Pregnancy and Labor

Question 1

Introduction

Answer 1

o “Morning” sickness – Not everyone can get this
o Weight gain –
o Length of pregnancy: It can vary from 37 weeks to 42.

Question 2

Growth in three areas

Answer 2

Uterus
Mammary Gland
Weight Gain

Question 3

Mammary Glands grow because..

Answer 3

§ Grow as they prepare to feed a baby down the road

Question 4

Weight gain happens because..

Answer 4

Due to enlargement of uterus/mammary glands, growing fetus and placenta (~20 lbs max), fluid accumulation, fat deposits

Question 5

Effects on Digestive System

Answer 5

Morning sickness ·Heartburn : Stomach acid that gets into the esophagus causes heartburn. ·Constipation: The reason for this is due to the fact that the digestive system gets a lot more pressure put on it.

Question 6

Effects on Cardiovascular System

Answer 6

Increased blood volume
Potential for varicose veins b/c of problems with venous circulation late in pregnancy: Exercising and wearing the proper socks can help with these types of veins.

Question 7

Urinary Frequency, Why?

Answer 7

Because the urinary bladder is pressed up against the body.

Question 8

Placenta Functions

Answer 8

HCG
Estrogens
Progesterone
Gas/Nutrients Exchange

Question 9

Placenta Functions; Human Chorionic Gonadotropin

Answer 9

HCG
This will be at its highest at around 30 days, and it only made during initial development of the fetus. This is the first indicator in a pregnancy and can be used in a pregnancy test.

Question 10

Placenta Functions; Progesterone

Answer 10

Estrogen and Progesterone sky rocket once someone becomes pregnant.

Question 11

Partruition (Labor)

Answer 11

Expulsion of infant from mother’s body

Question 12

False Labor

Answer 12

(Braxton Hicks contractions)
§ Irregular
§ Do not progress

Question 13

True Labor

Answer 13

§ Contractions at regular intervals
§ Pain intensifies
Initiated and maintained by oxytocin

Question 14

True Labor (2); Initiated and maintained by oxytocin

Answer 14

Pressure on cervix from fetal head Stimulates posterior pituitary to secrete oxytocin Stimulates contraction of uterine smooth muscle Pushes fetus towards cervix
And repeat…

Question 15

Pregnancy Steps (1)

Answer 15

Estradiol from the placenta readies the uterus for a response to oxytocin

Question 16

Pregnancy Steps (2)

Answer 16

The fetus’s head pushing against the cervix acivates stretch-sensitive sensory neurons that send stimulatory signals to the mothers hypothalamus

Question 17

Pregnancy Steps (3)

Answer 17

The hhypothalamus stimulates secretion of oxytocin from the posterior pituitary gland

Question 18

Pregnancy Steps (4)

Answer 18

Oxytocin stimulates stronger uterine contractions

Question 19

Pregnancy Steps (5)

Answer 19

Prostaglandins sescreted by the uterus also enhance contractions. Sensory input to the hypothalamus is further enhanced by contractions

Question 20

Prior to Labor

Answer 20

1. Baby Drop’s
2. False Contraction
3. Cervix Softens
4. Water Breaks - Sometimes

Question 21

Baby “Drops”

Answer 21

When the head actually drops into the true pelvis, that is the difference that gives a little room at the top

Question 22

Cervix Softens

Answer 22

It will become softer during labor because it will need to move out of the way during labor.

Question 23

Water Breaks - Sometimes

Answer 23

A lot of people will be in labor for sometime before their water even breaks.

Question 24

Labor Stages (1)

Answer 24

Dilation stage: start having regular contractions – fully dilated cervix (typically 6-12 hrs.) :Sometimes it can be two days, maybe in 20 minutes?

Question 25

Labor Stages (1) - Early Labor

Answer 25

cervix gradually effaces and dilates (to about 4 cm). :It has to efface or else the baby will not fit through the cervix.

Question 26

Labor Stages (1) - Active Labor

Answer 26

contractions longer, stronger, and closer together (4-10cm)

Question 27

Labor Stages (1) - Transition Labor

Answer 27

end of active labor (CRAZY contractions) (usually 8-10cm)

Question 28

Labor Stages (2)

Answer 28

Expulsion stage: fully dilated – birth of baby (“pushing stage”)
§ May take hours to minutes

Question 29

Labor Stages (3)

Answer 29

after birth – delivery of placenta
§ Generally 5-30 minutes after delivery of baby
§ Placenta sometimes called “afterbirth”

Question 30

Changes in Mother after Pregnancy

Answer 30

Loss of Excess Fluids
Lactation
Contraction/Shrinkage of Uterus
Hormonal Changes

Question 31

Changes in Mother after Pregnancy; Loss of Excess Fluid

Answer 31

1. Expulsion of amniotic fluid during birth
2. More frequent copious urination
3. Increased sweating
4. Discharge of lochia

Question 32

Discharge of Lochia

Answer 32

Lochia = postpartum bleeding (similar to a period, but much heavier!)
Lasts 2-3 weeks (or even more for some!)
§ All of the uterine tissues (and associated blood) that was built up to support the pregnancy must be broken down & expelled: The reason behind this is due to 40 weeks of material being built up in order to support the child.

Question 33

Changes in Mother after Pregnancy; Lactation

Answer 33

(production of breastmilk by mammary glands)

1. Increased levels of prolactin = Allows milk to be secreted
2. When baby suckles, posterior pituitary is stimulated to secrete oxytocin.

Question 34

Changes in Mother after Pregnancy; Contraction/Shrinkage of Uterus

Answer 34

1. Within ~6 weeks, uterus shrinks to near pre-pregnancy size
2. Uterine contractions help with this. These contractions may be painful (“afterpains”).
3. Oxytocin also helps with this process:

Question 35

Changes in Mother after Pregnancy; Hormonal Changes (1)

Answer 35

1. Pregnancy = increase in estrogens & progesterones necessary to maintain and increase uterine lining
2. Within 3 days AFTER pregnancy, these levels drop dramatically.

Question 36

Changes in Mother after Pregnancy; Hormonal Changes (2)

Answer 36

3. Within 1 week after birth, prolactin levels rise
   §Oxytocin also increased during nursing
4. These hormone changes are believed to contribute to “baby blues” or the more serious “post-partum depression”