Posts Tagged ‘Pregnancy’

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.

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Considering using a midwife? Here is info to help you choose a maternity care provider.

Monday, October 26th, 2015

pregnant-woman-on-weight-scale-shrunkSpecial thanks to our guest, Ginger Breedlove, PhD, CNM, FACNM, for providing this post.

A Certified Nurse-Midwife (CNM) and Certified Midwife (CM) are trained health professionals who have completed a graduate education program. They can provide you with a full range of services before and during pregnancy, labor and birth, and postpartum. CNMs and CMs are experts in the care of women who have a healthy pregnancy.

Midwives work in collaboration with physicians for consultation and referral if complications should arise. CNMs and CMs primarily deliver babies in the hospital (97%) with 3-4 % attending at home or in birthing centers.

What can a CNM/CM midwife provide?

  • Gynecological exams
  • Preconception planning
  • Labor and delivery support
  • A more natural childbirth experience
  • Assistance and support with breastfeeding and newborn care

Is there anything a CNM/CM cannot do?

Midwives are trained and licensed to provide comprehensive maternity care services, and work with physician’s to provide medical assistance when necessary. CNMs and CMs provide care to women desiring a non-medicated birth, as well as women that choose epidural anesthesia for birth. Should you need a medical intervention, they work with the collaborating physician and medical team for special care such as Cesarean section. If you have a high-risk pregnancy or a condition such as high blood pressure or Type 2 diabetes, or develop a medical complication, your midwife will refer you to an obstetrician for care.

There are different training credentials for midwives, including some (CPMs) that do not have nursing or graduate degree education.

Here is helpful information about the variety of midwife credentials in the U.S.:

  • Certified Nurse-Midwives (CNM)  are registered nurses who have graduated from a nurse-midwifery education program, passed a national exam and are certified through the American Midwifery Certification Board. CNMs can practice in all 50 states and the District of Columbia.
  • Certified Midwives (CM) are midwives who have completed a midwifery accredited education program and have passed the same national exam as CNMs. CMs can practice in 5 states: Delaware, Missouri, New York, New Jersey, and Rhode Island. Certified Midwives are also certified through the American Midwifery Certification Board.
  • Certified Professional Midwives (CPM) have training and clinical experience in childbirth and have passed a national exam. CPMs are certified through the North American Registry of Midwives. The majority of CPMs work in private homes and a few in birthing centers.

How do you find or learn more about a midwife?

The American College of Nurse-Midwives can help you find a midwife in your area.
The National Association of Certified Professional Midwives also provides information on midwives.

Dr.Ginger BreedloveGinger Breedlove, PhD, CNM, FACNM is the current President of the American College of Nurse Midwives and full-time professor at Shenandoah University in Winchester, VA. She currently sits on the March of Dimes National Nurse Advisory Council, and is engaged in numerous working groups to improve the health of mothers and babies during the childbearing years. As a midwife for over 35 years, Dr. Breedlove has cared for women in hospitals as well as birthing center settings.

Moving through pregnancy: tips to stay active

Tuesday, September 29th, 2015

Pregnant woman walkingMoving, staying active and gaining the right amount of weight during pregnancy can help keep you and your baby healthy. For most women, being active during pregnancy is a good thing. But you don’t need to head to the gym to increase activity. With a few daily changes to your routine, you’ll be moving more in no time.

Healthy pregnant women need at least 2½ hours of exercise each week which is about 30 minutes each day. This may sound like a lot, but don’t worry. You don’t have to do it all at once. Instead, get moving by doing a few minutes of activity throughout your day.

Here are some tips to help you reach your fitness goals:

  • Park farther away in the parking lot when you visit stores or go grocery shopping.
  • Set a timer on your phone to get up, stretch and walk around your house or office once every hour.
  • If you are watching TV, take the time to stretch out your arms and legs.
  • Walk and talk while you are on the phone, whether it be outside or around your house.
  • When walking around the office, grocery store or parking lot, walk the long way instead of taking shortcuts.
  • Plan fun outdoor weekend activities. Apple picking season is in full-swing – take a walk around the orchard while you pick some apples.
  • Skip the elevator and take the stairs.
  • Calling or emailing your co-worker at work? Get up and take a walk over to chat instead.

Tomorrow is National Women’s Health and Fitness Day. The goal is “to encourage women to take control of their health; to learn the facts they need to make smart healthy choices, and to make time for regular physical activity.” By making small changes to your day, you can reach your fitness goals. Be on the lookout for events planned in your local area.

