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CHAPTER 9 -PREGNANCY & PARENTING:

CHAPTER 9 -PREGNANCY & PARENTING Instructor: Wendy Crapo

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Used by permission of THE ACADEMY OF NURSING 2355 E. 3900 S. S.L.C., UT 84124 801-506-0064

DECIDING TO BE A PARENT::

DECIDING TO BE A PARENT: Race: Highest birthrate = Mexican Americans & Cuban Americans Education: Highest birthrate = only high school education Income: Highest from ages 15-29 = lowest income 30-44 years highest = high income

BIRTHRATES BY ETHNIC GROUP:

BIRTHRATES BY ETHNIC GROUP

Changes in Average Number of Children per Family:

Changes in Average Number of Children per Family

Number of Children per Married/Unmarried Women:

Number of Children per Married/Unmarried Women

Households with Children:

Households with Children

CHILD-FREE: NOT CHILD LESS :

CHILD-FREE: NOT CHILD LESS Want right mate Right time to have children Complete education Build career Establish secure relationship Money - $300,000 to raise a child (subsequent children are less expensive and sons) (Missing something they wanted or were supposed to have) Generally well educated and career oriented.

COSTS OF PARENTING :

COSTS OF PARENTING “It’s not how much money you parent with that really counts. It’s how you parent.” Parents generally spend a three years earning, averaged over the child’s life.

PREGNANCY:

PREGNANCY Changes: Couples relationship May deepen and strengthen the relationship Need to resolve dependency issues and money issues Sexuality may increase, decrease – no rules about sex during pregnancy Priorities & values change Roles change Mother/daughter relationship (now treated as adult) Physical changes: attractiveness

Fetal Development:

Fetal Development Month by Month

First Month:

First Month By the end of the first month, the embryo is about 1/10 of an inch long . The heart, which is no larger than a poppy seed , has begun beating.

Two Months:

Two Months The embryo is about 1 inch long and has distinct, slightly webbed fingers. Veins are clearly visible. The heart has divided into right and left chambers.

Three Months:

Three Months By now the fetus is 2 1/2 to 3 inches long and is fully formed. He has begun swallowing and kicking. All organs and muscles have formed and are beginning to function.

Four Months:

Four Months Your baby is covered with a layer of thick, downy hair called lanugo . His heartbeat can be heard clearly. This is when you may feel your baby's first kick .

Five Months:

Five Months A protective coating called vernix caseosa begins to form on baby's skin. By the end of this month, your baby will be nearly 8 inches long and weigh almost a pound .

Six Months:

Six Months Eyebrows and eyelids are visible. Your baby's lungs are filled with amniotic fluid , and he has started breathing motions. If you talk or sing , he can hear you.

Seven Months:

Seven Months By the end of the seventh month, your baby weighs about 3 1/2 pounds and is about 12 inches long . His body is well-formed. Fingernails cover his fingertips.

Eight Months:

Eight Months Your baby is gaining about half a pound per week , and layers of fat are piling on. He has probably turned head-down in preparation for birth. He weighs between 4 and 6 pounds .

Nine Months:

Nine Months Your baby is a hefty 6 to 9 pounds and measures between 19 and 22 inches. As he becomes more crowded, you may feel him move around less.

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Discomforts of Pregnancy

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Discomfort Constipation Bleeding gums Backaches What to avoid? Relief Cause Weight gain, posture Massage, warm bath Lying on back, one position for long time Lack of nutrition Brush & floss daily, fruit & veggies Smoking Position of baby, diet Fruits, water Over the counter laxatives Dizziness Move to quickly Slow down, rest Groin pressure Baby pushing down Elevate legs Heavy lifting, stairs if necessary

