BIRTH PLANNING
Senior Health
Birth Planning
• Obstetrician/Gynecologist
– 4 years of training in pregnancy, delivery and women health and
infertility.
• Maternal-Fetal Specialist
– High risk pregnancy specialist with OB/GYN
• Family Physician
– General medical care for the whole family.
– Referral to OB/GYN, only for low risk pregnancy
• Nurse Mid-wife
– Licensed registered nurse cares for mother and fetus
– Trained in delivery of baby and after care.
– Works with doctor, unless complications.
Hospital Birth
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Modern medical equipment
Medication available
Recommended for high risk pregnancy
Delivery by doctor OR Mid Wife
Birthing Center
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Home like setting-usually on hospital grounds
Medication free
Parents have control of process
Receive individual care
Labor-Delivery and after care in the same
room.
Home Birth
• No birth risks for mother or fetus
• Labor-Delivery and After care all in same
setting
• Maximum control over birth
• Share experience with family and friends
• NO medicine or medical care immediately
available
• May not be covered by insurance
Birth Plan Medications
• Natural Childbirth
• Advantage
– No side effects from medication
– Experience birth and delivery
– No medical machines to be hooked up to
• Disadvantages
– Pain/Discomfort without medication
– Point of no return- Medication
Systemic Medications
• Narcotics or tranquilizer
• IV into blood stream or injection into muscle
• Advantage
– No anesthesia
– Takes “edge” or reduces anxiety
– Cope with some pain
• Disadvantages
– Doesn’t control all pain
– Slows down labor
– Could effect fetus or baby
Regional Medication
• Decreases sensation to specific parts of the body.
– Mother is alert and awake with NO pain waist down.
Spinal Tap
-Injected in the dura of
spinal cord
Advantage
-Rapid pain relief
Disadvantage
-Position for injection
-Harder to push fetus
out
-Decrease in blood
pressure
-Headaches
Epidural
-injected into sac around spinal cord.
Advantage
-Awake and alert during labor
-Increases energy during delivery
Disadvantage
-Spotty pain relief
-Position for injection position
-Loss of sensation of body
Pregnancy and
Parenting
Female Anatomy
Fertilization
• Fertilization is the union of the sperm and the
ovum, or egg.
• This occurs around the time of ovulation in a
women.
– The egg is capable of being fertilized for about 12-24 hours
after ovulation.
– The sperm can live inside a woman’s body for up to 5 days.
• This occurs in the fallopian tube.
• As soon as the ovum is fertilized, it is called a
zygote.
Fertilization
• Look Who's Talking
Zygote
• Once the zygote has formed, a protective
membrane around it will prevent more sperm
from entering the ovum.
• As the zygote makes its way to the uterus the
cells will divide many times to form a cluster
of cells that has a hollow space in the center.
• This is called a blastocyst.
Blastocyst
Implantation
• When the blastocyst attaches to the lining of
the uterus.
• The lining of the uterus is made up of layers of
tissue that will protect and nourish the
fertilized egg.
• Once implanted the cluster of cells is now
called an embryo.
• The embryo is now the size of a dot on top the
letter “i.”
Embryonic Development
• The cells of the embryo will continue to divide
and form 3 layers of tissue.
• One layer becomes the respiratory and
digestive systems.
• Another layer develops into muscles, bones,
blood vessels, and skin.
• The third layer becomes the nervous system,
sense organs and the mouth.
Embryonic Development Con’t
• The Amniotic Sac will also form at this time.
• This is a sac filled with fluid that forms and
surrounds the developing embryo. It acts as a
shock absorber, and insulates the embryo from
temperature changes.
• Placenta – A blood rich tissue developed from an
outer layer of cells from the embryo and tissue
from the mother. The embryo is connected to
the placenta by the umbilical cord.
• Umbilical cord – a tube through which nutrients
and oxygen pass from the mother’s blood into
the embryo’s blood. The umbilical cord also
carried waste products from the embryo.
Embryonic Development Con’t
• During the first six weeks the embryo grows
rapidly in length and gains weight.
• At the start of the embryonic period the
embryo is about .5-1 inch long.
• At eight weeks the embryo is 1.5 inches long.
• At the end of the eighth week the embryo is
now called the fetus, and will be called the
fetus till birth.
Fetal Development
• The development of the fetus is now divided
into 3 trimesters.
• 1st trimester – 1 to 3 months
• 2nd trimester – 4 to 6 months
• 3rd trimester – 7 to 9 months
1st Trimester
• During the 1st month: the blood begins
circulating, and the brain begins to form but does
not function
• During the 2nd month: the external body parts
and internal organs begin to form, genitals also
start to form but you can not tell the gender yet.
• During the 3rd month: the male and female begin
to look different, fingers, toes , and nails start to
form, the head is about half the size it will be at
birth.
1st trimester
2nd Trimester
• During the 4th month: Muscles move , sweat
glands, eyebrows, and eyelashes begin to
form.
• During the 5th month: fetus gets hair,
movements can be felt, heartbeat can be
heard.
• During the 6th month: the brain starts to
work, eyes open, ears work, finger and
footprints form.
2nd trimester
Fetus is about 8 inches long
3rd Trimester
• During the 7th month: the fetus adds body fat,
moves a lot, responds to sound
• During the 8th month: less active, still growing
in weight and length, nails and bones begin to
harden
• During the 9th month: Lungs and other organs
become fully developed (except for brain and
reproductive system which won’t fully mature
until teen years)
3rd trimester
Ultrasounds
1st Trimester
2nd Trimester
3rd Trimester
How do you know your pregnant?
