3 pre pregnancy important vaccinations


In Indonesia, specifically pregnancy preparation by vaccination is still rarely performed. Most women had come to the doctor after pregnancy they entered the age of one or two months. In fact, pre pregnancy vaccine is important for fetal growth. Moreover in the first 8 weeks when the phase of embryological progress. At this time the mother's health should be well maintained, so as not to affect fetal growth.

There are three types of vaccines that need to get pre-pregnancy mothers to protect the fetus, namely: 1. MMR (Measles, Mumps, Rubella)

Rubella is an infection of the marked symptoms of red spots (pink-red rash) on the face and then spread to other body parts. The disease is accompanied by mild fever and enlarged lymph nodes. Pregnant women who are infected rubella in the first three months, risky and impaired fetal development establishment, by 50-85%.

Rubella-infected fetus, abnormalities called congenital rubella syndrome. Abnormalities that may include eye problems (cataracts), heart, or a smaller head circumference (microcephaly). At the age of 16-20 weeks of pregnancy, birth defects experienced by the fetus is hearing loss or deafness. While rubella infection in pregnancy advanced maternal age (more than 20 weeks) rarely causes birth defects. Babies who have disabilities due to rubella will continue to carry these disorders during their lives. Generally 1 in 10 babies who suffered rubella infection will die within one year of age. Nothing can be done to the fetus if the period of rubella-infected pregnant mothers.

2. Vaccination TT (tetanus toxoid)

Tetanus is a disease caused by the bacterium Clostridium tetani toxin. Is also called lockjaw because sufferers often experience muscle spasms in the jaw. Tetanus bacteria enter the body through wounds. If the mother is exposed to bacteria during the birth process, infection can occur in the mother's womb and the umbilical newborn (Tetanus neonatorum). TT vaccination is usually offered to the couple since I was a prospective bride. Unfortunately, many couples who refused. This happens due to misunderstanding. Many thought that the TT vaccine is a contraceptive injection for spacing pregnancies. Although cases of pregnant women suffering from tetanus is rare in early preventive measures still good right?

3. Hepatitis
epatitis is an inflammation of the liver caused by a virus. Infection can be caused both acute and chronic. The majority of patients will become career (carriers) without clinical symptoms but can transmit the disease because the blood is viral hepatitis. Besides the blood, the virus can be found in the urine, feces, and saliva, depending on the type of virus. The nature of transmission of the virus which is very easy, cause hepatitis can be transmitted mother to fetus during pregnancy, at birth, or afterwards. Risk of transmission remains high, even if the baby was born by cesarean. Although no defects found in babies infected with hepatitis B in the womb or if the mother in pregnancy have hepatitis B, these babies may suffer from diseases such as chronic liver of chronic hepatitis, cirrhosis hepatis and hepatomas (liver tumors are malignant).

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Am I Pregnant?

If you're unusually tuned into your body, you might begin to suspect that you're pregnant within the first few days of pregnancy. But most women don't suspect they are pregnant until they miss a period, and a few don't suspect or believe they are pregnant for months after conception.

Here are 5 common signs of early pregnancy. You may experience all, some or none of these symptoms.

1. A Missed Period: Missing your period is the most clear-cut sign of pregnancy. But it is not definitive, as stress or other factors may cause irregular periods.
2. Frequent Trips to the Bathroom: Even before missing a period, most pregnant women report having to go to the bathroom more often. You may even have to get up during the night! This occurs after the embryo has implanted in the uterus and begins producing the pregnancy hormone called human chorionic gonadotropin (hCG). This hormone triggers frequent urination.
3. Fatigue: Utter exhaustion is a very early sign of pregnancy. Fatigue is a result of high levels of the hormone progesterone.
4. Morning (and Noon and Night!) Sickness: Guess what? That queasy feeling isn't limited to mornings. Most pregnant women who experience morning sickness feel slightly nauseated at other times during the day as well. About half have vomiting, but very few have severe enough morning sickness to develop dehydration and malnutrition.
5. Sore (and Enlarged) Breasts: If you're pregnant, your breasts will probably become increasingly tender to the touch, similar to the way they feel before your period, only more so. Once your body grows accustomed to the increase in hormones, the pain will subside.

