9.ATOD.1.6,  page  1  

Essential Standard Clarifying Objective 9.ATOD.1  

Understand  the  health  risks  associated  with  alcohol,  tobacco,  and  other  drug  use.  

9.ATOD.1.6  Summarize  the  consequences  of  alcohol  or  

tobacco  use  during  pregnancy.  

Materials Needed: Appendix  1a,  b  –  Copies  of  Anatomical  Structures  of  Pregnancy  (not  labeled;  labeled)  PowerPoint  slide  –  Anatomical  Structures  of  Pregnancy  (labeled)  Resealable  bag  and  water  Small  object  to  represent  a  baby  One  large  clear  container  of  water  with  bright  blue  food  coloring    One  needle  or  sharp  pin  Video  –  Stop  Smoking  Now:  Reasons  Not  to  Smoke  When  You’re  Pregnant  from  the  series,  I  Am  Your  Child.  [20  minutes]  $10.00  Ordering  information:  (888)  447-­‐3400  http://www.parentsaction.org/categories/Resources/DVDS/  Appendix  2  –  teacher’s  copy  of  Kayla’s  Story  Appendix  3  –  Gestation  Period  including  Sensitivities  to  Toxic  Substances    Appendix  4  –  Definitions  of  Pregnancy  Complications  Appendix  5  –  What  is  Fetal  Alcohol  Syndrome  (FAS)?  PPT  slides  –  Better  Safe  than  Sorry    Appendix  6  –  graphic  organizer  –  The  Effects  of  Alcohol  and  Tobacco  During  Pregnancy  PPT  Slides  –  What  Are  the  Effects  of  Smoking  During  Pregnancy?    Review: Distribute  copies  of  Anatomical  Structures  of  Pregnancy  (Appendix  1a,  not  labeled)  to  each  student.  Ask  students  to  label  and  identify  the  structures  on  their  own  papers.  When  students  are  finished,  the  teacher  will  review  answers  using  the  PPT  slide  Anatomic  Structures  of  Pregnancy  (labeled)  as  a  reference.  [Teacher  may  choose  provide  a  word  bank  of  terms  from  Appendix  1b.]    Focus: Option  1  Fill  a  small  plastic  resealable  bag  with  water  and  place  a  small  object  which  represents  a  baby  inside  the  bag.  Fill  a  large  clear  container  with  water  and  mix  in  food  coloring.  Poke  several  holes  using  a  needle  or  a  pin  into  the  small  plastic  bag.  Explain  to  the  class  the  small  plastic  bag  represents  the  placenta,  the  large  container  of  water  represents  the  womb,  and  the  blue  water  represents  alcohol  the  mother  has  been  drinking.  Place  the  small  bag  into  the  large  container  and  explain  how  they  will  examine  this  small  bag  later  during  the  class.    It  will  take  a  few  minutes  for  the  colored  water  from  the  container  to  pass  through  the  small  holes  in  the  sealable  bag  so  it  is  recommended  that  the  lesson  continue  and  during  Teacher  Input  –  refer  to  bag  and  container.  Students  will  notice  that  the  plastic  bag  now  contains  colored  water  as  well.  Process  activity  by  discussing  if  a  pregnant  woman  consumes  alcohol,  it  

NC  School  Health  Training  Center  NC  Association  for  the  Advancement  of  Health  Education  

