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Go beyond Basic Ovulation Timing with the Conception Kit® at-home system

The Conception Kit® at-home system provides more comprehensive benefits than ovulation kits alone to help couples conceive. 

Couples who have been trying to get pregnant for a few months or more may eventually decide to take a more proactive approach.  There are many factors that can affect a couple’s ability to conceive including the timing of sex. Because fertilization can only occur while a woman is ovulating, it is helpful to track this cycle to know when the best time is to have intercourse.  There are many different ovulation kits and fertility monitors on the market, but most only help couples identify the optimal time for sex.  The Conception Kit® at-home system takes this technology one step further by including the Conception Cap® to concentrate and protect semen around the opening of the cervix to further optimize the chances for conception during this critical period.

Maximize Your Chances of Getting Pregnant During Ovulation

Ovulation is the most fertile time during a female’s cycle and is the best time to have sex because it is the period during which an egg is released.   When used correctly, ovulation kits are nearly 99% accurate and provide helpful insight into the timing of intercourse.   However, there is still the chance that sperm are unable to fertilize an egg during this period, especially when you consider that 90% of sperm die within the first ten minutes inside the vagina.  To improve the chances of conception, couples can use the Conception Kit® at-home system.  The Conception Kit® includes 24 ovulation predictors for timing the Luteinizing Hormone Surge (LH Surge) and provides medical-grade materials to protect and concentrate sperm near the cervix.

How to Use the Conception Kit® at-home system

To use the kit, couples start by reading the Instruction for Use Manual and recording details of their cycle in the Conception Journal.  The Practice Conception Cap® helps the couple learn proper placement on the cervix.  Ovulation predictors determine when the best time for conception to occur.  Next, the couple enjoys sex in the comfort of their own home using the Latex-Free Semen Collector and Sperm Friendly Intimate Moisturizer.   Semen is collected and transferred from the semen collector to the soft and flexible Conception Cap® which is then placed over the cervical os (opening) and left there for 4-6 hours.  The Conception Cap® protects the sperm so they can live up to and beyond 6 hours and are concentrated around the opening of the cervix so they have the best chance of entering the uterine cavity to fertilize the egg.  This way, semen with low sperm count or motility is given the optimal chance of penetrating the cervix. Lastly at the end of the woman’s cycle the pregnancy test is used to determine if conception has been achieved.

The Conception Kit® at-home system is available by prescription only and is covered as a prescription benefit under many insurance policies for a $35-$80 co-pay.  It is an ideal first step for couples seeking early infertility treatment options and provides considerably more benefits than ovulation kits alone.

About Conceivex, Inc.

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This is in no way an overview of the CAPPA 2014 session by Diana, but instead my notes of what impacted me from the session.

diana barnes

 

Have you thought of the birth of a child as a developmental crisis? It is! Well Diana shared a few things that can cause this crisis. She seems to think there are four myths of motherhood:

  1. Mothering is instinctive
  2. There is a notion of the perfect mother
  3. Supermoms
  4. Madonna images

She said often moms feel like these myths are true. They often are trying to obtain that perfect mother spot. But we know birth experiences can cause her to not feel perfect before the baby is even put in her arms. She feels awful if she does not have the perfect bonding time. And she is trying to figure out what a “good” mother is. But feelings like wishing her baby was a different gender can cause her to feel awful about her baby. And these are things she is often afraid to share with others.

She said dads often have issues with gender roles. And they have difficulty with occupational roles vs. family roles. Diana said she hated it when dad’s would say they were babysitting their own children!

She suggested that moms who are struggling with this change to motherhood to figure out what they loved to do before. She suggested integrating pieces of the things they loved back into their lives. She shared about how stress crosses the placenta. Often the seeds of postpartum depression are planted during the pregnancy. Depression in pregnancy can often be seen in the child four years later showing up in conduct disorders. Excessive depression symptoms in pregnancy show more propensity toward depression afterwards. So it is important to get help if you are feeling anxiety and depression during your pregnancy.

The baby blues often have the same symptoms of premenstrual type emotions. You can be tearful, irritability, sadness, sleeplessness, anxiety and exhaustion. Postpartum depression occurs in 15-30% of the folks who have the blues. And although folks feel it happens early in the newborn period, it can happen anytime in the first year. It often happens in the first 3 months but can be as late as 6-9 months before it shows up. Moms often have more confusion when depression hits due to exhaustion and sleep deprivation, not eating and often lots of weight loss.

Obsessive compulsive disorder occurs for many moms during this time. There is confusion between reality and truth. This is where thoughts of hurting the baby can enter into the equation.

