Antidepressants During Pregnancy

antidepressants_during_pregnancy

The use of antidepressants during pregnancy is a controversial topic when considering the mental health of the mother, as well as the physical health of the baby. Women with depression may have an increased risk of harming the fetus if they continue to take certain antidepressants during pregnancy. However, depression itself can also harm your baby.

If you are pregnant or planning to become pregnant, talk with your health care provider about all of your options.

Depression and Pregnancy

Many women battling with depression are prescribed antidepressants by their doctor to help manage symptoms. For years, it was thought that pregnancy protected against depression. This mentality was due to the shifting hormones in a woman’s body. However, scientists now understand that this is not the case; nearly one out of every 20 women who take antidepressants has taken them three months before they became pregnant or during the pregnancy.

The use of antidepressants during pregnancy is a topic that remains controversial because it is unknown what effects these drugs can have during fetal development. Antidepressants are known to cross the placenta, entering your baby’s bloodstream. It is also unknown whether or not some antidepressants remain in your child’s body after they are born.

Antidepressants and Pregnancy

Many doctors and health care providers recommend avoiding antidepressant use during pregnancy if at all possible. Although this may be the recommendation, this can sadly not be the case for each woman suffering from depression. The reality is, some severe cases of depression require medication to help keep the person alive. If you need to stay on antidepressants during pregnancy your doctor or provider will monitor your baby’s growth and development closely throughout the pregnancy.

In 2006, the Food and Drug Administration (FDA) issued a public health advisory in regard to the use of antidepressants during pregnancy. This advisory talked about the possible risks of birth defects associated with antidepressant use. This prompted many women to stop using antidepressants altogether. However, studies show that up to one-third of pregnant women experience depression symptoms in the first trimester of pregnancy, beginning before they even realize they are pregnant.

Risks

During pregnancy, blood volume nearly doubles. This means that antidepressants are distributed to the baby through the placenta, which can lead to higher concentrations of medication in your baby’s body than their mother’s system.

There are many potential risks involved with anti-depressant use during pregnancy. If you take antidepressants, it is important to speak with your health care provider about the benefits and potential risks for yourself and your baby.

Some of the possible side effects associated with antidepressant use during pregnancy:

  • May lead to miscarriage or stillbirth
  • Can cause muscle problems in newborns.
  • Restrict fetal growth, resulting in small or underweight babies
  • Increased risk of birth defects such as cleft palate, heart problems, and limb malformations

In addition, babies exposed to antidepressants in the womb may experience withdrawal symptoms, such as:

  •  Breathing problems
  • Jitteriness
  • Irritability
  • Trouble feeding
  •  Low blood sugar (hypoglycemia)
  • Poor tone

Alternative Ways to Help Cope with Depression During Pregnancy

If you struggle with depression and are looking to steer clear of antidepressants during your pregnancy there are ways to help cope with your depression.

Some of these natural approached to depression include:

  •  Exercise more
  • Spend time outdoors
  • Practice yoga and meditation
  • Minimize your stress
  • Eat healthy
  • Get plenty of sleep

More Questions?

If you have more questions regarding the health of your baby during pregnancy and your mental health contact Midwife360. Owner and certified midwife P. Fadwah Halaby and her team of midwives strive to take the holistic approach to gynecology and pregnancy services. We truly believe in empowering and educating each woman and family we care for. Contact Midwife360 with any questions or to schedule an appointment today.

5 Natural Remedies for Morning Sickness

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Nausea and morning sickness during pregnancy are some of the most common symptoms that women experience. You’re not alone if morning sickness has you feeling a little under the weather. In fact, about 70% of pregnant women get morning sickness.

This article discusses five natural remedies for morning sickness during pregnancy that have been shown to be safe and effective.

Ginger

Firstly, ginger has been used in a medicinal capacity for many many years. It is used to ease morning sickness, motion sickness, as well as cancer-related nausea. Research suggests that ginger may help settle an upset stomach in pregnant women experiencing morning sickness.

Ginger comes in many forms such as:

  • Ginger tea
  • Ginger chews
  • Ginger lollipops
  • Ginger ale
  • Natural form
  • Supplements

Moms to be can take ginger supplements three to four times daily after consulting with their health care provider.

Eat Smaller and More Frequent Meals

Eating smaller, more frequent meals can help reduce morning sickness. It’s important to make sure that you’re not eating too little during the day and making up for it by overeating in one sitting later on. This will only further upset your stomach allowing your blood sugar to drop.

