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ObjectivesBefore class begins, write the objectiveson the board. Have students copy theobjectives into their notebooks at thestart of class.

Ask students to share their do’s anddon’ts for pregnant women. Listthem on the board. Refer back to this list throughout the section, correcting any misconceptions thatstudents might have had.

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1. Focus

Warm-Up Myth/Fact

A HealthyPregnancy

492 Chapter 19

Section 2

Objectives� Identify four behaviors

that are essential for ahealthy pregnancy.

� Explain the importanceof prenatal carethroughout pregnancy.

Vocabulary• prenatal care• obstetrician• trimester• ultrasound• chorionic villus sampling• amniocentesis • ectopic pregnancy• miscarriage• preeclampsia• gestational diabetes

Staying Healthy During PregnancyAmanda starts her day with a bowl of oatmeal. Later, she and her hus-band go out for a brisk walk. At night, she skips a party where people willbe smoking.

Amanda and her husband are thinking about having a baby. Evenbefore she becomes pregnant, Amanda started taking extra care to have ahealthy pregnancy. Getting proper nutrition and exercise and avoidingdrugs and environmental hazards are especially important both beforeand throughout pregnancy.

Proper Nutrition “Now you’re eating for two,” people sometimessay to pregnant women. This is because a pregnant woman needs to eatmore calories to support the growth of her own body and the developingembryo or fetus. During pregnancy, a woman needs to consume about300 more calories than usual. The best way to obtain these extra caloriesis to eat a well-balanced diet rich in the key nutrients listed in Figure 4.

One vitamin that is especially important during pregnancy is folicacid, or folate. Folic acid is essential for proper development of anembryo’s neural tube, which later develops into the spinal cord and brain.The neural tube forms early in an embryo’s development, often before awoman knows she is pregnant. Therefore, a woman should not wait untilshe knows she is pregnant to get enough folic acid. Doctors recommendthat all women of childbearing age consume at least 0.4 mg (400 micro-grams) of folic acid every day.

A Healthy Pregnancy

Myth A pregnant woman doesn’tneed to visit the doctor until shebegins to show, or look pregnant.

Fact Regular doctor visits from thebeginning of pregnancy until the birthare recommended to ensure health.

List some other do’s anddon’ts for pregnant women. Review andupdate your list when you complete thissection.

Doctor’s Appt.

10:00 AM

FYI !FYI !Changes During PregnancyAlmost every organ and system in a woman’sbody is affected by pregnancy. The mostimportant changes occur in the reproduc-tive system. Ovulation and menstruationcease. The muscular walls of the uterus getstronger and more elastic. The cervix pro-duces a mucus plug that prevents bacteriafrom entering the uterus.

A pregnant woman also experiencesphysiological changes that allow sufficientblood and oxygen to reach the growingembryo. Her heart beats slightly faster, andthe volume of blood circulating in her bodyincreases. The amount of oxygen her bodyuses increases by 15 to 20 percent.

Sensitive Issues Discussing prenatal care may be dis-tressing to girls in your class who arepregnant, have been pregnant, orthink they could be pregnant. Boyswho are fathers, or think they couldbe fathers, might also be concerned.Be aware of any student who is moreself-conscious than usual. Take carenot to draw attention to this student.Focus only on prenatal care from theperspective of a married couple, butdo make yourself discreetly availableto answer questions.

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Less Proficient Readers After students read about the four behav-iors that are essential for a healthy preg-nancy, have them create a word web thatsummarizes the reading. Suggest that stu-dents use the title of the subsection,Staying Healthy During Pregnancy, in the

center circle of the web. Students can usethe run-in headings to name the behaviorsthat branch from the center circle. Finally,students should add details in circles thatare attached to each behavior.

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Adapted Reading/Note Taking 19-2

Staying Healthy During Pregnancy

Active LearningExplain that pregnant women can par-ticipate in many forms of exercise, butare cautioned against participating inothers. Have students work in smallgroups to prepare an informationalbrochure about exercise for pregnantwomen. The brochure should help thewomen distinguish forms of exercisethat are not appropriate from formsthat are highly recommended. Studentsshould divide up the task of collectingdata. Some can search reliable Websites. Others can interview an obstetri-cian and a fitness instructor who workswith pregnant women.

