The Developing Person Through the Life Span Prenatal Development and Birth

Prenatal Growth Three main periods of prenatal development Germinal Period (1st two weeks after conception): rapid cell division and beginning of cell differentiation Embryonic Period (3rd through 8th week): basic forms of all body structures develop Fetal Period (9th week until birth): fetus grows in size and matures in functioning

The Germinal Period Zygote begins duplication and division within hours of conception Development of the placenta Organ that surrounds the developing embryo Sustains life via the umbilical chord Implantation (about 10 days after conception) Developing organism burrows into the placenta that lines the uterus

The Germinal Period

The Embryonic Period Embryo 3rd through the 8th week after conception Begins when the primitive streak appears down the middle of the cell mass Primitive streak becomes the neural tube and later the brain and spinal column Eyes, ears, nose, and mouth form Heart begins to pulsate Extremities develop and webbed fingers and toes separate

The Embryonic Period

The Fetal Period Fetus 9th week after conception until birth Genitals form and sex hormones cause differences brain organization Cephalocaudal and proximodistal growth Heartbeat detectable via stethoscope Cortex is not fully mature at birth Brain at birth is biggest part of baby Cephalocaudal Development proceeds from the head downward. This is the cephalocaudal principle. It describes the direction of growth and development. The child gains control of the head first, then the arms, and then the legs. Infants develop control of the head and face movements within the first two months after birth. In the next few months, they are able to lift themselves up by using their arms. By 6 to 12 months of age, infants start to gain leg control and may be able to crawl, stand, or walk. Coordination of arms always precedes coordination of legs. Proximodistal Development proceeds from the center of the body outward. This principle also describes the direction of development. This means that the spinal cord develops before outer parts of the body. The child's arms develop before the hands and the hands and feet develop before the fingers and toes. Finger and toe muscles (used in fine motor dexterity) are the last to develop in physical development

The Fetal Period Age of viability Age at which a preterm newborn may survive outside the womb with medical care About 22 weeks after conception Brain is able to regulate basic body functions Chances of survival increase with each day after the 22-week mark As the word is used in United States constitutional law since Roe v. Wade, viability is the potential of the fetus to survive outside the uterus after birth, natural or induced, when supported by up-to-date medicine.

The Fetal Period

Birth Fetal brain signals the release of hormones to trigger the mother’s uterine muscles Labor begins Average duration for first babies: 12 hours Quicker labor for later babies Apgar scale Quick assessment of newborn’s heart rate, breathing, muscle tone, color, and reflexes Completed twice (1 minute and 5 minutes after birth) Score of 0, 1, or 2 in each category Desired score: 7 (total) or above

A Normal, Uncomplicated Birth!

Apgar score is a method to quickly summarize the health of newborn children. Dr. Virginia Apgar, an anesthesiologist at New York–Presbyterian Hospital, developed the score in 1952 in order to quantify the effects of obstetric anesthesia on babies.

Medical Assistance Cesarean Section (c-section) Surgical birth Fetus can be removed quickly Rates and reasons for c-sections vary Lower rates in poorer countries Higher rates in richer countries 1/3 of births in the United States Less trauma for the newborn but slower recovery for the mother Subsequent cesarean deliveries may be necessary

Newborn Survival Infant mortality has decreased due to better medical care 1900: 5% Today: <1 in 200 Childbirth has become safer for mothers Death rate in poorest nations: 1 in 20 women Excessive medical care also has disadvantages Increase in unnecessary c-sections is associated with higher rate of low-birth weight babies

Traditional and Modern Birthing Practices Home births Hospital births Doula Woman who helps with labor, delivery, breast-feeding, and newborn care May be related to lower rate of cesarean sections A doula is an assistant who provides physical as well as emotional support during childbirth. Doulas help women in a non-medical capacity. A midwife is a professional who has institutional qualification to help a pregnant woman in delivering a baby. A doula, also known as a birth companion, birth coach or post-birth supporter, is a nonmedical person who assists a woman before, during, or after childbirth, as well as her spouse and family, by providing physical assistance and emotional support. The provision of continuous support during labor is associated with improved maternal and fetal health and a variety of other benefits, including lower risk of induction and interventions and less need for pain relief. These benefits are particularly significant when continuous support is provided by someone who is not there as family/friend or as medical staff. Additionally, a doula is sometimes hired to work with families beyond the postpartum stages, providing continued physical and emotional support, for as long as needed. The World Health Organization defines a midwife as: A person who, having been regularly admitted to a midwifery educational program that is duly recognized in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery. The educational program may be an apprenticeship, a formal university program, or a combinatio

