Women who have tried everything to get pregnant may have one more option: A medical clown. Seriously.

A study of 229 Israeli women undergoing in-vitro fertilization (IVF) to treat infertility received 15-minute visit from a trained "medical clown" immediately after the embryos were implanted. The success rate ballooned to 36%, compared with 20% for women who weren't given the silly treatment.

The goal of the study was to see if reduced stress, caused by laughter, could increase the chance of that the injected embryo will successfully make its way into the womb.

Afraid of clowns? Other treatments, including acupuncture have lead to positive results for women undergoing IVF.

You can't become a medical clown just from attending your local clown college. The University of Haifa in Israel is the only school in the world that actually awards a degree in hospital jokery.

These professional funnymen, who have taken courses in nursing, have made strides in Israeli children's wards by helping young patient communicate their pain and distract them from their suffering.

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No one would look twice at the sight of Amanda Hurst breast-feeding her infant son, but watching her do the same for her 6-year-old is a different story.

Hurst, 29, of Hemingfield, England, currently breast feeds both her sons, 5-month-old William and 6-year-old Jonathan, she revealed in an interview with the Daily Mail.

She tried to wean Jonathan off the habit at age 3, she says, but failed.

"I explained to him, 'This is the last time you can breastfeed," she told the paper. "He was like 'yeah, alright Mum,' and went to bed. When he came to feed in the night, I said, 'You're 3 now, you don't breastfeed, you're a big boy."

But Hurst reveals she herself didn't want to stop, and it was her husband who convinced her to continue.

The practice was sporadic for a few years and Hurst thought Jonathan was growing out of it -- until she had her second baby.

At that point, Jonathan began to demand breast milk more often to keep up with his infant brother.

"If you'd not had cake for three years and someone put a slice in front of you, you might want to have a bit," she said.

Hurst complied, not knowing how long her son would want to keep going.

"At first I thought I would only do it for four months then it was six months. He started walking at nine months and then he was a year, but he was still enjoying it, and I was too, so I just carried on," she said. "I didn't set myself any deadlines for stopping...It seemed normal, nobody said anything to me, I'm not sure whether people even noticed. It wasn't until he was 3 that I thought 'maybe this is a bit weird.'"

Hurst acknowledges that some may find her decision bizarre.

"I know some people think it's strange," Hurst told the Daily Mail. "But I think it's perfectly natural...There are people who find it hard to understand, including my mum and dad, but they respect me for standing up and being counted."

While the Mayo Clinic recommends that mothers breast-feed until their infants are 1-year-old, the American Academy of Pediatrics advises there is likely no risk to continuing past that recommendation.

"There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer," the AAP states on its website.

That's good news for Hurst, who has no idea when she'll be able to stop.

"My opinion is that you should carry on until the child doesn't want it anymore, within reason," she told the Daily Mail.

"I would like him to grow out of it," she added, telling the paper that Jonathan is asking for breast milk "less and less" these days and even has his own age-appropriate 7-year-old girlfriend.

But she does admit she may have cut it off earlier if she had known it would go this far. "If I thought he would still be breastfeeding now I probably wouldn't even have started."

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An assistant professor of medicine, and associate director of the Mount Sinai Hospital echocardiography laboratory, Dr. Lori Croft is a cardiologist who specializes in pregnancy and the heart.

Who's at risk

Although pregnancy causes no cardiac problems for the vast majority of women, certain groups of women have an ­elevated risk of heart complications during pregnancy.

"A woman who has a history of heart disease, heart murmur, rheumatic fever or high blood pressure is potentially at risk during pregnancy," says Croft. "If you fall into one of these groups, you should talk with your doctor before becoming pregnant."

Overall, less than 1% of pregnancies are complicated by heart disease.

"Far and away the majority of women will have no cardiac issues and will not need to see a cardiologist during pregnancy," says Croft. "However, though rare, heart problems when present can affect anyone — age and ethnic background aren't a factor."

In particular, women with certain complex congenital heart problems have an elevated risk. "For some rare conditions, pregnancy is not advised at all," says Croft.

In a very small number of cases, previously asymptomatic women discover they have a heart defect when it shows symptoms for the first time due to the additional stress of pregnancy.

There are three heart-related conditions that are most likely to develop in otherwise healthy women during pregnancy: heart murmur, arrhythmia and hypertension.

"Women often develop a murmur from the extra blood flow in the heart, but only rarely is it pathologic," says Croft. "An arrhythmia is a heartbeat that may be too fast or too slow, regular or irregular, and usually no treatment is required."

The most common cardiac complication during pregnancy is hypertension, or high blood pressure. "This affects about 8% of all pregnancy women, most often after the 20th week," says Croft.

"High blood pressure during pregnancy can affect the supply of oxygen to both the mother and the baby, putting them both at risk," she says. If you develop hypertension during pregnancy, the most serious form it can take is pre-eclampsia, which requires immediate attention because it can be life-threatening. Certain risk factors place you at increased risk of developing hypertension during
pregnancy and pre-eclampsia.