Visual Learning: Figure 4 Review the nutrients listed in Figure 4.Discuss food sources of these vitaminsand minerals. If necessary, refer studentsto the charts in Chapter 8, Section 2.Explain that pregnant women are routinely given vitamin supplements aspart of their prenatal care. Ask: Whyshould women who are consideringpregnancy get adequate amounts ofthese nutrients? (Critical embryonicdevelopment has already occurredbefore a woman realizes that she ispregnant.) Caption Answer folic acid, calcium, vitamin B complex

Sample answer: proper nutri-tion, exercise, and avoiding

alcohol and other drugs

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FIGURE 4 Proper nutritioncontributes to the healthydevelopment of a baby. Reading Tables Name threenutrients that play a role in the development of thenervous system.

Nutrient Needed For

Folic acid Formation of neural tube; brain and spinal cord development

Protein Muscle formation and growth

Calcium Bone and tooth formation; nerve and muscle development

Iron Oxygen delivery by blood cells

Vitamin A Cell and bone growth; eye development

Vitamin B Nervous systemcomplex development

Important During PregnancyNutrients

Exercise Regular physical activity is also important for a healthy preg-nancy. A fit woman will better meet the extra energy demands of carryingthe fetus. She also reduces her risk for diabetes and other health problemsduring pregnancy. A woman should get her doctor’s approval for her exer-cise program. Some forms of exercise should be avoided—for example,horseback riding, where there is a high risk of falling.

Avoiding Alcohol and Other Drugs As soon as she plans tobecome pregnant, a woman should abstain from all alcohol, tobacco, andany other drugs not prescribed or approved by her doctor. These sub-stances, even in small amounts, can harm or kill the developing baby,decrease the newborn’s chance to live, or cause lifelong problems. Forexample, women who drink alcohol during pregnancy risk having a babywith fetal alcohol syndrome. As you read in Chapter 15, symptoms of fetalalcohol syndrome may include mental retardation, minor to severe heartdefects, and delayed growth.

Some drugs that are typically safe outside of pregnancy can causeharm to a fetus. A pregnant woman should talk to her doctor before usingany prescription drugs or over-the-counter drugs, such as pain medica-tions; creams and lotions; and vitamins. Likewise, a woman should gether doctor’s approval before using herbal teas or herbal supplements.

Which recommendations for pregnant women arealso good everyday advice for yourself?

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Chapter 19, Section 2

Building Health SkillsAdvocacy Have students write an e-mailto an imaginary older cousin or sisterwho is newly pregnant. In their e-mails,students should describe one environ-mental hazard their cousin or sistermight inadvertently come into contactwith. Students should explain how thissubstance or organism can harm thegrowing embryo and advocate foravoiding it.

Prenatal Care

Building VocabularyPoint out the meanings of the Latinroots of the word trimester. Tri- means“three;” mensis means “month.” Askstudents to list and define other wordsbeginning with the prefix tri-. (Triangle,a figure with three angles; trilogy, astory with three parts; triplets, threebabies born at the same time.) Then ask students to think of words that usethe Latin root word mensis. (Semester,originally a school term of six months;menstruation, bleeding that occurs eachmonth in fertile women)

Cooperative LearningExplain to students that during visits toher doctor, a pregnant woman has anopportunity to ask questions about herpregnancy, as well as how to care forher baby after it is born. Have studentgroups produce a list of questions thata woman might ask her doctor during aprenatal visit. Then ask groups to sharetheir questions with the class.

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• Record medical history and weight • Note conditions that could affect the pregnancy

• Prescribe prenatal vitamins as needed

TrimesterFirst• Monitor heartbeat of fetus• Measure growth of uterus

• Monitor for complications using ultrasound and other tools

TrimesterSecond

Avoiding Environmental Hazards Some common substancesfound in the environment, including many chemicals and disease-causing organisms, can seriously harm a fetus. Pregnant women shouldtake care to avoid exposure to these substances.

� X-rays The radiation from X-rays can harm a developing embryo orfetus. This is why doctors and dentists ask women if they could pos-sibly be pregnant before taking an X-ray.

� Lead The main source of exposure to lead is from lead-based paintpresent in older homes. If a pregnant woman lives in a home builtbefore 1978, she should contact her state health department for infor-mation on getting her home tested for lead.

� Mercury Most exposure to this dangerous metal comes from eatingcontaminated fish. Pregnant women should eat commercially caughtfish only once a week, and should not eat swordfish or shark.

� Cat litter Cat feces can contain a parasite that is especially dangerousto a developing fetus. Pregnant women should avoid contacting soiledcat litter or garden soil.

