Biological Beginnings Outline for Essentials of Life-Span Development 4th Edition
Biological Beginnings Outline for Essentials of Life-Span Development 4th Edition BS260
Butler County Community College
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2: Biological Beginnings The Evolutionary Perspective o Natural Selection and Adaptive Behavior This is the idea that as the evolutionary process by which the individuals of a species that are best adapted to the environment will produce the best offspring that is fit to survive through the next evolutionary process o Evolutionary Psychology The new approach to evolutionary psychology is the belief that those that can bear children or produce offspring will survive versus the people who cannot bear children which will not be "fit" to survive Evolutionary Developmental Psychology An extended childhood period might have evolved because humans require time to develop a large brain and learn the complexity of human societies Many of our evolved psychological mechanisms are domain-specific meaning that the mechanisms apply only to a specific aspect of a person's psychological makeup Essentially, our minds are not a general purpose device that can be applied equally to a vast array of problems but it deals with the main problem at hand (ex developing better hunting methods) Evaluating Evolutionary Psychology One sided evolutionism sees social behavior as the product of evolved biological characteristics An alternative is a bidirectional view in which environmental and biological conditions influence each other Evolutionary pressures created changes in biological structures that allowed the use of tools which enabled our ancestors to manipulate the environment constructing new environmental conditions In other words, evolution gave us bodily structures and biological potentialities but it does not dictate behavior Genetic Foundations of Development o DNA is not just inherited from our parents; it's also what we've inherited as a species from the species that came before our own o The nucleus of each human cell contains chromosomes, which are threadlike structures made up of deoxyribonucleic acid, or DNA o Genes, the units of hereditary information, are short segments of DNA o Proteins, in turn, are the building blocks of cells as well as the regulators that direct the body's processes o Genome- the complete set of developmental instructions for creating proteins that initiate the making of a human organism o Genome-wide association method- to identify genetic variations linked to a particular disease such as cancer, cardiovascular disease, or Alzheimer disease o Human Genome Project was a report indicating that humans have only about 30,000 genes but recently, studies are showing that the number of human genes has been revised down to around 20,700 o Humans appear to have far more proteins than they do genes o Instead of being a group of independent genes, the human genome consists of many genes that collaborate both with each other and with nongenetic factors inside and outside the body o Genetic expression- activity of genes is affected by the environment o Stress, radiation, and temperature can influence gene expression o Genes and Chromosomes Genes are not only collaborative; they are enduring Mitosis, Meiosis, and Fertilization Mitosis The cell's nucleus- including the chromosomes- duplicate itself and the cell divides This causes two new cells to form, each containing the same DNA as the original cell, arranged in the same 23 pairs of chromosomes Meiosis This is a type of cell division that forms eggs and sperm (gametes) A cell of the testes or ovaries duplicates its chromosomes but then divides twice, thus forming four cells Each of these cells only have half of the genetic material of the parent cell At the end of meiosis, each egg or sperm has 23 UNPAIRED chromosomes Fertilization The egg and sperm fuse to create a single cell, also known as a zygote The 23 unpaired chromosomes from the egg and the 23 unpaired from the sperm combine to form a set of 23 paired chromosomes Each parent is half of the offspring's genetic material In females, there is often a pair of chromosomes called X chromosomes In males, the 23rd pair consists of an X chromosome and a Y chromosome Y chromosome makes offspring male Sources of Variability The chromosomes in the zygote are not exact copies of those in the mother's ovaries and the father's testes Chance events, a mistake by the cellular machinery, or damage caused by an environmental agent such as radiation may produce a mutated gene (a permanently altered segment of DNA) Genotypes All of a person's genetic materials Susceptibility genes Those that make an individual more vulnerable to specific diseases or acceleration of aging Longevity genes These make an individual less vulnerable to certain diseases and more likely to live to an older age Phenotype Consists of observable characteristics including physical characteristics (such as height, weight, and hair color) and psychological characteristics (such as a personality and intelligence) For each genotype, a range of phenotypes can be expressed providing another source of variability o Genetic Principles Dominant and Recessive Genes