Milestones of Life

By Mutea Rukwaru

Milestones of Life traces the human life from womb to tomb. It highlights the various challenges encountered along the way.

The following areas are covered:

Pregnancy, birth process, birth complications and birth defect
Prenatal environment, abortion and miscarriage, psychosexual stages of personality development and parenting skills
Adolescence and its characteristics
Adolescence pregnancy, sexually transmitted diseases among adolescents, dating and courtship
Premarital sex, depression, suicide, dropping out of school and juvenile delinquency
Alcohol, substance abuse, drugs, television, movies and internet
Family contract and family constitution
Adulthood
Challenges of old age
Bereavement, mourning and grief
Helping children cope with death
Challenges of widowhood

• Language: English
• Publisher: Mutea Rukwaru
• Release date: Jun 5, 2017
• ISBN: 9781370155927

Mutea Rukwaru

Mutea Rukwaru is an accomplished author of international reputation.He is an author of 17 bestselling books. He has written widely in the areas of research and family. He has wide knowledge in world of practice having been in the Department of Social Development for 33 years and also being in the world of academia, that is Universities and Kenya Schools of Government.Some of the top selling books include:Anatomy of CrimeFinancial Success Every Family's DreamEducation at CrossroadTraining at its bestMilestones of lifeHow to be a better CounselorThe winning familyThe Tie that bindsHappy though marriedFundamentals of social researchWhat happy couples knowSuccessful time managementStatistics can be funStrong in the stormSnapshot view of Social ResearchSocial Research Methods a complete guidePowerful Proposal, Powerful PresentationUpcoming titles being published by Eureka publishers are: Limits of Medicine, Dreams of my Motherland and A Place to feel at HomeMutea Rukwaru holds a Masters of Arts in Sociology (Counseling) and a Bachelor of Arts (Sociology), Upper Second class honors from Nairobi University

Book preview

MILESTONES OF LIFE

MUTEA RUKWARU

ISBN 9966 – 9802 – 8 – 8

CHAPTER ONE

THE BEGINNINGS

Fertilization and pregnancy

"When I see children, I see that God

Has not yet given up on human kind"-

Rabindranath Tagore, Indian poet.

About fourteen days after the beginning of the menstrual period fertilization may occur. A couple expecting a child can estimate the approximate time of conception (fertilization) by adding fourteen days to the date of the onset of the last menstrual period. They can predict the time of birth by adding 266 days to the fertilization date. Most babies are born within ten to fifteen days of this calculated time.

Fertilization takes place when the sperm cell from a male unites with an egg from a female during the process of COITUS to form a single cell called ZYGOTE. The eggs and the sperms are known as GAMETES or SEX CELLS.A newborn baby girl has about 400,000 immature eggs (ova) in her ovaries each one in its own small sac called follicle. Ovulation occurs about once every twenty-eight days in a sexually mature female, that is one mature follicle in one of her two ovaries ruptures and expels an ovum. If two ova are released and they are fertilized it results to FRATERNAL TWINS or DIZYGOTIC TWINS. If the fertilized ovum splits, it results to IDENTICAL TWINS or MONOZYGOTIC TWINS.

Fertilization is a process. Ordinarily, before fertilization can occur sperm has to be ejaculated during sexual intercourse that is the male deposits semen containing sperm cells in the vagina near the cervix. The sperm cell must then move upward through the uterus and uterine tube. Lashing (large amount of something) of sperm tails and muscular contractions within the walls of the uterus and uterine tube, stimulated by prostaglandin in the semen, which aid the sperm cells journey. During the first part of the reproductive cycle, the uterus and cervix contain a thin watery secretion that promotes sperm transport and survival.

During the later part of the cycle, the progesterone concentration is high; the female reproductive tract secretes a viscous fluid that hampers sperm transport and survival.

