Maternity Insurance|Maternity Care|Postpartum Care

Sciatica during pregnancy is a common complaint. Sciatica is described as sharp pain that runs along the large sciatic nerve from the back down the legs. Sciatica during pregnancy is an unpleasant, but treatable form of back pain.

Here's how to find relief.

Back pain is a common complaint during pregnancy. And it's quite expected since you're continuously gaining weight. You're also walking in a new and different way. On top of that, your hormones are relaxing the muscles and ligaments are loosening throughout your body. But you don't have to live with it for the duration of your pregnancy. Often, you can treat - or prevent - back pain during pregnancy with simple self-care strategies or complementary therapies.

Focus on good posture.

Your center of gravity shifts forward as your baby grows. Often, your body will attempt to compensate in some way to avoid falling forward, which can strain the muscles in your lower back -and this is what leads to back pain.. Tuck your buttocks under, pull your shoulders back and downward, and stand as straight and tall as you can.

Sit properly...and stand as little as possible.

If possible, sit with your feet elevated. Choose a chair with lumbar support. Your lower back should be supported with a small pillow. Change position often, and try not to stand for extended periods of time.

Stay active.

Low intensity exercise on a regular basis can keep your back strong and may actually prevent and/or relieve back pain. Try brisk walking, swimming or riding a stationary bike. Just make sure your doctor or health care provider is aware of, and approves of these activities

Try alternating heat and cold.

Applying heat to your back is helpful for treating tight muscles. Try soaking in a warm bathtub or apply a heating pad. Some pregnant women find relief by alternating ice packs with heat. Applying ice or a cold wrap is effective for inflammation.

Sleep on your side.

Sleep on your side, not your back. Make an investment in a full-body pillow. Place the pillow between your legs while sleeping, and if possible try keeping your knees bent while sleeping.

Consider complementary treatments.

When treating sciatica during pregnancy, the effectiveness of chiropractic care or acupuncture may not be clear. Some women find comfort and relief, while others may not. These methods done correctly are likely safe during pregnancy - as long as you're receiving proper prenatal care. Before attempting these methods its vital that you discuss your back pain with your health care provider. It's important to insure your back pain isn't caused by a separate underlying condition.

The good news is, there has been a recent breakthrough in the development of an extremely gentle yet effective technique of treating sciatica during pregnancy. Many pregnant women have received amazing and instant relief by learning and applying this gentle method. This gentle method utilizes "sciatic moves" as well as moves on the lower back to effectively relieve labor pain brought on by sciatica. So...if you find the tips above ineffective or not quite enough to relieve your pain, then learning this breakthrough method may be perfect for you. This amazing technique was developed by a doctor and is now available in a step-by-step guide.

Who wouldn't want to see a baby in the house?

However pregnancy may really mean great responsibilities and women who are in the right age experience lots of inconveniences associated with it so it will probably bring more pain if the expectant mother is actually a young mom.

How can a young mother deal effectively with the responsibilities that are expected of her? Here are some of the tips that can surely help a young mother deal with her task effectively and still enjoy a great and fulfilling life.

• Get the best tips from the people who raised you. The best pieces of advices will surely be coming from the people who truly care for you and your baby's welfare and for sure these are also the people who would always lend a helping hand at times when you need one.

• It would be best for young pregnant women to use a maternity belly band or a pregnancy belly band during pregnancy in order to be assured of safety. Maternity bands can support the typically weak pelvic area of the young mother and this can allow pregnant women to move comfortably without the thought of losing the baby.

• Make it a point to have a regular check-up with your doctor. Teenage pregnancy is often classified as high-risk so it wouldn't be smart to risk your life and your baby's life by not following the advice from your obstetrician.

• Start prioritizing things in the most ideal manner. There are lots of complications associated with young parenthood so it would be ideal to face things in a matured way and set the less important things aside. There is no better person to attend to your baby's need other than your hands-on care.

• Take care of yourself. There are still lots of opportunities that lie ahead of you. You are still young and for sure you need care as much as your baby needs your attention. Live a healthy life and choose the people you deal with. You really need to be smart in order to find enough reasons to look forward to a brighter future with your family.

Young mothers who got pregnant early in life surely have taken a big leap form being an ordinary girl to a young mother who has to handle lots of responsibilities. Don't let young age affect the good life that you need to enjoy. Young mothers can still be the best especially when they can gain the maturity that mothers of ideal ages usually possess.

Learning that you are pregnant is an exciting time. After the initial joy and exuberance, your thoughts quickly turn to both you and your baby's health. You have been accustomed to eating for one and, hopefully, have a healthy and fit lifestyle and are already making sound dietary choices. If not, the news of a brand-new life that is vitally linked to you and dependent upon you to help it survive and thrive will inspire you to do your very best nutritionally.

Juicing and pregnancy combine to help you consume the healthiest food for your baby. Your maternal instinct to care for your baby will prompt you to examine your diet. What type of food should you eat? Are you getting enough vitamins, minerals and other nutrients to support both you and the baby? Ideally, you want your baby's growth to proceed normally, without complication. You want every milestone and check-up along the way to delivery to be positive! Better nutrition and a healthy and fit lifestyle will help to ensure this.

Perhaps you are like many who eat on the run and grab quick meals. If so, juicing and pregnancy will seem like a marriage made in heaven! With a juicer and fresh fruits and vegetables, you can prepare delicious drinks that are chock-full of nature's goodness. While your developing child will benefit from better food choices, there is a big health benefit to you as well. Getting the right combinations of vitamins, nutrients and minerals will help fight off morning sickness and fatigue. The increased fiber from consuming healthy fruits and vegetables will reduce or eliminate constipation, and increased iron will battle anemia.

Cooking destroys many valuable nutrients contained in fruits and vegetables, while juicing maintains the health benefit. Also, most people find it hard to consume the recommended daily amount of fruits and vegetables. Often, we find ourselves in a type of "vegetable rut." With a juicer, you can greatly increase and vary the fruits and vegetables you consume. Here are some suggestions to start. First, to boost iron, anti-oxidants, folic acid and flavonoids, you will want to include spinach and asparagus. Asparagus actually contains an ingredient, glutathione, that your developing infant literally craves for cell production.

Another great addition to your juice is tomato, which provides both calcium, potassium and vitamin C. Carrots are another popular choice as they provides a wealth of nutrients, but use caution due to their sugar content. This caution applies also to fruit juices. You will want to concentrate more heavily on vegetables. You can increase the nutrient value in your healthy drink by adding in a little kale, broccoli or cauliflower. These all contribute calcium, an essential nutrient for the development of healthy bones for your baby.

While these green vegetables juices are healthy, you may not find them initially appealing. If so, just try drinking a smaller amount mixed into another juice, or even water, that you find palpable. For example, mix small amounts of green vegetable juice into orange juice or tomato juice in order to take all the nutrients these greens offer. As your taste buds adjust, dilute it less or not at all. Other fruits and veggies that have particular benefit in pregnancy are watermelon (which helps prevent preeclampsia), beets (especially rich in iron), alfalfa sprouts (bone growth and development), and pears (absorption of calcium).

