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The no-period pill Lybrel V

Updated June 1, 2009
If you've heard about Lybrel, the no-period pill, and wondererd about its safety, Dr. Julie Silver has the information you need. Watch to learn more about the benefits and risks of this oral contraceptive.
 

Making fertility-friendly lifestyle choices

Updated March 25, 2017

If you are thinking about getting pregnant, you can do many simple, effective things right now to improve your chances of conception, because lifestyle can have profound effects on the reproductive functions of women and men. This means that increasing your fertility potential is something that you both can do without outside help. In addition to adopting a fertility-boosting diet and getting into the fertility zones for weight and exercise, there are a number of lifestyle choices you can make for improving fertility naturally.

Give up nicotine, marijuana, cocaine, and steroids

Tobacco smoking has been linked to reduced fertility in both women and men. In addition, a recent British study has found an association between smoking and stillbirths, low birthweight babies, and sudden infant death syndrome (SIDS). A woman who smokes is likely to have less chance of becoming pregnant and giving birth when treated with in vitro fertilization (IVF) than a woman who doesn't smoke. This is especially true if she smokes twenty or more cigarettes a day. A mechanism that may link cigarette smoking and reduced pregnancy rates following IVF is the observation that smoking appears to accelerate the rate of egg loss. Women who smoke have the elevated hormone levels that indicate a depleted supply of eggs and prematurely aged follicles.

When You Visit Your Doctor - Pregnancy: 1st Trimester

Updated January 30, 2017

Pregnancy: 1st Trimester

Questions to Discuss with Your Doctor:

  • Your age and how it will affect your pregnancy.
  • Have you been pregnant before? If so, what was the outcome of each pregnancy. Did you have a full-term pregnancy (your baby was born close to your due date)? Did you give birth via a vaginal delivery or a cesarean section ("C-section") surgery? If you had a C-section, what type of C-section was it? Did any of your pregnancies end in miscarriage, voluntary abortion, or an ectopic (tubal) pregnancy?
  • Does this pregnancy come at a good time for you?
  • When was the first day of your last menstrual period?
  • What is the usual length of your menstrual cycle?
  • Do you have any medical problems such as diabetes, high blood pressure, thyroid problems, asthma, tuberculosis, epilepsy, or heart disease?
  • Have you ever had any sexually transmitted infections such as gonorrhea, herpes, syphilis, or human papilloma virus (HPV)?
  • Do any medical problems tend to run in your family such as sickle cell anemia, cystic fibrosis, Down syndrome, or hemophilia?
  • Are you taking any medications (including over-the-counter medications)? If so, what are they?
  • Do you smoke? If so, how many packs per day?
  • In an average week, how many alcoholic beverages do you consume?
  • Do you use any recreational drugs?
  • Did you have any problems getting pregnant?
  • Do you eat a well-balanced diet? Are you taking any vitamins, including folic acid (folate)?
  • Do you exercise regularly?
  • What is your home situation like? Who do you live with? Is your partner supportive of this pregnancy? If not, has your partner hit or threatened you?
  • Are you having any problems with morning sickness (that is, nausea and vomiting)?
  • Are you having any bleeding from your vagina?

Your Doctor Might Examine the Following Body Structures or Functions:

  • Temperature, blood pressure, pulse, weight
  • Chest exam
  • Heart exam
  • Abdominal exam
  • Pelvic exam with Pap smear and cervical cultures
  • Leg exam

Your Doctor Might Order the Following Lab Tests or Studies:

  • Confirm pregnancy with blood or urine test
  • Complete blood count and blood type
  • Blood tests for syphilis, rubella antibodies, hepatitis B, HIV
  • Urinalysis
  • Portable Doppler instrument or stethoscope to measure fetal heart sounds
  • Urine culture
  • "Triple screen" (also known as "AFP-3" or "Enhanced AFP"
  • Genetic testing
 

When You Visit Your Doctor - Pregnancy: 3rd Trimester

Updated January 30, 2017

Pregnancy: 3rd Trimester

Questions to Discuss With Your Doctor:

  • Do you have adequate support at home from family or friends?
  • How do you feel? Have you had any problems since your last visit?
  • Have you had any vaginal bleeding or spotting?
  • Have you had any pain or uterine cramping?
  • Have you had any discharge or leakage of fluid from your vagina?
  • Have you noticed swelling of your face or ankles?
  • Have you had any problems with your vision?
  • Are you getting frequent headaches?
  • Have you noticed a change in the frequency or intensity of fetal movement?
  • Are you planning to breast-feed or bottle-feed?
  • Have you selected a pediatrician for your baby?
  • Are you taking classes on labor and delivery?
  • Have you added health insurance coverage for your new baby?
  • Have you purchased a special car seat to hold your baby when riding in your car?
  • Have you decided on whether the baby will have a circumcision, if a boy?
  • Have you talked with your doctor about the length of your stay in the hospital?
  • Do you know the signs of going into labor so that you can call your doctor when labor begins? (These include uterine contractions and rupture of the membranes).

