Pregnancy, Birth, and Childhood: Signs, Development, and Care

1. Chapter 19 Pregnancy, Birth, and Childhood

2. Signs of Pregnancy • Missed menstrual period • Tenderness in the breasts • Nausea • Vomiting • Fatigue • Change in appetite • Pregnancy Tests • Blood test – done by physician, testing for the presence of HCG (human chorionic gonadotropin) in the blood. • Urine test – also tests for HCG; can be done by a physician or home pregnancy test

3. Development Before Birth Timeline • 1. Fertilization – takes place in the fallopian tube. • 2. The zygote – the united sperm and egg travels through the fallopian tube and begins to divide. • 3. Cell division - structure is growing • 4. The blastocyst (embryo) enters the uterus • 5. Implantation – embryo attaches to wall of the uterus.

4. Structures development in the Uterus • Amniotic sac – fluid-filled sac develops around the embryo and grows as embryo grows. • Placenta – holds the embryo to the uterine wall and delivers oxygen and nutrients. • Umbilical cord – carries nutrients and oxygen from the placenta to the embryo and wastes from the embryo to the placenta.

5. Stages of Pregnancy First Trimester – first three months after conception. After month 2 the embryo is called a fetus. At 8 weeks the heart beat can be heard. Second Trimester – months 4 – 6. The fetus begins to move and kick. Third Trimester – months 7 – 9. The fetus continues to grow and develop. By the end of the 9th month, the fetus is ready to be born. Healthy Pregnancies last anywhere from 36-42 weeks.

6. Staying Healthy During Pregnancy ProperNutrition: Pregnant women need to eat more calories to support the growth of her own body and the developing fetus. Eating a well balanced diet rich in the key nutrients is important. Key Nutrients: folic acid, protein, calcium, iron, vitamin A, Vitamin B complex

7. Exercise: regular physical activity is important for a healthy pregnancy. It helps reduce the risk for diabetes and other health problems during pregnancy as well as helping the woman meet the extra energy demands of carrying the fetus. (Get doctors approval for the exercise program)

8. 3. Avoiding Alcohol and Other Drugs: these substances, even in small amounts, can harm or kill the developing baby, decrease the newborn’s chance to live, or cause lifelong problems.

9. 4. Avoiding Environmental Hazards: X-rays – can harm a developing fetus Lead – most exposure is from lead-based paint Mercury – most exposure comes from eating contaminated fish. Fish intake should be limited for pregnant women. Cat litter – cat feces can contain a parasite that is especially dangerous to a developing fetus. Pregnant women should avoid contact.

10. Prenatal care – medical care during pregnancy Obstetrician – a doctor specialized in pregnancy and childbirth Routine Visits to the Obstetrician: First trimester: record medical history and weight; note conditions that could affect the pregnancy; prescribe prenatal vitamins as needed. Second trimester: Monitor heartbeat of fetus; measure growth of the uterus; monitor for complications using ultrasound and other tools. Third trimester: Check position and size of fetus; check for warning signs of premature (early) birth; continue to monitor for complications; discuss birth process. Monitoring Tools: Ultrasound – high frequency sound waves used to create an image of the developing fetus. This can help doctors tell the age of the fetus, the gender, if there are multiple babies, the position and if the bones and muscles are developing. Chorionic Villus Sampling (CVS) – a test done around the 8th week that detects inherited disorders in the embryo such as hemophilia or extra chromosomes; this uses a piece of the developing placenta. (not a routine test) Amniocentesis – another test done around the 14th week to test for abnormalities in the fetus. (not a routine test)

11. Complications – problems can occur at any time during pregnancy. Ectopic pregnancy: where the fertilized egg implants in the fallopian tube instead of the uterus. Surgery is necessary to remove the embryo and repair the damaged fallopian tube. Miscarriage: the death of the embryo or the fetus. Almost all miscarriages occur in the first trimester. Preeclampsia: also known as toxemia, is characterized by high blood pressure, swelling of wrists and ankles and high levels of protein in the urine. Prevents the fetus from getting enough oxygen. Treated with bed rest or medication. Gestational diabetes: diabetes that develops in pregnant women marked by high blood sugar levels. If untreated could cause the fetus to grow to large which increases the risk of a difficult birth; could cause premature birth

12. Childbirth *Birth takes place in three stages. Stage 1: Labor Strong contractions of the muscles of the uterus cause the cervix to increase in width or dilate. End of Stage 1 – cervix enlarges to 10 centimeters. Stage 2: Delivery of the Baby Crowning occurs (top of the head) An episiotomy may be performed (cutting of the perineum) End of Stage 2 – baby is out and the doctors will clamp and cut the umbilical cord. Stage 3: Delivery of the Afterbirth (placenta) The mother will still have contractions from the uterus to push out the placenta. Postpartum period – first 6 weeks after the birth; period of adjustment

13. Complications at Birth *Some complications result in a surgical delivery or premature birth. Low birth weight and the birth of more than one baby may cause complications as well. Stillbirth – occurs when a fetus dies and is removed from the body after the 20th week of pregnancy. Surgical delivery – a cesarean section – mother may be asleep or awake during the procedure; doctor makes an incision in the lower abdomen into the uterus and removes the baby and the placenta. Premature birth – delivery of a live baby before the 37th week of pregnancy. Low birth weight – a newborn weighing less than 5.5 pounds at birth. They face an increased risk of health problems as newborns, chronic lifelong problems and even death. Multiple Births: Identical twins – twins that develop from a single fertilized egg Fraternal twins – twins that develop from two different eggs released by the ovaries. Triplets or more

14. Childhood • Early Childhood • Birth to Eighteen Months – cries for help; learns to sit, crawl, stand and walk; responds to attention with smiles • Eighteen months to Three Years old – plays alongside others; learns many words; physical coordination improves • Three to Six Years old – plays with others; has lots of energy; become more independent and active; communication skills advance more rapidly; children start to develop a sense of right and wrong • Six to Twelve Years old – physical growth, mastering new skills and making friends are key areas of development during middle and late childhood. Late childhood is also known as pre-adolescence. It is the stage of development for adolescence (teen years).