Brenda Lane's Blog

Posted by Brenda Lane

I happen to be one of those people who love statistics. I love to read statistics from surveys and be able to quote them. The problem is remembering them when I need that information!

Here are a few of the latest statistics on the number of Obstetrical procedures performed on women who give birth in hospitals in the United States as reported by the hospital discharge forms:

• 537,000 mothers had episiotomies
• 928,000 had their membranes ruptured (water broken)
• 616,000 had their labors induced
• 1,262,000 had cesareans

There is reason to believe that some of these numbers may actually be higher than what is reported. According to the Listening to Mothers Survey in 2006, nearly 40% of mothers had their labors induced. If the CDC reports approximately 4 million births occurring in 2005, then just under 2 million of those mothers would have had their labors induced, not 600,000.

How do you feel about the number of obstetrical procedures being reported? Share your thoughts on our forum.

Brenda

Posted by Brenda Lane

This week, I published an article on the topic of unassisted births. For those who are not familiar with the term unassisted birth, it refers to a type of homebirth in which the mother and primary labor partner or spouse choose to give birth without medical assistance.

I can sympathize with the countless women who have told me that in a previous birth, "No one listened to me." I have heard mothers share that they experienced intervention done without their knowledge or their consent.

While parents should educate themselves and take responsibility for the choices they make during pregnancy and labor, most parents are not experts in the field of birth. They have not had training in diagnosing or treating problems. They are also too personally involved (mothers) or distracted (fathers).

Unassisted birthers claim that birth is natural and emergencies rarely happen. That is true. I have been a doula for 12 years, have witnessed over 300 births and have only seen a true emergency about 3 times. However, there are situations that may not be dire emergencies immediately, but if signs are missed or untreated for too long, they can result in emergencies.

Perhaps unassisted births have come into our culture due to a lack of respect for the process of labor and for the laboring woman, on the part of some medical professionals today. My personal opinion is that we need to seek more safe options for birth for every laboring woman rather than encourage parents to try to do it themselves.

Be sure to share your thoughts about unassisted birth on the forum and vote on our poll! (Be sure to go to the bottom of the page.)

Warmly,

Brenda

Posted by Brenda Lane

Expectant parents have the added stress this time of year, waiting for labor to begin, wondering if they should induce labor so that the baby does not arrive on Christmas and trying to rest during postpartum.

One of the best reminders that expectant and new parents have about the purpose for the holidays is right in front of them. Christmas gives us the perfect time to reflect about new birth, families, the importance of relationships and beauty in even the simplest and humblest surroundings. I think about how little Mary had in the stable yet she had what she needed - shelter and warmth. And the newborn Jesus had everything he needed - warm breastmilk and being swaddled in warm cloths.

So here is my note to parents due in the next week. Take it easy. Reflect on your blessings. Enjoy the simple pleasures. And going into labor on Christmas is not the worst that could happen. It makes for a very unique birth story. Anyone who shares a birthday with the Lord Jesus must be special. I am also married to one of those people!

Have a wonderful holiday week!

Brenda

Posted by Brenda Lane

A recent press release from the Centers for Disease Control and Prevention indicates that the number of birth to teenage mothers is increasing. This is the first increase in births to teens in the past 14 years. From 2005-2005, the number of babies born to teenage mothers rose 3 percent. Experts believe that this is a notable change, though they admit it is too early to suspect that this may be a trend.

The number of births to unmarried mothers is also increasing significantly. From 2002 to 2006, the number of births to unmarried mothers rose by 8%. The most dramatic increase was with women ages 25-29, where births to unmarried mothers rose by 10%.

One of the most troubling aspects of these two statistics is the concern about the increased possibility of a lack of a male parental influence and role model on these babies. Although I have known some wonderful fathers who were not married to their child's mother, it can be a precarious arrangement for the children. One of my great passions is that I so value the role of the father in the home. For more information on this topic, see The Vital role of Fathers Part I and Part II.

Do any of you have concerns, as I do, when I read these statistics? Share your thoughts on the forum.

Warmly,

Brenda

Posted by Brenda Lane

Many mothers with breech babies are discovering that there options for turning babies or having vaginal breech births are all but disappearing these days.

New research in Israel may be changing some of these options with regard to the use of external cephalic versions. This technique is done in the hospital setting by an obstetrician and uses ultrasound to turn the baby manually from a breech to a head down (vertex) position.

A new study published in the December issue of Obstetrics & Gynecology shows that when a provider performs an external version with the use of spinal anesthesia, the rate of successfully turning the baby rose to 67% versus 34% for women without receiving a spinal The study also reported no cases of either placental abruption or fetal distress.

This is exciting research that can truly help women who are seeking more options for turning their breech babies!

Warmly,

Brenda

Posted by Brenda Lane

A study published in the December 2007 issue of the Green Journal highlights that there is a link between the increase in cesarean rates and also the increase in the cost of liability insurance premiums for physicians.

Reseachers found that over a 5 year period, the cesarean rate increased. During the same time frame, insurance premiums rose by over $20,000. They conclude that "higher rates of primary cesarean delivery are associatedwith increased medical professional liability premiums for obstetrician–gynecologistsin Illinois."

We can only wonder if internationally, other ob-gyns are finding the same results with regard to the "cost" of doing so many cesareans. Clearly it is not simply costing consumers more, but doing more cesareans also costs the physician.

Brenda

Posted by Brenda Lane

The latest issue of the American Journal of Gastroenterology provides a look at the relationship between pregnancy and gastroesophageal reflux symptoms. In a telephone survey, about 260 women were studied at intervals of 12, 24 and 36 weeks of pregnancy as well as at 1 year postpartum.

The results of this study showed that the incidence of frequent GERS was higher after pregnancy than for women in the control group.

Researchers concluded that "incidence of GERS is similar across the three trimesters of pregnancy. Accumulated weight gain during pregnancy is associated with a higher risk of GERS in the third trimester. Pregnancy might constitute a risk factor for developing GERS 1 yr postpartum."

Brenda

Posted by Brenda Lane

Are you expecting a baby? Are you prepared for the out-of-pocket expenses you may have during the nine months pr pregnancy and including the costs for the birth?

According to a new survey by the Agency for Healthcare Research and Quality, the average expenses during the prenatal period and including the birth were approximately $7,600 in 2004. These expenses also included prescriptions and tests.

Even though most women who were privately-insured had a majority of these expenses covered, the out-of-pocket expenses were typically about 8% of the total bill or about $660. Women who had private insurance were also billed approximately $2,000 more for the cost of the birth of the baby versus mothers with Medicaid.

How do you feel about the escalating costs of medical expenses in order to have your baby? The reality is that there are ways as a society, to reduce these expenses including giving birth in free-standing birth centers and choosing a midwife as your provider.

Brenda

Posted by Brenda Lane

The Harvard School of Public Health has published a compelling cohort study found in the November 2007 issue of Obstetrics and Gynecology.

Over 17,000 women without a history of infertility were followed over an 8 year period as they tried to become pregnant. Results showed that those women who followed a "fertility diet" had a reduced risk of developing an ovulatory disorder infertility.

The fertility diet included a higher intake of monounsaturated fats versus trans fats, vegetable protein instead of animal protein, lower carbohydrates, multivitamins, high fat dairy and iron-rich vegetables and supplements.

Women who followed this diet ,as well as made other lifestyle changes such as more physical activity, lowered their risk of ovulatory disorder infertility by 69%.

This is more good news that women who are experiencing at least some types of infertility may be able to conceive without resoring to highly interventive or costly forms of fertility treatments.

Brenda

Posted by Brenda Lane

Pregnant women are often told to "take it easy" and not lift anything heavy during pregnancy. Some of us while we were pregnant might have been limited by what we actually could do given our cumbersome and growing bellies! However, it would not be unusual to see pregnant women insisting that they were in fact "super women" and could do it all, including working in a stressful environment straight up to the time they went into labor.

New research is actually showing that women should slow down during pregnancy. In fact, strenuous physical labor and work may increase your chances of having preterm birth.

Canadian researchers interviewed about 6,000 mothers after birth regarding their work environment during pregnancy. Results showed an association between the mothers who had preterm birth and those who had a demanding physical posture for at least 3 hours per day, those who had whole-body vibrations as well as high levels of job stress in combination with a lack of support.

So if you are pregnant and experiencing either physical or emotional stress, consider changing your work environment to protect your baby!

Brenda

Posted by Brenda Lane

A new study in the November issue of Psychological Science shows that the mother's level of oxytocin, also known as the "love hormone", plays a role in the mother's bonding behaviors with her newborn.

The 62 mothers who participated in the study were tested for oxytocin levels in their first and third trimesters as well as one month after the baby was born. The mothers were also observed for their interactions with their newborns. Researchers also asked the mothers how they felt and behaved toward their child.

The mothers who had higher oxytocin levels in their first trimesters were more likely to exhibit more bonding behaviors with their babies. Also, mothers with higher levels later in pregnancy or after birth showed more personalized bonding behaviors that would not have been easily duplicated by another adult such as singing they a special song or feeding them in a special way.

Researchers conclude that oxytocin "functions in humans just like in mammals [and] has a 'sensitizing' or 'priming' effect, just like in mammals, so that its elevation across pregnancy possibly prepares women to bond with their infants."

These are incredibly fascinating studies to read since they show that a mother's bond with her baby begins very early in pregnancy.

Brenda

Posted by Brenda Lane

The Cochrane Review has published new research to see the effect of an amniotomy (or artificially breaking the mother's bag of waters during labor) on both labors that have started spontaneously as well as labors where the progress has slowed or stalled.

