1. Conceiving Children: Process and Choice

2. Parenthood as an Option:Advantages of Remaining Childless • More time for self and partner • More financial resources • Marriages less stressful • More spontaneity • More devotion to career

3. Parenthood as an Option:Advantages of Having Children • Children give & receive love • May enhance relationship • Builds self-esteem, sense of accomplishment • Greater meaning & satisfaction

4. Parenthood as an Option:Advantages of Having Children PLAY VIDEO

5. Becoming Pregnant:Enhancing the Possibility • Intercourse just prior to or at ovulation • Predicting ovulation • Mucus, calendar, BBT methods • Ovulation-predictor urine tests

6. Infertility • Diagnosis • More than 6 months of trying = problem • 1 in 6 U.S. couples seek help • Causes • Complex, hard to determine • Unidentifiable in 15% of the cases

7. 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

8. Male Infertility • Abnormal sperm count or motility • Caused by poor nutrition • Substance abuse • Environmental toxins • STDs • Impaired sperm production • Varicocele • Congenital abnormalities

9. Reproductive Technologies • Artificial insemination • Surrogacy • Assisted reproductive technology (ART) • In vitro fertilization (ZIFT or GIFT)

10. Concerns Regarding Reproductive Technologies • Expense • 75% failure rate • 20-30% end in multiple embryos • Health and financial concerns

11. 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

12. Miscarriage: Spontaneous Abortion • Occurs in first 20 weeks • 10-20% of all pregnancies • Emotional impact can be significant • Individual or couple may consider grief-support

13. Elective Abortion: U.S. StatisticsPart 1 • 25% of U.S. pregnancies end in elective abortion • 1% occur after 20 weeks • 1.3 million abortions each year • 43% of women will have abortion by age 45

14. Elective Abortion: U.S. StatisticsPart 2 • Of yearly abortion rates: • Young, unmarried, white women obtain most • 20% married women • 61% previously given birth • Women with 4+ children are more likely to have an abortion than women with fewer children • 43% Protestant; 27% Catholic

15. 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

16. Elective Abortions: Cross-Cultural AnalysisPart 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 & emergency contraception • Germany, the Netherlands & Belgium have 66% lower rates than U.S.; France 50% lower

17. Elective Abortions: Cross-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 & access to contraception

18. When Abortions are Performed

19. Types of Abortion Procedures • Medical abortion • Suction curettage • Dilation & evacuation • Prostaglandin induction • Late-term abortion • Illegal abortion

20. Medical Abortions

21. Safety of Abortions • Risk of dying from surgical abortion is lower than risk of pregnancy fatality • Unsafe and illegal abortions cause 13% of all world-wide maternal deaths

22. U.S. Abortion Controversy: Historical Overview • Early American law allowed abortion until quickening • 1973 Roe vs. Wade • 1977 Hyde Amendment • State restrictions or limitations • Waiting period, parental notification

23. U.S. Abortion Controversy: Current Debate • Majority of Americans believe abortion should remain legal • Pro-life goals • Pro-choice goals

24. 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

25. Experience of Pregnancy:Male Partner • Ecstasy to ambivalence to fearfulness • Toward partner may feel closeness or separation • Concern about financial impact • Active involvement helps

26. Fetal Development: First 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

27. Fetal Development:Second 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

28. Fetal Development:Third Trimester • Develop size and strength • Down-like hair disappears • Skin smoother • Vernix caseosa • protective creamy, waxy substance

29. 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)

30. Placenta

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

32. Pregnancy after Age 35 • Essentially safe with prenatal care • Fertility decreases with age • Heightened rate of fetal defects due to chromosomal abnormalities

33. Contemporary Childbirth • Prepared childbirth • Lamaze • Birthplace alternatives • Homebirth

34. First Stage Childbirth • 10 to 16 hours in duration • Bloody show • Water breaks • Effacing or thinning of cervix • Slight dilation

35. First Stage Childbirth

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

37. Second Stage Childbirth

38. 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

39. Third Stage Childbirth

40. Cesarean Section • Baby delivered through incision • Vaginal birth after cesarean (VBAC) is possible • 1970: 5.5% U.S. births by C-section • 2004: 29% U.S. births by C-section • Higher C-section rates have not improved maternal and infant survival rates

41. Postpartum • Range of feelings from excited and happy to tearful • Postpartum blues affect 26 to 85% • Postpartum depression 10 to 15% • Sleep deprivation heightens stress

42. Breastfeeding: Types of Milk • Initial colostrum has protein & antibodies • Mature milk “comes in” soon • Milk will “dry up” if baby does not suckle at the breast

43. Advantages to Breastfeeding • Digestible food with antibodies • Prevents uterine hemorrhage • Emotional & sensual experience • Promotes bonding

44. Short-term Disadvantages to Breastfeeding • Vaginal dryness due to decreased estrogen • Temporary breast tenderness • Leaking milk • Harder to share feeding duties

45. When to Resume Sexual Interaction after Childbirth • Vaginal Birth • After lochia flow stops & vaginal area heals • 3-4 weeks • C-section • When healed • When desire returns • Varies considerably • Often 6-8 weeks

46. 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