preterm labor and prematurity
“O” or Oh no! The effect of bed rest on an intimate relationship
February 4th, 2010During pregnancy intercourse, and more particularly orgasm, can be the most intense a woman has ever experienced. Because of the increase in blood supply during pregnancy, a woman’s perineum and sexual organs are all engorged (filled to the brim) with blood and this engorgement results in heightened sensitivity. Many women report that some of the best sex they’ve ever had was while they were pregnant. And while many may worry about the effects on the growing baby, you’ll be happy to know that an orgasm does not at all harm the baby. Even though the uterus contracts, the growing baby is so well insulated in the amniotic fluid and the strong, muscular uterus they experience mama’s orgasm as a soft ripple in the waters.
Pregnancy can also have a negative effect on a woman’s sexuality. Many women lose all interest in sexual intercourse while pregnant due to hormone fluctuations causing a significant drop in libido. Lack of desire can also be due to the usual aches and pains of pregnancy, fatigue, nausea, the additional weight and change in body configuration leaving many women less than in the mood.
No one can predict how a woman will feel sexually while she is pregnant. Some women who enjoy robust sex lives prior to pregnancy lose all interest once they become pregnant. Likewise, more reserved women may begin initiating sexual intercourse during pregnancy. Even from pregnancy to pregnancy women report variations in their sexual libidos. They may be insatiable during one pregnancy and completely uninterested during the next.
But what about bed rest? Can women on prescribed bed rest engage in sexual intercourse? Unfortunately, most women on prescribed bed rest are advised against engaging in sexual intercourse. Since an orgasm results in rhythmic contractions of the pelvic organs, a woman at risk of preterm labor absolutely must avoid such activity. Even without the added pregnancy intensity, anything that can cause uterine contractions and lead to preterm labor must be avoided. Some indications for bed rest may allow for some sexual activity. Gestational diabetes and hypertension (but not pre-eclampsia) for example, may require modified bed rest yet may allow for (limited?) sexual activity. When a woman is prescribed bed rest, she should ask her obstetrician or midwife specifically what her limitations are when it comes to sexual activity
As we previously established, intimacy is a very important component of an adult relationship. It may seem like a bed rest prescription means the death of intimacy-at least for the duration of the pregnancy. But nothing could be further from the truth! Intimacy is the act of sharing between a couple; spending time enjoying one another, exchanging private thoughts and emotions, engaging in activities that they find mutually enjoyable. This can still happen between a pregnant woman and her partner. Likewise, while intercourse may be prohibited, not all physical contact is taboo. Consider these alternatives:
- a back and shoulder massage
- a foot massage
- brushing each others hair
- deep kissing
Bed rest is not all bad for a relationship. Bed rest may actually usher in a new phase of intimacy for a couple as their efforts to find alternative ways to share intimate moments work to draw them closer.
Was my little brown baby destined to be a preemie?
November 6th, 2009According the the March of Dimes, in the United States today more than 1,400 babies in the U.S. (one out of every eight) will be born prematurely. Considering that this is one of the richest nations in the world touting an exceptional health care system, this is unacceptable. How can we be losing so many babies? Why is this happening?
There are a myriad of reasons that preterm labor (labor that begins before 37 weeks gestation) occurs and we have discussed many of them already because they are the reasons that many women end up on prescribed bed rest. Just to review:
- uterine and cervical abnormalities
- High blood pressure or pre-eclampsioa
- Diabetes
- placental issues
- multiple gestation
- older mom
- fertility issues
Unfortunately, these problems represent only part of the picture. Several social and cultural factors also increase the risk of babies being born prematurely.
My daughter was born at 36 weeks and 6 days and weighed only 5 lbs 3 oz. By clinical definition she was premature (born before 37 weeks gestation-even if it was only by 4 hours!) and low birth weight (she weighed less than 5 lbs 5 oz). One would think this strange given that I had excellent prenatal care, was very healthy before I had her (although I had had fibroids removed just before I conceived her), was well nourished, in a stable relationship and an in a middle to upper middle class socioeconomic bracket. By all accounts, I should have had a healthy full term baby. Yet, like so many other African American and Afro-Caribbean women in the United States and Great Britain, I had a preemie.
African American and Afro- Caribbean women have a 15 to 18% increased risk of having a premature baby as compared to Caucasian, Asian or Latina women. Infant mortality amongst African American Women and Afro-Caribbean women in the United States and Great Britain is nearly double that of white babies and the disparity cuts across all socioeconomic levels. As an African American woman, this is alarming news to me. Equally alarming is the fact that immigrant African and Caribbean women who come to this country have healthy babies while their daughters, born and raised here, are more likely to have infants that are premature, low birth rate, and have other medical issues.
There is little to no explanation given for this discrepancy. One may want to cite the fact that black women have higher rates of obesity than women of other races and obesity increases the risk of preterm labor. Obesity also increases the risk of developing high blood pressure and diabetes, also risk factors for preterm labor and premature birth. African American women and Afro-Caribbean women in the United States and Great Britain have higher rates of poverty, higher rates of teen pregnancy, poorer access to health care, poorer nutrition and more problems with drugs, alcohol and violent crime than women of other races. As a result, their infants have poorer outcomes. But even the most educated and well to do black women are still having premature and low birth weight babies so social standing alone cannot account for these disparities.
With prompting from the World Health Organization, researchers internationally are finally starting to examine why the disparities between black women and women of other races exist in the US and the UK. Why don’t black women in other nations have high rates of preterm labor and prematurity? What is so different for black women in the US and UK that when they have children their children are at risk of being born too soon, born too little and dying too soon. (Oh yeah, did I mention that black women in the US and UK also have the highest rates of infant mortality, nearly double that of women of other races?? Yes, even now in the 21st century!) Until now such analysis has been taboo; no one really wanted to tackle the issue because it promises to have some controversial roots. But I believe it’s time that we really look at the disparities and at any latent messages, actions or discrimination that may be taking place.
As a black woman who had a preemie (and a healthy term baby as well!) I really want to know what is causing black women to deliver early and to have small babies at greater risk for death. What is it about our western society that appears lethal to us? I want to unearth the cause, expose it and then get rid of it because that same influence may some day cause my daughter, my preemie, to give birth to a preemie. It’s time to break this cycle of prematurity.
