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This is the journey to birth.
Herein lies the promise of our lives,the hope of all our futures,
the source of so many human dreams.
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For most parents,the journey's end, birth,
proclaims the arrival of one more healthy,happy, beautiful child into our world.
For most parents,pregnancy is a season of success.
For most parents, it is a reaffirmationof their own good health,
their own wise decisions.
However, some 6.8% of babiesborn in the United States
are of low birth weight,and by being under 5.5 pounds,
they are at increased risk.
In fact, low birth weightis the greatest single killer of infants.
It is at the root of many defectsoccurring in later life.
It costs Americans $1.5 billionof medical treatment each year.
Isn't it ironicthat in the nation possessing
the most advancedmedical care and technology,
a nation obsessed withthe notion of extending human life,
that we rank a mere 18th in the world
in being able to prevent infant mortality?
Don't be intimidated by statistics.
There is much an expectant mother
can do to improveher chances of a healthy child.
Meet Kathy Schell, mother of two,and soon to have her third.
Her views are those heldby many pregnant women.
I know pregnant women
really should be concerned abouttheir diet.
I know we all try and we all talk about
how good we're going tobe but there are days
when you just wantto go to Peppermint Park
and eat 10 hot fudge sundaes.
Before this pregnancy is over,I'm going to do that.
[laughs]
Let's see what your weight is this week.
It's getting up there.
The concept of weight gain in pregnancy
has really changedover the past 10 15 years.
The mandate usedto be the lower the weight gain,
the better, targeting at around 14 15 poundsfor an entire pregnancy.
Dr. Harold Fox.
Today, we're encouraging approximately25 pound weight gains
and which are associatedwith very good fetal growth
and generally very good nutrition
for the mother as well as for the fetus.
This 25 pound target, fortifiedby a diet rich in calcium and iron,
offers mothers like Kathy hopethat their fetuses will flourish.
Even now, at the beginning of pregnancy,
at the very outset of our journey,diet is important.
Today, six weeks on the way towards birth,
we can sense the embryo's fragilityand dependence.
At this stage, the embryois the size of a mere adult thumbnail.
Its future shape is onlyjust being defined.
Moving up its back, we can perceivethe developing spinal cord.
Arms and legs are also being formed.
Inside the eye,there is the first glimmer of its lens,
and beyond that, a suggestion of an ear.
Kathy knows that eating well by itself
is no guarantee against birth defects.
Many still defy science,but in numerous cases,
genetic and chromosomalbirth defects can be ruled
out as early as eightweeks after conception.
The risk of some birthdefects can even be predicted
before pregnancy by genetic counseling.
Since there was no reasonfor concern with Kathy's pregnancy,
she was told its continuingsuccess depended mostly on her,
with the support of her husband.
One precaution Kathy had taken early
in her pregnancywas examination by ultrasound,
a procedure that actuallyvisualizes the developing
fetus through a sensorplaced on the abdomen.
There's the heart right in this area,right there.
What we're tryingto do is to look at each chamber
and make sure that they're of equalsize or relatively equal size,
and that's what we're seeing here.
On the screen, for instance,you can see the four-chamber view.
A couple of ventriclesin the picture right now.
This looks like a great heart.
Such windows into the wombare enabling not only mothers
to perceive the state of their ownpregnancy but scientists to comprehend
the very intricacies of fetal development.
When the fetus is eight weeks old,
we now know just how vulnerable it is.
This is the time when mere budsare growing into recognizable arms
and hands and fingernails.
When tiny stumpsare evolving into delicate legs.
This is the time when developmentis at its most precarious.
A time when a physician's adviceregarding the use of any medication,
including common over-the-counter drugs,should especially be sought.
Thanks to these windows into the womb,
a mother can now have a clearer idea
of how to conduct her ownlife during pregnancy.
I am not a smokerand I've never been a smoker
but I do have severalfriends who smoke regularly
and also have continuedto smoke during their pregnancy.
They however made a very serious effort
to cut down to 5 10 cigarettes a day.
I personally see no reasonwhy that would be a problem to the fetus.
