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
In the past, only pregnant women age 35 and older were given a test for Down syndrome, a complication that is more likely to occur in older women. The long-utilized procedure involved amniocentesis, in which samples of amniotic fluid were withdrawn by needle for lab testing. This invasive procedure, usually administered in the fourth month of pregnancy, carried some risk, including the potential loss of the fetus.
Today, a variety of less invasive tests are widely available. Some can detect in the first trimester of pregnancy any evidence of Down syndrome or other chromosomal defects in the developing fetus.
In late December 2006, the American College of Obstetricians and Gynecologists recommended that every pregnant woman, regardless of age, be given a choice of tests for Down syndrome. Mothers-to-be can now have peace of mind without the ordeal of unnecessary amniocentesis. The new policy will also facilitate the detection of Down syndrome in mothers who would have gone unchecked under the “35-plus” guideline.
Age 35 was always an arbitrary threshold for testing pregnant women for Down syndrome, a condition in which an extra chromosome causes mental retardation. A baby with this condition is characteristically born with a broad, flat face and small head. Sometimes, serious heart defects are also present.
About one in 800 babies is born with Down syndrome. Down syndrome is more prevalent in pregnancies of women over 35. At age 25, the risk is about one in 1,200. By age 35, the chances are closer to one in 300. More Down syndrome babies are actually born to younger women than to older ones, as fewer women over 35 are still having babies.
The decision to do away with the previous age 35 guidelines was made because of the great improvement in screening tests. The January issue of the journal Obstetrics & Gynecology is publishing the new recommendations for testing of pregnant women.
Source: Oakland Tribune; Lauran Neergaard (from Associated Press story); Dec. 31, 2006
January 2nd, 2007
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
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: 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
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