Chapter 2: Heredity, Prenatal Development, and Birth

LIFESPAN DEVELOPMENT Heredity, Prenatal Development, and Birth Heredity Genotypes and Phenotypes Genetic Disorders Chromosomal Abnormalities Behavioral Genetics Prenatal Development The Germinal Period The Embryonic Period The Fetal Period Prenatal Brain Development Teratogens Maternal Factors Prenatal Assessment Complications of Pregnancy Preparation for Childbirth Stages of Birth for Vaginal Delivery Assessing the Neonate Problems of the Newborn Postpartum Maternal Concerns Heredity, Prenatal Development, and Birth Heredity and Genetics • The chapter will explain how genes shape who we are and influence our development. • It will cover what happens genetically during conception. Genetic and Chromosomal Disorders • You'll learn about some common genetic and chromosomal disorders that can affect development. Prenatal Development • The process of development before birth will be discussed. • Special focus on the effects of teratogens (substances or factors that can harm the fetus during pregnancy). Parental Impact • Both the mother and father contribute to the development of the fetus, and their roles will be explored. Heredity Nature and Genetics • Heredity refers to how genetics influence development. • Genes are the instructions (sequences of nucleotides) that create proteins, which shape the structure and functions of cells. Humans have around 20,500 genes (as found in the Human Genome Project). Chromosomes and Cells • Humans have 46 chromosomes in each cell (arranged in 23 pairs; one from each parent). • Mitosis: The process by which most cells copy their chromosomes and divide into two identical cells. • Meiosis: The process for making gametes (sperm and eggs), where chromosomes are halved, so each gamete only has 23 chromosomes. When sperm and egg combine, the total is 46 chromosomes. Chromosome Types • Of the 23 chromosome pairs, 22 pairs are autosomes (similar in length). • The last pair is the sex chromosomes: o XY = male o XX = female Genetic Diversity • Due to the process of meiosis and the variety of genes, it's nearly impossible to have genetically identical non-twin offspring. Genotypes and Phenotypes Genotype vs Phenotype • Genotype: The genetic makeup, or the total set of genes inherited from both parents. • Phenotype: The physical traits or features expressed (what you actually see, like eye color or height). Homozygous and Heterozygous • Homozygous: When you inherit the same version of a gene from both parents (e.g., both parents give you the same eye color gene). • Heterozygous: When you inherit different versions of a gene from each parent (e.g., one parent gives you a gene for brown eyes, and the other gives you a gene for blue eyes). Dominant and Recessive Genes • Dominant genes: Express themselves in the phenotype, even if paired with a different version (e.g., dimples, curly hair). • Recessive genes: Only show in the phenotype if both copies are the same (e.g., red hair, nearsightedness). Alleles • Different versions of a gene (like the gene for eye color can have multiple alleles: brown, blue, green). Polygenic Traits • Most traits (e.g., height, skin color) are controlled by multiple genes, not just one. Incomplete Dominance • Sometimes, the dominant gene doesn’t completely hide the effect of the recessive gene (e.g., sickle cell disease). 1|Hikamac chi LIFESPAN DEVELOPMENT • Sickle cell: The healthy red blood cell shape is dominant, and the sickle cell shape is recessive. People with one sickle cell gene are carriers and might show some symptoms in certain conditions (e.g., at high altitudes or after intense exercise). Genetic Disorders Dominant Gene Disorders • Tourette's Syndrome: Causes mild tics; most people can control symptoms. • Huntington's Disease: Affects the nervous system, fatal, but symptoms appear only in midlife. Recessive Gene Disorders • Cystic Fibrosis: Causes thick mucus in lungs and digestive system, affects breathing and digestion. • Sickle Cell Anemia: Red blood cells are sickle-shaped, affecting oxygen transport in the body. • Phenylketonuria (PKU): The body can't process certain amino acids, leading to intellectual deficits if untreated. • Tay Sachs Disease: Enzyme deficiency leading to progressive damage to the brain and body; death occurs by age 5. • Albinism: Lack of pigment in skin, hair, and eyes, with possible vision problems. Sex-Linked Disorders (on the X chromosome) • Fragile X Syndrome: Causes learning and behavior problems. More serious in males (who have only one X chromosome). • Hemophilia: A blood clotting disorder, more common in males. • Duchenne Muscular Dystrophy: Weakens muscles, leading to difficulty moving, and can be