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Studies Provide Shocking Postpartum Depression Statistics

Thursday, May 9th, 2013

Becoming a new mother should be the happiest time in the lives of most women—at least, that is what society tells us. But every year, thousands of women across the country who have recently given birth, or who are about to give birth, report experiencing depression and postpartum depression. This issue only came to light in the past few decades, as an increasing number of women overcome the “shame” associated with mental illness to talk about and raise awareness of their experiences. Increased awareness of postpartum depression means that fewer women feel the need to hide their problems, and more women will seek help earlier in the onset of postpartum depression when it can be more easily treatable.

However, there are still a lot of problems when it comes to awareness. One of those issues is the fact that the segment of the population that is most likely to be diagnosed with it is the segment least likely to be knowledgeable about the subject. In this study, which identified women positively diagnosed with postpartum depression as well as the demographics of affected women, it was revealed that women positive with a diagnosis were more likely to be younger, African American, and to be in a lower income bracket.

In addition, most of the women who were found to have postpartum depression were also found to have a comorbid generalized anxiety disorder. That means that many instances of depression may also dismissed as common anxiety, or the typical concerns of a new mother. It is important to correctly identify depression, as it can have an immense effect on both mother and baby in the period after birth. In fact, many women will suffer depression for years afterward. In this study alone, 14 percent of the women in the study were positively diagnosed.

Women should be informed about postpartum depression and its effects, and they should know that it is a common problem after pregnancy. Of course, postpartum depression is just one of the many issues that a woman might face regarding pregnancy and childbirth—my mission in life is to inform women of all ages and races of what is going on with their bodies, and in my book, “Inside Information for Women”, I discuss pregnancy and childbirth in detail, in the hopes that more women will go through the process with the knowledge that they need to remain safe, healthy, and happy throughout their pregnancy and well afterwards.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Pregnancy, Women's health issues | No Responses »
Tags: anxiety, postpartum depression, Pregnancy, women's health

Preserving Fertility for Cancer Survivors

Monday, May 6th, 2013

Cancer is a devastating diagnosis for a woman of any age, but for a young woman who is hoping to eventually start a family, there can be a host of other problems associated with this disease. No matter what type of cancer a woman faces, it can have severely damaging effects on her reproductive health. Radiation therapy and chemotherapy can cause major problems with a woman’s eggs, and can even make them not viable for future reproduction. Women who suffer from ovarian and cervical cancers may even be forced to undergo a full or partial hysterectomy.

For many young women, the second question they ask after determining their prognosis is what effect their cancer will have on their future ability to start a family. Fortunately, advances in science over the past few decades have made it entirely possible for a woman to preserve her fertility after a cancer diagnosis. There are many options available for women who want to start a family after they have recovered from their illness. However, it is important to note that many of these options must be pursued early on in a cancer diagnosis—especially if the woman is choosing to freeze her eggs for future in vitro fertilization use.

Many women may see egg freezing as their only choice, and will not want to pursue this avenue when undergoing cancer treatment—this may leave them feeling as if they might never have the chance to start a family. This study shows that most women believe egg and embryo banking is their only option. This is most certainly not the case. Women who are concerned about their potential for reproduction should talk with their doctors and learn all the options before they give it up for a lost cause. There are many mothers out there who have had their children after surviving this horrible disease. I invite people to read my book, “Inside Information For Women”, for more information on the effects of breast and other cancers on the female body.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Pregnancy | No Responses »
Tags: cancer, egg banking, infertility, Pregnancy

Some Basic Stats on Weight Gain During Pregnancy

Thursday, May 2nd, 2013

I cannot believe my eyes every time I see the gossip magazines talking about some celebrity’s upcoming pregnancy. No matter how you feel about a woman, you should be happy for her and supportive when she’s facing the prospect of motherhood, especially when it’s her first baby that is on the way. But rather than talk about the positive aspects of parenthood, or even silly things like what baby clothes she’s buying, or the type of crib she’s going to put into her nursery, all the magazines can do is talk about the weight they’ve gained during their pregnancy.

This is simply astonishing to me. When did the most important part of a woman’s pregnancy become how much weight she is putting on? As if our society’s standards of beauty weren’t bad enough, now we have to go and turn those “skinny at all costs” ideas on expectant mothers? The simple fact is normal-sized women are supposed to put on weight during pregnancy. Obese women have other recommendations for pregnancy weight gain. Studies show that the average woman should gain at least 25 to 35 pounds while pregnant. Actually, the ideal weight gain should be closer to 11 kg or about 22 pounds. This obsession with weight has led to a condition known as “pregorexia”, which is a rare condition, but becoming more common, which pertains to a woman’s drive to control pregnancy weight gain through extreme dieting and exercise. This is an eating disorder and it shouldn’t be when it comes to women who are pregnant. It is an outgrowth of all of this idiotic media focus on appearance and body images that average women strive to resemble celebrities.