Dominant-and-recessive gene principle Dominant gene This gene overrides the potential influence of the other gene Recessive gene This will only be effective if the two genes of a pair are both recessive Sex-Linked Genes X-linked inheritance This is when a mutated gene is carried on the X-chromosome Because males only have one X-chromosome, if their X-chromosome carries a disease, they have no backup and can develop an X-linked disease Females have two X-chromosomes so they are less likely to develop this disease but may be carriers Polygenic Inheritance Polygenic These are characteristics that reflect the influence of many different genes that have interacted Gene-gene interaction This is a term used to describe studies that focus on the interdependence of two or more genes in influencing characteristics, behaviors, diseases, and/or development o Chromosome- and Gene-Linked Abnormalities Chromosome Abnormalities Down Syndrome Due to an extra chromosome, there are mild to severe intellectual disabilities and physical abnormalities This can be treated with surgery, early intervention, infant stimulation, and special learning programs You can find the incidence numbers in Figure 2.4 on page 42 Klinefelter Syndrome (XXY) This is an extra X-chromosome causing physical abnormalities An effective treatment would be hormone therapy Fragile X Syndrome Due to an abnormality in the X-chromosome, there can be intellectual disabilities, learning disabilities, and even cause a short attention span Treatment would include special education and speech and language therapy Turner Syndrome (XO) This happens when there is a missing X-chromosome in females and it can cause intellectual disabilities and sexual underdevelopment Treatment would include hormone therapy in childhood and puberty XYY Syndrome This is caused by an extra Y-chromosome and can cause an above average height There is no special treatment required Gene-Linked Abnormalities Cystic Fibrosis This is a glandular dysfunction that interferes with mucus production This messes with breathing and digestion, thus resulting in a shortened life span Diabetes This is where the body doesn't produce enough insulin This can cause abnormal metabolism of sugar Early type-1 onset can be fatal unless treated with insulin Hemophilia This is delayed blood clotting It causes internal and external bleeding It can be treated with blood transfusions/injections which will reduce or prevent damage Huntington Disease This is where the central nervous system deteriorates, producing problems in muscle coordination and mental deterioration Because it doesn't typically appear until around the age of 35 or older, death is likely to occur 10 to 20 years after the first symptoms appear Phenylketonuria (PKU) This is a metabolic disorder that if ignored can cause intellectual disability A special diet, used to treat this abnormality, can result in average and normal life span Sickle-cell Anemia This is a blood disorder that limits the body's oxygen supply It can cause joint swelling as well as a potential for heart and kidney failure Penicillin, medication for pain, antibiotics, and blood transfusions can be used as treatment Spina Bifida This is a neural tube disorder that causes brain and spine abnormalities A treatment would involve corrective surgery at birth, orthopedic devices, and physical/medical therapy Tay-Sachs Disease This is a deceleration of mental and physical development It is caused by an accumulation of lipids in the nervous system It can be treated with medication and special diet Unfortunately, death is likely by 5 yrs of age The Interaction of Heredity and Environment: The Nature-Nurture Debate o Behavior Genetics This is the field that seeks to discover the influence of heredity and environment on individual differences in human traits and development Example: twin study The behavioral similarities between identical twins is compared with those between fraternal twins Example: adoption study Investigators wanted to know whether the behavior and psychological characteristics of adopted children were more like those of the adoptive parents or those of the biological parents o Heredity-Environment Correlations Passive Genotype-environment correlations These occur due to biological parents providing a rearing environment for the child Evocative genotype-environment correlations These occur due to a child's characteristics eliciting certain types of environments Active (niche-picking) genotype-environment correlations These occur due to children seeking out environments that they find compatible and stimulating o The Epigenetic View and Gene x Environment (G x E) Interaction The Epigenetic View This states that development is the result of an ongoing, bidirectional interchange between heredity and the environment Gene x Environment (G x E) Interaction This is the interaction of a specific measured variation in DNA and a specific measured aspect of the environment o Conclusions about Heredity - Environment Interaction The most accepted vies is that complex behaviors are influenced by genes in ways that give people a propensity for a particular developmental trajectory In terms of development, the individual requires a particular