Health Chats
Pregnancy: What to Expect from Conception to Birth
Wednesday May 06, 2009, 03:00PM - 04:00PM (EST)
603463?1220626855
Elaine Brown, MD - BLOG
gynecology, Billings, MT
The nine months of pregnancy are a time of excitement and anticipation of the day you greet your newborn, but it can also be a time of change and anxiety as your body adapts to the little one growing inside of you. You've probably received a lot of advice about what you should and should not do during a pregnancy, what is safe for the baby and what isn't, and what is normal and what isn't. Learn all about what to expect and when to expect it - from hearing the baby's heartbeat for the first time to feeling that kick from inside, from morning sickness to cravings - and learn to differentiate between old wives' tales and scientific research. From trying to conceive to the first trimester to labor, learn what to expect during your pregnancy in this live health chat with Dr. Elaine Brown, MedHelp's resident expert on Fertility, Pregnancy, and Gynecology.<br><br> Dr. Brown is an expert in women's health. She did her internship at Massachusetts General Hospital and Harvard University – Brigham & Women’s Hospital, where she also completed her OB/GYN residency. With the help of her husband, who is also a doctor, and her indispensable "right-hand" 7-year-old daughter, Jacey, Dr. Brown is currently on leave and enjoying her time with newborn triplets James, Jay and Jacob. As a mother of four, Dr. Brown is uniquely qualified to answer your questions from a professional and personal perspective.
Elaine Brown, MD:
I personally like Femara better than Clomid--the pregnancy rates are about the same, but the rate of multiples is lower with Femara and it has fewer adverse effects on the uterine lining and cervical mucous.  ALSO have you had a semen analysis done on your other half?
ChitChatNine:
Hi Dr. Brown,  What are your thoughts on having amniocentesis done on a routine basis for women over 30 ?  Is that the benchmark age ? or is it 35?
Elaine Brown, MD:
ChitChatNine
Elaine Brown, MD:
The bench mark age is 35.  We chose that age because at that age the risk of a complication from an amnio is the same as the risk for having a baby with Down's syndrome.  With the combination of first trimester, second trimester testing and good ultrasound, we can now detect about 94-96% of babies with Down's without amnio
KristieN:
If multiple early pregnancy loss occurs, is there anyway to find out why that happens? and, what should we do to prevent that?  
Elaine Brown, MD:
There are lots of tests to determine why recurrent miscarriages occur.  Some of the most important are for anticardiolipin syndrome, lupus, and an abnormally shaped uterus. Progesterone levels can also be done early in pregnancy to see if supplementation is needed
palo_alto_mom:
During my friend's pregnancy, she had severe anemia and had to be hospitalized and on bed rest for a large portion of her pregnancy. How do you prevent this from happening? If she had another pregnancy, would this happen again?
Elaine Brown, MD:
There are some kinds of anemia that are hereditary, and therefore can't be treated, for example with blood transfusion. If your friend has thalassemia for example, it could definitely happen again.  For most women, a good diet and supplemental vitamins esp C and iron are sufficient
auntie23:
What viruses/diseases are dangerous for pregnant women?  I have three young kids who are always 'catching stuff' at daycare, and I often worry about bringing them around my sister-in-law (who is currently pregnant).  
Elaine Brown, MD:
The biggy is Fifth's disease or Parvo virus.  Chicken pox and measles can also be dangerous, but most adults are immune to those.  Fifth's is most dangerous when exposure occurs in the first or early second trimesters
JoyRenee:
My doctor also prefers Femara. But I have heard that it isn't as widely studied as Clomid.
Elaine Brown, MD:
That's correct!  I have personally had BETTER pregnancy rates with it when I've used it.  But Clomid has been around forever!
Pam:
Hi Dr. Brown!   Thank you so much for giving us your time today!  My question: Is spotting "normal" during the first tri-mester?
Elaine Brown, MD:
No problem!  I would say its common but not normal.  Anytime someone has spotting during her pregnancy I always have her come in for an ultrasound to check everything out.  (unless she had one just yesterday).  Most of the time it just goes away and everything is fine
Jeaneen:
Thanks Dr, Brown for taking the time out for us.  I've been looking for someone to give me some advice and you helped me a lot. My husband is quite excited to just have the maybe.
Elaine Brown, MD:
Good luck! No matter what, keep trying--its worth it!
chantal21:
Is it true, that on some birth control methods, if the egg gets fertilized, that it could keep the fertilized egg from attaching to your uterus, resulting in an early miscarriage?  If so, which ones should be avoided and what would you recommend? (I have never been on any form before, but wanted to know if that it is true?) I'm 22 and have been through 2 miscarriages and I'm now pregnant with baby #2. I would never want to be on something in the future that could cause harm. Thanks.
Elaine Brown, MD:
Hi chantal21!
Elaine Brown, MD:
That is a misconception about the Morning after pill--it definitely does NOT work that way.  That could be one of the ways an IUD works, but we think it works more by preventing conception.  You may want to avoid the IUD "just in case"
Elaine Brown, MD:
by the way congratulations!
Sandy M:
My sister has been diagnosed with Placenta Previa.  What exactly is that and how should it be treated?
Elaine Brown, MD:
Hi Sandy M
Elaine Brown, MD:
Placenta previa is a condition in which the placenta implants over the opening of the uterus which is known as the cervix.  I always describe it like a cork in a bottle.  It prevents the baby from taking the normal exit, and for complete placenta previa a c/section is always necessary.  We will very often deliver these babies early--36-37 weeks, because there are lots of contractions after that time and those could cause the placenta to separate.  Also, she should never have a pelvic exam, or intercourse
teresako:
Hi Dr. Brown, Is it true that playing classical music will make the child smarter?
Elaine Brown, MD:
teresako
Elaine Brown, MD:
babies can hear inside the uterus.  We think that music of any kind, but especially classical helps the neurons in their brains form synapses or connections.  Theoretically this should increase their intelligence.
chantal21:
Ok thanks! And thank you so much for your time!
Elaine Brown, MD:
Good luck with number 2!
ChitChatNine:
I developed gallbladder issues with my 3rd pregnancy and we thought it resolved, but apparently it didn't because I actually had a gallbladder attack while having a C-section with my 4th baby even though I was symptom free- all during that pregnancy!  And the pain was there even with the anesthesia .. they thougth it was gas pangs but the pain never let up 24hrs later, etc.  They did an ultrasound the next morning and I had many gallstones but been lucky and avoided surgery all these yrs later (asymptomatic) ... How common are gallstones and pregnancy ?
Elaine Brown, MD:
HI ChitChatNine!
Elaine Brown, MD:
VERY common!  pregnancy causes some physiologic changes that cause gall stones.  Laparopscopic cholecystectomy (removal of the gall bladder) is a pretty minor surgery these days.  Most people have it as an outpatient. I once did a combo c/section lap choly.
sk123:
What are some common symptoms associated with pregnancy in the early stages? I've also heard that morning sickness doesn't last the entire pregnancy. Are there different symptoms associated with the different trimesters?