Archive for the ‘Planning for Baby’ Category

Epilepsy and pregnancy

Thursday, May 21st, 2015

speak to your health care providerEvery year in the US, approximately 20,000 women with a seizure disorder give birth. Most of these pregnancies are healthy. But there are a few additional concerns that women who have epilepsy must consider when thinking about getting pregnant.

What is epilepsy?

Epilepsy is a brain disorder in which a person has repeated seizures over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. Epilepsy is a specific type of seizure disorder.

People with epilepsy are usually prescribed medication to help to control seizures. These are known as antiepileptic drugs (AEDs). There are a number of different types of AEDs and they are prescribed depending on age, the type of seizure, and the side effects of the medications. Some individuals with epilepsy may need more than one AED to control their seizures.

Can epilepsy cause problems during pregnancy?

If you have epilepsy and are thinking about getting pregnant, there are a few important things that you need to consider.

  • Women who have epilepsy have an increased chance to have a baby with a birth defect compared to women who do not have epilepsy. This may be the result of the epilepsy or the AEDs used to control seizures. Some AEDs have been associated with an increased risk of cleft lip and palate, neural tube defects, and heart defects.
  • Pregnancy can cause a change in the number of seizures. Most women with epilepsy will have no change in the number of seizures they experience or they will have fewer seizures during pregnancy. A few women will experience more seizures.

Controlling seizures during pregnancy is very important. Having a seizure during pregnancy can cause problems for you and your baby. Seizures during pregnancy can cause:

  • Decreased oxygen to the baby and fetal heart rate deceleration during the seizure.
  • Injury to the baby as a result of any falls or trauma experienced during the seizure. This can include premature separation of the placenta from the uterus (placental abruption) or miscarriage.
  • Preterm labor
  • Premature birth

Should you continue to take anti-seizure medications during pregnancy?

Many women with epilepsy are concerned about taking their AEDs during pregnancy. But according to ACOG, “Because there are serious risks associated with having a seizure during pregnancy and because the potential risk of harm to your baby from taking AEDs is small, experts recommend that seizures be controlled with AEDs, if necessary, during pregnancy. However, the type, amount, or number of AEDs that you take may need to change.”

Will you need any special care during your pregnancy?

One of the most important things that any woman can do to have a healthy pregnancy is to schedule a preconception checkup. If you have epilepsy, it is important to talk to your prenatal care provider as well as your neurologist prior to getting pregnant. Here are some other things to consider:

Before pregnancy:

  •  Review your seizure medications with both your prenatal provider and your neurologist. If changes need to be made, it is better to do this prior to getting pregnant.
  • Take a prenatal vitamin with folic acid. Talk to your health care team about how much folic acid is right for you.
  • Eat a healthy diet, get enough sleep, and avoid cigarettes, alcohol.

During pregnancy:

  • Plan for additional visits to your health care providers. Medication levels will need to be monitored to make sure they stay consistent.
  • Talk to a genetic counselor about prenatal testing.
  • Most women with a seizure disorder can have a vaginal birth.
  • Women with epilepsy are encouraged to breastfeed. Talk to your health care team.

If you have epilepsy, planning and working with your health care team can help to ensure that you have the healthiest pregnancy possible.

Questions?  Send them to AskUs@marchofdimes.org.

 

How much weight should I gain?

Tuesday, May 19th, 2015

During pregnancy, you need to gain a healthy amount of weight to support your growing baby. In this video, Dr. Siobhan Dolan talks about how much weight you should gain and what to do during pregnancy to maintain a healthy weight for you and your baby. It’s important to learn how gaining too much or too little weight can cause problems for your baby including premature birth. Don’t forget to talk to your provider about what is right for you.

Can your meds cause drug withdrawal in your baby?

Friday, May 15th, 2015

pillsNeonatal abstinence syndrome (NAS) is a group of conditions a newborn can have if he’s exposed to addictive street or prescription drugs before birth. If you take drugs during pregnancy, they can pass through the placenta to your baby. After birth, the baby is still dependent on the drug, however, now that the drug is no longer available, the baby experiences drug withdrawal. Today, one of the most common causes of NAS is maternal use or abuse of opioids during pregnancy.

Using these drugs during pregnancy can cause NAS:

• Opioids, including the prescription medicines codeine, hydrocodone (Vicodin®), morphine (Kadian®, Avinza®) and oxycodone (Oxycontin®, Percocet®). The street drug heroin also is an opioid.
• Barbiturates, like phennies, yellow jackets and Amytal®
• Benzodiazepines, like sleeping pills, Valium® and Xanax®

Signs and symptoms of NAS:

• Body shakes (tremors), seizures (convulsions), overactive reflexes (twitching) and tight muscle tone
• Fussiness, excessive crying or having a high-pitched cry
• Poor feeding, poor sucking or slow weight gain
• Breathing fast
• Fever, sweating or blotchy skin
• Trouble sleeping and yawning frequently
• Diarrhea or vomiting  (throwing up)
• Stuffy nose or sneezing

Signs and symptoms of NAS can be different for every baby. Symptoms may appear within a few minutes after birth or as much as two weeks later. NAS can last from 1 week to 6 months after birth.

