If you mention pregnancy in a room full of women, each one who has borne a child will have a story to

tell. There will be laughter about food cravings, body shape, and balance issues. There will be tales of
babies who arrived early and attended their own showers, as well as recollections of induced labors that
jettisoned infants who were reluctant to leave the womb. There will be complaints about advice from
the medical world that was later discovered to be prenatally hazardous. Young, healthy women who had
never smoked or ingested alcohol, who carefully consumed a nutrient-rich variety of fruits, vegetables,
and other foods, who made sure they were well rested, and who enjoyed the support of partner,
friends, and family may talk about miscarriage, premature births, or other life-threatening complications
that accompanied their pregnancies. Older mothers, or those who inadvertently or intentionally drank
alcohol, smoked cigarettes or marijuana, and paid little heed to their diets, will boast about plump,
healthy newborns who are now at the top of their high school classes. While these women express relief
that their offspring seem to have dodged the bullets that they themselves fired, others speak of how
they deal with consequences they might have avoided. A few of the women in the room may reflect on
what it was like to be pregnant as a teenager, a single parent, or a widow. As an observer, you will note
that nearly every woman in the room was, or has become, keenly aware that a mother’s behavioral
choices during pregnancy may affect the outcome for her child. In this chapter, we will discuss normal
prenatal development as well as the things that can go wrong. You will see that the timetable inside the
womb differs drastically from what we observe externally as the three familiar trimesters that a
pregnant woman experiences. Inside the womb, there are three stages as well, but these stages pass
quickly as the organism becomes a zygote, then an embryo, and finally a fetus. The transition from
embryo to fetus (the final stage) occurs at 8 weeks, a full month before the pregnant woman enters the
second trimester of her pregnancy—and, often, before she is aware that she is pregnant. At this point,
all of the embryo’s major organs are formed. The rest of the prenatal period is a time of growth,
developing function, and prenatal development development that occurs between the moment of
conception and the beginning of the birth process. From Conception to Birth Potential Problems in
Prenatal Development Birth and the Perinatal Environment Applying Research to Your Life: Cultural and
Historical Variations in Birthing Practices Potential Problems at Birth Applying Developmental Themes to
Prenatal Development and Birth Prenatal Development 3 and Birth C H A P T E R Copyright 2012
Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part.
Due to electronic rights, some third party content may be suppressed from the eBook and/or
eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the
overall learning experience. Cengage Learning reserves the right to remove additional content at any
time if subsequent rights restrictions require it. 90 PART TWO Biological Foundations of Development
the refinement of organs and structures that already exist. This means that a woman may pass through
the most critical periods of pregnancy before she even knows she is pregnant. Even though she may be
aware that behaviors such as ceasing to consume alcohol or monitoring the nutritional value of her diet
are beneficial, her window of opportunity for minimizing risk may pass before she realizes that she has
reason to make behavioral changes. In this chapter, we present information about both maternal and
paternal behaviors that may impact the course of prenatal development. Some of these behaviors are
associated with negative impacts such as low birth weight, cognitive deficits, or birth defects. Others are
associated with healthy newborn outcomes and positive outcomes for the maturing child. Just because a
risk or benefit is associated with a certain maternal behavior does not mean that engaging in the
behavior will ensure that outcome. For example, both increasing maternal age and alcohol consumption
during pregnancy are associated with severe cognitive deficits in newborns, but, as just noted, many
women who wait to conceive or who drink alcohol while pregnant bear perfectly healthy, bright
newborns. In addition, although good nutrition, adequate amounts of sleep, and support from the
mother’s partner are associated with positive newborn outcomes, young women with healthy lifestyles
who receive both emotional and behavioral support from a spouse or partner may still bear newborns
with birth defects or low IQs. The behavioral information in this chapter provides a means for
prospective parents to minimize the risks that threaten healthy prenatal development, but perhaps the
most important message of the chapter is that all sexually active men and women should be aware of
the possibility of a pregnancy, the critical period of the early weeks of pregnancy, and the wisdom of
adjusting their lifestyles to provide a healthy prenatal environment, just in case. From Conception to
Birth In Chapter 2, we learned that development begins in the fallopian tube when a sperm penetrates
the wall of an ovum, forming a zygote. From the moment of conception, it will take approximately 266
days for this tiny, one-celled zygote to become a fetus of some 200 billion cells that is ready to be born.
