Ed11a:
Child and Adolescent
Learners and Learning
Principles
Module 4: Prenatal Development and
Childbirth
Prepared by:
Maya R. Sanchez
Faculty, Institute of Arts & Sciences
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MODULE 4
Prenatal Development and Childbirth
Learning Outcome:
At the end of the unit, the students shall:
Explain the course of prenatal development
Identify the environmental influences on prenatal development
Enumerate and discuss the stages of labor methods of childbirth delivery
Overview:
The course deals with understanding the prenatal development from the process of
conception until the end of the pregnancy period. Moreover, this module also contains a discussion
on the environmental influences that may affect the prenatal development. The stages of labor and
methods of delivery are presented to familiarize the students with the processes involved.
Preliminary Activity:
Interview your mother or anyone in your family who has experienced pregnancy
and ask them to share their experiences. What are the challenges they have
encountered in the course of their pregnancy?
Content:
Conception and Prenatal Development
Conception occurs when an egg from the mother is fertilized by a sperm from the father. In
humans, the conception process begins with ovulation, when an ovum, or egg (the largest cell in
the human body), which has been stored in one of the mother’s two ovaries, matures and is
released into the fallopian tube.
If the woman has had sexual intercourse within one or two days of the egg’s maturation,
one of the up to 500 million sperm deposited by the man’s ejaculation, which are travelling up the
fallopian tube, may fertilize the egg. Although few of the sperm are able to make the long journey,
some of the strongest swimmers succeed in meeting the egg. As the sperm reach the egg in the
fallopian tube, they release enzymes that attack the outer jellylike protective coating of the egg,
each trying to be the first to enter. As soon as one of the millions of sperm enters the egg’s coating,
the egg immediately responds by both blocking out all other challengers and at the same time
pulling in the single successful sperm.
The Zygote
Within several hours of conception, half of the 23 chromosomes from the egg and half of
the 23 chromosomes from the sperm fuse together, creating a zygote — a fertilized ovum. The
zygote continues to travel down the fallopian tube to the uterus. Although the uterus is only about
four inches away in the woman’s body, the zygote’s journey is nevertheless substantial for a
microscopic organism, and fewer than half of zygotes survive beyond this earliest stage of life. If
the zygote is still viable when it completes the journey, it will attach itself to the wall of the uterus,
but if it is not, it will be flushed out in the woman’s menstrual flow. During this time, the cells in the
zygote continue to divide: the original two cells become four, those four become eight, and so on,
until there are thousands (and eventually trillions) of cells. Soon the cells begin to differentiate,
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each taking on a separate function. The earliest differentiation is between the cells on the inside of
the zygote, which will begin to form the developing human being, and the cells on the outside,
which will form the protective environment that will provide support for the new life throughout the
pregnancy.
The Embryo
Once the zygote attaches to the wall of the uterus, it is known as the embryo. During the
embryonic phase, which will last for the next six weeks, the major internal and external organs are
formed, each beginning at the microscopic level, with only a few cells. The changes in the
embryo’s appearance will continue rapidly from this point until birth.
While the inner layer of embryonic cells is busy forming the embryo itself, the outer layer is
forming the surrounding protective environment that will help the embryo survive the pregnancy.
This environment consists of three major structures: The amniotic sac is the fluid-filled reservoir in
which the embryo (soon to be known as a fetus) will live until birth, and which acts as both a
cushion against outside pressure and as a temperature regulator. The placenta is an organ that
allows the exchange of nutrients between the embryo and the mother, while at the same time
filtering out harmful material. The filtering occurs through a thin membrane that separates the
mother’s blood from the blood of the fetus, allowing them to share only the material that is able to
pass through the filter. Finally, the umbilical cord links the embryo directly to the placenta and
transfers all material to the fetus. Thus the placenta and the umbilical cord protect the fetus from
many foreign agents in the mother’s system that might otherwise pose a threat.
The Fetus
Beginning in the ninth week after conception, the embryo becomes a fetus. The defining
characteristic of the fetal stage is growth. All the major aspects of the growing organism have been
formed in the embryonic phase, and now the fetus has approximately six months to go from
weighing less than an ounce to weighing an average of six to eight pounds. That’s quite a growth
spurt.
