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BergerCA8e_lecCh4.ppt

Kathleen Stassen Berger

Part I

Prenatal Development and Birth

Chapter Four

  • From Zygote to Newborn
  • Risk Reduction
  • Birth

From Zygote to Newborn

  • Prenatal development is divided into three main periods:
  • germinal period (0-2 weeks)
  • embryonic period (3-8 weeks)
  • fetal period (9 weeks-birth)

  • germinal period:
  • first two weeks of prenatal development after conception
  • Characterized by rapid cell division and the beginning of cell differentiation.

Germinal: The First 14 Days

  • embryonic period:
  • approximately the third through eighth week after conception
  • all body structures, including internal organs, begin to develop
  • fetal period:
  • stage of prenatal development from ninth week after conception until birth, during which the organs grow in size and mature in functioning

Germinal: The First 14 Days

  • implantation:
  • process in which developing organism burrows into placenta that lines uterus
  • placenta:
  • organ that surrounds developing embryo and fetus, sustaining life via the umbilical cord

  • Embryo:
  • name for a developing human organism from about the third through the eighth week after conception

Embryo: From the Third Through the Eighth Week

  • The developing organism is called a fetus from the start of the ninth week after conception until birth.

  • during the fetal period the fetus develops from tiny, sexless creature to a 7 1/2-pound, 20-inch boy or girl

Fetus: From the Ninth Week Until Birth

  • At the end of the third month, the fetus has all its body parts.
  • Weighs approximately 3 ounces, and is about 3 inches long.
  • Early prenatal growth is very rapid, but there is considerable variation from fetus to fetus, especially in body weight.

The Third Month

  • In the fourth, fifth and sixth months:
  • heartbeat becomes stronger
  • cardiovascular system becomes more active
  • brain increases about six times in size

  • age of viability:
  • Age at which a fetus can survive outside the mother’s uterus if specialized medical care is available.
  • about 22 weeks after conception
  • In the final three months of prenatal life:
  • brain waves indicate responsiveness.
  • lungs expand and contract, using the amniotic fluid as a substitute for air.
  • heart valves, arteries, and veins circulate the fetal blood.

Risk Reduction

  • teratogens: agents and conditions that can:
  • harm the prenatal brain
  • impairing the future child’s intellectual and emotional functioning

  • Once it was thought the placenta screened out all harmful substances.
  • Doctors on an Australian military base traced an increase in blindness among newborns to rubella (German measles) contracted by pregnant women a few months earlier.
  • Realized that some diseases during pregnancy could harm a fetus.

Determining Risk

The effort to understand what triggered such damage gave rise to:

  • teratology: science of risk analysis, the study of birth defects
  • risk analysis: to determine likelihood of harm, science of weighing the potential effects of a particular:
  • event
  • substance
  • experience

Timing of Exposure

  • Second important factor is the dose and/or frequency of exposure.
  • threshold effect: situation in which a certain teratogen is relatively harmless in small doses but harmful once exposure reaches certain level (the threshold)
  • interaction effect: result of a combination of teratogens
  • Sometimes risk is greatly magnified when embryo or fetus is exposed to more than one teratogen at the same time.

Genetic Vulnerability

  • Several lines of evidence suggest that genes may be crucial.
  • Dizygotic twins, exposed to same teratogens but have only half their genes in common, are born with different abnormalities.
  • Suggests both protective and vulnerable genes.
  • Cleft lip, cleft palate, club foot more common in some families.
  • Suggests genetic vulnerability.

Protective Measures

  • Impact of teratogens cannot be predicted before mid-pregnancy.
  • Some pregnant women are exposed to the tetragons with no evident harm.
  • Some defects occur even thought the woman avoids all known tetragons while pregnant.

