Can Women with PCOS Be Pregnant?

Polycystic ovary syndrome (PCOS) is one of the most common reasons for female infertility, which affects millions of women.

Motherhood Fertility Centre, one of the leading fertility centres in Hyderabad, provides a number of effective fertility treatments for PCOS patients, with in vitro fertilisation (IVF) being the most popular among these treatments.

This is due to the efficiency of female factor infertility treatments, such as PCOS, which has allowed Motherhood Fertility Centre to be considered as the best fertility centre in Hyderabad.

Some women who go for PCOS infertility treatment are able to conceive through the use of fertility drugs and some lifestyle changes. However, most women can’t cure it through medication, and instead have to opt for IVF treatment. The best infertility specialists in Hyderabad work here at Motherhood Fertility Centre to research the best strategies for this.

What is PCOS?

PCOS is a general condition in which the ovaries show the presence of cysts that create a balloon-shaped sac. Usually the ovaries help to balance hormones within the body, but women suffering from PCOS complain about menstrual problems, excess hair growth and weight gain as a result of hormone imbalance.

Symptoms of PCOS

  • Problems during periods, such as pain, heavy bleeding, irregular periods and, sometimes, the absence of periods
  • Excessive hair growth on the body, known as hirsutism
  • Sudden weight gain
  • Problems with infertility, such as difficulties in conceiving
  • Dark colored patches on the skin
  • Acne and pimples on the face

Treatment for PCOS

The main treatment for female infertility is IVF.

Women with PCOS should first consult with doctors at the IVF centre in Hyderabad. Infertility specialists will then propose injectable fertility drugs to stimulate the ovaries so that they can provide a large quantity mature eggs. The matured eggs are retrieved from the ovaries, and are placed together with sperm into petri dishes.

Typically, high doses of fertility medication is required to force the ovaries to mature the eggs, but with the help of in vitro maturation (IVM), this dosage can be lowered and IVF treatment can be conducted.

After fertilisation, the eggs will divide and grow after three to five days, and one or two are then transferred into the uterus. This process is called embryo transfer. After two weeks, infertility specialists will conduct a pregnancy test to identify the results of the treatment.

Apart from IVF treatment, Motherhood Fertility Centre also offers Blastocyst Culture Transfer, Intracytoplasmic Sperm Injection (ICSI) treatment and stimulated Intrauterine Insemination (IUI) treatment.

Study Shows Teens Feel Pressured to Get Pregnant

Woman Holding Negative Pregnancy Test Kit

Female adolescents are experiencing relationship abuse at alarming rates, according to a new Michigan State University study that specifically researched reproductive coercion – a form of abuse in which a woman is pressured to become pregnant against her wishes.

Heather McCauley, assistant professor in the School of Social Work, and co-researchers found nearly one in eight females between ages 14 and 19 experienced reproductive coercion within the last three months. Forms of such abuse included tampering with condoms and a partner threatening to leave.

The study, published in the journal Obstetrics & Gynecology this month, is the largest adolescent study on the issue. It uses data from a previously conducted randomized trial at eight school-based health centers in California during the 2012-13 school year and assessed 550 sexually active female teens.

To date, most research has focused on young adult women. But because adolescent relationships differ so much from adult relationships, clinicians need to know how to spot reproductive coercion in their younger patients and tailor clinical assessment and intervention for this population, McCauley said.

“We looked at whether adolescents who experience reproductive coercion displayed the ‘red flags’ we typically teach clinicians to look for – like coming into the clinic multiple times for emergency contraception or pregnancy testing,” McCauley said. “We found no difference in care-seeking behaviors between girls who experienced reproductive coercion and girls who didn’t, so those red flags may not be present. Therefore, clinicians should have conversations with all their adolescent patients about how relationships can impact their health.”

Previous research has also identified disparities in reproductive coercion by race/ethnicity, with black women more likely than white women to experience such abuse, she said. But, again, that wasn’t the case in this study, highlighting the need for researchers and clinicians to understand how to talk about relationship abuse with female teens.

