Phases of Pregnancy

Phases in pregnancy (otherwise known as trimesters) are stages of growth and

development of the baby while inside the mother’s womb (uterus).

Pregnancy is the state of carrying a fetus (embryo) within the body from the period of
conception until birth.

The phases consists of three parts: the first trimesters, the second trimester and the
third trimester.

THE FIRST TRIMESTER: Week 1 to week 12

- the first symptom of being pregnant is missing your period.
The mother undergoes through:
- fatigue t gain or loss
- breast tenderness - aversion or liking to certain food and
- increased urination smells
- fullness or mild aching of the - headaches
abdomen - menstruation will stop
- nausea (with and without vomiting)
that is prominent during the morning;
also known as morning sickness
-
weigh
The baby’s developments:
● at 4 weeks
- the spinal cord and main nervous
system has begun to form
- the heart starts to form
- arms and legs will develop
- it is now 1/25 of an inch long

● at 8 weeks
- all major organs have formed
- the heart will begin to beat
- the arms and legs grow longer (along
with fingers and toes)
- the sex organs are now prominent
- the face starts to develop features
- the umbilical cord will become visible
- the baby is now an inch long and
weighs 1/8 of an ounce

● at 12 weeks
- the nerves and muscle begin to work
together (they can form a fist)
- the external sex organs can determine if
it’s a boy or girl
- eyelids will develop to protect the eyes
until week 28
- the baby is 3 inches long and weighs an
ounce

THE SECOND TRIMESTER: Week 13 to week 27

- is the least stressful trimester for most women for they have adjusted to the
changes that the baby has brought
- the baby bump will become very noticeable
- mothers will start to wear maternity clothes
The mother undergoes through:
- breast changes - hand pain, numbness, or weakness
- leg cramps (carpal tunnel syndrome)
- back pain - Braxton Hicks contractions
- pelvic ache and hip pain - linea nigra (a line from the navel to
- stretch marks the pubic hair)
- hemorrhoids and constipation - melisma (hyperpigmentation in the
- heartburn (a symptom of GERD) skin)
- nosebleeds and bleeding gums
The baby’s developments:
● at 16 weeks
- the muscoloskeletal system system
continues to grow
- skin begins to form and is near
transluscent
- meconium develops in the baby’s
intestines
- it is now 4 to 5 inches long and
weighs 3 ounces

● at 20 weeks
- the baby is able to move (kick and
stretch)
- it is covered in lanugo (fine white hair)
and vernix (thin wax around the skin)
- eyebrows, eyelashes, and nails have
formed
- the baby can hear and swallow
- it is about 6 inches long and weighs 9
ounces

● at 24 weeks
- the baby’s bone marrow will start to
make blood cells
- taste buds form
- fingerprints and footprints have
developed
- hair will grow at the top of the baby’s
head
- the lungs have formed, but do not yet
work
- the baby has a regular sleep cycle
- the baby stores fat, and now weighs 1.5 pounds, and is about 12 inches
long.
THE THIRD TRIMESTER: Week 29 to week 40 (birth)
- the phase in which the baby takes its final developments
- severe nausea and discomfort will be most prominent in the trimester
- the phase in which birth takes place
- normal births can be from week 37 to week 40

The mother undergoes through:

- more Braxton Hicks contractions joints)
- fatigue - difficulty in sleeping
- back pain - frequent urination
- pelvic ache and hip pain
- breathing difficulty
- edema (accumulation of bodily fluids
at
th
e

The baby’s developments:

● at 32 weeks
- the bones are fully-formed but soft
- lanugo begins to fall off
- movements and kicking increase
- “practice breathing” occurs
- the eyes can open and close
- The body can now store iron and
calcium
- it now weighs 4.5 ounces and is 15 to
17 inches long

● at week 36
- the vernix thickens
- body fat increases
 - movements become less forceful
- it weighs around 6 pounds, and is about 16-19 inches long

● at week 37 to 40
- the baby is now considered full term
- all of its organs can function on their
own
- average birth weight is between 6
pounds, 2 ounces to 9 pounds, 2
ounces and average length is 19 to 21
inches long

