Chapter 11 Conceiving Children: Process and Choice

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Chapter 11Conceiving Children Process and
Choice

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Parenthood as an OptionAdvantages of Remaining
Childless

• More time for self and partner
• More financial resources
• Marriage less stressful
• More spontaneity
• More devotion to career

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Parenthood as an OptionAdvantages of Having
Children

• Children give and receive love
• May enhance relationship
• Builds self-esteem, sense of accomplishment
• Greater meaning and satisfaction

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Becoming PregnantEnhancing the Possibility

• Intercourse just prior to or at ovulation
• Predicting ovulation
• Mucus, calendar, BBT methods
• Ovulation predictor urine tests

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Infertility

• Diagnosis
• More than 6 months of trying problem
• Not conceiving after at least 1 year
• 1 in 6 U.S. couples seek help
• Causes
• Complex, hard to determine
• Unidentifiable in 15 of cases
• 85-90 of cases can be treated
• Challenges in relationships

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Female Infertility

• Failure to ovulate regularly
• Below normal body weight
• Smoking and substance abuse
• Infertility increases with age
• Cervical mucus may destroy sperm
• Sperm may not reach the egg
• Fertilized egg may not implant

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Male Infertility

• Abnormal sperm count or motility
• Caused by poor nutrition
• Substance abuse
• Environmental toxins
• STIs
• Impaired sperm production
• Varicocele
• Congenital abnormalities

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Reproductive Technologies

• Artificial insemination
• Surrogacy
• Assisted reproductive technology (ART)
• In vitro fertilization (IVF, ZIFT, or GIFT)

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Concerns Regarding Reproductive Technologies

• Expense
• Legal, ethical, and personal dilemmas
• 75 failure rate
• 20-30 end in multiple embryos
• Health concerns

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Pregnancy Detection

• First signs
• Light period, spotting, or no period fatigue
  tender breasts
• Nausea/Vomiting appetite change
• Blood or urine for HCG
• Subtle softening of uterus at 6 weeks

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MiscarriageSpontaneous Abortion

• Occurs in first 20 weeks
• 10-20 of all pregnancies
• Emotional impact can be significant
• Individual or couple may consider grief support

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Elective Abortion U.S. Statistics Part 1

• 25 of U.S. pregnancies end in elective abortion
• 1 occur after 20 weeks
• 50 of women will have abortion by age 45

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Elective AbortionU.S. Statistics Part 2

• Of yearly abortion rates
• Young, unmarried, white women obtain most
• 20 married women
• 60 previously given birth
• Women with 4 children are more likely to have an
  abortion than women with fewer children
• 43 Protestant 27 Catholic

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Reasons Why Women Decide to Have Elective
Abortions

• Younger women
• unprepared for motherhood
• Older women
• difficulties meeting needs for current children
• In the U.S. two-thirds of women who have
  abortions cite financial reasons
• 60 of abortions occur among those with incomes
  below 28,000 for a family of 3

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Elective Abortions Cross-Cultural Analysis Part 1

• U.S. has one of the highest abortion rates among
  developed countries
• All countries with lower rates provide
• Comprehensive sex education
• Easy access to inexpensive birth control and
  emergency contraception
• Germany, the Netherlands, and Belgium have 66
  lower rates than U.S. France 50 lower

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Elective AbortionsCross-Cultural Analysis Part 2

• Highest abortion rates are in countries
• With severe restrictions on abortion
• Do not provide the social services for women and
  children
• Do not provide sex education and access to
  contraception

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Types of Abortion Procedures

• Medical abortion
• Suction curettage
• Dilation and evacuation (D and E)
• Prostaglandin induction
• Late-term abortion (intact dilation and
  evacuation)
• Illegal abortion

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Medical Abortions
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U.S. Abortion Controversy Historical Overview

• Early American law allowed abortion until
  quickening (movement of the fetus)
• 1973 Roe vs. Wade
• 1977 Hyde Amendment
• State restrictions or limitations
• Waiting period, parental notification

