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Getting pregnant is easier said than done for at least 10% percent of women in the U.S.  About 90% of women will conceive after one year of trying. If you’ve been trying to get pregnant without success, consider these reasons and possible solutions.

1. You’re not having sex at the right time. The only way a woman can get pregnant is if the egg is fertilized by sperm but if there’s no egg, there’s no baby. If you don’t get your period every month, there’s a strong possibility that you’re not ovulating. What can you do? Buy an over-the-counter ovulation kit (many are sold at the dollar store) to determine if you’re ovulating.
2. You might have scar tissue in your tubes or in your uterus.  If you’ve had a history of a sexually transmitted infection or pelvic inflammatory disease (PID), your tubes might be blocked. A procedure called a hysterosalpingogram (HSG) inserts dye into the uterus and tubes to see if they’re open or closed.
3. Your partner’s sperm count might be low. Male infertility accounts for 23% of reasons why women can’t get pregnant. If you’ve been trying unsuccessfully to get pregnant after a year, please see your healthcare provider.
4. There might be something wrong with your uterus.  “Congenital anomalies” means something was wrong with your uterus from birth.  An HSG will make the diagnosis.
5. You could have endometriosis which is tissue from the uterus on places such as the ovaries, rectum, abdomen or other unlikely places. Severe pain during the times of your period gives a clue about this possible condition.
6. Your eggs might be too old. Your age plays a significant role in your ability to conceive. If you’re over 30 and can’t get pregnant, please see your health care provider. IVF (in vitro fertilization) is very successful for women in their 30’s.
7. You’re having a lot of miscarriages. Two or more miscarriages could signify an autoimmune disorder and a good reason to see a infertility specialist.
8. There might be something wrong with either your genes or your partner’s. Another reason to see an infertility specialist.
9. You’re trying too hard.  There have been studies that have proven that meditation and hypnosis has helped women get pregnant.  You might be one of those success stories when all else has failed.
10. You’re overweight.  If you’re overweight and not getting your period, you’re not ovulating. I had a patient who had been trying to conceive unsuccessfully for years. She lost 10 pounds, became pregnant and the mother of a beautiful baby girl. Losing weight can help.

If you’ve been trying to get pregnant unsuccessfully for over a year, it’s time to move your feet and find out why.

Years ago, Vitamin C was frequently in the spotlight because of the scientist, Linus Pauling who made the bold assumption that it was the cure for the common cold. While that topic is still subject to debate, it appears that Vitamin C has been proven to help pregnant mothers who smoke.

The dangers of smoking during pregnancy are well known. Not only does it increase the risk of developing lung cancer, it can also increase the chances of having a small baby, the placenta separates too soon before the birth of the baby (also known as a placenta abruption) and preterm labor. There is also an increase in Sudden Infant Death (SIDS) and pre-eclampsia.

At a recent international medical conference, the Oregon Health and Science University presented a medical study that looked at pregnant smokers who were aged 15 and older and gave them 5400 mg tables of Vitamin C. They compared these women with those who smoked but did not take Vitamin C.  Of course, both groups of women were counseled to stop smoking but continued during the course of their pregnancy. At birth, the infants of both groups were given lung tests and the Vitamin C group had better results. These results are significant because babies of smokers can also have breathing problems and death before the age of 28 days.

The researchers plan to test the babies again at age 12 months to see if there are any differences between babies of the same age who have wheezing problems.

Does this study give pregnant women who smoke the green light to continue? Of course not, but if they can’t stop smoking then taking Vitamin C might help reduce some of the harmful effects smoking has on their newborn.

Until next time, remember – a healthy pregnancy doesn’t just happen, it takes a smart mother who knows what to do.

1. To determine the age of the pregnancy
2. To document that the baby is alive
3. To determine the position of the baby
4. To determine “normal” anatomical organs, usually after 18 weeks
5. To determine the position of the placenta
6. To determine the cause of bleeding
7. To determine whether you are having more than one baby
8. To document that the baby is in the uterus and not a fallopian tube
9. To measure amniotic fluid late in the pregnancy
10. To periodically watch the baby if you have a high-risk condition

There will be temptation for pregnant moms to get “keepsake” ultrasounds done in the mall for entertainment purposes. Not only are those ultrasounds not approved by the FDA but they could potentially miss an important diagnosis if they are not read or interpreted by a physician. The conditions listed above will give you legitimate reasons for requesting an ultrasound that can be done by a professional under the supervision of a doctor.

Remember, a healthy pregnancy doesn’t just happen. It takes a smart mom who knows what to do.

You have been which might be considered fluid for the past two days. You call your provider, who advises you to go to the hospital for further evaluation. Upon your arrival at the hospital, the nurse does something called a nitrogen test.  Nitrogen is a substance that turns blue when exposed to amniotic fluid, mucus or blood. Your nitrogen test proves negative. Should you be discharged home? Yes or No.