COMPLICATIONS IN PREGNANCY: (Hernandez)

Special Conditions:
● NAUSEA
Nausea is an uneasiness of the stomach that often comes before
vomiting. This occurs during early stages of
pregnancy (nausea occurs in appro ximately 50%-90% of
all pregnancies; vomiting in 25%-55%)

Prevention and Management:

● Small frequent feedings instead of three large meals and high
carbohydrates
● Low fat foods such as crackers
● Liquids should be taken between meals

● TOXEMIA
Also known as pre-eclampsia characterized by abrupt hypertension (a sharp rise in
blood pressure), albuminuria (leakage of large amounts of the protein albumin
into the urine) and edema (swelling) of the hands, feet, and face. Toxemia is one
of the most common complication of pregnancy. It occurs in the third trimester of
pregnancy.

Prevention and Management:

● Proper nutrition
● Intake of iron and folic acid as prescribed by the physician

● MORNING SICKNESS
- Around half to two-thirds of all pregnant women will
experience morning sickness.
- Possible causes include high levels of hormones,
blood pressure fluctuations and changes in
carbohydrate metabolism.
Prevention and Management:
● Eating a few dry crackers before you get up in the morning
● Avoiding foods and smells that make you nauseous
● Intake of folic acid as prescribed by the doctor

● ANEMIA
During pregnancy, your body produces more blood to support
the growth of your baby. If you're not getting enough iron
or certain other nutrients, your body might not be able to
produce the amount of red blood cells it needs to make
this additional blood.

Prevention and Management:

● Proper nutrition
● Get enough iron
● Eat well-balanced meals
● Add more foods that are high in iron to your diet.

● DIABETES
During pregnancy, the placenta makes hormones
that can lead to a buildup of glucose in your blood.
Usually, your pancreas can make enough insulin to
handle that. If not, your blood sugar levels will rise
and can cause gestational diabetes.

Prevention and Management:

● Fluid intake
● Proper Nutrition
● Exercise

● CONSTIPATION
Up to half of pregnant women get constipated
Reason for constipation during pregnancy is an
increase in the hormone progesterone, which
relaxes smooth muscles throughout the body. This
means that food passes through the intestines
more slowly.
Prevention and Management:
● Fluid intake
● Eat Fruits and Vegetables
● Drink plenty of water
METHODS AND STEPS OF CHILDBIRTH: (Conde)

SHORT RECAP: What is Childbirth?

Childbirth, also known as labor or birth, is the culmination of human pregnancy with the
emergence of a newborn infant from the mother’s fetus. Depending on the mother,
childbirth may or may not be painful. Usually, the birth weight is determined once the
baby is delivered.

1.) Vaginal Delivery

With this, the baby is born through the birth canal. Labor time is very hard to
determine, though most women give birth at around 38-41 weeks of pregnancy.
The nation’s largest ob-gyn organization recommends that pregnant women plan for
vaginal birth unless there is a medical reason for a cesarean.
In new guidelines issued in 2013, The American College of Obstetricians and
Gynecologists says maternal-request cesareans are especially not recommended for
women planning to have several children, nor should they be performed before 39
completed weeks of pregnancy.

Benefits of vaginal delivery:

● shorter hospital stays
● lower infection rates
● quicker recovery
● babies born vaginally have a lower risk of respiratory problems

WHAT HAPPENS DURING A VAGINAL DELIVERY?

First Stage: Dilation and Effacement of the Cervix

A. Early (or Latent) Phase - cervix dilates from zero to three or four centimeters
This first step in the journey toward childbirth lasts an average of 6 to 10 hours for a
first-time mother, but can be much shorter (especially if you've given birth before) or
much longer.
The beginnings of labor may be subtle or dramatic - and it happens differently in every
woman.
In some women, the cervix dilates to three centimeters well before any noticeable, real
contractions (or labor) begin. Other women can have strong, contractions that don't
change her cervical dilation at all.
Contractions can be mild and somewhat irregular.
Pinkish discharge and feel a bit of abdominal discomfort. The "water" may "break"
(rupture of membranes) in this early phase.

