Potty Training

Potty Training

While it may seem to you that pregnancy was not too long ago, before you know it, your baby will soon be a toddler! The shift from diapers to potty training is an important stage of development for every toddler, just like the shift from breastfeeding to eating solid foods. In fact, toilet training is a big change for young children, as it is based on the accumulation of a variety of other developmental milestones, such as acquiring the necessary motor skills to be able to go potty. If you're looking for advice on how to potty training, we have some great potty training tips that will help you potty train your child.

Tips on Potty Training Your Toddler

When Will My Toddler Be Ready for Toilet Training?
Most children are ready to potty train at age two; however the range of readiness for toilet training spans from eighteen months all the way to four years of age. The average time at which infants change from diapers to toilet training is between 18 and 24 months.

Your toddler's ability to be ready to potty train is based on his overall development. For example, your toddler will have mastered the following skill clusters by the time he is ready for potty training:

• gross motor: sitting, walking, controlling the head
• fine motor: holding a spoon, picking up cereal between the thumb and finger
• language: demonstrates clear speech, can understand and be understood by others
• social: plays with family members, other children
• sensory: developed sense of sight, sound, touch, taste and smell

Signs of Potty Training Readiness
The following are signs that your toddler is ready to begin to potty train:

• asking to use regular underwear
• demonstrating discomfort with diapers, particularly dirty diapers
• knowing the words for stool and urine
• staying dry for two hours at a time
• having regular bowel movements

Potty Training Tips
Before beginning toilet training, it is important to keep the following guidelines in mind so that the potty training experience will be a positive one for both you and your toddler:

• do not start potty training at a stressful time; for example, during a move or when a baby is on the way or if you have just given birth
• do not punish for accidents or mistakes; instead, treat these lightly
• follow your child's pace; provide encouragement and support for even the smallest of milestones

Potty Training Resistance
If your toddler becomes resistant, she may refuse to sit on the potty or even have a bowel movement in the bathroom. Other signs of potty training resistance include becoming irritable and insisting on wearing diapers.

Reasons for toilet training resistance include:

• being scared to sit on the potty
• starting potty training before your child is ready
• having inconsistent training (i.e. having different caregivers for potty training)
• experiencing punishment

Labor Medications

Medications Used During Birth

Now that you are pregnant, your excitement is probably growing as you anticipate welcoming your new little baby into the world. But despite this excitement, you may be a little (or even a lot) nervous about getting through labor first. Deciding whether or not to use medications during labor and delivery can be particularly nerve wracking for many moms-to-be. But you can lower your anxiety levels considerably just by becoming familiar with the types of medications that you may be offered during childbirth. Here is some detailed information about the various types of labor medications, their side effects, and the pros and cons of using them.

Epidural
The epidural is by far the most common type of medication given to women during birth. An epidural is actually a mixture of anesthetic medications (like lidocaine or chloroprocaine) and narcotics (like Demerol or morphine). An epidural is administered through a catheter. This catheter is inserted in your back into the space surrounding the outside membrane of your spine. It helps to relieve labor pains by blocking most of the pain that you experience in your lower body. The epidural takes about 20 minutes to start working, but it allows for continuous pain relief while you are giving birth.

Pros:

• The epidural blocks most child birth pains
• It works for extended periods of time
• You can easily control the amount of medication that runs through the epidural catheter
• An epidural leaves you awake and alert for labor

Cons:

• It is an awkward procedure and takes time to begin working
• An epidural makes it necessary to have continuous fetal monitoring
• You may lose your ability to stand or get out of bed for the rest of your labor
• Epidurals can interfere with your ability to push, extending your labor
• Occasionally, epidurals can cause your blood pressure to drop, decreasing baby’s heart rate
• Very rarely, epidurals can cause severe headaches (if spinal fluid leaks during insertion of the catheter)

Spinal Block
Like the epidural, the spinal block is a mixture of anesthetic medications and narcotics. It is administered during the active stages of labor or just prior to a cesarean section. The spinal block works immediately to relieve pain as the medication is injected directly into the fluid in your spinal column. A spinal block provides total pain relief from the chest down for up to two hours.

Pros:

• Spinal blocks allow for complete pain relief
• A spinal block allows you to remain awake and alert throughout labor

Cons:

• The spinal block procedure can be uncomfortable to have administered
• A spinal block can cause loss of bladder control, necessitating a catheter
• Spinal blocks can cause a decrease in your blood pressure, which may lower baby’s heart rate
• A spinal block may interfere with your ability to push
• Side effects can include itching, tingling, nausea, and lightheadedness

Systemic Medications
During labor you may also be offered various narcotics and tranquilizers to help you deal with any pain and anxiety that you may be experiencing. Narcotics help to dull your labor pains, but they won’t eliminate them completely. Tranquilizers won’t be helpful for your pain, but they can help to reduce your anxiety, allowing you to rest during labor. These medications are usually given intravenously or through intramuscular injection. They usually last between four and eight hours.

Pros:

• These medications can reduce pain and relieve anxiety effectively
• They may allow you to catch up on rest during the early stages of labor
• Tranquilizers and narcotics can be administered easily, without the help of an anesthesiologist
• They are less likely to slow labor

Cons:

• Systemic medications can pass through the placenta and enter baby’s bloodstream, making him less active upon delivery
• These medications may affect baby’s health, including his heart rate and ability to breathe
• Side effects can be unpleasant and include dizziness, drowsiness, nausea, and itching
• Narcotics are less effective on pain than the epidural or the spinal block
• These medications may reduce your memory of labor and delivery

Pudendal Block
A pudendal block uses anesthetic medications to numb the area between the vagina and the anus. You may be offered a pudendal block if you have had an episiotomy or if a tear has occurred during labor. A pudendal block can also help reduce the pain associated with a vacuum-assisted delivery or a forceps delivery. A pudendal block lasts anywhere from several minutes to an hour.

Pros:

• A pudendal block provides excellent local pain relief
• The pudendal block rarely causes any side effects for mom or baby

Cons:

• A pudendal block doesn’t relieve labor contractions
• This medication can sometimes decrease your urge to push
• Rarely, a pudendal block can cause your blood pressure to drop, which may interfere with your baby’s heart rate
• There is a possibility of an allergic reaction with a pudendal block

Breastfeeding as Contraception

Contraceptive Benefits of Breastfeeding

If you are pregnant or have just given birth, you may be considering breastfeeding your child. Breastfeeding is one of the healthiest things that you can do for your baby. Your breast milk is designed specially to provide your baby with all of the vitamins, nutrients, and antibodies that she needs to stay healthy. But breastfeeding is not only beneficial to your baby. It can also be very healthy for you as well. In addition to helping you recover from pregnancy more quickly, breastfeeding can also be used as a natural family planning method. Known as the lactational amenorrhea method (LAM), this method is highly effective in preventing pregnancy in the months after childbirth.

What is the Lactational Amenorrhea Method?
The lactational amenorrhea method is just one of a variety of highly effective natural family planning methods. This method is used after childbirth, and involves breastfeeding your child exclusively for at least six months in order to prevent pregnancy. The LAM method has been around for thousands of years but declined greatly in popularity over the past century. In 1988, however, the LAM method was reintroduced thanks to new studies that proved its effectiveness in preventing pregnancies during the postpartum period.

How Does the Lactational Amenorrhea Method Work?
The LAM method works by changing the way in which your body produces your reproductive hormones. In order to ovulate and menstruate, your pituitary gland (a small gland inside of your brain) produces two hormones: follicle stimulating hormone (FSH) and gonadotropin releasing hormone (GnRH). These hormones send signals to your eggs to mature and subsequently be released during ovulation. When you breastfeed, though, this process gets interrupted, thereby interfering with the production of both FSH and GnRH.

As your baby suckles, nerve impulses travel through your body and are received by your brain. This signals the production of a hormone called prolactin, which works to inhibit both FSH and GnRH. As a result, ovulation does not occur and menstruation stops, making it almost impossible to become pregnant.

Who Can Use the Lactational Amenorrhea Method?
Any woman who is dedicated to exclusively breastfeeding her child after birth can use the LAM method to protect against pregnancy. It is most effective in women who:

• are exclusively or almost exclusively (85% of feeds) breastfeeding
• have not experienced the return of their menstrual periods
• are less than six months postpartum

How Do You Use the Lactational Amenorrhea Method?
LAM is one of the simplest natural family planning methods to use. It involves no complex calculations or calendars and requires little preparation or planning. Simply follow these steps when feeding your baby for the first six months of life:

• begin breastfeeding as soon as possible after delivery
• breastfeed between six and ten times a day, upon request
• avoid long intervals between feeds
• avoid the use of bottles and pacifiers
• don’t give any supplemental food or liquids to your baby (such as juice or water)

How Effective is the Lactational Amenorrhea Method?
The LAM method is actually highly effective in preventing pregnancy when used correctly during the first six months of the postpartum period. If you continue to breastfeed regularly and exclusively and your periods do not return, LAM is between 98% and 99% effective. Most women have trouble maintaining such a rigorous breastfeeding schedule, though. These women should use an alternate form of birth control in addition to LAM.

