The Lie of the EDD: Why Your Due Date Isn't when You Think
How the 40 week pregnancy myth came about and why it's totally wrong.
http://www.associatedcontent.comarticle/1047180/the_lie_of_the_edd_why_your_due_date.html

Low Levels Of Vitamin D Linked To Common Vaginal Infection In Pregnant Women

Low Levels Of Vitamin D Linked To Common Vaginal Infection In Pregnant Women

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Vitamin D really seems to be the miracle drug of the day.

Widespread Use Of Labour Induction Potentially Harmful To Woman And Baby

11 May 2009

Induction of labor is on the rise in the U.S., standing at 41% according to a large national survey of women who gave birth in 2005. But, a new study published in the April issue of BJOG, the peer-reviewed journal of the Royal College of Obstetricians and Gynaecologists, finds that the best available evidence does not support many reasons medical providers give for using drugs or other measures to cause labor to begin.

The investigators found support only for inducing labor at or beyond 41 completed weeks of gestation and under some conditions when a woman's membranes break before labor. However, there is not good evidence for inducing labor in many other situations, including when the fetus is believed to be large or to have restricted growth, or when a woman is pregnant with twins, has insulin-dependent diabetes, or has low levels of amniotic fluid.

The study's lead author, Dr. Ellen Mozurkewich, a maternal-fetal medicine specialist at the University of Michigan, said, "The best available evidence does not support routine inductions in many situations for which induction is currently being recommended to patients. More research is necessary to clarify the risks and benefits of induction in these situations."

Many pregnant women may be receiving inappropriate care. For example, 17% of women who participated in Childbirth Connection's national Listening to Mothers II survey in 2005 said they had been induced because their caregiver was concerned that their baby was too big. However, best evidence suggests that labor induction is not beneficial in this case.

"We now know that every week of gestation counts in terms of brain and lung development. When there is no good reason to end pregnancy, mothers and babies benefit from waiting for labor to begin on its own," said Carol Sakala, Director of Programs, Childbirth Connection. "Starting labor early can lead to negative outcomes for the woman and/or baby."

To foster high quality maternity care, Childbirth Connection, a research and advocacy organization, commissioned this study through a grant from the Transforming Birth Fund of the New Hampshire Charitable Foundation.

Concerns about inducing labor without an established medical rationale include increased risk of cesarean section for some mothers (e.g., first-time mothers and women with a cervix that is firm and closed), and babies who are born before full lung and brain maturation. Estimates of how long a fetus has been developing can be off by up to two weeks, and labor induction can unwittingly end with a preterm birth.

Source
Childbirth Connection

Brain Maturation In Preemies May Be Delayed By Iron Deficiency In Womb

(Terri here- all the more reason to be eating lots of leafy greens, liver, lentils and blackstrap molasses during your pregnancy. I'm serious!)

05 May 2009

Iron plays a large role in brain development in the womb, and new University of Rochester Medical Center research shows an iron deficiency may delay the development of auditory nervous system in preemies. This delay could affect babies ability to process sound which is critical for later language development in early childhood.

The study evaluated 80 infants over 18 months, testing their cord blood for iron levels and using a non-invasive tool -- auditory brainstem-evoked response (ABR) -- to measure the maturity of the brain's auditory nervous system soon after birth. The study found that the brains of infants with low iron levels in their cord blood had abnormal maturation of auditory system compared to infants with normal cord iron levels.

"Sound isn't transmitted as well through the immature auditory pathway in the brains of premature babies who are deficient in iron as compared to premature babies who have enough iron," said Sanjiv Amin, M.D., associate professor of Pediatrics at the University of Rochester Medical Center and author of the abstract presented today at the Pediatric Academic Society meeting in Baltimore. "We suspect that if the auditory neural system is affected during developmental phase, then other parts of the brain could also be affected in the presence of iron deficiency."

As many as 20 to 30 percent of pregnant women with lower socio-economic status are iron deficient. Iron deficiency in pregnant woman can cause anemia, a condition in which there are not enough red blood cells to carry oxygen around the body. Anemia can cause a range of problems in pregnancy from exhaustion to preterm labor and low birth weight. But physicians didn't know that an iron deficiency in a fetus may also delay auditory neural maturation. which could lead to language problems.

