DiversityNursing Blog

Ultrasounds Show Fetuses React To Mothers' Smoking

Posted by Erica Bettencourt

Wed, Mar 25, 2015 @ 04:30 PM

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The impact of a mother's smoking can be seen on the face of her unborn baby, new research suggests.

Scientists at Durham and Lancaster Universities in England performed high-definition 4-D ultrasound scans on fetuses between 24 weeks and 36 weeks gestation and spotted distinctive differences in those whose mothers smoked. They say their findings add to the evidence that smoking may harm a developing fetus.

"Technology means we can now see what was previously hidden, revealing how smoking affects the development of the fetus in ways we did not realize," co-author Brian Francis, a professor at Lancaster University, said in a press statement.

The study, published in the journal Acta Paediatrica, involved 20 pregnant women; four were smokers who averaged about 14 cigarettes a day, and 16 were non-smokers. Each woman underwent four ultrasound scans over a three-month period.

The researchers say the fetuses whose mothers smoked showed a much higher rate of mouth movements, suggesting that their central nervous systems, which control such movement, did not develop at the same rate and in the same manner as the fetuses of non-smokers.

"Fetal facial movement patterns differ significantly between fetuses of mothers who smoked compared to those of mothers who didn't smoke," said lead author Dr Nadja Reissland, of Durham University's Department of Psychology.

"Our findings concur with others that stress and depression have a significant impact on fetal movements, and need to be controlled for, but additionally these results point to the fact that nicotine exposure per se has an effect on fetal development over and above the effects of stress and depression."

All of the babies involved in the study were born healthy. The Centers for Disease Control and Prevention warns that smoking during pregnancy increases the risk of preterm delivery and low birthweight, which can lead to a range of health problems. 

Previous studies have found that infants exposed to smoking in utero have delayed speech processing abilities, and the researchers say the ultrasound scans may shed light on that aspect of development. 

"This is yet further evidence of the negative effects of smoking in pregnancy," Francis said.

The researchers say more studies are needed, including a look at the impact fathers' smoking may have on their unborn children.

Source: www.cbsnews.com

Topics: smoking, mother, infant, newborn, pictures, fetus, ultrasounds

The Gentle Cesarean: More Like A Birth Than An Operation

Posted by Erica Bettencourt

Tue, Mar 10, 2015 @ 02:25 PM

JENNIFER SCHMIDT

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There are many reasons women need cesareans. Sometimes the situation is truly life-threatening. But often the problem is that labor simply isn't progressing. That was the case for Valerie Echo Duckett, 35, who lives in Columbus, Ohio. After receiving an epidural for pain, Duckett's contractions stopped. By late evening she was told she'd need a C-section to deliver her son, Avery. Duckett says she has vague memories of being wheeled into the operating room, strapped down and shaking from cold.

"They were covering me up with warm blankets,"she says. "I kind of slept in and out of it." Her only memory of meeting her newborn son for the first time was from some pictures her husband took.

This is the experience many women have. The cesarean section is the most common surgery in America — about 1 in 3 babies is delivered this way. But for many women, being told they need a C-section is unpleasant news. Duckett says she felt like she missed out on a pivotal moment in her pregnancy.

"It took me a long time even to be able to say that I gave birth to Avery," she says. "I felt like I didn't earn the right to say I gave birth to him, like it was taken from me somehow, like I hadn't done what I was supposed to do."

Duckett's reaction to her C-section is unfortunately a common one, says Betsey Snow, head of Family and Child Services at Anne Arundel Medical Center, a community hospital in Annapolis, Md.

"I hear a lot of moms say, 'I'm disappointed I had to have a C-section.' A lot of women felt like they failed because they couldn't do a vaginal delivery," says Snow.

Now some hospitals are offering small but significant changes to the procedure to make it seem more like a birth than major surgery.

In a typical C-section, a closed curtain shields the sterile operating field. Mothers don't see the procedure and their babies are immediately whisked away for pediatric care — a separation that can last for close to half an hour. Kristen Caminiti, of Crofton, Md., knows this routine well. Her first two sons were born by traditional cesarean. She was happy with their births because, she says, it was all she knew. Then, just a few weeks into her third pregnancy, Caminiti, who is 33, saw a post on Facebook about family-centered cesarean techniques catching on in England.

