At least for me, being diabetic and pregnant meant staying on an ever-present schedule, with little spontaneity. Every moment was either a time to monitor my diabetes, an occasion to record the results of the routine, or an opportunity to feel guilty for doing neither.

I met with a perinatologist, an obstetrician who specializes in high-risk pregnancies, even before conceiving. He ordered a battery of tests to determine if I were healthy enough to support a pregnancy and then helped me improve my blood glucose control. It is important for a pregnant diabetic to keep her blood sugar levels as close to normal as possible, since high glucose levels in the mother can contribute to serious health problems for the baby, even before the woman realizes she is pregnant.

Under the perinatologist’s guidance, I worked for almost two years to lower my average blood sugar level. I faxed him my glucose tests weekly and, in turn, he suggested adjustments in insulin dose and timing. He was eventually satisfied with my diabetic control and gave me the green light to try to conceive. I was delighted to be pregnant within a month.

Then it was up to me to continue the routine I had developed over the long period of preparation. Each day I ran 10 to 15 blood glucose tests to detect any high or low blood sugar levels promptly and gave myself five to eight insulin injections in response to those readings.

This regimen continued around-the-clock. At night I set my alarm to ring at 3 a.m., so I could test my blood sugar, once again. If my glucose level was high (hyperglycemia), I gave myself supplemental insulin. If it was low (hypoglycemia), I drank milk. Much of the time I felt awful, but it was hard to discriminate between just being pregnant or actually having hypoglycemia, so I ran blood tests frequently to determine the culprit.

Living out this daily routine was more of an extravaganza than either my husband or I had expected, but we tried to keep a sense of humor throughout the nine months. The larger I got, the more I complained, and I was especially loud and grumbly at night. Eventually, I moved to a downstairs bedroom where my husband had installed a baby monitor. This way he could hear me shout if I had an emergency, but he also had the option of turning down the volume on my moans and groans.

There was a sudden change of plans at 37 weeks. By then, I was only able to sleep comfortably for 20 to 30 minutes each night, and my blood pressure was beginning to rise. The perinatologist thought it was time to induce labor, and I seconded the motion.

Thirty-six hours and one emergency Caesarean section later, our daughter was born. She was a 9-pound 10-ounce bundle of determination. My feelings of pride and satisfaction — not to mention exhaustion — had never been greater.

While I felt especially courageous to be a diabetic giving birth to a baby, I realize now that my pregnancy required the same of me that it requires in any woman, diabetic or not. Vigilance and discipline? Yes. Discomfort and loss of sleep? Surely. Joy tempered by worry? Of course. Perhaps I needed to develop these attributes a little earlier than some pregnant women do, but the qualities themselves are not unique to a woman who is diabetic.

It turns out to be fairly easy to describe the difficulties of a diabetic pregnancy but much harder to convey the sense of fulfillment in having a child. My daughter’s birth has deepened the meaning of “challenge” for me and has amplified the meaning of “joy.”

My naivete was a blessing, as it is unlikely I would have chosen to get pregnant had I really understood the complexities of my carrying a baby. In exchange for a pregnancy full of routine, I plowed ahead and delivered a little girl who has reintroduced spontaneity, gusto and pizzazz into my life.

“My theory is that the more we get away from pregnancy as a natural spiritual process, the less we support women and their partners through it,” said Stoline, who is opening a women’s mental health and wellness center, Millwood Place, in Fallston, Md.

For example, she said, there is a subtle dance of neurochemical readiness between mother and fetus before birth. Technological intervention in the birthing process is necessary in some cases, but overused in others, to the detriment of that mother-child bond.

That intervention, followed by the isolation of a mother at home with a newborn, can lead some women into a period of postpartum depression.

“Our society likes to think motherhood is a matter of using your head,” said Stoline, who is the mother of two young children. “What we tend to forget is that motherhood is a relationship, a unique bond with another person that can’t be replaced.”

Lest any mother feel further overwhelmed, Zax has some reassuring words based on her research. After all, she said, “No caring mother gets up in the morning and says, ‘oh, gee, I wonder how I’m going to screw up my kid today.’”

First, she asked daughters what they want most from mothers. The overwhelming answer? “Approval.”

And what do mothers want from children? “Understanding of how hard they work at being a mother,” she said. “And I say amen to that.”

If you find you are judging yourself harshly, however, stop before you get out your cat o’ nine tails to flail away, she said. It’s not your fault if things are not going the way you expected. Look at the context you are in: who you are, what your kids are like and what is going on around you. It is likely that it doesn’t look anything like someone else’s standard, or even your own childhood.

On a scale that surpasses anything you and your parents went through, today’s families are being hit with the fallout from fast technology, high expectations and too many choices, said Ronni Eisenberg, an expert in how to be organized.

