Child Care & Development

1. Child Care & Development Chapter 5 Prenatal Care & Childbirth

2. Signs of Pregnancy • Presumptive Signs – could be cause of pregnancy or something else (often menstruation) • Amenorrhea – delay (10 or more days) in the menstrual cycle • Nausea – present in 1/2 to 2/3 of all pregnancies, usually happens at the same time daily from Week 4 – Week 12 • Frequency of Urination – the growing uterus puts pressure on the bladder; also due to hormones • Swelling/tenderness of Breast – often the first sign a woman notes • Other signs: Tiredness, skin discoloration, backache, groin pain, leg cramps, dizziness

3. Signs of Pregnancy • Positive Signs – definitely caused by pregnancy • HCG – hormone found in blood and urine of pregnant women; detected as early as first two weeks of pregnancy • Fetal Heartbeat – heard through a Doppler at 12 Weeks and a stethoscope at 16 Weeks • Fetal Movement – Begins at 11 Weeks, not felt until around Weeks 16-18 • Fetal Image – through ultrasound • Fetal Shape – may be felt through abdominal wall • Uterine contractions – painless; a doctor may notice during routine exams

4. Medical Care • Obstetrician – doctor who specializes in pregnancy and childbirth • The First Appointment – the doctor will: • Gather general health info from both parents • Ask details of the woman’s menstrual cycle and past pregnancies • Physical exam of mother-to-be • Urine and/or blood test • Estimate due date (40 weeks after beginning of last menstrual cycle) • Make next appointment

5. Medical Care • Doctor visits: • First six months – once a month • Seventh and eighth month – twice a month • Ninth month – at least once a week

6. Factors That Affect the Baby’s Health • High Risk Mothers-to-be • Age – women over 36 tend to have babies with more health problems, disabilities and disorders; teens tend to have babies who are premature, have low birthweight, disabilities, or are born dead • Low birthweight – babies who weigh less than 5 ½ lbs. • Rh factor – only a factor when the mother is Rh negative; baby may develop Rh disease that destroys its red blood cells • Emotional stability – when the mother is stressed, the adrenaline crosses the placenta to the baby, carrying stress signals; long lasting, severe, frequent stress may result in a difficult delivery or a baby who is smaller, fussy, or quite active

7. Health Habits During Pregnancy • Good nutrition is vital for: • Mother’s weight • Baby’s weight gain • Baby’s growth • Baby’s mental capacity • Baby’s physical performance • By Week 12, the baby completely depends on the mother for food • Pregnant teens under 17 years of age have more nutritional problems because they are still growing themselves

8. Health Habits During Pregnancy • Diets for pregnant women include: • Calcium • Iron • Folic acid • Protein • At least eight 8 oz. glasses of water • Limited caffeine (no more than one cup of coffee; in tea, soft drinks, and chocolate as well) • Suggested weight gain is between 25 and 35 lbs. • Women need to eat 300 extra calories starting in the fourth month

9. Health Habits During Pregnancy • Mothers-to-be should get eight to nine hours of sleep, with at least one 15-30 minute rest period • Never take drugs, even over-the-counter medicines, unless doctor prescribes • Continue physical activity within normal limits, avoiding contact sports

10. Illnesses in the Mother • Gestational Diabetes – appears in pregnant women who did not have diabetes prior to pregnancy; usually goes away soon after pregnancy • Women with gestational diabetes usually have larger babies (10-12 lbs.) • Pregnancy Induced Hypertension (preeclampsia or toxemia) – sudden increase in blood pressure, protein in urine, and swelling; happens late in pregnancy • Treatment includes bed rest, medicine, or early delivery of the baby

11. Drugs • Fetal Alcohol Syndrome (FAS) – happens when mothers drink heavily during pregnancy; babies are shorter, weigh less, have slow growth and development • Nicotine – reduces baby’s oxygen, can cause brain to develop abnormally; babies are smaller than average or premature; could result in miscarriage • Illegal drugs – cross the placenta quickly and reach the baby; babies have low birthweight or are born premature; may be born addicted and have to go through withdrawal

12. Complications of Pregnancy • Miscarriage – the expulsion of the baby before Week 20, most common in the first three months; also called spontaneous abortion • Stillbirth – the loss of a fetus after 20 Weeks of pregnancy; the baby is born dead • About 1/3 of all pregnancies end in the loss of a baby • See p. 146-148 for other complications of pregnancy

13. Monitoring the Baby’s Development • Ultrasound – sound waves bounce off the fetus to produce an image of the fetus inside the womb • Sonogram – the picture of the fetus that ultrasound produces • Chorionic Villus Sampling – test done between Weeks 8 and 12 to detect serious problems with the fetus • Amniocentesis – test done between Weeks 14 and 16 to check for multiple congenital problems • CVS and Amnios are not routine procedures; only done when problems are suspected

14. Decisions Concerning Childbirth • Home vs. hospital delivery • Method of delivery • Natural childbirth – no drugs • Lamaze – breathing techniques • Sedation – drugs administered by IV • Anesthesia – includes Epidural • Leboyer – comfort of baby the focus

15. The Last Weeks of Pregnancy • Labor – the process that moves the baby out of the mother’s body • Signs of Labor • Increased adrenaline/energy • Mucous plug in cervix becomes loose (bloody show) • Amniotic sac breaks; may also break after labor has begun • Contractions – the length and strength gradually increases throughout labor; once contractions start, the mother should not eat or drink • False labor – irregular contractions prior to true labor; also called Braxton-Hicks contractions

16. The Last Weeks of Pregnancy • Lightening – the change in the baby’s position; lower in the pelvis, head toward birth canal • Breech – the baby is in butt-first position; 2% of births • Stages of Labor • Dilation/opening of cervix • Delivery of Baby • Delivery of Placenta • See p. 160-162 for complications of delivery

17. The Last Weeks of Pregnancy • Version – the doctor manually rotates the baby’s position • Oxytocin/Pitocin – drugs used to speed up labor by causing contractions to start and/or stregthen • Forceps – curved instrument that fits around baby’s head to ease baby down birth canal during contractions • Vacuum Extraction – a suction is used to gently pull the baby down the birth canal • Cesarean Section – abdomen and uterus are surgically opened and baby removed

18. Hospital Care • Birthing Room – homelike delivery room in hospital; furnished like a bedroom, used for labor, delivery, and recovery • Rooming-in – baby stays in mother’s hospital room as much as possible • Mother and baby home within 24 to 48 hours, unless C-section or other complications • Nurses on duty in the nursery at all times • Some restrictions on visitors, including young children, brothers and sisters

19. Postpartum Care • Postpartum care – the care the mother receives during the six to eight weeks after delivery • Eat a nutritious diet, especially if breastfeeding • Rest • Slowly get back into exercise • Use support system • Postpartum Mood Disorders • Baby Blues – mild; 40-85% of all deliveries • Postpartum Depression – 10-15% of all deliveries; 26-32% in teens • Postpartum Psychosis – 0.1% of all deliveries; severe mental illness