“Our midwives are very good. Alison immediately recognized the symptoms of PCOS and did the right thing by recommending testing and reassigning care to me. PCOS is frequently underdiagnosed due to the variety of symptoms that present,” Dr. Grady said.

According to the Centers for Disease Control and Prevention, women with PCOS are insulin-resistant and prone to Type 2 diabetes. It is one of the most common causes of infertility. Women with PCOS can develop serious health issues, especially if they are overweight. These issues include diabetes, gestational diabetes, heart disease, high blood pressure, high cholesterol, sleep apnea and stroke.

“Having PCOS places an expectant mother and her baby at high risk for complications during pregnancy and delivery similar to having gestational diabetes,” Dr. Grady said.

“Dr. Grady was honest and caring. He listened and knew all about PCOS to prevent me from developing more issues,” Taylor said. “He explained everything clearly, and I was confident we were in the right place.”

Taylor’s pregnancy was going well. At 34 weeks, she had started undergoing twice-weekly fetal non-stress tests. During the second week, it showed an increase in amniotic fluid. Taylor learned from Ronald Wright, M.D., another OB/GYN at the same practice as Dr. Grady, that the condition could cause early labor.

The next day, Taylor’s family held a baby shower. Everyone was excitedly anticipating the birth of a grandchild and great-grandchild. The following day, as Taylor was bending over to start the bath, her water broke.

Taylor called Dr. Grady’s office and was told to come to Norton Clark Hospital make sure everything was OK. The concern was that she could develop an infection. Dawn Moravec, R.N., was Taylor’s nurse and monitored her nearly the entire time she was in the labor and delivery unit. Neonatal nurse practitioner Christine Cooper, APRN, MSN, NNP-BC spoke with Taylor frequently.

“My birth team, especially my nurse Dawn, made me feel calm; they were capable and gave it to me straight without scaring me,” Taylor said. “I appreciated that.”

“My little Graham was already big at a little over 6 pounds and nearly 35 weeks along, and they wanted to go ahead and deliver him to avoid potential infection.”

Taylor knew that the hospital had a Level II neonatal intensive care unit affiliated with Norton Children’s Hospital and that the baby would receive excellent care once he arrived. Hospitals with a Level II NICU can care for babies born at 32 to 35 weeks who may have moderate medical issues and are expected to recover relatively quickly.

After Graham Thomas Spears entered the world, he did not take that first, big breath. The NICU team took over and helped him do just that.

“After they helped him breathe and cleaned him up, they brought him to me. When he opened his eyes and looked at me, I knew he was OK,” Taylor said.

With Taylor’s hormones in high gear, her nurse Dawn made sure to move her into a room right across from the NICU so she could see baby Graham often.

“The entire team of NICU nurses were all so caring and accommodating,” Taylor said.

“Baby Graham had trouble eating and stayed in the NICU 17 days until he was able to maintain his weight,” Dr. Grady said.

“The lactation consultants helped me try to breastfeed but were not pushy.

They conveyed sensitivity showing me how to hold Graham to feed,” Taylor said. “I had to pump to feed him at first, but because of their help, I was able to start exclusively breastfeeding when he was around 2 months old.

“While no one wants a NICU stay, ours was a bit of a blessing in disguise as we learned so much from the nurses. We brought him home with a sense of relief and the comfort of feeling prepared to take care of him.”

Taylor’s family had recently experienced dark times with severe illness and had family members pass away.

“This precious boy has breathed new life into our families,” Taylor said. “Graham has become their new light.”

“I tell anyone who is trying to get pregnant or looking for a place to have their baby, there is an incredible place with a stellar staff in Jeffersonville, Indiana.

Our birth experience at Norton Clark Hospital was one we will never forget, and the staff hold a special place in our hearts.”

The post Midwife finds underdiagnosed condition, helping expectant mom safely deliver her newborn son appeared first on Norton Healthcare.

The draft recommendation by the U.S. Preventive Services Task Force, an independent panel that makes evidence-based recommendations about ways to prevent disease, advises that all pregnant people, regardless of hypertension history, have their blood pressure measured throughout their pregnancy.

