PSY3370 Chap_04
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Transcript of PSY3370 Chap_04
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Chapter 4:
PrenatalDevelopment
and Birth
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Prenatal
Development
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Prenatal development is dividedinto 3 periods and lasts
approximately 266 days:
Germinal period: first 2 weeks afterconception, zygote created.
Embryonic period: occurs from 2 to 8weeks after conception.
Fetal period: begins 2 months afterconception and lasts until birth.
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2008 The McGraw-Hill Companies, Inc. All rights reserved.
Significant Development in the Germinal
Period
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2008 The McGraw-Hill Companies, Inc. All rights reserved.
The Placenta and the Umbilical
Cord
19 i h
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2008 The McGraw-Hill Companies, Inc. All rights reserved.
To32wks
Less than1/10th of aninch long
Less than1 inch long
About 16.518 incheslong, weighs4 to 5 pounds
19 incheslong, weighs6 pounds
About 5.5inches long,weighs about4 ounces
About 10-12inches long,weighs 1/2to 1 pound
About 11-14inches long,weighs 1 to1.5 pounds
About 14-17inches long,weighs 2.5to 3 pounds
About 3inches long,weighs about1 ounce
Thirdtrimesterbegins
Second trimester begins
Firsttrimesterbegins
The ThreeTrimesters
of PrenatalDevelopment
See Figure4.3 intextbookfor moredetails
Fig. 4.3
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Prenatal Development
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Issue of Abortion
Beliefs and words seasoned with love
If strongly opposed, then what alternativesare you offering.
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Teratogen: any agent that causesbirth defects: Drugs (prescription, nonprescription). Alcohol, tobacco. Environmental pollutants. Infectious diseases. Nutritional deficiencies.
Maternal stress. Advanced age of a parent.
Severity of damage to the unborndepends on: Dose. Time of exposure. Genetic susceptibility.
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2008 The McGraw-Hill Companies, Inc. All rights reserved.
Mostserious
damagefromteratogens
in first2-8 wks
Zygote Embryonic period (wks) Fetal Period (wks)
Period of susceptibilityto functional defects
Period of susceptibilityto structural defects
Fig. 4.4
1 2 3 4 5 6 7 8 9 16 32 38
Teratogens and Timing of TheirEffects on Prenatal Development
Central nervous system
Heart
ArmsEyes
LegsEars
Teeth
Palate
External genitalia
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Fetal alcohol syndrome:abnormalities in newborn dueto mothers heavy use of
alcohol in pregnancy.
Abnormalities include:
Facial deformities.
Defective limbs, face, heart.
Most have below-averageintelligence.
Some are mentally retarded.
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Moderate drinkers during pregnancyhad babies who were less attentive
and alert even at 4 years of age.
Maternal smoking can cause :
respiratory problems.
SIDS.
ADHD.
low birth weight.
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Illegal drugs that harm duringpregnancy:
Cocaine. Marijuana.
Heroin.
Incompatible blood types (Rh factor).
Environmental hazards: exposure toradiation or chemicals.
STDs, HIV infection, AIDS.
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Fetal Alcohol Syndrome
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Other Parental Factors
Maternal factors:
Maternal diet and nutrition.
Emotional states and stress.
Maternal age.
Paternal factors:
Paternal exposure to teratogens including
smoking. Paternal age.
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2008 The McGraw-Hill Companies, Inc. All rights reserved.Fig. 4.6
20
0
30
4050
60
70
80
90
100
10
2004
1990
Non-LatinoWhite women
AfricanAmerican
women
Latinowomen
Percentage of U.S. Women Using Timely
Prenatal Care: 1990 to 2004
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Preparation for Labor & Delivery
Classes
Attitude
Plain for pain managementNatural vs Drugs
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Birth
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Three stages of birth:
Uterine contractions begin at 15 to 20minutes apart and last 1 minute; thisstage lasts an average of 12 to 24 hours.
Babys head begins to move through
dilated cervix opening; this stage lasts 1.5hour on average.
Afterbirth: umbilical cord, placenta, andother membranes are detached andexpelled.
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Birth complications include anoxia:
insufficient oxygen to brain when
delivery lasts too long.
Childbirth setting:
Hospital delivery room.
Home delivery with midwife.
Doula provides continuous
physical, emotional, and educational
support for mother before, during,
and after childbirth.
