Chapter 3: Prenatal development, birth and the newborn

From conception to birth

Prenatal development: changes that transform a fertilized egg into a newborn baby

- Period of Zygote (Weeks 1-2):

o The period begins with fertilization (sperm penetrates and fertilizes the egg to form a
single-celled zygote)
o Day 2-3: zygote begins to divide through a process called mitosis  it continues to
divide as it moves through the fallopian tube towards the uterus
o Day 4-5: dividing cells form a hollow structure called blastocyst (comprises about 100
cells)
o Day 8-9: Implantation occurs as blastocyst attaches itself to the uterine wall and
establishes connections with a woman’s blood vessels
 This will allows exchange of nutrients and waste between the embryo and
mother
 This stage will takes about a week and triggers hormonal changes that signal to
the woman that she is pregnant
- Period of the Embryo (Weeks 3-8)
o Embryo: occurs when the blastocyst is completely embedded in the uterine wall
o At the beginning of the period, 3 layers form in the embryo:
 Ectoderm: forming hair, outer layer of skin and nervous system
 Mesoderm: forming muscles, bones and circulatory system
 Endoderm: forming lungs and digestive systems
o The embryo is set in an amniotic sac (that cushions the embryo and maintains a
constant temperature)
o The embryo is linked to the mother by 2 structures:
 Umbilical cord: blood vessels that join the embryo to the placenta
 Villi: finger-like projections
- Period of Fetus (Weeks 9-38)
o Longest phase of prenatal development
o Month 1:
 Major organs and systems begin to form
 Limbs develop and become more defined
 Facial features such as eyes, nose and mouth start to form
o Month 2:
 Muscles and bones continue to develop and strengthen
 Reproductive organs differentiate
o Month 3: reproductive organs is more defined
o Month 5 & 6: eyebrows, eyelashes, scalp hair emerge
 The skin is covered with a thick greasy substance called vernix
o Month 7-8: fetus reached age of viability (age where fetus can survive on its own)
 They can be born this early but face other challenges
Influences on Prenatal Development

General Risk Factors

- Nutrition:
o Woman should expect to gain between 11-16 kg during pregnancy (average weight)
 Underweight woman gains as much as 18 kg
 Overweight gains about 7 kg
o Spina bifida: disorder in which embryo’s neural tube does not close properly during first
month of pregnancy
 occurs when mothers do not consumer enough folic acid (vitamins B)
 children with this disorder need crutches or wheelchairs
- Stress:
o Stress: person’s physical and psychological responses to challenging situations
 Greater anxiety = giving birth early/ having babies who weigh less than average
o Stress cause the mother’s body to reduce oxygen intake which in turn increase the fetus
heart rate and activity level
o Stress also weaken a pregnant woman’s immune system  easier to contract illness
- Mother’s age:
o Older mothers are more likely to have difficulty getting pregnant and miscarriages

Teratogens

- Teratogen: agent that causes abnormal prenatal development

o Falls under 3 categories:
 Diseases: these diseases can pass from the mother to attack the embryo directly
 E.g., AIDS, Syphilis, Rubella, Herpes
 Drugs: when consumed by pregnant women can pose special dangers to fetus
 E.g., Alcohol, caffeine, Marijuana, Nicotine, Aspirin
 Fetal Alcohol Spectrum Disorder (FASD): disorder affecting babies who
mothers consumed large amounts of alcohol while they were pregnant
 Environmental Hazards: toxins in the food they eat, fluids they drink or air they
breathe
 E.g., Air pollutants, Lead, Mercury, PCBs, X-rays

The Birth

The Stages of Labour

- Labour typically begins 266 days after conception

- It proceeds through 3 stages:
o Dilation of cervix
 Contractions of the uterus  these contractions force the amniotic fluid to
release out
 Longest stage of labour (usually 12-14 hours)  If this stage goes on for too
long, they have to perform a C-section
 o Delivery of baby
 Once the cervix is fully open, the baby is ready to be born
 First, the baby’s head emerges  this process is known as Crowning
 If the baby is in feet-first position (breech presentation), C-section
required!
o “Birth” of placenta: last 10-15 minutes

Preparation for Birth

1. Prepared childbirth  going to classes to learn basic facts about pregnancy and childbirth
a. Natural birth: woman remains in an upright position rather than flat on her back
b. Home delivery: similar to natural birth but handled by nurse-midwives
2. Dealing with pain are emphasized over medication
a. Hypoxia: occurs when the umbilical cord is pinched or tangled during delivery
i. Leads to the shut off of oxygen and blood to the baby
3. Involvement of a supportive adult
a. Doula: person similar with childbirth who is not part of medical staff provides emotional
and physical support throughout labour and delivery
4. Adjusting to Parenthood:
a. Postpartum depression: after the birth, mother is affected by the feeling of low self-
worth, disturbed sleep, poor appetite and apathy
b. This affect 10-15 percent of new mother

The Newborn

- Apgar score (0-10): Measures the healthiness of the baby

o Factors rated:
 Heart rate
 Respiratory effort
 Muscle tone
 Reflex responsivity
 Color
o 4-6 score = need special attention
o 3 or less = life-threatening situation
- BNAS: assess behavioural aspects of newborn’s condition
o Factors rated:
 Reflexes
 Motor Capacities
 Responsiveness to objects and people

Newborn states

- Newborns spend most of their day alternating among 4 states:

o Alert inactivity: calm and attentive  eyes open wide to inspect the environment
o Waking activity: baby moves arms or legs in bursts of uncoordinated motion
o Crying: baby cries vigorously
  Basic cry: starts softly then gradually more intense  occurs when baby is
hungry or tired
 Mad cry: intense version of basic cry
 Pain cry: sudden, long shriek followed by long pause and gasping crying
 Swaddling: wrapping the infant tightly in a blanket to stop the cry
o Sleeping: baby’s eyes are closed
 Baby sleeps 16-18 hours daily
 They go in cycle of wakefulness and sleep every 4 hours
 REM sleep: newborns move their arms and legs, their eyes may move about
beneath their eyelids
 Non-REM sleep: breathing, heart rate and brain activity steady (they simply lie
quietly with no movements)