Transcription:
Tips for a Healthy Pregnancy

Disclaimer: The medical health information provided during this program is for general information and educational purposes only, and is not a substitute for professional advice. None of the given information is for the purpose of diagnosis or treatment. Neither does this program serve as approval for any health product or brand. This program aims to enhance your personal health and wellness through the adoption of healthy lifestyles and your prompt presentation to the health professional whenever you suspect that you are ill. For treatment and professional advice, ensure you consult your physician. Good Health with Memorial Hospital. I'm Melanie Cole, and I invite you to join us as we discuss Healthy Pregnancy and Birth Basics with Dr. Chris Jones. He's an Obstetrician Gynecologist with Memorial Hospital. Dr. Jones, it's a pleasure to have you with us today. So, let's just start with preconception health. What would you tell a woman right now that she can be doing before she gets pregnant to help to ensure a healthy pregnancy? What about a preconception check-up? Who should have one? Tell us a little bit about your best advice about what she should be doing right now.

Chris Jones, MD, OB/GYN, FACOG (Guest): Well, thanks Melanie. It's a pleasure to be here to talk with you. there is actually a visit that we call a preconception visit where a patient comes in and talks about just the things we're going to talk about today. Unfortunately, I think that probably the number of people that actually do that prior to pregnancy is I would say probably on the order of less than So, you know, I definitely would like have more expectant moms come in and talk about preconception care, but you know, some of the things we talk about are, or that we will talk about here today are kind of, I know, I don't want to say common sense, but some kind of just basic strategies to stay healthy.

Obviously, it's best not to be smoking, not to be using any drugs. It's probably best not to drink when you're trying to get pregnant. Now, I don't want to scare a lot of people because a lot of moms will come in and say I had a drink or two, and I just found out I was pregnant last week. Now the vast majority of times, that's not going to have any harmful effects, but idealy we can avoid all of those potential teratogens, which are congenital anomaly substances. And then there's a couple of infections that we like to make sure that patients are immune to prior to pregnancy. main ones that we speak about are the rubella and varicella infections.

Varicella is known as chicken pox. we can test that easily just with a blood test to find out if a patient is already immune to it. And if not, then we, there's vaccinations that can provide that protection from those two infections. And both of those infections can cause serious problems in pregnancy. then in general, again, general health it's best to be at a healthy weight. Obesity leads to a higher risk and a wide variety of pregnancy complications. So, trying to keep a healthy weight with a good diet and exercise is extremely important prior to pregnancy, because once you get in pregnancy and we don't really want patients necessarily trying to if they are already obese, we don't want them necessarily trying to lose weight during pregnancy. cause that not be healthy for the pregnancy, but obviously we'll want them to have a healthy weight gain during pregnancy. so ideally it's better to try to get to a weight prior to pregnancy.

Host: What great information. So Dr. Jones, when I remember when I was pregnant for the first time, and I had so many questions and things that do seem like common sense but then there are other things that women just don't know, like how much weight should they gain. And we hear we're supposed to eat for two. We're going to answer so many of those questions, but let's start with right when she gets pregnant and then she comes to see you and prenatal vitamins are generally recommended. Tell us a little bit about what those are, where we find those and why they're so important. What should women be looking for? Cause there's a lot on the market today.

Dr. Jones: you

I try not to make this too complicated for patients. So, generally I think any prenatal vitamin that you can buy over the counter your pharmacy or Walgreens or Walmart, or what have you, are going to be adequate and supply necessary nutrients and vitamins that you may need for healthy pregnancy. Certainly you want to make sure, this is something that, again, would be very important for someone to be doing is make sure that there's some folic acid in your prenatal vitamins. We have very good data supplement with folic acid decreases the risk of neural tube defects, which most commonly would be something like spina bifida, which some of your listeners may be familiar with.

that dosage for that is 0.4 milligrams a day of folic acid. And generally they're really going to be just in your prenatal vitamin you can get over the counter. Then, some people talk about omega three fatty acids. There was some evidence, a number of years ago that potentially that helped development. I certainly don't think it's use omega threes in a prenatal vitamin or even supplement with omega threes. But I also don't necessarily think that someone who doesn't do is harming their baby. But you know, if you can find one with the omega-3 probably optimal, but those are the two main things we talk about a lot Omega threes and folic acid.

