Chapter 11 Conceiving Children: Process and Choice

1. Chapter 11Conceiving Children: Process and Choice

2. 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

3. 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

4. Becoming PregnantEnhancing the Possibility • Intercourse just prior to or at ovulation • Predicting ovulation • Mucus, calendar, BBT methods • Ovulation predictor urine tests

5. 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

6. 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

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

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

9. Concerns Regarding Reproductive Technologies • Expense • Legal, ethical, and personal dilemmas • 75% failure rate • 20-30% end in multiple embryos • Health concerns

10. 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

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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. Medical Abortions

19. 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

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

21. 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

22. Pregnancy at Ninth Month

23. 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

24. 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

25. Blastocyst

26. 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

27. Fetal DevelopmentThird Trimester • Develop size and strength • Down-like hair disappears • Skin smoother • Vernix caseosa • protective creamy, waxy substance

28. 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)

29. Placenta

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

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

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

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

34. First Stage Childbirth

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

36. Second Stage Childbirth

37. 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

38. Third Stage Childbirth

39. 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

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

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

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

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

44. 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

45. 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