Advantages of the Lactational Amenorrhea Method
There are a number of advantages of breastfeeding for contraceptive purposes:

• LAM is highly effective in preventing pregnancy when used correctly.
• LAM is easy and simple to use.
• LAM is inexpensive and causes no side effects.
• LAM doesn’t interfere with intercourse.
• LAM is acceptable in most cultures.
• There are numerous health benefits of breastfeeding for both you and baby.

Disadvantages to the Lactational Amenorrhea Method
As with any birth control method, LAM is not without its drawbacks:

• LAM is most effective in the first six months of postpartum. After six months, LAM becomes less effective.
• It can be difficult to maintain regular breastfeeding schedules, especially for working mothers.
• LAM does not protect against STDS.

Lactational Amenorrhea Method after Six Months
LAM can be continued after your baby has turned six months of age, though it will be less effective than it is during the early postpartum period. After six months, your baby will require supplemental feeding, and this may interfere with breastfeeding. As long as your baby continues to breastfeed for more than 65 minutes a day, and your periods have not returned, LAM should still be quite effective in preventing pregnancy.

With perfect use, the LAM method is between 90% and 96% effective in guarding against pregnancy after six months. However, it is recommended that women use an additional type of birth control after their baby turns six months of age.

Breastfeeding

Breastfeeding

As you progress through your pregnancy, you may be trying to decide whether or not to breastfeed your baby when she arrives. Many new mothers choose to breastfeed because of the health and wellness options that it offers. Breastfeeding is not only a healthy and nutritional source of food for your baby, but it also offers you and baby the chance to bond with one another. So if you are considering breastfeeding, here are some important facts that you may need to know to help get you and baby off to a great start!

The Benefits of Breastfeeding
Deciding to breastfeed can be a big decision, especially when you consider that it sometimes requires a lot of time, patience, and effort. However, breastfeeding is also one of the healthiest and most beneficial things that you can do for your baby. Your breast milk is designed specially to meet the nutritional needs of your baby. It contains just the right amount of vitamins and minerals to ensure that he grows and develops properly. It also contains special antibodies that will help your baby to fight off illness and infection. Additionally, many babies find breast milk easier to digest than formula, which means he’ll experience fewer bouts of diarrhea and constipation. Here are some other advantages of breastfeeding:

• Breastfeeding requires less planning, work, and money than bottle-feeding.
• It will help you to get your pre-pregnancy body back more quickly (because breast-feeding helps to burn calories).
• Your breast milk is always sterile and ready to go.
• Breastfeeding may lower your risk of breast cancer and ovarian cancer

Types of Breast Milk
During the days after labor and delivery, your body will begin to produce colostrum, which is the first type of breast milk your baby will receive. Colostrum is a thick, yellowish liquid that is rich in protein, vitamins, minerals, and immune factors. This milk helps to nourish your baby in her first days and helps to protect her against infections and disease. After a couple of weeks, your regular breast milk will begin to come in. This milk is high in fat and will help your baby to get the calories and extra sustenance she will require as she grows.

When to Start Breastfeeding
Breastfeeding can begin as soon as you give birth to your little one. Babies are born with the ability to suck, and your baby will automatically show off his sucking reflexes soon after birth. Many women choose to have their babies placed on their chests immediately after labor and delivery. This allows the baby to find his own way to your nipple, and begin the breastfeeding process.

It is important to start this breastfeeding bond as soon as possible, in order to encourage your baby to latch on and feed correctly. Many women choose to have their babies stay with them by their bedside to make the breastfeeding process easier. Your baby should be breastfed on demand, or approximately every two to three hours, during infancy.

Breastfeeding Twins: Tandem Breastfeeding
If you are going to give birth to twins, you may seriously be considering bottle-feeding. However, breastfeeding twins is not as hard as it may seem. Moms of twins often engage in tandem breastfeeding, during which they feed both twins at once (one on each breast). Contrary to popular belief, you will not run out of breast milk if you are breastfeeding twins. The more milk your twins drink, the more milk your breasts will produce in return, leaving lots leftover. Breastfeeding twins can be tiring, though, so try to get them on the same schedule if you can, and sleep whenever they are sleeping.

Diet During Breastfeeding
If you choose to breastfeed your baby, it is important that you maintain a healthy diet. It is important that you eat enough fruits, vegetables, grains, and proteins to ensure that you and baby are receiving the proper vitamins and minerals. A good breastfeeding diet will look much like your diet during pregnancy. There are also some foods to avoid while breastfeeding. In particular, foods and beverages containing caffeine can be unhealthy for baby, so cut back on coffee, colas, and chocolate.

Medications During Breastfeeding
While you are breastfeeding, it is important to be aware of the types of medications that you choose to take. Almost all medications will pass into your breast milk and could affect baby’s health. Medications that were safe during pregnancy or are safe for infants are generally fine to take while breastfeeding, but speak with your prenatal practitioner to be on the safe side.

Complications with Breastfeeding
Unfortunately, breastfeeding is not all fun and games. It can occasionally cause minor health complications, which can be uncomfortable for you. The most common complications during breastfeeding are:

• Cracked and Sore Nipples: Sometimes, breastfeeding can cause your nipples to become cracked and sore. As a result, breastfeeding can become painful, especially if you are doing it a lot. Painful nipples can be soothed with ice or with pure lanolin cream. Also, avoid wearing tightly-fitted breastfeeding bras or irritating fabrics.
• Engorgement: Engorgement happens when your milk begins to come in very quickly. This causes your breasts to swell up and become hard. You can relieve engorgement by breastfeeding often or by expressing your milk using a breast pump.
• Mastitis: Mastitis is a breast infection that happens when bacteria enters the milk ducts. This can leave your breasts feeling warm, sore, and tender. Mastitis can be treated with frequent breastfeeding and a course of antibiotics.

Who Shouldn’t Breastfeed
Despite it’s nutritional benefit, not every woman is able to breastfeed. There are certain situations in which breastfeeding is not recommended, as it could be dangerous for mother or baby. You shouldn’t breastfeed if:

• you have HIV/AIDS
• you have an active infection, like tuberculosis
• you are abusing drugs or alcohol
• you are undergoing chemotherapy
• you are taking medications that will negatively affect baby

Postpartum Bleeding

Postpartum Bleeding

Now that baby has arrived, you are probably waiting for your body to begin to go back to normal. Well, your body is on its way, but "normal" may take some time to achieve. For the first few weeks, for instance, you will have to deal with postpartum bleeding. Postpartum bleeding is a completely normal part of the postpartum period and, for the most part, goes away on its own. However, bleeding during the postpartum period can sometimes indicate underlying health complications.

Lochia

Lochia is the name given to postpartum bleeding. Every woman who delivers a child, either vaginally or through cesarean section, will experience this type of bleeding. It is the way in which your body expels excess mucus, placental tissue, and blood after giving birth.

Lochia is very similar to the bleeding you experience during your menstrual period, however, it is much heavier. It typically begins in the hours immediately following birth and usually continues for two or three weeks. However, in some women lochia can last for up to six weeks.

Symptoms of Lochia
Lochia usually begins as a bright red discharge from the vagina. This blood typically continues to be bright red in color for between four and ten days. After ten days, your lochia will become a pink color, eventually changing to a yellowish-white color. This blood flow may be constant and even, or it may be expelled in intermittent gushes. Lochia may also be accompanied by numerous small blood clots, about the size of a grape.

Dealing with Lochia
Postpartum bleeding can sometimes be annoying to contend with, however, there are some ways to make the going easier:

• Rest as much as you can, and avoid excess standing and walking (this will exacerbate the blood flow).
• Use heavy duty maxi pads to soak up the blood.
• Do not use tampons for at least six weeks after pregnancy. Tampons can introduce bacteria in to the vagina and uterus, causing infection.

Warning Signs
Typically, lochia is not the result of any health complication and will end on its own when your body is ready. However, some women do experience problems with their postpartum bleeding. If you experience any of the following signs, call your health care provider or visit your nearest emergency room:

• bright red discharge for more than seven days after birth
• discharge that smells bad
• fever and chills
• abnormally heavy bleeding (in which a maxi pad is soaked in less than one hour)

Postpartum Hemorrhaging

Postpartum hemorrhaging is a more severe type of post-pregnancy bleeding. If you lose more than 500 mL of blood after a vaginal birth, or more than 1000 mL after a cesarean section birth, you are classified as having postpartum hemorrhaging. Postpartum hemorrhaging can be a very dangerous condition, and is associated with various complications including heavy blood loss and even maternal death.

Postpartum hemorrhaging occurs in between 1% and 10% of all pregnancies in the United States. It usually begins in the 24 hours immediately following childbirth (early postpartum hemorrhage), however, it can occur anytime during the six weeks following delivery (delayed postpartum hemorrhage).

