Preparing for Birth and Delivery

iStock_000017314383XSmallIts that time now. The nine months that originally felt like they were going by so slowly, are suddenly here. All those weeks of anticipating the birth of your baby are over. Here you are: 40 weeks pregnant (maybe a little more or a little less) and its time to have your baby. Are you ready for the delivery of your baby? There are a few things you may want to make sure you have thought about.  We are going to review them here.

Your Birth Plan: Your birth plan is a list of things that you want to exclude or include during labor. It can include who you want involved during your labor. This can include your partner, parent, other relatives or other children. Remember not all hospitals have the same rules regarding how many people can be in the laboring room so it is important to ask ahead of time what your specific hospital allows. You can also exclude people from your labor room such as extra staff or certain family members. Remember the delivery of your baby is a private and personal thing and you have the right to your specific wishes. Your birth plan can also include if you want to have a natural progressing labor, that is without medications like pitocin that can speed up labor. Remember this can only be done if your labor is uncomplicated. If you have a high risk labor or if the baby is in distress, the birth plan will be altered by the doctor of other health care provider that is taking care of you. Birth plans can be long and detailed or simple and easy. It is up to you.

What to bring to the hospital: Basically you can pack as if you are going to be away for a few days. Remember to bring toiletries such as soap, deodorant, etc. Bring your ID and Insurance information. Take any special paperwork (eg. pregnancy passport or ACOG papers) that you may need that includes information about your prenatal care, especially if you are delivering at a hospital that doesn’t have your record. Other items to remember: toothbrush, pajamas, slippers, hairbrush, change of clothes, bathrobe, extra underwear, socks, pony tail holder, chap-stick, lotion, nursing bra, nursing pads, cold pack, camera, take-home outfit for baby, something to read, snacks for your partner or labor coach, camera and cell phone chargers.

Be aware of what can happen: Be sure to educate yourself on different things that can happen during labor. This can be a lengthy list but I will mention the most common things here.  Continue reading

Truths and Myths About Nutrition in Pregnancy (Guest Post) by Dusty Narducci M.D.

iStock_000015450812XSmallWhile you are pregnant you should eat as much as you want? FALSE.

Your pre-pregnancy weight determines how much you should eat while pregnant. If you were a healthy, normal weight before you became pregnant then you should aim to eat only 300 extra calories per a day.

Example of 300 calories:

  • 2 scrambled eggs and 1 plain English muffin
  • ½ sandwich and 1 glass of skim milk
  • 2 small bags of popcorn
  • 3 oz salmon fillet and 1 oat bran dinner roll

How much weight should you gain during pregnancy?

This is also determined by your pre-pregnancy weight. Your pre-pregnancy weight can be determined by calculating your Body Mass Index (BMI). Your doctor can calculate this for you. If you are a healthy weight before becoming pregnant you should aim to gain between 25-35 pounds. Expect to gain 1-5 pounds during the first trimester and 1 pound a week for the rest of your pregnancy. If you are overweight before becoming pregnant you should gain 15-20 pounds during pregnancy. It is important to not try and lose weight while pregnant. Being underweight before pregnancy should result in a 30-40 pound weight gain. Speak to your doctor about how much weight you should gain during your pregnancy.

Women who are pregnant or plan on becoming pregnant need extra nutrients? TRUE.

Your diet, even when you are not pregnant, should include a variety of carbohydrates, proteins, minerals, vitamins and healthy fats. If you plan on becoming pregnant or have recently discovered that you are pregnant it is important to start taking a prenatal vitamin. Prenatal vitamins have extra iron and Folic acid. Folic acid is required in higher amounts before or while you are pregnant to prevent neural tube defects of your unborn child. Iron in our red blood cells allows oxygen to travel to our organs and to the baby. Not having enough iron in your blood, also called anemia, can be prevented with prenatal vitamins.

What foods should I avoid while pregnant?

Caffeine should be limited to 200 milligrams per day (two 8-ounces of coffee) while pregnant. Fish that is high in mercury can be harmful to the developing fetus. A good rule is to avoid larger fish like swordfish, mackerel shark and tile-fish  The following fish have less mercury but should still be limited to no more than 12 ounces per a week: canned tuna, salmon, shrimp, pollock, and catfish. Listeriosis caused by bacteria found in some uncooked deli meats, raw hot dogs, and unpasteurized soft cheeses and milk. Pregnant women are susceptible to Listeriosis, to prevent stillbirth all pregnant women should avoid food potentially carrying this bacteria.

Do some women crave weird food while pregnant?

Pregnant women can crave any type of food during any point of their pregnancy. Sometimes pregnant women crave and eat nonfood items such as dirt, clay, ice, baby powder, or cornstarch. This condition is called Pica and can occur for many reasons, one of them being during pregnancy. Eating nonfood items can be harmful to you and your baby, so if you are experiencing strange cravings talk with your doctor.

It is important to follow the Food Groups while being pregnant? TRUE.

For a healthy and happy pregnancy it is important for you and your baby to receive the daily recommended foods.

