Prenatal Development and Birth

Course of prenatal development

• Prenatal development begins with fertilization and ends with birth.

• It lasts between 266 days and 280 days (from 38 weeks to 40 weeks; around 9 months)
(Santrock, 2021).

• It can be divided into three periods: germinal, embryonic, and fetal.

Germinal Period

• Takes place in the first 2 weeks after conception.

• Begins with the creation of the zygote and ending with implantation.

• Cell differentiation begins.

• The zygote develops into a blastocyst a few days after conception.

• The inner part, the embryonic disk will eventually develop into the embryo, and the outer
membrane, the trophoblast differentiates into membranes that will protect and nourish the
embryo (Rathus, 2017).

• Implantation is the attachment of the zygote to the uterine wall.

• Implantation occurs about 11 – 15 days after conception

Embryonic period

• Occurs two to eight weeks after conception

• Begins with implantation

• The most rapid prenatal changes take place as the groundwork is laid for all body structures
and internal organs (Berk, 2018).

• Rate of cell differentiation intensifies and mass of cells is now called embryo

• Three layers of cells are formed, endoderm, mesoderm, ectoderm

• The inner layer of cells, the endoderm, develops into the digestive and respiratory systems.

• The mesoderm is the middle layer, will become the circulatory system, bones, muscles, and
excretory and reproductive systems.

• The outer layer of cells contains the ectoderm, which will become the nervous system,
sensory receptors, and skin.
 • Life-support systems are formed and they include the amnion, the umbilical cord and the
placenta.

Amnion

• Contains a clear fluid in which the developing embryo floats

• Keeps the temperature of the prenatal world constant and provides a cushion against any
jolts (Berk, 2018).

• The umbilical cord contains two arteries and one vein, and connects the baby to the
placenta.

• The placenta consists of a disk-shaped group of tissues in which small blood vessels from the
mother and the offspring intertwine but do not join.

Organogenesis

• Organ formation that takes place during the first two months of prenatal development

Fetal period

• Period between two months after conception and birth

• During this “growth and finishing” phase, the organism increases rapidly in size (Berk, 2018).

• Organ systems mature to the point at which life can be sustained outside of the womb.

• In the third month the fetus is about 3 inches long and can smile, frown, suck, swallow,
urinate, move arms, legs, fingers, and toes
• Fingerprints are present
• Sex is distinguishable (Santrock, 2021)

• Prenatal development is sometimes divided into trimesters, or three equal time periods.

• At the end of the third month, the first trimester is complete.

Second trimester (middle 3 months)

• A growth spurt occurs in the body’s lower parts.

 • The mother can feel arm and leg movements.

• A grasping reflex is present and irregular breathing movements occur.

• At six months of pregnancy the fetus is viable, it has a chance of surviving outside of the
womb

Third trimester

• Heart and lungs increasingly capable of sustaining independent life

• Gains in weight and length

• Each day improves the possibilities of a healthy life and normal cognition (Berger, 2018).

The Brain

• The basic architecture of the brain develops during the first and second trimesters.

• The neural tube is the first part of the nervous system to form.

• It develops from the ectoderm roughly 18–24 days after conception.

• Failure of the neural tube to close results in 2 birth defects:

• Anencephaly is the result of the highest regions of the brain failing to develop, leading to
death.

• Spina bifida results in paralysis of the lower limbs to varying degrees.

• Neurogenesis, the massive proliferation of new neurons begins once the neural tube has
closed, around 5 weeks.

• It continues throughout the pregnancy.

• At its peak approximately 200,000 neurons are created every minute.

Neuronal migration

• Neurons move to their destination in the brain

• After migration neurons must mature and develop a more complex structure.

• Beginning around the 23rd week connections between neurons begin to develop.
 • The third trimester of prenatal development and the first two years of postnatal life are
characterized by connectivity and functioning of neurons.

Teratology and hazards to prenatal development

• A teratogen is any agent that can cause a birth defect or negatively alters cognitive and
behavioral outcomes (Santrock, 2021).

• Teratogens include drugs, incompatible blood types, environmental pollutants, infectious

diseases, nutritional deficiencies, maternal stress, advanced maternal and paternal age, and
environmental pollutants.

• Teratogens are most harmful during critical periods, especially during the embryonic stage
when the organ systems are developing (Rathus, 2017).

• Teratology is the field of study that investigates the causes of birth defects.

• The severity and type of defect can be a function of dose, genetic susceptibility, and time of
exposure.

Prescription and non prescription drugs

• Prescription drugs that can function as teratogens include antibiotics, antidepressants,

hormones and accutane

• Nonprescription drugs that can be harmful include diet pills and high dosages of aspirin

Psychoactive drugs

• Alter states of consciousness, modify perceptions, and change moods.

• Include caffeine, alcohol, nicotine, cocaine, heroine

• Maternal caffeine consumption is linked to lower birth weight.

Incompatible blood types

• Incompatibility between the mother’s and father’s blood types poses risk to prenatal
development

Environmental Hazards

Radiation, toxic wastes, and other chemical pollutants

Maternal diseases

• Can cause birth defects by crossing the placenta or causing damage during birth.

• Rubella, syphilis, genital herpes, and HIV/AIDS can produce birth defects and/or damage
during birth.

Other parental factors

• Maternal diet and nutrition

• Maternal age

• Emotional states and stress

• Paternal factors

Maternal Diet and Nutrition

• Malnourishment might result in a baby to be born malformed.

• Obesity is a risk factor for stillbirth and placement in a neonatal intensive care unit.
• Neural tube defects are linked with less-than-adequate folic acid consumption.

Maternal age

• The mortality rate of infants born to adolescent mothers is double that of infants born to
mothers in their 20s.
• The risk of Down syndrome increases with age, beginning at age 35.
• The risk for low birth weight, preterm birth, and fetal death increases for women over 35
years of age.

Emotional States and Stress

• Intense fears, anxieties, and stress in pregnancy have been linked to preterm delivery and
low birth weight.
• High stress levels increase the likelihood of having a child with emotional or cognitive
problems, ADHD, and language delay

Emotional States and Stress

• Intense fears, anxieties, and stress in pregnancy have been linked to preterm delivery and
low birth weight.
 • High stress levels increase the likelihood of having a child with emotional or cognitive
problems, ADHD, and language delay

Paternal Factors

• Men’s exposure to environmental toxins may cause abnormalities in sperm that lead to
miscarriage or diseases such as childhood cancer.
• Smoking increases the risk of early pregnancy loss.
• The risk of autism in children increases with paternal age.

Birth

The Birth Process

• The first stage lasts about 6–12 hr for a woman having her first child.
• The cervix dilates to about 4 inches as a result of uterine contractions.
• Uterine contractions are 15 to 20 minutes apart and last up to 1 minute.

• The second stage begins when a baby’s head moves through the cervix until the baby’s body
emerges completely

• Lasts about 45 min to an hour.

• The third stage is called afterbirth, at which time the placenta, umbilical cord, and other
membranes are detached and expelled.

Assessing the Newborn

• The Apgar Scale is widely used to assess the health of newborns at 1 and 5 min after birth

• Evaluates an infant’s heart rate, respiratory effort, muscle tone, body color, and reflex
irritability.

• The Brazelton Neonatal Behavioral Assessment Scale (NBAS) is typically performed within
24–36 hr after birth.

• The NBAS assesses the newborn’s neurological development, reflexes, and reactions to
people and objects.