pregnancy Archives

Is Sex Safe During Pregnancy?

It’s completely normal to be worried about protecting the health and safety of your developing baby. Many couples, especially first-time parents, worry about how pursuing intimacy in their relationship will affect the little one growing inside mama. Which brings us to the age-old question. Is sex safe during pregnancy? The simple answer is yes, for normal pregnancies sex while your pregnant is fine. However, there are a few things you should be aware of before jumping into the sack. Change in Your Libido While some women crave sex during pregnancy, it’s the last thing on other women’s minds. Pregnancy can affect your body in ways you’d never expect. So, based on your hormonal functions, you may not be in the mood. Some things that can have an effect on your libido early on during pregnancy include: Later in your pregnancy, things such as weight gain, and back pain can dampen your enthusiasm for sexual intercourse. Keep in mind, your partner can be affected by your pregnancy as well. Their desires may be toned down to fatigue, or simply anxious about hurting the baby during intercourse. When is Sex Safe During Pregnancy? For the most part, sex during pregnancy is completely safe for everyone involved. Your developing baby is protected by both the amniotic fluid in your uterus and the strong muscles of the uterus itself. Sexual activity won’t affect the baby in the least. You may be wondering about alternative forms of sex as well. While some alternative sexual activities are completely safe for both you and baby, others might be more detrimental to your health. If you are pregnant and plan to have sex with someone you are not in a monogamous relationship with, using condoms is recommended to protect against possible transmission of STDs. Any sexual position that you feel comfortable is completely safe. However, towards the second trimester, you’ll likely feel more comfortable in positions that are not directly putting pressure on your back. When is Abstinence Recommended? During your final weeks of pregnancy, your doctor may suggest abstaining from sex. Both female orgasms and semen can stimulate contractions. This is due to the release of a chemical called prostaglandins which is said to trigger contractions when you’re close to your due date late in the third trimester. If you have a history of pre-term labor or have any of the following conditions your doctor will likely recommend practicing abstinence during the remainder of your pregnancy. Sex with a partner that has been diagnosed with an STD or STI should be avoided due to possible risk of your or your baby contracting the STD. At the very least, it’s important to use protection as always when any sexual activity with a person that has been diagnosed with any STD. Final Thoughts While usually, sex is safe during pregnancy. However, there are certain conditions that may require abstinence. Experiment with a mixture of positions throughout your pregnancy that offer the most support and comfort during sexual activities. Don’t hesitate to give us a call to schedule an appointment with your doctor. Our caring staff is always available to answer any questions or concerns via phone regarding sexual intercourse during your pregnancy as well.

Midwife Education, OB

What is Natural Childbirth?

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Natural childbirth is a labor and delivery that does not include the use of routine medical interventions, particularly anesthesia, the most common forms being epidurals and spinal blocks. It also attempts to minimize surgical interventions such as episiotomies, forceps, and caesarean sections. A natural childbirth may occur in a hospital while under the supervision of a physician or midwife, or at home assisted by a midwife. Natural Child Birth Options Pregnant women who are approaching their due date may often become anxious about the process of delivering a healthy baby and what it may entail. In order to relieve any unnecessary anxiety or concern, it is helpful to become informed about childbirth, which options are available and have a birth plan ready for when it is time for delivery. It is important to speak with your health care provider to explore both natural and medical options for you and your baby. This way you can be prepared and empowered to make a decision. Each birth is different, and the health of mother and baby is ultimately paramount. Alternative Options to Medical Interventions Some of the alternative options to medical interventions include: Massage Massage stimulates your body to release endorphins that can help ease the pain, reduce anxiety and make contractions feel less intense. Massage can be performed on the shoulders, back, feet/hands and the perineal area. Breathing and Relaxation Exercises This can include a variety of methods such as mindfulness and meditation, specific breathing techniques, vocalization, visualization, and progressive muscle relaxation. Acupressure A form of Traditional Chinese Medicine, acupressure can be used to apply pressure on specific points to provide pain relief, calm anxiety and encourage an efficient labor. This can be learned and practiced on yourself or by your partner. Positioning and Movement Certain birth positions have been favored in natural childbirth including squatting, and being on hands and knees versus the traditional lithotomy – laying on the back with hips and knees flexed – position. Walking, gentle stretching and the use of a birthing ball can also be helpful in the labor process. Hot and Cold Therapy Intermittent heat and cold in the form of warm and cold packs may be used on the lower back, lower abdomen and perineum during labor to help with pain and discomfort. Hypnotherapy This is an integrative mind-body technique which can aid women to replace fear and expectations of pain with expectations of a safe, gentle and comfortable birth. It can be self-performed or performed by a partner using deep breathing, vocabulary cues or visualization. Final Thoughts When it comes to childbirth today, women have a variety of options to explore and choose from. It is important that you feel as comfortable, prepared and relaxed as possible when preparing for your labor and delivery. Being educated about both natural and traditional medical birth options will allow you and your doctor to make an informed plan that best suits you and your baby’s needs. Please don’t hesitate to call with any further questions or concerns you may have regarding natural childbirth.

