PRENATAL PERIOD

Life in Utero
 Objectives

AT THE END OF THIS LECTURE THE

STUDENT SHOULD BE ABLE TO
• Describe the stages of prenatal development
• Identify factors that may affect prenatal
development
• Discuss the birth process
• Explain the changes that take place in the post
partum period
YOU’RE ONE IN A MILLION!!!
 Union

Chromosome Male chromosome Female chromosome

a DNA molecule with part or all

of the genetic material of an 46, XY 46, XX
organism
PREGNANCY INITIATES HUMAN LIFE
BY FERTILIZATION/CONCEPTION

• 44 autosomes
Female • xx sex
Zygote
chromosomes

• 44 autosomes
Male • xy sex
Zygote
chromosomes
The
Zygote
The rule of
prudence holds that
one must follow the
safer course of
action and always
treat a living
fertilized ovum as a
human person,
whatever its stage of
development, with
all the rights of a
human being.”
– Peschke, Christian Ethics, 1994
 STAGES OF PRENATAL DEVELOPMENT

Germinal Stage
• 1st 2 weeks

Embryo Stage
• 3rd week to end of 8 weeks

Fetal Stage
• 9 weeks to birth
 Germinal Stage

Creation of zygote to implantation

Characterized by rapid cell division, multiplication
and slight specialization
After the
blastocyst
attaches to the
uterine wall, the
mass of cells is
called an
embryo

Germinal Stage
Embryonic
Stage
To lay the foundation
(anlagen) of all vital
organs and body
systems.

There would be rapid

changes in form and
specific allocation of
cells, formation of
rudimentary organ and
body systems
 Embyronic Stage

Marked changes in form: elongated to curved.

Embryonic Stage

End of embryonic
stage
 Most organs can
already be
appreciated
 Fetal Stage

Fetus looks human

Rapid change
 length20x increase
 weight:
• 4 mo = 4 oz
• 7 mo = 3 lb
• 8 mo = 7 lb
Complexity of organs differentiated and functional
Develop ability to survive independently (viability)
 Fetal Stage

The proportions of
the body changes
dramatically
At two months the
head represents
about half of the
fetus but, at the
time of birth it is ¼
of its total size
 Fetal Behavior Manifesting Consciousness, Free will, Relationship Formation

Actively informs others of his/her presence by 4th month. Mother feels

fetal movement (“quickening”). Later others feel fetal kicks thru skin of
abdomen.

Develops wide repertoire of activities. Kicks, turns, cry, grimace, clench

fist, open and close eyes, sucks thumb, etc.

Senses activated, feels pain, wards off amniocentesis needle, hearing

route – responds to music and mother’s voice.

Develops inborn reflexes needed for extrauterine survival.

 Reflexes formed prenatally

Reflexes are unlearned, organized involuntary

responses in the newborn that occur
automatically in the presence of certain stimuli.
• Rooting reflex – feeding
• Sucking reflex – feeding
• Grasping reflex – protection
• Startle reflex – protection
• Eye Blink reflex – protection
• Gag reflex – prevent choking
• Moro reflex - protection
 Maternal Factors Affecting Prenatal Development

Hormonal imbalance
• Thyroid deficiency associated with congenital
hypothyroidism

Drug intake

• Misoprostol (Cytotec)

Maternal stress - increase adrenal

hormones - affect newborns
• Chronic Anxiety – child hyperactive, irritable, sleep
disturbance, poor feeding
 Maternal Factors Affecting Prenatal Development

Narcotic addiction

• newborn with s/s acute withdrawal

Radiation exposure 1st 20 wks

• gross deformities

Maternal Illness

• Rubella 1st trimester – mental retardation, deafness,

cardiac anomalies
• AIDS – vertical transmission to newborn
 Maternal Factors Affecting Prenatal Development
Alcohol
Slight intake (2 shots/day)
 lower IQ age 7
 future adverse effects on
behavior and psychologic
function
Heavy intake
 Fetal Alcohol syndrome
(FAS) low intelligence,
mental retardation, delayed
growth, facial deformities
Smoking
 Reduced oxygen, increase
carbon monoxide  fetal
circulation, nicotine, other
toxins  slow fetal RR and
increase FHR
 Result - increase risk of
miscarriage, increase infant
mortality rate, shorter, low birth
weight infants, language and
intellectual dev’t. delayed
 2nd hand smoke mother 
fetus
 Phocomelia
Thalidomide
 1950’s – 1960’s
 Used for morning sickness in pregnant women
 Produced thalidomide babies known as phocomelia
Alcohol Fetal Syndrome
Challenges at Birth
 Transition from intrauterine to extrauterine life

