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Loving Mother

Articles and events on women's and children's health including pregnancy, childbirth, breastfeeding, doula care, midwifery and public health.

ARTICLES ON WOMEN’S AND CHILDREN’S HEALTH

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Male Pregnancy|Midwifery|Multiples|Maternal Mortality|Normal Birth|NOW Resolution on Choices in Childbirth|Prematurity| Pregnancy |Postpartum Depression |

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MALE PREGNANCY ARTICLES

1) Male Pregnancy Roller Coaster

Thursday, 6 January, 2000

The developing fetus drives hormone changes

Men accompany the mother of their child on a nine-month hormonal roller coaster, it has been discovered. Canadian researchers have shown that expectant fathers’ hormones fluctuate up and down, mimicking their partners’ levels. During pregnancy, levels of several hormones rise in an expectant mother; prolactin which triggers lactation, cortisol which is related to a mother-baby bonding and the main female sex hormone, oestradiol. Immediately after the birth, the levels crash. Anne Storey of Memorial University, Newfoundland, and her colleagues wanted to find out if the same was true for men.

Drastic changes

New Scientist reports that they recruited 34 couples from an antenatal class and took blood samples at different times during and after the pregnancies.

Pregnant man: A 1970s Health Education Council advertisement

The researchers found that in fathers, levels of cortisol, prolactin and testosterone changed significantly during their partners’ pregnancies.

“The differences for mums were much more drastic, but the patterns were similar,” says Dr Storey.

Testosterone dropped by 33% just after the baby’s birth, and the lower levels of testosterone were associated with men becoming more parental, the researchers found. Dr Storey speculates that a combination of behaviour and pheromones from a pregnant woman somehow prompts the father to prepare for the birth of his child: “There’s something about the couple being together that sets the stage.”

Crying on cue

The team also asked fathers about changes that might signal a “sympathetic pregnancy”, such as fatigue, change of appetite and weight gain. Fathers who reported these symptoms also had higher prolactin levels and a steeper drop in testosterone than those who did not.

Finally, the researchers studied short-term changes. After giving a blood sample, volunteers listened to a six-minute tape of a newborn baby’s cries and watched a video about the difficulties of learning to breastfeed. Thirty minutes later, their blood was sampled again.The researchers found that both the men and the women experienced pronounced hormonal changes after exposure to the baby cues, with cortisol levels plummeting.

MIDWIFERY ARTCILES

1) UK Midwife  Gives Birth to Triplets

Olivia, Gabriella and Alessia with parents Carmella Testa and Richard Rees

A midwife has beaten the odds by giving birth to three identical bouncing baby girls

The triplets were born early but are now at home and doing well. It is thought the odds of naturally conceiving identical triplets could be as high as one in 200 million.

After being born seven weeks early, Olivia, Gabriella and Alessia, have gained weight and are thriving at home.Carmella Testa, aged 23, from Peterborough and her fiancé Richard Rees found out they were expecting triplets at the 12-week scan.

The blue-eyed girls were born by emergency caesarean in January after Miss Testa developed high blood pressure.

It was three weeks before the couple were able to bring them home because weighing between 3lb 4oz (1.47kg) and 3lb 10oz (1.64kg) they had to be cared for in incubators.

‘Shock’

“I knew they would be identical because there was just one placenta, so they were from the same egg.

I’m so overwhelmed when I see them. I can’t believe they are mine and that they are perfect
Carmella Testa

“I was very shocked. They weren’t planned. They were born on 9 January, two days after my birthday so they were a lovely present,” said Miss Testa.

Both parents have a history of twins in their families but not triplets.

Her colleagues in Peterborough Maternity Unit gave her extra special treatment. “I’m quite small – only 5ft – so at the unit, they joked that out of all the midwives, it would have to be me that gave birth to triplets. “Everyone was great there. My three close friends delivered each of the babies.”

The girls have each now gained 7lbs (3.2kg) and are doing really well, although the couple admit life is now pretty hectic. “It’s a miracle. I’m so overwhelmed when I see them. I can’t believe they are mine and that they are perfect,” she said.