Read our article to understand why physical activity is good for most pregnant women and to learn which activities are safe.

You’re pregnant. Should you have a doula help you?

Monday, September 21st, 2015

pregnant woman smilingA doula can provide significant support to you and your partner throughout your journey to parenthood. Last week we talked about what a doula is and the support services they provide for pregnant women during pregnancy, labor, delivery and postpartum. If you are considering working with a doula, we want to help you make an informed decision.

Research has shown that continuous support from a doula may:

• Decrease the use of pain medications during labor and delivery
• Reduce the need for Pitocin, a labor-inducing drug
• Decrease the incidence of C-sections and the use of forceps
• Result in shorter labor and delivery with fewer complications
• Allow moms and partners to feel supported

In addition, women who had continuous support from doulas gave birth to babies who were less likely to have low five-minute Apgar scores.

Is there anything a doula can’t do?

A doula can be a great addition to your care team, however a doula cannot provide medical advice or replace your health care provider.

What about your partner?

A doula will not replace your partner. In fact, a doula can support your partner or family member to become as involved in the birth process as you desire. A doula can help teach your partner how to comfort and support you during the birth process.

Where can you find a doula?

• To find a certified doula near you, use DONA’s online locator or visit
• Ask your health care provider or child birth instructor for a referral or information on how to find a doula.
• Contact your local hospital or health department for a referral.
• Ask your social network or health care team about free or low cost doula services. Insurance coverage for doula fees vary by plan. Some doulas offer free services and many communities offer volunteer doula programs supported by federal and city funds.

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What is a doula?

Monday, September 14th, 2015

mom-with-newborn-in-hospitalA doula is a trained and experienced professional who provides physical, emotional and informational support to a pregnant woman and her partner. A doula provides care for moms-to-be during pregnancy, labor, delivery, and the postpartum period. She also helps women carry out their birth plans so that they have a positive childbirth and postpartum experience.  The word “doula” comes from the ancient Greek meaning “a woman who serves.”

There are different kinds of doulas:

A birth doula understands the birthing process and the emotional needs of a woman in labor. If you are pregnant, a birth doula will help you develop a birth plan and assist in carrying out your plans during labor and delivery.

Your relationship with your doula will start with one or more meetings during your pregnancy. Once you start your contractions, she will stay with you throughout your labor to provide physical comfort, emotional support and help as you make informed decisions.

A postpartum doula can provide you with education, companionship and support after your baby is born. She can assist with newborn care, meal preparation, light household tidying and can help your family adjust to your newest addition. She will also be able to offer evidence-based (scientifically proven) information on feeding, soothing, coping skills and emotional and physical recovery from your labor and delivery.

A bereavement doula is a newer form of support. Although DONA does not offer a bereavement doula training program, many doulas are able to find other programs in their communities and online to receive certification. A bereavement doula can provide assistance, support, resources and referrals to families who are experiencing the loss of their baby.

A doula that provides bereavement support may be known by a different title, such as a Baby Loss Family Advisor. These professionals have been trained to help you navigate through the difficult days – from the moment you hear the news to preparing for the hospital experience and for when you return home.

Many birth and postpartum doulas are trained and certified through DONA International, toLabor, and CAPPA.

Now that you know what a doula is, tune in next week to learn if you should consider having one help you.

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Thinking about maternity leave

Thursday, August 6th, 2015

pregnant woman with ipadHave you heard that Netflix is offering unlimited paid parental leave to their employees? During their first year as new parents, Netflix employees can take as much time off as they choose while still earning their normal salary. This is really an amazing policy. If you’re working and pregnant, you probably have thought a lot about maternity leave. Over the past 30 years, the participation rate in the labor force of women with children under age 3 has risen from 34.3% in 1975 to 60.9% in 2011. Half of all mothers work during pregnancy and return to work after their baby is born. And among women who worked during their pregnancy between 2005 and 2007, 58.6% returned to work 3 months after giving birth and 72.9% returned to work 6 months after giving birth. It is important to know what options are available to you so that you can plan ahead.

Under the Family and Medical Leave Act (FMLA) employees can take time off from work without pay for pregnancy- and family-related health issues. The act provides up to 12 weeks of unpaid, job-protected leave per year. It also requires that you can keep your health insurance benefits during the leave. To qualify, you must have worked for your employer for at least 12 months, worked at least 1,250 hours during the last 12 months, and worked at a location where the company has 50 or more employees within 75 miles.

