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What to Reject when You're Expecting

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Despite a health-care system that outspends those in the rest of the world, infants and mothers fare worse in the U.S. than in many other industrialized nations. The infant mortality rate in Canada is 25 percent lower than it is in the U.S.; the Japanese rate, more than 60 percent lower. According to the World Health Organization, America ranks behind 41 other countries in preventing mothers from dying during childbirth. In fact, the rate of maternal deaths in the U.S. has risen over the past decade, and the number of premature and low-birth-weight babies is higher now than it was in the 1980s and 1990s. Why are we doing so badly? Partly because mothers tend to be less healthy than in the past, “which contributes to a higher-risk pregnancy,” says Diane Ashton, M.D., deputy medical director of the March of Dimes. But another key reason appears to be a health-care system that has developed into a highly profitable labor-and-delivery machine, operating according to its own timetable rath

Postpartum care

After months of anticipation and the rigors of labor and delivery, your attention shifts to caring for your new baby — but you also need to take care of yourself. Postpartum care may involve managing vaginal tears or a C-section wound, sore breasts, leaking milk, urination problems and hair loss. And postpartum care isn't limited to your physical health. Postpartum care also includes your mental well-being, such as managing mood swings, irritability, sadness and anxiety. For the smoothest recovery, share any concerns you may have about postpartum care with your health care provider. Chances are, what you're feeling or wondering about is entirely normal. Count on your health care provider for assurance as you handle postpartum care and adjust to life with a newborn.

Labor and delivery

Every woman's labor and delivery experience is unique. Still, understanding what's typical can help you know what to expect as your due date approaches. Labor and delivery generally follows a fairly predictable pattern — the cervix softening and opening, the amniotic sac rupturing, the contractions getting stronger and closer together. Sometimes, however, labor and delivery takes surprising twists and turns. You may reconsider your wishes about pain medication, or you may need an unexpected C-section. However your labor and delivery unfolds, remember that your health and your baby's health are what's most important. Discuss your labor and delivery preferences with your health care provider, including options for pain medication and thoughts about episiotomy and other procedures. Then look forward to welcoming your baby into the world.

Pregnancy week by week

Healthy pregnancy When you learn that you're pregnant, you might begin planning your pregnancy week by week. Every day you might have more questions about healthy pregnancy. What should you eat? Can you exercise? What type of prenatal tests should you consider? If you're carrying twins or other multiples, you might have even more questions about your pregnancy week by week. How much weight should you gain? How can you prevent preterm labor? Will you need bed rest? Whatever your questions, understanding your pregnancy week by week can help you make good decisions throughout your pregnancy. Learn nutrition do's and don'ts, and get the basics on other healthy pregnancy issues — from exercise to back pain and sex. The more you know about your pregnancy week by week, the more prepared you'll be to face what lies ahead. First trimester The first few months of pregnancy — the first trimester — are marked by rapid changes for both you and your baby. For y

Pregnancy symptoms

If you're experiencing pregnancy symptoms, you're probably eager to know if you're actually pregnant — whether you've been trying to get pregnant for months or your pregnancy symptoms came as a surprise. Early pregnancy symptoms such as fatigue, tender breasts and mood swings sometimes indicate pregnancy. In other cases, these classic pregnancy symptoms may be something else — such as an illness or the start of your period. Often, the easiest way to know what's behind pregnancy symptoms is to take a home pregnancy test. If your home pregnancy test is positive, make an appointment with your health care provider. You may also want to try a pregnancy due date calculator. If you're pregnant, estimating your due date is an important part of your prenatal care.

Parental health

Parental health is key to a healthy pregnancy. After all, healthy parents are more likely to have healthy babies. Start with parental health basics, such as updating your vaccines, eating healthy foods, taking prenatal vitamins and exercising regularly. Parental health takes on additional significance if you have a chronic medical condition that may affect your pregnancy. Work with your health care provider to manage your condition both before and during pregnancy. Remember, taking good care of yourself is the best way to take care of your baby. Parental health includes considerations about age, too. If you're older than 35 and hoping to get pregnant, understand the issues older mothers face — and know what it takes to have a healthy pregnancy.

Pregnancy Fertility

Getting pregnant can be an exciting time. For some, getting pregnant seems to happen simply by talking about it. For others, getting pregnant takes plenty of patience and perhaps a bit of luck. Understanding when you're most fertile can make getting pregnant easier. It's also important to consider simple do's and don'ts of conception. For example, maintain a healthy weight, eat a healthy diet and have sex regularly — especially near the time of ovulation. Don't smoke or drink alcohol. Of course, healthy sperm counts, too. With frequent unprotected sex, most healthy couples conceive within one year. If you have trouble getting pregnant, don't go it alone. A fertility specialist or other health care provider may be able to help. Infertility affects men and women equally — and treatment is available.

