Vitamins and Pregnancy

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It's at most common that pregnant mothers should need the very best for their newborns and to that end, it is significant to prepare sure that they are all consuming the most full of nutrients diets for their unborn child.

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Vitamins and Pregnancy

It’s
at most common that pregnant mothers should need the very best for
their newborns and to that end, it is significant to prepare sure that
they are all consuming the most full of nutrients diets for their
unborn child. Even so, this may confirm to be difficult due to nausea,
cravings and loss of appetite for some foods.
One of the optimum ways to guarantee that both mother and their newborn
are receiving enough vitamins and minerals is to take prenatal vitamin
supplements.
Many doctors will advise prenatal vitamins when before time as six
weeks into a pregnancy with some in spite of supporting that they be
captured if a woman is planning to impregnate. The logic behind this is
that it will aid avoid certain birth defects.
Prenatal vitamins are particularly created to guarantee that both
mother and baby get the correct quota of vitamins and nutrients anyway
of any uncommon eating customs during pregnancy. Vitamin and mineral
shortages can have bad effects on the growth and well being of the
unborn child.




Folic acid is one of the minerals that are included in prenatal
vitamins and is an needed nutritive throughout pregnancy. As well as
actuality important for the growth of the unborn child, Folic Acid has
been shown to reduce the risk of neural tube defects such as spina
bifida.
Calcium is one of the majority significant essentials in an pregnant
mum foodstuffs as it is essential for the improving bone growth of the
unborn child. However, prenatal vitamins do not always contain enough
calcium while others do not contain any at all. The ones that do have
it only contain around 250 mg whilst the recommended intake while
pregnant are 1200 to 1500 milligrams. It is therefore, important to pay
close attention to the calcium content in prenatal vitamin supplements
and to make up any deficit with the use of dairy products.
Iron is another influential mineral included in prenatal vitamins and
is reliable for serving the mother and the baby’s blood to carry
oxygen. Iron shortages can conduct to extreme birth defects for the
baby as well as other difficulties for the mother.
Other vitamins and minerals contained in prenatal vitamins include
Vitamin D, Vitamin C, thiamine, riboflavin, vitamin E, vitamin B-12,
and zinc. Each of these is significant for the mother and her growing
baby.
As accompanied by all supplements, prenatal vitamins are just that –
supplements and to that purpose, they should not be captured in place
of a nutritionally balanced diet. Separately from anything else, any
vitamin supplement requires the nutrients found in food to be properly
absorbed by the body.
Many moms to be may appear that they understand enough about nutrition
and eat well enough without the require to take prenatal vitamins. Even
so, it is important to be realistic about the nutrition that you can
maintain while pregnant as nausea and loss of appetite can make a big
difference to nutritional consumption.
Even if you are in luck enough not to practice morning sickness and
nausea, it can yet be difficult to be sure that you are receiving
enough vitamins and minerals for both, you and your newborn. Best
suggestion is to play it safe and take a prenatal vitamin, in spite of
if it is just an insurance policy.
If you are disordered or unsure about which prenatal vitamins are best
for you and your newborn, speak with your doctor about your choices.

Read more about Vitamins and Supplements

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Culture & Conversation Family

Breastfeeding, Bias, and Men Who Give Birth: Q&A With Trans Activist Trevor MacDonald

Britni de la Cretaz

In his new parenting memoir, Trevor MacDonald talks about pregnancy and breastfeeding as a trans man—and why we must dislodge the idea that bearing children is only women's labor.

Pregnancy, birth, and breastfeeding are acts often associated with womanhood. We talk about pregnant women and nursing mothers, but this language—which depends on the male-female gender binary—seems inadequate as trans and nonbinary folks are increasingly visible in the parenting sphere.

With his first book, Where’s the Mother?: Stories From A Transgender Dad, Trevor MacDonald hopes to blow the conversation wide open. MacDonald is a Canadian author who has been blogging about his journey as a nursing man on his blog, Milk Junkies, since 2011. He also facilitates a Facebook group for trans folks who nurse, and he initiated and helped design a University of Ottawa study focusing on the experiences of transmasculine individuals with pregnancy, birth, and infant feeding.