The fetus begins to take on many of the characteristics of a human being, including moving
(by the third month the fetus is able to curl and open its fingers, form fists, and wiggle its toes),
sleeping, as well as early forms of swallowing and breathing. The fetus begins to develop its
senses, becoming able to distinguish tastes and respond to sounds. Research has found that the
fetus even develops some initial preferences. A newborn prefers the mother’s voice to that of a
stranger, the languages heard in the womb over other languages (DeCasper & Fifer, 1980; Moon,
Cooper, & Fifer, 1993), and even the kinds of foods that the mother ate during the pregnancy
(Mennella, Jagnow, & Beauchamp, 2001). By the end of the third month of pregnancy, the sexual
organs are visible.
Stages of Prenatal Development
The process of prenatal development occurs in three main stages. The first two weeks after
conception are known as the germinal stage, the third through the eighth week is known as the
embryonic period, and the time from the ninth week until birth is known as the fetal period.
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Germinal Stage
The germinal stage begins at conception when the sperm and egg cell unite in one of the
two fallopian tubes. The fertilized egg is called a zygote. Just a few hours after conception,
the single-celled zygote begins making a journey down the fallopian tube to the uterus.
Cell division begins approximately 24 to 36 hours after conception. Through the process of
mitosis, the zygote first divides into two cells, then into four, eight, sixteen, and so on.
Once the eight-cell point has been reached, the cells begin to differentiate and take on
certain characteristics that will determine the type of cells they will eventually become.
As the cells multiply, they will also separate into two distinctive masses: the outer cells will
eventually become the placenta, while the inner cells form the embryo.
Cell division continues at a rapid rate during the approximately week-long journey from
fallopian tube to uterus wall. The cells develop into what is known as a blastocyst. The
blastocyst is made up of three layers, each of which develops into different structures in the
body.1
1. Ectoderm: Skin and nervous system
2. Endoderm: Digestive and respiratory systems
3. Mesoderm: Muscle and skeletal systems
Finally, the blastocyst arrives at the uterus and attaches to the uterine wall, a process
known as implantation. Implantation occurs when the cells nestle into the uterine lining and
rupture tiny blood vessels. The connective web of blood vessels and membranes that form
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between them will provide nourishment for the developing being for the next nine months.
Implantation is not always an automatic and sure-fire process.
Embryonic Stage
At this point, the mass of cells is now known as an embryo. The beginning of the third week
after conception marks the start of the embryonic period, a time when the mass of cells
becomes distinct as a human. The embryonic stage plays an important role in the
development of the brain.
Approximately four weeks after conception, the neural tube forms. This tube will later
develop into the central nervous system including the spinal cord and brain. The neural
tube begins to form along with an area known as the neural plate. The earliest signs of
development of the neural tube are the emergence of two ridges that form along each side
of the neural plate.
Over the next few days, more ridges form and fold inward until a hollow tube is formed.
Once this tube is fully formed, cells begin to form near the center. The tube begins to close
and brain vesicles form. These vesicles will eventually develop into parts of the brain,
including the structures of the forebrain, midbrain, and hindbrain.
Around the fourth week, the head begins to form, quickly followed by the eyes, nose, ears,
and mouth. The blood vessel that will become the heart start to pulse. During the fifth week,
buds that will form the arms and legs appear.
By the eighth week of development, the embryo has all of the basic organs and parts
except those of the sex organs. At this point, the embryo weighs just one gram and is about
one inch in length.
By the end of the embryonic period, the basic structures of the brain and central nervous
system have been established. At this point, the basic structure of the peripheral nervous
system is also defined.
Fetal Stage
Once cell differentiation is mostly complete, the embryo enters the next stage and becomes
known as a fetus. The fetal period of prenatal develop marks more important changes in
the brain. This period of development begins during the ninth week and lasts until birth.
This stage is marked by amazing change and growth.
The early body systems and structures established in the embryonic stage continue to
develop. The neural tube develops into the brain and spinal cord and neurons continue to
form. Once these neurons have formed, they begin to migrate to their correct locations.
Synapses, or the connections between neurons, also begin to develop.
Between the ninth and twelfth week of gestation (at the earliest), reflexes begin to emerge.
The fetus begins to make reflexive motions with its arms and legs.
