Natural Childbirth Options
Always check with your doctor before you begin any physical activity to make sure that it's safe for you to exercise during your pregnancy. Some questions have been raised about the effects of exercise on pregnant women, but there is no proof that gentle exercise has any negative effects. Studies have not shown any benefits for the baby, but exercise might help you feel better and maintain your weight. Exercise also helps prepare a woman for childbirth by strengthening the muscles and increasing vitality, and it will be much easier to get back into shape after the baby has been born. If you don't have any serious medical problems and you have an uncomplicated pregnancy, it is probably safe for you to do some exercising. Preterm labor (A typical full-term pregnancy lasts 37 to 42 weeks, calculated from the first day of your last menstrual period to childbirth. Preterm labor, or premature labor, is the early onset of uterine contractions before 37 weeks, but after 20 weeks of pregnancy.)
The Swedish Medical Birth Registry survey showed a rate of MCMs for valproate of 9.7 , while for carbamazepine it was 4 22 . This finding was reproduced in the Finnish National Medical Birth Registry with a valproate MCM rate 10.7 compared with those of untreated women (2.8 ) 23 . In this report, only the use of valproate, either as monotherapy or in polytherapy significantly increased the rate of malformations above that of the untreated women no other AEDs as monotherapy or in polytherapy imparted an increased teratogenic risk. These data showing the increased risk of MCMs with valproate compared with other treatments are summarized in Table 9.2.
Most women with epilepsy can successfully bear children. However, population-based studies have found reduced birth rates to both men and women with epilepsy. In a large Finnish cohort of patients with newly diagnosed epilepsy, birth rates were lower than in the general population for both men (hazard ratio HR , 0.58) and women (HR, 0.88) 50 . It is not clear to what extent reduced fertility among people with epilepsy is due to biological disease- or treatment-related factors or to psychosocial causes. A biological contribution to the reduced birth rates to women with epilepsy is plausible, since epilepsy is associated with reproductive endocrine dysfunction in women, specifically increased frequency of anovulatory cycles 51 and polycystic ovary syndrome (PCOS) 52 .
Other types of pain relief provide comfort and relieve stress. Many women learn special techniques in a childbirth class to help them feel more comfortable and in control during labor and birth. These include some of the following techniques Sit on a special birthing ball.
Many of our neuronal networks are constructed from birth by the repetitive use of cognition and emotion. They differ in complexity depending on the variety of different pathways in use. Optimal stimulation enhances the spectrum of possible reactions, and mechanisms like kindling facilitate the reactive choices. If there are severe limitations of the capacity or function of neuronal connectivity, the person will not always be able to respond appropriately to differentiated situational demands. Instead, they will repeatedly rely on use of available standard reaction types. Such stereotype reactions, provoked due to limitations in limbic connectivity could be the organic basis of personality disorders.
Assess your benefit coverage as your family status changes. Marriage, divorce, childbirth or adoption, and the death of a spouse are all life events that may signal a need to change your health benefits. You, your spouse and dependent children may be eligible for a special enrollment period under provisions of the Health Insurance Portability and Accountability Act (HIPAA). Even without life-changing events, the information provided by your employer should tell you how you can change benefits or switch plans, if more than one plan is offered. If your spouse's employer also offers a health benefits package, consider coordinating both plans for maximum coverage.
We cannot extrapolate these findings to the situation in developing countries, where the health care system is quite different. In many developing countries, most deliveries in rural areas are conducted by traditional birth-attendants, the families are large, and the frequency of preterm deliveries is at least twice as high as in developed countries.6 Many of the mothers are malnourished and exposed to a variety of infections that may affect the baby in utero or at the time of delivery. These factors need further studies to evaluate their contribution to perinatal brain damage. In developing countries perinatal brain damage would account for 13 to 14 of the putative risk factors for epilepsy in children.7 (Commission ILAE 1994) In a hospital-based study from south India, static encephalopathy related to perinatal brain damage accounted for 9 of putative risk factors. This pathology was the risk factor for 13.5 remote symptomatic epilepsies.26
By now, you have probably arrived at the hospital or birth center. If you have no medical or obstetric complications, you should be able to move around. You may find that it feels good to walk, but you will probably want to stop and lean against someone or something during contractions. If you feel exhausted, sit in a rocking chair or lie in bed on your left side. This might be a good time to take a warm shower or bath if you have access to these facilities. Warm water can help ease the pain of labor, and women sometimes progress quite rapidly with the relaxation that water provides.
Ricketts and osteomalacia of nutritional origin are common in developing countries, more so in women in childbearing age who wear purdha.12-15 Osteomalacia in India is common especially in females who are under purdah, repeated childbirth with prolonged lactation and poor intake because of economic and sociocultural reasons.12 Reports from northern India revealed low serum 25 (OH) vitamin D in healthy individual which, has been attributed to low intake of calcium and poor sun exposure especially in adolescents females.16,17 WWE with preexisting nutritional osteomalacia when exposed to AEDs, particularly to enzyme-inducing AEDs are at a greater risk of developing abnormalities in calcium and bone metabolism. High rate of home deliveries by traditional birth-attendants - Emphasis should be made for attended delivery, preferably in the hospital.
