Equally unsettling was the clip shown of the debate between Barbara Boxer (D-CA) and Republican Challenger Carly Fiorina. Having lived in the Bay Area for all of the 1990’s, having friends who have lost their jobs in Silicon Valley and some specifically at Hewlett Packard under Fiorina, I can clearly see the faults of both candidates. But these two political battles illuminate, as do the contests nationwide approaching in November, this is not a time to be complacent. There is a lot at stake.

I hesitated to write this blog post because I felt that it veered too far off topics pertinent to mamas on bed rest. But the more I thought about it the more I realized that I was doing exactly what I hope other people won’t do this November-walk away from issues that are important to me, throwing up my hands in exasperation and then decrying in outrage the sorry state of affairs that things have become.  It has become patently clear to me that if we women don’t sit up and take notice and hold our lawmakers and representatives accountable for upholding our rights to safe, effective reproductive health care, we will return to the restrictive reproductive lifestyles that were the norm in the days of our grandmothers at the turn of and through the mid portion of the 20th century.

Now this may sound cynical or leftist. But let’s just look at what is happening. In 1960 the first oral contraceptives went on the market and almost concurrently, the feminist movement kicked into high gear. For the first time ever, women had some control over when they would become pregnant and bear children. Yes, condoms and diaphragms have been available for centuries in various forms, but the pill was a more effective form of birth control and as such, gave women unprecedented control over their sexuality; when or if they would marry and when or if they would have children.

When Roe v. Wade passed in 1973, women gained even more freedom to direct their reproductive lives. Not only did they have more effective birth control, but if that birth control failed or was not used, for whatever reason, they now had access to safe, legal pregnancy termination. Women were no longer bound by unintentional pregnancy to a life forever altered. Like their male counterparts, they could walk away as if the event had never happened, free to pursue careers, callings or whatever personal aspirations they may have.  I don’t mean to sound cynical or callous. The decision whether or not to have an abortion is always a HUGE decision for women.  Of women that I know who have had terminations, they never made that decision lightly.  But the truth of the matter is that men (not all but many) have walked away from women that they impregnated without so much as a parting glance because they were pursuing careers, didn’t want children, didn’t want serious relationships, etc… and women were left holding the bag so to speak, branded “naughty little girls” for “giving up the Pu” in the first place.

These benchmarks along the continuum marking attainment of women’s reproductive rights have created an environment of possibility for women that never existed in all of history and women have taken advantage of these opportunities. Women have gone from having only teaching, nursing, secretarial and service work as career choices to  being able to pursue any career discipline they chose. Women now are 46.8% of the US workforce according to the US Department of Labor. Women are expected to be 46.9% of the workforce by 2018 and that number is expected to continue to climb.

But these numbers are based on our current laws. If many of the conservative laws proposed are passed, access to and coverage of birth control will be markedly reduced if not eliminated entirely. Abortions, while still legal, will be so difficult to obtain that they will no longer be an option for the average woman. Women who take too much time off due to child care issues or pregnancy bed rest or delivery complications will lose their jobs-spiraling them into economic insecurity. Women who become pregnant unintentionally will either have to have the baby-whether they can financially afford the child or not (another example of economic insecurity), give the baby up for adoption-and still risk job loss if require more than the allotted 12 weeks of unpaid leave allowed by the Family Medical Leave Act (provided they work for employers who are legally bound to provide the FMLA benefit!) or risk having an unsafe, covert termination. Women will be slowly pushed back into economic dependence and to subservient roles that sparked the cry for women’s rights in the 20′th century in the first place. Is this really what we women want? Are we going to simply give up our reproductive rights, while idly standing by and decrying that there is nothing that we can do? Are we going to let all the work that women before us did, often suffering personal torture and injury in the process because we aren’t paying attention or are “too busy” to get involved?

There is much at stake right now. It’s easy to look at our economy and lack of jobs and say, “Obama promised change and look at what we got? We should have kept what we had!” But keep this in mind, under Obama and the democrats we still have the right to have abortions. Even though conservatives are creating hurdles, we still  have the right to have abortions and even though providers are increasingly scarce, some do still exist. While many conservatives are trying to remove contraception from insurance policies and repeal “Obamacare”, current health care laws do allow for coverage of contraception and voluntary sterilization-benefits we could lose under conservative representation. The very lifestyle that we all enjoy that includes reproductive freedom and the right to work at whatever craft/career we choose could begin to fade as early as November 5, 2010 and vanish shortly thereafter. You may be reading this thinking, ” I don’t have time to think about that, I am about to lose my job, I have a baby on the way and my benefits are running out.” I hear you and I understand. But don’t get so focused on your current situation that you can’t look down the road a bit.  What you are experiencing now may only be the beginning. I am asking you to look up, sit up, speak up and hold our legislators accountable for upholding our rights. If we don’t speak now, we’ll have no right to complain later when our rights are gone. It’s much easier to hold onto what we’ve got than to try to get back what we’ve lost.