If you have any of the above symptoms, consider taking a pregnancy test as soon as possible.
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Common Causes of Depression

Health experts' understanding of depression has come a long way in the last few decades. In many cases, depression doesn't have only one cause. It often results from a mix of biology, psychology, and stressful or traumatic events.
Reasons for depression include:

* Biology. Researchers still have a lot to learn about exactly why people become depressed. But some experts say depression often results from an imbalance of certain chemicals in the brain. These chemicals are called neurotransmitters. Antidepressants work by affecting the levels of these chemicals — bringing them back into balance.
There's also a genetic connection. If depression runs in your family, you have a higher chance of becoming depressed.
Having other general health conditions or diseases can increase your risk of depression. For instance, if you have a heart attack, you have a 65% risk of becoming depressed afterwards. Conditions such as cancer, heart disease, thyroid problems, and many others increase your risk of becoming depressed.
Your gender makes a difference, too. Women are about twice as likely as men to become depressed. No one's sure why. But the hormonal changes that women go through at different times of their lives may be a factor. Psychology. Studies show that people who have a pessimistic personality are more likely to become depressed. This doesn't mean that getting a "better attitude" will resolve your depression.
* Stressful events. Many people become depressed during difficult times. Losing a family member or close friend, being diagnosed with a serious illness, going through a divorce, or any other traumatic event may trigger depression.
* Medications and substances. Many prescription drugs can cause the symptoms of depression. Alcohol or substance abuse is common in depressed people. It often makes their condition worse.
Some people have a clear sense of why they become depressed. Others don't. The most important thing to remember is that depression is not your fault. It's not a flaw in your character. It's a disease that can affect anyone.

Reviewed by Brunilda Nazario, MD
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6 Sex Mistakes Women Make

Ladies, be honest: when your sex life becomes a little humdrum, out comes the mental catalogue of all the ways your partner isn’t quite measuring up. Guys tend to get a bad rap when it comes to understanding women’s bodies and what turns us on, making them easy targets in the blame game when sexual satisfaction starts to wane. And sure, they make their fair share of bedroom errors. But as the saying goes, it takes two to tango. As it turns out, top sex and relationship experts say that women make plenty of sex mistakes of their own. Here’s what they have to say about the six most common mistakes women make in the bedroom and what you can do to get the satisfaction you so rightly deserve.
Sex Mistake #1: Not Initiating Sex With Your Partner

It’s 2009 and still, many of us worry about ladylike behavior. We don’t want to appear pushy or come on too strong for fear of being labeled aggressive. According to Les Parrot, professor of psychology at Seattle Pacific University and author of a new book called Crazy Good Sex, failing to initiate sex is one of the biggest mistakes women make.

“Most guys feel like they are always the initiator and that sets up disequilibrium on the passion scale in the relationship,” he says. Generally, men want to be pursued by their partners just as much as women do.

Holding onto outdated ideas about sex roles also inhibits satisfaction with our sexual relationships, says "Dr. Ruth," aka Ruth Westheimer, PhD, a psychosexual therapist, professor at New York University, and lecturer at Yale and Princeton universities. “They used to think that women are less interested in sexual activity and I don’t want to say that anymore. I think there are women who are as interested in sex [as men].”

Show your interest by taking the first step from time to time. Your partner will likely appreciate it, and you may find a new level of satisfaction in taking responsibility for your sexual experience, something Westheimer feels strongly women must do.
Sex Mistake #2: Worrying About What You Look Like

Thinking about how you look during sex stops you from enjoying yourself and ruins your chances of achieving an orgasm.

“Don’t think about the fat on your belly or the makeup on your face,” advises Westheimer. “Concentrate on the pleasure of the act. You must give yourself permission to have an orgasm.”

“Men want their wives to abandon themselves in sex play, and that’s not likely if she is anxious about her physical concerns,” Parrott says.

Helen Fisher, PhD, a cultural anthropologist at Rutgers University and author of a new book called Why Him, Why Her, says men don’t notice half the things women obsess about anyway.

“It’s amazing what men don’t notice if you’re enthusiastic, energetic, interested in them, and flexible minded.”

According to Fisher, there is an evolutionary explanation for the selective blindness men show to our physical flaws. For Darwinian reasons, says Fisher, men are (unconsciously, of course) looking for women who are able to bear healthy babies. Starting millions of years ago, men who attracted fertile women and had a lot of children lived on. Those who couldn’t died out. Although maybe not as necessary today, Fisher says that primal survival mechanism lives on.

