No Preterm Babies for you (Nov. 2004)
(Brent Rooney [email protected])
[dedicated to Professor Barbara Luke & Gail Dahl, pioneers in
better births]
A healthy full-term pregnancy is the 'Full Monty' and a beauty to
behold. A healthy term newborn brings a double delight: a brighter
future for the new family member and cancer risk reduction for mom
via a full-term gestation.
Let's look at an ideal scenario to bring about this marvelous baby
(full-term and no significant defects). In addition to making healthy
birth choices for yourself, you want to pass on your knowledge to your
daughters: what is the best age for them, all things considered, to
deliver a healthy first born? Between the ages of 18 and 25. 21 And
there is a bonus for mom in having an early FIRST birth. A woman who
has a first birth at age 33 has a 41 percent higher risk of breast
cancer versus a first birth at age 23. 37 If your mom and dad
encouraged a very physically active lifestyle and kept fat in your
diet in the range of 20%-25% of total calories, then you should not
even have reached puberty until age 15-18; in China the average is 15
years (in Thailand it's 16). Your diet has been optimum and your
parents played a 'trick' on you: most of your healthy meals were yummy
(you'll play the same 'trick' on your kids). You decide that a first
birth for you at age 21 or 22 would be best. At age 20 you marry a
solid guy, who likes kids and he has committed to doing more of the
household chores for 2 years after the first birth; being married
boosts your odds that your first pregnancy will be full-term.27
Pre-conception checklist for you:
1. optimum diet (vegetarian, fresh, organic, unrefined, not "GM", &
tasty); healthy fats but up slightly to 25%-30% of total calories
, from a normal 20%-25% for young physically active women. FRESH
wheat germ is one special food for you, since it has high amounts
of vitamins B6, FOLIC ACID, and E. 38 keep it in the 'frig'.
2. vitamin/mineral supplements.1,29,30,41 FOLIC ACID (vitamin
B9) & the minerals magnesium, zinc, selenium, & iodine are
especially key; magnesium relaxes you and your uterus (womb),
but avoid over-dosing on minerals!
3. zero smoking.5
4. zero drugs, zero booze, no coffee, no medical X-rays
5. find a reputable midwife for your birth.2,3 ask her which
obstetrician she most trusts; midwives reduce the risk of low
birth weight births by about 31%.2 (If you are 'low risk', a
midwife should should be sufficient to help the delivery, with
encouragement from hubby)
6. filtered water only (including cooking).
7. at least a yearly medical checkup from a prevention oriented
medical practitioner you trust
8. safe and vigorous exercise (e.g. swimming).4 (Do not overdo it)
9. you and hubby are faithful, so 'VD roulette' (& associated
infections) is not a concern
10. you have never had elective surgery in your abdominal area and you
intend never to have it.6,7,10 [this reduces the chance of an
'incompetent' cervix, a muscle at the 'neck' of the uterus]
11. read the following 3 books:
-Pregnancy & Childbirth TIPS (Gail Dahl) - extremely practical &
useful
-Every Pregnant Woman's Guide to Preventing Premature Birth (B
Luke)
-Everywoman's Book (Paavo Airola) - takes you through a healthy
life sequence
12. listen to relaxing music and relaxation tapes.8 (High distress
during pregnancy increases preterm birth risk by about 75%).31
Your home should have 'full spectrum' (natural light) which will
help relax you.12 Ask your health food store where full spectrum
light bulbs can be bought.
13. chiropractic check-up at least once yearly by a GOOD
chiropractor.39 you do not want a bad back when you are pregnant.
if your abdominal muscles are strong, you are less likely to have
back problems.
Pre-conception checklist for hubby, 'Mark': "Mark's" list is
virtually a 'ditto' of your list. If there are things that make
you tense and irritable, 'Mark' should find ways to prevent them.
'Mark' should provide you with a few pleasant surprises every
week. What are husbands for, anyhow?
What about work?
