Sexuality, Pregnancy, and Childbirth
Chapter Five
Sexual Anatomy
 External Female Genitals
 Internal Female Genitals
(Vulva)
 Uterus
 Mons pubis
 Endometrium
 Labia majora
 Cervix
 Labia minora
 Ovaries
 Prepuce
 Fallopian tubes
 Clitoris
 Hymen
 Urethral opening
 Vagina
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Figure 5-1 The Female sex organs
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Reproductive Anatomy
 Male Sex Organs: Two components
 Penis
 The Glans
 Corpus spongiosum
 Scrotum
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Function (Temperature 93.6 degrees F)
Testes
Epididymis
Seminiferous tubules within the Testes
Vas Deferens
Prostate
Cowper’s glands
Seminal vesicle
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Figure 5-2 The male sex organs
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Hormones and The Reproductive Life
Cycle
 Hormones: Endocrine glands
 Androgens
 Testes produce androgens - testosterone
 Ovaries produce estrogen and progesterone
 Cortex of the Adrenal gland produces androgens in both males
and females
 Pituitary gland
 Hypothalamus
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Differentiation of the Embryo
 Determined by a interaction of genetic, physiological and
environmental factors.
 Conception - combining of 23 pairs of chromosomes
 22 are the same and the twenty-third is the sex chromosomes.
 Egg carries an X sex chromosome.
 Sperm carries either a X or Y chromosome.
 XX provides the blueprint to produce a female.
 XY provides the blueprint to produce a male.
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Female Sexual Maturation
 Begins around 8-13 with breast development and rapid body
growth between 9 and 15.
 Physical maturation.
 Breast development
 Rounding of the hips and buttocks
 Hair growth in pubic region and arm pits
 The Menstrual Cycle - four phases.
 Menses.
 Days 1-5
 Estrogenic phase.
 Days 6-13
 Ovulation phase.
 Day 14
 Progestational phase.
 Days 15-27
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Menstrual Problems
 Dysmenorrhea (the occurrence of painful cramps during
menstruation)
 Some symptoms caused from prostaglandins (fatty acids)
 Premenstrual syndrome (PMS)
 A collection of physical, psychological, and emotional symptoms related to a
woman's menstrual cycle.
 Premenstrual Dysphoric disorder (PMDD)
 A collection of physical and emotional symptoms that occurs 5 to 11 days
before a woman's period begins, and goes away once menstruation starts.
 Lifestyle changes to reduce symptoms:
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Limit salt intake
Exercise
Don’t use alcohol or tobacco
Eat a nutritious diet
Relax
If systems persist, keep a daily diary
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Male Sexual Maturation
 2 years later than girls
 Begins about 10 or 11 years old
 Physical changes.
 Testicular growth
 Penis growth
 Pubic hair growth
 Voice deepens
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Aging and Human Sexuality
 Menopause
 Ovaries gradually cease functioning
 Decreasing estrogen
 Increase risk of disease
 Males
 Gradual decrease of testosterone
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Sexual Function
 Sexual stimulation
 Comes from both physical and psychological stimuli
 Physical stimulation
 Through the senses
 Erogenous zones
 Psychological stimulation
 Fantasies
 Ideas
 Memories of past experience
 Mood
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Sexual Response Cycle
 Physiological mechanisms
 Vasocongestion (increase blood flow to the tissues)
 Myotonia (muscle tension)
 Four phases Characterize the sexual response cycle
Excitement phase
2. Plateau phase
3. Orgasmic phase
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4.
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Males (refractory phase)
Resolution phase
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Sexual Problems
 Common Sexual Health Problems
 Biological and psychological conditions:
 Women:
 Vaginitis
Candida (yeast infection)
Trichomonas (genital and urinary tract infection)
 Endometriosis (uterine lining develops or grows in other parts of the body)
 Pelvic Inflammatory Disease (PID)
 any infection in the lower female reproductive tract that spreads to the
upper female reproductive tract
 50-75% of PID cases are caused by STDs
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 Men:
 Prostatitis (inflammation of the prostate gland)
 Testicular cancer
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Most common in men in their twenties and thirties.
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Sexual Dysfunctions
 Common sexual dysfunctions:
 Male –
 erectile dysfunction
 premature ejaculation
 retarded ejaculation
 Women –
 orgasmic dysfunction
 Treatment
 Psychosocial - troubled relationships
 Behavioral
 Relaxation and massage techniques
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Sexual Behavior
 The development of sexual behavior
 Gender roles and gender identity
 Gender role is everything you do in your daily life that expresses your
maleness or femaleness as defined by society.
 State of being male or female
 Transsexual – those that feel that their biological sex does not match their
gender identity.
 Transvestites – wearing clothing identified with the other gender.
 Intersexed –born with ambiguous genitals – neither fully female nor fully
male.
 Biological and cultural influences
 Gender-role flexibility
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Responsible Sexual Behavior
 Careful decision making
 Open, honest communication about intentions
 Agreed-On sexual activities
 Sexual privacy
 The use of Contraception
 Safer sex
 Sober sex
 Taking responsibility for the consequences
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Understanding Fertility
 Conception
 Involves the fertilization of a women’s egg by a man’s sperm
 Each month a women’s ovaries release an egg
 24 hours if not fertilized
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3-4 days - the egg travels through the fallopian tubes
Egg not fertilized
Millions of sperm
Sperm release an enzyme
Egg and sperm each carry 23 chromosomes
Ovum, blastocyst, embryo, fetus
 Fraternal twins and identical twins
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 Female infertility
Infertility
 One of two key causes
 Tubal blockage (40%)
 Failure to ovulate (40%)
 Blocked Fallopian tubes are most commonly caused by pelvic inflammatory
disease (PID)
 Chlamydia or gonorrhea
 Endometriosis
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Infertility
 Male infertility
 Accounts for about 20% of infertile couples
 Four main categories
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Hypothlamic pituitary disease
Congenital disorders (abnormality of the human body)
Testicular disease
Disorders of sperm
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Infertility Treatment
 Intrauterine insemination
 Artificial intrauterine insemination - the hoped-for outcome of intrauterine
insemination is for the sperm to swim into the fallopian tubes and fertilize a
waiting egg, resulting in pregnancy.
