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misc.kids.pregnancy General Pregnancy FAQ - Part 2 of 2

( Part1 - Part2 )
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Archive-name: misc-kids/pregnancy/general/part2
Posting-Frequency: monthly
Expires: Fri, 15 Nov 1996 00:00:00 GMT
Last-Modified: 1995/10/16

See reader questions & answers on this topic! - Help others by sharing your knowledge
These are mostly things which I saved off the net - if it is mine, it
will say so unless I happened to be one parent answering a question...

I will keep pulling what seem to be thorough articles off the net, and I
will also take submissions on any general pregnancy topic if people will
send them!  Send me all that great stuff you saved because you thought
it would make a good FAQ! 

-Sabrina
(ps.  Those who took the time to compile answers to a question or type
in info from a book will get credit unless they ask for their personal
onfo to be deleted;  answers to posted questions will have their personal
info deleted unless they ask for it to be included... This is for brevity!)

--------------------------
Index
--------------------------

Twins and More - Resources
Perineal Massage Instructions
Sling Patterns
Natural Ways to Bring On Labor
Pre-Eclampsia and Toxemia Prevention
Exercise In Pregnancy
Exercise Video Reviews
Help!  How Do I Sleep Comfortably?
Sciatica - Pain in Back or Down Legs
Drugs During Pregnancy

------------------------------------------------
Twins and More - Resources
------------------------------------------------

From:         Jezebel <jezebel@netcom.com>

Twins mailing list - To subscribe to the list, send e-mail to
twins-request@cup.hp.com. In the body of the message, write

subscribe twins <yourname@address>

The list is also available in digest form. Among other net resources,
there is a newsgroup called alt.parenting.twins-triplets. America Online 
users can participate in scheduled "live chats" for parents of multiples. 
For information on these, contact TWINMOM212@aol.com.
 
These are the books I have found most useful. Each of them includes an
extensive list of resources available to parents of multiples (the lists
in _Having Twins_ and _Mothering Twins_ even include a number of
international organizations). 

_Having Twins_ by Elizabeth Noble (some call it the "bible" of multiple
     pregnancy)
_Mothering Twins_ by Linda Albi, et al.
_Multiple Blessings_ by Betty Rothbart

If you have trouble finding any of these books, they can be ordered from 
a support organization called Twin Services, which offers many other 
publications, along with a counseling hotline and referrals.

Twin Services
PO Box 10066
Berkeley, CA 94709
Twinline: 510/524-0863

Other good support organizations:

Triplet Connection
PO Box 99571
Stockton, CA 95209
209/474-3073 or 474-0885

MOST (Mothers of Supertwins)
PO Box 951
Brentwood, NY 11717-0627
516/434-MOST

National Organization of Mothers of Twins Clubs
12404 Princess Jeane
NE Albuquerque, NM 87112-4640
505/275-0955

-----------------
From: louvet@irisa.fr (Pascale Louvet)

Try the Twins and Supertwins mailing list :  (see above for address...)

Topics of Discussion:
--------------------
This list is intended for discussion of *all* aspects of twins and 
supertwins (triplets, quadruplets,...).  Though a lot of the day-to-day
discussion revolves around survival strategies and equipment purchases
for new parents of twins and more, discussion of other topics is very
welcome.  If there is a topic pertaining to multiples that you'd like to
discuss here, please feel free to start a thread if there is not one
currently going on.  In particular, this list is also intended for adult
twins and supertwins to discuss issues about being a multiple -- there
*are* other adult twins and triplets on the list, they just don't pipe in
all that often.  Feel free to introduce yourself and start a discussion
of topics of interest to you.  (The new parents really appreciate being 
able to see things from the perspective of those of you who survived your 
childhoods as multiples relatively intact!)

Ftp Archive:
-----------
An ftp accessible archive of Twins list traffic is being maintained.
To gain ftp access, E-mail Bob Forde at foe@ornl.gov.  To obtain a
Who's Who on the list, use ftp and get the twins list directory (long)
or the twins list index (shorter).  To add your entry, send it to the
list with the subject "Roll Call" and you will be added.  If you do not
have ftp access, mail to Bob Forde at foe@ornl.gov and he will send you
whichever you request.

Bob has also added an archive of threads starting from April or May 1994.
These may be found in D:\public\twins\threads.  If you have a question
you suspect has been discussed here a million times before, you may want
to try there first.  However, in Bob's words: "I do NOT intend to
replace the folks on the list or squash new thoughts, just create a
rough FAQ library to start discussions."

Frequently Asked Questions (FAQ):
--------------------------------
Jean Dickey maintains and distributes a twins FAQ (list of frequently
asked questions, with answers).  It is available from her by email at
dickeyj@clemson.edu, or from the ftp site described above.

----------------------------------------
Perineal Massage Instructions
----------------------------------------

From: swnymph@remarque.berkeley.edu (Sabrina Cuddy)

>: Could someone please e-mail me the method for perineal massage?  We are
>: expecting in April and my wife had episiotomies with our first two.  Can
>: we please get some advise so she can perhaps avoid being cut this time?

Well, all these requests must mean nobody is sending anything, so I'll
try...  I have here an excellent 2-page pamphlet with pictures.  If you
really want to learn to do this, I suggest finding something similar
so you can really SEE it!  This one is from ICEA (International 
Childbirth Education Association) by Elise Fleming.  Write for copies
to: ICEA, PO BOX 20048, Minneapolis, MN 55420-0048, USA.

I also hate to be a pessimist, because perineal massage does help, as
do Kegel exercises and squatting during pregnancy, but once you have
had an episiotomy the scar tissue is more likely to tear than either
intact skin or scar tissue from a previous tear.

Anyway, here are the basics from this pamphlet:

Cautions:  Avoid the urinary opening to prevent UTI, and if you have
active herpes lesions, wait until they heal to avoid spreading the virus.

General Hints:  Use a mirror to find the vagina and perineum at first.
If you feel tense, take a warm bath or use a warm compress 5-10 min on
your perineum.

