Friday, March 19, 2010

Dads in the Delivery Room and One Man's Story

A few months ago, a French obstetrician suggested that if fathers really wanted to help their partners in the delivery room, they would just stay away. They may think they are helping, Dr. Michael Odent said, but they are probably only making the mothers stressed, slowing their production of the hormone oxytocin, which results in a prolonged labor and an increased risk of cesarean section.

Whether this is true is the subject of much debate, but even if it is, the argument misses a key reason for the increase in the percentage of fathers in the delivery room. They are there to support the mothers, yes, but they are also there for themselves.

Josh Tyson says he believes this. His second son was born a few months ago, and today he describes the dad’s-eye view of birth. He found new emotional depths in that room, he writes — the deep joy of meeting his son, the deep awe of watching his wife.

The Performance by Josh Tyson

I’ve seen a man pull a line of boxcars with his teeth. I’ve watched a friend light his chest on fire and let another friend hop over his flaming torso on a skateboard. I’ve seen an actor on ”Deadwood” very convincingly pretend to pass kidney stones. None of this even comes close to the awesome experience of seeing my wife, Nicole, give birth.

She has done it twice now. The first time was in January 2008, when she was pregnant with our son Elias. She began having contractions early on a Sunday morning, but following the advice of doctors we waited to go to the hospital until later that night, when her contractions were minutes apart. In the interim, we packed an overnight bag, ran several errands and went to see “There Will Be Blood.” While I was impressed with Daniel Day-Lewis’s artful displays of brute force throughout that movie, several hours later, I saw a bend of will and determination I had never encountered (there was also blood). My wife passed on an epidural and spent several hours battling contractions on a birthing ball. I kept my mouth shut and rubbed her lower back in between each round. As the breaks between contractions got shorter and shorter and the contractions went longer and longer, I didn’t know what to do, other than hold her hand and watch for the top of a head. We were both screaming by the time she pushed our son into this weird, weird world, and the looks on our faces in a picture that the midwife took paints a very accurate portrait of how we felt. Dazed. Confused. Overjoyed.

Her second performance came just weeks ago, again in January (our boys have consecutive birthdays on the 13th and 14th). Her water broke in bed at 5:30 a.m. — something new — and I ran to the linen closet to get some towels, thinking, How can this actually be happening again? Nicole was calm. She called the doctor and each of our mothers, and her only gripe when we arrived at the hospital two hours later was that she was dripping fluid everywhere. The delivery-room nurses were surprised when we told them Nicole didn’t want an epidural. She is only about 110 pounds without child but exhibits a genuine fierceness of character and body that continually surprises me. There were six other births happening that morning, and we found out that Nicole was the only one going without drugs.

I thought of the weeks leading up to a minor operation to remove my wisdom teeth when I was 19. At the time, I obsessively imagined and re-imagined the oral surgeon’s cracking the teeth into four pieces and ripping them from my jaw line, and every time, my stomach would drop and I would get lightheaded. I was sort of, maybe, a little bit on the verge of tears the morning of the procedure. Once I was in the chair, they couldn’t gas me fast enough. Then I tried to imagine nine very slow-building months of knowing that when the creature inside you was big enough, he would push his way out of a very small opening, millimeters at a time — nine months of knowing that the requisite pain is singular and unmatched by any other form of discomfort known to our species. I thought about enduring that pain for a second time and began to wonder what the hell my wife was thinking.

“It was hard because this time I knew that as bad as it hurt, it was going to hurt even more,” she told me afterward, “but at the same time I also knew that it doesn’t last forever.” Her other point was that she wanted to be engaged with giving birth to this little man. And engaged she was. After about 30 minutes on a Pilates ball, she announced that she was ready, and the nurses came rushing in. Her doctor had to run from a nearby building and made it just in time to coach her through five rounds of pushing. This time, I helped hold one of her knees out to the side so she could open her hips and push. As amazed as I was at her focus —she pretty much just chanted the mantra “O.K.” between contractions before getting down to business — I was equally astonished at how powerful her vagina is. I’ve always been a big fan of my wife’s, but now I have the slightly intimidating sensation of sharing living space with a veritable oracle.

