Prenatal Care Labor and Delivery

1. Prenatal CareLabor and Delivery Mr. Van Saders Mr. Keith

2. Teen Pregnancy • Misconceived Ideas corrected: • Girl can get pregnant during her __________ _______(period) • Girl (can – can not) get pregnant while having sexual intercourse standing or in a hot tub • _____ can break during protected sexual intercourse. • Woman can get pregnant while breast _______ • Douching (will – will not) prevent pregnancy • Babies born to teenagers are ____ times more at risk to die in the first year (crib death, etc) • Risk of maternal death (mother dies) during pregnancy, birth, post delivery are ____ greater for teenagers

3. Fertilization Process • Human reproduction usually begins with the physical act of sexual intercourse. How is this different from 100 years ago? • Spontaneous generation just magically happened • Homunculus man plants a perfect tiny human being inside the woman. • ______ century it was scientifically verified the part sexual intercourse plays in human reproduction - combination of both the male and female genetics. • ______ hugging, kissing, caressing to get the person sexually aroused - the male gets an erection and the female vagina lengthens, widens & moistens, Scene's Glands & Bartholin's Glands • ________ when the man reaches orgasm he ejaculates up to 500 million sperm inside the woman, usually around the cervix. • Within hours many sperm make their way into the woman’s body with only a few ______ make their way into the fallopian tubes. • The female does not have an ejaculation, she may experience orgasm but not necessarily at the same time as the male. She does not release an ____ cell when she has an orgasm but she may become moist. • If no egg is present in the fallopian tubes the sperm will _____ in a few days. • If an egg is present in the _________ ______ fertilization may take place.

4. Fertilization Process • Sperm surround the egg – releasing _______ to break down the protective cells surrounding the mature egg. • Only the ______ of one sperm enters the egg. No other sperm may enter because the egg cell outer ________ changes sealing out all other sperm. • The two nuclei combine – 23 chromosomes from the male and 23 from the woman combine to form __ pairs of chromosomes. • Chromosomes are small thread-like structures in the nucleus of the cell that are made up of ______, carriers of hereditary traits, that determine which traits we inherit from our parents. • Sex of the child: • Egg has a ______ chromosome pattern gene • Sperm has a ______ or ______ chromosome pattern gene • ______ chromosome pattern will be a girl • XY chromosome pattern will be a ________ • The _________ determines the sex of the child

5. Development of a Human Being • With in the first 36 hours the fertilized egg (zygote) cleaves (divides) forming two identical connected cells, 4 cells, 8 cells, 16 cells, until a hollow ball of cells is formed (blastula). Once the blastula is implanted in the uterus (1 to 2 weeks) it is called an embryo. This cleaving process will continue for the next 9 months. • Super Structures: • ______: looks like the yellow part in an egg – it provides nourishment for the embryo until the placenta is developed. • ______holds the embryo to the _______ ____ and becomes the umbilical cord • ___________ cord – rope like structure –width of your thumb, 14 to 36 inches long, & all nourishment and waste pass through this structure. It has no _________. • Placenta – network of _______ ______ and other tissues which is attached to the wall of the uterus. It serves as a ________ point for all nourishment & waste. The blood of the mother and the fetus never _________ . The blood vessels grow side by side & are not _______. Blood type of the fetus can be _________ from that of the mother.

6. Development of a Human Being - Terms • Super Structures: • Placenta – there is a space between mother and fetuses blood systems. ________ & ________ diffuses across this space. • _______ Sac: fluid filled membrane that surrounds the growing embryo and fetus. Called the bag of water. Functions: controls temperature, provides room to grow and move, and protects the fetus from injury. • __________: a fertilized egg (ovum) • _________: A hollow ball a cells that divides as it travels to the uterus. It gets its nourishment from the blood enriched walls of the womb. • _____________: implanted blastocyst in the uterus • _______ :from the 10th week until the birth and now looks like a tiny human being.

