UNIT 1

CHILD CARE AND DEVELOPMENT

LESSON1: Understanding Child Development

Learning Objectives:

CHILD

Biologically, a child (plural children) is a human being between the stages

of birth and puberty, or between the developmental period of infancy and puberty. The
legal definition of child generally refers to a minor, otherwise known as a person
younger than the age of majority.[1] Children generally have fewer rights and less
responsibility than adults. They are classed as unable to make serious decisions, and
legally must be under the care of their parents or another responsible caregiver.

Child may also describe a relationship with a parent (such as sons and daughters of any
age)[4] or, metaphorically, an authority figure, or signify group membership in a clan,
tribe, or religion; it can also signify being strongly affected by a specific time, place, or
circumstance, as in "a child of nature" or "a child of the Sixties".

Some English definitions of the word child include the fetus (sometimes termed the
unborn).[10] In many cultures, a child is considered an adult after undergoing a rite of
passage, which may or may not correspond to the time of puberty.

Children generally have fewer rights than adults and are classed as unable to make
serious decisions, and legally must always be under the care of a responsible adult
or child custody, whether their parents divorce or not. Recognition of childhood as a
state different from adulthood began to emerge in the 16th and 17th centuries. Society
began to relate to the child not as a miniature adult but as a person of a lower level of
maturity needing adult protection, love and nurturing. This change can be traced in
paintings: In the Middle Ages, children were portrayed in art as miniature adults with no
childlike characteristics. In the 16th century, images of children began to acquire a
distinct childlike appearance. From the late 17th century onwards, children were shown
playing with toys and later literature for children also began to develop at this time.

What is Development?

Development is a process that creates growth, progress, positive change or the addition
of physical, economic, environmental, social and demographic components. The
purpose of development is a rise in the level and quality of life of the population, and the
creation or expansion of local regional income and employment opportunities, without
damaging the resources of the environment. Development is visible and useful, not
necessarily immediately, and includes an aspect of quality change and the creation of
conditions for a continuation of that change.

The international agenda began to focus on development beginning in the second half
of the twentieth century. An understanding developed that economic growth did not
necessarily lead to a rise in the level and quality of life for populations all over the
world; there was a need to place an emphasis on specific policies that would channel
resources and enable social and economic mobility for various layers of the population.

Through the years, professionals and various researchers developed a number of

definitions and emphases for the term “development.” Amartya Sen, for example,
developed the “capability approach,” which defined development as a tool enabling
people to reach the highest level of their ability, through granting freedom of action, i.e.,
freedom of economic, social and family actions, etc. This approach became a basis for
the measurement of development by the HDI (Human Development Index), which was
developed by the UN Development Program (UNDP) in 1990. Martha Nussbaum
developed the abilities approach in the field of gender and emphasized the
empowerment of women as a development tool.
In contrast, professionals like Jeffrey Sachs and Paul Collier focused on mechanisms
that prevent or oppress development in various countries, and cause them to linger in
abject poverty for dozens of years. These are the various poverty traps, including civil
wars, natural resources and poverty itself. The identification of these traps enables
relating to political – economic – social conditions in a country in an attempt to advance
development. One of the emphases in the work of Jeffrey Sacks is the promotion of
sustainable development, which believes in growth and development in order to raise
the standard of living for citizens of the world today, through relating to the needs of
environmental resources and the coming generations of the citizens of the world.

Reference: https://sid-israel.org/en/what-is-development/

Stages of Growth Child Development

Definitions of stages of growth in childhood come from many sources. Theorists such as
Jean Piaget, Lev Vygotsky, Lawrence Kohlberg, and Erik Erikson have provided ways
to understand development, and recent research has provided important information
regarding the nature of development. In addition, stages of childhood are defined
culturally by the social institutions, customs, and laws that make up a society. For
example, while researchers and professionals usually define the period of early
childhood as birth to eight years of age, others in the United States might consider age
five a better end point because it coincides with entry into the cultural practice of formal
schooling.

There are three broad stages of development: early childhood, middle childhood, and
adolescence. The definitions of these stages are organized around the primary tasks of
development in each stage, though the boundaries of these stages are malleable.
Society's ideas about childhood shift over time, and research has led to new
understandings of the development that takes place in each stage.
Early Childhood (Birth to Eight Years)

Early childhood is a time of tremendous growth across all areas of development. The
dependent newborn grows into a young person who can take care of his or her own
body and interact effectively with others. For these reasons, the primary developmental
task of this stage is skill development.

Physically, between birth and age three a child typically doubles in height and
quadruples in weight. Bodily proportions also shift, so that the infant, whose head
accounts for almost one-fourth of total body length, becomes a toddler with a more
balanced, adult-like appearance. Despite these rapid physical changes, the typical
three-year-old has mastered many skills, including sitting, walking, toilet training, using
a spoon, scribbling, and sufficient hand-eye coordination to catch and throw a ball.

Between three and five years of age, children continue to grow rapidly and begin to
develop fine-motor skills. By age five most children demonstrate fairly good control of
pencils, crayons, and scissors. Gross motor accomplishments may include the ability to
skip and balance on one foot. Physical growth slows down between five and eight years
of age, while body proportions and motor skills become more refined.

Physical changes in early childhood are accompanied by rapid changes in the child's
cognitive and language development. From the moment they are born, children use all
their senses to attend to their environment, and they begin to develop a sense of cause
and effect from their actions and the responses of caregivers.

Over the first three years of life, children develop a spoken vocabulary of between 300
and 1,000 words, and they are able to use language to learn about and describe the
world around them. By age five, a child's vocabulary will grow to approximately 1,500
words. Five-year-olds are also able to produce five-to seven-word sentences, learn to
use the past tense, and tell familiar stories using pictures as cues.
Language is a powerful tool to enhance cognitive development. Using language allows
the child to communicate with others and solve problems. By age eight, children are
able to demonstrate some basic understanding of less concrete concepts, including
time and money. However, the eight-yearold still reasons in concrete ways and has
difficulty understanding abstract ideas.

A key moment in early childhood socioemotional development occurs around one year
of age. This is the time when attachment formation becomes critical. Attachment theory
suggests that individual differences in later life functioning and personality are shaped
by a child's early experiences with their caregivers. The quality of emotional attachment,
or lack of attachment, formed early in life may serve as a model for later relationships.

From ages three to five, growth in socioemotional skills includes the formation of peer
relationships, gender identification, and the development of a sense of right and wrong.
Taking the perspective of another individual is difficult for young children, and events
are often interpreted in all-or-nothing terms, with the impact on the child being the fore-
most concern. For example, at age five a child may expect others to share their
possessions freely but still be extremely possessive of a favorite toy. This creates no
conflict of conscience, because fairness is determined relative to the child's own
interests. Between ages five and eight, children enter into a broader peer context and
develop enduring friendships. Social comparison is heightened at this time, and taking
other people's perspective begins to play a role in how children relate to people,
including peers.

