Saturday, February 27, 2010

Mom's Diet During Pregancy and Baby's Chance of Allergies

The adage, 'eat a rainbow' is especially important during pregnancy. Keep reading...


From Reuters Health Information

Mom's Diet During Pregnancy May Alter Infant's Allergies

By Joene Hendry

NEW YORK (Reuters Health) Feb 19 - Eating lots of vegetables and fruits during pregnancy may lower the chance of having a baby with certain allergies, hint study findings from Japan.

Greater intake of green and yellow vegetables, citrus fruit, and veggies and fruits high in beta carotene may lessen the risk of having a baby with eczema, Dr. Yoshihiro Miyake at Fukuoka University and colleagues found.

Foods high in vitamin E similarly may lessen the risk of having a wheezy infant, they reported online January 22nd in Allergy.

Beta carotene and vitamin E are two of many antioxidants thought to benefit health. But prior investigations of maternal antioxidant intake and childhood allergies offered conflicting findings. This area of research "is still developing," Dr. Miyake noted in an email to Reuters Health.

In the current study, Dr. Miyake's team evaluated vegetable and fruit intake during pregnancy in 763 women, as well as eczema or allergic wheeze in their infants.

The women were 30 years old on average and about 17 weeks pregnant at enrollment.. When their babies were between 16 and 24 months old, the women provided birth and breastfeeding history, number of older siblings, and exposure to smoke.

The team found that 21% of the youngsters wheezed or had a "whistling in the chest in the last 12 months," and fewer than 19% had eczema.

According to the investigators, mothers who ate greater amounts of green and yellow vegetables, citrus fruits, or beta carotene while pregnant were less apt to have an infant with eczema.

For example, after allowing for other eczema risk factors, eczema was more common among infants whose mothers ate the least versus the most green and yellow vegetables - 54 and 32 infants, respectively.

Likewise, higher intake of vitamin E during pregnancy was associated a reduced likelihood of having a wheezy infant -- a finding that supports previous investigations from the U.S. and U.K.

Boosting intake of green and yellow vegetables, citrus fruits, and antioxidants such as beta-carotene and vitamin E among pregnant women "deserves further investigation as measures that would possibly be effective in the prevention of allergic disorders in the offspring," the researchers conclude.

Allergy 2010.

Reuters Health Information © 2010

Saturday, February 6, 2010

Free Our Midwives!

Remember the Midwives' Modernization Act? (See my blog posting from September 2009). Well, New York State still has a Written Practice Agreement for it's Licensed Midwives and the MMA is still on the legislative starting block. Citizens in the Ithaca area have put together a fabulous organization and website "Free Our Midwives". Check it out and and consider supporting the cause. Photos and letters are especially helpful! Please visit:


may all babies be born into loving arms

Our vision for is to create a virtual home base for a statewide movement to support the Midwifery Modernization Act.

Subscribing to this site is free and serves a number of purposes:

*Creates numbers and solidarity. Legislators have specifically asked about the consumer support behind the legislation. Gathering in one place (virtually) allows us to show our numbers and act as a group, strengthening our impact.

*Stay Informed and Ready for Action. Passing this legislation is going to take some time and the specifics of actions needed may change. Having a home base allows us to communicate quickly and effectively about what needs to happen, and who needs to receive emails, letters or phone calls.

*Simple Way to Share with Friends, Families, Co-workers and Community Members. Sharing this site with friends, family and neighbors makes it easy to inform those you know. Create a group email explaining why this legislation is important and send them the link along with a request for them to subscribe. Pass this site along using your facebook account and tell people why you think it’s important for them to participate. If friends and family aren’t in New York State they can participate in the Photography Project. When you receive an announcement or a call to action from us you can share it via email, facebook, twitter or any social venue of your choice. It’s easy and fast!

*We’re Inspired! We plan on highlighting the profiles of New York State midwives along with the people who benefit from their care. We will be posting the pictures that roll in from the photography project and any community member who hosts an event is welcome to send their pictures in and be featured on the site!

