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Brenda Lane's BlogPosted by Brenda Lane If you live near a major highway, have you ever wondered how it may affect your pregnancy? Well, new research from Quebec published in the Journal of Epidemiology and Community Health studied whether living close to a highway might interact with both socioeconomic status and education level to affect birth outcomes. The study population came from all live births registered in Montreal for a 4 year period from 1997 to 2001. They found that among all the mothers who live within 200 meters of a major highway, they were 14% more likely to have a pre-term birth and 17% more likely to have a low birth weight baby in comparison to mothers living farther away. Researchers also discovered that among affluent women living within a 200 meter proximity to a major highway, the risk of pre-term birth was 58% greater as well as a 81% increase in having a low birthweight baby and a 32% increase in a small-for-gestational-age baby as compared to mothers from other socioeconomic categories. No one really knows why wealthier mothers would be at greater risk from exposure to highway pollution. One possible explanation is that lesser affluent mothers are often exposed to additional factors such as secondary smoking, poor nutrition and even domestic violence so that the exposure from highway polution may not be as great. Brenda Posted by Brenda Lane Many women suffer from striae gravidarum, otherwise known as stretch marks, during pregnancy. Products containing cocoa butter, typically in lotions or creams, have been claiming for years that they can prevent stretch marks from occuring. A recent study published in the International Journal of Obstetrics and Gynecology attempted to discover whether or not cocoa butter is an effective topical cream to prevent stretch marks. Researchers in Beirut, Lebanon had 200 mothers participate in the study. Half were given a topical cream containing cocoa butter, the other were given a placebo. They were instructed to apply the cream daily, starting in their first trimester and continuing throughout their pregnancy. Results showed no difference in the mothers who used the stretch mark cream versus the placebo. Some mother do find that applying rich creams helps the itchiness of their skin during pregnancy, but remember that it will not prevent stretch marks from happening. Brenda Posted by Brenda Lane Fish oil appears to be have many advantages to our health including cardiovascular benefits, reduction of cancer and reduced pain and inflammation. During pregnancy, consumption of fish oil has been shown to be linked with increased IQ in the baby. After birth, fish oil may help to reduce postpartum depression. Researchers are now finding that when mothers take fish oil supplements, they can reduce their baby's risk of developing asthma. Over 500 mother-child pairs were followed over a 16 year period. Mothers were given either fish oil, olive oil or nothing daily during the last 10 weeks of their pregnancy. Results showed that at the age of 16, the children whose mothers had been given fish oil supplements were 63% less likely to have asthma, and 87% less likely to have allergic asthma than the children whose mothers did not take fish oil. This is yet another reason to include this important supplement in your diet! Brenda Posted by Brenda Lane Tearing during the pushing stage of childbirth is common. Even though some mothers may have an intact perineum or have tears that are so minor that they do not require stitches, often some amount of repair is required. Typically repairs to the mother's perineum are done very shortly after birth. However new research suggests that waiting for as much as 12 hours, even with deep tears into the anal sphincter, does not result in any additional risk to the mother. Swedish researchers looked at 165 mothers who were randomly assigned to either an immediate repair group or a group that waited 8-12 hours to receive repair for tears into the anal sphincter. Over the following year, there were no differences in incontinence between the two groups and researchers concluded that there was neither benefit or harm by waiting for as much as 12 hours after birth to repair deep tears. Be sure you discuss ways to decrease tearing during birth with your care provider. You can also increase your chances of an intact perineum by using perineal massage. Brenda Posted by Brenda Lane August in the mid-Atlantic region of the U.S. where I live can be gastly. It is not uncommon to see temperatures in the upper 90's to lower 100's. With fuel prices as they are, many people this year will be trying to conserve more. However being pregnant also can add as much as 1 degree to a mother's basal body temperature! So how can you stay cool and beat the heat of the summer? Here are a few suggestions: 1. Install ceiling fans in every room. Circulating the cooler air will help keep the temperature down. 2. Keep yourself hydrated. And be sure to bring bottled water or other non-carbonated beverages with you to keep cool. 3. If you are out driving, find shady areas to park if possible. 4. Try keeping your air conditioning set at a higher temperature and leave it there. In some cases you may be able to remain cool enough with ceiling fans even at a higher a/c termperature of 75-78 degrees. 