Fourteen randomized, controlled trials where included in this systematic review. The sample size for all of these trials was nearly 4900 women in labor. Two separate reviewers examined the same research to further validate the results.

What these reviewers discovered was that there was no evidence that the length of the first stage of labor was altered in any way by breaking the mother's water. There were also no differences found in the mother's satisfaction with her birth experience or the baby's Apgar scores at 5 minutes.

There was a slight increase in the risk of cesarean birth in the mother's who had their waters broken artifically, although reviewers noted that the difference was not statistically significant.

Researchers conclude that "on the basis of the findings of this review, we cannot recommend that amniotomy should be introduced routinely as part of standard labour management and care. We do recommend that the evidence presented in this review should be made available to women offered an amniotomy and may be useful as a foundation for discussion and any resulting decisions made between women and their caregivers."

For more new research about infection after your water breaks, read this blog.

Brenda

Posted by Brenda Lane

The September issue of the American Journal of Obstetrics and Gynecology includes a study that examines whether or not mothers who have a specific infection will increase their risk for complications with the placenta.

Mothers with a diagnosis of placental abruption made up the experimental group of the study, while a counterpart control group included an equal number of mothers who matched the experimental group in both race and ethnic group as well as the number of pregnancies they had previously.

The experimental group, who were diagnosed both prenatally and at term with placenta abruption, also had a statistically higher chance of having chorioamnionitis. Researchers conclude that "the association was strongest in the presence of severe chorioamnionitis at term and, to a lesser extent, at preterm gestations. These observations suggest that the histologic findings in abruption are accompanied by severe inflammation, in both preterm and term gestations."

Brenda

Posted by Brenda Lane

In the October issue of Obstetrics & Gynecology, researchers wanted to see if more providers would be interested in offering their services as providers of vaginal breech deliveries once they became certified.

The study included a survey that was mailed to over 300 Australian obstetricians. All of the obstetricians were being trained over a four year period in doing vaginal breech deliveries. 53% of the doctors trained in this type of delivery reported feeling confident in performing vaginal breech births, however only 11% of the group surveyed reported that they would be offering vaginal breech services as a specialist to their patients.

One has to wonder why this could be occuring? Is it because there continues to be less familiarity on behalf of consumers to ask for this type of delivery? Is it due to the fact that performing a cesarean generates more revenue for health care providers.

For more information, see the articles in Vaginal Breech and Turning a Breech Baby.

What are your thoughts about fewer doctors offering vaginal breech services to their patients? Join us on the forum.

Brenda

Posted by Brenda Lane

The October 2007 issue of the Green Journal has publlished a new study that looks at the effect of cancer on the outcomes of childbirth.

In a 25 year study, over 6,000 mothers in Scottish maternity hospitals participated. This group consisted of mothers who had a first pregnancy between 1980 and 2005 and included women who had a history of cancer as well as those who did not.

The cancer survivors had a statistically higher chance of postpartum hemorrhage, cesarean birth, instrumental delivery (forceps or vacuum extraction used) as well as preterm birth.

Reseachers conclude that "while largely reassuring to women intending to become pregnant after surviving cancer, the results indicate areas of increased risk that require additional surveillance."

Brenda

Posted by Brenda Lane

Does pregnancy bring on more episodes of depression? How often do pregnant women experience depression before, during and after they give birth? The October issue of the Americam Journal of Psychiatry includes new research that has attempted to shed light on those issues.

Between 1998 and 2001, over 4,000 women took part in this study that began 39 weeks before pregnancy and ended 39 weeks after they gave birth. About 15% of this total group who participated experienced depression at some phase during the study.

Of the women who experienced depression in the 39 weeks prior to pregnancy, over half of them had depression during pregnancy. In the group of women who reported having depression after pregnancy, over half of them experienced depression either before or during pregnancy.

Researchers concluded that about one in every 7 women experienced depression during the 39 week block prior to pregnancy through the 39 week period following pregnancy.

For related information about postpartum depression, read the entire series.

Brenda

Posted by Brenda Lane

The latest issue of The Journal of Endocrinology and Metabolism includes a recent study on a possible link between preeclampsia and a deficiency in vitamin D.

Research done at the University of Pittsburgh Graduate School of Public Health followed more than 200 women expecting their first baby from their 16th week of pregnancy through birth. They recorded the number of mothers who developed high blood pressure and protein in their urine after the 20th week of pregnancy. What they found was that that mothers who had the lowest amounts of vitamin D in their blood (measured as maternal 25-hydroxyvitaminD [25(OH)D) were more likely to develop preeclampsia during pregnancy.

Authors conclude that "maternal vitamin D deficiency may be an independentrisk factor for preeclampsia. Vitamin D supplementation in earlypregnancy should be explored for preventing preeclampsia andpromoting neonatal well-being."

Are you taking your prenatal vitamins? Make sure you are getting enough vitamin D in your diet or ask your provider if you should be taking supplements.

Brenda

Posted by Brenda Lane

The September issue of the American Journal of Epidemiology has published new research on the topic fatty fish consumption and a possible link to what is known as fetal growth restriction or fetal growth retardation.

The researchers used a questionnaire format to measure the amount of both fatty and lean fish that the mothers ate at midpregnancy. Over 40,000 Danish mothers took part in the study. After birth, the babys' birth weight, birth length, and head circumference were all measured from the 40,000 subjects.

Results showed that mothers who are more than 60 grams of fish per day were significantly more likely to have a baby below the 10th percentile for age and gender as compared to the mothers who ate 5 grams of fish per day.

In fact, the results indicated that consuming fatty fish caused the increase in the growth restriction for the babies, while the lean fish consumption did not. Authors of the study believe that "consumption of fatty fish, a knownroute of exposure to persistent organic pollutants, could beassociated with reduced fetal growth."

Here are examples of fatty fish: sardines, ocean trout, Atlantic salmon, tuna, herring, mackerel

Here are examples of low fat fish: flounder, whiting, oysters, shrimp, lobster, crabs, squid, mussels, prawns

Brenda

Posted by Brenda Lane

Swedish researchers have compiled information from over 100,000 mothers in a new study that looked at whether or not the risk of infection to the baby (also called sepsis) does indeed increase after her water breaks.

The study, published in the September 2007 issue of Obstetrics and Gynecology, found that the risk of newborn infection did in fact increase over time. The risk was .3% for a duration of less than 6 hours and increased to 1% for over 24 hours.

The overall length of labor did not increase the rate of newborn infection, however.

Authors of this study recommend that "pregnant women to call their health professional immediately or go to the hospital when their water breaks."

In some cases providers may recommend that the mother be given IV antibiotics if her water breaks and she does not go into labor with progressing contractions within a few hours.

Be sure you ask your own provider about their own protocals for you to follow when your water breaks.

Brenda

Posted by Brenda Lane

Years ago, I had a close friend who was trying to manage spending most of her pregnancy lying on her side on the couch or in bed due to a threat of preterm labor. I had a new appreciation for all of the challenges she experienced as I helped her throughout her difficult pregnancy with her.

Although there are days when we would all likely enjoy nothing more than to get caught up on some sleep and spend all day watching tv while in bed, restricted activity for weeks at a time for most active women can be extremely challenging.

A few of the things that can make bed rest difficult is that it can negatively affect you both physically and emotionally. Extended bed rest can result in muscle weakness and increase a woman's discomfort with constipation. It is not uncommon for mothers to also experience insomnia, mood swings, and guilt about not being able to care for oneself.

I am beginning a new series on the issue of preterm labor and bed rest issues. Be sure to check out the entire series as well as share your thoughts and questions on our forum.

Warmly,

Brenda

Posted by Brenda Lane

In a study of nearly 300 women, Quebec researchers found that more new mothers reported having dreams that were either very disturbing or with fears that harm would come to their babies. These anxiety-producing dreams occurred more often in new mothers than in either nonpregnant women or pregnant women.

In addition, the new mothers reported more "dream-enacting" behaviors which include moving around in bed, expressing emotions and talking while asleep. Researchers also found that even a small percentage of fathers experienced these dream-enacting behaviors after their child was born.

The authors conclude that "the intense physical, hormonal and emotional changes surrounding pregnancy and childbirth likely play a role in infant-related dreams and associated behaviors in new mothers and moms-to-be."

Be sure to also review the recent article on insomnia during pregnancy.

Hope you are enjoying the cooler fall weather!

Warmly,

Brenda

Posted by Brenda Lane

The British Journal of Nutrition recently published research that suggests a link between what a mother eats and the eating habits of her offspring.

Using animals, British scientists discovered that pregnant or breastfeeding rats who ate a diet that was the equivalent of a human high calorie, high fat and salty diet, produced offspring who developed a taste for those same things after they were born. The other group who was fed a normal diet, had pups that did not overeat.

Researchers believe that "eating large amounts of junk food rich in fat, sugar and salt in pregnancy and breastfeeding may influence the way the appetite centers develop in the brain of the offspring, leading to a greater preference for junk food."

I must admit that during my pregnancies, I could be a textbook case for these findings. I craved ice cream and frozen yogurt in my first pregnancy and ate a lot of it. They are among my first daughter's favorite foods! The second time around, I craved salty snacks like nuts and Doritos. My next daughter favors those salty foods.

A good lesson to learn is that our diet during pregnancy does have an amazing effect on our children, not just in the foods they learn to eat but also in terms of how their bodies grow and develop.

For a fascinating look at the effect of prenatal nutrition on your growing baby, see this article!

