After weeks of bed rest during pregnancy, new mothers need to rebuild muscles and strengthen their stamina. Now a group of women will test new interventions in aiding that recovery during a pilot study at Case Western Reserve University’s Frances Payne Bolton School of Nursing.

“Putting people in bed is not a benign kind of thing,” says Judith Maloni, a professor of nursing at the Bolton School. She has been studying the effects of bed rest for nearly two decades and aerospace research studies conducted by NASA have shown that bed rest changes every major organ system in the body and its function.

During her study, “Rebound: A Self-Management Intervention for Recovery from Ante-partum Bed Rest,” Maloni will test a set of exercises and educational programs that help women learn to manage their recovery after both bed rest and birth.

The study is supported by the Bolton School’s Center for Excellence for Self-Management Advancement through Research and Translation (SMART). It is among four projects the center is piloting to learn more about teaching individuals how to manage their own health care.

Nearly 1 million pregnant women annually are sent to bed near the end of their pregnancies to prevent preterm labor, premature rupture of membranes, placenta previa, incompetent cervix or placental abruption.

According to Maloni, many women leave the hospital and cannot understand why they suffer back problems and muscle aches and are fatigued while other new mothers seem to bounce back after giving birth.

Maloni said she would like bed-rest moms to understand that what they are experiencing is normal for women who have been on bed rest.

They may need physical therapy and other interventions to regain the strength to do normal activities like taking care of other children, doing household tasks or participating in activities in the community or with friends, said Maloni.

Following delivery, these women must overcome the long-term effects of bed rest. Other research has found these effects can be bone loss; decreases in body mass, fluid loss and plasma; depression; and muscle weakness.

Maloni will recruit 80 women who have had good physical and mental health and had at least 21 days or more of bed rest prior to their baby’s birth.

These women will be evaluated two days into the study with follow-ups after two months and three months. At the end of testing, Maloni will offer the new intervention to the women in the control group.

The new intervention is a set of cardiovascular and strength exercises developed for the elderly, who, like new mothers, may be in a state of physical deterioration.

Women in this group will be tested for their physical capabilities during a six-minute walk, 30 seconds of sit-stands and two minutes of stepping in place.

In a prior study on the ability of bed-rest mothers to function after childbirth, Maloni reported that women who were given the exercises from the Rikkli Jones Senior Fitness Test walked an average of 217 feet in 4.8 minutes. This was the same level of performance as women in the 70-75 age group.

Maloni has studied the postpartum conditions of bed-rest moms until six weeks and found that many of them are still fatigued. By following the women to the third month, she hopes to discover if longer intervention is need to help women regain lost strength and stamina.

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Pregnant woman on bed rest who are interested in participating in the study are encouraged to visit http://www.fpb.case.edu/bedrest/.

Source: Susan Griffith
Case Western Reserve University

On Monday, USA Today examined the rate of smoking among pregnant women and the success rates of various programs to help such women quit. According to Tom Glynn of the American Cancer Society, about 45% of pregnant smokers are able to quit, compared with a rate of about 10% to 20% among all smokers who usually quit after going through a smoking cessation program.

Research shows that even three minutes of smoking cessation counseling by a physician doubles the likelihood that a pregnant woman will quit smoking, Tracy Orleans, senior scientist at the Robert Wood Johnson Foundation, said. Robert Wood Johnson implements a program in which counselors give pregnant women who do not smoke coupons for infant supplies, Orleans said. The program tests women’s blood for nicotine byproducts. “It breaks quitting up into smaller segments of time,” Orleans said, adding, “So women think, ‘I just have to get through the next month,’ or ‘If I can make it just 10 more days until I get my next checkup, I can get this $20 gift certificate.’ It helps you rally the willpower you need.”

However, half of pregnant smokers who quit begin smoking again within six months of childbirth, according to CDC. Up to 80% of women who quit during pregnancy are smoking again within one year, the American Legacy Foundation reports. People often return to smoking during times of stress, and women who are experiencing postpartum depression are more likely to resume smoking, according to Alex Parks of the American Legacy Foundation. The American Cancer Society reports that about half of women who smoke during pregnancy are living with a mood disorder. Because mothers often see pediatricians more than their own physicians, the American Academy of Pediatrics’ Smoke-Free Home Program trains pediatricians on counseling parents to quit smoking. About 75% of women smokers say they want to quit, and about half say they have tried in the last year, according to the American Cancer Society (Szabo, USA Today, 7/28).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2008 The Advisory Board Company. All rights reserved.

