According to US Department of Health and Human Services | National Institutes of Health, having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular prenatal care improves the chances of a healthy pregnancy. This care can begin even before pregnancy with a preconception care visit to a health care provider.
Listen in as Dr. David Benavides, obstetrician/ gynecologist and a member of the medical staff at Doctors Hospital of Laredo, explains the importance of good prenatal care to help insure a healthy mom and a healthy newborn.
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The Importance of Prenatal Care
Featured Speaker:
Dr. Benavides’ mission is to provide the highest quality of comprehensive healthcare for women of all ages. In his spare time, he enjoys playing the guitar, helping out with the youth ministry at his church, and spending time with his wife and four children.
David Benavides, OB/GYN
Dr. David R. Benavides is an obstetrician gynecologist and a member of the Medical Staff at Doctors Hospital of Laredo. He is a native Laredoan who received his medical degree from the University of Texas Medical Branch in Galveston, Texas. He completed his residency training at Parkland Hospital in Dallas.Dr. Benavides’ mission is to provide the highest quality of comprehensive healthcare for women of all ages. In his spare time, he enjoys playing the guitar, helping out with the youth ministry at his church, and spending time with his wife and four children.
Transcription:
The Importance of Prenatal Care
Melanie: (Host): According to the US Department of Health and Human Services and the National Institutes of Health, having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular prenatal care improves the chances of a healthy pregnancy and this care can begin even before pregnancy with a preconception care visit to a health care provider. My guest today is Dr. David Benavides. He's an obstetrician gynecologist and a member of the medical staff at Doctors Hospital of Laredo. Welcome to the show, Dr. Benavides. What do you tell women is the most important bit of information you like them to know about the importance of prenatal care?
Dr. David Benavides (Guest): What I like to tell them to always start thinking about pregnancy and your child, as we all care for our children, and to get early prenatal care because it could definitely improve any adverse outcomes that we try to avoid during pregnancy, and frequent early care is definitely important to all women seeking pregnancy or definitely who are pregnant.)
Melanie: What's meant by prenatal care?
Dr. Benavides: Prenatal care is basically to seek medical care to identify any kind of medical condition that can affect a pregnancy, to avoid any adverse outcomes to the pregnancy, to develop a close relationship with your physician to identify any problems that could arise or that do arise, to treat and formulate a safe pregnancy for the patient.
Melanie: What steps do you want a woman to take if she was just starting to think about getting pregnant? What is it you want her to do, Dr. Benavides? Do you want her to start taking folic acid, prenatal vitamins, or is it too soon for that? Would you like her to try and get some exercise, get her body in shape? What steps do you want her to take?
Dr. Benavides: Well, definitely if they're starting to think about pregnancy, those are all the good recommendations. You were speaking of pre-conceptual care as opposed to prenatal care and it's never too early to do that for women. You have to make sure that a healthy woman leads to a healthy pregnancy. So, it helps you develop a plan for your reproductive life. We do talk about increase their daily intake of folic acid, at least 400 mcg, make sure that their immunizations are up to date. If the patient has any medical conditions such asthma, diabetes, or hypertension, we can address those and get early treatment and optimize the treatment for that because optimal treatment for any of those conditions will lead to a healthier pregnancy. Also, talking about avoiding things like smoking, drinking, or the obvious use of drugs. Also, we could speak of attaining a healthy weight through an exercise program because those are definitely think that could lead to adverse outcomes in pregnancy, and just to learn about their family history or their partner to identify any potential diseases that could be carried to their infant and try to counsel appropriately or visit genetic counselors when needed, and those are all definitely the things that we can do at a pre-conceptual visit.
Melanie: That's great pre-conceptual advice for women who are thinking about getting pregnant. Now, once they are pregnant then what do you want them to do right when they first find out because women are never sure what's the most sensitive time of their pregnancy. What do you want them to know about all of those things that we're just speaking of when they're actually pregnant?
