Risk of Medicine During Pregnancy and Smart Nurseries

I recently Read two articles that I found very interesting. The first article was about the FDA and how they are requiring drug companies to prevent more detailed risks of taking their medicines during pregnancy and while breastfeeding.

Prior to this new requirement, drug companies used an alphabet system to indicate risk, with ‘X’ being the most dangerous. They found that this system was a bit to broad and as a result, some drugs could not be completely categorized, or did not fit all the criteria of a particular category.

The new system, is more specific, and breaks down the risk into 3 parts: pregnancy, lactation, and fertility. This method requires drug companies to give a complete breakdown of the risk and the reactions that have resulted from taking the drug, in all three categories.

According to the article, most pregnant women in the United States take an average of three to five prescription drugs when they are pregnant, so it is important for them to know what exactly they are consuming and whether or not it will harm their fetus. The only thing that the new system does not do, is require these drug companies to carry out studies if there aren’t any on their drugs. I think requiring them to provide all the information available is a very good start, however the next move should be to get them to conduct studies and research where there is none.

The second article I read was on the smart nurseries.

In class, someone (I apologize, I do not remember who) presented on attachment between mother and infant. This article is not necessarily similar, it discusses a new monitor that parents can use to check the heart-rate and sleep patterns of their newborns. The article also shows they way advancements in technology and a continuous update in the number of  baby gadgets available can sometimes take away from the natural connection that a parent can give his/her/their child. The issue with technology, is that it is not always reliable. If your monitor isn’t charged, it will not work. If it suddenly stops working in the middle of the night, as these things sometimes do, what then do you do?

To be honest, I think baby gadgets are very useful and can relieve some of the stress that comes with parenting (unless of course you are not tech savvy in which case, you would have a difficult time figuring out these gadgets and reading their data)  however the results can not always be relied upon, especially with things as trivial as heart beat regulation and sleep in infants.


Safer, Easier Childbirth

In our last class we briefly discussed how giving birth is not celebrated, or recognized as a great feat like battling of cancer or surviving a disease. I thought about this some more over the course of the week and realized that we should be celebrating motherhood and one’s ability to deliver a baby safely. However, the difference between labor and diseases like cancer is that cancer is intended to kill you,childbirth on the otherhand is not.

I read a BBC article on how scientists are working towards understanding the reasons why some women have very easy births and some women have long hard labors that end in emergency delivery. The scientists are trying to figure out in detail, exactly how the womb works, so that they can learn more about prematurity, miscarriages, stillborns etcetera. According to the article, emergency caesarean births have risen by 50% in the last 30 years. At the centre for better births at the women’s hospital in Liverpool, a team of 20 scientists are looking at how the womb’s contractions are regulated and controlled. The article discussed determining having predictors for when a birth would be difficult (like the way they have biomarkers for diseases).

Going back to the class discussion on how and why certain people don’t die in childbirth, would expecting mothers in low income countries be a part of this research? Is this research going to encompass all people? are environmental and economic factors considered? ( availability of personnel and equipment/medicine, and like what happened with Monique?) How can these women be included? would this research only include women in middle/high income countries where maternal mortality is not as high?



Economic Benefits of Family Planning in Nigeria

Family Planning is an issue that we have discussed briefly in this class, especially in the beginning. Although this is not a large issue in the US, developing countries are really struggling to control this. Nigeria is one of those countries, seeing as I did my presentation on the birthing practices in Nigeria, I decided to share this.

I read an article on Family Planning in Nigeria recently. The UN was advising that family planning be encouraged so that population growth can be managed. With a population of over 170 million (A figure that is expected to double in about 20 years and surpass the US in 2050), living in a country thats only a bit over two times the size of California, Nigeria is quickly becoming overpopulated.

The article also discussed how the country could benefit economically if family planning was promoted and encouraged. According to the director of the United Nations Population Fund Babatunde Osotimehin, Nigeria would benefit a great deal from a “Demographic Dividend” This demographic dividend occurs when “The working population of a country is larger than the younger dependent population”  According to Osotimehin “A slight decline in fertility would raise output per capita by 5.6 percent over a span of 20 years and 11.9 percent over a 50 year span”

What are some policies that can be put in place to encourage family planning in Nigeria?


Importance and Prevalence of Midwives: Raising awareness

                Before taking this class, I was not aware of the extent to which midwives and traditional birth attendants  were involved in the healthcare sector. I wasn’t even aware of their role. I have interacted with them in hospitals and clinics but I was sure they did more than check blood pressure or height and weight and assist the doctor with a few things. I was also not aware that birthing centers existed and people could go there to have their children. I did a little research and I found that there are so many roles that midwives birthing attendants, doulas etcetera can play in lieu of a doctor and it is important for these options to remain available. Midwives are also prevalent in countries that have the best “maternal and infant outcomes” (Midwives Alliance of North America). I thought I was the only one who had no clue how involved midwives were.  While having a conversation with some friends about this class, I asked them their take on midwives and midwifery. A lot of them also were not aware the extent to which midwives were utilized. one of them brought up the fact that midwives provide a more personal care. In some of my other classes we have discussed bedside manner and how this plays a significant role in the outcome of the patient. Doctors see a lot of patients each day and as a result do not always have the ability to empathize with their patients. Patience, compassion and understanding are important, especially for pregnant women. I think it is important to continue to promote the training and the  use of midwives, TBAs and other specialists. It is also important to promote the other birthing options. There are probably several other people who are unaware.




Training and Incentives

Like we’ve discussed in class, the terms “midwife” or “skilled birth attendant” mean different things in different cultures. They differ in terms of levels of education, authority and skill. I thought about having it mandated that all midwives worldwide have a certain skill and education level, but then I thought about the midwives and skilled birth attendants in places like Mali and how  Monique was one of the only trained midwives in her location. Besides not having the infrastructure to train these individuals, I thought about wars and other obstacles that may prevent training or would make them reluctant to even go through the training process. From the case study that was done in Liberia, one of the issues that was mentioned was a shortage of midwives as well as a shortage of doctors. In cases where there is  a shortage of midwives and other health professionals what are the options left for people who need medical care? and how can this shortage problem be solved? Nowadays in a lot of African countries, individuals receive their training in foreign countries and continue to practice in the country where they received training. They usually leave with the intention of returning but the incentives/benefits of having these degrees and certificates  in most of these countries do not reflect their level of training. This summer in Nigeria, a lot of the doctors went on strike because they were not receiving their salaries. Like we also discussed in class, rural areas are less likely to be staffed with TBAs and TTMs because of distance and other factors. People would be reluctant to live so far from the city.   I know for rural northern Nigeria, it was difficult for the National Primary Health Care development center to gather volunteers and midwives to relocate there. In addition to training more midwives and healthcare professionals, how can conditions in these rural locations be modified to make living easier so that these trained individuals would choose to stay.