PRENATAL DEVELOPMENT

AND BIRTH
MR. ANDIE RAFAEL E. QUIBALLO
ATTACHED FACULTY
PSYCHOLOGY AND HUMAN SERVICES DEPARTMENT
 • DESCRIBE THE CHANGES THAT OCCUR IN THE THREE
PERIODS OF PRENATAL DEVELOPMENT
•
LEARNING
DESCRIBE WHAT OCCURS DURING PRENATAL BRAIN
DEVELOPMENT
•
OBJECTIVES:
DEFINE TERATOGENS AND DESCRIBE THE FACTORS THAT
INFLUENCE THEIR EFFECTS
• LIST AND DESCRIBE THE EFFECTS OF SEVERAL COMMON

PRENATAL •
TERATOGENS
EXPLAIN MATERNAL AND PATERNAL FACTORS THAT

DEVELOPMENT •
AFFECT THE DEVELOPING FETUS
EXPLAIN THE TYPES OF PRENATAL ASSESSMENT
• DESCRIBE BOTH THE MINOR AND MAJOR
COMPLICATIONS OF PREGNANCY
 Begins with conception

Ends when fertilized egg implants in uterine wall

PRENATAL • Fertilized egg = Zygote

DEVELOPMENT: 2 weeks long

GERMINAL Cell division occurs (mitosis)

• After five days of mitosis = 100 cells = blastocyst
PERIOD • Inner layer = Embryonic disk (becomes the
embryo)
• Outer layer of cells = Trophoblast (becomes the
support system which nourishes the
developing organism)
THE GERMINAL PERIOD
• ZYGOTE BEGINS DUPLICATION AND DIVISION WITHIN HOURS OF CONCEPTION
• DEVELOPMENT OF THE PLACENTA
• ORGAN THAT SURROUNDS THE DEVELOPING EMBRYO AND IS ATTACHED TO THE WALL OF THE UTERUS
• SUSTAINS LIFE VIA THE UMBILICAL CHORD (NOURISHES ORGANISM AND CARRIES WASTE
PRODUCTS AWAY)
• IMPLANTATION (ABOUT 10 DAYS AFTER CONCEPTION)
• DEVELOPING ORGANISM BURROWS INTO THE PLACENTA THAT LINES THE UTERUS
• ORGANISM GROWS RAPIDLY
• PREGNANCY CAN BE DETECTED DUE TO NEW CHEMICALS IN THE MOTHER’S URINE
GERMINAL
PERIOD
 From 3-8 weeks after conception

PRENATAL
Blood vessels from trophoblast
DEVELOPMENT: form placenta
EMBRYONIC • Structure attached to the uterus
PERIOD • Provides nourishment and oxygen from
the mother to the developing embryo
• Connected to embryo via the umbilical
cord
THE EMBRYO
(6-7 WEEKS
GESTATIONAL
AGE)
THE EMBRYO
 Major structures (organs,
limbs, brain) start to develop
PRENATAL
• Vulnerable to damage from harmful
DEVELOPMENT: agents
EMBRYONIC
Growth occurs in two patterns
PERIOD
(CONTINUED) • Cephalocaudal – From head to tail
• Proximodistal – From the midline
outward
THE EMBRYO
• DEVELOPING HUMAN ORGANISM FROM ABOUT THE 3RD THROUGH THE 8TH WEEK AFTER CONCEPTION
• BEGINS WHEN THE PRIMITIVE STREAK APPEARS DOWN THE MIDDLE OF THE CELL MASS
• PRIMITIVE STREAK BECOMES THE NEURAL TUBE AND LATER FORMS THE BRAIN AND SPINE OF THE CNS
• HEAD TAKES SHAPE
• EYES, EARS, NOSE, AND MOUTH FORM
• HEART BEGINS TO PULSATE
• EXTREMITIES DEVELOP AND WEBBED FINGERS AND TOES SEPARATE
 From 9 weeks post-conception until
birth