What I have seen my wife do is nothing short of astonishing. I’m sure that, had she taken an epidural, it still would have been a more-than-memorable experience, but watching her summon all of her strength and channel it directly into such a small and elastic part of her body was phenomenal. The fact that it gave rise to our amazing son Arius makes me sure that nothing that I’ve seen anywhere can or ever will compare. I am a very proud and humbled husband, looking forward to tapping my wife’s immense fire and might as we continue along the divinely beleaguered path of parenthood.


When Picking Baby Names, Beware of Initials

If your little girl grows up, gets married, and decides to take her husband's last name - it won't be your fault if her new initials form an undesirable three letter word.

As if you didn't have enough to worry about when choosing a name for your little one, here is one more thing to pay attention to. Here is a list of initials you should try to avoid.

  • O.V.A. You may have had a hell of a time conceiving, but your baby's initials don't need to remind her of it for the rest of her life.
  • R.U.B. The jokes here are endless, from "rubber ducky" for the younger set to dealing with "rubber" ribbings as they enter the teenage years.
  • D.O.C. Bugs Bunny reruns will still be on the Cartoon Network. Why subject him to a lifetime of "What's up, doc?"
  • S.T.D. Really, do you need me to tell you why?
  • H.O.E When kids make fun of your kid, they won't be referring to the gardening tool!
  • E.F.F. So many people I know (myself included) replace a curse from flying our of their mouth by saying something like, "are you effing kidding me?" So by the time your baby is a big kid I am guessing "eff" will be just as bad as saying "f**k."
  • P.I.G. Pigs are cute and lovable until kids turn 4 or 5 years old. Then they become fat smelly things that roll around in the mud.
  • U.G.H. Would you want these initials? Enough said!
  • D.U.I. Innocent lives are taken regularly because adults can't get it through their thick skulls that they should not DUI. That is a terrible, terrible association for a kid to have with their name.
  • V.A.J. Bad for a girl... worse for a boy.
  • I.C.K Can't you just see a very sweet Ivy Coraline Konte having to endure her classmates calling her "icky?"
  • I.L.L. Why set your kids up for a lifetime of sickness? Unless, of course, you think being ill is cool - and then it's acceptable.
  • K.U.M. Ewww. Gross.
  • S.I.N. Atheist or not, you can't deny that starting your kid off with these initials could potentially doom them for life.
  • B.O.O. Oh ... the jokes won't only surface around Halloween, but they could potentially turn a fun kid holiday into a dreaded time of year.
  • R.I.P. You do know this stands for "rest in peace," right? And people say that when you are dead. Probably not the best set of initials to give a newborn.
  • F.A.Q. Already pegging your kid as a Mr. Know-It-All? Don't do it ... it means they'll turn out the opposite!
  • B.A.R. I guess you could decorate the nursery with vodka bottles and peanut cans?
  • K.I.S. This will be especially hated around age 11 when the boys and girls pretend not to like each other, but really do like each other, and are constantly egging each other on to kiss anyone of the opposite sex!
  • F.A.T. Really bad if your kid has any kind of weight problem.
  • Y.O.U. How many times do you think they'll hear, "Why is it always about you?"
  • L.U.V. I actually like this one ... so if your last name begins with a "V" i recommend finding a first and middle name that form these initials.
  • R.A.W. An under-cooked chicken could kill you with that damn salmonella poisoning. Raw could mean death.
  • F.O.X. How many people really have a last name that begins with an X? Still, unless you are Rubert Murdoch's kid, there is no need to be the namesake for "the most trusted name in news."
  • F.L.Y. If I thought of "fly" as in "Superman can fly" then this would be a cool set of initials, but all I can think about is an annoying insect that wants to land on my food... or the zipper you never pulled up on your pants.
  • J.I.Z. Ewww. Gross again.

Feel free to add to the list!