Brenda

Posted by Brenda Lane

A recent study published in the American Journal of Psychiatry has shown that the use of antidepressants during pregnancy is associated with an increase in preterm birth and a lower gestational age at birth.

The study included 90 pregnant women that were divided into three groups: 49 women had major depressive disorder and were taking antidepressants for more than 50% of their pregnancy; 22 women had major depressive disorder and were treated either briefly or not treated and the remaining 19 were a healthy group of pregnant mothers for comparison.

The average fetal age was 38.5 weeks, 39.4 weeks and 39.7 weeks from all three above groups. The rate of pre-term birth and rates of admission to the NICU were both significantly higher in the group treated with antidepressants.

Researchers found that the presence of depression alone did not increase the risks of preterm birth or decrease in fetal age at birth. "This result was surprising to us, as we had anticipated that depression and anxiety during pregnancy would be associated with an increased risk of preterm birth," researchers reported.

They also found that both the treated and untreated groups of mothers reported similar degrees of depression and anxiety during pregnancy.

Clearly there is much about depression and pregnancy that we do not know. However, it is crucial for all expectant mothers to know that taking antidepressants for long periods of time during pregnancy does put them at a higher risk for the above complications.

For more information about postpartum depression, visit our series.

Brenda

Posted by Brenda Lane

Perhaps you are one of thousands of mothers who are expecting a baby in the next few months. Now that summer is over and we are moving into the fall season, you may be looking for some of the latest articles to help you prepare for the big day ahead.

Coming very soon is a new series of articles on how to manage the discomforts of pregnancy, from relieving back pain to treating heartburn. Do you suffer from insomnia? All of these topics and more will be covered extensively in this new series which will be out just in time for the Labor Day weekend.

Also as you prepare for birth, you may be comparing childbirth classes offered in your local area. If you have not found one to your liking or you want to supplement your class with additional information, be watching for a series right around the corner that offers an online childbirth class, complete with specific topics covered in classes, what to practice that week and how to better prepare for birth and parenthood. One of the most frequently heard complaints from expectant parents is that they did not learn much from their class. If you are disappointed in your class or you don't have the time or the money, these online classes are just the ticket for you!

Have a great Labor Day and a great day of labor, whenever your baby happens to arrive.

Warmly,

Brenda

Posted by Brenda Lane

University of Pittsburgh researchers have reported that the incidence of bacterial vaginosis during pregnancy, (the most common type of vaginal infection) is nearly doubled if either she or her sexual partner is black versus white.

Given the fact that bacterial vaginosis is also a risk factor for preterm birth, and that the risk for preterm birth is also double for black mothers versus that of white mothers, this is compelling information.

This study examined 325 women in their first trimeter of pregnancy. They found that the risk of developing bacterial vaginosis was 26.2% among white women and 45.3% among black women.

While researchers can't know for sure the reason(s) for the racial disparity, they speculated that "the male contribution to bacterial vaginosis may be due to environmental factors, such as circumcision status or a man's genital bacteria. They also theorize that "immune discordance between the male and female partner may contribute to risk."

This study did not look at whether or not birth or gestational age at the time of birth was affected by the presence of bacterial vaginosis. It is an interesting study that brings up at least as many questions as it answers. Ideally more studies will need to be done in order to help mothers prevent bacterial vaginosis especially given the high rates of preterm birth in the African-American community today.

Brenda

Posted by Brenda Lane

This week the FDA released a new report warning mothers of a rare, but serious side effect from taking codeine (a commonly-prescribed painkiller for postpartum pain) on their breastfed infants.

Findings report that this rare side effect is the equivalent of a morphine overdose for women who are "rapid metabolizers" of the drug. Some evidence shows that certain people who are rapid metabolizers convert codeine more rapidly and completely than what happens in most cases. In one reported case, the newborn died from the overdose effect of this drug through breastfeeding.

The FDA recommends the following:

" Nursing women taking codeine need to carefully watch their infants for signs of morphine overdose and seek medical attention immediately if the infant develops increased sleepiness (more than usual), difficulty breastfeeding or breathing, or decreased tone (limpness). Nursing mothers may also experience overdose symptoms such as extreme sleepiness, confusion, shallow breathing or severe constipation."

Physicians are also advised to prescribe the lowest dosage available and to carefully monitor both mothers and babies for this rare but life-threatening side effect of codeine.

Since medications can contain a combination of drugs (for example, Tylenol plus codeine), it is always important for mothers to check with their provider on what medications are being offered, get a list of ingredients and information about appropriate dosages from their providers prior to taking any drug.

Brenda

Posted by Brenda Lane

If you are like most people, you run yourself ragged in "doing things" whether it's work-related, taking care of your spouse and children, picking up the house, doing errands and maybe at the end of the day, falling into bed into a stupor out of exhaustion. Taking time to do something just for you and making time in your day for refreshment and renewal is so important, but it can be very hard to do. During pregnancy or in the days and weeks that follow birth, there is never a more important time to get mental and physical rejuvenation.

Here are some suggestions you might find helpful as you walk through your own pregnancy or you are a new mother:

1. Find a consistent time for private moments that works for you. Perhaps it is a midnight or at 5am or at afternoon nap time. Use that time to pray, journal, meditate or enjoy some quiet reading. Ideally this should be at least 30 minutes of alone time.
2. Set your alarm clock for 20 minutes before your wake-up time to do some stretching or light exercise.
3. Arrange for an occasional massage. Either have your partner help you or seek a professional. If finances are an issue, contact a massage school near you for massage therapists in training who offer reduced fees.
4. Plan a weekend getaway with your spouse or a close friend.
5. Meet your best friend for coffee, dessert or lunch on a regular basis.

Remember that if you neglect yourself, it will be very difficult for you to be effective at anything else in your life.

Do you have ways of finding renewal that have worked for you? Share them.

Brenda

Posted by Brenda Lane

One question I hear frequently from expectant mothers is how do you know when medical intervention should be used and when to keep trying other methods. This is not an easy question to answer, but let's take a moment to examine it from many angles.

First of all, most of us would agree that childbirth itself is a natural event and there is not need to intervene in most cases. Women's bodies are wonderfully designed to labor and give birth to babies without resorting to medical science for help. Women can labor in a give birth in 2 hours or 2 days and they are both very normal and natural. What often seems to get in the way for our culture today is that we have placed time limits on how long mothers can labor without feeling pressured into receiving pitocin, having their water broken or having a cesarean. Though all of these interventions can be helpful, the bottom line, when should you call it quits?

I have seen women require 48 hours to labor. Their bodies needed that time in order for everything to fall into place. Not only does the cervix need to rotate, thin out and dilate, but the baby needs to rotate and mold in order for birth to happen. For some mothers, that can take many many hours of contractions. Long labors are not at all uncommon with a first baby. As long as the baby's heart rate is strong and reassuring as indicated on a dopplar or fetal monitor and the mother is doing well during labor, there should be almost no limit placed on that mother before resorting to intervention, except her own preferences or desires.

In fact, research is starting to show us that even longer periods of pushing (which was always believed to be a particularly challenging time for a baby) are not harmful to babies.

It may be that our limits are imposed by medical institutions simply because we are taking up space in a hospital. Or even that the types of comfort measures available to mothers are so restricted that she feels unable to continue any longer.

If you are interested in this topic, be sure to also talk with your care provider about their philosophy and reasons to intervene.

Brenda

Posted by Brenda Lane

I don't know about you, but what I hear from expectant mothers is how terrible they feel, how much they hurt, how little sleep they are getting and basically how miserable they are during their long nine months of pregnancy. It almost seems as if pregnancy was simply the months of suffering that each mothers has to endure before she can finally meet her baby.

What about the joys of pregnancy? Are there any?

I can recall many aspects of pregnancy that were pleasurable. The recognition of the first kick. Hearing the baby's heartbeat on the dopplar. Seeing the ultrasound photos. Taking the childbirth education class. Talking to other expectant parents to share in their experiences. Preparing for the baby's arrival. Even daydreaming about what my baby would look like or if it was going to be a boy or a girl. All of those things were joyful aspects of my pregnancies that I am grateful to have had the opportunity to experience.

One beautiful way to record the joyful moments of your pregnancy is to start a journal or scrapbook. In it you can record those spectacular events like the first kick or have a place to store your ultrasound photo. You might even write some notes to your baby so that they can read them when they are older.

Just remember that pregnancy does bring us moments of pure joy, despite some of the challenges. In fact, the stage of pregnancy can be a very interesting metaphor for life. Daily challenges, sometimes even pain, but little glimpses of joy along the way.

Stay cool in this heat wave!

Brenda

Posted by Brenda Lane

A review published in the American Family Physician highlights the challenges faced by mothers in labor with their first babies who have failure to progress.

According to these Massachusetts reseachers, at least 50% of primary cesareans are performed on the first-time mother who is experiencing a "failure to progress" in labor. This failure to progress or "dystocia" can have many causes including ineffective contractions and the position of the baby.

Researchers in this review recommended that before physicians do a cesarean due to dystocia, that mothers should be given several hours of pitocin to make sure she has effective contractions. In addition, allowing the mother to push for "longer than traditional time limits" if the baby' heart rate is reassuring and the baby's head is descending.

They also recommended the use of trained labor support companions (birth doulas), waiting until the mother is in active labor to be admitted to the hospital, avoiding inductions until 41 weeks and "using epidural analgesia judiciously."

This is a very interesting study and further demonstrates the benefits of encouraging the natural course of labor as well as the measurable advantages of doulas to the laboring mother.