Testing and treatment:

Your provider can see if your baby has NAS by testing his first bowel movement or urine. Your provider can also use what is called a neonatal abstinence scoring system which gives points for each NAS symptom depending on how severe it is. Treatment can include medicines to manage severe withdrawal symptoms, getting fluids through a needle into the vein, or giving higher-calorie baby formula to newborns that have trouble feeding or slow growth.

How can I prevent NAS?

If you’re pregnant and you use any of the drugs that can cause NAS, tell your health care provider right away. But don’t stop taking the drug without getting treatment from your provider first. Quitting suddenly (sometimes called cold turkey) can cause severe problems for your baby, including death.

If you’re addicted to opioids, medication-assisted treatment (also called MAT) during pregnancy can help your baby. NAS in babies may be easier to treat for babies whose moms get MAT during pregnancy. Medicines used in MAT include methadone and buprenorphine.

Even if you use a prescription drug exactly as your provider tells you to, it may cause NAS in your baby. If you are pregnant or think you may be pregnant, talk to your provider about any drug or medicine you are taking.

Our website has more information on where you can find help.

Have questions? Email us at AskUs@marchofdimes.org.

Schedule your well-woman checkup today

Monday, May 11th, 2015

nwhw-banner-toolsNational Women’s Health Week (NWHW) is as a time to help women understand what it means to be healthy and well.The goal is to get women to make their own health a top priority.

Today is National Women’s Checkup Day. It’s a day when women are encouraged to schedule their annual well-woman visit. If you are thinking about getting pregnant, it is a great time to schedule your preconception checkup.

What is a preconception checkup and why is it important?

A preconception checkup is a time to see your health care provider to help assure that you are as healthy as possible before you conceive. During this visit you and your provider can:
• Discuss your family history, family planning, and lifestyle habits, such as alcohol and tobacco use.
• Get or schedule necessary tests, such as screenings for blood pressure and diabetes.
• Set health goals, such as being active and maintaining a healthy weight.

It is important to schedule a checkup every year. Even if you’ve already had a baby, it is a good idea to see your provider if you are thinking about getting pregnant again. Thanks to the Affordable Care Act, it’s considered a preventive service and must be covered by most health plans at no cost to you.

So schedule your checkup today! For more information on National Women’s Health Week and to learn about other ways that you can get involved, visit their website.

Getting healthy between pregnancies

Friday, May 8th, 2015

snugglingAre you getting ready to celebrate Mother’s Day? Flowers, handmade cards, and breakfast in bed are all lovely gifts. But one of the most important things that you can do as a mom is to give yourself the gift of a healthy pregnancy. If you are planning to have another baby sometime in the future, start now to make sure that your body is ready.

The interconception period is the time between the end of one pregnancy and the beginning of another pregnancy. This time between pregnancies allows you and your provider to address any risk factors that may have contributed to prior pregnancy complications, including premature birth, preeclampsia or gestational diabetes.

Here are some things to consider during the interconception period:

  • Birth spacing: Before getting pregnant again, it is best to wait at least 18 to 23 months. This gives your body time to recover from the previous pregnancy.
  • Preexisting medical conditions: Diabetes or high blood pressure can affect your pregnancy. Making sure these conditions are under control before you get pregnant again is very important. Now is the time to alter any medication dosages or change prescriptions completely. It is also the time to modify any lifestyle factors that may be contributing to your condition.
  • Weight: Trying to get to a healthy weight before pregnancy is very important. Being overweight or not weighing enough can affect your ability to conceive. And if you’re at a healthy weight before pregnancy, you’re less likely than women who weigh too little or too much to have serious complications during pregnancy.
  • Smoking: When you smoke during pregnancy, you pass harmful chemicals through the placenta and umbilical cord into your baby’s bloodstream. This can cause health problems for your baby. Being exposed to secondhand smoke during pregnancy can cause a baby to be born with low birthweight. And secondhand smoke also is dangerous to your baby after birth. Try to quit smoking before getting pregnant again.
  • Family history: Your family health history can help you and your provider look out for health problems that may run in your family and it may help to find the cause of any past pregnancy problems.
  • Getting enough folic acid: Finally, make sure you continue to take 400 micrograms of folic acid every day. All women of child-bearing age, even if they’re not trying to get pregnant, should take folic acid. Folic acid helps prevent neural tube defects but only if taken before pregnancy and during the first few weeks of pregnancy, often before a woman may even know she’s pregnant. Because nearly half of all pregnancies in the United States are unplanned, it’s important that all women take folic acid every day.

