Prenatal Development

• The course of prenatal development can be divided into three periods:

  • Germinal Embryonic

  • Fetal

Germinal Period

• The germinal period takes place in the first 2 weeks after conception

  • Includes

    • The creation of the fertilized egg - zygote

    • Rapid cell division - mitosis

    • The attachment of the zygote to the uterine wall - implantation

Embryonic period

• The embryonic period takes place 2 to 8 weeks after conception

• Includes:

  • The specialization of cells to perform specific tasks - cell differentiation

  • The mass of cells is now considered an ambryo, and it is conformed of 3 layers of cells.

    • Endoderm 0 the inner layer which will develop into the digestive and respiratory systems

    • Mesoderm - the middle layer which will become the ciculatory system, bones muscles, excretory system, and reproductive system

    • Ectoderm - the outermost layer which will become the nervous system and brain, sensory receptors, and skin parts (e.g., hairs and nails).

Fetal Period

• The fetal period lasts about seven months, it is the prenatal period between 2 months after conception and birth (in typical pregnancies).

Teratology and Hazards to Prenatal Development

• A teratogen is any agent that can potentially cause a birth defect or negatively alter cognitive and behavioral outcomes.

• Dose, genetic susceptibility, and the time of exposure to a teratogen influence both the severity of the damage to the embryo/fetus, and the type of defect

Teratogens

• Prescription and nonprescription drugs; antibiotics, asma medications, some antidepressants, certain synthetic hormones, and Acutane

• Psychoactive drugs: caffeine, alcohol, nicotine, cocaine, marijuana, and heroin.

• Synthetic opioids and opiate-related pain killers: fentanyl, OxyCotin, and Vicodin

• Environmental hazards: toxic waste, chemical pollutants, x-ray radiation, fertilizers, and pesticides.

Other Hazards to Prenatal Development

• Maternal Diseases

  • Rubella

  • Syphilis

  • Genital herpes

  • AIDS

• Other parental factors

  • Maternal diet and nutrition

  • Parental age

  • Maternal emotional states and stress

  • Parental genetic factors

The Birth Process

• There are 3 main stages of birth:

  • 1st stage - uterine contractions are 15-20 minutes apart and last up to 1 minute

  • 2nd stage - begins when the baby’s head starts to move through the cervix and birth canal

    • Ends when the baby completely emerges from the mother’s body.

  • 3rd stage - afterbirth; when the placenta, umbilical cord, and other membranes are detached and expelled.

Childbirth settings and attendants

• In 2020 in the United States:

  • 98% of births took place in hospitals

  • 1.26% in homes

  • 0.74% in free-standing birth centers

• Midwifery is a profession that provides health care to women during pregnancy, birth, and the postpartum period

• A doula is a caregiver who provides continuous physical, emotional, and educational support for the mother before, during, and after childbirth.

  • Unlike midwives, duolas do not have medical training and cannot be used as a substitute for a doctor in delivering a baby

Methods of childbirth

• Natural childbirth is a method that aims to reduce mother’s pain by decreasing fear through

  • Education about childbirth

  • Relaxation techniques during delivery

  • Medicated and non-medicated

• Prepared childbirth includes a special breathing technique to control pushing in the final stages of labor, as well as detailed education about anatomy and physiology

• Cesarian delivery is a surgical procedure in which the baby is removed from the uterus through an incision made in the abdomen

• Although some may choose a scheduled cesarian as their birth plan, other’s may require one if the baby is in breech position - baby’s buttocks are the first part to emerge from the vagina

Assessing the Newborn

• Almost immediately after birth, a newborn is taken to be weighed, cleaned up, and tested for signs of developmental problems that may require urgent attention.

• The Apgar Scale evaluates an infant’s heart rate, respiratory effort, muscle tone, body color; and flex irritability of a newborn at 1 and 5 minutes after birth

  • The obstetrician or nurse evaluates and gives newborn a score of 0, 1, or 2 in each of the 5 health signs

  • Total score of 7-10 indicates condition is good, score of 5 indicates there may be developmental difficulties, score of 3 or below signals emergency and indicates baby may not survive

Preterm and Low Birth Weight Infants

• Low birth weight infants - those that weigh less than 5 ½ lbs at birth

• Preterm infants - those born before the completion of 37 weeks of gestations

• Small for date infants - those whose birth weight is below normal when the length of pregnancy is considered.

  • May be preterm or full-term

The Postpartum Period

• Physical adjustments

• Emotional and psychological adjustment

• Bonding

Physical Adjustments

• Period after childbirth lasts until the mother’s body has completed its adjustment and has returned to a nearly prepregnant state.

• Body makes numerous physical adjustments in the first days and weeks after childbirth.

  • After delivery, the body undergoes sudden and dramatic changes in hormone production.

  • May have a great deal of energy or feel exhausted and let down

  • Fatigue can undermine their sense of well-being and confidence in their ability to cope with a new baby

  • Loss of sleep is a big concern as it can contribute to stress and impaired decision making

    • sleep affects everything else

    • Like your cognitive processes becoming fuzzy because of lack of sleep

Emotional and Psychological adjustments

• Emotional fluctuations are common in the postpartum period.

• For some, these fluctuations decrease within several weeks after delivery, but others may experience more long-lasting mood swings

  • About 70% of new mothers experience the postpartum blues

    • 2-3 days after birth, they feel slightly depressed, anxious, and upset

    • May come and go for several months and tend to peak at 3-5 days after birth

    • mild version of postpartum depression

  • Other may develop postpartum depression, which involves a major depressive episode that typically occurs about 4 weeks after delivery

    • Strong feelings of sadness, anxiety, or despair that last for at least 2 weeks.

    • Full on clinically diagnosed depression

Bonding

• Bonding is the formation of a connection, especially a physical bond between parents and the newborn in the period shortly after birth

• Some hospital practices deter bonding:

  • Drugs given to the mother at a high dose can make them drowsy and unable to respond to or stimulate newborn

  • Parents and newborns are open separated shortly after delivery

  • Preterm infants are isolated from their parents even more than full-term infants

  • Many hospitals offer a rooming-in arrangement, in which baby remains in the room most of the time during the hospital stay. Testing procedures can also occur in the room.