Birth Control Pills Safety

Are the pills safe?  Should I keep taking them?

The birth control pills, (oral contraceptives) are very safe.  They have been available for about 50 yrs and have been extensively tested.  Most contain 2 hormones, estrogen and a progestin.

The hormones in the pills work by keeping the egg from leaving the ovary and making the cervical mucus thicker.  The estrogen and progestin also make the lining of the uterus thinner and the cervical mucus thicker keeping the sperm from getting to the egg that may have already been released when the woman started the pills.

Of course, no medication will ever be 100% safe and if a woman is over 35 and smokes, she should not use the birth control pills. This woman would be at increased risks of heart attack or stroke already and if she adds birth control pills, she increases her risk.  Also women with poorly controlled hypertension, poorly controlled diabetes or who have already had a heart attack, stroke, or blood clots in legs or lungs should not use the pills.

Researchers published a study in 2012 that found that there may be an increase of 1 woman per 10,000 women younger than 50 who might have a stroke or heart attack if they use birth control pills.

A certain type of pill that contains the progestin drospirenone may also increase the risk of heart attack or stroke in susceptible women.

Taken properly, the birth control pills can be 99% effective.  The risks of an unintended pregnancy may be considerable for the mother and for the baby.

The American Congress of Obstetrics and Gynecology recently suggested that because of this, their safety and the increased number of unintended pregnancies, that birth control pills should be available without a prescription.

Baby Sign Language

Can we teach our baby sign language?

Yes, it is possible to teach a young infant modified gestures from the American Sign Language.  As the child’s motor skills develop, studies have shown that babies may be able to communicate effectively using hand motion accompanied by eye contact. Using hand gestures a baby can communicate, often more than a year before they can speak.

You can start teaching your baby signs as early as 6 months.   Signing babies can communicate their needs instead of getting frustrated.

As you teach baby sign language, it’s important to continue talking to your infant. Spoken communication is still an important part of the young child’s speech development.  Teach signs for practical words like hungry, mommy, daddy, diaper, and sleepy-nap.

There are many books and videos, online information to teach parents these techniques.

The most important elements are:

  • Be patient
  • Continue speaking to baby
  • Make it a daily habit
  • Use signs to describe routine baby activities and common objects
  • Have fun, low pressure
  • Involve the other care-givers



Weight Gain in Pregnancy

How much weight should you gain during pregnancy?

The amount of weight that you will gain in pregnancy varies greatly.  Some weight gain is necessary just from the weight of the fetus, the placenta, the increased blood supply found in pregnancy, and etc.

A major factor is where your weight is before pregnancy, whether underweight or overweight.  It is very hard to come up with absolute numbers, numbers written in stone.  In general if the woman is underweight, she could gain from 28 to 40 lbs in total over the entire pregnancy.  A woman fortunate to be at a normal or ideal weight should look for perhaps 18 to 25 lbs gain total.  The overweight to obese woman may gain as little 11 lbs or as much as 25 lbs.

Most of the weight gain in a normal pregnancy is after 20 wks of gestation or after 4 ½ months.

Another important point is what is the weight gain made of? Is it a result of high calorie sweets converted to fats, or is it the result of fluid retention from pre-eclampsia or other medical conditions.

Excessive weight gain in pregnancy increases the chance of developing diabetes, hypertension, and delivery complications which would increase the possibility of cesarean delivery.  Too little weight gain may result in a small growth restricted infant or perhaps increased chance of pre-term labor.

As a general rule, if the mother eats a healthy diet consisting of high fiber, nutrition rich, and higher protein foods and engages in light to moderate exercise throughout the pregnancy, whatever amount she gains will be appropriate for her unique body.


What is a partial hysterectomy?

The term “partial hysterectomy” is a slang phrase meaning the entire uterus has been removed and the ovaries and tubes have been left.  A simple hysterectomy is surgery that removes the top or fundus of the uterus and the bottom or the cervix.

A total abdominal hysterectomy involves making an opening in the abdomen and taking out the uterus through that opening or incision.

If the cervix is left in place, this surgery is called a subtotal or a supracervical hysterectomy.

Surgery to remove the uterus may be performed from inside the vagina, a vaginal hysterectomy.

Minimally invasive procedures have been developed that allow the entire uterus or just the upper part to be removed using 2 to 4 small band-aid size incisions in the abdomen. This is a laparoscopic hysterectomy or laparoscopic assisted hysterectomy.

Taking the ovaries and fallopian tubes is a bilateral salpingo- (the tubes) oophorectomy (the ovaries.)

Endometriosis, painful menses, pressure or pain from an enlarged uterus with benign fibroid growths, or cancer are some of the reasons for a hysterectomy.

Once the uterus has been removed, the woman will no longer be able to deliver children.  She will also no longer have regular menstrual cycles; although sometimes there may be a small amount of bleeding from the cervix if enough of the lining remains.


What exactly is Endometriosis?

Endometriosis occurs when the cells lining the inside of the womb wander around the pelvis and abdomen.  There are many theories about how this happens. The most likely is that the menstrual flow spills out the fallopian tube instead of all coming out into the vagina. That flow could spread to the ovaries, the top, front and back of the womb, the bladder, or the intestines, or the peritoneum (the lining of the abdomen.)

When they stick to other areas, those lining cells act as if they are still inside the womb and grow, shed, and bleed in response to the normal hormones of estrogen and progesterone.  The problem is there is no place for the blood and tissue to go so it sits wherever it forms and sticks to more organs and forms scar tissue, adhesions. The adhesions can be tight bands like piano wire or they can just clump tissue and organs together in hard cement-like masses.

This can be extremely painful, usually worse during the time leading up to and including the menstrual cycle.  Depending on location and how far into the organs endometriosis invades, some women may have extreme pain with a relatively small amount of endometriosis, whereas other women have wide areas involved and have relatively little discomfort.

There is a tendency for this to run in families. The only way to diagnosis endometriosis is through surgery.  Doctors can make an educated guess however, based on the woman’s symptoms, her family history, or how she responds to treatment.

Current treatment is based on changing the hormone sequence affecting the endometriosis.  Doctors use birth control pills, anti-estrogen shots such as Lupron Depot, Depo-Provera injections, and if no relief, surgery.  Endometriosis can make it difficult for a woman to become pregnant, but is she has mild disease and is successful in becoming pregnant, the pregnancy hormone changes can wipe out the endometriosis.