"How many times a day do you go to the bathroom?" - complete stranger on elevator

I've found many more strangers talking to me in the past few weeks as I ballooned to an obviously 9-mos pregnant lady.

In Finland, I don't recall a single stranger asking me about my pregnancy or commenting on my belly. In fact, I don't even recall anyone ever getting up on a bus or the metro to give me a seat or anyone ever offering to help me with my bags, etc. But, then again, strangers in Finland don't talk to each other about much in any case.

The oddest question here I've gotten so far is about how many times a day I go to the bathroom. Really. Asked by a total stranger on the elevator. I was leaving the doctor's office and stepped onto the elevator with a bottle of water when a woman who I believe is a drug company rep just thought she'd ask out of curiosity. I really haven't a clue. Zillions? Every 15-30 mins? At least 4 times a night?

Most comments are very friendly and a surprising amount have come from grandfather types who often stop me in the stores. "Oh, when are you due? Is it a boy or girl?" Followed by stories and even pictures of their own grandchildren. Very sweet.

Women are more likely to make observations like "You don't look at all pregnant from behind!" or "You're all baby". Even my doctor couldn't resist the last one. Or, women tend to ask if its a boy or girl and are certain from the shape of my bump that its indeed a boy.

Baggers at the grocery store are eager to help me out to my car. And, today at the garden center a man who happened to park next to me offered to help load the flowers and soil into my trunk. "I don't mean to insult you, but can I lend you a hand?"

Heading into the home stretch!

Finally in the last month with Tex!! We're almost as ready as we can be to welcome him. Just need to finalize that middle name .....

I've been seeing the doctor now once a week. At 37 weeks, we had our final ultrasound to check on Tex's position, the health of the placenta, amount of amniotic fluid, make a weight estimate and otherwise take a final look. Good news is that he is headed south and everything critical checked out fine. He got an 8/8 on his biometric profile :-) We also got to count some little toes and fingers, see his well-rounded cheeks and verify he is indeed a he. Tex weighed in around 6 lbs already with another 1/2 lb - 1 lb expected before birth. Peanut was 7.9 lbs herself so it sounds reasonable.

In addition the ultrasound check, in the US at this point most pregnant women are screened for group B streptococcus (GBS) bacteria. This is something that never came up in Finland and so I was not tested with Peanut.

Between 10 and 30 percent of pregnant women carry GBS bacteria in the vagina or rectal area, where they may pass it to their babies during labor or birth. With proper prenatal testing and treatment during labor, though, the risk is small.

Without treatment, one or two out of every 200 babies born to "GBS positive" mothers would become infected with the bacteria and develop what's called early-onset GBS disease ... which can cause sepsis (an infection in the blood), pneumonia, and meningitis in newborns....

getting screened when you're between 35 and 37 weeks of pregnancy and receiving antibiotic treatment during labor if you test positive will greatly reduce your baby's risk of becoming infected

During the last month at each visit, my doctor also does a pelvic exam to see if the cervix has begun dilating and/or effacing in preparation for labor. I'm not sure about the value of these exams since a woman can walk around 2 cm dilated for weeks and not go into labor while someone who had no progress can suddenly go into full labor.

If Tex follows his big sister's example, we won't be seeing him for another several weeks :-)

More older moms, cesearans and other US baby trends

A Babycenter newsletter highlighted recent baby trends in the US:
The teen pregnancy rate in the United States is at an all-time low, while the rate of caesarean deliveries is at an all-time high.

At the same time, the birth rates for mothers aged 30 and older rose in 2005 to levels not seen in nearly 40 years.

These findings are part of the Annual Summary of Vital Statistics: 2005, published in the February issue of Pediatrics.


The data in the report comes from U.S. vital statistics records, birth certificates, fetal death reports and death certificates. Here are some of the report's other findings:
• A record number of unmarried women are having children. The total number of births to unmarried women rose by 4 percent, to 1,525,345, in 2005.
•Slightly more than 1.7 million people were added to the U.S. population in 2004, or 5.8 persons per 1,000 population.
• The preliminary estimate of births for 2005 was 4,140,419, an increase of 1 percent from 2004.
• The general fertility rate in 2005 was 66.7 births per 1,000 women aged 15 to 44 years, the highest level since 1993.
• The infant mortality rate was 6.79 per 1,000 live births in 2004, not statistically different from the year before. The report also found continued differences in infant mortality rates by race and ethnicity. Non-Hispanic black newborns were more than twice as likely as non-Hispanic white and Hispanic infants to die within a year of birth.