Harmful Substances Teratogens Behavioral teratogens Substances and conditions that can impair prenatal development and result in birth defects or even death Not all teratogens can be avoided Structural abnormalities are obvious at birth Behavioral teratogens Affect the child’s developing brain Developmental retardation, hyperactivity, and learning disabilities Effects do not become evident for months or years

Risk Analysis Knowing which risks are worth taking How to minimize chance of harm Teratology: science of risk analysis Threshold effect: when a teratogen is harmless in small doses but becomes harmful at a certain level (threshold)

Applying the Research Fetal alcohol syndrome (FAS) A cluster of birth defects including abnormal facial characteristics, slow physical growth, and retarded mental development May occur in the child of a woman who drinks alcohol while pregnant

Low Birthweight Low birthweight (LBW) Very low birthweight (VLBW) Less than 2,500 grams (5½ pounds) at birth United States Steady increase in LBW over the past 25 years 8% of newborns are seriously underweight More susceptible to teratogens, higher birth risks, lower survival rate Very low birthweight (VLBW) Under 1,500 grams (3 pounds, 5 ounces) at birth Extremely low birthweight (ELBW) Under 1,000 grams (2 pounds, 3 ounces) at birth

Preterm or Slow Growing? Birth that occurs at 35 or fewer weeks after conception Usually associated with low birthweight Small for gestational age (SGA) Birthweight is significantly lower than expected, given the time since conception Suggests impairment throughout prenatal development and serious problems

Complications During Birth Cerebral palsy: -damage to the brain’s motor centers -speech and/or muscles are impaired Anoxia: -lack of oxygen -over time can cause brain damage or death

The Newborn Brazelton Neonatal Behavioral Assessment Scale (NBAS) A test that measures responsiveness records 46 behaviors, including 20 reflexes

Moving and Perceiving The Newborn The first movements are not skills but reflexes, involuntary responses to a particular stimulus.

The Newborn Some reflexes aid survival breathing thrashing shivering sucking rooting swallowing spitting up

The Newborn Other reflexes signify normal functioning: Babinski reflex. When feet are stroked, their toes fan upward. Stepping reflex. When held upright with feet touching a flat surface, infants move their legs as if to walk. Swimming reflex. When laid horizontally on their stomachs, infants stretch out their arms and legs. Palmar grasping reflex. When something touches infants’ palms, they grip it tightly. Moro reflex. When someone startles them, infants fling their arms outward and then bring them together on their chests, as if to hold on to something, while crying with wide-open eyes.

The Father’s Role Supportive father helps mother stay healthy Father can decrease or increase mother’s stress (affects fetus) Most fathers are helpful to their pregnant wives Two way street: Pregnant mothers should support, involve, and encourage fathers

The Father’s Role Couvade: symptoms of pregnancy and birth experienced by fathers Parental alliance: cooperation between a mother and a father based on their mutual commitment to their children the parents support each other in their shared parental roles. Couvade: a practice in certain cultures in which the husband of a woman in labor takes to his bed as though he were bearing the child. Couvade syndrome, also called sympathetic pregnancy, is a proposed condition in which a partner experiences some of the same symptoms and behavior as an expectant mother. These most often include minor weight gain, altered hormone levels, morning nausea, and disturbed sleep patterns. In more extreme cases, symptoms can include labor pains, postpartum depression, and nosebleeds. The labor pain symptom is commonly known as sympathy pain. Couvade syndrome is not recognized as a real syndrome by many medical professionals. Its source is a matter of debate. Some believe it to be a psychosomatic condition, while others believe it may have biological causes relating to hormone changes.

Postpartum Depression Sadness and inadequacy felt by 8-15% of new mothers in the days and weeks after giving birth Symptoms range from baby blues to postpartum psychosis baby care feels burdensome and thoughts of mistreating the infant may exist Paternal involvement can have beneficial effect Some fathers are depressed themselves Causes for Postpartum Depression vary

There's no single cause of postpartum depression, but physical and emotional issues may play a role. Physical changes. After childbirth, a dramatic drop in hormones (estrogen and progesterone) in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply — which can leave you feeling tired, sluggish and depressed. Emotional issues. When you're sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive, struggle with your sense of identity or feel that you've lost control over your life. Any of these issues can contribute to postpartum depression.

Bonding Parent-Infant Bond The strong, loving connection that forms as parents hold, examine, and feed the newborn Early skin-to-skin contact is not essential Cross-fostering in monkeys Newborns are removed from their mothers and raised by another female or male Strong and beneficial relationship sometimes develops

Bonding Birth complications can have lingering impact on later life Mothers and fathers should help with early caregiving if newborn must stay in the hospital Kangaroo care Child-care technique in which the mother of a LBW infant holds the baby between her breasts Allows baby to hear mother’s heartbeat and feel her body heat Research confirms beneficial effects

The End