1. Pregnancy and Birth

2. Am I Pregnant? Common Symptoms ….  Missed menstrual period  Breast tenderness  Morning sickness  More frequent urination Approximately 50% of teenagers will not have sex by the time they graduate high school. The decision to be abstinent takes a lot of planning. What are three steps a teenager can take in planning for and remaining abstinent?

3. Diagnosing Pregnancy  Presumptive Signs: breast changes, amenorrhea, nausea, vomiting, fatigue, frequent urination  Probable Signs: Positive pregnancy test, physical changes in the uterus  Positive Signs: Ultrasound or X-ray of fetus, fetal heartbeat, fetal movement

4. Pregnancy Tests  Physician tests  Home pregnancy tests  test based on detection of hCg  Human chorionic gonadotropin - a hormone secreted by the placenta; it is the substance detected in pregnancy tests

5. Prenatal Development  Nine months of pregnancy are divided into three equal periods of three months – called trimesters – First trimester - months 1 to 3 (embryo- first 2 months) (fetus- next 7 months) – Second trimester - months 4 to 6 – Third trimester - months 7 to 9

6. The Embryo and Its Support Systems  Placenta - an organ formed on the wall of the uterus through which the fetus receives oxygen and nutrients and gets rid of waste products  Umbilical cord - the tube that connects the fetus to the placenta  Amniotic fluid - the watery fluid surrounding a developing fetus in the uterus

8. Fetal Development During the First Trimester  Develops into a fetus with most of the major organ systems present 4th to 8th week - external body parts develop  7th week - liver, lungs, pancreas, kidneys, and intestines have formed and begun limited functioning  End of 12th week - 10 centimeters long;weighs 19 grams

11. Mom’s Physical Changes: First Trimester  Large increase in levels of hormones  Breasts swell and tingle; development of mammary glands  Need to urinate  Morning sickness  Vaginal discharges may increase  Feelings of fatigue and sleepiness  Depression is common  Emotional roller coaster

12.  Quickening occurs - woman becomes aware of fetal movements – around the end of the 14th week  Fetal heart beat can be detected  Fetus opens its eyes Fetal Development During the Second Trimester

15. Mom’s Physical Changes: Second Trimester  Morning sickness disappears  Constipation and nosebleeds sometimes occur  Edema - water retention and swelling  Colostrum may come out of the nipple  Emotional well-being improves

16. Fetal Development During the Third Trimester  Fetus’s skin is wrinkled and covered with downlike hair- lanugo and a waxy protective layer- vernix  Fetus turns in uterus to assume a head-down position  Fetus experiences rapid growth

18. Sex During Pregnancy  Intercourse can continue safely throughout pregnancy, unless otherwise stated by doctor  Some anecdotal evidence of hormones in semen inducing labor

19. Nutrition During Pregnancy  Diet during is extremely important  Woman must get enough protein, folic acid, calcium, magnesium and vitamin A  The fetus comes first – it draws the nutrients it needs first, and whatever is left is for mom

20. Nutrition Deficiencies  Calcium – future risk of bone and tooth loss  Folic acid – (folate) much higher risk of neural tube defects. (decreases risk by 50%)  Zinc – malformations of the central nervous system

21. Effects of Drugs Taken During Pregnancy  Teratogens - a substance that produces defects in a fetus Examples of teratogens:  Antibiotics  Alcohol - fetal alcohol syndrome  Tobacco  Other psychoactive drugs (cocaine, heroin)  Thalidomide- drug that can cause limb defects  Other drugs - check with physician and “when in doubt, don’t”

22. Birth: The Beginning of Labor  Bloody show- discharge of mucous plug, along with some blood, that sealed the cervix  Amniotic sac ruptures- “water breaking”  Contractions may start  Labor divided into 3 stages

23. The First Stage of Labor: Dilation and Contractions  Regular contraction of uterus muscles  Effacement of cervix (thinning)  Dilation of cervix (enlargement) o Divided into 3 stages: – Early first-stage labor (0-5 cm dilation) – Late first-stage labor (5-8 cm dilation) – Transition phase (8-10cm dilation)

25. Pain Management  Epidural or Spinal Medication regional blocks prevent the nerves from sending signals to the brain; numbs or reduces pain in part of the body (from the abdomen down).  Mental Relaxation Techniques Some techniques aim to focus your thoughts, others to distract you. Music, breathing, visualization are common.  Narcotic Analgesics reduces your entire body’s ability to sense pain or discomfort. Administered through a shot or IV and will wear off within a few hours. Not recommended if you are within two hours of your baby’s birth.  Physical Comfort Measures Hot and cold packs, massage, sipping cool water are common.  Position Changes Some positions improve your baby's ability to navigate through the pelvis, other positions hinder his efforts. Some positions can help to reduce the pressure associated with a back labor, other positions make it easier to relax your body and rest.  Water Tubs and showers help to handle contractions with less discomfort.

26. The Second Stage of Labor: Delivery of the baby  Begins when cervix is fully dilated  Urge to push or bear down  Crowning – top of the head is visible  Fontanel- soft spots between the skull bones of the baby  Episiotomy may be performed – incision that is sometimes made at the vaginal entrance during birth  Baby is born

27. The Third Stage of Labor: Delivery of the afterbirth  Placenta detaches from walls of the uterus  Afterbirth is expelled  Several contractions may accompany placental expulsion  Episiotomy and tears are sewn up

31. Cesarean Section  A method of delivering a baby surgically, by an incision in the abdomen  Reasons to have a C Section: – Baby is too large, mother’s pelvis is too small - Baby not in head down position – Cervix is not dilating – Umbilical cord prolapses – Excessive bleeding – Placenta previa

32. Newborn testing  APGAR- the rating (0-2) of baby’s physical characteristics 1 and 5 minutes after birth  If there are problems with the baby an additional score is given at 10 minutes.  A score of 7-10 is considered normal, while 4-7 might require some resuscitative measures, and a baby with apgars of 3 and below requires immediate resuscitation. Aactivity Ppulse Ggrimace Aappearance Rrespiration

33. The 4 th trimester  Parenting a newborn  Physical and emotional changes again  Post-partum depression a possibility