B. Active Phase -- cervix dilates from four to seven centimeters

This phase is when the serious prep work for childbirth begins, and when most women
begin to labor more intensely. It can last an average of three to six hours for first
babies, and about half that for subsequent births.

Contractions usually come steadily, gradually increasing in intensity and frequency,

from three to five minutes apart. Pains may be centered in the lower back, abdomen,
or thighs, and they may be intense enough to make it hard for you to talk

C. Transition phase -- cervix dilates to eight to ten centimeters

The final phase of the first stage can last 20 minutes to two hours for first babies, and
may go quite quickly in subsequent births.

Contractions during this phase are usually intense, spaced about one to three minutes
apart. Increasing fatigue, shakiness, and nausea are all common in this phase, as the
body does the hard work of reaching complete dilation and effacement.

A strong urge to push or bear down, along with pressure in the rectal area and
stinging in the vaginal area as the baby's head moves down toward the vaginal
opening

Second Stage: Pushing and Birth

The second stage of childbirth begins when the cervix is fully dilated. It lasts about an
average of one-half hour to two hours in first-time moms. In subsequent births, it may
last anywhere from a few minutes to two hours.

Contractions don't stop now, though they often come farther apart. Some women
experience nausea and vomiting. As you begin pushing, you may become increasingly
breathless and fatigued.
The body will feel intense pain around your vaginal and perineal areas as the baby's
head crowns, or protrudes at its widest part outside the vaginal opening.
If you have an episiotomy (an incision made in the area between the vagina and the
rectum to widen the vaginal opening) it will probably happen at this point.

The mother may be asked to push more gently or slowly as the rest of your baby's
head and body emerge. Finally, with one last push, the baby is out.

Third Stage: Delivery of the Placenta

The incredible moment of baby's birth is followed swiftly by the delivery of the placenta
(sometimes called "the afterbirth"). This usually takes anywhere from a few minutes to
a half hour.

2. Caesarian Section (C-Section)

A cesarean section or C-section is the delivery of a baby through a surgical incision in
the mother's abdomen and uterus. In certain circumstances, a C-section is scheduled
in advance, or when unforeseen circumstances are present

Events that may require C-Section:

● Multiples (twins, triplets, etc)
● A very large baby
● Previous surgery, C-Sections, or other uterine conditions
● Baby is in breech (bottom first) or transverse (sideways) position
● Placenta previa (when the placenta is low in the uterus and covers the cervix)
● Fibroid or other large obstruction

STAGES/STEPS IN A C-SECTION

1. DECISION/PLANNING
The decision to have a cesarean can arise before labor, often called a planned or
scheduled cesarean.
The decision might also happen in labor. This might be because it is thought that labor
is taking too long, mother or baby is not tolerating labor well, or other issues arise like it
is found that the baby is in a malposition. This is typically called an unplanned
cesarean.
In a few cases, it is due to an emergency, as in the case of a placental abruption,
severe bleeding, etc.

2. BEGINNING OF C-SECTION
Once the mother has received anesthesia, usually a spinal or epidural and all that
entails, the mother will be ready for surgery. The anesthesia can take a bit to
accomplish, sometimes 20-30 minutes. The powerful numbing will happen quickly and
effectively.

3. MULTIPLE LAYERS OF INCISION

There are multiple layers that your surgeon must go through before reaching the baby.
The doctor will use a combination of sharp instruments and blunt dissection as s/he
goes through each layer. The mother may also hear whirring noises as a machine is
used to cauterize or burn small blood vessels to prevent bleeding.

4. SUNCTIONING AMNIOTIC FLUIDS

When the doctor reaches the uterus, the mother will also hear suctioning. After cutting
through the uterus, the amniotic fluid will be suctioned away to make a bit more room
in the uterus for the doctor's hands or instruments such as forceps or a vacuum
extractor.

5. THE PRESENCE OF THE BABY’S HEAD

The baby is usually engaged in the pelvis, usually head down, or perhaps rear first or
breech. Whatever part has entered the pelvis will be lifted out by the doctors.
Mothers may feel pressure at this point. Some women report feeling nauseated during
this intense, but brief moment.

