Pregnancy Prison - High Risk Pregnancy Recipe

As a mother who doesn't know the problems surrounding these mothers, I feel very annoyed when I read that women are "the fastest growing part of the prison population." 1 In 30 years, the number of hospitalized women has increased from 11,212 to nearly 113,000.1,2

There is a huge difference between state and state in this population. In 2004, the number of female hospitalizations in Oklahoma was 10 times higher than in Massachusetts or Rhode Island.1 Although the reason for this difference is beyond the scope of this article, those states with high female estimates need to be true. Be prepared for the problem. Pregnant women within their system. More women = more mothers will be jailed.

So why do women rise in prison? According to the Rebecca Human Rights Project, "Women have a disproportionate burden in the drug war, resulting in a significant increase in the number of women facing imprisonment for the first time, the vast majority of which are non-violent offsets." 3 Compared with men, the crimes of imprisoned women are usually non-violent. Violent offsets are often the result of offsetting alcohol, drugs and property.4

Reality: pregnancy and imprisonment

Between 6% and 10% of women entering the prison are pregnant.5 The nature of this population means that it is primarily classified as "high risk". Medical problems that have a negative impact on pregnancy outcomes are common. These include: diabetes, epilepsy, HIV, high blood pressure, heart and kidney disease. In addition, many of these women did not receive adequate medical care before being imprisoned. They are more likely to smoke, are heavy drinkers and use illegal drugs.6 These factors have contributed to their increased [usually specialized] need for prenatal care and their need for pregnancy education, counseling and drug abuse treatment programs. influences. Beyond.

Premature birth: a difficult and complicated problem in obstetrics

Racial differences exist not only in the prison population, but also in 67% of non-whites6, but also in preterm births [PTB], with the highest proportion of black women [17.5%], followed by Hispanics [12.1%], followed by whites [ 11.1%.]7 Studies have shown that black women have a three to four-fold chance of being born very early [between 20 and 24 weeks], in part because they are susceptible to infection. Many of the issues discussed in the report reflect the risk of PTB. Factors [pregnancy less than 37 weeks of delivery]. PTB is a major global issue, and it is regrettable that the US ranking is worse than most other developed countries. The conditions described in this article can lead to premature birth.

The risk factors for preterm birth are the main causes of infant morbidity and mortality, those are 8:

• Loss of pregnancy or history of PTB [#1 risk factor]

• Abnormal uterus or carrying multiple babies

• Family history of PTB

• Diabetes*

• Periodontal disease *

• Bacterial vaginosis [BV]* and other genital infections such as trichomoniasis, chlamydia infection, syphilis and gonorrhea.

•high pressure*

• History of cervical surgery [including multiple D&C / abortion]*

as well as:

• Black women [high risk if they are underweight or overweight]*

• Obese women with a BMI of 35 or higher or women with a lower BMI

• teens

• Heavy smokers*

• People who take certain antidepressants

• Unemployed women*

• Heavy drinkers, cocaine or heroin users*

* These factors are likely to occur in pregnant women who are imprisoned.

Special attention to prison health care workers 8 [Editor's book entitled "High Risk Pregnancy - Why Me?"]

Depending on the risk factors of women in the prison system, certain conditions and problems may be encountered in such an environment. The following are possible pregnancy problems that medical personnel may encounter when working with these special needs groups.

Premature rupture of membranes [PPROM]

Who is at risk? Female:

*Before PTB

* at an economic disadvantage

* BMI is low

*Cereclage or biopsy procedure on the cervix

*Experiencing early contractions

* Have urinary tract infection or sexually transmitted diseases

*experiencing vaginal bleeding

*is a smoker

Women suspected of having an early rupture should immediately use NitrazineTM paper and/or observe "ferns" for specialized care and confirmation. The appropriate management plan under the guidance of the perinatal physician should be supervised according to the type of rupture [away from terminology, recent, etc.]. [Some women with full-term rupture should also be assessed/monitored immediately.] Other management options may include hospitalization during pregnancy, antibiotics, prenatal corticosteroids, and routine monitoring of infection/contraction. IMPORTANT: Care should be taken to limit [preferably avoid] internal inspections to reduce the risk of infection/infection. [This is the biggest problem providers face when managing PPROM, as well as premature birth.]