Triplet births on the rise

A new BJOG study reveals how the rate of births from triplets has increased, even after excluding pregnancies that were the result of assisted reproductive technology (ART) in the form of in vitro fertilisation (IVF).

Norwegian researchers examined the records of over 2 million pregnancies in the Medical Birth Registry of Norway between 1967 and 2006, to compare births from triplet pregnancies with singleton and twin pregnancies. All reported live births and stillbirths from the 16th week were looked at. Triplet births are known to be associated with higher adverse pregnancy outcomes when compared to singleton and twin births and this was tested by observing trends in birth weight, gestational age and perinatal mortality. Although perinatal mortality has fallen over the last forty years for singletons, twins and triplets, the perinatal mortality for triplets remains 10 times higher than that for singleton births.

The study focused on two periods: 1967 – 1987 and 1988 – 2006 (after ART was introduced) and these were further divided into five-year blocks. The peak incidence of triplet births were between 1987 and 1991 (3.5/10,000 pregnancies). This decreased to 2.7/10,000 between 2002 and 2006, probably as the result of the introduction of new national clinical guidelines recommending a policy of single embryo replacement at IVF (with which all fertility clinics in Norway have adhered). However, the rate of triplet pregnancies remains almost 2.5 times higher than it was in the 1970s, most likely due to the use of ovulation inducing drugs (such as gonadotrophins and clomiphene) which are not recorded as ART in the official figures, and the increase in average maternal age.

Maternal age for triplet pregnancies increased by an average of 2.5 years when comparing both time periods while the cesarean section rate in triple pregnancies increased from 46.7% to 92%. The gestational age of triplet births fell from 34.1 weeks in the first period to 32.1 weeks in the second period. This was matched by a fall in the birth weight of triplets over the two time periods. However, the perinatal mortality rate for triplets was 13.6% before the introduction of ART and 7.1% afterwards, reflecting the improvements in neonatal care. This fall only paralleled that in singletons, and the comparative ten-fold higher risk of death for triplets remained unchanged.

The Norwegian data showed, in agreement with most other studies, that the fetal growth rate for triplets slows in the third trimester when compared to singletons. This is the result of competition between the fetuses for nutrients in the womb. Researchers also note that modern obstetric practice recommends early intervention for triplet births and the improved perinatal mortality rate observed confirms the appropriateness of this practice.

“Our study findings show that it is very important to prolong the triplet pregnancy beyond the 28th week of gestation. The mortality rate below versus above this cut-off point is 50% and 3.8 % respectively.”

“To reduce the number of triplet pregnancies further, all hormonal treatment for ovulation induction should either be monitored more carefully with cancelling of multifollicular cycles, or moved to IVF with single embryo transfer.”


Thursday, March 18, 2010

Study Links High Stress During Pregnancy To Children's Asthma Risk

Massachusetts researchers say stress experienced by mothers during pregnancy increases the risk their children will develop asthma.

The researchers, with Brigham and Women's Hospital and Harvard University in Boston, looked at the differences in immune function markers in umbilical cord blood between babies born to mothers in high-stress situations and those with lower stress.

They said in a statement that they found noticeable differences in patterns that could be linked to asthma later in the children's lives.

The researchers said their study is the first to show that increased stress in urban environments could account for the high prevalence of asthma among African-American children.

Animal studies have already suggested that a mother's stress during pregnancy can impact children's immune system.

The study is published in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.


Infertility treatments may raise preterm birth risk

Couples who conceive through certain types of infertility treatment may have a higher-than-normal likelihood of having a premature baby, a new study suggests.

Danish researchers found that among more than 20,000 women who gave birth at their hospital between 1989 and 2006, those who had conceived through in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) had a higher risk of preterm delivery.

Of the 730 babies born to women who underwent IVF or ICSI, nearly 8 percent were premature and 1.5 percent were very premature -- born before the 32nd week of pregnancy. A normal pregnancy lasts 40 weeks.

In comparison, roughly 5 percent of babies born to fertile mothers were premature, and 0.6 percent were born very preterm, the researchers report in the journal Fertility and Sterility.

