Infertility in Women

To become pregnant, each of these factors is essential:

*You need to ovulate. Achieving pregnancy requires that your ovaries produce and release an egg, a process known as ovulation. Your doctor can help evaluate your menstrual cycles and confirm ovulation.
*Your partner needs sperm. For most couples, this isn't a problem unless your partner has a history of illness or surgery. Your doctor can run some simple tests to evaluate the health of your partner's sperm.
*You need to have regular intercourse. You need to have regular sexual intercourse during your fertile time. Your doctor can help you better understand when you're most fertile during your cycle.
*You need to have open fallopian tubes and a normal uterus. The egg and sperm meet in the fallopian tubes, and the pregnancy needs a healthy place to grow.

For pregnancy to occur, every part of the complex human reproduction process has to take place just right. The steps in this process are as follows:

*One of the two ovaries releases a mature egg.
*The egg is picked up by the fallopian tube.
*Sperm swim up the cervix, through the uterus and into the fallopian tube to reach the egg for fertilization.
*The fertilized egg travels down the fallopian tube to the uterus.
*The fertilized egg implants and grows in the uterus.
In women, a number of factors can disrupt this process at any step. Female infertility is caused by one or more of these factors.

**Ovulation disorders

Ovulation disorders, meaning you ovulate infrequently or not at all, account for infertility in about 25 percent of infertile couples. These can be caused by flaws in the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or by problems in the ovary itself.

-Polycystic ovary syndrome (PCOS). In PCOS, complex changes occur in the hypothalamus, pituitary gland and ovaries, resulting in a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It's the most common cause of female infertility.
-Hypothalamic dysfunction. The two hormones responsible for stimulating ovulation each month — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — are produced by the pituitary gland in a specific pattern during the menstrual cycle. Excess physical or emotional stress, a very high or very low body weight, or a recent substantial weight gain or loss can disrupt this pattern and affect ovulation. The main sign of this problem is irregular or absent periods.
-Premature ovarian insufficiency. This disorder is usually caused by an autoimmune response where your body mistakenly attacks ovarian tissues or by premature loss of eggs from your ovary due to genetic problems or environmental insults such as chemotherapy. It results in the loss of the ability to produce eggs by the ovary, as well as a decreased estrogen production under the age of 40.
-Too much prolactin. Less commonly, the pituitary gland can cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production and may cause infertility. Most commonly this is due to a problem in the pituitary gland, but it can also be related to medications you're taking for another disease.

**Damage to fallopian tubes (tubal infertility)

When fallopian tubes become damaged or blocked, they keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include:

-Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other sexually transmitted infections
-Previous surgery in the abdomen or pelvis, including surgery for ectopic pregnancy, in which a fertilized egg becomes implanted and starts to develop in a fallopian tube instead of the uterus
-Pelvic tuberculosis is a major cause of tubal infertility worldwide.

**Endometriosis

Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth — and the surgical removal of it — can cause scarring, which may obstruct the tube and keep the egg and sperm from uniting. It can also affect the lining of the uterus, disrupting implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg.

**Uterine or cervical causes

Several uterine or cervical causes can impact fertility by interfering with implantation or increasing the likelihood of a miscarriage.

-Benign polyps or tumors (fibroids or myomas) are common in the uterus, and some types can impair fertility by blocking the fallopian tubes or by disrupting implantation. However, many women who have fibroids or polyps can become pregnant.
-Endometriosis scarring or inflammation within the uterus can disrupt implantation.
-Uterine abnormalities present from birth, such as an abnormally shaped uterus, can cause problems becoming or remaining pregnant.
-Cervical stenosis, a cervical narrowing, can be caused by an inherited malformation or damage to the cervix.
-Sometimes the cervix can't produce the best type of mucus to allow the sperm to travel through the cervix into the uterus.

**Unexplained infertility:
In some instances, a cause for infertility is never found. It's possible that a combination of several minor factors in both partners underlie these unexplained fertility problems. Although it's frustrating to not get a specific answer, this problem may correct itself with time

How Is Female Infertility Treated?
Female infertility can be treated in several ways, including:

»Laparoscopy. Laparoscopy. Women who have been diagnosed with tubal or pelvic disease can either undergo surgery to reconstruct the reproductive organs or try to conceive through in vitro fertilization (IVF). Using a laparoscope inserted through a cut near the belly button, scar tissue can be removed, endometriosis treated, ovarian cysts removed, and blocked tubes opened.

»Hysteroscopy. A hysteroscope placed into the uterus through the cervix can be used to remove polyps and fibroid tumors, divide scar tissue, and open blocked tubes.

»Medical therapy. Women suffering from ovulation problems may be prescribed drugs such as clompiphene citrate (Clomid, Serophene), letrozole, or gonadotropins (such as Gonal F, Follistim, Humegon and Pregnyl), which can lead to ovulation. Gonadotropins can induce ovulation when Clomid or Serophene do not work. These drugs also can enhance fertility by causing multiple eggs to ovulate during the cycle (normally, only one egg is released each month). Gonadotropin therapy may be offered for unexplained infertility or when other factors have been corrected without resulting in pregnancy. Metformin (glucophage) is another type of medication that may restore or normalize ovulation in women who have insulin resistance and/or PCOS (polycystic ovarian syndrome).

»Intrauterine insemination. Intrauterine insemination refers to an office procedure in which semen is collected, rinsed with a special solution, and then placed into the uterus at the time of ovulation. The sperm are deposited into the uterus through a slender plastic catheter that is inserted through the cervix. This procedure can be done in combination with the previously listed medications that stimulate ovulation.

