Deciding whether or not to have a child..

1. Deciding whether or not to have a child..

2. Self Discovery Do you want children? If yes, are you ready to have on? • Do you currently spend time with children and teens? Do you enjoy it? • What are your thoughts on the responsibilities and commitment of parenthood? • How do you cope with stress? • What are your hopes and fears about parenthood?

3. Self discovery Contd.. • what values and morals would you like to pass on to your children? • What are your priorities for your children? • What are your thoughts about disciplining children? • How will your lifestyle change? • Talk to people who have children and to people who have decided not to have children.

4. Want a baby, think about this! • Make sure everyone is on board with the idea! • Income is stable • Always take in to consideration what you will be giving up in order to have children or what could be the consequences. • Do the advantages of having children out number the disadvantages of having children in your own personal life?

5. Voluntary Childless • Among women of childbearing age in the United States, approximately 6-7% define themselves as “voluntary childless” (CDC, “Fertility,” 2005; Hollander, 2007). • In child-oriented cultures, these “voluntary childless” women or couples may be viewed negatively by people from their own society or culture.

6. Advantages & Disadvantages • There are disadvantages and advantages to mostly everything in life, yes that includes having children. ** Child-free couples who stay together consistently report great marital satisfaction compared to traditional married couples(with children), but the divorce rate amongst “child-free” couples if larger.

7. Conception

8. Vocabulary • Oocyte- An immature reproductive egg or ovum. • Menarche- The beginning of menstruation during puberty; a girls first period • Follicular Phase- The early period during a woman’s monthly fertility cycle when the pituitary gland secretes follicle stimulating hormones(FSN) to enhance ovum development.

9. Vocabulary Contd.. • Luteal Phase- The later period of a woman’s monthly fertility cycle when the lining of the uterus thickens in preparation for receiving a fertilized ovum if conception has occurred. • Seminiferous tubules- Tightly wound microscopic tubes that comprise the testicles in the male, where sperm cells are generated. • Zygote- A fertilized ovum or egg moving down the fallopian tube.

11. Conception • Ovulation: “The Ovum’s Journey • The Sperms Journey • The Ovum-sperm “Rendezvous”

12. If it all goes right you end up with this!!

13. References • (CDC, “Fertility,” 2005; Hollander, 2007). • “Childless by Choice” (2001); Connidis & MCMullin (1999).

14. BEGINNING OF PREGNANCY The endometrium (uterine wall) thicken in preparation for the zygote. A fertilized egg moving down the fallopian tube. Divided many times and consists of approx. 90 cells surrounding a fluid filled core, before implanting in the uterine wall.

15. Resembles a tadpole or tiny shrimp • Buds of arms and legs begin to appear • Heart begins to beat • The size of an eraser on a pencil • Weighs less then 1 oz • Grows to 1 inch long • Distinct fingers and toes appear • Heart muscle has divided into chambers • Facial features are visible • Placenta is functioning • Now called a fetus • Grows to about 3 in. • Fingers and toes have nails • Fetus begins to move but cannot usually be felt by the mother • All vital organs and muscles are formed • Weighs about 1.2 oz

16. Increases in movement (Kicking, sucking, and swallowing) • Fingers and toes are more clearly defined • Sex of fetus may now be determined • 6 or 7 in. long • Weighs around 6 or 7 oz. • Increases more movement (rolls, flips, and somersaults • Fetus enters a predictable waking-sleeping cycle • Mother can definitely feel movements • Eyelashes & eyelids appear • 8-10 in. long • Weigh Nearly 1lb • Skin is red and wrinkled & covered with vernix (protective coating) • Eyes open and close • Lungs are breathing the amniotic fluid in & out • Hear sounds from outside world • 11-14 in. long • Weigh1.5-2 lbs

17. Taste buds have developed • Muscle tone develops through kicking and stretching • Clear responses to external sounds • Layers of fat are forming beneath the skin • Internal organs are maturing quickly • High chance of survival if born prematurely • 14-16 in. long • Weigh about 3 lb. • Fetus rotates to head-down position • Brain grows quickly • Fetus’s kicks and elbow thrusts now become visible from the outside surface • Internal organs, except for the lungs, are nearly fully developed • Skull bones are flexible • 18 in. long • Weighs 4-6 lbs • Lungs develop fully & ready to breath air • Skin typically becomes pink & smooth • Turns & settles head down • Low in the mother’s uterus, in preparation for birth • Fewer noticeable movements • 18-22 in long • 6-9 lbs

