Selected Podcast

Top Pregnancy Fears (And Why You Shouldn't Worry)

Pregnancy can seem scary, especially with your first child. Knowing what is normal can ease your maternity stress.

Dr. James Brown, Medical Director of Women and Children's Services, discusses top pregnancy fears to ease your worried mind.
Top Pregnancy Fears (And Why You Shouldn't Worry)
Featuring:
James E. Brown, MD
James E. Brown, MD graduated from the Suny Upstate Med Ctr. Dr. Brown works in North Syracuse, NY and 1 other location and specializes in Obstetrics & Gynecology. Dr. Brown  is affiliated with Saint Josephs Hospital and St Joseph's Hospital Health Center.

Learn more about James E. Brown, MD
Transcription:

Bill Klaproth (Host): Along with the joy and anticipation of having a baby comes concern and worry as well. Here to tackle your biggest pregnancy fears and put your mind at ease is Dr. James Brown, Medical Director of Women and Children’s Services at St. Joseph’s Health. Dr. Brown, thanks for your time. So it’s completely normal to have some fear and worry when it comes to pregnancy, is that right?

Dr. James Brown (Guest): It most certainly is. Patients come in, frantic at times, because they’re so concerned and worried about the what ifs, and most of the time, everything goes along really, really perfectly well.

Bill: Well that is the good news. So what are some of the biggest concerns that women have?

Dr. Brown: You know I think at the beginning of pregnancy when patients are first arriving in the office, their biggest first concerns are how to deal with the morning sickness and their greatest fear of is the pregnancy going to continue, are they going to miscarry, and if it continues what about birth defects. Those are probably the top three things that at the initial visit the patients are most concerned about.

Bill: So help put women’s mind at ease. Let’s talk about birth defects and miscarriage. I know those are scary things, but why should women not worry so much about those two?

Dr. Brown: Well I think the birth defects there’s something that people can do if they’re thoughtful about when they’re trying to get pregnant, and that’s the use of prenatal vitamins. Folic acid, which is what makes the prenatal vitamin do its good job, has been shown to absolutely decrease the chance of a particular type of birth defect that happens with the nervous system, they’re called neural tube defects, or spina bifida is the common name, and the addition of folic acid in your prenatal vitamins before you get pregnant and in the first several weeks of pregnancy can really help significantly diminish that from occurring. The other thing is knowing not to use alcohol and other type prescription medications that carry no risk, so that you’re aware of them, and those are the central defects, those are things like cleft palate and cleft lip, and so again if you avoid alcohol at the beginning of pregnancy and you’re aware of what medications by prescription can cause those things, you can avoid that risk very easily. In terms of a miscarriage, miscarriages are really quite common. The majority of times, we find that the reason for the miscarriage is there is something genetically wrong with the pregnancy, something like a chromosomal abnormality, Down Syndrome being probably one of the more common type of chromosomal abnormality, but there are other chromosomal abnormalities like that, one called trisomy 13, one called trisomy 18, so they comprise the majority of it. It’s kind of nature’s thing, well maybe this pregnancy isn’t meant to be because of the abnormalities that occur, so there really isn’t a whole lot you can do about miscarriage, but we put people’s minds at ease because most OB/GYN and family physician offices are going to actually do an ultrasound at the first visit, and once we document and identify that there’s a fetal heartrate present, the risk of miscarriage dramatically decreases to less than 1% to 2%, so having that first visit really improves your outcomes tremendously just by documenting that a fetal heart rate is present, a baby’s heart rate is actually there.

Bill: Well that’s very good to know. So, Dr. Brown I have some other ones here. Let me ask you about these, and you mentioned this one already – morning sickness, what do we need to know about that, and why shouldn’t women be concerned about that one so much?

