May 14, 2012
In celebration of National Women’s Health Week and Pregnancy Awareness Month, we are pleased to introduce our Guest Blogger, Katie Moore. Katie Moore is an active writer within the blogging community who discusses maternity, motherhood, prenatal health, and childbirth. She loves being able to share her ideas with others, and while she enjoys writing, her real passion and full time job is being the best wife and mother she can be!
Welcoming a new baby is one of the most exciting times in a woman’s life. Upon meeting that special tiny person, your life will never be the same. Although you know life will be different, you may not be sure exactly how things will change. Here are some ways you may have to adjust, along with some tips for enjoying your first moments and days with a newborn.
Long labors are tiring, but nothing will re-energize you more than the feeling of finally having your newborn in your arms! So that you can give those first moments with your little one your undivided attention there are a few immediate postpartum decisions that should be made ahead of time. These include:
- Feeding method. Are you planning to breastfeed or bottle feed? It’s important to figure this out beforehand, especially if you feel strongly about nursing your baby. Babies are ready to nurse almost as soon as they are born, so knowing what you prefer is important.
- Cord blood banking. If you are planning to bank your baby’s cord blood, it needs to before before your baby’s birth. Cord blood banking is where the umbilical cord blood is collected after birth and stored for your family – to provide the unique benefit of being available as a potential medical resource, should the need arise in the future.
- Routine newborn procedures. Most hospitals routinely give babies routine tests and screenings as well as both erythromycin eye drops and a Vitamin K injection shortly after birth. Be sure to research these procedures and tests to be sure that you feel comfortable with them before you go into labor.
After you’ve gotten through the initial postpartum phase at the hospital, it’s time to take your baby home and adjust to caring of your baby without the help of ever-present nurses and doctors. Although every newborn is different, there are some common factors that tend to surprise most new parents. For instance, you may have heard that you lose a lot of sleep when you have a newborn. This is true, but it may shock you how much your baby sleeps during the first few days at home. Newborns need a high quantity of sleep, but do not always have quality sleep, as they have to eat and be diapered frequently.
So how do you best adjust to these changes? Sleep when baby sleeps, accept help from loved ones, and do not forget to eat! You should try to already have some healthy and quick meal options on hand. That way, you can feed yourself while you keep up with the frequent feeding needs of your sweet baby. Care for yourself during this special time!
February 23, 2012
A lie unchallenged becomes the truth. While I admire GOP candidate Rick Santorum’s decision to raise a special needs child, I certainly wish he would keep his political agendas out of my exam room. Yes, it takes love and courage to raise a child with Trisomy 18, a genetic disorder that’s associated with severe physical and mental challenges. However, this does not make Santorum an expert on prenatal tests and to say anything to the contrary, is both reckless and immoral.
Prenatal tests, especially those that tests for chromosomal abnormalities, are optional. A woman can decline the tests if she chooses to do so and I’ve had patients who have exercised that perogative in the past. But first, let me tell you why these genetic tests are so important. If a woman discovers that she has a baby with Trisomy 21, commonly known as Down’s syndrome, both she and her pediatrician will have time to prepare for possible complications. Many genetic disorders are associated with heart conditions and require immediate surgery after birth. There are instances where the baby is born with a pediatric cardiologist in the delivery room who then whisks the baby away to have a life-saving cardiac procedure. This cannot happen if you don’t have the prenatal test.
In my 25-year career as a physician, I’ve only had 2 confirmed cases of Trisomy 21 and both mothers decided to keep their pregnancies. However, please be aware that there are some genetic disorders that are incompatible with life and the baby expires shortly birth. Most mothers do not want to experience that type of emotional trauma.
Mr. Santorum, please stop using Women’s Health as a stepping stone to gain entrance into the White House. If you can’t campaign for President based on truth and merit, then perhaps you’re not cut out for the job.
January 19, 2011
Although the journey to a healthy pregnancy and delivery begins with the selection of a healthcare provider; the challenge is to find the right one. This is the person who will be in charge of your pregnancy up until the time of the delivery, so it certainly is not a casual date. For the next 280 days, your life and the life of your unborn child will be in this person’s hands. A background check is therefore in order.
One of the best ways to find the right provider is by word-of-mouth referral from neighbors, friends or family members however please don’t stop there. Labor and delivery nurses are also a great source of referral because they have seen physicians and midwives under their most vulnerable and challenging moments. Once you have a name, you need to check the provider’s credentials. You can obtain this information from your local medical society or state medical board, and in many instances it can be verified online. In the appendix of The Smart Mother’s Guide, you will find the addresses, phone numbers and websites of the state medical boards in all fifty states, as well as Puerto Rico and the Virgin Islands.
Please do not feel intimidated about checking a provider’s credentials; they are public information. You can find out whether the provider’s medical license is current or expired. You will also be able to obtain information on whether the provider was ever disciplined by the Board for medical malpractice or unprofessional behavior or misconduct. Health care providers are not exempt from problems with alcoholism, drug addiction, professional incompetence, unprofessional or unethical behaviors. Although less than 5 percent of providers have egregious problems, you want to make certain that your provider is not one of them.
