“No, thanks.  We are CHRISTIANS, therefore we would never terminate a pregnancy.  We will love this baby no matter what.”  Often this reply takes on a southern  “why bless your little heart”  type of tone.

Because this is now a popular political football, moms should know that there are many reasons for genetic screening other than termination. Actually, in my 11 years of delivering babies I have never seen a patient who elected to have a termination due to the results of a genetic screening test. Having the testing can provide reassurance to perceived high risk moms and can help those who receive the diagnosis to better plan for the challenges ahead.

I spend a lot of time in our book discussing the many options for genetic screening. Many women get peace of mind and reassurance from having the testing. Having a normal test result is extremely comforting. Having a peaceful, faith filled pregnancy is the entire purpose of our book. And to me this is an important topic to consider in order to have the most peace-filled pregnancy possible.

Women over 35 often worry about being at higher risk for having a child with down syndrome. While the risk does increase with age, most down syndrome babies are born to women in the low risk age group, because these women HAVE the most babies.  This is why we make testing available to all moms.

For more discussion on age related risks check out this previous post.

There are findings that can pop up on ultrasound called soft markers. One of these findings can be seen on up to 4% of normal pregnancies, but also can in certain instances be associated with down syndrome. In most cases they are not (yes, confusing I know) and they can cause undue stress if genetic testing has not been previously preformed.

While I have no doubt that you would love and cherish a child born with down syndrome, having a child with special needs does change your life. Being able to plan ahead by meeting with support groups and mentors can be very valuable. Special needs children can often not attend traditional childcare centers, so being able to plan for childcare can be essential.

Knowing about abnormalities can help you and your doctor plan for delivery. For instance, if the baby has down syndrome (or any other type of syndrome), it is often helpful to deliver at a larger hospital with a neonatal specialist on staff. These babies can sometimes have special needs after delivery. Up to fifty percent of babies with down syndrome will be born with a heart defect, so delivering at a hospital that has a pediatric cardiologist on staff would be beneficial. As another example, babies who have spina bifida are usually allergic to latex. If your doctor knew ahead of time, special precautions could be taken at the time of delivery. So, testing can have an effect on pregnancy management.

A new test that has recently become available is the MaterniT 21.  This is a blood test that can be performed at any point after 10 weeks that can detect down syndrome with a sensitivity of 99%.  The test amplifies DNA particles and looks at free circulating fetal DNA. This test seems better than traditional screening tests (such as the QUAD screen) because it can be performed at any time and is more accurate.  It also does not have the risk of miscarriage that can be seen with amniocentesis.  The technology is quite amazing if you think about it.

One of the biggest issues people have with the other screening tests is a high false positive rate (up to 20%).  Meaning that the results come back positive 20% of the time when everything is actually OK, which can definitely cause some serious anxiety. The data on the MaterniT21 also shows a false positive rate of .5%, which is extremely low and thus is a huge benefit. It is currently approved for women over 35 or other risk factors for down syndrome (e: abnormal QUAD screen).

Genetic screening is not for everyone.  It is a very personal decision that each women should prayerfully make based on her situation and risk.  I attempt to lay out the options for my patients and let them decide what they feel is right for them.  This additional option gives them one more choice that is accurate and doesn’t have a risk of miscarriage.

Correction: The first version of this post stated that MaterniT21 was FDA approved.  This is not correct.  The data from the initial trials have been published in peer reviewed journals and is ontrack for approval for 2013.

MaterniT21: A New Option for Down Syndrome Testing is a post from: The Pregnancy Companion

I’ve had the great privilege of having peer moms surrounding me since I became one myself. I don’t know what I would do without my best mommy friends to call on weekly, sometimes daily. The camaraderie that develops when walking through a season as tough as motherhood is invaluable. Even if you do things slightly different than your other mothering friends, there is still so much to learn from one another. You may do nothing more than offer each other an empathetic, “I hear ya girl” when sharing challenges and frustrations. This simple sisterhood may be the very thing that carries you through to high school graduation.

If you haven’t already, I encourage you to find a mom tribe in your area. If you feel like you are the only one in this stage of life in your church or city I assure you, you are not. There has got to be some other women keeping that OB office in business! You may not immediately click with women you find in your area. After all, relationships must be invested in and cultivated. But this is one of the most important things you can do for your child and for yourself. Here are a few suggestions for finding your mom tribe. . .

