Chapter 10: Conception, Pregnancy, and Childbirth R7-12 Flashcards
Conception
union of a sperm cell and an ovum
Y chromosomes
Creates a boy
-faster swimming sperm than X (why more boys than girls)
Male fetuses are more likely to be lost in spontaneous _____
abortions
-which often occur in the first month
Upon ejaculation, ___ to ___ million sperm are released and only ___ in ___ get in the vicinity of an ovum
200-400 million
1 in 1000
Sperm cells are apparently attracted by
Sperm cells are apparently attracted by
zona pellucida
A gelatinous layer that surrounds an ovum
hyaluronidase
An enzyme that briefly thins the zona pellucida, enabling one sperm to penetrate
Physicians often recommend that couples try to conceive on their own for ___ months before seeking medical assistance
six
Infertility
Inability to conceive a child
-failed to conceive for over a year
In vitro fertilization can cost up to
$15 000
About __% of infertility lies in men, while ___% lies in both partners
40% men
20% both
Motility
Self-propulsions. Motility is a measure of the viability of sperm cells
Autoimmune responses
The production of antibodies that attack naturally occuring substances that are (incorrectly) recognized as foreign or harmful
Problems in producing normal, abundant sperm may be caused by:
genetic factors, advanced age, hormonal problems, diabetes, injuries to the testes, varicose veins in the scrotum, drugs (alcohol, narcotics, marijuana, and/or tobacco), antihypertensive medications, environmental toxins, excess heat, and emotional stress
Low sperm count (or the absence of sperm)
the most common problem
To be considered normal, sperm must be able to:
- To be considered normal
- sperm must be able to
artificial insemination
The introduction of sperm into the reproductive tract through means other than sexual intercourse
Women encounter the following major fertility problems:
Irregular ovulation, including failure to ovulate (MOST COMMON)
Obstructions or malfunctions of the reproductive tract, often caused by infections or diseases involving the reproductive tract
Endometriosis
Declining hormone levels of estrogen and progesterone that occur with aging and may prevent the ovum from becoming fertilized or remaining implanted in the uterus
The following fertility problems are found in men:
Low sperm counts
Irregularly shaped sperm (e.g., malformed heads or tails)
Low sperm motility
Chronic diseases such as diabetes
Infections such as sexually transmitted infections
Injuries to the testes
Autoimmune responses, in which the man produces antibodies that deactivate his sperm
A pituitary imbalance and/or thyroid disease
Ovulation can often be induced by fertility drugs such as
- clomiphene (sold as Clomid), which stimulates the pituitary gland to secrete FSH and LH, which in turn stimulate the maturation of ova.
- Pergonal, contains a high concentration of FSH, which directly stimulates maturation of ovarian follicles
Endometriosis (1 in 6 cases)
A condition caused by the growth of endometrial tissue in the abdominal cavity, or elsewhere outside the uterus, and characterized by menstrual pain
Laparoscopy
A medical procedure in which a long, narrow tube (a laparoscope) is inserted through an incision in the naval, permitting visual inspection or organs in the pelvic cavity
In Vitro Fertilization (IVF)
A method of conception in which mature ova are surgically removed from an ovary and placed in a laboratory dish with sperm
gamete intrafallopian transfer GIFT
sperm and ova are inserted together into a fallopian tube for fertilization. Conception occurs in a fallopian tube, rather than in a laboratory dish.
Zygote intrafallopian transfer (ZIFT)
involves a combination of IVF and GIFT. Sperm and ova are combined in a laboratory dish. After fertilization, the zygote is placed in the mother’s fallopian tube, to begin its journey to the uterus for implantation.
ZIFT’s advantage over GIFT
the fertility specialists can ascertain that fertilization has occurred before insertion is performed.
Donor IVF
Ovum is taken from one women, fertilized, and injected into the uterus or fallopian tube of another women
Embryonic transfer
Female volunteer is artificially inseminated by the male partner of the intended mother, than the embryo is removed from the volunteer and inserted intot he uterus intended mother
Intracytoplasmic sperm injection (ICSI)
A single sperm is injected directly into an ovum
-may lead to: increase in birth defects, including heart, stomach, kidney, and bladder problems, cleft palates, hernias, and malformation of the penis.
surrogate mother
artificially inseminated by the partner of an infertile woman or by one of two men who are a couple. She carries the baby to term and then turns the baby over to the father and his partner
Surrogate mother in Canada
Legal
- must be no contract
- can not pay women
The main provisions of the Assisted Human Reproduction Act include:
A ban on human cloning
A ban on selection of a baby’s sex for non-medical purposes
A ban on payment to a surrogate mother
A ban on payment to a sperm donor
For many women, the first sign of pregnancy is (most common)
a missed period.