When the researchers accounted for factors like the mother's age, weight and exposure to cigarette smoking, the IVF and ICSI procedures were still linked to a 53 percent greater risk of preterm delivery and a doubling in the odds of very premature birth.

Other forms of fertility treatment -- namely, fertility drugs and insemination -- were not related to the risk of preterm delivery.

Nor was the higher risk with IVF and ICSI explained by elevated rates of twin or higher-order births. The study included only singleton births.

Together, the researchers say, the findings suggest that something about the IVF and ICSI procedures themselves might raise the odds of preterm birth.

Both IVF and ICSI involve joining a woman's egg and a man's sperm in a lab dish, then -- if fertilization is successful -- transferring one or more embryos to the woman's uterus. ICSI is typically used for male fertility problems, including a low sperm count or poor sperm quality. It involves isolating a single sperm and injecting it directly into the egg.

"The IVF/ICSI procedures include hormone stimulation and mechanical procedures. Both of these factors may influence the risk of preterm delivery," lead researcher Dr. Kirsten Wisborg, of Aarhus University Hospital in Denmark, told Reuters Health in an email.

The fact that other forms of fertility treatment were not linked to preterm delivery suggests that infertility itself is not to blame, according to Wisborg. However, she pointed out, couples who undergo IVF or ICSI may have a different "reproductive pathology" than those who conceive via fertility drugs or insemination, as they frequently have been infertile for a longer period and have failed to conceive through those "low-tech" fertility treatments.

There may also be other factors, unmeasured in this study, that put women who undergo IVF or ICSI at greater risk of preterm delivery, Wisborg said.

Another possibility, Wisborg said, has to do with the "vanishing twin" phenomenon. Some of the singleton births to women who underwent IVF or ICSI may have begun as a twin pregnancy, with only one fetus surviving beyond the early stages. Research suggests that these surviving fetuses are at increased risk of preterm delivery and low birth weight.

The most important factor in reducing preterm birth risk with IVF or ICSI is to avoid higher-order pregnancies, according to Wisborg. But women can also lower the risk, she said, by not smoking and avoiding alcohol during pregnancy.


Rheumatoid arthritis tied to pregnancy complications

Pregnant women with rheumatoid arthritis may have increased risks of high blood pressure, having an underweight baby or needing a cesarean section, a new study suggests.

Rheumatoid arthritis (RA) arises when the immune system mistakenly attacks tissue in the joints, leading to inflammation, pain and progressive joint damage. The disease is more common in women than men, and frequently develops during the childbearing years.

So far, studies have come to conflicting findings as to the potential effects of RA on pregnancy. Some, for example, have found that women with RA have higher risks of preterm delivery and having an underweight newborn, while others have found no such link.

For the new study, researchers used records from Taiwan's national health system to compare 1,912 new mothers with RA with 9,560 new mothers without the disease.

They found that women with RA had a two-fold higher risk of pre-eclampsia -- a potentially dangerous condition, marked by high blood pressure and protein in the urine, that develops in the second or third trimester.

Women with RA were also 47 percent more likely to have a low-birth-weight baby and 19 percent more likely to require a C-section, according to findings published in the Annals of Rheumatic Diseases.

Still, with the exception of C-section -- reported for 42 percent of women with RA and 38 percent of those without RA -- the large majority of women did not have these pregnancy complications.

Just under 3 percent of women with RA developed pre-eclampsia, compared with just over 1 percent of women in the comparison group. Eight percent of new moms with RA had a baby weighing less than 5.5 pounds, versus 5.5 percent of the comparison group.

Women with RA were also more likely to have a newborn who was "small for gestational age," a sign of restricted growth in the womb. The problem was seen in 17 percent of women with RA, and 15 percent of women without the condition.

It is not clear why there is an association between RA and certain problems of pregnancy, according to Dr. Herng-Ching Lin and colleagues at Taipei Medical University.

Although the current study was large and allowed the researchers to account for a number of factors in the odds of pregnancy complications -- like the women's age and family income -- it also lacked some important information.