5. If the temperature is over 100, you may be better off staying indoors altogether. Do you have other ways to stay cool during pregnancy? Let us know on the forum. Brenda Posted by Brenda Lane There is much in the literature today about how many pounds women should gain to maintain a healthy pregnancy. Research now shows that mothers who gain too much may be increasing their child's risk of obesity. A retroactive study on over 10,000 mothers who gave birth betwen 1959 and 1965 and their children (who were followed until the age of 7) participated in the study. Interestingly this study was conducted to examine the risk factors for cerebral palsy but since the question of weight gain during pregnancy was included, this research was also found. Children whose mothers gained more than the recommended amount of weight were 48% more likely to be over their ideal weight at the age of 7. For more information on healthy eating during pregnancy, be sure to look over the article in the nutrition series. Brenda Posted by Brenda Lane The online issue of BMC Pregnancy and Childbirth has published a clinical trial that examines the effectiveness of self-help techniques for mothers who have back pain issues as a result of pregnancy. Findings from this Dutch study showed that mothers did better by learning self-management techniques offered by a physical therapist. The physical therapist in the experimental group addressed specific issues such as how to hold the baby when their back was causing them pain, however they were allowed to choose the exercises they found the most helpful. The control group could seek advice from a doctor, receive physical therapy or do nothing. At 3 months, there were significant differences between the two groups. The mothers who received specialized care had less pain, returned to work sooner, and had fewer physical limitations than those with standard care. There were no differences between the two groups at one year postpartum. Brenda Posted by Brenda Lane Experts now agree that there are few, if any, benefits to the mother when care providers perform an episiotomy during labor. And in fact the case to avoid doing episiotomies just got even stronger. The June issue of Obstetrics and Gynecology has published a study that indicates that doing episiotomies previously was more likely to cause tearing in subsequent births. Over 6,000 mothers were included in the study from 1995 to 2005 with nearly 50% of the total having had episiotomies. Only 26% of the mothers who did not have an episiotomy the first time ended up with a second degree tear, while over 50% of the mothers with episiotomies had second degree lacerations with later births. Researchers found that having a prior episiotomy was a significant risk factor for both second degree tears as well as deeper tears, such as third or fourth degree lacerations. If you are interested in reducing your chances of tearing, talk to your own care provider about this research and other ways to avoid an episiotomy. Brenda Posted by Brenda Lane It has long been known that there are correlations between pregnancy and dental health. Studies have shown that poor dental health can lead to preterm labor. New evidence now shows that the more children a mother has, the more likely she will have missing teeth. The trend seems to hold across racial and socio-economic boundaries among American women. Dr Stefani Russell explains that there may be a cause and effect result from pregnancy and dental health in the following areas:
So word to the the wise mothers out there, take good care of your own teeth when you are trying hard to take care of your families! Brenda Posted by Brenda Lane If you are the average mother today, you will be in the early part of labor for many hours. Even active labor can be on average 4-6 hours, not to mention pushing for another 2 hours. Mothers often find that their stamina quickly diminishes and motivation to keep going becomes harder to find. One thing that makes a long labor harder is not being able to eat or drink during labor. The American College of Nurse Midwives (ACNM) has recently released a clinical bulletin that says that restricting a mother's intake of food and drink does not always benefit her. In addition to hydration and nutrition, knowing you can drink and eat as you please provides the mother with a sense of control and can decrease her stress level. Even many anesthesiologists now recommend that clear fluids should be allowed for women during labor. ACNM does recommend that the woman's health status be considered in whether or not it is advisable to eat and drink. Be sure to discuss the option of eating and drinking during labor with your caregiver prior to your due date. Brenda Posted by Brenda Lane While experts have known for many years that smoking causes the adult woman to reach menopause sooner than a non-smoker, new research indicates that the effects of chemicals can also have long-range consequences for the female baby after she is an adult. Scientists believe that smoking not only interferes with the mother's estrogen production, thereby reducing her production of ovarian follicles, but they could also affect the development of the follicles in utero. Yet one more reason for why smoking is clearly a substance to be avoided during pregnancy. If you are just finding out that you are pregnant and you are a smoker, please consider quitting now! Or if you live with a smoker, try to reduce your exposure to secondary smoke as much as possible. Brenda Posted by Brenda Lane The issue of cesarean delivery on maternal request (CDMR) or elective cesareans without an indicated risk, has been one that seems to have growing attention worldwide. From celebrities to average women across many cultures, cesareans on maternal request appear to be increasing. Research over a 12 year period in 21 countries in Southeast China indicates an increase in cesareans from 22% in 1994 to 56% in 2006. The greatest contributor to the overall cesarean rate, experts believe, is the rising numbers of cesareans on maternal request. This statistic of CDMR has shyrocketed from .8% to 22% from 1994 to 2006. Interestingly, the requests for elective cesareans were not dependent on the mother's age, hospital of choice or occupation. One has to wonder why we are seeing this trend in other countries and how we have come so far from recognizing the benefit of vaginal birth as our bodies were designed for. Brenda Posted by Brenda Lane Not long ago, I attended an amazing birth that demonstrated yet again how mothers can indeed beat the odds stacked against them and have the kind of birth they want. It does require some work, prior research and good support. However, no matter where you choose to have your baby, there are simple ways you can advocate for yourself. 