fatal. Chromosomal Abnormalities Chromosomal abnormalities occur when a child inherits too many or too few chromosomes, often due to the mother's age. Older eggs are more likely to have chromosomal issues. Common Chromosomal Abnormalities • Down Syndrome (Trisomy 21): Occurs when there is an extra chromosome 21. Affected individuals often have intellectual disabilities, specific physical features (like short fingers, folds of skin over the eyes), and potential heart defects. • Trisomy 13: Extra chromosome 13 causes severe birth defects, and affected babies typically die within weeks or months. • Trisomy 18: Extra chromosome 18 leads to multiple birth defects, and the baby usually dies early. Sex-Linked Chromosomal Abnormalities • Turner Syndrome (XO): A female has only one X chromosome instead of two. This affects cognitive functioning, sexual development (e.g., no breast development or menstruation), and leads to short stature. • Klinefelter Syndrome (XXY): A male has an extra X chromosome, leading to small testes, breast development, infertility, and low testosterone levels. Genetic Counseling • Helps individuals and couples understand and test for genetic conditions that could affect their health or children. • Reasons for Seeking Counseling: o Family history of genetic conditions. o Belonging to an ethnic group with higher genetic risk. o Results of genetic testing (e.g., blood tests, ultrasound, amniocentesis). o Concerns about older parental age, previous miscarriages, or infertility. Behavioral Genetics The study of how genetics and the environment interact to influence behavior, often referred to as the nature vs. nurture debate. Both genetics and environmental factors can shape a person's behavior, and sometimes, environmental triggers can bring out symptoms of a genetic disorder. • Genotype-Environment Correlations: These refer to how genetic factors influence the environment and vice versa. There are three types of correlations: o Passive Genotype-Environment Correlation: Children inherit both genes and the environment from their family. For example, children with athletic parents may inherit the genes for athleticism and be encouraged to engage in sports. o Evocative Genotype-Environment Correlation: People's inherited traits influence how others treat them. For instance, a shy child may receive different social responses than an outgoing child. o Active Genotype-Environment Correlation (or niche picking): People actively seek environments that fit their genetic tendencies. For example, musically inclined children may seek out music lessons. • Genotype-Environment Interactions: This refers to how genetic predispositions interact with the environment. Studies like adoption research show that a child’s behavior can be influenced by both their genetic makeup and 2|Hikamac chi LIFESPAN DEVELOPMENT the environment they are raised in. For example, a child with genetically inherited psychopathology may have fewer behavior problems if raised in a structured environment. • Epigenetics: Studies how environmental factors like diet, stress, and toxins can modify gene expression (how genes are turned on or off). These changes in gene expression can be passed on to future generations. For example, identical twins may develop different traits as they age, despite having the same genetic makeup, due to different environmental influences. Human Genome Project (HGP) • Began in 1990 to map the human genome (all the genes in human DNA). By 2003, scientists completed the sequencing of the 3 billion base pairs that make up the human genome. • The project has helped identify genes related to over 1800 diseases. It also created a database called HapMap, which catalogs genetic variations in different populations, improving understanding of disease risks and responses to treatments. • Pharmacogenomics: Using genetic information to predict how people will respond to certain drugs. For example, tests can determine how a patient will respond to treatments for cancer or HIV. • The HGP aims to identify genetic markers for various types of cancer, develop more effective medications, and explore the ethical, legal, and social implications of genetic knowledge. • Ethical Concerns: The HGP also addresses concerns like who owns genetic information and how it may affect healthcare and society. Prenatal Development Prenatal development is divided into three periods: • Germinal Period: o Lasts about 2 weeks. o Begins at fertilization and ends when the fertilized egg (zygote) implants into the uterus. o Early cell division occurs, forming a blastocyst, which then attaches to the uterine wall. • Embryonic Period: o Lasts from about 2 to 8 weeks. o Major organs and body systems