Dr. Benavides: The first evidence of pregnancy is a missed menses and you can definitely visit your physician if you're thinking that you're pregnant, or if you're late on your menses or, obviously, any at-home pregnancy test through the urine can tell you. Nowadays the tests are almost as sensitive as the ones I have here at the office. Obviously, we can elaborate on that with serum blood tests, but once that woman finds out that they are pregnant, they need to come in to the office for their prenatal visit and that should happen immediately because we can start, like we've mentioned before with pre-conceptual, we can start identifying any kind of diseases or factors that could affect the pregnancy. It's just something as simple as when we obtain a history, we talk about family history of hypertension, diabetes, things like that. With the first visit, when you do come in, the earlier the better. Different things that we need to know like blood work, blood type, screening for infection, anemia. Something as easy as a blood test can identify a lot of factors that could potentially contribute to adverse outcomes in the pregnancy. We also need to establish the health of the pregnancy by doing ultrasound, making sure that we have a developed fetus. We want to see the heartbeat and different things like screening for sexually transmitted diseases that could definitely have adverse outcomes on pregnancy.
Melanie: Dr. Benavides, what about if a woman does have diabetes when she's pregnant, or asthma, or any of those things you've mentioned? What about medications and what do you tell women when they ask you can they stay on their medications while they're pregnant?
Dr. Benavides: That's a very good question because there are some patients that have these medical condition that are being treated by family physicians or internal medicine but, unfortunately, some of these medications for high blood pressure can have adverse outcomes on the infant's. So, when they come to me and they say they have high blood pressure and, “I'm on this type of medication,” we have to make sure that the classification of the medication will not harm the baby because definitely you do not want to get off of these medications because you're on them to optimally control these diseases which will improve the pregnancy but, at the same time, if we have to change the medication for your hypertension to medication that is safe in the pregnancy, that is definitely what’s warranted. As far as diabetes, we can talk about the adverse outcomes of diabetes like having an infant that's heavier than normal, increased risk for a cesarean C-section. Unfortunately, with diabetes that's uncontrolled, you also are at an increased risk for cardiac defects, and ultimately a higher risk or stillbirths which would be the ultimate adverse outcome that we want to prevent. We would definitely speak of those, pick a treatment for those, and what we could do to improve the outcome of the pregnancy.
Melanie: Speak about exercise in pregnancy for a minute, Dr. Benavides. Women are not sure what they're allowed to do and, if they were an exerciser before they got pregnant, are they allowed to continue their exercise right through their pregnancy? What do you recommend for them?
Dr. Benavides: Yes, exercise in pregnancy is definitely allowed and it's actually encouraged. I know that the American College of Obstetrics and Gynecology just came out with a new article that does encourage patients who are pregnant to continue their exercise program. So, basically, what we tell patients is just because you're pregnant does not mean that you have to be on bed rest or cannot do the things that you normally could. What we recommend is that if you were doing it before pregnancy, you could probably continue doing it during pregnancy no matter what gestational age. Obviously, with this prenatal care, once we establish that it's a healthy pregnancy, that you do not have multiple pregnancies, that there's no conditions like, for example, something called “placenta previa” in which the placenta attaches in front of the cervix where exercise would contradicted. Once we have ruled those things out, then your physician can tell you that now you can continue your exercise program, you can continue to jog, or whatever it is, lifting weights, aerobic exercise--all of that is definitely indicated and encouraged in pregnancy. Obviously, there has been studies that show that a healthier baby, a decreased admission to NICU when women exercise, healthier size of the placenta and blood flows through the baby. So, those are definitely all indications that women can exercise and should exercise during pregnancy as long as there are no contraindications that you can discuss with your physician.
Melanie: How much weight should a woman gain during their pregnancy and what can they do during their pregnancy to make sure that they have a child that's a healthy weight? Do those two things connect?
Dr. Benavides: Yes, they do. The current recommendations are the amount of weight that you gain is dependent on the weight that you're starting, and there are different recommended weight gain based on a simple formula that we can do when you come in for your first prenatal visit. We calculate your body mass index and based on the body mass index, your physician will tell you need to gain as much as 35 pounds, if you're below weight. If you're at a normal weight, between 25 and 35; or, if you're overweight, less than or at 15 pounds. So, it depends on how much that you're weighing during your prenatal visits, and if you stay within those recommended weight gains, your infant will be at a better weight and adverse outcomes like diabetes in pregnancy will be eliminated, and they will be less likely to have any indication to go to neonatal intensive care unit.
Melanie: Dr. Benavides, what do you tell women about ultrasound and amniocentesis during prenatal care?
