Sleep Aids For Pregnancy

If you're reading this article, chances are you've been spending too many nights tossing and turning. Knowing this is normal during pregnancy — especially in your first and third trimesters — doesn't make it any easier to bear. Now you're desperate to get some shut-eye, and we can help. If you're already practicing good sleep hygiene but still not slumbering peacefully, here are a few remedies to help you get the sleep you crave.

Pillows
Using pillows to support your belly and back in bed can mean the difference between a sleepless night and a peaceful slumber. Tucking a pillow between your bent knees supports your lower back and may make side-sleeping (your best option as pregnancy advances) more comfortable. A pillow tucked behind your back can also help you to maintain a side-lying position while you sleep. Maternity pillow abound, but regular pillows work fine, too.

• Single or dual pregnancy wedge
Wedge-shaped pillow support your belly when you lie on your side. You can also use them to prop yourself up to a semi-recline when you're lying on your back. The dual pregnancy wedge is two pillows (attached with adjustable Velcro tabs) that provide simultaneous support in front and back.

• Full-length body pillow
Body pillow are at least 5 feet long and are designed to support the back and cradle the belly.

* Sleeping Bean
Support your belly and your back by wrapping yourself around this column-shaped pillow. It makes a good nursing pillow later, and you can use a smaller Sleeping Bean as a bolster or bumper to protect your baby in his crib. Available from Bean Products ; call (800) 726-8365.

Foods
What you eat — and when you eat it — can affect the quality of your sleep.

Warm milk
Drinking a glass of warm milk before bedtime is a time-tested way to bring on sleep. Experts believe the amino acid L-tryptophan (found in milk and other foods such as turkey and eggs) makes eyelids heavy by raising the level of a chemical in the brain called serotonin. Others suggest the somnambulant effects of warm milk may be all in your head. But if it helps you snooze, does it really matter? Warning: Don't go all the way and take tryptophan supplements — they're not safe during pregnancy.

Protein-packed snacks
If bad dreams, headaches, or full-body sweats are disturbing your sleep, you could be suffering from low blood sugar. To fix the problem, try a high-protein snack before bed such as an egg, some peanut butter, or a slice of turkey on bread to keep your blood sugar up during the night.

Relaxation techniques
If you're tense, anxious, or overtired, sleep can seem as hard to grab as your own shadow. Try these simple, time-tested techniques to help calm your mind, relax your muscles, and put sleep within your grasp.

Yoga and stretching
In addition to helping you relax, yoga and stretching have the added benefit of keeping you toned and flexible during pregnancy. Many gyms, health clubs, and YMCAs offer yoga and stretch classes; some are designed specifically for pregnant women. Or you can create your own stretch routine with simple moves for your neck and shoulders, calves and hamstrings, and back and waist. Although you don't want to work up a sweat too close to bedtime (see Exercise, below), gently stretching your muscles during the day and before bedtime can make falling asleep easier.

Massage
Getting a massage relaxes tense or tired muscles. If you visit a professional massage therapist, make sure he or she has experience working with pregnant women and uses a table and pillow designed for that purpose. Professional massage can be expensive, but getting a foot, hand, or neck massage at home from your generous partner is a perfect way to wind down before bed.

Deep breathing
Breathing deeply and rhythmically can ease muscle tension, lower your heart rate, and help you fall asleep faster. Lie down on the carpet or your bed with your feet shoulder-width apart. (If you're in the second half of your pregnancy, rest on your side with a pillow between your legs for support or wedge a pillow partly under the right side of your back so you're tilted slightly to the left.) With your mouth closed, breathe slowly through your nose, feeling your stomach rise as you gradually fill your diaphragm and lungs with air. Hold for one second before exhaling through your nose to the count of four.

Progressive muscle relaxation
It may take you several weeks to master progressive relaxation, but once you do, it can really help you sleep. Lying on your bed or even on the floor, you can release tight muscles by first tensing and then completely relaxing them. Focus on one group of muscles at a time and alternate between your right and left side. Start by tensing and releasing your hand and forearm muscles, followed by your biceps and triceps, face and jaw, chest and shoulders, stomach, thighs, and so on until you reach your feet.

Guided imagery
Picture yourself in a quiet, relaxing scene — lying on a warm sandy beach or walking in a field of wildflowers. Now imagine every detail of the scene, including the sounds, smells, tastes, and textures around you. If you can't picture a relaxing setting, use an image from a photograph or magazine and fill in the missing details. It may take some practice, but guided imagery can calm your restless or anxious mind and help you slip into a deep sleep.

Exercise
Regular exercise during pregnancy makes you healthier both physically and mentally, and it can help you sleep better, too — provided you don't exercise vigorously within four hours of bedtime. Working out too close to bedtime can rev you up and even rob you of deep sleep by interfering with your natural sleep cycle. Instead, work up a sweat in the morning, afternoon, or early evening.

Prescription and over-the-counter medications
Ideally you should avoid all medications (including herbal remedies) during pregnancy, since most drugs have not been tested on pregnant women and it can be hard to know what affect they may have on your baby. If you have a severe sleep problem or disorder, your practitioner may recommend a prescription or over-the-counter drug to use during your second or third trimester. But you should never take any medication during pregnancy without first consulting your doctor or midwife.

Over the counter medications
Ask your doctor or midwife if you can take an antihistamine. Diphenhydramine hydrochloride and doxyalamine (brand names include Benadryl, Sominex, and Unisom) are generally considered safe during pregnancy, although drowsiness is a side effect — not the primary effect — of the drug. Since other possible side effects include impaired alertness and dizziness, you should not drive or operate machinery after taking this medication.

Prescription medications
If you're suffering from severe insomnia or anxiety, your healthcare provider may recommend that you take a prescription sleeping medication. Warning: Never drive or operate machinery after taking a drug to help you sleep.

source from http://www.babycenter.com

Your Likelihood Of Having Twins Or More

How common are twins and other multiple pregnancies?
Increasingly common, largely because more and more women are taking fertility drugs or turning to assisted reproductive technology (ART) to help them conceive. These treatments greatly increase a woman's chance of having twins or higher-order multiples. The famous McCaughey septuplets are one extreme example of the potential consequences of fertility treatments.

These days, about one in 32 births are twin births. This rate has gone up 65 percent since 1980, and it's more than double the rate among women who conceive without medical assistance — one in 89.

The rise in triplets and quadruplets is even more dramatic. Between 1980 and 1998, the rate of triplets and higher-order multiple births shot up by more than 400 percent, but it's crept back down over the past few years as fertility treatments have become more refined. In 2003, one in 535 births resulted in triplets, quadruplets, or more.

Meanwhile, the likelihood of having identical twins (when one fertilized egg divides in half) is about one in 250. This rate hasn't changed over the decades and is remarkably constant all over the world.

How likely am I to have more than one baby if I'm undergoing fertility treatment?
Fertility drugs stimulate your ovaries, increasing the odds that you'll release several eggs at the same time. On average, 20 percent of women taking gonadotropins will become pregnant with more than one baby. Women who get pregnant while taking the drug Clomid have a 5 to 12 percent chance of twins.

If you undergo in vitro fertilization (IVF), your chances of having more than one child are 20 to 40 percent, depending on how many embryos are placed in your womb. Other fertility techniques such as GIFT (gamete intrafallopian transfer) and ZIFT (zygote intrafallopian transfer) are also more likely to result in multiple pregnancies.

