1. Child Care & Development
Chapter 5
Prenatal Care & Childbirth

2. Signs of Pregnancy
Presumptive Signs – could be cause of pregnancy or something else (often menstruation)
Amenorrhea – delay (10 or more days) in the menstrual cycle
Nausea – present in 1/2 to 2/3 of all pregnancies, usually happens at the same time daily from Week 4 – Week 12
Frequency of Urination – the growing uterus puts pressure on the bladder; also due to hormones
Swelling/tenderness of Breast – often the first sign a woman notes
Other signs:
Tiredness, skin discoloration, backache, groin pain, leg cramps, dizziness

3. Signs of Pregnancy Positive Signs – definitely caused by pregnancy
HCG – hormone found in blood and urine of pregnant women; detected as early as first two weeks of pregnancy
Fetal Heartbeat – heard through a Doppler at 12 Weeks and a stethoscope at 16 Weeks
Fetal Movement – Begins at 11 Weeks, not felt until around Weeks 16-18
Fetal Image – through ultrasound
Fetal Shape – may be felt through abdominal wall
Uterine contractions – painless; a doctor may notice during routine exams

4. Medical Care
Obstetrician – doctor who specializes in pregnancy and childbirth
The First Appointment – the doctor will:
Gather general health info from both parents
Ask details of the woman’s menstrual cycle and past pregnancies
Physical exam of mother-to-be
Urine and/or blood test
Estimate due date (40 weeks after beginning of last menstrual cycle)
Make next appointment

5. Medical Care Doctor visits: First six months – once a month
Seventh and eighth month – twice a month
Ninth month – at least once a week

6. Factors That Affect the Baby’s Health
High Risk Mothers-to-be
Age – women over 36 tend to have babies with more health problems, disabilities and disorders; teens tend to have babies who are premature, have low birthweight, disabilities, or are born dead
Low birthweight – babies who weigh less than 5 ½ lbs.
Rh factor – only a factor when the mother is Rh negative; baby may develop Rh disease that destroys its red blood cells
Emotional stability – when the mother is stressed, the adrenaline crosses the placenta to the baby, carrying stress signals; long lasting, severe, frequent stress may result in a difficult delivery or a baby who is smaller, fussy, or quite active

7. Health Habits During Pregnancy
Good nutrition is vital for:
Mother’s weight
Baby’s weight gain
Baby’s growth
Baby’s mental capacity
Baby’s physical performance
By Week 12, the baby completely depends on the mother for food
Pregnant teens under 17 years of age have more nutritional problems because they are still growing themselves

8. Health Habits During Pregnancy
Diets for pregnant women include:
Calcium
Iron
Folic acid
Protein
At least eight 8 oz. glasses of water
Limited caffeine (no more than one cup of coffee; in tea, soft drinks, and chocolate as well)
Suggested weight gain is between 25 and 35 lbs.
Women need to eat 300 extra calories starting in the fourth month

9. Health Habits During Pregnancy
Mothers-to-be should get eight to nine hours of sleep, with at least one minute rest period
Never take drugs, even over-the-counter medicines, unless doctor prescribes
Continue physical activity within normal limits, avoiding contact sports

10. Illnesses in the Mother
Gestational Diabetes – appears in pregnant women who did not have diabetes prior to pregnancy; usually goes away soon after pregnancy
Women with gestational diabetes usually have larger babies (10-12 lbs.)
Pregnancy Induced Hypertension (preeclampsia or toxemia) – sudden increase in blood pressure, protein in urine, and swelling; happens late in pregnancy
Treatment includes bed rest, medicine, or early delivery of the baby

11. Drugs
Fetal Alcohol Syndrome (FAS) – happens when mothers drink heavily during pregnancy; babies are shorter, weigh less, have slow growth and development
Nicotine – reduces baby’s oxygen, can cause brain to develop abnormally; babies are smaller than average or premature; could result in miscarriage
Illegal drugs – cross the placenta quickly and reach the baby; babies have low birthweight or are born premature; may be born addicted and have to go through withdrawal

12. Complications of Pregnancy
Miscarriage – the expulsion of the baby before Week 20, most common in the first three months; also called spontaneous abortion
Stillbirth – the loss of a fetus after 20 Weeks of pregnancy; the baby is born dead
About 1/3 of all pregnancies end in the loss of a baby
See p for other complications of pregnancy

13. Monitoring the Baby’s Development
Ultrasound – sound waves bounce off the fetus to produce an image of the fetus inside the womb
Sonogram – the picture of the fetus that ultrasound produces
Chorionic Villus Sampling – test done between Weeks 8 and 12 to detect serious problems with the fetus
Amniocentesis – test done between Weeks 14 and 16 to check for multiple congenital problems
CVS and Amnios are not routine procedures; only done when problems are suspected

14. Decisions Concerning Childbirth
Home vs. hospital delivery
Method of delivery
Natural childbirth – no drugs
Lamaze – breathing techniques
Sedation – drugs administered by IV
Anesthesia – includes Epidural
Leboyer – comfort of baby the focus

15. The Last Weeks of Pregnancy
Labor – the process that moves the baby out of the mother’s body
Signs of Labor
Increased adrenaline/energy
Mucous plug in cervix becomes loose (bloody show)
Amniotic sac breaks; may also break after labor has begun
Contractions – the length and strength gradually increases throughout labor; once contractions start, the mother should not eat or drink
False labor – irregular contractions prior to true labor; also called Braxton-Hicks contractions

16. The Last Weeks of Pregnancy
Lightening – the change in the baby’s position; lower in the pelvis, head toward birth canal
Breech – the baby is in butt-first position; 2% of births
Stages of Labor
Dilation/opening of cervix
Delivery of Baby
Delivery of Placenta
See p for complications of delivery

17. The Last Weeks of Pregnancy
Version – the doctor manually rotates the baby’s position
Oxytocin/Pitocin – drugs used to speed up labor by causing contractions to start and/or stregthen
Forceps – curved instrument that fits around baby’s head to ease baby down birth canal during contractions
Vacuum Extraction – a suction is used to gently pull the baby down the birth canal
Cesarean Section – abdomen and uterus are surgically opened and baby removed

18. Hospital Care
Birthing Room – homelike delivery room in hospital; furnished like a bedroom, used for labor, delivery, and recovery
Rooming-in – baby stays in mother’s hospital room as much as possible
Mother and baby home within 24 to 48 hours, unless C-section or other complications
Nurses on duty in the nursery at all times
Some restrictions on visitors, including young children, brothers and sisters

19. Postpartum Care
Postpartum care – the care the mother receives during the six to eight weeks after delivery
Eat a nutritious diet, especially if breastfeeding
Rest
Slowly get back into exercise
Use support system
Postpartum Mood Disorders
Baby Blues – mild; 40-85% of all deliveries
Postpartum Depression – 10-15% of all deliveries; 26-32% in teens
Postpartum Psychosis – 0.1% of all deliveries; severe mental illness