begin to form. o The organism is now called an embryo. o • Development of the placenta and umbilical cord begins, supporting the embryo. Fetal Period: o Lasts from about 9 weeks to birth. o The organism is now called a fetus. o Growth continues rapidly, and organs mature. o Movement, sensory experiences, and physical development continue. The Germinal Period (First 2 Weeks) • • • • • • Duration: About 14 days. Conception: Occurs when a sperm fertilizes an egg, forming a zygote (a single new cell with combined genetic information from both parents). Fertilization Location: Happens in the fallopian tube, where the sperm meets the egg. Zygote Development: o The zygote begins dividing through mitosis. o After about 5 days, it becomes a blastocyst (100 cells). o Inner cells (embryonic disk) will become the embryo. o Outer cells (trophoblast) become the support system (placenta). Implantation: The blastocyst attaches to the uterine wall. This marks the end of the germinal period. Survival Rate: Only about 50-75% of blastocysts implant in the uterine wall successfully. Many zygotes fail to survive due to improper cell division or other issues. The Embryonic Period (Weeks 3-8) • • • • • Duration: Begins in week 3 and lasts until week 8. Implantation Complete: The blastocyst becomes an embryo after implantation in the uterine wall. Placenta Development: Blood vessels grow to form the placenta, which connects to the mother’s uterus. It provides nourishment and oxygen to the developing embryo via the umbilical cord. Cell Differentiation: Cells continue to specialize, leading to the development of various structures. Growth Patterns: o Cephalocaudal Development: Growth occurs from head to tail (head and brain develop first). o Proximodistal Development: Growth occurs from the center of the body 3|Hikamac chi LIFESPAN DEVELOPMENT • • • • outwards (torso develops first, followed by arms, hands, and fingers). Development Milestones: o Week 4: The head starts developing and the heart begins to beat. o Early Stages: The embryo has gills and a tail, but these disappear by the end of the period. Vulnerability: This is the most critical period for the embryo, as major body structures form, and exposure to harmful substances (like drugs or alcohol) can cause significant damage. Size by Week 8: The embryo is about 1 inch long and weighs about 8 grams. Movement: The embryo can move and respond to touch by the end of this period. The Fetal Period (Weeks 9 - Birth) • • • • • Duration: Begins at week 9 and lasts until birth. Development of Body Parts: By week 3, the fetus has all its body parts, including external genitalia. Development Milestones o 3rd Month: The fetus has developed hair, nails, and teeth. The excretory and digestive systems continue to develop. o 4th to 6th Month ▪ Eyes become more sensitive to light. ▪ Hearing develops. ▪ Reflexes such as sucking, swallowing, and hiccupping appear. ▪ Sleep-wake cycles begin. o 6th Month: The fetus reaches the age of viability (about 24 weeks), meaning it may survive outside the womb with medical support. At this stage: ▪ Neurons in the brain are mostly developed, though still growing. ▪ The fetus can feel pain. 7th to 9th Month (Last Trimester) o The fetus is preparing for birth: ▪ Muscle exercises occur. ▪ Lungs start expanding and contracting. ▪ The fetus gains about 5 pounds and 7 inches. ▪ In the 8th month, a layer of fat develops under the skin to help regulate body temperature after birth. Around 36 Weeks o • • The fetus is nearly ready for birth, weighing about 6 pounds and measuring 18.5 inches long. By 37 Weeks: o All major organ systems are fully developed, and the fetus could survive outside the womb with fewer risks of prematurity. 40 Weeks (Full-Term): o The fetus has little room to move and birth is imminent. It has reached its full size and weight, ready for delivery. Prenatal Brain Development Week 3 (Embryonic Period) • Prenatal brain development begins with the differentiation of stem cells. These cells can develop into all the different cells of the brain. • These stem cells are located on the neural plate of the embryo. • By the end of week 3, neural ridges form, creating the neural groove and later the neural tube. • The center of the neural tube forms the brain's ventricles and spinal canal. Week 8 (End of Embryonic Period) • By week 8, the neural tube has developed into three main parts of the brain: o Forebrain o Midbrain o Hindbrain Fetal Period (After Week 8) • Neuron Production: The brain starts producing 85 billion neurons (nerve cells). • Neurogenesis (the formation of new neurons) is mostly complete by 5 months of gestation. • Neural Migration: Neurons migrate to their specific locations in