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With the rise in the use of in-vitro fertilization and other fertility treatments comes a rise in the occurrence of multiple births. Fertility experts are alarmed by the rising number of multiple births and as a result are calling on fertility clinics to reduce the number of embryos implanted in a woman during the in-vitro fertilization process.
Results from the most recent studies and evidence from successful fertility treatments indicate that high pregnancy rates are achieved even if fewer embryos are implanted. Both patients and fertility clinics, however, are opting to implant larger numbers of embryos during a cycle in hopes of increasing the odds of successfully achieving pregnancy. These trends put both mother and baby at great risk during pregnancy, delivery, and beyond.
Pregnancies involving multiples, 2 or more fetuses, are at a greater risk of complications. These complications include premature delivery, complications during pregnancy that would force a mother onto bedrest or result in miscarriage, and birth defects and other health problems to one or more of the fetuses, to mention a few. Careful consideration should be given to all the potential complications when a couple and the fertility clinic are deciding on the number of embryos to implant in a given cycle.
There are no enforceable rules regarding the number of embryos that should be implanted during a given cycle, however, fertility experts have made some recommendations that they hope clinics and parents will adhere to. The recommendations are as follows:
- For women under 35 years old, no more than two embryos should be implanted during a single cycle, and transfer of only one embryo should be considered.
- For women between the ages of 35-37, no more than two late stage embryos or 3 early stage embryos should be implanted.
- For women age 38-40, no more than 4 early stage embryos should be implanted.
- And finally, for women over 40, up to 5 embryos can be considered, but individual circumstances need to be taken into account.
These recommendations are in place to help reduce the occurrence of multiple pregnancies. More than a third of all pregnancies conceived using infertility treatments like in-vitro fertilization result in multiple births. Fertility specialists have found that increasing the number of embryos does not necessarily impact the chances of achieving pregnancy. Pregnancy can just as easily be achieved with the implantation of fewer embryos. If the chances of successful pregnancy are not dramatically increased by implanting a larger number of embryos than why risk the added complications of multiple birth.
Each situation is of course different, and your doctor and the fertility clinic you are working with should be making decisions that are right for you and your circumstances. Talk with your doctor about your wishes and their recommendations, and be sure to educate yourself about the benefits and risks of implanting multiple embryos before making a decision.
(source: MSNBC)
Recently I read this article on MSNBC discussing our society’s increasing intolerance of children. I found it rather interesting. According to this article, increasingly we as a society are expecting children to be quiet and well behaved in public, at all times with no exceptions. We get upset when children are present in fancier restaurants, movie theatres, and museums. We seem to have gone back to that whole “a child should be seen and not heard” idea.
I think the problem boils down a couple of things.
First, there seems to be this increasing expectation for children to behave as miniature adults. We expect children to be able to know the difference between a fancy restaurant and a family restaurant. We expect them to understand the importance of being quiet when in certain places and situations. We no longer seem to see a kid as a kid. Children aren’t miniature adults, they are kids learning as they go along how to behave, what is expected of them, and the difference between right and wrong.
Secondly, parents seem to be part of the problem. Some parents seem to have this idea in their heads that their children will just naturally know how to behave in all situations. They assume a child can sit quietly and still for the hour or so it takes for the family to eat at a nice restaurant, or even worse, sit quietly during a movie that is 2 hours or more. Children learn from experience and from observation how to act in a given situation. They will not likely know at age 2 what is expected in a quiet restaurant setting, or at age 6 how to sit through a long movie (especially one that is not a cartoon).
As a society we seem to have become much less patient, especially when it comes to children. I admit that sometimes I am guilty of this. I have found myself sitting in a restaurant next to a family and think, “can’t they control their kids; we are trying to have a nice meal.” We seem to expect children to be on their best behavior at all times, when adults can’t even abide by that rule. Kids will be kids, and we need to develop more understanding and patience. Yes, sometimes kids are behaving badly in places they probably shouldn’t be in the first place, but we can’t change everything. What we can change is how we react.
What are your thoughts? Have your ever found yourself being intolerant, or being on the receiving end of intolerance when you have been out with your kids?
According to a recent MSNBC article, while couples in Europe and Asia are opting for smaller families the trend here in the US seems to be toward larger families. More and more these days couples are opting for families of 3 or more kids. In 2004 11 percent of births were to women who already had 3 children up from 10 percent in 1995. Not much of a change really, but pediatricians and gynecologists are reporting that more and more they are encountering women who are open to having more than 2 children, even more than 4.
Duke University sociologist, Phillip Morris, says that the trend appears to be toward wealthier couples having more children. These couples see that they can already easily afford the 2 or 3 children that they already have so why not have more. This is a big change from wealthy couples being the ones to opt for smaller families in the past. It is also quite different from what is being seen in other countries, especially in Asia and Europe, where wealthy couples are opting more and more to have 1, or even no children.
Families are growing, as evidenced by the fact that the population just reached 300 million people this month. The growing acceptance and occurrence of larger families can be seen in the fact that our population is growing at a pretty large pace while other countries are experience stagnate or even declining population growth.
On a personal note, I am actually from a large family, 5 children. My mother always wanted to have lots of kids, even when she was growing up she would always tell people she wanted 5 or 6 kids when she grew up. For her generation that was unusually, the trend at that time was for smaller families. It now seems that things are swinging back to larger families being more common. I can’t say that I would be open to having a large family, 2 sounds more like it for me.
It will be interesting to see how the landscape of this country changes as it continues to grow and what impact an increase in larger families have on education, politics, and healthcare.
What size is your family? Are you planning to have a large family?
You are in your third trimester, the delivery date is fast approaching, and all the books and your doctor are telling you to pack the bag you will take to the hospital for the delivery. But what exactly should be in that bag?
