Humid, Hot and Carrying Child?

Excessive heat and humidity can be hard on anyone. Pregnancy only intensifies those feelings. If you are due in the summer or early fall, you can relate. You don’t have to have a miserable summer, but you do need to take a few extra precautions.

First of all, and I cannot reiterate this enough, keep yourself hydrated. That means making sure you drink plenty of fluids.  Water is best, but so are occasional juices and sports drinks which replace electrolytes that are being sweated away. Infuse fruits into your water to give it more taste if you need to. You do not want to let yourself get dehydrated. It can worsen pregnancy aches like swelling and can even trigger preterm contractions, so drink up!

During pregnancy, many women have increased sensitivity to the sun. This means you might burn more easily and may need to wear more sunscreen than usual.  Basically, you should never leave the house without wearing sunscreen with an SPF of at least 30. Make sure you cover all of your skin. Don’t overlook ears, neck or feet and remember to reapply every few hours and after swimming or towel drying.

Don’t rely on sunscreen alone to keep your skin protected.   Wear loose, lightly-colored clothing. This reflects the sun’s rays rather than absorbing them as dark colors do. Cotton, linen and natural fibers are best because they are light, airy and comfortable.

Wear a hat. The best choice is a hat with a wide brim that covers your face and neck. That fact that these are very fashionable at the moment is just another perk. The same can be said about a good pair of sunglasses. Don’t feel guilty about spending a little extra on a good pair of UV- filtered sun glasses.  They protect the eyes from painful sunburns, cataracts, and glaucoma.   Also, the skin around the eyes, including the lids, is one of the most prone areas to skin cancer!

Go to the pool!  If you’ve got a pool, use it often. If you don’t have one, get a large inflatable pool. These are relatively inexpensive and can hold several people. You’ll love the option of going to your back yard and relaxing in the cool water. If you have other children at home, they will love it too!  Now is not the time to consider tanning or laying in the sun – stay in the shade. A big umbrella with a glass of ice cold water should be your “go to” destination. If possible, use a canopy or position umbrella over the pool for the ultimate pregnancy paradise.

Sometimes, it’s better to just stay indoors.  If it’s too hot (heat index in the 90’s) stay inside with air conditioning. If you must go out, try to limit the outside activity to the cooler parts of the day such as early morning or evening. Also, carry a spray/mister bottle around with you. Nothing feels better than a cold mist on your face, forehead and neck.

All of these tips are simple to do, but sometimes it’s hard to know when you’ve been out too long. Get indoors at the first sign of dizziness, fatigue or excessive thirst. Lie down in a cool area and hydrate. If you don’t feel better soon, call your provider.

See you at the pool!

Tyler's CNM Photo

Tyler Halvaksz, CNM

Lexington Women’s Health

Advanced Maternal Age

As more women are delaying childbearing until later in life, it is important to understand the risk involved in waiting. Advanced maternal age generally refers to a woman who has reached her 35th birthday by the date of delivery. The rate of births to women 35 and older has gradually increased, and in 2009, 14 percent of all babies were born to mothers 35 and older.

For most, the perceived risks outweigh the actual risk. An objective look at the risks of delivering after age 35 can be helpful to put them all into perspective.

One of the most common concerns for women in their 30s and 40s is whether they will be able to conceive. For most, the answer is yes. Studies show that fecundity (the rate at which a woman will conceive on the first attempted cycle) begins to slowly decline after age 32 through age 37. There is a more rapid decline from 37 to 45. Women 35 and older who want to conceive and have a history of irregular cycles, chronic pelvic pain or pelvic infections should have these problems evaluated by their healthcare provider prior to attempting pregnancy.

Aneuploidy, the presence of an extra or missing chromosome, can result in birth defects and developmental delay. The risk of Down’s syndrome, the most frequent chromosomal disorder seen in newborns, increases gradually with age. At 35, the risk is approximately 1 in 250 births. At 40, the risk increases to 1 in 50. If a woman delivers at 45, the risk is 1 in 10.

Chronic medical conditions such as high blood pressure and diabetes are more common in women of advanced maternal age. Even women 35 and older who have been perfectly healthy are at increased risk of developing pregnancy-induced hypertension and diabetes. Developing either condition can result in additional visits to the healthcare provider for monitoring the mother and the baby, bed rest and need for preterm delivery.

