Guest Post: By Elizabeth Stein.
New York, New York – August 3, 2010 – Many pregnant women feel unprepared for one of the hardest and yet most rewarding days of their lives, the day they give birth to a child. Elizabeth Stein, a leading women’s health expert and Certified Nurse Midwife who heads up the NYC practice AskYourMidwife.com explains why a birth plan is important and how to create one that meets each pregnant woman’s needs.
“A Birth Plan will help you remain proactive — your goal should be healthy mom, healthy baby, positive emotional experience,” explains Elizabeth Stein CNM, MSN, MPH. She encourages pregnant women to avoid unrealistic expectations and to “go with the flow of your body.” “Be flexible and open minded.” To this end, she has created a roadmap for developing a Birth Plan with her top tips to help all pregnant women be prepared for their special day. Underscoring the importance of being proactive, Stein advises women to create a Birth Plan and to go over it with their midwife or physician.
Stein recommends creating a Birth Plan and discussing it during a prenatal visit toward the end of pregnancy (36 weeks on). It is also a good idea to discuss each point in depth before labor, she advises.
Elizabeth Stein’s Top Ten Tips for Creating a Birth Plan
- Remember, your baby is going to come when the baby wants to come. Your baby is in charge. Your baby does not read the due date on the prenatal chart or your sonogram report. Your due date is used to manage the pregnancy to schedule prenatal appointments, schedule tests, sonograms and an induction if necessary.
- Know exactly who will deliver you. Does your midwife or physician belong to a group? If that person is not on call the day you go into labor, who will actually deliver you? Clarify this so you are not disappointed.
- Rest up. Labor is like running a marathon. Save your energy spurt for when you are in labor. When you get that energy spurt that predates labor, save it inside of you. Don’t waste your energy cleaning the kitchen or bathroom.
- Stay home as long as possible unless told by you midwife or physician to go the hospital. It is more comfortable to labor at home in familiar surroundings than the hospital. If you have no risk factors you may labor at home. Early labor can last many hours so don’t become exhausted. Eat, drink, walk, rock and take a shower.
- Know when you should go to the hospital. You should go to the hospital immediately if your water breaks or you are group B strep positive or have a medical or obstetrical reason and were told to go straight to the hospital. Talk to your midwife or physician to find out exactly when they want you to call them or go directly to the hospital.
- Eat and drink continuously at home. Know the hospital rules and follow them regarding eating and drinking in labor. Most hospitals don’t allow eating solid foods in labor, but many will allow clear liquids. Other hospitals may only allow IV’s and ice chips. Plan on respecting these rules. This emphasizes the importance of eating and drinking at home prior to admission. Even if you vomit labor (common in labor) some of the food will have been absorbed into your body.
- How will you labor? Walking, on a birthing bed, sitting in a chair, rocking on a big ball, in the shower? A combination of all of them?
- Be open-minded about measures that promote a vaginal delivery. AROM (artificial rupture of membranes), pitocin and epidural. Some women say “I want natural”. I define natural as vaginal and cesarean as surgical. Do everything you can to have that vaginal delivery.
- Know when to bail out and have a cesarean delivery. There are no gold stars for torture. Cesarean delivery is a not a failure, just another route of delivery. You just don’t want to have a cesarean that isn’t indicated (decided on too early). Discuss with your midwife or physician how and when they decide to perform a cesarean in labor. In other words, how do they manage labor? Realize that some conditions are delivered by cesareans: breech, multiples (usually), placenta previa. Understand how prolonged dilatation and descent (taking a long time for your cervix to open and your baby to descend) is managed.
- If you are planning to deliver in a birth center or at home, know the protocols for transfer. What are the reasons for transfer to the hospital, who decides-midwife or patient? Who has the final say if there is a disagreement about the need to transfer? How will you get to the hospital? What hospital will you be transferred to? Does the midwife have privileges there? Will a physician take over your care? Did you meet him/her during your pregnancy or is the physician a stranger? Will your midwife stay with you?
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Tags: Belly Chat, Belly Talk, birth club, pregnancy chat, pregnancy forum
More press releases from the 2010 ESHRE conference:
Rome, Italy: Scientists have discovered that when they transplant ovaries from young mice into aging female mice, not only does the procedure make the mice fertile again, but also it rejuvenates their behaviour and increases their lifespan. The question now is: could ovarian transplants in women have the same effect?
