Chapter 9

Cesarean delivery

Baby is surgically removed from uterus. This should only should be used for difficult deliveries. For example, if the umbilical cord is wrapped around the neck

What is the ovum?

It is the female egg cell, largest cell in human body

How are identical twins formed?

One sperm egg splits

What is a follicle?

The fluid-filled sac that houses the ovum. It leaves one ovary about every 28 days at midpoint in the menstrual cycle and travels to the fallopian tube

How long can the sperm live for?

The sperm has a lifespan of 24-48 hours

When does the unborn child learn how to balance themselves in the womb?

They learn how to balance selves at 5 months

Vestibular system

This consists of hearing and balance.

2-3 months (prenatal timeline)

- 81/2 weeks: neurons synapse - facial features develop - can see gender - 9 weeks: baby sucks thumb, drink fluid, tongue movement, sighs, stretches, moves head - hands touch the mouth 50 times per hour

Embryo (8 weeks) (prenatal timeline)

- Brain is the first organ to develop (6-7 weeks- brain activity has begun) - Brain is dividing into chambers - Eyes begin to develop (4-5 weeks) - Lungs (4-5 weeks) - heart begins to beat - beginning of spinal cord development - Hands begin to move (6-7 weeks) - Major organ begin to develop

7-8 months (prenatal resources)

- Breathing motions are common - Lower esophagus muscles functioning - cortex of brain is almost fully formed - Memory→ prefers female voices to male voices - rapid weight gain

Recommendations during pregnancy

- Exercise that isn't brand new to mother - Flying- up to 36 weeks - Nutrition

Nutrition (environmental effects)

- Maintains maternal energy - Provides foundation for fetal tissue - Builds energy reserves for postpartum lactation - Mothers should have some weight gain (especially second trimester) - Do not diet during pregnancy (not recommended) - Pregnancy diet should be 20% protein, 30% fat, 50% carbs - Three meals of fish a week is recommended - Vitamins and minerals - WIC

Environmental effects

- Nutritional - Maternal characteristics, experiences, personal habits - Drugs and disease

Zygote stage (prenatal timeline)

- Rapid cell division - fertilization - Day 6: implants in uterus - Placenta and umbilical cord develop

4-5 months (prenatal period)

- The retina in the eye has discrete layers - baby can hear and respond to sounds - Teeth enamel begins to develop between 16 and 20 weeks - head circumference is still larger than body - all layers of skin are developed - Fetal movement begins to follow daily cycles

9 months (prenatal timeline)

- Weight doubles - The fetal brain is about a quarter of its eventual size - The brain contains the neurons

5-6 months (prenatal timeline)

- brain weight is at 100 grams - behavioral states (see various behaviors) - premature birth is possible - blink-startle response

3-4 months (prenatal timeline)

- teeth are growing - cilia is lining airways - body is sensitive to touch - bone structure is protected by fat - stem cells arrive in bone marrow - producing hormones - sodium and water (through skin)→ regulate volume of amniotic fluid

6-7 months (prenatal timeline)

-terminal sacs now appear→ become alveoli - the ability to taste - affected by what mother eats - distinguish sounds - pupils react to light - memory forms

Delivery methods

1. Cesarean method 2. Lamaze method 3. Natural childbirth

Three phases of pregnancy period

1. Fetus (happens between 8 weeks until birth) 2. Zygote (2 weeks) 3. Embryo (2 weeks-8 weeks)

How long can fertilization occur?

10-24 hour period fertilization can occur

By __ weeks, the fetus responds to light.

26 weeks

Fertilization process

300-500 sperm reach the egg. They attempt to breach the egg (break through), but only one does. When one sperm breeches the outer membrane of the ovum, a chemical reaction prevents others.

AIDS while pregnant

AIDS can be transmitted by injecting drugs using a needle contaminated with the disease. If a woman contracts this disease when pregnant, her child can also get the disease when it is born.

Criticism on birthing methods

About 50 years ago, there was criticism on birthing methods, such as separating the baby from mother immediately (not good), taking baby from mom and mom might not see baby for about 24 hours, stimulate labor-- use chemicals, routinely used forceps for delivery, delay breastfeeding (once frowned upon).

Which drug is proven to cause mental retardation and abnormalities?

Alcohol is a drug that actually has been proven to cause mental retardation and abnormalities of the body.

Dramatic changes from prenatal to postnatal world in the environment for the newborn

Amniotic fluid (goes from this fluid to air), temperature (constant in womb, now goes into temp that fluctuates), sensory stimulation (child moves from state of minimal sensory stimulation (except twins) to all of senses stimulated), nutrition (depend on mother's nutrition to now depending on food from outside), digestive system, respiratory system (oxygen no longer passing through mother to child, lungs must operate on own), elimination system (waste isn't going to pass through placenta, own system needs to work).

28th week of pregnancy

Baby turns head down (get ready for birth)

Home births

Began in 1970. This has to be done with trained midwife or low risk pregnancy. This can lead to increased problems for child and mother.

