Sunday, September 11, 2022

Body dissatisfaction among pregnant mothers can have long-term health effects on mothers and children; reveals study

Pregnancy is frequently portrayed as a time of great enthusiasm and anticipation. The typical physical changes that occur during pregnancy, however, can raise the likelihood of body dissatisfaction in some pregnant and postpartum women.

Defined as a negative subjective view of one's body size or shape, body dissatisfaction can increase the risk of postpartum depression and eating disorders, both of which can have long term health consequences for mother and child.
A research team led by Rachel Vanderkruik, PhD, MSc, recently conducted a survey to learn more about the prevalence of body dissatisfaction in pregnancy and postpartum; identify the factors that contribute to these feelings; and what type of intervention could help.
What the Survey Found
In a survey of 161 pregnant and postpartum individuals between the ages of 18 and 45, 50% of respondents reported feelings of body dissatisfaction.
Over 40% of respondents said being pregnant or having a baby had made them self-conscious about their appearance. "It's been really hard. I like to be thin. I have no control over my body gaining weight. It has caused anxiety and depression," one respondent wrote.
More than 60% of respondents believed they should be thin or thinner than their current size, and over half said comments from others about their body or size had an impact on their body image.
Respondents said the downsides of pursuing an ideal body image included poor mental health, disordered eating and exercise habits, lost time and money, and negative self-talk.
Not all respondents reported negative feelings about their bodies, however. Some said pregnancy and childbirth led to a greater appreciation for what their bodies were capable of and helped them focus more on their own health and nutrition.
"During pregnancy I started to accept my appearance more and learn to appreciate my body for what it could do, not just how it could look," said one respondent.
When it comes to possible solutions, 82% of respondents said they'd be interested in a program that focused on body acceptance during pregnancy and postpartum. Most would prefer the interventions to be virtual, facilitated by professionals and conducted in a group setting.
"I would like to speak with other women about how to be healthy postpartum but also [how to be] accepting of the body changes and how we will not look like we used to pre-pregnancy."
There is currently a lack of intervention programs specifically targeted to pregnant and postpartum individuals, Vanderkruik says.
However there are existing evidence-based programs for body acceptance, such as The Body Project, that could be adapted to address the unique needs of pregnant and postpartum individuals.
Another existing intervention, Project Health, could be adapted to address the issue of excessive gestational weight in a way that is also sensitive to feelings of body dissatisfaction.
Notably, nearly half of survey respondents reported pre-pregnancy body mass index (BMI) in the overweight or obese categories.
While weight gain is normal during pregnancy, being overweight or obese pre-pregnancy or gaining excess weight while pregnant can also increase health risks for mother and baby.
"There's a tension--we want to prevent any body-shaming or unrealistic expectations about returning to a certain body shape or size shortly after delivering," Vanderkruik explains. "At the same time, we want to support healthy behaviors and a healthy lifestyle, too."
More research will be needed to address the limitations of the survey and further detangle the complex relationship between weight, body image and healthy behaviors in pregnancy and postpartum.
"We would need to do more research on these issues; there were limitations to our survey study, including that assessments participants' BMI and mental health were self-reported, and that it was cross-sectional (it only captured data from one point in time)," Vanderkruik says.
"But judging by the response to the survey study, the issues of body image and eating seem to be something that many pregnant and postpartum individuals care about and are interested enough to take the time to complete the survey without compensation and provide thoughtful information."
The results were recently published in the Archives of Women's Mental Health.
Vanderkruik, a Staff Psychologist and the Associate Director of Research and Cognitive Behavioral Sciences at the Ammon-Pinizzotto Center for Women's Mental Health at Massachusetts General Hospital, has heard individual reports of body dissatisfaction from clients in her clinical practice.
With the survey, she wanted to gain a better sense of the scope of the problem and raise awareness of the challenges it creates.
"I think there can be some shame and discomfort talking about issues of body image in pregnancy and postpartum," Vanderkruik says. "There is still a culture that emphasizes being so happy to be pregnant and such."
"But women's experience with their bodies changing is significant, and I think there is not always a lot of honest conversations about the impact of that."

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

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Sunday, December 15, 2019

Water births are as safe as land births

A pain-less delivery would be a dream for many mothers, and a complete solution to that is yet to be found. But a new study found that water births are no more risky than land births. In water birth, the woman gives birth in a water-filled tub rather than a bed. Few US hospitals or birth centres offer tub births because of perceived risk to the newborn, mainly suggested by case studies of neonatal infections or cord tearing.