-Missing a period is therefore not a fully reliable indicator, as stress can delay periods
human chorionic gonadotropin (hCG)
-Found as early as 10 days after conception
Hormone produced by women shortly after conception. hCG stimulates the corpus luteum to continue producing progesterone. The presence of hCH in a women’s urine indicates that she is pregnant
human chorionic gonadotropin (hCG)
refers to the nausea, food aversions, and vomiting a woman may experience during pregnancy
-subsides by about the 12th week of pregnancy.
Miscarriage
A spontaneous abortion
- specific cause is not identified
- prevalent among older mothers
The normal gestation period ____ days is from the onset of the last menstrual cycle before conception
280
The normal gestation period is ___ days when we measure from the date at which fertilization is assumed to have taken place, which normally corresponds to two weeks after the beginning of a woman’s last menstrual cycle
266
Naegele’s rule to calculate the delivery date:
1) Write down the date of the first day of the last menstrual period.
2) Add seven days.
3) Subtract three months.
4) Add one year.
The Germinal Stage
- Within 36 hours of conception, the zygote divides into two cells (dividing rapidly, becomes 32 cells in another 36 hours)
- Takes zygote three or four days to reach the uterus
Germinal Stage definition (aka period of the ovum)
The period of prenatal development before implantation in the uterus
Blastocyst
Embryo that consists of a sphere of cells surrounding a cavity of fluid
-Occurs at the germinal stage of embryonic development
Jenny;s baby is in day 9… it is called a blastocyst
Embryonic Stage
Lasts from implantation through the eighth week
-characterized by the differentiation of major organ systems
amniotic sac
A sac containing the fetus
amniotic sac
Fluid within the amniotic sac
-suspends and protects the fetus
placenta (after birth)
An organ connected to the fetus by the umbilical cord. The placenta serves as a relay station between the mother and the fetus, allowing the exchange of nutrients and wastes
umbilical cord
A tube that connects the fetus to the placenta
The Fetal Stage
- begins by the ninth week and continues until birth
- By about the ninth or tenth week, the fetus begins to respond to the outside world by turning in the direction of external stimulation
By the end of the first trimester
The major organ systems, fingers, toes, and external genitals are formed, the gender can be visually determined, and the eyes are clearly distinguishable.
By the end of the first trimester,
Maternal Diet Maternal Diseases and Disorders Critical Periods of Vulnerability Rubella (German Measles) Syphilis HIV and AIDS Pregnancy-Induced Hypertension Ectopic Pregnancy Rh Incompatibility Maternal (and Paternal) Drug Use Vitamins Narcotics Marijuana Alcohol Cigarette Smoking
Teratogens
Environmental influences or agents that can damage an embryo or fetus
-They include alcohol, aspirin, the metals lead and mercury, radiation, and disease-causing organisms such as viruses and bacteria
critical periods of vulnerability
A period when an embryo or fetus is vulnerable to the effect of a teratogen
Rubella (aka German measles)
Viral infection that can cause deafness, intellectual disabilities, and heart disease in an embryo
Syphilis
Sexually transmitted disease caused by a bacterial infection
Stillbirth
Birth of a dead fetus
3000 stillbirths a year (8 for every 1000)
Acquired immunodeficiency syndrome (AIDS)
A condition cause by HIV that destroys white bloods cells in the immune system, leaving the body vulnerable to various ‘opportunistic’ diseases
Pregnancy-induced hypertension (aka pre-eclampsia)
A life-threatening condition characterized by high blood pressure
ectopic pregnancy
A pregnancy in which the fertilized ovum implants outside the uterus, usually in the fallopian tube
Rh incompatibility
A condition in which antibodies produced by a pregnant women are transmitted to the fetus, where they may cause brain damage or death
fetal alcohol syndrome (FAS)
A cluster of symptoms in the infant caused by maternal alcohol consumption during pregnancy. These symptoms are typified by developmental lags, characterized facial features, and a smaller-than-average body and brain
Dropping or lightening
Early in the ninth month of pregnancy, the fetus’s head settles in the pelvis
Labour begins
with the onset of regular uterine contractions.