No more 'baconized' ham, prunes, kegels...

We are almost there with little Tex!! Though I think being pregnant is a wonderous and amazing process -- there's a mini-human growing inside of me -- and hope it is something every woman can enjoy, I'm really looking forward to the end of

• prunes everyday
• having to microwave my cold cuts so that everything is basically like bacon
• remembering to do kegels
• dropping food on the front of all my clothes (since the crumbs & droplets can't get past the bump)
• sleeping on my side surrounded by pillows of all shapes & sizes
• my belly slipping out from underneath the maternity shirts that no longer are long enough
• jumping out of bed in the middle of the night to walk out yet another leg cramp in my calf
  
• my aching back...ha, that's just a joke, everyone knows a new mom's back aches even more :-)
  

Wham, Bam, Thank You Ma'am!

I had another pre-natal appointment for Tex this morning. It was the usual drill - sit in the waiting room for 20 mins, meet the nurse for 5 mins to measure weight and check blood pressure, quick trip to the bathroom, sit waiting in the doctor's room for 15 mins and, then, at long last, meet the doctor for a quick, clinical 10 mins to measure my belly, listen to the heartbeat and answer "no, no, no" to "any cramping, any bleeding, any questions?"

"Ok, great, see you again in two weeks."

In a way its efficient and we all get to know what we need to know. I don't have so many questions this time around since I've been through this before and, fortunately, nothing unusual is happening.

My pre-natal appointments for Peanut in Finland covered the same basic health checks, but then the midwife also was interested in how was I feeling - really - and how were things at home otherwise. Were we getting everything ready? Was I eating, sleeping, emotionally feeling OK? She also usually checked my hands for signs of swelling. And, then we spent a bit more time discussing how my measurements were tracking since she hand wrote them all into my Neuvola booklet which I carried with me. I always knew exactly what month/day we were at and how much weight I had gained compared to last week and how much my belly had grown.

Tex enters his third trimester

We marked the beginning of Tex's third trimester with a test-filled visit to the doctor. Auntie Em happened to be in town and got to experience it all first-hand....

My appointment included the one-hour (non-fasting) glucose screen test for gestational diabetes which is given to all pregnant women here. I had eaten an small omlet with some cheese and ham in the morning, and tried to avoid all sources of sugars to make sure the test result was as clean as possible.

We arrived on time, but sat around waiting for 30 mins until I re-checked with reception. In a rather unfriendly way, the receptionist said she'd check with my nurse to see what was happening. 15 mins later, she called me back to drink the 50 grams of sugary, room-temp glucose. I had 5 mins to get it down and then we ran through the other usual check-up measurements after which I was shown to a room to wait for the doctor. His visit was also quick once he arrived - a check of the heartbeat and measuring my abdomen.

From now on out, we'll be back every two weeks.

I still had 30 mins before it was time to draw blood for the glucose screen so we took a fast driving tour of downtown Grapevine. At the appointed time, I went back to the lab so blood could be taken for the glucose screen, an anemia test and and Rh antibody test. Results later though I get the Rhogam injection pretty much regardless of the Rh antibody test outcome.

Back in Helsinki with Peanut, it was nice that our neuvola was never very busy. We would arrive and go directly to the door of our mid-wife and usually had no wait. Sometimes she was wrapping up a previous appointment, but then it would be 5 mins at the max. She handled all the measuring, most tests and appointments herself. The anemia test consisted of a pin-prick to my finger and she had the results immediately from a gadget on her desk. I did have to go to the lab downstairs for Rh antibody tests though never was given an injection since the results were always negative. There was never any mention of a glucose screen test - I don't know if they profile the mothers and test only those who seem high risk or if some sort of diagnosis can be made otherwise.

Oh, the weather outside is delightful!

Christmas is nearly here - I'm at home, blogging! Not shopping, not cooking, not decorating and its a beautiful sunny day, not much more you could ask for.

The nesting instinct is kicking in this time around not so much as a clean and prepare the nest, but as a "craft your way to readiness". Yes, Michaels, JoAnn's and Garden Ridge have become all too regular places for me to visit. Sadly, I'm not very gifted in the crafting sense as the number of "I'll just try it again" projects around here will attest to. But, its not the final outcome that counts, it the process!!

