Rubella (German Measles)
   Whereas exposure to the “normal” kind of measles is not known to be dangerous during pregnancy, an infection of rubella in the mother can lead to miscarriage, deafness, mental retardation, and defects of major organs in the baby. The risk is greatest if exposure to the virus occurs in early pregnancy (prior to 12 weeks), but reduces in the latter trimesters.
   There currently exists a widespread (optional) program of vaccination against rubella for pre-pubescent girls but, as with any vaccination, these are not 100% effective. I was a case in point, receiving a rubella shot at the age of 12. When first pregnant at 17, it was assumed I was immune and no tests were done. Yet at the age of 25, when pregnant with my second child, I was tested again for rubella antibodies and found to be non-immune. Therefore, even if you have had these shots, don’t assume that you are actually immune. If you are against the principles of vaccination, you will need to be especially careful if you hear of any rubella-affected child in your community. In either case, you should still avoid any contact with that child or family until beyond the first trimester.

Genital Herpes
   Around 30% of all women carry genital herpes or Herpes Simplex Virus Type 2 (HSV-2). Many of these may not know it. If you know that you carry the virus, you should be sure to inform all the members of your birthing team before-hand, since internal examinations and foetal monitoring both increase the chance that herpes will be spread from the vagina to the child during labour. If your sexual partner is a carrier of the virus, be sure to use condoms during sex during pregnancy, as transmission to the woman at this time can both induce premature labour and cause serious complications for a newborn. Type 1 Herpes, known as cold sores, can also be passed on by touching the sores and then the baby.
   The ramifications of a baby being infected with herpes during birth (or sometimes within the womb) is that there can be an outbreak of rashes or sores on the skin, most often on the hands, feet and around the eyes. More serious conditions like brain infection, lethargy, fits, jaundice or apnoea can develop if not diagnosed and treated early. Although infection in-utero or during birth is rare (about 5% for infected women), all care must be taken by any infected mother or father to avoid the likelihood of passing it on to the baby.
   There are two schools of thought on this topic. The conservative approach is that all women should be tested pre-
 

natally and that if there is an outbreak in the mother close to the time of labour, a caesarean section should automatically be performed. The other approach is that with careful management the risk of infecting a newborn is reduced to negligible.
   If you are HSV-2 positive, talk to your midwife and doctor about their birthing approach to this matter, and be sure to communicate the way in which you would prefer any scenario to unfold.
   A woman who knows she carries herpes can use a combination of yoga practices and lifestyle adjustments such as diet and stress management to help reduce the likelihood of an outbreak around the time of birth. See Chapter 9, Prescriptive Programs – “Cleansing and Healing” and “Stress Management” .

Chlamydia
   Chlamydia infections in a pregnant mother are known to be associated with low infant birth weight. Also, the newborn baby can suffer eye infections, pneumonia, gastro intestinal infections, and infections of the genitals. Since Chlamydia is an STD, avoiding it is best achieved by careful selection of sexual partners before and during pregnancy, and use of condoms where any doubt exists. See also Chapter 3 – “Sexually Transmit-ted Diseases”, on page 111.

Toxoplasmosis
   Toxoplasmosis is a parasite found in some forms of meat and sometimes in the faeces of cats. Maternal infection occurs mainly due to eating raw or poorly cooked meat, or close contact with infected domestic animals and where they have soiled. If transferred to the baby during the first trimester it can cause birth defects and other less serious ailments.
   It is estimated as extremely unlikely (1 in 400,000) that general handling of cats can pass on the parasite. However, experts advise that pregnant women should take the obvious precautions of either not handling cat litter at all; of using gloves to handle it; and of being careful of cat soil when gardening. Washing your hands after all such activities is highly recommended.
   The likelihood of infection through meat can best be dealt with by the careful purchase, cooking and storage of meat foods – or else by becoming vegetarian!

Cytomegalovirus
   This virus can cause serious foetal defects if contracted during pregnancy, some of which are noticeable at birth and some which go on to develop in early childhood. CMV is only just becoming acknowledged as being even more