it's person to face it's about topics that affect us he. climate change turns. only. welcome to in good shape on t.w. here's your host dr constantly go touch from the moment of fertilization until the big day today we're going to look at the 9 months that lead to the birth of a new born child today it could shape is all about pregnancy and therefore i'm going to meet dr matthew nodumbo offspring who's the chief gynecologist here if

they even give us if i come from host in britain well welcome to. pregnancy is a wonderful time in a woman's life it's not a disease but if there are complications today we can help. or was it when you realized that you're pregnant. and that very happy accident yeah. just happy and cannot wait he says if. you are pregnant wonderful news from many couples and with the help of ultrasound doctors can follow the fetal development now see what that might be diagnosis and certainly.

difference in detective. and then the couple has to decide what is the next step. no is an active and clever 4 year old. but it didn't look like things would turn out that way. when his mother sorry i was 6 months pregnant with him test showed that the membrane between the left and right half of know his brain was missing that can be a sign of a genetic disorder such as treme 13 or 18 doctor explained what that might mean when taking the lead and you hoped that we were told that when those babies survive top earth they usually just live a few days that's what they sent us away with so at that point we believed he wouldn't survive the tour. and if he did he might be completely disabled. and again. being told that we would lose our child and at such a late stage in the pregnancy felt like the world was caving and. an amniocentesis

soon proved that the baby did not have a tricity disorder but there was still the question of the missing membrane the doctors warned that the baby might be born blind or disabled suddenly sorrow and mark were being asked if they wanted to terminate the pregnancy. so immediately as having been we never considered it and certainly not for a disability if we thought he'd be in pain or would have been suffering the maybe i'd have thought about it a little more life and. now as father mark has now quit his job as a laboratory assistant and he's studying to become a pediatrician. it is going to start soon and as we went through the various stages with the doctors they didn't really deal with us as human beings and they didn't seem very understanding and we said we didn't want all of that that's why i thought medicine might mean someone who's more focused on the patient is someone

with real empathy who will approach things on the human level of management it's again when no one finally arrived it became clear it was a healthy child. so catarina has gone to the delivery room and we've got some time to talk and what do you think our doctors and pathetic enough in such situations i hope so that they are. sometimes it may be that's not so bad usually we know about this situation of the couple and we try to help them in this situation we just saw in the report that the couple decided to have the child despite of the poor guy you know says but i guess there's a lot of pressure going on for abortion so what's your opinion how much pressure is there on this kind of prenatal diagnosis i think not support that i did notice and make this pressure the change in the social well you'll see in our society everybody wants to have a perfect product and i think the present idea of not sick is

a result of this development and it's not the reason for this development is there some pressure on you as an o.b. g.y.n. in performing the fetal prenatal diagnosis i by myself don't feel this pressure i see it's my duty to have lied and why this couple what we can do it today what possibilities of diagnosis exist and very important to do that before not idea of this is done and to think about the consequences before you have done this diagnosis and why are women encouraged to have those tests is just or because of old age of the pregnant woman sometimes it's because of old age because. increasing. means increasing risk of kinetic the moment is. more and more the younger women do or demand for. this they want to have. a perfect baby it's

a good division it's ok but they don't accept. anything else and how accurate those tests the tests can only show you the probability of getting a baby. if there is. a question of the baby is healthy or not that it's necessary to do invasive tests like moves and to use this. to prove that how fetus develops depends largely on what it is spirit says in the group take alcohol for instance especially if it's consumed in large amounts by the mother could be dangerous to the child in germany up to 5000 babies born and nearly damaged by alcohol and that can take a long time to diagnose. enough is a very special connection with animals. when she's playing with her friend's dog she

blossoms. but with people she has problems she often rubs them the wrong way. i guess i'm a bit more aggressive than other people. i feel bad about it and it hurts even though i want to be friendly it doesn't always work. i'm all. cut of lena has fetal alcohol spectrum disorder her mother drank during her pregnancy catalinas condition isn't immediately apparent for a long time her foster mother susanna had no idea what was wrong she worried and doubted her parenting skills and often felt guilty. and it was so hard to understand. why doesn't she understand something she's already learned why is she forgotten something again why can't she grasp a situation in many respects she seems very intelligent and empathetic in others it

just doesn't work. we know lived with susanna her husband and their biological daughter deborah from the age of 3 months she was very active from the start and made a lot of demands on her foster parents. comes around i'm not quite so whenever we had to cross the road she would just refuse and throw herself on the ground i'd have to pick her up and carry her but she's also very affectionate you might have. things got harder at school catalina couldn't concentrate and was always trying to be the center of attention. she would talk a lot. and then she'd start interrupting people during conversation was. she to interrupt get even louder and maybe start banging around on things. even turning someone's face toward her when they wouldn't listen things like that. now doesn't.

