MODULE 6: PARENTHOOD
Roles & Responsibilities of Parenting
• Parenthood – the state of being a parent, which
begins when one has a child by birth or adoption
• A child brings dramatic and long-lasting
changes.
Responsible Parenthood
• a privilege and obligation exercised by married couple
to deliberately and generously decide to raise a large
family or, for different reasons and motives & with due
respect for the moral law
• to avoid a new birth for an interdeterminate period
• involves the issue of when and how many children to
have
Planned Parenthood
• maintaining fertility until the person can choose the
right time for assuming the responsibilities of being a
parent
• common justifications for planned parenthood: danger
to the mother's or child's health and life, eugenic
hereditary defects, and socio-economic difficulties
__________________________________________________
New Responsibilities
• Raising a child is more than a day-to-day
assignment…
It is LIFE-LONG commitment!!
• A child needs - - - - physical care, guidance, love,
support, financial care
• You have to consider the child’s needs first.
• First time parents can feel overwhelmed.
• Family
• Friends
• Community Resources
Changes in Lifestyle
• Caring for a young child takes a huge amount of time
and energy.
• Parents have limits placed on their personal freedom.
• Couples are better able to adjust to these changes in
life if they prepare for them.
Emotional Adjustments
• Parents feel conflicting emotions such as:
• Fear of not being a good parent
• Frustration at the loss of personal freedom
and the addition of new responsibilities.
• Worry over money matters
• Jealousy of the baby and the attention
• Depression due to exhaustion or to the
physical changes of pregnancy and birth.
Changes in Relationships
• Some parents feel overwhelmed by negative
emotions and begin to bicker or fight with one
another.
• The key to getting past troubled spots is for the couple
to have good communication.
• Grandparents feel love and joy of their own and want
to spend time with the baby.
• New parents may feel that the grandparent’s advice is
really a criticism and resent it.
• The grand parents my feel hurt if their suggestions are
rejected.
• develop
Changes in Work
• Working women may quit work or cut back on their
hours to care for their child.
• Workers who often put in overtime or weekends may
be less willing to put in extra hours.
• Companies have policies to help working parents.
• On-site child-care facilities
• Flexible hour
The Rewards of Parenthood
• Parents feel happiness, pride, and love.
• Parents can see the world with new eyes.
• Enrich an already healthy marriage
• Parents experience a great sense of accomplishment.
Making Decisions About Parenthood
• People who are thinking about parenthood should
have a clear picture of what parenthood is.
• They also need to take a realistic look at themselves
to see if they are ready for parenthood.
Emotional Maturity
• Emotional maturity – being responsible enough to
consistently put someone else’s needs before you
own
• Being secure enough to devote your full
attention
• Prospective parents should take an honest look at
their maturity
Desire for Parenthood
• Our marriage is in trouble. Maybe having a baby will
solve our problems.
• I want to give a baby my care and love.
• I feel good about myself and believe that parenthood
will be rewarding.
• Our parents want grandchildren.
• A baby is someone who will love me and belong to
me.
Financial Concerns
• Raising a child is VERY expensive!!
• Couples should take a careful look at the cost
involved over the years ahead.
Management Skills
Becoming a good manager is a matter of following five steps:
1. Set Goals
• Decide what is important for you and then
make them into objectives for you to achieve.
2. Identify Resources
• Figure out your resources to achieve your
goal.
3. Make a Plan
• Decide how you will use your resources to
meet that goal.
4. Put the plan in action.
• Once you have a plan, start working toward
your goal.
5. Reevaluate from time to time.
• Do you need more resources or different
ones?
• Did you achieve your goal more easily than
you expected?
Parenting: A Learning Process
• Parenting – caring for children and helping them
Demands Good Judgment:
 1. Requires knowing when to help and when to back off MODULE 7 A: Preventing Pregnancy
2. Parents need to avoid pushing children to try activities
they are not yet ready for. Abstinence
• They have to avoid holding children back out  Only 100% method of birth control
of fear they may fail.  Abstinence is when partners do not engage in sexual
3. The skills that parents need change as the child intercourse
grows.  Communication between partners is important for
Having Reasonable Expectations those practicing abstinence to be successful
• An essential first step in effective parenting. Reasons for abstaining
• Caregivers need to be sure to match their  Moral or religious values
expectations to the particular child.  Personal beliefs
• Caregivers need to respect the differences between  Medical reasons
children.  Not feeling ready for an emotional, intimate
Finding a Comfortable Parenting Style: relationship
• Authoritarian – based on the idea that children  Future plans
should obey their parents without question.
• Democratic – children have more input into the Types of Birth Control
rules and limits  Hormonal
• Permissive – parents give children a wide range of  Barrier
freedom.  IUD
Getting Help  Methods based on information
Ways to Build Parenting Skills  Permanent sterilization
• Reading books and magazine articles about parenting Preventing Ovulation or Killing the Sperms
• Gaining experience with children  These methods are interventions which suppress the
• Asking advice from family members and friends generative functions which may or may not leave the
• Observing other parents and children reproductive glands intact.
The Tasks of Parenting Breastfeeding
3 Basic Tasks  a natural method of child spacing
1. Meet the child’s basic needs  it stimulates natural hormones which prevent
2. Nurture ovulation
3. Guide children to show appropriate behavior  provides 98% contraceptive protection for up to six
Meeting Children’s Needs months after delivery
Hormonal Methods
• Provide food, clothing and shelter
 The hormones estrogen and progesterone
• Watch over their safety and health
administered to stop the ovaries from releasing eggs.
• Begin teaching them language
 Oral Contraceptives (Birth Control
• Foster intellectual growth by taking an active role in
Pill)
their schooling
 Injections (Depo-Provera)
• Teach them to get along with others  Implants (Norplant I & II)
• Provide opportunities for them to love and be loved. Birth Control Pills
Nurturing  Pills can be taken to prevent pregnancy
• Giving a child opportunities for encouragement  Pills are safe and effective when taken properly
and enrichment.  Pills are over 99% effective
• Parents are children’s first teachers.  Women must have a pap smear to get a prescription
• Parents need to give children the freedom they need for birth control pills
in order to learn.  Pills DO NOT prevent STD’s
• Adults should remove as many barriers as possible  Stops ovulation
that prevent children from exploring the world on their  Thins uterine lining
own.  Thickens cervical mucus
• Deprivation – lack of an enriching environment
• Provide love and support
• Some parents become overprotective and
overattentive.
Communicating Positively
• Use words that the child can understand, but avoid
talking down.
• Be clear. Think in terms of the child’s point of view.
• Be positive and polite.
• Give praise and love.
• Limit the directions to those that are essential.
• Talk about what’s meaningful to the child.
  Stops ovulation
 Stops menstrual cycles!!
 Thickens cervical mucus
SIDE EFFECTS
 Extremely irregular menstrual bleeding and spotting
for 3-6 months!
 NO PERIOD ☺ after 3-6 months
 Weight change
 Breast tenderness
 Mood change
*NOT EVERY WOMAN HAS SIDE-EFFECTS!

