Lecture Notes

Chapter 7 Conception, Pregnancy, and Childbirth

Modified: 2007-05-18

The topics in this chapter highlight the reproductive functions of sexuality. Today these topics have become more complex because of our ability to limit or enhance fertility, and because of the many innovations in reproductive technologies. Soon, we may have to debate the ethics and possibilities of human cloning and reproduction outside of human bodies.

During our work on this chapter we will take time to have our Mother's Roundtable discussion. Let me know if you want to participate or know someone who would participate. Mothers will visit our class and share their experiences about pregnancy and giving birth.

Video: We will also watch videos of pregnancy and birth

Conception
- Sperm
  - small (microscopic)
  - head, mid-piece, tail
  - small
  - mitochondria in acrosome (source of energy)
  - flagellation
  - many and many are needed (why)
- Ovum
  - larger than sperm (barely visible)
  - passive locomotion (currents in fallopian tube)
- Conception
  - usually occurs in outer 1/3 of fallopian tube
- Video
Development of the Conceptus
- Beginning of life controversy
- Embryology
  - Differentiation
    - Ectoderm--hair, skin, nervous system, lens of eye
    - Endoderm--digestive system, respiratory system
    - Mesoderm--muscles, skeleton, reproductive system, circulatory system
  - Cephalocaudal trend
  - Placenta, umbilical cord, HCG
The Stages of Pregnancy
- Psychology of pregnancy
  - i.e., what to say when woman announces she is pregnant
- Signs of pregnancy
  - Presumptive
    - amenorrhea, tender breasts, nausea
  - Probable
    - positive test result
  - Positive
    - fetal movements, fetal hearbeat, fetal imaging
- Pregnancy tests
- Stages of pregnancy
  - First trimester
  - Second trimester
  - Third trimester
- Fathers and pregnancy
  - Couvade
  - Changing role of fathers
Sex During Pregnancy
- Safe
- Stop at 4 weeks prior to parturition
- Positions
Nutrition During Pregnancy
- Do not "eat for two"
- Eat healthy diet and include: protein, folic acid, calcium, magnesium, and vitamin A
- Weight gain
Effects of Drugs Taken During Pregnancy
- Antibiotics
- Alcohol
- Cocaine
- Steroids
- Other Drugs
- Dads and Drugs
Birth
- The Beginning of Labor
- Presentations
  - Breech
  - Transverse
  - Normal
- The Stages of Labor
  - First stage
    - Regular contractions
    - Dilatation of cervix to 10 cm.
  - Second stage
    - Baby moves into birth canal
    - Crowning
    - Episiotomy
  - Third stage
    - Delivery of placenta or afterbirth
- Cesarean Section (C-Section)
  - US rate higher than rest of first world
  - Longer recovery period
Natural Childbirth
- The Lamaze Method
  - Breathing and relaxation techniques taught
  - Rarely reduces pain
  - Good for primiparas
- The Bradley Method
  - Husband as coach
  - Drug-free method
  - Relaxation
- The Use of Anesthetics in Childbirth
  - Trend is to use fewer
- Home Birth vs. Hospital Birth
  - Not recommended because of emergencies
  - Compromise--make hospital more home like
After The Baby Is Born: The Postpartum Period
- Psychological Changes
  - Postpartum depression
- Attachment to the Baby
- Circumcision of males
Breastfeeding
- Prolactin and oxytocin
- Colostrum
- Uterine shrinking
- Weight loss
- Sociology of breastfeeding
  - Nipple guards?
Problem Pregnancies
- Ectopic Pregnancy
  - Implantation in wrong place (not in uterus)
- Psuedocyesis (False Pregnancy)
- Pregnancy-Induced Hypertension
  - preeclampsia
  - eclampsia
- Viral Illness During Pregnancy
  - Rubella or German measles
  - Herpes
- Birth Defects
- Rh Incompatibility
  - When mother is Rh- and fetus is Rh+
  - Rh- is recessive phenotype
  - Blue baby
  - Rhogam
- Miscarriage (Spontaneous Abortion)
  - 20-40% of pregnancies
  - most are defective fetuses
  - possible legal issue?
- Prematurity
  - Major public health problem
  - Defined by low birth weight
  - Largely preventable by adequate maternal care
Infertility
- About 15% of population
- Definition--cannot conceive within one year
- Many treatments
New Reproductive Technologies
- Artificial Insemination
- Sperm Banks
- Embryo Transfer
  - Surrogate mothers
- Test-Tube Babies
- GIFT & ZIFT
  - gamete intra-fallopian transfer
  - zygote intra-fallopian transfer
- Cloning
- Gender Selection

URLs
- What happens in the first 9 months--discusses what happens from conception to pregnancy
- The fetal senses--article of sensory capacities of developing fetus
- Birth psychology--index page of the APPPAH
- Obstetric Ultrasound--shows how ultrasound imaging works
- Bradley method--home page for husband-coached childbirth
- Baby Bag Online--index page about mothers and babies (large site)
- Pregnancy tests--page with information about commonly available tests
- Pregnancy tests and complications--large index page from "Ask the Midwife"
- Couvade--abstracts about topic
- Weight gain estimator for pregnancy--allows you to estimate ideal weight during pregnancy
- Breastfeeding answers--Q&A about breastfeeding
- What is a teratogen?--definition and examples
- Teratogens--examples of some of the most common teratogens
- Postpartum depression--list of symptoms and more
- La Leche--home page of breastfeeding advocacy group
- March of Dimes--home page of leading anti birth defects group
- Amniocentesis--outline of procedure, effects, and results
- Problems and Complications in Pregnancy & Birth--index page
- Pregnancy related FAQs--index page of FAQs

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