Identical triplets occur when one fertilized egg splits to create three separate embryos. Non-identical triplets occur when three separate eggs are fertilized. This is more common in women who have undergone fertility treatment.

2) MIDWIFERY IN DENMARK

 Midwives in Denmark are Amongst the Brightest in the Land

Summarized from an article printed in National Geographic,July 1998

Denmark’s stable, sophisticated society is due, in part, to the similar upbringing of all it’s children. Whether born rich or poor, “at birth you become a member of the Lutheran Church”, and then go off to uniform day care centers and kindergartens, and “folkeskole” for grades one to nine. Here language instruction in English begins, continuing with German and French in seventh grade. This education is the same for all children–no matter what their economic status. However, in the ninth grade, official social stratification begins. If you are a serious student, you will attend “gymnasium”; if you are vocationally-minded, you will attend technical or business school. About 40 percent of the population will attend gymnasium. The state then starts paying students a small stipend, based on parental income, “to even up the odds” a bit. (I bet they don’t have to it pay back!). After three years in gymnasium, students take the test that will decide their future career (sort of like our Graduate Records Exam?). This is called “The Studenter Exam”. It comes as no surprise that those with the highest scores get admitted to the best colleges and professional schools. But in contrast to the U.S., it takes a high score to get into the humanities and a lesser score to major in math, physics, chemistry and theology. Like the U.S., those with the highest scores get the first dibs at medicine, dentistry and psychology programs. “On the other hand, to become a midwife (“Earth Mother” in Danish), it takes a very high score, it being a popular career. So the woman in blue scrubs who tells your wife to take a deep breath and push hard may be a great deal brighter than the guy in the pulpit who explains the parable of the vineyard.

MULTIPLES ARTCILES

1) Triplets for woman with two wombs

Photo of Hannah and the triplets
Hannah’s triplets were born from two eggs.

A UK woman with two wombs is believed to be the first in the world with the condition to give birth to triplets. Hannah Kersey, 23, from Northam in Devon, had identical twins Ruby and Tilly, who were born from one womb, Grace, who was born from the other. The girls had to stay in hospital for nine weeks after being born seven weeks early by Caesarean, but have now returned home to their parents.

The odds of having triplets from two wombs are about 25 million to one.

The chances of a woman with two wombs having twins or two separate births is estimated to be five million to one.

Against the odds

Only 70 women in the world are known to have been pregnant in two wombs, reports suggest. The condition, which is actually called uterus didelphys, affects one in 1,000 women in the UK. In Miss Kersey’s case, the babies were conceived from two eggs – one in each womb – which were fertilised at the same time by two different sperm.

There are very few world firsts nowadays, but it may be one
Consultant Dr Simon Grant, who delivered the babies

One egg then divided, producing identical twins, while the other developed into a single baby.

Hannah and her partner Mick Faulkner said they were “over the moon” at how healthy and happy the girls are. Hannah said: “They are three lovely and incredible children, all with very different personalities.”Gracie seems to be the ringleader – maybe because she grew up in her own womb. “Ruby is very laid back and quiet, happy to sit and watch what is happening around her.

 

WOMB ABNORMALITIES
Occur when the uterus fails to fuse normally during development
Vary in severity – sometimes the division extends into the vagina
Can cause fertility problem

“Tilly, who was the baby that struggled to survive inside me, is a real fighter, wanting to keep up with her sisters and not be left out.”

Dr Simon Grant, a consultant at Southmead Hospital who delivered the babies, said: “There are very few world firsts nowadays, but it may be one.”

Mr Ellis Downes, consultant obstetrician and gynaecologist at Chase Farm Hospital in London, said: “It is quite amazing. Women with two wombs have conceived a baby in each womb before but never twins in one and a singleton in the other.”

Leading expert Mr Peter Bowen-Simpkins added: “For a woman to spontaneously conceive and give birth in this way is a real rarity. They have been extremely fortunate.”