If you had an episiotomy before, concentrate part of the time on the scar
area to help it stretch.

Remember that upright positions for delivery (sitting, standing, squatting),
or side-lying reduce strain on the perineum.  Lying on your back with
feet in stirrups is most likely to get you an episiotomy.

After birth, do Kegel exercises to tone up the muscles which have stretched.

Directions:
Wash your hands.

Sit or lean back in a comfortable position.

Put a lubricant such as KY jelly, cocoa butter, vitamin E oil, or
vegetable oil on your thumbs and around your perineum.  If your body
produces enough natural lubricant, you can use that, too.

Place your thumbs 1-1 1/2 inches (3-4cm) inside your vagina (your
fingers fall against your buttocks).  Press downwards (towards your
anus) and to the sides at the same time.  Gently but firmly keep
stretching until you feel a slight burning, tingling, or stinging
sensation.

Hold the pressure steady at that point with your thumbs for about 2
minutes until the area becomes a little numb and you don't feel the
tingling as much.

Keep pressing with your thumbs.  Slowly and gently massage back and
forth over the lower half of your vagina, working lubricant into the
tissues.  Keep this up for 3-4 minutes.

As you massage, gently pull outwards on the lower part of the vagina
with your thumbs hooked inside.  This stretches the skin as the baby's
head will during birth.

Do this every day after the 34th week, and after a week you should 
notice an increase in flexibility and stretchiness.

If you can't reach or are uncomfortable doing this, your partner can
do it for you - using thumbs or index fingers, and being sensitive
to your feelings as well as your directions for more or less pressure.
------------------

From:         cyndi@nyet.atl.ga.us (Cynthia Hardie)

I couldn't find the instructions my midwife gave me for Perineal
Massage. I did find instructions in the Birth Partner by Penny Simkin. 

We did the massage about 5 weeks before my due date. I couldn't really do
this myself so had to depend on my hubby. My friend said that they were
able to use her thumb pushing down and doing a u pattern. These are only
guidelines, once you start you will get a pattern that works for you. We
tried to do this every day.

                      Perineal Massage  
                     ------------------
To start you will need vegetable oil, or water-soluble jelly. Baby oil
or mineral oil is very drying to the tissue. We poured the veggie oil
in a bowl and slightly warmed it.

Either partner can do the massage. Be sure to start with short
fingernails, and clean hands. Get in a semi-sitting position, with legs
bent and relaxed.

Rub the enough oil into the perineum (area between vagina and anus) to
allow your fingers to move easily over the tissue and lower vaginal
wall.

Use your index fingers. Start with one and progress to two. Place your
fingers well inside the expectant mother's vagina (up to the second
knuckle);Rotate them in opposite directions upward along the sides and 
lower boarder while pulling outward gently. Do this for three minutes.
This movement will stretch the vaginal tissue,the muscles surrounding
the vagina, and the skin of the perineum.

Finish the massage by rubbing the skin of the perineum between the
thumb and forefinger (thumb on outside,finger on inside) for about 1
minute. In the beginning, the tissue feels tight, but with time an
repeated massages it relaxes and stretches. The massage takes four to
five minutes.

Tell the expectant mother to concentrate on relaxing the perineum as
she feels the pressure. As she becomes more comfortable with the
massage, increase the pressure just enough to make the perineum begin
to sting from the stretching.  This same stinging sensation will occur
as the baby's head is being born.

Ask your midwife or OB if they have instructions. They may have tips or
suggestions. If this is you second <or more> baby, you need to give
extra attention to any scars from episotomies or tears.

This isn't something that you must do in order to avoid an episotomy but it
helps. Some people find that this massage isn't something they want to do.
My sister tried it but hated it, hopefully YMMV.

----------------------
Sling Patterns
----------------------

From: vg3@ee.wustl.edu (Vasudha Govindan)
Subject: Patterns for slings

Here are sling related posts I saved from misc.kids long time ago.
Hope you find them useful. There were other posts in this thread,
but I didnt save them all. I have removed the names and addresses
of the posters (not sure what the proper nettiquite is).

-Vasudha
--------------------------------------------------------------------

These are instructions for making a "tube sling." 

Use 36" wide material. Measure the diagonal distance from the point where
your left shoulder meets the arm, to the top of your right hip bone (on
the side of your body). Multiply this by two, and add a seam allowance (or
more if you like carrying your baby low) and sew it together. 

Some people have tried tying a knot too, but that can be less comfortable.
If you're creative, you could also figure out how to use metal rings and
make it adjustable, like the store-bought kind. Remember also, this is a
YMMV thing. Try basting the seam first to see if it's the right fit before
sewing it together. Or use a folded bedsheet pinned together to determine
how much fabric you need before going out and buying it. 

By the way, this idea comes from a booklet called "Outside Wombs"  by
Christina Otterstrom-Cedar. She also has instructions for making other
wrap-around slings, and diagrams and photos for how to use the slings in a
wide variety of positions. You can order the booklet by sending $5.00 (US
or Cdn) to Box 82, Eagle Bay, BC, Canada, V0E 1T0. (I have no connection
to this person, nor do I stand to benefit from telling you about this. I
just bought the book when I saw someone wearing a home-made sling that
looked so comfortable and un-bulky, with such a happy baby inside :))
----------------------------------

I bought a pattern for a baby sling, but haven't had time to sew it
yet. In the meantime, my husband and I have been using a piece a 45"
wide fabric tied with a square knot. That works reasonably well for us,
but we look forward to the shoulder padding of the "real" sling, and
being able to adjust it, too. (Not to mention getting rid of that knot
in the middle of our backs.)

I got the pattern through the mail from:

ASA inspirations
P.O. Box 11683
Champaign, IL 61826.

It cost $6.95 (p/h included).