Those most at risk are first-time mothers, women carrying multiple babies, teenage mothers, women older than 40 and women who had high blood pressure or kidney disease before pregnancy.

Signs and symptoms

Pregnancy is a physiological state that places a burden on the heart. "The heart has to work harder for nine months," says Croft. "A pregnant woman's heart pumps 30%-50% more blood than before pregnancy."

While a healthy heart can handle this extra load, a diseased heart can't always cope. "Different kinds of heart diseases may cause different problems during pregnancy," says Croft.

Even normal pregnancies produce cardiac and respiratory symptoms that can mimic more serious complications. "So it's vital to differentiate normal signs and symptoms of pregnancy from a true problem during pregnancy," says Croft.

Symptoms that can arise during a normal pregnancy include fatigue, shortness of breath, swelling in lower extremities, dizziness, lightheadedness, palpitations and increased heart rate.

"Pregnant women should tell their physician if they experience any of these symptoms, so their physician can determine if any evaluation is needed," says Croft.

It's good to keep an eye out for the symptoms of a significant problem. The warning signs for pre-eclampsia include visual disturbances, severe headaches, abdominal pain and lower-extremity swelling. Arrhythmias can cause palpitations, dizziness, fainting, shortness of breath and chest discomfort.

Traditional treatment

Providing medical care for pregnant cardiac patients poses extra challenges. "Some patients may only require reassurance, while some more require in-depth counseling," says Croft. "And if you take medications, it's key that your doctor advises you about which are best for pregnancy."

Good medications are available for treating chronic and gestation hypertension, though the only treatment for pre-eclampsia is delivering the baby.

Only in rare cases do pregnant patients require cardiac surgery.

"Some women may be surgical candidates because they have acute aortic dissection, an acute regurgitant valve or severe valvular stenosis," says Croft. "But a much more common part of my job is reassuring women with low-risk cardiac pathology about their condition, thus eliminating unnecessary anxiety."

Research breakthroughs

Thanks to surgical and medical management advances, many women with congenital heart disease now live to childbearing age and can successfully carry a pregnancy.

"The medical care of a pregnant cardiac patient is a considerable challenge," says Croft. "But with good communication between obstetricians and cardiologists, we can successfully manage care for these patients despite their elevated risk."

Questions for your doctor

A great question for every woman to ask, is "Do I have any restrictions during my pregnancy?" If you have a diagnosed heart problem, ask: "Is my child at risk to inherit my heart condition?"
Another good question is, "Am I at increased risk of C-section?

What you can do

Make sure that your doctor knows about any medications you're taking, including over-the-counter ones. If you have a known heart problem, talk to your physician going through pregnancy.

Watch your blood pressure.

Dr. Lori Croft advises patients to have their blood pressure checked often throughout pregnancy.
Stay healthy.

The rules everyone knows about are indeed essential: Don't drink or smoke, eat healthy and exercise if your doctor allows it.

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Fi StarStone, a British woman who runs a child-care advice website, posted constant updates after going into labor last Friday, according to the Daily Mail.

Her decision to tweet about her labor was to "dispel some of the myths of childbirth," she told The Daily Mail.

After posting nine updates that were followed by hundreds of people online, she gave birth Friday afternoon to a baby boy in a birthing pool at home. Oscar John Michael Victor Stone, weighing 7 pounds and 9 ounces, was born following a labor during which his mom used no pain relief.

When she went into labor, she posted, "Here we go lovelies! Contractions started at 2:30am! Baby decided he wants to come to his sister’s 1st birthday party on Saturday!"

Her final tweet before the birth was, Still going my lovelies. Still no pain relief."

And just 20 minutes after the birth of her son, the mom posted another update: "Introducing Oscar John Michael Victor Stone. Thanks so much for all your support. I’m shattered and sore but the happiest mummy on the planet."

Her husband, Richard, said his wife had decided to send updates during labor because so many mothers follow her through her website, Childcare is Fun.

And the proud mom of two told The Daily Mail, "I did it this way to show them the positive side of childbirth and to show it could be done without pain relief and while tweeting the whole time."

No word yet on when Oscar will be getting his very own Twitter account.

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New moms know that breastfeeding can be good for babies, providing them with much-needed nutrition as well as a shot of antibodies and other cells that help build immune systems. Now, evidence suggests that the practice may keep the mothers themselves healthier too.

Researchers led by Dr. Eleanor Bimla Schwarz at University of Pittsburgh found that women who breastfeed are half as likely to develop type 2 diabetes as women who do not. That's a big statistical difference, and although it's not clear what is behind the gap, scientists speculate that it has something to do with pregnancy pounds that expectant moms gain. Breastfeeding helps moms lose the abdominal fat they gain during pregnancy more efficiently. And while abdominal — or visceral — fat is important for the gestating baby's development, it can be detrimental to a mother's health if it continues to build after delivery, since it's been linked to greater risk of metabolic disorders such as insulin resistance and heart disease as well as diabetes.