Other takeaways from the study:

  • 17% of teens reported physical or sexual abuse.
  • Females who experienced reproductive coercion had four times the odds of also experiencing other forms of relationship abuse.
  • Females exposed to both relationship abuse and reproductive coercion were more likely to have a sexual partner who is five or more years older.

“These findings highlight how common reproductive coercion and other forms of abuse are in adolescent relationships, yet the signs of a teen’s unhealthy relationship may be tricky for clinicians, parents and other adults to spot,” McCauley said. “So, parents could open the door for their teen to disclose abuse by having a conversation with them about healthy and unhealthy relationship behaviors, including those that interfere with their decision making about their own reproductive health.”

Additional researchers on the study are Amber Hill, Elizabeth Miller and Kelley Jones, from UPMC Children’s Hospital of Pittsburgh; Daniel Tancredi, from University of California Davis School of Medicine; and Jay Silverman, from University of California San Diego School of Medicine.

The study was funded by the National Institute of Justice and the National Center for Advancing Translational Sciences.

What Are The Benefits Of Prenatal Exercise? And Why You Must Do It?

As soon as you hear the impending pregnancy good news, the topmost suggestion received from people is to take care of yourself and get proper rest. Well, it’s not entirely wrong because you must take proper care of yourself during all trimesters of your pregnancy, but it doesn’t mean you have to stay inactive all day.

Working out can actually prove to be really helpful during and after the pregnancy. We all know exercising daily is good for our health and a pre-natal workout is just as important. Exercising during pregnancy has many benefits, and you can find pre and post natal personal training programs focused on exercises best suited for you.

Until and unless your doctor has forbidden you from any kind of physical activity, it is always good to consider working out for at least 20-30 minutes every day. It is not only helpful in maintaining a proper posture, but it is beneficial post pregnancy too. For many years, there has been a myth that working out during pregnancy may result in complications during the pregnancy. However, researchers have turned down this theory. Pre-natal exercises are good for the baby as well as for the mother but make sure to do it carefully and preferably under supervision.

Here are some of the major benefits that you can reap from pre and postnatal training sessions.

Improve energy levels

No doubt pregnancy can drain your energy levels. However, working out every day can prove to be really beneficial for boosting up your energy levels and helping to increase energy throughout the day. Prenatal exercises improve your cardiovascular system this way you don’t feel tired very often. You can do your daily routine tasks without easily getting tired or drained.

Helps you getting better sleep

During pregnancy, most women can experience sleepless night, uneasy sleeping, and difficulty in finding the right position to sleep. By involving yourself in physical activities and exercises you are bound to sleep early. Exercising can be tiresome especially for pregnant women this helps you in getting better sleep at night.

Lower pregnancy-related risks

According to research done in 2017, women who exercise regularly during pregnancy are less likable to have risks that come with gestational diabetes. Moreover, you can surely avoid a C-section by staying active during pregnancy. Staying active and exercising during the pregnancy can fairly reduce the chances of undergoing a C-section. Cesarean delivery needs more aftercare and the recovery time is also more as compared to a normal delivery. Pre-natal exercises can definitely be very beneficial for you to avoid some of the complications during the pregnancy.

Lesser weight gain

We all know that losing pregnancy weight is not that easy in fact it can be quite stubborn. Women who exercise during pregnancy do not tend to gain a lot of weight. But this does not mean that you won’t gain weight however weight gain in inactive pregnant women is higher. Regular exercising helps in building muscles and burning fat, and as a result, you do not gain excessive weight which is very difficult to lose after the pregnancy.

Quick post-delivery recovery

Staying active and working out during the pregnancy and exercising will be beneficial for you during the pregnancy but will also help in faster recovery after the delivery. When you perform exercises during the pregnancy you are improving your fitness levels. As a result, you are able to recover faster. A study done in 2012 reveals that women who worked out or participated in some kind of physical activity during the pregnancy recovered faster post the delivery.

Uplifts Mood

Mood swings are very common during the pregnancy; in fact, pregnant women are more prone to depression, moreover, one in two pregnant women report some kind of depressed and anxious behavior during the pregnancy. This is very common and you can do a lot to stay away from depression during the most memorable time of your life. Many women notice a change in their moods after exercising. A prenatal workout is one of the best ways to stay fit and keep yourself away from pregnancy-related anxiety and depression as exercising keeps you busy and on the run.

