1. Pregnancy and Childbirth

3. Why has the fertility rate changed over time? ●Better healthcare and nutrition. Fewer children die because of childhood diseases. ●Don’t need children to help work on family farms/businesses. ●People with more resources tend to have fewer children

4. Infant and Maternal Mortality Infant Mortality: # of babies that die at birth for every 1000 births ●4.3 in Quebec 2011 Maternal Mortality: # of mothers that die during childbirth for every 100,000 deliveries ●7.8 in Canada in 2009-10

5. Zygote, Embryo or Fetus??? TimelineName at this stage of development When fertilization occursZygote Weeks 0-8Embryo Weeks 9-40+Fetus

6. Embryo: weeks 0-8 First trimester begins with zygote, then embryo, and finally fetus (week 9). Brain, heart, limbs, eyes and spinal column begin to form.

7. Amniotic Sac Surrounds developing embryo, contains amniotic fluid which protects the embryo from shock Placenta Organ that grows attached to the wall of the uterus; attached to baby by the umbilical cord Umbilical cord A flexible cord containing blood vessels that carry nutrients from mother to the baby, and waste from the baby to the mother

8. Fetus: weeks 9-40+ Pregnancy is divided into three “trimesters”, each being about 13 weeks long. The baby is called a fetus from the middle of the 1st semester through the end of the 3rd.

9. People who assist with Childbirth ★ Obstetrician-Gynecologist (doctor) ★ Family Practitioner (doctor) ★ Nurse-midwife ★ Doula ** ★ Family members/friends **

10. Methods of Childbirth The three main methods: ❏ Natural childbirth - vaginal delivery, no pain medication ❏ Medicated birth options - vaginal delivery but use medical pain control methods ❏ C-section

11. Methods of Childbirth (cont’d) Other methods: ●Water birth ●Hypnobirthing ●Use of reflexology, meditation, chiropractic care, accupuncture to control pain or prepare for birth

13. Choice of Locations for Delivery A.Hospital A.Birthing Center A.Home

14. A. Hospital Locations for Delivery Reasons for choosing a hospital: ❏ Care given by specially trained doctors and nurses. ❏ Access to emergency medical interventions, including surgery ❏ Access to pain relief: IV, injections, gas, epidural, etc.

15. Hospital Birthing Room

16. Things to consider: ❏ Little privacy or sense of intimacy; many medical people coming and going ❏ May be pressured to have medical procedures performed ❏ Must follow hospital rules around eating and drinking, number of people able to be present, wearing hospital gowns, etc.

17. B. Birthing Center Location for Delivery ❏ Cared for by certified nurse-midwife ❏ Close to a hospital; can be transferred if necessary ❏ Comfortable, home-like environment; friends and family welcome ❏ Can eat and drink, wear you own clothes ❏ Usually option for water birth

18. Room in a Birthing Center

19. Things to consider: ❏ Must move to the hospital if complications arise ❏ Limited access to pain relief; no medications or epidurals available ❏ Often only available in larger towns/cities

20. C. Home Birth Locations for Delivery ❏ Chosen because of the comfort of being at home and in charge of the birthing process ❏ Very low percentage (less than 2%) of births in Canada ❏ Usually attended by a nurse-midwife

21. Set up for a birth at home

22. Things to consider: ❏ Need to be close to a hospital in case of complications ❏ No pain medication/epidural available ❏ Risk of infant mortality is 2-3X higher for home births vs. hospital or birthing center