"We are concerned by these findings because of its potential implications for language development," Amin said. "More study is needed to fully understand what this delay in maturation means. This finding at least underscores an already understood need to monitor iron levels in pregnant women."

Source:
Heather Hare
University of Rochester Medical Center

National Cesarean Rate Continues to Rise

(Terri here: This report is so disheartening. Please check out Lamaze's website for great information, as noted in the last paragraph of this article. I LOVE Lamaze's Care Practice Papers- they are essential to any pregnant mama.)

Evidence Increases for Risks in Cesarean
Surgery as National Rate Continues to Rise

WASHINGTON (March 18, 2009)—As research continues to mount for the risks of cesarean surgery, the Centers for Disease Control released new, staggering statistics reporting that 31.8% of women endure birth by cesarean in the United States (2007). This announcement comes after the release of significant findings from the New England Journal of Medicine reinforcing that birth by cesarean surgery before 39 weeks of pregnancy causes increased complications in newborns.

Despite the latest advances in medical technology, health care providers cannot determine a baby’s due date with 100% accuracy. Therefore, cesarean surgeries scheduled before a woman’s estimated due date could result in a baby born as early as 36 weeks to a few days before the baby is actually due. During the last few weeks of pregnancy, a baby’s lungs mature and a protective layer of fat forms, both of which are vital developments for a healthy baby. In addition, babies need time for their lung cells to shift from being fluid producing to fluid absorbing cells. Without time during labor to prepare the baby to breathe, lungs cells may not be ready. Thus, babies born by cesarean surgery, even when they are full-term, need to go to an intensive care unit more frequently than babies who were born vaginally to get help breathing.

Research published in the New England Journal of Medicine (NEJM) supports earlier findings that cesarean surgery performed prior to 39 weeks of pregnancy increases poor outcomes in babies. Of the babies in the NEJM study born before 39 weeks, more than 26% had complications, including the need to be on a ventilator, respiratory distress syndrome, low blood sugar and severe infection (sepsis).

“Overuse of cesarean surgery complicates the otherwise natural process of birth,” says Lamaze Institute Chair Debra Bingham, LCCE, MS, RN, DrPH, “Allowing the natural process to occur not only reduces risks for mothers in this and future pregnancies, but also reduces health risks for her baby.”

Spontaneous labor is almost always the best indication for a baby’s physical readiness for life outside of the womb. As one of the key steps to a healthy birth, Lamaze International recommends that women let labor begin on its own. Allowing labor to begin naturally increases the likelihood that a baby is healthy and ready for birth. When a birth outcome is good, mother and baby can bond and start breastfeeding immediately after birth—both of which provide the best start for a baby’s growth and development.

Lamaze International President Pam Spry, PhD, CNM, FACNM, LCCE says, “Maternity care in the United States is at a crossroads. The most commonly used practices don’t align with the best evidence for a healthy birth.” The Milbank Report’s Evidence-Based Maternity Care: What It Is and What It Can Achieve reveals that several routine maternity care practices, including cesarean surgery, contradict best evidence and are overused in the United States.

Cesarean surgery—a major abdominal surgery—also carries risks for women, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as stillbirth and placenta problems like percreta and accreta, which can lead to excessive bleeding, bladder injury, hysterectomy and maternal death. The research is clear, however, that when medically necessary, cesarean surgery can be a lifesaving procedure for both mother and baby, and worth the risks involved.

Two of the most important decisions a woman can make are where she gives birth and who she chooses as her care provider. Lamaze International has developed tools to help women with these decisions, including the questions to ask and other reference material. Visit http://magazine.lamaze.org/ to learn more about the Lamaze during pregnancy, birth and beyond.

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About Lamaze International
Since its founding in 1960, Lamaze International has worked to promote, support and protect birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area networks, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers. For more information about Lamaze International, visit www.lamaze.org.

Premature Birth Report Card for US: Nation gets a D

This article from March of Dimes is very interesting. I would like to point out that they call for the nation to look at inductions and scheduling c-sections weeks before term.
Here is the article.

Depression can double risk of having a preemie

Depression during pregnancy, that is.
Here is the link.