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Prenatal Partners For Life–

Trends in Folic Acid Supplement Intake Among Women of Reproductive Age

QuickStats: Infant Mortality Rates* for 10 Leading Causes of Infant Death

The Obstetric Fistula Fallacy

Majority of Pregnancy-Related Deaths Are Cardiac-Related

Oral Bacteria May Travel to Amniotic Sac, Increasing Chance of Pregnancy-Related Complications

Prenatal Partners For Life
Prenatal Partners for Life is a group of concerned parents (most of whom have or had a special needs child), medical professionals, legal professionals and clergy whose aim is to support, inform and encourage expectant or new parents.

We offer support by connecting parents facing an adverse diagnosis (for example, Downs Syndrome, Trisomy 18, Anacephaly) with other parents who have had the same diagnosis.

We have many resources such as adoption agencies with clients waiting to adopt and love a special needs child should a parent feel they could not care for them.

We provide bereavement support including financial aid for funeral costs and markers should a beloved child not survive long after birth.

We also provide education and support for those in the medical community who are charged with the care of these "extra special" needs children.

We believe each child is a special gift … and there must be an alternative to abortion and infanticide.


TRENDS IN FOLIC ACID SUPPLEMENT INTAKE AMONG WOMEN OF REPRODUCTIVE AGE. Daily intake of 400 µg of folic acid before conception can reduce by approximately 80% the risk for having an infant with a neural tube defect (NTD) such as spina bifida or anencephaly (1).

Although other risk factors for NTDs exist, such as diabetes, obesity, and family history of NTDs, prevention measures have focused predominantly on promoting folic acid consumption.

Women can ensure they are consuming the recommended amount of folic acid by eating one serving of breakfast cereal fortified with 100% of the recommended daily value of folic acid or by taking a supplement with 400 µg folic acid daily (2).

Annual surveys indicate that 40% of all U.S. women of reproductive age (i.e., aged 15–45 years) took supplements containing folic acid in 2007 (MOD, unpublished data, 2007), up from 28% in 1995 (3). To analyze trends in folic acid–containing supplement intake among California women aged 18–44 years during 2002–2006, the CA Department of Public Health conducted trend analyses of data from the California Women's Health Survey (CWHS).

This report summarizes the results of those analyses, which indicated that although the overall prevalence of intake of folic acid–containing supplements remained stable from 2002 (40%) to 2006 (41%) in CA, use of such supplements decreased among Hispanic women and women with less education.

Downward trends among Hispanic women are of particular concern because 1) Hispanic women are at increased risk for having a fetus or an infant with an NTD compared with women of other races/ethnicities (4,5), 2) the number of births to Hispanics in CA increased during 1993–2003 (6), and 3) Hispanics accounted for nearly 52% of all births in CA in 2005 (CA Dept Public Health, unpublished data, 2005). Development of additional targeted and evidence-based public health interventions for increasing folic acid intake among these populations is needed. [CDC, MMWR Weekly, 26October2007/ 56(42);1106-1109]


The three leading causes of infant mortality (congenital malformations, disorders related to short gestation and low birthweight, and sudden infant death syndrome) accounted for approximately 43% of all infant deaths in the United States in 2005.

Mortality data for 2005 are preliminary; the numbers of deaths attributed to certain causes might be underestimated.
[Kung HC, Hoyert DL, Xu JQ, Murphy, SL. E-stat deaths: preliminary data for 2005 health E-stats. Hyattsville, MD: US Department of Health and Human Services, CDC; 2007. Available at;
CDC, MMWR Weekly, 26October 2007/ 56(42);1115]

THE OBSTETRIC FISTULA FALLACY. What is obstetric fistula?

Obstetric fistula occurs when a pregnant woman's pelvis is not sufficiently wide to allow the baby to be delivered vaginally. As a result, the baby's head becomes fruitlessly pressed against the unyielding pelvic bone, so tightly that blood flow to the woman's surrounding tissues is cut off. This causes these tissues to necrotize, forming a hole, or fistula.

