my mother in law cut this article out for me. love it.
Jennifer Block: Better childbirth? Lower costs? Midwives deliver
The current U.S. maternity-care system is not serving us well. Fortunately, there's a solution.
By JENNIFER BLOCK
Some health-care trivia: In the United States, what is the No. 1 reason people are admitted to the hospital? Not diabetes, not heart attack, not stroke. The answer is something that isn't even a disease: childbirth.
Not only is childbirth the most common reason for a hospital stay -- more than 4 million American women give birth each year -- it costs the country far more than any other health condition. Six of the 15 most frequent hospital procedures billed to private insurers and Medicaid are maternity-related. The nation's maternity bill totaled $86 billion in 2006, nearly half of which was picked up by taxpayers.
But cost hasn't translated into quality. We spend more than double per capita on childbirth than other industrialized countries, yet our rates of preterm birth, newborn death and maternal death rank us dismally in comparison. Last month, the March of Dimes gave the country a "D" on its prematurity report card; California got a "C," but 18 other states and the District of Columbia, where 15.9 percent of babies are born too early, failed entirely.
The United States ranks 41st among industrialized nations in maternal mortality. And there are unconscionable racial disparities: Black mothers are three times more likely to die in childbirth than white mothers.
In short, we are overspending and undeserving women and families. If the United States is serious about health reform, we need to begin, well, at the beginning. The problem is not access to care; it is the care itself. As a new joint report by the Milbank Memorial Fund, the Reforming States Group and Childbirth Connection makes clear, American maternity wards are not following evidence-based best practices. They are inducing and speeding up far too many labors and reaching too quickly for the scalpel: Nearly one-third of births are now by Caesarean section, more than twice what the World Health Organization has documented is a safe rate. In fact, the report found that the most common billable maternity procedures -- continuous electronic fetal monitoring, for instance -- have no clear benefit when used routinely.
The most cost-effective, health-promoting maternity care for normal, healthy women is midwife-led and out-of-hospital. Hospitals charge from $7,000 to $16,000, depending on the type and complexity of the birth. The average birth-center fee is only $1,600 because high-tech medical intervention is rarely applied and stays are shorter. This model of care is not just cheaper; decades of medical research show that it's better. Mother and baby are more likely to have a normal, vaginal birth; less likely to experience trauma, such as a bad vaginal tear or a surgical delivery; and more likely to breast-feed. In other words, less is actually more.
The Obama administration could save the country billions by overhauling the American way of birth.
Consider Washington, where a state review of licensed midwives (just 100 in practice) found that they saved the state an estimated $2.7 million over two years. One reason for the savings is that midwives prevent costly Caesarean surgeries: 11.9 percent of midwifery patients in Washington ended up with C-sections, compared with 24 percent of low-risk women in traditional obstetric care.
Currently, just 1 percent of women nationwide get midwife-led care outside a hospital setting. Imagine the savings if that number jumped to 10 percent or even 30 percent. Imagine if hospitals started promoting best practices: giving women one-on-one, continuous support, promoting movement and water immersion for pain relief, and reducing the use of labor stimulants and labor induction. The C-section rate would plummet, as would related infections, hemorrhages, neonatal-intensive-care admissions and deaths. And the country could save some serious cash. The joint Milbank report conservatively estimates savings of $2.5 billion a year if the Caesarean rate were brought down to 15 percent.
To be frank, the U.S. maternity-care system needs to be turned upside down. Midwives should be caring for the majority of pregnant women, and physicians should continue to handle high-risk cases, complications and emergencies. This is the division of labor, so to speak, that you find in the countries that spend less but get more.
In those countries, a persistent public health concern is a midwife shortage. In the United States, we don't have similar regard for midwives or their model of care. Hospitals frequently shut down nurse-midwifery practices because they don't bring in enough revenue. And although certified nurse midwives are eligible providers under federal Medicaid law and mandated for reimbursement, certified professional midwives -- who are trained in out-of-hospital birth care -- are not. In several state legislatures, they are fighting simply to be licensed, legal health care providers.
Barack Obama could be, among so many other firsts, the first birth-friendly president. How about a Midwife Corps to recruit and train the thousands of new midwives we'll need? How about federal funding to create hundreds of new birth centers? How about an ad campaign to educate women about optimal birth?
America needs better birth care, and midwives can deliver it.
Jennifer Block is the author of "Pushed: The Painful Truth About Childbirth and Modern Maternity Care." She wrote this article for the Los Angeles Times.
and here's another article flo found while she was helping me find this one online.
Showing posts with label childbirth. Show all posts
Showing posts with label childbirth. Show all posts
Wednesday, January 7, 2009
Tuesday, November 25, 2008
sinking heart.
hopefully this doesn't send shock waves around the world.
if it does, its worth it.
i just watched the SADDEST birth i have ever seen. it was the woman's third child, she went in to get induced, she got induced, he came and checked her, she was 5cm... he told her he was gonna break her water... then laughed and said 'oh, is that ok with you?' ... he broke her water and then gave her pitocin. she was in absolutely no pain. she kept saying she wasn't in pain and she was afraid that she wasn't gonna get the epidural soon enough and she might feel a little 'uncomfortable'. her contractions never started hurting... she got an epidural. he checked her after a bit, still she just laid there like NOTHING was going on....she felt like she needed to push but she said 'oh i'm probably wrong' and the nurse said 'most likely if you feel you have to, you're ready' the doctor came, she was 10cm... he told her he was going to turn the epidural off and she just kept whining about how she didn't want to feel one little bit of pain and that when she pushed it better come out really fast. she pushed and when she did the nurse had to tell her how to push and for how long and the baby was out fast. she mentioned how she has never tried to have a natural birth because she's always been to afraid to even feel the pain. i can't even believe that someone could have given birth to three kids and has never even felt what labor is like! that's so outrageous.
there are so many things about this that make me sooooo sad. sad that she doesn't see herself as strong enough to bear that pain and overcome it. sad that she doesn't trust her body or herself enough to listen to what its telling her and do it. she has no idea what she's missing out on and all she cared about was getting the baby out without every feeling any part of the experience. it was just sooooo insane to see a birth completely run by the doctor. everything she did was because the doctor said, the whole experience was just like if you went to the doctor and laid in a bed while they poked and prodded you except in the end a baby came out. seeing the way the doctor treated her was so foreign to me. he wasn't mean, he was totally nice, just so business. this is his job, but that's all he treated like. there was no heart, no relationship in what happened in that room. it was a medical procedure that she was having done to her. she never got up, never moved, never felt a contraction, didn't know how to push for herself.... i dont understand how this is looked at as normal?!!? she said when she was getting the epidural 'in no other situation would i do this, but i'm having a baby, so i need it'... talking about in no other circumstance would she take drugs like that... so what i dont get is why would the one time you see fit to do it be the one time there's a baby living inside you? and i just feel so sad that she thinks she needs it. women are strong, women are made to birth babies and our bodies are amazing. they do it and they do it better than anything, with strength and grace... but she doesn't know that her body can do that, no one told her she could.. no one believed for her that she could.
i'm sooooo thankful i had people around me to encourage me that i could do this, that i was strong and i didn't have to be afraid... i'm so thankful i had an army of people who loved me and believed in me and lifted me up when i felt broken and pushed me through... i'm so thankful that now i truly know what i am capable of and that i have accomplished one of the greatest things you can in life... i allowed my body to birth my children. i didn't let a doctor run my birth, i didn't let drugs artificially make my body do the work, and i wasn't absent from the experience... and because of those things my life was changed through those births. it makes me so sad when women dont get to experience this, or willingly choose not to. they'll never know what they've missed.
if it does, its worth it.
i just watched the SADDEST birth i have ever seen. it was the woman's third child, she went in to get induced, she got induced, he came and checked her, she was 5cm... he told her he was gonna break her water... then laughed and said 'oh, is that ok with you?' ... he broke her water and then gave her pitocin. she was in absolutely no pain. she kept saying she wasn't in pain and she was afraid that she wasn't gonna get the epidural soon enough and she might feel a little 'uncomfortable'. her contractions never started hurting... she got an epidural. he checked her after a bit, still she just laid there like NOTHING was going on....she felt like she needed to push but she said 'oh i'm probably wrong' and the nurse said 'most likely if you feel you have to, you're ready' the doctor came, she was 10cm... he told her he was going to turn the epidural off and she just kept whining about how she didn't want to feel one little bit of pain and that when she pushed it better come out really fast. she pushed and when she did the nurse had to tell her how to push and for how long and the baby was out fast. she mentioned how she has never tried to have a natural birth because she's always been to afraid to even feel the pain. i can't even believe that someone could have given birth to three kids and has never even felt what labor is like! that's so outrageous.
there are so many things about this that make me sooooo sad. sad that she doesn't see herself as strong enough to bear that pain and overcome it. sad that she doesn't trust her body or herself enough to listen to what its telling her and do it. she has no idea what she's missing out on and all she cared about was getting the baby out without every feeling any part of the experience. it was just sooooo insane to see a birth completely run by the doctor. everything she did was because the doctor said, the whole experience was just like if you went to the doctor and laid in a bed while they poked and prodded you except in the end a baby came out. seeing the way the doctor treated her was so foreign to me. he wasn't mean, he was totally nice, just so business. this is his job, but that's all he treated like. there was no heart, no relationship in what happened in that room. it was a medical procedure that she was having done to her. she never got up, never moved, never felt a contraction, didn't know how to push for herself.... i dont understand how this is looked at as normal?!!? she said when she was getting the epidural 'in no other situation would i do this, but i'm having a baby, so i need it'... talking about in no other circumstance would she take drugs like that... so what i dont get is why would the one time you see fit to do it be the one time there's a baby living inside you? and i just feel so sad that she thinks she needs it. women are strong, women are made to birth babies and our bodies are amazing. they do it and they do it better than anything, with strength and grace... but she doesn't know that her body can do that, no one told her she could.. no one believed for her that she could.
i'm sooooo thankful i had people around me to encourage me that i could do this, that i was strong and i didn't have to be afraid... i'm so thankful i had an army of people who loved me and believed in me and lifted me up when i felt broken and pushed me through... i'm so thankful that now i truly know what i am capable of and that i have accomplished one of the greatest things you can in life... i allowed my body to birth my children. i didn't let a doctor run my birth, i didn't let drugs artificially make my body do the work, and i wasn't absent from the experience... and because of those things my life was changed through those births. it makes me so sad when women dont get to experience this, or willingly choose not to. they'll never know what they've missed.
