Prenatal Care and Childbirth

1. Prenatal Care and Childbirth Chapter 5

2. At no other time are two people closer than a mother and baby during prenatal period • Even before she knows she’s pregnant her body is undergoing changes to prepare for the 9 months

3. Mother gives the baby a safe “home” in her uterus • She eats, breathes, and gets rid of wastes for them both, her body works to bring the baby into the world

4. “Be good to your baby before it is born.” • Parents to be should take this slogan seriously • Ideally, these steps should begin before a woman becomes pregnant

5. Good health habits in younger years are beneficial • Complete physical check up • As soon as you realize your pregnant go for prenatal check up • Reduces risk of complications

6. Signs of Pregnancy • Can’t feel sperm and egg unite • Can’t feel cells dividing • Body begins to nourish and protect new life • Hormones trigger changes in some woman’s organs

7. Presumptive – can be signs of pregnancy or something else Amenorrhea Nausea Tiredness Frequent urination Swelling/tenderness of breasts Internal changes other signs See page 131 figure 5-1 Positive signs – HCG – hormone in blood and urine Fetal heartbeat Fetal movement Fetal image Fetal shape Uterine contractions Signs of Pregnancy

8. Medical Care • Obstetricians – doctors who specialize in pregnancy and birth • The first appointment- couple should go together • Gather general information • Details on menstrual cycle • Past pregnancies • Complete physical exam • Weigh the woman, blood pressure, respiration • Pelvic exam • Urine and blood tests (anemia) • Blood sugar test • Due date estimated

9. The Unborn Baby’s Environment • At conception, baby begins to form traits from both mom and dad • Inherited traits merged into one person • Influence child’s growth and development • Environmental factors – those factors caused by a person’s surroundings • The mother’s age, weight, health habits, and hazards she encounters affect the baby

10. Factors that Affect the Baby’s Health • Unborn relies on mom • Healthy mom usually means healthy baby • High risk mothers have factors that don’t promote a healthy pregnancy • Age, physical health, Rh factor, emotional stability

11. Mom’s age • Ideal time to have a baby is 21 to 28 • Teens and women over 36 are high risk • Pregnant teens are still growing themselves (can’t always meet babies needs) • Premature – babies born too soon • Low birthweight – babies who weigh less than 5 ½ pounds at birth • Women over 36 tend to have babies with health problems, disabilities and disorders

12. Mother’s Physical Health • Affects the outcome of pregnancy • Learn how the health problem may affect the pregnancy • Take steps to protect the baby • Special testing etc • Healthy weight important • Low weight (15%) can lead to low birthweight • (20%)May experience fatigue, high blood pressure, heart strain and blood sugar problems

13. Weight cont • Having a healthy weight and good exercise important • Good nutrition a must

14. Rh Factor • Protein substance found in the red blood cells of about 85% of the population • (found in Rhesus monkey) • Rh + and Rh – • Problem when father is + and mom is – • 12% of marriages • Baby may develop Rh disease (anemia that destroys the baby’s red blood cells

15. Rh • Rh + baby affects mom for later pregnancies • She builds up antibodies to fight the + in her – system • Anti Rh immune globulin was approved to help • Receive within 72 hours after the birth of each Rh + child

16. Mother’s Emotional Health • Positive thoughts and feelings important • Negative feelings stimulate the nervous system • Adrenaline is a hormone that prepares the body for stress • Feel more energetic, controls heart rate, breathing and muscle tension

17. Happy mom = lower adrenaline • Later in pregnancy if mom has adrenaline so does the child and hears mom’s increased heart rate and muscle tension • Unborn can handle some stress • Long term and severe or frequent can make delivery more difficult • Baby may be smaller, fussy or quite active

18. Health Habits During Pregnancy • Good health as for all people • May need to eat more of some foods • May need vitamins • Be cautious about physical activities • Ask doctor for guidelines

19. Nutrition • “eating for two” is correct • First week baby relies on yolk sac • By 12th week relies on mom • Shouldn’t double your calories but definitely eat more