On its own, IUI (intrauterine insemination), in which sperm are injected into the uterus with a syringe, is the only fertility treatment that doesn't increase the chances of conceiving multiples. But most women who undergo IUI also take a fertility drug.

Fertility drugs and other treatments primarily increase your chance of having fraternal twins, where two eggs are fertilized by two different sperm. But there is now some evidence that women who undergo certain treatments also have somewhat higher rates of identical twins.

What other factors affect the chances that I'll have more than one baby?
While identical twins generally happen by sheer chance, there are several factors that influence your chances of having fraternal twins:

• Heredity: If you're a twin or if twins run in your family, you're slightly more likely to have a set yourself. Women who are fraternal twins have a one in 60 chance of bearing twins.

• Race: Twins are more common than average in African Americans and less common in Hispanics and Asians.

• Age: The older you are, the higher your chances of having fraternal twins or higher-order multiples. A 2006 study found that women over 35 produce more follicle stimulating hormone (FSH) than younger women. Ironically, increasing levels of this hormone are a sign of failing ovaries and declining fertility. But FSH is also the hormone that causes an egg to ripen in preparation for ovulation each month, and women with extra FSH may release more than one egg in a single cycle. So while older women are statistically less likely to get pregnant, if they do get pregnant, they're more likely to have twins.

• Number of pregnancies: The more pregnancies you've had, the greater your chances of having twins.

• History of twins: Once you have a set of fraternal twins, you're twice as likely to have another set in future pregnancies.

• Body type: Twins are more common in large and tall women than in small women.

source from http://www.babycenter.com

When And How To Find Out If You're Carrying Twins Or More

How and when will I learn whether I'm carrying twins or more?
Several decades ago, most women who were pregnant with multiples didn't find out until they were in labor. But such late-term surprises are rare today. Women typically discover they're having more than one baby during a routine ultrasound, often in the first trimester.

Your practitioner will likely recommend an ultrasound in your first trimester if you're unusually large for your gestation date. The most likely explanation is that you or your practitioner miscalculated your conception date. The ultrasound will help determine how far along you really are and whether your size is due to your carrying more than one baby.

If you're pregnant as a result of a fertility treatment such as Clomid, gonadotropins, or in vitro fertilization (IVF), you'll probably have an ultrasound within the first eight weeks to count the number of embryos that have implanted. Ultrasound is almost foolproof at revealing multiple pregnancies, particularly after six to eight weeks. However, the more babies you're carrying, the easier it is for one to get overlooked.

How do twins end up fraternal or identical?
Fraternal twins develop from two eggs that are released and fertilized at the same time. They're known as dizygotic (DZ). Identical twins develop from one egg that splits into two and are thus known as monozygotic (MZ).

By the way, since they come from the same egg, monozygotic twins do share the same DNA, but these so-called "identical" twins are never truly the same. Although they have the same genetic makeup, they may have distinguishing characteristics that allow their parents to tell them apart. This may be due to environmental influences, either inside or outside the womb. Also, certain genes may end up being expressed differently in each twin.

How and when can I find out whether my babies are DZ or MZ?
Prenatal tests such as chorionic villus sampling (CVS) and amniocentesis can tell you for sure — at least in theory. These tests can be tricky to perform in multiples, and you may not be able to get a sample of each baby's DNA.

If you can't or don't want to have these tests, an ultrasound can often tell you whether your babies are dizygotic or monozygotic, based on whether there are one or two placentas and whether the babies are the same gender.

An experienced technician performing a trans-vaginal ultrasound between 9 and 14 weeks can determine with nearly 100 percent certainty whether your babies share a single placenta. (The accuracy rate drops to about 90 percent in the second trimester as the womb becomes more crowded.)

If your babies share a placenta, they're monozygotic. If there are two placentas, your twins may be DZ or MZ. All dyzygotic twins and 20 to 30 percent of monozygotic twins have separate placentas.

By 18 to 20 weeks, a technician may be able to identify the babies' genders, assuming that both babies are positioned so that the technician can get a good look at their genitals. If an ultrasound clearly shows that you have a boy and a girl, you'll know that your babies are dizygotic. Monozygotic twins are nearly always the same sex.

If the ultrasound shows two placentas and only one gender — or if the results are unclear — you may have to wait until your babies are born for your answer. After the birth, your practitioner will determine whether the twins shared a placenta. Because separate placentas sometimes fuse together and appear as one, a laboratory test may be needed to tell how many there were.

If placental analysis doesn't solve the mystery, you can order an at-home DNA test for a little over $100, but you'll have to wait one or two weeks for the results. As mentioned above, monozygotic twins will have almost always have identical DNA, while dizygotic twins will share about 50 percent of their DNA.

As your babies grow up, it'll probably be easy to tell what type of twins they are just by looking at them. If they look so much alike that other people can't tell them apart, they're almost certainly monozygotic. Any obvious difference in their hair color, eye color, or facial features means that they're dizygotic.

Why is it important to know whether twins are dizygotic or monozygotic?
Finding out whether twins are DZ or MZ isn't simply a matter of satisfying idle curiosity. It can also be important to know for medical reasons.

For one thing, monozygotic twins who share a single placenta face a special health risk during pregnancy. Up to 15 percent of these twins will develop twin-to-twin transfusion syndrome (TTTS), a dangerous condition in which one twin "donates" fluids to the other. The twin on the receiving end tends to grow more rapidly than the donor twin.

Without treatment, the condition is usually fatal for both babies. If your twins are sharing a placenta, your caregiver will monitor their weight gain and watch for other signs of TTTS. If your caregiver suspects TTTS, prompt treatment may prevent complications and keep your babies healthy.

Even after your babies have grown up, it could be important to know whether they're dizygotic or monozygotic. For example, if one twin is found to have a genetic disease, an MZ sibling will have it, too. A DZ sibling, on the other hand, might be spared.

There's one more reason to find out whether your twins are fraternal or identical: Everyone will ask — from friends and relatives to strangers on the street. People are fascinated by twins, so be prepared to answer the question over and over again throughout your pregnancy and for years to come.

source from http://www.babycenter.com

Having Male Twin Sibling Reduces A Woman's Fertility

WASHINGTON (Reuters) - Women who have a male twin are less likely to marry and have children, perhaps because of being exposed to their brother's testosterone for nine months in the womb, researchers reported on Monday.

A study of Finnish twins showed that women were 25 percent less likely to have children if their twin was a male. Those who did have children gave birth to an average of two fewer babies than women who had a twin sister.

Based on an analysis of 18th and 19th century data, researchers found women who had a male twin also were 15 percent less likely to get married, Virpi Lummaa of the University of Sheffield in Britain and Finland's University of Turku and colleagues reported.

"We show that daughters born with a male co-twin have reduced lifetime reproductive success compared to those born with a female co-twin," they wrote in their report, published in the Proceedings of the National Academy of Sciences. "This reduction arises because such daughters have decreased probabilities of marrying as well as reduced fecundity."

Researchers have long known that fetuses are influenced by hormones in the womb. Because male and female fetuses have similar levels of the "female" hormone estrogen, girl twins are more likely to be affected by testosterone in the womb.

Studies of rodents show that hormones in the womb affect a baby's development, but researchers have lacked studies of actual populations to see if what is in theory possible biologically in fact happens in real life.

Lummaa's team used Finnish church records that dated from 1734 to 1888, looking at the births and marriages affecting 754 twins.

