At-home births; new statin guidelines
Q: My daughter is considering having her first child at home with a midwife. I'm pretty skeptical, and she wants me to be there with her. What should I tell her? - Rita M., Naples, Florida
A: Currently, about 1 percent of women go through home birth (about 25 percent of those are unplanned). And there are pros and cons to planned home births, Rita. But as for determining the smart choice, well, a lot depends on your daughter's health and location. First, we want to point out a few "musts" that are in our book "YOU: Having a Baby."
-Your daughter must be healthy and free of hypertension, preeclampsia, gestational diabetes, congenital heart problems and any other illness.
-She must be eating a sound prenatal diet, taking prenatal vitamins and be a non-smoker.
-She must be able to get to a hospital quickly, even during rush hours (complications in deliveries are notorious for coming at inconvenient times), and should have a fully licensed midwife present. Some states require an OB-GYN for backup, so check on that.
Bottom line: She must be low-risk for any complications. And even in that situation, the American College of Obstetricians and Gynecologists believes that "hospitals and accredited birth centers are the safest settings for birth."
Oh, one more thing: Research from the University of Pittsburgh Medical Center suggests that pain during childbirth can be psychologically harmful to some women and can lead to an increased risk of postpartum depression. Women who experience less pain during labor due to the use of epidurals (administered in a medical setting) have a lower risk for postpartum depression.
On the other side: Planned home births are associated with fewer vaginal, perineal and third or fourth-degree lacerations (because the delivering mom can move around more) and less morbidity since mom and baby are not exposed to hospital-borne infections.
Also, giving birth in a hospital doesn't mean your daughter will avoid complications or postpartum depression, and she may have a great at-home birth! A lot depends on her health and her OB-GYN's recommendations.
Your daughter must be a strong woman to consider this. We suspect that whatever she chooses - and remember, it's her choice - she'll do fine.
Q: I don't have cardiovascular disease, but my doctor wants me to take a statin. Should I? - Henry J., Oakland, California
A: Statins are a remarkable medication. They can trigger negative side effects, such as muscle aches and pains, but it happens far, far less than people think. But you didn't mention your doc's reason for suggesting statins. Do you have high blood pressure, elevated lousy LDL cholesterol or diabetes? Any or all will do.
We agree with the just-released U.S. Preventive Services Task Force guidelines that low- to moderate-dose statins reduce the probability of heart attack or ischemic stroke by at least a moderate amount in adults ages 40 to 75 who have one or more CVD risk factors (dyslipidemia, diabetes, hypertension or smoking) and a calculated 10-year CVD event risk of 10 percent or greater.
Now, these recommendations are important, but we want to add to them: You have to makeover your lifestyle at the same time to dodge a roster of chronic diseases (dementia, diabetes, heart and kidney problems and more). Start by kicking the Five Food Felons off your plate (that is, all trans and most saturated fats, all added sugars and syrups, and any grain that isn't 100 percent whole), and kick up your heels by walking 10,000 steps a day, jumping 40 times a day, and doing strength building exercises two to three days a week.
If your statin causes negative side effects, there's a new kid on the block: The Cleveland Clinic's Dr. Steve Nissen conducted the first major clinical trial and found self-injection of the relatively new nonstatin cholesterol-lowering drug evolocumab reduces levels of lousy LDL cholesterol more effectively than ezetimibe, a traditional drug used in statin-intolerant patients.
Distributed by King Features Syndicate, Inc.
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