HEALTHY MOTHERS, HEALTHY BABIES

CONTENTED and healthy, a newborn baby lies cradled in its mother’s arms. The father is aglow with pride. Because this happy scene occurs millions of times every year, it is easy to take normal childbirth for granted. After all, it is a natural process—so, what is there to worry about?

Granted, births usually go well, but not always. Hence, prudent prospective parents take reasonable measures to avoid unnecessary complications. For example, they learn about the causes of childbirth problems, they seek quality prenatal care, and they take some simple steps to reduce risks during labour and delivery. Let us consider these points in more detail.

Causes of Childbirth Problems

One cause of childbirth problems for both mother and baby is lack of good care during pregnancy. Dr. Cheung Kam-lau, consultant paediatrician for the neonatal care unit of Prince of Wales Hospital in Hong Kong, says that “having no prenatal care can put pregnancies in high risk.” He also states that “most of these mothers expect healthy, chubby babies, but things just don’t always happen ideally.”

Regarding the problems that can affect mothers, the Journal of the American Medical Women’s Association states that “the major direct causes of maternal mortality” are excessive bleeding, obstructed labour, infection, and abnormally high blood pressure. Effective treatments are well-known, however, and in most cases “modern medical care . . . does not require highly technical interventions,” the journal adds.

Readily available care could also help many babies. The UN Chronicle reports that “two thirds of newborn deaths could be prevented if all mothers and newborns” obtained medical treatment that is “well-known, feasible and deliverable without complex technology.” Sadly, though, the lack of knowledge and the laxity in prenatal care on the part of mothers is all too common, reports the Philippines News Agency.

Optimal Prenatal Care for Mother and Baby

“Healthier mothers have healthier babies,” says the UN Chronicle. It also observes that when a woman gets inadequate medical care or none at all during pregnancy, childbirth, and the period thereafter, her baby also receives little or no medical care.

In some lands it may be difficult for a pregnant woman to get adequate care. Perhaps she has far to travel, or she may be unable to cover medical costs. Still, if at all possible, an expectant mother should try to get at least some professional prenatal care. This is particularly important for a woman who lives by the teachings found in the Holy Bible, which states that human life is sacred, including that of the unborn.—Exodus 21:22, 23; Deuteronomy 22:8.

Does adequate care mean seeing a doctor every week? No, not necessarily. In regard to certain common complications that arise during pregnancy and childbirth, the World Health Organization (WHO) “found that women who visited their doctors only four times during their pregnancy” enjoyed results that “were comparable to those who had 12 or more visits.”

What Doctors May Do

In order to improve prospects for the mother and her unborn child, health-care professionals, particularly those who specialize in obstetrics, take the following steps:

▪ They review the patient’s medical history and perform an examination to determine risk and forestall complications that may involve the mother or her developing baby.

▪ They may take blood and urine samples to check for such problems as anaemia, infection, Rh incompatibility, and disease. The latter may include diabetes, rubella, sexually transmitted diseases, and kidney disease, which can elevate blood pressure.

▪ When advisable and acceptable to the patient, they may recommend vaccinations for such things as influenza, tetanus, and Rh incompatibility.

▪ They may also recommend vitamin supplements, especially folic acid.

When doctors identify the risks associated with individual pregnancies and take the needed precautions—or help the mother to do so—they enhance the prospects of a positive outcome for her and her unborn baby.

Minimizing Risks During Labour and Delivery

“The most dangerous time for a pregnant woman is the critical period around labour and delivery,” says Joy Phumaphi, former assistant director general for Family and Community Health at WHO. What can be done to prevent serious problems, even life-threatening ones, at this critical time? Actually, the steps are simple, but they do need to be taken in advance. This is especially important for those who refuse blood transfusions for Bible-based reasons or for those who want to avoid blood because of the significant medical risks.—Acts 15:20, 28, 29.

Such patients should do what they reasonably can to ensure that the health-care provider, whether a doctor or a midwife, is both competent and experienced in administering medical alternatives to blood transfusion. Also, expectant parents would be wise to check that the hospital or delivery facility is willing to cooperate. Here are two good questions to ask the doctor:

 1. What will you do if the mother or the baby loses a significant amount of blood or if there are other complications?

 2. If you are not here when the baby comes, what alternative arrangements will be made?

The prudent woman will, of course, check with her doctor to ensure that her blood count is as high as possible within the normal range prior to labour. To build up the patient’s blood, the doctor, in turn, might recommend that she take folic acid and other B-group vitamins, as well as iron supplements.

