STUDY – Vitamin D deficiency linked to primary C-section rate

image-3931619-35797336-2-websmall_0_dd0f5a04af6e73346ed777299ec88556_1A small study found that twice as many women (28%) who were vitamin D deficient at the time of giving birth had a Caesarean delivery compared with those with normal levels (14%).

Read the article from Medscape

Karen Robinson, a local Certified Professional Midwife, said the following about the benefits of vitamin D during pregnancy:

Vitamin D is getting a lot of scrutiny lately and is being found to be a superstar vitamin that we haven’t paid enough attention to.

Vitamin D supplementation can help increase immunity and decrease the impact and frequency of colds and common viruses.

Its role is also being looked at closely in the implantation of the placenta, how well the placenta functions, and therefore prevention of pre-eclampsia.

In our world of indoor jobs and layers of sunscreen when we do go outside, it’s easy to see how the majority of us may be deficient in Vitamin D.

The best places to get Vitamin D include a bit of sun exposure every week (so that the body can manufacture its own Vitamin D), fatty fish (salmon, mackerel, tuna, etc), fish oil (especially cod liver oil) and beef liver.

So, one thing doulas can do for their clients is to encourage good diet (lots of fresh fruits and vegetables, clean meats and plenty of fats) and suggest they consider supplementation of Calcium/Magnesium, Folic Acid, and Vitamin D.

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Octuplets Born!

A California woman just gave birth to the second set of octuplets in the US nine weeks early!  The greatest thing about it?  Mom plans to breastfeed all eight babies.  It’s possible, the Harris sextuplets were breastfed exclusively for 6 months.  When they were little in the NICU mom would pump between 50-60 bottles a DAY!  Read all about it…

A US woman has given birth to eight babies, becoming just the second person recorded in the US to have delivered a set of living octuplets.

The six boys and two girls, who were nine weeks premature, were delivered by Caesarean section in the hospital near Los Angeles, California.

The babies weighed in at between 1lb 8 ounces (820g) and 3lb 4oz (1.47kg) and are all said to be doing well.

They were screaming and kicking around very vigorously, a doctor said.

The mother, whose identity has not been revealed, has asked that limited information be released about the births.

MULTIPLE BIRTHS
US first live-born octuplets delivered in Texas, 1998; seven survive
Octuplets born in Italy, 2000; two die shortly after delivery
Octuplets born in Mexico City, 1967, but all died within 14 hours, according to Encyclopedia Britannica
World’s first surviving set of septuplets born in Iowa, US, 1997
First all-female surviving sextuplets born in the UK, 1983, to the Walton family

She checked in to the hospital 23 weeks into her pregnancy and gave birth seven weeks later.

A spokeswoman at the Bellflower medical centre described the deliveries, which took place in the space of five minutes, as “truly amazing”.

The medical team had scheduled a Caesarean section for seven babies, but doctors were surprised when an eighth came out.

“Lo and behold, after we got to Baby G, which is what we expected, we were surprised by Baby H,” said Dr Karen Maples.

Three of the babies needed help breathing, but all were otherwise doing well, a doctor said.

The babies will be in incubators for at least six weeks and the mother is planning to breast feed them all, the hospital officials said.

“She is a very strong woman, so she probably will be able to handle all eight babies,” said Dr Mandhir Gupta.

He added that the mother was “doing very, very well” and was “really excited that she got all of these babies, and that they’re doing good so far”.

The team did not give any more details about the mother’s identity or say whether she had used fertility drugs.

‘Just enjoy it’

The US’s first live-born set of octuplets was delivered in Houston, Texas, in 1998.

The seven surviving children of the octuplets born to Nkem Chukwu are pictured with another unidentified child and their mother as they celebrate their 10th birthday in Houston, Texas, 20 December 2008

Octuplets mother Chukwu said the new parents had much to look forward to

One baby died about a week later – but the surviving children celebrated their 10th birthday in December.

Their Nigerian-born mother, Nkem Chukwu, said the new parents had much to look forward to, the Associated Press news agency reported.

“Just enjoy it. It’s a blessing, truly a blessing,” Mrs Chukwu was quoted as saying. “We’ll keep praying for them.”

Mrs Chukwu and her husband had tried for a long time to have children before turning to fertility drugs.

Feb 12 – You Are What Your Mama Ate

jp-logo5 pm – 6:30 pm

Green Monkey Baby
1511 S. Pearl St.