Panic disorders can also arise during this time. Shortness of breath, trembling, agitation and restlessness and excessive sudden anxiety arise. This happens to 10% of women. Often their symptoms make them feel like they are having a heart attack. There is often a family history of this. And this can be triggered by having had a traumatic event in their past or a traumatic birth experience. This can lead to PTSD symptoms. Reliving past experiences, feeling a sense of doom accompanied by nightmares and flashbacks occur.

PPDS- the next level of concern has women saying they feel something is wrong, they feel like they are just going through the motions, they try to find comfort and support and yet are guarded in their recovery. They often feel they are struggling to just survive. They feel they have died to self

Postpartum Psychosis is life threatening and the mom needs hospitalization. This is an emergency. She may be delusional and have hallucinations. She may be manic as well- happy one moment and then deeply sad.

There are psychosocial issues that cause depression after the birth of a baby. Having a sick baby, a lack of support, complicated birth, multiples, and a stressed life prior to the birth can add to this situation. There can be biological issues such as a thyroid deficiency, previous depression, a family history of depression, premenstrual dysphoric disorder, fertility issues and pregnancies that are close together. There are also psychological issues such as an unsupportive spouse, poor relationships with family members- especially her mom, trauma, issues that are unresolved and ambivalence toward becoming a mom.

Attachment to our infant is based on the things we feel are significant. So our infant learns attachment during this time based on how the mother is responding to him or her. The baby is figuring out if this is a safe place or not. The first six months for the infant is essential for them to feel this proper attachment. This lack of attachment affects the next generation.

Diana shared about a video on  the still face experiment. This social interaction with the newborn is essential for their development. So helping this mom will be helping her baby and the whole next generation. We need to have a network of help for new mothers. This decreased responsiveness can be helped when the mom is helped.  These moms often are either very unkempt looking or overly made up. But either way they are both disconnected to their babies. Babies will have cognitive delays if they are not properly attached to their caregiver. But long term the results can be devastating.

My thoughts are that women need to be listened to in their early pregnancy. We need to help her in her prenatal preparation so that her network for success is established prior to the birth. Doulas can assist with helping moms feel listened to in their labors and have more gentle births. We need to have a network of support after the birth for new families. Postpartum doulas are an essential for those first few weeks. And women who still have issues need to be diagnosed early and treated quickly.

I do feel that if a woman is nurtured properly during her exposure to motherhood in her earlier years, mothering can be instinctive. But I feel motherhood has been do disrespected over the years that women have not been nurtured to listen to their instinctive voices, thus making that instinctive mothering diminished.

 

 

Nancy Bowers spoke on the updated information on multiple births at the CAPPA 2014 conference. Here are my notes- not a full overview of her talk but instead the things that I was most impacted by- thanks!

NancyBowers

She discussed the different types of twins:

  • Monozygotic- identical twins and the four ways they may share amniotic sacs
  • Dizygotic twins

Did you know the majority of twins share a placenta regardless of the type of twin? {I am sure this is what my notes say- but I wonder if this is because twins often have fused placentas… “Though fraternal twins have their own separate placentas, sometimes the two fertilized eggs implant close to each other in the uterus, which can result in their placentas fusing. The two fused placentas look like one placenta, causing them to be mistaken for identical twins.}

She asked a few questions and shared her answers:

