Posts Tagged ‘pregnant women’

Pregnancy and the Holidays

Once Halloween passes, you’ll see all of the Thanksgiving and Christmas decorations out in the department stores. This time of year is my absolute favorite, and last year I loved it even more! November and December are the “feast months,” full of parties, potlucks and big family dinners that will make you appreciate the fact that you can indulge a little bit. While “eating for two” is somewhat of a myth, it’s okay to splurge a little bit around the holidays. My OB noticed my extra weight gain in January last year, but I didn’t get in trouble! I’m sure the doctors and midwives know that their expecting patients will be enjoying a little extra of the holiday fare.

While you are enjoying all the extra food associated with the Holidays, keep a few things in mind:

1. Be careful about eating food that has been left out. It is common for holiday food to be served “buffet style” and sometimes it is left out a little too long. Enjoy hot and cold foods when they are first put out, but stick to the cookies and the pretzels after the first hour, once the hot foods have cooled and the cold foods have come up to room temperature.

2. Balance your sweets with healthy foods. Try to avoid packing in too much sugar, since it is hard for your baby to metabolize all that glucose. If you’re starving, have an extra serving of fruit salad or turkey. If you have gestational diabetes, stick to your diet!

3. Double check the punch and the eggnog. Make sure it’s non-alcoholic. I would certainly hope your host would warn you, but you never know if Uncle Bob spiked the bowl.

4. Skip the meat and cheese platter. Deli meats and certain cheeses are especially at risk for carrying the bacteria that causes listeria, which is very dangerous for pregnant women and their babies. If you’re dying for hard salami, heat it up to a safe temperature first.

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You Will Read News: Beware the BUMP in your relationship – why …

As statistics suggest that one man in ten is unfaithful when his partner is pregnant, it seems that Vincent Simone’s pre-baby fling earlier this year wasn’t such an isolated case, as Anna Moore discovers

Vincent Simone and Kristina Rihanoff

Vincent Simone and Kristina Rihanoff in rehearsal for the Strictly tour last December. They started seeing each other soon after Vincent’s partner Susan Duddy announced she was pregnant

The safe arrival of baby Lucas in August has surely been a bittersweet affair for Susan Duddy, the air hostess and former partner of Strictly Come Dancing star Vincent Simone. When Susan became pregnant last December, she’d been with Vincent less than a year, but she was living in his Guildford home and the couple had discussed starting a family. But discussion is one thing – a real, live bump is quite another…

When Susan, 36, broke the news, the dancer, who has been dubbed the ‘Italian stallion’, showed a ‘mixed’ reaction. ‘He seemed confused,’ Susan later recalled. ‘One minute he was really excited, saying, “We’ll need to have another baby right after so there’s not a big age gap,” and the next moment he was freaking out about what it meant for his career.’

Still, the couple pressed ahead, put an offer on a larger house and started discussing names. Two weeks later, Vincent left for a Strictly tour – and promptly threw himself into an affair with fellow dancer Kristina Rihanoff (neglecting to tell her about Susan or the baby). He later confessed all to Susan, but flitted between the two women, blowing hot then cold, sometimes begging Susan’s forgiveness, before creeping off to meet Kristina.

Ten months on, Susan is living with her parents and newborn son. However, she and Vincent have not ruled out reconciliation – and are sufficiently united to pose for Hello! ‘Susan and I are bonding more now,’ said Vincent.

‘I’m going to be the best dad ever.’ The pregnancy, it seems, simply frightened the life out of Vincent, and he describes the experience as a mini-breakdown. ‘I was a mess,’ he explains. ‘When I look back at that time, I just see dark, a blur. I went off the rails. It wasn’t me.’ Even Kristina has backed this up, saying to the press, ‘I think Vincent was very confused and scared about becoming a father and panicked.’

In fact, the pre-baby fling may be more common than we suppose. While newly pregnant women are grappling with swirling hormones and a rapidly changing body shape, men have their own issues to fret over: responsibility, commitment and, realistically speaking, a lot less sex. An affair offers a refuge and, if need be, an exit.