18. Potential Problems in Pregnancy Common Discomforts • Breast • Tenderness • Nausea • & • Vomiting • Leg • Cramps • Backache • Shortness • Of • Breath • Varicose • Leg • Veins • Sleeplessness • Frequent • Urination

19. Serious & Life-threatening Difficulties • Fertilized egg attaches and grow outside the uterus, in the fallopian tube. • Tubal Pregnancy • High risk of rupture of the fallopian tube, causing internal bleeding, hemorrhaging, and death • Causes of ectopic pregnancy is infection with STI such as chlamydia and gonorrhea • Normal pregnancy until vaginal bleeding and abdominal pain • Must see physician • Treatment is a single injection of a medication called methotrexate. • 90% unless the zygote is too large. “out of place” Ectopic Pregnancy

20. Serious & Life-threatening Difficulties • Spontaneous abortion – loss of fetus during the first 20 weeks • Silent miscarriage – woman unaware of pregnancy; heavy menstrual period • Mother’s age Miscarriage Miscarriage • Illness or STI • Abnormalities of the uterus • Hormonal imbalance • Environmental toxins • Alcohol & cocaine • Heavy caffeine intake • Radiation

21. Serious & Life-threatening Difficulties • Premature birth • Birth of fetus before 37 week • Pregnant with more than one fetus the average gestation • More prone to learning disabilities, diabetes, hearing impairment, and coronary heart disease • Show low cognitive development, attention, perceptual, and motor skills and can continue into later childhood. Preterm Birth • Very stressful • Sexual activity does not increase the chances of premature birth • Sexual intercourse and orgasm for woman later in pregnancy appear to be lowering the rates of preterm deliveries. • Twins gestation to 35 week #1 cause of infant mortality PARENTS INFANT • Triplets gestation to 32 week • Infants require special care in a hospital until healthy enough to be taken home

22. Serious & Life-threatening Difficulties • Baby born with physical abnormality or metabolic dysfunction • May result in physical or mental disability • Occur less than 1% • 2nd Leading cause of infant mortality • Testing the fetus while in the uterus for abnormalities decreases the chances of an infant being born with serious problem • Over 4,500 specific birth defects have been identified Fetal Abnormalities (Birth Defects)

23. Serious & Life-threatening Difficulties • When a woman drinks alcohol while pregnant • Abnormal facial features • Small head size • Shorter-then-average height • Low body weight • Poor coordination • Hyperactive behavior • Difficulty paying attention • Poor memory • See more on page 345 • Any agent that has potential to cause a fetal abnormality • Drug & Alcohol • Microbe such as measles • Chemical • antifreeze • radiation • mercury • Most common worldwide • Tobacco & Alcohol Teratogen Fatal Alcohol Spectrum Disorders

24. Embryonic & Fetal Testing • Amniocentesis • Require the extraction of a small amount of fluid from the sac surrounding the fetus • Chorionic Villus sampling (CVS) • A sample of placental tissue • Report minor discomfort from these procedures • Offered the option of these tests, especially blood result are positive in fetal abnormalities. • Medical science’s ability to screen for genetic or physical defects of embryo or fetus • Blood Test can predict some disorder • Spina bifida • Down syndrome • Magnetic resonance imaging (MRI) • Fetal abnormalities earlier and accurate • Ultrasonic visualization • Allow parents and doc. see the fetus and any birth defects

25. ABORTION Termination of a pregnancy before week 37

26. Abortion cont’d • Contraception vs. abortion • Spontaneous vs. induced abortion • Pro life vs. pro choice

27. Types of abortions • Surgical abortions • vacuum aspiration • Dialation and evacuation • Medial abortions • mifepristone • Methotrexate

28. Dilation and evacuation

29. Pros • Medical surgical • High success rate -high success rate • Women in control -early and later pregnancies • More natural -one doctor visit • Not invasive -less involvement by women • Occurs at home

30. cons • Medical surgical • Only first trimester -invasive procedure • Two doctor visits -greater sense of grief • Can take days or weeks -risk of infection • More bleeding

31. REDUCE ABORTIONS • ROE VS. WADE • PARENTS’ CONSENT FOR MINORS • MORNING AFTER PILL • BIRTH CONTROL • EDUCATION

32. BIRTH • STAGE ONE LABOR • Contractions begin • Transition phase-rapid contractions • 12-14 hours • Breech birth-bottom first

