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Women & Infants
 
Having a Baby
Ask the Experts - Q&A

What should I bring with me to the hospital on delivery day?

 

We recommend that you bring a labor bag that contains socks/slippers, lotion, focal point, two pillows, telephone numbers, cd's, camera- extra batteries, pen and paper, lollipops, lip balm, toothbrush, pediatrician's name and contact information, baby book with page to record footprints, hair ties or clips, tennis ball in a sock for massage, aromatherapy item.

Your coach/partner should bring a cooler with snack, soda, juice; Tylenol or any of their own medication as needed (ie. insulin, etc.), and Ipod or cell phone chargers. In your suitcase, you should have personal items such as a brush, comb, toothbrush and toothpaste; bra (nursing bra if breastfeeding); underpants; slippers and bathrobe; two or three nightgowns; and loose (maternity) clothes to wear home.

For your baby, you should bring: an outfit for the trip home; undershirt; receiving blanket; warm hat and cover if the weather is cooler; and a car seat that you've practiced putting into car Hopefully this is helpful, we want you to be comfortable so please bring anything else that may add to your comfort.

If I am already overweight and plan on having a baby, what is the quickest way to lose weight?



 

 More and more scientific evidence is showing that being in the best health possible before pregnancy may have significant impacts on the baby. It is a great idea to be an appropriate weight for your height or a BMI of <25.0(body mass index). Unfortunately, there is no quick way to lose lots of weight. Weight loss is simply eating less calories than what you need for individual growth, activity and exercise. However, we all know that it is not that simple.

There are many commercial weight loss plans/programs that may help you lose weight. Chances are you will lose weight as long as you follow their low calorie plan and/or increase your exercise to burn more calories than you eat. However, try to remember a few points. You must make lifestyle changes including eating lower calorie, more healthful foods such as low solid fat and low sugary foods, more vegetables and fruits and whole grains, and keeping up with regular moderately intense daily exercise. If these changes are not made then you may initially lose weight and then sooner or later re-gain the weight and maybe even more. This type of up and down weight loss and gain may be more harmful than good.

To learn more about healthy eating and a balanced diet see the website www.mypyramid.gov and/or have your healthcare provider refer you to a registered dietitian who is the food and nutrition expert. To find a RD in your area go to www.eatright.org and click on "Find a Dietitian".

 - Doreen Chin Pratt, director, Outpatient Nutrition Services


Three weeks ago, I bled and they checked the baby and he is fine. Now I'm getting discharge that's brown. I'm not sure what that means. Can you tell me what that means?



 

The brown discharge is most likely old blood that is left over from the original bleed. This is not concerning as long as the baby is moving well. If you experience any bright red bleeding, regular cramping or contractions or leaking of fluid (membrane rupture), you should return to see your doctor.

-Barbara M. O'Brien, MD, director of perinatal genetics in the Division of Maternal-Fetal Medicine

What should I be expecting if I'm between six to seven weeks pregnant?

 

Six to seven weeks is a time when you may not notice any changes at all even though you are pregnant - except you should be missing your period. The other symptoms that you may notice now - or soon - are some mild lower belly pain, nausea at any time (not just in the morning), headaches, fatigue, emptying your bladder more often, and some increase in the size of your breasts or just some breast tingling or tightness.

- Robert Berry, MD, director of ambulatory care


How do I breastfeed properly? And does it hurt when the baby sucks on my nipple?



 

Learning to breastfeed successfully can be a challenge for both mother and baby. Initially, it may be difficult to figure out which position works best for you and baby or if your baby is getting enough nutrition. Whatever position seems to be the best for you will be the one in which you do not experience pain or pinching at the breast but rather a gentle tugging sensation. Whenever a latch is painful or if you experience damage to your nipples, you will need some outside help from a health professional that specializes in breastfeeding. Certified lactation consultants can work with you and your baby to achieve breastfeeding success. If you are struggling with breastfeeding, help is always available through phone advice from the Warm Line and by scheduling an appointment with a lactation consultant.

- Jean Turtle, RNP, IBCLC, Maureen Brown-Ginsberg, RN, IBCLC



My tubes have been tied for 13 years. Can I still have a baby?



 

The only way to have a baby after your tubes have been tied is through IVF or by getting your tubes surgically re-opened. You have to check with your insurance company to see if either of these procedures would be covered by your plan. Unfortunately, many women have to pay for these procedures themselves in this particular situation.

 - Robert Berry, MD, director of ambulatory care



Is the parent of the pregnant mother permitted in the room with her?



 

We allow two significant others in the labor-delivery-recovery (LDR) rooms with laboring patients. They are both identified as the coaches by the patient and then banded for their stay in the LDR. If there is a cesarean section, one coach can go into the operating room with the patient if the patient is not having general anesthesia. During post-op recovery, one coach can stay with the patient and baby. The second coach at that point will need to wait in the main lobby.