Healthy baby

Pregnant women who involve in moderate exercising since the beginning of their trimester deliver healthier baby. In fact, mothers who indulge in prenatal exercises tend to have quicker mid-trimester growth rate, the baby is also nourished than those pregnant women who have a sedentary lifestyle. So it is always a good choice to work out and stay active during the pregnancy.

There are a number of benefits that pregnant women can reap from indulging in prenatal exercises. All in all, it is very beneficial for the baby and the mother in particular. However, if it is your first pregnancy make sure you are working under the supervision and also ask your doctor prior to deciding to workout daily. Until and unless there are some complications involved in the pregnancy medium intensity workout, it is always a good choice along with staying active make sure to have a balanced diet.

Community Workers Adopt Mobile Technology to Improve Maternal-Child Health

MAMA

As world leaders get ready to meet in New York in September to set a new development agenda for the next 15 years, their discussions will likely focus on maternal and child health. A report published by the World Health Organization (WHO) last May 13, in fact, highlights that progress has been insufficient to improve mothers’ health and reduce child mortality.

800 women still die every day in the world from preventable causes related to pregnancy and childbirth, while less than one third of all countries have achieved or will meet the target of reducing child-death rate by two-thirds.

Although the Millennium Development Goals have helped address many important public health challenges, there is still the need to ensure the “world’s most vulnerable people have access to health services,” said Dr. Margaret Chan, Director-General of WHO, in a statement presenting the report.

Local solutions to a global problem

South Africa is a good illustration of these public health emergencies – and of possible solutions. In a country where 30 percent of pregnant women do not access prenatal care, more than 12 percent of the population live with HIV and around 40% of maternal deaths are HIV/AIDS-related, a number of initiatives show encouraging results.

A study published last October by the Philani Maternal, Child Health and Nutrition Trust together with the University of California, Los Angeles, and Stellenbosch University in South Africa found that repeated home visits by trained community health workers to neighborhood mothers led to significant health improvements both for mothers and children, including in the prevention of mother-to-child HIV transmission.

Trained and recruited by the Philani, these health workers – known as mentor mothers – provide a lifeline for families otherwise excluded from the reach of many public health services. In the past 7 years, they have brought healthcare interventions into the homes of tens of thousands of pregnant women and new mothers. They taught them how to rehabilitate underweight children and improve their chances of giving birth to healthy babies, helped obtain state welfare allowances, and assisted in the prevention of preventable illnesses.

Tablets for health workers

Mentor mothers’ work has now caught the attention of some professors at Stanford University (California) who have started a project in February to support them with sturdy tablets pre-loaded with education videos. These videos explain basic health and nutrition facts in a simple and intuitive way, with the aim of helping mentor mothers in their work of expanding access to health knowledge and improving health conditions.

Nomfusi Nquru, one of the twelve mentor mothers testing the project, cannot conceal her excitement about using these tablets. “It is something new and a chance to use technology that I do not get to use,” she said in an interview. “Mothers react excitedly to the videos and seem to pay careful attention to what is being said. Hearing lessons in a different way is something that catches the mothers’ attention and afterwards they ask questions on how to feed their children well and look after themselves in their pregnancies.”

The tablet project is the brainchild of Dr. Maya Adam, a lecturer at Stanford School of Medicine with years of experience in developing digital educational content. After running a successful online course on child nutrition followed by thousands of people around the world, she has now decided to use her experience to help mothers in the developing world. “When we first introduced the teaching tablets, it was quite amazing to see how quickly these mothers picked up the new technology” she says. “In a way we are bypassing the blockage in access to education at least in the short term and providing these women with the opportunity to access knowledge using the technology we have today.”

According to Adam, who has spent years as a volunteer at Philani during her medical school and undergraduate studies, recruiting successful mothers and training them to become community health workers “is a powerful model for passing on good health practices in a way that is sustainable because women are counseling within their own communities. They are not going anywhere and they are not coming in from somewhere else with a solution that will then disappear when they leave.”