You are self-employed and work out of your home. But what if this
were not the case? If the job is very physically demanding or
makes you tense, it is best to get a leave of absence (if
possible) as soon as your pregnancy is confirmed. Women in the
U.S. military who get pregnant are often forced to keep working
almost till labor, with the result: they have about FIVE times the
normal risk of a preterm delivery.9 If you cannot get a leave of
absence, then at least do the following:
1. work less than 40 hours per week.32
2. Relax by listening to relaxing music (on your 'Walkman').8
3. do not stand for 3 or more hours in a day.32
After Conception:
Clearly, you are maintaining all the pre-conception health habits,
except exercise will be milder and less frequent (perhaps, 3-4
times per week). Taking a good set of vitamin/mineral supplements
pre-conception and during the first trimester reduces your risk of
a very preterm (under 35 weeks gestation) birth by about 86%.1
(Your multivitamin/mineral should not have iron, since vitamin E
and iron are antagonistic) If you can not obtain sufficient iron
from foods (such as kelp, brewer's yeast, blackstrap molasses,
wheat bran, pumpkin/squash seeds, soybeans, sunflower seeds,
millet, parsley, almonds, etc.), Dr. Michael Murray recommends
iron bound to either succinate or fumarate.34 Paavo Airola
recommends against iron in the form of ferrous sulfate since it
boosts the odds of miscarriage.12 You are being visited by a
midwife and you keep referring back to the 'Bible': P&CT
(Pregnancy & Childbirth TIPS, Gail Dahl); there is a section for
each month of a 9 month pregnancy. Gail Dahl has been through that
journey herself and has gathered key information from moms,
midwives, and academic experts.
Post-conception checklist:
1. avoid standing for long periods or carrying heavy loads.9,10
sitting for long periods cramps your unborn's living space too.
2. consider swimming as your main exercise (walking is good also);
avoid hot-tubs and saunas since they will increase infection
risk.33
3. listen to relaxing music and relaxation tapes.8
4. hubby and family are doing more household chores
5. fill out your Personal Birth Plan (P&CT, pp. 10-12) so your
midwife and/or obstetrician know exactly what you expect (e.g.s.
breastfeeding your newborn within the first few minutes after
birth; no induced birth unless there are very clear medical
indications for it). The PBP is a legal document. Keep one copy in
your purse, hubby has a copy, as do your midwife & obstetrician.
6. avoid noisy environments.10
7. avoid excessive time driving.10
8. zero cigarettes, drugs, booze, coffee
9. during pregnancy, fat is beautiful; consume healthy bottled oils
(e.g. Udo's Choice) every day; 60% of your baby's brain is FAT.
10. never consent to an induced birth unless the health benefit of
such is clear. Gail Dahl has stated that the first full-term birth
may take 1-2 weeks longer on average than subsequent births.
11. fish oil: there is some evidence that women who consume fish oil
during their pregnancy can prolong their pregnancy by about 3-4
days.35 make sure that any fish oil you consume is not polluted.
12. ultrasound testing: "In the meantime it would seem prudent to
limit ultrasound examinations of the fetus to those cases in which
the information is likely to be of clinical importance." 36 This
statement comes from researchers in the well respected medical
journal The Lancet.36 One group of women who only had one
ultrasound test was compared to one group of women who had five
ultrasound tests each. The group with five tests, had a 65% higher
risk of very low birth weight infants.
Preterm Risk for Minority Groups
Within minutes after birth you start breastfeeding..... You've
taken smart steps and you are very pleased with your new 'bundle
of joy'. But why has there been no progress in the U.S. & Canada
over the last twenty- five (25) years in reducing the rate of
preterm births? Let's consider one particular group with a high
risk of premature birth:
African-American women. Professor Barbara Luke (Every Pregnant
Woman's Guide to Preventing Premature Birth) lists being
African-American as being a nonmodifiable risk factor for PB
(Preterm Birth).10 Does this mean that a specific black woman must
accept a higher risk of PB? I believe that the answer is a firm
NO! Why? Compared to Caucasian women, black women (on average)
have the following disadvantages:
a. consume fewer supplemental vitamin/minerals.13,25
b. more likely to use birth control pills (depleting the body of
vitamins).14
c. exercise less (resulting in higher weight & lower fertility).15
d. over twice as likely to have elective surgery in the abdominal
region;16 Barbara Luke (M.P.H., University of Miami) writes
that such procedures increase premature birth risk by 30% (page
32).10 If surgery damages your cervix (a muscle at the neck of the
uterus), it may become 'incompetent', allowing the unborn to 'slip
out' prematurely. Long term mental distress can also result from
such procedures.28 Thus, it is prudent not to ever have an
elective 'termination' of pregancy.10,40 Termination Risk
e. Less likely to breastfeed four or more months (thus, higher risk
of a pregnancy within 6 months of the previous birth).17,26
[exclusive breastfeeding for at least six (6) months is a natural
(but not perfect) form of birth control that helps women space
their babies; having a pregnancy start within 6 months of a
previous birth boosts your odds of having a preterm baby].
