Psychology Chapter 4 Mild Anoxia Typically Does Not Lead Permanent

Chapter 4

4

PRENATAL DEVELOPMENT AND BIRTH

LEARNING OBJECTIVES

After reading and studying the material in this chapter, the student should be able to

understand the following ideas/concepts.

4.1 PRENATAL DEVELOPMENT

4.2 THE PRENATAL ENVIRONMENT AND FETAL PROGRAMMING

• Discuss the concept of fetal programming, and evaluate its usefulness in understanding

4.3 THE PERINATAL ENVIRONMENT

• Examine current childbirth practices and analyze the use of various interventions on

4.4 THE NEONATAL ENVIRONMENT

• Compare and contrast breast- and bottle-feeding, offering pros and cons of both practices.

CHAPTER OUTLINE

I Prenatal Development

A. Conception

1. Midway through menstrual cycle (every 28 days or so), ovum is released

a. Egg usually disintegrates and leaves in menstrual flow

2. Infertility – not being able to get pregnant after a year of trying

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a. Equally traced to men and women

b. Simple intervention methods

i. Man wears looser pants or underpants

ii. Woman takes temperature to determine ovulation

c. Assisted reproductive techniques used to increase fertility

i. Artificial insemination – injecting sperm of partner or donor into a woman

B. Prenatal Stages

1. Lasts for about 266 days (nine months)

a. Zygote to fetus—one cell to billions

b. Prenatal development occurs in three stages:

2. The germinal period

a. Lasts about two weeks

3. The embryonic period

a. Lasts from the third to eighth week

b. Organogenesis – every major organ takes shape

c. Blastocyst layers differentiate forming new structures

i. Outer layer becomes amnion—watertight membrane surrounding chorion

dioxide molecules pass

d. Interior cells of blastocyst give rise to ectoderm (e.g., brain and spinal cord),

mesoderm (e.g., bone, heart, kidney), and endoderm (lungs, bladder) layers

e. Brain development apparent after three to four weeks

i. Neural plate forms neural tube (bottom is spinal cord)

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f. Organs (e.g., heart, eyes) take shape

g. Arms and legs appear

h. Sexual differentiation

i. Begin existence with undifferentiated sex tissue

4. The fetal period

a. Ninth prenatal week to birth

b. Significant brain development

i. Proliferation of neurons (hundreds of thousands per minute throughout

pregnancy)

c. Organs formed in embryonic period continue to grow and function

i. Harmful agents no longer cause major malformations as organs already

formed

d. Third month

i. Distinguishable sex organs appear

ii. Bones and muscle form

iii. By end of third month (first trimester), movement of limbs

e. Second trimester (months four to six)

i. Refined activities (e.g., thumb sucking)

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patterns

iv. DiPietro and colleges found increasing fetal heart response to stimuli, like

Checking Mastery

1. What is conception, and what techniques can be used to assist conception?

➢ Answer: Conception occurs when a single sperm penetrates an ovum (or egg

2. How does the development of the brain and nervous system unfold during the embryonic

and fetal periods?

➢ Answer: The brain and nervous system undergo dramatic change during the

3. When is survival outside the womb possible?

➢ Answer: The age of viability is reached at around 23–24 weeks of gestation and

II The Prenatal Environment and Fetal Programming

A. Mother’s Womb Is the “Prenatal Environment” for Unborn Child

1. Fetus is impacted by physical environment

2. Until the early1940s incorrect belief that placenta protected embryo and fetus

from hazards

3. New focus on environmental factors that negatively impact prenatal development

B. Teratogens

1. Teratogens – any disease, drug, or environmental agent that can harm prenatal

organism

a. Generalizations concerning teratogens

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i. Only 15% of newborns have minor problems, and perhaps 5% have more

significant anomalies

2. Drugs

a. Thalidomide

i. A type of tranquilizer widely used in Europe in the 1950s for relief of

b. Tobacco

i. Warnings labels have decreased number of pregnant women who smoke,

but about 22% of women smoke during first trimester (when some may

not know they are pregnant) with rates dropping to around 14% in the

vi. Sudden infant death syndrome – sleeping baby suddenly stops breathing

and dies; risk increases when mother smokes while pregnant

vii. Maternal smoking linked to mild cognitive deficits that may last into

childhood

c. Alcohol

i. Alcohol consumed by mom crosses the placental barrier

ii. Fetal alcohol syndrome (FAS) – more severe cluster of symptoms (e.g.,

small size, distinct facial features) associated with alcohol consumption

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ix. Binge drinking (four or more drinks during a single session) have larger

