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October 4 –10 was National Nurse Midwifery Week in the United States. To honor midwives all across our country and the world I have compiled a list of web sites that will educate and inspire us all. It is my wish that all who stop here take the time to visit each and every site through the month of October and reflect upon the stories and wisdom contained therein. See you next month!!

This month I had the pleasure of interviewing Simone Valk, a midwife practicing in Rotterdam, Holland. Simone graciously gave of her time to share a bit about herself, the training of midwives in Holland and the general nature of maternity care in Holland. The differences between our systems of healthcare is quite evident, but I found the differences in philosophy most impressive, and sobering.

As a midwife, I am often privileged to witness displays of human emotion that seem to occur exclusively within the context of birth. There are few other transitions of life that elicit the sort of emotion, be it positive or negative, that childbirth does. At every birth I attend there is always a memorable moment, often subtle and intimate, little insights into human nature that I tuck away in my subconscious.

In the United States, nearly one in four births is a cesarean birth. Many of these cesareans are unexpected, so it is a good idea for the expectant mother to become informed and educated about the procedure before her baby arrives.

As mothers-to-be, most women imagine a picture perfect pregnancy-- mild or no morning sickness in the first weeks, and within the fourth month, the soft kicking of new life within. Along with the growing, telltale tummy of an expectant mother, comes the choosing of a name decorating a nursery, buying baby clothes, and baby showers in honor of the mommy-to-be and the impending "arrival".

All obstetricians and reproductive endocrinologists know the placenta as the uppermost important organ for normal fetal growth till maturity. This endocrinological organ can be affected by many pathological states like other maternal organs.

In contrast to the pattern seen with singleton births, twins born to older mothers do not appear to have a greater risk of birth complications than do twins born to younger mothers, according to a recent study by researchers at the National Institute of Child Health and Human Development (NICHD) and the University of Kansas.

Vaginal deliver rates after previous caesarean section have been on the increase through the 1980s and 1990s but even at the dawn of the 21st century, trial of scar remains a controversy in obstetric care.

Cesarean deliveries are now the most commonly performed abdominal surgery in the United States. In 2005, an estimated 30.3 % of all births involved C-section procedures, and preliminary estimates from the Centers for Disease Control and Prevention indicate that the incidence of C-sections will continue to rise in the coming decade.

Although Group B Streptococcus was first described over one hundred years ago, GBS began becoming noticed as a leading cause of infection and death in newborns only in 1961. According to the CDC, roughly 1 to 3 babies out of every 1,000 children born in the United States suffers invasive Group B Strep disease, mostly in the first week of life.

The word "ectopic" means "out of place." An ectopic pregnancy is a pregnancy that is not growing in the usual location (the uterine cavity). Ectopic pregnancies can occur in a number of abnormal locations, each with different characteristic growth patterns and treatment options.

Ectopic pregnancy, or preembryo implantation outside the endometrial cavity (i.e., fallopian tube, cervix, abdominal or pelvic cavity), is a potentially fatal condition with an incidence of ~1:150 diagnosed pregnancies.

Expect to have feelings; about the labor, the birth, towards the baby, about nursing or not, about responsibility, about your partner, etc.

Test your ob/gyn knowledge in our DailyDx.

As soon as a pregnancy becomes recognized, each (prospective) parent generally starts to accept and plan for their new arrival. If the pregnancy is lost, this is often considered a "death within the family" and the couple will go through an intense grieving process. The loss of a pregnancy can be devastating for a couple, regardless of the number of children in the family or the cause for the loss.

She just paged you again. It is “urgent”, just like the last 5 times. You sigh deeply: no matter how many times you tell her that her labs are normal, explain that some shortness of breath is expected in the last trimester, or reassure her that her heartburn is not a first sign of a heart attack (yes, you checked) – it simply won’t stick.

Vulvodynia is a general term which means, simply and literally, "pain in the vulva." It is not the name of a disease, but a symptom, just like "headache." Vulvar vestibulitis is a syndrome in which there is pain at specific points in the vulvar vestibule (the portion surrounding the entrance to the vagina).

Do you have Chronic Pelvic Pain?Have you been referred to a Physical Therapist? and do you wonder why?What can a Physical Therapist do for you?

Pelvic pain in this category indicates a problem that if not treated urgently will cause serious harm or death. One serious cause of acute pelvic pain is a ruptured tubal (ectopic) pregnancy. Many women with a tubal pregnancy will continue to have menstrual-like bleeding, so they do not consider this possibility.