Although the increasing availability of antiretroviral drugs has led a growing number of HIV-positive women in Jamaica to have children, many women say that health workers in the country do not always agree with their decision to become pregnant, the Jamaica Gleaner reports. According to the Gleaner, women account for approximately 50% of HIV cases in the Caribbean. In addition, 75% of HIV-positive people in Jamaica are in their reproductive years.

Debbie Carrington, care and treatment coordinator for people living with HIV at the Jamaican Ministry of Health and Environment, said that HIV-positive women in Jamaica should not be made to feel that they do not have the right to become pregnant. According to Carrington, the ministry works to prevent unplanned pregnancies in HIV-positive women through counseling and family planning, “just as we do in those without HIV.” Carrington added that when HIV-positive women become pregnant, the ministry takes steps to help women prevent mother-to-child HIV transmission.

However, patients do not always receive counseling and reproductive health services from public health clinics, Tina Kong — a physician at the Comprehensive Health Clinic in Kingston, Jamaica — said. Family planning clinics often provide information about contraception, but health workers at general clinics and sexually transmitted infection clinics may not be trained to do so, the Gleaner reports. “Contraception services in clinics are integrated in thought but not in action,” Kong said. In addition, staff shortages cause health personnel to spend less time with patients, limiting the amount of information that can be provided (Jamaica Gleaner, 7/23).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

View drug information on Carrington patch.

Lamaze: Pregnancy, Birth & Beyond, the magazine for expectant families, published by Rodale Custom Publishing in partnership with Lamaze International, was awarded recently with four 2008 Magnum Opus Awards and an APEX 2008 Award, two of the publishing industry’s most prestigious awards.

Magnum Opus Awards recognize “corporate and custom publications that deliver - strategically, editorially and visually - with a quality consistency of the highest order.” The 2008 Magnum Opus Awards for Lamaze: Pregnancy, Birth & Beyond are:

Gold, Other Print Publication, Best Editorial - New
Silver, Best All Around by Organization Type, Non-Profit Publication
Special Recognition, GRAND, Other Print Publication
Honorable Mention, Other Print Publication, Best Supplement Annual or One-Shot

The APEX Awards, an annual competition sponsored by the Writing That Works newsletter, recognizes excellence in publications work by professional communicators. Lamaze: Pregnancy, Birth & Beyond won an APEX 2008 Award in the category entitled “Award of Excellence, New Web and Intranet Sites” for http://www.lamaze.org/magazine.

“We are thrilled that our magazine has garnered such prestige and attention from these awards,” said Lamaze International President Allison J. Walsh, IBCLC, LCCE, FACCE. “Our partnership with Rodale has yielded a publication that not only benefits expectant families, but also is recognized for its editorial and visual qualities.

“We are honored to receive these awards for Rodale on behalf of our partners at Lamaze International and we are thrilled that the industry understands the value of custom publications as a means to expand the relationship businesses have with their customers,” said Valerie Valente, VP and Publishing Director for Rodale Custom Publishing.

Lamaze: Pregnancy, Birth & Beyond is written exclusively by health care professionals to help expectant parents build confidence for a normal and healthy pregnancy, childbirth and early parenting. The magazine, which is printed in English and Spanish, is distributed four times per year.

The online version of Lamaze: Pregnancy, Birth & Beyond is available in English and Spanish, and provides online tools and expanded educational resources for women and their families. The site’s newest feature is a free weekly pregnancy e-mail newsletter for expectant parents entitled Lamaze…Building Confidence Week by Week, which provides trustworthy information, practical tips and inspirational stories to help guide women and families through pregnancy and beyond. Lamaze International began its partnership with Rodale to publish the magazine as well as the online consumer Web site in January 2008.

Companies interested in sponsorship opportunities should contact Lauren Loomis at laurenloomis@avmpublishing.com or at 847-835-9442. Childbirth educators interested in receiving free copies of Lamaze: Pregnancy, Birth & Beyond for their classes should call 877-527-1977.

About Lamaze International

Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area networks, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers. For more information about Lamaze International and the Lamaze Institute for Normal Birth, visit http://www.lamaze.org.