The Preemie Primer was written by Jennifer Gunter, MD, a board certified obstetrician/gynecologist, who is also board certified in pain medicine and board certified in physical medicine and rehabilitation. At a first glance it seems like Dr. Gunter is yet another “expert” telling you what the “scientific evidence” says you should do for your baby. While Gunter offers comprehensive information on caring for a premature infant, the book is far from dry and overly ‘jargoned’.  At its best it is a deeply personal account of how Jennifer Gunter, wife and mother, navigated the peaks and valleys of caring for her markedly premature boys Oliver and Victor (born at 26 weeks) while also grieving the loss of their triplet brother Aidan, born at 22 weeks. She is simply sharing what she learned and knows with other parents and has created a powerful resource for parents of preemies.

Now I don’t want to discount Dr. Gunter’s knowledge. She has done a great job of pulling together the necessary medical information pertaining to preterm labor, prematurity and caring for mom and baby (ies) post partum. But the honest truth is that much of the “medical” information is freely available-on the web and in books and texts.  But The Preemie Primer is for parents of preemies who, at a time when this information is in critical need, they dont’ have a nanosecond to spare seeking it out. Part of what makes it such an excellent resource is that not only is the medical information readily at hand in one place, Dr. Gunter also includes information on self care for parents (asking for help with post partum depression for example, deep breathing, meditating…) and navigating the complex US insurance system to get the care premature babies and children desperately need. Yes, the chapters on  “The Mind-Body Connection” and “Making the System Work for You” were really helpful and informative and a welcome departure from the sterile statistics, instructions and definitions.

But far and away the “precious jewel” of this book is that it is written by Jennifer Gunter, wife and mother to two navigated the peaks and valleys of caring for her markedly premature boys Oliver and Victor (born at 26 weeks) while also grieving the loss of their triplet brother Aidan, born at 22 weeks.premature little boys and an angel in heaven. The success of The Preemie Primer results from the fact that as I read it, I felt as if I was sitting across from Jennifer Gunter, drinking coffee and chatting as she tells her story.  I think the most powerful parts of the book are the gray insets that tell her personal story, her personal struggles to care for her living boys while at the same time grieving her angel Aidan. The times she was so overwhelmed with emotions that all she could do was cry. At those times her credentials were irrelevant. She was a mom, struggling for herself and for her sons, and as vulnerable as the rest of us.

One of my favorite vignettes was her conversation with the hospital representative as she disputed charges for Aidan. Anyone who has ever had the frustration of speaking with hospital representatives who are insensitive, unyielding and basically ignorant to medical procedures will totally relate to this conversation. Gunter was arguing to have charges made for Aidan’s “care” removed from her hospital bill.  You feel the pang in your own heart as you hear Gunter tell this representative that Aidan died and did not receive care as is indicated on the bill.

While I like and highly recommend The Preemie Primer (Remember, I said it should be in every new OB bag!), I realize it is a tough sell. In the same way that obstetricians don’t discuss the possibility of bed rest until a woman is having it prescribed, I doubt The Preemie Primer will become recommended reading for mainstream pregnancy. And this is unfortunate. Having had a late preterm birth, I would have loved to have had even an inkling of what to expect. As high risk as I was, no one ever even mentioned that I was at risk for preterm labor. I was never counseled about the signs and symptoms of preterm labor. When I delivered my daugher at 36 wks and 6 d, I fully expected to have her put on my chest, to nurse her and then to have her in my room. Instead she was whisked away from me by nurses and neonatologists and then admitted to the NICU (which is never mentioned or visited in hospital tours). I was completely blind-sided by the entire experience.

Our culture likes to “stay positive” and always “look on the bright side”.  But turning a blind eye to potential catastrophe is just plain stupid. No woman wants bed rest, a premature infant or, heaven forbid, to have a stillbirth. But the reality is that these events happen. Just because we don’t talk about them or “don’t have that in my family or medical history” doesn’t mean that they can’t happen to us. Obstetricians and midwives should talk about them (at the very least) and give parents tools and resources that they can readily access in the event that the most awful and unexpected happens. So yes, I do think that The Preemie Primer should be put in OB bags-or made readily available in OB offices, hospital gift shops, family resource centers and the like.

We have to face the fact that not everyone has the picture perfect pregnancy, labor and delivery. But things needn’t spiral completely out of control. Research shows that patients who feel that their health care providers are honest and up front with them, explaining every test and treatment and potential outcome are far less likely to come away with ill feelings or to sue their providers. We have to have the hard conversations. But if OB’s and midwives don’t want to do that, or feel uncomfortable or as if they are “scaring” their patients, then have resources readily available.  As Dr. Gunter said herself during our podcast interview, “Plan for the worst but expect the best”.

The Preemie Primer is available on this website via our Amazon.com store in the Infancy/Childhood section. We respectfully ask that if you decide to purchase The Preemie Primer as a result of reading this blog post or listening to the podcast interview with Dr. Gunter that you do so via our store as it helps to fund the operation of this website.

