hey y'all welcome back i'm mama doctor
jones a board certified ob gyn a month
for and today we're going through 10
things people wish they had known about
pregnancy or birth before they got
pregnant i came across this buzzfeed
article recently where they had to ask
people that question and as i was going
through it i thought some of these are
not quite accurate so we're gonna go
through some of them today if you're new
here and you'd like to subscribe we
would love to have you i talk about all
things periods pregnancy and everything
in between hit that subscribe button
turn on notifications so you never miss
an upload let's jump into the video so
the first person says after a c-section
is complete they administer pitocin to
start contractions your body still has
to go through contractions to bring down
the size of your uterus contractions
when you've just had major surgery on
those muscles is incredibly painful no
one not even my ob gyn who did the
cesarean told me ahead of time while
this person is exactly right that they
definitely should have been told what
medications they were being given i
think that the uterus would likely be
contracting whether the person had
pitocin or not so the uterus has to
contract after delivery whether that
delivery has happened vaginally or via
c-section to reduce the size of the
uterus and to close off those vessels
that were growing the placenta and
reduce bleeding now we often do give
pitocin after a delivery and what is
called active management of the third
stage so labor has three stages the
first stage of labor is the time from
when labor starts up until the time when
you start pushing
the second stage of labor is the time
from pushing to delivery and the third
stage of labor is a time from delivery
of the baby to delivery of the placenta
so active management of the third stage
means giving some pitocin during that
time to help the uterus contract better
and this reduces the incidence of
postpartum hemorrhage so why is that
important well postpartum hemorrhage is
one of the top causes of maternal
mortality
around the world and specifically in the
united states so this is common practice
and i definitely agree that people
should know what medications they're
getting but that's the reason that it's
being done your uterus would be
contracting whether you had a vaginal
delivery or a c-section and whether you
got pitocin or not because that's how
you don't have bleeding but the extra
pitocin reduces the incidence of heavy
bleeding so the answer to this is we
need better pain control this person
should have been given more pain
medicines if they needed it not we don't
want the uterus to contract after it's
been cut through that has to happen
number two i wish i had known that
hyperemesis gravidarum is a thing that
can kill you hyper imminent gravidarum
is a severe morning sickness and
vomiting that can lead to dehydration
and weight loss i wish i knew that
people wouldn't take it seriously until
i was
literally bleeding out from organ
failure doctors and society seriously
treat pregnant women so badly i hate
that this person has been through this
because it definitely sounds like they
had a bad experience and weren't taken
seriously and hyperemesis on its own
even with a great healthcare team can be
really really awful but i can't imagine
how much worse that is if you feel like
nobody is listening to you hyperemesis
is a severe form of nausea and vomiting
in pregnancy and it's not just typical
morning sickness it's often associated
with dehydration to get the diagnosis of
hyperemesis you have to have lost five
percent of your body weight so it is
much more severe than just what you
think of normally with pregnancy it's
also associated with an increased
incidence of anxiety and depression both
in pregnancy and in the postpartum
period there's lots of risk factors for
hyperemesis the most frequently seen
risk factor is you've had it in a
previous pregnancy you're likely to get
it again but not always you can have it
at a higher incidence if you have
multiples if you have something called a
molar pregnancy if you have a genetic
risk so if it runs in your family you
may be at a higher risk there's lots of
things that cause you to have an
increased risk but we don't know the
actual like full-on cause of hyperemesis
itself it's likely related to some of
the hormone fluctuations but it also
seems to have some kind of like baseline
nutritional component as well and then a
whole component that we likely just
don't even understand yet there are lots
of treatment options but they are not
always effective in making you feel
better sometimes they just are effective
in like helping us limp along until
you get done being pregnant so it can be
very debilitating and i definitely
empathize with this person because i've
seen patients go through this and how
horrible it can be the general consensus
is that in developed nations where
health care is somewhat accessible the
mortality rates for hyperemesis are
basically zero so it can be very
dangerous especially if there's no
