Prenatal Testing

During pregnancy there are a bunch of different tests done to be sure you and your baby are healthy and stay healthy to the end.  At each prenatal visit there will be some new test that you will have the option to have or one that your doctor or midwife may feel is necessary for your circumstance.  

Your first prenatal visit is where your doctor or midwife will learn a slew of information about you by the testing done and the questions they ask.  They will do tests to find things such as:

• Blood type
• Rh factor (+ or -)
• Anemia
• Infections
• Immunity to rubella and chicken pox

Your doctor or midwife may recommend a series of tests depending on:

• Age
• Family health history
• Ethnicity
• Results of routine testing

Some of the testing done are just screening tests. Screening tests only can determine risk or probability, not actuality.  From the information gathered of a screening test your doctor or midwife can then decide if further diagnostic testing should be done to give you a definitive result. Diagnostic tests and confirm and narrow down andy health problems in your or your baby.

Common prenatal tests that are offered and/or recommended throughout the pregnancy are:

Urinalysis - done routinely at prenatal visits to test, sugar, protein, ketones, leucocytes, white blood count, and bacteria -  used to diagnose:

--Urinary Tract Infection

--Dehydration

--Preeclampsia

Chorionic Villus Sampling - diagnoses some birth defects between 10 and 13 weeks such as:

--Down Syndrome

--Cystic Fibrosis

First Trimester Screening - detects some higher risk birth defects between 11 and 14 weeks such as:

--Chromosomal Disorders

--Heart Problems

--Multiples
--Paternity

Amniocentesis - diagnoses some birth defects between 14 and 20 weeks such as:

--Down Syndrome

--Cystic Fibrosis

--Spina bifida

Ultrasound -  Ultrasounds are not routine but common between 18 and 20 weeks.  They are used to detect any problems with the baby's organs and body systems and confirm the age of your baby and be sure he or she is growing properly.  You also may be able to find out the gender of your baby if he or she cooperates.

Glucose challenge screening - detects gestational diabetes between 26 and 28 weeks.  Depending on the results from the initial screening, your doctor may recommend the glucose tolerance test which is used to diagnose gestational diabetes.  

Non-stress test - If your baby is showing little to no movement or any signs of distress a non-stress test is done to determine the reasoning. It is a monitor placed around the baby bump to measure the baby’s heart rate based on his or her movement. Biophysical profile - This test is used along with a non-stress test to monitor the overall health of your baby and to help decide if the baby should be delivered early.

It is an ultrasound done after a non-stress test. The biophysical profile looks at 5 fetal things: 

--breathing

--movement

--muscle tone

--heart rate

--amount of amniotic fluid.

Group B streptococcus infection - used to find bacteria that causes pneumonia in newborns - done between 36 and 37 weeks.

If your doctor or midwife recommends certain prenatal tests, don't be worried.  Never hesitate to ask as many questions as you want.  It is so important to keep yourself informed about what is going on. Don’t fret and remember that screenings do not diagnose, they detect possible risk.  Your doctor or midwife will guide you in the right direction to keeping you and your baby healthy.  

Miscarriage -- My Story

Today is a special day for me.  A year ago today was the due date for my little girl, Aurora Rose.  In October of last year my husband and I went to the doctor’s for a prenatal visit.  After having some bleeding and discomfort we had an ultrasound to learn there was no heartbeat.  We had just found out we were going to be having a baby girl.  It was probably one of the most difficult things my husband and I have ever dealt with.  It was a very traumatizing experience and took time to heal.  After that, I needed to find out more information to really understand miscarriages.  I had been told so many things from different people and doctors as to why this happened and what it meant for me and my husband in the future.  I needed to know more.  I hope to share some of my knowledge with y’all and to comfort any woman who has gone through a miscarriage.

Something I couldn’t quite wrap my head around was why this happened.  What caused this?  I went through so many emotions and feelings.  I questioned myself everyday for a long time.  What did I do wrong?  Is there anything I could have done?  The truth is half of first-trimester miscarriages are thought to be random events caused by chromosomal irregularity in the fertilized egg. The egg or sperm had the wrong number of chromosomes resulting in a fertilized egg that can't develop normally.