Implications for in-school learning. The time from birth to eight years is a critical period
in the development of many foundational skills in all areas of development. Increased
awareness of, and ability to detect, developmental delays in very young children has led
to the creation of early intervention services that can reduce the need for special
education placements when children reach school age. For example, earlier detection of
hearing deficits sometimes leads to correction of problems before serious language
impairments occur. Also, developmental delays caused by premature birth can be
addressed through appropriate therapies to help children function at the level of their
typically developing peers before they begin school.

An increased emphasis on early learning has also created pressure to prepare young
children to enter school with as many prerequisite skills as possible. In 1994 federal
legislation was passed in the United States creating Goals 2000, the first of which states
that "All children will enter school ready to learn" (U.S. Department of Education, 1998).
While the validity of this goal has been debated, the consequences have already been
felt. One consequence is the use of standardized readiness assessments to determine
class placement or retention in kindergarten. Another is the creation of transition
classes (an extra year of schooling before either kindergarten or first grade). Finally, the
increased attention on early childhood has led to renewed interest in preschool
programs as a means to narrow the readiness gap between children whose families can
provide quality early learning environments for them and those whose families cannot.

Middle Childhood (Eight to Twelve Years)

Historically, middle childhood has not been considered an important stage in human
development. Sigmund Freud's psychoanalytic theory labeled this period of life
the latency stage, a time when sexual and aggressive urges are repressed. Freud
suggested that no significant contributions to personality development were made
during this period. However, more recent theorists have recognized the importance of
middle childhood for the development of cognitive skills, personality, motivation, and
inter-personal relationships. During middle childhood children learn the values of their
societies. Thus, the primary developmental task of middle childhood could be
called integration, both in terms of development within the individual and of the
individual within the social context.

Perhaps supporting the image of middle childhood as a latency stage, physical

development during middle childhood is less dramatic than in early childhood or
adolescence. Growth is slow and steady until the onset of puberty, when individuals
begin to develop at a much quicker pace. The age at which individuals enter puberty
varies, but there is evidence of a secular trend–the age at which puberty begins has
been decreasing over time. In some individuals, puberty may start as early as age eight
or nine. Onset of puberty differs across gender and begins earlier in females.

As with physical development, the cognitive development of middle childhood is slow

and steady. Children in this stage are building upon skills gained in early childhood and
preparing for the next phase of their cognitive development. Children's reasoning is very
rule based. Children are learning skills such as classification and forming hypotheses.
While they are cognitively more mature now than a few years ago, children in this stage
still require concrete, hands-on learning activities. Middle childhood is a time when
children can gain enthusiasm for learning and work, for achievement can become a
motivating factor as children work toward building competence and self-esteem.

Middle childhood is also a time when children develop competence in interpersonal and
social relationships. Children have a growing peer orientation, yet they are strongly
influenced by their family. The social skills learned through peer and family
relationships, and children's increasing ability to participate in meaningful interpersonal
communication, provide a necessary foundation for the challenges of adolescence. Best
friends are important at this age, and the skills gained in these relationships may
provide the building blocks for healthy adult relationships.

Implications for in-school learning. For many children, middle childhood is a joyful time
of increased independence, broader friendships, and developing interests, such as
sports, art, or music. However, a widely recognized shift in school performance begins
for many children in third or fourth grade (age eight or nine). The skills required for
academic success become more complex. Those students who successfully meet the
academic challenges during this period go on to do well, while those who fail to build the
necessary skills may fall further behind in later grades.

Recent social trends, including the increased prevalence of school violence, eating
disorders, drug use, and depression, affect many upper elementary school students.
Thus, there is more pressure on schools to recognize problems in eight-to eleven-year-
olds, and to teach children the social and life skills that will help them continue to
develop into healthy adolescents.

Adolescence (Twelve to Eighteen Years)

Adolescence can be defined in a variety of ways: physiologically, culturally, cognitively;

each way suggests a slightly different definition. For the purpose of this discussion
adolescence is defined as a culturally constructed period that generally begins as
individuals reach sexual maturity and ends when the individual has established an
identity as an adult within his or her social context. In many cultures adolescence may
not exist, or may be very short, because the attainment of sexual maturity coincides with
entry into the adult world. In the current culture of the United States, however,
adolescence may last well into the early twenties. The primary developmental task of
adolescence is identity formation.

The adolescent years are another period of accelerated growth. Individuals can grow up
to four inches and gain eight to ten pounds per year. This growth spurt is most often
characterized by two years of fast growth, followed by three or more years of slow,
steady growth. By the end of adolescence, individuals may gain a total of seven to nine
inches in height and as much as forty or fifty pounds in weight. The timing of this growth
spurt is not highly predictable; it varies across both individuals and gender. In general,
females begin to develop earlier than do males.

Sexual maturation is one of the most significant developments during this time. Like
physical development, there is significant variability in the age at which individuals attain
sexual maturity. Females tend to mature at about age thirteen, and males at about
fifteen. Development during this period is governed by the pituitary gland through the
release of the hormones testosterone (males) and estrogen (females). There has been
increasing evidence of a trend toward earlier sexual development in developed
countries–the average age at which females reach menarche dropped three to four
months every ten years between 1900 and 2000.
Adolescence is an important period for cognitive development as well, as it marks a
transition in the way in which individuals think and reason about problems and ideas. In
early adolescence, individuals can classify and order objects, reverse processes, think
logically about concrete objects, and consider more than one perspective at a time.
However, at this level of development, adolescents benefit more from direct
experiences than from abstract ideas and principles. As adolescents develop more
complex cognitive skills, they gain the ability to solve more abstract and hypothetical
problems. Elements of this type of thinking may include an increased ability to think in
hypothetical ways about abstract ideas, the ability to generate and test hypotheses
systematically, the ability to think and plan about the future, and meta-cognition (the
ability to reflect on one's thoughts).

As individuals enter adolescence, they are confronted by a diverse number of changes

all at one time. Not only are they undergoing significant physical and cognitive growth,
but they are also encountering new situations, responsibilities, and people.

Entry into middle school and high school thrusts students into environments with many
new people, responsibilities, and expectations. While this transition can be frightening, it
also represents an exciting step toward independence. Adolescents are trying on new
roles, new ways of thinking and behaving, and they are exploring different ideas and
values. Erikson addresses the search for identity and independence in his framework
of life-span development. Adolescence is characterized by a conflict between identity
and role confusion. During this period, individuals evolve their own self-concepts within
the peer context. In their attempts to become more independent adolescents often rely
on their peer group for direction regarding what is normal and accepted. They begin to
pull away from reliance on their family as a source of identity and may encounter
conflicts between their family and their growing peer-group affiliation.

With so many intense experiences, adolescence is also an important time in emotional

development. Mood swings are a characteristic of adolescence. While often attributed to
hormones, mood swings can also be understood as a logical reaction to the social,
physical, and cognitive changes facing adolescents, and there is often a struggle with
issues of self-esteem. As individuals search for identity, they confront the challenge of
matching who they want to become with what is socially desirable. In this context,
adolescents often exhibit bizarre and/or contradictory behaviors. The search for identity,
the concern adolescents have about whether they are normal, and variable moods and
low self-esteem all work together to produce wildly fluctuating behavior.