PRENATAL Major structures continue to develop

DEVELOPMENT:
FETAL PERIOD Growth

Age of viability = First chance of

survival outside uterus (24 weeks)
THE FETAL PERIOD
FETUS

• DEVELOPING HUMAN ORGANISM FROM THE START OF THE 9TH WEEK AFTER
CONCEPTION UNTIL BIRTH

• GENITALS FORM AND SEX HORMONES CAUSE DIFFERENCES IN FETAL BRAIN

ORGANIZATION

• CEPHALOCAUDAL AND PROXIMODISTAL GROWTH

• HEARTBEAT DETECTABLE VIA STETHOSCOPE
• ALL BODY PARTS AND SYSTEMS COMPLETE PRENATAL DEVELOPMENT
• CORTEX IS NOT FULLY MATURE AT BIRTH (E.G. PREFRONTAL LOBES)
• BRAIN AT BIRTH IS FAR BIGGER THAN ANY OTHER PART OF THE BABY
THE FETAL PERIOD
AGE OF VIABILITY

• AGE AT WHICH A PRETERM NEWBORN MAY SURVIVE OUTSIDE

THE MOTHER’S UTERUS IF MEDICAL CARE IS AVAILABLE

• ABOUT 22 WEEKS AFTER CONCEPTION

• BRAIN IS ABLE TO REGULATE BASIC BODY FUNCTIONS (E.G.
BREATHING)

• CHANCES OF SURVIVAL INCREASE WITH EACH DAY AFTER THE

22-WEEK MARK
 PRENATAL
DEVELOPMENT
AGE MILESTONES
 Stem cells produced along neural plate

PRENATAL Neural groove appears during 3rd week

BRAIN • Eventually turns into neural tube

DEVELOPMENT • Neural tube becomes brain and spinal cord

Neurogenesis (formation of neurons) mostly

completed after five months of gestation
• Neurogenesis in hippocampus may be lifelong
PRENATAL BRAIN
DEVELOPMENT
(CONTINUED)

Gray matter

• Regions of brain that contain cell

bodies
• Responsible for movement and
cognitive activity

White matter

• Axons that form neural pathways

• Covered with myelin – Fatty substance
that aids neurotransmission
• Connects gray matter areas
• Conducts neural impulses
 Environmental factors that
can contribute to birth
defects

TERATOGENS
Effects depend on:
Timing – Number – Exposure – Genetics –
Earlier is Teratogens More is Sex, genetic
usually worse may interact usually worse vulnerability
SIGNIFICANT FACTORS
• TIMING OF EXPOSURE
• CRITICAL PERIOD: TIME WHEN A BODY PART DEVELOPS
• FIRST TWO MONTHS FOR STRUCTURAL ABNORMALITIES
• OFTEN BEFORE WOMAN KNOWS SHE IS PREGNANT
• TIME WHEN MOST SPONTANEOUS ABORTIONS OCCUR
• SENSITIVE PERIOD: TIME WHEN TERATOGENS CAN INTERFERE WITH RECENT GROWTH
SIGNIFICANT FACTORS
AMOUNT OF EXPOSURE
•THRESHOLD EFFECT: CERTAIN TERATOGENS ARE RELATIVELY HARMLESS UNTIL
EXPOSURE REACHES A CERTAIN LEVEL
•BISPHENOL A (BPA)
• CHEMICAL COMPOUND USED TO MAKE CLEAR PLASTIC
• SMALL DOSES ARE HARMLESS BUT THRESHOLD FOR HUMANS IS UNKNOWN
• PREGNANT MOTHERS SHOULD AVOID PLASTIC CONTAINERS AND DISHWARE
•PRESCRIPTION DRUGS
•VITAMIN A
• HIGH DOSES CAN BE HARMFUL
SIGNIFICANT FACTORS

GENETIC VULNERABILITY
• SOME ZYGOTES CARRY GENES THAT MAKE THEM VULNERABLE
• CERTAIN GENES INCREASE LIKELIHOOD OF CLEFT LIP IN JAPANESE PEOPLE
• SOME WOMEN DO NOT METABOLIZE FOLIC ACID WELL
• INCREASES RATES OF NEURAL-TUBE DEFECTS (E.G. SPINA BIFIDA)
 CRITICAL
PERIODS OF
PRENATAL
DEVELOPMENT
ALCOHOL