Sometimes a miscarriage is caused by problems that happen during early development; such as: an egg that doesn't implant properly.  Most of the time, it is difficult to really pinpoint the exact reasoning behind a miscarriage, even with a full work up.

Any woman can have a miscarriage but there are some factors that put women at higher risk.

• Age 
• A history of miscarriages
• Chronic diseases or disorders
• Uterine or cervical problems
• Genetic defects 
• Infections
• Smoking 
• Drinking
• Drug use
• Certain medications
• Diagnostic genetic testing

It is so important to listen to your body.  Some women, like myself, who may not have all the proper knowledge and don’t want to be alarmists let things go.  If something doesn’t feel right, under no circumstance should you overlook it.  One of the first signs of a miscarriage is vaginal bleeding or spotting.  This is tricky because for some women, bleeding or spotting is experienced with a perfectly normal, healthy pregnancy.  You may notice abdominal cramping associated with the vaginal bleeding.  No matter what if you experience bleeding or pain call your doctor or midwife so they can do proper testing and determine what is going on.

Miscarriages are a loss and women need proper grieving.  It is so important to remember that it is not your fault.  I know how difficult it is to having an overwhelming sense of guilt, that maybe you could have done something different that would have prevented it.  The truth is, you couldn’t.  My way of viewing it, which isn’t for everyone, but in my eyes, God had a plan for Aurora Rose, her job was to help my body prepare for my son Bradley Michael.  I had irregular periods, barely ovulated, and was told by 7 different doctors I could never have kids.  After my miscarriage, 5 months later I was pregnant with my son.  Since, I have had a regular period every month.  Something else that will help in coping with your loss is find support.  So many other women out there are experiencing what you are and there is no reason it should not be discussed.  You shouldn’t feel shame or embarrassment, which I felt afterwards.  Surround yourself with positive, supportive people who understand what you are going through.  The most difficult part for me was understanding that my husband didn’t grieve the same way that I did, but it was just as much a loss for him as it was for me.  Because he didn’t have the same connection to the baby that I did, I just felt it didn’t matter as much to him and I couldn’t have been more wrong.  Lean on each other and remember your partner is hurting just as much.

It is okay to be scared but don’t think that just because you had one miscarriage means you can’t have kids. Wait a little bit and ty again.  Take the time you need to heal and deal with your loss.  Remember you are not alone.

Headaches During Pregnancy

On a good day, not pregnant, headaches can be one of the most uncomfortable things.  During pregnancy having a headache is the cherry on top of the sundae.  Headaches during pregnancy are one of the most common complaints and can cause a great deal of discomfort.  They do seem to be most common during the first trimester and the third trimester and of course, due to hormonal changes.

Why am I getting headaches?
You may be experiencing headaches during your first trimester because of the change in your hormones and increase in the blood volume that circulates through your body.  There are some outside factors that will put you at greater risk for getting headaches during your pregnancy.
-Stress
-No sleep
-Dehydration
-Low blood sugar
-Poor posture
-Vision changes
-Changes in caffeine use
-History of headaches or migraines
If you are experiencing headaches associated with vision changes, abdominal pain, nausea/vomiting, swelling in your hands, feet, and/or face call your doctor or midwife immediately because this could be pregnancy induced hypertension. 

How can I deal with my headaches during pregnancy?
There are a few things you can do that will lower your chances of getting headaches during pregnancy.
-Exercise
-Have good posture
-Try your best to get comfortable and get sleep
-Drink plenty of water
If you are finding that you are getting headaches and you aren’t getting relief there are some natural things you can try first to relieve the headache.  I am one for trying a natural approach first before trying any pain medication for relief.

-Apply a warm compress around your eyes and nose.
-Apply a cold compress or ice pack at the back of your neck.

-Try eating smaller meals more frequently. This will help you maintain you blood sugar levels.