A discussion and lecture of nutrition and pregnancy…

Join in a discussion on Dr Odom’s Retrospective Study on Juice Plus & Pregnancy

Doug Odom, M.D.
OB/GYN Clinic of Jackson

Assistant Clinical Professor, University of Mississippi Medical Center

Dr. Odom earned his medical degree from the University Of Mississippi School Of Medicine in 1969. He performed his internship at St. Elizabeth Medical Center in Dayton, Ohio, then returned to Mississippi and UMC for a three-year residency in Obstetrics & Gynecology. He has since maintained an active private practice in Jackson, Mississippi, delivering babies and practicing at three area hospitals while serving on the visiting or teaching staff at three additional hospitals.

Mar 12 – Meet the Doulas Night (Wash Park)

house-of-doula

Thursday, March 12
6:30 pm

Green Monkey Baby
1511 S. Pearl St.

RSVP

House of Doula is a great company that allows you to register for doula services just like you would register for a stroller or carseat.  This mixer is a place where you can mingle with the House of Doula doulas (myself included!) and find one you’d like to interview one-on-one at a later time.

Light refreshments will be served, bring your husband and/or children!

Call Amanda Glenn with any questions, 720.219.8482

Scheduled Inductions/C-sections – Why Every Week Counts

I recently read a great article in the Wall Street Journal about some new trends to induce or schedule c-sections prior to an estimated due date.  Past 34 weeks the baby’s lungs are done “cooking” and the chance that Baby will survive is pretty good, but scientists are finding more and more evidence that those precious few weeks mean more to fetal development than we previously thought.

A word on starting labor:

  • Labor is usually started by the BABY when Baby’s lungs are ready and Baby has reached good maturity in the womb
  • It is well within normal limits for babies to be born healthy anywhere between 37 and 42 weeks (and sometimes beyond!)
  • The average length of pregnancy for a first time mom is 41 weeks, 3 days (or 10 dates past estimated due date)
  • Methods of induction can seriously mess up natural body chemistry and function and cause other serious measures (failed induction, infection, c-section, etc.)
  • If your body isn’t ready to go into labor, it won’t.  Oftentimes inducing labor (either natural remedies or with drugs) will fail if your body and your baby aren’t ready

Here is that great article from the Wall Street Journal:

This time of year, some hospitals see a small uptick in baby deliveries thanks to families eager to fit the blessed event in around holiday plans or in time to claim a tax deduction. Conventional wisdom has long held that inducing labor or having a Caesarean section a bit early posed little risk, since after 34 weeks gestation, all the baby has to do was grow.

But new research shows that those last weeks of pregnancy are more important than once thought for brain, lung and liver development. And there may be lasting consequences for babies born at 34 to 36 weeks, now called “late preterm.”

[Why Every Week of Pregnancy Counts] New research shows that the last weeks of pregnancy are more important than once thought for brain, lung and liver development.

A study in the American Journal of Obstetrics and Gynecology in October calculated that for each week a baby stayed in the womb between 32 and 39 weeks, there is a 23% decrease in problems such as respiratory distress, jaundice, seizures, temperature instability and brain hemorrhages.

A study of nearly 15,000 children in the Journal of Pediatrics in July found that those born between 32 and 36 weeks had lower reading and math scores in first grade than babies who went to full term. New research also suggests that late preterm infants are at higher risk for mild cognitive and behavioral problems and may have lower I.Q.s than those who go full term.

What’s more, experts warn that a fetus’s estimated age may be off by as much as two weeks either way, meaning that a baby thought to be 36 weeks along might be only 34.

The American College of Obstetricians and Gynecologists, the American Academy of Pediatrics and the March of Dimes are now urging obstetricians not to deliver babies before 39 weeks unless there is a medical reason to do so.

“It’s very important for people to realize that every week counts,” says Lucky E. Jain, a professor of pediatrics at Emory University School of Medicine.

It’s unclear how many deliveries are performed early for nonmedical reasons. Preterm births (before 37 weeks) have risen 31% in the U.S. since 1981 — to one in every eight births. The most serious problems are seen in the tiniest babies. But nearly 75% of preterm babies are born between 34 and 36 weeks, and much of the increase has come in C-sections, which now account for a third of all U.S. births. An additional one-fifth of all births are via induced labor, up 125% since 1989.

Many of those elective deliveries are done for medical reasons such as fetal distress or pre-eclampsia, a sudden spike in the mother’s blood pressure. Those that aren’t can be hard to distinguish. “Obstetricians know the rules and they are very creative about some of their indications — like ‘impending pre-eclampsia,'” says Alan Fleischman, medical director for the March of Dimes.

Why do doctors agree to deliver a baby early when there’s no medical reason? Some cite pressure from parents. “‘I’m tired of being pregnant. My fingers are swollen. My mother-in-law is coming’ — we hear that all the time,” says Laura E. Riley, medical director of labor and delivery at Massachusetts General Hospital. “But there are 25 other patients waiting, and saying ‘no’ can take 45 minutes, so sometimes we cave.”