During the third month of gestation, the sex organs begin to differentiate. By the end of the
month, all parts of the body will be formed. At this point, the fetus weighs around three
ounces. The fetus continues to grow in both weight and length, although the majority of the
physical growth occurs in the later stages of pregnancy.
The end of the third month also marks the end of the first trimester of pregnancy. During the
second trimester, or months four through six, the heartbeat grows stronger and other body
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systems become further developed. Fingernails, hair, eyelashes, and toenails form.
Perhaps most noticeably, the fetus increases about six times in size.
During the period from seven months until birth, the fetus continues to develop, put on
weight, and prepare for life outside the womb. The lungs begin to expand and contract,
preparing the muscles for breathing.
How the Environment Can Affect the Vulnerable Fetus
Prenatal development is a complicated process and may not always go as planned. About
45% of pregnancies result in a miscarriage, often without the mother ever being aware it has
occurred (Moore & Persaud, 1993). Although the amniotic sac and the placenta are designed to
protect the embryo, substances that can harm the fetus, known as teratogens, may nevertheless
cause problems. Teratogens include general environmental factors, such as air pollution and
radiation, but also the cigarettes, alcohol, and drugs that the mother may use. Teratogens do not
always harm the fetus, but they are more likely to do so when they occur in larger amounts, for
longer time periods, and during the more sensitive phases, as when the fetus is growing most
rapidly. The most vulnerable period for many of the fetal organs is very early in the pregnancy —
before the mother even knows she is pregnant.
Harmful substances that the mother ingests may harm the child. Cigarette smoking, for
example, reduces the blood oxygen for both the mother and child and can cause a fetus to be born
severely underweight. Another serious threat is fetal alcohol syndrome (FAS), a condition
caused by maternal alcohol drinking that can lead to numerous detrimental developmental effects,
including limb and facial abnormalities, genital anomalies, and mental retardation. Therefore, the
best approach for expectant mothers is to avoid alcohol completely. Maternal drug abuse is also of
major concern and is considered one of the greatest risk factors facing unborn children.
The environment in which the mother is living also has a major impact on infant
development (Duncan & Brooks-Gunn, 2000; Haber & Toro, 2004). Children born into
homelessness or poverty are more likely to have mothers who are malnourished, who suffer from
domestic violence, stress, and other psychological problems, and who smoke or abuse drugs. And
children born into poverty are also more likely to be exposed to teratogens. Poverty’s impact may
also amplify other issues, creating substantial problems for healthy child development (Evans &
English, 2002; Gunnar & Quevedo, 2007).
Mothers normally receive genetic and blood tests during the first months of pregnancy to
determine the health of the embryo or fetus. They may undergo sonogram, ultrasound,
amniocentesis, or other testing. The screenings detect potential birth defects, including neural tube
defects, chromosomal abnormalities (such as Down syndrome), genetic diseases, and other
potentially dangerous conditions. As maternal age increases, the risks for numerical chromosomal
abnormalities increase. The mortality rate of infants born to adolescent mothers is double that of
infants born to mothers in their twenties. Early diagnosis of prenatal problems can allow medical
treatment to improve the health of the fetus.
On the other hand, paternal factors may also contribute to birth defects such as father’s
exposure to lead, radiation, certain pesticides and petrochemicals may cause abnormalities in
sperm that lead to miscarriage or diseases such as childhood cancer.
The Three Stages of Labor
Labor is described in three stages. Together these stages complete the delivery and the
passage of the placenta.
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Stage One
During the first stage, the woman reaches full cervical dilatation. This begins when
contractions start, and it is the longest stage of labor. The first stage is divided into three phases:
latent, active, and transition.
In the latent phase, contractions occur more often, become stronger, and become more
regular. During this phase the cervix thins. This is called effacement. The latent phase
varies from woman to woman and from labor to labor. It may take a few days or be as short
as a few hours. The latent phase tends to be 10 to 12 hours for a woman who has had
children. For first pregnancies, it may last closer to 20 hours. Many women confuse the
latent phase of labor with Braxton Hicks contractions. Membranes may rupture in the early-
to mid-portion of the first stage of labor. If they rupture, the labor process often speeds up.