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Discomfort Heartburn Headaches Gas What to avoid? Relief Cause Large meals, diet Eat small meals, exercise Foods that cause gas Hormones, stress Scalp massage, warm cloth Processed foods, caffeine Large meals Small meals, milk may soothe Spicy foods, meals before bed, lying flat Hemorrhoids Pressure on rectum Warm bath, “Tucks” Insomnia Worries, uncomfortable Warm milk, reading Caffeine, long naps Reading on toilet, constipation

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Discomfort Nosebleeds & Nasal Congestion Mood swings Leg cramps What to avoid? Relief Cause Pressure from baby weight Regular walking Standing in one position for long time Hormones Open communication Processed foods, caffeine Increased blood volume Cool mist humidifier, more Vitamin C Over the counter nasal sprays Sciatica Pressure on sciatic nerve Massage or physical therapy Acne Diet, sweating, lack of water Wash skin Heavy makeup, too much sun Heavy lifting, climbing ladders

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Discomfort Sore ribs Urination Swelling What to avoid? Relief Cause Diet – body holds water Drink water, loose clothes Salt or processed foods Small bladder Empty bladder Water before bed Baby growth Change positions Half sit-ups Stretch marks Baby growth Good nutrition, oil or creams? Varicose veins Swollen blood vessels Support hose, change positions often Crossing legs, high heeled shoes Spending money on expensive products

PREGNANCY LOSS:

PREGNANCY LOSS Spontaneous abortion (miscarriage) Infant mortality (lowest rate ever but 19 countries still have lower rates) 32,000 babies, under one year, die every year mostly related to poverty SIDS Coping with loss – need to experience the grieving process

History of Delivery:

History of Delivery

Early :

Early 1647 - Forceps developed - many babies died in the early years of their use Before 19th century was uneventful - life went on as normal no pain relief Mid 19th century women feared childbirth - painful or even fatal higher social status less children you had 1800’s - Chloroform was used to relieve women of any pain - it was harmful and even fatal to mother and baby

Mid:

Mid 1882 - First successful Cesarean delivery death rate remained high until 20th century 1900’s - Middle class women would be confined until well after the baby was born Introduction of Maternity clothes (Lane Bryant)

1920 “Twilight labor”:

1920 “Twilight labor” Morphine and scopolamine (general anesthetic) (These drugs proved to be harmful to baby and mother) Use of stirrups to prevent any tearing or ripping

1950 and Beyond:

1950 and Beyond 1950’s - Use of drugs in “assisted” childbirth becomes popular 1970’s - “Natural” childbirth is newly popular Midwife becomes popular 1980’s - Back toward hospital births

CHOICES IN CHILDBIRTH :

CHOICES IN CHILDBIRTH Hospital Birth (read page 319) Responding with family-centered childbirth and rooming-in Norm is still impersonal births Bright lights, loud noise, monitors

Medicalization of Childbirth:

Medicalization of Childbirth Hormones given to intensify contractions and shrink uterus after delivery Drugs go directly through placenta to baby (may reduce heart & respiratory rates & general responsiveness) Episiotomy (61%) Research recommended liberal or routine use of episiotomy be abandoned Fetal Monitoring

Medicalization of Childbirth continued:

Medicalization of Childbirth continued Helpful in high-risk but not low risk (stethoscope works) Forceps & Vacuum extractors Too often used as substitute for patience & skill Table births (against gravity) Most cultures use birthing chairs, kneeling, or squatting C-sections account for ¼ of births in US Circumcision?

CHILDBIRTH IS A NATURAL PROCESS:

CHILDBIRTH IS A NATURAL PROCESS Can technology do the job better? Is lower birthrate due to advances in medicine? Should pain of childbirth be avoided at all costs? If a child is still born or disabled why do we look for someone to blame? WOMEN NEED TO UNDERSTAND THEY DO HAVE A SAY IN THE BIRTH PROCESS Read article about pain relief Activity:

POSTPARTUM PERIOD:

POSTPARTUM PERIOD Biological Hormone drop Labor, dehydration, blood loss Psychological Question abilities as a mother Overwhelmed Social factors Financial & emotional burden