A View From Science

  • Alcohol in high doses is a proven teratogen.
  • 40 years ago drinking during pregnancy was believed to be harmless.
  • Obstetricians noted that some patients who drank heavily while they were pregnant had babies with distorted faces.
  • fetal alcohol syndrome (FAS)
  • fetal alcohol effects (FAE)

  • fetal alcohol syndrome (FAS): cluster of birth defects, including:
  • abnormal facial characteristics
  • slow physical growth
  • retarded mental development
  • fetal alcohol effects (FAE): condition in which child has been exposed to alcohol before birth
  • has some signs of fetal alcohol syndrome but does not meet all the criteria

Benefits of Prenatal Care

  • Tests done during pregnancy can diagnose problems early on, and remedies can be put in place in some instances.
  • sonogram: image of unborn fetus (or an internal organ) produced by high-frequency sound waves (ultrasound)

  • For full-term fetus and a healthy mother, birth can be simple and quick.

The Newborn’s First Minutes

  • Most newborns begin to breathe as soon as their head emerges.
  • first breath causes infant’s color to change
  • eyes open wide
  • the tiny fingers grab
  • toes stretch and retract
  • mucus in the baby’s throat is removed
  • umbilical cord is cut to detach the placenta
  • placenta is expelled

Apgar scale: quick assessment of newborn’s condition including:

  • the baby’s color
  • heart rate
  • reflexes
  • muscle tone
  • respiratory effort

Medical Intervention

  • about 31% of births in the U.S. are cesarean section, (also called c-section)
  • incision through mother’s abdomen and uterus to allow fetus to be removed quickly, instead of being delivered through the vagina

Birth In Developing Nations

  • In the U.S. only 1% of births take place at home.
  • Worldwide most births occur at home.
  • doula- a woman who helps with the birth process

- also helps with breastfeeding and newborn care.

  • anoxia:
  • lack of oxygen that can cause brain damage or death to the baby
  • means “no oxygen”
  • cerebral palsy:
  • disorder that results from damage to brain’s motor centers
  • People with cerebral palsy have difficulty with muscle control, so their speech and body movements are impaired.

Anoxia

  • Average weight of a newborn is 7½ lbs.
  • low birthweight (LBW): a body weight at birth of less than 5½ lbs.
  • very low birthweight (VLBW): a body weight at birth of less than 3 lbs, 5oz.
  • extremely low birthweight (ELBW): a body weight at birth of less than 2 lbs, 3 oz.

Low Birthweight (LBW)

  • preterm birth: occurs 3 or more weeks before full 38 weeks of a typical pregnancy
  • Preterm babies are typically (but not always) LBW because they miss final weeks of weight gain.
  • small for dates or small for gestational age (SGA)- birth weight is lower than expected given the time of conception.

Social Support

  • The developing person is affected by quality of:
  • medical care
  • education
  • culture
  • social support
  • Fathers and other relatives, neighbors, cultures, and, clinics can reduce risk of birth complications

Mothers, Fathers, and a Good Start

  • Birth complications can have a lingering impact on the new family, depending partly on:
  • sensitivity of hospital care
  • the home
  • To reduce stress on an infant who has to stay in the hospital, parents are encouraged to help with early caregiving.

  • kangaroo care: form of child care in which the mother of a low-birthweight infant spends at least an hour a day holding the baby between her breast, like a kangaroo

Help from Fathers

  • Fathers can be crucial in the effort to produce a healthy baby.
  • Supportive father-to-be helps a mother-to-be:
  • stay healthy
  • well nourished
  • drug-free

  • parental alliance: cooperation between a mother and a father based on mutual commitment to their children
  • Parents agree to support each other in their shared parental roles.

  • new mother’s feelings of inadequacy and sadness in days and weeks after giving birth including:
  • irritability
  • eating disruptions
  • sadness
  • feeling overwhelmed and inadequate
  • affects 10-15% of women

Postpartum Depression

  • parent-infant bond: strong, loving connection that forms as parents hold, examine, and feed newborn
  • cross-fostering: newborns are removed from their biological mothers in first days of life and raised by another female or even male

Bonding