Preparing for Birth Chapter 5

5.1 A Healthy Pregnancy Early Signs on Pregnancy Within a Few Weeks of Conception• A missed menstrual period (often the first indicator)• A full feeling or mild ache in the lower abdomen• Tiredness or faintness• A frequent, urgent need to urinate• Swollen breasts, causing discomfort or tenderness• Nausea or vomiting, particularly in the morning

These symptoms are common, but they do not always mean that a woman is pregnant.

Medical Care• An obstetrician is a doctor who specialized in

pregnancy and childbirth.• Obstetricians will schedule regular checkups

during pregnancy, and checkups will become more frequent as the pregnancy progresses.

• Nothing is more important to the health of the baby than for the mother to get regular medical care and advice from the beginning to the end of pregnancy.

The First Exam • Check for the her blood pressure, pulse,

respiration, and weight.• Discussion of her medical history• Measurement of her pelvis to determine whether

it is wide enough to allow a baby of normal size to pass through.

• Analysis of her urine for signs of infection or diabetes

• Blood test to rule out anemia. Anemia is a condition that results from not having enough red blood cells. Symptoms include fatigue, shortness of breath, rapid heartbeat, and feeling weak and cold.

The First Exam • The blood test also shows whether or not the

mother’s blood contains certain protein. This protein is referred to as the Rh factor.

• Knowing about the presence (Rh positive) or absence (Rh negative) of this protein is very important. The Rh factor is determined genetically.

• If a mother’s blood does not have the protein and the fetus’s blood does, the mother’s blood builds up antibodies that attack the protein the fetus’s blood. Doesn’t affect first pregnancy but puts future ones in danger.

• Once identified, the mother can receive an injection, thus protecting any Rh positive fetus.

The First Exam • A check of the woman’s immunity to rubella, also

called what?• If a pregnant woman has not been vaccinated

against this disease and has never had it , she must be especially careful to avoid anyone who has it.

Periodic Checkups • Expectant mothers have checkups once a month

until about the sixth or seventh month of pregnancy. After that, it’s twice a month. Final month checkups occur once a week. (monitors baby’s development and health)

• Gestational diabetes is a form of diabetes that occurs only during pregnancy. If left untreated can cause baby to be heavier weight than usual.

• Preeclampsia is a condition characterized by high blood pressure and the presence of protein in the mother’s urine. (can prevent baby from getting enough blood)

• Both of these serious conditions can occur during the second half of pregnancy.

Discomforts of Pregnancy • If a woman experiences one or more of the following

symptoms, she should discuss them with her doctor:• Nausea or vomiting-most common complaint (morning

sickness)• Sleepiness-common in early pregnancy • Heartburn-burning feeling in upper abdomen • Shortness of breath-pressure on lungs from baby (common in

late pregnancy)• Varicose veins-pressure on the blood vessels in the legs• Muscle cramps in legs-stretches, rest, and a diet rich in

calcium may alleviate pain • Lower back pain-avoid lifting. Exercise to strengthen back.

Possible Serious Complications• Vaginal bleeding• Unusual weight gain or loss• Excessive thirst• Diminished need to urinate or pain during urination• Severe abdominal pain • Persistent headaches• Severe vomiting• Fever• Increased vaginal mucus • Swelling of the face, hands, or ankles• Blurred vision or dizziness• Prolonged backache

Physical ChangesMonth Pregnancy Development

Month 1 Missed menstrual period.Other signs may not be noticeable yet.

Month 2 Breasts begin to swell.Possible nausea and fatigue.

Month 3 Breast become firmer and fuller.Uterus about size of an orange. Weight gain about 2-4 pounds.

Month 4 Discomforts of early pregnancy are goneAppetite increases.

Month 5 Enlarged abdomen becomes apparent.Slight fetal movement.

Month 6 Fetal movements sensed as strong kicks, thumps, and bumps. Weight gain total 10-12 pounds.

Month 7 Increased size may affect posture.

Month 8 Discomfort from increased size. Weight gain 18-20 pounds.

Month 9 Lightening is felt as fetus drops into pelvis. Total weight gain 25-35 pounds.

Weight Gain During Pregnancy • Women typically gain between 24 and 30 pounds

during a healthy pregnancy.• Recommended weight gain is about a pound a

month during first 3 months.• In 4th through 9th months, weight gain should be

about 3 to 4 per month.• Gaining too little weight can increase the risk of

fetal death or premature birth.• Gaining too much can increase the risk of

complications and added stress on the mother’s body.

Daily Routines• Eat a healthful diet. Eat a variety of nutritious

meals and snacks.• Get plenty of rest. Taking frequent breaks

during the day may provide more energy.• Exercise. Moderate exercise is important to

everyone. Walking, yoga, or swimming. • Practice good hygiene. Keeping the skin clean

helps the body maintain a healthy temperature and eliminate waste.

Emotional Health During Pregnancy • Emotional and physical stress of pregnant women

may cause them to go into depression. • Books can help expectant mothers understand

their concerns and improve their outlook.• Professional counseling or local support groups

may also help.