The doctor will also consider a number of other factors. For example, did his patient’s prenatal visits reveal any health problems that may need attention? Does the prospective mother need to be off her feet? Should she get more rest? Would it be wise for her to gain or lose weight or get more exercise? And does she need to give more attention to bodily hygiene, including oral hygiene?

Studies show that gum disease in pregnant women is associated with an increased risk of preeclampsia, a serious complication that is characterized by, among other things, a sudden rise in blood pressure, severe headache, and edema (excess build-up of fluid in the tissues). Preeclampsia can lead to premature delivery and is a leading cause of fetal and maternal death, especially in developing lands.

Indeed, a careful physician will give attention to any sign of infection in the prospective mother. And if she has premature labour pains, he will recommend prompt hospitalization, which can be lifesaving.

“Women risk death to give life,” says Dr. Quazi Monirul Islam, director at WHO’s Department of Making Pregnancy Safer. But good medical care during pregnancy, at birth, and immediately afterward can help to avert many complications, even death. Most important, of course, try to maintain good health. After all, if you want a healthy baby, you need to do your best to be a healthy mother.

Couples who are Jehovah’s Witnesses may consult with the local Hospital Liaison Committee (HLC) for Jehovah’s Witnesses before the birth of their child. Committee members visit hospitals and doctors to provide them with medical information on the nonblood management of Witness patients. Additionally, HLCs likely can assist in finding a physician who respects the patient’s beliefs and who has experience in nonblood medical management.

Although more studies are required to determine if gum disease causes an increased risk of preeclampsia, it is always wise to take good care of your gums and teeth.

According to figures released in October 2007, one woman dies nearly every minute—536,000 a year—because of problems associated with pregnancy.—United Nations Population Fund

“Each year 3.3 million babies are stillborn and more than 4 million newborns die within 28 days of coming into the world.”—UN Chronicle

  

PREPARATION DURING PREGNANCY

 1. Choose your hospital, doctor, or midwife wisely by doing advance research.

 2. Make regular visits to your doctor or midwife, establishing a trusting, friendly relationship.

 3. Give careful attention to your health. If possible, take the appropriate vitamins, but avoid medication (even over-the-counter products) unless your doctor approves. It is wise to avoid alcohol. “Although the highest risk is to babies whose mothers drink heavily, it is not clear yet whether there is any completely safe level of alcohol during pregnancy,” states the National Institute on Alcohol Abuse and Alcoholism.

 4. If you experience premature labour pains (prior to the 37th week), contact your doctor or maternity ward immediately. Prompt attention may help to prevent a premature delivery and the complications that can result.

 5. Document personal decisions relating to medical care. For example, many have found it helpful to have a durable power of attorney (DPA) card filled out ahead of time. Find out what is used and legally acceptable in your country.

 6. After the birth be mindful of your health and that of your baby, especially if the baby came prematurely. Consult the paediatrician right away if you observe any problems.

[Footnotes]

The original Hebrew text refers to a fatal accident to either mother or unborn child.

[Footnote]

Blood transfusions are commonly given to anaemic premature babies, whose organs have difficulty producing sufficient red blood cells.

Culled from AWAKE Magazine

SLEEP DEBT—ARE YOU A VICTIM?

 MILLIONS of people today are in serious “debt.” This debt can be a major factor in wrecking their cars, damaging their careers, and even ruining their marriages. It can adversely affect their health and life span. It is a deficit that contributes to immune suppression, creating susceptibility to various infections. Conditions as different as diabetes, heart disease, and extreme obesity, as well as other health problems, have been linked to it. Yet, most victims are oblivious of this debt.

The culprit is sleep debt, which develops when a person does not get the amount of healthful sleep needed for well-being. This can be caused by voluntary sleep deprivation resulting from a person’s life-style or by involuntary sleep deprivation because of illness.

Medical researchers estimate that earth’s population is now getting, on average, an hour less sleep per night than what is needed. While this may seem slight, a nightly six-billion-hour debt has become the focus of research into both the variety of sleep-related illnesses and their impact on the quality of life.

The medical world once viewed the chronic inability to sleep as just one disorder, commonly called insomnia. However, a commission created by the U.S. Congress recognized 17 distinct sleep disorders. At any rate, insomnia has so many causes that it is often considered to be a symptom of other problems, much as a fever suggests some sort of infection.