Which of these five factors are unmodifiable by women who are
aware that they affect PB odds? Not one of them is unmodifiable!
Some claim that poor health results for a minority group strongly
implicate 'Socio-Economic-Status' (i.e. being poor). Does poorer
economic status explain the preterm birth risk of
African-Americans? Although low birth weight and preterm birth are
not necessarily coincident, often they are. Mexican-Americans have
a lower SES than non-Mexican-Americans .. However,
Mexican-American women (who were born in MEXICO) have a LOWER risk
of low birth weight than non-Mexican-Americans.19 But if he
Mexican-American women were born in the U.S., they have a low
birth weight risk greater than non-Mexican-American women.19 Thus,
medical researchers speculate that culture has an effect on PB
risk. Smoking is a risk factor for low birth weight newborns.
Mexican-American women have over 50% less risk of being smokers
than other American women.20 Black women of SES equal to Caucasian
women have a higher low birth weight risk. 24 A young black woman
who watches her health P's & Q's, should have a LOWER than average
PB risk. Why? Young women who consistently (!) follow a good
vitamin/mineral regime, reduce their very preterm (under 35 weeks)
odds by about 86%.1,29,30 Some believe that vitamin/mineral
supplements will compensate for eating much junk food. This is an
unwise thought. Fire on all cylinders and do not depend on just
one thing to produce a good result. Black women have 2-3 times the
risk of very preterm birth compared to Caucasian women.22 A very
low birth weight infant has over twenty-five (25) times the risk
of cerebral palsy ( versus a normal weight infant) and thus,
PREVENTION is key.23 The father of medicine, Hippocrates said,
"Let your food be your medicine and let your medicine be your
food." Please listen to this wise medical man. Hippocrates also
advocated to healers to "First, do no harm."
Which pregnancy is the most important, first, second, or third? A
full-term pregnancy at a young (under 25) age slashes your risk of
breast cancer; so it's important that your first pregnancy be a
full-term one.18 If your first pregnancy is not full-term, you
have increased the odds (at least 30%) that your next birth will
be preterm. 6,7,10 Many factors to reduce preterm risk have been
covered, but I'll repeat two, especially important to a young
woman:
1. marriage to a supportive husband.27
2. a good midwife who 'knows the ropes'
[a pregnancy that is other than a low risk one will require that
an obstetrician be part of your health team]
And keep your PERSONAL BIRTH PLAN in mind and your helpers on
track. (A website that may be useful to you: [22]Pregnancy and
Childbirth Tips- Gail Dahl's site. A healthy full-term pregnancy
is the 'Full Monty' and a beauty to behold.
Postscript: Delayed Childbearing Author Gina Maranto 'told it like
it is', "Mitchell-Leef, a prominent endocrinologist, declared that
in effect women have been sold a bill of goods. For years
physicians have said little as women have chosen to put off having
children until their mid-thirties, their late thirties, their
forties. The time had come, Mitchell-Leef believed, for a message
to be delivered. She told the participants [annual meeting of the
American Fertility Society, 1994]- mostly psychiatrists,
psychologists, and clinical social workers - that women should be
advised to consider having children earlier in their lives rather
than later. In response her audience, most of whom had witnessed
the anxiety and grief experienced by older women whose infertility
treatments had ultimately failed, burst into applause" (The
Atlantic Monthly, June 1995). Thank you, The Atlantic Monthly!
