Pregnancy and Birth Questions and Answers

Question: I am currently 35 weeks pregnant. At my doctors visit yesterday my doctor says that I am measuring only 30 cm and that I have to go for an ultrasound next week to rule out any problems. What sort of "problems" could I be facing. I am 32 and this is my 3rd pregnancy... I have a 2 year old and I miscarried last year.

Answer: Your baby is at an amazing stage when he is 12 weeks "old". He weights about 1 oz and is 2 1/2 to 3" long, big enough to snuggle into the palm of your hand. His heart has been beating since 18-25 days old and brain waves have been recorded at 40 days. He squints, swallows, and can make a fist. He is sensitive to heat, touch, light and noise. He sucks his thumb. All of your amazing baby's body systems are working when he reaches 12 weeks.

Answer: The more we learn about the importance of nutrition in pregnancy, the more we realize how vital good nutrition is. Food is the building blocks of your baby, literally, and though your baby may seem to grow well despite a lack of good nutrition, the consequences can be devastating. Not enough protein, a common concern in our modern high-carbohydrate, high-fat eating habits can lead to Pregnancy Induced Hypertension, Pre-eclampsia, Eclampsia (toxemia) and even HELLP - a life-threatening condition where the mother's liver is shutting down. High sugar content often leads to Gestational Diabetes which is detrimental to both mother and baby's health. For more information on good nutrtion, visit www.blueribbonbaby.org.

A birth plan is not a way to "plan" your birth, but rather an excellent communication tool. It facilitates an open and honest relationship between a woman and her caregiver during pregnancy and between a woman and her nurses during labour. In putting together a birth plan, a woman can make informed choice about what she wants during her labour and birth. She then brings those wishes to her caregiver to discuss those choices and help her find out what her caregiver recommends, what other options are available, and ultimately how supportive her caregiver is about her choices. When the points on a birth plan have all been discussed and agreed upon, the birth plan forms a guideline for nurses to follow in terms of what decisions have been made prenatally between the woman and her caregiver, facilitating the support nurses can give to her. Birth plans do need to be flexible and address the various outcomes that may unfold as birth is unpredictable. We suggest summarizing the final birth plan into one page with each point separate to make it easy to read and follow, insuring the important concerns are not missed.

Question: I know doulas and midwives have different qualification and educations. But I was wondering in terms of support for an expecting mother, what's the overall difference between a doula and a midwife? Is there a benefit to have one over the other?

Answer: Their care is actually complimentary. In a nutshell, a midwife is primary caregiver trained to provide all encompassing care for you and your baby during pregnancy and birth and the recovery period following birth of about 6 weeks to 2 months. Their role would parallel a medical doctor but with more training, knowledge and expertise in normal birth. An obstetrician is then one step above in that they specialize in high risk pregnancies, but may not necessarily have the same knowledge a midwife has of normal birth.

A doula on the other hand is a trained professional who provides physical, emotional and informational support during pregnancy birth and the immediate postpartum. A doula does not provide clinical support i.e. mother and fetal health checks like blood pressure, fetal heart rate and vaginal exams. This non-clinical support of women in labour has been shown through studies to have:

*	50% reduction in the cesarean rate
*	25% shorter labor
*	60% reduction in epidural requests
*	40% reduction in oxytocin use
*	30% reduction in analgesia use
*	40% reduction in forceps delivery

I would encourage you to have both. A midwife is often able to support similarly to a doula during labour. However if there is any complications and especially during the actual birth, your midwife is often not able to provide both the emotional and physical support while she is also getting ready for and delivering your baby. This is where a doula can really be of benefit to you, and the shared care of the additional support will provide you with a wonderful team to help you and your partner through this amazing experience.

Question: It's my first pregnancy and I'm in my 9th week. My breasts are large and I am afraid that after I have my baby they will still be too big. Is there any way to make them in the same size? Do I wear a smaller bra all day to keep it in the same size or it will hurt me?

Answer: It is perfectly normal for your breasts to become larger and sensitive during pregnancy. The sensitivity will disappear by your second trimester and they will no longer be uncomfortable. Most women find their breasts enlarge about one bra size and this is due to your body preparing to provide all the nutrition your baby needs in the first months after your birth through breast milk. Your breasts will return to their normal size after your baby after you stop breastfeeding your baby.