What Causes Postpartum Hemorrhaging?
The most common cause of postpartum hemorrhage occurs when the uterus does not contract after birth. This allows the uterus to continue bleeding, and can result in massive blood loss. Other causes of postpartum hemorrhage include:

• failure to pass all of your placenta
• forced removal of the placenta
• trauma to the uterus, cervix, or vagina during delivery

Who’s At Risk for Postpartum Hemorrhaging?
Every woman is at risk for developing postpartum hemorrhage. However, there are certain factors that will increase your risk. These include:

• multiple birth
• placenta previa
• induced labor
• birthing a large baby

Symptoms of Postpartum Hemorrhaging
It is extremely important that every new mother knows how to recognize the symptoms of postpartum hemorrhage. Quick treatment is essential in order to prevent massive blood loss and death. Symptoms include:

• massive blood loss
• passing large clots
• dizziness, lightheadedness, or fatigue

Treating Postpartum Hemorrhage
Postpartum hemorrhage is usually taken very seriously. If you are suffering from this type of bleeding, you will likely be treated in hospital. Treatment includes:

• uterine massage to stimulate contractions and stop blood flow
• the medication Pitocin, which stimulates uterine contractions
• the removal of excess placenta, typically by hand to prevent further bleeding
• blood transfusion (if there is massive blood loss)
• hysterectomy (if there is damage to the uterus)

Baby Blues

The Baby Blues

For the last nine months you have done nothing but anticipate the arrival of your new baby. You have imagined how exciting, fun, and joyful it would be to spend time with her. You couldn’t wait to hold her in your arms. But now that she is here – well, things aren’t as great as you thought they would be. If you have been feeling a little bit anxious, nervous, and sad now that baby has arrived, you may be wondering exactly what’s wrong with you. These feelings are actually very common in moms who have just given birth. Known as the "baby blues" this mild change in mood can be distressing, but it is a completely normal part of pregnancy.

What are the Baby Blues?
The baby blues is the affectionate term given to a mild form of depression that occurs after labor and delivery. It’s also known as the postpartum blues, and usually occurs about three or four days after baby has arrived. The baby blues are best described as a general feeling of sadness or anxiety that typically lasts no more than two weeks. The baby blues usually pop up out of the blue and disappear all on their own.

How Common are the Baby Blues?
The baby blues are actually a lot more common then most women think. In fact, between 50% and 80% of all new mothers experience some form of the baby blues in the days after childbirth. It tends to be more common in women who have just given birth to their first child.

What Causes the Baby Blues?
Researchers aren’t 100% sure about what causes the baby blues, however, a variety of factors do seem to be involved.

• Physical Changes: The physical changes that you undergo in the days after labor and delivery probably have a great deal to do with the mood changes associated with the baby blues. During pregnancy, your body’s hormone levels continuously rise. In fact, your progesterone and estrogen levels were probably up to ten times their pre-pregnancy levels in order to help support fetal development. After labor, your hormone levels begin to drop suddenly, because they are no longer needed to support baby’s growth. And different hormones begin to kick in, allowing you to breastfeed you new little one. These hormonal ups and downs can really take their toll on your emotions.
• Fatigue: The exhaustion caused by childbirth as well as by the constant care you may be providing your little one also seem to contribute to the baby blues.
• Anxiety over Baby: Welcoming a new baby into the world can be a very scary thing to do. You may feel overwhelmed with your new responsibilities or you may be worried about how you are going to take on this new role. While these fears are perfectly normal, they can also contribute to the baby blues.

Symptoms Associated With the Baby Blues
Symptoms of the baby blues are usually mild and typically appear in the days immediately following birth. They also tend to clear up on their own within two weeks after birth. Symptoms of depression may include:

• irritability
• sadness and crying
• loneliness
• feeling overwhelmed or anxious
• mood swings
• lack of energy and fatigue

Baby Blues or Postpartum Depression?
It is important that you are able to distinguish between the baby blues and postpartum depression. Postpartum depression is a more severe form of depression that can occur in the year following childbirth. Its symptoms are usually intense and last much longer than those of the baby blues. Here is a quick comparison to help you identify which type of depression your are suffering from.

Baby Blues	Postpartum Depression
occasional crying or sadness	frequent crying and pervasive sadness
lack of energy	persistent fatigue
anxiety or nervousness	severe anxiety, which may include hyperventilation or panic attacks
disturbed sleep patterns	insomnia or hypersomnia
reduced appetite	loss of appetite
loneliness	loss of interest in regular activities
	weight changes
	thoughts of self harm or suicide

Dealing with the Baby Blues
If your symptoms seem to be those of the baby blues, there are some things that you can do to help boost your mood.

• Express your feelings to those around you.
• Ask for support from friends and family members.
• Get lots of rest.
• Prioritize. You don’t have to do everything right away.
• Speak with your partner about dividing the parenting responsibilities.
• Take time out for yourself. Go out with friends, watch a movie, or just take a relaxing bath.
• Exercise regularly.
• Eat a healthy and balanced diet.

If your symptoms seem to be getting worse or have lasted longer than a couple of weeks, it may be time to consult with your health care practitioner. She may be able to suggest a depression treatment that will help to alleviate your symptoms.

Preterm Labor

Preterm Labor

Pregnancy is a great time to enjoy yourself; after all, you get to watch your baby grow and develop! Unfortunately, pregnancy can also be a scary time for some women, mainly because there are so many complications to worry about. Many pregnant women worry about going into preterm labor. Preterm labor is a very serious pregnancy complication, as it could put you and your baby at risk for future health problems. In order to reduce your chances of experiencing preterm labor, be sure that you are familiar with the symptoms of the condition and the steps that you can take to prevent it.

What is Preterm Labor?
Also known as premature labor, preterm labor occurs when you begin to experience regular contractions or cervical dilation before 37 weeks of pregnancy. Usually, a typical pregnancy lasts anywhere between 38 and 42 weeks. Your baby needs to spend this amount of time in your uterus in order to ensure that his organs and tissues are properly developed.

Preterm labor is a risky complication. If labor begins too early, there is the chance that your baby could be born prematurely. Premature birth puts your baby at increased risk for certain serious health complications and fetal development problems.

Who Experiences Preterm Labor?
Preterm labor is actually fairly common in the United States. 12% of all babies born here are premature; this works out to about 1 in every 8 babies. Sometimes, premature labor is induced, especially if you are experiencing certain health complications, like preeclampsia.

Any pregnant woman can experience preterm labor, however, there are certain factors that could increase your chances of going into early labor . These risk factors include:

• being under 17 or over 35 years of age
• having experienced a previous preterm birth
• carrying twins or higher order multiples
• experiencing poor weight gain during pregnancy
• smoking, drinking alcohol, or doing drugs during pregnancy

Preterm Labor Causes
Preterm labor is usually the result of a combination of factors. Some factors that may contribute to early labor, include:

• Infection: Infections, like chlamydia, trichomoniasis, and bacterial vaginosis, can weaken the membranes that surround your amniotic sac. This could lead to premature rupture of the membranes and preterm labor.
• Placental Problems: Placental complications like placenta previa and placental abruption may trigger preterm labor.
• Abnormal Uterus: Structural problems with your uterus could also trigger preterm labor. A particularly large uterus (common with multiple births) or a short cervix (less than 25 millimeters), can lead to early labor.
• Chronic Illness: Illnesses, such as sickle cell disease, lupus, and diabetes can trigger early labor.
• Trauma: Injury to the abdomen or uterus can also be a contributing factor in some cases of preterm labor.

Signs of Preterm Labor
It is essential that every pregnant woman is able to recognize the signs of preterm labor. Being able to spot these symptoms can go a long way to reducing your baby’s risks for associated health complications. Keep an eye out for these symptoms of preterm labor:

• abdominal contractions
• contractions accompanied by nausea, diarrhea, or indigestion
• preterm labor contractions occurring more than every ten minutes
• increased pressure in the thighs, vagina, or pelvic area
• increased lower back pressure
• vaginal bleeding
• increase or change in vaginal discharge (particularly bloody or mucus-like discharge)

What Happens During Preterm Labor?
If you think that you may be experiencing preterm labor, contact your health care provider immediately or go to the nearest hospital. You will likely be monitored for contractions and your caregiver will check your baby’s heart rate for signs of distress. Your health care provider will also test you for any signs of infection and for cervical dilation or effacement. You may be given an ultrasound pregnancy test to check your baby’s growth and the amount of amniotic fluid in your uterus.

Depending upon which week of pregnancy you are in, and if you are experiencing contractions, your health care provider may try to stall labor. If you are less than 34 weeks pregnant and your water has not broken, your caregiver may provide you with medications to help stop your labor contractions. You may also be given corticosteroids to help develop baby’s lungs. If you are between 34 and 37 weeks pregnant and your water has broken, your health care provider may recommend inducing labor.

Risks Associated with Preterm Labor
Preterm labor can be risky for baby. If unaddressed, preterm labor can lead to preterm birth. Preterm birth puts your baby at increased risk for:

• brain abnormalities
• breathing problems
• digestive disorders
• delayed learning and development later in life
• health complications later in life

Preventing Preterm Labor
There are certain things that you can do to help prevent going into preterm labor.

