I will give you some facts that you might not have heard about. I just want you to be able to make informed descisions.

Is Ultrasound safe?

Nobody really knows and everyone has a different view. There has been surprisingly little research to identify whether or not ultrasound has any negative effect on fetal health or subsequent health in childhood or adult life.
A number of studies have suggested that ultrasound waves can have a damaging effect on living tissue. Studies on animals have demonstrated a number of such effects including nerve damage, and an increase in the rate of cell death.
In humans, studies have suggested a wide variety of possible problems related to exposure to ultrasound including premature ovulation, premature labour, and low birth weight7. Other studies have suggested long term effects include a possible relationship with childhood cancers especially leukemia, as well as delayed speech development and dyslexia.

Unfortunately many of these trials have been too small or flawed in their methodology. None of the randomized controlled trials have been large enough to yield any firm data one way or the other. The fact is we simply do not know. One of the main problems for researchers is that ultrasound technology has not been around long enough for long term data to be collated. Record keeping is also a problematic area with no common standards for recording when and for how long women have been exposed to ultrasound in pregnancy.
In addition there are no international standards on how a scan should be carried out. Each caregiver has their own policies and practices in relation to the frequency with which they recommend scanning, variable time of exposure and different types and age of equipment affecting accuracy and level of exposure.

Hepatitus B immunization at birth?

Even though hepatitis B is an adult disease, is not highly contagious, is not deadly for most who contract it, and is not in epidemic form in the U.S. (except among high risk groups such as IV drug addicts), in 1991 the Advisory Committee on Immunization Practices of the Centers for Disease Control recommended that all infants be injected with the first dose of hepatitis B vaccine at birth before being discharged from the hospital. This, despite the fact that almost nothing is known about the health and integrity of an individual baby's immune and neurological systems at birth. The FDA allowed drug companies to use "safety" studies which only included a few thousand children monitored for only four or five days after vaccination to check for reactions. As "proof" their hepatitis B vaccine is safe to be used in children, Merck & Co. stated in their 1993 product insert that "In a group of studies, 1636 doses of RECOMBIVAX HB were administered to 653 healthy infants and children (up to 10 years of age) who were monitored for 5 days after each dose." And, although doctors routinely inject hepatitis B vaccine into children along with many other vaccines such as DPT, HIB, MMR and chicken pox vaccine, Merck & Co. state in the 1996 product insert: "Specific data are not yet available for the simultaneous administration of RECOMBIVAX HB with other vaccines." The Institute of Medicine report noted that no controlled observational studies or controlled clinical trials have ever been held to evaluate repeated reports that hepatitis B vaccine can cause Guillain-Barre syndrome; arthritis; transverse myelitis, optic neuritis, multiple sclerosis and other central demyelinating diseases of the nervous system (degeneration of the myelin sheath of the brain that helps transmit nerve impulses); or sudden infant death syndrome (SIDS). On top of that all vaccines stimulate only an artificial, temporary immunity, and the length of immunity conferred by the hepatitis B vaccine and the future need for more "booster" doses later in life is still not clear.

Vitamin K information.