Are Prenatal Vitamins Really Necessary?

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Healthy nutrition is important throughout life, and especially during pregnancy. Even with a wide variety of whole foods, a mother and baby may require nutrients above and beyond what is contained in food. Think of prenatal vitamins as insurance to make sure you are getting all of the essential nutrients during pregnancy. Whether currently pregnant or planning to become pregnant, women can benefit from taking prenatal vitamin and mineral supplements as early as possible. It is particularly important if you meet any of the following criteria: Follow a vegetarian or vegan diet Are lactose intolerant or have other food intolerance Smoke or abuse other substances Have a blood disorder Have an eating disorder Experience chronic disease Have had gastric bypass surgery Are having twins or higher multiples Even if you do not fall into these categories, ensuring you get all of your nutrient requirements daily will help give you optimal strength and energy levels. It will also give your baby the best head start possible during all of the important stages of development in the womb. Important Vitamins and Minerals Before and During Pregnancy You may be wondering which nutrients are especially important when pregnant, and how to choose the best supplement. Consult with your health provider to discuss your individual needs and which prenatal vitamins you should take before, during and after pregnancy. Many pregnant women do not get enough of this mineral from their diet to meet the body’s increased need. This can lead to a deficiency called anemia, in which the blood has a low number of healthy red blood cells. Iron supports the baby’s growth and development and can cut your risk for preterm delivery, low birth weight and even infant mortality. Folic Acid. This B vitamin is important to take even if you are in the planning stages of conceiving. The body absorbs the synthetic version of folic acid better than the natural one typically found in food, so even with a balanced diet, a folic acid supplement is recommended. It can reduce your baby’s risk of neural tube, heart, and other defects. Iodine is important for healthy thyroid function during pregnancy. It can also lower the risk of miscarriage, stillbirth and stunted fetal growth and development. Calcium helps your baby grow a healthy heart, strong bones, and teeth, nerves, and muscles as well as develop a normal heart rhythm. It can also reduce your risk of hypertension and preeclampsia. This mineral is important even after you give birth and if you are breastfeeding. Vitamin D. This vitamin is necessary for the absorption and metabolism of Calcium and Phosphorus. It is beneficial for immune function, healthy cell division and bone health in both mother and baby. You may be wondering if you should be concerned about other nutrients. Not all prenatal vitamins include omega-3 fatty acids which may help promote your baby’s brain development. Your health care provider may recommend this or other supplements, particularly if you do not eat fish or other omega-3 rich foods. Which Prenatal Vitamin Should I Take? There are many prenatal vitamins available in pharmacies to purchase over-the-counter. Consult with your health care provider if you are unsure which specific brand best meets your needs. He or she may recommend a prenatal vitamin that has the proper doses of nutrients for your particular circumstance. Final Thoughts If you still have questions or concerns about prenatal vitamins, don’t hesitate to contact us. Our physicians at Northside Hospital Cherokee provide nutritional counseling and can quickly get you on the right path to the proper allotment of vitamins and supplements for you and your little one on the way.

Contraception Education

Birth Control No-Nos

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Birth control is offered in many varieties with different instructions, so it can be confusing for women to know that what they are doing is correct. By using birth control correctly, you can increase its effectiveness. Here are the different methods of birth control and the common errors or actions you should avoid to keep yourself protected. Hormonal Contraception Hormonal methods of birth control have a low chance of error if used correctly. The pill is a common choice, but the first mistake is selecting the wrong pill for your body and lifestyle. Call your doctor for an appointment today to explore options and make the right decision. Birth Control Pills Missing a pill or forgetting to take the pill for a couple of days can negatively affect the way it works. This common error can be helped with certain steps. If you forget your pill, take one as soon as you remember, even if that means you take 2 in one day. If you forget 2 days of pills, take 2 the day you remember and 2 the following day to get back on track. Use a backup method until your next period. A big “no, no” when using the pill is to avoid taking rifampin, a drug used to treat tuberculosis, as it interferes with the effectiveness of the pill. General antibiotics are fine; however, be sure to use another form of birth control if you need to take anti-seizure drugs, anti-HIV drugs, and some anti-fungal medications. The Patch The patch is less effective when you apply it at the wrong time of your cycle. To have high effectiveness, you must implement it on the first day of your menstrual cycle or the first Sunday following your period. Also, be cautious of the day you change your patch, and do not apply it to skin that is moisturized, has make-up, or is ultra dry. Vaginal Rings The vaginal ring releases hormones into the body the same way the pill does. A typical mistake is not inserting it within 5 days of the beginning of your period. You will also be at risk of getting pregnant while using the ring if you forget to remove it after 3 weeks and don’t replace it within 7 days. Condoms and Barrier Methods When using a female condom, common mistakes include not applying enough lubrication and not entering the penis directly into the condom. Make sure to remove the female condom carefully after sex to avoid leakage. With male condoms, effectiveness is decreased if you do not leave enough space at the tip or do not remove the air before intercourse. Never reuse condoms, and make sure to hold the base when withdrawing. Be sure to check the expiration date before use along with the size and fit. If a diaphragm is not the right size for you, then it will not be as effective. Be sure to consult your doctor with questions at any point when using contraception. A common mistake to avoid is leaving your diaphragm in for more than 30 hours. Plan to remove the diaphragm or sponge 6 hours after sex and no sooner. Intrauterine Devices (IUDs) With IUDs being almost mistake-proof, they are one of the most effective forms of birth control. However, as with the pill, the ring and the diaphragm, the IUD only protects users from pregnancy, not sexually transmitted infections. Error or lack of effectiveness can arise from not checking the placement of your IUD after insertion. Be sure to check for the string inside your vagina as directed by your physician. Do not use a copper IUD if you are allergic to copper. If you are not in a committed relationship and have multiple partners, the IUD may not be the right choice for you. Similarly, with other forms of birth control, do not use an IUD if you are pregnant. When taking contraception post-pregnancy, check with your OB for the best course of action. Final Thoughts If you are considering birth control or are currently unhappy with your contraception, call your doctor with questions or for an appointment to explore options. Birth control is primarily designed to protect you from an unwanted pregnancy. It does not provide STD protection, so always use condoms if you are not in a committed relationship or may be at risk for STD exposure. To increase the effectiveness of your birth control, make sure to educate yourself about the risks and follow the appropriate instructions.