33. Labor stages cont’d • Stage two • Birth of baby • Passage of head • Episiotomy • Stage 3 • Placenta expelled from uterus with umblical cord detachment

34. Stage one and two of labor

35. Stage three

36. Birth settings • Hospitals • Birthing centers • Home births • Cesarean sections

37. Postpartum Issues & Impaired Fertility

38. “Baby Blues” Normal, relatively mild depressed mood that includes feelings of sadness, crying spells, and extra anxiety Causes: Exhaustion from labor Hormonal shifts Fatigue of nights with little and/or poor sleep Stress of lifestyle change Short-lived, pass within 1-2 weeks May affect fathers too

39. Postpartum Depression (PPD) PPD- psychological depressive disorder that begins within 4 weeks after childbirth Shares symptoms of other forms of depression: Deep sadness Emotional apathy Withdrawal from family and friends Loss of interest in favorite activities Fatigue Changes in eating habits Feelings of failure or inadequacy

40. Postpartum Depression (PPD), continued PPD symptoms more severe than depression: Troubling lack of interest in new baby Overly intense worry about baby's welfare Fears of harming infant in some way Often extreme anxiety or panic attacks 10-20% of new moms suffer, of which only 50% are formally diagnosed

41. Postpartum Psychosis A severe form of PPD A psychological disorder that begins within 4 weeks after childbirth Symptoms can include those of PPD and also: Delusions Hallucinations Extreme mental disorganization Lack of recognition/diagnosis can lead to dire consequences: Pathological neglect of infant Infant abuse Infanticide (murder of infant)

42. PPD Treatments Similar to treatments for other forms of depressive illness Include psychotherapy and antidepressant medication Usually meds not prescribed for nursing mothers- can be secreted in breast milk and harm baby Primary reason why many women with PPD go untreated/forced to stop nursing sooner However, many newer antidepressants (Prozac, Zoloft, Paxil, Lexapro) are safer: They do enter mother's milk but little to none enters infant's system- no adverse effects found Benefits of breast-feeding in some cases, for both mother and child, outweigh risks of not treating PPD

43. Sexual Activities After Childbirth Most women not very eager to engage in sexual activities- exhausted, sore Exact time before women feel ready for sex depends on many factors: Length and difficulty of labor Whether she had an episiotomy Whether birth was vaginal or C-section Most doctors recommend waiting at least 6 weeks after birth to have intercourse Allows for adequate time to heal and for cervix to close so bacteria that may enter vagina during sex can't travel up into uterus Very trying time for some couples

44. Sexual Activities After Childbirth, continued Couples still want to feel close and intimate with each other but without physical discomfort Non-intercourse activities that couples can do: Kissing Touching Masturbation (individual, shared, for each other) Oral sex Couples should avoid inserting anything into vagina

45. Breast Feeding & Return of Fertility Cycle Breast feeding- one of the most healthful activities new mother can do for her child Benefits: stronger immune system and resistance to specific diseases After childbirth, a woman's normal menstrual cycle resumes in about 4-6 weeks Lactational amenorrhea: a time of suspended menstruation in breast-feeding mothers How long this lasts depends on: How often they breast-feed Whether or not they are breast-feeding exclusively Common fertility myth: a woman can't get pregnant while she is breast-feeding... This is FALSE!

46. Impaired fertility Chapter 9

47. Infertility • - sometimes called “impaired infertility” • -the lack of conception by a heterosexual couple after 12 consecutive months of trying • Approximately 10% of couples meet the definition of infertility in the U.S. alone

48. Causes of Impaired fertility • 25% due to a male sperm factor (low number, poor quality, or low motility) • 20% due to female ovarian problem ( no ovulation or poor quality ova) • 14% due to a female tubal problem (fallopian tube blockage) • 41% due to other problems, or there are no identifiable problems in either partner.

49. Age and infertility • As women enter their 30s and 40s, it may take longer to conceive, but this doesn’t imply that they can’t become pregnant • Approximately 45% of women over 40 who wish to get pregnant eventually do, however after the age of 45 the odds become very slim

50. Damaged or blocked fallopian tubes • Caused by one of two conditions: • - untreated sexually transmitted infections, such as chlamydia or gonorrhea, may lead to pelvic inflammatory disease, which may in turn damage or block the fallopian tubes • -endometriosis, which is when uterine tissue cells are growing outside the uterus, potentially affecting the passage of sperm through the fallopian tubes