• LEADING PREVENTABLE CAUSE OF INTELLECTUAL DISABILITY

• POSSIBLE OUTCOMES:
• COGNITIVE AND BEHAVIORAL PROBLEMS
• FETAL DEATH
• FETAL ALCOHOL SPECTRUM DISORDERS
FETAL ALCOHOL SPECTRUM DISORDERS
Fetal Alcohol Spectrum Disorder Facial Features

Facial Feature Potential Effect of Fetal Alcohol

Head size Below-average head circumference

Smaller than average eye opening, skin

Eyes
folds at corners of eyes

Nose Low nasal bridge, short nose

Midface Smaller than average midface size

Lip and philtrum Thin upper lip, indistinct philtrum

TOBACCO

• INCLUDES
ALL NICOTINE DELIVERY METHODS (VAPING, GUM, PATCH) AND
SECONDHAND SMOKE
• POSSIBLE OUTCOMES:
• LOW BIRTH WEIGHT, PREMATURE BIRTH, MISCARRIAGE
• ECTOPIC PREGNANCY (FERTILIZED EGG IMPLANTS ITSELF OUTSIDE OF THE UTERUS)
• PLACENTA PREVIA (PLACENTA LIES LOW IN THE UTERUS AND COVERS ALL OR PART OF THE CERVIX)
• PLACENTA ABRUPTION (PLACENTA SEPARATES PREMATURELY FROM THE UTERINE WALL)
LEGAL AND ILLEGAL DRUGS
• BOTH PRESCRIPTION AND OVER-THE-COUNTER MEDICATIONS
• DIFFICULT TO DETERMINE EFFECTS OF ILLEGAL DRUGS
• PEOPLE MAY USE MORE THAN ONE DRUG
• PEOPLE MAY HAVE OTHER UNHEALTHY BEHAVIORS

• POSSIBLE OUTCOMES:
• PROBLEMS WITH BRAIN DEVELOPMENT
• LOW BIRTH WEIGHT, STILLBIRTH, MISCARRIAGE
• NEONATAL ABSTINENCE SYNDROME
POLLUTANTS

• LEAD, PESTICIDES, MERCURY, RADIATION, BPA

• POSSIBLE OUTCOMES
• PROBLEMS WITH BRAIN DEVELOPMENT
• LEARNING PROBLEMS
• SENSORY IMPAIRMENT
• MISCARRIAGE, LOW BIRTH WEIGHT, PREMATURE BIRTH
DISEASES

• TOXOPLASMOSIS – CAUSED BY PARASITE IN RAW MEAT, CAT FECES, DIRT

• POSSIBLE OUTCOMES: PREMATURE BIRTH, STILLBIRTH, BRAIN/EYE DEFECTS
• SEXUALLY TRANSMITTED DISEASES
• POSSIBLE OUTCOMES:
• TRANSMISSION OF STD
• PREMATURE BIRTH, MISCARRIAGE, STILLBIRTH, ECTOPIC PREGNANCY
DISEASES (CONTINUED)

• RUBELLA (GERMAN MEASLES)

• MOSTLY PREVENTABLE THROUGH VACCINATION
• ABOUT HALF OF INFECTED PEOPLE HAVE NO VISIBLE SYMPTOMS
• POSSIBLE OUTCOMES:
• VISION AND HEARING PROBLEMS
• INTELLECTUAL DISABILITY
• HEART DEFECTS
MATERNAL AGE
• OVER 35 – ASSOCIATED WITH INCREASED RISK OF:
• GENETIC DISORDERS, PREMATURITY, MISCARRIAGE, STILLBIRTH
• DIABETES AND HIGH BLOOD PRESSURE
• OLDER MOTHERS TYPICALLY MORE CONFIDENT AND STABLE
• TEENAGE – ASSOCIATED WITH INCREASED RISK OF PREMATURITY AND LOW
BIRTHWEIGHT
• OFTEN HAVE POOR NUTRITION AND MEDICAL CARE
• MORE LIKELY TO DRINK, SMOKE, AND USE DRUGS
MATERNAL FACTORS

• GESTATIONAL DIABETES – BODY CAN’T MANAGE GLUCOSE APPROPRIATELY

• ASSOCIATED WITH PREMATURITY, STILLBIRTH, DIFFICULT BIRTH DUE TO LARGE BABY SIZE, BREATHING
PROBLEMS

• HYPERTENSION – TOO MUCH PRESSURE ON ARTERY WALLS

• ASSOCIATED WITH PREMATURITY AND LOW BIRTH WEIGHT
• BOTH DIABETES AND HYPERTENSION ENDANGER MOTHER’S HEALTH
MATERNAL FACTORS (CONTINUED)