Experiment with various combinations and let your creativity soar! Try melons, strawberries, citrus fruits, celery, mango, bean sprouts, and others. For those times you just don't feel like eating, or can't, juicing and pregnancy combine wonderfully to keep you on track to providing nutrition for your baby. Just make a healthy drink and sip it slowly to enjoy all the benefits it offers to both you and your developing infant. Start slowly. It may help to write down your health and nutrition goals and review them regularly. You will certainly want to review them with your physician, as with any diet modification in pregnancy.

Juicing and pregnancy, under your physician's supervision, will be both rewarding and satisfying. In fact, you will most likely make this a lifestyle change and continue juicing well after your delivery.

A woman naturally gets excited when she finds out that she is pregnant. In many cases, this happiness is soon diminished when the financial burden of having a child is realized. Thirteen percent of American women who become pregnant have no maternity insurance coverage. They face the risk of inadequate pre-natal care and must find their own resources for funding the cost. If the pregnancy is complicated, this adds to the burden.

Even those with insurance may find to their dismay that maternity is not covered. A costly add-on premium may be required. Some insurers do not offer maternity coverage or consider it a pre-existing health condition. This is illegal by Federal law, and there are several loopholes.

There are many group insurance plans that do provide maternity coverage as a service to members. There may be a waiting period of three months to one year before the clause becomes effective. What happens if one becomes pregnant during the waiting period? If you are carrying COBRA (extended coverage from a previous employer), check to see if maternity is covered. This may be costly but well worth it.

Some states have plans for pregnant women like Medi-cal in California. Federally sponsored programs like Medicaid also exist, but they are mostly for low-income groups.

Another option is MaternityCard. It is designed to provide help to pregnant women and is well accepted. This covers a wide spectrum of maternity medical needs and less expensive than regular insurance.

Ideally, maternity coverage begins immediately. There are some women that naturally get excited when they finds out that they are pregnant. In many cases, this happiness is soon diminished when the financial burden of having a child is realized. Thirteen percent of American women who become pregnant have no maternity insurance coverage. They face the risk of inadequate pre-natal care and must find their own resources for funding the cost. If the pregnancy is complicated, this adds to the burden. There are some plans

that have a 30-day waiting period. Always study the package that is offered before accepting it.

Maternity is a period between conception and birth of the child. For most women and their partners alike, this period is filled with anticipation and excitement as they await the coming of their new baby. But this period can be quite burdensome too to the couple, especially to the mother. Aside from physical and emotional burden they experience, and lifestyle changes they have to deal with, the couple is faced with financial burden as well. Vitamins, maternity clothes, check ups and the baby's stuff are only few of the things they must spend for. To aid expectant mothers get through this very important stage in her life, insurance companies provide assistance through maternity insurance plans.

A maternity insurance provides financial security to women who are in the pregnancy period. This is especially helpful to middle-income mothers who may not be able to pay for high costs of pregnancy and childbirth all at once. It helps them cut maternity costs and allows them to avail of appropriate health care, services and medication they and their child need. There may be some medical assistance programs that also help cut expenses during pregnancy but they are not enough while a maternity insurance covers more maternity expenses.

In the event of any complication that may cause the mother or the baby to stay in the hospital for a longer time and may require an operation or other medical services, the couple can count on the maternity insurance. For instance, if the baby is premature, he or she would have to spend weeks or even months in an incubator. Expenses incurred during the period of incubation may not be covered by existing medical plan but unexpected expenses brought by these eventualities may be covered by maternity insurance plans.

Getting a maternity insurance is one of the best ways one can take care of her baby even when he or she is not yet born. Financial security allows the mother to get the best prenatal care that shall ensure that the baby develops normally. Furthermore, with the help of a dependable maternity insurance company, the couple can eliminate worries on how to pay for pregnancy and childbirth expenses. Going through the maternity period without these worries but instead, with the right attitude and disposition, ensures that the mother can give birth to a child that is physically, mentally and emotionally healthy.

With all the risks involved in pregnancy and childbirth, getting a maternity insurance is a life-saving decision. It helps an expectant mother get through her life's most crucial moment with security and hope. Moreover, maternity insurance is payable in easy installments so she and her husband can surely have more peace of mind. However, it is important to be extra careful in purchasing maternity insurance plan. If you are planning to get maternity insurance, make sure to get it only from a reliable insurance provider to prevent problems in the long run. It would be best to shop around first to know where to get the best maternity insurance policy that shall benefit you and your baby.

In the past year, I have had the privilege to attend several births as a student midwife and I can honestly say that each experience has touched me in a special way. I can recall dancing with a woman as she swayed to the rhythm of her contractions; I have dabbed the sweat from many a woman's brow with a cool washcloth in between her "surges". I have even felt the raw power of a woman's determination course through her body as she leaned back into my arms and pushed with all her might to bring her baby into this world. Of course, some of my favorite memories are when women have gently birthed their newborns into my hands as their family watches with pure awe and reverence on their faces as they greet their newest member. They have just witnessed not only the birth of a new baby-they have witnessed the "birth" of a new mother as well. It is moments like these that capture a mere glimpse of the intense beauty and power that make birth so special.

Pregnancy and birth are elements of an incredibly momentous journey into motherhood for a woman. This life changing event can have a profound impact on a woman and her family as each member assumes a new role in relation to the little bundle of joy-mother, father, big brother, big sister, grandparents and others. Since each member of the human race enters this world through their mother's womb, pregnancy and birth have always been normal, elemental human experiences in family life.

Worldwide, hundreds of thousands of babies are born each day-many of whom are birthed into the hands of a midwife. In fact, in most developed countries, the majority of births are attended by midwives. The United States differs in this aspect, however, as midwifery was not allowed to flourish at the turn of the 20th century. At that time, a physician-led campaign attempted to smite the entire midwifery profession, prohibiting many midwives from practice. The shockwaves of this campaign are still felt to this day. Based on a 2010 National Vital Statistics Report, less than 20% of births in the U.S. are attended by midwives.

In developed countries that have an established standard of care that provides access to midwifery care for most, if not all women, their birth outcomes are better than in the U.S. Despite the advances in technology, specialized obstetrical training and astronomical healthcare expenses, the U.S. consistently lags behind in the maternal-neonatal health care statistics. In an excerpt from her book, Into These Hands: Wisdom from Midwives, Geradine Simkin, the Executive Director of Midwives Alliance of North America, tells us: "The U.S. has one of the highest infant mortality rates in the modern world, ranking about thirtieth among developed nations, and the rate is higher for infants of color. Although the U.S. maternal mortality rate has improved over the past century, it has not improved at all since 1982 and appears to be increasing. Our maternal mortality rate is as dismal as some developing nations and the rate is higher for women of color. The safety, reliability, price and performance of our current maternity care system are issues of grave concern." It is clear that the highly interventive, over-medicalized approach to care of women during pregnancy and birth that is so prevalent in the U.S. is not improving outcomes for mothers and babies. What is it about integrating open access to midwifery care into the healthcare system for all women that improves pregnancy and birth outcomes?

