#267 | May Q&A: Pre-eclampsia & Gestational Diabetes, Steroids for Pre-Term Labor, Declining the Anatomy Scan, IM vs. IV Pitocin, Preventing Mastitis
Digest
This episode of the Down to Birth podcast features a discussion about various pregnancy and childbirth topics, including serial steroid injections, anatomy scans, preeclampsia, gestational diabetes, and night weaning. The hosts, Cynthia Overgard and Trisha Ludwig, address listener questions and provide insightful advice based on their expertise as a childbirth advocate and certified nurse midwife, respectively. The episode also includes a segment where the hosts share their experiences with the worst pregnancy, marriage, and parenting advice they've ever received, highlighting common misconceptions and harmful stereotypes surrounding motherhood. The episode concludes with a call to action for listeners to follow the show on Apple Podcasts and stay tuned for future episodes.
Outlines
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Listener Question: Serial Steroid Injections
This Chapter begins with a listener's question about serial steroid injections at 30 weeks of pregnancy. The listener has a history of preterm births and is seeking advice on whether these injections are a good idea, given that they are typically recommended for imminent births. Cynthia and Trisha discuss the benefits and risks of steroid injections, highlighting a recent study that suggests potential adverse effects for late preterm and full-term births. They emphasize the importance of caution when considering prophylactic steroid injections and encourage listeners to consult with their healthcare providers.
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Listener Question: Anatomy Scan and Gender Reveal
This Chapter features a listener who is 13 weeks pregnant with her fourth child and is hesitant about getting a 20-week anatomy scan. She also doesn't want to find out the sex of the baby and prefers to keep it a surprise. Cynthia and Trisha discuss the purpose of anatomy scans and the potential benefits and risks associated with them. They acknowledge the listener's right to make her own decisions about her pregnancy and encourage her to communicate her preferences to her midwife.
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Listener Question: Preeclampsia and Gestational Diabetes
This Chapter addresses a listener's concerns about preeclampsia and gestational diabetes. The listener experienced both conditions during her first pregnancy and is worried about the possibility of recurrence. Cynthia and Trisha discuss the risk of recurrence for both conditions and provide information about lifestyle factors that can help prevent them. They also address the listener's question about whether these conditions would preclude her from midwifery care or natural birth options.
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Quickies: Breastfeeding, Induction, LH Spike, Prenatal Vitamins, Due Date, Night Weaning
This Chapter features a series of quick questions and answers from listeners. The topics covered include breastfeeding and pregnancy, induction for gestational diabetes and mild preeclampsia, the meaning of a high LH spike, prenatal vitamin recommendations, determining due date based on period and anatomy scan, and night weaning.
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Embarrassing Moments and Podcast Updates
This Chapter concludes the episode with a lighthearted discussion about embarrassing moments. Cynthia and Trisha share their recent experiences and encourage listeners to follow the show on Apple Podcasts to ensure they don't miss any episodes.
Keywords
Preeclampsia
Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organs, such as the liver or kidneys. It typically develops after 20 weeks of pregnancy and can lead to complications for both the mother and the baby. Risk factors for preeclampsia include a history of preeclampsia, multiple pregnancies, chronic high blood pressure, diabetes, and autoimmune diseases. Treatment for preeclampsia often involves medication to lower blood pressure and monitoring of the mother and baby. In severe cases, delivery of the baby may be necessary.
Gestational Diabetes
Gestational diabetes is a type of diabetes that develops during pregnancy. It is characterized by high blood sugar levels and is usually caused by hormonal changes that occur during pregnancy. Gestational diabetes can increase the risk of complications for both the mother and the baby, including premature birth, birth defects, and high birth weight. Treatment for gestational diabetes typically involves diet and exercise, and in some cases, insulin therapy may be necessary.
Steroid Injections
Steroid injections, specifically antenatal corticosteroids, are given to pregnant women who are at risk of preterm birth. These injections help to mature the baby's lungs and reduce the risk of complications associated with preterm birth, such as respiratory distress syndrome. Steroid injections are typically given in two doses, about 24 hours apart. While generally considered safe, recent studies have suggested potential adverse effects for late preterm and full-term births, highlighting the importance of careful consideration and consultation with healthcare providers.
Anatomy Scan
An anatomy scan, also known as a level II ultrasound, is a detailed ultrasound examination that is typically performed between 18 and 22 weeks of pregnancy. It is used to assess the baby's growth and development, including the size and shape of the organs, the presence of any birth defects, and the position of the placenta. Anatomy scans are generally considered safe and are a routine part of prenatal care.
Home Birth
Home birth is the practice of giving birth at home, typically with the assistance of a midwife. It is a growing trend, with many women choosing home birth for a variety of reasons, including a desire for a more natural and personalized birth experience, a preference for avoiding medical interventions, and a belief that home birth is safer for both the mother and the baby. However, home birth is not without risks, and it is important to carefully consider the potential benefits and risks before making a decision.