For related information see:

Questions to Ask Your Provider

Long Labors and What to do

When to go to the Hospital

Brenda

Posted by Brenda Lane

A recent study in Washington state looked at a large sample size of mothers in 2000 to determine how many inductions took place without a medical indication.

What researchers found was that 33% of the original sample size of 4541 mothers had their labors induced. (Other statistics do indicate labor induction rates hover between 20-40%.) Of this group of women who received labor inductions, about 15% of them did not have a medical indication for the induction or the indication was not recorded incompletely.

Since nearly 1/3 of all women will be facing a labor induction, according to this and other studies, knowing what your options are as well as what the true medical indications for inductions are is crucial for all expectant mothers today.

For more information on labor inductions, see the following articles:

Labor Inductions Part 1 - statistics, non-medical reasons for induction

Labor Inductions Part 2 - medical reasons for induction, questions to ask

Are inductions more painful? - exploring the reasons why inductions hurt more than spontaneous labor

Warmly,

Brenda

Posted by Brenda Lane

I don't know any pregnant woman who enjoys being pregnant, especially in the third trimester, during the heat of the summer. One husband recently shared with me that his expectant wife was so warm that they set their thermostat at 63 degrees in the house since she was so hot all the time.

What are some ways you can beat the heat during the summer if you are pregnant?

1. First - don't leave the house without a container of water. You should be drinking about 8 glasses of water every day since dehydration can bring on pre-term labor contractions.
2. Limit outdoor activities to first thing in the morning or later in the evening when the temperature drops.
3. If you need to drive in the heat, seek out parking places in the shade so your car won't get as hot when you return.
4. Find activities to do indoors to stay busy such as scrap-booking, knitting, sewing or planning the baby nursery.
5. Plan meals that can be heated quickly in the microwave or even eat your meals cold to avoid turning on the oven.
6. Keep overhead fans running during the day and buy a personal, battery-operated fan to use for times when you are trying to cool down.
7. Swimming is a great activity during pregnancy, however avoid swimming in an outdoor pool at times during the heat of the day from 10am to 2pm.
8. Be sure to use sunscreen if you plan to be outdoors for any activity.

Do you have any other ideas to beat the summer heat? Share them with us.

Warmly,

Brenda

Posted by Brenda Lane

There are so many factors stacked up against expectant women these days. Incredibly high induction and epidural rates have no doubt influenced the escalating cesarean rates internationally. More and more birth centers are closing. What can mothers do to increase their own chances of having a vaginal birth? Here are only a few things you can do:

1. Choose a good childbirth class - do not fall for the marketing of classes that are offered in many hospitals today unless you can speak to the instructor ahead of time. Be sure that comfort measures and options for labor are taught and not just the protocals of the hospital.

2. Use a doula - over 25 research studies have demonstrated that the presence of a doula can lower a mother's chances of having a cesarean. In my own practice, I have found that about 15% of my clients have cesareans, versus the almost 30% cesarean rate in the US.

3. Give birth outside a hospital setting. If you have the option of using a birth center of having a homebirth, consider whether you are ready to make a commitment to this type of birth. Remember not everyone has a comfort level so be sure to pray about this decision and "go with your gut instinct" on this.

4. Get out of bed and change positions during labor! This is crucial to rotate babies and keep labor progressing as well as for mother's comfort.

5. Don't forget that changing positions during pushing is just as crucial! Some babies will still need to rotate and often the position changes will "free the baby's head" by allowing your pelvic outlet to open at different angles.

6. Ask for more time. I attended a birth where the doctor had decided that a cesarean was the only option. I suggested to my client that she could indeed ask the doctor for more time since both she and the baby were doing well. About 45 minutes later, she ended up having a vaginal birth! It is never too late to step up and advocate for yourself.

There are times when I wish that I could fill pages and pages of books with all of the knowledge I have in my head from attending births for the last 12 years. Childbearing women today are so in need of educating themselves about their options and how to advocate for their health care.

Obviously I am very passionate about this issue. What are your thoughts regarding educating yourself about ways to reduce your chances of having a cesarean? Is it worth it? Tell us what you think.

Warmly,

Brenda

Posted by Brenda Lane

Pregnancy is not always a time of serenity and peaceful preparation for every expectant mother. It can be laden with a whole array of pain and discomforts. Beginning in the first trimester with morning sickness and ending with back pain as you near your due date, most women do experience at least some level of unpleasant pregnancy symptoms throughout the entire nine months.

To make matters worse, you are always limited in finding relief for your symptoms since not all medications are safe to use during pregnancy.

If you are struggling with a few or many pregnancy discomforts, here is your chance! We are collecting a list of the most common symptoms during pregnancy. All you need to do is list the ones that are (or were) the most bothersome to you in our discussion forum. From this list, we will generate a series of articles the top pregnancy discomforts as well as many ways to get help or find relief.

So be sure to be a part of our series! We'd love to hear from you!

Warmly,

Brenda

Posted by Brenda Lane

One of the things that continually surprises me over the years is that there is still a debate over how we should be feeding our babies. While previous generations of mothers may have been misinformed about the benefits of breastfeeding, mothers today are clearly in the information age.

If you are expecting a baby or planning to become pregnant and are deciding how best to feed your baby, thousands of articles on the benefits of breastfeeding for both mother and baby are at your fingertips. Even health experts and international organizations today agree that all mothers should feed their babies breastmilk for as long as possible. See my complete series on breastfeeding just to wet your appetite.

One idea that appears to be pervasive among mothers who decide to formula-feed their babies is that they do not want to be made to feel "guilty" about their choice. They see it as a viable option and a choice they are making for personal reasons. The problem is that formula is not truly an equal feeding choice. In many ways, it can be compared to feeding your older child a diet of fast food. Is there nutrition in this food choice? Yes, some. Has it been shown to be harmful? The answer is unequivocally yes.

The correlation between both fast food and infant formula in terms of the risk of obesity is also very interesting. Yet I doubt that there are many parents who try to defend their position to feed their children a diet of completely fast food. We all know that as a society, it is lkely contributing to a whole host of health-related problems. Why is it that we are still hanging on to the option of feeding our babies infant formula when we know the choice is not a safe one?

Should you have any doubt about the safety or nutrition of infant formula, please read my article on the Hazards of Infant Formula. Here I have touched on the known and suspected risks of infant formula, yet there are countless others you can find elsewhere on the internet.

What are your thoughts about infant formula in relation to breastmilk? Let's get a discussion going.

Brenda

Posted by Brenda Lane

The 4th of July is a popular summer holiday for families in the United States. One in which we are reminded of the great freedoms we have in this country in so many arenas.

We can use this holiday as a symbol for freedom of many kinds. Freedom to give birth as a woman chooses is one that cannot be taken for granted today. Unfortunately, complete freedom in birth is not possible for all women around the globe. Women are inhibited from the choices they seek because of financial reasons, limits to their health care, distances they must travel, their own health care complications or the options in their own communities in terms of places of birth or care providers, to name a few.

If you are someone who has been able to have the type of birth you hoped for, in many ways, you are exception, rather than the rule. Let's continue to hope and pray that birthing options for all women will increase rather than decrease in the next generation. Our only hope is that our daughters' generations will refuse to settle for less options and stand up for their freedom to give birth without unnecessary interventions that benefit both themselves and their babies.

Warmly,

Brenda

Posted by Brenda Lane

A new study released by the March of Dimes reports that the average costs for a vaginal birth in the United States today is $8,800. No surprise that the costs for a cesarean birth are higher. The new report indicates that the average cost for a cesarean birth is $11,000.

These costs are problematic for a number of reasons. One is that they represent the average costs. If a mother is high-risk or develops complications during pregnancy or birth, the costs will only escalate further.

Another significant issue is that families who do not have medical insurance may be financially crippled by these costs simply to give birth to their baby, not to mention the costs parents incur for other needs of the baby after birth.

There are several potential solutions to these escalating costs. One would be to choose midwives instead of obstetricians. The costs for midwifery services are often about 50% less than what doctors charge for the same service.

Another solution is to have parents consider out-of-hospital settings to give birth. These choices include homebirths and birth centers. Both of these options drastically reduce the overall medical costs to have a baby.

What are your thoughts about these escalating costs to have a baby? Tell us about what you think.

Warmly,

Brenda

Posted by Brenda Lane

In recent years, mothers are encouraged more and more to stay out of bed and move as often as possible during labor. In fact there are multiple benefits for the mother and baby to change positions including helping to progress the labor, relieving back discomfort, reducing contraction pain, rotating the baby as well as increasing circulation.

In my travels, I discovered a helpful photo slide show of photos that mothers may find beneficial. Some of my personal favorites of the ones that are pictured are:

1. The slow dancing position with a partner - this is relaxing and helps the baby move down and/or rotate.
2. The lunge position which is helpful for turning a posterior or OT baby or to progress a slowed labor.
3. Hands and Knees position - this can reduce back pain and help to rotate a posterior baby.
4. Side-lying - this is a great position to conserve energy as well as to push in (with the top leg elevated) if the baby still needs to turn.

I often encourage my doula clients to seek positions that feel comfortable to them in labor since often they have a sense about what feels better. Another position (not pictured) is straddling a birth ball which can relieve pressure on the pelvic floor and is more relaxing than sitting in a chair.

Be sure to spend time practicing some of these positions, including use of the birth ball and lunging, prior to birth since they can be tricky to learn at first.

Just remember to keep moving during labor! You will feel better and it often is the key to a successful labor!

Warmly,

Brenda

Posted by Brenda Lane

Fatherhood is a truly amazing time in the life of a man. It can serve as a life-altering event that changes a man deeply from thinking primarily of his own needs to realizing that not only does he have new responsibilities, but the needs of his baby often take precedent over his own.