Braxton Hicks contractions
So-called fake labour contractions, which are relatively painless
-they don’t widen the cervix or advance the baby through the birth canal
Childbirth has ____ stages
3
First stage of childbirth
- uterine contractions efface and dilate the cervix to about 10 centimetres in diameter, so the baby can pass
- THE LONGEST STAGE
efface
Cause to become thin
Dilate
Open or widen
___ to ___ hours of labour is considered about average for a first pregnancy
12-24
Transition
Process during which the cervix becomes almost fully dilated and the infant’s head begins to move into the birth canal
The second stage of childbirth
- begins after transition, when the cervix is fully dilated and the baby begins to move into the birth canal (vagina)
- fetal membrane rupture and amniotic fluid gushes out
- Umbilical cord cut after breathing starts
Crowning
When the baby’s head becomes visible at vaginal opening
-full emergence ends the second stage
begins after transition,
Surgical incision in the perineum that widens the birth canal, preventing random tearing during childbirth
The third, or placental, stage of childbirth (after birth)
- a few minutes to an hour or more
- the placenta is expelled and the uterus begins the process of contracting
Methods of Childbirth
Methods of Childbirth
Prepared Childbirth (The Lamaze Method)
Caesarean Section
Lamaze method
Women lears how to relax and breath in patterns that conserve energy and lessen pain, with the help of a coach who’s present during childbirth
Caesarean Section (C section)
Method of childbirth in which the fetus is delivered through a surgical incision in the abdomen
-could be due to cord, position, distress, length of labour
transverse position
A crosswise birth position
midwife
A health professional who provides primary care to w omen and her baby during pregnancy, labour, birth, and the postpartum period
Birth Problems
Preterm and Low-Birth-Weight Children
Stillbirth
Premature / preterm
Born before 37 weeks of gestation
The normal period of gestation is ___ weeks
40
Postpartum period
the weeks following birth (Baby blues)
-caused by hormone changes (last for about 10 days)
Postpartum depression (PPD)
- begins within four weeks after delivery and may linger for weeks or months
- symptomized by serious sadness, feelings of hopelessness and helplessness, feelings of worthlessness, difficulty concentrating, and major changes in appetite (usually loss of appetite) and sleep patterns (often insomnia)
Breastfeeding
Negatives to breastfeeding
HIV can be transmitted to infants via breast milk
-may undernourished the mother by feeding the baby
Prolactin
Pituitary hormone that stimulates milk production
Loctation
Production of milk by the mammary glands
Does Breastfeeding Affect Sexual Behaviour?
women who breastfeed are more likely than those who bottle-feed to experience decreased sexual desire, decreased frequency of sexual intercourse, and painful intercourse due to lack of vaginal lubrication
lochia
A reddish vaginal discharge that may persists for a month after childbirth
Sex / intercourse after birth
Obstetricians usually advise a six-week waiting period, for safety and comfort
Why are women giving birth later in life? There are a number of reasons:
Improved access to safe, effective contraception allows women to choose whether and when they’ll have children, how many they’ll have, and how far apart they’ll space them.
More women are completing postsecondary education during their childbearing years and are therefore delaying motherhood.
Increasing numbers of women choose to limit the number of children they have, so they can continue working full time.
Financial constraints lead some women to limit the number of children they decide to have.
It’s becoming more and more socially acceptable in Western society to choose not to have children.
How long does it take to get pregnant?
Around 5.3 months to get pregnant
- around 21% chance of pregnancy with single act of penile-vaginal intercourse
Journey of the sperm
300-55 million sperm ejaculated
- 2000 get to fallopian tube with the ovum
- 50 get to the ovum
-Sperm moves against the flow by the cilia, at 1-2cm/hr
Conception usually occurs within ___ hours after ovulation
24
Sperm typically last ___ hours but can last as long as ___ days
48
5
Once fertilization occurs, the walls of the ovum become _____, if more than one sperm enters typically a spontaneous _____ will occur
impervious (prevent excess genetic material from entering the egg as too much can cause issues)
spontaneous abortion
Other than pregnancy, what else can stop period / mensruation?