Adam hopes that the tablets will facilitate the learning and accelerate the training of new mentor mothers. Initial feedback from the twelve mentor mothers seems to confirm her intuition: responding to a questionnaire prepared by Stanford University, they all reacted enthusiastically to the introduction of the tablets in their work.

“Community health workers can help bridge the gap, in the short term, between what we need in access to healthcare providers and what we have,” says Adam. “If we wait for access to education and healthcare in South Africa to catch up with the need for it in these under-resourced communities, we are going to wait for a long time. By using technology like the tablets we can accelerate that process in communities otherwise cut off from main infrastructures.”

Adam intends to start an evaluation of the project next year, but is already working on a more ambitious goal of creating an open access health promotion library for community outreach workers.

“That’s my dream,” she says. “We are now raising funds for additional tablets, each costing around $170 U.S. dollars, and preparing translations of the videos into Spanish and other languages to extend the reach of this project. The videos are all picture-based, so they can easily be translated and used in other countries. We have the technology, we have the equipment. If we can get support, we can really put our heads down and start creating a comprehensive, multilingual, open access library to promote the health of mothers and children everywhere.”

A promising tool

Stanford University is the latest of a number of projects providing health workers with mobile technology. OpenSRP, for example, is a tablet-based open source platform that allows health workers to register and track the health of their entire clients.

“The use of mobile health technologies is a promising mechanism to ensure that we can better measure health outcomes in order to inform processes intended to improve health along the continuum of care,” says Dr. Lale Say, coordinator of the adolescents and at-risk populations team at the Department of Reproductive Health and Research of the WHO. “Digital technologies like those used in this project have proven valuable for both community members as well as the health workforce to gain access to quality information that can help make timely and well informed health decisions that can impact on the lives of mothers and their children.”

Post Partum Depression Can Be a Child Protection Issue

Post partum depression (PPD) occurs in about 20 – 25% of women after giving birth. Some level of the “baby blues” might well occur in larger numbers. The risks of PPD are that women can then go on to experience longer term depression or, in a small number of cases, go on to post partum psychosis. The latter can often be quite dangerous as it can include risks of suicide and homicide. It tends to be a psychiatric emergency.

pregnantPPD has the potential to interfere with the attachment process between mother and child. It can reduce the mother’s desire to interact with the baby and to provide stimulation (physical and emotional).

The good news is that it is highly treatable. A review by The Cochrane Library has shown that some very simple interventions can make a significant difference.

The piece of their extensive review showed that one intervention that is simple to manage and effective is peer support. Simply having someone touch base and ask, “How are you doing?” makes a difference. In essence, it is someone who just cares, is there and allows for the expression of a mother’s true feelings. This can be a major preventative tool that reduces PPD. The Cochrane review found this to be the case.

The research also found that home visits by such people as community nurses are beneficial. Interpersonal psychotherapy was also valuable.

When we reduce PPD, we improve the situation for families which in turn will reduce the need for child protection intervention. What is most appealing about the results of this research is that we do not need to build new and elaborate programs. Peer or lay support by phone works. Keeping up with nursing post delivery visits work. And, when needed, access to basic mental health support.

We should also be mindful that recent research suggests that post partum depression may have an onset up to two years after birth. There is also data indicating that fathers can also suffer from depression after the birth of a baby. Untreated there is a real risk of abuse or neglect.

The Affordable Care Act (ACA) and Preventative Health for Women

 

diverse-group-of-womenThere are several elements of the Affordable Care Act (ACA) that will majorly impact our healthcare system, but one of the most important new provisions is preventative measures for women’s healthcare.  Although certain preventative measures are allowed under the ACA, there are still certain employers who are exempt when it comes to providing contraceptive coverage in their healthcare plans. However, there are plenty of measures that are covered under the plan and will truly benefit women all over the country including well woman exams, breast exams, STI & HIV screenings and counseling and screening and counseling for domestic violence. These types of preventative measures can only provide positive results for women with health insurance.