MacDonald’s book explores his transition from living as female to living openly as a man, and how that transition ultimately led to his decision to carry and birth a child with his partner.

By sharing his experiences and documenting the many challenges he faced as a man who planned to give birth and nurse his baby, MacDonald asks readers to reconsider everything they think they know about what it means to be a gestational parent. By the end of the book, readers come away understanding that despite a person’s gender, pregnancy and nursing are universal experiences and valid regardless of how they happen. MacDonald’s voice is an important and necessary one in the birthing community, and there are surely many more people out there like him.

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Rewire: You talk a lot about struggling to find literature that you related to because pregnancy, birth, and breastfeeding are typically only associated with women—and motherhood. Can you tell me about the kind of language you’d like to see used to talk about these experiences and why it’s important?

Trevor MacDonald: I think I was a bit naive at first when I was reading those materials. I felt like, “If only the authors knew, I’m sure they would have used different language. They just didn’t know about people like me.” And that’s definitely been the case for some of those authors. Many are starting to change language and using words like “parents” or “pregnant people.” It’s a simple shift, really.

Where I was naive, though, is that there are some people who really don’t want to use inclusive language. Ina May Gaskin is one. I had read her book [Ina May’s Guide to Childbirth] during my first pregnancy and had been so inspired by her writing, and the birth stories are so valuable and needed. I was so hungry for information about what others had experienced. I love that book so dearly, and to realize she really was opposed to including gender-diverse people in her writing was really upsetting. [Gaskin signed this open letter by Woman-Centered Midwifery, a group of “gender-critical” midwives who believe that biological sex determines gender and were concerned about the Midwives Alliance of North America’s use of gender-neutral language to talk about pregnancy and birth.]

It’s also really important to me to point out that no one needs to throw out the words “mother” or “woman”; you just need to include more words. So you could say “women and men and gender-nonconforming people” or “parents.” It’s nice to have more than one word to mix things up a little bit.

Rewire: What was the decision to carry a baby like for you?

TM: It was something I’d never thought I would do until after I transitioned and after getting together with my partner. For me, transitioning in the medical way that I did [through hormone therapy and top surgery involving breast removal] made me comfortable enough with myself to contemplate carrying a baby. Before that, there was so much stress and constant background noise in my thoughts and in my life to do with gender, with bathrooms, and with all the ways I really wasn’t comfortable. When I transitioned and so much of that fell away, I started to consider things I never had before. It helped that I was able to present as male throughout my pregnancies because I had taken testosterone [before pregnancy]. Those things enabled me to express my gender and present myself during pregnancy in ways that were comfortable for me.

Rewire: Did you experience any gender dysphoriathe distress or discomfort that occurs when the gender someone is assigned does not align with their actual gender—during your pregnancy?

TM: For sure, but for me it was more around medical stuff than around everyday living. In my everyday life, I was still presenting as male. But with health-care providers, especially providers who specialize in prenatal care, they’re so used to everything being woman-centered, and it’s really important to some providers to use woman-centered language.

I didn’t have any providers who had worked with an openly trans client before, so people certainly had trouble with the language. One midwife offered a blanket apology that she was going to have trouble remembering to use the right words and that she didn’t mean to be offensive. For me, I think I would have preferred if she had made more of a commitment to trying to change her language—going beyond apologizing, but trying to do something to remember to use my pronouns. I think it must be hard when it’s your first client who has asked you to use new language. It’s a new skill that has to be practiced and learned, like any other.

Another place where I sometimes experienced challenges was when people at work who had previously been using the correct pronouns for me switched to using the word “mom” and female pronouns when they found out I was pregnant.

But for me personally, in my body, I didn’t feel like the experience of being pregnant triggered dysphoria. It was more the way society responded to me that did.

Rewire: Birthing at home was something important to you. Can you talk a bit about why that option felt safest?

TM: I think the difference for me was that care is different. In Canada, we have midwifery care that is part of the health-care system, and it is covered by insurance. We still have a shortage of midwives, so not everyone who wants one can get one. I was fortunate to get midwives for both my births. For me, the continuity of care that they provide and that you get with a home birth is important.