It is important to note that a journey to the upper portions of the uterine tube takes less than an hour following sexual intercourse. It is of interest to note that as many as 200 million to 600 million sperm cells may be deposited in the vagina by a single ejaculation. Sperm cells may live up to 72 hours within the female reproductive tract. Consequently, sexual intercourse probably must occur 72 hours before ovulation or within 24 hours following ovulation if fertilization is to take place. Sperms are tadpole like and this shape helps in mobility. They are one of the smallest cells in the body. And is much more active than the ovum. Spermatozoa are produced in the testicles (testes) of a mature male at a rate of several hundred million a day and are ejaculated in his semen at sexual climax. For fertilization to occur at least 20 million sperm cells must enter a woman’s body at one time. They enter the vagina and try to swim through the cervix (the opening to the uterus) and into the fallopian tubes. Only a tiny fraction of the millions of sperm cells make it this far. More than one may penetrate the ovum, but only one can fertilize it to create a new human being.

Paten (1968) has pointed out that spermatozoa maintain their ability to fertilize an egg from a span of 24 – 48 hours. If conception does not occur the sperm cells are devoured by the white cells in the woman’s body and the egg passes through the uterus and exits the vagina. The beginning of life for all of us came long before that first lusty cell, when as newborn babies we left our mother’s womb. Instead the beginning is a split second when a sperm joins an egg (ovum) to start a new life. The question of which sperm joins which egg has tremendous implications for the kind of person that a new being will become.

What sex it will be

What it will look like

Which disease it will be susceptible to

What kind of personality it may possess, though this is hotly disputed

Male infertility is likely to occur in some instances. Male infertility is the inability of sperm cells to fertilize an egg cell. This is due to several causes:

One is the issue of testes. If during the foetal development the testes do not descend into the scrotum, the higher temperature of the abdominal cavity or inguinal canal causes the developing sperm cells in the seminiferous tubules to degenerate.

Certain diseases such as mumps may inflame the testes (orchitis) impairing fertility by destroying cells in the seminiferous tubules.

Both quality and quantity of sperm cells are essential factors in the ability of a man to father a child. If a sperm cannot swim, or if there are simply too few sperm cells, completing the arduous journey to the well protected egg may be impossible. Sometimes even a sperm cell that enters an egg is unsuccessful because it lacks the microtubules necessary to attract and merge the nuclei of the two cells.

Modern science is good. In the past, sperm analysis was based on microscopic examination. Today computer aided sperm analysis (CASA) is standardizing and expanding criteria for normalcy in human male seminal fluid and the sperm cell it contains. To analyse sperm, a man abstains from intercourse for two to three days, and then provides a sperm sample, which must be examined within the hour. The man must also provide information about his reproductive history and possible exposure to toxins. The sperm sample is placed on a slide under a microscope and then a video camera sends an image to a videocassette recorder, which projects life on a digitised image. The camera also sends the image to a computer, which traces sperm trajectories and displays them on a monitor or prints a hard copy.

CASA systems are helpful in studies that use sperm as biomarkers of exposure to toxins. For example the sperm of a man who works in the dry cleaning industry and are exposed to solvent perhcloroethylene (believed to damage sperms) were compared with sperm from men who work in the laundry industry and exposed to many of the same chemicals except this one. CASA showed a difference in sperm mobility that was directly related to level of exposure as measured by exhalation of the chemical. Although the men in both groups had the same numbers of children, the dry cleaners partners took much longer time to conceive than did their launderers partners.

The organ of the female reproductive system is also critical. The organs of the female reproductive system are specialized:

to produce and maintain the female sex cells or egg cells,

to transport these cells to the site of fertilization,

to provide a favourable environment for developing offspring,

to move the offspring to the outside

to produce female sex hormones.

The primary sex organs of this system are the ovaries, which produce the female sex cells and sex hormones. The ovaries are solid oval structures measuring about 3.5 centimetres in length and 2 centimetres in width and 1 centimetre in thickness. An individual ovary is located in a shallow depression on each side in the lateral wall of the pelvic cavity. Of the several million oocytes (eggs) formed originally, only a million or so remain at the time of birth, and perhaps 400,000 are present at puberty. Of these probably fewer than 400 or 500 will be released for the ovary during the reproductive life of a female.