IMPLANTS
 Implants are placed in the body filled with hormone
that prevents pregnancy
 Physically inserted in simple 15 minute outpatient
procedure
 Plastic capsules the size of paper matchsticks
inserted under the skin in the arm
 99.95% effectiveness rate
Norplant I vs. Norplant II
 Six capsules
 Five years
 Two capsules
 Three years
 The pill works in several ways to prevent pregnancy.
The pill suppresses ovulation so that an egg is not
released from the ovaries, and changes the cervical
mucus, causing it to become thicker and making it
more difficult for sperm to swim into the womb. The
pill also does not allow the lining of the womb to
develop enough to receive and nurture a fertilized
egg. This method of birth control offers no protection
against sexually-transmitted diseases.

Norplant Considerations
 Should be considered long term birth control
Positive Benefits of Birth Control Pills
 Requires no upkeep ☺
✓ Prevents pregnancy
 Extremely effective in pregnancy prevention > 99%
✓ Eases menstrual cramps
SPERMICIDES
✓ Shortens period
 Chemicals kill sperm in the vagina
✓ Regulates period
 Different forms:
✓ Decreases incidence of ovarian cysts
-Jelly -Film
✓ Prevents ovarian and uterine cancer
-Foam -Suppository
✓ Decreases acne
 Some work instantly, others require pre-insertion
Side-effects
 Only 76% effective (used alone), should be used in
• Breast tenderness combination with another method i.e., condoms
• Nausea Preventing sperm from reaching the egg in the fallopian tube
• Increase in headaches
• Moodiness BARRIER METHODS
• Weight change  Spermicides
• Spotting  Male Condom
Taking the Pill  Female Condom
 Once a day at the same time everyday  Diaphragm
 Use condoms for first month  Cervical Cap
 Use condoms when on antibiotics  Prevents pregnancy blocks the egg and sperm from
 Use condoms for 1 week if you miss a pill or take one meeting
late  Barrier methods have higher failure rates than
 The pill offers no protection from STD’s hormonal methods due to design and human error
 Birth control shot given once every three months to MALE CONDOM
prevent pregnancy
 99.7% effective preventing pregnancy • Most common and effective barrier method when
 No daily pills to remember used properly
 The same way as the Pill!
 • Latex and Polyurethane should only be used in the
prevention of pregnancy and spread of STD’s
(including HIV)

 Perfect effectiveness rate = 97%

 Typical effectiveness rate = 88%
 Latex and polyurethane condoms are available
 Combining condoms with spermicides raises
effectiveness levels to 99%
FEMALE CONDOM
 Made as an alternative to male condoms
 Polyurethane The diaphragm is a flexible rubber cup that is filled with
 Physically inserted in the vagina spermicide and self-inserted over the cervix prior to
 Perfect rate = 95% intercourse. The device is left in place several hours after
 Typical rate = 79% intercourse. The diaphragm is a prescribed device fitted by a
 Woman can use female condom if partner refuses health care professional and is more expensive than other
Reality  : The Female Condom barrier methods, such as condoms
The female condom is a lubricated polyurethane sheath,
similar in appearance to a male condom. It is inserted into the CERVICAL CAP
vagina. The closed end covers the cervix. Like the male  Latex barrier inserted in vagina before intercourse
condom, it is intended for one-time use and then discarded.  “Caps” around cervix with suction
The sponge is inserted by the woman into the vagina and  Fill with spermicidal jelly prior to use
covers the cervix blocking sperm from entering the cervix. The  Can be left in body for up to a total of 48 hours
sponge also contains a spermicide that kills sperm. It is  Must be left in place six hours after sexual intercourse
available without a prescription.  Perfect effectiveness rate = 91%
 Typical effectiveness rate = 80%
Vaginal Ring (NuvaRing) Cervical Cap
NuvaRing is a flexible plastic (ethylene-vinyl acetate The cervical cap is a flexible rubber cup-like device that is filled
copolymer) ring that releases a low dose of a progestin and an with spermicide and self-inserted over the cervix prior to
estrogen over 3 weeks. intercourse. The device is left in place several hours after
 95-99% Effective A new ring is inserted into the intercourse. The cap is a prescribed device fitted by a health
vagina each month care professional and can be more expensive than other
 Does not require a "fitting" by a health care provider, barrier methods, such as condoms.
does not require spermicide, can make periods more
regular and less painful, no pill to take daily, ability to
become pregnant returns quickly when use is
stopped.
DIAPRAGHM
 Perfect Effectiveness Rate = 94%
 Typical Effectiveness Rate = 80%
 Latex barrier placed inside vagina during intercourse
 Fitted by physician
 Spermicidal jelly before insertion
 Inserted up to 18 hours before intercourse and can be
left in for a total of 24 hours
  May experience heavier periods
 Surgical sterilization which permanently prevents the
transport of the egg to the uterus by means of sealing
the fallopian tubes is called tubal ligation, commonly
called "having one's tubes tied." This operation can be
performed laparoscopically or in conjunction with a
Cesarean section, after the baby is delivered. Tubal
ligation is considered permanent, but surgical reversal
can be performed in some cases