About Rodale

Rodale Inc. is the authoritative source for trusted content in health, fitness, and wellness around the world, reaching more than 70 million people globally. The company publishes some of the best-known health and wellness lifestyle magazines, including Men’s Health, Prevention, Women’s Health, Runner’s World, Best Life, Bicycling, Running Times, Mountain Bike, and Organic Gardening, and is also the largest independent book publisher in America with a collection of international titles, including The South Beach Diet and The Abs Diet franchises, and Al Gore’s New York Times bestseller, An Inconvenient Truth. Rodale’s broad range of media platforms includes magazines, books, video, and extensive Web sites. The company is also a leader in direct-response marketing and has more than 25 million active customers in its database. Visit the Web site at http://www.rodale.com.

Source:
Lamaze International
http://www.lamaze.org

The Christian Science Monitor on Tuesday examined the debate over whether “childbirth is a natural bodily function or a medical event necessitating hospitalization.” The Monitor profiled the case of midwife Diane Goslin, who practices in an Amish area of Lancaster County, Pa. Goslin was ordered last fall by the Pennsylvania Board of Medicine to stop assisting pregnant women during childbirth. The board said Goslin was “practicing medicine and nurse midwifery without the appropriate licensure” (McCauley, Christian Science Monitor, 7/22).

The Pennsylvania Commonwealth Court in May ruled that Goslin was not practicing medicine without a license by assisting at home births. State officials initially charged Goslin because she is a lay midwife and not a nurse midwife. Only people who have nursing degrees can be licensed to practice midwifery in the state, but Pennsylvania law does not prohibit the practice of lay midwifery — usually defined as midwives trained through apprenticeship. The court did not address whether it is necessary to be certified as a nurse-midwife to practice midwifery in the state (Daily Women’s Health Policy Report, 5/28).

According to the Monitor, the order arose because an infant delivered by Goslin died one day after birth. The death was not considered her fault, nor has there been any suggestion that her rates of death or complications are unusual. The case was the third time Goslin had charges dropped against her for allegedly violating licensing regulations in 18 years of practicing midwifery. Although Goslin has been cleared and continues to deliver infants, her work remains “under a legal question mark” because Pennsylvania recognizes only nurse midwives.

According to the Monitor, the home birth debate recently has been joined by such participants as former talk show host Ricki Lake — whose documentary,”The Business of Being Born,” looks at the current maternity care system and at-home childbirth — as well as the American College of Obstetricians and Gynecologists, which recently reiterated its opposition to home birth, according to the Monitor.

Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said, “The (issue of) the medicalization of childbirth has been around for a long time now,” adding, “There will always be (people like) the Amish, who want no technology,” and those who will refuse to have an infant unless they can deliver at a hospital. Caplan said debate on the issue should be “removed from the ideological push and pull” and instead be driven by safety data specific to a woman’s age and risk factors, as well as the availability of emergency backup care. However, such data are always changing and debatable, the Monitor reports.

The Midwives Alliance of North America said research suggests that safety rates of home births are equal to or better than those of hospital births among women who have low-risk pregnancies. According to the Monitor, such comparisons are “difficult” to make because the 40,000 to 45,000 infants born at home represent about 1% of all U.S. births annually (Christian Science Monitor, 7/22).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2008 The Advisory Board Company. All rights reserved.

The concept of “teenage pregnancy” is “stigmatizing, prejudicial” and “counterproductive” and should be abandoned by advocates aiming to reduce unplanned pregnancies among teenagers, Mike Males, a researcher for the online information service YouthFacts.org, writes in a Los Angeles Times opinion piece.

According to Males, the term is counterproductive because it “perpetuates pre-1950s sexist misnomers” that the partners involved in teenage pregnancy are in high school. According to the California Center for Health Statistics, a “large majority of male partners involved in teenage pregnancy are not the high school boys frequently blamed, but men ages 20 and older,” Males writes, adding that instead of “criticizing the ‘high rate of teenage pregnancy’ in the U.S., shouldn’t we be condemning the ‘high rate of adults impregnating teens?’” According to Males, in an “era of gender equality — in which men are expected to share in sexual responsibility and child-raising — why is a 19-year-old woman knocked up by a 22-year-old man stigmatized as part of the ’social problem of teenage pregnancy,’ but a 22 year-old-woman impregnated by a 19-year-old man isn’t?’” He adds, “Isn’t the real problem, regardless of the mothers’ ages, fathers who fail to support their kids?”

