%PDF-1.3
%
9 0 obj
<>>>/BBox[0 0 612 792]/Length 53>>stream
xs
w3T0WI2P0T5T R
Ɩf
!\!Y\ !p
o
endstream
endobj
5 0 obj
<>>>/BBox[0 0 612 792]/Length 53>>stream
xs
w3T0WI2P0T5T R
Ɩf
!\!Y\ !p
o
endstream
endobj
4 0 obj
<>>>/BBox[0 0 612 792]/Length 53>>stream
xs
w3T0WI2P0T5T R
Ɩf
!\!Y\ !p
o
endstream
endobj
8 0 obj
<>>>/BBox[0 0 612 792]/Length 53>>stream
xs
w3T0WI2P0T5T R
Ɩf
!\!Y\ !p
o
endstream
endobj
1 0 obj
<>>>/BBox[0 0 612 792]/Length 53>>stream
xs
w3T0WI2P0T5T R
Ɩf
!\!Y\ !p
o
endstream
endobj
7 0 obj
<>>>/BBox[0 0 612 792]/Length 53>>stream
xs
w3T0WI2P0T5T R
Ɩf
!\!Y\ !p
o
endstream
endobj
6 0 obj
<>>>/BBox[0 0 612 792]/Length 53>>stream
xs
w3T0WI2P0T5T R
Ɩf
!\!Y\ !p
o
endstream
endobj
3 0 obj
<>>>/BBox[0 0 612 792]/Length 53>>stream
xs
w3T0WI2P0T5T R
Ɩf
!\!Y\ !p
o
endstream
endobj
11 0 obj
<>stream
2018-09-11T01:17:07+05:30
Arbortext Advanced Print Publisher 9.0.114/W
2019-08-10T23:46:18-07:00
Acrobat Distiller 8.1.0 (Windows); modified using iText 4.2.0 by 1T3XT
application/pdf
BFM-2018-0048-ver9-Cadwell_3P 485..492
uuid:1841770a-c9df-4f80-bdcf-3204dc355b0c
uuid:6384d855-bc93-4547-a26e-ab1cbf049f60
endstream
endobj
12 0 obj
<>stream
x+ |
endstream
endobj
13 0 obj
<>stream
xS**T0T0 Bi ye(
endstream
endobj
14 0 obj
<>stream
x+ |
endstream
endobj
15 0 obj
<>stream
xS**T0T0 Bi yA$
endstream
endobj
16 0 obj
<>stream
x+ |
endstream
endobj
17 0 obj
<>stream
xS**T0T0 Bi y\'
endstream
endobj
18 0 obj
<>stream
x+ |
endstream
endobj
19 0 obj
<>stream
xS**T0T0 Bi yn)
endstream
endobj
20 0 obj
<>stream
x+ |
endstream
endobj
21 0 obj
<>stream
xS**T0T0 Bi yw*
endstream
endobj
22 0 obj
<>stream
x+ |
endstream
endobj
23 0 obj
<>stream
xS**T0T0 Bi yJ%
endstream
endobj
24 0 obj
<>stream
x+ |
endstream
endobj
25 0 obj
<>stream
xS**T0T0 Bi y8#
endstream
endobj
26 0 obj
<>stream
x+ |
endstream
endobj
27 0 obj
<>stream
xS**T0T0 Bi yS&
endstream
endobj
29 0 obj
<>stream
/GS1 gs
BT
/F5 1 Tf
9.843 0 0 9.843 62.022 725.1588 Tm
0 0 0 rg
.0101 Tc
0 Tw
[(self-e)-3.7(fca)-3.7(cy,)]TJ
7.3823 0 0 6.5614 114.5763 729.5242 Tm
.0145 Tc
(12)Tj
9.843 0 0 9.843 125.8582 725.1588 Tm
.013 Tc
[(le)5(ad)-374(t)6(o)-374(m)4.9(ore)-369.4(op)6.1(tim)4.9(al)-368.4(suc)5(k).4(l)6(i).3(n)6.1(g)-374(as)-373.8(a)5(s).6(s)6.3(e)-.8(ss)6.3(ed)]TJ
-6.4854 -1.1174 TD
.0121 Tc
[(in)-432.5(th)5.2(e)-439.4(s)5.4(econ)5.2(d)-438.3(w)4.4(eek,)]TJ
7.3823 0 0 6.5614 146.948 718.5825 Tm
.0145 Tc
(13)Tj
9.843 0 0 9.843 158.8535 714.1605 Tm
.0124 Tc
[(and)-432.2(t)-.3(o)-432.2(i)-.3(n)5.5(c)-1.4(reas)5.7(e)-439.1(t)5.4(he)-433.4(pr)5.6(ob)5.5(ab)5.5(ili)5.4(ty)-432.2(of)]TJ
-9.8376 -1.1116 TD
.013 Tc
[(ex)6.1(cl)6(us)6.3(ive)-277.2(b)6.1(re)5(ast)6(f).4(e)5(e)-.8(d)6.1(i).3(ng)6.1(.)]TJ
7.3823 0 0 6.5614 160.0441 707.5841 Tm
.0145 Tc
(1418)Tj
9.843 0 0 9.843 72 692.277 Tm
0 Tc
[(When)-388(SSC)-389.9(begins)-387.8(immediately)-393(after)-388(birth)-391.6(and)-390.4(the)-384.7(baby)]TJ
-1.0137 -1.1116 TD
[(remains)-264.6(in)-267.3(SSC)-263.2(continuously)-262.3(and)-263.6(without)-268.2(interruption,)-265.9(he)-262.5(or)]TJ
0 -1.1174 TD
[(she)-505.4(seeks)-514.3(the)-505.7(breast,)-507.6(progresses)-513.8(in)-503.4(a)-509.1(predictable)-512.5(fashion)]TJ
0 -1.1116 TD
[(through)-341.9(Widst)-7.8(ro)]TJ
6.2723 .023 TD
()Tj
.4147 -.023 TD
[(ms)-344.1(9)-346.7(Stages,)]TJ
7.3823 0 0 6.5614 182.4944 663.7605 Tm
(19)Tj
9.843 0 0 9.843 193.2661 659.3951 Tm
[(\(Table)-344.3(1\))-347.7(self-attaches)-348.4(and)]TJ
-13.3337 -1.1116 TD
[(begins)-197.8(to)-192.4(suckle)-193.2(\(eighth)-199.2(stage\),)-196.6(usually)-193.2(within)-197.9(the)-194.7(rst)-194.2(hour)-194.4(or)]TJ
0 -1.1174 TD
[(so.)-293.4(Delay)-8.8(ed)-291.3(breastfeeding)-301.2(initiation)-300.9(\(past)-294.6(the)-298.3(rst)-297.9(hour)-292.4(after)]TJ
0 -1.1116 TD
[(birth\))-300.5(increases)-308(the)-298.3(risk)-303.8(of)-295.9(neonatal)-306.3(mortality.)-298.5(A)-301.5(recent)-303.9(sys-)]TJ
T*
[(tematic)-318.1(review)-315.2(and)-309.7(meta-analysis)-319.7(of)-313.2(studies)-314(from)-316.6(both)-309.8(high)]TJ
0 -1.1174 TD
[(and)-390.4(low)-390.2(income)-390.4(countries)-392.4(found)-391.4(that)-391.7(infants)-389(who)-390.1(initiated)]TJ
0 -1.1116 TD
[(breastfeeding)-214.8(between)-219.6(2)-208.4(and)-211.8(23)-209.5(hours)-212.6(after)-209.5(birth)-213.1(compared)-215.1(to)]TJ
T*
[(those)-340.7(who)-344(initiated)-346.9(breastfeeding)-347.3(within)-341.9(the)-338.7(rst)-344(hour)-338.4(after)]TJ
T*
[(birth,)-279.9(had)-280.9(a)-284.5(33%)-280.8(increased)-285.2(risk)-280.8(of)-278.6(neonatal)-283.3(mortality.)]TJ
7.3823 0 0 6.5614 274.507 576.1132 Tm
(20)Tj
9.843 0 0 9.843 72 560.7495 Tm
-.0215 Tc
[(Al)-5.4(tho)-5.3(ugh)-494.9(t)-5.4(h).4(e)-496.1(b).4(en)-5.3(et)-5.4(s)-494.7(of)-494.9(im)-6.5(medi)-5.4(ate)-6.5(,)-491.5(co)-5.3(nt)-5.4(inu)-5.3(ous)-5.1(,)-491.5(u)-5.3(nin)-5.3(t).3(er)-5.3(-)]TJ
-1.0137 -1.1116 TD
[(r)-5.3(upt)-5.4(ed)-546.7(S)-5.2(S).6(C)-547.8(a)-6.5(nd)-546.7(ea)-6.5(rl)-5.4(y)-546.7(b).4(r)-5.3(eas)-5.1(tfe)-6.5(e)-.7(di)-5.4(ng)-546.7(h)-5.3(a)-.7(ve)-553.7(bee)-6.5(n)-546.7(wi)-5.4(del)-5.4(y)-546.7(re)-6.5(-)]TJ
T*
-.0197 Tc
[(searche)-4.7(d)-182.1(and)-182.1(c)-4.7(onrme)-4.7(d)2.2(,)-184.4(f)2.3(e)-4.7(w)1.4(er)-182(than)-187.8(half)-182(of)-182(newborns)-181.9(worldwide)]TJ
0 -1.1174 TD
0 Tc
[(ar)19.7(e)-238.4(b)0(r)15.1(e)0(a)18.5(s)0(t)20.9(f)0(e)19.7(d)-237.2(in)-232.7(th)20.7(e)-238.4()0(r)21(s)0(t)-232.5(h)0(o)20.8(u)0(r)20.9(.)-239.6(Ac)18.8(co)19.7(rd)20.9(in)20.7(g)-243(t)0(o)-227(U)0(N)19.1(I)0(C)19.8(E)0(F)19.8(,)]TJ
7.3823 0 0 6.5614 268.3842 532.2329 Tm
-.0162 Tc
(21)Tj
9.843 0 0 9.843 278.0219 527.8676 Tm
-.0623 Tc
[()-62.3(T)-48.4(h)-62.3(i)-41.6(s)]TJ
-21.9445 -1.1116 TD
0 Tc
[(le)19.5(av)19.7(es)-452.4(77)-445.7(mi)19.5(ll)14.8(io)20.7(n)-456.1(n)0(e)19.7(w)0(b)14.2(o)0(r)20.9(n)0(s)-445.5(w)0(a)13(i)0(t)20.6(i)0(n)20.7(g)-456.1(to)15(o)-456.1(l)0(o)20.7(n)0(g)-451.5(f)0(o)20.9(r)-456.1(th)15(is)-445.6(r)15.3(st)]TJ
T*
[(cr)19.7(it)20.6(ic)13.8(al)-245.4(co)19.7(nt)20.7(ac)12.8(t)-254.7(w)0(i)19.8(t)0(h)-250(t)0(h)20.7(e)0(i)19.5(r)-254.5(mo)19.6(th)15(er)-245.2(ou)20.8(ts)15.1(id)20.7(e)-255.7(o)0(f)-249.8(t)0(h)20.7(e)-255.7(wo)20(mb)19.6(.)70.4()-260.2(\()0(p)20.9(.)0(8)18.5(\))]TJ
0 -1.1174 TD
[(In)20.9(co)19.7(ns)15.3(is)20.9(te)19.6(nc)19.7(y)-312.1(i)0(n)-301.8(t)0(h)20.7(e)-313.3(pr)20.9(ac)12.8(ti)20.6(ce)-304(of)-301.7(SS)21.2(C)-313.2(h)0(a)19.7(s)-311.9(be)19.7(en)-302.9(hi)20.7(gh)20.8(li)20.6(gh)15.1(te)19.6(d)-312.1(i)0(n)]TJ
0 -1.1116 TD
[(th)20.7(e)-203.8(m)0(o)19.6(s)0(t)-192.2(r)0(e)19.7(c)0(e)18.5(n)0(t)-192.4(C)0(o)19.8(c)0(h)19.7(r)0(a)14(n)0(e)-187.7(r)0(e)14(v)0(i)20.7(e)0(w)-188.5(o)0(f)-192.2(e)0(a)18.5(r)0(l)15(y)-196.9(SS)15.4(C)-198(f)0(o)15.1(r)-196.9(mo)19.6(th)15(er)19.7(s)-202.5(a)0(n)19.7(d)]TJ
T*
[(th)20.7(ei)19.5(r)-162.3(h)0(e)19.7(a)0(l)19.5(t)0(h)15(y)-156.6(ne)19.7(wb)14.2(or)20.9(n)-156.6(i)0(n)15(f)0(a)19.7(n)0(t)20.7(s)0(.)]TJ
7.3823 0 0 6.5614 175.4645 477.4676 Tm
(3)Tj
9.843 0 0 9.843 180.737 473.1022 Tm
[(Ju)21(st)-151.9(47)20.8(%)-163.4(o)0(f)-146.2(t)0(h)15(e)-157.8(38)-152(tr)20.7(ia)19.6(ls)-151.9(el)19.5(ig)15(ib)20.7(le)]TJ
-12.0608 -1.1174 TD
[(fo)20.9(r)-266(i)0(n)20.7(c)0(l)19.5(u)0(s)15.3(i)0(o)20.7(n)-266(in)-255.8(th)20.7(e)-261.4(a)0(n)13.9(a)0(l)19.5(y)0(s)21(i)0(s)-255.6(r)0(e)19.7(p)0(o)20.8(r)0(t)15(e)0(d)-251(t)0(h)15(a)0(t)-251.2(S)0(S)15.4(C)-261.3(be)13.9(ga)19.7(n)-260.3()56.5(e)19.7(ar)19.7(ly)20.7()56.5()]TJ
0 -1.1116 TD
[(or)-411.1()62.3()0(i)20.7(m)0(m)18.4(e)0(d)19.7(i)0(a)19.5(t)0(e)19.6(l)0(y)15(.)13.9()56.5()-415.8(Si)20.9(xt)20.7(y-)15.1(si)20.9(x)-415.8(s)0(t)15.1(u)0(d)20.8(i)0(e)19.6(s)-415.6(we)18.8(re)-412.3(as)19.9(se)19.9(ss)15.5(ed)-406.5(an)19.7(d)-421.6(e)0(x)19.7(-)]TJ
T*
[(cl)19.5(ud)20.8(ed)-366.2(fr)20.9(om)-360.5(th)20.7(e)-370.9(r)0(e)14(v)0(i)20.7(e)0(w)]TJ
7.3823 0 0 6.5614 155.9055 444.5857 Tm
(3)Tj
9.843 0 0 9.843 163.2755 440.2204 Tm
[(pr)20.9(im)19.5(ar)19.7(il)20.6(y)-369.7(b)0(e)13.9(c)0(a)18.5(u)0(s)21(e)-370.9()62.3()]TJ
/F10 1 Tf
8.1154 0 TD
(.)Tj
/F5 1 Tf
1.3708 0 TD
[(th)20.7(e)-370.9(i)0(n)20.7(v)0(e)19.7(s)0(t)15.1(i)0(-)]TJ
-19.7731 -1.1116 TD
[(ga)19.7(to)20.7(rs)-313(di)20.7(d)-317.9(n)0(o)20.8(t)-323.8(st)20.9(at)19.5(e)-319(t)0(h)20.7(a)0(t)-308.8(t)0(h)15(e)-319(in)20.7(fa)19.7(nt)20.7(s)-323.4(i)0(n)-307.6(t)0(h)20.7(e)-319(in)20.7(te)13.8(rv)20.9(en)19.7(ti)20.6(on)-307.5(gr)15.1(ou)20.8(p)]TJ