-----------------------------------
Natural Ways to Bring On Labor
-----------------------------------

From: tcramer@iquest.net (Tracy Cramer)

I know how you feel because I was overdue with the newest boss of the
house just 8 short weeks ago. 12 LONG days overdue! I also posted a
plea for suggestions....

* Castor oil isn't generally a good idea, so avoid it if you can.

* Raspberry Leaf Tea tones the uterus & may help

* I took Black Cohosh capsules which were recommended in a book I found
at the local health food store.

* Accupressure - on right foot between the inside ankle bone & achilles
tendon.

* Spicy food

I took the Black Cohosh capsules for 3 days before Austin was born. I
did the accupressure several times a day.

I also listened to classical music while talking to my belly - I told
the baby it was time to be born because we were ready for him while
rubbing my belly. (I know it sounds dumb, but I was pretty desperate!)

The evening I had him, I had Kentucky Fried Chicken for dinner. With
the chicken I had fries that I dumped hot sauce on. I told my husband I
was going to make the kid so miserable in there, he'd want to leave.

I don't know what worked but I think actively trying to stimulate labor
also works psychologically. Because you are doing something
"constructive" rather than sitting around worrying about labor
starting, your mind thinks "hey, she's really serious! Maybe it's
time!" This is just a theory though :)
----------------------

From: LEJL36B@prodigy.com (Sheryl Angeloni)

Please be careful with your efforts to induce labor.  Nipple stim
produces oxytocin which is the natural form of pitocin used medically
to induce labor.  Ideally you should be monitored to be sure you aren't
stressing your baby with too much oxytocin.  Just be patient.  Let you
baby decide when he (or she) is ready to join the world.

Sheryl, OB nurse and been there 5 times myself

----------------------------------
Pre-Eclampsia/Toxemia
----------------------------------

From: Linda Franz <lfranz@lookout.ecte.uswc.uswest.com>

The following information about pre-eclampsia (whose symptoms include
protein in the urine), is taken from information found in my ALACE 
(formerly Informed Birth and Parenting) Childbirth Education manual.

Pre-eclampsia (also called toxemia and eclampsia and the newest
moniker, PIH, or pregnancy induced hypertension) can be a serious
complication of pregnancy, but often contradictory things are said
about it. Doctors still don't really know what causes this complication
of pregnancy characterized by extreme swelling of the limbs, protein in
the urine, and elevated blood pressure.

Dr. Tom Brewer, working very pragmatically with inner-city women in
Richmond, CA, found that by increasing their protein intake, he was able
to lower the toxemia rate from something like 17% to .5%.  He then
tried to develop an explanation for why this was successful.  His idea
is that metabolic toxemia of late pregnancy (MTLP) is the manifestation
of a liver malfunction caused by malnutrition.  The increased blood
volume needed for a healthy pregnancy requires extra albumen, a protein
that also keeps water in circulation in the blood.  Without an adequate
diet, the liver cannot make enough albumen and water leaks into the
tissues, the blood volume falls, and the placenta function decreases.
The woman appears puffy and has a sudden weight gain with this extra
fluid.  Blood pressure rises to try to maintain adequate blood flow and
the woman may develop headaches, dizziness, or fainting.  The kidneys
try to absorb fluid, and shut down completely if the blood volume is
critcally low.   Protein appears in the urine because the tissues in
the body begin metabolizing themselves since the liver has been
overstressed in many of its functions, such as making protein.  Some of
the protein that the tissues use when they break down to provide for
the woman'sprotein needs is excreted in the urine.

PREVENTATIVE TREATMENT, therefore, involves good nutrition counseling,
and insuring that pregnant women receive ADEQUATE PROTEIN (75-100
gms/day) and ESSENTIAL VITAMINS AND MINERALS FROM THEIR DIET.  If
toxemia does develop, the pregnant mother should EAT A HIGH PROTEIN
DIET (120 gms a day), SALT HER FOOD TO TASTE, REMAIN ACTIVE, and take
antibiotics to reduce the load on her liver.  In severe cases, she
should be given human serum albumen in the hospital.

Many of the symptoms of MTLP are also associated with other problems 
in pregnancy and health, so a careful diagnosis should be done to 
determine if a woman with these symptoms actually does have toxemia. 

For more information, read "What Every Pregnant Woman Should Know: 
The Truth About Diet and Drugs in Pregnancy" by Gail Brewer and Tom 
Brewer, MD  (NY: Random House).  

I'm not sure if Brewer's work is being recognized by the medical
establishment, or not.  Perhaps suggesting this book to your OB/midwife
would be helpful if You find the information in this book useful.  Some
midwives have taken up the practical aspects of his work, and not only
prevent toxemia, but have seen beginning symptoms turn around
dramatically when they are caught early enough.

I can also e-mail to anyone who's interested a specific set of 
recommendations for anyone noting one or more of the warning signs 
of PIH.  The regimen was developed by a midwife, who's seen 
dramatic results with women who have followed it, often within
three days.

----------------------------------------
Exercise in Pregnancy (including Kegels)
----------------------------------------

From:         fitfor2@netdepot.com (Lisa Stone)

1.  Listen to your body.  If something feels uncomfortable or painful,
don't do it.

2.  Avoid any exercise while lying on the back after the first
trimester.  This position can cause the growing uterus to restrict
blood return through the vena cava which lies directly behind the
abdomen.

3.  Drink plenty of water before, during, and after exercise.  You need
to stay well-hydrated to regulate both your body temperature and your
growing baby's.

4.  Exercise in a well-ventilated area and wear loose-fitting,
breathable clothing to prevent over-heating.

5.  Be aware of your changing center of gravity.  Avoid any activity
that involves sudden directional changes or that risks even mild
abdominal trauma such as downhill skiing, rollerblading, horseback
riding, etc.

6.  Exercise regularly, preferably 20-30 minutes a day at least 3 times
per week.  Regular exercise will reduce the chance of injury and will
help keep you in shape for "Labor Day."