• Maintain regular prenatal health checkups.
• Follow a healthy pregnancy diet.
• Avoid smoking, drinking, and drug use during pregnancy.
• Do not engage in strenuous physical activities.
• Tell your health care provider about any unusual pregnancy symptoms that you are experiencing.

Genetic Disorders

Genetic Problems with Baby

Pregnancy can be a worrisome time for some parents-to-be. You may find yourself wondering daily about your baby’s prenatal health, happiness, and development. Genetic disorders are often of special concern to many expectant couples. Genetic disorders can put your baby at risk for slow mental and physical development, physical defects, and lifelong illnesses. However, new screening tests are now available to help detect these genetic disorders before your baby is born. These can help to ensure that your baby receives the appropriate medical attention and treatment after birth.

What are Genetic Disorders?
Genetic disorders are physical defects or illnesses that are caused by problems in your body’s genetic code. Everybody is made up of 46 chromosomes, and these chromosomes carry your DNA. DNA is responsible for dictating how you will look, act, and develop. When a baby is conceived, he receives 23 chromosomes from his mother and 23 chromosomes from his father. These chromosomes come together to complete an entire genetic code. Sometimes, however, defects can occur in some of the chromosomes or individual genes. As a result fetal development can change, and your baby can be born with a genetic disorder.

How are Genetic Disorders Transmitted?
Some genetic disorders are hereditary. Parents can sometimes carry a defective gene inside of their DNA. When two parents with the same defective gene conceive a child together, their baby will also be born with this defective gene. This can sometimes result in a genetic disorder. While chromosomal disorders can be hereditary, they can also develop after fertilization, as the embryo splits during development.

Common Genetic Disorders
There are many different types of genetic and chromosomal disorders. It is important to be aware of these disorders so that you can assess your baby’s risk of developing one.

Downs Syndrome
Downs Syndrome is actually a chromosomal disorder, caused by the presence of an extra chromosome. In this case, instead of having two of chromosome 21, your baby will have 3. This is why Downs Syndrome is sometimes referred to as Trisomy 21.

Downs Syndrome is characterized by delayed physical and mental development. Children with Downs Syndrome tend to have slower language skills and a lower IQ. Other physical characteristics of Downs Syndrome include a smaller head, a broad, flat face, and small ears. Downs Syndrome affects 1 out of every 1,000 children born in the United States, however, your risk for having a baby with Downs Syndrome increases with maternal age. Women who are 35 have a 1 in 350 chance of having a child with the syndrome, while women who are 45 have a 1 in 30 chance.

Sickle Cell Anemia
Sickle cell anemia is a hereditary disorder that is passed down from both parents. It causes red blood cells to take on an abnormal sickle-shaped appearance, which results in chronic anemia. Sickle cell anemia can also cause episodes of severe pain and a number of other health related illnesses. About 70,000 children in the United States are currently affected by sickle cell anemia. The disease is most common among people of African or Latin American descent, though it can affect a child of any background or culture.

Tay-Sachs Disease
Tay-Sachs disease is a devastating illness that causes severe mental and physical incapacity. A hereditary disease, this illness can be passed on to your baby if both your and your partner are carriers of the Tay-Sachs genetic defect. Symptoms of the illness generally appear a few months after birth and gradually worsen. They include blindness, seizures, dementia, and paralysis. Most children born with Tay-Sachs disease die before the age of five. This illness is most common among people of Ashkenazi Jewish or French Canadian descent.

Phenylketonuria (PKU)
PKU is a genetic disorder that affects children who have parents who carry the PKU genetic defect. This disorder affects how the body processes protein, and, if left untreated, can lead to severe developmental and physical delays. It can trigger mild to moderate mental retardation. About 1 in 10,000 children are born with this disease every year in the United States.

Fragile X Syndrome
Fragile X Syndrome is caused by a defect in one of your baby’s X chromosomes. It is typically passed on through the mother and affects male children, although female children can also be affected. Fragile X syndrome is characterized by late physical and mental development as well as particular physical defects. Children with Fragile X syndrome tend to have a prominent chin, highly flexible joints, and long fingers. They also experience varying levels of impaired mental growth. Every year, about 1 in 2000 males and 1 in 4000 females are affected by Fragile X syndrome.

Testing for Genetic Diseases
Thanks to new technological advances, it is now possible to screen for many genetic birth defects and disorders before you conceive a child. If you have any risk factors for genetic diseases, it is possible for you to speak with a genetic counselor and get tested to find out if you carry any genetic defects that may be passed on to your future children. Common risk factors include:

• having a family history of genetic disease
• having a child with a genetic disorder
• being of advanced maternal age

Screening tests are often simple and straightforward, requiring only a blood or saliva sample. It is also possible for you to screen your child for some genetic disease while she is still in utero. Pregnancy test procedures often involve the use of ultrasound, amniocentesis, or chorionic villi sampling (CVS) to detect physical abnormalities or genetic defects. It is now possible to do prenatal screening for:

• Down Syndrome
• Tay-Sachs Disease
• Sickle Cell Anemia

Coping After Miscarriage

Coping with Miscarriage

Coping with a miscarriage can be one of the most difficult things you will ever have to do. Miscarriage often brings about feelings of fear, guilt, sadness, and depression. It you have recently experienced a miscarriage, you may be finding it difficult to go to work, see friends, or just get out of bed in the mornings. You may also be worried about your future fertility and happiness. Though it may seem hard right now, there are certain steps that you can take to help ease your pain. By acknowledging your grief, finding the right support, and learning to let go, you will find that you will be able to deal better with the terrible pain of miscarriage.

Emotions and Miscarriage
There are a number of different emotions that you may be experiencing if you have gone through a miscarriage. An important part of coping with your miscarriage is allowing yourself to feel these emotions, openly and honestly.

• Shock and Grief: Immediately after a miscarriage, many women enter into an initial state of shock. Miscarriages are often sudden and unexpected, and therefore yours may have left you feeling as if you have been run over by a bus. Though an awful feeling, this shock is a natural part of the coping process. After shock, you may experience different levels of grief. Everybody expresses their grief in different ways, whether it’s screaming and shouting, or sitting in silence. It is completely okay for you to experience this sadness.
• Anger and Guilt Numerous women experience feelings of anger and guilt after a miscarriage. You may find yourself silently cursing that pregnant woman sitting next to you, or angrily wondering why this miscarriage had to happen. You may also find that you are blaming yourself for your miscarriage. It is normal to experience this anger and guilt, but you must keep reminding yourself that you are not to blame.

Grieving Your Loss
It is very important that you and your partner work together to grieve your loss. Take some time off work in order to remember and reflect. You may want to memorialize your baby in a special way. You could:

• Plant a tree in his honor.
• Make a donation, in his memory, to a charitable foundation,
• Have a quiet ceremony to celebrate your time together.
• Prepare a journal or scrapbook to celebrate his life.

Turning To One Another
Miscarriage can be a very stressful experience for both you and your partner. Your partner will also be feeling similar emotions to you, so you need to support one another. You may find that your relationship becomes strained as both of you come to terms with your grief, so it is important to stay close and connected. Set aside some quiet time for just the two of you: go for a walk, see a movie, or just cuddle with each other. This quiet time can help you to stay connected during the grieving process.

Turning to Others
Dealing with others may be particularly difficult at this point in time. Your friends and family will want to help you, but they may not know how to respond to your pain and loss. You might find that your family members say things like, "You can always have another baby" or, "Maybe it’s all for the best." Of course, these comments are highly insensitive and only work to trivialize your grief. But they are not said out of ignorance or malice; many people simply don’t know how to deal with loss themselves.

Try to voice your grief to your family and friends the best you can. Ask for their support in the form of a shoulder to cry on or a friendly ear to listen. If family comments are getting you down, politely ask family members to just listen, not speak. They will not take offense. Find one family member of friend who you can rely on. Lean on this person for support and don’t hesitate to call on her when you need it.

Getting Support

Grieving is something that every individual has to do after they have experienced a miscarriage. But you don’t have to do it alone. There are many resources out there for women and couples who have experienced miscarriage or stillbirth.

Support Groups:
Support groups are specially designed to help you deal with your emotions of grief, anger, and depression in a group setting. There are a number of support groups that help women and couples deal specifically with the news of miscarriage. Pregnancy loss support groups can provide you with coping tips and information on recovering from miscarriage and dealing with your grief. These groups are often very helpful because they allow you to talk with other couples that have also experienced miscarriage. Ask your health care provider or local hospital or women’s center for a listing of support groups in your area.

Talk Therapists:
Talk therapists can meet with you individually or they can help you and your partner to grieve your loss together. Talk therapy allows you to express your feelings surrounding your miscarriage in an open setting. It can also help to provide you with techniques that will enable you to better understand what has happened. Talk therapists can also offer you ways to help move on when you are ready.

