The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.

Isabela State University

City of Ilagan
Chapter Three

PRE-NATAL DEVELOPMENT

Introduction

The time elapsing between conception and birth which normally averages about 266 days or 280
days from the first day of the last menstruation.

In this module, general introductory topics include the stages of prenatal development, risks
caused by environmental exposures such as alcohol, tobacco, other drugs, maternal stress and
diseases, stages of the birth process and kinds of birth, complications of pregnancy and delivery
which are the leading cause of death for both mother and child in developing countries and the
behaviors of newborns.

LEARNING OBJECTIVES: Upon completion of the all topics and activities presented in this
module you are expected to:

1. Enumerate and discuss the stages and characteristics of prenatal development.

2. Enumerate and describe the stages of the birth process and the kinds of birth.
3. Identify and explain the different complications of pregnancy, labor, and delivery.
4. Describe the behaviors of a newborn.

LEARNING CONTENT

Pre-Natal Period begins at conception to birth, approximately 270 – 280 days in length, or
nine calendar months.
Characteristics of Pre-Natal period
1. The hereditary endowment, which serves as the foundation for later development,
is fixes, once and for all, at this time.
2. Favorable conditions in the mother’s body can foster the development of
hereditary potentials while unfavorable conditions can stunt their development,
even to the point of distorting the pattern of future development.
3. The sex of the newly created individual is fixed at the time of conception and
conditions within the mother’s body will not affect it, as is true of the hereditary
endowment.
4. Proportionally greater growth and development takes place during the prenatal
period than at any other time throughout the individual’s lifetime.
5. The pre-natal period is a time of many hazards, both physical and psychological.
6. The pre-natal period is the time when significant people form attitudes toward new
created individuals.

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

How Life Begins

In a nutshell:
• New life begins with the union of a male sex cell and female sex cell.
• These sex cells are developed in the reproductive organs, the gonads.
• Spermatozoa-male sex cells which are produced in testes
• Ova – female sex cells produced in ovaries
• Each male and sex cells contain 23 mature chromosomes, which contains genes,
the true carriers of heredity.
• In a mature ovum, there are 23 matched chromosomes while in the mature
spermatozoon, there are 22 matched chromosomes and one unmatched
chromosome which either be the X or Y.
• Male cells go through two preliminary stages: MATURATION AND
FERTILIZATION.
• Female cells go through three preliminary stages: MATURATION, OVULATION
and FERTILIZATION.
Maturation
- A process of chromosome reduction through cell division.
- The mature cell, which contains three chromosomes, is known as haploid cells.

Ovulation
- The preliminary stage of development limited to the female sex cells. It is the
process of escape of one mature ovum during the menstrual cycle.
- When the length of the menstrual cycle is normal, approximately 28 days.
Ovulation occurs between the fifth and the 23rd days of the cycle, with the average
on the eleventh day.

Fertilization
- It occurs at the time of conception.
- The third stage of development preliminary to the beginning of a new life.

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan
Timetable of Pre-Natal Development
The union of a male sperm cell and a
female egg cell to form a new organism.

Divided into three periods:

-Period of the zygote
-Period of the embryo
-Period of the fetus

Period of the Zygote (fertilization to end of 2nd week)

• Happens 2 weeks after conception
Includes:
• Creation of the zygote;
• Continued cell division; and
• The attachment of the zygote to the uterine wall
• Rapid cell division
• By the end of the stage, the fertilized egg becomes a blastocyst wall of the uterus.

Germinal Period

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

24 to 30 hours after fertilization 4 to 5days

48 hours after fertilization (2 days)

72 hours after fertilization (3 days) 6 to 7 days

96 hours after fertilization (4 days)

11 to 15 days

Happens 2 to 8 weeks after conception

Zygote becomes Embryo

Period of the embryo (end of 2nd week to end of the second lunar month)

• Cell differentiation intensifies

• Life- support systems for the embryo develop
• Organs appear
• At the end of four weeks:
- Embryo is ¼ inch in length

- Heart, digestive system, backbone and spinal cord begin to form

- Placenta (sometimes called “afterbirth”) begins developing
- The single fertilized egg is now 10,000 time larger than size at conception

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

• At the end of 8 weeks:

- Embryo is 1 1/8 inches in length
- Eyes nose, lips tongue, ears and teeth are forming
- Embryo is moving, although the mother cannot yet feel movement
- Heart is functioning

• Organogenesis
- The process of organ formation during the first two months of prenatal
development.