Even occasional deprivation of sleep can be disastrous. Consider the case of Tom. Although an experienced truck driver, he plunged his 18-wheel vehicle over an embankment, spilling 100 gallons [400 L] of sulfuric acid onto a major highway. Tom admits: “I fell asleep.” Studies of two U.S. highways estimated that drowsy drivers caused some 50 percent of the fatal crashes.

Consider, too, the occupational dangers of being around a sleepy coworker. Says Australian researcher Ann Williamson: “After 17 to 19 hours without sleep [participants’] performance on some tests was equivalent or worse than that at [a blood-alcohol concentration of] 0.05%.” In other words, subjects functioned as if at or beyond the legal limit in some countries of alcohol permitted in a driver’s bloodstream! With hundreds of thousands of sleep-related auto and job-site accidents happening annually, the worldwide cost to productivity and family is enormous.

What factors may contribute to sleep debt? One is the social phenomenon often called 24/7—operating 24 hours a day, seven days a week. USA Today describes this as “a cultural earthquake that is changing the way we live,” noting that “a new wave of round-the-clock retailers and services is profiting by mocking the clock.” In many lands people watch all-night television programs and access the Internet when they should be sleeping. Then there is the toll taken by emotional disorders, often involving anxieties heightened by stress and the pace of life. Finally, there are a variety of physical diseases that can contribute to sleep debt.

Many doctors note how difficult it is to get their patients to take sleep debt seriously. One doctor complained that chronic fatigue is even considered “a status symbol” by some. And because their condition often worsens very gradually, victims of sleep deprivation may not recognize that they suffer from a serious sleep disorder. Many reason, ‘I’m just getting old’ or, ‘I can’t cope with life, so I tend to shut down’ or, ‘I’m tired all the time because I can never get the long rest I need.’

Reversing this sleep debt is a complex challenge. But understanding how a healthful sleep cycle works and learning to identify the signs of sleep debt can provide the motivation to change

Getting the Sleep You Need

MOST of the progress in understanding sleep mechanics has been made in the last 50 years. What has been learned explodes some long-standing misconceptions. One is the assumption that since many bodily functions slow down during rest, sleep is little more than a state of inactivity.

By studying brain-wave patterns, medical researchers have learned that there are repeated cycles and stages of sleep. Far from being inactive, the human brain runs at high speed during certain periods of sleep. Healthful sleep involves going through these cycles four or more times every night and spending a sufficient amount of time in each cycle.

The Complexity of Sleep

A normal night’s sleep is most easily divided into two types: what is commonly called REM (rapid eye movement, or dream) sleep and non-REM (nondream) sleep. You can tell that a person is in REM sleep when the bulge of his eyeballs can be seen rapidly moving under his eyelids.

Non-REM sleep can further be divided into four stages. After lying down, you gently enter stage one—drowsiness or shallow sleep. During this stage your muscles relax and your brain waves are irregular and rapid. Its first occurrence each night typically lasts between 30 seconds and 7 minutes. When you move into stage two—true sleep—where you will usually spend 20 percent of the night, brain waves become larger. You may have fragmented thoughts or images passing through your mind, but you are unaware of your surroundings and cannot see even if your eyes are open.

Next come stages three and four—deeper to deepest sleep. Here, in what is also called delta sleep, your brain produces large, slow waves. It is now that your body is most difficult to rouse, as most of your blood is directed to the muscles. During this time (usually about 50 percent of the night), body recovery and repair take place, and it is during delta sleep that young bodies grow. It is important to note that anyone, youth or adult, who does not experience the deeper delta stages will likely feel fatigued, apathetic, or even depressed the next day.

Finally, each cycle is completed by the radically different REM stage. During this dreaming stage (typically occurring about every 90 minutes), more blood is directed to the brain and your brain waves are almost the same as if you were awake. However, you cannot move your muscles. This immobility apparently keeps you from acting out dreams and hurting yourself or others.

These REM, or dream, cycles get longer each time they occur during the night and appear to be crucial to mental health. In computerlike fashion, the brain sorts through short-term memory storage, deleting unimportant data and retaining what is desired for long-term memory. Abnormally infrequent dream cycles are known to result in emotional difficulties. Insomniacs, for example, spend less time than average in REM sleep, contributing to a vicious downward spiral of increasing anxiety.

So, what happens when we are regularly deprived (voluntarily or involuntarily) of these repeated cycles, thus creating a sleep debt? If we get fewer consecutive hours of sleep than we need, we won’t get as much of the last and longest REM sleep period, which is vital to mental health. If our sleep patterns become irregular, consisting of a series of naps, we often don’t get to the deep delta sleep that is necessary to mend our bodies. Those in serious debt suffer from shortened attention spans, memory and vocabulary loss, a lessened ability to think analytically, and diminished creativity.

