Part 2 - Sexuality, Pregnancy, and Childbirth
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| heteronormativity | set of norms that stipulate that there are complementary genders (man and woman) who have "natural roles"and are heterosexual
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| sex | refers to "biological" categorization, i.e. "male" or "female"
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| gender | refers to the ways societies structure how to be "male" or "female"
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| transgender | when gender identity / gender expression do not match the assigned sex
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| What is infertility? Explain the difference between those 34 or younger and those 35 or older. | - (34 or younger) inability to conceive after 1 year of regular unprotected sex
- (35 or older) inability to conceive after 6 months of regular unprotected sex
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| in vitro fertilization | - a complex series of procedures used to treat fertility or genetic problems and assist with the conception of a child
- during IVF, mature eggs are collected (retrieved) from the ovaries and fertilized by sperm in a lab
- "test tube babies"
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| GIFT | - Gamete IntraFallopian Transfer
- treatment useful if there is tubal blockage
- ova are collected and inserted into oviducts below the point of blockage
- sperm from partner or donor are placed in the oviduct
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| ZIFT | - Zygote IntraFallopian Transfer
- treatment useful if there is tubal blockage
- zygote(s) inserted below the blockage in the oviduct
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| oligospermia | - olig = few
- low sperm count
- can be due to tight clothes, hot tubs, etc. (heat)
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| azoospermia | - a = without; zoo = living being
- absence of sperm
- due to vasectomy for example
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| hysterosalpingogram (HSG) | - hyster = uterus; salping = oviducts; gram = record
- an X-ray test that looks at the inside of the uterus and fallopian tubes and the area around them
- done for those who are having a hard time becoming pregnant (infertile)
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| erection reflex | - a spinal reflex triggered by mechanoreceptors in the glans penis; effects:
- increased vasodilation to penile arterioles
- decreased vasoconstriction to penile arterioles
- increasing blood flow into the penis
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| The corpus luteum of pregnancy secretes ___. | estrogens and progestins
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| zygote | - a diploid cell resulting from the fusion of two haploid gametes (egg + sperm)
- a fertilized egg
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| morula | a solid ball of cells resulting from division of a fertilized ovum, and from which a blastula is formed
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| blastocyst | - the blastula stage of mammalian embryonic development, consisting of an inner cell mass, a cavity, and an outer layer (the trophoblast)
- forms 1 week after fertilization
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| trophoblast | - the outer epithelium of a mammalian blastocyst
- forms the fetal part of the placenta, supporting embryonic development but not forming part of the embryo proper
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| process of implantation of the blastocyst | - blastocyst adheres to the endometrial lining, and trophoblastic cells cords begin to penetrate
- they tunnel deeper, carving out a hole for the blastocyst
- at completion of implantation, the blastocyst is completely buried in the endometrium
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| human chorionic gonadotropin (hCG) | - hormone secreted by the chorion
- maintains the corpus luteum until the placenta takes over in the last 2 trimesters
- maintained corpus luteums secrete estrogens and progestins
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| placenta (both maternal and fetal contributions) | - maternal contributions: human chorionic gonadotrophin, estrogen, progesterone
- fetal contributions:
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| role of the placenta in the synthesis of estrogen | - fetal placenta secretes CRH
- CRH triggers fetal anterior pituitary to produce ACTH
- ACTH triggers fetal adrenal cortex to produce cortisol and DHEA
- DHEA is converted to estrogen by the maternal placenta
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| (parturition) relaxin | - hormone produced by the corpus luteum of pregnancy and placenta
- helps with dilation of the cervix to accommodate the passage of the fetus (from the uterus -> vagina -> outside); cervical softening
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| (parturition) corticotropin-releasing hormone [CRH] | - secreted by the fetal portion of the placenta (and fetal hypothalamus) into both the maternal and fetal circulation
- leads to the production of DHEA (precursor to estrogen)
- triggers parturition
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| (parturition) estrogen | - hormone made from DHEA by the maternal placenta
- stimulate an increase in oxytocin receptors in the myometrium
- promotes local prostaglandin synthesis
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| (parturition) oxytocin | - helps trigger contractions of the uterine myometrium that are sufficiently strong to expel the fetus