Newborn infants routinely receive a vitamin K shot after birth in order to prevent (or slow) a rare problem of bleeding into the brain weeks after birth. Vitamin K promotes blood clotting. The fetus has low levels of vitamin K as well as other factors needed in clotting. The body maintains these levels very precisely. Supplementation of vitamin K to the pregnant mother does not change the K status of the fetus, confirming the importance of its specific levels.
Toward the end of gestation, the fetus begins developing some of the other clotting factors, developing two key factors just before term birth. It has recently been shown that this tight regulation of vitamin K levels helps control the rate of rapid cell division during fetal development. Apparently, high levels of vitamin K can allow cell division to get out of hand, leading to cancer.
What's the Concern? The problem of bleeding into the brain occurs mainly from 3 to 7 weeks after birth in just over 5 out of 100,000 births (without vitamin K injections); 90% of those cases are breastfed infants, because formulas are supplemented with unnaturally high levels of vitamin K. Forty percent of these infants suffer permanent brain damage or death.
The cause of this bleeding trauma is generally liver disease that has not been detected until the bleeding occurs. Several liver problems can reduce the liver's ability to make blood-clotting factors out of vitamin K; therefore extra K helps this situation. Infants exposed to drugs or alcohol are especially at risk, and those from mothers on anti-epileptic medications are at very high risk and need special attention.
Such complications reduce the effectiveness of vitamin K, and in these cases, a higher level of available K could prevent the tragic intracranial bleeding. This rare bleeding disorder has been found to be highly preventable by a large-dose injection of vitamin K at birth.
The downside of this practice however is a possibly 80% increased risk of developing childhood leukemia. While a few studies have refuted this suggestion, several tightly controlled studies have shown this correlation to be most likely. The most current analysis of six different studies suggests it is a 10 or 20% increased risk. This is still a significant number of avoidable cancers.
"In 1990 Golding et al reported a study of a 1970 birth cohort in Britain in which they noted an unexpected association between childhood cancer and pethidine given in labor and the neonatal administration of vitamin K. Subsequently, Golding and others conducted a case-control study designed to examine the risk of cancer associated with intramuscular vitamin K administration among infants born in two hospitals in Avon between 1965 and 1987 and diagnosed with cancer between 1971 and 1989. They reported a significant association between intramuscular vitamin K and cancer when compared to no vitamin K or oral vitamin K. They recommended exclusive use of oral vitamin K."
Apparently the cell division that continues to be quite rapid after birth continues to depend on precise amounts of vitamin K to proceed at the proper rate. Introduction of levels that are 20,000 times the newborn level, the amount usually injected, can have devastating consequences.
Nursing raises the infant's vitamin K levels very gradually after birth so that no disregulation occurs that would encourage leukemia development. Additionally, the clotting system of the healthy newborn is well planned, and healthy breastfed infants do not suffer bleeding complications, even without any supplementation.
While breastfed infants demonstrate lower blood levels of vitamin K than the "recommended" amount, they show no signs of vitamin K deficiency (leading one to wonder where the "recommended" level for infants came from). But with vitamin K injections at birth, harmful consequences of some rare disorders can be averted.
Infant formulas are supplemented with high levels of vitamin K, generally sufficient to prevent intracranial bleeding in the case of a liver disorder and in some other rare bleeding disorders. Although formula feeding is seen to increase overall childhood cancer rates by 80%, this is likely not related to the added vitamin K.
Extracting data from available literature reveals that there are 1.5 extra cases of leukemia per 100,000 children due to vitamin K injections, and 1.8 more permanent injuries or deaths per 100,000 due to brain bleeding without injections. Adding the risk of infection or damage from the injections, including a local skin disease called "scleroderma" that is seen rarely with K injections, and even adding the possibility of healthy survival from leukemia, the scales remain tipped toward breastfed infants receiving a prophylactic vitamin K supplementation. However, there are better options than the .5 or 1 milligram injections typically given to newborns.

A Better Solution
The breastfed infant can be supplemented with several low oral doses of liquid vitamin K(possibly 200 micrograms per week for 5 weeks, totaling 1 milligram, even more gradual introduction may be better). Alternatively, the nursing mother can take vitamin K supplements daily or twice weekly for 10 weeks. (Supplementation of the pregnant mother does not alter fetal levels but supplementation of the nursing mother does increase breast milk and infant levels.)
It has been suggested that longer regimens of oral vitamin K would prevent late VKDB while avoiding the concerns with vitamin K injection. In 1992, The Netherlands adopted a regimen of 1 mg oral vitamin K at birth, followed by daily doses of 25 mcg from 1 week to 3 months of age in breastfed infants. Surveillance data collected on infants receiving this regimen have revealed no cases of late VKD

