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9.ATOD.1.6, page 1
Essential Standard Clarifying Objective 9.ATOD.1
Understand the health risks associated with alcohol, tobacco, and other drug use.
9.ATOD.1.6 Summarize the consequences of alcohol or
tobacco use during pregnancy.
Materials Needed: Appendix 1a, b – Copies of Anatomical Structures of Pregnancy (not labeled; labeled) PowerPoint slide – Anatomical Structures of Pregnancy (labeled) Resealable bag and water Small object to represent a baby One large clear container of water with bright blue food coloring One needle or sharp pin Video – Stop Smoking Now: Reasons Not to Smoke When You’re Pregnant from the series, I Am Your Child. [20 minutes] $10.00 Ordering information: (888) 447-‐3400 http://www.parentsaction.org/categories/Resources/DVDS/ Appendix 2 – teacher’s copy of Kayla’s Story Appendix 3 – Gestation Period including Sensitivities to Toxic Substances Appendix 4 – Definitions of Pregnancy Complications Appendix 5 – What is Fetal Alcohol Syndrome (FAS)? PPT slides – Better Safe than Sorry Appendix 6 – graphic organizer – The Effects of Alcohol and Tobacco During Pregnancy PPT Slides – What Are the Effects of Smoking During Pregnancy? Review: Distribute copies of Anatomical Structures of Pregnancy (Appendix 1a, not labeled) to each student. Ask students to label and identify the structures on their own papers. When students are finished, the teacher will review answers using the PPT slide Anatomic Structures of Pregnancy (labeled) as a reference. [Teacher may choose provide a word bank of terms from Appendix 1b.] Focus: Option 1 Fill a small plastic resealable bag with water and place a small object which represents a baby inside the bag. Fill a large clear container with water and mix in food coloring. Poke several holes using a needle or a pin into the small plastic bag. Explain to the class the small plastic bag represents the placenta, the large container of water represents the womb, and the blue water represents alcohol the mother has been drinking. Place the small bag into the large container and explain how they will examine this small bag later during the class. It will take a few minutes for the colored water from the container to pass through the small holes in the sealable bag so it is recommended that the lesson continue and during Teacher Input – refer to bag and container. Students will notice that the plastic bag now contains colored water as well. Process activity by discussing if a pregnant woman consumes alcohol, it
NC School Health Training Center NC Association for the Advancement of Health Education
9.ATOD.1.6, page 2
easily passes through the placenta and the membrane which separates the maternal and fetal blood systems. When this happens, alcohol is transported directly to the fetus and to all its developing tissues and organs. Option 2 Show the video Stop Smoking Now: Reasons not to Smoke When You’re Pregnant from the series, I Am Your Child. [20 minutes] Ordering information: (888) 447-‐3400 | FAX (213) 477-‐2230, Parents' Action for Children | P.O. Box 2096 | Culver City, CA 90231. Option 3 Read Kayla’s Story (Appendix 2). Process by asking how they would feel if a behavior they practiced affected the health of their baby. Statement of Objectives: Today in class we are going to be discussing the effects of alcohol and tobacco on unborn children. By the end of the lesson you will be able to summarize the consequences of alcohol or tobacco use during pregnancy. Teacher Input: Have students look at the Gestation Period (Appendix 3). Have several students point out the sensitive areas that are greatly affected by tobacco and drug use during pregnancy. Ask students to point out what stage(s) of the gestation period are the eyes affected. When would major physical abnormalities occur? What stages is the heart affected by toxins such as tobacco or other drugs? Keep in mind that a drug’s effects on a developing baby are 20 times greater than the drug’s effects on an adult. Show Definitions-‐Pregnancy Complications (Appendix 4) and make the following points: Research has shown that women’s smoking during pregnancy increases the risk of pregnancy complications, premature delivery, low-‐birth-‐weight infants, stillbirth, and sudden infant death syndrome. When the woman is smoking, it could cause the umbilical cord to constrict. This decreases the amount of oxygen being delivered to the fetus. Option 1 Download PowerPoint Viewer from following site and show the PowerPoint: http://pubs.niaaa.nih.gov/publications/Science/curriculum.html. In addition to information and resources, this link directs to the PowerPoint, Better Safe Than Sorry as well as curriculum slides and videos. Display PPT Slide, What is Fetal Alcohol Syndrome? (Appendix 5) Discuss the following as students complete graphic organizer. Fetal Alcohol Syndrome (FAS) is a lifelong yet completely preventable set of physical, mental, and neurobehavioral birth defects associated with alcohol consumption during pregnancy. A FAS diagnosis requires evidence of abnormalities in three specific areas:
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9.ATOD.1.6, page 3
1. growth 2. central nervous syndrome functions 3. facial characteristics
Fetal Alcohol Syndrome (FAS) is the leading known cause of mental retardation and birth defects in the western hemisphere. When a mother drinks alcohol, it enters her blood stream and also the growing baby’s blood stream through the placenta. If conducting water experiment, check the plastic bag at this time. Process information provided in the Focus Step if the colored water is now in the bag. If not, wait a few minutes and recheck. Alcohol is a teratogen, which is a substance known to be toxic to human development. Depending on the amount, timing, and pattern of use, if alcohol reaches the baby’s blood supply, it can interfere with healthy development and cause Fetal Alcohol Syndrome or other alcohol related disorders. There appears to be no difference in the type of alcoholic beverage (beer, wine, hard liquor) and its effects on pregnancy. Early exposure (during the first trimester) presents the greatest risk for serious physical defects, and later exposure increases the changes of neurological and growth deficiencies or miscarriages. There is no safe amount of alcohol during pregnancy. Tobacco Using tobacco and drugs during pregnancy can be detrimental to the unborn child. There are many proven facts of the consequences of the toxic substances entering the pregnant woman’s body. Show PowerPoint slides, What Are the Effects of Smoking During Pregnancy? While presenting consequences on slide, ask students the following:
• Considering these risks, why do you think mothers smoke while pregnant? • Do you feel it is worth the risk? Why or why not? • What one message do you want to say to a woman considering pregnancy to
educate her on smoking risks while pregnant? Tobacco and drug use are extremely harmful during pregnancy. Babies born to pregnant women who smoke or use drugs might be killed by the effects of these substances. Those who live are more likely to be smaller, have a lower birth weight, and be less likely to survive than those of tobacco and drug-free mothers. Even after birth, there are hazards for the children of parents who smoke. These children are more likely to suffer from asthma or other respiratory diseases. Option 2 Play and discuss information from two CDC podcasts:
1) “If You are Pregnant, Don’t Smoke”, which describes the danger of smoking during pregnancy http://www2c.cdc.gov/podcasts/player.asp?f=7868 (3 min)
2) “Don’t Drink and Deliver” http://www2c.cdc.gov/podcasts/player.asp?f=11983 (3:50)
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9.ATOD.1.6, page 4
Distribute index cards and have students write three pieces of information they learned while listening to the audios. Guided Practice: Utilizing cooperative groups, students will create a roadside “billboard.” The assignment should include at least one health consequence of using alcohol or tobacco during pregnancy and one picture. Independent Practice: Upon accessing the website www.fodey.com, students will generate a newspaper clipping. Assessment includes creating name of newspaper, headline, date, brief news article stating consequences of either alcohol or tobacco use while pregnant and a concluding message promoting abstinence from drugs during pregnancy. The completed newspaper image can be downloaded to a website or a blog. If internet is not available, students will complete same activity as above but without computer enhancement.
Closure: Today we have discussed the consequences of alcohol and tobacco use during pregnancy. These problems can be serious lifelong concerns for the affected child. Children with severe impairments might not be able to take care of themselves as adults. These lifelong problems can be prevented by increasing awareness of the dangers of alcohol consumption and tobacco use during pregnancy and enhancing access to prenatal care and treatment for drug problems.
