Midwife Matters

Pregnancy preparations, women's health, and care options

Nausea and Vomiting in Pregnancy

Pregnant_purpleYou could hardly wait to become pregnant and now it has finally happened!  As thrilled as you are, you soon realize that morning sickness can be an incredibly uncomfortable problem during pregnancy.  Morning sickness, or nausea in pregnancy can interfere with your daily life.  Each woman and each pregnancy can be different.  That sick feeling usually begins around the 6th week of pregnancy and for many women ends around the 16th week. Fortunately, for a lot of women the vomiting and queasiness go away at some point during the day so they can begin feeling hungry again and keeping some food down.  These kinds of episodes can occur at any time during the day, not just the morning and typically are not harmful to you or your tiny baby.

Nobody knows exactly why so many women get morning sickness during pregnancy.  However, there are helpful tips that you can try to alleviate your chances of nausea, these include:

  •  Eating a few crackers in the morning before you get out of bed.  Set them next to your bed the night before. Lay in bed  for about 15 minutes, relax and let your stomach settle before getting up in the morning.  Always get up slowly.  Try to eat small snacks during the day between meals and don’t let your stomach become empty.  Skipping meals is never a good idea.
  •  Eat what you feel like eating when you feel like eating it.  Everybody has the story of wanting ice cream at midnight. I wanted a McDonald’s hamburger like crazy once and I wouldn’t normally even consider eating such a thing!
  • It is usually best to avoid spicy, fatty or fried foods. Also, try not to lie down right after eating a larger meal.  If smells bother you that can be a part of pregnancy as well.  Try to keep windows open and fresh air flowing.
  • Definitely feel free to ask other people to help you with cooking or walk away from smells that can be irritating.     Sometimes eating cold foods can be easier than hot items since they tend to have less of a smell. In addition they can actually be soothing on an irritated stomach.  I loved chocolate shakes during pregnancy
  • Trying ginger, lemons or peppermint has been found to relieve nausea.  Make sure that you are using real ginger, not artificial. Ginger root tea, ginger gum or snaps and fresh ginger or syrup added to water are all safe. Peppermint oil on a cotton ball, which is safety pinned to your clothing may help control nausea associated with odors. For some women salty chips, crackers, or pickles can settle the stomach enough to eat a larger meal.
  • Staying hydrated is important so continue drinking small amounts of fluids frequently during the day. Although something may have been your favorite drink before pregnancy, you might have to try new things.  I found 7up worked far better for my nausea than Sprite.
  • Always try to get plenty of rest because nausea can worsen when you get tired.  This is a time in your life to nap and pregnant women in their first trimester tend to need more sleep anyway.  You may miss some work or other activities might have to wait, so try to rely more on family and friends until things improve.
  • If you’re able, try taking your prenatal vitamins with food or just before bed.  Also, a vitamin lower in iron may alleviate this side effect. If the multivitamin worsens your nausea, you could consider just taking the folic acid 400 mcg alone on a daily basis until your nausea resolves.
  • For many women acupressure bands, called Seabands, can also provide relief from nausea.  The small plastic button on the bracelet pushes against an acupuncture point.  They are reasonably priced and available over the counter.
  • Doxylamine has been used to reduce vomiting and is found in over-the-counter products such as Unisom.  In addition, Benadryl 25-50mg, before bedtime can help alleviate nausea and promote a good night’s sleep.  These are both considered well-tested and safe medications to take in pregnancy. Finally, Vitamin B6 10-25 milligrams taken 3 times daily has been found to help with nausea, although may be less effective with vomiting.

However, if none of these things seem to be helping then it might be time to visit your Midwife.   There are other prescription medications available which may provide you with some much needed relief.  Additionally, for about 1-2% of the population, pregnancy results in a condition involving excessive vomiting call Hyperemesis Gravidarum.  The condition can be difficult to manage and may require IV fluids and medications.  Maintaining contact with your health care provider allows earlier recognition and treatment, which can be so helpful to both you and your unborn baby.

Nasrin

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Labor Companions: The Power of Supporting Mother and Baby

Cultural, ethnic and family systems seem to influence who is present for the momentous and sacred experience of giving birth.  As midwives we have seen that birth is a powerful experience that is often marked as one of the most important life experiences for a woman.  Birth can have a deep impact on her sense of  how she views herself and ongoing  future challenges in life.

Picture 012Your birth is always YOUR unique birth.  Most likely you will not birth like your neighbor, your sister or your mother.  Embrace that you will have YOUR birth.  Go with the flow, trust you will know what is best for you.  I think it is best that labor companions be companions, not  “coaches”.  They are your companions to offer loving presence, gentle reassurance, offering suggestions (not directives) and a spirit of believing in you.  Their presence should empower you.  A Doula can be very valuable as a companion.  The Mother’s partner often needs support also so do not hesitate inviting someone in addition to your partner.  Midwives are present to support and protect the normal physiological process of birth. We are also present to identify deviations of  normal and provide evidence based interventions that are specific to your labor.   There are no routine interventions done by midwives.  They are always in response to the individual needs of the Mother and baby.

Sometimes I have witnessed labor become a spectator event, people want to watch.  Now I personally think every woman is unique and may have different needs and wishes.  But I also think there should be careful consideration by the Mother as to who will offer:  a loving presence, gentle reassurance, the spirit of believing in you and  releasing you to your unique birth experience.  Do not underestimate the cost of emotional power taken from the mother when there are people present who are not the choice of the Mother.  It does influence the unfolding of labor and progress in the birth.

What to do if there are individuals who want to be present but you have not  invited them?

