December 30th, 2008
Do you have a living will? Do your friends and family members? If you’re here because you’re expecting a baby, the last thing you want to be thinking about is what could happen to you sometime down the road. But, it is precisely when we start our families that we begin to realize how fragile life is and how vulnerable we all are.
Living wills, or advance directives, are often thought of as something for the elderly or ill. While a living will is very important for them, it’s equally important for us when we’re healthy. As we have time to think about what we want, do research and talk to others, we can decide what we think we want should the unthinkable happen and we become incapacitated - unable to decide for ourselves what type of medical treatment we want. Or don’t want.
What is a living will?
A living will tells your family and doctor what it is you wish to be done if you’re not able to tell them yourself. For example, if you’ve been in a car accident and you are in a coma - how aggressive do you want the doctors to be? If you have cancer are in the last stages, how far do you want care to go? If you have a stroke and are considered to be in a vegetative state, do you want to be fed by a tube? Those are just a few of the questions that are answered with living wills.
Why have one if you’ve told people what you want?
Many of us have discussed with our families and maybe our friends, what we would like done for us if we ever become incapacitated. I know I have - but I also know that my wishes have changed over the years, depending on what stage we were at and how old my children were at the time.
If you’ve told your family what you want, this is a great start, but it’s not enough. When you’re ill or have been injured, they may not be in any shape to fulfill your wishes. They may not remember, they may think there’s hope - or maybe they aren’t around or have been injured as well. There are many, many factors that could result in your wishes not being followed.
Can you do it yourself?
While you can do a living will yourself, whether it will be recognized as a legal document to be followed by the healthcare workers may be very iffy. To be absolutely sure that your wishes are noted and will be followed for legal purposes, you should go through a lawyer or the legal designate for your province or state.
Are they revocable?
Absolutely! Just like a regular will, you don’t *have* to stick with what you’ve written for a living will. You can change your mind and change the contents whenever you want. The only thing that you must ensure is that every change is done legally and is noted for all to follow.
Do doctors have to follow the living will?
To learn the ins and outs of legal wills in your state or province, it’s best to get legal advice. A professional can help you understand what you can and can’t do.
So, do you have one? Are you thinking about getting one? I’m running a survey about living wills and am looking for answers from everyone - those who have living wills and those who do not. The goal of the survey is to get at least 1000 answers so we can try to determine what the biggest concerns are and where the educational needs are.
Please consider taking my survey, which you can find here: Living Wills and Advance Directives.
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Tags: pregnancy blog, living wills, chronic illnesses, advance directives
By Marijke -- 0 comments
December 30th, 2008
It may not have been planned that way, but could the lack of health insurance or under-insurance of millions of Americans be resulting in more home births?
If so, this could be both good and bad.
First the good: Many women want to give birth at home. A home birth gives them more control over the natural process and they feel it’s a better experience all around.
Now the bad: Some women, due to difficulties or health issues, shouldn’t be giving birth at home without putting themselves or their baby at risk.
According to this Salt Lake City Tribune article, More moms choose to give birth at home, some women and their partners are considering the thousands of dollars for a hospital to be a luxury and they’re opting for less expensive, midwife-led labor and deliveries.
While home births may be the right thing, money shouldn’t be the deciding factor. To me, there’s something wrong with that picture.
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Tags: pregnancy blog, home births, midwives, midwife, no health insurance
By Marijke -- 0 comments
December 30th, 2008
It seemed a bit odd when I first read the news report, but maybe it makes sense. You tell me.
Before it became so easy to move about the globe as easily as it is to move across a state or province, women who covered from head to toe in clothing, like with burqas or hijab with facial covering, lived in sunny, hot climates (most of the time). Countries that did have winter also had extreme summer conditions. But now, as immigration spreads throughout the world, women are bringing their traditional garments and wearing them in different climates, ones that may have very few hours of sunshine over extended periods of time.
