1. BIRTH PLANNING
Senior Health

2. Birth Planning Obstetrician/Gynecologist Maternal-Fetal Specialist
4 years of training in pregnancy, delivery and women health and infertility.
Maternal-Fetal Specialist
High risk pregnancy specialist with OB/GYN
Family Physician
General medical care for the whole family.
Referral to OB/GYN, only for low risk pregnancy
Nurse Mid-wife
Licensed registered nurse cares for mother and fetus
Trained specifically in delivery of baby and after care.
Works with doctor, unless complications.

3. What is a high risk pregnancy?
You have a health problem, such as: Diabetes.
Cancer.
High blood pressure.
Kidney disease.
Epilepsy
You use alcohol or illegal drugs, or you smoke.
You are younger than 17 or older than 35.
You are pregnant with more than one baby (multiple pregnancy).
You have had three or more miscarriages.
Your baby has been found to have a genetic condition, such as Down syndrome, or a heart, lung, or kidney problem.
Having a baby with a genetic problem, such as Down syndrome.
You have an infection, such as HIV or hepatitis C.

4. Hospital Birth Up to date medical equipment Medication available
Recommended for high risk pregnancy
Delivery by doctor OR nurses

5. Birthing Center Low risk pregnancies
Home like setting-usually on hospital grounds
Medication free
Parents have control of process
Receive individual care
Labor-Delivery and after care in the same room.
No cesarean sections

6. Home Birth For a healthy, low-risk pregnancy
You want to enjoy the comforts of your home and familiar surroundings
Labor-Delivery and After care all in same setting
Maximum control over birth
Share experience with family and friends
NO medicine or medical care immediately available
Midwives bring necessary equipment

7. Birth Plan Medications
Natural Childbirth
Advantage
No side effects from medication
Experience birth and delivery
No medical machines to be hooked up to
Disadvantages
Pain/Discomfort without medication
Point of no return- Medication

8. Systemic Medications Narcotics or tranquilizer
IV into blood stream or injection into muscle
Advantage
No anesthesia
Takes “edge” or reduces anxiety
Cope with some pain
Disadvantages
Doesn’t control all pain
Slows down labor
Could effect fetus or baby
Drowsy & difficulty breathing

9. Regional Medication Decreases sensation to specific parts of the body.
Mother is alert and awake with NO pain waist down.
Spinal Tap
-Injected in the dura of spinal cord
Advantage
-Rapid pain relief
Disadvantage
-Position for injection
-Harder to push fetus out
-Decrease in blood pressure
-Headaches
Epidural
-injected into sac around spinal cord.
Advantage
-Awake and alert during labor
-Increases energy during delivery
Disadvantage
-Spotty pain relief
-Position for injection position
-Loss of sensation of body

10. Pregnancy and Parenting

11. Female Anatomy

12. Fertilization
Fertilization is the union of the sperm and the ovum, or egg.
This occurs around the time of ovulation in a women.
The egg is capable of being fertilized for about hours after ovulation.
The sperm can live inside a woman’s body for up to 5 days.
This occurs in the fallopian tube.
As soon as the ovum is fertilized, it is called a zygote.

14. Fertilization
Look Who's Talking

15. Zygote
Once the zygote has formed, a protective membrane around it will prevent more sperm from entering the ovum.
As the zygote makes its way to the uterus the cells will divide many times to form a cluster of cells that has a hollow space in the center.
This is called a blastocyst.

16. Blastocyst

17. Implantation When the blastocyst attaches to the lining of the uterus.
The lining of the uterus is made up of layers of tissue that will protect and nourish the fertilized egg.
Once implanted the cluster of cells is now called an embryo.
The embryo is now the size of a dot on top the letter “i.”

18. Embryonic Development
The cells of the embryo will continue to divide and form 3 layers of tissue.
One layer becomes the respiratory and digestive systems.
Another layer develops into muscles, bones, blood vessels, and skin.
The third layer becomes the nervous system, sense organs and the mouth.

19. Embryonic Development Con’t
The Amniotic Sac will also form at this time.
This is a sac filled with fluid that forms and surrounds the developing embryo. It acts as a shock absorber, and insulates the embryo from temperature changes.
Placenta – A blood rich tissue developed from an outer layer of cells from the embryo and tissue from the mother. The embryo is connected to the placenta by the umbilical cord.
Umbilical cord – a tube through which nutrients and oxygen pass from the mother’s blood into the embryo’s blood. The umbilical cord also carried waste products from the embryo.

21. Embryonic Development Con’t
During the first six weeks the embryo grows rapidly in length and gains weight.
At the start of the embryonic period the embryo is about .5-1 inch long.
At eight weeks the embryo is 1.5 inches long.
At the end of the eighth week the embryo is now called the fetus, and will be called the fetus till birth.

22. Fetal Development
The development of the fetus is now divided into 3 trimesters.
1st trimester – 1 to 3 months
2nd trimester – 4 to 6 months
3rd trimester – 7 to 9 months

23. 1st Trimester
During the 1st month: the blood begins circulating, and the brain begins to form but does not function
During the 2nd month: the external body parts and internal organs begin to form, genitals also start to form but you can not tell the gender yet.
During the 3rd month: the male and female begin to look different, fingers, toes , and nails start to form, the head is about half the size it will be at birth.

24. 1st trimester

25. 2nd Trimester
During the 4th month: Muscles move , sweat glands, eyebrows, and eyelashes begin to form.
During the 5th month: fetus gets hair, movements can be felt, heartbeat can be heard.
During the 6th month: the brain starts to work, eyes open, ears work, finger and footprints form.