Writing it Out:
Writing is an excellent way to let out your emotions that have built up inside. Through writing, people are often better able to deal with their feelings and begin to move on. In fact, studies have shown that journal writing can help speed up the healing process. Writing through an online space can be helpful as you not only get to release your emotions, but may also contribute to the healing of those who read your story.

Fertility Counselors:
Fertility counselors can help you deal with miscarriage by discussing the details around your loss. A fertility counselor can meet with you and your partner to discuss the reasons why your pregnancy ended. Fertility counselors often help couples to deal with feelings of guilt that so often surround a miscarriage.

When Things Become Too Much
It is natural for you to experience sadness, loneliness, and grief after a miscarriage. However, if you begin to experience extreme depression, it is important that you seek help. Depression can manifest in many ways, but is often accompanied by extreme sadness, prolonged fatigue, lack of interest, and feelings of guilt or self-harm. Depression can be treated through therapy and medications, so be sure to get help from your health care provider if you feel you need it.

Stillbirth

Stillbirth

Now that you are pregnant, you may find yourself worried about the health and wellbeing of your baby. You may be especially nervous about your pregnancy during the first twelve weeks of pregnancy, as it is during this time that miscarriages most commonly occur. However, if you are pregnant, there is a risk of stillbirth later in your pregnancy. Like miscarriage, a stillbirth can be an emotionally and physically traumatic experience. It is important to be aware of the signs and symptoms of stillbirth as your progress through your pregnancy.

What Is a Stillbirth?
Stillbirth refers to the death of a fetus anytime after the 20th week of pregnancy. Stillbirths can occur right up until the time of labor and delivery. Generally, stillbirth is only experienced in about 1 out of every 200 pregnancies. Most stillbirths occur before delivery, however, up to 14% of all stillbirths do occur during the delivery period.

Signs of a Stillbirth
If you are pregnant, it is important that you be able to recognize the signs of a possible stillbirth. By catching the symptoms early on, it may be possible to prevent a stillbirth from occurring. Warning signs include:

• lack of movement from you baby
• significant decrease in baby’s movement
• vaginal bleeding

If you notice any change in your baby’s movements, it is important to notify your health care provider as soon as possible.

Risk Factors for Stillbirth
Though any pregnant woman can experience a stillbirth, certain factors do increase your risk of having a stillborn baby. These factors include:

• alcohol consumption during pregnancy
• drug use during pregnancy
• preeclampsia during pregnancy

Diagnosing a Stillbirth
While diagnosing a stillbirth is not a pleasant thing to do, it is necessary if your baby has stopped moving or if you are experiencing continued vaginal bleeding. Your health care provider will perform a pregnancy ultrasound in order to determine the health of your baby. An ultrasound creates an image of the inside of your uterus and projects this image onto a screen. Using an ultrasound, your health care provider can determine the age, weight, and sex of your baby. She can also determine how healthy your baby is.

Treating a Stillbirth
A stillbirth generally requires no treatment as it usually resolves naturally. Once a baby dies inside the uterus, your body will go into labor within two weeks of the death. Your body will expel the baby as your progress through labor.

It can be very emotionally upsetting to wait for your body to naturally progress into labor though. Many women who experience a stillbirth opt to have labor induced immediately. Labor can also be induced if your body takes longer than two weeks to go into labor.

Causes of Stillbirths
Stillbirths can be the result of a variety of different factors.

Placental Abruption: Placental abruption occurs when the placenta begins to tear away from the wall of your uterus. This prevents your baby from getting enough oxygen or the nutrients that he needs to survive. Placental abruption can also result in heavy bleeding.

Chromosomal Abnormality: Sometimes, babies are created with chromosomal abnormalities. These babies can have difficulties with proper development, motor skills, speech, and memory. In some cases, children with chromosomal abnormalities can become very sick, and even die. Your body can sometimes sense when your baby is suffering from a chromosomal abnormality, causing a miscarriage. Other times, this chromosomal abnormality goes undetected until your baby grows to a point where it can no longer support itself. One of the main reasons for a stillbirth is chromosomal abnormality.

Other causes of stillbirths include:

• bacterial infections
• gestational growth problems
• environmental risks

Preventing Stillbirths
Over the past twenty years, the number of stillbirths in the United States has decreased by almost 50%. This is probably related to the increased quality of maternal care and new knowledge about maternal risk factors in stillbirth. If you are worried about a possible stillbirth, there are a few things that you can do to help prevent it.

Get Proper Prenatal Care: It is very important to receive regular prenatal health care throughout your pregnancy. Your prenatal health care provider can ensure that your baby is safe and that you are doing all that you can to ensure a healthy pregnancy. Prenatal care can also identify possible problems early on, so that they can be resolved without any major pregnancy complications.

Monitor Baby’s Movements: It is a good idea to keep track of how much your baby moves on any given day. This will help you to recognize any changes in your baby’s daily action patterns. Count the number of kicks that your baby performs every day after the 25th week. If she is producing less than ten kicks a day, consult with your health care provider to make sure that everything is okay. You can also rent a fetal doppler machine to help monitor your baby’s heart rate.

Pregnancy After Stillbirth
If you have experienced a stillbirth, you may be fearful about trying for another pregnancy. This is understandable – stillbirth is a very traumatic experience. Pregnancy after a stillbirth is entirely possible, though it is important that you give yourself time to heal, both physically and emotionally. Speak with family and friends about your experience, or seek counseling for stillbirth support. This will help to make your next pregnancy a positive and happy experience.

The likelihood of a recurrent stillbirth depends upon the cause of your initial stillbirth. While repeated stillbirths do happen, they are very uncommon. Even in the case of genetic defects, recurrent stillbirths are very unlikely.

Miscarriage

Miscarriage

Losing a baby can be a very traumatic experience. Miscarriage often brings up feelings of sadness, depression, guilt, and anxiety. Having a miscarriage may even make you fearful to have another child. If you have had a miscarriage, it is important for you to be able to work through your emotions and pain. Learning about and understanding why miscarriages happen may help you to come to terms with your own loss.

What is A Miscarriage?
The term miscarriage is used to describe any pregnancy loss before 20 weeks. Before 20 weeks gestation, your baby cannot survive outside your uterus. Sometimes, for natural or accidental reasons, a baby can be expelled from the uterus and out of the body. Miscarriages are often referred to as spontaneous abortions, because they can happen without warning.

How Common Are Miscarriages?
Miscarriages are surprisingly common occurrences. Up to 25% of women will experience at least one miscarriage during their childbearing years. Some women will experience more than one miscarriage in their lifetime. Up to 50% of pregnancies are actually thought to end in miscarriage, however, many of these pregnancy losses occur before the woman even knows she is pregnant. The risk of miscarriage increases as you age, with women over the age of 40 having a 30% chance of experiencing a miscarriage.

When do Miscarriages Occur?
Most miscarriages occur before the end of the first trimester. This means that most spontaneous abortions happen before the twelfth week of pregnancy. These miscarriages are called early miscarriages. Though less common, some miscarriages do occur into the second trimester. These miscarriages are referred to as late miscarriages.

Who’s At Risk?
Any woman can experience a miscarriage, however, certain women are at increased risk. Risk factors include:

• smoking during pregnancy
• drinking during pregnancy
• doing drugs during pregnancy
• having certain STDs or infections
• having thyroid disease or diabetes
• suffering from certain autoimmune diseases, like Lupus

Symptoms of Miscarriage
If you are pregnant, it is important that you be able to identify the signs of a miscarriage. If you think that you are having a miscarriage, contact your health care provider or local hospital right away. Symptoms of a miscarriage include:

• vaginal bleeding that doesn’t stop within a few days
• abdominal cramping
• lower backache
• heavy bleeding accompanied by blood clots or tissue

It is important to understand that many pregnant women experience slight bleeding during their pregnancies. Bleeding is often a normal occurrence and doesn’t always signal a miscarriage. To be on the safe side though, inform your health care provider of any type of vaginal bleeding during your pregnancy.

Causes of Miscarriage
Unfortunately, many women experience miscarriages for which there are no explanations. It is often difficult to determine the cause of a miscarriage, especially if it occurs during the first trimester. Your health care provider will examine your fetal tissue in order to try to determine why your baby was miscarried. Sometimes, reasons for a miscarriage can be determined after careful examination.

Chromosomal Abnormalities
Chromosomal abnormality is the most common reason for early miscarriages. In fact, up to 70% of first trimester miscarriages are the result of chromosomal defects. Chromosomes are special strands that carry your baby’s DNA. Every baby should have 23 pairs of chromosomes, which help to determine their physical characteristics and allow them to carry out physical functions. After fertilization, sometimes the egg begins to split improperly, creating the wrong number of chromosomes. Molar pregnancies, in which the fetus develops abnormally, or in which the placenta or amniotic membranes don’t form, are a common type of chromosomal abnormality.

