1. Birth and Development

2. Gestation: period of time that embryo/foetus spends in the uterus
Parturition/birth: process of expelling the foetus from the Uterus
Labour: series of events preceding parturition.
During final 3 months of gestations uterus undergoes weak irregular contractions

3. STAGEs of labour

4. 1st stage of labour (Dilation of the cervix)
Lasts approx 8-9 hours (approx 4 every subsequent birth)
Begin: Uterine contractions are occurring every 30 minutes. (Labour pains)
Waves of muscle contractions (like peristalsis) from uterus to cervix, cause uterus to slightly shorten and pull back cervix causing it to dilate.
End: Complete dilation (opening) of the cervix (10cm)
Foetus head generally facing mothers left or right pelvic bone.
Forms the birth canal: passage through which foetus will be expelled

5. 2nd stage of Labour (Stage of expulsion)
Lasts approx 20 mins – 2 hrs.
Often marked by the breaking of the amniotic sac (release of amniotic fluid)
Uterine contractions with voluntary abdominal contractions move foetus along birth canal, turning baby’s head to face mothers back.
Slowly head will emerge and then turn to face sideways again. (allows shoulders to fit through more easily)
Remainder of baby is expelled. (covered with vernix: waxy substance)

6. 3rd stage of Labour (afterbirth)
After baby is expelled, umbilical cord is clamped and cut. (remains attached to baby will dry up and fall off leaving ‘navel’ or ‘umbilicus)
Approx 5 mins after delivery, placenta, remains of umbilical cord and other membranes are expelled. (afterbirth)

7. Changes at birth

8. Baby before birth:
first breath of life due to shock / slap/ clamp umbilical cord (increase in CO2)
Gas / nutrient / waste exchange occurs between placenta and endometrium
Ductus venosus (liver bypass)
Foramen ovale (hole in septum wall)
Ductus arteriosus (lung bypass)
Umbilical artery
Umbilical vein

9. Baby after birth:
decrease resistance in lungs: ductus arteriosus redundant (deteriorates)
more flow in left atrium  pressure closes foramen ovale
decreased blood flow through ductus venosus (deteriorates)
to account for higher muscle activity / temp control / increase in O2
45 breaths / min (1st 2 weeks)
125 – 130 beats / min
increased red blood cell count

10. Mother after birth:
Puerperium (8weeks – uterus returns to normal size)
due to contractions & gradual shrivelling
Fluid discharge (blood, endometrium) lasts up to 3 – 6 weeks
Mood changes (postnatal depression, 3rd day blues)
Menstruation returns:
Breastfeeding – in approx. 6 months
No breastfeeding– within 10 weeks

11. Breastfeeding & Milk Production

12. The Breasts Until puberty, male / female breasts are very similar
Approx 10-11, female nipples bulge (due to oestrogen / progesterone)
Each breast = 15 – 25 sections (lobes) subdivided into lobules.
Walls of each lobule consist of glandular alveoli (milk secreting region)
All surrounded by fatty connective tissue
Lobules open up into ‘milk space’ for storage (15 – 25)
During the 1st weeks after birth, newborns environment must be kept as close to the Uterus as possible:
Food & water  milk
Warmth & comfort  cuddling arms / small soft bed

13. Lactation
initiation & maintenance of milk secretion and delivery to infant
Changes during Pregnancy
lobes become larger & more complex
nipple area darkens in colour
oil secreting glands enlarge (prevents drying out of nipple)
growth and development of breast
Changes at Birth
1st secretion: Colostrum (watery, yellow / white – similar to normal milk but little fat & high levels of antibodies)

14. Milk Let-Down Reflex Baby suckles nipple msg sent to brain via nerves
brain tells pituitary gland to secrete Oxytocin & Prolactin
Oxytocin triggers contraction of muscles around lobules / Prolactin triggers milk production
Milk is ejected into ducts
Up to 1.5 L of milk / day may be produced
Needs Vit D, Calcium, phosphate

15. Development: Infancy to adolescence

16. Infancy Physical Development:
In 1st year body length increases by 1/3 and weight triples. (71-74cm, 9kg)
Head/leg ratio changes dramatically with legs growing much faster than the head.
By 15, body proportions are very similar to adulthood.
Social Development:
Socialisation: ability to behave in a manner that is accepted and approved by other people.

17. Pattern of development
Infancy
Motor Development:
The ability to control movement of a particular part of the body
Pattern of development
Order of development
Cephalocaudal
Development from head to foot
Proximodistal
Development outwards. (forearm movements learnt first, finger movements last)
Gross to Specific
Development of larger muscle movements before finer muscle movements

18. Adolescence
Transition between childhood and adulthood (starts approx 11+)
Puberty: time during which an adolescent develops sexual maturity (ability to reproduce)
Physical Development:
Adolescent growth spurt: rapid increase in height and weight (males: , females: 11-14)
Growth in height, weight, heart & lungs etc.
Reproductive development: development of primary and secondary sexual characteristics.
Social Development:
Transition to independence