Since Christmas arrives before Tex, my family gets to be the lucky recipient of all manner of crafted gifts. I've made braclets, picture galleries, hand-printed sweatshirts and then there was the finally abandoned attempt at a hand-painted tea tray. It really wasn't pretty and I had to buy one in the end. Some of the more successful gifts I created with photos on Snapfish. I figured what could a grandparent love more than a coffee mug with their cute granddaughter or a calendar that features more adorable pics of her every month.

Inspiration hasn't yet struck me for Tex's craft projects, but I'm sure his room will be full of them!

Making a down payment on Tex

At our recent 20 week prenatal visit, we were stopped at the receptionist on our way out. It was time to discuss insurance and payments for Tex.

The receptionist pulled out a worksheet where it outlined the "global obstetrical fee" (ie, the package deal for prenatal care + delivery of baby + postpartum 6 week check-up for mama. It excludes possible anesthesia (epidural) and post delivery hospital costs for mom and any baby-related care costs. Since we have chosen an in-network doctor and hospital, we got a special discounted rate of $2,369.00.

After we pay our annual deductible ($300.00), our insurance covers 80% of the remaining fee leaving us with a balance of $714. The entire amount has to paid by the 28th week of pregnancy though we could make interest-free payments up to that date.

As we tried to understand what else we could be billed for, the receptionist joked that anyone who enters your room will leave you with a bill, even the guy who sweeps the floor. She added that often the bills will beat the mama and baby home!

It was a very different approach with Peanut's delivery in Finland where a bill for 130 euros arrived weeks later in the mail. On the surface, it looks virtually free, but let's not forget the generous contributions Peanut's papa & I made through the years in taxes. I have no idea what the hospital charged KELA for the delivery so its really hard to compare the real costs. If I'm suddenly overwhelmed with free time, I'll let you know how it works out, but don't hold your breath :-)

Reaching for pregnancy nirvana

I've been a closet yoga -ist for over 5 years now. I'm the type to pop in the VCR tape or DVD, roll out my mat in front of the TV and just practice at home. I'll be devoted for weeks and then months can go by without a single downward facing dog or mountain pose.

Back in Finland, I did enjoy the Friday afternoon Power Stretch session hosted in the basement/fall-out shelter of the Nokia Research Center. But, once I moved to NHO, it was just me and the TV again.

With Peanut, I picked up Shiva Rea's Prenatal Yoga DVD. There were three ladies - one for each trimester - in all the segments showing how to modify the movements as your body changed. Before I got there myself, I always felt so sorry for Poppy, the woman in her third trimester, who ended up sitting for half the poses.

The program was really an energy booster and made me feel much more comfortable with all the changes taking place. Who knows what impact it had on the actual delivery, but I diligently practiced my kegels and yogic squats in hopes of preparing myself.

I've now dusted it off again and try to get in two sessions a week while Peanut is at Baby School. Its not quite as soothing as the first time around. My body is much achier and doesn't appreciate the stretches as much. Perhaps its just a matter of persistence.

If you can get your S.O. into it, there is a nice segment on pregancy massage techniques!

I didn't use or enjoy the Postnatal Yoga DVD as much. And, after a couple of months, I was back to the regular workout version.

Congrats you're having a baby - here's your promo bag!

On our very first prenatal visit for Tex here in Dallas, we met with the dr in his office after the sonogram confirmed a little heartbeat.

On his desk was a large plastic bag that looked to be packed full of papers and samples. I thought to myself a drug company rep must've dropped off the latest goodies for the dr while he was out.

It turned out the bag was for us! It was brimming with coupons, free magazine samples, prenatal vitamin samples and other booklets and papers telling us all about what's out there for baby.

Now, I, like most people, enjoy getting a bag full of free stuff :-) Especially when its appropriately targeted.

What was interesting was the amount of ad space dedicated to the formula vendors. The bag was sponsored by Infamil and carried several marketing pieces about baby forumulas. I noticed that in UK, for example, all infant formula ads have to marked with a notice that highlights that breastfeeding is the most complete nourishment for a baby up to 6 mos. Here in the US, there is no such requirement. Our bag also had mail-in cards to sign-up for the formula clubs promising formula coupons, free toys, a free diaper bag, free formula samples and more, more, more. Who can resit?
Enfamil Family Beginnings

I also got free issues of American Baby (sign up online for free subscription), Fit Pregnancy (the swimsuit issue), Baby Talk (another free subscription available online) and Women's Health and Fitness. (Where was my sample of Cookie!!??) I flipped through all of them when I was feeling queasy in the early days and now often go back to look for decorating ideas, find out what all is available in baby strollers and to cut out pictures of infants for Peanut's photo book.

