Pregnancy can bring on a wide range of symptoms from cravings and “the glow” to morning sickness and of course, weight gain. While most are merely uncomfortable, others may indicate a potential complication. It’s important to be aware of what pregnancy symptoms you should call your doctor about right away:

1.  Extreme fatigue or dizziness

While is natural to feel a little more tired than normal during pregnancy, extreme fatigue and dizziness may be a sign of anemia. Anemia is the result of a low count of red blood cells, meaning that not enough oxygen is being transported throughout the body.

In addition to extreme fatigue and shortness of breath, shortness of breath and breathing complications can be seen. This is another indication that oxygen transport is inefficient. Normally, this can be treated conservatively by consuming more iron-rich foods or iron supplements.

2. Severe nausea

Nausea and vomiting are common symptoms, especially in the early stages of pregnancy (thanks, hormones). Commonly referred to as morning sickness, these symptoms can actually strike at any time of day. However, there is a fine line between normal and extreme. If vomiting becomes constant, it may be a sign that you have hyperemesis gravidarum–a condition that has the potential to cause severe dehydration if left untreated. If you are unable to keep fluids down for more than 8 hours, you should call your doctor.

3. Vaginal spotting/bleeding

Research shows that an estimated 20-30% of women experience some degree of bleeding in early pregnancy. In some cases, particularly within the first two weeks following conception, this may be implantation bleeding which occurs as the fertilized egg implants itself in the lining of the uterus. Other potential causes in early pregnancy could be an infection, such as UTI, or irritation caused by intercourse.

However, vaginal bleeding may also be a sign of a more pregnancy complication. If you are bleeding, the American Pregnancy Association recommends wearing a pad or panty liner so that you can monitor how much you are bleeding and what type of bleeding you are experiencing. If you experience heavy, bright red vaginal bleeding or passing clots, you should call your doctor.

4. Severe cramping

While pain with kicking is normal, especially in the later stages of pregnancy, severe cramping or stomach pain should be noted. If the cramping does not subside, this may indicate a potential problem with the placenta or a disruption in the natural progression of the pregnancy, including but not limited to miscarriage.

5. A spike in the mother’s blood pressure

A slight increase in blood pressure during pregnancy can be normal due to the extra stress on the body. However, if blood pressure starts to spike, in association with other symptoms such as swelling and blurred vision, a condition known as preeclampsia may be present.

If this does occur, early delivery may be necessary and the baby may need additional time under medical supervision to continue natural development before being released.

6. Decreased fetal movement

Sometime between 13 and 25 weeks, you will feel your baby begin to move. In many cases, first-time moms may not feel these movements as early as women who have been pregnant before, but it’s important to remember that each woman and each pregnancy is different. If you are more than 20 weeks pregnant and have not felt movement, talk to your doctor.

Once you feel your baby move, you should contact your doctor if you notice a decrease in fetal movement (less than 10 movements in a one hour period).

7. Fever over 101°F

You may think a mild fever is no big deal, but if you are pregnant and have a fever over 101°F that does not respond to Tylenol it’s important that you don’t ignore it.

8. Urinary burning, frequency or pain

Burning or pain when urinating, or changes in the frequency of urination, may be a sign of a urinary tract infection. Around 5% of women can expect to develop at least one UTI during pregnancy and of those, 1 in 3 are likely to experience a recurrence. Generally, UTIs are treated with an antibiotic, but in cases where infection has reached the kidneys, IV antibiotics may be recommended.

Left untreated, UTIs can lead to kidney infection, as well as an increased risk of fetal growth restriction, preeclampsia and preterm birth.

9. Vaginal fluid with color or odor

Discharge is not uncommon during pregnancy, however, it should be clear or white with no smell.

10. Labor Symptoms

If you experience labor symptoms, you should call your doctor immediately. These include five contractions in 1 hour, if less than 36 weeks; contractions every five minutes or less for 1 hour; and/or rupture of membranes, commonly known as your “water breaking.”

Contact Raleigh OB/GYN

While no one ever wants to incur a complication during pregnancy, preparing for the “what-ifs” and knowing what to look out for is the best way to prevent harm to the baby or the mother. Careful observation and open communication with your physician is necessary in order to promote the best interests for both throughout the duration of a pregnancy.

