8.4: Pregnancy

Complications of Pregnancy

Minor complications: There are a number of common side effects of pregnancy. Not everyone experiences all of these nor to the same degree. And although they are considered “minor” this is not to say that these problems are potentially very uncomfortable. These side effects include nausea (particularly during the first 3-4 months of pregnancy as a result of higher levels of estrogen in the system), heartburn, gas, hemorrhoids, backache, leg cramps, insomnia, constipation, shortness of breath or varicose veins (as a result of carrying a heavy load on the abdomen). What is the cure? Delivery!

Major Complications: The following are some serious complications of pregnancy which can pose health risks to mother and child and that often require hospitalization. Ectopic pregnancy occurs when the zygote becomes attached to the fallopian tube before reaching the uterus. About 1 in 50 pregnancies in the United States are tubal pregnancies and this number has been increasing because of the higher rates of pelvic inflammatory disease and Chlamydia (Carroll, 2007). Abdominal pain, vaginal bleeding, nausea and fainting are symptoms of ectopic pregnancy. Toxemia or blood poisoning due to kidney malfunction is experienced by 6 to 7 percent of women during their last months of pregnancy. If untreated toxemia can lead to preeclampsia or swelling and hypertension or progress to eclampsia which is can involve coma or death.

Maternal Mortality: Approximately 1000 women die in childbirth around the world each day (World Health Organization, 2010). Rates are highest in Subsaharan Africa and South Asia although there has been a substantial decrease in these rates. The campaign to make childbirth safe for everyone has led to the development of clinics accessible to those living in more isolated areas and training more midwives to assist in childbirth.

Example

Listen to this NPR story about a midwife’s experience in a remote region of Afghanistan:

In Afghanistan, Midwives ‘Are Like Guardian Angels For Infants And Mothers’

Spontaneous abortion is experienced in an estimated 20-40 percent of undiagnosed pregnancies and in another 10 percent of diagnosed pregnancy. Usually the body aborts due to chromosomal abnormalities and this typically happened before the 12th week of pregnancy. Cramping and bleeding result and normal periods return after several months. Some women are more likely to have repeated miscarriages due to chromosomal, amniotic, or hormonal problems; but miscarriage can also be a result of defective sperm (Carroll et. al., 2003).

Problems of the Newborn

Low Birth weight

We have been discussing a number of teratogens associated with low birth weight such as cocaine, tobacco, etc. A child is considered low birth weight if he or she weighs less than 5.8 pounds (2500 grams). About 8.2 percent of babies born in the United States are of low birth weight (Center for Disease Control, 2010). A low birth weight baby has difficulty maintaining adequate body temperature because it lacks the fat that would otherwise provide insulation. Such a baby is also at more risk for infection. And 67 percent of these babies are also preterm which can make them more at risk for respiratory infection. Very low birth weight babies (2 pounds or less) have an increased risk of developing cerebral palsy. Many causes of low birth weight are preventable with proper prenatal care, however.

Premature Birth

A child might also have a low birth weight if it is born at less than 37 weeks gestation (which qualifies it as a preterm baby). Early birth can be triggered by anything that disrupts the mother’s system. For instance, vaginal infections or gum disease can actually lead to premature birth because such infection causes the mother to release anti-inflammatory chemicals which, in turn, can trigger contractions. Smoking and the use of other teratogens can lead to preterm birth.

Anoxia

Anoxia is a temporary lack of oxygen to the brain. Difficulty during delivery may lead to anoxia which can result in brain damage or in severe cases, death.

Babies who suffer both low birth weight and anoxia are more likely to suffer learning disabilities later in life as well.