environment that is more complex, just like the mixture of genes we inherit Environmental influences (nurture) Culture Parenting Family dynamics Schooling Neighborhood quality Biological encounters Viruses Birth complications Biological events in cells Prenatal Development o The Course of Prenatal Development The Germinal Period This is the period of development that takes place in the first two weeks after conception This includes the creation of the zygote, cell division, and the attachment of the multicellular organism to the uterine wall One week after conception The specialization for different tasks of the cells has begun and the organism is now called the blastocyst The blastocyst consists of a hollow ball of cells that eventually develop into the embryo Trophoblast This is the outer layer of cells that later provides nutrition and support for the embryo Implantation This is the embedding of the blastocyst in the uterine wall and this will take place sometime in the second week after conception The Embryonic Period This is the period of prenatal development that occurs from two to eight weeks after conception Now, we call the mass of cells an embryo The embryo consists of three layers The endoderm This is the inner layer of the cell which will develop into the digestive and respiratory cells Mostly internal body parts The ectoderm This is the outermost later which will become the nervous system, sensory receptors, and skin parts Mostly surface parts The mesoderm This is the middle layer which will become the circulatory system, bones, muscles, excretory system, and reproductive system Mostly parts that surround the internal areas Embryo's three layers These form the life-support systems for the embryo development Systems include the amnion, umbilical cord, and the placenta Amnion It's like a bag or envelope containing a clear fluid in which the developing embryo floats It also contains a fluid, known as the amniotic fluid which will provide an environment that is temperature and humidity-controlled as well as shockproof Umbilical cord This typically contains two arteries and one vein and connects the baby to the placenta Placenta This consists of a disk-shaped group of tissues in which small blood vessels from the mother and the offspring intertwine but don't join The Fetal Period This period lasts about 7 months It's the prenatal period that extends from two months after conception until birth in typical pregnancies Three months after conception (12 weeks), the fetus is about 3 inches long and weighs about 1 ounce. It has become active, moving around it's arms, legs, and head, as well as opening and closing it's mouth About now is when most features such as the face, forehead, eyelids, nose, chin, upper arms, lower arms, hands, and lower limbs can easily be distinguished In most cases, genitals can be identified, proving the fetus to be male or female By the end of the 4th month of pregnancy (16 weeks), the fetus is about 6 inches in length and will weigh approximately 4 to 7 ounces A growth spurt is now occurring in the body's lower parts For the first time, mom's can often feel the movement of the arms and legs By the end of the 5th month of pregnancy (20 weeks), the fetus is about 12 inches long and weighing around a pound Skin structures have formed, including toenails and fingernails The fetus is much more active By the end of the 6th month of pregnancy (24 weeks), the fetus is about 14 inches long and gained around 6 to 12 more ounces Eyes and eyelids are completely formed and a fine layer of hair covers the head The grasping reflex is now present and irregular breathing movements may occur During this time, the fetus has a chance of surviving outside the womb (this means it is viable) By the end of the 7th month of pregnancy (28 weeks), the fetus is about 16 inches long and weighs about 3 pounds It is adding body fat During the last two months of prenatal development, fatty tissues develop and the functioning of various organ systems step up During the 8th (32 weeks) and 9th (36 to 38 weeks) month of pregnancy, the fetus grows longer and gains substantial weight (approximately 4 more pounds) At birth, the average American baby is around 20 inches long and about 7.5 pounds Not only can pregnancy be broken down into prenatal development, it can also be broken down into trimesters Figure 2.8 on page 51 of the textbook has broken this down the trimesters for us The Brain By the time the baby is born, it has around 100 billion neurons, which are nerve cells During prenatal development, the neurons will move to specific locations and become connected The basic architecture of the brain is actually assembled during the first two trimesters of prenatal development Four important phases of the brain's development during the prenatal period involve the: (1) formation of the neural tube (2) neurogenesis (3) neural migration (4) neural connectivity As the embryo is developing, the nervous system begins to form as a long hollow tube located on the embryo's back It's a pear shaped neural tube This forms at about 18 to 24 days after conception and develops outside of the ectoderm The tube closes at the top and bottom ends at about 24 days after conception and still has