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The Germinal Period (14 days)

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The Embryonic Period (3rd week) most vulnerable

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The Fetal Period (9th week to birth)

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Alcohol

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Tobacco

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Prescription Drugs

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The environment can have an important influence on development, and this also includes the prenatal period. The growth that happens during the nine months of prenatal development is nothing short of astonishing, but this period is also a time of great vulnerability. Fortunately, the effects of many of these hazards can be greatly lessened or even avoided entirely. While dangers do exist, the vast majority of babies are born healthy.

Today, researchers understand a great deal about teratogens, a term used to describe the broad range of conditions and substances that can increase the risk of prenatal problems and abnormalities. Teratogens can cause a wide range of problems from low birth-weight to brain damage to missing limbs. In order to minimize and avoid these dangers, it is essential to understand what poses a risk to the fetus and how such dangers can affect development.

Many diseases are capable of injuring a growing fetus. For example, doctors discovered that when a mother contracts rubella (also known as the German measles) early in her pregnancy, her child might suffer blindness, heart abnormalities, and brain damage as a result.

During the 1960s, a rubella epidemic led to nearly 20,000 infants in the United States being born with impairments linked to the disease. Since then, immunizations have dramatically decreased ​the incidence of rubella and lowered the number of children affected by the illness.

In the past, doctors believed that the placenta served as a barrier to protect the growing fetus against toxins. During the 1960s, a number of pregnant women were prescribed the drug thalidomide which caused more than 10,000 infants to be born missing legs, arms, or ears. The birth defects caused by the drug made the dangers of certain medications very clear.

Today, doctors recognize the teratogenic effects of many medicinal drugs including anticonvulsants, tetracycline, anticoagulants, bromides, and most hormones.

Because of the potential dangers, it is important for pregnant women to avoid any medications that have not been specifically recommended by their doctor. You have also probably noticed that most television ads for new medications include some type of statement warning that women who are pregnant or who may become pregnant should avoid taking the drug.

Because such medications are thought to be able to affect the fetus as early as 10 to 14 days after conception, it is essential to cease taking certain medications if you think you may become pregnant. Fortunately, because doctors and mothers-to-be are far more aware of the potential dangers, the rates of medication-linked birth defects have been reduced considerably over the past few decades.

Unfortunately, prenatal damage caused by psychoactive drugs such as alcohol, cocaine, heroin, inhalants, and tobacco are still far too common. All psychoactive drugs have a deleterious effect on prenatal development leading to problems including low birth-weight, premature birth, and impaired brain development. The effects of such drug use can lead to both short-term and long-term deficits. Babies exposed to psychoactive drugs in-utero may show signs of drug withdrawal after birth, such as crying, startling, difficulty sleeping, and erratic eating.

As they continue to develop and grow, these children may face learning problems such as an inability to pay attention, poor self-control, increased irritability, or even major developmental delays.

What impact can these psychoactive substances have on development?

Tobacco use can result in low birth-weight as well as an increased risk of abnormalities such as urinary tract and limb malformations.

Alcohol use during pregnancy causes fetal alcohol syndrome which is characterized by facial abnormalities including a smaller than average head size, a flattened nose, wide spacing between the eyes, and a narrow upper lip. Fetal alcohol syndrome also results in intellectual impairments, impaired physical growth, learning disabilities, and behavioral problems.

Fortunately, the effects of many environmental dangers can be minimized or even avoided entirely. Thanks to increased awareness of the effects of diseases, medications, and drugs, mothers are able to better ensure that they are healthy and free of harmful substances by the time they conceive a child.

While environmental dangers pose a definite risk to the growing fetus, they do not always cause harm. The impact of such hazards involves the interaction of a number of factors, including the timing of the exposure, the duration of the exposure, and possible genetic vulnerabilities that may be present.

