Teratogens and childbirth

Question 1

Cocaine and crack in correlation with

Answer 1

• Women doing this are less likely to get prenatal care, more likely in poverty, more likely in sexual transmission, more likely receiving partner violence or violence from others, may have a bad enough drug addiction and not a good enough support system that they can’t stop.
‣ Dangerous conditions such as placental separation
• Less likely to survive

Question 2

Cocaine and crack in correlation with low birthweight, length, and head circumference

Answer 2

• This is even for gestational age.
• Head circumference does more correlate with IQ
◦ Thought that if you get way too small it may mean that not enough brain matter developed
◦ Male head circumference was positively correlated with big head circumference
◦ Thought that head circumference is a direct relation to use of Cocaine

Question 3

Cocaine and crack in correlation with cry patterns

Answer 3

‣ Cry patterns are off
• Seems very specific to Cocaine use
• Off in ways that are hard to explain, but when you hear it you know. the cry is so adversive (very high pitched, the same effect of fingernails on a blackboard) makes it so that you may not want to be around them.
‣ Training people to work with them is a big part
◦ Hearing a baby cry is what initiates the release of breast milk. This is sometimes why a new mother may leak milk

Question 4

marijuana is related to

Answer 4

‣ May be linked to low birth weight and other problems
• Decreased birth weight, synapse formation, dopamine levels, socialization, memory, synaptic plasticity, short-term memory,
‣ May be linked to learning disabilities
• Decreased verbal reasoning scores, short-term memory, abstract reasoning, visto-spatial memory
• Increased aggression (females), anxiety, depression, impulsivity, inattention, hyperactivity, etc.

Question 5

Fetal alcohol syndrome (FAS)

Answer 5

• Where a child has problems with growth learning, has distinctive facial features and structural abnormalities
◦ Tend to be smaller on average as they grow
◦ Tend to see a number of learning problems and things like ADHD.

Question 6

fetal alcohol effect

Answer 6

Milder form, and often the kids seem fairly typical
◦ However, then in adolescents their behavior tends to take a violent swing for the worse.
‣ Sometimes in teenage girls they will disappear for days at a time and go on a binge then just reappear and act like nothing happened.

Question 7

Mercury

Answer 7

◦ Seafood has high levels. The lowest ones are salmon, clam, perch, shrimp, whitling, tilapia, oyster
‣ Cognitive problems
‣ Vision and hearing problems

Question 8

Polychlorinated biphenyls (PCBs)

Answer 8

‣ Found in flame retardant PJs, couches used to be full of them, new rugs or mattress toppers that have that chemical smell to them have this in it.
‣ The old subway bread used to have this in it.
◦ May lower fertility
◦ Linked to prematurity and low birth weight

Question 9

Maternal disease - rubella

Answer 9

‣ German measles -> can cause miscarriage or serious birth defects in developing babies.
◦ Can cause deafness, cataracts, heart disease, intellectual disability, liver or spleen damage
• Humans are the only known reservoir, spreads when an infected person coughs or sneezes.
◦ Mild illness, rash, lymphadenopathy, and low-grade fever
• Protection can be from the MMRV vaccine (measles-mumps rubella, varicella)

Question 10

Maternal disease - AIDS

Answer 10

• perinatal transmission is avoidable
  
  • some treatment is available
  • important to keep the blood of the mother and baby separate from each other

Question 11

Maternal disease - toxoplasmosis

Answer 11

‣ Miscarriage, stillbirth or damage to the bay’s brain and other organs, particularly the eyes
• Tends to start with birds and mice, then moved onto someone else when a cat or other animal eats a infected animal. then the parasite is released through feces, so pregnant women should not clean the litter box

Question 12

Cytomegalovirus

Answer 12

‣ Most common virus passed from mothers to babies (can lead to major problems)
‣ Linked to microcephaly (when there is a brain stem but the rest of the brain is extremely small), and other problems in some infants
‣ Some infants do not seem to be effected
• Getting tested to see if you have been exposed to this or have had it is important, likely may have it from working in a hospital, or being around kids a lot.

Question 13

Maternal health:
Exercise
Nutrition
Stress

Answer 13

◦ Exercise
‣ Good to get in a good routine before pregnancy
◦ Nutrition
‣ Make sure to get protein, fiber, and good fats. Taking prenatal vitamins, and listen to your body. Satisfy your cravings when you can
• People wanting to crave dirt, especially in the salt with red clay. Shows a deficiency in zinc.
◦ Stress
‣ High levels of stress among other things can start rewiring the brain. Can have an effect on brain development. We can’t avoid it completely, but reducing the amounts of unnecessary stress can be helpful.

Question 14

Maternal health
RH blood compatibility
Maternal age
Toxemia (eclampsia)

Answer 14

◦ RH blood incompatibility
‣ It is the second child that is likely to be effected by this
◦ Maternal age
‣ Know that maternal age at the extreme puts the baby at risk. At a older age a more likely to have genetic issues, especially Down Syndrome. Very young women can be the same, because their body may not be completely ready yet for delivery.
◦ Toxemia (eclampsia)
‣ Trying to not be too active -> may lead to bed rest
• Often with those with blood pressure issues, or people with diabetes

Question 15

Teratogens

Answer 15

Teratogen - agents that can induce or increase the incidence of birth defect in a developing child
◦ Only against development
‣ If it happens in an early phase especially in the age of the embryo they are more likely to have issues like miscarriage, developmental issues, defects, or anything else.
◦ During the fetal period we still don’t want to expose them to things that may cause problems. Most of those that cause damage won’t be as much during this period.
‣ The exception to this is smoking. It can make the blood system more likely to have a detachment (embryonic sac detaching from the uterus), it also lessens the amount of oxygen that the fetus gets.

