Ch.8 Pregnancy

Early Signs of Pregnancy

• Some women experience signs or symptoms of pregnancy within a week of conception. For other women, pregnancy symptoms may develop over a few weeks or may not be present at all.

• If you have been sexually active and experiencing any of the following symptoms it is important to take a pregnancy test.

• Implantation Bleeding:

• Implantation bleeding can be one of the earliest

pregnancy symptoms. About 6-12 days after

conception, the embryo implants itself into the

uterine wall. Some women will experience

spotting as well as some cramping.

• Other Explanations: Actual menstruation,

altered menstruation, changes in birth control

pill, infection, or abrasion from intercourse.

• Delay/Difference in Menstruation:

• A delayed or missed menstruation is the most common pregnancy symptom leading a woman to test for pregnancy. When you become pregnant, your next period should be missed. Many women can bleed while they are pregnant, but typically the bleeding will be shorter or lighter than a normal period.

• Other Explanations: Excessive weight gain/loss, fatigue, hormonal problems, tension, stress, ceasing to take the birth control pill, or breast-feeding.

• Swollen/Tender Breasts:

• Swollen or tender breasts is a pregnancy

symptom which may begin as early as 1-2

weeks after conception. Women may notice

changes in their breasts; they may be tender to

the touch, sore, or swollen.

• Other Explanations: Hormonal imbalance, birth

control pills, impending menstruation (PMS) can

also cause your breasts to be swollen or tender.

• Fatigue/Tiredness:

• Feeling fatigued or more tired is a

pregnancy symptom which can also start

as early as the first week after conception.

• Other Explanations: Stress, exhaustion,

depression, common cold or flu, or other

illnesses can also leave you feeling tired

or fatigued.

• Nausea/Morning Sickness:

• This well-known pregnancy symptom will often

show up between 2-8 weeks after conception.

Some women are fortunate to not deal with

morning sickness at all, while others will feel

nauseous throughout most of their pregnancy.

• Other Explanations: Food poisoning, stress, or

other stomach disorders can also cause you to

feel queasy.

• Backaches:

• Lower backaches may be a symptom that

occurs early in pregnancy; however, it is

common to experience a dull backache

throughout an entire pregnancy.

• Other Explanations: Impending

menstruation, stress, other back problems,

and physical or mental strains.

• Headaches:

• The sudden rise of hormones in your body can cause you to have headaches early in pregnancy.

• Other Explanations: Dehydration, caffeine withdrawal, impending menstruation, eye strain, or other ailments can be the source of frequent or chronic headaches.

• Frequent Urination:

• Around 6-8 weeks after conception, you

may find yourself making a few extra trips

to the bathroom.

• Other Explanations: Urinary tract

infection, diabetes, increasing liquid

intake, or taking excessive diuretics.

• Darkening of Areolas:

• If you are pregnant, the skin around your

nipples may get darker.

• Other Explanations: Hormonal imbalance

unrelated to pregnancy or may be a

leftover effect from a previous pregnancy.

• Food Cravings:

• While you may not have a strong desire to eat pickles and ice cream, many women will feel cravings for certain foods when they are pregnant. This can last throughout your entire pregnancy.

• Other Explanations: Poor diet, lack of a certain nutrient, stress, depression, or impending menstruation.

Pregnancy Test

• Most pregnancy tests are 99% accurate!

• Most can be used as early as the day you miss your period.

• For best results, try testing first thing in the morning, when your urine is most concentrated.

• If the control indicator doesn't show up properly, the test may be faulty.

Choosing an Obstetrician

1. Make sure it is someone you trust and

with whom you will cooperate.

2. Get recommendations from friends,

family, doctors, nurses, and childbirth

education groups.

3. Check the hospital the doctor is affiliated

with to make sure they have an intensive

care nursery.

History

• During Victorian times the subject of pregnancy was taboo.

• Pregnancy was hidden. The Hoop skirt was invented in the 1860’s to disguise the pregnancy of a French empress.

