Child Development: Chapter 3: Prenatal Development

Placenta

A disk-shaped group of tissues in which small blood vessels from the mother and the offspring intertwine but do not join.

Postpartum Depression

A major depressive episode that typically occurs about four weeks after delivery. Women with postpartum depression have such strong feelings of sadness, anxiety, or despair that for at least a two-week period they have trouble coping with their daily tasks. About 10 to 14 percent of new mothers experience postpartum depression.

Emotional states and stress

A mother's stress may influence the fetus Maternal depression may also have an adverse effect on prenatal development and birth

Bonding

A special component of the parent-infant relationship. The formation of a connection, especially a physical bond between parents and the newborn in the period shortly after birth.

The Apgar Score

A widely used method to assess the health of newborns at 1 and 5 minutes after birth. Evaluates infants' heart rate, respiratory effort, muscle tone, body color, and reflex irritability. An obstetrician or a nurse does the evaluation and gives the newborn a score, of 0, 1, or 2: A total score of 7-10 indicates a good condition 5 indicates possible developmental difficulties A score of 3 or below signals an emergency and that the baby might not survive.

Physical Adjustments

A woman's body makes numerous physical adjustments in the first days and weeks after childbirth Fatigue can undermine the new mother's sense of well-being and confidence in her ability to cope with a new baby and a new family life

Small for date infants (also called small for gestational age infants).

Are those whose birth weight is below normal when the length of the pregnancy is considered. They weigh less than 90% of all babies of the same gestational age. Small for date infants may be preterm or full term.

When does neuronal migration occur?

At approximately 6 to 24 weeks after conception

The Fetal Period

Between two months after conception and birth in typical pregnancies. Growth and development continue their dramatic course during this time. The fetus is about 3 inches long and weighs about 3 ounces. By the end of the 4th month the mother can feel arm and leg movements. By the end of the 5th month, the fetus is about 12 inches long and weighs close to a pound. Structures of the skin have formed (toenails and fingernails). The fetus is more active, showing a preference for a particular position in the womb. By the end of the 6th month, the fetus is about 14 inches long and has gained another half pound to a pound. The eyes and eyelids are completely formed, and a fine layer of hair covers the head. A grasping reflex is present and irregular breathing movements occur.

The increase is likely due to:

Births to women 35 years and older Multiple births Management of maternal and fetal conditions Increased substance abuse Increased stress

Nicotine

Cigarette smoking by pregnant women can also adversely influence prenatal development, birth, and postnatal development Preterm births and low birth weights, fetal and neonatal deaths, respiratory problems and sudden infant death syndrome (SIDS, also known as crib death) are all more common among the offspring of mothers who smoked during pregnancy

The Brazelton Neonatal Behavioral Assessment Scale (NBAS)

Performed within 24 to 36 hours after birth to assess newborns' neurological development, reflexes, and reactions to people and objects. Also used in research studies on infant development. 16 reflexes are assessed, along with reactions to animate & inanimate stimuli.

The Germinal Period

Takes place in the first two weeks after conception. It includes the creation of the fertilized egg (zygote), cell division, and the attachment of the zygote to the uterine wall. Rapid cell division by the zygote continues throughout the germinal period.

Time of Exposure

Teratogens do more damage when they occur at some points in development than at others

Fetal alcohol syndrome (FAS)

The abnormalities include: Facial deformities Defective limbs, face, and heart. Most of these children are below average in intelligence, and some are mentally retarded

Implantation

The attachment of the zygote to the uterine wall, takes place about 11 to 15 days after conception.

Kangaroo care

The baby, wearing only a diaper, is held upright against the parent's bare chest, much as a baby kangaroo is carried by its mother. Typically practiced for two to three hours per day Skin-to-skin over an extended time in early infancy.

