Your Maternity Journey Vol. 2

Your Birth Plan: Things to Think About

Like every mom-to-be, you’re probably thinking a lot about your baby. Who will she look like? Will he have hair? When will baby arrive? As your due date gets closer, it’s time to focus a bit more on yourself and think about ways to make your birth experience as comfortable and meaningful as possible. That’s why we invite our moms to fill out a Birth Preferences Plan.

Taking the time to fill out the plan in advance lets us know how you feel about things like pain management, aromatherapy, doulas, and more. That way, we can do our best to make you physically and emotionally comfortable. This plan is not a contract and can be modified at any time. If, for example, you change your mind about not having pain management, all you need to do is speak up. Our goal is for you to have a safe delivery with healthy mom and healthy baby, while creating a positive experience that is as true to your plan as possible. However, you should be prepared to adjust your birth preferences if it becomes medically necessary to do so.

The Best of Both Worlds: Midwives and OB/GYNs

MarinHealth Medical Center is one of the few Bay Area hospitals with both Certified Nurse Midwives (CNMs) or and OB/GYN hospitalists available 24/7. Our OB/GYNs and midwives function as a team, drawing upon each of their areas of expertise to provide the best care for women during the birthing process.

Your baby’s birth is an intensely individual experience. Both midwives and physicians are licensed and highly regulated health care providers who are committed to guiding you safely through every stage of labor.

A Certified Nurse Midwife (CNM) is a registered nurse with a master’s degree in Nursing or Public Health. Midwives must earn a national certification from the American College of Nurse Midwives. Midwives care for women throughout the lifespan, offering prenatal care, well-women gynecological care, and postpartum care. Midwives are experts in normal, physiological birth. Research has demonstrated that midwives are more judicious in their use of medical interventions in the birthing process. Fetal and maternal outcomes are equally good when comparing OB/GYN- and CNM-assisted births. If you are having a normal pregnancy, desire a minimum of interventions, and expect to have a vaginal birth, a midwife could be a good choice for you.

An OB/GYN is a physician who has completed medical school followed by a four-year residency program. These physicians are trained to manage high-risk pregnancies, perform C-sections, use forceps or vacuums to facilitate delivery, and repair complicated tears that can occur during a vaginal delivery. If a midwife assists with your delivery, our physicians will still be available to consult and assist if any complication should occur. MarinHealth Medical Center’s collaborative, compassionate team of maternity experts is here to support you and ensure the best outcome for you and your family. If you are having a complicated or high-risk pregnancy or a scheduled C-section, an OB/GYN is the right choice for you.

Learn more about Certified Nurse Midwives and midwife-assisted birth.


Pregnancy No-Nos. What’s Real and What’s Not?

Medical science has progressed quite a bit since your grandmother’s day, when some pregnant women felt free to have a smoke or a martini while others subsisted on carrot sticks and celery to avoid weight gain. By the time your mother was expecting you, women knew that cigarettes, alcohol, and poor food choices were not good for them—not to mention their growing babies! But there is still a certain amount of confusion about what to avoid and why.

Exercise

Exercise is good for you and your baby. It can help you get better sleep and avoid excess weight gain and stiff, sore muscles. It can even brighten your mood if you’re feeling blue. Just a few caveats:

  • If your pregnancy is considered high-risk, talk to your doctor. Certain conditions require that you take it easy while you are expecting.
  • If you didn’t exercise before you became pregnant, this is no time to start training for a triathlon. Ask your doctor about incorporating a gentle fitness routine into your day.
  • Respect your changing body. Discuss your fitness routine with your doctor to see if you should make any modifications as you move into your second and third trimesters.
  • Once pregnant, consider avoiding sports where there is a fall risk like skiing or horseback riding.

Yoga

Yoga is beneficial both physically and emotionally, as long as you don’t do any heated yoga, such as Bikram. Tell your yoga instructor you are pregnant and he or she will provide modifications for twists and poses that require lying on your stomach. If head and handstand were not already part of your practice, this is not the time to work them in. Wait until after you have your baby and your center of gravity is back to normal.

