The Rh Factor

During your prenatal panel, blood will be drawn to determine your Rh factor.  You will be either Rh Positive or Rh Negative.  

 There is no worry if you are Rh Positive (Rh+), but the importance comes in when you are Rh Negative (Rh-) and the baby’s father is Rh+.   

Your baby is either Rh- or Rh+ as well, and there is increased risk if you are Rh- carrying an Rh+ baby.   

In this case, if the mother and baby’s blood mix, the mother can develop antibodies against her next baby’s blood (there is rarely a problem with first babies).  This can cause your baby to become anemic, have brain damage, develop jaundice, or even die. 

How can blood mix?

• Amniocentesis
• CVS
• Abortion
• Miscarriage
• Hemorrhage
• ruptured placenta
• after your first baby’s birth (blood may flow back into your circulation from the placenta)

If you are Rh-, your blood may be tested at intervals throughout pregnancy, or after the possibility that the blood may have mixed (if you experience bleeding).  You will be given the option to take the RhoGam injection between 24-28 weeks (your blood will usually be tested again at this time with the Coombs test, or titer test, to determine if your titer is rising or not) during pregnancy which will prevent your body from building antibodies against your baby’s blood should something happen in which the blood will mix. 

If the mother is low risk and has not previously had a Rh+ baby, and her titer is not rising, she can reject the RhoGam injection during pregnancy and postpone it until after the birth, after the baby’s Rh factor has been determined.  There is no need for Rhogam if the baby is Rh-.   

The Rhogam injection given during pregnancy will transfer to the baby, and at this time we are not sure of long term effects of that.

Just a little blurb to let you know that Motherhood Naturally is now offering cloth diapering classes for free.  The classes will be in my home, in a relaxed atmosphere. By all means bring your child/ren and let me show you the world of cloth diapers and how easy (and economical) they can be!  I have a large selection of cloth diapers available for demonstration purposes that businesses have kindly donated, so you have a great chance to see the many features available today.

Prenatal Panel

In the first trimester, you will probably receive a group of tests known in many health centers as the “prenatal panel.”  This panel of tests usually includes, but is not limited to, a complete blood count (CBC), blood typing (including Rh screen), rubella viral antigen screen, and hepatitis panel.  

Other tests may be obtained based on your health and previous pregnancy history. What is the CBC?A complete blood count (CBC) offers clues about your general health by analyzing three components of blood: red blood cells, white blood cells, and platelets. If any of these cells is out of balance, you may have a condition that needs to be addressed. For example, a CBC estimates the volume of your red blood cells. This measurement is called the hematocrit. If your hematocrit is low, you may be anemic, which is a common condition during pregnancy. Your health-care provider may recommend you boost your iron stores eating more iron-rich foods such as liver, lean red meat, dried fruits and nuts, leafy green vegetables, and iron-fortified breads and cereals. An elevated or low white blood cell count may indicate infection or inflammation because these cells are the body’s infection fighters. Platelets are very small cellular components of blood that help the clotting process. 

What is Blood Typing?A blood test will disclose your blood type if you don’t know it already. Each of the major blood types — A, B, AB or O — comes in two different varieties: negative and positive.   People with a negative blood type lack a certain protein called an Rh antigen. People with a positive blood type have this antigen. This information is important because complications can arise if your baby is Rh positive and you aren’t. What is Rubella?Another blood test will confirm whether your blood has antibodies to the rubella virus. Antibodies are special proteins produced by your body’s immune system as a response to a foreign substance, such as a virus. If you previously had rubella you develop “natural immunity,” or protection against the illness and you’re unlikely to get it again. If you don’t have any immune defenses against rubella, your doctor will advise you to steer clear of anyone who might have the disease. This is because the disease can cause serious complications during pregnancy, especially during your first trimester. Potential complications include miscarriage, stillbirth, or significant birth defects such as deafness, stunted growth, heart irregularities and mental retardation. These complications are called congenital rubella syndrome, and although your doctor may give you antibodies to help fight off infection, they won’t entirely eliminate the possibility of your baby developing the syndrome. If you aren’t immune to rubella, pregnancy is not the time to get vaccinated because the virus in the injection could be passed on to your fetus. Consider getting vaccinated after your baby is born if you’re planning to have more children.What is Hepatitis B?A blood test is the only surefire way to tell whether you’ve been infected with hepatitis B, a virus that attacks the liver. Hepatitis B usually spreads through sexual contact, shared needles, or bodily fluids. Although many people with this disease are entirely symptom-free, you can pass on the infection to your baby during childbirth. Hepatitis B doesn’t usually cause problems during pregnancy for either you or your unborn child.   However, during labor and delivery, large amounts of blood and other fluids are exchanged between mother and child, putting your infant at greater risk of exposure to the virus. If you are infected, To lower the risk of spreading the infection to your baby, he/she will be given hepatitis B immune globulin, as well as a vaccine immediately after birth. What is Syphilis?A blood test is also the best way to diagnose syphilis, a sexually transmitted disease that can easily go unnoticed in women. This uncommon but serious infection can also be transmitted to your developing child during pregnancy and delivery. Syphilis can cause miscarriage, stillbirth, or premature rupture of the amniotic sac or membranes. An infant born with the disease may have brain, liver, spleen, skin, bone, ear, or eye problems. If you are infected, it’s important to get treated with penicillin –particularly during the first few months of pregnancy — to greatly lower the risk of long-term damage to your developing baby. Treating a newborn immediately will prevent further harm in many cases.