There were coupons and product brochures from Baby Depot, Babies R Us and a local guide to what's what for babies in the metroplex. All complete with lists of 'must have' items for baby -- some over the top, but I know I would have appreciated the ideas for my first baby. And, there sure is a ton of gear, clothing and what nots that you can pile up if you want.

One of my favorite pieces is the "as your baby grows - from conception to birth" magazine. It has the most amazing photos from inside the womb of how a baby develops. Incredible color images of this tiny miracle! The photos are from a book called A Child is Born.

In contrast to all this, in Finland, I didn't see a piece of promo materials until I received my KELA box. In it were some free diapers, baby lotions and condoms. No coupons. At the hospital they had also tucked away, out of sight, on a shelf some small purple bags from the diaper brand, Libero. I just happened to overhear a nurse answer another mom that yes, you can pick one up if you want to, you don't have to.... Never anywhere were there any materials promoting formula.

Also, once Peanut was born and registered in the national population registry, we received some promotional mail at our home for her.

Take two and call me in the morning

I've noticed a different attitude towards pregnant women and medications here in the US as compared to the advice I received from my midwife in Finland. In both countries, there are those who believe nothing is truly safe to take during pregnancy. However, I think everything that is considered OK is fine in moderation. I've popped a few Tylenol over the past few weeks to ease a powerful headache and lower my fever so I could sleep. I see it always a question of balance -- which outweighs the other: the medications questionable harmful effect or the benefit from the comfort of it (ie, make it possible to rest or eat).

What medications are safe to take during pregnancy - OTC
Here in the US, at my first prenatal visit my doctor gave me a sheet with a list of safe to take over-the-counter medications:

• Tylenol or Extra strength Tylenol (ie, acetaminophen) for minor aches, pains and fevers. NOT aspirin or ibuprofen unless approved by dr.
• Sudafed or Robitussin for cough. Robitussin DM for cough suppression.
• Benedryl for allergies
• Mylanta, Maalox, Riopan, Tums for upset stomach and heartburn.
• Milk of Magnesia for occasional constipation.
  

My midwife in Finland only made suggestions when I asked about a specific symptom. I suppose the list in the US is because the volume of patients is much higher so they want to cover all the basics for everyone without having to field all those phone calls.

• Panadol (paracetamol) was OK for aches, pains and fevers
• Renni for upset stomachs and heartburn.
• But she didn't like the idea of taking anything for allergies and even suggested avoiding the anti-histamine eye drops I used during summer.
  

Morning Sickness medications
I was fortunate not have any morning sickness with Peanut so I don't really know what the stance is toward morning sickness medications in Finland. I did have a dear colleague (Hi K.S.!) who suffered immensely for many weeks with powerful morning sickness and she never mentioned any medications.

The info packet my doctor in the US gave me states there are no medications for morning sickness, yet I know of several moms here who have taken various pills to help alleviate the nausea and vomiting.

Flu Shots
Its that time of year again. My US doctor told me at the last visit their office usually gets a supply of flu vaccinations for pregnant mothers and it is a recommended shot. He said I can get it elsewhere, but just to make sure its not a live virus.

My midwife in Finland was opposed to me getting a flu shot during pregnancy.

The flu shot seems to cause a large amout of debate over the thimerosal (a preservative which contains mercury) it contains, its general effectiveness and belief that it can actually cause the flu.

From what I've read, here's the scoop:
Thimerosal - Yes, its in there in most vaccines, but in trace amounts, says the CDC:

Is it safe for pregnant women to receive an influenza vaccine that contains thimerosal?
Yes. A study of influenza vaccination examining over 2,000 pregnant women demonstrated no adverse fetal effects associated with influenza vaccine. Case reports and limited studies indicate that pregnancy can increase the risk for serious medical complications of influenza. One study found that out of every 10,000 women in their third trimester of pregnancy during an average flu season, 25 will be hospitalized for flu related complications.

