1. Pregnancy and Childbirth Chapter 8

2. ©2008 McGraw-Hill Companies. All Rights Reserved. 2 Deciding to Become a Parent  Physical health and age  Financial circumstances Birth to 18 years old $250,000  Relationship with your partner  Education, career and child care plans  Emotional readiness  Social support  Personal qualities  Philosophical or religious beliefs

3. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 3 Preconception Care 1.Preexisting medical conditions. 2.Prescription drug/OTC drug use. 3.Prior pregnancy or delivery problems. 4.Age. 5.Smoking, alcohol or other drug usage. 6.Any infections? 7.Diet. 8.Usage of diethylstilbestrol (DES). 9.Multiple births. 10.Family history of genetic disorders.

4. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 4 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

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6. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 6 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

7. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 7 Infertility Treatment  Intrauterine insemination Artificial intrauterine insemination  IVF,GIFT, and ZIFT In vitro fertilization (IVF) Gamete intrafallopian transfer (GIFT) Zygote intrafallopian transfer  Surrogate Motherhood  Emotional Responses to Infertility

8. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 8 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

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10. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 10 Continual Change in the Women’s Body  Uterus size  Forth Month  Breast changes 8 th week 10 th week  colostrum  Muscles and Ligaments loosen  Weight Gain

11. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 11 Changes During the Later Stages of Pregnancy  Increased needs placed on the mother.  Braxton hicks contractions.  Lightening.  Emotional responses to Pregnancy.

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13. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 13 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

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15. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 15 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

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17. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 17 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

18. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 18 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

19. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 19 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

20. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 20 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

21. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 21 Childbirth  Choices in childbirth Who is going to assist with delivery? Where is the baby going to be delivered?

22. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 22 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.

23. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 23 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

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25. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 25 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

26. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 26 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 90% of cesarean mothers will have subsequent deliveries by cesarean

27. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 27 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.

28. Pregnancy and Childbirth Chapter 8