- Susan Fair, RN, nurse manager of the labor-delivery-recovery rooms



I am about three weeks pregnant. Is it ok for me to still have sex without a risk of miscarrying?



 

Yes, it is okay to still have sex once you are pregnant without a risk of miscarrying. Of course, we are assuming that you have a normal pregnancy and have normal sex. If you have had bleeding in this pregnancy or if you have had major complications with a previous pregnancy, you should check with your care provider to be sure it is safe. Vaginal intercourse, oral sex and touching yourself or each other shouldn't be a problem. You should talk to your provider if you use lots of sex toys or if your approach to sex is really vigorous or exotic. But for most couples, it is rare to have a reason to avoid sex in early pregnancy.

 - Robert Berry, MD, director of ambulatory care



I would like some more information on VBAC (vaginal birth after cesarean) please. I am 19 weeks along with my second pregnancy. My first delivery was a c-section because she was breech. I'm interested in having a VBAC but my current ob/gyn will not even consider it.



 

Most women who have one prior cesarean delivery are candidates for what we call Trial of Labor After Cesarean (TOLAC). There are some reasons why you may not qualify for this: if your previous cesarean was done through a T-shaped uterine incision, which carries an increased risk of uterine rupture; or if you are planning to have the baby in an institution that does not have the capability to perform emergency cesarean delivery. If there are no medical reasons why you can't try TOLAC, the success rate is typically high.

For women who had a cesarean because the baby was in the breech position, the success rate of VBAC is approximately 84%. The most significant risk is uterine rupture. This risk is about 0.7% for women who have had a prior low transverse cesarean delivery. With uterine rupture, there is risk of death or significant injury to both the mother and the baby.

- Dr. James O'Brien, medical director of inpatient obstetrics



Do you make new mothers breast feed their child before leaving the hospital? Is it mandatory? I understand breast milk is best but some people can't do it.



 

This is a great question, and the short answer is NO, we would not make a new mother breastfeed her baby before leaving the hospital. While our nurses do educate patients about the benefits of breastfeeding, we certainly understand and respect that it is each patient's choice whether or not she chooses to breastfeed her baby. If you have any questions about the care or feeding of your baby, please call our Warm Line nurses at 1-800-711-7011.

 - Josephine Rueb, RN, Women & Infants Warm Line



Why can't I get pregnant?



 

Some women who are having difficulty getting pregnant may be dealing with infertility, a medical condition that afflicts many couples. Approximately one third of the cases are caused by conditions solely afflicting the woman, one third caused by conditions solely afflicting the man, and one third are problems involving both partners. In women, the most common cause of infertility is the irregular or defective release of eggs. The most common symptoms of ovulation disorders are a lack of regular or any menstruation.

Infertility FAQs

Other causes of infertility include blocked fallopian tubes or abnormalities of the uterus. Fallopian tubes can be blocked by adhesions from past pelvic infections, endometriosis, or ectopic (tubal) pregnancy. Abnormalities of the uterus include fibroid tumors, malignancy, or developmental problems. In men, infertility is caused by genetic or environmental factors that impair sperm production. This results in too few sperm or defective sperm that cannot fertilize the woman's eggs. Defective, absent or obstructed ducts also prevent sperm from flowing. The defects can be obvious during childhood, but not always.

Advanced age is the most common factor increasing the risk of a woman being infertile. Although there is considerable variance between women, reproductive efficiency begins to decline rapidly at approximately 35 years of age, has declined considerably by age 40, and is essentially gone by age 44. This decline is aggravated by lifestyle and health issues such as a poor diet, stress, being under- or overweight, smoking, excessive alcohol consumption, sexually transmitted diseases, chemotherapy or radiation, and general health problems.

For men, there is an age-related decline in fertility but it is slower. Lifestyle and environmental issues impact a man's reproductive efficiency as they do a woman's.

If you are 35 or younger and have been trying to conceive for at least one year, or if you are older than 35 and have been trying for at least six months, it may be time to speak with your gynecologist.

Good luck.

 - Dr. John Buster, Women & Infants Center for Reproduction and Infertility




When is the best time to get pregnant - before or after your period?



 

If a woman wants to get pregnant, she should have intercourse 14 days before she expects her next period. It can be helpful to chart your periods on a calendar for a couple of months to see how often you get one. Once you know this, have intercourse frequently around the 14th day before your period should come. Once you miss a period, do a urine pregnancy test at home or with your doctor to confirm you are pregnant.

 - Robert Berry, MD, director of ambulatory care



I might be pregnant but am not sure. I've missed my period for two weeks, my breasts feel bigger/ heavier/full looking, I just started to spot a little, I feel thirsty all the time, I get cramps sometimes, I'm tired and take naps during the day, I'm not in the mood to eat anything or if I do I can't finish it because I feel sick. Is it possible I might be pregnant?



