Being a faculty member in the Division of the Maternal Fetal Medicine (MFM) at the University of Michigan means I have had the privilege of working with many amazing families and playing a part in this very important time in their lives. My colleagues and I have spent our careers caring for women with pregnancies that for any number of reasons qualify them as being high risk.
Several months ago, we had the extraordinary honor of meeting Mr. and Mrs. Robert and Jessica Hicks and their family. Mrs. Hicks had learned she was pregnant with higher order multiples and was referred to our institution for the special level of care we provide for high risk pregnancies. Upon our initial consultation, we learned that Mrs. Hicks was not just pregnant with four babies, as they had previously been counseled, but rather five babies – quintuplets! Numerous ultrasounds, consultations, appointments, and eventually an inpatient hospitalization for Mrs. Hicks allowed our team to optimize the care that both she and her babies needed.
You’ve made the healthiest choice for your baby and are breastfeeding, but maternity leave is almost over and it’s time to get ready to go back to work. With a little planning and support, you can continue to breastfeed your baby. The earlier you can start planning the better, but it’s never too late to set up a good plan.
During Your Pregnancy
Talk with your manager/supervisor about your goal to continue breastfeeding when you return to work. The Affordable Care Act mandates that all employers with more than 50 employees provide mothers with babies younger than 12 months a reasonable break time and private place (other than a bathroom) to pump.
Do your homework on breast pumps. Some insurance companies cover the cost of purchasing a quality electric pump. If yours does not, investigate renting a pump. Quality, electric pumps are best. Less expensive, battery-operated pumps are not as effective and have been shown to diminish a mother’s milk supply.
Many women consider undergoing gynecologic surgery for a variety of conditions such as abnormal bleeding, pelvic pain, ovarian cysts, fibroids or endometriosis. Historically, these surgeries were often done through large abdominal incisions requiring long hospitalizations and recovery time, increased scar tissue and increased risks of bleeding and infection. In contrast, many women now have the option of having these procedures performed with minimally invasive surgery (MIS) techniques. MIS techniques are usually associated with less pain, quicker recovery, and lower risks of infection and bleeding. These surgical methods include vaginal surgery, laparoscopy and hysteroscopy. Laparoscopy is the performed with a small camera that is inserted into the abdomen with the use of several small instruments. Traditionally, this involves 3-5 small incisions on the abdomen. This can also be performed with a robotic surgical system or with a single port device where all of the instruments and camera are inserted through one small incision. Hysteroscopy is when a camera is inserted into the uterus through the cervical opening in the vaginal canal.
If a woman is considering gynecologic surgery, here are several things to think about:
The short answer is that we think pregnancy rates are improved when polyps that are found are removed. If a woman is planning to become pregnant, and we find a polyp as part of a fertility evaluation, we will remove it.
Polyps are on the list of things that can cause breakthrough bleeding during a woman’s cycle. Some other causes of breakthrough bleeding are fibroids and not ovulating regularly or well.
When you are pregnant, it may feel like your body is not your own any more as your body changes in unexpected ways.
Being aware of your new body is just one of the many benefits of prenatal yoga, which is why I encourage pregnant women to try it.
I talk to all of my patients about the benefits of exercise and prenatal yoga, so if this is a conversation that you haven’t had yet with your healthcare provider, it is one you want to have. You should talk to your doctor or midwife before you start yoga or any type of exercise class during pregnancy.
Why prenatal yoga? There are numerous studies about the benefits of prenatal yoga. Possible benefits include improving sleep, reducing stress and anxiety, and increasing the strength and flexibility of muscles.
Each woman’s breastfeeding experience is different (even from her first baby to her second), but the one constant is that there are a variety of supports in place to provide answers and encouragement. At no point should you feel like you have to do this alone, because there is a team of people and resources to support you.
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