Psychologist Robert Rodriguez, author of What’s Your Pregnant Man Thinking?, has worked with expectant couples for more than 20 years. His own surveys suggest that
ten per cent of men – the majority of them previously faithful – cheat on their partners during pregnancy.

A trawl through the internet would seem to back this up. On Mumsnet.com, the popular UK forum for mothers, a distraught user seeks advice after finding her husband strayed during her pregnancy. Elsewhere in cyberspace, a woman wonders why her husband stayed glued to her side through 16 years of fertility treatment, only to begin an affair when she became pregnant with twins.

In Sydney, there’s a woman whose husband of five years attributed his odd, erratic behaviour to his fears of impending fatherhood. In fact, he had also started a relationship with a colleague. ‘He was pretending to be unsure about being a dad, but really he was taking that time to romance and feather his nest before departing,’ the now single mother tells her online community.

Vincent Simone and Susan Duddy

Vincent with Susan Duddy. Though not together now, they haven’t ruled out giving their relationship another try

So what is happening? Surely there’s more to this than the fact that women may feel a little more tired and emotional and a little less attractive during the pregnant months? Even supermodel Heidi Klum found herself high and dry after becoming pregnant by F1’s Flavio Briatore. On the day that she announced she was expecting, he was papped kissing jewellery heiress Fiona Swarovski. But Heidi went on to meet singer Seal – while still pregnant – and she’s just had baby number four, a girl, to add to their brood.

Simon Jacobs, a psychotherapist who specialises in group counselling for men, certainly thinks that expectant fathers are affected. ‘Pregnancy – particularly when it’s your first – can be quite a lonely experience for men,’ he says. ‘There’s a lot of support for a woman – she slots into a community and has a high social status. There’s an excitement around her. People give her their seat on the train. She almost becomes public property. Her partner can soon start feeling like a spare part.’

At the same time, almost without exception, the man will be experiencing a whole range of emotions – from elation to pure panic. ‘There are fears around loss of control, loss of independence and feeling suddenly depended upon,’ says Jacobs. ‘The responsibility is a huge thing. A baby means a much bigger commitment than mere marriage.’

On top of this is a loss of identity. ‘Just as women often struggle with their place in the world as they enter motherhood, so do men,’ says Jacobs. ‘It sounds stereotypical, but, for many men, the ability to attract women is a huge issue, crucial to self-esteem. The image of a dad is less James Bond, and generally someone less dynamic. It’s the picture of cosy evenings in, reading bedtime stories to the children.’

‘Susan and I are bonding more now. I’m going to be the best dad ever’

Most damaging of all, however, is the fact that few men are likely to voice any of the above, and few pregnant women will want to hear it even if they do. ‘A pregnant woman wants to hear that her partner feels strong and solid and will be there for her all the way,’ says Jacobs. ‘In reality, I doubt that’s true for any man 100 per cent of the time. Men aren’t known to be great communicators, so what tends to happen is that their anxieties become internalised. And being isolated with difficult feelings can be a lethal combination.’

Reluctant to excuse the inexcusable, Jacobs does believe that a pre-baby fling can almost be a ‘cry for help. He may feel sidelined, neglected, frozen out by a preoccupied, pregnant partner. Some men do crave an awful lot of attention,’ he says. ‘The affair may be an indirect, inappropriate expression of all his suppressed fears; a way of saying what he’s unable to admit – to himself or anyone else.’

And it can also double up as an exit strategy. Alison, 44, had been with her husband Nick for four years when she became pregnant. It was only after the arrival of their daughter that she discovered he had begun an affair with a colleague four months into the pregnancy and ended it shortly before the birth.

‘Looking back, I can see that he had used various delaying tactics before agreeing to start a family,’ says Alison. ‘First he said we needed a bigger house, then he wanted to start a new business. Eventually, he couldn’t delay any more.’

Pregnancy was a challenge for Nick – a driven businessman who liked being in control and was used to being number one in Alison’s life. ‘He’d always said he wanted children, but when it actually happened I think he found himself way out of his comfort zone and panicked,’ says Alison.

‘As he saw it, an affair would offer an obvious escape route. It was fight or flight, and he chose to flee.’ When their daughter was a few months old, and they were still adjusting to life with a newborn, Nick reignited the affair and left. ‘He’d got it all set up and was out of the door before I had time to catch my breath,’ says Alison.

