MODULE 1 THE FEMALE REPRODUCTIVE ORGANS Female reproductive system consists of the internal reproductive organs and external genitalia. FEMALE REPRODUCTIVE SYSTEM Ovaries produce eggs (oöcytes) & hormones Uterine tubes transport the eggs Uterus where fetal development occurs Vagina or birth canal External genitalia constitute the vulva Mammary glands produce milk Uterine Tube Ovary Uterus Vagina Vulva OÖGENESIS Egg forming cells (oöcytes) go through two divisions 1º = primary 2º = secondary •Starts with a 2n=46 1ºoöcyte that divides, resulting in two n=23 cells, but one is a large 2º oöcyte and one is a small 1st polar body that may itself divide •Second division only occurs if 2º oöcyte is fertilized. Results in one large n=23 ovum (egg) and one small n=23 2nd polar body •Thus oögenesis results in one large fertilized egg (zygote) and possibly three small polar bodies OÖGENESIS – OÖGONIA TO OÖCYTES Germ cells from yolk sac migrate to ovary and become potential egg cells called oögonia In fetus, millions of oögonia produced by mitosis but most of them degenerate (atresia) Some develop into immature egg cells called primary oöcytes during fetal development 200,000 to 2 millions present at birth 40,000 remain at puberty but only 400 mature during a woman’s reproductive life Each month about 20 primary oöcytes become secondary oöcytes but usually only one survives to be ovulated from Graffian follicle OVARIAN FOLLICLES Ovarian Follicles Contain oöcytes (egg cells) in various stages of development Secrete estrogens that function for: Growth and repair of uterine lining Regulation of monthly female cycle Female sexual characteristics Maintenance of bone and muscle Mature (Graafian) follicle releases an oöcyte each month during ovulation OVARIAN FOLLICLES Oöcytes (egg cells) develop within follicles Stages of follicular development Primordial follicle Single layer of squamous cells around the oöcyte Primary follicle Layers of cuboidal granulosa cells around the oöcyte Granulosa cells secrete estrogens OVARIAN FOLLICLES Secondary Antral follicle cavity forms Graafian follicle Follicle mature ready to ovulate oöcyte Ovulation Follicle ruptures releasing oöcyte CORPUS LUTEUM After ovulation, empty follicle becomes a corpus luteum Corpus Luteum secretes:Progesterone – completes the preparation of uterine lining Estrogens – work with progesterone Relaxin – relaxes uterine muscles and pubic symphysis Inhibin – decreases secretion of FSH and LH Corpus albicans is a white scar tissue left after the corpus luteum dies. THE OVARY – PRODUCES THE EGG CELL UTERINE OR FALLOPIAN TUBES Narrow, 4 inch tube that extends from the ovary to uterus Infundibulum is open, funnel-shaped portion near the ovary Fimbriae are moving finger-like processes Ampulla is central region of tube Isthmus is narrowest portion joins uterus UTERUS HISTOLOGY OF THE UTERUS Endometrium Simple columnar epithelium Stroma of connective tissue and endometrial glands Functional layer Basal layer Replaces functional layer each month Myometrium Shed during menstruation 3 layers of smooth muscle Perimetrium Visceral peritoneum Passageway for birth, menstrual flow and intercourse Organ of copulation Term: - hymen VAGINA EXTERNAL GENITALIA MAMMARY GLANDS PUBERTY IN FEMALES Puberty begins with the first menstrual bleeding (menarche) Puberty begins when GnRH, LH and FSH levels increase MENOPAUSE Cessation of menstrual cycle Ages 40-50 What is happening? - Menstrual cycle become less regular - Ovulation is inconsistent Major cause: - Age related changes - Number of follicles are small - Reduced amount of estrogen Climacteric- from irregular cycles to complete cessation MODULE 2 THE MALE REPRODUCTIVE SYSTEM MALE REPRODUCTIVE SYSTEM Seminal vesiclesemen Prostate-semen Urethra-urine Epididymis-sperm maturation Scrotum-cools testis Ductus deferenssperm duct Peni s Testis-sperm formation Gonads, ducts, sex glands & supporting structures SCROTUM Sac of loose skin, fascia & smooth muscle divided into two pouches by a septum Contains the testes TESTES Septum Paired oval glands measuring 4-5 cm Each lobule is filled with 2 or 3 seminiferous tubules where sperm are formed Lobule Seminiferous tubule Capsul e SEMINIFEROUS TUBULES Interstitial cells- secretes testosterone Germ cells Sustentacular cells PENIS External male organ of copulation Transfers the sperm cell Terms: Erection Prepuce Corpora cavernosa Corpus spongiosum SPERMATOGENESIS SPERM FORMING CELLS GO THROUGH TWO MEIOTIC DIVISIONS Each of four spermatids develop into a sperm Second meiosis division give four spermatids,each with 23 single stranded chromosomes First meiosis division give two secondary spermatocytes, each with 23 chromosomes that become