the brain, especially in the cerebral cortex (outer layer of the brain), by around 24 weeks. Brain Development Milestones • Neocortex Neurons: Neurons in the neocortex (outer layer of the brain) migrate in a specific order. • Dendrites & Axons: Once in position, neurons begin growing dendrites (branches) and axons (long extensions) to create neural networks that process information. Gray and White Matter • Gray Matter: Areas with neuron cell bodies appear gray. • White Matter: Axons covered in myelin (a fatty substance) appear white and help with faster and more efficient communication between brain cells. Continued Development After Birth • Although cell differentiation is complete at birth, the growth of dendrites, axons, and the 4|Hikamac chi LIFESPAN DEVELOPMENT formation of synapses (connections between neurons) continue for years after birth. Teratogens What Are Teratogens? • Teratogens are harmful environmental factors that can lead to birth defects or developmental issues. • Common teratogens include maternal diseases, pollutants, drugs, and alcohol. Factors Influencing Teratogenic Risks • Timing of Exposure o The developing baby is most vulnerable during specific developmental stages (critical periods). Damage is worse if a teratogen is introduced during this time. o For example, arms and ears are most vulnerable at about 6 weeks after conception. • Amount of Exposure o Some substances may only cause harm if exposure reaches a certain level, which depends on the mother’s size and metabolism. • Number of Teratogens o Exposure to multiple teratogens can increase the risks and lead to more severe problems. • Genetics o A child’s genetic makeup can influence how they are affected by teratogens, as seen in fraternal twins exposed to the same prenatal environment but experiencing different effects. • Gender o Males are generally more vulnerable to teratogens than females, possibly due to the Y chromosome. Common Teratogens and Their Effects • Alcohol o One of the most harmful teratogens, leading to Fetal Alcohol Spectrum Disorders (FASD). o Fetal Alcohol Syndrome (FAS) is the most severe form, causing physical features like flattened noses, small eye openings, and small heads. Effects include intellectual disabilities, poor impulse control, ADHD, learning issues, and lower IQ. o Binge drinking greatly increases the risk of FASD. Tobacco o Tobacco use during pregnancy exposes the fetus to nicotine, carbon monoxide, and tar, reducing oxygen supply to the baby. o Associated risks include low birth weight, preterm delivery, miscarriage, birth defects, and learning disabilities. o Secondhand and thirdhand smoke (lingering smoke on clothes or furniture) also harm the baby, especially lung development. Prescription/Over-the-counter Drugs o Ibuprofen and other medications can cause issues like blood flow problems during the last months of pregnancy. o Pregnant women should avoid any drug unless prescribed by a healthcare provider. Illicit Drugs o Cocaine, heroin, marijuana, and other illicit drugs can cause low birth weight, preterm birth, birth defects, and brain development issues. o Neonatal abstinence syndrome occurs when babies are addicted to drugs before birth and go through withdrawal symptoms after birth. Pollutants o Lead: Exposure can cause miscarriage, low birth weight, and neurological problems. o Pesticides: May lead to birth defects, miscarriage, and learning problems. o Bisphenol A (BPA): Found in plastics, it can disrupt gene function and contribute to birth defects. o Radiation: Exposure during pregnancy can lead to birth defects, slow growth, and brain damage. o • • • • 5|Hikamac chi LIFESPAN DEVELOPMENT Mercury: Found in certain fish, it can cause brain damage and affect hearing and vision. Infections o Toxoplasmosis: Caused by a parasite in undercooked meat, unwashed fruits/vegetables, and cat feces. It can cause premature birth, birth defects, and eye/brain issues. o Sexually Transmitted Diseases (STDs): STDs like gonorrhea, syphilis, and chlamydia can cause miscarriage, birth defects, and premature birth. o HIV/AIDS: HIV can be transmitted to the baby during pregnancy or birth. Taking antiviral medications greatly reduces transmission risk. o German Measles (Rubella): If contracted early in pregnancy, rubella can cause deafness, brain damage, and other birth defects. o • Maternal Factors Mothers over 35 years old • Increased Risks: o Fertility problems, high blood pressure, diabetes, miscarriages, placenta previa, cesarean section, premature birth, stillbirth, and genetic disorders. • Positive Aspects: o Older parents tend to be more confident, stable, less stressed, and often financially secure. o Their children may do better