The next portion of the first stage of labor is the active phase. During this phase, the cervix
dilates rapidly. For most women, dilation goes from 3 to 4 centimeters to 8 to 9 centimeters.
The active phase is the most predictable, lasting an average of 5 hours in first-time mothers
and 2 hours in mothers who have given birth before.
Finally, there is the transition phase. During this phase, the cervix dilation continues to
dilate, but at a slower pace, until fully dilated. In some women, the transition phase is not
really noticeable, blending into the active phase. This is also a phase of more rapid
descent, when the baby is passing lower into the pelvis and deeper into the birth canal. In
mothers with no anesthesia, nausea, vomiting and uncontrollable shaking may occur.
These symptoms can be frightening to watch and experience, but they're a part of normal
birth. They signal that the first stage is almost completed.
Stage Two
The second stage is the delivery of the infant. During the second stage, mom actively
pushes out the baby. For first-time mothers, this can take 2 to 3 hours, so it's important to save
your energy and pace yourself. For second babies and beyond, the second stage often lasts less
than an hour -- and sometimes, only a few minutes. If you have an epidural anesthetic, the second
stage may require more time.
Stage Three
The third stage of labor is the passage of the placenta. This may occur right away, or take
up to 30 minutes. The process may be sped up naturally by breastfeeding (which releases
oxytocin), or medically by administering a drug called pitocin.
Methods of Childbirth
1. Vaginal Delivery
When a baby is born through the birth canal of a woman’s body, the delivery is termed
as a vaginal delivery. It may or may not be assisted with epidurals or pain-relieving
medication. The exact time of birth cannot be predicted in such a case, but most vaginal
births tend to happen once 40 weeks of pregnancy have been completed.
2. Natural Chidlbirth
This is one of the types of birth that is steadily gaining popularity. In this method, there
are no medical procedures or invasive therapies involved, and the process takes place
in the most natural manner possible. This is mostly a personal choice and the mother
needs to be committed throughout the way.
3. Caesarean Section
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In this method, the baby is delivered by opening up the abdomen of the mother and
surgically opening the uterus to remove the baby.
The name is derived from the Latin word ‘caedare’, which means ‘to cut’. Hence, this
type of the cut is called a C-section.
4. Forceps Delivery
This is a rather peculiar type of delivery method and is required in certain cases of
vaginal birth. This is an assistance to the usual vaginal delivery when the baby is on its
way via the birth canal but fails to fully emerge out. This could be because of small
obstructions, or the mother being tired and exhausted and hence being unable to push
the baby out.
In these cases, the doctor makes use of specially created tongs which
resemble forceps, and inserts them slowly into the birth canal. These are then used to
gently grab the baby’s head and guide it outwards through the canal.
5. Vacuum Extraction
Similar to the forceps delivery method, this delivery technique is used in the case of a
vaginal birth. For example, if the baby is on its way out but has stopped moving further
down the canal, the vacuum extraction method is applied.
The doctors make use of a specialized vacuum pump which is inserted up to the baby
via the canal. The vacuum end has a soft cup which is placed on the top of the baby’s
head. Vacuum is created so that the cup holds the head, and the baby is gently guided
outwards through the canal.
6. Vaginal Birth After Caesarean (VBAC)
Most of the time, once a woman has had a caesarean delivery, her chances of having a
vaginal delivery after that are pretty much nullified. But in recent times, certain
techniques are making it possible for women to have successful vaginal deliveries even
after the previous delivery method has been a C-section. This is termed as vaginal birth
after caesarean (VBAC).
Assessment:
Reflective Writing. Interview your mother and ask her of her experiences during
labor and giving birth of you. Choose a classmate and share your mother’s
experiences and make a reflection paper regarding the insights you gained from the
sharing.
Module Summary:
Module 4 covers the discussion on the stages of prenatal development including the
processes of evolution in each of the stage. The three stages of labor are described and explained
in order to have a clear picture of how a mother gives birth. Moreover, the different methods of
childbirth are defined to learn about their differences and applicability during labor and childbirth.
References:
1. Corpuz, B. (2018). The Child and Adolescent Learners and Learning Principles. Quezon
City: Lorimar Publishing Incorporated
2. [Link]
development/
3. [Link]
4. [Link]
5. [Link]
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