More Pregnant Women Getting Flu Shots

Studies Show Flu Vaccine Is Safe and Effective for Pregnant Women Pregnant women are more likely to get a flu shot than they were a few years ago, and for good reason: Evidence continues to mount that the vaccine safely protects both mother and newborn from influenza and its complications. One new study shows that pregnant women who get a flu shot are no more likely to miscarry. A second, small study shows that babies of moms who received the vaccine retain some immunity for two months after birth. In a third study, more than half of the pregnant women surveyed were immunized in the 2010-2011 flu season. Historically, the figure has hovered at a dismal 15%, researchers say. "We're building a large and consistent body of evidence regarding the benefits and safety of flu vaccination in pregnancy," says Kathleen Neuzil, MD, MPH. She is a member of Infectious Disease Society of America's (IDSA) pandemic influenza task force and director of the influenza vaccine projec

Pregnant Women to Get Pertussis Vaccine

CDC Committee: To Stop Deadly Infant Whooping Cough, Give Vaccine Late in Pregnancy To halt a spike in whooping cough cases and deaths in infants, pregnant women now are advised to get a booster shot of the pertussis vaccine in their late second or third trimester. Vaccination against whooping cough -- pertussis -- can't start before age 2 months. But the disease is particularly deadly for unprotected infants. Of the 194 U.S. pertussis deaths from 2000 to 2009, 152 were in infants ages 1 month or less. Twenty-three deaths were in infants ages 2 to 3 months. Doctors have been fighting recent outbreaks of whooping cough by giving the Tdap booster vaccine to women as soon as they give birth -- and also vaccinating everyone else who comes into contact with an infant. The idea, called "cocooning," is a good one. But in the real world, it's been nearly impossible to vaccinate most fathers -- and even harder to find and vaccinate grandparents, siblings, an

Cell Phone Use in Pregnancy: Risks for Child?

Possible Link Between Prenatal Cell Phone Exposure and Childhood Behavior Problems Exposure to cell phones before birth and afterward may increase a child's risk for developing certain behavioral problems, including hyperactivity, inattention, and problems getting along with peers. The new research does have limitations; the study researchers point out that there aren't enough data to say how, or even if, cell phone exposure may cause any behavioral problems in children. "There are theories, but I do not know." "Exposure to the fetus is likely to be very low, so it's unclear how it can influence fetal development." But taking some simple precautions to reduce exposure during pregnancy and among children seems prudent. "Be aware of your exposure and while the science develops, use precaution."  "It is very easy to reduce exposure by keeping your phone away from body and using a hands-free device, so why not do it?&qu

Acid-Reducing Drugs May Not Be Risky in Pregnancy

Proton-Pump Inhibitors Do Not Cause Birth Defects When Used in First Trimester The popular over-the-counter and prescription acid-blocking drugs proton-pump inhibitors (PPIs) do not appear to increase risk of birth defects when taken during the first trimester of pregnancy, a study shows. In the study, 2.6% of more than 840,000 live births occurring in Denmark from January 1996 through September 2008 involved major birth defects. The study showed that 3.4% of 5,082 infants whose mothers took PPIs during the four weeks before conception through first trimester were diagnosed with a major birth defect. By contrast, 2.6% of 835,886 infants whose moms did not take these acid-reducing drugs during the same time period were diagnosed with a major birth defect. The study is published in the New England Journal of Medicine. The researchers did an analysis of the study data on PPI use limited to the time period during the first trimester of pregnancy. Statistically speaking,

Acid-Reducing Drugs May Not Be Risky in Pregnancy

Proton-Pump Inhibitors Do Not Cause Birth Defects When Used in First Trimester The popular over-the-counter and prescription acid-blocking drugs proton-pump inhibitors (PPIs) do not appear to increase risk of birth defects when taken during the first trimester of pregnancy, a study shows. In the study, 2.6% of more than 840,000 live births occurring in Denmark from January 1996 through September 2008 involved major birth defects. The study showed that 3.4% of 5,082 infants whose mothers took PPIs during the four weeks before conception through first trimester were diagnosed with a major birth defect. By contrast, 2.6% of 835,886 infants whose moms did not take these acid-reducing drugs during the same time period were diagnosed with a major birth defect. The study is published in the New England Journal of Medicine. The researchers did an analysis of the study data on PPI use limited to the time period during the first trimester of pregnancy. Statistically speaking,

Household Chemicals Linked to Early Puberty, Infertility

Group Pushes for New Laws, More Study on Common Chemicals A growing list of common household chemicals may be linked to reproductive health problems, including early puberty and infertility. The list includes phthalates, the plastics chemical bisphenol A (BPA), perfluorinated compounds found in nonstick cookware, flame retardants, the antibacterial agent triclosan, and mercury, according to experts speaking at a news conference sponsored by Safer Chemicals, Healthy Families, a coalition seeking to overhaul the 1976 Toxic Substances Control Act (TSCA). The group is pushing for the passage of the "Safe Chemicals Act of 2010" in the Senate and the "Toxic Chemicals Safety Act of 2010" in the House. Among other things, these bills call on the companies who make chemicals to test them for safety, instead of the Environmental Protection Agency having to prove they are unsafe. Evidence Mounts Linda C. Giudice, MD, PhD, the chair of obstetrics, gynecology,

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