When our society starts shaming women for gaining weight during their pregnancy, or suggesting that women are unhappy because of a few extra pounds they’ve put on, it can do a lot of damage to mothers and children. Are we creating a culture of women who are asking their doctors no, “What can I do to keep my baby healthy?” but “How can I make sure I don’t gain too much weight while I’m pregnant?” I’ve already made it known what I think about our culture and its standards of beauty. The fact that people in our society would rather focus on thinness rather than on the health of expectant mothers and their children is unbelievable. On the other hand, the guidelines for weight gain in the average women should not be ignored. Women who gain 50-100 pounds during their pregnancy are also putting their pregnancy and unborn child at increased risk for preeclampsia, diabetes and caesarean birth.

When the appropriate weight gain is achieved in the normal-sized patient, women who are pregnant should not be ashamed of the weight they’ve gained—every pound that they put on should be worn as a badge of honor, as its proof that they are nourishing a happy and healthy infant with their bodies. When I see a woman who cares more about the health of her child than her dress size, I applaud them for having the courage to do what’s right and to stand up to the standards of our crazy society.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Pregnancy | No Responses »
Tags: Childbirth & delivery, obstetrics, Pregnancy, prenatal health

Know the Facts When Making the Decision to Breastfeed

Thursday, April 25th, 2013

There is not a doctor out there who will deny there are some definite benefits to breastfeeding. Both mother and baby experience these benefits, which range from helping mom to lose some of her baby weight to helping your infant gain greater immunity to childhood diseases. But when my patients ask me whether or not they should breastfeed after they give birth, the last thing I want to do is bully them, or use scare tactics to pressure them into breastfeeding if they don’t think that it is the best option for them.

Perhaps it’s just me, but I think these decisions are best left to the mother. It is not my job as a doctor to make those decisions for you. However, it is my job to make sure that you have the facts, and all the facts, before you decide either way. A lot of women might not know just how many benefits there are to breastfeeding, but on the contrary, a lot of women may have heard information that is just plain false. For example, plenty of people trying to push breastfeeding on young mothers will tell them that mother’s milk can prevent obesity later in life, but studies show that this is not the case at all.

Why is this important to me? Because I don’t think that any woman should be shamed for making the decision not to breastfeed if she doesn’t think that option is right for her. And there are plenty of women who have good reasons not to, whether they produce low amounts of milk, they need to return to work or take care of the rest of the family, or the process is just too painful for them. This is an important choice to make—possibly the most important choice that new parents will make in the first months of their child’s life. I want people to be informed about every option that they have, and will always encourage those who are uncertain about that choice to know everything they can, and to get their information from a source that isn’t trying to push some sort of an agenda. Let’s face it—parenthood is hard. You need information to make the right decisions. And there is absolutely nothing wrong with formula feeding. Unlike the milk from breastfeeding, which is deficient in Vitamin D and iron, formula feeding has enhanced those vital nutrients and there is also a quantitative check on just how much your baby is receiving in milk. There are NO randomized clinical studies or trials (Level I) that have compared exclusive breastfeeding with formula feeding. Therefore, the recommendations made are not based on evidence-based medicine. Breastfeeding sounds good, so it must be good and sound. With breastfeeding, that may not be the case. Each mother has to decide what is best for her family, her baby and her self. A panel of “experts” cannot recommend a course of action based on what “sounds” good without definitive outcomes of the two modes of management. This has not been done when it comes to comparing breastfeeding to formula feeding. Only observational studies exist and they are not the appropriate study design upon which to make decisions about such an important aspect of infant nutrition. The goal is to give your child the nutrition that he or she needs in order to grow.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Pregnancy | No Responses »
Tags: breastfeeding, Childbirth & delivery, obstetrics, Pregnancy

How Exercise Can Cure the Postpartum Blues

Monday, April 1st, 2013

There’s no way around it. Exercise is an effective solution for many of life’s common problems. Many women are constantly trying to find shortcut answers to their ailments, but there is really no alternative for a good old-fashioned workout. Obesity isn’t the only thing that exercise can reverse. Many experts agree that physical activity is an excellent solution for people who are struggling with depression. Since exercise releases endorphins into the brain, it can raise the spirits against all odds. Therefore, it’s no surprise that studies show exercise is a suitable cure for postpartum depression.