March Classes @ Debra Goodman PT

Just in case you didn't know, here is the class schedule for Debra Goodman's studio.


may all babies be born into loving arms

Registration Has Begun For March Classes at Debra Goodman Physical Therapy!

The Pregnancy Workout

Core Stability

The Bradley Method of Natural Childbirth

Growing With Yoga

The Pregnancy Workout with Debra Goodman, MSPT

This is the ultimate prenatal/postpartum fitness program. In this class, women will learn the fundamental exercises to feel great during and after pregnancy. Women will stay fit during pregnancy, prepare for labor and delivery, and learn rehab skills for postpartum.

Time: Wednesday, 6:30-7:45 pm

Date: Winter 2 Session: 3/3/10—4/14/10 (No class 4/7/10)

Location: 17 Computer Drive East, #17A, Albany, NY 12205

Cost: $135.00, Space is limited.

To Register: or (518) 944-0314

Core Stability with Debra Goodman, MSPT

It’s time to get strong and have fun at the same time! This class utilizes physioballs, foam rollers, and bands creating a challenging workout for the whole body! Guys, you are welcome to this one…

Time: Wednesdays: 5:20-6:15pm

Date: Winter Series 2: 3/3/10—4/14/10 (No class 4/7/10)

Fee: $120

Location: 17 Computer Drive East, #17A, Albany, NY 12205

To register: click on courses & classes or 944-0314

The Bradley Method of Natural Childbirth with Emily Marynczak, AAHCC

The Bradley Method is a complete course in childbirth education. This comprehensive class covers everything couples need to know to prepare for labor and delivery.

Time: Sunday, 9:30am

Date: Spring Series 3/21/10—6/6/10

Fee: $350

To register: click on courses & classes

Growing With Yoga with Cathy Prescott, E-RYT

Spring Session: Tuesday, 4/6/10 – 5/11/10

Growing With Yoga for Children (2 & 3 year olds), 9:30-10:15am, fee $60

Growing With Yoga for Toddlers (9 months and younger crawlers to 2 years), 10:30-11:15am, fee $60

Growing With Yoga for Mom & Baby (babies 6 weeks to 9 months old, and not yet crawling), 11:30-12:30pm, fee $72

To Register:

Physical Therapy with Debra Goodman, MSPT

Debra has a background in sports medicine, dance medicine, orthopedics, and women’s health.

Physical therapy is beneficial for the following issues:

Back pain, Neck pain, Pelvic/Hip pain, Sciatica, Wrist/Hand pain, Shoulder pain, Foot/Ankle pain, C-section recovery, Abdominal muscle recovery, Scar tissue problems, Vaginal Pain, Muscle weakness, Sports injuries, Posture education, & Body mechanics education

A one hour PT session typically includes manual therapy (massage, joint mobility techniques, & myofascial release) and specific guided exercise instruction. MEN are WELCOME to come and get treated!

Visit or call (518) 944-0314 for more information.

Friday, February 5, 2010

An article for your edification. Also interesting is to read the comments attached the this next site: The little picture under the date has the following written, "Tatia Oden French and her husband J.B. were expecting a girl in 2001 when she died during childbirth."

May all babies be born into loving hands

Pregnancy-related death rate on the rise

Nathanael Johnson, California Watch

Wednesday, February 3, 2010

The mortality rate of California women who die from causes directly related to pregnancy has nearly tripled in the past decade, prompting doctors to worry about the dangers of obesity in expectant mothers and about medical complications of cesarean sections.

For the past seven months, the state Department of Public Health has declined to release a report outlining the trend.

California Watch spoke with investigators who wrote the report, and they confirmed the most significant spike in pregnancy-related deaths since the 1930s. Although the number of deaths is relatively small, the rate in California is higher than in Kuwait or Bosnia.

"The issue is how rapidly this rate has worsened," said Debra Bingham, executive director of the California Maternal Quality Care Collaborative, the public-private task force investigating the problem for the state.