7. Development of a Human Being • 1st month; ¼th inch,1/1000th oz. heart, lungs & spinal cord are forming. Heart beats on the ____ day. • 2nd month: 1/30th oz, 1 to 1 &1/2 inches, limbs, eyes, milk teeth, ____ divisions of the ______, skin, all organs developing. • 3rd month: 1 oz and ___ inches in length, fingers, toes, open & close mouth, heart fully formed, movement can be felt, called a fetus • 4th month: 6 oz, _ inches, lanugo (______) forms over the body, swallowing and sucking reflexes, ___ identifiable, grab with hands, amniocentesis. • 5th month: 1 lb, 8 to10 inches, nails, scalp hair, heart =beat can be _____ with a stethoscope, skin is translucent. • 6th month: 12 inches, 2 lbs, kicks, _________ & ________, covered with vernix, mother can feel the fetus move freely. • 7th month:3 lbs, 14 to 16 inches, fat layer forms, hiccup, cry, and suck thumb, eyes are open, _________produced to prepare the lungs to breathe • 8th month: 18 inches, 5 lbs, extensive ________ growth, hair, kidneys mature. All internal organs are _________ development. • 9th month; 18 to 22 inches, 6 to 9 lbs,, lungs are mature, ____ _____ have developed enough to ___________ on their own, very little _________ fluid, maternal ________ are transferred to the fetus to fight disease and infection.

8. Changes in the mother • 1st month: no weight gain, _________ ______ ______, produces __ __ __ menstrual cycle _______, breasts become tender and may swell, ________ sickness – _________ system slows down, ________ change, good to exercise, stop drinking alcohol, smoking and taking drugs. Check with her doctor for common ailments and medications. • 2nd month: _____ weight gain, urinates more frequently, same as 1st month • 3rd month: 2 to 3 lbs, _________ of blood volume 30% to 40%. • 4th month: 3 to 4 lbs, total 5 to 7 lbs, increase _______ _______, itchiness • 5th month: 3 to 4 lbs, total 8 to 11 lbs, ______________ – produced to prepare for nursing, • 6th month; 3 to 4 lbs, total 11 to 15 lbs, nipples ________ as they come closer to the surface, _______ blood pressure & ______ ______bleeds . • 7th month: 3 to 4 lbs, total 14 to 19 lbs, may feel fetal ________ – hiccups, muscle cramps – legs, heart burn and indigestion. • 8th month: 3 to 5 lbs, total 17 to 24 lbs, ________ _______, constipation, & _______________ • 9th month: 3 to 6 lbs, total 20 to 30 lbs, urinates frequently, muscle fatigue, • Pituitary Gland produces __________ that starts the uterine ___________.

9. 3 Stages of Labor • 1st Stage • Phase 1 – ________ – contractions approximately hour apart and gradually quicken • Water breaks – ________ sac breaks • Phase 2 – _______ cervix is stretched apart 8-10 centimeters • 2nd Stage – _________ • Forceful contractions, 2-3 minutes apart • Episiotomy – incision made from vagina to anus to enlarge opening for baby • Baby is being born • 3rd Stage ____________ • Labor begins again and the remains of __________ _______ & __________ are forced out of body • Stitch mother up • Conditions that have aided birth process: • The vagina (birth canal) is extremely __________. • Ligaments (connects bone to bone) in the mothers pelvis ________. • The bones in the babies head have _______ ________ together and compress slightly • The baby breathes through the __________ ________ until it is born.

10. Changes & Things Done to Baby at Birth • Nasal and throat passages ________ once the head has cleared the mothers body • Umbilical cord is _____ and ______a few inches from the babies body and in 5 to 10 days will fall off forming the _______. • Give baby physical (_______ Test) Check: color, respiration, heart rate, etc. • Clean baby and put on an __________ ______. • Take footprints – 3 copies: permanent records, hospital and home copy • Place ________ in eyes and on body • Placed in recovery room to monitor pulse, temp, HR, respiration • Weigh and measure • Put in nursery • At first the baby will _________ weight – must rely on its own organs for __________ and __________. • It will take 6 to 8 weeks for the mothers _______ and _________ ______ to return to normal. • __________ is its’ most important way of communication: there are different types of cries: hungry, hurt, TLC etc. • The sex organ may be ________ when a baby boy is first born. • Eyes may __________ color over time