-Get a prenatal massage. Getting a massage will help you to relax a bit and relieve some stress.  Also, in rubbing the neck, temples, and shoulders will release endorphins and relieve some pain.

-Stay away from bright lights.

-Try to avoid eating chocolate.

If you aren’t getting any relief at all or start experiencing the symptoms associated with pregnancy induced hypertension contact your doctor or midwife immediately.

Urinary Tract Infection During Pregnancy

During my pregnancy I had so many complications that it was truly one big doctor’s appointment.  One of the most difficult things that happened during my pregnancy was called pyelonephritis (kidney infection) and kidney stones.  So many wonderful and not so wonderful changes are happening to your body during pregnancy.  With all the hormonal and physical changes during pregnancy you are at higher risk of getting urinary tract infections or pyelonephritis.

A urinary tract infection is exactly how it sounds...an infection in your urinary tract. Your urinary tract includes:
-Kidneys- 2 organs one on the right side, one on the left.  It filters wastes from the blood and makes urine
-Ureters- 2 tubes that carry urine from the kidney to the bladder
-Bladder- Holds the urine
-Urethra- the tube that carries urine from the bladder and excretes the urine out
You can get a urinary tract infection in any part of the urinary tract.  If you have a urinary tract infection you make experience symptoms like frequent urination, burning during urination, blood in your urine, odor associated with urine, cloudy, dark urine, and possibly pelvic pain.  It is very possible that women who have urinary tract infections have no symptoms at all, which can make things tricky.  Urinary tract infections can become complicated when they travel and reach the kidney.  This is when the UTI turns to pyelonephritis.

Pyelonephritis is an infection in the kidney.  This is what I experienced during my pregnancy.  Sometimes if you don’t have symptoms of a UTI it can become pyelonephritis because it isn’t treated, simply because you didn’t know.  Some of the symptoms are similar to a UTI but you have added flank pain, which is pain in the right or left side of your back that wraps to the front, fever, nausea and vomiting.  Normally, you get pyelonephritis from some kind of obstruction that backs up the urine because it allows a place for added bacteria to form.

During pregnancy you are at greater risk for UTIs or pyelonephritis.  This is because of that awesome hormone progesterone...yet again.  The lack of muscle tone causes the ureters to dilate which slows the flow.  You may feel like you are running to the bathroom a million times a day, but you are not completely emptying the bladder, again because of the lack of muscle tone, thanks to progesterone.  This allows bacteria to form.  

Having a UTI or pyelonephritis during pregnancy can lead to preterm birth or low birth weight if not treated properly.  This is why at all your prenatal visits your doctor or midwife will do a urine test (among other reasons).  As said before, some women don’t get symptoms which can lead to more problems, especially during pregnancy if gone untreated.  Luckily, there are antibiotics which are proven safe for momma and baby during pregnancy that will treat your symptoms and bacteria.  If your infection has reached the kidneys most likely you will be in an extreme amount of pain.  When I had it, the nurses were all telling me that if I could handle the pain from this infection, I would have no problem with labor...yeah, okay.  Pyelonephritis is usually cured with some IV antibiotics due to the nausea and vomiting it may be hard to stomach any of the oral antibiotics, and they can also give IV nausea medication and fluids.  It is so important to stay hydrated for you and your baby.

Here are some ways you can decrease your chances of urinary tract infections.

• Drink plenty of water
• If you have to go...GO! Don’t hold it
• Make sure you are wiping front to back.  I know it is hard with that big bump but do your best
• Keep your genital area clean with water.  Be very careful about using soaps because they can throw off the PH balance
• Clean your genital area and pee before and after sexual intercourse
• Drink cranberry juice.  It is known to reduce the bacteria that will cause a UTI

Is This Normal?

There are so many aches and pain during pregnancy.  At times it is hard to tell what it is concerning and what is not.  A huge question I have been asked lately is, “When should I  call my doctor? Is this normal?”  The thing about pregnancy is, so much is going on with your body and everyone is different.  You can not pinpoint a “norm” because what may be completely normal for one woman, could be concerning for another.