Midwives respect the normalcy of pregnancy and birth as a healthy part of the life cycle for women. Throughout the childbearing year, midwives provide holistic support and address concerns regarding the woman's physical, emotional, and social well-being. While providing hands-on support and monitoring during labor and birth, midwives are also committed to utilizing the least amount of technological interventions as necessary. Midwives do not ignore the fact that pregnancy and birth can become vulnerable to pathology or complications, and are not opposed to referring to specialized providers, such as obstetricians, or using technological or pharmacological interventions when there is an indication to do so.

It is true that technological interventions can provide myriad benefits, but midwives appreciate that every intervention also introduces some degree of risk. Take cesarean section for example: cesarean section can be a life-saving tool for both mother and baby, but we cannot ignore that this is a major abdominal surgery that carries the potential for harm. Potential risks of cesarean section include-but are not limited to-hemorrhage, infection, and death. The divergent perspectives on the potential benefits and harms of routinely interventive, highly medicalized care of women during pregnancy and birth that has become the standard in the U.S. is one of the areas that distinguishes midwifery from the field of obstetrics.

The practice of midwifery is supported by a comprehensive body of knowledge regarding the normal reproductive health of women and its potential for motivating a woman to make healthy lifestyle changes. Additionally, midwives spend more time with the women that they work with from appointment to appointment, providing prenatal care and education that is tailored to the individual needs of each woman and her family. Obstetrical practice is also supported by comprehensive knowledge of the reproductive health of women; however, there is a greater focus on the potential for pathology or complications to arise and making a diagnosis. As you can imagine, there is some overlap between the practices in the two specialties which allows midwifery care to serve as a compliment to obstetrical care, when needed. This makes midwifery care appropriate for not only women experiencing healthy, low-risk pregnancies but also for women who are experiencing high-risk pregnancies that require obstetrical management as well.

There are examples of care models, both domestically and internationally, where women receive both midwifery care and obstetrical care during their pregnancy. Those care models have seen a significant reduction in the neonatal mortality rates and a decrease in the rates of birth related trauma, infections, and complications-particularly in rates of pre-term births and of babies who are born with low-birth weights.

One such example of this care model exists at The Birth Place in Winter Garden, Florida. The Birth Place is directed by Certified Professional Midwife, Jennie Joseph who established the "Easy Access Clinic" within The Birth Place where no woman is ever turned away. Through collaborative partnerships with other medical providers in the community, including obstetricians, and the regional hospital, women receiving care at the Easy Access Clinic experienced lower rates of pre-term births, low-birth weights, and cesarean section. For example, according to the March of Dimes, the rates of pre-term births in Florida are approximately 14%. For women receiving care at the Easy Access Clinic, the rate of pre-term birth was less than 2%.

Let's face it, in these ever growing hard economic times, most companies that provide health insurance to their employees have had no choice but to cut back on the benefits coverage they offer. When reviewing the benefits being offered to you by your employer, get the answers to these questions so you know what you are being offered.

Also, if you are purchasing a health insurance policy on your own for the very first time, make sure you get the answers to these questions from your agent before you decide on purchasing the policy.

Here are the top 5 things you should ask your insurance carrier before using your insurance for the first time.

1. Is there coverage on my policy for "this/a" specific procedure or treatment?

Please don't just assume that there is coverage for something specific on your policy, as benefits are being removed from policies to save money, but were once considered to be standard on all policies. Let's take maternity for example. There are numerous national and local insurance companies that sell individual policies to people every day that do NOT cover maternity care. Sadly, most people do not find out about this until they are already pregnant. Make sure to verify with the agent if and how a service is covered on a specific plan prior to purchasing it.

2. Is there a pre-existing condition term on this policy, and have I met the determining criteria?

A pre-existing condition is a health problem that you have been treated for, or diagnosed with within 63 days to 24 months prior to the health coverage beginning date.

Basically, anything medical, mental, illness or injury related that was contracted or treated within the 63 days to 24 months time frame can be denied as a pre-existing condition.

If you have something denied as pre-existing, you will need to show proof, in writing from your prior carriers, that you have had uninterrupted health insurance prior to the start date of your new policy. There can not be greater than a 62 day window (the standard in most cases) in your coverage, or the pre-existing condition clause will exclude anything you were treated for prior to the start of the policy. In some cases, this includes diabetes.

3. Am I required to use specific doctors for visits to be covered under my insurance?

Many people do not know that with every health insurance they carry, there is a specific "network", or list of doctors that they need to use to minimize their medical costs. The best thing to do in the event that you need to use a doctor of facility is to call your insurance company to find out if there is a certain network that needs to be utilized prior to using a doctor. If you call the customer service number on your ID card, they can usually tell you if there are specific doctors to use. They can also assist you with locating doctors in your area. The best way to handle this is to make that call as soon as you get your insurance to avoid being rushed if you are ill or have an injury.

4. Do I need to use a specific laboratory for blood work and lab tests?

This again falls under the "network" doctors scenario. If you do indeed have a specific network to use, you can call your insurance customer service and find out in advance which laboratory in your area is the correct laboratory for you to utilize. Understand that in some cases, the hospital may be the most expensive cost option for laboratory tests.

5. What will my out of pocket expense be for the following treatment facilities?

Prior to using your insurance, you should have an understanding as to what your financial responsibility will be for each of the following. You can get the cost information by calling the customer service number on your identification card, and be aware; this is only a partial list of possible treatment options.

• A family physicians office visit


• A specialists office visit


• A laboratory visit for blood work


• An emergency room visit


• An in-hospital stay


• An out-patient hospital visit


• An urgent care visit


• An imaging facility visit

You should fully read and understand your health insurance policy before using it the first time. In the event that the insurance terminology is confusing to you, you should call the customer service number on your insurance card and ask them as many questions as it takes to answer everything that is on your mind. The insurance companies use your premiums to pay their employees to answer your calls and explain your insurance to you. If you ever get into a situation where you are not getting satisfactory service, please ask for the representative's name, and then ask to speak to their supervisor. Your premiums pay them to do their job, get what you are paying for.

Best wishes for your long and continued good health.

Lactation is the biological term used for the production of breast milk. When a baby suckles at the breast, nerve stimuli are sent from the special receptor cells located in the breast to the hypothalamus which is located in the brain. The hypothalamus is then stimulated to activate the pituitary gland ninto producing two different hormones.

These hormones are called oxytocin and prolactin. The hormone called oxytocin is stored in the pituitary gland and acts on muscle cells. These muscles surround the milk glands where milk is produced. Oxytocin causes the muscles cells to contract in turn squeezing milk out of the glands into the ducts.