-Health & beautiful babies,
Brent Rooney
[email protected]
web: www.vcn.bc.ca/~whatsup/NoPB.html
Send feedback to Brent
Rooney - [email protected]
References:
1. T Scholl, et al., American Journal of Epidemiology,
1997;146:134-141
2. M MacDorman, et al., Journal of Epidemiology & Community Health,
1998; 52:310-317
3. TA Wiegers, et al., European J of Obstetrics and Gynecology,
1998;79: 139-141
4. M Hatch, et al., American J Public Health, 1998;33:1528-1533
5. C Maden, et al., American J Public Health, 1992;82:391-394
6. B Berkowitz, et al., American J Epidemiology, 1981;113:81-92
7. JP Forbes, et al., British J of Obstetrics & Gynecology,
1985;99:1106-1112
8. J Janke, et al., JOGNN, 1999;28:255-263
9. M Fox, et al., American J Obstetrics & Gynecology,
1977;129:705-707
10. Barbara Luke, Every Pregnant Woman's Guide to Preventing Premature
Birth (1995)
11. Gail Dahl, Pregnancy & Childbirth TIPS
12. Paavo Airola, Everywoman's Book
13. S Yu, et al., American J of Public Health, 1996;86:240-242
14. Nancy Krieger, American J of Epidemiology, 1990;131:804-814
15. R Pate, et al, J American Medical Association, 1995;273:402-407
16. MMWR [CDC], August 8, 1997; 46 (No. SS-4):37-98
17. G Rhoads, et al., Pediatrics, 1988;81:365-371
18. Brian MacMahon, et al, International J of Cancer, 1983;31:701-704
19. D Shay, et al, American J Epidemiology, 1994;139:184-192
20. L McElroy, et al., Obstetrics and Gynecology, 1994;84:1033-1037
21. L Klein, et al., American J Obstetrics & Gynecology,
1974;120:249-256
22. G Alexander, et al., American J Public Health, 1993;83:1721-1725
23. A Ericson, et al, Arch Dis Child Fetal Neonatal Ed,
1998;78:F171-F174
24. G McGrady, et al., American J Epidemiology, 1992;136:266-276
25. G Block, American J Epidemiology, 1988;127:297-309
26. S Samuels, et al., American J Clinical Nutrition, 1985;44:504-510
27. S Amini, et al., WOMEN'S HEALTH ISSUES, 1996;6(5):264-272
28. L Janzon, et al., European J Obstetrics & Gynecology,
1998;79:173-178
29. G Spatling, et al., British J Obstetrics & Gynecology,
1988;95:120-125
30. T Scholl, et al., American J Epidemiology, 1993;137:1115-1124
31. M Hedegaard, et al., British Medical J, 1993;307:234-239
32. N Mamelle, et al., American J Epidemiology, 1984;119:309-322
33. W Willett, et al., J American Medical Association,
1992;268:882-885
34. Michael T. Murray, Encyclopedia of Nutritional Supplements
35. Neils J. Secher, et al., The Lancet, 1992;339:1003-1007
36. John P. Newnham, et al., The Lancet, 1993;343:887-891
37. D Trichopoulos, et al., International J Cancer, 1983;31:701-704
38. Encyclopedia of Natural Healing (Medical Editor: Dr. Zoltan Rona)
39. M Kelner, et al., Chiropractors : do they help?, 1986 (Fitzhenry &
Whiteside)
40. B Rooney, B Calhoun, Induced Abortion and Risk of Later
Premature Births, 2003;8(2):46-49
( www.jpands.org/vol8no2/rooney.pdf )
........................................................................
Appendix: Brent Rooney Publishing credits:
Elective Surgery boosts Cerebral Palsy risk.
European Journal of Obstetrics & Gynecology and
Reproductive Biology 2001;96(2):239-240
Delayed birth equals more cancers and preterm births.
Western Journal of Medicine. 2001;174:385-386
Exceptional Teaching, Jim Pierson, 2001 (pp. 23 & 234)
Low Birth Weight: Reducing the Risk (Birthing mag.
, Fall 1998)
Having an induced abortion increases risk in
future pregnancies. British Medical Journal
2001;322:430
Racism, Poverty, Abortion, and Other Reproductive
Outcomes. EPIDEMIOLOGY 2000;11:740-741
An Early First Birth for Breast Cancer Prevention
(ALIVE mag., April 1997)
No Breast Cancer for My Daughter - How to Reduce
the Risk, ALIVE magazine, July/August 1995)
[ALIVE: highest circulation health mag. in Canada]
Escape from Breast Cancer - (published on the world
wide web: www.vcn.bc.ca/~whatsup/ESCAPE.html )