It is very rare that women fly through pregnancy with ease and never have a situation where calling the doctor is necessary.  If you are one of those women, I am jealous!  I managed to have kidney stones, pyelonephritis (kidney infection), hyperemesis, fluid leak at 27 weeks, the list goes on.  Like you, I questioned, when do I need to all the doctor?  I was always so worried about being an alarmist because so many things feel uncomfortable and are changing during pregnancy.

A rule of thumb is when in doubt, call your doctor or midwife.  You want to be safe than sorry.  I just want to educate you further so when you do call your doctor or midwife you have a bit more knowledge on what you may be calling about.  So many times I went in a nervous wreck when it was nothing or I would go in completely calm and end up at the hospital.  Here are some questionable times for women, normal or not, and when to call your doctor or midwife.

Bleeding:

Bleeding can happen in the first trimester and this is because of implantation of the fertilized egg in the lining of the uterus.  No matter what the circumstance, if you have bleeding always call your doctor or midwife.  Especially if it is associated by cramping.

Fluid Leak:

Any fluid leak is tricky because some women can experience some incontinence throughout the pregnancy.  Yup, you could pee yourself.  This can often be confused with thinking your water has broken.  In my own experience, I had some fluid and at first I didn’t really say anything, then I showed my mom and we called the doctor.  When I called the doctor, she said it was probably urine and not to be too concerned.  I called back and they were closed so I got the on-call doctor who brought me right in to the hospital.  I kept having nurses and doctors explain that sometimes you can pee during pregnancy but I knew this wasn’t pee.  They did 3 tests to see what was going on and test the fluid, turns out it was NOT pee...it was amniotic fluid.  The story goes on, but back to my point, it is difficult to tell so don’t hesitate to call your doctor or midwife.  If you feel you aren’t getting answers you must be your own advocate!

Frequent Urination:

It is totally normal to be running to the bathroom more than ever before.  The baby can be pressing on the bladder causing this.  It becomes a problem when you are urinating frequently and have pain, burning or any discomfort during urination.  Also, beware of a constant urge to go.  This could be from the baby’s position but could also be signs of a Urinary Tract Infection.  

Changes In Discharge:

You will find changes to vaginal discharge throughout your pregnancy.  Discharge is totally normal but watch out for any itching, burning or unusual odor that may be associated with the discharge.  Be sure to mention any changes to your doctor or midwife.

Depression:

Prenatal Depression is something that is sometimes over looked.  How blue is too blue?  Being uncomfortable and miserable during pregnancy is normal depending on your situation.  If you find you are lethargic, having excessive mood swings, uncontrollable crying, and constantly feeling hopeless, you need to make sure you address this with your doctor or midwife immediately.

Nausea/Vomiting:

Be sure to monitor your nausea/vomiting.  If you are finding there is no relief and it is getting worse, it most likely is not just morning sickness.  The predictable spurts of nausea and vomiting that can be relieved would be classified as morning sickness.  If you are finding nothing will help and it is all day and all night with no let up, it could be hyperemesis.  Talk to you doctor immediately to see what you can do to help stay hydrated and as healthy as possible through your pregnancy.

Swelling:

Having swelling during your pregnancy can be normal, but it can also be a sign of some serious complications.  During pregnancy, all the hormonal changes will cause some water retention and minor swelling.  If you find any sudden swelling in your hands, feet, and/or face accompanied by headaches and/or blurred vision call your doctor or midwife immediately!  These are signs of a serious complication called preeclampsia.  You may also hear the terms, gestational hypertension, pregnancy induced hypertension or toxemia.