Some fathers adjust easily to the new dynamics in the family. The sleepless nights, the cries of the baby, the mood swings of his wife, to name a few. Others have a harder time making the transition to being a new father. I have heard from fathers that one of the biggest problems they have encountered is the lack of guidance and support immediately after the baby is born. Some have expressed that none of the caregivers involved them in baby care or encouraged them in any way to take a role in child-rearing. This is very disturbing to say the least.

In my latest article, I have included several ideas to help new dads have a smoother transition to their role as fathers in the family. The earlier that fathers establish their own unique connection to their children, as well as develop an understanding of what their wives are experiencing, the stronger the entire family unit will be.

What were some of your struggles as new fathers? Share them with us!

Warmly,

Brenda

Posted by Brenda Lane

In the May issue of the American Journal of Respiratory and Critical Care Medicine, UK reseachers have found that few, if any pregnancy complications were increased in women who have a history of asthma.

The study examined over 280,000 pregnancies and found that asthma did not significantly increase the likelihood of high blood pressure, diabetes, thyroid problems, assisted deliveries (use of forceps of vacuum extractors), placenta abruption, placenta previa, or pre-eclampsia.

When compared to women without asthma, mothers with asthma did have a higher risk of antenatal and postpartum hemorrhage, anemia and depression. They also had a slightly higher chance of giving birth by cesarean.

The authors conclude, " Our results provide reassuring evidence that the risks of most adverse pregnancy outcomes and obstetric complications are similar to those in women without asthma," the investigators conclude.

"With the possible exception of increased vigilance in monitoring certain complications in pregnant women with asthma, our findings do not indicate a necessity to alter current practice of optimal (asthma drug therapy) in women of child-bearing age in the general population."

Brenda

Posted by Brenda Lane

One of the most disturbing trends across the country and beyond has been the closing of many free-standing birth centers. In as few as the last three years, certified nurse-midwives have watched their malpractice rates skyrocket to over 50% increases in their previous coverage.

Some of these drastic increases have forced numerous birth centers to close their doors to expectant parents. In the last 2 years, I have seen 2 free-standing birth centers close, including most recently the Maternity Center in Bethesda, MD, which had a solid reputation in the area as the oldest birth center in the state.

One wonders if fewer and fewer options of birth centers will cause more mothers to seek homebirths. Yet homebirth midwives are also facing difficult times. Most midwives cannot practice without finding a back-up obstetrician to consult or refer their high-risk cases. Rarer still are obstetricians who support homebirth as an equally safe option as hospital births.

I'd love to know what thoughts you have on this issue of birth centers decreasing in number as well as the general trend toward fewer birthing options for expectant families.

Join me on the forum!

Warmly,

Brenda

Posted by Brenda Lane

A new review in the Journal of Midwifery and Women's Health discusses the complicated issue of the main reason cesareans are being performed today. This reason is called, "dystocia" and is characterized primarily by a lack of progress at some stage in the mother's labor.

As many as 2/3 of all cesareans done today are due to a lack of progress or dystocia. Dystocia does not cause any risk to the mother or baby and can be diagnosed at any point between 1 through 10 cm of dilation and even into second stage of labor when there is no measurable sign of progress.

Birth professionals agree that labor does have natural "plateaus" in which progress is stalled for a time. Often this happens in very long labors. It is common when these slower periods of progress occur for providers to recommend pitocin. At times the use of pitocin is helpful and at other times, it can cause more problems for both mother and baby.

The reviewers in this latest article recommend several factors to reduce the number of cesareans due to dystocia including:

1. Emphasizing normal weight and weight gain during pregnancy
2. Delaying admission to place of birth until active labor is established
3. Avoiding elective inductions for mothers with a first baby
4. Keeping mothers well-hydrated and fed during labor
5. Providinghigh-quality supportive care during labor

Expectant mothers should plan to research all of their options to avoid having a cesarean for a preventable reason such as dystocia.

Brenda

Posted by Brenda Lane

More mothers with breech babies are indeed finding fewer and fewer options to have a vaginal birth. One of the disappearing options seems to be that fewer providers are performing external cephalic versions, a technique used to turn a breech baby manually.

The Ob practitioner gives the expectant mother a muscle-relaxant, then using ultrasound, manually moves the baby's head from a breech to a vertex position from the outside of the mother's abdomen. Typically this procedure is done by two doctors. Mothers report that it can be uncomfortable.

The reality is that less obstetricians are in fact offering mothers with breech babies this option since it has been considered to be risky. A new review of the research shows that the risk of complications for an emergency cesarean was only 0.5% out of 805 births. It is clear that the choice to have a version is indeed a safe one.

For more ideas to turn a breech baby, check out this article.

Are you interested in ways to reduce your chances of having a cesarean? Read more here.

Warmly,

Brenda

Posted by Brenda Lane

Mothers have long been told to begin pushing at 10 centimeters, hold their breath for 10 seconds at a time and bear down atleast 3 times with every contraction. This is called directed or Valsalva pushing.

More research, including the latest review in the Journal of Midwifery and Women's Health, explains that this type of pushing can have negative consequences including less oxygen to the baby and damage to the mother's bladder, pelvic floor and perinuem. Reviewers recommend a technique of "laboring down" which is described at length in my article on Pushing Techniques. You might also consider reviewing related articles on Perineal Massage and Avoiding Episiotomies.

Mothers and their labor partners should ask their providers about how they can avoid directed pushing methods and consider many benefits to the mother and baby by a slower approach to pushing.

Were you encouraged to use directed pushing? Did you think it was effective? Share your story on the forum.

Warmly,

Brenda

Posted by Brenda Lane

1:00am - Doula's cell phone rings. Client (laboring mother) is calling to say her contractions are 5 minutes apart. Is it time to go to the hospital? Doula asks several more questions about the intensity of contractions, other symptoms and assesses how well mother is coping. Mother says she is resting easily between contractions and does not want to go in quite yet. A decision is made by parents to wait a few more hours and check back again.

3:00am - Laboring mother calls back; contractions are closer and stronger. She is now getting some back pain. They live about 30 minutes from the hospital. Doulas suggests the mother call her provider and discuss the possibility of going to the hospital.

3:30am - Client calls back and tells doula they are heading out the door. Doula hops in the shower, packs her bags and birth ball in the car, grabs a protein bar for the road and heads to the hospital.

4:30am - Doula meets clients on the labor and delivery floor. Mom is checked and found to be 2-3 cm dilated. The doctor suggests the mother walk a bit around the floor and be re-checked in a hour before being admitted.

5:00am - Doula accompanies mother and father as they walk, providing encouragement, doing light massage during contractions and answering questions. Doula offers mother clear fluids to drink after every few contractions.

5:30am - Mother is re-checked by the nurse in triage and found to be 4cm. Mother and father are admitted to the birthing suite. Doula reminds mother to empty her bladder.

6:00am - Labor nurse takes blood, monitors the fetal heart rate and gets information from mother to complete admission. Doula provides encouragement during contractions and reminds mother to relax.

6:30am - Mother becomes very uncomfortable in the bed so once the nurse is finished, doula suggests the mother sit on the birth ball. She adds a warmed rice sock to mother's back as the mother faces her partner and holds on to his knees for support. Doulas reminds mother to drink and empty her bladder regularly.

7:00am - Mother is placed back on the fetal monitor. Doula provides encouragement, massage and suggests positions that are more comfortable while mother is in the bed.

7:30am - Mother is anxious to get out of bed, so doula suggests the shower for relief. Father uses shower head to provide relief on the mother's back during contractions. Doula stands nearby providing encouragement and reminding mother to drink. Nurse shift changes and new nurse is assigned.

8:00am - Doctor shift changes and new doctor comes in to examine mother. Mother has dilated to 6cm. Mother decides she wants to continue to try more comfort measures before resorting to pain medication.

9:00am - Baby is monitored again. Doula suggests either more walking or some "slow dancing" since mother is getting uncomfortable sitting. Mother opts to walk.

9:30am - Mother is getting tired. Contractions are very close and very intense. Doula asks if mother wants to try the shower again. Mother agrees and find relief.

10:00am - Nurse asks to put mother back on the monitor. Mother says she is not sure she can lay down in the bed since now there is too much pressure and it hurts to lay down. Doula asks the nurse if it's possible to monitor the mother while she is seated on the ball or standing next to the monitor display. The nurse agrees.

10:30am - Mother feels a great deal of pressure and contractions are extremely intense. The nurse examines her and says she is 8-9 cm dilated. Doula suggests a hands and knees position over the top of the bed while waiting for pushing to begin. Partner massages mother's back during contractions.

11:30am - Mother gradually begins to feel the urge to push. Nurse examines her and finds she is fully dilated. Nurse tells the mother it is okay to start pushing. Doula assists mother with pushing techniques and positioning for pushing. Nurse places the monitors on the mother for continuous monitoring during pushing.

12:30pm - Doctor comes in to check progress. Finds the baby's head is low but the back of the baby's head is slightly to the mother's right side. He requests that the nurse let him know when the baby's head is visible.

1:00pm - Doula suggests a left side-lying position for pushing to rotate the baby's head. Partner places warm sock on mother's back during pushes to relieve discomfort. Doula and partner take turns offering clear fluids and ice chips to mother and wiping her forehead with cool cloths.

2:00pm - Mother says that the pressure is very intense and she is feeling burning. The nurse announces that she can see the baby's head and pages the doctor. Doula encourages the mother to breathe through contractions and to slow pushing to ease the baby out.