1. Ask for more time. If you are rushed into making any decision, be sure to ask if waiting for an hour or longer is possible. 2. Distinguish between true emergencies and routines. If your care provider recommends something, is it because there is a problem or a true indicated risk to you or your baby? Or is it something that is a routine procedure? Find out before you agree to something that may have an irreversible outcome. 3. Use additional support. It is hard to not be biased in this recommendation given that I am a doula myself and I believe wholeheartedly in the value of having a birth doula present. Very often having an additional person there to faciliate dialog can be a huge advantage to parents. Not only that, but birth doulas are skilled in comfort techniques and way to help labor progress. To me it is a no brainer that more parents need to use a doula since without the support and knowledge, there are seldom any options. 4. Don't be afraid to advocate for yourself. This is your day, your birth and your baby! There are very few events in your life that are more important so be assertive even if it requires you that you need to step outside your comfort zone. My heartfelt desire is that all of the expectant mothers reading this blog would have the kind of birth they want. Warmly, Brenda Posted by Brenda Lane What affect does stress have on your pregnancy or on your growing baby? Research tells us that there may be a link between stress and your baby's likelihood of developing allergies and asthma. Babies whose mothers reported more stress during pregnancy had increased levels of lgE. lgE is an antibody that is present during both asthma and allergies reactions. One of the study's authors, Dr. Peters, speculates that stress might make women more susceptible to allergens because it "may make the cells more permeable." In this case, even a low level exposure could trigger a reaction. It is quite possible that mothers whose immune systems are altered by stress could pass that tendency down to their babies. Yet one more example of how important it is to remain healty and as stress-free as possible during pregnancy! Brenda Posted by Brenda Lane If you are pregnant or breastfeeding, you are more than likely exposed to at least one type of medication prescribed by your physician or medical caregiver. Now the FDA is recommending that prescription drugs carry more comprehensive information about the effects of medications so that providers can provide more accurate and detailed information to their pregnant or breastfeeding patients. According to the new FDA report, "The proposed rule outlines what important information about the use of medicines during pregnancy and breast-feeding would be required to be added to product labeling for newly approved drugs. Under the proposal, drug labeling would explain, based on available information, the potential benefits and risks for the mother and the fetus, and how these risks may change during the course of pregnancy." The new proposed labeling would include three parts: 1. Fetal Risk Summary - describing known drug effects on the baby. 2. Clinical Considerations - potential effects of the drug if the mother takes it before she knows she is pregnant. 3. Data - more information on the use of the drug in human and animal studies that were used to identity the Fetal Risk Summary. The new recommended labeling can only help women and their babies be more educated about drug effects and other potential things to avoid during pregnancy. Brenda Posted by Brenda Lane It is generally understood that as soon as women become pregnant, alcohol is considered to be off-limits. Experts do not recommend any levels of alcohol that are safe so mothers are told that she should plan to avoid consuming alcohol at all during pregnancy. Given that recommendation, it is interesting that a new study has shown that mothers may not be telling the truth about their own alcohol use. Swedish mothers were asked to complete a questionnaire about alcohol use and urine and hair samples were taken. About 25% of the mothers who participated were identified as potential alcohol consumers. While only 1 mother indicated that she was a heavy user of alcohol, 7 mothers were identied as heavy alcohol users by the urine and hair samples. This study seems to indicate that, despite warnings to the contrary, as many as 1 in every 4 mothers are drinking some alcohol and a few are even drinking substantially during pregnancy. Brenda Posted by Brenda Lane Many mothers suffer from nausea during pregnancy. Some of them develop a severe form of morning sickness also known as hyperemesis gravidarum. One of the biggest risks of hyperemesis is dehydration resulting from severe naseau and vomiting. Hyperemesis may even require medication and hospitalization for IV fluids. While experts do not know the exact cause of nausea during pregnancy and treatment does not work the same for each person, new research is showing that mothers who are underweight prior to becoming pregnant are at a greater risk for hyperemesis. About 900,000 mothers took place in a Swedish study that compared the use of anti-nausea mediation and hospitalization in the following three groups: underweight, normal weight and