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 OVUMS
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 BABYS HEAD (TOP) AND DELIVERY OF THE BABYS 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 BABYS 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 WOMANS 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
