Prenatal Care and Childbirth Chapter 5

Signs of Pregnancy A woman cannot feel the sperm and egg unite. She cannot feel cells divide as the baby begins to develop. However, her body begins to change almost immediately. The signs of pregnancy help a woman recognize these changes.

Positive Signs-definitely caused by pregnancy Signs of Pregnancy Menstruation stops Nausea Tired/fatigue Frequency in urination Swelling and tenderness of the breasts Skin discoloration Internal changes (softening of the uterus, cervix or uterine enlargement) Other signs Presumptive Signs- could be the signs of pregnancy, but they could be the signs of something else. A doctor would determine their cause. HCG (Human Chorionic Gonadotropin)-hormone levels detected by lab tests. HCG found in blood and urine. Fetal heartbeat Fetal movement Fetal image-seen on an ultrasound Fetal shape-felt through the abdominal wall Uterine contractions Positive Signs-definitely caused by pregnancy

Medical Care Medical care is the best way to make childbearing safe and successful. A woman who suspects she may be pregnant should make an appointment with a doctor as soon as possible. Many pregnant women choose to visit obstetricians, or doctors who specialize in pregnancy and birth.

The First Appointment The doctor will first gather information such as the age and health history of each parent. Next, the doctor will ask the details about the woman’s menstrual cycle and any past pregnancies. The doctor will answer any questions the couple has a bout pregnancy. Then a physical exam is usually completed. The woman will be weighed, her pulse taken, blood pressure, etc. Her breasts may be checked and a pelvic exam done. Urine and blood tests will be done. Blood tests check for blood type, anemia and diseases that may harm an unborn child. Sometimes a test for blood sugar levels will be done. The doctor will advise the couple on health habits to be followed. At the end of the appointment, the obstetrician estimates the due date for the baby’s birth. Babies are born about 40 weeks after the beginning of the last menstrual period.

The Unborn Baby’s Environment At the moment of conception, the baby begins to firm traits from both mother and father. These inherited traits, or genetic factors are merged into one unique person. Development is not determined solely by genetic factors. Environmental factors are those caused by a person’s surroundings. The prenatal environment is the mother’s body.

Factors that Affect the Baby’s Health Mother’s Age -the ideal time for a woman to have a baby is between 21-28 years old. Teens and women over 36 are considered high risk. Mother’s Physical Health -women in excellent health prior to pregnancy are the most likely to have healthy pregnancies. Healthy weight, nutrition and activity levels are included in physical health.

Rh Factor Rh Factor –is a protein substance found in the red blood cells of about 85% of the population. People who have the substance are considered Rh+ and those that do not are RH-. The only time this causes a problem is when the mother is Rh+ and the father is RH-. This combination occurs in 12% of all marriages. If the baby inherits the RH+ blood type from the father, the baby may develop RH disease. This disease is a type of anemia that destroys the baby’s red blood cells.

Rh disease Rh disease does not affect the unborn baby of the first pregnancy; however, during any pregnancy some of the baby’s Rh+ cells may enter the mother’s bloodstream during birth. These cells are foreign to the mother and her body begins fighting them off. This then makes the mother immune to the blood cells of future Rh+ babies.

Rh Disease cont. In the next pregnancy, these antibodies cross the placenta and if the baby has RH+ blood, the antibodies destroy the baby’s red blood cells. A vaccination was approved to reduce the danger of Rh disease in 1968. The vaccine blocks the growth of antibodies in her body. The vaccine is almost 100% effective unless the woman’s body has already made antibodies to Rh+ cells.

Mother’s Emotional Health Positive thoughts and feelings are important for a woman to have a healthy baby. Negative thoughts and feelings stimulate the nervous system and the flow of adrenaline. The nervous system and adrenaline control heart rate, breathing, and muscle tension.

Can stress harm an unborn baby? An unborn baby can handle some stress, but if it is long-lasting, severe r frequent, the mother may have a more difficult delivery. Emotional support during pregnancy and delivery is good for the baby.

Health Habits during Pregnancy Nutrition-a nutritious diet is essential during pregnancy. Cells need proteins, fats, carbs, minerals and vitamins to help them grow. Diets for pregnant and nursing mothers should provide more calcium, iron, folic acid, and protein than non pregnant women. Water should be increased and caffeine should be decreased to about one cup per day.

Health Habits cont. Weight Gain-to meet the nutritional needs of themselves and their babies, pregnant women need to eat 300 extra calories per day, starting in the 4th month. Weight gain during pregnancy is not all stored as fat, much of the weight goes to the growing baby and the tissues that support it.

