Archive for the ‘Childbirth’ Category:
Blood Incompatibilities
Blood Incompatibilities
Erythroblastosis Fetalis (EBF)
EBF is the result of blood incompatibility between the mother and her fetus. Understanding how the negative and positive blood incompatibility occurs can be confusing, but here goes.
When the mom’s blood type is negative and the baby’s father’s type is positive, the baby has a 50/ 50 chance of being positive too. Being positive is what causes the problem between mom and baby. The mother’s body normally views the baby as a friendly, harmless parasite. In the Rh negative mom whose baby is Rh positive, the mother’s body views the fetal blood cells as dangerous intruders and takes action. Mom becomes sensitized and develops antibodies (weapons) to destroy the red blood cells in the baby. As the red blood cells are being destroyed, the baby becomes anemic. More problems develop as the baby tries compensating for the anemia. In severe cases, the fetal heart and liver can fail from trying to keep up, although with current treatment 70 percent of even severely affected babies survive.
Twins
Twins
Pass The Smelling Salts!
The possibility of more than one baby lurks somewhere in the dark recesses of every pregnant woman’s mind. Twins occur once in every 100 pregnancies. The thought may delight some and provoke horror in others.
Head Start
Before ultrasound, as many as 30 percent of twin pregnancies were surprises. The smelling salts weren’t needed until delivery. Early diagnosis of the twin pregnancy is critically important; plans must be made. In the first or early second trimester, an ultrasound exam can eliminate surprises. You can see two babies in there-no guessing. For the duration of your pregnancy and definitely after, you’ll need to make adjustments in your life-style.
Preterm Labor
Preterm Labor
Six to eight percent of all babies born arrive before 37 weeks’ gestation. These small numbers, however, account for 75 percent of all the neonatal deaths – a significant statistic. It costs as much to care for 5 preterm babies as it does 150 pregnant women. Everyone agrees that prevention is the best approach since Mother Nature provides the best incubator. But this is easier said than done.
An Obstetrical Stew
It’s extremely difficult to prevent something when you aren’t sure of the exact cause, as in 50 to 60 percent of preterm labors. The current strategy is to identify – in advance those women most at risk for preterm labor. A look at a risk-assessment guide reveals an obstetrical stew of social, physical, and pregnancy factors that contribute to preterm labor. The following is a sample list.
Preeclampsia
Preeclampsia
Facts and Fallacies
Preeclampsia has probably been around for as long as women have been getting pregnant. It’s also known as toxemia, pregnancy -induced hypertension, or EPH gestosis. Preeclampsia is the most misunderstood and myth-ridden disease in pregnancy. Let’s clear up some of the more common myths with some facts.
- Preeclampsia isn’t related to obesity or excessive weight gain during pregnancy.
- It isn’t caused by salt (sodium chloride). Women with preeclampsia actually have normal sodium levels. Salt restriction isn’t recommended.
- The condition isn’t cured or alleviated by taking water pills (diuretics) for the swelling.
- Preeclampsia isn’t caused by a diseased placenta, poisons, or toxins in the body. The term “toxemia” is still used, but it isn’t an accurate one to describe the disease.
- It isn’t prevented by vitamin therapy or high-protein or other special diets. There’s no known prevention.
Herpes
Herpes
Not So Simplex
Herpes simplex used to be just a plain old “cold sore.” In the 1980s it became the dread virus that threw a wet blanket on the fires of the sexual revolution. The herpes hysteria grew because medicine had neither prevention nor cure. Even the admonition “Hey, let’s be careful out there!” didn’t help. The herpes hysteria has diminished because of the more serious threat of AIDS.
The herpes virus is the Greta Garbo of sexually transmitted diseases elusive and mysterious. The true incidence of herpes isn’t known since it’s not reported to public health agencies. Even trying to confirm whether or not you have herpes can be maddening. Let me count the ways.
Complications in Pregnancy
Complications in Pregnancy
Rain on Your Parade
For the majority of women, pregnancy is a normal and physiologically uneventful process. You count on breezing through pregnancy with no problems, looking and feeling great. When complications arise, you’re forced to make adjustments in your idyllic pregnancy plan. It is not an easy adjustment for most women. Your self-esteem suffers. Disappointment and anger are common emotions as you struggle to deal with the unexpected events. You add anxiety and fear for you and your baby to the witch’s brew of unknowns facing you. You need expert care, added emotional support, and accurate information to cope effectively with the changes.