Dr. Benavides: Definitely ultrasound is a great tool nowadays to identify many risks to the pregnancy. Usually all physicians will start out with ultrasound in the first prenatal visit to establish many things like multiple pregnancies, the location of implantation, the risk for any threat, miscarriage sign, and it definitely has become a vital tool for any physician that is taking care of women who are pregnant. We also use it for rate of growth in infants and identifying any kind of anatomical defect that we might see. It's not one hundred percent but it definitely, by far, has decreased many adverse outcomes that we have seen in the past like intrauterine growth restriction, and it does not harm the infant. Many patients asked me is there some sort of radiation risk, the more sonos that we do, can that harm the baby? Through the use of the ultrasound, which is sound waves, there are no studies that show that they harm the baby. Then, there are other prenatal tests that we can do to identify genetic problems. Nowadays, we have a lot of blood tests that can identify things like Down's syndrome, Edward’s syndrome, different genetics problems that could affect the pregnancy. Amniocentesis is one way of evaluating that. It's actually the only way that you can prove those genetic studies one hundred percent of the time. Albeit, amniocentesis does have its risks to it, and your physician, if it were indicated, should talk to you about the risk of rupture, the risk of infection and things like that. Not every pregnant woman would need something like the amniocentesis but if you are at increased risk, if something were to happen, if we see something on ultrasound that might indicate that the infant might have a problem, we might suggest that. Women who are above the age of 35 have a slightly higher risk of having infants with genetic problems like Down's syndrome and would warrant those things. Not every pregnant patient needs something like that but definitely ultrasound is a vital tool that every physician is using in obstetrical care.
Melanie: In just the last few minutes, what should people think about when seeking prenatal care?
Dr. Benavides: What women should be thinking about is, as with any parents, I think we all are thinking of the health and safety of our child and when they seek prenatal care, they should seek to formulate a relationship with their physician to avoid any kind of adverse outcome to their infant, and to be forthcoming with the information and medication that they're on, smoking history, drinking--any of those issues that can affect the baby. They should be thinking that whatever they're doing is, obviously, for their health and the benefit of the baby, so that doesn't come when the baby is born that starts from what we've talked about from the very beginning, even before pregnancy.
Melanie: Why should they come to Doctors Hospital of Laredo for their care?
Dr. Benavides: They should come to Doctors Hospital because they provide good quality prenatal care. They have excellent staff, and will make your prenatal, and labor and delivery part of the pregnancy very comfortable. We all have to think about different conditions in pregnancy that could affect the infant and at Doctors Hospital we allow you to take the worry out of pregnancy and allow it to be a happy and excited time.
Melanie: Thank you so much for being with us today. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information, you can go to www.doctorshosplaredo.com. That's www.doctorshosplaredo.com. Physicians are independent practitioners who are not employees or agents of Doctors Hospital of Laredo, the hospital shall not be liable for actions or treatments provided by physicians. Doctors Hospital of Laredo is directly or indirectly owned by a partnership that includes physician owners including certain members of hospital medical staff. This is Melanie Cole. Thanks so much for listening.
The Importance of Prenatal Care
Melanie: (Host): According to the US Department of Health and Human Services and the National Institutes of Health, having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular prenatal care improves the chances of a healthy pregnancy and this care can begin even before pregnancy with a preconception care visit to a health care provider. My guest today is Dr. David Benavides. He's an obstetrician gynecologist and a member of the medical staff at Doctors Hospital of Laredo. Welcome to the show, Dr. Benavides. What do you tell women is the most important bit of information you like them to know about the importance of prenatal care?
Dr. David Benavides (Guest): What I like to tell them to always start thinking about pregnancy and your child, as we all care for our children, and to get early prenatal care because it could definitely improve any adverse outcomes that we try to avoid during pregnancy, and frequent early care is definitely important to all women seeking pregnancy or definitely who are pregnant.)
Melanie: What's meant by prenatal care?
Dr. Benavides: Prenatal care is basically to seek medical care to identify any kind of medical condition that can affect a pregnancy, to avoid any adverse outcomes to the pregnancy, to develop a close relationship with your physician to identify any problems that could arise or that do arise, to treat and formulate a safe pregnancy for the patient.
Melanie: What steps do you want a woman to take if she was just starting to think about getting pregnant? What is it you want her to do, Dr. Benavides? Do you want her to start taking folic acid, prenatal vitamins, or is it too soon for that? Would you like her to try and get some exercise, get her body in shape? What steps do you want her to take?