Below you will find examples of how you can eat foods containing specific nutrients during pregnancy:

  • Vitamin C/Fruits (85 or more milligrams per day, 3 servings): oranges, strawberries, peppers, potato, melon, tomato, mango
  • Protein (75-100 grams per day):
  • Meat (2-3 servings daily, 1 serving is equal to the size of a deck of cards): pork, chicken, lean beef, nuts (1/3 cup), tofu (1/2 cup), fully-cooked fish
  • Legumes (2-3 servings daily, 1 serving is equal to ½ cup): white/red kidney beans, black-eyed peas, chick peas, lentils, and split peas
  • Calcium/Dairy (1000 milligrams per day, 3-4 servings daily): 1 cup milk/yogurt, 1 egg, 1 cup cabbage/turnip greens,1.5 ounces of pasteurized cheese
  • Iron/Folic Acid/Vegetables/Grains (27 milligrams per day):
  • Green Leafy Vegetables (2-3 servings daily, 1 serving is equal to 1 cup): turnips, collard greens, lettuce, spinach
  • Whole Grains (3 servings daily, 1 servings is equal to ½ cup or 1 slice): bread, cornmeal, cereal, and oatmeal

Is morning sickness harmful to me or my baby?

Morning sickness can be the first sign of pregnancy, with nausea and vomiting starting around week 6 and lasting until the second trimester. Roughly 50% of pregnant women experience some type of morning sickness. Morning sickness is not harmful to you or your baby. A more serious condition called Hyperemesis gravidarum consists of severe vomiting that does not allow you to get enough nutrition to keep you and your baby healthy. This is a serious condition and requires medical treatment. Continue reading

Tips For a Healthy Pregnancy

healthypregA healthy lifestyle consisting of eating the right foods and avoiding certain behaviors is very important before, during, and after your pregnancy.  Eating foods that reduce your risk of heart disease and contribute to an overall well-being is simple. Berries, citrus and pomegranate juice have been shown to decrease the inflammatory effect that is associated with the development of arteriosclerosis or narrowing of the arteries.  Being active and maintaining a healthy weight gain in pregnancy can help you not only feel good but reduce your risk of gestational diabetes and pre-eclampsia.

Gestational diabetes is a condition that occurs in pregnancy when the insulin receptors do not function well and result in elevated glucose (sugar) levels in the blood.  This condition occurs in pregnancy because of the presence of certain hormones that interfere these receptors. This can happen to anyone but there are certain women at risk for it.  Risk factors for having gestational diabetes include:

  • Being overweight prior to pregnancy
  • Having a close family member with diabetes
  • Having a previous pregnancy with gestational diabetes

Gestational diabetes should be carefully monitored. Your health care provider will determine if your sugar levels can be controlled using diet and exercise or whether you will need to take medication. Most women with gestational diabetes will have normal deliveries. However, sometimes high levels of maternal glucose will result in large babies and at times, difficult deliveries. Very large babies may have to delivered by Cesarean section. Babies born to mothers with gestational diabetes are more likely to have complications after birth such a fluctuating sugar levels and difficulty breathing.

Preeclampsia is a condition that develops in pregnancy, usually after the 20th week, that causes an elevation of blood pressure and leakage of protein in the urine. It is caused by many different factors including an excessive inflammatory response to the pregnancy. Careful monitoring of the blood pressure and urine protein can help prevent problems associated with preeclampsia.

What can be done to help promote a healthy pregnancy and reduce the risk of these conditions? Continue reading

Common Teratogens in Pregnancy

Teratogens are substances that can cause harm in a developing fetus resulting in birth defects or fetal death. Teratogens affect growth and development of the baby. The effect of the teratogen depends on the specific substance and how much exposure has occurred. Common teratogens include alcohol, tobacco, illegal drugs and medications.

Alcohol should be avoided in pregnancy. The effect on the baby depends on how much alcohol is consumed. In early pregnancy excessive alcohol can cause miscarriage or premature labor. Exposure to alcohol throughout pregnancy can cause mental retardation resulting in a condition know as fetal alcohol syndrome.  These babies are born with both mental and physical ailments.

If you have an alcohol problem it is important to talk to your health care provider. It is important to be honest about how much alcohol you are consuming. Remember no amount of alcohol is safe in pregnancy.

Tobacco use in pregnancy can cause your baby to have problems growing. Smoking causes blood vessels to constrict causing the baby to receive less nutrients and less blood supply. Over time this leads to growth restriction. Women who smoke in pregnancy are more likely to have abnormal pregnancies that result in stillbirths or low weight babies. Please try to quit smoking before you get pregnant and if you cannot, speak to your health care provider about tips on how you can stop. There may be support groups available in your area.

Illegal drug use in pregnancy can lead to major problems in your developing baby. Among these drugs is marijuana, meth-amphetamines  heroin, cocaine, LSD, prescription medications and inhalants. Marijuana can cause similar problems as tobacco. Low birth weight and problems during delivery are common. Problems feeding, sucking, and developmental delay have also occurred. Continue reading