PREGNANT! Now What? Pregnancy Advice After Infertility or Loss

pregnant after infertility now what [Music] ellie crawford and today i want to talk to you about a topic i get asked all the time and i've personally been there myself what should you do what should you know when you're pregnant after going through infertility i am a fertility doctor i am a board certified in ob gyn and rei if you want to learn more about your fertility in your body please subscribe to the channel and stick around today this video is being released on international women's day this day is important as we celebrate women everywhere and one thing i want to talk about is the what comes next personally i'll tell you part of my story i waited to get pregnant until i was at the end of residency the beginning of fellowship i knew that ob gyn residency was really time consuming and i wasn't quite ready in the early stages to be a mom so i was on birth control pills for years and years which was great for me because i really did not want to be pregnant then when we started trying to get pregnant one i realized how little i knew about that process even though i was an ob gyn and two when we started trying and not having success and then having miscarriages i became very fearful and anxious about being pregnant and so my story is my first three pregnancies ended in miscarriage one of my most traumatic ones was when i was working as a chief resident on l d that means you're a senior level resident you're in charge you're the one deciding who needs a c-section who needs an intervention and i started miscarrying in the bathroom on lnd how to carry on my shift helping you know other people have babies while i was losing my own and that was a really hard time for me i then on my fourth pregnancy had an ectopic pregnancy which is a tubal pregnancy that was really terrible as well i had to get methotrexate which is a chemotherapy shot went through infertility workup and in pregnancy number five i was really timid and scared and i kept waiting to lose that pregnancy i just kept waiting i kept knowing this is not going to work none of the other ones have worked and honestly i didn't open myself up or enjoy being pregnant as much as i wish i had and so focusing on that side and what i want patients to know and using my own experience and looking backwards okay so the first thing is that there's this idea that you shouldn't be telling people when you're pregnant at least until you get to a certain gestational age or out of the first trimester or you're done with genetic screening and although i do think that's the case for pregnancy at large meaning like posting on social media having big reveals i do not recommend that to my patients personally one thing that i knew was when i was going through those miscarriages and that topic i hadn't told people that i was pregnant and when you haven't told anybody you're pregnant suddenly now it's really hard to come in and say oh i miss caring i never opened that up and i know there are people in my life friends and family who would have supported me at those moments but i did not give them the opportunity to do so nor did i tell people at work and i think work is an interesting dynamic i do think there would have been people who could have supported me but i kept it all inside nobody knew i was pregnant so nobody knew i was losing those pregnancies so number one i recommend that you tell people at least your close inner circle your person who's gonna come over and who's gonna show up and who's gonna be there tell them when you're early pregnant you don't don't tell them the moment you get a pregnancy test but tell them early on because if something goes wrong whoever that person is to you can be there to support you and if you don't want them in they can't do that number two you want to start focusing on doing everything you can without being anxious so stress relief techniques are going to be very important and that's different for everybody i found that you know walking was really helpful you can exercise at your previous level of exercise but often you don't feel good or you don't feel up to it but you know walking yoga getting outside breathing fresh air those things can be really helpful i also strongly recommend some way to focus especially if you've had loss in the past that anxiety into something else you can't control everything you can't control the outcome of the pregnancy obsessing over all the details are not going to be good and that's kind of what happens throughout all of motherhood so you have to learn to trust the process a little bit i found a lot of peace in journaling just kind of acknowledging those feelings and getting them out and that was very helpful during some of those moments where i truly was fearful or scared i also found education helpful so trying to learn more i loved some of the websites that told you what stage the baby was at what was developing gave little milestones from there you want to start looking at what can you do that's going to be good for the baby so let's shift our mind from i have infertility i've had losses this isn't gonna work too okay if we're optimistic and it's gonna work how do we prepare ourselves the best so as i already said number one exercise preparing your body for the changing that's coming your you know ligaments are going to loosen without relaxing and progesterone you're going to lose your balance and so it's staying fit whether it's strength training and cardio i like both for my pregnancy patients that's going to help you adjust to the changes of your body and tolerate you know labor and delivery whether that's a vaginal or c-section foods the foods you eat are really important one thing we've started to learn more about is something called epigenetics and not to scare anybody but to empower you your baby gets a genetic code from the egg and the sperm source and your body your environment is what is determining what genes are turned on and what genes are turned off meaning how stressed you are the toxins you're exposed to the foods you eat your metabolic conditions these things actually matter for the genetic determination of your baby's life so what you want to be doing is eating tons of foods that are high in fruits vegetables