“Men are much more attracted to women who show signs of health and youth and fertility. Rather than worry about the shape of your waist and hips, worry about your energy level and enthusiasm and interest in him,” Fisher advises.
Sex Mistake #3: Assuming Sex Is Casual for a Man

Westheimer believes we should all let go of old-fashioned notions, such as women are not sexual or that sex is just sex to men. “For some men, sex is a very important act. Don’t minimize it.”

The research, says Parrott, supports the idea that both men and women find sexual intimacy in the context of a committed relationship to be more satisfying.

“Numerous research studies make it very clear that the people who have the best quality and most frequent sex are married couples. That says a lot about the inadequacies of ‘casual sex,” Parrot says.

In a study being conducted by Fisher and her colleagues of university students engaging in one-night stands, the numbers show that men are just as serious about sex and relationships as women. In fact, more than 50% of women and 52% of men who went into a one-night stand, according to Fisher, reported that they did so hoping to create a longer relationship. One-third of them actually did so. What’s the lesson?

“Never assume that a man is not romantic,” Fisher says. “Two huge mistakes in this culture are that women are not sexual and that men are not as romantic [as women].”
Sex Mistake #4: Believing He’s Always Up for Sex

Sure, most teenage boys are ready and willing just about any time you ask, but not true for men. The pressures of everyday life -- family, work, bills -- can zap a man’s libido. This comes as a big surprise to many women, and often his lack of interest in sex is something we take personally.

“It comes as such a shock [to women] that they just don’t believe it,” Fisher says about the reaction many women have when their partner says they aren’t in the mood for sex. “They know themselves that they are not always interested in sex but they still love the man. But when they discover he doesn’t want to have sex, they think, ‘he doesn’t love me.’ Not true. He just doesn’t want to have sex.”

Talking very directly about sex, what we like and don’t like can make us feel uncomfortable, even with a partner we’ve been with for a long time and otherwise feel close to, says Parrott. But it’s the only way to achieve a satisfying sexual relationship.

“A woman must take responsibility for her sexual encounter,” says Westheimer. “No man can bring a woman to orgasm if she doesn’t take responsibility for her sexual experience. Even the best lover can’t know what she needs without her letting him know.”

The good news, according to Fisher, is that men very much want to please women.

“If you can tell them in a way that doesn’t kill their ego, they will appreciate it,” says Fisher. She advises women to sandwich what they don’t like in between five things they do, because he’s listening. “You won’t find out until the next time you’re in bed with him. But men do listen, particularly if you’re quite clear about it.”
Sex Mistake #6: Getting Upset When He Suggests Something New

After a couple has been together for a while, it’s natural to want to spice things up with a little variety. Just because your man wants to try something new doesn’t mean he’s unhappy with you or your sex life. In short: Don’t take it personally.

Still, it’s important that you tune into your comfort zone says Parrott.

“Nobody should ever feel obligated to do something they don’t want to do in the personal and intimate area of sexuality,” Parrott says. “If your man asks you about trying something that’s outside of your morals, make it clear that it’s off limits for you and explain why. Of course, do this in a loving way as best you can. If it is something that is not really a moral issue for you but you still don’t want to, again explain why. If it is a simply a startling request and you’re initially uneasy about it, try not to overreact. Instead, let him know you need some time to think about it.”

By Lisa Zamosky
Reviewed by Louise Chang, MD
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5 Things You Didn't Know About Masturbation

Although men may joke and tease each other about their solo sexual activity, women are typically less forthcoming about their own self-pleasuring. With a very close friend, some may compare notes discretely about the best vibrators or the stress relief going solo can provide.

But women's masturbation is not generally a common topic of conversation among girlfriends. Maybe it should be, say sex therapists. They point out that women's masturbation can have benefits both for health and relationships. Here are five things about masturbation women may not know:
1. "Normal" masturbation in women takes many forms.

Most women, like men, have masturbated at least once in their lives, research suggests. Frequency varies, and there's no "normal" for that. There's no ''normal" cutoff age, either, with the practice continuing into the 80s and beyond.

Women may feel guilty about it, especially if they are in a committed relationship, but there’s no need for guilt, sex therapists say. Sometimes a partner is tired, out of town, or otherwise unavailable. And it doesn't mean a woman needs to go without.