 

Any time your period is late or different for you, you could be pregnant. The pregnancy tests you can buy over the counter are very accurate or you can go to your primary care provider to get a test in the office. Although urine tests are usually accurate enough to make the diagnosis, blood tests can be used for very early pregnancies or when the urine test gives an uncertain result.

 - Robert Berry, MD, director of ambulatory care



How long does birth control stay in your system?



 

It is a little difficult to say how long birth control stays in your system because there are many kinds of birth control. But the combination birth control pill stays in your system for at least two days. However, it gradually becomes less and less effective the longer you go between doses. It is recommended that you take a pill every day so that the hormone level is high enough to prevent pregnancy. If you miss a day you can take two pills on the second day. If you go three days without taking a pill you should stop the pill, use condoms until your period starts, and then start a fresh pack - and try a new system to help you remember to take them daily.

 - Robert Berry, MD, director of ambulatory care



I'm pregnant and I tested positive for gestational diabetes. How might that affect my pregnancy? What do I need to do to keep my baby healthy?



 

Gestational diabetes is a condition which affects 5-10% of pregnancies in the United States. Every fetus produces hormones that cause mom to become resistant to the action of her own insulin. Most moms increase their production of insulin and maintain a normal level of blood sugar (glucose). Some moms develop gestational diabetes because they can't produce quite enough extra insulin to maintain normal blood glucose levels.

Glucose, a very small molecule, crosses the placenta to the fetus; fetal blood glucose levels mirror maternal levels. The fetus does not have diabetes, so he/she starts to release more insulin in order to lower his/her glucose level. However, insulin is a large molecule and does not cross the placenta so the fetus cannot help the mom to maintain normal glucose levels. No matter how much insulin the fetus produces, it cannot normalize its own blood sugar level since more glucose keeps coming from mom.

It turns out that high levels of fetal insulin can cause a number of problems. Fetal insulin appears to act as a growth hormone, making the baby grow bigger. A really big baby can make for a more difficult delivery, necessitating a cesarean section or leading to injury if the shoulders get stuck in the course of a vaginal delivery. Increased fetal insulin production can also make complications of prematurity more likely if the baby is born early. Additionally, stillbirth during late pregnancy is more likely. There is also evidence that infants of gestational diabetic moms may be more likely to develop childhood obesity after the age of 6 or 7, and also are more likely to develop diabetes as they grow up.

For these reasons, treatment is based upon two principles: (1) help the mom keep her blood sugar as close to normal as possible; (2) use various techniques of fetal evaluation to lower the risk of other complications. You should discuss with your obstetric caregiver what steps will be needed to manage your pregnancy. It is also a good idea to make sure your child eats a healthy diet and gets plenty of exercise during his/her formative years.

Be reassured that with modern approaches to gestational diabetes, most pregnancies have a very happy outcome!

 - Donald R. Coustan, MD, director, Division of Maternal-Fetal Medicine's Prenatal Diabetes Program
 

 

Can you eat whatever you want while being pregnant?



 

Eating well in pregnancy is based on the same principles of eating a healthy diet at other life stages. Some individuals must modify their diets due to many factors such as age, weight, medical conditions, lifestyle habits, food allergies and preferences and cultural beliefs.  There is scientific evidence that having good nutrition prior to becoming pregnant is as significant as during pregnancy. Adequately nourishing mom is important in order for her baby to receive proper nutrients for growth and development. Eating a diet based on the 2010 Dietary Guidelines for American and the new Food Pyramid is a good start.

You can eat most all foods during pregnancy with some caution for food safety issues such as washing all fruits and vegetables, avoiding unpasteurized dairy products and some large ocean fish such as striped bass, Chilean sea bass, bluefish, shark, tilefish, swordfish, king mackerel, fresh or frozen tuna and some fresh water fish like walleye pike.  Fish is a good source of protein, so eating smaller and younger fish or shellfish from unpolluted waters once or twice a week is generally safe.

To gain appropriate prenatal weight, generally, you need only 300 more calories per day in the second half of your pregnancy to meet your recommended weight gain based on weight before pregnancy. So  you really do not need to eat for two. Eating a variety of foods with emphasis on nutrient-dense foods like dairy, whole grains, low sugar and solid fats, meats or non-animal proteins (soy products and fruits and vegetables) can provide you with adequate major nutrients like calcium, iron, folic acid, vitamins A, D and C, and most minor nutrients.

Sometimes, your health care provider will prescribe a prenatal  multi-vitamin to  help supplement your diet.  Getting early prenatal care, making healthy food choices, and keeping normal activity are the things you can do to encourage a healthy pregnancy.  For special nutrition related health conditions, have your health care provider refer you to a registered dietitian.