A Westport, Conn.-based author of several books, including “Organize Your Home” (Hyperion, 1999, $9.95), Eisenberg said you can get your family to the point where you achieve a sense of balance for yourself. She should know. She’s raising a teen-ager and 8-year-old twins while running workshops and managing a consulting business.

But even if you can teach your kids the how tos of laundry and table-setting, Getting Organized
Ronni Eisenberg is the mother of three children and the co-author of a series of how-to-get-organized books, including “Organize Your Home” (Hyperion, 1999, $9.95). Mothers have so much to do today, they need to get organized to get it all done, she said.

can you get them to do it?

Absolutely, said Sal Severe of Phoenix, Ariz. A school psychologist and husband whose wife works full time, Severe is the father of four children, ages 3 months to 22 years. He said he gets plenty of firsthand experience in what makes kids tick. The most challenging age? “Adolescence, clearly,” he said.

The author of “How to Behave So Your Children Will, Too!” (Greentree, 1997, $21.95), Severe said the good news is that fathers are much more involved these days with child-rearing. He identifies three approaches for mothers and fathers who are dealing with kids of any age: consistency, patience and practice.

“Discipline is everything we do to teach our children,” said Severe. “It’s not a punishment.” The way to start making changes is to be aware of what needs to be done differently, make the commitment to change and then start doing it. “But don’t expect perfection,” he said.

Nor should you feel you have to compensate for being away 40 to 50 hours a week by giving children whatever they want. “Personally, I don’t think it works,” he said. What does work is to give kids limits that they understand, Some Mothers’ Helpers

help them practice, and then let them know if they got it right.

When mothers think their role is to manage their children’s behavior, an unfortunate thing happens, said Ann Tremaine Linthorst, a licensed family therapist from Orange, Calif., who practices pyscho-spiritual therapy. “Mothers tend to focus on what they don’t like, and not to notice what they do like,” she said.

“This gives rise to the Frankenstein principle: Paying attention to what you don’t like in another person’s behavior tends to create monsters on both sides of the seeing.”

Linthorst is the mother of two grown sons and the author of “Mothering as a Spiritual Journey: Learning to Let God Nurture Your Children and You Along with Them” (Crossroad Publishing, 1993, $12.95). She calls for mothers to stay connected to higher values like creativity, harmony and vitality and use them as a basis for going with their best sense of things. “Mothering is not nearly so much what we do for and to our children as it is how we think about them,” she said.

Even if it seems like every step of the way — from bringing home the first baby to saying goodbye to the last child leaving home — feels like a crisis, Linthorst said, “You can use it as an opportunity for learning and for spiritual growth.”

In fact, said Rutberg, the mother of two children, a whole lot is going on. On those little walks, she may not require a cell phone and a computer, but she does have call for a warm hand and a sense of wonder. For that is when she often teaches son, Teddy, age 2, about nature, or answers questions from her 4-year-old daughter Jamie about things like “Where is Pushing Buttons
You know what it is. The thing that really pushes your buttons, no matter how much you think you won’t overreact the next time your kid does it.

God?” and “Why is the sky blue?”

At the end of a long day with two small children, “I sometimes feel fried,” said Rutberg. “But this is what I wanted to do as a mother — teach my children and watch them develop.” Some of her favorite activities are reading children’s literature aloud and coming up with creative ways to do the ABCs.

Increasingly, for many mothers, those random moments of mothering are evaporating in the face of unyielding schedules. Modern mothers are at the center of a vortex, with everyone’s pressures — from their infants to their own aging mothers — swirling around them. There is always too much to do.

Mothering takes time and space, said Doctor, a psychiatrist specializing in women’s mental health at Mercy Medical Center in Baltimore, Md. “And with a pace of life that’s so fast and with so many expectations put on mothers, the experience is at risk in our society.”

Yet mothers are the last to say die. Tuned in to their kids and tired out by all there is to do, at the end of 1999 mothers are mixing their desire for timeless love with their need to time the minutes. And even as women are asking, “How am I doing?” they sense the only answer that counts is the one in their kids’ eyes.

“Frankly, I think we are writing the script every single day, based on where we are in our lives, and where our children are,” said Barbara Zax, a licensed marriage and family therapist in private practice in Los Angeles. “Being a mother is not a static process. It’s a work in progress all the time, even when the children are adults.”

And, she added, “It is a stunningly difficult job.”

Sometimes that shows up in the details, large and small. To work or not to work? Strict discipline or easy-going control? Bake from scratch, or use a mix?