Mira Kirshenbaum, psychotherapist and author of When Good People Have Affairs, believes that, in some cases, pregnancy can act as the ultimate affair accelerator. ‘He may have been faithful up until this point, but he could still be harbouring doubts,’ she says.

‘A pregnancy will instantly magnify any pre-existing issues. The walls of domesticity close in and a man may feel he’s in too deep. A pre-baby fling can be a means of exit – but one that’s messy, stressful and terrifically painful.’

The mess and pain can have terrible consequences. Tests on pregnant women have found that, during stressful times, the foetal heart rate goes up. Immense stress during pregnancy has been linked to slower growth and smaller babies, as well as an increased risk of preterm delivery. While Susan Duddy struggled to save her relationship with Vincent Simone, she was rushed to hospital suffering severe stomach pains and a threatened miscarriage.

Can any relationship survive such a betrayal? Do Susan and Vincent stand any hope of raising Lucas as one happy family? Relate counsellor Mo Kurimbokus says yes – though probably only with professional help.

‘If you have two people committed to that relationship, no matter how difficult the situation, of course you can make it through,’ he says. ‘But first you would need real, true communication, to talk to one another and listen, and really understand the feelings and emotions that have been hidden.’

Simon Jacobs, however, is less optimistic. ‘I suspect it breaks most relationships,’ he says. ‘It has to be the worst possible time to cheat. A woman is so vulnerable – physically and emotionally. You’re laying the foundations for the future and if a man is willing to risk everything at a time like that, you have to ask whether he’s capable of maintaining all the responsibility that comes with a family. I think it’s doubtful.’

If cyberspace is any indicator, it seems that, for most women, a pre-baby fling blows away any chance of a happy ending. It’s just a betrayal too far.

The single mother in Sydney says she’s ‘doing OK’ with her three-month-old baby – and advises women to record their partners’ conversations…

On Mumsnet.com, a woman whose husband initiated a pre-baby fling with an ex when she was just three months pregnant knew immediately that forgiveness was off the agenda. There was no need for a scene, no point in discussion. She kept her discovery secret and chose her moment. ‘I waited three months and asked him very calmly to leave on 1 April,’ she writes. ‘I had the last laugh.’

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Are You In Line for the H1N1 Vaccine?

I’ll be the first one to admit I was initially skeptical of the severity of the H1N1 virus when it first hit the media this past summer. When the controversy over the vaccine surfaced, I leaned towards not getting it, but now that we know a lot more about the virus and the effects it has had on our country, I am much more likely to get the vaccine if I can even get on the list. Because I am over 25 and my son is older than 6 months, I just missed the requirements for being in the high priority group – the first people to get access to the vaccine – but my son is on the waiting list for when the vaccine is available in my area.

Talking to my son’s pediatrician addressed many of the concerns I had about the vaccine. I wrote about this on the baby blog a few weeks ago. You can read about what he said here: Flu Shots for Babies. I was worried about him getting sick from the vaccine, for example, but apparently that is a myth about flu shots.

Tonight I saw a very sad story on the news about a woman who died shortly after she gave birth to a baby girl through emergency cesarean section. She had gotten sick with H1N1. Fortunately the baby girl lived, but her grandparents are heartbroken that she’ll never know her mother. Pregnancy compromises the immune system, making it even harder for pregnant woman to battle the flu. Pregnant woman will be some of the first to be able to get the H1N1 vaccine and doctors are strongly recommending that all pregnant women get the vaccine to protect themselves. The secondary benefit of getting the vaccine while pregnant is that you will pass on the immunity to your child.

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The subtitle of The Girlfriends’ Guide to Pregnancy

The subtitle of The Girlfriends’ Guide to Pregnancy, by Vicki Iovine is “Or Everything Your Doctor Won’t Tell You.” That’s exactly why I liked it so much!