Hygiene Practices -women should continue their normal grooming and body care habits. Rest and sleep -a mother-to-be needs much rest and sleep. Many doctors advise 8-9 hours of slept a bight. Physical Activity and Exercise -unless advised otherwise by her doctor, a pregnant woman can and should be active. Activity helps with weight gain, strengthens muscles used in delivery, increases energy and relieves tension.

Health Hazards to Avoid Diabetes-a disorder caused by the body’s inability to use sugar properly. Another kind of diabetes can occur during pregnancy called gestational diabetes-this appears in women who did not have diabetes before pregnancy and usually it goes away after pregnancy ends. Pregnancy Induced Hypertension (PIH)- the name for high blood pressure caused by pregnancy. Sometimes this is called toxemia or preeclampsia. It includes a sudden increase in blood pressure, protein in the urine, swelling. If untreated it can lead to damage of death of the mother, baby or both.

Health Hazards to Avoid cont. Sexually Transmitted Diseases- infectious diseases that are passed primarily through sexual intercourse. Some STDs can enter the bloodstream of the mother and cross the placenta to reach the unborn. Others infect the mother’s reproductive tract and can be passed to the baby during delivery. See pg. 142 in your textbook for STDs and their effect on the baby.

Health Hazards to Avoid cont. Drugs-this includes all medications, over the counter and prescribed my a doctor. Alcohol-Doctors advise women to never drink alcohol during pregnancy. Taking even 1 drink can cause the baby to be abnormal. Almost 3 in every 1000 babies are born with Fetal Alcohol syndrome. Nicotine-babies of smokers are usually smaller than average or premature. Wile a mother is smoking, the baby’s oxygen is greatly reduced. Smoking can cause a baby’s brain to develop abnormally.

Health Hazards to Avoid cont. Illegal Drugs -can cross the placenta quickly and reach the baby. If a woman is addicted to drugs, changes are her baby is too. Pregnant women who use drugs often have low birth weight and are premature. Pregnant women who use illegal drugs often neglect their own health by eating poorly, smoking or abusing alcohol.

Health Hazards to Avoid cont. Radiation -X-rays should be avoided during pregnancy, as the increase the likelihood of childhood cancer. Some also link X-rays to congenital disabilities in the fetus. Environmental Pollution -lead, chemicals, pesticides, and herbicides all pose risks to the unborn baby.

Complications of Pregnancy pgs. 146-148 Congenital Problems -is a physical or biochemical that is present at birth. It may be inherited or caused by environmental factors. A miscarriage - is the expulsion of the baby from the mother’s body before week 20 of pregnancy. Stillbirth is the loss of the fetus after 20 weeks of pregnancy. In a stillbirth, the baby is born dead.

Monitoring the baby’s development Ultrasound-a test that is d one to monitor an unborn baby. This test bounces sound waves off the fetus to produce an image of the fetus in side the womb. Chronic Villus Sampling (CVS)- is a procedure for finding abnormalities in the unborn by testing a small amount of chorion. This is used between 8-12 weeks of pregnancy. Amniocentesis-a prenatal test used to check for the presence of over 100 congenital problems. A medical professional inserts a needle through the abdominal wall into the uterus. Ultrasound is done at the same time to position the needle. The professional withdraws a small amount of fluid from the amniotic sac. This is done between 14-16 weeks of pregnancy.

The Role of the Family Today’s Fathers-to-be take a more active role than they have in the past. Fathers can be an emotional support for the pregnant women

Childbirth Decisions Home or hospital delivery? Choosing a method of delivery is a personal choice. Natural childbirth: the woman learns about the birth process so she knows what to expect. She is trained to breathe and relax in a way that helps the birth process. The woman delivers without the aid of medications or drugs. Lamaze method- the mother is taught to focus on something other than pain. She uses breathing patterns to keep her mind off of the pain. She attends Lamaze classes to help prepare her mentally and physically. Leboyer method -focuses on the comfort of the baby and mother. This method assumes that delivery is painful for the baby as well as the mother. This method uses low lights, nose is kept at a minimum, and the doctor supports the baby after the head appears. After birth the baby rests on the mother’s body then lowered into water that is near body temperature. Finally the baby is dressed and wrapped in a warm blanket.

Stages of Labor Stage 1 Stage 2 Stage 3 Dilation of the cervix Contractions every 15-20 minutes Uterus narrows Stage 2 The baby’s head enters the birth canal The mother’s muscles push to move the baby down Episiotomy may be made to widen the birth canal to prevent tearing. Baby is delivered Stage 3 About 20 minutes after birth the mother has a few irregular contractions. These cause the placenta to completely detach from the uterus and descend. This is commonly called the afterbirth.

Complications of Delivery pg. 161