Pregnancy Information by Ray Sahelian, M.D. - Answers to Pregnancy Questions


In order to have a healthy pregnancy, women should start taking measures to protect their babies before getting pregnant. That's the time to improve nutrition, be checked for medical problems that might affect a pregnancy, and shake poor lifestyle habits (smoking, taking drugs, or drinking alcohol in excess). Once you become pregnant, you should see your doctor or certified nurse-midwife on a regular basis to help safeguard your health as well as the well-being of your baby. Prenatal check-ups also give you the chance to voice any questions or concerns. It's important for you to be completely honest and to tell your doctor about any physical or emotional problems you may have. Initially, your physician will take a medical history, do a thorough examination, estimate your due date, and take tests to check for diabetes, urinary tract problems, anemia, hepatitis C virus, and sexually transmitted diseases, including human immunodeficiency virus (HIV).

Supplements helpful during Pregnancy
There is little risk in taking low dosages of supplements during pregnancy and the possibility that they could be beneficial. Prenatal vitamins may reduce the risk of brain tumors in children.
Biotin is a B vitamin
Folic Acid is a B vitamin
Choline - half of a 500 mg capsule a few times a week should be sufficient.
Fish Oils
Vitamin E - Women who get enough vitamin E during pregnancy may help lower their child's future risk of asthma. Vitamin E may aid in lung and immune system development.

Diet and Pregnancy
The diet a mother eats while she is pregnant can influence the health of her baby. For instance, maternal oily fish intake during pregnancy may protect offspring from asthma; however, eating fish sticks during pregnancy may increase asthma risk in children. Levels of vitamin E in women during pregnancy are inversely associated with the risk of asthma in their children.

Vitamin D and pregnancy
High levels of vitamin D, obtained through the diet or through supplements, during pregnancy appear to reduce the risk of recurrent wheeze or wheeze symptoms in early childhood.

Pregnancy and SSRI drug use
It may not be a good idea for pregnant women to take SSRIs during pregnancy unless absolutely necessary. Dr. Ema Ferreira and colleagues from the University of Montreal, Quebec, Canada, examined the outcomes in a group of infants born to mothers taking SSRIs or venlafaxine during their third trimester and mothers who were not taking any antidepressants, psychotropic medications, or benzodiazepines at the time of delivery. Included in the study were 76 mothers taking an SSRI or Effexor at the time of delivery and their 79 infants, and 90 unexposed mothers and their 91 infants. Among the exposed infants, "the signs most often observed involved the central nervous system: tremors, shaking, agitation, spasms, hyper- or hypotonia (muscle spasticity and loss of muscle tone, retrospectively), irritability and sleep disturbances," Dr. Ema Ferreira's team reports. There were symptoms involving the respiratory system as well as infants with rapid or slow heart beats. All of these signs appeared during the first day of life, and the average duration was 3 days for exposed infants. All premature infants who were exposed to the SSRI antidepressant agents exhibited behavioral manifestations, compared with about two thirds of exposed term infants. The average hospital stay was nearly four times longer for exposed preterm newborns than for unexposed preterm infants. Pediatrics, January 2007.

Pregnancy, premature delivery, and inflammation
High cholesterol and inflammation during pregnancy increase sa woman's odds of premature delivery. Pregnant women with elevated levels of cholesterol or C-reactive protein -- a marker of inflammation in the body -- are at increased risk of having their baby prematurely. Elevations in both measures raises the risk even further. Since diet influences cholesterol levels and inflammation, this indicates that diet has a role to play in premature delivery.

Early Pregnancy Symptom and Early Pregnancy Sign
The onset and degree of pregnancy symptoms will vary within women. Many women experience them within days of conception, others take a few weeks before pregnancy symptoms kick in and a lucky few feel no discomfort at all. The early pregnancy symptoms generally can be felt once implantation occurs (4 - 10 days from ovulation) and will lessen after the first trimester. Many pregnancy symptoms are very similar to those that occur right before menstruating. However, combined with high temperatures and a longer luteal phase - they are key indications that you have achieved pregnancy success!
     Early pregnancy symptoms include nausea and vomiting, breast tenderness, frequent urination, feeling tired or sluggish, light bleeding, dizziness and/or fainting, cramps, constipation and irritability. First pregnancy sign could be a missed period.