Don’t be ashamed if you’re feeling depressed after you give birth. It’s a common problem, and the reasons are clinical. Many of my patients worry that they are already being insufficient parents by feeling unhappy in their first few weeks of motherhood. Let your doctor know right away if you’re having these feelings, especially if they are severe. Once you’re on a treatment plan and are getting help for the problem, you should begin exercising regularly.

Postpartum depression is sometimes simply a misconception of the most common postpartum symptoms. Fatigue, trouble sleeping, a lack of concentration, and irritability are all likely after you’ve given birth. Since these are common signs of depression, you might assume it’s such. Since exercise will give you more energy, help you sleep better, and relieve some negative feelings, it is an easy cure. Additionally, many new moms say that their postpartum depression is partly a result of the isolation they feel when they are at home all day with the baby. Especially after a busy, working lifestyle, the schedule of a stay at home mom can be saddening. Exercise will not only offer a burst of endorphins, but it will also give you an opportunity to spend time with other women in your area at the gym or on the local track.

Postpartum depression can hit even the most excitable new moms, so don’t be surprised if you’re feeling the new baby blues in the weeks following your labor. While you should certainly follow whatever treatment plan your doctor recommends, you should also try getting into an exercise routine. It will improve your mood more than you might think, and the alone time itself will help you clear your head and find your happy place once again.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Pregnancy | No Responses »
Tags: Exercise, postpartum depression, Pregnancy

An Acne Treatment That Requires a Waiver

Thursday, March 28th, 2013

I don’t blame you if you’re desperately trying to find a cure for your acne. Acne is embarrassing and unsightly, and severe forms of it can even cause lifelong scars. Any woman in her right mind would feel the urge to do whatever she could to get that clear complexion you see in the magazines. Unfortunately, one type of effective acne treatment can cause serious birth defects, and it should be ruled out for any woman hoping to conceive even just within the year. Isotretinoin is a medication that can cure the severe type of nodular acne that cannot be cured otherwise. It is usually sold under the brand name Accutane, and women who start taking it actually need to sign a waiver stating that they won’t get pregnant during the prescribed amount of time.

Avoid any type of medication with isotretinoin if you’re hoping to become pregnant someday soon. While your complexion might become clearer, your baby would be born with eye and ear defects, or even cleft palate or serious heart defects. Worse yet, women who take this type of medication soon before their pregnancy often have miscarriages or stillbirths.

Essentially, if you are of childbearing age, seek an alternative to isotretinoin. The risks are too great, and your being on the medication will limit your options if you become pregnant even accidentally. The birth defects are permanent and very serious. While acne is frustrating, it is nothing compared to the lifelong problems that your child might have from a heart defect or the serious and expensive surgery that would be required for a cleft palate.

If you are in your reproductive years and are sexually active, talk to your doctor about the alternatives if he or she prescribes a medication like Accutane with the active ingredient isotretinoin. Though some may not be quite as effective, they are worth a shot to avoid birth complications. Only if you are absolutely sure you won’t be having any children in the next few years should you take the pill; even then, pregnancies can still occur. However, people are famous for changing their mind frequently about starting a family, so don’t make a hasty decision of requesting Accutane. Keep your options open as much as possible and look at the whole picture when it comes to using an acne medication that has the capability of causing birth defects.
– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | No Responses »
Tags: Accutane, acne treatment, birth defects, Pregnancy

A Brief History of the Dangers of Thalidomide in Pregnancy

Monday, March 25th, 2013

In the early 1950’s, a medication called thalidomide was prescribed to pregnant women who were suffering from severe morning sickness and pain. It was considered a sufficient and safe sedative for the problem. However, in the early 60’s, doctors started noticing rare birth defects in babies who were born to mothers on the medication. The birth defects were obvious and common, so experts took a second look at the drug and considered it more critically. As it turns out, their research showed that thalidomide did in fact cause the defects, and current research still supports that finding.

Decades ago, doctors didn’t even know that a medicine taken during pregnancy could actually affect a growing baby. They thought that as long as the drug didn’t kill the mother, the baby would be safe. This was obviously untrue, and thalidomide birth defects proved it. There is a famous photo from 1972 in which a young victim of gestational thalidomide intake is handing Princess Anne a bouquet of flowers with her foot because she was born without any arms at all.