I can’t help but think about the millions of Americans without health insurance and the women who will not benefit from these services. Breast cancer is the 2nd most common cancer death in women after lung cancer. Over 200,000 women get diagnosed annually and 40,000 die. Early detection can reduce the chances of getting breast cancer and having preventative screenings included in the ACA can reduce the number of women dying due to breast cancer.

STI and HIV Counseling and Screenings

According to the Guttmacher institute, 19 million new sexully transmitted infections (STI) are reported annually and half of these are among 15-24- year olds. It is estimated that 65 million Americans have a viral STI, with the most common one being genital herpes and it is not curable. Most STIs have no symptoms and can be very hard to detect with a doctor’s visit and many people have no idea they are infected with an STI. Some of these STIs, when left untreated, can lead to more serious illnesses such as pelvic inflammatory disease and cervical cancer. Having access to STI and human immunodeficiency virus (HIV) counseling and screenings included in the ACA is extremely important.

In the United States, we have varied opinions on sex, but the reality is our population is not retarding in growth. Sex can be as basic a desire as water, food and oxygen for some Americans. Evidence based research has uncovered that many Americans, especially younger adults and adolescents, do not have access to the factual information about STIs and HIV. In our media, we constantly glorify sex and adolescents are exposed to several television programs that include casual sex with multiple partners.

However, comprehensive sexual health education is not a standard in our country’s public schools. The ACA includes education and information about STIs and HIV, but the hard part is getting people to go to the doctor for this information. With the ACA enacted, there is an opportunity to start encouraging Americans to get annual screenings and to obtain prevention care in order to educate themselves on these issues.

Domestic Violence

One in four women will experience some type of domestic violence in their lifetime, and it is estimated that one-third of female homicide victims that police records have reports of are killed by their intimate partner. This is unbelievable and unacceptable to me. Domestic violence, rape, and sexual violence need to be brought to the forefront of Americans minds. This is a serious issue that needs to be addressed and I believe should be taught in schools along with sexual health information. The fact that the ACA covers screenings and counseling is incredible and this needs to be known. Women may not even know that their health insurance covers these types of things.

Family Planning

This brings me back to the ACA exemptions where certain employers are not required to provide contraceptive counseling and prescriptions. If employers, even those with religious beliefs do not support contraception, want a diverse body of people to be employed at their organization, they need to provide diverse healthcare plans that not only include basic health care, but specific healthcare pertaining to women including contraceptive coverage. It is estimated that nearly 99% of all women have used some sort of contraceptive method in this country.

Birth control can prevent unplanned pregnancies and abortions which saves our country money. Not all women want kids, so having these options are vital to their healthcare plans. Overpopulation is our number one social problem in this country, and it leads to many other issues including water shortages, food shortages and a large population of children being placed into foster homes or adoption agencies because of unplanned pregnancies. Having birth control be easily available and affordable will go a long ways toward prevention.

Income Inequality

Additionally, we must touch on is the gap between the rich and poor and how hard it is for millions of Americans to even obtain affordable health insurance. The ACA is a large step towards providing healthcare to the uninsured in our country, but it needs to be expanded further. It’s not perfect and many Americans are being caught in the Medicaid gap where they don’t make enough money to qualify for subsidy, yet they are in a State which refuses to expand Medicaid. If more Americans can received annual checkups and screenings, many may be able to identify and access preventive care to prolong life. Right now, it seems that the majority of Americans only go to the doctor when it is an emergency which needs to change.

Preventative healthcare is one of our country’s solution to address our nation’s growing healthcare problems. Hopefully, the ACA will lead to more systematic healthcare reforms in order to change the ways our country handles health issues and social problems. Feel free to share this with organizations that work with adolescents, schools, sexual health clinics, etc.. BeYouBeHealthy.org 

Intimate Partner Violence has Bigger Implications Around Post Partum Mental Health

Most social workers are familiar with the concerns arising from post partum depression. It has been linked to weakened bonding and possibly disrupted attachment between mother and infant. Newly published research done in Vancouver, B.C. alerts us to the problem as much broader and having some significant links to intimate partner violence (IPV).  Much of the past research has focused on the role of physical aggression, but this research by Susan Desmarais and her colleagues reminds us that the nature of IPV is much broader and each form has impacts upon women and their post partum mental health.

