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									                             CHAPTER 19

Summarize the events that occur during the first week after fertilization.
Describe the structures that protect and nourish the embryo and fetus.

The Beginning of the Life Cycle
   • Once a couple has decided to start a family, they may try to conceive, or get
   • In a fertile woman’s body, about once a month an egg enters one of the
      fallopian tubes and begins its journey to the uterus.
   • If the egg is on its way to the uterus, a sperm may fertilize it. This moment of
      fertilization is also called conception.

The Beginning of the Life Cycle
    • Only a few hundred sperm of the hundreds of millions that enter the vagina
        usually make it to the egg, and only one can fertilize it.
    • In the first week after fertilization, the fertilized egg undergoes many cell
        divisions and travels to the uterus.
The Zygote
    • The united egg and sperm is called a zygote
        (ZY goht).
    • Within 36 hours, while the zygote is still traveling through the fallopian tube,
        it begins to divide.
Cell Division
    • The original cell divides to make two cells.
    • The two-celled embryo divides into four cells, and so on, until the embryo is
        made up of dozens of cells.
The Blastocyst
    • From the two-cell stage until about nine weeks after fertilization, the growing
        structure is called an embryo (EM bree oh).
    • About five days after fertilization, the structure, called a blastocyst (BLAS tuh
        sist), is no longer a solid mass of cells, but a sphere of cells surrounding a
        hollow center.
    • Once the blastocyst forms, it begins to attach itself to the wall of the uterus.
   •   The process of attachment is called implantation.

Development in the Uterus
   • While the embryo grows, several other structures also develop.
   • These structures—the amniotic sac, placenta, and umbilical cord—protect and
      nourish the developing embryo, and later the fetus.

Amniotic Sac
  • Soon after implantation, a fluid-filled bag of thin tissue called the amniotic sac
      (am nee AHT ik) develops around the embryo.
  • Inside the sac, the embryo floats in amniotic fluid.

    • The attachment holding the embryo to the wall of the uterus develops into a
       structure called the placenta.
    • Within the placenta, oxygen and nutrients move from the mother’s blood into
       tiny blood vessels that lead to the embryo.

Umbilical Cord
  • About 25 days after fertilization, a cordlike structure called the umbilical cord
      (UM BIL ih kul) develops between the embryo and the placenta.
  • Blood vessels in the umbilical cord carry nutrients and oxygen from the
      placenta to the embryo and wastes from the embryo to the placenta.

The Growing Embryo
   • During the first two months of development, the major body systems and
      organs start to form in the embryo.
   • By the end of eight weeks, the embryo is about an inch long and has
      recognizable external features.

The Fetus
   • From the third month until birth, the developing human is called a fetus.
   • During the third to sixth month, the fetus begins to move and kick.
   • By the end of the ninth month, the fetus is ready to be born.

Zygote-The united egg and sperm.

Embryo-The stage of human development from the two- cell stage until about nine
weeks after fertilization.

Blastocyst-A hollow, spherical structure made up of about 50-100 cells, formed when a
zygote divides and grows.

Implantation-The process in which the blastocyst attaches itself to the wall of the

Amniotic sac -A fluid-filled bag of thin tissue that develops around the embryo.

Placenta-The structure that holds the embryo to the wall of the uterus.

Umbilical cord-The cordlike structure that connects the embryo and the placenta.

Fetus-The stage of human development from the third month after fertilization until


Identify four behaviors that are essential for a healthy pregnancy.
Explain the importance of prenatal care throughout pregnancy.

Staying Healthy During Pregnancy
Getting proper nutrition and exercise and avoiding drugs and environmental hazards
are especially important both before and throughout pregnancy.

Proper Nutrition
   • A pregnant woman needs to eat more calories to support the growth of her
       own body and the developing embryo or fetus.
   • The best way to obtain these extra calories is to eat a well-balanced diet.
   • Folic acid is essential for proper development of an embryo’s neural tube,
       which later develops into the spinal cord and brain.
   • Regular physical activity is important for a healthy pregnancy.
   • A fit woman will better meet the extra energy demands of carrying the fetus.
   • She also reduces her risk for diabetes and other health problems during

Avoiding Alcohol and Other Drugs
   • As soon as she plans to become pregnant, a woman should abstain from all
      alcohol, tobacco, and any other drugs not prescribed or approved by her
   • These substance, even in small amounts can
          • harm or kill the developing baby
          • decrease the newborns chance to live
          • cause lifelong problems
   • A pregnant woman should talk to her doctor before using any prescription
      drugs or over-the-counter drugs.