University of Michigan researchers analyzed 397 water births and 2025 land births from two midwifery practices. There were no differences in outcomes between water birth and land birth for neonatal intensive care admissions, and postpartum haemorrhage rates were similar for both groups. 

"The long and short of it is that if you use proper techniques...the outcomes are very good," said  senior author on the paper. "They mirror what we see in international studies of water birth." Ruth Zielinski, clinical associate professor of nursing and study co-author, said more facilities should offer water birth and have guidelines for implementing it.

Professional organizations tend to agree that women in labour should have access to water for comfort, but not all support birth in the water. This means hospitals must make women leave the tub before birth. During a water birth, babies take their first breath when removed from the tub. Until then, their lungs are filled with water, which is displaced when they hit the air and breathe. The connected umbilical cord provides oxygen.

"It's important not to re-submerge babies", Zielinski said. At U-M, they are birthed in the water, brought out almost immediately, and they're careful to not re-submerge them. Mom and baby exit the tub with help and warm blankets, typically prior to delivering the placenta so that blood loss can be more accurately calculated. Zielinski said more studies are needed to understand the satisfaction level of women who have water births.


this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     
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Wednesday, July 10, 2019

For the prevention of excessive bleeding after childbirth heat stable carbetocin has been added to essential list t

  • Heat-stable carbetocin has been added to the WHO Essential Medicines List of uterotonics for the prevention of excessive bleeding after childbirth
  • Excessive bleeding after birth, also known as postpartum haemorrhage (PPH), is the leading direct cause of maternal mortality worldwide
  • WHO guidelines recommend heat-stable carbetocin for PPH prevention in settings where oxytocin is unavailable or its quality cannot be guaranteed, and where its cost is comparable to other effective uterotonics
  • Heat-stable carbetocin was developed to address limitations in refrigeration and cold-chain transport of medicines in low- and lower-middle income countries
Due to postpartum haemorrhage (PPH), a woman was rushed to have emergency blood transfusions after childbirth. Her husband felt helpless, but thankfully she recovered.

A Pharmaceutical company today welcomes the World Health Organization’s (WHO) addition of heat-stable carbetocin to the WHO Model List of Essential Medicines (EML) of uterotonics for the prevention of excessive bleeding after birth. The EML identifies medicines the WHO deems essential for addressing the most important public health needs globally. 
 
Every year, 14 million women are affected by excessive bleeding after birth, also known as postpartum haemorrhage (PPH). Although most deaths are preventable, PPH is the leading direct cause of maternal death worldwide, causing approximately 70,000 deaths per year, 99% of which occur in low- and lower-middle income countries.

“The WHO’s addition of heat-stable carbetocin to the Essential Medicines List brings us one step closer to tackling this life-threatening condition that impacts thousands of women and their families,” said a researcher. “This milestone is thanks to collaboration from stakeholders around the world, and demonstrates how work across both the public and private sectors can help achieve development goals in global health. As the manufacturer, is now seeking registrations for heat-stable carbetocin and, once approved, our priority is to make heat-stable carbetocin available at an affordable and sustainable price in public sector healthcare facilities in low- and lower-middle income countries where cold-chain transport and refrigeration of medicines is often difficult to achieve or maintain.” 

This addition to the EML follows the 2018 update to the WHO’s recommendations on uterotonics for the prevention of PPH. The guidelines recommend heat-stable carbetocin for the prevention of excessive bleeding after all births in settings where oxytocin is unavailable or its quality cannot be guaranteed, and where its cost is comparable to other effective uterotonics. The CHAMPION trial, the largest clinical trial in PPH prevention, showed that heat-stable carbetocin is non-inferior to current standard of care oxytocin, for the primary outcome of ≥500 ml blood loss or additional uterotonic use, after vaginal birth. Heat-stable carbetocin remains effective at high temperatures, addressing a significant limitation of oxytocin, which must be stored and transported at 2 – 8°C.
Carbetocin is currently registered in more than 80 countries worldwide for the prevention of PPH due to uterine atony following caesarean section.The Dr. is now seeking registrations for heat-stable carbetocin for the prevention of PPH following all births. Once approved, the heat-stable formulation of carbetocin will be available at an affordable and sustainable price to publicly controlled or publicly funded healthcare facilities and healthcare facilities operating on a social marketing basis in low- and lower-middle income countries. 

About the EML
The WHO Model List of Essential Medicines (EML) serves as a guide for the development of national and institutional essential medicine lists and is updated and revised every two years by the WHO Expert Committee on Selection and Use of Medicines.

 
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