Pregnancy Calendar
A pregnancy calendar can help to give you a solid estimate. By entering just one piece of information into a pregnancy due date calendar you can assess a fairly accurate delivery date. You can use the pregnancy calendar in two ways. You can enter the first date of your last menstrual cycle into the pregnancy calendar. This will calculate forward. The results shown will give you your estimated date of conception, end of first trimester, the date to book your first birthing class, the end of your second trimester, and your estimated delivery date according to the pregnancy due date calendar. You can also enter the delivery date given to you by your doctor. This will calculate backwards. The pregnancy calendar will show you the same information above using either date. Calculator date due pregnancy.

Pregnancy test - EPT pregnancy test - Home pregnancy test
Pregnancy is the period of time when a fetus develops inside a woman’s uterus and ends with the birth of the infant. There are a variety of clinical laboratory tests related to pregnancy, from the time pregnancy is first considered through the initial days of the newborn’s life to pregnancy due date. Some of these tests are performed on most women at specified times throughout the pregnancy, others are ordered as needed to detect and address conditions or problems that arise during pregnancy. Some are offered to women who have increased risks because of their age or lifestyle, while others are selectively chosen based on the woman’s and her partner’s personal and family history. The purpose of these tests is to diagnose existing problems that may affect the mother’s or baby’s health, identify and address problems as they arise, and to assess the risk of a baby having a chromosomal or genetic abnormality. Most of the routine tests are associated with infections or conditions that should be resolved prior to a woman getting pregnant or, if she is already pregnant, should be resolved and/or monitored during her pregnancy. Many pregnancy tests can be ordered online.
     There are two basic types of pregnancy tests. Blood and Urine. They are both used to test for the presence of Human Chorionic Gonadotropic (hCG). hCG is secreted in your urine and detected in your blood beginning at different times during pregnancy. Blood test are the more accurate of the two types of testing. They can not only tell you if hCG is present, but a quantitative hCG can tell you how much hCG is present. This can be helpful in dating a pregnancy, or watching the levels to observe the well-being of the pregnancy. (hCG usually doubles about every two days during the first few weeks of pregnancy.). Urine tests are accurate for what they detect the presence of hCG. However, the amounts of hCG detectable by home pregnancy tests and lab urine pregnancy test varies. If you choose to use a home urine pregnancy test, make sure that your urine has been in your bladder for four hours. Do not drink excessive amounts of fluid in an attempt to increase the volume of urine, this can dilute the urine, making hCG not as detectable. If you are taking any medications, including fertility drugs, read the package inserts before testing to see if your medications will affect the results. If your pregnancy test is positive make sure that you seek prenatal care from a qualified doctor or midwife.

Ectopic Pregnancy - Tubal Pregnancy
Ectopic pregnancy occurs at a rate of 20 cases per 1,000 pregnancies in North America and is a leading cause of maternal mortality in the first trimester. Greater awareness of risk factors and improved technology allow ectopic pregnancy to be identified before the development of life-threatening events. The evaluation of ectopic pregnancy may include a combination of determination of urine and serum human chorionic gonadotropin (hCG) levels, serum progesterone levels, ultrasonography, culdocentesis and laparoscopy. Key to the diagnosis is determination of the presence or absence of an intrauterine gestational sac correlated with quantitative serum beta-subunit hCG (ß-hCG) levels. An ectopic pregnancy should be suspected if transvaginal ultrasonography shows no intrauterine gestational sac when the ß-hCG level is higher than 1,500 mlU per mL (1,500 IU per L). If the ß-hCG level plateaus or fails to double in 48 hours and the ultrasound examination fails to identify an intrauterine gestational sac, uterine curettage may determine the presence or absence of chorionic villi. Although past treatment consisted of an open laparotomy and salpingectomy, current laparoscopic techniques for unruptured ectopic pregnancy emphasize tubal preservation.
      Tubal pregnancy, also referred to as ectopic pregnancy, is the number one cause of death of women in the first trimester of pregnancy. The numbers of tubal pregnancies is on the rise. Tubal pregnancy, occurs when a fertilized egg is implanted outside the uterus, typically in one of the fallopian tubes. Once conception has taken place the now fertilized egg will usually take four or five days to travel from the ovary to the uterus. However, should the tube be blocked or damaged, or the egg simply fails to reach the uterus, the egg may be implanted in the tube and continue to develop there instead of the uterus. An ectopic pregnancy symptom