»In vitro fertilization. IVF refers to a procedure in which eggs are fertilized in a culture dish and placed into the uterus. The woman takes gonadotropins to stimulate multiple egg development. When monitoring indicates that the eggs are mature, they are collected using a vaginal ultrasound probe with a needle guide. The sperm are collected, washed, and added to the eggs in a culture dish. Several days later, embryos -- or fertilized eggs -- are returned to the uterus using an intrauterine insemination catheter. Any extra embryos can be frozen for later use, upon the consent of the couple.

»ICSI. Intracytoplasmic sperm injection is used when there is sperm-related infertility. The sperm are injected directly into the egg in a culture dish and then placed into the woman’s uterus.

»GIFT (Gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer)- Like IVF, these procedures involve retrieving an egg from the woman, combining with sperm in a lab then transferring back to her body. In ZIFT, the fertilized eggs -- at this stage called zygotes -- are placed in the fallopian tubes within 24 hours. In GIFT, the sperm and eggs are mixed together before being inserted.

»Egg donation. Egg donation helps women who do not have normally functioning ovaries (but who have a normal uterus) to achieve pregnancy. Egg donation involves the removal of eggs -- also called oocytes -- from the ovary of a donor who has undergone ovarian stimulation with the use of fertility drugs. The donor's eggs are then placed together with the sperm from the recipient's partner for in vitro fertilization. The resulting fertilized eggs are transferred to the recipient's uterus.

Medical therapy and in vitro fertilization can increase the chance of pregnancy in women diagnosed with unexplained infertility.

Care of umbilical cord stump

A newborn's umbilical cord stump typically falls off within about two weeks after birth. In the meantime, treat your baby's umbilical cord stump gently.

Wonder how to care for your newborn's umbilical cord stump? Until the stump dries out and falls off, keep it clean and dry.

¤Why your baby has an umbilical cord stump

During pregnancy, the umbilical cord supplies nutrients and oxygen to your developing baby. After birth, the umbilical cord is no longer needed — so it's clamped and snipped. This leaves behind a short stump. The umbilical cord doesn't contain pain-sensitive nerve fibers, so your baby won't feel any discomfort during this rite of passage.

¤Taking care of the stump

Your baby's umbilical cord stump will change from yellowish green to brown to black as it dries out and eventually falls off — usually within about two weeks after birth. In the meantime, treat the area gently:

*Keep the stump clean. Parents were once instructed to swab the stump with rubbing alcohol after every diaper change. Researchers now say the stump might heal faster if left alone. If the stump becomes dirty or sticky, clean it with plain water — then dry it by holding a clean, absorbent cloth around the stump or fanning it with a piece of paper.
*Keep the stump dry. Expose the stump to air to help dry out the base. Keep the front of your baby's diaper folded down to avoid covering the stump. In warm weather, dress your baby in a diaper and T-shirt to improve air circulation.
*Stick with sponge baths. Sponge baths might be most practical during the healing process. When the stump falls off, you can bathe your baby in a baby tub or sink.
*Let the stump fall off on its own. Resist the temptation to pull off the stump yourself, even if it's hanging on by only a thread.

¤Signs of infection

During the healing process, it's normal to see a little crust or dried blood near the stump. Contact your baby's doctor if your baby develops a fever or if the umbilical area:
-Appears red and swollen around the cord
-Continues to bleed
-Oozes yellowish pus
-Produces a foul-smelling discharge
If your baby has an umbilical cord infection, prompt treatment can stop the infection from spreading.
-Mayo Clinic

Importance Of Keeping A Family Budget

Living without a budget is similar to traveling across the country without a roadmap. While both can be accomplished, the result is usually expensive and wasteful. The household budget lists every anticipated expense in major categories that can be directly tied to actual expenditures. Many people view the use of a budget as restraining and remedial, but most wealthy people have grown their financial wealth through the use of a strict budget.

Family budgets establish spending guidelines for all of the family's finances. Creating a budget often elicits groans from all involved parties. Budgets carry the stigma of cutbacks and no spending on fun items. A family budget serves as a useful tool for families, regardless of income level. A budget may actually free money and assist in targeting the money on more useful items.

»Track Spending

A family budget allows the analysis of the family's money and how it is spent. The exercise of identifying spending habits reveals trends and money wasters. Small amounts of money add up quickly, creating a drain on the bank account if the items purchased are not necessities. Identifying the items on which money is spent is a key when establishing a family budget. Families often find themselves surprised when they explore where the money goes each month.

»Predict Spending

A family budget provides a tool to predict future spending. Foreshadowing expenses and spending trends allows the family to plan for upcoming events or unexpected expenses that inevitably arise. A review of the budget periodically allows the family to adjust spending based on previous months. The budget also allows the family to identify areas that can be cut when unexpected expenses do arise.

»Manage Debt

Consumer debt hampers many families, holding them back from financial freedom. A family budget helps control spending which allows extra money to go toward paying off debt. Setting a budget ensures that all credit cards and other forms of debt are paid on time each month, avoiding late fees and penalties. Extra money in the budget may also be set aside to aggressively pay off outstanding debt. This eventually frees more money to apply toward other areas of the budget, including a family savings account.

»Increase Savings

The savings account often falls neglected without a family budget. Small splurges eat away at any extra money in the bank account which could go towards savings. A family budget allows a percentage of the income to go toward a savings account or other investment options. Building the savings into the budget ensures the money makes it into the savings account before it is spent on other things.