9.ATOD.1.6,  page  2  

easily  passes  through  the  placenta  and  the  membrane  which  separates  the  maternal  and  fetal  blood  systems.  When  this  happens,  alcohol  is  transported  directly  to  the  fetus  and  to  all  its  developing  tissues  and  organs.    Option  2  Show  the  video  Stop  Smoking  Now:  Reasons  not  to  Smoke  When  You’re  Pregnant  from  the  series,  I  Am  Your  Child.  [20  minutes]  Ordering  information:  (888)  447-­‐3400  |  FAX  (213)  477-­‐2230,  Parents'  Action  for  Children  |  P.O.  Box  2096  |  Culver  City,  CA  90231.    Option  3  Read  Kayla’s  Story  (Appendix  2).  Process  by  asking  how  they  would  feel  if  a  behavior  they  practiced  affected  the  health  of  their  baby.    Statement of Objectives: Today  in  class  we  are  going  to  be  discussing  the  effects  of  alcohol  and  tobacco  on  unborn  children.  By  the  end  of  the  lesson  you  will  be  able  to  summarize  the  consequences  of  alcohol  or  tobacco  use  during  pregnancy.    Teacher Input: Have  students  look  at  the  Gestation  Period  (Appendix  3).  Have  several  students  point  out  the  sensitive  areas  that  are  greatly  affected  by  tobacco  and  drug  use  during  pregnancy.  Ask  students  to  point  out  what  stage(s)  of  the  gestation  period  are  the  eyes  affected.  When  would  major  physical  abnormalities  occur?  What  stages  is  the  heart  affected  by  toxins  such  as  tobacco  or  other  drugs?  Keep  in  mind  that  a  drug’s  effects  on  a  developing  baby  are  20  times  greater  than  the  drug’s  effects  on  an  adult.    Show  Definitions-­‐Pregnancy  Complications  (Appendix  4)  and  make  the  following  points:  Research  has  shown  that  women’s  smoking  during  pregnancy  increases  the  risk  of  pregnancy  complications,  premature  delivery,  low-­‐birth-­‐weight  infants,  stillbirth,  and  sudden  infant  death  syndrome.  When  the  woman  is  smoking,  it  could  cause  the  umbilical  cord  to  constrict.  This  decreases  the  amount  of  oxygen  being  delivered  to  the  fetus.    Option  1  Download  PowerPoint  Viewer  from  following  site  and  show  the  PowerPoint:  http://pubs.niaaa.nih.gov/publications/Science/curriculum.html.  In  addition  to  information  and  resources,  this  link  directs  to  the  PowerPoint,  Better  Safe  Than  Sorry  as  well  as  curriculum  slides  and  videos.      Display  PPT  Slide,  What  is  Fetal  Alcohol  Syndrome?  (Appendix  5)  Discuss  the  following  as  students  complete  graphic  organizer.  Fetal  Alcohol  Syndrome  (FAS)  is  a  lifelong  yet  completely  preventable  set  of  physical,  mental,  and  neurobehavioral  birth  defects  associated  with  alcohol  consumption  during  pregnancy.  A  FAS  diagnosis  requires  evidence  of  abnormalities  in  three  specific  areas:  

NC  School  Health  Training  Center  NC  Association  for  the  Advancement  of  Health  Education  

9.ATOD.1.6,  page  3  

1. growth  2. central  nervous  syndrome  functions  3. facial  characteristics  

Fetal  Alcohol  Syndrome  (FAS)  is  the  leading  known  cause  of  mental  retardation  and  birth  defects  in  the  western  hemisphere.  When  a  mother  drinks  alcohol,  it  enters  her  blood  stream  and  also  the  growing  baby’s  blood  stream  through  the  placenta.    If conducting water experiment, check the plastic bag at this time. Process information provided in the Focus Step if the colored water is now in the bag. If not, wait a few minutes and recheck. Alcohol is a teratogen, which is a substance known to be toxic to human development. Depending on the amount, timing, and pattern of use, if alcohol reaches the baby’s blood supply, it can interfere with healthy development and cause Fetal Alcohol Syndrome or other alcohol related disorders. There appears to be no difference in the type of alcoholic beverage (beer, wine, hard liquor) and its effects on pregnancy. Early exposure (during the first trimester) presents the greatest risk for serious physical defects, and later exposure increases the changes of neurological and growth deficiencies or miscarriages. There is no safe amount of alcohol during pregnancy. Tobacco Using tobacco and drugs during pregnancy can be detrimental to the unborn child. There are many proven facts of the consequences of the toxic substances entering the pregnant woman’s body. Show PowerPoint slides, What  Are  the  Effects  of  Smoking  During  Pregnancy? While presenting consequences on slide, ask students the following:

• Considering these risks, why do you think mothers smoke while pregnant? • Do you feel it is worth the risk? Why or why not? • What one message do you want to say to a woman considering pregnancy to

educate her on smoking risks while pregnant? Tobacco and drug use are extremely harmful during pregnancy. Babies born to pregnant women who smoke or use drugs might be killed by the effects of these substances. Those who live are more likely to be smaller, have a lower birth weight, and be less likely to survive than those of tobacco and drug-free mothers. Even after birth, there are hazards for the children of parents who smoke. These children are more likely to suffer from asthma or other respiratory diseases. Option 2 Play and discuss information from two CDC podcasts:

1) “If You are Pregnant, Don’t Smoke”, which describes the danger of smoking during pregnancy http://www2c.cdc.gov/podcasts/player.asp?f=7868 (3 min)

2) “Don’t Drink and Deliver” http://www2c.cdc.gov/podcasts/player.asp?f=11983 (3:50)

NC  School  Health  Training  Center  NC  Association  for  the  Advancement  of  Health  Education  

9.ATOD.1.6,  page  4  

Distribute index cards and have students write three pieces of information they learned while listening to the audios. Guided Practice: Utilizing cooperative groups, students will create a roadside “billboard.” The assignment should include at least one health consequence of using alcohol or tobacco during pregnancy and one picture. Independent Practice: Upon accessing the website www.fodey.com, students will generate a newspaper clipping. Assessment includes creating name of newspaper, headline, date, brief news article stating consequences of either alcohol or tobacco use while pregnant and a concluding message promoting abstinence from drugs during pregnancy. The completed newspaper image can be downloaded to a website or a blog. If internet is not available, students will complete same activity as above but without computer enhancement.

Closure: Today we have discussed the consequences of alcohol and tobacco use during pregnancy. These problems can be serious lifelong concerns for the affected child. Children with severe impairments might not be able to take care of themselves as adults. These lifelong problems can be prevented by increasing awareness of the dangers of alcohol consumption and tobacco use during pregnancy and enhancing access to prenatal care and treatment for drug problems.

 

9.ATOD.1.6,  Appendix  1a  

 

9.ATOD.1.6,  Appendix  1b  

http://hcd2.bupa.co.uk/fact_sheets/mosby_factsheets/Normal_pregnancy.html

 

9.ATOD.1.6,  Appendix  2  

Kayla’s Story

My name is Kayla and I am 28 years old. When I was 17 I began going out with a guy from another high school. I wasn’t a smoker, but he smoked. I started smoking to fit in with his friends and later on to calm me down after we argued. We fought a lot, especially after we learned I was pregnant. When I went to the doctor I was four months pregnant, and she told me I needed to stop smoking. I didn’t think it was that big of a deal. My mother had smoked when she was pregnant with me and I turned out alright. But as the months went by, I was told that my baby wasn’t growing as much as it needed to. The doctor said when I smoked, the baby gets less oxygen because of the carbon dioxide and other chemicals in cigarettes. I didn’t smoke that much, maybe a half a pack a day. But when my boyfriend and I broke up I probably smoked about a pack a day. I just couldn’t understand how we could break up when I was going to have his baby. And would he still help me take care of it? My parents were always on my case too. When the baby did arrive I was 36 weeks pregnant. It was a girl and I named her Taylor. She was one month early and only weighed 4 ½ pounds. She had to live in an incubator for several weeks. I was scared. I felt really bad because Taylor wasn’t breathing when she was born. When she was a baby and toddler she needed several surgeries to repair some heart valves. She also was missing one of her four heart chambers so she was sick a lot with her breathing. Her body wasn’t getting enough oxygen. We were often in the hospital and so Taylor missed out on school activities and making friends. Taylor is now 10 years old and is going to have another heart surgery next month. The doctors say she will have surgeries every few years until she is fully grown and then maybe as an adult. Taylor still has severe asthma and can’t run or participate much in sports, but she is able to attend school a little more now that she’s older. I wish I could tell you I quit smoking, but it’s the one thing I have that relaxes me. I am a single mom and work two jobs to support us along with Taylor’s hospital bills. I don’t smoke in the house but Taylor’s doctor told me that if I quit smoking, it will really help Taylor breathe better. Taylor has a long scar in the center of her chest from all of her surgeries and every time I look at it, I am reminded that she isn’t “normal” because of my smoking. Writing this letter is a big step and I really want to quit. I wish I had never started. Thank you for listening, Kayla