• RH DISEASE – TYPE OF ANEMIA IN BABY

• RH IS PROTEIN FOUND IN BLOOD (MOST PEOPLE RH+)
• IF MOTHER IS RH- AND FETUS IS RH+:
• MOTHER’S IMMUNE SYSTEM MAY REACT TO RH PROTEIN
• PRODUCE ANTIBODIES TO DESTROY FETUS’ RED BLOOD CELLS
• CAN BE PREVENTED BY TREATING MOTHER IN PREGNANCY
• CAN BE TREATED WITH TRANSFUSION IN BABY AFTER BIRTH
MATERNAL FACTORS (CONTINUED)

• WEIGHT GAIN – SHOULD BE ABOUT 25 POUNDS

• TOO MUCH INCREASES RISK OF DIABETES, HYPERTENSION, DIFFICULT BIRTH
• TOO LITTLE SUGGESTS BABY ISN’T GROWING PROPERLY
• STRESS
• HIGH STRESS INCREASES PREMATURITY/LOW BIRTH WEIGHT RISK
• POOR STRESS MANAGEMENT (E.G., ALCOHOL USE)
• POSSIBLY ASSOCIATED WITH ATTENTION AND ANXIETY PROBLEMS
WEIGHT GAIN DURING PREGNANCY
If you were a healthy If you were underweight If you were overweight If you were obese
weight before before pregnancy before pregnancy before pregnancy
pregnancy

• gain 25-35lbs • gain 28-40lbs • gain 12-25 lbs • gain 11-20lbs

• 1-4½lbs in the first • 1-4½lbs in the first • 1-4½lbs in the first • 1-4½lbs in the first
trimester and 1lb per trimester and a little trimester and a little trimester and less
week in the second more than 1lb per more than ½lb per than ½lb per week in
and third trimesters week thereafter week in the second the second and third
and third trimesters trimesters

Mothers of twins need to gain more in each category.

MATERNAL FACTORS (CONTINUED)

• DEPRESSION – FEELINGS OF SADNESS AND WORTHLESSNESS THAT INTERFERE

WITH DAILY FUNCTION
• INCREASED RISK OF:
• PREMATURITY AND LOW BIRTHWEIGHT
• POOR EMOTIONAL AND ATTENTIONAL CONTROL
• MANY MEDICATIONS ARE POSSIBLE TERATOGENS
• BABY BLUES – FEELINGS OF SADNESS LASTING ABOUT A WEEK AFTER BIRTH
• POSTPARTUM DEPRESSION – LONGER-LASTING DEPRESSION STARTING IN FIRST MONTH AFTER BIRTH
PATERNAL FACTORS

• AGE OVER 40 ASSOCIATED WITH INCREASED RISK OF:

• MISCARRIAGES, AUTISM, BIRTH DEFECTS, ACHONDROPLASIA (BONE GROWTH DISORDER) AND
SCHIZOPHRENIA

• MEN MORE LIKELY TO SMOKE

• MEN MORE LIKELY TO ENCOUNTER ENVIRONMENTAL HAZARDS (E.G., CHEMICALS)
AT WORK
 PRENATAL
ASSESSMENT
• ULTRASOUND – SOUND WAVES USED TO EXAMINE THE
FETUS
• LOOK FOR STRUCTURAL DEFECTS, GROWTH
PROBLEMS, MULTIPLE FETUSES
• CHECK AGE, LOCATION OF PLACENTA, HEART
RATE
• TYPICALLY DONE 16-20 WEEKS INTO
PREGNANCY
• MAY ALSO BE USED TO CHECK FETAL POSITION
DURING OTHER TESTS
 PRENATAL
ULTRASOUND
PRENATAL ASSESSMENT (CONTINUED)

• AMNIOCENTESIS – SAMPLE AMNIOTIC FLUID

• CHORIONIC VILLUS SAMPLING – SAMPLE PLACENTA
• BOTH USED TO CHECK FOR GENETIC DEFECTS
• RECOMMENDED FOR:
• MOTHERS OVER 35
• EARLY TESTS SUGGEST A PROBLEM
• FAMILY HISTORY OF GENETIC PROBLEMS
INFERTILITY

