This book reveals the structures of poverty, power, patriarchy and imperialistic health policies that underpin what the World Health Organization calls the "hidden disease" of vaginal fistulas in Africa. By employing critical feminist and post-colonial perspectives, it shows how "leaking black female bodies" are constructed, ranked, stratified and marginalised in global maternal health care, and explains why women in Africa are at risk of developing vaginal fistulas and then having adequate treatment delayed or denied. Drawing on face-to-face, in-depth interviews with 30 Kenyan women, it paints a rare social portrait of the heartbreaking challenges for Kenyan women living with this most profound gender-related health issue - an experience of shame, taboo and abjection with severe implications for women's wellbeing, health and sexuality. In absolutely groundbreaking depth, this book shows why research on vaginal fistulas must incorporate feminist understandings of bodily experience to inform future practices and knowledge.

This book examines the future of birthing practices, particularly by focusing on epidural analgesia in childbirth. It describes historical and cultural trajectories that have shaped the way in which birth is understood in Western, developed nations. In setting out the nature of epidural history, knowledge and practice, the book delves into related birth practices within the hospital setting. By critically examining these practices, which are embedded in a scientific discourse that rationalises and relies upon technology use, the authors argue that epidural analgesia has been positioned as a safe technology in contemporary maternity culture, despite it carrying particular risks. In examining alternative research the book proposes that increasing epidural rates are not only due to greater pain relief requirements or access but are influenced by technocratic values and a fragmented maternity system. The authors outline the way in which this epidural discourse influences how information is presented to women and how this affects their choices around the use of pain relief in labour.

This issue of Clinics in Perinatology will carry the reader through the perinatal period and examine pain management throughout that continuum. Beginning with the genetics of obstetrical pain and opioid use in pregnancy, the discussion moves to the provision of anesthesia to the mother and fetus during fetal surgery - an area of intense concern and interest in many centers. There is an extensive discussion of both pharmacologic and non-pharmacologic management of pain during delivery. A discussion of regional anesthetic techniques is increasingly relevant in light of increasing evidence of adverse neurodevelopmental consequences of fetal exposure to general anesthetics and sedatives. Pain, its implications and management, are extensively covered including discussions of how to assess neonatal pain and how best to provide sedation and non-pharmacologic pain management, systemic pharmacologic, or regional techniques. Of particular interest are the reviews of the potential neurodevelopmental impact of both the treatment and the failure to adequately treat pain in the newborn. This topic is receiving an enormous amount of attention from all those who care for children as well as government and the media.

"Clinical Pharmacology During Pregnancy" is written for clinicians, physicians, midwives, nurses, pharmacists and other medical professionals directly involved in the care of women during pregnancy. This book focuses on the impact of pregnancy on drug disposition and also includes coverage of treatments for diseases of specific body systems as well as essential content on dosing and efficacy.

The broad range of this book encompasses analgesics, antiasthmatics, antidepressants, heart and circulatory drugs, vitamins and herbal supplements, and more. Topics in chemotherapy and substance abuse are covered, as are research issues, including clinical trial design and ethical considerations.
Uses an evidence-based approach for therapeutics during pregnancyIncludes a summary of specific medications by indication with up-to-date information on dosing and efficacy in pregnancy for the given indicationIncludes a companion website containing support materials for professional or continuing education courses in OB pharmacology

Top authors were selected to write clinical review articles devoted to Advances in Respiratory Care of the Newborn. Articles are devoted to: Effects of chorioamnionitis on lung function and growth; Delivery room respiratory management of the term and preterm infant; CPAP or INSURE for initial respiratory support; Which CPAP is best?; Non-invasive respiratory support; Volume limited and volume targeted ventilation; Weaning from mechanical ventilation; Predictors of bronchopulmonary dysplasia; Brain Injury in Chronically Ventilated Preterm Neonates: Collateral Damage Related to Ventilation Strategy; The Pulmonary Circulation in Respiratory Failure; Novel methods for assessment of right heart structure and function in pulmonary hypertension; Control of oxygenation; Non-invasive monitoring by photoplethysmography; Cell-based strategies to reconstitute lung function in infants with severe bronchopulmonary dysplasia; Permissive Hypercapnea; Prevention of BPD with Nitric Oxide; and Aero-digestive pulmonary disorders in the neonate.