7.  Perhaps the most important thing you can do is to exercise the
Kegel or pelvic floor muscle daily to prevent urinary incontinence and
uterine prolapse, and to enhance sexual pleasure.  Practice this
exercise by stopping and starting the flow of urine.  Once you have the
hang of it, do not continue to perform the Kegel exercise while
urinating, but rather perform the exercise while driving in the car or
talking on the phone.  Try to do at least 100 every day.

8.  Pelvic Rocking is very good for the back and belly muscles - make
sure to do these in a slow and controlled manner to avoid injury, and
they can be valuable!  Carefully let your belly sag towards the floor
by tilting your pelvis forward - do not do this very far down, just
a small tilt, then back to neutral, pulling the abdominal muscles in
as you pull your back up.  Do 20-40 at a session 4 times a day, and
work up to 80 at bedtime.  These exercises help keep baby from being
in a posterior position and improve circulation to the lower body.
The circulation benefit will be enhanced by lying down for at least 10
minutes after exercising.  (this paragraph added by Sabrina after
consulting with Lisa!)

---------------------------------------------------
Exercise Videos In Pregnancy - Reviews From The Net
(more reviews are always welcome!)
---------------------------------------------------

>Does anyone have recommendations for a workout video for my wife?  She
>Does anyone have recommendations for a workout video for my wife?  She
>is 5.5 months along, feels great, and is looking for something to
>replace her former workout routine (which had some high-impact in it).
>
>Someone mentioned the Kathy Smith tape... has anyone tried this or any
>others?

I am an exercise video addict and I loved the Kathy Smith pregnancy
video.  It was a little easy on days that you're feeling full of energy
and not too big.  On those days I would sometimes go back and do some
of my regular low impact/step tapes.  I also had a pregnancy step video
that I liked a lot - something like Steppin thru Pregnancy.  I believe
there is also a fitness consultant who posts here who has a pregnancy
step video - I'm going to look for that one this time around.
-----------------

I did the Kathy Smith tape at the end of my pregnancy as until about 7
months its was too mild. Even then its a little mild, depending on the
level you are used to . I used a lot of my old high impact tapes for
step and regular aerobics and just toned them down to meet my energy
levels. Brisk walks were good too.  
--------------

I have been using the Kathy Smith Pregnancy Workout video since I 
was 3 months and find it quite beneficial. I was never an 
exercise fanatic, but find doing it three times a week makes me 
sleep better, and I believe has curbed my weight gain(not that 
I'm obsessing about weight during pregnancy). Exercise is always 
a good thing!
------------

I like the Fit For 2 video.  I found it more challenging than the Kathy
Smith tape, but not as strenuous as my non-pregnancy tapes.  It also
talks about the guidelines for exercise during pregnancy, so when I go
to a class at the gym, I can modify it to make it safe for me (a great
thing since the instructors at the club don't seem to know what to do
with a pregnant woman!).  I especially like the ab workout and the
relaxation part at the end.  Lisa Stone (the instructor) is so
energetic and the music is very upbeat (great after a long day at work)
and the choreography is straightforward and fun.  I know Lisa Stone
posts here pretty regularly, so maybe you can find out from her how to
get the tape.

---------------
Hi all!  I've been commissioned to conduct an informal survey on 
pregnancy workout videos so that Sabrina Cuddy can put the info into a 
FAQ.  Please rate the following tapes on intensity of the workout, 
music, choreography, the instructor, other info contained on the tape, 
etc.  You can post to the group or email me directly, and I'll forward 
everything to Sabrina.  Thanks in advance!  BTW, please be candid in 
your reviews, including the Fit For 2 video, because Sabrina wants to 
put together a non-biased FAQ for you.  I won't take it too personally! 

1.  Kathy Smith's Pregnancy Program
2.  Denise Austin's Pregnancy Plus
3.  Jane Fonda's Pregnancy Workout
4.  Pre & Postnatal Yoga
5.  Stepping Through Pregnancy
6.  Marie Osmond's Pregnancy Workout
7.  Dr. Debra Levinson's Workout For Pregnancy and Recovery
8.  ACOG's Pregnancy Workout
9.  Buns of Steel 8:  Pregnancy Workout
10. Fit For 2 Step Aerobic Workout For Pregnancy
11. Any others that I inadvertantly omitted

Lisa :)
-- 
ACE-certified pre- & post-natal fitness specialist
Founder, Fit For 2 Pre- & Post-Natal Fitness (Atlanta, GA)
Producer, Fit For 2 Step Aerobic Workout For Pregnancy video
          (http://www.nav.com/mainstreet/fitfor2.htm)
-------------------------

1.  Kathy Smith's Pregnancy Program

Do you have a year that this was produced?  I tried using a Kathy Smith 
pregnancy tape when I was last pregnant in 1993, and it was ridiculous.

The low impact workout was not long enough or intense enough to
accomplish anything, and the leg work was done standing up, leaning on
a chair.  This is a ridiculous position for anyone who is very
pregnant--you can accomplish a lot of the same stuff lying on the floor
on your side, without risk of falling over (and leg exercises are a
MUST for me because I have a tendency to get cramps if I don't keep
them up.)

I also tried the Jane Fonda tape and wasn't very impressed with that
either.  I ended up using my Homestretch tapes (she does explain
modifications for pregnancy on some of them.)
-------------------------

I have only done the Kathy Smith Pregnancy Video.  It was an OK
pick-me-up, especially on the days that I was really tired but it was
not what I would call a real "workout".  I was used to doing 30 minutes
on the stairmaaster and 30 minutes on the treadmill then nautilus and
free weights- or STEP.  The music was pretty silly and I got so bored
that I never made it through the toning exercises.  I was a little
surprised because I have both of her STEP tapes and really like them
compared to other STEP tapes on the market.
-------------------------

I like the Kathy Smith tape. I was a low-impacter pre-pregnancy, so I
didn't have to modify much of the routine to fit my comfort level.

Granted, I don't find it REAL challenging compared to what I did
before, but at least it gets me up and going and revitalized enough to
get through the rest of the evening.

