Tag Archive - pregnancy

Pregnancy with Low Back Pain or Sciatica

March 27, 2013 in Baby/Infant, Rehabilitation with 0 Comments

Screenshot_3_27_13_6_52_AMMany pregnant women with low back pain feel they will have to suffer with the pain until their baby is born. After delivery, some mothers continue to have symptoms, but their schedule doesn’t allow them to receive any treatment. Months and even years pass before they can find the time to address their back pain. The repetitive bending, lifting and nursing can further exacerbate their symptoms leaving the patient to feel helpless and limiting the amount of care they can provide to their new baby.

At St. David’s Spine and Sports Therapy, we advocate starting physical therapy for pregnant women as soon as symptoms commence. Injections and medications are not an option for this population; therefore, physical therapy is often their only attempt at conservative treatment. Many pregnant women respond very quickly to mechanical therapy and require no more than 6-8 visits to resolve their problem. Furthermore, most of these patients display directional preference which dictates the treatment plan giving these patients immediate pain relieve with just a few simple exercises. Often, these patients are fearful of exercise worsening their symptoms or harming the baby, so guidance from their physical therapist is essential to their recovery. By increasing awareness that early intervention is an option, these patients can avoid chronic problems and be able to enjoy their new baby without having to suffer from back pain or sciatica. A specialized therapist can also help the post-partum mother with more chronic problems. Consulting a therapist with advanced training in spine care can help alleviate back pain and allow you to focus on your new baby. 

Kim Greene, PT Dip. MDT
St. David’s Spine and Sports Therapy
Diploma in Mechanical Diagnosis and Therapy

3000 N. IH-35 Suite 530
Austin, TX 78705
Phone: 512 544-5092

Is Endometriosis a Contributing Factor Making it Difficult for Couples to Conceive?

March 6, 2013 in Baby/Infant, Fertility, Women with 0 Comments

Endometriosis occurs when the tissue that the lining of the uterus is composed of, also known as “endometrium,” is found within a woman’s body in locations outside of the uterus. This disease affects approximately 10% of women of reproductive age, and the percentage rises to 30% of women with infertility.

How would a woman know if she had endometriosis? Pelvic pain symptoms (painful periods and painful deep intercourse, for example,) which affect a woman’s quality of life, may increase suspicion for the presence of endometriosis, but laparoscopic day surgery with tissue biopsy is the gold standard for the diagnosis of any stage of endometriosis.

Endometriosis can adversely affect fertility at many levels. Not only can endometriosis distort the pelvic anatomy and make egg pick-up by the fallopian tube more difficult, but this disease can also adversely affect egg quality, egg numbers, fertilization rates, embryo development and implantation rates. While women in the general population have been reported to have a 15-20% chance of pregnancy per month, those with endometriosis may have a 2-10% chance of pregnancy per month. The time to pregnancy is increased in women with endometriosis who are trying to conceive with natural cycles.

Fertility treatment options are available for couples with endometriosis-associated infertility. These can range from ovulation induction medications (for example, clomiphene citrate, letrozole, gonadotropins) in conjunction with timed intercourse or intrauterine insemination (IUI), laparoscopic treatment of endometriosis, and in vitro fertilization (IVF). Success rates vary depending on the degree of endometriosis and the various other fertility factors. It is important for women with endometriosis to discuss their fertility potential with a fertility specialist in order to optimize the chances for a successful pregnancy.

Shahryar K. Kavoussi, M.D., M.P.H.
Board-Certified Reproductive Endocrinology & Infertility Specialist

Exercise in Pregnancy Can Improve Fitness and Obstetric Outcomes

January 10, 2013 in Baby/Infant, Exercise, Lifestyle Tips, Women with 0 Comments

(Bradley Price, MD, and OB-GYN at St. David’s Medical Center, recently co-authored an article on a recent study, “Exercise in Pregnancy: Effect on Fitness and Obstetric Outcomes— A Randomized Trial” in Medicine & Science in Sports & Exercise, The Official Journal of the American College of Sports Medicine.)