Mr Richard Warren of the Royal College of Obstetricians and Gynaecologists said most cases occur naturally, but the condition can run in families. Hannah’s mother and sister also have two wombs. {Photo: SWNS}

2) Woman Gives Birth to Second Set of Triplets

Friday, 31 August 2007

A woman in Ohio has given birth to her second set of triplets.http://news.bbc.co.uk/2/hi/health/6973101.stmVictoria Lasita and her husband Tim conceived both sets naturally, without fertility treatments that increase the chance of multiple pregnancies.”Holy smokes. Do you know what the odds of that are?” fertility expert Dr Glen Hofmann told the Cincinnati Enquirer.The chances of conceiving one set of triplets naturally were about one in 8,000, making the odds of having them twice far higher, he said.Having triplets once did not affect the chances of having triplets a second time, added Dr Hofmann, medical director of the Bethesda Center for Reproductive Health and Fertility.Casey Alexander was the first born at 1357 local time on Wednesday at just 4lb 2.5oz (about 1.9kg).He was followed by Caden Bradley, at 4lb 13.5oz (about 2.2kg) and Carson Charles, at 4lb 9.5oz (just over 2kg).
You take what God gives you
Victoria Lasita

Their father, Tim, who witnessed the Caesarean birth, said: “Everybody seems to be doing well.”

He said it was still too early to know when the babies will be ready to go home and join their older siblings, Jessica, Jillian and Brian, who will soon turn four.

The Lasitas have been married six years and have three grown children from previous marriages. But they decided they’d like “one more” after the birth of the triplets. “I guess we should have been more specific and said one more child, not one more set,” Victoria said. The Lasitas will be changing about 150 nappies a week for the new triplets.

Victoria said: “You take what God gives you. And this is what he’s decided we can handle.”

MATERNAL MORTALITY ARTICLES

1) Maternal Mortality Up

THE ASSOCIATED PRESS

August 27, 2007

U.S. women are dying from childbirth at the highest rate in decades.The high cesearean rates are partly to blame. See full article by clicking on link below. (This artcle does not bring out the fact that  African-American maternal mortality is 4 times higher than it is for

white Americans. A fact that has not changed in decades)

The rate of death in childbirth has risen, possibly due to more obesity and C-sections, but the risk is still small.

U.S. women are dying from childbirth at the highest rate in decades,  new government figures show. Though the risk of death is very small,  experts believe increasing maternal obesity and a jump in Caesarean  sections are partly to blame.

   

2) US Maternal Mortality on the Rise

2004 – Reprinted from perinatal e-news, LA Best Babies Network

The U.S. maternal mortality rate rose to 13 deaths per 100,000 live births in 2004, according to a report released by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics. By comparison, in 2003, the maternal mortality rate was 12 deaths per 100,000.

The CDC reports a total of 540 pregnancy-related deaths in 2004, 45 more deaths than in 2003. Some factors affecting the maternal mortality rate include:

  • Caesarean sections – Accounting for 29% of births, C-sections can cause excessive bleeding that may lead to death.
  • Obesity – Overweight women experience complications such as diabetes that can affect pregnancy outcomes.
  • Race – The maternal mortality rate among African-American women is three times greater than that of Caucasian women.
  • Quality of care – Approximately 40% of maternal deaths could have been prevented with appropriate prenatal care.
  • Age – Women that delay childbirth tend to experience pregnancy complications.

Learn more:

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3) How You Can Help Save Women’s Lives

“Maternal mortality is the leading cause of death for women of reproductive age. Here are seven things you can do to make a difference.”

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4) Maternal Death Rate Blamed on Changes in Reporting

Link to Article

Maternal Death Rate Increases

Robin Huiras

Monday April 21, 2008

Selected Paragraphs:

The maternal death rate has doubled in the past 10 years, but more women aren’t necessarily dying before, during, or after childbirth, researchers say. The numbers can be attributed to new reporting methods.

