Chapter 12

Question 1

Why is a planned pregnancy typically healthier?

Answer 1

There is a pre-screening for STIs and a knowledge of previous illnesses that may affect the child’s development. Also, the partner needs to remain healthy because they are a constant exposure of infection. Further, if pregnancies are planned parents can get prenatal care and education

Question 2

What are some elements that could affect an ova and sperm?

Answer 2

Sperm take 9-10 weeks to develop so avoid toxic substances like alcohol, drugs, radiation and steroids.
Get to an optimal weight
Remove plaque on teeth
Unsure about COVID

Question 3

How can you increase your chances of having a baby?

Answer 3

-Relax and enjoy it. If you are stressed during the conception, you will have a bunch of stress hormones that will lower your chances.
-Pay attention to ovulation cycle.
-Have partner coital ejaculate every 24 hours during 48 hour period around ovulation
-Avoid lubrications or douches

Question 4

How do you know you are pregnant?

Answer 4

-Missed period/long cycle
-Nausea/fatigue
-Breast tender
-Uterine cramping
-Pregnancy test
-Pelvic exam
-Ultrasound

Question 5

How do pregnancy tests work?

Answer 5

Measure human chorionic gonadotropin (hCG), the hormone that is secreted as the embryo implants in the uterus after 8-9 days after ovulation.
Home tests are inaccurate if taken too soon or after the 12th week

Question 6

What are Hegar’s signs?

Answer 6

Softening of the uterus and changes in the color of the cervix, vagina, and labia.

Question 7

What is an ectopic pregnancy?

Answer 7

The implantation of the conceptus in the oviducts.

Question 8

What occurs during ovulation? How does ejaculate change during this?

Answer 8

The cervix softens, opens slightly, and cervical mucus becomes thinner, stretchier, and more alkaline. The ejaculate becomes thicker due to proteins.

Question 9

How long are ovum and sperm available for fertilization?

Answer 9

Ovum (the egg) lives up to 24 hours, sperm up to 5 days

Question 10

How many people having PIV sex will get pregnant with no contraception?

Answer 10

85 in 100

Question 11

How does fertilization occur?

Answer 11

The egg is released near the fallopian tube during ovulation and then swept into the tube by fimbriae
Typically happens as the egg travels down the fallopian tube toward the uterus
When sperm reaches the ovum, the ovum secretes a chemical that allows sperm to fertilize it
The outer layer of the ovum changes and no other sperm can enter
It takes about 24 hours to be completed

Question 12

How long is a typical pregnancy? How long are each trimester?

Answer 12

Pregnancy is divided into trimesters, each stage 12 - 15 weeks long
A typical pregnancy is 38 - 42 weeks

Question 13

When is the first trimester? What happens in the first trimester?

Answer 13

1st day of last menstrual period (LMP) - 13 weeks
Because pregnancy is dated from LMP, many don’t know they’re pregnant until they are 5 - 6 weeks

Morning sickness
Fatigue
Chances of miscarriage are highest
A fetal heartbeat can be heard by the end

Question 14

Morning Sickness (aka NVP – nausea and vomiting during pregnancy)

Answer 14

50 - 80% of pregnant people
Caused by increases in hormones
High levels of morning sickness correlated with reduced miscarriages, female fetus, and lower breast cancer risk

Question 15

When is the second trimester? What happens in the second trimester?

Answer 15

14 - 28 weeks

For many, the most pleasant part
Nausea and fatigue decrease
16 weeks fetal movement felt
Most will have an ultrasound
Increase sex drive for many (Higher sexual satisfaction during this trimester)

Question 16

When can you tell the sex of the baby?

Answer 16

You can usually see genitals on ultrasound at 18 - 22 weeks

Question 17

When is the third trimester? What happens in the third trimester?

Answer 17

29 weeks - birth, around 40 weeks

Energy decreases
Many physical complaints (Exercise, good nutrition, and adequate rest can help )
May experience Braxton-Hicks contractions
Nipples may secrete colostrum (the first fluid the breast produce and the first thing baby will drink)
May feel anxious about birth, irritable, restless
Engagement: fetus moves into the head-down position

Question 18

What are Braxton-Hicks contractions?

Answer 18

uterus contracts momentarily, preparing the body for actual labor
Compared to labor: not as painful, long-lasting, close together, or regularly spaced

Question 19

When is a baby considered premature?

Answer 19

Before 37 weeks

Question 20

When is the best outcome for a baby?

Answer 20

39-41 weeks

Question 21

What percent of babies are born on due date?

Answer 21

4%

Question 22

How does natural labor begin?

Answer 22

Fetal adrenal glands release hormones to cause lung maturation
It also causes the pregnant person’s pituitary gland to release oxytocin
Oxytocin causes the uterus to contract, pushing the fetus’s head into the cervix, which then causes more oxytocin to be released (positive feedback loop)

Question 23

What is induced labor?