over ideal weight mothers. The results indicated that mothers who are under the ideal weight are more likely to use medication and require hospitalization for hyperemesis. The group with the least risk for hyperemesis was the group of mother over their ideal weight. Brenda Posted by Brenda Lane Are you expecting a baby and concerned about your risk for postpartum depression? Perhaps you have had depression prior to becoming pregnant or even during your pregnancy. You might also be wondering about how potentially having postpartum depression could affect your ability to parent your baby. While there are many risk factors for postpartum depression, new research indicates that women who have reported symptoms of depression during late pregnancy are more inclined to have postpartum depression (PPD). In addition, PPD is one of the most common causes of stress for new parents. If this news sounds like doom and gloom, remember that there are numerous treatment options for PPD as well as many ways to find support that you may need in the postpartum period. Many new mothers find that support from friends, family and/or a postpartum doula can go a long way to give you the confidence you need when you are feeling most vulnerable after giving birth. Warmly, Brenda Posted by Brenda Lane Fascinating research is showing that there may be correlations between the mother's diet and whether she conceives a boy or girl. Over 700 first time mothers participated on the study. Results showed that 56% of the highest calorie intake group at the time of conception gave birth to males, while only 45% gave birth to sons in the lowest calorie group. In terms of survival, researchers say that this makes sense. "If a mother has plentiful resources then it can make sense to invest in producing a son because he is likely to produce more grandchildren than would a daughter. However, in leaner times having a daughter is a safer bet," researchers report. So if a mother skips meals or is on a diet when she conceives, her body may read that as a sign that food sources are low since it lowers her levels of blood sugar. Brenda Posted by Brenda Lane Today is a day that we recognize the role our mothers have played on our lives. These are the amazing women who sacrificed much over the years, from the loss of sleep to making sure we had new shoes for school in the fall. Some of us may have had a special relationship with an older woman who acted as a mother to us. Many of these women dedicated their time to helping us in any way we might have needed support. All of these wise older women in our lives have taught us, shaped us, encouraged us and loved us. If you have someone special in your life who was either your own mother or acted as a mother to you at any point in your life, be sure to contact her today to say "thank you" for everything she has done for you. To all of the amazing and wonderfully wise women and mothers out there, "Happy Mother's Day!" Brenda Posted by Brenda Lane Are you on an exercise program during your pregnancy? Perhaps you are wondering if it is safe for you and your baby to continue to exercise. Not only does exercise benefit you in terms of toning your body for the long hours of labor, but it can have added benefits to help prevent preterm labor and birth. This new study done was conducted over a six year period with over 80,000 mothers. About 1/3 of the mothers in the study reported that they engaged in low inpact exercise such as swimming, walking, hiking or bicycling during their pregnancy. Researchers discovered that the mothers who did have regular exercise were less likely to give birth preterm than those that did not. Be sure you are carefully following exercise guidelines especially if you are very active during pregnancy. Brenda Posted by Brenda Lane A case report in the April 2008 issue of the American Journal of Obstretrics and Gynecology describes that injuries can occur to the baby as a result of the use of vacuum extractors during a cesarean. An online abstract of this case report is as follows, "The use of a vacuum device as a routine procedure at the time of repeat cesarean delivery was associated with major fetal intracranial hemorrhage. In the absence of clear evidence of benefit, the routine use of vacuum extraction at the time of cesarean delivery is not justified, given its potential for serious fetal injury."If you expect to have a cesarean or you want to avoid the risks associated with a vacuum extraction due to an unplanned cesarean, please consult with your primary provider to share your concerns with them prior to having your baby. Warmly, Brenda Posted by Brenda Lane As women progress in their pregnancies and become more bulky and uncomfortable, wearing a seat belt can become more restrictive. Mothers may even admit that they can't stand the tightness of the seat belt around their tummies in the last few weeks of pregnancy. However, now there is good reason to keep those seat belts fastened around you during your entire pregnancy! New research published in the April issue of the American Journal of Obstetrics and Gynecology has shown that in car collisions, not wearing a seat belt increased the risk of death to the unborn baby. Findings showed that if a mother wears her seat belt and she is in a severe motor vehicle accident, she can reduce the chance of her baby dying by 50%. For all of us who have been in severe car accidents, including myself, wearing a seat belt all the time whether pregnant or not, clearly saves lives. Brenda Posted by Brenda Lane There is a common myth among pregnant women that having a cesarean is safer for both mothers and babies. Rather than go through the unpredictable hours of labor and giving birth vaginally, a cesarean is a controlled and safer option with little short-term or long-term