Lecture 6: Conception, Pregnancy and Childbirth Flashcards
hyaluronidase
enzyme secreted by the sperm as they’re swarming the egg. Helps to dissolve the zona pellucida, allows one sperm to penetrate the egg.
second stage labour
- head into birth canal
- length
- urge to push
- crowning
- episiotomy
- first breath
psychological effects
50% of pregnant people suffer elevated levels of anxiety, depression, and grief
first stage labour
- effacement of cervix
- dilation of cervis
- length 2-24 hours
- 12-15 hrs 1st pregnancy
- 8 hrs, 2nd + pregnancy
- contractions
3rd trimester
- 27-38 weeks
physical changes in pregnant person
- uterus is large and hard
- symptoms from pressure on organs
- aware of fetal activity
- awkwardness
- braxton-hicks contractions
- engagement of head
psychological changes in pregnant person
- impatience, concern, re: health of baby and delivery
the negative factors of parenthood
- childcare is exhausting
- 35% of babies in USA are born to unmarried women
- fathers usually help much less than expected
- post-birth pain in vagina, uterus and breasts
- new mothers often feel incompetent
- expectations different than reality
- little contact with other adults
- father may feel neglected by mother
- new mothers feel they don’t live up to “perfect mother stereotype”
- people blame mothers for infants behaviour
Doula
Women’s servant, be present during delivery and labour to provide emotional support and education
what about postpartum sexual function?
- pregnancy and postpartum are a vulnerable time for couples sexual lives
- changes to sexual function (desire, arousal, lubrication, pain) are common after having a baby
- greater sexual distress, lower relationship satisfaction, and more depressive symptoms are more likely to experience persistent problems with postpartum sexual function
1st Trimester
- first 12 weeks
- physical changes in pregnant person
- breast swelling
- frequent urination
- bowel irregularity
- vaginal discharge
- nausea
- fatigue
teen pregnancy in canada
- teen pregnancy rates and teen abortions declined 36.9% from 1996 to 2006
- was 44/1000 in 2007, 30/1000 in 2017
beginning of labour
- mucous plug discharge
- reuptured memberanes
- increase braxton-hicks contractions
Ovulation
the egg is picked up by the fimbriae (finger-like structure at the opening of the fallopian tube) and the egg enters the fallopian tube.
The egg must be fertilized within 12-24 hours after its release or the egg will disintegrate
occurs on the 14th day of the menstrual cycle after the egg is released
How frequent do braxton hicks contractions get as you approach labour?
the positive factors of parenthood
- women report increase sense of their own strength
- parenting can be fun and interesting
- Identifying and developing ability to nurture
- fathers/partners express admiration and affection for their partner
- enjoys watching baby develop new skills
- more abstract than negative factors
Lowest rates of teen pregnancy
- 15-19 year olds
- PEI (23.4/1000)
- NB and NL (26/1000)
Zona pellucida
thin gelatinous layer that surrounds the egg. Helps to contain the chromosomes, proteins and the fats and nutritious fluids
Key points in fertilization and implantation
- Ovulation, 12-24 hour window
- Sperm follow chemical signal of the egg
- Zona Pellucida
- Hydralurondase
- Capacitation
- Implantation
prevention of miscarriage
- early prenatal care
- detect and treat illness
- avoid environmental hazards
Biology of Pregnancy
Zygote
- fertilized egg
- travels down the fallopian tube
- cell division begins ~36 hours after conception
- implantation occurs 5-7 days later
Embryo
- 2-8 weeks
Fetus
- 8weeks - birth
the father’s experience during the pregnancy
- some research on fathers, very little research on orher relationdship types
- couvade syndrome
- couvade ritual
- psychological changes for fathers in canada
Possible symptoms of Miscarriages
- low back or abdominal pain (dull, sharp or cramping)
- clot passes through vagina
- vaginal bleeding
risk factors of miscarriages
- history of psychiatric illness
- childlessness
- lack of social support
- poor relationship adjustment
- prior preganancy loss
Improving chances of conception
- track ovulation by basal body temperature (temperature will be slightly lower before ovulation and slightly higher the day after ovulation)
- Time intercourse right at ovulation or 1-2 days before
- maintain sperm count (2-3 times that week)
- gravity
Nagele’s Rule
The dates of the first day of the last menstrual period + 3 months + 1 week + 1 year
Probable signs of pregnancy
- 80-90% correct
- HCG
- Hegar’s sign