Neurologic illness in pregnant women requires special consideration on the part of the neurologist. These disorders can impact pregnancy in distinct ways, and their therapies must often be modified to protect the health of the mother and fetus. This issue of Neurologic Clinics features 11 articles on the interaction of the main neurologic disorders and pregnancy.

Pregnancy stresses the heart and circulatory system. During pregnancy, blood volume increases by 30 to 50 percent. The amount of blood the heart pumps each minute also increases by 30 to 50 percent, and heart rate increases as well. These changes cause the heart to work harder, as do labor and delivery. This issue covers diagnosis and treatment of cardiac symptoms and cardiac emergencies during pregnancy.

The Guest Editors have assembled a list of topics that provide state-of-the-art coverage on fetal surgery. Topics covered include fetal cardiac intervention, abdominal wall defects, NEC, esophageal atresia, and spinia bifida.? Some articles provide the clinical basics, like general concepts of fetal surgery, while others provide a detailed look at CDH in utero, CDH post natal, ECMO/placenta, stem cell, and anorectal malformations.

More than half a million babies in the US are born prematurely every year - preterm birth is the leading cause of infant mortality and those who survive may face lifelong problems.? This issue of the Obstetrics and Gynecology Clinics discusses the epidemiology, outcomes and clinical prediction of preterm birth, and offers information on various therapies.

This book discusses how to deal ethically with people with Fetal Alcohol Spectrum Disorder (FASD) in the police, courts and correctional services. Ethical and legal issues associated with the deficits of individuals with a brain disorders such as FASD are surfacing more and more frequently in criminal proceedings. People with FASD often have not been diagnosed and rarely exhibit any visible evidence of the disorder. It has been argued that this invisible disability puts them in a disadvantaged position in the justice system, since the awareness of this condition is limited. The need to identify and to address FASD more effectively and the many ethical issues this raises within the context of the law is increasingly acknowledged within judicial and legislative branches, as well as in government departments, agencies and community programs that provide services to those with FASD and their caretakers and families. This is the first book to give to elaborate on ethical and legal issues of FASD.

Technological developments in the life sciences confront us with new facets of a Faustian seduction. Are we "playing God" more and more, as claimed by critical authors of modernity? Achievements in genetic research produce ethical dilemmas which need to be the subject of reflection and debate in modern societies. Denial of ambivalences that ethical dilemmas arouse constitutes a threat to societies as well as to individuals. The book presents a compilation of some of the results of the interdisciplinary European study "Ethical Dilemmas Due to Prenatal and Genetic Diagnostics" (EDIG), which investigated some of these dilemmas in detail in a field which is particularly challenging: prenatal diagnosis. When results from prenatal diagnosis show fetal abnormalities, women and their partners are confronted with ethical dilemmas regarding: the right to know and the right not to know; decision-making about the remainder of the pregnancy and the desire for a healthy child; responsibility for the unborn child, for its well-being and possible suffering; life and death. This book provides answers from an ethical, psychoanalytical and medical viewpoint.

In the later stages of gestation, fetal functions undergo increasing change and development, preparing the fetus for the transition to its postnatal environment. Rapid maturation is witnessed in breathing, swallowing, sensory functions, sleep, and many other processes, with corresponding behavioral changes. By 35 to 40 weeks of gestation, fetuses are capable of living ex utero without support, but it is increasingly appreciated that even infants born at between 35 and 36 weeks can suffer long-term consequences. This book, which complements the author's previous volume on development of normal fetal movements during the first 25 weeks of gestation, discusses in detail the full range of behavioral phenomena observed during the final 15 weeks of gestation, with careful analysis of their mutual relationships. A key feature is the outstanding photographic material, difficult to obtain at this late stage, and the instructive graphs that are also included. The information provided will alert clinicians to deviations from the norm and to physiologic phenomena that can turn pathologic in infants born prematurely.

