WATCH THIS FIRSTCLICK FOR MOVIE

UNDERSTANDING PREGNANCY & PARENTHOOD

CHAPTER 9

OBJECTIVES

• LIST & DISCUSS REASONS FOR BECOMING OR NOT BECOMING A PARENT

• DESCRIBE THE PROCESSES OF FERTILIZATION & IMPLANTATION

• EXPLAIN HOW PREGNANCY TESTS WORK

• DESCRIBE THE MAJOR HEALTH HABITS IN PREGNANCY

• DESCRIBE AMNIOCENTESIS & CHORIONIC VILLUS SAMPLING

• DESCRIBE THE 3 STAGES OF LABOR

• LIST BENEFITS OF BREASTFEEDING

• DISCUSS INFERTILITY & PREGNANCY OPTIONS FOR INFERTILE PEOPLE

TERMS TO KNOW

• PLACENTA

• LOCHIA

• COLOSTRUM

• FLAT, CIRCULAR VASCULAR STRUCTURE WITHIN PREGNANT UTERUS THAT PROVIDES NOURISHMENT TO & ELIMINATES WASTE FROM DEVELOPING EMBRYO/FETUS. –PASSED AS AFTERBIRTH AFTER BABY IS BORN

• UTERINE TISSUE DISCHARGE FOLLOWING AFTERBIRTH - LASTS 1-2 WEEKS

• YELLOW PRECURSOR TO MATERNAL MILK

PARENTHOOD?

YES!!• TO CREATE A FAMILY

• TO MANIFEST A COUPLE’S LOVE

• TO IMPROVE A MARRIAGE

• TO LEAVE A LEGACY

• CARRY ON FAMILY NAME

• SOCIAL/FAMILY PRESSURE

• TO FEEL MASCULINE/FEMININE

• ADD FUN, EXCITEMENT, LOVE & COMPANIONSHIP TO ONE’S LIFE

NO, THANK YOU• INFRINGES ON CAREER/PERSONAL

GOALS

• INFRINGES ON INTIMATE PARTNERSHIP

• DOUBTS OF PSYCHOLOGICAL/ECONOMIC ABILITIES TO SUPPORT A CHILD

• WORLD IS ALREADY OVERPOPULATED

FERTILIZATION & IMPLANTATION

• FERTILIZATION

• IF ONE SPERM DOES MAKE ITS WAY INTO THE FALLOPIAN TUBE AND BURROWS INTO THE EGG, IT FERTILIZES THE EGG (AKA – CONCEPTION).

• THE EGG CHANGES SO THAT NO OTHER SPERM CAN GET IN. 

• AT THE INSTANT OF FERTILIZATION, THE BABY'S GENES AND SEX ARE SET

• IF THE SPERM HAS A Y CHROMOSOME, BABY WILL BE A BOY.

• IF IT HAS AN X CHROMOSOME, BABY WILL BE A GIRL.

• IMPLANTATION: MOVING TO THE UTERUS

• THE EGG STAYS IN THE FALLOPIAN TUBE FOR ABOUT 3 TO 4 DAYS.

• WITHIN 24 HOURS OF BEING FERTILIZED, IT STARTS DIVIDING FAST INTO MANY CELLS. IT KEEPS DIVIDING AS IT MOVES SLOWLY THROUGH THE FALLOPIAN TUBE TO THE UTERUS.

• IMPLANTATION: ATTACHING TO THE LINING OF UTERUS

• SOME WOMEN NOTICE SPOTTING (OR SLIGHT BLEEDING) FOR 1 OR 2 DAYS AROUND THE TIME OF IMPLANTATION.

• THE LINING OF THE UTERUS GETS THICKER AND THE CERVIX IS SEALED BY A PLUG OF MUCUS THAT STAYS IN PLACE UNTIL THE BABY IS READY TO BE BORN.