Signs Suggesting Need for Vitamin K:
• bleeding from the umbilicus, nose, mouth, ears, urinary tract or rectum
• any bruise not related to a known trauma
• pinpoint bruises called petechiae
• black tarry stools after meconium has already been expelled
• black vomit
• bleeding longer than 6 minutes from a blood sampling site even after there has been pressure on the wound
• symptoms of intracranial bleeding including paleness, glassy eyed look, irritability or high pitched crying, loss of appetite, vomiting, fever, prolonged jaundice.
Early or "Classic" HDN (also called Vitamin K Deficiency Bleeding) occurs in the first week of life. It is an iatrogenic condition, meaning that it is caused by medical care:
• premature clamping/cutting of the umbilical cord deprives babies of up to 40% of their natural blood volume, including platelets and other clotting factors.
• the use of vacuum extractor or forceps often causes bruising or internal bleeding, which uses up the baby's available clotting factors.
• the use of antibiotics inhibits the baby's generation of clotting factors.

What to do when you're overdue?
Since forever women all over the world have calculated the length of pregnancy as some time during the tenth cycle of the moon after the last menstruation. Amongst the Manus of New Guinea, little bundles of sticks are kept as moon counters. When ten bundles have been collected, the mother knows that her baby is ready to be born. In Malaysia, traditional midwives expect labor to begin when the woman's feet and ankles become cold, indicating that the body heat is moving towards the womb.
Jacqueline Vincent Priya, in her book 'Birth Traditions and Modern Pregnancy Care' says: "When I talked to pregnant women from traditional societies, their happy vagueness about when the birth was likely to take place always amused me. After my own experiences with modern doctors who provided a specific due date and started to worry if the baby hadn't arrived by that date, the relaxed attitude of these women was a tonic. They usually knew within a month or so as to when the baby might arrive and trusted their own internal knowledge and experience of the pregnancy as to when the birth would take place.
The following information has been produced to help you to be aware of some of the issues that may arise when pregnancy continues beyond the estimated due date, and to empower you for wise decision making. The EDD (estimated due date) has probably been in your mind since your first ante-natal checkup. It can be very disappointing and frustrating to find that you are still pregnant a week or more beyond this date. Added to the normal discomforts of the final weeks of pregnancy, you may very well feel fed up and desperate for labor to start. People around you may keep calling to find out if you have had the baby yet, and the hospital may be talking about booking a date to induce your labor. This can be a very vulnerable time. However you may not be genuinely 'overdue' at all, and unless there is an urgent medical problem, you can take your time to assess the situation and consider the options.
Induction of labor is a contentious subject. Most hospitals these days have a policy of routinely inducing between 40- 42 weeks. However this does not mean that induction is appropriate for everyone, nor does it address the other potential hazards, risks and consequences of routine induction policies. There are many doctors and midwives who are critical of routine induction policies and who prefer to follow a different approach. This involves assessing each woman who is 'overdue' individually and then deciding what would be best for her and her baby. The aim is to determine whether the pregnancy is normal or whether there are any signs of post maturity such as slowing of the baby’s heart rate or a very low amniotic fluid level and therefore cause for concern or possible intervention. An induction would only be preferred if the risk of the baby remaining in the uterus is considered greater than the risks associated with inducing. Sometimes, if the baby is thought to be at great risk, a caesarean section may be the preferable option. The decision making process should involve the parents and take their views into account. Legally you are not obliged to agree to an induction, whether or not it is hospital policy.
However if there are convincing signs of post maturity, if there is an existing medical or health problem or if you are having twins, where the risks of prolonged pregnancy are greater, it is best to follow the advice of your midwife or obstetrician. Other reasons to induce may include progressive high blood pressure or pre eclampsia, convincing indications of placental insufficiency and slow growth of the baby, significantly reduced amniotic fluid which is outside of the normal range, premature rupture of membranes with an extended period of no contractions (beyond 48 hours), or failure to progress in labor (this is called augmentation or acceleration of a labor which has already started).
