Pre-Eclampsia

This seems to come up a lot when women tell me their birth stories. I cringe inside, because the majority of the time it ends up with a c-Section.

crbs1370057

What is it?

Symptoms are: elevated protein levels in the Urine; high blood pressure or steadily rising blood pressure; headaches; swelling of ankles, face and hands; upper abdominal pain; visual disturbances; kidney, heart, or thyroid problems (Romm, 211).

Toxemia (a later stage of this condition) is life-threatening. Do not ignore these symptoms!

How can it be prevented?

A good diet
Plenty of water (plain, at least 6 Eight ounce glasses daily)
Lowering stress in your life, 2 aspects: exercise and some sort of meditative practice.

What can I do if the doctor says I am beginning to have pre-eclampsia?

For High-Blood Pressure
Eating well (see my nutrition hand-out), exercise (see my handout for exercise), and lowering stress will all assist in lowering high blood pressure when the other indicators are ruled out.  Often times women do not drink enough water and water is the first thing the ER recommends for high blood pressure.

Swelling
These are things you can do to lower the swelling:

  • Elevate your feet for 20 minutes a day
  • Lie on the left side when sleeping or resting (assists blood flow)
  • Exercise 30 minutes a day (even a long walk will help).
  • Eat more protein and salt foods to taste. You can use natural mineral waters to assist in electrolyte balancing.

Herbals: add Epson salts to foot soak, drinking nettle and dandelion infusion (assists in balancing the kidney retention and flow of fluids).

Next: TOXEMIA

 

 

Miscarriage – Part 1

MISCARRIAGE

A miscarriage is when a pregnancy spontaneously ends. It usually occurs before the 28th week of gestation. Miscarriages occur in approximately 20% of all pregnancies in the United States.

Many women have a miscarriage early in a pregnancy, without even realizing it. The miscarriage just seems to be a “heavy” period. Teenage girls and middle age women are the most common age groups. Miscarriages are more common early on than after the first trimester.

Those women who tend to miscarry repeatedly, or those women who really desire a baby, the loss of a baby can be devastating. Because so many people do not discuss the loss of a baby through miscarriage women do not know what to expect or what to do.

Although painful to think about, and it sounds rather blunt, a miscarriage is nature’s way of preventing an unhealthy baby from being carried to term. It may seem hard to accept, but we should realize that our bodies have a wisdom of their own and prevention of a miscarriage will not be effective with an unhealthy baby.

Other causes for miscarriages include:

• Hormonal imbalances
• Cervical looseness ( called “incompetent cervix”, a medical term)
• Infections
• Nutritional deficiencies
PREVENTING A THREATENED MISCARRIAGE

The signs of a threatened miscarriage include spotting, bleeding, or cramping which may also include a backache. These symptoms may begin suddenly or develop slowly. They can last just a few hours, or may last for days. The spotting or bleeding may be all that occurs. Or the symptoms may be more severe and cause fear that the baby will be lost. A physical exam is not wise at this point as it may stimulate the uterus further. Chances are a woman will still have the symptoms of pregnancy (breast soreness or tenderness and nausea) after spotting or bleeding. Although not always a good idea, the use of the Doppler may help reassure that the pregnancy is still viable.

GENERAL RECOMMENDATIONS

• If You are having contractions or are bleeding / spotting, do get off your feet and rest. Get up only when you need to go to the bathroom.
• Avoid lifting heavy objects and abstain from sexual activity until all signs of a miscarriage have been gone for at least a week
• Warm (not hot) baths will release tension and anxiety, and bring relief to lower back pain.
• Take time, while resting off your feet, to connect with the baby and tell the baby you want him/ or her. Send your baby your love. This may or may not be helpful, but you will feel comforted and assured you are doing all that you can for the pregnancy. Let the baby know you want the baby but also reassure the baby that if he or she must go, you understand and give permission.
• If you are unsure about the pregnancy to begin with, this is a good time to come to terms with having or letting go of the baby.

