Chapter 3 - Prenatal Development and Birth

. Xiomara is considering hiring a doula to help with childbirth. What is a doula and how is they different from midwives? Answer: Doula is a Greek word that means "a woman who helps."

A doula is a caregiver who provides continuous physical, emotional, and educational support for the mother

Psychotherapy, especially cognitive therapy, is effective in easing postpartum depression for many women.

Also, engaging in regular exercise may help in treating postpartum depression.

HIV-infected mothers can be (1) infected and symptomatic (show HIV symptoms), (2) infected but asymptomatic (not show HIV symptoms), or (3) not infected at all.

An infant who is infected and asymptomatic may still develop HIV symptoms up until 15 months of age.

The period of prenatal development that occurs two to eight weeks after conception. During this time, the rate of cell differentiation intensifies, support systems for the cells form, and organs appear.

Answer: Embryonic period

Justus and Rochelle are taking prenatal classes that involve a special breathing technique to control pushing in the final stages of labor and a detailed anatomy and physiology course. Which French obstetrician's work is this method based on?

Answer: Ferdinand Lamaze

. Teji's doctor is testing her Rh factor to determine compatibility. Based on the test results, the mother and fetus are incompatible. Give a brief description of Rh incompatibility and discuss the dangers associated with it.

Answer: Incompatibility between the mother's and father's blood type poses a risk to prenatal development. If a pregnant woman is Rh-negative and her partner is Rh-positive, the fetus may be

The Brazelton Neonatal Behavioral Assessment Scale is typically performed within _____ after birth.

b. 24 to 36 hours

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

b. blastocyst

. Briefly describe postpartum depression. What are some of the symptoms that distinguish it from a more typical case of baby blues. Based on the text and class what would you argue are two effective treatment methods for postpartum depression? Answer: Postpartum depression is characteristic of

women who have such strong feelings of sadness, anxiety, or despair that they have trouble coping with daily tasks in the postpartum period. Several antidepressant drugs are effective in treating postpartum depression and appear to be safe for breast feeding women.

Which of the following statements about cocaine use during pregnancy is true?

a. Cocaine quickly crosses the placenta to reach the fetus.

Which of the following is NOT one of the ways in which AIDS can be transmitted from the mother to the infant?

a. During sperm/egg adhesion in the fertilization process

Wren is three and a half weeks pregnant. Which of the following stages of prenatal development is Wren currently in?

a. Embryonic

Rubella, also known as _____, is a maternal disease that can cause prenatal defects.

a. German measles

_____ refers to the attachment of the zygote to the uterine wall. .

a. Implantation

The _____ prevents large molecules like red blood cells and harmful substances, such as most bacteria and maternal wastes, from entering the fetus.

b. placental wall

French obstetrician Ferdinand Lamaze developed a method similar to natural childbirth that is known as _____.

b. prepared childbirth

. Define and give an example of a teratogen. If you were pregnant list at least six things you should avoid, as they are teratogenic. Answer: A teratogen is any agent that can potentially cause a birth defect or negatively alter cognitive and behavioral outcomes

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

. Name and give an example of three different types of drugs that are used for labor. Answer: Three basic kinds of drugs that are used for labor are analgesia, anesthesia, and oxytocin/pitocin. Analgesics are used to relieve pain. Tranquilizers, barbiturates, and narcotics can all be used to relieve pain.

Anesthesia is used in late first-stage labor and the expulsion of the baby to block sensation in an area of the body or to block consciousness. An epidural block is a regional anesthetic commonly used in childbirth.Oxytocin is a synthetic hormone that is used to stimulate contractions; pitocin is used more

The inner layer of cells that develops during the germinal period. These cells later develop into the embryo.

Answer: Blastocyst

The formation of a close connection, especially a physical bond, between parents and their newborn in the period shortly after birth.

Answer: Bonding

A test that is given to the neonate within 24 to 36 hours after birth. It is designed to assess a newborn's neurological development and reflexes.

Answer: Brazelton Neonatal Behavioral Assessment Scale

This process, which takes place at approximately 6 to 24 weeks after conception, involves cells moving from their point of origin to their appropriate locations and creating the different levels, structures, and regions of the brain.

Answer: Neuronal migration

This is one of the life-support systems of the embryo. It is a disk-shaped group of tissues in which small blood vessels from the mother and the offspring intertwine.

Answer: Placenta

. Bronwyn is interested in using non-medical techniques to assist her with dealing with pain during childbirth. Based on the text and class discussion what are the two best options available to her, and why?