Breathing
 depends on developed
respiratory system. The
new born must breathe on
its own once the umbilical
cord is cut.
Adaptation to
temperature change
 intrauterine temperature is
constant; outside
temperature is variable and
thermoregulation may
need to be assisted
Transition from intrauterine to extrauterine life

3. Nourishment by oral feeding:

 by sucking the breast or by swallowing
nutriments. (former route via umbilical
cord)

4. Elimination:
 functional genitourinary and
gastrointestinal tracts are essential.
Urination and defacation begins at
birth. (formerly wastes were eliminated
via the umbilical cord)
 Click icon to add picture

Pregnancy
&
Postpartum
Period
 Cultural Beliefs About Pregnancy

 How expectant mothers behave during pregnancy may depend in part

on the prevalence of traditional home-care remedies and folk beliefs.

“Pag blooming “Kung ano

ang buntis, babae kinakain siyang
ang anak. ” bunga. ”

“Bawal •Health care workers

magkwintas o should assess whether a
ipalupot ang woman’s beliefs or practices
towel sa leeg o pose a threat to her or the
ulo. ”
fetus
 Prenatal Care

Should • Screening for manageable

include conditions
comprehensiv • Education about pregnancy,
e educational labor and delivery and
social and caring for the newborn
nutritional • Motivate positive attitudes
service toward pregnancy
Prenatal Care
 The Birth Process

• Lasts an average of 12 – 24 hours

• It is the longest of the 3
• Uterine contractions are 15 – 20 minutes apart and lasts up
to 1 minute
1st stage • Opening of cervix into the birth canal  4 inches
 The Birth Process

• Begins when the head of the baby starts to move through the
cervix and the birth canal
• Terminates when the baby completely emerges from the
mother’s body
2nd stage • 11/2 hours

• The placenta, umbilical cord and other membranes are

detached and expelled
• Last only for a couple of minutes
After birth
 Postpartum Period

Begins immediately after the birth of a child and

extends for about 6 weeks, as the mother's body,
including hormone levels and uterus size, returns to
a non-pregnant state
Entails great adjustments for the mother
 Recovering from childbirth
 Learn how to take care of the baby, learn how to feel good
about her self as the mother
 Postpartum Period

Drop in estrogen and

progesterone levels and
remain low until the
ovaries produces
hormones again in about
4 months
Involution
 The process by which the
uterus returns to its
prepregnant size
 Postpartum Period

Sexual intercourse?
 6 weeks after
Exercise
 As soon as she can
Practice relaxation techniques
 Postpartum Period

Emotional Adjustments
 Emotional fluctuations are common for mothers in the
postpartum period
 Hormonal changes, fatigue, inexperience
 Usually decrease within several weeks

Postpartu Postpartu
Postpatum
m m
Blues
Depression Psychosis
 Postpartum Period

Postpartum blues
 “baby blues”
 observed commonly and considered to be normative
 Characterized by mood lability, depressed or irritable mood,
interpersonal hypersensitivity, and tearfulness.
 typically arise and resolve 7 to 14 days following the delivery
and symptoms peak in severity in 5 days.
 Postpartum Period

Postpartum depression
 begins within the first 6 weeks following delivery
 tearfulness, emotional lability, feelings of guilt, loss of appetite,
suicidal ideation and sleep disturbances as well as feelings of
inadequacy and inability to cope with the infant, poor
concentration and memory, fatigue, and irritability.
 Adverse effects on early infant development
 accidents, sudden infant death syndrome, and an overall
higher frequency of hospital admissions.
 Postpartum Period

Postpartum Psychosis
 1 to 2 women per 1,000 following delivery of a child.
 The most tragic outcome associated with postpartum psychosis
is infanticide, the prevalence of which is poorly documented.
 Approximately 75% of women with postpartum psychosis have
an onset within 2 weeks of delivery
 Bonding

The formation of connection

Physical bond between
parents and the new born
especially in the period
shortly after birth
Parents and child need to
form an important
emotional attachment that
provides a foundation for
optimal development for
years to come
Thank you.
Santrock Life – Span Development
Kaplan and Saddock Synopsis of psychiatry