Chapter 9 Understanding Pregnancy and Parenthood

Parenthood
Not everyone is suited for parenthood. Parenting usually requires major adjustments in lifestyle to meet the needs of children. Pregnancy begins with fertilization, which is the fusion of a fathers sperm with a mothers ovum to form a zygote.

Parenthood

Pregnancy
Human chorionic gonadotropin (HCG) is produced by the placenta soon after implantation of the embryo. A pregnancy test is the analysis of the presence of HCG in a womans urine.

Pregnancy
HCG causes increased and prolonged production of estrogen and progesterone, which in turn causes the signs and symptoms of pregnancy: Absence of expected menstrual period Occasional nausea and vomiting (morning sickness) Enlarged and tender breasts Increased frequency of urination Fatigue

Pattern of HCG Secretion During Pregnancy

Pregnancy
The fetus is enclosed in a fluid-filled sac called the amnion. The amnionic fluid that the fetus is in protects the baby from jolts. The placenta is an organ that supports the growth and development of the baby.

Fetal Development
The nine months of pregnancy are divided into three 3-month segments, called trimesters. Characteristic changes occur in each trimester.

Sexual Interaction During Pregnancy

Sexual intercourse during pregnancy is OK unless a health care provider advises against sexual activity. Provided mother is interested, there is no physical reason to forgo sex during pregnancy.

Nutrition During Pregnancy

All of the fetus nutrients come from the mother via the placenta. Mothers who eat healthy diets give birth to healthier babies. Need to increase intake of essential nutrients and calories Need to supplement diet with iron and folic acid A weight gain of 28 to 30 pounds is normal.

Physical Activity During Pregnancy

Helps overcome feelings of lethargy and discomfort with changes in baby proportions Helps prepare the mothers body for childbirth Can improve circulation and reduce varicose veins Maintains the habit of being active Amount depends on the womans previous experience with exercise

Emotional Well-Being
Emotional well-being of the mother influences the health of the pregnancy. Pregnancy can be a time of intense feelings for the woman, her partner, and the entire family. Intense emotions are natural and normal. Quiet meditation and relaxation may help. Desires for either more or less sex are normal.

Prenatal Care
Receiving professional prenatal care reduces the risk of complications by ensuring: Fewer pregnancy-related illnesses Early discovery of problems with the placenta or uterus Discussion of proper nutrition Advice on alcohol, tobacco, and drugs Screening for maternal infections (e.g., rubella, syphilis, gonorrhea, herpes) Screening for Rh incompatibility

Risks to Fetal Development

Some causes of birth defects are unknown; others may be factors or agents adversely affecting the fetus during development. Many substances can easily cross the placenta and damage the developing fetus: DrugsLegal (prescription and over-thecounter) or illegal Alcohol Cigarette smoking

Detecting Birth Defects

Certain tests are performed when there is reason to suspect fetal abnormalities. Reasons for birth defect testing include:
Pregnant woman is over age 35. Parents have previously given birth to a child with birth defects. Parents have a history of genetic or chromosomal disorders and want to confirm the absence of birth defects in the unborn child.

Detecting Birth Defects

Tests that are performed:
Amniocentesis Chorionic villus sampling (CVS)

Childbirth
6- to 8-week courses help prepare expectant couple or parent for childbirth. A few weeks before the onset of childbirth (or labor) fetus becomes positioned for birth by descending in the uterus, a process called lightening. During the last half of pregnancy, a woman may experience Braxton-Hicks contractions, which feel like labor contractions but are not.

Childbirth
Labor is marked by the occurrence of strong, rhythmic, and eventually frequent uterine contractions. Childbirth is described as occurring in three stages despite the fact it is one continuous process. Labor time varies from woman to woman.

Childbirth
Stage 1: The mothers cervix has effaced (flattened and thinned) and dilates to allow the baby to pass from the uterus. Stage 2: Cervix is fully dilated and the infant descends through the vaginal birth canal. Stage 3: The expulsion of the placenta and membranes (afterbirth).

Childbirth

Medical Interventions in Childbirth

Options for controlling discomfort
Relaxation techniques Deep breathing Acupuncture Hypnosis Analgesics Anesthesia

Induction of Labor
Induction of labor involves medically stimulating uterine contractions and labor. Most common methods of inducing labor are administering prostaglandins to the cervix, breaking the amnoitic sac, and administering the hormone oxytocin (Pitocin).

Episiotomy
An incision in the perineum from the vagina to the anus Necessary when the head of the infant is too large for the opening, the infant is in distress, the infant is in an irregular position, there is need for a forceps delivery, or the perineum has not stretched sufficiently

Episiotomy
Episiotomies are not as highly recommended as they were in the past. Side effects include infection, increased pain, increase in third- and fourth-degree vaginal lacerations, slower healing, and increased discomfort when intercourse is resumed.

Cesarean Section (C-section)

A surgical procedure where the fetus is removed through an incision made in the abdominal wall and uterus Recommended when the fetal head is too large for the mothers pelvic structure, the mother is ill, there is active herpes infection in the vaginal tract, there is fetal distress during labor, or there are birth complications

The Postpartum Transition

The period of recovery after childbirth is called the puerperium. During this time, the physiological changes of pregnancy slowly reverse. After delivery, the levels of progesterone and estrogen, which are high during pregnancy, drop rapidly.

Breast-Feeding

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Breast-Feeding
Milk production is controlled by hormones. Breast-feeding has many advantages:
Transfers immunity Promotes development of digestive system Is associated with fewer allergies and digestive problems in infants Provides more balanced nutrition Helps uterus return to normal size Offers pleasurable experience

Infertility
Approximately one in five American couples are infertile, which means they are unable to become pregnant after a year of trying. In about 40% of infertile couples, the problem lies with the male partner. In about 10% of infertile couples, no cause can be determined.

Infertility
Common causes of blockage of reproductive tract are scarring of the fallopian tubes by gonorrhea or chlamydia infections and (less likely) scarring of the epididymis by a bacterial infection. Problems with insemination and sperm transport can cause infertility.

Enhancing Fertility Options

For conception to occur, more than 20 million healthy sperm must be deposited into the vagina. If a man has healthy sperm but not enough, the process can be facilitated by introducing the semen directly into the cervix with a syringe, which is called artificial insemination.

In Vitro Fertilization
In vitro fertilization (IVF) involves obtaining several ova from the ovaries and fertilizing them in a laboratory environment; the embryo is then placed inside the womans uterus.

Gamete Intrafallopian Transfer

Gamete intrafallopian transfer (GIFT) involves the ova being placed in equal numbers in each of the fallopian tubes and the semen being introduced directly into the fallopian tubes. GIFT is about 10% to 20% effective.

Zygote Intrafallopian Transfer

Zygote intrafallopian transfer (ZIFT) involves eggs being fertilized in vitro and the embryos being placed in the fallopian tubes. ZIFT is also about 10% to 20% effective.

Adoption
There are three avenues a couple can pursue to adopt a child:
Private adoptionstate licensed Public adoptionstate licensed International adoption