Share your stories of preterm labor and caring for a premature infant below.

It was almost too heartbreaking to read. After 20 minutes of trying, neonatologists had to tell Kate Ogg that her tiny little son Jamie, born at a mere 27 weeks and weighing only 2 lbs, was gone.

A Mother’s Loving Touch

Despite the fact that twin sister Emily was doing well, Kate Ogg and her husband David clung to each other and tiny Jamie completely absorbed in their grief. “I couldn’t let him go,” says Ogg. She stayed there, clutching the tiny body to her chest. Miraculously, after two hours of being hugged, stroked, talked to and kissed by his mom, little Jamie began showing signs of life.  First, it was just a gasp. The doctors assured Ogg and her husband that this was simply reflex a breath and that little Jamie was in fact gone. But when the infant began to stir a bit more, Ogg put a drop of breast milk on her finger and little Jamie drank it. Ogg could hardly believe her eyes. Then little Jamie opened his eyes, lifted his hand and grasped her finger. He finally turned his head from side to side. Even the doctors stared in disbelief. Little Jamie was alive, safe and secure in his mother’s arms against her chest.

Kangaroo Care

Numerous research studies have reported on the effects of a mother’s love and touch on infants, especially premature infants. Kangaroo Care, the position that Ogg unknowingly assumed with little Jamie, consists of placing a diaper clad premature baby in an upright position on a parent’s bare chest – tummy to tummy, in between the breasts.  The baby’s head is turned so that the ear is above the parent’s heart. Many studies report that this position soothes the infant; steadying heart rate, calming respiration, alleviating tummy upset and soothing colic. This soothing position has also shown to help babies sleep, gain weight and thus progress enough to leave the NICU and go home. Some researchers dispute the efficacy of kangaroo care, stating that data is too subjective and there are few measurable endpoints.  Most studies have proven that Kangaroo Care has a major, positive impact on babies and their parents. Some studies have proven there is no change, but no study has proven that Kangaroo Care has hurt either parent or baby.

The Mind/Body Connection, A Mother’s Love and Mamas on Bedrest

Jennifer Gunter, MD, gives a wonderful explanation of Mind-Body medicine in her book, The Preemie Primer.

“Mind-Body medicine is the idea that our thoughts and emotions influence physical health, and harnessing this connection improves both emotional and physical well-being.”

Gunter further explains that chemicals such as neurotransmitters and hormones send messages all over the body. These chemicals can either stimulate a stress response or be controlled and used to effect positive health outcomes. While thoughts are not enough to cure disease alone, they can certainly be complimentary.

So what does this mean for Mamas on Bedrest? It means that your thoughts can influence your pregnancy outcome. Bed rest is never anyone’s idea of a great way to spend pregnancy. Unfortunately, about one out of every five pregnancies ends up on bed rest for part of the pregnancy. You may be feeling somewhat discouraged on bed rest, worried and afraid that things won’t turn out well. Stop those negative thoughts-NOW! Because your thoughts affect your body’s chemicals, negative thoughts send out negative brain chemicals and hormones and can have a negative effect on your health and the health of your baby. Start now to tell your baby how much you love him or her. Sing happy songs to your baby, read to him and envision holding your little darling. While this may seem silly, you are actually changing the chemical make up of your body and the chemical make up of your pregnancy. But don’t believe me, look at what soothing words and loving thoughts did for little Jamie Ogg!

How have you used positive imagery and soothing thoughts to get you through your bed rest experience? Share you successes as well as you challenges in our comments section.

Do finances have you worried while on bed rest? Stay tuned to some exciting news coming from Mamas on Bedrest & Beyond.

Pre-Eclampsia is a medical condition that only affects women during pregnancy and post partum. It is characterized by high blood pressure and protein in the urine, subsequently creating a toxic physical environment for both mother and baby. It is frequently the reason a pregnant woman is prescribed bed rest. While it can occur anytime during pregnancy, it typically occurs after 20 weeks of pregnancy, in the late second or third trimester. Pre-Eclampsia occurs in 5-8% of all pregnancies globally and is the cause of some 76,000 maternal deaths and 500,000 infants annually.

Pre-Eclampsia can rapidly become a serious or even fatal medical condition. Women should know the signs and symptoms of pre-eclampsia and report any signs or symptoms they have to their health care provider immediately.

Major Signs and Symptoms of Pre-Eclampsia

None – The problem with Pre-Eclampsia, much like other hypertensive disorders, is that it often has no symptoms.
Hypertension is known as “the silent killer” and pre-eclampsia is no different. Bed rest has been shown to reduce blood pressure and frequently reduces the signs, symptoms and complications that may arise as a result of pre-eclampsia. Even though bed rest is inconvenient at best and quite uncomfortable and physically challenging at its worst, if your health care provider prescribes bed rest for pre-eclampsia, Please follow his or her directions, even if you feel fine.