VASECTOMY
 Male sterilization procedure
 Ligation of Vas Deferens tube
 No-scalpel technique available
 Faster and easier recovery than a tubal ligation
 Failure rate = 0.1%, more effective than female
sterilization
 During a vasectomy (“cutting the vas”) a urologist cuts
and ligates (ties off) the ductus deferens. Sperm are
still produced but cannot exit the body. Sperm
eventually deteriorate and are phagocytized. A man
is sterile, but because testosterone is still produced he
retains his sex drive and secondary sex
characteristics.

Interrupted Intercourse
(coitus interruptus)
 Also known as withdrawal method
 refers to the pulling out of the penis before ejaculation
 Not totally effective=some semen may be secreted
into the vagina before the actual ejaculation
Preventing fertilized egg from implanting in the uterine wall
(abortifacients)

Intrauterine Devices (IUDs)

Sponge
 considered both contraceptive and an abortifacient
The sponge is inserted by the woman into the vagina and
 may also alter fallopian tube motility, hindering the
covers the cervix blocking sperm from entering the cervix. The
movements of the egg and sperms
sponge also contains a spermicide that kills sperm. It is
available without a prescription
INTRAUTERINE DEVICES (IUD)
 T-shaped object placed in the uterus to prevent
pregnancy
 Must be on period during insertion
 A Natural childbirth required to use
IUD
 Extremely effective without using hormones > 97 %

Surgical Castration
 achieves permanent sterility by removing the
reproductive organs
 may be considered a form of mutilation
STERILIZATION
 Procedure performed on a man or a woman
permanently sterilizes
 Female = Tubal Ligation
 Male = Vasectomy
TUBAL LIGATION
 Surgical procedure performed on a woman
 Fallopian tubes are cut, tied, cauterized, prevents
eggs from reaching sperm
 Failure rates vary by procedure, from 0.8%-3.7%
  Must be in monogamous relationship  sexual dysfunction
 anxiety
 weakens moral values and causes loss of respect for
women and children
 lead to sexual permissiveness, marital infidelity,
premarital sex, risks of STDs

MODULE 7B: Natural Family Planning

Natural Family Planning & Fertility Awareness Method

Definition of NFP
Abortion
 dislodging implanted egg or embryo
 this process uses drugs or mechanical devices which
remove the implanted embryo from its nesting place in
the uterine wall and cause it to be prematurely
delivered before it can survive
◼ Women take a class on the menstrual cycle to
calculate more fertile times
◼ Requires special equipment and cannot be self-taught
◼ NFP abstains from sex during the calculated fertile
time
◼ FAM uses barrier methods during fertile time
◼ Perfect effectiveness rate = 91%
◼ Typical effectiveness rate = 75%
◼ No 100% safe day-irregular periods
◼ Methods of monitoring and interpreting natural
biological markers of fertility
◼ To help determine the fertile and infertile times of a
woman’s menstrual cycle
◼ Information can be be used to achieve or avoid
pregnancy
◼ Abstaining from intercourse and genital activity
during fertile time of cycle if avoiding pregnancy
◼ Not using contraception to interfere with fertility
◼ Developing non-genital ways of expressing intimacy
during the fertile times
◼ Being Open to Life

METHODS OF NFP
◼ Calendar Rhythm
◼ Basal Body Temperature (BBT)
◼ Cervical Mucus (or Ovulation Method)
◼ Sympto-Thermal Method (STM)
◼ Hormonal Monitoring

So – How Does NFP Work?

Six Day Fertile Window
◼ A man and woman together are fertile for only 6 days.
◼ The day of ovulation when a egg is released.
Risks of Contraception ◼ And the 5 days before ovulation!
Physical Problems Female Cervix:
 Surgical Procedures carry all the usual surgical and ◼ Produces thin watery fertile mucus when stimulated
anesthetic risks by estrogen
 Hormonal Contraceptives may cause side effects that ◼ Sperm live in good mucus 3-5 days
includes: ◼ Produces thick mucus plug when stimulated by
 tumors, cardiovascular, blood, lung, progesterone
and gall bladder disease, weight NFP measures …
gain, depression or mood Estrogen - secreted by the ovary’s follicle
disturbances, nausea, menstrual ◼ Stimulates cervical mucus production
disturbances, decreased sexual LH - secreted by the pituitary
desire, acne, breast tenderness ◼ Stimulates ovulation
 Its dreaded complications are blood clots which can Progesterone - secreted by the corpus luteum
clog vital organs and cause death ◼ Raises basal body temperature
 IUD- risks of expulsion, cramping, menstrual ◼ Dries cervical mucus
irregularities, perforation of the uterus, pelvic infection,
and ectopic pregnancy Natural Biological Signs of Fertility
Psychological and Moral Problems ◼ Changes in Resting Body Temp
 depression ◼ Changes in Cervical Mucus
 divorce ◼ Changes in Female Hormones
Note: some still use a Formula
The Beginning of Fertile Phase
◼ Presence of cervical mucus
◼ Rising levels of the hormone estrogen
◼ Shortest cycle minus 20 days; or day “8”

