The Importance of Folic Acid Before and During Pregnancy

Our bodies need folic acid all the time, but never more so than during the early weeks of pregnancy. Taking a daily prenatal vitamin with the recommended 400 micrograms (mcg) of folic acid before and during pregnancy can help prevent birth defects in your baby's brain and spinal cord. 

Folic acid, which is also called folate, is a B vitamin. Folic acid plays an important role in the production of red blood cells and helps your baby's neural tube develop into her brain and spinal cord.

Birth defects occur early in pregnancy, within the first 3-4 weeks, so it's important to have folic acid in your system during those early stages when your baby's brain and spinal cord are developing. The CDC recommends that you start taking folic acid every day for at least a month before you become pregnant, and every day while you are pregnant. However, the CDC also recommends that women of a childbearing age take folic acid every day, so you'd be fine to start taking it even earlier.

The recommended dose for all women of childbearing age is 400 mcg of folic acid each day. If you take a daily multivitamin, check to see if it has the recommended amount. While you're trying to conceive and throughout  pregnancy, women need 400 mcg of folic acid per day, It’s also recommended that breastfeeding women continue to take  folic acid.

Without enough folic acid in your body, your baby's neural tube may not close correctly and she could develop health problems called neural tube defects such as spina bifida . Getting enough folic acid may reduce your baby's risk of  neural tube defects by more than 50 percent. According to the CDC, if you've already had a baby with a neural tube defect, getting enough folic acid may reduce your risk of having another child with a neural tube defect by as much as 70 percent.

When taken before and during pregnancy, folic acid may also protect your baby against cleft lip and palate, premature birth, low birth weight, miscarriage and poor growth in the womb.

Folic acid has also been suggested to reduce your risk of pregnancy complications (one report found that women who took folic acid supplements during the second trimester had a reduced risk of preeclampsia), heart disease, stroke, some types of cancers and Alzheimer’s disease. 

Foods that can help you get more folic acid in your diet include fortified breakfast cereals, beef liver, lentils, spinach, egg noodles and great northern beans among many others. 

If you have questions about your prenatal vitamins or foods that contain folic acid, please don’t hesitate to ask us at your next appointment, we’d be happy to help ensure the best start for your baby!

November is National Prematurity Awareness Month

November is National Prematurity Awareness Month and we wanted to provide a little more information about premature birth, as well as offer support for women facing certain risk factors. A premature birth refers to a baby that is born at least three weeks before their due date. Important growth and development milestones occur throughout pregnancy, but even more so in the final months and weeks. Our hope is that through proper care and education, our patients can see their due dates and go home with healthy, full-term babies.

Although babies born very preterm are a small percentage of all births, these very preterm infants account for a large proportion of infant mortality rates. More infants die from preterm-related problems than from any other cause. Some premature babies require special care and spend weeks or months hospitalized in a neonatal intensive care unit (NICU). Those who survive are at risk of facing lifelong problems such as intellectual disabilities, cerebral palsy, breathing and respiratory problems, visual problems including retinopathy of prematurity, hearing loss, feeding and digestive problems. 

Even if a woman does everything "right" during pregnancy, she still at risk of having a premature baby. There are some known risk factors for premature birth. For example, one risk factor is having a previous preterm birth. Additionally, race can be a risk factor. Although most African American women give birth at term, on average, they are about 50% more likely to have a premature baby compared to Caucasian women. The reasons behind racial differences remain unknown and are an area of intense research at this time. Other known risk factors for premature birth include carrying more than one baby (twins, triplets, or more), problems with the uterus or cervix, chronic health problems such as high blood pressure, diabetes, and clotting disorders, certain infections during pregnancy, cigarette smoking, alcohol use, or illicit drug use during pregnancy.

On the other hand, sometimes doctors need to deliver a baby early because of concerns for the health of the mother or the baby. An early delivery should only be considered when there is a medical reason to do so. If a pregnant woman is healthy and the pregnancy is progressing well, it is best to let the baby come on his or her own time. Although most babies born just a few weeks early do well and have no health issues, some may have more health problems than full-term babies. For example, a baby born at 35 weeks is more likely to have jaundice, breathing problems and a longer hospital stay than a baby born at 37 weeks and beyond. 

It’s important, early on in your pregnancy to talk to us about ways to best control diseases such as high blood pressure and diabetes, how to pursue a healthy diet and which prenatal vitamins to include in your daily supplementation. It is also crucial to take 400 micrograms of folic acid daily before and during early pregnancy. Any concerns about pregnancy and any warning signs or symptoms of preterm labor will need medical attention and the care of a doctor or midwife. 