According to the Center for National Health Statistics’ Vital Statistics Report, which was released in January, the maternal death rate was 15 women per 100,000 live births in 2005 — a 100% increase compared to the 1996 rate of 7.5 deaths per 100,000 live births. But report co-author Donna Hoyert, PhD, says there’s more to the numbers than meets the eye.

“We think the main reasons for the increase is, since 2003, states have been adding a separate question (on death certificates) about whether there was a recent pregnancy,” Hoyert says. “In the past, that information was supposed to be reported in the cause of death section, but if nothing was reported about a pregnancy, we have no clue if hemorrhaging or other complications were related [to the death].”

Other states are expanding their definitions of maternal death from traditional causes, such as hemorrhage, preeclampsia, and blood clots. Fatal complications that occur more than 42 days and up to one year after delivery and deaths from external causes, such as unintentional injury and homicide, also are now included in the definition of maternal death, Hoyert says

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NORMAL BIRTH ARTICLES

1) Normal Birth: A Thing Of The Past?

10 Jan 2008

The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) asks the question “Is normal birth a thing of the past?” and gives guidelines from WHO for the management of maternity care, very similar guidelines to the CIMS Initiative. See full article below.

At a time when nearly one in three US births are cesarean and the rate of medical intervention in maternity care continues to rise, the January/February issue of the Association of Women’s Health, Obstetric and Neonatal Nurses’ Journal of Obstetric, Gynecologic and Neonatal Nursing (JOGNN) explores the evolution and implications of current high-tech birthing practices and offers nursing recommendations for a return to normal birth The “Reclaiming Normal Birth” issue features articles that explore evidence-based nursing practices to promote normal physiological birth – that is, birth that occurs naturally with minimal medical intervention. Also discussed is how to balance these care practices in today’s current birthing climate where interventions have become routine. According to the article, “Promoting, Protecting, and Supporting Normal Birth: A Look at the Evidence,” six evidence-based care practices adopted from the World Health Organization (WHO) can be implemented by nurses to promote physiological birth:

  • Care Practice 1: Labor begins on its own;
  •  Care Practice 2: Freedom of movement throughout labor;
  •  Care Practice 3: Continuous labor support;
  •  Care Practice 4: No routine interventions;
  •  Care Practice 5: Spontaneous pushing in nonsupine positions; and
  • Care Practice 6: No separation of mother and baby.

The article reviews evidence surrounding each of these care practices and determines that interventions that are not medical necessary increase the risk of complications for mother and baby during birth. However, nurses, as the most prominent, hands-on caregiver in the labor and delivery environment, are in a unique position to reintroduce care practices that support normal birth.In “The Emergence of High-Tech Birthing,” Elaine Zwelling, RN, PhD, a perinatal nurse consultant with the Hill-Rom Company, details the transition from pregnancy and birth as a normal, intervention- free event to a high risk and high-tech event.

Zwelling makes the case that normal birth, as defined by the six parameters adopted from WHO, may be difficult to achieve in the United States today due to routine high-tech interventions.

“As the primary caregivers for women during labor, nurses often find themselves walking a fine line between the wishes of the consumers and the preferences of the women’s medical care providers,” states Zwelling in the article. She recommends that nurses strive to balance high-tech with high-touch rather than selecting one over the other.

Both articles make the case that hospitals are well-equipped for high-risk, complicated births, but not set-up for normal birth due to policies, protocols and physical infrastructure. Therefore, advocating for normal birth is a challenge for nurses in the current maternity care environment and will require dramatic changes in the typical American hospital.

Continuing Nursing Education Credit may be earned by nurses who read and complete an online post-test and evaluation for the article, “Promoting, Protecting and Supporting Normal Birth: A Look at the Evidence,” by Amy M. Romano, MSN, CNM, a perinatal research and advocacy coordinator at Lamaze International, and Judith A. Lothian, RN, PhD, LCCE, an associate professor at the College of Nursing, Seton Hall University in South Orange, New Jersey.

AWHONN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

About JOGNN

The Journal of Obstetric, Gynecologic and Neonatal Nursing (JOGNN) is the bimonthly peer-reviewed journal of the Association of Women’s Health, Obstetric and Neonatal Nurses.