What to Expect: The Third Trimester

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The third trimester begins in the 28th week of pregnancy and ends when your baby officially becomes a newborn. This is a bulkier, less comfortable time, but will soon be over. At the end of this trimester, the fetus will be 17 to 23 inches long, fully formed, and weigh anywhere from 6 to 10 pounds. What Happens Now? Some new symptoms may appear, and familiar ones may intensify. They might include: Restless Leg Syndrome (RLS) and leg cramps: These can occur at any time. RLS is common in about 15% of pregnant women. Support hose, moderate exercise, less caffeine, and more fluids during the day may alleviate discomfort. Nasal congestion and snoring: Estrogen increases blood flow throughout the body, including nasal membranes. Nasal strips and saline drops often help. So can elevating the head during sleep. If snoring becomes intense, your obstetrician may want to rule out sleep apnea. Abdominal aches: The fetus is becoming more active. Growth is accelerating, widening the uterus so that it presses against your bladder, diaphragm and other organs. Discomfort is usually minimal. Fatigue: Finding a comfortable position in bed sometimes becomes difficult. It’s recommended that you not sleep on your back now, as the growing uterus can press on the main vein (vena cava) which pumps blood from your heart to the lower part of your body. Try sleeping on your left side, using pillows as props. Insomnia and/or bad dreams: Anxiety and overactive hormones may rob you of rest. Moderate exercise, a warm bath, massage, cutting caffeine and lowering the bedroom temperature helps enable sleep. Heartburn: Hormones and pressure from the uterus pushing the stomach upward can trigger indigestion. Consult your obstetrician before trying any remedies. Stretch marks: These may become itchy and more prominent. A good moisturizer can help. Varicose veins and hemorrhoids: Extra blood pumping through your body now can make these appear. Both usually diminish or disappear after birth. Clumsiness: Rapid body shape and size changes can make you misjudge distances and bump into surroundings. Try moving slower. This minimizes injury both to yourself and the fetus. Pregnancy fog and distraction: Forgetfulness and distraction are attributable to brain function changes during pregnancy. Research actually shows that women pregnant with females experience pregnancy fog more than those carrying males. This haziness disappears a month or two after birth. Until then, keep to-do lists on hand to jog your memory. Lack of bladder control/ frequent urination: Extra weight and pressure on the pelvic floor can result in leakage and constant bathroom visits. Do your Kegels and wear panty liners. Backache: A growing stomach pulls your center of gravity forward, triggering backache. Elevating your feet, a warm bath, and gentle massage can ease pain. If it’s intolerable, however, your doctor may want to rule out injuries like sciatica. Breast leakage: Your body is preparing for breastfeeding. Nursing Pads aid in preventing staining. Lightening: At about week 36, you might notice your shape changing. Your stomach will drop lower and you could start waddling. Your baby is changing position to prepare for birth. Your breathing will be easier, heartburn may diminish, but urination may become more frequent. Mucus plug: A clear gelatinous plug may detach from the uterus weeks or immediately before labor. This means the cervix is softening and preparing for delivery. Braxton Hicks: These irregular contractions are often mistaken for the real thing by first time moms. They can occur intermittently weeks before you actually go into labor. Bloody show: Pink or brown tinged mucous indicates that you are effacing and dilating. Labor is close at hand, but it can still be several days to a few hours away. Blood should not be bright red or excessive though. Call your doctor if it is. Water breaking: The amniotic sac has ruptured and labor is approaching. If steady contractions have not begun within 24 hours, labor might be induced to avoid infection. Contractions: These are regular and stronger than Braxton Hicks and will not diminish. Your doctor will advise you as to how long to wait before leaving for the hospital. What Precautions Can I Take During This Time? You can continue to do exactly what you’ve been doing all along- take care of yourself and your baby. Eat well but watch your weight. Rest when necessary, but avoid becoming inactive. Moderate exercise will make your labor and delivery easier. Avoid strenuous activity or heavy lifting. If you are uneasy about anything or notice radical symptoms that worry you, consult your doctor. How Important Are Fetal Kick Counts? (Very!) Dr. Litrel discusses the importance of counting fetal kicks during your pregnancy. Fetal Kick Counts Your baby’s movement may provide information that help us care for you during this pregnancy. During a convenient hour each day, after eating and emptying your bladder, please lie down (on your side is best) and concentrate on your baby’s movement. Note each movement. Smoking may interfere with the movements and should be avoided during pregnancy. Count the number of movements for thirty minutes. Your baby should move at least five times in that thirty minutes. If your baby moves less than five times during that thirty minutes call your physician or go to the hospital. Call your doctor if you experience: Decreased fetal movement Rupture of membranes (water breaking) Contractions every 2-5 minutes (more than five per hour) Cramps in the lower abdomen with or without diarrhea Low, dull backache felt below the waistline Temperature over 100 degrees Vaginal spotting or bleeding. Helpful Hints: Be sure to drink at least 8-10 glasses of water every day (in addition to anything else you drink). Eat small frequent meals to avoid heartburn. Use Tylenol for minor aches and pains. You may take warm baths or showers, place a heating pad on your back using low heat setting and rest with your feet elevated. What Tests are Performed During the Third Trimester? By this time, most precautionary tests have been completed, and only these regular routine tests are done