• Ask the leaders in your church to connect you with other new moms. Start with the children’s pastor. They should be able to introduce you to other moms of babies.
• Look for an established group such as MOPS in your town. These groups meet once or twice a month and usually provide childcare for a small, annual membership fee.
• Visit meetup.com to check for local play groups groups. Message the group leader for an introduction and details.
• Check with your local library for story times. Lots of moms attend these free events so it’s the perfect place to connect with others in your area.
• Don’t be afraid to strike up a conversation with another mom while your kids are playing at the park. Some of the best connections can be made around the jungle gym.

I am saying a special prayer today that all of the moms in our community will be able to find their mom tribe and connect quickly for support and friendship.

What are some other ways you have been able to connect with moms in your area? We’d love to hear what worked for you.

Finding Your Mom Tribe is a post from: The Pregnancy Companion

In honor of Valentine’s Day, we’re talking today about how dads-to-be can show LOVE to their wives throughout their pregnancy. Dr. Rupe had an OB appointment a few weeks back when the father-to-be pulled her aside to ask what he could do to help his wife throughout her pregnancy. I think we can all agree this dude deserves the father-to-be of the year award for that move! It prompted Dr. Rupe to think about what husbands can do to serve their pregnant wives. We asked our community of moms to weigh in as well on how their men helped them while they were carrying baby.

We’ve all seen the commercials or the scenarios played out on countless sitcoms. . .mama has a craving and daddy must run out wearing only his boxers (for fear that taking too long to change his pants would put his ice cream-craving, pregnant wife over the edge) in the middle of the night to grab some mint chocolate chip or heavenly hash. This may not be the best way for your man to show his love and care for you. . .but there are many other things he can do to serve you during your pregnancy.

Ladies, this post is not meant to make you feel badly for all the things your husband isn’t doing. It’s not meant to make you mad at him for not thinking to ask your doctor what he could do for you. We hope you will share this post with them in an effort to communicate what you might need from him during this time.

Dads-to-be. . .if you’ve not yet taken an active role in serving and caring for your pregnant wife, we hope this post will give you some ideas and encourage you to do so. There is no way you could understand how taxing it is to grow a life inside your body. It’s wonderful yet exhausting. It’s effortless yet challenging. It’s beautiful yet ugly. Those dichotomies alone are enough to make you mad!

With all of these suggestions, the important thing is to offer to do it before she has to ask. That is what makes a woman feel the most cared for. I don’t know many men who will refuse when asked to do something but it means so much more when we don’t have to ask and when you serve us with joy.

10 Ways Husbands Can LOVE On Their Pregnant Wives

1. Bring her a snack or drink. Learn her pregnancy eating habits and offer it before she has to ask.

2. Rub her back or feet or legs. Heck, rub anything that makes her feel better! Her body is likely aching a lot!

3. Offer to cook a few meals. This may not be your strength daddy but grilled cheese will do. Or pick up take out on the way home from work.

4. Send her to take a bath. She may not even want to make the effort but once she is soaking in that warm, bubbly tub, she will feel so much better!

5. Help out more with household chores. . .especially those that require bending over (in the 3rd trimester).

6. Be sensitive about sex and intimacy. Talk openly about it. Let her know your needs but understand her feelings as well.

7. Tell her she’s beautiful. Every. Single. Day.

8. Engage in baby prep and planning. She will be nesting. Big time. Don’t fight it. Surrender to her baby bliss and get involved!

9. If you already have children, help her with bath and bedtime routines (more so than you normally would) as this is when she is likely exhausted.

10. Be a good sport and joyfully take pregnancy photos with your beautiful, pregnant wife. You will cherish them in years to come.

I’m sure there are countless more ideas for how men can serve pregnant mamas. We’d love to discuss your ideas as well. Leave a comment to start the conversation!

We’re linking up with oh amanda’s Top Ten Tuesday again today. Check out her post with great encouragement for bloggers and many other links to super fun Top 10 posts!

Praying we will know how to give and receive LOVE today and everyday,

Jessica

10 Ways Husbands Can LOVE On Their Pregnant Wives is a post from: The Pregnancy Companion

A. “My contractions have been every 5 minutes for an hour, so I think this is it. Should I come to the hospital?” says the patient quite calmly.

“Which baby is this for you and how far dilated were you at your last visit?” I inquire.

“First baby,” patient says giggling. ”I was only 1 cm, but I’m just so excited. All the books say to come in when your contractions are 5 minutes apart!”

“Are you having any pain?” I ask, a little skeptical.

“Oh, I definitely felt some ’twinges’ with that last one,” she says with more giggling.

“Why don’t we give it a little longer. Wait until they really hurt, then check back with me,” I say {she can’t see the grin on my face}.