Avoiding Environmental Hazards
   • X-rays The radiation from X-rays can harm a developing embryo or fetus.
   • Lead If a pregnant woman lives in a home built before 1978, she should contact
      her state health department for information on getting her home tested for
   • Mercury Pregnant women should eat commercially caught fish only once a
      week, and should not eat swordfish or shark.
   • Cat litter Cat feces can contain a parasite that is especially dangerous to a
      developing fetus.

Prenatal Care
   • Besides taking care of herself at home, a woman also needs to plan for prenatal
       care, or medical care during her pregnancy.
   • Her doctor visits should be under the supervision of an obstetrician, a doctor
       specialized in pregnancy and childbirth.
   • The chances of having a healthy baby greatly increase if the mother visits her
       doctor or clinic for regular checkups throughout pregnancy.

The Three Trimesters
A pregnancy is divided into three periods of time—trimesters—each of which is
approximately three months long.
Monitoring Tools
  • Ultrasound High-frequency sound waves, or ultrasound, are used in most
      pregnancies to create an image of the developing fetus.
  • Chorionic Villus Sampling Around the eighth week of pregnancy, some
      women will undergo a test called chorionic villus sampling, or CVS.
  • Amniocentesis Another test that may be done around the fourteenth to
      sixteenth week of pregnancy is amniocentesis (am nee oh sen TEE sis).

   • Ectopic pregnancy In very rare cases of ectopic pregnancy, the blastocyst
      implants in the fallopian tube or elsewhere in the abdomen, instead of in the
   • Miscarriage The death of an embryo or fetus in the first 20 weeks of
      pregnancy is called a miscarriage.
   • Preeclampsia Also called toxemia, preeclampsia
      (pree ih KLAMP see uh) is characterized by high blood pressure, swelling of the
      wrists and ankles, and high levels of protein in the urine.
   • Gestational Diabetes Diabetes that develops in pregnant women is called
      gestational diabetes, and is marked by high blood sugar levels.


Prenatal care-Medical care received during pregnancy.

Obstetrician-A doctor who specializes in pregnancy and childbirth.

Trimester-One of three periods of time that divide a pregnancy. Each trimester is
approximately three months long.

Ultrasounded-High-frequency sound waves used to create an image of a developing

Chorionic villus sampling-A prenatal test in which a piece of the developing placenta
is removed and tested for inherited disorders.

Amniocentesis-A prenatal test in which a small amount of amniotic fluid is removed
and tested for abnormalities.

Ectopic pregnancy-A condition resulting from the implantation of the blastocyst in a
location in the abdomen other than the uterus.

Miscarriage-The death of an embryo or fetus in the first 20 weeks of pregnancy.
Preeclampsia-A serious condition during pregnancy characterized by high blood
pressure, swelling of the wrists and ankles, and high levels of protein in the urine.

Gestational diabetes-Diabetes that develops during pregnancy.


Identify the three stages of the birth process.
Describe four complicating factors that may arise at birth.

The Birth Process
   • A certified nurse-midwife is a nurse who is trained to deliver babies.
   • The birth process begins when the muscular walls of the uterus begin a series
       of contractions that will push the fetus out of the mother.
   • Birth takes place in three stages
           • labor
           • delivery of the baby
           • delivery of the afterbirth

The Birth Process
   • The work performed by the mother’s body to push the fetus out is called labor.
   • Labor for a first child may last from about 2 to 24 hours or longer.
   • Near the end of this first stage, the amniotic sac breaks, and the cervix
       becomes softer and wide enough or the fetus to pass through.
Delivery of Baby
   • Stage two involves the actual birth, or delivery, of the baby.
   • This stage can take from half an hour to more than two hours.
   • Once the baby is out
           • the doctor clamps and cuts the umbilical cord
           • the baby’s nose and mouth are suctioned
           • eye drops are put in the baby’s eyes
           • an injection of vitamin K is given
Delivery of Afterbirth
   • The third stage involves contractions of the uterus that push out the placenta,
       also called the afterbirth.
   • This stage typically takes about 15 to 30 minutes.
The Postpartum Period
   • During the first six weeks, called the postpartum period, many changes take
   • The newborn’s lungs begin to function for the first time.
   • The circulatory system and heart undergo changes.
   • The nervous system reacts to new sensations.
   • For the mother, changing hormone levels signal the breasts to produce milk
      and cause the uterus to gradually shrink back to its normal size.
   • Hormonal changes and fatigue may cause the mother to feel overwhelmed.