Answer: Some new nonmedicated techniques used in childbirth to reduce stress and pains are water birth, massage, acupuncture, hypnosis, and music therapy.

Jose's wife is pregnant but he smokes all the time inside the house. Cigarette smoke has been known to cause birth defects and negatively alter cognitive and behavioral outcomes in unborn babies. Jesus is exposing his child to which type of agent?

Answer: Teratogen

Veronica is one week from her due date when her Dr. tells her that the baby hasn't turned yet, meaning he is in _____.

Answer: breech position

Tadi lives in a community where women generally keep both preterm and posterm babies close for skin to skin contact. This is called _____ in the US.

Answer: kangaroo care

Describe the three main periods of prenatal development and what the major steps in developing into a person are for each stage. Answer: Typical prenatal development can be divided into three periods: germinal, embryonic, and fetal. The first period is called the germinal period.

During this time, the zygote is created, cell division takes place, and the zygote attaches to the uterine wall. The second period is called the embryonic period. During this time, the rate of cell differentiation intensifies, support systems for the cells form, and organs appear.

before, during, and after childbirth. Doulas remain with the parents throughout labor, assessing and responding to the mother's needs.

In the United States, most doulas work as independent providers hired by the expectant parents. Doulas typically function as part of a "birthing team," serving as an adjunct to the midwife or the hospital's O.B. staff.

. Naia's doctor has told her that because her baby hasn't turned he would like to perform a cesarean delivery. What can Naia expect to happen? Answer: A cesarean delivery is a surgical procedure in which the baby is removed from the mother's uterus through an incision made in her abdomen.

Normally, the baby's head comes through the vagina first. But if the baby is in a breech position, the baby's buttocks are the first part to emerge from the vagina. In 1 of every 25 deliveries, the baby's head is still in the uterus when the rest of the body is out. Breech births can cause respiratory problems.

The embryo is composed of the endoderm, ectoderm, and mesoderm. Life-support systems form. These include the placenta, the umbilical cord, and the amnion.

Organogenesis - the process of organ formation takes place. The third period is called the fetal period. During this time, dramatic growth and development occur. The mother can feel leg movements. The sex of the baby can be determined.

Rh-positive. If the fetus' blood is Rh-positive and the mother's is Rh-negative, the mother's immune system may produce antibodies that will attack the fetus.

This can result in any number of problems, including miscarriage or stillbirth, anemia, jaundice, heart defects, brain damage, or death soon after birth.

Typical prenatal development lasts between:

a. 38 to 40 weeks.

Uma has just given birth to a baby. Assuming he is perfectly average, and was born in the US, he is most likely _____ pounds and is approximately _____ inches long.

a. 7½ pounds; 20 inches

Brenda's baby was born just minutes ago, and the doctor is checking the baby's heart rate, respiratory effort, body color, reflex irritability, and muscle tone. Brenda's baby is being tested with the:

a. Apgar Scale.

Which of the following is MOST likely to occur in the child of a woman who smokes?

a. Attention deficit hyperactivity disorder

What does a very low Brazelton National Behavioral Assessment Scale (NBAS) score indicate?

a. Neurological problems

What does the result of a recent Norwegian study indicate regarding preterm infants?

a. The earlier preterm infants are born, the more likely they will drop out of school.

The blastocyst is composed of an inner layer of cells that develops during the germinal period and that will finally develop into the _____.

a. embryo

Cell differentiation intensifies and organs appear in the _____ period of prenatal development.

a. embryonic

Gisela is having her first baby and has received a drug that will numb the entire lower area of her body during labor. Gisela has been given a(n) _____.

a. epidural block

Sona is in the third stage of childbirth meaning she will now endure the:

a. expulsion of the placenta, umbilical cord, and other membranes.

The germinal period of development takes place in the _____ after conception.

a. first two weeks

Children born low in birth weight are more likely than their normal birth weight counterparts to develop all of the following EXCEPT:

a. muscular dystrophy.

Malorie was born during her mother's 32nd week of pregnancy. Malorie would be termed a _____ baby.

a. preterm

The birth process occurs in _____ stages.

a. three

By the end of the fourth month of pregnancy, the fetus measures approximately _____ inches.

b. 6

_____ is the shortest of the three birth stages.

b. Afterbirth

What is the rationale for the practice of waterbirth?

b. It creates an environment similar to that inside the amniotic sac.