The researchers had no information on the severity of each woman's RA or medication use during pregnancy. So it's not possible to tell how those factors might have affected the odds of complications, Lin's team notes.

A number of RA medications, like methotrexate and leflunomide, may be harmful to the fetus and must be stopped before a woman conceives. But certain other medications, like prednisone and non-steroidal anti-inflammatory drugs such as ibuprofen, may still be used during pregnancy.

Future studies, Lin's team writes, should try to determine the roles of RA severity and medication use in the pregnancy complications seen in this study. For now, the findings reinforce the recommendation that women with RA get good prenatal care, with regular visits to their obstetrician and rheumatologist.


Moms post-birth bleeding tied to early radiation

Women who had radiation to the abdomen in childhood to treat cancer may experience excessive bleeding after giving birth, new study findings suggest.

The study evaluated pregnancy and birth outcomes in 40 women who were 30 years old on average and had been treated when about 7 years old for cancers of the blood, kidney, bone, and other locations.

Twenty-eight of the women were pregnant with their first child, eight with their second, and the rest were on their third, fourth or fifth pregnancies.

In general, these women had outcomes similar to more than 9000 women who never had cancer, Dr. Sharon Lie Fong, at Erasmus Medical Center in Rotterdam, The Netherlands, and her colleagues found.

However, the six women previously treated with abdominal radiation appear to be the exception.

Although just two of the six bled severely after childbirth, percentage-wise this represents a higher rate (33 percent) of severe bleeding cases relative to that seen in the general population where just 5 percent bled after childbirth.

The researchers urge health care providers to be aware of this risk when treating women cancer survivors during pregnancy, particularly since this finding "has not been reported so far in childhood cancer survivors," Lie Fong's team notes in the journal Human Reproduction.

Notably, the women's very young age at cancer treatment -- about 7 years old on average -- did not seem to prevent harmful effects of radiation to their small, pre-puberty uteruses.

The six women who received radiation to the abdomen in childhood also delivered their babies an average of 4 weeks earlier than their cancer-free peers. However, babies born to the cancer survivors, including those previously treated with abdominal radiation, appeared as healthy as those born to cancer-free moms.

Due to the increased risks noted in this study, Lie Fong's team discourages home birth and encourages heightened prenatal care for women who received abdominal radiation for childhood cancer.


Wednesday, March 17, 2010

Kevin Costner Expecting His Seventh Child!

More celebrity babies on the way! Kevin Costner is expecting his seventh child!

The 55-year-old star and wife Christine Baumgartner are expecting their third child in June. They are already parents to two sons: Hayes Logan, 1, and Cayden, 2.

Costner has four children from previous relationships; three with ex-wife Cindy Costner, and one from a brief relationship following his divorce from Bridget Rooney.

Congratulations to the Baumgartner-Costner family!


Amy Poehler, Will Arnett expecting 2nd child

Amy Poehler and Will Arnett's funny family is growing.

A rep for the "Parks and Recreation" star confirms that Poehler, 38, is pregnant with her second child. Further information, including a due date, has not been released.

The new addition will join big brother Archie, 16 months, whom the former "Saturday Night Live" cast member delivered in Oct. 2008.

Known for their healthy senses of humor, Poehler and Arnett, 39, take parenthood a bit more seriously.

"As sort of clich├ęd as it sounds, it's just the best,” notes former "Arrested Development" star Arnett. "Because it's a human being that you're responsible for ... that's scary, but even in its scariest moments it's fantastic."


"Wonder Years" Danica McKellar is Expecting!

The Wonder Years child star, Danica McKellar, and her husband of one year, Mike Verta, are expecting their first child this fall, People reports.

"I'm nearing the end of my first trimester and I'm so excited - I've been bursting to tell people," says McKellar, 35. "When you do take the home pregnancy test, it doesn't quite seem real," says the mom-to-be. "But when you see the baby and the heartbeat on the ultrasound, it's so incredible. Me and Mike looked at each other and we could not stop the tears," she says. "We are so happy."