implantation
the fertilized egg (zygote) travels down the fallopian tubes and making its way to the uterus for implantation takes 5 days to implant
Positive signs
- fetal heartbeat
- active fetal movement
- fetal selection
highest rates of teen pregnancy
- MB (53.4/1000)
- NT (78.7/1000)
- NU (118.8/1000)
Miscarriages
- Preterm delivery
- Estimated up to 1/2 of all fertilized eggs are lost before person knows they are pregnant
- 15-20% of people who know they are pregnant experience miscarriage
- Most caused by chromosome problems in fetus
- other possible causes
- risk of miscarriage increases with age
- beginning by 30, greater between 35-40, highest after 40
negative emotions of emotional reactions
- fears, anxieties, concerns about pain of childbirth
- declining body image
- worry about health
- lack of an identity (besides “pregnant person”)
postpartum issues
physical changes
- drastic drop in levels of E and P
psychological changes
- blues, postpartum depression
attachment
postpartum sexuality
attitudes toward pregnancy
- attitudes depend on context
- michelle hebl (2007) field study and survey study
third stage labour
- placenta detaches
- afterbirth expelled
role of the partner
- excitement, pride
- role in pregnancy
- same concerns as person who gave birth
- concers re: being present at birth
2nd Trimester
- 13 - 26 weeks
physical changes in pregnant person
- decreased symptoms
- constipation, nosebleeds
- expanding belly
- fetal movements
- edema (water retention)
- breasts fully developed (colostrum)
Psychological changes in pregnant person
- calm, well-being, pride, excitement, maternal responsiveness
natural childbirth
- continuity of care with midwife
- becoming educated
- learning relaxation techniques
- learning controlled breathing
- social support
infertility solutions
- timing, frequency and positions of intercourse
- fertility drugs
- assisted insemination
- sperm donor
- in vitro fertilization
- surrogate mother
myths about motherhood
- motherhood is completely happy and satisfying
- being a mother is a woman’s ultimate fulfillment
- new mothers will feel perfectly component due to her “natural” mothering skills
prenatal care
- medical
- nutrition
- exercise
Positive emotions of emotional reactions
- hoped to be parent, excitement and anticipation
- “characteristically optimistic” adapt well
- sense of wonder
- pregnancy as transition into adulthood
- social support correlated with psychological and physical well-being
treatment of miscarriages
- important to be examined to ensure no tissue remaining in uterus
capacitation
once the sperm penetrates the zona pellucida - the layer thickens and blocks out the other sperms
Cesarean births
certain risks higher after c-section
- infection of bladder or uterus
- injury to uterus
- injury to baby
c-section rates can be reduced when hospitals adopt appropriate precautions
Obstacles to fertilization
- acidity of the vagina
- some are deformed
- swimming against currents of fallopian tubs
- wrong fallopian tube
Presumptive signs of pregnancy
- missed period, breast tenderness, nausea, more frequent urination, fatigue
- missed period + 2 others = 67% probability of pregnancy
Psychological aspects of infertility
daniluk (2001) emotional roller coaster
breast feeding
- colostrum
- milk after 2-3 days
- prolactin
- ocytoxin
sperm follow the chemical signal of the egg
egg exerts the chemical to attract the sperm, the sperm lives for 8 days in the body
effects of drugs on fetus (teratogens)
- alcohol
- fetal alcohol spectrum disorder
- fetal alcohol syndrome
- smoking
- marijuana
pregnancy during stressful events
- increased risk of premature delivery and low birth weight
infertility
- refer to inability to concieve or inability to impregnate a person
- getting pregnant
- 20% 1 mo., 50% 6 mo., 80% 1 year
- causes of infertility
- 40% female and 40% male
sex during pregnancy
- current medical advice
- changes in sexual behaviour
pronatalist view vs choice to be child free
trauma informed care for childbirth options?
Caesarean Section (C-section)
c-section surgical procedure used for delivery
- baby’s head is too large
- person’s pelvis is too small
- baby is breech or transverse
- cervix is not dilating
- person is nearing exhaustion
- placenta previa
about 28% of births in canada in 2017
midwives
most baby are delivered by midwives, attend more normal births than obgyn
lamaze method
relaxation techniques, controlled breathing, how to relax all the muscles during labour to reduce pain
emphasize on education and relaxation techniques
home births
less stress and more relaxed
