9. Be Careful of What You Read on the Internet
We have had pregnant women ask us the
most bizarre questions or present us with information that is totally
incorrect or only partially correct. When we ask them where they found
these facts, they often tell us “the Internet.”
Just because you read it on the Internet does not make it true. Some people think if they find it on the Internet, it’s a fact. That’s often not the case.
We know you can find a lot of good
information on the Internet, but then again, you can also find a lot of
misinformation. If you’re searching for advice or facts about something,
read what you find very carefully. If you have questions about
something you find, print out the piece and take it with you to a
prenatal visit so you can discuss it with your healthcare provider.
Grandma’s Remedy
If you want to avoid using medication,
try a folk remedy. Chew a combination of fresh mint and parsley leaves
to help deal with bad breath and intestinal gas.
Do not change anything your healthcare provider has told you. Do
address your questions and concerns at a prenatal appointment. Your
healthcare provider knows about your unique pregnancy situation. If you
disagree or question what you’re told, ask for a second opinion.
10 .Tuberculosis (TB)
Tuberculosis occurs more often in the
United States today than it did in the past. In our country, the disease
primarily affects the elderly, the poor, minority groups and those with
AIDS. The immigration of women from Asia, Africa, Mexico and Central
America has resulted in an increase of TB in pregnant women. In
addition, women who are HIV-positive are at greater risk for
tuberculosis because of decreased immunity.
Eyelash-Growth Enhancers
Prescription eyelash-growth enhancers,
such as Latisse, and over-the-counter products, such as Revitalash, are
used to help make eyelashes grow longer and thicker. If you normally use
these products, it’s best to stop using them during pregnancy. We don’t
have enough information to know if they’re safe during pregnancy.
Better to be safe than sorry.
Worldwide attention has been directed
toward rare, serious cases of TB. But relax—it’s highly unlikely
tuberculosis will be a problem for you or your baby. Even with an
increase in the number of TB cases, the risk to most women is very low.
Tuberculosis is caused by the bacteria Mycobacterium tuberculosis.
The most common site of tuberculosis infection is the lungs, but
infection can also occur in other parts of the body. You get it by
breathing in the bacteria; it’s passed to others through coughing and
sneezing.
Tuberculosis is diagnosed with skin
testing; the TB skin test is safe during pregnancy. If the skin test is
negative, no further testing is done. If it is positive, a chest X-ray
is usually done. If you have been vaccinated with the TB vaccine, BCG,
it can make diagnosis more difficult.
The infection can be active or lie dormant
(inactive) for a long time. Active TB usually shows up on a chest
X-ray. Latent TB often has no symptoms; if you have a chest X-ray, it
will be normal. Most people infected with tuberculosis have latent TB.
Latent tuberculosis can become active and cause a cough, with or without
sputum production, fever, night sweats, bloody sputum (hemoptysis),
fatigue and weight loss.
Medication is used to treat TB. Many of the drugs used to treat tuberculosis are safe during pregnancy.
A baby can become infected with active or
latent TB from its mother’s blood or from breathing the bacteria after
birth. If you have tuberculosis, baby’s pediatrician should be involved
immediately after birth. If you’re contagious, baby
may need to be separated from you for a short time. Most people aren’t
contagious after 2 weeks of treatment. After that time, it’s safe to
breastfeed.
11. Having a Baby Costs Money!
Every couple wants to know what it will
cost to have a baby. There are really two answers to that question—it
costs a lot, and cost varies from one part of the country to another.
From prenatal care to baby’s birth, the average cost of having a baby
today is around $8000 in the United States.
Insurance makes a big difference in the
cost to you. If you don’t have it, you’ll pay for everything. If you do
have insurance, you need to check out some things. Ask your employer or
insurance agent the following questions.
• What type of coverage do I have?
• Are there maternity benefits? What are they?
• What percentage of my costs are covered?
• Do I have to pay a deductible? If so, how much is it?
• Is there a cap (limit) on total coverage?
• If my pregnancy lasts into a new year, will I have to pay 2 years’ worth of deductibles?
• How do I submit claims?
• Do maternity benefits cover Cesarean deliveries?
• What kind of coverage is there for a high-risk pregnancy?
• Is the cost of taking childbirth-education classes covered?
• Does my coverage restrict the kind of hospital accommodations I may choose, such as a birthing center or a birthing room?
• What procedures must I follow before entering the hospital?
• Does my policy cover a nurse-midwife (if this is of interest to you)?
• Does coverage include medications?
• What tests during pregnancy are covered?
• What tests during labor and delivery are covered?
• What types of anesthesia are covered during labor and delivery?
• How long can I stay in the hospital?
• Does payment go directly to my healthcare provider or to me?
• What conditions or services are not covered?
• What kind of coverage is there for the baby after it is born?
