Pregnancy and Birth

Am I Pregnant?Common Symptoms ….

Missed menstrual period

Breast tendernessMorning sicknessMore frequent urination

Diagnosing Pregnancy

Presumptive Signs: breast changes, amenorrhea, nausea, vomiting, fatigue, frequent urination

Probable Signs: Positive pregnancy test, physical changes in the uterus

Positive Signs: Ultrasound or X-ray of fetus, fetal heartbeat, fetal movement

Pregnancy Tests

Physician testsHome pregnancy tests test based on detection of hCgHuman chorionic gonadotropin -

a hormone secreted by the placenta; it is the substance detected in pregnancy tests

Prenatal DevelopmentNine months of pregnancy are divided

into three equal periods of three months – called trimesters

– First trimester - months 1 to 3(embryo- first 2 months)(fetus- next 7 months)– Second trimester - months 4 to 6– Third trimester - months 7 to 9

The Embryo and Its SupportSystems

Placenta - an organ formed on the wall of the uterus through which the fetus receives oxygen and nutrients and gets rid of waste products

Umbilical cord - the tube that connects the fetus to the placenta

Amniotic fluid - the watery fluid surrounding a developing fetus in the uterus

Fetal Development During theFirst Trimester

Develops into a fetus with most of the major organ systems present

• 4th to 8th week - external body parts develop

7th week - liver, lungs, pancreas, kidneys, and intestines have formed and begun limited functioning

End of 12th week - 10 centimeters long;weighs 19 grams

Mom’s Physical Changes: First Trimester

Large increase in levels of hormones Breasts swell and tingle;

development of mammary glands Need to urinate Morning sickness Vaginal discharges may increase Feelings of fatigue and sleepiness Depression is common Emotional roller coaster

Quickening occurs - woman becomes aware of fetal movements

– around the end of the 14th weekFetal heart beat can be detectedFetus opens its eyes

Fetal Development During theSecond Trimester

Mom’s Physical Changes: Second Trimester

Morning sickness disappears Constipation and nosebleeds

sometimes occur Edema - water retention and swelling Colostrum may come out of the

nipple Emotional well-being improves

Fetal Development During theThird Trimester

Fetus’s skin is wrinkled and covered with downlike hair- lanugo and a waxy protective layer- vernix

Fetus turns in uterus to assume a head-down position

Fetus experiences rapid growth

Sex During Pregnancy

Intercourse can continue safely throughout pregnancy, unless otherwise stated by doctor

Some anecdotal evidence of hormones in semen inducing labor

Nutrition During Pregnancy

Diet during is extremely importantWoman must get enough protein,

folic acid, calcium, magnesium and vitamin A

The fetus comes first – it draws the nutrients it needs first, and whatever is left is for mom

Nutrition Deficiencies

Calcium – future risk of bone and tooth loss

Folic acid – (folate) much higher risk of neural tube defects. (decreases risk by 50%)

Zinc – malformations of the central nervous system

Effects of Drugs Taken During Pregnancy

Teratogens - a substance that produces defects in a fetus

Examples of teratogens: Antibiotics Alcohol - fetal alcohol syndrome Tobacco Other psychoactive drugs (cocaine, heroin) Thalidomide- drug that can cause limb defects Other drugs - check with physician and “when in

doubt, don’t”

Birth: The Beginning of Labor

Bloody show- discharge of mucous plug, along with some blood, that sealed the cervix

Amniotic sac ruptures- “water breaking”

Contractions may startLabor divided into 3 stages

The First Stage of Labor:Dilation and Contractions

Regular contraction of uterus muscles Effacement of cervix (thinning) Dilation of cervix (enlargement)o Divided into 3 stages:– Early first-stage labor (0-5 cm dilation)– Late first-stage labor (5-8 cm dilation)– Transition phase (8-10cm dilation)

Pain Management Epidural or Spinal Medication

regional blocks prevent the nerves from sending signals to the brain; numbs or reduces pain in part of the body (from the abdomen down).

Mental Relaxation Techniques Some techniques aim to focus your thoughts, others to distract you. Music, breathing, visualization are common.

Narcotic Analgesicsreduces your entire body’s ability to sense pain or discomfort. Administered through a shot or IV and will wear off within a few hours. Not recommended if you are within two hours of your baby’s birth.

Physical Comfort Measures Hot and cold packs, massage, sipping cool water are common.

Position Changes Some positions improve your baby's ability to navigate through the pelvis, other positions hinder his efforts. Some positions can help to reduce the pressure associated with a back labor, other positions make it easier to relax your body and rest.

Water Tubs and showers help to handle contractions with less discomfort.

The Second Stage of Labor: Delivery of the baby Begins when cervix is fully dilated Urge to push or bear down Crowning – top of the head is visible Fontanel- soft spots between the skull bones of

the baby Episiotomy may be performed – incision that is sometimes made at the vaginal

entrance during birth Baby is born

The Third Stage of Labor:Delivery of the afterbirth

Placenta detaches from walls of the uterus

Afterbirth is expelledSeveral contractions may

accompany placental expulsionEpisiotomy and tears are sewn

up

Cesarean Section

A method of delivering a baby surgically, by an incision in the abdomen

Reasons to have a C Section:– Baby is too large, mother’s pelvis is too small- Baby not in head down position– Cervix is not dilating– Umbilical cord prolapses– Excessive bleeding– Placenta previa

Newborn testing

APGAR- the rating (0-2) of baby’s physical characteristics 1 and 5 minutes after birth

If there are problems with the baby an additional score is given at 10 minutes.

A score of 7-10 is considered normal, while 4-7 might require some resuscitative measures, and a baby with apgars of 3 and below requires immediate resuscitation.

A activity

P pulse

G grimace

A appearance

R respiration

The 4th trimester

Parenting a newbornPhysical and emotional

changes againPost-partum depression a

possibility