Contractions:

A huge sign of labor, contractions.  How do you know when they are real or not?  I kept asking my mom throughout my pregnancy, how will I know?  Her response was always..”you’ll know.”  It could not be more true.  I was in what is call inactive labor for 2 weeks prior to delivery.  Inactive labor is when you are have true contractions but not dilating.  Some women experience Braxton Hicks contractions, which are practice contractions, prior to real labor.  The Braxton Hicks can be uncomfortable but definitely are not the real deal!  I had Braxton Hicks which were tightening and slightly uncomfortable.  When the real thing hit, I couldn’t even speak when I was in a contraction.  It is a tough call of knowing when to go and when to stay.  Timing your contractions is important.  Contractions in early labor last from 30 to 60 seconds and will be 5 to 10 minutes apart.  Let you doctor or midwife know and they will guide you.

These are some just instances where it is hard to tell what is normal or not.  I hope this gives you some more information.  As I said before, when in doubt do not hesitate to call your doctor or midwife.  You can never be too safe when it comes to pregnancy.  So much is unknown so it is normal to question things going on with your body.

Inducing Labor

What is inducing labor? One of the many questions I had during my pregnancy and delivery.  I never thought my delivery would go as it did, but then, that is the point about “What To Expect When It Isn’t Expected”.  I can not tell you exactly how your experience will go with an induction, but I can answer some questions that I have been asked about my own.  If nothing else it gives you a bit more knowledge.

What is an induced labor?

An induced labor is when your labor doesn’t start or progress on it’s own and you need the help of outside medications or methods to give birth.  

Is induced labor a guarantee?

No, in some cases inducing labor does not work.  If the baby is not ready to grace you with his or her presence, then an induction most likely won’t work.  When I was going through my induction I was very fortunate that each step went beautifully and the total process took 12 hours.  The girl in the room next to mine, unfortunately, had been going through her induction for a week and it was not progressing.  They were inducing her because of gestational diabetes but it was not terribly urgent for her to deliver as it was in my situation.  The poor thing was walking the halls and doing whatever she could to help the process.  It is important to know that know matter what, if the baby is not ready, the baby will not come naturally.

When is your labor induced?

There are a number of reasons and pregnancy complications that would lead you to an induced labor.

• Having a pregnancy complication, such as, preeclampsia, gestational hypertension, gestational diabetes, or kidney disease.
• Broken water with no contractions.  If you water has broken and labor does not follow you and your baby could be at risk of infection.  If there is a suspicion of infection, further testing will be done and your doctor or midwife will decide what is best for you and your baby.
• Your baby has stopped growing at a proper weight or is very overgrown.  Any feeling that your baby is at risk will lead to an induction or c-section.
• A lack of amniotic fluid around the baby.
• A placenta abruption, deterioration to the placenta or an insufficient placenta.
• Hitting the 42 week mark and no baby will usually lead to an induction.  You will be offered the option but some women do not opt for an induction which is totally fine as long as you and your baby are safe.  Waiting longer than 42 weeks can increase the risk of stillbirth or other medical problems so it is best to listen to your doctor or midwife and trust them.

How will my labor be induced?

There are a few different methods and medicines used for a labor induction.  I won’t lie to you, it can cause a bit of discomfort, but if it is what is best for you and your baby, you do what needs to be done.  The goal in an induction is to ripen the cervix, which means to get your cervix softened, thinned out, and beginning to dilate, and to begin labor.  Some methods and medication used to induce are: 

Prostaglandins -- If you are being induced but your cervix is not ripe, you'll begin the induction by having medication containing prostaglandins inserted into the vagina by the doctor or midwife at the hospital. This medication helps to dilate you and thin out the cervix.

Foley catheter -- You may have a catheter placed in the cervix.  The catheter has a small balloon that is not yet inflated at the end of it and is placed into your cervix. The balloon is inflated with water to puts pressure on the cervix helping the release of prostaglandins, this will cause the cervix to dilate and thin. When the cervix has dilated to about 5 cm it will fall out and be removed.

Rupturing the membranes (Breaking your water)-- If you're at least 4 to 5 cm dilated, but not showing much sign of progression, your doctor or midwife can insert an instrument that looks like a crochet needle through the cervix to break your amniotic sac. This looks like it will hurt and be uncomfortable, but it really isn’t.  It is no worse than having a vaginal exam.

