Lifespan Development 17e – Chapter 3: Prenatal Development and Birth (Page-by-Page Notes)

Page 3: The Course of Prenatal Development

• Germinal period: Takes place in the first two weeks after conception
  • Creation of the zygote
  • Continued cell division
  • Attachment of the zygote to the uterine wall
  • Blastocyst: Inner layer of cells that develops into the embryo

Page 4: WHEN IS THE BABY DUE?

• Due date calculation: From the first day of your last menstrual period, count back three months and add one week
  • Example: If your last menstrual period started August 2, you can expect your baby to be born within a week or so of May 9
  • Only about 1 in 20 babies is born on the actual due date
• Zygote conception visuals: Sperm penetrates the egg’s protective membrane, sheds its tail, fertilized egg divides; the successful sperm is one of millions
• Images are from American Baby Magazine: As Your Baby Grows

Page 5: INNER WORKINGS OF EARLY PREGNANCY

• The fertilized ball of cells (blastocyst) has a large role:
  • Outside cells become the placenta (attached to uterine wall; links mother and baby during pregnancy)
  • Inside cells become part of the baby
• A week after implantation, progesterone levels rise, causing the uterus to stop shedding its lining, which prevents a new period and signals pregnancy
• A week after fertilization, the ball of several hundred cells attaches to the uterine lining
• Hormonal changes and clinical confirmation: talk to your doctor or midwife about potential harmful exposures during early pregnancy
• Images: From American Baby Magazine: As Your Baby Grows

Page 6: Significant Developments in the Germinal Period

• Notable developments during the germinal period (no detailed bullet points provided on this slide in the transcript)

Page 7: The Course of Prenatal Development – Embryonic period

• Embryonic period: Occurs two to eight weeks after conception
  • Rate of cell differentiation intensifies; mass of cells is now called the embryo
  • Three germ layers form:
  • Endoderm
  • Mesoderm
  • Ectoderm
  • Support systems and organs begin to appear
  • Amnion (amniotic sac): Contains clear fluid in which the developing embryo floats

Page 8: The Course of Prenatal Development – Continued

• Umbilical cord: Contains two arteries and one vein; connects baby to placenta
• Placenta: Disk-shaped tissue where maternal and fetal blood vessels intertwine but do not join; transfers chemicals and nutrients between mother and baby
• Organogenesis: Organ formation during the first two months of prenatal development
• Fetal period: Period between two months after conception and birth

Page 9: Early Brain and Nervous System Development

• Brain neurons: nerve cells in the brain handling information processing; babies are born with approximately 20 to 100 billion neurons
• Neural tube: early formation of the nervous system; failure to close can cause anencephaly and spina bifida
• Key processes:
  • Neurogenesis: generation of new neurons
  • Neuronal migration: neurons move from their origin to their appropriate locations
  • Neural connectivity: neurons connect; this process continues postnatally

Page 10: The Placenta and the Umbilical Cord

• (Overview slide introducing the placenta and umbilical cord; details provided in Page 7-9 above)

Page 11: Incredible Transformations in Early Pregnancy

• Three weeks after conception: embryo is little more than a tube
• Ten days later: resembles a living creature; beginning of brain visible through skin
• At eight weeks: embryo floats in amniotic sac; limbs form
• Images from American Baby Magazine: As Your Baby Grows

Page 12: Developmental Milestones – 9 Weeks and Beyond

• By around 9 weeks, all major internal organs have formed and begun to function; embryo is now referred to as a fetus
• Fontanel: V-shaped soft spot on the head; allows skull to be compressed during birth
• Blood vessels outline the skull feature
• Images from American Baby Magazine: As Your Baby Grows

Page 13: STARTING TO LOOK HUMAN

• By the middle of the second month: arms take shape
• Eyebrows and eyes development:
  • Eyes form on stems extending from the brain toward the facial skin
  • Initially eyes are indentations; rapid development occurs at weeks 7, 8.5, and 10
  • In the third month, eyelids form and close over the eyes
• Nutrition tip (in slide): keep fat consumption to 30% of calories; choose low-fat dairy products
• Images from American Baby Magazine: As Your Baby Grows

Page 14: RAPID GROWTH

• Ear development: outer ear visible by around 10 weeks; fully formed by three months later
• Fetus can begin to respond to sound around the fourth or fifth month; fetus is stimulated and irritated by sounds
• Sensory development: fetus learns to hear a range of sound variations; brain begins to interpret sounds
• Yolk sac: provides early blood cell production; by the eleventh week it has fulfilled its role and is replaced by liver, spleen, and bone marrow for blood production; the sac detaches
• Notes: Prenatal visits give a father-to-be a chance to raise health concerns and discuss involvement in labor and pregnancy
• Images from American Baby Magazine: As Your Pregnancy Grows

Page 15: The Three Trimesters of Prenatal Development

• Three trimesters overview (structure and timing used in prenatal development discussions)

Page 16: Developmental Stages Diagram (a)-(h)