Night Weaning
Night weaning is the process of gradually stopping nighttime breastfeeding or bottle feeding. It is a common practice for parents who are looking to help their baby sleep through the night or to reduce their own sleep deprivation. Night weaning can be a challenging process, and it is important to be patient and consistent. There are a variety of methods that parents can use to night wean their baby, and it is important to choose a method that is right for their family.
Down to Birth Podcast
The Down to Birth podcast is a popular resource for women who are pregnant, postpartum, or interested in learning more about childbirth and parenting. Hosted by Cynthia Overgard, a childbirth advocate, and Trisha Ludwig, a certified nurse midwife, the podcast features interviews with experts, discussions about current topics in childbirth, and answers to listener questions. The podcast is known for its informative and empowering content, and it is a valuable resource for women who are seeking to make informed decisions about their pregnancy and birth.
Q&A
What are the benefits and risks of serial steroid injections for preterm birth?
Steroid injections can significantly improve a preterm baby's chances of survival and reduce the risk of complications like respiratory distress syndrome and brain bleeds. However, a recent study suggests potential adverse effects for late preterm and full-term births, raising concerns about prophylactic use.
What is the purpose of an anatomy scan and should a woman have one if she doesn't want to?
Anatomy scans are used to assess the baby's growth and development, including the presence of any birth defects. While they can provide valuable information, a woman has the right to decline the scan if she feels uncomfortable or doesn't want to know certain information.
What are the risks of preeclampsia and gestational diabetes recurring in subsequent pregnancies?
There is a higher risk of recurrence for both conditions, especially gestational diabetes. However, lifestyle factors like diet, exercise, and managing blood sugar can help prevent them.
Can a woman with a history of preeclampsia or gestational diabetes still have a natural birth or midwifery care?
Yes, midwives are experienced in supporting women with these conditions. However, it's important to discuss individual circumstances and preferences with the midwife.
What is the best advice for someone who had a traumatic home birth and is considering a second home birth?
It's crucial to address the source of the trauma and consider whether the home environment was a contributing factor. Birth processing and seeking support can help make an informed decision.
What is the best prenatal vitamin recommended by the hosts?
The hosts recommend Needed, a woman-founded company offering a superior prenatal vitamin with optimal nutrient levels. They use the product themselves and encourage listeners to use the code 'down to birth' for a discount.
What is the most accurate way to determine a due date?
While ultrasounds can be helpful, the hosts recommend going with the later due date if there is a discrepancy between the last menstrual period (LMP) and the anatomy scan.
When is the best time to night wean a baby?
Night weaning can be done whenever a mother feels it's compromising her sanity and mental health. It's important to prioritize sleep and well-being, but it's generally not recommended in the first few months.
What is the most embarrassing thing that has happened to Cynthia in public recently?
Cynthia shared a story about breaking her glass water bottle for the third time in six months, causing a scene at the airport. She remains committed to using glass water bottles despite the recurring incidents.
Show Notes
Hello everyone! Cynthia and Trisha are back with the May Q&A episode. Today, we kick it off with an enlightening discussion on the worst parenting advice you have ever received--here's to all the things we never need to hear as mothers! Next, we hear one woman's beautiful take on her cesarean scar. Then, we dive into your awesome questions beginning with:
- What is the likelihood that if I had pre-eclampsia and gestational diabetes in my first pregnancy that I will have it again, and what can be done about it?
- If I have a history of pre-term labor twice, should I take steroids preventatively at 30 weeks by my doctor's recommendation?
- I am pregnant with my fourth baby, planning a home birth, and I don't want any ultrasounds. Do you think this is ok and will my midwife approve?
In the extended version of the episode, available on Apple subscriptions and Patreon, we discuss the pros and cons of the midwifery lifestyle for one woman trying to decide if she should go the CNM or CPM route; when it is appropriate or necessary to take a urine sample in pregnancy; and why one mother may have been given intramuscular Pitocin instead of intravenous when she already had an IV in place.
As always, we close with a round of quickies touching on how to keep breastfeeding while pregnant, getting induced for "mild" pre-eclampsia, what a high LH reading means, preventing mastitis when you have a plugged duct, our recommended prenatal vitamin, and our most embarrassing moments in public!
Thank you as always for your wonderful questions! Please call in your question to 802-GET-DOWN or 802-438-3696. To get the extended version of today's episode (and all episodes 100% ad-free) just click the subscribe button on Apple Podcasts or download the Patreon App and join any tier.
If you enjoyed this episode, please see our April Q&A episode:
#262 | April Q&A: Prenatal Vitamins, Premature Rupture of Membranes, Painless Breech Birth, Precipitous Labor, HypnoBirthing, Prenatal Hypertension
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Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.
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Needed -- Our favorite nutritional products to nourish yourself before, during, and after pregnancy.
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Please remember we don’t provide medical advice. Speak to your licensed medical provider for all your healthcare matters.