I would discourage wearing a bra that is too small as it will not reduce your breast size and will be very uncomfortable. Find a comfortable bra that fits well and if you are planning on breastfeeding, purchase a nursing bra about one size bigger than your pre-pregnancy size. You can simply wear it during pregnancy as well as after baby is born.

Question: Please tell how we can get info about breast massaging before giving birth.. My wife is 2.5 months due and she has heard that there some ways to massage her breast so her breasts don't sag down. It is our 1st baby and she is 28.

Answer: There is little that can be done for the breasts themselves in terms of massage to reduce sagging. It is through hormones that the breasts enlarge during pregnancy as they prepare for breastfeeding your newborn. Once your wife has finished breastfeeding her breasts will return to their previous size and shape, though it is usually takes a few months for the fat pad to return to it's previous size and shape. Gravity is the real concern here and regardless of her having children or not, it is this that causes sagging, not pregnancy or breastfeeding. What she can do is to strengthen the pectoral muscles under her breasts to reduced the sagging and massage can help in that aspect, but it is massaging the musculature underneath rather than the breasts themselves. During pregnancy this is not often something to consider because the expanding breast size causes pain and sensitivity during this expansion and it would not be comfortable at all for her. Instead, purchase good quality bras in about one size bigger than her non-pregnant size to provide good support during pregnancy and good quality nursing bras for her while she is breastfeeding. Support is important in working against gravity. If possible, have a professional fit her bras as up to 70% of women wear the wrong bra size (usually too small) which can increase the discomfort her breasts may be giving her during pregnancy. Anecdotally, my breasts returned to the same size and shape after my two children after breastfeeding each of them for a year. I hope that helps and congratulations on your first baby!

Question: My wife is 5 weeks pregnant and weeks after her last period she was doing some painting (with and alkali paint) and she cleaned up her supplies with gas after she was done (not knowing of course that she was pregnant). She had gas on her hands and did inhale some fumes, and is now concerned about any possibly repercussions that it may have on the baby. Do you have any information on this topic, or could you point us in the right direction?

Answer: Congratulations on your pregnancy! The first thing to look for is a Material Safety Data Sheet on the type of gasoline she was exposed to. This outlines the specific risks of that product. I was only able to find one on aviation fuel which is similar and will suffice for the basic risks to your wife and your baby. It is at http://www.cpchem.com/MSDS/fuels/performance/UNLEADEDAVIATIONGASOLINE.pdf. I also found a good FAQ on gasoline exposure and risks at http://www.cs.uu.nl/wais/html/na-dir/autos/gasoline-faq/.html and http://www.epa.gov/otaq/regs/fuels/ostp-4.pdf. In short, a single exposure during pregnancy of gasoline absorption is negligible in terms of its affect on your baby. However, if she has been doing this consistently over time, the accumulation of toxins in her system could possibly increase the risk - though it would take considerable exposure for there to be concerns and she would have shown other symptoms especially pertaining to liver and liver function caused by toxic systemic effects. To be honest, mainstream families ingest a fair amount of petrochemicals through our food (margarine, artificial whipped toppings, etc.), cosmetics (lip stick, most makeup) and other sources as well despite the risks. Given that this is an isolated incident, the risk is minimal and her diet in terms of eating a well balanced, protein rich diet is much more important to your baby both in reducing the risk of exposure as well as building a healthy baby and ensuring a healthy mom too.

Question: My husband and I recently found out, quite to our surprise, that we're expecting. (I say quite to our surprise because I had an IUD inserted a few months ago.) Last week, while I was about 5 weeks and 5 days along, I went to see my OB/Gyn to get the IUD removed. He discovered that the strings were missing and said that if we wanted the pregnancy then he shouldn't go in looking for the IUD to remove it.

If I go ahead with the removal despite the missing strings, what sort of likelihood is there that the pregnancy will survive the procedure? Are there risks to my future fertility I should know about?

Answer: Many, many women experience a pregnancy while using an IUD Melissa. The concerns with an IUD are primarily an ectopic pregnancy, what type of IUD you have and where the coil is. The first and last can be determined by an ultrasound, the second one you will know or can easily find out from your doctor. If your IUD was a Mirena (hormonal) then the risks increase because of the supressive hormones this device emits.

