How much weight should I gain?
Weight gain should be slow and gradual. In general, you should gain about 2 to 4 pounds during your first three months of pregnancy and 1 pound a week for the remainder of your pregnancy, unless otherwise directed by your healthcare provider.
Your healthcare provider will tell you how much weight you should gain during pregnancy. A woman of average weight and height and/or normal BMI before pregnancy can expect to gain 25 to 35 pounds during pregnancy. You may need to gain more or less weight, depending on what your healthcare provider recommends.
It is not necessary to “eat for two” during pregnancy. It’s true that you need extra calories from nutrient-rich foods to help your baby grow, but you generally need to consume only 200 to 300 more calories than you did before you became pregnant to meet the needs of your growing baby.
Follow the guidelines below if you are gaining weight too quickly during pregnancy.
What if I have gained too much weight?
Be sure to eat a variety of foods to get all the nutrients you and your baby need. Follow the guidelines and serving recommendations on The Food Guide Pyramid to avoid further excess weight gain. Think about the foods you eat and avoid those foods that will not give you and your baby the nutrition you both need. Follow the glycemic index,which is simply a measurement of the impact carbohydrates have on your blood sugar levels. Check out http://tinyurl.com/8vqbtv. Make sure you are active and getting adequate time in for exercise.
Keep in mind that you will lose some weight during the first week your baby is born. You’ll be surprised at how quickly you lose the remaining weight by following a balanced diet and exercising.
Domestic Violence Awareness Month
Joanne sat bruised and exhausted, hugging her large, pregnant belly. In her mid-30s, blonde and blue-eyed, she was a respected teacher in an elementary school, but tonight she felt like a fugitive. Neither her mother nor her sisters knew how to reach her or where to find her. She was ashamed to say anything to them. But, for the first time in months, she at least felt safe. She would sleep tonight in the shelter. In the morning, she would call the school where she taught and tell them she needed a few days off for a family emergency. If she ever returned to her three-bedroom home, she reminded herself, she needed to change the locks on the front door. Joanne was married to a well-educated man, with a good job. He was also a wife abuser.
Joanne is not alone. One out of every 15 pregnant women in the United States is a victim of domestic violence each year.
WHAT IS DOMESTIC VIOLENCE?
Although even one incident is one too many, domestic abuse is defined as a pattern of behavior of threatened or actual violence committed by a current or former intimate partner. Domestic abuse is not only physical violence. Partners can also be emotionally or psychologically abusive by: failing to show affection or caring for a child; interacting only when necessary; staying emotionally uninvolved and detached. Why? The abusive partner usually seeks to gain power and control in the relationship through fear and intimidation. The abuser tries to control his partner’s behavior by isolating her from friends and family, monitoring her movements, belittling or humiliating her in private or in public or restricting her access to financial resources.
The abuser may force her to have sex or to perform sexual acts that make her feel degraded. He may limit her access to medical care or threaten to hurt himself or take away her children if she does not comply with his wishes. Sometimes women are not aware that they are being abused. They may believe that their partner’s behavior is due to a bad day at work, financial pressures, jealousy, depression or use of alcohol or drugs. Often, the abuser will say he’s sorry, bring her gifts, and promise never to hurt her again. Cultural or religious norms may also play a role in one partner’s response to the other’s controlling or punishing behavior.
WHO IS AT RISK?
According to a report released by the Johns Hopkins School of Public Health and the Center for Health and Gender Equity, “Violence against women is the pervasive yet least recognized human rights abuse in the world…The same acts that would be punished if directed at an employer, a neighbor, or an acquaintance often goes unchallenged when men direct them at women especially within the family.”
A U.S. Bureau of Justice study reports that women of any age and from any racial, ethnic, religious or socioeconomic background may experience physical or psychological abuse from an intimate partner, but that women between the ages of 19 and 29 reported more violence by intimate partners than any other group. In the United States, domestic abuse is also a crime. Although partner abuse exists among same-sex relationships, violence against women is most often perpetrated by a male partner they know and love. Many, like Joanne, are afraid or ashamed to talk about or report it.
