Articles filed under 'PREGNANCY & BIRTH'
In our society, abstaining from alcohol can be difficult, especially during parties and family celebrations. But women who are pregnant or even just trying to get pregnant should stay away from alcohol entirely.
For the woman who is dependent upon or an abuser of this legal drug, it may be impossible to abstain from drinking without first undergoing effective treatment. Pregnant women with alcoholism should join an alcohol abuse rehabilitation program and be checked closely by a health care provider during their entire pregnancy.
Because alcohol use appears to be the most harmful during the first three months of pregnancy, serious harm can occur to the fetus before a woman even knows she is expecting. Few are even aware of the possible consequences of their drinking to the developing child, known as fetal alcohol syndrome (FAS).
Fetal alcohol exposure is the leading known cause of mental retardation in the Western world. In the U.S., FAS occurs as often as or even more frequently than Downs Syndrome or Spinal Bifida. Symptoms of FAS can include the following:
* Slowed intrauterine growth
* Poor growth in the fetus and newborn
* Possible failure to thrive after birth
* Delayed development and signs of mild-to-moderate mental retardation, with the average IQ in the mid 60s
* Irregularities of the face, including small head and upper jaw; a short, upturned nose; smooth groove in the upper lip; smooth and thin upper lip; narrow, small eyes with large folds above the eye; heart defects; abnormal joints in the hands and feet; tremors in the newborn; agitation and crying
* Abnormalities of the skeleton
Any woman who is pregnant should avoid consuming alcohol throughout her entire pregnancy, as permanent birth defects can occur during each of the trimesters. It is unknown whether the timing or any specific amount of alcohol consumption is safe for the developing baby. Alcohol crosses the placental barrier and can cause physical, mental, and behavioral problems that can persist for a lifetime.
Drinking alcohol during pregnancy can be the first sign of possible fetal alcohol damage. Infant ECG and echocardiogram are able to detect problems such as a heart murmur or other heart structural defects. Ultrasound of the fetus can show delayed intrauterine growth.
The primary effect of FAS is permanent central nervous system damage, especially to the brain. The resulting under-formed or malformed brain structures can create an array of primary cognitive and functional disabilities. Among them are poor memory, attention deficits, impulsive behavior, and poor cause-and-effect reasoning. Since the brain develops during the entire pregnancy, the risk of brain damage exists during each trimester. Mental health problems and drug addiction are secondary disabilities that can manifest themselves later in life and be due to FAS.
Many women are unfamiliar with the potential, permanent consequences of drinking while pregnant. The lifetime medical and social costs of each child born with FAS are estimated as just under a million U.S. dollars. The social costs to the family are inestimable. All women who go off their birth control in order to conceive are advised to drink NO alcohol (and take no harmful drugs). It may be difficult to stop drinking, but it is the best way to give a baby the best possible health and start in life.
Sources: Wikipedia and other Internet health-related articles
May 26th, 2008
Some women in their 40s can still get pregnant without assistance from fertility clinics. That’s good news for those who have postponed motherhood, but for women who have completed their family, continuing fertility can be problematic. Today, the Pill and the IUD (intra-uterine devices) are both considered good options for some women in their fourth decade. These two methods are much safer than, for example, in the 1960s and 1970s. In the past, most women over age 40 underwent a tubal ligation (a fallopian tube-tying procedure), or relied on condoms or vasectomy with their male partner.
Sterilization is now easier for women, thanks to a non-surgical method of tubal treatment called Essure. The new technique was approved by the U.S. government in 2002. No cutting of the abdomen or tying of the tubes is involved. Instead, the doctor works through the cervix, using a thin tube to insert small devices into the ends of the fallopian tubes. These “plugs” in about three months produce scarring to block the woman’s tubes, thus preventing ovulated eggs from reaching the uterus.
Women over 40 should continue to use birth control until well into menopause. This age group has been shown to have high abortion rates, similar to those of adolescents. Under certain conditions, the Pill is now safe for “older” women. The dosage of estrogen in today’s Pill is greatly reduced and considered by many physicians to be a good alternative for lean, healthy women over 40. The Pill has other benefits besides contraception for appropriate women. It can help to control irregular menstrual bleeding and hot flashes, reduce hip fractures and cases of ovarian cancer. Yet, some physicians urge caution even in lean and healthy women who are approaching menopause.