double stranded. Primary spermatocyte with 2n=46 chromosomes Spermatogonium with 2n=46 chromosomes multiply by mitosis. SPERM MORPHOLOGY Adapted for reaching and fertilizing the egg Head contains DNA and the acrosome with enzymes for penetrating the egg Midpiece contains mitochondria to form ATP for energy Tail is flagellum used for locomotion MALE GLANDS Prostate Seminal Vesicles Secrete 60% of clear, alkaline seminal fluid, with fructose sugar, ATP and prostaglandins for normal sperm nutrition & function Chemicals for coagulation of semen Secretes 30% of milky, slightly acidic seminal fluid with an antibiotic to kill bacteria Cowper’s Glands Secrete clear, alkaline mucus to buffer and lubricate urethra SEMEN- MIXTURE OF SPERMS AND SEMINAL FLUID - 60% FROM SEMINAL VESICLES, 30% FROM PROSTATE , 5% TESTES, 5% BULBOURETHRAL GLANDS • • • • Substances include: Fructose Coagulation of proteins Enzymes Prostaglandins • • The thin milky secretions of the prostate have several functions: Regulate pH Liquefy the coagulated semen HORMONAL CONTROL OF MALE PHYSIOLOGY Hypothalamus GnRh Anterior Pituitary Follicle Stimulating Hormone Luteinizing Hormone Sertoli Cells Interstitial Cells Androgen Binding Protein Testosterone Spermatogenesis • Hypothalamus secretes gonadotropin releasing hormone (GnRH) • Anterior pituitary secretes FSH and LH • FSH causes Sertoli cells to secrete ABP and inhibin • LH causes interstitial cells to secrete testosterone • ABP and testosterone stimulate spermatogenesis • Control is Negative FB by testosterone and inhibin PUBERTY IN MALES Puberty- CHILD to ADULT CHANGES: ✓ Reproductive system matures ✓ Developmental changes in hypothalamus ✓ Elevated FSH levels ✓ Promote spermatogenesis ✓ Elevates LH levels EFFECTS OF TESTOSTERONE Testosterone ❑ major male hormone ❑ Necessary for spermatogenesis ❑ Responsible for the development of secondary male sexual characteristics ▪ ▪ ▪ ▪ ▪ Secondary sexual characteristis: Hair distribution and growth Skin texture Body fat distribution Skeletal muscle grow Changes in the larynx SENSORY IMPULSES AND INTEGRATION Rythmic massage of the penis Psychic stimuli Ejaculation while sleeping (wet dreaming) EMISSION AND EJACULATION Emission Muscle contractions close sphincter at base of bladder Fluids propelled through ductus deferens, seminal vesicles, & ejaculatory ducts into bulb of penis Prostatic fluid secreted into urethra Ejaculation Sympathetic nervous system reflex Skeletal muscles squeeze semen out through urethra ERECTION Sexual stimulation Parasympathetic nervous system reflex Dilation of the arterioles supplying the penis Blood enters the penis compressing the veins so that the blood is trapped Blood sinuses of penis engorge with blood OTHER SYSTEMS INVOLVED IN REPRODUCTION MODULE 3 NERVOUS SYSTEM Effects of Other System on Reproductive System Effects of the reproductive system on other system ➢ Stimulates sexual response, such as erection and ejaculation in males and erection of the clitoris in females ➢ Sex hormones influence CNS development and sexual behaviors ENDOCRINE SYSTEM Effects of Other System on Reproductive System Effects of the reproductive system on other system ➢ Stimulate the onset of puberty ➢ Testosterone, estrogen and and sexual characteristics inhibin regulate the release of ➢ Stimulates gametes formation hormones from the ➢ Promote uterine contraction for hypothalamus and pituitary delivery gland ➢ Makes possible and regulates milk production SKELETAL SYSTEM Effects of Other System on Reproductive System Effects of the reproductive system on other system ➢ Pelvis protects internal reproductive organs and developing fetus ➢ Estrogen and testosterone regulates bone growth and closure of the epiphyseal plate MUSCULAR SYSTEM Effects of Other System on Reproductive System ➢ Pelvic floor muscle support internal reproductive organs, such as the uterus ➢ Responsible for ejaculation ➢ Cremaster muscle help regulate testes temperature ➢ Abdominal muscle assist in delivery Effects of the reproductive system on other system ➢ Sex hormones increase muscle growth CARDIOVASCULAR SYSTEM Effects of Other System on Reproductive System Effects of the reproductive system on other system ➢ Delivers oxygen, ➢ Estrogen may slow the nutrients, hormones and development of immune cells atherosclerosis ➢ Remove carbon dioxide, waste products and toxins ➢ Vasodilation necessary for erection INTEGUMENTARY SYSTEM Effects of Other System on Reproductive System Effects of the reproductive system on other system ➢ Mammary glands produce milk ➢ Areolar glands prevent chafing during nursing ➢ Covers external genetalia ➢ Sex hormones increase sebum production (contributing to acne), secrete apocrine