Vigorous exercise
Body fat (low body fat)
illness
emotions
In about ___% of women they have spotting (spot bleeding) after implantation
20
Physical signs of early pregnancy
Breasts swelling and tenderness, frequent urination, irregular bowel movement, increased vaginal discretions
Morning sickness
Queasy sensation upon awaking (6-8 weeks)
-aversion to food or odours of certain food
1 in 200 experience extreme morning sickness with hospitalization required
Chadwick’s sign
Purplish vagina and cervix
Hegar’s sign
By week 6 of pregnancy
-soft area between cervix and uterus by month after missing period
False pregnancy
Associated with Women intensely desirous of having a child
- physical symptoms, including morning sickness, breast tenderness, fullness in pelvis, sensation of fetal movements
Blood test
picks up Early Pregnancy Factor (EPF) in blood
-time consuming and expensive
Immunological reaction to human chorionic gonadotropin (hCG)
Either in blood or urine
- only found after implantation
- near perfect accuracy in 7 days
First response home kits
Detect hCG in urine
- as early as 7 days
- 3% false pregnancy, 20% missed pregnancy
Pregnancy tests providing inaccurate results
- Absolute confirmation as early as 9 weeks through fetal heartbeat
- Fetal skeleton via ultrasound after 4th month (16 weeks)
- Fetal movements by end of 4th month
False labour
Sporadic contractions of the uterus
True labour
Regular and rhythmic uterine contractions (dilates cervix)
- Delivery of baby, placenta, and fetal membranes
- fetus trigger labour (not mother)
How the baby triggers labour
Fetus’s adrenal gland producing hormones that make the placenta and uterus increase secretion of prostaglandins - this leads to mother’s contractions
Oxytocin
Released in the late stages of labour by mother’s posterior pituitary gland - stimulates more powerful contractions
C-Sections in Canada
Most common inpatient surgical procedure performed in canadian hospitals
- 28.2% of hospital births in 2017 were C-sections
- Age 35+ are more likely to receive
Reading 7 (Davis) (r7)
The purpose: to investigate the variability in young heterosexual men’s perceptions of the advantages and disadvantages of condom use in their casual sexual relationships.
-Used focus groups
Findings: participants reported that condoms may affect the likelihood and quality of sex, one’s physical sensation during intercourse, and risk of STIs and unwanted pregnancy.
DID NOT USE PHYSICAL AGGRESSION
Positive decisional balance
(i.e., perceiving more pros than cons) is associated with increased engagement in a behavior
After birth, the postpartum period begins, which causes physiological changes
Estrogen and progesterone levels drop
-lactation hormones produced
Mild form of depression and crying after birth of child (baby blues)
50-80% for 24-48 hours
Sadness, crying, mood swings
Moderate form of postpartum depression
Depressed mood, insomnia, tearfulness, feelings of inadequacy, fatigue, irritability, inability to cope
Most severe of postpartum depression
Psychosis (0.01%)
One cause of infertility: man can not ejaculate deep in vagina
can include erectile dysfunction (ED)
Hypospadias (opening of urethra in not in tip but lower in shaft)
Low sperm count (or poor quality sperm)
If you have viable sperm but low sperm count
Use artificial insemination
concentrate the sperm and inject into vagina
Another cause of infertility (male)
Infectious diseases (mumps or prostate) Direct damage to testes (trauma, radiation)
Hypothyroidism and diabetes
Blockage of the duct system (sperm can’t get through channel - microsurgery needed)
Women fertility
Failure to ovulate
-due to hormonal deficiencies (pituitary, thyroid, adrenal)
Vitamin deficiencies, drug abuse, anemia, malnutrition, psychological stress
Blockage of reproductive system (fallopian tubes)
Infections of vagfina, cervix, uterus, fallopian tubes, ovaries
Tumors that obstruct
Drugs used for inducing ovulation
Clomiphene, human menopausal gonadotropin (HMG)
-drugs result in multiple births
__ to ___% of couples involuntarily childless
10 to 15 %
psychological impacts of infertility
Issues of self-definition
- especially if women believe their purpose is to become a mother (women)
- for men (lineage / continue on the blood line)
Adds stress to relationships creating friction or intensifying problems
Loss of sexual pleasure (getting pregnant becomes a task)
Greif, anger, guilt
Reading 8 Wright R8
Centerfold images (i.e., still-shot depictions of lone, provocatively posed, scantily clad women) are one of the most enduring, pervasive, and popular forms of sexual media.
Measured: young women’s attitude toward the male gaze following exposure
to centerfolds of varying explicitness
Findings: Women exposed to more explicit centerfolds expressed greater acceptance of
the male gaze than women exposed to less explicit centerfolds immediately after exposure
and at a 48 hour follow-up (the 2 days after was the difference between their study and prior)
The more sexualized media expose women’s bodies, the stronger they communicate the acceptability of the male gaze.
Reading 9 Crawford (R9)
What it looked for: Existence of sexual double standards: different standards of sexual permissiveness for women and men.
Measured: This review discusses methodological issues, including the strengths and limitations of quantitative and qualitative approaches. It also discusses implications for women’s high-risk sexual
behavior and sexual identity)” and suggests directions for future research.