About AWHONN

The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) was founded in 1969 and is the foremost nursing authority that advances the health care of women and newborns through advocacy, research and the creation of high quality, evidence-based standards of care.

AWHONN’s 22,000 members worldwide are clinicians, educators and executives who serve as patient care advocates focusing on the needs of women and infants. A leader in professional development, AWHONN is the first and only association to be awarded the designation Premier Provider by the American Nurses Credentialing Center for innovation and excellence in Continuing Education.

Association of Women’s Health, Obstetric and Neonatal Nurses

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NATIONAL ORGANIZATION FOR WOMEN (NOW) RESOLUTION ON CHOICES IN CHILDBIRTH

The largest and most important feminist organization in the country has expanded it’s definition of reproductive rights to include choices in childbirth.
A Report on The NOW National Conference Committee on Health and Reproductive Rights, July 3, 1999

NATIONAL ORGANIZATION OF WOMEN EXPANDS DEFINITION OF REPRODUCTIVE FREEDOM TO INCLUDE MIDWIFERY MODEL OF CARE

WHEREAS, The National Organization for Women has long supported reproductive freedom as a priority issue; and

WHEREAS, NOW believes that women should have compete authority over their reproductive lives; and

WHEREAS, reproductive freedom not only includes the ability to decide whether or when to bear children, but also the right to devise a birth plan with a medical provider of their choice in either a hospital or an alternative setting such as a freestanding birth center or private residence; and

WHEREAS, women have historically given birth with midwives; and

WHEREAS, the practice of midwifery has many benefits including lower costs, lower rates of premature births, higher rates of breastfeeding; and greater satisfaction with the birthing experience, and has been endorsed by The World Health Organization; and

WHEREAS, midwifery has a lower incidence of medical interventions during the birthing process, including routine episitomies and cesearean sections; and

WHEREAS, women’s access to midwifery and traditional birthing practices are many times limited by restrictive laws and non-coverage by private insurance companies and state-subsidized funding;

THEREFORE, BE IT RESOLVED that The National Organization for Women’s policy statements, brochures and fact sheets on reproductive freedom shall include references to birthing choices, safe childbearing practices, midwifery; and

BE IT FINALLY RESOLVED that NOW work in cooperation with state and national midwifery organizations to increase women’s limited access to midwifery and community awareness of childbirth, pregnancy and early parenting choices.

Submitted by: The Health and Reproductive Rights Hearing of The National Organization for Women, National Conference, Beverly Hills, CA July 3, 1999, Chair: Shiela Moore. Submitted by: Linda McCabe, Sonoma County N.O.W. (with assistance from: Suzette Henderson, Ohio-NOW and Mary Ceallaigh, Midwifery Childbirth Awareness Project of California Association of Midwives .

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PREMATURITY ARTCILES

1) Giving Infants a Helping Hand

Physical contact may help preemies gain weight faster and healthy babies digest food better

Spring-Summer 1997 Summarized from Newsweek

Scientist’s work with fragile neonates and preschoolers points toward the conclusion: that touch is vitally important to the development of healthy, happy children. Bolstering the immune system, cuddling and massage appears to have many positive effects.

At the University of Miami’s Touch Research Institute, director Tiffany Field cites many studies on the effects of touch. “Premature babies given daily massage gain 47 percent more weight and are discharged from hospitals six days earlier – at a savings of $10,000 each in medical costs. Cocaine-addicted and HIV-infected newborns show lower levels of stress as well as say that better weight gain and motor skills with touch therapy. From colic to sleep disorders to hyperactivity, therapeutic touch seems beneficial. Says Field, ‘Most of us think touch only has psychological benefits, but it’s actually an important stimulus to the central nervous system.”

