Midwifery is the health science and health profession that deals with pregnancy and the postpartum period, in addition to the sexual and reproductive health of women throughout their lives. In many countries, midwifery is a medical profession. A professional in midwifery is known as a midwife. A 2013 Cochrane review concluded that "most women should be offered midwifery-led continuity models of care and women should be encouraged to ask for this option although caution should be exercised in applying this advice to women with substantial medical or obstetric complications." The review found that midwifery-led care was associated with a reduction in the use of epidurals, with fewer episiotomies or instrumental births, a decreased risk of losing the baby before 24 weeks' gestation. However, midwifery-led care was associated with a longer mean length of labor as measured in hours. Trimester means "3 months." A normal pregnancy has 3 trimesters. First trimester screening varies by country. Women are offered a Pap smear and urine analysis, blood tests including a complete blood count, blood typing, hepatitis, HIV, rubella testing.
Additionally, women may have chlamydia testing via a urine sample, women considered at high risk are screened for Sickle Cell disease and Thalassemia. Women must consent to all tests; the woman's blood pressure and weight are measured. Her past pregnancies and family and medical history are discussed. Women may have an ultrasound scan during the first trimester which may be used to help find the estimated due date; some women may have genetic testing, such as screening for Down syndrome. Diet and discomforts such as morning sickness are discussed; the mother visits the midwife monthly or more during the second trimester. The mother's partner and/or; the midwife will discuss pregnancy issues such as fatigue, varicose veins, other common problems such as back pain. Blood pressure and weight are monitored and the midwife measures the mother's abdomen to see if the baby is growing as expected. Lab tests such as a UA, CBC, glucose tolerance test are done if the midwife feels they are necessary. In the third trimester the midwife will see the mother every two weeks until week 36 and every week after that.
Weight, blood pressure, abdominal measurements will continue to be done. Lab tests such as a CDC and UA may be done with additional testing done for at-risk pregnancies; the midwife palpates the woman's abdomen to establish the lie and position of the fetus and the engagement. A pelvic exam may be done to see; the midwife and the mother write a birth care plan. Midwives are qualified to assist with a normal vaginal delivery while more complicated deliveries are handled by a health care provider who has had further training. Childbirth is divided into four stages. First stage of labor The first stage of labour involves the opening of the cervix. In the early parts of this stage the cervix will become soft and thin thus preparing for the delivery of the baby; the first stage of labour is complete. During the first stage of labor the mother begins to feel strong and regular contractions that come every 5 to 20 minutes and last 30 to 60 seconds. Contractions become stronger, more frequent, longer lasting.
Second stage of labor During the second stage the baby begins to move down the birth canal. As the baby moves to the opening of the vagina it "crowns", meaning the top of the head can be seen at the vaginal entrance. At one time an "episiotomy", was done because it was believed that it prevented excessive tearing and healed more than a natural tear. However, more recent research shows that a surgical incision may be more extensive than a natural tear, is more to contribute to incontinence and pain during sex than a natural tear would have; the midwife assists the baby as needed and when emerged, cuts the umbilical cord. If desired, the baby's father may cut the cord. In the past the cord was cut shortly after birth, but there is growing evidence that delayed cord-cutting may benefit the infant. Third stage of labor The third stage of labour is. In order for the mother to do this they may need to push. Just like the contractions in the first stage of labour they may experience two of these; the midwife may assist the mother in delivering the placenta by pulling on the umbilical cord.
Fourth stage of labor The fourth stage of labor is the period beginning after the birth and extending for about six weeks. The World Health Organization describes this period as the most critical and yet the most neglected phase in the lives of mothers and babies; until babies were removed from their mothers following birth, however beginning around 2000, some authorities began to suggest that early skin-to-skin contact is of benefit to both mother and infant. As of 2014, early skin-to-skin contact is endorsed by all major organizations that are responsible for the well-being of infants. Thus, to help establish bonding and successful breastfeeding, the midwife carries out immediate mother and infant assessments as the infant lies on the mother's chest and removes the infant for further observa
The Callan–Giddings–Harvey–Strominger model or CGHS model in short is a toy model of general relativity in 1 spatial and 1 time dimension. General relativity is a nonlinear model, as such, its 3+1D version is too complicated to analyze in detail. In 3+1D and higher, propagating gravitational waves exist, but not in 2+1D or 1+1D. In 2+1D, general relativity becomes a topological field theory with no local degrees of freedom, all 1+1D models are locally flat. However, a more complicated generalization of general relativity which includes dilatons will turn the 2+1D model into one admitting mixed propagating dilaton-gravity waves, as well as making the 1+1D model geometrically nontrivial locally; the 1+1D model still does not admit any propagating gravitational degrees of freedom, but with the addition of matter fields, it becomes a simplified, but still nontrivial model. With other numbers of dimensions, a dilaton-gravity coupling can always be rescaled away by a conformal rescaling of the metric, converting the Jordan frame to the Einstein frame.