“It’s very important for women to have their blood pressure monitored, especially during pregnancy,” said Li Zhou, M.D., Ph.D., medical director, Norton Heart & Vascular Institute Women’s Heart Program. “Having hypertension, also known as high blood pressure, during pregnancy can cause a life-or-death situation for both mother and baby.”

Issues caused by high blood pressure, including preeclampsia, and eclampsia, are among the top causes of the rising maternal mortality rate in the United States. High blood pressure while pregnant also increases the risk of low birth weight and possibly can lead to preterm delivery.

In addition, high blood pressure increases the risk of heart attack, congestive heart failure, stroke, and kidney injury. Over the long term, high blood pressure during pregnancy can lead to a life time of hypertension and resulting in an increased risk of having cardiovascular diseases.

Hypertension that begins during pregnancy is defined as systolic pressure equal to or greater than 140 millimeters of mercury (mmHg) or diastolic blood pressure equal to or greater than 90 mmHg.

“If a woman is planning to become pregnant and she has a history of hypertension, there are important measures that can be taken,” Dr. Zhou said. “Talking to her OB/GYN and even establishing a relationship with the Norton Heart & Vascular Institute Women’s Heart Program can be very important to ensure a successful pregnancy.”

Norton Women’s Care OB/GYNs work closely with the Women’s Heart Program, Norton Children’s Maternal-Fetal Medicine and other specialists, so patients benefit from multiple viewpoints and areas of expertise.

A hypertension disorder affects 1 out of every 7 deliveries in the United States, according to the Centers for Disease Control and Prevention. Patients who are Black, American Indian or Alaska Native, as well as those who are older, are more at risk.

The post Experts recommend screening for high blood pressure while pregnant appeared first on Norton Healthcare.

The tetrahydrocannabinol, or THC, in marijuana will pass through your system to your baby and may harm your baby’s development. If you are planning to get pregnant, have learned you are pregnant or are breastfeeding, the American College of Obstetricians and Gynecologists recommends stop smoking weed, using marijuana edibles or exposing yourself to secondhand marijuana smoke.

“More research is needed on the harms of marijuana use during pregnancy, but we know there can be significant risks,” said Kathryn R. Bradley, M.D., OB/GYN with Norton Women’s Care. “Those who are pregnant, planning to get pregnant or breastfeeding can protect their own health and that of their baby by not using marijuana.”

Possible risks of smoking weed for your fetus or while breastfeeding

• Disrupted brain development before birth
• Low birth weight
• Smaller head circumference
• Increased risk of stillbirth
• Premature birth (before 37 weeks of gestation)
• Behavioral issues in childhood and with paying attention in school
• Lower Apgar score, which measures:
  • Breathing effort
  • Heart rate
  • Muscle tone
  • Response to stimulation such as a mild pinch
  • Color

There is no evidence that marijuana eases morning sickness. Your OB/GYN can recommend alternative ways to help your symptoms.

The study in the journal, “Birth Outcomes of Neonates Exposed to Marijuana in Utero,” analyzed the results of 16 other studies that included a total of nearly 60,000 patients. The authors concluded that educating patients about the risks of marijuana could improve neonatal health, especially in light of increased marijuana legalization and use.

The study compared pregnancies and outcomes for those who said they used marijuana versus those who said they didn’t. The authors wrote that enough data exists to rule out tobacco use along with marijuana as a factor in outcomes such as low birth weight and preterm delivery.

Studies have shown that cannabinoid receptors exist very early in embryonic development, making the fetus vulnerable to THC. The endocannabinoid system, which THC essentially hijacks to have its effects, appears to play an essential role in neuronal development and cell survival. That may suggest that very early fetal exposure to cannabis could be associated with abnormalities in fetal growth and changes in birth outcomes, but no direct link has been established.

The post Smoking marijuana while pregnant can increase risks for your baby significantly appeared first on Norton Healthcare.

Dieting, trying to stay the same weight or losing weight in the second or third trimester of your pregnancy can deprive your baby of nutrients needed to grow and develop. Obesity or being overweight during pregnancy can lead to high blood pressure, preeclampsia and issues with blood clotting, as well as gestational diabetes and other complications.

“The best way to have a healthy pregnancy is to optimize your health prior to pregnancy,

including achieving a healthy weight,” said Kara B. Knapp, M.D., an OB/GYN with Norton Women’s Care. “It generally is not recommended to ‘diet’ or attempt to lose weight during pregnancy, because it could keep the fetus from getting essential nutrients.”

