There are few times that I become gravely concerned about the way medicine is practiced and this is one of them. A recent medical study in the Journal of Hypertension reported some startling facts: pregnant women are receiving blood pressure medication that might be harmful to their babies.
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.
In today’s tough U.S. economy, healthcare is in the forefront because of the three trillion dollars spent each year. Patients are not seeing their money’s worth and neither is the U.S. government who writes the check for a large percentage of it. The cost of women having babies too early or prematurely costs our society $26 billion dollars each year. Something has to give.
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?
When food that we eat could potentially kill us, it’s tragic. Such is the case of peanut allergies in U.S. children that has become a great public health concern because of its increasing numbers and severity. According to medical studies, at least 18% of kids are allergic to food and 3 million American children have allergies to peanuts or tree nuts.
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 1st 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:
While the debate continues in the U.S. regarding whether life begins at conception, the Dominican Republic has shown what happens when a government says that it does.
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 14th 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?
If you’re trying to get pregnant, you need a well developed strategy, especially if you are 35 and older. Although 50% of pregnancies in the U.S. are unplanned, trying to get pregnant can still be a challenge.
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.
I was recently on a few pregnancy sites and was surprised at the number of times someone was confused as to whether or not they were pregnant. Finding out whether one is pregnant can provoke equal anxiety for both those who are attempting to get pregnant and for those who don’t want an unplanned pregnancy. Here are some facts:
- The most common sign of pregnancy is a missed period for women who are sexually active and have had normal periods in the past. While abnormal bleeding, back pain and breast tenderness are symptoms, they are not the most common symptoms. If you can set your clock by your monthly period and then it “disappears” for more than 2 weeks, you need a pregnancy test.
- How soon after a missed period can a pregnancy be detected?
- With a urine pregnancy test – 5 to 7 days after the last menstrual period (LMP)\
- With a blood pregnancy test – 1 to 2 days after the LMP
- Why the difference in the urine and blood test?
- The urine pregnancy test requires more pregnancy hormone (aka BHCG or beta HCG) than the blood test. The urine pregnancy tests requires 20 to 50 IU/L of beta HCG while a blood only requires 1 to 5 IU/L. Big difference isn’t it? However most clinics or healthcare providers’ offices will do a urine test first because it is less expensive than a blood test.
- Your home pregnancy test is positive. Now what should you do?
- Repeat the test at your clinic or healthcare provider’s office to make certain that your home test was not a false positive.
- Will an ultrasound confirm your pregnancy?
- Usually not until 6 weeks after your missed period or if your beta HCG level is above 1500 IU/L. If your beta HCG level is greater than 1500 IU/L, an ectopic pregnancy should be suspected and appropriately managed by your healthcare provider.
Have questions? Feel free to contact me at www.smartmothersguide.com Remember, a healthy pregnancy doesn’t just happen. It takes a smart mom who knows what to do.