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Causes and Risk Factors for Birth Injury 9

By Michael Monheit, Esq. - Philadelphia Lawyer Any injury that is caused to the fetus in the course of childbirth, regardless of whether the injury is during or after delivery, is known as a birth injury. Some causes and risk factors for birth injury can result in cerebral palsy, Erb's palsy, etc. Although most birth injuries cannot be predicted, there are many factors that may increase the chances of the baby being injured during childbirth. This article elaborates on all those factors that make a birth high risk. Factors That Increase Risk To Baby 1. Maternal Age: The risk to baby increases if the mother is too young (in her teens for example), or is above the age of 35. Very young mothers may not know how to care for the fetus or themselves during pregnancy, which may increase the chances of a pre-term birth that can be harmful for the fetus. As for women over 35, they are more at risk for gestational diabetes and other medical conditions that can endanger the life of the unborn baby. 2. Maternal Obesity: The weight of the mother is an important criterion in the assessment of risk for birth injury. If maternal Body Mass Index (BMI) is more than 29.0 kg/m2 before pregnancy, then the woman is considered to be obese. Being obese puts her at risk for the following conditions:
  • Maternal hypertension (high blood pressure)
  • Diabetes
  • Post-term gestation
  • Fetal macrosomia
Due to the above risks of obesity, chances of birth injury increase tremendously. Obese women are thus advised to lose some weight before becoming pregnant and should also try and ensure that they do not put on more than 6-7 kilos during their pregnancy. In fact, not just obese women but underweight women are also predisposed to having babies with birth injuries. Being underweight may also result in low birth weight of the baby. Thus, it is important to ensure that maternal weight is at, or as close to as possible, to the desired weight before pregnancy. 3. Maternal Diabetes: Insulin is a substance in the human body that helps to break down glucose so that the sugars can then be used as body fuel by the numerous cells in the body. If the breaking down of glucose does not happen efficiently, body cells cannot function properly, thereby causing ill health. Sometimes, a person's body does not produce as much insulin as is required for optimum functioning of the body, or does produce the insulin but cannot use it effectively. Such a person is said to be suffering from diabetes. If a mother-to-be suffers from diabetes, her fetus is at an increased risk of birth injury. During pregnancy, a woman can suffer from two main types of diabetes that can predispose her fetus to birth injury. These two types of maternal diabetes are:
  • Existing Diabetes: This is when the woman has diabetes from before she conceived.
  • Gestational Diabetes: After becoming pregnant, a woman's body may sometimes become resistant to insulin due to the various hormonal changes occurring in her body because of the pregnancy. Such diabetes that comes on during pregnancy is known as gestational diabetes.
Pre existing maternal diabetes can put the fetus at risk for birth defects as the mother's blood glucose levels can become very high during the vital first three months of pregnancy. Since gestational diabetes generally develops after the first trimester, it generally does not contribute significantly towards birth defects. However, any type of maternal diabetes does increase the fetus's chances of injury during birth due to the following reasons:
  • Fetal Macrosomia: Fetal Macrosomia is the medical term that is used to describe babies that are significantly larger than normal. If fetal weight is already at or more than 4500 grams, or is estimated to go up to more than that, then the fetus is said to be macrosomic.
  • Although fetal macrosomia may affect any fetus, babies of mothers with diabetes are at a higher risk for macrosomia. The source of all the vital nutrients a fetus receives is its mother's blood. A woman with maternal diabetes has high levels of glucose in her blood; because of which the baby's pancreas secrete extra insulin in order to break down this added glucose. All the extra glucose gets stored as fat, thus increasing the size of the fetus.
It is more difficult for a woman to deliver an excessively large fetus as compared to a smaller one. Since the size of the baby is huge, there are added chances that the shoulder (or shoulders) of the fetus gets stuck behind the mother's pelvis after the head is delivered. If such shoulder dystocia does occur, the baby may suffer a birth injury known as brachial palsy or Erb's palsy.
  • Hypoglycemia: The fetus of a woman with maternal diabetes has high levels of insulin in its blood due to the increased glucose in the mother's blood.
Once the baby is born, it stops receiving the added glucose from its mother but its insulin levels are still high. These high levels of fetal insulin result in very low sugar levels in the baby's blood after it is born. This condition is known as hypoglycemia and can be dangerous for the baby. In addition to the above, maternal diabetes also puts a fetus at increased risk of breathing problems because increased glucose levels can hamper the lung formation of the fetus. 4. Post Term Gestation: Yet another factor that increase a baby's chances of birth injuries is post term gestation. Post term gestation refers to a baby being born after its estimated due date. If a pregnancy has lasted for over 42 weeks, the baby is said to be born post maturity. The main risks of a prolonged pregnancy are:
  • Excessively large baby: A baby born past its due date is more likely to be excessively large than babies born before 42 weeks. Such babies are at higher risk for shoulder dystocia and Erb's palsy as explained earlier.
  • Assisted deliveries: If a baby is past its due date, labor may have to be induced and it is more likely that the delivery will be assisted with forceps and vacuum suction devices. And in such assisted deliveries, the risk of birth injury to the fetus increases significantly.
  • Meconium aspiration: When a baby is born later than 42 weeks, there is a danger of the baby breathing in fluid that contains its meconium (first stool). This is known as meconium aspiration and can be dangerous to the baby.
  • Aging placenta: A pregnant woman supplies its fetus with oxygen and important nutrients through her placenta. In a post term pregnancy, the placenta may start to age and can stop working optimally. This interferes with the oxygen and nutrient supply to the baby because of which it can stop growing. Decreased oxygen supply also puts the baby in grave danger during labor.
Due to all these risks to baby in a post term gestation, doctors nowadays do not wait for much longer after a woman's delivery date has passed and opt for cesarean section instead. Due to this the mother and fetus lose out on all the advantages of a normal vaginal delivery. 5. Hypertension: Chronic high level of blood pressure is known as hypertension. A pregnant woman may have existing hypertension, or can develop the condition as a result of pregnancy. This is known as preeclampsia or Pregnancy Induced Hypertension (PIH). Babies of women with hypertension are at an increased risk of birth defects. If the condition becomes very severe, it can lead to maternal seizures and birth injuries. In extreme cases, it can also result in the death of the mother and her baby. With proper prenatal care, many of these risks to baby can be lowered. A failure to take these steps can constitute medical malpractice. If a woman has any of these risk factors that can increase her baby's chances of birth injury, she should consult a doctor for preventive measures. About the author: Michael Monheit, Esquire is the managing attorney for Monheit Law, located in Philadelphia, Pennsylvania. He is also a member of Anapol Schwartz. Monheit Law, P.C. concentrates its practice in the field of plaintiff personal injury cases on a contingency fee basis. They can be found at http://www.monheit.com and http://www.anapolschwartz.com Image Source: http://flickr.com/photos/alvarez-tostado/363243449/