Dr. Benavides: Well, definitely if they're starting to think about pregnancy, those are all the good recommendations. You were speaking of pre-conceptual care as opposed to prenatal care and it's never too early to do that for women. You have to make sure that a healthy woman leads to a healthy pregnancy. So, it helps you develop a plan for your reproductive life. We do talk about increase their daily intake of folic acid, at least 400 mcg, make sure that their immunizations are up to date. If the patient has any medical conditions such asthma, diabetes, or hypertension, we can address those and get early treatment and optimize the treatment for that because optimal treatment for any of those conditions will lead to a healthier pregnancy. Also, talking about avoiding things like smoking, drinking, or the obvious use of drugs. Also, we could speak of attaining a healthy weight through an exercise program because those are definitely think that could lead to adverse outcomes in pregnancy, and just to learn about their family history or their partner to identify any potential diseases that could be carried to their infant and try to counsel appropriately or visit genetic counselors when needed, and those are all definitely the things that we can do at a pre-conceptual visit.
Melanie: That's great pre-conceptual advice for women who are thinking about getting pregnant. Now, once they are pregnant then what do you want them to do right when they first find out because women are never sure what's the most sensitive time of their pregnancy. What do you want them to know about all of those things that we're just speaking of when they're actually pregnant?
Dr. Benavides: The first evidence of pregnancy is a missed menses and you can definitely visit your physician if you're thinking that you're pregnant, or if you're late on your menses or, obviously, any at-home pregnancy test through the urine can tell you. Nowadays the tests are almost as sensitive as the ones I have here at the office. Obviously, we can elaborate on that with serum blood tests, but once that woman finds out that they are pregnant, they need to come in to the office for their prenatal visit and that should happen immediately because we can start, like we've mentioned before with pre-conceptual, we can start identifying any kind of diseases or factors that could affect the pregnancy. It's just something as simple as when we obtain a history, we talk about family history of hypertension, diabetes, things like that. With the first visit, when you do come in, the earlier the better. Different things that we need to know like blood work, blood type, screening for infection, anemia. Something as easy as a blood test can identify a lot of factors that could potentially contribute to adverse outcomes in the pregnancy. We also need to establish the health of the pregnancy by doing ultrasound, making sure that we have a developed fetus. We want to see the heartbeat and different things like screening for sexually transmitted diseases that could definitely have adverse outcomes on pregnancy.
Melanie: Dr. Benavides, what about if a woman does have diabetes when she's pregnant, or asthma, or any of those things you've mentioned? What about medications and what do you tell women when they ask you can they stay on their medications while they're pregnant?
Dr. Benavides: That's a very good question because there are some patients that have these medical condition that are being treated by family physicians or internal medicine but, unfortunately, some of these medications for high blood pressure can have adverse outcomes on the infant's. So, when they come to me and they say they have high blood pressure and, “I'm on this type of medication,” we have to make sure that the classification of the medication will not harm the baby because definitely you do not want to get off of these medications because you're on them to optimally control these diseases which will improve the pregnancy but, at the same time, if we have to change the medication for your hypertension to medication that is safe in the pregnancy, that is definitely what’s warranted. As far as diabetes, we can talk about the adverse outcomes of diabetes like having an infant that's heavier than normal, increased risk for a cesarean C-section. Unfortunately, with diabetes that's uncontrolled, you also are at an increased risk for cardiac defects, and ultimately a higher risk or stillbirths which would be the ultimate adverse outcome that we want to prevent. We would definitely speak of those, pick a treatment for those, and what we could do to improve the outcome of the pregnancy.
Melanie: Speak about exercise in pregnancy for a minute, Dr. Benavides. Women are not sure what they're allowed to do and, if they were an exerciser before they got pregnant, are they allowed to continue their exercise right through their pregnancy? What do you recommend for them?
Dr. Benavides: Yes, exercise in pregnancy is definitely allowed and it's actually encouraged. I know that the American College of Obstetrics and Gynecology just came out with a new article that does encourage patients who are pregnant to continue their exercise program. So, basically, what we tell patients is just because you're pregnant does not mean that you have to be on bed rest or cannot do the things that you normally could. What we recommend is that if you were doing it before pregnancy, you could probably continue doing it during pregnancy no matter what gestational age. Obviously, with this prenatal care, once we establish that it's a healthy pregnancy, that you do not have multiple pregnancies, that there's no conditions like, for example, something called “placenta previa” in which the placenta attaches in front of the cervix where exercise would contradicted. Once we have ruled those things out, then your physician can tell you that now you can continue your exercise program, you can continue to jog, or whatever it is, lifting weights, aerobic exercise--all of that is definitely indicated and encouraged in pregnancy. Obviously, there has been studies that show that a healthier baby, a decreased admission to NICU when women exercise, healthier size of the placenta and blood flows through the baby. So, those are definitely all indications that women can exercise and should exercise during pregnancy as long as there are no contraindications that you can discuss with your physician.