Unfortunately there are no reliable studies on the risk of miscarriage, though it has been reported as high as 50% with the IUD left in place. In my research, I have found that it certainly is possible to remove your IUD without the string attached and avoid a miscarriage. When you had your ultrasound to determine that your IUD was indeed still in place and if you have an ectopic pregnancy, did your doctor tell you where both the IUD and your baby's attachment was?

A doctor can consider using ultrasound or other instruments and techniques to guide removal. Sometimes patients or practitioners feel that attempting to remove an IUD is too dangerous or difficult, and the IUD may be left in place. This will depend on the placement of both the IUD and your baby's placenta as to the miscarriage risks involved. If the IUD is below your baby and with a skilled practictioner, the success rate will be high.

If the pregnancy continues without such complications and with the IUD in place, there is no evidence that the device will cause birth defects or other problems for the baby. A few reports do raise the possibility that preterm labor may be increased in these pregnancies, though the outcomes vary widely so the studies are inconclusive. There is no known risk to your future fertility if you do miscarry, the only risk would be if your uterus was perforated either by the IUD or during the process of removing it.

This is a very tough decision with no clear answers. I am sure you have done some great research and already know the above. I am sure the answers from the ultrasound will make your decision easier as you will have a better understanding of the risks involved. Please let me know what you decide and how it goes OK? I know of several women personally who have gone to term with healthy babies and an IUD sharing their uterus, so please don't think that the IUD will equate in problems for either you or your baby.

Question: I am 28 weeks pregnant and can feel a yeast infection coming on. What can I use instead of using the over the counter remedies?

Answer: I have designed a safe, effective 3-pronged protocol for yeast infections. First of all, you must eliminate sugar/carbs from your diet. Sugar feeds fungus and yeast is a fungus.

Secondly, take a probiotic supplement 3 times a day (the last dose before bedtime) to rebalance the ecology of your intestinal tract. Organic whole milk yogurt (rich in probiotics) can be inserted vaginally with an empty tampon dispenser.

Thirdly, the ripened black hull of the black walnut in liquid extract form is a safe, age-old remedy for yeast. It is usually found in health food stores in 1 ounce bottles. The dose is 1/2 teaspoon in 1/2 cup water twice a day, for about 3 months. The encapsulated leaf of black walnut, often found in health food stores, is not a good substitute. If you have difficulty locating it, you can find it on my website at www.andreacandee.com.

Answer: First and foremost, constipation must be avoided. A diet of fruits, vegetables, grains and lots of water will help this. A probiotic formula will also help bring balance to the intenstinal area.

A sage compress to the affected sites can help reduce the discomfort of varicose veins. Steep 2 tsp dried sage leaf (salvia officinalis) in a cup of boiled water for 20 minutes. Saturate a cotton cloth with the sage tea and compress the legs for 30 minutes, twice a day.

A good supplement to be taking to support weakened capillaries is rutin... it can be taken alone or in combination with other bioflavonoids.

Question: My question for you is one about fertility. I have a sister in law who is having problems conceiving a baby. She is doing some procedure (inner-uterine injections), next is in vitro fertilization. I was trying to find something that may help or enhance her chance to conceive.

Answer: Dr. Christopher's Female Reproductive Formula (formerly known as Fem-Mend) would be an excellent choice for improving her chances. The dosage is usually 3 capsules twice a day. You can reach them online at www.drchristopher.com. Of course, she should discuss the taking of this formula with her doctor.

Question: I have genital herpes and am 22 weeks pregnant. I have been having out breaks every month and a half compared to once or twice a year when I am not pregnant. I want to have a natural vaginal birth and want to know what my options are to prevent breakout close to delivery.

Answer: This is, indeed, a difficult issue. You really need to discuss with your OB what you can take while pregnant. Lysine is normally used for herpes outbreaks...ask if it's OK for you to use this amino acid while pregnant. Quantum Herb (800 348 0398) makes an Anti-Viral Formula containing St Johns Wort, Lomatium, Lemon Balm, Hyssop, Garlic, Thuja, Tea Tree, Echinacea, Olive leaf, Sweet Annie, Astragalus, Elderberry and Licorice...but, again, you need to check with your OB.