»Teach Financial Responsibility

Implementing a family budget sets a strong example for children. Financial responsibility begins at an early age, well before a child is old enough for a check book or a credit card. The responsible approach of creating a budget instills the value of money and responsible spending in the entire family. While they don't need to know every detail of the family's financial situation, understanding that spending money needs to be planned is a good lesson for kids to learn

STAGES OF LABOUR

The process of labor and birth is divided into three stages:

The first stage begins when you start having contractions that cause progressive changes in your cervix and ends when your cervix is fully dilated. This stage is divided into two phases:

Early labor: Your cervix gradually effaces (thins out) and dilates (opens).
Active labor: Your cervix begins to dilate more rapidly, and contractions are longer, stronger, and closer together. People often refer to the last part of active labor as transition.
The second stage of labor begins when you're fully dilated and ends with the birth of your baby. This is sometimes referred to as the "pushing" stage.

The third stage begins right after the birth of your baby and ends with the delivery of the placenta.

Every pregnancy is different, and there's wide variation in the length of labor. For first-time moms, labor often takes between ten and 20 hours. For some women, though, it lasts much longer, while for others it's over much sooner. Labor generally progresses more quickly for women who've already given birth vaginally.

First stage: Early labor

Once your contractions are coming at relatively regular intervals and your cervix begins to progressively dilate and efface, you're officially in labor. But unless your labor starts suddenly and you go from no contractions to fairly frequent and regular contractions right away, it can be tricky to determine exactly when true labor starts. That's because early labor contractions are sometimes hard to distinguish from the inefficient Braxton Hicks contractions that may come right before, contributing to so-called false labor.

(By the way, if you're not yet at 37 weeks and you're noticing contractions or other signs of labor, don't wait to see if your contractions progress. Call your caregiver immediately so to determine whether you're in preterm labor. If you're at least 37 weeks pregnant, your caregiver has likely given you instructions on how to track your contractions and when to call.)

Assuming your pregnancy is full-term, though, time will tell: If you're in early labor, your contractions will gradually become longer, stronger, and closer together. Eventually they'll be coming every five minutes and lasting 40 to 60 seconds each as you reach the end of early labor. Some women have much more frequent contractions during this phase, but the contractions will still tend to be relatively mild and last no more than a minute.

Sometimes early labor contractions are quite painful, even though they may be dilating your cervix much more slowly than you'd like. If your labor is typical, however, your early contractions won't require the same attention that later ones will.

You'll probably be able to talk through them and putter around the house. You may even feel like taking a short walk. If you feel like relaxing instead, take a warm bath, watch a video, or doze off between contractions if you can.

You may also notice an increase in mucusy vaginal discharge, which may be tinged with blood – the so-called bloody show. This is perfectly normal, but if you see more than a tinge of blood, be sure to call your caregiver. Also call if your water breaks, even if you're not having contractions yet.

Early labor ends when your cervix is about 4 centimeters dilated and your progress starts to accelerate.

How long early labor lasts

It can be difficult to tell exactly when early labor starts, so it's often not easy to say how long this phase typically lasts – or even, after the fact, how long it lasted for a particular woman. The length of early labor is quite variable and depends in large part on how ripe (dilated and effaced) your cervix is at the beginning of labor and how frequent and strong your contractions are.

With a first baby, if your cervix isn't effaced or dilated to begin with, this phase may take six to 12 hours, although it can be significantly longer or shorter. If your cervix is already very ripe or this isn't your first baby, it's likely to go much more quickly.

Coping tips

Don't become a slave to your stopwatch just yet – it's stressful and exhausting to record every contraction over the many long hours of labor, and it isn't necessary. Instead, you may want to time them periodically to get a sense of what's going on. In most cases, your contractions will let you know in no uncertain terms when it's time to take them more seriously.

Meanwhile, it's important to do your best to stay rested, since you may have a long day (or night) ahead of you. If you're tired, try to doze off between contractions.

Be sure to drink plenty of fluids so you stay well hydrated. And don't forget to urinate often, even if you don't feel the urge. A full bladder may make it more difficult for your uterus to contract efficiently, and an empty bladder leaves more room for your baby to descend.

If you're feeling anxious, you may want to try some relaxation exercises or do something to distract yourself a bit – like watching a movie or reading a book.

First stage: Active labor

Active labor is when things really get rolling. Your contractions become increasingly intense – more frequent, longer, and stronger – and you'll no longer be able to talk through them. Your cervix dilates more quickly, until it's fully dilated at 10 centimeters. (The last part of active labor, when the cervix dilates from 8 to 10 centimeters, is called transition, which is described in the next section.)

Toward the end of active labor your baby may begin to descend, although he might have started to descend earlier or he might not start until the next stage.

As a general rule, once you've had regular, painful contractions (each lasting about 60 seconds) every five minutes for an hour, it's time to call your midwife or doctor and head to the hospital or birth center. Some caregivers prefer a call sooner, so clarify this ahead of time.

In most cases, the contractions become more frequent and eventually happen every two and a half to three minutes, although some women never have them more often than every five minutes, even during transition.

How long active labor lasts

For many women giving birth for the first time, active labor will last between four and eight hours, though for others, it can be even longer or as short as an hour.

The active phase tends to go more quickly if you're getting oxytocin (Pitocin) or have already had a vaginal birth. If you have an epidural or a big baby, it may last longer.

Coping tips

Most women opt for pain medication , such as an epidural, at some point during the active phase.

But many of the pain-management and relaxation techniques used in natural childbirth – such as breathing exercises and visualization – can help you during labor, whether or not you're planning to receive medication.

A good labor coach can be a huge help now, too. And you'll probably appreciate lots of gentle encouragement.

It may feel good to walk, but you'll probably want to stop and lean against something (or someone) during each contraction. You should be able to move around the room freely after your caregiver evaluates you, as long as there are no complications.