Melanie: How much weight should a woman gain during their pregnancy and what can they do during their pregnancy to make sure that they have a child that's a healthy weight? Do those two things connect?
Dr. Benavides: Yes, they do. The current recommendations are the amount of weight that you gain is dependent on the weight that you're starting, and there are different recommended weight gain based on a simple formula that we can do when you come in for your first prenatal visit. We calculate your body mass index and based on the body mass index, your physician will tell you need to gain as much as 35 pounds, if you're below weight. If you're at a normal weight, between 25 and 35; or, if you're overweight, less than or at 15 pounds. So, it depends on how much that you're weighing during your prenatal visits, and if you stay within those recommended weight gains, your infant will be at a better weight and adverse outcomes like diabetes in pregnancy will be eliminated, and they will be less likely to have any indication to go to neonatal intensive care unit.
Melanie: Dr. Benavides, what do you tell women about ultrasound and amniocentesis during prenatal care?
Dr. Benavides: Definitely ultrasound is a great tool nowadays to identify many risks to the pregnancy. Usually all physicians will start out with ultrasound in the first prenatal visit to establish many things like multiple pregnancies, the location of implantation, the risk for any threat, miscarriage sign, and it definitely has become a vital tool for any physician that is taking care of women who are pregnant. We also use it for rate of growth in infants and identifying any kind of anatomical defect that we might see. It's not one hundred percent but it definitely, by far, has decreased many adverse outcomes that we have seen in the past like intrauterine growth restriction, and it does not harm the infant. Many patients asked me is there some sort of radiation risk, the more sonos that we do, can that harm the baby? Through the use of the ultrasound, which is sound waves, there are no studies that show that they harm the baby. Then, there are other prenatal tests that we can do to identify genetic problems. Nowadays, we have a lot of blood tests that can identify things like Down's syndrome, Edward’s syndrome, different genetics problems that could affect the pregnancy. Amniocentesis is one way of evaluating that. It's actually the only way that you can prove those genetic studies one hundred percent of the time. Albeit, amniocentesis does have its risks to it, and your physician, if it were indicated, should talk to you about the risk of rupture, the risk of infection and things like that. Not every pregnant woman would need something like the amniocentesis but if you are at increased risk, if something were to happen, if we see something on ultrasound that might indicate that the infant might have a problem, we might suggest that. Women who are above the age of 35 have a slightly higher risk of having infants with genetic problems like Down's syndrome and would warrant those things. Not every pregnant patient needs something like that but definitely ultrasound is a vital tool that every physician is using in obstetrical care.
Melanie: In just the last few minutes, what should people think about when seeking prenatal care?
Dr. Benavides: What women should be thinking about is, as with any parents, I think we all are thinking of the health and safety of our child and when they seek prenatal care, they should seek to formulate a relationship with their physician to avoid any kind of adverse outcome to their infant, and to be forthcoming with the information and medication that they're on, smoking history, drinking--any of those issues that can affect the baby. They should be thinking that whatever they're doing is, obviously, for their health and the benefit of the baby, so that doesn't come when the baby is born that starts from what we've talked about from the very beginning, even before pregnancy.
Melanie: Why should they come to Doctors Hospital of Laredo for their care?
Dr. Benavides: They should come to Doctors Hospital because they provide good quality prenatal care. They have excellent staff, and will make your prenatal, and labor and delivery part of the pregnancy very comfortable. We all have to think about different conditions in pregnancy that could affect the infant and at Doctors Hospital we allow you to take the worry out of pregnancy and allow it to be a happy and excited time.
Melanie: Thank you so much for being with us today. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information, you can go to www.doctorshosplaredo.com. That's www.doctorshosplaredo.com. Physicians are independent practitioners who are not employees or agents of Doctors Hospital of Laredo, the hospital shall not be liable for actions or treatments provided by physicians. Doctors Hospital of Laredo is directly or indirectly owned by a partnership that includes physician owners including certain members of hospital medical staff. This is Melanie Cole. Thanks so much for listening.