1. Chapter 12- Conception, Pregnancy, and Childbirth Sample Presentation Fall, 2014

2. Fertilization and Development

3. Spermatogenesis ●Occurs in the seminiferous tubules ●First mitosis ●Then meiosis ●Formation of sperm ○Acrosome ○Tail

4. Question: Starting with a single primary spermatogonia, how many spermatids will you get at the end of the 2nd meiotic division?

5. Oogenesis ●First in the ovary ●Then moves into fallopian tube

6. Fertilization ● Sexual intercourse ● Cervix ● Up uterus ● Into fallopian tube ● Meets egg ● Acrosomal Reaction

7. Development ● Blastocyst forms 1st ● Then implantation forming placenta ● Lack of blastocyst implantation- menstruation ● fetus (after 8th week), HCG ● 8 weeks= thumb size, 15th week=lanugo(hair) ● 5 months= 1 pound, 9 months= 7 pounds ● Traditionally 40 weeks

8. Being Pregnant

9. Pregnancy Myths -Standing on your head after sex can increase your chances of becoming pregnant -The shape and height of your belly can determine the sex of the baby -Eating for two -Cannot drink coffee while pregnant -You cannot have sex while you are pregnant

10. Changes in Women During Pregnancy -Her Feelings about the pregnancy -A couples relationship -Mother/daughter relationship -Her body starts to change -Changes in her diet - prenatal vitamins

11. The First Trimester (weeks 1-13) -May not look pregnant - ⅔ of women experience nausea, vomiting, fatigue, and painful swelling of the breasts -May have fears -Diagnosis for fetal abnormalities -The fetus will have developed all of its organs by the third month -Pregnancy mood swings and food cravings -https://www.youtube.com/watch?v=4CelzoPZZvohttps://www.youtube.com/watch?v=4CelzoPZZvo

12. The Second Trimester (weeks 14-27) -Women can feel the fetus move -Most enjoyable trimester -Fears of the pregnancy start to fade away -The baby will be four times bigger than it was at the end of the third month -Screening tests -Sex life between partners changes -women might be more sexually driven when the men are not or vice versa

13. Third Trimester (weeks 28-40) -Braxton Hicks may start to occur -Getting closer to delivering the baby -Baby starts to get ready to come out -breach -Your body starts to show signs of being ready to give birth -Edema -water retention - Periods of depression

14. Complications of Pregnancy -Effects of Teratogens -Alcohol - fetal alcohol syndrome - fetal alcohol effect - Tobacco -Heroin, morphine,codeine, and opium - greater risk for spontaneous abortions

15. Complications cont. -Infectious Diseases -German measles - STI’s -can be transmitted from a pregnant woman to the fetus, newborn, or infant before, during, or after birth - Ectopic Pregnancy -occurs in about 1% of all pregnancies - Preterm Births -Births that take place to 37 weeks of gestation

16. Pregnancy Loss -Normal pregnancy lasts about 40 weeks -death of a fetus before 20 weeks is called early pregnancy loss - Miscarriage -spontaneous loss of a fetus before it can survive on its own -usually happens between weeks 6 and 8 -more than 50% happen because of chromosomal abnormalities -first sign of a miscarriage is vaginal bleeding and some pelvic cramps - Infant Mortality -Sudden infant death syndrome (SIDS)

17. Sexual Behavior During Pregnancy -Some women are very interested in having sex while they are pregnant (fluctuates) -There are no rules against having sex while pregnant but there are some precautions -A couple may be uncertain on how to express their sexual feelings -When is it okay to resume having intercoure? -4-8 weeks after giving birth

18. Discussion What are your views about having sex during pregnancy?

19. What is Infertility? ● Not being able to conceive after a year of unprotected sex with partner ● When women have a problem with any of these steps: o ovulation o fertilize o womb o implantation

20. Is Infertility a Common Problem? ● YES! ● 6% of married women in the U.S. of ages 15 to 44 are unable to pregnant ● 11% of women (regardless of marital status) also ages 15 to 44 in the U.S. have difficulty getting pregnant or carrying a pregnancy to term

21. Infertility a Problem Just for Women? ● NO! both men and women contribute to infertility ● 7.5% of all sexually experienced men younger than 45 years old have reported seeing a fertility doctor at some point in their life.

22. Infertility in Men ● Conditions that contribute to infertility in men: o varicoceles o diabetes o cystic fibrosis o trauma o infection o treatment w/chemo or radiation o testicular failure

23. What Increases a Woman’s Risk of Infertility? ● Fertility can decline as a woman gets older ● As a woman gets older it can cause: o ovaries less able to release eggs o small number of eggs left o her eggs are not as healthy o more likely to have health conditions that can cause fertility problems o she is more likely to have a miscarriage

24. Woman’s Risk of Infertility continued ● Smoking ● Excessive alcohol use ● extreme weight gain or loss ● excessive physical or emotional stress that results in amenorrhea

25. Treating Infertility ● Medicine ● Intra-Uterine Insemination (IUI) -also known as artificial insemination ● Assisted Reproductive Technology (ART) o IVF- in vitro fertilization o ZIFT- zygote intrafallopian transfer o GIFT- gamete intrafallopian transfer o ICSI- intracytoplasmic sperm injection

26. Giving Birth

27. Labor and Delivery ● During later months a hormone called relaxin is produced ● Braxton-Hicks contractions ● Contractions begin to thin and dilate the cervix ● Labor can generally be divided into 3 stages

28. First Stage ● Usually the longest ● Last 4-16 hours or longer ● Early sign is the expulsion of slightly bloody mucus. ● “Breaking of the waters” ● End of first stage is called transition o Contractions come more quickly, and the baby’s head enters the birth canal.

