DEAR READERS: In yesterday's column, I discussed new evidence that the Zika virus probably causes a brain birth defect that leads to small heads and brains (microcephaly). This can occur when a pregnant woman is infected early in pregnancy, when the baby's brain is developing.
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.
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.
DEAR READER: In yesterday's column, I answered questions about the Zika virus. Today, I'd like to answer several more, and also talk about how we can protect ourselves against this and other epidemics.
DEAR READERS: Not surprisingly, we've been getting lots of letters about the Zika virus. In today's column, I'd like to answer the questions that many readers are asking.
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.
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.
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.
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.
DEAR DOCTOR K: My husband and I are planning on having our first baby. I've been told that what I eat, and how much stress I have while I'm carrying the baby, could affect the baby's health decades later. That seems hard to believe. Is there any truth to it?
DEAR READER: It makes sense that a child's nutrition and exercise during childhood might affect the child's health as an adult. But it's harder to imagine that your behavior and your health while you are pregnant could affect your child's health for decades to come. But over the past 35 years, many studies have found that a mother's diet and stress levels can shape her child's health in middle age.