Here are a couple of suggestions:

  • Have a conversation with your “group”.  Share that you welcome their thoughts and prayers for you during labor.  Maybe suggest they light a tea candle in honor of the work you are doing.
  • Reassure them they are welcome to come celebrate with you after you and the baby have met.
  •  Limit phone calls into your room.  You need to be present to your labor, not all the inquiries of “what is happening”.   Technology is wonderful , but can also interrupt a significant moment.
  • Have a pre-birth celebration in which you invite your family and friends to offer  a “Rite of Passage to Motherhood “party.  Ask for blessings.    As women share their birth stories take what is helpful and remember you are safe, loved and supported.
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To Get a Flu Shot in Pregnancy or Not?

According to a New York Times wellness blog, a new study in the journal Clinical Infectious Diseases found that women who received flu shots had babies that were 37% less likely to be born premature.  It also noted that babies weighed more at birth than infants who were born to unvaccinated mothers.   The study concluded that the flu shot was not only safe for pregnant women but is protective as well.  Read more here.

It is not too late to get your flu shot now!!

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More Than One Reason for Pregnant Women to Take Folic Acid

According to the Journal of the American Medical Association a new study has found that taking folic acid when pregnant can dramatically cut the risk of autism in their child.  The current recommendation for  women in pregnancy is to take 400 micrograms of folic acid to reduce the risk of spina bifida.

According to the study, to get the maximum benefit to reduce autism, women need to take the folic acid daily 4 weeks prior to conception and for the first 8 weeks of pregnancy.

To read the entire article click here.

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Look What is Brand New!!

Today is the grand opening of the Mother Baby Center!!  We are so excited to move into this spectacular new building with our patients.

This is a  wonderful collaboration between some of the most trusted names in fetal, maternal, newborn and pediatric care: Abbott Northwestern Hospital and Children’s Hospitals and Clinics of Minnesota.

To learn more about the Mother Baby Center  click here or on our locations tab!!

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The Preconception Visit

Welcome to the grand opening of Midwife-Matters!  We worked hard to get this site started and are so excited to share our experiences with you.  Getting started seems like a good theme for me to blog about today.

Sometimes we plan our pregnancies and sometimes life has other plans for us.  When trying to conceive the timing of intercourse with ovulation is the key. We usually ovulate 14 days before our upcoming period.  So, if you have a 28 day cycle and call the 1st day of your period “day 1”, then you would ovulate around day 14.  If you have a 35 day cycle then you would ovulate around day 21 etc.  An easy way to predict what your due date would be is to take the date of your last menstrual period, subtract 3 months and add 7 days.  So if you wanted a “May” baby, you would try to conceive in August.

I frequently see women for preconception counseling.  At that visit I take an in depth look at your health history, medications, genetic risks, immunization history, lifestyle choices, occupational hazards and family history.  Some things in life are out of our control, like our family history.  Lifestyle choices can be altered to support a healthy pregnancy.

1)  Take a look at your prescription medications.  Consider discontinuing medication that is not necessary and look into the safety of your medications in pregnancy.  It is best to seek medical advice before stopping medications.

2)  Start taking folic acid. Folic acid is a B vitamin. Women who take 400 micrograms of folic acid starting before conception through the first 3 months of pregnancy can help prevent defects in the baby’s brain and spine development.

3)  Try to improve any unhealthy life style choices. Quit smoking!  Stop using street drugs!  Stop drinking alcohol!  All these substances pose risks for your baby.  Caffeine is more controversial.  Some studies tell you to discontinue due to an increased link to miscarriage.  Other studies say moderate (1-2 cups per day) is OK.  I chose to believe the latter studies when I was pregnant, I couldn’t give up my morning cup of coffee!

4)  Learn to eat a healthy diet if not already doing so. Eat plenty of protein, choose whole grains, eat 4 servings of calcium rich foods (milk, cheese, yogurt) For those who are lactose intolerant try kale, broccoli, arugula, turnip greens, dried figs, oranges, oatmeal, soy beans, soy milk, tofu, or almonds to get your calcium.  Eat 5 servings of fruits and veggies daily.

*Remember, once pregnant, not to “eat for 2”.  Pregnant women need about 200-300 calories more a day.  You want to avoid excessive weight gain in pregnancy (that’s another whole topic to blog about another day).

There are also special diet considerations once you are pregnant:

1)  Avoid soft, unpasteurized cheeses. They can carry bacteria called Listeria, which can be harmful to get in pregnancy. Deli meats can also contain listeria but become safe if heated thoroughly.

2)  Follow recommendations for fish consumption. Fish, although very healthy, can also be contaminated with mercury. There are guidelines that set limits, which differ depending on the variety of fish. Sushi is more controversial. There are still the mercury concerns but also concerns about the risk of parasitic infections, which would be more difficult to safely treat in pregnancy.

3)  Avoid raw meats. Uncooked meat can be contaminated with bacteria or carry a parasite called toxoplasmosis that can affect your baby.  Cats can be infected with toxoplasmosis so handling cat litter could also expose you.  Some people will have very little they need to change from their normal lifestyle, others may feel overwhelmed by the information I have provided.

Remember to take things one step at a time.  I welcome your feedback and would love to visit with you for more in-depth, personal recommendations and advice.

Eileen

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Thinking about getting pregnant?

If you are contemplating a pregnancy in the future take this quiz for important information you should know before you get pregnant.

Preconception health quiz

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Have you seen this March of Dimes public service announcement sponsored by MultiCare?  It stresses the importance of waiting for labor to start naturally for the best outcomes for you and your baby.  Check it out…

http://www.youtube.com/watch?v=9W4SQI7LIfI&feature=player_detailpage

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