  1. Are twins high risk?  Yes because everything is in twos so risks are increased. There is a increase of twin to twin syndrome with identicals where 1/2 of all twins can have one baby that is less than 10% of the growth of the other twin. Low birth weight becomes an issue causing risks. There is also a higher risk of cerebral palsy with multiples. Early and ongoing education is recommended.
  2. How long is it safe to carry twins?  The outcomes seem to be best for the twins and moms if they give birth by 38 weeks. The studies show the longer the pregnancy is after 38 weeks increases the risk of death therefore surveillance is needed to make sure they are doing okay. Older moms actually have better outcomes with multiples than young moms. The recommendation for weight gain is for a normal weight mom- 37 to 54 pounds, overweight moms should gain 31 to 50 pounds, ovese moms should gain only 25 to 42 pounds and underweight moms need to gain more!
  3. Can preterm birth be prevented?  Yes and no… many of the things that were once considered standard care are not evidenced based and may cause harm- bed rest, prophylactic tocolytics, cervical cerclage and 17a hydroxy-progesterone caproate. Terbutaline and magnesium sulfate actually increase the risk of pulmonary edema in the mom. 60% of twins come preterm.The average weight of twins is 5 pounds 2 ounces.
  4. When is a cesarean birth indicated?  And this really is determined by the skill and comfort of the care provider- breech is something some care providers see as a variation of normal. But there is a reason for the birth to be surgical in some situations. 43% of twins are both vertex (head down), 38% have the presenting baby vertex. 19% are other presentations. www.ajog.org sadi that vaginal births should be attempted if the presenting baby is vertex. I would suggest if you find out you have twins- make sure you have a provider who provides the most options to you!
  5. Is breastfeeding multiples realistic?  YES but often twins do not show hunger cues as obviously as a single baby. Getting the babies to the moms early and regularly is the key. Getting a pump to the mom who can not get her babies within 6 hours of the birth is essential. And pumping eight times within 24 hours is necessary. Kangaroo care is so helpful. Simultaneous nursing when at least one of the babies knows what she is doing is helpful- this can take several weeks. Skin to skin time is precious time. Get lots of help with latch and positioning.
  6. What do new parents of multiples need in the first months? HELP! Bonding is a process. Spend time alone with each baby. Focus on the differences in them. Respond to them individually and uniquely. Use their names – not “the babies.”  In the first three weeks all the mom needs to be doing is eating, sleeping and feeding her babies. She needs help with all other responsibilities.
  7. Co-bedding multiples at home, is it safe? Co bedding studies for multiples in the NICU shows great benefits to doing so. But the AAP says that low birth weights, prematurity, overheating, rebreathing, size discordance and folks putting their twins on their sides are reasons why co bedding is discouraged. But studies showed twins who slept together stayed in their parents room longer, had sleep synchronicity and could be safe with healthy twins. The same rules for safe co sleeping should be used if you choose to co bed.

My experiences with twins are a bit differing from Nancy’s recommendations. I think it is imperative to get great ongoing education and support when you are carrying multiples. I think it is important to ask your provider a ton of questions about their practice for managing twins as I have seen very different approaches to the care of the mom and babies. So know all of your options.

 

Most of us guess at our due dates. It is based on last menstrual periods with the speculation that you will ovulate mid month. Unless you have perfect ovulation cycles and your baby gestates perfectly on schedule- or you have IUI or IVF , you really may not know exactly when you are due. The earliest ultrasound is usually the best one to determine the age of the baby based on developement. What is considered term pregnancy? ACOG defined this in 2013, http://www.acog.org/

Definition of Term Pregnancy

ABSTRACT: In the past, the period from 3 weeks before until 2 weeks after the estimated date of delivery was considered “term,” with the expectation that neonatal outcomes from deliveries in this interval were uniform and good. Increasingly, however, research has shown that neonatal outcomes, especially respiratory morbidity, vary depending on the timing of delivery within this 5-week gestational age range. To address this lack of uniformity, a work group was convened in late 2012, which recommended that the label “term” be replaced with the designations early term (37 0/7 weeks of gestation through 38 6/7 weeks of gestation), full term (39 0/7 weeks of gestation through 40 6/7 weeks of gestation)late term (41 0/7 weeks of gestation through 41 6/7 weeks of gestation), and postterm (42 0/7 weeks of gestation and beyond) to more accurately describe deliveries occurring at or beyond 37 0/7 weeks of gestation. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine endorse and encourage the uniform use of the work group’s recommended new gestational age designations by all clinicians, researchers, and public health officials to facilitate data reporting, delivery of quality health care, and clinical research.

In fact, approximately 7% of babies are not delivered by 42 weeks, and when that happens, it is referred to as a “post-term pregnancy. ”

42-weeks-pregnant-the-end-of-pregnancy-e1357175738877

ACOG even has a pamphlet with information titled  What to Expect After Your Due Date.

It is stated that  the risks of waiting to have your baby once you are postdates are:  dysmaturity syndrome- decreased alertness, low birth weight, and increased respiratory distress, the placenta gets older and may not work as well, the fluid gets less and can cause the umbilical cord to become pinched, the chance of the baby becoming too big is increased and the risk of meconium aspiration is increased. They say it may also lead to an increase of a cesarean birth.  They suggest checking on the baby’s well being by using two tests, a biophysical and a non stress test.

There is an excellent blog Birth Without Fear that addresses this as well- http://birthwithoutfearblog.com/2011/08/22/what-acog-has-to-say-about-due-dates/

The Cochran Database is considered a location of studies and summaries that are evidenced based. http://summaries.cochrane.org/

Induction of labour in women with normal pregnancies at or beyond term (more…)

Published September, 2012 in PEDIATRICS Volume 130

Kwok, Leung, Lam and Schooling

 This is a very limited study- but it appears that breastfed children reach puberty later than children who were not breastfed and instead were fed cow’s milk formula. The concern regarding this study is that there may be some socioeconomic issues that were factors as well.