0 -1.1174 TD
[(re)19.7(ce)18.5(iv)15(ed)-193.4(im)13.7(m)15(e)0(d)13.9(i)0(a)19.6(t)0(e)-199.3(o)0(r)-198(e)0(a)18.5(r)0(l)20.7(y)-208.4(sk)21(in)20.7(-t)15(o-)20.9(sk)21(in)-198.2(co)19.7(nt)20.7(ac)12.8(t.)24.1()56.5()-208.4(\(p)20.9(.8)18.5(\))-208.4(T)0(h)19.6(e)0(r)19.7(e)]TJ
0 -1.1116 TD
[(is)-209.5(al)19.5(so)-209.4(in)20.7(co)19.7(ns)21(is)15.1(te)19.6(nc)19.7(y)-220(i)0(n)-203.9(d)0(u)20.8(r)0(a)14(t)0(i)20.6(o)0(n)-209.5(o)0(f)-203.8(S)0(S)15.4(C)-215.2(wi)19.8(th)-209.7(pu)20.8(bl)20.7(is)15.1(he)19.7(d)-214.2(r)0(a)19.7(n)0(g)15.1(e)0(s)]TJ
T*
[(of)-249.8(ti)20.6(me)-252.3(fr)15.1(om)-245.3(15)-249.9(mi)13.7(nu)20.8(te)19.6(s)]TJ
7.3823 0 0 6.5614 156.9259 400.7621 Tm
[(22)24.7(,2)28.1(3)]TJ
9.843 0 0 9.843 175.748 396.3968 Tm
[(to)-250(mo)19.6(re)-251(th)20.7(an)-251(30)-249.9(ho)20.8(ur)15.1(s.)]TJ
7.3823 0 0 6.5614 263.7921 400.7621 Tm
(3)Tj
9.843 0 0 9.843 72 385.3983 Tm
[(The)-362.8(purpose)-365.8(of)-365(this)-361.6(study)-368.3(was)-362.2(to)-365.2(analyze)-363.8(the)-367.5(process)-366.7(of)]TJ
-1.0137 -1.1116 TD
[(uninterrupted)-610.2(SSC)-608.8(between)-605.5(healthy)-609.3(newborns)-609.6(and)-603.5(their)]TJ
T*
[(mothers)-223.1(immediately)-220.2(after)-221(planned)-223.3(vaginal)-223.4(birth)-218.8(in)-215.4(a)-221.1(hospital)]TJ
0 -1.1174 TD
[(that)-339.9(had)-338.5(implemented)-341(this)-338.5(practice)-342(change)-338.4(for)-337.3(both)-338.6(vaginal)]TJ
0 -1.1116 TD
[(and)-280.9(cesarean)-285.1(births.)]TJ
/F3 1 Tf
8.9663 0 0 8.9663 62.022 314.7023 Tm
[(Materials)-332.7(and)-338.2(Methods)]TJ
/F11 1 Tf
0 -1.8336 TD
(Design)Tj
/F5 1 Tf
9.843 0 0 9.843 72 281.8204 Tm
[(Th)19.6(is)-198(re)19.7(se)19.9(ar)13.9(ch)-199.2(de)19.7(si)20.9(gn)-198(wa)18.8(s)-208.3(a)-209.6(cr)19.7(os)21(s-)15.3(se)19.9(ct)19.5(io)20.7(na)13.9(l)-202.8(d)0(e)13.9(s)0(c)19.9(r)0(i)20.7(p)0(t)20.7(i)0(v)20.7(e)-209.6(st)15.1(ud)20.8(y)]TJ
-1.0137 -1.1174 TD
[(ut)20.7(il)20.6(iz)13.8(in)20.7(g)-340.9(v)0(i)20.7(d)0(e)19.7(o)-340.9(et)19.5(hn)20.8(og)15.1(ra)19.7(ph)20.8(ic)-331.8(it)20.6(er)19.7(at)19.6(iv)15(e)-342.1(r)0(e)19.7(v)0(i)20.7(e)0(w)-332.5(a)0(n)19.7(d)-340.9(an)19.7(al)19.5(ys)15.3(is)-330.4(as)]TJ
0 -1.1116 TD
[(we)18.8(ll)-261.6(as)-262.4(da)19.7(ta)-262.7(ex)19.7(tr)20.7(ac)18.5(te)19.5(d)-271.8(f)0(r)20.9(o)0(m)-262.6(p)0(a)19.7(t)0(i)20.6(e)0(n)19.7(t)-271.9(re)19.7(co)13.9(rd)20.9(s.)]TJ
/F11 1 Tf
8.9663 0 0 8.9663 313.0582 725.7825 Tm
[(Sample)-338.6(and)-329.4(setting)]TJ
/F5 1 Tf
9.843 0 0 9.843 323.0361 709.3416 Tm
[(The)-604.7(study)-604.5(was)-609.9(conducted)-606.8(at)-602.5(Loma)-607(Linda)-607(University)]TJ
-1.0137 -1.1116 TD
[(Medical)-444.3(Center)-447.8(\(LLUMC\),)-442.5(a)-440(large)-445.7(teaching)-444.5(hospital)-442.2(with)]TJ
/F12 1 Tf
-.167 -1.1174 TD
(*)Tj
/F5 1 Tf
.9964 0 TD
[(2,500)-330.4(births)-334.9(per)-327(year.)-332.7(The)-334(hospital)-332.7(was)-327.7(designated)-337.1(Baby-)]TJ
-.8294 -1.1116 TD
(Friendly)Tj
/F8 1 Tf
7.3823 0 0 6.5614 346.507 680.825 Tm
()Tj
/F5 1 Tf
9.843 0 0 9.843 354.2739 676.4597 Tm
[(in)-192.4(2009,)-186.4(and)-194.5(redesignated)-196.5(in)-192.4(2014,)-192.2(and)-194.5(is)-186.4(located)-195.8(in)]TJ
-4.1873 -1.1116 TD
[(California,)-248.5(a)-244.2(state)-244(with)-247.4(one)-240.6(of)-244.1(the)-246.5(highest)-245.1(breastfeeding)-249.4(rates)]TJ
0 -1.1174 TD
[(in)-284.6(the)-281.1(United)-279.6(States.)]TJ
7.3823 0 0 6.5614 394.0723 658.9415 Tm
(24)Tj
9.843 0 0 9.843 323.0361 643.5778 Tm
[(Hospitals)-478.5(designated)-481.1()50.8(Baby-Friendly)43.5()-473.4(b)0(y)-474.5(the)-476.9(U.S.)-476.3(au-)]TJ
-1.0137 -1.1116 TD
[(thorit)-7(y,)-304(Baby-Friend)-9.6(ly)-307.6(USA,)-307.8(are)-310.9(expected)-318.9(to)-307.6(implement)-314.6(the)]TJ
T*
[(routin)-6.8(e)-198.1(practice)-203.8(of)-203.8(helping)-199.2(new)-201.2(mothers)-205.8(breastfeed)-205.6(within)-203.7(the)]TJ
0 -1.1174 TD
[(r)15.3(st)-370.8(ho)20.8(ur)-370.8(af)19.7(te)19.5(r)-381.2(b)0(i)20.7(r)0(t)20.7(h)0(.)-373.1(T)0(h)19.6(i)0(s)-370.8(i)0(s)-370.8(i)0(n)20.7(t)0(e)19.6(r)0(p)20.9(r)0(e)19.7(t)0(e)13.8(d)-375.5(as)-371.8(im)19.5(me)18.4(di)20.7(at)19.5(e,)-374.3(co)19.7(n-)]TJ
0 -1.1116 TD
[(ti)14.8(nu)20.8(ou)20.8(s,)-171.4(un)20.8(in)20.7(te)19.5(rr)20.9(up)15.1(te)19.6(d)-173.9(S)0(S)15.4(C)-174.9(fo)15.1(r)-173.9(a)0(l)13.8(l)-174(he)19.7(al)13.8(th)20.7(y)-179.6(n)0(e)19.7(w)0(b)20(o)0(r)20.9(n)0(s)-169(f)0(o)20.9(r)-179.6(at)-170.5(le)19.6(as)19.9(t)]TJ
T*
[(1)-323.6(h)0(o)15.1(u)0(r)-313.2(a)0(f)19.7(t)0(e)19.5(r)-323.6(bo)20.8(th)-313.3(va)19.7(gi)20.7(na)13.9(l)-318(a)0(n)13.9(d)-323.6(ce)18.5(sa)19.9(re)19.7(an)-314.4(bi)20.7(rt)20.7(hs)-313(wh)14.2(et)19.6(he)19.7(r)-323.6(o)0(r)-313.2(n)0(o)20.8(t)]TJ
0 -1.1174 TD
[(th)15(e)-296(m)0(o)19.6(t)0(h)15(e)0(r)-285.6(p)0(l)14.9(a)0(n)19.7(s)-300.4(to)-284.5(br)15.1(ea)18.5(st)20.9(fe)19.7(ed)19.7(.)-302.9(I)0(f)-290.1(t)0(h)20.7(e)-296(mo)19.6(th)15(er)-285.6(pl)15(an)19.7(s)-300.4(t)0(o)-284.5(b)0(r)15.1(e)0(a)18.5(s)0(t)20.9(-)]TJ
0 -1.1116 TD
[(fe)14(ed)19.7(,)-400.8(S)0(S)21.2(C)-399.5(sh)21(ou)20.8(ld)-394(co)19.7(nt)20.7(in)20.7(ue)-389.3(un)15.1(ti)20.6(l)-398.6(t)0(h)20.7(e)-399.7(co)19.7(mp)19.6(le)13.8(ti)20.6(on)-388.1(of)-388.1(th)15(e)-399.7()0(r)21(s)0(t)]TJ
T*
[(br)15.1(ea)18.5(st)20.9(fe)19.7(ed)19.7(.)-216.5(T)0(h)19.6(e)-209.6(st)20.9(af)14(f)-208.4(a)0(t)-205.1(t)0(h)20.7(e)-209.6(st)15.1(ud)20.8(y)-208.4(h)0(o)15.1(s)0(p)21(i)0(t)20.6(a)0(l)-205.1(h)0(a)19.7(d)-208.4(re)19.7(ce)12.7(iv)20.7(ed)-199.2(a)-215.4(5)0(-)20.9(d)0(a)19.7(y)]TJ
0 -1.1174 TD
[(in)15(-s)21.1(er)19.7(vi)20.7(ce)-344.3(tr)20.7(ai)13.8(ni)20.7(ng)-342(on)-342(th)20.7(e)-353.6(i)0(m)19.5(p)0(o)20.8(r)0(t)20.7(a)0(n)19.7(c)0(e)-344.4(o)0(f)20.9(,)-354.8(an)19.7(d)-352.4(a)0(p)19.7(p)0(l)20.7(i)0(c)19.5(a)0(t)19.5(i)0(o)15(n)-346.7(of)15.1(,)]TJ
0 -1.1116 TD
[(sk)15.3(in)20.7(-t)20.7(o-)20.9(sk)15.3(in)-180.9(us)21(in)20.7(g)-196.9(t)0(h)20.7(e)-192.3(PR)20(EC)18.6(ES)19.8(S)-191(m)0(e)18.4(t)0(h)15(o)0(d)20.8(.)]TJ
7.3823 0 0 6.5614 471.855 538.3558 Tm
-.0162 Tc
(15)Tj
9.843 0 0 9.843 481.0392 533.9904 Tm
0 Tc
[(Th)19.6(is)-180.7(ob)20.8(se)19.9(rv)15.1(at)19.6(io)20.7(na)19.7(l)]TJ
-17.066 -1.1116 TD
[(st)15.1(ud)20.8(y,)-258(ap)19.7(pr)20.9(ov)20.8(ed)-256.8(by)-255.6(th)15(e)-267.2(h)0(o)20.8(s)0(p)21(i)0(t)20.6(a)0(l)19.6()0(s)-261.2(I)0(n)20.9(s)0(t)20.9(i)0(t)20.6(u)0(t)14.9(i)0(o)20.7(n)0(a)19.7(l)-266.2(Re)18.6(vi)20.7(ew)-257.7(Bo)19.8(ar)14(d,)]TJ
0 -1.1174 TD
[(in)15(cl)19.5(ud)20.8(ed)-452.6(mo)19.6(th)20.7(er)19.7(s)-461.7(w)0(h)20(o)-461.9(we)18.8(re)-452.6(pl)14.9(an)19.7(ni)20.7(ng)-451.5(a)-463(v)0(a)19.7(g)0(i)20.7(n)0(a)19.7(l)-462(bi)20.7(rt)15(h.)-448(Th)19.6(e)]TJ
0 -1.1116 TD
[(pr)15.1(ot)20.7(oc)19.7(ol)-175.1(in)15(cl)19.5(ud)20.8(ed)-176.2(vi)14.9(de)19.7(o)-185.4(r)0(e)19.7(c)0(o)19.7(r)0(d)15.1(i)0(n)20.7(g)-185.4(st)20.9(ab)13.9(le)-176.3(ba)19.7(bi)20.7(es)-181.7(an)19.7(d)-185.4(m)0(o)19.6(t)0(h)20.7(e)0(r)14(s)-185.2(in)]TJ
T*
[(SS)15.4(C)-445.6(d)0(u)20.8(r)0(i)20.7(n)0(g)-434.2(t)0(h)20.7(e)-445.8(r)15.3(st)-434.1(ho)20.8(ur)-434.1(af)19.7(te)13.8(r)-444.6(b)0(i)20.7(r)0(t)20.7(h)-444.6(an)19.7(d)-444.6(d)0(o)20.8(c)0(u)13.9(m)0(e)18.5(n)0(t)20.7(i)0(n)20.7(g)-444.6(th)20.7(e)]TJ
T*
[(me)18.4(di)14.9(ca)18.5(ti)20.6(on)20.8(s)-271.6(m)0(o)19.6(t)0(h)20.7(e)0(r)19.7(s)-271.6(ha)19.7(d)-271.8(r)0(e)19.7(c)0(e)18.5(i)0(v)20.7(e)0(d)-262.5(d)0(u)20.8(r)0(i)15(n)0(g)-255.6(l)0(a)13.8(b)0(o)20.8(r)0(.)]TJ
1.0137 -1.1174 TD
[(Over)-375(the)-379(course)-377.3(of)-370.8(4)-375.5(weeks,)-374.8(1)-375.5(week)-376.2(each)-376.5(in)-376.7(May,)-371.7(July,)]TJ
-1.0137 -1.1116 TD
[(August)-7.4(,)-222.3(and)-229.1(December)-228.7(2013,)-226.7(informed)-230.1(consent)-228.9(was)-224(obtained)]TJ
T*
[(from)-610.3(clinically)-608.4(uncomplicated)-613.8(nulliparas)-606.8(and)-609.2(multiparas)]TJ
0 -1.1174 TD
[(planning)-280.9(a)-273(vaginal)-281(delivery.)-274(Mothers)-280.4(were)-278.3(approached)-280.6(upon)]TJ
0 -1.1116 TD
[(arrival)-482.5(to)-474.6(the)-476.9(labor)-479.1(and)-476.8(delivery)-483.7(ward.)-476.4(Informed)-477.6(consent)]TJ
T*
[(materials)-291.3(were)-284(available)-285.7(in)-278.8(English)-285.4(and)-280.9(Spanish,)-282.8(with)-282(trans-)]TJ
