Childbirth & delivery browsing by tag


It Is Okay to Decide Not to Have Kids

Thursday, August 15th, 2013

For many women, the choice to become a mother is an easy one. To these women it feels natural; they look forward to it and, usually, love it once it happens. For other women, the choice is also clear – the choice not to become a mother. For many women, this is an easy choice to make, but not such an easy one to share with their loved ones. After all, we still live in a culture that expects women to become mothers. A girl becomes a woman, gets married, and has kids. A woman who deviates from this plan is somehow “wrong.” Women have fought so hard over the years for equal rights, including the right to make choices for themselves – so why are we still so hard on women who make the choice to remain child-free?

Lately, the ranks of childless women have been speaking up in a big way. They are making themselves heard loud and clear: We don’t want kids. Period. Not, we don’t want kids now, but we realize we might change our minds later. Not, we can’t have kids. But we don’t want them. It is not going to happen.

These women will not be made to feel guilty because so many women want kids but can’t have them. Nor will they buy into the idea that they are selfish or bad because they choose freedom over babies. And they do not accept the premise that they somehow do not understand their own desires or “will change their minds later.” They are bravely claiming for themselves lives of free time, solitude at will, career immersion, or vacations at the drop of a hat – basically, they are choosing to do what they want to do, when they want to do it.

Unfortunately, an “us and them” mentality has begun to take shape around this issue. Moms, understandably, get defensive when they feel like their choices are being disparaged. Childless women feel ostracized by moms. This is a disturbing trend that we should nip in the bud, because women can potentially be such a great support system for each other.

And let’s be honest: the fact of the matter is that no matter what you choose, you are going to be judged for it. You are either fat and lazy or thin and stuck-up. You are either poor and uneducated or rich and mean. You are either a bad mother with too many kids or you are a selfish, close-minded woman with no kids. You can’t please everyone, and sometimes, you can’t please anyone but yourself. So please yourself. Life is short; how you live yours must be your own choice.

As women, it’s time we stop tearing each other down and start empowering each other to make individual choices – and supporting each other in those choices. It’s not “us and them.” We are all still women, with dreams and plans and feelings. Let me empower you: it’s okay not to have kids – and it’s okay to have them. No one can make the choice for you but you.

– Yvonne S. Thornton, M. D., M. P. H.

Obesity a Direct Cause of Preterm Birth

Monday, June 17th, 2013

Though mothers shouldn’t be forced to think they need to remain svelte throughout their pregnancies, and shouldn’t be shamed of healthy weight gain during pregnancy, there is one serious issue that women need to keep in mind when they are preparing to become pregnant. It is impossible to plan out every step of a pregnancy, and there will always be unexpected complications that arise during the 40 weeks to delivery. However, there are precautions that women can take to prevent serious problems and to decrease the risk of preterm delivery, according to one study.

One of the biggest risk factors for preterm delivery is obesity in pregnant women. One study in Sweden has shown that not only is preterm delivery a risk, but some obese mothers shown signs of extreme preterm delivery. Even though this cohort study was conducted in a country that is not as heterogeneous as the United States, this is a serious concern, and one that may have serious implications for both doctors and potential parents. The most important thing for everybody involved in a birth with one of these risk factors to keep in mind is that such complications are not only possible, but that they are heightened due to the circumstances. Everybody involved must make plans for the possibility of an earlier birth, and everybody involved should be more open to the possibility of safety measures such as bed rest, gestational diabetes, kidney and heart problems as well as a host of other medical issues that can arise. In general, women who are obese when pregnant will likely need to be in contact with their physician more often than a woman who maintains a healthier weight.

Women who have not yet become pregnant and who are considered obese may want to speak with their doctors about their options before pregnancy. Even a small weight loss can be enough to curtail some of the biggest problems related to pregnancy, while a significant weight loss can have even more lasting effects. However, remember that any weight loss plan must be discussed in detail with your doctor—making yourself unhealthy just to drop a few pounds will not do your or your family any favors.

– Yvonne S. Thornton, M. D., M. P. H.

How Does “Bedside Manner” Affect Patient Pain?

Thursday, June 6th, 2013

You’ve probably heard somebody talk about a doctor’s “bedside manner”. It can be fun to watch television shows such as House, M.D., where the doctor is not-so-nice to his patients, but there is a very real reason that doctors like this are often not successful in the real world, and why part of a doctor’s medical training includes learning how to communicate with their patients and treat them appropriately, especially after a major medical event such as childbirth or surgery.

While you can guess that the way a doctor interacts with their patient can affect their psychological well-being, you might not have considered the fact that the same interaction can influence the patient’s perception of pain. In fact, one study has shown that discussing pain with patients who have had a Caesarean childbirth adversely affects their perception of pain, and can actually make them feel worse.  This raises several important for both doctors and patients as they consider what it means to have a good “bedside manner”.

There are two ways to quantitate the perception of pain.  One is a numerical scale ( and the other is a visual analog pain scale, also known as the FACES or Wong-Baker scale (,   These pain scales allow the physician or nurse to get a better idea of the extent of the patient’s discomfort.  Still, even with these pain scales, some doctors still will act like “House”.

Talking about pain  is also a complex issue because it forces both doctors and patients to consider how they will manage pain and discomfort after surgery or childbirth. On the one hand, it is important for the doctor to know that their patient is feeling all right, and that there are no potential complications that need to be addressed. Some patients, especially those who have never undergone major surgery before, may feel that certain types of pain are “natural” and will not speak about these issues with their doctor. However, if asking about pain leads to negative effects, it important for doctors to choose their wording carefully in order to acquire the information they need while still aiding in their patient’s comfort.

It is always important for patients to have a doctor whom they feel that they can trust—who they already know through interacting with them has a bedside manner that meets their needs. This is especially important for women who are preparing to give birth, as they will want to heal as quickly as possible so they can begin to care for their newborns.

– Yvonne S. Thornton, M. D., M. P. H.

Even External Products Can Pose Risk to Expectant Mothers

Monday, May 27th, 2013

As an expectant mother, women will hear any number of dos and don’ts. Being pregnant forces women to learn an entirely new way to treat their body, as certain chemicals can cause a great deal of harm to developing fetuses. It is likely that almost all pregnant women know the risks of drugs, alcohol, and tobacco, and a great deal will choose not to drink heavily sugary or caffeinated drinks for the duration of their pregnancies in order to prevent potential damage due to changes in their bodies from these products.

However, many patients still do not understand the importance of monitoring the products that they use externally. Chemicals can just as easily be absorbed through the skin, and can cause as much damage as if they were ingested. This is why women who are pregnant are asked not to dye their hair or to expose themselves to other chemicals until their child is born. For evidence of how easily chemicals can enter into the body, look at this case study in which a pregnant woman was found to be host to considerable amounts of mercury due to a face cream she had purchased in Mexico.

Though that list of dos and don’ts can seem pretty exhausting, there is one easy rule-of-thumb that expectant mother’s can use when it comes to the products that they choose to use during their pregnancy. When it doubt, it is always better to be safe than sorry. Put that food or that product aside if you are uncertain about it and talk to your doctor. He or she will be more than happy to help you decide whether or not the product that you are using is safe for you and your baby. The harmful effects of some chemicals to the body far outweigh the benefits of soft skin or the perfect hair color.

– Yvonne S. Thornton, M. D., M. P. H.

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.