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Prenatal Development
Prenatal development is divided into 3 periods and lasts approximately 266 days:
To 32 wks
About 11-14 inches long, weighs 1 to 1.5 pounds About 10-12 inches long, weighs 1/2 to 1 pound
Fig. 4.3
Prenatal Development
Issue of Abortion
Beliefs
and words seasoned with love If strongly opposed, then what alternatives are you offering.
Drugs (prescription, nonprescription). Alcohol, tobacco. Environmental pollutants. Infectious diseases. Nutritional deficiencies. Maternal stress. Advanced age of a parent.
Central nervous system Heart Arms Eyes Legs Ears Teeth Period of susceptibility Palate to structural defects External genitalia
Period of susceptibility to functional defects
Fig. 4.4
Fetal alcohol syndrome: abnormalities in newborn due to mothers heavy use of alcohol in pregnancy.
Abnormalities include:
Facial deformities.
intelligence.
Moderate drinkers during pregnancy had babies who were less attentive and alert even at 4 years of age.
Maternal smoking can cause :
Maternal factors: Maternal diet and nutrition. Emotional states and stress. Maternal age. Paternal factors: Paternal exposure to teratogens including smoking. Paternal age.
Percentage of U.S. Women Using Timely Prenatal Care: 1990 to 2004 1990 2004
100 90 80 70 60 50 40 30 20 10 0
Latino women
Fig. 4.6
Attitude
Plain
Birth
Three
stages of birth:
Uterine contractions begin at 15 to 20 minutes apart and last 1 minute; this stage lasts an average of 12 to 24 hours.
Babys head begins to move through dilated cervix opening; this stage lasts 1.5 hour on average. Afterbirth: umbilical cord, placenta, and other membranes are detached and expelled.
Birth complications include anoxia: insufficient oxygen to brain when delivery lasts too long.
Childbirth setting:
Methods of childbirthkey choices involve use of medication and when to have a cesarean delivery. Drugs used:
Analgesia pain relief. Anesthesia blocks sensation. Oxytocics synthetic hormones to stimulate contractions.
Natural childbirthaims to reduce pain by decreasing fear and breathing techniques (Grantley Dick-Read). Prepared childbirthLamazespecial breathing and education about anatomy and physiology.
Massage Acupuncture
Hypnosis
Music therapy
Cesarean Delivery: Needs to be used if baby is in breech position or other complications. Many today are choosing cesarean delivery. Women in need of cesarean delivery are more quickly identified. Doctors may order cesarean out of caution, and to avoid lawsuit if there is a possibility of maternal or fetal distress. Today, 29.1 percent of all births are cesarean.
Apgar Scale, used 15 minutes after birth: evaluate heart rate, body color, muscle tone, respiratory effort, and reflex irritability. Brazelton Neonatal Behavioral Assessment Scale performed within 2436 hours after birth:
27 items are organized into 4 categories physiological, motoric, state, and interaction.
Assesses newborns neurological development, reflexes, and reactions to people.
0
Blue, pale Absent No response Limp and flaccid Breathing for no more than 1 min.
1
Body pink, extremities blue
2
Entire body pink
Slow less than Fast 100 to 140 100 beats per min. beats per min. Grimace Coughing, sneezing, crying
Respiratory Effort
Inactive, weak, Strong, active some flexion of motion extremities Irregular and slow Breathing good with normal crying
Fig. 4.7
Causes of low birthweight: Preterm babies. Small-for-date babies. Problems in developing countries.
Possible consequences of low birthweight: Brain injuries. Lung and liver diseases. Learning disabilities. ADHD. Lower levels in reading and math achievement. Deficits are evident in adulthood.
About 50% of low-birthweight children are enrolled in special education programs. Low birthweight is linked to asthma.
Early speech therapy. Intensive enrichment programs. Kangaroo care and massage therapy.
Weight Gain Comparison of Premature Infants Who Were Massaged with Those Not Massaged
Premature infants who were massaged Premature infants who were not massaged Infant weight
3 lb. 7 oz 3 lb. 5 oz 3 lb. 3 oz 3 lb. 1 oz 2 lb. 15 oz
8 10 12 14
Age (days)
Fig. 4.8
Postpartum period lasts about 6 weeks after childbirth when woman adjusts physically and psychologically back to the prepregnant state:
Postpartum blues: symptoms appear 2 to 3 days after delivery and subside within 1 to 2 weeks
Percentage of U.S. Women Who Experience Postpartum Blues and Postpartum Depression
70%
20%
10%
No symptoms
Postpartum depression: symptoms linger for weeks or months and interfere with daily functioning
Fig. 4.9
A Fathers Adjustment:
Generally ignored, but fathers go through considerable adjustment. Some feel baby has replaced them in terms of mothers affection. Fathers should actively care for the baby. Parents should set aside time to be together.
Usually occurs in period shortly after birth. Critical component in childs development. Isolation of premature baby and use of drugs in birth process may harm bonding process. Some experts advocate a rooming-in arrangement while mother and child are in the hospital.