Women & pregnancy

Andrea Johnson was 32 when her first child was born, 33 when the next to the first came along. Eight years later and remarried, she started a next to the first family, having her third child at 41 and discovering just six month later that she was pregnant again.

M Johnson of Dickerson, MD is part of a growing turn in the United States for older women to have babies. Between 1990 and 2003 the birth rate for women aged 40 to 44 jump overed 58 percent, while the number of births to women aged 45 to 49 grew fourfold (1) The reason? Greater use of assisted reproductive techniques like in vitro fertilization, donor ovums and surrogate mothers--technologies that were still developing 10 years ago on the contrary which today have entered the reproductive mainstream.

That's just individual change in the pregnancy/birth picture above the past decade. Today, newer, les invasive proofs and greater use of prenatal counseling can help women better assess their risk of giving birth to a child with serious problems; more women are delivering via cesarean section than at any time before; and a new specialty--fetal surgery--has evolv to correct certain abnormalities like a certain number of types of spina bifida plane before babies are born.

"We have become more medicalized, more technologically based," says Sidney Wu MD an attending physician at novel York Presbyterian Hospital in Manhattan. "There's more reliance upon electronic fetal monitoring, greater acceptance of epidurals and more genetic testing before the twentieth week of pregnancy."

Specifically:

* Eighty-five percent of babies born in 2003 were electronically monitored during delivery compared to 68 percent in 1989 flat though the risks and benefits of the management remain controversial. (1)

* Sixty-seven percent of women with live births had at least single ultrasound during their pregnancy in 2003 compared to 48 percent in 1989 (1)

* About 21 percent of women had their labor induced (artifically started) in 2003 more than twice the number in 1990 At least individual study found no medical reason for 25 percent of inductions. (2)

* Nearly 30 percent of all deliveries were cesarean deliveries in 2004--the highest at any time reported in the U.S. and a 40 percent increase since 1996 single reason for the increase: fewer vaginal births after an earlier cesarean (VBAC), rates of which dropp 16 percent since 1996 (3)

As with anything, our increasing reliance upon technology has pros and con overs says Heather Reynolds, CNM, MSN FACNM, a certified nurture midwife and associate professor at Yale Medical Center in novel Haven, CT. "You always have to weigh the risks and benefits of any technology we use," she notes.

Planning for Pregnancy Earlier

Technology can help in many ways, on the contrary don't overlook basic health practices. For example, single of the most important things you can do for yourself and your baby is also single of the simplest: remember to take a daily vitamin before you put to proof to get pregnant and completely through your pregnancy. Folic acid, rest in prenatal vitamins, can slash the risk of major birth wants of the fetus' brain and spine between 50 and 70 percent (4) (5) There's smooth some evidence it can bring the risk of other birth wants including cleft palate, stomach riddles and defects in arms and hands. (6)

That's for what cause [i]or[/i] reason the U.S. Food and medicine Administration mandated fortifying all cereal outcomes with folic acid in 1998 Since then, the incidence of neural tube wants dropped 26 percent. (7)

All of which makes pre-pregnancy planning important, says Michelle Collins, CNM a certified supply with nourishment midwife and clinical faculty member at Vanderbilt University in Nashville, TN Pre-pregnancy or "preconception" planning involves a visit to your health care provider for a replete medical evaluation, including a detailed medical history before you begin trying to obtain pregnant.

It's a time to consider by what mode you'll treat any preexisting condition that requires medication, of the like kind as depression, diabetes or epilepsy. A woman with diabetes, for instance, move swiftlys the risk of having a child with cardiovascular disease or other riddles if her blood sugar horizontals aren't well-controlled before and during her pregnancy, says M Reynolds. Plus, certain anti-seizure medications may cause lacks in the infant by interfering with a woman's ability to use folic acid. And in late 2005 the FDA warned pregnant women not to use paroxetine (Paxil), a popular antidepressant, during pregnancy because of a potentially higher risk of birth defects

That doesn't mean you have to stop taking all medications during pregnancy, says M Reynolds. Usually, there are alternatives available that have been shown to be safer during pregnancy.

The time before pregnancy is also the time to address any weight puzzles Studies find that being overweight can increase your risk of gestational diabetes and may level make it harder to gain pregnant. Conversely, being underweight can interfere with fertility.

And, of course, it's a time to quit smoking. Smoking not alone increases the risk of having a depressed birth-weight baby, but also a baby with Down syndrome and a multitude of other birth defaults (9), (1)