Tragically, the baby is usually killed, and the fistula causes the mother pain, chronic incontinence, and uncleanliness that leads to ostracization. The prevalence of obstetric fistula in Sub-Saharan Africa has led to concern among doctors and humanitarian workers worldwide. The chief factor is child marriage. Many of these girls are simply not physically mature enough to bear children. Another factor is the lack of attended births. When problems arise during delivery, there is little the untrained local midwife can do. Still, not only is fistula relatively easy to prevent – a caesarian section delivers a live child without damage to the birth canal – but it is easily reversible. Obstetric fistula are virtually unknown in developed nations
In 2003, the UNFPA started what it called its Campaign to End Fistula. At first glance, the their goals seem noble. The campaign's web site,, states the program's goals as:
— Prevent fistula from occurring.
— Treat women who are affected.
— Renew the hopes and dreams of those who suffer from the condition. This includes bringing it to the attention of policy-makers and communities, thereby reducing the stigma associated with it, and helping women who have undergone treatment return to full and productive lives.
This summary is vague and non-threatening. Who, after all, would object to "renewing the hopes and dreams of those who suffer from the condition"

? But this pleasant mask covers an ugly reality, all too familiar to those of us who study the UNFPA.
In the body of its report, the UNFPA maintains that "Fistula can be eliminated – but prevention is the key. The U.S. must support initiatives for family planning and repeal the global gag rule to save women and children around the world." Here is the UNFPA's real agenda: It wants increased funding for fertility reduction programs around the world and an end to the Mexico City Policy, which prevents U.S. funds from going to organizations that perform or promote abortions.
"The strategy to make pregnancy safer is straightforward," claims the U.N. organization, but instead of focusing on the provision of better medical care to women in high-risk pregnancy, it gives priority to "family planning services to prevent unwanted pregnancies."

The Planned Parenthood of America has also jumped on the obstetric fistula bandwagon. While PPFA has done little to help women suffering from obstetric fistula, it has been quick to criticize the UNFPA funding cuts made by President Bush, claiming that they result "in the maiming of thousands of women each year." In a 2006 press release, Planned Parenthood president Cecile Richards insisted that "denying funding for programs that prevent childbearing injuries shows how far some politicians will go to promote extremist ideology over the health and safety of women."
As far as extremist ideology is concerned, the Planned Parenthood Federation and the UNFPA seem to have pretty much a monopoly on it. These are the groups that are in bed with China's population control police, who routinely force women to abort second children and then sterilize them to boot. They complain that pro-lifers have no understanding of women's issues, and then condone the horrible practices of China's one-child policy. Who really cares about women's issues?
Feminists, who generally disdain marriage and family, have little interest in helping women to safely deliver children. Rather, their goal is to prevent them from conceiving and bearing babies in the first place. It is not only pro-lifers who have noticed this. Nicholas Kristof of the New York Times – no conservative he – is among those who have observed that the feminists do not emphasize "traditional child-bearing roles." Treading lightly, he concluded that this was the reason that the obstetric fistula problem did not reach a wide audience and was unable to gain widespread support.
For this commonsense observation he was pilloried by Michele Landsberg of the Toronto Star, who said, asserting that Kristof unfairly blamed feminists for the fistula problem, "He is seriously off the mark. Feminist organizations have long worked on issues of maternal health, but fistula has been a hidden issue because the sufferers themselves were so secretive."
But Kristof was right. Feminists only deal with issues that lend themselves to their agenda. Once they figured out a way to spin obstetric fistula to their advantage, they have been hawking it for all they're worth.
Feminists and pro-choice groups share the blame for obstetric fistula, because they are precisely the ones that are impeding progress on it. If these groups could stop insisting that the "right" to abortion is necessarily involved in fistula relief, the problem would quickly be solved. It's that simple. [Colin Mason is the Director for Media Production at PRI, PRI Weekly Briefing, 24 October 2007, Vol. 9 / No. 39]

MAJORITY OF PREGNANCY-RELATED DEATHS ARE CARDIAC-RELATED. Pregnancy-related deaths are usually the result of peripartum cardiomyopathy, preeclampsia, HELLP syndrome, fatty liver of pregnancy, and amniotic fluid emboli, according to a retrospective autopsy case analysis.

HELLP is a group of symptoms that occur in pregnant women who have hemolysis (H), elevated liver enzymes (EL) and low platelet count (LP). HELLP syndrome occurs in pregnant women with preeclampsia or eclampsia. If severe, it causes elevated blood pressure and protein in the urine and can progress to life-threatening seizures (eclampsia).

