Pregnancy

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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.

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Risk Factors For Urinary Incontinence

Thursday, May 23rd, 2013

There can be a lot of embarrassment associated with urinary stress incontinence, and a lot of women may feel like they can’t talk about it with anybody—even their doctor. However, those women should know that there is nothing to be ashamed of. It’s a fact of life that many women will have to deal with throughout their lives, whether it is after pregnancy, the result of aging, or due to any other number of causes.  In fact, with this study you can see just how many risk factors there are for UI. Moreover, UI (urinary incontinence) is not something to be ashamed of because it is the particular structure of women’s bodies that causes it to be so prevalent in the female gender.  It is also not related to the mode of delivery, i.e., cesarean vs. vaginal delivery.  Nuns have the same prevalence of urinary incontinence as mothers.

UI doesn’t necessarily mean you can’t hold it in at all—it simply means that there may be times or situations where women experience a little leakage, or there may be times when they are unable to “hold it” completely until they reach a restroom. Women may experience UI when they laugh or sneeze, or they might simply find the need to wear a panty liner throughout the day. It is a myth that there is nothing that can be done for UI.

The first and most important step in dealing with this issue is to speak with your doctor and specifically a urogynecologist. This is absolutely necessary, as there may be medical causes for sudden UI. If there are no medical causes, there might be other causes for UI, such as smoking.  If the cause is something like obesity, simply losing some excess weight can help. Your doctor can also recommend exercises that can help strengthen the pelvic wall and reduce UI. In extreme cases, your doctor may even recommend surgery to treat urinary incontinence. However, nothing can be done if patients are unwilling to speak to their doctor about the problem. Communication is always the first step in treating any issue.

– Yvonne S. Thornton, M. D., M. P. H.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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Your High Blood Pressure Meds May Have to Wait

Thursday, March 14th, 2013

The importance of being healthy before going into a pregnancy cannot be stressed enough.  While it’s true, many women find out they’re pregnant and immediately alter their lifestyles to something healthier, this is not always immediately possible.  In fact, there are some ailments that can’t be medically treated once you get pregnant because of the dangers to the baby.  High blood pressure, in some cases, is one of these issues.

According to the New England Journal of Medicine, doctors studied more than 29,000 infants in Tennessee who were born within the years of 1985-2000.  209 of those babies were exposed to ACE (angiotensin-converting enzyme) inhibitors during the first trimester and 202 more were exposed to other medications also prescribed for hypertension.  Upon birth, they found that the infants exposed to ACE inhibitors were more likely to develop congenital defects.  These included malformations in their cardiovascular systems and central nervous systems, as well as kidney abnormalities.  These findings have led them to believe that exposure to ACE inhibitors during the first trimester is not safe for developing babies and should be avoided.  Luckily, exposure to antihypertensive medications not classified as ACE inhibitors did not seem to increase the risk of defects.

This is why it’s so important to get medical issues like high blood pressure under control before deciding to get pregnant.   Preconceptionally, there are other things you can try besides medication. Try to exercise, lose that extra weight around your waistline and eat a healthy diet.  In this diet, you should restrict your intake of sodium, if at all possible.  However, if you find yourself pregnant and still struggling with hypertension, your obstetrician or perinatologist will prescribe antihypertensive medications that are safe for pregnancy.  Continued high blood pressure during pregnancy is not good for you or the baby.  You may suffer a stroke or develop kidney compromise and the baby may be born very small or not survive the pregnancy.

So, although high blood pressure may have an adverse effect on your pregnancy, and some medications may be harmful to the health of your fetus, taking the right medication to control it can make all the difference in the world.

– Yvonne S. Thornton, M. D., M. P. H.

 

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