Chapter Eight

1. Chapter Eight Pregnancy and Childbirth

2. Your physical health and age Financial circumstances Your relationship to your partner Your educational, career, and child care plans Your emotional readiness for parenthood Your social support system Your personal qualities, attitudes towards children, and aptitude for parenting Your philosophical or religious beliefs Deciding to Become a Parent

3. Preconception Care • The birth of a healthy baby depends in part on the mother’s overall wellness before conception • The U.S. Public Health Service recommends the following type of Preconception Care: • Assessment of health risks • Promotion of Healthy Lifestyles behavior • Treatment of any problems that will increase health risks

4. Understanding Fertility • Conception involves an ovum from a woman and sperm from the man • The sperm and egg must meet in the fallopian tube, which after fertilization, will travel to the uterus for implantation (zygote) • It there is no union, the egg will disintegrate within 24 hours and expelled with the uterine lining during menstruation

5. Identify Aids toFertilization • Sperm can travel 1 inch/hour • Sperm can live for days inside the fallopian tubes (approx. 48-72 hours)

6. Causes of Infertility • Low sperm count • Poor sperm motility • Sperm abnormalities • Lack of ovulation • Obstruction of fallopian tubes • PID • Endrometrosis • Age

7. Treating Infertility • Surgery • Fertility drugs • Surrogate Motherhood • Intrauterine Insemination • IVF, GIFT, and ZIFT • in vitro fertilization • gamete intrafallopian transfer • zygote intrafallopian transfer

8. Early Signs of Pregnancy • Missed menstrual period after sexual intercourse the previous month • Morning sickness/nausea • Increase in size/tenderness of breasts • Slight bleeding • Sleepiness, fatigue, and emotional upset

9. Continuing Changes in the Woman’s Body • Increased frequency of urination • Enlargement of the uterus • Breast enlargement and increased sensitivity • Increased in the size of the abdomen • Cervix becomes softer by the sixth week

10. Changes During the Later Stages of Pregnancy • Backaches from the baby’s weight • Joint swelling • Braxton Hicks contractions • “Lightening” of the fetus

11. Emotional Responses to Pregnancy • Both partners may have anxiety about the approaching birth • Rapid changes in hormone levels can cause a pregnant woman to experience unpredictable emotions such as fears of possible dangers to the fetus • Periods of depression due to physical appearance and limited physical ability could occur

12. Fetal Development (First Trimester) • After 30 hours, the fertilized egg goes through many forms of cell division • A Blastocyst is formed by the 4th day after fertilization • An embryo is created by the end of the 2nd week from the blastocyst separating into 3 layers • The outermost shell of cells becomes the placenta, umbilical cord, and amniotic sac • Between weeks 2-9, all major body structures are formed, including the heart, brain, liver, lungs, and sex organs After the second month, the embryo will become a fetus

13. The Second Trimester • Growth improves to about 14 inches and the weight increases to 1.5 lbs. • All body systems are working and the fetal heartbeat can be heard • Fetal movements can be felt by the mother, beginning by the 4th to 5th month

14. The Third Trimester • The fetus gains most of its weight during the last 3 months • Fat layers are acquired during the 8th month as well as acquired immunity from the mother • Importance is placed on providing the fetus with important nutrients • The respiratory and digestive organs are developing at this stage

15. Diagnosing Fetal Abnormalities • Ultrasonography (ultrasound) • Amniocentesis (removal of fluid from uterus) • Chorionic villus sampling (removal via cervix) • Triple marker screen (TMS) The above methods are considered as a new area of study called Fetal Programming

16. Regular Checkups Blood tests Prenatal Nutrition Tobacco Caffeine Avoiding drugs and other environmental agents Alcohol (FAS) Accutane (acne drug) STD’s and other infections Proper activity/exercise Importance of Prenatal Care

17. Complications in Pregnancy and Pregnancy Loss • Ectopic pregnancy – implantation in the fallopian tube • Miscarriage – usually due to abnormalities in the first few weeks • Preeclampsia – blood pressure becomes elevated and could be life threatening • Low Birth Weight – (LBW) is when a baby weighs less than 5.5 lbs • Infant Mortality – death of a child less than one year of age i.e. (SIDS)

18. 3 Stages of Labor • Effacement/Dilation of the cervix: cervix opens to 10cm during this stage • Delivery of the fetus: “crowning” of the fetus • Delivery of the placenta: within 30 minutes afterbirth is expelled

19. Cesarean Deliveries (C-section) • Fetus is removed from the uterus through the abdominal wall due to the following factors: • Fetus is improperly positioned • Mother’s pelvis is too small • Fetus is especially large • Fetus shows signs of distress • Umbilical cord is compressed • Placenta is being delivered before the fetus • Mother’s health is at risk

20. The Postpartum Period • A stage of about 3 months following childbirth • It takes about 6-8 weeks before a woman’s reproductive organs to return to their prebirth condition • Lactation begins about 3 days after childbirth • The return of menstruation make take up to 6 months, depending upon hormonal activity • Fluctuating emotions are the result from the hormone level changes, which could result in “postpartum depression” or happiness of the new arrival

21. Chapter Eight Pregnancy and Childbirth