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PDF Editor FAQ

What are some strange but true facts about pregnancy doctors rarely talk about?

It can kill you, disable you, or land you in the hospital for weeks to months. First-trimester abortion is far safer.Pregnancy is the only condition I know of where patients are routinely NOT told the risks or counseled about their options or informed that another option is better for their health. In fact, a huge political and religious machinery exists to convince females that abortion is what’s dangerous and should be restricted “for your own good, little ladies”, whereas pregnancy is risk-free. Obstetricians - in fear of offending their patients and/or being hounded viciously on social media by church groups, nuts, and politicians - have mostly abdicated responsibility and just keep their mouths shut and allow this harmful myth to tighten its grip on large parts of America.(I find this despicable. If ACOG had any courage or decency, they would pass a statute affirming that every OB is obligated to inform every pregnant woman of the risks and benefits of pregnancy, as well as the risks and benefits of termination. Make it a blanket policy, so every OB starts doing it and no OB can be singled out as an isolated “baby-killer” or “enemy of Jesus.”)Disclosure: I’m a former OB resident. I delivered babies for about ten months total. In just ten months, Among my own patients,I saw:one patient dead from amniotic fluid embolism.one patient dead from peripartum cardiomyopathy.One disabling stroke during deliveryOne heart attack during deliveryDozens of pregnancy-related infectionsApproximately twenty patients come close to death but surviveAbout forty patients sent to the ICUSeveral dozen patients hospitalized for three weeks or more - losing their jobs and sometimes their homes and relationships in the processDozens of emergency operationsDozens of emergency transfusionsDozens of exacerbations of underlying illness, from diabetes to lupus to asthma to congenital heart diseaseHundreds of women admitted for “routine” complications like relentless vomiting, severe dehydration, preterm labor, threatened miscarriage, preeclampsia, and placental abnormality. (These complications are always treated as ‘no big deal’ by the medical textbooks, but they are actually a pretty damn big deal if you’re a minimum wage worker at the chicken-parts factory, where you can get fired for missing more than three days a year. The textbook authors, it is safe to say, have never worked at a chicken-parts factory.)Dozens of patients sustain severe pelvic damage during delivery, which will likely affect their future health and happiness and relationshipsDozens of awful social situations directly caused by pregnancy - job loss; impoverishment; domestic slavery; school dropout; homelessness, beatings, husband dumped them; husband took a mistress; parents ostracized them or sent them to a “Florence Crittendom home”; in-laws blamed them; women hiding their pregnancy from a partner who would beat them if he found out; pregnant women forced into marriage to protect their parents’ reputations (this one was usually an issue only in immigrant families); penniless women forced to raise a child alone because FOB threatened violence or child abduction if mother dared pursue child support payments. And so on.But as OB’s, whenever a new patient came in saying she was pregnant, we never warned her about any of those possibilities or mentioned the lower-risk option of termination. We never obtained informed consent to give prenatal care and continue imposing the risks of gestation and delivery. Amongst ourselves, we never questioned out loud the secrets we were keeping or the quiet coercion we were imposing on patients - patients who didn’t know medical facts, patients who might have harbored secret doubts, patients who maybe had hoped for an honest discussion, but were afraid we’d browbeat them if they mentioned the word abortion. We just put on big smiles and cooed and trilled and said, “How wonderful!” and kept the patients uninformed.I found it sickening and unethical. But I did it, just like everyone else.

Are there verified cases of a condition that is the opposite of postpartum depression, where a woman is depressed prior to pregnancy but not depressed after giving birth?

As this question demonstrates, there appears to be much less awareness of depression during pregnancy than of postpartum depression. But prenatal depression in women has been studied and documented.According to The American Congress of Obstetricians and Gynecologists (ACOG)[1][1][1][1], it is estimated that 14%-23% of pregnant women experience depression during pregnancy, and 5%-25% experience depression postpartum.In May 2015, the ACOG published an opinion[2][2][2][2] stating that:“Perinatal depression, which includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery, is one of the most common medical complications during pregnancy and the postpartum period, affecting one in seven women.”Further they state:Although definitive evidence of benefit is limited, the American College of Obstetricians and Gynecologists recommends that clinicians screen patients at least once during the perinatal period for depression and anxiety symptoms using a standardized, validated tool.An article from Harvard Medical School[3][3][3][3] updated in March 2017 states that:Depression in pregnant women is often overlooked, partly because of a widespread misconception that pregnancy somehow provides protection against mood disorders. In reality, almost 25% of cases of postpartum depression in women start during pregnancy, and depression may peak at that time, according to a study published in the British Medical Journal.More than 9,000 women recorded their moods during the fourth and eighth month of pregnancy and again two and eight months after giving birth. The questionnaire, which was specially designed for pregnant women and new mothers, concentrated on thoughts and feelings—emotional swings, crying spells, low self-esteem, hopelessness, irritability, and inability to enjoy normally pleasurable activities. The researchers paid less attention to physical symptoms, because they did not want to mistake physical effects of pregnancy (such as appetite loss, fatigue, and insomnia) for symptoms of depression. Depression ratings were highest at the eighth month of pregnancy and lowest eight months after childbirth. Fourteen percent of the women scored above the threshold for probable clinical depression just before the child's birth, compared with 9% two months later.While this is just one study, it suggests that women are at greater risk for depression during pregnancy than in the postpartum period.Footnotes[1] Depression and Postpartum Depression: Resource Overview[1] Depression and Postpartum Depression: Resource Overview[1] Depression and Postpartum Depression: Resource Overview[1] Depression and Postpartum Depression: Resource Overview[2] Screening for Perinatal Depression[2] Screening for Perinatal Depression[2] Screening for Perinatal Depression[2] Screening for Perinatal Depression[3] Depression during pregnancy and after - Harvard Health[3] Depression during pregnancy and after - Harvard Health[3] Depression during pregnancy and after - Harvard Health[3] Depression during pregnancy and after - Harvard Health

What vitamins and supplements should I take in my first trimester of pregnancy?

It is important to start prenatal vitamins to help prevent brain and spin birth defects. You want to make sure that there is adequate folic acid, vitamin D, and calcium in the supplement you pick.The prenatal vitamin should contain 400-800 mcg daily of folic acid, 1000 mg daily of calcium, and 600 IU daily of vitamin D. I would recommend getting a prescription prenatal vitamin from your provider.References:American College of Obstetricians and Gynecologists (ACOG). Practice guidelines available at http://www.guuidelines.gov

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