Your Doctor Might Examine the Following Body Structures or Functions:

  • Breasts (to see if your nipples are inverted)
  • Abdominal exam, including measurement of the height of your fundus (top of the uterus)

Your Doctor Might Order the Following Lab Tests or Studies:

  • Culture of the vagina and rectum for Group B streptococcus bacteria
  • Fetal ultrasound
 

When You Visit Your Doctor - Pregnancy: 2nd Trimester

Updated January 30, 2017

Pregnancy: 2nd Trimester

Questions to Discuss with Your Doctor:

  • How do you feel? Have you had any problems since your last visit?
  • Have you had any vaginal bleeding or spotting?
  • Have you had persistent vomiting?
  • Have you had any pain or uterine cramping?
  • Have you noticed swelling of your face or fingers?
  • Have you had any problems with your vision?
  • Are you getting frequent headaches?
  • Have you had any vaginal discharge?
  • Have you noticed fetal movement?
  • Are you planning to breast-feed or bottle-feed?

Your Doctor Might Examine the Following Body Structures or Functions:

  • Blood pressure, weight
  • Abdominal exam including measurement of the height of your fundus (top of the uterus) and using a portable Doppler instrument or stethoscope to measure fetal heart sounds

Your Doctor Might Order the Following Lab Tests or Studies:

  • Consider repeat complete blood count
  • Fetal ultrasound
  • Glucose tolerance test

Your Doctor Might Order the Following Treatment:

  • Rhogam (Rh-Immunoglobulin), if your blood type is Rh negative (see p. 920)
 

Emergencies and First Aid - Birth of the Placenta

Updated February 3, 2017

Birth of the Placenta

The placenta, which has provided the fetus with nourishment, is attached to the umbilical cord and is delivered about 20 minutes after the baby. Do not pull on the cord; delivery of the placenta occurs on its own. You can help by gently massaging the woman’s lower abdomen. The uterus will feel like a hard round mass.

Massaging the abdomen helps the uterus contract, which also helps stop bleeding. After the placenta is delivered, place it in a plastic bag to take with the woman and baby to the hospital. It is normal for more bleeding to occur after delivery of the placenta. Continue gently massaging the woman’s lower abdomen.

Depression during pregnancy and after

Updated March 21, 2017

For too many women, joyfully anticipated pregnancy and motherhood bring depression as an unexpected accompaniment. Children as well as mothers suffer. Depression during pregnancy may result in poor prenatal care, premature delivery, low birth weight, and, just possibly, depression in the child. Depression after childbirth (postpartum depression) can lead to child neglect, family breakdown, and suicide. A depressed mother may fail to bond emotionally with her newborn, raising the child's risk of later cognitive delays and emotional and behavior problems. Fortunately, if the depression is detected soon enough, help is available for mother and child.

Depression During Pregnancy

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 womem start during pregnancy, and depression may peak at that time, according to a study published in the British Medical Journal.

Understanding Infertility

Updated October 1, 2001

Infertility

 

Fertility Changes with Age

Surprising news for both men and women: your biological clocks have been ticking for longer than you think. The results of recent research show fertility begins to decline in women as early as age 27 and in men around age 35. But the news isn't all bad; the fertile period (or open window for conception) during a woman's cycle remains the same length between ages 19 and 39.

The study, published in the May 2002 issue of the journal Human Reproduction, involved 782 European couples practicing the rhythm method of contraception. Women recorded their daily body temperatures, the days they had sex, and the days of their menstrual bleeding. Fertility was measured by the probability of becoming pregnant per menstrual cycle.

Ask the Doctor: Is Zika virus a risk for pregnant women in mosquito-ridden areas of the United States?

Published

Q. My daughter, who just moved to Atlanta with her husband, is pregnant. I'm worried that she will be exposed to Zika virus once mosquito season gears up. What can she do to minimize the risk that her baby will have microcephaly?

A. You can relax. Although the mosquito that transmits Zika virus, Aedes aegypti, is occasionally found in the southeastern United States, so far, there has been no mosquito-borne Zika transmission in the United States. However, your daughter may want to check the website of the CDC (www.cdc.gov) for updates, especially if she or her husband expects to travel to Latin America or the Caribbean. There have been reports that, rarely, Zika can be transmitted sexually from men to women. Therefore, men should use condoms if they have been exposed to the virus and their partner is pregnant. And since Atlanta has quite a few types of mosquitoes, she may want to know that insect repellents containing ingredients such as DEET, picaridin, and IR3535 are safe to use during pregnancy.

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