treatment given at all but most of the
time as long as you can keep someone
hydrated you might feel horrible for a
long time but the mortality rates
associated with hyperemesis are
extraordinarily low number three around
month seven i developed
pregnancy-induced asthma which is a
thing and i was told it would disappear
immediately after birth but it stuck
around for almost 10 years i looked this
one up because i had never heard of
pregnancy-induced asthma and there's
actually no literature that says that
you are at an increased risk of
developing asthma and pregnancy now that
being said you certainly are at an
increased risk of if you have asthma it
getting worse in pregnancy so most
likely what happened in this situation
is this person had undiagnosed or very
very mild asthma prior to pregnancy that
they didn't know about and it just
worsened in pregnancy number four my
second pregnancy messed with my vision
it caused such dry eyes that things were
blurry and i went to the eye doctor and
was told that it's uncommon pregnancy
issue and would clear up eventually it
started to clear up when i started
nursing less and it started about
halfway through the pregnancy but didn't
fully clear up until my baby's first
birthday vision changes from pregnancy
and the physiology changes that happen
in pregnancy are actually relatively
common we see this quite a bit people
can get pregnancy-induced dry eye from
lacrimal duct having less secretions
during pregnancy and most of this is
likely thought to be hormone related
hormone changes can also cause
blurriness from a variety of different
things and they usually are temporary i
don't know that i've ever seen them be
permanent this is absolutely something
that can happen the good news is that
it's usually temporary but definitely
something that people can see dry eye
blurriness just general vision changes
all of those things can be associated
with pregnancy number five epidurals
don't always work as intended my skin
was numb but i felt absolutely
everything else so epidurals are a
wonderful option but this person is
exactly right that they're not always
completely reliable and most of the time
they don't confer complete absence of
pain the way that epidurals are put in
makes the medication kind of inherently
uptake different in everybody just
depending on individual anatomy so there
are some options if you have an epidural
put in and it's not working at all
sometimes the anesthesis can come back
and take the
epidural out try it again see if that
helps but i think having a good
expectation going into labor that when
you get an epidural it should help some
and in very rare cases like this
person's describing it might help not
very much or any at all but most of the
time you're going to be somewhere in
between most people will get pretty good
pain relief but not total pain relief
number six i wish i had known about
postpartum hair loss i had my first baby
three months ago and the hair loss is
horrible so postpartum hair loss is
actually a really interesting phenomenon
to me and it definitely happens most
people experience this but the reason
why is so fascinating to me so the
hormonal changes that happen in
pregnancy and the physiologic changes
that happen in pregnancy make all of
your hairs sync up into the same cell
cycle most of the time you're going
through life and all of your hairs are
in different parts of the cycle they're
either in like growth or maintenance or
ready to fall out phase so in pregnancy
the ratio of antigen phase which are
hairs that are growing and telogen phase
which are hairs that are resting is a
lot higher and then once you are
postpartum that ratio reverses and so
you don't have as much hair growth and
they're all synced up into the same cell
cycle so all of those synced up hair
cycles hair follicles they fall out at
the same time like six to 12 weeks after
delivery so it's really not that your
hair just all falls out it's just that
all the hair that you would have been
losing gradually through pregnancy has
decided to leave at the same time when
you are postpartum and i remember with
every single of my deliveries thinking
yeah actually this is the time that i'm
gonna go bald but it does stop it does
get better and it is a normal
physiologic process that can be
extremely frustrating and sometimes a
little anxiety producing if you are
someone who loves your nice thick hair
that you had in pregnancy
what are you doing
playing with thomas can you let me film
you wanna go find daddy so i can finish
what i'm doing
sorry
number seven water breaking being the
first sign of labor like in every movie
only happens like sometimes my water
didn't break until i was about 15 hours
into labor with my first child then my
second only broke when i was ready to
push this is absolutely true in fact
when we learn about the progression of
labor normal and abnormal in medical
school and in residency water breaking
is not even included like there's no
place in progression of labor where
water having been broken or not is