Also, you need to avoid chocolate, colas, coffee, stimulating herbs like ginger, cayenne. If you research the internet, I'm sure you will find other restrictions that will help not stimulate outbreaks. Of course, in your situation, hormones are high and stimulate outbreaks.

Question: I have been recently diagnosed with symphysis pubis. I am in agony am awaiting for an appointment to visit a physiotherapist. I am 24 weeks pregnant and can hardly walk sometimes. Will I have to go full term or will I be able to have a c section or be induced early as I don't think I could suffer another 4 months of this.

Answer: Pubis Symphysis Dysfunction (SPD) is a sometimes very painful condition in which the pubis symphysis joint separates. It is caused by the hormone relaxin loosening the supporting ligaments, causing a gap between the two bones. Relaxin is responsible for ensuring the flexibility of the pelvis during childbirth. Movement like twisting, walking and sitting with the legs apart can cause pain because of the bones rubbing against each other and/or strain on the supporting ligaments.

However, there is hope. Certainly do talk to your physiotherapist, she may have some excellent information and ideas to help you. A number of women find support through a tight support similar to a belt that wraps around your pelvis and holds the joint together. Almost all report a significant reduction in pain or complete alleviation of symptoms with this.

Herbs that support connective tissue: horsetail, gotu kola, chlorella/barley grass, royal jelly, marshmallow root, licorice root, hawthorn berry, leaf and flower, oatstraw. A good formula to restore healthy cartilage there would be aloe vera, wild yam root, panax ginseng, licorice root, dong quai root, damiana leaf, scullcap, sarsparilla root, burdock root, alfalfa, peony root, ginkgo biloba, dandelion root, uva ursi, and bayberry root. Nutrition does not help overnight, but it will certainly alleviate the condition as you continue to use herbs as support. Talk to your herbologist or naturopathy for more information.

Finally, you asked if you will have to go full term. For the health of your baby, I highly recommend you allow your baby to mature fully during your pregnancy as preterm delivery can severely compromise his or her health. A study published in the journal Pediatrics on August 2, 2004 shows that even slightly early infants are at risk.

"Conventional wisdom has been that babies who were near-term, but still premature, would do as well as full-term babies. ... But those of us who take care of these children know from experience that they may have more jaundice or hypoglycemia than full-term infants do," said study author Dr. Marvin Wang of Mass. General Hospital for Children. Researchers at the Boston hospital compared 95 full-term babies born at 37 weeks gestation or later with 90 babies born at 35 or 36 weeks gestation.

Premature babies were significantly more likely to have health problems and 18 had multiple ailments, while none of the full-term babies had more than one problem. Among the conditions were jaundice, hypoglycemia (low blood sugar), respiratory distress, the need for intravenous feeding and difficulty maintaining body temperature. Premature babies often require different and more expensive treatment, and the cost of their initial hospital stays averaged $2,600 more than full-term infants. "There can be valid medical reasons for delivering early, but our study calls into question the presumption that elective delivery at 35 or 36 weeks poses no risk to the infant," Wang said.

Question: I am currently 7 months pregnant. I have always been a fitness freak and have taken good care of my body and love to exercise. Presently I am still working out almost everyday so I can hopefully return to my regular body without many problems. However, when I first got pregnant, I was underweight and during my first 3 months gained 13 pounds. At first I was worried, but then figured my body was just getting me up to my normal weight range. My butt and my hips have taken the biggest change expanding immensely. Before I was pregnant I had worked very hard to get my hips down to a nice size and now they are so wide. My question is - are my hips just adjusting to pregnancy or will they still be that big after th baby is born. I realize they will not just suddenly disappear, but I am just wondering if getting bigger hips is normal in pregnancy and how easy is it for them to go back to original size?

Answer: Congratulations on staying healthy with regular exercise, I wish more mothers would do the same. With your expanded hips and butt, what your body is doing is storing fat to ensure your baby will have a good milk supply after your birth. The butt and thighs are the most accessible place for fat storage your body has, so that is where the extra pounds are stored. It is interesting to see the shift of normal and overweight women's fat distribution during pregnancy to those specific spots for that very reason. Rest assured, the fat distribution will normalize after your baby's birth, especially if you breastfeed.