risk. The truth is that cesareans are major abdominal surgery. In fact, it is more likely for the mother to suffer from minor complications as well as major health risks after having a cesarean. New research in the latest issue of the American Journal of Obstetrics and Gynecology has indicated that mothers increase their chances of having a stroke within the first year after having a cesarean. The risk of stroke after a cesarean was 1.67 times greater after 3 months, 1.61 times greater within 6 months and 1.49 times greater within 12 months after having a cesarean. Researchers concluded that a cesarean was an independent risk factor for stroke. If you are considering having a cesarean without an indicated medical risk, please talk to your care provider about the possibility of vaginal birth. Brenda Posted by Brenda Lane If you give birth to a preterm baby, scientists have discovered that you are more likely to have higher cholesterol later in life. New findings were presented at the 2008 meeting of the Society for Gynecologic Investigation in San Diego. Dr. Janet Catov, an assistant professor at the University of Pittsburgh School of Medicine, reports that it is hard to say if the high cholesterol triggers the preterm birth or if something in the pregnancy or the preterm birth triggers the cholesterol problem. Results showed that mothers who gave birth prior to 34 weeks gestation, had a 2.3 times greater chance of having a cholesterol over 240mg/dl which is a level considered to be high risk by the American Heart Association. Researchers believe that this study indicates that a woman's previous medical history, including her pregnancy, provides a window into her future risk for heart disease. If you have had a preterm birth and now have high cholesterol, it is recommended that you have regular follow-up every year with a complete physical. Brenda Posted by Brenda Lane A Norwegian study published in the British Medical Journal is showing that there may be a genetic component to having a baby in the breech position during pregnancy. Researchers examined over 2.2 million births over two generations to see if their hypothesis was correct (that both men and women who were breech themselves at birth were more likely to have a child who was also in a breech position.) In fact, what the study showed was that both men and women who were breech themselves, were more than twice as likely to have a child delivered in a breech position. The strongest recurrence were found with men and women who were delivered vaginally in a breech position. Passing this "breech tendency" down to their offspring only occured with participants who reached full term at birth. For related information see Turning Breech Babies and Vaginal Breech. Brenda Posted by Brenda Lane I just recently completed a 3 day workshop in preparation for becoming a postpartum doula. It was exciting to be a learner after having been involved in the field of pregnancy and birth for nearly 18 years as a childbirth educator, birth doula and birth doula trainer. The workshop, coupled with recent experiences helping families during the postpartum period, made me realize that this is an especially challenging time in the life of each new family. More parents are waiting until they are older to have children. That translates to having older grandparents of the baby and in some cases, the grandparents might be at an age where they might be limited in how they can help out their own children. Not to mention, more and more families are moving away from their relatives, which makes it harder to have support. Let's face it. Postpartum is exhausting for the mother. She is still recovering from the birth and now she is up every 2 hours day and night feeding her baby. And meal preparation and laundry will not simply get done on their own. If the father returns to work right away, the demands on the new mother could be overwhelming for her if she does not have additional support. I love the concept that postpartum doulas represent such a simple yet effective way to guide the family through this time. WIth an experienced helper to walk them through baby care, breastfeeding, preparing a nutricious meal or just being a listening ear, it's a win-win for mother, baby and the entire family! For more about finding a postpartum doula or training to become one, visit DONA International. Warmly, Brenda Posted by Brenda Lane Years ago the only time a woman would have a cesarean would be there were risks to either her or her baby. In fact, the cesarean rate in the 1970's was only about 5% of all births. Now nearly 30 years later, cesarean rates across the world are climbing, with the cesarean rate in the US very close to the top of the list at 30%. We can no longer assume that cesareans are being done due to strictly emergency situations. The most common reasons for a cesarean are for a stalled or non-progressing labor or because of a previous cesarean. Only a small handful of mothers are choosing or electing to have a cesarean without an indicated risk. And very few cesareans are currently performed because of emergencies. What if you are pregnant and getting close to your due date and your doctor recommends that you have a cesarean? Perhaps the size of the baby is measuring big due to a recent ultrasound. What dhould you do? Here are some questions to ask your provider should he or she recommend that you have a cesarean without a medical reason: 1. If a cesarean is recommended due to the baby's size, how accurate is an ultrasound to measure the baby's weight? 2. Is it possible to consider an induction prior to doing a cesarean? 