0 -1.1174 TD
[(lation)-399.8(services)-397.9(available)-395.1(for)-394.9(Spanish-speaking)-400.9(participants.)]TJ
0 -1.1116 TD
[(The)-213(studys)-214.8(inclusion)-212.9(criteria)-214.2(included)-213(women)-216.1(who)-211.5(were)]TJ
/F8 1 Tf
22.7393 0 TD
()Tj
/F5 1 Tf
.5529 0 TD
(18)Tj
-23.2922 -1.1116 TD
[(years)-318.6(of)-313.2(age,)-320.1(low)-315.3(risk)-315.3(\(as)-315.3(determined)-321.2(by)-313.2(the)-315.6(admitting)-318.1(doc-)]TJ
T*
[(tor\),)-284.4(English)-279.7(or)-278.6(Spanish)-285.1(speaking)-281.8(as)-279.6(their)-283.4(primary)-280.9(language,)]TJ
0 -1.1174 TD
[(and)-436.4(who)-430.4(were)-433.8(estimated)-429.5(to)-434.3(be)-429.6(between)-432.7(37)-434.2(and)-430.7(42)-428.4(weeks)]TJ
0 -1.1116 TD
[(gestation.)-309.6(Infants)-302.5(were)-301.3(eligible)-305.4(if)-301.8(they)-299.4(were)-301.3(full-term)-306.3(gesta-)]TJ
T*
[(tion,)-319.1(stable,)-323.5(and)-315.5(had)-321.3(no)-319(known)-317.4(abnormalities.)-322.3(To)-314.4(safeguard)]TJ
0 -1.1174 TD
[(protected)-405.3(health)-406.6(information,)-404.2(names)-400.5(and)-401.9(identifying)-405.4(infor-)]TJ
0 -1.1116 TD
[(mation)-354.8(were)-353.2(removed)-351.1(from)-351.1(data)-352.4(collection)-349.1(material,)-357.1(which)]TJ
T*
[(were)-318.6(assigned)-310.4(a)-313.3(linked)-313.3(code.)-309.7(This)-310.8(unique)-313.2(code)-312(was)-310.4(also)-310.8(re-)]TJ
0 -1.1174 TD
[(corded)-343(on)-330.5(the)-338.7(video)-335.1(of)-336.2(the)-338.7(baby)-333.9(taken)-336.3(during)-335(the)-338.7(rst)-338.2(hour)]TJ
0 -1.1116 TD
[(after)-284.4(birth.)]TJ
1.0137 -1.1116 TD
[(Ninety-six)-341.5(mothers)-338.3(consented)-341.6(to)-330.6(participate)-345.6(in)-336.4(the)-332.9(study.)]TJ
-1.0137 -1.1174 TD
[(Five)-299.3(had)-298.2(been)-294.7(scheduled)-301.3(for)-297(repeat)-298.2(cesareans,)-301(and)-298.2(therefore)]TJ
ET
62.022 224.334 490.167 .22676 re
f
62.022 68.542 490.167 .28348 re
f
BT
/F7 1 Tf
9.845 0 0 9.845 240.3779 230.2866 Tm
(Table)Tj
/F5 1 Tf
2.9944 0 TD
(1.)Tj
/F7 1 Tf
1.2554 0 TD
(Widstro)Tj
3.2766 .023 TD
()Tj
.4376 -.023 TD
(ms)Tj
/F5 1 Tf
1.7218 0 TD
(9)Tj
/F7 1 Tf
.8292 0 TD
(Stages)Tj
/F5 1 Tf
-28.6315 -1.6182 TD
[(Babies)-285.7(progress)-285.2(through)-289.3(nine)-281.7(observable,)-287.4(instinctive)-284.6(stages)-290.3(during)-282.5(the)-286.5(rst)-286(hour)-280.4(after)-289.6(birth)-281.7(when)-288.1(in)-284.3(immediate,)-283.5(continuous,)]TJ
.9905 -1.0135 TD
[(and)-338.1(uninterrupted)-332.5(skin-to-skin)-334.5(contact)-339(with)-333.4(the)-332.6(mother.)-340.1(Stage)-335.5(8)-329.2(i)0(s)-336(suckling,)-335.1(the)-332.6(rst)-337.8(experience)-338.4(of)-330.2(breastfeeding.)]TJ
.0115 -1.0077 TD
[(1.)-332.6(The)]TJ
/F9 1 Tf
2.9772 0 TD
[(birth)-333.4(cry)]TJ
/F5 1 Tf
3.8985 0 TD
[(is)-330.2(a)-336.2(distinct)-332.1(and)-338.1(specic)-332.7(cry)-338.1(as)-331.2(the)-338.3(babys)-335.2(lungs)-333.2(expand)-330.8(for)-337(the)-332.6(rst)-337.8(time.)]TJ
-6.8757 -1.0135 TD
(2.)Tj
/F9 1 Tf
1.0365 0 TD
(Relaxation)Tj
/F5 1 Tf
4.6356 0 TD
[(is)-289.9(a)-284.3(time)-288.8(immediately)-288.1(after)-289.6(the)-286.5(birth)-287.5(cry)-286.3(ends,)-290.5(when)-282.4(the)-286.5(baby)-287.3(becomes)-293.6(still)-287.7(and)-286.3(has)-286.1(no)-284.1(visible)-290.6(movements.)]TJ
-5.6722 -1.0135 TD
(3.)Tj
/F9 1 Tf
1.0365 0 TD
(Awakening)Tj
/F5 1 Tf
4.745 0 TD
[(begins)-283.5(as)-290.9(the)-286.5(baby)-287.3(opens)-288.1(the)-286.5(eyes)-288.3(for)-285.1(the)-292.2(rst)-286(time,)-286.4(blinks,)-285.9(has)-291.9(small)-283.9(mouth)-288.5(movements,)-287.6(and)-286.3(limited)-292.1(hand)]TJ
-4.745 -1.0135 TD
[(and)-332.4(shoulder)-337.3(motions.)]TJ
-1.0365 -1.0077 TD
(4.)Tj
/F9 1 Tf
1.0538 0 TD
(Activity)Tj
/F5 1 Tf
3.386 0 TD
[(involves)-302.9(larger)-307.9(body)-303.4(movements,)-304.9(including)-304.3(whole)-306.6(arm)-304.8(motions,)-305.3(specic)-304(nger)-305.4(movements,)-304.9(shoulder)-308.5(motion,)]TJ
-3.386 -1.0135 TD
[(head)-334.5(lifting,)-333.5(and)-332.4(stable)-336.7(open)-333.4(eyes.)]TJ
-1.0538 -1.0135 TD
(5.)Tj
/F9 1 Tf
1.0826 0 TD
(Rest)Tj
/F5 1 Tf
2.0616 0 TD
[(could)-334.5(happen)-336.5(at)-331.6(any)-332.4(point)-339.3(during)-328.6(the)-338.3(rst)-332(hour,)-335.6(interspersed)-337.9(between)-333.9(stages)-336.4(or)-336(as)-331.2(a)-336.2(transition)-334.1(between)-339.7(stages.)]TJ
-3.1442 -1.0077 TD
(6.)Tj
/F9 1 Tf
1.025 0 TD
(Crawling)Tj
/F5 1 Tf
4.054 0 TD
[(involves)-274.2(the)-275(baby)-275.8(moving)-272.2(purposely)-275(toward)-278.8(the)-275(breast)-273.2(and)-274.8(nipple.)-275.7(It)-272.8(could)-276.9(be)-273.8(accomplished)-277(through)-277.8(sliding,)]TJ
-4.054 -1.0135 TD
[(leaping,)-335.5(bobbing,)-332.9(or)-330.2(pushing.)]TJ
-1.025 -1.0135 TD
(7.)Tj
/F9 1 Tf
.9962 0 TD
(Familiarization)Tj
/F5 1 Tf
6.5359 0 TD
[(is)-249.6(a)-249.8(stage)-249.2(at)-245.2(the)-251.9(mothers)-246.4(nipple)-249.3(where)-250(the)-251.9(baby)-247(licks,)-245.8(tastes,)-253.5(touches,)-248.7(and)-246(moves)-249(around)-249(the)-251.9(nipple)-249.3(and)]TJ
-6.5359 -1.0135 TD
[(areola)-337.9(area.)]TJ
-.9962 -1.0077 TD
(8.)Tj
/F9 1 Tf
1.0826 0 TD
(Suckling)Tj
/F5 1 Tf
3.7891 0 TD
[(involves)-337.5(the)-332.6(baby)-333.4(self-attaching)-341.6(to)-330.4(the)-338.3(nipple)-329.9(and)-338.1(initiating)-334.6(breastfeeding.)]TJ
-4.8717 -1.0135 TD
(9.)Tj
/F9 1 Tf
1.0826 0 TD
(Sleeping)Tj
/F5 1 Tf
3.7891 0 TD
[(is)-336(an)-331.4(involuntary)-335.1(activity)-339.2(of)-330.2(the)-338.3(baby)-333.4(around)-335.3(1.5)-333.6(to)-330.4(2)-335(hours)-333(after)-335.7(birth.)]TJ
8.7511 0 0 8.7511 70.0157 56.7496 Tm
[(Adapted)-332.1(from)-333.4(Widstro)]TJ
8.817 .0194 TD
()Tj
.4146 -.0194 TD
[(m)-333.3(e)0(t)-334.5(al.)]TJ
6.5633 0 0 5.8334 178.4125 60.6614 Tm
(19)Tj
/F3 1 Tf
8.9663 0 0 8.9663 62.022 749.6502 Tm
(486)Tj
46.1067 0 TD
[(CADWELL)-335.2(ET)-338.7(AL.)]TJ
ET
endstream
endobj
42 0 obj
<>stream
h,=N0 F
p&P1 CUSv
301#!&&F({>lώNu|oߏx~ݹwCb4W{igHdCd9>> nQ*/XjE!gyg,K ih5VUȢ{g_,F$
Pc)
"YdT
)+TQR/ٜ?(bX>.rPD=/rS f'O7pJNJ`b?!!h 0
endstream
endobj
44 0 obj
<>stream
hތ1KBQ5DE3&҈KO@#4Baۂ'!ѝ qdp8E
D+s9@
20F
0)QP0D\0>2?aNa,jdVw|~=x}!>͗G_YG x
endstream
endobj
47 0 obj
<>stream
/GS1 gs
BT
/F5 1 Tf
9.843 0 0 9.843 59.7543 725.1588 Tm
0 0 0 rg
0 Tc
0 Tw
[(did)-533.3(not)-539.1(meet)-532.2(the)-534.5(inclusion)-535.4(criteria)-542.5(and)-534.4(were)-537.5(considered)]TJ
0 -1.1174 TD
[(mistakenly)-642.6(consented.)-644.6(Other)-641.2(participants)-644.8(removed)-644.8(from)]TJ
0 -1.1116 TD
[(study)-420.1(analysis)-425.7(included)-420.3(one)-419.2(mother)-423.8(with)-420.2(a)-417(previously)-421.2(un-)]TJ
T*
[(disclosed)-542(physical)-541.1(condition)-541.4(that)-541.5(would)-536.4(preclude)-542.3(breast-)]TJ
T*
[(feeding)-396(and)-390.4(one)-390.4(who)-390.1(was)-396.8(recategorized)-395.9(as)-394.8(at)-389.4(less)-391.2(than)-391.6(37)]TJ
0 -1.1174 TD
[(weeks)-336.8(gestation)-335(after)-336.2(being)-335.1(consented.)-333.6(One)-333.6(mother)-331.6(was)-333.4(re-)]TJ
0 -1.1116 TD
[(moved)-278.6(after)-278.6(the)-281.1(baby)-276.3(was)-275.8(born)-275.1(with)-276.2(an)-279.8(unexpected)-280.8(cleft.)-276.4(Of)]TJ
T*
[(these)-272.7(88,)-264.8(4)-266(did)-268.4(not)-268.4(include)-269.5(para)-271.6(status)-266.8(in)-267.3(the)-269.5(medical)-271.9(record,)]TJ
0 -1.1174 TD
[(resulting)-339.5(in)-336.4(84)-336.3(dyads)-334.8(in)-336.4(the)-332.9(nal)-339.6(group)-333.8(who)-338.2(could)-335.1(be)-337.4(cate-)]TJ
0 -1.1116 TD
[(gorized)-401.8(by)-393.9(Robson)-399.1(criteria.)-396.2(Standard)-402.7(procedures)-400.2(were)-393.5(fol-)]TJ
T*
[(lowed)-405.1(for)-394.9(all)-402.1(study)-397.1(participants,)-400.6(with)-403(the)-396.2(exception)-405.3(of)-393.8(the)]TJ
0 -1.1174 TD
[(addition)-281.1(of)-284.4(the)-275.3(video)-283.3(recording)-283(of)-278.6(the)-281.1(baby)-282(for)-279.7(the)-281.1(rst)-280.6(hour)]TJ
0 -1.1116 TD
[(after)-284.4(birth)-282.2(while)-284.3(skin-to-skin)-283.9(with)-276.2(the)-286.8(mother.)]TJ
/F11 1 Tf
8.9663 0 0 8.9663 59.7543 571.6912 Tm
[(Data)-337.7(collection)-333.6(procedures)]TJ
/F5 1 Tf
9.843 0 0 9.843 69.7323 555.2502 Tm
[(Immediately)-254.6(after)-255.6(the)-246.5(birth,)-251.1(video)-254.5(recording)-248.5(of)-249.8(the)-252.3(mother)]TJ
-1.0137 -1.1116 TD
[(and)-257.9(baby)-253.2(commenced.)-256.6(Hospital)-253(protocol)-257.9(stated)-250.9(that)-253.5(the)-258(baby)]TJ
