period Breast tenderness Morning sickness More frequent urination
menstrual
Diagnosing 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
Pregnancy Tests
Physician
tests Home pregnancy tests test based on detection of hCg Human chorionic gonadotropin a hormone secreted by the placenta; it is the substance detected in pregnancy tests
Prenatal Development
Nine
months of pregnancy are divided into three equal periods of three months – called trimesters – First trimester - months 1 to 3 (embryo- first 2 months) (fetus- next 7 months) – Second trimester - months 4 to 6 – Third trimester - months 7 to 9
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 Umbilical cord - the tube that connects the fetus to the placenta Amniotic fluid - the watery fluid surrounding a developing fetus in the uterus
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 7th week - liver, lungs, pancreas, kidneys, and intestines have formed and begun limited functioning End of 12th week - 10 centimeters long;weighs 19 grams
Mom’s 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 Depression is common Emotional roller coaster
Fetal Development During the Second Trimester
Quickening
occurs - woman becomes aware of fetal movements – around the end of the 14th week Fetal heart beat can be detected Fetus opens its eyes
Mom’s Physical Changes: Second Trimester
Morning sickness disappears Constipation and nosebleeds sometimes occur Edema - water retention and swelling Colostrum may come out of the nipple Emotional well-being improves
Fetal Development During the Third Trimester
Fetus’s
skin is wrinkled and covered with downlike hairlanugo and a waxy protective layer- vernix Fetus turns in uterus to assume a head-down position Fetus experiences rapid growth
Sex During Pregnancy
Intercourse
can continue safely throughout pregnancy, unless otherwise stated by doctor Some anecdotal evidence of hormones in semen inducing labor
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
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
Effects of Drugs Taken During Pregnancy
Teratogens - a substance that produces defects in a fetus
Examples of teratogens: Antibiotics Alcohol - fetal alcohol syndrome Tobacco Other psychoactive drugs (cocaine, heroin) Thalidomide- drug that can cause limb defects Other drugs - check with physician and “when in doubt, don’t”
Birth: The Beginning of Labor
Bloody
show- discharge of mucous plug, along with some blood, that sealed the cervix Amniotic sac ruptures“water breaking” Contractions may start Labor divided into 3 stages
The First Stage of Labor: Dilation and Contractions
Regular contraction of uterus muscles Effacement of cervix (thinning) Dilation of cervix (enlargement) o Divided into 3 stages: – Early first-stage labor (0-5 cm dilation) – Late first-stage labor (5-8 cm dilation) – Transition phase (8-10cm dilation)
Pain Management
Epidural or Spinal Medication regional blocks prevent the nerves from sending signals to the brain; numbs or reduces pain in part of the body (from the abdomen down). Mental Relaxation Techniques Some techniques aim to focus your thoughts, others to distract you. Music, breathing, visualization are common. Narcotic Analgesics reduces your entire body’s ability to sense pain or discomfort. Administered through a shot or IV and will wear off within a few hours. Not recommended if you are within two hours of your baby’s birth. Physical Comfort Measures Hot and cold packs, massage, sipping cool water are common. Position Changes Some positions improve your baby's ability to navigate through the pelvis, other positions hinder his efforts. Some positions can help to reduce the pressure associated with a back labor, other positions make it easier to relax your body and rest. Water Tubs and showers help to handle contractions with less discomfort.
The Second Stage of Labor: Delivery of the baby
Begins when cervix is fully dilated Urge to push or bear down Crowning – top of the head is visible Fontanel- soft spots between the skull bones of the baby Episiotomy may be performed – incision that is sometimes made at the vaginal entrance during birth Baby is born
The Third Stage of Labor: Delivery of the afterbirth
Placenta
detaches from walls of the uterus Afterbirth is expelled Several contractions may accompany placental expulsion Episiotomy and tears are sewn up
Cesarean Section
A method of delivering a baby surgically, by an incision in the abdomen Reasons to have a C Section: – Baby is too large, mother’s pelvis is too small - Baby not in head down position – Cervix is not dilating – Umbilical cord prolapses – Excessive bleeding – Placenta previa
Newborn testing
APGAR- the rating (0-2) of baby’s physical characteristics 1 and 5 minutes after birth If there are problems with the baby an additional score is given at 10 minutes. A score of 7-10 is considered normal, while 4-7 might require some resuscitative measures, and a baby with apgars of 3 and below requires immediate resuscitation.
A
P
activity
pulse
G
A R
grimace
appearance respiration
The 4th trimester
Parenting
a newborn Physical and emotional changes again Post-partum depression a possibility