3. Would the provider be patient for you to have a long labor or use a variety of pushing positions if the baby is larger? Remember that how you give birth not only affects your recovery but also how you give birth to your next baby. Brenda Posted by Brenda Lane If you have tested positive for GBS in your first pregnancy and are now pregnant again, you may be wondering what your chances are to test positive again. Researchers have discovered that there are several risk factors that can make it more likely for you to continue to carry this bacteria into your next pregnancy. This study published in the March 2008 issues of Obstetrics and Gynecology indicated that the amount of GBS colonization in the first pregnancy was one risk factor for testing positive for this bacteria again. (For more information on this test result, please see your care provider.) Also, if you become pregnant again within a short period of time (within 4 years) the study also indicated that your chances of testing positive for GBS would be nearly 40% higher. Remember that even if you have tested positive, GBS can easily be treated during labor. Brenda Posted by Brenda Lane In the March 2008 issue of Obstetrics and Gynecology, researchers from France have taken a look at over 700 pairs of twins with regard to whether a vaginal birth should be an option and should be considered "safe." Safety was determined by several outcome factors including the Apgar scores of the twins and visits to the NICU. Results showed that overwhelmingly, mothers can safely give birth vaginally to twins after 35 weeks of gestation when the first twin is in a head down (vertex) position. In fact, out of the original 758 pairs of twins participating in the study, 515 sets of these twins were both born vaginally. One of the concerns that mothers of twins have expressed to me over the years is that what if they go all the way through labor and give birth vaginally to twin A (the first or lower twin in the mother's pelvis) and then they have to give birth to twin B due to unforeseen problems. This study actually addressed that issue and found that only 3 of these mothers had both a cesarean and vaginal birth. This should be yet another encouragement to mothers of twins around the world! Brenda Posted by Brenda Lane In the latest issue of Obstetrics & Gynecology, a study conducted at Washington University in St Louis, MS has indicated that there is a lower risk of uterine rupture in mothers of African-American descent who have experienced a previous cesarean than mothers of other racial groups. The retrospective study on over 25,00 mothers also looked at the possible differences in choice to have a VBAC, success of VBAC as well as the risk from various other complications. It is interesting to note that black mothers were more likely to make the choice for a trial of labor, but less likely to have a successful VBAC. But the most fascinating part of this study was that, even after adjusting for other variables, African-American mothers were 40% less likely to have a uterine rupture than other racial groups (.6% compared to 1.1%) This is a dramatic difference and would serve to motivate any mother of African-American descent who is concerned about the safety of VBAC that the odds are clearly in her favor! Brenda Posted by Brenda Lane If you are pregnant and trying to figure out whether or not to exercise, here is new information about exercise and how it may increase your risk of miscarriage. Danish researchers interviewed over 90,000 women during pregnancy from 1996-2002. (The study appears in the November 2007 issue of the British Journal of Obstetrics.) A relationship was found between women who exercised during the first trimester and their risk of miscarriage for mothers who exercised more than 7 hours a week. Miscarriage was even more common among the mothers who engaged in high-impact exercise programs. Interestingly, researchers found no association between exercise and miscarriage after 18 weeks of pregnancy. This study emphasizes the delicate period of time that we already know with regard to harmful substances in the first trimester. If you are planning to exercise throughout your pregnancy, be sure you do so with caution in your first trimester and use only low impact exercises. Brenda Posted by Brenda Lane Numerous studies have pointed to the potentially harmful effects of caffeine use during pregnancy. Some of these effects include small birth weight and miscarriage. Now a new study points to a link between caffeine and the risk of undescended testicles in male babies. This study looked at over 20,000 babies in a period between 1959 and 1967 in California. There were 84 cases in which undescended testicles persisted for more than 2 years among over 7,000 sons born to the mothers participating in the study. Compared to other groups, mothers who had sons with undescended testicles consumed more caffeine - (equivalent to about 3 cups of coffee per day.) There were no differences among the mothers who smoked and drank alcohol in this particular result. Researchers believe that this is a significant finding since the rate of testicular cancer is increasing and that this type of cancer is more prevalent among males with cryptorchidism (undescended testicles.) Brenda Posted by Brenda Lane When I was expecting for the first time 20 years ago, I had a demanding full-time job and I had every intention of working as close to my due date as possible. My pregnancy decided to do things differently, however. At around 36 weeks, I was diagnosed with PIH, pregnancy-induced hypertension. My doctor strongly recommended that I cut my hours back to part-time so that I could reduce my physical activity. I remember telling him that I could not do my job in 20 hours a week and he responded that if I didn't do that, he would advise I leave my job altogether. His message to me was clear. My pregnancy needed to come first. I was also not in control of when my labor would start or how