mean i kept making the same mistakes. she either didn't understand rules or forgot them. just like her times tables her teachers didn't believe she was trying to learn them they thought she was stubborn. and lazy. helps him and i told the teacher many times that some days i'd remember them but on others not. and he said fine. and. the next day he'd forgotten how it is it was really dumb of him to pick on me. with the . on fast minds what did he do that seems like he was picking on you. and those are the one who said you can do it even though i told him so many times i couldn't even though i was trying. but he kept going on at me. and then i'd

lose my temper. much of you know was frustrated and her teachers were too even though they were all giving their best cuts of you know ended up changing schools several times then when catalina was 13 susanna read an article about fetal alcohol syndrome and realized that the description was a match. she was sent to a clinic for tests which showed that she had brain damage due to prenatal exposure to alcohol. i was shocked. she has a disability and it's permanent no matter how many fantastic therapies i can find or how brilliant a parent i am. certain things won't change. the hearts and that's one more time in the exact opposite when my mother told me i have fetal alcohol syndrome i gradually become to understand why i am so. and so different from the

other. unless. the diagnosis helped catch her we know wasn't to blame nor was her family. going to colleges like thomas at athens university clinic warn against even. glass of wine during pregnancy. in the 1980 s. and ninety's it was common to hear that it's ok and that a little alcohol will help raise blood pressure again after the baby's born things you can still hear some gun ecologists but women shouldn't drink at all during pregnancy because we just don't know how much if any alcohol is safe. but the experts know that many women drink alcohol when they don't even know they're pregnant. dr cooper says that's no reason to panic. because when it comes to alcohol doing serious damage very early in pregnancy it's an all or nothing affair. that the fertilized egg makes it or it doesn't if you're trying for

a baby then it would be better to stop drinking and. as soon as you know you're pregnant then you should definitely stop altogether. the fetal alcohol syndrome happens in the womb but the effects are felt for a lifetime today caterina lives in a home for people with developmental disabilities and visitor foster parents on the weekends. and her husband knew they wouldn't be able to parent or alone in the long term. and like every young person catalina wanted to spread her wings she has plans for the future. just a few fun i. like to find my own apartment with someone who maybe comes by once in the morning and in the evening to check the time make a. good. time to also like to find

a job i enjoy doing. i like working with animals that's why i'd like to do something with animals. as my home. many adults with fetal alcohol syndrome struggle with the challenges of adulthood. touch of the misfortunate that she has support and her special connection with animals. go to them for see what do you think are patients and pregnant women informed enough about the risks of our call and they're even got a clue just to say this occasional glass of wine doesn't hurt i think the couples today very good informed they do it usually they do it by internet. they can find all the information important but surely it depends on the social status of the couple so we have still those problems. and next to a whole there are a lot of things a pregnant woman can do to harm their child yes it's nicotine that's

a big problem with its abuse of drugs is a problem and if you are exposed to radiation that's also a very very thing but there are a lot of things pregnant women can do right yes they can do they should live their lives before because pregnancy is not a disease so you can do all the things you have done before exercise and be fit eat healthy was much richer means. vegetarians foods all these things if the mother feels good the baby feels really so this is a hospital but not let's take a look how rebirth takes. in a birthing center. you know what it will be. a girl a girl ok she's in the right position pose it to an expectant mother is being examined by a midwife at

a birthing center in berlin here she is skin the baby moved over into the pelvis to get into a good starting position. this will be child number 2 for the mother and tanya. asked 105 centimeters. i feel comfortable here and i have a lot of faith in the midwives. most pregnant women don't get to enjoy an experience like. the midwife uses a wooden stethoscope to monitor the child's heartbeat christina shopper has hoped to deliver around a 1000 babies enough 30 years in the profession spending the 1st 5 in the maternity unit at the hospital. there is a difference to a hospital where there might be 3 or 4 women giving birth but. you don't have as much time to attend to them. and sometimes they get a hormone trip to speed the labor up. birthing center the midwife provides even before the above they have plenty of time to get

to know the mothers starting with the prenatal classes. or hear it sort of like grit your teeth and let's get this done. if things get bad there is no option here for an anaesthetic or morphine based medication. as a midwife i believe that the best pain killer is a caring and attentive midwife. time for you praises and encourages you and keeps telling you we'll do this together as a. little polish 3 years old today he's accompanying his mother and his little sister she was also born here at the center in a relatively speedy delivery unlike her brother. miami athens or. about 11 and a half hours into things i spent a while in the past and then late but just stalled. somehow failed to find the exit

