Women’s Health: Did you know that new moms experience a 4th trimester? Pregnant moms spend a lot of time learning what to expect from pregnancy and how to care for their newborns. But, while pregnancy anecdotes and birth stories take top billing at baby showers and get-togethers, girlfriends and family members tend to leave the challenging aspects of the “fourth trimester,” the first six weeks postpartum, left unsaid. Changes that happen to a woman’s body during and after childbirth are not usually widely discussed with soon-to-be moms. There are so many exciting things to look forward to with a new baby. But pregnancy and childbirth can also have some less-than-desirable effects on a woman’s body, especially her pelvic floor. About 15 percent of new mothers need treatment for childbirth ailments such as urinary and fecal incontinence, complications from obstetrical tears, pelvic pain and other pelvic floor issues. Navigating the fourth trimester Know that help is out there. Whether it’s breastfeeding trouble or sleep deprivation, experts are ready to throw a lifeline when needed. Seek that help. Just having a lactation consultant watch a baby latch on can ease any fears of mom feeding baby incorrectly. It’s easier to make the decision to get help when you have that list of where to turn to for help ready before a baby arrives. Focus on what works for you and your baby. From your pediatrician to the nurse at your OB-GYN’s office, everybody doles out different advice. Whose do you take? Try them all to find what works and keep your and your baby’s health in mind. Consider if lanolin is right for you. Lanolin, a popular gift at baby showers, is a natural substance used to prevent nipples from cracking, blistering or drying out from breastfeeding. Pasque says Vaseline is tolerated easier. She has many new moms who come into the office with rashes because they are allergic to lanolin. Stock up on healing supplies. Warm-water sitz baths, ice packs, doughnut pillows, peri bottles (i.e., squirt bottles to rinse with water instead of wiping after toileting for the first few weeks) and 100 percent cotton pads help heal the vaginal trauma caused by delivery. Consider physical therapy or massage. If incontinence issues arise, see a physical therapist who specializes in pelvic floor exercises to strengthen the muscles that hold up the bladder and uterus. Therapists will ensure the exercises are done properly, and they have gadgets that monitor progress. Moms who delivered by cesarean section also may benefit from a therapist massaging the incision scar. The tightness of the collagen fibers in the skin can make bending over painful, among other issues. Manipulating the tissue can promote blood flow and accelerate healing. Avoid constipation. Chronic straining, especially if mom had a perineal tear, can put tension on the stitches and is hard on the pelvic floor muscles. Consider using a laxative like Miralax (rather than a stool softener) daily until the constipation subsides. It’s safe for breastfeeding moms as well. Try walking. If it still hurts to walk nearly a month after giving birth, see a doctor. The spine could be out of alignment, or a pelvic bone may have broken during delivery. Watch for postpartum depression. More intense than baby blues, which is marked by crying, sadness, anxiety and feeling overwhelmed, postpartum depression affects 13 percent of mothers and may appear a year after giving birth. Extreme irritability, insomnia and fear of the baby getting hurt in unusual ways are symptoms that are sometimes dismissed. If you’re a new or expecting mom, you probably have a million more questions. Contact your doctor for more info.
What Moms-to-Be Should Know About Prenatal Genetic Testing When a woman finds out she is pregnant, doctors appointments and a barrage of information comes quickly. This includes early decisions about prenatal genetic testing. The optional tests, which can help detect the risk of abnormalities, can supply important information before a baby’s birth. Most genetic testing comes in the form of a simple blood draw which can provided a large amount of information about the baby. Although the results can help families make informed decisions, the tests aren’t perfect. Blood-based screening tests cannot always say with certainty that a baby is affected, a deficit that can be difficult to handle during pregnancy. This is why it is a good idea to talk about any type of genetic testing before a baby is conceived. Some of those discussions are easier to have outside the context of pregnancy. But a lot of couples should consider talking about what they would do if the results are positive. Screening Options There are two blood-based methods to screen for chromosome abnormalities in pregnancy. These options includes:
- First-trimester screening: This test has two parts: bloodwork looking at hormones in a mother’s blood and an ultrasound. The ultrasound is used to measure the back of the baby’s neck. extra fluid on the neck can be a sign of Down’s syndrome, heart defects or other complications. This information is used to provide an overall risk assessment. The test will detect about 93 percent of Down’s syndrome cases with a 5 percent false positive rate. It also screens for other chromosome abnormalities and can sometimes detect pregnancies at high risk for complications such as poor growth later in pregnancy.
- Cell-free DNA screening: DNA fragments from the placenta that are in a pregnant mother’s blood can be used to try to identify pregnancies at higher risk for chromosome abnormalities.
