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A study released this week in the Journal of the American Medical Association has found that babies born prematurely (before week 37) are at risk for health consequences into adulthood. The study used data from tracking done by Norwegian doctors of 1.2 million people born in Norway between 1967 and 1988.
It has been commonly known for quite some time now that infants born before the 37th week of pregnancy were at risk for health problems as infants, however, little was known about the long term health consequences until now. The study found that preemies were at a greater risk of death during childhood, were less likely to reproduce as adults, had slightly lower educational attainment, and were more likely to deliver their own children prematurely. The more premature the infant was the more likely they were to suffer long term effects into adulthood.
Modern technology has made it possible for babies born as early as 22 weeks to be saved. However, as research is beginning to show the complications continue long after that premature baby has grown up.
Talk to your doctor about your risk for premature delivery and what you can do to help your pregnancy go full term. If you had a premature baby talk to your child’s pediatrician about what you can do to ensure your child has the best outlook in life.
Episiotomy, it is the word that every pregnant woman dreads, and tends to avoid talking about. An episiotomy is an incision made in the perineum during delivery. The incision is made by your doctor to help speed delivery and to avoid tearing. Some doctors perform episiotomies routinely on all patients while others try to avoid them. It is very important to talk to your doctor about their use of episiotomies, especially if you have a particular preference one way or the other.
Research has begun to show that women who tear spontaneously during delivery tend to recovery in the same or less time as those who have episiotomies. The general practice for many years was for all women to have an episiotomy, however, the trend has changed (thank goodness!) and they are beginning to be performed less frequently.
Some of the reasons you may find that you need an episiotomy include:
- The baby’s heart rate slows and the doctor wants to speed up the delivery for the welfare of the baby.
- You are carrying a large baby and the doctor doesn’t anticipate that extra room will be needed.
- If the tissue in your perineum begins to bleed and it appears that you may tear in multiple places.
- You have a doctor that performs episiotomies routinely.
The best thing to do if you wish to avoid an episiotomy is to make sure your doctor does not perform them routinely. Talk to your doctor about your preferences and make sure you chart indicates you wish to avoid an episiotomy if you can. Remember, however, that it may be impossible to avoid an episiotomy. If one is deemed medically necessary it is probably better to go with it than to risk multiple or severe tearing.
Talk to your doctor about the risks of an episiotomy or vaginal tearing. Be sure you know what limitations you may have after the delivery, what recovery may be like for you, and when your doctor will want to see you post delivery to examine the incision.
I received the January/February edition of Mothering in the mail the other day. It contains an interesting list of movies about childbirth and babies. It truly is amazing just how many different movies there are about the childbirth, motherhood, and all things baby. I thought I would share some of the list with you.
The Movies:
Baby-Led Breastfeeding: The Mother Baby Dance
There is always the usual TLC programing including A Baby Story and Bringing Home Baby, but these movies seem like they would provide a little different perspective on childbirth and the whole motherhood process. I think I might need to check out a few of these films, they sound pretty interesting. If you have seen any of them please let us know what you thought.
I have to admit that I had a very easy pregnancy. Not all women are blessed with an easy pregnancy, so I was very thankful. Throughout the nine months I was free of any complications, I didn’t gain too much weight, I continued to exercise, and I felt great. My doctor often said that I was making his job too easy, that was until my daughter was born.
As I mentioned in my post about our daughter’s arrival, she decided to enter this world with her one arm up beside her head causing some pretty significant tearing. By the way she still loves to have her arms and hands up by her face!! My doctor said after he had stitched me up that it was some of the worst tearing he had seen in a long time, not too comforting to hear. He reassured us that he had taken his time (it took almost 2 hours) to make sure that every thing was stitch up well and that it should all heal just fine. While he and another OB worked on stitching me up I did over hear something about a hematoma developing by the one internal tear but I didn’t really know what that meant. I was told it shouldn’t cause any problems, and that I would just need to take it easy for a while.
Before I left the hospital my doctor and his partner both paid me a visit to check on me and make sure that everything looked ok. Reassured that everything should be fine and equipped with the details on when I should call them I headed home. Everything was great for the first few days. I was, of course, in pain and taking the prescribed medication, but by the third or fourth day home I was off the heavy duty stuff and felt pretty good. My husband and I decided to take our daughter for a quick little walk to the grocery store (which is two blocks away) so we could pick up a few things. The walk went well and I continued to feel good for most of the day.