Here is a list of things to consider taking with you for your trip to the hospital to have your baby.
For You:
- A nightgown, or over-sized shirt to where during labor and delivery. Although a hospital gown will be provided you may feel more comfortable wearing something of your own.
- Socks, you gotta keep those tootsies warm!!
- Washcloth and towels so you can clean up after the delivery and before you leave to the hospital to go home. The hospital may provide some, but it is good idea to be prepared just in case they don’t.
- Slippers so you can wander around the maternity ward both during labor and after the delivery when you are sick of lying in the hospital bed.
- A few nightgowns to wear during your stay in the hospital after the baby arrives. If you are going to be nursing be sure to pack nightgowns that are designed for nursing mothers.
- A robe, again for those walks around the hospital, and in case your room is cold.
- Several pairs of underpants, bring extras.
- A pack of large, self-adhesive sanitary pads as you may not like the ones provided by the hospital.
- Toiletries, including shampoo, soap, toothbrush & toothpaste, a hairbrush, plus any other toiletries you would like to have with you.
- The phone numbers of all the people you want to call about the arrival of the baby.
- Any important paperwork that you need to have with you for the hospital stay, like insurance forms, pre-registration forms, etc.
- A pillow. Your own pillow will be more comfortable than the flat ones provided at the hospital.
- Reading material, cds, and other items to help keep you and your partner occupied during your stay.
- A change of clothes to wear home from the hospital, you will want them to be loose fitting and comfortable.
For The Baby:
- A receiving blanket, you might want a couple of these just in case the baby spits up on the ride home.
- An outfit to wear home from the hospital, be sure it is appropriate for the temperature outside.
- Diapers, most hospitals provide some, but just to be safe bring your own
- A warm blanket if it is cold outside
- A carseat (the hospital will not let you take the baby home without one)
You will want to have your bags packed early, just in case the baby decides to come early. If you are planning to do a hospital tour it would probably be a good idea to ask the hospital what they provide for both you and the baby so we can adjust your packing list accordingly. You can also ask your doctor or midwife for suggestions. Most pregnancy books
The second trimester is full of more changes both with your body and with the baby. Your baby will continue with its miraculous development. As you will see each week something new is happening. You enter the second trimester in week 13 and it continues through week 27.
During the second trimester the pregnancy will likely begin to feel more real, you will be done with those pesky first trimester symptoms of morning sickness and exhaustion (hopefully), and sometime during this trimester you will begin to feel the baby move. Some women do still suffer from morning sickness, however, for the majority of women this symptom will have disappeared. Your body will be growing and likely you have out grown your favorite pair of jeans and are looking for bigger, more comfortable clothing to wear.
The development of the baby continues at a pretty rapid pace. By the beginning of the second trimester the baby has already begun to move but since it is still so small you can’t feel it yet. Other changes your baby will go through during the first weeks of the second trimester are the development of its reproductive organs. In boys the prostate gland begins to develop and in girls the ovaries move from the abdomen to the pelvis. The baby’s mouth will be completely formed by the end of the 14th week. Skin will begin to form, starting out nearly transparent. Eyebrows and scalp hair will begin to grow. The eyes, ears, and bones will further their development. By week 16 your baby will begin be able to make facial expressions.
Midway through the second trimester fat will begin to accumulate under the skin helping to keep the baby warm. During the 17th week nerve endings will connect with the ears and your baby will begin to be able to hear. Some of the sounds they hear are your heart beat, the gurgling of your stomach, blood moving through the umbilical cord, and may even be startled by loud sounds from the outside world. As the skin further develops it will become covered by fine hairs called lanugo that help to protect the baby. The kidneys begin producing urine around this time, which is excreted into the amniotic sac.
The 20th week will mark the halfway point of your pregnancy. The baby is about 6 inches long now and weighs about 9 ounces. It is around this time that you can begin to feel the baby move. During the next few weeks your baby will begin to swallow small amounts of sugar from the amniotic fluid giving them another source of nourishment. The bone marrow will begin to produce blood cells, something done by the liver and spleen until now. The reproductive organs will continue to develop. The baby’s lungs will begin to produce surfactant, a substance that allows the air sacs in the lungs to develop getting them ready for life outside. He or she will begin to look more like a newborn. With very intensive medical care babies born at 23 weeks can survive, however, there are serious risks and complications including bleeding in the brain, and most don’t survive.
Over the remaining weeks of the second trimester your baby will develop its individual fingerprints and footprints. Your baby will begin to be able to control their balance as the inner ear reaches full development. Now that you can feel the baby move you will likely notice that they have developed a regular sleep-wake cycle. As the hands begin to reach full development the baby will begin exploring the structure of the inside of your uterus, a means of entertain for your little one. The baby’s eyes are fully developed now but remain closed. By the end of the second trimester the baby will weigh approximately 1 ½ pounds and will continue growing like a weed. Their lungs, liver, and immune system will continue to mature making it easier for them to survive outside the womb. A baby born at 27 weeks has an 85% chance of survival; however, serious complications are still possible.
The changes your baby goes through on a weekly basis during the second trimester are truly amazing. Here are a few websites that have some great pictures so you can see what your baby looks like as it goes through the various developmental stages.
Enjoy this time in your pregnancy. The second trimester is often referred to as the honeymoon period. It is during this time in your pregnancy, when you are free of most of the early symptoms and before the symptoms of later pregnancy kick in, that you can really enjoy being pregnant.
Remember that each pregnancy is different. So, be sure to talk to your doctor or midwife if you have any specific questions about your pregnancy or about the development of your baby.
(Source: WebMD, Mayo Clinic )