VIOLENCE DURING PREGNANCY
Domestic violence tends to begin or escalate during pregnancy. In fact, one in six women reports their first incidence of partner abuse during pregnancy. One study concludes that a woman is more likely to be abused by her partner than suffer from pre-eclampsia, gestational diabetes or placenta previa, conditions for which women are routinely checked. The abuser sees his partner’s pregnancy as a threat; he believes she will care more about the baby than about him. Pregnant women in abusive relationships are at higher risk for medical complications that include bleeding problems, miscarriage, vaginal and cervical infections, high blood pressure and premature labor and fetal distress. Abuse in pregnancy also increases the risk for low-weight gain and low birth weight infants. Once the baby is born, domestic abuse may escalate.
WHAT ABOUT THE CHILDREN?
Young children are often silent witnesses to domestic violence, and many are also the targets of their fathers’ physical, emotional or sexual abuse. Each year an estimated 3.3 million children in the United States are exposed to violence by family members against their mothers or female caretakers. Children exposed to violence at home are likely to suffer from chronic depression and anxiety and may express their sadness and anger through acting out, defying people in authority and through other behavioral problems. Children may become too traumatized to learn or develop normally and may be unable to reach their full potentials as adults. Children who witness domestic violence at home are more likely to repeat the cycle as adults. Experts say young girls are more likely to tolerate abusive behavior from their own intimate partners, and young boys are more likely to become abusers themselves.
One in every five women who seeks medical care in emergency rooms is there as a result of injuries inflicted in a domestic violence dispute
U.S. businesses spend an estimated $5 billion dollars a year on medical expenses related to domestic violence and another $100 million per year for lost wages, time away from work, and employee turnover directly related to family violence.
More than 1 million women a year seek medical assistance for potentially lethal injuries caused by battering.
Approximately 2,000 to 4,000 women in the United States are killed each year by abusive partners or ex-partners.
Making a Safety Plan
When you feel ready to leave your home, it will be helpful to have put aside some things that you will need. It may be safer to keep those items at a neighbor’s or a friend’s house:
Extra set of car keys
Cash, checkbook or credit cards
Driver’s license and social security cards (for you and your children), green card, passport or work permit
Clothes for yourself and your children
Children’s school records
Health insurance cards
Court papers or court orders
Lease agreements or mortgage payment book
Taking the First Step
Making a decision to end a relationship with an abusive partner is often difficult. For some women, it is the desire to protect their children that brings them to the point of asking for help. Taking action is hard because domestic abuse usually takes place over a long period of time and a woman’s self-esteem and confidence are slowly eroded. She becomes isolated from her community, friends and family. A woman may also remain in an abusive relationship because she is afraid of what family members may say or because she lacks financial resources. She may worry about compromising her partner’s professional status in the community. Often, she still has hope that the abuse will stop and that her partner will come to his senses. Each woman knows when she is ready to leave an abusive relationship. When she does, she can take the first step toward ending the abuse by asking her midwife, other healthcare provider, the police or her employer-assistance program for help.
BREAKING THE SILENCE
Help is available. Call the toll-free National Domestic Violence Hotline: (800) 799-SAFE (7233). From all 50 states, the District of Columbia, Puerto Rico and the U.S.Virgin Islands, victims of domestic violence, their families and friends receive crisis intervention, referrals to shelters, medical care, legal assistance and social-service programs. Trained counselors who speak more than 125 languages are available.
Are You in a Dangerous Relationship?
Your partner may be a good provider, a successful and respected member of his profession, even a caring father of your children. You may still love your partner and he may be sorry for hurting you and may promise never to do it again. However, he may also behave in ways that are considered abusive and illegal.
How can you tell?
Have you ever been afraid of, or felt threatened by your partner?
Do you worry that things you do may cause your partner to get angry, emotionally abusive or physically violent?
Has your partner ever attempted to injure you physically by grabbing, punching, kicking, arm twisting,choking or pulling your hair?
Has your partner ever hurt your pets or destroyed your clothing or other things you care about?
Has he threatened to destroy or take away your home or personal property?
Has your partner prevented you from taking medication, seeking medical care, or insisted on being present at all medical appointments?
Does your partner control your access to financial resources? Decide what and how much you can buy? Control the bank accounts? Refuse to pay bills?
Does he hide deeds to your home, wills, financial savings, and passports?
Has your partner threatened to harm himself or other people you care about? Has he ever threatened to harm or take away your children?
