Source: http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/in-depth/prenatal-care/art-20045660?pg=2

Sources:

~http://www.ncbi.nlm.nih.gov/pubmed/20159393

~http://www.ncbi.nlm.nih.gov/pubmed/20159393

• Cervical Dilation
•  Cervical Ripeness
• Cervical Effacement
•  Station of baby (position in relation to pelvis -5 to +5)
• Position of the baby (anterior vs. posterior)
• Position of the cervix
• May find cervical anomalies, like early dilation and effacement, so that appropriate changes can be made to the woman's care, including bedrest, hospitalization, tocolytics, etc.
• May stimulate the cervix so that a medical induction does not become "necessary"

Source: http://www.drmomma.org/2010/04/myth-of-vaginal-exam-in-pregnancy.html

• Increased risks of infection, even when done carefully and with sterile gloves
• Increased risk of rupturing the membranes
• May stimulate the cervix prematurely
• Information collected does not accurately predict when labor will begin and may excite or disappoint women unnecessarily 

Sources:

~http://www.pregnancy.org/article/are-vaginal-exams-pregnancy-necessary

~http://www.scienceandsensibility.org/?p=5673

Pelvic Exams Near Term: Benefit or Risk? Talking to Mothers About Informed Consent and Refusal

http://www.scienceandsensibility.org/?p=5673

Premature rupture of membranes at term. Retrospective study of 88 cases

http://www.ncbi.nlm.nih.gov/pubmed/7569588

Chorioamnionitis in the delivery room

http://www.ncbi.nlm.nih.gov/pubmed/21090085

Bacterial vaginosis and intraamniotic infection

http://www.ajog.org/article/S0002-9378(97)70568-4/abstract

Premature rupture of the membranes and ascending infection

http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1982.tb05028.x/abstract

Are you having any contractions? Have you noticed a pattern?

Is there any discharge? If so, is there any color or odor?

Did you do anything differently today, or something that might have been stressful on your body?

1.) Bleeding in any quantity, especially if the blood is bright red.

2.) Discharge or fluid from the vagina

3.) Severe pain

4.) Persistent spots

5.) Swelling*

6.) Fever over 

7.) Pain when urinating

8.) Naseau or vomiting

*in the video, I talk about how swelling *is* a sign of blood-pressure changing.  I should have said "probably", because I am not a medical professional. Swelling is *probably* a sign that your blood pressure is changing.

Disclaimer: 
The material included on this site and in the VLOG is for informational purposes only.  It is not intended nor implied to be a substitute for professional medical advice. The reader/viewer should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

Artificial rupture of the amniotic membranes during labour, sometimes called amniotomy or ’breaking of the waters’ was introduced in the mid-eighteenth century, first being described in 1756 by an English obstetrician, Thomas Denman (Calder 1999). Whilst he emphasized reliance on the natural process of labour, he acknowledged that rupture of the membranes might be necessary in order to induce or accelerate labour (Dunn 1992). Since then, the popularity of amniotomy as a procedure has varied over time (Busowski1995), more recently becoming common practice in many maternity units throughout the UK and Ireland (Downe 2001; Enkin 2000a ; O’Driscoll 1993) and in parts of the developing world (Camey 1996; Chanrachakul 2001; Rana 2003). The primary aim of amniotomy is to speed up contractions and, therefore, shorten the length of labour.

 

The first recorded use of amniotomy in the United States was in 1810; it was used to induce premature labor. Amniotomy and other mechanical methods remained the methods of labor induction most commonly employed until the 20th century. Amniotomy, or artificial rupture of the amniotic membranes, causes local synthesis and release of prostaglandins, leading to labor within 6 hours in nearly 90% of term patients. Turnbull and Anderson found that amniotomy without additional drug therapy successfully induced labor in approximately 75% of cases within 24 hours.

• http://www.glowm.com/section_view/heading/Induction%20of%20Labor/item/130#r5
• http://apps.who.int/rhl/reviews/CD006167.pdf

• Amniotomy was associated with a reduction in labour duration of between 60 and 120 minutes in various trials
• There was a statistically significant association of amniotomy with a decrease in the use of oxytocin: OR = 0.79; 95% CI = 0.67-0.92 in several randomized trials
• AROM does not involve any type of medication to mom or baby and is considered by some to be the most “natural” means of induction in a hospital setting.