All of us here at News Moms Need wish you a very happy and healthy Mother’s Day!

Questions?  Send them to AskUs@marchofdimes.org.

Nurses are central to the March of Dimes mission

Thursday, May 7th, 2015

midwifeThere is no doubt about it – nurses are critical in the care of infants in the hospital. Premature babies are cared for in the NICU by nurses with advanced education. They care for babies with serious, often life threatening medical conditions. Many families have told us how impressed they have been by the expertise, compassion and professionalism of the NICU nursing staff who cared for their baby.

In addition to being the lifeline to parents who have very sick or premature babies, nurses also work hard to help women learn how to have a healthy pregnancy. They assist women as they labor and deliver and teach a new mom how to breastfeed.

The March of Dimes is grateful to our nurses as they are health care providers, educators, researchers, fundraisers, chapter volunteers and advisors. To support them in their work, we offer continuing education modules and nursing scholarships.

As this is National Nurses Week, it is a good time to pause and think about the work that nurses do every day. Even better, it is a great time to thank them.

The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. We recognize that our nurses are a big part of helping us achieve our goals. Thank you. Thank you. Thank you!

Preeclampsia can lead to premature birth

Monday, May 4th, 2015

preeclampsia, headachePreeclampsia affects one in every 12 pregnancies. It is the cause of 15 percent (about 1 in 8) of premature births in the United States. Women with preeclampsia are more likely than women who don’t have preeclampsia to have preterm labor and delivery. Even with treatment, a pregnant woman with preeclampsia may need to give birth early to avoid serious problems for her and her baby.

What is preeclampsia?

Preeclampsia is when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. This condition can happen after the 20th week of pregnancy or right after birth. Preeclampsia can be a serious medical condition. Without medical treatment, preeclampsia can cause kidney, liver and brain damage. It can also cause serious bleeding problems. In rare cases, preeclampsia can become a life-threatening condition called eclampsia that includes seizures. Eclampsia sometimes can lead to coma and even death.

Know the signs and symptoms:

• Severe headaches
• Vision problems, like blurriness, flashing lights, or being sensitive to light
• Pain in the upper right belly area
• Nausea or vomiting
• Dizziness
• Sudden weight gain (2 to 5 pounds in a week)
• Swelling in the legs, hands, and face

If you have any of these signs or symptoms, contact your prenatal care provider right away.

Preeclampsia can develop gradually, or have a sudden onset, flaring up in a matter of hours. You can also have mild preeclampsia without symptoms. It’s important that you go to all of your prenatal care visits so your provider will measure your blood pressure and check your urine for protein.

How is preeclampsia treated?

The cure for preeclampsia is the birth of your baby. Treatment during pregnancy depends on how severe your preeclampsia is and how far along you are in your pregnancy. Even if you have mild preeclampsia, you need treatment to make sure it doesn’t get worse. Treatments may include medications to lower blood pressure, corticosteroids or anticonvulsant medications to prevent a seizure.  If not treated, preeclampsia can cause complications during pregnancy and result in premature birth.

What causes preeclampsia?

We don’t know what causes preeclampsia, but you may be more likely than other women to have preeclampsia if you:

• are pregnant for the first time
• had preeclampsia in a previous pregnancy. The earlier in pregnancy you had preeclampsia, the higher your risk is to have it again in another pregnancy.
• have a family history of preeclampsia.
• have high blood pressure, kidney disease, diabetes, a thrombophilia, or lupus.
• are pregnant with multiples (twins, triplets or more).
• had in vitro fertilization (IVF) – a method used to help women get pregnant.
• have poorly controlled asthma.
• are older than 40.
• are obese.

If your provider thinks you’re at high risk of having preeclampsia, he may want to treat you with low-dose aspirin to help prevent it. Talk to your provider to see if treatment with aspirin is right for you.

 

Why can’t I get pregnant?

Friday, May 1st, 2015

womann reading HPTOne of the most common questions we get in the Pregnancy and Newborn Health Education Center is about conception. Women want to know when they will get pregnant and why it is taking longer than they thought it would. Often they wonder if something may be wrong and they should seek out a reproductive specialist.

If you’ve been trying to get pregnant for 3 to 4 months, don’t panic, and keep trying. The good news is that most couples will conceive on their own, although it may take longer than expected. Nearly 9 out of 10 couples who try to get pregnant do so within one year.