Eat slowly and mindfully, adding nutrients into the body. Although you may feel the temptation to skip meals because of the nausea, remember you are eating for two. Try eating foods without additives and that are easy on the stomach

Some ideas are:

  • Fruit
  • cooked sweet potatoes
  • smoothies
  • rice
  • non-processed carbohydrates

Peppermint Aromatherapy

Another natural remedy for morning sickness is peppermint aromatherapy. Studies show that it can help reduce not only nausea during pregnancy but in women who have just given birth via C-section as well. Moreover, peppermint oil is thought to help ease morning sickness by stimulating the digestive system and calming the nervous system.

Try dotting your peppermint essential oil onto these parts of the body:

  • Wrist
  • Temples
  • Under the nose
  • Neck
  • Back
  • Upper chest area

Vitamin B6 & Magnesium

Additionally, some healthy vitamins and supplements that are known to help with morning sickness and nausea are vitamin B6 and magnesium. Vitamin B, as well as magnesium, can be found in many prenatal vitamins or supplements.

Eating more protein-rich foods like:

  • Meats
  • Fish
  • Poultry
  • Avocado
  • Bananas
  • Pistachios
  • Sunflower seeds

Magnesium can be taken in supplements, topically with magnesium spray, as well as mixed in a bath with Epsom salts.

Avoid Strong Smells

Lastly, and maybe a bit obvious, is avoiding strong smells that may trigger nausea. Many pregnant women experience heightened senses like smell, which you can blame on your pregnancy hormones. Due to our estrogen levels being so high, any small scent that passes our nostrils can seem like an all-out assault on our noses.

Try avoiding these items:

  • Cigarette smoke
  • Perfumes
  • Chemicals in cleaners 
  • Strongly scented foods
  • Candles

If You are Experiencing Morning Sickness

If morning sickness and nausea are a problem for you during pregnancy, there are many natural and at-home remedies that can help. Many women experience it and in most cases, it goes away by week 14.  However, if the nausea is severe, you may want to consult with your health care provider.

If you are looking for or have any questions about pregnancy, birth, and family planning contact Midwife 360. We not only provide holistic gynecology but pregnancy services, which include home birth and water birth to women throughout South Florida. We are here to assist you as well as educate you every step of the way.

Postpartum Hair Loss

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Hair loss is a natural process that many people experience. However, hair loss or thinning during postpartum can be especially challenging, since it’s often accompanied by breakage, and scalp irritation. The good news is that hair grows back.

The hair loss that many new moms experience a few months after having a baby is called postpartum hair shedding. This hair loss happens because the levels of estrogen and progesterone in your body are decreasing or going back to normal after spiking during pregnancy. This often causes your hair to grow slower and less full. It’s not true hair loss during postpartum because it will grow back. Dermatologists refer to hair loss as excessive hair shedding.

What Causes Postpartum Hair Loss

The hair loss most often associated with pregnancy is due to the hormonal changes during and after pregnancy. During pregnancy women notice their hair growing thicker and looking more full. The hormones during pregnancy keep your hair from falling out. However, following pregnancy, these hormones drop and the hair begins falling out and thinning.

The condition, which is also referred to as postpartum alopecia, is relatively common, affecting between 40-50% of women in the months following childbirth.

How Hormones Affect Hair Loss/ Growth

Estrogen is the leading hormone that affects hair growth during pregnancy, postpartum, as well as in menopausal women. Many women during their pregnancy experience fuller and thicker hair growth. This is due to the increase of the estrogen hormone in the body. Thus, producing more hair follicles during the growing phase of the growth cycle.

However, following the birth of your new baby, your estrogen levels drop and return back to the level pre-pregnancy. This causes the new follicles to enter the resting phase of the growth cycle. During this phase, the hair grows slower and produces fewer strands, and begins to shed. Postpartum Thyroiditis can also result in an imbalance of thyroid hormones, which can also affect hair growth.

How Long Does Postpartum Hair Loss Last?

In most cases hair loss after postpartum is temporary. Hair will start to grow back within a few months. Excessive hair loss usually starts eight weeks after giving birth and will last for six to 12 months. If your hair does not begin growing back by your baby’s first birthday, you may consult with your dermatologist or healthcare provider. Month 15 is the lucky number where most women feel their hair is back to normal.