Saturday, November 8, 2008
happy birthday baby!
nola chlo is here, and yes i'm already blogging about her.
she was born at 7:24 this morning weighed 8.2lbs was 20 1/2 inches long and had a 14 inch head.
i went into labor last night after my midwife had come up and informed me my amneotic fluid was leaking... she left and i never went to sleep. i was having the same kind of contractions i'd been having for days until about midnight. they started to get a bit more intense and were consistently coming every 15 minutes. i didn't call mary until around 2 am. she started on her way up and i called erin to come be with me becuase even though labor wasn't on yet, i knew i needed her. when she arrived my contractions were every 5 minutes but bearable... i kept asking her if she thought it would just stop like every other time and she would just laugh at me and say 'um, no you're in labor'. mary arrived at around 3 or 330, i was still laughing in between contractions and talking, no big deal. ara woke up at 5 and was going to be picked up by my mother in law until i started pushing. i wanted to get in the tub so mary checked to see if it was time. i was expecting to be dialted to like 2cm or something and to feel totally defeated. she checked me, i was 6-7cm. ara left and i got in the tub... within an hour and 10 minutes of getting in the tub nola was out. i pushed for 22 minutes. my contractions were short the whole time which was amazing... but pushing this time was SOOO much more painful than with arabella. with ara, since i had pushed for almost 3 hours and been having contractions for so long i was just numb down there, this time i felt ever singe thing. i felt when she moved down, i knew exactly when she was starting to crown, all of it. it was insane. when her head was out i had to wait a minute for the next contraction to get her body out, in that moment i got to touch her head and when the next contraction came mary and i both pulled her out. the labor was just as hard as arabellas but in different ways... although the way i feel now is extremely easier than after arabella... plus my face isn't swollen to ten times its size! ara did amazing watching the whole thing and amy helped her stay grounded :)... arabella LOVES her... she has been waiting so long to see nolas face.. she was getting really crazy and disobedient right after nola came and finally when i got a moment with her i asked her what she needed, she looked down made a sad face and i said 'are you sad?' she said 'yea' and i said 'what do you want?' she said 'hold nola.' she wasn't jealous, she just wanted to hold her! once she did, she was so much better... nola is so adorable, she looks just like me when i came out, she has black hair! its crazy cause i expected her to look more like ara, but all they have in common is their undereyes from papa :) she has the cutest cry and makes super cute baby sounds.... and she has THE longest toes and fingers i have EVER seen.
that was our morning... here are the pictures to prove it ... and i have some short videos of the process that i will post later....
i'm so excited that she is finally here, i'm done with the pregnant phase of my life and our family is complete.
just so you know.... the lady holding her with glasses is my amazing midwife mary. there's a picture of ara holding her baby with her eyes
closed, she was being like mommy and nola, and the big bloody thing is my placenta.... gorgeous. it wasn't as huge around this time but it
was super thick.
i forgot the best part... not one single suture! woooo hooooo!
she was born at 7:24 this morning weighed 8.2lbs was 20 1/2 inches long and had a 14 inch head.
i went into labor last night after my midwife had come up and informed me my amneotic fluid was leaking... she left and i never went to sleep. i was having the same kind of contractions i'd been having for days until about midnight. they started to get a bit more intense and were consistently coming every 15 minutes. i didn't call mary until around 2 am. she started on her way up and i called erin to come be with me becuase even though labor wasn't on yet, i knew i needed her. when she arrived my contractions were every 5 minutes but bearable... i kept asking her if she thought it would just stop like every other time and she would just laugh at me and say 'um, no you're in labor'. mary arrived at around 3 or 330, i was still laughing in between contractions and talking, no big deal. ara woke up at 5 and was going to be picked up by my mother in law until i started pushing. i wanted to get in the tub so mary checked to see if it was time. i was expecting to be dialted to like 2cm or something and to feel totally defeated. she checked me, i was 6-7cm. ara left and i got in the tub... within an hour and 10 minutes of getting in the tub nola was out. i pushed for 22 minutes. my contractions were short the whole time which was amazing... but pushing this time was SOOO much more painful than with arabella. with ara, since i had pushed for almost 3 hours and been having contractions for so long i was just numb down there, this time i felt ever singe thing. i felt when she moved down, i knew exactly when she was starting to crown, all of it. it was insane. when her head was out i had to wait a minute for the next contraction to get her body out, in that moment i got to touch her head and when the next contraction came mary and i both pulled her out. the labor was just as hard as arabellas but in different ways... although the way i feel now is extremely easier than after arabella... plus my face isn't swollen to ten times its size! ara did amazing watching the whole thing and amy helped her stay grounded :)... arabella LOVES her... she has been waiting so long to see nolas face.. she was getting really crazy and disobedient right after nola came and finally when i got a moment with her i asked her what she needed, she looked down made a sad face and i said 'are you sad?' she said 'yea' and i said 'what do you want?' she said 'hold nola.' she wasn't jealous, she just wanted to hold her! once she did, she was so much better... nola is so adorable, she looks just like me when i came out, she has black hair! its crazy cause i expected her to look more like ara, but all they have in common is their undereyes from papa :) she has the cutest cry and makes super cute baby sounds.... and she has THE longest toes and fingers i have EVER seen.
that was our morning... here are the pictures to prove it ... and i have some short videos of the process that i will post later....
i'm so excited that she is finally here, i'm done with the pregnant phase of my life and our family is complete.
just so you know.... the lady holding her with glasses is my amazing midwife mary. there's a picture of ara holding her baby with her eyes
closed, she was being like mommy and nola, and the big bloody thing is my placenta.... gorgeous. it wasn't as huge around this time but it
was super thick.
i forgot the best part... not one single suture! woooo hooooo!
Friday, November 7, 2008
hole in my bag.
so i called my midwife again about all that fluid i've been telling you guys about... she came up tonight, we tested it and... its amniotic fluid.
so.... expect nola by the end of the weekend.
i'm a little stressed, cause its one thing to just go into labor and it comes on and you have no control, but its a whole other thing to hear 'you will go into labor in the next few days.' .... and just know what's coming.... i know i can do it, but its not fun looking forward in such reality to the worst pain you've ever experienced.
so.... expect nola by the end of the weekend.
i'm a little stressed, cause its one thing to just go into labor and it comes on and you have no control, but its a whole other thing to hear 'you will go into labor in the next few days.' .... and just know what's coming.... i know i can do it, but its not fun looking forward in such reality to the worst pain you've ever experienced.
Sunday, October 12, 2008
birth canal
does the size of that head compared to the size of that vagina make anyone else feel VERY uncomfortable? or is it just me?
the closer i get to being at the end (could be any time from wednesday, but lets not get our hopes up) the more i can NOT even WAIT to be normal again, not pregnant and to know that i will be that way for the REST of my life! i feel like i know i'm winning the lottery within the next month or something.... but at the same time i'm just getting bummed that i really do have to do this again. i HAVE to give birth. there's no way around it... well, no healthy way... i'm hoping this one is easier... although i seriously think that arabellas birth was perfect, i mean i felt like it was more than i could have asked for as far as my first experience and it changed my whole life... but it was hard, really really long, really intense, and i tore really really bad.... this time i'm just hoping for an experience like so many women tell me they get to have, fast, tears that aren't crazy, being able to stand up straight afterwards... i want to know what that would be like... and to have that feeling of it being so fast you're in such a fluster, like it takes over you and before you know it, you're done. i had that, but not until the last several hours of my birth (5? maybe longer, i dont know...) i could do without the extra 36 hours of intense pain that wore me out, yet wasn't bad enough to make me feel like i was wasted.. another awesome thing would be NOT pushing for 3 hours.... anyway, we'll see, i dont want to get my hopes up about it being any easier than with ara, although my midwife constantly tells me it will be... i just dont want to hope for that and then be let down. i'm rambling.
but at least this is it. after this i never have to give birth, i never have to be pregnant... ever. i can't even express the feeling that floods my heart when i think about that. its literally the best feeling i think i've EVER had. seth feels the same way. and its only a matter of weeks away! woo hoo! another cool part about this time is that i have only gained half the weight that i gained with ara, which is also the SAME amount i lost giving birth to ara.. wild. i know. i know i wont lose the same amount giving birth this time, but i also know it wont be so hard to get rid of this weight, as i will certainly have less to lose. (with ara i gained 50lbs- that's what happens when you drink a gallon of whole milk every two days, literally a gallon, oh and dont exercise or do ANYthing.- i lost 23 giving birth, and it took me until she was 1 to lose the rest! this time i have gained 25lbs total. awes sauce.)