One thing to note while you exercise. The ligaments and muscles, especially in your pelvis, will become more relaxed towards the end of your pregnancy, most notably in the last four weeks. This is to ensure a marked flexibility in your pelvis for baby to move through your pelvis more easily. If possible, opt for low impact or less weight bearing exercises like swimming to keep your fitness levels up and at the same time reduce the possibility of injury or muscle strain caused by the relaxed supportive ligaments. This relaxation of the pelvic structure will increase the pelvic dimension and sometimes your pelvis will stay more relaxed after your baby's birth, regardless of how he or she is born (vaginally or by cesarean). However regular exercise after your baby's birth will minimize this concern because of the added support strong muscles will give to the pelvis.

Question: I just found out that we were pregnant this week. According to my doctor I am approximately 6 weeks along. Besides my breast being very sore I don't really have any other symptoms. Should I be "touching wood" that, that is all the symptoms I have and "count my lucky stars" that I am not feeling sick all the time and I don't seem to be anymore tired or is something wrong? Or is the best yet to come?

Answer: Congratulations, you are indeed experiencing what a lot of women dream of, a wonderful beginning to your pregnancy. It is not at all abnormal to have a pregnancy without morning sickness or anything beyond breast discomfort. My first two were just as wonderful. Your breasts will likely become more sensitive as your pregnancy progresses, and you may also reap the rewards of the added hormones in glowing skin, shiny hair and nails that grow strong and healthy. Enjoy!

Question: I don't really understand the whole "due date" thing. Why do they go back to the start of your last period to determine it? I have been charting my temperature and when intercourse took place because my cycle was really crazy. When I go for my first prenatal appointment and take my chart will they adjust my date? I just thought that week 1 would begin when the sperm fertilizes the egg? Can you tell from the blood test how far along you are?

Answer: You are right, it is a bit complicated. Your pregnancy actually starts when your ovary releases the egg, which is assumed to be the first day of your last period. Fertilization or conception (when you had intercourse) is then 14 days later and implantation (when the egg attaches to the wall of your uterus) is 7 days after that. The average full-term pregnancy is approximately 10 lunar months or 280 days. This is for a woman who has 28 day cycles, which is not that common actually. Women's cycles may vary from 21 to 35 days. To help you determine your due date from your conception date, check out http://www.parentsplace.com/pregnancy/calculator/. And certainly do discuss your charting with your doctor and have it adjusted accordingly.

Question: I just found out that I am around 6 weeks pregnant. However I had a D&C done about 2 months ago. Is it safe to be pregnant so soon after this procedure?

Answer: First, let's learn about what a D&C is. D&C is the acronym for dilatation (dil-ahtay´-shun) and curettage (koo-retahzh´). It is a minor surgical procedure in which the surgeon first dilates or opens the woman’s cervix and then inserts a thin, spoon shaped instrument. The instrument, called a curettage, is then used to gently scrape the lining of the uterus. Reasons for a D&C are:

Possible complications include surgical-wound infection, excessive bleeding and inadvertent injury to the uterus. Post surgical pain is treated with an oral medication with most pain disappearing within 24 hours. Antibiotics may also be given to prevent infection.

Now to answer your question, it is perfectly safe to be pregnant this soon after a D&C, congratulations! It is routinely advised to use protection and avoid pregnancy for a few months for your emotional state rather than your physical state (unless there were complications arising from your d&c, but the chance of your becoming pregnant quickly would also be low) and if you are healthy, there is no reason to worry at all. Take care of yourself by eating well, exercising and enjoying this pregnancy.

Question: If I am on birth control and I became pregnant is it still possible for me to be spotting during the time when my period should be here. I am still taking the birth control and I have had two months where my period was just spotting and that has never happened to me in my whole life.

Answer: That is very common Gwen, much more so than most women believe. Birth control pills, when taken over a longer period of time, often will reduce or even stop your period. Take a pregnancy test to ensure you are not pregnant and then discuss with your doctor the option of reducing the hormone levels you are currently taking, if you want your period to resume. If you are pregnant and spotting, it likely will stop in your first trimester, however some women continue to spot right through their pregnancies. During pregnancy, only be concerned if it is a gush of bright red blood with lots of cramping as this is the primary symptoms of an abrupted placenta (where the placenta detaches or partially detaches from the uterine wall) or a miscarriage.

