The Shocking Truth: 10 Reasons Why You Are Not Getting Pregnant

The Shocking Truth: 10 Reasons Why You Are Not Getting Pregnant 3rd

Image courtesy of imagerymajestic / FreeDigitalPhotos.net

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.

A Dog and a Baby, Part 2

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

When Doctors Won’t Listen (Part 1)

ImageWe recently celebrated the arrival of a new addition in our family and it was a delivery made in Heaven. Our relative’s membranes ruptured, contractions started and she delivered a healthy baby 45 minutes after her arrival to the hospital. The doctor came 10 minutes before the baby was born and all she had to do was basically “catch the baby.”

Sadly, everyone is not as fortunate. Each month I review medical malpractice cases and shake my head in frustration because many of them could have been avoided if only someone had listened to the patient or paid attention in the labor room. Last week, the listeners of a popular morning radio show listened in horror to Angela Burgin Logan’s interview about her missed diagnosis of pre-eclampsia that almost killed both her and her unborn daughter. Fortunately she lived to tell the story which is now a movie entitled Breathe. Although Angela and her daughter are well, other women have not been as lucky.

Pregnant women need to start thinking in terms of “outcomes” regarding their pregnancy. As the healthcare “industry” moves deeper into the 21st century, healthcare providers and hospitals will be measured and paid according to the outcomes of the patient. You will hear terms such as “pay for performance” and “performance measures” used more frequently. A “normal” pregnancy does not necessarily mean a “normal” outcome at birth (aka healthy baby) if someone misses a sign or a signal of a potential life-threatening problem. Why does this happen? For reasons too numerous to count but the main culprit is lack of communication. A lab report with important results was not reviewed or signed. High-volume practices leave little time to provide quality care for patients and then of course, there is arrogance.

Two of the most empowering things a pregnant woman can do in order to improve her chances of having a healthy baby is to (1) select the right healthcare provider and (2) have strategies at hand in the event that she encounters administrative or clinical complications. In Part 2 of this discussion, I will provide some of those strategies in the event that you have a healthcare provider who will not listen to your concerns. Until then, remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.

http://youtu.be/rySO6jqj0ik

Happy Holidays: Reflections of a Miraculous Birth

When I think about Christmas, I instinctively think about the miracle of birth. Four million miracles (aka births) happen in our country each year and many more occur globally. On a hot summer night in the urban community of Harlem almost 30 years ago, I witnessed my first miracle as a volunteer and was never the same again.  The mother was a young teen who had been pushing for approximately forty-five minutes. She suddenly let out a piercing scream and out popped the hairy head of baby who started to wail. The mother sat straight up and peered down at the baby whose body had yet to be delivered. The delivery nurse admonished her to lie back down so that the baby could be delivered properly. Oh what a humorous and miraculous sight. I was in complete awe.

The events leading up to the birth of a baby are amazing. It begins with fertilization. The male sperm cannot fertilize an egg until it undergoes specific changes. It has the task of finding the egg which lies outside of the uterus. Does it turn left or right to enter the fallopian tube?  Only Nature knows for sure. In order to fertilize the sacred egg, the sperm must change its shape so that it can penetrate the egg’s protective barrier. Once fertilized, the egg must travel from the fallopian tube back into the uterus and implant into the uterine lining to begin its miraculous journey towards the human experience.

All paths to greatness begin with a journey. Sometimes that journey is simple. At other times it might be complex. Let us remember the journey of the three wise men that followed a star that led them to a special baby in Bethlehem.  And may we also remember that each of our lives began in a most miraculous way.

I wish all of my readers a very Merry Christmas and happy holiday.

Should A Woman Pregnant With Twins Terminate One Baby?

Twins. Oh how we adore them. They represent approximately 3.3% of all births in the U.S. and are associated with both joy and complications such as prematurity. When I saw the headlines of the August 14th edition of the Sunday New York Times, I paused to reflect. Have we gone too far?

The article, Unnatural Selection, Ruth Padawer reviews a growing trend among U.S. women who, when pregnant with twins requests that the twins be reduced to one pregnancy. We have grown accustomed to multiple births in our country based upon the increase in the use of fertility drugs. Indeed, 1% of all births and 16% of twin births are associated with the use of fertility drugs. Very few people complain when there is a request to reduce quadruplets (four babies) or quintuplets (five babies) to twins. And who doesn’t remember Nadya Suleman, the controversial “Octomom” who gave birth to 8 babies that were conceived with fertility drugs.

