Welcome to The Club

Since you’re reading this, there’s a good chance you are about to join the ranks of parenthood. And that’s probably a good way to say it: “join the ranks of parenthood”. It is difficult to explain the feelings of parenthood to those who have never experienced it. However, it is evident very early in parenthood that one has joined a very unique club. A club whose membership hangs on the successes and failures, ups and downs, pain and pleasures of their offspring.
Non-parents sometimes sneer at the overindulgence of parents in their offspring……they don’t understand…….we can’t help ourselves. It’s instinctual. It’s maddening. It’s joyful. It’s painful. It’s fulfilling. And at the same time that it’s sublimely selfless, it can be the most selfish of relationships. For one to have so much control over the life of another, and to feel, at times, so out of control…….done properly, the responsibility is overwhelming.

Those who work in maternal/child health often joke that newborns don’t come with user’s manuals. They are referring to the fact that shortly after giving birth, a new parent is sent home with a new baby, quite inexperienced and often wondering how to care for the life of a new human being. But there ARE manuals…..and there is help available. If your own parents did less than a splendid job with their parenting, consider asking for some professional assistance.

Abuse rates among the formerly abused are unacceptably high. Early parenthood is often exhausting, frightening and lonely. If you are uncertain whether or not you can be an EXCELLENT parent, ask for help. Your child deserves nothing less. Ask your doctor or midwife to refer you to a social worker for information about parenting resources in your community. We need to act as though each child is a future Nobel Prize winner or the next Mother Teresa…..we need to nurture them to their full potential. It’s an awesome task.

Fear and Anxiety

Have you ever heard the expression, “a face only a mother could love”? There’s a “Seinfeld” episode regarding a young family with a new baby. Jerry and Elaine are mystified at the gushing attraction of the parents and pediatrician to what is apparently a very homely baby. This is the power of parenthood. It is beyond reason. And it is very powerful.
That same power makes a female grizzly bear with young cubs one of the most fearsome creatures on Earth. Almost every year in the Rocky Mountains an unsuspecting hiker surprises a mother grizzly and becomes a victim of parental protectionism. The forces at work here are the essence of parenthood. Generally speaking, one cannot fathom the depths of this topic until one is a parent. Then, it’s all too clear. Pregnancy gives one a first glimpse.

This instinct is near-universal, it serves to protect the young……..but it also promotes the growth of wrinkles and ulcers, and induces insomnia. Whether your “child” is a half-inch-long embryo, a fetus about to be born, a 2-year-old crossing the street, or a 16-year-old with a brand new driver’s license, as a parent this fear and anxiety will now be a constant companion in your life.

You will worry from the beginning……

  • “Did I have a drink that weekend before I missed my period?”
  • “I took some aspirin early in my pregnancy.”
  • “My sister has a baby with Down syndrome.”
  • “I can’t keep any food down. Is my baby alright?”
  • “Am I getting enough protein?”
  • “Is the baby’s heartbeat OK?”

The reaction is normal. However, it isn’t easy. This will be a major part of your life for quite a while. What’s a mother to do? What every mother does…….worry. Besides, you can’t avoid it. But the way in which you channel your anxiety can make a big difference in your day-to-day life. How does a parent protect the 2-year-old on the sidewalk from the speeding cars in the street? You can stand on the porch and worry, hoping that a car does not hit the child. Or you can hold the toddler’s hand when near traffic. The same simplistic logic works well in pregnancy. Channel your anxiety into constructive behaviour. Here are some ways to do that:

  • Start prenatal care early.
  • Eat well. If you don’t; learn more about nutrition.
  • Avoid drugs.
  • Get some exercise.
  • Stop or cut down on your smoking.
  • Go shopping for healthy foods.
  • Avoid that neighbor who keeps telling you horror stories about her labor
    and births.
  • Take a pregnancy yoga class.
  • Read a book about raising children.
  • Go catch a movie at the afternoon matinee.
  • Prepare your home for your newborn.

  • Go to childbirth education classes.
  • Call your Mom and apologize for all grief you gave her; tell her you love
    her.
  • Sing to your baby; s/he can probably hear something at some point.
  • Find a trustworthy doctor or midwife who will give you adequate time to
    dispel your more unrealistic fears and anxieties.

The Odds

Most prospective parents worry considerably whether or not their baby is normal and healthy. Many of the bad things that happen in a pregnancy are actually relatively rare occurrences. The list which follows presents some of these complications and the incidence with which each occurs (and some other factual information). (The denominators of the fractions are “live births” unless stated otherwise.) Don’t forget about the Glossary.
These numbers can generate the fear and anxiety discussed above. Don’t focus too much on them. They are presented here because for 2 reasons. First, knowledge is power. However, many people would argue that a “little” knowledge taken out of context is worse than no knowledge at all……there is some truth to that. So, find a doctor or midwife who will take the time to put all this information into perspective for you. Secondly, although pregnancy is often a cause for celebration, it can almost be a fact of life which is serious and threatening. For many women who experience a problem during pregnancy, it may be the first time they ever experience the harsher realities of life.

Take these isolated facts and use them as a foundation for discussion with your midwife or doctor. Channel your anxiety into productive, constructive behaviour. Chances are you and your baby will be just fine. The Odds are in your favor.

