UNIT 3: Pregnancy to Birth

UNIT 3: Pregnancy to Birth TOPICS: The Changing Body The Anatomy of Pregnancy The Gestational Period Common Discomforts of Pregnancy Preterm Labour and Birth Fetal Development GOAL: To increase knowledge of prenatal maternal care and fetal development. OBJECTIVES: 1. To develop an understanding of fetal development and understand how proper maternal health can affect it. 2. To gain insight into how the body changes during pregnancy and the discomforts that it may cause. 3. To understand why pregnancy is calculated at 40 weeks. 4. To develop an understanding of fetal development throughout the trimesters of pregnancy. 5. To identify the signs and symptoms of preterm birth. OVERHEADS: Premature Labour U3-6 Pregnant Anatomy U3-7 HANDOUTS: The Anatomy of Pregnancy Crossword Unit Quiz TEACHER S RESOURCE (for additional information only): Healthy Beginnings Book (can be purchased by clicking here) Websites: www.niagararegion.ca 36

CURRICULUM EXPECTATIONS: Expectations Covered in Unit 3 Parenting, Grade 11, Open Self and Others *Overall Expectations describe factors that contribute to the healthy development of children before and during birth, and in the first few months after birth *Specific Expectations Pregnancy, Birth, and Postnatal Care outline the stages in the biological process of conception, pregnancy, and birth Stages of Growth and Development explain how development from conception to three years of age affects and is crucial for development later in life analyze behaviours, conditions, and environments that influence positive or negative growth and development of the fetus, infant, and young child (e.g., breast-feeding, bonding, infant stimulation; violence, addictions, neglect) Science, Grade 9, Academic Biology: Reproduction Understanding Concepts describe, in general terms, human development from conception to the growth of human organs and body proportions, including embryonic human development from early cleavage to the morphological stages Science, Grade 9, Applied Biology: Reproduction-Process and Applications Understanding Concepts explain signs of pregnancy in humans and describe the major stages of human development from conception to early infancy 37

CONTENT THE CHANGING BODY: Maternal Changes Finding out about a pregnancy can be one of the most exciting times in a person s life, especially if it has been planned for a while. With all of its excitement, pregnancy can also bring anxiety. What s happening to my body? What if there is something wrong with the baby? Am I going to feel like this for the next nine months? This anxiety is perfectly normal. In early pregnancy, the body may not look very different. Although, the body will have already gone through several changes and may cause one to feel very different. High levels of pregnancy hormones are responsible for most of the changes that a woman s body will be going through. Her body is creating a safe place for her baby to grow. This process is complex and can be very energy consuming. This is why most feel so exhausted in the early months of pregnancy. It is important for pregnant women to take care of themselves during this time get sleep when needed, eat a well balanced diet and help create a safe environment for her growing baby. One of the changes is that the curve of the waist is starting to disappear and clothing begins to feel snug. The uterus is slowly growing from the size of a kiwi to the size of a grapefruit. It tries to protect itself from infection-causing bacteria by forming a mucous plug at the opening of the cervix. Breasts may also be starting to feel fuller, heavier and tender; this is because the milk glands are developing. Also, the brown areas of skin around the nipple (areola) is becoming darker and will start developing little bumps (Montgomery glands) that produce an oily substance that keeps the nipple area from drying out. The blood supply to the vaginal area increases during pregnancy and may even change the skin to a darker, purplish colour. These hormone changes can also cause one to be more aware of their breathing or feeling out-of-breath. During all of this, the heart has to work harder because of the extra blood produced in the body for the growing placenta and to provide oxygen and nutrients to the growing baby. TEACHING STRATEGIES TEACHER S RESOURCE Healthy Beginnings, pp. 24 Brainstorm: the symptoms or changes that can occur with pregnancy. Take each symptom and have the students identify possible remedies. 38