The impact of the media and societal expectations on adolescent development has
been far reaching. Young people are bombarded by images of violence, sex, and
unattainable standards of beauty. This exposure, combined with the social, emotional,
and physical changes facing adolescents, has contributed to an increase in school
violence, teen sexuality, and eating disorders. The onset of many psychological
disorders, such as depression, other mood disorders, and schizophrenia, is also
common at this time of life.

Implications for in-school learning. The implications of development during this period
for education are numerous. Teachers must be aware of the shifts in cognitive
development that are occurring and provide appropriate learning opportunities to
support individual students and facilitate growth. Teachers must also be aware of the
challenges facing their students in order to identify and help to correct problems if they
arise. Teachers often play an important role in identifying behaviors that could become
problematic, and they can be mentors to students in need.

Conclusion

The definitions of the three stages of development are based on both research and
cultural influences. Implications for schooling are drawn from what is known about how
children develop, but it should be emphasized that growth is influenced by context, and
schooling is a primary context of childhood. Just as educators and others should be
aware of the ways in which a five-year-old's reasoning is different from a fifteen-year-
old's, it is also important to be aware that the structure and expectations of schooling
influence the ways in which children grow and learn.
Reference: https://education.stateuniversity.com/

What is Child Development?

Child development refers to the sequence of physical, language, thought and emotional
changes that occur in a child from birth to the beginning of adulthood. During this
process a child progresses from dependency on their parents/guardians to increasing
independence. Child development is strongly influenced by genetic factors (genes
passed on from their parents) and events during prenatal life. It is also influenced by
environmental facts and the child’s learning capacity.

Child development can be actively enhanced through targeted therapeutic intervention

and the ‘just right’ home based practice, recommended by Occupational Therapists and
Speech Therapists.

What does child development include?

Child development covers the full scope of skills that a child masters over their life span
including development in:

 Cognitive Development – the ability to learn and problem solve

 Social and emotional development – interacting with others and mastering self-
control
 Speech and Language Development – understanding and using language, reading
and communicating
 Fine Motor Skills Development – fine motor (finger) skills and gross motor (whole
body) skills
 Gross Motor Skills Development – the registration of sensory information for use
Why is child development important?

Observing and monitoring child development is an important tool to ensure that children
meet their ‘developmental milestones’. Developmental milestones (a ‘loose’ list of
developmental skills that believed to be mastered at roughly the same time for all
children but that are far from exact) act as a useful guideline of ideal development.

By checking a child’s developmental progress at particular age markers against these

arbitrary time frames, it allows a ‘check in’ to ensure that the child is roughly ‘on track’
for their age. If not, this checking of developmental milestones can be helpful in the
early detection of any hiccups in development. This ‘check’ is usually carried out
through child/mother services and Paediatricians as infants and toddlers, and later
through preschool and school term skills assessments.

The earliest possible detection (and early intervention treatment if appropriate) of

developmental challenges can be helpful in minimizing the impact these developmental
hiccups can have on a child’s skill development and subsequently their confidence, or
serve as an indicator of a possible future diagnosis.

Developmental milestone checklists or charts are used as a guide as to what is ‘normal’

for a particular age range and can be used to highlight any areas in which a child might
be delayed. However, it is important to be aware that while child development has a
predictable sequence, all children are unique in their developmental journey and the
times frames that they meet the many developmental milestones.

Problems in Child Development:

Problems in child development can arise due to: genetics, prenatal circumstances, the
presence of a specific diagnosis or medical factors, and/or the lack of opportunity or
exposure to helpful stimuli. Specific assessment by the best fit professional (which may
initially be the GP or Paediatrician, and then Occupational Therapist, Speech Therapist,
Psychologist and/or Physiotherapist) can provide clarity about the developmental issues
and extent of concern as well as can help to formulate a plan to overcome the
challenge(s). As the process of child development involves multiple skills developing
simultaneously, there may then be benefit in consulting multiple professionals.

Overcoming the developmental challenges is crucial to maximising the ease and speed
of development, minimizing the gap that occur between a child’s ability and those of
their same aged peers, the confidence of the child as well as the frustration that can be
encountered by the child’s parents and/or care-givers.

Reference: https://childdevelopment.com.au/areas-of-concern/what-is-child-
development/

Lesson II: Child Development Theories

Child development theories focus on explaining how children change and grow over the
course of childhood. Such theories center on various aspects of development including
social, emotional, and cognitive growth.

The study of human development is a rich and varied subject. We all have personal
experience with development, but it is sometimes difficult to understand how and why
people grow, learn, and act as they do.

Why do children behave in certain ways? Is their behavior related to their age, family
relationships, or individual temperaments? Developmental psychologists strive to
answer such questions as well as to understand, explain, and predict behaviors that
occur throughout the lifespan.

In order to understand human development, a number of different theories of child

development have arisen to explain various aspects of human growth.

Background
Theories of development provide a framework for thinking about human growth and
learning. But why do we study development? What can we learn from psychological
theories of development? If you have ever wondered about what motivates human
thought and behavior, understanding these theories can provide useful insight into
individuals and society.

How Our Understanding Has Changed

Child development that occurs from birth to adulthood was largely ignored throughout
much of human history. Children were often viewed simply as small versions of adults
and little attention was paid to the many advances in cognitive abilities, language usage,
and physical growth that occur during childhood and adolescence.

Interest in the field of child development finally began to emerge early in the 20th
century, but it tended to focus on abnormal behavior. Eventually, researchers became
increasingly interested in other topics including typical child development as well as the
influences on development.

How We Come to Understand Changes

Why is it important to study how children grow, learn and change? An understanding of
child development is essential because it allows us to fully appreciate the cognitive,
emotional, physical, social, and educational growth that children go through from birth
and into early adulthood.

Some of the major theories of child development are known as grand theories; they
attempt to describe every aspect of development, often using a stage approach. Others
are known as mini-theories; they instead focus only on a fairly limited aspect of
development such as cognitive or social growth.

There are many child development theories that have been proposed by theorists and
researchers. More recent theories outline the developmental stages of children and
identify the typical ages at which these growth milestones occur.1
Freud's Psychosexual Developmental Theory

Psychoanalytic theory originated with the work of Sigmund Freud. Through his clinical
work with patients suffering from mental illness, Freud came to believe that childhood
experiences and unconscious desires influenced behavior.

According to Freud, conflicts that occur during each of these stages can have a lifelong
influence on personality and behavior. Freud proposed one of the best-known grand
theories of child development.

According to Freud’s psychosexual theory, child development occurs in a series of

stages focused on different pleasure areas of the body. During each stage, the child
encounters conflicts that play a significant role in the course of development.

His theory suggested that the energy of the libido was focused on different erogenous
zones at specific stages. Failure to progress through a stage can result in fixation at that
point in development, which Freud believed could have an influence on adult behavior.

