psychology 201 ch 3

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blastocyst.

After about 4 days, the zygote consists of about 100 cells, resembles a hollow ball, and is called a

"teach" the fetus, by providing auditory stimulation (e.g., rhythmic sounds, speech, music). Makers of these products claim that a fetus exposed to this stimulation will reach developmental milestones earlier and be better prepared for school. However, I suggest that you save your money. The learning shown in the studies described in the previous paragraph—such as recognizing voices—occurs quite rapidly after birth without prenatal "education." Also, some of the more sophisticated forms of learning that are claimed to occur are probably impossible in utero, either because they require simultaneous visual stimulation (e.g., to pair voices with faces) or because they depend on brain development that takes place after birth.

After reading about findings like these, you may be tempted to buy products that claim to

Sample of fetal cells is obtained from amniotic fluid Screen for genetic disorders

Amniocentesis

an unhappy, difficult baby (DiPietro et al., 1996).

An active fetus is more likely than an inactive fetus to be

Spotlight on Theories A Theory of the Risks Associated with Teenage Motherhood

BACKGROUND Children born to teenage mothers typically don't fare very well. During childhood and adolescence, these children usually have lower scores on mental-ability tests, they get lower grades in school, and they more often have behavioral problems (e.g., they're too aggressive). However, why teen motherhood leads to these outcomes remains poorly understood. THE THEORY Sara Jaffee (2003) believes that teenage motherhood leads to harmful consequences through two distinct mechanisms. One mechanism, called social influence, refers to events set in motion when a teenage girl gives birth—events that make it harder for her to provide a positive environment for her child's development. For example, she may drop out of school, limiting her employment opportunities. Or she may try to finish school but become a neglectful parent because she spends so much time studying. According to the second mechanism, called social selection, some teenage girls are more likely than others to become pregnant, and those same factors that cause girls to become pregnant may put their children at risk. For example, teenage girls with conduct disorder—who often lie, break rules, and are aggressive physically and verbally—are more likely to get pregnant than girls who don't have conduct disorder. The behaviors that define conduct disorder don't bode well for effective parenting. In addition, conduct disorder has a genetic component, which teenage mothers could pass along to their children. According to social selection, the mother's age at birth is not really critical; these girls would have difficulty parenting effectively even if they delayed motherhood into their 20s or 30s. Instead, the factors that put girls at risk for becoming pregnant as teenagers also put children from those pregnancies at risk. Hypothesis: According to the social influence mechanism, measures of the child-rearing environment should predict outcomes for children born to teenage moms. For example, if teenage motherhood results in less education and less income, then these variables should predict children's outcomes. According to the social selection mechanism, the same characteristics that are associated with a teenage girl's becoming pregnant should predict outcomes for her children. For example, if teenage girls are more likely to get pregnant when they're not as smart and have conduct disorder, then these same variables should predict outcomes for the children of these teenage moms. Test: Jaffee (2003) evaluated both hypotheses in a 20-year longitudinal study conducted in New Zealand in which about 20% of the mothers had given birth while teenagers. She measured mothers' antisocial behavior as well as their education and income. She also assessed children's outcomes. For simplicity, we'll consider just one outcome: whether the children had, as adolescents or young adults, committed any criminal offenses. Jaffee found that, compared to children born to older mothers, children born to teenage mothers were nearly three times more likely to have committed a criminal offense. This was as a result of both social influence and social selection mechanisms. Consistent with the social influence mechanism, teenage moms were less educated and had lower incomes, and these variables predicted their children's criminal activity. Consistent with the social selection mechanism, teenage moms were more likely to have a history of antisocial behavior, and this history predicted their children's criminal activity. Conclusion: The adverse outcomes associated with teenage motherhood don't have a single explanation. Some of the adversity can be traced to cascading events brought on by giving birth as a teenager: Early motherhood limits education and income, hindering a mother's efforts to provide an environment that's conducive to a child's development. But some of the adversity does not reflect early motherhood per se; instead, girls who become pregnant teenagers often have characteristics that lead to adverse outcomes regardless of the age at which they gave birth. Application: Policymakers have created many social programs designed to encourage teenagers to delay childbearing. Jaffee's work suggests two additional needs. First, policies are needed to limit the cascading harmful effects of childbearing for those teens who do get pregnant (e.g., programs to allow them to complete their education without neglecting their children). Second, many of the problems associated with teenage pregnancy are only coincidentally related to the fact that the mother is a teenager; programs are needed to help these girls learn effective parenting methods. Of course, not all teenage mothers and their infants follow this dismal life course. Some teenage mothers finish school, find good jobs, and have happy marriages; their children do well in school, academically and socially. These successes are more likely when teenage moms live with a relative—typically the child's grandmother (Gordon, Chase-Lansdale, & Brooks-Gunn, 2004). And they're more likely when teenage moms participate in home-visiting programs in which registered nurses visit teenage moms to provide assistance, advice, and encouragement (Kitzman et al., 2010). However, teenage pregnancies with "happy endings" are definitely the exception; for many teenage mothers and their children, life is a struggle. Educating teenagers about the true consequences of teen pregnancy is crucial. Fortunately, the pregnancy rate among U.S. teenagers has declined steadily from its peak in the early 1990s (Martin et al., 2012). Are older women better suited for pregnancy? This is an important question because present-day U.S. women typically are waiting longer than ever to become pregnant. Completing an education and beginning a career often delay childbearing. In fact, the birthrate in the 2000s among 40- to 44-year-olds is at its highest since the 1960s (Hamilton et al., 2010). Older women like the one in the photo have more difficulty getting pregnant and are less likely to have successful pregnancies. Women in their 20s are twice as fertile as women in their 30s (Dunson, Colombo, & Baird, 2002), and past 35 years of age, the risks of miscarriage and stillbirth increase rapidly. For example, among 40- to 45-year-olds, pregnancies are much more likely to result in miscarriage or in babies with low birth weight (Khalil et al., 2013). What's more, women in their 40s are more liable to give birth to babies with Down syndrome. However, as mothers, older women are quite effective. For example, they are just as able to provide the sort of sensitive, responsive caregiving that promotes a child's development (Bornstein et al., 2006). Older women have more difficulty getting pregnant and are more likely to have miscarriages, but they are quite effective mothers. In general, then, prenatal development is most likely to proceed normally when women are between the ages of 20 and 35, are healthy and eat right, get good health care, and lead lives that are free of chronic stress. But even in these optimal cases, prenatal development can be disrupted, as we'll see in the next section.

