prenatal care

Mamas on Bedrest: Texas earned a “C”. What’s your state’s premature birth grade?

November 18th, 2014

World Prematurity DayHello Mamas,

November 17th is World Prematurity Awareness Day. All over the globe there will be educational events, initiatives, presentations and activities all designed to raise awareness about the very serious problem of prematurity. Premature birth is the leading cause of neonatal death in infants under one year old and each year, 15 million babies die as a result of being born too soon-and are too young and too sick to survive.

Now we are all likely sitting here and thinking, that’s a shame. Those poor babies in developing countries have such a tough road to hoe. Well fasten your seat belts! Despite spending more than most other countries on the planet for health care, The United States has one of the worst rate of premature births of the developed nations. Each year nearly 500,000 infants are born too soon in the US-that’s 1 out of 9 infants!! These numbers are sobering. What’s more, where you are born has a lot to do with your chances of being born prematurely.

Taking a look at the US as a whole, there has been a reduction in the overall rates of preterm labor and premature births. As of this month, the March of Dimes reports rates of premature births (2013 data) has fallen for the 7th straight year to 11.4% and as such, the nation has reached its goal (9.6%) set for Healthy People 2020 7 years early. But when we look at individual states, there is a much different picture. While some states are doing well reducing the number of premature infants born, others are not faring so well. Texas, where I live, currently has a grade of “C”, while my home state of Massachusetts is graded a “B” and only Maine, New Hampshire, Vermont, Oregon and California earned “A” Grades. Sadly, Mississippi, Louisiana, Alabama and Puerto Rico earned “F’s”.

The March of Dimes is working aggressively with state, national and international health representatives to determine what factors are the major reasons babies are born prematurely, and what interventions can be put in place to ameliorate them so that babies won’t be born too soon. The solutions are really pretty simple. It’s not more technology. It’s not more complicated political laws. It’s education. Women need to know that as soon as they become pregnant, they must begin prenatal care. It’s access. Women globally need access to comprehensive, affordable prenatal care. In developing nations as well as in many areas of the United States, women don’t have easy access to health care services. If the nearest health care center is 3 hours away by car and they don’t have a care and no access to any sort of public transportation, they won’t get regular prenatal care! It’s resources. In many rural or economically depressed areas, women simply don’t have the money for food, shelter and prenatal care.  Health care resources may be limited. Access to the midwifery model of care; Attendant care with midwives and doulas which have been shown to reduce the rates of complications and poor birth outcomes, makes these women vulnerable to poor birth outcomes. Breastfeeding Education. Many women still are uneducated about the benefits of breastfeeding, don’t receive breastfeeding education/suppport and don’t have access to pumps.

So how does your state rate? What’s its grade? How is your prenatal care? Let us know in the comments section below. If you need assistance or information, feel free to include that in your comment or write privately to info@mamasobedrest.com

Mamas on Bedrest: PublicHealth.org’s Prenatal Care Guide

October 6th, 2014

Good Monday Morning, Mamas!

Today’s post is a review of the prenatal care guide published by PublicHealth.org. PublicHealth.org is an organization that works to provide the public information about a variety of health care issues. They research their topics and try to provide the most current data and additional, useful information for both consumers and researchers alike. They asked me to share with you their resource on prenatal care and so here is my review on the guide.

Now you may be reclined in your bed thinking, Darline, why the *&^( do I need a guide on prenatal care?? I’m already pregnant and on bedrest for heavens sake! Well, I decided to share this guide with you all because many of you will go on to have subsequent pregnancies after this one and it is critical that you prepare your self-physically and emotionally-for that pregnancy.

At first glance, I find that it has a decent overview of things to be on the look out for before, during and after pregnancy. They broke the guide down into

  • Provider options
  • Nutrition and lifestyle changes
  • First, Second and Third Trimester Changes
  • Newborn Care
  • Post partum care

However, this guide is more like a checklist of things to be on the lookout for, to talk with your provider about and some things that you can do for yourself than an actual, practical guide. While the information provided was useful, I personally didn’t feel like there was enough explanation or information provided for most of the topics listed.  And I feel many topics, very important tops, were omitted.

Now admittedly, I am a self professed data (and detail) head, so I more, “the meat of the matter”. But (for example) to list the recommendation for folic acid and not give even a brief explanation as to why folic acid is important (for the prevention of neural tube defects {holes along the spinal column} or Spina Bifida) I feel is incomplete information. I find it frustrating to have something mentioned, but no explantation given about it’s use or function. Much of the information provided is in this format. But providing a list without much explanation really isn’t very helpful.

Another example. They have a section, “What foods should Pregnant mothers avoid” and they gave a brief list of foods to avoid. But what about foods mothers should add or increase. like foods high in Calcium and iron? What about talking about eating several small meals a day to help ease nausea? There was no mention on this aspect of nutrition.

As a public health organization, I would have expected a discussion of taking the flu shot while pregnant, genetic testing and more on the prenatal tests already being done.

And the biggest negative for me: NO MENTION OF BED REST!!!

But this guide (to my understanding) is free and as such, isn’t an awful starting point for mamas to begin learning what to expect during their pregnancies. However, it really is just a starting point. I would highly recommend mamas who are serious about taking extremely good care of themselves through the prenatal period take a look at this guide, but them continue their research with books like, “What to Expect When Expecting” “Our Bodies Ourselves: Pregnancy and Birth”, Henci Goer’s “The Thinking Woman’s Guide to Childbirth”, “Optimal Care in Childbirth” and others provide (Like our blog!!) much more information so that mamas can make informed healthcare choices for themselves and their babies. 

So do take a look because I feel that there are never too many resources. However, know that as you read through this guide, you are likely going to have more questions and will need to seek out other, more complete resources, for answers.

Mamas on Bedrest: Pessaries as a treatment for Cervical Insufficiency

September 29th, 2014

Hello Mamas!

In today’s video blog, I am discussing the use of pessaries for the treatment of cervical insufficiency. In answering a question from Mama on Bedrest Rose from our Facebook Community, I share the background on pessaries (typically used for treatment of bladder prolapse and urinary incontinence), how some Obstetricians are using them for cervical insufficiency and what the current research says about efficacy. THIS IS IN NO WAY A RECOMMENDATION FOR YOU TO GET A PESSARY!! If you think that you may be a candidate for a pessary, you may want to share this video with and talk with your healthcare provider.

References:

Uptodate – A medical reference website.