In addition to the FMLA leave, your employer may have its own maternity leave policies. Talk to your boss or someone from human resources (also called HR). Here are some questions you may want to ask:

  • Does your employer offer paid maternity leave? Some employers offer paid time off for the birth of your baby. Talk with someone from HR to find out if you have paid maternity leave.
  • Does your health insurance continue while you’re on maternity leave? If you get your health insurance through your employer, your HR person can tell you about what your insurance plan covers. You may need to change your health plan after your baby’s born to make sure he’s covered, too.
  • Does your employer offer flex time or telecommuting for when you’re ready to go back to work? For example, can you work fewer hours each week or work from home at the beginning? And then increase your hours or your time in the office little by little over a few weeks?
  • Are there other programs or services that your employer offers to new moms? If you’re breastfeeding, find out if your employer has a lactation room. This is a private space (not a bathroom) that you can use to pump breast milk. Employers with more than 50 employees must provide this space for breastfeeding moms.

Finally, choosing a child care provider that works best for you can be tough. Try to explore your options and finalize your plans before your baby arrives.  If you can organize childcare before you deliver, it will make your time at home with your baby more relaxing and enjoyable.

Severe bleeding during pregnancy can be placenta previa

Monday, July 27th, 2015

contemplative pregnant woman During my mom’s pregnancy with me, she was diagnosed with placenta previa, a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits on the top of the vagina. If you have placenta previa, when your labor starts, your cervix begins to thin out and dilate (open up), and the blood vessels connecting the placenta to your uterus may tear. This can cause severe bleeding.

My mom remembers the day I was born, like it was yesterday. She remembers my Aunt running down the hall to get towels for her while she stood in the bathroom bleeding during her third trimester. She was rushed to the hospital and had an emergency Cesarean section (C-section) performed. My mom says she can still remember what the pressure felt like on her lower abdomen during the procedure.

We don’t know what causes placenta previa, which happens in about 1 in 200 pregnancies. If you have placenta previa early in pregnancy, it usually isn’t a problem. However, it can cause serious bleeding and other complications later in pregnancy.

Diagnosis and symptoms

The most common symptom of placenta previa is painless bleeding from the vagina during the second half of pregnancy. If you have spotting or bleeding during pregnancy, it’s important you call your provider right away. But, not all women with placenta previa have vaginal bleeding. In fact, about one-third of women with placenta previa don’t have this symptom. An ultrasound can usually pinpoint the placenta’s location to determine if you have placenta previa.

Is there treatment?

Treatment depends on how far along you are in your pregnancy, the seriousness of your bleeding and the health of you and your baby. The goal is to keep you pregnant as long as possible, but at any stage of pregnancy, a C-section may be necessary if you have dangerously heavy bleeding or if you and your baby are having problems.

How can I reduce my risk?

We don’t know how to prevent placenta previa, but you may be able to reduce your risk by not smoking or doing illicit drugs such as cocaine. If you have a healthy pregnancy, and there isn’t a medical reason for you to have a C-section, it’s best to let labor begin on its own. The more C-sections you have, the greater your risk of placenta previa.

As soon as my mom held me in her arms, she said she forgot all about the scary hours beforehand. She was so grateful that she had gone to the hospital when she did.

Remember, if you have spotting or bleeding at any point in your pregnancy, call your provider right away or go to the emergency room.

Bleeding during pregnancy – what does it mean?

Monday, July 6th, 2015

bleeding during pregnancyIf you are pregnant and experience spotting or bleeding, it can be very scary. When you see blood, your first thought may be “is my baby ok?” Bleeding and spotting from the vagina during pregnancy is common. Up to half of all pregnant women have some bleeding or spotting.

Bleeding? Spotting? What’s the difference?

Spotting is light bleeding and happens when you have a few drops of blood in your underwear. Bleeding is a heavier flow of blood, enough that you need a panty liner or pad to keep the blood from soaking your underwear or clothes.

Bleeding in early pregnancy

Bleeding doesn’t always mean there’s a problem, but it can be a sign of serious complications. There are several things that may cause bleeding early in your pregnancy, such as having sex, an infection, or changes in your cervix and hormones. You may bleed a little when the embryo attaches to the lining of your uterus (called implantation bleeding). This may occur 10-14 days after fertilization. Although this spotting is usually earlier and lighter than a menstrual period, some women don’t notice the difference, and don’t even realize they’re pregnant.

Sometimes bleeding and spotting in the first trimester can be a sign of a serious problem such as miscarriage, ectopic pregnancy, or molar pregnancy. But keep in mind that bleeding doesn’t always mean miscarriage. At least half of women who have spotting or light bleeding early in pregnancy don’t miscarry.