General Effectiveness - that is, will the vaccination prevent you from getting the flu?
Not entirely. There are hundreds of strains of the flu virus each year and the vaccination is made to prevent what is guessimated to be the most widely spread. This years vaccine actually contains three strains.

The CDC claims:
With the flu shot, when the "match" between vaccine and circulating strains is close, the vaccine prevents influenza in about 70%-90% of healthy persons younger than age 65 years.

Can you get sick from the vaccine?
Its a killed virus so its not possible to become infected by the shot itself. Any illness that you get after the vaccination is coincidental.

Its time for belly oil again

As my belly begins to swell with Tex, I've been looking forward to using my belly oil again. I picked up a bottle while we were in the Netherlands though it seems you can find it in the US as well with a little work.

Weleda, a German company specializing in natural products, makes the Pregnancy Body Oil I love so much. It just smells so delicious and I swear it makes my belly warm and tingly.

I found it in the apteeki in Finland when I went to look for a refill for my Palmer's lotion. There weren't many lotions so I decided to give it a try. I was pretty skeptical of a body oil at first thinking it would be greasy and messy. It wasn't and the warmth it generated (I'm sure it does!!!!) felt extra wonderful during the frigid winter mornings and evenings. Whether or not it helped with my skin - who knows - I didn't have any stretch marks and felt reasonably comfortable in my skin even as Peanut grew to her largest size.

Checking in on Tex

I've just had my third prenatal visit for Tex this week.

To catch up, at the second visit, which was around week 12, the nurse met us for the usual weight, blood pressure and urine check before we saw the doctor. This time we also had an ultrasound to make sure Tex's growth rate was on track. There was some confusion between the nurse and doctor so we ended up with just an external (on the belly) ultrasound since the doctor thought I was thin enough for it to suffice. Usually this ultrasound is internal (transv*ginal).

Indeed, we saw Tex waving around. The picture wasn't as clear as the internal would have been, but it allowed the doctor to make the needed measurements. All along, he continued in a very reassuring manner, telling us everything was very normal and on track.

This past visit - after a 40 minute wait in the waiting room - I again first met my usual nurse (whose name I still don't know!) and then my doctor. This time he measured the growth of my uterus and used a doppler device to listen to Tex's heartbeat. He summed up it was all fine, but didn't actually tell me any of the measurements.

I was offered an AFP screening test, something which is not offered in Finland, to screen for certain neural abnormalities, such as Down's Syndrome, spina bifida and anencephaly. It is an optional test, which he said about 50% of his patients opt for and didn't really make any recommendation for me to take or not take. It has a reputation for not being very accurate and
causing more worry than answers.

Prescription Prenatal Vitamins + DHA supplement

At the very first prenatal visit here in Texas, my doctor gave me a prescription for Citrical prenatal vitamins that included a DHA supplement. A prescription prenatal? Why? It costs $20 for a 30 day supply -- and that's with health insurance!

I had been taking a generic prenatal vitamin from the time we started thinking about having Tex since its important to get at least three months of folic acid in your system before pregnancy to help prevent some neural birth defects. With Peanut, I had taken the LadyVita vitamin for pregnant and nursing mothers which was available at the apteekki.

In the beginning, I asked the OB/GYN I had seen in Finland for a pre-pregnancy check-up which folic acid supplement to take. She looked confused and didn't understand why I wanted to take it. Hmmmm???

Then, once pregnant, I asked my midwife in Finland which brand of prenatal vitamin she recommended. She wondered why I would even be taking a prenatal vitamin. In her opinion, as long as I ate a healthy and proper diet, I didn't need any additional vitamins. "Those Americans just eat hamburgers and french fries so they are not healthy enough without vitamins," she scoffed.

Yes, that's probably true, but a pregnancy diet needs to be very carefully balanced and followed everyday in order to get the needed vitamins and minerals consistently. However, my philosophy during my pregnancy was to do everything in moderation and to continue doing those things I had prior to pregnancy (within guidelines of course!). I have virtually always taken vitamin supplements so that's what I planned to continue to do. I do follow a pregnancy diet and eat well, but know that I'm no nutrition expert and sometimes given to laziness in the kitchen.

Nonetheless, I was not wholly sold on the idea of prescription prenatal vitamin. My doctor explained its valuable because of the lower amounts of vitamin A and higher amounts of calcium as compared to generics. Most importantly, it came with the DHA supplement. DHA is an omega-3 fatty acid considered to be key to healthy brain, eye and nervous system development. My usual source has been salmon, but I know I don't eat it frequently enough.