Question: I am about 6 1/2 months pregnant and the last ultrasound that I had showed excess fluid in the fetus kidneys. Although the doctor did say not too worry and there is another ultra sound planned for 6 weeks from now. I am concerned. I was wondering what it means to have excess fluid, does it mean there will be damage to my child's kidneys or have complications once he is born? And if there is anything that I can do to prevent further damage to the babies kidneys. I have searched the web and found very little useful information so if you could shed any light on my situation I would be most grateful.

Answer: There is little useful information simply because rarely does an ultrasound diagnosis showing excess fluid around the kidneys result in a concern for your baby. There truly is nothing you can do beyond eating a healthy diet, drinking an adequate amount of water, and not stressing about your baby's health. I know it's tough, it can be very difficult when a test result shows a concern. Do know that ultrasound is a very imperfect diagnostic tool who's accuracy greatly depends on the technician and when in pregnancy the test was done (i.e. the closer to term the less accurate for estimating the size of your baby). Case in point, I have two cousins who were pregnant at the same time, both had at least three ultrasounds. One was told her son had downs syndrome and was strongly counseled to abort him (they chose not to). The other was told her daughter was perfectly healthy. The first cousin's son was perfectly healthy and the second cousin's daughter has downs syndrome.

Relax and enjoy the rest of your pregnancy Jessica, it won't be long before you meet your beautiful baby!

Question: Can people with different blood types have a child without blood transfusions?

Answer: Absolutely! The only concern is if the mother's blood is negative and the father's is positive AND for some reason the mother's blood has built antibodies against the positive blood type and no rh(d) immunoglobulin was given when it happened. I am the daughter of a type negative mother and a type positive father, as are my two sisters, and we were perfectly healthy at birth. For more information on this, check out http://www.childbirthsolutions.net/articles/preconception/rhesus/index.php.

Question: Help! This is my first baby and I am scheduled to have an "induced labour" 6 days past my due date and I'm really scared of going ahead with this. I've been told by friends "Don't do it", do not have an induction and I have read some horrifying things. I don't want to make the wrong decision. At the hospital they will be putting in the gel to soften my cervix on Mon evening and will check me out in the morning and add gel if necessary or will go ahead and break my water and start the IV drip of oxitocin. This is so un-natural. I am extremely worry about risks and side effects on my baby and myself.

The reason given to me by my doctor for the forced labour is that I'll be 41 wks and he doesn't want me to have any problems going over due. I understand and have read some on posterm-over due babies, this concerns me too. I never felt my due date to be accurate. Personally, my husband and I feel 40 wks should have been one week later. But they based my due date on my 1st ultrasound results. My baby just dropped the day after their estimated due date. I've had little to no noticeable contractions. I feel okay and the baby is active.

Induction is definitely a decision that should not be taken lightly and I am glad you are questioning and learning about induction benefits and risks. Yet it is a tough decision as to following your doctor's advice or in following your heart.

Answer: No one can predict your baby's due date except for your baby. It is only when your baby is ready to be born that labour will start because of the complex combination of hormones and hormone receptors which interact between your baby and your body without you even knowing.

It is standard practice for the last 10 years or so based on a questionable study that doctors routinely induce labour at 41 weeks. Prior to that, most women were allowed to go into labour naturally and 42 weeks was still deemed a term pregnancy. Doctors would not even do non-stress tests until after 42 weeks. This ruling is strongly being challenged currently in Canada (where the study was done) and will hopefully result in a reverse of the current rate of inductions which is significantly higher than it was previous to the study's publish date.

Even if your ultrasound was perfectly accurate, it in no way can tell if your baby is ready as some babies are "term" (meaning clinically gauged as a full term baby and ready for birth) at 38 weeks and some are not "term" until 42 weeks or longer. Doctors have long been taught that a term pregnancy falls between week 38 and 42 so in essence, even considering induction prior to a full 42 weeks could yield a premature baby with all the inherent risks of a preterm birth. A case in point, my sister was on fertility treatments and knew to the hour when she conceived. She chose to wait until she went into labour naturally despite her midwife's concerns which was three weeks and one day past her "due date" and her baby was dated perfectly at term.