Prolactin is the second hormone which is involved in the lactation process. Prolactin is also produced by the pituitary gland and is released into the blood stream each and every time the baby suckles at the breast. When prolactin is released into the blood stream, it travels to the milk glands in the breast and stimulates the glands to produce milk. The level of prolactin increases in the mother during pregnancy, but milk production is suppressed by another hormone, progesterone, until its level drops off after birth.

Oxytocin causes what is known and referred to as the "letting down" of milk from the glands. This causes different sensations in different mothers. Some will report shooting pains, others report a tingling feeling and sensation. Some report no sensation at all. All are normal. After this process, the milk is then transferred from the breast to the baby by a combination of two processes:

* Active milk expulsion by the mother due to the let down reflex

* Active removal by the baby who works on the breast tissue with tongue and jaw to receive milk.

The more a baby feeds at the breast the more milk will be produced. The mother needs to bring the baby to the breast often so that her milk supply can keep up with the demands of her growing baby.

Source: MNT Training OCN Maternity Practitioner Award Course Handbook.

Like most states, South Carolina follows the leave provisions outlined in the Federal Family and Medical Leave Act (FMLA), with only a few variations. The federal law states that if federal provisions conflict with those outlined in state laws, employees have the right to mix and match to receive the most generous benefits possible. The following paragraphs illustrate how this state's laws differ from the federal FMLA.

Employers are grouped into two sectors: the Public and Private sector, and the State employers sector.

Employers in the Public and Private Sector that have more than 20 employees may grant paid leave to employees choosing to donate bone marrow. The employer must agree to any leave extending 40 work hours. The federal FMLA, however, does not have any provisions for donating organs.

The federal FMLA does not grant paid sick leave to employees to care for sick immediate family members - only unpaid leave - but it does allow for the substitution of unpaid leave with paid leave. Luckily for state workers, the state leave policies require state employers to provide tjeir employees with 8 paid sick days per year to care for immediate family members, such as their spouse, children, parents, siblings, grandparents, legal guardians and grandchildren.

South Carolina employees are also entitled to 6 weeks of accrued sick leave to care for a child upon adoption, differing from the federal FMLA, which only guarantees unpaid leave.

South Carolina's leave laws include a section on maternity leave, stating that all policies and practices applying to disability must be applied identically to conditions related to pregnancy, miscarriage, childbirth and recovery, and that an employer must make reasonable accommodations for an employee with a disability (which includes those affected by the previously listed conditions related to pregnancy), unless impractical. The federal FMLA only gives 12 workweeks of unpaid leave to employees for the birth and care of a newborn child and does not include as broad a definition of pregnancy as South Carolina's leave laws.

South Carolina's leave laws also have two causes which have no counterpart in the federal FMLA, regarding employees suffering extreme hardships and the ability to donate excess sick days to a state pool. Regarding employee emergencies or extreme hardships - employees may be permitted to use the rest of their annual leave in cases of extreme hardship if they've already exhausted all sick leave and 30 days of accrued annual leave. Employees with more than 15 sick days can also donate their days to a pool for state employees with personal emergencies.

A midwife strikes up imagery of labor and delivery in the Middle Ages, but they are still very much with us in the 21st century. A midwife is a health care professional who specializes in reproductive health. They are responsible for providing prenatal care to expecting moms, and they also attend the birth and then give the mother and new child postpartum care. By tradition, midwives usually help women to have a natural birth experience.

The specific services that a midwife offers depend on her license credentials and certification, as well as any restrictions imposed by the specific state. A nurse-midwife will provide the most extensive array of services, since they have the added nursing license. The services might include family planning, preconception care, gynecological exams, prenatal care, labor / delivery support, menopausal management, and newborn care. Midwives also often provide reproductive education for the mother, pertaining to subjects such as nutrition, exercise, pregnancy health, contraception, and breast feeding.

There are several different types of midwives. All must receive certification through the North American Registry of Midwives. Here are the different types:

• 
  CNM: Certified Nurse-Midwife. This is a person who has been trained in nursing as well as being a midwife. They have received a bachelor's degree and have American College of Nurse Midwives certification.


• 
  CRM: Certified Professional Midwife. This is a person who has been trained as a midwife and has met the standards provided by the North American Registry of Midwives.


• 
  DEM: Direct-Entry Midwife. This is a person trained as a midwife through self-study, a midwife school, apprenticeship, or a college program.


• 
  CM: Certified Midwife. This is a person trained in midwifery. She has a bachelor's degree and is certified through the American College of Nurse Midwives


• 
  Lay Midwife. This is a person with no official certification, but who has been informally trained in midwifery through either apprenticeship or self-study.

The main benefit for most women who select a midwife is that they want to go through the birthing process in a natural way. Also, midwives usually offer some kind of easy payment plans or sliding fees. Plus, in the end, the maternity costs are considerably less when you use a midwife.

Drawbacks of Midwives

There are some times when using a midwife are not recommended. These all revolve around situations in which complications with the pregnancy arise. Most midwives are not equipped to handle situations that require a medical intervention.

The American Pregnancy Association says that choosing to use the services of a nurse-midwife will be a good choice for low-risk pregnancies where there is not likely to be a major medical complication. Sixty to 80 percent of pregnancies will fit in this category. APA also cites a review of 800,000 births, in which it was discovered that a standard hospital approach to birthing offers no significant advantage to giving birth over a midwife setting. Just be sure to discuss the matter first with child-care and medical professionals to determine if this is the right choice for you.

Pregnancy period is the most exciting period of a woman's life which with excitement also brings some complications, but today there are many home remedies available for these pregnancy complications. These pregnancy problems can be in the form of nausea, stretch marks, fatigue, swelling or undesired pains.

Nausea or morning sickness during pregnancy is the initial symptom of pregnancy. It can prove to be troublesome when out for some work. This pregnancy complication can be cured by taking some medicines prescribed by the doctor. But, when a home remedy is available for curing a problem then why should one go for medicines.

Yes, there are many Home remedies available for overcoming this pregnancy complication. These are briefly mentioned as below.

As can be seen, pregnancy is a stage where a woman faces various complications relating to her health. However, most of these pregnancy complications can be cured easily by some home remedies.

Ultrasound's during pregnancy are a very important tool for many different reasons. You will see in reading this information that you should not hesitate to have an ultrasound, or a few ultrasound's, done during the course of your pregnancy.

Some people believe that ultrasound imaging can be harmful to your unborn baby. This has never been more wrong. There are actually several dangers that go along with not having ultrasound's done while you are pregnant. You will want to make sure that you are taking the best care of your body and your unborn baby while you are pregnant. Ultrasound is one of the best ways to ensure that you are doing just that. You will see that there are a lot of different things that can be prevented if you will just take the time to have a few ultrasound's done.