like arabella always says 'come out nola!!' (but please do it as chill as possible, haa)
Friday, October 3, 2008
birth fest 2008
what? this? oh its just a picture of Caucasian jesus holding a baby. i've been getting everything ready for the birth.. oh and for the baby... i ordered my birth kit and birth tub... got all her clothes and all the linens for the birth washed and ready.. i can't believe i'm doing this again. its kiiiiinda way more scary this time, but reading breaking dawn helped cause at least my birth wont be as narnar as hers.... oh man. relating it to real life. yikes. anyway i'm at this weird point now because i DO NOT want to be pregnant anymore, most the time i haven't even really felt that pregnant, but i just got to the point where i'm so done with this, i'm so ready to be me again, forever... no more pregnant skylana... never. i've had my fill... but at the same time i'm getting panicked about having both of them here, and being a feeding machine again, losing part of myself again for a time. its not my favorite thing. i thought i was going to have all this alone time leading up to having nola and it hasnt worked out so far... so i'm just starting to feel like i can't breathe or something, like my life is about to end again for a while and time is running out. i just have to get through nola's first year and i know every thing will be better.... anyway.. its not that i'm not excited to see her, cause i really really am... i just can't express how much i DONT like nursing and being woken up every two hours, and i know it will be that much harder doing it while trying to take care of ara too.... it definitely takes its toll. thank God for seth, its so good to have husband who is so amazing and a marriage that is so solid and sound.... because this time is hard for both of us, really hard, but we're both able to remind each other that this is not normal life, this is the rough part, the pregnancy/baby part, the part where i've got hormones all over the place trying to rule my life!... hahha... but really that if we just focus on the fact that this will be done soon, we'll get through and the annoying little things about this time to get to us so easy. i have no idea if ANY of this makes sense. ... but there ya have it. i haven't blogged lately because my computer charger broke, i just got the new one yesterday... so i was using seth's computer and his freaking mac is the WORST thing ever. the internet pretty much NEVER works. ... so outrageously slow.... slow enough for me to give up the internet pretty much altogether.. which is big.
Wednesday, July 30, 2008
birth sisters.
hahah gross.
but really, i was reading emery's blog and thinking about the bond i have just this past two years come to understand for the first time... the bond between women.
i have never been the type to want to stand up and shout that i am a woman, that i am
strong and i am just one of many (i've always thought it was cheesy)... but when i think about natural childbirth i want to scream it at the top of my lungs. no, i dont feel that way with all childbirth (dont be offended at that, its just the truth. i do not feel that way with all childbirth)....
there truly is this bond and intense closeness i feel with other women who choose natural childbirth and have really understood and come into that power of being a strong woman... a woman who knows, i mean KNOWS, she can do anything in this world because she has accomplished the MOST difficult task that exists.
i feel a bond with flo like i have with no one else, because she held me up when i was at the end of myself.. she knew what i needed cause she had been there and her words are what pushed me through and gave me the strength to push my baby out. she held me up, in a way no one else ever has.
i feel a bond with my midwife because in all my mess and pain she knew i would push that child out and she made the way, and after, when my body was weak she held me up, she took care of me like mother to a child. she held me up, in a way no one else has.
i feel a bond with all the women around me who have a passion to see their children brought into this world in the most peaceful, healthful way possible, who will endure whatever comes their way, who will endure pain that is indescribable, that will endure exhaustion that they never thought existed all for the sake of a child they have never seen...
women who have a passion to see this for more and more women, to see all women experience this life changing moment for the sake of their hearts and the sake of the healing it brings, they hold me up ... we hold each other up.
i feel a bond in a movement to change the face of birthing in this country, to end the criminal and unjust ways that have begun to steal the moment a woman becomes a woman. these woman are my sisters, they are a part of me.
i am a woman. i am strong. i am one of many.
but really, i was reading emery's blog and thinking about the bond i have just this past two years come to understand for the first time... the bond between women.
i have never been the type to want to stand up and shout that i am a woman, that i am
strong and i am just one of many (i've always thought it was cheesy)... but when i think about natural childbirth i want to scream it at the top of my lungs. no, i dont feel that way with all childbirth (dont be offended at that, its just the truth. i do not feel that way with all childbirth)....
there truly is this bond and intense closeness i feel with other women who choose natural childbirth and have really understood and come into that power of being a strong woman... a woman who knows, i mean KNOWS, she can do anything in this world because she has accomplished the MOST difficult task that exists.
i feel a bond with flo like i have with no one else, because she held me up when i was at the end of myself.. she knew what i needed cause she had been there and her words are what pushed me through and gave me the strength to push my baby out. she held me up, in a way no one else ever has.
i feel a bond with my midwife because in all my mess and pain she knew i would push that child out and she made the way, and after, when my body was weak she held me up, she took care of me like mother to a child. she held me up, in a way no one else has.
i feel a bond with all the women around me who have a passion to see their children brought into this world in the most peaceful, healthful way possible, who will endure whatever comes their way, who will endure pain that is indescribable, that will endure exhaustion that they never thought existed all for the sake of a child they have never seen...
women who have a passion to see this for more and more women, to see all women experience this life changing moment for the sake of their hearts and the sake of the healing it brings, they hold me up ... we hold each other up.
i feel a bond in a movement to change the face of birthing in this country, to end the criminal and unjust ways that have begun to steal the moment a woman becomes a woman. these woman are my sisters, they are a part of me.
i am a woman. i am strong. i am one of many.
Monday, July 14, 2008
amen
the following is an excerpt from my friends blog, you can read the rest here, and please do...
"What facts do I wish I were armed with?
Let's start with the fact that I didn't have the true facts.
The risks associated with the medicines in epidurals have been completely minimized by most health care providers, and women have been flat out told that the drugs DON'T cross the placenta.
I won't share the thousands of anecdotal stories of sleepy babies born under the use of these drugs, or the recorded stories of maternal injury and death resulting from the use of these drugs, OR the cascade of interventions that can occur after using these drugs. I'm just going to post a few startling statements from the FDA itself.
First off, 2 medications are given simultaneously via the epidural.
One medication is a local anesthetic, and one is an opioid.
Common local anesthethics include lidocaine (Xylocaine), ropivicaine (Naropin) or bupivicaine.
One of these is used in combination with an opioid such as Fentanyl.
Here are a few official statements regarding the use of Fentanyl, Bupivacaine, and Naropin (emphasis mine):
Bupivacaine
(pregnancy class C)
Local anesthetics rapidly cross the placenta, and when used for epidural, caudal, or pudendal block anesthesia, can cause varying degrees of maternal, fetal, and neonatal toxicity. (See Pharmacokinetics in CLINICAL PHARMACOLOGY.) The incidence and degree of toxicity depend upon the procedure performed, the type, and amount of drug used, and the technique of drug administration. Adverse reactions in the parturient, fetus, and neonate involve alterations of the central nervous system, peripheral vascular tone, and cardiac function.
Maternal hypotension has resulted from regional anesthesia. Local anesthetics produce vasodilation by blocking sympathetic nerves. Elevating the patient’s legs and positioning her on her left side will help prevent decreases in blood pressure. The fetal heart rate also should be monitored continuously and electronic fetal monitoring is highly advisable.
Epidural, caudal, or pudendal anesthesia may alter the forces of parturition through changes in uterine contractility or maternal expulsive efforts. Epidural anesthesia has been reported to prolong the second stage of labor by removing the parturient’s reflex urge to bear down or by interfering with motor function. The use of obstetrical anesthesia may increase the need for forceps assistance.
The use of some local anesthetic drug products during labor and delivery may be followed by diminished muscle strength and tone for the first day or two of life. This has not been reported with Bupivacaine.
It is extremely important to avoid aortocaval compression by the gravid uterus during administration of regional block to parturients. To do this, the patient must be maintained in the left lateral decubitus position or a blanket roll or sandbag may be placed beneath the right hip and gravid uterus displaced to the left.
Naropin
(pregnancy class B)
Local anesthetics, including ropivacaine, rapidly cross the placenta, and when used for epidural block can cause varying degrees of maternal, fetal and neonatal toxicity (see CLINICAL PHARMACOLOGY and PHARMACOKINETICS). The incidence and degree of toxicity depend upon the procedure performed, the type and amount of drug used, and the technique of drug administration.
Adverse reactions in the parturient, fetus and neonate involve alterations of the central nervous system, peripheral vascular tone and cardiac function.
Maternal hypotension has resulted from regional anesthesia with Naropin for obstetrical pain relief.
Local anesthetics produce vasodilation by blocking sympathetic nerves. Elevating the patient's legs and positioning her on her left side will help prevent decreases in blood pressure. The fetal heart rate also should be monitored continuously, and electronic fetal monitoring is highly advisable.
Epidural anesthesia has been reported to prolong the second stage of labor by removing the patient's reflex urge to bear down or by interfering with motor function. Spontaneous vertex delivery occurred more frequently in patients receiving Naropin than in those receiving bupivacaine.
Fentanyl
(pregnancy class C)
Fentanyl readily passes across the placenta to the fetus; therefore, Fentanyl transdermal system is not recommended for analgesia during labor and delivery."
"What facts do I wish I were armed with?
Let's start with the fact that I didn't have the true facts.
The risks associated with the medicines in epidurals have been completely minimized by most health care providers, and women have been flat out told that the drugs DON'T cross the placenta.
I won't share the thousands of anecdotal stories of sleepy babies born under the use of these drugs, or the recorded stories of maternal injury and death resulting from the use of these drugs, OR the cascade of interventions that can occur after using these drugs. I'm just going to post a few startling statements from the FDA itself.
First off, 2 medications are given simultaneously via the epidural.
One medication is a local anesthetic, and one is an opioid.
Common local anesthethics include lidocaine (Xylocaine), ropivicaine (Naropin) or bupivicaine.
One of these is used in combination with an opioid such as Fentanyl.
