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Pregnancy Q&As
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Expert: Dr. William Camann
November 16th, 2009What is the difference between a spinal and epidural procedure? Spinal and epidural procedures are both regional anesthetics that anesthetize a particular region of the body. (Under general anesthetic the patient is unconscious.)
Spinal anesthetics are used primarily for elective cesarean sections, where the duration of the surgery is known. Spinal anesthetic involves a single injection of anesthetic medication directly into the fluid surrounding the spinal cord. Once the drug is injected, it is impossible to extend the duration of a spinal anesthetic. The effects of spinal anesthetic can last for one to 10 hours.
An epidural is administered in a similar fashion but, in contrast to a spinal, an epidural involves placing a catheter into the epidural space (located near the spinal cord). Medication is injected through the catheter to numb the nerves. Due to the presence of the catheter, epidural anesthetic can be made to last as long as needed and the amount of medication can also be altered. Epidural is used for labor since delivery is unpredictable in length and intensity.
If you are given an epidural for labor, and need to have an emergency cesarean section, a stronger medication can be injected through the epidural catheter to provide sufficient anesthesia for the surgery.
Dr. William Camann is the director of obstetric anesthesia at the Brigham and Women's Hospital in Boston. He is also an associate professor of anesthesia at Harvard Medical School, and past-president of the Society for Obstetric Anesthesia and Perinatology. An internationally recognized authority on obstetric anesthesia and pain control during childbirth Dr. Camann is the co-author of Easy Labor, Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth (Random House/Ballantine Books, 2006). You can find out more about his book at easylabor.net
Permalinkepidural procedure, spinal anesthetic, complications, william camann, difference, cesarean section, pain relief, child birthExpert: Dr. Peter Doubilet and Dr. Carol B. Benson
October 18th, 2009How early can pregnancy be detected? Pregnancy can be detected by three or four weeks gestational age (or one to two weeks after ovulation). If your period is late and you think you may be pregnant, you have two options. The first is to take an at-home urine test with a home pregnancy test. These tests are easy to use (just pee on a stick and wait) and have a 90 percent accuracy rating. Alternatively, you can have your doctor order a blood test (almost 100 percent accuracy).
Both blood and urine pregnancy tests check for the presence of a chemical called human chorionic gonadotropin, which is produced during a pregnancy. Waiting two weeks post conception (one the first day of a missed period) is recommended, but positive results can be detected as early as one week after conception.
After a pregnancy has been detected by a blood or urine test, your doctor will request an ultrasound to confirm that a live embryo is present. Ultrasounds can first be seen at five weeks pregnancy and an embryo and heart beat can be detected by six weeks. Pregnant women who aren’t experiencing any problems will usually have their first ultrasound around three months.
Peter Doubilet and Carol Benson are a married couple with five grown children between them. They teach and see patients at the Brigham and Women's Hospital in Boston where Peter is Senior Vice Chair of Radiology and Carol is Director of Ultrasound and Co-Director of High Risk Obstetrical Ultrasound. Together they have written Your Developing Baby (McGraw-Hill, 2008).
Permalinkpregnancy detection, see pregnancy on ultrasound, late period, pregnancy tests, pregnancy testing, first ultrasoundExpert: Dr. Marjorie Greenfield
July 13th, 2009Is it safe to fly during pregnancy? For women with normal, low-risk pregnancies, air travel is usually perfectly safe. That said, there are a few things you should be aware of before you pick up your boarding pass.
First of all, it’s important to check in with your doctor or midwife so that they can give you the all-clear. (You don’t want to book a flight if you're showing any signs of preterm labor or have any risk factors for early delivery.)
Then, once you’re airborne, don’t forget to get up from your seat every couple of hours and walk up and down the aisle for five to 10 minutes to reduce the risk of blood clots in your legs.
Finally, if you’re travelling in your third trimester, be sure to contact the airline regarding its cutoff policy. (For instance, all American Airlines and Air Canada flights allow pregnant women to fly up to and including 36 weeks, after which air travel is only allowed for short flights, under special circumstances and must be cleared by the airline's medical desk with a note from your doctor saying that you're fit to travel.)
