A bit about Pregnancy

From The American Statesman, something interesting about Pregnany

AMERICAN-STATESMAN STAFF


Monday, August 03, 2009

It's been four months, and they have the drill down: Line up, hop on the scale, get the belly measured. These women are not weight-watching, though — they're pregnant.

At People's Community Clinic and locations across the country, more low-income women are taking part in a new concept of prenatal care: group pregnancy checkups. It's a trend medical experts say is breeding happier expectant moms and healthier babies.

Research published in 2007 by the American College of Obstetrics and Gynecology says group visits by young, mostly African American women resulted in significantly fewer premature births. That study, led by Yale University, showed that of 1,047 women randomly assigned to either group prenatal visits or standard care, 9.8 percent of those in group visits had premature births compared with 13.8 percent of those who received standard care. The study is a key reason that the March of Dimes, in its battle against prematurity — a risk for disabilities and even death — has put more than $1.3 million into funding such programs nationwide.

Nurse practitioner Peggy Wall at People's, which provides health care to uninsured people in the Austin area, is a believer. People's began its group pregnancy program last fall, and with a $15,000 grant from the March of Dimes it has so far enrolled 60 women, or 8 percent of the pregnant women its practitioners have seen since the program started. She says women gain more in a two-hour visit as a group than they would in a few minutes alone with a nurse or doctor.

The women voluntarily sign up for the program, which includes first-time moms and those who have had children. They check themselves in and record their weight and blood pressure as Rosa Hernandez, who is Wall's medical assistant and was instrumental in getting the program started, assists.

Wall saw 11 patients in a group visit on a Wednesday night last month and spent a few minutes examining each woman and then meeting with them as a group.

"You've added a centimeter," Wall said in Spanish to patient Alejandra Martinez, 37, who was approaching her seventh month of pregnancy.

Wall then pulled out a wand-like device that uses sound waves to listen to the fetus's heartbeat. "Está bien," (It's fine), Wall told Martinez, who lay on a chaise lounge behind a sheer white curtain, affording nurse and patient a measure of modesty tinged with elegance in a clinic meeting room.

Researchers are just beginning to study why group visits might reduce premature births, said Deborah Walker, an associate professor of nursing at Wayne State University in Detroit. A theory is that social support leads women to eat better, stop smoking and "do the health-promoting things you need to do," she said.

Besides People's, CommUnityCare — the public clinic system that serves low-income and underinsured people in Travis County — offers the CenteringPregnancy program, said Zakiya Larry, spokeswoman for the March of Dimes' Austin Division.

CommUnityCare spokeswoman Debbie Cobalis said the lone public clinic with a program, Rosewood Zaragosa, received $17,400 from the March of Dimes and launched it in November 2007. Officials hope to expand it to more clinics, she said.

The all-woman philanthropy Impact Austin provided a $102,000 grant to help People's plan for a program in October for joint pediatric visits, so women can bring their same-age babies to appointments together, said People's CEO Regina Rogoff. The clinic will open on Saturdays for those visits, she said.

The women in Wall's Wednesday group, who meet twice a month at 6 p.m. and range in age from 18 to 39, sounded interested in the pediatric program. They easily chatted together in a circle of chairs during the check-in period. They brought covered dishes to share during the video and discussion period. The women, all of them Hispanic, chat easily together, mostly in Spanish, although many are bilingual and slip quickly into English.

"We like this," Nadyeli Medina, 27, said, as the women beside her nodded. "I would tell my friends to do this."

She said she has learned the importance of healthy eating. "Instead of hamburgers," Medina said, "I like salads more than I did."

Some of the women in the six groups at the clinic are immigrants and are isolated during the day; their working husbands have the car and cell phone, said Sharon Lynch, clinical operations manager and a nurse at People's.

"The women are away from their families," Lynch said. "They exchange numbers and hold parties for each other. They hold relationships that develop into lifelong friendships."

Maria Ricario, 31, said a previous session taught her about massage for easing back pain. She taught her husband, and "he does it every night now," said Ricario.

Hello again
On the theme of Pregnancy, here is something a little differant, I do hope you all like it. From the Statesman .com
Wall started the discussion by asking what names women had chosen for their babies — she always tries to start on a positive note. Then she moved to a topic they asked for more information about — post-pregnancy birth control — and then moved to a video about the stages of childbirth. It featured real women going through labor and elicited grimaces, even from the women who have had babies.

Medina grabbed Hernandez when the baby in the video was born. Afterward, one woman asked whether an epidural can cause back pain months or years later. Wall said no, that was a common misconception.

The night ended with a relaxation exercise. Wall suggested the women massage one another's hands with lotion she provided. Each woman turned to the person beside her and gently slathered a hand. Flowery smells and giggles filled the room. The clock ticked past 8 p.m. No one got up.

More of the usual stuff at www.backpainloss.com

Regards

Paul