"The study used data from humans living in a pre-industrial era so as to obtain results that are not affected by advanced health care and contraception," Lummaa said in a statement.

"Our results show that females who had a male cotwin have reduced fitness compared to those who had a female cotwin, but the success of males is unaffected by the sex of their cotwin," the researcher wrote.

Perhaps the female twins had more masculine attitudes and behaviors that affected their decision to get married, the researchers speculated. Male features could have made the women less attractive to mates, they added.

Other studies have shown, for instance, that exposure to testosterone in the womb affects facial features and even finger lengths.

Also, exposure to elevated levels of testosterone during development can promote diseases that compromise fertility, such as reproductive cancers, the said.

By Maggie Fox

source from http://www.babycenter.com

Second-born Twin Has Higher Post-delivery Risk

Second-born twins are twice as likely as the firstborn to die at birth or shortly after due to complications during delivery, British researchers report.

The risk — which remains very small — appears to be lessened when both twins are delivered by caesarean section, the study found.

"Compared with the first twin, the second twin is more than twice as likely to die during delivery or in the first four weeks of life," said lead author Dr. Gordon Smith, the head of the department of obstetrics and gynecology at Cambridge University. "This is observed among twins born at term — 36 weeks or later — but not in prematurely delivered twins," he added.

The absolute risk to the second twin is still very small, about one in every 250 twin births, Smith said.

His team published its findings in the March 2 online edition of the British Medical Journal.

In the study, Smith's group collected data on twin pregnancies in England, Northern Ireland, and Wales between 1994 and 2003. The researchers detected 1,377 cases of twin pregnancies where one twin died during delivery or shortly after.

The deaths were due to direct complications of birth, Smith said. These included prolapsed umbilical cord (delivery of the baby's umbilical cord occurs prior to the baby's birth), complications of breech birth, and separation of the second twin's placenta after delivery of the first twin.

"We found that the risk for the second twin tended to be less among those delivered by caesarean section," Smith said. "This is consistent with previous studies, which had also suggested that planned caesarean section was associated with lower risks of death and morbidity for the second twin," he said.

However, there is no information that shows directly that caesarean section is protective, and the risk to any one twin baby remains very small, Smith said.

"Among twins born prematurely, the high risk of death due to prematurity probably masks the small additional risk of death due to complications of delivery for the second twin," the researcher added.

Whether a woman chooses to have a caesarean delivery depends on the viewpoint of the individual woman, Smith said.

"This will involve her motivation to achieve a normal birth, her attitudes toward small risks of serious adverse events and her plans for future pregnancies. In particular, women planning many future births, and younger women, whose plans may be difficult to predict, may do better not to consider planned caesarean section due to the effects of this on future pregnancies," he said.

One expert believes that the risk of death of the second born twin is even smaller in the United States than in Britain.

"I would hate to see this study used as an excuse to have every mother with twins have a caesarean section," said Dr. F. Sessions Cole, the director of newborn medicine and head of the neonatal intensive care unit at St. Louis Children's Hospital.

Cole said that most twins delivered at full term are delivered vaginally. "Having all mothers with twins deliver by caesarean section would result in more risk to the mother than the small risks to the babies," he said.

Once the first twin is delivered, it is important to carefully monitor the second twin, Cole said. If there appears to be problems with the second twin, that baby may be delivered by caesarean section, he noted. "That's the standard of care today."

Cole believes that the data in the study applies only to Great Britain. "There would be fewer such deaths in the United States," he said. "There is much greater monitoring attention given to the second twin in the United States, given the malpractice risk that any obstetrician faces when he or she delivers twins," he said.


-- Steven Reinberg, HealthDay News

source from http://www.babycenter.com

Sexual Positions For Baby-making

Are some sexual positions better than others for conceiving?
There's no evidence that any particular sexual position is more likely to lead to conception. You may have heard that positions that deposit the sperm closest to the cervix — such as the missionary position (man on top) — are more promising than other positions. But there are no studies to back this up.

Proper timing, on the other hand, is a crucial factor. To make conception more likely, have sex a day or two before you expect to ovulate and then again on the day of ovulation.

Will having an orgasm help my chances of conceiving?
Some people believe that a woman who climaxes after her partner ejaculates is more likely to get pregnant, but there's no evidence to support this notion either.

The female orgasm isn't a necessary component of conception, but it is possible that uterine contractions help sperm move toward the fallopian tubes. (Such painless contractions happen involuntarily even when you're not having sex, particularly around the time of ovulation.)

Should I stay lying down afterward?
There's no evidence that it makes a difference, but it can't hurt. Remaining horizontal for 15 minutes or so after intercourse allows more semen to remain in your vagina. Of course, with millions of sperm in every ejaculation, there should be plenty of sperm in your vagina even if you get up right away.

NOTE: If you've been trying to conceive for a year or more without success (or three to six months if you're 35 or older), or your periods are irregular, your best bet is to see a fertility specialist.

source from http://www.babycenter.com

No Meat? No Worries: Diet For A Healthy (Vegetarian) Pregnancy

How can I make sure I'm getting the nutrients I need from a vegetarian diet?
"Many pregnant women who eat a vegetarian diet worry that they're not getting enough protein," says Elizabeth Somer, a dietician and author of Nutrition for a Healthy Pregnancy: The Complete Guide to Eating Before, During, and After Your Pregnancy (Owl Books, 2002). In fact, she says, it's pretty easy to fulfill your protein needs just by drinking cow's or soy milk.

Of bigger concern, she says, are omega 3 fatty-acids (a nutrient that plays an important role in brain function and development), zinc, iron, vitamin B12, vitamin D, folate and calcium. With the exception of the omega-3s that are mainly found in fatty fish, especially in salmon, most of these essentials are easy enough to find in foods that even vegans (people who eat no animal products at all) consume. If you don't eat at least two servings of fish each week, you'll have to get your omega-3s through foods like flax seed and walnuts.

Diet recommendations
Beyond the two weekly servings of omega-3s (Check the food label on the packaging for serving information.), here's what Somer recommends pregnant vegetarians eat every day:

1. Four servings of cooked dried beans and peas because they're full of zinc, iron and protein. A few nuts and seeds can also be added.

2. Four servings of calcium-rich foods, including nonfat or low-fat milk or calcium- and vitamin D- fortified soy milk. Cheese and cottage cheese are good for calcium but won't supply the vitamin D your body needs to absorb it and move it into the bones. "Look for foods that have 300 mg of calcium per serving, which equates to about 30 percent of the daily value as listed on the label," says Somer.

3. Eight to ten servings of fruits and vegetables because they're full of antioxidants. "I recommend five to seven servings of vegetables and three to five of fruit," says Somer.

4. Six to 11 servings of whole grains, including foods such as brown rice, oatmeal and whole wheat bread.

5. One or more servings of a food that has vitamin B12, such as milk, fortified soy milk, egg yolk, or fermented soy foods like miso and tempeh.

Vegetarian recipes
Tired of your cookbooks? Here are two of Somer's favorite vegetarian recipes:

Recipe 1: Polenta and Black Bean Casserole

(Serves 4; 1 serving includes 415 mg calcium, 152 mcg folic acid, 4.5 mg iron and 9 g fiber)

Ingredients:

2 15-ounce cans black beans, drained and rinsed

1 15-ounce can Mexican tomatoes, chopped

1 4-ounce can diced green chilies

1 teaspoon cumin

1 teaspoon coriander

1/2 teaspoon chili powder

1 cup of your favorite salsa

1 cup cilantro, chopped

1 18-ounce package precooked, ready-to-eat polenta (plain or basil flavored)

1 cup low-fat Monterey Jack cheese, shredded

Directions:

• In Dutch oven, combine all ingredients expect polenta and cheese. *Cover and simmer over medium heat for 15 minutes, to enhance flavors.