Not only can ultrasound's during pregnancy be vital to the development of your unborn baby, but they can also be very fun, exciting and rewarding. Your baby is only inside of your for a short while before they make their grand entrance into the world. This is why it is so important to cherish the memories that can be made during this special time of their gestation. You will be able to find that you bond better with your baby if you take the time to see them through the use of sonograms and ultrasound imaging.

When you are first finding out that you are pregnant, an ultrasound can be very useful in determining just how far along you are in your pregnancy. This will help the doctors have a better idea of when your baby should be born. This is very important when it comes to having things done on a timely manner when you are pregnant. The ultrasound's will also keep track of the weight of your baby. It is a good idea to have them regularly to make sure that your baby is growing and developing the way that they should be.

On a more serious note, it is also a great tool to be able to rule out certain birth defects and genetic disorders such as down syndrome. This can help the doctors be more able to prepare for the birth of a baby who may need additional care after birth. There are other things that can go wrong during a pregnancy as well, such as placenta ruptures and abnormalities. The ultrasound's during pregnancy will also help to rule out things such as this during your pregnancy.

If you ever feel that you may have had a miscarriage, it is a great idea to have an ultrasound done to be able to rule that out as well. It can be a very scary time, and being able to see your child's heartbeat beating away is one of the greatest things that will help to ease your mind if you are worried about this. Please take the time to have ultrasound's during pregnancy.

Any woman who is spotting and cramping during pregnancy should be concerned but should not panic. Many women experience at least some spotting or cramping or both during pregnancy especially during the first trimester and this may or may not be a sign of something more serious wrong. Seeking medical advice may prevent problems later on or may simply be needed to reassure the expectant mother that all is well and the pregnancy is continuing as normal. Either way a doctor's reassurance or intervention is important when spotting and/or cramping occurs.

Spotting and Cramping during the first trimester

Many women experience spotting and cramping during the first trimester of their pregnancy though not often together. Since most miscarriages occur within the first 12 weeks of pregnancy it is advisable for any woman experiencing heavy spotting to seek a physicians care especially if that spotting is accompanied by cramps, fever or chills.

Many pregnant women will experience what is known as implantation spotting. This simply means as the egg is working its way into the wall of the uterus it may cause irritation that will result in light spotting. This spotting is usually pale pink or dark rusty color in nature. There may also be some light cramping that occurs during implantation and often women mistake these two events as a signal that their menstruation cycle is about to begin.

Other causes of spotting during the first trimester could occur after paps smears or internal exams or after sexual intercourse. This spotting is caused due to body changes and the fact that a woman's cervix is slightly more sensitive than when she is not pregnant. This bleeding usually consists of a few light drops that doesn't last more than a day or two. If the spotting is heavy or accompanied by cramping it is wise to seek a doctors care.

Cramping during the first trimester is also not unusual and is often due to the uterus stretching to accommodate the growing fetus. These cramps are usually mild. Cramps that are low in the abdomen and are stronger than regular menstruation cramps may be sign of a Ectopic pregnancy so it is extremely important to seek a doctors advice if you are experiencing severe cramping.

Second Half Pregnancy Bleeding or Cramping

Women who are experiencing spotting in the second half of their pregnancy need to visit a doctor as soon as possible as spotting in the last half of pregnancy is less common and could be a sign of a real problem. Spotting during this time could be due to an inflamed cervix or a growth on the cervix. It could mean an infection is present that should be treated or could be a sign of preterm labor.

Cramping during the second half of pregnancy is usually fairly normal and can be caused by something as simple as constipation or gas or if it occurs later in the pregnancy could be caused by the onset of labor. During this time cramping may also occur due to the continued stretching of the uterus.

While there is often some cramping and spotting during pregnancy, it is always best to have things checked out to insure that your pregnancy is progressing and you and your unborn child are both healthy.

Having a child can add up, especially if you don't have any health insurance. Even if you have health insurance, you're going to find that the side fees can break the bank as well. While you don't want to have a child and not get any care, it's important that you look into getting care, even if you don't have the money. If you don't have the money, reference with your state's health department to see if there is any assistance.

With prenatal care, you're going to see your OB/GYN on a frequent basis. Depending on how far along you are, this will depend on how often you go. For example, if you're only 1 month into your pregnancy, you will probably go once a month. Once you're around 8 months, you will go every other week, up to your birth.

Your prenatal care will generally include your vitamins, your doctor appointments, and your Ultrasounds. While your health insurance will cover this, it's important to see if they cover maternity. If they don't cover your maternity procedures, you will have to pay out of pocket. Many Doctor's offices will work on a cash discount basis if you really want to.

Looking at the costs of prenatal care

Every state and hospital is going to vary, but you will find that each visit will be around $100 to $300. Your Ultrasounds can run anywhere from $200 to as much as $1,000. You will need around 2 ultrasounds during your care. You can get more if you choose to, or if they find something that may require another one.

The average cost including your ultrasound, vitamins, and doctor's visits will average around $3,000. This number can be significantly higher in some states, while it can be lower in other states. If you have insurance that covers maternity, you will find that you will pay your deductible, or co-pay (however your insurance works).

The cost doesn't include problems either. If you have problems or complications during your pregnancies, you may have to get medicine prescribed to you.

As you can see, it can add up. Before you have a child, make sure that you have insurance that covers maternity. This is going to be your best bet when it comes to the procedure.

I often have the privilege to talk with young women experiencing an unanticipated pregnancy. Their emotions, thoughts and fears can be varied, intense and distressing. It is important that they feel safe and comfortable enough to explore their inner experience and feelings. It is especially important to learn about the aspect of their pregnancy that is most upsetting. This varies from woman to woman. For example, it is not uncommon to hear from a woman that when she told her boyfriend about the pregnancy, he became upset and offered to pay for an abortion saying that he was not ready to be a father and that a baby would interfere with his goals and plans for the future. Another common source of distress is being afraid to tell her parents about the pregnancy. Others might worry that not only would she suffer the wrath of her parents, but she would also endure cruel gossip from friends, peers and the community. A woman in a situation like this may feel quite distressed thinking that a baby would interfere with going to college and achieving her career goals. The prospect of being a single parent may be frightening. I often hear women explain that because they are afraid and feel alone, they are surprised that in their distress they are considering abortion, thinking it may be the best solution to their crisis, which is what they frequently consider their unanticipated pregnancy.

To reduce her sense of distress it can be useful to discuss her fears. Perhaps fears of losing the respect of her parents and family, forfeiting her college scholarship, and not having the freedom of others her age. It is important for a woman experiencing an unanticipated pregnancy to be able to talk about her situation, her thoughts and her feelings. Because she probably feels scared and alone, she needs a safe place to tell her story and articulate her sense of distress. Most women are greatly relieved to tell their story out loud to another person. In helping someone else understand what she is thinking and feeling, it is typical that she will better understand herself.

It is useful to explore how although the pregnancy can feel like a crisis, it is taking up just part of her life. . . not her whole life. I often recommend that women think about what would be different if when she went to bed tonight and a miracle took away the problems the pregnancy caused. For example, a woman might talk about how much she wanted to go to college and retain the respect of her family and friends. Thinking about the impact of this "miracle" might help her identify what she needs as support and resources.