"Maternal death is rare, in that only 58% of cases were caused by or strongly associated with pregnancy; 42% of cases had fatal complications that might have occurred in other, nonpregnancy settings," Amanda Crowe, MD,
pathology resident, University of Alabama at Birmingham, reported here during a poster session at the American Society for Clinical Pathology (ASCP) 2007 Annual Meeting.

In a retrospective case series from the University of Alabama at Birmingham Hospital, which serves a high-risk clinic and treats high-risk transfers, the number and causes of maternal deaths were determined at autopsy by
searching 4307 reports from between January 1, 1991, and March 9, 2007.

This search identified 36 cases of maternal death (0.8% of all cases). The age range was 14 to 46 years (mean age, 26.2 years).

Deaths were categorized as conditions seen only in pregnancy, conditions where pregnancy is a risk factor, surgical complications, and underlying conditions not related to pregnancy.

Twelve deaths (33%) were caused directly by pregnancy, 9 deaths (25%) were pregnancy associated, 4 deaths
(11%) were caused by surgical complications, and 11 deaths (31%) were from underlying medical conditions.

Pregnancy-related deaths were caused by peripartum cardiomyopathy, preeclampsia, HELLP syndrome, fatty liver of pregnancy, and amniotic fluid emboli, whereas deaths in the pregnancy-associated category included pulmonary thromboemboli, infection, drug reaction, and aortic dissection.

Surgical complications included hemorrhage, intraoperative death, and esophageal perforation.

Deaths attributed to underlying conditions were cases in which there were preexisting, potentially fatal medical problems that were not pregnancy related, Dr. Crowe said.

"Advances in the field of obstetrics and gynecology have now made the peripartum period much safer for both mother and child," she added.

Elizabeth Wagar, MD, from the University of California, Los Angeles, and program chair of the ASCP annual meeting committee, who was not associated with the study, noted in an interview with Medscape Pathology that maternal death occurred in only 0.8% of all autopsies (more than 4300 autopsies were reviewed).

"Modern healthcare has clearly reduced the percentages of deaths that are associated with pregnancy. In the 19th century, as many as 700 deaths occurred per 10,000 births. Many of these deaths were related to delivery
complications and infection," Dr. Wagar noted.

"The present study indicates most maternal deaths were caused by or strongly associated with pregnancy and were due to preexisting medical problems that were not pregnancy related. Notably, mortality was not related to infectious disease complications, a common cause of maternal mortality 100 years ago."
Dr. Crowe has disclosed no relevant financial relationships.

[American Society for Clinical Pathology 2007 Annual Meeting: Abstract 2.
Presented October 18, 2007; Carole Bullock, MA, 22October07, New Orleans;]



Oral Bacteria May Travel to Amniotic Sac, Increasing Chance of Pregnancy-Related Complications, Study Says

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Bacteria in the mouth may be able to travel through the bloodstream to the amniotic sac and infect the fluid there, putting pregnant women at risk for miscarriage, preterm delivery and other pregnancy-related complications, according to a study in a recent issue of the British Journal of Obstetrics and Gynecology, Reuters Health reports.

Researchers from Queen Mary's School of Medicine and Dentistry in London examined samples of dental plaque and amniotic fluid from 48 women attending a hospital for an elective caesarean section. They noted that seven of the amniotic samples also contained a type of bacterium commonly found in the mouth. Although the samples contained only low levels of the bacteria, the scientists noted an association between microbes in the amniotic fluid and complications in the women's previous pregnancies.

Previous research has shown that the amniotic fluid that surrounds the developing fetus is normally sterile, but when the sac becomes infected from amniocentesis or a genital tract infection, the risk of pregnancy-related complications rises. The researchers theorized that oral bacteria may be able to travel from the mouth to the sac via the bloodstream, although they stated that more research is needed to confirm the findings [Reuters Health, 7/10/02; Kaiser  12July 2002]



Each miscarried baby is a loss and each family grieves differently.  Proper burial of our miscarried babies in a little casket was very important to us.  Even after diligently searching, we were not able to find a little baby casket or tiny coffin for any of our miscarried babies.  Heaven's Gain is our attempt to aid parents in finding a small baby caskets sized appropriately for their baby who died less than full term…We hope our tiny baby burial caskets and other miscarriage burial products will acknowledge and uphold the dignity of each miscarried baby and bring comfort and closure to each grieving mother, father, and family. [from this website]