Pregnant Women and Vaccination

5 03 2012

Dr. Mary Beth Koslap-Petraco, PKIDs’ advice nurse practitioner, talks about the vaccines pregnant women need.

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Right-click here to download podcast (8 min/4 mb)





Labor Inductions Lead to Earlier Births

11 06 2010

It is my personal belief that pregnant women who are less than 6 feet tall should not be allowed to carry twins. Not literally, of course, but as a 5’3” pregnant woman carrying twins, I more or less cried with relief when my OB recommended an induction at 39 weeks.

Given a recent study which associates an increased rate of induction with lower birth weight and earlier birth, I ought to have paused a bit before submitting to the induction.

In the study, researchers found a correlation between the increased rate of induced labor in the U.S. (48% between 1993 and 2003) and earlier births, as well as lower birth weight.

Circumstances which merit an induction are hotly debated, with some decrying most inductions as invasive and unnecessary while others maintain that better technologies allow for more medically appropriate interventions.

Possible reasons for an induction include:

• Fetal distress

• Uterine infection

• 10 days past estimated due date

• Maternal medical condition

The reasons for the increased rate of induction were not investigated as part of this study, but the resulting earlier births and lower birth weights are of concern because of their correlation with complications such as respiratory infections and related illnesses. And the increased usage of labor induction could be a bellwether of further complications for newborns.

Most traditional healthcare providers will recommend against inducing labor unless it’s deemed medically necessary. Despite the temptation to push labor along using various “natural” methods, the Mayo Clinic recommends instead that you:

1. Stay in touch with your healthcare provider

2. Turn on your answering machine/voicemail

3. Relax and let nature take its course.

(Rachael Brownell is the statuesque mother of three adorable munchkins, and PKIDs’ Director of Outreach.)


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HPV and Pregnancy

14 04 2010

For most women, HPV (human papillomavirus) is an infection that comes and goes without sign or symptom.

For some women, it’s a horrible infection that causes cervical cancer.

Treatments for cervical cancer depend on many variables, including what stage of cancer one has.

Some of these treatments attempt to preserve fertility while maintaining high survival rates. Two such treatments are:

  • Conization – removing abnormal areas of the cervix (also known as a cone biopsy)
  • Trachelectomy – removing part or all of the cervix

These treatments may affect the cervix in such a way that it could be more difficult to become pregnant or carry a pregnancy to full term, but they are still considered to be “fertility-preserving therapy” because other procedures are even more likely to affect fertility and pregnancy.

About the only way to prevent HPV infection is to have only one intimate partner during your lifetime, but that partner has to also have only one intimate partner—you. If that sounds unlikely to you, there are vaccines available that can reduce your chances of getting HPV (and therefore cervical cancer)—check with your doctor to see if it’s a good choice for you.

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Thinking of Pregnancy? Think Preconception Care.

13 01 2010

In the 1980s, prenatal care entered the public mainstream as a way of improving maternal and infant health outcomes.

Prenatal care intervention now reaches most American women for the duration of their pregnancies.  However, nationally, maternal and infant health outcomes haven’t continued to improve, and some problems have worsened for reasons that continue to be preventable.

Because prenatal care usually doesn’t begin until week 11 or 12 of a pregnancy, preconception care as an intervention is gaining attention as a way of continuing to improve maternal and infant outcomes.

Preconception care attempts to identify and modify medical, behavioral and social factors that put a woman’s health and the health of her future pregnancies at risk for negative outcomes.

According to the American College of Obstetricians and Gynecologists (ACOG), preconception care screens for risks and provides health promotion, health education, and interventions to address identified risks to women in their reproductive years.

With preconception care, a woman has the opportunity to change and modify her behaviors or risk factors prior to becoming pregnant, thereby improving the chances for positive outcomes during the first weeks of pregnancy when the fetus is most susceptible to developing certain problems before many women even realize they are pregnant.

Preconception care can be of great benefit to women who are at risk for negative pregnancy outcomes resulting from infectious diseases.  For example, ensuring that women are vaccinated for rubella provides protection against the mother transmitting congenital rubella syndrome to her infant.

Providing hepatitis B vaccination prevents transmitting hepatitis B infection to infants and protects the woman from risks that may come with hepatitis B infection, such as liver cancer, liver failure, cirrhosis or death.

Preconception screening and treatment for sexually transmitted diseases (STDs) reduces the risk of having an ectopic pregnancy, infertility, or chronic pelvic pain from sexually transmitted chlamydia and gonorrhea.

Preconception screening and treatment also reduces fetal risk for death or physical or developmental disabilities such as mental retardation and blindness that can occur as a result of fetal exposure to STDs.

Additionally, preconception screening for HIV/AIDS provides an opportunity for prompt treatment and information so that women or couples can make early decisions about pregnancy timing.  These interventions have a record showing evidence-based effectiveness in improving pregnancy outcomes.

What does this mean for you?  If you are a woman in your reproductive years, talk to your doctor about your reproductive life plan.  Your doctor can work with you to evaluate your health risks and provide recommendations and information so that you can make choices to positively affect your health and future pregnancies for years to come!

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