Understanding Human Sexuality 13th

Edition Hyde Solutions Manual

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Chapter 6
Conception, Pregnancy, & Childbirth

Lecture Outline

Are You Curious?

Questions are posed regarding the effects of ingested substances on a fetus, sexual activity post
childbirth, and the effects of STIs on reproduction.

I. Conception

• On about day 14 of an average menstrual cycle the woman ovulates.

• The sperm is composed of a head, a midpiece, and a tail.
• A typical ejaculate has a volume of about three milliliters, or about a teaspoonful, and
contains about 200 million sperm.
• Sperm swarm around the egg and secrete an enzyme called hyaluronidase.
• The fertilized egg, called the zygote, continues to travel down the fallopian tube.
• Timing the intercourse so that it occurs around the time of ovulation will improve the
chances of conception. The timing of ovulation can be determined by keeping a basal
body temperature chart.

II. Development of the Conceptus

• The nine months of pregnancy are divided into three equal periods of three months, called
trimesters.
• During the embryonic period of development (the first eight weeks), most of the fetus’s
major organ systems are formed with amazing speed.
• The inner part of the ball of cells implanted in the uterus now differentiates into two layers,
the endoderm and the ectoderm.
• Another group of cells has differentiated into the trophoblast, which has important
functions in maintaining the embryo and which will eventually become the placenta.
o It serves as a site for the exchange of substances between the woman’s blood and the
fetus’s blood.
• The umbilical cord is formed during week five of embryonic development.
• The amniotic fluid maintains the fetus at a constant temperature and, most important,

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cushions the fetus against possible injury.

• The development of the fetus during the first trimester is more remarkable than its devel-
opment during the second and third trimesters.
o By the end of week 12 (end of the first trimester), the fetus is unmistakably human
and looks like a small infant.
o During month seven the fetus usually turns in the uterus to assume a head-down
position.
o At the end of month eight the fetus weighs an average of 2,500 grams (five pounds
four ounces).

III. Pregnancy

• For most women, the first symptom of pregnancy is a missed menstrual period.
o Other early symptoms of pregnancy are tenderness of the breasts—a tingling
sensation and special sensitivity of the nipples—and nausea and vomiting (called
morning sickness, although these symptoms may happen anytime during the day).
o More frequent urination, feelings of fatigue, and a need for more sleep are other early
signs of pregnancy.
• A pregnancy test may be done by a physician, at a Planned Parenthood or family planning
clinic, or at a medical laboratory.
• The basic physical change that takes place in the woman’s body during the first trimester is
a large increase in the levels of hormones, especially estrogen and progesterone, that are
produced by the placenta.
• A woman’s emotional state during pregnancy, often assessed with measures of depression,
varies according to several factors: her attitude toward the pregnancy, her social class,and
the availability of social support.
• During month four, the woman becomes aware of the fetus’s movements (quickening).
o Edema—water retention and swelling—may be a problem in the face, hands, wrists,
ankles, and feet; it results from increased water retention throughout the body.
• Depression is less likely during the second trimester if the pregnant woman has a
cohabiting partner or spouse.
• The uterus is very large and hard by the third trimester.
o The uterus tightens occasionally in painless contractions called Braxton-Hicks
contractions.
• Psychological well-being is greater among women who have social support (often in the
form of a cohabiting partner or spouse), have higher incomes, are middle class, and
experience fewer concurrent stressful life events, in the third trimester.
• Some patrners experience pregnancy symptoms, including indigestion, gastritis, nausea,

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change in appetite, and headaches, referred to as couvade syndrome.