Around 8pm that night, the sixth day after our daughter was born, I began to notice I was bleeding a little heavier than I had been in the last couple of days and that the blood seemed to be pretty bright red (both signs of a potential problem). I didn’t think too much about it at first figuring it was just because of the walk that day and decided I would just keep on eye on things. As the evening progressed I continued to have the heavier bleeding and noticed a few small clots, I still didn’t think it was that big of a deal. By the time my daughter got up to eat at about 11pm the bleeding had gotten increasing worse and I was going though several pads an hour. I read through my information and determined that it was probably a good idea to call my doctor. I woke my husband at around midnight, gave him the baby, and called my doctor’s exchange. While I was awaiting his call I passed a very large clot (about the size of my fist) and was bleeding heavily. Understandably I was pretty freaked out, as was my husband who doesn’t do too well around blood. I explained what was going on to my doctor when he called and told him I was really scared. He advised me to wait and see what happened over the next hour, if it didn’t slow down or got any worse I should head into the ER. He explained that bleeding does sometimes happen and that it probably wasn’t anything to worry too much about. I felt a little reassured after talking to him but was still freaking out a little.
So we laid in bed and we waited, by 1am I was still unable to stand without gushing a lot of blood so we packed up and headed to the ER. By the time we arrived I had already bled through my pants and was feeling a little light headed. I advised the ER nurse of this and she quickly got me to the bathroom where I could clean up and change and then into a bed. The ER doctor came in to talk to me about what was going on and checked me out. He determined, after much poking and prodding, that the bleeding appeared to be coming from one of my tears. He advised they would send me for an ultrasound to make sure that the bleeding wasn’t coming from my uterus and he would call my doctor to let him know what was going on. I couldn’t have the ultrasound right away cause my bladder wasn’t full so I was hooked up to an IV for fluids and waited. Within minutes my doctor arrived at the hospital. We talked a little bit about what the ER doctor had seen and he said that unfortunately he would have to check me as well. Sure enough he found the same thing, bleeding from the one tear. He packed me full of gauze to help slow the bleeding and made arrangements for emergency surgery to repair the tear. Yikes, not exactly what I wanted to hear!
By 5am I was in the OR getting ready to have surgery. The next thing I knew I was waking up in the recovery room all fixed up (the wonders of modern medicine). I had lost a lot of blood both prior too and during the surgery so my doctor requested blood work to determine my hemoglobin levels. Normal for a woman is 11, my results came back at 5.6, not good. Since my levels were so low and I had lost so much blood it was determined that I would need a blood transfusion. Later that morning I was hooked up to my first of two units of blood. For the remainder of the day we sat around and waited while the transfusion was completed.
My doctor checked on me several times. On his last visit he said that once the final unit of blood was complete and my blood was draw for another hemoglobin test I could go home. He didn’t think I would get the rest I needed at the hospital and trusted my husband and I to be smart about things and call him immediately if something happened. He said he would call me the next day with the blood test results and that I should come in to see him in a few days to get checked out again. So we waited while the final unit of blood was administered and then by 9pm on the day our daughter turned one week old we were heading home, again.
So, it turns out that the hematoma that had developed under the one tear began to bleed when the swelling in the birth canal started to go down, that was what caused the hemorrhaging. There was nothing I could have done any differently, and I was assured the walk I had taken that day had nothing to do with it. The tear has now been repaired and on my follow up visit a few days later everything looked good. It was a very scary thing to have to go through but I had a great husband to help me through, and an outstanding doctor. I really can’t say enough about how important it is to choose the right caregiver for your prenatal care.
I’ve learned the hard way that things don’t always go the way you hoped after the delivery, sometimes complications come up. The important thing is to know what to watch out for, to have good communication with your doctor, and to know yourself enough to recognize when something isn’t right. It has now been two weeks since my little scare and everything seems to be ok.
My daughter decided to make her appearance a little early. I was 38 weeks and 2 days when I went into labor. I woke up that morning feeling some contractions but I wasn’t quite sure it was the real thing cause they weren’t that close together, coming 15 to 20 minutes apart, and weren’t really that strong. I decided I would see how things went figuring I was just having more painful braxton hicks as I had heard that those could get pretty intense as you approached true labor. I started timing the contractions and went about my day.
I had my regular scheduled appointment with my doctor that day so I figured I would just see what he had to say about the contractions and take it from there. By the time I was getting ready to leave for my appointment my contractions were about 10 minutes apart but still not real strong. For a few minutes I considered calling my husband to come home and take me to the doctor’s office but decided against it. My doctor checked me out and we talked about the contractions I had been having all morning. I was 3 centimeters dilated and 80% effaced (I had been 2 centimeters and 80% the week before). He said I was definitely having “positive” contractions and that I would likely have the baby in the next couple of days. He did warn me though that the contractions could abruptly stop as well and it could be longer than that before the baby arrived. He said to make sure we had everything ready to go and to just keep an eye on the contractions. The instructions were to head into the hospital when the contractions were 3-5 minutes apart, my water broke, or I just felt like things had really changed. I went home still having contractions every 8 to 10 minutes, and still not that strong. After talking to the doctor I figured it would probably be another couple of days.