Blighted Ovum
Another frequent cause of miscarriage is a blighted ovum. A blighted ovum is created when a pregnancy sac develops in your uterus but contains no fetus. For some reason, your baby may have stopped developing early or there may never have been an embryo present at all. Blighted ovum pregnancies are usually detected during an ultrasound, although they can sometimes go unnoticed.

Ectopic Pregnancy
Sometimes, women miscarry because they have developed an ectopic pregnancy. An ectopic pregnancy, also known as a tubal pregnancy, occurs when a fertilized egg becomes implanted outside of the uterus. Typically, ectopic pregnancies develop in the fallopian tubes, although they can also occur in your ovaries or in your abdomen. Ectopic pregnancy symptoms usually include severe abdominal pain.

Treatment for Miscarriage
There is usually no treatment for a miscarriage. Your uterus will expel your baby along with any pregnancy tissue through your vagina, much like a period. If you continue bleeding for many days, your health care provider may decide to perform a dilatation and curettage (D&C). This procedure removes any tissue that may still remain in your uterus.

Pregnancy After Miscarriage
Though a miscarriage can be a very frightening and difficult experience, most women go on to have another successful pregnancy. It is important to wait until you are fully recovered before you try to conceive again.

Recovery really depends upon your own physical and emotional state. Women who were further along in their pregnancies when they miscarried may require a longer recovery time. Typically, recovery takes sometime between a few weeks and a few months; your period will likely return after about a month or so. Once you have had a couple of regular menstrual cycles, it is safe for you to try to conceive again.

Emotional recovery is just as important as physical recovery, though, and can take longer than your physical recovery. Many women and men need time to grieve their loss. While you may feel physically ready to try to conceive again, take the time to work through your emotions surrounding your pregnancy loss before becoming pregnant again.

For Baby

Infant Products Review


Having a new baby is challenging enough, and for first time parents it can be overwhelming. It can be impossible to get out of the house to go shopping and even harder to know exactly what to buy. Strollers, crib sheets, car seats, baby clothes, rockers, changing tables, bottles, breast pumps...the list just goes on. That's why on-line shopping is a godsend for the over-stressed parent. Below are some quality, affordable products that have made many parents' lives much easier. Many of these have been recommended by American Baby Magazine and others.

(I hope you find these items as useful as I have. Please let me know if you have new items to add or if any of these didn't work for you. -MTW)

Newborn Kick Start Gym
by Playskool

Although this toy frightened our baby the first time she heard the sounds, now she really loves it. It keeps her busy, and you can take off the hanging toys and put your own up if baby gets bored.

Pack 'n' Play
by Graco

I had one of these for each of my children. Once your baby starts crawling it's important to have a safe place to let him/her down when you can't be right there. The Pack 'n' Play is also great for picnics (no worries that baby may start putting grass or bugs in her mouth) and doubles as a travel crib.

Pacifiers
by Nuk

Of all the pacifiers I've tried, I'm convinced that Nuk is the best. The shape of the pacifier helps it stay in the baby's mouth without popping out. Although there is a latex version, I actually prefer the silicone version as it is odorless, tasteless, and hypo-allergenic.

Vibrating Infant Rocker
by Fisher Price

This chair has been indispensable for us due to our colicky baby. It takes one D battery and will vibrate like a moving automobile. Our baby slept through the night for the first time in this thing. We use it for feeding, sleeping, and everything else. You can take it apart and throw the fabric cover in the washer. My older kids like to sit in it too. Some assembly is required.

Wooden Cradle
by Futura

I like this cradle because it is classy-looking, made of hard wood, and rolls easily from room to room. On the down side, assembly is required.

Travel System (Navy Stars)
by Graco

In the olden days you had to put the baby in the carrier, then take her out of the carrier and put her in the car seat, then once you arrived at your destination you had to take her out of the car seat and put her in the stroller--usually with a considerable number of tears in between. Those days are gone. This "travel system" is a carrier, car seat, and stroller all in one. Just snap the carrier into the car seat base, then snap it into the stroller when you're ready to go without ever disturbing baby. Whoever invented this is a genius.

Open Top Swing
by Graco

A baby swing is an essential item for all new parents. It has literally been a lifesaver for me and my husband as we struggle with a colicky baby. The six speed model is shown here, but I have the three speed model which works perfectly fine and is a little less expensive. It's battery powered, so no winding is needed. Considerable thought has been put into the design of this swing, so don't settle for anything else! Warning: extensive assembly is required.

What to Expect the First Year
by Arlene Eisenberg, Heidi E. Murkoff, Sandee E. Hathaway

This book has month-by-month information about when to expect as your baby grows and develops. There are useful breastfeeding tips, and a comprehensive list of baby illnesses with symptoms. Information is easy to find and comprehensive.

Nursing Pads

Nursing a baby can result in a lot of embarrassing dripping and leaking. Don't leave home without some good nursing pads. These are disposable -- change them often and don't get the reusable kind as these can facilitate breast infection.

Mini Electric Breast Pump
by Medela

Medela makes some of the very best pumps I've tried (and I've tried quite a few!). The Mini Electric version works well for me and is affordable. If you plan on doing more heavy duty pumping, you might try their hospital grade version.

Diaper Genie
by Playtex

Dirty diapers stink and Diaper Genie is the solution. 'Nuff said!

Birth and Postpartum

Labor and the Postpartum Period

Well, now baby is on his way and you are all ready to go! It’s an exciting moment for both you and your partner; soon you will begin a new stage in your family’s life. You know all about the stages of labor and delivery and are prepared for anything. But what happens to your baby during birth? And what about after birth? It seems that your baby has a lot of hard work to do himself!

During Birth
While you are busy getting ready for the arrival of a lifetime, your baby is also very busy getting ready for his trip. By the time labor arrives, or is induced, your baby has already dropped and is making his way down the birth canal. Traveling through the birth canal isn’t always as easy as it sounds. In fact, it can be quite stressful for your baby as he is under a lot of pressure and must go without out oxygen temporarily.

Despite this stress, a vaginal birth is actually better for your baby. Studies have shown that giving birth by cesarean section increases a child’s risk of developing respiratory problems compared to babies born vaginally. However, sometimes a cesarean section is warranted. When complications arise during natural childbirth, a cesarean section can actually save the life of both you and your baby. Additionally, women having multiple births are also often encouraged to have a c-section.

Birth Stories
While your baby travels through the birth canal, his body begins to produce two hormones: adrenaline and noradrenaline. Your baby will never again produce such high amounts of these two chemicals. Both chemicals help to make your baby’s trip a successful one. The adrenaline aids your baby in adjusting to the air environment he will soon encounter. This chemical opens up his lungs and dries out his bronchi, preparing him to breathe. The noradrenaline works to slow your baby’s heartbeat. This helps him to go without oxygen for a prolonged period as he works his way out of the birth canal.

In general, your baby shouldn’t have too much trouble making his way into the world. His body should pass easily through the birth canal. His head, however, may be a different story. This is actually the most troublesome part of your baby to make its way out of the birth canal. Luckily, the skull isn’t completely hardened at birth, allowing your baby’s head to be gently altered in order to help it pass through.

After Birth
Your baby has now arrived! He has made his journey down the birth canal and his head has just entered a bright new world. Before the shoulders appear, the doctor will immediately suction your baby’s mouth and nose in order to help him breathe. After your baby’s entire body emerges, he will be placed on your abdomen and dried off. Your baby’s skin will be covered in a creamy substance, called vernix, which may be mixed with some blood. His skin may also look a little blue, so don’t be surprised. You will be able to bond right away with your little one.

Newborns don’t have very good temperature control, so he must be kept warm and dry. He will be covered in a warm towel and given a little cap to wear, which will keep heat from escaping from his head. You, your partner and your new little baby will all be given identical ID tags, so don’t worry about any mix ups. Your baby’s footprints will also be taken. Feel free to ask for a copy as a memento.

The doctor will then clamp your baby’s umbilical cord in two places. Your partner may be quite excited at the prospect of cutting between the two clamps! A vial of blood will be collected from your baby’s cord, in order to determine his blood type and to run other necessary tests. If your baby is still breathing with a lot of mucous, his nose and mouth will probably be suctioned again. At one and five minutes after birth, your baby will be given a series of tests designed to check his breathing, heart rate, color, reflexes and muscle tone. These tests are part of the Apgar assessment and will help determine whether your baby needs any extra attention.

The First Hours
The first hours of your baby’s life will be busy ones. He will be given antibiotic drops in his eyes to prevent any infection. Bacteria that he was exposed to during or after birth could cause serious problems, even blindness. In the United States, these drops are now required by law. Your baby will also be given an injection of Vitamin K to help his blood clot. Your baby will be weighed and his length and the circumference of his head will be measured. After three hours at a stable temperature, baby will have his first bath! He will be sponged down and his hair will be washed, if necessary. He will also receive a complete exam in the nursery.

Even if your birth plan involves having a home birth, your baby will still have all the appropriate tests and care that he needs after birth. You will just be able to enjoy and bond with your baby in the comfort of your own home.

