Achieving adequate pregnancy weight gain is critical to optimize infant and maternal outcomes. Extremes of pregnancy weight gain—excessive and inadequate—can jeopardize the health of the mother and her baby. Excessive pregnancy weight gain is associated with increased risk of pregnancy complications, cesarean delivery, and an overly large infant. In the longer term, women with excessive gain during pregnancy are prone to retain pregnancy weight and are at risk for life-long obesity and diabetes. Inadequate gain is associated with negative infant outcomes such as low birth weight, growth restriction, and increased risk for cardiovascular disease as an adult. Worldwide, more women are entering pregnancy overweight or obese. This trend is a more recent phenomenon even in developing countries. Some countries or regions have guidelines for pregnancy weight gain but others do not. The 2009 United States Institute of Medicine Guidelines are presented and discussed for the general population or women during pregnancy as well as for less clear-cut cases, such as twins and women with extreme obesity. Midwives and health workers need to be comfortable discussing guidelines for pregnancy weight gain in their settings—whether in a classroom, home, or clinic.
Part of the book: Selected Topics in Midwifery Care
Worldwide, male circumcision is done for religious or cultural reasons, and to a lesser degree for medical indications. Newborn male circumcision is associated with fewer genitourinary infections in younger males. In the current decade, a substantial body of research suggests that male circumcision is effective as a prophylactic measure against HIV and other sexually transmitted infections. The compelling HIV reductions in 3 African randomized control trials in circumcised men have prompted use of male circumcision as a key part of HIV prevention in developing nations. More recently, the use of male circumcision as a public health measure in developed nations is a topic of international discussion.
Part of the book: Circumcision