Pilar is using non-medical techniques for pain management during labor; she has someone insert fine needles into specific locations of her body. She is most likely using _____.

b. acupuncture

Two increasingly used interventions in the neonatal intensive care unit NICU are _____ and _____.

b. massage therapy; kangaroo care

When the _____ is delivered, estrogen and progesterone levels drop steeply and remain low until the ovaries start producing hormones again.

b. placenta

T. Berry Brazelton, along with Barry Lester and Edward Tronick, developed the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) specifically to assess:

b. the "at-risk" infant.

The most common treatment for heroin addiction, methadone, is associated with:

b. very severe withdrawal symptoms in newborns.

Implantation of the zygote to the uterine wall occurs at about _____ days after conception.

c. 11 to 15

Approximately _____ percent of all low birth weight children are enrolled in special education programs.

c. 50

A total score of _____ on the Apgar Scale indicates that the newborn's condition is good.

c. 7 to 10

A pediatrician is testing baby Rosaria. The doctor assesses Rosaria's neurological development, reflexes, and reactions to people and objects. Rosaria's pediatrician is using the:

c. Brazelton Neonatal Behavioral Assessment Scale.

Which of the following is true about the effects of cocaine use by pregnant women?

c. Cocaine exposure during prenatal development is associated with reduced length and head circumference.

Michael and Jessica are having their first child and have told their physician they would like a rooming-in arrangement. This means that:

c. Jessica's baby will stay in her room.

Which of the following is a threat to the infant caused by the breech position?

c. Respiratory problems

Which of the following statements about the different conditions that pose threats for newborns is true?

c. Small for date infants have below normal weight when the length of the pregnancy is considered.

Which of the following is TRUE of the stages of childbirth?

c. The first stage is the longest of the three birth stages.

Which of the following is the Apgar Scale especially good at determining?

c. The newborn's ability to respond to stress of delivery

The Apgar Scale is a method used to assess the health of newborns. A score of 3 would indicate:

c. an emergency because the baby's survival is in doubt.

Dakota was born after 40 weeks of gestation and weighed 4 pounds. Dakota would be considered:

c. low birth weight.

What is the recommended daily dosage of folic acid for pregnant women, as issued the U.S. Department of Health and Human Services?

d. 400 micrograms

Neuronal migration occurs at approximately _____ weeks after conception.

d. 6 to 24

In assessing the health of newborns, the _____ identifies high-risk infants who need resuscitation.

d. Apgar Scale

Which of the following techniques is used to overcome the threat of problems related to the breech position during delivery?

d. Cesarean section

The Apgar Scale uses which of the following measures?

d. Newborn's heart rate

Which maternal age group has increased risk of low birth weight, preterm delivery, and fetal death?

d. Thirty-five years and older

Before delivery of her baby, Karen experiences several traumatic life changes. She separates from her husband, discovers that her mother is seriously ill, and begins a more stressful job. Will Karen's baby be significantly affected by all the stress in Karen's life?

d. Yes, the baby will be at risk for ADHD and language delays.

The _____ provides an environment that is temperature and humidity controlled, as well as shockproof.

d. amniotic fluid

The outermost layer of the embryo is called the _____.

d. ectoderm

Five weeks after conception, the developing organism is called a(n) _____.

d. embryo

Sidra has a baby that was born at 27 weeks. Her baby is considered:

d. extremely preterm infants.

Mariah has given birth to a baby girl. Even one month after delivery, she is experiencing very strong feelings of sadness and anxiety. She is so morose that she is having trouble coping with daily tasks. Mariah is most likely suffering from:

d. postpartum depression.

Juan-Carlos was born full term but was underweight for his gestational age. He would be considered:

d. small for date.

. Describe the effect of alcohol on pregnancy. What is FAS? What are some of the problems children with FAS face? Answer: Heavy drinking by pregnant women can be devastating to their offspring. Fetal alcohol spectrum disorders (FASD) are a cluster of abnormalities and problems

that appear in the offspring of mothers who drink alcohol heavily during pregnancy. The abnormalities include facial deformities and defective limbs, face, and heart. Most children with FASD have learning problems and many are below average in intelligence with some that are mentally retarded.

. What is AIDS? Describe the modes and effects of transmission from the mother to the child. Answer: AIDS is a sexually transmitted infection that is caused by the human immunodeficiency virus (HIV), which destroys the body's immune system. A mother can infect her offspring with HIV/AIDS in

three ways: (1) during gestation across the placenta, (2) during delivery through contact with maternal blood or fluids, and (3) postpartum (after birth) through breast feeding. The transmission of AIDS through breast feeding is especially a problem in many developing countries. Babies born to

_____ replaces traditional 15-minute physician visits with 90-minute peer group support settings and self-examination led by a physician or certified nurse-midwife.

a. CenteringPregnancy

Sylvia is almost nine months pregnant and very close to her delivery date. The doctors have found that she has an active case of genital herpes. Which of the following is the best course of action to prevent Sylvia's baby from contracting the disease?

a. Perform a cesarean section

Which of the following is recommended by the U.S. Food and Drug Administration?

a. Pregnant women should consume no caffeine or consume it only sparingly.