B. “Doctor, I think I’m in labor, but I’m not…… huff, huff, pant… sure…..if I should come in yet,” patient asks in obvious distress.

“How far apart are your contractions?” I inquire.

“They are…. just a second….” I hear phone being put down.

{Insert blood curdling shrieks and moans for the next 60 seconds.}

“…. about 6 minutes apart.”

“Yes, please come in right away!” I reply.

I don’t fault these women for not knowing exactly what is going on in their body. A woman’s first labor is a totally new experience. She can’t possibly know fully what to expect.

TV has also given everyone a warped view of the labor process. There are the cheesy sitcoms, where women have one contraction and then nearly have the baby in the car. On the other hand you have “A Baby Story” where they nicely edit an entire pregnancy and delivery into one half hour show*. Real life is not quite so predictable and usually not so fast.

Latent or early labor refers to the time from when contractions first start until you reach 5 centimeters of dilation. For the first time mom, this time period can be upwards of 24 hours with the average being about 12. Also, many moms will have false starts where their labor will kick in and then putter out over a few hours. After 5 centimeters, active labor thankfully kicks in and dilation happens at closer to 1-2 centimeters per hour.

A good rule of thumb for first time moms is that you should come to the hospital when your contractions are every 5 minutes for a hour and so uncomfortable that you can’t talk through them. When you time your contractions, start from the beginning of one contraction until the beginning of the next.

Women often get concerned about WHERE IN THEIR BELLY they should feel contractions. Are real contractions in the back? Pelvis? Everywhere? In active labor, contractions are usually felt as a total abdominal tightening pain that then causes a severe pressure into the pelvis. Real labor contractions CAN be felt anywhere in the abdomen, though more important than where is the intensity in which they are felt. Labor pain has often been described to me as ‘knife like stabbing pains in your vaginal area’ {often there are also expletives in this description…but I will leave those out}.

“But my cousin knows this girl who knows this other girl whose ex-roomate’s best friend didn’t even know she was in labor and she had her baby in the car on the way to the hospital!” you might say.

Ah yes. Everyone’s biggest fear. While crazy things like that DO happen on occasion, in my 11 years of delivering babies it has never happened with a first time mom.**

Now with additional babies, the rules change. By the time you have your sixth, we usually tell you to come to the hospital if you sneeze. I have had few patients deliver en route with third and fourth babies.

When you reach 35 weeks, usually your doctor will begin examining your cervix at each visit. She will use your dilation, combined with which baby it is for you and how far from the hospital you live to determine how soon you should come to the hospital.

And when in doubt, just call.

*Doctors hate it when you say “This isn’t how they do it on ‘The Baby Story’.”

** Full disclosure: While I’ve never had a patient give birth to her first baby in a car, it did happen to a relative of mine. But it’s really rare, so don’t sweat it.

How Do I Know if I’m Really in Labor? is a post from: The Pregnancy Companion

Before I get started, let me just say – this post is not completely comprehensive. I don’t think any post about any deal can be. But I’ve done my best in the midst of infant illness (did I mention he threw up all over the place while I was changing his large, poopie diaper this morning) and preschool craziness. I promised I would do some research on the NEW best place to buy diapers since Amazon.com announced they were changing their Subscribe and Save and Amazon Mom programs. Turns out, for some, Amazon might still be the best place to buy diapers.

Really, it all depends on your favorite, most trusted brand as well as whether or not you want the convenience of a subscription and delivery or if you want to search for and use coupons on a regular basis. Still, there’s some good information here (if I do say so myself) for the stores we shop at the most.

{A Few Notes}

• All diapers are priced in Sz 3 because a) that is the size my little man is currently in, b) it seems that is the size infants stay in the longest and c) it would simply be too much to include all sizes in a blog post. Use sz 3 as your guide and if your child is in a smaller or larger size, chances are the price comparisons are similar.
• These prices do not include sales tax for obvious reasons.
• These prices do not take into account coupon savings potential as that would vary greatly every week/month. If you can add coupons to these prices, you may decide one store is a better deal that week than another. {As a side note, Babies R Us always has great coupons/GC w/ purchase deals.}
• If you would like to include coupon savings into your consideration, I suggest you check out the weekly Top Diaper Deal posts on faithfulprovisions.com {Kelly is amazing and if you aren’t already, you should regularly check out her site for great savings and while you are at it, grab her book Saving Savvy!}
• If you are looking for a no-brainer diaper strategy, then simply choose your brand of choice below and look for the red entry (least expensive per diaper without coupons or deals).
• If you are not already an Amazon Prime member, the $79 per year fee would add an additional .02-.04 per diaper depending on box qty (based on 1 box per month est).
• Please also take into consideration you will not pay tax at Amazon.com so that is an additional savings if you have significant sales tax in your area.
• Prices for Sams Club and Costco do not include yearly membership fee. As with Amazon Prime, this would only make sense if you are already a member. If not, it would add an additional .02-.03 per diaper for your $50 yearly fee (broken out over 12 months at 1 box per month est).
• I did not even include diapers.com on this list. What a joke. Their prices do not even compare to any listed below. Even with their $5 off every case deal.

