Articles filed under 'Pregnancy & Birth'
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:Â CNN.ComÂ
December 8th, 2006
When researchers in London studied 600 adult women who had miscarried and 6,000 with successful pregnancies, they discovered that very underweight women were 72% more likely to miscarry during the first three months. Those with a body mass index (BMI) below 18.5 were especially prone to miscarry.
The causes of miscarriage are not fully understood. Well-established risk factors include increased maternal age, a history of previous miscarriage, and infertility. Other factors such as alcohol use, smoking, and extreme emotional stress might play a role, as well as excessive caffeine intake. Eating small amounts of chocolate daily may actually be beneficial, according to the study.
In study participants, women who had a previous abortion or those who got pregnant through in vitro fertilization (IVF) were 60% and 40%, respectively, more likely to lose the baby in the first trimester. On the other hand, those who had a “planned†pregnancy increased their chances of carrying the baby to term by 60%. Additional findings were that morning sickness may actually be a good sign, an indication that the pregnancy is progressing well.
 Women who on most days ate fresh fruit and vegetables appeared to have a better outcome than those whose meals did not regularly include them. Of special importance, women who supplemented their diet with folic acid and iron, or vitamins containing them, showed the most pronounced benefits – cutting their risk of miscarriage in half.
In the United Kingdom, about 1 in 5 pregnancies end in miscarriage each year. Researchers intended this study to provide helpful information to the thousands of women who do not understand why they miscarried and to suggest ways to prevent it in the future.
Whenever possible, women who want to become pregnant are encouraged to do pre-pregnancy planning with their doctor. Any existing medical conditions such as excessive thinness, obesity or diabetes should be treated and if possible controlled before conception is attempted. After conceiving, it is important to have the pregnancy followed by a physician.
The findings of this study are published in the British Journal of Obstetrics and Gynecology.
Source:Â BBC News
December 6th, 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
When you hear the term “postpartum depression,†you may immediately think of the extreme sadness that sometimes affects women after childbirth. It may surprise you to learn that while 14% of new mothers are afflicted with the condition, about 10% of fathers can also experience moderate or severe postpartum depression.
A study of 5,000 two-parent families with a child nine months old revealed that depression in new fathers was more than twice as common as in the general male population. The study, published in the August issue of the journal Pediatrics, indicated that depression can start two to three weeks after birth and may last up to a year or longer if untreated.
Fathers with this condition are less likely to interact positively with their child through playing, reading, telling stories or singing songs to their child. In addition, it is difficult for them to be supportive of the child’s mother.
When both mother and father are depressed, their new baby is more apt to be exclusively bottle-fed and put to bed on its stomach instead of on its back, now recommended as a safety measure for infants.
The father’s happy interaction with his new baby is necessary for the child to develop cognitively and emotionally in normal ways. Depressed new fathers are more likely to be irritable, aggressive, and sometimes hostile to the infant and the child’s mother.
The depressed new father may feel burdened or trapped by the financial responsibility of a first or additional child. He may also miss the closeness he previously had with the mother. For some husbands, it may feel as though an intruder has come into the couple’s marital relationship or that his own needs are being neglected.
Talking with a doctor, counselor, psychologist, or social worker can help to make a diagnosis and determine whether depression exists and whether it should to be treated. Severe postpartum depression is not just “baby blues†caused by the fatigue of meeting new demands. In serious cases, it manifests itself in severe sadness or emptiness, withdrawal from family and friends, or a sense of failure. There may even be thoughts of suicide in extreme cases.
If your husband is displaying symptoms of depression, gently approach the subject. You might say, for example, “I believe you have been depressed since our baby was born.†Let him know that it is almost as common for men to suffer postpartum depression as it is for women.
After talking openly about the subject, you may both want to seek help. All of you will benefit in doing so.
Source: WebMD
Technorati Tags: postpartum depression, child birth
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:Â San Francisco Chronicle, June 8, 2006 (from an article by David Brown appearing in the Washington Post)
June 19th, 2006
Women who have abnormal Pap or cervical smear tests are usually sent for further investigation. Doctors use one of four different techniques to remove suspicious cells for further examination. All have been shown to be equally successful in preventing progression to cervical cancer. Women should be aware, however, that three of the techniques carry a small risk of complications with a future pregnancy.
In Great Britain, researchers from the Royal Preston Hospital in Lancashire analyzed results from 27 studies. They looked at various treatments used to remove abnormal cells and sometimes a margin of healthy cells around them. Their conclusions were published in the Lancet medical journal.
Laser ablation, which destroys the abnormal cells, was the only treatment not linked to any pregnancy risks. Cold knife conisation uses a scapel to remove a cone-shaped wedge of tissue, and laser conisation employs the laser to do the same thing. Researchers found that in subsequent pregnancies, cold knife conisation increased the risk of giving birth prematurely, of having a low birthweight baby, or needing a Caesarean. Laser conisation had similar risks, although not to the same extent.
