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Is it safe to color my hair during pregnancy?

Yes, it is perfectly fine to color the hair during pregnancy.  There is very little of the hair dye absorbed into the system. This small amount of chemical has not been found to be harmful to the growing fetus.

If a woman is still concerned, she could wait until the pregnancy is beyond the third month into the fourth month or the last half of the pregnancy when all of the babies’ organs are already formed.

The fumes of the hair preparation may be a problem in pregnancy, but this should be minimal in a well ventilated area.

The hairdresser may be concerned about how well the hair will take the color because of the changes of pregnancy.

It is important that a pregnant woman feel comfortable in her appearance and if she wants to touch of the color or change her hair color, she should go ahead.

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Labor Induction

Why can’t we just induce the labor now?

 

If the pregnancy is healthy, it’s best to let labor begin on its own.  This give the baby’s lungs and other organs time to fully develop before the baby is born.

The healthcare provider (ob doctor, nurse midwife) may recommend inducing labor in certain situations. Some of these are:

  • If you’re close to 2 weeks past the due date.
  • The baby has stopped growing
  • There is less fluid surrounding the baby
  • If you have diabetes or high blood pressure
  • There is an infection inside the uterus
  • The mother lives far from the hospital and/ or has a history of short labors and fast deliveries
  • The pregnancy is at least 39 weeks by certain dates and there is an overriding social or emotional reason to deliver the baby

 

Labor may be induced with medications.

A prostaglandin pill is usually placed in the vagina next to the cervix, the end of the womb sitting in the vagina. This medication is used if the cervix is not ripe and ready to go into labor.  Prostaglandins sometimes stimulate enough contractions so the mother will go into labor on her own without any further medicines or manipulation.

Oxytocin also known as Pitocin is used if the cervix is ripe, to start or help the contractions.  This medication is delivered through the IV and is measured on a mechanical pump to adjust the dosage.

 

Mechanical methods or manipulations are also used.

A Foley catheter may be inserted into the small opening of the cervix. A balloon at the tip of the catheter is inflated which puts pressure on the walls of the cervix allowing the mother’s own natural prostaglandins to be released.  Once the cervix softens ups and opens, the catheter is removed or just falls out on its own.

The healthcare provider may rupture the membranes, the sac inside the uterus, letting the amniotic fluid out if the mother’s cervix is open and the baby’s head is well applied to the cervix.  This tends to stimulate labor, although sometimes additional oxytocin is needed to increase the frequency and effectiveness of the contractions.

 

There are certain home remedy techniques that have been tried including herbal preparations and nipple stimulation that may cause uncontrolled uterine contractions and put the mother and baby at risk.

Sometimes an induction just doesn’t work and depending on the reason for the process, the mother can be safely discharged from the hospital to rest at home and try again in a few days.  In the case where there is a problem if the pregnancy continues, a cesarean section delivery may be the only reasonable course of action.

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How soon can I determine my baby’s sex?

This is one of the most common questions of soon-to-be-moms.

A sonogram around 18 to 20 weeks from the last menstrual cycle can usually determine the baby’s sex.  The position of the baby during the ultrasound will determine how easy we can see the gender.  We usually can tell if the genitals look like a “hamburger” a girl, or a “hot dog” a boy.  There is no way to influence the baby’s position during the exam.

Amniocentesis or chorionic villus sampling are two very reliable methods of checking for the baby’s chromosomes.  We usually use these tests to check for abnormalities rather than just the gender.  The chorionic villus sampling may be done as early as 8 weeks and the amniocentesis at 14 weeks.  These tests are invasive and do carry some risks.

In the past few years there has been a new test that samples the mother’s blood and checks for the presence of fetal cells.  The free DNA is harvested and is used to test for 3 common chromosome abnormalities Trisomy 18, 21, and 13. It is approximately 99% accurate and can be performed at 10 weeks from the last menstrual period.   The test can also check the baby’s sex as well.

There are companies that offer paternity testing using the free circulating DNA. If accurate, this would be very useful in cases of disputed paternity.  The large lab companies such as LabCorp and Quest do not offer this type of testing at this time.

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Home Births

We’re planning a Home Birth, what do you think doctor?

 

Pregnant women may opt for a home birth because of the great level of comfort and sense of control enjoyed in familiar surroundings.

Someone said that to see what a natural home birth in the past was like, we should stroll through some of the cemeteries with graves from the 18th and 19th centuries when all births were at home and read the tombstones of the young women and infants buried there.