o In twenty-first-century American culture, many partners expect to be actively
involved in parenting.
• There are lots of family contexts in which women have babies these days besides the
traditional one of being married to the baby’s father.
• Most pregnant women continue to have intercourse throughout the pregnancy.
• Diet during pregnancy is extremely important.
o Part of a good diet is maintaining a healthy weight, as overweight and obese women
are at increased risk of negative outcomes for both themselves and the fetus.
o It is particularly important that a pregnant woman get enough protein, folic acid,
calcium, magnesium, and vitamin A.
A pregnant woman needs to know that when she takes a drug, not only does it circulate
through her body, but it may also circulate through the fetus.
o Long-term use of antibiotics by the woman may cause damage to the fetus.
o The abuse of alcohol during pregnancy may result in an offspring who displays a
pattern of malformations termed the fetal alcohol syndrome (FAS).
o Cocaine use during pregnancy is associated with an increased risk of premature birth
and low birth weight.
o Marijuana use may lead to adverse pre- and post-natal outconmes, and is implicated
in infertility.
o Synthetic hormones such as progestin can cause masculinization of a female fetus;
Long-term exposure to DES is associated with an increased risk of low birth weight.
o Maternal smoking during pregnancy exerts a retarding influence on fetal growth,
indicated by decreased infant birth weight and increased incidence of prematurity.
o Tricyclic antidepressant medications such as amitriptyline and imipramine have been
associated with birth defects in some studies but not others.
o SSRI exposure during pregnancy is associated with adverse post-natal outcomes.
o Although not classified as a drug, X rays deserve mention here because they can
damage the fetus, particularly during the first 42 days after conception.
• New theories suggest that drugs taken by men before a conception may also cause birth
defects, probably because the drugs damage the sperm and their genetic contents.

IV. Birth

• The signs that labor is about to begin vary from one woman to the next.
o There may be a discharge of a small amount of bloody mucus (the “bloody show”)
indicating the beginning of labor.
• Labor is typically divided into three stages:
o The first stage of labor begins with the regular contractions of the muscles of the

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uterus which is responsible for producing two changes in the cervix—effacement

(thinning out) and dilation (opening up)—both of which must occur before the baby
can be delivered.
o Second-stage labor begins when the cervix is fully dilated and the baby’s head begins
to move into the vagina, or birth canal.
o During third-stage labor, the placenta detaches from the walls of the uterus, and the
afterbirth (placenta and fetal membranes) is expelled.
• Cesarean section is a surgical procedure for delivery; it is used when normal vaginal birth
is impossible or undesirable.
o In the cesarean section, an incision is made first through the abdomen and then
through the wall of the uterus.
o The physician lifts out the baby and then sews up the uterine wall and the abdominal
wall.
• Women can often choose to give birth at home, in a birthing or maternity center, or in a
hospital delivery suite.
• One of the most widely used methods of prepared childbirth was developed by French
obstetrician Fernand Lamaze.
o The Lamaze method involves two basic techniques: relaxation and controlled
breathing.
• Usage of anesthetics prevents the mother from using her body as effectively as she might
to help push the baby out; it may inhibit uterine contractions, slow cervical dilation, and
prolong labor.
• Birth at home is likely to be more relaxed and less stressful; friends and other children are
allowed to be present.
o In case of an unforeseen emergency requiring medical procedures, home birth may
be downright dangerous for the mother, the baby, or both.

V. After the Baby Is Born: The Postpartum Period

• With the birth of the baby, the woman’s body undergoes a drastic physiological change.
o During pregnancy the placenta produces high levels of both estrogen and
progesterone.
o Endocrine changes include an increase in hormones associated with breast-feeding.
• For a day or two after parturition, the woman typically remains in the hospital, although
many women leave the hospital less than 24 hours after delivery.
o Some new mothers experience postpartum depression, characterized by depressed
mood, insomnia, tearfulness, feelings of inadequacy, and fatigue.
o The most severe disturbance is postpartum psychosis, for which early symptoms
include restlessness, irritability, and sleep disturbance; later ones include

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disorganized behavior, mood swings, delusions, and hallucinations.

o Physical stresses are also present during the postpartum period; hormone levels have
declined sharply, and the body has been under stress.
o Research clearly shows that the development of the mother’s attachment (bond) to
the infant begins even before the baby is born.
• Following the birth, the mother is at some risk of infection or hemorrhage, so the couple
should wait at least two weeks before resuming intercourse.

