Pregnancy and Childbirth

• Pregnancy and birth are key topics in lifespan development.

Care Before Pregnancy

• Health and lifestyle behaviors influence becoming pregnant and a successful pregnancy.
• These behaviors have lifetime effects on both the mother and child.
• Getting medical care and checkups is important.
• One should undergo genetic testing to find out risks of birth defects.
• Manage any known health issues.
• Eat a well-balanced diet to maintain a healthy weight and practice physical fitness.
• Intake of folate (vitamin B9) promotes healthy brain and spinal cord development and may prevent neural tube and midline defects.
• Avoid alcohol, drugs, and smoking, including secondhand smoke.
• Consult with a doctor before using any medications, including over-the-counter ones.
• Women use their cognitive, physical, social, and emotional resources to support their developing babies.

Medical Care Providers

• Prenatal care is medical care for a pregnant woman and her baby.
• Obstetricians (OB-GYNs) are doctors who specialize in pregnancy and childbirth and oversee high-risk pregnancies.
• Family practitioners may also provide prenatal care.
• Certified nurse-midwives (CNMs) are nurses specializing in pregnancy and birth.
• CNMs' permitted actions depend on the state; in Texas, they can attend births at a hospital (with admitting privileges), birthing center, or home.
• CNMs can administer antibiotics and nitrous oxide, but cannot administer Pitocin.
• Certified professional midwives (CPMs) have passed the same midwife licensing exam as CNMs but are not nurses.
• CPMs cannot attend births in hospitals and administer any non-OTC medication.

Prenatal Appointments

• The first appointment includes health screenings, blood, and urine samples
• The expected due date is calculated based on the last menstrual period (LMP).
• Appointment schedules vary: once a month until after month 7, every two weeks in month 8, and every week in month 9.
• Typical appointments measure weight, blood pressure, and fundal height.
• Fundal height is the distance from the pubic bone to the top of the uterus, used to estimate the baby's size.

Nutrition

• Additional Calorie Needs:
  • 1st trimester - none
  • 2nd trimester - 300 extra calories daily
  • 3rd trimester - 500 extra calories daily
• A normal weight gain during pregnancy is between 25-35 pounds.
• Prenatal vitamins contain extra folate, calcium, and iron.
• Calcium aids in building strong bones and teeth.
• Iron reduces the chance of the baby being born at a low birthweight.
• Low birthweight is defined as a baby born weighing less than 5.8 pounds.
• Avoid certain foods due to the risk of foodborne illness, including raw fish and unpasteurized milk.

Weight Gain During Pregnancy

• Baby: 7-8 pounds
• Uterus: 2 pounds
• Placenta: 1.5 pounds
• Amniotic fluid: 2 pounds
• Increased maternal blood volume: 3-4 pounds
• Increased maternal breast mass: 2 pounds
• Increased maternal fat and other nutrients: 6-8 pounds
• Increased fluid retention: 4 pounds
• Total weight gain: 25-35 pounds

Lifestyle

• Stress can negatively impact all life stages, leading to emotional and physical disorders.
• Stress during pregnancy can lead to early birth and low birthweights.
• Ways to reduce the stress are surrounding the mother with a support group, having an accommodating employer, and government assistance such as WIC.
• Women, who were physically active before pregnancy, can safely continue non-contact exercises.

Genetic Disorders

• Genetic disorders are passed down through family genes.
• Some can be tested for before pregnancy, and others during.
• Accuracy of the tests varies; false positives are common.
• Some disorders can be treated.
• Disorders include: cystic fibrosis, Down syndrome, Fragile X syndrome, Huntington's disease phenylketonuria (PKU), sickle-cell anemia, spina bifida and Tay-Sachs disease.
• Disorders associated with faulty genes or chromosomes are passed down from parent to child.
• Disorders caused by absent, damaged or extra chromosomes (e.g., Down syndrome/Trisomy 21) are not hereditary.
• Stillbirth is the delivery of a deceased baby.

Teen Mother

• More likely to develop high blood pressure and experience preterm labor/delivery, resulting in low birth weight.
• Low birth weight babies may have physical challenges or developmental delays.
• Often do not receive early prenatal care.
• Adequate emotional and social support is needed, but may be hard to find.
• More likely for both mother and child to be socially and economically disadvantaged throughout their lives.
• Teen mothers experience increased stress, especially if social support systems, such as those from schools are not in place.