• Visual representation of stages from two-celled organism to a 20-week fetus (labels listed on slide: a) two-celled organism, b) germinal period at 32 days, c) embryo at 21 days, d) 4-week-old embryo, e) 5-week-old embryo, f) 12-week-old embryo, g) 6-week-old fetus, h) 20-week-old fetus)

Page 17: POSSIBLE SYMPTOMS/EFFECTS OF PREGNANCY (mother)

• Common symptoms:
  • Sore, swollen breasts
  • Nausea, vomiting
  • Frequent urination
  • Sleepiness or sleeplessness
  • Changes in skin, hair, teeth, nails
  • Constipation
  • Weight gain
• Source cited: Kitzinger, S. (2003). The Complete Pregnancy & Childbirth

Page 18: EFFECTS ON MOTHER (cont)

• Additional effects:
  • Cramps
  • Varicose veins
  • Hemorrhoids
  • Stretch marks
  • Edema (swelling)
  • Shortness of breath
  • Heartburn
  • Dizziness, headaches, nosebleeds
• Images referenced from Veinhealth.com and About.com

Page 19: PUPPP syndrome

• PUPPP (pruritic urticarial papules and plaques of pregnancy) syndrome noted
• Image references from Google Images

Page 20: EMOTIONAL/PSYCHOLOGICAL EFFECTS OF PREGNANCY

• Mood swings and emotionality
• Anxiety about baby
• Dreams related to pregnancy
• Changes in libido
• Nesting behaviors

Page 21: POSSIBLE EFFECTS ON FATHER

• Fathers may experience: pride, anxiety, protective instincts
• Changes in libido and anxiety about sex
• May feel neglected or left out

Page 22–23–24: Hazards to Prenatal Development – Teratogens

• Teratogen: any agent that causes a birth defect or alters cognitive/behavioral development
• Teratology: the study of birth defects
• Damage depends on: dose, genetic susceptibility, time of exposure
• Critical window: heightened sensitivity around 3–4 weeks during organogenesis
• Historical note: harm discovered post-WWII in Japan due to thalidomide use in pregnant women in the 1950s, leading to severe limb defects
• Includes: substances, drugs, diseases, environmental hazards

Page 23: Teratology and Hazards to Prenatal Development 1

• Key concepts:
  • Teratogen effects depend on dose, genetic susceptibility, timing
  • Fetal period exposures can cause stunted growth, brain development problems, organ function problems

Page 24: Teratology and Hazards to Prenatal Development 2

• Prescription drugs that can act as teratogens include:
  • Antibiotics: streptomycin and tetracycline
  • Some antidepressants: miscarriages, preterm birth, autism spectrum disorders
  • Hormones: progestin and synthetic estrogen
  • Accutane (isotretinoin) for acne
  • Oral contraceptives (isotretinoin is a related drug; note mentions isotretinoin again)
• Harmful nonprescription drugs
• Diet pills
• High-dose aspirin

Page 25: Teratology and Hazards to Prenatal Development 3

• Psychoactive drugs: affect the nervous system and can cause neurological, medical, and cognitive deficits
• Examples and associated risks:
  • Caffeine: increases BP/heart rate; potential effects on ADHD risk
  • Methamphetamine: higher infant mortality; cognitive, behavioral effects
  • Cocaine: small size, impaired reflex/motor development, memory and development issues; potential ADHD
  • Marijuana: low birth weight; higher NICU admission
  • Heroin: withdrawal and behavioral problems; potential ADHD

Page 26: Teratology and Hazards to Prenatal Development 4 – Alcohol and Nicotine

• Alcohol: Fetal Alcohol Spectrum Disorders (FASD); associated with learning/behavior problems; risks include early death from suicide, accidents, poisoning, or drugs
• Nicotine: low birth weight, ADHD, impaired newborn brain development; increased risks of miscarriage, stillbirth, lung problems, asthma, SIDS

Page 27: Fetal Alcohol Spectrum Disorders (FASD)

• Symptoms include: small body size, small brain, distinct facial features (e.g., small eye openings, sunken nasal bridge, flat nasal bridge, thin upper lip, smooth philtrum)
• Potential cognitive/behavioral issues: mental retardation, learning disabilities, ADHD
• Visual references show FASD imagery

Page 28: Blood Type Incompatibility and Environmental Hazards

• Rh incompatibility between mother and fetus can risk prenatal development (Rh factor)
• Environmental hazards include radiation, X-rays, toxic wastes, lead, mercury, DDT, and other pollutants
• Toxoplasmosis risk from handling raw meat, cat or reptile feces

Page 29: Maternal Diseases and Viruses

• Maternal diseases: rubella (German measles), syphilis; can cause deafness, blindness, mental retardation, death
• Genital herpes: risk if baby passes through birth canal
• AIDS: risk to newborn
• Viruses: ongoing study of links to schizophrenia with prenatal exposure
• Diabetes mellitus: challenging to control insulin levels during pregnancy

Page 30: Other Factors in Prenatal Development

• Ectopic (tubal) pregnancy: about 1%; life-threatening to mother
• Parental factors:
  • Maternal diet, nutrition, weight (obesity)
  • Maternal age:
  • Emotional states and stress
  • Miscarriage: up to 20% of pregnancies (most common in first trimester)
  • Paternal factors: father’s exposure to alcohol, drugs, radiation, smoking