How To Help with Hair Loss/ Growth

There are natural and home remedies that a new mom can implement into her daily routine to help with postpartum hair loss. Some of these can include all-natural shampoos that are specifically for hair loss and helping with new growth. Fenugreek seeds are also helpful when soaked and used as a scalp/hair mask. This herb is also helpful for the production of breast milk.

Adding “hair-healthy” foods into your diet can also promote healthier and quicker hair growth. Including things like:

  • Leafy greens
  • Eggs
  • Healthy fats (avocado, nuts)
  • Vitamin B12
  • Berries
  • Sweet Potatoes

Before the consumption or use of any of these listed always check with your healthcare provider to ensure the safety of you and your baby.

If You Have Any Other Questions

For all pregnancy and women’s care needs contact the professionals at Midwife360. We provide holistic gynecology and pregnancy services, including home birth and water birth to women throughout South Florida. We support and educate women every step of the way through family planning, healthcare options, and birthing. Contact us today to schedule an appointment or speak with one of our midwives.

Natural Remedies for Pregnancy Heartburn

natural_remedies_for_pregnancy_heartburn

Pregnancy heartburn is a common ailment that many moms experience. At MidWife360 in South Florida, we hear these complaints all the time. 

Heartburn or acid reflux is uncomfortable, but generally not a danger to mom or baby. Many people don’t experience heartburn until they are pregnant or later on in life. You may be wondering, how do I know if I have heartburn?

What is Pregnancy Heartburn?

Acid reflux is when stomach acid creeps up towards the esophagus. This is common in pregnancy due to hormonal changes, and the pressure of the baby on the stomach. Unfortunately, it tends to worsen as the pregnancy progresses. A burning sensation in the throat is the most common symptom, but there are other symptoms associated with acid reflux. 

Other Symptoms Include:

  • Nausea or upset stomach
  • Burning sensation in the chest and throat
  • Acid taste
  • Gnawing feeling in the stomach
  • Cough
  • Raspy voice

Is Testing Needed?

Labs and testing are not usually needed due to how frequent and apparent it is to diagnose heartburn. That being said, if you are pregnant and experiencing chest pain, that needs to be addressed by a medical professional. Be sure to let your doctor or midwife know right away. 

The most common medications prescribed to pregnant women with heartburn are antacids, proton pump inhibitors and histamine blockers. These medications are usually safe and effective for brief periods of time. However, because heartburn can persist for larger time frames, some women tend to try natural remedies in order to avoid long term use of medications. As well as any side effects. 

5  Natural Remedies for Pregnancy Heartburn

The medical professionals at MidWife360 know that heartburn can often be managed safely with herbs and supplements. 

1. Raw Almonds

Check the packaging and be sure the almonds are raw, not roasted. Try consuming 8 to 10 plain raw almonds on a daily basis. The almonds can help keep the stomach acid where it belongs by toning the gateway between the stomach and the esophagus.  

2. Melatonin

Melatonin is a common natural sleep aid. Fortunately, it can also help to keep heartburn at bay. Similar to almonds, it helps tone the muscular gateway between the stomach and esophagus. Try taking 0.3 milligrams before going to bed each night. 

3. Slippery Elm

Slippery elm is an herb that is safe to consume during pregnancy. It gets its name from becoming slippery when wet. This gentle herb aids heartburn by coating the lining of the esophagus and stomach. This will help protect the delicate tissues. 

Look for slippery elm lozenges at a natural foods store. We recommend taking 2 to 4 lozenges when needed or try taking them before going to bed. 

4. Marshmallow Root

Marshmallow Root is an herb that is safe during pregnancy, and like slippery elm,  also becomes slippery when wet. This herb works in the same way as slippery elm, by creating a coating on the lining of the esophagus and stomach. Thus, protecting those delicate tissues from acid and allowing them to heal. 

Marshmallow root can be consumed in tea, twice daily. Put one tablespoon in one cup of boiling water and steep for half an hour, and then enjoy. Alternatively, you can take two pills of the marshmallow root 2 to 4 times a day. 

5. Plain Crackers

Acidic foods or spicy foods tend to trigger heartburn and should be avoided. If you do experience heartburn following a meal or snack you ate, try eating plain or saltine crackers. The crackers are able to absorb the excess of acid in the stomach. Thus, helping to stop the signs and symptoms of heartburn.