In most cases, preterm labor begins unexpectedly and with no known cause. It’s important to seek care if you think you might be having preterm labor, because we may be able to help you and your baby delay the onset of preterm labor.

Warning signs include contractions every 10 minutes or more frequently, change in vaginal discharge (leaking fluid or bleeding from the vagina), pelvic pressure (the feeling that the baby is pushing down), dull backache, cramps that feel like a menstrual period or abdominal cramps with or without diarrhea.

Birth is a complex and wonderful process. Fortunately, the outcome for most women is a full-term, healthy baby. More research still is needed to understand the risk factors for premature birth, such as how family history, genetics, infections, race and ethnicity, nutrition, and environment may work together to put some women at greater risk for a premature delivery.

If you have any specific questions about the occurrence of premature birth, feel free to give us a call. 

Additional Resources:

Preterm Birth—CDC's Division of Reproductive Health

Promotes optimal reproductive, maternal, and infant health. CDC scientists and their partners are collaborating with states, university researchers, and partners in health care to understand why preterm births occur, and what can done to prevent prematurity.

Preterm Labor and Birth

More information from the National Institute of Child Health and Human Development.

Premature Babies

The National Library of Medicine provides links to the latest news and research on preterm birth.

Premature Birth

Learn more information about the care of premature babies from the American Academy of Pediatrics.

Healthy Pregnancy

Learn how to be healthy (before, during, and after pregnancy) and give your baby a healthy start to life.

CDC's National Center on Birth Defects and Developmental Disabilities

Promotes the health of babies, children, and adults, and enhances the potential for full, productive living.

Dr. Sebestyen Named Best OB/GYN For the Third Year in a Row

On Friday, October 25, Dr. Sebestyen received the award for best OB/GYN (patient’s choice) at the Austin Birth Awards. This is the third year in a row she has received this honor and we’re so proud to share the news! A big thank you to all of our patients for supporting her nomination and voting for Dr. Sebestyen. This type of recognition is true confirmation that our efforts are appreciated and valued in our community.

The Austin Birth Awards feature a list of qualified professionals in many service areas related to birth and parenting. All finalists were nominated by those in the community who have personally experienced great service and outcomes from birth related service providers. This year nominations were accepted from June 1, 2013 through July 15, 2013 and final voting on the top four finalists ended on October 15, 2013 at midnight. The 3rd Annual Awards Ceremony & Gala took place on October 25, 2013 at the Carver Museum Theater & Reception Area at 7p.m.

The Austin Birth Awards are a project of the Get Babied Foundation and the Central Texas Healthy Mothers Healthy Babies Coalition. Together, their mission is to recognize Austin area birth professionals that are going out of their way to provide quality care for the women of Austin. A result of the yearly poll is a list of the best referrals for pregnancy care in Austin, selected and voted on by real people to determine the best and brightest mother-friendly birth professionals the city has to offer.

Another highlight for our practice was cheering on St. David’s North Austin Medical Center, where our OBGYN North patients deliver, as they received the award for the best labor and delivery unit in Austin.

For more information about Austin Birth Awards, visit http://www.austinbirthawards.org/.

Natural Beginning Birth Center Welcomes Community for Public Open House

As many of you know, on September 2 we opened our new birth center, Natural Beginning. We’ve been busy with births and getting settled into our new space, but we wanted to take the opportunity to share this incredible new option with our current and future patients. 

On Friday, November 8th, we are opening our doors from 4p.m.-7p.m. and inviting the community into the birth center to see our new space and celebrate alongside our team of midwives as well as the physicians from OBGYN North. 

Please feel free to share this open invitation with your friends, we’ve been looking forward to opening our doors to the public and sharing Austin’s newest birthing option with the community! 

Thank you for your support and we’ll look forward to seeing you soon! 

Birth Statistics from June, July, August and September

June

Total Vaginal Deliveries - 55

Total C-Section Deliveries - 7

Total Deliveries - 62

July

Total Vaginal Deliveries - 46

Total C-Section Deliveries - 7

Total Deliveries - 53

August 

Total Vaginal Deliveries - 41

Total C-Section Deliveries - 8

Total Deliveries - 49

September 

Total Vaginal Deliveries - 40

Total C-Section Deliveries - 24 (8 were repeat C-Sections)

Total Deliveries - 64

Cumulative statistics for 1300+ deliveries

13% Primary C-Section

85% VBAC success rate

67% of patients planning birth without an epidural were successful

OBGYN North Highlights National Breast Cancer Awareness Month

October is National Breast Cancer Awareness Month and National Mammography Day is October 22. Our goal, as a practice, is to raise awareness through educating women and helping them by providing excellent preventative care. 

