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West Nile Virus Without the Bite

Thursday, August 23rd, 2012

Another West Nile Virus scare is sweeping the nation. In fact, many regions have declared states of emergency due to the number of infected people in their area. This has led to more spraying and other strategies meant to kill mosquitos carrying the virus and to prevent them from breeding further this year. It’s not just the bite of those mosquitos that can transmit the virus though, which is making some mothers nervous.

Approximately, two weeks after being bitten by a mosquito carrying the West Nile, the virus finishes its incubation period and the infected person may start noticing symptoms. Although they cannot transmit the disease through any sort of casual contact, there are a few ways someone could accidentally pass the illness on to someone else. This can occur as a result of blood transfusions and organ transplants, telling us that the blood plays a major role in transmission. That also means that mothers can pass the virus from their blood to their unborn babies or even to a baby they are breastfeeding. This is not common, as least as far as documentation shows, but it is possible. If you are pregnant or breastfeeding and have begun to feel ill after being bitten by a mosquito in the past couple of weeks, you may want to speak to your physician just to make sure it is not West Nile. While some people never develop symptoms, those with compromised or delicate immune systems, such as the elderly, babies, and pregnant women, could contract more severe cases with symptoms like swollen lymph nodes, rashes, fever, aches, and nausea. In a small percentage of cases, the virus is fatal, but this is rare when it is caught and treated early.

For the most part, this West Nile scare is exactly that- a scare. In truth, more people die every year from the common flu than from any outbreak of West Nile thus far. However, that doesn’t mean you should ignore any symptoms if you suspect you may have it, especially if you are pregnant. In the meantime, get rid of standing water near your home, stay inside during dusk and dawn hours, and wear a safe repellent if you think you will likely be around mosquitos. When you’re carrying or caring for your baby, it’s always better to be safe than sorry.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Pregnancy, Women's health news | No Responses »
Tags: Pregnancy, virus, west nile

PTSD from Infertility?

Monday, August 13th, 2012

Normally, when you think of post-traumatic stress disorder, you think of soldiers returning from battles with a foreign enemy, not women battling infertility. Surprisingly though, researchers have found that women undergoing fertility treatments are highly likely to develop PTSD and are calling for a change in the definition of the disorder.

Based on a survey conducted by Allyson Bradow who is the Director of Psychological Services at Home of the Innocents, 50% of women who went through fertility treatments met the criteria for PTSD. As a result of their stressful experiences, infertile women are 6 times more likely to suffer from PTSD than the general population. This has led some to believe that perhaps the definition for PTSD needs to be expanded. Currently, its definition limits its diagnosis to those who have “experienced or witnessed a life-threatening event or [an] event that could cause serious injury.”

Bradow believes that it should also be diagnosed for those who have experienced trauma due to the failure to meet expectations for life.

The ability to procreate is believed to be a fundamental life process. Trauma is defined as a wound or injury. The word origin of injury comes from the Latin “injuria” (in = not + jus = right) and its definition is to cause one to suffer hardship and loss undeservedly and unexpectedly. Therefore, if one loses his/her ability to procreate, this satisfies the definition of trauma. It is not uncommon for couples struggling with infertility to suffer from anxiety, depression, and other related symptoms. Any time a person’s heart is set on something, particularly a life accomplishment like procreation, they are bound to react extremely emotionally to a negative outcome. Some find procreation so important, that they feel they have not lived up to the expectations of life when they cannot conceive and are severely traumatized by it. Whether or not this stress can be considered PTSD or not is yet undecided. What is clear though is that infertility physicians and clinics need to ramp up their counseling services. If infertility is an unfixable issue, then couples need help finding a way to be content with it, so they can live emotionally- and mentally-healthy lives.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Fertility & Infertility, Women's health issues, Women's health news | No Responses »
Tags: fertility, infertility, Pregnancy, PTSD, Women’s health

Don’t Forget to Ask

Monday, August 6th, 2012

When you are pregnant, there are a lot of things running through your mind at once, most of them being questions. As the date of delivery approaches, those questions become all the more important and all the more difficult to remember to ask. Here are a few important ones that you should add to your list.

