1. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Chapter 12 Conceiving Children: Process and Choice

2. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Parenthood as an Option Advantages of remaining childless –more time for self and companion –more financial resources –marriages less stressful –more spontaneity –more devotion to career

3. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Parenthood as an Option (cont.) Advantages to having children –children give & receive love –may enhance relationship –builds self-esteem, sense of accomplishment –greater meaning & satisfaction

4. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant Enhancing the possibility –intercourse just prior to or at ovulation –predicting ovulation mucus, calendar, BBT methods ovulation-predictor urine tests

5. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant (cont.) Infertility –diagnosis more than 6 months of trying = problem 1 in 6 U.S. couples seek help secondary infertility –causes complex, hard to determine unidentifiable in 15%

6. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant (cont.) Infertility (cont.) –female infertility failure to ovulate regularly –Below normal body weight –Smoking and substance abuse female may destroy sperm sperm may not reach the egg fertilized egg may not implant

7. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant (cont.) Fig. 12.1 During normal ovulation, one follicle matures, releasing the egg for fertilization in the fallopian tube.

8. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant (cont.) Infertility (cont.) –male infertility abnormal sperm count or motility –Caused by poor nutrition or infection –Substance use –Environmental toxins impaired sperm production –Congenital abnormalities

9. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant (cont.) New reproductive technologies –Surgical biopsy –Intracytoplasminc sperm injection (ICSH)

10. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant (cont.) Infertility (cont.) –effects on sexuality heightened anxiety, depression, & stress lead to isolation from each other heightened inadequacy, anger, guilt, grief lead to sexual dissatisfaction treatment lowers spontaneity, heightens performance anxiety

11. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant (cont.) Alternatives to intercourse for conception –artificial insemination of sperm into biological or surrogate mother –surrogacy –assisted reproductive technology (ART) –in vitro fertilization (ZIFT or GIFT) –health and financial problems

12. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant (cont.) Alternatives for conception –problems with assisted reproduction expensive 75% failure rate 20-30% end in multiple embryos

13. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Becoming Pregnant (cont.) Pregnancy detection –first signs: light period, spotting, or no period; fatigue; tender breasts –nausea/vomiting; appetite change –blood or urine tests for (HCG) –at 6 weeks, subtle softening of uterus

14. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Spontaneous and Elective Abortion Miscarriage –occurs in first 20 weeks –10-20% of pregnancies –emotional impact can be significant –couple needs grief-support

15. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Spontaneous and Elective Abortion (cont.) Elective abortion –Approximately 25% of U.S. pregnancies end in elective abortion; 1% occur after 20 weeks

16. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Spontaneous and Elective Abortion (cont.) Fig. 12.2 When abortions are performed.

17. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Spontaneous and Elective Abortion (cont.) Elective abortion (cont.) –Procedures medical abortion suction curettage in 90% dilation & evacuation late-term abortion procedures illegal abortions

18. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Spontaneous and Elective Abortion (cont.) Elective abortion (cont.) Fig. 12.3 How medical abortions work.

19. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Spontaneous and Elective Abortion (cont.) Elective abortion (cont.) –shared responsibility –emotional reactions anxiety & depression prior most feel relief afterwards no lasting emotional distress

20. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Spontaneous and Elective Abortion (cont.) Abortion controversy –historical overview Early American law allowed abortion until quickening 1973 Roe vs. Wade 1977 Hyde Amendment State restrictions or limitations Waiting period, parent notification

21. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Spontaneous and Elective Abortion (cont.) Abortion controversy (cont.) –current debate majority of Americans believe abortion should remain legal pro-life goals pro-choice goals recent debate is more violent ethnic differences in views toward abortion

22. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice The Experience of Pregnancy For the woman –wide range of positive and negative emotions –emotions are affected by physical changes First trimester increased fatigue, nausea, and breast changes Second trimester movement felt; heightened sense of well-being Third trimester increased size; greater discomfort

23. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice The Experience of Pregnancy (cont.) Fig. 12.5 Pregnancy at the ninth month. The uterus and abdomen have increased in size to accommodate the fetus.

24. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice The Experience of Pregnancy (cont.) For the man –ecstasy to ambivalence to fearfulness –sense of separation –concern about financial impact –active involvement helps

25. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice The Experience of Pregnancy (cont.) Sexual interaction during pregnancy –inhibited during 1st & 3rd trimesters; or progressive decline –some women experience increases in desire –no restrictions on sexual activity or orgasm unless woman is at risk –modified positions often needed

26. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Fetal Development First Trimester –zygote –blastocyst = multiple cells that implant –7-8 weeks: can detect heartbeat –8 weeks: spinal canal, arms/legs, fingers/toes, –3rd month: internal organs

27. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Fetal Development (cont.) Fig. 12.4a The blastocyst implanted on the uterine wall.

28. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Fetal Development (cont.) Second and Third Trimester –fetal movements –end of 5th month: 1 pound, head hair, fat –6th month: eyes open –further differentiation and fat stores

29. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Fetal Development (cont.) Risks to fetal development –harmful substances pass to baby through placenta prescription and nonprescription drugs 1997; viable fetus can be protected under child abuse laws nicotine, caffeine, alcohol (FAS)

30. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Fetal Development (cont.) Fig. 12.6 The placenta exchanges nutrients, oxygen, and waste products between the maternal and fetal circulatory systems. (a) The placenta attached to the uterine wall. (b) Close-up detail of placenta.

31. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Fetal Development (cont.) detection of birth defects amniocentesis (14 to16 weeks) chorionic villus sampling (10 weeks)

32. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice A Healthy Pregnancy (cont.) Prenatal care important for development –health assessment before pregnancy –components include good nutrition, adequate rest, routine health care, moderate exercise, prenatal education

33. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice A Healthy Pregnancy (cont.) Risks to fetal development –Bacteria, viruses –Drugs –Cigarette smoking –Fetal alcohol syndrome –Prescription medicines

34. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Pregnancy after age 35 20% of childbearing women in U.S. Heightened rate of fetal defects due to chromosomal abnormalities Essentially safe with prenatal care Infertility increases with age

35. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Childbirth Methods Contemporary childbirth –Lamaze –Prepared childbirth –Birthplace alternatives –Home birth

36. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Childbirth First Stage (10 to 16 hrs) –bloody show –water bag breaks –effacing or thinning of cervix –slight dilation

37. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Childbirth (cont.) Second Stage –From: full dilation –Infant descends through vagina –To: delivery of baby –30 min to 2 hours

38. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Childbirth (cont.) Third Stage –From: delivery of the baby –To: delivery of the placenta –Placenta separates & is pushed out –20 to 30 minutes

39. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Childbirth (cont.) Cervical dilation and labor –early labor (up to 4 cm) –active labor (4-8 cm) –transition (8-10 cm)

40. Our Sexuality, 9th Edition, Robert L. Crooks Chapter 12: Conceiving Children: Process and Choice Childbirth (cont.) Medical interventions: pros & cons –medications regional drugs (e.g., epidurals) –episiotomy (cutting perineum) –delivery assistance; forceps or vacuum extraction