• In several randomized trials there was a marked trend toward an increase in the risk of Cesarean delivery: OR = 1.26; 95% Confidence Interval (CI)=0.96-1. 66.
• Trial reviewers suggest that amniotomy should be reserved for women with abnormal labour progress.
• In 15 studies containing 5583 women there was no clear statistically significant difference between women in the amniotomy and control groups in length of the first stage of labour
• Evidence does not support routinely breaking the waters for women in normally progressing spontaneous labour or where labours have become prolonged.
• [Once membranes are broken} most obstetricians want the baby birthed as soon as 6 hours post-onset to reduce the risk of infection from the introduction of bacteria into the vagina due to repeated vaginal exams. Some obstetricians will wait as long as 24 hours but that is less common. In contrast, midwives, who do not routinely perform cervical checks unless specifically indicated or requested, thus limiting the chance of infection, will often allow up to 36-48 hours as long as no indications of an active infection are present.
• A large study of 3000 women’s opinions of the intervention was conducted by the National Childbirth Trust (1989). Two thirds of the women in this study reported an increase in rate, strength and pain of contractions following membrane rupture; they found these contractions more difficult to cope with, needed more analgesia and felt that the physiology of labour was disturbed.
• When there is concern that labour is slowing down, benign measures to intensify contractions such as positional changes and movement may prevent the need for more invasive interventions (Simkin 2010). The Cochrane review of maternal positions and mobility during first stage labour supports the positive impact mobility has in shortening labour (Lawrence et al. 2009).
• Smyth et al. 2007 studies showed that amniotomy is not an effective method of shortening spontaneous labour and increases the risk of caesarean section and more fetal heart abnormalities

• http://www.ncbi.nlm.nih.gov/pubmed/10796086
• http://www.ncbi.nlm.nih.gov/pubmed/23780653
• http://summaries.cochrane.org/CD006167/PREG_amniotomy-for-shortening-spontaneous-labour#sthash.mSDKXAcC.dpuf
• http://www.givingbirthnaturally.com/ways-to-induce-labor.html
• https://www.rcm.org.uk/sites/default/files/Rupturing%20Membranes.pdf

• http://onlinelibrary.wiley.com/doi/10.1111/j.0001-6349.2005.00700.x/abstract;jsessionid=1DAA1BECADB5A8556C9A3920E3726843.d02t01
• http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=0CDsQFjAD&url=http%3A%2F%2Fwww.researchgate.net%2Fpublication%2F236275554_The_less_studied_effects_of_Amniotomy%2Ffile%2Fe0b4951b37ec067930.pdf&ei=avz7U96DLM6BygTO8oK4Aw&usg=AFQjCNFnuAFkfDAlqvd6mUyFysoAMs94cQ&bvm=bv.73612305,d.aWw
• http://www.scienceandsensibility.org/?p=556
• http://navelgazingmidwife.squarespace.com/navelgazing-midwife-blog/2010/1/1/baby-born-in-the-caul-amniotic-sac.html

Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

Happy New Year!!  Wishing all of our readers many blessings as you welcome the new year.  I trust your holidays were wonderful and that you are looking forward to all the promise of a fresh slate.

Couples struggling with infertility often turn to assisted reproductive therapy in an effort to start the family of their dreams. A study out of the University of Adelaide’s Robinson Institute found that pregnancies conceived with assistance such as in vitro fertilization (IVF) are more likely to end in stillbirth, preterm birth, low birth weight, or neonatal death, compared with natural pregnancies.

"More research is now urgently needed into longer term follow-up of those who have experienced comprehensive perinatal disadvantage," said lead researcher Professor Michael Davies from the University of Adelaide's Robinson Institute. "Our studies also need to be expanded to include more recent years of treatment, as the technology has been undergoing continual innovation, which may influence the associated risks."

Pregnant women who are vaccinated against the flu are significantly less likely to deliver premature or low-birth-weight babies compared to unvaccinated expectant mothers, new Canadian research finds.

Based on more than 12,000 women in Nova Scotia who gave birth in the immediate aftermath of the H1N1 flu pandemic, the study adds to mounting evidence that the flu can have “really detrimental effects for both mothers and their babies,” said first author Alexandra Legge, a fourth-year medical student at Dalhousie University in Halifax.

High levels of bacteria are associated with water breaking 

prematurely in pregnant women, a new study indicates.

Researchers arrived at their findings by analyzing samples of amniotic sacs (fetal membranes) from 48 women after they gave birth. The report is published in the Jan. 8 online issue of the journal PLoS One.

Nearly one-third of early deliveries are associated with premature rupture of fetal membranes, and it's important to learn more about why this happens, the researchers noted.

It's a sad reality that a lot of moms are familiar with postpartum depression. For anyone that has suffered from this type of clinical depression, you know the impact it can have on both the lives of the individual suffering, and those around her. There have been studies upon studies to find a way to eradicate the symptoms; some have been proven helpful and others not so much. But what if you knew of something that could eradicate all the above? Something so simple, natural and readily available. Would you give it a try? What if that particular “something” just happened to be encapsulating your placenta and eating it? Ew. But what if it really worked?