Katherine R. Hutt of Vienna, Va., said she uses books, experts, friends, church and family to provide a framework for her approach to mothering. But what she relies on most is her gut instinct. It comes in handy for everything from career to cookies, and “the zillions of little day-to-day decisions that are Mothering Styles
In the book she co-authored with Stephan Poulter, “Mending the Broken Bough”, family therapist Barbara Zax identifies different styles of mothering. There is no pure type of mother, she said, but most mothers have one distinctive style along with bits of each of the others. up to me,” she said.

After her second child was born, Hutt turned 15 years of experience in the highway safety field into Nautilus Communications, a “virtual” public relations and marketing firm based in her home. Now that she’s eliminated commuting and Saturday errands, she has more time for child-centered activities like weekend bike rides with Billy, 8, and Katie.

“I try to make parenting decisions based more on what’s fun than what’s expected,” said Hutt, who opts for things like slice-and-bake cookies so she and her kids get right to the good part — decorating the tops.

“I am acutely aware of being responsible for my kids’ childhood memories,” Hutt said. To make the best choices, she said she draws on her own favorite memories, like tooling around with her mother and sister in a white VW Bug for after-school adventures. “My mother was an inspiration on how to give your kids a happy childhood,” she said.

But this is not the case with breast cancer. We know very little of practical value — with a few promising exceptions — on how to prevent this disease.

We do know, for example, that women who began menstruating earlier in life (before age 12) and those who enter menopause later in life (after age 55) have a statistically increased risk of developing breast cancer. Similarly, we know that women who have no children or those who have a first child after age 30 or 35 have a somewhat increased risk of developing breast cancer — early pregnancy seems to convey some protection. Further, there is evidence that after menopause, obesity contributes to a woman’s risk of breast cancer. The use of estrogen replacement therapy also seems to increase the risk slightly, although in most cases that risk is outweighed by the overall health benefits.

The media, however, often reports the calls of those who claim that exposure to trace levels of environmental chemicals, such as DDT and PCB, cause breast cancer. There is no evidence that this is the case. Similarly, for more than two decades there have been those who maintained that diet is an important factor in the causation of breast cancer. But according to a recent issue of the American Cancer Society Journal CA: A Journal for Clinicians, “current info don’t support specific dietary recommendations for decreasing breast cancer risk.”

On a related subject: While it has long been hypothesized that alcohol is a risk factor for breast cancer, there is, according to CA, no solid evidence here as well. In the case of both alcohol and diet, however, women would be well advised for general health reasons to adopt a moderate, varied low-fat diet and consume alcohol in moderation if they choose to drink.

Clearly, having a mastectomy to prevent cancer is a drastic measure, with both physical and psychological effects. But the future is promising for chemoprevention generic drugs such as tamoxifen and a related drug called raloxifene. The former has been proven to reduce cancer frequency in high-risk women; the latter is now under study.

The bottom line is that the best hope for breast cancer prevention lies not in the avoidance of hypothetical risks — such as trace chemicals in the environment — as a cause of breast cancer, but rather in turning to the scientific evaluation of chemopreventive pharmaceuticals, particularly for high-risk women.

The authors “noticed a fourfold increase in referrals (for bone injury) between 1994 and 1996.” Following the initiation of a new military equal opportunities policy in 1993, women recruits were “exposed to the same rigorous, physically demanding exercise as men.”

To determine whether or not the inclusion of women prompted the observed increase in injury, the researchers examined the bone scans of all 264 recruits (143 men, 121 women) treated by army physicians for lower limb trauma between 1995-1997. During that period, 3,367 men and 855 women enlisted in the British army.

According to the authors, 10.9% of all female recruits displayed “abnormal” bone scans indicating either stress fracture or shin splint, compared with just 3% of male recruits.

In an interview with Reuters Health, lead author Dr. M.A. McLeod attributed this finding to the fact that “the female skeleton is lighter than that of the male and the muscles are less bulky, rendering them less efficient in counteracting periods of severe stress and strains.”

The researcher also pointed out that female subjects experienced a higher number of pelvic fractures, compared with males (17 versus 2, respectively). This finding might also have an anatomical basis, McLeod said, since an area of the underside of the pelvic bone, called the ramus, is somewhat thinner in women than in men. This factor, in addition to the “increased angular biomechanical strain (placed) on the wider pelvis” of women may account for some of the disparity in injury rates observed between the sexes, the researcher concluded.

Manual expression is the most portable and inexpensive method of “pumping” milk, and is also a skill all new mothers may want to learn for the prevention and relief of engorgement, a painful swelling of the breasts when milk isn’t removed. The process is more time-consuming than using a good breast pump, but is easy and more comfortable for most women.

From time to time it is simple to get pregnant while sometimes its not, so if you are solved to become pregnant, then here are several hints on how to get pregnant fast.