If you're tired, try sitting in a rocking chair or lying in bed on your left side. This might be a good time to ask your partner for a massage. Or, if you have access to a tub and your water hasn't broken, you can take a warm shower or bath.

Transition

The last part of active labor – when your cervix dilates from 8 to a full 10 centimeters – is called the transition period because it marks the shift to the second stage of labor.

This is the most intense part of labor. Contractions are usually very strong, coming every two and a half to three minutes or so and lasting a minute or more, and you may start shaking and shivering.

By the time your cervix is fully dilated and transition is over, your baby has usually descended somewhat into your pelvis. This is when you might begin to feel rectal pressure, as if you have to move your bowels. Some women begin to bear down spontaneously – to "push" – and may even start making deep grunting sounds.

There's often a lot of bloody discharge. You may feel nauseated or even vomit now.

Some babies descend earlier and the mom feels the urge to push before she's fully dilated. And other babies don't descend significantly until later, in which case the mom may reach full dilation without feeling any rectal pressure. It's different for every woman and with every birth.

If you've had an epidural, the pressure you'll feel will depend on the type and amount of medication you're getting and how low the baby is in your pelvis. If you'd like to be a more active participant in the pushing stage, ask to have your epidural dose lowered at the end of transition.

How long transition lasts

Transition can take anywhere from a few minutes to a few hours. It's much more likely to be fast if you've already had a vaginal delivery.

Coping tips

If you're laboring without an epidural, this is when you may begin to lose faith in your ability to handle the pain, so you'll need lots of extra encouragement and support from those around you.

Consider a massage. Some women appreciate light touch (effleurage), some prefer a stronger touch, and others don't want to be touched at all.
Sometimes a change of position provides some relief – for example, if you're feeling a lot of pressure in your lower back, getting on all fours may reduce the discomfort.
A cool cloth on your forehead or a cold pack on your back may feel good, or you may find a warm compress more comforting.
On the other hand, because transition can take all of your concentration, you may want all distractions – music or conversation or even that cool cloth or your partner's loving touch – eliminated.

It may be useful to focus on the fact that those hard contractions are helping your baby make the journey out into the world. Try visualizing her movement down with each contraction.

The good news is that if you've made it this far without medication, you can usually be coached through transition – one contraction at a time – with constant reminders that you're doing a great job and that the your baby's arrival is near.

Second stage: Pushing

Once your cervix is fully dilated, the work of the second stage of labor begins: the final descent and birth of your baby. At the beginning of the second stage, your contractions may be a little further apart, giving you the chance for a much-needed rest between them.

Many women find their contractions in the second stage easier to handle than the contractions in active labor because bearing down offers some relief. Others don't like the sensation of pushing.

If your baby is very low in your pelvis, you may feel an urge to push early in the second stage (and sometimes even before). But if your baby's still relatively high, you probably won't have this sensation right away.

As your uterus contracts, it exerts pressure on your baby, moving him down the birth canal. So if everything's going well, you might want to take it slowly and let your uterus do the work until you feel the urge to push. Waiting a while may leave you less exhausted and frustrated in the end.

In many hospitals, however, it's still routine practice to coach women to push with each contraction in an effort to speed up the baby's descent – so let your caregiver know if you'd prefer to wait until you feel a spontaneous urge to bear down.

If you have an epidural, the loss of sensation can blunt the urge to push, so you may not feel it until your baby's head has descended quite a bit. Patience often works wonders. In some cases, though, you'll eventually need explicit directions to help you push effectively.

Your baby's descent

The descent may be rapid. Or, especially if this is your first baby, the descent may be gradual.

With each contraction, the force of your uterus – combined with the force of your abdominal muscles if you're actively pushing – exerts pressure on your baby to continue to move down through the birth canal. When a contraction is over and your uterus is relaxed, your baby's head will recede slightly in a "two steps forward, one step back" kind of progression.

Try different positions for pushing until you find one that feels right and is effective for you. It's not unusual to use a variety of positions during the second stage.

The first glimpse

After a time, your perineum (the tissue between your vagina and anus) will begin to bulge with each push, and before long your baby's scalp will become visible – a very exciting moment and a sign that the end is in sight. You can ask for a mirror to get that first glimpse of your baby, or you may simply want to reach down and touch the top of his head.

Now the urge to push becomes even more compelling. With each contraction, more and more of your baby's head becomes visible. The pressure of his head on your perineum feels very intense, and you may notice a strong burning or stinging sensation as your tissue begins to stretch.

At some point, your caregiver may ask you to push more gently or to stop pushing altogether so your baby's head has a chance to gradually stretch out your vaginal opening and perineum. A slow, controlled delivery can help keep your perineum from tearing. By now, the urge to push may be so overwhelming that you'll be coached to blow or pant during contractions to help counter it.

How the head emerges

Your baby's head continues to advance with each push until it "crowns" – the time when the widest part of her head is finally visible. The excitement in the room will grow as your baby's face begins to appear: her forehead, her nose, her mouth, and, finally, her chin.

After your baby's head emerges, your doctor or midwife will suction her mouth and nose and feel around her neck for the umbilical cord. (If the cord is around your baby's neck, your caregiver will either slip it over her head or, if need be, clamp and cut it.)

Your baby's head then turns to the side as her shoulders rotate inside your pelvis to get into position for their exit. With the next contraction, you'll be coached to push as her shoulders emerge, one at a time, followed by her body.

Out at last!

Once your baby hits the atmosphere, he needs to be kept warm and will be dried off with a towel. Your doctor or midwife may quickly suction your baby's mouth and nasal passages again if he seems to have a lot of mucus.

