Are you pregnant, or thinking about having a baby? The Doctors offers tips for maintainng a healthy pregnancy!
What Side to Sleep on
Brianna, from Pacific Palisades, California, is 20 weeks pregnant and has been told that she should only sleep on her left side. But doing so has left her sore and worried if she wakes up in any other position. She asks Dr. Lisa what side is best to sleep on.
“You can [lie] on your right side, too,” Dr. Lisa says. “After the second trimester, though, you just don’t want to go flat on your back, because the uterus can be heavy enough to compress the major vessel that’s supporting [the] baby. So what you want to do is if you’re even just wedged, you’re fine, but really, in studies, maximal is the left side, but you’re OK if you’re on your right side.
“You’re just going to get more and more uncomfortable when you sleep, so you may need to take catnaps, too,” Dr. Lisa adds. “But that’s absolutely normal during pregnancy.”
Are Epidurals Safe?
An epidural, an anesthetic that blocks pain in a particular area, is among the most popular pain-relief methods given during childbirth, but are there risks to alleviating the pain?
“Women do not get a gold star for being in pain,” Dr. Lisa says. “If that’s something you want to do, that’s fine. That’s absolutely not going to change anything. But you absolutely do not have to be in pain to have a baby. Women have actually died of too much pain, and women in other countries, who cannot get epidurals, would kill for an epidural.
“There are risks for any procedure, but they’re very minimal if it’s done in a safe environment,” Dr. Lisa continues. “They can actually be very helpful for certain conditions in pregnancy, like a twin pregnancy and obviously, for a cesarean-section.”
Because the epidural does make a puncture wound, risks include possible infection, bleeding and severe headaches. “But they are very rare,” Dr. Lisa says. “It’s definitely an option women should think about.”
Summer Pregnancy Risks
Dr. Lisa offers tips to keeping mom and baby safe during the summer months:
• Dehydration can cause preterm labor, so it's essential for women to keep themselves hydrated. Drinking plenty of water and sports drinks and wearing cool clothing will help keep a woman's body in balance.
- Decrease salt intake, as salt will aggravate dehydration and contribute to the risk of pre-term labor.
- Avoid flip flops, because a woman's center of gravity is off during pregancy. Instead, wear sandals that can provide support.
• Wear lots of skin protection because the high levels of estrogen increase a woman's chance of developing melasma, also known as the pregnancy mask, or splotchy marks on the face. Make sure to wear an SPF of 50 every day.
• Stay active! Swimming is a great activity because it keeps a woman cool and relieves aches and pains as well.
Botox during Pregnancy
“It’s a no-brainer,” plastic surgeon Dr. Drew Ordon says. “I wouldn’t do Botox, fillers, laser treatments or any unnecessary local anesthetics while you’re pregnant.”
Because there is no information as to whether prior Botox injections affect pregnancy, Dr. Lisa adds that it’s important for women to tell their doctor if they’ve had the procedure done. “We’ll survey the pregnancy really carefully, just to make sure there’s nothing going on, i.e. early ultrasounds and things like that,” she notes.
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By the end of gestation, most women are eager to give birth and meet their child.
• Walking — can stimulate the cervix
• Intercourse — prostaglandins in male's semen help stimulate contractions
• Nipple stimulation — can stimulate contractions
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Illnesses during Pregnancy
Syphilis and Pregnancy
Claire, from Tomball, Texas, e-mails that she is six weeks pregnant and afraid that she has contracted syphilis from her boyfriend. Her symptoms include painless sores and a rash around her vagina. Dr. Lisa says that syphilis infections are on the rise and stresses that Claire needs to see her doctor for immediate treatment.
Syphilis is a sexually transmitted disease (STD) caused by the bacterium treponema pallidum. Syphilis can be transmitted through vaginal, anal, or oral sex, and contact with an open sore or contact with a skin rash. The bacteria can enter the body through the penis, anus, vagina, mouth or through broken skin. The disease progresses in three different stages, the first of which includes one or more painless sores on the genitalia, often followed by a rash. If left untreated, the disease can destroy the central nervous system and severely damage organs.
An infected pregnant woman can pass the disease to her unborn child during her pregnancy. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth (a baby born dead) or of giving birth to a baby who dies shortly after birth. An infected baby may be born without signs or symptoms of the disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies may become developmentally delayed, have seizures or die.
Syphilis is not spread by contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing or eating utensils.