Most women experience pelvic pain at some time during their lives. Many times pelvic pain is just the normal functioning of the reproductive or other organs. Other times pelvic pain may indicate a serious problem that needs urgent treatment. Here we look at the causes of pelvic pain, and how the cause of pelvic pain is determined.

Many women want to know how to acquire a flat stomach. They are especially curious about this following surgical procedures i.e.: laparotomy, laparoscopy and hysterectomy.

An episiotomy is a surgical incision into the perineum, the area between the bottom of the vaginal opening and the anus, in order to increase the size of the vaginal opening during childbirth. If it is done as part of gynecologic surgery, it's called a perineorrhaphy.

What could possibly be worse than struggling with a painful condition and feeling ashamed to discuss the problem because of its intimate nature? Such is the case for many suffering with pudendal neuralgia, a little known disease that affects one of the most sensitive areas of the body. This area is innervated by the pudendal nerve, named after the Latin word for shame.

0) No Pain1) Slight Pain, slight ache, pain comes and goes very mild. Able to perform all tasks normally and pain is easily forgotten while attending to something else. No pain medications required.2) Slight pain which lasts a bit longer, still able to perform usual tasks and again, if concentration is shifted away from the pain, the pain is forgotten about. No pain medications required.3) Pain is more noticeable and it comes and goes more frequently. Still able to perform usual tasks but it takes a bit of effort. Mild analgesic usually will help with this type of pain.4) The pain lasts for longer periods, it is much more noticeable and it is starting to bother and interfere with concentration and tasks requiring more effort and concentration. Mild analgesia should alleviate this type of pain, maybe more doses than one single dose may be required. A hot pack or ice pack may also help alleviate the pain.5) The Pain is now very noticeable, it is interfering with everyday tasks and a pain reliever is now required at 4 to 6 hourly intervals. Depending on the patient, someone with acute pain, may still respond well to mild analgesia probably at 4th hourly, maybe with added codeine (if the patient is able to take it) and even heat or ice may help with some relief of this level of pain.6) The Pain level is medium heading towards strong now and it is becoming more constant and it is not easily forgotten about. Pain relief is now required and it may need to be stronger than just mild analgesia, added codeine may help with the level of pain relief, this all depends on whether the pain is acute or chronic and on the patient's actual level of pain tolerance. A chronic pain patient may still have this level of pain even with strong pain relief.7) The pain level is now medium to strong and the pain is continuous. It is not relieved by mild to medium analgesia. Stronger narcotics are now required for pain relief. Chronic pain patients may still be at this level, even with strong narcotic pain relief. Heat may also aid with relief. Its becoming harder to concentrate due to the strength of the pain.8) The pain is becoming unbearable, strong narcotic pain relief is required. The chronic and acute pain patient will be irritable, hot and may be flushed, perspiration may be noticeable. Blood pressure may also be elevated. Patient may start to shake a bit if the pain has been going on for too long.9) The pain now is unbearable, only strong narcotic pain relief for the acute patient will help with the pain. The chronic pain patient will be irritable, the patient may be flushed and their palms are usually sweaty, blood pressure usually raised, pain relief needs to be increased and re-assessed. Nausea or vomiting may be present. The patient may be trembling or shaking due to the amount of pain, moaning and groaning may be present. Whether the pain is acute or chronic, the patient is usually unable to sleep or concentrate on the smallest task.10) The pain level is totally unbearable, the patient maybe vomiting or can even lose consciousness. The patient may also become delirious, moaning and groaning without making any sense. The blood pressure may still be elevated or by now may have dropped and the patient may go into shock. The patient must be treated by his/her symptoms, if cold, then the patient should be kept warm and if hot they should be cooled down. Pain relief is needed urgently. The patient may even become incontinent.

For those of us involved in the field of weight control, there is no greater reward than helping someone overcome their struggles with weight. Too often, people with weight issues feel they are weak, lack willpower, or have a psychological “block” that makes taking off just a few pounds seem like a task of Herculean proportions.

In November of 1996 (at the age of 25) I was diagnosed PCOS, and about 2 weeks later I started having very intense pelvic pain that I thought was due to a pulled muscle. The pain continued for several months, and after an examination and discussion with my family doctor, we believed it was ovarian cysts.

Oral and topical pre-exposure prophylaxes are successful in preventing the transmission of human immunodeficiency virus via sexual intercourse, according to a presentation at the 13th European AIDS Conference of the European AIDS Clinical Society (EACS). Established in 1991, the EACS is a leading scientific society composed of clinicians that aims to educate, train and compose guidelines for those clinicians in Europe treating patients with HIV and AIDS.