Opinionated, Anecdotal, Generalized Facts

  • Chance, if you’re pregnant and make it to term, of getting the bundle of
    joy you envision- 94%
  • Chance of being completely surprised by some aspect of your pregnancy,
    regardless of preparation- 95%
  • Chance that your labor and birth will happen as you plan- inversely proportional
    to the length and amount of detail of your plan
  • Chance you will find something of interest to you on this website- 100%
  • Chance you will dispute something on this website- 100%
  • Chance, with a heterosexual couple, that the male mate can be sufficiently
    reprogrammed to provide sensitive, feminized care during labor- 50%
  • Chance that you will get this care by hiring a doula- 90%
  • Chance that the average male will rationalize the cost and quickly relinquish
    this role to a doula- 84%
  • Chance that one of the grandmothers will be overly involved in aspects
    of your pregnancy and parenting- 47%
  • Chance that a complete stranger will make a personal comment to you about
    your pregnancy- 92%
  • Chance that this comment will offend you- 73%

Miscarriage

  • Rate after confirmed pregnancy-15-30%
  • Estimate of miscarriage rate after all conceptions->50% (probably perceived
    as “late periods”)
  • Percentage of miscarriages associated with chromosomal abnormality or developmental
    defect- 60%

Birth defects

  • all birth defects (including things as benign as skin tags)- 7/100
  • birth defects needing medical attention- 3/100
  • life-threatening defects- 1/100

  • Reasons for birth defects:
    • Single gene mutations- 20%
    • Chromosomal abnormalities- 5%
    • Teratogens- <7%

    • Unknown- >60%

Down Syndrome

Maternal Age Incidence
20 1/1923
26 1/1124
35 1/365
40 1/109
49 1/12

Neural tube defects

  • 1-2/1000 in the U.S.
  • 3-9/1000 in Great Britain

Multiple Gestation (without the use of fertility drugs)

  • Twins-
    • in women of Caucasian descent- 1/89
    • in women of African descent- 1/71
    • in women of Asian descent- 1/160
  • Identical Twins (monozygotic)- 4/1000
    • Proportion of twins who are identical- 1/3
  • Triplets-
    • in women of Caucasian descent- 1/9200

    • in women of African descent- 1/5100
  • Quadruplets-
    • in women of Caucasian descent- 1/570,000
    • in women of African descent- 1/240,000

Risk of multiple gestation when clomiphene (Clomid, Serophene) is used
to induce ovulation- 1/15

Risk of multiple gestation when hMG or FSH (Pergonal, Humegon, Repronex,
Fertinex, Follistim, Gonal-F) is used to induce ovulation- 1/3

Gestational Diabetes (GDM)

  • Overall, 5%
  • Future Risk of Adult Onset Diabetes in women with GDM
    • if obese- 60%
    • if not obese- 15%

Toxemia/Pre-eclampsia

  • in first time mothers-6-7%
  • in others- <1%

Cesarean section in the U.S.

  • percentage of births by c-section, 1995- 21%
    • in 1965- <5%
  • Health 2000 benchmark- 15%
  • Rate of c-section if this is your first baby- 25%
  • Rate of c-section if this is your second (or more) baby and your first
    baby was born vaginally- 2%
  • Proportion of c-sections which are repeat c-sections (i.e., had a previous
    c-section)- 1/3
  • Success rate for vaginal birth after previous c-section- 60-80%
  • Risk of rupture of the uterine scar in women attempting vaginal birth after
    previous c-section:
    • if previous incision was “low transverse”- 0.2-1.5%
    • if previous incision was “low vertical”- 1-7%
    • if previous incision was “classical” (vertical in the upper uterus)- 4-9%
  • estimate of the number of unnecessary c-sections needed to prevent a single
    case
  • of newborn cerebral palsy- 500-2,000

Malpresentation

  • Breech- 3-4%
  • Face- 0.2%
  • Persistent Occiput Posterior (those babies delivering in occiput posterior)-
    3%

Maternal death

  • U.S.- 9.6/100,000
  • U.S., Causasian women- 7.6/100,000
  • U.S., African-American and others- 16.6/100,000

Sudden Infant Death Syndrome

  • U.S.- 1/1,000
  • SIDS rate prior to 1992 Back to Sleep recommendation- 20% higher

Circumcision

  • % of infant males circumcised in the U.S., 1995- 64%
  • % of infant males circumcised in Canada- 48%
  • % of non-Jewish/non-Muslim men circumcised on this planet- 1%
  • RISKs of circumcision-

    • overall risks:

      • 0.2-0.6% (according to the American Academy of Pediatrics)
      • 3% (according to the American Urological Society)
    • risk of death- 4 in the U.S. in the last 45 years (a number highly suspected
      as far too low by circumcision opponents)

  • RISKs of not circumcising
    • Risk of hospitalization for urinary tract infection in male infants
      • Circumcised- 2/1,000
      • Uncircumcised-7/1,000
    • lifetime risk of penile cancer in uncircumcised men- 1-10 per 100,000
    • lifetime risk of penile cancer in circumcised men- 1-3 per 100,000

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