Diabetes and Pregnancy
Engaging in regular physical activity before and during pregnancy reduces a woman's risk developing pregnancy -induced diabetes (also known as gestational diabetes). A lack of exercise may be one of the few modifiable risk factors for gestational diabetes, which affects upwards of 7 percent of pregnancies and is associated with harmful effects on the fetus and mother-to-be. Babies born to mothers with gestational diabetes may be abnormally large, may suffer from jaundice, low blood sugar and low calcium, and may experience traumatic births, while women with gestational diabetes are more likely to become diabetic after pregnancy. SOURCE: Epidemiology, January 2006.

Viral Infection in Pregnancy
Treatment with the anti virus drug valacyclovir, sold as Valtrex, reduces recurrent bouts of genital herpes in pregnant women. Thus far, treatment with this drug appears to be safe in mothers, fetuses, or neonates.
Genital herpes is usually caused by herpes simplex virus type-2 (HSV-2). It's estimated that up to 25 percent of pregnant women have been exposed to the virus and about 20 percent of them have a recurrence during pregnancy. This often occurs late in pregnancy, raising the risk that mom will transmit the virus to her baby, which is a big concern given that HSV-2 can be deadly to the fetus or newborn infant. To curb the odds that mom will pass the virus on to her infant, it's recommended that women with active genital herpes sores, or early symptoms suggestive of an outbreak, deliver by cesarean section. It's previously been reported that the antiviral drug acyclovir, started late in pregnancy can reduce recurrent genital herpes bouts and may reduce the need for cesarean delivery resulting from active HSV-2 lesions. American Journal of Obstetrics and Gynecology March 2006.

Pregnancy and Heart Attack
The risk of heart attack in women of reproductive age is low, and the risk increases three to four times in pregnant women compared with women who are not pregnant. Overall, 6 of every 100,000 pregnant women will have a heart attack. the heart attack risk increases with age, with pregnant women over 40 years old 30-times more likely to have a heart attack than pregnant women under the age of 20.

Sex and Pregnancy
For women who've previously had a preterm delivery, having sex during early pregnancy does not affect the likelihood of having another preterm birth.

Yoga and Pregnancy
The practice of yoga during pregnancy seems to improve birth weight and reduce prematurity and overall complications. Dr. Shamanthakamani Narendran, from the Vivekananda Yoga Research Foundation in Bangalore, and colleagues studied 169 pregnant women trained in the integrated approach to yoga and in 166 "controls" who received routine prenatal care. The yoga training included various loosening exercises, postures ("asanas"), relaxation, deep breathing exercises ("pranayamas"), and meditation, which was practiced for 1 hour daily. Fourteen percent of deliveries were premature in the yoga group compared with 29 percent in the controls. Rates of pregnancy-related high blood pressure were also lower in the yoga group. Possible mechanisms whereby yoga improves pregnancy outcomes include increased blood flow to the placenta, decreased transfer of maternal stress hormones, and decreased premature release of hormones that trigger the onset of labor. SOURCE: Journal of Alternative and Complimentary Medicine, April 2005.

Urinary Incontinence and Pregnancy
The risk of having stress urinary incontinence many years following first childbirth is significantly increased in those women with an onset of stress urinary incontinence symptoms following first delivery or during first pregnancy compared with those women who do not experience initial symptoms.

Blood sugar elevation in pregnancy and cryptorchidism
Boys born to mothers who have relatively minor elevations in glucose during pregnancy are at significantly increased risk of having abnormal testicular descent. In the condition, also known as congenital cryptorchidism, the testes remain in the pelvis rather than moving into the scrotum.

