. He evaluates newborns with the APGAR scores developed by Virginia Apgar. It evaluate babies for 5 qualities: 

• Muscle tone

• Pulse

• Reflex irritability

• Skin color

• Breathing effort

Blood Flow

There is is an interesting description of blood flow through the placenta. The series of connections for the placenta:

1. Mother’s uterine wall

2. Basal plate of the placenta

3. Intervillous space of the placenta

4. Chorionic plate of the placenta

5. Umbilical cord

6. Baby

Placenta and the Umbilical Cord

The umbilical cord contains one artery and two veins. The author describes a rerouting of  blood in the baby during pregnancy, to avoid traveling through the baby’s lungs, to adapt to the fact that the baby is not breathing.  In the intervillous space, the blood vessels of the baby and mother touch, but do not interconnect. Nutrients, waste products, oxygen and carbon monoxide pass between the two systems of blood vessels. The author states that the placenta is a “nearly impermeable” barrier to pathogenic bacteria. But he fails to mention some important exceptions: listeria, syphilis and the Zika virus. In the case of Zika virus, the virus builds tunneling nanotubes through the trophoblasts. 

Circumcision

Opinion is divided on the circumcision of the foreskin of the male baby. Advocates say that circumcision protects males from syphilis, genital warts and HIV. Opponents of circumcision call it male genital mutilation. 

Childbirth

The author has a long section on childbirth. Studies have shown that the mother should be allowed to adopt whatever position that she finds to be most comfortable. The hormone relaxin causes ligaments in the pelvis, back and abdomen to relax, so that it is easier for the baby to push its way through the pelvis. The cervix softens near the time of childbirth.