According to the stage in embryological development, cortical malformations can be classified in three major groups malformations due to abnormal neuronal and glial proliferations, malformations due to abnormal neuronal migration and malformations due to abnormal cortical organization (postmigrational) 30 . Within each group, generalized and localized malformations are identified. The most common and better identified conditions include focal cortical dysplasia (disruption of cortical lamination with poorly differentiated glial elements), hemi-megaloencephaly (predominantly unilateral cerebral hemisphere pathology associated with an enlarged hemisphere), focal transmantle dysplasia (abnormal brain tissue extending through the entire cerebral mantle from the pia to the ventricular surface), lissencephaly (absence of normal sulca-tion), heterotopia (abnormal location of normal brain cells), polymicrogyria (shallow and small gyri separated by shallow sulci or wide gyri) and...
Relevant past history should concern enquiry about the progress of mother's pregnancy, the circumstances at birth, psychomotor development, diseases during infancy and childhood, neurological sequel consequent to these diseases, and the time interval before the appearance of the symptoms. The place and the conditions during birth should be documented. The psychomotor development must be evaluated according to age specific milestones including but not limiting to sitting, walking, talking etc. A developmental abnormality is probably a sign of central nervous system (CNS) disease. In developing countries obstetrical trauma and perinatal hypoxic-ischemic brain insults are frequent. Multiparity, prematurity, malnutrition, anemia, lack of hygiene and neonatal infections are highly prevalent and may result in many types of cerebral lesions that could result in seizure disorder in later life.19 Of the 1374 patients with epilepsy studied in the community in 9 African countries, mother's...
Common causes of symptomatic epilepsies include head trauma, birth trauma, cerebrovascular disorders, cerebral anoxia, brain infections, cortical malformations and brain tumours. In resource-poor countries, parasitic infestations such as malaria, neurocysticercosis and paragonimiasis are important risk factors. Most epilepsies starting in adult life are symptomatic and investigations to detect any underlying aetiology are mandatory.
The causes of adult onset epilepsy are very varied (47, 52). Both idiopathic epilepsy and epilepsy attributable to birth trauma may begin in early adulthood. Other important causes of seizures in adulthood are head injury, alcohol abuse, brain tumours and cerebrovascular disease. In devel
An abnormal delivery presentation in which the baby's feet, knees, or buttocks come into the birth canal first, before the baby's head does. Episiotomy. An incision into the perineum (area of skin between the vagina and the anus) that is made during childbirth to enlarge the opening for delivery. Kegel exercises. Strengthen the pelvic-floor muscles done regularly during pregnancy and after childbirth can help prevent leakage of urine, as well as increase sexual responsiveness. Preterm labor. A typical full-term pregnancy lasts 37 to 42 weeks, calculated from the first day of the last menstrual period to childbirth. Preterm labor, or premature labor, is the early onset of uterine contractions before 37 weeks, but after 20 weeks of pregnancy.
This group comprises up to 20 of all people who develop epileptic seizures. AEDs in this group are palliative rather than suppressive of seizures. There is a continuous tendency to have seizures despite intensive treatment with all AEDs, although occasionally patients may move to the uncertain prognosis group when exposed to a novel AED. Some patients in this group may also be amenable to surgical intervention with subsequent change to prognostic group. Conditions include seizures associated with neurological deficit present from birth (tuberous sclerosis, Sturge Weber syndrome, cerebral palsy etc), epilepsia partialis continua, progressive myoclonic epilepsies, West syndrome, Lennox Gastaut syndrome and others in which atonic tonic seizures are a prominent feature, partial seizures associated with gross structural lesions and some of the localization related cryptogenic seizures.
Diabetic women should be closely monitored to make sure their blood sugar levels are normal or near normal. If the maternal blood sugar rises too high, the increased sugar crossing into the placenta can result in a large, overdeveloped baby with defects or blood sugar level abnormalities. Having a large baby can also result in injuries during birth and increase the need for cesarean delivery or other assistance during delivery, such as forceps or vacuum delivery. Women who are diabetic may also suffer from a greater loss of some nutrients. It is important to maintain tight control of blood sugar before and during pregnancy. have given birth to a large baby previously have given birth to a baby that was stillborn or had certain birth defects
There are many benefits to be gained from the practice of yoga. It can help you mentally and physically during your pregnancy, and it is also beneficial for the physical and mental development of the fetus. Yoga helps ensure an optimum supply of blood and nutrients to the developing fetus, and can ensure a smooth pregnancy and a relatively easy childbirth. The authors recommend consulting a good basic yoga book for details on the positions that will be discussed and working with an experienced yoga instructor. 7. Relieving tension around the cervix and birth canal Yoga also helps women adjust to the physical demands of labor, birth, and motherhood. One of the first things you learn in a yoga class is how to breathe fully, using a breathing technique called ujayi. This technique requires you to take in air slowly through your nose, filling your lungs entirely, and then exhaling completely until your stomach compresses. Learning how to do ujayi breathing primes you for labor and...