9.ATOD.1.6, Appendix 1a
9.ATOD.1.6, Appendix 1b
http://hcd2.bupa.co.uk/fact_sheets/mosby_factsheets/Normal_pregnancy.html
9.ATOD.1.6, Appendix 2
Kayla’s Story
My name is Kayla and I am 28 years old. When I was 17 I began going out with a guy from another high school. I wasn’t a smoker, but he smoked. I started smoking to fit in with his friends and later on to calm me down after we argued. We fought a lot, especially after we learned I was pregnant. When I went to the doctor I was four months pregnant, and she told me I needed to stop smoking. I didn’t think it was that big of a deal. My mother had smoked when she was pregnant with me and I turned out alright. But as the months went by, I was told that my baby wasn’t growing as much as it needed to. The doctor said when I smoked, the baby gets less oxygen because of the carbon dioxide and other chemicals in cigarettes. I didn’t smoke that much, maybe a half a pack a day. But when my boyfriend and I broke up I probably smoked about a pack a day. I just couldn’t understand how we could break up when I was going to have his baby. And would he still help me take care of it? My parents were always on my case too. When the baby did arrive I was 36 weeks pregnant. It was a girl and I named her Taylor. She was one month early and only weighed 4 ½ pounds. She had to live in an incubator for several weeks. I was scared. I felt really bad because Taylor wasn’t breathing when she was born. When she was a baby and toddler she needed several surgeries to repair some heart valves. She also was missing one of her four heart chambers so she was sick a lot with her breathing. Her body wasn’t getting enough oxygen. We were often in the hospital and so Taylor missed out on school activities and making friends. Taylor is now 10 years old and is going to have another heart surgery next month. The doctors say she will have surgeries every few years until she is fully grown and then maybe as an adult. Taylor still has severe asthma and can’t run or participate much in sports, but she is able to attend school a little more now that she’s older. I wish I could tell you I quit smoking, but it’s the one thing I have that relaxes me. I am a single mom and work two jobs to support us along with Taylor’s hospital bills. I don’t smoke in the house but Taylor’s doctor told me that if I quit smoking, it will really help Taylor breathe better. Taylor has a long scar in the center of her chest from all of her surgeries and every time I look at it, I am reminded that she isn’t “normal” because of my smoking. Writing this letter is a big step and I really want to quit. I wish I had never started. Thank you for listening, Kayla
9.ATOD.1.6, Appendix 3
Gestation Period
Including Sensitivities to Toxic Substances such as Tobacco and Other Drugs
http://journals.cambridge.org/fulltext_content/PSM/PSM35_05/S0033291704004155tbl001.gif
9.ATOD.1.6, Appendix 4
Definitions – Pregnancy Complications
Premature Delivery A baby born before 37 complete weeks of pregnancy. Most pregnancies are about 40 weeks.
Low Birth Weight Classified as a baby that weighs less than 5 pounds and 8 ounces. This can usually be attributed to the health of the mother during pregnancy.
Still Birth When the fetus dies in the womb or during labor.
Sudden Infant Death Syndrome
A condition when an infant suddenly dies without any cause that can be found through an investigation or autopsy. Usually the infant is sleeping and when the parents go to check on the infant they find him/her dead.
9.ATOD.1.6, Appendix 5
What is Fetal Alcohol Syndrome (FAS)?
Definition: A characteristic pattern of severe birth defects present in babies born to mothers who drink alcohol during their pregnancy.
Facts about FAS: When the mother consumes alcohol, it is absorbed into the bloodstream at the same rate for the infant as it is absorbed for the mother. Ethanol, the main ingredient in alcohol, seems to have a toxic effect on the fetus causing physiological and central nervous system damage. The alcohol also interferes with protein synthesis which decreases nutrition for the mother and developing fetus.
Fetal Alcohol Syndrome requires at least one feature of each of three categories: 1. Growth retardation - abnormally small-for-age weight, length, and/or
head circumference 2. Central nervous system disorders - abnormal brain functioning, delays
in behavioral development, and/or intellectual impairment 3. At least two of the following - small head, small eyes, or a poorly
developed philtrum (the groove above the upper lip), short nose, or flattened midfacial area
o FAS is the leading known cause of mental retardation in the western world. It
has also been reported that learning disabilities, cross-eye, nearsightedness, malformations of the ears, liver and kidney problems, retarded bone growth, increases in upper respiratory infections, undescended testicles, and hernia have been connected with FAS.
o It has been reported that one-half of the infants of alcoholic mothers can be
found to have FAS. Alcohol consumption causes birth defects in about 3 out of 1,000 births.
o The most severe damage is done during the first trimester when heavy alcohol
is being consumed. Often the mother does not even know she is pregnant before the damage has taken place.
o FAS is the most common preventable form of mental retardation.
9.ATOD.1.6, Appendix 6
Graphic Organizer The Effects of
Alcohol and Tobacco during Pregnancy Define Fetal Alcohol Syndrome How does FAS affect the
following? Growth retardation: Central system: Facial Features:
What is the relationship between FAS and mental retardation?
Why is damage during the first trimester more difficult to prevent?
List the effects of smoking during pregnancy on the unborn baby.
What chemicals in smoke might harm the baby?
How might exposure to secondhand smoke by a pregnant woman harm the baby?
What advice would you give to a woman who smokes or drinks and wants to get pregnant?