What if My Doctor’s Unavailable?

Although your physician may have set a due date, that is only a best guess as to when you will actually deliver. Normally, your doctor will try to be available for a delivery in the week before and after that date. However, extenuating circumstances or a very early delivery could cause them to be unavailable when you need them. Instead of panicking when the time comes and taking whoever happens to be available, plan for this situation ahead of time. Speak with your doctor about potential back-ups. Ask who they recommend and if you can get their numbers for your on-call list. It might also be a good idea to meet them, so if they do end up delivering your baby, you will have already established a relationship with them, making for a more comfortable experience.

Who Can Come with Me?

Back in the day, women would bear their pain alone but for the doctors and nurses in the delivery room, but now, most moms want to bring in the father, or at least some trusted family member or friend. For a standard delivery, this shouldn’t be a problem, but if there are complications, they may be asked to leave so that doctors have more room to work. Normally, they will ask you to restrict access to the delivery room to one or two people and with all the chaos birth can bring, you’ll appreciate not having too many people around. If you will be having a C-Section surgery though, having someone in the delivery room may or may not be possible. Be sure to ask before promising access to anyone.

Will Someone Be There to Show Me?

Some women panic a bit after going through delivery and finally getting the chance to be alone with their new baby. They suddenly realize that they don’t know how to change a diaper or that breastfeeding is harder than it looks. Luckily, there are people on staff at the hospital who can guide you through your first attempts at these tasks. They can give you tips to help you get your baby to latch for breastfeeding and show you the proper way to take care of their sanitary needs as well. Ask your chosen hospital about who they have available to go through these questions with you once you have delivered.

If you have more questions, be sure to join me for my live webcast, Inside Information for Women, every Thursday at 1pm Eastern. I can take your call and do my best to answer any burning questions you might have regarding your pregnancy, delivery, or women’s health in general. In the meantime, if your due date is approaching, be sure to write down the questions you have, so you will remember to ask each one at your next pregnancy check-up. That way, when your baby and body are ready to deliver, your mind will be ready too.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Fertility & Infertility, Parenting, Pregnancy, Women's health issues | No Responses »
Tags: c-section, delivery, Pregnancy, Women’s health

What’s Making Depressed Mom’s Deliver Early?

Monday, July 30th, 2012

Nothing messes with our hormone’s more than pregnancy, which is why we feel so emotional during that time. These emotions can certainly run the gamut, but when a tearful moment turns into weeks of depression, it’s time to call your physician. There are studies pointing to depression as a factor when it comes to some premature births. Besides that, it is simply a dangerous state in general for a pregnant or new mom to be in.

Researchers for the North Shore University Health System at the University of Chicago studied 14,000 pregnant women. Their results showed that among the women who were clinically depressed, 14% delivered before their due date. In women who were not depressed, preterm births were only at 10%. Although 4% may not seem like much, when you’re talking about the health of your newborn, 4% is a big increase in odds. The study did include socioeconomic factors as well, but did not study some other confounding variables. Despite those flaws, the study found depression to be the common thread in many of the preterm births.

However, this doesn’t mean that being depressed will definitely lead an early delivery. The way people handle depression can also affect their health and the health of their unborn baby. Women using antidepressants, eating more comfort foods, drinking or using drugs could all be increasing these odds by not taking care of their depression properly. Fewer than half of pregnant women in the U.S. are screened for depression. It’s always a good idea to seek out the advice of a physician before self-medicating, whether you are pregnant or not. A good physician will try to determine the underlying cause of your depression instead of simply treating it. Also, while it hasn’t been proven that antidepressants themselves may be linked to preterm births absolutely, there are studies suggesting a correlation. Upon speaking with your physician, they may be able to offer alternative therapies for treating your depression rather than trying to prescribe medication to stop preterm birth——because that medication usually is ineffective with potentially harmful side-effects.

This information isn’t really surprising, as stress has long been known to have negative effects on pregnancy. With depression being yet another source of stress for soon-to-be mom’s, and a medically-diagnosed one at that, you would be wise to take note of your mood. It probably won’t stop swinging, but at least that’s better than slipping into long-term sadness.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Pregnancy, Women's health issues | No Responses »
Tags: depression, Pregnancy, preterm birth, Women’s health

Pregnancy and Power? It’s About Time!