STAGE/TIMES OF FETAL DEVELOPMENT

• ZYGOTE: (CONCEPTION – DAY 3)

• BLASTOCYST: (DAY 3 – IMPLANTATION)

• EMBRYO: (IMPLANTATION – 8 WEEKS)

• FETUS: ALL MEMBRANES & PLACENTA IS FORMED – (9 WEEKS – BIRTH)

TRIMESTERS OF PREGNANCY

1ST0-12 WEEKS

HEART IS BEATING STEADY AT 4 WEEKS, MAY BE HEARD WITH VAGINAL ULTRASOUND AT 7

WEEKS

2ND13-28 WEEKS

FETUS CAN HEAR

MOTHER MAY FEEL MOVEMENT

BRAXTON-HICKS MAY START AROUND WEEK 20

3RD29-40 WEEKS

BY WEEK 32, BABY “PRACTICES” BREATHING

BRAXTON-HICKS MAY BE STRONGER

BABY “DESCENDS” BY WEEK 38

THE MIRACLE OF LIFE MOVIE

HOME PREGNANCY TEST KITS

• ANALYZE A WOMAN’S BLOOD OR URINE FOR THE PREGNANCY HORMONE (HCG – HUMAN CHORIONIC GONADOTROPIN)

• FDA APPROVES ONLY SOME AT HOME KITS

• SOME BRANDS ARE NOT 100% ACCURATE

• FALSE POSITIVES (OCCUR IN ABOUT .03% OF ALL TESTS )

• FALSE NEGATIVES (OCCUR IN ABOUT 20% OFF ALL TESTS)

• LIKELY ADMINISTERED TOO EARLY

PREGNANCY COMPLICATIONS

• ECTOPIC PREGNANCY – PREGNANCY THAT OCCURS OUTSIDE THE UTERUS (USUALLY FALLOPIAN TUBES)

• MISCARRIAGE – SPONTANEOUS ABORTIONS PRIOR TO 20TH WEEK

• MULTIPLES – FRATERNAL OR IDENTICAL TWINS OR MORE

• TOXEMIA- PIH (PREGNANCY INDUCED HYPERTENSION) –AFFECTS KIDNEYS, HEART, CIRCULATION – POSS. COMA, HEADACHES, SWELLING, WEIGHT GAIN OF 3#/WEEK

• THROMBOPHLEBITIS – BLOOD CLOTS IN LEGS

• PLACENTA PREVIA – PLACENTA IS LOW IN UTERUS, WILL SEPARATE BEFORE BABY IS BORN & WILL LEAD BABY W/O O2

• PRECLAMPSIA – HIGH BP DUE TO PREGNANCY

• GESTATIONAL DIABETES – DIABETES DUE TO PREGNANCY

• PRE-TERM LABOR; NOT BRAXTON-HICKS CONTRACTIONS – CONTRACTIONS THAT BEGIN EARLY IN THE 3RD TRIMESTER

• PREMATURE BIRTHS – THOSE BORN 3 OR MORE WEEKS EARLY

• STILLBIRTHS

HEALTH HABITS DURING PREGNANCY

• NUTRITION

• WEIGHT GAIN 28-30#=NORMAL

• PRE-NATAL VITAMINS RECOMMENDED

• PHYSICAL ACTIVITY & EXERCISE

• AVOID CONTACT SPORTS, SCUBA DIVING, DOWNHILL SKIING

• BASE ACTIVITY OFF PRE-PREGNANCY ACTIVITY LEVELS/INTEREST

• WALK/SWIM/YOGA =SAFE FOR ALL

• EMOTIONAL WELL BEING

• TAKE TIME TO QUIET THE MIND, BE PATIENT WITH MYRIAD OF FEELINGS ( ENTHUSIASM, ANTICIPATION, FEAR, HYPO/HYPERSEXUAL DESIRE)

• PRENATAL CARE

• STUDIES SHOW THE MORE PRENATAL CARE RECEIVED, THE FEWER PROBLEMS ASSOCIATED W/ PREGNANCY, DELIVERY, AND PRODUCE A HEALTHY BABY