Fig. 2.7 Live birth rates in mothers with epilepsy on treatment compared with general population (study of a UK population of over 2 million persons). Fig. 2.7 Live birth rates in mothers with epilepsy on treatment compared with general population (study of a UK population of over 2 million persons).
Proper antenatal care, advances in fetal monitoring, supervised deliveries, and specialist care in case of high-risk pregnancies have considerably reduced birth related brain injuries in the developed world. In the developing world maternal and child health care systems are poorly developed and not yet optimal. Perinatal morbidity and mortality is still very high because of a variety of factors, poor maternal health at the start of pregnancy, lack of antenatal and postnatal care, large family size, home deliveries by traditional birth-attendants, and high frequency of preterm deliveries.10,27 In the developed world survival of very-low-birth-weight (VLBW) and extremely-low-birth-weight (ELBW) infants is not unusual. With development in the treatment of respiratory distress syndrome, the incidence of ventricular hemorrhages, an important prognostic factor in these infants, has been considerably de-creased.29 The reported incidence of periventricular leukomalacia (PVL) in premature or...
Labor is a series of continuous, progressively more intense contractions of the uterus that help the cervix to efface (thin) and dilate (open), allowing the fetus to move through the birth canal. Labor usually starts 2 weeks before or after the estimated date of delivery. No one knows exactly what triggers the onset of labor, and each pregnant woman experiences labor differently. Women in the United States who have epilepsy give birth to approximately 20,000 newborns every year. The authors have attempted to define
During the final stage of labor, you may be oblivious to whatever else is going on around you, because you are focused on the baby. If this is your first baby, you may feel a few contractions after you have delivered the placenta. You may continue to feel contractions intermittently for the next day or two if you have previously had a baby. These contractions are known as afterbirth pains. They are similar to strong menstrual cramps. Ask the doctor for pain medication if necessary. You may also get a case of the chills or feel shaky after the birth. This is perfectly normal and will not last long. Ask the nurse for a warm blanket.
In poverty-ridden regions, chronic malnutrition and limited access to prenatal and antenatal medical services negatively impact maternal health and substantially increase the risk of birth injury and neonatal infections. Improved nutrition for women of childbearing years and increased access to prenatal clinics would assist in decreasing these early central nervous system (CNS) injuries. Perinatal care should be optimized with the use of trained traditional birth attendants (TBAs) and TBAs must have access to a secondary referral source that can provide surgical intervention, if needed. A greater number of TBAs are needed, especially in rural regions, to support the evaluation and monitoring of pregnant women well before their delivery. This will facilitate the timely identification of problems so preemptive measures can be taken before birth trauma or perinatal infections occur. Optimal prenatal care will also identify potentially devastating infectious disorders, such as syphilis...
Mastitis is an infection of the breast that causes swelling, burning, redness, and pain. It is usually caused by bacteria that enter the breast via damaged nipples. Mastitis usually occurs in just one breast, and may cause a nursing mother to feel feverish and ill. If you have any of these symptoms, let your doctor know at once so that you can start treatment. Mastitis usually develops in nursing mothers about a month after childbirth. Sometimes there is a discharge of pus. Rest and good nutrition will help you get back your energy.
The process of labor and childbirth is divided into three stages The first stage of labor consists of an early phase, which begins with the onset of contractions and the gradual effacement (thinning out) and dilation (opening) of the cervix. The next phase of stage one is called the active phase, during which the cervix begins to dilate more rapidly, and the contractions are longer, stronger, and closer together. This is usually the time to call the doctor. The active phase ends with the transition period, during which the cervix fully dilates to 10 centimeters.
The body processes AEDs differently during pregnancy. This can lead to medication levels that are too high (which can cause side effects) or too low (which can cause more seizures). Blood levels of medication usually become lower with the weight gain of pregnancy, and your neurologist will probably have to increase your dosage to limit unnecessary seizures. It is important to control seizures during pregnancy because it is safer for the baby and the mother. As stated previously, pregnant women who have epilepsy should not stop taking their AEDs without permission from their doctor. Each woman who has epilepsy will react differently to pregnancy and childbirth, and your doctor will discuss any possible risks, and monitor you and your fetus closely. Pregnant women with epilepsy who want to have a home birth need to consider the complications that could arise if a seizure occurs during labor. Water births also need to be carefully considered, because consciousness may be impaired during...
Pregnancy And Childbirth
If Pregnancy Is Something That Frightens You, It's Time To Convert Your Fear Into Joy. Ready To Give Birth To A Child? Is The New Status Hitting Your State Of Mind? Are You Still Scared To Undergo All The Pain That Your Best Friend Underwent Just A Few Days Back? Not Convinced With The Answers Given By The Experts?