ECOSISTEMAS, LOS HÁBITAT O LAS ESPECIES Introducción (versión 1)
D. Mitigación de impactos Principio rector 12: Mitigación de impactos
Th e postpartum period, a stage of about three months following childbirth, is a time of critical family adjustments.
Parenthood begins literally overnight, and the transition can cause considerable stress.
Breastfeeding Lactation, the produc- tion of milk, begins about three days after childbirth. Prior to that time (sometimes as early as the second trimester), colostrum is secreted by the nipples. Colostrum contains antibodies that help protect the newborn from infectious diseases and is also high in protein.
Th e American Academy of Pediatrics recommends breastfeeding exclusively for six months, then in combination with solid food until the baby is one year of age, and then for as long after that as a mother and baby desire. Currently only 11% of U.S. mothers breast-feed exclusively for six months. Human milk is per- fectly suited to the baby’s nutritional needs and digestive ca- pabilities, and it supplies the baby with antibodies. Breastfeeding decreases the incidence of infant ear infections, allergies, anemia, diarrhea, and bacterial meningitis. Pre- schoolers who were breastfed as babies are less likely to be overweight, and school-age children who were breastfed are less anxious and better able to cope with stress. Breastfeeding even has a benefi cial eff ect on blood pressure and cholesterol levels later in life.
Breastfeeding is benefi cial to the mother, as well. It stimu- lates contractions that help the uterus return to normal more rapidly, contributes to postpregnancy weight loss, and may reduce the risk of ovarian cancer, breast cancer, and post- menopausal hip fracture. For women who want to breast- feed but who have problems, help is available from support groups, books, or a lactation consultant. However, bottle- feeding can also provide adequate nutrition, and both breast- feeding and bottlefeeding can be part of loving, secure parent-child relationships.
When a mother doesn’t nurse, menstruation usually begins within about 10 weeks. Breastfeeding can prevent the return of menstruation for six months or longer. However, ovula- tion—and pregnancy—can occur before menstruation re- turns, so breastfeeding is not a reliable contraceptive method.
Postpartum Depression Th e majority of women experi- ence fl uctuating emotions during the postpartum period as hormone levels change. About 50–80% of new mothers expe- rience “baby blues,” characterized by episodes of sadness, weeping, anxiety, headache, sleep disturbances, and irritability. About 5–9% of new mothers experience postpartum depres- sion, a more disabling syndrome characterized by despon- dency, mood swings, guilt, and occasional hostility. Rest, sharing feelings and concerns with others, and relying on sup- portive relatives and friends for assistance are usually helpful in dealing with mild cases of the baby blues or postpartum depression, which generally last only a few weeks. If the de- pression is serious, professional treatment may be needed.
Attachment Another feature of the postpartum period is the development of attachment—the strong emotional
postpartum depression An emotional low that may be experienced by the mother following childbirth.
t e r m s
Breastfeeding can enhance the bond between mother and child. The American Academy of Pediatrics recommends breastfeeding exclusively for six months and then in combination with solid food until the baby is at least one year of age.
T I P S F O R T O D A Y A N D T H E F U T U R E
Wellness includes understanding your own sexuality and all its components. Preparation for being a parent begins long before pregnancy; it requires prospective parents to make responsible choices.
R I G H T NOW YOU CA N :
■ Deal with any sexual question or problem you’ve been
avoiding. Unless you’re sure it isn’t a physical problem, start by scheduling an appointment with your doctor.
■ If you’re in a sexual relationship, consider the information
you and your partner have shared about sex. Are you com- fortable that you and your partner know enough about each other to have a safe, healthy sexual relationship?
■ Take some time to think about whether you really want to
have children. Cut through the cultural, societal, family, and personal expectations that may stand in the way of making the decision you really want to make.
■ Th ink of one thing your mother or father did as a parent
that you particularly liked; if you become a parent, consider how you can be sure to do the same thing for your children.
I N T H E F U T U R E YOU CA N :
■ If you’re in a sexual relationship, or if you plan to begin
one, open (or reopen) a dialogue with your partner about sex. Make time to talk at length about the responsibilities and consequences of a sexual relationship.
■ Make behavioral changes that can improve your prospects
as a parent. For example, you may need to adopt healthier eating habits or start exercising more consistently.
■ If you want to be a parent someday, start looking at the
many sources of information about pregnancy, childbirth, and parenting. Th is is a good idea for anyone—man or woman—who plans to have a family.
tie that grows between the baby and the adult who cares for the baby. Parents can foster secure attachment relation- ships in the early weeks and months by responding sensi- tively to the baby’s needs—for example, by responding appropriately to the baby’s signals of gazing, looking away, smiling, and crying. A secure attachment relationship helps the child develop and function well socially, emotionally, and mentally.