• INFERTILITY – INABILITY TO CONCEIVE WITHIN 12 MONTHS

• AFFECTS 10-15% OF COUPLES IN THE US
• MALE FACTORS THE CAUSE IN ABOUT 1/3 OF THESE – USUALLY LOW SPERM PRODUCTION
• FEMALE FACTORS THE CAUSE IN ABOUT 1/3 OF THESE
• FAILURE TO OVULATE
• PELVIC INFLAMMATORY DISEASE – INFECTION OF REPRODUCTIVE ORGANS, OFTEN
CAUSED BY STD
REPRODUCTIVE TECHNOLOGY
• IN VITRO FERTILIZATION (IVF)
• REMOVE EGGS AND FERTILIZE OUTSIDE THE BODY
• REINSERT FERTILIZED EGG IN THE UTERUS

• GAMETE INTRA-FALLOPIAN TUBE TRANSFER (GIFT)

• IMPLANT BOTH SPERM AND OVA INTO THE FALLOPIAN TUBE

• ZYGOTE INTRA-FALLOPIAN TUBE TRANSFER (ZIFT)

• SPERM AND OVA ARE FERTILIZED OUTSIDE OF THE BODY
• ZYGOTE IMPLANTED IN THE FALLOPIAN TUBE

• MAY NOT BE COVERED BY INSURANCE

POTENTIAL COMPLICATIONS OF PREGNANCY

• ECTOPIC PREGNANCY – ZYGOTE IMPLANTS IN THE FALLOPIAN TUBE INSTEAD OF THE

UTERUS
• PREECLAMPSIA (TOXEMIA) – INCREASED BLOOD PRESSURE AND LEAKAGE OF PROTEIN
IN URINE
• ACCOUNTS FOR ABOUT HALF OF MATERNAL DEATHS IN US
• ECLAMPSIA – WHEN PREECLAMPSIA CAUSES SEIZURES

• SPONTANEOUS ABORTION (MISCARRIAGE)

• USUALLY CAUSED BY CHROMOSOMAL ABNORMALITIES
LEARNING OBJECTIVES: BIRTH
• DESCRIBE HOW EXPECTANT PARENTS PREPARE FOR CHILDBIRTH
• DESCRIBE THE STAGES OF VAGINAL DELIVERY
• EXPLAIN WHY A CAESAREAN OR INDUCED BIRTH IS NECESSARY
• DESCRIBE THE TWO COMMON PROCEDURES TO ASSESS THE
CONDITION OF THE NEWBORN
• DESCRIBE PROBLEMS NEWBORNS EXPERIENCE BEFORE, DURING,
AND AFTER BIRTH
PREPARATION FOR CHILDBIRTH

• GOOD HEALTH, MINDSET, INFORMATION

• CHOOSING WHERE TO GIVE BIRTH
• CHOOSING HEALTH CARE PROVIDER
• LAMAZE METHOD
• TEACHING MOTHER TO BE IN CONTROL DURING BIRTH
• EMPHASIS ON RELAXATION, FOCUS, SUPPORTIVE PARTNER
STAGES OF BIRTH: FIRST STAGE
• BEGINS WITH UTERINE CONTRACTIONS
• INCREASE IN DURATION, FREQUENCY, INTENSITY
• BRAXTON-HICKS CONTRACTIONS = FALSE LABOR

• OTHER SIGNS OF LABOR:

• BLOODY DISCHARGE FROM THE CERVIX
• AMNIOTIC SAC RUPTURES (“WATER BREAKS”) – BUT ONLY HAPPENS NOW IN ABOUT 15% OF PREGNANCIES

• CERVIX DILATES TO 10CM (4 INCHES)

• TYPICALLY LASTS 12-16 HOURS
STAGES OF BIRTH: SECOND STAGE
• BABY PASSES THROUGH BIRTH CANAL
• TAKES ABOUT 10-40 MINUTES
• USE COMBINATION OF CONTRACTIONS AND PUSHING
• NORMALLY BABIES DELIVERED HEAD-FIRST
• THEN ROTATED SO THAT SHOULDERS COME THROUGH SEPARATELY
• EPISIOTOMY – INCISION MADE BETWEEN THE VAGINAL OPENING AND ANUS TO
AVOID TEARING THE TISSUE
STAGES OF BIRTH: THIRD STAGE

