Trusted Information for Healthy Pregnancies
34 weeks
Birth planning leads to surprising increase in premature births
Feb 8th
The rising trend of expectant mothers being involved in every aspect of planning their births has had an unintended consequence - a rise in pre-term deliveries.
"It never would have occurred to me or anyone I knew to think you had any kind of control over when the baby would come out," said Laura Crawford, who gave birth more than a decade ago.
Crawford, producer of the Kentucky Educational Television documentary "Born too Soon," said the increasing incidence of what is called late pre-term births is among the topics explored in the film.
Prematurity rates in the nation have increased quietly over the past two decades, according to public health officials. The premature-birth rate in Kentucky is 15.2 percent, and it's rising faster than the national rate, which is 12.7 percent. Kentucky has one of the highest rates of pre-term births, trailing only Louisiana, Alabama, Mississippi and South Carolina.
Some of Kentucky's rise is related to some not-so surprising subjects, including the rate of maternal smoking (more than twice the national average), poverty and environment.
Other reasons are more surprising. They include the rise in scheduling births.
It's just within the last three or four years that the scope of the problem of late pre-term births - babies born between 34 and 36 weeks' gestation - has become apparent, said Dr. Ruth Shepherd, division director for maternal and child health in Kentucky's Department of Public Health. Roughly 10 percent of all babies born in Kentucky fall into the late pre-term category.
Ideally, she said, babies shouldn't be delivered before 39 weeks.
Often, there are legitimate reasons for early delivery, especially if the health of mother or child is at risk.
Increasingly, choices are made for reasons other than health. Delivery might be scheduled to coincide with grandparents' dates of arrival from out of town, or before Dad must ship out for Iraq.
There are several complicating factors, Crawford said. The documentary states that people tend to underestimate the impact of premature births, especially late pre-term births. They tend to overestimate how accurately a due date can be determined.
Shepherd said there can be real consequences. They can include immediate physical challenges, including underdeveloped lungs and long-term problems involving learning and behavioral disabilities, for example.
And even if a mother gets an ultrasound within the first 16 weeks - the best way to accurately determine the due date - the date can be off by two weeks either way.
Those two weeks can be crucial, she said.
"It's an issue of planning and control," she said. Planning is good. The Centers for Disease Control and Prevention recommends that mothers have a birth plan. But, Shepherd said, "you can take it too far if you don't pay attention to the science."
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A Natural Birth: Seamus’s Story
Jan 26th
My story starts back in 2006.
I have a history of miscarriage. I had two early losses before giving birth to Noah, but for some reason had thought it would not happen again.
We decided to start trying for another baby in December 2005, and got pregnant right away. However, this pregnancy sadly ended in a miscarriage at the end of January, a very traumatic loss.
Since this was my third loss, despite not being consecutive, I talked my GP into referring me to the hospital for further testing. I had a ton of blood taken for various different tests, however by the time my appointment came along to see the consultant to discuss my results I was already pregnant again, after suffering a chemical pregnancy the cycle before, it turned out this time the baby was going to stick. I had about 8 scans as they monitored my pregnancy very closely this time.
However, things were not to go completely smoothly, as at 16 weeks I consented to having the triple test done for Downs/Edwards syndrome/Spina Bifida, something I regret doing as I feel very strongly against abortion apart from in extreme medical circumstances. This test came back with an elevated risk for Downs Syndrome, at 1 in 200. (The risk for my age, 29, should have been 1 in 1000.) Due to my loss history I refused an amniocentesis. The risk for losing my baby was double the actual risk of it having Downs and I could not accept those odds. So I opted for a detailed scan instead. The scan showed no soft markers for Downs and confirmed what we already suspected was true, that I was carrying another little boy.
At 34 weeks, I had another scan which also showed no markers for Downs. The consultant tried to talk me into an amnio at that stage, which I refused, as I could see little point. She said,
Do you know what risk you are taking?
I felt that was completely ridiculous, as whatever abnormalities my child might have had, we would just deal with whatever came up. I would love my child no matter what and strongly believe that we got given what we can handle and no greater than that. My gut told me though that my child was healthy and I clung onto this.
We started to plan the delivery, our local hospital had recently upgraded their birthing pool so that mothers could actually give birth in it rather than just laboring in it and then getting out before the birth itself. I fully intended on using this pool, especially after researching it and finding out that a warm bath is the second most effective form of pain relief after an epidural!