Before You Go Home
Before you and your baby embark on your journey home, a few more tests need to be completed to keep your baby healthy. After 48 hours, a metabolic screen is done. Your baby’s heel will be pricked with a tiny needle to collect a drop of blood. This blood is then tested for phenylketonuria (PKU) and hypothyroidism. Your baby will probably also receive his first Hepatitis B vaccine before you are discharged. If you or a member of your family is a carrier of Hepatitis B, this vaccine will be given much earlier. If your HIV status is unknown, your baby will receive an HIV test as well. Lastly, hearing tests may be done to check out your baby’s ears. After these tests, you and your baby are ready to be on your way!

Birth Presentation

Birth Presentations – How Does Your Baby Lie?

As babies grow and develop they need to find the most comfortable and accommodating position in the womb. Babies can switch positions in the womb frequently, depending on how large they are and how generous the uterus is. However, by the time labor arrives, babies generally figure out how to get in the right position to make their way out into the world. But what position is the right position? What if your baby can’t turn around? It is important to know the possible positions of childbirth and what steps to take to have a safe and healthy labor delivery.

Presentation
The term presentation refers to the position of your baby as it moves into the birth canal. Babies can move many times and into many different positions before labor arrives. Generally speaking, most babies come to the same final presentation. These babies are born in a head-first (or crowning labor) position and facing downwards.

However, some will position themselves in a more difficult presentation. The positions of these babies, who account for less than 5% of all births, are called fetal malpresentations. Babies who have a premature birth, have little room in the uterus, or are stuck in a breech position may be unable to reposition. If they are unable to do so, a doctor may be able to assist the baby in turning. If this fails, a natural birth may be impossible. A cesarean birth instead of a vaginal birth may be the safest option.

Fetal Lie
Fetal lie is another important part of a baby’s presentation. The position of the baby’s spine in relation to its mother’s is called the fetal lie. The vast majority of babies lie in the same direction as the mother’s spine. This is called a cephalic lie. However, a baby’s spine can sometimes lie at an angle to the mother’s. When the baby is off on a slight angle it is called an oblique lie. This is fairly rare, occurring in only 1 out of every 300 births. When your baby lies at a right angle to your spine, creating a T-shape, it is called a transverse lie. This too is rare, occurring in only 1 out of every 300 births.

When the fetal lie is not in line with the mother’s spine, some problems can occur. Cord prolapse, or when your baby’s umbilical cord arrives before she does, is the most common problem associated with oblique and transverse fetal lies. This can sometimes stop oxygen and blood from reaching your baby’s brain, resulting in tissue, organ, or brain damage. Generally, most babies will right themselves before labor. However, if you know your baby is in a difficult lie and your water breaks, seek medical help right away.

Flexion Attitude
Flexion attitude is the final aspect making up your baby’s presentation. The position of baby’s head at childbirth is called flexion attitude. Most babies arrive in a downward-facing position, with their chin touching their chest. Although irregularities in flexion attitude are rare, they can occur. Some babies arrive looking up, called face presentation. Others arrive in brow presentation. These babies do not have their chins tucked up to their chest, resulting in the brow of the head arriving first. However, only 1 out of every 500 births exhibit these types of flexion attitude.

Breech Birth
The most common type of fetal malpresentation is the breech birth. In this position the baby arrives feet, knees, or buttocks first. Fewer than 3-4% of babies are born in this position. Often, the doctor or midwife can try to gently move the baby by applying pressure to your abdominal wall. Half of all breech babies can be moved into a better presentation by doing this. Shifting of the baby is best done after 36 weeks and before labor begins. If your baby is still in a breech presentation during labor, a natural or home birth may be difficult. Instead a cesarean section is likely the best option.

There are various breech positions in which your baby can present herself. If she arrives buttocks first in a V-shaped position, with the legs extending over the head, it is called a frank breech. In a complete breech, your baby arrives sitting with both legs crossed and pushed up. An incomplete breech presentation will have the baby arriving with one leg crossed and one leg extending down the birth canal.

Footling
A footling presentation is similar to an incomplete breech presentation. In this presentation, the baby will arrive with one leg stretched down the birth canal. If two legs are extended into the birth canal, it is called a double footling presentation.

Compound Presentation
In a compound presentation, more than one part of the baby arrives at the same time. The most common arrival is likely to be the head and the arm together. This presentation is only a problem if your pelvis will not allow for the extra space necessary to birth the baby. In this case, an episiotomy may need to be done while you are giving birth or, in extreme cases, a cesarean section, to ensure the safe delivery of the baby.

Shoulder Presentation
This presentation, with the shoulders arriving first, is among the most rare. Only 1 out of every 1000 babies arrive in this position. It is necessary to have your doctor reposition the baby if possible. If labor has already begun, a cesarean section will be required

Cesarean Section

Birth by Cesarean Section

The months have flown by and now it’s almost time for baby to arrive! You have probably created a birth plan by now and are eagerly anticipating meeting your new little one. But now is also an emotional time for you and you may be experiencing worries and fears about your labor and delivery. The possibility of having a cesarean section may be at the top of your list of fears. Whether you are planning to give birth by cesarean section or not, it is important to know the ins and outs of this procedure, as well as the benefits and risks associated with it. Being prepared for the possibility of cesarean section will go a long way to allaying those fears.

What is a Cesarean Section?
A cesarean section is commonly called a c-section. Instead of a vaginal birth, during a c-section, your baby is delivered through your abdomen. For this procedure, the doctor begins by making a small, thin incision into your abdomen. Another incision is then made into your uterus, exposing the amniotic sac that holds your baby. The baby is then gently pulled out of the uterus and welcomed into the world.

When is a Cesarean Section Needed?
Most women prefer to give birth vaginally. Doctors also prefer this route as it is minimizes the amount of recovery time for mom and is the natural way for a baby to make his way into the world. However, you may suddenly find yourself being wheeled out of the delivery room into the operating room if certain complications arise during your labor.

The majority of cesarean sections are performed because of some difficulty arising during the labor and delivery process. You may be pushing with all your might, but baby still refuses to make her way down the birth canal. In cases like these, a c-section is often in order. During childbirth, your doctor will monitor you and your baby’s progress. If your cervix stops dilating (arrest of dilation) or if your baby is being stubborn about descending into the birth canal, your doctor may feel a c-section is necessary. It is hard on both you and the baby if labor is taking too long. To avoid extra complications, your doctor might suggest taking the baby out abdominally. In fact, 1/3 of all c-sections are performed because of slow labor. Also, if your baby’s heart beat suddenly becomes irregular a c-section could prevent her from becoming too stressed.

Your doctor will also keep an eye out for other situations that may cause problems for you and baby during your labor. A prolapsed umbilical cord could prevent your baby from getting the air and blood he needs to survive on his trip down the birth canal. This will necessitate birthing baby through cesarean section. If the doctor suspects your placenta may be tearing away from your uterus, a c-section will also be in order as this could endanger your baby.

Sometimes other factors can lead to a c-section. If your baby is too large to fit down the birth canal and through the cervix, a cesarean is probably the best option. If you are diabetic, have placentia previa or an outbreak of genital herpes, a cesarean section will be necessary to protect baby.
If you are expecting multiple births, a c-section may also be elected.

What will Happen During the Cesarean Section?
If you do end up having a c-section, don’t worry. By being prepared for the event you will feel much more calm and in control. Focus on the arrival of your baby who you can’t wait to meet! Unless it is an emergency situation, your doctor will talk to you about the procedure and ask you to sign a consent form. Then you will be brought to the operating room and given an anesthetic. General anesthetic is rarely given nowadays, so it will probably be an epidural or spinal block to numb your lower half. A catheter will be inserted into your bladder so that it can drain. An IV will also be put in your arm to keep you energized.

The nursing staff will screen you off so you won’t be able to see the cesarean being performed. However, your partner, after they dress up in surgical garb, will most likely be able to watch if he or she desires. A small horizontal cut is made just above your pubic bone. This is called a bikini cut and is less risky then the vertical classical cut. It is less likely to rupture if you decide to have another baby. A second cut will be made into your uterus and then it is time for the baby to arrive! The surgeon will gently pull your baby out, and while the bundle of joy is being checked out, you will have your placenta removed.

Your baby will then be handed over to your partner so you all can spend your first moments together. Meanwhile, the doctor will stitch you up, either with stitches or staples. This process takes about thirty minutes. Next, you and your newborn will be taken to be monitored, probably for three or four hours. Then you can join each other on the maternity ward!

Risks of Cesarean Sections
Hearing about the risks of c-sections may cause you to be even more afraid of the process. But remember, these risks are minimal, and your doctor will only suggest a c-section when it is absolutely necessary. As with any surgery, there is some risk associated with the anesthesia used during cesarean births. If you happen to be sensitive to the anesthetic used, you may experience a drop in blood pressure of respiratory complications. Infection is also of concern. Organs close to your uterus, like the kidney and bladder, may be infected during the c-section. If you have a c-section you may also notice increased blood loss. You will lose about twice as much blood as with a vaginal birth.