a tubular appearance 6 weeks after conception There are two birth defects related to a failure of the neural tube to close which would be anencephaly and spina bifida Anencephaly This is when the head end of the neural tube doesn't close The highest regions of the brain will fail to develop and the baby dies in the womb, during child birth, or shortly after birth Spina bifida This is the incomplete development of the spinal cord This may result in varying degrees of paralysis of the lower limbs Both obesity and diabetes place the fetus at risk for developing neural tube defects In a normal pregnancy, once the neural tube has closed, a massive proliferation of new immature neurons begins to take place about the fifth prenatal week and will continue throughout the remainder of the prenatal period This is called neurogenesis As many as 200,000 neurons are being generated Around 6 to 24 weeks after conception, neural migration occurs This is when cells begin moving outward from their point of origin to their appropriate locations and creating the different levels, structures, and regions of the brain Once migrated to its target destination, it has to mature and develop a more complex structure At about the 23rd prenatal week, connections between neurons begin to form This process continues postnatally o Prenatal Tests Ultrasound Sonography This is generally performed 7 weeks into a pregnancy and at various times during the pregnancy This is a noninvasive prenatal medical procedure High frequency sound waves are directed into the pregnant woman's abdomen and the echo from the sounds is transformed into a visual representation of the fetus's inner structures It can easily detect structural abnormalities in the fetus There is no risk to the woman or fetus when this technique is used Chorionic Villus Sampling This is done between the 10th and 12th weeks of pregnancy and it may be used to screen for genetic defects and chromosome abnormalities Chorionic villus sampling (CVS) This is a prenatal medical procedure in which a tiny tissue sample from the placenta is removed and analyzed Results would typically be available in about 10 days Amniocentesis This would be preformed between the 15th and 18th week of pregnancy Amniotic fluid is withdrawn by syringe and is tested for chromosomal or metabolic disorders The earlier it is performed, the more useful it is in deciding how to handle a pregnancy when the fetus is found to have a disorder This does bring a small risk of miscarriage, about 1 woman in every 200 to 300 miscarries after having this performed Maternal Blood Screening This would be performed between the 16th and 18th weeks of pregnancy This identifies pregnancies that have an elevated risk for birth defects The current blood test is called a triple screen It measures three substances in the mother's blood If shown up abnormal, the next step is usually an ultrasound examination If the ultrasound doesn't show why there was an abnormal triple, amniocentesis is then used Fetal MRI This is used to diagnose fetal malformations MRI stands for magnetic resonance imaging This uses a powerful magnet and radio images to generate detailed images of the body's organs and structures Ultrasounds are preferable but if there appears to be something wrong, then a fetal MRI is performed Fetal Sex Determination Chorionic villus sampling has often been used to determine the sex of the fetus at some point between 11 and 13 weeks of gestation A meta-analysis of studies confirmed that a baby's sex can be detected as early as 7 weeks into pregnancy o Hazards to Prenatal Development General Principles Teratogen This is any agent that can potentially cause a birth defect or negatively alter cognitive and behavioral outcomes These include drugs, incompatible blood types, environmental pollutants, infectious diseases, nutritional deficiencies, maternal stress, advanced maternal and paternal age, and environmental pollutants Teratology This is the field of study that investigates the causes of birth defects The dose, genetic susceptibility, and time of exposure to a particular teratogen would influence both the severity of the damage and the type of defect to an embryo or fetus Dose The greater the dose of an agent, or drug, creates a greater effect Genetic susceptibility The type or severity of the abnormality caused is linked to the genotype of the pregnant woman and the genotype of the embryo or fetus Time of exposure They will do more damage when they occur at some points in development than at others The probability of a structural defect is greatest early in the embryonic period This is when the organs are being formed After organogenesis is complete, teratogens are less likely to cause anatomical defects Exposure during the fetal period would more likely stunt growth or create problems in the ways organs function Prescription and Nonprescription Drugs These would include antibiotics Such as streptomycin and tetracycline Some antidepressants Certain hormones These would include progestin and synthetic estrogen Accutane Nonprescription drugs that would be harmful Diet pills and Aspirin Low doses of aspirin pose no harm to the fetus but high doses could contribute to maternal and fetal