glands secretion (contributing to body odor) and stimulate axillary and pubic hair growth LYMPHATIC SYSTEM AND IMMUNITY Effects of Other System Effects of the reproductive on Reproductive System system on other system ➢ Immune cells provide against microorganisms and toxins and promote tissue repair by releasing chemical mediators ➢ Removes excess interstitial fluid ➢ Blood-testes barrier isolates and protects sperm from the immune system RESPIRATORY SYSTEM Effects of Other System on Reproductive System Effects of the reproductive system on other system ➢ Provide oxygen and ➢ Sexual arousal increases removes carbon dioxide respiration ➢ Helps maintain the body’s pH DIGESTIVE SYSTEM Effects of Other System on Reproductive System Effects of the reproductive system on other system ➢ Provides nutrients ➢ Developing fetus crowds digestive organs URINARY SYSTEM Effects of Other System on Reproductive System Effects of the reproductive system on other system ➢ Removes waste production ➢ Helps maintain the body’s pH, ions and water balance ➢ Urethra common passageway for sperm cells and urine in males ➢ Developing fetus compresses the urinary bladder HUMAN SEXUALITY MODULE 4 SEX AND GENDER Sex refers to the distinct biological differences between male and female. It is determined by the genitals and chromosomes. It begins at conception. Gender characterizes how a particular person presents oneself in a culture (gender role) how one identifies himself/herself based on mental awareness (gender identity) GENDER IDENTITY Socially constructed Usually assumed that a person is of the gender that corresponds to his/her sex: males are masculine, females are feminine Men are traditionally expected to be strong, independent, dominant and aggressive Women are seen as passive, dependent, subordinate, and nurturing SEX AND GENDER ARE NOT ALIGNED LGBT (lesbian, gay, bisexual, and transgender) -a person does not exhibit the typical definitions of a male or female, called INTERSEX HUMAN SEXUALITY Sexuality the expression of the sex The sphere of interpersonal behavior, especially between the male and the female Most directly associated with resulting to genital union It attracts a man and a woman towards each other to procreate and fulfill each other LIBIDO/SEX DRIVE ensures the continuation of the species It triggers the desire, orchestrates the physiological changes in the human body to produce egg and sperm, maintain pregnancy, and foster nurturing instincts that care for and protect the offspring Can be a source of pleasure and fulfillment as well as heartbreak and loss, even violence. SEXUAL ACT “Sexual intercourse” Physical union of male and female through which human beings procreate Characterized by the penetration or insertion of the penis into the vagina Culminates in orgasm in which the penis ejaculates semen with sperms into the vagina SEXUAL EXPERIENCE AND RESPONSE DEPENDS ON: Nervous system: triggers the excitement, hormonal secretions, orgasms and ejaculation Circulatory system – causes blood to accumulate in the genetal areas, making them swell Muscular system – the muscle of thighs, buttocks, uterus and vagina contract Norepinephrine – causes a calm feeling of well being and relaxation ATTITUDE TOWARDS SEX AND SEXUAL ACTIVITY It is everyone’s duty to protect his/her sexual integrity from fancies, words, actions, pornography, and violence that make sex trivial One should not allow the act of sexual intercourse and expressions of the libido to be subject to importunate curiousity and unwarranted intrusions by others ATTITUDE TOWARDS SEX AND SEXUAL ACTIVITY Sexual attraction, even satisfaction, should not be mistaken for true love Sexual activity should be performed rationally, responsibly, respectfully, and consensually Good sex happens at the right time, with the right person, and for the right reason ATTITUDE TOWARDS SEX AND SEXUAL ACTIVITY Heterosexual marriage is the most common adult expression of sexuality… but many alternative exist: - celibacy for religious reasons - singleness by choice - polygamy - same sex partnership No single profile predicts a happy, healthy, and fulfilling sex life. Personal attitudes, parents, family, love and God all contribute to achieve it Do you think human sexuality is different from animal sexuality? If so, in what way do they vary? -begins when a sperm successfully fertilizes an egg From Egg and Sperm to Zygote Oogenesis refers to the production or development of a mature egg from one of the hundred thousands of oocytes (immature eggs) to become a mature egg. Oogenesis begins before birth but ovulation occurs once a month from puberty to menopause. Ova are viable and can be fertilized, for approximately 24 