What to Expect: The Second Trimester

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The second trimester takes place from the 14th to the 27th week of a woman’s pregnancy. This is usually the most comfortable and pleasant time. Mercurial Jekyll/Hyde moods begin to balance out. You no longer sob uncontrollably over a run in your hose, or laugh maniacally when someone passes gas. Morning sickness is becoming a distant memory, and you can now start showing off that baby bump in all those maternity tops you’ve carefully selected. Even that sex drive that may have waned somewhat during the nausea, exhaustion and general malaise of your first trimester may return. What Happens Next? The egg (zygote) evolved from being the size of a pinhead into a recognizable little human being, first called an embryo and, after 8 weeks of gestation, a full-fledged fetus. New symptoms may occur, but generally, they are more tolerable than the previous three months. These may include: Nightmares: Stress, hormonal change and anxiety can affect sleep, causing you to dream about outrageous, even horrible scenarios. Waking up in a cold sweat may happen more often. Abdominal discomfort: Aches and pains caused by a stretching uterus and ligaments is normal. Excruciating pain, however, is not. Call your doctor if you experience anything other than moderate discomfort. Quickening: This is the term given to feeling the fetus stir inside you. At about 16 to 20 weeks, you will feel a slight flutter. As the baby grows and takes up more room, movement is felt more distinctly. Blips: An odd bubbling sensation that turns into a stronger methodical twitch as pregnancy continues is simply the fetus experiencing hiccups. Don’t worry. He or she is not having seizures. Your dinner probably just didn’t agree with it. Breathlessness: The uterus can crowd the lungs as the fetus grows, disrupting smooth air flow. Unless you are gasping for air, some breathlessness is normal. Body shape changes: The waist thickens, hips expand, your derriere can widen, and even your face may produce an extra temporary chin if you gain too much weight too quickly. By the end of the second trimester, you will have probably gained 16 to 22 pounds. Only two can be attributed to the baby. The rest is placenta, uterus, amniotic fluid, body fluid and blood. Your body also stores about 7 pounds of fat throughout pregnancy to prepare you for breastfeeding. Stretch marks: Your tummy and thigh skin, elastic as it is, can only stretch so much at a rapid pace before the middle layer of skin (dermis) tears, exposing the deeper layers. Most of these marks diminish or disappear after birth. Bleeding gums: Many women experience sensitive, bleeding gums due to hormonal changes. Use floss gently and get a softer toothbrush, but don’t skimp on your dental hygiene habits. Heartburn, constipation and hemorrhoids: All are common. Smaller meals are recommended, along with more fiber and fluids. Try Sitz baths and speak to your doctor about an ointment or cream to relieve irritation. What Precautions Can I Take During This Time? Keep in shape with moderate, low impact exercise. Eat healthy and keep junk food to a minimum. The more weight you gain, the harder your labor can be, and losing excess pounds afterwards may be difficult. Avoid unnecessary medical procedures such as Botox injections, chemical peels etc. Even whitening your teeth or coloring your hair can be harmful. Take no medications without speaking to your obstetrician. Keep all your prenatal appointments. You will probably be seen once a month during this time, more often if problems are detected. It’s important to monitor your progress. What Tests Are Performed During the Second Trimester? Urine tests: These will be requested at every visit to monitor protein levels. Maternal serum alpha-fetoprotein (MSAFP) and multiple marker screening (MMS): One or the other are offered for genetic screening and are optional. They are used to measure specific fetal protein output to determine if there is a possibility of Down syndrome or spina bifida. If positive, an ultrasound or amniocentesis is done for confirmation. Sonogram: This non-invasive procedure can be done at any time during pregnancy, but is typically conducted at the end of the first trimester or during the second to confirm gender and due date. It can also reveal such conditions as placenta previa, cleft palate, and many other developmental or growth problems. Glucose screening: This checks blood sugar levels for gestational diabetes. If readings are elevated, a glucose tolerance test may be ordered. Fetal Doppler ultrasound: Sound waves determine if fetal blood flow is normal. How Big is My Baby Now? The fetus is about 14.5 inches long and weighs a little less than 2 pounds. It is about the size of a cantaloupe and is able to blink, sleep and wake up. The brain is very active and developing rapidly. Its maturing taste buds can now taste what you eat. Experts even believe dreaming is possible. Hearing is becoming more acute and sensitive eyes may react to light. Each trimester has its own unique milestones, and our doctors have the knowledge and expertise to make sure that your pregnancy is progressing safely and well. For more information, visit Northside Hospital Cherokee. For an appointment, call our clinic at 770.720.7733.