Prenatal development is often divided into three major phases. The first phase, called the period of the
zygote, lasts from conception through implantation, when the developing zygote becomes firmly
attached to the wall of the uterus. The period of the zygote normally lasts about 10 to 14 days (Leese,
1994). The second phase of prenatal development, the period of the embryo, lasts from the beginning of
the 3rd week through the end of the 8th. This is the time when virtually all the major organs are formed
and the heart begins to beat (Corsini, 1994). The third phase, the period of the fetus, lasts from the 9th
week of pregnancy until the baby is born. During this phase, all the major organ systems begin to
function, and the developing organism grows rapidly (Malas et al., 2004). The Period of the Zygote As
the fertilized ovum, or zygote, moves down the fallopian tube toward the uterus, it divides by mitosis
into two cells. These two cells and all the resulting cells continue to divide, forming a ball-like structure,
or blastocyst, that will contain 60 to 80 cells within 4 days of conception (see ❚ Figure 3.1). Cell
differentiation has already begun. The inner layer of the blastocyst will become the embryo, and the
outer layer of cells will develop into tissues that protect and nourish the embryo. period of the zygote
the first phase of prenatal development, lasting from conception until the developing organism becomes
firmly attached to the wall of the uterus. period of the embryo the second phase of prenatal
development, lasting from the 3rd to the 8th prenatal week, during which the major organs and
anatomical structures take shape. Within hours, the fertilized ovum (zygote) divides, beginning a
continuous process of cell differentiation. Dr Cahzaud/Mona Lisa/LookatSciences/ Phototake Copyright
2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in
part. Due to electronic rights, some third party content may be suppressed from the eBook and/or
eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the
overall learning experience. Cengage Learning reserves the right to remove additional content at any
time if subsequent rights restrictions require it. CHAPTER 3 Prenatal Development and Birth 91
Implantation As the blastocyst approaches the uterus 6 to 10 days after conception, small, burrlike
tendrils emerge from its outer surface. When the blastocyst reaches the uterine wall, these tendrils
burrow inward, tapping the pregnant woman’s blood supply. This is called implantation. Implantation is
quite a development in itself. There is a specific “window of implantation” during which the blastocyst
must communicate (biologically) with the uterine wall, position itself, attach, and penetrate. This
implantation choreography takes about 48 hours and occurs 7 to 10 days after ovulation, with the entire
process being completed about 10 to 14 days after ovulation (Hoozemans et al., 2004). Once the
blastocyst is implanted, it looks like a small translucent blister on the wall of the uterus (see Figure 3.1).
Only about half of all fertilized ova are firmly implanted, and perhaps as many as half of all such implants
are either genetically abnormal and fail to develop, or burrow into a site incapable of sustaining them
and are miscarried (Moore & Persaud, 1993; Simpson, 1993). So nearly three zygotes out of four fail to
survive the initial phase of prenatal development. Development of Support Systems Once implanted, the
blastocyst’s outer layer rapidly forms four major support structures that protect and nourish the
developing organism (Sadler, 1996). One membrane, the amnion, is a watertight sac that fills with fluid
from the pregnant woman’s tissues. The purposes of this sac and its amniotic fluid are to cushion the
developing organism against blows, regulate its temperature, and provide a weightless environment
that will make it easier for the embryo to move. Floating in this watery environment is a balloon-shaped
yolk sac that produces blood cells until the embryo is capable of producing its own. This yolk sac is
attached to a third membrane, the chorion, which surrounds the amnion and eventually becomes the
lining of the placenta—a multipurpose organ that we will discuss in detail later (see ❚ Figure 3.2). A
fourth membrane, the allantois, forms the embryo’s umbilical cord. implantation the burrowing of the
blastocyst into the lining of the uterus. amnion a watertight membrane that surrounds the developing
embryo, serving to regulate its temperature and to cushion it against injuries. chorion a membrane that
becomes attached to the uterine tissues to gather nourishment for the embryo. placenta an organ,
formed from the lining of the uterus and the chorion, that provides for respiration and nourishment of
the unborn child and the elimination of its metabolic wastes. umbilical cord a soft tube containing blood
vessels that connects the embryo to the placenta. embryo the name given to the prenatal organism
from the 3rd to the 8th week after conception. blastocyst the name given to the ball of cells formed
when the fertilized egg begins to divide. Cell division and formation of inner cell mass (4 to 5 days)
Embryonic disk Trophoblast cells 6. 16 to 32 cells (72 hours) 5. Implantation (8 to 14 days) 7. Blastocyst
Uterus Uterine lining Ovary Fallopian tube 4 cells (48 hours) 4. Fertilization occurs usually within 24
hours 2. Cervix Single-celled mature ovum discharged by ovary on days 9 to 16 of menstrual cycle 1. 2
cells (36 hours) 3. ❚ Figure 3.1 The period of the zygote. period of the fetus the third phase of prenatal
development, lasting from the 9th prenatal week until birth; during this period, all major organ systems
begin to function and the fetus grows rapidly. © Cengage Learning Copyright 2012 Cengage Learning. All
Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights,
some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has
deemed that any suppressed content does not materially affect the overall learning experience.