bleeding Psychoactive Drugs These kinds of drugs act on the nervous system to alter states of consciousness, modify perceptions, and change moods Caffeine This is often consumed by drinking coffee, tea, or sodas and possibly by eating chocolate High consumption of energy drinks hasn't been studied yet Alcohol Fetal alcohol spectrum disorders (FASD) This is a cluster of abnormalities and problems that appear in the offspring of mothers who drink alcohol heavily during pregnancy These defects include Facial deformities Defective limbs, face, and heart Most children with FASD have learning problems and/or are below average in intelligence and/or have an intellectual disability These children have deficiencies in the brain pathways involved in working memory Drinking one or two servings of beer or wine or a serving of hard liquor a few days a week can have negative effects on the fetus A popular belief would say that this level of alcohol use won't cause FASD Nicotine Cigarette smoking by pregnant woman can also influence prenatal development, birth, and postnatal development Preterm births, low weights, fetal and neonatal deaths, respiratory problems,, sudden infant death syndrome, and cardiovascular problems are common among offspring of mothers smoking during pregnancy 25% of infants are born with a low birth weight due to prenatal smoking Smoking is also a risk factor for the development of ADHD in children Environmental tobacco smoke is linked to an increased risk of low birth weight in offspring as well as diminished ovarian functioning in female offspring Another study found that environmental tobacco smoke was associated with 114 deregulations, especially those involving immune functioning, in the fetal cells of offspring There is also increased risk of stillbirth for mothers with exposure to environmental tobacco smoke during the prenatal development Cocaine Cocaine will quickly cross the placenta and reach the fetus Cocaine exposure during the prenatal development is also associated with a low birth weight, low birth length, and low birth head circumference It has also been linked to lower arousal, less effective self- regulation, higher excitability, and lower quality of reflexes once they are at the age of 1 years old. There is impaired motor development at 2 years old Slower rate of growth through 10 years of age Increased behavioral problems High rates of aggression and delinquency Increased likelihood of being in special education that involves support services Likely to have neurological, medical, and cognitive deficits Marijuana Prenatal exposure is often related to lower intelligence in children Linked to marijuana use at 14 years old Use is also associated with stillbirth Heroin Mothers of children that are addicted to heroin often have children that show behavioral difficulties at birth Withdrawal symptoms Tremors Irritability Abnormal crying Disturbed sleep Impaired motor control Many still show behavioral issues at their first birthday and have attention deficits may appear later in their development Environmental Hazards Some hazards to the embryo or fetus would include radiation, toxic wastes, and other environmental pollutants X-ray radiation can affect the developing embryo or fetus especially in the first few weeks after conception If there is an X-ray done, as long as the abdomen is being protected by a lead apron, it is generally safe Maternal Diseases This can produce defects in offspring by crossing the placental barrier or even cause damage during birth Rubella (German measles) is one disease that can cause prenatal defects If a woman wants to try to become pregnant, it is recommended that they have a blood test Syphilis is more damaging later in prenatal development (this is four months or more after conception) Damages would include eye lesions which would lead to blindness and skin lesions Genital herpes This can be contracted when the newborn is delivered through the birth canal 1/3 of babies delivered though an infected birth canal die 1/4th suffer brain damage It is best if the woman has a c-section AIDS is an STI caused by HIV, which will destroy the body's immune system A mother can infect her child in three ways Across the placenta during gestation Through contact with maternal blood or fluids during delivery Breast feeding Babies born to HIV-infected mothers can be… Infected and symptomatic, this means that they show HIV symptoms Infected but asymptomatic, this means that they do not show HIV symptoms Not infected at all An infant who is infected and asymptomatic may still develop HIV symptoms up to 15 months of age Other Parental Factors Maternal diet and nutrition A developing fetus or embryo is completely reliant on its mother for nutrition, which comes from the mother's blood Nutritional status of the embryo or fetus is determined by: Total caloric intake Intake of proteins Intake of vitamins Intake of minerals Children born to malnourished mothers would be more likely to be malformed than those that are born to healthy mothers Maternal obesity also effects pregnancy outcomes through increased rates of hypertension, diabetes, respiratory complications, and infections in the mother Obesity is associated with an increased risk