negative impact than four drinks over four sessions

x. Facial abnormalities occur in first trimester while stunted growth and

d. Cocaine

i. No “cocaine syndrome”

ii. Can cause spontaneous abortion, placenta detachment, or fetal strokes

3. Diseases

a. Rubella – German measles

i. In early 1940s, discovered prenatal impact that included blindness,

deafness, heart defects, and brain damage

ii. Impact greatest during first trimester (nearly 15% of pregnant women with

rubella miscarry)

b. Diabetes

i. Gestational diabetes is a fairly common pregnancy complication

ii. Controllable by diet

iii. Poor control increases risk for negative impacts (e.g., miscarriage, large

fetal size, immature lung development)

c. Syphilis

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or die

d. AIDS – acquired immune deficiency disorder

i. Caused by human immunodeficiency virus (HIV)

4. Environmental hazards

a. Radiation

i. Mothers near Nagasaki and Hiroshima when nuclear bomb dropped

tended to have still-born or seriously handicapped children

ii. Can lead to higher rates of congenital defects in children

iii. Expectant mothers are routinely advised to avoid X-rays

b. Pollutants

i. Infants born to mothers near 9/11 World Trade Center site lighter, shorter,

and slighter but impact may involve a combination of exposure to toxic

C. The Mother’s State

1. Parents can set stage for healthy pregnancy (Application Box on growing

healthier babies)

a. Better diet (good nutrition, avoiding alcohol, consuming less fish)

2. Age and race/ethnicity

a. Ages 20 to 40 are “safest” childbearing years

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3. Emotional condition

a. Damage may be due to stress hormones like adrenaline (also called

epinephrine), which temporarily increase fetal motor activity

4. Nutritional condition

a. Recommend additional 300 calories per day and 25 to 35 pound weight gain

(for normal weight women)

b. Malnutrition can lead to birth defects

e. Prenatal nutrition is important but so is diet and care after birth

D. The Father’s State

1. Little research on father’s contribution (beyond genetic)

a. Risk of miscarriage rate increases with paternal age

b. Elevated risk of heart defects, neural tube defects, kidney problems, and

Checking Mastery

1. What principles can help us understand the effects of teratogens?

➢ Answer: Teratogens have their greatest impact during the critical period when an

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2. What have researchers learned about the effects on the child of alcohol consumption

during pregnancy?

➢ Answer: Alcohol consumption during pregnancy, particularly if heavy and/or

3. What effects are likely to be seen among babies born to mothers who smoked throughout

their pregnancies?

➢ Answer: Babies born to mothers who smoked throughout their pregnancies are

III The Perinatal Environment

A. Perinatal Environment (social and medical environment surrounding birth)

1. Major shift in birthing practices in Western cultures where birth has become more

medical, involving technology and doctors (1930, 80% of births at home; today

1%)

a. Many modern couples like security of medical technology but want comforts

2. Childbirth is three-stage process

a. Labor

i. Begins with contractions of uterus and dilation of cervix

b. Delivery of baby

i. Fetus passes out of uterus/cervix

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B. Possible Hazards

1. Anoxia – oxygen shortage (also called asphyxia)

a. Due to umbilical cord pinched or tangled, sedatives given to mother, mucus in

baby’s throat, or breech presentation (feet or buttocks first) during a vaginal

delivery

2. Complicated delivery

a. Forceps – salad tong-like instrument used to help extract baby

i. Due to soft head, use of forceps may lead to cranial bleeding and brain

damage

3. Medications

a. Medications used during birth to reduce pain (analgesics and anesthetics), to

relax mothers (sedatives), and to induce or intensify contractions (stimulants)

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C. The Mother’s Experience

1. Unique experience involving many psychological factors

a. Attitude toward pregnancy, knowledge about birth process, sense of control

2. Cultural factors

a. Desirability to have children varies by culture

i. China “one–child” policy resulted in fewer babies per family and slowed

population growth

b. Birth practices differ by culture

i. Among the Pokot people of Kenya, families celebrate, dad stops hunting,

baby given hot ash and herbs to vomit amniotic fluid, mom given time to

3. Postpartum depression

a. “Baby blues” – mild feelings of anxiety, irritability, and depression common

for a few days after birth but typically fades

i. Possibly the result of steep drop in hormone levels, stress associated with

delivery, and new responsibility of parenting

b. Postpartum depression – more serious post-birth feelings of anxiety,

moodiness, and depression experienced by some women in months after

birthing

i. Postnatal depression affects approximately 15-20% of new mothers; tends

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D. The Father’s Experience

1. Western society fathers historically excluded from birth process

a. Today, many men prepare for childbirth

i. Take prenatal classes

ii. Are present at birth

b. Birth of their child tends to be a significant event in the life of most men

Checking Mastery

1. What steps occur during the process of childbirth?

➢ Answer: Childbirth begins with regular contractions of the uterus that eventually