Though there is no official FDA recommended daily allowance for DHA, the concensus (I found on the Internet) seems fall between 200 - 350 mg/day for pregnant women.

So, my current solution is this: continue with my generic prenatal because its so much cheaper, drink some extra milk/fortified OJ for more calcium and pick up the a separate DHA supplement available OTC for less the $20 I would pay a month for the prescription vitamin. As a bonus, each box of the Expecta brand DHA supplement comes with a coupon for $1.50 off your next purchase.

I miss my maternity neuvola card

When I was expecting Peanut in Helsinki, I was given a "Maternity Health Clinic" card. Really a small booklet where at each midwife and doctor's visit my vital stats were recorded. The midwife and doctor also made the same notes into their own file. All by hand. I remember being surprised that the Katiloopisto hospital where Peanut would be born had no access to the information electronically - they, too, would have to decipher the hand-written notes from my maternity card.

I was told I should keep my Finnish Maternity card with me at all times so in essence I'd have my pregnancy health record on hand if I ever had to go to a different clinic or hospital. But, I liked it so I could keep track of how things were developing: my weight, blood pressure, blood test results, protein, glucose and iron tests, height of the uterus, Peanut's heart rate and position. It was fun to pull it out every once in a while at home to see how far we had progressed.

Here in the US, the notes are made by the nurse and my doctor into the folder kept at his office. A few times, I've even had to ask if I gained weight or how my blood pressure was as the nurse silently made her notes. I try to recall the details and write them down for myself in my own notebook. I suppose the idea is that if I need care, I will go only to his office and my selected hospital where my doctor will be available and aware of my condition.

"Tex" -- arriving early 2007!

The latest news here is that Peanut will become a big sister next year! "Tex" will make his/her appearance in early spring 2007! We thought "Tex" was appropriate as the hospital forms pointed out, we will not just be having a baby, but a new Texan.

We're excited all around and, blogwise, I'm excited about lots of posting ideas comparing pregnancy in the US and Finland.

Its already been a vastly different experience even though we're only a few months along.

To begin with, the doctor wanted to see us as soon as we thought we might be pregnant. In our case that was barely 6.5 weeks along when the tell-tale signs were confirmed with an at-home pregnancy test.

In Finland, I had been advised to wait a bit later before contacting the neuvola - I called around 9 weeks. When I did call, the first question was "Was this a wanted pregnancy?" so they could determine which side of the health clinic to connect me to.

Here, we met the doctor right away. At our first visit, I gave up at least 6 viles of blood for a variety of standard tests: blood type, Rh, blood count, immunity for Rubella, screen for antibodies, hepatitis, syphilis and HIV.

Then, the doctor did a sonogram. I was amazed that you could see/hear anything so early! But, "Tex" was there - a little blurry blob with no distinguishable features, except a strong and clear heartbeat. It was the heartbeat the doctor was after. He was very enthusiastic and explained that once you hear a heartbeat the chance for miscarriage already diminishes to just around 5%.

In Finland, our first meeting with the doctor and a sonogram was at 12 weeks. Before then, we just assumed everything was normal and met with our midwife.

So far, we've paid $15 as our insurance co-pay. However, I've seen what the doctor's office is billing the insurance company:
$960 for blood tests
another $960 for sonograms and doctor's consultations.

Yikes!

Try to keep to just 10 shots of vodka a week during pregnancy - ??

According to Alko, the Finnish state-run alcohol monopoly, a "reasonable" amount of alcohol can continued to be consumed by women during pregnancy. According to their brochure on Pregnancy and Alcohol, the top-end of a reasonable amount is ten drinks a week. Ideally, this alcohol consumption should be spread through out the week and not take place all at once on the weekend as this may slow the development of the fetus!!!

Yikes!!! What kind of advice is that -- from a company (or rather State) that stands to make money by selling alcohol to pregnant women??

Further, in the brochure:
> 9 out of 10 women in Finland cut back on the amount of alcohol they drink during pregnancy to 1 - 2 drinks a week; many quit entirely.
> About 10% of pregnant women consume more than the recommended amount.
> About 5% of pregnant women consume more than 10 drinks/week.