There is no one "method" of masturbation in women that's normal. "A range of ways is 'normal,''' says Paul Joannides, PsyD, a psychoanalyst in Waldport, Ore.

Fingers and vibrators are two common methods of women's masturbation. More than half of 2,056 women, aged 18 to 60, used a vibrator either during masturbation or intercourse, says Debby Herbenick, PhD, MPH, associate director of the Center for Sexual Health Promotion at Indiana University, Bloomington, who led the survey.

Other women who masturbate report they use the back of a vibrating toothbrush head, the handle of a hairbrush, or water jets in the bathtub, Joannides says.

Although some experts worry about side effects from vibrator use, such as genital numbness or pain, less than 30% of the women in Herbenick's vibrator survey said they had experienced them.

But another expert, Frank Sommers, MD, a Toronto psychiatrist, worries that excessive vibrator use during masturbation could desensitize women to orgasms with a partner. “I tell my patients, ‘Look on a vibrator as whipped cream -- you wouldn’t want to eat it every day.’’’

He believes too much vibrator use ‘’habituates your autonomic nervous system to such stimulation that a human could not duplicate it.”
2. Masturbation can improve your mood -- without the ''obligations'' of partnered sex.

However a woman chooses to masturbate, it can improve her spirits. "It can improve a depressed mood," says Kathleen Segraves, PhD, a sex therapist and associate professor of psychiatry at Case Western Reserve University and a therapist at Metrohealth Medical Center in Cleveland, Ohio. "Not clinical depression, but the 'blue funk' days."

"With solo sex, there is no distraction, and you can focus on your own experience without making sure someone else is having a good time," she says.

It doesn't mean you don't love your partner, maybe just that you need to think only about yourself sometimes, experts say. "The woman doesn't have to be outside her head, wondering, 'Am I taking too long?'" Segraves says.

3. Masturbation can improve your sex life with your partner.

Women who masturbate on a regular basis learn what feels good for them, Segraves says. "It helps build sexual confidence," she says. "It helps you guide the partner when you have a partner.”

You can say, for instance: "Please put your hand here," and not be embarrassed, she says.

Women who use a vibrator during masturbation tend to have better sexual functioning with a partner, Herbenick says.

Sex therapists typically recommend masturbation for women who have a difficult time reaching orgasm. It can help them learn about their body and feel less self-conscious.

"We know that women compared to men have a harder time learning to orgasm," Herbenick says. Masturbating can help, and masturbating with a vibrator may help even more, she says. "Using a vibrator, for reasons we don't understand, helps women orgasm." The survey is published in the Journal of Sexual Medicine.

Those who used a vibrator, she found, even if it had been a year since the use, "had better sexual functioning in terms of vaginal lubrication, desire, arousal and ease of orgasm, and they tended to have less pain or discomfort during intercourse."

But "it may be that those who don't find sex painful tend to use a vibrator,” she says.
4. Masturbation can help you relax.

Women are more apt than men to over-analyze a bad day and think: "How could I have done this better?" They are more likely than men, some researchers have found, to replay an argument or bad interaction with people in their head. It all adds up to excess stress.

Researchers call this rumination, and it has been linked in numerous studies to depression.

"If you can start pleasuring yourself, that will often interfere with ruminations," Segraves says. "Not all the time," she says. But it may help.
5. Masturbation can provide pain relief.

Women who masturbate often report that it helps relieve menstrual cramps and to improve the symptoms of premenstrual syndrome (PMS), such as irritability and crankiness.

Masturbating to orgasm may help migraine, too. Although orgasm has sometimes been found to trigger a migraine headache, it may also relieve it, according to some research. Scientists speculate that some factor associated with orgasm (by yourself or with a partner) may suppress pain or actually suppress the migraine process.