Globally, postnatal depression (PND) is a growing public health problem. PND affects 10 to 15% of women in Western society. It caused by a combination of biological, psychological and social factors. Two models have attempted to define and explain PND; the biomedical and the sociological models. The traditional biomedical model views PND as a medical condition which implies there is individual pathology and abnormality. Whilst the biomedical model has been the dominant model in treating PND, it has been criticized by feminist sociologists and psychologists for its rigidity in defining and explaining PND. In contrast, the psychosocial model of health acknowledges the biological factors that impact on emotional well-being, but places more emphasis on the personal and social factors that impact on emotional well-being, but places more emphasis on the personal and social factors that contribute to depressive symptoms such as gender, poverty, social disadvantage and social class. The central argument throughout this book is the importance of support before and after the birth for women's emotional well-being. This book will also include women's journeys through pregnancy, childbirth, motherhood, postnatal depression, and resolution. To date, literature has focused on women's lived experiences of PND rather than their personal journeys through pregnancy, childbirth and early motherhood. Additionally, the adjustment to fatherhood has received less attention. For example, little is known about the impact of postnatal depression on the partner, what support partners offer when women with the intention to fill the gap in knowledge of cultural and social issues relating to pregnancy, childbirth, and motherhood for woman who were diagnosed with, and had resolved, PND.

This issue provides valuable information on the many different pulmonary concerns that arise in pregnancy. Topics include: Radiation in pregnancy, Pharmacotherapy in pregnancy and lactation; Respiratory physiology; Asthma in pregnancy; Cystic Fibrosis in pregnancy, Pulmonary embolism in pregnancy; Interstitial lung disease and connective tissue diseases in pregnancy; Pulmonary hypertension in pregnancy; Tuberculosis in pregnancy; Pneumonia in pregnancy; Sleep in pregnancy; Smoking and smoking cessation in pregnancy; High altitude and pregnancy; Fetal oxygenation and ventilation.

They are laborers, soldiers, refugees, and orphans. In areas of the world torn by poverty, disease, and war, millions of children are invisible victims, deprived of home, family, and basic human rights. Their chances for a stable adult life are extremely slim. The powerful interdisciplinary volume Vulnerable Children brings a global child-rights perspective to the lives of indigenous, refugee, and minority children in and from crisis-prone regions. Focusing on self-determination, education, security, health, and related issues, an international panel of scholars examines the structural and political sources of children's vulnerabilities and their effects on development. The book analyzes intervention programs currently in place and identifies challenges that must be met at both the community and larger policy levels. These chapters also go a long way to explain the often-blurred line between vulnerability and resilience. Included in the coverage: Dilemmas of rights-based approaches to child well-being in an African cultural context. Poverty and minority children's education in the U.S.: case study of a Sudanese refugee family. The heterogeneity of young children's experiences in Kenya and Brazil. A world tour of interventions for children of a parent with a psychiatric illness. An exploration of fosterage of Owambo orphans in Namibia. UNICEF in Colombia: defending and nurturing childhood in media, public, and policy discourses. Vulnerable Children is a must-have volume for researchers, graduate students, and clinicians/professionals/practitioners across a range of fields, including child and school psychology, social work, maternal and child health, developmental psychology, anthropology, sociology, social policy, and public health.

This issue of Clinics in Laboratory Medicine, Guest Edited by Anthony Odibo and David Krantz, will feature article topics such as: Screening for Chromosomal abnormalities; Cystic fibrosis screening; The role of second-trimester screening, in the post-first trimester screening era; Modifying risk for Aneuploidy with second-trimester ultrasound after a positive serum screen; Cost-effectiveness of Down syndrome screening paradigms; Biochemical and biophysical screening for the risk of Preterm delivery; Pre-implantation genetic diagnosis; Prenatal testing for infectious disease, Thrombophilias, Preeclampsia, Neural Tube Defects; Management of Multiple Pregnancy; Genetic Counseling Issues in Down syndrome Screening; First Trimester Ultrasound Markers; Quality Control of Nuchal Translucency; Clinical Implications of First Trimester Screening; Adverse Pregnancy Outcomes after Positive Screening; First Trimester Combined Screening: Instant Risks Approach.