Bleeding in late pregnancy

Causes of late pregnancy bleeding include labor, sex, an internal exam by your provider or problems with your cervix, such as an infection or cervical insufficiency. It could also be a sign of preterm labor, placenta previa, placental abruption or uterine rupture.

How to tell if the bleeding is dangerous

Bleeding or spotting can happen anytime, from the time you get pregnant to right before you give birth. Bleeding can be a sign of a serious complication, so it’s important you call your prenatal care provider if you have any bleeding or spotting, even if it stops. If the bleeding is not serious, it’s still important that your provider finds out the cause. Do not use a tampon, douche or have sex if you’re bleeding.

Before you call your provider, write down these things:

• How heavy your bleeding is. Is it getting heavier or lighter and how many pads are you using?
• The color of the blood. It can be different colors, like brown, dark or bright red.

Go to the emergency room if you have:

• Heavy bleeding
• Bleeding with pain or cramping
• Dizziness and bleeding
• Pain in your belly or pelvis

Treatment for your bleeding depends on the cause. You may need a medical exam or tests performed by your provider.

Bottom Line

If you are bleeding or spotting at any point in your pregnancy, call your provider right away and describe what you are experiencing. It’s important that your bleeding or spotting is evaluated to determine if it is dangerous to you and your baby.

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Shingles, pregnancy and kids – know the facts

Wednesday, June 10th, 2015

Many pregnant women have written to us expressing concern about being exposed to a family member who has shingles. Usually it is their parent or grandparent, or another older adult who has the virus. However, did you know that children can get shingles, too?

When my daughter was in fourth grade, she came home from school with a tiny rash on her back about the size of a quarter, complaining of pain and exhaustion. I had never seen a rash like that before; it was a little clump of tiny bumps. Sure enough, her pediatrician diagnosed it as shingles. I was shocked, as I never associated shingles with kids. Although it isn’t common, it does happen, and the risk of getting singles increases with age. My daughter had a mild case, and after about 2 weeks she was on the mend. She was lucky – it can be very painful and last longer.

What causes shingles?

Shingles (formally known as Herpes Zoster) is caused by the Varicella Zoster virus, the same virus that causes chickenpox. Only someone who has had chickenpox – or, rarely, has gotten the chickenpox vaccine – can get shingles, according to the CDC. The chickenpox virus stays in your body and can re-appear at a later date, often many years later. When it reappears, it does not return as chickenpox – it comes back as shingles.

How common is shingles?

My daughter had chickenpox (the disease) when she was four years old. At that time, the vaccine was not yet available. It is far less common to develop shingles if your child has had the chickenpox vaccine. By vaccinating your child against chickenpox you will decrease her chances of getting shingles later in life.

At least 1 million people a year in the United States get shingles. Shingles is far more common in people 50 years of age and older. It also occurs more in people whose immune systems are weakened because of a disease such as cancer, or drugs such as steroids or chemotherapy.

Can you catch shingles from someone who has shingles?

No, you can’t catch shingles from another person who has shingles. However, a person who has never had chickenpox (or the chickenpox vaccine) could get chickenpox from someone with shingles. However, this is not very common. Shingles is not spread through the air and infection can only occur after direct contact with the rash when it is in the blister-phase. A person with shingles is not contagious before the blisters appear or after they scab over.

If you are pregnant or trying to get pregnant…

• First, get a blood test to find out if you’re immune to chickenpox. If you’re not immune, you can get a vaccine. It’s best to wait 1 month after the vaccine before getting pregnant.

• If you’re already pregnant, don’t get the vaccine until after you give birth. In the meantime, avoid contact with anyone who has chickenpox or shingles.

• If you’re not immune to chickenpox and you come into contact with someone who has it, tell your provider right away. Your provider can treat you with medicine that has chickenpox antibodies. It’s important to get treatment within 4 days after you’ve come into contact with chickenpox to help prevent the infection or make it less serious.

• Tell your provider if you come in contact with a person who has shingles. Your provider may want to treat you with an antiviral medication.

What does all this mean for your child?

• If you think your child may have shingles, contact her health care provider. Prompt treatment may shorten the duration and keep pain to a minimum.

• Get your child the chickenpox vaccine to protect her against chickenpox, and so that she has a far less chance of getting shingles in the future.

Learn more about shingles exposure and chickenpox during pregnancy.


If you have questions, send them to

View other posts in the series on Delays and Disabilities: How to get help for your child.



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.

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