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U.S. Abortion Controversy Current Debate

• Majority of Americans believe abortion should
  remain legal
• Pro-life goals
• Pro-choice goals

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Experience of Pregnancy

• Wide range of positive and negative emotions
• Emotions are affected by physical changes
• First trimester
• increased fatigue, nausea, and breast changes
• Second trimester
• movement felt heightened sense of well-being
• Third trimester
• increased size greater discomfort

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Pregnancy at Ninth Month
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Experience of PregnancyMale Partner

• Ecstasy to ambivalence to fearfulness
• Male partner may feel closeness or separation
  toward female counterpart
• Concern about financial impact
• Active involvement helps

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Fetal DevelopmentFirst Trimester

• Zygote united sperm cell and ovum
• Blastocyst multiple cells that implant
• Heartbeat at 9-10 weeks after last period
• 2nd month spinal canal, arms/legs
• 3rd month internal organs

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Blastocyst
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Fetal DevelopmentSecond Trimester

• Sex of fetus can be distinguished
• External body parts develop including
  fingernails, eyebrows, and eyelashes
• Skin covered by fine down-like hair
• Growth in size
• Fetal movements (quickening) by end of 4th month
• By end of 2nd trimester fetus has opened its eyes

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Fetal DevelopmentThird Trimester

• Develop size and strength
• Down-like hair disappears
• Skin smoother
• Vernix caseosa
• protective creamy, waxy substance

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Risks to Fetal Development

• Harmful substances pass to baby via placenta
• Prescription and non-prescription drugs
• 1997 viable fetus can be protected under child
  abuse laws
• Nicotine, caffeine, alcohol (FAS)

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Placenta
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Prenatal Care

• Health assessment before pregnancy
• Good nutrition
• Adequate rest
• Routine health care
• Moderate exercise
• Prenatal education

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Pregnancy after Age 35

• Essentially safe with prenatal care
• Fertility decreases with age
• Heightened rate of fetal defects due to
  chromosomal abnormalities

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Contemporary Childbirth

• Prepared childbirth
• Lamaze
• Birthplace alternatives
• Homebirth

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First Stage Childbirth

• 10 to 16 hours in duration
• Bloody show
• Water breaks
• Effacing or thinning of cervix
• Slight dilation

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First Stage Childbirth
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Second Stage Childbirth

• 30 minutes to 2 hours in duration
• Begins at full dilation
• Infant descends through vagina
• Ends with delivery of baby

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Second Stage Childbirth
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Third Stage Childbirth

• 20 to 30 minutes in duration
• Begins at delivery of the baby
• Placenta separates and is pushed out
• Ends with delivery of placenta

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Third Stage Childbirth
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Cesarean Section

• Baby delivered through incision
• 1970 5.5 U.S. births by C-section
• 2006 31 U.S. births by C-section
• Higher C-section rates have not improved maternal
  and infant survival rates

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Postpartum

• Range of feelings from excited and happy to
  tearful
• Baby blues affect 75
• Postpartum depression (PPD) affect 15
• Sleep deprivation heightens stress

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Breastfeeding

• Initial colostrum has protein and antibodies
• Mature milk comes in soon
• Milk will dry up if baby does not suckle at the
  breast

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Advantages to Breastfeeding

• Digestible food with antibodies
• Prevents uterine hemorrhage
• Emotional and sensual experience
• Promotes bonding

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Short-term Disadvantages to Breastfeeding

• Vaginal dryness due to decreased estrogen
• Temporary breast tenderness
• Leaking milk
• Harder to share feeding duties

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Sexual Intercourse After Childbirth

• Vaginal Birth
• After lochia flow stops and vaginal area heals
• 3 to 4 weeks
• C-section
• When incision healed
• When desire returns
• Varies considerably
• Often 6 to 8 weeks

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Sexual Interaction After Childbirth

• Activities can include more non-coital and/or
  affectionate behaviors
• Factors that interfere
• Fatigue lowers desire and ability
• Decreased time due to caring for baby
• Negative pre-pregnancy attitudes