The most fundamental difference between doctors and midwives is their approach to childbirth. Physicians are trained to treat complications and are present only at the birth of the child, not during labor. Midwives, on the other hand, are not as qualified to treat medical complications, but they specialize in teaching women about their pregnancies and providing a personalized approach. Midwives stay with their clients throughout labor and birth.

When making your decision remember the first rule of thumb: if a high-risk pregnancy has been identified, a physician should be your care provider. For some high-risk pregnancies specialists are needed, such as a perinatologist, and other members of the health-care team may be called in to consult at various times throughout the pregnancy. A physician may be able to coordinate and monitor a high-risk situation more effectively than a midwife.

Second, check with your insurance company. Most will cover midwifery, others will not. Insurance companies also vary on what services they will and will not cover, so be on the lookout. Is there a separate deductible for pregnancy care that you may not be aware of?

Careful checking applies to choosing a doctor as well. Each doctor is affiliated with a hospital and when choosing a doctor you will want to check out the hospital, too. Hospitals vary in type of birthing experiences offered, cost for services, neonatal care available, etc. The physician and hospital are usually a package deal so do your research carefully.

In choosing a physician two choices are available: an obstetrician (OB) or a family doctor. In most large and more populated areas OBs deliver babies, while in smaller, less populated areas, family doctors do.

There are also different types of midwives to choose from. Certified nurse-midwives (CNM) are registered nurses, who have usually been trained in graduate schools to handle low to moderate-risk clients. They work closely with physicians in case of serious complications. Most CNMs deliver babies in hospitals, but sometimes work in birthing centers or homes. Another type is called a lay, licensed, or traditional midwife depending on the state in which they practice. Their training varies and they deliver babies in birthing centers or homes.

If you prefer a midwife, it’s wise to make sure she has the qualifications and training you’re most comfortable with and has an affiliation with a hospital and physician. Complications arise during labor 10-15 percent of the time and can pose a significant risk to child and mother if emergency help is not readily available.

There are no-cost physician and midwife referral services in most metropolitan areas; call your local medical society. But the best sources of information are often new moms. Ask friends and co-workers for referrals; they may know of a physician or midwife who is perfect for you. Most importantly, choose a practitioner whom you feel comfortable with and will be best able to help you have the kind of birth experience you want.

Extra fluids will meet you and your baby’s increased needs during this time as well as to maintain overall well being. Fluids soften skin, reduce constipation and the incidence of urinary tract infections , and eliminate toxins and waste products from the body. Increasing your water intake during pregnancy can lessen or eliminate headaches.

As your body fluids increase there is a risk of salt depletion to you and your baby so it is essential to keep up your salt intake. You should not limit salt intake during pregnancy unless recommended by a physician.

You and your baby need to be kept well hydrated. Drink plenty of water, at least eight cups a day, and avoid high-calorie soft drinks. Carbonated beverages have no nutritional value and can produce gas that may make you uncomfortable. The excess sugar can lead to unnecessary weight gain or contribute to blood sugar difficulties. As an alternative to sodas, drink unsweetened fruit juice or vegetable juice.

Caffeine in large doses should be avoided during pregnancy. It has a diuretic effect that will lessen the amount of fluid your body utilizes. Consuming over eight servings of caffeine a day has been linked to miscarriages, premature birth, and stillbirth. Smaller amounts of a serving or two a day have not been found to cause problems, however. Caffeine is found in soft drinks, coffee, chocolate, and over-the-counter medications .

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Even though extreme weight loss is a stupid idea, there continue to be numerous websites that endorse extreme weight loss. Certainly, these websites are marketing an item that promises to support this type of weight loss.

It can be counter productive and unhealthy to lose weight too quickly. Teenage girls who attempt to lose weight by desperate measures like throwing up, overuse of laxatives and forgoing meals will probably end up being bigger than girls who have a lot of fat in their diet.  This is the reason that a lot of overweight adults say that went on diets when they were very young.

Weight loss needs to occur at a rate that is slow, to keep the weight off. Consider this; if you gained a large amount of weight through the years, to lose it in a healthy way, you need to lose weight in a similar way. By gradually changing your eating habits and exercising, weight loss will happen slowly and you will live your life this way instead of hating diets.

A doctor must be included if it becomes medically necessary for quick weight loss. A bariatric operation, for instance will result in extreme weight loss because of the procedure and careful monitoring by a doctor. There are some liquid diet plans that are effective, (Oprah Winfrey was on this diet when she lost weight the first time) however it is difficult to keep the weight off.

As well as not being effective, fast weight loss can cause you to become ill or you could die from it. Perhaps one of the most well known cases recently of extreme weight loss ending up in death was Luther Van dross’ off and on diets and being unsuccessful in managing his ailments that were connect to his weight.

Eventually, it might be a better idea to keep your extra weight than to continuously take part in extreme diets.