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'Pregnancy & Childbirth' posts

Why pregnant women should receive flu vaccine and pertussis booster

Why do we recommend that pregnant women receive both the flu vaccine and the pertussis booster during pregnancy? Here are a few reasons:
 
The influenza virus, better known as the flu, has been proven over and over to have the potential to cause serious disease in pregnancy.  That includes an increased risk that when pregnant women “catch” the flu, they may require admission to the intensive care unit, require a ventilator and, less commonly, even death.  It’s serious.   Babies of women who are infected with the flu during pregnancy are more likely to be born prematurely and are at increased risk for stillbirth.

We recommend the flu vaccine at any point in pregnancy and offer the single dose, preservative free vaccine in our office to all pregnant women (with the exception of those who have a medical reason not to get it.)  A common misconception is that the vaccine causes the flu - it does not.  Another misconception is that it is not safe for the developing baby to be exposed to the vaccine itself or the immune response it generates.  There is no evidence to support this fear in almost 50 years of administrating this vaccine and close follow up of those receiving it.

We recommend the flu shot, which is an inactivated virus. The Flumist is a live attenuated virus that is not recommended in pregnancy.

Your family members should also receive the vaccine as they can pass the flu on to a newborn who has not yet gotten the vaccine.  Babies can suffer severe complications if they are infected with the virus before they can receive the vaccine.
 
The other vaccine we recommend during pregnancy is the Tdap booster.  The benefit of the pertussis booster outweighs any perceived risk.  Pertussis, or the whooping cough, is at epidemic levels especially on the west coast including Washington State.  That may be  ...

Getting healthy for pregnancy

It’s a new year and whether you are planning to start a family or expecting a return visit from the stork, it is a good idea to prepare for pregnancy. Although pregnancy is a natural process, we often have patients ask how they can best prepare their bodies for one of life’s greatest journeys.

Below are answers to a few common questions that I often receive from my patients:


What if I am taking birth control?

Depending on the type you use, you may want to stop birth control a few months in advance of planned conception. Birth control suppresses ovulation and impacts fertility. The good news is the affects of birth control do not last long. For example, we recommend that women finish a pack of birth control pills, have their next menstrual cycle and then go through one additional full cycle before attempting to conceive. During this time, it is important to use a barrier method of contraception (condoms) if you plan to engage in sexual intercourse.

An IUD (Intrauterine Device) can thin the lining of the uterus. I recommend that patients with an IUD ....

New options for genetic testing in pregancy

Congratulations!  You just found out you are pregnant and so many things start going through your mind.  When you’re not dry heaving or completely exhausted you start planning for your exciting future but in the back of your mind you wonder… how do I know everything is okay with my baby?

We are entering an exciting time in the field of obstetrics that involves less invasive and more accurate options for genetic testing in pregnancy.  ACOG, the American College of Obstetrics and Gynecology, recommends that all women, regardless of maternal age, be offered prenatal testing for chromosomal abnormalities. 

For quite sometime our options for this testing have been somewhat stagnant.  We have offered noninvasive risk profiling that involves a mixture of blood tests and ultrasounds at various times in the first and second trimesters to help evaluate the baby’s risk for Down syndrome or other lethal chromosomal abnormalities.  Depending on how these tests are processed, the sensitivity ranges from 80-95% with about a 5% false positive rate.  They are fairly accurate at identifying babies at higher risk, but can have false positive results (meaning an abnormal result followed by more invasive testing that shows normal results but of course this causes a lot of worry for the patient). 

Obviously we want to be able to offer testing that has a high rate of detection and a low rate of false positives.  More invasive testing is often offered also.  This testing involves removing a sample of placental cells called chorionic villus sampling, or removing a sample of fetal cells from the amniotic fluid called amniocentesis.  These cells are then analyzed for chromosomal abnormalities.  Although these invasive tests are the most accurate, they do carry a small risk of miscarriage or fetal loss. 

Fortunately, new testing has come out on the market called cell free fetal DNA testing.  This is ....

Signs of Hearing Loss for Babies and Children

Early identification and intervention of childhood hearing loss is linked to improved outcomes in communication and learning. Most newborns receive a hearing screening before being discharged from the hospital. However, some children may experience hearing loss sometime after that initial screening. Childhood hearing loss can be caused by a number of factors including family history, health problems at birth, syndromes, persistent middle ear fluid, chronic ear infections, and exposure to loud noise or head trauma. Children with normal hearing typically demonstrate similar listening and vocalization behaviors. If your child does not display these behaviors, it may be a sign of possible hearing loss or other problems.

Does your baby…

 

Birth – 3 months

  • Wake or startle in response to a sudden noise?
  • Seem to be soothed by your voice?

4-6 months

  • Move ...

Due July 2013: The Lytle Center for Pregnancy & Newborns

No matter how many times you’ve been through it, expecting, having, and raising a baby are truly some of life’s biggest challenges. Making that adventure a little less stressful is what The Lytle Center for Pregnancy & Newborns will be all about when it opens in July 2013 at Swedish/First Hill.

It will be the “go-to” place for moms and dads (and brothers and sisters and grandmas and grandpas) expecting a new baby. In this warm, welcoming space, new families will take classes, gather support from each other, get help with lactation, purchase necessities, and take advantage of a new mom and well-baby exam a few days after birth to make sure everything’s going just right.

Here are just a few of the services that will be available at The Lytle Center:

Mindfulness for Childbirth and Parenting

What is mindfulness?

Mindfulness is defined by Nancy Bardacke, author of Mindful Birthing, as "the awareness that arises from paying attention, on purpose, in the present moment, and non-judgementally. It is cultivated through meditation practice and can help you navigate the uncharted waters that lie ahead with more joy, kindness, awareness, calm and wisdom than you might have otherwise. Mindfulness is a universal capacity of the human mind, but unless we intentionally choose to cultivate it, we can spend much of our lives on automatic pilot, sleepwalking through life rather than being fully present for it."

What makes mindfulness helpful for pregnancy? Or parenting?

"Taking the time to learn mindfulness through meditation practice now can help you more skillfully manage the inevitable stresses of pregnancy and the irreducible element of uncertainty of the birthing process. More than that, mindfulness meditation can help you manage the intense sensations of childbirth we usually call pain, increasing your confidence and decreasing the fears that so often accompany this profound journey into the unknown. And mindfulness can help you cultivate lifelong inner skills for healthy living, wise parenting, and loving partnership. " (- Nancy Bardacke)

How do I learn how to meditate to cultivate mindfulness?

The best way to learn is by taking a mindful birthing weekend workshop or 9 week course which are just now becoming available in our area (click here for a flyer about a weekend workshop coming up in March).  Other ways to learn are...

What is umbilical cord blood banking?

Umbilical cord blood banking is a procedure where your OB takes some of the blood (and now tissue) from the placenta and umbilical cord after your baby is born and the cord has been cut. You may never have thought about what we do with that stuff.

What happens to your baby's umbilical cord?

In the past, it has usually been discarded as medical waste, although some women want to take it home with them. Over the last two decades medical advances have been developed in which the cells from that blood can be used to treat several diseases. The cells have unique characteristics that allow them to change into a multitude of different cell types (called pluripotent cells.) The idea is that some children and adults with certain genetic abnormalities or certain cancers can benefit from these cells. The cells can be grown to replenish the normal cells or treat abnormal cells.

The options for umbilical cord banking are divided primarily into what’s called public and private cord blood banking.

Private cord banking

Private cord banking is just what it sounds like: we collect the blood at the time of your delivery and you send it to a business that processes it and stores it for you. The cost of this varies currently from somewhere between $2000 and $3000 for initial processing and from about $120 and $300 per year to store it. In this case, you are storing the cells for yourself and your family.

Public cord banking

Alternatively, public cord banking is something anyone who delivers at certain hospitals has the opportunity to do. There is a public cord blood system that has been growing since 1990 that is similar to the blood bank and is used for individuals who need the blood due to illness or injury.

At Swedish, all patients can donate cord blood to the Puget Sound Blood Center. The cord blood collected for this bank is available to all individuals based on need. The cord blood collected is not specifically available to the individual who donated it. We are happy to collect blood from all families, but are finding increased needs in patients who are ethnic minorities or a mixed race couple. The cord blood also can be directed to Fred Hutchinson Research Center for ongoing research regarding current and future treatments.

Isn't cord blood banking controversial?

There are ...

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