{Summary}

Store Brand/Value Diapers

Target and Walmart store brands have the best price. But it depends on whether or not you like the quality.

For value diapers like Luvs, Amazon has the best price at .15 per diaper (w/S&S). Amazon Prime membership brings it down to .13 per diaper. Your yearly membership fee would be paid for with this .02 per diaper savings so you would enjoy free shipping and streaming for basically no additional cost.

Pampers {Cr=Cruisers, Bd=Baby Dry}

Best price on Cruisers is Sams (in store or online w/ free shipping) or Amazon (w/S&S and free shipping) at .23 per diaper. Amazon Prime brings it down to .19 per diaper.

Best price for Baby Dry is Sams (online w/ free shipping) or Babies R Us (in store) or Amazon (w/ S&S and free shipping) at .20 per diaper. Amazon Prime brings it down to .17 per diaper. Again, your Prime membership would be paid for each year with this .03 per diaper savings.

Huggies {Sd=Snug and Dry, Lm=Little Movers}

Best price for Snug and Dry is Costco or Sams (Sams in store or online w/ free shipping) at .18 per diaper.

Best price for Little Movers is Sams (online w/ free shipping) at .23 per diaper. Amazon only meets these prices with Prime membership so it would not be worth the expense if you are not already a member.

For me, I’m a Pampers Swaddlers mom. But that is because I was getting them for such a good price through Amazon (.18-.19 per).  I didn’t include them in this analysis because they are considerable more expensive without the 30% off I was getting from Amazon. Now that things have changed, I’ll likely switch to Pampers Baby Dry. They are comparable and still much softer than store or value brands.

Are there any brands/deals I haven’t included on this list? We’d love to hear your secrets to getting great diaper deals.

The Best Place To Buy Your Favorite Diapers is a post from: The Pregnancy Companion

I’ve been reading this incredible book, Kisses from Katie. I’m sure many of you have heard of it. I’ll admit, I was reluctant to open the cover and commit after receiving it as a birthday gift from one of my best friends. She couldn’t say enough about how it would change my life but I was sure it would only make me feel like a loser for not giving my life to help orphans in a foreign land. But alas, it was time to start another book for my pre-lights out reading ritual and this one kept staring at me from my nightstand. The first night I read it, I couldn’t put it down. Surprisingly, instead of guilt, I felt an amazing rush of joy and peace as I closed the book that first night. I laid my head upon my pillow feeling inspired instead of accused and lighthearted instead of guilty.

If you haven’t picked up the book, I urge you to get it and open your heart to Katie’s inspiring story. What a remarkable young woman. A modern day Mother Theresa. I thought her story would make me feel guilty for not choosing a similar path but the way in which she honestly shares her journey made me feel encouraged instead. I am in awe of her choices and her strength yet I know that is not the path the Lord chooses for every one of us. Her story does, however, put in me a passion to do what I can from the place God has called me. I may not abandon every Western comfort to live in Africa and mother 13 children, but I can share the blessings he’s given me (both financial and spiritual) with those in need.

If I am convicted of one thing it’s that we have not brought enough attention to the cause he did lay on our hearts before we started the blog and released the book. My heart connected to Compassion International’s Child Survival Program the moment I heard about it. How could I care so much about the women around me getting the chance to have healthy, happy babies when women all over the world are robbed of this blessing due to poverty and lack of proper medical care? I quickly signed up for the program and for a mere $20 a month, I have the blessing of helping 38 mothers and their 40 children in Lenchani, Kenya. Through the program, these women receive food, medical care and training from pregnancy and through the early stages of motherhood until their children are eligible for Compassion’s Child Sponsorship program.

I urge you to read more about this program and ask the Lord if he would have you partner with us. Katie’s book truly opened my heart and mind to the numbers of children and families around the globe who are in need. Of course I knew this was the case but reading her detailed account of life in Uganda brought faces and personalities to those numbers which makes the reality of the need more personal.