VI. Breast-feeding

• Two hormones, both secreted by the pituitary, are involved in lactation (milk production).
o Prolactin stimulates the breasts to produce milk.
o Oxytocin stimulates the breasts to eject milk.
• Breast-feeding provides the baby with the right mixture of nutrients, it contains antibodies
that protect the infant from some infections and diseases, it is free from bacteria, and it is
always the right temperature.
• A few women are physically unable to breast-feed, while some others feel psychologically
uncomfortable with the idea.

VII. Problem Pregnancies

• An ectopic pregnancy (misplaced pregnancy) occurs when the fertilized egg implants
somewhere other than the uterus.
o Most commonly, ectopic pregnancies occur when the egg implants in the fallopian
tube (tubal pregnancy).
• In pseudocyesis, or false pregnancy, the woman believes that she is pregnant and shows the
signs and symptoms of pregnancy without really being pregnant.
• Pregnancy-induced hypertension includes three increasingly serious conditions:
o Hypertension refers to elevated blood pressure alone.
o Preeclampsia refers to elevated blood pressure accompanied by generalized edema
(fluid retention and swelling) and proteinuria (protein in the urine).
o Eclampsia—the woman has convulsions, may go into a coma, and may die.
• Certain viruses may cross the placental barrier from the mother to the fetus and cause
considerable harm, particularly if the illness occurs during the first trimester of pregnancy.
o If a woman gets german measles during the first month of pregnancy, there is a 50
percent chance that the infant will be born deaf or mentally deficient or with cataracts
or congenital heart defects.
o Herpes simplex is teratogenic, that is, capable of producing defects in the fetus.
• Substances taken during pregnancy and illness during pregnancy, may cause defects in the

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fetus.
• Amniocentesis, chorionic villus sampling, and genetic counseling are available to detect
birth defects.
• The Rh factor is a substance in the blood; if it is present, the person is said to be Rh
positive (Rh+); if it is absent, the person is said to be Rh negative (Rh−).
o Techniques for dealing with Rh Incompatibility have been developed; an injection of
a substance called Rhogam prevents the woman’s blood from producing antibodies.
• Miscarriage, or spontaneous abortion, occurs when a pregnancy terminates through natural
causes, before the conceptus is viable (capable of surviving on its own).
• Preterm birth happens when delivery occurs prior to 37 weeks’ gestation.
o It is a cause for concern because the premature infant is much less likely to survive
than the full-term infant.

VIII. Infertility

• Infertility refers to a woman’s inability to conceive and give birth to a living child, or a
man’s inability to impregnate a woman.
o The most common cause of infertility in women is pelvic inflammatory disease (PID)
caused by a sexually transmitted infection, especially gonorrhea or chlamydia.
o The most common cause of infertility in men is infections in the reproductive system
caused by sexually transmitted diseases.
• Infertility does not significantly reduce marital satisfaction, but it does cause conflict.
• For those with fertility problems, a number of new reproductive technologies, such as in
vitro fertilization, are now available.

IX. Assisted Reproductive Technologies

• Artificial insemination involves artificially placing semen in the vagina or uterus or

fallopian tubes to produce a pregnancy; thus it is a means of accomplishing reproduction
without having sexual intercourse.
o In humans there are two kinds of artificial insemination: artificial insemination by the
husband (AIH) and artificial insemination by a donor (AID).
• Because it is now possible to freeze sperm, it is possible to store it, which is just what some
people are doing: using frozen human sperm banks.
• Embryo transfer—a fertilized, developing egg (embryo) is transferred from the uterus of
one woman to the uterus of another woman.
• Through in vitro fertilization, or IVF, it is possible for scientists to make sperm and egg
unite outside the human body (in a “test tube”).
• GIFT (for gamete intrafallopian transfer) is an improvement, in some cases, over IVF.

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o Sperm and eggs (gametes) are collected and then inserted together into the fallopian
tube, where natural fertilization can take place, followed by natural implantation.
• ZIFT (zygote intrafallopian transfer) involves fertilization of the egg with sperm in a
laboratory dish and then placing the developing fertilized egg (zygote) into the fallopian
tube, again allowing natural implantation.
• The most reliable method of gender selection is preimplantation genetic diagnosis (PGD).
o This technique involves the removal of eggs from the woman and fertilizing them via
IVF.
• Prenatal genetic diagnosis—determination of a fetus’s genotype at a specific locus.