Emotional Health During Pregnancy • These are ways to cope with stress while

pregnant:• Avoid sugary foods and caffeine. Make

pregnant women nervous and jumpy.• Exercise. Gently exercises, such as stretching

can help women feel lighter and more energetic.• Take a time-out. Taking time to relax and enjoy a

favorite activity or hobby can help.• Practice relaxation techniques. Learn

breathing or visualization exercises through books or classes.

Emotional Health During Pregnancy cont.• Talk about concerns. Benefit from talking to

supportive friends or family members, especially those who have children of their own.

• Take a class for expectant parents. The more pregnant women know about the birth process, the greater their sense of control. Feeling prepared can help reduce stress.

Nutrition During Pregnancy • Vegetables-keeps mother’s heart healthy.• Dark green vegetables (broccoli and spinach)• Orange vegetables (carrots and pumpkins)• Dry beans and peas• Starchy vegetables (potatoes and corn)• Others, celery and onions.

• Grains-contains carbohydrates, which provide energy. Includes Bread, pasta, oatmeal, and tortillas.

• Grains are divided into whole grains and refined grains. • Whole grains contain the entire grain kernel.• Refined grains have been milled, causing parts of the grain to

be removed.

Nutrition During Pregnancy cont.• Fruits help maintain a health heart and blood

vessels.• Fruit juices are high in calories and do not contain

fiber. • bananas, apples, tomatoes, avocadoes, strawberries, and

oranges.• Milk products is important for pregnant women to

get adequate calcium. Osteoporosis is a condition in which bones bcome fragile and break easily.• Milk, cheese, ice cream, and yogurt. • Choose low-fat or fat-free

Nutrition During Pregnancy cont.• Oils are fats that are liquid at room temperature.

Come from plants or fish. Healthier than solid fats. • Nuts, olives, and some fish.

• Meat and Beans provide protein, that is vital to the baby’s growth and development of bones and teeth.• Meat, poultry, fish, dried beans, nuts, and eggs.

Vitamins and Minerals• Vitamins help to maintain a healthy pregnancy. Spina

bifida are linked to vitamin deficiency. Most important vitamins:

• Vitamin A ensures proper eye development and helps keep skin healthy.

• The B vitamins assist in general fetal development.• Vitamin C helps build healthy teeth and gums. Helps

form connective tissue of skin, bone, and organs.• Vitamin D aids in the creation of bones and teeth.• Folic acid is necessary for normal spinal development

in the fetus. (citrus fruits, broccoli, asparagus, beans, peas, seeds, nuts, etc.)

Vitamins and Minerals• Pregnant women need iron, a mineral that helps

prevent anemia and assists in developing the baby’s own blood supply.

• Extra iron is stored in the baby’s liver and used in the months right after birth.

• During this time, a baby who lives on breast milk lacks iron in the diet. Mother can get iron from dried beans, raisins, meat, and leafy green vegetables.

• Calcium and phosphorus are also important minerals during pregnancy. They work to produce strong bones and teeth.

Nutrition and Pregnant Teens and Special Diets• It is essential for a teen’s own body and for her

growing baby to get al the needed nutrients for proper growth and development.

• Some people are sensitive to certain foods, such as dairy or vegetarians. A pregnant woman needs to discuss theses considerations with her doctor to ensure that her fetus gets the needed nutrients for healthy growth and development.

Sensitivities to Milk • A person is lactose intolerant if milk products

cause symptoms such as abdominal pain and gas. Lactose is a type of sugar found in milk.

• Lactase is an enzyme that helps digest lactose. Yogurt helps some people digest milk.

5.2 Preparing for the Baby’s Arrival • Parents should discuss their hopes, fears, worries,

and other aspects of parenting with each other before the baby’s arrival.

• How will they handle guidance and discipline? How will parenting tasks be shared? How will they manage the new expenses?

• Developing a basic daily schedule helps keep things on tack.

• Routines also help infants and young children know what to expect and when to expect it.

Other Children in the Family • It’s not always easy for children to accept a new

baby in their lives. (can any of you relate to this?)• Parents should be prepared for a wide range of

attitudes, from jealousy and confusion to excitement and love.

• Adjusting takes time.• Talking about concerns and acceptance of a

child’s feelings can help foster a positive relationship between siblings.

Clothes, Equipment, and Space• Babies need clothes, bedding, bath supplies, and

travel equipment such as a stroller. • Newborns may sleep as many as 18 to 22 hours a

day. • During the 1st six months, most babies sleep 15 to

18 hours a day. • Baby may share a siblings’ room, room of their

own, or with their parents.

The Crib• Babies spend countless hours alone in a crib. Crib

safety should be a high priority.• Slats. Should be more than 2 3/8 inches apart. A

slat is the flat, narrow strip of wood on the sides of a crib.

• Paint. Paint should not contain lead and should be smooth.

• Structure. Corner post should be all the same height.

• Sides. Crib should be about 9 inches above the mattress to keep baby from falling out when lowered.

• Latch. Should lock securely. Never use a crib with a broken latch.

• Mattress. Should be firm and fit crib exactly. No space between crib and mattress.