Preeclampsia

This condition only affects women during pregnancy and their unborn babies, usually after 20 weeks, or within 6 weeks of birth. Preeclampsia accounts for about 5-8% of pregnancy. Because women who are hospitalized are more likely to have high blood pressure, it is important to monitor these women. [The number one risk factor was previously, followed by women with high BMI, chronic hypertension, diabetes or kidney disease, and women over 40 or under 18 years of age.] Regular prenatal care must track and manage possible sunsets. If detected, special measures must be taken to develop appropriate monitoring plans for the health and safety of mothers and babies. [Note: Acetylsalicylic acid [aspirin] has been shown to significantly reduce the incidence of severe pre-eclampsia, hypertension, and IUGR.

Warning signs All providers working with pregnant women should pay attention to:

*Hypertension is 140/90 or higher and is observed twice within six hours. A 15 degree or higher increase in diastolic blood pressure or a 30 degree or higher increase in systolic blood pressure is a concern, especially for other symptoms.

* Edema, especially hands and face.

* Protein in the urine. Even if the blood pressure is below the threshold, +1 or higher may mean the beginning of pre-eclampsia. 2+ is a major red flag.

* Weight gains of more than two pounds a week or six pounds a month [but this is not the most reliable test].

* Migraine-like headaches that do not disappear even during treatment.

* Nausea and/or vomiting in the second or third trimester of pregnancy [not to be confused with stomach or food poisoning].

* Changes in vision, such as temporary vision loss, flashing sensation, increased sensitivity to light, blurred vision or spots in front of the eyes. This is a very serious symptom and should be checked immediately.

* Stomach pain is good for pain in the right rib and/or right shoulder of the body. This may be mistaken for heartburn, indigestion or kicking.

* Sudden and specific lower back pain, unlike normal pain in the lower back. This is a possible sign of HELLP or other liver problems, especially if the patient has other symptoms of pre-eclampsia.

* Reflective hyperactivity.

Placental abruption

This occurs when the placenta is separated from the uterus due to internal bleeding, sometimes between twenty weeks and when the baby is born. The hematoma further separates the placenta from the uterine wall, causing compression and impairing the baby's blood supply. Although very rare, it occurs only in 1% of pregnancies, but because women have high blood pressure [the most common cause, 44% of all cases], diabetics, heavy smokers and/or drinkers, or cocaine use History, therefore including higher risk.

Tests to determine this include: abdominal ultrasound, complete blood count, pelvic examination, fibrinogen levels, partial thromboplastin time, and prothrombin time. Placental abruption should be suspected when a pregnant mother has or does not have sudden local abdominal pain with bleeding. It may be necessary to monitor the top of the uterus [the fundus] because the rising fundus can indicate bleeding. Early recognition and proper management are key.

Symptoms of placental abruption

* 80% have vaginal bleeding.

* 70% have abdominal or back pain and uterine tenderness.

* 60% of babies show fetal distress.

* 35% have abnormal uterine contractions.

* 25% experienced preterm birth.

Intrauterine growth restriction [IUGR]

When the newborn's birth weight and/or body length is below the 10th percentile of their gestational age, they are considered to be growth-limited and their abdominal circumference is below the 2.5th percentile.

This is a complex issue involving multiple causes. However, there are several well-known risk factors including: alcohol abuse, drug addiction, malnutrition and smoking. Ultrasound is used for diagnosis and childbirth at an appropriate time, either too early or too late, necessary for effective pregnancy treatment. [Baseline height monitoring can also help detect growth-limited infants, but ultrasound is more accurate/ideal.] If IUGR is determined, vascular and biophysical tests should be monitored weekly or bi-weekly depending on the situation.

Short cervical length, premature delivery, cervical insufficiency [IC], infection

These are complex topics in the obstetrics field, with thousands of studies and as many opinions. They are directly or indirectly related to each other, so I tied them together due to space constraints. The following is a brief summary of recent research,...

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