Researchers found that newborn rat pups failed to grow when removed from their mothers. Without their mothers licking them, baby rats showed decreased levels of growth hormones. When a lab assistant imitated the mother’s licking with a wet paintbrush, “hormone levels rose and the pups resumed growing”. Likewise for human babies. Studies have shown that touching can also lead to weight gain. The pressure releases hormones that make food absorption more efficient — and babies grow faster. Touch also decreases stress. Infants who receive massage show lower levels of the stress hormone in their urine — a hormone that kills important immune cells at higher levels.

While many parents of preemies are seeing the benefits of infant massage, the medical establishment isn’t always quite as enthusiastic. Many doctors stop short of prescribing massage to help babies grow or reduce their stress. Touch research is still relatively new. Many questions remain unanswered. Yet more and more neonatal intensive care units are beginning to add touch to their therapy, and parental interest in infant massage continues to grow.

So once again, science is catching up to the wisdom of a mother’s intuition.

2) Skin-to-Skin Contact May Reduce Pain in Preterm Neonates

By Laurie Barclay, MD

May 1, 2008

Skin-to-skin contact to reduce pain in preterm neonates has been shown to be effective in infants from 28 weeks of gestation through term, according to the results of a crossover trial reported in the April 23 Online First issue of BMC Pediatrics.

“Skin-to-skin contact, or kangaroo mother care (KMC) has been shown to be efficacious in diminishing pain response to heel lance in full term and moderately preterm neonates,” write Celeste Johnston, DEd, RN, from McGill University School of Nursing in Montreal, Quebec, Canada, and colleagues. “The purpose of this study was to determine if KMC would also be efficacious in very preterm neonates.”

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PREGNANCY ARTICLES

1) Pregnancy and Auto Immune Disease

Summarized from an article in Self Magazine

It has long been a mystery why certain autoimmune diseases, like schroederma (in which the skin becomes increasingly hard), occur ten times more frequently in women than in men. Research now indicates that pregnancy may increase the risk of having autoimmune diseases because of a flux of fetal cells in the mother’s bloodstream during delivery. Researcher Diana W. Bianchi, M.D. Chief of Genetics at the New England Medical Center in Boston, has harvested fetal cells from mothers up to 27 years after giving birth. This has given rise to the idea that not all “autoimmune” diseases are reactions to the cells of the body and may instead be related to the “foreign” genetic material still present from childbirth. If this hypothesis is proven to be correct, scientists might be able to formulate new and better ways to fight diseases such as schroederma.

POSTPARTUM DEPRESSION ARTICLES

1) Effects of Postpartum Posttraumatic Stress Disorder

By Lauren C. Spooner, Ph.D- c

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Empirical support has accumulated for evidence of posttraumatic stress symptoms following approximately 30% of childbirth experiences (Olde, van der Hart, Kleber, & van Son, 2006). In the wake of postpartum posttraumatic stress disorder (PTSD), the personal, relational, and societal implications can be far-reaching for women and their families and can pose a grim public health concern. Women who experience intrusive memories of a traumatic birth can develop sexual avoidance (O’Driscoll, 1994), and secondary tokophobia (fear of childbirth following a traumatic delivery) (Hofberg & Brockington, 2000). Further, some women, in order to avoid future distressing birth experiences, will request a planned cesarean section for subsequent births (Ryding, 1993), which is accompanied by greater risks. Some women avoid future pregnancies altogether even when they want more children (Beck, 2004).

Additionally, researchers have found inadequacies in prefrontal cortex functioning in individuals with PTSD, which is associated with diminished cognitive activation and compromise of executive functioning (Rothbaum, Kozak, Foa, & Whitaker, 2001; van der Kolk, 1996). Individuals with PTSD typically have abnormally high levels of stress hormones and when reminded of the traumatic event, have increases in heart rate, skin conductance, and blood pressure (van der Kolk). Taken together, these altered physiological responses may result in overall poor health for postpartum women. Additionally, in an attempt to numb intrusive thoughts associated with a traumatic event, women are at a high risk for developing alcohol or other drug dependence (Sartor et al., 2o11).

In addition to the deleterious effects on the health and well-being of new mothers, PTSD can negatively affect an individual’s ability to parent effectively. More… (download PDFPDF Logo 16px)

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