Instructor Resource

Kuther, Lifespan Development: Lives in Context, 3e

SAGE Publishing, 2023

Lecture Notes
Chapter 3: The Prenatal Period, Birth, and the Newborn
Learning Objectives
3-1 Describe the three periods of prenatal development.

3-2 Explain how exposure to teratogens and other environmental factors can influence the
prenatal environment.

3-3 Compare the influence of maternal and paternal characteristics on prenatal

development.

3-4 Identify barriers to prenatal care and intersectional influences on access to prenatal
care.

3-5 Summarize birth options and the process of childbirth.

3-6 Examine risks for low birth weight, characteristics of low birth weight infants, and ways
of supporting positive outcomes of low birth weight infants.

3-7 Discuss the neonate’s physical capacities.

Annotated Chapter Outline

I. Prenatal Development
A. Neonate: A newborn.
B. Conception
i. Women can only conceive during a short time, aligning with the 28-day cycle.
ii. A man’s testes produce millions of sperm every day.
iii. Sperm are guided by the heat of an expectant ovum.
iv. Zygote: Contains 46 chromosomes at the moment of conception, half from the
ovum and half from the sperm.
C. Germinal Period (0 to 2 Weeks)
i. Germinal period: The newly created zygote begins cell division as it travels down
the fallopian tube toward the uterus.
ii. Cell differentiation begins at 72 hours after fertilization.
iii. Blastocyst: A fluid-filled sphere with cells forming a protective circle around an
inner cluster of cells form which the embryo will develop.
iv. Implantation: When the blastocyst burrows into the wall of the uterus, beginning
at day 6 and ending at day 11.
D. Embryonic Period (3 to 8 Weeks)
i. Embryo: The developing organism after implantation.
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Kuther, Lifespan Development: Lives in Context, 3e
SAGE Publishing, 2023
ii. Support structures form as the embryo develops.
iii. Amnion: A membrane that holds amniotic fluid.
iv. Placenta: A principal organ of exchange between the mother and developing
organism.
v. Neural tube: Begins to form after 22 days after conception and will develop into
the central nervous system.
vi. Webbed fingers and toes become apparent during the seventh week.
vii. All of the basic organs and body ports have been poorly formed 8 weeks after
conception.
E. Fetal Period (9 Weeks to Birth)
i. Fetal period: The organism grows rapidly, and its organs become more complex
and begin to function.
ii. Fetus: The organism’s new name during the fetal period.
iii. Limb movements become coordinated in the 14th week.
iv. Lanugo: The fine down-like hair that covers a fetus’s body.
v. Vernix caseosa: Greasy material that protects the fetal skin from abrasions.
vi. The fetal body grows substantially during the last three months of pregnancy.
vii. The age of viability: The age at which advanced medical care permits a preterm
newborn to survive outside the womb.
viii. The age of viability is usually about 22 weeks after conception.
II. Environmental Influences on Prenatal Development
A. Teratogen: An agent, such as disease, drug, or other environmental factor, that disrupts
prenatal development.
B. Principles of Teratology
i. Critical Periods
a. There are certain points in which the developing organism is more
susceptible to damage from teratogens.
b. The embryo is most sensitive during the embryonic period.
ii. Dose
a. Dose level influences a teratogen’s effects.
b. Longer amount of time and the greater the dose may have a bigger
impact.
iii. Individual Differences
a. Vulnerability may vary with genetics.
b. Genetic makeup of mother and prenatal environment can affect the
likelihood of teratogens.
iv. Complicated Effects
a. A variety of birth defects can result from the same teratogen.
b. Sleeper effects: Detrimental outcomes of exposure to teratogens and
early risks that appear only later in development.
C. Types of Teratogens
i. Prenatal development can be influenced by many factors.
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Kuther, Lifespan Development: Lives in Context, 3e
SAGE Publishing, 2023
ii. Almost no pregnancy is free from teratogens.
iii. Prescription and Nonprescription Drugs
a. More than 90% of pregnant women take OTC medications.
b. Isotretinoin is associated with miscarriage and severe abnormalities.
c. While nonprescription drugs are less researched, they can also have
effects.
d. Caffeine is the most common OTC drug taken during pregnancy, but its
effects are unclear.
iv. Alcohol