academically and are less prone to emotional or physical issues. o Women who delay motherhood often live longer and have better overall health. Teenage Pregnancy • Increased Risks for Teen Mothers: o Health complications like anemia, high blood pressure, and premature birth. o Babies may have low birth weight and underdeveloped organs, leading to serious health problems. o Teen mothers are less likely to get prenatal care and may engage in harmful behaviors (e.g., smoking, drinking, poor diet). o There is also a risk of repeat pregnancies soon after the first. Gestational Diabetes • • Occurs in about 7% of pregnant women. Risks: Premature birth, stillbirth, breathing problems, jaundice, low blood sugar, and heavier babies. • Risk Factors: Age over 25, being overweight, family history of diabetes, and certain racial/ethnic backgrounds. • Can lead to long-term health issues if not managed properly. High Blood Pressure (Hypertension) • Can be gestational (temporary) or chronic (existing before or after pregnancy). • Risks: Premature birth, low birth weight, placental abruption, and preeclampsia (dangerous high blood pressure). Rh Disease • Occurs when an Rh-negative mother has an Rh-positive baby. • Risks: Anemia, jaundice, brain damage, and death for the baby in severe cases. Weight Gain During Pregnancy • Healthy Weight Gain: o Women should gain between 25-35 pounds (depending on pre-pregnancy weight). o Too little weight gain risks low birth weight, while too much increases the risk of premature birth, large babies, or complications like diabetes. Stress • High stress levels can lead to premature or low-birthweight babies. • Stress-related behaviors (e.g., smoking, drinking) can harm the pregnancy. • Babies may experience developmental issues and health problems due to maternal stress. Depression • Affects 1 in 7 women during or after pregnancy. • Risks: Premature birth, low birth weight, irritability, and developmental delays in babies. • Certain antidepressants can cause birth defects, so it’s important for women to consult a doctor before taking them during pregnancy. Paternal Impact • Risks of Older Fathers (over 40): Increased chances of miscarriage, autism, birth defects, and mental health issues like schizophrenia in children. • Environmental Risks: Men may work with hazardous chemicals (e.g., lead, pesticides) that can affect sperm quality and increase risks for miscarriage or birth defects. • Secondhand Smoke: Men can also indirectly harm fetal development if they smoke around the mother. 6|Hikamac chi LIFESPAN DEVELOPMENT Routine Prenatal Care • Blood and urine tests, along with screenings, help identify conditions that could increase risks for both the mother and baby. Ultrasound • Purpose: Uses sound waves to examine the fetus, check for defects, and gather information about the pregnancy. • Types: o Transvaginal Ultrasound: Used in early pregnancy. o Transabdominal Ultrasound: Used after 10 weeks, typically between 16-20 weeks. • Uses: o Check fetal age, placenta location, fetal position, movement, heart rate, and amniotic fluid. o Detect birth defects or problems. • Additional Ultrasounds: If any issues are detected, more ultrasounds may be recommended. Amniocentesis • A needle is used to take a small amount of amniotic fluid and cells from around the fetus for testing. • Used when further diagnosis of a birth defect is needed. Chorionic Villus Sampling (CVS) • A small sample of cells is taken from the placenta for testing. • Both amniocentesis and CVS have a risk of miscarriage and are not done routinely. Infertility and Reproductive Technology • Infertility o Affects 10-15% of couples in the U.S. o Common Causes: ▪ For men: Low or no sperm production. ▪ For women: Failure to ovulate or pelvic inflammatory disease (PID), often caused by infections like chlamydia or gonorrhea. • Fertility Treatments o Fertility Drugs: Used to stimulate ovulation. Surgical Procedures: Repair reproductive organs or remove scar tissue. o In Vitro Fertilization (IVF): Eggs are removed, fertilized outside the body, and then implanted into the woman’s uterus. ▪ Success depends on the egg's age and whether it’s fresh, frozen, or donated. Other Fertility Procedures o Gamete Intra-Fallopian Tube Transfer (GIFT): Both sperm and eggs are implanted into the fallopian tube for natural fertilization. o Zygote Intra-Fallopian Tube Transfer (ZIFT): Eggs are fertilized outside the body and then implanted into the fallopian tube for natural implantation in the uterus. o Success Rates: ZIFT has a higher success rate than IVF but is less common. o Prenatal Assessment • Complications of Pregnancy Minor Complications • These are common side effects of pregnancy, though