of preterm birth, cardiovascular disease, and type 2 diabetes in the adolescent and adult offspring It is also linked to an increase in stillbirth and increased likelihood that the newborn would be placed in a neonatal intensive care unit Maternal nutrition that is important for normal prenatal development includes folic acid, which is a B-complex vitamin A lack of folic acid is related to neural tube defects in offspring It is recommended that pregnant women consume a minimum of 400 micrograms of folic acid per day Orange juice and spinach are examples of foods with high folic acid Fish is typically recommended as a part of a healthy diet but beware, pollution has made many kinds of fish risky to eat during pregnancy Some fish contain high levels of mercury Mercury that falls into the water can accumulate in large fish such as shark, swordfish, king mackerel, and some species of large tuna Because mercury is easily transferred across the placenta, it is best to avoid this because the embryo's developing brain and nervous system are highly sensitive to the metal There have been some outcomes including miscarriage, preterm birth, and lower intelligence Maternal age Adolescent mothers, as well as mothers aged 35 and older, are of special interest when looking at maternal age Mortality rate of infants born to adolescent mothers is double that of infants born to mothers in their 20's Adequate prenatal care decreases the probability that a child born to an adolescent girl will have physical problems However, they are the least likely to obtain prenatal assistance from clinics and health services Maternal age has also been found to have a link in the risk of a child having Down syndrome It is rare for a child to be born with Down syndrome to a mother 16 to 34 years of age Once a mother reaches 40 years old, the probability is slightly higher than 1 in 100 that a baby born to her will have Down syndrome and by age 50, it is almost 1 in 10 Mothers that are 35 and older also have increased risk for low birth weight, preterm delivery, and fetal death Emotional states and stress Any kind of negative moods, anxieties, physiological changes, or intense fears can affect the mother's fetus There is an increased likelihood of mothers experiencing this to engage in unhealthy behaviors High levels of depression, anxiety, and stress during pregnancy are linked to internalizing problems in adolescence Pregnant women with high levels of stress are at increased risk for having a child with emotional or cognitive problems, ADHD, and language delay Maternal depression during pregnancy was associated with low birth weight in full-term offspring Maternal stressful life events prior to conception increased the risk of having a very low birth weight infant Paternal factors Men's exposure to lead, radiation, certain pesticides, and petrochemicals could cause abnormalities in sperm that would lead to miscarriage or diseases such as childhood cancer Smoking during the mother's pregnancy could also cause problems for the offspring Another would be an increased risk of early miscarriage This could be related to the mother being exposed to the second hand smoke Smoking around the time of the child's conception was also linked to an increased risk of the child developing leukemia If the father is 40 years old or older, there is an increased risk of spontaneous abortion, autism, and schizophrenic disorders o Prenatal Care This involves a defined schedule of visits for medical care and often include comprehensive educational, social, and nutritional services This is also very important for women in poverty an immigrant women because it will link them with other social services Some prenatal programs for parents focus on home visitation Use of this is associated with reduced risk of low birth weight Nurse-Family Partnership This involves home visits by trained nurses beginning in the second or third trimesters of prenatal development There is approximately 50 home visits beginning and during this period and extend through the child's first two years This has lead to better work circumstances, fewer pregnancies, stability in relationship partners for the mother, and improved academic success and social development for the child Exercise during pregnancy helps prevent constipation, conditions the body, reduces excessive weight gain, and is associated with a more positive mental state This improved the mother's perception of their health 12 weeks of twice weekly yoga or massage therapy have shown greater decrease in depression, anxiety, and back and leg pain than a control group Reduced risk of cesarean delivery Birth and the Postpartum Period o The Birth Process Stages of Birth First stage Longest stage Uterine contractions are 15 to 20 minutes apart and last about a minute in the beginning Each contraction cause the woman's cervix to stretch and open As time goes on, contractions get closer together occurring every 2 to 5 minutes Intensity increased Then, contractions dilate the cervix to an opening of about 10 centimeters (4 inches) so that the baby can move from the uterus to the birth canal This lasts an average of 6 to 12 hours for first time mothers but shorter for those that have experienced it