When Do Labor and Delivery Start? 3

When you conceive and become pregnant, your body begins to prepare to give birth. Pregnancy is considered to be full-term about 38 weeks from fertilization, i.e. approximately 40 weeks from the start of the last menstruation. Thus, pregnancy lasts about nine months. So when do labor and delivery start for most mothers? Every labor and delivery is different. How long the labor lasts and how fast or slow it progresses differs from woman to woman and from birth to birth. Some women experience very distinct signs of labor, while others do not. There are several early symptoms that reveal that your labor is about to start and your baby is going to be born. Among these early labor symptoms are loose bowel movements. The intestine commonly empties just before labor starts. A quick decrease in the level of hormone progesterone is being considered for causing this effect. Another early sign of labor is a feeling of shivering or trembling that you might experience without any sensation of cold or weakness. Passing the mucus plug from the vagina (this is also called the "bloody show") is a common early sign of labor, as well. This may happen one day or several weeks before labor begins, or after a vaginal exam. Labor can also start with a trickle or gush of water from the vagina. This means that the bag of water, meaning the amniotic sac that surrounds the baby, has broken. No one knows exactly what causes labor and delivery to start or why so many pregnancies become overdue. One of the recent studies published in European Journal of Obstetrics & Gynecology and Reproductive Biology (Vol. 132, June 2007) revealed that when the level of specific mRNA molecules in mother's blood circulation increases, the labor is about to begin. What is interesting is that these molecules are of fetal origin. Could it be so that the baby sends a signal to the mother's body that it's time to deliver? What if the mother's body doesn't recognize this message? Could that be one of the reasons why so many pregnancies become overdue and EDD are passed? Holistic approaches aim to maintain an ideal balance and help our bodies to function better in various situations of life. This is how these methods help the mother's body to be more sensitive to mutual communication between the mother and the baby during pregnancy, labor and delivery. Maternity Acupressure is a natural holistic method that helps the mother's body to prepare for childbirth. Maternity Acupressure is beneficial, also, for the baby because it helps the baby to take the optimal position for the birth and to be engaged into the mother's pelvis. Maternity Acupressure method can also be used to induce the labor naturally if the pregnancy is already overdue. Because of the high success rate, Maternity Acupressure has quickly become a popular natural labor induction remedy used by many professional pregnancy and labor caregivers. As Maternity Acupressure uses only application of pressure on specific spots on the skin, it can be safely used at home with basic instructions. Studies prove that over 83% of pregnant mothers using acupressure to induce labor naturally experience a normal and natural childbirth with significantly less medical interventions than pregnant mothers who don't use this method. Additionally, they delivered their babies in shorter time without signs of hyper stimulation or distress. On the contrary, acupressure seems to avert the mother and the baby to become distressed during labor and delivery. Thus, holistic methods, such as Maternity Acupressure, might have a remarkably beneficial effect in preparing the mother and the baby for the birth that occurs at the right time in the most optimal manner. Article by Lena Leino, a Maternity Acupressure specialist. Maternity Acupressure is a holistic method for inducing labor naturally. If you are overdue and tired, visit her site, http://www.MaternityAcupressure.com , for more information about the Maternity Acupressure method and how you can you use this technique to start labor naturally at home, help cervix to dilate and stimulate labor contractions. Image Source: http://flickr.com/photos/olibac/1837033181/