The problem may be occurring nationwide. The Joint Commission, the leading health care accreditation and standards group in the United States, issued an alert to hospitals on Jan. 26, stating: "Unfortunately, current trends and evidence suggest that maternal mortality rates may be increasing."

To help improve care, the advisory asked doctors to consider morbid obesity, high blood pressure and diabetes, along with hemorrhaging from C-sections, as contributing factors to deaths.

In 2007, the U.S. Centers for Disease Control and Prevention reported that the national maternal mortality rate had risen. But experts such as Dr. Jeffrey C. King, who leads a special inquiry into maternal mortality for the American College of Obstetricians and Gynecologists, chalked up the change to better counting of deaths. His opinion hasn't changed.

"I would be surprised if there was a significant increase of maternal deaths," said King, who has not seen the California report.

But Shabbir Ahmad, a scientist in California's Department of Public Health, decided to look closer. In 2006, he organized academics, state researchers and hospitals to conduct a systematic review of every maternal death in California from 2002 to 2006. It's the largest state review ever conducted. The group's initial findings provide the first strong evidence that there is a true increase in deaths - not just the number of reported deaths.

Changes in the population - obese mothers, older mothers and fertility treatments - cannot completely account for the rise in deaths in California, said Dr. Elliott Main, the principal investigator for the task force.

"What I call the usual suspects are certainly there," he said. "However, when we looked at those factors and the data analyzed so far, those only account for a modest amount of the increase."

C-sections increase

Main said scientists have started to ask what doctors are doing differently. He added that it is hard to ignore the fact that C-sections have increased 50 percent in the same decade that maternal mortality increased.

The task force has found that changing clinical practice could prevent a significant number of these deaths.

Despite the increase in deaths, pregnancy is still safe for the vast majority of women.

In 2006, 95 California women died from causes directly related to their pregnancies - out of more than 500,000 live births. That's a small number by public health standards. But if California had met the goal set by the U.S. Department of Health and Human Services to bring the state's maternal mortality rate down to a level achieved by other countries, the number of dead would have been closer to 28.

It's not clear which mothers are most at risk, but researchers have long known that African American mothers are three to four times more likely to die from pregnancy-related causes. That racial association is not stratified by socio-economic status: Even high-income black women are at a greater risk.

While the maternal mortality rate among black women is rising, the task force found a more dramatic increase in deaths among white, non-Hispanic mothers.

Real stories

Each maternal death shatters families. That cold sum - 95 dead - represents 95 stories of people such as Tatia Oden French. In 2001, she was newly wed and had just finished her doctorate in psychology. She was about to have a baby girl she would name Zorah Allie Mae French.

"She's the type of person that just walked into the room and lit it up," said her mother, Maddy Oden.

During the labor, Maddy Oden was at home waiting for a call announcing the birth of her granddaughter. Instead, her daughter needed an emergency C-section.

"I woke up at 4 in the morning and I knew that something was wrong," Oden said.

Then the phone rang. French was in trouble. Powerful contractions had forced amniotic fluid into her bloodstream, stopping her heart and killing the baby. When Oden got to her daughter at an Oakland hospital, there was only one thing she could do: "We said a prayer," Oden said, "and I closed her eyes."

The subsequent lawsuit was dismissed: The doctor had not deviated from the standard of care.

Finding ways to help

Rather than track down the cause of every death and assign blame, the California task force is focused on finding solutions. Bingham and Main have found that doctors and nurses are eager to help after seeing the numbers.

In 1996, the maternal death rate in California was 5.6 per 100,000 live births, not far from the national goal of 4.3 per 100,000. Between 1998 and 1999, the World Health Organization changed its coding system to include definitions of obstetric death, which may have increased reporting of deaths. The California rate was 6.7 in 1998 and 7.7 in 1999.

Because the number of mothers who die is small, the rate tends to fluctuate from year to year.

In 2003, when California put a new checkbox on death certificates asking if the deceased was pregnant within one year of death, the rate jumped to 14.6. And in 2006, the last year for which data is available, the rate stood at 16.9. The national rate was 13.3 per 100,000 live births.