What to Expect: The First Trimester

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Congratulations, you’re pregnant! If you’re already a parent, you know what to expect, but if this is your first child, pregnancy can be a mysterious, sometimes almost frightening process. Today’s pregnancy tests are so precise, that they can detect the presence of human chorionic gonadotropin (Hcg) levels within days following fertilization. Immediately after a fertilized eggs attaches to the woman’s uterine wall, her body produces this hormone. A pregnancy strip can confirm conception has taken place by identifying Hcg presence in only a few drops of urine. What Happens Next? The average pregnancy lasts 280 days or 40 weeks, calculated from the first day of the woman’s last menstrual period. The first trimester covers week 1 to 12. As soon as the fertilized egg (zygote) latches on to the uterine wall, both the umbilical cord and placenta begin to form. Hormonal changes rapidly begin taking place in your body. Often, early symptoms of pregnancy are mistaken for PMS. These symptoms and others include: Spotting or bleeding Fatigue Dizziness (and possibly even fainting) Aversion to certain foods Queasiness or nausea Headache Cramps Bloating Moodiness Backache Breast tenderness More frequent urination (micturition). Can Anything be Done to Counteract These Symptoms? When the egg implants itself into the uterine wall, spotting may occur, but it’s always wise to report any bleeding to your doctor to rule out the possibility of miscarriage, ectopic pregnancy or infection. Additional progesterone can elevate blood pressure, dilate vessels, overheat the body, and force the heart to beat faster when sending blood to the uterus. All these changes can bring about fatigue, moodiness, dizziness and possible fainting. Progesterone can also slow some body functions down, including digestion which causes nausea, vomiting, constipation, and indigestion. The body reacts by trying to purge what is upsetting it, resulting in morning sickness. Higher Hcg in the body, especially in a multiple pregnancy, can also trigger nausea. It’s best to avoid foods that repel you during this stage. For intolerable nausea or vomiting, inquire about supplements or devices that can ease discomfort. If you experience dizziness, move slowly, especially when you get up from sitting or lying down. Should faintness occur, sit down with your head between your knees. Rest when possible. Moderate headaches may be relieved with acetaminophen, but never without consulting your physician. If symptoms are excessive, speak to your doctor. Cramps, bloating and backache can also be attributed to hormonal fluctuations. Frequent urination, even in this early stage, is usually the result of uterine growth and pressure against the bladder. Fluid intake should not be limited, as this is a normal occurrence. Breast tenderness is also hormonal. The breasts are preparing themselves for the baby’s upcoming nutritional needs. Investing in a good support bra may help. What precautions can I take during this time? Don’t smoke, and avoid exposure to second hand smoke. Don’t drink alcohol or use recreational drugs. Mention any prescription drugs you use to your doctor. Avoid caffeine Disclose any work hazards to your obstetrician, such as exposure to harmful chemicals, radiation, dangerous metals, toxic waste, etc. Do not eat or handle raw meat. Wash all fruits and vegetables thoroughly. Wear gloves while handling soil. If you own a cat, have someone else change the litter, and wash hands diligently after animal contact to avoid risk of toxoplasmosis which can harm your baby. Discuss your diet with your doctor and make necessary recommended changes. Take any vitamins, supplements and minerals your doctor prescribes regularly. Is it Safe to Engage in Sex During the First Trimester? Unless you have a specific medical condition of concern, it is safe to have sex. How Big is My Baby in the First Trimester? Between week four and twelve, your baby grows from the size of a tiny fig seed to roughly the length of that credit card you’re probably beginning to max out in happy anticipation. He or she is almost 3 inches long, weighing approximately one ounce and is about the size of a golf ball. Yet, by now, those tiny fingers have fingerprints. Organs are formed, functioning, and are visible through almost transparent skin. A heartbeat can be detected. The body is beginning to catch up with the head that still accounts for one third of body size. Reflexes are becoming sharper. The fetus can make sucking motions and respond to stimuli such as prodding. Eyes are close together on the face instead on either side of the head. Ears are forming and almost in position. The skeleton is made of cartilage that will gradually become bone. Gender is discernable. What Tests Are Performed During the First Trimester? Your blood will be will screened for type, count, RH factor, anemia, German measles (rubella), hepatitis B, HIV and other sexually transmitted diseases, along with exposure to diseases such as toxoplasmosis and varicella. Other test will look for genetic problems such as sickle cell anemia, Tay- Sachs disease, cystic fibrosis, etc. A combination blood/ultrasound nuchal translucency for Down syndrome and other chromosomal abnormalities may be offered during the latter part of this trimester. Glucose levels will be analyzed for signs of diabetes and urine checked for albumin which may indicate preeclampsia An ultrasound, usually near the end of the first trimester, will determine a due date, gender, and normal fetal progress. Although your baby develops throughout your entire pregnancy, extra precaution during the first trimester when fetus growth is so accelerated is vital. Our doctors can guide you in all the ways possible to ensure both your health and that of your child. For more information, visit Northside Hospital Cherokee. For an appointment, call our clinic at 770.720.7733.