Weight gain recommendations during pregnancy

Source: Centers for Disease Control and Prevention.

Being overweight or obese can make conception more difficult, interfere with ultrasound testing and make it more difficult to monitor the baby’s heart.

Complications of being overweight during pregnancy

Preeclampsia – This condition is becoming more common, increasing 25% over the last two decades. Preeclampsia symptoms usually occur after the 20th week of pregnancy up until your due date and can up until six weeks postpartum.

Preeclampsia can range from an elevation in blood pressure up to maternal seizures called eclampsia.

Gestational diabetes – If the body is not able to make and use all the insulin it needs for pregnancy, glucose cannot leave the blood and provide energy. As glucose builds up, the result is gestational diabetes.

Pregnant patients with gestational diabetes are more likely to develop Type 2 diabetes later in life, and high blood sugar can cause rapid fetus growth and delivery complications.

How to not gain too much weight during pregnancy

• Early in your pregnancy, talk to your obstetrician about how much weight you should gain. If possible, work with your obstetrician before you’re pregnant to determine how best to get your body ready for a baby.
• Stay away from high-calorie snacks and empty calories such as chips and candy. Focus instead on healthier foods, including vegetables.
• Monitor your weight gain and make adjustments to your eating habits throughout your pregnancy.
• Continue to exercise to keep your entire body healthy and strong. Talk to your doctor about safe exercise, especially after the 12th week of pregnancy.

The post Don’t try to lose weight while pregnant — go for healthy weight gain with good nutrition and exercise appeared first on Norton Healthcare.

Infants born to vaccinated mothers were shown to have antibodies in their systems, offering a level of protection against COVID-19 that otherwise would not exist. These antibodies were higher in vaccinated mothers than those who’d had COVID-19. Children under age 5 are currently not eligible to receive a vaccine. Discussions are underway to grant an emergency use authorization that will make children ages 6 months to 5 years eligible to receive the vaccine produced by Pfizer. However, that still does not offer protection to younger infants.

Still more research released by the Centers for Disease Control and Prevention shows that babies born to a parent who had received two doses of the Pfizer or Moderna vaccine were 60% less likely to be hospitalized with COVID-19 in the first six months.

“We know that the vaccine is safe during pregnancy, and knowing it offers protection for infants makes it a stronger case for patients to receive it,” said Maria R. Schweichler, M.D., an OB/GYN with Norton Women’s Care. “This is something all pregnant patients should feel comfortable doing to protect their unborn child.”

Having COVID-19 while pregnant increases risks of maternal death and possible complications

Patients who get COVID-19 while pregnant have an increased risk of being admitted to intensive care, being placed on a ventilator and even death, compared with those without COVID-19 and those who are not pregnant but have COVID-19.

Additional research shows that infection with the coronavirus that causes COVID-19 makes pregnant patients at greater risk for maternal death, infant growth restrictions, stillbirth or serious complications. It also increases the risk of preterm birth and of an infant needing care in the neonatal intensive care unit.

COVID-19 can damage the placenta, increasing the risk of stillbirth

The placenta is a lifeline for an unborn baby. A new study in the Archives of Pathology & Laboratory Medicine found that the placenta can be destroyed by COVID-19, causing stillbirth. The damage to the placenta deprived the infant of oxygen.

“During this pandemic, you can still have a healthy pregnancy,” Dr. Schweichler said. “You need to do everything you can to avoid getting COVID-19, including masking, distancing and practicing good hand hygiene.

One of the most important things to do, however, is get the COVID-19 vaccine. It will protect you from severe illness, reduce the risks of a severe complication in your pregnancy and even protect your unborn child.”

Pregnant patients can get the COVID-19 at their Norton Women’s Care obstetrician’s office.

The post Protection from the COVID-19 vaccine is passed on to babies appeared first on Norton Healthcare.

But a recent statement by 13 scientists from around the globe raised concerns about acetaminophen and fetal development, causing many questions for pregnant patients.