• MATERNAL INFECTIONS OF CONCERN TO CHILD = HIV, HERPES, GONORRHEA, SYPHILIS, RUBELLA(GERMAN MEASLES) CAN BE MANAGED

• AVOID DRUGS, ALCOHOL, CIGARETTE SMOKE

EXERCISE DURING PREGNANCY? - YES

ABSOLUTE CONTRAINDICATIO

NS TO AEROBIC EXERCISE DURING

PREGNANCYSIGNIFICANT HEART DISEASE

RESTRICTIVE LUNG DISEASE

INCOMPETENT CERVIX

MULTIPLE GESTATION AT RISK FOR PREMATURE LABOR

PERSISTENT 2ND OR 3RD TRIMESTER BLEEDING

PLACENTA PREVIA AFTER 26 WEEKS OF GESTATION

PREMATURE LABOR DURING THE CURRENT PREGNANCY

RUPTURED MEMBRANES

PREECLAMPSIA/PREGNANCY-INDUCED HYPERTENSION

RELATIVE CONTRAINDICATIONS

TO AEROBIC EXERCISE DURING

PREGNANCYSEVERE ANEMIA

UNEVALUATED MATERNAL CARDIAC ARRHYTHMIA

CHRONIC BRONCHITIS

EXTREME # -/ MORBID OBESITY OR UNDERWEIGHT

HX OF EXTREME SEDENTARY LIFESTYLE

INTRAUTERINE GROWTH RESTRICTION IN CURRENT PREGNANCY

POORLY CONTROLLED: HYPERTENSION, SEIZURE DISORDER, HYPERTHYROIDISM, TYPE 1

DIABETES

ORTHOPEDIC LIMITATIONS

HEAVY SMOKER

WARNING SIGNS TO TERMINATE

EXERCISE WHILE PREGNANT

VAGINAL BLEEDING

DYSPNEA(LABORED BREATHING) PRIOR TO EXERTION

DIZZINESS

HEADACHE

CHEST PAIN

MUSCLE WEAKNESS

CALF PAIN OR SWELLING (NEED TO R/O THROMBOPHLEBITIS)

PRETERM LABOR

DECREASED FETAL MOVEMENT

AMNIOTIC FLUID LEAKAGE

HOW BIRTH DEFECTS ARE DETECTED

AMNIOCENTISISCHORIONIC VILLUS SAMPLING

HOW BIRTH DEFECTS ARE DETECTED

AMNIOCENTESIS• PERFORMED DURING WKS 14-18

• AMNIOTIC FLUID SAMPLED

CVS - CHORIONIC VILLI SAMPLING• PERFORMED DURING 1ST

TRIMESTER; AS EARLY AS WK 8

• PLACENTA SAMPLED

WHY CHECK FOR BIRTH DEFECTS

• IF PREVIOUS CHILDREN WERE BORN WITH BIRTH DEFECT

• HX OF GENETIC/CHROMOSOMAL DISORDERS

• BIRTH MOTHER OVER 35 YEARS OLD

• ENABLES FAMILY TO PREPARE/PLAN

CHILDBIRTH PREP/CLASSES

• PARTICIPANTS HAVE A BETTER BIRTHING EXPERIENCE & GREATER INVOLVEMENT IN PARENTING

• TEACH BASIC BIOLOGY OF PREGNANCY & BIRTH, BREATHING & RELAXATION EXERCISES

• INFORM OF OPTIONS: HOSPITAL OR BIRTHING CENTER

• INFORM OF PROCEDURES: NATURAL, EPIDURAL, C-SECTION, WATER BIRTHS

• INFORM OF SERVICES: MID-WIFE, DOULA, LALECHE SUPPORT

GIVING BIRTH

• FEW WEEKS PRIOR TO LABOR, BABY POSITIONS ITSELF IN WOMB (LIGHTENING)

• 95% = HEAD DOWN; 5% BREECH

• MAY EXPERIENCE BRAXTON-HICKS CONTRACTIONS

• CERVIX EFFACES ( FLATTENS, THINS & DILATES SLIGHTLY)

• THEN 3 STAGES OF LABOR TAKE PLACE

3 STAGES OF LABOR

EARLY/ACTIVE LABOR

CONTRACTIONS

BLOODY SHOW

WATER BREAKS (AMNIOTIC FLUID)

BIRTHCROWNING

DELIVERY

(CORD CUT)

