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'Pregnancy & Childbirth' posts

Having a healthy road to pregnancy

If you’ve been thinking about getting pregnant, here are some steps to take before your pregnancy to ensure a healthy and successful journey to becoming a mom.

  1. Start taking prenatal vitamins at least a month before conceiving. The folic acid in these vitamins (usually between 400 and 800 micrograms) will help decrease risk of a neural tube defect, like spina bifida. The spinal cord forms and closes by four weeks gestation, before many women even know that they are pregnant, so it’s important to get on this early.

  2. Starting pregnancy at a healthy weight decreases your risk of complications of pregnancy like high blood pressure and gestational diabetes. Good control of chronic medical problems will also help a future pregnancy go much more smoothly.

  3. Consider  ...

Renovated Level II Nursery Swedish Issaquah Now Open!

The Swedish Issaquah Women, Infants and Children’s team is excited to announce the opening of our Level II Nursery, helping us provide specialized, around-the-clock care to premature babies born as early as 32 weeks gestational age.

The nursery is staffed by highly skilled neonatal advance practice registered nurses, with support by neonatologists. These nurses and physicians are part of the Pediatrix Medical Group, the same group of clinicians who staff Swedish’s Neonatal Intensive Care Unit at the First Hill campus and the special-care nurseries at Swedish’s Ballard and Edmonds campuses.

Our nursery features:

  • Six private, state-of-the-art hospital rooms offering the latest in neonatal technology and space for parents to sleep.

  • A multidisciplinary medical team trained to take care of premature newborns. The care team includes advanced practice registered nurses and physicians who specialize in neonatology, plus registered nurses, respiratory therapists, social workers, care managers, dietitians, lactation consultants, child life specialists, physical and occupational therapists, pharmacists and more.

  • A family-centered environment where newborns and their parents receive tender, loving support they deserve. The Robin’s Nest lounge provides families a place to relax, while staying close to their little ones.

  • A location in close proximity to other related services. The Level II Nursery is located on the second floor of the hospital near the Labor & Delivery, Post Partum and Pediatric Units.  

In  ..

Breastfeeding, Disease Modifying Therapies (DMTs), and Postpartum Relapse in Multiple Sclerosis

Women with multiple sclerosis (MS) have higher risk of relapse during the postpartum period.  Can exclusive breastfeeding alone prevent relapses? How soon after delivery should disease modifying therapies (DMTs) be reintroduced? Are any DMTs safe to take while breastfeeding? 
 
While disease modifying therapies (DMTs) have been shown generally to reduce relapse rates, none of them are indicated for use during pregnancy and lactation. Therefore, the question of when to restart DMTs postpartum remains a difficult one for physicians counseling MS patients who wish to breastfeed their children.
 
Trying to predict the risk of relapse for any one individual is very difficult. The risk factors for postpartum attacks include ...

What you should know about Long Acting Reversible Contraceptives or IUDs

Does it seem that more of your friends are using IUDs or contraceptive implants?  IUDs, intrauterine devices, and contraceptive implants are becoming more popular in the United States.  In this post, we will discuss these birth control methods and why they are gaining in popularity. 

IUDs are plastic devices that are placed in the uterus by a healthcare provider.  There are three products available in the U.S.:

Newborn screening testing in Washington

For most parents, the newborn period is a time of profound joy, incredible challenges, and LOTS of questions.  As pediatricians, some of the questions we are frequently asked are related to a simple blood test done on all infants in Washington State.  Commonly referred to as the “newborn screen” or “NBS”, “PKU”, or “newborn metabolic testing”, this test checks for several congenital disorders that are rare but can be life-threatening. 

Often parents want to know:

  • What does the test involve? The newborn screen is done by pricking the heel of the infant at around 24 hours of age, then collecting a few drops of blood onto a piece of test paper.  This is dried and then sent to the state lab, where the testing is performed.  Because some of the conditions may take several days to show up, the test is repeated at 7-14 days old (usually by your primary care doctor; it can also be done in the hospital if the baby is still there for any reason).

  • Does it hurt? The needle prick is performed by trained nurses and is done quickly.  It may feel similar to pricking your finger to test blood sugar.  And you can significantly decrease the discomfort of the quick poke by breastfeeding your baby during or immediately after the test!

  • Why do we need this? The diseases we check for are typically rare, but if undiagnosed and untreated can cause a variety of complications, including blindness, poor growth, brain damage, and even death.  The reason that testing every baby is essential is that babies with these conditions can look and act perfectly healthy even while the disease is damaging their bodies, until they get so sick they need to be hospitalized or have permanent damage.  Starting treatment as early as possible can prevent many of the complications.

  • What are you testing for? The ...

Importance of planning pregnancies with Multiple Sclerosis (MS)

A recent study addressed the outcomes of pregnancy in women with MS who were taking fingolimod (Gilenya). Of 66 pregnancies on the medication, 41 attempted to carry the pregnancy to term. 26 of the 41 had healthy newborns. There were, 9 miscarriages, 24 elective abortion, 4 ongoing pregnancies and 1 with an unknown outcome. Of the elective abortions, four were for fetal malformations. There were 5 cases with abnormal fetal development in the 66 pregnancies. Poor fetal outcomes were found in 14.6% of the pregnancies. This contrasts with a 3% rate of poor outcomes for most pregnancies.

This paper highlights the importance of care in planning pregnancies in MS. It is now known that women with MS have ...

Managing pain during labor

One of the most common concerns women have during their pregnancy is how to manage pain during labor and delivery.  Labor pain may be more or less intense than you expected, or may hurt in a different way. It is hard to predict how any labor will go or how anyone will respond to pain.

Labor pain is due to contractions of the muscles of the uterus and by pressure on the cervix. This can feel like strong cramping in the abdomen, groin, and back. Some women experience pain in their sides or thighs as well. Women can also feel pressure on the bladder and bowels by the baby's head and the stretching of the birth canal and vagina. Some find the hardest part is not the contraction itself, but the fact that the contractions keep coming.  

One of the best ways to alleviate fears for women is to learn about the available strategies for coping with pain. There are both medical and non-medical tools that may be a good match for you.

While you are deciding, think about what appeals to you most. Ask your health care provider these questions:
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