a. Alcohol abuse is the leading cause of developmental disabilities in
newborns.
b. Fetal alcohol spectrum disorders: The continuum of effects of exposure
to alcohol, which vary with the timing and amount of exposure.
c. Fetal alcohol syndrome (FAS): A cluster of defects appearing after
heavy prenatal exposure to alcohol.
d. Moderate drinking can be harmful to development.
v. Cigarette Smoking and E-Cigarette Use
a. Fetal deaths and other issues are 1.5 to 3 times more frequent in
mothers who smoke.
b. There is no research to support the idea that e-cigarettes are healthier
than regular cigarettes.
vi. Marijuana
a. There are few long-term studies on the effects of marijuana on
development.
b. Exposure to THC may lead to developmental delays.
vii. Cocaine
a. Prenatal exposure to cocaine leads to a variety of issues, including
impaired motor skills and reduced brain volume.
b. Research suggests subtler long-term effects to cocaine exposure.
c. Peer substance abuse and depression are more likely to lead to cocaine
usage than prenatal exposure.
viii. Opioids
a. Prenatal exposure to opioids poses serious risks to development.
b. Children exposed to opioids perform more poorly than their peers.
ix. Maternal Illness
a. Maternal illnesses, such as rubella, can cause a variety of serious
consequences.
b. HIV can be transmitted during birth.
c. Women of color and those in poverty are less likely to receive HIV
treatment.
d. Treatments for HIV are lowest in developing countries where
interventions are unavailable.
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Kuther, Lifespan Development: Lives in Context, 3e
SAGE Publishing, 2023
x. Environmental Hazards
a. Prenatal exposure to various chemicals and pollution can impair
development.
b. Exposure to radiation can cause mutations.
D. Contextual Factors and Teratogens
i. It is important to take a look at an intersectional perspective, as infants are often
exposed to multiple teratogens.
ii. Many states view maternal substance use as fetal abuse.
iii. Policies criminalizing substance abuse affect women of color and low-income
families the most.
iv. Criminal sanctions can discourage women from seeking essential prenatal care.
v. Poverty, inconsistent parenting, and stress also interact with prenatal exposure
to teratogens.
III. Maternal and Paternal Characteristics and Prenatal Development
A. Maternal Characteristics
i. Nutrition
a. The quality of diet influences the health of the sperm and egg.
b. Fetal malnutrition can lead to poor growth before and after birth.
c. Spina bifida: Occurs when the lower part of the neural tube fails to
close and spinal nerves begin to grow outside of the vertebrae, often
resulting in paralysis.
d. Anencephaly: A neural tube defect that occurs when the top part of the
neural tube fails to close and all or part of the brain fails to develop,
resulting in death shortly after birth.
ii. Emotional Well-Being
a. Exposure to chronic stress during pregnancy poses many risks for
prenatal development.
b. Stress hormones raise the fetus’ heart rate and activity level.
c. Emotional problems in infancy, childhood, and adolescence are
associated with maternal prenatal anxiety.
d. Contextual factors affect the reaction to stress from children, including
poverty and racism.
iii. Maternal Age
a. Many women are becoming pregnant later in life, which can cause risks
for the newborn.
b. The majority of women over 35 give birth to healthy children.
B. Paternal Characteristics
i. Fathers primarily influence the home context.
ii. Advanced paternal age likely leads to a greater risk of birth defects.
iii. Fathers and mothers pass on epigenetic markers that influence the health of
their offspring.
IV. Contextual and Cultural Influences on Prenatal Care
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Kuther, Lifespan Development: Lives in Context, 3e
SAGE Publishing, 2023
A. Prenatal care: A set of services provided to improve pregnancy outcomes and engage
the expectant mother, family members, and friends in health care decisions.
B. Barriers to Prenatal Care
i. 25% of women do not receive prenatal care until after the first trimester.
ii. Women often do not seek prenatal care due to a lack of insurance.
C. Race, Ethnicity, and Prenatal Care
i. Prenatal care is closely linked with education.
ii. There is a strong connection between low socioeconomic status and poor birth
outcomes.
iii. Protective cultural factors and strong social support systems, as seen in Latina
women, often contribute to positive birth outcomes.
iv. These ideas lessen when Latina women acculturate to American society.