This book addresses the essential topic of child survival in Tanzania, especially focusing on the role of mutual assistance, which has received little attention to date. Further, it identifies a range of key factors for child survival by combining a literature review, regional data analysis, and case studies. These studies center on rural villages in high Under-5 mortality rate (U5MR) regions and assess their strengths and weaknesses regarding child survival. By focusing on deprived rural areas as of 2002 and evaluating the improvements in the 2012 census data, the book also highlights the potential held by rural semi -subsistence economies. An analysis of the focus villages indicates that children in food-sharing circles had better chances of survival. However, food sharing is not necessarily inclusive; a significant number of children have fallen out of such circles, especially in mainland villages. Furthermore, monetary support for children's medicine has often failed to arrive in time. Lastly, the book argues that, in addition to direct factors such as access to health services, water and sanitation, food intake, and education, it is essential that children receive inclusive support at various levels: family, community, village, national, and international.

This book offers a timely and detailed exploration and analysis of key contemporary issues and challenges in child sexual abuse, which holds great relevance for scholarly, legal, policy, professional and clinical audiences worldwide. The book draws together the best current evidence about the nature, aetiology, contexts, and sequelae of child sexual abuse. It explores the optimal definition of child sexual abuse, considers sexual abuse in history, and explores new theoretical understandings of children's rights and other key theories including public health and the Capabilities Approach, and their relevance to child sexual abuse prevention and responses. It examines a selection of the most pressing legal, theoretical, policy and practical challenges in child sexual abuse in the modern world, in developed and developing economies, including institutional child sexual abuse, female genital cutting, child marriage, the use of technology for sexual abuse, and the ethical responsibility and legal liability of major state and religious organisations, and individuals. It examines recent landmark legal and policy developments in all of these areas, drawing in particular on extensive developments from Australia in the wake of its Royal Commission Into Institutional Responses to Child Sexual Abuse. It also considers the best evidence about promising strategies and future promising directions in enhancing effective prevention, intervention and responses to child sexual abuse.

In order to bridge the lack of information on child labour and to stimulate policy interventions the IREWOC Foundation (International Research on Working Children) has undertaken action-based research in the field of the worst forms of child labour in Latin America. In 2006 and 2007 a comparative study on the Worst Forms of Child Labour was carried out in 7 different economic sectors in Bolivia, Guatemala and Peru focussing on the hazardous worst forms. The central research objectives were as follows: * to map the working and living situations of children who are working in specific economic sectors and what the consequences of this work are for their physical and emotional wellbeing. * to investigate the reasons why these children are working in these worst forms sectors. The research results were expected to give important insights into the currently polarised debate between those who state child labour is above all related to cultural considerations and those who state that economic reasons are fundamental to the phenomena of child labour. * to map the existing policy initiatives for child labourers in the worst forms and to identify the best practices. In the face of challenges imposed by achieving the Millennium Development Goals (MDGs) set by the UN, specific attention was paid to educational initiatives. Is education a useful tool in combating child labour, and vice versa, is child labour a significant obstacle to achieving universal primary education? Although the evidence from the various cases discussed in the book illustrate positive trends in terms of the worst forms of child labor, thousands of children were still found to be engaged in activities that form a direct threat to their physical, mental and moral health and jeopardize their education. This book proposes several practical recommendations for possible interventions.

A concise clinical reference that facilitates the diagnosis of intrauterine and perinatally acquired infections was the goal in creating the Congenital and Perinatal Infections: A Concise Guide to Diagnosis. Information about the natural history, m- agement, and outcome of these infections is well detailed in many other sources and so has not been included. Rather, the focus of the book is diagnosis. The initial chapters provide general information about serological and nonserological assays that are used for the diagnosis of infections, and a chapter about the placenta includes details about histopathological findings that can be helpful with the diagnosis of congenital inf- tions. The remainder of the book is devoted to the diagnosis of specific congenital and/ or perinatal infections. As illustrated in the chapters about specific infections, the approach to diagnosis of a congenital or perinatally acquired infection in the neonate begins, when possible, with consideration and diagnosis of infection in the pregnant woman, knowledge of how the infection is transmitted, and the risk of that infection for the woman and her fetus or neonate. The possibility of congenital or perinatal infection in neonates is usually considered because of the diagnosis of, or concern about a s- cific infection in, a mother during pregnancy that can be transmitted to the neonate or because of clinical findings in the neonate at birth that suggest an infectious cause.

