Miscellaneous
Dr. Kang and Dr. Power take care of both pregnant women and their babies....but we gotta start somewhere! Are you thinking of getting pregnant....Well this is the podcast for you!! Generally women and their partners have quite a few questions about how to get their pregnancy off to the healthiest start! This podcast is to introduce us and answer these questions. Right after this little reminder! Preparing for Pregnancy: MK: Alicia, what are your recommendations for eating in pregnancy? AP: there is some evidence that the diet you are eating around the time of conception can influence how your body diverts its energy to your placenta - so make sure you are eating a well balanced diet, of real food. Start taking a prenatal vitamin as soon as you find out you are pregnant, or better yet when you start thinking about getting pregnant. Maria...what about exercise??? MK: Exercise: is good! anything you have been doing, keep doing - 30-45 min 3-4 times a week. AP: When it comes to alcohol during pregnancy, there is no safe amount of alcohol during pregnancy. Maria, what do you think about alcohol during pregnancy? MK - You are absolutely right. Most people have heard of Fetal Alcohol Syndrome or Fetal Alcohol Spectrum Disorders (FASD) and there is a broad range of effects to the baby including general size, brain size, development, learning disorders...these are lifelong problems that can affect the baby. There is no safe amount or safe time during the pregnancy to drink. And before you ask about all those women in Europe who drink during pregnancy, there are consensus guidelines out there, which means that even the European countries like France and Italy recommend avoiding alcohol during pregnancy. I looked into this and Bulgaria and the UK have come out with the guideline of no more than 1-2 units of alcohol once or twice a week. They still say that if you are pregnant or trying to get pregnant, you should avoid alcohol. This is probably has more to do with harm reduction and public health strategy. Bottom line, the earliest intervention we can promote is a healthy pregnancy and this starts with avoiding alcohol. AP: what about drugs, marijuana? MK: This is a big topic. Drugs like heroin, cocaine and ecstasy complicate your pregnancy and can compromise blood flow to your baby. This means your baby may be very small and premature. Plus the smaller and earlier your baby is born, the more problems it can run into during those critical first few days and weeks of life. This can really affect brain development down the road. Another major problem immediately after babies are born is withdrawal. Babies will actively withdraw in the same way that adults do. They are sweaty, have high heart rates, have diarrhea, are in pain and can even have seizures. On top of that, withdrawing babies spend less time with their moms, have difficulty feeding and are hard to manage even for experienced moms and caregivers. The effects of Mary J haven't been teased apart as much as heroin, cocaine and ecstasy but it's known as the "gateway drug". This means, that it easily paves the way for more illicit drug use. I think this is why the research is difficult to perform and to analyze, because there are not as many mom's using JUST marijuana. The bottom line is: AVOID illicit drug use. But more importantly, if you are struggling with a drug and/or alcohol problem, please just get help. There are programs for pregnant moms who are struggling and it's not about taking your baby away. The more you seek out help and work at it, the better your baby will be in every aspect. Get on board with a maternity care provider that you connect with. And reach out the the Addictions Outpatient Clinic - 1125 Pembroke Street here in Victoria, BC. MK: what about health conditions? Alicia what do you normally counsel women on? AP: If you have medical conditions, it is important to be as stable as possible when you are trying to conceive - some examples of diseases that should be stable are diabetes, seizure disorders, crohn's or colitis, hypertension, kidney disease, depression and anxiety. Please tell your health care provider as soon as you think you may want to get pregnant, as certain medications are safer than others in pregnancy and so they may decide to change a medication to plan for pregnancy. Many people are on antidepressants and often ask the question about whether they should stop their medication prior to conceiving...this is a complicated question with no easy answer...but the most important part of the answer is that a stable mother is the most important thing to work towards. If your care provider is unsure, they can always ask someone who does this all the time for help. The docs at grow health are always happy to see women to discuss these issues prior to becoming pregnant! Book an appointment with a care provider, and depending on where you live your options will be a midwife, nurse pratitioner, family doctor or Obstetrician. In Victoria bc, the options are a midwife or family doctor. We will be doing a future podcast on this topic. MK: Now dad's also play a role in this, and probably good for them to be on the same track as future mom's. Eating healthy, exercising, stopping smoking/drugs and minimizing alcohol is always a good rule of thumb. AP: now lets get to the nitty gritty of things.... Mk: yes indeed....what do you tell people about how to get pregnant! AP: Basics on menstrual cycles and when to try to get pregnant. Most women have a 28 day cycle. This starts on the first day of your menstrual cycle, and ends the day before your next menstrual cycle. Most women ovulate around day 14, and the egg generally needs to be fertilized within 24 hours so I usually recommend women have intercourse on day 14, day 12 and day 16. If you really want to hedge your bets then you could add on day 10 and 18. We usually recommend 48 hours between intercourse to allow for the man's sperm to reaccumulate to a reasonable number. The majority of people, with consistent trying will be pregnant within 6 months of starting, if you are under the age of 36 and not pregnant by 6 months, it is probably a good idea to see your health care provider, if you are older than 36 years, i usually recommended seeking health advice after 3 months of unsuccesful trying. AP: What is the latest on Zika virus and pregnancy.... MK: Current recommendations are that women consider a delay in conceiving a child for 2 months and that a male partner delay conceiving a child for 6 months after returning from travel to a Zika virus affected area. Pregnancy resources: http://www.health.gov.bc.ca/library/publications/year/2015/babys-best-chance-2015.pdf