From the vicinity of each ovary tube (fallopian tube) leads to the upper part of the womb (uterus). The uterus is a hollow, muscular organ shaped somewhat like an inverted pear in which the baby grows. The lower, narrower end of the uterus is called the cervix and projects into the inner end of the vagina. The mouth of the cervix is named OS. The vagina is the passage leading to the surface of the body, the entrance being called the ORIFICE or INTROITUS; the maidenhead hymen is a fold of the membrane lying within the orifice, partly covering and shielding the entrance to the vagina. The entrance is further concealed on the outside by two folds of skin on either side – the labia minora and labia majora. The labia not only enclose the entrance to the vagina but the opening nearby leading to the bladder. They also enclose a small organ called CLITORIS, which is a rudimentary and undeveloped penis. The clitoris has no more function (reproductive) in women than nipples in men but like the penis in man it is very sensitive and readily responsive to sexual stimuli. In some communities CLITORIDECTOMY was and is still sometimes performed to reduce sexual sensation as a safeguard against premarital relations and loss of virginity without regard to the loss of pleasure in marriage. Subsequently it is important to note that the clitoris on average is 2 centimetres long and 0.5 centimetres in diameter including a portion embedded in surrounding tissue.

Placenta is also very important in the birth process. It becomes fully developed between 3 – 4 months of pregnancy. Nourishment is supplied to the foetus and waste products are excreted until the time of birth. Should fertilization not take place the ovum on reaching the uterus disintegrates, the devitalised tissues and accompanying blood escaping through the vagina as menstrual flow. The length of the menstrual cycle varies from woman to woman and at times even from month to month of the same woman but the most usual time is 28 days. During the first five days this disintegration of the lining or endometrium of the uterus takes place with the resulting menstrual flow. There follows a period of repair from about the sixth to the eleventh day when a fresh lining is prepared. At about the twelfth or thirteenth day ovulation occurs and further development of the lining enabling it to secrete the nourishment necessary for the fertilized egg, takes place. Implantation takes place about the twenty-third day.

For one out of six couples, trying for parenthood is a time of great concern, as pregnancy remains elusive. Physicians define infertility as the inability to conceive after a year of trying (for more details CF Rukwaru` s 2005 Tie that binds) A physical cause is found in 90% of cases, and 60% of the time the abnormality lies in the females reproductive system. Some specialists use the term sub fertility to distinguish individuals and couples who can conceive unaided, but for whom this may take longer than is usual.

One of the more common causes of female infertility is:

Hyposecretion of gonadotropin hormones from the anterior pituitary glands followed by failure to ovulate (an ovulation).Fertility specialists can treat absence of ovulation due to too little secretion of gonadotropin hormones by administering ovulation stimulating biochemicals.

Another cause is endometriosis, in which tissues resembling the inner of the uterus (endomentrium) grows in the abdominal cavity. This may happen if small pieces of the endometrium move up through the uterine tubes during menses and implant in the abdominal cavity.

Some women become infertile as a result of infections such as gonorrhoea. Infections can inflame and obstruct the uterine tubes; making conception impossible.

Some women stimulate production of viscous mucus that can plug the cervix and prevent entry of sperm.

The first step in finding the right treatment for a particular patient is to determine the cause of the infertility.

David Shier (2004: 861) describes diagnostic tests that a woman who is having difficulty conceiving may undergo, which are the following:-

In summary the following can cause involuntary infertility:

Health – ill health may enhance or impair infertility.

Disturbance in hormone production may result in underdeveloped organs and deficiencies in the quantity, viability, mobility and quality of spermatozoa or in interference with ovulation, implantation and secretion.

The organs may be injured or malformed.

Biochemical abnormalities, malnutrition and other noxious physical agents can reduce potency and fertility.