At a hospital birth, there is no way to meet all your providers before you go there and labor, and I felt like there might be a lot of explaining that I might have to do. I did go to a hospital during pregnancy and another time when I had a miscarriage. I had to come out to every provider there, starting with the first nurse and every subsequent person that I saw. Each person needed to hear the same story about how I, a man, was pregnant. One doctor even had a lot of questions about how I could no longer be taking testosterone and still have facial hair. I couldn’t imagine having to explain those things and educate during labor.

Even with midwives, though, it’s not a magical recipe for getting exactly the kind of care that you need. I still had midwives at my first birth that I hadn’t met before.

Rewire: How do you think care providers—whether they’re doctors or midwives, or lactation consultants—can best support families like yours, or people who are not women but may be giving birth or nursing their babies?

TM: I think considering the topic, doing reading and practicing using the language ahead of time, before they ever meet their first trans or gender-nonconforming client is really important. There are more and more resources available now and places to go to read about people’s experiences, and there are a number of different medical associations who have called on their members to do exactly that. This is so they are not asking their individual patients to educate them, particularly when that person needs care and is in a vulnerable position. That’s not the time to be asking questions that they could learn about in other places.

Rewire: Finding donor milk for your son Jacob seemed to be quite a challenge. You mention that you produce about a quarter of the milk your baby needed, and the rest had to come from donors. Can you talk about what some of the challenges to finding donor milk are? Do you think protocols that see milk sharing as “risky” keep babies from being breastfed who might otherwise benefit from receiving breast milk?

TM: I think some of the taboo against milk sharing is really starting to shift in our culture right now. Currently, a lot of regulatory bodies—for example, the Food and Drug Administration and Health Canada—have a position against peer-to-peer milk sharing—like through Facebook groups like Human Milk 4 Human Babies, where we found many of our milk donors.

But La Leche League (LLL) has actually changed their position on it. LLL’s leaders, who facilitate their local support groups, used to not be allowed to discuss peer-to-peer milk sharing in any way, but last year the organization released a statement with a new policy. Leaders are allowed now to share information and can say that these milk sharing websites exist. It would be a great shift if other groups start to take a position more like LLL, where they can provide information. It would be awesome if medical professionals started to tell patients that these networks exist. Karleen Gribble has written papers about the ethics of peer-to-peer milk sharing and the ethical implications of letting patients know about it and how care providers could discuss risks and benefits, not just of peer-to-peer milk sharing, but of using formula.

In pop culture, when people talk about being worried about milk sharing, the fear most often brought up has to do with diseases like HIV. But something we had to consider as well was the medications that people were taking and whether it could be passed through breast milk. Many people who donate milk through peer-to-peer sharing do so because formal milk banks have such strict requirements around who can donate to them. Formal milk banks are not necessarily in competition with peer-to-peer milk sharing, which is important to understand.

Rewire: You talk a lot in the book about milk donation and the community that sprung up around you to help your family achieve your breastfeeding goals. Can you speak about the support you received and how it affected your breastfeeding journey?

TM: We met people that we otherwise never would have met and never would have become friends with. Many of our milk donors are still our friends, and they were such a diverse bunch of people. From a Mormon donor to a military family to a Mennonite family, all these different kinds of families from different backgrounds came together to help us feed our baby. It was amazing to meet these different people and to realize that despite us being a different kind of family in this one particular way, what was most important to all these people was that a baby needed breast milk.

Rewire: It sounds like prior to having your son, you didn’t know any other trans people who had nursed their babies. Has that changed? Are their experiences similar to yours?

TM: Before Jacob, I only knew about the guy, Thomas Beatie, who went on Oprah. I didn’t know anyone in person. I knew a few trans people who had children prior to transition. Through writing my blog, that’s how I first started to connect to a lot of other trans parents and people who were carrying babies while being out as trans. People asked me questions through my blog about how I navigated the medical system and a lot of questions about breastfeeding.

I also got a lot of questions from cisgender women as well, who were grappling with all kinds of different breastfeeding challenges. Many people deal with low milk supply and try to use a supplementer, like I use to nurse my baby (since I only make about a quarter of the milk my baby needs, I use a supplementer to deliver the milk at my chest, which allows me to feed my baby at my chest). So many people can relate to these challenges. A lot of the time, it’s a private struggle that people have, and it’s intense but you don’t necessarily talk about it that much. All kinds of people reached out to me because they could relate to these issues.