Hypertension – Hypertension or high blood pressure is defined as two blood pressure readings over 140/90 at two different times at least six hours apart. However, pregnant women with normally low blood pressure, such as 110/65, may be diagnosed with pre-eclampsia prenatally or in the post partum period when their blood pressure rises to 135/80 and/or they develop signs and symptoms of pre-eclampsia.

In 1990 the National Institutes of Health, National High Blood Pressure Education Program: Working Group Report on High Blood Pressure in Pregnancy issued the following research guidelines:

In the past it has been recommended that an increase of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure be used as a diagnostic criterion, even when absolute values are below 140/90 mm Hg. This definition has not been included in our criteria because the only available evidence shows that women in this group are not likely to suffer increased adverse outcomes. Nonetheless, it is the collective clinical opinion of this panel that women who have a rise of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure warrant close observation, especially if proteinuria and hyperuricemia (uric acid [UA] greater than or equal to 6 mg/dL) are also present.

For this reason, it is extremely important that women know what their baseline blood pressure readings are and at each prenatal visit they ask their providers what their blood pressure is. In this way, both health care provider and patient can be on the look out for blood pressure abnormalities and address them as soon as possible.

Swelling (Edema) – Swelling can be an insidious symptom of pre-eclampsia because so many women experience swelling of their hands and/or feet or even their faces when they are pregnant. However, when the swelling is significant enough to change your facial features, you should notify your health care provider immediately, advising them that you believe the swelling has become excessive. You may need to show them a photo of you prior to pregnancy, your driver’s license for example, to prove your point. In any event, if swelling concerns you, make sure it becomes a concern of your health care providers and that it is addressed.

Proteinuria – Proteinuria occurs when proteins, usually filtered by the kidneys and retained in the blood stream, leak into the urine because the small blood vessels in the kidneys have become damaged allowing the proteins to pass through. (This is usually due to your elevated blood pressure. Remember, pre-eclampsia creates a toxic physical environment to both mother and baby!)

Other Common Signs and Symptoms of Pre-Eclampsia

Sudden Weight Gain – Since weight gain is a hallmark of pregnancy, it’s often hard to discern between regular pregnancy weight gain and weight gain associated with Pre-Eclampsia. The rule of thumb is that if you start gaining more than 2 lbs per week or more than 6 lbs in a month, you should consult with your health care provider as this could be an indication of pre-eclampsia.

Headache – Severe, migraine-like headaches which are often one sided and dull and throbbing could be a warning that your blood pressure is dangerously high. Contact your health care provider immediately for evaluation.

Nausea or Vomiting – While nausea and/or vomiting is common in the first trimester, it usually abates during the second and third trimesters. If you have sudden onset of nausea and/or vomiting in the second or third trimester, contact your health care provider immediately for evaluation.

Changes in Vision – If you experience any sudden blurred vision, double vision, flashing spots, or sudden light sensitivity, this is another warning that your blood pressure may be dangerously high.  Contact your health care provider immediately for evaluation.

Racing pulse, mental confusion, heightened anxiety, trouble catching your breath – While all of these symptoms can occur in pregnant women, when they suddenly occur from out of the blue and especially if they occur together, this is cause for concern. Contact your health care provider immediately.
Stomach or Right Shoulder Pain – I want to be a bit more specific here. The pain you may be experiencing here is right upper quadrant abdominal pain, specifically, liver pain. The pain may be “radiating” or “referred” to the right shoulder, but its origin is in the liver. This pain requires immediate attention as it is an indication that the liver is under stress and you may be suffering from HELLP (Hemolysis-bursting of red blood cells, Elevated Liver enzymes levels, and Low Platelet count) as serious obstetrical complication. It is imperative that you be evaluated immediately if you have symptoms of HELLP to avoid more serious complications or even death.

Lower back pain - Low back pain is so common in pregnancy that it is difficult to distinguish between the typical low back pain of pregnancy and low back pain associated with pre-eclampsia. If you are unsure, certainly consult your health care provider. But consult with your health care provider immediately if the low back pain is present with right upper quadrant abdominal pain as this may be another sign of pre-eclampsia.

This is a cursory overview of Pre-Eclampsia and we will delve into the subject with more depth in coming blog posts. Just remember that pre-eclampsia can have serious medical consequences for both you and your baby including death, so if you are concerned about symptoms, consult with your health care provider and have an immediate evaluation.

This list of signs and symptoms is edited and reprinted from the list presented on The Pre-Eclampsia Foundation website. This website is a holds a wealth of information on pre-eclampsia; current research and resources for more information and to get more help and/or support.

Did you have pre-eclampsia during your pregnancy? Are you a Mama on Bedrest now for pre-eclampsia? Share your story in our comments section below.

Libby283, A mama to be posted the following “hypothetical question”  to the community on The Bump.