The baby's head is out! Once the head is out, the doctor will suction the baby's nose
and mouth for fluids.
In a vaginal birth, these are squeezed out by the process of labor. In a cesarean birth,
the baby needs some extra help getting rid of these fluids.

6. DISLODGING THE BABY’S HEAD AND SHOULDERS

The surgeon will need to maneuver the baby back and forth to help them be free. The
mother may feel wiggling.
Once the baby has been well suctioned, the doctor will start to help the rest of the body
be born. S/he will check for umbilical cord entanglement or other complications as the
body is born.
The mother may also have the assistant surgeon pressing on the upper part of her
abdomen of fundus to assist in the birth.

7. THE BABY IS FINALLY BORN

The baby is finally here! The baby will typically be briefly held over the drape to show
the mother her baby and then taken away by a nursery nurse or neonatologist to a
nearby warmer depending on the setup of the operating room.
With some prior planning, the mother can request to be skin-to-skin with her baby
immediately, while they finish the surgery.
If the baby goes to the warmer, it is usually in the same room as the surgery. The baby
will be suctioned again to ensure that they have help clearing the amniotic fluid. The
baby may also have some basic care like weighing, measuring, etc.

The repair of the uterus and the layers that were cut during the surgery need to be
completed before the end of the surgery. During this portion of the surgery, the
placenta will also be removed and examined by your doctor.
This is the longest part of the cesarean section, which in total takes about 45-60
minutes to complete. During this time, the baby can usually be with you for
breastfeeding or holding.

8. WOUND CARE AFTER C-SECTION

After everything is finished surgically, the surgeon will suture or staple your incision
shut. It will then be covered with a bandage.
The mother will be watched in the post-op area for at least an hour to ensure that her
vital signs are stable and that she isn’t bleeding too heavily. The mother will then be
taken to her postpartum room where she will spend the remainder of her stay, which is
usually four days.

3. Vaginal Birth After Caesarian

In the past, a C-section ended any hope of future vaginal deliveries. Though
nowadays, thanks largely to changes in surgical technique, VBAC is possible in many
cases.
VBAC isn't right for everyone. Sometimes a pregnancy complication or underlying
condition prevents the possibility of a successful VBAC. Many local hospitals don't offer
VBAC because as they don't have the staff or resources to handle emergency C-
sections.

DIFFERENT METHODS (AND THE STEPS) OF CHILDBIRTH

(CONTINUATION): (Muzones)

3.) Vacuum Extraction

• a procedure sometimes done during the course of vaginal childbirth.
• a health care provider applies the vacuum (a soft or rigid cup with a handle and
a vacuum pump) to the baby's head to help guide the baby out of the birth canal.

STEPS:
During the procedure
 1. Lie on your back with your legs spread apart. You might be asked to grip
handles on each side of the delivery table to brace yourself while pushing.
2. Your health care provider will insert the vacuum cup into your vagina, place the
cup against the baby's head, and check to make sure no vaginal tissues are
trapped between the cup and the baby's head. Then your health care provider
will use the vacuum pump to create suction.
3. During the next contraction, your health care provider will rapidly increase the
vacuum suction pressure, grasp the cup's handle and try to guide the baby
through the birth canal while you push. Between contractions, your health care
provider might maintain or reduce the suction pressure.
4. After your baby's head is delivered, your health care provider will release the
suction and remove the cup.
5. Vacuum extractions aren't always successful. If your health care provider is
unable to safely deliver your baby with assistance from a vacuum, a cesarean
delivery will be recommended.

After the procedure

1. After delivery, your health care provider will examine you for any injuries that
might have been caused by the vacuum. Any tears will be repaired. If an
episiotomy was performed, it will be repaired as well.
2. Your baby will also be monitored for signs of complications that can be caused
by a vacuum extraction.