Rewire: What do you wish you had known before giving birth to Jacob?

TM: I wish I had trusted my own instincts a little bit more, and given myself more space to just see what my body would want to do in labor. I felt like I was looking to my care providers and my doula for suggestions, and I’m sure a lot of people have that experience when they’re going through something they’ve never been through before.

Rewire: What do you hope people take away from your book?

TM: I really hope that it will open up conversations. I hope it will provide opportunities for people to talk more about gender diversity, not just generally, but in parenthood and related to pregnancy and breastfeeding. If this book contributed to a conversation that way and opened up discussion, that would be amazing. I would be really thrilled.

This interview was conducted by email and by phone. It has been lightly edited for length and clarity. 

Commentary Human Rights

Improving Reproductive Care for Women in Jail Is Not an Impossible Task

Kyl Myers

Women in city and county jails frequently face barriers to accessing contraception, abortion, prenatal care, and disease screening and treatment. But preventive family planning can be improved in jails around the United States by implementing a few core tenets for those incarcerated there.

Millions of the most medically underserved women in America enter local jails each year, where their reproductive health care and family planning needs are grossly overlooked. Women in city and county jails frequently face barriers to accessing contraception, abortion, prenatal care, and disease screening and treatment. But preventive family planning can be improved in jails around the United States by implementing a few core tenets for those incarcerated there.

Although the direct results of improving such care have not yet been studied, it seems a safe guess that releasing healthier, more empowered women with control over their fertility would have positive outcomes for them and the families and communities to which they return.

The U.S. Department of Justice reports that the female jail population has been the fastest-growing correctional population. In 2012, women accounted for more than 26 percent of all persons arrested, primarily for drug-related charges. Regardless of the growing rate of female incarceration, the National Commission on Correctional Health Care has stated that women’s sex-specific health-care needs remain unmet due to their minority status in a male-dominated jail population.

There are no federally mandated guidelines for women’s health care in jails. Correctional health-care arrangements vary; contracted providers may deliver health services at jails on site, or incarcerated persons may be transported to local hospitals or clinics for care. Often, these health care arrangements do not include appointments with obstetrics and gynecological health providers. The scholar and lawyer Kendra Weatherhead argues that the medical inadequacies incarcerated women face infringe on their rights established in the Eighth and 14th Amendments.

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Although some members of the public may believe that contraception and other reproductive care needs aren’t necessary because of facilities’ sex-segregation, discontinuing women’s birth control and not providing contraceptives before release may increase the likelihood of women experiencing an unintended pregnancy post-incarceration. Jails are different than prisons in that they are designed for short-term stays of people in pretrial detention or who have been sentenced to less than one year for low-level felonies. The average length of stay in America’s jails is around 30 days, but while jail time is short, it is also frequent. Recidivism rates are alarmingly high in the United States—half of women who have been incarcerated return to jail at least once within three years after their release.

Unfortunately, many women have a revolving-door experience with incarceration. An unintended pregnancy may further complicate a woman’s efforts to meet her probation or parole requirements; thus, helping women avoid unintended pregnancies may lead to a reduction in recidivism, or at least a reduction in women returning to jail with unwanted pregnancies, for which they may be unable to decide the outcome.

Overall, most women in jail are between the reproductive ages of 18 and 45; are sexually active; and already have children, for whom they are the primary caregivers. It is also estimated that 25 percent of incarcerated women are either pregnant or gave birth in the year prior to their arrest. Compared to women who have never been arrested, women with a history of involvement in the corrections system experience higher rates of unintended pregnancies, abortion, sexually transmitted infections, and domestic and sexual violence—again displaying the need for improved health care in jails.

To assess women’s family planning needs and desires for contraception, the following recommendations should be initiated in all local jails housing women.

Upon booking into jail, all women should be asked if they are sexually active with men and currently using a method of birth control.

