Pregnancy

Is it safe to take an antidepressant during pregnancy?

DEAR DOCTOR K: I have been on SSRI medicines for depression for five years. I'm trying to get pregnant, and I hear that SSRIs might be dangerous. What do I need to know?

DEAR READER: I love to receive questions that I can answer confidently. Yours is not one of them. The evidence from different studies is conflicting. Here's my best attempt to weigh the risks against the benefits.

Is there any new information on the link between Zika virus and birth defects?

DEAR DOCTOR K: In a recent column, you said that doctors were still conducting research to see if the Zika virus does, as feared, cause birth defects -- particularly, babies born with small heads and brains. Has there been any new information on that?

DEAR READER: There has, and it's important. The new information was summarized in articles in the New England Journal of Medicine in April.

I have a heart condition. What do I need to know before I get pregnant?

DEAR DOCTOR K: I have a heart condition. What do I need to know before I get pregnant?

DEAR READER: When a woman is pregnant, her heart is working for two. Blood passes through her placenta to her baby. This places additional demands on her body's circulatory system, particularly the heart. Among other changes, her heart pumps a much higher volume of blood each minute. As a woman with a heart condition, it's particularly important for you to understand what this added workload might mean to your health, and to your baby's.

What happens during a C-section?

DEAR DOCTOR K: My doctor says she is going to have to deliver my baby by C-section. What will happen during this procedure?

DEAR READER: A cesarean delivery, or C-section, is surgery to deliver a baby through the abdomen. It may be scheduled in advance when a woman cannot or should not deliver the baby through the vagina. A C-section may also be performed if continuing with labor or delivery becomes risky to the mother or baby. Finally, a cesarean may be done as an emergency procedure if there is immediate risk to a mother or baby.

Does the pain medications used during childbirth pose any risks to my baby?

DEAR DOCTOR K: I'm about to have my first baby. Can you tell me about medications that may be used during childbirth? Will they pose any risks to my baby?

DEAR READER: Many medications can be given for pain relief during childbirth. Other drugs may be given to assist your labor. The pain medicines may not stop pain completely, but they will greatly lessen it. Narcotics such as meperidine (Demerol) are frequently used to relieve labor pain. If a baby is born soon after a mother receives any narcotic, the baby's rate of breathing may be slower than normal at birth. This effect generally is short-term. If it occurs, it can be reversed with an anti-narcotic drug.

It is safe to have the pertussis vaccine while pregnant?

DEAR DOCTOR K: I am pregnant. My doctor wants me to have a pertussis vaccine. Why? And is this safe?

DEAR READER: Pertussis, also known as whooping cough, is a highly contagious bacterial infection that causes violent coughing. The coughing makes it hard to breathe and produces a deep "whooping" sound. Pertussis bacteria spread through droplets that move through the air when an infected person sneezes, coughs or talks. Pertussis can occur at any age, but serious illness is most common in infants and young children.

I have Type 2 diabetes, how can I achieve a healthy pregnancy?

DEAR DOCTOR K: I have Type 2 diabetes, and I would like to get pregnant. What can I do to increase my chances of having a healthy baby?

DEAR READER: Like you, some women already have either Type 1 or Type 2 diabetes before they become pregnant. There also is a kind of temporary diabetes that develops during pregnancy called gestational diabetes. It goes away after the baby is born. You're right to be concerned. Type 1, Type 2 and gestational diabetes all cause high blood sugar and can cause pregnancy complications. But for this column, I'll focus on pregnancy and Type 2 diabetes.