The article highlighted a recent study to assess the benefits and risks of aerobic exercise during pregnancy, using a fitness regimen based on the 2002 American College of Obstetricians and Gynecologists (ACOG) guidelines. Inactive women were randomized at 12-14 weeks gestation to a group which remained sedentary, or to a group which performed moderate aerobic exercise for 45-60 minutes, 4 days per week, for 36 weeks.

The results were that active women displayed improved aerobic fitness and muscular strength, experienced less premature labor, less incidence of gestational diabetes, delivered comparable size infants with significantly fewer Caesarean deliveries and recovered faster postpartum. Active women did not display gestational hypertension or experience injuries related to the exercise regimen. It was also determined that previously sedentary women who began exercising at 12-14 weeks showed improved fitness and delivery outcomes.

Dr. Price will be speaking further about this subject at an upcoming free community seminar:
Get Fit Pregnancy!
Wednesday, January 23
6:00-8:00 p.m.
St. David’s Medical Center, Medical Office Building, Fifth floor

A free pregnancy fitness consult will be offered to attendees as well. To register or learn more about this seminar please call 512.478.3627 or download the event flyer.

Patients as Lifesavers – Cord Blood Donation with Texas Cord Blood Bank

February 15, 2012 in Baby/Infant, Children, Community, Pregnancy, St. David's HealthCare, Women, Women: Ages & Stages with 3 Comments

The words “cord blood” may not mean very much to you, but for some patients, those two words may mean the difference between life and death.

Right now, you may be asking yourself “what is cord blood?”
Cord blood is blood that is left in the umbilical cord and placenta after the birth of a baby. The umbilical cord and placenta are usually discarded after a baby is born.

This special blood is a rich source of stem cells which can treat a number of illnesses and life threatening diseases.

Now you may be thinking “wait, aren’t stem cells tiny embryo’s?”
The types of stem cells that are found in cord blood are not the same as embryonic stem cells. These stem cells are simply in the blood of the placenta and umbilical cord and are typically disposed of after birth. These cells have proven to be life saving in the face of several diseases and illnesses such as leukemia, lymphoma and disorders of the immune system, just to name a few. This program is not controversial and is supported by many faith based communities because of the difference in the type of stem cell.

St. David’s Medical Center in downtown Austin is the only facility in the city currently offering free cord blood collection and donation. Until now, the only option for cord blood collection was through a private bank that requires a fee for collection and storage. Cord blood that is collected and donated may be used to treat someone who is a match with a life threatening disease such as leukemia, aplastic anemia or genetic blood disorders like sickle cell anemia.

Here’s a snapshot at the process of cord blood donation:

  • Receive information about cord blood collection and donation from your doctor during your prenatal visits.
  • Discuss screening done for all cord blood donors with your doctor. Most healthy moms are able to donate, but there are some common reasons you may not be able to donate such as a twin pregnancy.
  • Decide if participation in this program is right for you and your family.
  • Instead of discarding your umbilical cord and placenta after delivery, your baby’s cord blood will be collected by your physician after the baby is born. This process does not pose a risk to you or your baby, and it not painful to you in any way at all. Once the cord blood is collected, the placenta and umbilical cord are disposed of per Texas law.

The decision to collect and donate cord blood is personal for each and every family. Your options include – storing your cord blood at a private bank, donating and storing your cord blood to a public bank, or discarding the cord blood after delivery. Understanding those options may help you choose whether you would like to be a cord blood donor.

You may never know if someone’s life could be saved by the use of this special blood, but how special is the thought that you may be giving a child a second chance at life or helping a child live a normal, healthy life!

For more information about donating cord blood, please check out Texas Cord Blood Bank’s website at:
http://www.bloodntissue.org.

*All information used with the permission of Texas Cord Blood Bank.

