Birth Story

Here are the most popular baby names in the United States, as tallied by the Social Security Administration.

Boys

1. Jacob

2. Ethan

3. Michael

4. Alexander

5. William

Girls

1. Isabella

2. Emma

3. Olivia

4. Sophia

5. Ava

Jesus' nativity, the son of God born of a virgin mother, is one of the great mysteries of Christianity.

The story we can grasp more easily is of his humble beginnings in a manger. Most people who were hoping for the Messiah expected him to be born in power and sumptuousness, but Jesus' birth attendants were the animals whose home he shared in his first days.

One lesson for all of us in Jesus' birth is that we cannot judge the value of any human life, as weighed against another.

Every human being enters the world from the body of his mother in a moment of supreme vulnerability. Regardless of the circumstances, for mother and baby alike, it is one of the most fundamental human experiences any of us will ever have.

Every birth is a new beginning, for the child, for her family, and for the world, in a way. Every birth should be joyful, peaceful, transcendent.

Have a happy Christmas!

"Adoration of the Shepherds" by Mikael Toppelius / Wikimedia Commons

I always enjoy The Bloggess, a/k/a Jenny Lawson, and I surely do wish I could do those things she does with pictures.

With her permission, I offer a Christmas cookie from one of Lawson's recent posts, "Lesson 7: Your Birth Plan. Good Luck With That." As is so often true of The Bloggess, collateral damage aside, she has hit the nail on the head. Plus, it's seasonal:

The person making your actual birth plan decisions is your baby. Related: babies don’t give a shit about your plans. Making a plan for the birth of a child is like making a plan for decorating your Christmas tree in the middle of a house fire. Until you’re actually in the heat of battle, you have no idea whether you’re going to want drugs or whether you’ll have to have a c-section or whether you’ll be stuck in traffic and the baby will be delivered by a cab driver who will burn off the umbilical cord with his cigar. And that’s fine. Hell, the Virgin Mary had her baby in a damn barn and he turned out okay.

In the end, none of that matters. Whether you welcome your baby in a hut or in a hospital or in the orphanage where you adopt her, the same basic rule applies: If you’re lucky enough to end up with a baby, you win.

The end.

The Baby Friendly Hospital Initiative, an international program, has created a list of things birth facilities in the United States can do to optimize the chances that mothers will choose to breast-feed their babies.

Here are "The Ten Steps To Successful Breast-feeding," from BFHI USA:

1. Have a written breast-feeding policy that is routinely communicated to all health-care staff.

2. Train all health-care staff in skills necessary to implement this policy.

3. Inform all pregnant women about the benefits and management of breast-feeding.

4. Help mothers initiate breast-feeding within one hour of birth.

5. Show mothers how to breast-feed and how to maintain lactation, even if they are separated from their infants.

6. Give newborn infants no food or drink other than breast milk, unless medically indicated.

7. Practice “rooming in” — allow mothers and infants to remain together 24 hours a day.

8. Encourage breast-feeding on demand.

9. Give no pacifiers or artificial nipples to breast-feeding infants.

10. Foster the establishment of breast-feeding support groups and refer mothers to them on discharge from the hospital or clinic.

The BFHI is underwritten by the World Health Organization and the United Nations Children's Fund (UNICEF).

Three-fourths of American babies start life on the breast, but moms are giving up on breast-feeding sooner than officials would like to see.

Healthy People 2010, a national statement of health goals, sets the bar for breast-feeding at birth at 74 percent. Fully 75 percent of American moms are breast-feeding at birth, so the country is (barely) meeting that objective.

However, the goals would have half of mothers breast-feeding at six months of life and a quarter continuing on at a year. In practice, 43 percent are breast-feeding at six months and 22 percent at one year.

"We need to direct even more effort toward making sure mothers have the support they need in hospitals, workplaces and communities to continue breastfeeding beyond the first few days of life, so they can make it to those six- and 12-month marks," said William Dietz, M.D., Ph.D., director of Nutrition, Physical Activity, and Obesity for the Centers for Disease Control and Prevention in Atlanta, Ga.

The CDC issues an annual report card of how "key community settings" like hospitals and child-care centers are supporting breast-feeding, which research has demonstrated can improve an individual's lifetime health outlook.

While the overall news is good for moms' getting a start on breast-feeding at birth, the swing among the various states ranges from 90 percent in Utah to to 53 percent in Mississipi.

At a baby shower before my older daughter, Nora, was born, I held up each newly unwrapped garment and device for the shower guests to admire  with a big, stiff smile, because I had no idea what to do with any of it. I was the youngest of four children, and while I babysat as a teen-ager, I was never the girl people were clamoring to have watch their infants. In any case, baby technology had moved along quite a bit since then.

The theme for my first few months as a mother was discovery  — oh, yes, indeed, many, many discoveries, made usually in a panic, in the middle of the night. Breast-feeding, like everything else, was uncharted terrain for me. My mom had tried to breast-feed a couple of my older sisters but told us she was too "nervous" to succeed. As a baby, I was premature and colicky, and wound up thriving on soy formula.

I don't think either of my sisters who had children breast-fed. (They are both deceased, or I would ask them. Mamas, don't let your babies grow up to be smokers.)

By the late 1980s, though, breast-feeding was common but still spottily supported. Interviewing pediatricians a few months before my due date, I remember my delight when I found a male (!) doctor I liked a lot who supported my plan to breast-feed exclusively for several months. (His wife had breast-fed their four children, which can dispose a male doctor to be more supportive of breast-feeding than he might be otherwise.) He left the practice about a week before Nora was born. So much for planning.