The modern family birthing centers have comfortable rooms with rocking chairs, adjustable beds, large sofas, etc. to allow the expectant parents to feel comfortable and have a safe delivery in a monitored setting. You can bring some items from home to make it even more comfortable if you desire.

Medicine, monitors, and examinations are a necessary part of a safe delivery experience.  Not everyone opts for pain medication or regional anesthesia-epidurals, but it is there for those women who do want it.

Most ob doctors really have no preference what position the woman labors in just as long as she’s not flat on her back.  The woman can walk in the room, sit up in the bed, rest on her side, or rock in the chair.  We just need to be able to monitor the baby and the contractions.

Labor attendants are used by some women during labor or the partner can coach the mother during labor and delivery.  If there is no coach or attendant, usually the hospital labor nurse will be there to provide encouragement and help during labor and delivery.  The delivering practioner, the ob doctor, the nurse midwife will be in and out during the labor process and will guide the mother during delivery.

The purpose of the ongoing monitoring is to pick up the clues sometimes subtle that a problem is developing or to prevent a sudden development from worsening.  It is remarkable how fast we can go from the relief of a happy delivery to an emergency such as postpartum hemorrhage or mother or baby not breathing properly.

The healthcare practioner that you picked is someone that you have known at least for months or several weeks.  You should feel comfortable with this person and feel that she is knowledgeable and would do everything she can for you and your baby.  You should be assured that she respects your wishes and your customs.  You should also be willing to listen to the advice she gives and reasons for certain procedures or maneuvers.

No matter how close a family lives to the hospital, even just down the street, there will be some delay in getting to the birthing center, evaluating the situation and performing whatever intervention is necessary in the case of some emergency with the birthing process.

Considering all of this, it just does not seem reasonable to risk the health and life of the mother and the baby to deliver a baby away from a modern health center.

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Forceps Delivery

Will I need forceps for my delivery?  How about a vacuum extractor?

 

In a forceps delivery, the physician applies the metal instruments shaped like a pair of large curved spoons to the baby’s head after the mother is fully dilated.  With great care, the physician pulls on the instrument during a contraction while the mother pushes.

 

Your doctor might recommend a forceps delivery if:

  • You’re pushing, but labor isn’t progressing.
  •  If there is a  change in your baby’s heartbeat and an immediate delivery is necessary
  • You have a medical condition such as a narrow aortic valve and your doctor needs to limit the amount of time you are allowed to push for your safety.
  • The  baby’s head is facing the wrong direction such as occiput posterior –facing up rather than down –occiput anterior

 

Minor marks on your baby’s face after a forceps delivery are normal and temporary. Serious infant injuries after a forceps delivery are rare.

If a forceps delivery seems to be the best option, your doctor will explain the risks and benefits of the procedure and ask for your consent.

History tells us that the modern forceps were invented by the eldest son of the Chamberlin family in the early 17th century or late 16th century.  Five generations of the Chamberlin family kept the secret of the instruments that were the key to the success of their midwife/obstetrician dynasty as they served the Royal families and nobles of Europe. 

My first experience with forceps was as a third year medical student.  A woman presented in advanced labor ready to deliver. She said she had delivered 4 or 5 children before but had not had prenatal care for that pregnancy.  This was just the case for me a doctor-in-training.  I performed all the maneuvers that I had studied and was just waiting for the placenta to deliver when we discovered the feet of the second baby presenting.  The room exploded with personnel and I watched as the chief resident skillfully applied forceps and guided the after-coming head of the seven pound healthy baby boy out of the birth canal.  This experience probably had a good deal to do with my decision to go into obstetrics and gynecology.

Attempts at forceps deliveries aren’t always successful. If the doctor isn’t able to properly apply the instrument, she may opt for a Cesarean section instead.

The vacuum extractor is used for all of the same reasons as the forceps and may be used instead of forceps at the preference of the doctor. The main advantage of the vacuum is that it is easier to place on the baby’s head.

Use of forceps and vacuum extractors to assist in a vaginal delivery rather than cesarean section in certain selected cases is promoted by the American Congress of Obstetricians and Gynecologists.

A number of obstetricians however, well trained in their use, have abandoned the use of forceps and vacuum extractors. This is because of sometimes poor publicity concerning these instruments and fear of medical litigation.  These instruments, like anything else are safe when used properly and in the hands of trained practioners.