In addition, another “reason to jettison the pejorative idea of ‘teenage pregnancy’ is that teen motherhood may be a viable strategy for poorer and minority groups in the U.S. and other countries to maximize the survival of their offspring,” Males writes, adding, “Because poorer groups tend to die younger, having babies early in life may ensure that grandparents and extended family members will be alive and healthy enough to help raise children.” However, studies finding that teenage “motherhood may actually make economic sense for poorer young women” have been “ignored by all sides in the debate,” Males writes. He adds, “That teenage motherhood may represent a rational long-term economic choice for poorer women wasn’t what activist groups that invoke the ’social costs’ of teen pregnancy wanted to hear.”

If groups such as Planned Parenthood, the Family Research Council and the National Campaign to Prevent Teen and Unwanted Pregnancy “really want to reduce unwanted teen pregnancies, they should study such factors as poverty, the older ages of male partners, the advantages having children afford poorer young women and the plunge in births among married teens and adults, among other realities,” Males writes, concluding, “That would be easier if the stigmatizing concept of ‘teenage pregnancy’ was not part of our health policy deliberations” (Males, Los Angeles Times, 7/13).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2008 The Advisory Board Company. All rights reserved.

Malaria is one of the most devastating diseases afflicting humanity. It infects and debilitates about 600 million people and kills up to three million people every year, mainly in the wet tropical regions of the world. Children and pregnant women are at particularly high risk.

The malaria parasite is injected into humans by an infected mosquito. The parasites then infect healthy red blood cells, transforming them into sticky sacks containing up to thirty-two new daughter parasites. The hijacked red blood cells stick to blood vessel walls, thereby avoiding being flushed through the spleen and being destroyed there by the body’s immune system.

WEHI scientists have revealed key elements in the parasite’s “sticky sack” adhesion strategy. They have identified eight new proteins that transport the parasite’s major adhesion factor, PfEMP1, to the surface of infected red cells, where it promotes the formation of sticky knobs. They have also shown that removal of just one of these proteins disrupts the ability of the parasite bag to stick to blood vessel walls.

This discovery has greatly enhanced our understanding of how the parasite commandeers the red blood cell for its own survival and avoids our immune defences. It also suggests that a drug that inactivates an essential adhesion protein would be an effective anti-malarial.

All currently available malaria drugs attempt to disrupt the metabolism or biological function of the parasite. Unfortunately, malaria parasites are evolving resistance to such drugs, suggesting that quite a different strategy may be required - hence the importance of targeting the “stickiness factors.” The inability of the parasite to prevent its transport to the human spleen would lead to the parasite’s natural destruction.

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The team of WEHI-based and international collaborators includes Alan Cowman, Alex Maier, Melanie Rug, Matthew O’Neill, Monica Brown, Srabasti Chakravorty, Tadge Szestak, Joanne Chesson, Yang Wu, Katie Hughes, Ross Coppel, Chris Newbold, James Beeson, Alister Craig and Brendan Crabb.

The work was supported by the Wellcome Trust, the NHMRC, the Howard Hughes Medical Institute and the National Institutes of Health.

The findings were published in the prestigious international journal, Cell.

Source: Brad Allen
Research Australia

The nation’s fourth and eighth graders scored higher in reading and mathematics than they did during their last national assessment, according to the federal government’s latest annual statistical report on the well-being of the nation’s children. Not all the report’s findings were positive; there also were increases in the adolescent birth rate and the proportion of infants born at low birthweight.

These and other findings are described in America’s Children in Brief: Key National Indicators of Well-Being, 2008. The report is compiled by the Federal Interagency Forum on Child and Family Statistics, a working group of Federal agencies that collect, analyze, and report data on issues related to children and families, with partners in private research organizations. It serves as a report card on the status of the nation’s children and youth, presenting statistics compiled by a number of federal agencies in one convenient reference.

“In 2007, scores of fourth and eighth graders were higher in mathematics than in all previous assessments and higher in reading than in 2007,” said Valena Plisko, associate commissioner of the National Center for Education Statistics, a part of the U.S. Department of Education.

This year’s report also saw an increase in low birthweight infants (less than 5 pounds 8 ounces). Low birthweight infants are at increased risk for infant death and such lifelong disabilities as blindness, deafness and cerebral palsy.

“This trend reflects an increase in the number of infants born prematurely, the largest category of low birthweight infants,” said Duane Alexander, M.D., director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health. Although not all the reasons for the increase are known, infertility therapies, delayed childbearing and an increase in multiple births may be contributing factors.

The birth rate among adolescent girls ages 15 to 17 also increased, from 21 live births for every 1,000 girls in 2007, to 22 per 1,000 in 2007. This was the first increase in the past 15 years.