If you experience any of the above symptoms, call Raleigh OB/GYN at (919) 876-8225. One of our physicians is on call 24 hours a day to handle emergencies and deliveries.

One of the common misconceptions about labor and delivery involves the various pain relief options that are available. In particular, many first-time moms might assume that the options include epidural or no epidural. But, there are various other medication and non-medication forms for pain management.

Each woman has a different threshold for pain and reacts to pain medications differently. In many cases, you won’t know what kind of pain relief you want until you’re in labor. But, in order to make an educated decision, it’s important to understand the pros and cons of each. Here are six options to relieve labor pain that you may consider:

1. Epidural Anesthesia

As an expectant mother, you have more than likely heard of epidural anesthesia. One of the most common medical pain relief options available, an epidural is a regional anesthesia that blocks pain in a particular part of the body, a pain management option chosen by more than 50% of women giving birth at hospitals.

Before epidural anesthesia is administered, the pregnant patient is given intravenous (IV) fluids. While sitting up and leaning forward to arch your back, an anesthesiologist will apply an antiseptic solution then inject a local anesthetic to numb the area.

A needle is then inserted into the spinal cord in the lower back followed by a catheter which is threaded through the needle into the epidural space. Once the needle is removed, the catheter remains in place and allows the medication to be injected either periodically or continuously. Pain relief typically occurs in around 20 minutes.

While an epidural does not slow dilation, it may slow your ability to push effectively. As with any medication, epidurals do have potential side effects such as nausea, itching, shivering, drop in blood pressure or severe headache.

If you have had spine surgery, are allergic to anesthetic or have blood-clotting problems, you may not be able to get an epidural and will need to consider other options to relieve labor pain.

2. IV Analgesics

For women who choose not to get an epidural, or are early in labor and would like to wait to get an epidural, pain medication through an IV is an option. This type of medication relieves pain without the loss of feeling or muscle movement that occurs with an epidural. While IV analgesics can help to dull the pain, they typically do not take the pain away like an epidural may. They are commonly administered with a single shot or intravenously (IV). It’s important to know that analgesics are another term for opioids. They have the potential to make your baby drowsy, so may not be an option if you are within an hour of delivery.

3. Nitrous Oxide

Rex Hospital also now offers nitrous oxide, which is an inhaled gas, to help with labor pain. According to the Journal of Midwifery & Women’s Health, “Nitrous oxide labor analgesia is safe for the mother, fetus, and neonate and can be made safe for caregivers. It is simple to administer, does not interfere with the release and function of endogenous oxytocin, and has no adverse effects on the normal physiology and progress of labor.”

Those who choose to use nitrous oxide during labor may still have an awareness of labor pain, but many women find it helps them relax and decreases their perception of labor pain.

4. Heat or Cold Therapy

Your body temperature may change drastically throughout the labor and delivery process. A hot or cold pack can help relieve the pain and discomforts that arise with contractions.

Cold therapy can useful for reducing swelling and inflammation. Similarly, heat therapy may help relieve severe pain and tension in your muscles. By relieving major muscle tension and loosening your body, you may be better able to rest between your contractions making for a more enjoyable labor and delivery.  

5. Rhythmic Breathing

Another common non-medical labor pain relief tactic is to ‘just breathe’. Breathing along with your contractions can significantly help you control your ‘labor waves’ and offer relief. During your pregnancy, consider taking a Lamaze class or learn guided meditation techniques.

Depending on what feels most natural for you, you will want to either take deep inhales that expand your diaphragm or short patterned breaths that keep you focused more on your breaths than on the pain.

Not only does rhythmic breathing help pregnant women feel more relaxed and in control during labor but increased oxygen also helps the individual in pain feel stronger and have more energy during the pregnancy and labor.

Additionally, patterned rhythmic breathing can quickly become an automatic response to pain which can help mothers even after their pregnancy to manage stress in their everyday lives.

6. Averting Focus: Music, Imagery, Conversation

Similar to breathing exercises and rhythmic breathing, you can use music, imagery, and conversation to avert your focus and still feel in control during labor.

According to the College of Nursing and Health Sciences, music therapy is one of the most powerful non-medical treatments for labor pain because music targets the parts of the brain that also respond to pain and replaces them with feelings of happiness and calm.

Similarly, by choosing imagery such as your phone, your significant other’s face, or an object in the room, you can focus your attention on something other than the pain which can help you cope.

