Pregnancy

Question 1

What are the different perspectives on birth

Answer 1

Biomedical

• birth is a medical event
• focus = illness, pathology, potential problems

Psychological

• birth is an experience
• focus = satisfaction and fulfilment

Social

• type of childbirth is socially determined
• e.g., increased intervention

Cultural

• birth/motherhood is fulfilling

Question 2

how has giving birth changed in UK since 1927

Answer 2

in 1927, 85% of births occurred at home; now < 2%

~40% are “normal births” - i.e., no medical procedures

increasing medicalisation - e.g. caesarean-section rates

Question 3

Psychosocial factors in pregnancy

Answer 3

Question 4

Factors associated with foetal / neonatal mortality, difficult labour, low birth weight, infant morbidity

Answer 4

physical, sexual or emotional abuse

illicit drug use*

(heavy) alcohol use

nutrient deficiencies

excessive or low maternal weight gain

Question 5

How could you change prenatal behaviours?

Answer 5

provision of information can change health behaviour

= basis for antenatal classes

Question 6

What does a socioeconomic disadvantage increase a risk of?

Answer 6

maternal morbidity – physical and psychological

maternal mortality

infant mortality

low birth weight = most important factor in infant morbidity & mortality

Question 7

What may cause maternal stress?

Answer 7

• may be a response to adversity
• related to coping responses (including harmful behaviour)
• concern about changing roles

Question 8

What response could stress invoke?.. explain

Answer 8

Stress can cause physical effects on the mother and hence the fetus via hormones, immunity, BP, blood supply and nutrients.

it can also cause psychological response leading to a change in behaviour

Question 9

Stress and associated foetal outcomes

Answer 9

premature labour + delivery

lower birth weight

moderated by psychosocial resources – e.g., SES

Question 10

how does maternal stress affect the infant?

Answer 10

= increased sensitivity to stress

= more anxiety and fearfulness

= more emotional and behavioural difficulties

= more cognitive and attentional difficulties

+ higher rates of ADHD, schizo, depression, etc. later in life

Question 11

Why is support during pregnancy important

Answer 11

• greater perceived control
• less stress
• greater satisfaction with birth
• lower likelihood of traumatic birth
• lower likelihood of postnatal depression

Question 12

Why is support during labour important?

Answer 12

* shorter labour

* less c-section / ventouse / forceps

* less analgesia

* better Apgar scores