Pregnancy and Birth

This month I had the pleasure of interviewing Simone Valk, a midwife practicing in Rotterdam, Holland. Simone graciously gave of her time to share a bit about herself, the training of midwives in Holland and the general nature of maternity care in Holland. The differences between our systems of healthcare is quite evident, but I found the differences in philosophy most impressive, and sobering.

As a midwife, I am often privileged to witness displays of human emotion that seem to occur exclusively within the context of birth. There are few other transitions of life that elicit the sort of emotion, be it positive or negative, that childbirth does. At every birth I attend there is always a memorable moment, often subtle and intimate, little insights into human nature that I tuck away in my subconscious.

In the United States, nearly one in four births is a cesarean birth. Many of these cesareans are unexpected, so it is a good idea for the expectant mother to become informed and educated about the procedure before her baby arrives.

The possibility of twins or more passes through the minds of every pregnant mother, but nevertheless having the presence of more than one fetus confirmed on ultrasound is a shock. Thankfully the length of the pregnancy allows plenty of time to adapt. Indeed, 'it' rapidly becomes 'they' and one feels a sense of incompleteness for those friends who are expecting just one.

As mothers-to-be, most women imagine a picture perfect pregnancy-- mild or no morning sickness in the first weeks, and within the fourth month, the soft kicking of new life within. Along with the growing, telltale tummy of an expectant mother, comes the choosing of a name decorating a nursery, buying baby clothes, and baby showers in honor of the mommy-to-be and the impending "arrival".

Prenatal-onset Group B Strep (POGBS) Disease: Giving a Name to Group B Strep DiseaseAcquired before Birth and Four Courses of Action to Help in Its Prevention

Multiple gestation is the medical term that refers to a woman who is pregnant with twins, triplets, or other higher-order multiple pregnancies. This will occur in slightly less than 2% of all pregnancies. Within the category of multiple gestation, twin births are by far the most common, accounting for 95% of all multiple pregnancies.

All obstetricians and reproductive endocrinologists know the placenta as the uppermost important organ for normal fetal growth till maturity. This endocrinological organ can be affected by many pathological states like other maternal organs.

To determine the risk factors related to recurrent caesarean section (C.S) morbidity and to suggest a morbidity scoring system based on these risk factors which can help in the prediction of C.S. morbidity.

In contrast to the pattern seen with singleton births, twins born to older mothers do not appear to have a greater risk of birth complications than do twins born to younger mothers, according to a recent study by researchers at the National Institute of Child Health and Human Development (NICHD) and the University of Kansas.

Vaginal deliver rates after previous caesarean section have been on the increase through the 1980s and 1990s but even at the dawn of the 21st century, trial of scar remains a controversy in obstetric care.

Several studies have been conducted about Bacterial Vaginosis and its relation with preterm labor that was accompanied with controversial results. The aim of this study was to compare the frequency of Bacterial Vaginosis and common genitourinary infections between term and pre-term pregnancies.

Cesarean deliveries are now the most commonly performed abdominal surgery in the United States. In 2005, an estimated 30.3 % of all births involved C-section procedures, and preliminary estimates from the Centers for Disease Control and Prevention indicate that the incidence of C-sections will continue to rise in the coming decade.

OBGYN.net spoke with Marti Perhach about her endeavors to increase awareness of Group B Strep and its effects on pregnant women and their babies. Marti is a woman who has faced the effects of GBS first hand and has shared her personal story with other parents.

Although Group B Streptococcus was first described over one hundred years ago, GBS began becoming noticed as a leading cause of infection and death in newborns only in 1961. According to the CDC, roughly 1 to 3 babies out of every 1,000 children born in the United States suffers invasive Group B Strep disease, mostly in the first week of life.

To compare, in singleton and twin pregnancies, the effectiveness of transvaginal ultrasound versus digital examination in predicting preterm delivery in women with suspected preterm labor.

The word "ectopic" means "out of place." An ectopic pregnancy is a pregnancy that is not growing in the usual location (the uterine cavity). Ectopic pregnancies can occur in a number of abnormal locations, each with different characteristic growth patterns and treatment options.

Ectopic pregnancy, or preembryo implantation outside the endometrial cavity (i.e., fallopian tube, cervix, abdominal or pelvic cavity), is a potentially fatal condition with an incidence of ~1:150 diagnosed pregnancies.

Expect to have feelings; about the labor, the birth, towards the baby, about nursing or not, about responsibility, about your partner, etc.

Test your ob/gyn knowledge in our DailyDx.

As soon as a pregnancy becomes recognized, each (prospective) parent generally starts to accept and plan for their new arrival. If the pregnancy is lost, this is often considered a "death within the family" and the couple will go through an intense grieving process. The loss of a pregnancy can be devastating for a couple, regardless of the number of children in the family or the cause for the loss.

She just paged you again. It is “urgent”, just like the last 5 times. You sigh deeply: no matter how many times you tell her that her labs are normal, explain that some shortness of breath is expected in the last trimester, or reassure her that her heartburn is not a first sign of a heart attack (yes, you checked) – it simply won’t stick.

Vulvodynia is a general term which means, simply and literally, "pain in the vulva." It is not the name of a disease, but a symptom, just like "headache." Vulvar vestibulitis is a syndrome in which there is pain at specific points in the vulvar vestibule (the portion surrounding the entrance to the vagina).

Pelvic pain in this category indicates a problem that if not treated urgently will cause serious harm or death. One serious cause of acute pelvic pain is a ruptured tubal (ectopic) pregnancy. Many women with a tubal pregnancy will continue to have menstrual-like bleeding, so they do not consider this possibility.

Most women experience pelvic pain at some time during their lives. Many times pelvic pain is just the normal functioning of the reproductive or other organs. Other times pelvic pain may indicate a serious problem that needs urgent treatment. Here we look at the causes of pelvic pain, and how the cause of pelvic pain is determined.

Many women want to know how to acquire a flat stomach. They are especially curious about this following surgical procedures i.e.: laparotomy, laparoscopy and hysterectomy.

In November of 1996 (at the age of 25) I was diagnosed PCOS, and about 2 weeks later I started having very intense pelvic pain that I thought was due to a pulled muscle. The pain continued for several months, and after an examination and discussion with my family doctor, we believed it was ovarian cysts.

Following caesarean section for abruption, a patient continues bleeding and is taken back to the operating room. There, a D & C is performed, and a Bakri balloon is inserted and inflated. The patient continues to deteriorate and shows signs of continued bleeding. After a third surgery, in which a hematoma was evacuated from under the fascia, the Bakri is released. After removal, there is no significant vaginal bleeding.

Hyperparathyroidism is a syndrome caused by excessive secretion of parathyroid hormone. Primary hyperparathyroidism results in raised ionized serum calcium with adverse effects on many organs. The effects particularly in pregnancy may be severe.

A Randomized Comparison of Group Cognitive-behavioral Therapy, Surface Electromyographic Biofeedback, andVestibulectomy in the Treatment of Dyspareunia Resulting from Vulvar Vestibulitis