Prenatal Development Birth and Development Introduction Our Presentation

Prenatal Development: Birth and Development

Introduction Our Presentation covers: ● Basic Prenatal Development and care ● Life After Birth ● Basics Information on the Newborn

Pregnancy ● Trimester 1: ○ ○ ○ Covers the first three months of pregnancy Conception takes place at the beginning of first trimester Woman’s hormone levels change with growth of child Usually can’t not visibly tell that the woman is pregnant ■ Extremely critical development that will become permanent base for further growth Woman may experience fatigue and morning sickness

● Trimester 2 Covers months 4 through 6 of pregnancy ○ Woman is usually visibly pregnant at this point ○ Fetus is growing in size and begins moving ○ ● Trimester 3 Covers last three months of pregnancy ○ Fetus continues to dramatically increase in size ○ Woman feels fatigued and uncomfortable ○

Ready for Labor? Choose Between: ● Doula - this is a trained companion who provides knowledgeable support ● Midwife ● Doctor A pregnant woman should receive regular prenatal care regardless of which option she goes with

Labor ● Labor happens in 3 stages ● the first stage lasts 10 -20 hours overall but has several important steps and because of this, it’s broken into three sub-stages ● Early Labor- The first stage where there’s usually non-painful contractions and the cervix begins to dilate

● Active Labor- the second sub-stage It lasts anywhere from 3 to 8 hours ○ The woman experiences stronger contractions ○ Her cervix dilates to 4 centimeters ○ If the woman chooses this is when she’ll be given pain medication ○ ● Transition Final sub-stage that lasts 15 minutes to 3 hours ○ The woman experiences rapid contractions ○ The cervix dilates to 10 centimeters ○ A woman’s water breaks most often in this part of labor ○

Last Stages of Labor

Miscarriage Basic Facts ● Usually caused by genetic abnormalities in the fetus ● The woman can almost always have children again ● There is grief and pain that comes with a miscarriage and it is completely normal and real

External Factors Environmental Factors Personal Factors

External Factors ● ● Nutrition Smoking Alcohol Drugs

Nutrition during pregnancy ● About 300 extra calories are needed for development of fetus ● 25 -35 pounds is normal weight gain for pregnancy ○ less than that could result in problems with obesity later in life and brain development and functioning ● Restrict “dangerous” foods ○ caffeine, fish, luncheon meats ● Be sure to get adequate nutrients ○ Calcium, Folic acid

Smoking reduces Oxygen and nutrient flow to fetus. ● Causes growth retardation and low birth weight ● Raises the risk of miscarriage or sudden infant death ● Can cause babies to go through withdrawal after birth Quitting as late as the 2 nd trimester can help the child to regain normal growth rate.

Alcohol Consuming alcohol can cause abnormalities in the child called Fetal Alcohol Syndrome (FAS) ● FAS can cause physical abnormalities ○ facial features, small stature/head ● FAS can also cause mental abnormalities ○ cognitive effects, trouble controlling behavior, trouble regulating emotions These fetal alcohol spectrum disorders can not be reversed.

Drugs Over-the-counter drugs: ● Should be avoided if possible ● Physician should be consulted if they can not be avoided Illegal drugs: ● Should be avoided in general ● Causes infants to have trouble sending clear messages (ex. crying) so they receive inadequate care. ● Child becomes more susceptible to addiction later in life

Personal Factors ● ● Stress Disease Infertility Teratogens

Stress High stress in the mother can cause: ● Low birth rates of the infant ● Slower growth rate of fetus ● Temperamental difficulties of the infant Stress in the early stages of the pregnancy has a greater impact on fetal growth and length of gestation. This mostly applies to chronic stress of the mother.

Disease ● Can affect unborn child Some sexually transmitted infections(STI) (HIV, Syphilis, etc. ) can infect unborn baby ○ Some STI’s can affect baby while baby passed through birth canal (gonorhea, genetal herpes, etc. ) ○ Neonatal herpes is herpes born of infants that, if do not respond to treatment, are at risk for neurological damage, mental retardation, or even death.