Older Mothers

• Sometimes referred to by doctors as geriatric pregnancies.
• Women are pregnant when after turning 35.
• They have a slightly increased risk of birth defects or abnormalities due to mother's longer exposure to environmental toxins and age of the egg.
• Increased chance of having multiple babies, like twins or triplets.
• Older mothers are more likely to have gestational diabetes or caesarian section deliveries.
• Gestational diabetes is diabetes that occurs only during pregnancy and women who have it have a 25% chance of developing Type 2 diabetes later in life.
• Caesarian section is surgical birth.

Sexually Transmitted Infections

• Also known as STDs.
• Bacterial STIs are caused by bacteria and can be cured with antibiotics.
• Pelvic inflammatory disease (PID) can cause infertility in women.
• Syphilis can lead to serious mental disorders and death.
• Viral STIs are caused by viruses and cannot be cured as treatments can help symptoms, but symptoms will return.
• Human papillomavirus (HPV) is linked to cervical cancer.
• Human immunodeficiency virus (HIV) causes acquired immune deficiency syndrome (AIDS), spread through blood or sex.
• Asymptomatic - a person shows no signs or symptoms.
• STIs can be passed from mother to baby and can pose risks to the developing baby.

Drug Use

• Can cause severe and long-term birth defects, affecting the physical, cognitive, and socio-emotional development of the baby.
• "Drugs" include illegal, prescription, and over-the-counter drugs; secondhand smoke is also included.
• Drug use by fathers can also have an adverse effect.
• Nicotine, found in tobacco, can cause premature and low birth weight.
• Fetal Alcohol Syndrome (FAS) is caused by prenatal exposure to alcohol, causing head and facial abnormalities and damages the heart, brain and skeletal system.
• Sudden Infant Death Syndrome (SIDS) is unexpected death for unknown reasons during the first year of life.
• Babies exposed to drugs go through painful drug withdrawal after birth, with trouble breathing, sucking/eating, and keeping food in their stomachs.

Paternal Factors

• Quality of sperm can be affected by lifestyle, health, and age.
• Alcohol use before conception can also increase the risk of birth defects.
• Secondhand smoke can be inhaled by the pregnant mother.

First trimester

• From conception until week 12.
• A missed period is often the first sign.
• Germinal period - from conception until implantation (2 weeks)
• Conception - when the sperm and egg join.
• Zygote - single-celled human cell with genetic information from both parents.
• Blastocyst - after the zygote begins to divide; attaches to the lining of the uterus.
• Embryonic period - from week 2 to week 9
• Embryo - term for developing baby after week 2.
• The blastocyst forms three layers: ectoderm, mesoderm and endoderm.
  • Ectoderm (outermost layer) - includes nervous system, ears, nose, and eyes.
  • Mesoderm (middle layer) - includes bones, muscles, circulatory and the reproductive system.
  • Endoderm (Innermost layer) - includes digestive and respiratory systems.
• Fetal period - term for developing baby from 3 months to birth.
• Fetus - stage where all baby’s body parts are already in place.

Second Trimester

• Week 13 to week 24
• Mother's body shows the effect of pregnancy, enlarged belly
• Baby's body parts become more distinct, clearer facial features
• Movements start in the first trimester, become more coordinated, may be felt by mother
• Often find out sex of baby at 20 week anatomy scan
• At the end of the trimester, baby weighs 1-1.5 pounds and is 12–14" long
• Morning sickness over, mother experiences pregnancy glow

Third Trimester

• Organ formation continues to increase, especially the lungs
• Good chance of survival in premature birth
• Earliest surviving age is 22 weeks
• Fatty tissue develops
• The baby's body becomes longer and heavier.
• End of month 7, baby weighs 3 pounds and measures 16 inches
• By birth, the baby weighs 7-8 pounds and 20 inches long
• The baby turns to a head-down position, ideally facing towards the mother's back.
• As the baby moves into the pelvis, the mother can breathe more easily
• Mothers experience "nesting," the desire to prepare for the baby

Birth

• Full-term- a baby is born after 37 weeks
• Braxton-Hicks contractions are mild cramps/belly tightening, irregular in timing
• Signs of labor are losing the mucus plug, water breaking (amniotic sac breaks)
• Contractions get stronger, longer, closer together as labor progresses
• A mother is not considered to be in active labor until her cervix is 5 centimeters dilated and her contractions are progressing.

Questions covering genetic disorders, pregnancy complications. Includes risks for teen and older mothers, gestational diabetes.