Thursday, July 26th, 2012

Although many of us have gone through a pregnancy and maintained a rigorous career at the same time, it’s not something you often see when it comes to Fortune 500 positions. Really, you don’t see many women in Fortune 500 leadership positions at all. With Yahoo’s hiring of Marissa Mayer as their new CEO though, they now have both and she’s getting a lot of media attention as a result.

When Yahoo made the controversial move to snag Mayer away from Google, it wasn’t her intelligence and obvious experience that made the media pounce on the story. Instead, it was her pregnancy. People just couldn’t understand why Yahoo would take on a pregnant woman to save their downward sliding company. Obviously, their process for selection has been long and they’ve done their research regarding who has the ideas and skills necessary to turn their company around. When their first pick got caught lying on his resume, they didn’t take long to convince Mayer to leave Google, their main competitor.

Some say that Mayer will not be able to devote the kind of time and energy needed to revive the company as she gets further into her pregnancy and especially during maternity leave. It seems that these people have never met a modern woman. Most American mom’s work 40 hour plus weeks and take care of two or three kids, all while performing well at their positions. In fact, according to the Bureau of Labor Statistics, seventy percent of American women with children under the age of eighteen are earning a paycheck while raising their children. It’s shocking to realize that Mayer is the first pregnant Fortune 500 CEO ever. Why can’t a woman use her uterus and her brain at the same time? Has it really taken us this long to get over female stereotypes, particularly those concerning pregnancy? This is the ultimate in multi-tasking. I know for a fact that both career and family can be balanced in a successful way. In fact, I feel that it is my family who gave me the strength to achieve success in the first place. My second memoir, Something to Prove, chronicles that journey. I’m sure the arrival of Mayer’s baby will only drive her even harder to realize her career goals and those of Yahoo as well. As far as seeing a pregnant woman in such a powerful position, I’d say it’s about time!

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Parenting, Pregnancy, Something to Prove: Memoirs of a Ditchdigger's Daughter, Women's health issues | No Responses »
Tags: Marissa Mayer, maternity leave, Pregnancy, Women’s health

Postpartum Anemia May be Avoided with Iron Supplements

Thursday, June 7th, 2012

Most women know that because of their menstrual cycle, it’s a good idea to take iron supplements to replenish the minerals lost during that time of month. Otherwise, their deficiency could lead to anemia as well as other symptoms. What women should also realize though is that iron deficiency is a big factor in causing postpartum anemia as well.

When you give birth, you are immediately thrown into a chaotic new schedule, added responsibility, and the constant task of taking care of a very fragile new human being. Of course, as the child’s mother, you no doubt find great joy in this responsibility, but that doesn’t make it any less exhausting. If your iron levels after giving birth aren’t where they should be, that exhaustion can be a lot worse. Iron deficiency can cause people to feel exhausted, to have low endurance for physical activities, to struggle with short-term memory, to find themselves unable to focus, and to feel depressed and irritable. When a mother gives birth, it puts a lot of stress on her body, which can cause imbalances and a decrease in iron levels in particular. This is why it’s so important for women to maintain a very different diet when they are pregnant, about to give birth, and breastfeeding. A study in the Journal of Obstetric, Gynecologic, & Neonatal Nursing states very clearly that, “the increased iron requirements of pregnancy cannot be met by the typical US diet or the iron stores of most women. Therefore, if women are left unsupplemented during pregnancy, they bear a considerable risk of developing iron deficiency,” which in turn increases their risk of postpartum anemia. Other factors that can increase that risk include short intervals between pregnancies, because they don’t allow a woman’s body time enough to recover, and cesarean deliveries, which usually include more blood loss.