Markers of Peak Fertility

◼ Cervical mucus – clear, stretchy, slippery
◼ Rise in basal body temperature
◼ LH hormone peaks

The End of the Fertile Phase

◼ Peak in cervical mucus plus count of 3
◼ Rise in temperature plus count of 3
◼ Peak in LH plus count of 3
◼ Longest cycle minus 10 days; or day “19”

Clearblue Fertility Monitor WITHDRAWAL

◼ Low Fertility ◼ Removal of penis from the vagina before ejaculation
occurs
◼ NOT a sufficient method of birth control by itself
◼ Effectiveness rate is 80% (very unpredictable in
teens, wide variation)
◼ 1 of 5 women practicing withdrawal become pregnant
◼ High Fertility ◼ Very difficult for a male to ‘control’

Billings Ovulation Method

▪ Cervical Mucus
▪ Perfect Use = 99 - 100%
◼ Peak Fertility ▪ Typical Use = 89 - 99%

Creighton Model System (CrM)

◼ Standardized form of the Ovulation Method
◼ Basis for what is called NaProTechnology
◼ Correct Use = 99.9
◼ Typical Use = 96.8
Basic Instructions for Achieving and Avoiding Pregnancy
◼ Achieve - Have intercourse during the fertile window! Sympto-Thermal Methods (STM)
◼ Avoid – Don’t have intercourse during the fertile • Combines indicators of fertility
window! • Common indicators are BBT, cervical mucus, and
Effectiveness of NFP calendar formulas
◼ Accurate charting • Provided by Couple to Couple League and Northwest
◼ Accurate observations Family Systems
◼ Consistent use • Correct Use = 99%
◼ Mutual motivation • Typical Use = 85 – 94%
◼ Loving cooperation
NFP is close to 98% effective! Sympto-Hormonal Method
◼ CPEFM plus
Methods of NFP ◼ Cervical mucus

◼ Correct use = 98-99%

◼ Typical use = 87-90%

Benefits of using NFP . . .

➢ No harmful side effects
➢ Supports reproductive health
➢ Environmentally friendly
➢ Virtually cost free
➢ Are adaptable—to achieve or avoid pregnancy
➢ Requires couple communication
➢ A “shared” responsibility
➢ Encourages sexual maturity
➢ Respects God’s design for married love!
NFP Respects God’s Design MODULE 7B: Natural Family
“To experience the gift of married love while respecting the Natural Family Planning & Fertility Awareness Method
laws of conception is to acknowledge that one is not the master ◼ Women take a class on the menstrual cycle to
of the sources of life but rather the minister of the design calculate more fertile times
established by the Creator.” ◼ Requires special equipment and cannot be self-taught
(Humanae vitae, #13) ◼ NFP abstains from sex during the calculated fertile
Therefore, time
Spouses “should never act to suppress or curtail the life-giving ◼ FAM uses barrier methods during fertile time
power given by God that is an integral part of what they ◼ Perfect effectiveness rate = 91%
pledged to each other in their marriage vows.” ◼ Typical effectiveness rate = 75%
(Married Love and the Gift ◼ No 100% safe day-irregular periods
of Life, 2006)
Definition of NFP
Fertility is Sacred ◼ Methods of monitoring and interpreting natural
◼ Stewards of the gift of life biological markers of fertility
◼ Cooperators with God’s love ◼ To help determine the fertile and infertile times of a
woman’s menstrual cycle
◼ Information can be be used to achieve or avoid
pregnancy
◼ Abstaining from intercourse and genital activity
during fertile time of cycle if avoiding pregnancy
◼ Not using contraception to interfere with fertility
◼ Developing non-genital ways of expressing intimacy
during the fertile times
◼ Being Open to Life

METHODS OF NFP
◼ Calendar Rhythm
◼ Basal Body Temperature (BBT)
◼ Cervical Mucus (or Ovulation Method)
◼ Sympto-Thermal Method (STM)
◼ Hormonal Monitoring

So – How Does NFP Work?

1.Six Day Fertile Window
• A man and woman together are fertile for only 6 days.
• The day of ovulation when a egg is released.
• And the 5 days before ovulation!
 The Beginning of Fertile Phase
◼ Presence of cervical mucus
◼ Rising levels of the hormone estrogen
◼ Shortest cycle minus 20 days; or day “8”
Markers of Peak Fertility
◼ Cervical mucus – clear, stretchy, slippery
◼ Rise in basal body temperature
◼ LH hormone peaks
The End of the Fertile Phase
◼ Peak in cervical mucus plus count of 3
◼ Rise in temperature plus count of 3
◼ Peak in LH plus count of 3
◼ Longest cycle minus 10 days; or day “19”

Female Cervix:
◼ Produces thin watery fertile mucus when stimulated
by estrogen
◼ Sperm live in good mucus 3-5 days
◼ Produces thick mucus plug when stimulated by
progesterone
Female Ovary