War Against Maternal, Newborn and Child Mortality 0

According to The Partnership for Maternal, Newborn and Child Health established in 2005, every year 10.6 million children under the age of five die of causes that are mostly preventable and manageable. Why the war against maternal, newborn and child mortality? Because half a million women die during pregnancy or birth, and another 10 million suffer from related complications. These statistics are staggering and heartbreaking. These are also the same statistics that the media and medical community use to scare women in developed countries. They try to lead us to believe that the reason the rates are so much lower than in undeveloped countries is because of modern obstetrical care. While modern obstetrical care does save some women and children without a doubt, they cannot take full credit for having a lower neonatal mortality rate than the average third world country. Most laboring mothers in developing countries do not have access to:
  • Bacteria free running water
  • A clean home for a birthing environment
  • Sanitation systems
  • education about proper hygiene, warmth, and breastfeeding
  • Accurate information about birth
  • Access to medical intervention in the event of an emergency
  • Adequate prenatal nutrition
Many women in developing countries do not know the importance of keeping a newborn warm for example. A simple newborn cap to keep the infant warm could save countless lives. Visit Annies Attic for information on how to provide basic essentials to women in third world countries who desperately need caps and sterile blades to cut umbilical cords. Taken fromAnnies' Attic: "Go to savethechildren.org or warmupamerica.org to download your kit of step-by-step directions and materials, or call (800) 728-3843. There are knit and crochet patterns, a template for your note to the President, a tag to personalize your gift to a mother in need and all the information you need to join in this effort and save lives."

The Benefits of Waterbirthing 0

Considering a waterbirth? Think about it this way.....Wouldn't a peaceful and serene birth, with a relaxed and focused mother be a wonderful way to bring a baby into this world? Having a waterbirth is an option for moms who want to give birth naturally. Childbirth is such a powerful experience for a woman. But, too often, women totally give up their power and gift of childbirth over to other people to control. Having a waterbirth gives the woman a feeling of empowerment and pride in being able to choose how she delivers her child. What about what the baby goes through? Just imagine that your little one is as cozy and warm as can be for the past 9 months. You have given that little wonder a warm and secure environment only to have him arrive in a cold, bright and noisy world. That is why waterbirthing is such a beautiful way to bring your little wonder into this world. Imagine the having your baby arrive in a warm, quite, safe and inviting environment where the first touch is your arms. I can't think of a more beautiful way to start a relationship. The benefits of waterbirthing is so numerous... here are just a few
  • ease the pain of labor where only 10% of mom's ask for pain relief
  • relaxation of mom
  • can facilitate a slow labor
  • relaxed pelvic floor
  • relieve anxiety
  • empowers the mom
  • can increase blood circulation
If you decide you want to use water to help you labor, you need to have a few things in mind. The water temperature should be around your body temperature. Be careful when entering the tub and try to enter between contractions. Make sure the tub is large enough so that you can move freely and be able to change positions to what makes you feel comfortable. Women usually enter the tub when they are about 5-8 cm dilated. Check with your caregiver, but you should not need to worry about infection if your membranes have ruptured, as long as you are following proper hygienics. The following are some interesting statistics about waterbirths
  • The women had shorter labors.
  • Cervical dilatation was more efficient- 2.5 centimeters per hour compared with 1.25 centimeters per hour for mothers who did not take advantage of water during their labors.
  • The descent of the babies was twice as fast.
  • The women reported less pain.
  • The cesarean section rate was one-third that of traditional hospital births.
  • Mothers labeled "high-risk" because of high blood pressure showed a dramatic reduction in their blood pressure within minutes of immersion in the pool.
(see end note #1) Whether you decide to just labor in water, or have an actual waterbirth you can still take advantage of what water has to offer. Waterbirthing can be not only a gentle way to bring your little one into the world, but as you can see, it is also a SAFE alternative. Also, remember that being educated is the most important thing you can do to keep yourself happy and healthy throughout your pregnancy. #1 Sears, William,Martha Sears,and Linda Hughey Holt. The Pregnancy Book. New York: Little, Brown and Company, 1997. Author: Heather Hill About the author: Heather Hill is the author of several natural childbirth articles. Read more about natural childbirth at http://www.hip-chick-pregnancy-guide.com