Findings: Studies show thaI sexual double standards are influenced by situational and interpersonal factors
(e.g., the target’s age, level of relationship commitment, and number of partners), and that double standards are local constructions, differing across ethnic and cultural groups
Reiss classified attitudes toward premarital
sexual activity into Four general categories: abstinence (premarital intercourse considered wrong for both sexes), double standard (males considered to have greater right to premarital intercourse), permissiveness without affection (premarital intercourse considered right for both sexes regardless of emotional involvement), and permissiveness with
affection (premarital intercourse considered right for both sexes if pan of a committed relationship)
Findings from Reiss: Overall. 42% of the
student samples endorsed abstinence from premarital
intercourse, with a sizeable minority endorsing permissiveness wi th (19%) and without (7%) affection
Men’s endorsement of a double standard was
strongest at the first date but also existed for intermediate dating stages.
Evidence of double standards exists if women are evaluated differently than men for engaging in comparable levels of sex ual activity under the smne conditions.
Finally. there is a notable gap in research on sexual double standards in the area of attention to racial and ethnic
diversity
Reading 10 Blumberg (R10)
Findings: Highly sexual women reported that their lives have been strongly affected by their sexuality
Methods: Demographic questionnaire prior to interview, and then a 60 question interview
3 negative themes: Constant struggle to find and maintain a sexually satisfying relationship, difficulties in relationship with other women, and a general sense of being at best misunderstood and at worst being painfully rejected
3 positive themes: satisfaction with becoming a unique individual apart from judgments, physical satisfaction, generall satisfying nonsexual relationships with men and women.
Would not change permanently
Culture nor biology alone is sufficient to completely understand human sexual behaviour
Addiction or compulsion is not applicable (addicts lose control)
Culture nor society provides the answer
Partners didn’t like them masturbating
Highly sexual due to be sexualized at an early age, but not always true. Most are not raped or molested at a young age
Reading 12 de graaf (R12)
Dimensions of general parenting that have been studied rather extensively: support, control, and knowledge (of parents of their child’s whereabouts)
The results show that, in general, higher scores on support, control, and knowledge relate to a delay of first sexual intercourse, safer sexual practices, and higher sexual competence.
Sex before age 14 is due to coercion and unprotected among older adolescents
Higher levels of parental support correlate with a delay of first sexual intercourse.
Furthermore, parental support correlates with higher levels of contraceptive and condom use among sexually active adolescents, more positive feelings regarding sexuality, and higher levels of competence in sexual interactions.
Both too much control and a lack of control can be disadvantageous (authoritative and authoritarian)
Clear and fair demands seem to correlate with a delay of firstsexual intercourse and less unwanted sexual experiences.
Reading 11 Simon r11
What is was: . A thematic and critical literature review was conducted to determine what is known about adolescents’ experiences with online sex education
What they found: Four major themes could be dis-cerned from the literature, revealing that:
(a) adolescents report engaging with sex information online;
(b) adolescents are interested in a number of topics, including sexually transmitted infections and pregnancy;
(c) the quality of adolescent-targeted sex information online can belacking, but adolescents can evaluate these sources; and
(d) Internet-based interventions can increase adolescents’ sexual health knowledge
Together, these findings suggest that online sex education plays a role in adolescents’ lives, though their process of applying online information offline is gener-ally unknown.
How they are different: this is the first review todate that exclusively examines adolescents’ use of the Internet as a sex education resource.
unclear whether online sex education replaces or supplements traditional sources of sex education, like SBSE
Use online sex ed want to learn about sexual experiences, not just sexual health
Internet 5 A’s: Availability, acceptability, affordability, anonymity, and aloneness
Sperm counts of ___ million to 150 million sperm per millilitre of semen are considered normal.
A count of less than 20 million is generally regarded as low.
40
Sewell reading 1 r1
Searched for: This study examined how people define having sex utilizing a new approach to this area of
research.
Results: for both sexes, some behaviors (e.g.,
penile-vaginal intercourse) were far more confidently rated (i.e., ‘‘definitely sex’’) than were others (e.g., oral-genital stimulation)
Qualitative results, paired with quantitative findings, suggest that individuals consider a variety of contextual factors when making these definitional decisions.
among men ages 18 to 96, the oldest and youngest groups were less likely than others to label some behaviors as sex
ambiguous sexual encounter as ‘‘having sex’’ seemed to be influenced by their perception of the consequences of labeling it as such (e.g., negative self-evaluation)
People are more
likely to call a behavior sex if at least one person has
an orgasm during the act
Multivariate procedures (e.g., MANOVA), such as those utilized in the present study
Limitations: no study in this area has
asked participants for qualitative explanations for their
decisions about whether intimate behaviors count as
having sex
The measures used comprised three parts: a page of
demographics and two sets of study questions
‘‘69’’ position added
Limitation: age range was limited
Abbey reading r3
Objective: To provide evidence regarding the construct validity of a sexual aggression proxy in
which male participants go on multiple virtual dates with a woman.
Method: Focus groups and surveys and cognitive interviews
