1. Pregnancy and Childbirth
Chapter Eight
Pregnancy and Childbirth

2. 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

3. 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”

4. 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”

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

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

7. 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”

8. 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

9. 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

10. 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

11. 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”

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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)

18. 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

19. 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

20. 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

21. Pregnancy and Childbirth
Chapter Eight
Pregnancy and Childbirth