Cengage Learning reserves the right to remove additional content at any time if subsequent rights
restrictions require it. 92 PART TWO Biological Foundations of Development Purpose of the Placenta
Once developed, the placenta is fed by blood vessels from the pregnant woman and the embryo,
although its hairlike villi act as a barrier that prevents these two bloodstreams from mixing. This
placental barrier is semipermeable, meaning that it allows some substances to pass through but not
others. Gases such as oxygen and carbon dioxide, salts, and various nutrients such as sugars, proteins,
and fats are small enough to cross the placental barrier. However, blood cells are too large (Gude et al.,
2004). Maternal blood flowing into the placenta delivers oxygen and nutrients into the embryo’s
bloodstream by means of the umbilical cord, which connects the embryo to the placenta. The umbilical
cord also transports carbon dioxide and metabolic wastes from the embryo. These waste products then
cross the placental barrier, enter the pregnant woman’s bloodstream, and are eventually expelled from
the pregnant woman’s body along with her own metabolic wastes. Thus, the placenta plays a crucial role
in prenatal development because this organ is the site of all metabolic transactions that sustain the
embryo. The Period of the Embryo The period of the embryo lasts from implantation (roughly the 3rd
week) through the 8th week of pregnancy (see ❚ Figure 3.3). By the 3rd week, the embryonic disk is
rapidly differentiating into three cell layers. The outer layer, or ectoderm, will become the nervous
system, skin, and hair. The middle layer, or mesoderm, will become the muscles, bones, and circulatory
system. The inner layer, or endoderm, will become the digestive system, lungs, urinary tract, and other
vital organs such as the pancreas and liver. Development proceeds at a breathtaking pace during the
period of the embryo. In the 3rd week after conception, a portion of the ectoderm folds into a neural
tube that soon becomes the brain and spinal cord. By the end of the 4th week, the heart not only has
formed but has already begun to beat. The eyes, ears, nose, and mouth are also beginning to form, and
buds that will become arms and legs suddenly appear. At this point, the embryo is only about 1/4th of
an inch long but already 10,000 times the size of the zygote from which it developed. At no time in the
future will this organism ever grow as rapidly or change as much as it has during the 1st prenatal month.
During the 2nd month, the embryo becomes much more human in appearance as it grows about 1/30th
of an inch per day. A primitive tail appears but is soon enclosed by protective tissue and becomes the
coccyx, the tip of the backbone. By the middle of the 5th week, the eyes have corneas and lenses. By the
7th week, the ears are well formed, and the embryo has a rudimentary skeleton. Limbs are now
developing from the body outward; that is, the upper arms appear first, followed by the forearms,
hands, and then fingers. The legs follow a similar pattern a few days later. The brain develops rapidly
during the 2nd month, and it directs the organism’s first muscular contractions by the end of the
embryonic period. During the 7th and 8th prenatal weeks, the embryo’s sexual development begins with
the appearance of a neural tube the primitive spinal cord that develops from the ectoderm and
becomes the central nervous system. ❚ Figure 3.3 A human embryo at 40 days. Placenta Uterine wall
Umbilical cord Chorion Amnion Cervix ❚ Figure 3.2 The embryo and its prenatal environment. Neil
Harding/Stone/Getty Images © Cengage Learning Copyright 2012 Cengage Learning. All Rights Reserved.