I do not ever want to be so wrapped up in my stuff that I forget about the needs of those around me – near and far. I pray we will all open our hearts to ask him to reveal our part in being his hands and feet to the world.

Knowing I’m called to compassion,

Jessica

Called to Compassion is a post from: The Pregnancy Companion

10. The First Flicker

When a patient comes in for their first pregnancy visit, I usually do a sonogram.  At 6 weeks, when the baby is smaller than a grain of rice, the heart beat is first visible as a tiny flutter. Miscarriages are very common, so I’m always a little nervous for the patient as I turn on the machine, but when that flicker pops up on the screen, both myself and the patient both exhale a little. Sometimes they tear up, other times they smile and stare in wonder at miracle life growing inside them. No matter the patient response, seeing that tiny flicker signifying the beginning of life, makes me grin from ear to ear.

9. Patients Who Follow Directions

Doctors get a lot of flack for being ‘pill pushers.’  I read a recent FB post where a women was complaining that her doctor never talks to her about diet or nutrition, he only prescribes her medication. {Ironically she had posted a picture earlier that day of the giant cheese burger and fries she was eating}.  I have the opposite complaint.  For every 50 people that I discuss exercise,  lifestyle changes or quitting smoking, probably only about 1 actually does it.  When I see someone back for their annual and they have quit smoking, finally lost the weight or started exercising it’s all I can do to contain myself from breaking out into a happy dance.  It makes me want to hand out gold stars.

8. Surgery

People think of OB/GYNs as delivering babies and doing pap smears all day, but we also do a lot of surgeries: cesarean sections, hysterectomies, laparoscopies, etc.  This is something I really enjoy. Surgery is interesting intellectually and fun to do.  It’s also satisfying to be able to solve a problem:  you have a giant cyst that hurts? I cut it out, you feel better.  All done!

7. When an Appointment Type Changes from ‘Discuss Infertility’ to ‘New OB’

We always run a pregnancy test when patients come in for infertility testing.  Every once in while it will come up positive.  That is always a great day!

6. Relationships

At the beginning of each day I scan my list of patients to be seen that day and some names just bring a smile to my face. I’ve been in practice for almost seven years now, so I have gotten to know some of my patients pretty well.  I’ve seen them get married, have a couple babies and watch their babies grow through the pictures they bring in at their visits.  When you have taken care of women through 2 or 3 pregnancies you get to know them pretty well.  Then, when they come back later for their checkups, it’s so fun to catch up on their lives.  I have to watch myself that I don’t get too chatty or I can run behind, but I do really enjoy the relationships I have formed over the years.

5. The Perfect Call

Those of you that already have babies are probably familiar with that slightly panicked feeling you get the first time your baby sleeps through the night. You wake up (on your own), glance at the clock  and realize with a shock that it’s morning. “Wait? but I never got up with the baby,” you think as you run to the baby’s room to make sure he’s OK.  Did my husband get up with him? Did I sleep too soundly and not hear his cries? Then you see him sleeping peacefully in his crib, and you realize that a wonderful, wonderful thing has occurred:  your baby has slept through the night!

I’m on call every 4th night. Most of these nights include middle of the night phone calls and/or deliveries at 4 am.  That is fine. That’s my job. I love delivering babies… even at 4 am. But once in a blue moon there is a magical call night. I will awake in the morning with a feeling of  slight panic as I check my phone to make sure I didn’t sleep through any calls, only to realize that it was a perfect call.  No pages. No babies. Just wonderful precious sleep.

4. Never Being Bored

As a child, one common complaint I had for my mother was, “I’m Bored!”  This is not a phrase I have uttered in a long time. This morning as I was eating my cereal, I got a call form the hospital, ” Your patient just arrived and she feels like she needs to push!”.  Twelve minutes later I was in a hospital room delivering a baby as I caught my breath, having literally run from the parking lot.  I enjoy the variety of things I get to see, and if I am truly honest with myself, the excitement as well.

3. Surprise Gender Births

Growing up I, like everyone else,  would watching people have babies on TV shows.  The TV doctor (who was always a man) would hold up the baby and say, “Its a Boy!” and the room would cheer.  Nowadays, most couples find out the gender of the baby at the ultrasound appointment, so the ultrasound tech is the one who gets to tell the fun news.  I feel a little betrayed by TV doctors on this matter.  On the rare pregnancy that a coupe has kept it a surprise until birth, I get really excited.  I FINALLY get to say, “Its a Girl!” to a room full of cheering family. This is a job I take very seriously and get very excited about. I encourage  patients not to find out… but alas they usually don’t listen.  However, on the rare occasion they do, it’s really fun.