Not only does it work, but it does much more than combat the “baby blues.” January Jones, Kim Kardashian, Tia Mowry-Hardrict and Tamara Mowry-Housely all rave about their experiences with encapsulation. Before you allow your stomach to churn, put down your lunch for a few moments and take a few moments to learn more about placenta encapsulation and postpartum depression.

Scientists have found two new genetic causes of neonatal diabetes - a form of diabetes that occurs in the first 6 months of life. 

The research by the University of Exeter Medical School provides further insights on how the insulin-producing beta cells are formed in the pancreas. 

The team discovered that mutations in two specific genes which are important for development of the pancreas can cause the disease. 

At age 10, the children who had received maternal contact as infants slept better, showed better hormonal response to stress, had a more mature functioning of their nervous system and displayed better thinking skills.

Premature babies who cry a lot may be more likely than other preemies to have behaviour problems by the time they reach preschool, a new study suggests.

Experts said the reasons for the finding are not certain, and no one knows whether "interventions" to soothe preemies' crying would ward off behaviour issues later.

"In many ways, this study raises more questions than it answers," said Dr Andrew Adesman, chief of developmental and behavioural paediatrics at Steven & Alexandra Cohen Children's Medical Centre in New Hyde Park, New York.

For older children and adults, RSV is usually like a cold. Since there isn't a good vaccine against it, Dr. Starke says parents of babies should act fast if their baby has trouble breathing.

"You notice their chest going in and out, they're breathing rapidly, those kids need to be seen right away," he said.

Dr. Starke says there's no treatment for RSV, so parents may want to be extra cautious about taking their babies out in public during this RSV epidemic.

The latest study documented in the journal Rheumatology, was conducted on more than 7,000 older Chinese women. It revealed that breastfeeding was strongly related to a reduced risk of rheumatoid arthritis (RA). Mothers who breastfed, their risk of rheumatoid arthritis came down by almost half compared to those who never breastfed.

There were studies conducted prior to this that focused on the association between breastfeeding and RA, but the results produced were mixed.  It is a well known fact that breastfeeding benefits infants. But there has been growing evidence that breastfeeding has a positive impact on the health of the mothers too. This latest cross sectional study examined the association between breastfeeding and RA and also on the intake of oral contraceptives.

December is here and it’s time for my yearly PSA on protecting your baby from respiratory viruses.  When there is a newborn in the house, everyone wants to come over to meet the baby!!  They are pretty hard to resist.

Bruss and I are big advocates for our children, especially the youngest members of our family, during cold and flu season.  Our Night Owl had a life-threatening experience with RSV when he was three months old, and that has made us painfully aware just how fragile our sweet peas can be. 

We have three sweet peas from our Fall 2012 class that we have not met yet because we have been passing around a cold for the last month at the Bowman House.  Otter finally succumbed yesterday, and in her, this cold manifested as croup.  A sobering reminder that an infant’s health is so much more important than our selfish desire to see the babies – I shudder to think what would have happened if we had seen those babies over the past weekend when the virus was active with no symptoms yet.

You can click HERE to read last year’s PSA with a list of precautions you can take to minimize your sweet pea’s exposure to germs.  I list 5 concrete steps to Keep Sweet Pea Healthy in that post.  In a nutshell, limit exposure and practice good hand washing.

This year, I want to take some time this year to share polite ways to insist that people who are not healthy keep their germs to themselves and away from your children.  It is unfortunate that people really do not understand how devastating their “little cold”, sniffle or runny nose can be to a child with small airways and an evolving immune system.

THE Announcement
Here is wording you can work into the text of an announcement via email or social media:

We respectfully request that you keep our child’s health in mind when planning your visit with us. As much as we are excited to introduce [Sweet Pea] to our closest friends and family, we also need your help in keeping him/her healthy.  If you are feeling unwell, or have been exposed to a fever within the last 24 hours, we ask that you reschedule your visit.  We will understand if you choose not to come due to illness and will look forward to seeing you when you are in full health.

Q: When can we come see you?

A:  We are resting and recovering right now.  As long as you are in full health, we would be happy to see you in a couple of days.  We completely understand if that day arrives and you need to reschedule if you are not feeling well.  As much as we want you to meet [Sweet Pea], keeping him/her healthy is our first priority.

We are so excited to celebrate with you on [date, time].  Since we have infants in attendance, their health is our priority.  If you are feeling unwell, or have been exposed to a fever within the last 24 hours, we ask that you refrain from attending.  We will understand if you choose not to come due to illness and will look forward to celebrating [occasion] with you when you are in full health.

Sign for Car Seat or Carrier www.healthylittleones.com

 You can purchase your own boy or girl themed card HERE http://www.healthylittleones.com/OnTheGo.html

RSV Day 4: By this time, some of Night Owl's tubes had already been taken out.	RSV Nurses working to straighten the remaining lines
RSV Unhooked and still sedated