The answer is no, you should not be discharged home. You first need to have an ultrasound to make certain you have adequate fluid. You could have legitimately been leaking fluid for several days and now have no fluid. Without fluid, an infection called chorioamnionitis could easily develop. Or if your fluid is extremely low (also known as oligohydramnios), you might need to be delivered.

Did you learn something? Well here’s another quiz also taken from the book:

You have had a dull headache all day. For the past two weeks you have received nonstress tests because you complained of decreased fetal movement. You had a two-hour wait before a bed became available in the triage unit. The nurse takes your vital signs, and your blood pressure is 140/90. After twenty-five minutes, your nonstress test is reactive, the triage unit is becoming busy, and the nurse calls your physician with a report of your NST results but omits your blood pressure result and complaint of a headache. However, she does advise your physician that the labor is busy and they need your bed. Your physician’s midwife is on call and sends you home. Is this correct?

No. Although the nurse was correct to report a reactive nonstress test, she did not mention your elevated blood pressure or your complaint of a headache. In this clinical situation, other tests would be necessary to make certain that you are not developing pre-eclampsia.

In pregnancy, the unexpected things, if not managed properly could get you in trouble. Sadly, many healthcare providers do not discuss potential problems with patients until they are smack in the midst of a crisis.

Want to be prepared? Then order a copy of The Smart Mother’s Guide at www.smartmothersguide.com. Remember a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.

When physicians decide to specialize in obstetrics, we know exactly what we’re getting into. We have two patients, both mother and unborn baby and we don’t want either to die. Each year 4 million babies are born in the U.S. and between 6 to 8% of their mothers will have high blood pressure. Why are physicians and healthcare providers concerned about high blood pressure? Because if untreated, it can cause a stroke leading to death.

During pregnancy, a patient can have there are 3 types of high blood pressure: (1) chronic hypertension that occurs before 20 weeks, (2) gestational hypertension that occurs after 20 weeks but is not associated with protein in the urine and (3) pre-eclampsia that occurs after 20 weeks and is associated with protein in the urine. Pre-eclampsia, if untreated can lead to seizures (also known as eclampsia) and strokes. It is one of the most common reasons for death as a result of pregnancy. The treatment for pre-eclampsia is the delivery of a baby because the placenta is causing a problem. If the patient’s blood pressure is extremely high and life-threatening, medicine is also given to prevent the woman from having a stroke until she is delivered.

On the other hand, chronic hypertension is treated with medication during pregnancy to prevent strokes from occurring.  But what type of medicine? The FDA classifies medicines in 5 categories from “A” to “X” to describe how they will affect the unborn baby. Category A poses no harm to the baby and Category X should never be given because it has been proven to cause birth defects. The blood pressure medication Lisinopril is a category X medication. It should never, never be taken during pregnancy.

Pregnant moms please read those labels and ask questions before taking medication.  A healthy pregnancy doesn’t just happen. It takes a smart mom who knows what to do.

Women’s health is the topic of great political debate as you may well be aware if you listen to the news or watched both political parties’ national conventions during the past two weeks. Do women control their destinies? Do we and will we continue to have control over our bodies? These are the questions at hand. While there’s great chatter about this topic as the U.S. election nears, there’s also a quiet revolution occurring in our healthcare system that will directly affect pregnant women.

Prenatal care as we know it will begin to change, especially if you receive Medicaid or government sponsored insurance. The current trend is to visit your healthcare provider’s office individually and wait to be seen. In the future, you will be seen by your healthcare provider as a member of a group, not as an individual. This is called enhanced prenatal care with group appointments and will be the wave of the future.

Groups of 10 pregnant women will be seen at the same time for approximately 10 prenatal visits that will last approximately 90 minutes. It is anticipated that 2 healthcare providers will not only take your vital signs, listen to your baby’s heartbeat, but will also allow you to interact with the other patients in this group setting to discuss prenatal issues, receive health education information and any concerns that you may have. Believe it or not, this model of care is not new.  The concept was called Centering Pregnancy and was developed by nurse midwife Sharon Shindler-Rising in 1989.

In the future, doulas and social workers along with midwives will become more prominent in terms of prenatal care as things continue to evolve. Are you ready for group prenatal visits?

Food allergies in infants may present as a severe rash, bloody stool, poor weight gain, swelling or vomiting. These allergies are usually acquired during the 1^st or 2d year of life. Allergies to cow’s milk and hen’s eggs are typically outgrown during childhood or adolescence, whereas peanut and tree nut allergies are more likely to continue into adulthood. The danger with peanuts is that it can cause severe breathing problems and a sudden drop in blood pressure which could potentially cause death.

Eating peanuts during pregnancy has always been controversial. Some schools of thought state that pregnant women should avoid eating peanuts to decrease the chance of allergies in their children. Other studies felt that there was no association with peanut allergies and a pregnant women’s diet.

Well now there’s a recent medical study from Denmark that states something completely different. According to the study, pregnant women should actually eat peanuts to reduce the risk of peanut allergies in their unborn.