inconvenient it could be. It turned out that my daughter arrived two weeks earlier than my due date right before any of us had time to transition my job responsibilities over to someone else. My point is that time and time again, we think we know what is best. As women, we sometimes feel the need to prove to everyone and ourselves that we can do it all - pregnancy, work and raise our family. The reality is that pregnancy is a great time to start to begin new priorities. A job is just a job. It's never who you are. Relationships and family are as close to the top on our priority list as we can get. Along those lines, I believe that expectant mothers need to take a few weeks to prepare for their new families. Perhaps having a few weeks before your due date to rest, prepare meals for the freezer and put the last touches on the baby nursery is a better choice than trying to be a "super pregnant woman." Brenda Posted by Brenda Lane Have you considered banking your baby's umbilical cord blood? Chances are high that you are being inundated with literature that tells you it is a wise health investment to guarantee that stem cells will be available to treat your child or a sibling later in life. While it is true that cord blood is a rich source of stem cells, cord blood storage companies are charging exhorbitant amounts of money with very little likelihood that you will ever be able to use the cord blood to treat your own child. New recommendations published in the February 2008 issue of Obstetrics & Gynecology suggest that patients question if your care provider has any financial interests in these cord blood storage companies. In addition, ACOG's Genetics department has discovered that there is only about a 1 in 2700 chance that you will use your baby's stem cells for treatment, and there is also no information about how long cord blood can safely be stored. Parents should be cautioned that cord blood banking is a huge business that makes big promises without much research or support from the medical community. Brenda Posted by Brenda Lane The Archives of General Psychiatry has published new research on how the mother's stress during pregnancy may affect her child. Over a 22 year period, this study was conducted on women who were exposed to a number of a stressors 6 months prior to conception and during pregnancy. These stressors included death of a close relative or a major illness of a relative such as a stroke or heart attack. The children whose mothers were exposed to these stressors were then followed from the age of 10 until death to identify any onset of schizophrenia. What researchers did find was that the death of a close relative during the mother's first trimester of pregnancy did increase the chance of schizophrenia in her offspring. The other stressors did not increase the child's chance of schizophrenia. This study shows another example of the complexities of the intra-uterine life of the baby and what happens to the mother, including her emotions, does have an affect on her baby. Brenda Posted by Brenda Lane Are you finding that you can't lose your pregnancy weight after the baby is born? Are you also struggling with a loss of sleep? Well, the two may in fact be related according to a new study in the American Journal of Epidemiology. Nearly 1,000 mothers participated in this Boston study between 1999-2002. The mothers who slept less than 6 hours each night during the first 6 months postpartum were 2.3 times more likely than the mothers who got 7 hours of sleep to retain at least 5 kilograms (about 11 pounds) of weight at the one year mark. This study confirms other studies which correlate a lack of sleep to other types of weight gain. How important, then, is getting enough sleep as compared to exercise and nutrition in losing pregnancy weight? Researchers note that, "getting enough sleep may be as important as a healthy diet and regular physical activity in preventing excess weight retention after childbirth." Brenda Posted by Brenda Lane You are in your second trimester and at your doctor visit, the nurse asks you if you have registered for childbirth classes yet? "No, I still have weeks left," you say. "Oh you need to register for those when you first find out you are pregnant!" she responds. Great. You are not just mad at yourself for not knowing this seemingly obvious thing you were "supposed" to be doing, but also that it would have been helpful had your care provider given you a timeline at your first visit. Now where do you turn? The good news is that even for someone with only a few weeks left to go, you have several options. Here is a list of things you can do if you have missed your chances for classes:
Be aware that some of the television programs that show births do not always depict reality. Drama sells and so what is often aired is the most dramatic and high tech/high risk births, which are not the norm for most births today. Another way to prepare is to take a look at what coping methods you already use for stress and pain. Do you take deep breaths when you have stomach pain, walk around a bit to see it if goes away, take a drink? You will likely be able to use those same methods for labor. And remember that your body is already made and programmed to do this by itself. Allow the process to happen and you will do great! Warmly, Brenda Posted by Brenda Lane Experts in the field of prenatal health and fetal exposure to nicotine and cigarette smoke have long known that babies can have negative short and long-term affects from smoking. However, groundbreaking research has recently been published in the December 2007 issue of Journal of Clinical Investigation. This research shows that if there is a chemical pathway from the mother's use of nicotine both before pregnancy and during breastfeeding can reduce