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Monday, 01 October 2012 17:28

NOTES- chapter 4

Written by David Sheppard
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n  Prenatal Development and Birth

n  Slides prepared by Kate Byerwalter, Ph.D.,
Grand Rapids Community College

n  A remarkable journey…are you ready? 

n  Stages of Prenatal Development

n  Germinal Period  (0-2 weeks)

¨  Conception occurs in fallopian tubes

¨  Cell differentiation and multiplication

¨  42% of conceptions successfully implant in uterus

n  The Start of the Journey

n  Stages of Prenatal
Development (cont.)

n  Embryonic Period (3-8 weeks)

¨  Major organs develop

¨  At 8 weeks, organism is less than 2˝ long!

n  Fetal Period (9 weeks-birth)

¨  Sex organs develop

¨  Brain development is significant

¨  Age of viability occurs around 22 weeks

n  The Fetus

n  Stages of Prenatal Development (cont.)

n  Age of viability is the age at which a preterm newborn might survive.

n  Weight plays a crucial role

¨  Only 20% under 1½ pounds survive

¨  By 28 weeks, survival rate is 95%

n  Make it Real: Do’s and Don’ts of Pregnancy

n  List some things you have heard that a woman should or shouldn’t do while pregnant.

n  Risk Reduction

n  Teratology = the study of birth defects

n  Teratogens = harmful agents to the developing organism

¨  Examples: diseases (e.g., rubella), lifestyle choices (e.g., drug use), medications, toxins

¨  Teratology is a science of risk analysis.

n  Determining Risk

n  Timing of exposure

¨  Critical period is the time of greatest vulnerability (for each body structure)

¨  Amount of exposure

¨  Threshold effect and interaction effect

¨  Genetic vulnerability

¨  Ethnicity, sex (males as greater risk)

n  Critical Periods of Development

n  Fetal Alcohol Syndrome

n  Caused by heavy drinking (> 5 drinks/day)

¨  Causes severe cognitive, physical, and behavioral deficits

¨  Is the leading behavioral cause of mental retardation

n  Fetal Alcohol Syndrome

n  Cigarette Smoking

n  Cigarette smoking cuts off oxygen to the developing baby by 20%, significantly increasing the risk of having a low birthweight newborn.

n  Birthweight

n  The average weight of a newborn is 7½ lbs.

¨  LBW is considered less than 5½ lbs.

¨  Preterm is less than 35 weeks.

n  Possible Causes of LBW

n  Lifestyle choices 

¨  e.g., cigarette smoking accounts for 25% of LBW births worldwide!

n  Maternal malnutrition

n  Multiple births

n  Prescription drugs

n  Unknown causes

n  The Birth Process: Methods of Delivery

n  Hospital (majority of U.S. births)

n  Birthing centers (5%)

n  At home (1%)

n  Doula: someone who helps women with labor, delivery, breastfeeding

n  Cesarean Section (28%)

¨  Intended for emergencies

n  “Look out world, here I come!”

n  Newborn’s First Minutes

n  Apgar Scale

¨  An assessment of risk taken 1 and 5 minutes after birth

¨  Measures 5 vital signs

¨  Score of 7 or higher = infant is fine

¨  Score below 7 = infant needs help breathing

¨  Score below 4 = infant needs critical care

Cesarean section is performed in about 28% of U.S. births.

n  Birth Complications

n  Cerebral Palsy includes difficulties with movement control, often resulting from a combination of genetic vulnerability and anoxia (lack of oxygen).

n  Bacterial infection caused by GBS

n  Intensive Care for Infants

n  Kangaroo care: allows the parents of an infant in intensive care to be involved, holding the newborn at least an hour a day

n  This helps the newborns sleep better and become more alert when awake. It also helps with bonding.

n  Long-Term Effects of Intensive Care

n  There are some long-term delays for preterm infants (e.g., slower to communicate, hold bottle).

n  Infants with serious defects who survive often have long-lasting disabilities.

n  However, ongoing family support and services make a big difference in outcome.

n  The Importance of Support

n  Mothers in Mexico receive exceptional support during pregnancy (familia)–this correlates with fewer LBW births, despite lower incomes and less prenatal care than Mexican immigrants in the U.S.

n  A parental alliance between father and mother of the developing baby is key!

n  Postpartum Depression

n  8-15% of women experience postpartum depression, a sense of inadequacy and sadness after birth.

n  Possible causes: preexisting depression, stress, marital problems, infant difficulties

n  Postpartum Depression (cont.)

n  Symptoms include irritability, sleep and eating disruptions, sadness, feeling overwhelmed and inadequate as a mom, no interest in baby, or overly worried about baby.

n  Antidepressants and support help.