Does he prevent you from communicating with other people by withholding phone calls, keeping you from speaking with or visiting co-workers, friends or family? Prevent you from going to work or school?
Do you feel as though he is constantly checking up on you?
Does your partner often put you down, devalue your abilities, and make you feel guilty,or embarrass you in front of others?
Does your partner demand to have sex when you don’t want to or when you are ill? Force you to perform sexual acts that make you uncomfortable or hurt you? Hurt sexual parts of your body? Insist on unprotected sex or use of pornography?
If you have answered yes to one or more of these questions, know that none of this behavior is acceptable; you don’t deserve it. You may want to seek counseling. If you feel you are in danger, help is available to you 24 hours a day when you are ready to seek it. You can call the National Domestic Violence Hotline toll-free, (800) 799-SAVE (7233) or (800) 787-3224 (TDD). You don’t have to give your name, and your wishes will be respected. Trained counselors who speak several languages are available immediately. They can provide crisis assistance and information about shelters and health care centers, as well as free legal assistance and counseling. If you are in immediate danger, you should call 911.
Domestic violence is not biased, it crosses all socioeconomic backgrounds. Stop it now. IT may save you and your family’s life.
Article by Nicette Jukelevics, Childbirth Educator certified by the International Childbirth Education Association
Presented by Angel J. Miller, MSN, CNM, CEO, WomanPlace, Inc.
Generally, it’s possible to safely continue breast-feeding while pregnant — as long as you’re careful about eating a healthy diet and diligently drinking plenty of fluids. There’s an important caveat, however. Breast-feeding can trigger mild uterine contractions. Although these contractions aren’t a concern during an uncomplicated pregnancy, your health care provider may discourage breastfeeding while pregnant if you have a history of preterm labor. In an uncomplicated pregnancy there is no evidence that continuing to breastfeed will deprive your unborn child of necessary nutrients. In addition, according to the LeLeche League International Breastfeeding Answer Book, 3rd Edition 2003, page 407. “Although uterine contractions are experienced during breastfeeding, they are a normal part of pregnancy. Uterine contractions also occur during sexual activity, which most couples continue during pregnancy.” if you are having a difficult pregnancy and are at risk for preterm labor and birth, and in particular, have been advised to avoid intercourse during pregnancy, then weaning would probably be advisable.
It is important to have a healthy diet if you plan to breastfeed during pregnancy. Depending on how old your nursing child is, you may need an additional 650 calories a day if your breastfeeding child is under the age of six months, or about 500 if your child is now eating other foods. This is in addition to the 350 (second trimester) and 450 (third trimester) calories you need during your pregnancy. (No additional calories are needed during the first trimester as you work your way through morning sickness and some healthy foods are just not palatable. In malnourished populations, pregnant, nursing mothers do have lower weight gain and lower weight babies, as well as lower weight nursing siblings, than those who wean.
If you’re considering breastfeeding while pregnant, be prepared for changes your nursing child might notice. Although breast milk continues to be nutritionally sound throughout pregnancy, the content of your breast milk will change — which may affect the way your milk tastes. In addition, your milk production is likely to decrease as your pregnancy progresses. These factors could lead your nursing child to wean on his or her own before the baby is born.
Your comfort may also be a concern. During pregnancy, nipple tenderness and breast soreness are common. The discomfort may intensify while breast-feeding. Pregnancy-related fatigue may pose challenges as well. If you want to continue breast-feeding while pregnant — or breast-feed both the baby and the older child after delivery — you may need additional support from loved ones or other close contacts. Also check with your health care provider about taking supplemental prenatal vitamins.
Info provided from Midwifery Care Associates and LeLeche League International, Breastfeeding Answer Book, 3rd Edition, 2003.
Sara Walters, B, Breastfeeding During Pregnancy, Carmathen Wales UK; from New Beginnings, Vol. 25, No. 1, January-February 2008, pp. 32-33
Originally posted on thebipolarbastille.:
For Williams, we dropped the ball. As society we didn’t step in, couldn’t help, and we are the ones who lost. We are the ones who were lucky to have known such a brilliant artist, and we are the ones heartbroken in the loss.
