chapter 3: prenatal development and birth ©2009 the mcgraw-hill companies, inc. all rights...
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CHAPTER 3: PRENATAL DEVELOPMENT AND BIRTH
©2009 The McGraw-Hill Companies, Inc. All rights reserved.
Life-Span DevelopmentTwelfth Edition
Prenatal Development
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Conception occurs when a single sperm cell from the male unites with an ovum (egg)
Prenatal development is divided into 3 periods and lasts approximately 266-280 days:
Germinal period: first 2 weeks after conception, zygote created
Embryonic period: occurs from 2 to 8 weeks after conception
Fetal period: begins 2 months after conception and lasts until birth
Prenatal Development
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Germinal Period: period of development that takes place the first two weeks after conception Rapid cell division by the zygote Blastocyst: group of cells after about 1 week Trophoblast: outer layer of cells that later provides
nutrition and support for the embryo Implantation: attachment of the zygote to the uterine
wall; occurs 10 to 14 days after conception
Prenatal Development
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Prenatal Development
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Embryonic Period: development from 2 to 8 weeks after conception Begins when blastocyst attaches to uterine wall Mass of cells is now called an embryo Three layers of cells: endoderm, mesoderm, and ectoderm Amnion: a bag that contains a clear fluid (amniotic fluid)
in which the embryo floats Umbilical Cord: connects the baby to the placenta Placenta: group of tissues containing mother and baby’s
intertwined blood vessels Organogenesis: process of organ formation during the first
two months of prenatal development
Prenatal Development
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Prenatal Development
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Fetal Period: development from two months after conception to birth Rapid growth and change Viability: the age at which a fetus has a chance of
surviving outside the womb Currently 24 weeks; changes with advances in medical
technology
Prenatal Development
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The Brain: Babies have approximately 100 billion neurons (nerve
cells) at birth Architecture of the brain takes shape during the first two
trimesters Increases in connectivity and functioning occur from the
third trimester to 2 years of age Neural tube develops 18 to 24 days after conception
Anencephaly Spina bifida
Prenatal Development
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The Brain: Neurogenesis: the generation of new neurons
Begins at fifth prenatal week and continues throughout prenatal period
Neuronal migration: cells move outward from their point of origin to their appropriate locations Occurs approximately 6 to 24 weeks after conception
Hazards to Prenatal Development
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Teratogen: any agent that can cause a birth defect or negatively alter cognitive and behavioral outcomes Drugs (prescription, nonprescription) Incompatible blood types Environmental pollutants Infectious diseases Nutritional deficiencies Maternal stress Advanced age of parent
Hazards to Prenatal Development
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Severity of damage to the unborn depends on: Dose Genetic susceptibility Time of exposure
Critical period: a fixed time period during which certain experiences or events can have a long-lasting effect on development
Hazards to Prenatal Development
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Hazards to Prenatal Development
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Prescription and Non-prescription Drugs: Many women are given drugs while pregnant
Some are safe; some can cause devastating birth defects Known prescription teratogens include antibiotics,
some antidepressants, some hormones, and Accutane Non-prescription teratogens include aspirin and diet
pills
Hazards to Prenatal Development
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Psychoactive Drugs: drugs that act on the nervous system to alter states of consciousness, modify perceptions, and change moods Includes caffeine, alcohol, nicotine
Caffeine: small risk of miscarriage and low birth weight for those
consuming more than 150 mg. daily Increased risk of fetal death for those consuming more
than 300 mg. daily FDA recommends not consuming caffeine or consuming it
sparingly
Hazards to Prenatal Development
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Alcohol: Fetal alcohol syndrome: abnormalities in newborn due to
mother’s heavy use of alcohol in pregnancy Facial deformities Defective limbs, face, heart Most have below-average intelligence; some are mentally retarded
Even light to moderate drinking during pregnancy has been associated with negative effects on the fetus
FDA recommends no alcohol consumption during pregnancy
Hazards to Prenatal Development
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Nicotine: Maternal smoking can negatively influence prenatal
development, birth, and postnatal development Associated with:
Preterm births and low birth weight Fetal and neonatal death Respiratory problems SIDS (sudden infant death syndrome) ADHD (attention deficit hyperactivity disorder)
Hazards to Prenatal Development
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Illegal drugs that harm during pregnancy: Cocaine Methamphetamine Marijuana Heroin
Incompatible blood types (Rh factor) Can cause mother’s immune system to produce
antibodies that will attack the fetus
Hazards to Prenatal Development
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Environmental hazards: Radiation Environmental pollutants and toxic wastes
Maternal Diseases: Sexually transmitted diseases (syphilis, genital herpes,
AIDS) Rubella Diabetes
Hazards to Prenatal Development
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Maternal factors:Maternal diet and nutritionMaternal ageEmotional states and stress
Paternal factors: Exposure to teratogens Paternal age
Prenatal Care
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Prenatal care typically includes: Screening for manageable conditions and treatable
diseases Medical care Educational, social, and nutritional services
Centering Pregnancy: relationship-centered program
Importance of prenatal care
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20
0
30
40
50
60
70
80
90
100
10
20041990
Percentage
Non-Latino White women
African American
womenLatino women
Percentage of U.S. Women Using Timely Prenatal Care: 1990 to 2004
The Birth Process
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Three stages of birth: Stage 1: uterine contractions begin at 15 to 20 minutes
apart and last up to 1 minute, becoming closer and more intense with time Causes the cervix to stretch and open to about 10 cm This stage lasts an average of 12 to 14 hours
Stage 2: baby’s head begins to move through dilated cervix opening and eventually emerges from the mother’s body This stage lasts approximately 45 minutes
