1. Chapter 9 Understanding Pregnancy and Parenthood

2. Understanding Pregnancy and Parenthood
Choosing Whether or Not to Be a Parent
Becoming Pregnant
Pregnancy
Health Habits During Pregnancy
Risks to Fetal Development
How Birth Defects are Detected

3. Understanding Pregnancy and Parenthood
Childbirth
Medical Interventions
Postpartum Transition
Infertility
Adoption

4. Choosing Whether or Not to Be a Parent
Parenting is not for everyone
5% of fertile American married couples choose not to become parents.
Parenting usually requires major adjustments in lifestyle to meet the needs of children.
Before committing to this decision, potential parents must be as certain as they can that their decision is appropriate for their life goals and that they have the means to care for their children.

5. Becoming Pregnant
Most pregnancies last for a 40 week period where the fetus grows inside the mothers uterus.
Fertilization
During each of a woman’s menstrual cycles, one or more ovum are readied for fertilization and freed from the ovary, called ovulation
Once released from the ovary an egg can survive about 24 hours
Sperm take about 70 days to become mature and can survive up to 7 days once in the vagina.

6. Becoming Pregnant Fertilization
The cervix is the passageway from the vagina to the uterus. During ovulation the cervical mucous becomes more fluid and organized into channels that help the sperm move toward the uterus.
Fertilization = The fusion of a father’s sperm with a mother’s ovum to form a zygote or fertilized egg
Once the zygote implants in the woman’s uterus it is called an embryo.

7. Becoming Pregnant Fertilization
During the first 3 days after fertilization the cells of the embryo replicate at daily intervals and the embryo moves along the fallopian tube toward the uterus.
By the 4th day the embryo consists of cells.
By the 6th day the embryo attaches to the lining of the uterus and soon implants.

8. Becoming Pregnant

9. Pregnancy
Human chorionic gonadotropin (HCG) is produced by the placenta soon after implantation of the embryo.
A pregnancy test is the analysis of the presence of HCG in a woman’s urine.
Ectopic Pregnancy
Occasionally the fertilized egg implants somewhere other than the uterus.
Requires immediate intervention to save the tube from bursting.

10. Pregnancy
HCG causes increased and prolonged production of estrogen and progesterone, which in turn causes the signs and symptoms of pregnancy:
Absence of expected menstrual period
Occasional nausea and vomiting (“morning sickness”)
Enlarged and tender breasts
Increased frequency of urination
Fatigue

11. Pattern of HCG Secretion During Pregnancy

12. Pregnancy Fetal Development Three trimesters
By 10 weeks nearly all the body is formed; the rest of the pregnancy consists of growth and allowing the organs to become functional.
The fetus is enclosed in a fluid-filled sac called the amnion.
The amniotic fluid that the fetus is in protects the baby from jolts.

13. Pregnancy Fetal Development
The placenta is an organ that supports the growth and development of the baby.
Manufactures hormones needed to maintain pregnancy and transports oxygen and nutrients from the mother to the fetus and waste products from the fetus to the mother.

14. Pregnancy Fetal Development Changes in the mother
10% increase in heart rate
20-30% increase in heart output
Increase in red blood cells
Uterus grows

15. Pregnancy

16. Pregnancy Sexual Interaction During Pregnancy
Sexual intercourse during pregnancy is OK unless a health care provider advises against sexual activity.
Provided the mother is interested, there is no physical reason to forgo sex during pregnancy.

17. Health Habits During Pregnancy
Nutrition
All of the fetus’ nutrients come from the mother via the placenta so plenty of good nutrients are required.
Mothers who eat healthy diets give birth to healthier babies.
Need to increase intake of essential nutrients and calories
Need to supplement diet with iron and folic acid
A weight gain of 28 to 35 pounds is normal.

18. Health Habits During Pregnancy
© Jones and Bartlett Publishers

19. Health Habits During Pregnancy
Physical Activity During Pregnancy
Helps overcome feelings of lethargy and discomfort with changes in baby proportions
Helps prepare the mother’s body for childbirth
Can improve circulation and reduce varicose veins
Maintains the habit of being active
Amount depends on the woman’s previous experience with exercise

20. Health Habits During Pregnancy

21. Health Habits During Pregnancy
Emotional Well-Being
Emotional well-being of the mother influences the health of the pregnancy.
Pregnancy can be a time of intense feelings for the woman, her partner, and the entire family.
Intense emotions are natural and normal.
Quiet meditation and relaxation may help.
Desires for either more or less sex are normal.

22. Health Habits During Pregnancy
Prenatal Care
Receiving professional prenatal care reduces the risk of complications by ensuring:
Fewer pregnancy-related illnesses
Early discovery of problems with the placenta or uterus
Discussion of proper nutrition
Advice on alcohol, tobacco, and drugs
Screening for maternal infections (e.g. syphilis, gonorrhea, herpes)
Screening for Rh incompatibility

23. Risks to Fetal Development
Some causes of birth defects are unknown; others may be factors or agents adversely affecting the fetus during development.
Many substances can easily cross the placenta and damage the developing fetus:
Drugs—Legal (prescription and over-the-counter) or illegal
Alcohol
Cigarette smoking

24. How Birth Defects are Detected
Certain tests are performed when there is reason to suspect fetal abnormalities.
Reasons for birth defect testing include:
Pregnant woman is over age 35.
Parents have previously given birth to a child with birth defects.
Parents have a history of genetic or chromosomal disorders and want to confirm the absence of birth defects in the unborn child.