Problems during delivery

Birth complications include breech presentation, which usually requires a C section. 3% of babies are born breech 3-4 weeks before birth when put in position, 1-2 birth canal. Umbilical cord can easily wrap around neck during breech.

What can happen if drugs and alcohol are consumed during the early stages (or any stages) of pregnancy?

Brain damage caused by the use of drugs can affect the child's capacity to think and the damage of the spinal cord can affect the child's ability to walk. Malformations can occur in important organs, such as the kidneys. Sometimes organs may lose their blood supply, causing the child to possibly kill a part of its bowel. When the child is born, the child can have a bowel obstruction and need to get surgery so the child will be able to consume food to live. Sometimes the baby may also lose some of its fingers or toes.

Breech birth

Butt first birth (usually taken out with C section)

When does the unborn child react to pain?

By 20 weeks, unborn child reacts to stimuli that recognizes pain

How many heart beats per minute does the child's heart beat by 4 weeks?

By 4 weeks, heart beats 105 to 113 beats per second

21st week of pregnancy

Can survive outside uterus (supposed to go about 40 weeks in womb)

Teratogens

Causing malfunction (alcohol, drugs)

Effects on the child from maternal characteristics

Crankiness, difficult delivery, retardation, stillbirth, nervous system damage

Maternal characteristics

Depressed emotional state, small physical size, over age forty, Rh incompatibility, low blood-oxygen level

Can drugs cause a child to be born prematurely?

Drugs can cause a child to be born premature, or before the full nine months are over. Premature babies could be underweight and have a small head.

During which week does alcohol do the most damage to the unborn child?

During the third week of pregnancy, alcohol can do the most of its damage to the unborn child.

Positive influence during pregnancy

Exercising, eating healthy, rest, dressing appropriately, good attitude/healthy mind, support, classes for pregnant women, and go to doctor

Fetal Alcohol Syndrome (FAS)

Exposure to alcohol before birth can cause a condition called fetal alcohol syndrome (FAS). This is the number one cause of mental retardation. The child may have a small head, resulting in an underdeveloped brain. The brain is smoother with less bumps and curves like a normal brain has. Babies may have small eyes, drooping lids, thin upper lid, and a short upturned nose. These babies can be born with lung and heart problems. They can also have problems with behavior and social skills. Even the slightest consumption of alcohol can harm a fetus within the womb.

Week 12 of pregnancy

External genitalia begins to differentiate, bones ossify (harden)

24th week of pregnancy

Eyelashes, eyebrows, eyelids are open

Between how many weeks does a fetus experience massive growth?

From eight weeks to birth, a fetus experiences massive growth.

Lamaze method

In 1931, this was created by Dr. Lamaze. The mom has coach (usually father). Parents need to take 12 week course of entire process of birth, development of child, etc. The mother learns how to relax muscles and control breathing. The classes will teach what exercises are appropriate for pregnancy.

Leboyer method

In 1976, Frederick Leboyer came up with Leboyer method. He stated that infants are startled by environment they are born into and believes through this method that change from womb to world should be as relaxed and happy as possible (with as little environmental change as possible- minimal noise, light, etc.). After birth, baby should be placed on mother so the baby could receive comfort. The umbilical cord shouldn't be cut until they know baby could breathe on their own. The child should also be placed in warm water before wrapped in blankets.

Birthing centers

In hospital setting or center that only delivers babies. A midwife assists mom (trained, not medical professionals). The midwife assists at a birthing center or home. The father is also involved.

First trimester

In the first trimester, the child develops the most. The baby's heart, lungs, liver, kidneys, brain, and spinal cord develop during this time. The brain and spinal cord are one of the first organs to begin developing within the child.

What is the second stage of the unborn child? Describe.

It is the embryo period. It begins in the moment that zygote implants in uterine wall and lasts until about eight weeks. About 95% of body parts develop. The neural tube begins: spinal cord, brain, and head-to-tail axis (HOX gene- Homeobox), which is a group of related genes that control body plan of embryo along cranio (head) - cardial (tail) axis. The development of this insures that body parts will beat right ends of body. The placenta develops, with amnion (also developing) (it is the sac lining the uterus). The amniotic fluid protects fetus, maintains temperature and collects waste. This gives child room for movement.

What is the last period of pregnancy?

It is the fetus period. It is about 9 weeks to birth. The child really begins to take on physical features of human. The head becomes more proportional to rest of body. The limbs become more differentiated. The child grows rapidly during this time. The greatest threat is maternal undernutrition.

What is fertilization?

It is the joining of sperm to the egg

Natural childbirth

Late 70s early 80s- new movement of natural childbirth. No pain medication taken.

When does the life of a child begin?

Life begins at moment of conception

36th week of pregnancy

Limbs are organs are fully formed, lungs are preparing for birth

AIDS can cause...

Mental retardation

Syphilis can cause...

Miscarriage, physical malformations, mental rertardation, low birth weight

Genital herpes can cause...

