Birth & Pregnancy Flashcards
What is conception?
fertilization of the egg by the sperm
Describe the stages of conception:
- ovulation occurs: egg is released from the follicle, on approx. day 14 of the cycle.
- The egg is picked up by the fimbriae (finger like structures on the fallopian tube).
- Sperm travels through the cervix and uterus to one of the fallopian tubes (2 to 4 million). The egg must be fertilized with 12-24 hours or it will disintegrate.
- only 2-3 million sperm make it as far as the egg. Since gravity and they can only move 1-3cm every hour, 3000 times their length in distance by the time they reach the egg.
- Sperm follow chemical signals from the egg. The egg is surrounded by a nutritious fluid called the zona pellucida. Sperm has to dissolve the layer to penetrate it using hyaluronidase. This is called capacitation: removal of the plasma membrane overlying the sperm to allow for greater binding between the sperm and the egg.
- The moment conception occurs, the zona thickens to block out all other sperm. This occurs in the fallopian tubes.
- The zygote moves down to the uterus, taking about 5 days
- Zygote implants in the uterus
Explain the difference between the morning after pill and the abortion pill?
You can take the morning after pill within 5 days after sex because of the long process stated above (the sooner you take it the better because this journey doesn’t take everyone 5 days).
The morning after pill is a high dose of regular birth control pills that make the sperm inhabitable.
BUT! if the zygote is already implanted it will not have any affect in which case you would need to take the abortion pill.
What is basal body temperature? How is it used to detect pregnancy?
BBT: the lowest waking temperature.
An abrupt rise in body temperature about the time when ovulation should occur that stays elevated for 2 weeks indicates a high probability that a woman is pregnant. Usually .2 to .4 degree change. But only detectable if a woman was keeping track prior to becoming pregnant.
The rise is temperature is due to the progesterone secreted by the creation of the corpus luteum and later by the placenta.
What are some other early indicators of pregnancy?
tender breasts, nausea, vomiting, frequent urination, fatigue
What is the placenta?
An organ that connects the fetus to the uterine all for gas and nutrients exchange.
Chemical tests, how do they work?
Detect: Human Chorionic gonadotropin (HCG) in women’s urine. You can tell faster with blood because it takes a few.
You can tell this faster with a blood test because it takes longer to be present in urine.
What do doctors look for in a pelvic exam to detect pregnancy?
Hegar’s Sign - soft spot between the uterine body and the cervix
How do you calculate the delivery date with Nagele’s Rule?
Take the day of the first day of the woman’s last menstrual cycle, -3months, +7 days, +1 year.
What is the amniotic sac?
A sac filled with amniotic fluid, that helps to protect the embryo from outside damage and harmful temperature changes.
Explain the 1st trimester
The first 8 weeks of pregnancy is called the embryonic stage.
The placenta and amniotic sac develop
Develops major organs and systems, facial features, feet, hands
Becomes a fetus in week 9
Human physical characteristics develop towards the end, like limbs, digits, testicular tissue, finger nails, toenails - usually able to determine sex by ultrasound
The umbilical cord attaches…
the embryo to the placenta
First trimester effects on the pregnant person.
o Tingling, soreness and fullness in breasts
o Nausea, tiredness, and change in appetite (revulsion or craving)
o “morning sickness” - can actually occur at any time during the day
Women who experience morning sickness…
are less likely to miscarry
what does primiparous mean?
Pregnant for the first time
Describe the second trimester:
Fetal movements can be detected as early as 13-16 weeks or as late as 18-20 weeks, depending if you are a first time mother.
