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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.

 

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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 »
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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.

 

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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 »
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Fertility Financing Becomes a Popular Option

Thursday, July 19th, 2012

How much is a baby worth to a couple trying to get pregnant?  It’s likely priceless, but to the lending industry, it’s worth millions.  Apparently, because of the steep cost of fertility treatments, some couples are turning to financing to get enough money to improve their odds of having a child.

One couple in Rockville, Md, Jill and Tom Clinton, tried desperately to get pregnant, but after a heartbreaking miscarriage, they decided to try a fertility clinic.  Unfortunately, the cost of the average in-vitro fertilization cycle is about $12,000 and their insurance wouldn’t cover any of it.  Additionally, it often takes several cycles to get good enough odds for a successful pregnancy.  In order to make it happen, they drained their savings and were happy to receive a baby boy from that investment.  When they wanted a second child though, there was no money left for fertility treatments, so their doctor told them about the possibility of getting financing.  After more research, they found that fertility financing companies are being created around the country and the industry is growing fast.  It’s so popular in fact, that Capex MD, the company the Clintons decided to use, funds a whopping one million dollars in fertility loans each month and that number is rising steadily.

It appears unclear as to why this new industry is growing so fast.  Some speculate that more couples are trying to get pregnant later in life and so are more likely to need fertility treatments, while others believe it’s simply the new option that is giving rise to the results.  Couples who previously couldn’t afford in vitro fertilization now have the option to get financing and so they do.  Either way, it is causing concern among medical ethics committees like the one at Langone Medical Center.  They wonder if lending companies aren’t taking advantage of the desperate nature of couples in this situation, seemingly holding a miracle right in from of them.  Arthur Caplan, head of the Langone Medical Center Ethics Division worries that couples are “not going to hear the failure and success rate, the interest rate, and what the risks are of the treatments.” Instead, couples may only pay attention to the idea that there is one more opportunity to allow them to give pregnancy another try.

– Yvonne S. Thornton, M. D., M. P. H.

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Reversing the Biological Clock with Someone Else’s

Thursday, July 12th, 2012

Because so many women hold giving birth as one of their ultimate lifetime experiences, they don’t want to miss out on it because of infertility or the aging process.  Unfortunately though, as women get older, their ability to reproduce decreases.  With so many American women waiting until later in life to start their families, these upwardly mobile women are finding problems with fertility issues to be more common than they had expected.  For this reason, doctors have been working on adding to their various fertility treatments to help these older women give birth.  In vitro fertilization is one method that has gained a new strategy that seems to be reversing the biological clock of women over 40 years of age.

For women who are 43 years or older, the likelihood of getting pregnant, even with the help of three cycles of in vitro fertilization, is only 10 percent.  This is because a woman is born with all the eggs she will ever have and over time, the number of eggs of a woman significantly decreases from 1 million at her birth down to 34,000 at 36 years of age.  Not only are there less in numbers but the likelihood of the remaining eggs to function normally in the reproductive process becomes less.  However, researchers have found that when one uses a “donor” egg, i.e.,  when a young woman’s eggs are donated and in vitro fertilization is used in combination with these younger eggs, the chances of pregnancy increase to 60 or even 80%.   Nearly 250,000 women participated in this reproductive study by researchers at the Baylor College of Medicine and what they found was quite promising.  Even infertile, older women using donated eggs and in vitro fertilization had the same chances of getting pregnant as fertile young women using natural means.

Although these findings are exciting for those desperate to have a baby later in life, the process is not as easy as it sounds.  It is an expensive, unpleasant process, and not without its drawbacks.  It’s important to remember that the baby is not genetically related to the mother.  Some women find that less appealing (to be carrying a child that does not have her DNA).  Moreover, sometimes infertility is a sign of other reproductive problems that can cause issues during a pregnancy and long-term concerns for a child born in this manner.  For this reason, it is extremely important to consult with your OB/GYN before proceeding with such a program.  Many “older” celebrities have become mothers in this fashion.  But, keep in mind, healthy babies come from healthy mothers, so one should consider all other options before traveling down this path to motherhood.

You can read more about infertility in the chapter, “I’m not pregnant—and I want to be” in my health book, “INSIDE INFORMATION FOR WOMEN”.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

Posted in Fertility & Infertility, Parenting, Pregnancy | No Responses »
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Fertility Institute Plays God

Monday, June 25th, 2012

For many, having children is an important goal, and when they find that for some reason they cannot, it can be heart wrenching.  Couples can go through years of suffering attempting to conceive, only to find that they are infertile.  When this is discovered, some couples resort to expensive fertility procedures in an attempt to have a child.  One fertility clinic though, decided to capitalize on the desperation of would-be parents by holding a contest offering free in vitro fertilization to the winners.

According to the CDC, 11.8% of women are infertile and 7.3 million of them have used infertility services.  These services are extremely expensive though, and many couples cannot afford them.  Because the services are elective, competition for clients is fierce in the fertility market.  The Sher Fertility Institute decided to embark on a marketing campaign in which couples would compete for their services through a video contest.  Forty-five hopeful couples submitted heart-breaking videos about their struggle to conceive, hoping to woo the judges and win one free cycle of in vitro fertilization.  Only three couples could win, but the amount of attention the institute received more than accomplished their goal of marketing exposure.  Critics of the contest believe that the institute is making light of a very serious situation though, and that they are taking advantage of the desperation of infertile couples in order to boost sales.  With contestants who have suffered five or six miscarriages and even a stillbirth, it seems cruel to get their hopes up with a contest that appears to be the miracle they’ve been waiting for.  Additionally, it doesn’t cause other couples, watching the contest, to consider all aspects of making such a decision.

For the most part, experts seem to agree that in vitro fertilization is safe.  However, they also warn against complications and want would-be parents to be aware of the risks they’re taking.  Professor Nygren, a speaker at the World Congress of Fertility and Sterility in Munich, concluded that there are low levels of increased problems which can come with in vitro fertilization, but these “may be due to the fact that all patients undergoing IVF procedures are patients who already have reproductive problems.”  He also pointed out that there seem to be more complications associated with those who opt for Multiple Embryo Transfer instead of Single Embryo Transfer.

Although the winners of the Sher contest are likely ecstatic at their free IVF cycle, many others are disgusted by the institute’s advertising practices.  If you and your partner are struggling to have a child, be sure to speak with your OB/GYN about all of your options before jumping into a contest where doctors are playing god for a bigger paycheck.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

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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.

 

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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 »
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Jobs Should Provide Health Insurance, Not Moral Judgment

Thursday, May 17th, 2012

The debate over health insurance has certainly been heated over the past few years, and most of those arguments stemmed from concerns over financing and constitutional rights.  More recently though, it seems they have decided to narrow their focus to something a little more personal for women, and that’s contraception.  Although employers rarely want to know what you’re using your health insurance for due to privacy concerns, some would like to prevent their female employees from using their insurance for birth control.

The arguments behind this have been few.  Some claim that cutting birth control out of their health insurance plans would save money.  While this is somewhat true, in the grand scheme of things, it’s a bit ridiculous.  Birth control is easy to produce and access, and with so many competing contraception options and companies, the price is affordable.  Additionally, when female employees take birth control, they prevent pregnancies, which are much more costly for health insurance plans in the way of prenatal check-ups, hospital stays, maternity leave, and eventually, another family member to add to the plan.  In the long run, employers would actually save money by giving their employees access to contraception.

Money isn’t the only argument though.  There are religious organizations that don’t want to provide birth control to their employees out of religious, or moral, concerns.  Although the foundation of their organization stems from a particular religion, they employ people who are not necessarily a part of that faith.  There are religious hospitals, private schools, and nonprofit organizations for example, who have hundreds of staff members from all walks of life.  They feel that they have a right to impose their moral judgment on all of their employees. If they must abide by the same antidiscrimination laws that prevent them from firing someone because of their religion, race, or sexual orientation, then why should they be allowed to discriminate when it comes to health insurance?

Obviously, as a physician, I believe that the gift of life is precious.  That’s also why I believe though, that women need to be ready to receive that gift.  It takes a huge commitment to raise a child, and even more to develop that child into an intelligent, caring, and well-balanced person.  Our jobs are there to give us the opportunity to provide for our families, both in terms of money and health insurance and in terms of allowing a woman, mother or not, to feel as if she is self-sufficient, contributing and using the talents that she has developed over a lifetime. Mothers especially need an outlet other than their children.  Our jobs have no right to decide when we start that family though and by no means do they have the authority to judge the morality of our decisions.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Contraception (birth control), Parenting, Pregnancy, Women's health news | No Responses »
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