This year, West Nile virus has become a serious problem in some areas of the country, such as Texas. Because there is no real treatment for West Nile virus infection, pregnant women may want to take extra care to not expose their babies to the virus.

Note: If you just want to know the risk factors for developing PTSD after giving birth, and what you can do to possibly prevent childbirth causing PTSD, scroll down to the end. 

If you already gave birth and suspect that you might have birth trauma or PTSD, please get help and support! Here are a few resources that may help:
https://www.solaceformothers.org/resources/
https://www.birthtraumaassociation.org.uk/for-parents/ (UK)
https://www.postpartum.net/

Many childbirth educators and other childbirth professionals have suspected it for a long time, but now there is peer-reviewed proof (if there was not any already): just having the label of having gestational diabetes mellitus (GDM) raises a woman’s risk of having a cesarean section.

In the study, “Gestational diabetes mellitus: A risk factor for non-elective cesarean section,” which has been published in the online version of the Journal of Obstetrics and Gynaecology Research from the Japan Society of Obstetrics and Gynecology, researchers showed that even though the rate of cesarean indicators was not significantly different, mothers with GDM had a statistically significant higher rate of non-elective cesarean. The study authors think it may be knowledge of the diabetes itself influencing doctors.

You could argue that these are Japanese doctors in the study, not American, so the results don’t apply in this country. I think it is reasonable to use caution here (and around the world), because human nature is pretty much an international language. 

The best thing is always to try to reduce your risk of getting complications such as gestational diabetes (or as it is now sometimes called, “gestational glucose intolerance”). If you do have or end up with GD/GDM, talk with your birth attendant. Find out his or her parameters for when they would consider cesarean or other interventions necessary in your case. Ask for the doctor’s cesarean rate to see how it compares to other doctors, hospitals, and areas. If you don’t like what you find, it’s ok to switch practices. You may want to consider using a midwife, as they tend to treat pregnancy and birth as more of a normal occurence than a disease. Additionally, do what you can to keep the gestational diabetes under control with low-glycemic eating, regular exercise, and any other recommendations made by your health care professionals. Having well-controlled diabetes gives you a lot more options.

Once you are at your birth location, who has the most influence over how your birth turns out?

Yes, you have a lot of influence. But your OB/Gyn or midwife has an equivalent – possibly greater- amount of influence over your birth experience. This is true even if you have a birth plan, a well-trained coach, and a doula. That’s why it is very important to find an OB/gyn or midwife (also called a birth attendant) who supports the kind of birth you want to have.

When I doula births where mom wants to have a normal, natural labor, and has a doctor that is fine with letting her “try,” mom often ends up with interventions that she did not want, and that may not have been truly medically necessary. During one labor I was at, mom’s labor partner spent a good deal of the time in the hall, “talking” with the doctor. The doctor thought mom’s labor was going too slowly, but mom did not want to speed anything up. Poor dad had many quiet conversations in the hall with the doctor, declining the interventions, instead of being a constant support to his wife. Mom was healthy, had the birth experience she wanted, and got her wonderful present at the end (a healthy baby), but it was a fight. Other women are not as fortunate. I have been at births where the birth attendant was about to do a procedure such as amniotomy (breaking the bag of waters) without even telling mom what they were going to do, let alone asking consent. I had to announce the doctor or midwife’s intentions and ask mom if that was ok with her. No woman should have to spend labor wondering if something will be done to her without her knowledge, or arguing with the hospital staff to have the kind of birth she prefers. As long as you and baby are safe and healthy, a birth attendant that has similar beliefs in regard to pregnancy and birth as you have will support you in the kind of labor you want to have. That is what you are looking for.

Before you can interview birth attendants (doctors and midwives), you need to know a bit about your own desires for labor and birth. Take some time thinking about what kind of birth experience you want and where you want to have your baby. Also consider your feelings on medical procedures such as episiotomy and cesarean, and whether or not you might like to have a natural (unmedicated) birth. You can always change your mind later, but if you drastically change your desires, you may also need to change birth attendants.

Below are some interview tips, and a link to a PDF with suggested interview questions that you can print and bring with you.

Health insurance companies in the United States are now required to cover breast pumps (and lactation consultants!) for any woman who wants to breastfeed her baby. This section of Obamacare (the Affordable Care Act) went into effect for 2013.

The law states that insurance companies must cover some kind of breast pump, but not what kind. At this point (Feb., 2013), many insurance companies are only offering a manual pump. These are worked by hand, not electricity, and usually do not have any of the bells and whistles that come on higher-priced models, but still work well. Some insurance companies will only cover rentals of high-end, hospital-grade pumps, and some will cover either rentals or purchases. Some women may still want to buy or rent their own, depending on what kind of pump they would prefer to have, and what their insurance covers.

New research out of Denmark seems to show a higher risk of autism in babies born to women who had the flu while pregnant, and in those babies born to women who had a fever for longer than a week during pregnancy. In the study, women who had a normal pregnancy had an autism risk of about 1%.  The study, published in Pediatrics online November 12, 2012, was done as a combination of telephone interviews and gathering diagnoses of autism from the Danish Psychiatric Central Register. Women were not tested to see if they actually had the flu, but the study results do give some reason for caution. The study included over 96,000 children born in Denmark between 1997 and 2003. While most common infections during pregnancy did not seem to have any effect on the child, mom getting the flu during pregnancy seemed to double the risk of autism, and mom having a prolonged fever (about a week or longer) seemed to triple the risk of autism.

The good news is that even the highest risk group in the study, that with fever during pregnancy lasting a week or more, still only had an autism rate of 3%. The other piece of good news is that women are able to take actions to reduce their risk of becoming ill during pregnancy.

Many experts recommend that all pregnant women get a flu shot to help reduce the risk of getting influenza. Since flu shots are most effective against the strains of flu in the shot that year, and there are many different strains of flu, some women are concerned about how effective the shot really is. There are also some concerns about the safety of the shot, including the use of thimerosal (a mercury-based preservative) in some batches of flu vaccine. While the CDC states that the small amounts of thimerosal in flu vaccines have not been shown to cause harm, some people are still concerned because of how small the developing baby is. Studies have shown that Thimerosal accumulates in brain tissue and can contribute to neurological problems. Thimerosal has been removed from all vaccines given to children in the United States because of these concerns of possible mercury toxicity. Fortunately for those who want to get a flu shot, there are shots available without mercury.

There are also many other things a woman can do to support her immune system and reduce the likelihood of getting sick during pregnancy, or to get better more quickly if she does get sick. These are great to use in case the shot does not cover all of the common strains of flu out this year, or for those women who prefer to avoid the flu shot.

1) Relax. Chances are you will begin labor AFTER the storm has passed. Relaxing will lower your stress level, and help you be less likely to go into labor, too.

2) Get support. Make sure you will have someone staying with you during the storm just in case. Having someone you trust with you can help reduce stress, and is very helpful if labor does begin.

3) Plan ahead. If you think you might be in labor before the storm hits, or have a “hunch” you will give birth during the storm (especially if you are past 41 weeks), take a room at a hotel immediately next to your birth place. Most hospitals and birth centers have hotels a block or less away. This way, if you do get farther along in labor, getting to your birth place is much easier and safer. Again, have someone stay with you for support.

4) Prepare. Make sure you have supplies of food, water, clean towels, battery-powered lighting, blankets, a fully charged phone (preferably multiple phones, a back-up battery, or a hard line phone), and a hard copy of your birth attendant’s and birth place’s phone numbers. That way, you’re prepared in case you lose power, or are housebound for a few days.