Chapter 6 - Pregnancy and Childbirth

Question 1

what are the first steps of conception?

Answer 1

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

Question 2

sperm work together to break down ____ by secreting ____

Answer 2

zona pellucida; hyaluronidase

Question 3

what are the last few steps of conception?

Answer 3

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

Question 4

presumptive pregnancy signs

Answer 4

missed period, nausea, breast tenderness

Question 5

probable pregnancy signs

Answer 5

positive pregnancy test, increased basal body temperature, increased human chorionic gonadotrophin (HCG)

Question 6

positive pregnancy signs

Answer 6

detection of fetal heartbeat or movement, detection of skeleton via ultrasound

Question 7

how is delivery date calculated?

Answer 7

using Nagele’s Rule

Question 8

first trimester (fetal development)

Answer 8

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

Question 9

second trimester (fetal development)

Answer 9

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

Question 10

effects on body during the second trimester

Answer 10

indigestion, constipation, breasts enlarge with milk, nipples darken, stretch marks on breasts and stomach; most women report less nausea after the first trimester

Question 11

third trimester (fetal development)

Answer 11

brain and nervous system finish growing by 7 months; fetus turns to head-down position to prepare for birth

Question 12

effects on body during third trimester

Answer 12

issues with balance, backache, leg cramps, frequent urination, swelling of hands or feet; healthy weight gain of 25-35 lbs

Question 13

sexual activity during pregnancy

Answer 13

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

Question 14

which nutrients are important to include in a pregnancy diet?

Answer 14

protein, folic acid, calcium, magnesium, iron, vitamin A

Question 15

vaginal birth

Answer 15

fetus takes head-down position; effacement (thinning of cervix) occurs; dilation; amniotic sac ruptures “water breaking”

Question 16

stage 1 labour (vaginal birth)

Answer 16

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)

Question 17

stage 2 labour (vaginal birth)

Answer 17

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

Question 18

stage 3 labour

Answer 18

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”)

Question 19

non-pharmacological pain management during labour

Answer 19

use of birthing balls, controlled breathing, soaking in a tub, walking around, using massage or distraction techniques

Question 20

pharmacological pain management during labour

Answer 20

tranquilizers and narcotics; epidurals or spinal blocks

Question 21

what is a c-section

Answer 21

(caesarean section) baby is delivered through an incision made through the abdomen and wall of the uterus

Question 22

some reasons why a c-section may be necessary

Answer 22

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

Question 23

what happens immediately after baby is born?

Answer 23

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

Question 24

what is the main cause of postpartum emotional issues

Answer 24

hormonal changes; levels of estrogen and progesterone returning to normal

Question 25

three major postpartum conditions

Answer 25

postpartum blues (80%); postpartum depression (10%-20%); postpartum psychosis (0.2%)

Question 26

how long should women wait before having intercourse after sex

Answer 26

six weeks; recently tho changed to whenever couple is ready

Question 27

breastfeeding is recommended for the first ____ months?

Answer 27

six -can continue up to two years and beyond

Question 28

colostrum, produced by the breasts, is high in ____ and ____ which helps ____

Answer 28

nutrients; antibodies; protect the baby from infection

Question 29

when does milk production begin

Answer 29

2-3 days after delivery

Question 30

prolactin

Answer 30

is released to stimulate milk production

Question 31

oxytocin

Answer 31

needed to eject the milk from the breasts

Question 32

lactational anovulation

Answer 32

regular menstrual cycle is delayed because of exclusive breastfeeding

Question 33

in relation to sexuality, masters and johnson said that women who breastfeed...

Answer 33

had higher levels of sexual interest in the months following delivery

Question 34

ectopic pregnancy

Answer 34

fertilized egg implants somewhere other than uterine lining; most commonly caused by obstructed fallopian tube

Question 35

miscarriages

Answer 35

most occur within six weeks of gestation; most common reason is a defect in embryo or uterus; can negatively affect mother (psychologically)

Question 36

Rh incompatibility

Answer 36

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

Question 37

pregnancy-induced hypertension

Answer 37

1. high blood pressure associated with pregnancy OR 2. pre-eclampsia includes fluid retention and swelling as well as protein in the urine; can lead to convulsions, coma, and even death

Question 38

congenital anomalies

Answer 38

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

Question 39

what's one way that congenital anomalies can be detected

Answer 39

maternal serum screening for elevated levels of alpha‐fetoprotein (AFP) and other markers in the mother’s blood

Question 40

two more invasive ways of detected congenital anomalies

Answer 40

Amniocentesis and chorionic villus sampling

Question 41

a preterm baby is born before __ weeks of gestation (out of 40 weeks)

Answer 41

37 -linked to low birth weight -60%-80% of infant deaths (with no congenital anomalies) are due to preterm birth

Question 42

anoxia

Answer 42

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

Question 43

prolonged anoxia can lead to...

Answer 43

cerebral palsy, brain damage, intellectual disability, and even death

Question 44

stillbirth

Answer 44

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

Question 45

maternal mortality and morbidity

Answer 45

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

Question 46

how many couples in Canada have fertility issues

Answer 46

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

Question 47

most common cause of male infertility

Answer 47

low sperm count; infertility affects 1 in 10 men

Question 48

most common cause of female infertility

Answer 48

irregular ovulation; infertility affects 1 in 12 women

Question 49

psychological impact of infertility

Answer 49

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

Question 50

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