News Moms Need

How old were you when you had your baby? Today, 1 in 5 women in the US has her 1st child after age 35. Halle Barry currently is pregnant at age 46! The good news is most have healthy pregnancies & healthy babies. There are, however, a number of challenges and concerns. 

Join us on Twitter Tuesday May 14th at 1 PM ET for our next pregnancy chat. Learn about these issues and things you can do to help start a family when you’re no longer in your 20s. Join in the conversation by using #pregnancychat.

Advertisements abound these days for weight loss programs and quick fix diets. Did you eat all your favorite traditional treats over the holidays and have a cup or two of cheer? I certainly did and am now feeling like it’s time to behave – time to swap the cookies for carrots, the fruitcake for fruit.

For those of you thinking about pregnancy, it’s especially important to get your weight under control before you conceive. To know if you’re overweight or obese, find out your body mass index (BMI) before you get pregnant.  BMI is a calculation based on your weight and height.

If you’re overweight, your BMI is 25.0 to 29.9 before pregnancy. Two in 3 women (66 percent) of reproductive age (15 to 44 years) in the United States is overweight.  If you’re obese, your BMI is 30.0 or higher before pregnancy. About 1 in 4 women (25 percent) is obese.

If you’re overweight or obese, you’re more likely than pregnant women at a healthy weight to have certain medical problems during pregnancy. The more overweight you are, the higher are the risks for problems. These problems include:
   • Infertility (not being able to get pregnant)
   • miscarriage (when a baby dies in the womb before 20 weeks of pregnancy)
   • stillbirth (when a baby dies in the womb before birth but after 20 weeks of pregnancy) 
   • high blood pressure and preeclampsia (a form of high blood pressure that only pregnant women get). It can cause serious problems for mom and baby.
   • gestational diabetes 
   • complications during labor and birth, including having a really big baby (called large-for-gestational-age) or needing a cesarean section (c-section).

Some of these problems, like preeclampsia, can increase your chances of preterm birth, birth before 37 completed weeks of pregnancy. This is too soon and can cause serious health problems for your baby. (We’ll talk about how mom’s weight issues can affect her baby’s health in tomorrow’s post.)

For those women who are severely overweight, some are turning to surgery. New studies suggest that weight-loss surgery may help protect obese women and their babies from gestational diabetes, high blood pressure, overly large babies and cesarean delivery during pregnancy.

So think about staying healthy and shedding those unwanted pounds before you get pregnant. Talk with your health care provider, find a plan that’s good for you and stick to it. You’ll have a healthier and more comfortable pregnancy when the time comes.

There can be many reasons why a woman might not get her period. For women who are sexually active and in their 20s or 30s, pregnancy is the first thing that pops to mind. If you’re in your 40s or 50s, it could be the beginning of the transition leading to menopause, or perimenopause. Whatever the reason, it’s important to find out why.

Extreme exercise can be a cause. Did you know that between 5% and 25% of female athletes work out so hard that they stop getting their periods? This is called exercise-induced amenorrhea. I had two friends, both avid runners, who were unable to conceive while they were in training and running marathons. Their intense exercise altered the manufacturing and releasing of reproductive hormones involved in the menstrual cycle. While still remaining active, my friends had to significantly dial back their exercise routines before they were able to have children. But both of them went on to have kids.

Another substantial body stressor that can affect the operation of reproductive hormones is a severely changed eating pattern. Women with eating disorders like anorexia nervosa are greatly altering their hormonal balance by depriving their body of nutrition. This can shut down a normal reproductive cycle.

Women who breastfeed often do not see the return of a normal period for many months. If that happens to you, don’t feel like you’re home-free in the contraception department. This lack of a period does not necessarily mean you’re not ovulating and it is possible to get pregnant during this time.

Medical conditions like problems with your uterus, polycystic ovary syndrome (PCOS), thyroid conditions or pituitary gland disorders, or problems with the hypothalamus can cause amenorrhea. Women who are extremely overweight or obese can lose their period.

If you miss your period for an extended period of time and aren’t sure why, check into it with your health care provider.

April 24-30th is National Infertility Awareness Week, designed to raise awareness about the disease of infertility and encourage the public to take charge of their reproductive health.  Started by RESOLVE:  The National Infertility Association in 1989, the week brings together the professional family-building community, corporate partners and the media to 1) ensure that people trying to conceive know the guidelines for seeing a specialist when they are trying to conceive; 2) enhance public understanding that infertility is a disease that needs and deserves attention; and 3) educate legislators about the disease of infertility and how it impacts people in their state.

If you’re thinking about fertility treatment, read our information with a variety considerations including how do I know if I need a fertility specialist? How do I find one? What sorts of diagnosis and treatment options are there? What are the costs and will my insurance cover them? Where can I go for more information?  For more information and links to resources on the Awareness Week, click on this link.

Uterine adhesions, sometimes called Asherman syndrome, are scar tissue that can damage the uterine lining (endometrium). The damage may range from mild to severe. Causes of uterine adhesions can include:

• D&C (dilation and curettage), which may be done after a miscarriage (this is a surgical procedure, in which the cervix is dilated and the uterus is emptied with suction or with an instrument called a curette)
• Other uterine surgery
• Severe infection of the uterine lining (endometritis)

Some women have no symptoms, while others may have light or infrequent menstrual periods. Adhesions can contribute to infertility, repeat miscarriage and premature birth. Imaging tests and hysteroscopy can diagnose adhesions. Adhesions can be removed during hysteroscopy, improving the chances of a normal pregnancy.