When to Call the Doctor
When to Call the Doctor
Two kinds of women drive doctors crazy: those who call for every little twinge and those who wouldn’t call if they were staked to an ant hill because “I didn’t want to bother you.” Here are some hints to help you avoid falling into these two categories.
Any Vaginal Bleeding
Vaginal bleeding doesn’t automatically mean disaster, but the source of the bleeding needs to be investigated. Panic usually follows if you’re on the toilet when you discover the bleeding because even a few drops will look like gallons as soon as they hit the water. Wipe with toilet paper and make note of the color-bright red or more reddish-brown? Did the bleeding start after some activity, such as intercourse or moving furniture? Is it associated with cramping or localized pain anywhere? Your doctor will ask you these questions and how much blood you think you lost. Just remember the difference between bleeding and hemorrhaging: If blood isn’t running down your leg and filling up your shoe, you’re not hemorrhaging. Keep calm and call your doctor.
Prenatal Workup
Getting To Know You
Your official relationship with your doctor begins with the three-part prenatal workup. First, a medical history reveals any past or current health problems for you or in your immediate family that may affect your pregnancy. The questions are very standard, so don’t get excited when you’re asked if you mainline heroin or have syphilis. If you have any unusual (or what the “moral majority” might consider) unspeakable diseases or habits, don’t be embarrassed or withhold information. With few exceptions, health care providers are nonjudgmental or at least desensitized. The goal is to give you the best care possible and work with whatever problems exist, no matter what they are.
Next is a physical exam. Besides the usual poking, prodding, and stick out your tongue routine, your pelvis is evaluated for its potential as a gateway for your baby’s journey into the new world. Adequate and borderline are two terms commonly used. “Adequate” means that the baby should slip through without problems; “borderline” means wait and see: It might be a tight squeeze. If your doctor describes your pelvis as big as the Grand Canyon, consider it a compliment. But don’t get ugly and hateful if your doctor says “She has a pelvis I could deliver through” and you end up with a cesarean birth. It happens. Nothing is 100 percent guaranteed.
Prenatal Care
Choosing a Doctor
Good Vibrations
Choosing a doctor or birth attendant without careful thought has all the pitfalls of an arranged marriage: You don’t know what you’ve committed to until it’s too late. Save yourself and the doctor wasted time and emotional trauma by doing your homework now.
Think about what kinds of personality traits make you the most comfortable. If your doctor is the autocratic type and you want to share in the decision-making process, you’ll be at each other’s throats in no time. If you don’t like to worry about details, a take-charge type may be just your style. Decide what is your style and find someone who’ll “wear well” over the months of your pregnancy. Breaking up after you’re several months into the relationship can be inconvenient, if not painful, for both of you.
From Homestyle to Single-Room Maternity Care
From Homestyle to Single-Room Maternity Care
The ’70s homestyle room with the dying fern and rocking chair is now dated. Many obstetrical units are adopting the newer and more practical concept of single-room maternity care. This concept is the wave of the 90s in obstetrics as more women choose this option. With single-room maternity care, Mom stays in an LDRP (labor/ delivery/ recovery/ postpartum) room, eliminating the inconvenience and discomfort of moving from a labor bed to the delivery room and then moving again to the recovery room and still again to the postpartum floor. The ideal room design usually accommodates 8 people. The labor bed converts into a birthing bed. The delivery equipment, such as oxygen and resuscitation is efficiently and conveniently located behind pictures and in drawers so as to not detract from the homelike setting. Some hospitals offer romantic, candlelight, gourmet dinners for the new parents.
Although the single-room maternity concept is ideal, many older hospitals are unable to provide this service in its purest form. What you may find is a compromise such as the labor and birthing room, combined with recovery and postpartum provided on the postpartum maternity floor. It’s still a great improvement over the traditional method of a separate room for each aspect of the birthing process. The days of having to move to a gurney when you’re fully dilated while the nurses frantically tell you not to push are mercifully becoming obsolete.