Dr Noriko Kagawa will tell the 26th annual meeting of the European Society of Human Reproduction and Embryology in Rome today (Tuesday) that successful ovarian transplants increased the lifespan of the mice by more than 40%. “At present ovarian transplants are performed with the aim of preserving a woman’s fertility after cancer treatment for instance, or of extending her reproductive lifespan. However, the completely unexpected extra benefit of fertility-preserving procedures in our mouse studies indicates that there is a possibility that carrying out similar procedures in women could lengthen their lifespans in general,” she said.
A very small number of women in the world have had ovarian transplants, and some have been more successful than others. Dr Kagawa stressed that there was still a lot of research to be carried out before it would be known whether ovarian transplants had similar, rejuvenating effects in women, particularly as it would involve waiting for many years until the patients became older.
Dr Kagawa, Associate Director for Research at the Kato Ladies’ Clinic in Tokyo (Japan), told the conference that she and her colleagues had conducted two mouse experiments. In the first, both ovaries were removed from young female mice (about 140 days old), and transplanted in to six older mice (aged over 525 days) that were too old to be fertile any more. In the second experiment, only one ovary was removed from the young mice (about 170 days old) and transplanted into eight aged mice (over 540 days old). The average normal lifespan for this particular breed of mice (C57BL/6J) is 548 days, and they normally reach a mouse “menopause” at about 525 days old.
All the mice that received transplants in both experiments became fertile again, while control mice that had not received transplants did not. In the first experiment the mice resumed normal reproductive cycles that lasted for more than 80 days, and in the second experiment, they lasted for more that 130 days.
Dr Kagawa said: “All the mice in both experiments that had received transplants resumed the normal reproductive behaviour of young mice. They showed interest in male mice, mated and some had pups. Normally, old mice stay in the corner of the cage and don’t move much, but the activity of mice that had had ovarian transplants was transformed into that of younger mice and they resumed quick movements. Furthermore, the lifespan of the mice who received young ovaries was much longer than that of the control mice: the mice that had received two ovaries lived for an average of 915 days, and the mice that had received one ovary, for an average of 877 days. The newest of our data show the life span of mice that received transplants of young ovaries was increased by more than 40%.
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“The results show that transplanted normal ovaries from young mice can function in old, infertile mice, making them fertile again, but, in addition, extending their lifespan. Women who have ovarian tissue frozen at young ages, perhaps because they are about to embark on cancer treatment, can have their young ovarian tissue transplanted back when they are older. Normally we would be doing this simply to preserve their fertility or to expand their reproductive lifespan. However, our mice experiment suggests that this might also improve overall longevity. Further research has to be conducted before we can know whether or not this is the case.”Dr Kagawa said it was not known why the ovarian transplant increased the lifespan of the mice, but it might be because the transplants were prompting the continuation of normal hormonal functions.
She and her colleagues have been collaborating for the past six years with Dr Sherman Silber, from St Luke’s Hospital, in St Louis, Missouri (USA), who has performed a number of successful ovarian transplants in women, either because they were about to be treated for cancer or because they had not yet found the right partner in life. Their future collaborative research will include investigating whether it is possible for a woman to have a transplant using an ovary that is not her own and with minimal drugs to suppress the body’s natural immune response to what it perceives as a “foreign” body. They are also looking at culturing follicles in ovarian tissue in the laboratory in order to obtain mature eggs that can be used for IVF.
In the meantime, the researchers believe it is very important for doctors and patients to know that women have options when faced with cancer treatment that could destroy their fertility. “We have been successful in getting frozen ovaries to function completely normally after thawing and transplantation,” said Dr Kagawa. “So this should no longer be considered an ‘experimental’ procedure. Ovarian transplantation is the proper and necessary accompaniment to otherwise sterilising treatment for young cancer patients. We must not neglect to freeze and save at least one of their ovaries before cancer treatment.
This information was brought to you by Cision http://www.cisionwire.com
Tags: Dr Noriko Kagawa, ESHRE, ESHRE 2010, ovarian transplants