Lecture Extension

Infertility Treatment Failure and Coping Strategies

With an estimated 14 percent of all couples in the U.S. experiencing infertility problems, the
impact of treatments and failed attempts on emotional well-being is of growing interest,
particularly as new assisted reproductive technologies are developed. How do couples react
when faced with an unsuccessful attempt at pregnancy? Current research indicates that, rather
than a generalized negative reaction to such news, there is great variability in response, with
some degree of depression being common in the week immediately following a failed IVF
attempt (Berghuis & Stanton, 2002; Terry & Hynes, 1998). People’s coping strategies had an
impact on the adjustment during the weeks following the attempt at pregnancy, with approach-
oriented coping correlating with more positive mental health outcomes than avoidance or
escapist strategies (Berghuis & Stanton, 2002; Terry & Hynes, 1998). Berghuis and Stanton
(2002) additionally found that positive coping measures among females are associated with
effective strategies employed by their partners.

Sources:
Berghuis, J., and Stanton, A. “Adjustment to a dyadic stressor: A longitudinal study of coping
and depressive symptoms in infertile couples over an insemination attempt.” Journal of
Consulting and Clinical Psychology 70, no. 2 (2002), pp. 433-438.
Terry, D. and Hynes, G. “Adjustment to a low-control situation: Reexamining the role of
coping responses.” Journal of Personality and Social Psychology 74, no. 4 (1998), pp.
1078-1092.

Discussion Questions

DQ1: Signs of pregnancy – What are the signs of pregnancy? How can they be classified? Are
any of these signs clear and unambiguous? Which of these signs suggest that a woman should get

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a pregnancy test?

DQ2: The period as a sign – The missed menstrual period is often perceived as a clear signal of
pregnancy. What other reasons might cause a missed period? Why can’t a woman assume that
she is not pregnant if she menstruates?

DQ3: Spontaneous abortions – Define spontaneous abortion. What percentage of preclinical

pregnancies is estimated to end in a spontaneous abortion? What percentage of clinically
diagniosed pregnancies are lost? What do scientists think causes spontaneous abortion?

DQ4: Myths and realities of pregnancy – A close friend confides in you that she is afraid of
pregnancy. She heard that pregnant women experience unpleasant physical (e.g., aches and
pains, fatigue, and illness) and psychological (e.g., crying spells and depression) symptoms. She
is especially concerned that pregnancy might have a bad effect on her relationship with her
partner. What information would you give her about these fears?

DQ5: Sex and pregnancy – Is it safe for a woman to have sexual intercourse in the first, second,
and third trimester? What can be done to make the intercourse more comfortable for a pregnant
woman? How soon after childbirth can a woman have sex?

DQ6: Discussing episiotomies – What is episiotomy? What are the reasons given by physicians
for performing an episiotomy? Discuss arguments against performing an episiotomy. What
evidence exists either way?

DQ7: The Lamaze method – The Lamaze method is often touted as “prepared” childbirth. Is it
natural? Why does it require training? What are its potential benfits? Do you think the method
deserves its reputation?

DQ8: The postpartum period – What is the postpartum period? What kind of psychological
changes might a woman expect during this period? How many women experience these
changes? How long do the changes last? How often are the psychological changes severe? Are
postpartum psychological changes natural? Normal? What social factors contribute to the
incidence, length, and severity of these changes?

DQ9: The politics of breastfeeding – What are the benefits of breastfeeding for the infant and
the mother? Many women in America do not breastfeed or, if they do, they do so only for a short
time. What are the pros and cons of breastfeeding? What measures can be taken to make
breastfeeding more convenient for women?