By Kathleen Doheny
WebMD Feature
Reviewed by Louise Chang, MD
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Pregnancy Raises Swine Flu Death Risk

Pregnant women, even if they are healthy, are at high risk of hospitalization and death from H1N1 swine flu, the CDC reports.
A CDC analysis shows that pregnant women are more likely than the general population to develop severe disease after infection with the pandemic H1N1 swine flu virus. They are four times more likely to be hospitalized, with an unusually high death rate.
Although media reports have focused on deaths among pregnant women with underlying disease, most pregnant women who have died of swine flu were healthy when they caught the pandemic virus.
Even so, the findings do not mean that all pregnant women will suffer severe disease, says study leader Denise J. Jamieson, MD, MPH, an obstetrician-gynecologist at the CDC's Women's Health and Fertility branch.
"Most women who become ill with flu are going to have mild disease just like in the general population," Jamieson tells WebMD. "But it does seem pregnant women are at increased risk of severe illness and death. So the proportion of deaths among pregnant women is larger than you would expect."
The CDC has details on 266 of the 305 U.S. swine flu deaths reported as of July 29. Fifteen of these 266 deaths -- about 6% -- were among pregnant women. Most of the deaths were among women in their third trimester.
Pandemic Flu Deaths in Pregnant Women Not New
It's not a new phenomenon:

• During seasonal flu epidemics, pregnant women -- especially those in the third trimester -- are far more likely to be hospitalized for lung and heart disease than women who recently delivered a child (considered the closest comparison group).

• In a study of 1,350 women who had flu during the 1918 pandemic, about half the women got pneumonia and about half of the women with pneumonia died -- a case-fatality rate of 27%. Women in their third trimester were particularly vulnerable.

• During the 1957 flu pandemic, pregnant women accounted for half of the flu deaths among Minnesota women of reproductive age.

There's also a risk to the fetus. In past pandemics, there were high rates of stillbirth, spontaneous abortion, and premature delivery among pregnant women who had the flu. Flu comes with fever, which can result in brain damage to the fetus.
In the current swine flu pandemic, Jamieson says, it's too soon to know much about fetal outcome. But she says women with swine flu do seem to be at high risk of premature delivery.
But the major risk is to the pregnant woman herself. That risk is based on her pregnancy and not on other risk factors. "Pregnant women are at risk just by virtue of being pregnant," Jamieson says.
Why? It's not entirely clear, but there are two likely mechanisms:

• As pregnancy evolves, a woman's diaphragm is pushed upward and she has decreased lung capacity. This makes respiratory disease more dangerous.

• During pregnancy, a woman's immune system shifts away from the kinds of immune responses most effective in battling viral infections. This makes her more susceptible to some viral diseases such as flu.

CDC to Pregnant Women with Flu: Take Tamiflu or Relenza
All of the pregnant women who died of pandemic H1N1 swine flu had another thing in common: They, or their doctors, waited too long to start them on anti-flu drugs.
Tamiflu and Relenza both fight swine flu. These drugs work far better when started within two days of the first flu symptoms.
Many women -- and many doctors -- are hesitant to start medications during pregnancy. But when flu symptoms strike, the antiviral drugs Tamiflu and Relenza pose vastly less risk than the flu itself.
"Clinicians who take care of pregnant women seem hesitant to start antivirals," Jamieson says. "It has been an issue of prompt antivirals vs. concerns about the fetus. But we are recommending that women be treated, because the benefits outweigh the risks of the drug."
Mark Phillippe, MD, chairman of obstetrics, gynecology, and reproductive sciences at the University of Vermont, recently wrote an editorial warning doctors to offer pregnant women aggressive treatment if they have flu symptoms. He was not involved in the CDC report.
"I certainly agree with the CDC recommendation," Phillippe tells WebMD. "The risk of becoming seriously ill and of dying is significantly higher for pregnant women than for the rest of the population. The big advantage we have over previous pandemics is we have an opportunity to save lives by early treatment. Based on the case reports so far, most of the women who died had a delay in treatment."
Jamieson says that a pregnant woman who develops flu-like symptoms should call her doctor right away. She should not go directly to her doctor's office to avoid exposing other pregnant women to swine flu. If her doctor prescribes Tamiflu or Relenza, she should start treatment as soon as she can.
"The safest thing she can do for herself and her pregnancy is to take the medication order to prevent an overwhelming infection," Phillippe says. "And when the swine flu vaccine comes out, pregnant women need to be among the high-risk groups that receive the vaccine first."
Especially outside the U.S., media have trumpeted advice that pregnant women should avoid crowds and basically hide out during the flu pandemic. That is NOT what women should do.
"Pregnant women should continue their everyday activities and not take any extra precautions other than avoiding people who have the infection and washing their hands frequently," Jamieson says. "But if they suspect they may have the flu, they do need to promptly call their health care provider."

By Daniel J. DeNoon
WebMD Health News
Reviewed by Brunilda Nazario, MD
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