We as a nation seem to be getting fatter by the minute.  We’re always reading about obesity and the problems it causes, of which there are many.  But some women, whether because they pay too much attention to the fashion police or they have too much stress or other issues in their lives, are really, really thin.  Some women are just tiny, but some have an eating disorder that makes and keeps them thin.  Anorexia and bulimia are two eating disorders that wreak havoc with your body.

Anorexia nervosa is a disorder making a person incapable of maintaining a minimum body weight considered healthy for a person’s height and age.  Intense fear of gaining weight causes severe dieting and/or excessive exercising.  Bulimia is a similar disorder but often consists of binge eating and then vomiting, perhaps combined with laxative use, to prevent weight gain.  Among other health issues, both of these conditions can cause infertility.

Women need to have a certain amount of body fat in order to menstruate, conceive and carry a baby.  If a woman’s body fat reserves drop too low, her body starts to protect itself and she may stop menstruating, since this is a process that is not vital to her survival.  This can prevent her from conceiving.  (A bulimic woman may actually carry a little more weight and therefore may continue to menstruate.  But the process of binge eating and vomiting may be too harsh on her body to sustain a pregnancy if one is conceived.)

And women aren’t the only ones with eating problems that can affect pregnancy. Men who are anorexic (oh yeah, we’re not the only ones) and have a very low body fat ratio may have a significant drop in sperm production, also hampering the ability to conceive.

If you are hoping to conceive but haven’t been able to yet, consider analyzing your body weight and eating patterns.  Look at it from different perspectives.  If either you or your partner is particularly thin, consider altering your diet and gaining some weight.  Talk with your provider about how to reach and maintain a healthy weight.

Many of us have heard that Kelly Preston, wife of John Travolta, is pregnant at the age of 47. Wow, you go girl!  I hear some women asking “If she can, why can’t I?”  Good question, complicated answer. 

Women over age 35 may be less fertile than younger women because they tend to ovulate (release an egg from the ovaries) less frequently. Certain health conditions that are more common in this age group also may interfere with conception. These include endometriosis, blocked fallopian tubes and fibroids.

A woman over age 35 should consult her health care provider if she has not conceived after 6 months of trying. Studies suggest that about one-third of women between 35 and 39 and about half of those over age 40 have fertility problems.  At age 47, most babies are conceived with some form of fertility treatment.   This can be time consuming and expensive.

Most miscarriages occur in the first trimester for women of all ages. The risk of miscarriage increases with age. Studies suggest that about 10 percent of recognized pregnancies for women in their 20s end in miscarriage. The risk rises to about 35 percent at ages 40 to 44 and more than 50 percent by age 45. The age-related increased risk of miscarriage is caused, at least in part, by increases in chromosomal abnormalities.

Women in their late 30s and 40s are very likely to have a healthy baby. However, they may face more complications along the way than younger women. Some complications that are more common in women over 35 include: gestational diabetes, high blood pressure, placental problems, premature birth, stillbirth.  About 47% of women over age 40 give birth via cesarean section.

All these things taken into consideration, many women who do conceive in their late 40s, either on their own (unlikely but not impossible) or with some fertility treatment, do manage to have healthy babies.  The important thing to remember is to have a preconception checkup and early and regular prenatal care.

My daughter has endometriosis and it has caused her a bunch of problems over the years.  She went through horribly uncomfortable periods, painful ovulation, bouts of diarrhea contrasted with constipation… For years she was not a happy camper.

Endometriosis, aside from making one feel lousy, can interfere with fertility and make having a child difficult.  Read more about endometriosis in our previous post. 

My daughter ultimately had surgery to “clean up” as much unwanted tissue in her abdomen as possible.  Happily, she now has two daughters and far fewer discomforts every month.  If you have symptoms and think you may have endometriosis, talk to your doc about it.  Don’t suffer in silence.   Although you can’t get rid of it all together, there are ways of treating it.

Chlamydia is a bacterium that causes a sexually transmitted infection (STI). A chlamydial infection contracted before or during pregnancy can be the cause of reproductive problems, so it’s important to clear it up a.s.a.p. About 2.8 million new cases of this infection occur every year in the U. S. in both sexes, making this one of the most common STIs. It occurs most frequently in people under age 25.

Chlamydia usually has no symptoms, although some infected women experience vaginal discharge and burning on urination. Untreated, chlamydia can spread to the upper genital tract (uterus, fallopian tubes and ovaries), resulting in pelvic inflammatory disease (PID), often with a superinfection with other bacteria – so not nice!  And PID can damage a woman’s fallopian tubes and lead to ectopic pregnancy or infertility.

About 10 percent of pregnant women in the United States are infected with chlamydia. Untreated, they face an increased risk of premature rupture of the membranes (PROM) (bag of waters) and preterm delivery. Babies of untreated women often become infected during vaginal delivery, and infected babies can develop eye infections and pneumonia, which require treatment with antibiotics.

The Centers for Disease Control and Prevention (CDC) recommends that all pregnant women be screened for chlamydia infection at the first prenatal visit. Testing is easy and is done on a urine sample or vaginal fluid obtained with a swab. The good news is that chlamydial infection can be cured with antibiotics that prevent complications for mom and baby. It’s important to note that the partner of an infected woman also should be treated, because the infection can be passed back and forth between sexually active couples.

Small amounts of caffeine probably don’t reduce a woman’s chances of becoming pregnant. Most studies have found no effect on fertility when women consume less than 300 mg of caffeine a day. A few studies have found that women who consume more than 300 mg a day may be more likely to have trouble conceiving. But, again, this has not been proven. If you’re trying to get pregnant it’s better for your body if you drink water, milk and fruit juice. But, the occasional cappuccino is probably just fine. You might want to ask your doctor during your pre-pregnancy check-up what he/she thinks.