WLAC Breastfeeding Is Crucial During a Childs Early Development Questions

you will have to answer each of the three (3) questions in a separate paragraph with insightful, in depth and complete answers using both personal and textbook information which must include at least one in-text citation from the assigned reading per post (1 quote per chapter). Acceptable minimum amount to get maximum points: at least 150 words per question (each of the THREE paragraphs). Posts that do not meet the minimum word length will receive a ZERO.

The reference/citation should include the page from which students paraphrased or quoted material from the textbook and must be in parentheses. Example: “Many people believe that the best way to achieve wellness is to adopt a holistic approach” (p. 5). NO BIBLIOGRAPHY REQUIRED. College level writing and responses are needed

DO NOT COPY ANY PASTE THE QUESTIONS, ONLY SUBMIT YOUR ANSWERS.

OVERVIEW

Managing our fertility and making sure we produce healthy offspring are among the most crucial behaviors for adults. Methods of birth control are discussed in excellent detail, allowing the student to decide which option is safest and most desirable. This chapter also discusses emergency contraception for those times when unprotected sex did occur. Once a couple decides to have a child, it is important to understand what factors can lead to the best possible outcome. Appropriate diet and exercise are discussed. The harmful effects of drugs on the fetus as well as other agents that can cause harm are thoroughly examined. This chapter also deals with options for couples who are having difficulty conceiving or who may be infertile.

LEARNING OBJECTIVES

1. Discuss the different types of contraceptive methods, compare their effectiveness in preventing pregnancy and sexually transmitted infections.

2. Summarize the legal decisions surrounding abortion and the various types of abortion procedures used today.

3. Discuss key issues to consider when planning a pregnancy.

4. Explain the importance of prenatal care and the physical and emotional aspects of pregnancy.

5. Describe the basic stages of childbirth, methods of managing childbirth, and the complications that can arise during labor and delivery.

6. Review primary causes of and possible solutions to infertility.

OUTLINE

I. Methods of Fertility Management.

A. Conception refers to the fertilization of an ovum by a sperm.

1. The following conditions are necessary for conception:

a. A viable egg.

b. A viable sperm.

c. Possible access to the egg by the sperm.

B. Contraception or birth control refers to methods of preventing conception.

1. Perfect Failure rate refers to the number of pregnancies that are likely to occur in a year when used exactly as directed every time. (See Table 6.1)

2. Typical Use Failure rate is the number of pregnancies likely with typical use – making the usual mistakes.

3. Some methods can protect to some degree against STIs.

4. Barrier methods use a physical or chemical block to prevent the egg and sperm from joining, hormonal methods interfere with normal ovulation, surgical methods permanently prevent pregnancy.

C. Barrier methods.

1. The condom is the only temporary form of birth control for males in the United States. It is the only barrier that is effective in preventing the spread of many STIs such as herpes and HIV, also reduce cervical abnormalities in women that can lead to cancer (See Figure 6.1)

a. For greatest efficacy, they should be used with a spermicide and with water-based lubricants.

b. A complaint about condoms is that they ruin spontaneity.

2. Foams, suppositories, jellies, and creams contain chemical spermicides. They must cover the cervix, providing a chemical and physical barrier that stops sperm. (See Figure 6.2)

3. The female condom differs from the male condom because it covers the external genitalia, which can reduce the risk for some STIs such as genital warts and herpes.

a. Advantage is that women have more control over reproduction and STI

prevention.

b. One reported disadvantage is that it is awkward and noisy.

4. Diaphragms with spermicide provide a chemical and physical barrier to sperm. (Figure 6.3)

a. It must be left in place 6-8 hours after last intercourse and must be

removed within 24 hours of insertion.

b. Advantages include ability to place before sexual activity, lower cost over the long run, protection of the cervix.

c. Disadvantages include difficulty placing it; if left in place too long or used during menstruation, risk of toxic shock syndrome (TSS), which is a bacterial infection, increases, increased risk for bladder infections.

5. The cervical cap fits snugly over the cervix to keep sperm out of the uterus.

a. Insertion may take place anywhere up to two days prior to intercourse,

and must be left in place for six to eight hours after intercourse.

b. Maximum time it can be left on the cervix is 48 hours. If removed and cleaned, it can be reinserted immediately. It cannot be left in for more than 48 hours or used during menstruation because of risk of TSS.

