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Pregnancy and Childbirth

Pregnancy and Childbirth. Chapter 8. Deciding to Become a Parent. Health and age Emotional preparedness Financial circumstances Two parent family will spend between $11,000-$22,000 per year, per child pending on total family income Relationship Future plans

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Pregnancy and Childbirth

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  1. Pregnancy and Childbirth Chapter 8

  2. Deciding to Become a Parent • Health and age • Emotional preparedness • Financial circumstances • Two parent family will spend between $11,000-$22,000 per year, per child pending on total family income • Relationship • Future plans • Education, career and child care plans • Attitude and aptitude • Beliefs • Philosophical or religious

  3. Preconception Care • Preexisting conditions. • Medications. • Prior pregnancy. • Age. • Tobacco, alcohol , caffeine use. • Infections. • HIV. • Diet. • Diethylstilbestrol (DES). • Multiple births. • Genetic disorders.

  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

  5. Infertility • Female infertility • One of two key causes • Tubal blockage (40%) • Failure to ovulate (40%) • Blocked Fallopian tubes are most commonly caused by pelvic inflammatory disease (PID) • Chlamydia or gonorrhea • Endometriosis

  6. Infertility • Male infertility • Accounts for about 20% of infertile couples • Four main categories • Hypothlamic pituitary disease • Congenital disorders • Testicular disease • Disorders of sperm

  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. Pregnancy • 3 periods of about 3 months (13 week trimesters) • Tests • Home pregnancy 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

  9. Continual Change in the Women’s Body • Uterus size • First 3 months, the uterus enlarges to about three times its nonpregnant size • 4th month, large enough to make abdominal protrude • 7th-8th month, pushes up into the rib cage • Breast changes • 8th week • 10th week • colostrum • Muscles and Ligaments loosen • Weight Gain

  10. Table 8-2 Recommended Weight Gain During Pregnancy

  11. Changes During the Later Stages of Pregnancy • Increased needs placed on the mother. • Braxton hicks contractions. • Lightening. • Emotional responses to Pregnancy.

  12. 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

  13. 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

  14. 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 • Quadruple marker screen (TMS) • Maternal blood test • Analyze four hormone levels and compared to appropriate standards • Fetal programming • Conditions in the womb may influence the risk of adult diseases • Amniocentesis, CVS, and TMS • Chromosomal, genetic and other abnormalities

  15. The Importance of Prenatal Care • Regular medical checkups • Blood tests • Prenatal nutrition • Avoidance of drugs, and other environmental hazards: • Teratogens • 1st trimester • Congenital malformations • Alcohol • Tobacco • Caffeine • Drugs • STD’s and other infections

  16. The Importance of Prenatal Care • Activity and exercise • Moderate exercise program • 30 minutes most days • Cardiovascular exercises • Kegal Exercises • Prenatal exercise classes • Preparation for childbirth

  17. Complications of Pregnancy and Pregnancy Loss • Ectopic pregnancy • Spontaneous Abortion, or miscarriage • Stillbirth • Preeclampsia/eclampsia • Placenta Previa • Placental Abruption • Gestational Diabetes • Preterm Labor • Labor Induction • Low-birth Weight (LBW) • 5.5 LBS. • Infant Mortality • SIDS • Coping with loss

  18. Childbirth • Choices in childbirth • Who is going to assist with delivery? • Physician • High risk? • Certified Nurse-Midwife • Where is the baby going to be delivered? • Hospital • Home

  19. Labor and Delivery • Entire process 2-36 hours. • First stage of Labor. • Average13 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: • Contractions may last 60-90 seconds and be 1-3 minutes apart

  20. 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 • Stage typically lasts 5-30 minutes • Apgar Scale of the Baby • Heart rate • Respiration • Color • Reflexes • Muscle tone • Total score is between 0 and 10

  21. 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

  22. Cesarean Deliveries • 2006 about 31.1% 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

  23. Postpartum Period • 3 months following childbirth. • Critical family adjustment. • Vaginal delivery leave hospital 1-3 days. • Cesarean section 3-5 days. • 6-8 weeks for the mother’s reproductive organs to return to prebirth condition • Breastfeeding • About 74% of mothers breast-feed • Lactation begins about 3 days post childbirth • Colostrum prior to lactation • American Academy of Pediatrics 6 months exclusively • Postpartum depression.

  24. Pregnancy and Childbirth Chapter 8

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