The specific time of when the growing organism is exposed to the danger can play a major role in the ultimate outcome. Throughout prenatal development, there are times of greater susceptibility known as critical periods. For example, an embryo is most vulnerable to teratogens in the first eight weeks after conception. However, damage to major areas of the body including the brain and eyes can also occur during the later weeks of pregnancy.

In addition to abstaining from drugs, alcohol, medications, and other substances, proper medical care, social support, and postnatal care can all play an important role in minimizing the dangers of environmental toxins.

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What Environment Factors Influence Prenatal Development?

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The environment can have an important influence on development, and this also includes the prenatal period. The growth that happens during the nine months of prenatal development is nothing short of astonishing, but this period is also a time of great vulnerability. Fortunately, the effects of many of these hazards can be greatly lessened or even avoided entirely.

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Rebecca Fraser-Thill

Rebecca Fraser-Thill is the co-author of the forthcoming textbook "Visualizing the Lifespan" (Wiley, 2010). She was an instructor of psychology at Bates College for six years, where she taught child psychopathology, abnormal psychology, and infancy. She holds a master's degree in developmental psychology from Cornell University.

The placenta attaches a fetus to a woman's uterine wall, bringing maternal blood vessels close to fetal vessels. Important nutrients and other positive factors pass from the mother's blood into the fetal blood, helping support fetal growth and development. Although the placenta also contains a special protective filter, or barrier, some potentially negative factors can pass from maternal into fetal blood, possibly harming the fetus. If you're pregnant or thinking of becoming pregnant, talk to your doctor about how best to protect your fetus and help ensure a healthy newborn.

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Maternal blood carries glucose that crosses the placenta, providing energy for fetal metabolism. It also contains amino acids, which also cross the placenta and help produce proteins needed for fetal development. Finally, factors called "growth factors" also cross from the mother's blood into fetal blood; they help support development of many different fetal tissues. (ref3p2)

If a pregnant woman becomes malnourished, the fetus might not get sufficient nutrients or other factors, slowing its growth and possibly resulting in an underdeveloped newborn. (ref1p98) If maternal blood glucose is too high, the mother might develop gestational diabetes, which could cause the baby to be too large and have a difficult birth. (ref2)

A mother's age can also affect the fetus, with older women at increased risk of fetal problems. A study in the "Western Journal of Medicine" in November 2000 evaluated fetal loss due to stillbirth, spontaneous abortion or other problems in more than 600,000 Danish women. The authors found increased negative outcomes in women older than 35, with about 1/5th of their pregnancies resulting in loss of the fetus, compared to younger women; this increased to more than half by age 42. (ref9)

Research also indicates that a woman's overall health impacts her pregnancy. For example, a 2013 study in the "Journal of Obstetrics and Gynecology Canada" found that obese women, at higher risk themselves of hypertension and other problems, were also more likely to have babies with low birth weight or metabolic problems, compared to women of average weight. (ref10)

Alcohol crosses from the mother's blood into the fetal circulation and, according to a study published in November 2005 in "Obstetrics and Gynecology," one in five pregnant American women indulge in binge drinking. (ref5) Drinking any alcohol during pregnancy can put the fetus at risk of problems called "Fetal Alcohol Spectrum Disorders," which can be moderate to severe. The negative impact on the fetus can include (ref6) poor growth, weak muscle tone, slow development of speech, or heart or facial malformation. (ref4)

Factors in cigarette smoke can also pass into fetal blood, causing potentially serious problems. Nicotine narrows blood vessels, slowing movement of oxygen and nutrients to fetal cells; along with other chemicals in smoke, it might cause low birth weight and increased risk of asthma, gastrointestinal problems or obesity in newborns. (ref7) A study published in February 2008 in "Nicotine and Tobacco Research" found that factors from smoke can also raise the risk of spontaneous abortion or premature birth, and might also cause fetal neurological problems. (ref8)

Some prescription drugs that can cross the placenta might also have negative effects on the fetus. These include the antibiotic tetracycline, which can damage developing teeth, some blood-thinners that can slow nervous system development, and chemotherapy drugs. (ref1p145-6) Illegal drugs such as heroin are especially damaging during the early stages of pregnancy, but might also harm the fetus later in development, slowing fetal growth and causing premature birth or, in rare cases, fetal death. (ref5)

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Many factors can affect the development of a fetus. Environmental agents that can negatively affect prenatal development are called teratogens. Teratogen exposure tends to be most detrimental during the first trimester (the first three months) of pregnancy, when formation of the organs and brain occurs. However, some substances, such as alcohol,...