According to this article, Ireland too grey for the burqa, wearing the burqa is severely restricting women from obtaining the necessary sunlight to absorb vitamin D and this, in turn, is affecting their babies. The issue is that in hotter, sunnier climates, the sun is strong enough to send rays through the clothing, while this isn’t possible in grayer, less sunny places.
The most commonly known problem with lack of vitamin D is rickets, the bowing and bending of bones because they aren’t strong enough to support a child’s weight. But there are other health problems that can affect a baby whose mother is vitamin D deficient. This includes a possible link with the children developing Type 1 diabetes later on in life.
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Image: iStock
Tags: pregnancy blog, muslim women, vitamin d deficiency, burqas
By Marijke -- 0 comments
December 29th, 2008
Since I’ve begun writing Womb Within, I’ve posted a few times about multiple births larger than 4 babies - it’s really not such a rarity it seems. But, it’s still newsworthy.
A pair of first-time parents have joined the super-multiple club as they welcomed their quintuplets (4 girls, 1 boy) on December 27. That’s one heck of a Christmas present! Born at Staten Island University Hopsital in New York, were said to have been named Allesia Louise, Amanda Frances, Ella Lilliana, Emily Ann and Matthew Sabatino, according to news reports.
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Tags: pregnancy blog, quintuplets
By Marijke -- 0 comments
December 29th, 2008
It’s a bit simplistic, but it gets the point across. If you’re wondering about nutrition while pregnant, why not play this Shopping cart game from the March of Dimes website.
As you wander down the food aisles and pick your groceries, you learn why certain foods are better than others. It’s worth checking out.
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Tags: pregnancy blog, nutrition while pregnant
By Marijke -- 0 comments
December 28th, 2008
At the beginning of the month, I drew your attention to an article about midwifery, Male midwives in history. The blog responsible for that post has followed up with another very interesting one called Men in the Birthroom.
You can learn about two French male midwives from the 17th century, Jacques Guillemeau and Francois Mauriceau, and how they felt about midwifery and female midwives. If you leave them a comment, tell them I sent you! :-)
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Tags: pregnancy blog, male midwives, midwifery, midwives
By Marijke -- 0 comments
December 25th, 2008
Hi all! If you celebrate the holidays, I hope you’re having a joyful and peaceful time. Some of you are celebrating with a new family member, while others are waiting for one to join them. And, some of you are hoping or praying that next Christmas, this will be you. Whatever situation you are in, I wish you a happy holiday.
I’m taking a short break from blogging, but not from working. I work a few days here and there in a chronic care/long-term place and I agreed to work yesterday, today, and tomorrow. Don’t feel badly for me - most people say that they’re sorry that I have to work Christmas. I don’t have to and although I’d rather not, nurses are needed 24 hours a day, 7 days per week.
So, I get to enjoy my wonderful family on Christmas Eve, Christmas night, and the next evening as well before I’m home during the day again.
Peace.
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Image: MorgueFile.com
By Marijke -- 0 comments
December 24th, 2008
Cycling champion and testicular cancer survivor Lance Armstrong is going to be a dad again, and this time without any outside help.
In 1996, Lance was diagnosed with an advanced stage of testicular cancer. It had spread throughout his body and was given a grim prognosis. However, the grim ending wasn’t meant to be and Lance lived to become a 7-time Tour de France cycling champion as well as head of his organization, Livestrong.org.
Lance was married when he was sick and after recovery. He and his then-wife Kristin Richards had three children using in vitro fertilization (IVF) because Lance had stored his sperm before undergoing chemotherapy. But - and here’s where this may give hope to many men who had testicular cancer - his girlfriend, Anna Hansen, is now pregnant and the couple didn’t use IVF or outside help.
The news doesn’t say when the baby is due, but hopefully all will go well for everyone.