The best estimates show that less than 30 percent of the increase is attributable to better reporting on death certificates. Even after adjusting the numbers to reflect better reporting, the maternal death rate between 1996 and 2006 has more than doubled, Main said.

When researchers unveiled their initial findings to a conference of the American College of Obstetricians and Gynecologists in 2007, there were gasps from the audience, according to participants attending the San Diego event.

The idea that California was moving backward even in an era of high-tech birthing was implausible to some. Confirmation of the trend was noted in a 2008 report written by 27 doctors and researchers. The report was described in detail to California Watch.

The state of California has yet to share the report with the public. Researchers say that, after reviewing the report in 2008, officials in the Department of Public Health asked for technical clarifications. Revisions were complete and approved in the first half of 2009, according to Ahmad.

Al Lundeen, the department's director of public affairs said, "There was no effort to hold that report back. It just needed some more revisions."

Taking action

The California task force isn't waiting to determine the ultimate cause of these deaths. It has started pilot projects to improve the way hospitals respond to hemorrhages, to better track women's medical conditions and to reduce inductions.

Dr. David Lagrew, meanwhile, thinks he may have arrived at an answer. In 2002, Lagrew, the medical director of the Women's Hospital at Saddleback Memorial Medical Center in Orange County, noticed that many women were having their labor induced before term without a medical reason. He knew that having an induction doubled the chances of a C-section.

So he set a rule: no elective inductions before 41 weeks of pregnancy, with only a few exceptions. As a result, Lagrew said, the operating room schedules opened up, and the hospital saw fewer babies admitted to the neonatal intensive care unit, fewer hemorrhages and fewer hysterectomies.

All this, however, came at a cost: The hospital had to take a cut in revenue for reducing the procedures it performed. Lagrew doubts that any hospital has increased its C-section rate in pursuit of profit, but he adds that the first hospitals to adopt controls on early elective inductions have been nonprofits.

On average, a C-section brings in twice the revenue of a vaginal birth. Today, the C-section is the single most common surgical procedure performed in the United States.

Although the state hasn't released the task force's report, the researchers and doctors involved forwarded data to the national Joint Commission, which issued incentives for hospitals to reduce inductions and fight what it called "the cesarean section epidemic."

"You don't have to be a public health whiz to know that we are facing a big problem here," said Bingham, the executive director of the task force.

Online resources: To read more about maternal mortality rates and pregnancy-related deaths, go to

California Watch is a project of the Center for Investigative Reporting with offices in the Bay Area and Sacramento.

This article appeared on page A - 1 of the San Francisco Chronicle

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Wednesday, February 3, 2010

Pilates & Pregnancy: Safe Ab Exercizes

Debbi Goodman, MSPT is a local treasure. The following article was written by Debbi. Check it out. Then check out her classes. Pregnant or not, you can benefit from time with Debbi!

May all babies be born into loving hands

Pilates and Pregnancy: Safe Ab Exercises

Pilates Ab exercise for pregnant women

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By Debbi Goodman, MSPT

Pilates is a wonderful form of exercise for pregnant women. Through Pilates, women can stay strong and fit throughout their pregnancies. Pilates can help women stay connected to their changing body, improve posture and reduce pregnancy aches and pains. However, Pilates instructors working with this population need to be knowledgeable about the anatomical and physiological changes that occur during pregnancy, as well as about the birth process. In addition, it is extremely important that Pilates instructors have a clear understanding of how pregnancy affects the abdominal muscles.

Pregnancy: A Real Ab Stretch
During the course of pregnancy, the abdominal muscles will stretch by over 50 percent of their original length. Strengthening the abdominal muscles is critical during pregnancy to help support the growing uterus, decrease lumbar compression and reduce pelvic pressure. Women who practice safe abdominal strengthening during pregnancy have less low back pain, less pelvic pain, better mobility, easier deliveries and faster recoveries.