Protecting women against the dangers of late stage cancer begins with preventative measures that include regular screenings. Maintaining optimal health and choosing to make preventative care a priority can save a women’s life. The best way to do that is to do a monthly self exam and to schedule mammograms every one to two years  beginning at age 40, or earlier if there‘s a family history of breast cancer under 50 years old.

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. The mutated cells can invade surrounding tissue, but with early detection and treatment, most people can continue a normal life. Breast cancer is the most commonly diagnosed cancer in women, with one in eight women diagnosed in their lifetime. As the second leading cause of death among women, each year it is estimated that over 220,000 women in the United States will be diagnosed with breast cancer and more than 40,000 will die. 

Although breast cancer in men is rare, an estimated 2,150 will be diagnosed with breast cancer and approximately 410 men will die each year.  Male breast cancers are more often familial (hereditary) whereas breast cancer in women is more commonly sporadic (random). Screening recommendations can differ in women with many family members with breast cancer, and individual risk can be calculated with the Tyrer-Cuzick model (www.ems-trials.org/riskevaluator). 

In recent years, perhaps coinciding with the decline in prescriptive hormone replacement therapy after menopause, there has been a gradual reduction in female breast cancer incidence rates among women aged 50 and older. Death rates from breast cancer have also been declining since 1990, in part due to better screening, early detection, increased awareness, and improved treatments options. Thankfully only a small percentage of breast lumps turn out to be cancer, but women (and men) should see a physician if they discover a persistent lump in the breast or notice any changes in breast tissue such as dimpling, new inversion of nipples or nipple discharge.

Mammography is the best available method to detect breast cancer in its earliest, most treatable stage. In fact, mammography can detect cancer cells an average of one to three years before a woman can feel a lump. Mammography also identifies cancers too small to be felt during a clinical breast examination.

With awareness comes prevention, and in the end that alone is saving lives. If you would like more information about breast cancer, please contact us, we'd be happy to schedule an appointment with one of our physicians or midwives. 

Natural Beginning Shares Details on the First Delivery at the Birth Center

On Sunday, September 15, less than two weeks after Natural Beginning opened their doors, Stacy Smalley and Siobhan Kubesh delivered Baby Ivy, the first baby in our new birth center. 

We recently had a chance to chat with the mother about her experience and we wanted to share the Q&A session with our current and future patients. 

-Was labor and delivery what you expected based on the knowledge you had ahead of time? 

This being my second child, I was hoping that, like most anecdotes I’d heard, it would be an easier and faster birth than my first.  Indeed it was!  Labor was shorter, and delivery was much more straightforward.  I also got to deliver in the tub, which was just as marvelous as I’d built it up to be.

-What was your favorite part about birthing at NBBC? 

The tub was glorious!  Also, I had the utmost confidence in my two midwives, Siobhan & Stacy.  They directed me perfectly throughout the labor and delivery, and explained things to a high level as I like my health care professionals to do. They were extremely patient and resourceful and I felt great ease knowing I was in their hands.

-What was the experience like as a whole?

I labored at home for about 6 hours before coming in to the birth center at 8:30.  I think I had steeled myself up for the pain of natural childbirth enough that I almost waited at home too long!  When I arrived Stacy measured me at 8 cm.  After that exam and a quick check on baby’s heartbeat, I arrived in my beautiful room at about 8:45, with very intense contractions.  My water broke at 9:01, and Siobhan said the most glorious sentence to me: “Cate, with second pregnancies, when the water breaks the baby is usually very close to birthing”.  I had a couple contractions on the floor, hugging a birthing ball, before getting in the tub.  Unlike my first birth, where I never felt the urge to push, I felt strong urges to push this time around.  Stacy coached me in breathing techniques – I clung to her words as I focused intently on the window – and very shortly baby Ivy swooshed out into the water.  The warm water made it all feel very comfortable, and then there I was, lounging in a cozy tub with my baby girl on my chest.  What a great feeling, what a great birth.

-How is your daughter doing? 

Baby Ivy is doing great!  She took to nursing easily and vigorously, right at the birthing center.  She squeals and smiles and wiggles and smells great so all the bonding is happening right on schedule.  

We are thrilled to share her experience and look forward to many more beautiful births at the center. In fact, the second baby has already arrived. If you have any questions about our birth center, please give us a call.