PY2505.2 ~ {Antenatal Development}
antenatal + prenatal
during pregnancy, refer to the period before birth
postnatal + postpartum
after pregnancy [usually upto one year but could be more or less]
perinatal
period around the time of birth, starts around 22 weeks of gestation and lasts until 7 days after birth [encompasses pregnancy + postnatal period]
gestation
time that the baby is in the womb, [mother is pregnant]
stages of gestation
divided into 3 trimesters
1st = 1-13 weeks, 2nd = 14-27 weeks, 3rd = 28-40 weeks
what happens in the stages
1 = embryo develops into fetus and all major organs begin to form
2 = fetus grows in size, and organs + body systems continue to mature
3 = when fetus gains weight + organs complete their development in preparation for birth
fetus
the baby whilst in the womb, unborn offspring [used from the 9th week of gestation until birth]
maternal + utero
relating to the mother (either before or after birth)
[In utero – in the uterus]
physical changes in pregancy
weight gain + body shape + functional limitations + fatigue + nausea + fetal movements
Loss of control - Autonomous vs collaborating bodies – (Carter, 2010)
fatigue, nausea, vomitting, constipation, weight gain
effects of physical change
doesn't fit the socially constructed ideal of female body + incongruence of the physical manifestation of the mothering role to their other roles as a romantic partner, or working woman – need to protect their body image satisfaction
[Hodgkinson, Smith & Wittkowski, 2014]
high levels of body dissatisfaction in the postpartum period
[Hodgkinson, Smith & Wittkowski, 2014]: identity
conflict with other roles e.g. working woman, partner, daughter, friend, etc
(Smith,1999): identity
shift from pulic world to local world, in the sense that maybe going out less, if noone else is having children at the same time [so less socialising makes the world more inward and intimate]
[Atkinson, Shaw &. French, 2016]
adopting the behaviours of a pregnant woman may help with acceptance of the new identity; no drinking alcohol
social changes in pregnancy
ideas of confinement [general encouragement to rest, presccriptive practices around food, activity + hygeine]
surveillence medicine makes pregnancy feel like a more medical experience rather than a natural one
surveillance medicine
meant to reduce still births + miscarriages
makes pregnancy feel like a more medical experience rather than a natural one
as decreases risks and can be comforting to parents but may also be associated with increased anxiety/worry and medicalisation of pregnancy
cognitive impairment
very limited research to show there's any impairment associated with pregnancy + so some changes are direct biomedical ones + cultural stereotypes
baby brain
a set of cognitive + emotional changes experienced during pregnancy + in the postpartum period, a temporary state where you feel more forgetful, distracted, or mentally foggy, you might also report difficulty concentrating, lower mental clarity, or forgetfulness
sleep
disturbances are often experienced during pregnancy [potentially due to hormonal and physiological changes: frequent urination (Lee,1998)]
baby blues
affects 3/4 of postpartum women, considered a 'normal' occurrence, onset around day 3 usually resolved within 2 weeks, tesrfulness, feeling overwhelmed, irritability which causes hormonal drop + sleep deprivation
maternal mental health disorders
has been estimated that upto 18% of women experience depressed mood during pregnancy, with nearly 13% having an episode that would meet the DSMIV diagnistic criteria for major depressive order (Gavin, et al., 2005) + depression and anxiety also affect 15-20% of women in the first year childbirth
why is pregnancy a risk factor for MH problems
upto a quarter of all maternal desths are related to maternal MH problems + overlap of reproductive years & onset of MH conditions + stress of preg as a trigger for an underlying biological vulnerability + sleep disturbance
post-partum psychosis
oftwn qith mania + depressive symptoms in immediate postnatal period, which can become very severe extremely quickly, affects 1-2 in every 1000 [most prevalent in women with Bipolar disorder]
perinatal OCD
intrusive thoughts + compulsive behaviour, commonly thoughts about deliberately or accidentally hurting the baby, likely to be subclinical but very distressing for the woman
DSMIV
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, classification system published by the American Psychiatric Association (APA) in 1994, provided a comprehensive list of MH disorders along with criteria to aid in diagnosis + categorization of various psychological conditions
post-partum PTSD
birth trauma; affects 30000 women a year in the UK and can resut from a difficult labour with a long + painful delivery + unplanned caesarean section + emergency treatment + other shocking unexpected and traumatic experiences during birth [can also affect partners]
challenges diagnosing maternal MH issues
most go undiagnosed becuase signs & symptoms similar to those of preg, reluctance to seek help: potential feelings of guilt [perception of being a bad mother] + stigma that preg should be a happy time + concerns of child being removed
how many extra calories per day should a pregnant women eat in the third trimester
from 6-9 months