But if you have been trying to get pregnant for over a year or longer than six months if you are over 35, then you may want to talk to your health care provider. Infertility means that the body’s ability to perform the basic function of reproduction is impaired. According to the Center for Disease Control and Prevention (CDC), approximately 1 in 8 couples of childbearing age have difficulty conceiving or carrying a pregnancy to term.

There are many possible causes of infertility. If your provider does refer you to a specialist, it is important to know that both you and your partner will most likely need to undergo testing. Infertility affects men and women equally. And 25% of infertile couples have more than one factor that contributes to their infertility.

Some lifestyle factors that contribute to infertility are a woman’s weight and whether she or her partner smoke. Women who weigh too much or too little can have difficulty conceiving. Getting to a healthy weight and maintaining it may help to reverse some infertility.

Smoking also reduces fertility for both men and women.  According to the American Society for Reproductive Medicine (ASRM), up to 13% of female infertility is caused by cigarette smoking and women who smoke have an increased risk of miscarriage.

The majority of couples (85-90%) who experience infertility can be treated with surgery or medications. Only a small percentage of couples (less than 3%) will need to undergo advanced procedures, such as in vitro fertilization, to conceive.

Insurance coverage for infertility treatments varies from company to company and state to state. Because treatment can be very costly, be sure to learn more about the costs and your insurance coverage while you are still thinking about treatment options.

If you are concerned about your ability to get pregnant, make sure you talk to your provider. She can guide you and help you determine what the next step is for you and your partner.

Questions?  Send them to AskUs@marchofdimes.org.

Your top STD questions answered

Monday, April 27th, 2015

get tested for STDs1. What is an STD?

A sexually transmitted disease (STD) is an infection that you can get from having sex with someone who is infected. About 19 million people get an STD each year in the US. Some common STDs are genital wartsgenital herpes, syphilis, gonorrhea, chlamydia, and hepatitis B.

2. What’s the big deal?

STDs can cause problems if you are trying to get pregnant. If you are already pregnant, STDs can be harmful to you and your baby. Your baby can get infected while passing through the birth canal during labor and delivery. Some STDs can cross the placenta and infect your baby in the womb. Having an STD can complicate your pregnancy and have serious effects on your baby, which may be seen at birth or may not be discovered until months or years later.

3. How do you know if you have an STD?

Many people with an STD don’t know they’re infected because some STDs have no symptoms. If you are not yet pregnant, ask your provider to test you. Most problems during pregnancy and in your developing baby can be prevented be receiving testing and treatment and going to all of your prenatal care appointments.

4. How will an STD affect your unborn baby?

STDs may cause problems during pregnancy, including premature birth,  premature rupture of the membranes (PROM), ectopic pregnancy, birth defectsmiscarriage or stillbirth.

5. How can you protect yourself and your baby?

Whether you are pregnant or planning to become pregnant, talk to your health care provider about getting tested for STDs. If you find out you have an STD, get treatment right away. Receiving treatment can help protect you and your baby during pregnancy and birth.

You can also receive certain vaccines, such as the HPV vaccine, which can help protect against genital warts. You can get the HPV vaccine up until age 26.

The best way to prevent yourself from getting an STD is by not having sex; however if you do, have sex with only one partner who doesn’t have sex with others. Use a condom if you’re not sure if your partner has an STD or ask your partner to get tested and treated for STDs.

FASDs – what you need to know

Monday, April 6th, 2015

Alcohol Awareness MonthIt’s important to stop and think before you drink.

Many women who are pregnant or thinking about pregnancy know that heavy drinking during pregnancy can cause birth defects, but it’s important to note that even light drinking may also harm your developing baby. No level of alcohol use during pregnancy has been proven safe – none. Drinking alcohol during pregnancy can cause fetal alcohol spectrum disorders or FASDs, which include a wide range of physical and mental disabilities and lasting emotional and behavioral problems in a child.

What happens to your baby when you drink?

When you drink alcohol during pregnancy, so does your baby. The same amount of alcohol that is in your blood is also in your baby’s blood. The alcohol in your blood quickly passes through the placenta and to your baby through the umbilical cord. Although your body is able to manage alcohol in your blood, your baby’s little body isn’t. Your liver works hard to break down the alcohol in your blood. But your baby’s liver is too small to do the same and alcohol can hurt your baby’s development.

That’s why alcohol is much more harmful to your baby than to you during pregnancy.

What should you do?

The good news is that FASDs can be completely avoided. If you had an occasional drink before knowing you were pregnant, chances are it probably won’t harm your baby. But it’s very important that you stop drinking alcohol as soon as you think you might be pregnant.

Also, be sure to get regular prenatal care and tell your health care provider about any concerns you may have.

Bottom line: There is no safe amount of alcohol a pregnant woman can consume. Even a small amount can harm your baby.

April is alcohol Awareness Month – help us get the word out. Stop and think before you drink.