At the time, my employer offered an unpaid 12-month maternity leave. Even though my husband was then serving an apprenticeship as a reporter at the old City News Bureau of Chicago, pulling down $11,000 a year, we had saved prodigiously and agreed I should take the full 12 months. So I was free to breast-feed without the constraints of a job.

It went well — not perfectly, but well. I vividly remember the early days, holding the newborn Nora on my forearm, her head against the crook of my elbow, her tush cradled in my hand.

At one point, though, I had a bout of mastitis, which was terrifying while in progress, as my breast hardened, heated up and turned red. I managed to find a lactation specialist who advised me over the phone — they seemed to be scarce and far-flung at the time. My best source was a calm old book, Nursing Your Baby by Karen Pryor, which a friend had recommended. It never failed me.

I breast-fed Nora almost exclusively for about five months. (She did get the odd bottle, including one her first night of life, in the hospital — not my idea.) I thought breast-feeding was beyond easy — always available, always satisfying, and so blissful for both of us. However, I did feel like a combination of Cinderella, always scampering home from the ball in time for that next feeding, and Bossy the Cow.

Nora had eight teeth by the time she was eight months old, when she hit on a delightful (for her) new game. She bit me, hard, at the end of every feeding. She never broke the skin, but she hurt me. She would laugh heartily while I jumped and howled, and then she would hop down and crawl off. Every feeding.

I spent two weeks soliciting advice, reading books, trying all kinds of things to get her to stop. Nothing worked. It seemed to me that giving me that good painful chomp was the best part of breast-feeding for Nora now, while I dreaded every session. She was eating all kinds of food and drinking from a cup. Most women I knew breast-fed for several months — seldom more than a year — and the recommendations hadn't yet come down that advise staying the course for at least a year.

So I weaned Nora. It took two weeks. She was nine months old when we finished. She was a bright and busy girl, and she barely noticed. At first, I wept, then I was sad for a long time.

But I had a life again. I was still Nora's mom, I still wasn't back at work, but I could move freely out in the world. My mind began to re-focus on activities and issues that went beyond parenting. At the time, I felt relief weighing against the regret. I still think it was not a bad thing for that child, at that time, or for me.

The Bill & Melinda Gates Foundation this month committed $1.5 billion over the next five years to support programs that will work to improve maternal and child health, family planning and nutrition in developing countries.

Bill and Melinda Gates

Melinda Gates announced the  plan on Monday at Women Deliver 2010, a gathering of world experts, advocates and policy makers in Washington D.C.

“In poor countries, pregnancy and childbirth often end in tragedy. Our goal must be to build a world where every birth brings joy and hope for the future,” Gates said.

Gates said that the money will be used to support local efforts toward a comprehensive approach to health that will include family planning, prenatal care, nutrition and improving the conditions under which women give birth.

“Every year, millions of newborns die within a matter of days or weeks, and hundreds of thousands of women die in childbirth,” said Gates. “The death toll is so huge, and has persisted for so long, it’s easy to think we’re powerless to do much about it. The truth is, we can prevent most of these deaths – and at a stunningly low cost – if we take action now.”

Gates said, “Most maternal and newborn deaths can be prevented with existing, low-cost solutions – such as basic prenatal care, or educating mothers about the importance of keeping babies warm,” said Gates. “Countries that have made women’s and children’s health a priority – and have invested in proven solutions – are achieving amazing results.”

Researchers at the Institute for Health Metrics and Evaluation at the University of Washington say that maternal mortality has fallen more than 35 percent since 1980, from more than 500,000 maternal deaths to about 343,000 in 2008, according to a press release from the Gates foundation.

Deaths among children younger than 5 are also down dramatically. About 7.7 million children are expected to die this year, down from 11.9 million in 1990, and 16 million in 1970, the release stated.

The Bill & Melinda Gates Foundation, one of the world's largest philanthropic entities, is a "family foundation driven by the interests and passions of the Gates family," according to its stated principles. The foundation seeks to impact a number of major global issues, including health and education.

Bill Gates, founder of the Microsoft computer software giant, co-chairs the foundation with Melinda Gates and his father, William H. Gates Sr.

Photo by Kjetil Ree / www.commons.wikimedia.org

Preterm births in the United States went up steadily from 1981 to 2006, but now they seem to be going back down, according to a new report from the National Center for Health Statistics in Hyattsville, Md.

This is the first two-year downturn in nearly three decades, the report states.

The peak year for preterm births was 2006, when they accounted for 12.8 percent of all births. The rate in 2008 was 12.3 percent.

A preterm birth is one that occurs before 37 weeks of gestation. Babies born before this point are more likely to have serious health problems compared with infants born later in pregnancy. Even babies just shy of 37 weeks are more likely to have "neurodevelopmental problems," or to die before they turn one year old, than are babies born at term, the report states.

Preterm rates appear to be falling among women of all age groups younger than 40, among all ethnic groups, in all types of deliveries and in most parts the country. Several states saw a flat rate of preterm births over the last two years, but only Hawaii experienced an increase. The decrease was similar for singleton and multiple births.

However, the report notes that "the U.S. preterm birth rate remains higher than in any year from 1981 to 2002, with large differences still evident by race and Hispanic origin. Further research is necessary to explain the factors behind the current downturn and to develop approaches to help ensure its continued decline."