Tag Archives: childbirth

I Have a What Pregnancy?


Posted on September 10, 2012 by

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There are many possible complications or disorders that can occur during a pregnancy, but two of the most misunderstood are the ectopic and molar pregnancies. These are rare but potentially dangerous nonviable pregnancies that require medical treatment. Here is a summery of what you need to know.

Ectopic Pregnancy

What is it?: This is a fertilized egg that implants in the fallopian tube, not the uterus. This is not a viable pregnancy, as the fertilized egg cannot grow outside of the uterus. As the cells grow, the fallopian tube can rupture. This is a life-threatening condition that requires immediate treatment. The cause is not precisely known, but some factors that can increase chances of having an ectopic pregnancy are a birth defect of the fallopian tube, endometriosis, having an IUD in place at the time of pregnancy, in vitro fertilization, and scarring from past infections or surgery.

What does it feel like?: You may experience normal pregnancy symptoms early on, such as breast tenderness. Signs of an ectopic pregnancy are vaginal bleeding, cramping on one side of the pelvis, pain in lower abdomen, feeling faint, and pain in the shoulder area.

How will I know?: A pelvic exam may reveal pain. Blood tests for the pregnancy hormone HCG done approximately two days apart is useful for differentiating between an ectopic and a normal pregnancy. An ultrasound can also be done to determine if there is a uterine pregnancy, however remember very early pregnancies may be too small to be visible on the ultrasound.

What happens next?: Again, this is not a viable pregnancy and is life-threatening to the woman. If the fallopian tube has not ruptured, a drug called methotrexate can be given, or a surgical procedure can be done to remove the pregnancy. Once the fallopian tube ruptures, emergency medical help is needed to stop bleeding and prevent shock.

Molar Pregnancy

What is it?: This is an intra-uterine pregnancy where the tissue that normally turns into the placenta instead over-grows to become an unusual mass. This can be a partial molar pregnancy, where some fetal development occurs, or a complete molar pregnancy, where there is no fetal development. This is another type of pregnancy that is nonviable.  

What does it feel like?: Severe nausea and vomiting may occur, as well as vaginal bleeding, heat intolerance, rapid heart rate, trembling hands, weight loss, high blood pressure.

How will I know?: An ultrasound will reveal an abnormal growth in the uterus, and perhaps excessive or smaller than expected growth. HCG blood tests, kidney and liver function tests, or a CT of the abdomen may be ordered.

What happens next?: Typically a suction curettage, also called a D&C, is done to empty the uterus. Follow up exams will be necessary to make sure that the abnormal tissue doesn’t start to grow again.

The best way to avoid complications of these types of pregnancy is early detection.  If you aren’t looking to get pregnant, choose a reliable birth control method. If you are, listen to your body and know what symptoms to look out for.

Stages of Labor


Posted on September 3, 2012 by

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It’s Labor Day and I couldn’t resist the temptation to write about the other kind of labor. Besides, the other kind of labor is fresh in my mind since I experienced it just four short weeks ago.

There are three stages of labor:

1st Stage
  • Early – early labor can be characterized by bloody show (a blood-tinged vaginal discharge), cervical dilation (up to 3cm), mild back pain, and/or mild contractions. Early labor can last for hours and sometimes goes unnoticed.
  • Active – much more noticeable and uncomfortable contractions which help get the cervix dilated to 10cm. Some consider the last 3cm of dilation to be “transition,” which is characterized by very intense, back-to-back contractions. Some women experience nausea and may vomit during transition.
2nd Stage
  • Delivery of the baby - you might think that delivery of the baby would be the last stage of labor but, alas, labor isn’t over just because the precious bundle made its screeching arrival into the world.
3rd Stage
  • Delivery of the placenta – about 5 to 30 minutes after the baby is delivered, it’s the placenta’s turn. As the uterus continues to contract and shrink back down, the placenta slowly peels away from the lining of the uterus. Many women don’t even notice when this happens, especially with that long awaited bundle on their chests, but in my opinion, it’s a not-to-miss event. The placenta is a VERY cool organ. Ask the doctor to show you both sides of the placenta (they look different), the umbilical cord, and what’s left of the sac. The doctor will take a few minutes to inspect the placenta to be sure it came out intact. If it doesn’t, it can cause hemorrhaging and/or infection.

There are many resources out there that you can use to educate yourself about the stages of labor and what you can do to promote comfort during those stages. No two pregnancies or labors or childbirths are exactly the same, so when your friends are telling you horror stories about their labors, take it with a grain of salt. Also, ask lots of questions of your OB or midwife. Make sure your support person knows what to expect. And if you have a birth plan, make sure everyone involved in your labor and delivery knows about it and supports it (unless medically indicated otherwise). And lastly, it’s called labor for a reason … expect to come out of it looking like a Mack truck just ran over you.

Need a Pregnancy Test? Read This First


Posted on August 30, 2012 by

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If you’ve missed a period or are having pregnancy symptoms, your next step is a pregnancy test. Just taking the test alone can be somewhat overwhelming because there are so many options and sometimes the directions aren’t clear. Here’s what you need to know about getting a pregnancy test:

When do you take them?

Most pregnancy tests will be accurate around two weeks after conception. This does not necessarily mean two weeks after you’ve had sex, as the date of conception may not be precisely the date of intercourse. Sperm can live for up to 5 days inside the vagina or uterus so if, for example, you have sex on a Monday and ovulate on Wednesday, you might get pregnant on Wednesday. Some women find their tests are negative for longer than two weeks, so if you have a negative test and still have not gotten your period or are experiencing pregnancy symptoms, take a repeat test after a week or consult your doctor.

Generally speaking, positive is positive

The most common test uses a control line and a test line, with two lines meaning positive. It’s important to know that even a very faint second line is positive. Sometimes I find that a faint line confuses people and leads them to believe that it is not negative or unclear. That is absolutely not true, if there is a second line the test should be read as positive.

Another thing to know is that pregnancy tests look for HCG, or human chorionic gonadotropin, which is a hormone produced during pregnancy. This is important because there is a myth that taking emergency contraception or the birth control pill may cause a false positive, and this is absolutely untrue. False positive results can occur due to some medications or illnesses, and false negatives can occur due to a faulty test, taking the test too early in your pregnancy, or not following instructions. If you are unsure of your test results, contact your doctor for a repeat test or a blood test.

Home test vs. a clinic test

The pros of an at-home test: you have privacy, and it may be cheaper and faster than taking a test in a doctor’s office.

The cons: you may experience confusion about performing the test correctly, and you may have questions about your results that you are unable to answer yourself or find online. Some people find it awkward to buy tests at the store.

The pros of a clinic test: it’s performed by professionals who use high quality tests. Also you have immediate support, information and referrals at your disposal.

The cons: it may be less cost effective, and you may have to wait for an appointment.

If you take a home pregnancy test:

  • Follow instructions! Make sure to perform the test as directed and read the test within the correct time frame.
  • Some recommend taking the test first thing in the morning, as urine is more concentrated at this time. While this is true and it may be helpful if you are early in your pregnancy, it is not 100% necessary for an accurate test.
  • Take the test in the morning on a weekday. Why? Because if you take the test at night or on the weekend, you may find yourself having to anxiously wait until you can get in to see your doctor or contact someone for information. The morning on a weekday gives you plenty of time to call your doctor and make an appointment.
  • Have a companion. You may want privacy and if that’s what you need then go with that! But sometimes having someone you trust to support you whether this is a happy or a sad time can be helpful.

Don’t forget your local Planned Parenthood offers affordable and accurate pregnancy tests with helpful educators to answer your questions.

Focusing on Defeating the Fear of Childbirth


Posted on July 5, 2012 by

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As the major participant in two home births, I’d like to comment on the recent research reporting that women who have a fear of childbirth have longer labors.

I don’t know how any female cannot approach her first experience with labor completely free of fear. There are so many factors to worry about and so much that could go contrary to your most detailed plans. Even though I was in the best physical shape of my life before I became pregnant, I was very anxious about how I would manage the pain. Despite its intensity, I made it through fine. However, this was little help with my second pregnancy because I knew what to expect! It turned out my second labor was 4.5 hours compared to my first at 10.5.

Here are a few thoughts that might be helpful:

  • Do your research. Understand what is going to happen to your body and why it is happening. Knowing my cervix was dilating and effacing each time I had a contraction helped me know there was an end in sight and reminded me why I was feeling the pain.
  • Have a knowledgeable and calm support person with you. When I was feeling out of control, my midwives reminded me that each contraction was bringing me closer to the birth of my baby, what I was feeling was normal and that I was doing great. If a certain family member will increase your anxiety or get panicky seeing you in labor, they may be better off being nearby but not where they will add to your anxiety.
  • Be up and mobile as much as you can during early labor. This can help distract you and may even move things along. I rocked in a rocking chair and listened to classical music to help me relax until I felt ready to be in bed.
  • Don’t underestimate the power of breathing slowly and deeply. Count as you inhale and exhale. A birth coach can really help you with this and feel useful, as well.
  • Do what you can so you are in control as much as possible. Don’t be shy about saying you need something. Please rub my back here. Don’t touch me there. Back off a few feet. Let me squeeze your hand even if you think I’m going to break it. Know ahead of time what the protocols are so you won’t be upset if told you need a monitor or can’t be out of bed. Being able to labor in different positions of your choosing can help you be more comfortable. I gave birth the first time squatting on the floor holding unto the bedpost.
  • Remember that you are not the first person doing this. I kept reminding myself that women have been birthing babies since there have been woman and babies. My body was designed to do this. I kept turning negative thoughts into positive ones. I am strong, I am invincible, I am WOMAN!

Pregnancy, Childbirth & Parenting: What to Expect When No One Tells You What’s REALLY Going to Happen


Posted on May 9, 2012 by

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(Mother’s Day is just around the corner so here’s a funny, yet informative piece for expecting and parenting mommies everywhere.)

This is the stack of books that towered on my nightstand during my first pregnancy. Each night I would read something like “this week your baby is growing eyelashes,” or “your baby is the size of a grapefruit,” or “watch out for swollen ankles!” Informative, but the real warnings started rolling in from my girlfriends, “don’t take nice pajamas to the hospital, you’ll bleed all over them,” and “the billing department at the hospital has no shame,” and “take your own pads, the hospital ones are the thickness of a mattress.” But even my girlfriends didn’t share some things (until I brought them up) so I’m going to share them with you with hopes that you’ll appreciate the information, even if it doesn’t happen to you.

Orgasm = Response from Baby – Soon after you can feel the baby moving, you may experience the craziest mind zinger you could imagine. One minute you’re on top of the most mind-blowing, satisfying, fulfilling orgasm ever, and the next you’re feeling the baby do a somersault. Nothing like your mind zipping from a place of selfish pleasure back to the reality that you’re about to be a mother! This can happen as a result of an orgasm achieved by masturbation or sex. Why, you ask? Well, the rhythmic contractions of an orgasm are similar to the rhythmic contractions of labor so the uterus could be tightening down on baby, causing it to move to adjust to the change. Also, in the refractory period (after orgasm), lots of a hormone called oxytocin is released, which can also cause the baby to respond. Oxytocin is the “love hormone” or bonding hormone that makes some of us want to cuddle after sex. It is also the hormone responsible for bonding between mother and just-born baby and, in part, why kangaroo care is often promoted in hospitals. There’s a scientific reason why orgasms can make babies respond, but it doesn’t make it any less surprising when it happens.

Orgasm = Major Leakage (if you’re nursing) – Oxytocin is released during orgasm, but so is prolactin. The release of prolactin after orgasm is meant to counteract the effects of dopamine, which is responsible for sexual arousal. Prolactin is also what stimulates milk production and “let down.” So seconds after an orgasm, you may feel that tell-tale tingly feeling of let down and, if you do, be prepared for major milk leakage.

My Knees Are in My Ears and You’re Talking About What? – My husband loved our midwives as much as I did. My midwife stayed in the room through every last minute of the 3.5 hours I was pushing. As the contractions fizzled out, I’d take a rest. At one point, I woke up to my husband joking about “vajazzaling” with the midwife. Seriously?

Holy Blood Clots, Batman! – Expect big and small blood clots, discharges of various kinds, and a war scene in your toilet for at least a week after delivery. If you pushed for any significant amount of time, expect your vagina and/or vulva to be swollen. You might be so swollen, in fact, that sitting and scooting across the bed or couch are simply not possible. Tip: roll over onto your hip and slide out of bed on your hip, not butt. Trust me.

What the Hell, Uterus?!? – Just when you thought your uterus was done being on center stage, she reappears for an encore performance. If you nurse, expect some pretty significant uterine cramping in the beginning. Despite the discomfort, you actually want this to happen. These contractions help the uterus to shrink back down, helping you get your abdomen back after its squishy phase immediately following delivery. And by squishy, I mean like a bowl of rising dough in both appearance and texture.

Baby is Here, Check Your Selfishness at the Door – I knew that I wouldn’t be able to go to the movies as often and that the time spent on my hair and makeup would be substantially less, but I did not expect to fall apart the first time I couldn’t do something fun because I’m now a mother. Let me set the stage: It’s two or three weeks after delivery, I’m still sore, and I’m nursing. I can’t go anywhere, and I really don’t want to go anywhere, but everyone else, husband and family in town, want to go to the Rays home opener. If you knew my husband, you’d know this day is more fun to him than his own birthday. I was trying to be a big girl so I told them to go on and have fun. As they donned their lucky jerseys, I started crying. A lot. My husband was great; he just let me cry and said that he’d stay home with me if it would help. It wouldn’t help; it would just make me feel guilty. This hot mess moment was my realization that my life had forever changed. I would make sacrifices, much more meaningful than missing a baseball game, and have to deal with the fact that I asked for this. It is VERY hard sometimes to be selfless in order to meet the needs of your children. And dare I say it? Ok, yes I will, since we are being honest here: sometimes your own selfishness will turn to resentment of your partner or children. That isn’t a pretty thing to say out loud or feel, but it is the truth. Don’t worry – you’re still a great mom.

Your Husband/Partner Isn’t Made of Steel – I never expected to come home from an evening meeting to find my baby AND husband with bloodshot, tearful eyes, set in faces that looked of pure exhaustion. Our little one was about three months old and had received vaccinations that day. They made her so irritable and feverish that she screamed one of those high-pitched, endless, blood-curdling screams for the entire 2-3 hours I was gone. He didn’t know what to do but he didn’t reach out to me for help because he wanted me to have “me time” without worrying about what was going on at home. I took one look at them, gave my husband a hug, and took the baby from him. He had to go sit alone in a room for a while to collect himself. If the above-mentioned moment was my “a-ha!” moment, this was his. We now have an agreement that we will not leave one another alone on the evening of a vaccination.

Speaking of Vaccinations – If you don’t like vaccinating your kids, so be it. Just do your research. Don’t persist on some ideology not supported by science. But on the other hand, trust your gut and stick up for yourself. And here’s a real tough lesson we learned: opt out of the Band-Aids. Getting them off your little one’s tender skin is almost as traumatizing as the shot itself.

Hunting for Day Care SUCKS – If you actually care how and with whom your child is spending his/her day, you already know that finding a day care that you can feel good about just plain sucks. Do not settle for less than a perfect fit. In fact, start searching months before your kid arrives. Not to make you feel any more guilty, but ages 0-5 are the most important years of a person’s life. Show me a psychopath and I’ll show you a person who didn’t get his/her developmental/psychosocial/physical/nutritional/attachment needs met when they were ages 0-5.

The Hardest Job in the World – Contrary to popular belief, being a stay-at-home mom is NOT the hardest job in the world: being a working mom is. Not only do you have all the same responsibilities of a SAHM, you also have to balance that with your career. One of my friends shared this tidbit with me and it still resonates with me today: A working mom always feels inadequate at one thing or the other. She meant that no matter how hard you try or how good your situation is, there will always be times when you feel inadequate at work or at home. Case in point: a really important deadline at work versus a sick child at home – which do you choose? Sure, you find a way to stay with the sick kid since your partner is out of town and your nearest family member is eight states away, but that feeling of inadequacy at work creeps in and makes you feel like sh*t. I was a Peace Corps volunteer and those two years were WAY easier than parenting. “Peace Corps: the toughest job you’ll ever love” … my ass!

#2 – I don’t mean pooping here. Although I do recommend you keep a stool softener on hand for just after birth. You don’t want a hard poop ruining your day. What I mean by #2 is that I’m expecting #2 in a couple months (another girl). Even though parenting is tough and stretches me beyond the person I ever knew I could be, or would have to be, I’ve willingly signed up for a second round. In my opinion, being good parent is the greatest contribution that I can make to this world. The world needs more good people and that’s something I know I can deliver on. I’ve always been very driven and never quite known why. It all makes sense now: all of the education, experiences, and life lessons – they weren’t for me, they were for her, and they were pieced together strategically so she could be raised by exactly the mother she needs. Somehow, that stately Master’s degree on my wall pales in comparison to when my daughter shows concern for another human being. This is how I measure my success now and I love it.

So with all that said … Happy Mother’s Day! (Now would someone please send me a survival guide for raising girls who are 2.5 years apart, particularly between the ages of 11-18?)

Happy Mom = Happy Baby? Antidepressants and Pregnancy


Posted on February 6, 2012 by

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Antidepressants and PregnancyPregnancy and medicine is always a controversial subject. One of the numerous controversies that’s been brewing over the past several years is over the use of antidepressants in pregnancy and whether or not it’s important for a mother, who is already taking antidepressants, to continue her medicine during pregnancy. Obviously, the important question is – does it harm the fetus?

Studies are mixed and so are doctors’ opinions. Many in the medical community are coming out now and saying that it’s more important to have a happy mother throughout the pregnancy and if antidepressants are a way of reaching that goal, then it’s OK for the mother to continue her treatment throughout pregnancy. (The important caveat is that breastfeeding while on antidepressant therapy is not encouraged.) However, recent studies say that there may be a higher risk of premature births, smaller birth weights, and even autism if treatment is continued.

It may be important which antidepressant is taken during pregnancy as well. Generally, tricyclic antidepressants, certain SSRIs including Zoloft, and Wellbutrin are probably safe to take throughout pregnancy, but other tricyclic antidepressants may have a link to limb malformations if taken in the later months of pregnancy. As you can see, the literature and studies are mixed.

So, if you’re concerned, what can you do? Think about your happiness, because a happy mother equals a happy baby. If talk therapy works for you, you may be able to make it through without medication. If your pregnancy hormones are throwing your moods all out of whack and you’re not happy? It may be more important for you – and your baby – to maintain your medications throughout the entirety of pregnancy. (The famous internet celebrity, Dooce (Heather Armstrong) maintained her medication throughout her pregnancy and her daughter was fine.) As always, it’s important to work with your doctor to make the right choice for you.

But remember, if you’re happy, your baby is happy. Make the decision that’s right for you.