Answer 23

Using techniques to artificially start labor
Variety of techniques:
Medications that mimic hormones, cause contractions
Sweep the membranes, break the amniotic sac

Question 24

What are the three stages of the birth process?

Answer 24

1. Regular contractions until the cervix is fully dilated to 10cm
2. Delivery
3. Placenta delivery

Question 25

Describe the third stage of birth process

Answer 25

Placenta delivery: The placenta no longer needed, detaches from the uterine wall, and follows the baby out of the vagina Contractions continue to help expel the placenta Usually not painful Medical staff check the placenta to be sure it’s intact, healthy

Question 26

Describe the second stage of birth process

Answer 26

Delivery: Usually, beings when the cervix is fully dilated Feel an overwhelming urge to push the baby out Pushing begins Contractions less intense Crowning: the emergence of the baby’s head at the opening of the vagina Length of stage: average 30 - 90 min The stage ends when the baby passes through the cervix and out of the vagina

Question 27

When is an episiotomy preformed?

Answer 27

Cut perineum to enlarge the vaginal opening Used to be routine, now only 12% get one in the US Mild tearing is common, but severe tearing is rare

Question 28

What is an epidural? What percent gets one? What are the side effects?

Answer 28

Small tube is placed in the back and local anesthetic is supplied through the tube, numbs from the belly button to the knees. Reduces pain, but can still usually feel pressure which helps with pushing during 2nd stage. 60-70% gets one Side effects: itching, chills/shivering, nausea, decrease in blood pressure, unable to move legs. Fetus may have a lower BP and affected breastfeeding and respiration rate.

Question 29

What is the side effects of a c-section for a fetus?

Answer 29

higher rates of respiratory problems, lower APGAR (Appearance, Pulse, Grimace, Activity, Respiration) scores, difficulty breastfeeding, lack of contact with beneficial bacteria

Question 30

What is the side effects of a c-section for a parent?

Answer 30

Major abdominal surgery so increased risk of infection, hemorrhaging, blood clots Recovery is more intense and takes longer (6 - 8 weeks) Increases risks for future pregnancies, but many are able to have healthy pregnancies after and even have a VBAC

Question 31

What is the rate in America for a c-section? What is recommended by WHO?

Answer 31

1/3 WHO recommends 15%

Question 32

What is a c-section?

Answer 32

Incision made through the abdominal wall and into the uterus The baby and placenta were removed through the opening The full operation lasts 20 - 90 minutes Most people awake, numb from the waist down from epidural Used for many reasons, usually medically indicated but sometimes “elective”

Question 33

Early Labor (1st stage of labor)

Answer 33

Dilate from 0 to 3 cm Short, far apart, mild to moderate contractions The longest part of the labor Mildly uncomfortable May see a thick, blood-tinged, mucus known as “bloody show” The amniotic sac may rupture

Question 34

Active Labor (1st stage of labor)

Answer 34

Dilate from 4 to 8 cm Longer, moderate to intense contractions getting closer together Usually lasts between 3 - 8 hours

Question 35

Transition Labor (1st stage of labor)

Answer 35

Dilate from 8 to 10 cm Longest contractions at peak intensity, very painful, very close together The shortest part of 1st stage: 30 min - 1 hour

Question 36

Describe the first stage of labor

Answer 36

Regular contractions until the cervix is fully dilated to 10cm The cervix begins: Dilation: expansion of opening Effacement: thinning out Contractions occur regularly, slowly build in intensity, duration and get closer together Longest stage 8 - 14 hours, longer for the first birth Contractions are stronger, and labor shorter when women are upright, moving around

Question 37

When can you have sex after birth?

Answer 37

Can have vaginal intercourse around 2 - 4 weeks after normal delivery May take longer if c-section, episiotomy, major tearing May have less desire, slower excitement, and less lubrication for the first few months But many are back to pre-pregnancy levels after 3 months

Question 38

How long does it take for the uterus to return to normal?

Answer 38

Takes about 6 weeks for the uterus to return to normal, but typically less time if breastfeeding

Question 39

How long do you have vaginal discharge after birth?

Answer 39

10 days — 3 or 4 weeks

Question 40

Baby Blues

Answer 40

A period of strong negative emotions in the first days/weeks after birth 70 - 90% of people experience this (mixed in with positive emotions)

Question 41

What percent of baby blues turn into Postpartum Depression?

Answer 41

10-20% Partners may also develop depression and rarely parent may experience Postpartum Psychosis

Question 42

When do babies begin breast feeding?

Answer 42

Most babies will start within 1 hour of birth

Question 43

What do most babies consume in the first few days of breast feeding?

Answer 43

Colostrum Yellow-thick, easy to digest Very nutritious and contains protective antibodies

Question 44

When does regular milk start flowing?

Answer 44

3-4 days

Question 45

What is recommended length of time for breast feeding? What are actual rates?

Answer 45

Breastfeeding is recommended for a minimum of a year, and a maximum of two years US: 83% start, 56% at 6 months, 36% at 1 year