1. Prenatal Development And Birth Chapter 3 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

2. 3 - 2 Chapter Outline Prenatal development Birth The postpartum period © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

3. 3 - 3 Prenatal Development The course of prenatal development Teratology and hazards to prenatal development Prenatal care Normal prenatal development http://www.youtube.com/watch?v=fKyljukBE70&noredirect=1 © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

4. 3 - 4 The Course of Prenatal Development Divided into three periods Germinal, embryonic, and fetal – Germinal period: Takes place in the first two weeks after conception Blastocyst: Inner layer of cells Trophoblast: Outer layer of cells © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

5. 3 - 5 The Course of Prenatal Development – Embryonic period: Occurs two to eight weeks after conception Embryo - Mass of cells Three layers of cells – Endoderm, mesoderm, ectoderm Organogenesis: Organ formation that takes place during the first two months of prenatal development – Fetal period: Two months after conception and birth in typical pregnancies © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

6. 3 - 6 Figure 3.1 - Significant Developments in the Germinal Period © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

7. 3 - 7 Figure 3.2 - The Placenta and the Umbilical Cord © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

8. 3 - 8 Figure 3.3 - The Three Trimesters of Prenatal Development © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

9. 3 - 9 The Course of Prenatal Development Brain – Neurons: Nerve cells, which handle information processing at the cellular level in the brain Birth defects related to a failure of the neural tube – Anencephaly – Spina bifida – Agenesis of the corpus callosum Neurogenesis - Generation of new neurons Neuronal migration - Cells moving outward from their point of origin to their appropriate locations http://www.youtube.com/watch?v=mMDPP-Wy3sI © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

10. 3 - 10 Teratology and Hazards to Prenatal Development Teratogen: Agent that causes a birth defect Teratology - Field of study that investigates the causes of birth defects Teratogen influence – Dose – Genetic susceptibility – Time of exposure © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

11. 3 - 11 Teratology and Hazards to Prenatal Development Prescription drugs – Streptomycin and tetracycline – Hormones - Progestin and synthetic estrogen – Accutane Nonprescription drugs – Diet pills and high dosages of aspirin © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

12. 3 - 12 Teratology and Hazards to Prenatal Development Psychoactive drugs – Caffeine – Alcohol Fetal alcohol spectrum disorders: Appear in the off spring of mothers who drink alcohol heavily during pregnancy http://www.youtube.com/watch?v=X9ap3Iimimk © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

13. 3 - 13 Teratology and Hazards to Prenatal Development – Nicotine – Cocaine – Methamphetamine – Marijuana – Heroin – Incompatible blood types – Environmental hazards © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

14. 3 - 14 Teratology and Hazards to Prenatal Development – Maternal diseases Rubella Syphilis Genital herpes AIDS – Other parental factors Maternal diet and nutrition Maternal age Emotional states and stress Paternal factors http://www.ted.com/talks/annie_murphy_paul_what_we_learn_before_we_re_born.html © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

15. 3 - 15 Prenatal Care Screening for manageable conditions and treatable diseases Programs include educational, social, and nutritional services Exercise during pregnancy: – Helps prevent constipation – Conditions the body – Reduces excessive weight gain – Is associated with a more positive mental state © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

16. 3 - 16 Prenatal Care CenteringPregnancy – Relationship-centered program which provides complete prenatal care in a group setting Home visitation – Nurse Family Partnership © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

17. 3 - 17 Birth The birth process Assessing the newborn Preterm and low birth weight infants © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

18. 3 - 18 Birth Process Stages of birth – Three stages – 1 st stage - Uterine contractions are 15 to 20 minutes apart and last up to 1 minute – 2 nd stage - Begins when the baby’s head starts to move through the cervix and birth canal Ends when the baby completely emerges from the mother’s body – 3 rd stage Afterbirth: When the placenta, umbilical cord, and other membranes are detached and expelled © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

19. 3 - 19 Birth Process In the United States, 99 percent of births take place in hospitals – Midwifery – Doula: Caregiver who provides continuous physical, emotional, and educational support for the mother before, during, and after childbirth Methods of childbirth – Medication Analgesia, anesthesia, and oxytocin © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

20. 3 - 20 Birth Process – Natural childbirth: Reduces the mother’s pain by decreasing her fear through: Education about childbirth Relaxation techniques during delivery – Prepared childbirth: Special breathing technique to control pushing in the final stages of labor Detailed anatomy and physiology course © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