You may ask why this is important. But “early puberty is associated with hormone related cancers and cardiovascular diseases.” So delaying puberty is certainly of interest to us now!

Cow’s milk formula is suggested as causing early puberty due to the specific nutrients in milk such as animal protein, animal fat, and calcium. It goes back to human milk for human babies. Is it no wonder that giving a different animal’s milk to a human would have proteins and fats and different calcium that we cannot absorb properly?

This study could not be replicated in different places around the world.  The US showed more of a larger quantity of early onset of puberty based on quantity of milk consumed. The study showed different results based on quantity vs. frequency of milk consumption. They were concerned that there were many other factors that could be different in different populations. So they felt it was a bit inconclusive.

The other issue that arose with the study was the type of formula given. Some people were using soy based formula although it should not be substituted over cow’s milk without a medical reason for doing so.  (This made me wonder how many families make decisions regarding formula use without getting advice from their pediatrician. And the concerns about soy are rampant regarding the estrogen issues in soy. )

This study was conducted beyond infancy- they looked at milk consumption at 6 months, 3 years and 5 years.  The fallacy in the study was regarding infants on exclusive breastfeeding vs. some supplementation vs. formula feeding.  In Hong Kong where the study was conducted, has a short breastfeeding duration thought to be due to moms returning to work quickly.  Three months was the duration they were seeking for the study but many moms had quit exclusively breastfeeding within two months.

The study was also conducted looking at two factors- frequency of milk consumption and when consumption started. They did a lousy job of collecting the data since exclusive vs. part time breastfeeding was confusing to the stats.

They also seemed to have a hard time determining what constituted the onset of puberty. For girls it was a bit simpler- they looked at breasts development. But for boys it was conflicting if it was the genital stage or the testicular volume for boys. They decided to use the genital stage II to be the factor- and my guess is the testicular volume results were not looked at once they decided to use the genital status. But you can see this is not a precise situation.

They classified the children in a few ways: gender, the families- education, occupation and income and then infant maternal issues that included second hand smoke exposure, mother’s age at the birth and the place of the birth.

I think this study is too flawed to be a conclusive one. Relying on the mother’s recall on consumption and the various conflicting issues seem to corrupt the results.

I think we can hold that human consumption of human milk can cause less problems- but the onset of puberty based on frequency and quantity of consumption can just be considered a possible factor not a conclusive one.

 

Published December, 2011 in PEDIATRICS Volume 128

Jones, Kogan, Singh, Dee, Grummer-Strawn

This study was trying to determine what factors were causing the duration of breastfeeding to remain low in the US. It was sad to see that in the 75% of the children breastfed only a little more than 16% were breastfed exclusively for six months. Race showed little difference in the exclusivity of breastmilk in the first six months but race did have a difference in the non Hispanic black children who were breastfed less. Government agencies and medical organizations promote breastfeeding- and it does seem to have made a difference.  Since the value of breastfeeding exclusively is thought to make a difference in reduction of medical cost of 2.2 million dollars per year, it is in the government’s interest to promote it. They hope to change the percentage that was found in 2006 of just over 14% exclusively fed for six months to a little over 25% and hope to increase breastfeeding being initiated to over 80%.

The factors that were considered associated with breastfeeding being exclusive for six months included: race, income, density of residence, mom’s age, education, marital status and BMI.  They knew of no study that took into consideration the mom’s emotional or mental health, whether she was native or immigrant, if there was a smoker in the home or the family structure. They interviewed over 91 thousand families targeting only one child and the children being between 6 months and five years of age.

Exclusive breastfeeding was determined to be done for 180 days with nothing else- no other food or liquid offered including water. The study wanted to look at these factors: mother’s age at time of birth, education level, immigrant/nativity status, mental/emotional health, race, birth weight of the baby, family structure, poverty status, and tobacco use in the household and density of residence. (more…)

My review of “Breastfeeding and the Use of Human Milk”

Published March, 2012 in PEDIATRICS Volume 129

Policy Statement by AAP

This is the policy statement from the American Academy of Pediatrics. It was six years ago since they made a public policy statement on breastfeeding. I love that they feel breastfeeding is a public health issue not just a life style or parenting choice. They make an affirmation on exclusive breastfeeding for six months. And they encourage it to continue after other foods have been added up to a year or as long as it is a relationship that the dyad of mother and baby desire.