Note to the instructor: In addition to the many benefits of breastfeeding discussed in the

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textbook, it is interesting to point out the sexualization of the breasts (the idea that breasts serve a
primarily sexual, as opposed to reproductive, function) and the contradictions that mothers face
as a consequence. In addition, there are risks of sanction for breastfeeding in some public
facilities in some jurisdictions.

DQ10: Infertility – What is infertility? How long should a couple try to get pregnant before
worrying that they may be infertile? What are the common causes of infertility in men and
women? Which of these causes are preventable? What can people do throughout their lives to
reduce their chances of experiencing infertility?

DQ11: Fertility and relationship issues – How might fertility problems affect a healthy
relationship? Why might this happen? What can couples, experiencing infertility, do to make
sure their fertility problems don’t affect their relationship?

DQ12: Stereotypes of birth – What is the most common story you hear about childbirth? What
part of childbirth is focused on? How is childbirth most often represented on TV? How is the
mother presented? The father/partner? How does this contribute to our expectations about our
own experiences? How might it make childbirth more frightening or difficult?
Note to the instructor. There are many commercial films and clips on You Tube portraying
childbirth that can be used to stimulate this discussion.

DQ13: The challenge of “fathering” – What role would your male students envision for
themselves in parenting if they had a child? Do they believe they are adequately prepared for that
role? What role would your female students ideally like a partner to take in the parenting of
children?

DQ14: Emotions and pregnancy – Many of us are familiar with stereotypes about women’s
emotions during pregnancy. What do the data suggest about the physiologic effects on emotions
for women during this time? What do the psychological data suggest? What factors influence a
woman’s emotional state most dramatically? What kind of factors are they? Based on this
information, how might we best improve women’s well-being during pregnancy?

DQ15: The controversy over amniocentesis – What is amniocentesis? Is amniocentesis

recommended for all pregnant women? Why or why not? What is considered a good reason to
perform it? What ethical issues does amniocentesis present?

DQ16: Dads and drugs – Does substance use by the father have any effect on the unborn child?
If yes, what are the possible effects? Can the substance use affect the child in more than one
way? What advice would you give to a man who was planning to father a child in the near
future? What kind of research would you like to see about fatherhood and drug use?

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DQ17: Pregnancy and drugs – What illegal drugs discussed in the textbook can cause birth
defects? What sort of problems result from the use of these drugs? What legal drugs can cause
birth defects? What are the problems that result from their use? On comparing the frequency and
intensity of problems seen from the use of illegal and legal drugs, which drug appears to be more
of a problem?

DQ18: Giving birth and taking control – Who has control over the birthing process in the
typical American birth? What are some of the benefits of this approach? What are some
drawbacks? What are some ways that doctors maintain control of the birthing process? How do
technical terms, machines, and drugs all contribute to this situation? Who benefits most from the
current situation?

Note to the instructor: Technical terms make it difficult for the mother to know what’s going on.
Machines give the doctors information about her birth that she doesn’t understand and of which
she isn’t informed. Furthermore, drugs make it difficult for her to read her body, making her
more dependent on the doctor for information. This discussion is complemented by Classroom
Activity 10.

DQ19: Infertility treatments – What does the typical in vitro fertilization (IVF) treatment
entail? How much does it cost? What are the risks to the mother and the child/children? Why do
you think a lot of women decide to undergo IVF instead of adoption? How might societal
emphasis on biological children be dysfunctional for our society?

DQ20: The ethics of reproductive technology – Some frozen fertilized eggs are never used.
What do you think should be done with the fertilized eggs? Should they be discarded
(destroyed), sold, given to couples who want babies, used for research, or kept indefinitely?
What has been done with them? What is a realistic solution to the problem? How did you come
to your conclusion?

Note to the instructor: In the past, unused, frozen fertilized eggs have been frozen indefinitely,
adopted, used for research, and discarded.

DQ21: Protecting the unborn – To what extent should laws protect unborn fetuses? How
should the law approach the case of a woman who wants an abortion, a person who beats up a
pregnant woman, a woman who drinks alcohol, a person who smokes around a pregnant woman,
or a woman who uses hard drugs? Are your answers consistent with each other? How should we
balance the interests of a fetus against the freedom of others?