“The very first thing and most important thing to emphasize is that there’s no need for patients or even recently pregnant patients to panic or have concern that they may have caused harm to their child by taking acetaminophen,” said Kristin E. Reeve, M.D., a maternal-fetal medicine specialist with Norton Children’s Maternal-Fetal Medicine.

The American College of Obstetricians and Gynecologists has recently published a consensus statement, agreeing that there is no connection between proper use of acetaminophen and fetal development.

“Any medication taken during pregnancy should be discussed with the patient’s provider,” Dr. Reeve said. “We recommend that the medications be taken only when medically necessary, and taken at the lowest needed dose for the shortest needed duration of time.”

Acetaminophen, known often by its brand name Tylenol, long has been the only pain reliever considered safe during pregnancy. In addition to relieving pain, it is also helpful at reducing fever.

“Acetaminophen was and still remains the safest over-the-counter pain reliever that is available to patients in this country,” Dr. Reeve said. “The last thing I want is for pregnant patients to hear this news and become concerned and start taking another over-the-counter pain reliever during their pregnancy that could actually be more harmful than acetaminophen.”

The bottom line: There is no clear evidence that acetaminophen causes harm to a developing fetus. If you are pregnant, talk to your provider about any medications, whether over-the-counter or prescription.

The post Should you take acetaminophen during pregnancy? appeared first on Norton Healthcare.

Si estás embarazada o planeando un embarazo, es posible que te preguntes cómo el coronavirus/COVID-19 podría afectarte a ti y a tu bebé. Los obstetras y ginecólogos, parteras y otro personal que brinda atención obstétrica en Norton Healthcare están monitoreando de cerca la pandemia de COVID-19. A medida que la situación continúa evolucionando, la seguridad del paciente sigue siendo nuestra principal prioridad. Contamos con planes y protocolos que son consistentes con las recomendaciones de los Centros para el Control y la Prevención de Enfermedades (CDC, por sus siglas en inglés) y continuamos actualizándolos según sea necesario. Además, nuestros proveedores obstétricos están siguiendo las recomendaciones del Colegio Americano de Obstetras y Ginecólogos.

¿Un embarazo me pone más en riesgo de COVID-19?

Según los CDC, las personas embarazadas y recientemente embarazadas tienen un mayor riesgo de enfermedad grave por COVID-19 —incluida la enfermedad que requiere hospitalización, cuidados intensivos o un ventilador o equipo especial para respirar, o resulta en la muerte— en comparación a personas no embarazadas. Además, las embarazadas con COVID-19 tienen un mayor riesgo de parto prematuro y podrían tener un mayor riesgo de otros resultados de embarazo deficientes.

Siempre es importante protegerse de las enfermedades durante el embarazo. Si estás embarazada, puedes seguir las mismas precauciones que todos los demás para protegerte y prevenir la propagación del COVID-19. Es especialmente importante que las personas embarazadas, y las que viven con ellas o las visiten, tomen medidas para protegerse de contraer y propagar COVID-19.

¿Puedo transmitir COVID-19 a mi bebé en el útero o a través de la leche materna?

Según el CDC, la transmisión materno-infantil del coronavirus durante el embarazo es poco probable, pero después del nacimiento un recién nacido es susceptible a la propagación de persona a persona. El virus no se ha detectado en el líquido amniótico o la leche materna. Un número muy pequeño de bebés han dado positivo al virus poco después del nacimiento. Sin embargo, se desconoce si estos bebés contrajeron el virus antes o después del nacimiento.

Si estoy embarazada, ¿debo recibir la vacuna contra el COVID-19?

Según el CDC, la vacunación contra el COVID-19 se recomienda para todas las personas de 12 años o más, incluidas las personas que están embarazadas, amamantando, tratando de quedar embarazadas ahora o que podrían quedar embarazadas en el futuro. La Sociedad de Medicina Materno-Fetal recomienda enérgicamente que las personas embarazadas, en posparto y lactantes y las que estén considerando el embarazo reciban la vacuna contra el COVID-19. La vacunación es el mejor método para reducir las complicaciones maternas y fetales del COVID-19. Asimismo, el Colegio Americano de Obstetras y Ginecólogos establece que todas las personas elegibles, incluidas las personas embarazadas y lactantes, deben recibir una vacuna contra el COVID-19 o una serie de vacunas. Asegúrate de hablar con tu obstetra/ginecólogo o partera para hablar sobre lo que es mejor para ti y tu bebé.