• While bean mixture is simmering, slice polenta into 1/4-inch-thick rounds.

• Spray a 9x5x3-inch loaf pan or a 1-quart casserole with nonstick spray.

• Layer bottom of pan with 1/3 of bean mixture, then add one layer of polenta rounds (1/2 of the polenta). Sprinkle with 1/3 cup of cheese. Add another layer of beans, polenta, cheese, then beans, and finish with cheese.

• Bake 50-55 minutes, or until bubbly hot.

• Drain liquid from the pan, cool for five minutes, slice and serve.

Recipe 2: Glazed Blueberry-Lemon Bread

(Makes 12 slices; 1 slice includes 82 mg calcium, 12 mcg folic acid, 1.2 mg iron and 1 g fiber)

Ingredients:

1 3/4 cup unbleached all-purpose flour

2/3 cup sugar

1 tablespoon baking powder

1/4 teaspoon salt

1 cup 8th Continent vanilla soy milk

3 tablespoons canola oil

1 tablespoon lemon peel, grated

2 large eggs

2 cups frozen blueberries, partially thawed

1/4 cup unbleached all-purpose flour

1/4 cup ready-to-spread vanilla or cream cheese frosting

2 teaspoon 8th Continent vanilla soy milk

1 teaspoon grated lemon peel

Directions:

• Preheat oven to 350 degrees. Spray 9x5x3-inch loaf pan with vegetable cooking spray.

• In large bowl, stir together flour, sugar, baking powder, salt.

• In small bowl, whip until thoroughly blended 1 cup soy milk, oil, 1 tablespoon lemon peel, eggs.

• Gently stir soy mixture into flour mixture until just moistened.

• Toss slightly thawed blueberries (no longer icy but still firm) with 1/4 cup flour. Place in sieve or strainer to remove excess flour then fold gently into batter.

• Pour batter into pan and bake 55 minutes or until toothpick comes out clean. Cool 10 minutes in pan on wire rack then remove and cool completely, for one hour.

• While bread cools, stir together frosting, 2 teaspoons soy milk and 1 teaspoon lemon peel. Let sit and then drizzle over cooled bread.

source from http://www.babycenter.com

UK Tells Pregnant Women To Boost Vitamin D Intake

Sat, Dec 29, 2007 (Reuters Life!) - The British government has told pregnant and breastfeeding women to increase their intake of vitamin D during the darker winter months to reduce the risk of seizures and the bone disease rickets in their children.

The Department of Health said doctors were reporting increasing numbers of cases of vitamin D deficiency in children.

It said that children from Asian, Afro-Caribbean and Middle Eastern backgrounds could be at greater risk.

Dark skinned people do not absorb as much sunlight — a source of the vitamin — through the skin, and may also cover up most exposed parts of their body for cultural reasons, it said.

"We are seeing significant numbers of children with vitamin D deficiency," said Colin Michie, a paediatrician at Ealing Hospital in London.

"If a pregnant or breastfeeding woman is lacking in vitamin D, the baby will also have low vitamin D and calcium levels which can lead babies to develop seizures in the first months of life."

In the summer, 15 minutes exposure to sunshine on the arms head and shoulders will create sufficient quantities of the vitamin in the body, the Department of Health said.

But in winter months when sunshine is limited, the vitamin must be obtained from food sources such as oily fish like salmon, tuna and sardines, eggs, fortified cereals and bread.

The health department said pregnant and breastfeeding women and children under four could benefit from taking a daily 10 mg supplement of vitamin D during winter.

It advised those who thought they might be at risk of vitamin D deficiency to consult their family doctor.

A lack of the vitamin can lead to rickets, a condition common at the start of the last century and thought to have been eradicated in the 1950s because of improved nutrition.

It can cause deformities in bones, poor teeth formation, stunted growth and general ill health.

source from http://www.babycenter.com

Pregnancy Signs and Symptoms

The period that never comes is the classic sign of pregnancy, but some women get a clue before that. Many symptoms of pregnancy can arise right away: headache, nausea, fatigue, skin breakouts and increased sensitivity to scent are among the less delightful signs of impending motherhood.

If you think you might be pregnant but aren’t totally sure, you can wait until the 28th day of your cycle and then take a home pregnancy test. If you take one before the last day of your cycle, you stand a pretty good chance of getting a false negative reading.

Or, you can wait another day or two and see whether your period arrives. The old fashioned method is a lot cheaper, but sometimes, you just gotta know right away. If you don’t get pregnant right away, there may be a perfectly practical explanation. If you have been taking the birth control pill, your body may take a while to get back into the rhythm of ovulation, and it may be more than a month before it’s back on track. If you have used Depo-Provera, it could be as long as a year, and again, that’s natural. When we interfere with our bodies hormonally, they respond, and it takes time for them to reset their internal regulating functions.

When you don’t get pregnant, there may be one or more reasons behind it. If your partner has a low sperm count, you may have trouble conceiving. If there are problems with the viability of eggs, pregnancy may not occur. Many very early pregnancies terminate naturally after a few days, and women don’t even know it because they haven’t even shown signs of pregnancy yet. These early terminations are nature’s way of preventing a pregnancy when the embryo is not viable.

Most women of childbearing age, if they are having regular, unprotected sex, have a 20-40% chance of getting pregnant in each cycle. Accumulated over the course of six months, your chances of getting pregnant are very good indeed. Your age also has a bearing on how long it takes to conceive. Women under 25 years of age have a 96% chance of getting pregnant within a year of trying. Women age 26-34 have an 86% chance, and women 36-44 have a 78% chance of getting pregnant within a year.

The older you are, the shorter the time you should wait before contacting a doctor. It’s counterintuitive since as you can see above, the older you are, the lower your chances of conceiving, but the older you are, the less you should wait. When people do have problems with fertility, addressing the problem sooner maximizes the chances they have of still being fairly young when the baby is born, so you don't want to wait too long. If you are under 30 years old, don’t be surprised if it takes as

long as a year to get pregnant. If you’re between 30 and 35, expect to wait up to nine months: if you haven’t conceived by then, you may want to see your doctor. If you’re between 36 and 40,see your doctor if you haven’t conceived after six months, and if you’re forty or over, you may want to see your doctor after three months.

Your gynecologist will refer you for fertility testing, and if you don’t conceive after around six months of working with your doctor, you may decide to work with a doctor who specializes in fertility treatments.

source from http://www.parenttime.com

Fertility & Pregnancy Myths

You shouldn’t exercise much.
Actually, one of the worst things you can do to your body is to stop exercising before or during pregnancy. Starting a pregnancy with low energy and too much weight will put you in line for joint problems, hemorrhoids, the sodden feeling we all get when we don’t have enough activity and a tough weight loss challenge once the baby is born.

It is true that some kinds of exercise are not safe for pregnant women: squatting and abdominal exercises in particular should be avoided.