“It is critical that we continue monitoring this trend carefully,” said Edward J. Sondik, PhD, director of the National Center for Health Statistics in the Centers for Disease Control and Prevention. “Compared with other teens their age, teen mothers are less likely to finish high school or to graduate from college. Infants born to teen mothers are more likely to be of low birthweight.”

Among the favorable changes in the report were a decline in childhood deaths from injuries and a decrease in the percentage of eighth graders who smoked daily.

These and other findings on the nation’s children and youth are described in the report’s content areas:

Demographic Background

Family and Social Environment

Economic Circumstances

Health Care

Physical Environment and Safety

Education

Health

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The Forum’s Web site at http://childstats.gov/ contains all data updates and detailed statistical information accompanying this year’s America’s Children in Brief report. As in previous years, not all statistics are collected on an annual basis and so some data in the Brief may be unchanged from last year’s report.

Members of the public may access the report on-line at http://childstats.gov/.

Source: Robert Bock
NIH/National Institute of Child Health and Human Development

USA Today on Wednesday profiled the book “Baby Basics,” an “easy-to-read pregnancy primer” by Heidi Murkoff, author of the bestselling “What To Expect When You’re Expecting.” According to Murkoff, the abridged book stemmed from her recognition that the one million low-income women who give birth each year do not have access to the 614-page, $14.95 book.

Consequently, Murkoff established the What To Expect Foundation, which produces “Baby Basics,” which has distributed 350,000 copies and been translated into Chinese and Spanish. “All moms should have access to this information,” Murkoff said. The foundation also finances programs in which outreach workers in clinic waiting rooms work with women before their prenatal appointments and “Mom’s Clubs” to teach women how to have healthy pregnancies.

Executive Director Lisa Bernstein said the foundation also teaches pregnant women to read its books. Bernstein said, “We see pregnancy as this incredibly teachable moment,” adding, “We’ve hidden literacy into prenatal education.” Murkoff added that reading helps women have healthier pregnancies, make better medical decisions and become better mothers.

Theodore Barrett — an assistant professor of obstetrics and gynecology at the University of Medicine and Dentistry of New Jersey who started an intensive program for 600 patients with low literacy at his prenatal clinic in Newark, N.J., with foundation funding — said that each patient received a copy of “Baby Basics” and met with a health educator. After the sessions, Barrett said that fewer women ended up in the emergency department or missed prenatal appointments, and that more returned for post-delivery checkups (Szabo, USA Today, 7/2).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2008 The Advisory Board Company. All rights reserved.

A rise in births among Hispanics, not immigration, is increasing the group’s overall population, according to a study published in the June issue of Population and Development Review, USA Today reports.

For the study, researchers Kenneth Johnson, a demographer at the University of New Hampshire’s Carsey Institute, and Daniel Lichter of Cornell University analyzed data from the National Center for Health Statistics. They found that from 2000 to 2007, the Hispanic population increased by 10.2 million and that 58.6% of the increase — or 6.8 million — was because of births. During the same seven-year period, the total U.S. population increased by 20.2 million, with about 60% of that growth the result of births. About 6.8 million Hispanics were born and 812,000 Hispanics died during the study period, according to the data. “In all of the uproar over immigration, this is getting missed,” Johnson, said, adding, “All the focus is on immigration. …At some point, it’s not. It’s natural increase.”

The natural increase - more births than deaths - is increasing among Hispanics in the US because Hispanics on average are younger than the general population and likely to have more children, according to USA Today. The median age for Hispanics is 27.4 years old, compared with 37.9 for the general U.S. population, 40.8 for whites, 35.4 for Asian-Americans and 31.1 for blacks.

The study found that in some cities considered “established immigrant gateways,” such as Los Angeles and Chicago, the entire increase in the Hispanic population comes from new births, according to USA Today. The “Hispanic baby boom is transforming the demographics of small-town America in a dramatic way,” USA Today reports. Researchers found that in some rural parts of the U.S. where populations would otherwise have remained stagnant or declined, Hispanic births might be the only factor in maintaining a viable population. From 2000 to 2007, 221 counties would not have grown without an increase in the Hispanic population.

Steve Camarota, research director at the Center for Immigration Studies, which promotes limits on immigration, said that because more than 50% of Hispanic births are to low-income uneducated women, the increase in births poses additional challenges for communities (Nasser [1], USA Today, 6/30).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2008 The Advisory Board Company. All rights reserved.