NFP measures …
Estrogen - secreted by the ovary’s follicle
◼ Stimulates cervical mucus production
LH - secreted by the pituitary
◼ Stimulates ovulation
Progesterone - secreted by the corpus luteum
◼ Raises basal body temperature
◼ Dries cervical mucus

Natural Biological Signs of Fertility

◼ Changes in Resting Body Temp
◼ Changes in Cervical Mucus
◼ Changes in Female Hormones
Note: some still use a Formula

Basic Instructions for Achieving and Avoiding Pregnancy

◼ Achieve - Have intercourse during the fertile window!
◼ Avoid – Don’t have intercourse during the fertile
window!
Effectiveness of NFP ➢ A “shared” responsibility
◼ Accurate charting ➢ Encourages sexual maturity
◼ Accurate observations ➢ Respects God’s design for married love!
◼ Consistent use
◼ Mutual motivation NFP Respects God’s Design
◼ Loving cooperation “To experience the gift of married love while respecting the
NFP is close to 98% effective! laws of conception is to acknowledge that one is not the master
of the sources of life but rather the minister of the design
Methods of NFP established by the Creator.”
(Humanae vitae, #13)
Therefore,
Spouses “should never act to suppress or curtail the life-giving
power given by God that is an integral part of what they
pledged to each other in their marriage vows.”
(Married Love and the Gift of Life, 2006)

Fertility is Sacred
◼ Stewards of the gift of life
◼ Cooperators with God’s love

MODULE 8: FACILITATING REPRODUCTION

WITHDRAWAL
Infertility: Extremely Prevalent
◼ Removal of penis from the vagina before ejaculation
▪ Failure of a couple to conceive after 1 year of regular
occurs
intercourse without use of contraception
◼ NOT a sufficient method of birth control by itself
▪ Primary infertility – No prior pregnancies
◼ Effectiveness rate is 80% (very unpredictable in
▪ Secondary infertility – Prior pregnancy
teens, wide variation)
◼ 17-26% of couples worldwide (90 million women)
◼ 1 of 5 women practicing withdrawal become pregnant
◼ 27-47% of infertile couples have impaired male
◼ Very difficult for a male to ‘control’
fertility; decline in semen quality worldwide over last
50 years
Billings Ovulation Method
▪ Cervical Mucus
▪ Perfect Use = 99 - 100%
▪ Typical Use = 89 - 99%

Creighton Model System (CrM)

◼ Standardized form of the Ovulation Method
◼ Basis for what is called NaProTechnology
◼ Correct Use = 99.9
◼ Typical Use = 96.8

Sympto-Thermal Methods (STM)

• Combines indicators of fertility
• Common indicators are BBT, cervical mucus, and
calendar formulas
• Provided by Couple to Couple League and Northwest
Family Systems
• Correct Use = 99%
• Typical Use = 85 – 94%

Sympto-Hormonal Method Major causes of of infertility:

◼ CPEFM plus ▪ Female factor
◼ Cervical mucus ▪ Ovulatory dysfunction
◼ Correct use = 98-99% ▪ Abnormalities of female
◼ Typical use = 87-90% reproductive tract
▪ Peritoneal factors
Benefits of using NFP . . . ▪ Reproductive aging
➢ No harmful side effects ▪ Male factor
➢ Supports reproductive health ▪ Abnormal semen quality
➢ Environmentally friendly ▪ Abnormalities of male reproductive
➢ Virtually cost free tract
➢ Are adaptable—to achieve or avoid pregnancy ▪ Delayed marriage and child-bearing
➢ Requires couple communication ▪ Sexually transmitted diseases
 ▪ Lifestyle habits (smoking, alcohol) STEPTOE AND EDWARDS
▪ Obesity
▪ Environmental contaminants (chemicals, radiation, air ◼ Birth of Louise Brown
pollution, heavy metals) First IVF Baby, 1978
▪ Genetic malformations of reproductive tract and
endocrine disorders
What is IVF?
IVF (in vitro fertilization) is a method in which egg cells are
fertilized by sperm cells outside the mother’s womb (in vitro).
The resulting embryos are then transferred back into the
uterus.

STEPS IN IVF
◼ Follicle suppression
◼ Controlled ovarian hyperstimulation
◼ Aspiration of eggs from follicles
◼ Fertilization, incubation and selection of embryos
◼ Embryo transfer
◼ Pregnancy test

FOLLICLE SUPPRESSION AND CONTROLLED OVARIAN

HYPERSTIMULATION

High Quality Egg

What is ART?
Assisted Reproductive Technologies:
◼ All fertility treatments use drugs to stimulate
ovoluation
◼ Fertility therapies where eggs and sperm are
manipulated
◼ Involve surgically removing eggs from women and
combining them with sperm in the laboratory
◼ Majority of the babies born with ART are healthy and Low Quality Egg
without complications
◼ Predominantly IVF – In Vitro Fertilization
◼ Expensive
◼ Most attempts fail to produce a live birth
◼ Separates procreation from the marital act
◼ Large loss of embryos in failure to implant, discarding
embryos, pre-implantation diagnosis, freezing,
selective reduction