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Tags: Tags: pregnancy blog, lance armstrong, cyclist lance armstrong, testicular cancer survivor lance armstrong, kristin richards, anna hansen, testicular cancer, in vitro fertilization, IVF
By Marijke -- 0 comments
December 24th, 2008
Pre-eclampsia, high blood pressure during pregnancy results in a high-risk pregnancy. Pre-eclampsia can lead to the much more serious condition, toxemia - also called eclampsia. Now, according to an Reuter’s article, Preeclampsia Test To Reduce Maternal And Neonatal Deaths, says that there may be a way to detect the risk of pre-eclampsia. This is a significant finding considering that pre-eclampsia affects between 3 to 10% or 5 to 8% of all pregnancies, depending on which statistics you use.
Aside from a rising blood pressure, women who develop pre-eclampsia start "spilling" protein into their urine, a substance that shouldn’t be there normally. This is one reason why a pregnant woman’s urine is tested regularly. According to the Preeclamsia Foundation, "Globally, preeclampsia and other hypertensive disorders of pregnancy are a leading cause of maternal and infant illness and death. By conservative estimates, these disorders are responsible for 76,000 maternal and 500,000 infant deaths each year."
If you’re pregnant, please take your blood pressure seriously! There may be some ways to help reduce the risk of developing pre-eclampsia: Stretching Exercises May Reduce Risk of Preeclampsia, Gum disease in pregnant women may raise risk for preeclampsia, and Pregnancy + Fiber = lower chance of preeclampsia?).
You can get more information on pre-eclampsia at the Preeclampsia Foundation.
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Tags: pregnancy blog, preeclampsia, pre-eclampsia, high blood pressure in pregnancy, eclampsia, toxemia
By Marijke -- 0 comments
December 23rd, 2008
As women, we tend to blame ourselves for a lot of things that aren’t even in our control. I’ve heard many women do this if their labor doesn’t progress - move quickly enough - especially if they end up having to have a Cesarean section (C-section) as a result.
So, why do some women have this problem?
First, the idea of labor dystocia, or failure to progress, is determined on how quickly it’s expected for a woman to take to dilate and deliver the baby. This does vary depending on if you’ve already had a baby or not as second and subsequent deliveries are usually (not always) quicker than the first.
The failure to progress isn’t measured by the overall length of the labor, but how long it takes to dilate per hour *and* how long it takes for the baby to come forward, or descend and get well placed to be born. For example, the rule of thumb for a woman having a second child is she should dilate about 1.5 cm per hour, while first time moms are a bit slower at 1.2 cm per hour. The usual rate for the descent is about 2 cm per hour.
It’s not unheard of for a woman’s labor to be "perfect" for the first few hours and then for the labor to stop progressing and this can be extremely discouraging and frustrating for the woman.
Why a C-section then?
Labor is hard work not only for the mom, but also the baby. Every time you have a contraction, an incredible amount of force is being placed on the baby - this is why the fetal heart is monitored so closely. The medical personnel want to be sure that the baby is able to tolerate the birth process.
If your labor doesn’t progress, this can become too stressful on the baby and the heart rate may begin to drop, putting the baby in danger. At this point, the doctor’s main concern is to get the baby out as fast as possible, and that is with a C-section.
What causes labor dystocia?
For many women, it just happens, but there are a few risk factors too:
- obesity - obese women may have more difficulty progressing through labor
- baby not in the right presentation, positioned in the best way for birth
- anxiety - maternal anxiety can cause the body to slow down
- dehydration - one reason IVs are used is to be sure that mom stays hydrated
- inefficient contractions
- large baby
- pregnancy past 41 weeks
- epidurals - for some women, epidurals slow down progress, but for others, they may speed it up
What can be done?
In many cases, the obstetrician will recommend oxytocin, a medication that brings on or spurs on labor. This may work, but if not, often the only option for a safe delivery is to intervene with a C-section.
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Tags: pregnancy blog, labor and delivery, labor dystocia, failure to progress, c sections, cesarean sections, epidurals
By Marijke -- 0 comments
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