This week we discussed contraception. What method do you believe is most convenient. According to your lecture material, what are some advantages or disadvantages of this method? Which of these methods do you think is the most inconvenient, why?
CHAPTER 9: CONCEPTION, PREGNANCY, AND BIRTH
Roger R. Hock
HISTORICAL PERSPECTIVES
• The Pain of Giving Birth
• Medical pain control did not come into common practice until the mid to late
nineteenth century.
• General anesthesia
• Ether
• Chloroform
• Twilight sleep
• Midwifery
THE EARLIEST FORM OF CHILDBIRTH PAIN MEDICATION WAS DEEP SEDATION
USING A HANDKERCHIEF CONTAINING A FEW DROPS OF CHLOROFORM, A
CHEMICAL DISCOVERED IN THE MID-1800S BY SIR JAMES SIMPSON, WHO,
AFTER EXPERIMENTING ON THE DRUG HIMSELF, WAS DISCOVERED
UNCONSCIOUS IN HIS STUDY BY HIS BUTLER.
DECIDING WHETHER OR NOT TO
HAVE A CHILD
• Self-Discovery: Are you Destined to be a Parent?
• Choosing Not to Have a Child
• The Influence of the Child’s Sex
• Sexuality, Ethics and the Law: Sex-Preselection Technology
CONCEPTION
• Ovulation: The Ovum’s Journey
• Oocyte
• Menarche
• The Follicular Phase
• The Luteal Phase
• The Sperm’s Journey
• The Ovum-Sperm “Rendezvous”
• Zygote
• Human Chorionic Gonadotropin (hCG)
FIGURE 9.2 OVULATION OCCURS WHEN THE OVARIAN FOLLICLE
CONTAINING A MATURE OVUM RUPTURES AND RELEASES THE OVUM
TOWARD THE OPENING OF THE FALLOPIAN TUBE.
FIGURE 9.6 SPERM CELLS IN THE EJACULATE
THE TYPICAL MALE EJACULATE CONTAINS AN AVERAGE OF AROUND 400
MILLION SPERM CELLS.
FIGURE 9.7 SPERM CELLS ON THE SURFACE OF THE OVUM
ONLY ONE SPERM CELL WILL BE ALLOWED TO PENETRATE THE OVUM’S
MEMBRANE.
FIGURE 9.8 ZYGOTE MOVING THROUGH THE FALLOPIAN TUBE
THE FERTILIZED EGG, NOW KNOWN AS A ZYGOTE, BEGINS TO DIVIDE AS IT
TRAVELS ALONG THE FALLOPIAN TUBE.
PREGNANCY
• First Trimester
• Second Trimester
• Third Trimester
FIGURE 9.10 FROM CONCEPTION TO PREGNANCY. CONCEPTION AND
PREGNANCY ARE SEPARATE EVENTS OCCURRING ABOUT A WEEK APART.
EMBRYO AT ONE MONTH.
FETUS AT FIVE MONTHS.
POTENTIAL PROBLEMS IN
PREGNANCY
• Ectopic Pregnancy
• Miscarriage
• Preterm Birth
• Fetal Abnormalities
• Teratogens
FETUS AT SEVEN MONTHS
POTENTIAL PROBLEMS IN
PREGNANCY
• Embryonic and Fetal Testing
• Amniocentesis
• Chorionic Villus Sampling (CVS)
FIGURE 9.14 AMNIOCENTESIS PROCEDURE
DURING AMNIOCENTESIS, FLUID FROM THE SAC SURROUNDING THE FETUS IS
EXTRACTED AND TESTED FOR GENETIC CHARACTERISTICS AND IS CAPABLE OF
DETECTING MANY POTENTIAL ABNORMALITIES.
ABORTION
• Abortion Procedures
• Surgical Abortions
• Medical Abortions
• Surgical or Medical: Pros and Cons
• The Psychological and Emotional Experience of Abortion
• Reducing the Number of Abortions
• The Birth Process: Labor
• Stage One Labor
• Stage Two Labor
• Stage Three Labor
• Choices and Decisions in Childbirth
• Doctor or Midwife?
• OB/GYN
• Midwife
• Nurse/Midwife
• Birthing Settings
• Birthing center
• Home birth
BIRTH
FIGURE 9.16 THE STAGES OF CHILDBIRTH
CROWNING OF THE BABY’S HEAD (TOP) AND DELIVERY OF THE BABY’S HEAD
(BOTTOM).
MANY HOSPITALS TRY TO CREATE A MORE COMFORTABLE, “HOME-LIKE”
BIRTHING ENVIRONMENT.
BIRTH
• Choices and Decisions in Childbirth
• Pain Medication during Labor and Delivery
• Birth by Cesarean Section
FIGURE 9.18 C-SECTION BIRTH
A CESAREAN SECTION IS PERFORMED WHEN MEDICAL COMPLICATIONS
PREVENT A VAGINAL DELIVERY OR, IN SOME CASES, IT IS THE METHOD OF
DELIVERY ELECTED BY THE MOTHER.
POSTPARTUM ISSUES
• Postpartum depression
• Sexual activities after childbirth
• Breast-feeding and the return of the fertility cycle
FOR AS MANY AS ONE IN FIVE
WOMEN, POSTPARTUM
DEPRESSION (PPD) IS A
PSYCHOLOGICAL DISORDER THAT,
IN ADDITION TO ALL THE TYPICAL
SIGNS OF DEPRESSIVE ILLNESS,
ALSO MAY INVOLVE A LACK OF
INTEREST IN THE NEW BABY,
OVERLY INTENSE WORRY ABOUT
THE BABY’S WELFARE, AND FEARS
THAT SHE MIGHT HARM THE
INFANT IN SOME WAY. IF NOT
TREATED, THIS MAY CAUSE THE
RELATIONSHIP BETWEEN THE
MOTHER AND INFANT TO SUFFER,
AND THE WELLBEING OF BOTH
MAY DETERIORATE.
• Scope of the infertility problem
• Infertility
• Causes of impaired fertility
• Ovum and sperm problems
• Age
• Frequency of intercourse
• Timing of intercourse
• Fertility testing
• Laparoscopy
IMPAIRED FERTILITY
FIGURE 9.19 PROBABILITY OF PREGNANCY FOR A COUPLE WITH NORMAL
FERTILITY (WHEN WOMAN IS UNDER THIRTY YEARS OF AGE)
SOURCE: ADAPTED FROM PETROZZA (2006).
FIGURE 9.20 LAPAROSCOPY
A LAPAROSCOPY ALLOWS A PHYSICIAN, THROUGH A TINY INCISION, TO
CHECK VISUALLY A WOMAN’S OVARIES, FALLOPIAN TUBES, AND
SURROUNDING STRUCTURES FOR ANY PROBLEMS THAT MAY CONTRIBUTE TO
INFERTILITY.
IMPAIRED FERTILITY
• Solutions to Impaired Fertility
• Treatments
• Fertility Drugs
• Surgical Procedures
• Assisted Reproductive Technology (ART)
• Rates of Success for Assisted Reproductive Technology
• Solutions to Impaired Fertility
• Adoption
• Why couples select adoption
• Cost of adoption