Anemia during Pregnancy
Anemia is the most common blood condition in the United States, affecting about 3.5 million Americans. It occurs when blood lacks enough healthy red blood cells. Pregnant women are more susceptible to iron-deficiency anemia, due to increased blood supply demands. “Most of the women whom I treat become anemic during the pregnancy,” Dr. Lisa says. “It’s really, really common. And one of the reasons is because the blood volume, when you become pregnant, doubles.
“If you’re anemic for a long time, sometimes you can have a lower-birth-weight baby,” Dr. Lisa continues. “But really it doesn’t have so many problems with the infant as much as the mother afterwards, because a woman is going to lose blood in labor. If you already are behind in the [number] of red blood cells you have, you are at risk, if you lose blood, [of] needing a transfusion afterwards.”
During pregnancy, women should increase their iron intake from 18mg to 30mg per day, and iron supplements are recommended. While added iron can cause constipation, the Centers for Disease Control and Prevention recommends that all pregnant women take a daily supplement of iron as a preventative measure. “It’s not easy,” Dr. Lisa says. “But it’s extremely important.”
Skin Issues During Pregnancy
During pregnancy, surging hormones cause a number of changes to the body, including blotches on the skin and acne. “If you’ve never had acne before, now is the time it will erupt all over your skin,” dermatologist Dr. Jessica Wu says.
A problem many women face during pregnancy is that many skin products are not safe for them or the baby because they have tetracyclyn or Retin A. “If you take tetracyclyn, you’ve got to stop it, otherwise your baby will have gray teeth,” Dr. Wu says.
A safe solution is the Belli Skincare line of products, which are specially tested and pregnancy safe. They were developed by Dr. Jason Rubin in 2002 and are the only skincare line that offers teratology screening, which produces a higher safety standard that guards against ingredients with even remote links to birth defects.
Belli’s pregnancy line offers products that help with stretch marks, acne, chloasma, dry skin and swelling. They also offer products geared towards post-birth mothers and babies, with the same safety requirements. The products can be found in high-end maternity and baby boutiques, in many OB-GYN offices and on the Web.
Test for Premature Birth
Premature labor, or premature birth, is the leading cause of infant mortality in the United States.
Premature birth is defined as an infant born at 37 weeks of gestation or earlier (a full gestation lasts 40 weeks), and afflicts approximately one in eight babies. A new product called FullTerm Fetal Fibronectin test, is FDA approved and can predict whether a mother is at risk for premature labor.
Pregnant and Constipated?
To remedy constipation during pregnancy, try eating prunes, drinking lots of water, exercising, and taking fiber laxatives and stool softeners. Often, the extra iron in prenatal vitamins causes constipation.
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Meds and Pregnancy
Flu Shots During Pregnancy
Flu shots are recommended for many people, but should pregnant women get them as well? Dr. Lisa advises pregnant women in their second and third trimesters to get them, especially during flu season. “A woman’s immune system, when she’s pregnant, it’s supporting two people,” Dr. Lisa says. “She’s going to get a lot sicker than just you and me.”
“What’s nice is if the mom gets the flu shot, she gets those antibodies against the flu, passes those to her baby, and then when the baby is born, the baby will have those antibodies for about the first six months or so,” Dr. Jim says.
Dr. Lisa warns pregnant women against using any flu vaccines made from live viruses, such as the nasal-spray vaccine.
Pain Meds and Pregnancy
Not all over-the-counter pain relievers are the same, and for pregnant women, it is important to know which are safe for both mom and baby. Dr. Lisa says if you are pregnant and in pain, taking an acetaminophen is perfectly safe, however she advises against nonsteroidal anti-inflammatory drugs (NSAIDs). Studies show that NSAIDs can increase the risk of certain heart defects in children. Consult with your doctor before taking aspirin because it thins the blood.
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Stop the Swelling
Tangie, from Las Vegas, is 27 weeks pregnant, and her legs and feet have started to swell. She asks if that is normal and what she can do to reduce the inflammation.
Dr. Lisa explains that swelling in the legs and feet during pregnancy is normal, because pressure from the uterus compresses the blood vessels, causing fluid retention.
Remedies for Swollen Feet
• Elevate your feet
• Wear compression stockings
• Avoid standing or sitting for long periods of time
• Stay cool, since heat can make the swelling worse
If you suffer from severe or sudden swelling, it could be a sign of preeclampsia. Symptoms of preeclampsia include headaches, blurred vision and dizziness. Swelling in only one leg, especially if you have pain or tenderness in your calf or thigh, could be a sign of a blood clot. Make sure to talk to your doctor if you suffer from these symptoms.