I don't find the legwork any problem yet (at 24 weeks). I like the abs
workout. The upper-body work is not very challenging, even when I
modify it with light weights and more reps. The stretching is pretty
good and the relaxation section is educational for those who have never
learned to do it. I haven't even looked at the post-preg exercises yet.
The beginning part on the virtues of exercise is a waste of time, but
the starting-out tips were helpful and I still review them
occasionally.

Overall, I'd say it's pretty good and gets me more motivated to
exercise than trying to walk an hour in 90-degree weather (in Tucson,
Ariz. and that's at 5:30 p.m.!)

I haven't looked at the other tapes.
-----------------------------

Don't know if this will help or not, but in the Spring 1995 issue of Shape
Magazines "Fit Pregnancy", 9 videos were rated by the editors (?, I assume).
Here they are...

Rating ***** (best) to (*) worst.  I will type in some (but probably
not all of the comments they included in the rating).  If anyone wants
more info about a particular video, let me know.

Buns and Abs of Steel 9:  Post Pregnancy Workout   *****
  Recovering from childbirth herself, Madeleine Lewis gives new mothers a 
  winning workout.  A gently-yet-effective program for returning to 
  pre-pregnancy shape, this video contains three progressive, 10-minute
  routines.  You can start the first one almost immediately after delivery,
  even if you've had a C-section.

Buns of Steel * - Pregnancy Workout   ****1/2
  Madeleine Lewis, one of the best choreographers in the business, lives up
  to her reputation with this solid aerobics workout.  Excellent cuing,
  easy-to-follow moves and signature Buns of Steel lower-body toning make
  this a first-rate video.

Denise Austin's Prepregnancy Plus Workout  ****
  Austin is as effervescent and energetic as ever, and she presents good 
  information on pregnancy from medical experts.  The first 30 minutes of this
  video show low-impact aerobics and abdominal work adapted for expectant
  moms.  Then there are 20 minutes of a more intense postnatal workout.  
  Easy-to-follow, simple dance style.

Dr. Debra Levinson's Exercises for Pregnancy and Recovery  **
  Debra Levinson, D.C., demonstrates stretching, breathing and variations of 
  simple yoga poses.  The exercises are not difficult, but modifications for
  pregnancy are not shown and some exercises, unless adapted, may stress a
  pregnant woman's back and neck.

Fit for 2 Step Aerobic Workout for Pregnancy  *
  Even seasoned exercisers need to be wary of the speed and intensity of this
  tape.  It's a high-intensity workout for the very active.  Choreographer
  Lisa Stone should review the pregnancy exercise guidelines that she states
  so well at the beginning.  Stone, not pregnant herself, enthusiastically
  leads the workout, but the expectant women behind her are having a tough
  time keeping up.  She reminds everyone to "hold their abs in tight," a
  difficult feat for those in their second or third trimesters.  Stone
  teaches without consideration for the pregnant viewer.

Kathy Smith's Pregnancy Workout  *****
  Filmed in 1989 during Smith's first pregnancy, this is still the best pre-
  and psotnatal tape on the market.  An excellent total-body workout with
  lots of modifications; includes low-impact aerobics and toning.  Graphics
  are explicit, the pace perfect.  Includes informational insert.

Miracle of Life Pregnancy Workout  ***
  This creative, moderate-intensity, Latin-flavored, low-impact workout
  includes upper-and lower-body toning and relaxation.  Gloria Quinlan cues
  the moves but gives little information and few modifications during the
  workout.  Those accustomed to low-impact workouts shouldn't hae a
  problem with the lack of instruction.  Available in Spanish.

MomJam  ****1/2
  Former National Aerobics Champ Tyla Reich was expecting when she led this
  lively, simple-to-follow 84-minute tape.  Her perkiness is matched by that
  of her pregnant co-stars, actresses Mimi Rogers, Cassandra ("Elvira") 
  Peterson and Sheryl Lee Ralph.  They may have been forced to mouth 
  saccharine-cute lines, but his is no wimpy workout.  The aerobics session 
  uses some complicated arm-and-leg combos, and the groans during the 
  strength training (with Dynabands) are genuine enough.  The workout ends 
  with a soothing
  guided relaxation and stretch.

Steppin' Babies  *
  If you can follow this tape - een without a baby in your arms - you are
  WOnderWoman.  Instructor Laura J.S. Brown is convinced that holding baby
  while you step your way back to fitness is better than leaving the infant
  with a sitter, but she demonstrates poor stepping technique and gives
  inadequate instruction.  You'll find it difficult to follow the video and
  adjust your newborn without tripping - especially since the camera angles
  don't always give a good view of the moves.  Choreography is typical of a
  step class at the high-intermediate level, not what you would expect for
  exercisers recovering from childbirth.  The pivots, lunges, repeaters and
  quick changes are inappropiate while holding a baby in your arms.

Finally, done - gotta get back to work!!  I did type the entire article
in after all as it seems to have a lot of good information.  Once again, 
this was a rating done in the Shape magazine Fit Pregnancy, Spring 1995.
Hope it helps...

Kirsten (werne@bedford.progress.com)
PS  The opinions are Shape Magazines, the typos are mine!
--------------------------------

>Don't know if this will help or not, but in the Spring 1995 issue of Shape
>Magazines "Fit Pregnancy", 9 videos were rated by the editors (?, I 
assume).
>Rating ***** (best) to (*) worst.  
>
>Fit for 2 Step Aerobic Workout for Pregnancy  *

I guess this review is going to continue to haunt me for a while :(  If
anyone is basing their video choices on this review, please email me
and give me the opportunity to state my case (thanks to those of you
who already have!).  There are always at least 2 sides to every issue,
after all!  BTW, the Fit For 2 video was one of only 2 featured on
NBC's Today Show in a segment on exercise during pregnancy.