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Methods of childbirthkey choices involve
use of medication and when to have acesarean delivery.
Drugs used:
Analgesia pain relief.
Anesthesia blocks sensation. Oxytocics synthetic hormones to stimulate
contractions.
Natural childbirthaims to reduce pain by
decreasing fear and breathing techniques(Grantley Dick-Read).
Prepared childbirthLamazespecialbreathing and education about anatomy and
physiology.
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Other non-medicated techniques to
reduce pain Waterbirth
Massage
Acupuncture
Hypnosis
Music therapy
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Cesarean Delivery:
Needs to be used if baby is in breechposition or other complications.
Many today are choosing cesareandelivery.
Women in need of cesarean delivery aremore quickly identified.
Doctors may order cesarean out of
caution, and to avoid lawsuit if there is apossibility of maternal or fetal distress.
Today, 29.1 percent of all births arecesarean.
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Measuring neonatal health and responsiveness:
Apgar Scale, used 15 minutes after birth:
evaluate heart rate, body color, muscle tone,respiratory effort, and reflex irritability.
Brazelton Neonatal Behavioral Assessment Scaleperformed within 2436 hours after birth:
27 items are organized into 4 categoriesphysiological, motoric, state, and interaction.
Assesses newborns neurological development,
reflexes, and reactions to people.
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2008 The McGraw-Hill Companies, Inc. All rights reserved.
Score 0 1 2
Body ColorBlue, pale Body pink,
extremities blueEntire body pink
HeartbeatAbsent Slowless than
100 beats per min.Fast100 to 140beats per min.
Reflex
Irritability
No response Grimace Coughing,
sneezing, crying
Muscle Tone Limp and
flaccid
Inactive, weak,
some flexion of
extremities
Strong, active
motion
Respiratory
Effort
Breathing
for no more
than 1 min.
Irregular and slow Breathing good
with normal
crying
The Apgar Scale
Fig. 4.7
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Causes of low birthweight:
Preterm babies.
Small-for-date babies. Problems in developing countries.
Possible consequences of low birthweight:
Brain injuries.
Lung and liver diseases.
Learning disabilities.
ADHD. Lower levels in reading and math
achievement.
Deficits are evident in adulthood.
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About 50% of low-birthweight children
are enrolled in special education
programs.
Low birthweight is linked to asthma.
Some defects can be improved with:
Early speech therapy.
Intensive enrichment programs.
Kangaroo care and massage therapy.
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Care for preterm infants:
Kangaroo careholding preterminfant so there is always skin-to-
skin contact.
Massage therapyTiffany Fields
research.
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2008 The McGraw-Hill Companies, Inc. All rights reserved.Fig. 4.8
3 lb. 1 oz
3 lb. 7 oz
2 lb. 15 oz
3 lb. 3 oz
3 lb. 5 oz
Infant
weight 40 6 8 122 1410
Age (days)
Prematureinfants whowere massaged
Prematureinfants who
were notmassaged
Weight Gain Comparison of Premature InfantsWho Were Massaged with Those Not Massaged
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The
Postpartum
Period
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Postpartum period lasts about 6 weeks afterchildbirth when woman adjusts physically andpsychologically back to the prepregnant state:
Influenced by preceding conditions andexperiences.
Mother learns to care for the baby, feel goodabout herself, and those close to her.
Physical: hormone changes, weight loss,
return to menstruation, loss of energy orfatigue.
Psychological: feelings of depression,anxiety, coping in new role, excessiveworrying.
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2008 The McGraw-Hill Companies, Inc. All rights reserved.Fig. 4.9
Postpartum blues:symptoms appear 2 to 3
days after delivery andsubside within 1 to 2 weeks
No symptoms
10%
70%
20%
Postpartum depression: symptomslinger for weeks or months andinterfere with daily functioning
Percentage of U.S. Women WhoExperience Postpartum Bluesand Postpartum Depression
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A Fathers Adjustment:
Generally ignored, but fathers go throughconsiderable adjustment.
Some feel baby has replaced them interms of mothers affection.
Fathers should actively care for the baby.
Parents should set aside time to betogether.
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Bonding (formation of emotional
attachment) between infant andmother:
Usually occurs in period shortly after
birth.
Critical component in childs
development.
Isolation of premature baby and use of
drugs in birth process may harm bonding
process.
Some experts advocate a rooming-in
arrangement while mother and child are
in the hospital