Stages of Birth

The birth process occurs in three stages . The first stage is the longest of the three stages. Uterine contractions are 15 to 20 minutes apart at the beginning and last up to a minute. Contractions cause the woman's cervix to stretch and open. As the first stage progresses, the contractions come closer together, appearing every two to five minutes. By the end of the first birth stage, contractions dilate the cervix to an opening of about 4 inches, so that the baby can move from the uterus to the birth canal. The second stage begins when the baby's head moves through the cervix and ends with the baby's complete emergence. Afterbirth is the third stage at which time the placenta, umbilical cord, and other membranes are detached and expelled.

What influences teratogens?

The dose, genetic susceptibility, and the time of exposure to a particular teratogen influence both the severity of the damage to an embryo or fetus and the type of defect:

teratology.

The field of study that investigates the causes of birth defects

Hypnosis

The induction of a psychological state of altered attention and awareness. The individual is unusually responsive to suggestions

Acupuncture

The insertion of very fine needles into specific locations in the body. Used as a standard procedure to reduce the pain of childbirth in China

Organogenesis

The name given to the process of organ formation during the first two months of prenatal development.

The Postpartum Period

The period after childbirth that lasts for about six weeks or until the mother's body has completed its adjustment and has returned to a nearly pre-pregnant state. It is a time when the woman adjusts, both physically and psychologically, to the process of childbearing. Involves a great deal of adjustment and adaptation. The adjustments needed are physical, emotional, and psychological.

The brain (third trimester)

The third trimester of prenatal development and the first two years of postnatal life are characterized by connectivity and functioning of neurons The nervous system begins forming as a long, hollow tube located on the embryo's back . This pear-shaped neural tube, which forms at about 18- to 24-days after conception, develops out of the ectoderm.

In the U.S., the increase in the number of low birth weight infants is due to:

The use of drugs Poor nutrition Multiple births Reproductive technologies Improved technology and prenatal care that result in more high-risk babies surviving

Music Therapy

The use of music to reduce stress and manage pain.

Centering Pregnancy

This program is relationship-centered Provides prenatal care in a group setting Replaces traditional 15-minutes physician visits with 90-minute peer group support Led by a physician or certified nurse-midwife.

Caffeine

Two cups of coffee or two to three cans of cola per day increase risks for spontaneous abortion and low birth weight Pregnant women who consumed 300 or more milligrams of caffeine a day had an increased risk of fetal death

Maternal age

Two maternal ages are of special interest: adolescence and thirty-five and older Maternal age is also linked to the risk that a child will have Down Syndrome

Marijuana

Use by pregnant women has negative outcomes for offspring. Prenatal exposure was linked to marijuana use at 14 years of age In sum, marijuana use is not recommended for pregnant women.

Massage

Used as a procedure prior to and during delivery

Amnion

a bag or envelope containing a clear fluid in which the developing embryo floats.

trophoblast

an outer layer of cells that later provides nutrition and support for the embryo.

What are two birth defects related to a failure of the neural tube to close?

anencephaly spina bifida

Prescription drugs that can function as teratogens include

antibiotics, such as streptomycin and tetracycline some antidepressants certain hormones, such as progestin and synthetic estrogen Accutane (prescribed for acne)

rooming-in

arrangement, in which the baby remains in the mother's room most of the time during its hospital stay.

blastocyst

consists of an inner mass of cells that will eventually develop into the embryo.

Umbilical Cord

contains two arteries and one vein and connects the baby to the placenta.

Non-prescription drugs that can be harmful include:

diet pills and aspirin

What are examples of teratogens?

drugs, incompatible blood types, environmental pollutants, infectious diseases, nutritional deficiencies, maternal stress, advanced maternal and paternal age, and environmental pollutants.

neurogenesis

generation of new neurons

What happens at 6 months?

he fetus for the first time has a chance of surviving outside of the womb—that is, it is viable.