For most people, the arrival of a child creates a deep sense of joy and accomplishment. However, adjusting to parenthood requires eff ort and energy. Talking with friends and relatives about their experiences during the fi rst few weeks or months with a baby can help prepare new parents for the period when the baby’s needs may require all the energy that both parents have to expend. But the pleasures of nurturing a new baby are substantial, and many parents look back on this time as one of the most signifi cant and joyful of their lives.
F O R M O R E I N F O R M A T I O N 115
S U M M A R Y
• Th e female external sex organs are called the vulva; the clitoris plays an important role in sexual arousal and orgasm. Th e vagina leads to the internal female sex organs, including the uterus, ovi- ducts, and ovaries.
• Th e male external sex organs are the penis and the scrotum; the glans of the penis is an important site of sexual arousal. Male inter- nal sexual structures include the testes, vasa deferentia, seminal vesicles, and prostate gland.
• Th e menstrual cycle has four phases: menses, the estrogenic phase, ovulation, and the progestational phase.
• Th e ovaries gradually cease to function as women approach age 50 and enter menopause. Th e pattern of male sexual responses changes with age, and testosterone production gradually decreases.
• Th e sexual response cycle has four stages: excitement, plateau, orgasm, and resolution.
• Physical and psychological problems can both interfere with
sexual functioning. Treatment for sexual dysfunction fi rst addresses any underlying medical conditions and then looks at psychosocial problems.
• Human sexual behaviors include celibacy, erotic fantasy, mastur-
bation, touching, cunnilingus, fellatio, anal intercourse, and coitus.
• Responsible sexuality includes open, honest communication;
agreed-on sexual activities; sexual privacy; using contraception; safe sex practices; sober sex; and taking responsibility for consequences.
• Fertilization is a complex process culminating when a sperm
penetrates the membrane of the egg released from the woman’s
ovary. Infertility aff ects about 15% of the reproductive-age popula- tion of the United States.
• During pregnancy, the uterus and breasts enlarges, muscles and
ligaments soften and stretch, and other body functions become more effi cient.
• Th e fetal anatomy is almost completely formed in the fi rst tri- mester and is refi ned in the second; during the third trimester, the fetus grows and gains most of its weight.
• Prenatal tests include ultrasound, amniocentesis, chorionic vil-
lus sampling, and quadruple marker screening.
• Important elements of prenatal care include regular checkups,
good nutrition, avoiding drugs and other harmful environmental agents, and talking childbirth classes.
• Pregnancy usually proceeds without major complications. Prob-
lems that can occur include ectopic pregnancy, spontaneous abor- tion, preeclampsia, and low birth weight.
• Th e fi rst stage of labor begins with contractions that exert pres- sure on the cervix, causing eff acement and dilation. Th e second stage begins with complete cervical dilation and ends when the baby emerges. Th e third stage of labor is expulsion of the placenta.
• During the postpartum period, the mother’s body begins to re-
turn to its prepregnancy state, and she may begin to breast-feed. Both mother and father must adjust to their new roles as parents.
F O R M O R E I N F O R M A T I O N
BOOKS
American College of Obstetricians and Gynecologists. 2010. Your Preg-
nancy and Childbirth: Month to Month, 5th ed. Washington, DC: ACOG.
Advice on conception, pregnancy, prenatal care, and delivery o p tions. American Dietetic Association. 2009. Expect the Best: Your Guide to
Healthy Eating Before, During, and After Pregnancy. New York: Wiley.
Provides up-to-date dietary information and meal-planning guides for
women who want to get pregnant, are pregnant, or have had a baby.
Bogle, K. 2008. Hooking Up: Sex, Dating and Relationships on Campus. New York: New York University Press. A sociologist looks at the “hookup”
culture on college campuses today.
Jones, S., and M. Jones. 2012. Great Expectations: Your All-in-One Resource
for Pregnancy & Childbirth. New York: Sterling. A comprehensive guide to pregnancy and early parenthood, written in an accessible style; illustrated.
Kelly, G. F. 20011. Sexuality Today, 10th ed. New York: McGraw-Hill. An accessible approach that highlights cross-cultural examples, popular top-
ics and issues, and case studies featuring college-age individuals .
Lees, C., et al. 2007. Pregnancy and Birth: Your Questions Answered. London: Dorling Kindersley. Answers hundreds of common questions
about conception, pregnancy, and delivery.
McCarthy, B., and E. McCarthy. 2012. Sexual Awareness: Your Guide
to Healthy Couple Sexuality, 5th Ed. New York: Routledge. A guide to enriching couple relationships with improved sexual awareness and communication.
Connect to Your Choices
Connect to Your Choices
Have you ever thought about where you get your ideas and plans about having children? Many factors can infl uence our ideas, some not as obvious as others. Do you assume you will have children one day because it’s an expected life path? Are you infl uenced by media portrayals of parents who do everything successfully—raise children, pursue careers, have active social lives? Do family members say or do things that convey their wish that you eventually have children? Are you infl uenced by friends who are starting families at this time?