But your trainer or aerobics coach will tell you what you shouldn’t do, and other than that, plenty of regular physical activity will keep you healthy throughout your pregnancy. If you’re not much of an exerciser anyway, you may want to start exercising some months before getting pregnant just to help yourself weather the strain on the back and to keep your energy levels higher.

Too much exercise would be something that a few athletes, ballet dancers or eating-disordered women do to keep their weight well down before normal levels. If you exercise so much that your periods are irregular or have gone completely missing, you probably won’t be able to get pregnant anyway because your body will have temporarily shut down its ovulation schedule. In this case, you should check in with your doctor to plan an exercise schedule that is moderate and a diet that will help your baby grow strong and healthy once you have conceived.

Men’s underwear can prevent pregnancy.
Only if you sew him into it! There have been studies that showed that men who wore briefs had lower sperm counts than men who wore boxers. Millions of “briefs” men switched to boxers in order to do their part in making a baby, enduring the discomfort of having everything suddenly loose around their legs until their partners passed the pregnancy test. There are also studies that have shown no statistical difference in the fertility of men due to their underwear. The scientific opinion seems at this point to be that it doesn’t much matter what a man does with his underwear as long as he takes them off every once in awhile. That’s pretty much key in babymaking.

Men should postponed sex to “store up” sperm.
Naah. Unless a man has a definite problem with low sperm count, he has plenty and I mean PLENTY of sperm to get the job done, each and every time.

Women can’t get pregnant during menstruation.
While technically this is true, let’s discuss the exception that makes

hundreds of women into mothers each year. While during your period you can’t get pregnant because you are not ovulating, you can have sex during your period, the sperm can hang around for a sperm lifespan of five days, and if you ovulate a little early while that sperm is still enjoying his post-coital cigarette, hey! Presto! And you’re pregnant. The chances are slim, though, and if you’re trying to get pregnant, sex during your period probably won’t be much help on the path to parenthood.

source from http://www.parenttime.com

Monitor Your Baby's Heart Beat at Home with a Fetal Doppler

Once you’ve achieved maternity, there are a range of interesting products that can help you make the most of your fertilized condition. One of our favorites is the BabyBeat, a doppler-type ultrasound device that lets you measure your baby’s heartbeat from as early on as ten weeks into your pregnancy.

You’ve probably heard of the “Doppler effect”, usually illustrated using a train whistle as an example. When a train is approaching, you hear the whistle, and as it comes closer, the tone of the whistle, becoming louder, also becomes significantly higher. As the train passes you, the sound seems to drop down and become lower again.

It isn’t that the train’s whistle actually varies in tone, though; the sound only seems higher as the train gets closer to you, and as it moves away, the tone sounds lower. The actual frequency of the tone is what you hear when the train is right next to you: the effect of speed and distance traveled changes your perception of the tone, which increases or decreases due to the direction in which it is traveling.

Doctors have used Doppler-based ultrasound for decades, not only for pregnant women but for medical and surgical applications. Ultrasound is based on the idea that you can locate things in space by sending out a frequency, which bounces off an object and returns to you at a measurably different frequency. By calculating the speed of sound in the first place and measuring the returning frequency, you can determine where things are inside the body. In the oceans, navy ships use a similar sound-based technology, called sonar, to locate underwater mountains and ridges as well as to track other ships. A ship sends out a tone, which bounces off other objects and returns as another frequency. This tone can be “read” by an expert sonar listener, or it can be fed into a computer and return as a readout. The ultrasound test performed by your OB-Gyn works in much the same way: the sound “bounces off” your baby, generating an image that’s displayed on a computer screen.

Don’t confuse Baby Doppler products with an ordinary microphone! Microphones will magnify the sounds outside as well as inside your body, with resulting interference noises. They simply can’t be as effective as doppler-based systems. Doppler is an interactive technology, and more precise than any mic. Baby Doppler, or ultrasound, has until recently, only been available at scheduled appointments at your OB-Gyn’s office. Typically, every few months, the mom-to-be goes in for a checkup, and the baby’s image is projected on a screen, while the delighted parents listen to the baby’s heartbeat. Now, thanks to modern technology, you can listen to your baby’s heartbeat right at home, any time you like.

Extraneous sounds create a murky noise that interferes with your listening pleasure. Other baby doppler products record everything, including the sound of the probe moving across your skin. The BabyBeat’s unique audio processing function sifts out unwanted sounds, giving you a clear, easy-to-hear sound. Our specialized noise reduction system is very popular with parents-to-be who want to hear the baby, not static!

And what would our Noise Reduction system be without our specialized Home Theater system, featuring durable speakers and Superior Sound Quality! Our speakers are the best you will find in baby doppler products.

The BabyBeat have been designed to fit easily into your hand. Fingertip controls let you do whatever you need to without have to reach, twist or strain. Ideal for the pregnant woman who would rather not perform intricate yoga moves to listen to her baby!

The Velvet-Touch probe has a soft feel that is much more pleasant than the usual probe. (In fact, it probably shouldn’t even be called a “probe”. Let’s just call it the Velvet-Touch.)You won’t get chills or shivers when you use it.

All the BabyBeat Dopplers arrive at your door with 2 ounces of ultrasound gel, a reference guide and instruction manual, new batteries and a CD that teaches you which sounds you are hearing when you use your Baby Doppler.

Aside from being able to heart your child’s heart beating, the Advanced Technology Standard BabyBeat with Recorder also lets you record the sound. Unlike other baby doppler products, you don’t have to hook the BabyBeat up to a computer to record; simply press a button! You can save each BabyBeat session to play back at a later time. With CD recording capabilities on your home computer, you can transfer the recording to CD for a wonderful keepsake or gift for grandparents-to-be. (If you don’t have a CD burner, you can send the Recorder to us with your baby’s heartbeat on the last recording, and we’ll make the CD for you! The BabyBeat also contains the technology you need to send your baby’s heartbeat recording via email.

The Standard Babybeat Legacy Baby Doppler was our first baby doppler, and features an angled probe for maximum clarity of sound and Static Suppression Doppler to prevent unwanted noise. It uses one 9-volt battery, which is usually good for around 250 one-minute sessions. The Legacy is available for rent at only $24 a month. The Legacy is perfect if you don’t want to record, but only want to hear your baby’s heart. For only $30 a month, you can rent the Standard BabyBeat without the recorder (but you can get it with the recorder for only $2 more!. You may also wish to purchase your own for $499.

The BabyBeat is lightweight and easy to handle (a real boon when you can’t reach your shoes!) It runs off three long-lasting AAA batteries, and can usually provide 1200, one-minute sessions on one set of batteries. You can rent the BabyBeat with Recorder for $32 a month, or buy one for $499.

source from http://www.parenttime.com

What Is the Multiple Marker Test?

Between the 15th and 20th weeks of pregnancy, expectant mothers typically are offered a blood test called the multiple marker test. It can sometimes be called a triple screen or a quad screen, depending on the number of things measured.

For the screening, a sample of blood is drawn from the mother to measure the levels of hCG (human chorionic gonadotropin) and estriol, which are produced by the placenta, and alpha-fetoprotein (AFP), which is produced by the fetus. Sometimes the level of inhibin-A, which is made by the placenta, also is measured. The levels of these substances can help doctors identify a fetus at risk for certain birth defects, including neural tube defects (like spina bifida) and chromosomal abnormalities (likeDown syndrome).

