Pregnancy and Childbirth

1. Pregnancy and Childbirth • Review Embryo Development • Changes to mother during Pregnancy • Labor • Childbirth • Lactation and post-natal growth

2. Early embryonic development--summary • Basic body plan laid down • No organs formed • Placenta develops • Very little growth, fetus still tiny

3. From fetus to adult • Fetal “germ layers” destined to become specific adult structures • Overall adult body reflects early fetal form • Guts inside • Brain/spinal cord dorsal midline • Muscles, bones in flesh of outer part of body

4. Fig. 29-5a, part 1, p. 1083

5. Fig. 29-5a, part 2, p. 1083

6. Fig. 29-5b, part 1, p. 1083

7. Fig. 29-5b, part 2, p. 1083

11. Pregnancy--changes in female anatomy • Shift in organs • Bladder, rectum pushed superiorly, squeezed--change in urination, defecation patterns • Stomach compressed--eat more often, less at each meal • Immune response may change appetite to avoid possible poisons for fetus • Postural changes to compensate for anterior weight • Breasts enlarge--first milk production

12. Fig. 29-9a, p. 1090

13. Fig. 29-9c, p. 1090

14. Initiation of Labor Fig. 29-10, p. 1092

15. Birth • Stage 1. Dilation Stage • Ligaments loosen • Cervix dilates • Stage 2. Expulsion • Baby moves through pelvic girdle--head is rotated 90 degrees • Floor of pelvis • Kegel exercises • Perineal support • Avoid ripping or episiotomy • Baby skull--sutures not fused, bones can be slide on top of each other giving pointed look • Stage 3. Placenta. • Detaches and is expulsed within one hour.

16. Birth

17. Hospital Birth Vocabulary • Labor: Period during which pregnant mother experiences contractions and pushing of uterus. Begins with painful contractions that gradually become more frequent from a few minutes to a few seconds. During labor, the cervix dilates, eventually reaching about 10 cm. Once dilated, contractions change character to a pushing sensation as movement of baby through pelvic canal begins • Perineum: region between vagina and anus • Episiotomy: Deliberate cut into perineal region to expand vaginal opening. Many progressive birth attendants now believe this should be avoided. Some obstreticians do it reguarly • Epidural: Anaesthetic applied directly to lumbar spinal cord with an inserted needle. Deadens pain to pelvic region while leaving muscular ability to contract active. Can be done during labor to decrease pain. • Induction: Process of imitating labor artificially. • Water breaking/rupturing of membranes. Tearing of amniotic sac to release amniotic fluid inside. This is sometimes done as a way to try and induce labor. • Pitocin/oxytocin: hormone released by mother’s pituitary and also fetus to initiate labor and birth process. Sometimes injected to induce labor. Often injected after birth to insure complete expulsion of placenta. • Apgar score: Quick assessment of baby’s responsiveness immediately after birth • Silver nitrate: Eye-drop antibiotic given to most newborns to prevent infection of eye and surrounding tissues with bacteria that could cause blindness or vision problems. • Meconium: First stool from feces present in baby at birth accumulated from cellular breakdown, especially Hb during pregnancy.

19. Lactation and milk letdown Fig. 29-12, p. 1095

20. Advantages of breast-feeding for baby • It's natural and of suitable temprature. Containing all the nutrients needed by the baby in the ideal concentrations for digestion and absorbtion. • Breast milk have antimicrobial properties as it contains antibodies, cells (as lymphocytes), lyzozymess and antiviral substances like interferone. • It's safer than animal milk as it doesn't cause gastroenteritis and can prevent inflammatory bowel disease (IBS). • Reduced risk of respiratory diseases and diarrhea. • It's protein is very easy to be digested. • Doesn't cause allergy and can reduce the incidence of atopy. • Contains long chain polyunsaturated fatty acids, which are essential for the development of both the retina and the nervous system of the newborn. • Low salt content (safer on the kineys). • Reduces the risk of diabetes mellitus. • Breastfeeding builds a strong bond between the baby and the mother.

21. Advantages of breast-feeding for mother • Breast milk is also beneficial for the mother as it helps better involution of the uterus. Suckling stimulates the secretion of oxytocin, the hormone responsible for uterine invlution. • It's the cheapest milk and it needs no effort in preparing. • Cancer breast and ovarian cancers are less in breastfeeding moms. • Breastfeeding is a natural contraceptive way. • Breastfeeding also has a great psychological effect and emotional satisfaction for both the mother and the baby, it gives the mother a sense of confidence in herself that she is capable of feeding and taking care of her beloved one.

22. Fig. 29-13, p. 1096