There’s also a perception that delivering early by c-section is safer for the baby, even though it means major surgery for the mom. “The idea is that somehow, if you’re in complete control of the delivery, then only good things will happen. But that’s categorically wrong. The baby and the uterus know best,” says F. Sessions Cole, director of newborn medicine at St. Louis Children’s Hospital.

He explains that a complex series of events occurs in late pregnancy to prepare the baby to survive outside the womb: The fetus acquires fat needed to maintain body temperature; the liver matures enough to eliminate a toxin called bilirubin from the body; and the lungs get ready to exchange oxygen as soon as the umbilical cord is clamped. Disrupting any of those steps can result in brain damage and other problems. In addition, the squeezing of the uterus during labor stimulates the baby and the placenta to make steroid hormones that help this last phase of lung maturation — and that’s missed if the mother never goes into labor.

[Why Every Week of Pregnancy Counts] Gail Zuniga/WSJ

“We don’t have a magic ball to predict which babies might have problems,” says Dr. Cole. “But we can say that the more before 39 weeks a baby is delivered, the more likely that one or more complications will occur.”

In cases where there are medical reasons to deliver a baby early, lung maturation can be determined with amniocentesis — using a long needle to withdraw fluid from inside the uterus. But that can cause infection, bleeding or a leak or fetal distress, which could require an emergency c-section.

Trying to determine maturity by the size of the fetus can also be problematic. Babies of mothers with gestational diabetes are often very large for their age, but even less developed for their age than normal-size babies.

Growing beyond 42 weeks can also pose problems, since the placenta deteriorates and can’t sustain the growing baby.

Making families aware of the risks of delivering early makes a big difference. In Utah, where 27% of elective deliveries in 1999 took place before the 39th week, a major awareness campaign has reduced that to less than 5%. At two St. Louis hospitals that send premature babies to Dr. Cole’s neonatal intensive-care unit, obstetricians now ask couples who want to schedule a delivery before 39 weeks to sign a consent form acknowledging the risks. At that point, many wait for nature to take its course, says Dr. Cole.

Join a Discussion

Are parents too eager to induce labor or schedule an early C-section for sheer convenience? Are doctors too willing to go along? Share your views.

Excercize, Pregnancy, and Pre-eclampsia

A new study has appeared in orgyn.com, a website dedicated to the research in the field of women’s health.  This study details the effects of exercise during pregnancy and the preventative factors with respect to preeclampsia (a condition diagnosed by high blood pressure and protein in the urine during pregnancy which, if left untreated, can lead to maternal seizure and death mother and/or baby).

Previously it had been thought that exercise could prevent preeclampsia since exercise lowers blood pressure.  This study showed that among the low to moderate exercise groups the rate of preeclampsia wasn’t affected at all.  However, in the high exercise group (over 420 minutes of exercise per week) the rate of preeclampsia actually increased.  While it’s good to be in general good health during pregnancy and exercise is a part of that, this seems to show that it’s not a good idea to exercise to the brink of body-builder status 🙂

Here is the full article:

AXX9K1Exercise and pre-eclampsia risks

Issue 25: 5 Jan 2009
Source: BJOG: An International Journal of Obstetrics and Gynaecology 2008;in press
Researchers have found that physical activity in early pregnancy may not have a protective effect against pre-eclampsia, and that high levels of exercise may actually increase the risk of developing the condition.

In a new paper published in the BJOG: An International Journal of Obstetrics and Gynaecology, the researchers from centers in Copenhagen and Odense, Denmark, in Oslo, Norway, and in Boston, Massachusetts, USA, write that it has been thought that physical activity in pregnancy protects against pre-eclampsia. This is based at least in part on physiological principles (such as exercise being understood to lower blood pressure) and has been supported by the findings of some case-control studies.

However, the researchers write, high quality empirical evidence on the association between physical activity and pre-eclampsia is limited. For the new study they analyzed data in the Danish National Birth Cohort, the largest prospective database of its kind, which enrolled 101,045 pregnant women between 1996 and 2002.

The study population consisted of 93,315 women with singleton pregnancies, of which 92,676 resulted in a liveborn child.

The women in the cohort were categorized into seven groups according to the amount of leisure-time physical activity they performed in the first trimester, as documented by telephone interviews. The groups were: 0, 1-44, 45-74, 75-149, 150-269, 270-419, and 420 or more minutes per week.

The researchers assessed the risks of pre-eclampsia and of severe subtypes of pre-eclampsia (including HELLP and eclampsia), according to the level of activity. They found no statistically significant relationships, including no protective effects, except for in the two groups with the highest levels of physical activity – where the risk of severe subtypes of pre-eclampsia was significantly raised.

