1. Identify the hazards, risks, and complications of pregnancy.

There are many circumstances that may cause complications during

pregnancy. Excessive vomiting for an extended period of time, or
hyperemesis gravidarum, can cause dehydration and malnutrition. Vaginal
bleeding may have serious consequences although the implications depend on
the stage of the pregnancy. In early pregnancy it may be the result of
spontaneous abortion but in the later stages of pregnancy vaginal bleeding
may suggest placental problems. Protein in the mothers urine, or toxemia or
eclampsia may cause maternal or fetal death or fetal brain damage. Diabetes
or gestational diabetes may require intense prenatal care. The mother must
take care to monitor her blood-glucose levels and control them through diet
and sometimes insulin injections. If the mother has too much amniotic fluid,
or polyhydramnios, this could suggest the baby is no drinking it and may
signify a problem with the baby.

2. Critically evaluate ethical dilemmas faced by parents in deciding to

keep their baby.
Expectant parents who have made the decision to keep their baby face
many ethical dilemmas. Men and women mentally represent the growing fetus
in different ways. Mothers may have an easier time recognizing the
pregnancy as a reality upon hearing the babys heartbeat, seeing the baby via
ultrasound and feeling the babys movements. Fathers may be at a
disadvantage in recognizing the reality of the pregnancy because they are
not physically connected to the fetus. However, attending doctors
appointments with his partner may help with this by allowing him to hear the
babys heartbeat and see the baby via ultrasound. This may help the parents
reconcile with the reality of the pregnancy. Once the baby is born they will
have to reconcile the expectations of their perfect dream baby with the
actual baby that is born to them.
Roles may be an issue with expectant parents as well. The mother and
father may have to renegotiate their own relationship to accommodate the
new addition to their family. Additionally, there are decisions to be made
such as who will work, who will care for the baby, and how they will manage
these new responsibilities. They must also take into consideration what kind
of support and services they will need in raising a child, and determine what
is available to them.

Environmental factors must also be taken into consideration when

deciding to have a baby. For instance, couples living in poverty may have to
elicit the help of social services to ensure the baby will be afforded
everything an infant needs. This may also include counseling services to help
alleviate the added stresses of poverty. Lifestyle is an important factor
both in the pregnancy as well in the postpartum stage. If the mother
smokes, drinks alcohol, or uses drugs, is she capable of giving those things up
on during her pregnancy or will she need substance abuse counseling. Are
both parents capable, if applicable, of refraining from substance abuse once
the baby is born? If there are mental or physical illnesses present, how will
these be addressed both during the pregnancy and postpartum?

3. Describe relevant environmental effects on prenatal development.

Some complications can be attributed to factors in the maternal uterine
environment. Complications such as these may cause IUGR, or intrauterine
growth retardation. The factors that can lead to IUGR include maternal age,
multiple gestations, maternal nutrition, maternal illness, maternal
drug/alcohol use, maternal smoking, maternal stress or maternal depression
and anxiety. Older women run higher risks of giving birth to babies with
chromosomal abnormalities. Younger women run a higher risk of infant death,
pregnancy complications, and infant mental retardation because they are less
likely to seek prenatal care than older women. Multiple gestations increase
the risk for IUGR or premature labor. Poor nutrition increases the risk of
IUGR and low birth weight. Maternal illnesses such as nonbacterial
infections, toxoplasmosis, rubella, German measles and STDs can cause a
host of complications such as miscarriage, fetal death, mental retardation,
and eye, ear, bone, or brain damage. Maternal drug use, illicit, prescription,
or OTC may result in giving birth to addicted babies or many other
complications. Maternal alcohol abuse may lead to fetal alcohol syndrome
(FAS), which may have lasting consequences such as facial deformities,
mental retardation, learning disabilities, and behavior problems. Maternal
smoking can cause low birth weight. Maternal stress may increase the risk of
premature birth, low birth weight, and IUGR. Maternal depression and
anxiety have been linked to poor regulation of behavior, physiology, and
biochemistry.

4. Describe the problems associated with premature birth.

Respiratory distress syndrome (RDS) occurs when a baby is born before
the lungs are fully developed. Some babies may need a ventilator to help
them breath, which increases the risk of other potential complications.
Long-term ventilation can lead to scarring and a narrowing of the airway
which may require the baby undergo a tracheostomy, which is a small opening
made in the babys throat through which he or she will breath. Long-term
placement of the tracheostomy may have an impact on speech development.
Another potential problem that can be caused by ventilators is called
bronchopulmonary dysplasia (BPD). This occurs when the baby requires
oxygen after reaching 36 gestational weeks. BDP is a predictor of
inadequate motor coordination at the age of 3 years. Apnea, or periods when
the baby stops breathing is common among premature babies. Babies born
before 34 weeks may have not developed the reflexes needed for feeding
such as sucking. This requires that the baby be tube-fed until he or she
develops the necessary reflex. Premature babies are also more likely to
develop jaundice, which can cause mental retardation. Very small premature
babies are at high risk of bleeding or infection of the central nervous
system, which may result in permanent disabilities.

5. Identify and describe parental emotional effects on the fetus.

An increasing number of parents and health professionals now believe
that a childs emotional well-being begins at conception. There is some
evidence to suggest that depressed or anxious women give birth to babies
with low birth weight, babies who tend to cry more, and possibly suffer more
neurological problems than babies born to mothers without depression or
anxiety.

6. Evaluate the significance of the concept of a sensitive period for

developing mother-infant bonding.
One study indicated that mothers who have close and frequent contact
with their babies immediately after birth had better mothering skills. The
concept of the sensitive period between mothers and their babies has
changed the way hospitals handle birthing procedures by encouraging
physical contact between mother and child from birth, assuming the child

and mother are healthy and do not require special care. It has not been
proven that early contact has any long-term benefits for forming
attachments. The forming of attachments is an ongoing process between
mother and child, so mothers who give birth by caesarian section, adoptive
mothers, or mothers whose childrearing practices may be hindered by early
contact have ample opportunity to form strong emotional attachments with
their babies after the sensitive period.