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Stages
of
Pregnancy
1
Objectives
• To evaluate the importance of good
prenatal care
• To summarize the signs, symptoms and
trimesters of pregnancy
• To identify the stages of fetal growth and
development
• To examine the birth process, stages of
labor and delivery and possible
complications
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Signs and Symptoms
Of Pregnancy
Sign
3
After Conception
Darkening of areola
1-14 weeks
(first sign)
Tender or swollen
breasts
1-2 weeks
Feelings of
exhaustion
1-6 weeks
Nausea and
vomiting
2-8 weeks
Missed period
2-4 weeks
Signs and Symptoms
Of Pregnancy
Sign
Frequent urination
After Conception
6-8 weeks
Fetal heart beat
10 weeks
Fetal movement
16-22 weeks
Backaches
During entire
pregnancy
Frequent headaches
Sometimes entire
pregnancy
During entire
pregnancy
Food cravings
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Good Prenatal Care
Exercise, good food and responsible prenatal
care are the keys
Get early prenatal care from doctor, even before
you are pregnant
Eat a well-balanced diet, including a vitamin
supplement that contains folic acid
avoid alcohol, cigarettes, illegal drugs
limit caffeine
Exercise regularly with your doctor’s permission
Avoid x-rays, hot tubs, saunas and infections
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Before You Become
Pregnant
Make sure you are immune to rubella
(German measles)
Know your blood type
Stop smoking
Make sure your diet is healthy
Get any illnesses you might have under
control
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Health Professional
See your healthcare professional once
pregnancy is confirmed
•
•
•
•
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Obstetrician
Family practitioner
Nurse-practitioner
Nurse midwife
Medical Exams
The doctor will
Measure growth of the uterus
Listen to baby’s heartbeat
Take mother’s blood pressure and weight
Check her urine for evidence of protein or sugar
Ask the mother questions and concerns
blurred vision
leg cramps
abdominal cramps
unusual headaches
Sometimes perform ultrasound and genetic tests
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Nutrition During Pregnancy
Pregnancy takes about 300 extra calories a day to
maintain
Recommended weight gain is 25-35 pounds
Balanced diet of protein, fruits, vegetables, whole
grains and a minimum of sweets/fats
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6-11 servings of breads, other whole grains
3-5 servings of vegetables
2-4 servings of fruit
4-6 servings of milk and dairy
3-4 servings of meat and protein
6-8 glasses of water, not more than one soft drink or cup
of coffee per day
Nutrition During Pregnancy
Some nutrients have been found to provide
specific benefit to mother and child
 Folic acid —reduces the risk of birth defects of the brain
and spinal cord, referred to as the “neural tube”
 Calcium —helps prevent a new mother from losing her
own bone density as the fetus uses the mineral for bone
growth
 Iron —helps both the mother and baby’s blood carry
oxygen
 Vitamin supplement —needed by most women to
maintain adequate levels of these minerals
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Nutrition During Pregnancy
2500 babies are born with neural tube
defects each year
• Most common of these is spina bifida
(spine is not closed)
– The exposed nerves are damaged, leaving the child
with varying degrees of paralysis, incontinence and
sometimes mental retardation
Neural tube defects develop
in the first 28 days after
conception
When
is the time to start eating right for pregnancy?
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Nutrition During Pregnancy
US Public Health Service recommends that
all women of childbearing age get 400
micrograms of folic acid each day
FDA now requires that all flour products, such
as breads, buns and bagels be fortified
with extra folic acid
Sources of folic acid:
citrus fruits
nuts
fortified cereals and vitamin supplements
green leafy vegetables
beans
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Nutrition During Pregnancy
Avoid
Smoking
• Higher risk of preterm birth, low birth weight and stillbirth
• Babies are more likely to have poor lung development,
asthma, respiratory infections and die of sudden infant
death syndrome (SIDS)
• Second-hand smoke is also dangerous
Alcohol
• Can damage a developing fetus
• Travels rapidly through bloodstream, baby drinks also
• Causes mental retardation and facial abnormalities,
called fetal alcohol syndrome (FAS)
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Nutrition During Pregnancy
Alcohol (cont.)
• Estimated 12,000 children are born with FAS in the
US each year
X-rays
• Exposes the fetus to radiation and can potentially
cause birth defects
Hot tubs and saunas
• Raises core temperature of a pregnant woman’s body
and potentially harm the fetus
Medications
• No medications should be taken (even over the
counter) unless approved by doctor
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Nutrition During Pregnancy
Exercise
According to medical evidence, even a rigorous
workout is healthy during pregnancy
Check with doctor before beginning a new
exercise routine
Drink plenty of water
Staying in shape helps to maintain stamina
during labor
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Testing for Birth Defects
If doctor feels it is necessary
Ultrasound—uses high-frequency sound waves
to form pictures of the fetus on a computer
screen
can verify due date
determine causes of bleeding
check for overall health,
development, sex and position
of the baby
measure the amniotic fluid
check condition of the placenta
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Testing for Birth Defects
Alpha-fetoprotein Screening (AFP)—
measures the levels of alpha-fetoprotein in the
mother’s blood
abnormal levels can indicate a brain or spinal cord
defect, presence of twins, a miscalculated due date or
an increased risk of Down syndrome
Chorionic Villi Sampling (CVS)—inserts a
catheter or needle into the womb and extracts
some of the chorionic villi (cells from the tissue
that will become the placenta)
can detect same abnormalities as amniocentesis
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Testing for Birth Defects
Amniocentesis—examines the cells shed by
the fetus into the surrounding amniotic fluid
performed about 16 weeks into pregnancy
involves inserting a long, thin needle through the
mother’s abdomen to extract fluid from the womb
indicates chromosomal abnormalities such as Down
syndrome, Tay-Sach disease and others
can also assess the maturity of the baby’s lungs in
the last trimester
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When Will Baby Be Born?