AFTERBIRTHPLACENTA DELIVERED

MEDICAL INTERVENTIONS FOR LABOR

PAIN CONTROLANETHESIA: LOCAL, GENERAL

ACUPUNCTURE

MASSAGE

SUPPORTING THE PERINEUM

HYPNOSIS

BIRTH PARTNERS WITH SOCIAL SUPPORT

INDUCED LABORPROSTAGLANDINS TO CERVIX

BREAKING THE WATERS (AMNIOTIC SAC)

ADMIN THE HORMONE OXYTOCIN (PITOCIN)

SEXUAL INTERCOURSE (PROSTAGLANDIN IN SPERM)

EPISIOTOMYINCISION IN PERINEUM TO LESSEN

TEARING OF VAGINAL TISSUE WHEN NECESSARY

CESAREAN BIRTH

• C-SECTION

• RECOMMENDED WHEN NORMAL VAGINAL DELIVERY IS DANGEROUS OR IMPOSSIBLE

• BABY’S HEAD TOO LARGE FOR OPENING

• MATERNAL ILLNESS – TUMOR, HERPES, UNCONTROLLED DIABETES

• FETAL DISTRESS DURING LABOR

• BREECH POSITIONING

• EXTENDED & UNPRODUCTIVE LABOR

• MULTIPLE BIRTHS

POST-PARTUM TRANSITION

• PSYCHOLOGICAL & PHYSIOLOGICAL CHANGES

• BREASTFEEDING MAY BEGIN

• REMAINING UTERINE LINING (LOCHIA) DISCHARGED FOR 1-2 WEEKS

• ESTROGEN/PROGESTERONE LEVELS DROP RAPIDLY W/IN 72 HOURS OF DELIVERY

• HORMONES VARY WIDELY – BREASTFEEDING (PROLACTIN,OXYTOCIN) VS. BOTTLE FEEDING

• POST PARTUM DEPRESSION/BABY BLUES IN APPROX. 13% OF MOMS REQUIRE PROF. HELP

• SEXUAL ACTIVITY MAY RESUME AFTER APPROX. 3-4 WEEKS

• FATIGUE FROM NEW DEMANDS

BENEFITS OF BREASTFEEDING

• COLOSTRUM ( YELLOWISH PRECURSOR TO MILK) = RICH IN ANTIBODIES/NUTRIENTS

• ECONOMICAL, READILY AVAILABLE

• TRANSFERS IMMUNITY FROM MOM TO CHILD

• PROMOTES BABY’S DIGESTIVE SYSTEM

• BREASTFED BABIES HAVE FEWER ALLERGIES, LESS DIARRHEA, FEWER DENTAL PROBLEMS, & LESS COLIC

• NUTRITIONALLY BALANCED FOR HUMAN INFANTS

• MAY INCREASE THE PSYCHOLOGICAL BONDING BETWEEN MOTHER & CHILD

• HORMONES INVOLVED IN THE PRODUCTION & RELEASE CAUSE UTERINE CONTRACTIONS TO RETURN IT TO NORMAL SIZE

INFERTILITY

• APPROX. 1 IN 5 ALL MARRIED, CHILD BEARING AGE AMERICAN COUPLES ARE INFERTILE

• MALE FACTORS = 40%

• FEMALE FACTORS = 40-50%

• NO KNOWN FACTORS = 10%

• CAUSED BY HORMONES, ANATOMICAL DAMAGE, SPERM DELIVERY, BAD TIMING, AGE

OPTIONS FOR CHILDLESS COUPLES

• IUI – INTRAUTERINE INSEMINATION

• IVF – IN VITRO FERTILIZATION

• ADOPTION – INDEPENDENT, PRIVATE OR INTERNATIONAL AGENCIES

• SURROGATE MOTHER

• EGG DONATIONS

• SPERM DONATIONS

IUI VS IVFIUI

INTRAUTERINE INSEMINATION

• PROCESSED & CONCENTRATED MOTILE SPERM ARE INSERTED DIRECTLY INTO A WOMAN’S UTERUS

• TIMED ACC. TO OVULATION

• MAY BE PERFORMED 1-2 TIMES IN THE DAYS FOLLOWING DETECTION OF OVULATION.