The odds ratios for severe subtypes of pre-eclampsia, compared with the reference group who took no exercise, were 1.65 (95 percent confidence interval 1.11-2.43) for the women who took 270-419 minutes of physical activity per week, and 1.78 (95 percent confidence interval 1.07-2.95) for the women who took 420 minutes or more of physical activity per week.

Lead author of the paper Dr Sjurdur Ollsen said: “In our study we were unable to substantiate that physical activity in early pregnancy has a protective effect against pre-eclampsia. Another unexpected finding was that leisure-time exercise, in amounts that were only slightly higher than the recommended amount, seemed even to be associated with an increased risk of severe types of pre-eclampsia.” He suggested that further research is need to investigate this association, ideally utilizing large prospective cohort databases, but that in the meantime current recommendations on exercise in pregnancy should remain unchanged.

The journal’s editor-in-chief, Professor Philip Steer, commented that clinical guidelines in the UK stress that selective and moderate exercise during pregnancy, including aerobic and strength-conditioning exercises, can be beneficial, but he added: “While general fitness is a good thing in many respects, these data suggest that it may be unwise to exercise to peak fitness levels.

“This new research is useful as it provides us with an indication of how much exercise pregnant women should take. As with everything in life, too much of a good thing can be bad for you, and moderation in all things remains a good policy.”

Mother Blessings/Blessingways

In lieu of traditional baby showers, more and more women are planning Mother Blessings or Blessingways for the mother-to-be.   Unlike a baby shower, where the focus is on the baby, Mother Blessings celebrate the upcoming birth of woman into motherhood!  Birth is a rite of passage for many women and it’s great to show our support of her in her journey.  I also have two books, Mother Rising and Blessingways, in my library.

Here are some ideas of things you can do pamper the mother-to-be in your life.

  1. Start by naming the mothers in your lineage (children, mother, grandmothers, great grandmothers).  If you want you can link all of your wrists together with yarn or ribbon.  After everyone shares their lineage the ribbon is cut to make bracelets.  If you like, you can keep the ribbon on until the woman goes into labor to keep her in mind and support her.
  2. Cleanse the air with a sage smudge stick or salt lamp.
  3. Give the mom a relaxing foot soak or massage.
  4. Make the pregnant woman’s favorite food.
  5. Bring a “Bead and Seed.” Everyone brings a special bead and something from nature to symbolize the life growing inside her.  The beads are made into a bracelet that the mother wears until labor is over.
  6. Henna, of course, is my favorite addition to this! It’s particularly fun when the stain is still visible when the mother goes into labor.
  7. Think about hiring a belly dancer or take a belly dance class with friends.  Belly dancing was originally only for women dancing for women during labor, to show them how to use their abdominal muscles to move the baby out.
  8. Do some sort of fire/water/sand ceremony where each guest either lights a candle, pours a cup of scented water into a bowl, or layers colored sand in a glass while sharing a bit of advice or well-wishing (you can also do this with presenting your bead). You can pour the water into a special vial and keep it as a reminder of the support of your friends.
  9. If your friends have had children already, share a birth experience of your own.
  10. Instead of decorating onesies like so many baby showers do these days, have your guests decorate a square of fabric to be sewn into a blanket.
  11. You can even send the fabric out with the invitations. If you have the party early enough, you can finish the blanket or pillow case by the time the mother starts labor to remind her of the women who stand behind her.  A less time intensive option is to decorate a pillow case with positive birth phrases, encouragement, and quotes.
  12. Do a belly cast to preserve her shapeshift into motherhood.  You can purchase kits online and decorate them after they harden.  Some people put the baby’s hand prints on the belly after the baby is born or paint them with an image that is meaningful to them.  You can also have guests at the Mother Blessing decorate the belly themselves.  Another option is to hire a professional lifecaster to do the cast for you.  Unlike do-it-yourself kits where the finished product is the strips of plaster and gauze, lifecasting creates an exact replica of yourself by creating a cast and pouring medium into it (see right).  It’s definitely the more beautiful option, but also more expensive (around $150-300).  Some lifecasters in Denver are Chris Guarino, or to find other artists you can visit the Association of Lifecasters.
  13. Make a “Help” list where the guests can sign up to do chores or bring meals after the baby is born.
  14. Make a “Belly Bowl.” Some casting studios in your area may have the option to make a cast from the mom’s belly and turn it into either a bronze or ceramic bowl.  With the ceramic bowls you can decorate them yourself before firing.  With the bronze bowls you can choose different patinas (bronze finishes) and it “rings” when struck to the individual tone of mom and baby.