Prenatal health and other women’s health issues were topics of a recent interview with Dr. Linda Sewell, a Roseburg OB-GYN, who was interviewed by host Lisa Platt during a recent Talking Health program on News Radio 1240 KQEN.
The following is an edited version of that program.
Lisa: What are some of the issues that women are facing today?
Linda: Just access to medical care, not only in this community but across the country; it’s very difficult for people to get in to see doctors.
I think in general, the American population is just not very healthy. We don’t eat right, we don’t get enough exercise, we’re much more sedentary, and our children are much more sedentary than we were.
Lisa: What are some of the top concerns facing women who are considering becoming pregnant?
Linda: The biggest concern for me, if you’re considering pregnancy is to make sure that you are healthy. So get to a normal weight, because you know you’re going to gain weight during pregnancy. Stop smoking before you become pregnant. Smoking is one of the worst things we can do for that baby.
Lisa: Can you tell us how smoke, tobacco or substance abuse affect the fetus?
Linda: With alcohol we have something called fetal alcohol syndrome. Alcohol is also one of the worst things you can do if you’re pregnant.
Smoking, we know causes low birth-weight babies. It decreases the blood supply to the placenta and can cause you to have lots of problems during pregnancy and having a lot more visits to your doctor and difficult tests being done.
We know methamphetamine causes preterm delivery and low birth-weight babies, but we’re now finding that methamphetamine is causing long-term learning disabilities in children that were exposed during the pregnancy.
Narcotics is one of those things that we really need to address. We have a lot of people that are on narcotics that their doctors prescribe for pain management, but we know that a baby that is exposed to narcotics through the entire pregnancy can be born addicted to narcotics and that they have to be weaned off of those narcotics and that is pretty awful to have to witness.
Lisa: Can a woman go ahead and exercise throughout their entire pregnancy or up to a point?
Linda: Absolutely, I encourage women to continue to exercise throughout their pregnancy. I say whatever you’ve been doing in the past it’s OK to continue. But as your belly gets bigger, it may be harder to lift weights or to run.
Lisa: Let’s talk about prenatal care. What are some recommendations for women to do for their prenatal care during pregnancy?
Linda: Start taking your prenatal vitamins. Folic acid is high in prenatal vitamins and those first two weeks you are pregnant, before your pregnancy test is even positive, your baby is developing the neuro-tube and folic acid can help prevent things like spina bifida.
We have you come in the office every month, then every two weeks and then at the end it’s every week.
We really are looking at very specific things in the lab results throughout your pregnancy, that will tell us whether or not you’re staying healthy and towards the end of pregnancy those things can get worse , so then we want to see you more often to make sure things are going OK.
Lisa: Are there prenatal classes you would recommend for parents?
Linda: Mercy does a very nice prenatal class over four weeks. I recommend to my patients that they go there around 32 to 36 weeks, close to the end of their pregnancy.
The classes are about an hour long and they go over all kinds of things like what can you expect when you come in to deliver. They address what labor and delivery look like, what happens if you need a C-section, what are some of the challenges with labor, what if you need something like pertosin to help you, and what happens if you need to have special monitors put on.
It really makes people feel a lot more comfortable and then they also do a very good breastfeeding class and the first few weeks of child care.
Lisa: Are there prenatal classes for the dads too?
Linda: Dads are welcome at these classes. Lamaze is also offered at Mercy by a separate organization. These classes are designed to help women get through labor without any pain management and working with a coach. We recommend going to Lamaze classes even if you’re planning on having some pain control.
Lisa: What are some of the latest trends in women’s health?
Linda: One of the biggest trends is not doing Pap smears every year.
But the big thing to understand is that the Pap smear is a very small portion of the pelvic exam, so you still need to go in every year to get your Well Woman exam.
Lisa: How about mammograms, how often should women get them?
Linda: We recommend mammograms every year starting at age 40, with the caveat, if you have family history of breast cancer, more than two first-degree relatives, then you should have your mammograms started 10 years before the earliest age that someone in your family had breast cancer.
Lisa: What is your advice for women after menopause?
Linda: It’s different for everybody. Some women suffer from menopause and you hear about the hot flashes and mood swings, but you don’t hear as much about not sleeping well and being exhausted all the time, or about painful sex.
We can do vaginal health and estrogen in the vagina that will really help with sexual functions, but some women need systemic hormones just to control those symptoms. But hormone replacement has risks and benefits.
We want to give you the lowest dose possible to have the effect we’re looking for to control your symptoms. But it’s OK for many women to take hormone replacement.
The studies show that when we look at women in their early menopause years, at about 50 to 65, that hormone replacement can actually increase their health. But you need to take the hormones with advice of a doctor that knows what they’re talking about.
One thing I have a problem with, is women that get over-the-counter hormone replacement and sometimes they take too much of it, and that can lead to problems like uterine cancer.
So don’t take over-the-counter hormones lightly. They can be just as dangerous as any hormone that I can give you in my office.