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DQ22: Gender selection – What are some reasons for a person to prefer a girl over a boy as
their child? How about the preference of a boy over a girl? Is there anything wrong with having
such preference? How important is it? What are the pros and cons of selecting a baby’s gender?
If a gender-selection method that was absolutely accurate were to be developed, would you use
it? If you were only allowed to have one child, would you prefer to have a boy or a girl? Why?

DQ23: Infertility – How do you think you would react if you discovered that you are infertile?
What do you think you would do about having children? Would you consider assisted
reproductive technologies (ART) or surrogacy? Why or why not?

Classroom Activities

CA1: Personal reflections. Have students anonymously answer the questions in Personal
Reflections on Parenthood (Handout 6A). Ask them to disclose their answers and discuss them
with the class.

CA2: Quiz. Pass out What You Know about Making Babies (Handout 6B). Use their answers to
stimulate interest and prompt discussion of the sexual variations.
Note to the instructor: Questions 1, 2, 5, 6, and 8 are true.

CA3: Guest speaker. One of the most powerful experiences in a classroom can be when the
students have the opportunity to listen to and talk with a person who embodies the facts and
issues at hand. As a contrast to the emphasis on medicalized childbirth, have a nurse midwife or
doula come to the class and present information about alternative methods.

CA4: Reasons to (not) have children. Have students form groups to brainstorm a list of the
pros and cons of parenthood. Using a rational choice or exchange model, is parenting a good
choice? Many students are likely to note that they do not think that parenting is necessarily the
right choice for them, but that they probably will have children at some point. What are the
social consequences of remaining childless?
Note to the instructor: Reasons to have children may include the experience or pleasure of
raising children, passing on genes, a loving relationship, status or respect, companionship in old
age, moral worth, because it’s expected, and religious beliefs. Reasons not to have children may
include overpopulation, more time with partner, freedom to travel, dual careers, the financial
drain, you wouldn’t be a good parent, it’s an irrevocable decision, a fear of failure, and a sense of
the world as a dangerous place.

CA5: Forced choice: The timing of children. Make the two following statements: (1) It is
better to have a child at 18 than to wait until you are 40; and (2) It is better to have a child at 40
than to have one at 18. Ask students who agree with the first statement to stand on one side of

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 12

the room and students who agree with the second statement to stand on the other. Undecided
students must pick a side. Ask one or more students on the underrepresented side to explain why
they chose their side. Then, allow the other side to respond and to explain why they chose their
side. Allow the discussion to progress and allow students to freely switch sides when they are
convinced by the arguments from the other side.

CA6: Forced choice: Single parenthood. Make the two following statements: (1) I would
rather raise a child alone than never raise a child; and (2) I would rather never raise a child than
raise a child alone. Ask students who agree with the first statement to stand on one side of the
room and students who agree with the second statement to stand on the other. Undecided
students must pick a side. Ask one or more students on the underrepresented side to explain why
they chose their side. Then, allow the other side to respond and to explain why they chose their
side. Allow the discussion to progress and allow students to freely switch sides when they are
convinced by the arguments from the other side.

CA7: Forced choice: The dilemma of infertility. Make the two following statements: (1) I
would rather be childless than adopt; and (2) I would rather adopt than be childless. Ask students
who agree with the first statement to stand on one side of the room and students who agree with
the second statement to stand on the other. Undecided students must pick a side. Ask one or
more students on the underrepresented side to explain why they chose their side. Then, allow the
other side to respond and to explain why they chose their side. Allow the discussion to progress
and allow students to freely switch sides when they are convinced by the arguments from the
other side.

CA8: Debating Cesarean sections. Assign half of your students the job of defending the rate of
Cesarean sections performed in the United States and the other half the job of questioning the
rate. (You may choose to assign them their position the class period before the activity to allow
them to think about their arguments and/or do some research.) Engage the class in a debate.

CA9: A birthing story. Pass out both pages of A True Story …. One Woman, Three Births
(Handout 6C). Ask students to read the story silently in class and discuss it in small groups. See
the handout for discussion questions.
Note to the instructor: This activity is complemented by Discussion Question 18.