When you go home

1. If you had an episiotomy or a vaginal tear during delivery, the wound might hurt
for a few weeks. Extensive tears might take longer to heal.
2. While you're healing, expect the discomfort to progressively improve. Contact
your health care provider if the pain gets worse, you develop a fever, or you
notice signs of an infection.
3. If you're unable to control your bowel movements (fecal incontinence), consult
your health care provider.

ADDITIONAL INFORMATION:
Why it's done
A vacuum extraction might be considered if your labor meets certain criteria — your
cervix is fully dilated, your membranes have ruptured, and your baby has descended
into the birth canal headfirst, but you're not able to push the baby out. A vacuum
extraction is only appropriate in a birthing center or hospital where a C-section can be
done, if needed.

Your health care provider might caution against vacuum extraction if:
 ● You're less than 34 weeks pregnant
● Your baby has a condition that affects the strength of his or her bones, such as
osteogenesis imperfecta, or a bleeding disorder, such as hemophilia
● Your baby's head hasn't yet moved past the midpoint of the birth canal
● The position of your baby's head isn't known
● Your baby's shoulders, arms, buttocks or feet are leading the way through the
birth canal
● Your baby might not be able to fit through your pelvis due to his or her size or the
size of your pelvis
Risks
A vacuum extraction poses a risk of injury for both mother and baby.
Possible risks to you include:
● Pain in the perineum — the tissue between your vagina and your anus — after
delivery
● Lower genital tract tears
● Short-term difficulty urinating or emptying the bladder
● Short-term or long-term urinary or fecal incontinence (involuntary urination or
defecation)

4.) Forceps Delivery

• is a type of operative vaginal delivery. It's sometimes needed in the course of
vaginal childbirth.
• a health care provider applies forceps (an instrument shaped like a pair of large
spoons or salad tongs) to the baby's head to help guide the baby out of
the birth canal.

STEPS:
During the procedure
1. During a forceps delivery, you'll lie on your back, slightly inclined, with your
legs spread apart. You might be asked to grip handles on each side of the
delivery table to brace yourself while pushing.
2. Between contractions, your health care provider will place two or more fingers
inside your vagina and beside your baby's head. He or she will then gently
slide one portion of the forceps between his or her hand and the baby's head,
followed by placement of the other portion of the forceps on the other side of
your baby's head. The forceps will be locked together to cradle your baby's
head.
3. During the next few contractions, you'll push and your health care provider
will use the forceps to gently guide your baby through the birth canal.
 4. If your baby's head is facing up, your health care provider might use the
forceps to rotate your baby's head between contractions.
5. If delivery of the baby is certain, your health care provider will unlock and
remove the forceps before the widest part of your baby's head passes
through the birth canal. Alternatively, your health care provider might keep the
forceps in place to control the advance of your baby's head.
6. Forceps deliveries aren't always successful. If delivery with assistance of
forceps is not successful, your health care provider might recommend a C-
section for delivery. He or she might also recommend using a cup attached to
a vacuum pump to deliver your baby (vacuum extraction) as an alternative.
Your health care provider will assess your delivery situation and make a
decision about which option — forceps or vacuum extraction — is the right
choice for you.
7. If your health care provider applies the forceps but isn't able to move your
baby, a C-section is likely the best option.

After the procedure

1. After delivery, your health care provider will examine you for any tears that
might have been caused by the forceps. Any tears will be repaired. Your baby
will also be monitored for any signs of complications.

When you go home

2. If you had an episiotomy or a vaginal tear during delivery, the wound might
hurt for a few weeks. Extensive tears might take longer to heal.
3. While you're healing, expect the discomfort to progressively improve. Contact
your health care provider if the pain gets worse, you develop a fever or you
notice signs of an infection.
4. If you're unable to control your bowel movements (fecal incontinence), consult
your health care provider.

ADDITIONAL INFORMATION:
Why it's done
A forceps delivery might be considered if your labor meets certain criteria — your
cervix is fully dilated, your membranes have ruptured, and your baby has descended
into the birth canal headfirst, but you're not able to push the baby out. A forceps
delivery is only appropriate in a birthing center or hospital where a C-section can be
done, if needed.