As soon as the finding was discovered, doctors stopped using the medication to treat pregnant women for their ailments. However, it was not completely taken off the market, and some physicians still use it to treat conditions such as Hansen’s Disease. However, you should absolutely not take the medication while you are pregnant under any circumstances. It is one of those medications that will almost infallibly cause a birth defect in your child. If you take thalidomide regularly for a condition, speak with your doctor about a plan for pregnancy before you even start trying to conceive. Your body might need time to cleanse itself of the chemicals, so stopping when you find out you’re pregnant might even be too late.

Your baby bump will become your number one priority in life, so learning about which medications are safe and which are not can help you give your baby the healthiest gestation possible. As long as you follow your doctor’s orders and be careful of which medications you take, be they prescribed, herbal and over-the-counter, more likely than not, you’ll be holding a happy and healthy bundle of joy in no time.
– Yvonne S. Thornton, M. D., M. P. H.

Posted in Pregnancy | No Responses »
Tags: Hansen’s disease, medications, Pregnancy, thalidomide

Cocaine Use During Pregnancy

Monday, March 18th, 2013

When most women find out they are pregnant, they become total health nuts. Everything they eat and everything they do is centered around the proper development of their child. Unfortunately, some women suffer from problems with addiction and cannot jump into a healthy lifestyle so easily. Women who are addicted to cocaine when they find out they’re pregnant have a long way to go. The best option is to never start in the first place. However, if you find yourself using regularly and hoping to have a healthy pregnancy at the same time, here is why you need to quit immediately.

Studies show that cocaine use during pregnancy causes low birth weight, preterm birth, and babies who are born too small for their gestational age. These problems can all create developmental disabilities that last a lifetime. Basically, having a baby too early cuts off some of the most important stages of his or her development, so it’s really important that you try your best to bring a baby to full term by staying healthy.
When you use cocaine while pregnant, you are restricting the flow of oxygen and blood to your baby. Basically, you are suffocating your child. When your child cannot receive oxygen and nutrients in utero, development is slowed down, which is why these babies are usually born too small. They did not grow sufficiently because of the restricted flow. Also, the effect of cocaine on the placenta (the organ that nourishes the baby) often causes it to abruptly separate from its foundation, i.e. your womb, thus resulting in a medical condition known as “placental abruption”. This is life-threatening to both the fetus and the mother. There is no longer any support (or oxygen) for the baby because the placenta has separated from its bed. Along with severe pain in the mother, massive bleeding may occur behind the placenta where it is hidden but still deadly or can be seen as hemorrhage causing exsanguination of the mother. The baby dies and often the mother dies unless there is an immediate cesarean delivery. Often, cocaine-using pregnant women never make it to the hospital in time. Several pregnant celebrities have been whisked off to the hospital for emergency cesareans. I just wonder whether or not they had been using cocaine before they had pain and started bleeding.

If you are struggling with a cocaine addiction and have found out that you’re pregnant, get help immediately. If you wait any longer, you will only make your baby’s problems worse. Find a support group or a rehab center where you can find ways to cope with the addiction and discontinue your cocaine use. For women who use cocaine recreationally, I hope the results of this study serve as a warning sign against using it at all. Not only is it bad for your own body, but if you conceive at any point during your use, you could ruin your baby’s entire life. Give your baby a fighting chance and say no to cocaine during pregnancy.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Pregnancy | No Responses »
Tags: cocaine, drugs, Pregnancy, preterm birth

The Implications of a Prolonged Pregnancy

Thursday, March 7th, 2013

You’ve waited nine long and painful months. Your ankles are swollen, your mood swings are drastic, and your belly feels like it’s about ready to burst. When your due date comes and goes without those telltale contractions, it’s impossible for you not to get a little upset.

However, your doctor or midwife most likely gave you the midpoint of your due month, i. e., 40 weeks (280 days of gestation). Actually, your baby is considered mature between 38 weeks and 42 weeks (266 days to 294 days of gestation). A prolonged pregnancy is any pregnancy that lasts beyond 294 days or 42 weeks. I know you didn’t want to hear that, but that’s the truth. I did my post-doctoral thesis at Columbia on postterm pregnancies and we had mothers pregnant up to 44 weeks. While it seems like a really long time, it’s actually more common than you might think. No one actually knows why a pregnancy is prolonged. There are many theories, but no one has found the reason for a pregnancy going beyond 42 weeks, except in cases of anencephaly.