Lisa :) (fitfor2@netdepot.com)

P.S.  The Shape review was written by one woman (not an editor) who just so 
happens to have been involved in the production of 3 of the videos which 
received top honors (the two Buns of Steel tapes and the MomJam tape).  
Unbiased?  You decide! 
-------------------------------

The Fit for 2 Step Aerobic Workout for Pregnancy video is the best I have
seen.  Lisa is enthusiastic, knowledgable and supportive.  I use it at
home without a step and still get a great workout.  It is nice to learn
about the ACOG guidelines and realize that Lisa is following the most
recent information they provide.  It helped get back into shape after our
son was born also.  
-------------------------------

I belong to a health club that I use for aerobics and weights.  I have
also used quite a few of Kathy Smith's videos over the years so when I
became pregnant, I bought hers.  I am very disappointed.  The intensity
is light (with no tips to increase it.)   The choreography is choppy
and below par what I expect from a KS video.  The transitions between
steps are akward.

I especially hate the break in the KS video where the women put on
sunglasses and stand around singing a rap song.  I didn't think it was
"cute" the first time I saw it.  I can't FF fast enough every time!

Sorry to unload, I was expecting to get a good workout and feel
disappointed.  (Maybe it will be just right immediately post- partum.)
-------------------------------

I also have the Fit for 2 video and like it. I've never done any of the
other pregnancy tapes, but if the review says Fit for 2 is too intense,
I definetely wouldn't buy any of the others! I really don't think it's
too intense and I have no trouble doing it.
-------------------------------

I used #10, the Buns of Steel 8: Pregnancy Workout.  It was OK, in my
opinion.  It certainly got my heart rate up, but it was actually kind
of boring.  I attributed it to the instructor's enthusiasm and the low
level of difficulty of the exercises.  Also, the instructor was kind of
awkward, like she hadn't had much experience doing exercise videos.
The music was alright, and other info supplied by the instructor was
good but not news to me.

I used #1, Kathy Smith's pregnancy workout a few times.  I checked it
out from a local library.  I liked it a lot - it flowed better than the
Buns of Steel video, and the instructor kept me interested.  Music was
a bit peppier too, and choreography was more professionally done.

That's about all I can remember - it's been about 8 months since I used
either video!

---------------------------------
Help! How do I Sleep Comfortably?
---------------------------------

This is a common question because we have all heard that it is best
to sleep on our left sides.  The reason is that the vena cava, a
large vein which returns blood from the legs to the uterus, runs
along the right side of the spine.  Blood flow may be improved by
staying off the back or lying on the left side.

Low blood pressure symptoms, such as dizziness and nausea may result
from lying on your back after the first trimester.  If they don't, you
are probably fine!  Back pain may also result from sleeping on your
back, because of the weight of your uterus.

Here are some suggestions from the net:

> I almost always sleep on my back.  My doctor said not to worry about
> it because if I were compressing an artery, there would be symptoms
> (like legs getting numb) that would warn me to roll over.  I do,
> however, sleep propped up on pillows because I usually read myself to
> sleep in a semi-sitting position, so I'm not really flat on my back.

I sleep on my back and both sides as well.  I haven't gained that much
weight and am at 21 weeks, so I figure the back-sleeping position is
still OK, and I would feel something bad if it wasn't.  I have heard
that the left side is "best," so I try to use that as much as possible
- with a pillow between my knees.  However, now I've been getting a
cramp in my left leg which makes it uncomfortable to sleep on that
side!

I say, doing whatever is most comfortable for you is probably best.

-------------------
>Are there any other back sleepers out there?
>I have always preferred to sleep on my back, and I can't 
>seem to get comfortable on my side. I have beend sleeping
>with a pillow between my legs, and it helps somewhat, but
>my shoulder always feels like it's in the way.

Hi!  I was a back & side-sleeper before getting pregnant.  I now try to
limit myself to largely sleeping on my left side, as suggested as being
the good thing to do for my baby & my body.  I do miss sleeping on my
back but have found that sleeping on my left side with the aid of a
body pillow has really helped me to sleep comfortably.

I'd recommend that you try a body pillow.  I bought mind from a
bed/bath speciality shop.  They carried both down-filled and
polyester-filled pillows.  I thought I'd prefer the down but the poly
pillow was actually softer and squishier so I opted for it.  BTW, it
was around $20 and came with a pillow case.

--------------------
The answer is pillows! Prop her up. I sleep with one leg hooked over a
pillow, a pillow cushioning my belly and a pillow behind my back,
supporting it. also, a pillow under my head. It all gets a little
annoying when you have to get up four times in the night to go to the
bathroom, but it's worth it, and I've slept pretty comfortably. These
are big, firm King-sized pillows bought especially for this purpose.
Good luck!

---------------------
> Are there any other back sleepers out there?
> I have always preferred to sleep on my back, and I can't 
> seem to get comfortable on my side. I have beend sleeping
> with a pillow between my legs, and it helps somewhat, but
> my shoulder always feels like it's in the way.
> Any suggestions? Please!  :)

One easy one for the shoulder thing, try putting your regular pillow on
between your shoulder and your head; it makes the shoulder less
noticable.  I have seen, but have not ordered, a pillow in the Speigel
catalog called the prega-puff that is really two pillows (fairly small)
velcroed (so theyr'e adjustable together, you sleep between the two and
they support you from both sides.

-------------------------------------------
Sciatica - Nerve Pain in Back or Down Legs
--------------------------------------------

From: "Corrine R. Johnson" <JohnsonC@calvertgroup.com>

The book I grabbed "Your Pregnancy Week-by-Week --
by Glade B. Curtis" -- had this to say about:

			Sciatic-Nerve Pain

Many women experience an occasional excruciating pain in their buttocks
and down the back or side of their legs as pregnancy progresses.  This
is called sciatic-nerve pain because the sciatic nerve runs behind the
uterus in the pelvis to the legs.  Pain is believed to be caused by
pressure on the nerve from the growing and expanding uterus.