Miscarriage, physical malformations, mental retardation, low birth weight, prematurity

Rubella (measles) can cause...

Miscarriage, physical malformations, mental retardation, low birth weight, prematurity

What happens to an unborn child when a pregnant mother smokes cigarettes?

Nicotine, which is in cigarettes, can cross the placenta and cut off the flow of blood, nutrients and oxygen. Later on in life, the child could become more at risk for getting bronchitis or asthma. The child could be born prematurely or the mother could even have a miscarriage.

What is the prenatal period?

Pre-birth

Negative influence during pregnancy

Secondhand smoke/smoking, alcohol consumption, abusive relationship, doing too many things at once, drugs, stress/anxiety, low economic status/poor nutrition, and overdoing exercise

What happens to an unborn child when a pregnant mother smokes marijuana?

Smoking marijuana can cause similar problems. Babies can experience tremors, be unresponsive to things going on around them, and may have learning disabilities.

Poor nutrition during pregnancy can cause...

Stillbirth, neonatal death, low birth weight, short gestation, mental deficiency, rickets, cerebral palsy, epilepsy, speech defects, general physical weakness

Sudden infant death syndrome (SIDS)

Sudden infant death syndrome, or SIDS, happens between the ages of one week and one year. Everything seems to be fine with the child, until one night the child dies in its sleep. No one knows why this occurs. However, it has been proven that it happens more to babies that have been exposed to drugs before birth.

Placenta

Surrounding the baby inside of the womb is known as the placenta. The placenta is an organ that connects the child with the mother and transfers nourishment or anything the mother is eating or drinking from the mother to the baby. According to Margaret Lynn Yonekura, if a baby is receiving drugs through the placenta, it is harder for them to break the drugs down compared to adults. Some of the breakdown products can have an even more powerful impact on the baby in the womb because it is broken down differently inside of the body, which can lead to affecting the baby's brain development.

4th month of pregnancy

Teeth form, external ears form

What is a zygote?

The cell that is formed by the ovum and sperm uniting- the beginning of child development

Water birth

The child is born in pool or bathtub. This is done at home and in hospitals. However, this could cause death. This is recommended for low risk pregnancies and under medical supervision.

Prenatal Brain Development

The development begins 16 days after conception. The central nervous system (brain and spinal cord) develops from "tail" to head. At the fifth week, synapses are forming in the spinal cord. In the sixth to tenth week, movements develop. During 2nd trimester, brain takes overall vital functions. Finally, the cerebral cortex matures and is ready to control mental life.

What is semen?

The liquid ejaculated from the male's reproductive organs containing the sperm. It travels through the vagina, cervix, uterus, and into the fallopian tubes to fertilize the egg.

What is the sperm?

The male reproductive cell, millions are produced. They measures 1/600 of an inch and are shaped like a tadpole.

What is the first stage of the unborn child? Describe.

The zygote is the first stage. During this stage, there is rapid cell division from one cell to billions in 2 weeks. On day 6, it implants in uterus. Then the placenta and umbilical cord develop. Placenta is a covering that is going to protect infant; serves as medium of exchange of food and oxygen. The umbilical cord connects child to mom.

How many stages of pregnancy are there?

There are many stages. Pregnancy is broken down into three three month periods called trimesters. In each trimester, the baby can be affected in different ways. All drugs can hinder or completely stop the growth of the unborn child.

At how many weeks does the unborn child react to touch?

There is scientific evidence that by 8 weeks, the unborn child reacts to touch

What is conception?

This is the moment the sperm fertilizes the egg

Gestational Period

This is the scientific term for pregnancy, which proceeds in 3 stages.

Effects on the child from maternal experience and personal habits

Tissue damage, retardation, low birth weight, death, slow growth, retardation, miscarriage, fetal alcohol syndrome, heroin addiction

40th week of pregnancy

Toe and fingernails show. 1-2 weeks before delivery, the baby drops into mother's pelvis head first

What happens when unborn children are exposed to heroin?

When exposed to heroin, they may experience withdrawals. They may shake uncontrollably, vomit, have seizures, and can possibly die. According to Yonekura, the baby is usually jittery and sometimes the child will move so much that it could rub off the skin from its chin, knees, or elbows. These children can have trouble eating and sleeping. In the future, these children can have problems in school, mostly with learning disabilities.

WIC

Women, Infants, and Children program is a resource for supplemental food

Maternal experience and personal habits

X-ray exposure, smoking, substance abuse (e.g. alcohol, caffeine, cocaine, heroin)

Can babies be harmed or addicted to drugs if his/her mother consumed drugs while pregnant?

Yes, some are born already addicted to a certain drug, premature, brain damage, or with organ or physical deformities. Some of the parents of babies exposed to drugs are usually addicted to cocaine, heroin, crack, alcohol, or another type of drug. Even if a small amount of alcohol or a type of over the counter medication is taken while pregnant, the unborn child can still be harmed.

Three stages of Gestational Period

Zygote: conception to 2 weeks Embryo: 3-8 weeks Fetus: 9 weeks to birth