Sheila Kitzinger, a world renowned British expert on birth, has proven conclusively that first time (primipara) mothers carry their babies a full 10 days longer than mothers pregnant with their second or subsequent baby (multipara). Doctor's due date estimation is based on multipara pregnancies which means based on even the earliest due date, you still are not even at term.

Question: Is it really bad to be induced one-two days after turning 40 wks (if I'm correct on the due date)? I just don't know what to do.

Answer: I am sure you have studied the risks of induction and know the increased risk of preterm birth, interventions, assisted labour (vacuum or forceps) and cesarean section with all their inherent risks. I cannot tell you what you should do other than to listen to your instincts and not be swayed by your doctor who may not have your best interest in mind. You have already told me that you believe your due date estimation is off and you are strongly questioning your doctor's decision to induce you. I cannot stress to you strongly enough that it is YOUR decision of when, or even if, you should agree to an induction, or any intervention for that matter. Ask if you can have a non-stress test instead to assure you of your baby's health and if your baby is well, there is absolutely no reason for you to submit to something you are not ready for. I know how much you want to meet your baby, yet you have been pregnant for 9 months, a few more days to give to your baby in utero is a great gift to him or her in allowing your baby to be ready on his or her own terms.

Question: I am about 9 weeks pregnant and feel great do you think it is ok to go golfing with all the physical changes going on inside me at the moment?

Answer: You can certainly do almost any form of exercise and should be encouraged to do so. Only high risk exercise (riding an unsafe horse), extreme measures such as an increasing amount of intense workouts, or if your doctor cautions you because of a health concern (preterm labour for instance) would you reduce or avoid exercise. Enjoy the golfing this year Sandy, it is good for you and your baby.

Question: I would like to know if using alcohol & smoking during pregnancy can harm the fetus?

Answer: There have not been found any safe limits of alcohol during pregnancy and the earlier in pregnancy alcohol is consumed, the more pronounced the effect of fetal alcohol syndrome. Do an online search for this syndrome for more information. The more research that is done on the effects of smoking on unborn babies, the more they are learning how important cutting down or quitting is. Smoking reduces the amount of oxygen the baby receives and thus leads to smaller babies, premature labour and preemies as well as the effects of the carcinogens increase incidence of childhood cancers and stillbirth.

However, if you are drinking alcohol or smoking, do know that reducing or stopping completely will dramatically benefit your baby's health, and the earlier in pregnancy the greater the benefit.

Question: My wife is 20 weeks pregnant and she would like to know if it safe for her to use a heating pad for some back pain that she is experiencing.

Answer: Heat applied to a certain area of the body does not harm an unborn baby in any way, it is only a high fever which would raise the temperature of the entire body that would be of concern. However, all living beings have an energy running through them and given the fact that power lines can affect health, so could exposure to the electricity from an electric heating pad so close to the unborn baby. I would recommend a water bottle or other non-electric pad.

Back pain can be very difficult during pregnancy and can be caused by a number of things. One thing to note is her position while using the heating pad. If she is in a reclining position, there is a strong tendency for the baby to turn posterior, meaning baby's back turns towards her back. This can increase the discomfort because of the position of baby's head and will often lead to a longer and often more painful labour. For more information on posterior presentation, check our articles Posterior Positioning - Signs and Symptoms and Posterior Presentation - A Pain in the Back!.

The most common reason for measuring small for dates is either low amniotic fluid levels and/or IUGR (Intra-Uterine Growth Retardation - baby growing too slowly). It is very likely that nothing is wrong as external uterine measurements are very arbitrary. Is your baby continuing to be active? This is the most important indication of your babies health. Ensure you are eating well and drinking plenty of fluids to normalize amniotic fluid levels if that is what is causing this. IUGR is usually not a serious problem and rarely do babies diagnosed with this have other problems, but it is something to monitor more closely to ensure the health of your baby. To put you at ease, neither your age or your previous birth history of one miscarriage is related to this concern. But do write down a list of questions for the next time you see your doctor about your concerns, to help you better understand what is happening. An ultrasound may give a clearer picture of what is happening with your baby, but do remember it is a diagnostic tool subject to the expertise of the person doing the testing and cannot conclusively provide answers in all situations.

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