reaches the uterus. The next step is implantation:

By the end of the first week,

Sample of tissue is obtained from the chorion (part of the placenta) Screen for genetic disorders

Chorionic villus sampling (CVS)

two eggs are released and each is fertilized by a different sperm cell.

Fraternal twins, which are more common, are created when

speech that they heard during prenatal development. In one study (DeCasper & Spence, 1986), newborns recognized The Cat in the Hat when their mother had read it daily for the last several weeks of pregnancy. In another study (Partanen et al., 2013), newborns recognized novel words presented during the fetal period of prenatal development. These longlasting effects of prenatal experiences with foods and sounds illustrate that prenatal development leaves babies well prepared for life outside the uterus.

In addition, infants recognize

breech presentation

Most babies arrive head first, but a small percentage come out feet or bottom first, which is known as a

male embryos develop testes and female embryos develop ovaries.

Near the end of the embryonic period,

38 weeks, which are divided into three stages: the period of the zygote, the period of the embryo, and the period of the fetus.

The changes that transform a fertilized egg into a newborn human make up prenatal development. Prenatal development takes an average of

nutrients, oxygen, vitamins, and waste

Villi lie close to the mother's blood vessels and allow what products to be exchanged between mother and embryo.

Thalidomide was a powerful teratogen, an agent that causes abnormal prenatal development. Disease Potential Consequences AIDS Frequent infections, neurological disorders, death Cytomegalovirus Deafness, blindness, abnormally small head, developmental disabilities Genital herpes Encephalitis, enlarged spleen, improper blood clotting Rubella (German measles) Developmental disabilities; damage to eyes, ears, and heart Syphilis Damage to the central nervous system, teeth, and bones Some of these diseases pass from the mother through the placenta to attack the embryo or fetus directly. They include cytomegalovirus (a type of herpes), rubella, and syphilis. Other diseases attack at birth: The virus is present in the lining of the birth canal, and the baby is infected during the birth process. Genital herpes is transmitted this way. AIDS is transmitted both ways—through the placenta and during passage through the birth canal. The only way to guarantee that these diseases do not harm prenatal development is for a woman to not contract the disease before or during her pregnancy. Medication may help the woman but does not prevent the disease from damaging the developing baby. Drug Potential Consequences Accutane Abnormalities of the central nervous system, eyes, and ears Alcohol Fetal alcohol spectrum disorder, cognitive deficits, retarded growth Aspirin Deficits in intelligence, attention, and motor skills Caffeine Lower birth weight, decreased muscle tone Cocaine and heroin Retarded growth, irritability in newborns Marijuana Lower birth weight, less motor control Nicotine Retarded growth, possible cognitive impairments Notice that most of the drugs in the list are substances that you may use routinely: Accutane (used to treat acne), alcohol, aspirin, caffeine, and nicotine. Nevertheless, when consumed by pregnant women, they present special dangers (Behnke & Eyler, 1993). Cigarette smoking is typical of the potential harm from teratogenic drugs (Cornelius et al., 1995; Espy et al., 2011). The nicotine in cigarette smoke constricts blood vessels and thus reduces the oxygen and nutrients that can reach the fetus through the placenta. Therefore, pregnant women who smoke are more likely to miscarry (abort the fetus spontaneously) and to bear children who are smaller than average at birth (Cnattingius, 2004). Furthermore, as children develop, they are more likely to show signs of impaired cognitive skills, reduced academic achievement, and behavioral problems (Clifford et al., 2012; Wakschlag et al., 2006). Finally, even secondhand smoke is harmful: When pregnant women don't smoke but their environment is filled with tobacco smoke, their babies tend to be smaller at birth and to be born early (Meeker & Benedict, 2013). Most of these harmful effects depend on degree of exposure—heavy smoking is more harmful than moderate smoking—and on the fetal genotype: Some children inherit genes that are more effective in defending, in utero, against the toxins in cigarette smoke (Price et al., 2010). Alcohol also carries serious risk. Pregnant women who regularly consume quantities of alcoholic beverages may give birth to babies with fetal alcohol spectrum disorder (FASD). The most extreme form, fetal alcohol syndrome (FAS), is most likely among pregnant women who are heavy drinkers—for example, they drink 15 or more cans of beer over a weekend (May et al., 2013). Children with FAS usually grow more slowly than normal and have misshapen faces. Like the child in the photo, youngsters with FAS often have a small head, a thin upper lip, a short nose, and widely spaced eyes. FAS is the leading cause of developmental disabilities in the United States, and children with FAS have serious attentional, cognitive, and behavioral problems (Davis et al., 2013). Sarah is 22 and pregnant for the first time. She smokes half a pack of cigarettes each day and has one bottle of light beer with dinner. Sarah can't believe that the relatively small amounts she smokes and drinks could hurt the baby she's carrying. What would you say? She's probably wrong. There are no known "safe" amounts of cigarette smoking and drinking. For example, her drinking might be enough to cause alcohol-related neuro-developmental disorder. As a by-product of life in an industrialized world, people are often exposed to toxins in food they eat, fluids they drink, and air they breathe. Chemicals associated with industrial waste are the most common environmental teratogens, and the quantities involved are usually minute. However, as is true for drugs, amounts that go unnoticed by an adult can cause serious damage to a developing fetus (Moore, 2003). Table 3-3 lists five well-documented environmental teratogens. Table 3-3 Environmental Teratogens and Their Consequences Hazard Potential Consequences Air pollutants Low birth weight, premature birth, lower test scores Lead Developmental disabilities Mercury Retarded growth, developmental disabilities, cerebral palsy PCBs Impaired memory and verbal skills X-rays Retarded growth, leukemia, developmental disabilities Note: Air pollutants include carbon monoxide, ozone, lead, sulfur dioxide, and nitrous oxides.