21. 3 - 21 Birth Process – Cesarean delivery Breech position: Baby’s position in the uterus that causes the buttocks to be the first part to emerge from the vagina Cesarean delivery: Surgical procedure in which the baby is removed from the mother’s uterus through: – An incision made in her abdomen © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

22. 3 - 22 Assessing the Newborn Apgar scale: Assessing the health of newborns at one and five minutes after birth – Evaluates an infant’s heart rate, respiratory effort, muscle tone, body color, and reflex irritability © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

23. 3 - 23 Assessing the Newborn Brazelton Neonatal Behavioral Assessment Scale (NBAS): Used in the first month of life to assess the newborn’s: – Neurological development, reflexes, and reactions to people and objects © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

24. 3 - 24 Assessing the Newborn Neonatal Intensive Care Unit Neurobehavioral Scale (NNNS): Assessment of the newborn’s – Behavior, neurological and stress responses, and regulatory capacities © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

25. 3 - 25 Preterm and Low Birth Weight Infants Preterm and small for date infants – Low birth weight infants: Weighs less than 5½ pounds at birth – Preterm infants: Born before the completion of 37 weeks of gestation – Small for date infants: Infants’ birth weights are below normal when the length of pregnancy is considered © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

26. 3 - 26 Preterm and Low Birth Weight Infants Consequences of preterm birth and low birth weight – Extremely preterm – Very preterm Nurturing low birth weight and preterm infants – Kangaroo care: Involves skin-to-skin contact – Massage therapy © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

27. 3 - 27 The Postpartum Period Physical adjustments Emotional and psychological adjustments Bonding © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

28. 3 - 28 Postpartum Period Period after childbirth that lasts until: – Mother’s body has completed its adjustment and has returned to a nearly prepregnant state Adjustments needed are: – Physical – Emotional – Psychological © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

29. 3 - 29 Physical Adjustments © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Fatigue Hormonal Changes

30. 3 - 30 Figure 3.11 - Postpartum Blues and Postpartum Depression among U.S. Women © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

31. 3 - 31 Emotional and Psychological Adjustments Postpartum depression: Strong feelings of sadness, anxiety, or despair – Have trouble coping with daily tasks in the postpartum period – Treatment - Antidepressant drugs, psychotherapy, and regular exercise © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

32. 3 - 32 Bonding Formation of a physical bond, between parents and their newborn shortly after birth Rooming-in arrangement - Baby remains in the mother’s room most of the time during its hospital stay © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.

33. Class Exercise Review OCEAN personality traits (next slide) Draw a diagram of your identity, as you perceive yourself right now – See Dr. A’s example on the board – Rank your OCEAN traits, as they are right now Draw the same diagram of your identity at age 18 and who you think you will be 10 years from now – Also include OCEAN trait rankings for these as well Be ready to draw yours on the board to present to the class 3 - 33

34. Big “5” Personality Traits- OCEAN O = openness to experience – (inventive/curious vs. consistent/cautious). Appreciation for art, emotion, adventure, unusual ideas, curiosity, and variety of experience. Openness reflects the degree of intellectual curiosity, creativity and a preference for novelty and variety a person has. It is also described as the extent to which a person is imaginative or independent, and depicts a personal preference for a variety of activities over a strict routine.emotioncuriosity C = conscientiousness – (efficient/organized vs. easy-going/careless). A tendency to be organized and dependable, show self-discipline, act dutifully, aim for achievement, and prefer planned rather than spontaneous behavior.self-disciplinedutifully 3 - 34

35. Big “5” Personality Traits- OCEAN E = extraversion – (outgoing/energetic vs. solitary/reserved). Energy, positive emotions, surgency, assertiveness, sociability and the tendency to seek stimulation in the company of others, and talkativeness.surgencystimulation – NEO-PI-R A = agreeableness – (friendly/compassionate vs. analytical/detached). A tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others. It is also a measure of one's trusting and helpful nature, and whether a person is generally well tempered or not.compassionatecooperativesuspiciousantagonistic N= neuroticism – (sensitive/nervous vs. secure/confident). The tendency to experience unpleasant emotions easily, such as anger, anxiety, depression, and vulnerability. Neuroticism also refers to the degree of emotional stability and impulse control and is sometimes referred to by its low pole, "emotional stability".angeranxietyvulnerability 3 - 35