The best treatment for the pain is to lie on your opposite side.  This
helps relieve the pressure on the nerve.

----------------------------------------------
Drugs and Pregnancy (includes smoking/alcohol)
----------------------------------------------

From: "Corrine R. Johnson" <JohnsonC@calvertgroup.com>

			  WHAT CAN I TAKE?
		   by Bruce D. Shephard, M.D.
	   Baby Talk, America's First Baby Magazine
			    August 1995

>From Antacids to Tranquilizers, and everything in between, here's
what does and doesn't mix with pregnancy.

When you're pregnant, you worry about everything, from the foods you
eat to the medications you take.  When it comes to using drugs --
prescription or over-the-counter medications, even alcohol and
cigarettes -- doctors urge pregnant women to use extreme caution.  With
good reason.

In the 1950s. the drug thalidomide, used widely as a sedative, was
found to cause serious limb deformities in thousands of babies --
approximately one-third of the babies exposed to it during early
pregnancy.  As a result of this tragedy, Congress in 1962 passed new
laws requiring all drugs to be proven safe for anyone -- including
pregnant women.

Despite the thalidomide lesson, however, many pregnant women still
exhibit a certain casualness about taking medications during
pregnancy.  Many feel that because a drug is readily available, either
through prescription or over the counter, it must be safe for them to
use.  But using any drug while you're pregnant requires careful
consideration -- and discussion with your doctor.  Many drugs can be
subtle in their effects, causing minor anomalies instead of a major
defect.  Other drugs' effects may be long-term, causing problems in an
child that don't develop until adolescence or even later.  The truth is
that most birth defects have no single identifiable cause, but instead
are linked to a combination of genetic or environmental factors.  But
the use -- or misuse -- of drugs in pregnancy is one contributing
factor that can be easily be avoided.

			The Danger Period

In earlier days, doctors believed that the placenta acted as a
"barrier" to dangerous agents, protecting the fetus from anything its
mother was exposed to.  Now we know that most drugs easily cross the
placenta and reach the fetus.

Drugs or other agents that pass through the placenta to affect the
fetal environment are called environmental factors.  And environmental
factors that have been lined definitively to birth defects are called
teratogens.  Besides drugs, other known teratogens are heavy metals
(like lead) and certain chemicals to which a pregnant woman may
inadvertently expose herself ad her unborn baby.

Most fetal organ formation occurs during the first three months of
pregnancy, thus making the first trimester the most dangerous time for
exposing an unborn baby to teratogens.  The teratogenic period -- the
time when birth defects caused by environmental factors are most likely
to occur -- is the period from two to eight weeks of fetal development.
(If an embryo is exposed to a teratogen in the first two weeks of the
first trimester, it usually causes an "all or none" effect -- meaning
the pregnancy will end in miscarriage or the fetus will be unaffected.)

But fetal development continues beyond the first trimester, and the
developing baby remains vulnerable.  The female genital system, for
instance, does not completely form until well into the fifth month, and
the brain continues its development throughout pregnancy.  Therefore,
damage tot he fetus's biochemistry and physiology may occur in the
second half of pregnancy.  For example, the antibiotic tetracycline may
impair bone development when exposure occurs after the 20th week of
pregnancy.  And the drug Coumadin, which acts as a blood thinner in the
adult, may cause internal bleeding in the fetus in the last half of
pregnancy -- and can linger to cause this in the baby after birth.
Likewise, tranquilizers and other drugs affecting the central nervous
system may cause lethargy or decreased sucking in a newborn, or may
have a more delayed impact in the form of subtle behavioral changes
that appear later on in childhood.

The risk to a fetus from exposure to drugs is especially high during
the period between conception and the time a woman realizes she's
pregnant.  During those weeks, a woman may take over-the-counter and
even recreational drugs without knowing she's putting her baby in
danger.

Many pregnant women may think of over-the-counter drugs as harmless
because these medications are available with a prescription.  Even
after pregnancy is diagnosed, most western countries tend to support
the concept of using these medications to alleviate pregnancy
discomforts and symptoms as a relatively harmless practice.  However,
some over-the-counter drugs can cause problems for an unborn baby.
(For a list of over--the-counter drugs that are generally considered
safe for pregnant women, see attachment at the end of article.)

			A Rational Approach

How do you decide which drugs -- if any -- are safe to use while you're
pregnant?  We know a limited amount about the effects of drugs on
unborn babies, so it only makes sense to take the most cautious
approach.  The following points may help you make an informed decision
about using prescription and non prescription drugs, both before and
during pregnancy:

	o Avoid using any drugs (prescription, non prescription or
	   recreational drugs, including alcohol) when you're trying to
	   conceive.

	o Don't use any medication when you're pregnant,
	   especially in the first three months, unless it has been
	   prescribed by your doctor specifically for use during
	   pregnancy.  If you're having pregnancy-related discomforts,
	   use non drug remedies.  For example, morning sickness may be
	   relived by changing your diet, reducing stress or limiting
	   your activity.  Ask your doctor for suggestions.

	o If you and your doctor determine that you must use a
	   medication, choose its least potent form when ever
	   possible.  For example, when you need a decongestant, choose
	   one in an inhaler form, which delivers less medication than
	   a tablet.

	o Get information about any drug that you take.  Know the
	   drug's benefits and risks, as well as alternatives you can
	   use.  Ask your doctor thorough questions, read all leaflets
	   that come with the medication, and look for a Teratogen
	   Information Service (TIS) in your community (many are
	   affiliated with a hospital or university).  A TIS tracks
	   available information on a variety of environmental factors,
	   including drugs.

	o Be open with your health care provider.  This is imperative,
	   both for your health and your baby's.  Talking to your
	   doctor will not only help her spot any potential trouble,
	   but the information she provides can give you peace of
	   mind.  For example, many women who become pregnant while
	   taking oral contraceptives worry about possible birth
	   defects.  However, recent studies have disputed any link
	   between birth control pills and birth defects, a reassuring
	   fact for the hundreds of young women who conceive on the
	   Pill every year.  Your doctor can help you assess you own
	   situation.