Before deciding whether or not to induce labor the following can be considered: Estimated due date. The length of a normal pregnancy may be anywhere between 37-43 weeks and, very rarely, can even extend beyond this. If conception occurred later than the average estimate of day 14 of the menstrual cycle (with an irregular or longer menstrual cycle) this may be the reason that the baby is not yet ready for birth and labor hasn't started. Ultrasound scan estimates of the due date are approximate and are not always accurate. The usual method of estimating the average length of normal labor (nine months and one week since the first day of the last menstrual period) is known as Naegele's rule and was first established in the mid 19th century. There has been no satisfactory evaluation of this method and it has been shown that only around 5% of women go into labor on the EDD. It has also been shown that the results from obstetric 'wheels' made by different manufacturers used to calculate the length of pregnancy by this method is not consistent.
Research has shown that the average length of a first pregnancy may be 41 weeks and one day for many women with a 28 day cycle. Japanese and black women tend to have shorter pregnancies than white Americans. There is a wide range of variation in the length of a normal pregnancy. There is also a lot of controversy about the normal length of human gestation and therefore over the definition of post-term pregnancy. The normal length of gestation for babies is variable. Babies initiate labor themselves when their lungs are ready for breathing, by releasing hormones into the amniotic fluid. These are absorbed into the mother’s bloodstream and act as messengers to her brain. This kicks off the release of the hormone oxytocin which gets contractions going and starts labor. Being born too early may mean that maturation of the baby's lungs is not yet complete. That is why premature babies often need help to start breathing. If labor is induced when the dates are wrong the baby may be born prematurely and have problems breathing, possibly needing special care. If routine checks reveal no sign of anything abnormal in either mother or baby, then there is no pressing reason to intervene by inducing labor. Another option is to reassess the situation on a daily basis and to continue waiting for nature to take its course, provided there are no problems.
After 42 weeks, daily monitoring of the baby's heartbeat is recommended. This may necessitate a daily visit to the hospital and is the most reliable way to check the baby’s well being. A consistently satisfactory heartbeat indicates that the baby is getting enough oxygen and the placenta is functioning normally.
Take note of any encouraging signs that labor is imminent. These may include more frequent or mild contractions, a mucous discharge or 'show', unusual back pain, or feeling a bit 'spaced out'. Also don't worry if none of these are happening - not everyone experiences these changes prior to the onset of labor. Try to be patient, relax and take it easy without being unduly stressed or anxious. If there are no problems, then everything is on course and you will go into labor when your baby is ready. This is a great time to indulge in a pampering treat like a wonderful aromatherapy massage.
Natural Methods
Get some gentle exercise such as walking, swimming or doing yoga. Meditate and relax every day to stay in tune with your baby and your inner guidance. Acupuncture or reflexology combined with homoeopathy can be very effective in helping to get labor started. It's best to consult a specialized practitioner with experience in this area. Alternatively most complementary therapies can help to initiate labor, especially if you have already been having treatment during your pregnancy. Wait as long as possible and then try a glass of good organic wine one evening. Provided your membranes haven't broken you could try making love. There are natural prostaglandins in semen which soften the cervix, and nipple stimulation may also help to release oxytocin, the hormone that makes the uterus contract. Encouraging the bowel to empty often triggers the onset of labor. This can be done by eating a quality vegetarian curry or by the old fashioned (but effective) way of taking a dose of 50ml. of castor oil mixed with squeezed orange juice. Have another glass of fresh orange juice at hand to rinse your mouth with. Spit out to take away the oily taste and then drink the rest. This may make you feel a little uncomfortable and cause the bowel to empty within about three hours. Then luxuriate in a nice warm bath and have someone gently flush the warm water over your belly to help you relax. Drink three cups of organic raspberry leaf tea per day. This is a mild uterine tonic and stimulant.