Boy did things changed when I got home. I called my husband to tell him about the appointment, and about the contractions, as I had not mentioned them earlier when he left for work figuring at the time they were just braxton hicks. After giving him the scoop and telling him I would call him if things changed I hung up and laid down on the couch to take a little nap. Within a few minutes I was hit with a much more intense contraction which was followed 5 minutes later by another contraction. I timed the contractions for an hour and they were coming consistently at five minute intervals and lasting about a minute. I called my husband and asked him to come home cause at this point I was freaking out a little. It was very apparent that this was the real thing, our baby was on her way. When my husband arrived home we decide to keep timing the contractions for a while to see what was happening and then decide from there whether to go to the hospital. With stop watch in hand and my husband running around gather a few last minute things for our bag I timed contractions that were pretty intense and coming every 3 minutes and still lasting about a minute each. It quickly became apparent that it was time to head to the hospital.
We arrived at the hospital at about 6pm, 12 hours after the first pangs of contractions early that morning. I was sent to the triage room where I was hooked up to the fetal heart beat monitor so they could get an idea of how the baby was tolerating the contractions, and contraction monitor so they could see how often the contractions were coming and how intense they were. While a nurse asked us a million questions I started suffering through contractions that were now coming every 2 minutes and lasting a minute. It felt like I was hardly getting a break before the next contraction hit. Once the questionnaire was complete the nurse checked me and determined that I was 5 centimeters dilated and 100% effaced. I was in active labor. Within a few minutes I was transfered from the triage room to a labor and delivery room and my doctor was called. I was hooked up to the monitors in that room and I sat on the birthing ball (which by the way is really helpful during contractions) while I waited for my epidural. Arrangements were made for the anesthesiologist to come in when he was available to give me an epidural, which I was told could be a little while cause they were going through a shift change. Luckily he arrived within 15-20 minutes cause my contractions were now coming every minute or so, there was literally no break, they were just one right after another.
The epidural was administered and I was again laying peacefully in bed. Surprisingly the epidural didn’t hurt going in. It felt a little strange but was far less painful than an IV. Once the epidural was in place I was given some pitocin, which is used to help ensure the contractions don’t slow down too much. Often an epidural will slow down labor so the pitocin helps to counteract that. My husband and I turned on the TV and started watching “My Name is Earl”, wondering when our daughter would decided to come out. The nurse came in to check me every so often and I just tried to relax and rest knowing the big event was drawing near.
At about 9:30 or so I felt what I thought was my water breaking so I called the nurse in. She checked me and said she thought it was the “fore bag” as my bag of water was still intact and hanging down into the birth canal. She advised she could not tell how dilated I was because of the bag of water being in the way and she was going to have the on call doctor come in to break my water. The on call doctor was busy with another patient so I had to wait. When she walked in the room she started to tell me what she was going to do and what it feel like all of a sudden I felt a big gush of water, apparently my body decided her services weren’t needed. My water decided to break on its own. The doctor checked me and determined that I was 10 centimeters dilated and the baby was at -2 station, we were ready to go. I was told to relax as best I could, they would call my doctor and the nurse would come back in so we could start pushing.
At 10:30pm I started pushing. The baby was already in a good position and my early pushing was going well. After about 15 to 20 minutes of pushing my doctor called in to see how things were going, they told him to make his way in as my baby was ready to make her appearance. I continued to push with the nurse and my doctor arrived a few minutes later. He joined in the pushing excitement and we continued to make good progress.
After an hour of pushing my daughter was born. She weighed 7lbs 10oz and was 21 inches long. Unfortunately when she came out her one arm was up beside her head. After the placenta was delivered my doctor checked me and found that not only did I have a tear in my perineum but I also had a couple of tears inside along the vaginal wall. For two hours my doctor worked vigorously to stitch me up. My husband was over with the baby and when she was ready he brought her over so I could get a good look at her and give her a little kiss. Thank goodness for the epidural cause I didn’t really feel much as they stitched me up and I was able to remain calm. My doctor said in most cases like mine they would have had to take me to the OR but since I was staying very calm they were able to do it right there and I didn’t need to be separated from my baby.
I was finally able to hold her and begin the first breast feeding session a little over 2 hours after she was born. It went well. I was understandably exhausted at that point as it was almost 2am but I was so excited to be holding my little girl that I hardly noticed I was tired. Shortly after I fed the baby for the first time they began getting things ready to transfer me to the room we would be in for the remainder of our stay, however, I became very lightheaded and dizzy. My blood pressure was checked and it was really low. They decided to keep in the labor and delivery room for a little while longer until I felt better and my blood pressure stabilized.
Around 4am we were finally in our room and settling in for the evening. I fed the baby again and we all fell asleep for a short time.
Our stay at the hospital was about 48 hours. We had wonderful nurses and lactation consultants helping us figure out how to care for our little baby and taking care of me. We are so thankful for all the nurses that helped us during our stay, they made things so much easier. Leaving the hospital a couple of days after the delivery with our little bundle of joy was like nothing I can explain with words. It was amazing to think we had entered the hospital as a couple and were leaving as a family 
.