Your health care provider might recommend a forceps delivery if:

 ● You're pushing, but labor isn't progressing. Labor is considered prolonged if you
haven't made progress after a certain period of time.
● Your baby's heartbeat suggests a problem. If you are fully dilated, the baby is low
in the birth canal, and your health care provider is concerned about changes in
your baby's heartbeat, an immediate delivery may be necessary. In such a case,
he or she might recommend a forceps delivery.
● You have a health concern. If you have certain medical conditions — such as
heart disease or high blood pressure — your health care provider might limit the
amount of time you push.

Your health care provider might caution against a forceps delivery if:
● Your baby has a condition that affects the strength of his or her bones, such as
osteogenesis imperfecta, or has a bleeding disorder, such as hemophilia
● Your baby's head hasn't yet moved past the midpoint of the birth canal
● The position of your baby's head isn't known
● Your baby's shoulders or arms are leading the way through the birth canal
● Your baby might not be able to fit through your pelvis due to his or her size or the
size of your pelvis

Risks
A forceps delivery can possibly cause risk of injury for both mother and baby.
Possible risks to you include:
● Pain in the perineum — the tissue between your vagina and your anus — after
delivery
● Lower genital tract tears
● Difficulty urinating or emptying your bladder
● Short-term or long-term urinary or fecal incontinence (involuntary urination or
defecation) if a severe tear occurs
● Injuries to the bladder or urethra — the tube that connects the bladder to the
outside of the body
● Uterine rupture — when the uterine wall is torn, which could allow the baby or
placenta to be pushed into the mother's abdominal cavity
● Weakening of the muscles and ligaments supporting your pelvic organs, causing
pelvic organs to drop lower in the pelvis (pelvic organ prolapse)

THREE STAGES OF LABOR: (Muldez)

BIRTH
The passage of a baby from its mother’s uterus to the outside of her body is called
birth. During birth, the uterus contracts many times and pushes the baby through the
vagina and outside the mother’s body

LABOR
Labor is the process that lasts from the time contractions
start until the delivery of the child and the placenta. Labor
lasts a different amount of time for every woman and every
pregnancy.

There are three distinct stages of labor:

● 1st Stage
● 2nd Stage
● 3rd Stage

1st Stage
Begins with the first contraction and lasts until the cervix
has opened enough to allow the baby to pass through.
Contraction happens every few minutes and lasts a
minute.

The First Stage of labor is the longest and involves

three phases:
● Early Labor Phase
● Active Labor Phase
● Transition Phase

Early Labor Phase

The time of the onset of labor until the cervix is dilated to 3 cm

Active Labor Phase

Continues from 3 cm. until the cervix is dilated to 7 cm.
Transition Phase
Continues from 7 cm. until the cervix is fully dilated to 10 cm

2nd Stage
Starts when the cervix is completely open and lasts until the
baby is delivered. During this period, contraction happens
every 2 to 3 minutes. After the baby is born, the doctor cuts
the umbilical cord. Healthy babies breathe and cry almost
immediately.

3rd Stage
This is the final stage of labor. It is when the placenta is delivered. In
this stage, the mother’s uterine contractions push the placenta or
“afterbirths” out of her body. At this time, the birth is completed

In some cases, doctors have to deliver a baby by a caesarian section (CS). In this
procedure, the doctor surgically removes the baby and the placenta from the mother’s
uterus. Cases like this happen when the mother cannot or is not capable of delivering a
normal childbirth.

Duties and Responsibilities of Parents: (How)

● Provide physical care and love
● Instill discipline
● Develop social competence
● Provide education
● Train children to become good citizens
● Teach children to be financially responsible
● Guide children to grow spiritually
● Protect the Child and their rights
● Guide and support the child
 WRITTEN
REPORT IN
HEALTH:
PREGNANC
Y
Group 2 – Gauss:
G1 – Chua, Francesca Anne L.
G2 – Conde, Hazel Grace C.
G3 – Hernandez, Riane Joice J.
G4 – How, Maria Josette
G5 – Muldez, Lineth Julia B.
(Leader)
G6 – Muzones, Kyhm R.