Common Questions About Having a Baby
If you're pregnant—or just thinking about it—learn about staying healthy during pregnancy, prenatal testing, C-section births and more.
Handling Medical Conditions During Pregnancy
Never stop taking prescribed medications without first talking to your doctor. If you have a health problem, talk to your doctor before even trying to get pregnant. Many women with chronic health problems can have healthy babies, but they need proper support and guidance. When you do become pregnant, talk to your doctor about seeing a high-risk pregnancy expert as well.
If you have diabetes, you should be closely monitored early in your pregnancy to control blood sugar levels. If your blood sugar is too high, the sugar reaching the fetus can result in an overly large baby. This can cause problems while giving birth, as well as congenital defects or blood sugar issues in your baby.
You can also get diabetes during pregnancy, a health problem known as gestational diabetes. If that happens, you can control your blood sugar levels with proper food, medication and exercise. In most cases, gestational diabetes goes away after the baby's birth.
Healthy Living While Pregnant
The health of your baby depends on how well you take care of your own health, even before you become pregnant. Here are some of the things your obstetrician should do:
- Take your family and personal medical history to find any risk factors.
- Give you a physical exam to find any health issues that could complicate your pregnancy.
- Order certain lab tests to find out if you have any medical or infectious disease conditions that may need further care.
- Teach you how to take better care of yourself. Eating the right foods, quitting smoking and giving up alcohol will improve your chances of having a healthy baby.
About 1,500 to 2,000 pregnancies in the U.S. are affected each year by birth defects of the spine (spina bifida) and brain (anencephaly). These conditions can lead to serious disabilities, such as paralysis in the feet and legs, incontinence, learning disabilities, intellectual disabilities or partial to no development of a brain.
A significant number these types of birth defects can be prevented if women take 400 micrograms (0.4 mg) of folic acid daily, before and during the early months of pregnancy, according to the Centers for Disease Control and Prevention. Since half of all pregnancies in the U.S. are unplanned, many women don’t find out that they’re pregnant until well after the ideal time to prevent birth defects. As a result, women of childbearing age should make sure to get their daily folic acid requirements through food or multivitamins.
Grain products such as bread, rice, pasta and breakfast cereals are enriched with folic acid to meet standards set by the U.S. Food and Drug Administration. Dark green leafy vegetables, peas, beans, citrus fruits and most types of berries are rich in folic acid.
Most women can safely exercise during pregnancy, but talk to your doctor first to make sure it's all right for you. Stick to low-impact exercises such as swimming, stationary cycling, walking and light aerobics. Try not to do any activities that can lead to falls or injuries. Even mild injuries can hurt your fetus when you’re pregnant.
- Take your exercise outdoors only when the weather is cool, and try to keep your body from overheating. On hot days, it's often cooler in early morning or late evening.
- If you're exercising indoors, make sure the room is well ventilated.
- Use a fan to keep you cool.
- Drink plenty of fluids, even if you don’t feel thirsty.
- Eat a well-balanced diet. Even without exercise, you'll need to eat at least 300 calories more each day while you’re expecting.
Most vaccines are safe when you're pregnant. However, any woman who is pregnant or thinking about getting pregnant should talk with her doctor about vaccinations.
Many vaccines are made using "recombinant DNA" technology, which means they have no infectious materials. Other vaccines are made using "killed" viruses or proteins produced by a virus and are also noninfectious. These vaccines are considered safe during pregnancy.
All women who will be in their second or third trimester during flu season should get a flu shot, since pregnant women and their newborns have much higher rates of serious complications from the flu. You can't get the flu from a flu shot, despite the common myth.
Vaccines to prevent measles, German measles (rubella), mumps and varicella (chickenpox) should not be given while you are expecting. They're produced using live (but inactivated) viruses, and could make the fetus sick. Chickenpox is a more serious problem when you're pregnant, so doctors urge women to get vaccinated against chickenpox at least 3 months before they get pregnant. Your doctor can check your immunity with a blood test.
Pre-term and Cesarean Births
A pre-term birth (sometimes called a "premature" birth) is the birth of a baby earlier than 37 weeks. Pregnancy lasts about 40 weeks, which is called a "term."
As a rule, there are 3 types of pre-term births:
- Spontaneous: This type shows few warning signs and is linked to certain risk factors, such as urinary tract or vaginal infections, stress and feeling very tired.
- Early amniotic fluid break: This is most often linked to an infection in the womb that has weakened the membrane sac that surrounds the baby.