hours after ovulation. Spermatogenesis is the maturation of the immature sperms inside the testes. Sperms are released into the male duct system Immature to mature sperm takes about 53 days, starts at puberty continuing throughout life. Sperms are viable for 72 hours and believe to have maximum fertilizing capacity for only 24 hours. Fertilization starts when a million of sperms are ejaculated into the vagina during intercourse out of millions, only few (thousands) of sperms can survive the acidity of the vagina and swim upward through the movement of their flagella-uterus-fallopian tube to meet the egg it takes 15 minutes for the sperm and egg to meet to 3 days Zona pellucida is the capsule that surrounds the egg where the sperm penetrates. once the sperm and the egg merge it results to a zygote with a 46 chromosomes (23 from each parent) male offspring=ovum is fertilized by a Y sperm zygote is formed= series of cell divisions start=single celled zygote transform into many cells to give rise to the future embryo and placenta it remains in mobile state travelling from the fallopian tube to reach uterus in 3-4 days Monozygotic Twins (Identical Twins) One egg is fertilized by one sperm Embryo splits into two during the early stages of development Have identical genes and must be of the same sex Dizygotic Twins (Fraternal Twins) Two eggs are ovulated and each is fertilized by a sperm cell No more genetically similar than any other sibling in the family (can be same/different sexes) Maternal age, use of assisted reproductive technologies are factors Conjoined Twins occurs when a mitotic division is incomplete From Conception to Birth Implantation Period of the Zygote Period of the Embryo Period of the Fetus Implantation After approximately a week (6-7 days), the developing embryo is implanted into the uterus Zygote during this time takes the form of blastocyst with an inner cell mass (future embryo) and an outer cell mass (future placenta) Period of the Zygote Period of the Zygote Placenta is formed from both mother and fetal tissues as early as 1 week Placenta is a temporary disc-shaped organ that connect the fetus to the uterine wall Placenta=the life support system for developing fetus=passageway transfer for nutrients, waste & chemicals between the mother and the fetus by osmosis and diffusion Human chrorionic gonadotropin (HCG) hormone is produced During early pregnancy, HCG stimulates the corpus luteum to enlarge to support the uterus and zygote until the placenta takes over HCG detection is the basis for pregnancy test Placenta secretes its own hormones to support the pregnancy and play a role in labor, lactation and breastfeeding. Cord is the connecting link between the fetus and the placenta Continuous and purposefull cell division and cell differentiation reslts in the development of the embryonic membranes & different germ layers that give rise to specific organs and body systems at the 3rd week Period of the Embryo From 4th to 8th weeks of development= embryo Body parts are formed during this period Critical time because viruses, drugs, and inadequate nutrition can gravely affect the embryo's development Prenatal Structures Period of the Fetus From 9 weeks after conception to birth Increase in size and systems begin to function Fetus rests in a pale straw-colored liquid the amnion filled with amniotic fluid Age of viability: 22 to 28 weeks First Month By the end of the first month, the embryo is about 1/10 of an inch long. The heart, which is no larger than a poppy seed, has begun beating. First Month Two Months The embryo is about 1 inch long and has distinct, slightly webbed fingers. Veins are clearly visible. The heart has divided into right and left chambers. Two Months Three Months By now the fetus is 2 1/2 to 3 inches long and is fully formed. He has begun swallowing and kicking. All organs and muscles have formed and are beginning to function. Four Months Your baby is covered with a layer of thick, downy hair called lanugo. His heartbeat can be heard clearly. This is when you may feel your baby's first kick. 4 months Five Months A protective coating called vernix caseosa begins to form on baby's skin. By the end of this month, your baby will be nearly 8 inches long and weigh almost a pound. Six Months Eyebrows and eyelids are visible. Your baby's lungs are filled with amniotic fluid, and he has started breathing motions. If you talk or sing, he can hear you. 6 Months Seven Months By the end of the seventh month, your baby weighs about 3 1/2 pounds and is about 12 inches long. His body is well-formed. Fingernails cover his fingertips Eight Months Your baby is gaining about half a pound per week, and layers of fat are piling