The most common procedure, called LLETZ (large loop excision of the transformation zone), removes the area with abnormal cells from the cervix by employing a small tool and electric current. This procedure was also found to raise the risks of having a premature or small baby. In addition, it increased the chances of early rupturing of membranes.
Professor Peter Sasieni, a UK cancer research expert, stressed the importance of women being aware of potential side-effects. They should discuss various options with their doctor prior to treatment for cervical precancerous cells. The most important consideration is that a woman gets the treatment she needs to prevent cervical cancer. The chances of pregnancy risks are very small, he concluded.
Source:Â BBC News
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May 10th, 2006
More American women than ever are giving birth by C-section delivery, now accounting for 30 % of all births in the U.S. In the past decade, the rate of C-section births has doubled, despite the Center for Disease Control’s goal to lower the rate to 15 % among first-time mothers. Only about one in 10 of these surgical deliveries is estimated to be “elective.â€
C-sections are major abdominal surgeries, once performed as a last resort during a medical emergency. Yet, their numbers continue to climb for a variety of reasons.
Today, some women want the convenience of scheduling their delivery day, while others choose to avoid labor pains. A doctor may recommend a C-section due to fear of malpractice lawsuits stemming from vaginal deliveries. Obstetricians are more likely to operate if a baby is in the breech position or if the mother has had a previous C-section. Â
Experts do not agree on the amount of risk inherent in extracting a baby through incisions in the mother’s abdominal wall and uterus. Associated potential risks include bleeding and infection, as well as problems with anesthesia. Hospital stays are also longer following a Cesarean delivery.
The more C-sections a woman has, the more her chance of hemorrhaging during delivery or requiring a hysterectomy after the birth. Serious complications are usually rare and primarily occur during emergency surgery, says Dr. Gary Hankins, chair of the American College of Obstetricians and Gynecologists’ Committee on Obstetrics Practice.
He points out that vaginal childbirth can also pose risks such as tears and pelvic damage, problems which generally are temporary.
Following a 1996 British study, in which incontinence and sexual problems were thought to be more common after vaginal birth, more women began to opt for a C-section delivery.
Recent evidence contradicts those earlier findings. Myths about childbirth are still influencing women’s choices. It is important to replace them with strong scientific evidence, according to a presenter at a recent National Institutes of Health conference.
Newsweek magazine; April 3, 2006, page 45.
April 6th, 2006
Most miscarriages occur during the first few weeks of pregnancy. Sometimes women aren’t even aware they were pregnant.
They may think they were having an unusually heavy menstrual period. The cause of miscarriage is often due to health problems with the mother or defects in the developing fetus.
In a small study of 61 married women aged 18-32 in rural Guatemala, researchers measured cortisol levels in the women’s urine three times a week.
Measurements of this hormone produced by stress began before the women got pregnant and continued for three weeks post pregnancy. Over a year, 16 of these women had 22 pregnancies, in which 9 of them resulted in live births and 13 resulted in miscarriages.
This study found that miscarriages were 2.7 times more likely among women with high cortisol levels. Ninety percent of the women with high cortisol experienced miscarriages in the first three weeks of their pregnancy. Only 33 percent of women with normal stress levels miscarried in the first three weeks.
Researchers are calling for bigger studies to determine whether maternal stress contributes to miscarriage. Cortisol in the urine could indicate that a woman’s body isn’t in the best condition to carry a child to term.
Source:Â WebMD. Inc.;Â (original article by Miranda Hitti and reviewed by Louise Chang, M.D.); 2/21/06; Dr. Dean Edell, San Francisco-KGO weekday broadcasts.
March 30th, 2006
Accutane is a highly effective drug to treat severe acne, but it has disastrous consequences if a woman becomes pregnant while taking it. The drug has been linked to miscarriages and severe birth defects. The system, called iPledge, set up to guard against such possibilities is flawed. Each year, hundreds of women who receive prescriptions from their physicians for Accutane become pregnant while taking it.
The Federal government has vainly tried over the last two decades to institute safeguards against pregnancies in women on Accutane. The iPledge system requires women to take pregnancy tests and to be on birth control. Doctors complain that this inconvenient, cumbersome process is often impossible to manage.
The iPledge program is flawed, in some cases requiring pregnancy tests for male patients. Confusing instructions, lengthy delays in responding to complaints, and extensive waiting time on the telephone help line are common problems.
Some doctors advocate more regulation of Accutane. Others are fearful that the drug will become unavailable for the 6,000 patients — most of them male — with severe, disfiguring acne. For them, Accutane is a near-miraculous cure.
Physicians write more than 170,000 Accutane prescriptions each month, half of those for women.
Dr. Sidney Wolfe, director of health research at Public Citizen, complains that dermatologists are prescribing Accutane to “way too many people.†For this reason, he believes that efforts to limit pregnancies have failed.
Many dermatologists emphasize that Accutane can transform the lives of patients with even mild forms of acne by restoring their self-esteem. The controversy continues and may ultimately result in having Accutane withdrawn from the market.
New York Times, 2/11/06; from an article by Gardiner Harris
March 19th, 2006
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