0 -1.1174 TD
.01 Tc
[(w)-3.5(o)3.1(uld)-342.4(r)-2.6(em)-3.8(ain)-342.4(i)-2.7(n)-342.4(SSC)-343.5(w)-3.5(i)3(th)-342.4(the)-349.4(s)-2.4(em)-3.8(irec)-3.8(line)-3.8(d)-348.2(m)1.9(other)-348.2(f)3.2(or)-348.2(at)]TJ
0 -1.1116 TD
.013 Tc
[(le)5(ast)-385.6(t).3(h)6.1(e)-392.4(r)6.2(st)-391.4(h)6.1(o).4(u)6.1(r)-391.2(af)6.2(te)5(r)-391.2(b).4(i)6(r).4(t)6(h)-391.3(un)6.1(le)5(ss)-391.1(t)6(h).4(e)5(r).4(e)-392.4(w)5.3(as)-385.3(a)-392.4(m)4.9(ed)6.1(ica)5(l)]TJ
T*
.0117 Tc
[(reaso)4.8(n)-300.4(to)-300.4(di)4.7(scon)4.8(tin)4.8(ue.)-302.8(T)3.7(he)-301.6(baby)-300.4(was)-300.2(a)-2.1(l)4.7(l)-1(o)4.8(w)-1.8(ed)-300.4(to)-300.4(mo)4.8(ve,)-302.8(u)4.8(n-)]TJ
0 -1.1174 TD
.0069 Tc
[(i)-5.8(n)-5.7(te)-6.9(rr)-5.7(up)-5.7(t)-5.8(e)-1.1(d)-5.7(,)-422.7(th)-5.7(ro)-5.7(ug)-5.7(h)-420.4(W)-8(id)-5.7(st)-5.8(r)-5.7(o)]TJ
11.6749 .023 TD
0 Tc
()Tj
.4262 -.023 TD
.0133 Tc
[(m)6.5(s)-419.6(9)-414(S)6.6(t).6(ag)6.4(es)-413.8(\(T)5.3(ab)6.4(le)-415.2(1\))6.5(.)-416.3(T)-.5(h)6.4(e)]TJ
-12.1011 -1.1116 TD
.0122 Tc
[(stu)5.3(d)-.4(y)-328.7(p)5.3(ro)5.3(tocol)-328.8(i)5.2(nclu)5.3(ded)-328.7(t)-.5(he)-324.1(pro)5.3(vi)5.2(sio)5.3(n)-328.7(th)5.3(at)-328.8(i)5.2(f)-328.7(th)5.3(e)-329.9(b)-.4(aby)-328.7(w)4.5(as)]TJ
T*
[(remo)5.3(ved)-351.8(b)-.4(y)-357.5(t)-.5(h)5.3(e)-358.7(nu)5.3(rs)5.5(e)-358.7(o)-.4(r)-357.5(b)5.3(y)-357.5(N)-1.3(I)5.4(C)-1.4(U)-358.4(s)-.2(t)5.2(a)-1.6(f)5.4(f)-357.5(fo)5.3(r)-357.5(m)-1.6(o)5.3(r)-.4(e)-358.7(t)5.2(han)-351.8(1)-.4(0)]TJ
0 -1.1174 TD
.0126 Tc
[(mi)5.6(nu)5.7(tes)5.9(,)-347.9(t)5.6(h)0(e)-346.8(v)5.7(id)5.7(eo)-345.6(r)5.8(e)-1.2(cor)5.8(d)0(in)5.7(g)-345.6(w)4.9(oul)5.6(d)-345.6(b)5.7(e)-346.8(s).2(t)5.6(opp)5.7(ed)5.7(.)-347.9(T)4.6(he)-341(dyad)]TJ
0 -1.1116 TD
.013 Tc
[(wa)5(s)-350.8(t)6(hen)-345.2(d)6.1(ocu)6.1(m)4.9(ent)6(e)-.8(d)-345.2(a)-.8(s)-345()52.3()6.2(r).4(em)4.9(o)6.1(v).4(ed)-345.2(fo)6.1(r)-345.2(m)-.8(e)5(d).4(ic)5(al)-345.3(re)5(as)6.3(on)6.1(s.)52.3()]TJ
T*
.0118 Tc
[(Demo)4.9(graph)4.9(ics)-271.3(a)-2(n)4.9(d)-271.5(med)4.9(i)-.9(cati)4.8(on)4.9(s)-271.3(r)-.8(eceived)-271.5(d)4.9(uri)4.8(ng)-265.8(lab)4.9(o)-.8(r)-265.7(w)-1.7(er)5(e)]TJ
T*
.0132 Tc
[(co)6.3(lle)5.2(ct)6.2(ed)-293.2(f)6.4(rom)-294.4(t)6.2(h).6(e)-294.3(E)5.2(le)5.2(ct)6.2(ron)6.3(ic)-294.3(M)5.4(e)-.6(d)6.3(i).5(ca)5.2(l)-293.3(R)-.4(e)5.2(c)-.6(o)6.3(r).6(d)-293.2(S).7(y)6.3(s).8(t)6.2(e)-.6(m)5.1(.)-295.5(L)5.2(a)-.6(-)]TJ
0 -1.1174 TD
.0124 Tc
[(bor)-455.2(and)-455.2(d)5.5(el)5.4(iv)5.5(ery)-455.2(m)4.3(ed)5.5(icat)5.4(io)5.5(ns)-455(fo)5.5(ll)5.4(owed)-455.2(st)5.4(an)5.5(dard)-455.2(ho)5.5(sp)5.5(ital)]TJ
0 -1.1116 TD
.0119 Tc
[(pro)5(to)5(co)5(ls.)-475.3(P)-.6(r)5.1(o)-.7(v)5(i)-.8(ders)-478.6(and)-478.8(s)5.2(taf)5.1(f)-478.7(pr)5.1(escri)4.9(b)-.7(e,)-481.1(admin)5(i)-.8(st)4.9(er)5.1(,)-481.1(a)3.9(nd)]TJ
T*
.0098 Tc
[(re)-4(cord)-613.3(e)-4(a)1.8(c)-4(h)-607.6(partic)-4(ipants)-613.1(m)-4(edic)-4(ations)-613.1(in)-613.3(an)-613.3(E)-4(l)2.8(e)-4(c)1.8(tronic)]TJ
0 -1.1174 TD
.0117 Tc
[(Medical)-277.5(R)3.8(ecor)4.9(d.)]TJ
1.0137 -1.1116 TD
0 Tc
[(Robson)-186(criteria,)]TJ
7.3823 0 0 6.5614 132.1511 384.2645 Tm
(25)Tj
9.843 0 0 9.843 141.3354 379.8991 Tm
[(a)-186.6(well-established)-190.4(method)-181.9(of)-186.5(monitoring)]TJ
-8.2882 -1.1116 TD
[(and)-355.8(auditing,)-359.4(is)-359.2(used)-356.7(worldwide)-358.6(to)-353.7(standardize)-362.4(comparison)]TJ
0 -1.1174 TD
[(methods)-182.8(betwe)-8.8(en)-181.9(hospitals,)-181.5(systems,)-185.9(and)-183(countries.)-182.7(Births)-180.5(are)]TJ
0 -1.1116 TD
[(categorized)-306.1(as)-296.9(1)-294.8(o)0(f)-295.9(1)0(0)-301.7(groups)-294.4(based)-301.4(on)-295.9(ve)-298(parameters:)-300.2(ob-)]TJ
T*
[(stetric)-361.5(history)-353.3(\(parity)-354.6(and)-355.8(previous)-355.5(cesarean)-360(section\),)-360.2(onset)]TJ
0 -1.1174 TD
[(of)-393.8(labor)-392.7(\(spontaneous,)-393.1(induced,)-393.7(or)-393.8(cesarean)-394.5(section)-396(before)]TJ
0 -1.1116 TD
[(onset)-277.3(of)-272.9(labor\),)-276.2(fetal)-273(presentation)-281.8(or)-272.9(lie)-269.7(\(cephalic,)-283.2(breech,)-272.7(or)]TJ
T*
[(transverse\),)-197.2(number)-193.3(of)-192.2(neonates,)-194.2(and)-188.8(gestational)-194.5(age)-189.9(\(preterm)]TJ
T*
[(or)-393.8(term\).)-391.5(Appropriate)-401.4(data)-392.8(were)-393.5(accessed)-400.1(from)-391.5(the)-390.5(patient)]TJ
0 -1.1174 TD
[(record)-279.6(for)-279.7(each)-278.6(mother)-279.8(to)-273(determine)-285.6(the)-275.3(Robson)-278.2(criteria)-277.6(and)]TJ
0 -1.1116 TD
[(allow)-255.5(for)-256.7(analysis)-252.9(of)-249.8(the)-258(variance)-255.5(in)-250(experience)-258.8(of)-255.6(nulliparas)]TJ
T*
[(and)-240.6(multiparas,)-237(of)-238.3(induced)-234.8(mothers,)-238.1(or)-238.3(of)-232.6(mothers)-240.4(who)-234.6(had)-234.9(a)]TJ
0 -1.1174 TD
[(vaginal)-286.8(birth)-282.2(after)-278.6(cesarean)-285.1(\(VBAC\).)]TJ
1.0137 -1.1116 TD
.0131 Tc
[(Th)6.2(e)-524.8(p)6.2(ro)6.2(ces)6.4(s)-523.5(m)5(ea)5.1(sur)6.3(e)-.7(m)5(e)-.7(n)6.2(t)-523.8(t)6.1(ool)6.1(,)-520.2(t).4(he)]TJ
/F9 1 Tf
15.8737 0 TD
.0128 Tc
[(He)4.8(al)5.8(th)5.9(y)-525.1(C)-.8(h)5.9(i).1(l)5.8(d).2(re)4.8(n)]TJ
-16.8875 -1.1116 TD
.0125 Tc
[(Pr)5.8(oject)-190.3(S)5.6(ki)5.5(n-)5.7(to-)5.7(S)-.1(kin)-190.2(I)5.7(mp)5.6(lemen)5.6(t)-.2(a)5.6(t)-.2(i)5.5(o)-.1(n)-190.2(A)4.5(lg)5.6(ori)5.5(t)-.2(h)5.6(m)]TJ
/F5 1 Tf
19.2201 0 TD
.012 Tc
[(,)-187.3(\()-.6(HCP-)5.2(S2)5.1(S-)]TJ
-19.2201 -1.1174 TD
[(IA\))-328.8(w)4.4(as)-328.6(u)5.2(s)-.3(ed)-328.8(to)-328.8(cat)5.1(e)-1.7(go)5.2(ri)5.1(ze)-330(t)5.1(h)-.5(e)-330(p)5.2(rebir)5.3(t)-.6(h)-328.8(R)4.2(ob)5.2(son)-328.8(c)4.1(ri)5.1(teria)-324.2(a)-1.7(s)]TJ
0 -1.1116 TD
[(well)-265.8(as)-265.5(o)5(p)-.7(eratio)5(nali)4.9(ze)-261.1(th)5(e)-266.8(c)3.9(ol)4.9(lecti)4.9(o)-.7(n)-259.9(o)-.7(f)-259.9(s)-.5(peci)4.9(c)-261.1(meas)5.2(ur)5.1(abl)4.9(e)]TJ
T*
.0131 Tc
[(el)6.1(em)5(en)6.2(ts)-206.7(o)6.2(f)-206.8(th)6.2(e)-208(S)6.4(SC)-207.9(p)6.2(r).5(a)5.1(c)-.7(t)6.1(i).4(ce)5.1(.)-203.4(T)-.7(h)6.2(e)-208(t)6.1(ool)-201.2(ha)5.1(s)-206.7(b).5(e)5.1(e)-.7(n)-201.1(s).7(ho)6.2(wn)-201.1(to)-206.9(b)6.2(e)]TJ
0 -1.1174 TD
.0122 Tc
[(rel)5.2(e)-1.6(v)5.3(a)-1.6(n)5.3(t)-328.8(and)-323(h)-.4(as)-322.8(been)-323(ap)5.3(pli)5.2(e)-1.6(d)-323(i)-.5(n)-323(h)-.4(o)5.3(s)-.2(pi)5.2(tal)-328.9(s)-.2(ett)5.2(i)-.5(n)5.3(g)-.4(s)-328.5(f)5.4(or)-322.9(bo)5.3(th)]TJ
0 -1.1116 TD
.0115 Tc
[(vagin)4.6(a)-2.3(l)-208.6(a)-2.3(n)4.6(d)-208.5(cesar)4.7(e)-2.3(an)-214.2(b)4.6(i)-1.2(r)4.7(t)-1.2(hs)-208.3(in)-208.5(Aust)4.5(ralia)-209.6(and)-208.5(J)-.9(apan)4.6(.)-210.8(A)-2(n)4.6(a)-2.3(l)4.5(y)-1.1(s)4.8(i)-1.2(s)]TJ
T*
.0132 Tc
[(of)-408.3(co)6.3(ll)6.2(ec)5.2(ted)-408.4(d)6.3(at)6.2(a)-415.3(h)6.3(as)-408.2(be)5.2(en)-408.4(s)6.5(how)5.5(n)-408.4(t).5(o)-408.4(p).6(r)6.4(o).6(v)6.3(i).5(d)6.3(e)-415.3(i)6.2(n).6(s)6.5(i).5(gh)6.3(t)-408.5(i).5(n)6.3(t).5(o)]TJ
T*
.0073 Tc
[(w)-6.2(h).4(e)-6.5(r)-5.3(e)-530.6(d)-5.3(ya)-6.5(ds)-535(re)-6.5(ma)-6.5(in)-535.2(on)-5.3(,)-531.8(o)-5.3(r)-529.4(l)-5.4(ea)-6.5(ve)-6.5(,)-531.8(t).3(h)-5.3(e)-530.6(p)-5.3(a)-6.5(th)-5.3(wa)-6.5(y)-529.4(o)-5.3(f)-529.4(b)-5.3(es)-5.1(t)]TJ
0 -1.1174 TD
.0402 Tc
(practice.)Tj
7.3823 0 0 6.5614 97.1716 143.1496 Tm
.0529 Tc
(26)Tj
/F11 1 Tf
8.9663 0 0 8.9663 59.7543 116.8441 Tm
0 Tc
[(Video)-336.9(analysis)]TJ
/F5 1 Tf
9.843 0 0 9.843 69.7323 100.4031 Tm
[(Iterative)-267.2(analy)-8(sis)-262.2(of)-267.1(the)-263.8(video)-266(recording)-271.5(of)-261.4(each)-267.1(dyad)-264.8(was)]TJ
-1.0137 -1.1116 TD
[(performed)-186.2(by)-180.7(two)-182.9(research)-186(assistants)-185.7(who)-182.7(had)-183(been)-185.3(blinded)-181.9(to)]TJ
0 -1.1174 TD
[(patient)-373.3(records.)-376.1(The)-374.3(assistants)-375.8(had)-373.1(been)-369.6(trained)-373.1(to)-370.9(identify)]TJ
0 -1.1116 TD
[(each)-520.5(of)-514.8(Widstro)]TJ
6.52 .023 TD
()Tj
.4147 -.023 TD
[(ms)-516.9(9)-513.7(Stages)-515.6(of)-514.8(newborn)-516.6(behavior.)-521.5(The)]TJ
-6.9347 -1.1116 TD
[(training)-240.7(involved)-234.9(viewing)-234.6(a)-238.4(professional)-240(video)]TJ
7.3823 0 0 6.5614 242.9858 60.9449 Tm
(27)Tj
9.843 0 0 9.843 252.6802 56.5795 Tm
[(that)-236.2(dened)]TJ
5.9095 67.9242 TD
[(and)-609.2(illustrated)-613.9(each)-612.7(stage)-618.3(and)-609.2(then)-610.5(attending)-611.6(a)-612.8(2-hour)]TJ