DIETARY RECOMMENDATIONS

• To prevent a miscarriage, avoid all cold-natured and cold temperature foods. Cold has a downward moving, heavy force…causing an excess of downward flow in the pelvic area.
• It is better then, to eat warmer foods that are nourishing, such as soups. Also emphasis should be on whole grain stews, hot cereals, root vegetables, and dark greens until all symptoms have been gone at least for a week. For beverages: warm tea (preferably the pregnancy teas) and room temperature water should be consumed.
• Vitamin E is thought to assist placental attachment to the uterus…reducing the likelihood of spotting or a miscarriage. Take up to 800 IU of vitamin E for about three weeks. If you have a heart disease, do not exceed 50 IU per day without discussing the supplementation with your doctor.

Stress, Part 3

Stress

stress

Stress and Pregnancy

This is a huge transitional period for the family unit, and usually characterized as stressful. Due to new roles to learn, adjustments within the family unit, communication patterns are re-established. These shifts may trigger biologic changes, hormonal function shifts, and immune system vulnerability.

The whole family unit is thrown off it equilibrium due to restructure of family roles, adjustments to family goals, physical and emotional changes that pregnancy may bring. This is the case for the average and normal situation and pregnancy. What about other circumstances or high risk pregnancy?

If the pregnancy is from an already stressful situation such as a rape or domestic violence has occurred, the stressor of pregnancy brings additional problems. Decisions need to be made to assist the mother, if other children are involved, their safety attended to.

In high risk pregnancy situation, stress is further aggravated if hospitalization is required. “High risk” is a label given to those whom the health of the baby or mother to be is threatened.

The pregnant mother’s ability to adjust and or adapt to the situation may be in jeopardy by the excessive level of stress. The mother must understand the causative factors in being labeled high risk and accept the situation in order to have a good outcome. As well as the pregnant mother, all other family members need to assess, accept, and readjust to this prognosis.

Unfortunately, pregnancy on the reservation is almost always considered high risk. This is due to poverty, gang activity, teenage pregnancy, alcohol consumption and drug abuse.

Only YOU can change this! Change the additional stressors in your life, and then you can change the outcome of your pregnancy and delivery!

Stress

About Stress

stress

There are two types: the type that is good, making you feel satisfaction and happiness. And there is negative, which leads to fatigue and possibly, illness.

There is no singular thing to point to as a cause of the latter. But, what is known about it is that the body makes biochemical changes when it is present.

GAS or General Adaptation Syndrome, has three stages. These stages are: alarm, resistance, and exhaustion. In the alarm stage the quick initial response is lowered blood pressure and tachycardia. This is in preparation for the fight or flight response to continued stress. The body will continue to increase its production of adrenocortico-tropic hormones. Along with this is increasing heart rate and elevation in blood pressure.

If the condition becomes prolonged, to the point where the adaptation of the body is too great, vulnerability of the body occurs…and exhaustion. The body is not designed to stay in a heightened state of arousal.

If continued, the sympathetic nervous system becomes activated with vasoconstricted blood vessels, increasing blood pressure, increasing heart rate, and the secretion of adrenaline. The immune system will then become suppressed and the increasing cortisol will cause cholesterol and other lipids in the blood to increase at the same time.

Situations or “agents” that cause stress are called STRESSORS. These may include physical things such as heat, exertion, trauma, infection, or cold. Or it may be from psychological reasons such as fear, anxiety, or disappointment. Stress may be caused by external things. Examples may include poverty, inadequate housing, and certain life events.

Factors altering stress responses are called mediators. The MEDIATORS may be genetics, developmental factors, experience, and social context. Some people appear to be more resilient and cope better with stress, while others seem to be more vulnerable.

Issues Part 4

The issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression?

Infant mortality is higher in teen births, birth weights of their babies lower, the possibility of premature birth and the birth defects more common in premature births. Premature birth is higher in this sector of the population, often due to violence during the prenatal period.
The rise in teen birth Indian country is alarming. “46% of Native American mothers are under 20 when they have their first child, compared with 25% of mothers of all other races . The average age for becoming pregnant has become lowered from mid to upper teenage years down to pre-teen groups of 9-12 year old girls!

