Prenatal Development

What are the characteristics of a “good parent”?

Why have children?Benefits & drawbacks of having children

Role of birth controlEthnic and regional differences in having children

How large a family?Why do you think each country has a different average number?

How does time period play a role on deciding # of children?

Is there a best time during adulthood to have a child?

Young vs. old parentsFertility issues

Any environmental agent that causes damage during the prenatal period.

Can you name some specific teratogens?

Harm done by teratogen depends on the following factors:◦ Dose◦ Heredity◦ Other negative influences – poor nutrition, lack of

medical care◦ Age

Prescription and Non-prescription Drugs

Tobacco Environmental Pollution Infectious disease – (ex: AIDS, chicken pox, mumps, tuberculousis, malaria) – may result in miscarriage, physical malformations, MR, and/or low birth wt and prematurity.

Mother’s:◦severe malnutrition◦extreme stress◦Amount of exercise◦blood incompatibility◦age ◦previous births

Alcohol◦Fetal alcohol syndrome (FAS)

1. slow physical growth2. pattern of facial abnormalities (short

eyelid openings, thin upper lip, smooth or flattened lip)

3. Brain injury – small head and impairment in 3 of following areas: memory, language, attention span, activity level, planning and reasoning, motor, social skills.

Do you think it is possible to identify and accurately research the effects of ever possible teratogen? Why or why not?

How old is the organism when it is exposed to the teratogen? Is it at a time point when fetus is most vulnerable and still forming?

Critical period – time point in prenatal development when organism is most vulnerable to teratogen

What precautions do you think that couples must take once the mother has gotten pregnant? (Before, during and after the pregnancy.)

Pregnant women will encounter harmful teratogens on a daily basis. No control. Teratogens become harmful and damaging at a certain level/dosage (threshold effect).

What is the encountered dosage and frequency of exposure?

What happens when teratogens have been combined together? (interaction effect)

Certain disorders and diseases are more common in certain ethnic groups.

Folic acid vitamins before trying to get pregnant.

Gender – males are often at greater risk.

https://www.youtube.com/watch?v=dHRZjTiFEHs

https://www.youtube.com/watch?v=LafUmARkPpg

Seeking information◦ Reading books on pregnancy & childbirth◦ Enrolling in a parenting/prenatal class

(community centers)◦ Checking out websites

Helps mother feel confident (what about father?)

The baby becomes a reality◦Woman’s abdomen enlarges◦Ultra-sound images/sounds◦Baby kicking◦Touching the abdomen

Models of effective parenthood◦ Thinking about important models of parenthood in

own life◦ Coming to terms with any personal negative

experiences

The parental relationship◦ Context of the parents’ relationship. How happy is

the marriage? Satisfied? ◦ Excitement of first pregnancy◦ Better prepared to handle any changes

Birth and the Newborn BabyBirth and the Newborn Baby

http://www.today.com/video/today/38989084#38989084

To assess the newborn’s physical To assess the newborn’s physical condition quicklycondition quickly

Doctors and nursesDoctors and nurses Rating of 0, 1, or 2Rating of 0, 1, or 2 At 1 minute and again at 5 min after At 1 minute and again at 5 min after

birthbirth https://www.youtube.com/watch?v=zY87wohJl9I

7 or more – infant in good physical 7 or more – infant in good physical conditioncondition

4 to 6 - infant requires assistance in 4 to 6 - infant requires assistance in establishing breathing and other vital establishing breathing and other vital signs.signs.

Below 3 – infant in serious danger Below 3 – infant in serious danger and requires emergency medical and requires emergency medical attention.attention.