Amniocentesis

An amniocentesis is available for women over 35, for women with a family history of genetic disorders, and for expectant mothers who have had a quad-screen suggesting the possibility of a genetic disorder.   

Amniocentesis diagnoses the possibility of:

• Chromosome problems (such as Downs syndrome)
• Genetic diseases (such as cystic fibrosis, sickle cell disease)
• Neural tube defects (such as spina bifida)

Aside from testing for chromosomal abnormalities or birth defects, an amniocentesis can also test the baby’s lungs to see if they are mature if the mother is showing signs of premature labor, or if the mother will need to be induced early.  The amniocentesis can also determine the sex of the baby. 

How is it done?A needle, guided by ultrasound, is inserted through the abdomen into the amniotic sac to collect fluid surrounding the baby.  The amniotic fluid holds cells shed from the baby, and is an accurate way to test for chromosomal abnormalities and some birth defects.   

Results can be had in about 2-4 weeks, and findings are quite accurate. 

Amniocentesis is not without risk.  It can cause miscarriage in about 1-2 pregnant women out of 200.  There is also an increased risk of infection.

Chorionic Villus Sampling (CVS)

Having a CVS done will diagnose chromosomal abnormalities, such as Downs syndrome, Tay-Sachs disease, cystic fibrosis, or sickle cell anemia.  Because the placental tissue does not include amniotic fluid, some birth defects, such as spina bifida, can not be tested for. 

How is it done?A thin tube, guided by ultrasound, is inserted through the cervix and up to the placenta where a small amount of the placental tissue is removed (B) OR tissue is removed via a needle inserted through the abdomen (A) similar to the amniocentesis.   

This is generally done between 10-12 weeks, and  is available for women who will be 34 years of age or older when they deliver, or for those with a family history of genetic disorders diagnosed by CVS.  The CVS is not routinely available for pregnant women, and a meeting with a genetics councilor is required prior to the procedure.                                                                                                    CVS is considered more risky than the amniocentesis, causing more miscarriages, limb defects, and also carries the risk of infection.  Results can also be confusing to read, requiring more testing to understand the results. CVS is not as accurate as the amniocentesis, but the benefit for some is the chance to learn early in pregnancy that there could be chromosomal abnormalities.

 This test can be done to determine the possibility of your unborn baby a open neural tube defect, Downs syndrome or Trisomy 18

 Remember that no test or procedure is completely accurate when trying to determine if an unborn baby has a genetic defect.  These tests measure the possibility of a open neural tube defect, Downs syndrome or Trisomy 18, and both false negative and positive results do happen. 

The quad screen is generally done between 16-18 weeks, and results can be had in 2-3 days. 

Blood is drawn from the mother, and four specific biochemical markers (alphafeto-protein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (eC3), and inhibin-A) are measured.  These levels, in addition to other information, can determine the possibility of a disorder.  

What if you get a positive result?If you do have a positive result, if you choose, you can have an ultrasound and/or amniocentesis or CVS done to determine the possibility of a birth defect.  Generally a genetic evaluation will be done prior to further procedures.  

Who takes the test?This test is available for all pregnant women.  Many people will not take the test because the results can be so shaky, and they will not end a pregnancy because of a chance that their baby will have a disorder.  Others will take the test (and further procedures if necessary) to prepare themselves for the possibility, and then others will end the pregnancy.

By seven weeks, your baby is about the size of a raspberry

By two months, your baby is about the size of a kidney bean

By three months, your baby is about as long as a lime

By four months, your baby is about the size of an avacado

By five months, your baby is about 10 inches long

By six months, your baby is about a foot long!

By seven months, your baby is about 15 inches long

By eight months, your baby is nearly the size he or she will be at birth - generally around 6-7 lbs

At nine months, the average baby is about 18 inches long.