Question 16

Thalidomide

Answer 16

‣ Widely used in the 50-60s to help with severe and mild morning sickness.
• The problem is that no one has really looked at long term effects of it. The problem was that there was a series of babies being born with limb defects, hands right out of the shoulder socket, hip right out of hip bone, only thighs, or just major morphological issues. This is because the medication is taken during the embryonic phase when the mother experiences morning sickness, and the babies limbs are starting to develop.
• Will not prescribe in people that are post pregnancy and using cancer treatment, or pregnant women who have had cancer treatments.

Question 17

Diethylstilbestrol (DES)

Answer 17

Synthetic estrogen
‣ Seems like a miracle drug. Lowered the risk of miscarriage, and increased the delivery date
• The long term effect had not been studied. What happened in the 1980s was a lot of women born form someone who took DES were testing at a higher rate to cervical cancer, but not for testing positive for HPV.
◦ They were women whose mothers were prescribed DES

Question 18

Aspirin

Answer 18

‣ It is good to avoid aspirin and ibuprofen, try to only take with doctors approval.
• This is because aspirin is a blood thinner and can cause problems. It reduces blood clotting
‣ Low doses
• Can increase the risk that if something happens someone will bleed. Even at low doses in a catastrophe can lead to bad endings. The low dose by itself without anything else it may be ok
‣ High doses
• Increases risk of umbilical disruption and the embryonic sac detaching
◦ Can be dangerous for both the mom and baby

Question 19

Caffeine

Answer 19

‣ Can increase heart rate
‣ Try to stay under 300 mg/day
• High doses of caffeine can lead to more irritable babies, and change how they regulate information. Since caffeine can raise heart rate it can lead to a change in how the brain is regulated and functions.

Question 20

Stage one of the birth process

Answer 20

◦ Stage 1: dilation (the cervix relaxes, causing it to dilate and thin out)
‣ Labor - usually less than 12 hours
• The cervix will thin out and dilate. The dilation part typically comes it’s contractions. When they are 5 minutes apart is typically when you should come to the hospital. Similar to the feelings of period cramps
• Usually takes the longest for the first pregnancy. Some will have their first birth be fast, maybe even less than an hour
‣ Transition - usually less than 8 hours

Question 21

Stage two of the birth process

Answer 21

◦ Stage 2: expulsion (uterine contractions increase in strength and the infant is delivered)
‣ Usually less than 2 hours
‣ Crowning
• Typically when the pushing occurs. Hopefully coming head first, with arms down, and umbilical cord not around neck or cutting anything off.

Question 22

Stage three of the birth process

Answer 22

‣ Usually less than 30 minutes
• Typically comes out pretty easily and is when the placenta and the umbilical cord comes out.
• The placenta is considered sacred. Some bury them then plant a tree, some eat it, some save it to make jewelry, some may donate it to research. Very rich in nutrients

Question 23

The American way of birth

Answer 23

‣ The medical model - twilight sleep
• Women were knocked out, doctors went in and shaved the women and then took the baby out. Often forceps were used, and we now know that this can actually injure the baby.
• The medicine used was also not considered very safe for the baby
‣ The issue of reducing pain
• Not all people, but in general people of Jewish and Christian decent that if you go back to the story of Eve and the sin in the garden it is the sin for a women to be in pain for birth.
◦ Something most people now tend to take for granted, but some think it is inappropriate for people to take away the pain. Some also think that the woman should not be able to yell.

Question 24

Cesarean births

Answer 24

‣ Usually should only be done because the mother is not in a position to deliver, or the baby is at risk and needs to come out very quickly.
• These are being overused in the US right now.
• Can make future pregnancies more risky. once you have one a doctor may be more likely to do this for the future pregnancies. Makes future natural births more risky, so C-sections are safer, quicker, and easier.

Question 25

The Lamaze method

Answer 25

• More natural and usually has a support person with you. You practice breathing and relaxation, usually with the goal of not needing pain medication.
◦ Can instill high pressure into not using pain reduction medicine.
‣ Epidurals are relatively safe but can still pose some risk.

Question 26

what is birth for women

Answer 26

◦ Giving birth is the single most dangerous thing that women will do. throughout history it is also the most fatal thing that woman have done.

Question 27

The Leboyer method

Answer 27

‣ Birth without violence. Should be peaceful and relaxing. Born into a brightly lit, cold environment. the baby is born into a pool. the mother is birthing in a pool in warm water.
• Can work well for someone who has proper access to medical care if something should go wrong, and also for someone who is completely ok with this.

Question 28

The rope birth

Answer 28

‣ The theory that instead of lying on their back they hang onto a rope extending from the ceiling and going into a squatting position.
• Squatting position can increase the cervical position and works with gravity, both help speed things up. Most find this position more comfortable to give birth in.
◦ This is harder on the doctors and nurses.