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A natural birthing experience is desired by many expecting mothers…But what does ‘Natural Birth’ really mean?  For some women it means a vaginal birth with little or no medical interventions, for some it means a vaginal birth without pain medications (or without an epidural), for others it may mean any accomplished vaginal birth, and not a cesarean section.

Nearly a third of babies in this country are delivered by cesarean section. The more recent adoption of early skin-to-skin contact and intraoperative breastfeeding, not only benefit maternal-infant bonding, but also benefits the baby in terms of earlier success with breastfeeding.  It simulates a more ‘natural birthing’ experience, preventing the feeling of ‘disconnect’ for the parents of cesarean section babies, while separated from their baby in the operating suite.

As a practicing Ob/Gyn, I hold no strict or definite definition of ‘Natural Birth’.  I allow the patient to decide and define whatever ‘Natural Birth’ means to them.

Suzanne Hall, MD (@drsuzyyhall)

Expecting and new mothers are faced with many decisions in preparation for the care of their newborn baby, the decision to breastfeed, being among one of the most important ones.  We’ve all heard the advice of family and friends that “breastfeeding is better for the baby”, but how true do we really know this to be?

The fact is, it is true.  Medical research has shown human breast milk, over formula feeding, to benefit the infant in several ways.  Some of those benefits include, improvement in gastrointestinal functioning, improvement in immune defenses, thereby reducing the occurrences of several acute illnesses, and enhancing the maternal-infant bonding, possibly reducing infant stress.  Because of the proven health benefits to infants, many national health organizations have recommended exclusively breastfeeding infants for the first 6 months of life (i.e., Academy of Pediatrics, the American Congress of Obstetricians and Gynecologist, The World Health Organization.)

An exciting time for expecting parents is the first sensation of fetal movement, medically termed ‘quickening’.  Though fetal movement can be seen by ultrasound as early as the first trimester, the perceived, physical sensation of fetal movement generally occurs by around the 20^th week of the pregnancy.  This sensation of fetal movement may vary among women, and among different pregnancies.  Some first-time moms may not perceive this movement until up to 22^nd-24^th week of pregnancy, while others may recognize the sensation of movement as early as 16-18 weeks.

This sensation of early fetal movement has been described as feeling like the fluttering of a butterfly, a tickling, or a light tap.  The differences in the timing of your perception of fetal movement may be based fetal/placental location, or the anatomy of your abdominal wall.  Initially, it may be hard to distinguish these movements from a feeling of gas or a hunger pang.  But once you recognize the sensation as fetal movement, you’ll most likely be reassured and happy with your baby’s activity!

What is a Certified Nurse-Midwife?

More and more women in the US are choosing a certified nurse-midwife (CNM) for their pregnancy, birth, postpartum, and well-woman care. Certified Nurse Midwives are licensed health care providers educated in nursing and midwifery. They have master’s degrees in nursing, certified by the American Midwifery Certification Board, and are licensed to practice midwifery in the state of Michigan. National statistics show that in 2009 CNMs attended 11.9% of vaginal births, an all time-high. This trend has been discussed in newspapers such as the New York Times and in movies such as The Business of Being Born. As a leader and innovator in women’s health care, Eastside Gynecology and Obstetrics has committed to bring midwifery services to their clients, the only practice that does so in the area.

The midwives at Eastside Gyn/OB provide personalized, individualized care. We nurture each mother and her family with sensitive, holistic care. Our clients love that they get to know the person who will be taking care of them for their birth. We also have a commitment to promoting physiologic labor and birth, believing that labor works best when allowed to begin in its own time and progress at its own pace. At the same time, we are trained to recognize those situations where intervention is warranted and have the benefit of a close and supportive working relationship with the physicians in the practice when referral or consultation is needed.  As midwives, we aspire for you to have the birth experience that you desire. We promote mother-infant bonding immediately after birth, delayed cord clamping, breastfeeding, and childbirth classes such as hypnobirthing. We also desire for each birth to be a family experience for all who wish to be involved.

Did you know that up to 10-15% of pregnancies are affected by hypertension? About 5% of those cases are in women previously known to have hypertension (termed ‘chronic hypertension’), prior to pregnancy.  Another 5-8%, develop hypertension within the pregnancy (termed ‘gestational hypertension’ or ‘pregnancy-induced hypertension’.)

Hypertensive disorders are characterized by blood pressures consistently ranging 140/90 or greater.  Women with chronic hypertension (existing before pregnancy, or diagnosed before 20 weeks of gestation) may require blood pressure medications to control their blood pressure, even throughout the pregnancy.  Those medications should be reviewed with your healthcare provider, to assess their safety in pregnancy, even before conception.

If anyone should know the concerns of choosing pregnancy and childbirth later in life, as an Ob-Gyn physician, having given birth to my first child at 39 yo, I should think I’d be one of them.   With my training and experience as an Ob-Gyn physician, I was fully aware of my risks in deciding on childbirth…as a woman of ‘advanced maternal age’.  I counsel women on their risks nearly every day.

I already knew that at my age, it may take longer for me to get pregnant. I knew that advancing age is associated with subfertility (prolongation in time to achieve conception,) and I knew this to be related to altered/changing hormonal patterns as we age, leading to suboptimal ovulation.  I already knew that there is decreased ovarian reserve (fewer fertilizable eggs remaining in our ovaries) as we age.  I also knew that advancing age was associated with a higher risk of miscarriage, most likely related to the poorer quality of aging eggs, and the increased chances of fertilizing an egg containing abnormal chromosomal material...