. most met my brother not imagine what might have happened if i'd been out of hospital as kinds of unnecessary interventions i might have had you can see wouldn't have been necessary. but for midwives questions of liability are a growing burden. midwives can't do their jobs if they're constantly afraid they might get sued. that's no way to work of course you do have to be aware and attentive but you can't constantly be afraid. more than 7000 children have been born in this birthing center but a growing number of women prefer doctors to midwives. when you go to the doctor and you prescribed a ton of vitamins as soon as you're pregnant you get the sense that without them the baby wouldn't grow and be healthy unfixed. and then there's all the examinations during pregnancy it can be really stressful and make women more and

more anxious. we get women here in the birthing center who say this is the 1st time that someone's ever touched their belly. some of us you meant to harm you 1st had. that natural touch is what i'm tony appreciates that she gets to hear her baby's heartbeat without high end technology. ok great is the world i think it's a good look at you smile every. day i think this is. the pregnant woman. and i think it's because the station has found as much time as possible with the baby afterwards and. in this close contact you just. want a relationship with the woman and the baby and the father of course and then as you

depend on each other so what's next if you think i think it's to be a part of america every time the baby cries for the 1st time i like to see that parent smiling at the baby after giving birth to it and i think this is one for yeah. and i think it. gets. it's. the heartbeat of an unborn child half an hour before she enters the world by says very inception. if your body is the i'll be doing the c section there will be a screen between us but you'll be able to talk to me it's you just the mother has so opted for the c. section and the birth of her 1st child was a traumatic experience involving complications. once in the operating room she's given an epidural an anaesthetic injection to numb her lower abdomen and legs

during a non emergency c. section the mother remains fully conscious. the growing number of parents ask for a c. section even when the surgery is not a medical necessity. many say it's because they want the safest possible. this would be. we see pregnancy and birth as a special event because one month when people had 6 or 7 children it was something that didn't get much attention but today every birth is a major event a lot of people see a c section as the safer option easier to plan for than a spontaneous to leverage. but c sections have risks too it's major surgery so there can be complications some mothers also round up with artesian a kind of internal scar tissue it sounds because labor helps clear the baby's lungs

of fluid the newborn is more likely to have breathing problems. if you. feel. if. not every section is planned often the decision is made when labor is already underway. but there are ways to safely reduce the number of c sections. there are 3 important areas where we can help reduce the c section rate is 1st of all when there are changes to the fetal heart rate during birth. it's knowing which changes mean an intervention is necessary and which don't can help lower the c section rate . the next point is knowing that after a woman has had one c section it doesn't automatically mean all future births will have to be c. sections to. another very frequent reason for c. sections as when a normal labor appears to have stalled there are new studies that provide insights

into labors that fail to progress. so these 3 year ias and those insights can help us lower the c section rate without increasing the risk to mother or child. in 2014 almost 37 percent of the paths that this hospital by c section 3 years later updated standards help reduce the rate to 29 percent putting the hospital below the average rate for germany. this mother and her new born daughter doing well after the c. section. is how is caterina fairing these baby was delivered by dr dombrowski . just performed c section on katrina and how did it was the 5 everything was fine and the baby's fine it's another child ok yes mother and the fossil to the father too is very very important that's right so what

does a c section mother and baby i mean it's not the natural way of kids no it's not the natural way it's done no surgery and with all the possible complications of an afternoon surgery but sometimes if you have a medical indication for you. then it's a better rate but most of the time it's not the better way so there are medical causes for performing a severe inspection and there are non-medical indications as well we do sometimes see sections on demand of women of the couple wants to have a baby percy section if you're in brazil the road at the top of the babies born in the country by syrians. yes that's true brazil is a country over the highest rate of c. section in the world i think one of the reasons is that the health system has change. now it's necessary to have a presence of a doctor and

a midwife during the whole verse and that needs sometimes 10 hours 20 hours and it's very difficult to plan so they do the deliberate spicy sections cause faster it's faster you can plan it you can do it in the morning and not you know the night so that's one of the reasons but what is your opinion is another bridging way in about this there are some reasons to do worse the section that that's clear the better way if possible better than me and there might be even some problems with the microbiome of the baby after it's section this is what all of you are from brazil wrote to us yes that's why it's important for the baby to be colonized by the bacteria's of the bedridden smear of the mother. they'd need this to develop. this immune system. needs to be colonized by his intestine

and all these things necessary for the baby. is it not ok for us to visit the newborn i said so i think so before we go if you've got questions about me to ask our expert. sure but to me. on an upcoming show we'll be looking at all timers disease the human brain is an immensely complex organic brain disorders can affect memory language and the entire personality what do we know about the causes of all timers and can it be cured send your questions to shape at d w dot com the keyword is also timers we look forward to hearing from you. movie you know. c. section everything is fine because of his behavior ok and thank you. very. much . mr you. get. to see.

me.

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this is d. w. news line from berlin russians vote in local and regional elections that sparked the biggest anti-government protest the country has seen in years local media suggest the propylene united russia party may be dealt a heavy blow losing many seats in the moscow city do not but opposition leader alex cena bonnie warns the results could be arraigned retton also coming up. donald trump abruptly cancels peace talks with the taliban the us president says the move is in response to a taliban.