2. What risks does the baby potentially face during the birth process?

➢ Answer: The birth process may pose risks for the baby if the flow of oxygen is

IV The Neonatal Environment

A. Neonatal environment – emphasis on events in first months after birth

1. Cross-cultural variation in beliefs concerning newborns

a. The Beng (Ivory Coast)

i. View newborn as not of this world until after umbilical cord falls off

2. Brazelton Neonatal Behavioral Assessment – newborn assessment scale

a. Assess reflexes and responses to 26 situations

b. Test used to teach parents how to be responsive to infants

B. Breast or Bottle?

1. Breastfeeding more natural form of nutrition

a. Reached an all-time low in United States in early 1970s

i. 1 in 4 mothers nursing

ii. Bottle feeding the norm

e. Failure to breastfeed

i. Self-factors of mom (e.g., sore nipple)

ii. Baby issues (e.g., concern that baby is not getting enough nutrition)

iii. Younger moms, working moms, and African American moms less likely

sending home samples of formula

C. Identifying At-Risk Newborns

1. At-risk status may be due to genetic, prenatal hazards, or perinatal damage

2. Apgar test – used to assess newborn status

a. Assesses factors of heart rate, color, muscle tone, respiration, and reflexes

b. Simple five-minute test with score of 0, 1, or 2 for each factor

c. Apgar score of 7 to 10 good, 6 to 5 ok, less than 4 low score and at-risk status

i. Low score symptoms include not breathing or limp

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deaths

v. Account for 60% of money spent on pregnancy and delivery

x. Associated with multiple births

xi. Increase in multiple births in part due to greater use of ovulation–

stimulating drugs

xii. Higher-order multiple births (three or more children) have increased

dramatically in past decades

e. With neonatal care, many low weight babies survive

i. LWB, especially extremely low birth weight (less that 1,000 grams or 2

f. Several factors that can improve health and survival rates of preemies

i. Medical technology like surfactant therapy

ii. Mother’s breast milk can provide nutrients to boost immune system

iii. Skin-to–skin contact like kangaroo care (resting on a parent’s chest) can

provide rhythmic sounds and body temperature that may be helpful

iv. Massage therapy may help relax baby and assist in weight gain

g. Fate of low-birth-weight infants depends on biological condition and postnatal

environment

i. Problems amplified by growing up in poverty with a single parent

i. Responsive and attentive parenting critical

D. Risk and Resilience

1. Werner and Smith longitudinal study of Hawaiian infants

a. Children classified into risk groups involving levels of exposure to prenatal or

2. Protective factors help children overcome disadvantage

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Checking Mastery

1. What are two things you can do during your baby’s first weeks and months of life to

ensure a healthy start to life?

2. What are two factors that allow some babies to show resilience to negative events of the

prenatal or perinatal periods?

➢ Answer: Some babies seem to have more personal resources, such as “good genes”

SUGGESTIONS FOR CLASS DISCUSSIONS OR PROJECTS: To develop critical thinking

skills and enhance learning with exercises that support the course learning objectives.

1. Teratogens: Due to our reliance on chemicals to solve everyday problems, we live in a world

in which potential teratogens are becoming more abundant. To help students appreciate the many

2. Prematurity: Many students are familiar with prematurity but are not clear on its outcome.

Medical technology is keeping more and more premature babies alive, although many of these

3. Pregnancy and Parenting: Have students read and evaluate a current popular book on

parenting and pregnancy. Many are available, and their focus ranges from general to quite

4. Leboyer’s Birthing Method: Have students plan the “perfect” delivery, considering

preparation beforehand, setting, birth position, people present, use of drugs, and so on. Have

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5. Childcare and Cultural Differences: In some cultures, the roles of men and women

concerning childcare are very similar. In other cultures, men and women play significantly

6. Controversies Surrounding Stem Cell Research: Stem cell research is currently one of the

hot-button issues in American politics and society. To gain a better appreciation of the pros and