According to the study, 60,000 pregnant women were evaluated along with their children until age 7 to look at the association between eating peanuts and the development of allergies. The results were surprising. There was a 25% decrease in the number of babies that developed allergies by 18 months and a 30% decrease by age 7. They concluded that pregnant women eating peanuts one or more times a week reduced the risk of the development of childhood peanut allergies.  The researchers were bold enough to state that pregnant women should not avoid eating peanuts.

So, should U.S. pregnant women eat peanuts weekly to avoid future childhood allergies? It’s certainly food for thought.

A few years ago, I read a miraculous story about a stray dog that had saved the life of an abandoned baby in Kenya. The event occurred in May 2005 and it left such an indelible impression on me that I decided to not only include the story in The Smart Mother’s Guide to a Better Pregnancy, but a year later, I blogged about it.  I was intrigued that a mother abandoned her baby but a dog miraculously saved it. Three years later, the story has resurfaced as a result of a picture that was published on Pinterest and the interest regarding the outcome of both the baby and the dog was humbling. Many readers asked what happened to the dog and someone was kind enough to send a link that answered the question.

For those not familiar with the story, a dog found an abandoned baby in Kenya on top of a garbage heap near a race track wrapped up in an old pair of shorts. The dog had given birth to her puppies and was looking for food. The dog picked up the baby, carried it across a busy street and returned the baby to its compound along with its puppies. Some children who live near the compound heard the baby cry, saw her along with the dog and then told their parents who called the police. Unfortunately, baby abandonment was quite common because of extreme poverty.

The baby girl was 2 days old and they weren’t sure if she was going to make it. She spent 3 weeks in the NICU and was adopted quickly because of her miraculous rescue made by the dog. The biological mother was never found.

The heroic dog’s puppies died but she had a happy ending. She was given the name Mkombozi which means Savior in Swahili and adopted by the Kenyan SPCA. She now occupies a space (including her bed) in their office, functions as the “canine ambassador” and is very good with children who visit from school on field trips.

As I’ve stated before, pregnancy is a time of miracles. Somewhere in Kenya, there’s a 7-year old girl living and breathing because of the humanity of a dog. Perhaps we should all take out our notebooks and take lessons.

For more information on Mkombozi, please click on this link:

http://www.dogheirs.com/tamara/posts/533-mkombozi-the-stray-dog-saved-the-life-of-a-newborn-baby

In 2009, the Dominican Republic passed a law stating life begins at conception and Rosa Hernandez buried her 16 year old daughter (also named Rosa), as a result.

Rosa was 10 weeks pregnant when she discovered that she had leukemia. Hernandez wanted Rosa to receive chemotherapy in order to save her life. Instead, her doctors were reluctant to give chemotherapy because it would have caused a termination of pregnancy. So both Rosa and unborn grandchild died instead.

Hernandez pleaded with the physicians to no avail. They did not want to be accused of provoking an abortion if the fetus had died. The Dominican government allegedly stated that chemotherapy could be given to pregnant women as long as it’s not given for the purpose of causing an abortion. What an impossible situation. Of course chemotherapy is not given for the purpose of causing an abortion. It’s given for the purpose of killing cancer cells and saving someone’s life. Cancer affects 1 in 1500 pregnancies. Does that mean that all those women have to die?

Rosa’s doctors admitted her into the hospital at approximately 13 weeks but her body rejected the chemotherapy and she had significant bleeding. Despite heroic attempts, she died in the 14^th week of her pregnancy and Hernandez’s life will never be the same again.

Insurance companies and government policy should not and cannot treat acute or chronic illness. They are not doctors or nurses. If the U.S. adopts the same policy as the Dominican Republic and 1 in 1500 pregnant women have cancer each year, then 2,667 women could potentially die each year in the same manner as Rosa. Do we really want that?

One of the most important things that need to be established for women trying to conceive is to make sure that they have regular cycles or have a period every month. A regular monthly period means that the ovaries are working and producing eggs. If your menstrual cycles are irregular or skipping months, you are most likely not ovulating and need to determine why. The most common reason for irregular periods is polycystic ovarian syndrome, a condition where the ovary contains many cysts and don’t produce eggs. Therefore, iIf you have an irregular menstrual cycle and want to get pregnant, you should make an appt to see your physician right away

Ideally, you want to have sexual relations at least 36 hours before the egg is released so that fertilization can occur. The sperm can survive for 96 hours which gives it plenty of time to fertilize an egg. However, how do you when ovulation will occur? This is the key to a successful pregnancy.

Taking a temperature was the way women determined whether they were ovulating and it was not user-friendly. Some women did not want to be bothered using a thermometer on a daily basis. An easier ovulation method is to test a woman’s urine for an LH (luteinizing hormone) surge which indicates that ovulation will occur in the next 36 hours. These ovulation kits can be performed at home and are available in the dollar store.

76% of couples successfully conceived within one month of using an ovulation kit as opposed to 50% of couples who didn’t. So, if you’re trying to conceive in a hurry, using an ovulation kit might just be the way to go.