Pregnancy and Birth

1. Pregnancy and Birth

2. Am I Pregnant?Common Symptoms …. • Missed menstrual period • Breast tenderness • Morning sickness • More frequent urination Approximately 50% of teenagers will not have sex by the time they graduate high school. The decision to be abstinent takes a lot of planning. What are three steps a teenager can take in planning for and remaining abstinent?

3. Diagnosing Pregnancy • Presumptive Signs: breast changes, amenorrhea, nausea, vomiting, fatigue, frequent urination • Probable Signs: Positive pregnancy test, physical changes in the uterus • Positive Signs: Ultrasound or X-ray of fetus, fetal heartbeat, fetal movement

4. Pregnancy Tests • Physician tests • Home pregnancy tests • test based on detection of hCg • Human chorionic gonadotropin - a hormone secreted by the placenta; it is the substance detected in pregnancy tests

5. Prenatal Development • Nine months of pregnancy are divided into three equal periods of three months – called trimesters – First trimester - months 1 to 3 (embryo- first 2 months) (fetus- next 7 months) – Second trimester - months 4 to 6 – Third trimester - months 7 to 9

6. The Embryo and Its SupportSystems • Placenta - an organ formed on the wall of the uterus through which the fetus receives oxygen and nutrients and gets rid of waste products • Umbilical cord - the tube that connects the fetus to the placenta • Amniotic fluid - the watery fluid surrounding a developing fetus in the uterus

8. Fetal Development During theFirst Trimester • Develops into a fetus with most of the major organ systems present • 4th to 8th week - external body parts develop • 7th week - liver, lungs, pancreas, kidneys, and intestines have formed and begun limited functioning • End of 12th week - 10 centimeters long;weighs 19 grams

11. Mom’s Physical Changes: First Trimester • Large increase in levels of hormones • Breasts swell and tingle; development of mammary glands • Need to urinate • Morning sickness • Vaginal discharges may increase • Feelings of fatigue and sleepiness • Depression is common • Emotional roller coaster

12. Fetal Development During theSecond Trimester • Quickening occurs - woman becomes aware of fetal movements – around the end of the 14th week • Fetal heart beat can be detected • Fetus opens its eyes

15. Mom’s Physical Changes: Second Trimester • Morning sickness disappears • Constipation and nosebleeds sometimes occur • Edema - water retention and swelling • Colostrum may come out of the nipple • Emotional well-being improves

16. Fetal Development During theThird Trimester • Fetus’s skin is wrinkled and covered with downlike hair- lanugo and a waxy protective layer- vernix • Fetus turns in uterus to assume a head-down position • Fetus experiences rapid growth

18. Sex During Pregnancy • Intercourse can continue safely throughout pregnancy, unless otherwise stated by doctor • Some anecdotal evidence of hormones in semen inducing labor

19. Nutrition During Pregnancy • Diet during is extremely important • Woman must get enough protein, folic acid, calcium, magnesium and vitamin A • The fetus comes first – it draws the nutrients it needs first, and whatever is left is for mom

20. Nutrition Deficiencies • Calcium – future risk of bone and tooth loss • Folic acid – (folate) much higher risk of neural tube defects. (decreases risk by 50%) • Zinc – malformations of the central nervous system

21. Effects of Drugs Taken During Pregnancy • Teratogens - a substance that produces defects in a fetus Examples of teratogens: • Antibiotics • Alcohol - fetal alcohol syndrome • Tobacco • Other psychoactive drugs (cocaine, heroin) • Thalidomide- drug that can cause limb defects • Other drugs - check with physician and “when in doubt, don’t”

22. Birth: The Beginning of Labor • Bloody show- discharge of mucous plug, along with some blood, that sealed the cervix • Amniotic sac ruptures- “water breaking” • Contractions may start • Labor divided into 3 stages

23. The First Stage of Labor:Dilation and Contractions • Regular contraction of uterus muscles • Effacement of cervix (thinning) • Dilation of cervix (enlargement) • Divided into 3 stages: – Early first-stage labor (0-5 cm dilation) – Late first-stage labor (5-8 cm dilation) – Transition phase (8-10cm dilation)

25. Pain Management • Epidural or Spinal Medicationregional blocks prevent the nerves from sending signals to the brain; numbs or reduces pain in part of the body (from the abdomen down). • Mental Relaxation TechniquesSome techniques aim to focus your thoughts, others to distract you. Music, breathing, visualization are common. • Narcotic Analgesicsreduces your entire body’s ability to sense pain or discomfort. Administered through a shot or IV and will wear off within a few hours. Not recommended if you are within two hours of your baby’s birth. • Physical Comfort MeasuresHot and cold packs, massage, sipping cool water are common. • Position ChangesSome positions improve your baby's ability to navigate through the pelvis, other positions hinder his efforts. Some positions can help to reduce the pressure associated with a back labor, other positions make it easier to relax your body and rest. • WaterTubs and showers help to handle contractions with less discomfort.

26. The Second Stage of Labor: Delivery of the baby • Begins when cervix is fully dilated • Urge to push or bear down • Crowning – top of the head is visible • Fontanel- soft spots between the skull bones of the baby • Episiotomy may be performed – incision that is sometimes made at the vaginal entrance during birth • Baby is born

27. The Third Stage of Labor:Delivery of the afterbirth • Placenta detaches from walls of the uterus • Afterbirth is expelled • Several contractions may accompany placental expulsion • Episiotomy and tears are sewn up

31. Cesarean Section • A method of delivering a baby surgically, by an incision in the abdomen • Reasons to have a C Section: – Baby is too large, mother’s pelvis is too small - Baby not in head down position – Cervix is not dilating – Umbilical cord prolapses – Excessive bleeding – Placenta previa

32. Newborn testing • APGAR- the rating (0-2) of baby’s physical characteristics 1 and 5 minutes after birth • If there are problems with the baby an additional score is given at 10 minutes. • A score of 7-10 is considered normal, while 4-7 might require some resuscitative measures, and a baby with apgars of 3 and below requires immediate resuscitation.

33. The 4th trimester • Parenting a newborn • Physical and emotional changes again • Post-partum depression a possibility