1. Prenatal development (con’t)

2. Prenatal testing and screening
Women are having more babies-risk down syndrome (mental retardation & physical abnormalities)
Amniocentesis
draws fluid from amniotic sac
Ultrasound or sonography
uses high-frequency sound waves
Fetoscopy
small incision and optical viewer
Chorionic villus sampling
snip tissue from fetal sac
Maternal Blood Analysis/Maternal Serum Alpha Fetoprotein

3. Amniocentesis
Fetoscopy

4. Ultrasound

5. Fetal Monitoring Track the baby’s heart rate during labor.
Safe procedure that has saved the lives of many babies in high-risk situations.

6. Types of Delivery Methods
Normal Delivery (Spontaneous vaginal delivery SVD)
Forcept
Vacuum
Induction
Cesarean

7. Forceps Delivery
Used when the mother’s pushing during the second stage of labor does not cause the baby to move through the birth canal in a reasonable amount of time.
Forceps are metal clamps placed around the baby’s head to pull the infant from the birth canal.
Risk: can result in head injury or brain damage
Instrument delivery is used when the mother’s pushing during the second stage of labor does not cause the baby to move through the birth canal in a reasonable amount of time.
In the United States, forceps or vacuum extractors are used in about 12 percent of births. They are used less than 5 percent of the time in Europe. Their use can result in head injury or brain damage.
Neither method should be used when the mother can be encouraged to deliver normally and there is no special reason to hurry.
Forceps are metal clamps placed around the baby’s head to pull the infant from the birth canal.

8. Vacuum Extraction
A vacuum extractor is a suction tube that is attached to a plastic cup placed on the baby’s head.
A vacuum extractor is a suction tube that is attached to a plastic cup placed on the baby’s head.

9. Induced Labor
Labor is started artificially by breaking the amnion and giving the mother a hormone that stimulates contractions.
Used when continuing the pregnancy threatens the well-being of mother or baby
Contractions often longer, harder, and closer together.

10. Cesarean Delivery
A cesarean delivery is a surgical birth in which the doctor makes an incision in the mother’s abdomen & lifts the baby out of the uterus.
When babies are in a breech position (turned so that the buttocks or feet would be delivered first) cesareans are often justified.
Although the operation is safe, mothers need more time for recovery and cesarean newborns are more likely to be sleepy and unresponsive & to have breathing difficulties.
A cesarean delivery is a surgical birth in which the doctor makes an incision in the mother’s abdomen and lifts the baby out of the uterus.
In 1994, cesareans accounted for 24 percent of American births. The rate dropped slightly to 21 percent in Still, this is the highest rate in the world.
Cesareans have always been warranted by serious medical emergencies. However, surgical delivery is not always needed in other instances.
When babies are in a breech position (turned so that the buttocks or feet would be delivered first) cesareans are often justified.
Although the operation is safe, mothers need more time for recovery and cesarean newborns are more likely to be sleepy and unresponsive and to have breathing difficulties.

11. Stages of Childbirth What signs indicate that labor is near?
Stage 1: Time interval? What happens?
Stage 2: Time interval? What happens?
Stage 3: Time interval? What happens?

12. The Birth Process Stage 1 Dilation and effacement of the cervix
is the longest stage of labor—lasting, on average, 12 to 14 hours with a first baby and 4 to 6 hours with later births.
Dilation and effacement of the cervix is the widening and thinning of the cervix resulting in a clear pathway from the uterus into the birth canal.
Uterine contractions are forceful and regular. Gradually, they get closer together, occurring every 2 to 3 minutes, and become more powerful, continuing for as long as 60 seconds.
Transition is reached when the frequency and strength of contractions are at their peak and the cervix opens completely.
In Stage 2 Delivery of the Baby
, which lasts approximately 50 minutes for a first baby and 20 minutes in subsequent births, the infant is born.
Strong contractions continue, and the mother feels a natural urge to squeeze and push with her abdominal muscles, forcing the baby down and out.
An episiotomy is a small incision that increases the size of the vaginal opening and permits the baby to pass without damaging the mother’s tissues.
The baby’s head crowns when the vaginal opening stretches around the entire head.
Stage 3 Delivery of the Placenta
The final stage lasts about 5 to 10 minutes.
The final contractions and pushes cause the placenta to separate from the uterine wall and be delivered.

13. Stage 1 : Dilation of the cervix
The longest stage of labor
First baby  hours
Sebsequent babies  hours
Dilation of the cervix
is the widening and thinning of the cervix  resulting in a clear pathway from the uterus into the birth canal.
Contractions are forceful and regular Gradually, they get closer together, occurring every 2 to 3 minutes, and become more powerful, continuing for as long as 60 seconds.
Transition is reached when the frequency and strength of contractions are at their peak and the cervix opens completely.

14. The Birth Process
Stage 1
Figure

15. In Stage 2 : Delivery of the Baby
First baby 50 minutes
Subsequent births  20 minutes
Strong contractions continue  mother feels a natural urge to squeeze and push with her abdominal muscles  forcing the baby down and out.
An episiotomy is a small incision at the perineum  increases size of the vaginal opening  permits baby to pass without damaging the mother’s tissues.
The baby’s head crowns when the vaginal opening stretches around the entire head.

16. Stage 2
Stage 3
Figure

17. Stage 3: Delivery of the Placenta
The final stage lasts about 5 to 10 minutes.
The final contractions and pushes cause the placenta to separate from the uterine wall and be delivered.

18. BIRTH COMPLICATIONS Faulty Power Faulty Passageway Faulty Passenger
Problem with mother
Contraction not strong enough
Faulty Passageway
Problem in the uterus
Placenta Previa
Placenta Abruption
Faulty Passenger
Problem with baby
Breech
Head too big

19. Low-Birth-Weight Baby
Weigh less than 2,500gm
2 category
Preterm (premature)
Baby born before completing the 35th week of gestation
Small for date
May not be preterm but weigh less than 90% of all babies of the same gestational age

20. Low-Birth-Weight 1 in 16 infants is born underweight
More common among low-income, ethnic minority pregnant women.
Small-for-date babies are associated with more serious problems
Infections
Brain damage
Infant death
Poor school achievement
Probably due to inadequate nutrition before birth. Perhaps mothers didn’t eat well or placenta did not function normally or babies themselves have defects that prevent them from growing normally.
Probably due to inadequate nutrition before birth. Perhaps mothers didn’t eat well or placenta did not function normally or babies themselves have defects that prevent them from growing normally.

21. Preterm Babies

22. Factors influencing the development during prenatal period
Parents age
Too Young
Mum too old
Dad too old
Mother’s Pregnancy History
Frequent pregnancy
Frequent miscarriage/abortion
Mother’s Physical condition
Size (too fat/ thin)
Mother’s Diet
Mother’s Emotion
Teratogenic Agent