In determining the results of the test, doctors take into account:

• the mother's age, weight, and ethnicity
• whether she has diabetes
• if she is having twins or other multiples
• the gestational age of the fetus

Many of these factors affect the levels of the substances being measured and the interpretation of the test results, so the accuracy of this information is vital. If any of the information is inaccurate, the results from the screening may be as well.

Receiving Abnormal Results

If you have undergone the multiple marker test and received abnormal results, there is no need to worry yet. Just because the test is abnormal doesn't mean that your child has a birth defect. Rather, an abnormal screen indicates that the fetus should be evaluated further.

Usually, when a pregnant woman's results show high levels of AFP, pointing to a possible risk of spina bifida or other neural tube defects, her doctor will order a detailed ultrasound to examine the fetus, including the fetal skull and spine. In addition, an ultrasound can confirm the age of the fetus and whether the woman is carrying multiples. The doctor also may offer amniocentesis, which is the withdrawal of amniotic fluid from the uterus for further testing.

If a woman's multiple marker screen results reveal low levels of AFP and estriol and high levels of hCG and inhibin-A, she has an increased risk of having a baby with Down syndrome. The next step is usually an ultrasound to confirm the baby's due date and to look for any obvious abnormalities. Unfortunately, ultrasound is not a very good test for detecting Down syndrome. For this reason, patients are offered amniocentesis so chromosome testing can be done on the fetal cells found in the amniotic fluid.

In general, remember that the multiple marker test is just a screen. It can identify many fetuses that are at risk for certain birth defects, but will not identify them all. A positive screen does not necessarily mean that there is a birth defect, but that there is a need for more evaluation.

If you have any questions or concerns about multiple marker testing, talk to your doctor or seek the advice of a genetic counselor.

source from http://kidshealth.org

What is RH Incompatibility?

If you just found out you're pregnant, one of the first - and most important - tests you should expect is a blood-type test. This basic test determines your blood type and Rh factor. Your Rh factor may play a role in your baby's health, so it's important to know this information early in your pregnancy.

What Is the RH Factor?

People with different blood types have proteins specific to that blood type on the surfaces of their red blood cells. There are four blood types - A, B, AB, and O.

Each of the four blood types is additionally classified according to the presence of another protein on the surface of red blood cells that indicates the Rh factor. If you carry this protein, you are Rh positive. If you don't carry the protein, you are Rh negative.

Most people - about 85% - are Rh positive. But if a woman who is Rh negative and a man who is Rh positive conceive a baby, there is the potential for a baby to have a health problem. The baby growing inside the Rh-negative mother may have Rh-positive blood, inherited from the father. Approximately half of the children born to an Rh-negative mother and Rh-positive father will be Rh positive.

Rh incompatibility usually isn't a problem if it's the mother's first pregnancy because, unless there's some sort of abnormality, the fetus's blood does not normally enter the mother's circulatory system during the course of the pregnancy.

However, during delivery, the mother's and baby's blood can intermingle. If this happens, the mother's body recognizes the Rh protein as a foreign substance and can begin producing antibodies (protein molecules in the immune system that recognize, and later work to destroy, foreign substances) against the Rh proteins introduced into her blood.

Other ways Rh-negative pregnant women can be exposed to the Rh protein that might cause antibody production include blood transfusions with Rh-positive blood, miscarriage, and ectopic pregnancy.

Rh antibodies are harmless until the mother's second or later pregnancies. If she is ever carrying another Rh-positive child, her Rh antibodies will recognize the Rh proteins on the surface of the baby's blood cells as foreign, and pass into the baby's bloodstream and attack those cells. This can lead to swelling and rupture of the baby's red blood cells. A baby's blood count can get dangerously low when this condition, known as hemolytic or Rh disease of the newborn, occurs.

How Is Rh Disease of the Newborn Prevented and Treated?

In generations past, Rh incompatibility was a very serious problem. Fortunately, significant medical advances have been made to help prevent complications from Rh incompatibility and to treat any newborn affected by Rh disease.

Today, when a woman with the potential to develop Rh incompatibility is pregnant, doctors administer a series of two Rh immune-globulin shots during her first pregnancy. The first shot is given around the 28th week of pregnancy and the second within 72 hours after giving birth. Rh immune-globulin acts like a vaccine, preventing the mother's body from producing any potentially dangerous Rh antibodies that can cause serious complications in the newborn or complicate any future pregnancies.

A dose of Rh immune-globulin may also be given if a woman has a miscarriage, an amniocentesis, or any bleeding during pregnancy.

If a doctor determines that a woman has already developed Rh antibodies, then the pregnancy will be closely monitored to make sure that those levels are not too high. In rare cases, if the incompatibility is severe and the baby is in danger, a series of special blood transfusions (called exchange transfusions) can be performed either while the baby is still in the uterus or after delivery.

Exchange transfusions replace the baby's blood with red blood cells that have the Rh-negative factor. This procedure stabilizes the baby's level of red blood cells and minimizes further damage caused by circulating Rh antibodies already present in the baby's bloodstream.

Because of the success rate of the Rh immune-globulin shots, exchange transfusions are needed in fewer than 1% of Rh-incompatible pregnancies in the United States today.

What Can Happen if Rh Disease Is Not Prevented?

Rh incompatibility rarely causes complications in a first pregnancy and does not affect the health of the mother. But Rh antibodies that develop during subsequent pregnancies can be potentially dangerous to mother and child. Rh disease can result in severe anemia, jaundice, brain damage, and heart failure in a newborn. In extreme cases, it can cause the death of the fetus because too many red blood cells have been depleted.

If you're not sure what your Rh factor is and think you're pregnant, it's important to start regular prenatal care as soon as possible - including blood-type testing. With early detection and treatment of Rh incompatibility, you can focus on more important things - like welcoming a new, healthy baby into your household.

source from http://kidshealth.org

Gestational Diabetes?

Gestational diabetes is a kind of diabetes that comes on during pregnancy and goes away after labor and delivery. It affects about 4% of all pregnant women, according to the American Diabetes Association. Gestational diabetes is often diagnosed on screening tests done between weeks 24 and 28 of pregnancy.

While doctors aren't sure what causes gestational diabetes, it is believed that hormones from the placenta may block the action of insulin in the mother. This means that the mother needs more insulin, and sometimes, her pancreas cannot make enough to transport the sugar in the blood into the cells for energy. The mother's blood has high levels of glucose, and that extra glucose can cross the placenta, giving the growing baby a high blood sugar level.

In response, the baby's pancreas starts making extra insulin to transport the sugar into the cells to be used for energy. When the pancreas can't keep up, the extra blood sugar is stored as fat on the baby, and that can lead to health problems for the unborn baby. Infants of diabetic mothers are at risk for abnormal growth, premature delivery, and breathing problems, among other things.

If your doctor diagnoses you with gestational diabetes, it's likely that you'll be started on a treatment plan aimed at getting glucose levels under control. This includes a plan to manage your nutrition, physical activity, and weight gain.

While most diabetes diagnosed during pregnancy resolves after delivery, some women will have gestational diabetes during future pregnancies as well. And some who are diagnosed while pregnant may actually have been diabetic before the pregnancy. In these cases, the diabetes does not disappear after delivery.

source from http://kidshealth.org

Midwives

Congratulations, you're pregnant! Let the decision-making begin. Choosing a health care provider to care for you and your baby during your pregnancy is one of the biggest decisions you'll make.