Complications at Birth
   • Some complications result in a surgical delivery or premature birth.
   • Low birthweight and the birth of more than one baby also may cause
   • A stillbirth occurs when a fetus dies and is expelled from the body after the
      twentieth week of pregnancy.

Surgical Delivery
   • Sometimes delivery through the cervix and vagina is not possible because of
           • the position of the fetus in the uterus
           • the narrowness of the mother’s hips
           • illness
           • other conditions
   • A cesarean section (suh ZEHR ee un) is a surgical method of birth.
   • First the doctor makes an incision in the lower abdomen into the uterus, then
       he or she removes the baby and placenta.

Premature Birth
   • Delivery of a live baby before the 37th week of pregnancy is called premature
   • The lungs of a premature baby are usually not fully developed.
   • The baby may have additional problems if other organs aren’t fully developed.
   • A premature baby may receive care in an incubator.

Low Birthweight
   • A newborn that weighs less than 5.5 pounds at birth is considered to have low
   •   Premature and low-birthweight babies face an increased risk of health
       problems as newborns, chronic lifelong health problems, and even death.

Multiple Births
   • The delivery of more than one baby—for example, twins, triplets, or
       quadruplets—is called a multiple birth.
   • These births carry greater risk to the mother and babies, and are closely
       monitored by doctors.

Identical Twins
   • Twins that develop from a single fertilized egg, or zygote, are called identical
   • Because they develop from identical embryos, identical twins have the same
       inherited traits and are the same sex.

Fraternal Twins
    • Sometimes two eggs are released from the ovary and are fertilized by two
    • Fraternal twins are no more alike than any other siblings, and they may or may
       not be the same sex.

Triplets or More
Triplets, quadruplets, and other multiple births are less common than twins.


Certified nurse-midwife-A nurse who is trained to deliver babies.

Labor-The work performed by the mother’s body to push the fetus out at the end of

Postpartum period-A period of adjustment for parents and their newborn during the
six weeks after birth.

Stillbirth-The expulsion of a fetus that has died after the twentieth week of
Cesarean section-A surgical method of birth.

Premature birth-The delivery of a live baby before the 37th week of pregnancy.

Low birthweight-A newborn weight of less than 5.5 pounds.

Multiple birth-The delivery of more than one baby—for example, twins or triplets.


Describe the changes that children undergo during early childhood.
Identify key areas of development that occur during middle and late childhood.

Early Childhood
    • Babies and young children are not miniature adults.
    • From birth to age six, children change from helpless babies into confident
       individuals who can do many things for themselves.

Birth to Eighteen Months
    • At birth, many of the baby’s organs and systems are not yet fully developed.
    • By the time a baby is 3 or 4 months old, the brain, nerves, and muscles are
        ready for more coordinated movement.
    • By 18 months of age, he or she now has some “baby” teeth and can chew solid

Eighteen Months to Three Years
   • Most children learn to talk sometime between 18 months and 3 years of age.
   • Appetite decreases as growth slows down.
   • Physical coordination improves.
   • During this time, most children gain abilities to do things for themselves.

Three to Six Years
   • Between the ages of 3 and 6, children become more independent and active.
   • Most 4-year-olds talk in sentences.
   •   During this stage, children learn to play together and make friends.
   •   They start to develop a sense of right and wrong.

Middle and Late Childhood
   • Physical growth, mastering new skills, and making friends are key areas of
      development during middle and late childhood.
   • Middle childhood is defined as the period between age 6 and 8, and late
      childhood as ages 9 through 12.
   • Late childhood is also called pre-adolescence or the “tween” years.

Physical Growth
   • At around age 6 or 7, a child’s facial structure changes with the appearance of
       permanent teeth.
   • Muscles and bones continue to grow, and coordination develops further.
   • Their appetite also increases.

Mental Development
  • Children will feel pride in accomplishing tasks and attempting new challenges.
  • During middle and late childhood, the self-centeredness of early childhood
       lessens, and children continue to learn values.
  • They may start taking on responsibilities at home, such as chores, during this

Importance of Friends
   • The approval of friends and the need to fit in with a social group help children
      learn to work well in group situations.
   • Having a best friend also becomes important in pre- adolescence and will
      remain so into the teen years.


Pre-adolescence- The stage of development before adolescence.

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