Infertility is the inability to conceive a child within a year of frequent trying. ● 10%-15% of couples are infertile in the U. S. ● There a multitude of reasons that a person may be infertile It has been determined that 40% of the time the male is infertile, 40% of the time the woman is infertile, and the other 10% it can not be determined.

Teratogens are something that causes malformations in an embryo or fetus. They can be cause by: ● Disease during pregnancy ○ Rubella, Syphilis, HIV ● Substance ingested by mother ○ Alcohol, medication, drugs ● Toxins ○ Mercury from foods, X-ray exposure, environmental pollution Can result in structural abnormality, missing/malformed limbs, functional deficit, hearing loss, mental retardation,

Labor and Delivery Options - Hospital * Doctor delivers, sterile environment, nurses present, recovery room, and in-patient care = C-section or Natural Birthing - Birthing Center * either part of a hospital or own entity * very similar to hospital treatment - Home * water births very common

Birth Experiences of Baby - Enters the world - Breathing tests * removing any possible discharge that could block airway * 10% will require some form of resuscitation - The umbilical cord is cut once pulsing ceases

The APGAR Scale - A point/grading system used to determine overall well being of newborn administered at the 1 minute and 5 minute mark after birth - APGAR is an acronym for: * Activity level * Pulse * Grimace * Appearance * Respiration -Each category is rated 0, 1, or 2 where 2 is great and 0 is non present

APGAR cont. - a score of 7 and up is deemed normal - a 4 to 6 requires some intervention * additional suction to help breathing * massaging * administering oxygen - a 3 or lower means immediate, life saving, intervention is necessary

Mother’s Birth Experience - Varies greatly based on procedure and also culture * one study showed that a doula available led to fewer c-sections, forceps deliveries, less need for anesthesia, and a shorter labor time * difference between Western culture and some others = Micronesian women assist in the delivery at home and other women assist

Mother’s Experience cont. - In any case, a baby is delivered - Recovery period necessary - Not uncommon for the mother to understand the next step after delivery, in fact it is normal to not know * transitioning to motherhood = breastfeeding vs formula, changing diapers, soothing a crying baby become all real issues to learn to deal with

Mother’s Experience cont. - Biological effects of delivery * hormones oxytocin, cortisol, and prolactin are boosted to elevated levels = linked to feelings of nurturing and lactation

Postpartum Depression - Sadness, lack of energy, trouble concentrating and feelings of guilt and worthlessness that are severe enough to interfere with the mother’s everyday life * lasts for more than two weeks and begins within the first few months of motherhood - Much more serious than the “baby blues” * similar symptoms but do not last, and do not interfere with everyday life * often alleviated with rest

Father’s Birth Experience - Varies, again - Often said that the man is the dad before delivery and a father once he holds the child in his arms - In some cases fathers experience hormonal changes associated with the mother and pregnancy

Infant States - Different levels of consciousness used to regulate the amount of stimulation an infant receives * states range from crying to deep sleep

Newborns and sleep spend the majority of their day asleep 16 to 18 hours on average roughly half this time is REM sleep wake to eat roughly every 3 to 4 hours By 6 months, babies should be able to sleep through the night

While Awake - Quiet Alertness * eyes open * aware of surroundings * but quiet and still * usually an hour a day, but in 5 to 10 minute non consecutive increments - Active Alertness is same as above, but mobile - Crying is the last stage * attentiveness to needs determines duration

Risks - Infant mortality * deaths that occur within one year * 6. 9 deaths per thousand births in the US in the year 2000 - Sudden Infant Death Syndrome (SIDS) * leading cause of death between 1 month and 1 year

Risks cont. - Prematurity * a birth that occurs before a gestational period of 37 weeks * 12. 7 percent of births - Low birth-weight * a full term infant who weighs less than 5 pounds, 4 ounces - Now possible for both of the categories to live perfectly normal lives, whereas in the past there was little available care