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.

While patients who attempt to have a vaginal birth after C-section (VBAC) have about a 60% to 80% success rate, your safety and the safety of your baby are the most important thing to keep in mind.

“Vaginal birth isn’t right for everyone,” said Kimberly S. Barnes, APRN, CNM, a midwife with Norton Women’s Care. “The main thing is to weigh all the risks to determine what is best for you and your baby.”

What are the benefits of vaginal birth?

Some patients will be better candidates for a vaginal birth after C-section than others. If you and your doctor agree to try, you will have what is called a “trial of labor after cesarean,” or TOLAC. This means you will prepare for a vaginal birth and go into labor with the goal of delivering vaginally.

There are many reasons to consider vaginal birth. Some of the benefits include:

• Shorter recovery time. You may have a shorter hospital stay after a vaginal birth than you would for another C-section. Avoiding surgery will help you have a faster recovery after baby arrives.
• Some patients want to have the experience of a vaginal birth. Your partner, spouse or doula may be able to play a larger role in your delivery experience.
• Family planning. If you are thinking of having a larger family, a vaginal birth may help you avoid some of the issues that can arise from multiple C-sections.
• Lower risk of complications. Vaginal deliveries have lower rates of infection, bleeding, blood clotting and injury to abdominal organs.

What are the risks of vaginal birth after a C-section?

The primary risk is rupture of the uterine scar from a prior cesarean delivery. However, a rupture occurs in only about 1 in 500 patients who choose to deliver vaginally.

Even though ruptures happen in only about 1 in 500 pregnant patients, it can be very dangerous. You and your provider will need to weigh your options and evaluate your health status before deciding.

Are you a good candidate for vaginal birth after a C-section?

Being in good health and having had a prior vaginal birth make a patient a good candidate for VBAC.

Other factors include:

• The reason for the previous C-section is not present during this pregnancy.
• The baby is a normal size and is head-down.
• There is no prior history of preeclampsia, stalled or induced labor.

Having a birth plan can help make sure everyone involved in delivering your baby knows what you want to happen, whether it’s a VBAC or another option.

The post Can you have vaginal birth after a C-section? appeared first on Norton Healthcare.

“A successful VBAC can help avoid bowel or bladder issues, hysterectomy or even issues with the placenta in other pregnancies,” said Christopher Watkins, M.D., OB/GYN with Norton Women’s Specialists.

The more immediate benefits are a potentially shorter recovery, lower infection risk, less risk of blood loss and, of course, no surgery needed.

The VBAC risk is a uterine rupture, which means the scar from the previous C-section breaks open.

“When you have a C-section, there is an internal scar on the uterus and an external scar on the skin,” Dr. Watkins said. “If the scar on your uterus is vertical, there is a higher risk of rupture.”

Aside from VBAC risks, sometimes patients may need to have a C-section for other reasons. Those can include a pregnancy that has gone past 40 weeks, a large baby, high maternal weight, advanced maternal age, two or more previous C-sections or a C-section in the past 18 months. VBAC is less likely to succeed if the patient has preeclampsia, stalled labor or induced labor.

“The main thing is to talk with your obstetrician to determine what is best for you and your baby,” Dr. Watkins said.

Having a birth plan can help make sure everyone involved in delivering your baby knows what you want to happen, whether it’s a VBAC or another option.

Writing down how you imagine the birth going in detail will give you a birth plan starting point. Then, you can prioritize, strike out ideas and categorize thoughts.

It will also give you a framework for discussions with your health care provider, especially if you want to discuss VBAC risks and benefits.

Things don’t always follow the plan, so be flexible.

Include in your birth plan the childbirth classes you want to take and new parent classes to learn about taking care of your baby. Consider whether you want to discuss cord blood storage, any concerns around substance abuse and a checklist of what to take to the hospital.

The post Vaginal birth after cesarean section (VBAC) risks and benefits 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.

What is natural birth?