Safe Travel Tips for Moms to Be:

December 19, 2011 in Baby/Infant, Diet, Holiday, Lifestyle Tips, Pregnancy, Women, Women: Ages & Stages with 0 Comments

Traveling during the holidays and have some questions?  Here are some important travel and holiday tips from Dr. Linda Fonseca, Maternal Fetal Medicine physician with St. David’s Medical Center.

 Q- What recommendations do you have for women who are pregnant and traveling during the holiday season?

A- “Air travel is generally safe during pregnancy in the absence of obstetrical or medical complications. It is therefore important to ask you doctor first before making travel plans. If you are planning to fly this holiday there are a few things to consider. First, you must use your seat belt at all times since air turbulence cannot be predicted. Seat belts should be placed low on the hipbone. Secondly, the potential risk of blood clots from long periods of immobilization and low cabin humidity has been a cause for concern despite the lack of evidence of such events during pregnancy. The use of support stockings and periodic movement of legs are preventative measures that can be used to minimize the risk of lower extremity blood clots. Thirdly, it is best to avoid consuming gas-producing drinks while flying because entrapped gases expand in high altitudes. Stay hydrated by consuming water or juice. Finally, whole body scanners at airports have been a recent concern to all travelers even thought radiation exposure is minimal. If you remain concerned it is reasonable to ask for a different screening method such as wand scan or full body pat- down.”

“Regardless which method of travel you choose, it is always important to consider how far along you are and the potential for complications at the time of travel. The most common obstetric complications occur in the first and third trimester. So if you must travel during these periods it would be reasonable to have your prenatal records with you and your doctor’s contact information. Also make sure to take anti-nausea or heart burn medications because it is not uncommon to feel sick during a road trip or flight.”

Q- At what time during pregnancy should a woman no longer consider flying to travel?

A- “This is an individualized decision between you and your doctor however each airline has its own policy. Most airlines will allow you to fly up to 36 weeks. Remember the closer you get to term the more common it is to go into labor or have blood pressure problems unrelated to travel.”

Q-There are so many holiday gatherings and meals at this time of year, is there anything a pregnant woman should avoid eating for health reasons?

A- “Yes, holiday meals can contain food items that should be avoided during pregnancy because of the concern for infection. It is unsafe to consume unpasteurized milk or cheese. Unless it clearly labeled as pasteurized then you must avoid brie, feta, camembert, blue cheese and Mexican queso blanco/fresco. You must also avoid deli meat or uncooked meat and poultry. It is also important to stay away from pate, meat spreads and refrigerated lox. Sushi may contain uncooked seafood and shellfish and should also be avoided. Uncooked eggs can be found in some homemade Caesar salad dressing, hollandaise sauce, mayonnaise and custard recipes so it is important to ask the cook before consuming. Home made egg nog recipes call for raw eggs and alcohol and therefore should not be consumed. Store bought egg nog contains pasteurized eggs and does not contain alcohol so it can be consumed safely during pregnancy. Because there is no amount of alcohol that is considered safe during pregnancy it should be strictly avoided.”

Q-  Do you have any special travel recommendations for women who are pregnant and have a past history of pre-term labor or premature rupture of membranes?

A- “It is best not to travel after 23- 24 weeks (viability) with this obstetrical history because of the high risk of recurrence and the need to be near a tertiary center should these complications recur. If travel cannot be avoided but can be planned in a patient with such history it would be best to do travel prior to 23 wks and after 34 wks because management of the mother and baby are less critical.”

Q- If a woman who is pregnant and traveling starts to not feel well, what is the best course of action?

A- “If she is traveling by air she should tell the flight attendant immediately so that medical help can be enlisted. If she is traveling by car the patient or her travel companion can call her physician to address the concerns. If it is an emergency (labor, bleeding) then she should find the nearest hospital. It is always important to know the names, addresses and phone numbers of hospitals that are located along the travel route or nearest the final destination in case of emergency.”