In the United States, women's choices have traditionally been limited to an obstetrician or a knowledgeable family doctor. But for some women with low-risk, uncomplicated pregnancies, midwives offer an excellent alternative.

In Europe, midwives assist at more than 70% of normal vaginal births. Though midwives delivered only 7% of American babies in 1997, that percentage has been increasing since 1975. But most Americans aren't sure what they do, how they're trained, or if they're even available. Is a midwife a viable option for you?

The History of Midwives

The word "midwife" comes from Old English and means "with woman." Midwives have helped women deliver babies since the beginning of history. References to midwives are found in ancient Hindu records, in Greek and Roman manuscripts, and even in the Bible.

As early as 1560, Parisian midwives had to pass a licensing examination and abide by regulations to practice. Not all midwives had this level of education, however. English midwives received little formal training and weren't licensed until 1902. America inherited the English model of midwifery.

Early American midwives usually learned their craft through apprenticeship and tradition. They remained ignorant of scientific advances in fighting infection through hygiene and drugs such as penicillin. By the early 20th century, women and their babies were more likely to die under the care of midwives than under the care of doctors.

Around this time, American medical doctors began a campaign against midwifery in the press, the courts, and Congress. They cited the poor outcomes for mothers and babies under the care of midwives. Today's research into the first few decades of the 20th century suggests that doctors may also have wanted a greater market share of the maternity business and, therefore, didn't welcome competition from midwives.

Whatever the doctors' motivations, the rate of midwife-attended births dropped during and after the campaign. But the widespread criticism from the medical establishment prompted the foundation of the first certified American nurse-midwifery school in 1933. It aimed to incorporate the necessary medical training into midwifery's traditional approach to pregnancy and labor.

What Kind of Training Does a Midwife Have?

Midwives today come from a variety of backgrounds. The subtitle a midwife uses will indicate the level of education and training. Most American midwives are certified nurse-midwives (CNMs) who:

• have at least a bachelor's degree and may have a master's or doctoral degree
• have completed both nursing and midwifery training
• have passed national and state licensing exams to become certified
• are licensed in every state
• may work in conjunction with doctors

About 96% of births assisted by certified nurse-midwives occur in hospitals.

A certified midwife (CM) is not a registered nurse but otherwise meets the same qualifications as a certified nurse-midwife. Because this certification has only existed since 1997, there are few CMs. Currently, only the state of New York recognizes this certification as sufficient for licensing.

A lay or direct-entry midwife may or may not have a college degree or a certification. Direct-entry midwives may have trained through apprenticeship, workshops, formal instruction, or a combination of these. Not all states require them to work in conjunction with doctors, and they usually practice in homes or non-hospital birth centers. But not every state regulates direct-entry midwives or allows them to practice.

A certified professional midwife (CPM) is certified by the North American Registry of Midwives after passing written exams and hands-on skill evaluations. Direct-entry midwives and certified nurse-midwives can apply for this certification. They're required to have out-of-hospital birth experience, and usually practice in homes and birth centers. Their legal status varies according to state.

What’s the Midwife’s Philosophy?

A midwife's education stresses that pregnancy and birth are normal, healthy events until proven otherwise. Midwives view their role as supporting the pregnant woman while letting nature takes its course.

Midwives also focus on the psychological aspects of how the mother-to-be feels about her pregnancy and the actual birth experience. They encourage women to trust their own instincts and seek the information they need to make their own valuable decisions about pregnancy, birth, and parenthood.

Of course, many medical doctors (MDs) share these values. But an MD is more likely to use preventive testing and medical technology — such as ultrasound, continuous fetal monitoring, and the option of pain medications during birth — as a standard part of care during pregnancy and labor.

High-risk pregnancies undoubtedly require this approach. But many midwives find it unnecessary for most uncomplicated pregnancies.

What Does a Midwife Do?

Midwives generally spend a lot of time during prenatal visits addressing a woman's individual concerns and needs, and will stay with her as much as possible throughout labor. They sometimes encourage physical positioning during labor such as walking around, showering, rocking, or leaning on birthing balls — recommendations that aren't usually associated with a typical medical doctor. Midwives also usually allow women to eat and drink during labor.

Certified nurse-midwives, like doctors, will use some medical interventions, such as electronic fetal monitoring, labor-inducing drugs, pain medications, epidurals, and episiotomies, if the need arises. However, a certified midwife, certified professional midwife, or direct-entry midwife may not legally be allowed to use these techniques without a doctor's supervision. And birthing centers may or may not be equipped for these procedures.

Midwives of any licensing degree cannot perform cesarean sections (C-sections). If one were required, an obstetrician would have to perform your delivery. If any potentially life-threatening complications suddenly arose during delivery, midwives should also involve an obstetrician.

Certified midwives are trained in basic life support for newborns and, in the event of sudden complications with your baby after birth, can care for the baby until a pediatrician or neonatologist (an intensive-care specialist for newborns) is available.

Is a Midwife Right for You?

Several studies have shown that midwife-supervised births produce excellent outcomes with fewer medical interventions than average. Midwives' patients use electronic fetal monitoring less often and tend to have a reduced need for epidurals, episiotomies, and C-sections for successful deliveries. To some degree, this stems from the fact that midwives see only low-risk patients with uncomplicated pregnancies. But some researchers attribute the need for a minimum of medical intervention to the midwives' natural approach to the management of labor and delivery, which may reduce a woman's fear, pain, and anxiety during birth.

Midwifery is not advisable for women with higher-risk pregnancies. Those expecting twins or multiples and those with prior pregnancy complications, gestational diabetes, high-blood pressure, or chronic health problems of any kind before pregnancy should discuss their options with their primary health care provider or an obstetrician. Certified nurse-midwives who practice in major medical centers and work very closely with obstetricians and perinatologists (specialists in high-risk pregnancy) may take patients with risk factors. But midwives in solo practice or who practice in limited medical facilities generally do not.

The major difference between doctors and midwives is the doctors' ability to intervene surgically when necessary. Midwives can't perform C-sections and some can't administer drugs or anesthesia. If you feel more comfortable having those options immediately available, a doctor may be the right choice for you.

What if Something Goes Wrong?

Midwives are trained to recognize the signs of trouble in pregnancy and labor. If a complication develops at any time, the midwife should consult a doctor. If your midwife doesn't already have a practice agreement with a doctor, be sure to find out what will be done in case of a complication.

If you plan to deliver at a non-hospital birth center or at home, an emergency back-up plan is especially critical. If you must go to the hospital, your midwife will go with you and will continue to support you throughout your labor.

But it's a good idea to get an answer to these questions:

• What training or equipment does your midwife have to handle emergencies?
• How far will you be from the nearest hospital?
• Do you have fail-safe transportation?

Finding a Midwife

You can decide to use a midwife at any time during your pregnancy. Women often turn to midwifery a few months before their due dates, when they begin to seriously consider their birth plans.

To evaluate your medical needs, most midwives will request that you bring your prenatal care records to your first meeting. Few midwives will accept a patient well along in pregnancy unless she has had adequate prenatal care.

Interview a prospective midwife carefully. Investigate the midwife's background, certifications, experience, and emergency procedures. Because you'll be closely involved, make sure your personalities mesh. Do you feel comfortable with the midwife? Can you talk easily?

To locate a midwife, try asking your obstetrician-gynecologist (OB/GYN), family doctor, and friends for a referral.

source from http://kidshealth.org

All About Genetics

What do you know about your family tree? Have any of your relatives had health problems that tend to run in families? Which of these problems affected your parents or grandparents? Which ones affect you or your brothers or sisters now? Which problems might you pass on to your children?