If there are no complications, he'll be lifted onto your bare belly so you can touch, kiss, and simply marvel at him. The skin-to-skin contact will keep your baby nice and toasty, and he'll be covered with a warm blanket – and perhaps given his first hat – to prevent heat loss.

Your caregiver will clamp the umbilical cord in two places and then cut between the two clamps – or your partner can do the honors.

You may feel a wide range of emotions now: euphoria, awe, pride, disbelief, excitement (to name but a few), and, of course, intense relief that it's all over. Exhausted as you may be, you'll also probably feel a burst of energy, and any thoughts of sleep will vanish for the time being.

How long the second stage lasts

The entire second stage can last anywhere from a few minutes to several hours. Without an epidural, the average duration is close to an hour for a first-timer and about 20 minutes if you've had a previous vaginal delivery. If you've had an epidural, the second stage may last longer.

Third stage: Delivering the placenta

Minutes after giving birth, your uterus begins to contract again. The first few contractions usually separate the placenta from your uterine wall.

When your caregiver sees signs of separation, she may ask you to gently push to help expel the placenta. This is usually one short push that's not at all difficult or painful.

How long the third stage lasts

On average, the third stage of labor takes about five to ten minutes.

After delivery: Now what?

After you deliver the placenta, your uterus should contract and get very firm. You'll be able to feel the top of it in your belly, around the level of your navel.

Your caregiver, and later your nurse, will periodically check to see that your uterus remains firm, and massage it if it isn't. This is important because the contraction of the uterus helps cut off and collapse the open blood vessels at the site where the placenta was attached. If your uterus doesn't contract properly, you'll continue to bleed profusely from those vessels.

If you're planning to breastfeed, you can do so now if you and your baby are both willing. Not all babies are eager to nurse in the minutes after birth, but try holding your baby's lips close to your breast for a little while. Most babies will eventually begin to nurse in the first hour or so after birth if given the chance.

Early nursing is good for your baby and can be deeply satisfying for you. What's more, nursing triggers the release of oxytocin, the same hormone that causes contractions, which helps your uterus stay firm and contracted.

If you're not going to nurse or your uterus isn't firm, you'll be given oxytocin to help it contract. (Some providers routinely give it to all women at this point). If you're bleeding excessively, you'll be treated for that as well.

Your contractions at this point are relatively mild. By now your focus has shifted to your baby, and you may be oblivious to everything else going on around you.

If this is your first baby, you may feel only a few contractions after you've delivered the placenta. If you've had a baby before, you may continue to feel occasional contractions for the next day or two.

These so-called afterbirth pains can feel like strong menstrual cramps. If they bother you, ask for pain medication. You may also have the chills or feel very shaky. This is perfectly normal and won't last long. Don't hesitate to ask for a warm blanket if you need one.

Your caregiver will examine the placenta to make sure it's all there. Then she'll check you thoroughly to spot any tears in your perineum that need to be stitched.

If you tore or had an episiotomy, you'll get an injection of a local anesthetic before being sutured. You may want to hold your newborn while you're getting stitches – it can be a great distraction. If you're feeling too shaky, ask your partner to sit by your side and hold your new arrival while you look at him.

If you had an epidural, an anesthesiologist or nurse anesthetist will come by and remove the catheter from your back. This takes just a second and doesn't hurt.

Unless your baby needs special care, be sure to insist on some quiet time together. The eyedrops and vitamin K can wait a little while. You and your partner will want to share this special time with each other as you get acquainted with your new baby and revel in the miracle of birth.
-BabyCentre

For The Pregnant Mum

Aim for eight 8-ounce glasses per day (64 fluid ounces) of fluid, plus one 8-ounce cup for each hour of light activity. Milk, juice, decaffeinated drinks, and caffeinated drinks all contain plenty of water and "count" toward your fluid intake.

Keep in mind that juice and sweetened drinks also provide a lot of extra calories, so don't rely on them too much.

It's best to limit caffeine, too – including caffeinated teas and colas – to 200 mg (about one 12-ounce cup) per day. More than that raises the risk of miscarriage, according to a 2008 study.

(It's a myth that caffeinated drinks dehydrate you. Yes, caffeine makes you pee more. But the amount of fluid you actually lose because of this diuretic effect is so small that it's insignificant.)

Don't hesitate to drink water and other fluids because you're afraid of retaining water, either. Oddly enough, the more fluids you drink during pregnancy, the less your body retains. So if your feet and ankles are swollen, drinking more water actually helps.

Water carries nutrients through your blood to your baby, and drinking plenty of fluids helps prevent dehydration, too. This is especially important in the last trimester, when dehydration can cause contractions that can trigger preterm labor.

Water also helps prevent some common pregnancy problems such as constipation, hemorrhoids, and bladder infections (drinking water helps dilute your urine, which reduces your risk of infection).

If you need to drink more fluids, you don't want extra calories, and you don't like the taste of water, try adding a wedge of lemon or lime to your water, or a little juice, for additional flavor. If you're not sure how much water you drink each day, fill a container with your target amount and try to finish it by the end of the day.

BREAST SELF EXAMINATION

Breast self-examination (BSE) is a screening method used in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling.

Adult women of all ages are encouraged to perform breast self-exams at least once a month. Johns Hopkins Medical center states,

“Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.”

While mammograms can help you to detect cancer before you can feel a lump, breast self-exams help you to be familiar with how your breasts look and feel so you can alert your healthcare professional if there are any changes

HOW SHOULD A BREAST SELF-EXAM BE PERFORMED?