What triggers the body to demand sleep? A number of factors evidently combine to create a circadian (daily) rhythm, or wake-sleep pattern. Brain chemistry appears to play a role. Also, there is a nucleus of nerve cells located in the brain that evidently helps control the sleep cycle. This “clock” is situated close to where the optic nerves come together. Light thus influences how sleepy we feel. Bright light wakes you up, while darkness induces sleep.

Your body temperature is also involved. When your temperature is highest—typically midmorning and midevening—you are the most alert. As your body temperature drops, you become increasingly drowsy. Researchers agree that the pattern of wakefulness versus sleepiness varies with individuals.

How Much Sleep Do You Need?

Scientists tell us that, on average, humans require about eight hours of rest per night. But studies also show that individual needs vary dramatically.

An honest self-analysis can determine if you are already in a healthful pattern or are experiencing a sleep debt. Experts generally agree on these signs of healthy sleep:

▪ Sleep comes easily without resorting to drugs or fighting restlessness or anxiety.

▪ You are rarely aware of waking up in the middle of the night, but if you do wake up, you can go back to sleep quickly.

▪ Waking up occurs naturally at approximately the same time each morning and usually without the aid of an alarm clock.

▪ Once you are up and going, you feel awake and fairly alert all day.

Practical Points

What about those with occasional insomnia? Some experts suggest these practical steps:

1. Avoid alcohol as well as stimulants such as coffee or tea near bedtime. Many people mistakenly believe that alcoholic beverages will help put them to sleep. However, clinical studies show that alcohol can have a rebound effect and keep you awake.

2. Quit smoking. One authority notes: “Smokers have greater difficulty falling asleep, because cigarettes raise blood pressure, speed up the heart rate, and stimulate brain-wave activity. Smokers also tend to wake up more in the middle of the night, possibly because their body is experiencing withdrawal symptoms.”

3. Avoid extreme mental or physical stimulation just before bedtime. Exercise promotes proper rest but not if done immediately before trying to sleep. Tackling big problems or mental challenges just before you go to bed can interfere with the relaxed mood often needed to drift off to sleep.

4. Make sure that your bedroom is quiet, dark and, where possible, relatively cool. Regarding noise, consider one famous study of people living near an airport who claimed that they no longer heard the airplanes. When their sleep patterns were tested, their brain waves recorded each landing and takeoff! The researchers concluded that the test subjects averaged about one hour less of quality sleep each night than those in a quieter zone. Earplugs or other methods of reducing noise would have greatly assisted them in getting restful sleep. Some find that white noise (defined as any low-frequency, steady, and monotonous hum), such as made by an electric fan, is especially helpful if there is a need to mask street sounds.

5. Be cautious about taking sleep-inducing medications. There is growing evidence that many drugs prescribed to induce sleep are habit-forming, lessen in effectiveness with prolonged use, and have damaging side effects. At best, such drugs may be useful for short-term therapy.

Since insomnia can be brought on by stress, it is thought that one key to healthy sleep is making the time just before going to bed a quiet, pleasant period. It may be helpful to set aside the cares of the day and do something enjoyable, such as reading. There is an obvious and powerful advantage to the Bible’s advice: “Do not be anxious over anything, but in everything by prayer and supplication along with thanksgiving let your petitions be made known to God; and the peace of God . . . will guard your hearts and your mental powers.”—Philippians 4:6, 7.

Some Common Misconceptions

 1. Drinking caffeinated beverages is the best way to stay alert on a long drive.

Studies suggest that drivers often mislead themselves into thinking that they are more awake than they actually are. If you cannot avoid making a long, nighttime drive, it is better periodically to pull over in a safe area and take a short nap (from 15 to 30 minutes), followed by walking or jogging while stretching arm and leg muscles.

 2. If I am having sleep problems, napping is the answer.

Perhaps, but many experts believe that the ideal pattern is one long stretch of sleep every 24 hours. A short, midday nap (typically 15 to 30 minutes) may help restore alertness during the afternoon slump without throwing your longer sleep cycles out of rhythm. But napping within four hours of bedtime may be detrimental to healthy nocturnal rest.

 3. The dreams we remember have robbed us of proper rest.

Dreams (usually occurring during REM sleep) are a sign of healthful rest and typically happen four or more times during each normal night’s rest. Studies indicate that the dreams we remember are simply those from which we were awakened, either while they were happening or within a couple of minutes after they ended. On the other hand, a nightmare may create anxiety and make going back to sleep difficult.