20. Good nutrition is vital • Direct link between what she eats and the following: • Her weight gain • Unborn’s weight gain • Infant’s growth • Infant’s mental capacity • Infant’s physical performance

21. Diet is essential • Food Guide Pyramid for help • Diets need more calcium, iron, folic acid, and protein than non pregnant • Limit caffeine • See page 138 figure 5-5

22. Weight Gain • 25 – 35 pounds in pregnancy • Need 300 extra calories a day • Weight gain during pregnancy is not all stored as fat • Doctors watch the weight gain • Too little and baby not growing • Too much puts strain on mom’s heart

23. Weight Gain • During the first 3 months = 5 pounds • 4 to 8 months = 2 – 3 pounds per month • During the 9th month = 1 pound per week

24. Hygiene Practices • Continue good and normal grooming • Paying attention to appearance makes her feel better • Dental check up • Avoid very cold or very hot baths • Replace tub baths with showers or sponge baths during the last 4 to 6 weeks (possible internal infection or falls)

25. Rest & Sleep • Needs rest and sleep • 8 – 9 hours a night • 15 – 30 minutes rests during the day • Many feel tired and its good to rest

26. Physical Activity & Exercise • Limit physical activity • Be active but within normal limits • Avoid contact sports • Activities that jolt the pelvic area • Activities that could result in a fall • Childbirth classes help women learn conditioning exercises to relieve back and leg strain and prepare muscles for delivery

27. Health Hazards to Avoid • 20% of disabilities present at birth are caused by genetic factors • Most caused by environment: • Diseases, drugs, radiation, pollutants

28. Diseases or Illnesses in the Mother • Diabetes – body’s inability to use sugar properly • Gestational diabetes – it appears in women who are pregnant- goes away after pregnancy • Have larger babies (10 – 12 lbs) • Babies have higher risk high blood pressure, congenital problems, heart problems, and infant death

29. Pregnancy-Induced Hypertension (PIH) • High blood pressure caused by pregnancy • Dangerous condition • Preeclampsia or toxemia • Sudden increase in blood pressure, protein in the urine and swelling • Appears late in pregnancy, cause is unknown • Untreated can lead to damage or death of mom and baby or both • Medicine, bed rest

30. FYI • It can cause your blood pressure to rise and puts you at risk of stroke or impaired kidney function, impaired liver function, blood clotting problems, pulmonary edema (fluid on the lungs), seizures and, in severe forms, maternal and infant death. Because preeclampsia affects the blood flow and placenta, babies can be smaller and are often born prematurely. Ironically, sometimes the babies can be much larger. • While maternal death from preeclampsia is rare in the U.S., it is a leading cause of illness and death globally for mothers and infants.

31. Rubella and Other Infections • Rubella – German measles – virus that can cross the placenta and affect baby the first three months • Baby can be born blind, deaf, mentally disabled or heart problems • Also concerned about chicken pox, mumps and measles • Mom should have vaccine if possible • Don’t be exposed to these

32. Toxoplasmosis – caused by a parasite that primarily infects cats • Damages unborn’s nervous system • Avoid contact with cats • Garden with rubber gloves • Don’t change the cat’s litter boxes

33. Sexually Transmitted Diseases • Infectious illnesses that are passed primarily through sexual intercourse • STD’s may enter blood stream of mom and cross placenta to baby • Others infect mom’s reproductive tract and pass to baby through delivery • Others passed during breast feeding • See page 142 figure 5-8

34. All STD’s are danger to baby • Acquired Immunodeficiency syndrome (AIDS) • Most dangerous • Disease caused by human immunodeficiency virus (HIV) attacks body’s immune system • Passes through sex, blood and body fluids, delivery, breastfeeding • Prevention no cure

35. Drugs • Medications – alcohol, nicotine, illegal drugs • Medications – don’t use unless doctor directed • Some affects not know • Case by case whether the risk is worth it

36. Alcohol • Never drink • Any liquor can harm unborn • Fetal alcohol syndrome (FAS)- condition in infants that occurs when mothers drink heavily during pregnancy • Babies are shorter, weigh less • Growth/development slow • Small heads, unusual facial features, heart defects, poor motor development and disabilities • No one knows how much is safe • IS IT WORTH IT????