In the US, the guidelines for alcohol and pregnancy are very black & white and at the other end of the spectrum: no amount of alcohol is recommended for pregnant women. It is also believed that alcohol is the leading cause of birth defects. In the US, 5% of children born with birth defects are born with defects caused by alcohol consumption during pregnancy.

In Sweden, they estimate that 11% of school aged children with learning disabilities are suffering from the effects of alcohol consumed by their mothers during pregnancy.

In Finland, each year 200 - 300 children are born with severe defects due to mothers drinking alcohol during pregnancy.

And Norway recently decided to go for a zero tolerance recommendation for alcohol use during pregnancy.

With alcohol being an entirely optional item of consumption and the dangers to the fetus so thoroughly researched, I don't understand why Alko does not make the recommendation that no alcohol is ideally be consumed during pregnancy? Especially, in a country like Finland where alcohol abuse is high and the drinking culture does not frown upon drunkenness. Why not make it easy for pregnant women to simply say no and to give the fetuses more healthy environment?


More brilliant advice - alcohol and breastfeeding
Alko closes the pregnancy and Alcohol brochure with this information and advice about drinking alcohol and breastfeeding:
alcohol does pass into the mother's milk and the blood alcohol level of the mother's blood and breastmilk can be considered to be the same. So, if a mother is highly intoxicated (eg, 2.0 pro-mil), the amount of alcohol in the milk is 0,2 ml/1 deciliter - an amount so small that the baby would not get drunk (THANK GOODNESS!). However, even such a small amount may cause a child to be restless as they can sense the mother's drunken condition from her stumbling around, etc....and that's why you shouldn't nurse while drunk.

However, the midwives at Kätilöopisto were of a different opinion - don't drink alcohol when you are breastfeeding.

Hmmm, I wonder who knows better?

Vitamin D for a healthy baby and mom

Vitamin D supplements are recommended in Finland and the US for babies who are exclusively breastfed. It is the one vitamin not produced in high enough quantities by mom. Vitamin D is important for healthy bone development as it facilitates the absorption of calcium and a lack of it can lead to growth disorders and illness.

In Finland, however, the use begins at an earlier age. Our health center recommended that Peanut begin at age two weeks. We started with one drop a day and built up to the full 5 drops over 5 days. For infants under one year, the dose is 10 micrograms/day year round until the age of one - three when the dose is 5 - 6 micrograms/day. After that, from age 3 - 15, it is recommended that children continue the 5 - 6 micrograms/day during the dark time of year (Nov - March).

There were two major brands of Vitamin D drops - Devitol and Jekovit. The nurse suggested that Devitol tasted better. Though I tasted it - not much flavor as its sesame seed oil based - but to see Peanut screw up her face when she takes the drops tells me these is obviously some taste. The other difference was that Devitol has to be stored in the refridgerator, but you only have to give 5 drops a day. Jekovit can be kept at room temperature, however, you have to administer like 12 drops. That was the deciding factor for me! 5 drops is challenging enough. I only hope that it can be absorbed through the skin, particularly on the chin since that's where it often seems most of the drops end up.

MiniSun for mama
Since the sun is a major source of Vitamin D for humans, in Finland, pregnant and nursing mothers should take a Vitamin D supplement during the dark months - beginning of November to the end of March. Other sources for Vitamin D are milk products with Vitamin D additives, eggs and fish oil.

I chose a happily named product - MiniSun. It came in regular tablets and pear-flavored with added calcium (my choice). I had a suspicion that it seemed like a good idea for anyone living in Finland and convinced Peanut's dad to join me in taking a daily supplement. Whether it was psychosomatic or not, I think we both felt more cheerful as well :-)

Boy or Girl? We can't tell you...

Like many parents, we wanted to know if our Peanut was a boy or a girl before her birth.

Since I didn't have the amniocentesis test, the method open to us was to have an ultrasound.

In Helsinki (perhaps all of Finland), a woman has two ultrasound exams during her pregnancy to monitor the development of the fetus. The first one is around week 12 and the second around week 22. The ultrasounds are usually done at the maternity hospital where the baby will be born. In our case this was the Kätilöopisto.

The first ultrasound is to check the development and identify any potential issues, such as swelling or fluid at the base of the neck (a possible sign of Down's Syndrome). It also is used to determine the estimated due date by taking a measure of the femur to estimate the baby's age. We also saw the beginnings of the stomach and brain formation. In this exam, the used both an internal and external ultrasound device.