What is a teratogen, and what specific diseases, drugs, and environmental hazards can be teratogens?

weeks 3-8 After the blastocyst is completely embedded in the uterine wall, it is called an embryo. This new period typically begins the third week after conception and lasts until the end of the eighth week. During the period of the embryo, body structures and internal organs develop. At the beginning of the period, three layers form in the embryo. The outer layer or ectoderm will become hair, the outer layer of skin, and the nervous system; the middle layer or mesoderm will form muscles, bones, and the circulatory system; the inner layer or endoderm will form the digestive system and the lungs.

When do body structures and internal organs emerge in prenatal development?

The final and longest phase of prenatal development, the period of the fetus, extends from the ninth week after conception until birth. During this period, the baby-to-be becomes much larger and its bodily systems begin to work.

When do body systems begin to function well enough to support life?

In rapid-eye-movement (REM) sleep, babies move their arms and legs, they may grimace, and their eyes may dart beneath their eyelids. Brain waves register fast activity, the heart beats more rapidly, and breathing is more rapid. In regular or non-REM sleep, breathing, heart rate, and brain activity are steady and babies lie quietly without the twitching associated with REM sleep. Newborns spend about equal amounts of time in REM and non-REM sleep. REM sleep becomes less frequent as infants grow: By the first birthday, REM sleep drops to about 33%, not far from the adult average of 20% (Lushington et al., 2013).

While asleep, babies alternate between two types of sleep which are

has a chance to survive, which is why this age range is called the age of viability. By this age, the fetus has a distinctly baby-like look, as you can see in the photo. However, babies born this early have trouble breathing because their lungs are not yet mature. Also, they cannot regulate their body temperature very well because they lack the insulating layer of fat that appears in the eighth month after conception. With modern neonatal intensive care, infants born this early can survive, but they face other challenges

With these and other rapid changes, by 22 to 28 weeks most systems function well enough that a fetus born at this time

12 hours.

Within hours, the zygote divides for the first time; then division occurs every

a mad cry

is a more intense version of a basic cry; and a pain cry begins with a sudden, long burst of crying, followed by a long pause and gasping.

16 to 18 hours daily.

sleep is what newborns do more than anything else. They sleep

A basic cry

starts softly, then gradually becomes more intense and usually occurs when a baby is hungry or tired;

Fetal Behavior During the fetal period, the fetus actually starts.

to behave

fetuses differ in their usual heart rates and in how much their heart rate changes in response to physiological stress. In one study (DiPietro et al., 2007), fetuses with greater heart rate variability were, as 2-month-olds, more advanced in their motor, mental, and language development. Greater heart rate variability may be a sign that the nervous system is responding efficiently to environmental change (as long as the variability is not extreme).

. By about 6 months after conception, With these and other rapid changes, by 22 to 28 weeks most systems function well enough that a fetus born at this time has a chance to survive, which is why this age range is called the age of viability. By this age, the fetus has a distinctly baby-like look, as you can see in the photo. However, babies born this early have trouble breathing because their lungs are not yet mature. Also, they cannot regulate their body temperature very well because they lack the insulating layer of fat that appears in the eighth month after conception. With modern neonatal intensive care, infants born this early can survive, but they face other challenges, as I'll describe in

senses work. The fetus can hear the mother's heart beating and hear her speaking (Lecanuet, Granier-Deferre, & Busnel, 1995). And as the fetus swallows amniotic fluid, it responds to different flavors in the fluid. Late in pregnancy enough light passes through the abdominal wall for a fetus to see (Del Giudice, 2011).