"When you look at mammals, you have to consider lactation as part of the pregnancy experience," says Schwarz. "When women don't breastfeed after pregnancy, or lactation is curtailed or prematurely discontinued, women end up retaining more fat than they would have if they breastfed. Then the mother's health can suffer." (Read about mothers opting for breast-milk, not breastfeeding.)

Animal studies have helped reveal other reasons this is so. Breastfeeding, those studies found, can increase a mother's response to insulin, allowing her to break down glucose more effectively and keep sugar metabolism in check. Lactation also inhibits hormones that promote growth hormone activity, which can also affect insulin levels. In addition, studies have shown that when women do develop diabetes during pregnancy, known as gestational diabetes, breastfeeding the newborn can improve their glucose metabolism and help stabilize the condition. (See photos of pregnant belly art.)

Despite the growing body of research establishing the health benefits of breastfeeding, moms in the U.S. remain resistant.The American Academy of Pediatrics recommends that new mothers breastfeed their infants for at least six months, yet only 14% of women do. For the 86% who don't, Schwarz says lifestyle interventions such as exercise and changes in the diet can go a long way toward lowering their diabetes risk — even if it doesn't replace the health dividends the babies would be receiving if they were breastfed. "This [study] shows that perhaps counseling these women to try to reduce their personal risk of developing diabetes should be something that doctors should consider," says Schwarz. "And if you are pregnant or thinking about getting pregnant, or currently breastfeeding, then stick with it because it's important to both your baby's and your own health."

time.com

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Having a miscarriage is a difficult challenge for couples to overcome, both physically and mentally, but most are eager to try to conceive again as soon as possible after the loss. It is not clear, however, how long a couple should wait before attempting to become pregnant after miscarriage to maximize their chances of a healthy pregnancy.

A new report by researchers at University of Aberdeen in Scotland suggests that sooner may be better. The scientists found that women conceiving within six months of a miscarriage have better chances of a successful and complication-free second pregnancy than women who conceive later. But the conclusion is contrary to an earlier report from Latin America that found higher pregnancy rates among women who waited at least six months to conceive; that report formed the basis the World Health Organization's 2005 recommendation that women delay pregnancy for six months after miscarrying. (See the most common hospital mishaps.)

Since then, however, the World Health Organization (WHO) has called for more studies on conception after miscarriage, and the new Scottish study is the first attempt to provide better data on optimal timing for women. Dr. Sohinee Bhattacharya, an obstetrician at University of Aberdeen, led an analysis of more than 30,000 Scottish women in the national health registry who had lost their first pregnancy but were able to conceive a second time. In line with the WHO's advice, she found that a larger proportion of women (59%) conceived six months or more after miscarriage, compared with 41% who became pregnant within six months.

But the latter group, it turns out, was also least likely to miscarry again, and more likely to have a live birth. Women who conceived within six months of their miscarriage were 34% less likely to miscarry again, compared with those who became pregnant six months to a year after the initial miscarriage. (See pictures from an X-ray studio.)

While the study did not address the causes of miscarriage, Bhattacharya speculates that age may be a dominant factor. For many women who decide to start a family at an older age, waiting six months to attempt another pregnancy may work against them, since age is itself a primary contributor to miscarriage. "If a woman is over 30, then waiting another six months will reduce her chances of getting pregnant at all and increase her chances of having another miscarriage, simply because of the age difference," Bhattacharya says. "Our research shows that there is no justification in terms of health reasons for delaying." (See the top 10 medical breakthroughs of 2009.)

Dr. David Keefe, chair of obstetrics and gynecology at New York University Langone Medical Center, notes that in developed countries, the biggest predictor of a woman's likelihood of pregnancy is her age, not when her last pregnancy occurred.

That is not true, however, in developing nations, where it is more important that women have access to health care to ensure that any infection or other consequence of miscarriage are fully addressed before they try again. Studies conducted in these areas have recommended a longer interval following a miscarriage, says Keefe, noting that such guidelines were based not only on the toll of miscarrying, but also on the impact of carrying a baby to term. Health officials assumed that it takes a woman the same amount of time to recover physically after a miscarriage as after a full-term pregnancy — about six months. But that is not necessarily the case, since a successful pregnancy may deplete a woman's body more, in terms of nutrients, than a miscarriage.

The American College of Obstetricians and Gynecologists currently has no recommendations for when to conceive after miscarriage, but many obstetricians say they allow women to dictate when they feel ready to start trying again — which in most cases is sooner rather than later. "The guidelines have told us to wait six months, and sometimes even two years. So our heads told us to wait," says Keefe. "But our hearts always told us to get right back in the game."

The new data support that instinct, he says, and may help more doctors and hopeful parents feel comfortable about following up a failed pregnancy with another one as soon as possible.

time.com

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