Pitocin -- This is given through an IV drip to get contractions going.  In an induction once you have reached the point where you go down to the delivery room an epidural will be given if you decide you want one and Pitocin will be given through your IV.  For women who’s water does break but there is no progression, Pitocin is also given.  When your water breaks, most doctors or midwifes will want to deliver within 12 to 24 hours because the risk of infection for you and your baby increases the longer you go with a ruptured membrane.  The amount of Pitocin is adjusted as you start progressing.  I don’t want to deceive you, Pitocin will make the contractions come on very strong and they are painful.  In labor that start on it’s own there is a build, with Pitocin and it is WHAM! you are in labor.

In my own experience, all of these methods and medications were used together.  I was admitted and had the foley catheter done and medication also inserted to help in ripening the cervix.  Within a few hours the catheter fell out and I was having very strong contractions.  I was given some morphine for the pain to ease the contractions.  By this time I was in “inactive labor” for a week now.  This means contractions but no progression, going in I was about 3 cm dilated.  After the dose of morphine wore off I was brought down to delivery, given an epidural and the Pitocin started.  Shortly after, my water was broken, and a few hours later it was time to push.  I was vey fortunate and had a very successful induction.  It is so important to relax to help your body do what it needs to and help your baby relax.

Under what circumstances should my labor NOT be induced?

• If there is an indication that the contractions would be too much for your baby then you will most likely be brought in for a c-section.  It depends on the test results.
• Placenta previa, which is when the placenta blocks the exit for the baby.
• Your baby is breech (head up, feet down).
• You previously had a c-section. 
• You have genital herpes.
• You are having multiples.

I hope this helps inform you a bit about what inducing labor is and the procedure.  It can be scary, but I have to say, don’t be.  Most things about pregnancy and childbirth are unknown.  Whatever you endure is for your baby.  If you have any stories of your experience, questions or comments feel free to contact me at helpingmommytone@gmail.com!

Gestational Diabetes

A few days ago a girlfriend of mine went to the doctors to take a dreaded test... the glucose tolerance test.  The glucose tolerance test is done around the 26th to 28th week of pregnancy.  If your doctor has reason, such as history of diabetes or pre pregnancy weight being very high, the test will be done prior to the 13th week and repeated at 28 weeks.  A glucose tolerance test is done to see if you have gestational diabetes.  Some people think that if you have diabetes you are overweight.  That is not necessarily the case.  She only weighs 138 pounds at almost 30 weeks gestation.  She was asking me a slew of questions because it wasn’t clearly explained to her through her doctor and her first test came back a bit high.  She wanted to know: What exactly is gestational diabetes? Will this hurt the baby? Am I going to have diabetes after pregnancy? Do I need insulin? How did I get this? Do I need to lose weight? Am I going to be able to deliver the baby naturally? Could the test have been wrong!  With all these questions being asked by her, I figured many other women would have the same questions.  I know I did when I was pregnant and I learned from extensive research through my studies and doctors.  

Gestational diabetes is high blood sugar levels during pregnancy.  It is tested by getting a blood draw, drinking a sugary, syrupy substance, then waiting an hour and getting more blood drawn.  The body absorbs the glucose very quickly which causes the blood glucose levels to raise within the hour you are waiting.  The blood is taken to measure how well the body has processed this overdose of glucose.  Every state has a different “norm” for the blood glucose level.  Some state say if your number comes back less than 140mg/dL form the 1 hour glucose screening you are in the clear.  Where we are, the blood glucose level is supposed to be less than 130mg/dL.  If in the event your number comes back high, chances are your doctor or midwife will order to have a 3 hour glucose screening done.  The 3 hour test is a bit more intolerable than the 1 hour.  You must fast from midnight to when the test is done, you get blood drawn at the fasting point to see what the levels are, then drink, wait an hour and blood gets drawn again, then do this 2 more times.  Your office will give you the exact instructions if you need to do this screening.