Another sign of growing behavioral maturity is that the

brain; the rest forms the spinal cord. By the start of the fetal period, the brain has distinct structures and has begun to regulate body functions. During the period of the fetus, all regions of the brain grow, particularly the cerebral cortex, the wrinkled surface of the brain that regulates many important human behaviors.

At 4 weeks after conception, a flat set of cells curls to form a tube. One end of the tube swells to form the

The blastocyst burrows into the uterine wall and establishes connections with the mother's blood vessels. Implantation takes about a week to complete and triggers hormonal changes that prevent menstruation, letting the woman know she is pregnant.A small cluster of cells near the center of the blastocyst, the germ disc, eventually develops into the baby. The other cells are destined to become structures that support, nourish, and protect the developing organism. The layer of cells closest to the uterus becomes the placenta, a structure for exchanging nutrients and wastes between the mother and the developing organism .Implantation and differentiation of cells mark the end of the period of the zygote. Comfortably sheltered in the uterus, the blastocyst is well prepared for the remaining 36 weeks of the journey to birth.

By the end of the first week, the zygote reaches the uterus. The next step is implantation:

Based on mounting evidence that SIDS more often occurred when infants slept on their stomachs, in 1992 the American Academy of Pediatrics (AAP) began advising parents to put babies to sleep on their backs or sides. In 1994, the AAP joined forces with the U.S. Public Health Service to launch a national program to educate parents about the dangers of SIDS and the importance of putting babies to sleep on their backs. The "Back to Sleep" campaign was widely publicized through brochures, posters like the one shown in Figure 3-11, and videos. Since the "Back to Sleep" campaign began, the incidence of SIDS has been cut in half but it still remains the leading cause of death in 1- to 12-month-olds (Trachtenberg et al., 2012). Consequently, in the 21st century the National Institutes of Health (NIH) focused on groups in which SIDS is more common, including African Americans and Native Americans. The NIH developed ways to convey the "Back to Sleep" message in a culturally appropriate manner to African American communities (NICHD, 2004). In addition, the NIH developed educational programs for nurses and pharmacists. In 2012, the campaign was named Safe to Sleep and included additional recommendations to keep infants safe while asleep. Through these policies, the NIH hopes to spread the word to parents and others who care for infants: the keys to safe sleeping include keeping babies away from smoke, putting them on a firm mattress on their backs to sleep, and not overdressing them or wrapping them too tightly in blankets.

Child Development and Family Policy Safe Sleeping

common in many countries around the world. You might think that co-sleeping would make children more dependent on their parents or lead to other behavioral problems, but research provides no evidence of this (Barajas et al., 2011; Okami, Weisner, & Olmstead, 2002). Plus, co-sleeping has the benefit of avoiding the lengthy, elaborate rituals that are often involved in getting youngsters to sleep in their own rooms, alone. With co-sleeping, children and parents simply go to bed together, with few struggles.

Co-sleeping, in which infants and young children sleep with their parents, is

crowning

During labor, the appearance of the top of the baby's head.

eyebrows, eyelashes, and scalp hair emerge. The skin thickens and becomes covered with a thick greasy substance, vernix, that protects the fetus during its long bath in amniotic fluid

During the fifth and sixth months after conception,

cell division and travels down the fallopian tube toward the uterus.

During these first 2 weeks, the zygote grows rapidly through

38 weeks from conception to birth.

Normally, gestation takes

Neonatal Behavioral Assessment Scale, or NBAS (Brazelton & Nugent, 1995). The NBAS is used with newborns to 2-month-olds to provide a detailed portrait of the baby's behavioral repertoire. The scale includes 28 behavioral items along with 18 items that test reflexes. The baby's performance is used to evaluate functioning of four systems: Autonomic. The newborn's ability to control body functions such as breathing and temperature regulation Motor. The newborn's ability to control body movements and activity level State. The newborn's ability to maintain a state (e.g., staying alert or staying asleep) Social. The newborn's ability to interact with people

For a comprehensive evaluation of the newborn's well-being, pediatricians and child-development specialists use the

4 hours. That is, they will be awake for about an hour, sleep for 3 hours, then start the cycle anew. During the hour when newborns are awake, they regularly move between the different waking states several times. Cycles of alert inactivity, waking activity, and crying are common.

Newborns typically go through a cycle of wakefulness and sleep about every

Even before a woman becomes pregnant, a couple may go for genetic counseling, which I described in Module 2.1. A counselor constructs a family tree for each prospective parent to check for heritable disorders. If one (or both) carries a disorder, further tests can determine the person's genotype. With this more detailed information, a genetic counselor can discuss choices with the prospective parents. They may choose to go ahead and conceive "naturally," taking their chances that the child will be healthy. Or they could decide to use sperm or eggs from other people. Yet another choice would be to adopt a child. After a woman is pregnant, how can we know if prenatal development is progressing normally? Traditionally, obstetricians gauged development by feeling the size and position of the fetus through a woman's abdomen. This technique was not precise and, of course, couldn't be done at all until the fetus was large enough to feel. However, new techniques have revolutionized our ability to monitor prenatal growth and development. A standard part of prenatal care in North America is ultrasound, a procedure that uses sound waves to generate a picture of the fetus. When a genetic disorder is suspected, two other techniques are particularly valuable because they provide a sample of fetal cells that can be analyzed. In amniocentesis, a needle is inserted through the mother's abdomen to obtain a sample of the amniotic fluid that surrounds the fetus. Amniocentesis is typically performed at approximately 16 weeks after conception. In chorionic villus sampling (CVS), a sample of tissue is obtained from the chorion (a part of the placenta) and analyzed.

