1. Pregnancy and Childbirth
Chapter 8

2. 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
Disintegrates after 24 hours if not fertilized
3-4 days: The egg travels through the fallopian tubes
Millions of sperm but only a few reach the uterus
Sperm release an enzyme that softens egg
Fraternal twins and identical twins

3. Figure 8.1 Fertilization and early development of the embryo

4. Infertility Female infertility One of two key causes
Tubal blockage (40%)
Failure to ovulate (40%)
Blocked fallopian tubes are commonly caused by (PID)
Chlamydia or gonorrhea
Endometriosis
Age, behavior, and exposure to toxic chemicals or radiation affect ovulation

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

6. Pregnancy 3 periods of about 3 months (13 week trimesters) Tests
Home pregnancy tests
Human chorionic gonadotropin (HCG)
Can be used two weeks after fertilization
Early signs and symptoms
Missed menstrual period
Slight bleeding
Nausea
Breast tenderness
Increased urination
Sleepiness, fatigue and emotional upset

7. Figure 8.2 Physiological changes during pregnancy
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8. Continuing Changes in the Women’s Body
Uterus size
During the first 3 months, the uterus enlarges to about three times its nonpregnant size
4th month – large enough to make abdomen protrude
7th-8th month – pushes up into the rib cage
Breast changes
8th week – Breasts may tingle or throb
Muscles and ligaments loosen
Weight gain

9. Changes During the Later Stages of Pregnancy
Increased needs placed on the mother’s lungs, heart, and kidney
Preliminary contractions (Braxton hicks contractions)
Lightening
Emotional responses to pregnancy
Complications and changes in later pregnancy
Backache, fluid retention, leg cramps, heartburn, or constipation
Preliminary, or Braxton Hicks, contractions (irregular, short and painless)
Lightening is the setting of the fetus into the pelvic cavity

10. Figure 8.3 The fetus during the third trimester of pregnancy

11. Fetal Development First Trimester Blastocyst – Fourth day
Arrives in uterus
Embryo – End of second week
Inner cells divide into three layers
Endoderm– gut tube
Mesoderm– muscle, bone, blood, kidneys, and sex glands
Ectoderm– skin, hair, and nervous tissue
All major body structures are formed between 2nd and 9th week
2nd Month – Fetus

12. Fetal Development Second Trimester Third Trimester
Fetus grows to about 14 inches and 1.5 pounds
Third Trimester
Fetus gains protective fat layers, respiratory and digestive organs develop

13. Figure 8.5 A cross-sectional view of the fetus in the uterus and an enlargement of the placenta

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 (QMS)
Maternal blood test
Analyzes four hormone levels and compares to appropriate standards

15. The Importance of Prenatal Care
Regular medical checkups
Blood tests
Prenatal nutrition
Avoiding drugs and other environmental hazards:
Teratogens
1st trimester
Congenital malformations
Alcohol
Tobacco
Caffeine
Drugs
STDs and other infections

16. The Importance of Prenatal Care
Prenatal activity and exercise
Moderate exercise program
30 minutes most days
Cardiovascular exercises
Kegel Exercises
Prenatal exercise classes
Preparing for birth

17. Complications of Pregnancy and Pregnancy Loss
Ectopic pregnancy
Spontaneous abortion, or miscarriage
Gestational diabetes
Preterm labor
Low-birth weight (LBW)
Less than 5.5 pounds
Infant mortality
SIDS

18. Labor and Delivery Entire process 2-36 hours First stage of labor
Average of 13 hours for a first birth
Cervix is completely dilated (10 centimeters)
Hormonal changes
Contractions (30 seconds and occur every minutes)
Mucus plug is expelled and amniotic sac may rupture
Transition:
Contractions may last seconds and be 1-3 minutes apart

19. Childbirth Second Stage of Labor Third 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 score of the baby
Heart rate
Respiration
Color
Reflexes
Muscle tone
Total score is between 0 and 10

20. Figure 8.7 Birth: labor and delivery

21. 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

22. Pain Relief During Labor and Delivery
Childbirth preparation courses
Breathing and relaxation techniques
Lamaze, Bradley, or hypnosis
Epidural
Narcotics
Fentanyl or demeral
Provide less pain relief than a epidural

23. Postpartum Period 3 months following childbirth
Critical family adjustment
6-8 weeks for the mother’s reproductive organs to return to pre-birth condition
Breastfeeding
About 74% of mothers breast-feed
Lactation begins about 3 days post-childbirth
Colostrum is produced prior to lactation
Postpartum depression