0 -1.1174 TD
[(workshop)-441.4(about)-438.8(Widstro)]TJ
9.8549 .023 TD
()Tj
.4205 -.023 TD
[(ms)-436.3(9)-438.8(Stages.)-444.1(The)-437.6(two)-442(reviewers)]TJ
-10.2753 -1.1116 TD
[(separately)-315.2(and)-309.7(independently)-317.7(coded)-313.1(all)-310(of)-313.2(the)-309.9(video)-312.1(record-)]TJ
T*
[(ings)-292.3(using)-293.4(MAXQDA)-294.1(11.0.2,)-291.2(2013)-292.4(for)-291.2(the)-292.6(nine)-293.7(stages.)-294.3(This)]TJ
T*
[(required)-541.1(an)-539(iterative)-543.8(process)-539.5(of)-537.8(repeatedly)-545.8(watching)-542.2(the)]TJ
0 -1.1174 TD
[(videos)-180.5(to)-180.9(ne)-182.9(tune)-184.2(the)-183.1(start)-179.5(and)-183(end)-183(time)-179.8(of)-186.5(each)-180.7(stage,)-184(and)-183(the)]TJ
0 -1.1116 TD
[(elements)-330.4(of)-324.7(behavior)-328(of)-324.7(the)-327.1(newborn)-326.5(during)-323.5(that)-328.4(time.)-327.3(Dis-)]TJ
T*
[(agreements)-523.7(were)-525.9(resolved)-523.7(through)-520.4(conversation)-523.6(with)-523.9(the)]TJ
0 -1.1174 TD
(trainer.)Tj
/F3 1 Tf
8.9663 0 0 8.9663 310.8472 613.7006 Tm
(Results)Tj
/F5 1 Tf
9.843 0 0 9.843 320.8251 597.2596 Tm
[(The)-368.5(data)-369.7(in)-365.2(the)-367.5(Algorithm)-375.2(extracted)-371.9(from)-368.4(the)-367.5(video)-369.7(and)]TJ
-1.0137 -1.1116 TD
[(patient)-338.7(record)-331.4(are)-339.7(displayed)-334.9(in)-336.4(Figure)-336(1.)-332.8(This)-339.6(process)-337.9(map,)]TJ
0 -1.1174 TD
[(HCP-S2S-IA,)-304.6(an)-297.1(algorithm,)-304.1(is)-295.9(color)-300.5(coded,)-305(with)-299.3(green)-301.5(indi-)]TJ
0 -1.1116 TD
[(cating)-314.5(the)-315.6(pathway)-316.3(of)-313.2(best)-316.5(practice,)-316.6(yellow)-314.2(indicating)-319.1(prac-)]TJ
T*
[(tices)-376.5(for)-377.6(review,)-382(and)-373.1(red)-378.8(indicating)-382.5(practices)-377.5(that)-380.2(preclude)]TJ
T*
[(achievement)-370.8(of)-365(immediate,)-365.3(uninterrupted,)-366(continuous)-369.4(skin-)]TJ
0 -1.1174 TD
[(to-skin)-215.1(in)-215.4(the)-217.7(rst)-217.3(hour.)-215.2(Robson)-214.8(criteria)-220(for)-216.3(each)-221(mother)-216.4(were)]TJ
0 -1.1116 TD
[(determined)-511.3(from)-506.7(her)-511.3(hospital)-511.3(record)-510(and)-505.6(is)-509(displayed)-513.4(in)]TJ
T*
[(Table)-308.7(2)-312.1(and)-309.7(sorted)-312.9(according)-313(to)-307.6(the)-309.9(data)-312.1(extracted)-314.3(from)-310.8(the)]TJ
0 -1.1174 TD
[(algorithm)-283.4(in)-278.8(Table)-285.6(3.)]TJ
/F11 1 Tf
8.9663 0 0 8.9663 310.8472 474.8597 Tm
[(Prebirth)-332.1(Robson)-336.1(criteria)]TJ
/F5 1 Tf
9.843 0 0 9.843 320.8251 458.4188 Tm
[(According)-232.1(to)-232.7(Robson)-237.8(criteria)-237.2(for)-233.6(this)-229.1(Algorithm)-237(\(Table)-234.9(3\),)]TJ
-1.0137 -1.1116 TD
[(23)-509.1(\(27%\))-507.6(of)-509(the)-511.4(84)-509(participating)-513.8(women)-509.9(were)-514.4(rst-time)]TJ
T*
[(mothers)-344.1(with)-345.4(spontaneous)-348.3(labor)-346.6(\(Robson)-342.6(criteria)-346.7(1\))-347.7(and)-344.3(16)]TJ
0 -1.1174 TD
[(\(19.1%\))-281.8(were)-278.3(rst-time)-283(mothers)-286.5(who)-280.6(were)-278.3(induced)-280.9(\(Robson)]TJ
0 -1.1116 TD
[(criteria)-225.7(2\).)-224.5(Nineteen)-226.5(\(22.6%\))-224.2(were)-226.4(multiparas)-227.8(in)-221.2(spontaneous)]TJ
T*
[(labor)-404.2(\(Robson)-411.7(criteria)-410(3\),)-403(and)-407.6(15)-405.4(\(18%\))-409.7(of)-405.3(the)-407.8(multiparas)]TJ
0 -1.1174 TD
.017 Tc
[(wer)4.4(e)-446(in)4.4(du)4.4(ced)-444.9(\()-1.3(Ro)4.4(bs)4.6(on)-444.9(cri)4.3(t)-1.5(eri)4.3(a)-446(4A\).)-441.4(Ten)-444.9(\()-1.3(1)4.4(1)-1.4(.9)4.4(%\))-444.8(o)4.4(f)-450.6(t)4.2(h)4.4(e)]TJ
0 -1.1116 TD
.015 Tc
[(mothe)-4.5(r)2.4(s)-193.3(w)-4.2(ere)-194.6(categorize)-4.5(d)-193.4(a)1.2(s)-193.2(R)]TJ
12.464 0 TD
.019 Tc
[(o)6.4(b)6.4(s).8(o)6.4(n)-189.4(cr)6.4(it)6.3(er)6.4(i)6.3(a)-190.6(5,)-186(as)-189.3(t)6.3(h).6(e)5.2(y)-189.4(we)5.2(re)]TJ
-12.464 -1.1116 TD
.0129 Tc
[(la)-6.6(bor)-5.4(in)-5.5(g)-379.8(t).2(o)-379.9(h).3(a)-6.6(v).3(e)-381(a)-381(V)-.6(B)-6.5(A)-.6(C)-6.5(,)-376.4(wi)-5.6(th)-379.8(7)-379.9(\()-5.4(8.3%)-6.5(\))-379.8(i).2(n)-379.9(s)-5.3(pon)-5.5(ta)-6.6(neo)-5.5(u).3(s)]TJ
0 -1.1174 TD
[(la)-6.5(bor)-466.1(\()-5.3(5).4(A\))-5.3(,)-462.7(a)-6.5(nd)-466.1(3)-460.4(\()-5.3(3.6)-5.4(%)-.7(\))-466.1(i).3(n)-5.4(duc)-6.5(ed)-466.2(\(5)-5.4(B\))-5.3(.)-462.7(T)-.8(h)-5.4(e)-.8(re)-467.3(wa)-6.5(s)-466(one)]TJ
0 -1.1116 TD
.0178 Tc
[(mo)5.2(th)5.2(er)-311.6(wh)5.2(o)-317.4(m)4(et)-311.7(th)5.2(e)-318.5(c)4(ri)5.1(teri)5.1(a)-318.5(f)5.2(or)-311.6(Ro)5.2(bs)5.4(on)-311.6(8,)-313.9(as)-317.2(sh)5.2(e)-318.5(w)4.3(as)-317.2(an)5.2(-)]TJ
T*
.0171 Tc
[(t)4.4(i)-1.4(ci)4.4(pati)4.4(ng)-277.7(a)-278.9(t)4.4(win)-277.7(b)4.5(ir)4.5(th)4.5(.)]TJ
/F11 1 Tf
8.9663 0 0 8.9663 310.8472 314.0786 Tm
0 Tc
[(Immediate)-334.8(SSC)]TJ
/F5 1 Tf
9.843 0 0 9.843 320.8251 297.6944 Tm
[(The)-414.6(rst)-413.1(criterion)-415.7(for)-417.9(optimal)-413.7(SSC)-418.7(practice)-416.9(is)-416.8(SSC)-412.9(im-)]TJ
-1.0137 -1.1174 TD
[(mediately)-228.1(after)-226.8(birth.)-228(Immediate)-229.2(SSC)-228.6(was)-224(not)-228.1(observed)-229.8(in)-227(10)]TJ
0 -1.1116 TD
[(\(11.9%\))-281.8(of)-284.4(the)-281.1(dyads)-283(in)-284.5(this)-280.9(study)-281.9(due)-286.7(to)-278.8(emergent)-290.1(cesarean)]TJ
T*
[(birth.)-395.1(Reasons)-390.8(for)-394.9(these)-393.7(emergent)-399.5(cesareans)-395.5(included)-397.3(fetal)]TJ
0 -1.1174 TD
[(distress)-211.2(\(three\),)-209.3(nonreassuring)-206.4(fetal)-209.6(heart)-209.5(tracing)-211.8(\(two\),)-205.7(failed)]TJ
0 -1.1116 TD
[(VBAC)-267.4(\(one,)-268.2(whose)-272.3(newborn)-268.9(also)-270.4(had)-263.6(fetal)-273(distress)-268.8(and)-269.4(then)]TJ
T*
[(respiratory)-290.9(failure\),)-291.2(and)-292.4(failed)-291.4(inductions)-288.8(\(four,)-291.1(whose)-289.6(new-)]TJ
0 -1.1174 TD
[(borns)-379.7(also)-379.9(had)-378.8([one])-381(transient)-386.8(tachypnea,)-381([one])-381(respiratory)]TJ
0 -1.1116 TD
[(failure,)-203.7([one])-208.2(primary)-206(apnea)-204.8(of)-203.8(newborn,)-209(and)-200.3([one])-208.2(fetal)-203.9(heart)]TJ
T*
[(murmur\).)-232.4(Twenty-one)-240.1(\(25%\))-236.9(did)-233.8(not)-233.8(get)-235(immediate)-240.9(SSC)-234.4(due)]TJ
0 -1.1174 TD
[(to)-313.3(emergent)-318.9(care)-318.9(required)-322.2(for)-314.3(either)-320.2(the)-315.6(mother)-314.4(or)-318.9(the)-315.6(new-)]TJ
0 -1.1116 TD
[(born)-217.5(after)-226.8(vaginal)-217.7(birth.)-222.3(Reasons)-223.8(for)-222.1(this)-217.6(included)-224.5(respiratory)]TJ
T*
[(failure)-367.3(\(ve)-368.2(newborns\),)-366.5(chorioamnionitis)-373(\(four)-368.3(dyads\),)-368.1(and)]TJ
T*
[(postpartum)-336(hemorrhage)-338.2(\(four)-339.5(mothers\).)-337(Two)-333.7(newborns)-338.9(had)]TJ
0 -1.1174 TD
[(fetal)-382.4(heart)-388.1(murmurs,)-382(one)-384.6(of)-382.3(which)-382.1(also)-385.6(had)-384.6(a)-382.4(mother)-383.5(who)]TJ
0 -1.1116 TD
[(hemorrhaged.)-216(One)-218.4(of)-215.3(the)-217.7(mothers)-211.6(who)-217.3(hemorrhaged)-218.4(also)-218.6(had)]TJ
T*
[(a)-405.4(uterine)-413.4(rupture)-406.4(and)-407.6(her)-413.4(newborn)-407.1(had)-407.6(respiratory)-411.8(failure.)]TJ
0 -1.1174 TD
[(One)-414.3(newborn)-418.7(who)-413.1(was)-419.8()50.8(jittery)46.1()-415.8(went)-415.5(to)-417(the)-413.5(NICU.)-419.5(Two)]TJ
0 -1.1116 TD
[(mothers)-401.7(refused)-401.4(their)-398.6(babies)-400.5(after)-399.6(the)-402(birth,)-395.1(and)-401.9(three)-399.6(had)]TJ
T*
[(meconium-stained)-382(amniotic)-387.1(uid)-378.7(so)-376.4(were)-382(taken)-382.3(directly)-385.9(to)]TJ
0 -1.1174 TD
[(the)-223.5(exam)-232.6(table)-227(after)-226.8(birth)-230.4(before)-227.7(being)-225.7(returned)-230.1(to)-226.9(mother)-228(for)]TJ
0 -1.1116 TD
[(SSC.)-266.6(Twelve)-270.3(\(14.2%\))-264.5(of)-267.1(the)-263.8(dyads)-265.7(who)-269.1(did)-268.4(not)-262.6(receive)-271.6(SSC)]TJ
T*
[(immediately)-433.3(after)-434.1(vaginal)-430.8(birth)-431.9(because)-432.6(of)-428.4(initial)-435.7(medical)]TJ
/F3 1 Tf
8.9663 0 0 8.9663 59.7543 749.7069 Tm
[(MAPPING,)-335.7(MEASURING,)-341.3(AND)-337.2(ANALYZING)-336.9(SKIN-TO-SKIN)-336.9(CONTACT)-20309.5(487)]TJ
ET
endstream
endobj
51 0 obj
<>stream
/GS1 gs
BT
/F5 1 Tf
9.843 0 0 9.843 62.022 364.3086 Tm
0 0 0 rg
0 Tc
0 Tw
[(concerns)-219.4(did)-216.5(begin)-214.1(SSC)-217.1(within)-215.2(5)-214.2(minutes)-217.5(of)-215.3(birth.)-216.5(Fifty-three)]TJ
0 -1.1116 TD
[(dyads)-231.1(\(63.1%\))-224.2(met)-230.5(the)-223.5(standard)-229.9(by)-226.8(receiving)-232.5(immediate)-229.4(SSC)]TJ