How can prenatal development be monitored? Can abnormal prenatal development be corrected?

An important part of this preparation is a rich set of reflexes, unlearned responses that are triggered by a specific form of stimulation.Name Response Significance Babinski A baby's toes fan out when the sole of the foot is stroked from heel to toe. Unknown Blink A baby's eyes close in response to bright light or loud noise. Protects the eyes Moro A baby throws its arms out and then inward (as if embracing) in response to a loud noise or when its head falls. May help a baby cling to its mother Palmar A baby grasps an object placed in the palm of its hand. Precursor to voluntary grasping Rooting When a baby's cheek is stroked, it turns its head toward the stroking and opens its mouth. Helps a baby find the nipple Stepping A baby who is held upright by an adult and is then moved forward begins to step rhythmically. Precursor to voluntary walking Sucking A baby sucks when an object is placed in its mouth. Permits feeding Withdrawal A baby withdraws its foot when the sole is pricked with a pin. Protects a baby from unpleasant stimulation Some reflexes pave the way for newborns to get the nutrients they need to grow: Rooting and sucking ensure that the newborn is ready to begin a new diet of life-sustaining milk. Other reflexes protect the newborn from danger in the environment. The blink and withdrawal reflexes, for example, help newborns avoid unpleasant stimulation. Yet other reflexes serve as the foundation for larger, voluntary patterns of motor activity. For example, the stepping reflex looks like a precursor to walking. Reflexes indicate whether the newborn's nervous system is working properly. For example, infants with damage to their sciatic nerve, which is found in the spinal cord, do not show the withdrawal reflex; infants who have problems with the lower part of the spine do not show the Babinski reflex. If these or other reflexes are weak or missing altogether, a thorough physical and behavioral assessment is called for

How do reflexes help newborns interact with the world?

crying or on the verge of crying.

Newborns spend 2 to 3 hours each day

The impact of a teratogen depends on the genotype of the organism. A substance may be harmful to one species but not to another Apparently, heredity makes some individuals more susceptible than others to a teratogen. The impact of teratogens changes over the course of prenatal development. During the period of the zygote, exposure to teratogens usually causes the fertilized egg to be aborted spontaneously. During the embryonic period, exposure produces major defects in body structure. For example, women who took thalidomide during the embryonic period had babies with ill-formed or missing limbs. Women who contract rubella during the embryonic period have babies with heart defects. During the fetal period, exposure to teratogens either produces minor defects in body structure or causes body systems to function improperly. For example, when women drink large quantities of alcohol during the fetal period, the fetus develops fewer brain cells. Even within the different periods of prenatal development, developing body parts and systems are more vulnerable at certain times.he heart, for example, is most sensitive to teratogens during the first two-thirds of the embryonic period. Exposure to teratogens before this time rarely produces heart damage; exposure after this time results in milder damage. Each teratogen affects a specific aspect (or aspects) of prenatal development. Said another way, teratogens do not harm all body systems; instead, damage is selective. If a pregnant woman contracts rubella, her baby may have problems with eyes, ears, and heart, but normal limbs. If she consumes PCB-contaminated fish, her baby may have below-average cognitive skills but normal body parts and normal motor skills. The impact of teratogens depends on the dose. Just as a single drop of oil won't pollute a lake, small doses of teratogens may not harm the fetus. In research on PCBs, for example, cognitive skills were affected only among children who had the greatest prenatal exposure to these by-products. In general, the greater the exposure, the greater the risk for damage Damage from teratogens is not always evident at birth, but may appear later in life. In the case of malformed infant limbs or babies born addicted to cocaine, the effects of a teratogen are obvious immediately. A cocaine baby goes through withdrawal—shaking, crying, and inability to sleep. Sometimes, however, the damage from a teratogen becomes evident only as the child develops

How do teratogens affect prenatal development?

The Apgar score, a measure devised by Virginia Apgar, is used to evaluate the newborn baby's condition. Health professionals look for five vital signs, including breathing, heartbeat, muscle tone, presence of reflexes (e.g., coughing), and skin tone. As you can see in Table 3-5, each of the five vital signs receives a score of 0, 1, or 2, with 2 being optimal. Table 3-5 Five Signs Evaluated in the Apgar Score Points Activity Pulse Grimace (response to irritating stimulus) Appearance (skin color) Respiration 2 Baby moves limbs actively 100 beats per minute or more Baby cries intensely Normal color all over Strong breathing and crying 1 Baby moves limbs slightly Fewer than 100 beats per minute Baby grimaces or cries Normal color except for extremities Slow, irregular breathing 0 No movement; muscles flaccid Not detectable Baby does not respond Baby is blue-gray, pale all over No breathing The five scores are added together, with a score of 7 or more indicating a baby in good physical condition. A score of 4 to 6 means that the newborn will need special attention and care. A score of 3 or less signals a life-threatening situation that requires emergency medical care

How do we determine if a baby is healthy and adjusting to life outside the uterus?