on. He has probably turned head-down in preparation for birth. He weighs between 4 and 6 pounds. Nine Months Your baby is a hefty 6 to 9 pounds and measures between 19 and 22 inches. As he becomes more crowded, you may feel him move around less. The Mother No menstruation May feel the following: fatigue, light headedness, dizziness, fainting, abnormal cravings, nausea and vomitting (morning sickness) Can feel the movement of the baby from the 4th to fifth month Later month the mother can experience: heaviness, swollen legs, constipation, pelvic pains, frequent urination and uterine contarctions Influences on Prenatal Development General Risk Factors Teratogens: Diseases, Drugs, and Environmental Hazards How Teratogens Influence Prenatal Development Prenatal Diagnosis and Treatment General Risk Factors Nutrition: adequate amount of food, protein, vitamins, & minerals Stress: decreases oxygen to fetus and weakens mother’s immune system Mother’s Age: neither too young, nor too old Teratogens Substances that may harm the developing fetus and result in the formation of birth defects Teratogens: Diseases, Drugs, and Environmental Hazards • Many diseases pass through the placenta directly and attack the fetus • Potentially dangerous drugs not limited to cocaine but include alcohol and caffeine • Environmental hazards are treacherous because we’re often unaware of their presence How Teratogens Influence Prenatal Development Not universally harmful Harm particular structures at a particular point in development in particular animals Effects of Teratogens Fetal Alcohol Syndrome Can result in mental retardation / learning disability Facial Features Epicanthal folds Small, widely spaced eyes Flat midface Short, upturned nose Smooth, wide philtrum Thin upper lip Underdeveloped jaw Cleft Lip / Palate maternal alcohol consumption and maternal smoking during the early stages of pregnancy have been shown to increase the risk of developing orofacial clefts Prenatal Diagnosis and Treatment Diagnosis: ultrasound, amniocentesis, and chorionic villus sampling can detect physical deformities and genetic disorders Treatment: fetal medicine and genetic engineering are experimental What is an amniocentesis? An amniocentesis is a test that takes a small sample of the amniotic fluid. involves putting a long, thin needle through your abdomen into the amniotic sac. An amniocentesis is generally offered to women between the 15th and 20th weeks of pregnancy who are at higher risk for chromosome problems. The test may have indicated a higher risk for a chromosome problem or neural tube defect. What is a chorionic villus sampling ? involves taking a sample of some of the placental tissue. The exact method for CVS an vary, but the procedure involves putting a small tube (catheter) through your vagina and into your cervix. can be tested for chromosome problems and some other genetic problems. test can also look for other genetic problems and disorders if you have a family history of them. These other results also depend on the lab doing the testing. Unlike amniocentesis, CVS does not give information on neural tube defects such as spina bifida. may be offered if you are at higher risk for chromosome problems. You may also be offered it if you have a family history of a genetic problem that is testable from the placental tissue. CVS is usually done between the 10th and 13th weeks of pregnancy. For this reason, women who have CVS also need a follow-up blood test between 16 and 18 weeks of their pregnancy to screen for neural tube defects. Approaches to Childbirth • Childbirth classes provide information about pregnancy and childbirth • Childbirth classes teach pain control through deep breathing, imagery, and supportive coaching • Mothers who attend classes use less medication during labor and feel more positive about labor and birth MODULE 5B By taking the first day of the woman’s last menstrual cycle and adding 280 days, you can calculate when baby is due to be born. As the mother nears full term, several things happen: Baby loses the lanugo covering Baby drops down several (much vernix remains) and inches in the abdomen. This reaches an average size of 20 is called lightening. and The inches in length and 7 pounds. head becomes “engaged”. Eye color is slate-blue or black, This means it presses firmly and will not be fixed until after against the cervix. The birth exposure to light for some time. is close at hand. This is the correct term for the process of childbirth…the emergence of a child from its mother’s uterus. It starts with a signal from the pituitary gland. The hormone oxytocin is secreted into the bloodstream of the mother, and the process begins. (pitocin and