D. Hormonal Methods

1. Oral contraceptive pills combine synthetic estrogen and progesterone to prevent pregnancy.

a. Pills are meant to be taken in a cycle.

b. Today’s pill are lower in levels of hormones than earlier versions.

c. They can reduce the absorption of certain nutrients and reduce

effectiveness of certain medications, such as antibiotics increasing risk of

pregnancy, C and B complex vitamin loss.

d. Health risks from the pill include increased cardiovascular problems, especially for cigarette smokers.

e. Advantages include not interfering with lovemaking, lessening of menstrual difficulties such as cramps and PMS, lower risks for endometrial and ovarian cancer, less likely to develop fibrocystic breast disease, lower incidence of ectopic pregnancy, etc.

f. The major disadvantages are that it must be taken every day, doesn’t protect against STIs and the need for a physical exam prior to getting a prescription. Other disadvantages include increased blood pressure, tendency to produce blood clots, weight gain, etc.

2. Progestin-only pills are used when women suffer from side-effects related to estrogen.

3. Ortho Evra (the patch) is worn for one week and replaced on the same day of the week for three consecutive weeks; the fourth week is patch free.

a. Advantages include ease of use, and discrete yet durable

b. Disadvantages include symptoms such as headache, nausea, upper

respiratory infection, menstrual cramps, and abdominal pain. More

serious side effects include blood clots, stroke, or heart attacks, and lack

of protection against STIs.

4. NuvaRing is a soft, flexible ring about 2 inches in diameter that the user inserts into the vagina and leaves in place for three weeks.

a. Advantages include protection against pregnancy, n pill to take, no fitting

required, no spermicide needed.

b. Disadvantages include increased vaginal discharge and irritation or

infection. Cannot use some yeast infection medications, diaphragm or

cervical cap while the ring is in place.

5. Depo-Provera is a long-acting synthetic progesterone injected intramuscularly every three months.

a. It encourages spontaneity because there in nothing to take or place.

b. There are fewer health problems than with estrogen containing pills.

However side effects include irregular bleeding and weight gain.

6. Lunelle, a monthly injection is currently off the market.

7. Norplant has been withdrawn from the market due to legal issues.

E. Surgical Methods.

1. Female sterilization is called tubal ligation and is achieved by surgically tying

the fallopian tubes closed.

a. Ovarian and uterine functions are not affected.

b. Should be considered irreversible.

c. Risks are of infection, and any other risks of surgery.

2. Hysterectomy is surgical removal of the uterus. Only done when there is disease or damage to the uterus.

3. Vasectomy, done on men, is a procedure where the vas deferens are surgically blocked.

a. It is less complicated than female sterilization.

b. Testicular function is not affected. Sexual response and fluid volume are

not affected. Men will not notice any difference in hormonal function.

F. Other Methods of Contraception

1. Intrauterine devices (IUDs) are inserted into the uterus by a physician.

a. Three IUDs are available. The progestasert contains synthetic

progesterone and must be replaced once a year. The paragaurd, which has

copper and no hormones, can be left in place for up to four years. The

Mirena, a T-shaped plastic device, is effective for 5 years and releases

small amount of progestin.

b. Advantages include not having to take anything or place anything, thereby increasing spontaneity, and length of effectiveness.

c. Disadvantages may include heavier menstrual cramping and flow, uterine perforation, ectopic pregnancy, PID.

d. Recommended use for women without STIs and a monogamous partner without STIs. Also recommended for women who have already had children due to chances of perforation.

2. Withdrawal involves withdrawing the penis from the vagina just prior to ejaculation.

3. Emergency Contraceptives are methods of preventing pregnancy after unprotected sexual intercourse. They are ordinary birth control pills containing estrogen and progestin. They can be used up to 72 hours after unprotected intercourse.

a. Use of emergency contraceptive pills (ECPs) reduces risk of pregnancy

by about 75 percent.

b. Side effects for ECPs include nausea, vomiting, breast tenderness, headache, abdominal pain and cramps and dizziness.

c. These require a prescription.

4. Abstinence and “Outercourse” involves all sexual activities except intercourse

G. Fertility awareness methods (FAM) rely on alteration of sexual behavior. (see Figure 6.4)

1. There are several popular methods:

a. Cervical mucous method requires women to examine the consistency and

color of normal vaginal secretions. Prior to ovulation mucus becomes

gelatinous and stringy

b. The body temperature method relies on the fact that a woman’s basal body temperature rises after ovulation.

c. The calendar method requires women to record the exact number of days in her menstrual cycle to predict fertile times.

II. Abortion.

A. Abortion is the medical means of terminating a pregnancy and is a topic of political debate. There are several methods of abortion.