A natural birth is considered to be a delivery where the patient uses limited to no pain medication. While that is the medical definition of a natural birth, some people feel that any vaginal birth is natural childbirth, whether or not that includes receiving an epidural for pain management or Pitocin to induce labor. Others believe that natural birth includes no medical intervention at all. Patients can fall anywhere in between as far as what feels right for them and their pregnancy. Many women consider natural birth for a host of reasons, from wanting to avoid potential complications for themselves or baby, wanting limited medical interventions or to simply see what their bodies can do. Additionally, there may be benefits for natural birth, including shorter labor, faster recovery and potentially easier facilitation of breastfeeding.

However, there are certain criteria for who makes a good candidate for a natural childbirth.

“Natural birth can be a choice for those with low-risk pregnancies,” said Gigi L. Girard, M.D., OB/GYN with Associates in Obstetrics & Gynecology, a Part of Norton Women’s Care. “Natural birth isn’t recommended for patients with certain chronic conditions or a pregnancy that’s considered high risk, such as babies in breech position, multiple fetuses or babies with congenital conditions needing interventions.”

How to prepare for a natural birth

Choosing a low- or no-medication natural birth takes preparation. Here are some tips to help you prepare for a natural birth.

Find a health care provider for your pregnancy.

Midwives and OB/GYNs offer care before, during and after pregnancy.

“A common myth about natural childbirth is that only midwives offer it,” Dr. Girard said. “However, OB/GYNs are happy to help our patients achieve the birth plan as they envision it, while ensuring the health of mom and baby is always the priority. OB/GYNs can pivot with a patient’s pregnancy should complications arise, whereas midwives work strictly with low-risk pregnancies.”

Norton Healthcare offers both midwives and OB/GYNs for pregnancy care. One of our midwives or OB/GYNs can work with you to discover if a natural birth is safe for you and your pregnancy.

Make a natural birth plan with your provider.

Once it’s been deemed safe for you to proceed with a natural birth, coming up with a customized birth plan is the next step. Natural birth can include many different techniques and strategies for managing pain and delivery. Do you envision water labor? Nitrous oxide? Perhaps the Lamaze technique? Additionally, there are many natural childbirth tools and props to help you get through a natural delivery.

“When considering where to give birth, knowing what tools and support are available for you to achieve the birth plan you want is key,” Dr. Girard said.

Find support and learn about labor and delivery

Many patients considering natural birth work with a doula for support during delivery. Much like a coach, a doula assists before, during and shortly after childbirth. Doulas are hired by the patient and are considered a guest in the delivery room. Please review the Norton Healthcare visitor policy to know how many guests are allowed for deliveries.

“In addition to having a strong support system, those considering a natural birth should learn as much about labor and delivery as possible,” Dr. Girard said. “It can help to prepare mentally and find strategies that they believe will benefit them during their delivery.”

Norton Healthcare offers free classes for expectant parents on a wide range of topics, from childbirth to breastfeeding.

The post How to prepare for natural birth 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.

Just 61% of pregnant women got a flu shot during the 2019-2020 flu season, and only 40% also got the tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine to help reduce the risk of whooping cough infection, according to a Centers for Disease Control and Prevention (CDC) survey. When looking at Black and Hispanic women, only 53% and 67% got the flu shot, respectively. However, those who got both the flu and Tdap vaccine were much lower, at 23% for Black women and 25% for Hispanic women.

According to the CDC, “Factors including negative attitudes and beliefs about vaccines, less knowledge about and access to vaccines, and a lack of trust in health care providers and vaccines has been shown to contribute to lower vaccination rates in Black adults.”

“These numbers are just not high enough to protect women and their babies from severe illness,” said Jennifer C. Evans, M.D., MPH, system vice president, women’s and pediatric services for Norton Healthcare. “That’s why we’ve made a concerted effort to increase education and help all women get the vaccines they need.

Why am I coughing? Learn the difference between the four types of cough in adults

“In 2019, more than 81% of pregnant women coming to Norton Women’s Care received the flu shot, and 90% received Tdap vaccines.”