The good thing (for most) is that menstrual period will stop during your pregnancy. If a woman has any bleeding during her pregnancy, she should call her health care provider. COMMON DISCOMFORTS OF PREGNANCY: Increased frequency of Urination: A pregnant woman will feel the need to urinate more often. This is caused by increased pressure on her bladder by the growing uterus and increased urine produced by her kidneys. Limiting fluids in the evening may help ease the need to use the toilet during the night. TEACHER S RESOURCE Healthy Beginnings pp. 34-37, 59-62; 87-88. Morning Sickness: Nausea and/or vomiting is most often experienced in the first trimester, although for some it may last longer and is not limited to the morning. An expectant mother could try eating small frequent meals, crackers before getting up in the morning and limiting her intake of fluids with meals to help lessen the nausea. Headache: The female body goes through changes physically, emotionally and hormonally which may cause headaches. An expectant mother should drink plenty of fluids and have a well balanced diet. Increased Vaginal Secretions: This is caused by hormonal changes and increased congestion in the vaginal/uterine area. An expectant mother can wear a panty liner and should practice good hygiene. If the discharge is itchy, frothy or foul smelling she should see her health care provider. Breast tenderness/changes: This is caused by an increase in hormones and the development of milk glands. A well fitted bra is essential. Warm compresses may help ease discomfort, and if a woman s nipples are sore she can apply moisturizing cream while pregnant. Feeling Faint: This is caused by a combination of increased hormones, low blood sugar levels and the fact that a pregnant woman s circulatory system is working harder. This may be helped by changing positions slowly, eating regular meals and snacks, eating something sweet and 39

taking regular breaks. Feeling Tired: A woman may feel more tired during pregnancy. This is because her metabolism increases and progesterone (a hormone that is increased during pregnancy) has a sedative effect. When tired, an expectant mother should rest, take a nap or go to sleep. Low Back Pain: This is caused by stretching of the ligaments attaching the uterus to the pelvis, increased size of the abdomen and/or normal softening of the pelvic joints. A pregnant woman should work on her posture, lift with her legs (not her back), and use heat or massage to help relieve pain. Constipation: This is caused by food moving more slowly through the bowel. Pregnant women should eat a well balanced diet high in fruit and fibre, drink plenty of fluids and get regular exercise. Leg Cramps: This is thought to be caused by pressure on the abdominal nerves and fatigue. It could also be related to a calcium/phosphorous imbalance. To help prevent, expectant mothers should avoid becoming fatigued, elevate their feet when possible and could try taking a warm bath at bedtime. If leg cramps do strike, pointing toes towards the ceiling, or standing flat on her feet may help to stretch it out. Do not point toes. Heartburn: This is a burning feeling in the chest that in pregnancy is caused by hormone changes and the pressure of the growing uterus pushing food and stomach acid into the lower throat. To help prevent heartburn, a pregnant woman should avoid eating ½ hour before bed, add extra pillows to the bed, eat small meals and avoid chewing gum, smoking, caffeine, greasy and spicy foods. Hemorrhoids: These are caused by pressure of the growing uterus on the veins in the rectum. They can be aggravated by constipation. Daily exercise, plenty of fluids and a balanced diet high in fruit and fiber may help. 40

