Archive for the ‘Complications’ Category

A Message About Preeclampsia to Every Mother

Wednesday, June 4th, 2014

If your care provider is seeing a slight increase in your BP, a bit of protein in your urine, and asks you questions about headaches, swelling in your hands and face, pain under your ribs on the right, and if you’ve been seeing spots, they may tell you that you are turning preeclamptic. The Preeclampsia Foundation website can help clarify a lot of what they are telling you, and give you some tools to partner with your care provider in making sure of your diagnosis. Before you can proceed, having a good understanding of what you are facing is important for you and your baby’s health. A preeclampsia diagnosis is nothing to sneeze at, and therefore, it behooves you to learn what you can in order to participate fully in your care, and to make decisions based on information and instincts, rather than fear.

However, it is important to note that, if you do have preeclampsia, you are in a situation where the benefits of certain interventions (such as induction or occasionally cesarean section) very likely outweigh the risks of waiting it out. Preeclampsia doesn’t play fair. It is imperative that you speak clearly with your provider, and make sure you understand why they are suggesting certain procedures. Even if they are necessary, they can be hard to take in if you were planning an unmedicated vaginal birth. Knowing really is half the battle in this case. Do not be afraid to learn about preeclampsia, learn about the way your care provider treats it, and walk forward in confident awareness of the power you still have to choose rightly for you and your baby.

Some things to consider if your blood pressure slightly elevated during only one prenatal visit, and in the absence of other symptoms:

  • What is your stress level like?
  • Have you been sick lately?
  • Are you dehydrated?

Some questions to ask if you have more indicators and/or symptoms:

  • “Am I being diagnosed with preeclampsia, or are these numbers borderline?”
  • “Could this be pregnancy-induced hypertension? If so, how do you normally treat it? Can it lead to preeclampsia?”
  • “What other symptoms might come to light if it is preeclampsia?”
  • “Do I have the option of monitoring BP at home, and being checked every couple of days, or does this need to be taken care of now?”
  • “Is the protein in my urine shown via a reagent strip, and if so, can we double-check it with a 24 hour catch?”
  • “What are my options for induction if it becomes necessary? What are the benefits/risks/alternatives of each method? Which do you prefer, and why?”
  • “How soon do you typically decide to move on to a cesarean section if the induction does not work?”

Preeclampsia is not the end of the world, though it is serious. It is just one of several curve balls that get thrown at some women. It is not something that we currently know how to prevent with any degree of scientific certainty. We have a lot of ideas of what seems to help, but nothing we can hang our hats on just yet. One thing that I think is so important to understand is that we can do everything “right,” have a textbook healthy pregnancy, and still end up with preeclampsia or other problems. We are never guaranteed a “good” outcome when it comes to anything in life, and we should not expect our births to be any different.

What matters most is to do the best we can with what we have, and to be flexible when we are handed something unpleasant, difficult, or even downright terrifying. We face our fears and challenges head-on, and make the best decisions we can within our circumstances. We do not lose our power just because of a medical diagnosis. We just lose a few options we otherwise would have had. Never be afraid to ask your care provider, “Why?” The more you understand, the less scary it will be for you, and the better you will be able to process your birth after the fact.

Preeclampsia or no, your birth is still your birth. You are already a good mother. You can do this.

What do you know about preeclampsia? Where did you get your information? Have you had preeclampsia before? What was your experience with it? What did you learn from it? What advice would you give to someone facing a similar situation? Share your story in the comments…

Grace & Peace,
Tiffany

 

GBS & the Use of Antibiotics During Labor & Delivery.

Thursday, July 3rd, 2008

“While many studies have found that giving antibiotics during labor to women who test positive for GBS decreases the rate of GBS infection among newborns, research is beginning to show that this benefit is being outweighed by increases in other forms of infection.”

“A study of 43 newborns with blood infections caused by GBS and other bacteria found that, when the mothers of the ill newborns had been given antibiotics during labor, 88 to 91 percent of the infants’ infections were resistant to antibiotics. It is unlikely to be a coincidence that the drugs to which the bacteria showed resistance were the same antibiotics that had been administered during labor.24 For the newborns who had developed blood infections without exposure to antibiotics during labor and delivery, only 18 to 20 percent of their infections were resistant to antibiotics.”

“Preterm labor (i.e., labor before 37 weeks) is a well-accepted risk factor for transmission of GBS to the infant during labor and delivery. Due to the larger risk of transmitting GBS to a premature baby during delivery, most women who go into early labor will opt to receive IV antibiotics during their labor. However, infants born prematurely are at a greater risk from super-bugs caused by the very antibiotics that are supposed to be reducing their risk of infection. Severe complications for the babies, even deaths, have occurred when women whose waters broke before 37 weeks were given antibiotics to prevent transmission of GBS to their newborns. “

“Given the frightening results of these studies, what is a woman to do if she tests positive for GBS during her pregnancy? A closer look at the real risks of transmission, a frank talk with her provider of prenatal care, and a consideration of alternatives for eradicating GBS are all good places to start.”

“It should be noted that antibiotics such as penicillin kill GBS as well as other bacteria that might cause a newborn to become ill. Currently, the use of penicillin during labor may be a case in which the benefits outweigh the risks, depending on your individual risk factors for passing GBS on to your baby. However, it was only a few years ago that the same could have been said about other antibiotics. Ampicillin and amoxicillin have been rendered virtually useless for treating GBS by their prior overuse in laboring women in an effort to prevent GBS infection in newborns. How long will it be before penicillin, too, becomes useless in the battle to prevent GBS infections?”

“Ultimately, it is the pregnant woman herself who will have to decide what is right for her and her baby. Deciding to follow the recommendations of ACOG and the CDC is not necessarily the wrong choice, as long as a woman is adequately informed of the risks that come with antibiotic use. But none of us should blindly follow recommendations to interfere with the natural birth process without taking a good look at the risks, as well as the benefits, of doing so.” (Emphasis mine.)

Excerpts from “Treating Group B Strep
By Christa Novelli Published 08/31/2005 Pregnancy, Birth and Newborn Care