The national average for women who begin by breastfeeding their infant is at 75%. Hispanic population is higher and the black population is much lower. The government supplemental programs like WIC show a low rate of initiation of breastfeeding if the mom’s income was lower. And the very poor black population was the lowest. The studies also show women under 20 are lower at initiating breastfeeding and moms over 30 are the higher at initiating.

In ten years this initiative to try to promote breastfeeding has had little change in the moms who begin to breastfeed. I can’t help but wonder if the PSA ads that are not ever shown during daytime or primetime hours on television are considered a promotion of sorts by the government. If this is truly a public health issue, it is certainly not being covered by the media. I think the concerns of making women feel bad if they are not breastfeeding and making the formula companies angry seem to be of more concern. So the targets to get more women nursing seems to have had a little effect but the cessation of breastfeeding early on seems to be the norm in the US regardless.

One quarter of all women’s maternity services provide formula to moms in those crucial first two days after birth. Until the government steps in and really treats this as a public health issue, nothing much will change. The formula companies will continue to promote their artificial breast milk and moms will continue to get mixed messages from the maternity centers. The AAP notes that until the practices of hospitals change, the targets will not be met. (more…)

I just want to scream when doctors say a baby has lost too much weight and instead of getting the mom a great lactation support system in place, they demand the use of formula! There are a lot of criteria to look at! The first is an amazing article about whether the mom had a lot of IV fluids in labor:

Newborn Weight Loss and IV Fluids in Labor
Monday, October 31, 2011 at 8:15PM
Nancy Mohrbacher in Useful Breastfeeding Research

Until now, weight loss during the first 3 to 4 days after birth has been considered one indicator of how early breastfeeding is going.  If on Day 4 a newborn’s weight loss is in the average range of 5% to 7%, this usually means breastfeeding is going well.   Nearly all babies lose some weight after birth, because after floating in amniotic fluid for 9 months, they are born waterlogged.  Normal weight loss comes from the shedding of this excess fluid as they adjust to life on the drier outside.

But when babies lose more than 7% of birth weight during these early days, does this automatically mean they are not getting enough milk?  No, according to a recent study.

A greater weight loss may be completely unrelated to breastfeeding and due instead to excess IV fluids mothers receive within the final 2 hours before delivery.  According to this study, these excess IV fluids inflate babies’ birth weight in utero and act as a diuretic after birth.  Babies whose mothers received more IV fluids before birth urinated more during their first 24 hours and as a result lost more weight.  Number of wet diapers during the first 24 hours predicted infant weight loss.  This was true whether the babies were born vaginally or by c-section.  Another study published earlier this year had similar findings. (more…)

This is a great article that tells it like it is. http://commonhealth.wbur.org/2011/08/hospitals-bad-job-breast-feeding/ and this is the study link http://www.cdc.gov/vitalsigns/breastfeeding/

Yesterday I got a call from a mom who had had a baby less than 18 hours earlier. Her daughter had been born unmedicated and gently. She was a VBAC baby who weighed 9 pound even. Beautiful baby that within the first hour after birth had nursed beautifully. She then began to have her heel lanced and her blood sugar checked before feeding each time. This is not a little prick- it is a full lance of her foot- making it quite sore I am sure. Her blood sugar was fantastic. But this baby girl cried after nursing often times. She had 12 bowel movements- so obviously it was not because she was not getting enough colostrum to make her bowels move great- and we all know her stomach is the size of a marble irregardless of how big she was! But guess what? Instead of teaching the mom to swaddle or soothe her baby, the nurses convinced her that her baby was hungry and crying because the mom was not producing enough!!! AUGH! It makes me want to SCREAM!!!! So, this article shares what the CDC studies prove- the hospitals sabotage the nursing relationship-

“– (And this one is astounding to me, hence the bold) In nearly 80 percent of hospitals, healthy breastfeeding infants are given formula when it is not medically necessary, a practice that makes it much harder for mothers and babies to learn how to breastfeed and continue breastfeeding at home.”

Baby Bottles

I wonder how much formula she was sent home with! Why can’t we educate those who could really make a difference for moms and babies? I honestly tell people there is not one hospital in our area that I think does an excellent job after the baby is born. There is either some stupid policy about bathing the baby or having to pay for an isolete like a recent hospital I doula’d at… or stupid stuff like this mom went through. ENOUGH! We need to stand up and SCREAM NO! STOP IT! ENOUGH!