So what happens as children complete each stage? And what might result if a child
does poorly during a particular point in development? Successfully completing each
stage leads to the development of a healthy adult personality.

Failing to resolve the conflicts of a particular stage can result in fixations that can then
have an influence on adult behavior.

While some other child development theories suggest that personality continues to
change and grow over the entire lifetime, Freud believed that it was early experiences
that played the greatest role in shaping development. According to Freud, personality is
largely set in stone by the age of five.

Freud's Stages of Psychosexual Development

The Oral Stage

Age Range: Birth to 1 Year

Erogenous Zone: Mouth

During the oral stage, the infant's primary source of interaction occurs through the
mouth, so the rooting and sucking reflex is especially important. The mouth is vital for
eating, and the infant derives pleasure from oral stimulation through gratifying activities
such as tasting and sucking.

Because the infant is entirely dependent upon caretakers (who are responsible for
feeding the child), the child also develops a sense of trust and comfort through this oral
stimulation.

The primary conflict at this stage is the weaning process--the child must become less
dependent upon caretakers. If fixation occurs at this stage, Freud believed the individual
would have issues with dependency or aggression. Oral fixation can result in problems
with drinking, eating, smoking, or nail-biting.

The Anal Stage

Age Range: 1 to 3 years

Erogenous Zone: Bowel and Bladder Control

During the anal stage, Freud believed that the primary focus of the libido was on
controlling bladder and bowel movements. The major conflict at this stage is toilet
training—the child has to learn to control their bodily needs. Developing this control
leads to a sense of accomplishment and independence.

According to Freud, success at this stage is dependent upon the way in which parents
approach toilet training. Parents who utilize praise and rewards for using the toilet at the
appropriate time encourage positive outcomes and help children feel capable and
productive.
Freud believed that positive experiences during the toilet training stage serve as the
basis for people to become competent, productive, and creative adults.

However, not all parents provide the support and encouragement that children need
during this stage. Some parents punish, ridicule, or shame a child for accidents.

According to Freud, inappropriate parental responses can result in negative outcomes.

If parents take an approach that is too lenient, Freud suggested that an anal-expulsive
personality could develop in which the individual has a messy, wasteful, or destructive
personality.

If parents are too strict or begin toilet training too early, Freud believed that an anal-
retentive personality develops in which the individual is stringent, orderly, rigid, and
obsessive.

The Phallic Stage

Age Range: 3 to 6 Years

Erogenous Zone: Genitals

Freud suggested that during the phallic stage, the primary focus of the libido is on the
genitals. At this age, children also begin to discover the differences between males and
females.

Freud also believed that boys begin to view their fathers as a rival for the mother’s
affections. The Oedipus complex describes these feelings of wanting to possess the
mother and the desire to replace the father. However, the child also fears that he will be
punished by the father for these feelings, a fear Freud termed castration anxiety.

The term Electra complex has been used to describe a similar set of feelings
experienced by young girls. Freud, however, believed that girls instead
experience penis envy.
Eventually, the child begins to identify with the same-sex parent as a means of
vicariously possessing the other parent. For girls, however, Freud believed that penis
envy was never fully resolved and that all women remain somewhat fixated on this
stage.

Psychologists such as Karen Horney disputed this theory, calling it both inaccurate and
demeaning to women. Instead, Horney proposed that men experience feelings of
inferiority because they cannot give birth to children, a concept she referred to as womb
envy.

The Latent Period

Age Range: 6 to Puberty

Erogenous Zone: Sexual Feelings Are Inactive

During this stage, the superego continues to develop while the id's energies are
suppressed. Children develop social skills, values and relationships with peers and
adults outside of the family.

The development of the ego and superego contribute to this period of calm. The stage
begins around the time that children enter into school and become more concerned with
peer relationships, hobbies, and other interests.

The latent period is a time of exploration in which the sexual energy repressed or
dormant. This energy is still present, but it is sublimated into other areas such as
intellectual pursuits and social interactions. This stage is important in the development
of social and communication skills and self-confidence.

As with the other psychosexual stages, Freud believed that it was possible for children
to become fixated or "stuck" in this phase. Fixation at this stage can result in immaturity
and an inability to form fulfilling relationships as an adult.
The Genital Stage

Age Range: Puberty to Death

Erogenous Zone: Maturing Sexual Interests

The onset of puberty causes the libido to become active once again. During the final
stage of psychosexual development, the individual develops a strong sexual interest in
the opposite sex. This stage begins during puberty but last throughout the rest of a
person's life.

Where in earlier stages the focus was solely on individual needs, interest in the welfare
of others grows during this stage. The goal of this stage is to establish a balance
between the various life areas.

If the other stages have been completed successfully, the individual should now be well-
balanced, warm, and caring.

Unlike the many of the earlier stages of development, Freud believed that the ego and
superego were fully formed and functioning at this point. Younger children are ruled by
the id, which demands immediate satisfaction of the most basic needs and wants.

Teens in the genital stage of development are able to balance their most basic urges
against the need to conform to the demands of reality and social norms.

Erikson's Psychosocial Developmental Theory

Psychoanalytic theory was an enormously influential force during the first half of the
twentieth century. Those inspired and influenced by Freud went on to expand upon
Freud's ideas and develop theories of their own. Of these neo-Freudians, Erik
Erikson's ideas have become perhaps the best known.
Erikson's eight-stage theory of psychosocial development describes growth and change
throughout life, focusing on social interaction and conflicts that arise during different
stages of development.

While Erikson’s theory of psychosocial development shared some similarities with

Freud's, it is dramatically different in many ways. Rather than focusing on sexual
interest as a driving force in development, Erikson believed that social interaction and
experience played decisive roles.

His eight-stage theory of human development described this process from infancy
through death. During each stage, people are faced with a developmental conflict that
impacts later functioning and further growth.

Unlike many other developmental theories, Erik Erikson's psychosocial theory focuses
on development across the entire lifespan. At each stage, children and adults face a
developmental crisis that serves as a major turning point.

Successfully managing the challenges of each stage leads to the emergence of a

lifelong psychological virtue.

Erikson's Stages of Psychosocial Development

Overview

So what exactly did Erikson's theory of psychosocial development entail? Much like
Sigmund Freud, Erikson believed that personality developed in a series of stages.

Unlike Freud's theory of psychosexual stages, however, Erikson's theory described the
impact of social experience across the whole lifespan. Erikson was interested in how
social interaction and relationships played a role in the development and growth of
human beings.

Conflict During Each Stage

Each stage in Erikson's theory builds on the preceding stages and paves the way for
following periods of development. In each stage, Erikson believed people experience
a conflict that serves as a turning point in development.

In Erikson's view, these conflicts are centered on either developing a psychological

quality or failing to develop that quality. During these times, the potential for personal
growth is high but so is the potential for failure.

If people successfully deal with the conflict, they emerge from the stage with
psychological strengths that will serve them well for the rest of their lives.3 If they fail to
deal effectively with these conflicts, they may not develop the essential skills needed for
a strong sense of self.

