1. Sexuality, Pregnancy, and Childbirth Chapter 5

2. ©2008 McGraw-Hill Companies. All Rights Reserved. 2 Sexuality  Components Biological, gender, sexual anatomy and physiology, sexual functioning and practices, and sexual interactions.  Acceptable versus unacceptable behaviors

3. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 3 Reproductive Anatomy  External Female Genitals (Vulva) Mons pubis Labia majora Labia minora Prepuce Clitoris Urethral opening Vagina  Internal Female Genitals Uterus Endometrium Cervix Ovaries Fallopian tubes Hymen

4. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 4

5. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 5 Reproductive Anatomy  Male Sex Organs: Two components Penis  The Glans  Corpus spongiosum Scrotum  Function (Temperature 93.6 degrees F)  Testes  Epididymis  Seminiferous tubules within the Testes  Vas Deferens  Prostate  Cowper’s glands  Seminal vesicle

6. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 6

7. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 7 Hormones and The Reproductive Life Cycle  Hormones: Endocrine glands Testes produce androgens - testosterone Ovaries produce estrogen and progesterone Cortex of the Adrenal gland produces androgens in both males and females Pituitary gland Hypothalamus

8. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 8 Female Sexual Maturation  Begins around 8-13 with breast development and rapid body growth between 9 and 15.  Physical maturation.  Menstrual Cycle - four phases. Menses.  Days 1-5 Estrogenic phase.  Days 6-13 Ovulation phase.  Day 14 Progestational phase.  Days 15-27

9. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 9 Menstrual Problems  Dysmenorrhea Some symptoms caused from prostaglandins  Premenstrual syndrome (PMS)  Premenstrual Dysphoric disorder (PMDD) Cause Pharmacological treatment  Lifestyle changes to reduce symptoms Limit salt intake Exercise Don’t use alcohol or tobacco Eat a nutritious diet Relax

10. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 10 Male Sexual Maturation  2 years later than girls  Begins about 10 or 11 years old  Physical changes.

11. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 11 Aging and Human Sexuality  Menopause Ovaries gradually cease functioning Decreasing estrogen Increase risk of disease  Males Gradual decrease of testosterone

12. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 12 Sexual Function  Sexual stimulation  Physical stimulation  Psychological stimulation

13. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 13 Sexual Response Cycle  Physiological mechanisms Vasocongestion Myotonia  Excitement phase  Plateau phase  Orgasmic phase Males (refractory phase)  Resolution phase

14. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 14 Sexual Health Problems  Biological and psychological conditions: Women :  Vaginitis  Endometriosis  Pelvic Inflammatory Disease (PID) Men:  Prostatitis  Testicular cancer

15. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 15 Sexual Dysfunctions  Common sexual dysfunctions: Male – erectile dysfunction, premature ejaculation and retarded ejaculation Women – vaginismus and orgasmic dysfunction  Treatment Psychosocial - troubled relationships Behavioral Relaxation and massage techniques

16. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 16 Sexual Orientation  Person’s preference in sex partners Heterosexual Homosexual couples Bisexuals  Origins of Sexual Orientation Biological and genetic factors Freudian psychoanalysis - Oedipus complex Learning theory Complex series of biological and psychological interactions

17. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 17 Varieties of Human Sexual Behavior  Celibacy  Autoeroticism and masturbation  Touching and foreplay  Oral-Genital stimulation  Anal intercourse  Sexual intercourse

18. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 18 Atypical and Problematic Sexual Behaviors  Conflicting feelings about sexuality  Societies attitude toward sexual explicit material and prostitution  Commercial sex Pornography Prostitution

19. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 19 Responsible Sexual Behavior  Careful decision making  Open, honest communication about intentions  Sexual activities that both partners agree upon  Sexual privacy  The use of Contraception  Safer sex  Sober sex  Taking responsibility for the consequences

20. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 20 Understanding Fertility  Conception involves the fertilization of a women’s egg by a man’s sperm Each month a women’s ovaries release an egg  24 hours if not fertilized 3-4 days - the egg travels through the fallopian tubes Egg not fertilized Millions of sperm Sperm release an enzyme Egg and sperm each carry 23 chromosomes Ovum, blastocyst, embryo, fetus  Fraternal twins and identical twins

21. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 21 Infertility  Women Blocked fallopian tubes Pelvic Inflamm. Disease Endometriosis Hormonal imbalance Uterine Growths Allergic responses to sperm Smoking Alcohol Toxic chemicals or radiation  Men Low sperm count Poor motility Blocked passageways Toxic substances Smoking Drugs Testicular injury Infections Birth defects High Temperatures

22. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 22 Treating Infertility  Intrauterine insemination Artificial intrauterine insemination  IVF,GIFT, and ZIFT In vitro fertilization (IVF) Gamete intrafallopian transfer (GIFT) Zygote intrafallopian transfer  Surrogate Motherhood

23. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 23 Pregnancy  13 week trimesters  Tests Human chorionic gonadotropin (HCG) Two weeks after fertilization  Early signs and symptoms Missed menstrual period Softening of the uterus  Hager’s sign Slight bleeding Nausea Breast tenderness Increased urination Sleepiness, fatigue and emotional upset

24. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 24

25. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 25 Fetal Development  First Trimester Blastocyst  Inner cells divide into three layers  One layer – inner body parts  Middle layer – muscle, bone, blood, kidneys, and sex glands  Third layer – skin, hair, and nervous tissue Embryo - End of second week All major body structures are formed between 2nd and 9th week 2nd Month - Fetus

26. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 26 Fetal Development  Second Trimester Fetus grows to about 14 inches and 2 pounds  Third Trimester Fetus gains protective fat layers, Respiratory and Digestive organs develop

27. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 27 Diagnosing Fetal Abnormalities  Ultrasonography (Ultrasound) High frequency sound waves  Amniocentesis Fluid removal from the uterus  Chorionic Villus sampling Removal of tiny section of chorionic villi  Triple marker screen (TMS) Maternal blood test  Fetal programming Amniocentesis, CVS, and TMS Chromosomal, genetic and other abnormalities

28. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 28 The Importance of Prenatal Care  Regular medical checkups  Blood tests  Prenatal nutrition  Avoidance of drugs, and other environmental hazards Alcohol Tobacco Caffeine Drugs and chemicals STD’s and other infections

29. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 29 The Importance of Prenatal Care  Activity and exercise After 20 weeks avoid lying on your back Modify the intensity Avoid any potential for mild abdominal trauma Avoid heat stress Unusual symptoms Resume prepregnancy exercise gradually Kegal Exercises  Preparation for childbirth

30. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 30 Complications of Pregnancy and Pregnancy Loss  Ectopic pregnancy  Spontaneous Abortion, or miscarriage  Preeclampsia/eclampsia  Low-birth Weight (LBW) 5.5 LBS.  Infant Mortality SIDS  Coping with loss

31. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 31 Childbirth  Choices in childbirth Who is going to assist with delivery? Where is the baby going to be delivered?

32. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 32 Labor and Delivery  Entire process 2-36 hours.  First stage of Labor. 13 hours for a first birth. Cervix is completely dilated (10 centimeters) Hormonal changes. Contractions. (30 seconds and occur every 15-20 minutes) Mucus plug is expelled and amniotic sac may rupture. Transition.

33. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 33 Childbirth  Second Stage of Labor Baby slowly pushed into birth canal Baby squeezes through pelvis Head is usually delivered first Umbilical cord is cut  Third Stage of Labor Delivery of the placenta  Apgar Scale of the Baby

34. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 34

35. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 35 Pain Relief During Labor and Delivery  Childbirth preparation courses Breathing and relaxation techniques Lamaze or Bradley  Epidural  Narcotics Fentanyl or demeral Provide less pain relief than a epidural

36. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 36 Cesarean Deliveries  About 29% of babies born in the U.S.  Surgical removal of the baby Baby’s head too large Mother has a serious health condition Mother who is overweight or diabetes Difficult labor Fetal distress Dangerous infections

37. Chapter 5 ©2008 McGraw-Hill Companies. All Rights Reserved. 37 Postpartum Period  3 months following childbirth.  Critical family adjustment.  Vaginal delivery leave hospital 1-3 days.  Cesarean section 3-5 days.  Breastfeeding Just over 70% of mothers breast-feed Lactation begins about 3 days post childbirth Colostrum prior to lactation  Postpartum depression.

38. Sexuality, Pregnancy, and Childbirth Chapter 5