¿Necesito mantenerme alejado de mi bebé si tengo COVID-19 o creo que podría tener COVID-19?

El riesgo de que un recién nacido contraiga COVID-19 de su madre parece bajo, especialmente cuando la madre toma medidas como usar una mascarilla y lavarse las manos al cuidar del recién nacido. Habla con tu proveedor de atención médica sobre los riesgos y beneficios de que tu recién nacido permanezca en la misma habitación contigo.

¿Debo amamantar si tengo COVID-19?

La evidencia actual sugiere que no es probable que la leche materna propague el virus a los bebés.

Tú, junto con su familia y los proveedores de atención médica, debe decidir si y cómo comenzar o continuar la lactancia materna. La leche materna proporciona protección contra muchas enfermedades y es la mejor fuente de nutrición para la mayoría de los bebés.

¿Debo cumplir con mis citas prenatales y postnatales?

Tu atención prenatal y postnatal es importante para tu salud y la de tu bebé. Instamos a todas las pacientes embarazadas que se encuentren bien a asistir a sus citas. Sin embargo, si estás embarazada y tienes síntomas de una posible infección por coronavirus, llama a tu obstetra/ginecólogo o partera para obtener asesoramiento. Es posible que debas retrasar tus visitas de rutina.

¿Puede alguien venir conmigo a mis citas prenatales y postnatales?

Consulta nuestra política de visitantes para obtener la información más reciente antes de una visita.

Es hora de ir al hospital. ¿Mi parto se verá afectado por las políticas de visitantes?

Entendemos la necesidad única de las familias durante el nacimiento de un niño. Consulta nuestra política de visitantes para obtener la información más reciente antes de tu visita.

Cómo sobrellevar el estrés

Una pandemia puede ser estresante para todos. El miedo y la ansiedad por una enfermedad pueden ser abrumadores y causar emociones fuertes tanto en adultos como en niños. Sobrellevar con éxito el estrés te hará a ti y a las personas que te importan más fuertes.

La depresión durante y después del embarazo es común y se puede tratar. La depresión posparto es la depresión que puede ocurrir después de tener un bebé. Si crees que puedes estar experimentando depresión, busca tratamiento de tu proveedor de atención médica lo antes posible. Encuentra más información sobre la depresión durante y después del embarazo.

The post Coronavirus y embarazo: lo que necesita saber appeared first on Norton Healthcare.

Epilepsy is an umbrella term for a group of seizure disorders. A brain condition, epilepsy is sometimes the result of a brain injury or a family predisposition, but often there is no known cause.

Is it safe for someone with epilepsy to get pregnant?

Most women with epilepsy have normal, healthy babies. However, there are several factors that may make it more difficult to conceive including:

• Women with epilepsy have higher rates of some conditions that can cause infertility including polycystic ovary syndrome (PCOS).
• Women with epilepsy are more likely to have irregular menstrual cycles or cycles where no egg is released (anovulation), which can make it more difficult to get pregnant.
• Anti-seizure medicine and other drugs may affect the hormone levels in your ovaries, which can affect reproductive functioning.
• Women with epilepsy are more likely to have abnormalities in hormones involved in pregnancy.

What are some things I can do when trying to get pregnant?

Talk with your doctor about the medications you are taking for your epilepsy. Some drugs used to treat seizures may contribute to infertility, but some may reduce the effectiveness of hormonal birth control methods such as the pill. Take care of your general health with a balanced diet and exercise, as directed by your doctor.

What are the risks?

Any medication taken during pregnancy can affect the baby. Anti-seizure medication has been linked to birth defects, including cleft palate, neural tube defects, skeletal abnormality and congenital heart defects. Some studies suggest that the risk increases with higher doses of medication or when taking multiple anti-seizure medications.

Seizures during pregnancy can result in:

• Slowing of fetal heart rate
• Decreased oxygen to the fetus
• Fetal injury, including separation of the placenta from the uterus, or miscarriage from trauma (such as a fall during a seizure)
• Preterm labor
• Premature birth

Talk to your doctor about changing medications if you wish to become pregnant. Try to do it at least a year in advance so you have time to let your body adjust and see if the new medicine works well for you.

