Chapter 6 - Pregnancy and Childbirth Flashcards
what are the first steps of conception?
ovulation (egg released from ovary); egg is picked up by fimbriae and enters fallopian tube; 200-4–mil sperm start out to fertilize egg; sperm travels through cervix and uterus to one of the fallopian tubes; only ~200-300 sperm make it as far as the egg
sperm work together to break down ____ by secreting ____
zona pellucida; hyaluronidase
what are the last few steps of conception?
one (sometimes more) sperm enters the egg; fertilization occurs in the fallopian tube (infundibulum); now called a zygote, it continues to move down fallopian tubes into uterus; zygote implants in the uterus
presumptive pregnancy signs
missed period, nausea, breast tenderness
probable pregnancy signs
positive pregnancy test, increased basal body temperature, increased human chorionic gonadotrophin (HCG)
positive pregnancy signs
detection of fetal heartbeat or movement, detection of skeleton via ultrasound
how is delivery date calculated?
using Nagele’s Rule
first trimester (fetal development)
embryonic stage; placenta and amniotic sac develop; most major organs and systems develop; “fetal stage” after 8 weeks; can come with tingling and fullness in breasts, nausea, tiredness, appetite change
second trimester (fetal development)
movement can be detected as early as 13-16 weeks; heartbeat can be heard with stethoscope by 5 months; fetus is sensitive to light and sound by 6 months
effects on body during the second trimester
indigestion, constipation, breasts enlarge with milk, nipples darken, stretch marks on breasts and stomach; most women report less nausea after the first trimester
third trimester (fetal development)
brain and nervous system finish growing by 7 months; fetus turns to head-down position to prepare for birth
effects on body during third trimester
issues with balance, backache, leg cramps, frequent urination, swelling of hands or feet; healthy weight gain of 25-35 lbs
sexual activity during pregnancy
sex is safe during pregnancy up until the start of labour (fetus is protected by amniotic sac and mucus plug); women with a history of miscarriage or spotting may be advised to abstain from having orgasms
which nutrients are important to include in a pregnancy diet?
protein, folic acid, calcium, magnesium, iron, vitamin A
vaginal birth
fetus takes head-down position; effacement (thinning of cervix) occurs; dilation; amniotic sac ruptures “water breaking”
stage 1 labour (vaginal birth)
labour can last 8-14 hours; about half the time for subsequent pregnancies; contractions help dilate the cervix; early (4cm), active (8cm), transition (10cm, fully dilated, baby can pass through, shortest phase but most difficult ~30mins)
stage 2 labour (vaginal birth)
begins when cervix is fully dilated and baby’s head begins to move into vagina; ends with baby being birthed; birther begins to push; once baby has crowned the blood and mucus is cleared from their face to induce breathing
stage 3 labour
final stage; lasts few minutes to over an hour; sometimes called placental phase; placenta detaches from uterine wall and is expelled with other material (“afterbirth”)
non-pharmacological pain management during labour
use of birthing balls, controlled breathing, soaking in a tub, walking around, using massage or distraction techniques
pharmacological pain management during labour
tranquilizers and narcotics; epidurals or spinal blocks
what is a c-section
(caesarean section) baby is delivered through an incision made through the abdomen and wall of the uterus
some reasons why a c-section may be necessary
baby is too large; mother’s pelvis is too narrow; baby is in breech or transverse position; umbilical cord will pass through before baby does (prolapse); placenta previa
what happens immediately after baby is born?
umbilical cord it clamped and cut; skin to skin contact; breastfeeding; antibiotic in baby’s eyes; baby receives vit K injection to ensure blood clot forms normally
what is the main cause of postpartum emotional issues
hormonal changes; levels of estrogen and progesterone returning to normal
three major postpartum conditions
postpartum blues (80%); postpartum depression (10%-20%); postpartum psychosis (0.2%)
how long should women wait before having intercourse after sex
six weeks; recently tho changed to whenever couple is ready
breastfeeding is recommended for the first ____ months?
six
-can continue up to two years and beyond
colostrum, produced by the breasts, is high in ____ and ____ which helps ____
nutrients; antibodies; protect the baby from infection
when does milk production begin
2-3 days after delivery
prolactin
is released to stimulate milk production
oxytocin
needed to eject the milk from the breasts
lactational anovulation
regular menstrual cycle is delayed because of exclusive breastfeeding
in relation to sexuality, masters and johnson said that women who breastfeed…
had higher levels of sexual interest in the months following delivery
ectopic pregnancy
fertilized egg implants somewhere other than uterine lining; most commonly caused by obstructed fallopian tube
miscarriages
most occur within six weeks of gestation; most common reason is a defect in embryo or uterus; can negatively affect mother (psychologically)
Rh incompatibility
Antibodies from the pregnant woman’s blood destroy red blood cells in the fetus; occurs when the woman has Rh‐negative blood and the fetus has Rh‐positive blood
-risk is low in the first pregnancy but very high in subsequent ones; anti‐bodies will have formed by then and attack the (second +) fetus’s red blood cells
– Can lead to fetal anemia, intellectual disability, or death
pregnancy-induced hypertension
- high blood pressure associated with pregnancy
OR - pre-eclampsia includes fluid retention and swelling as well as protein in the urine; can lead to convulsions, coma, and even death
congenital anomalies
may result from genetics, illness/infection, use of drugs or alcohol
-folic acid supplements in the three months before conception and in the first trimester can reduce the incidence of congenital abnormalities from neural tube defects
what’s one way that congenital anomalies can be detected
maternal serum screening for elevated levels of
alpha‐fetoprotein (AFP) and other markers in the
mother’s blood
two more invasive ways of detected congenital anomalies
Amniocentesis and chorionic villus sampling
a preterm baby is born before __ weeks of gestation (out of 40 weeks)
37
-linked to low birth weight
-60%-80% of infant deaths (with no congenital anomalies) are due to preterm birth
anoxia
umbilical cord can be compressed as the
baby passes through birth canal, especially if
the baby is born in the breech position which causes oxygen deprivation
prolonged anoxia can lead to…
cerebral palsy, brain damage, intellectual disability, and even death
stillbirth
when a baby is born deceased any time after 28 weeks gestation and weighs at least 500 grams; global stillbirth rate is 18.4 per 1000 births; stillbirth often leads to increased psychological
difficulties in the birthing parent
maternal mortality and morbidity
830 women die from pregnancy‐ or childbirth‐
related complications around the world every day; almost all of these deaths (99 per cent) occurred in low‐resource settings
how many couples in Canada have fertility issues
1 in 8 couples
-40 per cent result from male infertility
-40 per cent result from female infertility
-20 per cent result from infertility in both partners or unknown causes
most common cause of male infertility
low sperm count; infertility affects 1 in 10 men
most common cause of female infertility
irregular ovulation; infertility affects 1 in 12 women
psychological impact of infertility
increased relationship conflict and decreases in sexual satisfaction; Psychological has a
greater affect on the female (the person attempting to become pregnant)
– BUT, infertility can challenge a man’s sense of masculinity and
virility as well
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