Midwifery:

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Midwifery Pregnancy and Parturition
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• Physiology of Pregnancy
• Maternal Physiology
• Fetal Physiology
• First Trimester
• Second Trimester
• Third Trimester
• Birth
• Lactation

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• Maternal Physiology
• Basal Metabolic Rate up 1
• Cardiac output transiently
• increases 30-40
• Blood volume increases 30
• Oxygen utilization increases 20
• Ventilation increases 50
• Renal tubule reabsorption up 50,
  filtration rate up 50

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• Weight Gain and Pregnancy
• Average is 24 lbs. and can be more.
• Fetus-7lbs
• Extraembryonic fluid/tissues 4 lbs.
• Uterus 2 lbs.
• Breasts 2 lbs.
• Body fluid 6 lbs.
• Fat accumulation 3 lbs.

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• Fetal Physiology- Respiration
• Gross breathing movements at 11 weeks
• Rapid and irregular, with REM
• Isolated slow movements- gasps
• Apnea- periods of no breathing
• Maternal eating breathing rate up
• Maternal smoking breathing rate down
• Function of fetal breathing, to stimulate lung
  growth and to condition muscles.

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Fetal Behavior Passive behavior 7-15
weeks early pregnancy 15 weeks all behaviors
are present 20-23 weeks, Diurnal patterns,
peak in the evening. Stimulated behavior
VAS broad band frequencies Learning Cessation
of response after repeated novel stimulation.
Requires 10-50 stimuli. Discriminates vowel
sounds and parent voices.
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Digestive Tract development anticipates
function .enzyme secreting cell differentiation
begins at 11-12 weeks, but secretion is
inhibited until after birth ..Meconium-fetal
stool- fills the lower digestive
tract ..Swallowing begins early, 11-12 seeks and
continues ..Suckling response develops
late-32-36 weeks.
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Labor and Delivery
.Lightening the fetus descends into the pelvic
cavity ..Cervix- dilation, effacement (softening
and thinning) ..False Labor- contractions
initiate then diminish ..Labor cervical
effacement-dilation to 10 cm. bloody
show-mucus plug fo the cervix breaking of
the bags of water contractions-shorter
intervals, longer, stronger
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Labor and Parturition Parturitionthe process by
which the baby is born