2:20pm - Doctor comes in and receives baby. A baby girl is born! Father cuts the cord. Congratulations to a happy mother and father! Placenta is delivered easily with one small push.

3:00pm - Doula stays by the mother's side, taking photos and offering fluid to the mother while the baby is being examined by the nurse. Doulas assists the mother with first breastfeeding. Baby girl latches successfully!

4:00pm - Everyone is settling in. Doula gives mother a light snack. More photos are taken of the mother and father with the birth team. Doula gathers up her belongings, gives the new parents a big hug and heads out to her car, smiling all the way home.

Brenda

Posted by Brenda Lane

The April issue of Obstetrics & Gynecology includes a description of a new model used to predict VBAC (Vaginal Birth after Cesarean) success. Over 7,000 women participated in this analysis over a 4 year period. In this article, Northwestern University researchers identified six factors that can predict success of a mother having a VBAC including:

1. Maternal Age
2. Body Mass Index
3. Ethnicity
4. Prior Vaginal Delivery
5. Occurence of a VBAC
6. Potentially recurrent indication for cesarean

Researchers found that using this predictive nomogram including the above variables, predicting VBAC success was accurate.

Expectant mothers who are planning a VBAC must also remember however that there are many ways they can reduce their chances of having another cesarean, despite some of the these predictive factors. Nothing is a guarantee or a 100% prediction when it comes to birth. Therefore mothers should be encouraged to do their own research, find out what options they have and learn more about ways to increase their own success of having a VBAC.

Do you plan to have a VBAC if you have had a previous cesarean? Why or why not? Share your thoughts with us on the discussion forum.

Brenda

Posted by Brenda Lane

More than 30 years ago, the first research study was conducted in Guatemala on the presence of a "continuous support person" who accompanied a woman in labor. Results showed that the presence of this lay person during childbirth had a dramatic effect on labor including fewer cesareans, less medication and other medical interventions used as well as shorter labors.

Since then more than 7 studies have been conducted in North America on the presence of a doula with similar results. For more information on the results of these individual studies, see the DONA Position Paper on Birth Doulas. Doulas have made such an impact on birth that pediatrician and founding member of DONA International, John Kennell, has been quoted as saying, "if doulas were a drug, it would be unethical not to use it."

Doula support during labor continues to not only have a measurable difference in birth outcomes, but also benefit the family in terms of additional support during pregnancy and postpartum. What are additional reasons that parents today hire doulas? Find out in the latest article on the Top Reasons Parents Hire a Doula. If you plan to use a doula, here are some helpful interview questions.

Be watching for the new series on doulas including how to become a doula!

Are you considering using a doula? Did you have a doula with you during labor? Share your story on the forum.

Warmly,

Brenda

Posted by Brenda Lane

The WHO and the UNAIDS have both recommended that the practice of male circumcision be made more available to prevent the rapid spread of HIV in many countries, most notably in sub Saraha Africa.

While only about 30% of men worldwide are circumcised, experts believe that making circumcision more readily available to at risk populations could reduce the transmission of HIV by as much as 50%.

The UN report was released in March 2007 and states that "of the 40 million people worldwide infected with the human immunodeficiency virus, 25 million live in sub-Saharan Africa, where the disease is spread mostly through heterosexual sex. Increasing male circumcisions could prevent 5.7 million sub-Saharan African men from contracting HIV over the next two decades, and save 3 million lives."

While parents in other countries may not choose to circumcise their male infants except perhaps for religious reasons, here is one example of how the practice of routine circumcision alone could ultimately save countless lives.

Brenda

Posted by Brenda Lane

New ASA guidelines released this month includes revision of former guidelines from 1998. Recommendations include offering epidurals or spinals to those mothers who may be interested in them even in early labor. They also include a recommendation that spinals and epidurals are preferred over general anesthesia for cesarean births.

The most interesting part of the the revised guidelines is allowing mothers the option to drink small amounts of clear liquids during labor. The ASA states that "drinking clear liquids in limited quantities has been found to bring comfort to women in labor and does not increase labor complications. Women with uncomplicated labor may drink small amounts of clear liquid, while those scheduled for nonemergency cesarean section may drink small amounts of clear liquids up to 2 hours before anesthesia administration."

Since many hospitals still restrict fluid intake to mothers in labor, expectant parents should be encouraged to dialogue with their providers about the option of drinking clear fluids. See this article for more information about eating and drinking.

What are your thoughts about the revised guidelines in terms of drinking clear fluids? Share your thoughts on the forum.

Brenda

Posted by Brenda Lane

Every new mother must make the decision about whether she should return to work or be a full-time mother. Some mothers, such as single mothers, may not have the choice to stay home if they need the income. Other families may simply not be able to meet their household budget unless both parents work.

However, if you are in a situation where you can choose to either go back to a full-time career or be a full-time mother, there are clearly pluses and minuses to both decisions. Moms who work outside the home often enjoy the addtional income as well as a sense of "projects completed". It can be more difficult for the stay-at-home mother to feel that her daily work is done since there is always another diaper to change and the house doesn't stay clean for very long.

In my latest article due to be published this week, I have highlighted some good reasons to stay home with your children. I am very interested, however, to hear from the other side of the spectrum. If you returned to work, what are some reasons you made that decision? Did you have any misgivings? How have you adjusted to both working and raising your children? Tell us more about your experiences on the discussion forum.

Brenda

Posted by Brenda Lane

One question I get from new parents all the time is "How do we know when it's time?" Meaning how do they read signs of labor to know when it's too early to get to their place of birth versus when it's too late. Fathers are notorious for worrying that the baby is going to be born in the car. Those stories are the ones that get published in all of the local papers, often with quite a bit of drama.

Several things parents should realize is that almost all emergency births happen to mothers with later babies, not with the first pregnancy. The other is that the other 98% of labors that last for hours or days and parents get to their place of birth too soon, they are never dramatic enough to publish in the paper.

Some parents hear in the childbirth class to go to their place of birth using the 5 - 1 - 1 formula. Contractions 5 minutes apart lasting for 1 minute for 1 hour. This can be a place to start, however, bear in mind that this formula says nothing about intensity. Your contractions should be intense enough that it causes you to start some of your deep breathing or use other pain relief techniques in order to cope with it. Not to mention that you should also be focused enough in between contractions to not have any desire for conversation.

For more information about things to consider, read the latest article on When to go to the Hospital.

Brenda

Posted by Brenda Lane

Nearly 200 mothers were randomly assigned to two groups in this study; those who used a squatting position for birth and those who were on their back with their feet in stirrups (also called lithotomy.)

Results were not surprising. 7% of the mother in the supine/lithotomy group had extensions beyond an episiotomy. 9% of the mothers in the supine group had second or third degree tears, while there were no second or third degree tears in the squatting group. There were no differences between the two groups in the baby's heart rate, apgar scores or risk of neonatal resuscitation.

Mothers on other countries should discuss their options for pushing positions and/or reducing tears with their provider as soon as possible in their pregnancy.

Brenda

Posted by Brenda Lane

The latest study on cord clamping was recently published in the March 2007 issue of Pediatrics. The researchers from Switzerland examined 39 infants who had median gestational age of 30 weeks. The infants were separated into two group; the experimental group had a 60-90 second delay in cord clamping, while the control group received traditional treatment. The tissue oxygenation levels at both 4 and 24 hours was higher in the experimental (or delayed cord clamping) group.

Researchers conclude that preterm infants can benefit from a delay in cord clamping.

Brenda

Posted by Brenda Lane

Successful rate of VBAC have fallen dramatically in the United States in the last years. Reasons for this are not clear. Some speculate that the perception of VBAC is that they carry more risk than a cesarean. Yet more research is now showing that cesareans also carry risks, including risks to the baby. See my blog.

As more than 30% of mothers have a cesarean with their first baby, all of them will be faced with making a decision for a VBAC or cesarean with the next pregnancy. What are some factors to consider when you are making this decision?

1. Babies benefit from a mother's labor by receiving her pregnancy hormones. This allows them to be better prepared to breathe on their own after birth. Even if the mother does not have a successful VBAC after her labor, she still gives her baby the benefit of receiving these hormones.
2. Research does indicate that the more cesareans a mother has, the more her risk of complications increase. Some experts go as far to recommend that if mother's have cesareans with all of their children, they should plan for a smaller number of children.
3. The biggest and most serious risk of VBAC comes the very small chance of a ruptured uterus, which can be a complication for both the mother and the baby. A mother can reduce her chance of having this complication by going into labor spontaneously rather than being induced.
4. There are many ways to increase your chance of a vaginal birth and reduce your chance of a cesarean.

If you are trying to decide for yourself whether or not to have a VBAC, please do your own research, get second opinions if your provider is not supportive, surround yourself with a supportive team, and pray about your best decision.

Any thoughts about VBAC versus cesarean? Why not share them?

Brenda

Posted by Brenda Lane

A recent study shows an interesting correlation between BMI and the likelihood of cesarean. Published in the February 2007 issue of the American Journal of Obstetrics and Gynecology, Danish researchers have discovered that women with a BMI below 25 (normal weight) had a 3.6% chance of a cesarean. Mothers with a BMI of 35 or above had a 18.5% chance of having a cesarean.

"There are a number of mechanisms by which excess weight could make it more difficult for women to deliver their infants vaginally," the researchers say.

The one thing to bear in mind about these studies is that it is not a given if you are overweight or obese that you will have a cesarean! Know that you still have many ways to increase your chance of a vaginal birth including taking a good childbirth class, hiring a doula, giving birth outside a hospital, using a midwife to attend your birth, laboring at home as long as is safe for you, eating and drinking in labor, avoiding getting pain medication too soon, waiting for spontaneous labor instead of being induced, not to mention staying as mobile as possible throughout labor.