 

9.ATOD.1.6,  Appendix  3  

Gestation Period

Including Sensitivities to Toxic Substances such as Tobacco and Other Drugs

http://journals.cambridge.org/fulltext_content/PSM/PSM35_05/S0033291704004155tbl001.gif

 

9.ATOD.1.6,  Appendix  4  

Definitions – Pregnancy Complications

Premature Delivery A baby born before 37 complete weeks of pregnancy. Most pregnancies are about 40 weeks.

Low Birth Weight Classified as a baby that weighs less than 5 pounds and 8 ounces. This can usually be attributed to the health of the mother during pregnancy.

Still Birth When the fetus dies in the womb or during labor.

Sudden Infant Death Syndrome

A condition when an infant suddenly dies without any cause that can be found through an investigation or autopsy. Usually the infant is sleeping and when the parents go to check on the infant they find him/her dead.

 

9.ATOD.1.6,  Appendix  5  

What is Fetal Alcohol Syndrome (FAS)?

Definition: A characteristic pattern of severe birth defects present in babies born to mothers who drink alcohol during their pregnancy.

Facts about FAS: When the mother consumes alcohol, it is absorbed into the bloodstream at the same rate for the infant as it is absorbed for the mother. Ethanol, the main ingredient in alcohol, seems to have a toxic effect on the fetus causing physiological and central nervous system damage. The alcohol also interferes with protein synthesis which decreases nutrition for the mother and developing fetus.

Fetal Alcohol Syndrome requires at least one feature of each of three categories: 1. Growth retardation - abnormally small-for-age weight, length, and/or

head circumference 2. Central nervous system disorders - abnormal brain functioning, delays

in behavioral development, and/or intellectual impairment 3. At least two of the following - small head, small eyes, or a poorly

developed philtrum (the groove above the upper lip), short nose, or flattened midfacial area

o FAS is the leading known cause of mental retardation in the western world. It

has also been reported that learning disabilities, cross-eye, nearsightedness, malformations of the ears, liver and kidney problems, retarded bone growth, increases in upper respiratory infections, undescended testicles, and hernia have been connected with FAS.

o It has been reported that one-half of the infants of alcoholic mothers can be

found to have FAS. Alcohol consumption causes birth defects in about 3 out of 1,000 births.

o The most severe damage is done during the first trimester when heavy alcohol

is being consumed. Often the mother does not even know she is pregnant before the damage has taken place.

o FAS is the most common preventable form of mental retardation.

 

9.ATOD.1.6,  Appendix  6  

Graphic Organizer The Effects of

Alcohol and Tobacco during Pregnancy Define Fetal Alcohol Syndrome How does FAS affect the

following? Growth retardation: Central system: Facial Features:

What is the relationship between FAS and mental retardation?

Why is damage during the first trimester more difficult to prevent?

List the effects of smoking during pregnancy on the unborn baby.

What chemicals in smoke might harm the baby?

How might exposure to secondhand smoke by a pregnant woman harm the baby?

What advice would you give to a woman who smokes or drinks and wants to get pregnant?