T*
[(after)-278.6(planned)-275.1(vaginal)-275.2(birth)-270.7(\(either)-280.9(immediately)-277.8(after)-272.8(birth)-276.4(or)]TJ
T*
[(within)-284.3(5)-277.6(minutes\))-281.9(\(Fig.)-284.2(1\).)]TJ
1.0137 -1.1174 TD
[(Of)-590.5(the)-592.1(23)-589.7(nulliparas)-595.2(who)-591.7(began)-589.6(labor)-594.3(spontaneously)]TJ
-1.0137 -1.1116 TD
[(\(Robson)-319.5(criteria)-329.4(1\),)-316.6(1)-317.9(\(4.3%\))-321(was)-321.9(not)-320.2(observed)-321.9(to)-324.9(have)-317.8(im-)]TJ
T*
[(mediate)-289.2(SSC)-286.2(due)-286.7(to)-284.6(emergent)-284.3(cesarean)-290.9(birth,)-285.6(and)-286.7(5)-283.3(\(21.7%\))]TJ
0 -1.1174 TD
[(did)-245.3(not)-245.3(get)-240.7(immediate)-252.4(SSC)-240.2(because)-248.3(of)-244.1(the)-246.5(need)-242.9(for)-245.1(emergent)]TJ
0 -1.1116 TD
[(care)-399.5(for)-400.7(the)-396.3(mother)-395(or)-399.6(baby)-397.2(after)-399.6(vaginal)-402(birth.)-395.1(Of)-400.5(the)-396.3(16)]TJ
T*
[(induced)-361.5(nulliparas)-364.8(\(Robson)-365.6(criteria)-364(2A\),)-358.9(4)-364(\(25%\))-357.9(were)-364.7(not)]TJ
0 -1.1174 TD
[(observed)-275.9(to)-267.3(have)-277.4(SSC)-269(due)-269.4(to)-273(emergent)-272.8(cesarean)-279.3(birth,)-268.4(and)-275.2(4)]TJ
0 -1.1116 TD
[(\(25%\))-283(did)-285.7(not)-285.7(get)-281.1(immediate)-287(SSC)-286.2(due)-280.9(to)-284.6(the)-286.8(need)-283.2(for)-285.5(emer-)]TJ
T*
[(gent)-224.6(care.)-224.4(Three)-227.9(\(8.8%\))-223.1(of)-221(the)-223.5(34)-221.1(multiparas)-227.8(\(Robson)-221.6(criteria)]TJ
0 -1.1174 TD
[(3)-323.6(and)-321.2(4A\))-320.9(were)-324.4(not)-320.2(observed)-321.9(to)-324.9(have)-323.5(SSC)-320.8(due)-321.2(to)-319.1(emergent)]TJ
0 -1.1116 TD
[(cesarean)-388.8(birth)-380.1(\(1)-382.3(spontaneous)-388.6(labor)-381.1(and)-384.6(2)-381.2(induced\),)-383.3(and)-384.6(7)]TJ
T*
[(\(21.2%\))-373.9(did)-372.1(not)-372.1(get)-373.2(immediate)-379.1(SSC)-372.6(because)-375(they)-374.3(required)]TJ
T*
[(emergent)-192.2(care)-192.2(immediately)-191.4(after)-192.2(birth)-190(\(4)-192.2(spontaneous)-192.7(labor,)-188.8(3)]TJ
0 -1.1174 TD
[(induced\).)-204.7(Of)-198.9(the)-200.4(10)-198(VBAC)-198.3(dyads)-202.3(\(Robson)-198.6(criteria)-208.4(5A)-198.9(and)-200.3(B\),)]TJ
0 -1.1116 TD
.0202 Tc
[(2)-245.8(\()1.9(20%\))-245.8(ha)-5.1(d)-245.8(e).7(mergent)-246(c)-5.1(esarean)-245.8(birth)-245.8(\()-3.9(1)-245.8(s)2(pontaneous)-245.6(labor)]TJ
T*
.019 Tc
[(an)-5.1(d)-437.1(1)-442.9(indu)-5.1(ced)-5.1(\))-437.1(a)-.5(n)-5.1(d)-437.1(4)-442.9(\().7(40)-5.1(%\))-437.1(r)-5.1(e)-.5(qui)-5.3(red)-442.9(e)-.5(mer)-5.1(g).6(en)-5.1(t)-437.2(c)-.5(a)-6.3(r).7(e)-438.3(\()-5.1(3)]TJ
0 -1.1174 TD
.0187 Tc
[(sp)-5.4(ont)-5.6(aneo)-5.4(us)-396.9(l)-5.6(a)-.8(bor)-402.8(and)-397.1(1)-397.1(i)-5.6(nduc)-6.6(ed\))-5.4(.)-393.7(Th)-5.4(e)-398.3(one)-398.3(s)-5.2(e)-.8(t)-397.2(o).3(f)-397.1(t)-5.6(win)-5.4(s)]TJ
0 -1.1116 TD
[(\(R)-6.5(obs)-5.2(on)-443.2(cr)-5.4(ite)-6.6(ria)-450.1(8).3(\))-443.1(r).4(e)-6.6(qui)-5.6(red)-443.2(e)-6.6(merg)-5.4(ent)-449.1(care)-450.1(a)-.8(nd)-443.2(d)-5.4(i).2(d)-443.2(n).3(o)-5.4(t)]TJ
T*
.0202 Tc
[(experienc)-5.1(e)-275.8(immediate)-281.6(S)-3.8(SC.)]TJ
/F11 1 Tf
8.9663 0 0 8.9663 62.022 94.9039 Tm
0 Tc
[(Continuous)-332.9(SSC)]TJ
/F5 1 Tf
9.843 0 0 9.843 72 78.463 Tm
[(The)-201.5(second)-204.6(criterion)-202.6(of)-198(optimal)-200.6(SSC)-205.6(practice)-203.8(is)-198(continuous)]TJ
-1.0137 -1.1116 TD
[(SSC.)-255.1(The)-259.1(process)-257.3(map)-259.1(Algorithm)-260(illustrates)-256.6(that)-259.3(5)-254.5(\(9.4%\))-257.6(of)]TJ
T*
[(the)-350.2(53)-347.8(dyads)-346.3(who)-349.8(began)-347.7(SSC)-349.6(immediately)-352.6(after)-347.7(birth)-345.6(were)]TJ
25.504 31.2637 TD
[(removed)-276.2(\(4)-267.1(for)-268.2(emergent)-272.8(care)-267(and)-269.4(1)-271.8(for)-268.2(routine)-268.3(care\))-268.1(and)-269.4(48)]TJ
0 -1.1116 TD
[(\(90.6%\))-293.3(continued)-294.7(on)-295.9(the)-292.6(best)-293.5(practice)-295.9(pathway.)-290.9(Of)-296.8(the)-292.6(ve)]TJ
T*
[(removed)-443.2(dyads,)-436.1(four)-442.1(were)-439.5(nulliparas)-439.7(\(two)-437.4(in)-440.1(spontaneous)]TJ
T*
[(labor)-306.3([Robson)-308(1A],)-301.3(two)-303.8(induced)-303.9([Robso)-7.4(n)-300.6(2A],)-301.3(and)-304(one)-304(was)]TJ
0 -1.1174 TD
[(an)-343.2(induced)-338.5(multipara)-347.9([Robson)-336.8(4A]\).)-342.7(One)-339.4(induced)-344.2(nullipara)]TJ
0 -1.1116 TD
[(\(Robso)-7.4(n)-312.1(2A\))-309.4(was)-316.2(removed)-316.5(for)-308.5(the)-315.6(routine)-314.4(care)-318.9(of)-307.4(weighing)]TJ
T*
.0225 Tc
[(an)4.1(d)-381.8(m)2.9(eas)4.3(u)-1.6(r)4.2(i)4(ng)-381.8(t)4(h)4.1(e)-388.7(n)4.1(ewbo)4.1(r)4.2(n)-1.6(.)-384.1(T)2.9(h)4.1(e)-382.9(newb)4.1(or)4.2(n)4.1(s)-387.3(r)4.2(e)3(mov)4.1(e)3(d)-381.8(f)-1.6(o)4.1(r)]TJ
0 -1.1174 TD
.0187 Tc
[(e)-6.6(m)-.9(erg)-5.4(e)-.8(nt)-374.2(care)-375.2(w)-.5(er)-5.4(e)-369.5(t).2(wo)-374.1(sp)-5.4(onta)-6.6(n).3(eou)-5.4(s)-368.1(n)-5.4(u).3(lli)-5.6(par)-5.4(a)-.8(s)-368.1(\()-5.4(Robs)-5.2(on)]TJ
0 -1.1116 TD
[(1)-5.5(\)).3(,)-393.8(one)-392.6(in)-5.5(duc)-6.7(ed)-391.4(nul)-5.7(lip)-5.5(ara)-392.6(\().3(R)-6.6(obs)-5.3(on)-391.4(2A\))-391.4(a)-6.7(nd)-391.4(on)-5.5(e)-386.8(i)-5.7(ndu)-5.5(ced)]TJ
T*
[(m)-6.7(u).3(lt)-5.6(ipar)-5.4(a)-432.8(\().4(Rob)-5.4(s).5(on)-431.7(4)-5.4(A)-.5(\),)-434(and)-431.7(b).3(o)-5.4(t).2(h)-431.7(s).5(p)-5.4(onta)-6.6(n).3(eo)-5.4(us)-431.5(nul)-5.6(lip)-5.4(ara)]TJ
0 -1.1174 TD
.0205 Tc
[(neonates)-199.3(were)-194.9(examined)-193.7(by)-199.5(the)-200.6(N)1.3(IC)-4.7(U)-194.6(t)2(ea)-4.8(m)-194.9(f)2.2(or)-193.7(more)-194.9(than)-193.7(5)]TJ
0 -1.1116 TD
.0188 Tc
[(m)-6.6(i).3(nu)-5.3(tes.)-370.5(The)-369.4(o).4(th)-5.3(er)-368.2(two)-368.2(w)-.4(er)-5.3(e)-363.6(e)-6.5(xamin)-5.3(e)-.7(d)-368.2(b).4(y)-368.2(t).3(he)-369.4(lab)-5.3(o).4(r)-368.2(a)-.7(nd)]TJ
T*
.0186 Tc
[(d)-5.5(e)-.9(li)-5.7(ver)-5.5(y)-454.8(nu)-5.5(rse)-6.7(s)-454.6(an)-5.5(d)-454.8(r)-5.5(etur)-5.5(ned)-460.5(t).1(o)-460.5(SSC)-461.6(aft)-5.7(e)-.9(r)-460.5(m)-1(ore)-461.7(t).1(ha)-6.7(n)-454.8(5)]TJ
0 -1.1174 TD
.0248 Tc
[(mi)6.3(n)6.4(u).7(t)6.3(e)5.3(s)-275.6(a)5.3(pa)5.3(r)6.5(t).5(.)]TJ
/F11 1 Tf
8.9663 0 0 8.9663 313.0582 199.5023 Tm
0 Tc
[(Uninterrupted)-339.2(SSC)]TJ
/F5 1 Tf
9.843 0 0 9.843 323.0361 183.0614 Tm
[(All)-303.9(48)-301.7(\(57.1%\))-304.8(of)-307.4(the)-304.1(remaining)-301.7(dyads)-306(had)-304(uninterrupted)]TJ
-1.0137 -1.1116 TD
[(SSC,)-283.9(not)-279.9(interrupted)-285.5(by)-278.7(either)-285.6(staff)-283(or)-278.6(family.)]TJ
/F11 1 Tf
8.9663 0 0 8.9663 313.0582 149.726 Tm
(Widstro)Tj
3.0729 .019 TD
()Tj
.3161 -.019 TD
[(ms)-333.2(9)-333.2(stages)-332(of)-336.7(newborn)-330.5(behaviors)]TJ
/F5 1 Tf
9.843 0 0 9.843 323.0361 133.285 Tm
[(Of)-458.1(the)-459.6(48)-457.2(dyads)-461.5(who)-459.2(received)-462.8(immediate)-459.8(and)-459.5(uninter-)]TJ
-1.0137 -1.1116 TD
[(rupted)-186.4(SSC,)-180.2(23)-180.7(\(47.9%\))-178.1(achieved)-186.4(the)-183.1(standard)-183.8(of)-180.7(best)-184.1(practice)]TJ
0 -1.1174 TD
[(by)-607(demonstrating)-605.5(the)-603.6(instinctive)-602.4(behaviors)-605.4(described)-606.6(in)]TJ
0 -1.1116 TD
[(Widst)-7.8(ro)]TJ
2.8165 .023 TD
()Tj
.4147 -.023 TD
[(ms)-217.4(9)-214.2(Stages)-216.1(and)-211.8(suckling)-217.4(in)-209.7(the)-217.7(rst)-211.5(hour)-217.5(\(the)-213(eighth)]TJ
-3.2312 -1.1116 TD
[(stage\))-8.8(,)-406.6(and)-413.4(25)-411.1(\(52.1%\))-414.2(did)-412.4(not.)-410(Of)-412(the)-413.5(15)-411.1(nulliparas)-416.7(with)]TJ
0 -1.1174 TD
[(sponta)-7.7(neous)-582.4(labor)-582.7(\(Robson)-584.5(1\),)-587.3(7)-582.8(\(46.7%\))-581.3(of)-583.9(the)-586.3(dyads)]TJ
0 -1.1116 TD
[(achieved)-468.6(the)-465.4(standard)-466.1(and)-465.2(8)-461.9(\(53.3%\))-466.1(did)-464.2(not.)-461.9(Of)-469.6(the)-459.6(six)]TJ
T*
[(nulliparas)-197.8(who)-200(were)-191.9(induced)-200.2(\(Robson)-192.8(2A\),)-197.6(none)-195.6(achieved)-197.9(the)]TJ
ET
/EmbeddedDocument /MC1 BDC
/Document /MC2 BDC
q
1 i
464.595 726.931 -243.599 -261.118 re
220.997 726.931 m
W n
q
243.876 0 0 261.156 220.977 465.792 cm
/Im1 Do
Q
Q
0 0 0 .39676 k
1 i
q 1 0 0 1 471.338 447.965 cm 0 0 m
2.584 0 l
2.584 23.189 l
7.75 23.189 l
7.75 0 l
10.334 0 l
5.167 -5.167 l
0 0 l
f*
Q
q 1 0 0 1 414.628 508.205 cm 0 0 m
2.583 0 l
2.583 24.998 l
7.75 24.998 l
7.75 0 l
10.331 0 l
5.166 -5.167 l
0 0 l
f*
Q
q 1 0 0 1 282.262 649.594 cm 0 0 m
2.56 0 l
2.56 40.542 l
