Transcription:
Caring for Mother and Baby

Melanie Cole (Host): Expectant and new parents are full of questions. Here to answer some of those common questions is Dr. Donald Dudley. He’s board certified in both obstetrics and gynecology and maternal-fetal medicine and he’s the director of UVA’s Division of Maternal-Fetal Medicine at UVA Children’s Hospital. Welcome to the show, Dr. Dudley. What are some of the most common questions that you get from parents and new parents?

Dr. Donald Dudley (Guest): Well, thank you and thank you for having me on this show. I’d say some of the more common questions that I receive are questions about the labor process and what they can expect in labor. Especially for first-time moms, it can be quite a time of anxiety because they just don’t know what it’s like and what’s going to be happening and they’re concerned about dealing with pain issues and all about just the practical things, like ‘what’s the hospital like,’ and the like. They often ask how long they have to stay in the hospital. Another common question is ‘when is the baby going to come,’ which is a hard question for us. We never really know. In some cases, we actually are able to schedule labor inductions, but we usually reserve that for obstetric or medical problems that require delivery at a scheduled time. So, new patients often come in with many questions on many topics, and our role really is to help educate patients about what they can expect during their pregnancy.

Melanie: Dr. Dudley, [what do you] tell them about the pain that they can expect? I’ve had two babies. I loved labor and delivery. I did. I loved it. But what do you tell them about the pain threshold that they can expect.

Dr. Dudley: Well, I actually really very much encourage that they undergo some form of labor education at our hospital, and really all hospitals where they have delivery services usually offer prenatal classes to teach ways to manage pain. Pain is a very subjective feeling. It’s the same pain, and yet there’s a wide range of responses to the pain. But for the most part, women tolerate this very well. There are options for pain control, for example, epidural analgesia, which a majority of our women tend to have. And I encourage, if they’re not able to cope with the pain, that there’s no reason to suffer through this much pain later in their labor process. And so, we have a number of options available to help manage this, but we really much prefer patients who can come in and manage the pain on their own.

Melanie: What are some of the most important things a new parent can do to get their newborns off to a great start in life?

Dr. Dudley: Well, I think the most important thing first is to eat a healthy diet. There are new weight gain recommendations during pregnancy that we try to follow as best as we can, but certainly eating a healthy diet. Avoiding any unnecessary medications or exposure during pregnancy is also important for the developing baby. There are some medicines that need to be taken during pregnancy and our role as obstetricians is to try to provide safe medication for the mother and for the baby. Also, avoid unnecessary exposures to things like pesticides and cleaning agents and things such as that that potentially can be toxic. It’s amazing how many chemicals are in the world that we just don’t know if they’re safe during pregnancy. I like my ladies to have the chance to exercise and, more importantly, to be aware of changes in their body and look for warning signs of problems such as preterm labor or high blood pressure. We spend quite a deal of time educating patients about the warning signs for these conditions.

Melanie: So what are some of the most challenging things that a new mother is going to face after giving birth?

Dr. Dudley: Well, in my experience in seeing patients soon after they deliver, probably one of the most challenging things is finding enough time for sleep. Fatigue is a very common problem early in the newborn period for the mother. I always ask my patients to be sure to sleep when the baby sleeps, which is easy to say and awfully hard to do sometimes. So, I’ll often see patients in after two weeks and ask them how much sleep they’re getting, and they’re getting maybe three to four hours of sleep in a 24-hour time period, which is really not enough for a healthy start for a new baby. So we work out strategies to try to help them improve their sleep. There are common challenges with nursing. We very much encourage women to breastfeed. Especially here at UVA, we have a very active program to try to help women learn all the tools for breastfeeding. Sometimes, that can be a challenge too, with getting a new mom and new baby to learn how to breastfeed together. Another common challenge is kind of the baby blues. It’s very common for women after having a baby to have some mood swings early after taking the baby home, where they’ll just be standing the sink, crying for no clear reason. And typically, this clears after about a week or two, and our patient’s moods get better. But in a substantial proportion of patients, they will develop a postpartum depression, and that’s something that we’re very much aware of and very often we will screen for all of our postpartum women about a couple of weeks to six weeks after their delivery to make sure that they’re not suffering from a post-partum depression.

Melanie: Dr. Dudley, what’s your best advice for new parents to be prepared to welcome their newborn home? Are there things that they should do before they go into labor to get ready to bring that little baby home?

Dr. Dudley: Yes. I think one of the most important things is to create an environment that’s safe for the baby and also safe for the mother. One of the most common problems that occur after they take the new baby home that can be devastating is this Sudden Infant Death Syndrome, and they often occur because of unsafe sleep practices in the home. It’s really important for parents to work with their pediatricians and their obstetricians to create a safe environment in the home and to emphasize safe sleeping habits for the baby. Another issue is to be sure to try to have as much help as they can get at the home the first few weeks, whether or not it’s their mother or mother-in-law, for the new mom, her mom, or her mother-in-law or sister, someone to help out around the house. I think it’s really important just so they can get some of that sleep that they need after they take the baby home.

Melanie: Now, what about things like car seats and getting that kind of thing ready and organized? You have to have a car seat before you can even leave the hospital, correct?

Dr. Dudley: Correct. If they can get their own car seat, that would be great. If they cannot afford one or cannot get one, most hospitals have a car seat program. You certainly have to have a car seat to take the baby home. Again, that’s the whole issue of safety, providing a safe environment for that baby. We need to take the baby home and that the baby be safe in all aspects from the minute you leave the hospital to the minute you get to the house and really for the rest of their lives.

Melanie: Dr. Dudley, we have about two minutes left. If you would, just tell the listeners your very best advice for new mom, new baby, bringing a newborn home, and then why parents should choose UVA for their care.

Dr. Dudley: Well, my very best advice is to keep a healthy lifestyle and to be very aware of what’s going on with their body and to really emphasize both the mother’s and the baby’s safety as they get started off with a new family. We really emphasize this at the University of Virginia. We have a “Be Safe” initiative throughout the hospital for we truly work to provide the safest environment for patients when they come in to the hospital. As many of the listeners may know, patient safety is of paramount importance and the healthcare system can sometimes, in the past, have not been emphasized as much as now. So we really do go the extra mile to provide a safe environment for mothers when they’re in labor and for their new babies. At University of Virginia, we have a very patient-friendly center. We’re a baby-friendly hospital. We emphasize skin-to-skin contact, rooming in. We’re going to be beginning a midwifery service in recognition that we not only provide outstanding care for mothers with high-risk conditions, but also that we’re a fabulous place to deliver for a low-risk baby, for completely normal pregnancy where there are no problems. We’re going to be embarking on a remodeling project to provide a much more patient-friendly atmosphere here at UVA. We anticipate that all these changes that we’re going to be doing are going to be providing what the patients need and what they want in order to have a wonderful start to having a new family.

Melanie: Thank you so much. It’s such an exciting time for the whole family. For more information on UVA Children’s Hospital, you can go to uvahealth.com. That’s uvahealth.com. You’re listening to UVA Health Systems Radio. This is Melanie Cole. Have a great day.