her daughter's production of eggs. "Mothers, mice in this case, exposed to PAHs (polycyclic aromatic hydrocarbons) -- environmental pollutants found in cigarette smoke, car exhaust, smoke produced by fossil fuel combustion, as well as in smoked food --before pregnancy and/or during breast-feeding, but not during pregnancy, can cause a reduction in the number of eggs in the ovaries of their female offspring by two-thirds. This limits the window in which the daughter will be able to reproduce," explained lead researcher Dr. Andrea Jurisicova. Find out even more about secondary smoke during pregnancy as well as other things to avoid to protect your baby. Brenda Posted by Brenda Lane The New England Journal of Medicine has published interesting findings about the effect of caffeine on very low birthweight preterm infants. Over 2006 infants of 500 to 1250 gm in birthweight were randomly assigned of either caffeine therapy or a placebo for apnea associated with prematurity. Results indicated that the caffeine therapy increased the likelihood of survival (46% versus 40%), reduced the incidence of cerebral palsy (4% versus 7%) as well as cognitive delays (33% versus 38%) when comparing the groups treated with caffeine therapy to those receiving a placebo. Researchers have concluded that, "caffeine therapy for apnea of prematurity improvesthe rate of survival without neurodevelopmental disability at18 to 21 months in infants with very low birth weight." This is great news for parents with very low birth weight babies. If you currently have a preterm infant or have a history of preterm labor, be sure to talk to your baby's care providers about this new treatment option. Brenda Posted by Brenda Lane The latest issue of Behaviorial Science (December 2007) addresses research on alcohol use during pregnancy and its effects on the growing baby. Results showed that exposure to alcohol during pregnancy significantly increased the infants' preference for alcohol. So far the research that has been conducted has been on rats, however one can assume that humans may indeed react in similar ways. An interesting related study also shows that when mother rats consumed a high fat diet, their young also preferred those high fat foods after they were born, as compared to those who were fed a normal diet. Clearly early exposure to nutrition and chemicals does affect our growing babies. All the more reason to avoid unsafe substances as well as have a healthy pregnancy diet. Did you notice that what you ate during pregnancy was also something your baby preferred to eat later? Share your story with us on the forum. Brenda Posted by Brenda Lane The December issue of the American Journal of Psychiatry has published a study on the issue of how pregnancy and postpartum may affect mothers with bipolar disorder. 89 mothers were admitted to the research study at 24 weeks of pregnancy. These mothers were followed during pregnancy, postpartum and into the first year after birth and decided themselves when, if at all, to discontinue medication (mood stabilizers.) About 70% of the mothers experienced a mood episode during pregnancy. The risk of recurrence was significantly higher in the mothers who discontinued treatment. Moreover, researchers found that the mothers were more likely to stop taking medication for bipolar disorder if their pregnancy was unplanned. Although there can be risks to the growing fetus in the first trimester from certain medications, researchers believe that "abruptly discontinuing medicationin an attempt to protect her baby, a woman or her physicianmay unwittingly increase the risk of relapse for mood episodes,while having little impact on the teratogenic effects of medicationexposure." As with any medication you may be taking during pregnancy or if you are concerned about other things to avoid during pregnancy, be sure to consult with your care provider. If you are experiencing depression or bipolar disorder, seek out a practitioner who is well-educated about mental health issues, prior to discontinuing medication. Brenda Posted by Brenda Lane The December 2007 issue of the Green Journal has a very interesting Norwegian study regarding mothers who may be opting to have fewer children after they have had a cesarean. The study looked at nearly 600,000 mothers who gave birth between 1967 and 1996. Researchers compared the number of subsequent births following both mothers who had given birth vaginally versus those who have birth by cesarean. Results showed that when the child survived the first year of life, a "cesarean delivery was associated with a significantly reducedprobability of a second birth." One can only wonder why having a cesarean would make more mothers opt to not have more children. Is there disappointment in giving birth by cesarean? Is the adjustment to motherhood more difficult? Is the physical recovery too demanding for mothers to want to give birth again? Some research has suggested that postpartum depression is more likely after a cesarean. Could that be a factor in causing more mothers to stop having children after they have had a cesarean? What do you think? Share your thoughts with everyone on the forum? Brenda Posted by Brenda Lane I often work with familes in my role as a doula who have given birth before. In fact I have several families on my calendar for 2008 who are all expecting baby #2 this year. While they all recall some positive memories of their birth experiences, they have one thing in common. All of them are motivated to do some things differently this time. Here is my top ten list for the most popular Birth Resolutions:
What are some of your Birth Resolutions in you are expecting a baby in 2008? Add your preferences to our list on the forum! Warmly, Brenda |
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