Shortness of Breath: This is caused by the top of the uterus pushing against the diaphragm causing decreased lung capacity. This can be aggravated by anemia (low hemoglobin) and smoking. To help shortness of breath, a pregnant woman should maintain good posture, avoid smoking and elevate the head of her bed at night. THE GESTATIONAL PERIOD: The 40 weeks of Pregnancy The duration of most pregnancies is about 266 days (38 weeks) from the time that fertilization occurs. However, a pregnancy is usually calculated from the first day of the woman s last menstrual period this method assumes that conception occurred two weeks from that day. By this definition, a full-term pregnancy is 280 days (40 weeks). About 85% of babies will arrive within one week before or one week after their due date. Thus, if a woman is told she is 20 weeks pregnant, her baby s developmental age is actually only 18 weeks. In a full term pregnancy there are three trimesters, each about a three month period: First trimester: Conception to 13 weeks Second trimester: 14 to 25 weeks Third trimester: 26 to 40 weeks YOUR DEVELOPING BABY The First Trimester The first trimester (or first three months; 0-13 weeks). It s a time of rapid growth and development and the woman s body adjusts to pregnancy. The choices a woman makes about her health and lifestyle will affect both herself and her unborn baby. By the end of this trimester, the baby is about 9 cm long and weighs about 48 grams. The fingers, toes and lungs are developed. Refer to TEACHER S RESOURCE: HEALTHY BEGINNINGS pp. 24-25 Activity: Pregnancy and Child Birth Stages (cards located in the resource area) Divide class into 3 equal groups. 1) This activity takes up a bit of space, set group up in an area with enough space to arrange the cards. 2) Have the students arrange the stages of pregnancy in the proper sequential order. 3) The first group to correctly order the cards WINS. 4) Discuss the stages of pregnancy and child birth, trimesters The Second Trimester 14-25 weeks, 4-5 ½ months The pregnancy is now considered well established, and a woman s chance of miscarriage is therefore lower. 41

Many women enjoy this trimester The baby really looks like a baby now, as all of the body systems are developed, functioning and beginning to mature. The baby s skin is red because the blood vessels are so close to the surface. Near the end of the second trimester the baby s eyelids begin to open and close and fingernails are full length The majority of the brain s development occurs during the period from now until 18 months after birth. OVERHEAD: Pregnant Anatomy Refer to TEACHER S RESOURCE: HEALTHY BEGINNINGS pp. 50-51 The Third Trimester 26 40 weeks, 6 months until birth Towards the end of the pregnancy the woman often starts to feel anxious, tired and looks forward to having the baby. The baby is fully formed and is steadily gaining weight and growing The baby s organ systems are still growing and maturing The baby has periods of activity and rest. The lungs become capable of breathing air between 26-29 weeks There is less room in the uterus for the baby to move around The baby will weigh between 3000-4000 grams (6 ½ to 9 pounds) at birth Refer to TEACHER S RESOURCE: HEALTHY BEGINNINGS pp. 66-67 A woman s body goes through several changes during pregnancy. It is important to understand why these changes occur and how a body can support a new life. PREGNANT ANATOMY The growing baby has everything it needs to live within the uterus. It is protected in a sac filled with amniotic fluid (bag of water). Conception: The sperm enters the egg. The fertilized egg then starts to divide into more and more cells. Within 7 days implantation occurs this is when the egg buries itself into the thickened lining of the uterus. Fetus is the growing baby. From conception until approximately two weeks it is called a zygote. Then it is called an embryo until 8 weeks of pregnancy. From 8 weeks until the baby is delivered it is a fetus. 42

Amniotic Fluid is the protective fluid surrounding the fetus composed of maternal serum and fetal urine. Umbilical Cord: Is the structure that connects the placenta and the fetus. It contains two arteries and one vein encased in a tissue called Wharton s Jelly. The fetus receives nutrients from its mother and eliminates waste through this cord. The cord is cut at birth and the stump falls off within the first two weeks of life. Placenta: This specialized organ connects the mother and the fetus. It is made up of blood vessels and tissue that allows for maternal fetal gas (O 2 /CO 2 ) and nutrient exchange. It is highly vascular and is eliminated following the delivery of the fetus. It s firmly attached to the lining of the mother s uterus connecting the mother to the fetus. The placenta allows blood to pass from mother to baby allowing for the exchange of oxygen and nutrients as well as protective antibodies. On the return trip, the blood picks up fetal waste products to be transported to the mom s blood stream for removal by her organs. It also excretes hormones (progesterone and estrogen) which are responsible for the changes in a woman s body during pregnancy. HANDOUT: The Anatomy of Pregnancy Crossword. OVERHEAD: Premature Labour: Signs and Symptoms Uterus: Also called a womb. It is a hollow muscular organ that provides for implantation, the nourishment of an embryo and the expulsion of the fetus at birth. Cervix: This is the bottom portion of the uterus that opens during labour to allow for the fetus to leave the uterus and enter the birth canal/vagina. Vagina: Is the tube that connects the cervix to the outside of the body through which the baby passes during a vaginal birth. Bladder: Is the organ that holds urine. 43