For the record, I have worked with several women who were obese as their doula. None of them have had a cesarean.

Warmly,

Brenda

Posted by Brenda Lane

Researchers in a new study published in Human Reproduction, has evidence that women who ate more low- fat dairy foods were twice as likely to have difficulty getting pregnant than those who ate less than one serving of nonfat dairy foods.

On the opposite side of things, women who consumed at least one high fat dairy food a day were more than 27% less likely to have trouble conceiving.

So if you are an ice cream lover (like I am!) this is very good news!

Brenda

Posted by Brenda Lane

Here are the results from our recent poll about which childbirth classes you think are best:

57% - Hospital classes

14% - Bradley

14% - Lamaze

14% - None at all

0% - Online classes

This is a discouraging statistic because it shows a true lack of education on the part of parent-consumers. While some hospital classes do provide sound instruction by qualified and certified childbirth educators, many of them do not. Classes offered in a hospital setting may not have the freedom to share current, up-to-date information or evidence based information to couples. They tend to be large and impersonal. More hospitals are scaling down their classes and offering shorter streamlined courses which translates to cutting out vital information. One of the most common topics that is left out of hospital-based classes today is teaching comfort measures.

Be sure you are finding out what information will be taught, how much practice is included and speak to the instructor prior to registering for class. Here are some good questions to ask before you sign up!

Where did you take your class? What was your experience like? Share your story.

Brenda

Posted by Brenda Lane

It is not uncommon for several of my doula clients each year to have very long labors. By today's standards, that may mean anything more than 8 hours. The truth is that not many women labor spontaneously (without being induced or augmented with pitocin) in a shorter period of time than a typical work day.

In today's "quick fix" society, very few mothers are "left alone" to labor without artificially speeding up the labor pattern with pitocin. In fact, a national survey reveals that pitocin is used in the majority of births in the US today.

What has happened is that any labor that takes longer is considered to be a complication. Care providers push pitocin as a way to speed up long labors and mothers who do not want to use pitocin often have to fight for it. The reality is that pitocin not only alters the course of labor but makes labor more painful and introduces other interventions such as continuous monitoring.

I have noticed that there are a few situations when pitocin and/or an epidural can be helpful, especially if the mother is losing steam after many days of laboring. However these situations are few and far between. Mothers can benefit greatly from staying at home, eating, drinking, resting, taking walks, showering and/or tub baths with an occasional period check on the baby at the birth center or hospital when they are having a long labor. See my article on Long Labors for more information about why letting nature take its course is often the best strategy.

Did you have a long labor? Did you have a choice about using or not using pitocin? Share your story with us.

Warmly,

Brenda

Posted by Brenda Lane

Over 40,000 births were reviewed in a recent report in the Canadian Medical Journal. The reseachers have discovered that the incidences of complications such as blood clots, infection and major bleeding is three times more likely with mothers who have had a planned cesarean versus those with a vaginal birth.

These results dispute the commonly held misconception that planned cesareans are "safer" to the mother. Doctors have often argued that if a cesarean is planned, there is greater control over complications and will result in fewer problems.

Given results that cesareans also carry more risk to the newborn, this new study is compelling evidence that mothers should be given the opportunity to have a VBAC instead of a planned cesarean.

How do you feel about planned cesarean birth? Share it with us on our discussion forum.

Brenda

Posted by Brenda Lane

The January issue of the Journal of Clinical Psychiatry has a new study that has interesting findings about postpartum depression. Not many mothers realize that symptoms of postpartum mood disorders can also include obsessive-compulsive thoughts, feelings or actions, also known as OCD (obsessive-compulsive disorder.)

This latest study shows that mothers are more susceptible after a first baby. About 6.5% of the mothers in the study developed OCD symptoms, as compared to 2% with later pregnancies.

Researchers recommend that all mothers should be screened for OCD in the postpartum period.

If you have had any symptoms of postpartum depression or OCD, see our entire series on postpartum depression for identifying PPD and getting help.

Brenda

Posted by Brenda Lane

An exciting new 2007 study may change the way doctors are now delivering twins when the first baby (Twin A) is in a breech position. For years, mothers have heard that their only safe option when the first baby is breech is to have a cesarean. New evidence suggests that the safer route for Twin A may indeed be a vaginal birth.

Researchers from France looked at 71 planned cesareans and 124 attempted vaginal births. They found no significant differences between the two groups in infant mortality, admission to the NICU, 5 minute APGAR scores, cord blood pH or birth trauma. In fact, the only significant difference was in the planned cesarean group. These mothers had a significantly higher rate of pulmonary embolism or deep vein thrombophlebitis (blood clots) which required anticoagulants.

Mothers of multiples should explore all of their options for birth with their providers. If necessary, get a second opinion during pregnancy. I would suggest that mothers look at finding doctors who are willing to perform vaginal breech births of twins in large teaching hospitals.

Take care!

Brenda

Posted by Brenda Lane

Despite the 2001 and 2004 EPA restrictions on consumption of seafood and fish during pregnancy, researchers from the University of Bristol have found instead that eating larger amounts of seafood during pregnancy may benefit the child's neurological functioning.

Women have been cautioned to not eat more than 2 servings of fish due to the amounts of mercury found in the larger predator fish. While experts do agree that certain fishes such as shark, tilefish, swordfish and king mackerel should not be eaten because of their high levels of mercury, this new research does question restricting other fish and seafood from the mother's diet.

In 1991, Bristol researchers began a long-term study (published in the Lancet) of over 14,000 women and 13,000 of their children in the UK to measure the affects of seafood consumption during the third trimester. The children were given intelligence tests at the age of 8. Children whose mothers consumed the most fish had significantly higher verbal IQ scores and fewer behavioral problems that the children whose mothers ate only the amount recommended by the EPA.

How much fish are you eating? It sounds like increasing your fish consumption of some of the safer fish may benefit, rather than harm your baby. For a list of safe fishes, see Foods to Avoid during Pregnancy.

Brenda

Posted by Brenda Lane

A January 2007 Review from the Cochrane Libraries (one of the most well-known and recognized medical research review groups) has recently examined the effectiveness of corticosteroids to treat babies who are born prior to 37 weeks' gestation.

The researchers looked at studies that compared corticosteroids to the effects of other drugs, placebos or no therapy. Only two studies could be included in the review, although researchers have identified that two additional studies that are currently underway could be included in future reviews.

Out of the total of 57 babies that were included from both studies, reseachers concluded that it was unclear about the safety or effectiveness of corticosteroid treatment for pre term infants. They found that "there is insufficient evidence to support the routine use of steroids in the treatment of primary or refractory neonatal hypotension."

Parents who have pre-term babies should then be asking good questions about any and all treatments for hypotension and the use of corticosteroids based on this information.

Brenda

Posted by Brenda Lane

If you support breastfeeding, you will want to get involved in this amendment to the Civil Rights Act of 1964. Here is what it includes:

1. Protection of breastfeeding for new mothers
2. Provide tax breaks for employers who offer breastfeeding areas in the workplace
3. Provide performance standards for breast pumps
4. Give tax deductions for breastfeeding equipment purchased by families

Here is what you can do to make sure this legislation is brought to the attention of the new Speaker of the House, Nancy Pelosi:

Purchase or make a card that congratulates Nancy on her new grandchild (she is currently expecting grandchild number 6 around Election Day - his name is Paul.)

Write in the card:

1) All babies have the right to breastfeed anywhere that the mother has a right to be.

2) Their mothers need policies in the law that support the government's Breastfeeding Awareness Campaign to educate employers and workers of mother's rights

3) Ask her to throw the full weight of her position behind getting the Breastfeeding Promotion Act PASSED this coming session.

4) Get all of your friends to sign your card before you mail it to Speaker Pelosi - or have several cards addressed and stamped and have your friends sign them.

5) Send this blog to everyone you know - mothers, friends, breastfeeding support groups, etc.. so that thousands of cards will land on Nancy Pelosi's desk right now.

Address:

Representative Nancy Pelosi

2371 Rayburn HOB

Washington, DC 20515

Posted by Brenda Lane

1. Boston - Rated number one for its unsurpassed health care, number of pediatricians and the lowest infant and maternal mortality rates in the country.

2. San Francisco - Made the top five list because of the excellent air quality, high breastfeeding rates, amount of fertility specialists and low rate of preterm births.

3. Minneapolis - Made the top cities list due in part to the best daycare options, number of fertility clinics and birthing centers. It also rated higher due to the availability of doulas and midwives.

4. Portland - As many as 89% of mothers in Portland nurse their babies which helped to put this city in the top five. Midwives and doulas are also a popular choice.

5. Omaha - daycare options, affordable housing and low maternal mortality make this a best city as well as the Baby Friendly Hospital designation for Methodist Hospital (one of only 50 in the country.)

For a complete report see this article in Fit Pregnancy.

Is your hometown a good place to have a baby? Why or why not? Tell us about it on the forum.

Brenda

Posted by Brenda Lane

A systematic review of several studies was conducted in the UK looking at over 480,000 births over a 12 year period.

Even though one US study did not show any correlation between season and preterm births, the London findings showed that three studies from developed countries and three from developing countries indicated a seasonal relationship with preterm birth.

Babies born in the winter months were more than 10% likely to be preterm, compared to those in the spring.

This is useful information, however we are still a long way from being able to prevent preterm birth! Hopefully there will continue to be more research done on preterm birth.