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Heartburn

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Backache

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Insomnia

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Most pregnancies occur without complications. However, some women who are pregnant will experience complications that can involve their health, their baby's health, or both. Sometimes, diseases or conditions the mother had before she became pregnant can lead to complications during pregnancy. Some complications occur during delivery.

Even with complications, early detection and prenatal care can reduce any further risk to you and your baby.

Some of the most common complications of pregnancy include:

high blood pressure

gestational diabetes

preeclampsia

preterm labor

a loss of pregnancy, or miscarriage

If you already have a chronic condition or illness, talk to your doctor about how to minimize any complications before you get pregnant. If you're already pregnant, your doctor may need to monitor your pregnancy.

Some examples of common diseases and conditions that can cause complications during your pregnancy include:

diabetes

cancer

high blood pressure

infections

sexually transmitted diseases, including HIV

kidney problems

epilepsy

anemia

Other factors that may increase your risk for complications include:

being pregnant at age 35 or older

being pregnant at a young age

having an eating disorder like anorexia

smoking cigarettes

using illegal drugs

drinking alcohol

having a history of pregnancy loss or preterm birth

carrying multiples, such as twins or triplets

The normal symptoms of pregnancy and the symptoms of complications are sometimes hard to distinguish. Although many problems are mild and don't progress, you should always contact your doctor if you have any concerns during your pregnancy. Most pregnancy complications are manageable with prompt treatment.

These are the most common complications women experience during pregnancy:

High blood pressure

High blood pressure occurs when the arteries that carry blood from the heart to the organs and the placenta are narrowed. High blood pressure is associated with a higher risk of many other complications, like preeclampsia. It puts you at a higher risk of having a baby well before your due date. This is called preterm delivery. It also increases your risk of having a baby who's small. It's important to control your blood pressure with medications during pregnancy.

Gestational diabetes

Gestational diabetes occurs when your body cannot process sugars effectively. This leads to higher-than-normal levels of sugar in the bloodstream. Some women will need to modify their meal plans to help control blood sugar levels. Others may need to take insulin to keep their blood sugar levels in control. Gestational diabetes usually resolves after pregnancy.

Preeclampsia

Preeclampsia is also called toxemia. It occurs after the first 20 weeks of a pregnancy and causes high blood pressure and problems with your kidneys. The only cure for preeclampsia is delivering the baby early. A doctor may induce labor if you're 37 to 40 weeks pregnant.

If it's too early to deliver your baby, your doctor will need to monitor you and your baby closely. They may prescribe medications or recommend bed rest at home or in the hospital for the rest of the pregnancy term.

Preterm labor

Preterm labor occurs when you go into labor before week 37 of your pregnancy. This is before your baby's organs, such as the lungs and the brain, have finished developing. Certain medications can stop labor. Doctors usually recommend bed rest to keep the baby from being born too early.

Miscarriage

A miscarriage is the loss of pregnancy during the first 20 weeks. According to the American Pregnancy Association (APA), up to 20 percent of pregnancies among healthy women will end in a miscarriage. Sometimes, this happens before a woman is even aware of the pregnancy. In most cases, miscarriage isn't preventable.

A loss of pregnancy after week 20 of pregnancy is called a stillbirth. Many times the cause for this isn't known. Issues that have been found to cause stillbirths include:

problems with the placenta

chronic health issues in the mother

infections

Anemia

Anemia means that you have a lower-than-normal number of red blood cells in your body. If you have anemia, you may feel more tired and weak than usual, and you may have pale skin. Anemia has many causes and your doctor will need to treat the underlying cause of the anemia. Taking supplements of iron and folic acid during your pregnancy may help since most cases of anemia occur due to a deficiency.