Here are a few official statements regarding the use of Fentanyl, Bupivacaine, and Naropin (emphasis mine):
Bupivacaine
(pregnancy class C)
Local anesthetics rapidly cross the placenta, and when used for epidural, caudal, or pudendal block anesthesia, can cause varying degrees of maternal, fetal, and neonatal toxicity. (See Pharmacokinetics in CLINICAL PHARMACOLOGY.) The incidence and degree of toxicity depend upon the procedure performed, the type, and amount of drug used, and the technique of drug administration. Adverse reactions in the parturient, fetus, and neonate involve alterations of the central nervous system, peripheral vascular tone, and cardiac function.
Maternal hypotension has resulted from regional anesthesia. Local anesthetics produce vasodilation by blocking sympathetic nerves. Elevating the patient’s legs and positioning her on her left side will help prevent decreases in blood pressure. The fetal heart rate also should be monitored continuously and electronic fetal monitoring is highly advisable.
Epidural, caudal, or pudendal anesthesia may alter the forces of parturition through changes in uterine contractility or maternal expulsive efforts. Epidural anesthesia has been reported to prolong the second stage of labor by removing the parturient’s reflex urge to bear down or by interfering with motor function. The use of obstetrical anesthesia may increase the need for forceps assistance.
The use of some local anesthetic drug products during labor and delivery may be followed by diminished muscle strength and tone for the first day or two of life. This has not been reported with Bupivacaine.
It is extremely important to avoid aortocaval compression by the gravid uterus during administration of regional block to parturients. To do this, the patient must be maintained in the left lateral decubitus position or a blanket roll or sandbag may be placed beneath the right hip and gravid uterus displaced to the left.
Naropin
(pregnancy class B)
Local anesthetics, including ropivacaine, rapidly cross the placenta, and when used for epidural block can cause varying degrees of maternal, fetal and neonatal toxicity (see CLINICAL PHARMACOLOGY and PHARMACOKINETICS). The incidence and degree of toxicity depend upon the procedure performed, the type and amount of drug used, and the technique of drug administration.
Adverse reactions in the parturient, fetus and neonate involve alterations of the central nervous system, peripheral vascular tone and cardiac function.
Maternal hypotension has resulted from regional anesthesia with Naropin for obstetrical pain relief.
Local anesthetics produce vasodilation by blocking sympathetic nerves. Elevating the patient's legs and positioning her on her left side will help prevent decreases in blood pressure. The fetal heart rate also should be monitored continuously, and electronic fetal monitoring is highly advisable.
Epidural anesthesia has been reported to prolong the second stage of labor by removing the patient's reflex urge to bear down or by interfering with motor function. Spontaneous vertex delivery occurred more frequently in patients receiving Naropin than in those receiving bupivacaine.
Fentanyl
(pregnancy class C)
Fentanyl readily passes across the placenta to the fetus; therefore, Fentanyl transdermal system is not recommended for analgesia during labor and delivery."
Thursday, May 29, 2008
cesarian sections and premature birth
my friend posted this article on her blog... and obviously i like it... check it out.
Friday, May 16, 2008
who would even take the time to read this much? (besides you flo)
my friend and i were talking about how we dont get why people freak out about women having any amount of alcohol when they're pregnant but its no questions asked when putting narcotics into your body to make life easier for yourself. .... how does this make any sense? i get if you're completely opposed to both, but if you're to pick one that's safer to me the more reasonable thing is small amount of alcohol not a drug
that causes paralysis of your entire lower body, potentially forever, not to mention numerous complications etc. i guess i do get it... i mean i think it makes no sense but i could see thinking that way if all i knew was what doctors say... cause they act like alcohol will kill your baby but epidurals are "completely safe", when they have never been proven to be, in fact proven more often to be the opposite.
this is info from a frequently asked questions website about epidurals....
Research on the Effects of Epidural
The summary to follow in this FAQ is from a book: "Obstetric Myths versus Research Realities" by Henci Goer, pub. Bergin & Garvey, 1995 ISBN 0-89789-427-8. (send me email if you want ordering info - I love this book, but do not wish to abuse the net with advertisements!)
Ms. Goer has written medical pamphlets and magazine articles for 10 years, and is an ASPO (Lamaze) certified childbirth educator and labor support person (doula). She has read through the literature, given overviews and abstracts as well as the citations for those who wish to read the original research. She starts out with a section on how to understand the statistics and read the literature with an eye to a well-designed study. The amount of work in this book could only be appreciated by seeing it - I have included only a few of her citations and this is only one of many topics covered... This book was written for birth professionals, but a consumer-oriented version is coming soon (est. early 1999).
Here is the summary from the section on epidurals:
Epidurals substantially increase the incidence of oxytocin augmentation, instrumental delivery, and bladder catheterization. (21 studies cited) [Saunders, NJ, et al. "Oxytocin infusion ... primiparous women using epidural..." BMJ 1989;299:1423-1426]
In first-time mothers, epidurals substantially increase the cesarean rate for dystocia. (12 studies cited) [Thorp, JA, et al. "The effect of intrapartum epidural ..." Am J Ob Gyn, 1993;169(4):851-858]
Epidurals decrease the probability that a posterior or transverse baby will rotate. Oxytocin does not help. (7 studies)
Having an epidural at 5cm dilation or more eliminates both excess posterior/transverse and excess cesarean for dystocia. (2 studies)
Epidurals may not relieve any pain or may not relieve all pain. (3 studies)
Innovations in procedure - lower dosages, continuous infusion, adding a narcotic - have not decreased epidural related problems. (13 studies) [Naulty, JS. "Continuous infusions of local ..." (this is a literature review) Int. Anes. Clin. 1990;28(1):17-24]
Delaying pushing until the head has descended to the perineum increases the chances of spontaneous birth. (a time delay of 1 hour is not really delaying - it needs to be a positional not timed thing...) Evidence is divided as to whether letting the epidural wear off before pushing increases spontaneous delivery. (4 studies)
Maternal complications of epidurals include: [Uitvlugt, A. "Managing complications of Epidural Analgesia" International Anesthesia Clin. 1990;28(1):11-16]
* Maternal hypotension(5 studies). This reduces uteroplacental blood supply and can cause fetal distress. (8 studies)
* Convulsions (4 studies)
* Respiratory paralysis (3 studies).
* Cardiac Arrest (6 studies)
* Allergic Shock (2 studies)
* Maternal nerve injury due to needle injury, poor positioning, forceps injury, infection, hematoma, or subarachnoid injection of chloroprocaine. The last three usually cause permanent injury. (9 studies)
* Spinal headache (3 studies)
* Increased maternal core temperature. (2 studies)
* Temporary urinary incontinence. (1 study)
* Long-term backache (weeks to years), headache, migranes, numbness, or tingling. (2 studies)
Serious complications occur despite proper procedure and precautions. The epinephrine test dose can cause complications. (12 studies)
Epidural anesthetics "get" to the baby. (5 studies)
Epidurals do not protect the fetus from distress. In fact, they cause abnormal fetal heart rate, sometimes severe, which may occur with or independant of maternal blood pressure (11% - 43% depending on the study and type of medication used - the 43% was found with Bupivacaine, the most common drug for epidural.) (15 studies) [Stavrou C, et al. "Prolonged fetal bradycardia during epidural analgesia" S Afr Med J 1990;77:66-68]
Epidurals may cause neonatal jaundice. (2 studies) [Clark, DA & Landaw, SA. "Bupivacaine alters red blood cell ... jaundice associated with maternal anesthesia" Pediatr. Res. 1985; 19(4):341-343]
Epidurals may cause adverse neonatal behavioral and physical effects. (these are both direct effects and indirect effects from the increased rate of labor complications and interventions.) The importance of this is debated. (4 studies)
Epidural anesthesia may relieve hypertension, but hypertensive women are at particular risk of epidural-induced hypotension, which reduces placental blood supply. (2 studies)
the book's author is henci goer check it out.
and this is just many different opinions about what women do in europe... where overall people tend to be healthier, happier and less stressed....
Do European women give up drinking?
January 2004
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I am currently pregnant with my second, and just as with my first, I am missing wine with dinner. I was so careful in my first pregnancy to avoid alcohol altogether, except for a very occasional sip. I always felt, though, and still do, that the prevailing no-amount-is-safe orthodoxy in this country is a little extreme, and probably inaccurate. I know that we have a number of European women in this network, and I would like to ask them about how drinking and pregnancy are viewed in Europe. I am especially curious about France and Italy where wine is so much a part of the dining experience. Do women in France and/or Italy stop drinking altogether when they get pregnant? Or do they continue to drink a glass of wine with dinner? What do French/Italian doctors and midwives tell their patients about drinking wine (or other alcohol) during pregnancy? How do French and Italian women view the no-alcohol-at-all approach in the U.S? Any French femmes out there with views to share?
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I am an American who spent her first pregnancy in Paris. My OB was an American, though she had been there for quite a while. In my experience, the ''no-amount-is-safe orthodoxy'' you described is particularly American. At restaurants, waiters would be routinely surprised, even shocked, when I would pass on having a glass of wine, even when I was visibly (very visibly!) pregnant. In fact, a few times my OB even directed me to have a glass! During that pregnancy I drank wine fairly often (a couple of glasses a week? My memory is rusty), but I did not drink hard alcohol nor did I drink during the first trimester (but that part is just personal superstition, not based on medical evidence). I'm now pregnant again (in the Bay Area this time) and, although my opinion on the! subject hasn't changed, I've found that I drink less -- though it may simply be because we go out to dinner less frequently!