they may vary in severity for each woman. While considered "minor," they can still be uncomfortable. These include: o Nausea (especially in the first 3-4 months) o Heartburn and gas o Hemorrhoids o Backache o Leg cramps o Insomnia o Constipation o Shortness of breath o Varicose veins (due to added weight from the abdomen) Major Complications • Ectopic Pregnancy o Occurs when the fertilized egg attaches outside the uterus, usually in the fallopian tube. o Symptoms: Abdominal pain, vaginal bleeding, nausea, and fainting. o About 1 in 50 pregnancies are ectopic, often due to conditions like pelvic inflammatory disease or chlamydia. • Preeclampsia (Toxemia) o Characterized by high blood pressure, protein leakage into urine, and 7|Hikamac chi LIFESPAN DEVELOPMENT • • swelling (especially of hands, feet, and face) in the third trimester. o Affects 5%-10% of pregnancies globally; more common in first pregnancies, obesity, diabetes, or multiple pregnancies. o Can lead to eclampsia (seizures), which is the second leading cause of maternal death in the U.S. o Fetal risks: Low birth weight, premature birth, stillbirth. o Treatment may include bed rest, medication, or early labor induction. Maternal Mortality o Around 700 American women die each year from pregnancy complications, with 60% of these deaths being preventable. o Common causes: Bleeding, infections, heart problems. o Contributing factors: High cesarean section rates and obesity. o Compared to other developed countries, this number is considered high. o Globally, about 1,000 women die from childbirth complications each day, particularly in Sub-Saharan Africa and South Asia. Spontaneous Abortion (Miscarriage) o Affects 20-40% of undiagnosed pregnancies and 10% of diagnosed pregnancies. o Most occur due to chromosomal abnormalities, often before the 12th week. o Symptoms: Cramping and bleeding, followed by a return to normal menstrual cycles after several months. o Some women may experience repeated miscarriages due to genetic or hormonal issues, or defective sperm. Preparation for Childbirth Prepared Childbirth • Involves being physically ready for childbirth and emotionally prepared for the new role as parents. • Includes learning about childbirth, newborn care, and adjusting to life with a baby. • The goal is to help parents feel more confident and prepared for the delivery and the changes ahead. The Lamaze Method • A popular method for preparing for childbirth, brought to the U.S. from Russia in the 1950s by Fernand Lamaze. • Focuses on helping the woman feel in control during labor. • Components include: o Muscle relaxation during contractions. o Breathing techniques to manage pain. o Focal point (a picture or object to focus on during contractions). o A support person (like a partner or coach) who is trained to help during delivery. Choosing Where to Have the Baby • Hospital Births: Most births (99%) occur in hospitals. • Home Births: About 1% of women choose to deliver at home, often with a certified nurse midwife. o Home births are safer for women with low-risk pregnancies. o Midwives are trained and less expensive than hospital births, but hospital births are recommended for safety due to possible complications. • Out-of-Hospital Births: Some women choose to deliver in: o Freestanding clinics or birthing centers. o Physician’s offices or other locations. • Factors influencing the choice of where to give birth: o Women who are older (over 25), have had previous children, and are white are more likely to choose out-ofhospital births. Stages of Birth for Vaginal Delivery First Stage • Begins with contractions that increase in frequency and duration (from 30 seconds and 15-20 minutes apart to 1 minute and 34 minutes apart). • False labor (Braxton-Hicks) can occur, especially in first-time mothers. Real labor pain increases with walking, while false labor may decrease. • The amniotic sac may break before labor starts in some cases, which may lead to labor being induced with medication to prevent infection. • The cervix dilates to 10 centimeters (about 4 inches), which may take: o 12-16 hours for first-time mothers. o 6-9 hours for women who have given birth before. 