whole grains you want to be trying to avoid you know processed foods or you know really heavily processed meats like those bacons and sausages and things that can be a carcinogen you want to be avoiding sweets all the time trying to keep your blood sugar in a normal range if you've had pcos gestational diabetes in the past any elevated sugars you want to talk to your doctor really early to see if you should be on any medications for that and you want to be avoiding toxins toxins in the world can come in what you put in and on your body so again some meat products specifically red meat may have some toxins in it also you know beauty products kitchen things you know what do you cook in you are you cooking on teflon are you heating up plastics what's going in the dishwasher are you drinking coffee out of styrofoam what about your beauty products your shampoo your face wash you know do those have chemicals in them we have to remember that things aren't really regulated here in the us as much as they are in other places so i think this is a great time to do what you can so just like i tell my infertility patients to do what you can to have the best outcome control your own variables because there's so much you can't control other things is you definitely need to have a prenatal vitamin prenatal vitamin needs at least 400 micrograms of folic acid most prenatals also have vitamin d omega-3 fatty acids and these can be very helpful for development of the baby for brain development there are a lot of prenatals right now that have methylated folate and even though we don't know that that's bad what we do know that studied is true folic acid so we don't have a study telling us if methylated folate is as good enough as preventing neural tube defects which are defects in the brain and spinal cord when it doesn't close all the way so we definitely want you protected against neural tube defects and that's why folic acid extremely early ideally before the pregnancy is essential sometimes in the first trimester you have a lot of nausea this can be from these raising hormone levels your body has not adjusted to these high progesterone state that's typically what is causing it so just think of mitigation strategies meaning sometimes salt or sour keeping little like small little things you can suck on saltine crackers often having an empty stomach is the worst so having you know crackers by your bed or a tiny little snack you can eat when you get up i used to love chocolate almond milk i know that's so super random but i had a little cup in the morning and that always made me feel better so trying to think about what can work for you to keep a little bit of food a little bit of protein on your stomach and that's going to help you not feel as empty or as sick if you're suffering from some of that you can also take things such as vitamin b6 and you can also try unisom or doxalamine those are over the counter options that we let patients try lastly i want to talk about what if what if you have bleeding or cramping during your early pregnancy number one cramping is really normal and this freaks everybody out i like to think about if we imagine what's happening you have a placenta in the uterus and this placenta is releasing little enzymes to degrade part of the blood vessels on this uterine wall so that these blood vessels can grow in and latch on that process hurts and most people are very surprised at how intense the cramps are coming personally and what i hear is i thought i was losing this pregnancy but it was fine but the cramps were so bad i was sure i was going to miscarry secondly bleeding can be common just as i described if i get a little blood vessel that's hanging out and i have blood coming out you can get some spotting that can be very common in the early pregnancy period it can also lead to something called an sch a subchorionic hematoma so those can be blood pockets kind of behind or next to the placenta if they get very large they can sometimes cause the placenta to not be able to fully implant but most the time they heal up they reabsorb on their own and it's no further issue however anytime you have bleeding you do want to let somebody know if the pregnancy has not been established to be in the uterus it potentially could be an ectopic pregnancy with early pregnancy bleeding that's actually how mind presented until you want to call a doctor you this is why having an ob gyn somebody who's managing your care before you get pregnant that you can call and you're already established there is going to be a very important however most the time early bleeding and pregnancy is just that it's just implantation bleeding it's not a big deal and things will be fine there's a lot of debate if you've lost pregnancies in the past if you should be on progesterone i have a whole video on progesterone so you can learn a little bit more about the implantation stage and what is happening and understanding your progesterone but most of the time what studies are showing us is that potentially starting progesterone right after ovulation may help for that implantation window but once you're pregnant if you have low progesterone levels that is likely the body's way of signaling that this pregnancy is not going to make it and it's not really going to last because the pregnancy is making hcg and that is stimulating progesterone production from that corpus luteum until the placenta is fully implanted around nine to ten weeks so this is a feedback mechanism that pregnancies use but that video will go more into what is exactly happening at implantation overall congratulations if you are pregnant after having prior losses or prior infertility i know it's a scary time this has been goal number one for so long and now you've achieved it and you don't know what to expect next try not to stress try to come up with coping mechanisms lean on your people and take care of yourself thank you guys so much as always you can get more fertility related information on the as a woman podcast or follow along on instagram thanks [Music]

Channel: Natalie Crawford, MD

Views: 32,529

Keywords: fertility, infertility, natalie crawford md, dr natalie crawford, as a woman podcast

Id: 1KisfmMAIPY

Length: 12min 50sec (770 seconds)

Published: Tue Mar 08 2022