2nd & 3rd Trimester Videos

Newborn Screening

The video explains the process of newborn screening, which involves tests to detect certain metabolic disorders in newborns. The first screening occurs within the first 24 hours after birth, requiring the baby to be at least 12 hours old. This involves a heel prick to collect blood, which is applied to a card. The second screening takes place at two weeks of age. These tests check for rare but serious conditions like PKU and hypothyroidism. The results are reviewed initially at the birth site and followed up with a call after the two-week screening if any issues are detected.

Monitoring Fetal Movement

The video discusses the importance of fetal movement as the best indicator of a baby's oxygenation during pregnancy, surpassing any technological methods. It is crucial to monitor fetal movement, particularly from week 28 onward. Fetal movement should be counted twice daily, ideally after meals. The transcript also mentions using mobile apps to track these movements, and explains that a good activity level consists of 10 distinct movements within 30 to 60 minutes, emphasizing the importance of correctly counting these movements to monitor the baby's health effectively.

Hypertension In Pregnancy

The video discusses hypertension during pregnancy, explaining that blood pressure thresholds are stricter for pregnant women (over 130/80) compared to the general population (over 140/90). It emphasizes the importance of early detection to prevent progression to preeclampsia and eclampsia, which can be life-threatening. The video outlines five key symptoms of hypertension in pregnancy: persistent headache, vision changes, swelling in the hands and face, upper abdominal pain, and neurological changes. If these symptoms are present, immediate medical attention is necessary.

Selecting A Pediatrician

The video describes the collaborative roles within a medical office that includes a family medicine doctor, a certified nurse midwife, and a family nurse practitioner. The family medicine doctor often acts as a pediatrician, while the nurse midwife and family nurse practitioner primarily handle newborn care for babies born to women they have provided prenatal care for. In cases where a newborn is at a higher risk, the nurse can involve Dr. Williams, the physician, to take over the care. The transcript emphasizes the importance of having a trustworthy pediatrician for the development and well-being of the family.

Postpartum Planning

The video discusses the process and importance of discussing future family planning during a patient's initial prenatal visit. This conversation includes whether the current pregnancy is intended to be the last and, if so, the methods for ensuring no further pregnancies, such as tubal sterilization. The goal is to increase the number of planned pregnancies. These discussions continue more intensively towards the end of the pregnancy and during the two-week and six-week postpartum visits.

Preterm Labor

The video discusses preterm labor, which involves symptoms indicating that birth may occur earlier than expected. It highlights that preterm labor can lead to preterm birth, particularly concerning after the 24-week mark of pregnancy when the baby is considered viable. Symptoms include contractions with a pushing sensation, changes in vaginal discharge, vaginal bleeding, and pelvic pressure. Belly cramps with or without diarrhea, and urinary tract infections (UTIs) presenting as front or lower back pain can also indicate preterm labor. The transcript emphasizes the importance of seeking immediate medical attention if any symptoms of preterm labor occur, noting that any healthcare provider can assist with this issue.

Labs and Typical Abnormalities

The video discusses the importance of prenatal visits, particularly focusing on the laboratory tests conducted before the first visit. The speaker highlights the need to review lab results to identify any abnormalities, such as anemia, infections, or lack of immunity to rubella measles. Rubella immunity is emphasized as crucial since contracting rubella during pregnancy can severely damage the fetus's neurological system. Local health concerns and outbreak-specific labs are also considered. The speaker notes that some patients are hesitant about lab tests but stresses their importance for ensuring a low-risk pregnancy and the necessity of being well-informed about one's health status.

Nausea in Pregnancy

The video discusses several strategies to manage nausea, emphasizing eating smaller, more frequent meals and opting for high-protein snacks like nuts and seeds. It suggests consuming plain crackers or whole grain cereals before rising from bed and avoiding greasy, fried foods. It also advises on eating complex carbohydrates and sour or tart-flavored foods and drinks. The video highlights the importance of staying active and taking vitamins with food to reduce nausea. Additionally, it mentions that certain scents, such as peppermint, can be helpful. If nausea becomes severe or vomiting is unbearable, consulting a healthcare provider is recommended, particularly during the first trimester.

Postpartum Depression

The video discusses the prevention and evaluation of postpartum depression starting from the beginning of pregnancy. Postpartum depression is a unique, hormone-related condition requiring specific evaluation methods, such as the Edinburgh Postpartum Depression Scale (EPDS). The speaker has pregnant women complete this scale at various stages throughout their pregnancy to assess the risk of postpartum depression. Additionally, behavioral health services, including evaluations by social workers or counselors, are integrated into the practice. Despite these preventive measures, the likelihood of postpartum depression can still be uncertain due to multiple contributing factors like maternal fatigue, birth circumstances, and grief over unmet birth expectations. The importance of taking postpartum depression seriously is emphasized.

Pain Management in Childbirth

The video discusses pain relief options available during childbirth, particularly in hospitals. It mentions that many people choose epidurals for pain management, which are considered safer than general anesthesia. The video also highlights that some prefer natural births without medication and that their birth plan preferences can determine their choice of birth location. Birth centers typically offer non-medicated births, whereas hospitals offer more pain relief options. The importance of discussing and accommodating patients' needs and preferences is emphasized.

Vaccines in Pregnancy: TDAP, Influenza, and Covid 19

The transcript discusses three vaccines recommended for pregnant women: Tdap, the flu shot, and the COVID-19 vaccine. Tdap focuses on preventing pertussis (whooping cough) in newborns, as they cannot be vaccinated until two months old. Vaccinating the mother during pregnancy protects the baby through the "cocooning" method. The flu shot is primarily for the mother's protection during flu season, as newborns are particularly vulnerable until they can be vaccinated at six months old. The COVID-19 vaccine is more controversial; its recommendation depends on individual circumstances, with healthcare providers offering information to help expectant mothers make informed decisions.

Carseats for Newborns

The video discusses the common issue of improper installation of newborn car seats, often due to a lack of reading instructions, particularly among fathers. It highlights the availability of better car seat clips in newer vehicles and the importance of securing the car seat correctly. It suggests that parents visit local police or fire departments or certified personnel to ensure proper installation. The speaker also recommends that new parents, especially with their first child, have their car seat inspected and receive guidance on safely placing their child in the car seat and attaching the seat to its base.

Vaginal Birth After C-Section (VBAC)

The video discusses VBAC (Vaginal Birth After Caesarean), emphasizing that the first VBAC should take place in a hospital to manage potential risks like placenta detachment or uterine tearing, which are rare with modern C-section scars. The World Health Organization advocates for more vaginal births and fewer surgical ones. Women traumatized by previous C-sections might want to risk a VBAC outside of a hospital, but this decision should be made carefully with healthcare provider advice. Successfully having a VBAC allows more flexibility in choosing birth locations for future deliveries.