insel11e_ppt08 pregnancy and childbirth

8/2/2019 Insel11e_ppt08 Pregnancy and Childbirth

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Pregnancy and Childbirth

Chapter 8


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2010 McGraw-Hill Companies. All Rights Reserved.

Deciding to Become a Parent

Health and age Emotional preparedness

Financial circumstances

Two parent family will spend between $11,000-

$22,000 per year, per child pending on total familyincome

Relationship

Future plans

Education, career and child care plans

Attitude and aptitude

Beliefs

Philosophical or religious2


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Preconception Care

1. Preexisting conditions.2. Medications.

3. Prior pregnancy.

4. Age.

5. Tobacco, alcohol , caffeine use.6. Infections.

7. HIV.

8. Diet.

9. Diethylstilbestrol (DES).

10. Multiple births.

11. Genetic disorders.

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Understanding Fertility

Conception Involves the fertilization of a womens egg by a manssperm

Each month a womens ovaries release an egg

24 hours if not fertilized

3-4 days - the egg travels through the fallopian tubes Egg not fertilized Millions of sperm Sperm release an enzyme Egg and sperm each carry 23 chromosomes

Ovum, blastocyst, embryo, fetus

Fraternal twins and identical twins

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Infertility

Female infertility One of two key causes

Tubal blockage (40%)

Failure to ovulate (40%)

Blocked Fallopian tubes are most commonly causedby pelvic inflammatory disease (PID)

Chlamydia or gonorrhea

Endometriosis

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7/30 2010 McGraw-Hill Companies. All Rights Reserved.

Infertility

Male infertility

Accounts for about 20% of infertile couples

Four main categories

Hypothlamic pituitary disease Congenital disorders

Testicular disease

Disorders of sperm

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Infertility Treatment

Intrauterine insemination

Artificial intrauterine insemination

IVF,GIFT, and ZIFT In vitro fertilization (IVF)

Gamete intrafallopian transfer (GIFT)

Zygote intrafallopian transfer

Surrogate Motherhood

Emotional Responses to Infertility

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Pregnancy 3 periods of about 3 months (13 week trimesters)

Tests Home pregnancy tests

Human chorionic gonadotropin (HCG) Two weeks after fertilization

Early signs and symptoms Missed menstrual period Softening of the uterus

Hagers sign

Slight bleeding Nausea Breast tenderness Increased urination Sleepiness, fatigue and emotional upset

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Continual Change in the Womens Body

Uterus size First 3 months, the uterus enlarges to about threetimes its nonpregnant size

4th month, large enough to make abdominalprotrude

7th-8th month, pushes up into the rib cage

Breast changes

8th week

10th

week colostrum

Muscles and Ligaments loosen

Weight Gain

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Table 8-2 Recommended Weight GainDuring Pregnancy

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Changes During the Later Stages ofPregnancy

Increased needs placed on the mother.

Braxton hicks contractions.

Lightening. Emotional responses to Pregnancy.

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Fetal Development

First Trimester Blastocyst

Inner cells divide into three layers

One layer inner body parts

Middle layer muscle, bone, blood, kidneys, and sexglands

Third layer skin, hair, and nervous tissue

Embryo - End of second week

All major body structures are formed between 2nd and

9th week 2nd Month - Fetus

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Fetal Development

Second Trimester

Fetus grows to about 14 inches and 2pounds

Third Trimester Fetus gains protective fat layers, Respiratory

and Digestive organs develop

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Diagnosing Fetal Abnormalities

Ultrasonography (Ultrasound) High frequency sound waves

Amniocentesis Fluid removal from the uterus

Chorionic Villus sampling

Removal of tiny section of chorionic villi Quadruple marker screen (TMS)

Maternal blood test Analyze four hormone levels and compared to

appropriate standards

Fetal programming Conditions in the womb may influence the risk of adult

diseases Amniocentesis, CVS, and TMS Chromosomal, genetic and other abnormalities

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The Importance of Prenatal Care

Regular medical checkups

Blood tests

Prenatal nutrition

Avoidance of drugs, and other environmental

hazards: Teratogens

1st trimester

Congenital malformations

Alcohol

Tobacco

Caffeine

Drugs

STDs and other infections

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The Importance of Prenatal Care

Activity and exercise Moderate exercise program

30 minutes most days

Cardiovascular exercises

Kegal Exercises Prenatal exercise classes

Preparation for childbirth

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Complications of Pregnancy andPregnancy Loss

Ectopic pregnancy

Spontaneous Abortion, or miscarriage

Stillbirth

Preeclampsia/eclampsia

Placenta Previa

Placental Abruption Gestational Diabetes

Preterm Labor

Labor Induction

Low-birth Weight (LBW) 5.5 LBS.

Infant Mortality

SIDS

Coping with loss

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Childbirth

Choices in childbirth

Who is going to assist with delivery?

Physician

High risk?

Certified Nurse-Midwife

Where is the baby going to be delivered?

Hospital

Home

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Labor and Delivery

Entire process 2-36 hours. First stage of Labor. Average13 hours for a first birth.

Cervix is completely dilated (10 centimeters)

Hormonal changes.

Contractions. (30 seconds and occur every15-20 minutes)

Mucus plug is expelled and amniotic sacmay rupture.

Transition: Contractions may last 60-90 seconds and be 1-3

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Childbirth

Second Stage of Labor Baby slowly pushed into birth canal Baby squeezes through pelvis

Head is usually delivered first

Umbilical cord is cut

Third Stage of Labor Delivery of the placenta Stage typically lasts 5-30 minutes

Apgar Scale of the Baby Heart rate

Respiration

Color

Reflexes

Muscle tone

Total score is between 0 and 10

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Pain Relief During Labor and Delivery

Childbirth preparation courses

Breathing and relaxation techniques

Lamaze or Bradley

Epidural

Narcotics

Fentanyl or demeral

Provide less pain relief than a epidural

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Cesarean Deliveries

2006 about 31.1% of babies born in the U.S.

Surgical removal of the baby

Babys head too large

Mother has a serious health condition Mother who is overweight or diabetes

Difficult labor

Fetal distress

Dangerous infections 90% of cesarean mothers will have subsequent

deliveries by cesarean

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Postpartum Period

3 months following childbirth.

Critical family adjustment.

Vaginal delivery leave hospital 1-3 days.

Cesarean section 3-5 days.

6-8 weeks for the mothers reproductive organs toreturn to prebirth condition

Breastfeeding

About 74% of mothers breast-feed

Lactation begins about 3 days post childbirth

Colostrum prior to lactation

American Academy of Pediatrics 6 months exclusively

Postpartum depression. 29


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Pregnancy and Childbirth

Chapter 8

insel11e_ppt08 pregnancy and childbirth

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