Twin Pregnancy
Multiple pregnancies have been on the rise in recent years with increasing numbers of twins. Generally, the growing use of fertility drugs is attributed as the main reason for this rise. However, there are a number of different reasons why a multiple birth may occur: Multiple eggs are released or there is more than one ovulation during your menstrual cycle. Two (or more) eggs are fertilized resulting in fraternal twins. This can occur naturally or through the use of fertility drugs. In the case of identical twins, one egg is released and fertilized but divides in two. This can happen with or without the aid of fertility drugs.

Teen Pregnancy Statistics
Teen pregnancy rates in the USA have declined steadily since 1990. While this is good news, teen pregnancy rates in the U.S. remain high, exceeding those in most developed countries1. High teen birth rates are an important concern because teen mothers and their babies face increased risks to their health, and their opportunities to build a future are diminished. About 10 percent of all U.S. births in 2002 were to teens (ages 15 to 19). About one in three teenagers becomes pregnant before age 20.3. Many of these pregnancies are unplanned.

Pregnancy Stage and Drugs - Pregnancy Info
Virtually all illegal drugs, such as heroin and cocaine, pose dangers to a pregnant woman. Legal substances, such as alcohol and tobacco, are also dangerous, and even medical drugs, both prescription and over-the-counter, can be harmful. If you are pregnant, avoid all drugs and medicines as much as possible. Some drugs can be harmful when used at any time during pregnancy; others, however, are particularly damaging at a specific stage of pregnancy. Most of the body organs and systems of the baby-to-be are formed within the first ten weeks or so of pregnancy. During this stage, some drugs—and alcohol in particular—can cause malformations of such parts of the developing fetus as the heart, the limbs, and the facial features. After about the tenth week, certain drugs may damage organs that are still developing, such as the eyes, as well as the nervous system. Continuing drug use also increases the risk of miscarriage and premature delivery.

Pregnancy and Smoking Tobacco
Smoking during pregnancy puts both mother's and baby's life at risk. If all pregnant women stopped tobacco use smoking, there would be an estimated 10 percent reduction in infant deaths, according to the U.S. Public Health Service. Cigarette smoke contains more than 2,500 chemicals, with nicotine, tar, and carbon monoxide thought to be the most dangerous to the fetus.
     Smoking during pregnancy can affect the baby's immune system which may explain why asthma and respiratory problems are more common in children whose mothers smoke. Babies of smokers are more likely to suffer from respiratory infections than children of non-smokers due to changes to biological receptors in the baby's immune system that are responsible for recognising and fighting infections and bacteria.

Alcohol and Pregnancy
Alcohol is one of the most dangerous drugs for pregnant women, especially in the early weeks. In the mother’s body, alcohol breaks down chemically to a cell-damaging compound that is readily absorbed by the fetus. Heavy drinking during early pregnancy greatly increases the risk of a cluster of birth defects known as fetal alcohol syndrome.

Drug Abuse in Pregnancy
Pregnant mothers caught using illegal drugs could go to prison for endangering their unborn children under a drug abuse bill passed by the Idaho State Senate in March, 2006.

Preganancy and Medicines - which to avoid
Isotretinoin (Accutane) and etretinate (Tegison) are used to treat chronic acne and psoriasis. They may cause chronic malformations during the stage of organ development. Anticonvulsants, such as phenytoin (Dilantin) and carbamezapine (Tegretol), are used to prevent epileptic seizures. They are associated with defects of the heart and face, as well as mental retardation. Anti-migraine drugs, such as ergotamine and methysergide, are used to head off migraine attacks but raise the risk of premature labor.
     Aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDs) interfere with blood clotting and increase the risk of uncontrolled bleeding for both mother and baby. Toward the end of pregnancy, they hinder production of the hormones that stimulate labor, so that labor may be dangerously delayed or extended.
Anticoagulant drugs based on coumarin are used in the treatment of heart disease and stroke, to slow blood clotting. Taken during early pregnancy, they are associated with facial malformations and mental retardation. Later on they raise the risk of uncontrolled bleeding.