When I put out the call for pregnancy book recommendations, you ladies came through in a BIG WAY with this book. Just as the title promises, the book is full of straight talk and advice on every aspect of this pregnancy thing. Iovine rarely sugar coats, though she is very much like a supportive and encouraging friend. She’s also not going to blow sunshine up anyone’s ass. Does labor hurt? HELL YES! Is it hard to take off the weight? Sorta, but it does come off! Is your male other half freaked out? Yep, probably.

Iovine herself has four children (mostly grown now), and shies away from nothing in this book. Not only is it honest, it’s hilarious. One section titled “Multiple Personality Disorder” which relates to pregnancy and sex really appealed to me, and I insisted on reading it aloud to Chuck through my giggles:

The thing that amazed my Girlfriends and me about the emotional life of pregnant women, particularly where sex was concerned, was the intensity of all the emotions you feel and the rapidity with which they change. You may spend the entire day fantasizing about wild animal sex with your partner, to the point where you chew off all your fingernails waiting for him to meet you at home. Then, when he finally arrives and starts going through the mail instead of studying the ultrasound photos that you just got, without him, at your morning appointment and have loving placed on the front door, you start screaming that this is one more undeniable sign that he is indifferent to you and the baby. By the time he has calmed you down and you go whimpering into the bathroom to refresh yourself and consider whether you’re still horny, you’ve fallen asleep in the tub and he’s pulling you out before you drown.

Hilarious, not just in regards to sex, but the emotional roller coaster in general. Chuck and I woke up earlyish for a Saturday in order to go look at a potential rental property with more bedrooms than we have now. I was smiley and nice to him this morning, and I assured him that I really was in a good mood. “For how long?” he laughed. “At least 20 minutes,” I replied.

That pretty much says it!

While the more medical of the pregnancy books are great–especially those like The Joy of Pregnancy that have a good deal of technical info and are broken down into the baby’s developmental stages–it’s necessary to have a good mix of soothing and straightforward. This book reminded me a great deal of talking to my mom (complete with her smartass sense of humor) about pregnancy if my mom could remember any of it. Apparently she was never morning sick, never overly tired, and got to skip out on some of the other unpleasantries of pregnancy. Or she’s lying. Or she’s blocked it all out in the last 28 (almost 29!) years.

Iovine’s life is a little unrealistic to most of us. She lives in California, has a good many model and actress friends, and a maid, but on the whole I didn’t find her too pretentious. She keeps the richer-than-thou talk to a minimum, but I do wish I had that cleaning lady and no need to work sometimes. Dream a little dream! *plays the world’s tiniest violin*

If you’re expecting or expect you might be expecting soon, read it! If you just want to giggle with the rest of us, read it for that, too.

Pregnancy Update:

  • Still nauseous (all the time).
  • Still sleepy (all the time).
  • Still cranky, I mean happy, I mean cranky, I mean tearful. You get the picture.
  • Still REALLY excited!
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What Is A Pregnancy Pillow? Do You Need It?

The Pregnancy pillow, also sometimes called the back and belly or body pillow is something that many pregnant women may be considering.

A pregnancy pillow is a rather like an extra, extra long bolster pillow that can fit your body contours, so that it fits the way that you like in order that you may get maximum support for your changing shape.

Pregnancy Pillow

Why during Pregnancy?

When pregnant, a woman’s body changes very much and very rapidly. The growing belly means that much weight is suddenly concentrated in the front of the body where earlier there was none.

Balance becomes a problem. Backache becomes a problem because of having to carry the unaccustomed weight and due to the fact that the woman’s center of gravity shifts.

Many pregnant women have trouble getting sleep during the night as well. Various other aches and pains manifest themselves during a pregnancy, either from hormonal changes or otherwise: legs can ache from carrying around the extra weight, swollen ankles could be a problem due to water retention.

How can it help?

A pregnancy pillow can help tide over or at least ease some of these discomforts. It is something that can give support to your growing belly; and also gives support to ease low back pain. If a woman suffers from swollen ankles during pregnancy, she is usually advised to rest with her feet slightly elevated.

A pregnancy pillow can help with doing this as well; it can help you sleep comfortably even with your feet elevated. Many women find that a pregnancy pillow that gives support to the back and the belly at the same time makes for restful sleep.

It can also be used in other parts of the house for instance if you want to curl up with a good movie or book on the living room couch, it can help you recline comfortably there as well.