syntocinon are common synthetic forms of this hormone, used to induce labor) There are 3 stages of childbirth: 1.LABOR 2.BIRTH OF THE BABY 3.BIRTH OF THE PLACENTA 3 signals indicate that labor has begun… 1. Contractions begin 2. Mucous plug is dispelled 3. Amniotic sac breaks 1. Initial uterine contractions are short and mild, but frequency, intensity, duration increase. During transition stage, the cervix completes dilation and stretches over baby's head. The entire process usually lasts up tp 15 hours 2. The mucous plug falls out as cervix dilates; it is accompanied by a tinge of blood, and is referred to as “bloody show” 3. Before labor begins, or in the early stages, the amniotic sac ruptures under pressure and fluid trickles or gushes out. Sometimes the sac must be broken manually. Prior to the beginning of labor, the thick cartilage walls of the cervix begin to thin out and lengthen. This process is called effacement. The cervix must be completely effaced in order to fully dilate. The purpose of “labor” is for the muscles to contract, pulling open the cervix. It must open (or dilate) to 10 cm. (approximately 4 inches) to allow for the birth of the baby. This is hard and painful work for the mother. The red arrows point to the cervical area and various stages in becoming fully effaced and dilated. Aptly named, labor is hard work. Contractions/dilation can be very painful. There are several methods that can help the mother manage the pain. Although medications can control pain, there is risk that the baby will be affected and become groggy. A regional anesthetic can be injected through the vagina into a nerve to relieve pain, but an epidural block is now the method of preference. An injection into the spinal column blocks pain. The mother remains awake. The mother will need to attempt to control this pushing movement. A slow expulsion of the baby from the vagina causes less damage to sensitive skin. In the second stage of parturition, the baby is expelled from the womb through the vagina by both the uterine contractions and by the additional maternal efforts of pushing or "bearing down". When the head is first visible, it is called “crowning”. An episiotomy is an incision through the skin and muscles in the perineum, made during a vaginal delivery. This procedure is performed in 2/3 of US births, and allows extra room for baby to pass out of the birth canal. The incision prevents tearing. It stitches easier and heals faster than a tear. Vaginal delivery accounts for 3 out of every 4 births in the United States. Most remaining vernix caseosa is rubbed off during delivery. A cephalic birth position is one that is head-first! The mother may stand with her legs apart, squat, lean over, recline backward or lie down with legs supported to facilitate the delivery. When the amniotic sac has not ruptured during labor or pushing, the infant can be born with the membranes intact. This is referred to as “being born in the caul”. The caul is harmless and it’s membranes are easily broken and wiped away. In medieval times, and in some cultures still today, a caul was seen as a sign of good fortune for the baby, in some cultures was seen as protection against drowning, and the caul was often impressed onto paper and stored away as an heirloom for the child. With the advent of modern interventive obstetrics, premature artificial rupture of the membranes has become common and it is rare for infants to be born in the caul in Western births. The "sutures" or anatomical lines where the bony plates of the skull join together can be easily felt in the newborn infant. The diamond shaped spaces on the top, top back, and sides of the skull are often referred to as the "soft spot" in young infants…correctly known as fontanelles (fontanels). The fontanelles actually allow the skull to change to a new shape, so it can emerge through the small cervical opening. This is called “molding” of the head. This change in the shape of the skull will go back to it’s original appearance in a few hours up to a few days. Immediately following delivery, if not during, a bulb syringe is used to suction mucous from the throat and nasal passages. It’s important that those first breaths be deep and clear. Healthy, loud cries assure that! The umbilical cord is connected at baby’s navel. The cord must be clamped and cut. (or tied off) Then another small plastic clamp is used, placed close to baby’s tummy. Stage 3 of childbirth follows delivery of the baby…it is the delivery of the afterbirth. After the placenta is delivered, it should be inspected for size, shape, consistency, and completeness. A one minute, thorough examination to detect normalcy or abnormalities may be critical in the