Pregnancy lasts about 280 days, 9 months
or 40 weeks
To figure due date:
1. Find the day the mother’s last period
started
2. Count backwards 3 months
3. Add 7 days
The baby will be born on or around that due date,
give or take two weeks before or after
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Weight Gain
Plan to gain 25-35 pounds
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Baby
7 ½ lbs.
Placenta
1 ½ lbs.
Uterus
2 lbs.
Amniotic fluid
2 lbs.
Breasts
1 lb.
Extra blood
3 lbs.
Tissue and fluid
3 lbs.
Mother’s reserves
5 lbs.
TOTAL
25 pounds
Quiz 1
1. Name three symptoms of pregnancy.
2. What might a health care professional do in a
pregnancy checkup?
3. What are 2 components of good prenatal care?
4. List 4 things that should be avoided during
pregnancy.
5. The recommended amount of weight gain is ___
to ___ pounds.
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Conception
Ovulation—woman’s
ovary usually releases
just one fertile egg
The egg is drawn into the
Fallopian tube which leads
to the uterus
If sperm are present in the
tube, the egg will be
fertilized (conception) and
continue its journey to the
uterus
The newly fertilized egg cell
will divide many times
before reaching the uterus
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Once fertilization occurs it
takes about 3-4 days to reach
the uterus
Once inside the egg cell, the
sperm will release the genetic
material it has been carrying
Conception
Sperm’s genetic material
(23 chromosomes) will
combine with the eggs genetic
material (23 chromosomes)
The process of cell division
Is called mitosis
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Implantation of the fertilized
egg cell in the wall of
the uterus--complete by
about the 10th day after
conception
Newly formed cell now has
46 chromosomes and is
called a zygote
After many divisions, there will
be a mass of cells, each cell
containing the identical genetic
material present in the first
fertilized egg cell
Fertilization Facts
Only about 50 sperm will ever reach the egg
and compete to be the one single sperm to
break through the egg’s protective layer
Sperm can live about 48 hours
inside the uterus
Did you know?
Almost half of the sperm will die shortly
after release and more will die while
searching for the fertile egg
The male deposits approximately 2-3 million
sperm, which have been developing for about
30 days
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First Trimester
1 through 12 weeks
Zygote— first two weeks
Embryo— two weeks to eight weeks
Fetus— eight weeks to birth
 3rd week— after implantation, a row of cells begins to form
inside the cell mass
this begins the embryo
 Placenta keeps baby’s blood separate from the mother’s, but
allows smaller particles to pass
 4th week— the embryo is about 1/8 inch long
 Internal organs form without an abdominal cavity surrounding
 Heart starts beating on the 18th day
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First Trimester
 4th week (cont.)—arm and leg buds soon appear
 Head and brain area still compose about 1/3 of the
embryo’s mass
 The still small embryo is attached to the placenta by the
umbilical cord
 Placenta firmly attached to the mother’s uterine wall
 Placenta—allows small particles in mother’s blood to
pass through to embryo’s blood, waste is also passed
through placenta to the mother’s blood
 5 weeks—embryo is about 1/3 inch long
 Other facial features begin to develop
 6 weeks—spinal column is clearly visible
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First Trimester
 6 ½ weeks—umbilical cord contains 2 arteries (from
embryo to placenta) and 1 vein (back from placenta to
embryo)—mother and embryo blood does not mingle
 7 ½ weeks—embryo (1 inch) attached to placenta via
umbilical cord
 8 weeks—embryo is now called a fetus
 10 weeks—fetus is about 2 inches and growing quickly
 Fetus has eyes, eye lids, nose, lips, fingers, among other
human features
 12 weeks—3 inches long, systems of body are well
developed, organs more or less complete
 Heart pumps about fifty pints of blood through the
circulatory system each day
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Second Trimester
13 through 27 weeks
 16 weeks—4th month, baby grows more rapidly, and
reaches a length of 8 inches
 Blood vessels are visible through thin, loose skin
 18 weeks—fetal “quickening” felt as baby moves and
kicks
 20 weeks—white, cheese-like substance, vernix, forms
to protect baby’s skin from chapping in amniotic fluid
 6th month—fetus develops layer of fat beneath skin and
lanugo, fine hair, covers head and body
 24 weeks—baby stands slight chance of survival if born
now—said to be “viable”
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Third Trimester
28th week to birth
 During last two months, fetus increases in weight by
almost 1 ounce a day
 Baby settles into a curled position, usually head down
 Last month—”lightening” occurs, baby drops into lower
pelvis
Signs that labor is about to begin
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Loss of mucous plug Loss of weight
Nesting instinct
Increase in
appetite
Quiz 2
1. When and where does conception take place?
2. The fertilized egg is called a ________ in the first
two weeks.