25. How Birth Defects are Detected
Tests that are performed:
Amniocentesis
Performed week 14-18
Draw out amniotic fluid for study and detection of several hundred fetal abnormalities
Chorionic villus sampling (CVS)
During 1st trimester
Draw out chrionic cilli from the uterus.

26. Childbirth Childbirth Preparation
6- to 8-week courses help prepare expectant couple or parent for childbirth.
Studies show that emotional support during labor can shorten labor time, give the woman a greater perception of control, decrease the need for pain medication, and lead to fewer complications.

27. Childbirth Giving Birth
A few weeks before the onset of childbirth (or labor) fetus becomes positioned for birth by descending in the uterus, a process called lightening.
During the last half of pregnancy, a woman may experience Braxton-Hicks contractions, which feel like labor contractions but are not because they are shorter and irregular.

28. Childbirth Giving Birth
Labor is marked by the occurrence of strong, rhythmic, and eventually frequent uterine contractions.
Childbirth is described as occurring in three stages, despite the fact it is one continuous process.
Labor time varies from woman to woman.

29. Childbirth Giving Birth
Stage 1: The mother’s cervix has effaced (flattened and thinned) and dilates to allow the baby to pass from the uterus.
Stage 2: Cervix is fully dilated and the infant descends through the vaginal birth canal.
Stage 3: The expulsion of the placenta and membranes (afterbirth).

30. Childbirth

31. Medical Interventions
Options for controlling discomfort
Relaxation techniques
Deep breathing
Acupuncture
Hypnosis
Massage
Medications that block pain awareness
Medications that block pain sensations (anesthesia)

32. Medical Interventions
Induction of Labor
Induction of labor involves medically stimulating uterine contractions and labor.
20% of America’s childbirths are induced
Most common methods of inducing labor are administering prostaglandins to the cervix, breaking the amnoitic sac, and administering the hormone oxytocin (Pitocin).

33. Medical Interventions
Episiotomy
An incision in the perineum from the vagina to the anus
Necessary when the head of the infant is too large for the opening, the infant is in distress, the infant is in an irregular position, there is need for a forceps delivery, or the perineum has not stretched sufficiently

34. Medical Interventions
Episiotomy
Episiotomies are not as highly recommended as they were in the past.
Side effects include infection, increased pain, increase in third- and fourth-degree vaginal lacerations, slower healing, and increased discomfort when intercourse is resumed.

35. Medical Interventions
Cesarean Section (C-section)
A surgical procedure where the fetus is removed through an incision made in the abdominal wall and uterus
Recommended when the fetal head is too large for the mother’s pelvic structure, the mother is ill, there is active herpes infection in the vaginal tract, there is fetal distress during labor, or there are birth complications

36. The Postpartum Transition
The period of recovery after childbirth is called postpartum.
During this time, the physiological changes of pregnancy slowly reverse.
After delivery, the levels of progesterone and estrogen, which are high during pregnancy, drop rapidly.
© Karl Weatherly/Photodisc/Getty Images

37. The Postpartum Transition
Breast-Feeding
Milk production is controlled by hormones.
Breast-feeding has many advantages:
Transfers immunity
Promotes development of digestive system
Is associated with fewer allergies and digestive problems in infants
Provides more balanced nutrition
Helps uterus return to normal size
Offers pleasurable experience

38. Infertility
Approximately one in five American couples are infertile, which means they are unable to become pregnant after a year of trying.
In about 40% of infertile couples, the problem lies with the male partner.
In about 10% of infertile couples, no cause can be determined.
Sterility is permanent infertility

39. Infertility
Common causes of blockage of reproductive tract are scarring of the fallopian tubes by gonorrhea or chlamydia infections and (less likely) scarring of the epididymis by a bacterial infection.
Problems with insemination and sperm transport can cause infertility.

40. Infertility Enhancing Fertility Options
For conception to occur, more than 20 million healthy sperm must be deposited into the vagina.
If a man has healthy sperm but not enough, the process can be facilitated by introducing the semen directly into the cervix with a syringe, which is called artificial insemination.

41. Infertility Enhancing Fertility Options
In vitro fertilization (IVF) involves obtaining several ova from the ovaries and fertilizing them in a laboratory environment; the embryo is then placed inside the woman’s uterus.
Success Rate is 20-40%

42. Infertility Enhancing Fertility Options
Gamete intrafallopian transfer (GIFT) involves the ova being placed in equal numbers in each of the fallopian tubes and the semen being introduced directly into the fallopian tubes.
GIFT is about 10% to 20% effective.

43. Infertility Enhancing Fertility Options
Zygote intrafallopian transfer (ZIFT) involves eggs being fertilized in vitro and the embryos being placed in the fallopian tubes.
ZIFT is also about 10% to 20% effective.

44. Adoption There are three avenues a couple can pursue to adopt a child:
Private adoption—state licensed
Public adoption—state licensed
International adoption

45. Understanding Pregnancy and Parenthood
Do you want to be a parent? Why or why not?
If you are unable to get pregnant the traditional way what interventions would you want?
Would you ever adopt? Why or why not?