Mucous Plug: Is a thick mucous that forms at the opening of the cervix canal during pregnancy. This prevents bacteria from entering the uterus. PRETERM/PREMATURE LABOUR AND BIRTH What is Premature Labour? Preterm (premature) labour is labour that starts before 37 weeks of pregnancy. Labour is a process, which happens at the end of the pregnancy. During labour, there are contractions (tightening) of the uterus (womb) which can cause the cervix (opening of the womb) to open. 6% of all births in the Niagara Region are premature. Approximately 1 in 17 babies in Niagara are born too soon. Could this happen to me? Yes, preterm labour can happen to anyone. Even if you are healthy and do all the right things, there is still a chance that preterm labour can happen to you. Some Signs & Symptoms of Premature Labour: Bad cramps or stomach pains that don t go away Bleeding, trickle or gush of fluid from your vagina Lower back pain/pressure, or a change in lower backache A feeling that the baby is pushing down Contractions, or change in the strength or number of them Significant change in your baby s movements An increase in the amount of vaginal discharge Some women may feel that something is not right Other Signs and Symptoms that Indicate the need for Medical Care: Fever, chills, dizziness, vomiting or a bad headache Blurry vision or spots before your eyes Sudden or severe swelling of your hands, feet or face What can a woman do to reduce the chances of Premature Labour? Although it is not possible to prevent all preterm (premature) labour from happening, there is still much she can do to help her baby to be born at the right time: Start seeing her doctor or midwife as early as possible in pregnancy 44

Go to prenatal classes early in pregnancy If a woman smokes, try to quit or at least cut down Pregnant women should take time to lie down or put their feet up during the day Follow Canada s Food Guide for Healthy Eating She should listen to her body notice when she feels different and talk to the doctor/midwife Recognize and learn to deal with the stress in her life Seek immediate help if she is being abused. UNIT QUIZ 45

References Best Start. (2004). Preterm labour: Signs and Symptoms. Ontario Prevention Clearinghouse. Available online at http://www.beststart.org/resources/rep_health/pdf/preterm_broch_eng_04.pdf [cited August 13, 2007]. Copeland, J. (2001). Birthpaths: A guide for your progress and comfort in labour. Kitchener: Conestoga College of Applied Arts and Technology. p.10. Health Canada. (2000). Family-Centred Maternity and Newborn Care: National Guidelines. Ottawa: Minister of Public Works and Government Services, pp. 5.19-5.20. Kitzinger, Sheila., (1994). The Complete Book of Pregnancy and Childbirth. New York: Alfred A. Knopf. Ministry of Education. (2000). The Ontario Curriculum Grades 11 and 12: Social Sciences and Humanities. Parenting Grade 11, Open. pp. 54-59. Ministry of Education. (1999). The Ontario Curriculum Grades 9 and 10: Science. Science Grade 9, Applied. pp. 15-23. Ministry of Education. (1999). The Ontario Curriculum Grades 9 and 10: Science. Science Grade 9, Academic. pp. 6-14. Simkin, P. & Ancheta, R. (2000). The Labour progress Handbook. Mass: Blackwell Science, Inc., p.173. Stone, J. & Eddleman, K. (2003). The Pregnancy Bible Your Complete Guide to Pregnancy and Early Parenthood. Buffalo: A Firefly Book. The Province of British Columbia, Ministry for Children and Families. (1998). Baby s Best Chance: Parents Handbook of Pregnancy and Baby Care, 5 th ed., Toronto: Macmillan Canada. The Society of Obstetricians and Gynaecologists of Canada (SOGC). (2005). Healthy Beginnings: Your handbook for pregnancy and birth 3rd Ed. Ottawa: ON. Library and Archives Canada Cataloguing in Publication. 46