I am sure by now we have all heard about the devastating loss of actor Robin Williams. Williams, who had suffered from depression, committed suicide after years of battling a crippling foe some of us know all too well. Depression, a component of many mental illnesses, is hard for some people to understand. How could someone just throw away everything? I have heard individuals close to me even say they could never forgive someone who committed suicide. “It’s the most selfish thing in the world.” These individuals understand suicide to be the easy way out. And in some cases it is selfish. But it…
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What to Strive For During Pregnancy
Develop a positive attitude. Pregnancy is for most women a happy, healthy time in which their bodies function the way they were designed to do. It is a time of looking forward not only to having an adorable baby, but also to starting an exciting, and challenging phase of life. Even though it can be a little scary because it is a new experience, most fears can be overcome, by thinking of it as a great adventure with a great reward at the end. Maintaining a realistic but optimistic attitude goes a long way in helping you through the pregnancy and birth even when everything does not go exactly as you expect. Please trust your body and your intuition. Trust your healthcare providers so that they can work with you to make your pregnancy, birth and early parenting experiences the best that they can be. Learn all you can about pregnancy, birth, and parenting. Read, take classes and watch DVD’s. Your healthcare providers want to help you become a well-informed consumer so let them know what you need to know during your visits. Ask questions!!
• Eat well. Good nutrition is important for a healthy mom and baby. Eat a well-balanced diet with adequate protein, fruits, vegetables, whole grains, and calcium. Most need extra calcium and magnesium supplements for bone health along with Vitamin D3. In addition to a balanced diet women should take a prenatal vitamin throughout the pregnancy. Some women may also need additional iron supplementation or an increase in iron rich foods. Optimal weight gain varies depending on your starting weight. A weight gain of about 15 pounds is recommended for those who are overweight at the beginning of pregnancy. The average weight for height woman should plan to gain 25-35 pounds. Those who are underweight need to gain approximately 28-40 pounds during pregnancy to ensure optimal nutrition for the fetus as well as building their own reserves.
• Exercise. Along with eating well, regular exercise is an important part of being healthy. With a normal pregnancy it is safe and helpful to exercise throughout your pregnancy, though some forms of exercise might not be appropriate during late pregnancy (i.e., kickboxing). Check with your healthcare provider especially if beginning an exercise program. You need to pay special attention to hydration, heart rate and body temperature, but, if done appropriately, exercise can help you have an easier pregnancy and labor! If you are able to talk through your activity, that exercise activity is appropriate.
Women who exercise routinely will have:
• less interventions during birth
• fewer Cesarean births
• shorter labors
• less risk for gestational diabetes
• lower rates of depression
General Exercise Guidelines:
• Thirty minutes of moderate exercise almost every day is appropriate for a normal pregnancy. (If you were inactive pre-pregnancy, you will need to start at a much slower level).
• Make sure you balance exercise with periods of rest and relaxation.
• Listen to your body; it is possible to hurt yourself, even with gentle exercise. As your belly grows, your center of gravity changes, joints soften, and positions or exercises that were easy become challenging. Listen to your body if it says “I need a break.” Avoid long periods in the supine position (lying directly on your back).
• Pay special attention to hydration, heart rate and body temperature. If you start to feel overheated, you should slow down and stop.
• No directed abdominal exercises after 20 weeks of pregnancy. As your baby and belly grow, abdominal muscles separate and focused strong abdominal exercise will exacerbate the separation.
• Enjoy sex during pregnancy. Enjoyment of sex during pregnancy is a healthy, satisfying part of a couple’s total relationship. Female orgasm during late pregnancy will cause uterine contractions, which are harmless to the baby and will not cause premature labor. (If orgasm did cause labor, induction of labor would be a simple, fun procedure!) Different positions for intercourse will need to be used as the woman’s abdomen enlarges. Any position which is comfortable is safe. Increased or decreased desire in women is normal both during pregnancy and the postpartum period.
• Intercourse should be avoided under the following conditions:
• After the membranes (bag of water) have ruptured – there is danger of infection.
• When bleeding or premature labor occurs, or if you have been told that there is a medical reason to avoid sex (such as with Placenta Previa)
• Women who have had repeated miscarriages (more than 2) should avoid intercourse during the time they usually miscarry.
• The only sexual activity reported as dangerous is blowing air into the vagina of a pregnant woman. This can detach the placenta from the uterine wall and/or cause an air embolism. If you have questions about sex, please feel free to discuss them with the nurse-midwives.