My latest craze these days is a household notebook I’ve created.  This isn’t a new idea by any means, but I am finding the organization exciting and want to tell everyone about it!  If you read my lastest post over in Home Life, you can visit a great link that is an amazing resource for household notebooks.

Anyway - a household notebook can be great for pregnancy and postpartum.  Many women find it hard to remember things during their pregnancy and also during the postpartum period.  Having a notebook where everything important is stored (along with prenatal appointments, belly and baby stats, etc.)

A daily, weekly and monthly to do list helps keep track of regular and routine tasks.  Make a note of all of the things you need to get done, when they need to get done, and their priority so you can take a peek when you’re having an “I don’t know what to do next” moment.  If you have a checklist of your cleaning tasks divided by room and frequency of needing cleaned, this can be VERY helpful during the postpartum period for your partner or other people eager to help.  All of your regular chores will be written down so they can take a look at your list and do something on it.

Keep a running list of items you want to buy before baby.

Make notes of things you’d like to try during your labor and birth, and postpartum if necessary.  Sitting down to write up a birth plan is helpful, but generally you won’t remember all of the details.  It’s great to keep a running list through pregnancy so you can avoid the “Oh, I wanted to try that!” afterwards.

Keep a list of favorite recipes and what cookbooks they can be found in.  Start planning some freezer meals so you don’t need to cook (or rather, your partner or family) after the baby is born.

Keep a list of books and movies you want to read.  After the baby is born if you’re nursing, there will be a lot of downtime.  If you’re not gazing at your baby (and that will be a lot!), you can catch up on some good books!

If you want to keep track of your new baby’s feedings and diaper changing, you can print off some pre-made charts (you can find some at chartjungle.com) and have them ready to go.

Start off on the right foot and print off health record forms to have ready for your baby.  Document important things like birth weight, length, blood type, and more.  If you choose to vaccinate,

I wanted to share with you a book i wrote for my children as one of the many ways I am preparing them for our homebirth coming up next month.  The book is not professionally edited or proofed.  it is not going to be published. It is just available free on my website for other moms to download if they are looking for a way to help prepare their children for a homebirth.

The book does contain actual birth photos from my last homebirth. The book is written from a Christian perspective. 

You can download it from www.motherhoodnaturally.com/store and click on the “Freebies” section.  You will also find a free, downloadable business directory there if you’re shopping for cloth diapers or supplies.

My baby turned posterior yesterday for a better part of the morning and afternoon.  If you’ve never experienced the pain a posterior baby can produce, count your blessings.

Anyway, it seemed no amount of positioning on my end would get this baby to budge.  Until i turned into a slide for my toddlers.  With my bum in the air and my shoulders and head on the floor, my toddlers (3 and 18 mos) had a ball climbing up mommy and sliding (or rolling) down her back.  Their weight offered counter pressure which helped with the pain.  The constant jostling, I’m guessing, encouraged the baby to kindly move off of my spine (in conjunction with my positioning).  It also helps to get on all 4’s and let the kids sit on your lower back - they had fun while I did some pelvic rocks that way.  And it really felt good.

Finally I experienced relief and my baby took up a more favorable position. Yay for toddlers!

So… If the baby is posterior when I go into labor, I think I’ve found a job for the kids!

For many women, epidurals are the pain relief of choice during labor and birth.  Unfortunately, many women are led to believe that they are completely safe, work effectively every time, and are nothing to worry about.  Many women and sometimes doctors claim they enhance the labor and birthing process and make for a happy, memorable event for the parents.  Some women decide early in their pregnancy that they want an epidural as soon as they go into labor.  It seems to be a growing trend that women “shouldn’t have to” experience pain during labor.
While epidurals are used nearly routinely in most hospital environments, they are not without their side effects to mom and baby, nor are they something to be worry-free about.  I am very surprised by the frequency of doctors claiming they are safe while there is evidence documenting the opposite.  The more I teach and follow up with my students and talk with pregnant women who are not students but have questions, the more frequently I run into women who have had short term or long term problems as a result of their epidurals, or their labor was effected in such a way from the epidural that a cesarean section or instrumental delivery had to be done. 
I’d like to start blogging about epidurals, doing little parts at a time. I think it makes for easier reading instead of putting everything out there at once.  This is something women need to know about, and need to educate themselves from a variety of sources.  There are a variety of ways to reduce pain during labor – both medical and non-medical – and each is capable of enhancing your labor and birth experience, while still making for happy memories.
Epidurals DO have their place in labor and delivery, and I will get into that.  But first I’d like to start off with what an epidural is and how it’s used, so we’re all familiar with it before I go into more detail.

Stay tuned…