Knowing how to check a provider’s credentials becomes especially important if you have relocated to a new community and are not familiar with healthcare providers. It is also helpful if you belong to an HMO (health maintenance organization) that presents you with a limited selection of providers. If you discover that someone on that list has a history of problems, you have leverage in negotiating for a different provider.
Be unapologetically pro-active about checking the backgrounds of prospective healthcare providers. A healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
December 8, 2010
The day Elizabeth Edwards announced that she had breast cancer, my heart sank. Finding a lump in the breast only heightens the suspicion that the prognosis may not be good. In Elizabeth’s case, it wasn’t. We all admired Elizabeth for different reasons. In my case, it was her love for healthcare reform that quickly grabbed my attention and we were both older moms of two small children. Elizabeth advocated universal healthcare and comprehensive insurance for all Americans, not a “compromised” version based on partisanship and politics. As the years wore on, she discussed her diagnosis of incurable breast cancer with passion stating that she knew that she had access to the best possible care but empathized with women who were not as fortunate.
It is said that behind every successful man lies the power behind the throne and we know this to be true about Elizabeth. She was an accomplished attorney in her own right who took a back seat to raise her kids and support the presidential candidacy of her husband. For a while I thought Elizabeth had won the battle against breast cancer during its remission but then it resurfaced its ugly head in the midst of her husband’s presidential campaign. She handled it with both dignity and grace. We collectively winced when she faced the infamous scandal that violated principal and moral authority and embraced her even more. The last years of her life were a celebration of uncertainty as she became more and more vocal about healthcare reform. As recent as last night, members of our healthcare advocacy group, Doctors For America, discussed sending Elizabeth a letter of gratitude for all of her efforts regarding healthcare reform. Alas, we were too late. She made her transition this morning.
Elizabeth might have lost the battle with cancer, but she certainly mastered the art of living. In her own words she explained “I have found that in the simple act of living with hope, and in the daily effort to have a positive impact in the world, the days I do have are made all the more meaningful and precious. And for that I am grateful.”
We’re grateful, too, Elizabeth. Very grateful.
May 3, 2010
Although most pregnant women anticipate a normal, uncomplicated delivery, there are exceptions to the rules. A shoulder dystocia is one of the more frequent complications in the delivery room and unfortunately there is no sure-fire way to predict it.
A shoulder dystocia means that extra maneuvers must be done to deliver the baby’s shoulders. If not managed properly, the baby could sustain permanent injuries to its neck and arms. The most common scenario is the successful delivery of the baby’s head but the rest of its body is “stuck.”. Once this occurs, the mother’s thighs should be flexed back as much as possible towards her abdomen. This is called a McRobert’s Maneuver. Here are things that should NOT be done if there is a shoulder dystocia:
- Pulling on the baby’s head in an attempt to deliver shoulders
- Pressure on the top of the uterus (aka fundal pressure) in an attempt to deliver the baby. This only aggravates the problem more. A better approach would be supra pubic pressure meaning gentle pressure right above the bladder in order to help dislodge the baby’s shoulders
- More than three attempts to deliver the baby with a vacuum extractor
Although a shoulder dystocia cannot be predicted, there are women who will have risk factors for its occurrence and include:
- A woman who has a short stature of 4’11 or less
- A woman with Gestational or Type 2 Diabetes
- A woman who has gained more than 50 pounds during her pregnancy
- A woman who has had a previous shoulder dystocia
- A woman who has been pushing for greater than 2 hours
- A woman who had had a difficult or prolonged labor
- A woman with an estimated fetal weight of 10 pounds or greater
Contrary to popular belief, an ultrasound does not predict which babies are at risk for having a shoulder dystocia. However, if you have any of the risk factors above, it is not unreasonable to ask your OB practitioner if they’re prepared to handle a shoulder dystocia should it occur.
Although I have said this many times, it still bears repeating: A healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
March 29, 2010
At some point during her pregnancy, a patient might complain of dizziness or “fainting.” However, the challenge is to determine if this is an isolated incident or does the patient need additional tests?
True fainting (or syncope) means that there has been a temporary loss of consciousness and the patient is no longer standing. This usually occurs when there is a temporary decrease in the blood flow to the brain. The most common reason patients faint is because of low blood sugar (hypoglycemia), especially during the first trimester. However, hypoglycemia does not explain all reasons for fainting.
During pregnancy, the blood vessels are opened wide (dilated) which sometimes decreases the amount of blood flowing within the chambers of the heart. It therefore beats slower. A slow heart beat (aka bradycardia) produces symptoms of dizziness or fainting. However, there are also serious conditions that also cause fainting and it’s important to know the difference. Listed below are examples of fainting that require additional tests:
- Fainting associated with a loss consciousness that lasts for greater than 15 minutes
- Fainting associated with loss of urine
- Fainting preceded by shortness of breath, light-headedness, chest pain and a fast heartbeat
- Fainting associated with significant disorientation, weakness of limbs, numbness and abnormal movements
Items 1, 2 and 4 require a neurology consultation to rule out a seizure disorder or a space-occupying tumor. Item 3 requires a cardiologist (heart specialists) to look for heart problems or, on rare occasions, a blood clot in the lungs. These are extremely rare conditions that most pregnant women will never experience.