v. It is important to think of intersectionality when discussing barriers to prenatal
care.
V. Childbirth
A. Labor
i. The first stage of labor is the longest and is known as dilation.
ii. Amniotic sac: A membrane containing the fetus surrounded by fluid.
iii. The second stage begins when the cervix is fully dilated and is known as delivery.
iv. The third stage occurs when the placenta separates from the uterine wall and is
expelled by contractions.
B. Medication During Delivery
i. 80% of births involve some kind of medication.
ii. Several types of epidurals exist that reduce pain but lengthen delivery.
iii. Proper administration of medication poses few risks to a newborn.
C. Cesarean Delivery
i. Breech position: A position in which the baby is facing feet-first and poses a risk
to the health of the baby.
ii. Cesarean section: A surgical procedure that removes the fetus from the uterus
through the abdomen.
iii. 32% of U.S. births involve a C-section.
D. Natural Childbirth
i. Natural childbirth: An approach to birth that reduces pain through the use of
breathing and relaxation exercises.
ii. The Lamaze method is the most common and involves teaching women about
their pregnant bodies.
iii. Doula: A caregiver who provides support to an expectant mother and her partner
throughout the birth process.
E. Home Birth
i. Home births comprise 1.5% of U.S. births.
ii. A healthy woman who is not carrying twins is unlikely to encounter any
problems.
 Instructor Resource
Kuther, Lifespan Development: Lives in Context, 3e
SAGE Publishing, 2023
F. Cultural Differences in Childbirth
i. Birth is a private event in the United States, with family visiting after the birth.
ii. In Italy, birth is a community event.
iii. The Jahara of South America gives birth in front of their entire communities.
iv. In Ghana, birth is tied to social status.
v. The Maya conduct rites to protect newborns from evil spirits.
vi. The Zinacanteco place their newborns before a fire and pray to the gods for
protection.
VI. Low-Birthweight Infants: Preterm and Small-for-Date Babies
A. 8% of U.S. births involve a low birthweight.
B. Low birthweight: When babies weigh less than 5.5 pounds at birth.
C. Preterm: When babies are born before their due date/premature.
D. Small for date: Full-term babies but have experienced slow growth and are smaller than
expected for their gestational age.
E. Contextual Risks for LBW
i. Race and ethnicity interact with socioeconomic advantages.
ii. The experience of racism and discrimination also affects LBW.
iii. Prevalence varies with ethnicity in socioeconomic status.
iv. The most economically disadvantaged Black and White women show similar LBW
rates.
v. Socioeconomic status also involves access to social services that can determine
birth outcomes.
F. Characteristics of LBW Infants
i. At birth, they often experience difficulty breathing and maintaining homeostasis.
ii. Deficits range from mild to severe.
iii. As they grow older, they show poor social competence and difficulty maintaining
relationships.
iv. Also face emotional risks and difficulties when interacting with parents.
G. Promoting Positive Outcomes of LBW Infants
i. Parenting context is a great influence on infant health.
ii. Positive parenting can allow infants to catch up to their normal-birthweight
peers.
iii. Interventions can help parents learn how to interact with their offspring.
iv. Kangaroo care: The infant is placed vertically against the parent’s chest, under
the shirt, providing skin-to-skin contact.
VII. The Newborn
A. Average newborns are 20 inches long and weigh 7.5 pounds.
B. Medical and Behavioral Assessment of Newborns
i. Apgar scale: Provides a quick and easy overall assessment of a baby’s immediate
health.
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Kuther, Lifespan Development: Lives in Context, 3e
SAGE Publishing, 2023
ii. Brazelton Neonatal Behavioral Assessment Scale (NBAS): A neurobehavioral
assessment commonly administered to newborns, especially those who are
judged to be at risk.
C. The Newborn’s Perceptual Capacities
i. Newborns are more perceptually competent than ever imagined.
ii. This is seen from the fact that both taste and smell are well developed at birth.
iii. The fetus can respond to auditory stimuli as early as 23 weeks.
D. Newborn States of Arousal
i. States of arousal: Degrees of wakefulness.
ii. Newborn sleep cycles are brief.
iii. REM sleep: Rapid eye movement sleep where the brain wave activity is similar to
being awake.
iv. REM sleep is important for brain development in newborns.