In the mirror:

1. Stand undressed from the waist up in front of a large mirror in a well-lit room. Look at your breasts. Don't be alarmed if they do not look equal in size or shape. Most women's breasts aren't. With your arms relaxed by your sides, look for any changes in size, shape, or position, or any changes to the skin of the breasts. Look for any skin puckering, dimpling, sores, or discoloration. Inspect your nipples and look for any sores, peeling, or change in the direction of the nipples.

2. Next, place your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. Turn from side to side so you can inspect the outer part of your breasts.

3. Then bend forward toward the mirror. Roll your shoulders and elbows forward to tighten your chest muscles. Your breasts will fall forward. Look for any changes in the shape or contour of your breasts.

4. Now, clasp your hands behind your head and press your hands forward. Again, turn from side to side to inspect your breasts' outer portions. Remember to inspect the border underneath your breasts. You may need to lift your breasts with your hand to see this area.

5. Check your nipples for discharge (fluid). Place your thumb and forefinger on the tissue surrounding the nipple and pull outward toward the end of the nipple. Look for any discharge. Repeat on your other breast.

In the shower:

6. Now, it's time to feel for changes in the breast. It is helpful to have your hands slippery with soap and water. Check for any lumps or thickening in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat on the other side.

7. Check both sides for lumps or thickenings above and below your collarbone.

8. With hands soapy, raise one arm behind your head to spread out the breast tissue. Use the flat part of your fingers from the other hand to press gently into the breast. Follow an up-and-down pattern along the breast, moving from bra line to collarbone. Continue the pattern until you have covered the entire breast. Repeat on the other side.

Lying down:

9. Next, lie down and place a small pillow or folded towel under your right shoulder. Put your right hand behind your head. Place your left hand on the upper portion of your right breast with fingers together and flat. Body lotion may help to make this part of the exam easier.

10. Think of your breast as a face on a clock. Start at 12 o'clock and move toward 1 o'clock in small circular motions. Continue around the entire circle until you reach 12 o'clock again. Keep your fingers flat and in constant contact with your breast. When the circle is complete, move in one inch toward the nipple and complete another circle around the clock. Continue in this pattern until you've felt the entire breast. Make sure to feel the upper outer areas that extend into your armpit.

11. Place your fingers flat and directly on top of your nipple. Feel beneath the nipple for any changes. Gently press your nipple inward. It should move easily.

Repeat steps 9, 10, and 11 on your other breast.

CAN I RELY ON BREAST SELF-EXAMS ALONE TO BE SURE I AM BREAST CANCER FREE?

Mammography can detect tumors before they can be felt, so screening is key for early detection. But when combined with regular medical care and appropriate guideline-recommended mammography, breast self-exams can help women know what is normal for them so they can report any changes to their healthcare provider.

If you find a lump, schedule an appointment with your doctor, but don't panic — 8 out of 10 lumps are not cancerous. For additional peace of mind, call your doctor whenever you have concerns.

SLEEP

God understands how important sleep is for us as His children. Ability to sleep is a blessing. How do I know this?
God gives His beloved sleep(Psalm 127:2b).

Take time to read through this write-up. . .

Sleep is a basic human need, as important for good health as diet and exercise. When we sleep, our bodies rest but our brains are active. Sleep lays the groundwork for a productive day ahead. Although most people need seven to nine hours of sleep each night to function well the next day, research reveals that most women get much less sleep than that.

Research also revealed that women are more likely than men to have difficulty falling and staying asleep and to experience more daytime sleepiness at least a few nights/days a week. Research has shown that too little sleep results in daytime sleepiness, increased accidents, problems concentrating, poor performance on the job and in school, and possibly, increased sickness and weight gain.

Getting the right amount of sleep is vital, but just as important is the quality of your sleep. Biological conditions unique to women, like the menstrual cycle, pregnancy and menopause, can affect how well a woman sleeps. This is because the changing levels of hormones that a woman experiences throughout the month and over her lifetime, like estrogen and progesterone, have an impact on sleep. Understanding the effects of these hormones, environmental factors and lifestyle habits can help women enjoy a good night’s sleep.

Common Sleep Problems
*Insomnia: Insomnia is the most common sleep problem. Sometimes, women begin to have sleepless nights associated with menstruation, pregnancy or menopause and find it difficult to break poor sleep habits. Fortunately, there are a number of approaches to improving sleep, including those you can do yourself such as exercise, establishing regular bed and wake times, dietary changes (less or no caffeine and alcohol) and improving your sleep environment. One recent study found that overweight, post-menopausal women who exercise in the morning experience less difficulty falling asleep and better quality sleep than evening exercisers.

If insomnia persists, and lifestyle, behavioral or diet changes do not help, a doctor may prescribe a sleep-promoting medication (hypnotic). In some instances, there may be an underlying and treatable cause, such as depression (women are twice as likely to report depression as men), stress, anxiety, reflux, bladder problems or pain. Doctors may prescribe antidepressants (for depression), anxiolytics (anti-anxiety drugs), medications for heartburn, incontinence or pain and/or hypnotic medications to improve sleep.

Narcolepsy: Feeling sleepy during the day or at times you expect to be awake may indicate a need for more sleep, the presence of a serious but treatable disorder such as those already mentioned, or narcolepsy, a chronic neurological disorder that affects approximately one in 2000 people. Narcolepsy symptoms frequently appear in teen years. In addition to excessive daytime sleepiness, people with narcolepsy have sudden "sleep attacks" (an over-whelming urge to sleep), suddenly lose muscle tone or strength (cataplexy) and may have disturbed nighttime sleep. Women who are pregnant or considering having a child should discuss medications with their doctor. Recent scientific break-throughs have led to new understanding of the cause of this condition and new treatments have given doctors more ways to help manage its symptoms.