Prenatal CareBesides taking care of herself at home, a woman also needs to plan for

or medical care during her pregnancy. Her doctor visitsshould be under the supervision of an a doctor specializedin pregnancy and childbirth. The chances of having a healthy babygreatly increase if the mother visits her doctor or clinic for regularcheckups throughout pregnancy.

The Three Trimesters A pregnancy is divided into three periodsof time— —each of which is approximately three months long.Figure 5 lists things the parents-to-be can expect at routine visits.

trimesters

obstetrician,prenatal care,

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FIGURE 5 A doctor monitors thehealth of the mother-to-be and herfetus during regular prenatal visits.

and HealthSummary

Have students write a summary about howto stay healthy during pregnancy. Studentsshould base their summaries on the fourbehaviors that are essential for a healthypregnancy described in the section.

L2Summaries should clearly differentiatebetween behaviors that should be practicedand behaviors that should be avoided.Challenge students to limit their summariesto one or two paragraphs.

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English Language Learners The terms that describe the monitoring toolsused during pregnancy and the possiblecomplications of pregnancy might be diffi-cult for students to say and comprehend.Work with students to create a notebookor bulletin board display of these terms.Include pictures or diagrams for terms that

lend themselves to visuals (such as ultra-sound and amniocentesis). Also includephonetic spellings and simple definitions.Have students practice saying the terms bypairing them with students who can pro-nounce the terms correctly.

EL

Visual Learning: Figure 5Use the charts in Figure 5 showing typicalevents during prenatal checkups tobegin a discussion on the importance ofprenatal care. Ask: What kinds of issuesare addressed by the doctor during thefirst trimester? (preparing for futurechanges during the pregnancy, helpingthe mother change her behaviors toensure a healthy baby) What is thefocus of prenatal care during the secondtrimester? (the health of the motherand the developing fetus and the presence of complications) The thirdtrimester? (getting ready for deliveryand monitoring the fetus and motherfor any health issues) Explain thatfathers are encouraged to accompanythe mother during prenatal visits to givesupport, share in the joy of monitoringthe growth of the fetus, and help makedecisions about complications thatmight arise.

Active LearningShare pictures of ultrasound images ofyour own children or those of fellowteachers, friends, or family. Pass aroundthe photos, or alternatively, make theminto slides to project, and have studentsname any structures they can identify.Point out that internal structures, suchas the brain, heart, stomach, and skele-ton, are also imaged by ultrasound andmay be visible in your pictures. Helpstudents locate any internal parts thatshow up in your pictures. Remind stu-dents that ultrasound is a very useful,low-risk tool for doctors to check on thehealth of a fetus.

Building Health SkillsMaking Decisions Explain that it is possible for parents to learn the sex oftheir baby during pregnancy. Discussthe advantages and disadvantages oflearning this information. Then ask students to write a paragraph explainingwhether or not they would want toknow the baby’s sex if they had tomake this decision.

Recognizable features includearms, legs, head, eyes, fin-

gers, and toes.

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L2Monitoring Tools Prenatal care gives a pregnant woman access tothe latest medical tests and technologies.

� Ultrasound Did you know that your first pictures may have beentaken months before you were born? High-frequency sound waves,or are used in most pregnancies to create an image ofthe developing fetus. Ultrasound may be used at any point duringpregnancy, although it is typically used in the sixteenth to twentiethweek. Using ultrasound, a doctor can tell the age of the fetus, whetherit is a boy or girl, and if the heart, muscles, and bones are developingnormally. Ultrasound may also detect the presence of more than onefetus or confirm the position of the fetus in the uterus.

� Chorionic Villus Sampling Around the eighth week of pregnancy,some women will undergo a test called or CVS. To perform the test, the doctor removes and tests a smallpiece of the developing placenta. CVS can detect inherited disordersin the embryo such as hemophilia or extra chromosomes. The test isonly done when risk factors are present, such as a family history ofgenetic disorders or when the mother is over the age of 35. An oldermother has an increased risk of having a baby with Down syndromeor other chromosomal abnormalities.

� Amniocentesis Another test that may be done around the fourteenthto sixteenth week of pregnancy is (am nee oh sen TEE

sis). The procedure involves inserting a needle into the woman’sabdomen and uterus to remove a small amount of amniotic fluid sur-rounding the fetus. The doctor then tests fetal cells naturally found inthis fluid for abnormalities. Like CVS, amniocentesis is only performedwhen the fetus is at higher risk for a genetic disorder. CVS and amnio-centesis are not routine tests because they slightly increase the risk ofmiscarriage, or death of the fetus.