"I clicked on the link and thought, 'I want that,' " she says.

The techniques are relatively easy and the main goals simple: Let moms see their babies being born if they want and put newborns immediately on the mother's chest for skin-to-skin contact. This helps stimulate bonding and breast feeding. Caminiti asked her obstetrician, Dr. Marcus Penn, if he'd allow her to have this kind of birth. He said yes.

When Caminiti told Penn what she wanted, his first thought was it wouldn't be that difficult to do. "I didn't see anything that would be terribly out of the norm," he says. "It would be different from the way we usually do it, but nothing terrible that anyone would say we shouldn't try that."

Family-centered cesareans are a relatively new idea in the U.S., and many doctors and hospitals have no experience with them. Penn and the staff at Anne Arundel Medical Center quickly realized the procedure would require some changes, including adding a nurse and bringing the neonatal team into the operating room.

And there were a bunch of little adjustments, such as moving the EKG monitors from their usual location on top of the mother's chest to her side. This allows the delivery team to place the newborn baby immediately on the mother's chest. In addition, Penn says, the mother's hands were not strapped down and the intravenous line was put in her nondominant hand so she could hold the baby.

At the beginning of October, Caminiti underwent her C-section. She was alert, her head was up and the drape lowered so she could watch the delivery of her son, Connor. Caminiti's husband, Matt, recorded the event. After Connor was out, with umbilical cord still attached, he was placed right on Caminiti's chest.

"It was the most amazing and grace-filled experience to finally have that moment of having my baby be placed on my chest," Caminiti says. "He was screaming and then I remember that when I started to talk to him he stopped. It was awesome."

And the baby stayed with her for the rest of the procedure.

Changes like this can make a big difference, says Dr. William Camann, the director of obstetric anesthesiology at Brigham and Women's Hospital in Boston and one of the pioneers of the procedure in the U.S. At Brigham and Women's, their version of the family-centered cesarean is called the gentle cesarean. Moms who opt for it can view the birth through a clear plastic drape, and immediate skin-to-skin contact follows.

Camann says the gentle C-section is not a replacement for a vaginal birth; it's just a way to improve the surgical experience. "No one is trying to advocate for C-sections. We really don't want to increase the cesarean rate, we just want to make it better for those who have to have it," he says.

So why has the procedure been slow to catch on? Hospitals aren't charging more for it — so cost doesn't seem to be a major factor. What's lacking are clinical studies. Without hard scientific data on outcomes and other concerns like infection control, many hospitals may be wary of changing their routines. Betsey Snow of Anne Arundel Medical Center says the family-centered C-section represents a cultural shift, and her hospital is helping break new ground by adopting it.

"It is the first time we have really done anything innovative or creative with changing the C-section procedure in years," she says.

Kristen Caminiti says her hope is that these innovations become routine. She says she'd like nothing more than to know that other women having C-sections are able to have the same amazing experience she had.

Source: www.npr.org

Topics: mother, delivery, birth, c-section, operation, gentle cesarean, nursing, health, baby, nurses, doctors, health care, hospital

Wisconsin Mom and Daughter Diagnosed with Cancer 13 Days Apart

Posted by Erica Bettencourt

Fri, Mar 06, 2015 @ 11:14 AM

ELIZA MURPHY

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It’s a battle they never thought they’d face, let alone at the same time.

Missy and Brooke Shatley, a mother and daughter from Prairie Farm, Wisconsin, both have cancer. They were diagnosed only 13 days apart.

“It’s that unbelief,” Missy, 38, told ABC News of her reaction when they learned the devastating news. “You feel numb like this can’t really be happening. This is happening to somebody else, it could never be you.”

 

Missy was diagnosed with stage 2 cervical cancer on December 26, the day after Christmas.

“I went in for my annual physical and that was the result of it,” she explained.

Then on January 8, Brooke, Missy and her husband Jason’s oldest child, was diagnosed with stage 3 ovarian cancer.

“Why us? Why?,” Missy asked. “Is it something in our water? Is it genetic? Why both of us in such a short time frame? The doctor said it’s not the water, it’s not the environment, it’s just a freak act of nature.”