“Boys and girls who experience sexual dating violence are more likely to initiate sex before age 11 ”. These issues would not have incurred had the elder women counseled and instructed their younger relatives on traditional women’s roles and young men counseled and instructed by elder males, as was traditionally done.

There were two ceremonies that were traditionally done for young girls, that are now rarely found in today’s Lakota Society. The pivotal ceremony for girls was the Isnati ceremony. This ceremony was done at a female’s first menses. The young girl would have had the instruction given by elder women regarding her role in society, especially as to virtuous behaviors, her place within society, pregnancy, and childbearing. women regarding her role in society, especially as to virtuous behaviors, her place within society, pregnancy, and childbearing.

Sexual Objectification of Native Women

Rape and domestic violence in Native populations have been on the rise, but within the teen population is another aspect to be considered: gangs. Gang rapes and gang violence is high among native youth, and the female population is especially vulnerable. Although there is a high risk, in one study it was reported that those who perpetrated dating violence did not use a condom deliberately despite “high risk activity such as sexual infidelity, involving “trains” and multiple sex partners ”.

As well as gang related violence and rape, young girls are also vulnerable to date rape. In 1994, “92% who had sexual intercourse reported as having been forced against their will ”. Women ages 16-24 experience the highest rates of rape and sexual assault. The violence that is inherent in this age group limits the ability of teenage girls to manage their reproductive health and also causes them to be vulnerable to sexually transmitted diseases.

1996, the rate of reported rape among Native women was 3.5 times higher than other races. This is just the reported rapes! Add to this population, those who have been subjected to another type of criminal activity: Sex Trafficking. It has occurred since the colonial era. It is only recently that the United States Government has classified Human Trafficking as a form of slavery.

Most of the Sex Trafficking occurs in areas near First Nation Reserves (Canada), Native American Reservations, and Alaskan Native communities. To understand the particular vulnerability of Native women to Sex Traffickers, you only need to look at the historical perspective. In the United States, the military that oversaw westward expansion ‘targeted native women for sexual assault, sexual mutilation, and slaughter’, as seen in numerous accounts of that time.

Compounding all the aforementioned issues is the accumulated impact of the historical experiences creating a “generational trauma” with increased levels of trauma response and stress that passed from one generation to the next, over several consecutive generations. The generational trauma is thought to be the ‘major contributor’ to the level of ‘poverty, violent victimization, depression, suicide, substance abuse, and child abuse’ in Indian country today. It is also thought to be the reason for generational prostitution and child trafficking in the Native families.

Traffickers exploit the areas in which this population has vulnerability. One method is to portray the sex trade as a quick way to become personally empowered and have financial independence. Another is to target those who are homeless or have been impacted by poverty.

Exploitation is done of those with mental illness, have substance abuse issues, FASD (Fetal Alcohol Spectrum Disorder), and those with who are Two-Spirit (transgender) are deliberately sought due to their vulnerability on the streets from violence, and are offered protection (Pierce and Koepplinger,3).

Next:  Part 5 – Conclusion (and references).

 

Issues Part 3

What are the issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression – Part 3

After years of encroachment upon traditional healing practices, the stage was set for an Eugenics movement. This movement “… in the 20th century began as a means of controlling the perceived increase in ‘degenerate’ population and maintaining or protecting hereditarily ‘fit’ members in society from being overrun by the genetically ‘unfit.’ (Forbes, 2)” or groups that were marginalized, such as Native Americans.

Initially, the population targeted was those with low intelligence and those with physical disabilities. But, soon it expanded to “ a program to implement ‘racial hygiene’ in the United States, eugenics essentially entailed taking the principle of natural selection and enforcing it by employing allegedly ‘scientific’ means (Forbes, 2)” The concern was that the white populace were being degraded by the influx of people with racial differences. The classifications included socio-economic, class, status and race.

…policies founded on eugenic theories (sic) started to emerge, forcing procedural sterilizations and other means of population control upon people believed to be unfit (Forbes, 2-3)”. In the late 60s and through the 70s the target was Native American people. Indian Health Services began a systematic sterilization policy.