management of mother and baby. An abnormal placenta may be one of the first indications that mother or baby has a problem. A suctioning method or vacuum is sometimes used to assist in difficult deliveries. It can turn the baby to a better position or perhaps just quicken the descent down the birth canal. A breech birth position is sometimes more difficult. It means that the baby is in the birth canal feet or buttocks first. An instrument called a forceps is sometimes used during delivery also. The cushioned tongs are used to hold, guide, or pull baby through the birth canal to hasten delivery. CAESARIAN SECTION birth position Also known as C-section or spelled cesarean section, 1. fetus is delivered through a horizontal incision in abdominal and uterine walls 2. advisable when: fetus in improperly aligned (such as a sideways position called transverse position), multiple fetuses, fetal distress, mother is worn out, or mother has a transferable genital condition or infection Birth Complications Lack of oxygen (anoxia): Often leads to surgical removal of the fetus (Csection) Premature and Small-for- date infants Prematurity is less serious than small-for-date Soon after birth, information will be gathered for baby’s official birth certificate. This becomes a matter of permanent public record; make sure it is correct, including spellings! It’s time to name the baby! Identification wrist or ankle bands are secured, as well as foot prints. The Newborn Assessing the newborn: Apgar to assess newborns’ health; NBAS for a comprehensive assessment of infants 4 primary states: alert inactivity, waking activity, crying, sleeping Half of newborns’ sleep is REM (deep sleep) Putting the baby to sleep on The hormone oxytocin that started the process of childbirth has several other effects on the body. 1. Research indicates that it plays a major role in establishing maternal behaviors in the mother. 2. Stimulates the muscles of the cervix, vagina, and uterus, helping them contract after delivery 3. Works in conjunction with a second hormone secretion from the pituitary gland, prolactin, to make and secrete milk from the mammary gland of the breast. This process is called lactation. The first secretion from the breast is called colostrum. It is sticky, and a milky-yellow color. It not only provides baby with perfect nutrition and is easily digestible, but also contains immunities from the mother. Breast milk best for the first 6 months of life protection againts infections, less allergy, healthier growth, better neuro development & lower rates of chronic disease economical & convenient natural method of child spacing protects the mother from infection, cancer, diabetes, osteoporosis & rheumatoid arthritis Requires all the private and government health institutions to adopt rooming-in and breastfeeding practices. Postpartum Depression Half of all new moms feel some irritation, resentment, and crying 10-15% feel more severe postpartum depression Postpartum depression affects warmth and enthusiasm of mothering Video on Postpartum Depression MODULE 6 “Children Are Watching” Video Clip http://www.youtube.com/watch?v=t3WioZcjbys What message is the video trying to convey? Parenthood Brings About Changes Parenthood – the state of being a parent, which begins when one has a child by birth or adoption A child brings dramatic and long- lasting changes. Responsible Parenthod a privelege and obligation exercised by married couple to deliberately and generously decide to raise a large family or, for different reasons and motives & with due respect for the moral law to avoid a new birth for an interdeterminate period involves the issue of when and how many children to have Planned Parenthood maintaining fertility until the person can choose the right time for assuming the responsibilities of being a parent common justifications for planned parenthood: danger to the mothr's or child's health and life, eugenic hereditary defects, and socio-economic difficulties New Responsibilities Raising a child is more than a day- to-day assignment… It is LIFE-LONG commitment!! Financial care LOVE A child needs ---Physical care Guidance Support New Responsibilities You have to consider the child’s needs first. First time parents can feel overwhelmed. Family Friends Community Resources Changes in Lifestyle Caring for a young child takes a huge amount of time and energy. Parents have limits placed on their personal freedom. Couples are better able to adjust to these changes in life if they prepare for them. Emotional Adjustments Parents feel conflicting emotions such as: Fear of not being a good parent Frustration at the loss of personal freedom and the addition of new responsibilities. Worry