Mastery Leads to Ego Strength

Erikson also believed that a sense of competence motivates behaviors and actions.
Each stage in Erikson's theory is concerned with becoming competent in an area of life.

If the stage is handled well, the person will feel a sense of mastery, which is sometimes
referred to as ego strength or ego quality. If the stage is managed poorly, the person will
emerge with a sense of inadequacy in that aspect of development.

Psychosocial Stages: A Summary Chart

Age Conflict Important Events Outcome
Infancy (birth to 18 months) Trust vs. Mistrust Feeding Hope
Early Childhood (2 to 3 Autonomy vs. Shame and Toilet Training Will
years) Doubt
Preschool (3 to 5 years) Initiative vs. Guilt Exploration Purpose
School Age (6 to 11 years) Industry vs. Inferiority School Confidence
Adolescence (12 to 18 years)Identity vs. Role Confusion Social Fidelity
Relationships
 Psychosocial Stages: A Summary Chart
Age Conflict Important Events Outcome
Young Adulthood (19 to 40 Intimacy vs. Isolation Relationships Love
years)
Middle Adulthood (40 to 65 Generativity vs. Stagnation Work and Care
years) Parenthood
Maturity (65 to death) Ego Integrity vs. Despair Reflection on Life Wisdom
A brief summary of the eight stages

Stage 1: Trust vs. Mistrust

The first stage of Erikson's theory of psychosocial development occurs between birth
and 1 year of age and is the most fundamental stage in life. Because an infant is utterly
dependent, developing trust is based on the dependability and quality of the child's
caregivers.

At this point in development, the child is utterly dependent upon adult caregivers for
everything they need to survive including food, love, warmth, safety, and nurturing. If a
caregiver fails to provide adequate care and love, the child will come to feel that they
cannot trust or depend upon the adults in their life.

Outcomes

If a child successfully develops trust, the child will feel safe and secure in the world.2
Caregivers who are inconsistent, emotionally unavailable, or rejecting contribute to
feelings of mistrust in the children under their care. Failure to develop trust will result in
fear and a belief that the world is inconsistent and unpredictable.

During the first stage of psychosocial development, children develop a sense of trust
when caregivers provide reliability, care, and affection. A lack of this will lead to
mistrust.
No child is going to develop a sense of 100% trust or 100% doubt. Erikson believed that
successful development was all about striking a balance between the two opposing
sides. When this happens, children acquire hope, which Erikson described as an
openness to experience tempered by some wariness that danger may be present.

Subsequent work by researchers including John Bowlby and Mary Ainsworth

demonstrated the importance of trust in forming healthy attachments during childhood
and adulthood.

Stage 2: Autonomy vs. Shame and Doubt

The second stage of Erikson's theory of psychosocial development takes place during
early childhood and is focused on children developing a greater sense of personal
control.

The Role of Independence

At this point in development, children are just starting to gain a little independence. They
are starting to perform basic actions on their own and making simple decisions about
what they prefer. By allowing kids to make choices and gain control, parents and
caregivers can help children develop a sense of autonomy.2

Potty Training

The essential theme of this stage is that children need to develop a sense of personal
control over physical skills and a sense of independence. Potty training plays an
important role in helping children develop this sense of autonomy.

Like Freud, Erikson believed that toilet training was a vital part of this process. However,
Erikson's reasoning was quite different than that of Freud's. Erikson believed that
learning to control one's bodily functions leads to a feeling of control and a sense of
independence. Other important events include gaining more control over food choices,
toy preferences, and clothing selection.

Outcomes

Children who struggle and who are shamed for their accidents may be left without a
sense of personal control. Success during this stage of psychosocial development leads
to feelings of autonomy; failure results in feelings of shame and doubt.

Finding Balance

Children who successfully complete this stage feel secure and confident, while those
who do not are left with a sense of inadequacy and self-doubt. Erikson believed that
achieving a balance between autonomy and shame and doubt would lead to will, which
is the belief that children can act with intention, within reason and limits.

Stage 3: Initiative vs. Guilt

The third stage of psychosocial development takes place during the preschool years. At
this point in psychosocial development, children begin to assert their power and control
over the world through directing play and other social interactions.

Children who are successful at this stage feel capable and able to lead others. Those
who fail to acquire these skills are left with a sense of guilt, self-doubt, and lack of
initiative.

Outcomes

The major theme of the third stage of psychosocial development is that children need to
begin asserting control and power over the environment. Success in this stage leads to
a sense of purpose. Children who try to exert too much power experience disapproval,
resulting in a sense of guilt.

When an ideal balance of individual initiative and a willingness to work with others is
achieved, the ego quality known as purpose emerges.
This Is How Children Develop a Sense of Initiative

Stage 4: Industry vs. Inferiority

The fourth psychosocial stage takes place during the early school years from
approximately ages 5 to 11. Through social interactions, children begin to develop a
sense of pride in their accomplishments and abilities.

Children need to cope with new social and academic demands. Success leads to a
sense of competence, while failure results in feelings of inferiority.

Outcomes

Children who are encouraged and commended by parents and teachers develop a
feeling of competence and belief in their skills. Those who receive little or no
encouragement from parents, teachers, or peers will doubt their abilities to be
successful.

Successfully finding a balance at this stage of psychosocial development leads to the

strength known as competence, in which children develop a belief in their abilities to
handle the tasks set before them.
How Children Develop a Sense of Industry vs Inferiority

Stage 5: Identity vs. Confusion

The fifth psychosocial stage takes place during the often turbulent teenage years. This
stage plays an essential role in developing a sense of personal identity which will
continue to influence behavior and development for the rest of a person's life. Teens
need to develop a sense of self and personal identity. Success leads to an ability to stay
true to yourself, while failure leads to role confusion and a weak sense of self.

During adolescence, children explore their independence and develop a sense of self.
Those who receive proper encouragement and reinforcement through personal
exploration will emerge from this stage with a strong sense of self and feelings of
independence and control. Those who remain unsure of their beliefs and desires will
feel insecure and confused about themselves and the future.

What Is Identity?

When psychologists talk about identity, they are referring to all of the beliefs, ideals, and
values that help shape and guide a person's behavior. Completing this stage
successfully leads to fidelity, which Erikson described as an ability to live by society's
standards and expectations.

While Erikson believed that each stage of psychosocial development was important, he
placed a particular emphasis on the development of ego identity. Ego identity is
the conscious sense of self that we develop through social interaction and becomes a
central focus during the identity versus confusion stage of psychosocial development.

According to Erikson, our ego identity constantly changes due to new experiences and
information we acquire in our daily interactions with others. As we have new
experiences, we also take on challenges that can help or hinder the development of
identity.

Why Identity Is Important

Our personal identity gives each of us an integrated and cohesive sense of self that
endures through our lives. Our sense of personal identity is shaped by our experiences
and interactions with others, and it is this identity that helps guide our actions, beliefs,
and behaviors as we age.