When a woman is reluctant to tell her parents about the pregnancy, it can be productive to think and talk more about her growing up years. When asked if she had ever been in trouble before, often times I will see the hint of a smile with the relief of remembering that her parents were supportive when she pushed the limits or had some difficulties previously. It can be helpful to recognize that the reaction of parents may not differ significantly from the woman's own reaction upon learning she was pregnant, and may be fueled largely by shock and fear. In fact, the history of a woman's relationship with her parents may even help her predict that the origins of their angry response would be from their love and care for her. Many parents have a deep longing to protect their children and may be distressed that she is going through such a difficult time.

Because tunnel vision is characteristic of those in a crisis mode, it is important to gain a broader perspective. I often suggest that after taking ten slow and deep breaths, she get a pad of paper and list her options: perhaps carrying the baby to term, adoption, raising the child herself, and abortion. It can be useful to think about what the implications of each decision might look like six months from now, a year from now, five years from now and ten years from now. This "time line" exercise is a helpful way to gain some distance from the crisis of the moment. Of course, this is an important and major life decision with implications touching the lives of others and reaching far beyond the sense of urgency of the moment. Better perspective helps in recognizing the importance of making a well thought out and informed decision rather than making an impulsive decision with unanticipated, negative long-range effects. It is important for a woman experiencing an unanticipated pregnancy to identify her resources, which might include access to medical care, good health, strength, energy, courage, insight, friends and caring parents. Hope and confidence increase and distress is reduced when she recognizes that resources can help her cope with the difficulties involved in peer group pressure, delaying college, or feeling bad about disappointing her parents. With increased confidence and more hope she can begin to focus more on getting the support she needs and work towards solutions that feel good to her.

Although she may have never thought she would seek an abortion, a woman will often acknowledge that she felt bad about initially considering making that choice. Nonetheless, in her distress it may have been difficult to see any other option. In most cases, it is useful to be able to talk about her situation in a safe and nonjudgmental atmosphere. She feels encouraged as she gains a better sense of what she needs to deal with her crisis in a way that is consistent with her values. It is always heartening to partner together to devise a plan to build support, strengthen resources and see a woman feel more confident about her ability to cope with the difficulties involved in her unanticipated pregnancy.

Height is always an advantage, even for women! People always notice you. If you are a businesswoman, business dealings become easier to handle since your height proves advantageous. You can prove to be a perfect model for designer clothing. Of course, there are many other things you can do with your height, but the entire list would take up too much space! The snag occurs when you become pregnant. You just cannot find the right maternity clothes to fit your tall frame!

This is when you start cursing your own body and keep wishing that you were born petite! You love pants, but none of them will cover the entire length of your legs. It is not even necessary to waste time on off-the-rack tops and maternity dresses- they will not fit you anyway!

Never mind, there is hope for you yet! Designers are sitting up and taking notice of people like you. It is difficult not to, considering that plenty of women are crossing six feet now-a-days. Contestants at beauty pageants are enough proof! Even the Internet has followed suit by displaying web sites catering to maternity clothes for tall women. Some of the styles can be mind-blowing! With so many clothes all over the place, it should now prove quite easy to stock up your wardrobe with maternity clothes that flatter your tall frame and cater to your personal tastes.

If its jeans you are after, visit Trendy Mama. This company caters to two different conversion styles and promises to customize jeans to suit every personality, including tall women. So you can just mail your order to the company, giving your own specifications. The company will take care of the rest.

Another company in LA, babystyle dot com also exhibits maternity clothes for tall women. Their specialty is maternity pants with 33-inch inseams. And there is quite a range available!

If you would like to explore further, there is Gap Maternity. The maternity tall pants they offer are meant for pregnant women requiring a 34-inch inseam. Stretch pants take precedence where maternity clothes are concerned; they are a popular favorite. Also, on and off clearance division sales can fetch you real bargains in the name of maternity clothes.

Other popular retailers are - Motherhood Maternity which has a great variety in styles and sizes, and Old Navy which displays an extensive range of clothing for shopping online.

If ultimately nothing checks out when shopping for maternity clothes, browse through the well-known J.C. Penney catalog. The clothes mentioned in the catalog are meant for tall women only. They are well-designed and of very good quality. Thus, you end up with clothes that are not only fashionable, but durable too!

Humana, founded in 1961 as a nursing home company, grew to become one of the largest of its kind within a decade. Within twenty years it became one of the largest hospital companies in America, and now, 47 years later, it is one of the largest publicly traded health benefits companies in the US and is ranked 150 in the Fortune 500.

Humana is headquartered in Louisville, Kentucky and has 7 million medical members primarily in 22 states and Puerto Rico. The company offers coordinated health insurance coverage and related services through traditional and internet-based plans to employer groups, government-sponsored plans and individuals. Humana provides services to companies with fewer than ten employees to companies who employ thousands. Small businesses are offered a wide range of products and services designed specifically to meet their needs. It also has specialty products such as dental, life and disability insurance.

HUMANA CHOICE CARE NETWORK

Humana Choice Care Network includes more than 320,000 physicians and ancillary care providers in fifty states and DC, serving 1.3 million PPO members. Their HMO plan has received accreditation from the national Committee for Quality Assurance (NCQA) and the American Accreditation Healthcare Commission (AAHC). Also, Humana is the first health benefits company to achieve registration for its Personal Nurses and Transplant Management Services.

Humana health insurance quotes are available in the following states:

Arizona
Kentucky
Ohio
Arkansas
Louisiana
South Carolina
Colorado
Michigan
Tennessee
Florida
Mississippi
Texas
Georgia
Missouri
Utah
Illinois
Nebraska
Virginia
Indiana
North Carolina
Wisconsin
Kansas

HUMANA ONE

Humana One is Humana's individual insurance plan. Within the Humana One system a number of different types of policies are available. An individual or family can elect to choose from four deductibles: $500, $1,000, $2,500 and $5,000. After the deductible expense is met, the Human Health Insurance policy pays 80% of the next $10,000 in covered expenses, the 100% up to $5,000,000. Doctor visits are included in the 80% coverage after the deductible is met. However, prescriptions are covered after a $500 deductible with a co-payment: $10 for generic drugs, $30 for brand name drugs, and $50 for drugs not listed on their formulary list.

