Posts Tagged ‘preconception care’

Thinking about becoming pregnant? Are you worried about your diabetes?

Monday, November 9th, 2015

Diabetes and pregnancyDiabetes can cause problems during pregnancy, such as premature birth, birth defects and miscarriage. But don’t panic; with some planning ahead, you can become as healthy as possible before you become pregnant.

When you eat, your body breaks down sugar and starches from food into glucose to use for energy. Your pancreas (an organ behind your stomach) makes a hormone called insulin that helps your body keep the right amount of glucose in your blood.  When you have diabetes, your body doesn’t make enough insulin or can’t use insulin well, so you end up with too much sugar in your blood.

Too much sugar can cause serious health problems, like heart disease, kidney failure and blindness. High blood sugar can be harmful to your baby during the first few weeks of pregnancy when his brain, heart, kidneys and lungs begin to form. It’s really important to get treatment for diabetes to help prevent problems like these.

If you are thinking about becoming pregnant and have diabetes, here are a few tips:

  • Manage your diabetes to get your blood glucose levels in to your target range. Try to get it under control 3-6 months before you start trying to become pregnant.
  • Take a multivitamin that contains at least 400 micrograms of folic acid every day.
  • Talk to your provider about any medications you are taking to make sure that they are OK to continue taking when you do get pregnant. He or she may want to change some medications now, before you get pregnant.
  • Eat healthy foods and keep moving.
  • Get support and guidance. Talk with your provider, a diabetes educator or a dietician about how to manage your diabetes.

Not sure if you are at increased risk of developing diabetes? Read our post to find out.

Remember: If you are thinking about becoming pregnant, now is the time to talk to your doctor about getting as healthy as you can before you conceive. Take small steps now toward a healthy pregnancy and a healthy baby.

Have questions? Text or email us at AskUs@marchofdimes.org.

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.

 

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.

Pregnancy in women with congenital heart disease

Monday, February 9th, 2015

heart and stethoscopeMost women who have congenital heart disease and decide to get pregnant will have a safe pregnancy with minimal risks. However, there are many factors that may need to be considered. During pregnancy, your heart has much more work to do. It has to beat faster and pump more blood to both the mother and the baby. If you are a woman who has congenital heart disease, then this extra stress on your heart may be a concern. Considering these issues before pregnancy and being prepared for potential complications can help you feel more confident and more in control throughout your pregnancy.

Preconception planning
The most important thing you can do if you are a woman with congenital heart disease is to talk to both your cardiologist and obstetrician before you get pregnant. This will allow you to understand what risks (if any) are involved for your pregnancy. You can also determine if there are any concerns with your heart that need to be fixed prior to pregnancy—for instance, do you need to alter any medications or have any surgical repairs? Doing all of this before pregnancy will allow you to make sure your heart and your overall health is ready for pregnancy.

Some medications carry a risk for birth defects. These include ACE inhibitors and blood thinners. Therefore, if you are taking these medications and want to have a baby, it is important to talk to your doctor about their safety and potential alternatives that may work for you. However, you should never stop taking any medications without your doctor’s approval.

You may also want to meet with a genetic counselor to review the risks of passing congenital heart disease on to your baby. This risk will vary depending on the cause of the heart disease.

Pregnancy
During pregnancy you and your doctors will want to minimize any risks for both you and your baby. You will need to have regular follow-ups with both your obstetrician and cardiologist. It is important that your doctors work together and coordinate your care. Some women will need to be followed by a maternal-fetal medicine specialist (an obstetrician who manages high-risk pregnancies).

Although most women with congenital heart disease have safe pregnancies, symptoms of heart disease can increase, especially during the second and third trimesters when the heart is working much harder. This may mean additional visits to both your cardiologist and obstetrician.

Typically if you have a personal or a family history of congenital heart disease, your obstetrician will offer you a fetal echocardiogram at around 18-20 weeks of pregnancy. This is a specialized ultrasound that allows your doctor to check out the anatomy of your baby’s heart and look for major structural changes. Not all heart defects can be identified through fetal echo though.

Delivery
It may surprise you to learn that most women with congenital heart disease can have a normal vaginal delivery. You and your doctor will want to discuss pain management options and have a plan in place. You may need additional monitoring both during and after delivery. This can include oxygen monitoring as well as EKGs (electrocardiogram—a test that checks for problems with the electrical activity of your heart).

If you have congenital heart disease work with both your obstetrician and cardiologist so that you can have the best outcome possible. As with most chronic medical conditions, planning for your pregnancy will allow you to make informed decisions about what is best for you and your baby.

 

Depression during pregnancy: what you need to know

Tuesday, August 12th, 2014

sad woman with coffee mugDepression is a serious medical condition. It is an illness that involves the body, mood and thought. It affects the way a person feels about themselves and the way they think about their life. So many people were shocked and saddened by the news about Robin Williams. But unfortunately, depression is far more common than many of us realize. And regrettably, many people still feel that depression is a sign of weakness and do not recognize it as the biological illness that it is.

As many as 1 out of 5 women have symptoms of depression during pregnancy. For some women, these symptoms are severe. Women who have been depressed before they conceive are at a higher risk of experiencing depression during pregnancy than other women.

Signs of depression
Depression is more than just feeling sad or “blue.” There are physical signs as well. Other symptoms include:
• Trouble sleeping
• Sleeping too much
• Lack of interest
• Feelings of guilt
• Loss of energy
• Difficulty concentrating
• Changes in appetite
• Restlessness, agitation or slowed movement
• Thoughts or ideas about suicide

It may be hard to diagnose depression during pregnancy. Some of its symptoms are similar to those normally found in pregnancy. For instance, changes in appetite and trouble sleeping are common when you are pregnant. Other medical conditions have symptoms similar to those of depression. A woman who has anemia or a thyroid problem may lack energy but not be depressed. If you have any of the symptoms listed, talk to your health care provider.

Treatment options
Since depression is a serious medical condition, it poses risks for you and your baby. But a range of treatments are available. These include therapy, support groups and medications.

It is usually best to work with a team of health care professionals including:
• Your prenatal care provide
• A mental health professional, such as a social worker, psychotherapist or psychiatrist
• The provider who will take care of your baby after birth

Together, you and your medical team can decide what is best for you and your baby.

If you are on medication and thinking about getting pregnant, talk to your doctor. You will need to discuss whether you should keep taking the medication, change the medication, gradually reduce the dose or stop taking it altogether.

If you are taking an antidepressant and find that you are pregnant, do not stop taking your medication without first talking to your health care provider. Call him or her as soon as you discover that you are expecting. It may be unhealthy to stop taking an antidepressant suddenly.

If you or someone you know is experiencing any signs of depression, please talk to your health care provider or someone you trust. Help is available and you can feel better.

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