Most pregnant women can avoid fainting episodes by drinking lots of fluids, avoid prolonged periods of standing, get up SLOWLY if sitting down for long periods of times and wear stockings that improve circulation. Thankfully, unless fainting has been associated with a serious condition, there will be no harm to the baby.
January 27, 2010
It happened again. Another lost soul in the last three weeks of her pregnancy found her way into my office. Although they had been together since her first trimester, he dumped her during the most vulnerable stage of her pregnancy. No, not her boyfriend; her Ob-Gyn provider. She had reached the age of legal adulthood and was summarily booted from her mother’s health plan. Although the patient and her husband had offered the physician a $1,000 down payment until her Medicaid benefit was approved, they were met with a resounding “No!” So off she went, with her medical chart in hand into the land of the uninsured. As I listened to her story with both empathy and remorse, I thought about my plumber, Handy-Manny. Manny has been my plumber for almost fourteen years and has been in business long before the emergence of the infamous Disney character. In fact, we suspect that Disney might have “borrowed” Manny’s identity, but that’s another story for another time.
One week after my husband and I returned home from Ethiopia with two new children in-tow, the pipes in our laundry room burst. We called Manny in a panic. He arrived promptly but gave us the bad news. This was our third leak in less than a year and the pipes in our 15-year-old home needed to be replaced. Ouch. The Ethiopia trip and adoption had set us back financially and we simply did not have the money. Not to worry, said Manny. “Pay me when you can. Your house needs the repair.” Because of our home’s unique configuration, Manny had to bypass the old pipes, install the new pipes through the attic and remove cemented tiles from the kitchen floor. It was not an easy feat. We paid Manny for his miraculous service with an interest-free payment plan for the next three months and continue to sing his praises in our leak-free home.
Churchill once said, “We make a living by what we get; we make a life by what we give.” I hope my medical colleagues are listening.
January 18, 2010
Whether you’ve been trying to conceive for years or immediately became pregnant after the first try, how do you tell your loved ones when that moment finally arrives? Listed below are ways that patients have shared regarding announcing that special news:
- Invite your husband and/or family to a restaurant and then ask the server to bring a baby’s high-chair for the future family addition.
- Create an announcement card from your first prenatal sonogram picture.
- Send a stork or baby balloon to your husband while he’s at work
- Announce it in the form of a Chinese fortune cookie
- Buy a baby’s outfit and give send it to your parents
- Hand out pink and blue carnations the next time you visit your parents
- Give your parents and husband a new family tree with an additional branch
- If greater than 12-weeks, record the sound of the fetal heart tones at your ob provider’s office and then play it for your husband and/or family members as a surprise
- Put your positive pregnancy test in an obvious place where your husband won’t miss it
- Buy greeting cards that refer to your parents and grandparents and your husband as “Dad”
Whether it’s your first pregnancy or the nineteenth as in the case of reality show mom Michelle Duggar, every pregnancy is meaningful so make sure you make the grand announcement in a unique and special way.
December 30, 2009
According to Answers.com, there is a baby born in the U.S. every 8 seconds, a figure that is both staggering and exhilarating. As an obstetrician, my greatest desires is for all 11,803 babies born each day to arrive healthy and safely. I would like to dedicate my last blog post of 2009 to all the beautiful moms-in-waiting and share some pearls from my 22-year professional journey.
The force that moves the air within our lungs, the blood within our veins, is the same force that has created the life within your womb. The most important key to a healthy pregnancy is the consciousness that lies within. Your child will be shaped by your thoughts, your dreams, your values, your energy. You are the ship that will carry the baby to the shores of its pre-ordained human experience. Please let the journey be smooth. Do not create a storm from worry, a tornado from doubt, a cloud from fear, a disaster from envy. The majority of patients who end up with emergency cesarean sections are those with “fetal distress.” What was causing the distress? Who was causing the distress? Let it not be you, its mother.
Because of the advent of 4-D ultrasound technology, we can actually observe fetal behavior in the womb. We can see babies yawning, sucking their thumbs, stretching their arms and legs, even playing with their umbilical cords. They respond to music, the rhythm of your heartbeat, a touch from your partner, the sound of your voice. You are literally filled with the miracle of life. There is no gift on Earth more precious than that.
You are smarter, stronger, and more brilliant that you can ever imagine. You have been selected, yes, selected, to be this child’s mother. That is the Divine Connection.
I wish you a healthy, joyous pregnancy and a prosperous and blessed New Year.
This excerpt is taken from The Smart Mother’s Guide® to a Better Pregnancy. All Rights Reserved.