What happens at 7 months?

he fetus is about 16 inches long and now weighs about 3 pounds.

teratogen

is any agent that can potentially cause a birth defect or negatively alter cognitive and behavioral outcomes. The word comes from the Greek word tera meaning "monster".

mesoderm

is the middle layer, it becomes the circulatory system, bones, muscles, excretory system, and reproductive system. produces parts that surround the internal areas.

ectoderm

is the outermost layer, becomes the nervous system and brain, sensory receptors (ears, nose, and eyes), and skin parts (hair and nails). produces surface parts.

Cesarean Delivery

the baby is removed from the mother's uterus through an incision made in her abdomen

breech position

the baby's buttocks are the first part to emerge from the vagina.

Dose

the greater the dose of an agent, such as a drug, the greater the effect.

endoderm

the inner layer of cells, which will develop into the digestive and respiratory systems. produces internal body parts

Involution

the process by which the uterus returns to its pre-pregnant size five or six weeks after birth.

Genetic Susceptibility

the type or severity of abnormalities caused by a teratogen is linked to the genotype of the pregnant woman and the genotype of the embryo or fetus

what are some older and some newer non-medicated techniques for child birth?

water-birth, massage, acupuncture, hypnosis, and music therapy.

neural tube

which forms at about 18- to 24-days after conception, develops out of the ectoderm. In a normal pregnancy, once the neural tube has closed, a massive proliferation of new immature neurons begins to take place about the 5th prenatal week and continues throughout the remainder of the prenatal period.

What developmental period is most vulnerable?

In general, the embryonic period is more vulnerable than the fetal period.

Cross-Cultural Variations in the incidence & Causes of Low Birth Weight

In some countries, such as India & Sudan, the percentage of low birth weight babies reaches as high as 31% In the U.S. there has been an increase in low birth weight infants in the last two decades. The U.S. low birth weight rate of 8% in 2004 is considerably higher than that of many other developed countries In both developed and developing countries, adolescents who give birth when their bodies have not fully matured are at risk for having low birth weight babies

What prenatal period does the life support system develop?

In the embryonic period

Incompatible blood types

Incompatibility between the mother's & father's blood type

Paternal Factors

Men's exposure to lead, radiation, certain pesticides, and petro chemicals may cause abnormalities in sperm that lead to miscarriage or diseases The father's smoking during the mother's pregnancy may also cause problems for the offspring

Midwives

Midwifery is practiced in most countries throughout the world ertified nurse midwives generally spend more time with patients during prenatal visits, place more emphasis on patient counseling and education, provide more emotional support, and are more likely to be with the patient one-on-one during the entire labor and delivery process

The Embryonic Period

Occurs from two to eight weeks after conception. The rate of cell differentiation intensifies. Support systems for cells form and Organs appear.

Natural and Prepared Childbirth

Aims to reduce the mother's pain by decreasing her fear through education about childbirth and by teaching her to use breathing methods and relaxation techniques during delivery This approach was developed in 1914 by English obstetrician Grantley Dick-Read.

What is included in the life support system?

Amnion Umbilical Cord Placenta

Medication - three basic kinds of drugs used for labor are:

Analgesia- is used to relieve pain-include tranquilizers, barbiturates, and narcotics (such as Demerol). Anesthesia- Anesthesia blocks sensation & consciousness.- Epidural block is regional anesthesia that numbs the woman's body from the waist down. Oxytocin/pitocin-is a synthetic hormone that is used to stimulate contractions. Pitocin is the most widely used oxytocin.

The Brain (birth)

By the time babies are born, they have approximately 100 billion neurons, or nerve cells, which handle information processing at the cellular level in the brain. The basic architecture of the human brain is assembled during the first two trimesters of prenatal development.

Psychoactive Drugs Act on the nervous system to alter states of consciousness, modify perceptions, and change moods. Examples include

Caffeine Alcohol Nicotine Illegal drugs such as cocaine, methamphetamine, marijuana, and heroin

neuronal migration

Cells move outward from their point of origin to their appropriate locations and creating the different levels, structures, and regions of the brain Once a cell has migrated to its target destination, it must mature and develop a more complex structure.