Padawer describes a woman who was pregnant with twins and sought a physician to reduce her pregnancy to one baby. She initially encountered difficulty because most physicians will not reduce a twin pregnancy unless they have a medical indication and feel that the mother is in jeopardy. The word “reduction” is a polite term for termination and very few physicians will terminate one-half of a twin pregnancy based solely upon maternal request. However since a termination of pregnancy is legal, some physicians will reduce a twin pregnancy to a single pregnancy based upon a mother’s request. According to Dr. Richard Berkowitz, a high-risk specialist at Columbia University Medical Center in New York City, “The overwhelming majority of women carrying twins are going to be able to deliver two healthy babies.” As a mother of two sons who are eleven months apart, I can understand the concerns one may have regarding raising twins. However, despite all of the perceived obstacles of raising two children who were born so close together, somehow my sons managed to thrive and their parents have maintained their sanity.

Should twin pregnancies be reduced to one? It’s an individual decision, so please — make it wisely.

Reflections of a Miraculous Birth

When I think about Christmas, I instinctively think about the miracle of birth. Four million miracles (aka births) happen in our country each year and many more occur globally. On a hot summer night in the urban community of Harlem almost 30 years ago, I witnessed my first miracle as a volunteer and was never the same again.  The mother was a young teen who had been pushing for approximately forty-five minutes. She suddenly let out a piercing scream and out popped the hairy head of baby who started to wail. The mother sat straight up and peered down at the baby whose body had yet to be delivered. The delivery nurse admonished her to lie back down so that the baby could be delivered properly. Oh what a humorous and miraculous sight. I was in complete awe.

The events leading up to the birth of a baby are amazing. It begins with fertilization. The male sperm cannot fertilize an egg until it undergoes specific changes. It has the task of finding the egg which lies outside of the uterus. Does it turn left or right to enter the fallopian tube?  Only Nature knows for sure. In order to fertilize the sacred egg, the sperm must change its shape so that it can penetrate the egg’s protective barrier. Once fertilized, the egg must travel from the fallopian tube back into the uterus and implant into the uterine lining to begin its miraculous journey towards the human experience.

All paths to greatness begin with a journey. Sometimes that journey is simple. At other times it might be complex. Let us remember the journey of the three wise men that followed a star that led them to a special baby in Bethlehem.  And may we also remember that each of our lives began in a most miraculous way.

I wish all of my readers a very Merry Christmas and happy holiday.

10 Summer Safety Tips for Pregnant Women

Summer is the season of sun, fun and the busiest time in the labor rooms. So, while you’re waiting for that sacred moment, here are some tips to help keep you safe:

  1. Ultraviolent rays are not your friend. Wear a hat with a three-inch brim and sunglasses when sitting in the sun
  2. Use a sunscreen with a minimum of 15 SPF or higher
  3. Women of color should also use a sunscreen. The incidence of skin cancer has increased for all races in recent years.
  4. You can swim in a chlorinated pool but check the chlorine level. The pH level of a pool should be between 7.4 to 7.6. Avoid using a public or private pool if it has been “shocked” (given extra chemicals).
  5. Enjoy your barbeques but don’t eat food that has been left outside for more than 2 hours.
  6. Use insect repellent to protect yourself from bugs if you go outside but use it sparingly. Mosquito bites increase the risk of developing the West Nile Virus which causes inflammation of the brain and spinal cord. Both the Center for Disease Control (CDC) and the U.S. Environmental Protection Agency (EPA) state it is safe for pregnant women to use insect repellents, specifically the longer-lasting agent DEET. For longer hours spent outside (over 3-4) use a repellent that contains at least 20% DEET. Products with more than 50% DEET does not offer additional protection and should not be used in pregnancy.
  7. Use Oil of Lemon Eucalyptus or PMD as a natural pesticide if you prefer to avoid chemicals.
  8. Stay well hydrated when in the sun. Drink plenty of water.
  9. Don’t over exert yourself in extreme heat. The human fetus’ temperature is about 1 degree higher than its mother’s and cannot regulate its temperature. If you remain cool, so does your baby.
  10. Thunderstorms increase during the summer. Have your disaster supplies ready as well as emergency numbers and a route mapped out to the hospital.

Summer is a time of enjoyment but please — play it safe.

How Pregnant Women Can Avoid Birth Complications at Night

A recent Dutch study (see Birth Complications More Common at Night) of over 700,000 births revealed that newborn deaths and complications occurred more often at night which came as no surprise. In a make-believe- world, everyone would have a baby before the end of the day-shift in a fully-staffed hospital manned by people who are alert. But reality is a different story. Obstetrics is a specialty of the unexpected and women can spontaneously develop labor at the most inconvenient times within a 24-hour day. Yet, all is not lost. With proper recognition of potential red flags, a pregnant woman may have a wonderful delivery even if it’s at the most wretched hour of the night or early morning. Based on my years of clinical experience and medical malpractice case reviews, here are some tips worth remembering:

  1. Try to be admitted to a hospital where they have 24-hour anesthesia service to avoid waiting for them to arrive from home. If there’s an emergency, an “in-house” anesthesia department will save precious time.
  2. Try to deliver in a level 3 hospital has neonatology specialists in the event that you baby requires immediate specialized care after birth.
  3. Make sure your information is updated properly during the change of shifts. If your fetal tracing has been lousy during the past hour or your blood pressure has been elevated, the incoming staff should be made aware.
  4. Do not hesitate to ask about the whereabouts of the doctor or midwife if they are not in the hospital. By law, the admitting physician or midwife should be documenting your care by writing notes on a chart. Your physician or midwife has the ultimate responsibility for your care; not the nurse.  If you’re in a teaching hospital and being managed by resident physicians, always ask to meet their supervisor, the attending physician.
  5. Ask whether you’re making progress in labor.  If you’ve been the same number of centimeters for greater than two hours, there might be a problem with your labor.

Being in labor at night should no longer be a grave concern.  When you are empowered with the proper information, the chances of encountering birth complications will be greatly reduced.

Startling Facts about Obesity and Pregnancy

I nodded my head in recognition as I read the Sunday New York Times article “Growing Obesity Increases Perils of Childbearing.”  According to the article, one in five pregnant women are obese and 38-year-old Patricia Garcia was one of them. During her pregnancy, Garcia almost died from a stroke and was forced to deliver her baby eleven weeks early by C. Section. Her baby had stopped growing in her womb and he needed to come out.

 Obesity in pregnancy can be a trial by fire, for both the patient and her healthcare provider.  I am presently taking care of three obese pregnant women and am keenly aware that they, like Garcia, can have a stroke at any given moment. One of my patients has sleep apnea and I was grateful to find a sleep specialist who accepted Medicaid. Her sleep study showed that her oxygen becomes extremely low when she’s asleep which places her at tremendous risk for anesthesia complications. We will now have to negotiate with Medicaid in an attempt to get her special equipment to minimize complications during her pregnancy. Two months ago an imaging center refused to perform an ultrasound on one of my patients who weighed over 400 pounds because they were afraid that she would break their table. We finally found a hospital that was willing to see her because they had equipment that could accommodate her size and girth. I see a fair amount of obese women in my practice because I am sensitive to their plight. Like the physician mentioned in the article, I too, had obese people in my family.

The statistics in the article were alarming: babies born to obese women are nearly three times more likely to die within the first month of life. They also have twice the risk of having a stillbirth. Five New York hospitals have formed a coalition to determine how best to address the problems associated with obese pregnant women. Wider beds and exam tables, longer instruments and high-definition ultrasound equipment must be purchased.  These efforts are commendable and other hospitals should follow suit. Obese pregnant women are at high-risk for death, if mismanaged. Until we, as a nation, do a better job of promoting prevention, the incidence of obesity is not going away. I hope my colleagues are prepared to handle the crisis.

Smart Tips for Pregnant Moms About Herpes

Herpes Simplex Virus (HSV) is a family of viruses that has been around for so long, it was described in ancient Greek and Egyptian history. Herpes is usually contracted through close bodily contact and although there are six types that can affect humans, the most common infections of pregnant women are caused by Herpes 1 (HSV 1) and Herpes 2 (HSV2).

Herpes 1 is an infection that causes fever blisters located on or near the mouth. In the past it was less common than Herpes 2 but in recent years is now responsible for 30 to 50% of lesions found on or near the vaginal area. Herpes 2 is an infection that causes blister-type lesions in the genital area and is usually painful to touch. The first-time (or primary) infection is usually the worst and is associated with painful and burning urination, fluid-filled blisters in the genital area, fever and sometimes a headache. Any infection thereafter is called a recurrent infection which is usually milder and has fewer symptoms. Contrary to popular belief, most infections are spread from one person to another when there are NO lesions or what’s commonly called asymptomatic shedding.

A first-time infection is treated with a medicine called Acylovir taken three times a day for 7 to 14 days. If a pregnant woman has Herpes 2 and a fever, she has to be admitted to the hospital to decrease her chances of developing pneumonia. For pregnant patients with recurrent infection, it is recommended that they take acyclovir three times a day beginning at 36-weeks up until the time of birth. Valtrex medicine may also be taken twice per day if the patient can’t tolerate Acylovir.

If lesions are present during labor, a cesarean section MUST be done to avoid an infection of the newborn. One out of 3200 babies will be infected with Herpes that causes severe diseases of the eye, skin and mouth. 80% of babies will die of Herpes 1 and 2 if they are not treated.

Please inform your healthcare provider of any symptoms of active lesions or previous history of Herpes immediately to avoid preventable complications.

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

Educate yourself by purchasing my latest book The Smart Mother’s Guide To A Better Pregnancy!