• How long can the baby stay in the hospital?
• Is there an additional cost to add the baby to the policy?
• How do I add the baby to the policy?
• How soon do we need to add the baby to the policy?
• Can we collect a percentage of a fee from my husband’s policy and the rest from mine?
Having a baby involves different costs.
Much of the covered cost for the hospital is determined by how long you
stay and the “services” you use. Having an epidural or Cesarean delivery
may add to the bill. Your healthcare provider’s bill is separate,
except under some plans. Another cost is the pediatrician, who usually
examines the baby, does a physical and sees baby each day in the
hospital.
It would be nice to think about costs
before pregnancy and be sure to have insurance to help out. However,
about half of all pregnancies are surprises. What can you do? First,
find the answers to your questions. Talk to your insurance carrier, then
talk to someone in your healthcare provider’s office who handles
insurance claims. This person may have answers or know of resources you
haven’t thought about. Don’t be embarrassed to ask questions. You’ll be
happier if you get answers.
Pregnancy is not the time to cut corners
to save money. Call around so you can compare hospitals and prices.
Sometimes it’s worth spending a little more to get what you want. When
you call, ask for specifics about what is included in the prices they
quote you. You may get a price that seems lower and better than others
but really doesn’t cover everything you’ll want and need.
Some hospitals and medical centers offer
“pregnancy packages.” A package can cover many services for one fee. Ask
about it in your area.
Costs of Having a Baby in Canada.
The Canadian healthcare system is different from that in the United
States. Canadians pay a premium on a monthly basis. Maternity costs
vary, depending on which province you live in. The healthcare provider
who delivers your baby is paid by the government. He or she submits the
bill to the government, not you.
Certified Nurse-Midwives,
Advance-Practice Nurses and Physician Assistants
In today’s obstetric-and-gynecology
medical practices, you may find many types of highly qualified people
helping to take care of you. These people—mostly women, but not all!—are
on the forefront in guiding women through pregnancy to delivery. They
may even help deliver their babies!
A certified nurse-midwife (CNM) is
an advance-practice registered nurse (RN). He or she has received
additional training delivering babies and providing prenatal and
postpartum care to women. A CNM works closely with a doctor or team of
doctors to address specifics about a particular pregnancy, and labor and
delivery. Often a CNM delivers babies.
A certified midwife can provide many
types of information to a pregnant woman, such as guidance with
nutrition and exercise, ways to deal with pregnancy discomforts, tips
for managing weight gain, dealing with various pregnancy problems and
discussions of different methods of pain relief for labor and delivery. A
CNM can also address issues of family planning and birth-control and
other gynecological care, including breast exams, Pap smears and other
screenings. A CNM can prescribe medications; each state has their own
specific requirements.
A nurse practitioner (NP) is also
an advance-practice registered nurse (RN). He or she has received
additional training providing prenatal and postpartum care to women. A
nurse practitioner may work with a doctor or work independently to
address specifics about a woman’s pregnancy, and labor and delivery.
An NP can provide many types of
information to a pregnant woman, such as guidance with nutrition and
exercise, ways to deal with pregnancy discomforts, tips for managing
weight gain, dealing with various pregnancy problems and discussions of
different methods of pain relief for labor and delivery. He or she can
also address issues of family planning and birth control and other
gynecological care, including breast exams, Pap smears and other
screenings. In some cases, a nurse practitioner may prescribe
medications or provide pain relief during labor and delivery (as a
certified registered nurse anesthetist [CRNA]).
A physician assistant (PA) is a
qualified healthcare professional who may take care of you during
pregnancy. He or she is licensed to practice medicine in association
with a licensed doctor. In a normal, uncomplicated pregnancy, many or
most of your prenatal visits may be with a PA, not the doctor. This may
include labor and delivery. Most women find this is a good thing—often these healthcare providers have more time to spend with you answering questions and addressing your concerns.
A PA’s focus is to provide many
health-care services traditionally done by a doctor. They care for
people who have conditions (pregnancy is a condition they see women
for), diagnose and treat illnesses, order and interpret tests, counsel
on preventive health care, perform some procedures, assist in surgery,
write prescriptions and do physical exams. A PA is not a medical assistant, who performs administrative or simple clinical tasks.
We are fortunate to have these dedicated
professionals working in OB/GYN practices and clinics. The care they
provide is crucial to the medical community and makes quality medical
care for women something every woman can look forward to.
12. Exercise for Week 9
Hold onto a door jamb or the back of a
sturdy chair. Beginning with your right leg, point your toe and lift
your leg forward to 90°, then lower it to the floor. Without stopping,
lift the same leg to the side, as far as you can but not beyond 90°.
Return to the starting position. Repeat 10 times for each leg. Tones leg muscles and buttocks muscles.