Also known for her role in The West Wing, Danica graduated summa cum laude in mathematics from UCLA, co-wrote and published math theorem in Hot X: Algebra Exposed, and continues to be an outspoken role model for young women to excel in math.

Congratulations to the McKellar-Verta family!


Tuesday, March 16, 2010

It's Always Sunny Stars Expecting First Baby!

It's Always Sunny in Philadelphia's Kaitlin Olson, 34, and Rob McElhenney, 32, are expecting their first baby this August, their rep has confirmed to PEOPLE.

"Rob and I are so excited it's stupid," says Kaitlin in a statement.

The last couple years have been pretty amazing for us and just when we thought things couldn't get any better, the greatest little thing in the world happened! We're totally beside ourselves.

The couple married in September 2008 in Malibu, Calif.

Rob, who created and executive produces It’s Always Sunny, will return alongside his wife for the sixth season this fall. Kaitlin recently made an appearance in Leap Year as Amy Adams’ best friend.

Congratulations to the happy couple!


Babies Are Born to Dance, New Research Shows

Researchers have discovered that infants respond to the rhythm and tempo of music and find it more engaging than speech.

The findings, based on the study of infants aged between five months and two years old, suggest that babies may be born with a predisposition to move rhythmically in response to music.

The research was conducted by Dr Marcel Zentner, from the University of York's Department of Psychology, and Dr Tuomas Eerola, from the Finnish Centre of Excellence in Interdisciplinary Music Research at the University of Jyvaskyla.

Dr Zentner said: "Our research suggests that it is the beat rather than other features of the music, such as the melody, that produces the response in infants.

"We also found that the better the children were able to synchronize their movements with the music the more they smiled."

"It remains to be understood why humans have developed this particular predisposition. One possibility is that it was a target of natural selection for music or that it has evolved for some other function that just happens to be relevant for music processing."

Infants listened to a variety of audio stimuli including classical music, rhythmic beats and speech. Their spontaneous movements were recorded by video and 3D motion-capture technology and compared across the different stimuli.


Monday, March 15, 2010

Psoriasis Increases Pregnancy Risks, Study Suggests

Pregnant women with psoriasis have a significantly increased risk of spontaneous abortion, preterm birth, hypertension ectopic pregnancy and other problems, researchers say.

The rate of each complication was three to four times greater than seen in women who did not have psoriasis, Dr. Xinaida Lima of Harvard University and Massachusetts General Hospital in Boston and colleagues reported in their poster presentation here at the American Academy of Dermatology meeting.

Authorities agree that pregnancy adversely affects psoriasis in most cases, but mixed results have come from studies evaluating associations in the opposite direction. Indeed, the study also suggested that women with psoriasis had a significantly lower rate of cesarean section compared with women who did not have the inflammatory skin disease.

Meanwhile, some past evidence has indicated psoriasis increases the risk of certain pregnancy complications, such as recurrent spontaneous abortion and hypertension. Other research has turned up no association between psoriasis and poor pregnancy outcomes.

Lima and colleagues sought to clarify the associations between psoriasis and pregnancy in a review of medical records for women with psoriasis diagnoses in the Partners healthcare system who became pregnant between 1999 and 2009.

For comparison, the investigators compiled a matched control group of women who did not have psoriasis.

The review identified 358 psoriasis patients who had had at least two diagnoses for psoriasis and 131,424 women who were similar except for no psoriasis diagnosis.

Preliminary statistical analysis showed that the women with psoriasis had significantly higher rates of five pregnancy complications:

  • Spontaneous abortion, 28.1 percent versus 7.2 percent
  • Preterm birth, 21.7 percent versus 7.4
  • Severe preeclampsia and eclampsia, 14.2 percent versus 2.9 percent
  • Placenta previa with and without hemorrhage
  • Ectopic pregnancy, 13.6 percent versus 3 percent

The C-section rate in the psoriatic patients was about a third that of the group without psoriasis, and that remained significant even after differences in race and obesity were taken into account.