Chapter 4 – Prenatal Development and Birth The Developing Person Through the Life Span 8e by Kathleen Stassen Berger Chapter 4 – Prenatal Development and Birth

Conception & Implantation Woman 28 day cycle Implantation or uterine lining discarded Man 300 million sperm

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 Brain and spinal column form 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 Heartbeat detectable via stethoscope Term: ultrasound

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

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

Three Stages of Birth Stage 1 Dilation and Effacement of the Cervix 12-14 hours (4-6 hours) Contractions Stage 2 Delivery of the Baby 50 minutes (20 minutes) Urge to push and squeeze Stage 3 Delivery of the Placenta Final push/contractions Placenta in 5-10 minutes

A Normal, Uncomplicated Birth

APGAR Scale A ppearance P ulse G rimace A ctivity R espiration

APGAR Scale

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

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

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 Appropriate weight due to length of pregnancy Small for gestational age (SGA) Birthweight is significantly lower than expected, given the time since conception Suggests impairment throughout prenatal development Usually have more serious problems More likely to die in 1st year, catch infections, have brain damage Middle childhood – lower intelligence test scores, less attentive, socially immature

Interventions for Pre-term Infants Isolette Respirator Feeding tube Intravenous medication Special Infant Stimulation Kangaroo care Parent Training in Caregiving

Complications During Birth Rh Factor Incompatibility Mother’s blood is incompatible with fetus Mother begins to produce antibodies to ‘fight’ the fetus’ blood Anoxia Lack of oxygen Can cause brain damage Breech Position Butt or feet first

The Newborn Brazelton Neonatal Behavioral Assessment Scale (NBAS) A test that measures responsiveness Records 46 behaviors, including 20 reflexes Provides a ‘portrait’ of the child Assists in developing a plan to enhance caregiving

Moving and Perceiving The Newborn The first movements are not skills but reflexes, involuntary responses to a particular stimulus. Breathing, thrashing, shivering, sucking, rooting, swallowing, spitting up

Other reflexes signify normal functioning 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

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

Bonding Parent-Infant Bond The strong, loving connection that forms as parents hold, examine, and feed the newborn Cross-fostering in monkeys Newborns are removed from their mothers and raised by another female or male Strong and beneficial relationship sometimes develops Birth complications can have lingering impact on later life Mothers and fathers should help with early caregiving if newborn must stay in the hospital