Refrain from Heartburn Triggers

  • Foods that can trigger heartburn: soda, coffee, spicy food, tomatoes
  • Try not to eat right before bed
  • Stay away from consuming mint, peppermint, spearmint. 
  • Don’t lay completely flat in bed, try propping yourself up with pillows. 

If you have any other questions or concerns about heartburn or acid reflux, the midwives at MidWife360 in West Palm Beach, Florida are here to help. 

We provide holistic gynecology and pregnancy services, including home birth and water birth to women throughout South Florida. Our mission is to awaken, nurture, and support freedom, grace, and integrity for family planning, childbirth and women’s care. We hope you will have an enjoyable pregnancy with these tips!

A Complete Guide to Miscarriage at Home

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Is Miscarriage Normal?

Pregnancy and miscarriage carry a ton of emotions, and one may feel devastated or uneasy when going through a natural miscarriage. Although this is can be an extremely tough time mentally and physically, it may be comforting to know you’re not alone. 

An estimated 10%-20% of women who know they are pregnant will have a miscarriage. Also, most women (87%) who do experience a miscarriage will have a successful pregnancy and birth following that miscarriage. 

Maybe your pregnancy test was positive after missing your period, or some women have that gut feeling without having missed a period yet. Feeling excited, scared, happy, nervous, or just numb are all in the normal range of emotions when you first discover a pregnancy. Or maybe you’ve been trying for months to get pregnant and now you finally are. 

Just when you feel like you are beginning to get comfortable with your pregnancy, you start to have some spotting, maybe a little red bleeding, and then some light cramping. 

Next Steps

Contacting your health care provider and making them aware of what is going on is important. They may offer to have an ultrasound or blood work done. The bleeding becomes heavier and the cramping gets stronger and you no longer have the pregnancy symptoms you were starting to feel prior. Unfortunately, you are most likely experiencing a miscarriage. 

If your body is already starting to bleed and cramp, this is a sign your body is getting ready to expel the products of conception. Sometimes there’s not an actual fetus present. This means it could be a chemical pregnancy with no fetus, just a gestational sac. 

If there are no complications, you can safely miscarry at home. You may want to have some ibuprofen on hand and a hot water bottle. Soaking in a warm bath can also be very soothing. The worst of it can take about 2 hours with some pretty intense cramping and heavy bleeding. 

When to Seek Help

You would need to seek out medical care if you have pain that you cannot tolerate, or if you begin to hemorrhage. The definition of a hemorrhage is, soaking a maxi pad to where you can wring it out, and doing this for 2 hours. Of course, if the bleeding is much heavier than that or you feel unsafe, don’t wait to get medical help. 

Missed Miscarriage

A ‘missed miscarriage’ is where the fetus stops growing but there’s no signs of bleeding or cramping right away. It’s usually during the first ultrasound that this will be diagnosed. Or if you were following the beta HCG hormone, and it isn’t doubling or rising appropriately in the first 10 weeks, a miscarriage can be diagnosed this way, as well. 

If you do have a missed miscarriage, do not wait before seeing your provider for an intervention. It is dangerous for the pregnancy to sit in your womb for months, as it can cause some dangerous bleeding when the natural miscarriage begins. You will most likely be given several options, depending on the preference of the provider. It is always best to be informed ahead of time, in case your provider does not offer all the common or available options. 

Intervention Options for Missed Miscarriage

  • D&C or Dilation and Curettage

A D&C is a fairly common procedure to eliminate uterine lining and pregnancy contents. This procedure is very safe and complications are rare. Light spotting and cramping is common in the first few days after a D&C. 

  • Medications

Medications like Misoprostol are also an option, which cause your uterus to cramp. This process usually takes about 24 hours to complete. This option is also very safe and complications are rare.  

Miscarriage is Common

Miscarriage is very common, you would have to have 3 in a row before it is considered a medical problem. An option is to see a Maternal Fetal Medicine doctor to have a consult regarding any specific blood tests needed to determine if you have a genetic predisposition to miscarriage. These may include: Anticardiolipin, TSH, Lupus anticoagulant, beta 2 glycoprotein, and maternal karyotype. 

Some providers will recommend taking a baby aspirin every day to reduce the risk of miscarriage. And sometimes they may recommend taking progesterone to help you maintain the pregnancy. These all depend on the results of the blood tests and the actual medical diagnosis that is causing the miscarriages.

