Prenatal Development & Birth Chapter 3 Conception • Strategies – The old fashioned way – In vitro – Surrogate – Artificial insemination • Following ovulation, fertilization occurs in fallopian tube • Cell division occurs in the zygote • Flows into uterus Prenatal Development • Germinal Stage – Fertilized egg not yet implanted in the uterus – Upon initial cell division the fertilized egg becomes a zygote – At approximately 12 days following fertilization, zygote is implanted in the lining of the uterus – Cells specialize into what will become organs Prenatal Development • Embryonic Stage – Differentiation of tissues into what will become organs (organogenesis) – Movements to stimuli based on “hard-wired” reflexes; – Critical period of pregnancy in that as organogenesis occurs, anomalies can result in miscarriage – Umbilical cord and placenta develop and provide nutrition and oxygen to and remove waste from the embryo – Developmental patterns: • Cephalocaudal Patterns • Proximodistal Patterns Prenatal Development • Fetal Period – – – – Begins approximately 8 weeks post fertilization Organogenesis is complete At approximately 3 months, genitalia can be identified At approximately 4 months, movements can be felt by the mother – At approximately 7 months fetus may be “viable” (can survive outside the womb with nutrition and temperature regulation support). Brain Development during Prenatal Period and Beyond • Growth: brain cells develop from the neural tube across the prenatal period and into infancy • Migration: brain cells migrate or move from the center of the developing brain to the periphery • Elaboration: – connections among the axons and dendrites of the cells are based on genetics during the prenatal period; – postnatal experience (nurture) enhances and inhibits elaboration (e.g. first 6 months of life the infant is particularly “wired” to learn sounds of language) Risks during Prenatal Development • Teratogens: Toxins that impact the developing organism prenatally – Nicotine—increased heart rate; low birth weight – Alcohol—fetal alcohol syndrome (mental retardation, physical abnormalities) – Rubella (German measles)—can be transmitted from pregnant mother to fetus; can result in blindness, other physical problems, and death – HIV—without medication can be transmitted from pregnant mother to fetus – Psychoactive drugs—multiple effects Risks during Prenatal Development • Maternal Anxiety and Stress during late pregnancy related to: – Attentional problems – Reactions to novelty • Maternal Age (extremely young and older) • STD’s – Herpes – HIV/AIDS – Syphilus Critical Periods in Gestation • Points at which key transitions occur tend to be the most critical – Attachment to the uterine wall – Organogenesis tends to most vulnerable to major “malformations.” (Germinal Stage) – Chronic exposure to toxins during fetal stage linked to delay in fetal growth and deficits in intellectual potential (fetal stage) Father’s Role • Health of Sperm—toxins, radiation, drugs and alcohol • Supportive partner—emotional support, support for alcohol & tobacco free pregnancy • Support and encourage access to health care Birth Process • Stage 1: – Dilation • Early labor – Initial irregular uterine contractions – Dilation or Effacing of the cervix to begin the birthing process • Active labor – Contractions become more regular and intense – Go to the birthing center/hospital – Cervix continues to efface Birth Process • Stage 2 – “Push” mode – Fetus enters birth canal – Birth occurs • Stage 3 – Contractions continue through delivery of placenta Birth Process: Birthing Options • Lamaze Method – Focusing – Relaxation – Breathing – Knowledge and understanding – Partner and shared experience Birth Process: Birthing Options • Leboyer Method – Alternative context – Home-like atmosphere – Neonate is placed on the mother’s chest with umbilical cord in place • Home birth – Screened for potential complications – Birthing professional present (e.g. Midwife, Nurse Practitioner) – Family/Partner involved Birth Process: Birthing Options • Drugs during labor & delivery – Overall, minimizing use of drugs during labor and delivery is best – General impact on neonate and infant is short term – More fragile (preterm, low birth weight) infants at greatest risk for negative outcomes with drugs – Drugs reduce mother’s ability to “push” during labor and delivery Birth Process: Birthing Options • Maternal comfort and safety is most important in selecting birthing option • Pregnancy complications can limit safe options • Prenatal health – Emotional support – Nutrition – Exercise – Prenatal health care Neonatal Condition • Apgar (1 minute & 5 minutes; Scores: 0, 1, or 2) – Heart rate. – Skin color. – Muscle tone (judged by whether the newborn's arms and legs are flexed or limp). – Breathing. – Reflex irritability (judged by whether the newborn cries or reacts when the skin is stroked or touched). Neonatal Condition • • • • • • Phenylketonuria (PKU) test for neonates Hearing Antibiotic eyedrops Vitamin Injections Early breast feeding provides antibodies Caring, supportive, safe, and healthy environment