- Chorionic villus sampling: Placenta tissue is extracted via the cervix (a similar approach to a Pap smear) or by using a needle inserted through the mother’s abdomen into the uterus. It is performed between the 10th and 13th weeks of pregnancy. Parents who want a confirmation sooner often choose this option.
- Amniocentesis: In this test, a needle is inserted through the abdomen to extract fluid surrounding the baby (the needle doesn’t touch the baby). The amniotic fluid contains fetal cells that can be used for diagnostic testing. It is performed 15 weeks into the pregnancy or later.
Women’s Health: What is Polycystic Ovary Syndrome (PCOS)? Polycystic ovary syndrome is a condition that affects women by altering the levels of hormones in your body, resulting in problems affecting many body systems. Most women that are diagnosed with polycystic ovary syndrome, generally produce excess male sex hormones (androgens), a condition called hyperandrogenism. The typical patient that has too many of these male hormones can often have excessive body hair growth (hirsutism), acne, and male pattern baldness, but that is not true in all cases. Hyperandrogenism and abnormal levels of other sex hormones often prevents normal ovulation and regular menstrual periods, leading to difficulty conceiving a child (subfertility) or a complete inability to conceive (infertility). Due to irregular and infrequent menstruation and hormone abnormalities, affected women have an increased risk of cancer of the uterine lining (endometrial cancer). Polycystic ovary syndrome generally includes multiple cysts in each ovary that can be seen with medical imaging. These cysts are small, immature ovarian follicles. Normally, ovarian follicles contain egg cells, which are released during ovulation. In polycystic ovary syndrome, abnormal hormone levels prevent follicles from growing and maturing to release egg cells. Instead, these immature follicles accumulate in the ovaries. Affected women can have 12 or more of these follicles. The number of these follicles usually decreases with age. The causes of polycystic ovary syndrome are complex. This condition results from a combination of genetic, health, and lifestyle factors, some of which have not been identified. Common variations in several genes have been associated with the risk of developing polycystic ovary syndrome. Because they are common, these variations can be present in people with polycystic ovary syndrome and in those without. It is the combination of these changes that helps determine a woman's likelihood of developing the disease. Polycystic ovary syndrome does not have a clear pattern of inheritance, it is estimated that 20 to 40 percent of women with polycystic ovary syndrome have an affected mother or sister. This increased familial risk is likely due in part to shared genetic factors, but lifestyle influences that are shared by members of a family likely also play a role. Talk to your doctor if you are interested in learning more about polycystic ovary syndrome.
Pregnancy Food Safety. It's a real thing. You know you need to keep an eye on what you eat during your pregnancy, but in this post we’re offering a few tips for food safety specifically during the holidays.
- Consider avoiding raw or unpasteurized milk and products made with it, such as soft cheeses. Raw or unpasteurized milk and products made with it can contain harmful germs, including Listeria. Avoid drinking raw milk and eating soft cheeses, such as queso fresco, Brie, Camembert, feta, goat cheese, or Roquefort, if they are made from raw or unpasteurized milk.
- Avoid other raw or unpasteurized products, such as juice or cider.
- Be super careful around seafood. Do not eat refrigerated smoked seafood unless it is in a cooked dish, such as a casserole,, or unless it is canned or shelf-stable.
- Be aware of holiday beverages. To reduce the possibility of fetal alcohol syndrome, watch out for alcohol-containing holiday punches and eggnogs. Avoid eggnog entirely unless you know it contains no alcohol and is pasteurized or made with pasteurized eggs and milk.
Studies have shown that a diet high in folate-rich foods (such as broccoli, mushrooms, avocado, just to name a few) can help prevent cancer, heart disease, birth defects, anemia and cognitive decline. Are you getting enough folate from your diet? Mean dietary intakes of folate (including food folate and folic acid from fortified foods and supplements) range from 454 to 652 micrograms per day in U.S. adults and from 385 to 674 micrograms in children. Keep in mind that adults need about 400 micrograms daily, and children need roughly 300 micrograms. The following is a list of a few common signs that you may be suffering from a folate deficiency:
- Poor immune function; frequently getting sick
- Chronic low energy (including chronic fatigue syndrome)
- Poor digestion; issues like constipation, bloating and IBS
- Developmental problems during pregnancy and infancy, including stunted growth
- Canker sores in the mouth and a tender, swollen tongue
- Changes in mood, including irritability
- Pale skin
- Premature hair graying
- Pregnant women or women looking to become pregnant
- Breast-feeding mothers
- Anyone with liver disease
- Anyone on kidney dialysis
- Anyone taking medications for diabetes
- Those frequently using diuretics or laxatives
- Anyone taking methotrexate