Stage 6: Intimacy vs. Isolation

Young adults need to form intimate, loving relationships with other people. Success
leads to strong relationships, while failure results in loneliness and isolation. This stage
covers the period of early adulthood when people are exploring personal relationships.2

Erikson believed it was vital that people develop close, committed relationships with
other people. Those who are successful at this step will form relationships that are
enduring and secure.

Building On Earlier Stages

Remember that each step builds on skills learned in previous steps. Erikson believed
that a strong sense of personal identity was important for developing intimate
relationships. Studies have demonstrated that those with a poor sense of self tend to
have less committed relationships and are more likely to struggler with emotional
isolation, loneliness, and depression.

Successful resolution of this stage results in the virtue known as love. It is marked by
the ability to form lasting, meaningful relationships with other people.

Stage 7: Generativity vs. Stagnation

Adults need to create or nurture things that will outlast them, often by having children or
creating a positive change that benefits other people. Success leads to feelings of
usefulness and accomplishment, while failure results in shallow involvement in the
world.

During adulthood, we continue to build our lives, focusing on our career and family.
Those who are successful during this phase will feel that they are contributing to the
world by being active in their home and community. Those who fail to attain this skill will
feel unproductive and uninvolved in the world.
Care is the virtue achieved when this stage is handled successfully. Being proud of your
accomplishments, watching your children grow into adults, and developing a sense of
unity with your life partner are important accomplishments of this stage.

Stage 8: Integrity vs. Despair

The final psychosocial stage occurs during old age and is focused on reflecting back on
life. At this point in development, people look back on the events of their lives and
determine if they are happy with the life that they lived or if they regret the things they
did or didn't do.

Erikson's theory differed from many others because it addressed development

throughout the entire lifespan, including old age. Older adults need to look back on life
and feel a sense of fulfillment. Success at this stage leads to feelings of wisdom, while
failure results in regret, bitterness, and despair.

At this stage, people reflect back on the events of their lives and take stock. Those who
look back on a life they feel was well-lived will feel satisfied and ready to face the end of
their lives with a sense of peace. Those who look back and only feel regret will instead
feel fearful that their lives will end without accomplishing the things they feel they should
have.

Outcomes

Those who are unsuccessful during this stage will feel that their life has been wasted
and may experience many regrets. The person will be left with feelings of bitterness and
despair.
Those who feel proud of their accomplishments will feel a sense of integrity.
Successfully completing this phase means looking back with few regrets and a general
feeling of satisfaction. These individuals will attain wisdom, even when confronting
death.

Strengths and Weaknesses of Erikson's Theory

Erikson's theory also has its limitations and attracts valid criticisms. What kinds of
experiences are necessary to successfully complete each stage? How does a person
move from one stage to the next?

Criticism

One major weakness of psychosocial theory is that the exact mechanisms for resolving
conflicts and moving from one stage to the next are not well described or developed.
The theory fails to detail exactly what type of experiences are necessary at each stage
in order to successfully resolve the conflicts and move to the next stage.

Support

One of the strengths of psychosocial theory is that it provides a broad framework from
which to view development throughout the entire lifespan. It also allows us to
emphasize the social nature of human beings and the important influence that social
relationships have on development.

Researchers have found evidence supporting Erikson's ideas about identity and have
further identified different sub-stages of identity formation. Some research also suggests
that people who form strong personal identities during adolescence are better capable
of forming intimate relationships during early adulthood. Other research suggests,
however, that identity formation and development continues well into adulthood.

Behavioral Child Development Theories

During the first half of the twentieth century, a new school of thought known as
behaviorism rose to become a dominant force within psychology. Behaviorists believed
that psychology needed to focus only on observable and quantifiable behaviors in order
to become a more scientific discipline.

According to the behavioral perspective, all human behavior can be described in terms
of environmental influences. Some behaviorists, such as John B. Watson and B.F.
Skinner, insisted that learning occurs purely through processes of association and
reinforcement.

Behavioral theories of child development focus on how environmental interaction

influences behavior and is based on the theories of theorists such as John B. Watson,
Ivan Pavlov, and B. F. Skinner. These theories deal only with observable behaviors.
Development is considered a reaction to rewards, punishments, stimuli, and
reinforcement.

This theory differs considerably from other child development theories because it gives
no consideration to internal thoughts or feelings. Instead, it focuses purely on how
experience shapes who we are.

Two important types of learning that emerged from this approach to development
are classical conditioning and operant conditioning. Classical conditioning involves
learning by pairing a naturally occurring stimulus with a previously neutral stimulus.
Operant conditioning utilizes reinforcement and punishment to modify behaviors.

Piaget's Cognitive Developmental Theory

Cognitive theory is concerned with the development of a person's thought processes. It

also looks at how these thought processes influence how we understand and interact
with the world.

Theorist Jean Piaget proposed one of the most influential theories of cognitive
development.
Piaget proposed an idea that seems obvious now, but helped revolutionize how we
think about child development: Children think differently than adults.

His cognitive theory seeks to describe and explain the development of thought
processes and mental states. It also looks at how these thought processes influence the
way we understand and interact with the world.

Piaget then proposed a theory of cognitive development to account for the steps and
sequence of children's intellectual development.

 Sensorimotor Stage: A period of time between birth and age two during which
an infant's knowledge of the world is limited to his or her sensory perceptions and
motor activities. Behaviors are limited to simple motor responses caused by
sensory stimuli.
 Pre-Operational Stage: A period between ages 2 and 6 during which a child
learns to use language. During this stage, children do not yet understand
concrete logic, cannot mentally manipulate information and are unable to take
the point of view of other people.
 Concrete Operational Stage: A period between ages 7 and 11 during which
children gain a better understanding of mental operations. Children begin
thinking logically about concrete events but have difficulty understanding abstract
or hypothetical concepts.
 Formal Operational Stage: A period between age 12 to adulthood when people
develop the ability to think about abstract concepts. Skills such as logical
thought, deductive reasoning, and systematic planning also emerge during this
stage.

Bowlby's Attachment Theory

There is a great deal of research on the social development of children. John

Bowbly proposed one of the earliest theories of social development. Bowlby believed
that early relationships with caregivers play a major role in child development and
continue to influence social relationships throughout life.3

Bowlby's attachment theory suggested that children are born with an innate need to
form attachments. Such attachments aid in survival by ensuring that the child receives
care and protection. Not only that, but these attachments are characterized by clear
behavioral and motivational patterns.

In other words, both children and caregivers engage in behaviors designed to ensure
proximity. Children strive to stay close and connected to their caregivers who in turn
provide a safe haven and a secure base for exploration.

Researchers have also expanded upon Bowlby's original work and have suggested that
a number of different attachment styles exist. Children who receive consistent support
and care are more likely to develop a secure attachment style, while those who receive
less reliable care may develop an ambivalent, avoidant, or disorganized style.

Bandura's Social Learning Theory

Social learning theory is based on the work of psychologist Albert Bandura. Bandura
believed that the conditioning and reinforcement process could not sufficiently explain
all of human learning.

For example, how can the conditioning process account for learned behaviors that have
not been reinforced through classical conditioning or operant conditioning According to
social learning theory, behaviors can also be learned through observation and
modeling.