This is just a hypothetical question and wondering if any other ladies had it happen and how it was handled…

What happens with maternity leave if you have a preemie baby that will require a lengthy hospital stay. For instance I only get 6 weeks maternity leave with my employer. If I delivered tomorrow, at 30 weeks, the baby would be in the hospital for the duration of the maternity leave. Does your doctor & employer let you go back to work early and then use the remaining leave time for when the baby comes home?

Just curious, but I hope I don’t have to worry about it as a reality.
There were some conflicting responses to her question, and I thought it a really good question to respond to on Mamas on Bedrest & Beyond. We’ll also be posting a reply on The Bump.

First and foremost, Libby283 is entitled to 12 weeks of unpaid medical leave as stipulated in the United States Family Medical Leave Act (FMLA). This act states that eligible employees are entitled to up to 12 weeks of unpaid leave with guaranteed job protection each calendar year to,

1. Deliver a baby,
2. Bring home An adopted or foster child
3. Care for a critically ill family member such as a spouse, child or parent
4. Heal and recuperate from serious illness.

Here is the actual text of The Family Medical Leave Act as posted on the US Department of Labor Website:

The Family and Medical Leave Act (FMLA) provides an entitlement of up to 12 weeks of job-protected, unpaid leave during any 12-month period to eligible, covered employees for the following reasons: 1) birth and care of the eligible employee’s child, or placement for adoption or foster care of a child with the employee; 2) care of an immediate family member (spouse, child, parent) who has a serious health condition; or 3) care of the employee’s own serious health condition. It also requires that employee’s group health benefits be maintained during the leave. The FMLA is administered by the Employment Standards Administration’s Wage and Hour Division within the U.S. Department of Labor.

So Libby283 is actually covered by the law as well as her employer.

What gets sticky is when people try to combine two or more leave policies to get more time off.  The scenarios play out very differently depending on your employer, your state laws and how you choose to use the federal law. Recently in Massachusetts, the courts ruled that the Massachusetts Maternity Leave Act entitled women to 8 weeks maximum for maternity leave (See Massachusetts Maternity Leave Act: No Help for Mamas on Bedrest). However, since that is only a state ruling, women could then attach an additional 12 weeks onto their leave as stipulated by the Family Medical Leave Act. What is allowed varies from state to state so women planning to become pregnant should find out what they are entitled to and to make provisions in the event of a complicated pregnancy (requiring bed rest) and/or a complicated delivery requiring an extended hospital stay for mama, baby or both.

What employers choose to do becomes another matter. Libby283’s employer can say, okay, you can have 6 weeks paid leave (not sure if she is being paid or not) but if you want the entire 12 weeks, the remaining 6 weeks is unpaid. In that way her employer has not violated FMLA and has not breached the company policies. Likewise, the company can say, you are entitled to the 12 weeks of unpaid leave as stipulated by FMLA, but we are not obligated to pay you. Or, if they are a really family friendly company, they may even offer 12 weeks of paid leave (haven’t seen this one in a while, but one could hope!)

As the law reads you are entitled to 12 weeks family medial leave total per calendar year. So Libby283 could in fact split her time off between when she actually delivers and is discharged and when her baby comes home. While this is good in theory, it is my experience that when a mama has a preemie, she is not back to work but in the NICU any chance she gets, so time off could still be an issue.

It’s clearly evident from Libby283’s question and the laws that this is a confusing issue.  Mamas on Bedrest & Beyond is committed to working with other organizations to advocate for improved maternity privileges including extending maternity leave and having maternity leave be paid. Subscribe to our blog and e-newsletter to stay abreast of what is happening with maternity leave and how we are working to initiate change at local, state and national levels.

I recently commented on a blog post by a fellow mom blogger CourtroomMama. I really appreciated her blog post, commenting on and explaining the appellant victory of Samantha Burton and the ACLU which overturned a court  decision that had ordered Ms. Burton to go on prescribed bed rest for pregnancy complications.

In March of 2009  a Florida court ordered Samantha Burton to go on prescribed bed rest as her doctor recommended due to complications with her pregnancy. Burton, a single mother with two living children had refused to go on bed rest citing that she could not afford to be out of work, unpaid and not able to provide for her family for the estimated 15 remaining weeks of her pregnancy. The ruling implied the court didn’t care about her right to make her own health decisions or her current children, but sought to protect her unborn child. To add insult to injury, Burton was also ordered to submit to any and all “medically necessary” treatments including  cesarean section. Sadly, Burton delivered a stillborn baby several days into her bed rest.  In August of 2009, The ACLU filed an Amicus Brief, i.e. a court appeal, on Ms. Burton’s behalf. This August, 2010, Burton and the ACLU won their appeal. The ACLU cited that the previous ruling had misused the “Best Interest of the Child” standard, applying it to an unborn fetus when it is typically reserved for issues of juvenile court involving “living” children.

I really encourage every one reading this blog to take a look at CourtroomMama’s post. She has done a really nice job of making legal jargon understandable for us commoners and she raises some very interesting questions as “food for thought” that we all should be heartily considering when it comes to maternity leave.