 - Doreen Chin Pratt, director, Outpatient Nutrition Services



I'm expecting in about two months and am very nervous about pain control. I don't want too much medical intervention. What other ways can I control my pain during labor?



 

Congratulations on your pregnancy! I'm sure that the next two months will go by very quickly.

Women & Infants has been helping women give birth for more than 125 years. In this time, we've gotten pretty good at understanding what women want, while always supplying what they need. For some women, an epidural is what they are looking for in the way of pain management. Others, like yourself, like to try to control their pain with no or minimal medical intervention.

In addition to a full anesthesia team that is available 24 hours a day, seven days a week, we also have a full array of amenities in place to make you and your coach/partner as comfortable as possible while your baby is born. In addition to the support and guidance from our labor room nurses who can suggest different positions and relaxation and breathing techniques, our labor-delivery-recovery rooms each offer such amenities as:

  • Aromatherapy – the use of pure essential oils from plants such as orange blossom can scent the air and be used for massage for a calming effect
  • Beds that adjust to 22 positions for the comfort of a laboring mom-to-be
  • Birthing balls – regular physiotherapy balls can help you get into a more comfortable position during labor, and are especially helpful if you are experiencing back labor
  • Birthing bar – this can help you get into a squatting position, which can help expand the size of your pelvis and use gravity to move the baby down
  • CD player - bring your favorite relaxing music to help you refocus from your pain
  • Rocking chairs
  • Walking corridor to help ease the pain of contractions
  • Warm packs
  • Soaking tubs - the warmth and pressure of the water in our soaking tubs may distract you from the contractions, delay the need for medication or lessen the amount of medication needed

    - Women & Infants' Warm Line

     

I'm trying to get pregnant, but no matter how much we try, it won't happen. Any suggestions or tricks that might help??? :)

Couples can improve their chances of having a baby by knowing the basics behind conception. Healthy young couples have about one- in-five odds of con¬ceiving each month. Conception is more likely to happen around the time of ovulation.

A woman can find out when she's ovulating each month with one of the following strategies:

  • Chart changes in your early-morning body temperature using a special basal thermometer. Your body temperature rises after ovulation and remains elevated until your next menstrual period. If you chart your cycle for three to four months, you and your partner can try to conceive the five days before your expected temperature rise.
  • Use an over-the-counter, FDA-approved home ovulation test kit.
  • Examine your cervical mucus throughout your menstrual cycle. It normally becomes clear and more abundant around ovulation.

Couples may want to talk to a doctor if pregnancy does not occur within one year. Women age 35 or older should only wait six months before speaking to a doctor.

There are also lifestyle issues that may impact a couple's ability to conceive. For women, being obese or too thin can hamper ovulation. And smoking and heavy alcohol drinking can impair fertility in both men and women. One study found no truth behind the myth that underwear briefs heated the scrotum any more than boxers did. Stress and depression may play a role in some cases of female infertility. Women who had been trying for more than a year to become pregnant were likelier to succeed after receiving relaxation training.

Whatever the cause of infertility, the road to pregnancy can certainly be stressful. So, reach out for support from friends or your partner. And be sure to exercise regularly and engage in other relaxing activities. 

 - Dr. Sandra Carson, Women & Infants' Center for Reproduction and Infertility 

 

I'm 41 and having my third baby. What should I be doing or looking for?

Congratulations on having your third baby. We hope you are feeling well and enjoying this pregnancy! It is probably going by quite quickly for you because you are so busy with the other two. The third baby can definitely be a challenge; but also a source of great joy and fun for your family. Soon you will have more children than hands; you and your partner will also be out numbered!

The good news is that the third child tends to be more easy going – because they have to be. They get carted around in the car a lot – bringing their older siblings to all of their activities. Regular naps are also difficult to schedule- they often occur in their car seats. One nice side effect is that a third baby often brings the other two children closer together. You may also notice the benefit of the siblings being able to entertain each other while you are tending to the many needs of the newborn. Caring for the new baby can become a family project –the older ones can work with you to care for the new baby. Teaching them how to prepare simple snacks/ meals (getting cereal/ making a sandwich etc.) for themselves may be helpful.

As far as your health is concerned you don't need to treat this pregnancy any different than the others. Continue with your regular activities and doctor/midwife visits. Your health care provider will monitor your health (blood pressure, glucose, etc.) as well as the health of the growing baby. If you do notice any symptoms that you did not notice with your previous pregnancies, please let your health care provider be aware of this. After delivery you may notice that the uterine cramping is more intense, and your breast milk tends to come in a bit earlier.

If you have further or more specific concerns please call the Warm Line at 1-800-711-7011. We are here Monday through Friday from 9am to 9pm, and Saturday and Sunday from 9am to 5pm. We wish you well for the rest of your pregnancy and in welcoming your new bundle of joy! 

- Women & Infants' Warm Line

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