- Medically indicated delivery: Certain health problems affecting the mother or fetus may call for an early delivery to prevent any complications.
The rate of C-section deliveries at Cedars-Sinai is 22%. C-section rates differ based on many factors, including the hospital, its doctors and individual patients. Many conditions affect whether a child will be delivered by C-section, such as the mother's height, weight and health issues, as well as the baby's birth weight.
If you're planning a C-section birth for health reasons, you can take the Cesarean Birth class at Cedars-Sinai.
Not all women can have a vaginal birth after C-section (VBAC), so talk with your doctor.
Among women who choose VBAC, 60-80% will not having any problems. Those who have problems may have an greater risk of infection, uterine rupture or other complications. Rupture of the uterus can be dangerous and even deadly. These types of complications are rare though.
To learn more, take the VBAC 101: Vaginal Birth After Cesarean class at Cedars-Sinai.
Prenatal Genetic Testing
Consider the testing if you fall into any of these categories:
- You'll be 35 or older at your due date.
- You have a child or close family member with a genetic problem, such as Down syndrome.
- You have a family history of open defects of the spine (such as spina bifida) or other birth defects or inherited diseases.
- You've had two or more miscarriages or difficulty getting pregnant.
- Both you and your partner are carriers for an inherited disease, such as Tay-Sachs, sickle cell anemia or cystic fibrosis.
- You have male family members with disorders such as muscular dystrophy or hemophilia.
- You and your partner are blood relatives.
- You've been exposed to drugs, X-rays or other agents that may be harmful to the baby.
Certain tests performed during pregnancy can show how the fetus is doing. You may want to have this type of testing if:
- Your pregnancy has gone beyond the due date.
- Your baby is showing poor growth in the womb.
- You're giving birth to more than one baby (twins, triplets).
- You have a chronic health problem, such as insulin-regulated diabetes or high blood pressure.
Genetic counseling helps pregnant couples learn what a genetic disease is and what it might mean for their baby. If you're having prenatal testing, you'll be given genetic counseling first.
Counseling starts with a family genetic history. Once the counselor assesses the risk of genetic disorders, he or she will talk with you about the risks, benefits and limits of prenatal testing.
- Amniocentesis removes and tests a small amount of fluid surrounding the fetus. It’s most often done between 16 and 20 weeks of pregnancy. An early amniocentesis can be done between 13 and 14 weeks of pregnancy.
- Chorionic villi sampling (CVS) tests tissue from the placenta to find genetic defects in early pregnancy. This test can be used to spot almost all disorders that can be found by amniocentesis, except for neural tube defects such as spina bifida. This test is often done between 10 and 12 weeks of pregnancy.
- Ultrasound uses sound waves to make a picture of the fetus. This test helps to check the age, growth, anatomy and health of the fetus, identify the causes of bleeding during pregnancy, check the position of the fetus and find out if there is more than one fetus.
- Expanded alpha-fetoprotein (AFP) genetic testing uses a protein made by the liver to find birth defects such as Down syndrome, trisomy 18 (a defect that causes severe deformity and intellectual disabilities) and open neural tube defects such as spina bifida
About 3% of all live births have a birth defect. Most can be found beforehand with the right prenatal testing.
About 50% of newborns with birth defects have a chromosomal defect that can be found by CVS or amniocentesis. Tests known as BUN screening and Expanded MSAFP screening can also help find chromosomal abnormalities.
The other 50% of newborns with birth defects may or may not have a structural abnormality that can be found by ultrasound. Doctors believe that ultrasound can find about 60% of these issues.
Other Considerations for Parents of Ashkenazi Jewish Descent
A number of recessive diseases happen more often, though not exclusively, in people from Ashkenazi Jewish families. These include Tay-Sachs and Canavan diseases. Both of these diseases can be found with a simple blood test.
Tay-Sachs is a disease in which the body can't produce a certain enzyme, causing the condition of the nerves to worsen over time. Symptoms first appear at 6 months, followed by death at 5 to 8 years of age.
Canavan disease also stems when the body can't make a certain enzyme, which causes the nerves to deteriorate over time. Signs of the disease include slow growth, poor muscle control and a large head. Children with Canavan disease appear normal at birth, but die by the time they are in their teens.
People from different ethnic groups have different risks for being carriers of diseases, especially cystic fibrosis. Those of Northern European descent and Ashkenazi Jewish descent have a 4% chance of being carriers. If both parents are carriers, then the risk of having a child with the disease is 25%.
People from other ethnic groups can also be carriers of cystic fibrosis, but often at lower rates.