7.686 40.542 l
7.686 0 l
10.246 0 l
5.12 -5.12 l
0 0 l
f*
Q
q 1 0 0 1 256.431 649.594 cm 0 0 m
2.56 0 l
2.56 25.675 l
7.686 25.675 l
7.686 0 l
10.247 0 l
5.121 -5.12 l
0 0 l
f*
Q
0 0 0 .39676 K
0 J 0 j .861 w 10 M []0 d
/GS2 gs
q 1 0 0 1 159.769 726.929 cm 0 0 m
-1.234 -268.632 l
S
Q
0 0 0 0 k
149.582 680.923 18.999 39.262 re
f
.74609 .74609 .26563 .097656 K
1 J .574 w
149.582 680.923 18.999 39.262 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
152.365 681.244 m
152.365 681.244 15.911 38.642 re
W* n
152.359 681.25 m
152.359 681.25 15.912 38.642 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F13 1 Tf
0 11.503 -11.503 -0 163.2418 683.0404 Tm
.74609 .74609 .26563 .097656 k
-.001 Tc
(BIRTH )Tj
ET
Q
.18359 .80078 .70703 .054688 k
249.314 703.166 103.32 11.997 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
249.36 705.214 m
249.36 705.214 103.267 7.8531 re
W* n
249.36 705.221 m
249.36 705.221 103.263 7.8525 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 253.4913 707.22 Tm
0 0 0 0 k
-.0011 Tc
.0056 Tw
[(No: Eme)10.6(r)5.9(g)-8.1(e)-1.4(nt Care )9.7(f)-13.9(o)10.8(r )9.5(M)17( or I )]TJ
ET
Q
.74609 .74609 .26563 .097656 k
174.981 680.435 51.659 40.122 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
175.026 682.484 m
175.026 682.484 51.6 27.689 re
W* n
175.022 682.49 m
175.022 682.49 51.605 27.69 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F13 1 Tf
6.3369 0 0 6.337 185.2144 704.3958 Tm
0 0 0 0 k
.0004 Tc
[(Im)8.2(media)9.3(te )]TJ
-.75 -1.2717 TD
.0002 Tc
[(Skin-to)12.3(-Skin?)13.3( )]TJ
ET
Q
.11719 .20313 .95313 0 k
249.314 687.208 103.32 11.968 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
249.36 689.304 m
249.36 689.304 103.267 7.7842 re
W* n
249.36 689.31 m
249.36 689.31 103.263 7.7831 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 253.4913 691.2396 Tm
0 0 0 0 k
.0038 Tw
[(Yes: Delay)11.9( up to)11.7( 5 )10.8(minut)5.2(e)-.2(s )]TJ
ET
Q
.47656 .15625 .65234 .003906 k
249.314 670.419 103.32 11.968 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
249.36 672.497 m
249.36 672.497 103.267 7.7831 re
W* n
249.36 672.503 m
249.36 672.503 103.263 7.7832 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 253.4913 674.4321 Tm
0 0 0 0 k
-.0002 Tc
-.002 Tw
[(Yes: Im)5.9(mediate)8.7( )-5.1(S)12.9(k)-9.1(in-to)10.7(-)5.8(Sk)-9.3(in)8.7( )]TJ
ET
Q
.74609 .74609 .26563 .097656 k
249.027 601.28 49.623 39.262 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
249.085 603.329 m
249.085 603.329 49.593 26.864 re
W* n
249.085 603.329 m
249.085 603.329 49.593 26.864 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F13 1 Tf
6.3369 0 0 6.337 256.3153 624.4088 Tm
0 0 0 0 k
-.0025 Tc
[(Conti)-5.4(n)-2.4(uous)7.2( )]TJ
-.4456 -1.2826 TD
0 Tc
[(Skin-to)12.3(-)-3.1(Skin?)13.2( )]TJ
ET
Q
.18359 .80078 .70703 .054688 k
321.639 632.305 103.319 11.969 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
321.686 634.394 m
321.686 634.394 103.278 7.7842 re
W* n
321.686 634.394 m
321.686 634.394 103.278 7.7842 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 325.8279 636.3249 Tm
0 0 0 0 k
.0005 Tc
.0043 Tw
[(No: Remov)10.4(ed )10(for)9.4( Eme)12.4(r)6.5(gent Care)11.4( )]TJ
ET
Q
321.639 615.516 103.319 11.967 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
321.686 617.594 m
321.686 617.594 103.278 7.783 re
W* n
321.686 617.588 m
321.686 617.588 103.278 7.783 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 325.8279 619.5168 Tm
0 0 0 0 k
-.0005 Tc
.0036 Tw
[(No: Remov)9.4(e)-.8(d )8.1(for)8.4( Routin)11.4(e).2( Care)8.5( )]TJ
ET
Q
.74609 .74609 .26563 .097656 k
321.582 530.104 51.66 39.262 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
321.616 532.165 m
321.616 532.165 51.677 26.793 re
W* n
321.616 532.165 m
321.616 532.165 51.674 26.793 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F13 1 Tf
6.3369 0 0 6.337 326.5859 553.1752 Tm
0 0 0 0 k
[(Uninterrup)12.1(t)0(ed)11.2( )]TJ
.0762 -1.2719 TD
[(Skin-to)12.1(-)-3.1(Skin?)13.2( )]TJ
ET
Q
0 0 0 .39676 k
q 1 0 0 1 342.303 578.148 cm 0 0 m
2.584 0 l
2.584 25.429 l
7.748 25.429 l
7.748 0 l
10.332 0 l
5.167 -5.166 l
0 0 l
f*
Q
.47656 .15625 .65234 .003906 k
321.639 599.386 103.319 11.967 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
321.686 601.475 m
321.686 601.475 103.278 7.7839 re
W* n
321.686 601.469 m
321.686 601.469 103.278 7.7839 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 325.8279 603.4 Tm
0 0 0 0 k
-.0014 Tc
.0062 Tw
[(Yes: Continuous)9.6( S)11.5(k)-10.5(in-to-Sk)-11.4(i).3(n)10.5( )]TJ
ET
Q
.18359 .80078 .70703 .054688 k
393.963 560.152 103.319 11.997 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
394.026 562.191 m
394.026 562.191 103.262 7.8519 re
W* n
394.02 562.196 m
394.02 562.196 103.262 7.853 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 398.1526 564.1942 Tm
0 0 0 0 k
.0004 Tc
.0044 Tw
[(No: Sta)12.1(f)-2.5(f i)14.1(n).2(te)9.3(r)6.4(f)-12.6(e)12.3(r)-1.6(ed)-5.9( )]TJ
ET
Q
.47656 .15625 .65234 .003906 k
393.963 527.061 103.319 11.968 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
394.026 529.133 m
394.026 529.133 103.262 7.7839 re
W* n
394.02 529.133 m
394.02 529.133 103.262 7.7839 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 398.1526 531.0643 Tm
0 0 0 0 k
.0001 Tc
-.0092 Tw
[(Yes )]TJ
ET
Q
q
96.888 732.245 420.378 -304.384 re
W n
.74609 .74609 .26563 .097656 k
393.936 427.861 92.987 11.924 re
f
Q
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
393.957 429.797 m
393.957 429.797 93 7.853 re
W* n
393.951 429.793 m
393.951 429.793 93.001 7.853 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F13 1 Tf
6.3369 0 0 6.337 411.8595 431.8618 Tm
0 0 0 0 k
.0127 Tw
[(Standard A)35.7(c)-.2(hiev)13(ed)-10( )]TJ
ET
Q
.18359 .80078 .70703 .054688 k
249.314 720.099 103.32 11.996 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
249.36 722.159 m
249.36 722.159 103.267 7.8691 re
W* n
249.36 722.166 m
249.36 722.166 103.263 7.8661 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 253.4913 724.1652 Tm
0 0 0 0 k
-.0001 Tc
.0049 Tw
[(No: Hospital Policy)9.9( or P)12.8(r)5.9(otocol )]TJ
ET
Q
466.287 482.375 20.664 11.969 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
466.356 484.419 m
466.356 484.419 20.595 7.7849 re
W* n
466.362 484.414 m
466.362 484.414 20.595 7.783 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 472.6282 486.3446 Tm
0 0 0 0 k
-.0028 Tc
(No )Tj
ET
Q
0 0 0 0 k
97.175 680.435 45.461 39.492 re
f
.47656 .15625 .65234 .003906 K
97.175 680.435 45.461 39.492 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
97.451 680.762 m
97.451 680.762 44.858 33.475 re
W* n
97.451 680.768 m
97.451 680.768 44.854 33.476 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F13 1 Tf
8.0589 0 0 8.059 101.582 706.8753 Tm
.74609 .74609 .26563 .097656 k
-.0011 Tc
[(Robsons)-7.2( )]TJ
.5213 -1.2393 TD
.0011 Tc
.0018 Tw
[(Crite)9(r)-1.1(ia)9( )]TJ
.3334 -1.2736 TD
.0007 Tc
0 Tw
(Noted )Tj
ET
Q
.74609 .74609 .26563 .097656 k
393.963 460.362 51.66 39.263 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
394.026 462.378 m
394.026 462.378 51.601 30.996 re
W* n
394.02 462.374 m
394.02 462.374 51.607 30.996 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F13 1 Tf
6.3369 0 0 6.337 402.6285 487.5836 Tm
0 0 0 0 k
-.0003 Tc
-.0019 Tw
[(Widst)5.7(r)-.4(m)7.5(s )]TJ
.6629 -1.2392 TD
0 Tc
0 Tw
(9 Stages )Tj
-.3803 -1.2935 TD
-.0008 Tc
[(achiev)10(ed? )]TJ
ET
Q
.47656 .15625 .65234 .003906 k
466.287 466.218 20.664 11.968 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
466.356 468.232 m
466.356 468.232 20.595 7.852 re
W* n
466.362 468.229 m
466.362 468.229 20.595 7.852 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 471.2512 470.2256 Tm
0 0 0 0 k
-.0019 Tc
(Yes )Tj
ET
Q
.18359 .80078 .70703 .054688 k
393.907 543.248 103.319 11.968 re
f
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
393.957 545.314 m
393.957 545.314 103.331 7.7839 re
W* n
393.951 545.321 m
393.951 545.321 103.331 7.783 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
6.3369 0 0 6.337 398.0836 547.2523 Tm
0 0 0 0 k
-.0002 Tc
.005 Tw
[(No: Fa)13.4(mily)10.6( inter)4.9(f)-13.2(ered)-7.2( )]TJ
ET
Q
0 0 0 0 k
97.175 665.367 45.461 10.218 re
f
0 0 0 .39676 K
.3 w