(Photo credit: Kit4na)
(Photo credit: Kit4na)

In their paper, published in the journal Pregnancy and Childbirth emphasizes that IPV incudes actual, attempted or threatened harm that can have an impact or detract from the victims well being across several domains – physical, psychological, sexual, economic and spiritual.

The authors also note that dear of abuse has both physical and psychological consequences on the pregnant mother.  Abuse, whether it occurs or is feared, raises cortical steroid levels in mothers which can have negative outcomes for mother and child.

Post partum mental  health concerns are more than just depression. Social workers must broaden their view to understand that the risks also include anxiety, obsessive compulsive disorder (OCD), and posttraumatic stress disorder along with psychosis.

These researchers studied 100 women to conclude that women who experienced IPV (both during and before pregnancy) reported a statistically significant higher rate of post partum mental health problems.  Physical assault during pregnancy appeared to have the greatest impact on post partum mental health and was associated with depression, OCD and PTSD. Psychological aggression during pregnancy was associated with symptoms of stress and PTSD. Sexual coercion both before and during pregnancy was associated with symptoms of OCD.

These findings have significant concern for child protection workers. It is vital that women be given an opportunity to talk about all forms of abuse that occurred both during the pregnancy as well as the periods leading up to it. In addition, workers must be careful to look for problems beyond depression.

Other research has shown, as acute mental health concerns grow in significance, it impacts the ability of the mother to care for the emotional and physical needs of the child. When we look beyond just the care of the child to understand why the mother is neglecting her child, we may often find various forms of IPV at the root of the behavior. If we do not properly investigate and intervene, then the mother is at increased risk of more intensive mental health concerns which may also lead to substance abuse as a means of managing the mental health concerns.

The good news is that mental health problems are treatable and the need to remove the child from the care of the mother is low. However, safety has to be created for both mother and child which means that the IPV needs to be uncovered. This is tricky, but it is our challenge.

New Tennessee Law Will Criminalize Pregnant Women

by Katherine Bisanz and Maggie Rosenblum
of Social Workers for Reproductive Justice

As we speak, the law in Tennessee is turning against women and families. The General Assembly has approved SB 1391, a bill that would turn pregnant women and new mothers into criminals.

SB 1391 takes a law that was intended to protect pregnant women from violence and instead turns them into assailants. The law would permit prosecutors to charge women with assault for losing pregnancies, or giving birth to babies with health problems at birth. The targets of the law are women who are in the most need of support: largely women who struggle with narcotic addiction during pregnancy.

Pregnant_woman2This is all happening under the guise of “finding a solution” for neonatal abstinence syndrome according to the State of Tennessee. They claim that the law is a way to use misdemeanor charges to get women into treatment. Anyone aware of the criminal justice system in our country knows that assault charges can heavily impact the course of a person’s life.

A prison or jail sentence could mean that women will be unable to be present to care for the families they already have or sustain the employment necessary to support a family and get through a treatment program. In a nutshell, Tennessee lawmakers seem to believe that they can “keep babies healthy” by punishing their mothers and don’t seem to grasp how terribly backwards and simply unrealistic this idea is.

It’s clear that no evidence-based information is backing this law being that research around the issue of child health have shown that babies are healthiest when pregnant women are treated with care, and when babies are kept close to their mothers after birth. Even women who struggle with addiction love their babies, and can have healthy pregnancies if they can form supportive relationships with their maternity care providers say Connecticut Affiliate of the American College of Nurse-Midwives.

Groups like National Advocates for Pregnant Women (NAPW) have made clear in past cases that punitive measures are the wrong approach in dealing with the “decades-old” question of how to handle pregnant women who take drugs. As opposed to taking a punitive approach that scares women away from seeking help, the state should treat pregnant drug abusers as addicts with medical problems, NAPW states.