ColorColor Muscle ToneMuscle Tone HeartbeatHeartbeat RespirationRespiration Reflex Irritability Reflex Irritability Each category rated on a scale Each category rated on a scale of 0-2of 0-2

Fetal monitors – Fetal monitors – electronic instruments electronic instruments that track the baby’s heart rate during that track the baby’s heart rate during labor. Is baby in distress? Lack of oxygen? labor. Is baby in distress? Lack of oxygen? Delivered immediately?Delivered immediately?◦Strapped across mother’s abdomen Strapped across mother’s abdomen

throughout laborthroughout labor◦Threading a recording device through Threading a recording device through

the cervix and place under baby’s scalpthe cervix and place under baby’s scalp

Pain killersPain killers◦Analgesics – drugs to relieve painAnalgesics – drugs to relieve pain◦AnestheticsAnesthetics◦Epidural analgesia – drug is Epidural analgesia – drug is delivered continuously through a delivered continuously through a catheter into small space in lower catheter into small space in lower spine.spine.

InstrumentsInstruments◦Forceps and vacuum extractorForceps and vacuum extractor

Induced laborInduced labor◦Started artificiallyStarted artificially◦Break the amnion fluidBreak the amnion fluid◦Give mother oxytocin Give mother oxytocin hormone that stimulates hormone that stimulates contractionscontractions

Artificial rupture of membranes to speed up labor.

Insert amnio-hook (large crochet hook with small sharp end). Snag amniotic membrane.

High risk of infection Lack of cushion for baby’s head

Oxytocin – injected into vein through an IV. Stimulates contractions. Induction of labor & use of pain meds can interfere with natural hormone process of giving birth.

Endorphins – calm & pain relieving effects. Natural morphine-like effects. Decrease perception of pain.

Adrenaline – secreted in response to stress, fear, and extreme pain.

Cesarean DeliveryCesarean Delivery◦Surgical birthSurgical birth◦Doctor makes incision in Doctor makes incision in mother’s abdomen’mother’s abdomen’

◦Lifts baby out of the uterus Lifts baby out of the uterus

BreechBreech◦Baby is buttocks or feet first and needs Baby is buttocks or feet first and needs

to be turned. Increases chance of to be turned. Increases chance of squeezing umbilical cord as the large squeezing umbilical cord as the large head moves through the birth canal. head moves through the birth canal. Depriving infant of oxygen.Depriving infant of oxygen.

Need an immediate cesarean deliveryNeed an immediate cesarean delivery

Frank Breech – bottom first with feet up near the head. Bottom come out first.

Complete Breech – bottom first with legs crossed Indian style. Knees bent & feet near the buttocks.

Footing Breech – one or both feet come out first. Leg or legs in place to come out first during delivery.

http://www.youtube.com/watch?v=O6jddbdeFUo

AnoxiaAnoxia◦Inadequate oxygen supplyInadequate oxygen supply

Preterm infants - Preterm infants - (born several weeks (born several weeks before due date). Before 35 weeks.before due date). Before 35 weeks.

Small for date infants Small for date infants – below their – below their expected weight considering length of expected weight considering length of pregnancy.pregnancy.

Less than 5.5 lbs = low birth Less than 5.5 lbs = low birth weightweight

Less than 3 lbs 5 ounces = very Less than 3 lbs 5 ounces = very low birth weightlow birth weight

Less than 2 lbs 3 ounces = Less than 2 lbs 3 ounces = extremely low birth weightextremely low birth weight

Joyous happy occasion for extended Joyous happy occasion for extended family. Religious and cultural rituals.family. Religious and cultural rituals.

Connection between parents and child. Connection between parents and child. Developing that Developing that parental bond.parental bond.

Quick connection with mother if want to Quick connection with mother if want to breast feed. Latching on. breast feed. Latching on.

Postpartum DepressionPostpartum Depression – sense of – sense of inadequacy and sadness inadequacy and sadness

Changes in the family system◦Demands of new parenthood◦Are there other children?◦Is she a single mother? How much available extended support?

◦ Parents’ age – have they waited to pursue occupational goals and life experience?

Financial responsibilities & Financial responsibilities & changes if mother stays changes if mother stays home with babyhome with baby

Gender rolesGender rolesEffect on marital satisfaction Effect on marital satisfaction and communicationand communication

http://www.youtube.com/watch?v=wfhpgPnGhkA

Getting into groups of 3-4 students. Devise Getting into groups of 3-4 students. Devise a therapeutic program for mothers battling a therapeutic program for mothers battling post-partum depression. post-partum depression.