By the fifth month, fetal heartbeat can be heard with a stethoscope
By the sixth month, the fetus is sensitive to light and sound, can open eyes
Fetus is usually viable at 26 weeks (fetus will likely not survive before 26 weeks)
What effects does the second trimester have on the pregnant person?
o Indigestion and constipation because of pressing on organs
o Breasts enlarge with breast milk, nipples darken
o Stretch marks develop on breasts and stomach
o Most women report feeling well during this time as the nausea and vomiting have disappeared after the first trimester
Explain the third trimester:
By the end of the seventh month, the brain and nervous system are complete
Fetus is covered with down-like hair to help regulate body temperature
Average weight for full-term is 7.5lbs
The turns to a head-down position during delivery, called cephalic presentation
What are the effects of the third trimester on the pregnant person?
o Balance becomes an issue because of the shift of weight due to the size of the fetus.
o Backache, leg cramps, frequent urination, or swelling on the hands and feet
o Typical weight gain 25-35 pounds
Is it safe to have sex while pregnant?
Yes, the amniotic sac protects the fetus as well as a mucus plug at the base of the cervix prevents the movement of bacteria.
Although, if there is a history of miscarriage doctors may tell women to obtain from sex so their orgasms don’t cause contractions early on.
Sexual desire and physiological response has been shown to increase during the second trimester and decrease in the first and third. Maybe because of nausea and then the sheer size of the baby.
The increase in blood to to breasts, pelvice and external genitals could cause discomfort and sensitivity or make sexual activity more enjoyable
Women who were more satisfied with their partner before pregnancy had greater sexual satisfaction than other women, lower rates of fatigue and more positive about becoming a mother.
Pregnancy is not found to be related to a increased number of problems related to sexual functioning `
Many women elect to have an…
M.D deliver their baby
Healthy women cared for by midwives have better maternal and neonatal outcomes like…
o Lower perinatal mortality rates
o Lower caesarean-section (c-section) rates
In Canada, women also expressed far greater satisfaction with their labour and birth if they were assisted by a
midwife
What is engagement?
a few weeks before the fetus is born, it starts dropping so that the widest part of the head is positioned against the pelvic bones
What is effacement?
the cervix begins effacement where the cervix begins to thin and shorten in prep for dilation
What is stage 1 of birth?
Average labour lasts 8.6 hours in a first pregnancy
o About half that time for subsequent pregnancies
Contractions (initially far apart and less frequent) dilate the cervix until it is fully dilated to 10 cm (go to hospital at 5cm), allowing the baby to pass through
Dilation is used to define the three phases of the first stage of labour.
- Early phase: cervix dilates to 4cm; contractions every 15-20 minutes
- Active phase: goes from 4-8cm, contractions are more frequent and intense
- Final phase/transition: shortest & most difficult, lasts 30min or less. cervix dilates to 10cm
What is stage 2 of birth?
The second stage begins when the cervix is fully dilated and the head starts to move into the vaginal canal.
It ends with the birth of the baby.
Women “bear down” to move the baby down the vaginal canal. For first pregnancies usually 80 min, 30min if not.
An episiotomy (incision of the perineum to help with passage of baby) used to be used to reduce tearing but has not been shown to be anymore beneficial.
Once baby is delivered, blood and mucous is sucked from the baby’s nose and mouth to induce breathing.
Babies who passes meconium (first stool) in utero to clear passageways.
What happens during stage 3
- It may last from a few minutes to over an hour
- Sometimes called the “placenta phase”
- Placenta detaches from the uterine walls and is expelled with other material called “afterbirth”
What is an epidural?
injection of local anesthetic into the epidural space of the spinal canal to numb the lower body
What is a spinal block?
injection of local anesthetic into the spinal fluid for numbness in the lower body
Explain C-sections and it purpose
The baby is delivered through an incision made through the abdomen wall of the uterus
There are many reasons for a C-section delivery:
o Baby is too large
o Mother’s pelvis is too narrow
o Baby is in a breech or transverse position
o Umbilical cord will pass through the cervix before the baby
There is evidence that c-sections are being performed way more often than they should be.
What is colostrum?
high-protein, antibody-rich fluid that flows from the breast before the full onset of lactation. Rich with vitamin K
Explain each:
- Postpartum blues: 8-% of women
- Postpartum depression: 10-20%
- Postpartum psychosis: 0.2%
- Postpartum blues: mild depression, anxiety, irritability occurs in the first few days after delivery
- Postpartum depression: severe depression within the first year
- Postpartum psychosis: psychosis occurring within the first 3 months.