Theme 2 - Pregnancy and birth Flashcards
what is the biomedical perspective of birth?
birth is a medical event - focus on illness, pathology, problems and medical intervention
why is the psychological perspective of birth?
birth is an experience - focus on satisfaction and fulfilment
what is the social perspective on birth?
type of birth is socially determined and influenced by social context
what is the cultural perspective on birth?
what is the view of birth in that particular culture - is birth/motherhood fulfilling?
how are deaths during childbirth distributed across the world?
unevenly
how many women die in childbirth each year?
300,000
what area of the world has the highest maternal death rate?
central africa
which factors have contributed to the fall in maternal mortality rates?
increased medical knowledge, better nutrition, better sanitation and better birth practices, knowing markers of foetal distress
how many deaths per 100,000 births are there in the UK per year?
12 in 100,000
how many deaths per 100,000 births are there in chad per year?
1100 in 100,000
what % of births occur at home in the UK?
<2%
what % of births in the UK are normal ie no medical interventions
40%
what % of births are via C section?
30% (half of these are emergency)
name five things that socioeconomic factors influence with regards to psychosocial factors in pregnancy
life events, stress, social support, knowledge and information about pregnancy
what can influence adaptive or maladaptive behaviour?
who is available to help
name 5 factors associated with foetal or neonatal mortality
difficult labour, low birthweight, abuse of mother, illicit drug use, heavy alcohol use, nutritional deficiencies, excessive weight gain/loss of mother
how can factors associated with foetal/neonatal mortality be reduced?
address issues that may have happened during childhood, provision of information during pregnancy, effective health promotion delivery to change behaviours (antenatal classes)
what can socioeconomic disadvantages lead to?
increased risk of maternal morbidity, women less likely to be physically and mentally well during pregnancy, high mother and infant mortality rates, low birth weight
what is the most important factor contributing to infant morbidity and mortality?
low birth weight
what three factors may stress be related to?
response to adversity, related to coping responses or concerns about changing roles
what are the two main ways that stress can affect the mother and baby?
physical (direct) and psychological/behavioural (indirect)
what can cortisol influence
immunity
what can increased blood pressure lead to?
changes in blood supply to the baby
what can psychological response to stress lead to?
the mothers behaviour which subsequently affects the foetus eg excess weight gain
name two things stress during pregnancy is associated with?
premature labour and delivery and lower birth weight
what moderates the effect of stress on the mother?
psychosocial resources - what support they have and how to alleviate stress
how can stress during pregnancy affect the infant?
increases sensitivity to stress, increased heart rate, more anxiety, fearfulness, emotional/behavioural difficulty, cognitive and attention difficulties
how can stress during pregnancy affect an individual later in life
higher risk of ADHD, schizophrenia and depression
how can the negative effects of stress be moderated?
by the postnatal environment - being supported after birth
what five factors can support in pregnancy and birth lead to?
greater perceived control, less stress, greater birth satisfaction, lower likelihood of traumatic birth and postnatal depression
what type of support is most beneficial?
continuous support
can can continuous support through pregnancy lead to?
shorter labour, less intervention, less analgesia and better Apgar score for baby
when is depression or anxiety most likely to occur in pregnancy?
later on
what can depression and anxiety in pregnancy be linked to?
less social support and poorer health
signs of baby blues
mild emotional disturbances in first week after birth, crying/confusion/labile emotion/depression/anxiety
what % of mother experience baby blues?
70%
what % of mothers experience post natal depression?
15%
what is the typical onset and average duration of postnatal depression?
onset usually within 6 weeks of birth and can last 3 or more months
what % of mothers go on to develop subsequent depression after post natal depression?
80%
what % of women experience postnatal psychosis?
0.1%
how can postnatal psychosis manifest?
manic, depressive or brief psychotic episode
what % of women develop PTSD after birth?
2% (20-30% of women find childbirth traumatic)
what are the symptoms of PTSD following birth?
flashback, intrusive thoughts, numbing and avoidance
in what women is PTSD more common in?
women that have had previous psychological problems, experienced sexual assault, had a stillbirth or lack of support during birth
what three things may a child experience as a result of having a mother with postnatal depression?
poor cognitive development, poor social/emotional development, behavioural difficulty
what group of infants are likely to be less responsive to faces and voices?
those with depressed mothers
what % of men experience postnatal depression?
10%
when does postnatal depression in fathers usually occur?
first 3-6 months postnatally
can paternal postnatal depression also affect child development?
yes