Humana offers custom build-your-own plans such as the Portrait Plan, Monogram Plan, Autograph Plan and the Autograph Plan/HSA.
Portrait Plan

This plan is designed for those who want to minimize risk in their lives and want the major coverage by offered by big employers. This plan could be a benefit to those who are self employed and also for those individuals who are early retirees from a company that does not offer health insurance.
The in-network co-insurance operates on a 80%/20% formula, where the insurance pays 80% and the subscriber pays 20%. This plan also offers unlimited office co-payments as long as you stay in network for your physician visits

Monogram Plan

The Monogram Plan offers a safety- net in coverage in case you ever need it. It's designed to provide low cost protection for those who are healthy and seldom visit a doctor. Those who avail themselves of this plan are generally those who are no longer covered under their parent's policies, college graduates, undergraduates, those who work part-time and those who work for a company that does not offer group insurance.
Autograph Plan

This plan has the most flexibility in regard to designing a health plan that works the best for an individual's specific needs. It also offers the better options for those who need to make to make multiple office visits due to injury or illness.

Autograph Plan/HSA

The benefits and options offered in the Autograph Plan are also available in the Autograph Plan/HSA. In addition you can avail yourself of potential tax advantages by using a HSA that lets you pay for qualified medical expenses with tax deductible contributions.

Optional Additions to Individual and Family Policies

Maternity Coverage. Premiums are an additional $107 dollars per month and the deductible is increased by $500. The insurance then pays up to 60% of the costs of routine pregnancy and childbirth.

Dr. Co-payments. This option allows an individual to purchase four Doctor's visits per year with a $25 co-pay for each visit. If you have more than four doctor's visits within a year you are subject to the deductible and co-insurance.

Dental insurance
Disability insurance

While Humana may offer very good coverage for the individual or older families who are no longer having children, it may not meet the needs for the family that is still growing. Paying only up to 60% for pregnancy and childbirth, a Humana Maternity policy still leaves the family with a pretty hefty out- of- pocket expense. Also, to be noted is that Dental Insurance is only available to those who all ready have a health insurance plan with Humana.

HUMANA HEALTH INSURANCE QUOTES

To decide if Humana One may be a good choice for your health insurance needs then be sure and compare quotes from many different companies side by side.

Pregnant women now have a wide range of options sure to satisfy their clothing needs throughout the first trimester pregnancy, second trimester pregnancy and third trimester pregnancy. With so many maternity merchandise choices to select from it can be overwhelming. There have never been more maternity merchandise and trendy maternity clothing including cheap clothes maternity, maternity plus size, maternity suit swim, maternity jeans, designer maternity clothes than there are today with styles, fabrics, colors and designs to suit every size and shape of expecting mother.

Maternity Clothes

Gone are the days when maternity merchandise choices were limited now there are clothing maternity and cheap clothes maternity fashions to satisfy every lifestyle and need. Some of the maternity merchandise available online and in maternity clothing stores can include; maternity jeans, maternity pantsuits, clothes designer maternity, maternity suit swim, maternity accessories (hairpieces and scarves), maternity wedding dresses, maternity jackets, maternity tops and pants, maternity shirts, clothes maternity plus size, maternity pajamas and intimate apparel, maternity lingerie, maternity dresses and skirts, maternity hosiery, bra maternity and maternity lounge wear to name a few.

Maternity Merchandise and Accessories

Along with all the wonderful maternity merchandise, there are maternity accessories that help new moms throughout the first trimester pregnancy, second trimester pregnancy and third trimesters of pregnancy. Some of the maternity merchandise and accessories can include; maternity skin care, maternity belts that helps to relieve backache experienced during pregnancy, nursing pillows (for after baby is born), diaper bags, maternity tights and hosiery, maternity underwear and maternity bras.

For expecting mothers the maternity merchandise and clothing can be endless so it helps to compare shop at different online sites and maternity shops to find the best prices in maternity merchandise.It also helps to purchase maternity fashions in basic colored items that allow for mixing and matching with items such as skirts, pants, tops and shirts. Elastic waists and maternity bras in cotton/spandex blends that allow for room to grow can be helpful. Maternity clothing and maternity accessories should be comfortable, stylish and easy to wear to support mom's ever growing belly.

Maternity merchandise, clothing maternity and cheap clothes maternity fashions have never been so funky and hip as they are today. There is sure to be maternity clothes to complement any lifestyle and event with maternity clothing to include; jeans, tops, skirts, dresses, pants, evening wear, swim suits, lingerie and bra maternity in a wide variety of lovely fabrics, designs and colors. A woman doesn't have to sacrifice her original style when pregnant there is without a doubt fashions maternity to suit every woman's personal tastes.

The maternity merchandise a woman owns will go along way in making her feel better throughout the first trimester pregnancy, second trimester pregnancy and third trimester pregnancy. The maternity merchandise, clothing maternity, cheap clothes maternity and clothes designer maternity choices have never been greater with plenty to choose from online and at shopping centers across America. There are several popular designers who now design maternity fashions in fabrics, styles and colors appealing to women of all shapes and sizes. Designer jeans maternity are available from many designers along with maternity wedding dresses, maternity jackets and tops, maternity pants, maternity dresses and skirts and maternity lounge wear to name a few.

One of the most popular pieces of maternity merchandise, clothing maternity and cheap clothes maternity is that of the jeans. Maternity jeans can be found with elastic waists allowing room to grow for expecting mothers. Button and zipper up jeans maternity are also available in a variety of designs to include; ink finish maternity jeans, rock finish maternity jeans, light and dark wash maternity jeans, low cut and boot leg maternity jeans, maternity denim capri's, cropped jean maternity and various colored maternity jeans. Maternity jeans are such a great option for women while being pregnant as they can be worn casually or dressed up with a nice maternity blouse or shirt.

The choices in maternity merchandise, clothing and maternity bras give pregnant women lots of clothing options throughout their first trimester pregnancy, second trimester pregnancy and third trimester pregnancy. There is no shortage of maternity clothing designs for women whether they are attending a wedding (with maternity wedding dresses available), event or at home or the office.

Most women today are worried about ways to succeed in preventing pregnancy. There are different ways in which one could achieve this but they don't always work. Down below you will find tips and advice that will help you maximize your chances in preventing pregnancy.

Let's look at some common urban myths that must be debunked:

You can get pregnant just from the first sexual intercourse or never! After the first period, women are completely vulnerable.

The chances do not decrease just because this is the first time you've had a sexual intercourse. Once a female gets her first period, she is able to get pregnant from any sexual intercourse and at anytime.

You can prevent pregnancy if the male removes his penis before ejaculation.

If a man decides to do so, it may reduce the chances of pregnancy but it still doesn't affect it enough. All you need is just one sperm to reach the ovum and the pregnancy process will immediately begin! Sperm can actually be released even before ejaculation so this whole idea is completely irrational.

You can prevent pregnancy if the male decides to wash the sperm after intercourse.

This technique is called douching (http://www.womenshealth.gov/publications/our-publications/fact-sheet/douching.cfm) and it's also not a very successful technique. As state before, sperm can be released before ejaculation. It is not possible for someone to successfully wash away the sperm because millions and millions of sperms are released. They would have already gotten far into the womb before they can be washed out. There are some better and more successful alternative ways for preventing pregnancy.

Contraception and Pills

There are all sorts of methods of contraception for both women and men to use. They do not promise 100% protection, but still provide protection.

