GASTROINTESTINAL SYSTEM CHANGES in the way she performs the role and the maternal

role is achieved.
Nausea and vomiting Common during the 1st
trimester due to increased Psychological Adaptation of Pregnancy based on Reva Rubin’s
hCG Theory:
Ptyalism Excessive saliva in
pregnancy due to changing  Distinct emotional responses of the mother to
hormones pregnancy
Heartburn and flatulence Often occur due to
reduction in gastric acidity, First trimester Second Third trimester
growing uterus and smooth trimester
muscle relaxation  Accepting  Accepting  Preparing
Heartburn The hormone progesterone the the baby for
causes the valve to relax, pregnancy  Fantasizes parenthood
which can increase the  Ambivalence about the  Identificatin
frequency of heartburn baby of baby’s
appearance
Flatulence  Excessive gas
during pregnancy
is caused by Emotional Aspects of Pregnancy:
hormone
progesterone First trimester is denoted by ambivalence
 This allows gas to (having mixed emotions or contradictory ideas
build up, which in about something or someone)
turn leads to
bloating, burping, Focus: bodily changes
and flatulence

Developmental task: to accept the

SKELETAL SYSTEM CHANGES
biological facts of pregnancy
Hormone relaxin Relaxation of pubic joints
during pregnancy
Lumbodorsal curve Increases in the 3rd
trimester, producing low Second trimester. The mother feels well and
back pain happy and fantasizes about the baby

Reva Rubin Maternal Role Attainment Theory: Focus: self-growth and development of
fetus
a. Anticipatory Stage – begins in the pregnancy and
includes the initial social and psychological
Developmental task: accepts the growing
adjustments to pregnancy. The mother learns the
fetus as part of her own
expectations of the role, fantasizes about the role,
related to the fetus in the uterus, and begins role
play.
b. Formal stage- begins with the birth of the infant and Third trimester. Personal identification of the
includes learning and taking of the role of the appearance of the baby
mother. Role behaviors are guided by formal,
consensual expectations and others in the mother’s
social system. Focus: the baby, mother’s delivery
c. Informal stage – begins as the mother develops process, responsible parenthood
unique way of dealing with the role not conveyed by
the social system. The woman makes her new role fit Developmental task: Preparation for
within her existing lifestyle based on past childbirth
experiences and future goals.
d. Personal stage – Role Identity Stage occurs as the
woman internalizes her role. The mother
experiences harmony, confidence, and competence
Fetal Development
 Cephalocaudal in progression
 1st trimester period of organogenesis
 2nd trimester period of rapid increase in length
 3rd trimester period of continuous growth and
development
 Cephalocaudal – refers to the growth and
development that occurs from the head down
to lower extremities
 Organogenesis – the three germ layers of the
embryo form into the major organs of the body
system
Development at 1-4 weeks (1 month):
 Length 0.75 to 1cm
 Weight 400 gm
 Spinal cord fused at midpoint
 Rudimentary heart appears as a bulge on the
anterior surface
 Extremities appear as buds
 Recognizable eyes, ears and nose
Development at 5-8 weeks (2months)
 Length 2.5cm; 20 g
 Completed organogenesis
 Heart with septum; beats rhythmically
 Facial features identifiable
 Extremities developed
 External genitals present but not clear
Development at 9-12 weeks (3 months)
 Length 7-8cm; weight 45 g
 Nailbeds formed formation of bone ossification
centers
 Tooth buds present
 Heart beat audible by doppler
 Kidney secretion starts
Development at 13-16 weeks (4 months)
 Length 10-17 cm; 55-120 g
 Feta heart beat audible by stethoscope
 Lanugo well-formed
 Functional liver and pancreas
 Fetus swallows amniotic fluid
 Urine present in amniotic fluid
 Sex determined by ultrasound
Development at 17-20 weeks (5months)
 Length 25cm; 223 g
 Quickening present
 Hair eyebrows formed
 Meconium present in upper intestine
 Vernix caseosa forms
 Definite sleeping patterns develop
Time for an ultrasound:
 An ultrasound is usually done for all pregnant
women at 20 weeks.
 Sex can be determined whether it’s a boy or a girl at
20 weeks,
Development at 21-25 weeks (6 months)
 Length 27-36 cm; 550 g
 Passive antibody transfer
 Meconium present in the rectum
 Start of surfactant production
 Eyelids open
 Pupils reactive to light, well-defined eyebrows and
eyelids
 Capable of hearing sounds
Developmental at 26-29 weeks (7 months)
 Length 35-38 cm; 1200 g
 Alveoli matures
 Surfactant present in amniotic fluid
 Testes begin to descend
 Thin retinal blood vessels which are extremely
susceptible to damage
Developmental at 30-34 weeks (8 months)
 Length 38-43 cm; weight 1800-2700 g
 Deposition of brown fat
 Fetus responds to external voice
 Active presence of Moro reflex
 Fetus assumes birth position
Development at 35-37 weeks (9 months)
 Length 42-48 cm; wright 1800-2700 g
 Body stores glycogen, iron and carbohydrates
 Calcium deposition
 Deposition of subcutaneous fats
 Presence of 1-2 creases on sole of foot
 Decreases in lanugo
Development at 38-40 weeks (10 months)
 Length 48-52 weeks; weight 3000g
 Fetus kicks actively
 Start of conversion of fetal hemoglobin to adult
 Vernix caseosa fully formed
 Sole creases cover 2/3 of feet
 Lightening maybe present
Birth!
 A mother’s due date marks the end of her 40th week.
 The delivery date is calculated using the first day of
her last period.
  Based on this, pregnancy can last between 38 and 42
weeks with a full-term delivery happening around 40
weeks
 Some post-term pregnancies – those lasting for
more 42 weeks – the due date may just not be
accurate.
 For safety reasons, most babies are delivered by 42
weeks
 Sometimes the doctor may need to induce labor.

Methods of Assessing Pregnancy and Methods of Estimating

EDC:

 Indirect / Non-invasive
o Naegele’s Rule
o Fundal Height
o McDonald’s Rule
o Haase’s Rule
 Direct / Invasive
o Ultrasonography
o Laboratory findings / deviations
- Urine tests
- Blood tests

Indirect / Non-invasive:

a. Naegele’s Rule – is a standard way of calculating the

due date for a pregnancy. The rule estimates the
expected date of delivery (EDD) by adding one year,
subtracting three months, and adding seven to the
first day of a woman’s last menstrual period (LMP).

Ex. Woman’s last menses began on 9/10/2018. What is

her EDD?

9–3=6
10 + 7 = 17
2018 + 1 = 2019

Her EDC is on June 17, 2019.