2. Telling Someone They are Having Twins

There is something so very fun about telling someone they are having twins.  They almost always freak out.  When you point to those TWO flickers on the ultrasound screen, it transcends all language barriers. People just go into joyful shock.  I once had a woman scream so loud that the entire office rushed into the room thinking something was wrong. Sometimes incredulous, joyful laughter occurs, other times they are speechless. Whatever the response it is the best thing ever, well at least the second best…..

1. First Breath

I’ve delivered a lot of babies over the years, but I still love it when the miracle of life happens before my eyes:  the baby takes its first breath of oxygen and begins to cry.  In those precious moments of birth I have a lot going on, my mind is going through multiple checklists to make sure mom is healthy and doing well.  But for a few seconds, as I lay that precious baby in the mom’s arms, I just let myself soak up the parents’ joy and wallow in the miracle of life.  I still shed a tear from time to time (especially when the dad starts bawling, that always gets me). I continue to count it a privilege that women honor me by allowing me to be a part of their births.

Top 10 Things I Love About Being an OB/GYN is a post from: The Pregnancy Companion

My Mommy & Me

Dear Mom,

I’m so SORRY for all the times I THREW UP on you, POOPED on you, WOKE you up in the middle of the night, JUMPED on my bed after you repeatedly told me not to, acted BORED when there was plenty for me to do, REFUSED to eat the food you worked so hard to provide, acted UNGRATEFUL or SELFISH, blatantly DISOBEYED, INTERRUPTED when you were trying to talk, thought you DIDN’T KNOW ANYTHING, acted like I DIDN’T NEED YOU, FORGOT to say ‘I Love You’. . .

I finally know how you felt.

Please forgive me.

Well gotta go, the kids are screaming. . .

Love,

Your older and (hopefully) wiser daughter

Dear Mom. . .I Finally Know How You Felt is a post from: The Pregnancy Companion

7 Week Ultrasound

Dr. Rupe shared a wonderful, comprehensive list on what to know while waiting for your first OB appointment last week. It was chock full of helpful medical facts and guidelines for you to follow even before you ever set foot in a room with the person who will deliver your baby. For all you information junkies, this list will hopefully fill your craving for knowledge as you wait for your 6-10 week check up.

As I was considering what to write about this week, I felt an overwhelming pull to follow up Dr. Rupe’s post with encouragement on what to set your mind on while waiting for that first appointment. If, like me, you have suffered pregnancy loss you may be very guarded during these first few weeks.  Perhaps you’ve never experienced loss but this is your first pregnancy and you’ve heard so many stories about loss that thoughts of the possibility are consuming your mind. Your reservations and your fears are understandable but they do not have to rule your heart.

5 Things Your Heart Needs to Know While Waiting for Your 1st OB Appointment

1. He is holding your baby’s life together in his capable hands {Colossians 1:16-17}.
2. He knows every concern in your mind but bring them to him so he can help you deal with it.
3. Worrying about it will not change anything. It will only make you miss out on the miracle happening inside you.
4. Now is the time to begin praying fervently for every little piece and part of your growing baby. These early stages of growth are so intricate. Cover    them with prayer instead of fear.
5. Faith and fear cannot dwell in the same place. Let faith in to push fear out.

{from, The Pregnancy Companion Introduction}

Now, before we jump into all of the stats, rules, and regulations, here’s what I want you to do. I want you to take a deep breath. In and out. Slowly. (This is good practice for your impending labor.) Breathe in slowly. And with that breath, I want you to take in a fresh infilling of the Spirit of God. Allow him to permeate your entire being and fill you with fresh faith, peace, and perspective. Now breathe out. Slowly. And with that release, I want you to let go of every concern or fear you’ve carried up until this point and every concern or fear you might be tempted to carry over the next nine months. Let go of every question, every symptom, and every insensitive, stupid thing your friend or family member will say to you. Let it go. Let it all go.

You see, when you allow God to come and fill you with his peace, there is no longer room for your fears. Faith and fear cannot dwell in the same place. So let him in and push fear out. Remember this exercise every time you encounter fear on this journey. You will likely encounter fear or worry or anxiety at some point. The important thing is not to give it place in your mind or your heart.

We are always praying for the mommies-to-be in our community so know that you are covered during this time of waiting. I know it can be hard, believe me! But a peaceful body is the best place for your baby to flourish so commit yourself to promoting peace within your heart and mind.