Warmly,

Brenda

Posted by Brenda Lane

Here are results from our last poll on the biggest concerns you have about labor and childbirth:

20% - said that they were most concerned about labor pain

10% - said that they were most concerned about not having enough support

10% - said that having a stalled labor was their biggest concern

30% - said that having a cesarean was the thing that concerned them most

30% - said that having complications during or after labor was their biggest concern.

It looks like the medical aspects of labor seem to be the most common fears surrounding labor and birth. Thank you all for participating and be watching for a new poll very soon!

Warmly,

Brenda

Posted by Brenda Lane

Norwegian researchers have proven that there are effective ways to naturally induce labor when the mother's water has broken. A 2006 randomized control trial of 100 women whose water was broken at term were randomly assigned to an "acupuncture group" versus a "no acupuncture" group.

Results showed that the acupuncture group had a shorter duration of labor overall, they needed less pitocin to induce their labors and the active phase of labor was significantly shorter than the group receiving no acupuncture.

The results did not change when size of the baby, use of an epidural or whether the mother had given birth before were factored in.

These are remarkable findings that should help educate mothers about the options they have when their water is broken and they would prefer to induce labor with natural methods.

Be watching for my new series on inducing labor with more detailed instructions on using acupuressure and other methods to naturally induce labor.

Warmly,

Brenda

Posted by Brenda Lane

Statistics are showing that as many as 80% of new mothers have some degree of postpartum depression. (PPD). The new term is "postpartum mood disorders" since postpartum symptoms can range from the very mild and temporary baby blues to major depression and even the most rare form, psychoses.

Baby blues is likely caused by hormones and occurs from day 3 to 2 weeks postpartum. Mild mood swings are typical. I can remember crying on the phone one afternoon at about 6 days postpartum when my husband told me he had to work 3 hours later than we expected. That was not a typical behavior for me! Baby blues resolves almost completely by 2-3 weeks postpartum.

PPD, on the other hand has similiar symptoms but can last weeks or even months longer than baby blues if not treated. For more information, see the article on Symptoms and take the Self Test for PPD. There are likely multiple causes of PPD.

It's hard to believe that women have been giving birth for thousands of years and yet we are only just beginning to touch the surface of what PPD is all about. One wonders if we are seeing more PPD today than compared to our grandmothers' generation. Or is it simply that we know to look for PPD now, whereas then it was simply not discussed?

I have noticed some very interesting things about PPD in my work with expectant and new mothers. PPD is sneaky - only a handful of women could "see it coming" so to speak or knew the risk factors. Most of them had mild to moderate symptoms in the first few weeks that they thought were simply due to life adjustments when in fact, it was PPD all along and the symptoms worsened over time. Many found that anti-depressants helped, but were worried that they would affect breastfeeding. Almost all of the mothers who had PPD also had very high-need babies or twins or had additional pressures on them; for example returning to work early or a husband who returned to work immediately.

One of the main reasons why I thought to write a series on PPD is that mothers still seem to know so little about it and very few of their providers talked to them about PPD ahead of time. Medication was the only form of treatment recommended.

Be watching as my series on PPD is published . If you think you might have it, see your provider asap! Please share the information with a friend or someone you know who is having a difficult time in postpartum. The sooner every mother knows about PPD, the happier mother, father and baby will be!

Warmly,

Brenda

Posted by Brenda Lane

New research published in the American Journal of Obstetrics and Gynecology (Dec. 2006) sheds light on the debate between the safety of the baby with cesarean birth versus vaginal birth.

Researchers studied a total of 18,653 births taken from the registry in Norway; 17,828 were planned vaginal births and 825 were planned cesareans during a six month period. 5.2% of the babies born vaginally were transferred to the neonatal intensive care unit (NICU) as compared to 9.8% of babies in the planned cesarean group. Also, lung disorders were higher in the cesarean group (1.6%) in comparison to the vaginal group (.8%).

Dr. Toril Kolas and colleagues say that, "for the child, the stress of vaginal delivery seems superior to elective cesarean delivery in many situations," Kolas and colleagues conclude. "Therefore, we emphasize the importance of limiting planned cesarean deliveries to cases with proven benefit for the mother and/or child," they write. "When a planned cesarean delivery is chosen, the operation should be as close to term as possible."

It is so important that all mothers weigh these options when they are considering a planned cesarean birth. For a complete list of the VBAC and cesarean articles on this site, click here.

What do you think about planned cesarean birth versus vaginal birth? Start a discussion on the forum.

Brenda

Posted by Brenda Lane

I can remember actually talking about names that we liked when my husband and I were dating! Women do those things when they find the "right" man, don't we ;) ?

Ultimately we did not use the names we talked about years earlier, but I can recall pouring over lists and buying baby name books (since the internet itself was just a baby 19 years ago.) You would think with an easy name like "Lane" that everything would sound great with it. We found out that was not necessarily the case. We had to experiment with many names to try to find the right ones.

Nicknames are always an issue. I had a much more difficult maiden name, so I knew to be sensitive to names that were hard to spell and/or pronounce. And hearing a name that you like is not the best way to choose one. Chances are very high that if you hear a great name it is one of the more popular ones and your child may be one of several with that name.

I decided to tackle some of these issues on my two latest articles with advice on choosing Baby Names as well as some of the better Baby Name websites including a list of the most popular names to help you if you are expecting.

Let me know if you found any other baby name sites you like and why on the forum!

Have a great weekend!

Warmly,

Brenda

Posted by Brenda Lane

A joint study by the NIH and Johns Hopkins School of Public Health shows that the baby's heart rate during labor may have indicators for the baby's future development.

137 mothers participated in the study and the baby's heart was reviewed 6 times for both rate and variability between 20 and 38 weeks of pregnancy. The researchers then looked at the children at 24-36 months of age for language, mental and motor abilities.

What they discovered was that after 28 weeks gestation, better variability in the fetal heart rate was associated with higher performance on a standardized development test at 2 years of age as well as improved language ability when the children were 2 1/2.

Researchers concluded that "these data suggest that the foundations of individual differences in autonomic control originate during gestation and the developmental momentum of the fetal period continues after birth."

Brenda

Posted by Brenda Lane

A combined team from Wake Forest, NC and Children's Hospital in Boston have discovered that cells from the amniotic fluid and placenta can regenerate into healthy tissue including brain, bone, muscle, and fat cells as well as blood vessels and liver cells. These cells in turn have been implanted into animals with diseased tissue and the cells regenerated into healthy tissue.

Study leader, Dr. Anthony Atala, says that it would only take about 100,000 women to donate stem cells from amniotic fluid in order to provide enough genetic diversity in stem cells that essentially every person in the US could potentially have a "match" to their own compatible tissue.

This is incredibly promising research, especially since it does not involve extracting the cells from embryos, thereby destroying them.

For a complete review of this study, see the Wake Forest University Institute for Regenerative Medicine web site.

Brenda

Posted by Brenda Lane

In the past, only women age 35 or older were recommended to be screened for Down Syndrome. The new ACOG press release indicated that the latest recommendations now include all pregnant women.

The new recommendations include offering the Nuchal Fold Translucency in addition to the AFP blood test. Women at risk should be offered the CVS or Amniocentesis. ACOG recommends that all women be screened for Down Syndrome prior to 20 weeks of pregnancy.

In my series on prenatal testing, I touch on the difficulties that many of these tests can cause including high rates of false positives or the need for more invasive testing. Many times mothers are placed in situations where they must make a decision to carry their baby or induce an abortion. At times, the tests themselves cause complications including miscarriage.

I have very mixed feeling about the information given to parents in prenatal tests. I think we open up a can of worms by knowing too much. I also wonder what damage is done when tests are wrong or right and mothers experience stress for months at a time. Are we too focused on an ideal of the "perfect child" that we can't accept anything less than that?

Too many questions and not enough answers...

What are your thoughts about this new recommendation - pro or con? Let's talk on the forum.

Brenda

Posted by Brenda Lane

A recent lawsuit was brought against a physician in Middlesex, MA for performing a cesarean without a medical reason. The surgery triggered multiple complications. This case was among the first ever where the patient successfully sued her doctor for doing a cesarean. She won $1.53 million in the lawsuit.

The mother, Mary Meador, reports that throughout her fourth pregnancy, her goal was to have a vaginal birth after birth (VBAC) and her obstretrician agreed to do one. However, two weeks before her due date, her doctor announced he would be on vacation and wanted to schedule a cesarean. When Meador objected, her doctor told her that labor would be too risky and compared her uterus to a "hydrogen bomb."

Meador testifies that she tried to find another physician to support her goals of a VBAC but she was too far along in her pregnancy. She went into labor and again asked to try for a VBAC, however another doctor in the practice performed a cesarean instead.

As a result of her cesarean, Meador developed complications including triggering a rare intestinal condition that caused her to lose 100 pounds and require tube feedings. Ultimarely she needed surgery that removed part of her intestine.

Meador says,

"For somebody who didn't want one surgery, I ended up with four," says Meador, now 50. She says she still cannot work."

This is a compelling story about a mother who was not given the option to pursue the kind of birth she hoped for an ultimately paid an enormous price for it.

What do you think about this story - let's talk about it on the forum!

Brenda

Posted by Brenda Lane

Here are the results from the last poll on what moms like best about pregnancy:

• 52% said feeling the baby move.
• 26% said anticipating the baby's arrival
• 15% said seeing the ultrasound pictures
• 5% said knowing you can eat more
• 0% said getting more attention

Thank you for participating! Watch for the new poll anyday and Happy New Year!

Warmly,

Brenda