Pills are probably the most unnatural way to prevent pregnancy. There are birth control pills available and you can obtain them through prescription. The morning pill is another emergency pill that can be taken within 24 hours of sexual intercourse.

No Sex During Ovulation Period.

This is a natural way for preventing pregnancy. Instead of using artificial contraception, you can decide to avoid having sexual intercourse during your ovulation period, which occurs around the 14th day of a normal 28 day cycle. This is the time when the eggs are released. So if the eggs are hanging around when the sperm comes in, there is higher chance of getting pregnant.

Despite which method you choose to follow, they will only work if you follow them properly and do not try to avoid cutting corners. Doing it so may lead to a potential unwanted pregnancy and if that ever becomes the case, always remember that it is not the child's fault that he or she was brought to this world and indeed was due to your careless actions. This brings up a subject that requires a lot of time and dedication to be covered, which is abortion.

Deciding to Avoid Pregnancy With Care: Talking About the Issue

Deciding to avoid pregnancy involves much more than just taking medicine and applying techniques which are implemented during, before or after sexual intercourse. Depending with whom you are trying to avoid a pregnancy issue this matter will require a good conversation between you and your partner.

Some man will treat this issue with ease and will support you every step of the way, while other guys will not understand at first and will want you to explain to them exactly what is on your mind and how you came with such a decision to avoid pregnancy or the other way around. In the end a good conversation will leave you both satisfied and there will be nothing else to worry about.

Preterm birth remains a major cause of newborn and infant illness and death. If its causes were better understood and prevention or treatment more effective, fewer babies would die every year. For a pregnant woman, prevention of preterm birth requires knowing the early signs of impending labor and seeking prompt care should any occur.

There is no exact physical or physiologic point at which a fetus ceases to be premature and becomes mature, no matter how precisely the pregnancy is dated. All the changes that occur are gradual, especially in the latter two-thirds of the third trimester. There are no great leaps forward in baby behavior from one day to the next. In general, however, 37 weeks completed gestation is considered mature. Any labor occurring before 37 weeks is considered preterm labor and any baby born before 37 weeks is considered preterm.

Today, a distinction is made between premature babies and preterm babies. "Maturity" refers to how well the baby is able to function outside the womb, with the most emphasis on the respiratory system, as breathing is a crucial function the baby must assume. A baby whose lungs cannot function is "premature." A "preterm" baby is one whose gestational age is less than 37 completed weeks gestation. Some "preterm" babies may not be "premature" from the perspective of their ability to breathe.

Acknowledging the difficulty in precisely dating a pregnancy, particularly prior to ultrasound, experts in the early part of the twentieth century suggested defining prematurity by weight, not gestational age. Any baby weighing less than 2,500 grams (2.5 kilograms), or approximately 5½ pounds, was considered premature. However, using weight imposes its own imprecision, as weight varies greatly with many other factors. We now make a distinction between birth weight and gestational age.

A baby's birth weight may be said to be appropriate for gestational age(AGA) or small for gestational age(SGA). Small babies may be small because they are preterm or small because they are "growth retarded," or "growth restricted." A baby may be both preterm and small for gestational age.

If two babies are the same birth weight, but one is born at 33 weeks and is the appropriate weight for this gestational age and the other is a growth restricted baby born at 38 weeks, in general, the older infant will have an easier time adapting to life outside the uterus. If a baby is large, but born early, it may still have the problems that accompany early birth. The baby who will have the most trouble is the one who is both premature and small for gestational age.

Prior to delivery, when the baby can physically be examined to determine its gestational age, the date of the first day of the last menstrual period is the best single piece of information regarding the duration of the pregnancy. When a woman does not remember this date, when she has irregular periods or gets pregnant after discontinuing a birth control method that made her periods stop, such as Depo-Provera(the "shot"), an ultrasound determines the duration of pregnancy. Ultrasound may also be relied upon when the uterine size does not match the dates. The ultrasound may need to be repeated to ascertain if the difference in uterine size and menstrual dates(called a size-dates discrepancy) is due to the baby growing excessively or not growing adequately, or if in fact the baby is growing as expected, just older or younger than the dates suggest. Serial ultrasounds, done several weeks apart, can measure the fetus's rate of growth. Proper growth may also be determined by using a variety of ultrasound measurements to assess the relationship of the size of the head, for example, to the size of the abdomen. If there is a big discrepancy between these two, the baby may be growing improperly.

Although 37 weeks gestation is considered mature, a fetus can reach maturity as early as 35 weeks. This does not mean that younger or smaller babies cannot survive. Today, they frequently do. With neonatal intensive care, highly sophisticated equipment for assisting babies to breathe, a recently developed medication called surfactant, which helps the lungs stay expanded, and round-the-clock attention by expert staff, premature babies have a better chance of survival than they did a few decades ago. Newborns can survive with birth weights as low as 500 grams(just over one pound) and a gestational age of about 23 or 24 weeks. Such tiny infants, however, often have developmental problems in childhood.

Most of the difficulty in functioning among preterm babies is seen in babies less than 34 weeks gestational age. Government statistics today make a distinction between moderately preterm births(32 to 36 weeks) and very preterm births(less than 32 weeks completed gestation). Distinctions are also made among low birth weight(less than 2,500 grams or 5½ pounds), very low birth weight(1,500 grams or less, approximately 31/3; pounds), and extremely low birth weight(1,000 grams or less, approximately 2¼ pounds).

In 1998, the overall percentage of premature births in the U.S. was 11.6. This rate has been on the rise. In 1990, it was 10.6 percent; in 1981, 9.4 percent. Most of the increase in 1998 was in the moderately preterm group-babies born between 32 and 36 weeks gestation.

One major reason that preterm births are rising is that multiple births have become more common. Pregnancies with more than one baby are more likely to end prematurely than are pregnancies with only one baby(called singleton pregnancies). Multiple birth babies are also more likely to be low birth weight.

Two trends account for the recent increase in multiple births. One is the greater number of births to women in their thirties, who are naturally more likely to have a multiple birth than younger women. The other is the proliferation of fertility treatments, some of which result in multiple fetuses. About 80 percent of births of triplets or more were due to fertility treatment in 1996 and 1997. In 2000, 18 percent of births to women aged 45 to 49 years was a twin, triplet, or higher order multiple birth. In 1999, one out of every 3 births to women aged 50 or older was a twin or triplet or higher-order multiple birth.

We cannot discuss the rate of prematurity in the United States without noting the difference between the rate for Caucasian women(10.2 percent) and for African-American women(17.6 percent). A small part of this difference is due to the slightly more common occurrence of multiple births among African-American women. Socioeconomic background (poverty, inadequate nutrition, and lack of access to health care) accounts for another part of the difference. Even among African-Americans who have achieved a high socioeconomic status, however, there is a difference in the preterm birth rates compared with Caucasians. We can only reflect that racial inequalities in this country continue to have effects even when aspects of inequity are overcome.