26. 2nd trimester
Fetus is about 8 inches long

27. 3rd Trimester
During the 7th month: the fetus adds body fat, moves a lot, responds to sound
During the 8th month: less active, still growing in weight and length, nails and bones begin to harden
During the 9th month: Lungs and other organs become fully developed (except for brain and reproductive system which won’t fully mature until teen years)

28. 3rd trimester

29. Ultrasounds
1st Trimester
2nd Trimester
3rd Trimester

30. How do you know your pregnant?
Symptoms include missed menstrual period, breast tenderness, morning sickness, frequent urination.
Pregnancy Tests
Blood and Urine Tests test for the hCG hormone.
Blood tests can test for hCG sooner and are more accurate. (6-8 days after ovulation)
Home pregnancy tests are the most accurate one week after a missed period.

31. Physical Changes
1st trimester: increase in hormones, breast swell, frequent urination, morning sickness, vaginal irritation, fatigue
2nd trimester: morning sickness disappears, constipation, nosebleed may occur, edema (water retention and swelling)
3rd trimester: weight gain (25-35lbs), discomfort, backaches, shortness of breath, swelling, heartburn, frequent urination

32. Psychological Changes
Depression
Negative/positive emotions
Psychological well being is best among those that have social support.
Postpartum depression – also known as the “baby blues,” happens after the birth and consists of mood swings and crying spells. May go away on own, if not the mother will need to seek medical treatment

33. Father/Partner’s Role
Couvade Syndrome – a healthy man whose partner is expecting a baby experiences pregnancy symptoms, “sympathetic pregnancy”
Symptoms occur during the 1st and 3rd trimesters and consist of nausea, heartburn, abdominal pain, appetite changes, backaches, etc.
Helps with labor – breathing techniques, may hold a leg, and cuts the umbilical cord

34. Prenatal Care
Pregnant women should have regular visits with an OB/GYN or midwife.
Blood Tests, pelvic examinations to identify any problems early on
Ask questions
Nutrition
Monitor weight
Exercise programs

35. Prenatal Nutrition
The mother to be needs large amounts of micronutrients, especially calcium, Vitamin E, Zinc, and Iron.
Iron Deficiency – will cause the fetus to draw its supply from the mother and leave the mother anemic, and exhausted.
Zinc Deficiency – malformations of the central nervous system.
Eating foods high in Folic Acid (whole grains and fish) reduces the risk of certain birth defects.
Spina Bifida – a birth defect where the backbone and the spinal canal do not close before birth

36. Medicines, Drugs, and Pregnancy
Any medication whether over-the-counter or prescription pose a potential danger to the fetus.
If illegal drugs are taken during pregnancy the baby can be born addicted and dependent on the drug.
Caffeine has been associated with an increased risk of birth defects and other problems.
Other harmful substances: food additives, aspirin, antibiotics, toxins, such as carbon monoxide and lead.

37. Alcohol and Pregnancy
Females who drink alcohol during pregnancy may cause permanent damage to the developing baby.
Alcohol use had been associated with many birth defects.
The alcohol passes from the mother into the bloodstream of the fetus.
Fetal Alcohol Syndrome (FAS) – mental retardation, slow growth, and physical defects, such as cleft palate, and hip dislocation.

38. Fetal Alcohol Syndrome

39. Tobacco and Pregnancy
Babies born to mothers who use tobacco have a greater chance of being born prematurely, and with low birth weights.
Babies that weigh less than 5 ½ lbs are at risk for serious health problems.
Low birth weight is the leading cause of death in a baby’s first year.
Smoking may affect the growth, mental development, and behavior of a child up to age 11.
Children also have a higher incidence of respiratory problems, such as bronchitis and pneumonia.

40. Stages of Labor
1st stage: Dilation- Stretching of the cervix, results from mild contractions.
2nd stage: Begins when the cervix is fully dilated (8-10inches), Passage of the baby through the birth canal, caused by continuing contractions.
Crowning – top of the head is visible
Episiotomy – incision made to the vaginal entrance
3rd stage: After Birth-contractions continue after the baby is born for 10 to 15 minutes to push out the placenta.

41. Cesarean Section Also known as a “C-Section”
A method of delivering a baby surgically by an incision to the mother’s abdomen and uterus.
Reasons:
Baby is too large
Cervix is not dilating
Umbilical cord
Excessive bleeding
Baby is in distress
Baby is in an abnormal position
Cesarean Section Clip

42. Recovery Time Vaginal Birth – 2 days after delivery
C-Section – 4 days after delivery

43. Infertility
Infertility refers to a woman’s inability to conceive and give birth to a living child, or man’s inability to impregnate a woman.
Causes:
Female – Pelvic Inflammatory Disease, Failure to ovulate, blockage of the fallopian tubes, body fat, hormones
Male – Infections to the reproductive system caused by STDs, low sperm count, low sperm motility
Both – Stress, lack of knowledge

44. Questions Why do miscarriages happen?
10-25% of all clinically recognized pregnancies will end in a miscarriage
Most miscarriage will occur within the first 13 weeks
Reasons for miscarriages vary and often can not be identified
Examples: chromosomal abnormalities, hormonal problems, lifestyle, problems with implantation,
Maternal age
Maternal trauma

45. Questions Birth Defects?
1 in every 33 babies is born with a birth defect.
Center for Disease Control Statistics

46. Questions What is the average number of children parents have?
According to 2010 Census 1.88
When do you start to show?
Most women start showing between 3 and 4 months
Women who have been pregnant before my start showing sooner