Cesarean section is more common in women 35 and older. Dysfunctional labor, complicating medical conditions and an increased rate of elective cesarean deliveries all contribute to a higher cesarean section rate.

Pregnancy and delivery are never risk-free. The risks encountered by women 35 and older are relative to the baseline risk and must be seen in light of the socioeconomic benefits of delayed childbearing. Preconception consultation can individualize and potentially reduce the risks for women considering a pregnancy at any age.

Jennifer Fuson, an OB/GYN with Lexington Women’s Health, practices at Central Baptist Hospital.

 

Why do they call it “morning sickness” when it lasts all day?

No one really knows what causes the nausea of pregnancy, but it affects over half of all pregnant women. It is thought to be related to the high hormone levels of pregnancy, like human chorionic gonadotropin (hcg) and estrogen.  The high progesterone level also relaxes a pregnant woman’s esophagus, so that she is more likely to have reflux and gagging.

Symptoms of nausea may be brought on by hunger or swings in blood sugar. Many notice that their nausea is worse when they are tired. Some moms report that smells may make their nausea worse. Sometimes even a vitamin is a trigger, but the vitamins are needed! There are some women who make extra saliva during pregnancy, and this constant swallowing makes them sicker.

The worst week of morning sickness is usually in the middle of the first trimester. By the second trimester, your body will have some relief.   If you need relief sooner, here are some things to try:

1.       Get lots of rest.   Fatigue can cause nausea even when you are not pregnant. What a great excuse to take a nap!

2.      Try frequent small meals that include some protein or fat.   The old advice of eating crackers may help temporarily, but a little cheese and turkey on the crackers will bring longer relief by keeping blood sugars stable. Sipping on flavored beverages all day long not only improve hydration, which makes you feel better, but may also help those with excess saliva production.

3.      Antacids. Tums contain calcium, and are good for pregnancy. In some cases, the heartburn and gagging is helped by pepcid 20 mg every day.

4.      Antihistamines. Doctors often prescribe antihistamines like phenergan to help with nausea, but benedryl (diphenhydramine) 25 mg as needed every 6 hours may also help.

OR   An older remedy for nausea was to recommend ½ of a unasom tablet (doxylamine 12.5 mg) every 6 hours.  Remember that any antihistamine may cause fatigue, and see step 1!

5.      Vitamin B supplementation.   Some people have less nausea with extra vitamin B6, 50 mg every day.

6.      Ginger. Ginger snap cookies, ginger ale, and candied ginger have all been said to improve nausea, though not well studied.

7.      Prescriptions have improved over the last 10 years. Doctors often recommend Zofran, Kytril, Reglan, Compazine or others to help with the nausea. Of course, all have side effects that should be discussed with a physician.

The extreme form of morning sickness is called hyperemesis. It causes relentless vomiting and can result in dehydration, weight loss, and nutritional deficiencies. While vomiting occasionally is common, hyperemesis occurs in less than 2% of pregnancies. Hyperemesis needs to be treated aggressively with medications and fluids, and should not be ignored.

 

Emily Cunningham, MD

Lexington Women’s Health

 Emily Cunningham 2014

 

Elective induced labor not without its risks

Induction of labor refers to stimulating labor to cause contractions before spontaneous natural labor begins. The term elective induction of labor is used when a woman undergoes stimulation of labor without a medical reason for doing so. A medical reason would include conditions that put the health or life of the mother or fetus at risk. Labor inductions are appealing for many reasons. First, they are convenient. The prospect of organizing a birth into an already overbooked family or work schedule can be very tempting. Excitement about meeting the infant, stress, discomfort and even pressure from friends and family are other reasons women may schedule an induction of labor. Although these seem like justifiable reasons to have a baby on a predetermined date, it is important to remember that labor induction is a medical procedure that could have life-threatening risks for both the mother and fetus.

Many methods are used to induce labor. Understanding those methods is an important part of understanding the overall risks involved. The more common methods include rupturing the amniotic membranes surrounding the fetus— often referred to as “breaking water”—and the use of intravenous Oxytocin, a synthetic form of a naturally occurring hormone that is responsible for labor and breastfeeding.