But than that, as long as you're know most generally we're not in Sub-Sahara Africa where sometimes patients and people aren't

getting the appropriate nutrition but most generally if you are a normal decent diet in America going to have. the quantities of macronutrients and micronutrients the prenatal vitamins are sort of more than enough you're,

to keep a healthy pregnancy. But again, the main thing is make sure that your prenatal vitamin has a folic acid component to it. Cause that has really good evidence that it helps decrease birth defects.

Host: certainly does And what about weight gain Dr. Jones? Are eating for, two? Are we eating two? Is that a wive's tale? Can you please tell us about whata safe amount of weight to gain or for women underweight when

Chris Jones, MD, OB/GYN, FACOG (Guest): Yeah,

Host: You

know, get pregnant. Can you speak about that a little?

bit

Dr. Jones: Yeah, I do think pregnant women are obviously eating for two. in terms of ideal gain during pregnancy, it really depends a lot on the patient's prepregnancy weight. So, larger women or obese women are going to be gaining less weight than underweight women. And normal weight women, There are some guidelines that of Medicine have handed out and we pretty much kind of go by these as far as our recommended weight gain for an underweight patient they may want to gain anywhere between gain anywhere between 25 and 40 Pounds during their pregnancy and that's contrasted with an obese patient that would be more like 11 to 20 pounds. So, that's bit of difference that an underweight patient should be gaining during pregnancy compared to the overweight patient and for your normal weight patient, we measure this by the BMIs I'm sure your listeners have heard of that. The body mass index for our normal BMI patients, we want to see about a 25 to a 35 pound weight gain.

Host: Well,

that was great information. So, and really succinct and concise. Now, we talk about morning sickness and general nausea? I had it with one child. didn't have it at all with other what can women do when they

start

to experience that morning

sickness.

which

really affect

Dr. Jones: Yes, it can. And I'm going through in medicine. We always seem to have spurts of particular types of patients that comes in. And right now I'm having a lot of patients have having troubles with morning sickness. So, generally a patient who's having troubles with morning sickness and by the way, morning sickness is sort of a misnomer. I would say very few of my patients just have nausea and vomiting during the morning. and then they're fine the rest of the day. Most patients don't necessarily follow that textbook definition. They're not quite so lucky. Generally if a patient problems with vomiting during pregnancy, or even just nausea, we'll recommend things like kind of a bland diet. We call it the, rice diet. So things like rice or sauce, toast don't tend upset the stomach, but I like to tell patients is that, if there's anything that you think that tastes good and that you can keep down, try it, if that is ice cream. Go ahead. If that's what you keep down and try the ice cream.

in general, the main thing also, we want to make sure that patients are getting plenty of water, and not getting dehydrated cause that become a problem in pregnancy. then above and beyond just kind of the bland diet things. We have some vitamins that seem to help, vitamin B6 seems to help, also Unisom which is an anti-histamine that you can take for sleep. two medications in the Unisom, which is again doxylamine, which has an anti-histamine plus the vitamin B6 has a lot of good evidence that it diminishes nausea and vomiting of pregnancy. then there's some non-pharmacologic methods that, that some people have found success with.

There's The Sea Bands that put use kind of a pressure point mechanism on the wrist that, that can tend to help patients. Some motivated patients with access and resources will try acupuncture. That seems to help some patients. And then if those kind of what we call conservative measures, don't help, then we talk pharmacologic measures to help patients. And in general, when we a patient on a medication, we talk about the risks and benefits because we don't necessarily have any medicine that we know for sure is a hundred percent safe in pregnancy. But we do have lots of medicines that we have a long history with and we haven't been able to detect So there's some medicines that, I will use with minimal hestitation you know, just talking to patient that it's really hard to do nice controlled trials on pregnant women in sometimes we do have to go to pharmacologic management for these patients especially if they're not keeping fluids down cause that's when it's obviously not healthy for mom or baby and then sometimes you know we'll have to use IV hydration Sometimes just getting some fluids in a patient will make them feel better and then in the worst case scenario, some of these patients are hospitalized we can turn the corner and

get

a handle on the situation that way And,

and then, in small minority of patients they'll end up having to yeah. Yes, it is pretty rare and Then even

Host: that's pretty rare

Dr. Jones: that have to go through,

intravenous feeding

Host: well.