During pregnancy, a hormone is present, called relaxin, which helps to increase laxity of all the muscles, joints, ligaments and joint capsules. The purpose of this hormone is to increase mobility of the tissues so that the body is able to accommodate the rapid fetal growth and prepare the body for delivery. The abdominal muscles are most directly affected by the growing fetus and have the ability to stretch significantly as the fetus grows.

The Diastasis Recti
At about 20 weeks and often sooner for a second pregnancy, the rectus abdominus will begin to separate along the linea alba with the two rectus halves moving laterally. This is called a diastasis recti.

Diagram courtesy of Healthy Moms Fitness

This is a normal occurrence during pregnancy, and this will occur in almost all women. However, when the diastasis recti occurs, there is less support for the lower back, which often results in an increase in low back pain or other discomforts. In addition, women who do not control the size of the diastasis may have difficulty closing it postpartum and may be at risk for an umbilical hernia, especially if there is a subsequent pregnancy without proper closure of the separation.

Exercises to Avoid During Pregnancy
Pilates instructors working with pregnant women need to pay careful attention to making sure the chosen exercises are appropriate for this group. Exercises that make the diastasis worse are any movements that require the rectus abdominus to contract strongly against gravity. When the rectus is asked to contract strongly, if the integrity of the muscle is lost, the two halves of the muscle will shorten and contract as two separate units with each half moving laterally. This, in turn, opens the separation further.

Precautions need to be taken during any supine exercises that involve lifting the head and shoulders off the ground or lifting both lower extremities off the ground, as well as during plank or push-up positions.

This means that many of the traditional abdominal exercises in the Pilates repertoire are not going to be appropriate and may be potentially dangerous with respect to opening the diastasis. Therefore, the Pilates instructor must be skilled in the ability to modify the program and knowledgeable about safe choices for pregnancy. It is also valuable for Pilates instructors to have knowledge in how to palpate a diastasis so they can screen clients who might be at risk for this abdominal muscle issue.

Safe Pregnancy Training
Safe abdominal strengthening during pregnancy should look deeper than the rectus and focus on training of the internal obliques and the transversus abdominus (TVA). Training of the TVA is particularly beneficial because contraction of the TVA directly supports the uterus, and a well toned TVA will help keep the rectus halves closer together and prevent the diastasis from opening excessively. Therefore, TVA training can reduce the size of the diastasis. In addition, training the TVA also helps women prepare for delivery, as one of the roles of this muscle is to assist during forceful expiration (i.e. pushing).

Training of these muscles can occur in all positions, but pregnant women are often most comfortable in sitting and quadruped positions, especially as the pregnancy progresses.

Gentle supine abdominal exercises—such as knee folds, heel slides, pelvic tilts and head lifts—are acceptable and are often much more challenging than one would expect as the abdominal muscles are becoming increasingly weakened.

Basic Abdominal Program for Pregnancy

Here are some examples of basic core exercises that should be included in every pregnant woman’s exercise program:

Seated or Quadruped Transversus Contraction

Helpful for minimizing diastasis, stabilizing spine and pelvis, and maintaining abdominal tone during pregnancy; essential after pregnancy. Transversus is easier to contract seated or on all fours versus lying down. Good position to begin training.

Seated Transversus: Start seated with body weight centered over pelvis and shoulders aligned over pelvis, practice pulling belly button to the spine without allowing ribcage to shear forward.

1. 30-Second Hold: Begin with a belly breath and expand the body, then exhale and move the belly button toward the spine. Hold it here for 30 counts. End with a belly breath.

2. Contracting Transverse: Same position as above. Inhale and expand body. Exhale all the way to the spine, hold for one count and then repeat 50-100 reps.

Quadruped: This position is beneficial as it takes weight off the pelvic floor and helps to increase perineum circulation.

Start on hands and knees with hands lined up with shoulders and knees lined up with hips; the spine should be neutral. If wrists are a problem, use fists on the floor. Allow belly to sag toward floor (without changing spine alignment), then pull belly button to spine maintaining neutral spine. Repeat 50-100 reps.

Supine Transversus Contraction:
This is the most difficult position in which to engage the transversus due to decreased proprioception.