Pregnancy and SSRIs
Infants who are exposed to selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Zoloft, in the womb are at risk for developing neonatal abstinence syndrome (NAS), a withdrawal disorder characterized by high-pitched crying, tremors, and disturbed sleep. Fetal exposure to SSRIs has been linked to major congenital malformations, but there is growing evidence that it may also be tied to NAS>
     Health Canada is advising women who are taking antidepressants known as Selective Serotonin Re-uptake Inhibitors (SSRI) and who are pregnant or intend to become pregnant to discuss the situation with their doctor due to potential risks to the baby.

Pregnancy week by week - Pregnancy Trimesters
The unborn baby spends around 38 weeks in the womb, but the average length of pregnancy (gestation) is counted as 40 weeks. This is because pregnancy is counted from the first day of the woman's last period, not the date of conception, which generally occurs two weeks later. Pregnancy is divided into three trimesters:

* First trimester - conception to 12 weeks. The moment of conception is when the woman's ovum (egg) is fertilized by the man's sperm. The gender and inherited characteristics are decided in that instant. Weekly pregnancy.
* Second trimester - 12 to 24 weeks
* Third trimester - 24 to 40 weeks.

Week 1
Thirty hours after conception, the cell splits into two. By day three, the cell (zygote) has divided into 16 cells. After two more days, the zygote has migrated from the fallopian tube to the uterus (womb). At day seven, the zygote burrows itself into the plump uterine lining (endometrium). The zygote is now known as a blastocyst.
Week 2
The developing baby is tinier than a grain of rice. The rapidly dividing cells are in the process of forming the various body systems, including the digestive system.

Pregnancy and Delivery Position
First-time pregnant women who give birth in a kneeling position experience less pain than those who deliver in a seated position. However, the duration of the active phase of labor (the time spent pushing) is similar with the two approaches, according to the study, published in March, 2006 BJOG: An International Journal of Obstetrics and Gynecology. Several studies have already reported the advantages of an upright delivery position compared to one lying down, such as less pain and more efficient contractions. However, this is the first time researchers compared the two most common upright delivery positions -- kneeling and sitting.

Exercise pregnancy to be fit pregnancy and reduce excess weight gain pregnancy and eat a healthy diet during pregnancy and proper nutrition

Sex during pregnancy
With a normal pregnancy, a woman can make love right up until the water breaks. However a pregnant woman should check with her doctor or midwife to see if she has a risk for premature labor or conditions such as a shortened or dilated cervix, leaking amniotic fluid, placenta previa, or bleeding. But as long as the pregnancy is normal, there should not be a problem having sex, even with the partner on top. The thick mucus plug that seals the cervix helps guard against infection.

Complication of pregnancy
Preeclampsia is a common pregnancy complication.

Pregnancy and Appendicitis
Pregnant women are prone to a number of conditions that can mimic appendicitis, so diagnosis of acute abdominal pain can be tricky in this situation. Magnetic resonance imaging is accurate for excluding appendicitis in pregnant women.

 can occur including bleeding pregnancy high pregnancy risk
during pregnancy spotting

Caffeine pregnancy
it is best to limit caffeine use during pregnancy.

Bile and Pregnancy
Pregnant women who develop a build-up of bile in the liver, a condition called intrahepatic cholestasis of pregnancy (ICP), have babies with an increased risk of developing respiratory distress syndrome, a potentially fatal disease that occurs when the tiny air sacs of the lungs collapse.

massage pregnancy
Pregnancy after miscarriage or pregnancy problem
pregnancy ultrasound

Bleeding during pregnancy
Hemorrhage and high blood pressure are the leading causes of maternal deaths in poor countries in Asia, Africa and Latin America. Each year about 8 million women suffer pregnancy-related complications and over half a million die, but many of the deaths could be prevented, according to the World Health Organization (WHO).

Pregnancy centers and abortion advice
Women who consult with pregnancy resource centers often get misleading information about the health risks associated with having an abortion, according to a report issued in July 2006 by Democrats on the House Government Reform Committee. Congressional aides, posing as pregnant 17-year-olds, called 25 pregnancy centers that have received some federal funding over the past five years. The aides were routinely told of increased risk for cancer, infertility and stress disorders, said the report, which was prepared for Rep. Henry Waxman, D-Calif.