over money matters Jealousy of the baby and the attention Depression due to exhaustion or to the physical changes of pregnancy and Changes in Relationships Some parents feel overwhelmed by negative emotions and begin to bicker or fight with one another. The key to getting past troubled spots is for the couple to have good communication. Changes in Relationships Grandparents feel love and joy of their own and want to spend time with the baby. New parents may feel that the grandparent’s advice is really a criticism and resent it. The grand parents my feel hurt if their suggestions are rejected. Changes in Work Working women may quit work or cut back on their hours to care for their child. Workers who often put in overtime or weekends may be less willing to put in extra hours. Companies have policies to help working parents. On-site child-care facilities Flexible hour The Rewards of Parenthood Parents feel happiness, pride, and love. Parents can see the world with new eyes. Enrich an already healthy marriage Parents experience a great sense of accomplishment. Making Decisions About Parenthood People who are thinking about parenthood should have a clear picture of what parenthood is. They also need to take a realistic look at themselves to see if they are ready for parenthood. Emotional Maturity Emotional maturity – being responsible enough to consistently put someone else’s needs before you own Being secure enough to devote your full attention Prospective parents should take an honest look at their maturity Desire for Parenthood Our marriage is in trouble. Maybe having a baby will solve our problems. I want to give a baby my care and love. I feel good about myself and believe that parenthood will be rewarding. Our parents want grandchildren. A baby is someone who will love me and belong to me. Financial Concerns Raising a child is VERY expensive!! Couples should take a careful look at the cost involved over the years ahead. Management Skills Becoming a good manager is a matter of following five steps: 1. Set Goals 2. Identify Resources 3. Decide what is important for you and then make them into objectives for you to achieve. Figure out your resources to achieve your goal. Make a Plan Decide how you will use your resources to meet that goal. Management Skills 4. Put the plan in action. Once you have a plan, start working toward your goal. 5. Reevaluate from time to time. Do you need more resources or different ones? Did you achieve your goal more easily than you expected? Parenting: A Learning Process Parenting – caring for children and helping them develop Demands Good Judgment: 1. Requires knowing when to help and when to back off 2. Parents need to avoid pushing children to try activities they are not yet ready for. 3. They have to avoid holding children back out of fear they may fail. The skills that parents need change as the child grows. Having Reasonable Expectations An essential first step in effective parenting. Caregivers need to be sure to match their expectations to the particular child. Caregivers need to respect the differences between children. Act your age!! Finding a Comfortable Parenting Style: Authoritarian – based on the idea that children should obey their parents without question. Democratic – children have more input into the rules and limits Permissive – parents give children a wide range of freedom. Getting Help Ways to Build Parenting Skills Reading books and magazine articles about parenting Gaining experience with children Asking advice from family members and friends Observing other parents and children The Tasks of Parenting 3 Basic Tasks 1. Meet the child’s basic needs 2. Nurture 3. Guide children to show appropriate behavior Meeting Children’s Needs Provide food, clothing and shelter Watch over their safety and health Begin teaching them language Foster intellectual growth by taking an active role in their schooling Teach them to get along with others Provide opportunities for them to love and be loved. Nurturing Giving a child opportunities for encouragement and enrichment. Parents are children’s first teachers. Parents need to give children the freedom they need in order to learn. Adults should remove as many barriers as possible that prevent children from exploring the world on their own. Deprivation – lack if an enriching environment Nurturing Provide love and support Some parents become overprotective and overattentive. Communicating Positively Use words that the child can understand, but avoid talking down. Be clear. Think in terms of the child’s point of view. Be positive and polite. Give praise and love. Limit the directions to those that are essential. Talk about what’s meaningful to the child.