CA10: Critical Thinking: Home birth. The critical thinking skill for this chapter is the process
f good decision making, in this instance regrading health care. Ask your students to use their
creativity and the textbook to brainstorm all the reasons why a home birth might be nice. Then,
brainstorm all the reasons why having a home birth might not be a good idea. In small groups,
ask your students to discuss what might be done at home to address the concerns that were listed
about home birth and what might be done at the hospital to try to attain the benefits of home

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 13

birth.

Outside Activities

OA1: Book review

Murkoff, H. and Hathaway, S. What to Expect When You’re Expecting, 5th ed. Workman
Publishing, 2016.
While intended for general public consumption rather than academic audiences, this book
has become a recommended staple during the pregnancies of millions of U.S. women.
Ask students to consider the topics covered in this month-by-month account and what the
popularity of this collection of basic information indicates about the current state of
sexuality and reproductive education.

OA2: Film analysis – Many libraries carry this NOVA special “The Miracle of Life, which
depicts the development of a fetus and the process of childbirth. You can either show the film in
class or ask the students to watch it individually. Ask each student to write a brief report on the
film, including comparing three events/processes/topics covered in the film with the coverage of
the same events/processes/topics in the text.

OA3: Interview – Assign your students the task of interviewing a woman who has gone through
one or more pregnancies and births. Students must decide what questions to use ask to drive the
discussion, find a woman to interview, administer the interview, and write an essay describing
the process of their the case study/interview.

OA4: Autobiographical essay – If you tried to have a child and found out that you or your
partner was infertile, would you try any of the technologies discussed? Which ones? Explain
your answer.

OA5: Research paper: Breastfeeding as a cross-cultural phenomenon – Breastfeeding

practices vary dramatically across cultures. Ask your students to write a research paper
comparing practices and understandings of breastfeeding in several different cultures. This paper
is a good exercise in for exploring students’ own issues of ethnocentrism, American
exceptionalism, and the sexualization of the breast.

Note to the instructor: This assignment is complemented by Discussion Question 9.

OA6: Research paper: The controversy over Cesarean sections – There is a great debate
among social scientists and doctors about the rate at which Cesarean sections are performed. Ask

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 14

your students to investigate this controversy. They may begin with the textbook and extend their
probe by searching sociological and psychological abstracts. Students should easily be able to
write a 3–5 page paper summarizing the controversy. Ask them to state their position at the end
of the paper, citing the literature thaey reviewed.

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for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded,
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 15

Handout 6A: Personal Reflections on Parenthood

Please write an answer to each question. Do not write your name on the survey.

1. How important is it to you to have children? Why do you think it is (not) important?

2. How important is it to you that the children you have are your biological children? Explain
your answer.

3. How much money would you be willing to spend trying to have biological children?
Would you give up your savings? Your house?

4. Would you consider adoption? Why or why not? If you adopted, what would your primary
worries be?

5. Do you think society places a great deal of importance on parenthood? If you decided not
to have children, do you feel that you might be stigmatized? Why or why not? How might
this have influenced your feelings about parenthood?

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 16

Handout 6B: What You Know About Making Babies

1. A female can become pregnant during True False Don’t Know

sexual intercourse even if the male does
not ejaculate.
2. Women can become sexually aroused True False Don’t Know
while breastfeeding an infant.
3. Attempting to select your child’s sex is True False Don’t Know
considered genetic engineering and is
illegal in America.
4. Expulsion of the fetus is the last phase of True False Don’t Know
childbirth.
5. Sexual intercourse in the last three months True False Don’t Know
of pregnancy is unlikely to harm the fetus.
6. Whether or not the mother and child are True False Don’t Know
separated immediately after childbirth has
no impact on maternal bonding.
7. Cesarean sections (C-sections) are True False Don’t Know
performed in fewer than 5 percent of
births.
8. A woman’s chance of becoming pregnant True False Don’t Know
is greater if she experiences orgasm.
9. If a pregnant woman has AIDS, it is likely True False Don’t Know
that her baby will get it because they share
a circulatory system.
10. Teen mothers are less likely to give birth True False Don’t Know
prematurely because their young bodies are
more fit for pregnancy.