By observing the actions of others, including parents and peers, children develop new
skills and acquire new information.

Bandura's child development theory suggests that observation plays a critical role in
learning, but this observation does not necessarily need to take the form of watching a
live model.
Instead, people can also learn by listening to verbal instructions about how to perform a
behavior as well as through observing either real or fictional characters displaying
behaviors in books or films.

Vygotsky's Sociocultural Theory

Another psychologist named Lev Vygotsky proposed a seminal learning theory that has
gone on to become very influential, especially in the field of education. Like Piaget,
Vygotsky believed that children learn actively and through hands-on experiences.5

His sociocultural theory also suggested that parents, caregivers, peers and the culture
at large were responsible for developing higher-order functions. In Vygotsky's view,
learning is an inherently social process. Through interacting with others, learning
becomes integrated into an individual's understanding of the world.

This child development theory also introduced the concept of the zone of proximal
development, which is the gap between what a person can do with help and what they
can do on their own. It is with the help of more knowledgeable others that people are
able to progressively learn and increase their skills and scope of understanding.

Reference: https://www.verywellmind.com/child-development-theories-2795068

Lesson III: Maternal and Child Health

Maternal and child health (MCH) refers to the health of mothers, infants, children, and
adolescents. It also refers to a profession within public health committed to promoting
the health status and future challenges of this vulnerable population.

How true it is that a healthy child needs a healthy Mom. A child cannot be healthy or
happy absent the presence of a healthy and happy mother. Prenatal and postpartum
maternal health is critical to a mother’s physical and mental well-being and contributes
to her ability to render loving, proper care to her newborn child at birth and years
thereafter.

Mothers play a fundamental role in the health as well as the quality of life of their
children, which is why it is so important to give focus to maternal health during
pregnancy. Most pregnant women give their focus to the development and health of
their unborn child. However, it is important for expecting mothers to have regular
prenatal visits not only to ensure the health of their child, but their own health as well
both during and after pregnancy.

During a woman’s pregnancy and throughout her prenatal doctor visits, any existing
health risks can be identified and steps taken to prevent any ongoing health problems
not only for the child but for Mom herself. The specialists here at Riverside Medical
Group are committed to helping all our new mothers to be the healthiest and best Moms
and care providers they can be to their newborn babies.

Don’t Overlook Your Maternal Health

Though it is more than natural for a new mother to want to ensure the overall health of
her child, it is every bit as important that they take appropriate steps to maintain their
own overall health during and after pregnancy. In doing so, the team here at Riverside
Medical Group encourages all our mothers-to-be to give focus to their own vaccination
history as part of their maternal health care.

Vaccinations are an important component of everyone’s individual health care and that
includes pregnant women as well. Here at Riverside Medical Group our team of
dedicated specialists will discuss with you your vaccination history including flu,
whooping cough, pneumonia, chicken pox, Hepatitis A and B, as well as Meningitis,
measles/mumps/rubella (MMR) and Human papillomavirus (HPV). Our physicians will
review your patient and family histories and determine which vaccinations, if any, should
be administered during pregnancy and which should be delayed until after the birth of
your child.
Other Health Concerns

In addition to immunizations, our prenatal specialists will discuss other health concerns
and issues with you during your prenatal visits. Pap tests should be routinely
administered even if your test due date falls within your pregnancy. Further
assessments and attention is given to risk factors linked to a number of potential health
issues which may include, but are not limited to:

 High blood pressure

 Diabetes
 Mental health; and
 Dental care

Additionally, it is the practice of our team of professionals to also provide insight,

knowledge and know-how women need to transition easily from her pregnancy to her
role as mother, giving focus to her health following the pregnancy and thereafter.

We think it is critical that women understand the importance of maternal health and not
only reach out for care needed during their pregnancy phases, but for their own
personal health following the birth of their child. Optimizing your health will ensure you
are able to give proper care and attention to your baby every stage of their life.

Who Should Attend Prenatal Classes?

Many people are under the impression that prenatal classes are just for new moms.
However, this could not be farther from the truth. Even repeat parents, when attending
prenatal classes, walk away having learned something new and valuable. Since each
and every pregnancy and birth is unique, and things don’t always go the way you plan,
being able to manage expectations and having insight on what can, will and could
happen, is beneficial to all parents, whether new moms or repeat moms.

In addition to all the topics we have listed up above, attending prenatal classes allows
moms to be and couples to interact with those healthcare providers and doctors that
may very well have a significant role in their labor and their baby’s delivery. When you
meet healthcare providers, it is important that you ask any questions you may have and
discuss any concerns. You may want to ask the anesthesiologist detailed questions
about the pain relief options available to you and what the side effects, if any, are.
When you take time out to talk about your concerns with the providers you allow
yourself the time needed to digest all the data and make informed decisions.

Reference: https://www.riversidemedgroup.com/why-maternal-health-is-important/

4 Common Pregnancy Complication

When you find out you’re pregnant, your thoughts and emotions may go into overdrive.
You might be as excited about this new person you will bring into the world as you are
terrified that something may go wrong.

Most pregnancies progress without incident. But approximately 8 percent of all

pregnancies involve complications that, if left untreated, may harm the mother or the
baby. While some complications relate to health problems that existed before
pregnancy, others occur unexpectedly and are unavoidable.

It can be scary to hear that doctors have diagnosed a complication. You may be worried
about your baby’s health and your own health. You may even feel panic that perhaps
something you did (or didn’t do) caused this to happen. These feelings are completely
normal. It may reassure you to know that nothing you did caused these complications.
And beyond that —these complications are treatable. The best thing you can do for you
and your baby is to get prenatal care from a provider you trust. With early detection and
proper care, you increase the chances of keeping you and your baby healthy.

A Johns Hopkins obstetrician discusses some common pregnancy complications and

how they can be managed.

Hyperemesis Gravidarum

What is it? While many pregnant women experience morning sickness (nausea,
possibly with vomiting, generally in the morning hours) and other discomforts during
pregnancy , women with hyperemesis gravidarum (HG) have morning sickness times
1,000. HG is severe nausea that results in significant weight loss and may require
hospitalization. (Though it may not make you feel any better, know that if you have HG,
you are in royal company — Her Royal Highness The Duchess of Cambridge, Kate
Middleton, suffered from it.)

What are the symptoms? Women with HG have severe nausea and vomiting. The
vomiting and reduced appetite leads to weight loss and dehydration. The major
difference between HG and normal morning sickness is that HG results in a weight loss
of 5 percent or more of your pre-pregnancy weight.

Who is at risk? Doctors do not yet fully understand HG, what causes it or who is more
likely to experience it.
Can you prevent it? You cannot prevent HG, but you can take steps to control and
manage it during your pregnancy. The most important thing you can do for you and your
baby is to get regular prenatal care. HG can lead to not getting enough nutrients, which
can be harmful to both you and your baby. However, with proper treatment, there are
typically no long-term effects to either mom or child after the pregnancy.