May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party
content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any
suppressed content does not materially affect the overall learning experience. Cengage Learning
reserves the right to remove additional content at any time if subsequent rights restrictions require it.
CHAPTER 3 Prenatal Development and Birth 93 genital ridge called the indifferent gonad. If the embryo
is a male, a gene on its Y chromosome triggers a biochemical reaction that instructs the indifferent
gonad to produce testes. If the embryo is a female, the indifferent gonad receives no such instructions
and will produce ovaries. The embryo’s circulatory system now functions on its own, for the liver and
spleen have assumed the task of producing blood cells. By the end of the 2nd month, the embryo is
slightly more than an inch long and weighs less than 1/4th of an ounce. Yet it is already a marvelously
complex being. At this point, all the major structures of the human are formed, and the organism is
beginning to be recognizable as a human (Moore & Persaud, 2003; O’Railly & Müller, 2001). The Period
of the Fetus The last 7 months of pregnancy, or period of the fetus, is a period of rapid growth (see ❚
Figure 3.4) and refinement of all organ systems. This is the time during which all major organ systems
begin to function and the fetus begins to move, sense, and behave (although not intentionally). This is
also a time when individuality emerges as different fetuses develop unique characteristics, such as
different patterns of movement and different facial expressions. The Third Month During the 3rd
prenatal month, organ systems that were formed earlier continue their rapid growth and become
interconnected. For example, coordination between the nervous and muscular systems allows the fetus
to perform many interesting maneuvers in its watery environment—kicking its legs, making fists,
twisting its body—although these activities are far too subtle to be felt by the pregnant woman. The
digestive and excretory systems are also working together, allowing the fetus to swallow, digest
nutrients, and urinate (El-Haddad et al., 2004; Ross & Nijland, 1998). Sexual differentiation is progressing
rapidly. The male testes secrete testosterone— the male sex hormone responsible for the development
of a penis and scrotum. fetus name given to the prenatal organism from the 9th week of pregnancy until
birth. Age since fertilization in weeks 9 12 16 20 24 28 32 36 38 ❚ Figure 3.4 Rate of body growth during
the fetal period. Increase in size is especially dramatic from the 9th to the 20th week. Adapted from
Before We Are Born, 4th ed., by K. L. Moore & T. V. N. Persaud, 1993, p. 89. Philadelphia: Saunders.
Adapted with permission of the author and publisher. Copyright 2012 Cengage Learning. All Rights
Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some
third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed
that any suppressed content does not materially affect the overall learning experience. Cengage
Learning reserves the right to remove additional content at any time if subsequent rights restrictions
require it. 94 PART TWO Biological Foundations of Development In the absence of testosterone, female
genitalia form. By the end of the 3rd month, the sex of a fetus can be detected by ultrasound, and its
reproductive system already contains immature ova or sperm cells. All these detailed developments are
present after 12 weeks even though the fetus is a mere 3 inches long and still weighs less than an ounce.
The Fourth through Sixth Months Development continues at a rapid pace during the 13th through 24th
weeks of pregnancy. At age 16 weeks, the fetus is 8 to 10 inches long and weighs about 6 ounces. From
15 or 16 weeks through about 24 or 25 weeks, simple movements of the tongue, lips, pharynx, and
larynx increase in complexity and coordination, so that the fetus begins to suck, swallow, munch, hiccup,
breathe, cough, and snort, thus preparing itself for extrauterine life (Miller, Sonies, & Macedonia, 2003).