• As these three layers’ form (endoderm, ectoderm, mesoderm,) the

support system for the embryo develop rapidly which are the:
-placenta
- umbilical cord
- amnion
Period of the fetus (end of 2nd week to end of the second lunar month)
• 2 to 7 months after conception
- Growth and development continue dramatically during this period.

• 3 months after conception

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

- Fetus is about 3 inches long.

- It has become more active by moving its arms and legs, opens and closes its,
mouth and move its head
- The genitals can now be identified as male or female

• The following are distinguished

- Face -chin
- Forehead - upper and lower arms
- Eyelids - hands
- Nose - lower limbs

• 4th months (16 weeks)

- Fetus is about 6 inches’ long

- Stronger pre-natal reflexes
- First arm and feet movement are felt by the mother

• 5th month (20 weeks)

- Fetus is about 12 inches’ long

- Structures of the skin have form
- Fetus is more active

• 6th month (24 weeks)

- Fetus is about 14 inches’ long

- Eyes and eyelids are completely formed
- Fine layer of hair covers the head
- Grasping reflex present and irregular movements occur

• 7th month (28 weeks)

- Fetus is 16 inches’ long

- Taste buds have developed
- Organs are maturing
- Skin is still wrinkled and red
- If born at this time, he/she will be considered a premature baby and require
special care.

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

• 9th month (38 weeks)

- Fetus is 19 to 20 inches’ long
- The lungs are mature
- Baby is now fully developed and can survive outside the mother’s body
- Skin is pink and smooth
- He/she settles down lower in the abdomen in preparation for birth and may
seem less active

• Drugs - excessive use of aspirin can harm circulatory system of fetus. Thalidomide, a
drug prescribed to alleviate morning sickness, was found to inhibit the formation of arms
and legs. Quinine, a cure for malaria, causes fetal deafness. Barbiturates may affect the
oxygen supply to the fetus & result in brain damage. Anti-histamines may increase the
mother’s susceptibility to spontaneous abortion

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

• Alcohol, coffee & tobacco – children who are born to mothers who ingest alcohol
heavily develop fetal alcohol syndrome, this is manifested in retarded growth and
damage to the nervous system. Caffeine slows down fetal growth and contributes to
premature birth. The nicotine in tobacco is a drug which may result to pre-mature births,
miscarriage & infant death, risk of developing leukemia, brain cancer.
• RH factor – this is caused by the genetic incompatibility between mother and child.
Fetal blood from an Rh positive baby may get into the blood of an Rh negative mother
thus producing antibodies that can destroy the baby’s system.
• Pollution – air pollution results in low birth weight.
• Maternal Factors
Mother’s emotion - maternal anxiety or anger may cause various hormones to be
released in the mother’s blood, though not chemical, may produce abnormality in the
baby’s emotions as well.

• Mothers over 35 have the risk of fertility problems, high blood pressure, diabetes,
miscarriages, placenta previa, cesarean section, premature birth , stillbirth , a baby with
a genetic disorder or other birth defects
Teenage Pregnancy. A teenage mother is at a greater risk for having pregnancy
complications including anemia, and high blood pressure.
Gestational Diabetes. Diabetes is a condition where the body has too much glucose in
the bloodstream
High Blood Pressure (Hypertension). Hypertension is a condition in which the
pressure against the wall of the arteries becomes too high.
Weight Gain during Pregnancy. During pregnancy most women need only an
additional 300 calories per day to aid in the growth of the fetus. Gaining too little or too
much weight during pregnancy can be harmful.

Maternal Infectious & non-infectious diseases:

• Rubella (German Measles) – during the 1st three (3) months of pregnancy may
result to blindness, deafness, brain damage & heart disease.
• Syphilis – May result to abortion, still born, premature birth, some will die shortly after
birth.
• Genital Herpes – may cause death or permanent brain damage.
• AIDS – mothers exposed to AIDS virus will give birth to children with the disease: head

& face abnormalities.