• PLACENTA DELIVERED WITHIN 20 MINUTES OF BIRTH

• EPISIOTOMY STITCHED UP (IF NECESSARY)
STAGES OF BIRTH
FOR A VAGINAL
DELIVERY
EPIDURALS

• EPIDURAL BLOCK – LOCAL ANESTHETIC

INJECTED IN AREA AROUND SPINE
• INTENDED TO RELIEVE PAIN WITHOUT
SLOWING LABOR
• USED IN 50% OF HOSPITAL BIRTHS IN US
CESAREAN SECTIONS
• CESAREAN SECTION – SURGICAL PROCEDURE TO REMOVE BABY THROUGH ABDOMEN
• USUALLY DONE WHEN PROBLEMS OCCUR OR ARE EXPECTED
• MULTIPLE BIRTH
• BABY NOT POSITIONED CORRECTLY OR TOO BIG
• MOTHER’S OR BABY’S HEALTH IN DANGER
• MAJOR SURGERY
• LONGER RECOVERY TIME THAN VAGINAL BIRTH
• RISK OF INFECTION
• MAY PREVENT LATER VAGINAL BIRTH
CESAREAN SECTION (C-SECTION)

• RATES AND REASONS FOR C-SECTIONS VARY GREATLY

• LOWER RATES IN POORER COUNTRIES (EMERGENCIES)
• HIGHER RATES IN RICHER COUNTRIES (PLANNED FOR THE CONVENIENCE OF MOTHER AND/OR
OBSTETRICIAN)

• 1/3 OF BIRTHS IN THE UNITED STATES

• LESS TRAUMA FOR THE NEWBORN BUT SLOWER RECOVERY FOR THE MOTHER
• SUBSEQUENT CESAREAN DELIVERIES MAY BE NECESSARY
INDUCED LABOR
• LABOR PRODUCED BY MEDICAL INTERVENTION
• MEDICATIONS
• ARTIFICIAL RUPTURE OF THE MEMBRANES
• USED WHEN:
• LABOR HAS NOT NATURALLY STARTED TWO WEEKS PAST DUE DATE
• BABY HAS STOPPED GROWING
• PRENATAL ENVIRONMENT UNHEALTHY (E.G., INFECTION, NOT ENOUGH AMNIOTIC FLUID, PLACENTA SEPARATES
FROM UTERINE WALL)
• MOTHER’S HEALTH PUTS HER OR HER BABY AT RISK
• WATER BROKE, BUT NO CONTRACTIONS
MEDICAL INTERVENTION

• INFANT MORTALITY HAS DECREASED DUE TO BETTER MEDICAL CARE

• 1900: 5%
• TODAY: <1 IN 200
• CHILDBIRTH HAS BECOME SAFER FOR MOTHERS
• DEATH RATE IN POOREST NATIONS: 1 IN 20 WOMEN
• EXCESSIVE MEDICAL CARE ALSO HAS DISADVANTAGES
• INCREASE IN UNNECESSARY C-SECTIONS IS ASSOCIATED WITH HIGHER RATE OF LOW-BIRTH WEIGHT
BABIES
 Performed at 1 and 5 minutes after birth

NEONATAL 5 characteristics rated from 0-2

ASSESSMENT: Appearance Pulse (heart Grimace (reflex Activity
Respiration

APGAR TEST
(color) rate) response) (muscle tone)

Score of 5 or less is cause for concern

APGAR
SCORES
NEONATAL ASSESSMENT: NBAS

• NEONATAL BEHAVIORAL ASSESSMENT SCALE (NBAS)

• MEASURES 46 ASPECTS OF FUNCTIONING COVERING:
• BREATHING
• MOTOR CONTROL
• RESPONSE TO STIMULATION
• SOCIAL INTERACTION
• GIVES INFORMATION ABOUT HOW TO INTERACT WITH BABIES
POSSIBLE PROBLEMS IN NEWBORNS: ANOXIA