*Nocturnal Sleep-Related Eating Disorder: Persons with nocturnal sleep-related eating disorder (NS-RED), an uncommon condition, eat food during the night while they appear asleep. Since parts of the brain that control memory are asleep, people with NS-RED cannot remember nighttime eating. One study indicates that over 66 percent of sufferers are women. NS-RED can occur during sleepwalking. It can be caused by medications (e.g. some drugs prescribed for depression or insomnia) or by sleep disorders (e.g. sleep apnea, restless legs syndrome) that cause awakenings and trigger sleep eating.

*Pain and Sleep: More women (58%) suffer from nighttime pain than men (48%), from research results. Pain conditions like migraine, tension headaches, rheumatic and arthritis conditions as well as heartburn are all more common among women. Pain may make it harder to fall asleep or lead to nighttime or early morning awakenings. Relaxation techniques, biofeedback, cognitive therapy, and over-the-counter and prescription medications may help. Treatment may target the pain, the sleeping difficulty, or both.

*Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD): RLS is a neurological movement disorder. The unpleasant feelings occur at rest and are relieved by movement, RLS sufferers have difficulty sleeping. Due to difficulties sleeping, RLS can lead to daytime sleepiness, mood swings, anxiety and depression. One study found that 42% of those with RLS stated that it affected their relationship with their partner.

Although the exact cause of RLS is not known, recent research indicates that iron or folate deficiency may be a risk factor. Treatment may include iron or vitamin supplements, lifestyle changes and medications.

About 80% of those with RLS also have PLMD or involuntary leg twitching or jerking movements during sleep that can occur every 20-30 seconds. These symptoms can be bothersome to a bed partner, but are also treatable.

*Shift Work: Some women work non-traditional hours (not the typical hours of 8a.m. to 4 p.m. ). Difficulty falling asleep is a common effect as is obtaining quality sleep during the day hours. Women who work on the night shift get less sleep and more disrupted sleep. Shift workers, in general, report more sleep-related accidents and illnesses. Night and rotating shifts can put a strain on a family when less time is available to meet family/home responsibilities and enjoy recreational and social activities. Female shift workers also suffer irregular menstrual cycles, difficulty getting pregnant, higher rates of miscarriages, premature births and low birth-weight babies more than regular day working women, according to several large studies. Still, most shift-working women do have normal, healthy babies. Changes in exposure to light and lost sleep caused by shift work may have biological or hormonal effects that are not yet entirely understood. One large study of women who worked night shifts over a 3-year period found a 60% greater risk for developing breast cancer. Women shift workers should consult their doctor if experiencing menstrual difficulties, infertility, pregnancy or other medical conditions/ problems.

*Sleep Apnea: Sleep apnea is a serious sleep disorder that is characterized by snoring, interrupted breathing during sleep and excessive daytime sleepiness. While apnea is more common in men, it increases in women after age 50. Because being overweight is a risk factor for sleep apnea, the increase in abdominal fat during menopause may be one reason menopausal women are 3.5 times as likely to get this sleep disorder. Some attribute the prevalence to hormonal changes such as the decrease in progesterone. Studies have also found that sleep apnea is associated with increased blood pressure, a risk for cardiovascular disease and stroke. If any of these symptoms appear, it is important to address them with your doctor. A number of effective treatment approaches are available.

Sow Seeds of Prayers

Pray without ceasing. There's so much to pray about. Let The Holy Spirit direct you in prayers. He makes intercessions for us. He is the One that can teach us to pray. He stirs up our hearts to pray ahead. Don't wait for things to get muddled up before you pray concerning those issues.

It is true that you're not yet married or even in a relationship just yet but it's never too early to pray concerning your marriage. Pray that you will marry right. Pray that God will give you a man after his heart as your husband. Pray for wisdom needed to build your future home. Pray that God will equip you for the ministry of marriage. Pray that you will not fail in your marriage. Pray that your marriage will bring glory to the name of the Lord. Pray against every plan of the devil concerning your marriage. Pray. . .

It is also true that you have not gotten married. It is not too early to pray for your children yet to be conceived/born. Envision what you want your children to be like and talk to God about it. Pray concerning their gestational period. Pray for their schooling seasons. Pray they won't choose the wrong career path. Pray they will be pillars in the house of God. Pray that they will be taught of The Lord. Pray that they will not be victims of evil circumstances. Pray that they will give you joy. Pray that they will marry right. . .

Why talk about the job I'll be doing in five years time you ask. Pray concerning it. Pray for favour. Pray you won't pick up the wrong job.

Pray concerning your business plans. Pray that God will open doors of opportunities for you. Pray that your business will be excellent. Pray that you will not suffer loss. . .

Keep praying as The Holy Spirit lays it on your heart. Pray ahead of time. We are admonished to keep asking until our joy is full. How about you ask early? Sow prayers into your tomorrow!

May the Lord attend to our prayers in Jesus' name.

KEGEL EXERCISES

Kegel exercises can help you prevent or control urinary incontinence and other pelvic floor problems. Here's a step-by-step guide to doing Kegel exercises correctly.

Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. You can do Kegel exercises, also known as pelvic floor muscle training, discreetly just about anytime.

Start by understanding what Kegel exercises can do for you — then follow step-by-step instructions for contracting and relaxing your pelvic floor muscles.

WHY KEGEL EXERCISES MATTER

Many factors can weaken your pelvic floor muscles, including pregnancy, childbirth, surgery, aging and being overweight.

