2. Anatomical changes

3. Female reproductive organ engorged with blood

4. Enlargements of the uterus

5. Lordosis (Accentuated lumbar curvature)

6. Relaxation of the pelvic ligaments and pubic symphysis due to production of relaxin from placenta

8. Placenta secrete human placental lactogen (hPL)

9. hPL together with estrogen and progesterone stimulate maturation of the breast for lactation

10. Promote growth of fetus

11. Placenta also releases human chorionic thyrotropin (hCT)

13. Gastrointestinal system

14. Morning sickness is common due to elevated progesterone

15. Heartburn is common because of organ crowding by the fetus

17. Urinary System

18. Kidneys have additional burden and produce more urine

20. Respiratory System

21. Nasal mucosa becomes congested and swollen

23. Cardiovascular system

24. Body water rises

25. Blood volume increases by 25 to 40 percent

26. Blood pressure and pulse increase

28. Initiation of labor

29. Estrogen levels rise

30. Stimulates the myometrial cells to form abundant oxytocin receptor

31. Uterine contractions begin

32. Braxton Hicks contraction

33. The placenta releases prostaglandins

34. Oxytocin is released from fetus and the pituitary

37. The time from labor’s onset until the cervix is fully dilated by the baby’s head

38. Uterine contractions begin and increase

39. The amnion ruptures, event commonly called “breaking the water”

41. Lasts from full dilation to delivery of the infant

42. Strong contraction occur every 2 – 3 min and last about 1 min

43. This period may last 2 hours

44. An episiotomy may be done to reduce tissue tearing

46. Delivery of the placenta and its attached fetal membrane

48. Adjustment of infant to extrauterine life For the first few minutes after birth, the infant’s physical status assessed based on HR Respiration Color Muscle tone Reflexes Apgar score of 8 – 10 indicates a healthy baby

49. Lactation Lactation is production of milk by the hormone prepared mammary glands Rising levels of placental estrogen, progesterone and hPL stimulate the hypothalamus to release PRF (prolactin releasing factor) The anterior pituitary responds by secreting prolactin The first three following birth, the mammary glands secrete colostrum

50. Milk production and the positive feedback mechanism

51. Advantages of breast milk to the infant Its fats and iron are better absorbed and its amino acids are metabolized more efficiently than those of cows milk It has beneficial chemicals, including IgA, lysozyme, interleukins and lactoperoxidase Its natural laxative effects helps to cleanse the bowels of meconium. A green black paste containing sloughed off epithelial cells, bile and other substances