• Diabetes – The fetus may be aborted or still born, deformities like extra ear skin often

with respiratory problems for a day or so after birth. And causes macrosomia (a
newborn with an excessive birth weight).

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

FIGURE 3.2 EFFECT OF TERATOGENS ON THE FETUS

Factors influencing prenatal risks:

There are several considerations in determining the type and amount of damage that might result
from exposure to a particular teratogen (Berger, 2005). These include:

• The timing of the exposure: Structures in the body are vulnerable to the most severe damage
when they are forming. If a substance is introduced during a particular structure's critical period
(time of development), the damage to that structure may be greater. For example, the ears and
arms reach their critical periods at about 6 weeks after conception. If a mother exposes the embryo
to certain substances during this period, the arms and ears may be malformed.

• The amount of exposure: Some substances are not harmful unless the amounts reach a certain
level. The critical level depends in part on the size and metabolism of the mother.
• The number of teratogens: Fetuses exposed to multiple teratogens typically have more problems
than those exposed to only one.

• Genetics: Genetic make-up also plays a role on the impact a particular teratogen might have on
the child. This is suggested by fraternal twins exposed to the same prenatal environment, but they
do not experience the same teratogenic effects. The genetic makeup of the mother can also have
an effect; some mothers may be more resistant to teratogenic effects than others.

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

• Being male or female: Males are more likely to experience damage due to teratogens than are
females. It is believed that the Y chromosome, which contains fewer genes than the X, may have
an impact.

C. THE BIRTH PROCESS:

As the time for birth approaches, the fetus generally lies head down in the uterus. The uterus at
this time resembles a large sack that opens into the vagina through the cervix (the neck of the
uterus).

Three Stages of the Birth Process:

1. Labor – a stage in the birth process which begins when the uterus contracts at regular and
progressively shorter intervals, pushing the baby down toward the birth canal while the lower part
of the uterus thins out. The first stage of labor lasts until the cervix is completely dilated. It usually
begins with faint contractions that grow stronger and more frequent.

2. Delivery – the stage in the birth process that begins once the infant’s head passes through the
birth canal and is born. When the baby is out or delivered, the midwife cleans his nose and mouth
with a suction apparatus to prevent substances from entering the lungs to make breathing easier.
Then the umbilical cord is tied and cut.

3. Afterbirth – the last stage in the birth process characterized by the expulsion of the placenta,
its membranes and the rest of the umbilical cord.

FIGURE 3.5 STAGES OF THE BIRTH PROCESS

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

Kinds of birth:
a. Natural or Spontaneous Birth -

It involves the birth of a baby and delivery of the placenta from the uterus and through the cervix
and the birth canal (vagina). This process results from contractions of the uterus during labor.
Most women deliver 38 to 40 weeks after becoming pregnant (conception). In some vaginal
deliveries, additional assistance is used to assist vaginal delivery by using forceps or vacuum
extraction applied to the baby's head.

b. Breech birth -

c. Transverse birth - the fetus is positioned crosswise in the mother’s uterus, vaginal
delivery is impossible. This requires Caesarean section unless it converts or is converted late in
pregnancy. The surgeon may be able to rotate the fetus through the wall of the uterus once the
abdominal wall has been opened. Otherwise, a transverse uterine incision is needed to gain access
to a fetal pole.

c. Instrument birth (Forceps delivery) – when the fetus is too large to emerge
spontaneously or when its position makes normal birth impossible, instruments must be used to
aid delivery.

d. Cesarean Delivery – the baby is bought into the world thru a slit made surgically in the
mother’s abdominal wall.

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

e. Lamaze Method of Childbirth

The Lamaze method of childbirth was developed in France by Dr. Fernand Lamaze in 1951.
As its popularity grew, it spread to the U.S. and became more widely known throughout
the late 1950s. Today the Lamaze method has expanded beyond the well- known breathing
techniques to include a broader philosophy that promotes a woman’s inherent ability to
birth her baby and supports the six care practices that support birth, which include:

- Labor should begin on its own

- A laboring woman should be free to move around during labor
- A laboring woman should have continuous support from others during labor .
- There should be no routine interventions during labor and birth
- Women should not give birth on their backs
- Mothers and babies should not be separated after birth and should have unlimited
opportunity for breastfeeding

The Lamaze technique also helps you learn how to stay in control during the birth process.
You will learn how to use a variety of tools to comfort yourself during labor, including
massage, repositioning, muscle relaxation, and heat or cold for soothing. Lamaze does not
frown upon the use of pain medication, but it helps women learn to be educated so that
they can make “informed consent” or “informed refusal” of various procedures offered to
them.