This comprehensive account of the deadliest Ebola outbreak in history examines its devastating effects on West Africa's most vulnerable populations: pregnant women and children. Noted experts across disciplines assess health care systems' responses to the epidemic in Liberia, Guinea, and Sierra Leone, emphasizing key areas such as pregnancy, prenatal services, childbirth, neonatal care, and survivor health among pregnant and non-pregnant women. The 30 chapters hone in on gender-based social issues exacerbated during the outbreak, from violence against women and girls to barriers to female education. At the same time, chapters pinpoint numerous areas for service delivery and policy improvements for more coordinated, effective, and humane actions during future pandemics. A sampling of the topics: Ebola virus disease: perinatal transmission and epidemiology Comprehensive clinical care for children with Ebola virus disease Maternal and reproductive rights: Ebola and the law in Liberia Ebola-related complications for maternal, newborn, and child health service delivery and utilization in Guinea The Ebola epidemic halted female genital cutting in Sierra Leone-temporarily Maternity care for Ebola at Medecins Sans Frontieres centers Stigmatization of pregnant women with and without Ebola Exclusion of women and infants from Ebola treatment trials Role of midwives during the Ebola epidemic Pregnant in the Time of Ebola is a powerful resource for public health specialists, anthropologists, social scientists, physicians, epidemiologists, nurses, midwives, and governmental and non-governmental agency staff studying the effects of the epidemic on women and children as a result of the most widespread Ebola outbreak to date.

It's natural... It's unsightly... It's normal... It's dangerous. To breastfeed or not? For millions of women around the world, this personal decision is influenced by numerous social, cultural, and health factors. Infant Feeding Practices is the first book to delve into these factors from a global perspective, revealing striking similarities and differences from country to country. Dispatches from Asia, Australia, Africa, the U.K., and the U.S. explore as wide a gamut of salient issues affecting feeding practices as traditional beliefs about colostrums, "breast is best" campaigns, partner attitudes, workplace culture, direct government intervention, and the pressure to be a "good mother." Throughout these informative pages, women are seen balancing innovation and tradition to nurture healthy, thriving babies. A sampling of topics covered: * Policy versus practice in infant feeding. * Infant feeding in the age of AIDS. * Managing the lactating body: the view from the U.S. * Motherhood, work, and feeding. * The effects of migration on infant feeding. * From breastfeeding tradition to optimal breastfeeding practice. Infant Feeding Practices is a first-of-its-kind resource for researchers and practioners in maternal and child health, public health, global health, and cultural anthropology seeking empirical findings and culturally diverse information on this sensitive issue.

This book presents new findings that deal with different facets of the well-being of children and their relevance to the proper treatment of children. The well-being of children is considered against the background of a wide variety of legal, political, medical, educational and familial perspectives. The book addresses diverse issues from a range of disciplinary perspectives using a variety of methods. It has three major sections with the essays in each section loosely organized about a common general theme. The first section focuses on issues concerning the relation between children's well-being and autonomy or agency. The second section deals with child well-being insofar as the limits of parental authority are concerned. The third section has a more applied orientation and addresses a variety of public policy controversies involving the interpretation of children's well-being.

Obesity has reached epidemic proportions globally and presents a major challenge to policy makers and clinicians alike. Recent research has suggested that obesity has its origins in early life and that early diet can programme a developing fetus and young infant s future susceptibility to obesity. This volume contains recent findings presented at the International Conference on Early Nutrition Programming and Health Outcomes in Later Life: Obesity and Beyond - a satellite meeting of the 15th European Congress on Obesity, held in Budapest in April 2007. Basic scientific research, data from epidemiological studies and clinical trial results were all presented during the programme.

This volume includes articles discussing the evidence for an effect of early nutrition programming on later obesity and cardiovascular risk; the growing evidence for an intergenerational cycle of obesity; the role of maternal leptin in programming appetite; possible cellular mechanisms for altered energy balance, including mitochondrial programming and the effects of regulators of metabolism; and how epigenetic changes might be the fundamental underlying mechanism explaining programming effects. Consumer understanding of the concept of early nutrition programming and the extent to which early nutrition programming is taken into account in infant feeding policies are also discussed.