37. Nicotine • Babies feel effects of smoking • Usually smaller in size • Nicotine raises mom’s heart rate, blood pressure, breathing rate and reduces the flow of blood • While mom is smoking, baby’s oxygen is greatly reduced • Need O2 to grow • Smoking after 16 weeks can lead to a miscarriage • Smoking can cause baby’s brain to develop abnormally • Learning problems, hyperactivity and poor attention spans • Ear infections and breathing problems • Second hand smoke just as dangerous

38. Illegal Drugs • Cocaine, crack, heroin, marijuana • All cross placenta quickly and reach baby • If woman is addicted, her child will likely be also • Babies goes through withdrawal • high-pitched crying, shaking poor feeding and fever • Mothers eat poorly, smoke or abuse alcohol • Slim chance of living a healthy life

39. Radiation Exposure • X rays should be avoided • Can increase childhood cancer • Linked to congenital disabilities • Inform doctors and dentists of pregnancy • Avoid X rays and don’t work by them

40. Environmental Pollution • Home and workplace should be safe • Lead, chemicals, pesticides and herbicides pose risks to unborn baby

41. Complications of Pregnancy • Reduced by good prenatal care • Follow doctor’s advice • Practice good health habits • Complications can damage the mother’s health • Cause congenital problems or loss of baby before birth

42. Congenital Problems • Physical or biochemical problem that is present at birth and may be caused by genetic or environmental factors • Inherited or caused by environmental factors • Figure 5-10 lists most common

43. Miscarriage • Expulsion (forcing out) of the baby from the mother’s body before week 20 of pregnancy • (spontaneous abortion) • Stillbirth – is the loss of a fetus after 20 weeks of pregnancy (born dead) • 1/3 of pregnancies end in loss of baby • most common in the first 3 months • Can occur before you know you are pregnant

44. Miscarriages result from congenital problems of the fetus • Pregnancy complications and certain diseases • Smoking, drinking, using drugs lead to fetal loss • Risk of a second miscarriage is higher for couples who have had one

45. Monitoring Baby’s Development • Help doctors determine baby’s health and exact age • Indicates size and gender of baby • Determine if one or more babies • Babies position

46. Ultrasound • Prenatal test in which sound waves bounce off the fetus to produce an image of the fetus inside the womb • Sonogram (picture of the fetus) • Technician holds a transducer over the mom’s abdomen • Produces visual image of fetus • Considered safe • Fairly routine

47. Chorionic Villus Sampling • Prenatal procedure for finding abnormalities in the unborn by testing a small sample of the chorion • Between weeks of 8 to 12 • Detects serious problems in fetus • Hollow tube inserted through vagina into uterus and guided to chorion • Small section suctioned off and analyzed • Slight risk for infection and miscarriage

48. Amniocentesis • Prenatal test in which a needle is inserted through the woman’s abdomen into the amniotic sac and sample of the fluid is removed for cell study • Checks for Down syndrome, Tay-Sachs disease and sickle cell anemia • 14 -16 weeks • Safe in 99% of cases • Miscarriage and premature births may result • Not a routine test • Only when problems are suspected

49. Tay sachs disease • a baby with Tay-Sachs disease is born without one of those important enzymes, called Hexosaminidase A (Hex A). So, as those fatty proteins build up in the brain, they hurt the baby's sight, hearing, movement, and mental development.

50. Sickle cell anemia • occurs when an abnormal form of hemoglobin (HbS) is produced. HbS molecules tend to clump together, making red blood cells sticky, stiff, and more fragile, and causing them to form into a curved, sickle shape. Red blood cells containing HbS can go back and forth between being shaped normally and being sickle shaped until they eventually become sickle shaped permanently. Instead of moving through the bloodstream easily, these sickle cells can clog blood vessels and deprive the body's tissues and organs of the oxygen they need to stay healthy.