Dr. Marjorie Greenfield is a practicing board-certified obstetrician-gynecologist and fellow of the American College of Obstetrics and Gynecology (ACOG). She is currently associate professor on the full-time faculty at Case Western Reserve University School of Medicine. She is also the author of The Working Woman's Pregnancy Book. marjoriegreenfield.comPermalinkis it safe to fly during pregnancy, third trimester flying, pregnancy airplane, pregnancy air travelExpert: Stephanie Curran, R.TCM.P
June 15th, 2009Can acupressure help during labor? Acupressure is a safe, effective, hands-on tool you can use during labor with the help of your partner or support person. Acupressure can keep the momentum of labor going and also helps with the release of endorphins to reduce the pain of contractions.
It's best to take an acupressure workshop before you deliver so you know how to find the right acupoints once you're in labor. Pressure should be applied to acupoints as each contraction begins, then held with steady pressure until the end of the contraction. If you begin using acupressure in the early stages of labor right through to delivery, the treatment can increase the efficiency of each contraction, help the cervix dilate and encourage your baby to descend into the birth canal.
To find out more and to see a demonstration of how acupressure can help during labor, click here.
Stephanie Curran has been practicing as an Acupuncturist and registered Traditional Chinese Medicine (TCM) practitioner since 2000 and founded the Elements of Health Centre in 2006. She has completed many specialized courses in the application of TCM for treating reproductive and obstetric conditions. Passionate about working with women throughout their pregnancies, Stephanie has completed doula training and has integrated acupuncture and labor support in both home and hospital settings. elementscentre.caPermalinkacupressure labor, labour, acupressure contractions, labor delivery, labor pain, pregnancyExpert: Debbie Young, CD(DONA), PCD(DONA), LCCE
February 9th, 2009I'm pregnant with my second baby and I'm exhausted. What can I do? A second baby is a challenge and a blessing. Whenever possible during your pregnancy, sleep while your toddler naps. Once your new baby is born, you may not be so lucky. It would be lovely if your children got on a similar schedule, but don't count on it. Newborns need to be cared for on cue, and that often does not coincide with any regular pattern for the first few months. You might find as time goes by your baby may be willing to nurse and rest while your toddler naps, allowing you a bit of time to relax.
Many families choose to have a postpartum doula assist them in the first few weeks to help ease the transition of adding a new baby to the family. A doula can help establish good sleeping patterns. She can also help with newborn questions, provide breastfeeding or infant feeding information, help with bath time, do light household organization, and ease the transition of integrating the new baby into the family with older children.
Another good resource into understanding your newborn's zones (including her sleep zones) is hugyourbaby.com. It provides information to help you understand how to help your baby sleep effectively so that you can get more rest as well.
Debbie Young, CD (DONA), PCD (DONA), LCCE is the president of DONA International and a childbirth educator at Genesis Medical Center in Davenport, IA. Young is also the owner of BabyMatters, a women's resource center for pregnant, birthing and postpartum families and has been a doula for over 20 years and a childbirth educator for over 21 years.
Permalinktired, pregnancy, exhausted, how to get sleep after baby, dona, debbie young, newborns, sleepExpert: Dr. Marjorie Greenfield
November 3rd, 2008How can I protect myself from colds and flu during pregnancy - and what can I do if I get sick? The best prevention against both cold and flu bugs is frequent and thorough hand washing. (The most common way to catch a bug is by touching a surface an infected person has touched, then touching your face.)
So, if you touch a doorknob, handrail, bank machine button (anything at all someone else may have touched), or if you shake hands with someone during cold and flu season, wash your hands or use an alcohol-based hand sanitizer, such as Purell. (Cold and flu viruses can live on surfaces for up to two days, especially on nonporous surfaces, such as plastic, metal or wood.)
Pregnant women should also talk to their doctors about getting the flu shot–no matter what trimester they are in. You're more vulnerable to getting very sick if you get the flu during pregnancy. A recent study in the New England Journal of Medicine found that the flu shot can also reduce a newborn's risk of infection if it's mother was vaccinated during pregnancy.Treating cold and flu symptoms during pregnancy
The general rule when it comes to treating cold and flu symptoms during pregnancy is to always use non-medical treatments first. (So if you're congested, try steam before Sudafed, for example.) The only exception is if you have a fever, in which case you should treat it with Tylenol (and not other pain relievers, such as Advil or Aspirin).
Other safe cold and flu treatments include: cough drops, Vicks Vapor Rub, honey and lemon, hot tea and saline nasal spray. It's also important to check in with your doctor if you get sick during pregnancy.