1. Vacuum aspiration is performed in low-risk, first trimester pregnancies.

2. Second trimester pregnancies are terminated using dilation and evacuation which combines vacuum aspiration with a technique called dilation and curettage.

3. Prostaglandin or saline induction abortions may also be done in second trimester. These are injected into the uterus, killing the fetus and causing labor contractions so that the fetus and placenta are expelled from the uterus.

4. Hysterotomy is surgical removal of the fetus from the uterus and is only done when the mother’s life is in danger.

5. Third trimester or late-term abortions involve partial delivery of the fetus allowing the doctor to aspirate brain tissue. Is only done when woman’s life is in danger or fetus is not viable. Is currently a hotly debated topic politically.

B. Mifepristone (RU-486) is a steroid hormone that induces abortion by blocking the action of progesterone which maintains the lining of the uterus during pregnancy.

1. Woman takes three pills and after 48 hours takes a dose of prostaglandins.

2. Can be used during the first nine weeks of pregnancy with a 96 percent effectiveness rate.

III. Planning a Pregnancy.

A. Emotional health is important when planning a pregnancy. Why do you want a child? Are you prepared for the sacrifices necessary to care for a child?

B. Preconception care should be sought to ensure maternal health.

C. Paternal health is an important consideration when planning a pregnancy.

D. Financial evaluations should be done to assess the affordability of having a baby.

E. Contingency planning is a process to plan to consider child care in the event of your death.

IV. Pregnancy.

A. Prenatal visits are important for both infant and maternal health.

1. The ACOG recommends 7-8 prenatal visits for low risk pregnancies.

2. Early care reduces the risk of infant mortality and low birth weight.

B. The relationship between a pregnant woman and her practitioner is very important.

1. There are several types of practitioners to consider.

a. An obstetrician/gynecologist is a MD who specializes in pregnancy and birth.

b. A family practitioner is a MD providing care for all ages.

c. Midwives are experienced practitioners who can attend pregnancies and deliveries.

d. Certified nurse midwives and lay mid-wives are other options.

C. Alcohol and drugs have detrimental effects (teratogenic) on a developing fetus.

1. Fetal Alcohol Syndrome (FAS) is a preventable birth defect caused by maternal use of alcohol while pregnant.

a. Total abstinence from alcohol during pregnancy is recommended.

b. Symptoms of FAS include mental retardation, slowed nerve reflexes,

small head size, abnormal facial features, small size

2. Cigarette smoking also has negative effects on developing babies. This includes use of smokeless tobacco, and side stream or environmental tobacco smoke (ETS).

a. There is a greater chance of stillbirth, miscarriage, and LBW babies.

b. There is also a link to cleft lip and palate., and sudden infant death syndrome.

b. Babies whose parents smoke are more susceptible to pneumonia,

bronchitis, and other upper respiratory diseases.

D. Radiation from X-rays can damage developing fetus.

E. Nutrition and exercise are an important part of prenatal health.

1. A deficiency of folic acid increases risk of substandard mental and physical development and is linked to neural tube defects.

a. Folic acid can be found in dark leafy greens, and has been added to

breads, pastas, rice and other grains.

2. Increases in iron, calcium, protein and fluids are necessary for healthy babies.

3. Weight gain during pregnancy should be around 25-35 pounds.

4. Exercise has been shown to have positive effects on birth weight and infant health.

F. Other factors of concern to a pregnant woman are rubella, toxic chemicals, and STIs.

G. Women ages 30-39 are having more babies than previously.

1. Down’s syndrome is the most common birth defect in babies born in the U.S.

2. Waiting offers advantages as well.

H. Pregnancy tests detect levels of human chorionic gonadotropin (HCG) in the woman’s urine.

I. The process of pregnancy begins when a sperm fertilizes an ovum in the fallopian tubes. (See Figure 6.6)

1. Early signs include a missed period, breast tenderness, extreme fatigue, sleeplessness, emotional upset, nausea, and vomiting.

2. Pregnancy is divided into three trimesters.

a. The first trimester is when various organ systems develop. During the

first two months the term used for the developing baby is embryo and at

the start of the third month, the embryo is called a fetus.

b. During the second trimester, the mother sees more physical changes and the placenta becomes well-developed.

c. The third trimester is when respiratory organs and digestive organs develop.

J. Prenatal testing and screening. (see Figure 6.7)

1. Amniocentesis is where the amniotic fluid is analyzed for 40 abnormalities.

2. Ultrasound and sonography use high-frequency sound waves to determine the size and position of the fetus.

3. Fetoscopy involves viewing of the fetus through an incision in the uterus.

4. Chorionic villus sampling involves snipping tissue from the fetal sac and

analyzing it.