Why breastfeed and why start right after birth….

World Breastfeeding Week (WBW) 2007 is encouraging breastfeeding in the first hour of life because research shows that early initiation and exclusive breastfeeding for six months can save lives. A 2006 study published in the journal Pediatrics suggested that 41 per cent of newborns that die in the first month of life could be saved if breastfed in the first hour of life. Colostrum is a sticky yellow-white substance yielded by the mother's breast soon after birth. It is rich in antibodies and essential nutrients. Giving newborns water or other liquids denies them a "good start in life" says the WHO, referring to the WHO Child Growth Standards and how babies fed colostrum within the first hour of being born measure up well against the standards. Breastfeeding in the first hour or so after birth also confers benefits to the mother, such as improved lactation and less loss of blood. This year, the theme "Breast Feeding the 1st Hour" is also linked with another phrase: "Welcome Baby Softly". The idea of this theme is to encourage health professionals to "protect" the first hour after birth and help mother and baby bond in a natural, uniterrupted way and maximise the chance the infant will latch onto the breast and stimulate lactation. President of the International Lactation Consultant Association (ILCA), Rebecca Mannel said that newborns are programmed to find the breast and will often find it by themselves when placed on the mother's chest, skin to skin. "In the early moments after birth, babies are in a quiet, alert state and ready to learn", said Mannel. "Babies use all five senses to explore that world. They use their eyes to memorize their mothers' faces, their ears to associate her voice with her face, and their sense of smell to guide them in finding the breast", she added. Newborns have a heightened sense of taste too, and this is particularly sensitive to the taste of breast milk. Mannel also said that "When mothers hold their babies skin-to-skin immediately after birth, their babies are kept warm, they regulate their heart, respiratory, and oxygen saturation rates, and they do not feel pain as acutely". Babies who have this experience cry less, and are calmer, she said.

The primary benefit of breast milk is nutritional. Human milk contains just the right amount of fatty acids, lactose, water, and amino acids for human digestion, brain development, and growth. Cow's milk contains a different type of protein than breast milk, human infants can have difficulty digesting it. Bottle-fed infants tend to be fatter than breast-fed infants, but not healthier.

Breast-fed babies have fewer illnesses because human milk transfers to the infant a mother's antibodies to disease. About 80 percent of the cells in breast milk are macrophages, cells that kill bacteria, fungi and viruses. Breast-fed babies are protected, in varying degrees, from a number of illnesses, including pneumonia, botulism, bronchitis, staphylococcal infections, influenza, ear infections, and German measles. Furthermore, mothers produce antibodies to whatever disease is present in their environment, making their milk custom-designed to fight the diseases their babies are exposed to as well.
A breast-fed baby's digestive tract contains large amounts of Lactobacillus bifidus, beneficial bacteria that prevent the growth of harmful organisms. Human milk straight from the breast is always sterile, never contaminated by polluted water or dirty bottles, which can also lead to diarrhea in the infant.
Human milk contains at least 100 ingredients not found in formula. No babies are allergic to their mother's milk, although they may have a reaction to something the mother eats. If she eliminates it from her diet, the problem resolves itself.
Sucking at the breast promotes good jaw development as well. It is harder work to get milk out of a breast than a bottle, and the exercise strengthens the jaws and encourages the growth of straight, healthy teeth. The baby at the breast also can control the flow of milk by sucking and stopping. With a bottle, the baby must constantly suck or react to the pressure of the nipple placed in the mouth.
Nursing may have psychological benefits for the infant as well, creating an early attachment between mother and child. At birth, infants see only 12 to 15 inches, the distance between a nursing baby and its mother's face. Studies have found that infants as young as 1 week prefer the smell of their own mother's milk. When nursing pads soaked with breast milk are placed in their cribs, they turn their faces toward the one that smells familiar.

Cascade of Intervention

Picture the following scenario. A first time mother is admitted to hospital in early labor. She is given a vaginal examination and gets an IV . She is attached to a CTG for continuous fetal monitoring. She will not be allowed to eat or drink. After a number of hours she is given a vaginal exam and it is found that she has not progressed significantly. According to active management she is then given a continuous infusion of oxytocin and her water gets broken. She will get another vaginal exam. Little or no progress. Because of the pain of the artificially induced contractions she requests an epidural. Because this renders her immobile and relaxes the muscles of the pelvic floor she is unable to use positioning and gravity to help the baby move down into a good position for birth. If she is fortunate, labor will progress normally and the baby will be born vaginally, although often with the assistance of vacuum. An episiotomy will most likely be cut. A common scenario however is that labor will not progress "normally" in accordance with the time limits. Fetal distress, as a result of the stronger oxytocin contractions, if often a concern by this stage. Cesarean is an all too common outcome.