You might BENEFIT from doing Kegel exercises if you:

> Have had a baby (Pelvic floor weakness due to childbirth). Childbirth can stretch and weaken pelvic floor muscles. And that can cause urine control problems. It can also allow one or more pelvic organs to sag. When the uterus sags, it's called uterine prolapse. Women can help prevent this problem by doing daily Kegels during and after pregnancy
> Leak a few drops of urine while sneezing, laughing or coughing
> Have a strong, sudden urge to urinate just before losing a large amount of urine (urinary incontinence)
> Leak stool (fecal incontinence)

Kegel exercises can be done during pregnancy or after childbirth to try to prevent urinary incontinence. Kegel exercises — along with counseling and sex therapy — might also be helpful for women who have persistent difficulty reaching orgasm.

**Keep in mind that Kegel exercises are less helpful for women who have severe urine leakage when they sneeze, cough or laugh. Also, Kegel exercises aren't helpful for women who unexpectedly leak small amounts of urine due to a full bladder (overflow incontinence).

HOW TO DO KEGEL EXERCISES

It takes diligence to identify your pelvic floor muscles and learn how to contract and relax them. Here are some pointers:

» Find the right muscles. To identify your pelvic floor muscles, stop urination in midstream. If you succeed, you've got the right muscles.

» Perfect your technique. Once you've identified your pelvic floor muscles, empty your bladder and lie on your back. Tighten your pelvic floor muscles, hold the contraction for five seconds, and then relax for five seconds. Try it four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.

» Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.

» Repeat 3 times a day. Aim for at least three sets of 10 repetitions a day.

**Don't make a habit of using Kegel exercises to start and stop your urine stream. Doing Kegel exercises while emptying your bladder can actually weaken the muscles, as well as lead to incomplete emptying of the bladder — which increases the risk of a urinary tract infection.

WHEN TO DO YOUR KEGELS

Make Kegel exercises part of your daily routine. You can do Kegel exercises discreetly just about anytime, whether you're sitting at your desk or relaxing on the couch. You might make a practice of fitting in a set every time you do a routine task, such as checking email.

WHEN YOU ARE HAVING TROUBLE

If you're having trouble doing Kegel exercises, don't be embarrassed to ask for help. Your doctor or other health care provider can give you important feedback so that you learn to isolate and exercise the correct muscles.

In some cases, biofeedback training might help. During a biofeedback session, your doctor or other health care provider inserts a small probe into your vagina or rectum. As you relax and contract your pelvic floor muscles, a monitor will measure and display your pelvic floor activity.

When to expect results

If you do Kegel exercises regularly, you can expect results — such as less frequent urine leakage — within about a few months. For continued benefits, make Kegel exercises a permanent part of your daily routine.

Here's my gift to you today, sisters! Hope you find this helpful.

Drug Abuse (Substance Abuse)

Drug abuse, also called substance abuse or chemical abuse, is a disorder that is characterized by a destructive pattern of using a substance that leads to significant problems or distress. Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. Psychoactive substance use can lead to dependence syndrome - a cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.

Drug addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the drug addict and those around them. Drug addiction is a brain disease because the abuse of drugs leads to changes in the structure and function of the brain. Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make sound decisions, and at the same time create an intense impulse to take drugs.

Policies which influence the levels and patterns of substance use and related harm can significantly reduce the public health problems attributable to substance use, and interventions at the health care system level can work towards the restoration of health in affected individuals.

Drug abuse is a serious public health problem that affects almost every community and family in some way. Each year drug abuse causes millions of serious illnesses or injuries. Abused drugs include

-Amphetamines
-Anabolic steroids
-Club drugs
-Cocaine
-Heroin
-Inhalants
-Marijuana
-PRESCRIPTION DRUGS

Drug abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms unborn babies and destroys families. There are different types of treatment for drug abuse. But the best is to prevent drug abuse in the first place.

What Happens to Your Brain When You Take Drugs?
Drugs are chemicals that tap into the brain's communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs are able to do this: by imitating the brain's natural chemical messengers, and/or overstimulating the "reward circuit" of the brain.

Some drugs like heroine produce messengers, called neurotransmitters, which are naturally produced by the brain. Because of this similarity, these drugs are able to "fool" the brain's receptors and activate nerve cells to send abnormal messages.

Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters, or prevent the normal recycling of these brain chemicals, which is needed to shut off the signal between neurons. This disruption produces a greatly amplified message that ultimately disrupts normal communication patterns.

Nearly all drugs, directly or indirectly, target the brain's reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that control movement, emotion, motivation, and feelings of pleasure. The overstimulation of this system, which normally responds to natural behaviors that are linked to survival (eating, spending time with loved ones, etc), produces euphoric effects in response to the drugs. This reaction sets in motion a pattern that "teaches" people to repeat the behavior of abusing drugs.
erson continues to abuse drugs, the brain adapts to the dopamine surges by producing less dopamine or reducing dopamine receptors. The user must therefore keep abusing drugs to bring his or her dopamine function back to ''normal'' or use more drugs to achieve a dopamine high.

Long-term drug abuse causes changes in other brain chemical systems and circuits, as well. Brain imaging studies of drug-addicted individuals show changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control. Together, these changes can drive an abuser to seek out and take drugs compulsively -- in other words, to become addicted to drugs.

Prevention Is Key

Drug addiction is a preventable disease. Research has shown that prevention programs that involve the family, schools, communities, and the media are effective in reducing drug abuse. Although many events and cultural factors affect drug abuse trends, when youths perceive drug abuse as harmful, they reduce their drug taking. It is necessary, therefore, to help youth and the general public to understand the risks of drug abuse and for teachers, parents, and health care professionals to keep sending the message that drug addiction can be prevented if a person never abuses drugs.