- positive feedback cycle (pressure of fetus against the cervix reflexively increases oxytocin secretion)
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| parturition | labor, delivery, and birth
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| role of the placenta in the synthesis of progesterone | the maternal placenta creates progesterone from cholesterol
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| major physiological changes of pregnancy to the cervix (1st trimester) | - cervical effacement (it becomes softer, thinner, and shorter)
- starts to dilate
-glands begin to release thick mucus that forms a mucus plug
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| major physiological changes of pregnancy to the cardiovascular system | - increases in: pulse, blood volume, cardiac output, white blood cells, clotting factors
- decrease in blood pressure
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| major physiological changes of pregnancy to the gastrointestinal system | - increases in: salivation, gum sensitivity, absorption time, absorption of iron, nausea, vomiting
- decrease in motility
- changes in appetite, taste, and smell
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| major physiological changes of pregnancy to the skin | - increased pigmentation
- darkened areola
- chloasma ("pregnancy mask")
- linea nigra (vertical line on the belly)
- striae (stretch marks on the belly)
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| barriers to prenatal care | - poverty mainly
- black women 3.3x more likely to die as a result of pregnancy complications than white women
- almost 30% of women did not enter care in the first trimester
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| factors associated with late or inadequate prenatal care use | - low education level
- being younger than 20 or older than 35
- multiparity (those that have had kids before)
- black people
- hispanic people
- residence in an area with few prenatal providers
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| lightening | - a drop in the level of the uterus during the last weeks of pregnancy as the head of the fetus engages in the pelvis
- releases pressure on the lungs
- puts pressure on the bladder and cervix
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| signs of pre-labor | - braxton-hicks (warm-up) contractions
- lightening (uterus level drops)
- release of the mucus plug
- weight loss
- back ache
- diarrhea
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| two primary signals of labor | - contractions
- the water breaks
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| dilation (of the cervix) | when the cervix widens/opens
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| effacement (of the cervix) | when the cervix becomes thinner, shorter, and softer
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| Braxton-Hicks contractions | - sporadic uterine contractions that occur during pre-labor
- warm up contractions
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| “waters breaking” | - when the amniotic sac ruptures and some of the fluid escapes the uterus
- signals that the fetus is getting ready to be born
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| role of oxytocin in labor | - causes strong contractions
- part of a positive feedback cycle that progressively increases until cervical dilation and delivery are complete
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| role of oxytocin in milk ejection | causes milk ejection by stimulating myoepithelial cells surrounding alveoli to squeeze secreted milk out through ducts
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| prolactin | - secreted by anterior pituitary
- stimulates the synthesis of enzymes essential for milk production by alveolar epithelial cells
- stimulates more milk secretion from alveolar cells to replace milk ejected as the baby nurses
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| colostrum | - product from the breasts during the first 2-3 after birth
- contains antibodies
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| foremik | - product from the breasts 10-14 days after birth
- watery milk
- contains lactoferrin and bifidus factor
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| hindmilk | - product from the breasts 10-14 days after birth
- creamy milk from nearly empty breasts
- high in protein
- contains lactoferrin and bifidus factor
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| lactoferrin | - decreases iron availability, which is needed for pathogen multiplication (so, less bad bacteria)
- in foremilk and hindmilk
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| Bifidus factor | promotes the multiplication of nonpathogenic microorganisms (so, more good bacteria)
- in foremilk and hindmilk
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| process of milk removal from breast | the baby's gums press on the areola as the tongue directs the milk into the back of the mouth (so, milk removed through PRESSURE)
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| Describe and contrast the public's reaction to the release of Kinsey's report on male sexuality in 1948 and on female sexuality in 1953, as shown in the documentary "Kinsey." | - MSR: a surprise to many people; quickly became a bestseller; Kinsey became well known
- FSR: bestseller too, but reaction not as positive b/c of sexism (women not supposed to be sexual); statisticians finally came a calling; so did religious leaders