Seafood

Sorry, no raw sushi for you! Seafood is rich in vitamins and minerals that are beneficial for mother, but raw fish and raw oysters can expose you and your baby to bacteria, parasites, and high levels of mercury. Avoid shark, swordfish, tile fish, and mackerel, all of which contain mercury, and limit tuna intake to no more than one can per week. And skip the smoked salmon, which can cause food-borne illnesses.

Meat

Raw and undercooked meat and eggs carry a risk of listeriosis and toxoplasmosis, conditions that can cause serious illness, severe birth defects and even miscarriage. Make sure all eggs and meat are thoroughly cooked, especially deli meats and cured meats like sausage. For example, grilled ham and cheese or pepperoni pizza are safe because they are cooked, but cold cuts are unsafe as they can cause foodborne illness such as listeriosis and toxoplasmosis.

Cheese

Soft cheese or artisanal cheeses may be made with unpasteurized milk, may contain the bacteria Listeria and is not safe for pregnant women. However, as you know, calcium is important for mothers and babies. The good news is you can consume cheese and yogurt made from pasteurized milk.

Produce

Be sure to wash and peel fresh produce. Avoid fruits and veggies that have been pre-cut in the store—you can do that safely at home yourself and you’ll know you’re using a clean knife. In recent years, we have seen several produce recalls due to bacterial contamination. Pay attention to these recalls!

Sex

Sex is typically safe until your water breaks, but ask your doctor if you have a high risk pregnancy.

Flu Shots

Studies have shown that pregnant women who get the flu are at greater risk for pneumonia, miscarriage, premature birth, low birth weight, and even birth defects. There is no live virus in the flu vaccine and it cannot give you the flu. It’s well worth taking the vaccine to help keep you and your baby safe.

Going to the Dentist

The fear that an oral cleaning poses a risk of infection during pregnancy has been debunked. There is no reason to skip your checkup or postpone necessary dental work. Do let your dentist know that you’re expecting, as pregnancy hormones can make you more susceptible to swollen and bleeding gums, and be sure to avoid dental x-rays.

Smoking

You don’t really need this lecture, do you? Studies show that babies born to mothers who smoked during pregnancy have a lower birth weight and are at a greater risk for learning disabilities. They are also more likely to take up smoking in their teenage years and start smoking earlier.

Alcohol

The dangers of drinking alcohol while pregnant are well documented. Babies of mothers who drink during pregnancy are at risk for fetal alcohol syndrome (FAS), a life-long condition that limits human potential. The symptoms include low birth weight, learning disabilities, behavior problems, and lagging patterns of growth and development milestones. It is not known what amount or frequency of alcohol in pregnancy causes FAS, so it is best to avoid it altogether.

Hot Tubs, Saunas, and Steam Rooms

Like heated yoga, hot tubs, saunas and steam rooms raise your body temperature. Research indicates this could increase your baby’s risk for birth defects and double your risk of miscarriage during the first trimester.

Caffeine

Caffeine can travel through the placenta and increase your baby’s heart rate. However, most current research indicates that women can safely consume up to 200 mg of caffeine per day—about one 12oz cup of coffee.

Kitty Litter

If you normally clean the litter box, you’re officially off the hook. Cat waste is full of bacteria and parasites, including Toxoplasma gondii, which can cause miscarriage and stillbirth. This parasite can also cause seizure disorders and mental disabilities in babies.

Hair Dye

Most research indicates the chemicals found in both semi-permanent and permanent dyes are safe to use during pregnancy, but it’s best to wait until the second or third trimester.

Skin Care

It’s time to reexamine your beauty routine, as many of your favorite skin care products may be off the table during pregnancy and breastfeeding. This includes retinoids and high doses of salicylic acid, such as in oral medications or chemical peels.

When in doubt, just check with your OB/GYN to make sure a particular food, product or activity is safe for both you and baby.