I had an epidural with Noah’s birth which had not taken properly (just down one side) and I had some horrible side effects (nausea and shaking). I was determined not to have one this time.
A good family friend of ours, Joana, is a midwife and had delivered Noah, we had her on call whenever I went into labor, although she would need some assistance as this would be her first waterbirth.
At 39 weeks, 4 days, I woke up to mild contractions, timed them as coming every 10 minutes.
As the day wore on though, they did not intensify, or get any closer together. By the time Gary got home from work I was getting very frustrated and at that point not even bothered if they stopped, I just wanted SOMETHING to happen or let me get some rest. At 9 p.m., I decided to try and get some sleep so went to bed. It was difficult as I was woken with every contraction, but I was determined I would need some sleep if I was going to have any energy to deal with labor.
Somehow I managed to get to sleep and the next thing I knew, it was 1 a.m. and I awoke having a very intense contraction. I lay there timing them again, and noticed they were coming about 3 minutes apart and lasting about 50 seconds each. I woke DH and we both got up, rang the in-laws. I got dressed and headed over to the hospital. I rang Joana on the way over.
At this point my contrax were 3 min apart, but every now and again I would have an extra one in between; they were painful but manageable. When we got there they had the pool all ready for me and they checked me before I hopped in. Joana was shocked to find I was already 9cm dilated – so I had already gone through most of labour at home!
I got into the tub and as soon as I hit the water I hit transition and started to lose it. Seconds after, I felt a huge pop and my waters broke. (Great timing!) I managed to focus on the contractions, which were getting really intense.
About 10 mins after I started to feel the urge to push, my body just took over – this part always freaks me out, how the body just does things with no input.
With my last labor, the pushing had been very, very difficult, as I was on my back wired up to machines after having an epidural, and it took over 2 hours to get him out.
This time though, I was able to get right into a good position and let gravity help me. Still, I was nervous. I also tore badly last time and was worried about it happening again.
In the end though I just realized the faster I get him out the sooner the pain is over and just pushed along with my body. I knew he was coming soon. I could feel the infamous “ring of fire”.
Joana called the other midwife in. They got me to squat right in the center of the pool as low as I could and as he came out, they told me not to touch his head, as it might stimulate him to breathe. His head popped out and very soon after the rest of his body.
When they told me the time was right I brought him up to the surface and laid him on my chest. I remember thinking how soft his skin was and what a big boy! He didn’t even cry and soon pinked right up nicely.
Seamus weighed on at 8lbs, 4oz, born at 4.50am (45 minutes after reaching the hospital) on the 24th February 2007. Perfectly healthy.
Written by Claire Louise. Read more details of the story here.
Pregnant women develop emotion-reading superpowers
Dec 14th
Raging hormones during pregnancy prompt mood swings, but may also lead to a heightened ability to recognize threatening or aggressive faces. This may have evolved because it makes future mothers hyper-vigilant, yet it could also make them more vulnerable to anxiety.
Previous studies have suggested that a woman's ability to correctly identify fearful or disgusted facial expressions varies according to her stage of the menstrual cycle, with perception heightened on days associated with high levels of the hormone progesterone. Since levels of progesterone and other hormones rise dramatically in late pregnancy, Rebecca Pearson and her colleagues at the University of Bristol in the UK investigated whether the ability to read faces varies during pregnancy.
They asked 76 pregnant women to assign one of six emotions to 60 computer-generated faces before the 14th week of pregnancy, and again after the 34th week. Faces expressing happiness and surprise tended to be correctly assigned at both stages of pregnancy, but for faces expressing fear, anger and disgust, the accuracy rates were higher in late pregnancy.
This may increase the chance that the woman will spot potential threats to her and her fetus, and prime her to be hyper-vigilant once she becomes a mother. But it could have a downside. Pearson points out that people with clinical anxiety are also better at identifying negative emotions in faces. Pregnant women aren't clinically anxious, but "they might interpret negative or emotional things around them in a slightly more sensitive way", she says.
The finding builds on a recent study by Ben Jones of the University of Aberdeen in the UK who found that pregnant women - and women in stages of the menstrual cycle where progesterone levels spike - are better at identifying faces showing signs of sickness. "It's preventing them from becoming sick by interacting with people who are ill," he says.
The next step will be to examine whether pregnant women and new mothers are also more sensitive to emotional cues in babies' faces, Jones says.
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