Epilepsy during labor and delivery

The most important thing is to work closely with your doctor and care team before and during pregnancy so you can minimize potential risks to your health and the health of your baby.

During labor and delivery, you may be afraid of having a seizure. While it is a possibility, the doctor will be aware of your condition and can give you IV anti-seizure medication. Or you may have a planned cesarean section (C-section).

The risks of pregnancy with epilepsy may sound overwhelming, but remember that the vast majority of women with epilepsy have uneventful pregnancies and normal, healthy babies. It is important to know the risks, follow your doctors’ guidelines and take care of yourself.

The post Pregnancy and epilepsy appeared first on Norton Healthcare.

Jan. 23 has been set aside to educate the community and reduce maternal mortality statewide. The alarming rate of maternal mortality and the racial gap in pregnancy loss and pregnancy-related deaths are nationwide public health concerns.

Norton Women’s Care has joined the effort to help ensure every expectant parent has a healthy pregnancy and delivery and can be assured that if issues arise they will have the appropriate medical treatment.

Among the steps Norton Women’s Care has taken to improve outcomes while reducing maternal morbidity and mortality:

• An ongoing initiative to reduce Cesarean sections.
• Hemorrhage carts located in labor and delivery and mother and baby units
• Norton Maternal Opiate and Substance Treatment (MOST) Program
• Drills with new, state-of-the-art patient simulator “Victoria” for all obstetrics staff and providers focusing on obstetric emergencies
• Implementation of emergency obstetric hypertension and hemorrhage protocols and supplies at Norton Healthcare facilities where there is not a labor and delivery unit
• Partnership with Park DuValle Community Health Center to provide quality OB/GYN care in underserved areas

Norton Healthcare’s childbirth quality report is also available online.

The post Kentucky sets Maternal Health Awareness Day in effort to reduce pregnancy-related deaths appeared first on Norton Healthcare.

Depression and anxiety are complications of pregnancy and childbirth –– just like any other complications a woman can experience

Depression and anxiety are complications of pregnancy and childbirth –– just like any other complications a woman can experience

“Postpartum depression is one of the most common complications of childbirth,” said Crista L. Hays, M.D., OB/GYN with Norton Women’s Care.

Women who have a history of depression and anxiety can be at greater risk for developing perinatal depression and anxiety. There are other factors that can contribute, including birth trauma, strife within relationships, poverty and history of abuse. Big life transitions, such as losing a loved one, getting a new job, pregnancy and childbirth can trigger depression and anxiety symptoms due to the stress involved within the transitions.

What are perinatal depression symptoms?

Perinatal depression and anxiety are different from the “baby blues,” a natural phenomenon that happens in the postpartum period where women may feel like they are on an emotional roller coaster. Perinatal depression symptoms can include:

• Anger: Parents may cycle through anger and guilt at a partner or the baby.
• Crying, sadness and trouble concentrating: A persistent low mood can include difficulty getting out of bed, difficulty concentrating and difficulty with self-care such as eating, sleeping and bathing.
• Severe anxiety: Anxiety can appear as heightened worries around parenting as well as panic attacks.
• Struggling with caring for self and others: If a parent feels disconnected from their child, it is a sign to get help. Not eating, showering, or being able to complete everyday tasks or tasks related to the care of their child can all be signs.
• Symptoms last for two weeks or more: Baby blues often resolve in the first two weeks after birth. If a parent is experiencing perinatal depression, they may experience symptoms daily for longer than two weeks.

What to do if you’re experiencing perinatal symptoms

ACOG recommends that physicians screen pregnant women and new mothers for depression and help them get treatment if they’re at risk. Norton Healthcare OB/GYN practices screen for perinatal depression during and after pregnancy to help direct women to the care they need.

If you’re feeling symptoms of perinatal depression, Dr. Hays suggests being direct with your health care provider.

“It’s OK to tell your doctor: ‘I’m really struggling, I can’t get out of bed, I can’t sleep.’ Be direct about your exact symptoms,” Dr. Hays said. “Admitting your struggles doesn’t mean you’re weak or a bad mom. It means you are owning your health and getting the care you need.”

The post Perinatal depression: What women should know appeared first on Norton Healthcare.