Women would go to the I.H.S. hospital, told they needed a cesarean section (for a variety of reasons), anesthetized; and when they awoke, these women found they had been given a hysterectomy, which is what happened to my friend. She stated that she was not informed of the need for a hysterectomy. She had gone to deliver her baby, the doctors examined her and stated that she needed an emergency cesarean section. She awoke, finding that she had her uterus removed. My friend’s experience was not uncommon, “…in 1975 alone, some 25,000 Native American women were permanently sterilized – many after being coerced, misinformed, or threatened .

In 1990, a former nurse at I.H.S. reported that tubal ligations were used on women who did not want the surgical procedure. Birth control also was forced upon unsuspecting females such as Depo-Provera, without informed consent, and prior to the FDA having given its approval (this would include the mentally retarded ).

Health risks of the drug Depo-Provera are high in native populations due to Diabetes, obesity, and cigarette smoking. Many who were forced to have it or Norplant administered were not informed of the risk. A secondary aspect is the cultural issues. Irregular bleeding that is caused by these drugs can prevented participation in traditional spiritual practices.

In my own research of the issues of native women in the child-bearing years I was shocked by the high numbers of cesarean sections done on this sector of women. The rate of C-Sections nation-wide is 32.8%; whereas South Dakota is around 25.3%. But, I.H.S. rates are higher than the state average, last internet search showed it at 34%.

Why is this of concern? The health risks of women in the child-bearing years due to unnecessary surgery being conducted. Childbirth is treated by the modern medical doctors as though the baby a ‘disease’ that needs to be cut-out, rather than a natural biological reproductive process. Had the traditional practices of midwifery had been continued within the native culture, allowed to flourish, there would have been very few cesarean sections necessary in our modern times.

Other Factors Regarding Childbirth in Indian Country

Next below the black woman, the native woman is recorded as 2nd to the highest in infant mortality rates . This is due to living in rural areas with poor access to proper care during pregnancy. “Poverty is an important risk factor for poor health outcomes ”.

Compounding the issues mentioned above are those of teen and pre-teen births. A female who is younger than 18 or 19 years of age are not fully developed, in other words are still growing themselves. Teenagers tend to eat poorly, are more prone to drink alcohol, smoke, and take drugs during pregnancy.

Next: What are the issues that affect Lakota Native women during pregnancy and childbirth in regards to: Racism, Sexism, and Oppression – Part 4

SIDS

SIDS: Sudden Infant Death Syndrome

crbs1370057CAUSES

No one knows for sure what the actual causes are for SIDS. Although, statistically, SIDS does occur more often when parents do drugs (even certain prescribed drugs), or alcohol while the mother is pregnant.

If you do not fit the category of drug using , then the puzzle is even harder. The most important thing to do is not take drugs or drink (including smoking marijuana), ask questions about prescribed drugs and consequences to the unborn fetus. Make sure you eat well, drink lots of water, and do moderate exercise during your pregnancy.

ISOLATED FEELING AFTERWARDS

Many people feel isolated after the death of a baby or infant. People tend to think that you should “get over” the loss quickly. This is especially true in the Lakota culture where the belief is the soul moves on after four days.

It may be difficult for you to grapple with your emotions, and especially anger or fear. The latter due to not understanding that there was not much you could have done to prevent SIDS.

AUTOPSY

If you have lost your baby due to SIDS, an autopsy may be required by law. Or you may be encouraged to give permission for an autopsy. Unfortunately, with SIDS you may not get any answers to the causes of death nor on how to prevent SIDS in the future.

 

Vices in Pregnancy – Part 1

woman pregnant smoking

Caffeine

Caffeinated beverages do not seem to cause birth defects or preterm labor and delivery in people…but there are other risks. Such as: fetal growth retardation, miscarriage, and low birth weight.

Woman who drink more than 300mg of caffeine are at the highest risk. That would be about three, five ounce cups. Those that both smoke and drink caffeine are at even a higher risk for babies with stunted growth.