• SINCE HIGHER CONCENTRATIONS OF QUALITY SPERM ARE DEPOSITED CLOSE TO WHERE THE EGG IS WAITING, CHANCES ARE INCREASED THAT EGG & SPERM WILL FIND EA. OTHER

IVF IN VITRO FERTILIZATION

• MOST SUCCESSFUL METHOD OF FERTILITY TREATMENT

• THE BASIC COMPONENTS:

• STIMULATION OF THE OVARIES TO PRODUCE MULTIPLE EGGS AT A TIME,

• REMOVAL OF THE EGGS FROM THE OVARY (EGG RETRIEVAL),

• FERTILIZATION OF THE EGGS IN THE LABORATORY,

• PLACEMENT OF THE RESULTING EMBRYOS INTO THE UTERUS (EMBRYO TRANSFER).

• SUCCESS DEPENDS PRIMARILY ON

• THE AGE OF THE WOMAN

• THE CAUSE OF INFERTILITY

• FACTORS RELATED TO THE QUALITY OF THE IVF LABORATORY

• COMPLICATIONS: MULTIPLE BIRTHS

THE PARENT RAP SONG

REVIEW 1• CONCEPTION, PREGNANCY & CHILDBIRTH ARE IMPORTANT & MEANINGFUL LIFE EXPERIENCES

• THE DECISION TO BECOME A PARENT REQUIRES PSYCHOLOGICAL & PHYSICAL PREPARATION SO EVERY CHILD CAN HAVE PARENTS PREPARED TO MEETS ITS NEEDS

• FERTILIZATION IS FOLLOWED BY CLEAVAGES OF THE EMBRYO AS IT MOVES INTO THE UTERUS.

• ABOUT THE 6TH DAY AFTER FERTILIZATION, THE EMBRYO IMPLANTS IN THE LINING OF THE UTERUS, AND FOR THE NEXT 266 DAYS OR SO THE FETUS DEVELOPS. AFTER 40 WEEKS OF PREGNANCY A BABY IS BORN

• HEALTH HABITS DURING PREGNANCY SUCH AS GOOD NUTRITION, SEEKING PRENATAL CARE, EXERCISE, & PHYSICAL ACTIVITY & EMOTIONAL WELL BEING CONTRIBUTE TO A SUCCESSFUL PREGNANCY

REVIEW 2• TAKING DRUGS, CONSUMING ALCOHOL, AND SMOKING CIGARETTES DURING PREGNANCY CAN

CAUSE FETAL DAMAGE OR BIRTH DEFECTS.

• TESTS, SUCH AS AMNIOCENTESIS OR CHORIONIC VILLUS SAMPLING, ARE AVAILABLE TO DETERMINE WHETHER BIRTH DEFECTS ARE PRESENT.

• OPTIMAL CHILDBIRTH CAN BE ACHIEVED BY ATTENDING CHILDBIRTH PREP CLASSES, ENSURING EMOTIONAL SUPPORT FOR THE MOM DURING CHILDBIRTH, AND MAKING WISE CHOICES ABOUT MEDICAL INTERVENTIONS, SUCH AS EPISIOTOMY & PAIN MAIN MANAGEMENT

• CHILDBIRTH IS DIVIDED INTO 3 STAGES: BEGINNING OF LABOR UNTIL CERVIX IS FULLY DILATED. THE SECOND STAGE IS THE BIRTH OF THE BABY. THE THIRST STAGE IS THE DELIVERY OF THE PLACENTA.

• THE PERIOD AFTER CHILDBIRTH MAY INVOLVE BREASTFEEDING AND RESUMPTION OF SEXUAL ACTIVITIES

REVIEW 3• APPROXIMATELY 20% OF AMERICAN MARRIED COUPLES ARE INFERTILE.

• SOME COUPLES CAN BE MEDICALLY ASSISTED TO BECOME PREGNANT (FERTILITY DRUGS); PREGNANCY ALSO MAY OCCUR WITH IN VITRO FERTILZIZTION OR ARTIFICIAL INSEMINATION

• ADOPTION IS AN ALTERNATIVE FOR CHILDLESS COUPLES

• CHILDREN CAN BE ADOPTED THROUGH A PRIVATE OR PUBLIC ADOPTION AGENCY IN AN INDEPENDENT OR PRIVATE ADOPTION, OR AN INTERNATIONAL ADOPTION.