There is nothing abnormal about a pregnancy going beyond 40 weeks, even to 42 weeks. The best way to ensure that your pregnancy lasts the normal 38 to 42 weeks is to stay healthy and active. Maintaining a healthy weight and avoiding harmful chemicals such as caffeine and alcohol will help you ensure that your pregnancy is as normal as possible. If that doesn’t work though, thanks to advances in modern technology and medicine, there are a few different options for women with prolonged pregnancies. After a pregnancy reaches the midpoint of term, i.e., 40 weeks, your obstetrician may want to test the baby for its well being with electronic fetal surveillance. Changes occur after 41 weeks that may jeopardize the baby’s health if not closely monitored. If mom’s perception of fetal movement is normal, i.e. at least four kicks in one hour, and the testing is normal, it is best to wait for Mother Nature to bring on labor naturally. However, if your physician or midwife has evidence that your baby may be in jeopardy, he or she will choose to induce your labor.

Stillbirth is a concern at any time during the pregnancy, but especially after 42 weeks. The amniotic fluid around the baby peaks at 34 weeks and decreases as the pregnancy progresses to term. That is the reason for monitoring and assessment of the fluid when the pregnancy has passed 40 weeks. The American College of Obstetricians and Gynecologists still defines postterm (prolonged) pregnancy as one extending beyond 42 weeks——not 40 weeks and not 41 weeks. Babies also gain weight in utero with each passing week, so the longer baby is in “the oven” the bigger it will become (but not by much) until it reaches a critical size and then its weight begins to decline. A mother need not worry about delivering a Butterball turkey, if she continues to normally gain ½ to one pound per week. Few babies born after their due date experience any real issues,

Much of pregnancy is up to chance. Once you conceive, the pregnancy is really on “automatic pilot”. From the time of conception to the time of delivery, the outcome of your pregnancy depends on your particular body and the way the hormones are interacting. The word, “obstetrics” means to “stand by”. Therefore, inducing labor in normal pregnancy before 42 weeks violates our very creed. That’s the fun of being pregnant. It’s up to Mother Nature. Some women may deliver at 38 weeks (which is normal for a term pregnancy), while others may deliver at 42 weeks (which is also normal). Both of my children were delivered beyond 42 weeks and both are Ivy-league graduates and totally healthy.

Try not to fret or force your doctor or midwife into inducing labor, which may not have been in the cards (or the best interest of your baby), only for you to end up with a cesarean birth rather than a natural one.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Pregnancy | No Responses »
Tags: birth, due date, labor, Pregnancy

Conception and Congestion

Monday, March 4th, 2013

You probably thought you knew all there was to know about pregnancy. You’ve read all the books, talked to your obstetrician, visited every website, and browsed every forum. At this point, you probably feel like a pregnancy expert. Believe it or not, there are probably still some symptoms you don’t even know about.

Many of my patients come to me complaining about harmless but bothersome conditions during their pregnancy wondering if their issue is out of the ordinary. One common complaint is congestion. It is more worrisome than other symptoms because most women who experience it think they might be coming down with a cold, which they worry might harm their baby. Luckily, congestion is completely normal, and it makes sense when you consider the cause.

Your blood volume increases during pregnancy and many of your blood vessels expand to accommodate it. Since there are tiny capillaries and vessels in your nose, their expansion causes a drastic change in the nose’s structure. The stuffiness you’re feeling during pregnancy is not a result of mucus. Instead, it’s the larger blood vessels blocking air from flowing in and out normally.

Studies show that two-thirds of all women report severe stuffiness during their pregnancy, so it is not at all uncommon. Usually, it is mild enough to not cause any serious problems, but let your doctor know right away if it seems to be affecting your ability to breathe normally. It could also affect your ability to exercise, so bring that up with your physician as well.

Congestion is one of those weird pregnancy symptoms that your doctor didn’t warn you about. It is harmless, which is why people usually don’t even report it. It is still common, inconvenient, and uncomfortable though. There is no treatment to alleviate the congestion safely, but cigarettes can exacerbate the problem, so make sure you quit if the symptom is a problem. In fact, you should quit either way.

While congestion is completely harmless, it’s okay if you still want to bring it up with your doctor if you’re concerned. As a physician, believe me when I say that there are no silly questions during pregnancy. I actually like to see women who really pay attention to their bodies, because they are the ones who take care of themselves and their growing baby best.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Pregnancy | No Responses »
Tags: congestion, Pregnancy, pregnancy symptoms