Other Non-medicated Techniques to Reduce Pain

a. Waterbirth – involves giving birth in a tub of warm water. Some women go

through labor in the water and get out for delivery, others remain in the water for
delivery.

b.Acupuncture – the insertion of very fine needles into specific locations in the
body, has been used as a standard procedure to reduce pain of childbirth in China
for centuries, although it only recently has begun to be used in the US for this
purpose.

c.Hypnosis – the induction of a psychological state of altered attention and

awareness in which the individual is unusually responsive to suggestions.

d.Music Therapy during childbirth – which involves the use of music to

reduce stress and manage pain.

COMPLICATIONS OF PREGNANCY, LABOR, DELIVERY AND BIRTH

a. Period of the zygote

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

• Starvation – they zygote will die of starvation if it has too little yolk to keep it alive until it can
lodge itself in the uterine wall or if it remains too long in the tube.

-occurs when the fetus presents to the birth canal with buttocks or feet first. This presentation
creates a mechanical problem in delivery of the
fetus.

• Lack of uterine preparation – implantation cannot occur if, as a result of glandular

imbalance, the uterine wall are not prepared in time to receive the zygote.
• Ectopic pregnancy

Period of the Embryo

• Miscarriages – falls, emotional shocks, malnutrition, vitamin deficiency and serious

diseases can cause the embryo to become dislodged from its place into the uterine wall.
• Developmental Irregularities – maternal malnutrition, vitamin and glandular
deficiencies, excessive use of drugs, alcohol and tobacco interfere with normal
development, especially that of the embryonic brain.

Period of the Fetus

• Miscarriages –are always possible up to the 5th month of pregnancy; the most
vulnerable time is when the woman’s menstrual period would normally occur.
• Prematurity – fetuses who weigh less than 2 pounds 3 ounces have less chance of
surviving than heavier fetuses and a greater chance of developing malformations.
• Complications of delivery – maternal stress affects uterine contractions and is likely
to lead to complications during birth.
• Developmental irregularities – any of the unfavorable environmental conditions
present during the period of the embryo will also affect development of fetal structures.

LABOR AND DELIVERY COMPLICATIONS

-the fertilized egg implants in a location outside the uterus and tries to develop there. The most
common site is in the fallopian tube but it can also occur in the ovary, the abdomen, and the
cervical canal.

Preterm Labor and Premature Delivery

One of the greatest dangers a baby faces is being born too early, before his or her body is mature
enough to survive outside the womb. The lungs, for example, may not be able to breathe air, or
the baby's body may not generate enough heat to keep warm.

A full-term pregnancy lasts about 38 to 40 weeks. Having labor contractions before 37 weeks of
pregnancy is called preterm labor. A baby born before 37 weeks of pregnancy is considered a
premature baby who is at risk of complications of prematurity, such as immature lungs,
respiratory distress, and digestive problems.

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

Prolonged Labor (Failure to Progress)

A small percentage of women, mostly first-time mothers, may have a labor that lasts too long,
sometimes called "failure to progress." Both the mother and the baby are at risk for several
complications, including infections, if the amniotic sac has been ruptured for a long time and the
birth doesn't follow.

Abnormal Presentation

"Presentation" refers to the part of the baby that will appear first from the birth canal. In the
weeks before your due date, the fetus usually drops lower in the uterus. Ideally, for labor, the
baby is positioned head-down, facing the mother's back, with its chin tucked to its chest and the
back of the head ready to enter the pelvis. That way, the smallest possible part of the baby's head
leads the way through the cervix and into the birth canal. This normal presentation is called
vertex (head down).

Because the head is the largest and least flexible part of the baby, it's best for the head to lead
the way into the birth canal. That way, there's little risk that the baby's body will make it through
the birth canal, but the head will get caught.