REPRODUCTIVE CHRONOLOGY
◼ 1934 Gregory Pincus: First animal IVF
◼ 1944 John Rock: First human IVF
◼ 1960 FDA approves “the pill”
◼ 1978 First IVF baby
◼ 2001 421 U.S. ART clinics with 41,000
live births annually
GREGORY PINCUS Embryologist Manipulating Ova and Sperm
◼ 1934 First in vitro fertilization of rabbit eggs
◼ Criticized as “mad scientist”
◼ Developed oral contraceptives in 1950’s
Dr. John Rock 1890-1984
◼ 1936 First doctor to open a Rhythm clinic in Boston
◼ 1944 First IVF; created four embryos in secret
◼ 1954 Collaborated with Pincus on U.S. clinical trials of the
pill
 PANAYIOTIS ZAVOS, PH.D.
◼ Currrently conducting human cloning experiments in
ICSI (Intracytoplasmic Sperm Injection) undisclosed country with drs. Severino antorini and
ben-abraham
◼ Goal: providing childless couples with the ability to
clone themselves as a form of reproduction

IVF Why not? MULTIPLE BIRTHS

◼ Multiple pregnancies with IVF (37.4%)

HIGH QUALITY THREE DAY OLD EMBRYO
◼ Triplets or more 8.4% (4.9% of live births)
◼ Prematurity: Average with triplets 33 weeks; 85%
survive
◼ Prematurity: Quadruplets average 29 weeks; 70%
survive
◼ Fetal risks: mental/physical disabilities such as
blindness, cerebral palsy; 5% in twins, 10% in triplets,
50% in quadruplets
◼ Fetal risks: death; seven times more likely to die in the
first year; 40x more likely to die in infancy
◼ Maternal risks: toxemia, diabetes, hemorrhage
◼ Family risks: depression, social isolation, divorce

IVF: Expensive
◼ Medication: $1,500-$7,000 per cycle
◼ Office visits, egg retrieval, fertilization, assisted
hatching, cryofreezing of embryo (six
months),ultrasound, lab tests: $12,000-18,000 PER
CYCLE;
◼ Egg donation $3,000-$50,000
IVF: Additional Costs
◼ Hospital costs - Singleton $10,000; Twins $20,000;
Triplets $40,000
EMBRYO TRANSFER ◼ Intensive care of baby: $100,000-$150,000 per month
◼ Work time lost--daily medical visits
◼ Frequently not covered by insurance

Fertility Preservation
Refers to saving or protecting an individual's reproductive
tissues or cells for procreation purposes

Sperm Freezing
◼ Sperm freezing and storage is the procedure
whereby sperm cells are frozen to preserve them for
future use. Scientists freeze the sperm using a
special media then keep sperm in liquid nitrogen at
minus 196 degree Celsius, and it can be stored for
many years while maintaining a reasonable quality.

Egg freezing
IVF why not? ◼ Also known as mature oocyte cryopreservation, is a
IVF permits the use of donor ova and sperm and cloned method used to preserve reproductive potential in
embryos women.
◼ Violates traditional Judeo-Christian concept of ◼ Eggs are harvested from women ovaries, frozen
marriage unfertilized and stored for later use. A frozen egg can
◼ Legal and biological confusion be thawed, combined with sperm in a lab and
◼ “Commercialization” of human life—sale of ova and implanted in uterus.
sperm
◼ Donor ova and sperm illegal in many countries
◼ Cloned embryos can be used
◼ Cloning a dangerous technology and makes massive
abuses possible
MODULE 9-11: HUMAN GROWTH AND DEVELOPMENT Infants and Toddlers: Physical Development
• Human growth and development is the study of how • Infants:
people change as they go through life. ▫ Establish a day and night sleeping pattern
• Development is similar for everyone, but each person ▫ Hold up their heads, roll over, and reach for
grows and develops at an individual rate. things
▫ Hearing and depth perception improve
Areas of Development ▫ Crawl and then walk
• Physical development - all the bodily changes that • Toddlers:
occur as a person grows and ages. ▫ Gain weight and height
• Intellectual development - a person’s ability to learn ▫ Run, jump, and climb
something and then apply this knowledge to new ▫ Scribble and stack blocks
problems and experiences.
• Emotional development - changes in a person’s Infants and Toddlers: Intellectual Development
ability to establish a unique identity and express • Infants:
feelings. ▫ Imitate facial expressions
• Social development - learning to interact with other ▫ Recognize people, places, and objects
people. ▫ Make sounds that resemble spoken
language
Hierarchy of Human Needs • Toddlers:
• A psychologist named Abraham Maslow developed a ▫ Experiment with objects
system of basic human needs. ▫ Play make-believe
• Hierarchy of human needs: ▫ Imitate adults
▫ Food, shelter, bodily comfort ▫ Begin to speak and communicate
▫ Safety, security ▫ Build a 200-word vocabulary
▫ To feel loved, have a sense of belonging
▫ Self-esteem, approval Infants and Toddlers: Emotional Development
▫ Desire to live up to one’s potential • Infants:
▫ Show basic emotions
▫ Anger and fear increase
▫ Develop stranger anxiety
▫ May develop separation anxiety
• Toddlers:
▫ Show empathy
▫ Able to cooperate
▫ Begin to express shame, embarrassment,
and pride
▫ Self-control emerges

Infants and Toddlers: Social Development

• Infants:
▫ Begin to smile and laugh
▫ Match emotional facial expressions of adults
▫ Able to interpret others’ emotions
• Toddlers:
▫ Play with siblings
▫ Show signs of gender-stereotypical toy
Genetics choices
• Genetics is an area of biology that deals with the
passing of genes from parents to children. Infant Health Issues
• Genes contain DNA: • Infants and toddlers should have a series of
▫ DNA consists of 23 pairs of chromosomes immunizations to prevent several diseases, such as
▫ Each pair is made up of one chromosome hepatitis B and polio.
from the mother and one from the father. • Children are also susceptible to accidental injuries,
Childhood such as choking, drowning, and poisoning.
• Infants and Toddlers • These fatal situations are often avoidable when
• Early Childhood children are given proper care and watched closely.
• Middle Childhood

Infants and Toddlers ( 0-2 years old ) Early Childhood

• Infancy generally refers to the first year of life. • Early childhood generally occurs between the ages of
• Toddler refers to the second year of life. 2 and 6.
• During this time, children continue to progress rapidly • During this time, children continue to develop
in all areas of development. physically, intellectually, emotionally, and socially.