Have you ever seen an ultrasound picture of a fetus? What features could you recognize?

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amniocentesis

chorionic villus sampling,

ultrasound,

• Check position and size of fetus• Check for warning signs of premature, or early, birth• Continue to monitor for complications• Discuss birth process

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EvaluateThese assignments can help you assessstudents’ mastery of the section content.

Section 2 ReviewAnswers appear below.

Teaching Resources• Practice 19-2• Section 19-2 Quiz

ReteachHave students work in groups to create aposter that describes the four behaviorsthat are essential to a healthy preg-nancy. Students should also add prenataldoctor visits and their importance.

Enrich

Teaching Resources• Enrich 19-2

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Chapter 19, Section 2

Content Update Use the Web Code toaccess up-to-date information aboutpregnancy care. Have students completethe Web activity.

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Health at Home

Ultrasound Pictures Students’ paragraphs should describe theirimpressions of the ultrasound picturesand the parts of the fetus they wereable to discern. Students should alsodescribe how the parents were feelingand how the ultrasound picturesaffected those feelings.

4. A small piece of the placenta is removed andtested; when there is a family history of agenetic disorder or when the mother is overthe age of 35.

5. high blood pressure, swelling of the wristsand ankles, high levels of protein in theurine; bed rest or medication

6. spinach

7. Similarity: Both are tests performed when thefetus is at risk for a genetic disorder.Difference: Fetal cells in the amniotic fluidare tested in amniocentesis. A piece of theplacenta is tested in chorionic villus sampling.

1. get proper nutrition, exercise, avoidalcohol and other drugs, avoid envi-ronmental hazards

2. Prenatal care greatly increases thechances of having a healthy baby.

3. three months

Section 2 Review

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Complications Problems can occur at any time during pregnancy.For some of these complications, timely treatment can reduce negativeconsequences or even save the life of the woman or fetus.

� Ectopic pregnancy In the very rare case of an the blastocyst implants in the fallopian tube or elsewhere in theabdomen, instead of in the uterus. It cannot develop normally andmay put the mother’s life at risk. Surgery is necessary to remove theembryo and repair the damaged fallopian tube.

� Miscarriage The death of an embryo or fetus in the first 20 weeks ofpregnancy is called a Almost all miscarriages take placeduring the first trimester. They can occur before or after a woman knowsshe is pregnant. At least 15 percent of recognized pregnancies end inmiscarriages. Miscarriage is usually caused by a serious genetic defect,but it is sometimes due to illness or a drug the mother has taken. Inother cases, there is no apparent reason for a miscarriage.

� Preeclampsia (pree ih KLAMP see uh), which is alsocalled toxemia, is characterized by high blood pressure, swelling ofthe wrists and ankles, and high levels of protein in the urine. Its onsetis usually in the second or third trimester. Preeclampsia prevents thefetus from getting enough oxygen. This serious condition is treatedwith bed rest or medication.

� Gestational Diabetes Diabetes that develops in pregnant women iscalled and is marked by high blood sugar levels.It usually develops later in pregnancy. If untreated, excess blood sugarcan pass through the placenta to the fetus. The fetus may grow too large,which increases the risk of a difficult birth. The birth may also occurearly, resulting in breathing problems for the newborn.

gestational diabetes

Preeclampsia

miscarriage.

ectopic pregnancy,

Section 2 Review

Key Ideas and Vocabulary1. List four healthy habits that a pregnant woman

should adopt before and during pregnancy.

2. Why is prenatal care so important throughoutpregnancy?

3. About how long is each trimester of a pregnancy?

4. What is chorionic villus sampling? Under whatconditions is it sometimes recommended?

5. Describe three symptoms of preeclampsia. How isit treated?

Critical Thinking6. Evaluating From the following list, which food

choice is generally recommended for pregnantwomen: swordfish, spinach, wine, herbal tea?

7. Comparing and Contrasting How are chorionicvillus sampling and amniocentesis alike? How arethey different?

HomeHealth at

Ultrasound Pictures Ask your mother or otherrelative with children if she saved any ultrasoundpictures from her pregnancy. Ask permission to seethe pictures. Ask about her emotions during theultrasound—were she and the father scared, happy,excited? Write a paragraph about the pictures andthe parents’ experience.

For: Updates on pregnancycare

Visit: www.SciLinks.org/healthWeb Code: ctn-6192

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