Great information for woman throughout this holiday season.  Tell us about your holiday traditions and advice for surviving the holiday season while pregnanct!

~Meg

[Image Credit]

Un-Expected Therapy

September 15, 2011 in Lifestyle Tips, Pregnancy, Women: Ages & Stages with 0 Comments


I recently started taking a pottery class- let me re-state this: I started taking a pottery class 4 weeks ago. In 12 hours of class time I have made a small jar or cup looking piece that is about 3 ½ inches tall and 2 inches wide. I have not fired it or glazed it yet. It’s somewhat depressing, but also inspiring at the same time.

I started taking this class to work on my skills and patience. Centering, centering, centering! It took me almost 6 hours to remember how to center my clay!

What I didn’t expect was to find a sense of community in the class. It feels almost therapeutic. The class consists of all women, all of us very different and at very different stages in life. Some of us have children, others don’t – some of us working busily in our careers, others retired.

Even though it’s challenging, working with the clay seems to provide us all the same benefit- relief. When I’m there in the studio, the only thing I’m thinking about is my current masterpiece.

There is a woman in the class is who about 7 ½ months pregnant or 30 weeks. As I watch her with the clay, I think how life is imitating art. How she is working so hard with this clay to get a perfected end result, much like her body is working hard to produce an entire perfect human being. Both are simply amazing. She is getting so close to the end result. Despite her growing tummy, she moves with intention and molds the clay.  She thought she would have to quit her classes as her stomach started to grow, but as it turns out she is more comfortable throwing pottery then she is most other times of the day. Her tummy lays low near the wheel as she pushes the weight of her body into her piece.  It doesn’t sound comfortable but she says she is!

The class talks about her upcoming due date offering tips and advice along with affirmations & validation.

I wonder to myself if she knew that this class would be an un-expected therapy when she signed up?

What are some of the activities that you did during pregnancy that offer other un-expected benefits?

Check out some of my work!

5 Recommendations for Record Breaking Heat and Pregnant Women

August 22, 2011 in Baby/Infant, Children, Community, Heat Safety, Lifestyle Tips, Outdoors, Women, Women: Ages & Stages with 0 Comments

This week I interviewed one of our new Maternal Fetal Medicine physicians, Dr. Linda Fonseca. Here in central Texas, we all know the heat has been exhausting and it has the opportunity to take an even greater toll on those who are pregnant.

Here are the things we chatted about:

Meg – How does the heat affect women who are pregnant?

Dr. Fonseca – “Pregnant women are more susceptible to dehydration because of the pregnancy and it can lead to serious problems. Heat can exacerbate dehydration from other conditions such as morning sickness or the stomach flu worse. Dehydration during pregnancy can lead to pre-term contractions or pre-term labor which can affect the outcome of the baby.”

Meg – What are the signs and symptoms of heat exhaustion and also heat stroke?

Dr. Fonseca – Many of the signs and symptoms of heat exhaustion can be easily disguised as something else. For heat exhaustion, be on the lookout for such things as: headaches, dizziness, cold or clammy skin, thirst, nausea, vomiting, tachycardia, dark urine and fatigue. Dr. Fonseca states that the signs and symptoms for heat stroke are much more severe and life threatening including: mental confusion or lethargy (an abnormal state of drowsiness), core body temperature of 104 degrees, seizures and lack of perspiration.

Meg – What can a patient do to decrease the risk of heat exhaustion?

Dr. Fonseca – “During these days of high temperatures, make sure to stay indoors as much as possible”. Dr. Fonseca encourages women to run errands in the early morning hours when it is still cool outside as opposed to the middle of the day when temperatures are the highest. She also recommends staying hydrated – “carry around a water bottle and take several sips throughout your day even if you are not thirsty”. Dr. Fonseca would like to remind women that they should increase their water intake if they are doing anything outdoors and to stay away from caffeinated drinks like soda or tea that can increase dehydration. “Caffeine is a diuretic which can cause your body to dehydrate much more quickly.” She also recommends wearing light clothing when doing anything outdoors and try to stay in the shade as much as possible.