What are the external factors that infl uence your choices about children? What are your inner motivations and core values, and how do they aff ect your choices? Based on what you learned in this chapter, will you make some diff erent choices in the future? If so, what will they be? Go online to Connect to complete this activity:
Meston, C., and D. Buss. 2009. Why Women Have Sex. New York: Times Books. Fascinating, readable, yet scholarly book about all aspects of
female sexuality, especially sexual desire.
Savage, D., and T. Miller, Eds. 2012. It Gets Better: Coming Out, Over-
coming Bullying, and Creating a Life Worth Living. New York: Plume. A collection of essays written to LGBT youth by celebrities, politicians, and ordinary people, conveying the message that a positive future is possible.
Taverner, W. J. 2009. Taking Sides: Clashing Views on Controversial Is-
sues in Human Sexua l ity, 11th ed. New York: McGraw-Hill. Includes pro and con position statements on sexuality i s sues relating to biology, be- havior, and legal and social issues.
Wynbrandt, J. 2008. Encyclopedia of Genetic Disorders and Birth Defects, 3rd ed. New York: Facts on File, Inc. A detailed overview of many types of
birth defects, both inherited and noni n herited.
ORGANIZATIONS AND WEBSITES
American Association of Sex Educators, Counselors, and Th erapists (AASECT). Certifi es sex educators, counselors, and therapists and
provides listings of local therapists dealing with sexual problems. http://www.aasect.org
American College of Obstetricians and Gynecologists (ACOG). Provides written materials relating to many aspects of preconception care, pregnancy, and childbirth.
http://www.acog.org
American Psychological Association: Information about gender identity and
sexual orientation. Question-and-answer format sections on trans-
gender and homosexuality.
http://www.apa.org/topics/sexuality/transgender.aspx
Th e American Society for Reproductive Medicine. Provides up-to-date
information about all aspects of infertility. http://www.asrm.org
Centers for Disease Control and Prevention, National Center on Birth
Defects and Developme n tal Disabilities. Provides information about
a variety of topics related to birth defects, including fetal alcohol syndrome and the importance of folic acid.
http://www.cdc.gov/ncbddd
Th e Kinsey Institute for Research in Sex, Gender, and Reproduction. One
of the oldest and most respected institutions doing research on sexuality.
http://www.kinseyinstitute.org
Sexuality Information and Education Council of the United States
(SIECUS) . Provides information about many aspects of sexuality
and has an extensive library and numerous publications. http://www.siecus.org
National Institute of Child Health and Human Development. Provides information about reproductive and genetic problems; sponsors the “Back to Sleep” campaign to fi ght SIDS.
http://www.nichd.nih.gov
S E L E C T E D B I B L I O G R A P H Y
American College Health Association. 2012. American College Health Association—
National College Health Assessment II: Reference Group Executive Summary Fall 2011. Linthicum, MD: American College Health Association.
American Psychological Association. 2012. Answers to Your Questions for a Bet-
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org/topics/sexuality/orientation.aspx).
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Blanchette, H. 2011. Th e rising cesarean delivery rate in America: What are the consequences? Obstetrics & Gynecology 118(3): 687–690.
Brown, R., and J. Harper. 2012. Th e clinical benefi t and safety of current and future assisted reproductive technology. Reproductive Biomedicine Online 25(2): 108–117.
Centers for Disease Control and Prevention. 2009. Assisted Reproductive Technology
Report (http://www.cdc.gov/art/ART2009/PDF/ART_2009_Full.pdf ).
Centers for Disease Control and Prevention. 2012. Breastfeeding Report Card—
United States, 2012 (http://www.cdc.gov/breastfeeding/data/reportcard.
htm).
Centers for Disease Control and Prevention. 2012. Sudden Infant Death Syn-
drome (SIDS) and Sudden Unexpected Infant Death (SUID) (http://www.
cdc.gov/SIDS/index.htm).
Chadwick, R., and R. Childs. 2012. Ethnical issues in the diagnosis and manage- ment of fetal disorders. Best Practice & Research: Clinical Obstetrics & Gyn-
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S E L E C T E D B I B L I O G R A P H Y 117
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P
eople have always had a compelling interest in managing fertility and preventing unwanted pregnancies, a practice commonly known as birth control. Records dating to the fourth cen- tury bc describe the use of foods, herbs, drugs, douches, and sponges to prevent conception, which is the fusion of an ovum and sperm that creates a fertilized egg, or zygote . Early attempts at contraception (blocking concep- tion through the use of a device, substance, or method) were based on the same principle as many modern birth control methods.Today women and men can choose from many diff erent types of contraceptives to avoid unwanted pregnancies. Modern contraceptive methods are much more predictable and eff ective than in the past. Still, about half of all pregnan- cies in the United States are unintended. Of these, about 40 percent end in abortion.
In addition to preventing pregnancy, many contraceptive products play an important role in protecting against sexu- ally transmitted diseases or STDs. Being informed about the realities and risks and making responsible decisions about sexual and contraceptive behavior are crucial components of lifelong wellness.