Infections

A variety of bacterial, viral, and parasitic infections may complicate a pregnancy. Infections can be harmful to both the mother and the baby, so it's important to seek treatment right away. Some examples include:

a urinary tract infection

bacterial vaginosis

cytomegalovirus

group B Streptococcus

hepatitis B virus, which can spread to your baby during birth

influenza

toxoplasmosis, which is an infection caused by a parasite found in cat feces, soil, and raw meat

a yeast infection

Zika virus

You can prevent some infections by washing your hands often. You can prevent others, such as hepatitis B virus and influenza, by vaccination.

Labor complications

Complications can also occur during labor and delivery. If there's a problem during labor, your doctor may need to change the way they proceed with the delivery.

Breech position

A baby is considered in a breech position when their feet are positioned to be delivered before their head. According to the APA, this occurs in about 4 percent of full-term births.

Most babies born in this position are healthy. You doctor will recommend against a vaginal birth if your baby shows signs of distress or is too big to pass safely through the birth canal. If your doctor finds out that your baby is in the breech position a few weeks before delivery, they might try to change the position of the baby. If the baby is still in the breech position when labor starts, most doctors recommend a cesarean delivery.

Placenta previa

Placenta previa means that the placenta is covering the cervix. Doctors will usually perform a cesarean delivery if this is the case.

Low birth weight

Low birth weight usually occurs due to poor nutrition or the use of cigarettes, alcohol, or drugs during pregnancy. Babies who are born at a low birth weight have a higher risk of:

respiratory infections

learning disabilities

heart infections

blindness

The baby may need to stay in the hospital for a few months after birth.

If you're pregnant, don't hesitate to call your doctor if there are any signs of a problem. Call your doctor right away if you experience any of the following:

bleeding from the vagina

sudden swelling of the hands or face

a pain in the abdomen

a fever

severe headaches

dizziness

persistent vomiting

blurred vision

You should also call your doctor if you think your baby is suddenly moving less often than usual during the third trimester.

Not all complications are preventable. The following steps may help promote a healthy pregnancy and prevent you from having a high-risk pregnancy:

If you're thinking of becoming pregnant, consult with a doctor beforehand to help you prepare. For example, if you already have a pre-existing medical condition, your doctor may recommend adjusting your treatment to prepare for your pregnancy.

Eat a healthy diet with lots of fruits, vegetables, lean protein, and fiber.

Take prenatal vitamins daily.

In general, the Mayo Clinic recommends a total of 25 to 35 pounds of weight gain for women who were at a healthy weight before pregnancy.

Attend all routine prenatal visits, including those with a specialist if one is recommended.

Quit smoking if you smoke.

Avoid alcohol and illegal drugs.

Ask your doctor if the medications you're already taking are okay to continue taking or if you should stop taking them.

Reduce your stress levels. Listening to music and doing yoga are two ways to reduce your stress levels.

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complications during pregnancy and delivery

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Complications During Pregnancy and Delivery

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Most pregnancies occur without complications. However, some women who are pregnant will experience complications that can involve their health, their baby's health, or both. Sometimes, diseases or conditions the mother had before she became pregnant can lead to complications during pregnancy. Some complications occur during delivery.

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1st stage: contractions 15-20 min increases to 3-4 min

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2nd stage: passage through birth canal. Contractions 2-3 min

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3rd stage: baby is out. Placenta is delivered

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APGAR
A: Appearance
P: Pulse
G: Grimace
A: Activity
R: Respiration

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A newborn baby is wet from the amniotic fluid and can easily become cold. Drying the baby and using warm blankets and heat lamps can help prevent heat loss. Often a knitted hat is placed on the baby's head.