Pregnancy

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Conception
• Conception is when sperm and egg meet and fertilization occurs • Sperm - one of the tiniest cells in the human body • Conception occurs in the outer third of the fallopian tube • Zygote - fertilized egg
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Improving the Chances of Conception
• Time intercourse so it occurs around time of ovulation • Sperm live inside a woman’s body for up to 5 days • Egg is capable of being fertilized for about the first 12 to 24 hours after ovulation • Position during and after intercourse is important
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Symptoms of Pregnancy
• • • • Missed menstrual period Breast tenderness Morning sickness More frequent urination

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Diagnostic Signs of Pregnancy
• Presumptive Signs: breast changes, amenorrhea, nausea, vomiting, fatigue, frequent urination • Probable Signs: Positive pregnancy test, physical changes in the uterus • Positive Signs: Ultrasound or X-ray of fetus, fetal heartbeat, fetal movement
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Pregnancy Tests
• Physician tests:
– Immunologic test based on detection of hCG – Beta-hCG radioimmunoassay

• Home pregnancy tests

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Development of the Conceptus
• Nine months of pregnancy are divided into three equal periods of three months - called trimesters
– First trimester - months 1 to 3 – Second trimester - months 4 to 6 – Third trimester - months 7 to 9

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The Embryo and Its Support Systems
• Placenta - an organ formed on the wall of the uterus through which the fetus receives oxygen and nutrients and gets rid of waste products • Human chorionic gonadotropin - a hormone secreted by the placenta; it is the substance detected in pregnancy tests

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The Embryo and Its Support Systems
• Umbilical cord - the tube that connects the fetus to the placenta • Amniotic fluid - the watery fluid surrounding a developing fetus in the uterus

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Fetal Development During the First Trimester
• Develops into a fetus with most of the major organ systems present • 4th to 8th week - external body parts develop

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Fetal Development During the First Trimester
• 7th week - liver, lungs, pancreas, kidneys, and intestines have formed and begun limited functioning • End of 12th week - 10 centimeters long; weighs 19 grams

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Fetal Development During the Second Trimester
• Quickening occurs - women becomes aware of fetal movements
– around the end of the 14th week

• Fetal heart beat can be detected • Fetus opens its eyes

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Fetal Development During the Third Trimester
• Fetus’s skin is wrinkled and covered with downlike hair • Fetus turns in uterus to assume a head-down position • Fetus experiences rapid growth

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Physical Changes: First Trimester
• Large increase in levels of hormones • Breasts swell and tingle; development of mammary glands • Need to urinate • Morning sickness • Vaginal discharges may increase • Feelings of fatigue and sleepiness
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Psychological Changes
• Depression is common • Negative emotions • Positive feelings

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Physical Changes: Second Trimester
• Morning sickness disappears • Constipation and nosebleeds sometimes occur • Edema - water retention and swelling • Colostrum may come out of the nipple

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Psychological Changes
• Psychological well-being is greater among women who have social support • Depression higher in some studies

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The Father’s Role in Pregnancy
• Couvade syndrome - male pregnancy symptoms • The father-to-be - many choose to be actively involved • Diversity in the contexts of pregnancy there are lots of various family contexts that exist today
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Sex During Pregnancy
• Intercourse can continue safely until 4 weeks before the baby is due • If intercourse is uncomfortable for woman, alternatives should be explored

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Nutrition During Pregnancy
• Diet during is extremely important • Woman must get enough protein, folic acid, calcium, magnesium and vitamin A • The fetus comes first – it draws the nutrients it needs first, and whatever is left is for mom

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Nutrition Deficiencies
• Calcium – future risk of bone and tooth loss • Folic acid – (folate) much higher risk of neural tube defects. (decreases risk by 50%) • Zinc – malformations of the central nervous system

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Effects of Drugs Taken During Pregnancy
• Teratogens - a substance that produces defects in a fetus • Antibiotics - may damage fetus • Alcohol - may cause fetal alcohol syndrome • Cocaine - increased risk of premature birth

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Effects of Drugs Taken During Pregnancy
• Steroids - can cause masculinization of a female fetus and other fetal damages • Other drugs - check with physician and “when in doubt, don’t” • Dads and drugs
– drugs can damage sperm and their genetic content
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Birth: The Beginning of Labor
• Bloody show • Amniotic sac ruptures • Progesterone-withdrawal theory

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The Stages of Labor
• Labor divided into 3 stages • Parturition - whole process of childbirth

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First-Stage Labor
• • • • Regular contraction of uterus muscles Effacement Dilation Divided into 3 stages:
– Early first-stage labor (0-5 cm) – Late first-stage labor (5-8 cm) – Transition phase (8-10cm)
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Second-Stage Labor: Delivery
• Begins when cervix is fully dilated • Urge to push or bear down • Crowning
– top of the head is visible

• Episiotomy may be performed
– incision that is sometimes made at the vaginal entrance during birth

• Baby is born
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Third-Stage Labor
• Placenta detaches from walls of the uterus • Afterbirth is expelled • Several contractions may accompany placental expulsion • Episiotomy and tears are sewn up

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Cesarean Section
• A method of delivering a baby surgically, by an incision in the abdomen • Reasons to have a C Section:
– – – – –
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Baby is too large, mother’s pelvis is too small Cervix is not dilating Umbilical cord prolapses Excessive bleeding Placenta previa
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After the Baby is Born: The Postpartum Period
• Physical changes
– Hormones levels return to normal – Woman may feel exhausted – Discomfort from episiotomy

• Psychological changes
– Postpartum depression

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Attachment to the Baby
• Bonding can occur before baby is born • Critical period of bonding occurs in minutes and hours immediately after birth

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Sex During Postpartum
• Couple should wait at least 2 weeks before resuming intercourse • If woman had an episiotomy, she may experience vaginal discomfort

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Breast-Feeding
• Biological mechanisms
– Prolactin - stimulates breasts to produce milk – Oxytocin - stimulates breasts to eject milk

• Physical and mental health
– Breast feeding is encouraged

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Problem Pregnancies
• Ectopic pregnancy - fertilized egg implants somewhere other than the uterus • Pseudocyesis - false pregnancy • Pregnancy-induced hypertension - includes 3 conditions:
– Hypertension – Preeclampsia – Eclampsia
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Problem Pregnancies
• • • • • Viral illness during pregnancy Birth defects Rh incompatibility Miscarriage - spontaneous abortion Preterm birth

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Infertility
• Refers to a woman’s inability to conceive and give birth to a living child, or a man’s inability to impregnate a woman • Causes - can be either female factors or male factors

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Causes in the Female
• • • • Pelvic inflammatory disease Failure to ovulate Blockage of the fallopian tubes Hostile mucus

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Causes in the Male
• Infections in the reproductive system caused by sexually transmitted diseases • Low sperm count • Low motility of the sperm

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Combined Factors
• Immunologic response • Lack of knowledge

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Psychological Aspects of Infertility
• Couple subjected to psychological stress • Man may feel that his masculinity or virility is in question

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Treatment of Infertility
• Fertility drugs • Microsurgery • New reproductive technologies

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Assisted Reproductive Technologies
• Artificial insemination - sperm are placed into vagina by means other than sexual intercourse • Sperm banks • Embryo transfer - embryo is transferred into uterus, usually from the lab.

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New Reproductive Technologies
• Test-tube babies - in vitro fertilization - egg is fertilized by sperm in a laboratory dish • GIFT - gamete intra-fallopian transfer • ZIFT - zygote intra-fallopian transfer • Cloning • Gender selection
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