Other presentations are:

Premature Rupture of Membranes (PROM)

Normally, the membranes surrounding the baby in the uterus break and release amniotic fluid
(known as the "water breaking") either right before or during labor. Premature rupture of

KATHREEN C. JOSON, PH.D. DEVELOPMENTAL PSYCHOLOGY 7

membranes means that these membranes have ruptured too early in pregnancy. This exposes
the baby to a high risk of infection.

Umbilical Cord Prolapse

The umbilical cord is your baby's lifeline. You pass oxygen and other nutrients from your body
to your baby through the umbilical cord and placenta.

Sometimes, before or during labor, the umbilical cord can slip through the cervix after your
water breaks, preceding the baby into the birth canal. The cord may even protrude from the
vagina -- a dangerous situation because the blood flow through the umbilical cord can become
blocked or stopped. You will probably feel the cord in the birth canal if it prolapses, and may see
the cord if it protrudes from your vagina. This is an emergency: Call an ambulance and get to the
hospital right away.

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

Umbilical Cord Compression

Because the fetus moves and kicks inside the uterus, the umbilical cord can wrap and unwrap
itself around the baby many times throughout pregnancy. While there are "cord accidents" in
which the cord gets twisted around and harms the baby, this is extremely rare and usually can't
be prevented.

Sometimes the umbilical cord gets stretched and compressed during labor, leading to a brief
decrease in blood flow to the fetus. This can cause sudden, short drops in fetal heart rate, called
variable decelerations, which are usually picked up by monitors during labor. Cord compression
happens in about one in 10 deliveries. In most cases, these heart rate changes are of no major
concern, and the birth proceeds normally. But a C-section may be necessary if the baby's heart
rate worsens or the baby shows other signs of distress.

Amniotic Fluid Embolism

This is one of the most serious complications of labor and delivery. Very rarely, a small amount
of amniotic fluid -- the fluid that surrounds the fetus in the uterus -- enters the mother's
bloodstream, usually during a particularly difficult labor or a C-section. The fluid travels to the
woman's lungs and may cause the arteries in the lungs to constrict. For the mother, this
constriction can result in a rapid heart rate, irregular heart rhythm, collapse, shock, or even
cardiac arrest and death. Widespread blood clotting is a common complication, requiring
emergency care.

Preeclampsia

Preeclampsia is a complication of pregnancy involving high blood pressure that develops after
20 weeks of pregnancy or shortly after delivery. Preeclampsia may lead to premature
detachment of the placenta from the uterus, seizure, or stroke.

Uterine Bleeding (Postpartum Hemorrhage)

After a baby is delivered, excessive bleeding from the uterus, cervix, or vagina, called
postpartum hemorrhage, can be a major concern. Excessive bleeding may result when the
contractions of the uterus after delivery are impaired, and the blood vessels that opened when
the placenta detached from the wall of the uterus continue to bleed.

Post-Term Pregnancy and Post-Maturity

In most pregnancies that go a little beyond 41 to 42 weeks, called post-maturity or a post-term

pregnancy, no problems develop. But problems may develop if the placenta can no longer
provide enough nourishment to maintain a healthy environment for the baby.

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan
NEWBORN BEHAVIORS

1. Crying – normally, crying begins at birth or shortly afterward. Occasionally, in a long and
difficult birth, the fetus will cry even while in the uterus. Pre-birth cries are rare and dangerous
for there is always the possibility that the fetus will be choked by the fluid in the uterus.

KATHREEN C. JOSON, PH.D. DEVELOPMENTAL PSYCHOLOGY 8

1. The birth cry is purely a reflex activity which results when air is drawn over the vocal
cords causing them to vibrate. Its purpose is to inflate the lungs, thus making breathing
possible and to supply the blood with sufficient oxygen.

2. Shortly after birth, the infants cry shows variations in pitch, intensity and continuity.

2. Sleep patterns – new born infants sleep a great deal of 16-17 hours a day.
3. Sucking patterns – at the first feeding, the neonate may suck raggedly, but within a few
days he/she, swallows and breathes in smooth coordination.

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The Child and Adolescent Learner KATHREEN C. JOSON, Ph.D.
Isabela State University
City of Ilagan

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