What struck me most about this Florida ruling and other rulings and declarations that rule in favor of “protecting an unborn child” is how the mothers in all of these cases are essentially reduced to a gestational vessels-their lives, their interests and sometimes even their health is subjugated in favor of the unborn child. In the Florida case, Ms. Burton clearly stated that she could not afford to be out of work for 15 weeks as she would be unable to pay for and care for her two living children. That was not a persuasive enough argument. Nor was the fact that ordering her to submit to medical treatments against her will was a flagrant violation of her civil rights. The court and Ms. Burton’s OB implied via this case and its ruling,

“You are incapable of making decisions regarding the health and well being of you and your child, so we are taking your right to make your own medical decisions-and your right to make decisions regarding how you will care for yourself and your family-out of your hands.”

Unfortunately, this is not an isolated court case and nor an isolated situation in which a woman’s rights are trounced in favor of the rights of someone else.  The fuel of the abortion argument as well as the controversy surrounding the usage of emergency birth control, is whether or not a woman has the right to decide when she will carry a pregnancy and hence control her health and her body. I was completely outraged when Republican Senate Candidate Sharron Angel (R-NV) stated that women should never be allowed to have an abortion, even in the case of rape. Within the course of her interview with Alan Stock, Ms. Angle made her infamous statement that women should take these “lemon” situations and make “lemonade.”

Besides being one of the most insensitive and ignorant statements I have ever heard of, I’d like Ms. Angle and others opposed to abortion, morning after contraception, voluntary sterilization and other medical treatments available to women that allow them to control when they choose to become pregnant to consider the fact that while they are telling women to have the children that they did not intend to conceive, they offer no tangible ways for these women to support themselves through the pregnancy and birth process. While some men share the responsibility of unintended pregnancy with their partners, many more who get their partners pregnant simply walk away taking no responsibility for the well being of the woman or unborn child. So with this being the case, is it any wonder that women are making what many would deem “radical decisions” regarding their health and the health of their unborn children?

The United States  makes few provisions for women, especially single women, to provide for themselves and their unborn children. Instead we choose to point fingers and make the case that women should not even have sex outside of marriage. At the core of Samantha’s Burton’s case is the fact that United States is one of few if not the only Western nation that offers no paid maternity leave, no professional home attendance after a woman gives birth and little to no assistance with childcare. (For more on how poorly the US compares to other countries, take a look at the THE WORK, FAMILY, AND EQUITY INDEX-WHERE DOES THE UNITED STATES STAND GLOBALLY? report)

Whether a woman is single or in a stable relationship, our workforce rules and regulations are antiquated. Back in the early to mid 1900’s when many of our workforce rules were put in place, the majority of employees were men and those women who were working, typically did so only until they started their families, then they stayed home and raised their children. But clearly this is no longer the case.   According to the US Department of Labor,

1. Of the 122 million women age 16 years and over in the U.S., 72 million, or 59.2 percent, were labor force participants—working or looking for work.
2. Women comprised 46.8 percent of the total U.S. labor force and are projected to account for 46.9 percent of the labor force in 2018.
3. Women are projected to account for 51.2 percent of the increase in total labor force growth between 2008 and 2018.

The rules governing the workplace are no longer applicable to today’s workforce. Ladies, why do we stand for them?

Women are capable of  making wise medical decisions. They are also capable of holding down full time jobs while taking care of themselves and their families. The laws governing personal rights and freedoms must be applied to women (as guaranteed by the constitution of the United States)-even if women make unpopular decisions or decisions that those in authority don’t understand. Women have the legal right to make those choices.

Likewise, Department of Labor and other workforce organizations need to re-evaluate the workforce, paying close attention to how the American  family has  evolved and our workforce rules need to reflect this evolution.  It is unacceptable for women to be forced to choose between their jobs and their families with the assumption that women can’t competently manage both. The assumption that women must be regulated by outside bodies (Pun intended!) is also unacceptable.  Given that women are fast becoming the majority in the workforce, isn’t it time that the laws reflect this majority?  Without re-evaluation and application of individual rights to women as well as re-evaluation of our workplace rules and standards,  we stand to see many more cases like Burton v. Florida.

The ruling is seen as a victory for businesses who have long contended that the Massachusetts Commission Against Discrimination, the governing body for the law, often rules too harshly against businesses while giving broad leeway to employees.

In a 4-to-3 ruling, the Supreme Judicial Court said the 1972 law guarantees full-time employees eight weeks off to give birth or to adopt a child, after which they are entitled to return to the same job or a comparable one. Beyond that, however, the law does not protect them.

Late in 2007, Just 5 weeks into my pregnancy, I discovered through ultrasound that I was pregnant with twins. My husband and I were shocked-yet we couldn’t have been happier. I had miscarried with our first pregnancy, so in a way it felt like we were making up for the baby we had lost.

