Conception, Pregnancy And Childbirth

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Conception, Pregnancy and Childbirth

Deciding Whether or Not to Have a Child
Choosing Not to Have a Child
Over 4 million (6.6%) American women of childbearing age “Childless by choice” or “child-free”
Viewed as violation of expectations in child-oriented society
DINKs: face subtle forms of discrimination & disapproval.
History and Childless Marriages
Women without children called “barren”
Men and their families would often reject, punish, or murder wives who did not produce children.

Are you ready to be a parent?
Your expectations about Yourself as a Parent
Do you currently spend time with children? Do you enjoy it?
How do you cope with stress?
What are your hopes and fears about parenthood?
Your Values and Expectations about Life
Values, morals, attitudes, priorities, expectations, discipline?
Your Lifestyle and How It Will Change
Talk to those who do and do not have children, may raise new issues for you to consider
Do you have a support system?
What do you do on your free time? What will do you when you don’t have any?
How do you think your life will change? Time, energy, and money?

Preconception Counseling
Advanced planning aimed at reducing perinatal mortality & morbidity
Optimize the health of a woman and her partner prior to conception.
Prenatal Care is TOO LATE to:
Screen for inherited conditions, control chronic diseases, change harmful medications, get immunized, avoid teratogens, start taking folate, decide whether you want a child, and address substance abuse

Preconception Visit
Maternal, Paternal, & Family health history
Past pregnancies, medications, lifestyle
Complete physical exam
Labs: complete blood count, hepatitis B, Syphilis, HIV, rubella, chlamydia, gonorrhea, pap smear, sickle cell prep, ppd, blood type, rh factor
Increase Calcium
Folic acid - 400 micrograms/day
Avoid preservatives
No hot tubs, saunas
Stop smoking
Alcohol consumption
Genetic material
OCP’s - when to stop

RH Factor
Rh negative mother and positive father
Mothers blood builds up antibodies capable of destroying the “Unfriendly” type of blood cells
Nothing serious happens with the 1st pregnancy
Injection of “Rh immuno-globlin” with in 72 hours after the termination of a pregnancy, childbirth, abortion or miscarriage
- If the mother does not get this treatment, she will produce antibodies that can damage children she may bear later. - Danger increases with each subsequent pregnancy - Child could die

Advanced Maternal age
Age 35: has become more common
Special Concerns - fertility gradually declines - risk of birth defects increases - gestational diabetes

Dating a Pregnancy
Nagele’s Rule subtract 3 months from LNMP + 7 days
Pregnancy Wheel
Ultrasound
EDD or EDC
Gestational Age (LNMP)
Conceptional Age (fertilization)

Due date? Nagele’s Rule
Approximate due date is 40 weeks after the first day of LMP.
Subtract 3 months from first day of LMP, then add 7 days and 1 year.
Pregnant woman, LMP June 28, 2005, she subtracts 3 months to get to March 28, then adds 7 days and 1 year. Her due date is April 4, 2006

Window of Opportunity
Ovulation: approximately 14th day
Oocyte viable for 12-24 hours
Sperm: viable 24-48 hours
If unprotected intercourse occurs up to 4 days before and up to 1 day after ovulation, window of opportunity

Monozygotic
Identical twins
A single egg is fertilized to form one zygote but the zygote then divides into two separate embryos.
The two embryos develop into fetuses sharing the same womb.
Identical genetic make-up

Dizygotic
Fraternal Twins
Usually occur when two fertilized eggs are implanted in the uterine wall at the same time.
Two eggs form two zygotes.

Embryonic-Fetal Differentiation of the External Reproductive Organs
Female and male reproductive organs formed from same embryonic tissue appear identical during the first 7 weeks in the uterus

Placenta and Umbilical Cord
Oxygen and nutrients transported
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