Chapter 7

Pregnancy and Childbirth

Conception and Implantation: Ovum Released

Conception and Implantation: Introducing Sperm

Conception and Implantation: Zygote to First Cell Division

Conception and Implantation: Blastocyst to Embryo

Conception and Implantation: Four Trophoblast Membranes

1. Produces blood cells

2. Develops into umbilical cord

3. Develops into amnion; protective fluid- filled sac

4. Chorion develops into placenta which serve as interface with mother

Personal Reflections

What qualities do you possess that will make you a good parent?

Do you have any qualities that might not make you a good parent?

What things can you do to prepare yourself to be a good parent?

How well-suited is your partner to be the mother or father of your child?

Problems with Implantation

Pregnancy

• Average length

• Due date calculation

• Trimester divisions

First Trimester: The Parents

• Pregnancy confirmed

• “Morning sickness” begins

• Couvade syndrome

First Trimester: Changes in Mother

• Enlarged and tender breasts

• Darkened areolas; enlarged nipples

• Increased frequency of urination

• Irregular bowel movements

• Fatigue

First trimester: The Embryo/fetus

• Measurements

• Terms• Ectoderm • Mesoderm• Endoderm

Second trimester: The Fetus

• Measurement• Viability• 5 months: Sucking motions and heartbeat

detected• 6 months: eyes can open, thumb sucking• Periods of sleep and wakefulness

Second trimester: The Mother

• “Quickening” (fetal movements) at 4-5 months

• Stretch marks, breast swelling and colostrum leakage, hemorrhoids, and water retention

• Renewed appetite with cessation of morning sickness

Fourth and Fifth Months

Third trimester – The mother

Walking, sitting, rising difficult

Pressure on the bladder and digestive organs

Frequent urination, indigestion, heartburn, gas, constipation, leg cramps, back pain, low energy level

Third trimester – Fetus

Fatty tissues develop under the skin in 7th month

Weight increases dramatically in the 8th to 9th month

Ninth Month: The Fetus

• At birth, full-term baby weighs about 7 ½ pounds; 20 inches long

• Born with vernix but lanugo has largely disappeared

• Fingernails may protrude beyond fingertips

Sexual Intercourse During Pregnancy

Is sex safe (and pleasurable) during pregnancy?

What do you think?

Complications of Pregnancy

97% of all births result in healthy infants

Smoking and Alcohol

• Smoking• Fetal Alcohol Syndrome • Fetal Alcohol Effect

It is best to avoid alcohol entirely during pregnancy!

Cocaine and Other Drugs

• Cocaine• Opiate dependency• Marijuana• Caffeine• Antibiotics, tranquilizers, antihistamines,

aspirin, mega-doses of some vitamins

Personal Reflections

Do you or your partner smoke, drink alcohol, or take drugs?

Do you and your partner eat a well-balanced diet and get ample sleep?

What decision about health can you and your partner make to ensure the health of your baby during pregnancy and afterwards?

Toxemia and Rh Incompatability

Preeclampsia Incidence and symptoms

Rh incompatibility Incidence and treatment

Detections of Problems in Pregnancy

• Chorionic villus sampling• Celocentesis• Amniocentesis• Ultrasound

Fetal Surgery

• Fetal surgery

• In utero gene therapy

Miscarriages (Spontaneous Abortion)

Nutrition and Exercise during Pregnancy

Increasing chances of having healthy baby• Eat good quality foods• Supplement with folic acid via a multivitamin• Maintain normal weight gain• Exercise regularly

Preparing for Childbirth

Prenatal medical examinations

Lamaze

Bradley

Leboyer

Home Births, Birthing Rooms and Centers, and Modern Midwifery

What do you know about each of these?

Anesthetics or “Natural” Childbirth?

• General anesthesia

• Epidural (spinal anesthetic)

• Prepared childbirth

Personal Reflections

Make a list of all the words that come to your mind when you think of childbirth, labor, and delivery.

Examine your list for negative stereotypical concepts. Are there alternatives?

Childbirth

Stages of Labor: First Stage

Stages of Labor: Second Stage

Stages of Labor: Third Stage

Episiotomy and Prepping

Episiotomy: Incision made at bottom of vagina to widen it

Yes or no? What does your text say?

Problems During Childbirth

Breastfeeding

• Colostrum• Milk production (lactation) • Prolactin• Oxytocin• Benefits of mother’s milk

Postpartum

Postpartum: 3 months following birth

Postpartum blues (baby blues): common letdown after birth due to hormonal changes, exhaustion and stress of adapting to new child

Postpartum Depression (PPD)

Sexual Intercourse After Birth

Things to consider:• Healing from a vaginal birth or c-section• Vaginal bleeding• Loss of estrogen• Adjustments to new roles and emotions for both

parents

Personal Reflections

Will pregnancy affect your sexual relationship with your partner? How? Why?

Will being parents affect your sexual relationship? How? Why?

What steps can you and your partner take to ensure that as parents your sexual relationship will continue to be fulfilling?

Infertility

• Infertility

• Fecundity

Did you know?40% of infertility problems are due to man, 40%

due to woman, 20% both partners

Infertility in Men

• Age

• Low sperm count or abnormal sperm

• Artificial insemination

• Intracytoplasmic sperm injection

Infertility in Women

• Endometriosis

• Fallopian tube blockage (25-35% of cases)

• Failure to ovulate regularly (most cases)

Assisted Reproductive Technology

• In vitro fertilization (IVF)

• Gamete intrafallopian transfer (GIFT)

• Zygote intrafallopian transfer (ZIFT)

Other Options

• Surrogate motherhood

• Older and even postmenopausal women have received hormonal treatments along with IVF to allow for childbearing later in life

Personal Reflections

Imagine that you and your partner have tried to conceive for 5 years. You have gone through innumerable tests, but nothing seems to work. How do you feel?

What would you do next? What options would you consider?

What options would you never consider? Why or why not?