Rejoicing in the miracle with you,

Jessica

What to Know While Waiting for Your 1st OB Appt: Part 2 is a post from: The Pregnancy Companion

From the first moment you see the test turn positive until you sit down with your doctor for the initial appointment, the waiting can sometimes feel like an eternity. Some of you will spend those weeks worrying if you really are pregnant since you feel so normal.  For others, the pregnancy symptoms will be so severe that you will be desperate for some relief. The following is a list of common concerns that I get asked about at the first pregnancy appointment as well as some helpful hints for common symptoms.

Vitamins
If you are not already on a prenatal vitamin, then please start one as soon as you find out you are pregnant. Folic acid is the most important ingredient in a prenatal vitamin. We recommend 1 milligram of folic acid per day during pregnancy. Taking folic acid can significantly reduce the risk of birth defects like spina bifida. If someone in your family has had a baby with spina bifida you may need to take higher doses of folic acid, so talk to your doctor.

One common question of expectant mothers is “Do I need a prescription prenatal vitamin?” The main difference in over the counter and prescription prenatal vitamins is a higher dose of the all-important folic acid that is included in a prescription vitamin. They have 1 mg, whereas most over the counter prenatals have 600 micrograms. Other “extras” that come with a prescription strength prenatal vitamin are stool softeners, special coatings to help you swallow, DHA (for brain development) and a special form of iron that causes less stomach upset. It’s usually easier to take the prescription prenatal because it has everything you need and it’s easier on your stomach. If it’s too expensive you can take the over the counter prenatal and simply add a folic acid and DHA supplement. It is important to note that folic acid is best absorbed as a supplement rather than its natural source.

You can take too many of some vitamins (like vitamin A) so you should not add additional supplements in pregnancy without talking to your doctor first. I’ve heard lots of women say that their prenatal vitamins upset their stomach so they took ‘a few’ Flintstone’s chewable vitamins instead. This is probably not a great idea because as I said, you can have too many of some vitamins. A better option would be to take one Flintstone chewable and then an additional folic acid supplement if you really can’t tolerate prescription prenatals. Here is link to a company that sells prenatals by mailorder for less than you can usually get them at the pharmacy: http://www.vitamedmd.com

Nutrition
Pregnancy should be a time of very purposeful, deliberate eating. Look at how many calories your body needs, and fill those calories with the most high yield nutritious foods. There are several websites that will tell you the amount of calories you need for your height and activity level. www.choosemyplate.gov is a good site that will give you a sample food pyramid based on your caloric needs. The best strategy is to plan ahead. Focus on getting 5 servings of fruits and vegetables a day with at least one of those vegetables being a dark green or leafy vegetable (sorry pickles don’t count). Drink lots of water. Around 8 glasses a day is ideal. Also make sure at least half of your grains are whole grains. You only need an additional 100 calories a day in the first trimester, so you not need to increase the amount of food eaten at this point.

Food Precautions:

Meat. All  meat should be well cooked. Raw sushi should be avoided as well as rare and medium-rare steak.

Alcohol. There is no known safe amount of alcohol during pregnancy so please discontinue all drinking.

Fish. Shark, swordfish, king mackerel, and tilefish contain high levels of mercury. It is recommended that they be avoided while pregnant. Salmon and tuna should be eaten in moderation. Please note that fish sticks and fast food fish sandwiches are in general made from low mercury fish. See the following link for a complete breakdown of fish safety. http://womenshealth.gov/publications/our-publications/fish-facts.pdf

Caffeine. Caffeine intake should be limited to 200 mg a day during pregnancy.

Unpasteurized food. Cheeses, milk and juices should all be fully pasteurized.  Soft cheeses such as feta and bleu cheese are some times sold in the unpasteurized form, so read labels.

Listeria associated foods. Several different foods have been associated with outbreaks of Listeria bacteria, which can be associated with miscarriage and bad pregnancy outcomes.  While the overall incidence of this bacteria is extremely low, precautions should be taken to make sure that all vegetables are thoroughly washed.  If a food cannot be well cleaned (such as fresh sprouts) it should probably not be eaten. Deli meats should be eaten only if fresh and for added precaution can heated in the microwave until sizzling to kill any possible contaminating bacteria.

Other precautions:

Smoking. Please stop smoking immediately when you find out you are pregnant. Smoking is associated with an increased risk of miscarriage, stillbirth, preterm delivery and fetal growth restriction. If you smoke more than a pack a day and are having difficulty quitting, talk to your doctor about whether the nicotine patch would be appropriate for you.

Cats. Toxoplasmosis is a parasite that can live in cat feces. If it is contracted during pregnancy it can cause severe pregnancy complications. You should avoid handling cat litter or being in the room when the cat litter is being changed. You can still pet your cat and be in the same room as the cat litter if needed.