Given their role as gatekeepers and mandated reporters, this law could have serious implications for the roles of social workers in the lives of their substance abusing clients in Tennessee.  Social Workers we are trusted to protect clients self-determination and strive to work with clients to empower and better their lives and this bill could compromise our ability to fulfill this imperative and not to mention obligatory aspect of our work.  Despite Rep. Weaver’s (R-TN) comments to the contrary, it’s hard to believe that child abuse allegations akin to those that have popped up in years past won’t arise in some form and in turn question social workers role as mandatory reporters.

This law will also erode choice as it relates to pregnancy. This law may be used by those who wish to prevent a woman from having an abortion who can now just report their concerns that a pregnant woman is using illegal narcotics in order to have her arrested so she will not be able to access abortion care.

Furthermore, this law may pressure some women into having an abortion they do not want in order to avoid prosecution under SB 1391. One study reported that “two-thirds of the women [surveyed] who reported using Cocaine during their pregnancies … considered having an abortion… (Jeanne Flavin, Our Bodies, And Our Crimes: The Policing of Women’s Reproduction in America 112 NYU Press 2009.)

Additionally, while the bill appears race-neutral at first glance, prosecutors and judges will wield the law against Black women more so than white women, based on a long tradition and culture of deeply embedded racial stereotypes about Black motherhood and drug use. The law would likely lead to Black women being thrown in jail for up to 15 years for aggravated assault should they choose to carry a pregnancy to term while struggling with an addiction to illegal narcotics. Should social workers be mandated to take part in this, they would directly be violating the discrimination clause of the NASW code of ethics, which includes the responsibility to racial justice and gender justice.

The NASW Code of Ethics states that, “Social Workers should act to expand choice and opportunity for all people… (NASW 2008).” If SB 1391 is signed into law it will limit choice and opportunities for all Tennessee families. We strongly urge the National Association of Social Workers and its Tennessee chapter as well as individuals who identify as social workers across the nation to speak out against TN SB 1391.

Pregnant and Parenting Youth in Foster Care Epidemic

teen_grad_1_560

Possibly one of the few things more challenging than being a teenage parent is being a teenage parent in foster care.  While the adverse effects of teen pregnancy have been well studied, researchers and social service providers are only recently coming to terms with the growing epidemic of pregnant and parenting youth in foster care.

According to a 2009 Chapin Hall Study  adolescents in foster care are at a significantly higher risk for pregnancy than the general adolescent population:

  • At ages 17 and 18, one third or 33% of young women in foster care were pregnant or parenting  
  • By age 19, more than half or 51 % of young women currently or formerly in foster care were pregnant or parenting, and nearly half of those young women had more than one child
  • 60% of 21-year-old former foster males report impregnating a female partner as compared to 28 % of the general population

To be clear, foster youth are children who have been removed from their families and are in the legal custody of the state. Another way to think of this is, the government is their parents. If that is the reality, than foster youth are basically “our children” and we are doing a pretty shabby job at being their parents.

What is possibly even more troubling than a 50% pregnancy rate is the experiences of these young parents while in foster care:

  • 1 in 5 pregnant teens in foster care received NO prenatal care
  • 22% of teen foster care mothers were investigated for child maltreatment
    (this is way above the 12% of teenage parent in general)
  • 11% of teen foster care mothers had their children removed from their custody 
  • 44% of foster care mothers graduated from high school; 27% for parenting foster fathers
  • Having a child while in foster care was the largest predictor of homelessness after exiting care

Teen pregnancy and parenting is only one of the indicators of poor foster care outcomes. Very few programs and policies address the needs of pregnant and parenting youth in foster care or work to prevent initial or repeat pregnancy.  Other critical foster care outcomes include a significant  increase in the risk of homelessness, incarceration, poor educational attainment, and poverty for foster youth ages 14-18 . But there is something uniquely disturbing about the fact that the children of foster youth are at-risk for entering foster care while their parents are still in foster care.

Though I am in no way suggesting that the U.S. do away with child protective services or foster care, circumstances such as these do beg the question, “Is the government any better at being a parent than the very caregivers these children are removed from?” This is a scary question to ask, but one that social workers must constantly be appraising.  The answer is not “no” but it is not a resounding “yes” either.