before Second birth stage The head begins to move through the cervix and the birth canal It ends when the baby completely emerges from the mother's body When the head is out of the mother's body, the contractions come almost every minute and last for about a minute This lasts for about 45 minutes to an hour Afterbirth (third stage) Placenta, umbilical cord, and other membranes are detached and expelled Childbirth Setting and Attendants Some women give birth at hospitals, home, or birthing centers Midwives This person provides health care to women during pregnancy, birth, and postpartum period They may give women information about reproductive health and annual gynecological examinations or refer women to general practitioners or obstetricians if a pregnant woman needs medical care beyond a midwife's expertise and skill Doulas They attend a pregnant woman They are a caregiver who provides continuous physical, emotional, and educational support for the mother before, during, and after childbirth They remain with the parents throughout labor, assessing and responding to their needs Methods of Childbirth Medication Analgesics This includes tranquilizers, barbiturates, and narcotics such as Demerol Anesthesia This is used in late first stage labor and during delivery to block sensation in an area of the body or to block consciousness It is a little iffy because it could be transmitted through the placenta to the fetus Epidural block This is a regional anesthesia that numbs the woman's body from the waist down Natural and Prepared Childbirth This is a method in which no drugs are given to relieve pain or assist in the birth process Women are taught to use breathing methods and relaxation techniques during pregnancy Lamaze Prepared childbirth This is a special breathing technique to control pushing in the final stages of labor and provides more detailed education about anatomy and physiology In this method, the pregnant woman's partner acts as a coach as well as attends the child birth classes with her and helps her with her breathing and relaxation during delivery Other Nonmedicated Techniques to Reduce Pain Water birth This involves giving birth in a tub of warm water Some women go through labor in the water and get out for delivery while others remain in the water for delivery The thought behind it? The baby has been in an amniotic sac for many months and that delivery in a similar environment is likely to be less stressful for the baby and the mother This is linked with a shorter second stage of labor Massage This is used during pregnancy, labor, and delivery It concluded that massage therapy reduced pain during labor Acupuncture This is the insertion of very fine needles into specific locations in the body Cesarean Delivery Breech position This in when the buttocks are the first part to emerge from the vagina 1 of every 25 deliveries, the baby's head is still in the uterus when the rest of the body is out Babies born in breech position can have respiratory problems Cesarean delivery The baby is removed from the uterus through an incision made in the mother's abdomen o The Transition from Fetus to Newborn If the delivery takes too long, the baby can develop anoxia This is a condition in which the fetus or newborn has an insufficient supply of oxygen This can cause brain damage Almost immediately after birth, a newborn is taken to be weighed, cleaned up, and tested for signs of developmental problems that might require urgent attention Apgar Scale This is used to assess the health of newborns at one and five minutes after birth It evaluates the heart rate, respiratory effort, muscle tone, body color, and reflex irritability The nurse now gives the newborn a score A score of 7-10 indicates that the newborn's condition is good A score of 5 indicates that there may be developmental difficulties A score of 3 or below signals an emergency and warns that the baby might not survive o Low Birth Weight and Preterm Infants Low birth weight Weigh less than 5 pounds at birth Very low birth weight Weigh under 2 pounds Preterm Born three weeks or more before the pregnancy has reached its full term Small for gestational age infants Birth weight that is below normal when the length of the pregnancy is considered They weigh less than 90 percent of all babies of the same gestational age They also have a 400% greater risk of death Incidence and Causes of Low Birth Weight Preterm babies are also low birth weight babies India and Sudan Poverty is rampant and the health and nutrition of mothers are poor They have as high as a 31% low birth weight rate United States There has recently been an increase in low birth weight infants in the last two decades Sweden, Finland, Norway, and Korea As little as 4% low birth weight rate New Zealand, Australia, and France As little as 5% low birth weight rate A recent meta-analysis found that among women with preterm birth and a singleton pregnancy, progestin treatment reduced subsequent preterm birth by 22% and neonatal death by 42% Progestin did not prevent preterm birth and neonatal death in multiple gestations Consequences of Low Birth Weight Preterm and low birth weights are healthy but as a group, have more health and developmental problems than normal