normal or abnormal that being said your
water breaking does help the process
along in many situations so some of the
products of the water breaking and like
what the cervix makes and the water
being present there can stimulate
certain hormones that can help labor to
progress and help contractions happen so
a lot of times labor will become more
intense after the water breaks but it is
definitely not a necessary part and it
doesn't have to happen at any particular
point to be normal number eight when you
go in for an emergency c-section they
are going to tie your hands and feet to
the operating table with no explanation
to you as to what is happening so there
is almost never a reason that your hands
need to be tied down during a c-section
and you should absolutely ask if that is
something that happens at their facility
if you are awake during your c-section
there's no reason that your hands should
be confined on the table so please
empower yourself because of what i'm
telling you now to ask if that's
standard and to say that you don't want
that the legs part is important because
when you are on the operating table
after you've had a spinal put in your
legs could inadvertently move even
though you probably won't be moving them
they could be moved by somebody else in
the room who's standing there or just by
muscle twitches or something like that
the legs are strapped on not tied down
just so they don't fall off the edge of
the table now with regards to this
person saying that there was no
explanation as to what was happening
that is a massive failure of
communication on the part of the medical
team i have no doubt that this happens
but it's absolutely not standard and it
is unacceptable there is always time to
stop and tell you what is happening even
in the worst of emergencies so if you
are in this situation it's always okay
to say stop i need more information can
someone please explain what's going on i
don't understand or nobody's
communicating with me you shouldn't have
to do that it should be default that
your medical team is communicating well
with you but if it's not happening it is
okay for you to say i need someone to
talk to me number nine back labor severe
back pain while giving birth was much
more painful than actually giving birth
this is actually really really common
and we don't exactly know
why some people get back labor and some
people don't there's probably an
association with a baby that's op or
occiput posterior meaning baby that is
facing out like the head is facing out
instead of to your back
but it's not a one for one everybody
with an op baby does not get back labor
and everybody with an oa baby where
babies facing like the floor if it came
out they don't always not have back
labor it's probably more likely in
people who have back pain with the
menstrual cramps so if you get really
bad back pain when you have period
cramps you may be more likely to have
back labor but we haven't exactly
identified why this happens to some
people and why it doesn't but the
consensus amongst patients who have told
me that it happened is that it is
way worse than actual contractions so i
i believe you number 10 pregnancy brain
is real it's not a joke it's not
exaggerated when you start forgetting
misplacing and outright losing things
you can start feeling as if you're also
losing your mind i feel like i
absolutely experienced this in my
pregnancy as well and i i know how this
person feels i think i've talked about a
story in this
channel at some point where i had put
laundry detergent in the dishwasher and
i yeah anyway that was my pregnancy
brain thing but the literature has
debated back and forth over the years
whether this was an actual thing that
happens the literature has found in many
studies including a meta-analysis from
2018 at least some development or some
level of cognitive dysfunction or
impairment that occurs during pregnancy
there's also some studies that look at
the format of the brain matter and there
have been changes found in that during
pregnancy as well so i believe that this
is a real thing i don't know that i can
prove it with the literature just yet
because it's kind of mixed on our
outcomes but i'm with you i feel like
this has to be a real thing
interestingly there's even a little bit
of data on expectant father's brains and
the changes in memory and cognition and
brain function while their partner is
pregnant as well which is kind of
fascinating all right y'all i hope that
you learned something today i wanted to
go through these because i think that
some of them actually are super
important for people to know before they
get pregnant but i also thought that
some of them were maybe a little bit
scary and not quite um
medically accurate so i just wanted to
go through some of them i hope that you
learned something today if you did leave
a like on this video if you're new here
and you'd like to subscribe we would
love to have you hit that subscribe
button turn on notifications so you
never miss an upload i will see you next
monday
[Music]
you