Maternal diet and nutrition

Children born to malnourished mothers are more likely than other children to be malformed Being overweight before and during pregnancy can also put the embryo or fetus at risk One aspect of maternal nutrition that is important for normal prenatal development is folic acid, a B-complex vitamin Eating fish is often recommended as part of a healthy diet, but pollution has made many fish a risky choice for pregnant women

Doulas

Doula is a Greek word that means "a woman who helps." A doula attends a childbearing woman. A doula is a caregiver who provides continuous physical, emotional, and educational support for the mother before, during, and after childbirth. Doulas remain with the mother throughout labor, assessing and responding to her needs. In the U. S. most doulas work as independent providers hired by the expectant mother.

What happens during the last two months or the prenatal development period?

During the last two months of prenatal development fatty tissues develop, and the functioning of various organ systems (heart and kidneys) steps up. During the 8th and 9th months, the fetus grows longer and gains substantial weight—about another 4 pounds. At birth, the average American baby weighs 7 ½ pounds and is about 20 inches long.

What prenatal development period is it when woman know they are pregnant?

Embryonic Period Also the major organs have begun to form

Emotional and Psychological Adjustments

Emotional fluctuations are common for mothers in the postpartum period. For some women, emotional fluctuations decrease within several weeks after the delivery, but other women experience more long-lasting emotional swings.

What are the three layers that form in the embryonic period?

Endoderm (inner) mesoderm (middle) ectoderm (outer)

Alcohol

Heavy drinking by pregnant women can be devastating to offspring (Shankaran & others, 2011). Fetal alcohol syndrome (FAS) is a cluster of abnormalities that appears in the offspring of mothers who drink alcohol heavily during pregnancy.

Water-birth

Involves giving birth in a tub of warm water. The rationale is that the baby has been in an amniotic sac for many months and that delivery in a similar environment is likely to be less stressful for the baby and the mother. Practiced more often in European countries such as Switzerland and Sweden than in the U. S. but is increasingly being included in U.S. birth plans.

Methamphetamine or "Meth"

Is a stimulant, speeding up an individual's nervous system. Babies born to mothers who use "meth" during pregnancy are at risk for a number of problems, including high infant mortality, low birth weight, and developmental and behavioral problems

Preterm and Small for Date Infants

Low birth weight Weigh less than 5 ½ pounds at birth Very low birth weight Weigh under 3 ½ pounds Extremely low birth weight Weigh under 2 pounds Preterm infant An infant born 3 weeks or more before the pregnancy has reached its full term

embryo

Mass of cells Happens in the embryonic period

Message therapy

Play in improving the developmental outcomes for preterm infants. Field and her colleagues (2004) taught mothers how to massage their full-term infants rather than having health-care professionals do the massage. They concluded that infants who were massaged with moderate pressure gained more weight, performed better on the orientation scale of the Brazelton, were less excitable and less depressed, and were less agitated during sleep.

The Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS)

Provides a more comprehensive analysis of the newborn's behavior, neurological and stress responses, and regulatory capacities. Especially useful for evaluating preterm and substance-exposed infants

Environmental hazards

Radiation, toxic wastes, & other chemical pollutants

Cocaine

Reduced birth weight, length, and head circumference Impaired motor development at 2 years of age Lower arousal, less effective self-regulation, higher excitability, and lower quality of reflexes at one.

Maternal diseases & Infections

Rubella Syphilis Genital herpes AIDS Diabetes

Prepared childbirth

Similar to natural childbirth. Developed by a French obstetrician Ferdinand Lamaze. Known as the Lamaze method A special breathing technique to control pushing in the final stages of labor, as well as more detailed education about anatomy and physiology than Dick-Read's approach provides. The Lamaze method has become very popular in the United States.