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I am not a European mother, but I have been in the health information field for several years and I can tell you this: no health education or prenatal care expert will go on the record saying that any amount of alcohol during pregnancy is okay. Alcoholism is such a problem, and the effects of binge drinking so devastating, that the safe public health message is to abstain completely. No one knows what a ''safe'' amount of alcohol is either, as scientists are loathe to run those kinds of studies on pregnant women, for obvious reasons. Privately, you might get your obstetrician to say that a drink or two in the last trimester is okay, or don't worry about that Tom Collins you drank before you knew you were pregnant. Probably there is a big c! ultural difference in the approach to alcohol in pregnancy, between here and Europe, but it is based on true concern about problems caused by alcohol abuse in pregnancy. a health writer
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I'm neither from Italy or France, but from Spain, where the wine culture is also very extended. The tendency I've seen while visiting pregnant and have heard from friends who leave there is that, in general, the attitude it more relaxed with regards to wine and other alcoholic beverages. I think the believe is that as long as it's not in excess and accompanied by food it won't harm the baby and it may help the future mom!
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While I cannot give you the French view, here is my personal European perspective. I am German and spent the first few months of my pregnancy over there. ! ; I asked my very experienced OB/GYN (he's been caring for pregnant women for about 30 years) about alcohol. He thinks that there is no evidence that the occasional glass of wine harms the baby. His general recommendation about nutrition was to eat/drink what you really crave, and to leave out anything that you have to force yourself to take - with the following precautions as far as alcohol is concerned:
1. No regular drinking (i.e. every single day).
2. No binge drinking (i.e. having quite a few drinks in one session).
3. Not hard liquor; stick to wine or beer.
Having said that, a German friend of mine strongly craved wine throughout part of her pregnancy, and had a small glass of wine almost every night over dinner for quite a few weeks (I believe this must have been in the second trimester). Her little boy is gorgeous and perfectly healthy. I also have a friend who had a hard time calming down! and going to sleep during pregnancy. She had a glass of beer virtually every night before going to bed, deciding that sleepless nights or medication would be more harmful to the baby than the beer (her baby is also bright and healthy).
Most of my European friends probably went the moderate route I took. I cut back on my 'wine every night with dinner' habit but continued to have the occasional glass throughout my pregnancy. It's a very personal decision, and only you can decide what you are comfortable with. Whatever you choose, though, don't let others make you feel guilty!! Many women around the world drink some wine during pregnancy and have perfectly healthy babies. You clearly care, and you'll find the right middle ground that works for you and your baby.
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Having just reviewed some of the literature on the effects of alcohol during pregnancy for the pediatric theory class I teach to nurse practitioners students, I would have to say that drinking during pregnancy is a very bad idea. They are still studying this issue and there may be periods of increased susceptibility, or genetic susceptibility, but they don't know enough to say how these variations affect the fetus. There was an article about this research in the NYT a few months back. You might want to go back and read it. I was surprised to learn how small amounts of alcohol can have subtle, but nasty, effects on some fetuses, see citation below:
''Adverse behavioral effects in children exposed prenatally to risk levels as well as low and moderate levels of alcohol have been reported by many researchers. Neonatally, habituation to stimuli (lessening of response to repetitive stimuli) was most affected and at 8 months, significant effects were observed by using! the Bayley Mental Developmental Index and Pyschomotor Developmental Index scales (global scales of infant behavioral functioning). 17 Furthermore, infants have longer reaction times when exposed prenatally to low to moderate levels of alcohol. 18....These findings suggest that alcohol teratogenesis can affect academic and social functioning even with prenatal alcohol exposure at social drinking levels.''
Sokol, Robert J. MD. Delaney-Black, Virginia MD, MPH. Nordstrom, Beth PhD. Fetal Alcohol Spectrum Disorder. JAMA. 290(22):2996- 2999, December 10, 2003
''Fetal alcohol exposure (even at ''social drinking'' levels) is associated with developmental difficulties in adolescence that are consistent with problems seen earlier in life. Clinicians should understand the potential role prenatal alcohol exposure plays in behavioral and cognitive problems'' J. Am. Acad. Child Adolesc. Phsychiatry, 1997, 36(9):1187-1194.
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I'm not European (sorry!) but I am an epidemiologist and toxicologist. We obsess about finding the lower limit of toxicity/effect. Yes the research says that one drink a day is within the acceptable limits but we are notoriously poor at measuring things in people who vary so greatly. Believe me, the epidemiology is not that good. I say, why take a chance? that is your child. Buy some pomagranate juice or the best grape juice you can find and get some peace of mind.
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Hi! I'm French, just returned to France after a year in Berkeley. I've never stopped drinking a little wine with dinner during my 3 pregnancies, and I felt OK with that. Important for me was not to drink without a meal, no strong alcohol, only wine (French wines have less alcohol that Californian wines)a! nd never more that one small glass. I was a little more careful when nursing my baby than when I was pregnant.
I think the no-alcohol rule is reasonable, but I don't feel like being reasonable all the time, it's important to be happy !
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As an American mom who enjoys a glass of wine with dinner -- or two ... or even three ;^) --as much as any of those bon vivant French femmes out there, here's my unofficial & personal opinion for which the Berkeley Parents Network cannot be held legally responsible or liable: Hold off until after the first trimester, then go ahead & uncork that lovely merlot & sip in moderation. Since you'll only be having one small glass with dinner, do consider treating yourself & upgrading to a finer-than-usual vintage. I did do a bit of research on the wine & pregnancy issue. It's hard to find information on this since doctors, nurses, midwives, & publishers of pregnancy information *have* to stick to the ''no amount is safe during pregnancy'' orthodoxy for legal as well as professional reasons. Since nobody knows the exact point at which alcohol consumption crosses the line from harmless to posing a hazard to the baby's development, it's better to err on the side of caution & try to avoid negative outcomes & the accompanying potential for lawsuits. However, it really *is* better to avoid alcohol & other potentially harmful environmental factors (paint fumes, dangerous falls, serious illnesses, etc.) during the first trimester, because that's when the baby's central nervous system & other vital organs begin developing. Those four margaritas you quaffed before you knew you were pregnant are probably okay though (as long as this isn't a normal habit), since humans are pretty resilient & it takes a week or so for the egg to implant in your uterus & begin sharing your blood supply.
You can also find more honest & open perspectives on email newsgroups like this one & online message boards hosted by medical & women's Web sites.
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I got pregnant while we were traveling in Italy in 2001. We had friends in Milan who arranged for me to visit their OB, and it was very interesting. He scoffed at the idea of having to give up wine, and said that a glass at lunch or dinner was fine. However, he was very concerned that I understand the widespread problem of toxiplasmosis in Italy, due to the number of feral cats in the fields where produce was growing. He told me to absolutely avoid rare meats and uncooked vegetables--no salad! (He also had a very fancy ultrasound machine with two viewing screens, so that my husband could watch the results sitting at a desk rather than leaning over me at the examining table. And he gave us a video of the ultrasound! But it was in the European video format, so we never watched it.)
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Here's an affirmative response re: alcohol while pregnant. In both my pregnancies, I had episodes of strong early contractions, and guess what? My doctors (two different practices) both times suggested that I lie down and have a glass of wine or two. Of course I was very apprehensive about this. But they assured me that it was safe and might very well help slow down the contractions. In both cases, I was past the first trimester, and in both cases they also urged me to make sure that I was well-hydrated. So I think it's safe within reason, but I should also clarify that I never had more than a glass or so of wine a week. My kids show no ill effects (and neither was born early).
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I'm sure you will get lots of comments on this one! Wine has been an important mutual interest for my husband and I for more than 20 years ! (wine groups, vacations to wine regions, collecting, etc.). During my first pregnancy, I had maybe 3-4 SIPS of wine the entire pregnancy. My second pregnancy I had a heart to heart with my OB (tops in the field) and asked whether it would be truly harmful if I occasionally had a 1/2 glass of wine with dinner. My OB said that her insurance wouldn't allow her to say it was okay, but in fact especially after the first trimester, a little wine with dinner wasn't going to do any harm. A pediatric MD friend of mine agreed. My European friends say that their doctors allow up to TWO GLASSES per day!! Personally, I was very happy to be able to have a half glass now and then. It certainly added to my quality of life during my pregnancy and while I undertand the dangers of fetal alchohol syndrome - its beyond belief that an occassional glass of wine with food after the first trimester could do harm. The syndrome w! as associated with alcoholic or heavy drinking women but given that a link was made between alcohol and birth issues, the medical community (really, the insurance companies) began preaching a ''zero tolerance'' rule. On the other hand, I did completely give up shellfish during my pregnancies!! By the way, both of my children were born totally healthy!
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I stayed away from absolutely everything when I was pregnant the first time. However, when I went into early labor, I was given a combination of drugs to stop the labor that were horrible. When the same thing happened with my second pregnancy, my new O.B. told me to go home and drink a glass of wine. I was surprised, and she pointed out that the glass of wine was far less harmful to the baby than the combination of drugs I had been given to stop labor the last time. I continued to drink a glass of wine, or a beer, almost daily for the rest of my pregnancy, which not only prevented my early labor, but also tasted good, too! BTW, my babies were both over 8 pounds, and as healthy as could be. I would say that certainly in your last trimester, there is no medical reason w! hy you can not have a glass of wine here and there. For the record, ask you O.B. Mine (who is very well respected) said it was fine.
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My wonderful OB told me that I could have a drink a day, more or less, when I told him I missed my after-work glass of wine or beer. Both my sons are big, bright, handsome fellows. I didn't have a drink every day, but many days I did have one. I suppose no alcohol is a good goal, but the level of puritanism now tied to pregnancy is sort of out of hand, IMHO. Use your noggin -- that's all it is.