This prenatal care program consists of approximately 50 home visits from the prenatal period through two years of age.

a. The Nurse Family Partnership

The middle layer of the embryo is called the _____.

a. mesoderm

The process of organ development during the first two months of prenatal development is known as _____.

a. organogenesis

Tara has just entered the fetal period. Therefore, it has been _____ months since conception.

a. two

The life-support systems for the embryo include the:

a. umbilical cord, placenta, and amnion.

_____ position refers to the baby's position in the uterus that causes the buttocks to be the first part to emerge from the vagina.

b. Breech

Which of the following is a small molecule that would be able to pass through the placental wall?

b. Carbon dioxide

Sidney is expecting her first child. She has recently begun to feel kicking movements. Which period of pregnancy is Sidney currently in?

b. Fetal period

Julianne lost her baby early in her pregnancy. Which of the following paternal factors could have possibly led to this outcome?

b. Her partner was a heavy smoker, even during her pregnancy.

Which of the following statements is FALSE about the effect of substance abuse by pregnant mothers?

b. Prenatal marijuana exposure is related to higher intelligence in children.

Giovanna was found to be Rh incompatible with her first child. To prevent her body from producing antibodies that will attack any future Rh-incompatible fetuses, her doctor gave her:

b. RhoGAM.

Which of the following organs or systems develop FIRST in prenatal development?

b. Spinal cord

Alicia is pregnant and is a heavy smoker. Which of the following is her baby MORE likely to have than is the baby of a nonsmoker?

b. Sudden infant death syndrome

Zia is pregnant and has a disease that, if untreated, may result in eye & skin lesions in her baby; this was also the disease that was the infamously studied in the Tuskegee experiment, perhaps one of the most unethical studies in the U.S. Which of the following diseases is Zia most likely to have?

b. Syphilis

44. A strategy that can help to prevent neural tube defects is for women to take:

b. adequate amounts of the B vitamin folic acid.

A teratogen is any agent that can cause:

b. birth defects.

The _____ is a layer of the embryo, which will become the nervous system and brain, sensory receptors, and skin parts.

b. ectoderm

The attachment of the blastocyst to the uterine wall begins the _____ period of prenatal development.

b. embryonic

The embryo's _____ develops into the digestive and respiratory systems.

b. endoderm

78. The lack of _____ in maternal nutrition has been associated with neural tube defects in offspring.

b. folic acid

"Teratogen" comes from the Greek word "tera," which means "_____."

b. monster

About _____ of all children who are born through the birth canal of a mother with active genital herpes become brain damaged.

b. one-fourth

A group of tissues in which small blood vessels from the mother and offspring intertwine but do not connect is the _____.

b. placenta

The fetus that Calista is carrying has reached the age of viability, meaning that it has a chance of surviving outside of the womb. Therefore, it can be inferred that Calista is _____ weeks pregnant.

c. 24 to 25

Identify the age group of women who are LEAST likely to obtain prenatal care.

c. Adolescence

_____ occurs when a single sperm cell from the male unites with an ovum or egg in the female's fallopian tube in a process called fertilization.

c. Conception

During which period of development is the unborn baby MOST at risk of developing a structural defect due to the effects of a teratogen?

c. During the embryonic period

Which of the following maternal diseases carries the risk of delivering very large infants, weighing 10 pounds or more?

c. Gestational diabetes

Which of the following substances is a large molecule that would NOT be able to pass through the placental wall?

c. Hormones

Which of the following is the U.S. Surgeon General's recommendation regarding alcohol intake during pregnancy?

c. No alcohol should be consumed during pregnancy.

Which of the following statements about the effects of marijuana exposure on offspring is TRUE?

c. Research has shown that mothers who use marijuana while pregnant risk their offspring using marijuana by age 14.

Tammy is pregnant with her first child. She tells you that she loves swordfish and has it for dinner two or three times a week. Based on current research, what should you advise Tammy about her diet?

c. Swordfish is not recommended for pregnant women because it can contain high levels of mercury.