Next Cycle and/or Pregnancy After Miscarriage 

You can have your beta HCG levels checked, or simply wait for your next cycle. You should have a period by 4-6 weeks after the miscarriage. If you don’t have your cycle within 4-6 weeks, contact your care provider for further testing or ultrasounds. It is recommended to actively prevent pregnancy for 2 cycles following a miscarriage to lower your risk of having another miscarriage right away.

Holistic Gynecology and Pregnancy Services

If you are looking for holistic gynecology and pregnancy services, including home birth and water birth in South Florida, contact Midwife 360 for all of your questions and needs.

The Health Insurance Rant

Palm Beach Water Birth at Home Midwife

Health Insurance A Lose:Lose Situation for Consumers and Providers

How did we come to this juncture where we are supporting the lumbering giant that is the insurance industry particularly as it relates to healthcare? I am an NPR person; I listen to NPR when I’m driving in my car and I heard a piece yesterday that really got me upset! They were talking about the rising cost of healthcare insurance. All of the big companies were planning on raising their rates next year and  Humana was going to be raising their rates higher than everyone else – like by 40%! It is predicted that for someone earning around 27K, their premium would be about $150/m. I remember when I earned less than 30K per year and paying out $150/m for health insurance would have been extremely difficult. So that’s one thing. The other, more important thing that really concerns me – and this, my friends, is the elephant in the room – is how the heck did we get to this place where we support this industry that has absolutely nothing to do with our health?

Difficult Contracting

I have been running my own small healthcare practice for 2 ½ years now. I have been struggling for recognition and compensation from these insurance companies from day 1. Achieving in-network status was the first thing. Cigna updated my new tax ID with my NPI (National Provider Identifier – a national registry that lets them know that the person is legit and bestows a unique identifying number) and we were good to go right away. I thought that all the other companies would do that. However, I found out that even though I’d been providing care for their members for nearly a decade. All of the other companies required me to apply for a contract, and most of the big guys denied me initially. Aetna came around after my national body (ACNM – American College of Nurse-Midwives) wrote a letter for me. Humana is just starting to consider a contract – after multiple Humana members applied for a gap exception for coverage for my care. Blue CrossBlue Sheild won’t even talk to me, doesn’t contract with non-MDs and is extremely difficult to deal with – even for their members. The rest of the companies fell somewhere in-between and eventually granted the in-network status.

Difficult Reimbursement

The next insult is the rates that I am bound to accept now that I have achieved the holy grail of in-network status. My clients pay their premiums and want to use their insurance plan. However, they are subject to their deductibles and co-insurance amounts which require a certain amount of investigation to discover and interpret. The industry standard requires those of us providing maternity care to refrain from billing any services until after the baby is born. This puts all maternity providers in a precarious position because everyone knows that most people are not as keen to pay for a service once the job has been completed. So the trick is to estimate what the insurance company is going to say that the client owes (the deductible and co-insurance up to the amount that is in the insurance contract for the service) and make payment arrangements for this to be paid off prior to their due date. This is irrespective of my charge for the service. If we overestimate, then we have to refund money to the client. If we underestimate, then we have to try to collect for the services that have already been performed.

The Game of Claims and Coding

Submitting forms and getting paid is the other side of this game. The act of submitting a claim is like a ritual or a game – literally. They will deny payment if the coding isn’t correct, but they won’t tell you what’s wrong with it. Most providers pay someone to do this for them and they have to subscribe to a billing platform that electronically submits the claim through one of several national clearinghouses that pass it along to the insurance company. If a paper claim is submitted, it has to be on a particular form that is printed in red ink – if the ink isn’t red, then they won’t accept the claim. All while the status of the claim is communicated to the provider through many forms that are generated, printed, and mailed. So much paper! So many people involved who are making an hourly wage!

Keep the Money Between Consumers and Providers

The bottom line is that all of this detracts from the relationship between me and my clients. The longer I participate intimately with this system, the more I am confused as to the purpose of the insurance industry in health care. Instead of paying out large sums of money for insurance premiums to people whose only job is to move paper around (accept or deny claims and issue checks or take-back letters) we could be using that money to pay for health care. Obviously, the industry is making money – record gains even – and that is off the backs of their members and their providers. I think those folks ought to find another career and we should move away from this cumbersome system.

#getridofhealthinsurance #protectsmallhealthcarebusiness #ontgetbetweenmeandmymidwife