 IVF,GIFT, and ZIFT
 In vitro fertilization (IVF) - fertilized egg in lab inserted into uterus
 Gamete intrafallopian transfer (GIFT) - insertion of eggs and sperm into
fallopian tube)
 Zygote intrafallopian transfer (ZIFT) - fertilized egg (zygote or embryo)
inserted into fallopian tube
 Surrogate Motherhood
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Pregnancy
 3 periods of about 3 months (13 week trimesters)
 Tests
 Home pregnancy tests
 Human chorionic gonadotropin (HCG)
 Two weeks after fertilization
 Early signs and symptoms
 Missed menstrual period
 Softening of the uterus
 Hager’s sign
 Slight bleeding
 Nausea
 Breast tenderness
 Increased urination
 Sleepiness, fatigue and emotional upset
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Continual Change in the Women’s
Body
 Uterus size
 First 3 months, the uterus enlarges to about three times its
nonpregnant size
 4th month, large enough to make abdominal protrude
 7th-8th month, pushes up into the rib cage
 Breast changes
 8th week
 10th week
 Colostrum (breast milk)
 Muscles and Ligaments loosen
 Weight Gain
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Changes During the Later Stages of
Pregnancy
 Increased needs placed on the mother.
 Braxton hicks contractions.
 Lightening (“dropping”)
 Emotional responses to Pregnancy.
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Fetal Development
 First Trimester
 Blastocyst
 Inner cells divide into three layers
 One layer – inner body parts
 Middle layer – muscle, bone, blood, kidneys, and sex glands
 Third layer – skin, hair, and nervous tissue
 Embryo - End of second week
 All major body structures are formed between 2nd and 9th week
 2nd Month - Fetus
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Fetal Development
 Second Trimester
 Fetus grows to about 14 inches and 2 pounds
 Third Trimester
 Fetus gains protective fat layers, Respiratory and Digestive
organs develop
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The Importance of Prenatal Care
 Regular medical checkups
 Blood tests
 Prenatal nutrition
 Avoidance of drugs, and other environmental hazards:
 Teratogens (an agent, such as a virus, a drug, or radiation, that
causes malformation of an embryo or fetus)
 1st trimester
 Congenital malformations (e.g., birth defects)
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Alcohol
Tobacco
Caffeine
Drugs
STD’s and other infections
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Diagnosing Fetal Abnormalities
 Ultrasonography (Ultrasound)
 High frequency sound waves
 Amniocentesis
 Fluid removal from the uterus
 Chorionic Villus (CVS) sampling
 Removal of tiny section of chorionic villi
 Quadruple marker screen (TMS)
 Maternal blood test
 Analyze four hormone levels and compared to appropriate standards
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The Importance of Prenatal Care
 Activity and exercise
 Moderate exercise program
 30 minutes most days
 Cardiovascular exercises
 Kegal Exercises
 Prenatal exercise classes
 Preparation for childbirth
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Complications of Pregnancy and Pregnancy Loss
 Ectopic pregnancy
 Spontaneous Abortion, or miscarriage
 Stillbirth
 Preeclampsia/eclampsia
 Placenta Previa (a condition that occurs during pregnancy when the placenta is abnormally
placed, and partially or totally covers the cervix)
 Placental Abruption (occurs when the placenta separates from the wall of the uterus prior
to the birth of the baby. This can result in severe, uncontrollable bleeding or hemorrhage)
 Gestational Diabetes
 Preterm Labor
 Labor Induction
 Low-birth Weight (LBW)
 5.5 LBS.
 Infant Mortality
 SIDS
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Childbirth
 Choices in childbirth
 Who is going to assist with delivery?
 Physician
 Certified Nurse-Midwife
 Where is the baby going to be delivered?
 Hospital
 Home
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Labor and Delivery
 Entire process 2-36 hours.
 First stage of Labor.
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Average13 hours for a first birth.
Cervix is completely dilated (10 centimeters)
Hormonal changes.
Contractions. (30 seconds and occur every 15-20 minutes)
Mucus plug is expelled and amniotic sac may rupture.
Transition:
 Contractions may last 60-90 seconds and be 1-3 minutes apart
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Childbirth
 Second Stage of Labor
 Baby slowly pushed into birth canal
 Baby squeezes through pelvis
 Head is usually delivered first; “crowning”
 Third Stage of Labor
 Delivery of the placenta
 Stage typically lasts 5-30 minutes
 Apgar Scale of the Baby
 Heart rate
 Respiration
 Color
 Reflexes
 Muscle tone
 Total score is between 0 and 10
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Pain Relief During Labor and Delivery
 Childbirth preparation courses
 Breathing and relaxation techniques
 Lamaze or Bradley
 Epidural (e.g., anesthesia to numb
abdomen and legs)
 Narcotics
 Fentanyl or demeral
 Provide less pain relief than a epidural
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Cesarean Deliveries
 2006 about 31.1% of babies born in the U.S.
 Surgical removal of the baby
 Baby’s head too large
 Mother has a serious health condition
 Mother who is overweight or diabetes
 Difficult labor
 Fetal distress
 Dangerous infections
 90% of cesarean mothers will have subsequent deliveries by cesarean
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Chapter 5 Connect Assignment Due
Tuesday, February
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th
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