News Moms Need

A maternal-fetal medicine specialist is an obstetrician who concentrates on the care of pregnant women and babies in high-risk situations. Another name for this doctor is a perinatologist.

A maternal-fetal medicine specialist treats women with a number of conditions. Complications with mom’s health, include:
• A history of multiple miscarriages or premature birth
• Diabetes (gestational or preexisting)
• Hypertension (high blood pressure)
• Preeclampsia
• Infectious disease (toxoplasmosis, parvovirus, HIV/AIDS, etc.) or chronic illness
• Rh disease
• A family history of heart, kidney, or other disease

A maternal-fetal medicine specialist often treat pregnant women who are carrying multiples (twins, triplets or more) as the risk for preterm birth is significantly increased.

This doctor also specializes in the care of women whose baby is known to have:
• Abnormal fetal growth
• A known birth defect or suspected genetic disorder, such as Down syndrome, Trisomy 13 or Trisomy 18
• A baby with macrosomia (too large)
• A baby with fetal growth restriction (too small)

If you find yourself in a position where the risk of complications is higher than the average pregnancy, ask your current health care provider for a referral to a maternal-fetal medicine specialist. You may or may not need the extra care, but it will be good to get a second opinion.

There are lots of myths about sex and pregnancy, such as:
   - Sex can be harmful or painful during pregnancy.
   - Intercourse could hurt the baby.
   - The baby somehow “knows” that sex is taking place.
 
The truth is that unless your doc or midwife advises you otherwise, sex during pregnancy is safe for the vast majority of us. And as for the baby, he or she has no idea what Mom and Dad are doing. The baby is well protected by a cushion of fluid in the womb and by the mom’s abdomen.

There are some circumstances, however, that can make sex during pregnancy unsafe. Women who have the following health complications should talk to their health provider before engaging in sex:
   - A history or risk of miscarriage 
   - A previous preterm birth or other risk factors for preterm birth 
   - Unexplained vaginal bleeding, discharge or cramping
   - Leaking amniotic fluid
   - Placenta previa (when the placenta is low and covers the cervix) 
   - Incompetent cervix (when the cervix is weakened and opens too soon)

If your pregnancy is considered to be high risk, you may need to be more cautious than other women. Your health care provider may advise you to avoid intercourse for all or part of your pregnancy. This is an important conversation to have, so don’t be shy.

But again, for most of us, sex is safe, nothing to fear and may even become a more intimate experience. Many women find that pregnancy makes them want sex more than they did before they became pregnant. This sex drive is caused by hormonal changes. For some women, newfound voluptuousness can play a role in making them feel sexier than ever.

Other women may find that their sex drive comes in waves while pregnant. Here is a link to some common changes you may find throughout your stages of pregnancy.

Dr. Jason Baxter will be our guest for our next #pregnancychat on short cervix and progesterone treatment. He is a Maternal-Fetal Medicine specialist practicing at Thomas Jefferson University.  Dr. Baxter cares for women at high risk for premature birth as well as with other pregnancy complications. He is an author of ground-breaking research on progesterone and prematurity prevention. Dr. Baxter has dedicated much of his research career to helping solve the mysteries of prematurity and to finding ways to prevent early deliveries that all too often have tragic consequences for babies and families. 

Perhaps you heard him on NPR as he discussed the latest research.

Dr. Baxter will be talking with us and answering questions.  Join us on Twitter at 1:00PM EST on Wednesday, November 30th.  Don’t forget to use #pregnancychat.

The rate of diabetes continues to increase. Today, about 1 in 9 adults has diabetes. But, according to the CDC, in the next four decades, the number of U.S. adults with diabetes is estimated to double or triple. That means anywhere from 20 to 33 percent of adults could have the disease.

Diabetes is the seventh leading cause of death in the United States. Racial and ethnic minority groups are the hardest hit by diabetes and its complications.

Nearly 9 out of 100 women in the United States have diabetes. About 3 out of those 9 don’t know it. It’s very important for all women to see their health provider regularly to watch for this disease and learn how to manage it.

If you have diabetes and are pregnant or trying to get pregnant, your health care provider will want to take extra special care of you. Pregnant women who have diabetes before pregnancy (preexisting diabetes) are considered to have a high-risk pregnancy. If diabetes is not well controlled, a mom and baby could face serious health complications:

• The woman is more likely to have a miscarriage and stillbirth.
• The baby is 2 to 4 times more likely to have a serious birth defect than other babies. Heart defects and neural tube defects are more common among babies born to women with diabetes.
• The baby is likely to be very large (10 pounds or more). This makes vaginal delivery more difficult and puts the baby at risk for injuries during birth.

The time to act is now. Join Healthy People 2020 in support of American Diabetes Month. Organizations and individuals can work together in their community to prevent diabetes and its complications. Learn more and teach others about the dangers associated with diabetes and how to prevent them.

You have the power to prevent and control diabetes. If you already have diabetes, work to lower your risk of serious complications. If you don’t have the disease, learn if you are at risk for type 2 diabetes. To learn more about diabetes and what you can do to prevent it, read the information from the CDC.

While the value of bedrest is questioned by some medical professionals, many of us who have experienced the loss of a pregnancy are willing to undergo bedrest in the hope that it will help ensure a healthy baby in our next pregnancy. Even if the evidence isn’t there, it seems like common sense – but it isn’t always.

Most physicians state they have ordered some form of bedrest, for patients with conditions like high blood pressure, bleeding or carrying multiples that increase their risk of going into preterm labor. But a review of the literature gave no indication that birth outcomes were any better.  In cases of cervical insufficiency (CI), when the cervix opens before it should, bedrest may be suggested and warranted. Other treatments for CI, like cerclage, have a more proven track record, though.

While some bystanders may say “What an easy life!” bedrest can be a pretty grim and lonely time.  The novelty wears off fairly quickly. Lack of exercise can make you incredibly weak while your muscles begin to atrophy. Weight loss can occur which is not healthy in pregnancy and may add to the risk of preterm labor. The monotony, especially if you are horizontal 24/7, can lead to depression and can strain family relationships.  Being left alone for hours with fears about a high-risk pregnancy is tough. And if the pregnant woman’s salary is a big part of the family income, major financial problems can arise.

The American College of Obstetricians and Gynecologists states that “bed rest, hydration and pelvic rest does not appear to improve the rate of preterm birth and should not be routinely recommended.”  It’s a tough decision.  Were you on bedrest?  How did you feel?  What suggestions do you have for coping?

We’ve all heard the stat: 1 in 8 babies is born preterm.  How do you know if you could be the one?  If you delivered early before, are pregnant with twins (or more!), have a short cervix, or concerns about your cervix or uterus you might be more likely to give birth early.

The fetal fibronectin (fFN) test can help predict your chances of delivering early.  The test is for women who are having signs of preterm labor.  It also is used for women who have risk factors for having a premature baby. Fetal fibronectin is the “glue” your body makes to hold your baby in your uterus.  For women at high risk of delivering early this test can be a great relief.  Your doctor or midwife can tell if your body may be getting ready for labor, even before you feel any symptoms.  The test can be performed in your healthcare provider’s office.

If the test is negative, your odds of delivering within the next two weeks are less than 1%.  This means you can enjoy your pregnancy without worrying!  A small percentage of women will receive a positive result, which means there is an increased chance your baby could arrive early.

Take charge of your pregnancy and your health; remember you are your biggest advocate!  At your next appointment:
• Talk with your healthcare provider about your risk of preterm birth 
• Learn the signs and symptoms of preterm labor
• Discuss whether or not you are a candidate for a fetal fibronectin (fFN) test