I certainly remember those times and ladies, I can tell you, you can also try chewing on mint. Mint leaves, peppermint works, peppermint tea ginger like a ginger juice or sips

Dr. Jones: rare

Host: that stuff has that anti-nausea. But Dr. Jones, you're just such a wealth of information. So I'd like to, before we get into some more birth basics, talk about a few of the services that are available. Some women have what's called a high risk pregnancy. Maybe they are someone who's been diagnosed with gestational diabetes, or they had diabetes before they got pregnant or they're pregnant with twins or any of those kinds of things. Can you tell us a little bit about what you do at Memorial Hospital for these.

women

Dr. Jones: here we will take care of a variety of of pregnant patients

and what you might want to consider high-risk. conditions Now Certainly with the highest risk patients not to deliver them here at least You know it's always important to be able to offer prenatal care even if a patient is high risk and is going to have to end up delivering at a tertiary center you still want to be able to offer good prenatal care locally So they don't have to travel, you know, 13 times during their pregnancy just to go see the doctor for a prenatal visit. So, we do offer that as well. Now on some of the patients that that can be considered somewhat high risk that we do take care of here and deliver here, we'll have conditions like gestational diabetes pregestational diabetes as well.

So that's diabetes prior to the pregnancy. Any sort of hypertension and preeclampsia, we will deliver patients as well here at this hospital, unless they develop conditions. that You know, warrant a referral or a transfer to a higher level of care with a perinatologist at a larger facility

Host: Well, that's great that you're offering all of those things. So now let's talk about some other things a woman can do to really help make this a better pregnancy. I loved Being pregnant, Dr. Jones. And I know I'm not that common, but I kind of loved it. I didn't like that I couldn't drink, my martinis that I love, but I did like being pregnant. So, exercise let's start there cause you've given us great information, about nutrition, but exercise, a lot of women don't know what to do and if that's the time to begin or if they were a previous exerciser, give us a little bit of advice about that

Dr. Jones: exercise actually one things in taking care of in the past and I cannot explain to you why was but in the past we treated pregnant women with kid gloves and basically said ah you need to rest you need to kind of take it easy and be careful Well of course certainly patients need to be careful and not do dangerous things BUt the more we look at exercise and pregnancy, the more we realized that it's extremely important for patients to exercise in pregnancy even. with You know, You can even measure some end points, some very concrete end points.

Patients that have a regular exercise program during pregnancy most likely will decrease their risk for ceasarean sections. But yeah, so I tell patients routinely that to try to keep a healthy pregnancy and, and also to stay you know, for your mental health, exercise obviously does help people with their mental health as well.

You know, pregnancy is a tough, a tough deal. And more things you can do to take care of yourself and take care of your mental health during pregnancy, it's going to be extremely important. And, you know, I feel exercise is a vital component as a part of that strategy to try to stay healthy and keep mental health best it can be during pregnancy. So we recommend at least moderate exercise to all pregnant women.

Host: So then tell us a little about pre-birth Stuff you want women to know that they should be thinking about before the birthing time comes around. Should they be setting stuff up? Should they be taking a breastfeeding class, or learning about caring for baby? Because some couples don't even know how to change a diaper. What is it you want couples to know during that pregnancy time That can help them for the day that they go home with baby even carseats

Dr. Jones: Yeah. Well You know, I think that one of the greatest resources for pregnant moms is, is family members, you know, ask family members for advice. Cause they'll have all kinds of little tips and tricks, for the day you bring the baby home. But in terms of, you know, getting ready for labor and delivery, obviously, you know, we've talked about exercise. I think that's extremely important. Obviously. I also think it's important to, to be consistent with your prenatal care so that hopefully if you have a problem that's starting to develop, you can catch it early and do something about it. So you don't show up in labor and delivery and have a huge problem.