birth weight females The number and severity of these problems increase when they are born very early and as their birth weight decreases Survival rates for babies born very early and very small are rising but with this, those that survive have increased rates of severe brain damage Extremely preterm infants These are born less than 28 weeks preterm Very preterm infants These are born at less than 33 weeks of gestational age Low birth weight children are more likely than their normal birth weight counterparts to develop a learning disability, ADHD, autism spectrum disorders, breathing problems such as asthma, and autism Very preterm, low birth weight infants had abnormal axon development in their brain and impaired cognitive development at 9 years of age About 50% of all low birth weight children are enrolled in special education programs Nurturing Low Birth Weight and Preterm Infants Kangaroo care This involves skin-to-skin contact in which the baby, wearing only a diaper, is held upright against the parent's chest This is most commonly practiced 2 to 3 hours per day over an extended time in early infancy Why use kangaroo care? Preterm infants often have difficulty coordinating their breathing and heart rate, and the close physical contact with the parent provided by kangaroo care can help stabilize the preterm infant's heartbeat, temp, and breathing They are also shown to gain more weight than those preterm that didn't experience kangaroo care Those that experienced kangaroo care for 16 weeks had more complex electroencephalogram (EEG) patterns, which reflects neurological maturation, at 40 weeks of age than preterm infants who did not receive kangaroo care Massage therapy This consists of firm stroking with the palms of the hands was given three times per day for 15 minute periods to preterm infants Massage therapy led to 47% greater weight gain than did standard medical treatment They were also more active and alert than preterm infants who were not massaged This was found to increase weight gain and the baby was discharged from the hospital 3 to 6 days earlier o Bonding Bonding Formation of a connection, especially a physical bond between parents and the newborn in the period shortly after birth Anesthesia given to the mother during delivery would make the mother drowsy, interfering with her ability to respond to and stimulate the newborn Some physicians believe that during the "critical period" shortly after birth the parents and newborn need to form an emotional attachment as a foundation for optimal development in years to come Rooming-in arrangements This is when the baby remains in the mother's room most of the time during its hospital stay o The Postpartum Period This is the period after childbirth or delivery that lasts for about six weeks or until the mother's body has completed its adjustment and has returned to a nearly prepregnant state Physical Adjustments After delivery, the mother's body undergoes sudden and dramatic changes in hormone production The placenta is delivered causing the levels of estrogen and progesterone to drop and remain low until the ovaries begin to produce hormones again Involution This is the process by which the uterus returns to its prepregnant size five or six weeks after birth After giving birth, the uterus weights 2 to 3 pounds By the end of five or six weeks, the uterus weighs around 2 to 3.5 ounces In order to speed up the process of the weight dropping, nursing the baby helps Emotional and Psychological Adjustments Postpartum blues Two to three days after birth, mothers begin to feel depressed, anxious, and upset These feelings may last for several months after the birth, typically peaking about three to five days after birth Postpartum depression This involves a major depressive episode that typically occurs about four weeks after delivery Some moms have such strong feelings of sadness, anxiety, or despair that for at least a two-week period they have trouble coping with their daily tasks Without treatment, the depression may become worse and last for many months Surprisingly, many women don't report having these feelings Risk factors for developing postpartum depression A history of depression Depression and anxiety during pregnancy Neuroticism Low self-esteem Postpartum blues Poor marital relationship Low level of social support History of physical abuse Migrant status Potential risk factors for postpartum depression Perinatal-related stressors such as perinatal complications, infant health and temperament, and type of delivery Several antidepressant drugs are effective in treating postpartum depression and appear to be safe for breast feeding women Psychotherapy, especially cognitive therapy, also is an effective treatment of postpartum depression for many women Regular exercise can help as well Can postpartum depression affect the way she interacts with her infant? Yes! Some caregiving activities are compromised which include feeding, sleep routines, and safety practices Fathers can also undergo considerable adjustment in the postpartum period, even when they work away from home all day Some feel that the baby comes first and gets all of the mother's attention Some feel that they are being replaced by the baby