			Substance Abuse

Substance abuse is never healthy for you, and when you're pregnant, it
can have devastating effects on your baby.  During pregnancy, dangerous
drugs can include things that, while not exactly healthy, might be
considered acceptable in many circles: cigarettes, alcoholic beverages
or even illegal drugs.  Most of these agents can be harmful to the
woman who uses them -- and they also readily cross the placenta and
reach the fetus, where they can cause serious problems.  For example,
alcohol consumption while pregnant can produce fetal alcohol syndrome,
perhaps the most well-known syndrome of birth defects associated with
drug abuse (see The Dangers of Drinking below).  In other cases, many
of these substances cause nutritional deficiencies and fetal growth
problems, rather than outright birth defects.

Here is a list of some of the more common illicit drugs -- and their
effects on an unborn baby:

	o Marijuana has been linked to birth defects in studies on
	   animals.  Many babies born to women who smoked marijuana
	   while they were pregnant exhibit problems such as impaired
	   fetal growth.

	o Narcotics like heroin can cause preterm labor, growth
	   problems and a fetal syndrome of narcotic withdrawal
	   following birth.  The incidence of sudden infant syndrome
	   (SIDS) is ten times greater among infants whose mothers used
	   narcotics while they were pregnant.

	o Cocaine use is associated with contractions of
	   the uterus, which may lead to preterm labor or bleeding
	   complications.  The drug has been linked to birth defects
	   (with incidence rates as high as one in ten among babies
	   whose mothers used the drug), as well as miscarriage,
	   stillbirth and growth retardation.

	o Amphetamines have been linked to heart defects
	   in babies born to women who used them.  Not just a street
	   drug, amphetamines are the main ingredient in many
	   over-the-counter diet pills.

	o Some tranquilizers, such as Valium, have been
	   associated with birth defects.  Also, heavy use in pregnancy
	   has been linked to an infant withdrawal syndrome after
	   birth, which has symptoms including low muscle tone,
	   irritability and an impaired ability to regulate body
	   temperature.

			The Dangers of Drinking

Fetal alcohol syndrome (FAS) is a distinct pattern of physical and
mental abnormalities that shows up in infants born to women who drank
during their pregnancies.  Its symptoms include some or all of the
following: low birth weight, poor coordination, facial deformities,
heart defects, hyperactivity and mental retardation.  The complete
syndrome occurs in roughly one or two out of every 1,000 births.

FAS ranks with Down syndrome and spina bifida as a major cause of
mental retardation.  Because a fetus can't metabolize alcohol as
quickly as an adult can, alcohol remains in a unborn baby's system
longer than it does in the mother's.  Doctors don't know how much
alcohol it takes to cause any of the FAS symptoms, so we recommend that
women abstain from alcohol throughout pregnancy.  In addition, women
trying to conceive are advised to avoid drinking alcohol.  Mothers who
breastfeed also should avoid alcohol, as a woman's body passes along
the same level of alcohol in her milk as she has in her own system.

			Smoking & Pregnancy

While it may not generally be considered a drug, cigarette smoke
contains several chemicals, as well as the drug nicotine.  Smoking has
been described as the most common "known harmful exposure" in
pregnancy, and it imposes serious risks to both mother and baby.  Fetal
and infant mortality rates are increased by over 50 percent in
first-time mothers who smoke more than one pack per day during
pregnancy.  Cigarette smoking can slow fetal growth and increase the
risk of low birth weight, stillbirth and a host of maternal
complications.

Smoking reduces a fetus's oxygen supply by as much as 50 percent,
because the carbon monoxide in cigarette smoke displaces oxygen in the
mother's bloodstream.  Babies born to smoking mothers also have highest
rates of SIDS and pneumonia.  But cigarettes can be dangerous for a
fetus even if the mother is not a smoker -- some studies have found
evidence of nicotine in babies born to women who were exposed to
passive cigarette smoke while they were pregnant.  The relationship
between smoking and birth defects is unclear.  Some studies show an
increased risk of neural tube defects (like spina bifida), cleft palate
and heart defects.

While you're pregnant, your blood carries nutrients -- as well as any
other substances to which you've been exposed -- to the developing
fetus.  Taking the cautious approach about any over-the-counter or
prescription medications, and avoid during drugs like nicotine and
alcohol, will help you protect your baby from the immediate danger of
birth defects and from the legacy of health problems that exposure to
these substances can bring.

			*** Over-The-Counter Drugs
			Considered Safe During Pregnancy ***


SYMPTOM				DRUG

Pain (such as a headache)	Acetaminophen (Tylenol)

Diarrhea			Kaolin and Pectin (Kaopectate)

Constipation			Mild laxatives (like Milk of Magnesia)

Heartburn			Antacids

Itching				Diphenhydramine (Benadryl)

Allergies, sinus congestion	Chlorpheniramine (Chlor-Trimeton)


***This list is not intended to replace a doctor's advice.  If you're
pregnant, talk with your doctor before taking any medications, and be
sure to alert any health care professional who might prescribe drugs
for you that your are pregnant. ****

		*** Prescription Drugs
		To Avoid During Pregnancy ***


These drugs have been linked to birth defects and should not be taken
by pregnant women:

		Accutane (an anti-acne drug)

		Lithium (an anti-depressant)

		Tegison (used to treat psoriasis)

		Coumadin (an anti-coagulant)

		Chloramphenicol, Nitrofurantoin & Tetracycline
				(antibiotics)

***This list is not intended to replace a doctor's advice.  If you're
pregnant, talk with your doctor before taking any medications, and be
sure to alert any health care professional who might prescribe drugs
for you that your are pregnant. ****


Bruce Shephard, M.D., is an obstetrician and gynecologist in Tampa,
Fla., and a member of Baby Talk's advisory board.  This article was
adapted from one the appeared in The 1995 Medical and Health Annual.

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