Prenatal Information

Having a healthy baby is the reason women to go the doctor  and this book explains what is important.   A growing baby depends on the mother for everything—nutrients,  oxygen,  and vitamins—from conception until delivery.   Babies born with health issues are very stressful to the parents.
People can’t expect  to use drugs,  alcohol,  smoke,  or have poor nutrition and expect to have a healthy child.   The most disturbing thing for a family is to have a baby that is not healthy—this can wipe out a family financially, mentally and emotionally.   Studies show that  “ prenatal care remains the single most important factor to reduce infant mortality”   Dr. Richard Smith,  President of MSMS.   For every $1 spent on prenatal care ,  $4  are saved on infant mortality.     Everything that is done and ordered by the doctor surrounds the focus of having a healthy baby,  the ultrasounds,   the lab tests,   the vitamins,  all the prenatal visits , the monitoring  are all done with the purpose of having a healthy child.  This book is  for extra information and it is NOT a  substitute for seeing your doctor;  however it can give you tips on important questions  that you need to ask your doctor.

By age 25,  about 50% of women in the US have had  at least 1 child,    and by age 44,  85 % have given birth,  so before getting pregnant it is important to implement measures to live a healthier life,  which we will cover in greater detail in the coming weeks.     The important points are to be involved in a regular exercise program,  loose weight if you are overweight,  stop smoking and drinking alcohol if you engage in these activities.  Don’t get pregnant within a month of getting a rubella vaccine,  and take folic acid (at least 400 mcg)  daily when you are trying to get pregnant.   If you have other health issues such as diabetes,  hypertension, asthma, seizures, thyroid imbalance, etc., it is important to have these under good control before trying to get pregnant.   Some of these  pre-pregnancy risk factors are reversible and an attempt should be made to minimize their effects on the individual prior to getting pregnant so that their effects on the pregnancy are minimized.

What to expect or prepare for in the first trimester:
  1. -importance of knowing what your menstrual cycle is like
  2. when is the most fertile time of the cycle?
  3. what should you do when you miss your period? (pregnancy testing),
  4. §-important clues to pay attention to  in the beginning
  5. what is happening to the fetus @ this time?
  6. -how do you figure out your due date?
  7. What does the baby have by the time 2 months have passed?,
  8. 3 months?
  9. When can you pick up the heart rate?  (by US or by the office Doppler?
  10. Does age have anything to do with it?

There are some tests  that are routine,  there are some that are extra depending on the situation  (such as CVS,  or amniocentesis), such as advanced maternal age, or prior child with a chromosomal abnormality.   The last  trimester  is probably the most crucial of the trimesters, because the baby is gaining the most weight and all its organs are getting ready to be able to survive on its own once it is born.   Very few babies survive  when they are born prior to 24 weeks.
What delivery options are available?   There is a  vaginal delivery versus cesarean section,  and there is controversy as to whether cesarean delivery  can be offered just because someone requests it or if it should only be done for the usual reasons:  (failure to progress,  fetal heart rate abnormalities, abnormal presentation to include breech and transverse lie).
Pain management in labor: breathing techniques, IV pain medication,  epidural, and  intrathecal.   Which one gets offered depends on the obstetrician,  anesthesiologist and patient wishes.
Whether someone can deliver vaginally after having had a cesarean delivery also depends on the hospital,  obstetrician, prior cesarean scar line on the uterus,  and anesthesia availability.   Many Ob docs around the country are limiting their deliveries to normal vaginal deliveries and repeat cesarean sections and are not offering an option to have a trial of labor following a cesarean section,  especially at community hospitals where there may not be a residency program.
To breast feed or not to breast feed.   Well,  as speaking from an obstetricians point of view,   breast feeding is the way to go—it is natures best option for milk for babies.  Plus it is cheaper—no bottles to heat up in the middle of the night,  no formula to mix up or that smells badly—and always ready and warm.   If Moms could stay home for  6 months to a year after having a baby,  then practically every one who has a baby could breast feed!    However, you know and I know that mom’s have to go to back to work about the 6 – 8 week mark,  and so

have to wean the baby at that time,  as most jobs are not that flexible to accommodate women so that they can continue to breast feed even after they return to work.   So many babies are bottle fed.   There are 7 main advantages to breast feeding and that is that 1) it promotes bonding:  2) it is a ready made supply;  3) it is always warm;  4) it usually suppresses the periods (but doesn’t mean a person can’t get pregnant again);  5) the extra calories burned to make the milk help with loosing the weight gained during pregnancy;

as the demand for milk increases,  so does the supply;  and 7) colostrum, or the very first milk  (within the first 3 days of birth ) is high in immune factors that protect the baby.   Studies have shown that breast fed babies are healthier than bottle fed babies,  there are fewer respiratory and gastrointestinal infections  in the first year of life,  there is also a decreased risk for breast cancer in the mother who breast feeds.

There are 9 minor disadvantages to breast feeding and that is that 1) the mother is the only one who can feed the baby  (unless breast milk is pumped from the breast and stored in advance);  and 2) there is no way to know exactly how much the baby eats.   You can only go by wet and dirty diapers, and a measure of the baby’s weight at it’s well checks; and 3) the milk taste can be affected by the mother’s diet which can have  an  effect on the baby.   For example, gas producing foods for the mom, can cause  gas in the baby.  People who breast feed find out very quickly what bothers the baby;   4) sometimes breast feeding is painful ;  5)  you might not be able to feed the baby in a private place when it gets hungry;   6) some women don’t loose weight while breast feeding,  they gain weight  because their appetite has increased a lot;  7) if you normally have to take certain medications,  you need to check with your doctor if it is safe to take them while breast feeding;    8)   sometime your breast may leak milk at inopportune times;  and 9) hormone levels can be lower while breast feeding so intercourse can be painful for a time due to vaginal dryness.
What are the advantages of bottle feeding?   1) Other family member can help feed the baby; 2) babies sometimes gain weight faster on formula (there is a higher sugar content);   3) you can begin your birth control sooner  when bottle feeding.   The disadvantages of the bottle fed baby are 1) that the immune system of the baby  is found to be not as good as breast fed babies,  2) there is a lot of controversy implicating problems with the plastic in the bottles as having an adverse effect  on the health of the baby; 3) and there is  more work involved with sterilizing the bottles,  heating the milk etc; and   4) many formulas contribute to gastrointestinal issues with the baby;     5) many formulas have an unpleasant odor to them; and 6) there are some studies to indicate that the extra hormones (ie estrogenic like compound in soy)  has long term effects on the development of the child.

My book,  “A Doctor’s Guide to Pregnancy”   is available @,, and
Click here to listen to my Voice America program:  A Doctor’s guide to Pregnancy

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