Studies have hown that the risk of Caesarean section can be as much as two-fold higher for women undergoing induction of labor. This is especially true for first-time mothers. Other associated risks include fever, infection, rupture of the
uterus, hemorrhage, blood transfusion and even death in rare instances. Fetuses
may experience stress during the process. Fetal distress is an indication for
Caesarean section.

There are also health care costs associated with induction of labor. Women who undergo labor induction require more medical intervention, more equipment, more medications and usually have longer hospital stays. Because of this, some insurance companies are now refusing to pay for elective labor inductions.

Women considering an induction of labor should discuss it with their doctor or
midwife. The discussion should include reasons induction might be appropriate,
risks, benefits and what procedures will be used to stimulate labor. Women should have a clear understanding of the entire process before proceeding. It is
important to remember that swollen feet and discomfort evident at the end of
pregnancy are only temporary conditions and that the most desired outcome for
any pregnancy is a healthy mother and a healthy baby.
Alisha C. Morgan, CNM

 

 

What you really need for the hospital!

The arrival of your baby is a time of excitement! It’s often a hectic time as well, so it can be difficult to remember to pack everything that you need AND want to bring to the hospital….Remember to pack early.  Some babies arrive early and some fashionably late!

The hospital will give you gowns, disposable underwear, and basic toiletries but the first few days postpartum are a notoriously messy time so you may not want to bring your brand-new lingerie. That’s why I’ve composed… Tanya’s list of

What you really need for the hospital

 

 

  • Nightgown(s) and robe- I say robe because it’s easy to throw on if you’ve got to go the the rest room and a visitor stops by.
  • Slippers
  • Bra/ nursing bra
  • Breast pads
  • Socks (fuzzy warm ones) I froze!
  • Underwear (several pair and not expensive ones)
  • Hair clips, bands, etc
  • Toiletries: toothbrush, toothpaste, hair brush, lip balm, lotion, deodorant, bath gel, shampoo and conditioner (unless you enjoy using the same liquid soap for all of these things)and a small make up bag
  • Comfortable and loose fitting clothing to wear home

 

Items for Baby

The hospital supplies most of the items you need for the baby.  They will have diapers, wipes, and toiletries in your room. Don’t forget to take the nasal bulb home with you-it is the best and you can’t buy one like it anywhere! 

Small diaper bag stocked with….

  • Outfit for pictures/matching      blanket for background
  • Going home outfit for baby
  • Receiving blankets
    • Baby car seat. (Call the Auto Safety Hotline at 1-888-DASH-2-DOT for more information on the safety rating of a particular model.) A car seat is required by law and MUST be properly installed in your car before you go to the hospital.
  • Warm clothing to wear      home/heavy bunting or blanket (if cold weather)
  • Baby socks/Baby hat      (especially for cold weather climates)
  • Burp cloths

Items for Partner/Labor Coach

  • Cell phone or email list of people to contact
  • Cash in case snack machines do not take credit/debit cards
  • Snacks/drinks if you have time to pack them
  • Sleep t shirt/pants if you plan on staying all night
  • Massage rollers, massage oils to relieve back pain due to labor, pillow or anything else you request to get comfortable
  • The object you’ve chosen to use to focus your attention during labor (the “focal point”)
  • Camera/video camera with charged battery and new or empty video card!

Items for Hospital Staff

  • Hospital admissions papers – Please pre-register! You may go online to www.centralbap.com to save you some time
  • Insurance Card(s)

When I was in labor with my first child, everything was going smoothly, we were pushing and I remember Dr. Fuson asked me if I wanted to take my socks off. I said yes.  She sweetly looked at me and said who did your pedicure, dear?  I naively said, Donnie did I can’t reach my toes anymore…she said, well you might want to leave your socks on.  Everyone in the L & D room cracked up and I thought I’m going to kill him.  He had pretty much painted my entire toes.  A 2 year old could have done a better job. I knew I should have taken the time to go to the salon I just didn’t!

I know this sounds corny but I wanted my husband, my Doctor and my Momma there.  Those 3 things meant I could deal with anything (well, that and the epidural!) And I knew that with those people I would have everything I needed.  Establish a good support team-It really does make a difference.  Even if they do a bad job on your pedicure they always come through when it really counts.

I’ll see you next time in the Chat Womb.

Tanya