If a woman over 40 is significantly overweight, has high blood pressure or diabetes, the Pill would not be a good option. For them, the chances of dangerous blood clots rise sharply. Middle-aged women who are obese, who smoke, have migraine headaches or other identified risk factors might instead consider IUDs or progestin-only treatments termed “mini-pills.” Although higher breast cancer rates have been found in older women taking estrogen-progestin pills to control menopausal symptoms, women 35 and older taking oral contraceptives have not shown an increase in breast cancers.
Another birth control product called Implanon, FDA-approved in 2006, is a matchstick-sized plastic rod that is implanted under the skin of the upper arm. Implanon is similar to the earlier Norplant and can last up to three years.
Today’s IUDs are safer and more effective than those used by women in the 1970s. The earlier Dalkon Shield version resulted in a number of serious medical problems due to its defective design. A large class-action lawsuit was filed and millions in payouts were made over the years. American women and their physicians are again considering the IUD as a simple and effective method of birth control.
Women should discuss with their OB-GYN physician their preferences for contraception, the appropriateness for their age group and their individual health risks. New options in birth control methods and technologies greatly reduce the risk of an unwanted pregnancy.
San Francisco Chronicle, Mike Stobbe, AP story, April 5, 2008
http://www.msnbc.msn.com/id/23954260/
April 8th, 2008
Although still very small, the risk of dying in childbirth is rising in the U.S. Between 2003 and 2004, maternal mortality rates rose from 12 deaths in 100,000 live births to 13 in 100,000 (Fewer than 600 American women giving birth in 2004 died in the process.) Infant mortality is actually more common than death of the mother. In 2004, the rate of infant deaths was 679 per 100,000.
Compared to a century ago, when about 1 in every 100 live births resulted in the mother’s death, the small rise may seem insignificant. But, with our modern technology and outstanding medical care, we should be concerned that the maternal mortality rate has risen at all.
Looking at possible causes for deaths related to childbirth, three factors may be at least partially responsible: the rising rates of Caesarean-section births (now accounting for about 29% of all births); increasing maternal obesity, and more women giving birth in their late 30s and into their 40s.
Today, C-section births are far higher than what public heath experts consider appropriate. As with other surgeries, Caesarean births carry risks from anesthesia, infection, and blood clots. Mothers with several previous C-sections may also be at risk of excessive bleeding or blood vessel blockages.
Women who are heavier can develop diabetes and other complications. In addition, they may have excess tissue. Generally, their babies are larger, making a vaginal birth more difficult. This factor, in turn, can lead to more C-sections.
More women are waiting longer to have their babies than even a few decades ago. Risks of complications to mother and baby are greater to a woman in her late-30s and 40s.
Studies show than at least 40% of maternal deaths could have been prevented had quality of care been better. Sometimes, despite excellent prenatal care and a healthy pregnancy, the mother dies for no apparent reason.
The woman’s race and economic status may also be factors. Maternal deaths are at least three times higher for Black women than for white women. Because they often do not get adequate prenatal care, Black women are more susceptible to complications such as high blood pressure.
Getting risk factor – especially diabetes, obesity and high blood pressure – under control before becoming pregnant and obtaining good prenatal care will help to ensure a healthy outcome for both mother and baby.
Source: Yahoo News
August 26th, 2007
Several decades ago, doctors routinely told their pregnant patients to gain about 25 pounds but no more than 35 pounds. Today, however, more expectant mothers may already be overweight or obese before conceiving. In these instances, weight gain guidelines should be reduced.
According to the March of Dimes, carrying too much weight while pregnant increases risks to mother and baby. These complications can include birth defects, problems with labor and delivery, death of the fetus, or delivery of very large babies. Overweight mothers are also more likely to produce babies who are too heavy as toddlers.
Setting appropriate pregnancy weight gain guidelines can be aided by referring to the woman’s body mass index (BMI) at the time she conceives. BMI is a combination of height and weight. Women with a “normal” body mass index are still encouraged to gain between 25 and 35 pounds. Women who are especially thin may be encouraged to gain up to 40 pounds. For those with a higher BMI (over 26), 15 pounds of weight gain may be more appropriate.
In 2003, about 1 in 4 expectant women in the U.S. gained more than 40 pounds during their pregnancy, up from 1 in 5 in 1990. Many women are putting on 50 or 60 pounds with their pregnancies, which can cause complications such as gestational diabetes. Obstetricians point out that an obese woman already has stored nutrients and does not need much additional weight to provide for her developing baby.
Women would do well to get their weight under control before becoming pregnant. Once conception has occurred, eating a healthy diet and engaging in moderate exercise are important for both mother and developing child.