• Travel if you wish. All types of travel are permitted during a normal low risk pregnancy. In pregnancies after 36 weeks, you should consider the fact that you may end up giving birth in an unfamiliar place with an unfamiliar provider. Try not to travel more than one hour away from your planned facility for your birth. Air travel is permitted as long as the airplane cabin is pressurized. Most airlines require a letter from your provider after 34 weeks gestation. Travel to high altitude locations is also permitted up to approximately 6000 feet. Be sure to drink plenty of water and walk around intermittently during the trip (every 60-90 minutes)
• Prepare your birth plan. You may develop a birth plan during your childbirth education class with your partner. Please be realistic and limit to two pages. Decide who you want to be with you and what each person will do to help. Be sure to tell your healthcare provider of any special procedures that you would like or want to avoid. Be sure when you complete your birth plan or “wish list” you discuss it in detail with your healthcare provider(s).
• Purchase and properly install an infant car seat. Most if not all states have child seat safety laws. Please obtain an infant car seat by 36 weeks so you may safely transport your newborn to and from home.
• Choose a pediatrician or family practice doctor. The following are some sample questions to ask:
• Where is the office located in relation to your home? The ease of travel to the office at any time and especially in an emergency is very important.
• If the doctor is a family practice physician, ask him/her what arrangements he has made in case of an admission to a hospital. Does he/she routinely see newborns?
• Where does the doctor have hospital privileges? What are the special practices, if any, of that hospital’s pediatric unit, i.e., open visiting or rooming-in?
• Does the doctor have staff privileges at the hospital where you might go for the birth of your baby? If not, who will see your baby?
• What is the size of the practice? How long do you have to wait to obtain an appointment? How much time is designated for each appointment?
• Who are the other persons who may be associated with the physician, another physician you might see, and/or a pediatric nurse associate who can answer many of the daily parental concerns? Is there a telephone hour?
• What are the arrangements for covering emergency calls, including nights and weekends?
• What are the various costs for care: office visit, immunization, telephone consultation, emergency visits?
• What are the doctor’s views on infant feeding? (Bottle and breast feeding as well as how to start the intake of solid food.)
• Is the doctor supportive of breastfeeding?
• What is the doctor’s management for newborn jaundice?
• How many times does the physician expect to see the baby for normal health maintenance?
• What are the doctor’s responses to your questions? If invited into the office, take the opportunity to observe doctor-child interaction. Did you feel comfortable talking with the physician?
• Discuss circumcision vs. no circumcision and his/her views on immunizations.
• Ask your friends who they use and what they think of their relationship with their pediatrician or family practice doctor.
Since these are suggested guidelines, you may have some other criteria upon which you are making your decision. You need to feel comfortable with the physician you choose for your baby.
What to Avoid During Pregnancy
• Take any medications (prescription or over-the-counter) without consulting your healthcare provider.
• Consume excessive amounts of caffeine. Recent studies have shown small amounts of caffeine are not harmful.
• Drink alcohol. The current recommendation is that no amount of alcohol is proven safe during pregnancy.
• Smoke. In addition to the risks of tobacco related disease for the mother:
• Babies born to mothers who smoke average 6 ounces less at birth than babies of nonsmoking women (a lot when only considering 7 or 8 lbs.!)
• Nicotine restricts the blood vessels and oxygen circulation of the mother.
• Increased carbon monoxide in the mother reduces oxygen levels in the fetus’ blood.
• Vitamin metabolism is disturbed in both mother and fetus.
• Incidence of low birth weight babies greatly increases for those who smoke one pack or more per day.
• There is a direct correlation that exists between smoking during pregnancy and the increased incidence of premature rupture of membranes, preterm labor, placenta abruption and stillbirth.
• Behavioral effects on infants of smoking mothers, determined by developmental testing, are noted as long as 8 months after birth.
We urge you and/or your partner, if either or both of you smoke, to register in a Smoking Cessation Program in your area. IT is the best thing to do for you, your partner, and your baby.
Your family is your life and protecting your children from harm’s way is a growing problem and now it is now possible with technology. Your child’s safety and whereabouts can now be monitored via your smartphone. Children can have the ability to alert you when they are under duress, in trouble or find themselves lost.