There is no EXACT cause for gestational diabetes, but it is known that the placenta, which is a source of your baby’s growth, does alter the way your body uses insulin when you have gestational diabetes.  If your body can not properly use and create insulin then it can lead to greater issues like hyperglycemia.  

Gestational diabetes can cause harm to your baby IF it is not properly monitored with intense cases. With gestational diabetes, any extra glucose will go through the placenta.  This will give the baby high blood glucose levels causing the baby to have extra insulin, more than necessary for their little bodies to grow, it will store as fat, leading to an overweight baby.

For most women, you will be put on a strict diet to keep your numbers down and all is good.  You may or may not end up going in for an induction do keep the baby from getting too big.  It depends on your doctor or midwife and what they feel is best.  More than not, all is fine and you will have your gorgeous healthy baby at the proper gestation.  So many women mistake induction for a c-section, they are different, and just because you may be induced does not mean you need to have a section.

I hope this answered some of your questions and helps to keep you informed!  Stay healthy, eat right, exercise and enjoy being pregnant! From this point on, it is over before you know it.

Keep It Down!

I want to discuss pregnancy induced hypertension (PIH).  It is something that is not necessarily a main concern initially when you are going through your prenatal visits.  It becomes a greater issue typically in the third trimester.  Questions I have been asked recently because of my experience are, “What is gestational hypertension?” “What is pregnancy induced hypertension?” What is preeclampsia?” “How do you get it?” “How can I prevent it?” “How will I know if I have it?”  I am going to answer all these questions and then some.

Hypertension is high blood pressure.  Blood pressure is the pressure of blood pushing against blood vessel walls.  When the force of the blood is above normal (120/80) this is considered high blood pressure.  Pregnancy induced hypertension (PIH) is high blood pressure accompanied by headaches, swelling in the face, feet and hands and protein in your urine.  PIH is also called preeclampsia, and toxemia.

There are certain factors that make you more at risk for PIH.  Being under the age of 20 or over the age of 35, being underweight or overweight, a history of hypertension, a history of PIH, a mother, sister, aunt or grandmother with a history of PIH or hypertension, kidney disease, immune disorder, and expecting multiples are all reasons you may be at higher risk.

If you experience any of the following immediately call your doctor or midwife:

-Swelling in the face, feet and/or hands

-Severe headaches accompanied by spots, dizziness and changes in vision

-Reduced urination or blood in the urine

-Flank or abdominal pain

-Vomiting and nausea

-Decreased fetal movement

These are all symptoms of PIH.

When you go to your prenatal visits your doctor or midwife will most likely take a urine sample and be testing routinely to see if there is any protein in your urine.  At every visit they also will check your blood pressure and weight.  If you have rapid weight gain, a high blood pressure and protein in the urine your doctor will order further testing for you and the baby.  There is question of high blood pressure when the systolic (above number) is between 120 and 139 and the diastolic (below number) is between 80 and 89, this is considered prehypertension.  Sometimes “office anxiety” kicks in and you temporarily have a higher read so in some cases it is best to ask your doctor to do another reading.  I had to get mine read at the beginning and end of my doctor appointments.

If PIH begins to get worse the only cure is to deliver the baby.  I remember being admitted to the hospital at 34 weeks and I was given magnesium to prevent any seizures and medication for the blood pressure.  At this point doctors and midwives need to look and see if the benefits outweigh the risk of using medication.  Make sure you do not hesitate to call your doctor or midwife if you are experiencing any of the above symptoms.

Rest Up Momma!

          There are many women that experience bed rest during pregnancy whether for a week or 3 months.  I was one of the “lucky ducklings” that was put on bed rest.  I had a few mommas e-mail me questions about my experience and if I found bed rest really helped.  I am going to start off by telling you that though I was prescribed bed rest, I did take occasional breaks.  Majority of the time I was not up and about, whether laying or sitting I was resting, but I would go for ride in the car just to get out and get some fresh air.  Research has not shown enough evidence that bed rest is beneficial for you and your baby; however, there isn’t research enough to prove that is isn’t.  Due to my experience with bed rest and my medical background, I just want to educate you a bit on bed rest.  I know so many expecting moms are faced with this and my hope is to let you know some pros, cons, risks, and benefits.