Infants may sleep in a cradle placed next to their parents' bed or in a basket that's in their parents' bed. When they outgrow this arrangement, they sleep in the bed with their mother; depending on the culture, the father may sleep in the same bed (as shown in the photo), in another bed in the same room, in another room, or in another house altogether!

How does co-sleeping work?

The mother is the developing child's sole source of nutrition, so a balanced diet that includes foods from each of the five major food groups is vital. Most pregnant women need to increase their intake of calories by about 10% to 20% to meet the needs of prenatal development. A woman should expect to gain between 25 and 35 pounds during pregnancy, assuming that her weight was normal before pregnancy. A woman who was underweight before becoming pregnant may gain as much as 40 pounds; a woman who was overweight should gain at least 15 pounds What a pregnant woman eats is also important. Proteins, vitamins, and minerals are essential for normal prenatal development. For example, folic acid, one of the B vitamins, is important for the nervous system to develop properly (Goh & Koren, 2008). When mothers do not consume adequate amounts of folic acid, their babies are at risk for spina bifida, a disorder in which the embryo's neural tube does not close properly during the first month of pregnancy. When the neural tube does not close properly, the result is permanent damage to the spinal cord and the nervous system; consequently, many children with spina bifida use crutches, braces, or wheelchairs In addition, inadequate macronutrients (e.g., protein) and micronutrients (e.g., zinc, iron) during prenatal development lead to problems in attention, memory, and intelligence (Monk, Georgieff, & Osterholm, 2013). Consequently, health care providers typically recommend that pregnant women supplement their diet with additional proteins, vitamins, and minerals.When pregnant women experience chronic stress, they're more likely to give birth early or have smaller babies, but this may be because women who are stressed are more likely to smoke or drink and less likely to rest, exercise, and eat properly. These questions address the impact on prenatal development of chronic stress, which refers to a person's physical and psychological responses to threatening or challenging situations. Women who report greater anxiety during pregnancy more often give birth early or have babies who weigh less than average (Copper et al., 1996; Tegethoff et al., 2010). What's more, when pregnant women are anxious, their children are less able to pay attention and more prone to behavioral problems as preschoolersIncreased stress can harm prenatal development in several ways. First, when a pregnant woman experiences stress, her body secretes hormones that reduce the flow of oxygen to the fetus while increasing its heart rate and activity level (Monk et al., 2000). Second, stress can weaken a pregnant woman's immune system, making her more susceptible to illness (Cohen & Williamson, 1991), which can, in turn, damage fetal development. Third, pregnant women under stress are more likely to smoke or drink alcohol and less likely to rest, exercise, and eat properly (DiPietro, 2004; Monk et al., 2013). Fourth, stress may produce epigenetic changes in which genes that help children to regulate their behavior are made less effective (Monk, Spicer, & Champagne, 2012). All these can endanger prenatal development. I want to emphasize that the results described here apply to women who experience chronic stress. Virtually all women are sometimes anxious or upset while pregnant. But occasional, relatively mild anxiety is not thought to have harmful consequences for prenatal development.Compared to women in their 20s, teenage girls are at greater risk to give birth early and to give birth to babies low in birth weight (Khashan, Baker, & Kenny, 2010). This is largely because pregnant teenagers are more likely to be living in poverty and do not receive good prenatal care. Nevertheless, even when a teenager receives adequate prenatal care and gives birth to a healthy baby, all is not rosy. Children of teenage mothers generally do less well in school and more often have behavioral problems

How is prenatal development influenced by a pregnant woman's nutrition, the stress she experiences while pregnant, and her age?

newborns can have perceptual experiences—they can see, smell, hear, taste, and feel sensory experiences are somehow registered in the newborn through learning and memory, because unless experiences are registered, they can't influence later behavior. All the basic perceptual systems are operating at some level at birth. The world outside the uterus can be seen, smelled, heard, tasted, and felt (Cohen & Cashon, 2003; Slater et al., 2010). Moreover, newborns show the capacity to learn and remember. They change their behavior based on their experiences (Rovee-Collier & Barr, 2010). For now, the important point is that newborns are remarkably prepared to interact with the world. Adaptive reflexes coupled with perceptual and learning skills provide a solid foundation for the rest of child development.

How well do newborns experience the world? Can they learn from experience?

Visit a health care provider for regular prenatal checkups. You should have monthly visits until you get close to your due date, when you will have a checkup every other week or maybe even weekly. Eat healthy foods. Your diet should include foods from each of the five major food groups (cereals, fruits, vegetables, dairy products, and meats and beans). Your health care provider may recommend that you supplement your diet with vitamins, minerals, and iron to be sure you are providing your baby with all the nutrients it needs. Stop drinking alcohol and caffeinated beverages. Stop smoking. Consult your health care provider before taking any over-the-counter medications or prescription drugs. Exercise throughout pregnancy. If you are physically fit, your body is better equipped to handle the needs of the baby as well as the demands of labor and delivery. Get enough rest, especially during the last 2 months of pregnancy. Also, attend childbirth education classes so that you'll be prepared for labor, delivery, and your new baby.

Improving Children's Lives Five Steps Toward a Healthy Baby

a healthy baby dies suddenly, for no apparent reason. Approximately 1 to 3 of every 1,000 U.S. babies dies from SIDS. Most of them are between 2 and 4 months old.