III. Childbirth.

A. There are many delivery options including hospitals, birthing centers, or home.

B. The birth process has three stages. (See Figure 6.8)

1. In the first stage of labor, the amniotic sac breaks and contractions of the abdomen and the lower back begin. This stage can last from a few hours to more than a day for a first child.

a. The end of the first stage is called transition, when the cervix becomes

fully dilated and the baby’s head begins to move into the vagina. Usually

lasts 30 minutes or less.

2. The second stage is called the expulsion stage. It may last from one to four

hours.

a. An episiotomy is an incision in the perineum to prevent tearing during birth.

3. The third stage is when the placenta or afterbirth is expelled and the umbilical cord is tied and severed.

C. There are several alternatives for managing labor.

1. Lamaze method is the most popular, teaching women proper breathing to control pain.

2. Harris method is based on gentle touching and controlled breathing.

3. Childbirth without Fear teaches women that the anticipation of pain creates more pain.

5. Leboyer method involves birthing in a calm, quiet environment.

6. The Bradley Method emphasizes little to no pain medications and little medical intervention. Deep relaxation methods are taught.

7. Water birth involves dimly lighted room with mother in a warm tub, baby delivered into the water and then placed at mother’s breast, usually done at home.

D. Some women prefer to use drugs to take the edge off the pain of birthing. Several options are available and should be discussed with the medical practitioner both before and during the delivery.

E. The postpartum period and breast-feeding.

1. Colostrum is secreted from the breast the first two days prior to breast milk production and is important because it contains vital antibodies to help the baby fight infection.

2. Breast-feeding is encouraged by the American Pediatrics Association because:

a. Breast milk is perfectly suited to babies’ nutritional needs.

b. Breast-fed babies have fewer illnesses.

c. When breast fed babies get sick, they recover quicker.

3. The postpartum period is the time where the woman’s body recovers to a nonpregnant state and last four to six weeks after birth.

F. Complications can occur even after a successful pregnancy.

1. Surgical extraction of the baby is called a cesarean section.

a. It may be due to wrong positioning or long labor.

b. Recovery takes longer after a C-section.

c. Subsequent births can be vaginal.

2. Miscarriage is defined as loss of a fetus before it is viable.

a. There are many reasons for miscarriage.

b. Rh factors may contribute to miscarriage.

c. Ectopic pregnancy or implantation of a fertilized egg outside the uterus

can result in miscarriage.

3. Stillbirth is when the baby is born dead, often for no apparent reason.

4. Sudden Infant Death Syndrome (SIDS) is defined as the death of an infant under one for no apparent reason.

a. Placing babies on their backs or sides reduces risk.

b. Babies should sleep on a firm surface without any fluffy pillows or blankets.

c. Babies need to be kept comfortable, not too warm, in a smoke-free environment.

IV. Infertility.

a. There are several causes of infertility in women.

1. Endometriosis is the leading cause of infertility in women

2. Pelvic inflammatory disease can cause blockage in the fallopian tubes, preventing sperm from reaching the egg.

3. STIs such as gonorrhea and chlamydia can cause infertility.

B. Men can also contribute to infertility.

1. Low sperm count is the single largest fertility problem.

a. It may be attributable to environmental factors.

b. The mumps virus can damage sperm cells.

C. Treatment for infertility includes various methods.

1. Fertility treatment includes diagnostic testing to rule out other problems.

2. Fertility drugs are an option for many women trying to conceive.

3. Alternative insemination is an option chosen by many infertile couples.

4. In vitro fertilization includes test-tube fertilization before implantation in a woman.

5. Gamete intrafallopian transfer method is where an egg is harvested from the woman’s ovary and placed in the fallopian tube with the man’s sperm.

6. Intracytoplasmic Sperm Injection (ICSI), first successfully performed in 1992, involves injecting a sperm cell into an egg.

7. Non-surgical embryo transfer is where a donor’s egg and husband’s sperm are implanted in the wife’s uterus.

8. Embryo transfer stays in donor’s body before being transferred to woman.

9. Embryo freezing involves suspending a fertilized embryo for future implantation.

10. Embryo Adoption Programs exist where couples who have previously saved embryos donate them to infertile couples.

D. Surrogate motherhood is an option for infertile couples to “hire” a woman to have a baby for them.

E. Adoption provides an alternative to couples who want children and for whom biological childbirth is not an option

the book is: Donatelle, R.J Health: The Basics 13^th Edition. Pearson Benjamin Cummings: San Francisco, 2018