The Crib• Safe Bedding. Soft bedding should NOT be

placed in a crib. Why?• End Panels. If end panels have decorative

cutouts, they should be very small, so baby’s head, arms, and legs cannot get caught in them.

• Age. If crib was pre-owned, it should be carefully checked to be sure it meets these current safety standards.

Diaper Changing Area• Whatever surface is used to change a diaper, it

should be covered with a cloth or towel that can be washed regularly.

• A baby should never be left unattended on any elevated surface such as a changing table or a bed, even if restraint straps are used.

Breast-Feeding vs. Bottle-FeedingAdvantages Disadvantages

Breast-feeding •Best source of nutrition for baby.•Gives the baby some immunity against diseases.•Creates a bond through physical closeness with mother.•Reduces risk that mother may feel depressed. •Is free.•Speeds the return of the mother’s uterus to normal size.•Reduced the mother’s risk of later having breast or ovarian cancer.

•Prevents father from participating in feeding.•Baby has to be fed more often.•May be painful for some mothers. •May be difficult because of work schedule.

Breast-feeding vs. Bottle-feeding

Advantages DisadvantagesBottle-feeding •Allows father to

participate in feeding.•Allows mother to have a more flexible schedule.•Eliminates concern about mother’s diet or medications she takes.•Ensures that baby gets essential nutrients.•Babies need feeding less often.•Available in shelf-stable forms for easier storage and portability.

•Can be expensive •Does not give baby any natural immunities to disease.•Involves a greater chance of baby developing allergies.•Creates risk that baby may not be given close physical contact during feeding.

Decisions About Feeding• Babies who are bottle fed drink formula. Formula

is a mixture of milk or milk substitutes, water, and essential nutrients.

• Whether a baby is bottle-fed or breast-fed the nurturing and touch that comes with being held and fed is as important as the food itself.

Choosing a Pediatrician• A pediatrician is a doctor who specializes in

treating children.• This doctor may be the child’s primary doctor for

years. • Anyone interested in becoming a pediatrician?

Making a Budget• A budget is simply a spending plan that people

use to use help estimate their present and future income and expenses.

• First step in making a budget is to identify income.• A fixed expense is a payment that generally

cannot be changed. Bills such as car payments, housing payments, and expenses, and taxes.

• A flexible expense is an expense that can be changed, such as food costs, household items, clothes, and entertainment.

Consider Child Care Options • Will one parent be able to cut back on working

hours or stay at home fulltime to care for the child? What other child care options are available, and what are their costs?

• Maternity leave is time taken off work by a mother after the birth of a baby.

• Paternity leave is when the father takes time off work after a baby’s birth.

• Under a federal law called the Family Medical Leave Act, employers with more than 50 workers must offer 12 weeks of unpaid family or medical leave to new mothers and fathers.

Estimate Other Expenses• Maternity clothes• Supply list (diapers, travel equipment, bedding,

clothing, etc.)• Formula• Substitute child care

5.2 Childbirth Options • Prepared child birth means reducing pain and

fear during the birth process through education and the use of breathing and conditioning exercises.

• Labor is the process in which the baby gradually moves out of the uterus and into the vagina to be born.

• Delivery is the birth of the baby.

Prepared Childbirth• Childbirth education is important. In addition to

learning breathing techniques, participants learn much more:

• How baby grows and develops throughout pregnancy

• Tests such as amniocentesis • Warning signs that may indicate a serious

problems• What to expect during labor and delivery• The role of the support person• Breathing and conditioning exercises to make

pregnancy, labor, and delivery more comfortable and less painful

• What to expect after the baby is born

Delivery Options/Health Care Professionals• The following healthcare professionals are

qualified to deliver babies:• Obstetricians because these doctors specialize

in the care of mother and babies both before and right after birth, they are qualified to handle any emergencies or problems that might occur.

• Family Doctors- some family doctors provide prenatal care and deliver babies.

Delivery Options/Health Care Professionals cont.• Licensed Midwives- a midwife is a health care

professional trained to assist women in childbirth.• 2 types of midwives• Certified nurse-midwives (CNMs)• Certified midwives

• CNMs are registered nurses. Both types have advanced training in normal pregnancy and birth. Must take a certified exam before they can practice.

Places to Give Birth/Home• Options may be limited by their health insurance

or by which their doctor uses. • Only in the last 100 years have babies been

mostly born in hospitals. • Unfortunately, it is not possible to know what

problems might arise like if the umbilical cord becomes compressed, or flattened.

• Many couples who choose home births have a midwife present to assist with the delivery.

Places to Give Birth/Hospital• The government requires insurance companies to

cover at least two days in the hospital after delivery for women who have routine, vaginal births.

• Hospitals have full staff to assist and additional educators on taking care of the baby. Parents should ask if hospitals offer any of the following:• Classes that prepare for delivery• Programs for siblings and fathers• Private rooms with music, soft lighting, and comfortable

furniture for family members.• Option for mother and baby to room together during time

in hospital.

Alternative Birth Center• An alternative birth center is a facility that

provides a more homelike environment for labor and delivery.

• Alternative birth centers might offer beds large enough for both the mother and father to rest.

• Also offer water births, meaning the mother is in water during the birth.

• Midwives usually handle births at these centers.