Marlena, who just found out she is pregnant, has very poor eating habits. Her total calorie intake is very low. She eats very little protein and unbalanced amounts of vitamins and minerals. If she continues her present eating habits, which of the following is MOST likely to occur?

c. The baby is more likely to be malformed.

Which of the following is FALSE regarding the complications of Rh incompatibility?

c. With each subsequent pregnancy, the risk of complications for an Rh-positive baby of an Rh-negative mother is reduced.

According to a recent study, which of the following observations was made about women who participated in CenteringPregnancy care?

c. Women had higher breast-feeding rates.

Naveen is entering the third stage of childbirth, also known as the _____ stage.

c. afterbirth

The _____ is like a bag or an envelope and contains a clear fluid in which the developing embryo floats.

c. amnion

During the fourth week of prenatal development, the urogenital system becomes apparent, and _____ emerge.

c. arm and leg buds

The _____ consists of three layers of cells: the endoderm, the mesoderm, and the ectoderm.

c. embryo

The second stage of childbirth begins with the _____ and ends with the _____.

c. emergence of the child's head; delivery of the child out of the mother

Petra is at the fourth month of her pregnancy. Her unborn child is now referred to as a _____.

c. fetus

The _____ stage is the longest of the stages of birth.

c. first

Voletta is at the stage of pregnancy when the zygote attaches to the uterine wall. Thus, she is in the _____ period of prenatal development.

c. germinal

85. The innovative prenatal care program CenteringPregnancy provides complete prenatal care:

c. in group settings.

Prenatal cocaine exposure has been linked to all of the following EXCEPT:

c. increased head circumference and lower excitability.

The _____ is a layer of the embryo, which will become the circulatory system, bones, muscles, excretory system, and reproductive system.

c. mesoderm

Two birth defects that are related to a failure of the neural tube to close at about 24 days after conception are _____ and _____.

c. spina bifida; anencephaly

By the time babies are born, they have approximately _____ neurons.

d. 100 billion

At the peak of neurogenesis, it is estimated that as many as _____ neurons are being generated every minute.

d. 200,000

Which of the following maternal diseases is likely to be transmitted to the infant through breast-feeding?

d. AIDS

Which of the following statements is TRUE regarding the impact of teratogens?

d. Exposure to teratogens does more damage when it occurs at some points in development than at others.

Priscilla just found out she was pregnant and her doctor prescribed a B-complex vitamin that promotes normal prenatal development and reduces the risk of preterm deliveries. Which of the following is the vitamin that Priscilla's doctor has prescribed?

d. Folic acid

Which of the following is a feature of the embryonic period of prenatal development?

d. Formation of support systems for cells

Which of the following diseases is transmitted to the newborn during delivery through the birth canal?

d. Genital herpes

Prenatal development can be divided into three periods. Which of the following is in the correct order from conception to birth?

d. Germinal; embryonic; fetal

Jasmine and her fetus are Rh incompatible. This means that:

d. Jasmine may produce antibodies that will attack the fetus.

According to recent research, which of the following risks is linked to environmental tobacco smoke?

d. Low birth weight

Which of the following is a conclusion drawn by the current proponents of prepared childbirth methods?

d. Natural childbirth methods are superior to aided methods or cesarean sections.

_____ act on the nervous system to alter states of consciousness, modify perceptions, and change moods.

d. Psychoactive drugs

Sarah is a 20-year-old college student who is paralyzed from her waist down. She can walk with difficulty with crutches but prefers her wheelchair. Sarah tells you that her condition is due to a birth defect related to a failure of the neural tube to close during gestation. Which of the following birth defects does Sarah MOST likely have?

d. Spina bifida

The inner layer of cells of the embryo is referred to as the:

d. endoderm.

By the end of the _____, contractions dilate the cervix to an opening of about 10 centimeters (4 inches), so that the baby can move from the uterus to the birth canal.

d. first birth stage

The creation of the fertilized egg takes place in the _____ period of prenatal development.

d. germinal

Rachel is in the first period of prenatal development. Even though she doesn't know it, she is in the _____ stage of prenatal development.

d. germinal period

It is well documented that infants whose mothers are addicted to _____ show several behavioral difficulties at birth, which include withdrawal symptoms, such as tremors, irritability, abnormal crying, disturbed sleep, and impaired motor control.

d. heroin

The _____ is the outer layer of cells of the blastocyst that later provides nutrition and support for the embryo.

d. trophoblast

The structure that contains two arteries and one vein, and connects the developing embryo to the mother's body, is called the _____.

d. umbilical cord