women

How to Have a Successful Labor and Delivery

It’s not too early to start thinking about labor and delivery. It helps to know what makes a labor and delivery successful. Below are some things to consider as you move through pregnancy.

Become informed about pregnancy and the birth experience. Knowledge is power. When you understand what can and will occur during pregnancy, you may be able to relax more.

The relationships you have with your healthcare team are important. Follow medical suggestions, watch your weight, eat healthfully, take your prenatal vitamins and go to all your prenatal appointments and tests. Expect your medical team to work hard for you. Each of you should support the other.

Being able to help make decisions about your medical care, including birth positions, pain-relief methods, feeding baby and your partner’s level of participation in labor and delivery, helps you feel more in control. Discuss questions and various situations with your healthcare provider at prenatal appointments.

Home Uterine Monitoring

Home uterine monitoring helps identify women with premature labor. It combines recording uterine contractions with daily telephone contact with the healthcare provider. A recording of contractions is transmitted from a woman’s home by telephone to a center where they can be evaluated. Your healthcare provider may be able to view the recordings at his or her office or home.

Cost for home monitoring varies but runs between $80 and $100 a day; some insurance companies cover it. The cost can often be justified if a premature delivery is prevented—it saves a lot of money in the care of a premature baby (sometimes more than $100,000). Not everyone agrees home monitoring is beneficial or cost-effective.

It may be difficult to find out if you need this type of monitoring. It is often considered on an individual basis. Discuss it with your healthcare provider if you had preterm labor in the past or have other risk factors.

Fish Can Be Healthy during Pregnancy

Eating fish is healthy; it is especially good during pregnancy. Women who eat fish during pregnancy often have longer pregnancies and give birth to babies with higher birth weights. Studies show the omega-3 fatty acids found in fish may help protect you from premature labor and other problems. Remember—the longer a baby stays in the uterus, the better its chances are of being strong and healthy at delivery.

Many fish are safe to eat, and you should include them in your diet. Most fish is low in fat and high in vitamin B, iron, zinc, selenium and copper. Many fish choices are excellent, healthful additions to your diet (with certain limits, as discussed below).

Good Fish and Shellfish Choices

Below is a list of fish that are safe to eat if you cook them thoroughly. Don’t exceed a total of 12 ounces of all fish a week!

bass

ocean perch

pollack

catfish

orange roughy

red snapper

cod

Pacific halibut

salmon

croaker

haddock

scrod

flounder

herring

sole

freshwater perch

marlin

 

 

The following shellfish are safe to eat if they are thoroughly cooked.

clams

crab

lobster

oysters

scallops

shrimp

 

In addition, fish sticks and fast-food fish sandwiches are OK to eat—they are commonly made from fish that is low in mercury.

Omega-3 Fatty Acids. Omega-3 fatty acids are good for you during pregnancy. They help protect your skin by keeping it lubricated and help to reduce skin inflammation. Fish oil is important to fetal brain development.

Anchovies, herring, mullet, mackerel (not King mackerel), salmon, sardines and trout are some fish with a lot of omega-3 fatty acids. Omega-3 fatty acids are also found in animal foods, including grassfed beef and eggs from hens fed special diets. If you’re a vegetarian or you don’t eat fish, add tofu, canola oil, flaxseed, soybeans, walnuts and wheat germ to your food plan. These foods contain linolenic oil, which is a type of omega-3 fatty acid.

Fish-oil capsules may be another option. If you buy fish-oil capsules, choose the filtered type because they don’t contain pollutants. Don’t take more than 2.4g of omega-3 fatty acids a day. Fish-oil capsules may upset your stomach. To solve the problem, freeze them or take them with meals or at bedtime.

Methyl-Mercury Poisoning. Some fish are contaminated as the result of man-made pollution. People who eat these fish are at risk of methyl-mercury poisoning.

Mercury is a naturally occurring substance and a pollution by-product. Mercury becomes a problem when it is released into the air. The worst methyl-mercury polluters are coal-burning power plants; they account for more than 40% of the methyl mercury released into the air. It settles into the oceans and from there winds up in some types of fish, where it accumulates in their muscles. Larger fish that live longer have the highest levels of mercury because they’ve had the longest time to accumulate it in their system.

Eating 12 ounces of fish every week during pregnancy may help your child enjoy better development during his or her early years.

Methyl mercury above a certain level in fish is dangerous for humans. We know methyl mercury can pass from mother to fetus across the placenta. Research shows 60,000 children are born each year who are at risk of developing problems linked to the seafood their mothers ate during pregnancy.

A fetus may be more at risk of methyl-mercury poisoning than an adult. Studies show one in five American women of childbearing age has mercury levels that are too high—about 8% of them have levels high enough to put a fetus at risk.

Pregnant women should limit their fish and shellfish intake to no more than 12 ounces a week. Twelve ounces is two to three average servings.

The amount of mercury in fish varies. Try to choose fish and shellfish that are lower in mercury. If you eat a lot of fish, a hair-mercury analysis may be recommended. This testing is often done at university medical centers.

There is debate about eating canned tuna. Talk to your healthcare provider about it at a prenatal appointment if this is a favorite of yours.

Some freshwater fish may also be risky to eat, such as walleye and pike. Consult local or state authorities for any advisories on eating freshwater fish. Other fish to avoid include some found in warm tropical waters, especially Florida, the Caribbean and Hawaii. Avoid the following “local” fish from those areas: amberjack, barracuda, bluefish, grouper, mahimahi, snapper and fresh tuna.

Fish to Avoid

There are fish to avoid during pregnancy and breastfeeding. The FDA recommends avoiding swordfish, shark, king mackerel and tilefish. Also avoid wall-eye, pike, amberjack, barracuda, blue-fish, grouper, mahimahi and snapper.

There are different thoughts about pregnant women eating tuna. Canned light tuna has less mercury than alba-core tuna, so eat that. Don’t eat more than one 6-ounce can of light tuna a week. If you want to eat a cooked tuna steak every once in awhile, keep your total tuna intake (fresh and/or canned) to no more than 6 ounces a week. If you have questions, talk to your healthcare provider.

Some Additional Cautions about Fish. Parasites, bacteria, viruses and toxins can contaminate fish. Eating infected fish can make you sick. Sushi and ceviche are fish dishes that could have viruses or parasites. Contaminated raw shellfish could cause hepatitis-A, cholera or gastroenteritis. Avoid all raw fish during pregnancy!

Fish can contain other environmental pollutants. Dioxin and polychlorinated biphenyls (PCBs) are found in bluefish and lake trout; avoid them.

You may want to double check tilapia. Farm-raised tilapia is one of the most highly consumed fish in America; however, it has low levels of omega-3 fatty acids and high levels of unhealthy omega-6 fatty acids.

We advise pregnant women not to eat sushi. However, if you’re craving sushi, eat a California roll (no raw fish) or shrimp tempura. Other dishes made with cooked eel and rolls with steamed crab and veggies are OK.

If you’re unsure about whether you should eat a particular fish or if you want further information, ask your healthcare provider for pamphlets about fish. Or contact the Food and Drug Administration for information.

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