• ANOXIA – LACK OF OXYGEN TO BRAIN

• HYPOXIA – LOW OXYGEN LEVELS
• COULD OCCUR DURING PREGNANCY (TERATOGENS, MATERNAL HEALTH)
• COULD OCCUR DURING BIRTH
• UMBILICAL CORD KINKED OR PROLAPSED
• CAN CAUSE BRAIN DAMAGE OR DEATH
POSSIBLE PROBLEMS IN NEWBORNS: LOW BIRTH WEIGHT

• LOW BIRTH WEIGHT – LESS THAN 5.5 POUNDS (2.5KG)

• MAY LACK ENOUGH FAT TO MAINTAIN BODY TEMPERATURE
• MORE AT RISK FOR INFECTION
• OFTEN A SIGN OF A POOR PRENATAL ENVIRONMENT
CAUSES OF LOW BIRTHWEIGHT
• GENETIC FACTORS
• MATERNAL ILLNESS
• EXHAUSTION
• INFECTION
• MALNUTRITION
• DRUG USE
• MULTIPLE BIRTHS
POSSIBLE PROBLEMS IN NEWBORNS: PRETERM BIRTH

• PRETERM BIRTH – BEFORE 37 WEEKS GESTATIONAL AGE

• OFTEN CAUSED BY TERATOGENS, ILLNESS, STRESS
• MAY NEED INTENSIVE MEDICAL CARE
• MAY HAVE LIFELONG MEDICAL OR DEVELOPMENTAL PROBLEMS
• RESPIRATORY DISTRESS SYNDROME – WEAK AND IRREGULAR BREATHING
POSSIBLE PROBLEMS IN NEWBORNS: SMALL-FOR-DATE

• SMALL-FOR-DATE – WEIGH LESS THAN 90% OF BABIES OF SAME

GESTATIONAL AGE
• MAY BE FULL TERM OR PRETERM
• ASSOCIATED WITH INCREASED RISK OF DEATH
• OFTEN A SIGN OF A POOR PRENATAL ENVIRONMENT
MOTHERS, FATHERS, AND A GOOD START

THE FATHER’S ROLE

• SUPPORTIVE FATHER HELPS MOTHER STAY HEALTHY
• FATHER CAN DECREASE OR INCREASE MOTHER’S STRESS (AFFECTS FETUS)
• MOST FATHERS ARE HELPFUL TO THEIR PREGNANT WIVES
• TWO WAY STREET: PREGNANT MOTHERS SHOULD SUPPORT, INVOLVE, AND
ENCOURAGE FATHERS
THE IMPORTANCE OF CLOSE CONTACT

• BIRTH COMPLICATIONS CAN HAVE LINGERING IMPACT ON LATER LIFE

• MOTHERS AND FATHERS SHOULD HELP WITH EARLY CAREGIVING IF NEWBORN MUST
STAY IN THE HOSPITAL
• KANGAROO CARE
• CHILD-CARE TECHNIQUE IN WHICH THE MOTHER OF A LOW-BIRTHWEIGHT INFANT HOLDS THE BABY
BETWEEN HER BREASTS
• ALLOWS BABY TO HEAR MOTHER’S HEARTBEAT AND FEEL HER BODY HEAT
• RESEARCH CONFIRMS BENEFICIAL EFFECTS
POSTPARTUM DEPRESSION
• SADNESS AND INADEQUACY FELT BY 8-15% OF NEW MOTHERS IN THE DAYS AND WEEKS AFTER
GIVING BIRTH
• SYMPTOMS RANGE FROM BABY BLUES TO POSTPARTUM PSYCHOSIS
• DEPRESSED MOTHERS FIND BABY CARE BURDENSOME AND MAY THINK ABOUT MISTREATING
THE INFANT
• PATERNAL INVOLVEMENT CAN HAVE BENEFICIAL EFFECT
• SOME FATHERS ARE DEPRESSED THEMSELVES
• CAUSES FOR POSTPARTUM DEPRESSION VARY
BONDING

PARENT-INFANT BOND

• THE STRONG, LOVING CONNECTION THAT FORMS AS PARENTS HOLD, EXAMINE, AND FEED THE NEWBORN
• EARLY SKIN-TO-SKIN CONTACT IS NOT ESSENTIAL