11. Types of Deliveries • Head First Birth (__________) Presentation) normal face down birth, umbilical cord goes past the hips and legs. • Spontaneous Abortion (miscarriage) The fetus is forced out of the mothers body before it is developed enough to ________. • _____ of the zygotes do not become implanted into the uterus • Many different reasons: drugs, genetics, previous miscarriages, accident, placenta detaches or umbilical cord collapse, disease, etc • 1 out of __ couples have trouble with pregnancy • Premature Birth: Born _______ full term, often multiple births • Still Birth: Baby is delivered _______ • Reasons: genetics, oxygen cut off, disease, drugs, etc. • Breech Birth: _____ ____ or buttocks first birth – the head comes out ______. Problem is not enough room & it could get stuck, blood supply in the umbilical cord becomes cut off or it become wrapped around the neck tangled • Caesarian: The fetus is _______ removed from womb – doctor make a ____ inch surgical cut through the skin, abdomen and _______ _____. It take about 5 to 10 minutes for the baby to be born and 20 minutes to an hour to stitch her back up again. It is _______ surgery and has a higher risk of infection and complications. • Reasons for a C-Section: baby is to big or pelvic girdle too small, baby is breech, mother is sick, mother has disease (AIDS, herpes – 30% increase, etc.), long – tough labor, addiction to drugs, mother has accident

12. Multiple Births • Fraternal Twins • Each has own amniotic sac, umbilical cord, placenta 0 0 • ____ eggs and ___ sperm – diff genetic material 00 00 • Identical Twins 1 2 • __ egg and __ sperm cleaves and separates forming 2 ________ zygotes • Same _________, genes, everything physical is the same 0 • Each has its’ own umbilical cord, amniotic sac, _______ may or may 0 0 not be shared. 00 00 • Fraternal Triplets 1 2 __eggs fertilized by _ different sperm, each has its own amniotic 0 0 0 umbilical cord, and placenta. They each have their own genetic 00 00 00 material 1 2 3 • Combination Triplet • _eggs, _ sperm, 1 develops ________the other zygote 0 0 forms an _______ twin. 2 must look alike the other is a 00 0 0 a fraternal zygote. 1 00 00 • Identical Triplets 2 3 • _ egg cell, _ sperm cell, during cell division it separates forming 0 an identical ________. One of those zygotes develops normally 0 0 and the other separates again. Each has its own umbilical cord 00 0 0 and amniotic sac and must look alike. 1 00 00 • Siamese Twin (Conjoined Twins)– share common body part 2 3

13. Pregnancy Terms to Know • Tests during pregnancy • Sonogram – (___________) uses sound waves to determine size and position of fetus • Amniocentesis – small amount of ________ ______ is drawn to check for defects (genetic diseases) • Miscarriage • Loss of fetus before it is _______ __ ______. • 1 in ______pregnancies result in miscarriage • 60 % of first pregnancies • Ectopic Pregnancy • Implantation of a fertilized egg in the ________ ______ • Medical emergency – death of mother (hemorrhage)

14. Birthing Techniques • Lamaze • Most common taught • Controlled _________ techniques to cope with labor • The Bradley Method • ___________ Child Birth • Drug/ Substance Free • Tuning into own body

15. Dangers to Fetus • Alcohol – ________ _______ _______ (FAS) • List Risks • Tobacco • premature or low _______ ______ • Mothers more likely to ________/_________ • Dangers b/c of second hand smoke • Medications and Drugs • Birth ________ and mental retardation • Physical dependency - __________ • Caffeine – risk of birth _________ and other problems • Rubella – birth defects before third month • STD’s • HIV - all mothers are _______ along with doctor’s pregnancy test • passed to fetus _____ - ______ of time • Blood during labor – episiotomy/ c-section • Treatment to reduce risk • Radiation – direct exposure can result in deformity • Dental x-rays not to worry • Other – use radiation shield

16. Breastfeeding - La Leche League • Breastfeeding Benefits – Baby • Low Cost • Gastrointestinal problems, respiratory problems, ear infections, protect from Developing Allergies, boost intelligence • May protect against obesity, Leukemia, type I diabetes, High Blood Pressure, SIDS, osteoporosis • Benefits to the Mother • NO sterilizing bottles, formula to buy or mix • Nursing burns calories – mother looses weight sooner • Stimulates uterus to contact to original size • Encourages mother to rest