Stage 3: umbilical cord, placenta, and other membranes are detached and expelled (afterbirth)
The Birth Process
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Childbirth Setting and Attendants: 99% of deliveries take place in hospitals Home delivery or freestanding birth center Compared to doctors, midwives:
Typically spend more time than doctors counseling and educating patients
Provide more emotional support Are typically present during the entire labor and delivery process
Doulas provide continuous physical, emotional, and educational support for mother before, during, and after childbirth
Methods of Childbirth
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Key choices involve use of medication and when to have a cesarean delivery
Typical pain medication: Analgesia: pain relief Anesthesia: blocks sensation in an area of the body
(can also block consciousness) Epidural block
Oxytocics: synthetic hormones used to stimulate contractions
Methods of Childbirth
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Natural childbirth: aims to reduce pain by decreasing fear and using breathing/relaxation techniques
Prepared childbirth (Lamaze): special breathing techniques; education about anatomy and physiology Basic belief is that, when information and support are
provided, women know how to give birth
Methods of Childbirth
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Other natural techniques used to reduce pain: Waterbirth: giving birth in a tub of warm water Massage Acupuncture: insertion of very fine needles into
specific locations in the body Hypnosis: the induction of a psychological state of
altered attention and awareness Music therapy: utilizes music to reduce stress and
manage pain
Methods of Childbirth
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Cesarean Delivery: the baby is removed from the mother’s uterus through an incision made in the abdomen Often used if baby is in breech position or other
complications arise Cesareans involve a higher infection rate, longer hospital
stays, and a longer recovery time Rate of cesarean births has increased dramatically in
recent years Better identification of complications Increase in overweight and obese mothers Extra caution by doctors to avoid lawsuits
Transition from Fetus to Newborn
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Birth process is stressful for baby Anoxia: a condition in which the fetus has an insufficient
supply of oxygen Baby secretes adrenaline and noradrenalin, hormones that
are secreted in stressful circumstancesMeasuring neonatal health and responsiveness:
Apgar Scale: assessed at 1 minute and 5 minutes after birth evaluates heart rate, body color, muscle tone, respiratory effort,
and reflex irritability 10 is highest, 3 or below indicates an emergency
Transition from Fetus to Newborn
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Transition from Fetus to Newborn
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Measuring neonatal health and responsiveness: Brazelton Neonatal Behavioral Assessment Scale
(NBAS): Typically performed within 24–36 hours after birth Assesses newborn’s neurological development, reflexes, and
reactions to people and objects Low scores can indicate brain damage or other difficulties
Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS): Provides a more comprehensive analysis of newborn’s behavior,
neurological and stress responses, and regulatory capacities Assesses the “at-risk” infant
Preterm and Low Birth Weight Infants
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Preterm and Small-for-Date Infants: Low birth weight infants weigh less than 5 ½ lbs. at birth Preterm infants are those born three weeks or more before full
term Small-for-date infants are those whose birth weight is below
normal when the length of the pregnancy is consideredRate of preterm births has increased
Number of births to mothers 35 years and older Rates of multiple births Management of maternal and fetal conditions Substance abuse Stress
Preterm and Low Birth Weight Infants
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Causes of low birth weight: Poor health and nutrition Cigarette smoking Adolescent births Use of drugs Multiple births/reproductive technology Improved technology and prenatal care
Preterm and Low Birth Weight Infants
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Possible consequences: Language development delays Lower IQ scores Brain injury Lung or liver diseases More behavioral problems Learning disabilities ADHD Breathing problems (asthma) Approximately 50% are enrolled in special education
programs
Preterm and Low Birth Weight Infants
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Some effects can be improved with: Early speech therapy Intensive enrichment programs Kangaroo care, massage therapy, and breast feeding
Kangaroo Care: treatment for preterm infants that involves skin to skin contact
Massage: research conducted by Tiffany Field
Preterm and Low Birth Weight Infants
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The Postpartum Period
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Postpartum period lasts about six weeks or until the mother’s body has completed its adjustment and has returned to a nearly pre-pregnant state
Physical Adjustments: Fatigue Hormone changes Return to menstruation Involution: process by which the uterus returns to its pre-
pregnant size 5–6 weeks after birth Weight loss/return to exercise
The Postpartum Period
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Emotional and Psychological Adjustments: Emotional fluctuations are common “Baby Blues” experienced by 70% of new mothers in the
U.S. Typically resolves in 1–2 weeks, without treatment
Postpartum Depression Excessive sadness, anxiety, and despair that lasts for two weeks or
longer Experienced by 10% of new mothers Hormonal changes after birth may play a role May affect mother–child interactions
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Postpartum blues: symptoms appear 2 to 3 days after delivery and subside within 1 to 2 weeks
No symptoms
10%
70%
20%
Postpartum depression: symptoms linger for weeks or months and interfere with daily functioning
Percentage of U.S. Women Who Experience Postpartum Blues and Postpartum Depression
The Postpartum Period
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A Father’s Adjustment: Many fathers feel that the baby gets all of the
mother’s attention Parents should set aside time to be together Father’s reaction is improved if he has taken
childbirth classes and is an active participant in the baby’s care
Bonding
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Bonding: the formation of a connection, especially a physical bond, between parents and the newborn in the period shortly after birth Isolation of premature babies and use of drugs in birth
process may harm bonding process Bonding may be a critical component in the child’s
development However, close contact in the first few days may not be necessary
Most hospitals offer a rooming-in arrangement while mother and child are in the hospital