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| What were the main findings from the Peplau (2003) article? | (GENDER diff.s:)
- men: greater sexual desire; aggression more strongly linked to sexuality
- women: more emphasis on committed relationships as a context for sexuality; sexuality more easily changed by cultural, social, and situational factors
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| What were the limitations of the findings reported from Peplau's (2003) article? | - much of the research is based on white, middle-class Americans
- little research available on MOGAI
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| MOGAI | marginalized orientations, gender alignments, and intersex
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| causes of male and female infertility | - MI: oligospermia; azoospermia; poor sperm motility; acc. gland/duct malfunction; varicocele
- FI: tubal factors (PID, STDs, uterine infection, ab. surgery, endometriosis); ovulation problems (PCOS, anovulation, premature menopause, ovarian cancer)
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| varicocele | - enlarged veins in the scrotum
- results in temperature increase in the testes, which affects sperm production
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| Know the three roles of estrogen in preparing the mother’s uterus and cervix for labor and delivery. | - increases gap junctions between myometrial cells and increases their oxytocin receptors, which increases uterine responsiveness to low levels of oxytocin
- increases prostaglandin production, which softens the cervix and increases oxytocin receptors
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| High levels of ___ are required throughout pregnancy with levels steadily rising until the birth of the baby. | progesterone
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| The cells that make up the placenta, known as ___, are able to convert cholesterol from the mother’s bloodstream into progesterone. | trophoblasts
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| function of the essential pregnancy hormone hCG secreted by the placenta | - useful early on in pregnancy, as it maintains P production from the corpus luteum
- increases blood supply to uterus
- alters the endometrium so that it is more likely to receive the implanting embryo
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| functions of the essential pregnancy hormone estrogen secreted by the placenta | - maintains, controls, and stimulates production of other pregnancy hormones
- needed for correct fetal development
- stimulates growth/correct function of placenta
- promotes growth of breast tissue (w/ P) and prepares the parent for breastfeeding
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| functions of the essential pregnancy hormone progesterone secreted by the placenta | - needed for correct fetal development
- prevents contractions until labor
- strengthens the pelvic wall muscles
- prevents lactation until after pregnancy
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| Many of the functions of progesterone require ___ and in fact, progesterone production from the placenta is stimulated by ___. | estrogen
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| ___ is made and released by the corpus luteum and then later, the foetal-placental unit, where the fetal liver/adrenal glands produce a hormone that is passed to the placenta and converted. Levels of this hormone ___ til birth. | - Estrogen
- increase steadily
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| chorion | - the outermost membrane surrounding the embryo
- contributes to the formation of the placenta
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| What is responsible for the progression of partruition? Explain. | - the positive-feedback cycle
- uterine contractions -> fetus pushed against cervix -> neuroendocrine reflex -> oxytocin secreted -> prostaglandin produced -> uterine contractions
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| identify and briefly explain the three stages of labor | - 1st: contractions; cervix dilation (to 10 cm) / thinning
- 2nd: pushing; delivery of baby
- 3rd: delivery of placenta
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| In the technocratic paradigm of childbirth, as described by Robbie Davis-Floyd, what is the view of the body, the patients, the relationship between practitioner and patient, and the role of science? | - basic underlying principle: SEPARATION
- body = machine
- patient = object
- practitioner alienated from patient
- science and technology super-valuated
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| In the humanistic paradigm of childbirth, as described by Robbie Davis-Floyd, what is the view of the body, the patients, the relationship between practitioner and patient, and the role of science? | - basic underlying principle: BALANCE AND CONNECTION
- body = organism
- patient = relational subject
- practitioner and patient connected/care for each other
- science and technology balanced with humanism
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| In the holistic paradigm of childbirth, as described by Robbie Davis-Floyd, what is the view of the body, the patients, the relationship between practitioner and patient, and the role of science? | - basic underlying principle: CONNECTION AND INTEGRATION
- body = energy system
- healing the whole person in
- unity between practitioner and patient
- science and tech. only to service the patient
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