97.175 665.367 45.461 10.218 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
97.312 665.54 m
97.312 665.54 45.203 8.6786 re
W* n
97.312 665.545 m
97.312 665.545 45.199 8.6797 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 117.3553 669.1294 Tm
0 0 0 .39371 k
-.003 Tc
(84 )Tj
ET
Q
174.952 665.367 51.374 10.218 re
f
174.952 665.367 51.374 10.218 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
175.095 665.54 m
175.095 665.54 51.118 8.6786 re
W* n
175.09 665.545 m
175.09 665.545 51.123 8.6797 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 198.0946 669.1294 Tm
0 0 0 .39371 k
-.003 Tc
(53 )Tj
ET
Q
q 1 0 0 1 355.477 720.127 cm 0 0 m
0 0 16.932 11.969 re
S 1 0 0 1 0 -16.989 cm 0 0 m
0 0 16.932 11.967 re
S
Q
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
355.592 705.284 m
355.592 705.284 16.806 5.5791 re
W* n
355.585 705.289 m
355.585 705.289 16.809 5.5801 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 361.4398 706.6683 Tm
0 0 0 .39371 k
-.003 Tc
(31 )Tj
ET
Q
355.477 670.305 16.932 11.967 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
355.592 672.428 m
355.592 672.428 16.806 5.5786 re
W* n
355.585 672.434 m
355.585 672.434 16.809 5.5791 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 361.4398 673.813 Tm
0 0 0 .39371 k
-.003 Tc
(41 )Tj
ET
Q
355.477 687.323 16.932 11.968 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
355.592 689.442 m
355.592 689.442 16.806 5.5791 re
W* n
355.585 689.447 m
355.585 689.447 16.809 5.58 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 361.4398 690.8265 Tm
0 0 0 .39371 k
-.003 Tc
(12 )Tj
ET
Q
249.027 586.212 49.623 10.333 re
f
249.027 586.212 49.623 10.333 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
249.222 586.391 m
249.222 586.391 49.319 8.7469 re
W* n
249.222 586.385 m
249.222 586.385 49.319 8.7469 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 271.3322 589.968 Tm
0 0 0 .39371 k
-.003 Tc
(48 )Tj
ET
Q
321.582 514.922 51.258 10.332 re
f
321.582 514.922 51.258 10.332 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
321.77 515.076 m
321.77 515.076 50.972 8.7469 re
W* n
321.754 515.082 m
321.754 515.082 50.985 8.7469 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 344.7009 518.6664 Tm
0 0 0 .39371 k
-.0028 Tc
(48 )Tj
ET
Q
427.8 632.277 16.934 11.997 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
427.921 634.4 m
427.921 634.4 16.806 5.6489 re
W* n
427.928 634.394 m
427.928 634.394 16.806 5.6485 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 435.0214 635.8415 Tm
0 0 0 .39371 k
-.0028 Tc
(4 )Tj
ET
Q
427.8 615.544 16.934 11.997 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
427.921 617.656 m
427.921 617.656 16.806 5.6489 re
W* n
427.928 617.656 m
427.928 617.656 16.806 5.6489 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 435.0214 619.1039 Tm
0 0 0 .39371 k
-.0028 Tc
(1 )Tj
ET
Q
427.8 599.414 16.934 11.997 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
427.921 601.538 m
427.921 601.538 16.806 5.6479 re
W* n
427.928 601.538 m
427.928 601.538 16.806 5.6479 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 433.7814 602.9869 Tm
0 0 0 .39371 k
-.003 Tc
(48 )Tj
ET
Q
q
96.888 732.245 420.378 -304.384 re
W n
q 1 0 0 1 500.24 560.152 cm 0 0 m
0 0 16.933 11.997 re
S 1 0 0 1 -.029 -16.933 cm 0 0 m
0 0 16.934 11.968 re
S 1 0 0 1 0 -16.158 cm 0 0 m
0 0 16.934 11.996 re
S
Q
Q
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
500.383 529.196 m
500.383 529.196 16.737 5.579 re
W* n
500.39 529.203 m
500.39 529.203 16.736 5.5779 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 506.243 530.5814 Tm
0 0 0 .39371 k
-.0028 Tc
(48 )Tj
ET
Q
489.763 482.634 16.936 11.997 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
489.913 484.764 m
489.913 484.764 16.739 5.58 re
W* n
489.919 484.758 m
489.919 484.758 16.738 5.58 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 495.7751 486.1376 Tm
0 0 0 .39371 k
-.003 Tc
(25 )Tj
ET
Q
489.794 466.333 16.933 11.997 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
489.913 468.439 m
489.913 468.439 16.807 5.649 re
W* n
489.919 468.435 m
489.919 468.435 16.808 5.649 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 495.7751 469.8817 Tm
0 0 0 .39371 k
-.003 Tc
(23 )Tj
ET
Q
q
96.888 732.245 420.378 -304.384 re
W n
489.794 427.903 16.933 11.996 re
S
Q
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
489.913 430.004 m
489.913 430.004 16.807 5.647 re
W* n
489.919 429.999 m
489.919 429.999 16.808 5.649 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 495.7751 431.4478 Tm
0 0 0 .39371 k
-.003 Tc
(23 )Tj
ET
Q
393.907 444.865 51.258 10.331 re
f
393.907 444.865 51.258 10.331 re
S
q
96.922 741.573 m
96.922 741.573 420.321 -313.751 re
W n
394.095 444.951 m
394.095 444.951 50.98 8.817 re
W* n
394.091 444.947 m
394.091 444.947 50.984 8.8169 re
W* n
96.888 732.245 420.378 -304.384 re
W n
BT
/F14 1 Tf
4.6149 0 0 4.615 417.0255 448.6677 Tm
0 0 0 .39371 k
-.003 Tc
(23 )Tj
ET
EMC
EMC
Q
/GS1 gs
BT
/F6 1 Tf
9.845 0 0 9.845 62.022 409.0959 Tm
0 0 0 rg
[(FIG.)-457.7(1.)]TJ
/F5 1 Tf
4.2383 0 TD
-.02 Tc
[(H)-39.1(e)-45.2(a)-39.4(l)-38.4(t)-38.4(h)-44(y)-493.2(c)-45.2(h)-38.3(i)-38.4(l)-44.2(d)-38.3(r)-38.3(e)-39.4(n)-499(p)-38.3(r)-44(o)-38.3(j)-38.4(e)-45.2(c)-39.4(t)-38.4()-38.3(s)-498.8(s)-43.9(k)-38.3(i)-38.4(n)-44(-)-38.3(t)-38.4(o)-38.3(-)-44(s)-38.1(k)-44(i)-38.4(n)-493.2(i)-44.2(m)-39.4(plementation)-452.9(a)-4.9(l)1.9(gorithm)-459.8(w)1.2(ith)-458.6(LLUM)-4.5(C)-453.9(data)-4.9(.)-455.3(LLU)-4.5(MC,)-461(L).9(oma)-459.8(L)-33.7(i)-26.9(n)-32.5(d)-26.7(a)]TJ
-4.2383 -1.0135 TD
.0093 Tc
[(U)-4(n)2.5(ive)-4.4(r)2.5(sity)-337.2(Me)-4.4(dica)-4.4(l)-331.6(C)-4.2(ente)-4.4(r.)]TJ
/F3 1 Tf
8.9663 0 0 8.9663 62.022 749.6502 Tm
0 Tc
(488)Tj
46.1067 0 TD
[(CADWELL)-335.2(ET)-338.7(AL.)]TJ
ET
endstream
endobj
62 0 obj
<>stream
h ˮl۶ɶm۶m۶];1nCІ1o1l0m&_3Ll0LmӚf0l0m[,n KZҖ,o+ZVլn
kZֱo6ln[ֶlo;vn{ :qG:юq':NqӜg:q.q\
Wծq\7nqwqz< OzӞ</z^
oz>|_|?~
endstream
endobj
55 0 obj
<>stream
Adobe d C
s !1AQa"q2B#R3b$r%C4Scs5D'6Tdt&
EFVU(eufv7GWgw8HXhx)9IYiy*:JZjz ? lٰf>oZOZ>9QCK5d Jwɇ/l"gg}O79yg=m/}_n7lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳgm{ˏ!~4_Sk.dgO9~|Y(mId!QH,M .Ev$i>eҥ
],|2_`sE=Ny+6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lҿ2 \Y6[9z֒,2Hqח7w.O!,j$f͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͝+/ %o5 I
+6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳgfO_O˙|^jipA#"Go>ZuXolID<єN|E6h7>rߗl=O0y~KwJP7=dQ3f͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛:u_O[EN. EO+#ZZi0y*CE
#=Gs9c49-^Sy2yIdvlZsc/Jבf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳfk+Xncі9YQ_UV0WTD T *ݢZaVy?JxdG'vXq2U=r\ٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛:W_K/fkHү5mRKUkRuwXԼjUTT'蚮:nbQ#9f͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͝]~Y]ɩwed#Pt"_r_ T3y?p|ݧjwVSOd#zt,GFT{6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳ~e mF@tqVje
f0/.=+&
=&D
NǧAٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳfΕ ٷsf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6l_.,{ Q-.]V-Zy-ǙI%vD$r v ?_J&+uA^u9͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6l6 R.jZsi|4)!! CY OZhZS˾^/YF^DH֨{6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳ`Rm3UV&)C!F
D䦛5ki.uj\DD$qʣ
3f͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳd͟z.OMgZj#mԪsmgCVDndG6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳyCȺךغiֶQA
1HܛR6q \ y w }ӝ/-+_\@1_Nkj${ wC<h9ax
Zplٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳ? m/MO%>mçDpELJzE!ȖY|-6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lt~k ޗ &m6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳgIAz_9Lvt/iЯMybR9U8IiyzQ
h!f͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٲaM[KhOQYm8]?/oP" ?X i:#~Pyx<&vMK$9'Y}/T ~CԟUtʝSH0ڎ6ൎ_^j:gkɴy-4&vI#(6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lt~k ޗ &m?6yZ,uȊK`[}?K_J* @5F$s6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳ? m/MO6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳfΓ _5>sly?+ou8uNjjMxlGAf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛'>J4O+[<5;ShRKuu]V' ?(9?+|-/H|7ǗuԥE-OA
1 ~~'=Iٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lVm%vݝD"eB~"HrWټ]SN`_FZ,}f_Td?FCf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛6lٳf͛:~Zi:?|ɢ^ڭ5FWoNJoȿuOپt*kZO垳j[Ӽ/e_j?ZmBg 3GW t