At 17 weeks into the pregnancy, I begin having contractions.

At 19 weeks into the pregnancy, we had the regularly scheduled ultrasound where most people usually find out if they are having a girl or boy. Would we have one of each? Two boys? Two girls? February 28, 2008 was going to be one of the most exciting days of our lives!

At the ultrasound, we first found out we were having a boy. Bliss! And then the sonographer told us that the other baby had died in utero. I had just heard both heartbeats two weeks before and we had an ultrasound before that, where we saw their fingers and toes and adorable faces. Worry set in. Would the loss of one baby cause me to miscarry and lose both babies? My doctor said we would just need to wait to see if we would make it to 24 weeks, which is the earliest point of viability.

At 24 weeks and 1 day, I went into preterm labor and was placed on prescribed bed rest.

We were able to halt labor, and after nearly four months of bed rest and A LOT of medication, our Little Guy arrived safely at 39 weeks and 3 days on July 20, 2008. He was perfect, But I was in the worse shape of my life!

Immediately after delivery I was in agonizing pain, could barely think and couldn’t put my thoughts together enough to speak. Over the next couple of days I grew worse. I couldn’t walk and I could only hold my son if someone handed him to me because I was so weak. I couldn’t empty my bladder, so a catheter was placed. I cried and said I wasn’t ready to go home, but still, the doctors sent me home.

I called the hospital every day to describe my worsening symptoms; headaches, sudden swelling in my legs, extreme weakness, dangerously high blood pressure. Each time I spoke to a different doctor. Perhaps because I was so weak and my thoughts and speech were so confused,  they couldn’t understand what I was saying. But on the fifth day home, I suddenly had chest pain and a nose bleed and my husband put me in the car and immediately drove me back to Labor and Delivery.

The doctors suspected preeclampsia, a condition characterized by often dangerously high blood pressure, extremity swelling and protein in the urine. It is treated with magnesium sulfate given intravenously to prevent seizure and stroke from the high blood pressure. It’s a horrible drug, with unbearable side effects for some, but it works. A few hours later when they tested my blood, they realized that the magnesium sulfate wasn’t leaving my body through my urine because I wasn’t urinating. It was trapped in my body because I was in acute kidney failure.

The pain was unreal and the thought of it still frightens me. Every moment was a struggle. The monitors sounded an alarm every time I shut my eyes because if I didn’t force myself to breathe, I stopped breathing. My sister was amazing, telling me, “Stay awake, Ang. You can get through this.” While doing her best to encourage and support me, she was running to the bathroom to throw up because she was so sick with worry. Meanwhile, my husband and my mom were at home with my newborn son and our two and a half year old, trying to maintain some kind of normalcy there.

After a week in the hospital, a blood transfusion and various IV fluids I was able to return home to my son. I was still very weak, but at least I was home.

When I thought of how lonely and frightened I was during my long months of bed rest, then to miss the first two weeks of my son’s life after all those hours waiting for him was almost unbearable. Part of me wanted to leave my experiences with bed rest and preeclampsia behind, to just move on. But I knew I was lucky to be alive. I had learned so much through my experience I decided to create a way for women on bed rest to reach out to one another online, to describe what they are experiencing and to help one another. That’s where the idea for KeepEmCookin.com came from.

Ladies, We can learn from one another and teach one another about high-risk pregnancy; what symptoms to look out for, how to care for ourselves and how to advocate for ourselves. We can share with one another the right questions to ask our doctors and how to make ourselves heard. Most importantly, We can do our part to guarantee that we have the healthiest pregnancies possible and keep our babies safely cookin’.

There are many reasons that mothers should be encouraged to breastfeed their babies. First of all, breastmilk contains antibodies that are protective to the newborn. We all know that a newborn has a very sensitive, immature immune system. Breast Milk contains many of the antibodies and protective agents from the mother that protect the newborn from illness and disease until its own immune system becomes more competent. Research has shown that babies who breastfeed exclusively for at least 6 months have a lower incidence of allergies, ear infections and other childhood illnesses. The following are many of the cited health benefits (from www.womenshealth.gov and www.aap.org):

Breastmilk adapts to meet the nutritional needs of the nursing child. The initial colostrum that feeds a newborn is dramatically different from the mature breast milk that nourishes a nursing toddler. Yet at each stage, breast milk is just the right composition of protein, carbohydrates, fats and water needed to meet the nutritional needs of the nursing child. Breast Milk also has enzymes that make it easier to digest so that there is little to no stomach upset in the child.