Source: CNN.com
August 17th, 2007
Results of recent studies have revived the controversy over circumcision in infants. The U.S. leads the way in holding to this practice, although in the past decade or so, the surgical procedure has declined. A 1999 survey of hospital records found circumcision rates varying widely by region — 81% in the Midwest, 66% in the Northeast, 64% in the South and 37% in the West.
In Europe, Asia, and Latin America, baby boys are not routinely circumcised, however Jewish and Muslim faiths traditionally subscribe to circumcision. Recent international studies have cast new light on the subject. Two trials held in Africa involving more than 7,500 men were stopped early because results showed that circumcised adult males had a 51% to 60% lower rate of contracting HIV, the AIDS virus, than their uncircumcised counterparts.
Researchers believe that the warm, moist area under foreskins of uncircumcised men can breed infections. Lifestyle and personal cleaning habits may have more impact on health, however, than the surgical removal of foreskin. In some areas of the world, clean water and soap may not be widely available, and in these areas, circumcision may make sense.
Doctors in the U.S. are split in their opinions on the potential benefits of circumcision. Those opposed believe that circumcision does unnecessary violence to the infant’s genitals, and that the decision should be left to the male in adulthood. Furthermore, they believe that removing a baby boy’s foreskin might diminish his sexual pleasure when he becomes sexually active.
Doctors who favor the procedure point out that studies over the years have shown circumcised males to have lower rates of urinary tract infections, penile cancer (a rare condition), and a variety of sexually transmitted diseases (STDs). Circumcised baby boys have fewer urinary tract infections and possibly other problems, but these can be treated with antibiotics or other strategies if needed.
Tradition, religion and philosophical beliefs will continue to be factors involved in the emotional choice involving circumcision. In the final analysis, it is up to the parents, guided by information from their baby’s doctor, to make the decision.
Whatever parents decide for their newborn sons will probably be fine, as there appear to be advantages and disadvantages either way. When in doubt, why not leave the penis intact and let the individual decide as an adult?
Source: MSNBC
March 5th, 2007
An 18-month study of over 2,000 healthy women ages 18 through 49 who were given continuous-use oral contraceptives to prevent menstruation has been shown to be safe and effective.
Among the study participants, 79% percent had progressively decreasing bleeding days, with an absence of bleeding after one year. In 59%, a complete cessation of menstrual cycles occurred soon after the first month.
Lead investigator David Archer, M.D., a professor of obstetrics and gynecology at Eastern Virginia Medical School, expressed excitement over this “significant improvement in the quality of life for women.” The study can be found in the December issue of Contraception.
Dr. Archer asserts that for the first time, continuous-use oral contraceptives have been shown to safely eliminate menstrual bleeding and the symptoms associated with it — cramping, headaches, bloating, and irritability.
The study was conducted at 92 sites in North America where researchers dispensed to participating women a birth-control pill produced by Wyeth Pharmaceuticals under the name Lybrel. The new birth control pill contains 20 micrograms of ethinyl estradiol and 90 micrograms of levonorgestrel.
Traditional birth control pills contain 21 days of active hormones and 7 days of placebos (no hormones) to provide contraception while the woman continues to have monthly periods. More recently, birth control pills that reduce menstruation to four times a year have been on the market.
Now, women can be free of the monthly “curse,” until they are ready to conceive. As the name Lybrel implies, women can choose to be “liberated” from the discomfort and inconvenience of unwanted menstrual cycles.
Source: Medical News TODAY
December 18th, 2006
A new mother faces a number of challenges after her baby is born, especially if it is her first child. During the first three months, and especially the first 10 to 19 days, a new mom is particularly vulnerable to mental problems. Not only postpartum depression, but potentially bipolar disorder (experiencing highs and lows), anxiety, adjustment problems, and even schizophrenia can visit her at her most vulnerable time.
Today, a woman may be isolated, away from the support of families that she might have called upon in generations past. Her hormones are fluctuating wildly during those first weeks and months after birth. Sleep deprivation and learning to breastfeed on demand may place additional strains on her ability to function and interact lovingly with her newborn.
When the tremendous responsibility of caring for an infant becomes a daily reality, a new mother may experience unanticipated feelings. She needs a strong support system to help her get past the initial “baby blues.” Her mental health greatly affects her ability to function well, enjoy relationships, cope with the stresses, and appreciate the joys of parenthood that she anticipated.
A Danish study based on medical records of 2.3 million people over a 30-year period revealed that new mothers were seven times more likely to be hospitalized for mental problems shortly after childbirth than women with older infants. Some received outpatient psychiatric treatment.
