preterm birth

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Pregnant Women and Work Concerns

Monday, November 25th, 2013

In 2012, women account for 47 percent of the salaried labor force in the United States (http://www.catalyst.org/knowledge/statistical-overview-women-workplace). It’s only natural that concerns would arise regarding pregnant women and working. Today, many pregnant women plan to work throughout their pregnancies – probably too many. Pregnancy alone places an extraordinary amount of stress on a woman’s body, and it is extremely important to get enough rest. The decision to stop working can be a tough one, financially, emotionally, and socially, but it may be essential to protecting maternal health and the health of the baby.

If a woman cannot stop working or chooses to work despite the risks, she should be aware of safety precautions that must be taken in order to minimize the risks involved. Even if she sits at a desk all day, she must remember to get up and move around regularly, drink plenty of water, and eat a healthy diet – those office fast-food runs aren’t going to cut it. If she stands for an extended time as a supermarket cashier, hairstylist, bank teller, etc, the pregnancy may be at risk for preterm delivery.  Therefore, she must walk around or sit down every hour or so.  Getting enough iron, calcium and protein may help somewhat with fatigue, but women should realize that fatigue is their bodies’ way of telling them to rest, so that’s what they should do.

Pregnant women should take steps to stay as comfortable as possible, including making sure the chairs they sit in are supportive, that they are not standing for prolonged periods of time, and that they are not doing excessive bending or lifting. Heavy lifting and twisting while lifting should be avoided altogether. Exposure to harmful substances should also be avoided.

A pregnant woman who works should seriously consider ways to cut back on activities in other areas of her life. For example, shopping online can create more time for rest. Or, if possible, hiring a service to clean the house or do yard work or enlisting the help of other family members is a good idea. She should also do everything in her power to get enough sleep, including going to bed early and lying on her side with pillows between her knees and under her belly for maximum comfort and to prevent swelling in her feet.

It will also be important to keep stress under control. Pregnant women should do what they can to reduce workplace stress. For example, making to-do lists and prioritizing tasks can help them take the work day one task at a time as well as identify tasks that can be delegated to someone else. Taking a few minutes alone to practice some relaxation techniques several times a day can keep stress at a minimum, as can having someone to talk to about frustrations.

The bottom line is that women should discuss their jobs with their health care providers to determine whether they need to make other arrangements for the duration of the pregnancy. A woman who is at risk for preterm birth should not work, period – she should be focused on resting with her feet up and drinking plenty of water. Although pregnancy is a normal physiologic process, the workplace may be unkind to a pregnant woman and if that is the case, a pregnant woman should seriously consider giving up her job, if at all possible, or at least cutting way back on her hours.

– Yvonne S. Thornton, M. D., M. P. H.

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.

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.