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Suzanne Hall, MD  (@drsuzyyhall)

Today we are going to discuss miscarriages.  Miscarriages happens in 1-2 out of every 10 pregnancies.  The majority of them will happen in the first 12 weeks of pregnancy. When you lose more than 2-3 in a row, it may be called recurrent miscarriage.  There are multiple reasons that can cause miscarriages.  Unfortunately, more than half of them are unknown.

Some of the known causes are chromosomal or genetic issues, medical conditions in the mother, and problems with the mom's uterus.  By far the most common is chromosomal issues. This accounts for more than 50-60% of the losses.  Some other causes are maternal medical conditions such as autoimmune disease like Lupus, uncontrolled high blood pressure, heavy smoking, clotting disorder and uncontrolled diabetes.  In addition, some women's uteri may have formed abnormally at birth. This is called uterine anomaly. This can also contribute to miscarriages as well.

For those of you that have experienced a miscarriage, there is no better way of describing it other than that it "sucks".  It is a lost of life. You'll feel sad just as if you would if you had loss someone.  In a way you did.

However, what I try to tell my patients is this. Know that the majority of the losses are from a chromosomal issue that is out of your control. So don't beat yourself up. Don't think back and say "maybe I shouldn't have done that, drank that, or taking that medicine".  There will be a natural feeling of guilt. But that's ok. Your human.  But understand that the majority of the times it's NOT YOUR FAULT.  This is very important to understand.

The good news is that even if you had 2 or 3 miscarriages, the chances of you having a healthy baby is still very high.  With the advances in medicine, we can correct uterine anomalies and treat the mom's medical conditions, and hopefully, help you achieve a healthy baby.

Until next time...

docbchen

Today we are going to discuss miscarriages.  Miscarriages happens in 1-2 out of every 10 pregnancies.  The majority of them will happen in the first 12 weeks of pregnancy. When you lose more than 2-3 in a row, it may be called recurrent miscarriage.  There are multiple reasons that can cause miscarriages.  Unfortunately, more than half of them are unknown.

Some of the known causes are chromosomal or genetic issues, medical conditions in the mother, and problems with the mom's uterus.  By far the most common is chromosomal issues. This accounts for more than 50-60% of the losses.  Some other causes are maternal medical conditions such as autoimmune disease like Lupus, uncontrolled high blood pressure, heavy smoking, clotting disorder and uncontrolled diabetes.  In addition, some women's uteri may have formed abnormally at birth. This is called uterine anomaly. This can also contribute to miscarriages as well.

For those of you that have experienced a miscarriage, there is no better way of describing it other than that it "sucks".  It is a lost of life. You'll feel sad just as if you would if you had loss someone.  In a way you did.

However, what I try to tell my patients is this. Know that the majority of the losses are from a chromosomal issue that is out of your control. So don't beat yourself up. Don't think back and say "maybe I shouldn't have done that, drank that, or taking that medicine".  There will be a natural feeling of guilt. But that's ok. Your human.  But understand that the majority of the times it's NOT YOUR FAULT.  This is very important to understand.

The good news is that even if you had 2 or 3 miscarriages, the chances of you having a healthy baby is still very high.  With the advances in medicine, we can correct uterine anomalies and treat the mom's medical conditions, and hopefully, help you achieve a healthy baby.

Until next time...

docbchen

So what should you expect in the first trimester of pregnancy?  For many of you, this is a very exciting time.  Especially if you’re a first time mom.  There is A LOT happening in your body both hormonally and physically.  Some will experience emotional swings because of the hormone surges.  So husbands, please be understanding.

From a physical standpoint, it is not uncommon to feel menstrual type cramps because everything is growing and being stretched.  This type of pain is typically cramping and sharp shooting in nature.  This is because there are ligaments that are attached to your uterus.  The easiest way to describe them is that they are like rubber bands that attach to your uterus.  So as you grow, they stretch.  And sometimes, if they stretch too much, they’ll spasm and you’ll experience a sudden sharp shooting pain.  This pain can feel like someone is jabbing you from the vagina up (doesn’t that sound good), and sometimes it’ll feel like a shooting vaginal pain down wards or across your lower abdomin.  These typically don’t last long, but it can be quite uncomfortable.  This is completely normal.  It does not mean you are trying to have a miscarriage.  It’s normal growth.  However, most Ob/Gyn’s will order an ultrasound to make sure everything is ok.

The other thing that can happen early on is nausea and vomiting.  This is normal because of the hormonal changes that is occurring.  It typically peaks between 8-10 weeks for most women, but some will continue beyond the 12th week.  There are a wide range of treatment including vitamins, pressure point stimulator, and medicine that can help.  Please talk to your health care provider if your experiencing severe nausea or vomiting.

The first trimester can also be a time of anxiousness.  This is true for anyone that has had a miscarriage.  Most miscarriage will happen in the first trimester, and the majority of these are related to chromosomal abnormalities.  While there are certain behavors that may increase the risk of miscarriage such as smoking and high caffeine intake, the majority of miscarriages are uncontrollable.  Symptoms of miscarrage are usually severe recurrent cramping that doesn’t ease up and vaginal bleeding.  If you have these symptoms, please notify your health care provider.

Hope this quick synopsis helped answer some of your questions.  Good luck!

docbchen