Meg- What is an adequate water intake to prevent dehydration? Many women feel like 8-10 glasses of water per day are hard to achieve because they feel very full.

Dr. Fonseca – “The goal is still 8-10 glasses per day especially in these high temperatures.” Dr. Fonseca encourages women to take small sips of water throughout the day to prevent those uncomfortable “full” feelings that accompany the growing fetus. The plastic water bottles most people are familiar with are approximately 16oz so a person would need 4-5 bottles of water per day to meet the water requirement.

Meg – Any special foods or drinks you recommend to ward off dehydration or electrolyte imbalance?

Dr. Fonseca – “I generally encourage my patients to eat fresh fruit (instead of dried fruit), especially in the summer that is high in water such as peaches, watermelon, or cantaloupe.” Dr. Fonseca tells her patients to stay away from caffeine and sugary drinks that may rob your body of water. She encourages them to drink water and supplement with electrolyte enhanced liquids such as Gatorade, vitamin water or pedialyte.

Always an advocate for sunscreen, she reminds patients to make sure they are wearing an SPF in the summer wherever their skin will see light, but especially on their face. “During pregnancy there is an increase in melanin which can increase the chance of chloasma during pregnancy. Chloasma is hyper pigmentation caused by an increase of hormones while you are pregnant. Make sure to wear an SPF daily when leaving the house.

-Has anyone out there had a baby during these summer months? What advice do you have for our moms to be?!

Stay cool-
Meg

Top 5 :: Things to bring to the hospital when having your baby:

August 15, 2011 in Baby/Infant, Lifestyle Tips, Pregnancy, Women, Women: Ages & Stages with 0 Comments

Friends and family often ask me what to bring to the hospital when they come to have their baby-
This is a classic tale of LESS IS MORE!

Remember that although our rooms are comfortable and spacious you will have a new addition in the room that comes with lots of new equipment (diaper bag, car seat, CLOTHES!). There may also be many people coming to give you and the baby well wishes.

Here is a top 5 of things you should definitely consider bringing to the hospital.

  1. Your own pillow. Nothing says home like the smell of your sheets and a comfortable pillow.
  2. A small radio or iPod speakers/docking station. Music has been shown to decrease anxiety, motivate and relax a person – makes a great addition to any labor or postpartum room.
  3. Comfortable slippers with non slick soles.
  4. Magazines, books or something to focus on during early stages of labor and after the baby arrives.
  5. A comfortable robe – this is a recommendation from a friend who recently had a baby. Since hospital gowns are ‘one size fits all’ she felt somewhat exposed in her gown as she is a very petite person and the gown engulfed her. A soft, lightweight robe that you can easily breastfeed would be very helpful & comforting.

What did I forget?

~ Meg
Learn More:

Baby-Friendly : St. David’s Medical Center

July 12, 2011 in Baby/Infant, Children, Community, Pregnancy, Women, Women: Ages & Stages with 0 Comments


You are officially invited on the baby friendly tour! St. David’s Medical Center downtown is embarking on a journey to become a designated “Baby-Friendly” hospital and we would like you to come along, watch our progress and cheer us on.

The Baby-Friendly Hospital Initiative (BFHI) is a global program which is sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage & recognize hospitals and birthing centers that offer an optimal level of care for infant feeding (babyfriendlyusa.org).

St. David’s Medical Center nurses have been reading, watching, learning and shadowing breastfeeding experts to be able to assist you in your endeavors to successfully breastfeed.

Did you know that recent studies show that women who breastfeed enjoy decreased risks of breast and ovarian cancer, anemia, and osteoporosis? (babyfriendlyusa.org)

We can’t wait to share with you all the great things we have learned.

Check out Commitment to Breastfeeding below!

-Meg