Your baby can also experience some problems associated with a cesarean delivery. Babies born through cesarean section tend to have a greater chance of having respiratory problems. In some cases, the surgeon could nick baby accidentally while making the incision.

Benefits of Cesarean Sections
Though cesarean sections seem like a scary and threatening process, they can actually be very beneficial to you and your baby. It is better to perform a c-section than to risk a long, complicated vaginal birth. Both you and baby will feel better for it. In fact, a c-section could save the life of both you and your newborn should complications arise during labor. Try not to feel scared. Remember that c-sections occur in almost 22% of all births.

Labor and Delivery

The Stages of Labor

As the big day approaches, you may be feeling more and more nervous about what giving birth will actually entail. You are probably worried about the pain, about your stay at the hospital and about how long the whole thing will take. By reading up on the stages of labor and delivery, as well as the experiences of other women, you will be able to ease your anxiety about the birthing process. By knowing as much as possible, you will be able to recognize the stages of birth for yourself, and be able to make conscious and well-informed decisions about what’s right for you.

First Stage: The Waiting Game
The first stage of labor includes three parts: early, active and transitional labor. The early phase is also called the latent period or pre-labor. During this stage of labor, contractions will begin. They may begin gently but will gradually become stronger and more intense. The contractions will help your cervix to change, becoming shorter and opening up more, so that the baby can begin its descent into the birth canal. This process is called effacement and dilation.

Depending on your baby and your body, your progression may be different than average. It can take some women as much as a few hours to dilate even a few centimeters. Once your contractions begin, you should call your doctor or midwife to let them know that your labor has started. Depending on how far apart your contractions are, you may have some time before you head to the hospital.

Once your cervix has dilated to 3 or 4 centimeters you are considered to be in the active phase of the first stage of labor. During this phase of labor, your cervix will change consistency. It will go from being firm and tight to being soft and stretchy. Your contractions should also be getting longer – they may last up to 60 seconds now and occur every 3 to 4 minutes. To ease the pain, step into your birthing pool or head to the hospital. At this time you may also choose to have natural childbirth or to use some pain medication, such as an epidural.

Your water may also have broken by this point. The breaking of the water occurs as a result of your body increasing production of a particular enzyme as you go into labor. This enzyme works to dissolve the collagen that keeps the fetal membrane together. The amniotic sac then splits and fluid is released. To induce labor naturally, the doctor or midwife may suggest breaking your water, if it hasn’t yet broken. The color of the amniotic fluid will be checked. This fluid should be clear. If it is tinted, called meconium staining, this may indicate that the baby is stressed.

During the transitional phase of early labor, your cervix dilates from 8 to 10 centimeters. Depending upon your body, you may feel intense flu-like symptoms. Some women experience nausea, chills, and shakiness. Try to keep your mind off the contractions, which are now occurring every 2 or 3 minutes. Listen to music or read until it is time to push.

Second Stage: Hard Work!
The second stage of labor is significantly shorter than the first, averaging about 90 minutes. It may go even faster if you’ve already had a child. But you will have to put in a lot of hard work. Although women are typically encouraged to give birth in a partially reclined position, trying a different position can actually be more beneficial in helping speed up labor and delivery. Try getting gravity to help you out by squatting, standing, or resting on all fours. Giving birth in an upright position can reduce your time in the second stage by as much as 60 minutes. Now is also a good time to utilize your Lamaze breathing techniques.

During this second stage of labor, your cervix will be completely dilated and you can begin to push. Your baby will start to make her way down the birth canal. You will feel the pressure of your baby’s head against your legs and you will have an urge to push. As you push, the baby moves further down your pelvis. Crowning will occur. This is when the baby’s head stretches the opening of the vagina. You may feel a stinging sensation. If necessary, an episiotomy will be done to help the baby’s head fit through the vaginal opening. A small cut is made in the vagina to facilitate this. The baby is then born and the umbilical cord is clamped.

Third Stage: Almost Done!
The final stage of labor occurs after the delivery of your baby and is also known as the afterbirth. During this stage, the placenta and other uterine substances are expelled from the body. After the baby is birthed, your contractions will start again, only they will be less intense. The contractions will help the placenta to release from the uterus and drop into the womb. It can then pass out of the vagina. This stage generally only takes 5 to 15 minutes, but it can last up to an hour. Most women aren’t even aware of this stage as they are busy being introduced with baby!

Signs of Labor

Recognizing Labor

For the last nine months, your baby has been happily developing inside of your womb. As the ninth month begins to wind down you can expect your baby to make her appearance. But when will she arrive? How will you know? Doctors and midwives can try to predict the arrival of your child, but it is impossible to know exactly when you will give birth. The vast majority of babies (about 95% of them) arrive sometime in the two-week period before or after the due date. It is important for you to learn as much as possible about the signs of labor so you will be able recognize them when it is time for your baby’s arrival.

How Will I Know When Baby’s on the Way?
Here are a few signs to look for to help you recognize that it’s time to get ready for labor and delivery. While not all of these signs indicate imminent childbirth, they can help give you a good idea of when you will be going into labor.

Lightening
You will likely experience the lightening of your baby a few weeks before you actually end up giving birth. Lightening refers to the dropping of your baby into your pelvis. During lightening, the baby will rotate himself so that he is ready to come out of the birth canal in a downward-facing position. This is a sign that your baby is preparing to enter the world. Many mothers can actually feel that their baby has dropped. If you notice a space between your breasts and abdomen, this can be a sign that your baby is preparing himself for life outside the womb.

During this stage, your breathing should become less labored and you should feel a lot less pressure in your stomach. You could also find yourself visiting the bathroom more frequently, though, because your baby’s new position will put even more pressure on your bladder. Additionally, some women complain of increased constipation and the appearance of hemorrhoids after lightening has occurred. You may also notice that your legs and feet swell and feel sore, making getting around a little difficult.

Bloody Show
To keep bacteria out of the womb during your baby’s growth, a plug of mucus forms at the neck of the cervix, blocking the uterus. When this plug drops out of the uterus it is called show. Sometimes, the plug looks pinkish-red when it is lost, and this is termed "bloody show". Show can occur up to three weeks before actual labor, but it is a sign that your baby’s birth is on its way. Some women will not lose this plug until hours before they go into labor. Keep a look out for this plug as it can give you some clues as to when your baby will arrive.

Braxton-Hicks Contractions
Women in the later stages of pregnancy will experience Braxton-Hicks contractions. These contractions help the uterus to practice for actual labor and delivery. As you near labor, these contractions can start to get more painful and intense and can’t be lessened by a shift in position. Pain will initiate in your lower back and then descend into your stomach, pelvis, and legs. If contractions start to come more frequently, and at regular intervals, you may be in labor. Time your contractions. If contractions last more than 40 seconds and arrive regularly, call your doctor and go to the hospital.

Breaking of Waters
Only about 15% of pregnant women actually experience the breaking of their waters, so this may not be the best marker of the early stages of labor. However, if it does occur, you should call your doctor and go to the hospital right away, as this is a sign you are in labor.

During pregnancy, your baby grows and develops in a sac of special water called amniotic fluid. When labor begins, this fluid sac can break sending a gush or just a trickle of water out. This fluid should be clear. If it is green or brownish in color this could be a sign that your baby is in distress, so head to the hospital right away.

The Nesting Instinct
Many women experience a rush of energy or persistent restlessness as labor approaches. If you find yourself eager to clean, tidy and participate in dozens of new activities, you may be nearing the end of your pregnancy. This rush of energy is referred to as the nesting instinct. Not only is this a sign that your body is preparing itself for the arrival of your baby, it is also a signal to you to start getting ready for labor.

What Should I Bring to the Hospital?
Once you are in labor, it will be too late to pack your bags before you have to head off to the hospital or birthing home. Be sure to prepare ahead of time by packing both necessities and some extra indulgences for yourself. These extras will help you feel more comfortable and can make all the difference at this emotional time.

You will need to bring things for the labor and delivery, things for your stay on the maternity ward, and things for your journey home with your new bundle of joy. It may be easier to pack three separate bags, if the hospital allows. Here is a handy list of some items you may want to bring to help you through childbirth as well as your hospital stay:

• a pair of socks to keep your feet warm and toasty
• a large nightgown or T-shirt with an opening at the front to make breastfeeding easier
• a nursing bra and extra panties that you don’t care too much about
• a spray bottle or washcloth to help keep you cool
• a hot water bottle for pain relief
• baby powder or massage cream that your partner can use to massage your back
• tennis balls to squeeze for pain relief or to use as a massage aid
• lip balm to keep lips moisturized
• favorite nourishing snacks or glucose tablets to keep you energized
• a thermos full of ice cubes to suck on
• music and games to pass the time
• cameras in case you want to snap some childbirth photos
• telephone numbers to update friends and relatives

Now that you know what signs of labor to look for and have your bags packed, it’s just a matter of time. Your baby will arrive when she’s ready!