By definition, children in foster care come into care from troubled circumstances, putting them at greater risk for a number of poor outcomes. But we must make a guarantee to these children that the new environments we provide for them will make them better off than the environments we took them from. We must transition child welfare into a place where safety and permanency are not our only goals.  Well-being and a better future are essential.

As a child welfare systems change analyst, I applaud the tireless work of child welfare workers and administrations and recognize it is one of the most difficult, yet rewarding, jobs to do. There are so many forces beyond our control and endless administrative hurdles to overcome. But we must still do better. We have to do better or what is the point of the entire system?

References & Resources: 

Boonstra, H.D. (2011). Teen pregnancy among young women in foster care: A primer. Guttermacher Policy Review, 14 (11) pp.8-19.

Center for the Study of Social Policy: Pregnant and Parenting Youth in Foster Care

Children’s Bureau, Administration of Children, Youth, and Families. The AFCARS Report: Preliminary FY 2012 as of July 2013.

Children’s Defense Fund. (2010). Fostering Connections to Success and Increasing Adoptions Act Summary.

Understanding Peripartum and Postpartum Depression

A new addition to the family brings with it lots of changes, and a myriad of emotions may be experienced in the first weeks of your new infant’s life. While a birth is anticipated over a long period, most believe it will be a joyful and uplifting experience, but it also can create some shifts that are not anticipated.  New parents expect to be sleep deprived and to have some challenges with breastfeeding, schedules, and trying to figure out their baby needs, but they also expect to have a happy blissful feeling about the birth of their new baby. However, depression is often an unanticipated occurrence.

newmomAlthough this may be the case for a majority of families, a sizeable minority of new moms have a different response.  Peripartum Depression is the term which is used to include depression in pregnancy and postpartum (after the birth) depression.  The percentage of depression is 18.4% during pregnancy and 19.2% postpartum (Dtsch Arztebl Int. 2012 Jun;109(24):419-24.).

Many new moms may feel weird or different because of their responses or feelings about pregnancy and/or after the birth.  They may not realize how common Peripartum Depression is for parents of newborns, and thus, feel alienated and hesitant to speak up about it.  This can intensify the new mother’s depressive symptoms, negative self-talk and sense of isolation.

New dads may want to help and support , but telling her to “snap out of it,” “it’s not that hard”,  they do not understand why she is feeling down, and/or she should be fine are very common responses. These responses can unintentionally further increase the new mom’s sense of isolation and alienation.  Then, the question becomes what can we do to support new mothers and how to identify Peripartum Depression (PPD) early?

Symptoms & Risk Factors:

The symptoms of Peripartum Depression can include irritability, crying, feeling restless, trouble sleeping, extreme exhaustion (can be emotional and/or physical), changes in appetite, difficulty focusing, increased anxiety and/or worry, disconnected feeling from baby and/or fetus, and losing interest in formerly pleasurable activities.   Less frequently in postpartum psychosis, it can include fear that the baby could be accidentally harmed and/or urges to harm the baby.  If we notice irritability and mood shifts early. then mom can get the support she needs to help circumvent the rollercoaster she would otherwise experience.

Risk factors for Peripartum Depression include a history of anxiety and/or depression, history of depression within the family, social isolation (ie. Minimal support network) and/or  a difficult birth.  Women who have these risk factors do not always get PPD and some get it without any of these risk factors. These symptoms are more of a guide to let us know who would more likely to be at risk.  If a woman has these factors present in her history then it is helpful for family members and the woman to know more about the signs of Peripartum Depression, as responding promptly can help to arrest the course of her depression.

Supporting new moms who are experiencing Peripartum Depression:

Family members can encourage new moms to make their medical providers aware of symptoms because it is critical for them to be involved as part of the support and intervention process. Self Care such as physical activity, communication, sunshine, rest, and getting outdoors can help with the depressive symptoms and decrease a mom’s sense of isolation.  It can also help to break the cycle of negative self-talk.  A local support group can be a good place for new moms to be with others having a similar experience and be with others who understand her experience.  Lastly, once a mother understands her own experience she can help educate and recognize others who may experience peripartum depression in her family and/or community.  This can go a long way in breaking the silence and stigma around this common phenomenon.

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