In sudden infant death syndrome (SIDS),

in a female fetus, this hormone is absent, so the same cells become a vagina and labia.

In the third month, the testes in a male fetus secrete a hormone but

a penis and scrotum;

In the third month, the testes in a male fetus secrete a hormone that causes a set of cells to become

every 4 hours. That is, they will be awake for about an hour, sleep for 3 hours, then start the cycle anew. During the hour when newborns are awake, they regularly move between the different waking states several times. Cycles of alert inactivity, waking activity, and crying are common.

Newborns typically go through a cycle of wakefulness and sleep about

identical twins.

Occasionally, the zygote separates into two clusters that develop into

"Yes" until their baby is about 3 months old. However, with older babies parents should consider why their infant is crying and the intensity of the crying (St James-Roberts, 2007). When an older baby wakes during the night and cries quietly, a parent should wait before responding, giving the baby a chance to calm herself. Of course, if parents hear a loud noise from an infant's bedroom followed by a mad cry, they should respond immediately. Parents need to remember that crying is actually the newborn's first attempt to communicate with others. They need to decide what the infant is trying to tell them and whether that warrants a quick response or whether they should let the baby soothe herself.

Parents are sometimes reluctant to respond to their crying infant for fear of producing a baby who cries constantly. Yet they hear their baby's cry as a call for help that they shouldn't ignore. Should parents respond?

35 weeks after conception (or earlier). Small-for-date infants are substantially smaller than would be expected based on the length of time since conception.

Premature infants are born at

Determine due date and position of fetus in uterus; check for physical deformities, multiple births, and child's sex

Procedure Description Primary Uses Ultrasound Sound waves used to generate an image of the fetus

The fetus can hear Rachel speaking, and these one-sided conversations probably help the fetus to become familiar with Rachel's voice. There aren't other obvious benefits, however, because the fetus can't understand what she's saying.

Rachel is 8 months pregnant and spends hours each day talking to her baby-to-be. Rachel's husband considers this a waste of time, but Rachel's convinced that her baby-to-be must benefit. What do you think?

At this point, probably not. Soon after birth, it's normal for women to experience occasionally feelings of sadness and anger. But if Rosa's feelings persist for a few more weeks, then they're likely to be symptoms of postpartum depression.

Rosa gave birth a week ago. Once or twice a day she has crying spells and usually gets angry at her husband, even though he's been quite helpful to her and the baby. Do you think Rosa has postpartum depression?

disrupt the flow of blood through the umbilical cord. If this flow of blood is disrupted, infants do not receive adequate oxygen, a condition known as hypoxia. Hypoxia sometimes occurs during labor and delivery because the umbilical cord is pinched or squeezed shut, cutting off the flow of blood. Hypoxia is serious because it can lead to developmental disabilities or death

Some of these complications, such as a prolapsed umbilical cord, are dangerous because they can

obvious. In fact, the fetus is a budding gymnast and kick-boxer rolled into one, punching, kicking, and turning somersaults. When active, the fetus moves about once a minute (DiPietro et al, 2004). However, these bursts of activity are followed by times when the fetus is still, as regular activity cycles emerge. Although movement is common in a healthy pregnancy, some fetuses are more active than others, and these differences predict infants' behavior

The delicate movements that were barely noticeable at 4 months are now

The umbilical cord houses blood vessels that join the embryo to the placenta. In the placenta, the blood vessels from the umbilical cord run close to the mother's blood vessels but aren't actually connected to them. Instead, the blood flows through villi, finger-like projections from the umbilical blood vessels

The embryo is linked to the mother by two structures which are

amniotic sac, which is filled with amniotic fluid that cushions the embryo and maintains a constant temperature.

The embryo rests in an

sensory experiences. For example, the fetus responds distinctively (its heart rate changes) to a recording of its mother voice compared with recordings of an unfamiliar female's voice (Kisilevsky et al., 2009). And after birth babies can remember events experienced in the uterus. Infants and children prefer foods that they tasted during prenatal development. In one study (Mennella, Jagnow, & Beauchamp, 2001), women drank carrot juice several days a week during the last month of pregnancy. When their infants were 5 and 6 months old, they preferred cereal flavored with carrot juice. In another study (Hepper et al., 2013), 8- and 9-year-olds were more likely to prefer garlic-flavored potatoes if their mothers ate garlic while pregnant.

The fetus can remember

the date of conception, which enables the physician to predict the due date more accurately. Ultrasound pictures are also valuable in showing the position of the fetus and placenta in the uterus, and they can be used to identify gross physical deformities, such as abnormal growth of the head. Ultrasound can also help in detecting twins or other multiple pregnancies. Finally, beginning at about 20 weeks after conception, ultrasound images can reveal the child's sex.