          Bed rest may be prescribed for the following reasons:
Pregnancy Induced Hypertension/Preeclampsia/Toxemia - For these conditions the only real cure is delivery.  I experience preeclampsia myself and thankfully had reached 37 weeks and was able to deliver.  If you have not reached the 37 week mark a doctor or midwife may prescribe bedrest so they can keep close watch on you.
Placenta Complications:
-Placenta Previa - When a woman has placenta previa this means the placenta has blocked the cervix not allowing the baby to exit.  Placenta previa can correct itself in some cases, but women may be put on bed rest to keep the pressure off the placenta and cervix.
-Placenta Abruption - This is when the placenta begins to separate form the uterine wall prior to delivery.
Cervical Insufficiency -  Cervical insufficiency means your cervix has begun dilating and effacing before your baby is full term and ready for delivery. With this condition there are no normally no symptoms.  Bed rest takes the pressure of your growing baby off the cervix.
Preterm Labor - If you are in preterm labor your body is ready to deliver the baby before the baby has reached full term.  There are many factors that can increase your risk of preterm labor such as:
-Smoking
-Alcohol Abuse
-Drug Abuse
-Health Conditions- preeclampsia, gestational diabetes, infections, blood clotting disorders
-History of preterm labor
-Having twins or multiple babies
-In vitro pregnancy
If you begin to experience contractions that are 10 minutes apart consistently, backache, increased vaginal pressure, cramping, gush of fluid, or any bleeding call your doctor or midwife because these are possible signs of preterm labor.

          By reducing activity and being put on bed rest there is a hope that the risk of preterm delivery or pregnancy complications will be reduced.  There are risks that can develop while on bed rest such as: blood clots, depression, anxiety, decreased birth-weight of your baby, difficulty delivering due to weakened bones and muscles, and slower recovery after birth.

          If you are prescribed bed rest you want to make sure you are getting a full explanation of what bed rest means to your doctor.  There are different degrees of bed rest so make sure you are asking the appropriate questions to be sure you are getting the proper information.  To keep yourself in the know here are some good questions you could ask your doctor or midwife.  What reasons are you recommending bed rest?  What degree of bed rest is appropriate?  What are the benefits for my baby and me? Do the benefits outweigh the risks?  What are some potential issues from bed rest for my baby and for me?  How long will I be on bed rest?  Can I do normal household chores? Can I take care of my other kids?  Is it best to lie on one side over the other?  Is it alright to continue sexual activity? If so, are certain positions safer than others?  If you don’t feel your questions have been answered to your satisfaction or feel uneasy it can not hurt to get a second opinion.

          Some research has shown that resuming your everyday activity to a lesser degree would be more beneficial for you than strict bed rest.  As I said before there are different degrees of bed rest.  Bed rest for a few hours a day while still resuming other activities to a lesser degree, bed rest which confines you to only activity in the home, and bed rest which means you are in bed only.  It is up to you and your doctor or midwife but make sure you feel comfortable with the decisions made.

           If you are prescribed bedrest and are limited to little or no activity it can be extremely difficult mentally.  It is important to give yourself some ways to pass the time productively, otherwise you will go insane.  I found myself going nuts throughout the day because I was alone and unable to drive or do anything.  Thank God for candy crush!  Have some friends come over and keep you company, even if just for an hour to watch a movie, it will make a big difference.  Use the time to bond with your baby, play music for him or her and talk to your baby, he or she can hear everything and is getting to know you.  Take the time to learn a new hobby like knitting.  Keep a journal of all your experiences, when the baby moves, how the baby reacts to certain things.

In my own experience I found bed rest to be both helpful but also not.  As I said before it is what you and your doctor or midwife decide and what is best for you and your baby.  I hope this helped educate you a bit about bed rest.  If you have any questions please feel free to contact me at helpingmommytone@gmail.com.