In fact, infants born prematurely may have difficulty breathing and suckling because they exit the womb
at an early stage in the development of these skills—simply put, they haven’t had enough time to
practice (Miller et al., 2003). During this period, the fetus also begins kicking that may be strong enough
to be felt by the pregnant woman. The fetal heartbeat can easily be heard with a stethoscope; and as
the amount of bone and cartilage increases as the skeleton hardens (Salle et al., 2002), the skeleton can
be detected by ultrasound. By the end of the 16th week, the fetus has assumed a distinctly human
appearance, although it stands virtually no chance of surviving outside the womb. During the 5th and
6th months, the nails harden, the skin thickens, and eyebrows, eyelashes, and scalp hair suddenly
appear. At 20 weeks, the sweat glands are functioning, and the fetal heartbeat is often strong enough to
be heard by placing an ear on the pregnant woman’s abdomen. The fetus is now covered by a white,
cheesy substance called vernix and a fine layer of body hair called lanugo. Vernix protects fetal skin
against chapping during its long exposure to amniotic fluid, and lanugo helps vernix stick to the skin. By
the end of the 6th month, the fetus’s visual and auditory senses are clearly functional. We know this
because preterm infants born only 25 weeks after conception become alert at the sound of a loud bell
and blink in response to a bright light (Fifer, 2005). Also, magnetoencephalography (MEG) has been used
to document changes in the magnetic fields generated by the fetal brain in response to auditory stimuli.
In fact, the use of MEG has revealed that the human fetus has some ability to discriminate between
sounds. This ability may indicate the presence of a rudimentary fetal short-term memory system
(Huotilainen et al., 2005). These abilities are present 6 months after conception, when the fetus is
approximately 14 to 15 inches long and weighs about 2 pounds. The Seventh through Ninth Months The
last 3 months of pregnancy comprise a “finishing phase” during which all organ systems mature rapidly,
preparing the fetus for birth. Indeed, somewhere between 22 and 28 weeks after conception (usually in
the 7th month), fetuses reach the age of viability—the point at which survival outside the uterus is
possible (Moore & Persund, 1993). Research using fetal monitoring techniques reveals that 28- to 32-
week-old fetuses suddenly begin to show better-organized and more predictable cycles of heart rate
activity, gross motor activity, and sleepiness/waking activity, vernix The white, cheesy substance that
covers the fetus to protect the skin from chapping. lanugo fine hair covering the fetus’s body that helps
vernix stick to the skin. age of viability a point between the 22nd and 28th prenatal weeks when survival
outside the uterus is possible. At 12 weeks after conception, the fetus is about 3 inches long and weighs
almost 1 ounce. All major organ systems have formed and several are already functioning. Nestle/Petit
Format/Photo Researchers, Inc. Copyright 2012 Cengage Learning. All Rights Reserved. May not be
copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content
may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any
suppressed content does not materially affect the overall learning experience. Cengage Learning
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CHAPTER 3 Prenatal Development and Birth 95 findings that indicate that their developing nervous
systems are now sufficiently well organized to allow them to survive should their birth be premature
(DiPietro et al., 1996; Groome et al., 1997). Nevertheless, many fetuses born this young will still require
oxygen assistance because the tiny pulmonary alveoli (air sacs) in their lungs are too immature to inflate
and exchange oxygen for carbon dioxide on their own (Moore & Persaud, 1993). By the end of the 7th
month, the fetus weighs nearly 4 pounds and is about 16 to 17 inches long. One month later, it has
grown to 18 inches and put on another 1 to 2 pounds. Much of this weight comes from a padding of fat
deposited just beneath the skin that later helps to insulate the newborn infant from changes in
temperature. By the middle of the 9th month, fetal activity slows and sleep increases (DiPietro et al.,
1996; Sahni et al., 1995). The fetus is now so large that the most comfortable position within a
restricted, pear-shaped uterus is likely to be a headdown posture at the base of the uterus, with the
limbs curled up in the so-called fetal position. At irregular intervals over the last month of pregnancy,
the pregnant woman’s uterus contracts and then relaxes—a process that tones the uterine muscles,
dilates the cervix, and helps to position the head of the fetus into the gap between the pelvic bones
through which it will soon be pushed. As the uterine contractions become stronger, more frequent, and
regular, the prenatal period draws to a close. The pregnant woman is now in the first stage of labor, and
within a matter of hours she will give birth. A brief overview of prenatal development is presented in
Table 3.1. Note that the stages of development through which the organism passes do not correspond
to the trimester stages used to describe the pregnant woman’s experience. In fact, the developing
organism passes through all three stages of prenatal development in the pregnant woman’s first
trimester. Furthermore, because the organism becomes a fetus at about 8 weeks after conception, it is
not at all uncommon for a woman not to realize she is pregnant before the periods of the zygote and
embryo have passed