Emotional stress and conflicts.

Impotence which is due to the following:

Emotional maladjustment

Premature ejaculation

Non ejaculation by men

Frigidity in women

Vaginismus (spasm) or vaginal anaesthesia in women may hinder penetration or make coitus so unsatisfying that it is rarely attempted

Lack of sexual appetite due to emotional or physical factors will mean infrequent intercourse and reduced chances of conception.

Unconscious fears or guilt on about having children may bring about avoidance of intercourse and there is a suspected though not yet defined correlation between unconscious fear and infertility in women not withstanding their ability to achieve a satisfactory sexual relationship.

Some less complex causes of infertility for instance:

Intact hymen

Faulty techniques in coitus

Practices due to ignorance of the reproduction process such as postcoital douching for cleanliness although conception is desired

In relation to adrenal glands that produce androgen and some oestrogen, if there is adrenal hyperplasia (enlargement) it can cause infertility.

In the case of cervix which produces mucus and contains uterine contents if it has a problem it will have poor or absent mucus

If the vagina which is the site of sperm entry has a problem for instance infection or vaginismus.

Uterus sustains conception

- So if it is absent

- Presence of fibroids

- Forgotten IUCD

- Endometritis

- Adhesions

Liver is very crucial because it produces bile and regulates metabolism. If it has a problem because of cirrhosis or cushings which causes low sperm count

Penis deposits sperm – the following can cause infertility

Infections such as gonorrhoea and filariasis.

Absence of seminal vesicles

Hypothyroidism causes low sperm count

Vas deferens conveys sperm. Problem can be if it is absent, ligated, occluded by infection

Azoospermia (lack of spermatozoa in the semen)

Trauma and congenital anomalies.

Septic abortion

Despite all the above challenges of infertility, fertility counselling can be very useful to the concerned partners.

PREGNANCY

"God could not be everywhere

and so he created mothers" Jewish proverb.

Pregnancy is the presence of a developing offspring in the uterus. It results from the union of genetic packages of an egg cell and a sperm cell – an event called fertilization. During a typical reproductive cycle, the corpus inteum degenerates about two weeks after ovulation. Consequently concentrations of estrogens and progesterone decline rapidly, the uterine lining is no longer maintained and the endometrium sloughs off as menstrual flow. If this occurs following implantation the embryo is lost (spontaneous aborted). A hormone called HCG (human chloronic gonadotropin) normally helps prevent spontaneous abortion. A layer of cells called a trophoblast that secretes HCG and later helps form the placenta surrounds the developing embryo. This hormone has properties similar to those of LH and it maintains the corpus inteum, which continues secreting oestrogen and progesterone.

Secretion of HCG continues at a high level for about two months, then it declines to a low level for about four months. The placenta also secretes a hormone called placenta lactogen that may stimulate breast development and prepare the mammary glands to secrete milk, with the aid of placenta estrogens and progesterone. Placenta progesterone and a ploypeptide hormone called relaxin from the corpus luteum inhibit the smooth muscles myometrium, suppressing uterine contractions until the birth process begins. The high concentration of placental estrogens during pregnancy enlarges the vagina and the external reproductive organs. Also, relaxin relaxes the ligaments holding the symphysis pubis and sacroiliac joints together. This action, which usually occurs during the last week of pregnancy, allows for greater movement of the foetus through the birth canal.

Other hormonal changes that occur during pregnancy include increased secretion of aldosterone from the adrenal cortex and of parathyroid hormone from parathyroid glands. Aldosterone promotes renal reabsorption of sodium, leading to fluid retention. Parathyroid hormone helps to maintain a high concentration of maternal blood calcium since foetal demand for calcium can cause hypocalcemia, which promotes cramps.

Pregnancy test

In the normal pregnancy a thorough history and complete physical examination are usually adequate to make the diagnosis of pregnancy. During the first 6 to 12 weeks of pregnancy, a woman may have the following signs

Missed periods

Breast tenderness