If you’ve ever been through a pregnancy, you know just how much it takes out of you. This can make it difficult to determine whether you are just “new mom tired” or medically ill tired. This is why it is imperative that you keep your physician as up to date as possible when it comes to exactly how you are feeling, whether physically, mentally, or emotionally. This way, you can work together to make sure your vitamins and minerals stay balanced, along with your overall well-being.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Pregnancy, Women's health issues | No Responses »
Tags: iron deficiency, Postpartum anemia, Pregnancy

Just Because You’re On the Pill, Doesn’t Mean You Won’t Get Pregnant

Monday, May 28th, 2012

With contraception so much in the news lately, it seems that we have heard all there is to say about it. A recent study regarding birth control though, has something quite different to say that definitely deserves our attention. It’s evident from the attention that political contraceptive debates received that there are a lot of women in the US who take the pill or some other form of birth control. According to the American Journal of Obstetrics and Gynecology though, many of those women wrongly assume that their contraception is infallible.

According to the Guttmacher Institute, 99% of women of reproductive age who have had sex use contraception. That’s a lot of women, but Researchers at Washington University in St. Louis found that a shocking 45% of those women believe that contraception can prevent pregnancy 100% of the time. With so many people taking birth control under this false assumption, it’s obvious there’s a need for education and media exposure. While the pill, which is the most popular form of contraception, is mostly successful at preventing pregnancy, it can indeed fail between 2%-9% of the time. And that’s the failure rate if you remember to take it every single day. The failure rate can increase when women miss pills, are in their first month of taking the pill, switching dosages, or taking medications like antibiotics, migraine medications, or antidepressants. Condoms have an even bigger failure rate of 15%-24%. This is why it’s so important for women to discuss their birth control options with their physician, and that discussion should include how effective each option is. The rates of contraception failure with respect to perfect use and average use are outlined in my health book, Inside Information for Women. Hopefully, that chapter will give you a better understanding of the types of contraception offered, their effectiveness and their applicability to your lifestyle.

This information shouldn’t make anyone panic, because as a whole, birth control is fairly effective, especially when compared to not using any contraception at all, which has a failure rate is 85%! However, knowing more about failure rates should make people aware of the actual risk involved in being sexually active, even while taking birth control. This information probably won’t cause people to think again before having sex, and it may not prevent unintended pregnancies. At the very least though, it gives parents like me yet another reason to teach our children that sexual activity does have consequences and is better saved for a time in our lives when we are ready to be responsible for our actions.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Contraception (birth control), Fertility & Infertility, Pregnancy | No Responses »
Tags: birth control, contraception, Pregnancy

Great Scores Don’t Necessarily Mean Great Doctors

Monday, April 16th, 2012

If you’re planning to go into the medical field like I did, then you’re probably aware of the strict application process most medical schools will put you through. If you don’t have the right grades or MCAT scores, you might not get into the school of your choice, no matter how badly you want to help people. Unfortunately, this means top medical schools are letting in bright students who are great test takers, but who can’t take care of patients.

Being a physician is about much more than memorizing information from medical encyclopedias and science classes. I’ve found that a strong sense of empathy and compassion for others, as well as a generosity of spirit has been crucial to my success in medicine. It allows me to put myself in my patients’ shoes, which in turn gives me a better sense of what to ask and what to look for.

Many aspiring doctors don’t have the grades to get them into the top schools, but they may have more emotional intelligence than the students who beat them out for those spots. Eventually, the positions of physicians are filled with very smart people who just don’t seem to take the time or care patients need. It takes patience to listen to everything a patient has to say and then to dig even deeper. It’s not about solving a puzzle as fast as possible. It’s about understanding underlying issues that may not be obvious at first glance and knowing how to uncover them tactfully. It all goes back to bedside manner, which seems to have disappeared in an absurd dichotomy of doctors having the attitude “I know it all and you know nothing”. Doctors must listen to patients. Our patients know their bodies better than their doctors do. After all, patients live in their bodies. We only visit those bodies.

Luckily, after three years of study, the American Medical Association has realized this and is encouraging medical schools to look deeper into their potential students than just their test scores. As a result, many are adding comprehensive interviews that attempt to find out who the applicant is as a person, not just as a student. The Association of American Medical Colleges has also announced that it will be changing the scope of the MCAT exam to include more emphasis on psychology, sociology, and biology. President of the AAMC, Darrell Kirch, said about the changes, “Being a good doctor is about more than scientific knowledge. It also requires an understanding of people.” I couldn’t agree more, and I hope this changing philosophy will help bring patients more compassionate and effective doctors.

— Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Health care policy, Women's health news | No Responses »
Tags: doctors, med school, medical school, medical training, Pregnancy

In came Beyoncé and the security guards. Out went the hospital’s common sense—and common decency.

Friday, January 13th, 2012

As an OB-GYN who has delivered thousands of babies—including several with rich and famous parents—I’m scratching my head over the insanity at Lenox Hill Hospital in New York City surrounding the birth of Beyoncé’s baby.

Here’s a sampling of what went on, according to The New York Times:

The familiar area outside the neonatal unit had been transformed: partitions had been put up, the maternity ward windows were completely covered, and even the hospitals’ security cameras had been taped over with paper. Guards with Secret Service-style earpieces roamed the floor.

“We were told we could walk no further,” Ms. Nash-Coulon said Monday. And when she and her husband, Neil, demanded an explanation, she added, the guard claimed, unconvincingly, “ ‘Well, they’re handling hazardous materials,’ ” even as a large group of people screened from view were passing through the main hallway he had declared off-limits.

Let me make this perfectly clear: The hospital had no right to bar other patients from having free access to their babies. Worse, from a safety perspective, doctors were prevented from visiting their own patients on rounds, because of this so-called “security.”

Someone in the hospital decided that the celebrity of a hip-hop artist was sufficient to ignore medical necessity and common decency. Not a good message to send to sick people.

Beyond that, I’m alarmed to learn that the baby was born by Cesarean, as so many celebrity babies are today. I could be mistaken, but I doubt that Beyoncé’s OB-GYN warned her of the risks before treating little Blue Ivy’s birth like just another item on the to-do list. The risks are real: a dramatic increase in maternal deaths due to hemorrhage and infection; more babies ending up in the neonatal intensive care units after Cesarean births because of respiratory distress.

If she’d been my patient, I’d have told her what I tell other mothers-to-be: if God wanted women to have Cesareans, he would have put a zipper in the pubic area.

– Yvonne S. Thornton, MD, MPH

Posted in Childbirth & delivery, General health news, Women's health issues | 1 Response »
Tags: baby, Beyonce, Blue Ivy, Cesarean birth, Childbirth & delivery, Lenox Hill Hospital, Pregnancy

Baby’s tastebuds mirror Mom’s food choices?

Wednesday, November 30th, 2011

You’ve probably heard the claim that exposing a baby in the womb to Mozart will increase his or her IQ. Despite the hype, the research doesn’t support major leaps in smarts (but, if nothing else, it might improve your child’s musical taste, later on).

Now, there’s some evidence showing that you may be able to shape a yet-to-be-born child’s taste in food.

“The flavor and odors of what mothers eat show up in the amniotic fluid, which is swallowed by the fetus, and in breast milk. There is evidence that fetal taste buds are mature in utero by 13 to 15 weeks, with taste receptor cells appearing at 16 weeks, according to researchers.

“’With flavor learning, you can train a baby’s palate with repetitive exposure,” said Kim Trout, director of the nurse midwifery/women’s health nurse practitioner program at Georgetown University.

“Trout recently co-authored a paper that reviews the evidence on prenatal flavor learning and its implications for controlling childhood obesity and diabetes, among the country’s most pressing health problems…”

Although I’m just as skeptical of this claim as I am about the one for baby-and-Mozart, I see real benefit in giving this a try, whether it makes your baby want broccoli or not. That’s because, in my practice, I see too many women gaining too much weight during pregnancy, which can not only cause complications for mother and baby, but can be almost impossible to shed once your baby is born.

So, bring on the Brussels sprouts, and eschew the Twinkies. Pass by the apple pie and bite into a nice juicy apple instead. Whether it does a thing to change your baby’s mind about what tastes good later in life, it will do a world of good for you both right now.

– Yvonne S. Thornton, MD, MPH

Posted in General health news, Pregnancy, Women's health issues, Women's health news, Your newborn baby | No Responses »
Tags: babies, baby, baby's tastebuds influenced by what mom eats when pregnant, diet, fetus, infants, newborn, Pregnancy