29. Second Stage ● Begins when baby’s head enters the birth canal and ends when the baby is born ● Baby is usually born gradually, with each contraction ● Baby will be wet and covered by vernix

30. Third Stage ● Uterus continues to contract and expels the afterbirth ● The Apgar score indicates the baby’s health. Ranging from 7-10 ● Uterus will still contract and return to its prebirth size and shape ● Takes about 6 weeks

31. Choices in Childbirth ● Hospital birth ● Elective deliveries ● Cesarean Section ● Prepared childbirth ● Breastfeeding o Lactation begins about 3 days after childbirth o Colostrum nourishes the baby before lactation begins

32. Becoming a Parent

33. Before The Baby ● See your doctor; DO NOT BRUSH IT OFF ● Have a place in your home for your child ● Ask questions to Parents ● Breast feed or Formula? ● Diapers... ● Set a Schedule ● Be open to anything

34. Your Relationship After becoming parents, it’s common for couples to: ● communicate less – about 50% of report this ● have more relationship stress than usual, and some relationship changes, including with family and friends ● report less time and less energy for sexual closeness ● experience more relationship conflict after the first few months.

35. Single Parenthood ● 12 Million single families ● 83% single moms; 17% single dads ●⅔ of those families with parent 30yrs ● A lot of financial hardship ● Gov’t programs ● The highest % of uninsured Americans (69%) ● 40% of U.S. single parents were employed in low-wage jobs

36. Avoid Myths ● I should have all the answers ● Parenting comes naturally ● I should be able to cope with myself

37. Your life with your Baby ● Make time for your partner w/wo your baby ● Exercise ● Eat Nutritiously ● Rest, Lots of Rest ● Get support when necessary ● DROP ALL BAD HABITS

38. Discussion Remember your best childhood memory with your parent(s) and share.

39. Abortion

40. What Is It? ● the deliberate termination of a human pregnancy, most often performed during the first 28 weeks of pregnancy

41. Reasons Women Get Abortions ●Birth control (contraceptive) failure. ○ Over half of all women who have an abortion used a contraceptive method during the month they became pregnant ●Inability to support or care for a child ●To prevent the birth of a child with birth defects or severe medical problems ○ Such defects are often unknown until routine second-trimester tests are done ●Pregnancy resulting from rape or incest ●Physical or mental conditions that endanger the woman's health if the pregnancy is continued

42. Abortion Procedures ● The type of abortion procedure used in elective pregnancy termination is primarily determined by how far a woman is into pregnancy ● During the first trimester, you will usually have the option of having a medical abortion procedure or a surgical abortion procedure ● Before considering the options, it is recommended that you obtain a sonogram to determine if the pregnancy is viable and for accurate pregnancy dating

43. First Trimester Abortion ● Methotrexate & Misoprostol (MTX): a medical abortion procedure used up to the first seven weeks of pregnancy. This medication combination is not as commonly used in the U.S. with the availability of mifepristone, which works more effectively for this use. ● Mifepristone and Misoprostol: a medical abortion procedure used up to the first seven to nine weeks of pregnancy. It can also be referred to as RU-486, the abortion pill and Mifeprex. ● Manual Vacuum Aspiration (MVA): a procedure used as early as 3 -12 weeks since the last period. Considered less invasive with only a local anesthesia being used on the cervix. ● Aspiration: a surgical abortion procedure used to terminate pregnancy up to 16 weeks from the last period. It can also be referred to as suction curettage, dilation and curettage (D & C) or vacuum aspiration.

44. Second Trimester Abortion ● Dilation & Curettage (D & C): a surgical abortion procedure used to terminate a pregnancy up to 16 weeks gestation. It is also referred to as suction curettage or vacuum aspiration. ● Dilation & Evacuation (D & E): a surgical abortion procedure used to terminate a pregnancy after 16 weeks gestation. ● Induction Abortion: a rarely performed surgical procedure where salt water, urea, or potassium chloride is injected into the amniotic sac; prostaglandins are inserted into the vagina and pitocin is injected intravenously.

45. Third Trimester: Late Term Abortions ● Third trimester or late term abortions are not legal in a number of states except in certain medical situations. The time frame referred to as late term is often based on when a baby is considered “viable” (meaning able to survive outside the womb) o Induction Abortion: a rarely done surgical procedure where salt water, urea, or potassium chloride is injected into the amniotic sac; prostaglandins are inserted into the vagina and pitocin is injected intravenously. o Dilation and Extraction: a surgical abortion procedure used to terminate a pregnancy after 21 weeks of gestation. This procedure is also known as D & X, Intact D & X, Intrauterine Cranial Decompression and Partial Birth Abortion.

46. Is Abortion Good Or Bad? PRO LIFE? PRO CHOICE?

47. Agree Or Disagree?

48. Why do women have abortions? A.Birth control Failure B.Inability to support herself C.Both A & B D.None of the above

49. True or False A third trimester abortion is legal in all states