If she is using a hormonal birth control method, ensure it is continued. Women incarcerated in U.S. jails are subject to discontinuation of their current contraceptive methods because of an assumption that birth control is an unnecessary medication in a sex-segregated jail. Generally, women experiencing incarceration are not given previously prescribed birth control pills, or kept on schedule with other hormonal methods such as Ortho Evra (the patch), NuvaRing (the ring), or Depo-Provera (the shot). In the case of managing a health issue such as endometriosis, a woman may be allowed to remain on birth control, but even then, discontinuation is common. This practice carries risks: Because hormonal birth control can take time to become effective, this puts women at risk of unintended pregnancy if they have to reinitiate birth control after release rather than continuing on a jail’s prescription. Furthermore, women’s health insurance and income are suspended during incarceration, which could further postpone a woman’s re-initiation of birth control while she waits for her insurance to activate or a first paycheck and an appointment with a family planning provider.

All reproductive-aged women should be asked if they are interested in initiating birth control during their jail stay.

An unintended pregnancy after incarceration could hinder a woman’s ability to successfully reintegrate into her community and increase her likelihood of returning to jail. After incarceration, most women have children they need to care for or regain custody of, and they often have to find housing and jobs—things that an unintended pregnancy could make more complicated. Most incarcerated women are sexually active and plan to have sex with male partners soon after their release and hope to avoid unintended pregnancies. However, women who are incarcerated are more likely to come from poor communities where access to contraceptive education and services is limited. Because health care in jail is subsidized, women experiencing incarceration who wish to could receive free family planning counseling and services, especially effective, reversible, long-term methods such as the arm implant, Implanon, or intrauterine devices such as Mirena, Skyla, Liletta, or ParaGard—methods that are especially difficult for disadvantaged, uninsured women to access in the community. At least two jails in the United States are providing incarcerated women with access to contraception during their stay, one in Rhode Island, the other in San Francisco, California. But two facilities on opposite sides of the country are not nearly enough.

If a woman had unprotected sex within five days prior to arrest and is eligible and interested in taking emergency contraception, it should be offered to her.

A 2009 study surveyed women within 24 hours of their arrest in San Francisco. They found that 29 percent were eligible for emergency contraception based on the above guidelines, and among those women, almost half were willing to take emergency contraception if it was offered to them in jail. Additionally, 71 percent of all women surveyed said they would accept an advance supply of emergency contraception upon release from jail. The researchers estimate that access to emergency contraception at time of arrest and upon release could potentially benefit more than 750,000 women entering the criminal justice system every year.

Administrators should establish whether a woman is currently pregnant or if she would like to take a pregnancy test.

The American Congress of Obstetricians and Gynecologists states that at any given time, approximately 6 to 10 percent of incarcerated women are pregnant, many of whom find out they are pregnant in a correctional facility. Unfortunately, pregnant women in jail are inconsistently counseled on their options for pregnancy outcome and access to termination services. Incarceration impedes women’s ability to access abortion in the case of unintended pregnancy and causes additional stress to women who desire to deliver and parent. If a woman is pregnant, she should be asked what her intentions are for the pregnancy outcome and should be provided with resources to accomplish her intentions. Women’s rights to prenatal care, humane treatment, and abortion services do not cease because of incarceration; however, incarceration greatly complicates their access to such services. This may result in pregnancy and delivery complications or a woman being forced to continue an unwanted pregnancy because she was unable to access an abortion.

If women want to become pregnant after release, they should be offered preconception counseling, prenatal vitamins, and information about parenting resources, such as Children’s Health Insurance Plan (CHIP) and Women, Infants and Children (WIC).

Women with a history of incarceration often face pregnancy complications and deliver low-birth weight babies due to poor prenatal nutrition or mother’s drug use. Providing women with resources and services promoting healthy pregnancies benefits women, their children and communities.

The fight for reproductive rights is difficult enough for women who have never experienced incarceration—the millions of women who enter U.S. correctional facilities have it worse and the problem is growing. We must challenge the system of mass incarceration occurring in America and fight to keep women out of jail for nonviolent offenses through advocating for better substance abuse treatment and alternatives to incarceration. Unfortunately, women already in these facilities often have few resources to advocate for themselves. We must engage with jail administrators and local legislators to ensure incarcerated women have access to reproductive health-care services and family planning resources. Jails are our jails. People from our communities are held there, and our money funds what they do and don’t have access to.

It is our responsibility to ensure reproductive rights and autonomy for those behind bars.

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