And in terms of, especially, you know, for first-time moms, you know, moms that have been pregnant and have had three or four babies it may not be so important for but birth classes important and at least goes a long way to making patients feel like they have some sense of control or some, a little bit more information as go into birth because obviously if you're a first mom you've never done anything like this before and it can be quite intimidating and some women are somewhat fearful of that and i think birth classes ameliorate that to a great degree and so we offer those here at Memorial and I think they're a great optionBut some classes, do have in terms of breastfeeding, we always say breast is best and it is, other hand, not everybody can breastfeed and that's understandable and we can still have healthy babies and healthy moms who are bottle Babies and moms and that's okay too. But we do, encourage patients who can to breastfeed. And we have, I would say two or three lactation certified lactation consultants here at Memorial Hospital. And I think it's important for patients who feel like it's important for them to be able to breastfeed actually meet with our lactation consultants prior to giving birth. there's just a ton of information, a lot of information, and it's probably better to kind of get ahead of that

curve before you got a baby there that's crying and screaming for food and you're having problems. So, think talking with the lactation consultant is extremely helpful and will increase our rates of successful breastfeeding and in of our babies.

Host: Well, that's certainly true. And you can listen to a podcast by Lyla Brooks Fritz too. She is one of your lactation consultants and she is just an awesome certified nurse Midwife So you do have a great staff

there Dr. Jones, what about for the dads Do you have any advice for them on helping the new mom, helping the mom during pregnancy? Because that's something that I think people don't really talk about is what the partner can do while the woman is going through this pregnancy. And, birth and really what they can do and also, while you're telling us Dr. Jones, during this COVID time, tell us what kind of birth protocols you have in place right now at Memorial Hospital.

Dr. Jones: Well, I mean, I, I do think obviously it's important for the dad to be involved in the mom's pregnancy and the birth. I think that's extremely helpful and, and, you know, not necessarily to direct and control obviously, but just to have someone there to empathize with what a pregnant patient is going through and to be able to support them during labor and delivery is really the primary role as I see it for the dad And in terms Of COVID policy here you know those things they seem to change on a weekly basis But right now, at least at Memorial Hospital, and I think this is pretty representative of what's happening around the country with maybe some minor variations, but we do allow patients to have a significant other in the room throughout the labor and delivery process.

You know, I think for a short period of time, I, you know, it seems like a decade ago in COVID years, but it was only two years, less than two years ago, I think for a short period of time, we were having no visitors but that obviously was not optimal. And I think we've realized that that probably was not the best idea. But again, you know, we were making these things up as, as we go during the pandemic. But In terms of our current policy, right now we can have one visitor at a time for our moms that are in labor and delivery. And but they can have two visitors total during their stay, but one visitor at a time and they have to kind of rotate in and out to try to limit exposure and limit exposure to staff and limit exposure to hospital personnel which is becoming more and more of a problem nationwide because lots of people are getting sick and having to be out and this is one

way that we try

Host: Yeah, no, that's great information that you let us know, only two visitors, but one at a time in a rotating fashion for the mother that's in her birth time. In the last minute and a half Dr. Jones, because you and I could really go on a lot for a long time. Can you give us your best advice for a healthy pregnancy some birth basics, anything that you think we didn't cover? Final thoughts and best advice.

Dr. Jones: reason Yeah I think my final thoughts would be that to really You know there's a lot of different ways to things and a lot of patients have different priorities when they come into labor and delivery And I desires and cause there's a variety of ways to have a healthy and a healthy birth know? and I think as you have a provider that your autonomy and understands your desires during your birth process I think that goes a long way to making it an enjoyable experience for you.

So I would say vet your providers Make sure you have someone that you're comfortable with I think that's just there can't be anything more important in the provider patient relationship than mutual respect.

Host: What a great ending Dr. Jones. you are So right. to treally trust your, OB GYN and the staff, and know that they're with you. They're rooting for you and the new little baby. And it's Really such an exciting time for a couple. Really that first couple of days, I just, I loved it anyway. Thank you. So thank you so much Dr. Jones for joining today. And listeners can call 217-357-2173 to schedule an appointment with Dr. Jones. that concludes this Episode of Say Yes to Good Health with Memorial Hospital and for more health tips, you can always our website at mhtlc.org to learn more about Memorial hospital's Obstetrics services. I'm Melanie Cole. Thanks so much for

Disclaimer: The medical health information provided during this program is for general information and educational purposes only, and is not a substitute for professional advice. None of the given information is for the purpose of diagnosis or treatment. Neither does this program serve as approval for any health product or brand. This program aims to enhance your personal health and wellness through the adoption of healthy lifestyles and your prompt presentation to the health professional whenever you suspect that you are ill. For treatment and professional advice, ensure you consult your physician.