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 17

Handout 6C: A True Story … One Woman, Three Births

(This true story is adapted from an essay written for a sexuality class.)

Although each of my births was different, and the pregnancies more complicated from diabetes
and age, I found myself becoming more adamant in my demands for a simpler, more natural,
delivery. My first child surprised us by coming almost four weeks early. Despite all I had read
about pregnancy and childbirth, and the videos I had seen, I was not prepared for the experience
itself. Our childbirth class focused on complicated breathing techniques practiced as much by the
labor coach as myself. This seemed to appeal to the husbands in the group because the breathing
patterns were so complex that they reminded me of technical sports statistics—difficult to
memorize and easy to forget. Our childbirth instructor had us pinch the skin on the underside of
our thighs, comparing this to the pains of labor. We also learned about all the pain relief
medications available to us. Epidurals were touted as the goal, not the default. The implicit
message in all this was, “Don’t worry, take drugs.”

When my water broke early, I was told to come immediately to the hospital. Because no serious
contractions set in immediately, I was put on intravenous pitocin to stimulate them. At that
moment, my birthing experience was taken out of my hands. When the contractions kicked in,
artificially induced, there were no pauses between them and no recovery time. I was hooked up
to so many monitors, internal and external, that I was prohibited from getting up and could only
lie on my right side. It was impossible to follow any of the instructed breathing patterns, even if I
had been able to remember them, because they are all based on the natural progression of a
contraction with its peaks and valleys. I asked for medication, but what they gave me proved
ineffective. When I thought I was splitting in half, I begged for an epidural and my dilation to be
rechecked. Reluctantly, a nurse complied, only to find that I was almost fully dilated and it was
too late for an epidural. Under the influence of pitocin, my cervix dilated from 1 to 10
centimeters in 1 hour and 15 minutes. When I was overcome with the urge to push, I was
wheeled into the delivery room, but the doctor wasn’t even gloved up. I was told to stop pushing.
I couldn’t. Christian was born within minutes, resulting in significant tearing. The repairs to my
perineum and vagina took over an hour. Two hours later, I hemorrhaged from all the trauma to
my uterus. Quick medical intervention saved my life, but the medical system had failed me.

When I went to deliver my second child, I was naturally terrified; however, the doctor listened to
me and provided me with a healthier birthing experience. With my third child, I wrote a birth
plan that I went over with my obstetrician and had her sign. I asked the doctor to intervene only
when medically necessary—that is, in a life-threatening situation. I stayed home until I felt I
needed to go to the hospital, getting permission in advance that I could go back home to labor if I
was not sufficiently dilated. On my birth plan, I specified “no episiotomy” unless absolutely
necessary, and none was done. The minor superficial tear was repaired in minutes. I finally

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 18

experienced a delivery where I set the standards. It surprised me how little pain I experienced
after birthing. Nurses approached me regularly offering me strong medications. When I inquired
about their concerns, I found they had assumed an epidural was used. This, they said, causes
much bruising during delivery because the woman cannot feel anything while she is pushing.

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for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded,
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 19

Handout 6C: A True Story … One Woman, Three Births

(Continued)

My nurse told me I was only the third woman she had seen in one year giving birth without an
epidural. What a sad statement.

Our culture treats birth as a medical experience rather than the natural process that it is.
Certainly, there can be complications, but many of these can be remedied in ways that do not
alienate the women from the birth or herself. How many doctors are versed in these techniques?
How many will show the patience and restraint it takes not to intervene to speed up the process?

Why did this woman’s birthing experience change so dramatically from her first birth to her
third? What exactly changed? How many of the changes were psychological in nature? How
many were medical in nature? How did the two interact? According to this story, what can a
woman do to increase the chances that her labor will be a positive experience?

© 2016 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized
for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded,
distributed, or posted on a website, in whole or part.