pregnant

Slide1: 

Pregnancy & Sexuality LOIS J. McDERMOTT, Ph.D. UNIVERSITY OF WASHINGTON DEPARTMENT OF PSYCHOLOGY Copyright 1996 by Lois J. McDermott. All rights reserved.

cross-culturalissues: 

cross-cultural issues

Diversity: 

Diversity beliefs about conception gender and personality of baby paternity rights dictate confinement birthing practices, rituals couvade - male birthing rituals postpartum taboos for female breast feeding - duration, purpose lactating males

planning for pregnancy: 

planning for pregnancy

Becoming Pregnant(60% unintended): 

Becoming Pregnant (60% unintended) health of the mother/father: pre-pregnancy screen - STD’s, illness health of sperm: 72 day exposure window: environmental toxins, drugs, hottubs, volatile gases (gas pump) health of embryo: days 20-56 LMP - crucial brain development health of baby: prenatal care, parenting unique sexual experience: baby-making sex is different

Pregnancy Testing: 

Pregnancy Testing reason to test ASAP vulnerability to toxins early abortion detect ectopic pregnancy methods of HCG tests home urine test lab urine test lab blood test issues of testing sensitivity - early results false negatives - exposure of embryo to toxins

Slide7: 

A wanted, first pregnancy

First Trimester - the women: 

First Trimester - the women implantation - HCG levels rise prolongation of E, P from C.L. morning sickness (23% M) chorionic villi sampling (CVS) wks 11-12 placental formation - E, P switch miscarriage 2/3 of conceptions; 1/7 aware 58% wk 1-2 genetically nonviable zygote 41% wk 3-13 hormone insufficiency 1% wk 13+

First Trimester - the couple: 

First Trimester - the couple ambivalence about the pregnancy ambivalence about sex ambivalence about the partner perception of the pregnancy F - concrete reality - invasion, disease, body process M- vague concept, not tangible, not real

Second Trimester - the women: 

Second Trimester - the women placental hormones maintain the pregnancy HCG, morning sickness wanes amniocentesis, ultrasound quickening - tentative pregnancy

Second Trimester - the couple: 

Second Trimester - the couple sexual changes: increased libido, vaginal secretions chronic pelvic engorgement breast secretion (colostrum) emotional, physical well-being perception of pregnancy: M - “mother”, “baby”, “separate person” experience movement, fetal heart tones, ultrasound pictures, sex of fetus F - lags behind mother in attachment

Third Trimester - the women: 

Third Trimester - the women marked weight gain 21-29 lbs., most should be gained late in pregnancy dramatic increase in uterus, fetus 50-60 times original size, fetal gain late in pregnancy edema, BP, toxemia, preeclampsia forced bed rest, seizure, death of mother Braxton-Hicks contractions distracting, not painful engagement, presenting center of gravity drops, pregnancy waddle

Third Trimester - the couple: 

Third Trimester - the couple impatience, anxiety, insomnia most withdraw from sex by 9th mo: fear of injury to fetus, mother fatigue, discomfort, lack libido, non sexy body “third person” present, increased fetal activity demands on communication, experimentation reasons to discontinue coitus painful coitus bloody show (some spotting okay) mucus discharge leaking amniotic fluid (“breaking waters”) onset of labor???

Delivery - the process: 

Delivery - the process onset - trigger from fetus vaginal delivery: 24 hours -3 stages 1st - dilation: oxytocin, pitocin, sexual stim 2nd - the baby: episiotomy, forceps 3rd - placenta C-section: major abdominal surgery emergency vs. scheduled US: 25%; Europe 8% US ranks 13% in perinatal death

Delivery- the emotions: 

Delivery- the emotions prepared childbirth assisted by partner, surrounded by family, friends; pride, exhilaration, joy, bonding, relief, success childbirth as trauma - PTSD out of control, uncontrollable events shock, overwhelming pain loss of self-esteem, feelings of failure loss of the “perfect, full experience” feeling being failed by others symptoms: depression, anxiety, self-punitive, dissociation, confusion

Postpartum - the women: 

Postpartum - the women dramatic hormone changes: nursing mothers - low P, E levels stimulate high prolactin and milk production suckling stimulation's oxytocin release which inhibits FSH, LH and ovulation (about 5 mo) non-nursing mothers - milk dries up, low P, E stimulates release of FSH, LH; ovulation immediately healing tissues: vaginal delivery - uterus (lochia), vaginal bruises, tears, perineum (episiotomy), stitches - 5 mo.; afterbirth pains C-section - abdominal muscles, uterus, surgery complications - 1+ year

Postpartum- the emotions: 

Postpartum- the emotions mother: post partum depression (PPD); onset - dramatic hormonal changes duration, severity - social support in the home physical pain, extreme fatigue - infant care emotional lability- overwhelmed, suffocated - infant contact father/partner: post partum depression - 62% emotional lability - jealousy, rejection, anger, bewilderment, blues - 80% depression - 20% psychosis - .1% 1-2 wks 1+ month months; delusions

Postpartum-sexual concerns: 

Postpartum-sexual concerns coital taboo - 6 weeks, healing uterus, infection, lochia low libido - high prolactin if nursing, fatigue painful coitus - low E causes reduced lubrication; healing tissues milk ejection - orgasm, nipple stimulation, milk let down sexual arousal, orgasm during nursing, infant cuddling and care

Pregnancy and Erotophobia: 

Pregnancy and Erotophobia more likely to have unplanned pregnancy embarrassment about body changes reduced sexual activity during pregnancy postpone prenatal visits, fewer visits less likely to nurse, briefer period unlikely to include father in delivery longer period of postpartum abstinence

Common Male Feelings: 

Common Male Feelings lonely, frightened, rejected incompetent, embarrassed jealous of mother and infant want to be involved, helpful proud, excited, loving, determined want to prove ones’ self

How Men Get Involved: 

How Men Get Involved attend prenatal visits attend birthing classes be present at the birth read: pregnancy, birthing, babies take paternity leave attend pediatrician visits get time alone with infant join fathering-support group