Before Missy’s diagnosis, Brooke, 14, had been experiencing severe abdominal pain that went undiagnosed for several weeks.

“The doctors told us she had a baseball-sized hemorrhagic disc and it would go away on its own and we should just wait,” Missy explained. “We waited for a few weeks and thought, ‘This is ridiculous,’ and we sought a second opinion.”

The Shatley’s then took Brooke to see the same specialist that had just diagnosed her mom days earlier. The devastating news was that Brooke’s tumor was larger than they originally suspected and needed to be operated on immediately.

“It was a four-and-a-half hour surgery,” Missy recalled. “It was a football-sized tumor. It had intertwined in her abdomen. You couldn’t tell by looking at her belly, but it was football-sized.”

The brave mother-daughter duo began undergoing intense treatments at the same time in Marshfield, Wisconsin, about two hours from their home--understandably weighing heavily on husband and father Jason, a dairy farmer, who was traveling back and forth to take care of them while also tending to their other two children and maintaining their farm.

“It’s hard,” Missy said. “Just to even think, ‘That’s my wife and daughter,’ how does anybody deal with that? Plus we have two other kids at home so he’s trying to be a husband, father, keep up with the farm, he’s being pulled in so many directions, how do you even begin?”

This week has been better for the family, however. Both Missy and Brooke are back home, resting and enjoying their time, although possibly brief, out of the hospital.

Missy just completed her final round of radiation and chemotherapy on March 2. She now must wait eight to 12 weeks before they can tell how effective the treatment was on her cancer.

Brooke still has one more round of chemo to complete, tentatively scheduled to begin on March 9.

Although their simultaneous diagnosis has been difficult, Missy says, in a way, it’s been nice to have that newfound bond with her daughter.

“You don’t want to experience it with anybody, but if you have to, doing it as a mother-daughter is helpful,” she said. “You’re bonding over raw emotions. It’s definitely a connection that you form.”

On March 28 their community is holding a benefit for the resilient pair, which Missy says is just one of the generous things they’ve done to help throughout this process.

“Not in a million years could I imagine the outreach we’ve had,” she said. “The surrounding communities have been phenomenal. We have a dairy farm so we’ve had people volunteer to do chores, saw wood, make meals, provide transportation for the other kids when we need it--anything and everything they’ve offered up.”

Most importantly, she added, “Prayers, lots of prayers.”

Source: http://abcnews.go.com

Topics: mother, chemo, health, nurse, nurses, doctors, health care, cancer, hospital, medicine, treatments, radiation, chemotherapy, daughter, cervical cancer

A Nurse Who Lends an Ear May Ease Anxiety in Moms of Preemies

Posted by Alycia Sullivan

Wed, Oct 16, 2013 @ 02:48 PM

One-on-one talks with nurses help mothers of premature infants cope with feelings of anxiety, confusion and doubt, a new study reveals.

"Having a prematurely born baby is like a nightmare for the mother," Lisa Segre, an assistant professor in the University of Iowa College of Nursing, said in a university news release. "You're expecting to have a healthy baby, and suddenly you're left wondering whether he or she is going to live."

Segre and a colleague investigated whether women with premature babies would benefit from having a neonatal intensive care unit (NICU) nurse sit with them and listen to their concerns and fears.

The study included 23 mothers with premature infants who received an average of five 45-minute one-on-one sessions with a NICU nurse and study co-author Rebecca Siewert.

"The mothers wanted to tell their birth stories," Siewert said in the news release. "They wanted someone to understand what it felt like for their babies to be whisked away from them. They were very emotional."

The sessions reduced depression and anxiety symptoms in the women, and boosted their self-esteem, according to the study published online recently in the Journal of Perinatology.

The findings show that "listening matters" when it comes to helping mothers of premature infants, Segre said.

"These mothers are stressed out, and they need someone to listen to them," she explained.

She and Siewert believe nurses are well-suited for the role.

"Listening is what nurses have done their whole career," Siewert said. "We've always been the ones to listen and try to problem solve. So, I just think it was a wonderful offshoot of what nursing can do. We just need the time to do it."

Source: US News Health

Topics: anxiety, mother, Preemie, one-on-one, listening, depression, reduce, NICU

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