Children 2-10 years old, toddlers and even newborns traveling and under supervision of others can be monitored 24/7 in five minute intervals and located immediately and automatically via e-mail or text messaging. You set the schedule – minutes or hours – and receive regular alerts with the exact location of your child. An SOS button allows older children to summon for help which includes their location as well as automatic tracking alerts to entrusted individuals you choose to receive them.
This child tracking solution is dependent upon 2 technologies – GPS (Global Positioning System) and wireless communications or cell phone (GSM). Anywhere you can receive both a GPS signal and have cell phone reception, the solution will work.
The solution was developed by the father of a young daughter who became lost at an amusement park for several hours. After finding her and being an IT technologist, decided to develop a solution for preventing this from happening again. He funded Amber Alert GPS and engineered the Law Enforcement Alerting Portal (‘LEAP”) used by law enforcement in states to issue the actual Amber Alerts. The LEAP system is the fastest and most efficient alerting technology in the nation, and allows States to share Amber Alerts cross-borders. To date, law enforcement in the States using the LEAP system have a 100% recovery rate of all children for whom an Amber Alert was issued.
Protect your children.
It is common to be in labor without your water breaking. Actually, only thirty percent of women experience their water breaking before the start of labor.
What Is My Bag of Waters? The bag of waters—or amniotic sac—is a bag or “membrane filled with fluid that surrounds your baby in your uterus during pregnancy.” The bag of waters is very important to your baby’s health. The fluid protects your baby and gives your baby room to move around. The bag itself protects your baby from infections that may get into your vagina.
Is it urine or is it amniotic fluid? If you are leaking, it can be difficult to determine if your membranes are leaking or if it is urine. In most cases, it is probably urine. There are several ways to tell the difference, but there is no definite answer. When in doubt, smell it! Urine has a distinct smell and color. You will leak urine when your bladder is full, when coughing , sneezing or laughing; even when you are exercising.
Only 3 percent of pregnant women will go into premature labor (before 37 weeks) as a result of ruptured membranes. In most cases your membranes will rupture as you are nearing the end of your pregnancy, and this is definitely one of the early signs of labor. If your water does break in public, and you have visions of a huge gush of water running all over the floor, then you have probably been watching too many movies. It is most likely going to occur as a slow trickle, or at most, a small gush of fluid of colorless and odorless amniotic fluid.
It is common to be in labor without your water breaking. Actually, only thirty percent of women experience their water breaking before the start of labor.
What Should You Do When Your Water Breaks ? First, don’t panic! Follow the instructions your healthcare provider discussed with you if and when your water breaks. Immediately after your water breaks, know that nothing should be placed in your vagina at this point. This will help prevent infection.
- Wear a maxi pads, not tampons, to keep the amniotic fluid from wetting your clothes
- Keep your vaginal area clean
- When you go to the bathroom, be sure to wipe from front to back
- Sexual intercourse is officially off-limits
Call your healthcare Provider immediately if:
- Your due date is more than 3 weeks away from today
- The water is green, or yellow, or brown, or has a bad smell
- You have a history of genital herpes, whether or not you have any herpes sores right now
- You have a history of Group B strep infection (“GBS positive”)
- You don’t know if you have GBS or not
- Your baby is not in the head-down position, or you’ve been told it is very high in your pelvis
- You have had a very quick labor in the past, or feel rectal pressure now
- You are worried.
- If you feel something in your vagina, or see any of the umbilical cord at the vaginal opening, get medical help immediately
Call your health care provider within a few hours if:
•Your due date is within the next 3 weeks and
• You are not in labor and the fluid is clear, pink, or has white flecks in it
• Your baby is in the head-down position
•Some health care providers will want you to come in to the office to confirm that the bag of waters has broken and listen to the baby’s heartbeat as soon as you notice that the bag of waters has broken. Others will suggest you stay home for several hours to wait for labor to start.
What Do I Do Until Labor Starts? Most women will go into labor within 48 hours. If you are waiting for labor to start and your bag of waters has broken:
• Put on a clean pad
•Do not put anything in your vagina
•Drink plenty of liquids—a cup of water or juice each hour you are awake
•Get some rest
•Take a shower
•If there is any change in your baby’s movements, call your health care provider right away
Check your temperature with a thermometer every 4 hours—call right away if your temperature goes above 99.6. For more information regarding this topic visit: