Preparing for Birth

Chapter 5

Section 5-1

Objectives:• List the early signs of pregnancy• Assess the importance of good medical care

throughout pregnancy• Identify possible discomforts and

complications of pregnancy• Plan a nutritious diet for expectant mothers• Explain the importance of stress

management during pregnancy

Terms• Obstetrician• Anemia• Rh factor• Gestational diabetes• Preeclampsia• Lactose intolerance• Lactase

Early Signs of Pregnancy p147

• Missed menstrual cycle• Full feeling or mild ache in the lower

abdomen• Tired for faint• Frequent, urgent need to urinate• Swollen breasts causing discomfort

or tenderness• Nausea and/or vomiting particularly

in the early morning

Note

• These are common but not always a sign of pregnancy.

• Take a pregnancy test or see a doctor.

Medical Care During Pregnancy p147

• See an obstetrician = doctor who specializes in pregnancy and child birth

• Doc schedule regular checkups • Your doc may be part of a group so you

may not see the one you chose every time you visit

• Your baby may be delivered by the on-call doc who is not your primary obstetrician

First Exam p148

• Bp, weight, pulse, respiration recorded• Medical history and any health conditions

are discussed• Measure of pelvis to determine if wide

enough for baby to pass through• UA (urine analysis) for signs of infections

or diabetes. Diabetes occurs when the body isn’t able to produce enough insulin to keep glucose levels within range. It affects the body’s ability to burn energy.

First Exam p148cont.

• Blood tests Rule out anemia.

Anemia results when there are not enough red blood cells – low ironSymptoms- fatigue, shortness of breath, rapid

heartbeat, cold, weak, Check for protein known as RH factor

If the mother does not have the Rh factor and the baby does, the mother’s blood looks at it as something it needs to fight off. It builds up antibodies that attack the fetus’s blood.

Doesn’t affect first pregnancy but will those afterwards

Injections can be given to prevent the antibodies from forming

First Exam p148cont

• Check the woman’s immunity to rubella (German Measles)

• Calculate approximate birth date = 9 months and one week after the first day of her final period Date can typically vary by 2 weeks

Assignment

• What is the RH factor and how does it affect the baby?

• Do Rh Factor Research Assignment.

Later Checkups p150

• 1x/mo until the 6th or 7th month at which time they increase to every 2 wks; then 1x/week

• Doc monitors the development and the mother’s health

• 24-28th week – glucose tolerance test to check for gestational diabetes

Later Checkups p150

Gestational Diabetes• Occurs only during pregnancy• Can cause the baby to be heavier

than normal• Usually goes away after birth• Usually controlled by diet or may

require meds 

Later Checkups p150

Preeclampsia• High bp• Protein in mom’s urine• Can prevent the baby from getting

enough blood which provides oxygen and food

• Treatments depends on how far along the mother is – rest or meds

Discomforts of Pregnancy p150

If you feel one or more of the following see your doc.

• Nausea and/or vomiting (rarely last beyond 4th month)

• Sleepiness (usually in early months d/t hormonal changes)

• Heartburn• Shortness of Breath (pressure on lungs,

common in late months)

Discomforts of Pregnancy cont. p150

• Varicose veins = twisted, enlarged veins or blood vessels close to skin’s surface. Get plenty of exercise, rest with legs elevated, and use support hose.

• Muscle cramps in legs – Gentle stretches, rest, and calcium rich diet alleviate pain

• Lower back pain – wear low healed shoes, exercise, some wear braces

Assignment p151 Teacher’s text

What can pregnant women do to prevent or treat the following pregnancy-related conditions without medication

• Constipation• Tooth decay• Hemorrhoids• Swelling• Lightheadedness• Gestational Diabetes• Migraines• Varicose Veins• Skin Changes• Lightheadedness

Possible Serious Complications p152

Report to doc immediately.• Vaginal bleeding • Unusual weight gain or loss• Excessive thirst• Diminished need to urinate or

painful urination• Severe abdominal pain• Persistent headaches

Possible Serious Complications cont p152

• Severe vomiting• Fever• Increased vaginal mucus• Swelling of the face, hands, or

ankles• Blurred vision or dizziness• Prolonged backache

Nutrition During Pregnancy p152

• Growth and brain development are dependent on the nutrients from the mother.

5 Types of Nutrients Needed

Protein• Meat, fish, poultry, beans, milk,

cheese, eggs, nuts, etc• Growth and development of bones

and teeth• Helps keep mom’s body in good

condition• Builds and repairs body tissues

5 Types of Nutrients Needed cont.

Vitamins• Folic Acid – take 2 x more than usual

before and during to help prevent spina bifida

• Vitamin A – – Proper eye dev– Yellow and orange fruits and

vegetables, dark green leafy vegetables

5 Types of Nutrients Needed cont.

• Vitamin B – – General fetal dev– Whole-grain breads and cereals

• Vitamin C – – Healthy teeth, gums, connective tissue

of skin, bone, and organs– Fruits, especially citrus, tomatoes

5 Types of Nutrients Needed cont.

• Vitamin D – – Creates bone and teeth – Fortified Dairy products– Sun at least 10-15 / day– Studies show many Americans are Vit.

D deficient

5 Types of Nutrients Needed cont.

Minerals• Iron –

– Prevent anemia in the mom– Have a store built up in the baby’s liver

so the nursing baby will have iron– Dried beans, raisins, dates, meat, leafy

green veg

5 Types of Nutrients Needed cont.

• Calcium & Phosphorus– Keep mother’s bones and teeth strong

while building the baby’s.– Milk and dairy products

5 Types of Nutrients Needed cont.

• Carbohydrates & Fats– Carbohydrates

• Energy• Whole grain breads and cereals, fruits,

starchy vegetables, sugars

– Fats • Brain dev, good skin and hair

Folic acid: An important way to prevent birth defects

Reviewed by the BabyCenter Medical Advisory Board

Last updated: November 2008• http://www.babycenter.com/0_folic-acid-a

n-important-way-to-prevent-birth-defects_476.bcHighlights

• It helps prevent neural tube defects (NTDs) – serious birth defects of the spinal cord (such as spina bifida) and the brain (anencephaly). Neural tube defects occur at a very early stage of development, before many women even know they're pregnant. They affect about 3,000 pregnancies a year in the United States.

Folic Acid Cont.

• The Centers for Disease Control and Prevention (CDC) reports that women who take the recommended daily dose of folic acid starting at least one month before they conceive and during the first trimester of pregnancy reduce their baby's risk of neural tube defects by 50 to 70 percent.

Folic Acid Cont.

• Some research suggests that folic acid may help lower your baby's risk of other defects as well, such as cleft lip, cleft palate, and certain types of heart defects.

• Your body needs folate to make normal red blood cells and prevent anemia.

Folic Acid Cont.

• Folate is essential for the production, repair, and functioning of DNA, our genetic map and a basic building block of cells. So getting enough folic acid is particularly important for the rapid cell growth of the placenta and your developing baby.

Folic Acid Cont.

• Many over-the-counter vitamins contain 400 mcg of folic acid, but not all do – so check the label carefully.

• The neural tube – from which your baby's spine and brain will develop – begins to form about three weeks after conception, so it's critical to get a sufficient daily dose of folic acid before conception and during the first trimester of pregnancy. 

Folic Acid Cont

• Sources of Folic Acid:• enriched grain products such as

breakfast cereals, bread, pasta, and rice

• lentils; dried beans and peas; • dark green vegetables such as

broccoli, spinach, collard or turnip greens, okra, and asparagus; and

• citrus fruit and juice.

Folic Acid Cont

• While your body only absorbs part of the folic acid in your diet, it absorbs all of the folic acid in a supplement.

Weight Gain During Pregnancy p156

• Some lose in the first few months due to morning sickness.

• Recommended gain (24-30lbs):• 1 lb/month in the first 3 months• ½ lb/week in 4th – 6th month• See chart page 156 figure 5-6

Personal Care and Activities p157

• Get plenty of rest• Exercise• Practice good hygiene – healthy

temperature and eliminate body waste, relaxing

Maternity Clothes

• Looser clothes allows for better movement and circulation

• Making Wise Choices p154, Figure 5-5 and p155 Question and Answer

How to Reduce Stress During Pregnancy

• Avoid sugary food or caffeine – can make you jittery

• Exercising – feel lighter and more energetic

• Taking time-out – relax• Practice relaxation techniques –

breathing or visualization• Talk about concerns• Take a class for expectant mothers

Post Partum Depression

• Emotional Health p159• Very emotional time• Hormonal changes cause mood swings, • Hormones as well as thinking about the baby

makes it difficult to concentrate and they may experience forgetfulness or be distracted

• How can women overcome this???• Women feel upset, worried, unattractive,

non-productive….all can lead to depression

Section 5-2 Preparing for the Baby’s Arrival p161

Objectives:• Describe the decisions and preparations

expectant parents must make for the physical needs of their baby.

• Explain why a budget is important and list the items parents need to include in a budget.

• Identify the considerations involved in making a decision about who will care for a new baby.

Section 5-2 Preparing for the Baby’s Arrival p161

Key Terms• Formula• Pediatrician• Fixed expenses • Flexible expenses • Maternity leave• Paternity leave

Good Time-management Skills

Extremely Important !!!Develop a basic daily routine for you and

baby• Keep you and baby on track • Save $$ • Saves time• Helps you and baby know what to expect next • Helps baby feel secure• Helps you feel in control • Gives you a sense of order rather than chaos• Helps you feel less overwhelmed

• Use time wisely• Combine errands• Take advantage of naps• Accept help from family – When they

ask what they can do, tell them or give them a couple choices. Have them do things that are more difficult for you to get done.

Other Children in Family p162

• The way children react to a new sibling depends on how well prepared they are before the baby’s arrival.

• Jealousy, confusion, excitement, love• Children need to know they are not

being replaced and will be just as important after the baby is born

Clothes, Equipment, and Space p162

• See Chart 5-7 p163 Go over each item – what it is and why necessary

• Assignment• Each person will be assigned to

calculate the cost of baby supplies. After each person reports findings, total all costs.

• In reality you can reduce costs by visiting garage sales, shopping secondhand stores, and borrowing.

Baby Room p164

• Newborns sleep 18-22 hrs/day• First 6 months most sleep 15-18 hrs/day

Debate over sleeping with or in parent’s room vs own room

• Needs• Quiet comfortable place• Crib - see p167• Bedding but not too soft due to suffocation or

remove fluffy items when in bed• Bumper pads• Baby monitor

Baby Room p164cont.

• Diaper Changing Area• Covered surface with an edge to

keep them from rolling off• Never leave unattended• Elevated to make it easier for you

Feeding & Pediatrician

• Decision About Feeding p164 see chart p165

• Pros Cons• Choosing a Pediatrician• A doctor who specializes in treating

children

Making a Budget p166

Easier to manage if you have a budget First Step • Identify fixed expenses• Car payments, house payments, taxes,

insurance • Things that usually don’t change and will have

routinelySecond Step• Identify flexible expenses• Food, household items, clothes, entertainment• Things that change and you may or may not

have them routinely

Making a Budget p166cont.

Third Step• Estimating Healthcare Expenses• Variety of ways to pay for the expense of

having a baby:InsurancePaymentsMedicaid

If you have private insurance you will have to meet deductibles and insurance maximums which can be a percentage or insurance maximum per person or family.

Making a Budget p166cont.

Fourth Step• Estimating Other Expense• Maternity clothes• Other baby equipment as we did on

the Basic Baby Supply Assignment• Babysitting

Making a Budget p166cont.

Fifth Step• Once you have estimated and listed all

your expenses, compare it to your net pay (take home pay)

• If the mom works outside the home and will have an income loss during the pregnancy, take this into consideration.

• Be sure to budget for savings.• If you expenses are higher than your

income you will need to cut back.

Making a Budget p166cont.

Ways to reduce costs:• Shop sales, thrift stores, yard sales• Use coupons• Borrow equipment and clothes (take

good care of, clean and return)• Swap or trade items

Work and Family

Child care – who will care for the child? Maternity or paternity leave – Family Medical Leave

Act• If your employer has more than 50 employees they

must offer you family or medical leave up to 12 weeks. • However, you need to have worked so a certain

number of hours before you are eligible for this leave. • It does NOT include pay. • Employers are required to give you back a job at the

same rate of pay, but not necessarily the same job. • Many people can’t afford to take off the whole 12

weeks

Assignment

• Do Chpt 5 Sect 2 Plus Additional Questions

Section 3 Childbirth Options p171

Objectives:• Compare and contrast the qualifications

of health care professionals who deliver babies.

• Outline ways expectant parents can prepare for birth.

• Analyze the benefits of childbirth classes• Evaluate the benefits and drawbacks of

the different types of delivery

Section 3 Childbirth Options p171

Terms• Prepared childbirth• Labor• Delivery• Midwife• Alternative birth center

• Prepared Birth = reducing pain and fear during the birth process through education and breathing and exercises

• Labor = process by which the baby gradually moves out of the uterus and into the vagina to be born

• Delivery = the birth

Decisions to Make• Childbirth Classes• Who will deliver the baby.• Where you will deliver the baby.

Childbirth Classes• Education by health care providers

and private teachers• Learn breathing techniques• Learn how the baby develops

throughout pregnancy• Learn warning signs of potential

problems

• Childbirth Classes cont.• Learn what to expect during delivery• Learn the role of coach• Learn how to make pregnancy and

labor more comfortable

Childbirth Classes cont.• Time for making a birthing plan = what

you want to happen during delivery– Pain relief– Birthing positions– Who will accompany the mother– Treatment of the baby after birth– What to do in case of emergency

• Learn what to expect after the baby is born

Who will deliver the baby p172

 • Obstetrician = specializes in the care of mother and baby

• Family doctors • Licensed midwife = someone trained

to assist in the birthCertified Nurse Midwife (registered nurses)Certified Midwife

Where Will the Baby Be Born?

• Hospitals.– Most born here– Trained personnel– Sanitary conditions– High-tech medical equipment– Gov’t required 2 days – Check your insurance– Safer than home births

Where Will the Baby Be Born?

• Hospitals cont.– Offer classes– Offer programs for siblings and

expectant fathers– Private rooms, soft lighting, music,

comfortable furniture• Home

– 2xs more likely to die than if born in hospital– The mother is at higher risk with home birth

Where Will the Baby Be Born?

•  Alternative birth centers – Not part of a hospital– Provide a more home-like atmosphere– Offer prepared birth (no medications)– Hospitals are a backup– Less costly than a hospital– Leave within 24 hours of birth– Check your insurance

Section 3 – Review Questions p174 #1-5Chapt 5 Test