Heart Health During Pregnancy

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Nutrition During PregnancyEvery pregnancy is different, and as a mom-to-be, you need your own, doctor-recommended diet to ensure you and your baby get all the nutrients you need. But refocusing on diet and exercise helps you maintain your weight, limit the effects of postpartum, and keep your baby growing strong. This February, Cherokee Women’s Health celebrates American Heart Health Month. After all, moms-to-be aren’t just keeping one heart healthy. From the first time you hear your baby’s heartbeat, your own is racing with anticipation, joy, and more than a few nerves. Keep your heart strong during pregnancy by taking care of your body and your health. Eat high fiber grains and nuts Get plenty of omega-3 fatty acids from olive oil and pregnancy-safe fish like salmon Avoid salt, which can increase blood pressure Do several low-to-moderate intensity workouts each week, unless your doctor recommends rest Avoid eating or drinking caffeine, which can cause irregular heartbeats Avoid Consuming Caffeine Caffeine increases your blood pressure and heart rate — bad news for both your pregnancy and your heart health. Not only can it lead to dehydration, caffeine crosses the placenta to your baby, who can’t yet metabolize it . Most women know to avoid major sources of caffeine like coffee during pregnancy, but you may not realize how many of your favorite craving snacks sneak caffeine into the mix. Caffeine is found in: Tea Soda Coffee (even decaf!) Chocolate Energy-enhancing foods and drinks (such as energy water or fortified foods) Coffee or chocolate flavored ice cream Some over-the-counter pain relievers like Excedrin While it’s considered safe to consume small amounts of caffeine during pregnancy, it’s easy to lose track. Talk to your doctor about how much caffeine is safe for you and your baby during your pregnancy. Heart Disease and Pregnancy If you’ve ever been diagnosed with heart disease, high blood pressure, or have had cardiac symptoms such as chest pain, shortness of breath or palpitations, alert both your cardiologist and your OB/GYN. List all medications you’re taking, and make sure none of them will have adverse side effects on your baby’s development. For more information on health during pregnancy, contact Cherokee Women’s Health.