• Prior to the 1900’s only unwed mothers or poor mothers delivered in hospitals.

• 1935 “twilight sleep” was popular for birth and more births were in hospitals by the 1940’s

• Death rates fell from 60.8 per 10,000 to 37.6 per 10,000

Obstetricians

• Specialize in delivering babies

• Most have OB-GYN after their name

Certified Nurse Mid-wife

• Trained to care for low-risk pregnancies

and to deliver their babies

• CNM works under the supervision of an

obstetrician

• They give personal attention to the patient

Cost of having a Baby

• Average hospital bill of $5,000-$10,000 for a vaginal delivery

• Add at least $2,000 if you need a c-section

• These figures do not include the medical costs associated with nine months of prenatal visits, ultrasound costs and other lab costs. If your baby is born premature or with health problems, neonatal costs can range from a few thousand for a short stay to more than $200,000 if you baby is born more than 15 weeks early

Medical Costs

• Ideally the mother will have medical

insurance that will cover most of the costs

of having the baby

Going through pregnancy and birth is very costly, but

worth every penny!

Crib with mattress- $160-$750 Crib bedding set- $35-$270 Crib blankets (4-6)- $8-$40 each Fitted crib sheets (2)- $8-$20 each Water-proof mattress cover- $10-$20 Bassinet or cradle- $35-$260 Changing table- $70-$600 Changing pad & cover- $25-$50 Dresser- $90-$650 Rocker or glider- $90-$500 Car seat- $35-$280 Stroller or travel system- $30-$300 Playpen or porta-crib- $60-$180 Swing- $45-$130 Play center or walker- $50-$125 Mobile- $25-$70 Baby carrier or sling- $20-$140

Toy box- $25-$90 Gym or play mat- $25-$90

Baby gate- $35-$250 Bouncer seat- $30-$90

Doorway jumper- $25-$60 High chair- $45-$240 Diaper bag- $10-$60 Diaper pail- $20-$45 Refills- $15-$20 (3 pack) Thermometer- $10-$90 First aid supplies (kit)- $20-$30 Humidifier or vaporizer- $15-$130 Bottles 8 oz & 4 oz (8-10)- $10-$20 (3 pack) or $20-$40 (starter set) Bottle warmer- $18-$35 Sterilizer- $30-$70 Breast pump & accessories- $45-$350 Breastfeeding pillow- $20-$35 Bath tub or seat- $15-$35 Hooded towels (4)- $6-$30 each Wipes (a lot)- $4-$5 (pack) Clothes for first year- $500-$1,200 Monitor- $20-$230

First Visit to the doctor

• Complete medical history – Menstrual history

– Other pregnancies

– Diseases, STI’s

• Weight

• Blood pressure

• Draw blood – Test for anemia

– RH factor

• Urine sample – Infection

– Diabetes

– hypertension

• Internal exam – Size and position of the uterus

– Pap smear

Regular Visits

• Visits will continue monthly until the 7th

month

• Seventh month visits increase to every 2

weeks

• Ninth month visits increase to weekly

RH Factor

• A protein present in blood. If it is present you are positive and if not you are RH negative.

• 85% of population has the factor

• When an Rh-negative woman carries an RH-positive baby some blood enters the mother’s circulatory system as the baby passes through the birth canal. Her immune system regards this foreign blood as a threat and produces antibodies.

• In future pregnancies brain deformities, jaundice, or miscarriage may result

RH+ RH-

Due Date

• Due Date is calculated by finding the

beginning of the last monthly cycle and

counting back 3 months and adding 7

days.

• You can also add 9 months and 7 days.

• Pregnancy last approximately 280 days or

10 lunar months

Trimesters

• Pregnancy is divided into three segments

each lasting three months.

