The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Eight years ago when I had my first son, I initially met with an OB-GYN recommended to me by a friend. I adored him—as well as his partners: a dynamic team of certified nurse-midwives. After learning that midwives tend to spend a lot of time with patients, have relatively few patients who require Cesarean sections and also encourage medication-free deliveries, I decided to have a midwife from the practice deliver my baby.
While many doctors and women feel that bed rest can't do any harm and might do some good during certain high-risk pregnancies, a recent review of research suggests otherwise. Often-overlooked side effects include muscle atrophy, cardiovascular deconditioning, potential bone loss and depression, says study author Judith A. Maloni, Ph.D., R.N., a professor of nursing at Case Western Reserve University in Cleveland.
Three decades ago, maternal-fetal medicine specialist Yvonne Thornton, M.D., was determinedly shedding the 67 pounds she gained during her first pregnancy when she found out she was expecting another baby. Thornton vowed not to let that derail her healthy eating habits again. “There was a strong dictum back then that no matter what you weighed, you should gain 26 to 35 pounds during pregnancy or risk fetal death,” says Thornton, now an OB-GYN professor at New York Medical College.
Fit Pregnancy has always viewed Sean Daneshmand, M.D., a high-risk OB-GYN in San Diego, as our own personal hero. An advisory board member to the magazine, he puts in countless hours reviewing articles and guiding us in topics that need attention.
We're not alone, apparently, in our appreciation for this amazing doctor: He's been named a CNN Hero for his work in establishing Miracle Babies, a nationwide nonprofit organization that provides financial assistance to families with babies in a neonatal intensive care unit.
“After my emergency Cesarean section, I was shell-shocked that I wasn’t pregnant anymore.” Jennifer O’Brien, East Greenbush, N.Y.
The treatments themselves don’t make a pregnancy high risk; the medical issues that often cause female infertility, such as diabetes, endometriosis, fibroids or simply being older, may. (“Male factor” issues are responsible for the infertility approximately 40 percent of the time, but treatment is often the same.)
However, up to 40 percent of such pregnancies result in twins. These pregnancies carry a three to six times higher risk for problems, such as high blood pressure, preterm delivery and low birth weight babies.
Catherine wrote wondering if it's OK to take a medication her doctor prescribed while she's breastfeeding, even though the label says, "not safe to take when breastfeeding." Michelle wants to know if it's OK to workout on her back if she feels fine ("not dizzy or anything"), even though she's read it's "not safe to lie on her back during pregnancy." Both are wondering, when do you absolutely need to follow the rules and when can you bend them? If the label says, "Not OK" but your doctor says "OK" what advice do you follow?
I got another sad email this week from a grandmother. Kristen's daughter is pregnant with her second baby. The first, I'm very sad to report, died at birth. Kristen says the baby was born very underweight (only 4 pounds) but not premature. There was a lot of meconium and the placenta was very small. Kristen's daughter has hypothyroidism but took excellent care of her health throughout her pregnancy. Still, tragedy hit hard. Now that she's expecting her second baby, it's impossible not to feel anxious about losing another baby.
Glenda wrote this week about her granddaughter. At 27 weeks pregnant, she sprung a small leak, had contractions and went to the hospital. The hospital staff confirmed that she was trickling a small amount of amniotic fluid. They also told her that the amniotic membranes might seal back up and with pelvic rest (no sex, tampons or sticking anything else anywhere near the cervix), everything might be all right. Glenda had never heard that amniotic membranes could leak then repair themselves and wonders if this is accurate information. She's mighty worried about her granddaughter. I'll bet.
Julie wrote with a special concern. She went to her 20-week ultrasound and got some worrisome news: her umbilical cord only has two vessels. Her placenta is very close to her cervix and her doctor said it had a "lip." Since Julie's writing me for information, it makes me wonder just how much her doctor explained when he dropped a worry-bomb on her.
Most pregnant women assume their babies will arrive right around their due date, give or take a week or so. Although that’s usually the case, a growing number of babies are being born prematurely, at fewer than 37 weeks gestation. Between 1981 and 2001, there was a 27 percent increase, to about 476,000 births per year. Currently, premature births in the United States account for 1 of every 8 births, according to the CDC.
Lisa McKinney figured that she was the perfect candidate for a trouble-free pregnancy. “I was so healthy. I went hiking, ate right, gave up coffee. I was enrolled in a prenatal fitness class. I took water aerobics. And still I got it,” she says.
It was preeclampsia, a mysterious and serious complication of pregnancy as old as history and still not well understood, despite major new studies to try to figure out its cause and to find ways to prevent it.