Science now believes that on this point,
Kathy is absolutely mistaken.
Any cigarette smoking affects the fetus.
Consider, for instance, its heartbeat.
Under normal circumstances,
the heart of the developing fetusmight beat 140 times a minute.
Shortly after the smokepenetrates the mother's lungs,
there is almost always a dramatic change.
Clearly, the mother's smoking is reducingthe supply of oxygen to the fetus,
thus forcing its heart to beat faster.
Smoking has other more insidious dangers,
as Dr. Zena Stein knowsfrom continuing research.
I think there are some thingsabout cigarette smoking,
which we now know incontrovertiblyfrom many, many studies.
One thing, for instance, a womanis more likely to have a miscarriage
if she's a cigarette smoker,
and the miscarriageis more likely to have affected
what looks like to have been an otherwisenormal pregnancy.
In a way,it's as if it was a waste of a pregnancy
due to the cigarette smoking.
The second thing we know,
and we knowthis even more firmly than the first,
is that the baby will be smaller in birth
weight than it otherwise would be.
A half a pound in birth weight
may not seem very important to many women,
and it's true that if the babyis about 7 pounds,
in between 6.5 and 7 and 7.5,there's not that much to it,
but as you go down in the birth weight,for instance,
a baby of 5 pounds,4.5 pounds is a small baby.
If 5 pounds is small,4.5 pounds is smaller.
I think if women knewthat during pregnancy,
that embryo and fetusthat's growing there,
is actually being impeded in its growthby the cigarettes they smoke,
she would never do this in the postnatalperiod.
When she sees her infant,she will give optimal environment
to the baby but she doesit during pregnancy.
She damps down on the rateof growth and I think that's wrong.
Since Kathy is a nonsmoker,we can assume that at 10 weeks of age,
her fetus' growth had not been inhibitedby the use of tobacco.
By now,while the fetus is a mere two inches long,
it can move actively.
Its liver is its most visibleinternal organ.
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As always,the fetus is both the beneficiary
as well as a potentialvictim of its mother's diet.
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I am now on my third pregnancy,and overall,
I'm just much more relaxedabout food in general and drinking.
I'm keeping it moderate.
I'm not a heavy drinker.
I truly deep down inside do not feel
that an occasional drinkis detrimental to the baby.
I think if it was,my body would be telling me something.
I've trust my body all along to tellme just what foods to eat.
I pick up on those feelingsand I go with it.
When I have a couple of glasses of wine,
my body's not giving meany ill effects and I see no danger.
Science does not agree withKathy about moderate drinking
for reasons that Dr. Kenneth Jones
has observed over many years.
We now know that alcohol can lead
to serious problems in the unborn baby.
At one end of the spectrum,we have babies with a condition
that is known as the fetalalcohol syndrome.
The fetal alcohol syndrome
is a very specificpattern of malformation,
which is seen in the offspringof chronically alcoholic women
who continue to drinkheavily during their pregnancy.
We now know that 44%of babies born to women
who are chronicalcoholics have this disorder
known as the fetal alcohol syndrome.
Eight years ago,Roger was born to such a mother,
one who drank excessivelyduring pregnancy.
The result, permanent brain damage.
His condition, fetal alcohol syndrome,
is accompaniedby a characteristic facial distortion.
He has a defective heart.
His hand and hip jointswill never be properly formed.
For Roger, there is no cure.
What can Roger's extremecondition tell the pregnant mother,
who is only a moderate drinker?
[?]
Although at the present time,
we clearly knowless about moderate drinking
than we know aboutchronic maternal alcoholism,
there are certain facts that we do know.
In a study that has recentlybeen completed,
we have discovered that 11%of babies born to women
who drink between two and four glassesof wine a night
or a day during the first trimesterof their pregnancy
have evidenceof the prenatal effect of alcohol.
It is my feelingthat the best chance that the fetus
has is for the mother not to drinkat all during her pregnancy.
There are very few thingsthat we really can prevent in this life.
This is one thingthat we clearly can prevent.
I think we should do everythingthat we possibly can to do so.
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By the end of the first trimester,in the 12th week of pregnancy,
a healthy fetus is able to performastonishingly delicate movements.