Early Childhood: Physical Development
• Physical growth slows down.
• Motor skills improve, allowing for greater coordination
and balance.
• A preference for the left or right hand develops.
• They begin to lose primary teeth and grow adult teeth.
Early Childhood: Intellectual Development
• They can see simple situations from someone else’s
point of view.
• A greater attention span develops.
• The ability to count up and down develops along with
the capability to perform simple addition and
subtraction problems.
• Language and memory skills improve.
Early Childhood: Emotional Development
• They tend to shift quickly from confident to unsure.
• The feeling of frustration erupts easily due to the
increasing intellectual abilities that are developing
faster than physical abilities.
• They develop self-esteem and learn to express their
emotions in acceptable ways.
Early Childhood: Social Development
• Children in this stage generally become better
communicators.
• Most children understand sharing and begin to play
with other children, which is called cooperative play.
Early Childhood Health Issues
• Children at this age have a considerable drop in
appetite as their growth slows down.
• Because they are eating less, it is particularly
important to make sure that all that they eat is good
for them.
• Children in this stage still need plenty of adult
supervision and guidance about safety issues.
Middle Childhood 6-11 years old
• Middle childhood generally occurs between the ages
of 6 and 11.
• During this time, children continue to develop
physically, intellectually, emotionally, and socially.
Middle Childhood: Intellectual Development
• Children in this stage display great strides in
intellectual growth.
• Their ability to think logically and understand more
complex ideas develops.
• They can employ strategies to remember things.
Middle Childhood: Emotional Development
• Children in this stage of development become more
independent and responsible as their confidence
grows.
• They may be able to describe their own personalities
and explain their emotions.
• They also have more self-esteem than younger
children.
Middle Childhood: Social Development
• They understand that people’s perspectives on issues
are caused by the information that they have.
• They can view their relationships with others from a
third-party’s point of view.
• They develop friendships that are based on trust.
• Their personalities and interests become more gender
stereotypical.
End of Childhood 11-13 years old
• The germ cells continue to increase in number
• Meiosis and development to form the mature
spermatozoa in the male and primary oocytes
Middle Childhood Health Issues
• Nearsightedness
• Ear infections
• Obesity
• Malnutrition
• Bedwetting
Adolescence 13-20
• Adolescence generally occurs between the ages of 13
and 20.
• Most attention is paid to the first half of this stage of
development.
• Adolescence is a time of transitioning from childhood
to adulthood in each area of development.
Adolescence: Physical Development
• Females:
▫ Gain up to 40 pounds
▫ Grow up to 10 inches
▫ Begin to menstruate
▫ Develop secondary sexual characteristics
• Males:
▫ Grow much taller and develop muscle mass
▫ Reproductive organs mature
▫ Develop secondary sexual characteristics
Adolescence: Intellectual Development
• Adolescents develop better critical thinking skills,
which enable them to interpret and evaluate
information.
• They become idealistic about the world around them.
However, they may also become more critical, when
the world does not live up to their ideals.
Adolescence: Emotional Development
• Adolescence is a challenging and confusing time for
many young people. They seek to establish their
identities.
• They are self-conscious and often influenced by the
thought that everyone is watching them.
• They are often and easily embarrassed.
Adolescence: Social Development
• Adolescents love to socialize with their friends.
• They each develop their own sense of morals and
values largely based on what their parents have
taught them.
• They also develop an awareness and interest in the
opposite sex.