After the baby arrives some find use for the pillow as a nursing pillow as well; as a support for the baby while breast feeding. In the alternative the pillow can be given away to a friend or a relative who can then use it for Fibromyalgia, arthritis, osteoporosis pain or back, neck and shoulder pain.

So the pregnancy pillow can have its uses even after you are done with your pregnancy. Amazon stocks pregnancy pillows for under $50 if you want to know where you may get one.

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Home Birth With Registered Midwife Safe As Hospital Birth

pregnancy laborAccording to recent Canadian study, giving birth at home in supervision of registered midwife can be as safe as hospital birth for both infant and mom.

In fact, planned home births with registered midwives may have lower rate of pregnancy complications, reports a study in Canadian Medical Association Journal.

Midwives provide round the clock care for women during pregnancy, child birth and postpartum in birthing centers and also at homes of pregnant women.

Dr. Patricia Janssen from the University of British Columbia and her team, says that women planning birth at home experienced reduced risk for all obstetric interventions  like postpartum hemorrhage or vaginal tearing. Even the babies were also less likely to need oxygen therapy or resuscitation.

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Female Fitness and Nutrition Scientist: Pregnancy and Weight Lifting

Pregnancy: It seems to me that society treats this as such a delicate time. But, really, does it have to be like that?

What I’m referring to mostly is weight lifting exercise, and what pregnant women can and can not do to help them have a healthier and happier pregnancy and delivery.

When I did a Google image search for pregnancy and exercise (or weight lifting), all I saw were pictures of very pregnant women doing yoga or ball exercises. The only weight lifting picture I could find was the one you see above. And, I wouldn’t even really consider that weight lifting (I think the last time I did a lateral shoulder raise I was 16 years old and a newbie). No squatting, no pushups, no chipups, nada.

But, what I really want to know, and what I need help from YOU (the female “you”, that is), is how and can a pregnant woman lift during her pregnancy?

Obviously, in the first 3-4 months, almost anything that you can tolerate should be do-able (when there’s not any nausea or uncontrollable fatigue). Then after the belly starts to bulge, any supine (lying on back) positions, should be avoided due to the potential to restrict blood flow through the vena cava.

The American College of Ob/Gyn has a one-sentence line about strength training:

Strength training will make your muscles stronger and may help prevent some of the aches and pains common in pregnancy. ”

But, other than this, it’s really a grey (or gray) area as far as weight lifting and pregnancy goes.

So, I’m doing as much research as I can here, scanning the peer-reviewed literature, and reading text books. But as I said, I need some help from real women who have lifted during their pregnancies:

What did you and could you do for weight lifting during your pregnancy?

Did you stop and just walk or doing light aerobics?

Did you keep doing what you were doing prior, but with some modifications (and what were they)?

Did you train harder? Did you try a new training program (And which one)? Etc.

I’d love to hear what you ladies out there did. One of my readers told me she was doing pull-ups the day before she delivered (wicked!) and another said she road her bike 10 miles a few days prior to delivery (and she was 2 weeks late, so she was quite big at this pt).

You can post your reply here, or send me an email (cassandraforsythe@gmail.com).

I promise that your thoughts and comments will be kept private if that’s what you’d like. Also, this information might end up as an article in the next issue of Muscle and Fitness Hers and Fit Pregnancy.

Cheers to a healthy and strong pregnancy!

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Fake Pregnancy Centres Create Fake Orphans

We admit it. Here at DAMMIT JANET! and back at Birth Pangs, we’ve been a tad obsessed with Crisis Pregnancy Centers/Centres.

We — OK, who am I trying to kid? it’s mostly moi — blog regularly about the lying and deception and manipulation these Christofascists perpetrate on vulnerable women. (And of course, just to blow our own horn a little, we did have a helluva good time helping persuade the Ottawa Senators to pull financial support from one of the lying-liar outfits.)

But it seems there is a whole other ugly side to these fakers, even though I did blog once about a crisis pregnancy centre in Ireland that was convicted of running an illegal adoption agency.