8|Hikamac chi LIFESPAN DEVELOPMENT Labor may begin with blood or amniotic fluid discharge. Second Stage • Passage of the baby through the birth canal. • This stage usually lasts about 10-40 minutes. • The mother pushes and relaxes as directed by medical staff. • The baby's head is delivered first, followed by the shoulders and body. • An episiotomy (small incision) may be made to prevent tearing, and the baby’s mouth and nose are suctioned. • The umbilical cord is clamped and cut. Third Stage • Placenta delivery (afterbirth) happens within 20 minutes after the baby is born. • If an episiotomy was performed, it is stitched during this stage. • This stage is usually painless. Pain Relief Options • Epidural anesthesia is commonly used in hospitals to manage pain during labor. It is a regional anesthetic injected near the spine, taking effect in 10-20 minutes. o It relieves most pain in the lower body without slowing down labor. o It's safe for the baby and can be used for both vaginal births and Csections. Cesarean Section (C-section) • A C-section is surgery where the baby is delivered through an incision in the mother’s abdomen. • It is performed when there are complications, such as: o Health problems in the mother. o Distress in the baby. o The baby’s position (e.g., breech). o Not enough space for the baby in the birth canal. o Multiple babies. • C-sections are considered major surgery with risks and longer recovery times. However, many women can have a vaginal birth later after a C-section. Induced Birth • Sometimes labor needs to be induced for medical reasons, such as: • o o o o o o o The mother is two weeks past her due date. The water breaks, but contractions do not start. Infection in the mother's uterus. The baby is not growing as expected. Not enough amniotic fluid. The placenta has partially or completely detached from the uterus. The mother has a medical condition like high blood pressure or diabetes. Assessing the Neonate Apgar Assessment • Done 1 minute and 5 minutes after birth to quickly check the newborn’s health. • The baby is scored on five features: o Heart rate o Respiration (breathing) o Muscle tone (assessed by gently touching the baby’s palm) o Reflex response (e.g., Babinski reflex) o Color (how the skin looks) • Each feature is scored 0 to 2, with 0 being the worst and 2 being the best. • A score of 5 or less indicates concern. • The second Apgar score should improve if the baby’s condition is better. Neonatal Behavioral Assessment Scale (NBAS) • This tool assesses: o Motor development (how the baby moves) o Muscle tone o Stress response (how the baby reacts to stimuli) • Used for babies with low Apgar scores and to compare babies across different cultures. Problems of the Newborn Anoxia • Temporary lack of oxygen to the brain during delivery. • Can cause brain damage or even death in severe cases. • Babies with both low birth weight and anoxia are at higher risk for learning disabilities later in life. Low Birth Weight • Babies weighing less than 5 pounds 8 ounces (2500 grams). 9|Hikamac chi LIFESPAN DEVELOPMENT • About 8.2% of babies in the U.S. are born with low birth weight. • These babies have trouble maintaining body temperature and are more at risk for infections. • 67% of low birth weight babies are preterm, increasing their risk for respiratory infections. • Babies with very low birth weight (2 pounds or less) are more likely to develop cerebral palsy. • Reduced fetal growth can also increase the risk of psychiatric disorders in adulthood, including ADHD, autism, depression, and OCD. Preterm Birth • Babies born before 37 weeks of pregnancy are considered preterm. • Causes include vaginal infections, smoking, and other teratogens. • Preterm birth increases the risk of respiratory distress syndrome, which causes weak and irregular breathing. Small-for-Date Infants • Babies with birth weights lower than expected for their gestational age. • Can be full term or preterm, but still weigh less than 90% of babies their age. • Small-for-date babies have higher death rates, over four times higher than other infants. • Many causes of low birth weight and preterm birth are preventable with proper prenatal care. • • • Due to increased oxytocin (bonding hormone), a mother’s brain becomes more alert to the baby’s needs, leading to anxiety. Symptoms include heightened alertness, intrusive thoughts about the baby’s safety, and stress. Should seek help from a healthcare provider if experiencing anxiety. Postpartum Maternal Concerns Baby Blues • Common emotional change occurring 3 to 5 days after birth. • Feelings of sadness, mood swings, trouble sleeping, and feeling let down. • Usually disappear within 10 days after birth. Postpartum Depression • More serious than the baby blues; occurs during pregnancy or within 4 weeks after birth. • About 1 in 8 women experience it. • Symptoms include sadness, sleeplessness, and difficulty bonding with the baby. • Risk factors: past depression, family history of depression, being under 20, experiencing stress, and substance use. • Can include psychotic features like hallucinations or delusions (e.g., harming the baby). • 1 in 500 to 1 in 1,000 women experience postpartum psychosis. Postpartum Anxiety 10 | H i k a m a c c h i