Ultrasound can be used as early as 4 or 5 weeks after conception; before this time the fetus is not large enough to generate an interpretable image. Ultrasound pictures are useful for determining

Until recently a woman's options were limited: She could continue the pregnancy or end it. But options are expanding. A whole new field called fetal medicine is concerned with treating prenatal problems before birth. Many tools are available to solve problems that are detected during pregnancy (Rodeck & Whittle, 2009). One approach is to treat disorders medically, by administering drugs or hormones to the fetus. Another way to correct prenatal problems is fetal surgery (Warner, Altimier, & Crombleholme, 2007). For example, spina bifida has been corrected with fetal surgery in the seventh or eighth month of pregnancy. Surgeons cut through the mother's abdominal wall to expose the fetus, then cut through the fetal abdominal wall; the spinal cord is repaired and the fetus is returned to the uterus. When treated with prenatal surgery, infants with spina bifida are less likely to need a shunt to drain fluid from the brain and, as preschoolers, are more likely to be able to walk without support (Adzick, et al. 2011). Another potential approach to treating prenatal problems is genetic engineering—replacing defective genes with synthetic normal genes.

Ultrasound, amniocentesis, and CVS have made it much easier to determine if prenatal development is progressing normally. But what happens when it is not?

A pregnant woman's fear led her to be tense, thereby increasing the pain she experienced during labor. These physicians argued for a more "natural" or prepared approach to childbirth, viewing labor and delivery as life events to be celebrated rather than medical procedures to be endured. Today many varieties of prepared childbirth are available to pregnant women. However, most share some fundamental beliefs. One is that birth is more likely to be problem free and rewarding when mothers and fathers understand what's happening during pregnancy, labor, and delivery. Consequently, prepared childbirth means going to classes to learn basic facts about pregnancy and childbirth (like the material presented in this chapter). A second common element is that natural methods of dealing with pain are emphasized over medical procedures, which involve possible side effects or complications. One key to reducing birth pain without drugs is relaxation. Because pain often feels greater when a person is tense, pregnant women learn to relax during labor, through deep breathing or by visualizing a reassuring, pleasant scene or experience. Whenever they begin to experience pain during labor, they use these methods to relax. A third common element of prepared childbirth is the involvement of a supportive adult, who may be the father-to-be, a relative, a close friend, or a trained birth assistant (known as a doula). These people provide emotional support, act as advocates (communicating a woman's wishes to health care personnel), and help a woman use techniques for managing pain. When pregnant women are supported in this manner, their labor tends to be shorter, they use less medication, and they report greater satisfaction with childbirth For Americans accustomed to hospital delivery, home delivery can seem like a risky proposition and some medical professionals remain skeptical (Declercq, 2012). However, many women are more relaxed during labor in their homes, and they enjoy the greater control they have over labor and birth in a home delivery. That said, women should consider birth at home only if they are healthy, their pregnancy has been problem free, labor and delivery are expected to be problem free, a trained health care professional is present to assist, and comprehensive medical care is readily available should the need arise

What are "natural" ways of coping with the pain of childbirth? Is childbirth at home safe?

Complication Features Cephalopelvic disproportion The infant's head is larger than the pelvis, making it impossible for the baby to pass through the birth canal. Irregular position In shoulder presentation, the baby is lying crosswise in the uterus and the shoulder appears first; in breech presentation, the buttocks or feet appear first. Preeclampsia A pregnant woman has high blood pressure, protein in her urine, and swelling in her extremities (as a result of fluid retention). Prolapsed umbilical cord The umbilical cord precedes the baby through the birth canal and is squeezed shut, cutting off oxygen to the baby.

What are some complications that can occur during birth?

The first stage begins when the muscles of the uterus start to contract. These contractions force amniotic fluid up against the cervix, the opening at the bottom of the uterus that is the entryway to the birth canal. The wavelike motion of the amniotic fluid with each contraction causes the cervix to enlarge gradually.Stage Duration Primary Milestone 1 12-24 hours Cervix enlarges to 10 cm 2 1 hour Baby moves down the birth canal 3 10-15 minutes Placenta is expelled

What are the stages in labor and delivery?

Alert inactivity. The baby is calm, with eyes open and attentive; the baby looks as if he is deliberately inspecting his environment. Waking activity. The baby's eyes are open, but they seem unfocused; the baby moves her arms or legs in bursts of uncoordinated motion. Crying. The baby cries vigorously, usually accompanying this with agitated but uncoordinated motion. Sleeping. The baby's eyes are closed and the baby drifts back and forth from periods of regular breathing and stillness to periods of irregular breathing and gentle arm and leg motion.

What behavioral states are observable in newborns?

It ends when the fertilized egg, called a zygote, implants itself in the wall of the uterus.

What happens to a fertilized egg in the first 2 weeks after conception?

For 10% to 15% of new mothers, however, irritability continues for months and is often accompanied by feelings of low self-worth, disturbed sleep, poor appetite, and apathy—a condition known as postpartum depression

What is postpartum depression and what are its effects?

Probably not. Mary needs to relax a bit. If her son is in danger, she'll recognize a pain cry or a mad cry. Otherwise, Mary should wait a moment before going to her son, to try to decide why he's crying and to give him a chance to calm himself.

When Mary's 4-month-old son cries, she rushes to him immediately and does everything possible to console him. Is this a good idea?

to remove it from the mother's uterus surgically (American College of Obstetricians and Gynecologists, 2011a). In a cesarean section (C-section), an incision is made in the abdomen to remove the baby from the uterus. A C-section is riskier for mothers than a vaginal delivery because of increased bleeding and greater danger of infection.

When a fetus is in distress or when the fetus is in an irregular position or is too large to pass through the birth canal, a physician may decide

swaddling

in which an infant is wrapped tightly in a blanket.


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