Page 31: Teratogens and The Timing of Their Effects on Prenatal Development

• Concept: teratogen effects are influenced by timing during fetal development; some periods are more sensitive than others

Page 32: Prenatal Care

• Purpose: Screening for manageable conditions and treatable diseases
• Programs include educational, social, and nutritional services
• Exercise during pregnancy benefits:
  • Enhances baby’s development
  • Improves maternal body conditioning and weight management
  • Boosts immune system and reduces stress
  • Regulates blood pressure
  • Associated with more positive mental state

Page 33: Stages of the Birth Process

• 1st stage – Labor: Contractions occur every 15–20 minutes and last up to 1 minute; can last up to 12 hours
• 2nd stage – Transition & Delivery: Cervix dilates to 8–10 cm; baby’s head moves through birth canal; ends with birth (roughly 45 minutes to 2 hours)
• 3rd stage – Afterbirth: Placenta, umbilical cord, and other membranes detach and are expelled (about 20 minutes)

Page 34: Birth Process in the United States

• 98.5% of births occur in hospitals
• Midwives: ~8% of hospital births
• Doula: ongoing physical, emotional, and educational support for mother before, during, and after childbirth
• Methods of childbirth often involve medications: analgesia, anesthesia, and oxytocin

Page 35: Birth Process – Natural Childbirth and Alternatives

• Natural childbirth aims to reduce pain by lowering fear via:
  • Education about childbirth
  • Relaxation techniques during delivery
  • Water birth (in warm water); see source link in slide
• New methods include: massage, acupuncture, hypnosis, and music therapy

Page 36: Birth Process – Prepared Childbirth and Cesarean Options

• Prepared childbirth (Lamaze) uses specific breathing techniques to control pushing in final stages
• Some use self-hypnosis
• Cesarean delivery: surgical removal of baby via abdominal incision
• Breech presentation: baby’s feet, legs, or buttocks emerge first; cesarean may be chosen for safety or other reasons

Page 37: POTENTIAL COMPLICATIONS at Birth

• Anoxia (lack of oxygen)
• Low birth weight (< $5\frac{1}{2}$ pounds)
• C-section considerations (breech, small pelvis, lack of strong contractions, premature, fetal distress, previous C-section)

Page 38–40: Assessing the Newborn

• Apgar Scale: assesses newborn health at 1 and 5 minutes after birth
• Evaluates:
  • Heart rate
  • Respiratory effort
  • Muscle tone
  • Body color
  • Reflex irritability
• Interpretation: low Apgar scores are associated with higher developmental risks
• Brazelton Neonatal Behavioral Assessment Scale (NBAS): used in the first month to assess neurological development, reflexes, and reactions to people/objects
• Neonatal Intensive Care Unit Neurobehavioral Scale (NNNS): assessment of behavior, neurological status, stress responses, and regulatory capacities

Page 41–43: Preterm and Low Birth Weight Infants

• Definitions:
  • Low birth weight: weight less than $5.5$ pounds at birth
  • Preterm: born before 37 weeks of gestation
  • Small-for-date: below normal weight given length of pregnancy
• Consequences: more health and developmental problems than normal birth weight infants
• Nurturing preterm/low birth weight infants:
  • Kangaroo care (skin-to-skin contact)
  • Massage therapy
  • Breast milk
• Preterm birth rate has declined across cultures in the United States

Page 44–45: Postpartum Period

• Definition: period after childbirth that lasts until the mother’s body has returned to a nearly prepregnant state
• Required adjustments: physical, emotional, psychological

Page 45–46: Postpartum Physical and Hormonal Adjustments

• Physical: hormonal fluctuations, fatigue, sleep deprivation
• Involution: uterus shrinks back to normal size
• Bleeding cessation and recovery timelines
• No sex for about 6 weeks
• Hormone levels drop abruptly (estrogen, progesterone)

Page 47–48: Emotional and Psychological Adjustments

• Postpartum depression: major depressive episode occurring after delivery; may affect daily functioning and bonding with baby
• Three levels of adjustment discussed: Baby blues, postpartum depression, postpartum psychosis
• Baby blues: mood swings, sadness; usually resolves in a few weeks
• Postpartum depression: persistent depressive symptoms; sleep disturbance; impaired functioning
• Postpartum psychosis: rare but severe; potential delusions; risk for harm; requires urgent treatment
• Treatments include antidepressants, hormone therapy, psychotherapy, and regular exercise

Page 49–50: Sleep Deprivation in Pregnancy and Postpartum Periods

• Sleep deprivation concerns during pregnancy and after birth
• Additional resources discuss broader effects on sleep and mood

Page 51: Bonding and Rooming-In

• Bonding: formation of a strong parent-newborn connection shortly after birth
• Factors affecting bonding include maternal medications causing drowsiness and NICU separation
• Rooming-in: keeping the baby in the mother’s room most of the time during hospital stay to support bonding
• Important note: There is no universally established critical period for bonding like in some animal studies; bonding can still occur with various hospital arrangements