Thanks to advances in medical research, doctors now have the tools to understand how certain illnesses, or increased risks for certain illnesses, pass from generation to generation. Here are some basics about genetics.

Genes and Chromosomes

Each person has a unique set of chemical blueprints that determines how his or her body looks and functions. These blueprints are contained in a complex chemical called deoxyribonucleic acid (DNA), a long, spiral-shaped molecule that's found inside each body cell. DNA carries the codes for genetic information and is made of linked subunits called nucleotides. Each nucleotide contains a phosphate molecule, a sugar molecule (deoxyribose), and one of four coding molecules called bases (adenine, guanine, cytosine, or thymine). The sequence of these four bases determines the genetic code.

The specific segments of DNA that contain the instructions for making specific body proteins are called genes. Right now, scientists believe that human DNA carries from 25,000 to 35,000 genes. Some genes direct the formation of proteins that eventually determine physical features such as brown eyes or curly hair. Others provide instructions for the body to produce important chemicals called enzymes (which help control the chemical reactions in the body).

Sometimes, depending on the codes of a specific gene, even a small error within the DNA structure can mean serious problems for the entire body. Sometimes, an error in just one gene can result in a life that's shortened or physically difficult.

Genes are found in specific segments along the length of human DNA, neatly packaged within structures called chromosomes. Every human cell contains 46 chromosomes, arranged as 23 pairs, with one member of each pair inherited from each parent at the time of conception. After conception, these 46 chromosomes duplicate again and again to pass on the same genetic information to each new cell in the developing child.

Human chromosomes are large enough to be seen with a high-powered microscope, and the 23 pairs can be identified according to differences in their size, shape, and the way they pick up special laboratory dyes.

Genetic Problems

Abnormal Numbers of Chromosomes (Trisomies and Monosomies)

Genetic problems can happen for many reasons. Sometimes, a mistake occurs during cell division, causing an error in the chromosome number either before or shortly after conception. The developing embryo then grows from cells that have either too many chromosomes or too few.

In trisomy, for example, there are three copies of one particular chromosome instead of the normal two (one from each parent). Down syndrome, trisomy 18 (Edwards) syndrome, and trisomy 13 (Patau) syndrome are examples of this type of genetic problem.

Trisomy 18 syndrome affects 1 out of every 3,000 newborns. Children with this syndrome have a low birth weight and a small head, mouth, and jaw. Their hands typically form closed fists with abnormal finger positioning. They may also have malformations involving the hips and feet, heart and kidney problems, and mental retardation. Only about 5% of these children live longer than 1 year.

Trisomy 13 syndrome affects 1 out of every 5,000 newborns. This syndrome causes cleft lip, flexed fingers with extra digits, hemangiomas (blood vessel malformations) of the face and neck, and many different structural abnormalities of the skull and face. It can also cause malformations of the ribs, heart, abdominal organs, and sex organs. Long-term survival is unlikely but possible.

In monosomy, another form of number error, one member of a chromosome pair is missing. There are too few chromosomes rather than too many.

Deletions, Translocations, and Inversions

Sometimes it's not the number of chromosomes that's the problem, but that chromosomes are incomplete or abnormally shaped. In both deletions and microdeletions, for example, some small part of a chromosome is missing. In a microdeletion, the missing part of a chromosome is usually so small that it amounts to a single gene or only a few genes.

Important genetic disorders caused by deletions and microdeletions include Wolf-Hirschhorn syndrome (affects chromosome 4), Cri-du-chat syndrome (chromosome 5), DiGeorge syndrome (chromosome 22), and Williams syndrome (chromosome 7).

In translocations (which affect 1 out of every 500 newborns), bits of chromosomes shift from one chromosome to another. With inversions (which affect about 1 out of every 100 newborns), small parts of the DNA code seem to be snipped out and reinserted flipped over. Translocations may be either inherited from a parent or arise spontaneously in a child's own chromosomes.

Both translocations and inversions typically cause no malformations or developmental problems in the kids who have them. However, adults with either translocations or inversions who wish to become parents may have an increased risk of miscarriage or chromosome abnormalities in their own children.

Sex Chromosomes

Genetic problems also occur when abnormalities affect the sex chromosomes. Normally, a child will be a male if he inherits one X chromosome from his mother and one Y chromosome from his father. A child will be a female if she inherits a double dose of X (one from each parent) and no Y.

Sometimes, however, children are born with only one sex chromosome (usually a single X) or with an extra X or Y. Turner syndrome is the name of the disorder affecting girls born with only one X chromosome, whereas boys with Klinefelter syndrome are born with XXY or XXXY.

Sometimes, too, a genetic problem is X-linked, meaning that it's carried by the X chromosome. Fragile X syndrome, which causes mental retardation in boys, is one such disorder. Other diseases that are carried by genes on the X chromosome include hemophilia and Duchenne muscular dystrophy.

Females may be carriers of these diseases, but because they also inherit a normal X chromosome, the abnormal X may be canceled out. Males, on the other hand, only have one X chromosome and are almost always the ones who have the disease.

Gene Mutations

Some genetic problems are caused by a single gene that's present but altered in some way. Such changes in genes are called mutations. When this is the case, the number and appearance of the chromosomes are often entirely normal. To pinpoint the defective gene, scientists use sophisticated DNA screening techniques. Some examples of genetic illnesses caused by a single problem gene include: phenylketonuria (PKU), cystic fibrosis, sickle cell anemia, Tay-Sachs disease, and achondroplasia (a type of dwarfism).

Although experts originally believed that no more than 3% of all human diseases were caused by errors in a single gene, new research suggests that this may be an underestimate. Within the last few years, scientists have discovered genetic links to many different diseases that weren't originally thought of as genetic, including several different types of cancer.

Oncogenes (Cancer-Causing Genes)

Researchers have identified 20 to 30 cancer-susceptibility genes that greatly increase a person's odds of getting some form of malignancy. For example, a gene has been identified on chromosome number 9 that may be linked to a common skin cancer called basal cell carcinoma. This gene, labeled PTC or patched, may someday be important in screening for this type of cancer. Another gene, called HNPCC, is carried by 1 out of every 300 Americans and may greatly increase an individual's chance of getting colon cancer. And the doubly dangerous gene called BRCA-1 seems to give women an 85% chance of developing breast cancer, as well as a 50% chance of ovarian tumors.

Other Genetically Linked Diseases

Altered genes may play a role in the development of many other devastating illnesses. Parkinson's disease, for example, may be linked to a gene on chromosome number 4, and multiple sclerosis may be linked to alterations in a gene on chromosome number 6. Alzheimer's disease, linked to a gene on chromosome 19, can already be diagnosed (in some cases) by screening for that altered gene, although such screening is viewed by many as controversial.

Although heart disease and diabetes appear to be related to simultaneous changes in many different genes, the first of these may already have been identified. According to the American Heart Association, this gene may be an artery-clogging gene that almost doubles the risk of fatty deposits blocking the coronary arteries. Having the gene may also triple someone's chances of getting adult-onset diabetes.

It's important to note that much of the newest information from genetic research has not yet been translated into useful screening tests. However, experts predict that this will soon change, and they estimate that the number of available genetic tests will increase dramatically in the years to come.

source from http://kidshealth.org