James Haley, MD, FACOG, FPMRS: Becoming a Doctor is a Challenge and a Calling

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Dr. Jim Haley has just finished a morning performing surgeries in the O.R., and is headed into a full afternoon schedule of patients. Chatting as the interview begins, he mentions that when the weekend comes, he’ll be participating in his first Obstacle Race – a run in which he will face mud pits, barb wire, and ice baths. “I guess I’ve always been drawn to action,” Dr. Haley smiles, “life and death drama. From the time I was 13 or 14, it seemed to me I was supposed to be a doctor. I figured maybe surgery or E.R. medicine. But when I got to medical school and delivered my first baby, I knew right then I wanted to be an obstetrician. “I don’t remember this, but after that first delivery, my wife Lisa tells the story of me coming home just laughing off and on all night – because it was SO COOL. I’d never experienced anything like that before! “I’m drawn to challenges. There’s a lot of challenges to being an obstetrician – the training, being on call, the long hours, and dealing with such an important part of peoples’ lives. But it seems like the challenges drive me in life – physical challenges, too. “Over the years I’ve been in 7 marathons, 1 ultra marathon, 15 triathlons, and 1 Iron Man. (An Iron Man is a Triathlon in which the participant swims 2.4 miles, runs 26, and bikes 112.) Recently, Dr. Haley also became one of the select number of Georgia OB/GYN’s to be board-certified in the subspecialty of FPMRS, Female Pelvic Medicine and Reconstructive Surgery. He says simply, “I like to go after things that are hard to do.” What experiences have shaped you as a doctor? “One great memory about being an OB was getting to deliver my two children. And it made me laugh, too. I’d delivered lots of babies and watched them being taken to the nursery afterward. But I noticed that this delivery was different: they weren’t taking this one away. They were leaving him in the room. And I had to laugh when I realized that was because he was mine. “But something that had a big impact on me was that Lisa and I had two miscarriages – I think this was God’s way of helping me be empathetic about the pain my patients feel when they lose a baby.” Do you have a philosophy about practicing medicine? Dr. Haley mentions his faith directly and without self-consciousness. “I think of being a doctor as my calling. I love the Lord, I love my family, I love my wife Lisa. As a Christian, we are called to serve and help others – this is the calling God has designated for me, and how I can do that.” Click here to learn more about Dr. Haley, and to watch his interview. FUN FACTS about Dr. Haley Top Doctor Dr. Haley was named “Patient’s Pick Top Doctor” for favorite Gynecologist in Cobb County by Atlanta Magazine in 2012. Iron Man Dr. Haley’s done 7 marathons, 1 ultra marathon, 15 triathlons, and 1 Iron Man. (Swim 2.4 miles, run 26 miles, bike 112 miles.) New Orleans Boy Dr. Haley lived in New Orleans for 22 years before becoming a Georgian, with two brothers still there. During Hurricane Katrina, Dr. Haley’s mother, age 91, came to live in Rome, Georgia – and is still there!

Teen Mom Shares Her Story

Diane /

Hannah with her sons and Aunt Cindy Hannah is a young mother we’re spotlighting this month to help educate teens about the challenges of teen pregnancy. We had a little Q&A session with Hannah in which she shared her experiences as a teen mom. Can you tell us what it was like becoming pregnant as a teen? I was in high school when I became pregnant so that in itself was difficult. I basically skipped my childhood so that was hard, especially when my friends were enjoying a regular teenage life. But everything had changed and nothing was more important than my baby so I knew I had to take it seriously and behave responsibly. How did you handle school? I stayed in school for the first four months of my pregnancy. After that, I took online classes. When I returned to high school about a year later, I was dual enrolled and took classes at Gainesville State as well, where I graduated with honors. From there, I went to college at North Georgia and then transferred to Brenau University, where I entered their nursing program. I also graduated with honors from there and now have my bachelor’s degree in nursing. What motivated you? My son was my biggest motivation. I wanted to give him a better life. I also wanted to prove to myself that I wasn’t going to be a statistic. Getting pregnant in high school meant facing a lot of judgment and criticism. I was told I wouldn’t amount to anything and that I wouldn’t even graduate high school. For me, regardless of my circumstances, my dreams were more important and I didn’t want to give up on them. How did you handle child care? I had an excellent support system. My parents were especially wonderful. They helped watch my son while I was in school or had to study. Without them, I don’t know where I would be. My grandparents and family friends also helped care for my son. Having a strong support system definitely played a huge role in my success. How has your life changed since then? There have been so many changes. I got married last May and gave birth to my second child in March of this year. In regards to my career, I’ll be working as a nurse at the Ronnie Green Heart Center of Northeast Georgia. I worked there as a nurse extern in the cardiac Intensive Care Unit during my last year in college and upon completion, they offered me a position. What would you like pregnant teens to know? I want them to know that their life is not over. That there’s still hope for a bright future. And even though they’ll probably be told they can’t make it, it’s simply not true. Even when the judgment seems unbearable at times, they just have to push through. It’s not easy but they can do it. After all, if I can become a success story, anyone can.