But not in two dimensions, because the conformal weight of the dilaton is now 0. The metric in this case is more amenable to analytical solutions than the general 3+1D case, and of course, 0+1D models cannot capture any nontrivial aspect of relativity because there is no space at all. This class of models retains just enough complexity to include among its solutions black holes, their formation, FRW cosmological models, gravitational singularities, etc. In the quantized version of such models with matter fields, Hawking radiation shows up, just as in higher-dimensional models. A specific choice of couplings and interactions leads to the CGHS model. S = 1 2 π ∫ d 2 x − g where g is the metric tensor, ϕ is the dilaton field, fi are the matter fields, λ2 is the cosmological constant. In particular, the cosmological constant is nonzero, the matter fields are massless real scalars; this specific choice is still not amenable to an exact quantum solution. It is the action for Non-critical string theory and dimensional reduction of higher-dimensional model.
It distinguishes it from Jackiw–Teitelboim gravity and Liouville gravity, which are different models. The matter field only couples to the causal structure, in the light-cone gauge ds2 = − e2ρ du,dv, has the simple generic form f i = A i + B i,with a factorization between left- and right-movers; the Raychaudhuri equations are e − 2 ϕ + f i, v f i, v / 2 = 0 and e − 2 ϕ + f i, u f i, u / 2 = 0. The dilaton evolves according to, u v = − λ 2 e − 2 ϕ e 2 ρ,while the metric evolves according to 2 ρ, u v − 4 ϕ, u v + 4 ϕ, u ϕ, v + λ 2 e 2 ρ = 0; the conformal anomaly due to matter induces a Liouville term in the effective action. A vacuum black hole soluti
The George Felpel House is located on NY 9H in Claverack, New York, United States. It is a stone Colonial Revival and Dutch Colonial Revival house built in the 1920s, its stones are the remnants of Claverack College, which existed on the property from 1779 to 1902. Local architect Henry Mouls designed it in Colonial revival style, with some aspects of genuine Colonial architecture from the region. In 1997 it was listed on the National Register of Historic Places; the house is on an 11-acre lot on the east side of Route 9H just south of the Reformed Dutch Church of Claverack. It is set back from the road, on the top of a low ruse, at the end of the north fork of an unpaved Y-shaped driveway. At the other fork is a garage, the other contributing resource to the Register listing. There are many mature trees around the lot, providing screening; the rear slopes down to a pond, once part of the college campus. The surrounding neighborhood has other older larger houses on large lots; the building itself is a two-story, three-bay structure topped by an asphalt-shingled gambrel roof.
It is sided except for asbestos shingles in the gable ends. A porte cochère projects from the south entrance, on the east is another gambrel-roofed wing. A screened porch is on the north end. At the center of the west facade is the entrance portico, its pedimented roof, two stories high, is supported by two Doric columns. An overscaled broken pediment on brackets shelters the main entrance. A triple window is above the main entrance on the second story; the main entrance is a Dutch door with a glass transom. It leads into a large central hall with a prominent staircase, its bannister and newels reflect the Crafts style. To the north of the central hall is a large living room, its fireplace has a wooden Federal style mantel flanked by French doors. The other side of the house has a dining room and front room with similar windows to the living room; the kitchen wing to the south has original cabinetry. The upstairs rooms are planned to their downstairs counterparts. Outside, the garage has clapboard siding.
It has been extended to the east to accomododate longer vehicles. There is a modern shed, a modern wellhouse-styled structure covering a cistern used by the college in the rear lawn; some of the original drain tiles from the diversionary channel have been found in the nearby soil. Claverack College known as Washington Seminary and Hudson River Institute, was founded by Reformed Church pastor John Gabriel Gebhard during the Revolutionary War, it was located on the property until its closure in 1902. During its existence, it educated Margaret Sanger and Stephen Crane; the buildings were razed shortly. Some of the stones they were built of remained, when George Felpel, a successful farmer from nearby Ghent, bought half of the former campus, he wanted to use them, he hired Gloversville architect Henry Moul, who had moved there from Hudson, near Claverack, to design a stone house in the newly popular Colonial Revival mode. Moul's design was sensitive to local architectural traditions from the Colonial era.
It had many features typical of Colonial Revival buildings, such as the colonnade, ornamented entry and central-hall plan. But it uses some distinctly regional touches, such as the triple-run interior stairway. Common in many early Dutch houses in the Hudson Valley, they have been preserved. On the outside he used the gambrel roof, an English feature copied by the Dutch, stoep benches flanking the entrance, similar to those seen on old engravings of streets in Albany; the building has remained a residence since. It has not been altered by any other owner, save the addition of the mock wellhouse. National Register of Historic Places listings in Columbia County, New York