• Symptoms include missed menstrual period,
breast tenderness, morning sickness, frequent
urination.
• Pregnancy Tests
– Blood and Urine Tests test for the hCG hormone.
– Blood tests can test for hCG sooner and are more
accurate. (6-8 days after ovulation)
– Home pregnancy tests are the most accurate one
week after a missed period.
Physical Changes
• 1st trimester: increase in hormones, breast
swell, frequent urination, morning sickness,
vaginal irritation, fatigue
• 2nd trimester: morning sickness disappears,
constipation, nosebleed may occur, edema
(water retention and swelling)
• 3rd trimester: weight gain (25-35lbs),
discomfort, backaches, shortness of breath,
swelling, heartburn, frequent urination
Psychological Changes
• Depression
• Negative/positive emotions
• Psychological well being is best among those that
have social support.
• Postpartum depression – also known as the
“baby blues,” happens after the birth and consists
of mood swings and crying spells. May go away
on own, if not the mother will need to seek
medical treatment
Father/Partner’s Role
• Couvade Syndrome – a healthy man whose
partner is expecting a baby experiences
pregnancy symptoms, “sympathetic
pregnancy”
• Symptoms occur during the 1st and 3rd trimesters and
consist of nausea, heartburn, abdominal pain, appetite
changes, backaches, etc.
• Helps with labor – breathing techniques, may
hold a leg, and cuts the umbilical cord
Prenatal Care
• Pregnant women should have regular visits
with an OB/GYN or midwife.
• Blood Tests, pelvic examinations to identify any
problems early on
• Ask questions
• Nutrition
• Monitor weight
• Exercise programs
Prenatal Nutrition
• The mother to be needs large amounts of
micronutrients, especially calcium, Vitamin E, Zinc, and
Iron.
• Iron Deficiency – will cause the fetus to draw its supply
from the mother and leave the mother anemic, and
exhausted.
• Zinc Deficiency – malformations of the central nervous
system.
• Eating foods high in Folic Acid (whole grains and fish)
reduces the risk of certain birth defects.
• Spina Bifida – a birth defect where the backbone and the spinal
canal do not close before birth
Medicines, Drugs, and Pregnancy
• Any medication whether over-the-counter or
prescription pose a potential danger to the fetus.
• If illegal drugs are taken during pregnancy the
baby can be born addicted and dependent on the
drug.
• Caffeine has been associated with an increased
risk of birth defects and other problems.
• Other harmful substances: food additives,
aspirin, antibiotics, toxins, such as carbon
monoxide and lead.
Alcohol and Pregnancy
• Females who drink alcohol during pregnancy may
cause permanent damage to the developing
baby.
• Alcohol use had been associated with many birth
defects.
• The alcohol passes from the mother into the
bloodstream of the fetus.
• Fetal Alcohol Syndrome (FAS) – mental
retardation, slow growth, and physical defects,
such as cleft palate, and hip dislocation.
Fetal Alcohol Syndrome
Tobacco and Pregnancy
• Babies born to mothers who use tobacco have a
greater chance of being born prematurely, and with
low birth weights.
• Babies that weigh less than 5 ½ lbs are at risk for
serious health problems.
• Low birth weight is the leading cause of death in a
baby’s first year.
• Smoking may affect the growth, mental development,
and behavior of a child up to age 11.
• Children also have a higher incidence of respiratory
problems, such as bronchitis and pneumonia.
Stages of Labor
• 1st stage: Dilation- Stretching of the cervix,
results from mild contractions.
• 2nd stage: Begins when the cervix is fully dilated
(8-10inches), Passage of the baby through the
birth canal, caused by continuing contractions.
– Crowning – top of the head is visible
– Episiotomy – incision made to the vaginal entrance
• 3rd stage: After Birth-contractions continue after
the baby is born for 10 to 15 minutes to push out
the placenta.
Cesarean Section
• Also known as a “C-Section”
• A method of delivering a baby surgically by an
incision to the mother’s abdomen and uterus.
• Reasons:
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Baby is too large
Cervix is not dilating
Umbilical cord
Excessive bleeding
Baby is in distress
Baby is in an abnormal position
Cesarean Section Clip
Recovery Time
• Vaginal Birth – 2 days after delivery
• C-Section – 4 days after delivery
Infertility
• Infertility refers to a woman’s inability to
conceive and give birth to a living child, or
man’s inability to impregnate a woman.
• Causes:
– Female – Pelvic Inflammatory Disease, Failure to ovulate,
blockage of the fallopian tubes, body fat, hormones
– Male – Infections to the reproductive system caused by STDs,
low sperm count, low sperm motility
– Both – Stress, lack of knowledge
Questions
• Why do miscarriages happen?
– 10-25% of all clinically recognized pregnancies will end in a
miscarriage
– Most miscarriage will occur within the first 13 weeks
– Reasons for miscarriages vary and often can not be identified
– Examples: chromosomal abnormalities, hormonal problems,
lifestyle, problems with implantation,
– Maternal age
– Maternal trauma
Questions
• Birth Defects?
– 1 in every 33 babies is born with a birth defect.
Center for Disease Control Statistics
Questions
• What is the average number of children
parents have?
• According to 2010 Census 1.88
• When do you start to show?
• Most women start showing between 3 and 4 months
• Women who have been pregnant before my start
showing sooner