Coffee (5 oz. cup) 60-180 mg
Tea (5 oz. steeped 4 minutes) 38-77 mg.
Cocoa (5 oz. cup) 2-20 mg.
Chocolate milk (8 oz.) 2-7 mg.
Cola drinks (Jolt, Mr. Pibb, Mountain Dew, etc.) 36-72 mg.
Non-prescription drugs (Excedrin, Anacin, etc.) 30-65 mg.


Tobacco

Cigarette smoke is full of chemicals. Many of these migrate to the sperm cells when they fertilize the ovum, and then continue to bombard the fetus when the mother smokes or is exposed to tobacco smoke.

Women who smoke are more likely to experience pre-eclampsia during pregnancy, preterm labor, premature rupture of the membranes, and premature delivery. The baby born to a smoking woman tends to be lower in birth weight, and more likely to die soon after birth than those who do not smoke.

The damage to the baby can persist into later life. They are at more risk for cancer as an adult, susceptible to middle-ear infections, asthma, chronic bronchitis, and wheezing.

If raised in a household where smoking is allowed children are more likely to develop hypertension, as well as neurological and behavioral problems such as attention deficit disorder. They also tend to score lower in intelligence tests later in life.

Men who smoke have a considerable higher risk of having children with birth defects and childhood cancer. This is probably due to the lowering of vitamin C levels in seminal fluids and sperm. Not even the best of nutrition can make up for the damage done by smoking!

Woman smoking and alcohol

Alcohol

Alcohol freely enters the placenta and directly exposes the developing baby to its toxic effects. It travels in the baby’s blood stream at the same concentration as that of the mother. If mother is “buzzed”, so is the baby!

Some babies born develop a condition called “Fetal Alcohol Syndrome” or FAS. They are shorter in length, lighter in weight, than other babies. They do not “catch up” eve with special postnatal care. They also have abnormally small heads, irregularity in their faces, limb abnormalities, heart defects, and poor coordination. Many are mentally retarded and may develop behavioral problems as they grow up (such as hyperactivity). Another condition, which is similar, is called “Fetal Alcohol Effect” or FAE.

No one knows how much alcohol it would take to damage a baby. Since it causes permanent physical and mental birth defects and no “safe” amount is known, the best bet is to abstain from alcohol.

Be aware of the alcohol that may be in certain foods. Such as: Irish Coffee, wine coolers, rum in fruit cakes, liquor-laced desserts, and cough medicines.

 

 

GBS

GROUP B STREPTOCOCCOS

1 out 10 healthy women have GBS living (or colonized) in their vaginas.

Before using antibiotics during labor as a preventative measure about 2.5 out of 100 women with GBS would have a baby that would develop a serious infection.

Out of those babies, 4% would have died.

So statistically: women with “colonized” GBS would have lost a child or 4 to 8 per 10,000.

Those few who survived had neurological damage.
Odds are reduced with full-term pregnancy, most were premature that developed GBS.

The solution would seem to be to test for GBS early in the pregnancy, and take the antibiotics at the time. This often does not work. This is due to the GBS reappearing after the course of antibiotics is done.

The Center for Disease Control Recommends:

• Screening at 35-37 weeks of pregnancy
• Give all women with colonized GBS IV antibiotics while in labor
• Or, if the status of GBS is unknown at birth, and the risk factors are present, give the IV antibiotics.

A baby born to a GBS positive mother does not need antibiotic treatment if the baby shows no signs of infection and is at least 35 week gestational age, and the mother began antibiotics at least four hours prior to birBut the baby should have blood cultures done.

If the mother has received antibiotic treatment due to a suspected uterine infection or baby shows any signs of an infection, the baby should receive a full septic work-up, including a spinal tap and antibiotic therapy.

Cases of newborn infections have declined since the introduction of testing routinely and treatment since the 90s.

The downside is that some cases of severe allergy occurred from the antibiotics. Although GBS strains have not seemed to develop resistance to penicillin, they have to other antibiotics.