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Are you looking for a keepsake of your baby before he or she is even born? Try a belly cast.
To help preserve the memory of your pregnancy, Sacred Journey presents the Belly Cast Kit, which creates a cast mold of your growing belly. “It was a great bonding experience for me and the baby, something to look forward to,” Marina says after having her 29-week pregnancy bump immortalized. She says her friends are planning to sign the cast to make it even more memorable.
You can also add some flair to your pregnancy with belly painting. Katie, who is seven months pregnant, had colorful flowers painted on her expecting tummy.
“[The experience] was fabulous,” Katie says. “It was very relaxing, and actually the brush was very cool, and the baby started kicking in response to the brush. It sort of accentuates my femininity that I feel like I’m naturally exuding right now.”
“The more you can decrease stress in the pregnancy, the better it is for the baby,” Dr. Lisa says. “They have better growth, the moms are happier; it decreases postpartum depression. It’s wonderful.”
Use water-based paints for belly painting, Dr. Lisa cautions, because acrylic paints can be absorbed into the blood stream and potentially affect the baby.
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Alternative Birthing Methods
Are Home Births Safe?
Giving birth can be a daunting event, and the pros and cons of different birthing options are important to assess. Actress, author, producer and talk show host Ricki Lake discusses her experiences with alternative birthing methods, chronicled in her controversial documentary, The Business of Being Born and her new book, Your Best Birth, directed and co-authored, respectively, by Abby Epstein.
Ricki says the impetus for the book came from having two extremely different birthing experiences, one in the hospital, and one at home. “The movie explores the medical system, when it comes to birth,” Ricki says. “It looks at statistics; it looks at how we’re doing as a country and as a society. It’s about knowing your options, doing your research.”
Both the documentary and the book were designed to educate mothers-to-be as consumers, and whatever birth method a woman chooses, Ricki wants a woman to do her homework, have the correct information, and make the best choice for herself.
“Becoming a mother is an amazing rite of passage,” Ricki says. “What a gift … it’s also an opportunity for women to be empowered and to be transformed in a positive way. Birth is a natural process, and it doesn’t have to be scary or an emergency situation waiting to happen.”
“As medical professionals, we’ve said that home birth is not the safest choice for pregnancy,” Dr. Lisa says, in keeping with the American College of Obstetrics and Gynecology (ACOG). “That’s because things do happen, and nature can be cruel, and babies do die, and mommies do die.”
Dr. Lisa says the main reasons women die in birth are: not getting to the hospital in time in an emergency situation, postpartum hemorrhage and emergency events, like the baby’s head getting stuck.
“Even when you do everything right in the hospital, you still might not have time,” Dr. Lisa says, but if women deliver at home, “What if something happens to your baby? There is nobody there to assist that baby right then and there.”
“The infant mortality rate that’s skyrocketing is not because people are choosing home birth,” Ricki counters. “There are some people who feel that having a baby in a hospital is taking a risk. A half a percent of women choose to give birth at home. The infant mortality rate skyrocketing is not because people are choosing home births.”
Dr. Lisa is passionate about her stance for hospital births only. “I’ve seen thousands and thousands and thousands of deliveries. I know what can happen. And you don’t want to see that happen at home, and you don’t want to be responsible for the death of your baby, or the death of your wife.”
“I am not saying hospital or home birth is best,” Ricki says. “I am pro-choice in this area, and I want women to have access to the information.”
Watch the home birth debate part Iand part II.
Jenny and Billy are expecting a child and are considering many options when it comes to delivery, including a water-birth at home and a hypnotism birth. To help them make their decision, two moms who gave birth outside of a hospital setting share their very different experiences.
Stephanie and her husband, Marcel, said they had a wonderful experience delivering their baby in a birthing pool at home.
Jana is a mother who says she regrets choosing an alternative birth for her son, because it almost cost him his life. Her son was born with a rare kidney disease that led to the rupturing of his lungs during birth, and he was oxygen-deprived for 45-minutes before being rushed to the hospital. He is now 14, and his life has been plagued with health problems.
Gia and her husband, Scott, say they created a spa-like atmosphere in their hospital delivery room and had an amazing experience. They used a method called HypnoBabies, where the mother says scripts to focus her mind away from pain.
Dr. Lisa stresses that OB/GYNs want the birthing process to be as beautiful as possible, and she suggests her patients make their hospital rooms comfortable. She warns that emergencies can arise quickly during labor and delivery — for both the baby and mother — sometimes requiring immediate surgery; that’s why being in a hospital setting is optimal.
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