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I found the attitude to drinking while pregnant in this country to be a bit silly. I am British and the general consensus in the UK is that it is perfectly fine to have a few glasses of wine per week, but o! f course, that binge drinking should be avoided. While I was pregnant I encountered women here who were rude enough to criticise me when I drank in public. I find this very offensive, and puzzling too, given that many of the same women were perfectly happy to take drugs during childbirth! Incidentally, I gave birth to a very healthy nine pound baby, so I say go ahead and enjoy your glass of wine!
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Here's a voice from Italy. Our doctors recommend moderation with alcohol, however an occasional glass a of wine at meals is OK. I was living in Scotland when I got pregnant and there the rule was maximum 1 unit of alcohol per day (1 unit= a glass of wine or a pint of beer!). It always seemed like a lot of alcohol to me and since it didn't appeal to me while pregnant I avoided it altogether for the first trimester, but I had a half a glass of wine a few times during the rest of the pregnancy.
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While I was pregnant I had a pregnancy book from the U.S., Canada and France. Interestingly they said different things about alcohol. The U.S. book recommended to completely stop drinking alcohol, the Canadian book said that once in a while wine was fine and the French book suggested that one glass of wine a day is fine but to watch out for hard liquor. So I made up my own rule of one glass of wine a day on the weekend only.
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Both my children were born in Europe - one in Switzerland, the other in Belgium - where the extreme precautions taken in America are viewed as exactly that. Of course I asked my OB/GYN in both countries about wine during pregnancy (and hair coloring as well - go ahead, but perh! aps wait until after the first trimester) and was told to enjoy a glass of wine, if I wished, with my dinner. As long as I was in otherwise good health and the pregnancy was going well, there were no major precautions given (obviously a glass of wine is different than a gin and tonic - use your judgement!). No raw fish, no soft cheeses (Brie and the like) - and that was it (one will often see French and Belgian women enjoying Steak Americaine/Steak Tartare, a popular dish consisting of finely minced raw steak mixed with raw egg and capers - a health nightmare for us cautious Americans!!!). Take my doctors' advice and enjoy your glass of wine - of course stop at one, and drink a glass of water with it perhaps, but there is no reason to avoid it completely. In Denmark they might tell you red wine is good for your breastmilk; in Belgium, dark beer! I enjoyed a glass of wine when I felt like it and both my children were b! orn healthy and enormous. Be prudent about your consumption and enjoy your pregnancy!!!!
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my American-born cousin who has lived in Italy all her adult life says beer is great for breast milk production and they believe it helps with colic. For pregnancy she said you don't want to drown the baby but a glass or so of wine is considered normal in her region, she lives in the town of Perugia (1 or 2 glasses of wine may in fact be considered none at all.) I am not European but have several friends and family members who are, and I did drink occasionally during my pregnancy. I don't think I felt like it in the first trimester, but after that I would have a half glass of wine occasionally and on a handful of occasions had a full glass. A good friend of mine is European and is now the head of the pediatric clinical education program at Cornell University, as well as the mother of two children. Her opinion is that drinking in moderation is absolutely fine. My daughter was 9 plus pounds and was completely healthy at birth, and she's now 19 months and has met every developmental milestone early. The thing that I found surprising was that even after you have the baby the sanctimonious attitude continues. Although there have ! been no reliable studies showing that moderate drinking has a negative impact on breastfed babies, and even a few studies that show the opposite, you will read in many U.S. baby books that you should not drink ANYTHING while breastfeeding. Once again, I have drunk in moderation since having our daughter, who is still breastfed, and I have not noticed any impact on her. A mom who believes in everything in moderation
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When my sister-in-law was pregnant in France, she was told to limit herself to a glass of wine with meals, no more than 2 cups of coffee, and no more than 5 cigarettes. Recommendations for baby care are different too. Those recommendations have a cultural basis, not just a scientific one. In all probability, the greatest health risk to drinking an occasional glass of wine during pregnancy is that someone might see you drinking it and attack you. Still, I w! anted to mention the information about smoking, since I suspect many people in this area would have a very different reaction to a pregnant woman smoking 5 cigarettes/day. Jennifer
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I've also read the NYT article and other reports on the latest research on alcohol and pregnancy. It's reported that alcohol, even a very small amount, can actually cause more damage in the baby's brain than drugs. If you wouldn't do drugs ''occasionally'' or ''just a small amount'' while you're pregnant, you certainly wouldn't want to drink alcohol either. It's probably better to be on the safe side and not drink, for just 9 months. Chris
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Regardless of what doctors here or in Europe advise, they can't guarantee everything that goes on inside our bodies. Ultimately, we are responsible for our bodies and their intake. Please ask you! rself if you want to risk guilt, if something goes wrong and live with the feeling that something may not have happened "if only you did something differently". I'm actually not much of a disciplined person myself, but when I was pregnant I considered it an honor and chose to change my nutrition from one day to the next (in practice of learning how to serve my baby's needs - not a bad time to start) and as soon as I had my entire body back to myself, I went back to wine, beer, french fries and the occasional junk food. (I guess, it also helped in just gaining 30+ lbs instead of 50-60). I just knew I had given it my best intentions and the rest was up to fate - I was at peace with that. another European mom
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I appreciate the diversity of opinions expressed regarding drinking while pregnant. I am concerned that in the responses it would seem that the main danger to exposing a fetus! s to alcohol is fetal alcohol syndrome which may sound extreme to folks who do not have a great deal of information. There are many other possible devastating outcomes: in my family of origin, one of my siblings ended up with the condition of hydrocephalus which translates to a whole variety of health problems, not the least of which is life long developmental disability. Was this due to my mother's drinking while pregnant? While I cannot say for sure, there is much evidence (both anecdotal and from medical professionals)to suggest that the drinking was a primary cause. This has impacted our family immeasurably, both in direct ways (the life long care for my sibling, for instance) as well as the less tangible ground swells of unspoken guilt and blame.
When I was pregnant, I read the literature carefully and determined that a very few glasses of wine in my final trimester would be acceptable. My baby is healthy and fine- but I think it is imperative that women know as much as possible about the dangers- and that for those nine months, what we don't know (and after reading the variety of responses, it is clear that we do not know definitively)can have devastating effects. I would urge- no matter what evidence you have from other cultures- that you make a glass of wine the rare exception until your body is no longer the nest of the growing baby. anon
and i think this is the article they are all talking about in the new york times, but i can't be sure....
either way, there's not much research on drinking lightly while pregnant and even if there is, its up for grabs... but there is a lot about epidurals.... more than what's on this blog if you want it.... anyway, so silly.
that causes paralysis of your entire lower body, potentially forever, not to mention numerous complications etc. i guess i do get it... i mean i think it makes no sense but i could see thinking that way if all i knew was what doctors say... cause they act like alcohol will kill your baby but epidurals are "completely safe", when they have never been proven to be, in fact proven more often to be the opposite.
this is info from a frequently asked questions website about epidurals....
Research on the Effects of Epidural
The summary to follow in this FAQ is from a book: "Obstetric Myths versus Research Realities" by Henci Goer, pub. Bergin & Garvey, 1995 ISBN 0-89789-427-8. (send me email if you want ordering info - I love this book, but do not wish to abuse the net with advertisements!)
Ms. Goer has written medical pamphlets and magazine articles for 10 years, and is an ASPO (Lamaze) certified childbirth educator and labor support person (doula). She has read through the literature, given overviews and abstracts as well as the citations for those who wish to read the original research. She starts out with a section on how to understand the statistics and read the literature with an eye to a well-designed study. The amount of work in this book could only be appreciated by seeing it - I have included only a few of her citations and this is only one of many topics covered... This book was written for birth professionals, but a consumer-oriented version is coming soon (est. early 1999).
Here is the summary from the section on epidurals:
Epidurals substantially increase the incidence of oxytocin augmentation, instrumental delivery, and bladder catheterization. (21 studies cited) [Saunders, NJ, et al. "Oxytocin infusion ... primiparous women using epidural..." BMJ 1989;299:1423-1426]
In first-time mothers, epidurals substantially increase the cesarean rate for dystocia. (12 studies cited) [Thorp, JA, et al. "The effect of intrapartum epidural ..." Am J Ob Gyn, 1993;169(4):851-858]
Epidurals decrease the probability that a posterior or transverse baby will rotate. Oxytocin does not help. (7 studies)
Having an epidural at 5cm dilation or more eliminates both excess posterior/transverse and excess cesarean for dystocia. (2 studies)
Epidurals may not relieve any pain or may not relieve all pain. (3 studies)
Innovations in procedure - lower dosages, continuous infusion, adding a narcotic - have not decreased epidural related problems. (13 studies) [Naulty, JS. "Continuous infusions of local ..." (this is a literature review) Int. Anes. Clin. 1990;28(1):17-24]
Delaying pushing until the head has descended to the perineum increases the chances of spontaneous birth. (a time delay of 1 hour is not really delaying - it needs to be a positional not timed thing...) Evidence is divided as to whether letting the epidural wear off before pushing increases spontaneous delivery. (4 studies)
Maternal complications of epidurals include: [Uitvlugt, A. "Managing complications of Epidural Analgesia" International Anesthesia Clin. 1990;28(1):11-16]
* Maternal hypotension(5 studies). This reduces uteroplacental blood supply and can cause fetal distress. (8 studies)
* Convulsions (4 studies)
* Respiratory paralysis (3 studies).