Dr. Brown: Well again, it sort of plagues people, but unfortunately or fortunately, he varies from one patient to the next, so some people can be pregnant and not have any morning sickness at all, and other people can be pregnant and have horrible morning sickness to the point where they need additional medical support and nutritional supplements. The bottom line is that the morning sickness is almost always going to resolve by itself by the time they leave the third or fourth month of pregnancy, so around that 12 week mark. So without doing anything, you can set your eye into the future, and know that at that 12 week mark, its going to resolve and get better in the vast majority of people. Having said that, there are some really neat options available for people that are not by prescription, that carry very minimal risk if any risk at all. Vitamin B6 supplements have been shown to really quiet the nerves within the stomach, and vitamin B6 you can get over the counter at any of your drug stores or grocery stores. They are small little pills that are tasteless and they are very easily tolerable and do some really nice benefits. The other types of interventions would be acupuncture. There are these wrist bands that anybody can get online or maternity stores which essentially have a pressure point within the wrist region that has a focus on nausea and the brain, and so these wrist bands that women wear actually tremendously improve the morning sickness that they have and can experience. Then lastly, there are some very well used medications by prescription that are very safe that your physician can prescribe, so you don’t need to be suffering. Know that there are some interventions that can be effective and help get you through those first several months of pregnancy.

Bill: You also mentioned preterm labor. Tell us about that.

Dr. Brown: Well you know, I have to give credit where credit’s due. When I first started my training, there was really not a whole lot we had to offer women for preterm labor prevention, but we’ve learned an awful lot in the last 25 years. We know that an ultrasound exam at the anatomy screening time, usually done somewhere between 18 and 20 weeks of pregnancy, that looks at the length of the cervix, that’s the piece of the uterus that dilates and allows preterm labor and/or labor to occur, but that ultrasound screening exam tells us who’s at more risk than not, and so if you happen to be one of those people that have a short cervix when we do that screening ultrasound, we can intervene and we can give you a progesterone hormone supplement which has been proven in the corrected double blinded study to be very effective in helping prevent preterm labor from occurring. We also have learned that the biggest risk factor is the history of having a preterm labor. So intervening early with that same progesterone supplement, actually prevents preterm labor from occurring if used appropriately and if started early enough in pregnancy. The last thing we know is really not necessarily medical findings, but more social findings, things like dentition, or dental care has been shown to be very associated with preterm labor. So, going to the dentist and getting cavities taken care of can actually help benefit you and prevent preterm labor from occurring, so there’s lots of things we’ve learned with preterm labor that really makes a huge difference in the long run; different from 20 years ago that we really didn’t have a whole lot to offer.

Bill: That’s wonderful information. How about emergency C-sections?

Dr. Brown: Well you know I think this is the biggest fear once people get nearer to their due date is how are they going to deliver and what’s going to happen? I think we try our best to calm people’s nerves as much as we can. Being prepared for labor is probably one of the most important things one can do, and that comes from taking birthing classes, which unfortunately in this country with the use of internet, really has not been utilized to the benefit that it should. People go online and they watch a 10 minute YouTube video and they feel that there’s enough, but a lot of those birthing classes really do educate people so much more and prepare them so much more for labor. There are actually studies that have been shown that women will tolerate labor and have a faster labor if they attend birthing classes. What we try to stress to women is, you don’t really have control over what’s going to happen. If your baby’s going to tolerate labor, it will tolerate labor, and if there’s something going on with the placenta or the uterus that it’s not going to tolerate it, you should do what you should do best, and that’s put your care in the best hands possible. That means being in a hospital, being in a facility that can intervene quickly and deliver that baby quickly so that you and the baby can do well. We actually track that at St. Joseph’s Health, and we can perform an emergency C-section in under seven minutes, and we track how closely we come to that on average, and how well or how the babies do afterwards and how the moms do afterwards. We really pride ourselves in the ability to intervene if an emergency occurs. Yes, we absolutely want everybody to have a healthy, normal labor, and have that successful vaginal delivery, but you need to know in the back of your mind when you need help, that your site can intervene and provide that service for you in a safe and effective way, and St. Joseph’s Health can do that.

Bill: Seven minutes, that is amazing. Well Dr. Brown, thank you so much for your time today. This has been very informative, and for more information, please visit womenshealthsjh.org, that’s womenshealthsjh.org. This is St. Joseph’s Health MedCast from St. Joseph’s Health, I’m Bill Klaproth. Thanks for listening.