Recognizing Serious Sleep Disorders

SOMETIMES one’s symptoms may indicate a serious sleep disorder. Chronic insomnia, which lasts more than a month, is often related to more serious problems, including depression. Chronic insomnia may also be a symptom of a serious physical ailment.

Sleep Apnea

Mario suffered from excessive daytime sleepiness. When he drove the family car, his wife had to watch him carefully, as he tended to lapse into momentary blackouts, which he rarely recalled. He snored loudly and irregularly every night and at times violently jerked himself awake, gasping for breath.

Mario had the classic symptoms of sleep apnea. Apnea literally means “no breath.” An episode of sleep apnea may last anywhere from ten seconds to two or three minutes. The victim often thrashes around gasping for air and then falls asleep again, only to repeat the apnea hundreds of times per night. There are three types of apnea.

Central apnea occurs when the brain’s respiratory control center doesn’t give the command to breathe regularly. With obstructive sleep apnea, the upper airway at the back of the throat actually closes, blocking air movement. Mixed apnea is a combination of the two and is the most common diagnosis. The victim of any type of apnea can end up in virtually the same condition as someone who stayed up all night, every night!

Those with sleep apnea may live dangerous lives, for they can blank out while on the job or at the wheel of their automobile. They may suffer from high blood pressure, an enlarged heart, and an increased risk of stroke or heart failure. Dr. William Dement of Stanford University estimates that 38,000 Americans die each year from the cardiovascular consequences of sleep apnea.

While most common in obese men over 40 years old, sleep apnea can occur at any age, even in young children. There are several treatments—all best supervised by a medical sleep specialist. The most effective nonsurgical treatment for obstructive sleep apnea is the use of a device to create continuous positive airway pressure. The patient wears a mask over his nose at night, and a pressure regulator (custom-set by a physician) delivers just the amount of air needed to prevent apnea. If this does not rectify the condition, there are several surgical approaches, including using laser or radio-frequency waves to remove excess tissue from the throat.

Narcolepsy

Another sleep disorder requiring medical attention is narcolepsy—a neurological condition that causes excessive daytime sleepiness. Buck, for example, was constantly drowsy. He would fall asleep abruptly, even during important meetings. He started holding keys in his hand so that when this happened, the noise they made hitting the floor would wake him. Then he developed cataplexy—a condition causing him to become weak in the knees and collapse whenever he became excited. Next came symptoms of sleep paralysis as well as occasional hallucinations just before he fell asleep.

Narcolepsy typically starts between the ages of 10 and 30. Sufferers sometimes develop what is called automatic behavior, wherein they appear to behave normally but do not remember the passing of extended periods of time. The tragedy of this disease is that it often goes undiagnosed for years, while the victim is viewed as lazy, mentally slow, or peculiar. It is presently considered incurable, but symptoms can be treated with medication and adjustments in life-style—with varying degrees of success.

Other Sleep Disorders

Two other disorders, sometimes appearing in combination with each other, directly affect the limbs, resulting in chronic insomnia. One is periodic limb movement disorder, in which the legs, and sometimes the arms, jerk and twitch during sleep. Consider Michael. Tests showed that episodes of periodic leg movements awakened him some 350 times each night!

A separate disorder is restless legs syndrome, in which sensations deep within the leg muscles and knees cause a powerful urge to move, thus preventing the sufferer from falling asleep. While this condition is sometimes associated with lack of exercise or poor circulation, some cases appear to be related to caffeine intake. Alcohol consumption is also known to aggravate the condition at times.

Bruxism is a disorder characterized by grinding or clenching the teeth during sleep. If it occurs regularly, it can cause abnormal wear of the teeth and extreme jaw discomfort, resulting in serious insomnia. Depending upon the degree of the problem, treatments vary from oral surgery to wearing a mouth guard at night.

This limited look at just a few of the many sleep-related disorders illustrates that it can be dangerous to ignore them. Treatment may be simple or complex, but it is often essential. If you or a loved one suffers from chronic insomnia or shows signs of any serious sleep disorder, it may be wise to get professional help soon. Even if treatment does not totally eliminate the problems, it may significantly reduce the risks involved and make the situation easier for all to endure. Then, in the future, as the Bible’s promises are fulfilled, “no resident will say: ‘I am sick.’” All illnesses will be completely removed as God makes “all things new.”—Isaiah 33:24; Revelation 21:3-5.

Culled from: AWAKE MAGAZINE