* Cardiac Arrest (6 studies)
* Allergic Shock (2 studies)
* Maternal nerve injury due to needle injury, poor positioning, forceps injury, infection, hematoma, or subarachnoid injection of chloroprocaine. The last three usually cause permanent injury. (9 studies)
* Spinal headache (3 studies)
* Increased maternal core temperature. (2 studies)
* Temporary urinary incontinence. (1 study)
* Long-term backache (weeks to years), headache, migranes, numbness, or tingling. (2 studies)
Serious complications occur despite proper procedure and precautions. The epinephrine test dose can cause complications. (12 studies)
Epidural anesthetics "get" to the baby. (5 studies)
Epidurals do not protect the fetus from distress. In fact, they cause abnormal fetal heart rate, sometimes severe, which may occur with or independant of maternal blood pressure (11% - 43% depending on the study and type of medication used - the 43% was found with Bupivacaine, the most common drug for epidural.) (15 studies) [Stavrou C, et al. "Prolonged fetal bradycardia during epidural analgesia" S Afr Med J 1990;77:66-68]
Epidurals may cause neonatal jaundice. (2 studies) [Clark, DA & Landaw, SA. "Bupivacaine alters red blood cell ... jaundice associated with maternal anesthesia" Pediatr. Res. 1985; 19(4):341-343]
Epidurals may cause adverse neonatal behavioral and physical effects. (these are both direct effects and indirect effects from the increased rate of labor complications and interventions.) The importance of this is debated. (4 studies)
Epidural anesthesia may relieve hypertension, but hypertensive women are at particular risk of epidural-induced hypotension, which reduces placental blood supply. (2 studies)
the book's author is henci goer check it out.
and this is just many different opinions about what women do in europe... where overall people tend to be healthier, happier and less stressed....
Do European women give up drinking?
January 2004
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I am currently pregnant with my second, and just as with my first, I am missing wine with dinner. I was so careful in my first pregnancy to avoid alcohol altogether, except for a very occasional sip. I always felt, though, and still do, that the prevailing no-amount-is-safe orthodoxy in this country is a little extreme, and probably inaccurate. I know that we have a number of European women in this network, and I would like to ask them about how drinking and pregnancy are viewed in Europe. I am especially curious about France and Italy where wine is so much a part of the dining experience. Do women in France and/or Italy stop drinking altogether when they get pregnant? Or do they continue to drink a glass of wine with dinner? What do French/Italian doctors and midwives tell their patients about drinking wine (or other alcohol) during pregnancy? How do French and Italian women view the no-alcohol-at-all approach in the U.S? Any French femmes out there with views to share?
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I am an American who spent her first pregnancy in Paris. My OB was an American, though she had been there for quite a while. In my experience, the ''no-amount-is-safe orthodoxy'' you described is particularly American. At restaurants, waiters would be routinely surprised, even shocked, when I would pass on having a glass of wine, even when I was visibly (very visibly!) pregnant. In fact, a few times my OB even directed me to have a glass! During that pregnancy I drank wine fairly often (a couple of glasses a week? My memory is rusty), but I did not drink hard alcohol nor did I drink during the first trimester (but that part is just personal superstition, not based on medical evidence). I'm now pregnant again (in the Bay Area this time) and, although my opinion on the! subject hasn't changed, I've found that I drink less -- though it may simply be because we go out to dinner less frequently!
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I am not a European mother, but I have been in the health information field for several years and I can tell you this: no health education or prenatal care expert will go on the record saying that any amount of alcohol during pregnancy is okay. Alcoholism is such a problem, and the effects of binge drinking so devastating, that the safe public health message is to abstain completely. No one knows what a ''safe'' amount of alcohol is either, as scientists are loathe to run those kinds of studies on pregnant women, for obvious reasons. Privately, you might get your obstetrician to say that a drink or two in the last trimester is okay, or don't worry about that Tom Collins you drank before you knew you were pregnant. Probably there is a big c! ultural difference in the approach to alcohol in pregnancy, between here and Europe, but it is based on true concern about problems caused by alcohol abuse in pregnancy. a health writer
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I'm neither from Italy or France, but from Spain, where the wine culture is also very extended. The tendency I've seen while visiting pregnant and have heard from friends who leave there is that, in general, the attitude it more relaxed with regards to wine and other alcoholic beverages. I think the believe is that as long as it's not in excess and accompanied by food it won't harm the baby and it may help the future mom!
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While I cannot give you the French view, here is my personal European perspective. I am German and spent the first few months of my pregnancy over there. ! ; I asked my very experienced OB/GYN (he's been caring for pregnant women for about 30 years) about alcohol. He thinks that there is no evidence that the occasional glass of wine harms the baby. His general recommendation about nutrition was to eat/drink what you really crave, and to leave out anything that you have to force yourself to take - with the following precautions as far as alcohol is concerned:
1. No regular drinking (i.e. every single day).
2. No binge drinking (i.e. having quite a few drinks in one session).
3. Not hard liquor; stick to wine or beer.
Having said that, a German friend of mine strongly craved wine throughout part of her pregnancy, and had a small glass of wine almost every night over dinner for quite a few weeks (I believe this must have been in the second trimester). Her little boy is gorgeous and perfectly healthy. I also have a friend who had a hard time calming down! and going to sleep during pregnancy. She had a glass of beer virtually every night before going to bed, deciding that sleepless nights or medication would be more harmful to the baby than the beer (her baby is also bright and healthy).
Most of my European friends probably went the moderate route I took. I cut back on my 'wine every night with dinner' habit but continued to have the occasional glass throughout my pregnancy. It's a very personal decision, and only you can decide what you are comfortable with. Whatever you choose, though, don't let others make you feel guilty!! Many women around the world drink some wine during pregnancy and have perfectly healthy babies. You clearly care, and you'll find the right middle ground that works for you and your baby.
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Having just reviewed some of the literature on the effects of alcohol during pregnancy for the pediatric theory class I teach to nurse practitioners students, I would have to say that drinking during pregnancy is a very bad idea. They are still studying this issue and there may be periods of increased susceptibility, or genetic susceptibility, but they don't know enough to say how these variations affect the fetus. There was an article about this research in the NYT a few months back. You might want to go back and read it. I was surprised to learn how small amounts of alcohol can have subtle, but nasty, effects on some fetuses, see citation below:
''Adverse behavioral effects in children exposed prenatally to risk levels as well as low and moderate levels of alcohol have been reported by many researchers. Neonatally, habituation to stimuli (lessening of response to repetitive stimuli) was most affected and at 8 months, significant effects were observed by using! the Bayley Mental Developmental Index and Pyschomotor Developmental Index scales (global scales of infant behavioral functioning). 17 Furthermore, infants have longer reaction times when exposed prenatally to low to moderate levels of alcohol. 18....These findings suggest that alcohol teratogenesis can affect academic and social functioning even with prenatal alcohol exposure at social drinking levels.''
Sokol, Robert J. MD. Delaney-Black, Virginia MD, MPH. Nordstrom, Beth PhD. Fetal Alcohol Spectrum Disorder. JAMA. 290(22):2996- 2999, December 10, 2003
''Fetal alcohol exposure (even at ''social drinking'' levels) is associated with developmental difficulties in adolescence that are consistent with problems seen earlier in life. Clinicians should understand the potential role prenatal alcohol exposure plays in behavioral and cognitive problems'' J. Am. Acad. Child Adolesc. Phsychiatry, 1997, 36(9):1187-1194.
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I'm not European (sorry!) but I am an epidemiologist and toxicologist. We obsess about finding the lower limit of toxicity/effect. Yes the research says that one drink a day is within the acceptable limits but we are notoriously poor at measuring things in people who vary so greatly. Believe me, the epidemiology is not that good. I say, why take a chance? that is your child. Buy some pomagranate juice or the best grape juice you can find and get some peace of mind.
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Hi! I'm French, just returned to France after a year in Berkeley. I've never stopped drinking a little wine with dinner during my 3 pregnancies, and I felt OK with that. Important for me was not to drink without a meal, no strong alcohol, only wine (French wines have less alcohol that Californian wines)a! nd never more that one small glass. I was a little more careful when nursing my baby than when I was pregnant.
I think the no-alcohol rule is reasonable, but I don't feel like being reasonable all the time, it's important to be happy !
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As an American mom who enjoys a glass of wine with dinner -- or two ... or even three ;^) --as much as any of those bon vivant French femmes out there, here's my unofficial & personal opinion for which the Berkeley Parents Network cannot be held legally responsible or liable: Hold off until after the first trimester, then go ahead & uncork that lovely merlot & sip in moderation. Since you'll only be having one small glass with dinner, do consider treating yourself & upgrading to a finer-than-usual vintage. I did do a bit of research on the wine & pregnancy issue. It's hard to find information on this since doctors, nurses, midwives, & publishers of pregnancy information *have* to stick to the ''no amount is safe during pregnancy'' orthodoxy for legal as well as professional reasons. Since nobody knows the exact point at which alcohol consumption crosses the line from harmless to posing a hazard to the baby's development, it's better to err on the side of caution & try to avoid negative outcomes & the accompanying potential for lawsuits. However, it really *is* better to avoid alcohol & other potentially harmful environmental factors (paint fumes, dangerous falls, serious illnesses, etc.) during the first trimester, because that's when the baby's central nervous system & other vital organs begin developing. Those four margaritas you quaffed before you knew you were pregnant are probably okay though (as long as this isn't a normal habit), since humans are pretty resilient & it takes a week or so for the egg to implant in your uterus & begin sharing your blood supply.
You can also find more honest & open perspectives on email newsgroups like this one & online message boards hosted by medical & women's Web sites.