Dr. Marjorie Greenfield is a practicing board-certified obstetrician-gynecologist and fellow of the American College of Obstetrics and Gynecology (ACOG). She is currently associate professor at Case Western Reserve University School of Medicine. Her new book, The Working Woman's Pregnancy Book, hit bookshelves in spring, 2008. www.marjoriegreenfield.com
Permalinksick pregnancy, colds and flu during pregnancy, safe cold and flu treatments for pregnant women, dr. marjorie greenfield, flu shot pregnancy, colds and fluExpert: Andrea Grace
September 22nd, 2008Is it safe to run during pregnancy? Running or jogging during pregnancy can be a great aerobic exercise, as long as you take a few precautions.
First, it's important to check with your doctor or midwife so they can give you the "all clear."
Usually, if you ran regularly before getting pregnant, it's fine to continue as long as you're still feeling okay. The key is to listen to your body and, at the first sign of discomfort, to slow things down.
The first trimester is a crucial time when the baby's major organs are forming and overheating is an issue. If your core temperature gets too high, it could cause problems with the baby, so be sure to take it slowly on hot days and drink plenty of fluids.
You may find that you're short of breath in the first and third trimesters and will have to modify your exercise routine accordingly. Eventually, your new shape may make running or jogging uncomfortable, in which case walking or power walking are great alternatives.
It's not a good idea to start running if you weren't running on a consistent basis before getting pregnant. Pregnancy is also not such a great time to start training for a marathon or any other race–save that for after the baby is born when you're ready to work toward getting back in shape.
Andrea Grace is the president and creator of Mommy and Baby Fitness pre- and post-natal fitness programs with locations across North America. She is a CanFitPro and ACE certified fitness professional with specialty certifications in pre-and post-natal and children's fitness. mommyandbabyfitness.com
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Expert: Dr. Marjorie Greenfield
August 11th, 2008Is flying harmful during pregnancy? For most women with a normal, healthy and low-risk pregnancy, travel is fine and is a fact of life. But there are a few things you should know before packing your bags:
1. The most stable part of pregnancy is from approximately 12 weeks to about 20 to 24 weeks and it's also when you're most likely to be feeling your best-so this is usually a good time to plan a trip. Just remember to check in with your doctor or midwife before going away, just so they're aware that you're leaving and can give you the all-clear.
2. On long trips when you're not moving, there's an increased risk of blood clots in your legs so it's important to get up and take a 10-minute walk every two or three hours. (And, if you're driving, that means getting out of the car for 10 minutes every two to three hours-usually your bladder requires that you do that anyway!)
3. People sometimes worry about radiation exposure when traveling by plane. If you're doing a tremendous amount of flying, there may be some amount of radiation exposure, but for most people it isn't an issue.
4. You may not want to be too far from home in your first trimester if you haven't seen your pregnancy on ultrasound or heard a heartbeat. (Early on, most women have a 15 to 30 percent chance of miscarriage, depending on their age and other risk factors, so they may not want to travel somewhere where there is less guarantee of finding quality medical care.)
5. You may also not want to be too far from home in your third trimester, especially if you're showing signs of preterm labor or have any risk factors for early delivery. If you end up going into labor early, you could be stuck in a foreign city with a newborn who needs to spend a few weeks in intensive care. It's important to talk to your doctor about whether it's advisable for you to go away and, if you do decide to travel, take a copy of your medical records with you.
6. If you need to travel later in your pregnancy, be sure to contact the airline regarding its cutoff policy. (For instance, all American Airlines and Air Canada flights allow pregnant women to fly up to and including 36 weeks, after which air travel is only allowed for short flights, under special circumstances and must be cleared by the airline's medical desk with a note from your doctor saying that you're fit to travel.)
7. If you're planning a visit to an exotic location, make sure your immunizations are up to date and be sure to check with your doctor and consult a travel medical specialist well in advance of your trip.
Marjorie Greenfield, M.D. is a practicing board-certified obstetrician-gynecologist and fellow of the American College of Obstetrics and Gynecology (ACOG). She is currently associate professor on the full-time faculty at Case Western Reserve University School of Medicine. Her new book, The Working Woman's Pregnancy Book, hit the bookshelves in May. marjoriegreenfield.comPermalinktravel, safety, pregnancy, safe, advice