Fetal Development

• Development progresses through three

stages:

• Zygote

– From conception until 2-weeks

• Embryo

– From 2 weeks until 8 weeks

• Fetus

– From 8 weeks until delivery

Morning sickness

• Nausea and/or vomiting associated with pregnancy

• Tips to avoid morning sickness: – Get up slowly

– Nibble on crackers

– Eat frequent, small meals

– Drink liquids between instead of with meals, eat ice chips

– Try chewing gum or sucking on hard candy

– Avoid caffeine

– Avoid strong smells

– Limit stress

Warning signs

• Vaginal bleeding

• Extreme puffiness in hands and/or face

• Severe or persistent abdominal pain

• Severe headache

• Dizziness

• Blurred vision

• Sudden weight gain of more than two pounds

• Sudden increase in thirst followed by little urination

• Painful or burning urination

• Chills and fever over 100 degrees

• Feeling no movement for 24 hours (after 20 weeks of pregnancy)

• Feeling little movement (after 28 weeks of pregnancy)

Prenatal Test

• Ultrasound – Done in the doctor’s office uses sound waves to show images of the

baby. Detects Multiple births, defects in organs, position before delivery, gender

• Amniocentesis – Fluid withdrawn from amniotic sac between 15 and 18th week. Detects

genetic and chromosomal disorders

• hCG – Blood test for high levels of hCG, which may indicate possibility of down

syndrome

• MSAFP – Blood test for AFP produced by the liver of the fetus and detected in the

mother's blood. Low levels may indicate Down syndrome

• Chorionic villus Sampling – Can detect cystic fibrosis and down syndrome

Miscarriage

• One out of every five pregnancies ends in

miscarriage or spontaneous expulsion of

the fetus

• Most occur the first 12 weeks

• If you suspect a problem you should put

your feet up and call the doctor.

• Physical activity, stress, and minor falls

are NOT believed to cause miscarriage

Steps to Good Prenatal Care

1. Eat a balanced diet.

1. Requirements Daily:

1. Milk (2-3 servings--1 cup each)

2. Vegetables (3-5 servings--1/2 to 1 cup each)

3. Fruits (2-4 servings--1 medium or 1/2 cup each)

4. Meat, poultry, fish, dry beans, eggs, nuts (2-3

servings--3 ounces or 1/2 cup each

5. Bread, cereal, rice, pasta(6-11 servings--1 slice,

1/2 cup, 1 ounce each)

6. 8 glasses water

2.Do not drink alcohol or use illegal

drugs

• Alcohol

(1-2 drinks per day) result in more frequent birth defects, lower birth weight, and a higher risk of miscarriage

(5-6 drinks per day) results in FAS( fetal alcohol syndrome) which is characterized by malformations, a small head, heart defects, and mental retardation

• Drugs – Change the mother’s physiology and effect the intra-

uterine environment

– Drug waste also builds and damages the developing fetus

– Marijuana causes growth retardation, changes in secondary sex characteristics, fetal distress, and prolongs labor

– Cocaine constrict blood vessels, can cause spontaneous abortion, placental abruption, difficult time adjusting to environmental stimuli after birth or addiction

– DO NOT TAKE ANYTHING WITHOUT CONSULTING THE DOCTOR IF YOU ARE PREGNANT!

3. Do NOT Smoke

Smoking causes smaller babies,

miscarriage, pre-maturity, stillbirth, death

of the baby soon after birth, impaired

intellectual and physical development.

4. Get plenty of rest

• Take time to put your feet up and rest.

• Nap when possible

5. Drink plenty of fluids

• Water helps to cool the body and gets rid

of toxins.

• Drink at least 8 glasses of water each day

• Dehydration can lead to pre-mature labor

6. Maintain a good emotional and

mental outlook

• Try to reduce stress where possible.

• Pregnancy dreams about death or being

trapped are normal.

• Do not over analyze every little ache or

pain.

7. Exercise Within Reason

• Avoid strain on the lower back

• Avoid over-heating

• No jumping, hopping or bouncing during

third trimester