Where do pregnant women go for advice in 2019?

Their grandmothers, their mothers, their obstetricians? Whom should they believe ? Can they trust anything in that old paperback “The Common Sense Book of Baby and Child Care” by Dr. Benjamin Spock? After all, millions were sold after it first came out in 1946 and could have been the bible in terms of where their grandmothers went for advice.

Circumcision, breast feeding, swaddling are just a few of the issues that confront pregnant women. And they know if they make a mistake, fail in their attempts to, for example, breast feed, there will be nosy friends, relatives and neighbors who will want to know why and will offer unsolicited advice.

Published last month is “Cribsheet” by economist and professor Emily Oster. Oster posits that “There are a lot of right choices” and that she began “using a lot of the decision-making and data-analysis tools” she uses in her job to make choices about her pregnancy.

Some of us realize that Oster is making a play on words. There is the literal sheet on a mattress. Even the dullest among us knows that it should be the sole thing in an infant’s crib and should be tight fitting. In other words, no blankets, pillows, bumper pads, toys. Crib sheet also refers to theft/plagiarism, typically using notes illegally during, for example, an exam. Will we begin to use her advice as so many used Spock’s?

A little case study: Hailey wanted to be pregnant: she was 30, had earned her M.A. from Wright State University and had been teaching math and English for three years. Tall, athletic (she played high school and college basketball and was on the rugby team for Wright State University and the city of Dayton), she felt well equipped to become pregnant. The unexpected happened: she learned that she was pregnant with twins.

That changed everything, but initially she had no idea just how much her life was to be altered.

To start with, her delivery date was for mid-February of 2019. That meant she needed to find a teaching job on-line for the 2018-2018 year. So she did.

Hailey began to have headaches, and her neck ached, and her blood pressure, always normal, started to behave erratically. She was monitored by her obstetrician both in and out of the hospital as she waited for each ultrasound to see if the twins, a male and a female, were growing at a normal pace and were safely positioned in her uterus.

Hailey’s symptoms, however, were not normal: preeclampsia – a condition, which can lead to serious complications for mother and babies – including death. The question then involved an ongoing assessment of the risks of early delivery: Were the babies developed enough to live outside the uterus? How long could she maintain the pregnancy without the possibility of having debilitating strokes or dying?

Her obstetrician made the decision: a C-section on Jan. 17, five weeks before the twins’ due date: The boy weighed 5 pounds, 11 ounces; the girl, 4 pounds, 7 ounces. Breathing tubes, feeding tubes and round-the-clock observation in a special unit at the hospital.

The wimpy white boy phenomenon that is discussed freely by neonatal nurses was used in reference to the boy, and scientists have identified male newborns as “fragile organisms.”

Post delivery, Hailey continued on a variety of meds for elevated blood pressure, and finally her blood pressure returned to normal.

You might ask, Why is there so much attention to problem pregnancies? At one time, a woman got pregnant, delivered, and went on with her life.

With statistical data, researchers are identifying death rates of infants, the geographic locations, and causes. They have determined that, generally speaking, an African-American female infant has the best chance for survival.

But what do we do with preemies, such as the boy and girl in my case study. Jayne Blanton Head, RNC-LRN, with 18 years in the neonatal unit at Baptist Health Corbin caring for preemies indicates the following:

· Preemies don’t know how to suck and need tube or syringe feeding every few hours;

· They must be kept naked except for diapers in isolettes with controlled temperature (they have little brown fat which regulates body temperature) and humidity;

· They can lose up to 10 percent of their birth weight, usually due to fluid shifts;

· Their oxygen saturation levels must be monitored and can range from 93 to 100 percent, but ideal is at least 95 percent

Problems arise, according to Head, with separation anxiety. Mothers can spend little time with the preemies, and with the feeding tubes, they don’t get to participate as they would like. There is also the issue with tobacco use if the mother is a smoker. She needs to scrub in, wear a gown, wash her hair so that the infant is not exposed to third-hand smoke.

An issue Head and those with whom she works confront from time to time is that “Some moms have addictions that they can’t give up, and we must carefully wean the babies from the drugs . And addiction is difficult to identify with preemies. Other moms come in to deliver and have had no prenatal care, no proper nutrition, folic acid, or prenatal vitamins.”

So on this Mother’s Day, know that becoming a mother can be complex, and that those who care for these infants in the first hours or weeks of their lives are to be commended.

Hailey says of those weeks before she could bring her twins home, “I feel they were taken from me, and it’s so important to know there are nurses like Jayne caring for our tiny ones.”