Lastly, just like medical professionals recommend talking to people who have experienced a trauma such as a car accident, having a conversation as you labor can help shift your focus away from the pain.

Which Option is Best?

When it comes to options to relieve labor pain, there is no one size fits all solution. What works for you or what you feel most comfortable with may be different than another expectant mother.

Of course, any woman can choose not to have any medications for pain control in labor, and if this is your desire, it may be helpful to take a childbirth class with this focus or to work with a labor support person, like a doula.

Your doctor can help answer any questions and address any concerns you have about the various options and offer suggestions about what may be best for you.

At Raleigh OB/GYN, our goal is to help expectant parents have a positive labor and delivery experience. For more information or to request an appointment, call (919) 876-8225.

The school year is back in full swing. Unfortunately, just as you’re settling into your new routine, the back-to-school crud is likely to rear its ugly head especially as temperatures slowly begin to cool and flu season approaches.

On average, elementary school children get eight to 12 colds or cases of the flu each school year. Taking care of a sick child is daunting enough, but what if you also have a newborn or infant at home?

Newborn babies are especially susceptible to infection since their immune systems aren’t as developed as older kids. Here are some tips to help prevent school-age siblings from spreading germs during your infant’s first year of life:

• Immunizations: Following the American Academy of Pediatrics vaccination schedule is the first line of defense for protecting against childhood illness. This won’t prevent the common cold, but it will help against more serious disease like pertussis (whooping cough) or measles. The AAP also recommends an annual flu shot for all children from age 6 months to 18 years.
• Handwashing: Frequent handwashing is the single most important thing you can do to prevent the spread of germs. Teach children to sing ‘happy birthday’ to him or herself twice to make sure they wash for at least 20 seconds. Stress the importance of using soap, not just plain water, and to clean between their fingers and around their fingernails. Hands should be dried with a clean paper towel or hot air dryer.
• Change clothes: Schools are a hotbed for germs, and dirt and bacteria can adhere to clothing. Have school-age children change clothes as soon as they get home.
• Establish contact rules: There are few things sweeter than a doting sibling who wants to help take care of or love on their baby brother or sister. To hinder the spread of germs, limit kissing to the top of the head or baby’s feet.
• No sharing: You’ve spent all this time teaching your child the importance of sharing, but now you have to explain the importance of not sharing. Keep frequently-played-with toys out of baby’s reach and clean them at the end of the day with a sanitizing wipe or in the dishwasher. Also make sure the older sibling doesn’t handle things like the baby’s bottle, pacifier or teether.
• How to cough and sneeze: Teach your child to cough or sneeze into his or her elbow. Keep tissues within reach to prevent them using their hand or clothes to wipe or blow their nose. Make sure they throw used tissues away immediately.
• Breastfeeding: If you are breastfeeding, continue to do so even when you or someone else in the household is sick. You should continue to nurse through illnesses such as a cold, sore throat, flu, stomach bug, or fever. Chances are your baby was already exposed before you showed systems and mother’s milk will provide antibodies specifically tailored to help your baby fight off the illness. There are only a few serious illnesses that might require a mom to stop breastfeeding for a period of time or permanently. If you’re unsure, consult your physician.

Unfortunately, you can’t always prevent the spread of germs. Children with viral infections can be infectious before they show symptoms, as well as after their symptoms clear up. But, here are some things you can do to help prepare an older sibling’s ability to fight off infection and reduce the length of time they are sick:

• Sleep: According to the CDC, school-age children should get 10-11 hours of sleep each night. Sleep deprivation hinders the immune system’s ability to fight off infection.
• Diet: A balanced, nutritious diet will help your child have the energy to get through the school day and increase their immunity defense against bacteria and viruses.
• Exercise: Regular activity is a critical part of staying healthy, even in winter months. At a minimum, children should have a daily dose of 40 minutes of activity.
• Proper clothing: Teach your children to keep their jackets zipped and hats on their heads when it’s cold.
• Daily vitamins: Taking the appropriate dose of children’s vitamins gives your child the added boost he or she needs to fight off airborne or direct-contact viruses. There are a lot of options on the shelf. Consult your child’s pediatrician for a recommendation.

Contact Raleigh OB/GYN Centre

If you’re currently pregnant or recently gave birth, contact us today for more tips on keeping you and your family healthy throughout the school year.