1. Copyright Atomic Dog Publishing, 2004 Chapter Ten Conception, Pregnancy, and Childbirth

2. Copyright Atomic Dog Publishing, 2004 Do You Want to Have Children? Social Influences Motivating Individuals to Have Children  Family  Friends  Religion  Race  Government  Cultural Observances Individual Motivations for Having Children Individual motivations, as well as social influences, play important roles in making the decision to have children.

3. Copyright Atomic Dog Publishing, 2004 Do You Want to Have Children? Personal Choices: Choose to Have a Child Without a Partner? Problems with rearing children alone:  Satisfaction of the emotional and disciplinary needs of the child  Satisfaction of adult emotional needs  Satisfaction of adult sexual needs  Lack of money  Absence of a father

4. Copyright Atomic Dog Publishing, 2004 Conception Conception/Fertilization The union of a sperm and an egg resulting in a zygote. Pregnancy State of carrying developing offspring within the woman’s body. Begins 5-7 days after conception.

5. Copyright Atomic Dog Publishing, 2004 Problems with Conception – Infertility - 1 Infertility The inability to achieve a pregnancy after at least 1 year of regular sexual relations without birth control, or the inability to carry a pregnancy to a live birth. Types of Infertility  Primary: Woman has never conceived despite regular sexual relations for 12 months  Secondary: Woman has previously conceived, but is currently unable to do so  Pregnancy wastage: Woman has been able to conceive but unable to produce a live birth

6. Copyright Atomic Dog Publishing, 2004 Problems with Conception – Infertility - 2 Causes of Infertility Infertility problems may be attributed to the man (40%), the woman (40%), or both (20%). Psychological Reactions to Infertility Not being able to get pregnant may be a psychological crisis, a grief experience, or an economic burden.

7. Copyright Atomic Dog Publishing, 2004 Assisted Reproduction - 1 Hormone Therapy Drug therapies are often used to treat hormonal imbalances, induce ovulation, and correct problems in the luteal phase of the menstrual cycle. Artificial Insemination The introduction of sperm into a woman’s vagina or cervix by means of a syringe, rather than a penis. The sperm may be from a husband (AIH), or a donor (AID).

8. Copyright Atomic Dog Publishing, 2004 Assisted Reproduction - 2 Artificial Insemination of a Gestational Carrier/ Contract Mother A woman who voluntarily agrees to be artificially inseminated, carry a baby to term, and give up the legal right to the baby at birth to a couple or individual desiring such a baby.

9. Copyright Atomic Dog Publishing, 2004 Assisted Reproduction - 3 Ovum Transfer/Embryo Transfer A procedure in which sperm is placed into a surrogate woman. When the egg is fertilized, her uterus is flushed out, and the zygote is implanted into the otherwise infertile female partner.

10. Copyright Atomic Dog Publishing, 2004 Assisted Reproduction - 4 In Vitro Fertilization/Test Tube Fertilization Procedure that involves removing the woman’s ovum and placing it in a lab dish, fertilizing it with a partner’s or donor’s sperm, and inserting the fertilized egg into the woman’s uterus. Other Reproductive Technologies  Gamete intrafallopian transfer (GIFT)  Zygote intrafallopian transfer (ZIFT)  Intracytoplasmic sperm injection

11. Copyright Atomic Dog Publishing, 2004 Preconception Care Care to help ensure the development of a healthy baby during pregnancy.  Risk assessment  Interventions to reduce risk  General health promotion

12. Copyright Atomic Dog Publishing, 2004 Pregnancy -1 The Developing Embryo

13. Copyright Atomic Dog Publishing, 2004 Pregnancy - 2 Pregnancy Testing Signs of pregnancy may include a missed period, morning sickness, enlarged and tender breasts, frequent urination, and excessive fatigue. However, pregnancy is best confirmed by laboratory tests and a physical examination. Physical Changes During Pregnancy Side effects of pregnancy are listed in the following table.

14. Copyright Atomic Dog Publishing, 2004 Pregnancy – 3 Table 13-1 Side Effects of Pregnancy 1st Trimester Weeks 0-14 2nd Trimester Weeks 15-26 3rd Trimester Weeks 27-40 NauseaX VomitingX Frequent urinationXX Leg crampsX Vaginal dischargeXXX FatigueXXX ConstipationXXX SwellingXX Varicose veinsXX BackacheXX HeartburnX Shortness of breathX

15. Copyright Atomic Dog Publishing, 2004 Pregnancy - 4 Growth of the Embryo and Fetus from 2 to 15 Weeks After Conception

16. Copyright Atomic Dog Publishing, 2004 Pregnancy - 5 Amniocentesis

17. Copyright Atomic Dog Publishing, 2004 Pregnancy - 6 Prenatal Care and Prenatal Testing  Ultrasound scan  Amniocentesis Miscarriage Miscarriage/Spontaneous Abortion The unintended termination of a pregnancy

18. Copyright Atomic Dog Publishing, 2004 Pregnancy - 7 Psychological Changes During Pregnancy  Stress related to physical issues  Stress associated with ‘weight gain’  Stress due to concern for the baby’s welfare Sex During Pregnancy Sexual desire, behavior, and satisfaction may change during pregnancy. Although massive hormonal changes take place in pregnancy, no evidence links these changes to reduced libido.

19. Copyright Atomic Dog Publishing, 2004 Childbirth - 1 Stages of Labor

20. Copyright Atomic Dog Publishing, 2004 Childbirth - 2 Labor Labor occurs in three stages, and although there are great variations, it lasts an average of 13 hours for the woman having her first baby (primigravida) and about 8 hours if the woman has given birth before (multigravida).

21. Copyright Atomic Dog Publishing, 2004 Childbirth - 3 Cesarean Childbirth A surgical incision made in the woman’s abdomen and the uterus to deliver a fetus. Personal Choices: Hospital or Home Birth? Although more than 95% of all U.S. births do occur in the hospital, some expectant parents are concerned that traditional childbirth procedures are too impersonal, costly, and potentially dangerous.

22. Copyright Atomic Dog Publishing, 2004 Childbirth - 4 Childbirth Preparation Five essential elements of Lamaze:  Education about anatomy and physiology  Respiration techniques  Conditioned relaxation  Cognitive restructuring  Social support

23. Copyright Atomic Dog Publishing, 2004 Adoption - 1 Who Chooses to Adopt a Child? Characteristics of those who typically adopt are White, educated, and high income. Characteristics of Children Available for Adoption Adoptees in the highest demand are infant, White, healthy children. Older, non-White children with health problems have been difficult to place.

24. Copyright Atomic Dog Publishing, 2004 Adoption - 2 Same-Race Adoptions In a study on transracial adoption attitudes of college students, overwhelmingly positive attitudes were found toward transracial adoption. Data comparing children reared in transracial and same-race homes show few differences.

25. Copyright Atomic Dog Publishing, 2004 Transition to Parenthood - 1 Transition to Motherhood  Postpartum Blues  Choosing Priorities Transition to Fatherhood The importance of the father in the lives of children extends beyond economic considerations into the children’s current and future physical and psychosocial health.

26. Copyright Atomic Dog Publishing, 2004 Transition to Parenthood - 2 Changes in a Marriage Researchers disagree on the effect of children on a couple’s marriage. Declines in marital happiness may be due to children or the passage of time.