The second is more extensive and covers the development of the internal organs and the brain. In particular they check the position of the placenta; measure the head and femer; development of brain and its chambers; heart and its chambers; kidneys and urinary tract; stomach; backbone; umbilical cord and the amount of embroyotic fluid. Its at this age that the gender of the baby could also been seen.

However, public hospitals are told specifically that they cannot tell parents the gender of the baby - even if the technician is able to see it. One reason is that these are publically funded hospitals and they don't want to waste money or time on a item that is not critical to the health of the baby. Time is certainly an issue - I was 'triple-booked' for my ultrasound slot, meaning my turn would come once the person who had the actual time slot and the person double-booked for it had their exams! Another reason is that ultrasounds are not a 100% accurate way to determine gender. They don't want the responsibility of giving parents the wrong information.

Each one cost me 22 EUR and we were given several "photo" print outs to take home. These we quickly scanned and emailed off to the anxiously awaiting grandparents and family for their first glimpses of Peanut.

How to Find Out
Well, we still wanted to know. So we had to go to a private clinic for another ultrasound.

We chose to go to Femeda, a clinic in Helsinki on the recommendation of a friend and also because they have 3D ultrasounds! I think Peanut's Dad was especially fascinated by the technology :-)

It was admittedly very cool to see a 3D image of Peanut. This was printed out and could be recorded onto a VCR tape or DVD. Both of which we forgot at home, but we re able to purchase at the clinic. During the exam we also saw more detailed images of the organs and could see that her facial features were forming normally (ie, no cleft lip). Every one of these visits is reassuring to expectant parents. Though the 3D peek was almost seemed to be a bit more than we should be seeing - somehow almost invading her privacy.

This visit was more expensive - around 150 EUR with a portion refundable by KELA.

Where to buy

Here's a list of stores selling maternity and baby clothing, equipment, etc.

Our favorites:
Lastentarvike - a chain with stores across Finland. Their mega-store, I believe the largest in Finland, is in Petikko outside of Helsinki
Lindex - a low price store with limited maternity wear and underwear as well as good selection of baby clothes similar to a Target in the US
H&M - has the affordable MaMa line for expectant mothers and also makes mini-sized fashion outfits for baby
Kappahl - expansive baby wear department
IKEA - offers baby furniture, linens, toys and more
Stockmann - of course!
KKKK Supermarkets - diapers, baby clothes, bath tubs, baby wipes, toys, stollers, etc
Etola - toys, toys, toys as well as all sorts of equipment made of plastic (bathtubs, potties, plates, etc)


Some boutiques I've visited (with prices to match!)
Belua in Helsinki (also sells the HugaBub baby wrap)
bebes in Helsinki baby and maternity clothing, books, lotions etc, gifts
Nelliina in Tapiola gifts, photo frames, nursery decor
BamBami in Kämp Galleria a Dutch chain - strollers, car seats, clothing, furniture, gifts


Others:
Seimi designer baby furniture
Embia in Lahti clothing, cloth diapers
Pikku Eero sleepsacks, baby wraps, clothing
Pikku Kenguru with several locations furniture, nursery decor, clothing, gifts
Missy Mom
Lasten Verkkopuoti
Pikku Prinssi
Pikku Selma
Pehmo Peput nursing wear, baby wraps, cloth diapers
Jutta natural clothing, baby swim gear, cloth diapers
Lastenturva mega store in Varisto (Vantaa) - baby carriages, etc
Vaavisänky rental baby beds
Vauvatalo Johanna baby stollers, beds, car seats and more
Pienet Ihmiset
Kulta Pieni sleep sacks, baby wraps, cloth diapers, clothing, toys
Liinameri baby wraps, cloth diapers, nursing pillows
Vauva Buumi baby wraps, backpack carriers, cloth diapers
Me & Mama cloth diapers, baby wraps, natural fabrics, maternity wear, toys, baby care products
Vauvatar online shop with baby carriages, stollers, jogger strollers, car seats, feeding chairs, beds, etc
Suomen Lastenvaunutukku wholesaler of baby carriages/stollers featuring some brands out of the ordinary - Koelstra (Dutch), Quinny (Dutch), Princess (German), ABC Design (German), Haberkorn (Austrian), NeoNato (Italian)