Exercise. We recommend you stay active during pregnancy. This helps you maintain your overall stamina, avoid excess weight gain and decreases your risk for gestational diabetes. If you are not already active, then I recommend you start walking or swimming 30 minutes daily, or at least 5 times a week. As you exercise, you want to maintain your heart rate at under 150 beats per minute. This is an exertion level of about 6-7 (on a scale of 1-10). At this level you should still be able to talk.

If you are already active in an exercise routine such as running or aerobics, you can usually continue with the above modifications. Make sure to keep your heart rate under 150. It is also a good idea to maintain your flexibility and strength. A prenatal yoga or pilates class (or DVD) can help you maintain your core muscles to help reduce the back pain associated with mid-pregnancy. After 15 weeks, exercises that involve laying flat on your back should be avoided. Additionally weight lifting should be limited to under 40 pounds.

Heat. There are a few things that are known to cause malformations at this stage of development. One of them is extreme heat. This is a time when it is especially essential to avoid hot tubs or very hot baths (higher than body temperature). Having a high core temperature in early pregnancy has been shown to cause malformation of the spinal cord. If you have a fever at this time it is best to take acetaminophen (Tylenol) to help keep your temperature down. If that does not lower your temp, call your doctor.

Medications. Be cautious of taking any medications that might interfere with the development of the baby. Check with your doctor before taking any additional medication: prescription, over the counter, herbal supplements and/or additional vitamins. Thyroid medication and asthma medications are probably the most common medications that women can take in pregnancy. They are safe for the baby and can be harmful if discontinued suddenly.  If you care taking any other mediation, then notify your doctor’s office to determine if it is safe to continue.

Medications that are generally accepted as safe in pregnancy:

Tylenol

Benedryl

Guafenesin

Throat lozenges

Tums

Volace

Milk of magnesia

Immodium

Other things that are considered safe:

Hair dye has not been proven to cause malformations because it is minimally absorbed by the skin. Coloring your hair is considered safe, but if you want to be overly cautious you can wait until you are 12 weeks along.

Self-tanning lotions are also minimally absorbed and are considered safe to use. We always recommend you stay away from tanning beds and this applies during pregnancy as well.

Regular cleaning supplies are fine (sorry, I can’t give you an excuse to get out of your housekeeping). Just make sure you keep all areas well ventilated while cleaning. Avoid solvents such as paint thinner. Use common sense, if a chemical requires specialized disposal, you probably shouldn’t handle it while you are pregnant.

Most cosmetics and lotions are safe. If you use Retin-A, you should probably discontinue use during pregnancy. If you have questions about any prescription lotions, ask your doctor.

Sex is safe as long as you are not having any bleeding or complications.

Symptoms

Cravings. If you are craving a specific fruit, then go with it. If you need a Hershey’s bar every afternoon then you may need to slow down. I tell patients to give into their ‘bad’ cravings once or twice a week, just not once or twice a day!

There are weird cravings that could be a signal that something abnormal may be going on. For instance if you crave plain ice all the time, you could be anemic. Also some women will crave dirt or laundry soap, as well as other non-foods. This could be a signal of specific vitamin deficiencies. If this is the case inform your doctor. Needless to say, don’t give in to these ‘bad’ cravings!

Fatigue. I think fatigue is the least discussed early pregnancy symptom. Everybody knows about the “morning sickness,” but sometimes fatigue can be the most debilitating symptom in early pregnancy. The source is thought to be a combination of the high levels of HCG and Progesterone. But whatever causes it, from about 6 weeks to 12 weeks most pregnant women just want to sleep. Like 12 hours a night…and then take a nap later. If you can get away with it, go for it. The good news is that fatigue and nausea seem to get better after 12 weeks.

Links to discussions on other symptoms:

Nausea

Constipation

Vaginal Discharge

In our book I go into greater detail on all these issues and symptoms, with Jessica adding a faith based perspective on how to journey through pregnancy without fear. If you are looking for additional resources,  I also recommend the ACOG Pregnancy Guide.

Hopefully this post will help fill the information gap that may crop up during those weeks between peeing on the stick and your initial pregnancy appointment. As an obstetrician, I love seeing patients for their first pregnancy visit. The joy and excitement on their faces when they see that first tiny flicker of the heart beat on the sonogram, still melts my heart.  Thank you for letting us be a part of your journey and congratulations during this exciting time in your pregnancy.

What to Know While Waiting for Your 1st OB Appointment is a post from: The Pregnancy Companion