5 Tips for Surviving Your OB Visit

Diane /

You’re having a baby! Yipee!! Oh but wait, that means doctor’s appointments. But after that initial joy, reality sets in and you realize you’re in store for a lot of appointments. And exams. And blood being drawn. Ugh. But fear not, we’re here to help you with real issues expectant moms face when visiting the OB. The Wait! Oh, the Wait! You booked your appointment and what happens? You sit in the waiting room for what seems like days. No one likes waiting but thank goodness, most of us now have smart phones to help distract us. So to help pass time, whip it out and play a game of Words with Friends, check your friends’ status updates or get caught up on your work emails. Whatever it is, these distractions can be a huge help in passing the time. Book Your First OB Appointment Early Sure, an extra hour of sleep is awesome but if you book your appointment early in the day, you’re more apt to be seen quicker than if you booked a later appointment. Why? Because an early appointment means the office is less likely to be running behind. But what happens if an early appointment isn’t available? Call ahead to see if things are running on time. The receptionist may just tell you it’s okay to show up a little later. Just be sure to triple check how late you can show up as you’d hate to lose your spot altogether! Dr. Gandhi on What to Expect at Your First OB Visit Your first OB visit is the best time to discuss all of your pregnancy questions. Go to Your Happy Place The dreaded exam. Nobody likes it. After all, you’re showing your most intimate parts to a near stranger and you can’t help but wonder if you’re “normal” or if you groomed well enough, etc., etc. Oh, the things that run through our minds when we’re on that exam table! Some of us joke to the point of embarrassing ourselves (yours truly), while others think of anything other than the task at hand. But just remember this, while it’s the first time in months that your legs have been in stirrups, it’s the umpeteenth time your doctor has seen the same parts just that week. And as any OB will tell you, they’ve seen every size, shape and form and they certainly aren’t passing judgment. They’re simply there to help you with your health concerns. Blood Work Being probed and having your blood drawn isn’t exactly on anyone’s bucket list. But there are a few things you can do to help alleviate the discomfort. Start by talking to your doctor before the exam. Ask them what you can expect to feel before they start. Just knowing what to expect can take a lot of the fear and surprise out of it. And the less tense you are, the less discomfort you will feel. Another great tip is listening to music on your iPod, taking deep breaths or visualizing a favorite vacation. When you’re having your blood drawn, look away and don’t be afraid to turn into a Chatty Cathy. These tricks will definitely help take your mind off of things. Ask Those Questions If you ever feel like your doc breezes in and out before you even have a chance to ask one question much less the list of questions you had in mind, you will definitely leave your appointment frustrated and worse than that, without the information you need. To help ensure you get what you need out of your appointment, have a list of your questions in hand when the doctor enters the room and just start asking! And please know, it’s highly likely that your doctor isn’t even aware that you’re feeling rushed. She just knows that she has a lot more patients to see and is doing her best to keep on schedule. To get more time next time, ask if you can schedule a longer appointment. Just be sure to ask if you’ll be billed extra and if insurance will cover it. Birth Plans: More Like a Wish List You’ve put a ton of time into creating the perfect birth plan and you’re so excited to show your doctor how invested you are and what happens? She barely glances at it. What?! Before you get upset, try looking at it from the doc’s point of view. If everyone handed her a novel of a birth plan, she’d never get around to seeing her patients. So what to do? Make a list of bullet point items and discuss them with her. And make sure you prioritize and touch on the deal breakers without focusing so much on your “wish list”. This will help ensure that you’ll be heard and your doc is more apt to take your preferences seriously. Hopefully these tips will make your next OB visit a little more pleasant. To schedule your appointment, please call us at 770.720.7733 or visit us online at cherokeewomenshealth.com.

Giving Birth is Like Riding a Roller Coaster

Diane /

I love the twists, turns and rapid descents of roller coasters. Do you remember the first roller coaster you ever rode? Nope, it wasn’t at Six Flags or some other awesomely fun amusement park. It was while you were maneuvering through the birth canal. That’s right, the process of being born is very much like riding a roller coaster. Cardinal Movements The journey an infant takes and the adaptations made while being born is referred to as the cardinal movements. The first cardinal movement is called descent. Just as you feel when your stomach drops as the roller coaster rushes down full speed, down into the valley, securely positioned into your seat by the tight lap bar, an infant’s head is pushed deep into the pelvis. Flexion Next is flexion. Do you remember trying to raise your head in the coaster while diving into the valley at high speed? This is similar to an infant’s chin that’s secured onto the breast bone as they prepare for the tight fit. Just as you can’t raise your head, neither can a baby. Engagement Engagement is next. This is the moment you catch your breath before the next thrill, the next turn. This is when an infant’s head reaches the pelvic inlet. The infant now undergoes a sharp internal rotation, sometimes at a 90 degree angle, in order to accommodate your pelvis. And just as the coaster comes out of its last turn, the infant extends its head, only to take one last turn before applying the brakes. External Rotation Next is external rotation. This is the this final turn that allows for the infant to line its head up to its back to allow for the final step, which is expulsion. And finally, the screams. All at once, the cries of excitement and relief converge. Season Passes Just as you might have a season pass for an amusement park, some women open up admission to allow for riders every season! Two, three, four or more deliveries later, these season passes can take a toll on a woman’s equipment. Can you imagine the CEO of Six Flags complaining because they’ve sold too many tickets for the roller coasters and are now making too much money? Well that’s kind of how women view it when they come to see me about pelvic complaints. After all, what right do they have to complain about the wear and tear on their equipment when the birth of a child makes them so rich with love and blessings? We Are Human It’s this very notion that I try to absolve. Urinary incontinence, pelvic organ prolapse, and suffering obstetric lacerations are not a rite of passage. It simply reveals how vulnerable our bodies are to trauma. It simply makes us human. Thankfully, our ability to repair our bodies makes us sustainable. The miracle of birth does not need to be altered but the recovery can be optimized. When I see a woman and discuss these very personal issues, I keep in mind this notion she came with and value her beauty as a mother. I also try to reassure her and offer solutions to restore her beauty as a woman as well. After all, being a woman and a mother are two of the most beautiful things on this planet and they deserve to be treasured. -Dr. Peahen Gandhi

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