And one can’t deny the economics of breastfeeding. Breast Milk is free. It is always ready, no mixing necessary and it is always the right temperature. Some breastfeeding advocates has gone so far as to say that low income women should be forced to breastfeed. Low income, less educated women are less likely than women of higher economic and educational status to breastfeed. Their children are also more likely to have frequent ear infections, allergies, asthma and other childhood illnesses. Proponents state that educating and encouraging lower income and less educated women to breastfeed their babies could reduce healthcare costs and improve the long term health, intelligence and well-being of lower income children. (There is currently no data to support these claims)

But opponents of mandatory breastfeeding state that breastfeeding is not for every mom. Many women cite pain, inability to produce sufficient quantities of milk, lack of support for breastfeeding amongst their famiies and friends, work schedules and feeling embarrassed while nursing as reasons they did not breastfeed for very long or at all. Still, breastfeeding has many benefits for mama as well including:

• Reduced risk of breast, ovarian, cervical, and endometrial cancers
• Reduced risk of anemia
• Protection against osteoporosis and hip fracture in later life
• Reduced risk of mortality for women with rheumatoid arthritis has bee associated with total time of lactation
• Helps mother’s body return to its pre-pregnancy state faster-promotes weigh loss; 1/2 of calories needed to make milk is pulled from fat stores
• Helps delay return of fertility and to space subsequent pregnancies
• Moms miss less time from work due to child related illnesses
• Helps the uterus contract after birth to control postpartum bleeding

 And althoug it is not listed here, breastfeeding has been linked to reduction in post partum depression. (Read our previous blog posts -April and May 2010-on the topic!)

US culture does not support breastfeeding as evidenced by restaurants and other public establishments banning breastfeeding or banishing breastfeeding mothers to restrooms to feed their babies. Breastfeeding mothers have had to file lawsuits to be able to breastfeed their babies or to have breastfeeding/breast pumping areas available in their workplace. The US’s lack of paid maternity leave makes it nearly impossible for new mothers to establish breastfeeding. When faced with the choice of staying home to breastfeed and/or adjusting their work environments or schedules in order to breastfeed, many women are not only unwilling but are also unable to make such concessions. Many women say they won’t have a job to come back to and can’t put their entire family’s security in jeopardy.

The breastfeeding debate will wage on and every mama will have to decide for herself what is the best method of feeding her baby. Since August is World Breastfeeding Month,  Mamas on Bedrest, take this time on bedrest to consider what is the best method for you to feed your baby and if it is breastfeeding, gather your resources and support now. Mamas on Bedrest & Beyond is pleased to offer several resources for breastfeeding mamas on our website as well as in our Amazon.com store.

How are you planning to feed your baby? Share your comments with us below.

If we can be of assistance, don’t hesitate to contact us at info@mamasonbedrest.com

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What I didn’t mention at that time, and what has just come to my attention, is the fact that once a woman has had Gestational Diabetes in one pregnancy, she is at increased risk for developing Gestational Diabetes in her subsequent pregnancies.

In the July 12, 2010 issue of the American Journal of Obstetrics and Gynecology, lead author Darios Getahun, MD, MPH, from the Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena notes, 

 “Well-controlled gestational diabetes may prevent complications that result in fetal and maternal morbidity, such as high blood pressure during pregnancy, urinary tract infections, cesarean delivery, big babies, birth trauma, and a variety of other adverse outcomes, including future diabetes. Because of the silent nature of gestational diabetes, it is important to identify early those who are at risk and watch them closely during their prenatal care.”

Dr. Getahun and his colleagues reviewed obstetrical records from Kaiser Permanente in Southern California from 1991 to 2008 in an effort to determine of development of Gestational Diabetes was more prevalent in subsequent pregnancies. They also sought to determine if Gestational Diabetes is more prevalent among women of any particular race.

What Getahun and his colleagues found is that women who had Gestational Diabetes with their first pregnancies and had a second pregnancy had a 41.3% risk of developing Gestational Diabetes with their second pregnancy vs 4.2% risk in women who did not have Gestational Diabetes in their first pregnancies. Women who had Gestational Diabetes in their first two pregnancies had an even higher risk of developing Gestational Diabetes in their third pregnancies.

While the authors note that the study is limitied by the fact that the data used is analyzed retrospectively and there was no note of pre-pregnancy weights, pregnancy weight gain, what if any lifestyle interventions were implented or any other potentially confounding factors, based on the data reviewed, they are confident in reporting that women who develop Gestational Diabetes during their first pregnanies are at increased risk of developing Gestational Diabetes in subsequent pregnancies.

Dr. Getahun and his colleagues also noted that recurrence of Gestational Diabetes is more prevalent in Hispanic women and Asian/Pacific Islander women.

If you develop Gestational Diabetes during your first pregnancy, be sure that you and your obstetrician/midwife implement a plan to screen early in your subsequent pregnancies for Gestational Diabetes. If you do develop Gestational Diabetes in subsequent pregnancies , It is imperative that you Obstetrician/midwife monitor and manage your blood sugars with meticulous care so that you and your babies are at the lowest possible risk for complications.

For more information about Gestational Diabetes, check out our Resource Page. Gestational Diabetes is under the Pregnancy tab.

The full citation of Dr. Getahun’s paper can be found on the American Journal of Obstetrics and Gynecology website.

Please share your comments below.