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I got pregnant while we were traveling in Italy in 2001. We had friends in Milan who arranged for me to visit their OB, and it was very interesting. He scoffed at the idea of having to give up wine, and said that a glass at lunch or dinner was fine. However, he was very concerned that I understand the widespread problem of toxiplasmosis in Italy, due to the number of feral cats in the fields where produce was growing. He told me to absolutely avoid rare meats and uncooked vegetables--no salad! (He also had a very fancy ultrasound machine with two viewing screens, so that my husband could watch the results sitting at a desk rather than leaning over me at the examining table. And he gave us a video of the ultrasound! But it was in the European video format, so we never watched it.)
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Here's an affirmative response re: alcohol while pregnant. In both my pregnancies, I had episodes of strong early contractions, and guess what? My doctors (two different practices) both times suggested that I lie down and have a glass of wine or two. Of course I was very apprehensive about this. But they assured me that it was safe and might very well help slow down the contractions. In both cases, I was past the first trimester, and in both cases they also urged me to make sure that I was well-hydrated. So I think it's safe within reason, but I should also clarify that I never had more than a glass or so of wine a week. My kids show no ill effects (and neither was born early).
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I'm sure you will get lots of comments on this one! Wine has been an important mutual interest for my husband and I for more than 20 years ! (wine groups, vacations to wine regions, collecting, etc.). During my first pregnancy, I had maybe 3-4 SIPS of wine the entire pregnancy. My second pregnancy I had a heart to heart with my OB (tops in the field) and asked whether it would be truly harmful if I occasionally had a 1/2 glass of wine with dinner. My OB said that her insurance wouldn't allow her to say it was okay, but in fact especially after the first trimester, a little wine with dinner wasn't going to do any harm. A pediatric MD friend of mine agreed. My European friends say that their doctors allow up to TWO GLASSES per day!! Personally, I was very happy to be able to have a half glass now and then. It certainly added to my quality of life during my pregnancy and while I undertand the dangers of fetal alchohol syndrome - its beyond belief that an occassional glass of wine with food after the first trimester could do harm. The syndrome w! as associated with alcoholic or heavy drinking women but given that a link was made between alcohol and birth issues, the medical community (really, the insurance companies) began preaching a ''zero tolerance'' rule. On the other hand, I did completely give up shellfish during my pregnancies!! By the way, both of my children were born totally healthy!
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I stayed away from absolutely everything when I was pregnant the first time. However, when I went into early labor, I was given a combination of drugs to stop the labor that were horrible. When the same thing happened with my second pregnancy, my new O.B. told me to go home and drink a glass of wine. I was surprised, and she pointed out that the glass of wine was far less harmful to the baby than the combination of drugs I had been given to stop labor the last time. I continued to drink a glass of wine, or a beer, almost daily for the rest of my pregnancy, which not only prevented my early labor, but also tasted good, too! BTW, my babies were both over 8 pounds, and as healthy as could be. I would say that certainly in your last trimester, there is no medical reason w! hy you can not have a glass of wine here and there. For the record, ask you O.B. Mine (who is very well respected) said it was fine.
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My wonderful OB told me that I could have a drink a day, more or less, when I told him I missed my after-work glass of wine or beer. Both my sons are big, bright, handsome fellows. I didn't have a drink every day, but many days I did have one. I suppose no alcohol is a good goal, but the level of puritanism now tied to pregnancy is sort of out of hand, IMHO. Use your noggin -- that's all it is.
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I found the attitude to drinking while pregnant in this country to be a bit silly. I am British and the general consensus in the UK is that it is perfectly fine to have a few glasses of wine per week, but o! f course, that binge drinking should be avoided. While I was pregnant I encountered women here who were rude enough to criticise me when I drank in public. I find this very offensive, and puzzling too, given that many of the same women were perfectly happy to take drugs during childbirth! Incidentally, I gave birth to a very healthy nine pound baby, so I say go ahead and enjoy your glass of wine!
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Here's a voice from Italy. Our doctors recommend moderation with alcohol, however an occasional glass a of wine at meals is OK. I was living in Scotland when I got pregnant and there the rule was maximum 1 unit of alcohol per day (1 unit= a glass of wine or a pint of beer!). It always seemed like a lot of alcohol to me and since it didn't appeal to me while pregnant I avoided it altogether for the first trimester, but I had a half a glass of wine a few times during the rest of the pregnancy.
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While I was pregnant I had a pregnancy book from the U.S., Canada and France. Interestingly they said different things about alcohol. The U.S. book recommended to completely stop drinking alcohol, the Canadian book said that once in a while wine was fine and the French book suggested that one glass of wine a day is fine but to watch out for hard liquor. So I made up my own rule of one glass of wine a day on the weekend only.
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Both my children were born in Europe - one in Switzerland, the other in Belgium - where the extreme precautions taken in America are viewed as exactly that. Of course I asked my OB/GYN in both countries about wine during pregnancy (and hair coloring as well - go ahead, but perh! aps wait until after the first trimester) and was told to enjoy a glass of wine, if I wished, with my dinner. As long as I was in otherwise good health and the pregnancy was going well, there were no major precautions given (obviously a glass of wine is different than a gin and tonic - use your judgement!). No raw fish, no soft cheeses (Brie and the like) - and that was it (one will often see French and Belgian women enjoying Steak Americaine/Steak Tartare, a popular dish consisting of finely minced raw steak mixed with raw egg and capers - a health nightmare for us cautious Americans!!!). Take my doctors' advice and enjoy your glass of wine - of course stop at one, and drink a glass of water with it perhaps, but there is no reason to avoid it completely. In Denmark they might tell you red wine is good for your breastmilk; in Belgium, dark beer! I enjoyed a glass of wine when I felt like it and both my children were b! orn healthy and enormous. Be prudent about your consumption and enjoy your pregnancy!!!!
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my American-born cousin who has lived in Italy all her adult life says beer is great for breast milk production and they believe it helps with colic. For pregnancy she said you don't want to drown the baby but a glass or so of wine is considered normal in her region, she lives in the town of Perugia (1 or 2 glasses of wine may in fact be considered none at all.) I am not European but have several friends and family members who are, and I did drink occasionally during my pregnancy. I don't think I felt like it in the first trimester, but after that I would have a half glass of wine occasionally and on a handful of occasions had a full glass. A good friend of mine is European and is now the head of the pediatric clinical education program at Cornell University, as well as the mother of two children. Her opinion is that drinking in moderation is absolutely fine. My daughter was 9 plus pounds and was completely healthy at birth, and she's now 19 months and has met every developmental milestone early. The thing that I found surprising was that even after you have the baby the sanctimonious attitude continues. Although there have ! been no reliable studies showing that moderate drinking has a negative impact on breastfed babies, and even a few studies that show the opposite, you will read in many U.S. baby books that you should not drink ANYTHING while breastfeeding. Once again, I have drunk in moderation since having our daughter, who is still breastfed, and I have not noticed any impact on her. A mom who believes in everything in moderation
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When my sister-in-law was pregnant in France, she was told to limit herself to a glass of wine with meals, no more than 2 cups of coffee, and no more than 5 cigarettes. Recommendations for baby care are different too. Those recommendations have a cultural basis, not just a scientific one. In all probability, the greatest health risk to drinking an occasional glass of wine during pregnancy is that someone might see you drinking it and attack you. Still, I w! anted to mention the information about smoking, since I suspect many people in this area would have a very different reaction to a pregnant woman smoking 5 cigarettes/day. Jennifer
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I've also read the NYT article and other reports on the latest research on alcohol and pregnancy. It's reported that alcohol, even a very small amount, can actually cause more damage in the baby's brain than drugs. If you wouldn't do drugs ''occasionally'' or ''just a small amount'' while you're pregnant, you certainly wouldn't want to drink alcohol either. It's probably better to be on the safe side and not drink, for just 9 months. Chris
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Regardless of what doctors here or in Europe advise, they can't guarantee everything that goes on inside our bodies. Ultimately, we are responsible for our bodies and their intake. Please ask you! rself if you want to risk guilt, if something goes wrong and live with the feeling that something may not have happened "if only you did something differently". I'm actually not much of a disciplined person myself, but when I was pregnant I considered it an honor and chose to change my nutrition from one day to the next (in practice of learning how to serve my baby's needs - not a bad time to start) and as soon as I had my entire body back to myself, I went back to wine, beer, french fries and the occasional junk food. (I guess, it also helped in just gaining 30+ lbs instead of 50-60). I just knew I had given it my best intentions and the rest was up to fate - I was at peace with that. another European mom
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I appreciate the diversity of opinions expressed regarding drinking while pregnant. I am concerned that in the responses it would seem that the main danger to exposing a fetus! s to alcohol is fetal alcohol syndrome which may sound extreme to folks who do not have a great deal of information. There are many other possible devastating outcomes: in my family of origin, one of my siblings ended up with the condition of hydrocephalus which translates to a whole variety of health problems, not the least of which is life long developmental disability. Was this due to my mother's drinking while pregnant? While I cannot say for sure, there is much evidence (both anecdotal and from medical professionals)to suggest that the drinking was a primary cause. This has impacted our family immeasurably, both in direct ways (the life long care for my sibling, for instance) as well as the less tangible ground swells of unspoken guilt and blame.
When I was pregnant, I read the literature carefully and determined that a very few glasses of wine in my final trimester would be acceptable. My baby is healthy and fine- but I think it is imperative that women know as much as possible about the dangers- and that for those nine months, what we don't know (and after reading the variety of responses, it is clear that we do not know definitively)can have devastating effects. I would urge- no matter what evidence you have from other cultures- that you make a glass of wine the rare exception until your body is no longer the nest of the growing baby. anon
and i think this is the article they are all talking about in the new york times, but i can't be sure....
either way, there's not much research on drinking lightly while pregnant and even if there is, its up for grabs... but there is a lot about epidurals.... more than what's on this blog if you want it.... anyway, so silly.
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