So, I should not have been surprised to read today that ‘Christian Organizations Shame and Coerce Women Into Giving Up Their Children’. It’s a longish article by Kathryn Joyce, author of ‘Quiverfull: Inside the Christian Patriarchy Movement’.

Using good old shame and guilt, they pressure single pregnant women into giving up their children to ‘good’ Christian families. And with their usual disregard for truthiness, they lie to women about the terms of ‘open’ adoption. Women think they’ll be able to see their children only to find out, oopsie, no, you can’t honey.

Pregnant women are housed with ’shepherding’ families, isolated from friends and family who may offer other advice.

After delivery, women are rushed into surrenders. Taken to states with shorter ‘change one’s mind’ periods. Paperwork is delayed until the ‘change one’s mind’ period is just about up.

And such shenanigans go back a ways:

In 1984 Leslee Unruh, founder of Abstinence Clearinghouse, established a CPC in South Dakota called the Alpha Center. The first center had opened in 1967, but in 1984 Unruh’s CPC was still a relatively new idea. In 1987 the state attorney’s office investigated complaints that Unruh had offered young women money to carry their pregnancies to term and then relinquish their babies for adoption.

“There were so many allegations about improper adoptions being made and how teenage girls were being pressured to give up their children,” then-state attorney Tim Wilka told the Argus Leader, that the governor asked him to take the case. The Alpha Center pleaded no contest to five counts of unlicensed adoption and foster care practices; nineteen other charges were dropped, including four felonies. But where Unruh left off, many CPCs and antiabortion groups have taken up in her place.

(Read more about Leslee Unruh in an article by Amanda Robb, niece of murdered abortion provider Dr Bernard Slepian.)

In a sadly ironic twist, the crap works best on religious, anti-choice women.

Religious women may be particularly susceptible to CPC coercion, argues Mari Gallion, a 39-year-old Alaska mother who founded the support group SinglePregnancy.com after a CPC unsuccessfully pressured her to relinquish her child ten years ago. Gallion, who has worked with nearly 3,000 women with unplanned pregnancies, calls CPCs “adoption rings” with a multistep agenda: evangelizing; discovering and exploiting women’s insecurities about age, finances or parenting; then hard-selling adoption, portraying parenting as a selfish, immature choice. “The women who are easier to coerce in these situations are those who subscribe to conservative Christian views,” says Gallion. “They’ll come in and be told that, You’ve done wrong, but God will forgive you if you do the right thing.”

Mirah Riben, vice president of communications for the birth mother group Origins-USA [which calls itself 'The voice of mothers who lost children to adoption'], as well as author of The Stork Market: America’s Multi-Billion Dollar Unregulated Adoption Industry, says that many mothers struggle for decades with the fallout of “a brainwashing process” that persuades them to choose adoption and often deny for years–or until their adoptions become closed–that they were pressured into it. “I see a lot of justification among the young mothers. If their adoption is remaining open, they need to be compliant, good birth mothers and toe the line. They can’t afford to be angry or bitter, because if they are, the door will close and they won’t see the kid.”

. . . .

There were nineteen lawsuits against CPCs between 1983 and 1996, but coercive practices persist. Joe Soll, a psychotherapist and adoption reform activist, says that CPCs “funnel people to adoption agencies who put them in maternity homes,” where ambivalent mothers are subjected to moralistic and financial pressure: warned that if they don’t give up their babies, they’ll have to pay for their spot at the home, and given conflicted legal counsel from agency-retained lawyers. Watchdog group Crisis Pregnancy Center Watch described an Indiana woman misled into delaying an abortion past her state’s legal window and subsequently pressured into adoption.

As they say, go read the whole thing, though if you want to check out the other links, you’ll have to do it from here since I put them in.

BONUS: The first commenter, Amy Adoptee, has a blog. Go read, especially this one.

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Glucose Test In Pregnancy Could Predict Heart Disease

gestational diabetesA new study in Canadian Medical Journal reveals that glucose challenge test for pregnancy diabetes may also show future risk of heart disease in pregnant women.

It is  particularly important because it can help doctors to start using current screening procedures to identify gestational diabetes in pregnant women who are at risk of developing cardiovascular diseases in future.