Vaccines help women and babies

The flu shot can be safely given at any time during a pregnancy, while Tdap is preferred during weeks 27 to 36.

“One of the most important things a pregnant woman can do  is get flu and whooping cough vaccines,” said Jamil T. Elfarra, M.D., specialist with Norton Children’s Maternal-Fetal Medicine. “The flu can have extremely serious consequences if you are pregnant, so you want to do everything you can to prevent it.”

Infants receive the whooping cough vaccine at 2 months old, and the flu vaccine starting at 6 months old. Until then, they rely on antibodies from their mother to protect them.

“The majority of infants who get a severe illness from whooping cough, or pertussis, are 3 months and younger,” Dr. ElFarra said. “Since they cannot begin vaccinated until that 2 month time period, they are extremely vulnerable from getting the infection, most likely from family members and caregivers. The vaccine will help protect the baby, but also help keep the mother from getting pertussis and passing it to her baby after birth.

“Vaccines are extremely safe and also help protect your baby, since you’ll pass antibodies on during pregnancy as well as afterward through breastfeeding.”

If you are expecting, talk to your physician about these important vaccines. Anyone who is going to be around your baby, such as family members and anyone else providing care, should also receive the flu shot and make sure they received necessary pertussis vaccinations at least two weeks before they are around your baby.

The post Not enough Black and Hispanic women get flu and whooping cough vaccines while pregnant appeared first on Norton Healthcare.

PCOS is more common than you may realize. It affects 6% to 12% (as many as 5 million) of U.S. women of reproductive age, according to the Centers for Disease Control and Prevention. The chronic condition is treatable and can be managed effectively working with your OB/GYN. If you’re having irregular periods and suspect something isn’t right, it’s probably time to see a gynecologist.

Diagnosing and treating PCOS early can help control symptoms and prevent long-term issues from developing, including diabetes, heart disease and uterine cancer.

PCOS symptoms

Common symptoms of PCOS can include:

• Irregular periods
• Infertility
• Facial hair
• Pelvic pain

PCOS treatment

PCOS is treated differently depending on your goals.

“For patients who aren’t trying to get pregnant, PCOS can be treated with hormone therapy or birth control pills,” said Shannon O’Brien, D.O., OB/GYN with Norton OB/GYN Associates.

If a couple has been trying to conceive for a year and has not been successful, sometimes PCOS can be the reason, according to Dr. O’Brien.

“Sometimes medications that improve ovulation are needed to help a couple conceive,” Dr. O’Brien said.

Once you make an appointment, what should you expect from your doctor? According to Dr. O’Brien, it’s relatively simple to check for PCOS.

“We want to find out about the patient’s health history and do a physical exam,” Dr. O’Brien said. “Bloodwork can inform us of abnormalities including thyroid issues, elevated cholesterol, increased blood glucose, and elevated testosterone. An ultrasound may be used to detect cysts on your ovaries. Our treatment plan will be tailored to manage your symptoms and help you achieve your health goals.”

Don’t put off seeking treatment

Because PCOS can have serious consequences on your health, always see your doctor if something seems not right with your menstrual cycle.

“The good news is that there are treatment options for PCOS that make it very manageable,” Dr. O’Brien said. “What’s important for those with PCOS to know is that early diagnosis and treatment really can help prevent long-term health issues. Your gynecologist can treat PCOS, but only if you make that appointment for an evaluation.”

Being overweight can contribute to PCOS, so diet and exercise can help. They can go along with, but do not substitute for, a gynecologist’s care and treatment.

“You’ll want to talk to your doctor about the best way to manage your PCOS,” Dr. O’Brien said.

See your doctor every year for your overall health

Even if you don’t have symptoms of PCOS, if you haven’t seen your OB/GYN in a while, now is a good time to make an appointment.

“Keeping an annual OB/GYN appointment is an important way you can help take charge of your health and discover any issues before they become more serious,” Dr. O’Brien said.

The post PCOS and pregnancy: What to know appeared first on Norton Healthcare.