Pregnancy questions
Q.  Is it okay to take CoQ10, lipoic acid, or curcumin during pregnancy?
     A. I am not sure, but I suspect a low dose of CoQ10, such as 10 to 30 mg, a few times a week would be safe, and a low dose of curcumin, let's say 500 mg a few times a week would also be okay, but we don't studies to confirm this. As to lipoic acid, 10 to 20 mg a few times a week should also be okay.

Q. Is Mangosteen safe for a pregnant woman in her third trimester?
     A. There have not been such studies with mangosteen and pregnancy, so we don't know.

Q. Can glucosamine and chondroitin be taken during pregnancy?
     A. Studies have been done testing these nutrients in women who are pregnant. The decision on supplementation will rest on a combined agreement between the patient and the doctor considering the risks and benefits of other therapeutic options. If a patient would otherwise require the use of NSAIDs, most likely glucosamine would be a safer alternative.

Q. Is serrapeptase safe to take during pregnancy?
     A. Since we don't have human studies with serrapeptase in pregnancy, we suggest not using this product while pregnant.

Q. I am curious to know if i can take Passion Rx with Yohimbe while im pregnant, i have had no sex drive at all not due to my pregnancy, its just not there, please let me know.
     A. We don't recommend taking any sex herbs during pregnancy since studies are not available to tell us how they influence the hormonal system during pregnancy.

Q. Q. I am interested in knowing whether it is okay for a woman to continue to take Sam- e while pregnant. Are there any studies?
     A. We are not aware of studies with SAM-e and pregnancy but SAM-e is powerful and influences body chemistry to a great extent and we suggest you discuss with your doctor. We are not in a position to make individual recommendations.

Q. Hello, my name is Jennifer. I use Passion Rx and absolutely love it!!! I have recently found out that I am pregnant and was wondering if you kknow if it is safe to take Passion Rx while pregnant?
     A. We don't recommend using Passion Rx during pregnancy since the herbs could influence hormonal levels.

Q. I'm thinking of taking DHEA or pregnenolone as a mood lifter and libido enhancement. I'm 7 months into my pregnancy. Would these be safe in low doses?
     A. We would definitely not recommend taking DHEA or pregnenolone, even in low amounts during any period of pregnancy.

Q. I just recently ordered passion RX and I am a little bit concern. I would like to no if passion RX is safe during pregnancy. or thinking about becoming pregnant when using this product. would there be any complication.
     A. We have not tested passion rx for pregnancy, so we really don't know if it is safe during pregnancy, but to be on the safe side we suggest not using it during this time. As to before becoming pregnant, again we have not tested it during this period, but it would be a good idea not to use herbal supplements at least a month before becoming pregnant. good luck!

Q. I really need your help. I am in the early stages of pregnancy and take a range of supplements for a joint condition I have in my knees. I am desperate to find out whether the supplements are safe to take during pregnancy and cannot seem to find anyone to give me any information - my doctor says ask the manufacturer of the supplements and the manufacturers say ask my doctor. It appears no-one seems to know. The supplements and dosage I take are as follows: Glucosamine Sulphate (1000mg per day), Calcium (400mg per day), Magnesium (200mg per day), MSM (Methyl-sulfonyl-methane) (1000mg per day), Hydrolysed Collagen ( 1500mg per day), derived from a fish source. I notice lots of information on your website regarding collagen and it has been suggested to be that the high content of mercury from the fish source may be a problem during pregnancy. I would value your opinion on this and wonder whether I could try changing the collagen to a chicken or bovine based collagen. What do you think? I really hope that you can help give me an indication as to whether there is any information to suggest whether I should carry on taking these supplements during pregnancy which I rely heavily upon.
   A. The reason why your doctor and supplement manufacturers cannot give assurances that these supplements are safe during pregnancy is that hardly any human studies have been done which each, let alone the combination. Therefore, how can anyone safe they safe or not safe to use? If the manufacturers, or your doctor said they were safe to use during pregnancy, and something happened to the fetus (because of the supplements or just by coincidence), there would be a risk for lawsuit (not as likely in other countries as in the USA, we live in a litigious society). Unfortunately, that is the real dilemma everyone faces. Lack of adequate studies and fear of legal action if something does not go right.