Researchers say that heart disease is number one killer of women, while women with gestational diabetes have higher risk of developing heart diseases when compared to those who doesn’t have.

“Women who had an abnormal glucose challenge test but then did not have gestational diabetes had an increased risk of future cardiovascular disease compared to the general population, but a lower risk than women who actually did have gestational diabetes,” co-author Dr. Baiju Shah, of the Institute for Clinical and Evaluative Sciences in Toronto, said in a news release.

Source: HealthDay

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Pharma Knowledge Base: Are Antidepressants Safe During Pregnancy?

Women who take antidepressants face a difficult choice when they become pregnant, and for many the risks vs. benefits of continuing treatment are not clear, a joint report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists finds.

The report confirms that there are far more questions than answers about the dangers antidepressants pose to the babies born to women who take them.

It also presents guidelines to help doctors and patients identify who should and should not consider stopping drug treatment.

Pregnant women who experience psychotic episodes, have bipolar disorder, or who are suicidal or have a history of suicide attempts should not be taken off antidepressants, the report concludes.

“We know that untreated depression poses real risks to babies. That is not conjecture,” Yale University School of Medicine ob-gyn Charles Lockwood, MD, tells WebMD. “We know much less about the risks associated with antidepressant use. It is clear that more study is needed.”
According to one study, the rate of antidepressant use during pregnancy more than doubled between 1999 and 2003. The study found that in 2003, one in eight women took an antidepressant at some point during her pregnancy.

Greater use of selective serotonin reuptake inhibitor (SSRI) antidepressants like Prozac, Paxil, and Zoloft were largely responsible for the increase.

These drugs were generally considered safe for pregnant women at the time, but safety concerns soon emerged, especially regarding Paxil.

Separate studies from Sweden and the U.S. suggested an increased risk for congenital heart defects in babies born to women who took Paxil during pregnancy.

The reports led the FDA to issue an advisory in December 2005 warning about the potential risk based on early results of two studies.

But the joint panel found the evidence linking Paxil use during pregnancy to heart problems in newborns to be inconclusive.

Lockwood tells WebMD that if the risk is real, it is probably not limited to Paxil alone.
“It is very likely to be a class effect and not just this one drug,” he says.
Miscarriage, Low Birth Weight, and Preterm Birth

SSRI use during pregnancy has also been linked in some studies to an increased risk for miscarriage, low birth weight, and preterm delivery.

But once again, the report found no definitive link between the use of the antidepressants and these pregnancy outcomes.

“Antidepressant use in pregnancy is well studied, but available research has not yet adequately controlled for other factors that may influence birth outcomes including maternal illness or behaviors that can adversely affect pregnancy,” the joint panel writes.

The report was published in both the American Psychiatric Association journal General Hospital Psychiatry and the American College of Obstetricians and Gynecology journal Obstetrics and Gynecology.

The joint panel concludes that a gradual reducing of antidepressant dosages and stopping antidepressants altogether may be appropriate for women who hope to become pregnant if they have had mild or no symptoms for six months or longer.

The group also recommended that:

Women who are already pregnant should not attempt antidepressant withdrawal if they have severe depression.

Psychiatrically stable women who want to stay on antidepressants during pregnancy should consult with their psychiatrist and ob-gyn about the potential risks and benefits.

Women with recurrent depression or those who have symptoms despite drug treatment may benefit from psychotherapy when available.

Psychiatrist Ariela Frieder, MD, who specializes in treating pregnant women with depression at Montefiore Medical Center in New York City, tells WebMD that her patients tend to be very concerned about how antidepressants will affect their baby and much less aware of the dangers posed by untreated depression.

Frieder was a practicing ob-gyn in her native Argentina before moving to New York where she did her residency in psychiatry.

“Many women want to stop treatment abruptly and even stop on their own, but this can be very risky,” she says.

Jennifer Wu, MD, an ob-gyn who practices at New York’s Lenox Hill Hospital, agrees.

“The old conventional wisdom was that pregnancy was a honeymoon period for depression and that patients would be able to come off their medications and be OK,” she tells WebMD. “But we have learned that this is not true. It has become more and more apparent that pregnancy is a vulnerable time for patients with a history of depression.”

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