5. How Your Actions Affect Your Baby’s Development

Outside Noises Can Affect Baby

Can a baby hear sounds from outside its mom’s body while inside the uterus? From various studies, we know sounds penetrate amniotic fluid and reach your baby’s developing ears. In fact, ultrasounds done around this time have shown babies reacting to loud noises.

If you work in a noisy place, you may want to request a quieter area. Data suggests chronic loud noise and short, intense bursts of sound may cause hearing damage to the baby before birth.

It’s OK to expose your growing baby to loud noises, such as a concert, every once in a while. But if you’re repeatedly exposed to noise that is so loud it forces you to shout, it may be dangerous for your growing baby.

Moving during Pregnancy

Moving to a new city at any time can be stressful; when you’re pregnant, it can also be challenging. How can you find a new healthcare provider? What hospital will you use?

Before you leave your old home, find a hospital in the area you’re moving to that you want to use, then find a healthcare provider (who is accepting new patients) who delivers at that hospital. Do this as soon as you learn you’re moving because it may take some time to get in to see the new healthcare provider for your first appointment.

A real-estate agent should be able to help in this situation. Ask about a hospital with a level-2 or level-3 nursery. These hospitals are better able to deal with various complications of pregnancy and birth. Even if you haven’t had any problems, you’ll rest easier knowing the hospital can handle an emergency.

When you’ve chosen the hospital, call the labor-and-delivery department and ask to speak with a supervisor. Explain your situation, and ask for recommendations for three or four good obstetricians who deliver at the hospital, who are accepting new patients.

When you have the names, call each office and explain your situation. Request information about fees and insurance coverage. Ask if you can get an appointment for the first week you’re in town. Then make your decision about which healthcare provider you want to use, and call back and confirm your appointment.

After you decide on someone, go to the healthcare provider you now see, and ask for copies of your medical records. Be sure they include results of any tests you’ve had. Take everything with you. If the office says they’ll send them to the new healthcare provider, tell them that’s fine, but you must also have copies to take with you. Sending records can take a long time.

If you haven’t had your alpha-fetoprotein test or a triple-screen test done, and you are between 15 and 19 weeks of pregnancy, ask your current healthcare provider to order them and have the results sent to you at your new address. It can take several weeks to get the results of these two tests, and it will be helpful for your new healthcare provider to have the results when you go to see him or her. Ask your healthcare provider to write a short letter of introduction that you can give to your new healthcare provider. This is a brief summary of your pregnancy, current health and health concerns.

6. Your Nutrition

Many pregnant women are concerned about eating out. Some want to know if they can eat certain types of food, such as Mexican, Vietnamese, Thai or Greek food. They’re concerned spicy or rich foods could be harmful to the baby. It’s OK to eat out, but you might find certain foods don’t agree with you.

The best types of food to eat at restaurants are those you tolerate well at home. Chicken, fish, fresh vegetables and salads are usually good choices. Eating foods at restaurants that feature spicy foods or unusual cuisine may cause stomach or intestinal distress. You may even notice an increase in weight from water retention after eating at a restaurant.

Avoid restaurants that serve highly salted food, food high in sodium or food loaded with calories and fat, such as gravies, fried food, junk food and rich desserts. It may be difficult to control your calorie intake at specialty restaurants.

Another challenge of eating out is maintaining a healthy diet if you work outside the home. It may be necessary to go to business lunches or to travel for your company. Be selective. If you can choose off the menu, look for healthy or low-fat choices. Ask about preparation—maybe a dish can be steamed instead of fried. On a business trip, take along some of your own food. Choose healthy, nonperishable foods, such as fruits and vegetables, that don’t need refrigeration.

Crohn’s Disease and Pregnancy

Crohn’s disease is a chronic illness in which the intestine or bowel becomes inflamed and scarred with sores; it usually affects the part of the small intestine called the ileum. However, Crohn’s can occur in any part of the large or small intestine, stomach, esophagus or even the mouth.

Crohn’s disease is part of a group of diseases called inflammatory bowel disease or IBD. See the discussion of IBD in Week 18. Crohn’s disease most commonly occurs between ages 15 and 30. Sufferers experience periods of severe symptoms followed by periods with no symptoms. Symptoms include chronic diarrhea, rectal bleeding, weight loss, fever, abdominal pain and/or tenderness and a feeling of fullness in the lower-right abdomen.

Tip for Week 24

Overeating and eating before going to bed at night are two major causes of heartburn. Eating five or six small, nutritious meals a day and skipping snacks before bedtime may help you feel better.

If you have active Crohn’s disease, getting pregnant may be more difficult. An active disease raises the risk of problems. A flare-up may occur during pregnancy, most often in the third trimester, but flare-ups are often mild and respond to treatment.

Is Food Hot Enough to Be Safe?

Don’t rely on a taste test to determine if food is hot enough to be safe to eat. When reheating leftovers, use a quick-reading thermometer to make sure food has reached an interior temperature of 165F. This is the temperature at which harmful bacteria are killed.

Symptoms may be less severe because pregnancy alters the immune system. Being pregnant may also protect against future flare-ups and may reduce the need for surgery. During pregnancy, your body produces the hormone relaxin. Researchers believe relaxin may also curb the formation of scar tissue.

You probably won’t need to change your medicines during pregnancy. Sulfasalazine, mesalamine, balsalazide and olsalazine don’t hurt the baby. Infliximab (Remicade) and adalimumab (Humira) may be necessary during pregnancy and breastfeeding. Avoid methotrexate during pregnancy.

You may need various tests during pregnancy. Experts believe it’s safe to have a colonoscopy, sigmoidoscopy, upper endoscopy, rectal biopsy or abdominal ultrasound during pregnancy. Avoid X-rays and CT scans. Ask your pregnancy healthcare provider about an MRI if one is recommended.

If you’ve had a bowel resection, you probably won’t have problems during pregnancy. An ileostomy may decrease fertility. If you develop an abnormal opening near your rectum or in the vaginal area, you may need a Cesarean delivery.

The type of delivery you have depends on the condition of the tissues around the vagina and anus. A Cesarean may be recommended if you develop a fistula or to reduce your risk of developing fistulas.

Many women suffer flare-ups immediately after birth. Healthcare providers believe this is due to the hormonal changes after pregnancy.

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