Adolescent Health Issues
• Feelings of inadequacy are often displayed in the form
of eating disorders, such as anorexia nervosa and
bulimia.
• Some adolescents turn to chemical substances for
stress relief, because of peer pressure, or to escape
from problems.
• Suicide is a leading cause of death in adolescence.
Early Adulthood
• Early adulthood generally occurs between the ages of
20 and 40.
• During this time, adults continue to develop and
change physically and intellectually.
• They also continue to change socially and
emotionally. However, at this point in life, these two
areas become difficult to distinguish.
Early Adulthood: Physical Development
• Early in this stage:
▫ In prime physical condition
▫ Typically stronger and faster
• Later in this stage:
▫ Body need to be stretched and warmed up to
prevent injury
▫ Metabolism slows down
▫ Decline in vision and hearing
▫ Hair begins to thin and gray
▫ Women may have fertility problems
Early Adulthood: Intellectual Development
• People typically settle in a career and develop
expertise in that field.
• Creativity tends to increase.
• Later in this stage, people are better able to manage
many responsibilities at one time and to balance work
and home life.
Early Adulthood: Emotional and Social Development
• Adults develop an image of themselves in relation to
the adult world around them.
• Adults develop values, skills, and credentials in the
workplace.
• They acquire fulfilling adult friendships and work
contacts.
• They might get married and have children.
Middle Adulthood
• Middle adulthood generally occurs between the ages
of 40 and 60.
• They continue to develop and change physically and
intellectually.
• They also continue to change socially and
emotionally. As in early adulthood, at this point in life,
these two areas are difficult to distinguish.
Middle Adulthood: Physical Development
• People typically experience some high-frequency
hearing loss, declining vision, and loss of lean body
mass.
• The hair continues to thin and gray and weight gain
occurs. Skin begins to wrinkle and sag due to loss of
elasticity.
• Disks in the spinal column begin to collapse, which
could result in shrinking as much as an inch in height.
• In women, menopause occurs.
Middle Adulthood: Intellectual Development
• Middle adults experience an increase in problem-
solving abilities and expertise.
• However, there are decreases in the ability to:
▫ Remember large quantities of information
▫ Retrieve information from memory
▫ Multi-task
Middle Adulthood: Emotional and Social Development
• Middle adults become concerned about the next
generation and have a desire to guide and connect
with it.
• Self-acceptance is at its best.
• Some people retire.
• Family relationships change:
▫ Children become independent.
▫ Parents begin to age and need assistance.
▫ Sibling relationships become more satisfying.
Late Adulthood
• Late adulthood generally occurs between the ages of
60 and 80.
• During this time, adults continue to develop and
change physically and intellectually.
• They also continue to change socially and
emotionally. However, at this point in life, these two
areas become difficult to distinguish.
Late Adulthood: Physical Development
• The body continues to decline:
▫ Vision and hearing decline.
▫ Senses of taste, smell, and touch become
less sharp.
▫ The immune system ages.
▫ Bone mass continues to diminish.
• Neurons die at a faster rate. However, the brain
compensates with new synapses.
Late Adulthood: Intellectual Development
• Late adults continue to experience a decline in their
ability to recall from their memories.
• Finding the right words and organizing them into
speech become increasingly challenging
• Although late adulthood includes the continued
decline of some functions, people in this stage of life
are at their most wise.
Late Adulthood: Emotional and Social Development
• People at this stage may be widowed. If they are not
widowed, they are probably more satisfied with their
marriages than in the past.
• Their relationships with siblings become even
stronger.
• They may become grandparents or great-
grandparents.
• Their faith and spirituality may become more
important.
 • They also have an increased interest in politics and • Skin loses elasticity due to the shrinking of elastin
are more likely to vote. fibers.
______________________________________________ • The loss of subcutaneous fat produces sagging,
wrinkles, and lines.
Caring for the Older Person • The skin becomes more sensitive to UV rays from the
• Calcium supplements and exercise should be sun.
encouraged Reproductive System
• Children or relatives of the older person must take • Sexual dysfunction could appear in the form of
time to be with the person in order not to feel function, pleasure, and desire.
depression. • Females:
Aging ▫ Menopause
- Aging ▫ Decrease of estrogen and progesterone
- Mortuary Science ▫ Androgen continues to be produced
- The study of aging is called gerontology. • Males:
- As people age, their bodies begin a process of decline ▫ Decrease of testosterone
in every major system. ▫ Decrease of sperm count
- There are several theories in regards to the cause of ▫ Difficulty maintaining an erection
aging. Urinary System
o Decline of cell reproduction • The kidneys shrink.
o Nutrition, injury, disease, and the • A decrease in blood flow to the kidneys diminishes its
environment ability to cleanse the blood stream of waste.
o Aging viruses • People may experience a loss of muscle control in the
o Free radicals bladder and sphincters.
• Problems with glucose control could lead to
Skeletal System hyperglycemia.
• As early as age 40, the bone mass and density begin Digestive System
to diminish. • Peristalsis decreases, which can cause:
• People can lose some height as the cartilage disks ▫ Constipation
between the vertebrae shrink. ▫ Diverticulosis
• The shortening of the spinal column causes a shift in ▫ Difficulty swallowing and digesting food
weight, which alters posture. • Ability to taste decreases with age.
• Range of motion and flexibility decrease as joints lose • Less saliva is produced, and gum disease and loss of
water and start to fuse and ligaments and tendons teeth can occur.
harden.
Endocrine System
Muscular System • Both men and women experience a decline in adrenal
• Atrophy is the wasting away of tissue. gland production.
• Regular exercise can do much to counteract the • Women also experience a reduction of estrogen and
affects of aging on the muscular system. progesterone.
• For men, the prostate gland becomes larger while the
Cardiovascular System production of testosterone from the testes diminishes.
• Fibrous tissue begins to replace the muscle tissue of
the heart. As a result: Immune System
▫ The heart becomes less adept at contracting • The immune system becomes weaker, which leaves
and expanding. the elderly vulnerable to infectious diseases.
▫ The valves become thicker, making it more • Because of their weakened immune systems, the
difficult to fully close. elderly are encouraged to get flu vaccinations prior to
• In general the heart becomes far less efficient at flu season.
pumping blood. Therefore, the output of the heart Respiratory System
decreases. • The exchange of oxygen and carbon dioxide
decreases.
Nervous System • As a result:
• The cerebral cortex portion of the brain slowly ▫ Irregular activity quickly leaves the elderly
decreases in size, which causes impaired thinking, breathless.
reasoning, and remembering. ▫ The elderly are at much greater risk of
• Neurons die at an increased rate and those that respiratory disease.
remain are degenerating, which results in: Mortuary Science
▫ Slower nerve conduction • After people die, their bodies must be cared for in a
▫ Slower reaction times specific, scientific manner.
▫ Decreases in motor and sensory abilities • Mortuary science is the scientific care of the body and
Integumentary System the emotional and ceremonial needs of the remaining
• Glands produce less lubrication to the skin’s surface, family members.
leaving the skin dry and fragile.