Given the most basic restraintand consideration by its mother,
it not only survives, it thrives.
Bound together through the umbilical cord,
the mother can keepfew secrets from the fetus
for it must depend on her wayof life for sustenance.
One contemporarydevelopment in our way of life
is the dramatic increasein the use of drugs.
I personally do not take drugsbefore or during my pregnancies,
nor do I have friends that take drugs.
I think it's just a really dumbidea to fool around with them
and you're just taking a real risk.
They chemically alter the body
and I just wouldn't take the risk of them
chemically alteringthe fetus just to have a kick.
I don't think the kick is worth it.
Kathy's feelings aboutdrugs are absolutely correct.
Drug use is becoming a nationwide problem
as Dr. Xylina Bean knows firsthand.
This is a baby who was bornto a mother who was hooked on PCP.
Since the mother was hooked on PCP,the baby was born addicted to PCP.
Babies who were bornto drug-abusing mothers
tend to be very tense when they're born.
They tend to be what we callhyperactive or hypertonic.
They tend to be very jittery,which means that they shake a lot.
They tend to be very irritable,and they do tend to cry a lot.
Because of the increasedtype of activity that they have,
this often interferes with their eating,sleeping,
and they often have,for instance, diarrhea.
Basically,it interferes with the kind of things
that are necessary for the baby
to do in the first coupleof days of life in order to thrive.
While studiesof the long-term effects of drug
abuse during pregnancyare still being conducted,
we can now say with assurancethat an infant born hooked is an infant
who is clearly not giventhe best start in life.
Mum I need you to watch me.
I'm a real believer in exercising
because I've seenit through my own pregnancies,
that it really helps with the back aches,it helps with cramps,
it gives you extra energy.
It's terrific.
I think it really makes a difference
whether you feelgood or bad during your pregnancy.
For mothers like Kathy who enterpregnancy in good health,
continuing the modest exerciseprogram is recommended,
but for those who neverstrenuous exercise before,
pregnancy is not the time to begin.
Throughout, the mother,particularly the working mother,
should respond to any subtlechanges in her body,
possible signals of premature labor,
by immediately contacting her physician.
Had we been able to observeKathy's fetus at 18 weeks,
we would've seen that it had grownto 5.5 inches in length.
By now,its mouth and lips were fully formed
and its nose containedremarkable nasal plugs
whose purpose sciencestill does not fully understand.
While its eyes were closed,they were fully formed.
All important anatomicalsystems are now developed.
During the next 20 weeks preceding birth,
it will change little in shape,
but its size will increasenearly four times.
The womb is filled with amniotic fluid,
which the fetus inhalesand exhales as if it were air.
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On the day Kathy's baby was due,she was still waiting.
38 weeks, 3 days,and 17 hours after her pregnancy began,
Kathy went into labor and was takento the hospital by her husband.
Because the fetus had shifted position
during the last few days of her pregnancy,
and because her first childwas delivered by cesarean section,
a decision was made to performthe same procedure this time.
Here comes the [?]
Getting the head out now.
The baby is almost out.
Everything is out but its head.
[background conversation]
That was a [?].
Yes, I know.
So is it [?].
[?] do you need it?
Got it.
[background conversation]
Here we go.
6:53, it's a baby boy.
Baby boy.
[?]?
Okay.
Okay.
Let's [?]
Poor baby.
Yes, hello.
Hello, happy birthday.
Yes.
There's your baby.
Oh, how sweet.
You don't need this anymore.
Is he okay?
He just seems to be grunting right now.
He's okay.
He's getting used to breathing.
Exactly.
Blake Butler Schell.
Weight 7 pounds, 9 ounces.
Health, excellent.
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Hi.
Today, his greatest journey is at an end.
Thanks largelyto the wise decisions of his parents,
that journey was a stunning success.
[?]
I know, but I want to look at him.
[chuckles]
Hi.
I'm your mom.
You have a brotherand a sister waiting to see you.
Who are you going to look like?
Oh, he is cute.
He has a sweet,and so nicely proportioned.
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