Start lying on the back with bent knees, feet on the floor hip-width apart. Begin exercise with a belly breath, then exhale belly to the spine without doing a posterior pelvic tilt. Exercise can be performed using the 30-second hold, contracting transversus, or use traditional abdominal stabilization techniques such as knee folds while keeping the trunk stabilized.

Sample Prenatal Mat Workout
Now that you know the basics, here’s an example of safe mat exercises for pregnant women:

Spine Twist
Modified Roll-Up/Roll-Down
Rowing 3,4,5,6
Spine Stretch Forward
Chest Expansion
Legs Against the Wall
Modified Hundred—kneeling or supine with one leg at a time in table top
Neck Roll—seated
Swimming—hands & knees
Shoulder Bridge

To Learn More
Working with pregnant women can be extremely rewarding, but this is a population that requires special attention. Instructors working with this population should take the time to learn about the process of pregnancy and how it affects the musculoskeletal system. Instructors need to understand the precautions of working with this group to insure that the exercise programs are meeting the needs of this unique population. See The Pilates Bookshelf: Top Pregnancy Resources for a list of my recommendations for quality books and resources about maternal fitness.

About the Author

Debbi Goodman, MSPT is a licensed manual physical therapist with specialties in women’s health, dance medicine and sports medicine. She has been a physical therapist for Westside Dance Physical Therapy, New York City Ballet, School of American Ballet and the Kane School of Core Integration. Debbi has had a private women’s health/orthopedic practice in New York City, and since moving to the Albany area in 2004, she has developed a private practice in the Capital District. Debbi is one of the few physical therapists trained in internal evaluation and treatment of the pelvic floor muscles. In addition, she is specifically skilled in treatment of pregnancy problems including: sciatica, back/neck pain, pelvic pain and rib pain, and postpartum problems including: cesarean section recovery, urinary incontinence, pelvic/vaginal pain and post-delivery scars. Debbi also teaches continuing education workshops for physical therapists, trainers and Pilates instructors focusing on educating professionals on exercise during pregnancy, and she is an instructor for prenatal and postpartum group fitness classes.

Monday, February 1, 2010

Info on Maternal blood testing for fetal sex

Oh, what a strange (and interesting) world we live in. The following is a InfoPoem from Wiley-Blackwell. 'POEM' stands for patient-oriented evidence that matters.


May all babies be born into loving hands

Maternal blood testing accurate for fetal sex

Clinical Question:

Is maternal blood testing late in the first trimester accurate to determine fetal sex?

Bottom Line:

Test results of maternal plasma for fetal DNA late in the first trimester to determine fetal sex are accurate. The main current indication of this testing is to avoid invasive testing of the female fetus for X-linked congenital disorders. (LOE = 1b)


Scheffer PG, van der Schoot CE, Page-Christiaens GC, Bossers B, van Erp F, de Haas M. Reliability of fetal sex determination using maternal plasma. Obstet Gynecol 2010;115(1):117-126.

Study Design:

Diagnostic test evaluation




Outpatient (specialty)


The presence of cell-free fetal DNA originating from the placenta in the plasma of pregnant women was discovered in the 1990s. Early knowledge of fetal sex can be helpful; for example, to avoid invasive testing of female fetuses for X-linked conditions. A polymerase chain reaction (PCR) test of maternal plasma can determine the presence or absence of sequences specific to the Y chromosome or paternal alleles present in the father, but absent in the mother. These Dutch authors report the results of 201 cases tested from 2003 to 2009. Fetal sex was ascertained by karyotyping, ultrasound, or after birth in 98% of cases. Ultrasound prior to PCR testing was performed to confirm viable singleton gestation. The researxhers used a minimal gestational age of 7 weeks for indication of risk for congenital adrenal hyperplasia and 9 weeks for all others to reduce the likelihood of false-negative results due to low levels of fetal DNA. Testing for presence of paternal sequences absent in the mother was also performed to confirm the presence of fetal DNA. There were no cases of misclassification of boys and girls. In all cases of inconclusive results (n = 10), the sex of the newborn was female.

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