New fathers are sometimes affected by the mental adjustments in the changed family dynamics, but they are not subjected to the same physical and social changes associated with actually giving birth to a child. The prevalence of mental disorders appeared in about 1 per 1,000 births for women and only .37 per 1000 men in the Danish families studied.
There is no hard data on women in developed countries worldwide affected by postpartum depression, but in the U.S. alone, this condition occurs in about 15% of new mothers. Most had no previous history of mental illness.
Psychiatric screening of new mothers and treatment for those who need it would be highly beneficial. They may initially need antidepressant medications to help them get past the most difficult periods of adjustment. Brooke Shields’ book on the subject can assist depressed new mothers in understanding that they are not alone, and their condition will clear up with time and with treatment when necessary.
Source: CNN.Com
December 8th, 2006
A British study of 9,000 youngsters monitored from birth to age 10 strongly suggests that breast-fed infants are better able in later life to cope with stressful situations than bottle-fed babies. It is thought that breast-feeding influences development of pathways in the body linked to the stress response. For example, anxiety appeared to be less in breast-fed babies when their parents later separated or divorced.
Other benefits of breast-feeding a child have long been known. Breast milk contains nutrients, hormones, enzymes, growth factors and antibodies that mothers pass to their child. Research has shown that breast-feeding reduces infections, respiratory illness and diarrhea in babies.
Although the benefits of breast-feeding are confirmed in study after study, a Finnish study of 200 mothers and their babies revealed new information about the optimal length of breast-feeding.
Babies who were breast-fed up to six months seemed to avoid early allergies that more frequently developed in young children whose mothers nursed them for nine months or more. The hypothesis is that after a certain time frame, the immune system needs exposure to external antigens to develop properly.
Allergic reactions appeared earlier in children exclusively breast-fed for longer than nine months. When weaned by six months, children’s allergies occurred in later childhood and early adulthood and seemed to be influenced by pollen exposure, diet and disease.
Sources: Reuters August 4, 2006; NewScientist.com
Technorati Tags: Breast Feeding, child birth, Womens Health
August 16th, 2006
A study of 50 women given a drug combination to help prevent recurrent miscarriages and 52 untreated women showed better outcomes in the group receiving drug therapy.
Clinical researchers at the University of Vienna School of Medicine were encouraged by results in the treated group compared to untreated women of similar age and number of miscarriages.
In those receiving high-dose, low duration prednisone and aspirin, progesterone and folate in early pregnancy, 77% gave birth, compared to 35% in the untreated group. In the treated women, 19% miscarried in the first trimester, compared with 63% in the comparison group.
None of the treated women miscarried in the second trimester, while 2% of untreated women did. In addition, the treated group did not show a higher rate of preterm birth or fetal growth restriction.
Recurrent miscarriage is defined as at least three consecutive spontaneous miscarriages before 20 weeks of gestation. While many women have unknown causes, contributory factors to spontaneous pregnancy loss are higher maternal age, smoking, and drinking.
Study results were published in the journal Fertility and Sterility. Researchers concluded that this particular drug regimen increases a woman’s chances of having a baby after experiencing repeated miscarriages. More trials are called for to confirm these results.
Source: MSNBC
Technorati Tags: Miscarriage, Womens Health, Pregnancy, Treatment
August 3rd, 2006
Even in the first trimester of pregnancy, a class of blood pressure medications called ACE inhibitors may not be safe for the developing fetus. In a new study of nearly 30,000 pregnant women, 7% of babies born developed severe birth defects when their mother took an ACE inhibitor drug early in pregnancy.
A black box warning already alerts women not to take them during the second and third trimesters. The risk of developing birth defects was shown to be three times as high in women taking part in this study.
Defects found in babies of women taking ACE inhibitors in early pregnancy involved the heart (33%), limbs or face (25%), kidneys (no numbers given), brain or spinal cord (10%). Many of these problems are curable with surgery, while others can cause permanent disability or retardation.
ACE inhibitors are the second most commonly prescribed type of medications in the U.S., with 149 million prescriptions written last year. Hypertensive women attempting to become pregnant should ask their doctors for a different type of blood pressure medication.
Among those who took another anti-hypertensive drug, only 1.7% had babies with defects. Women in the group taking no blood pressure medicine had birth defects in 2.6% of babies.
More information is needed about the safety of ACE inhibitors during early pregnancy. In the meantime, women trying to conceive would be advised to stay away from this category of drugs to control high blood pressure. If possible, they should attempt to achieve healthy levels of blood pressure before getting pregnant.
Source: San Francisco Chronicle, June 8, 2006 (from an article by David Brown appearing in the Washington Post)
June 19th, 2006
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