3. The baby from the 2nd week to the 8th week is
called a(n) ________.
4. From the 8th week to birth, baby is called a _____.
5. By the _____ week, all major organs are present.
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Labor
Labor
Series of continuous, progressive
contractions of the uterus which help the
cervix to open (dilate) and to thin (efface),
allowing the fetus to move through the
birth canal
Usually starts two weeks before or after the due date,
What triggers the onset of labor is still a mystery
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Signs of Labor
 Bloody show—small amounts of mucous, slightly
mixed with blood; expelled from vagina
 Uterine contractions—uterine muscle spasms
occurring at intervals of less than 10 minutes,
usually indicate that labor has begun; contractions
become more frequent and severe
 Rupture of amniotic membranes—(water breaks)
labor sometimes begins with amniotic fluid gushing
or leaking from vagina; most women go into labor
within 24 hours of rupture
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Stages of Labor
First Stage (dilation of cervix)
 Contractions are more frequent (usually 5 to 20 minutes
apart)
 Dilation of the cervix is necessary for the fetus to move
through the birth canal
 Contractions become more frequent and intense, occur
every 2 to 4 minutes and last between 45 and 60
seconds
 Cervix is completely dilated to 10 centimeters at the end
of this stage
 Epidural block may be given during first stage; local
anesthetic delivered to block pain from waist to feet
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Stages of Labor
Second Stage (expulsion of fetus)
 Begins with cervix completely opened and ends with
delivery of baby
 Also called “pushing” stage
 “Crowning” occurs when baby’s head is visible at
opening of vagina
 Doctor may perform an episiotomy—a small incision in
the skin below the vagina, prevents tearing of the vaginal
tissues as the baby emerges
 Usually most painful stage
 May last 10 minutes to 2 hours
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Stages of Labor
Third Stage (expulsion of the placenta)
 Lasts from a few minutes to 30 minutes
 Mild contractions
 Placenta (organ that has nourished the baby inside of
the uterus) is expelled
Average labor and delivery time is 12 to 14 hours, but
any length of time up to 24 hours is considered normal
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Types of Birth

Vaginal—baby delivered through the birth canal

Caesarean—fetus is delivered through an
incision in the mother’s abdomen
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Caesarean Delivery
Conditions under which Caesarean delivery
may be recommended
1.
2.
3.
4.
5.
6.
7.
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Breech presentation (fetus is feet or buttocks first)
Unfavorable shape of pelvis
Large fetus (over 8 lbs.)
Premature rupture of amniotic sac
Active genital herpes
Fetal distress (significant increase or decrease in fetal
heart rate
Prolonged pregnancy (more than 42 weeks)
Diagnosing the Infant
Apgar scale—a simple and effective method
of diagnosing potential problems in full-term
and preterm newborns
Baby is examined for
five vital signs
1. Heart rate
2. Respiration
3. Skin color
4. Muscle tone
5. Reflex response
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Diagnosing the Infant
Apgar scale
scores
3 or lower
indicates that
emergency
medical attention
is needed
7-10 indicates
child is in
good
condition
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Performed at
1 minute and
5 minutes
after birth
4-6 indicates
that
assistance
is needed
Becoming Parents
Becoming parents affects your relationship
 Reality of caring for the baby can be overwhelming
 Lack of sleep is a factor in the early months of baby’s life
 Less energy and lack of sleep turn errands and housework
into difficult chores, not able to concentrate, irritable
 Feelings of jealousy
 Pregnancy temporarily robs mom of former body
 Less interested in intimacy
 Overwhelming company and advice from friends and family
 May have different approaches to parenting
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Becoming Parents
New parents checklist
Communication is the best
tool to diminish anger and
prevent arguments
Find time to be together
as a couple
Be aware of one another’s
emotions and needs
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Enjoy the time with your
new baby
Quiz 3
1. Define labor.
2. List the three signs of labor.
3. List and explain the three stages of labor.
4. What is caesarean birth?
5. What is the name of the test performed on infants
after birth?
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Quiz 3 (cont.)
6. How does becoming a parent affect your
relationship?
7. What is one of the first signs of pregnancy?
8. What should women avoid during their pregnancy?
9. Define amniocentesis.
10. Pregnancy is divided into __________.
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Acknowledgements
KidsHealth. 2002. www.kidshealth.org
Babyonline.com. 2002. www.babyonline.com
Williams, Rebecca D. Food and Drug Administration. “Healthy Pregnancy,
Healthy Baby.” 2002. vm.cfsan.fda.gov/~dms/fdbaby2.html
Childbirth.org. 2002. www.childbirth.org
Production Coordinators
Treena Aston
Allison Mangold
Production Manager
Geoff Scott
Executive Producer
G.W. Davis
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