How is it treated? If you have been diagnosed with HG, the priority is ensuring you
have enough nutrients to keep you and your baby healthy. For some women, a diet of
bland foods and fluids may be enough, while others may need to take medication to
help relieve the nausea. In severe cases, you may need to be hospitalized to receive
nutrients and fluids via intravenous (IV) line. You may feel down about having to be in
the hospital during your pregnancy. But remember that you are just doing what you
need to do to protect your and your baby’s health!

Many women start to feel better by the 20th week of pregnancy, while some continue to
experience symptoms throughout the entire pregnancy.

What should I ask my doctor? If you’ve had HG in the past, talk to your doctor when
you are thinking about getting pregnant again. It’s important to make sure you are
physically, emotionally and psychologically ready to begin another pregnancy. If you
had severe weight loss or other nutritional deficiencies, you’ll need to talk to your doctor
about making sure you are healthy before getting pregnant.

Gestational Diabetes

What is it? Diabetes is a condition that prevents your body from breaking down sugar.
Gestational diabetes mellitus (GDM) is a type of diabetes that occurs during pregnancy.
One of the biggest risks of gestational diabetes is that your baby may grow much larger
than normal, a condition called macrosomia. During delivery, a baby’s shoulders can get
stuck. If the baby is thought to be too big for a safe vaginal delivery, your doctor will
recommend a cesarean section .

What are the symptoms?

Gestational diabetes has no outward signs or symptoms. Doctors screen for it between
24 and 28 weeks of pregnancy, or earlier in high-risk women such as those who are
overweight or have a history of gestational diabetes.

Who is at risk? Risk factors for gestational diabetes include being overweight or
having a history of GDM in previous pregnancies. If you are at high risk, your doctor will
screen for GDM earlier than 24 weeks, typically in the first trimester.

Can you prevent it? Losing weight before pregnancy, sticking to a healthy diet and
getting regular exercise can lower your risk of developing GDM.

How is it treated? You and your doctor should discuss how you can best control the
GDM. Good old diet and exercise seem to be a good place to start. A very high
percentage of gestational diabetes can be controlled by diet. Still, some women with
GDM will need to take medications (pills or even insulin) to control blood sugar levels.

Exercise during pregnancy , even just walking 30 minutes a day, is also great for
controlling blood sugar. It’s best to do something you enjoy so you’ll stick with it, but you
should let your doctor know what type of exercise you are doing.

What should I ask my doctor?

If you’ve had GDM, you and your baby are both at risk of developing type 2 diabetes
later in life. So talk to your doctor about steps you can take to reduce that risk.

Placenta Previa

What is it? While you are pregnant, the placenta provides your baby with oxygen and
nutrients for proper development. The placenta normally attaches to the upper part of
the uterus, but in placenta previa it either totally or partially covers the cervix (which is
the opening between the uterus and vagina).

Who is at risk? You may be at higher risk if you have scarring on your uterus from
previous pregnancies or from a uterine surgery, or if you have fibroids .
What are the symptoms? The main symptom is vaginal bleeding that is not
accompanied by cramping or other pain. Some women, however, do not experience any
symptoms. Your doctor will confirm a diagnosis using an ultrasound or physical exam.

Can you prevent it? There’s nothing you can do to prevent placenta previa. However,
you can increase your and your baby’s health by getting regular prenatal care. If you are
at high risk — because of a previous surgery, C-section or fibroids — make sure to tell
your doctor. He or she may want to monitor you more closely during your pregnancy.

How is it treated? Placenta previa may result in bleeding during pregnancy. Some
women have no bleeding, some have spotting and others may experience heavy
bleeding. If the bleeding is heavy, you may need to stay in the hospital for a period of
time. Women with placenta previa will require a C-section to deliver the baby, usually
scheduled two to four weeks before their due date.

What should I ask my doctor? Always talk to your doctor if you notice any vaginal
bleeding at any point during your pregnancy.

Preeclampsia

What is it? Preeclampsia is a condition that causes dangerously high blood pressure.
It can be life-threatening if left untreated. Preeclampsia typically happens after 20 weeks
of pregnancy, often in women who have no history of high blood pressure.

What are the symptoms? Symptoms of preeclampsia may include severe headache,
vision changes and pain under the ribs. However, many women don’t feel symptoms
right away. The first alert is usually when a woman comes in for a routine prenatal visit
and has high blood pressure. In those cases, your doctor will test for things like kidney
and liver function to determine whether it’s preeclampsia or just high blood pressure .
Who is at risk? Risk factors for preeclampsia include having a history of high blood
pressure, being obese (having a body mass index, or BMI, greater than 30), age
(teenage mothers and those over 40 are at higher risk) and being pregnant with
multiples.

Can you prevent it? While you can’t prevent preeclampsia, staying healthy during
pregnancy may help. If you have risk factors, experts recommend that you see your
obstetrician either before you become pregnant or very early in your pregnancy, so you
and your doctor can discuss ways that you can reduce your risk. For example, many
women at risk for preeclampsia are prescribed a baby aspirin after the first trimester.

Regular prenatal visits are the best way to control preeclampsia. During those routine
visits, your doctor will check your blood pressure. If it’s high, further tests can diagnose
the condition so you can start getting the treatment you need.

How is it treated? The condition only goes away once the baby is born, so delivery is
the best way to treat preeclampsia. However, delivering the baby too early can put the
baby at risk for health problems. The decision about how to treat you will largely depend
on how far along the pregnancy is. You may need to be hospitalized so your team can
monitor you and your baby closely.

What should I ask my doctor? Your doctor will discuss the risks and benefits of
delivering the baby early versus continuing the pregnancy and trying to manage the
preeclampsia as long as possible through other methods. After delivery, the condition
will go away, but you will be at greater risk for heart disease later in life. Talk to your
doctor about what you can do to help reduce and manage those risks.

Pregnancy Complications: The Bottom Line

While these conditions may differ from one another, you may have noticed one common
thread: Regular prenatal (even preconception) care is crucial. Women are encouraged
to come in for a preconception consult to talk about what they can do to reduce their
risks. Being healthy before pregnancy is the best thing you can do for your baby.
 Reference: https://www.hopkinsmedicine.org/health/conditions-and-diseases/staying-healthy-during-
pregnancy

Why Are Maternal, Infant, and Child Health Important?

Pregnancy can provide an opportunity to identify existing health risks in women and to
prevent future health problems for women and their children. These health risks may
include:

 Hypertension and heart disease

 Diabetes
 Depression
 Intimate partner violence
 Genetic conditions
 Sexually transmitted diseases (STDs)
 Tobacco, alcohol, and substance use
 Inadequate nutrition
 Unhealthy weight
The risk of maternal and infant mortality and pregnancy-related complications can be
reduced by increasing access to quality preconception (before pregnancy), prenatal
(during pregnancy), and interconception (between pregnancies) care. Moreover,
healthy birth outcomes and early identification and treatment of developmental delays
and disabilities and other health conditions among infants can prevent death or disability
and enable children to reach their full potential.

Reference: https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health