Pregnancy and Childbirth Chapter Eight Pregnancy and Childbirth

Deciding to Become a Parent Your physical health and age Financial circumstances Your relationship to your partner Your educational, career, and child care plans Your emotional readiness for parenthood Your social support system Your personal qualities, attitudes towards children, and aptitude for parenting Your philosophical or religious beliefs

Preconception Care The birth of a healthy baby depends in part on the mother’s overall wellness before conception The U.S. Public Health Service recommends the following type of Preconception Care: Assessment of health risks Promotion of Healthy Lifestyles behavior Treatment of any problems that will increase health risks See Dimensions of Diversity Box on “Ethnicity and Genetic Diseases”

Understanding Fertility Conception involves an ovum from a woman and sperm from the man The sperm and egg must meet in the fallopian tube, which after fertilization, will travel to the uterus for implantation (zygote) It there is no union, the egg will disintegrate within 24 hours and expelled with the uterine lining during menstruation See Figure 8-1 on the process of conception See Box: Creating a Family Health Tree”

Identify Aids to Fertilization Sperm can travel 1 inch/hour Sperm can live for days inside the fallopian tubes (approx. 48-72 hours)

Causes of Infertility Low sperm count Poor sperm motility Sperm abnormalities Lack of ovulation Obstruction of fallopian tubes PID Endrometrosis Age

Treating Infertility Surgery Fertility drugs Surrogate Motherhood Intrauterine Insemination IVF, GIFT, and ZIFT in vitro fertilization gamete intrafallopian transfer zygote intrafallopian transfer See Box: “Reproductive Technology”

Early Signs of Pregnancy Missed menstrual period after sexual intercourse the previous month Morning sickness/nausea Increase in size/tenderness of breasts Slight bleeding Sleepiness, fatigue, and emotional upset See Figure 8-2 on changes that occur to a woman’s body during pregnancy

Continuing Changes in the Woman’s Body Increased frequency of urination Enlargement of the uterus Breast enlargement and increased sensitivity Increased in the size of the abdomen Cervix becomes softer by the sixth week

Changes During the Later Stages of Pregnancy Backaches from the baby’s weight Joint swelling Braxton Hicks contractions “Lightening” of the fetus See Figure 8-3

Emotional Responses to Pregnancy Both partners may have anxiety about the approaching birth Rapid changes in hormone levels can cause a pregnant woman to experience unpredictable emotions such as fears of possible dangers to the fetus Periods of depression due to physical appearance and limited physical ability could occur See Box: “Pregnancy Tasks for Fathers” See Box: “Gender Matters”

Fetal Development (First Trimester) After 30 hours, the fertilized egg goes through many forms of cell division A Blastocyst is formed by the 4th day after fertilization An embryo is created by the end of the 2nd week from the blastocyst separating into 3 layers The outermost shell of cells becomes the placenta, umbilical cord, and amniotic sac Between weeks 2-9, all major body structures are formed, including the heart, brain, liver, lungs, and sex organs See Figure 8-4 on fetal development See Figure 8-5 on blastocyst becoming an embryo After the second month, the embryo will become a fetus

The Second Trimester Growth improves to about 14 inches and the weight increases to 1.5 lbs. All body systems are working and the fetal heartbeat can be heard Fetal movements can be felt by the mother, beginning by the 4th to 5th month

The Third Trimester The fetus gains most of its weight during the last 3 months Fat layers are acquired during the 8th month as well as acquired immunity from the mother Importance is placed on providing the fetus with important nutrients The respiratory and digestive organs are developing at this stage

Diagnosing Fetal Abnormalities Ultrasonography (ultrasound) Amniocentesis (removal of fluid from uterus) Chorionic villus sampling (removal via cervix) Triple marker screen (TMS) See Box: “Mind, Body, Spirit’ The above methods are considered as a new area of study called Fetal Programming

Importance of Prenatal Care Regular Checkups Blood tests Prenatal Nutrition Tobacco Caffeine Avoiding drugs and other environmental agents Alcohol (FAS) Accutane (acne drug) STD’s and other infections Proper activity/exercise See “Take Charge” Box See Table 8-1 on environmental factors affecting fetal or infant development

Complications in Pregnancy and Pregnancy Loss Ectopic pregnancy – implantation in the fallopian tube Miscarriage – usually due to abnormalities in the first few weeks Preeclampsia – blood pressure becomes elevated and could be life threatening Low Birth Weight – (LBW) is when a baby weighs less than 5.5 lbs Infant Mortality – death of a child less than one year of age i.e. (SIDS)

3 Stages of Labor Effacement/Dilation of the cervix: cervix opens to 10cm during this stage Delivery of the fetus: “crowning” of the fetus Delivery of the placenta: within 30 minutes afterbirth is expelled See Box: Critical Consumer See Figure 8-6 on the 3 stages of labor

Cesarean Deliveries (C-section) Fetus is removed from the uterus through the abdominal wall due to the following factors: Fetus is improperly positioned Mother’s pelvis is too small Fetus is especially large Fetus shows signs of distress Umbilical cord is compressed Placenta is being delivered before the fetus Mother’s health is at risk

The Postpartum Period A stage of about 3 months following childbirth It takes about 6-8 weeks before a woman’s reproductive organs to return to their prebirth condition Lactation begins about 3 days after childbirth The return of menstruation make take up to 6 months, depending upon hormonal activity Fluctuating emotions are the result from the hormone level changes, which could result in “postpartum depression” or happiness of the new arrival

Pregnancy and Childbirth Chapter Eight Pregnancy and Childbirth