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>> ANNOUNCER: "SECOND OPINION" IS BROUGHT TO YOU BY BLUE CROSS BLUE SHIELD – ACCEPTED IN ALL 50 STATES. BLUE CROSS BLUE SHIELD – LIVE FEARLESS.

 

>> ANNOUNCER: "SECOND OPINION" IS PRODUCED IN CONJUNCTION WITH UR MEDICINE, PART OF UNIVERSITY OF ROCHESTER MEDICAL CENTER, ROCHESTER, NEW YORK.

 

>> DR. PETER SALGO: THIS IS "SECOND OPINION." I'M YOUR HOST, DR. PETER SALGO. THIS WEEK, "MYTH OR MEDICINE."

 

>> LORALEI THORNBURG: PRE-ECLAMPSIA, OR TOXEMIA OF PREGNANCY, COMPLICATES A LOT OF PREGNANCIES. IS IT OVER? IS YOUR CHANCES DONE OF GETTING IT, ONCE THE BABY IS OUT? FIND OUT MORE ON "MYTH OR MEDICINE."

 

>> DR. PETER SALGO: AND SPECIAL GUEST ANNA SPROUL-LATIMER IS HERE TO SHARE THE STORY OF THE BIRTH OF HER SON AND THE DECISIONS SHE MADE.

 

>> ANNA SPROUL-LATIMER: MY DOCTOR CALLED ME AT NOON ON THAT MONDAY AND SAID, "WELL, THERE'S A LOT OF PROTEIN IN YOUR URINE. I'M GOING TO DIAGNOSE YOU WITH PRE-ECLAMPSIA NOW. YOU NEED TO COME IN TO THE HOSPITAL TODAY, AND WE WILL START AN INDUCTION OF LABOR."

 

>> DR. PETER SALGO: SHE'S HERE FOR A SECOND OPINION.

 

>> DR. PETER SALGO: THANKS SO MUCH FOR BEING HERE, ANNA. I KNOW YOU'VE GOT A LOT TO TELL US, SO WE'RE GOING TO GET RIGHT TO WORK. BUT, FIRST, LET ME INTRODUCE YOU TO YOUR "SECOND OPINION" DOCTORS. THEY'RE GOING TO BE HEARING YOUR STORY FOR THE FIRST TIME. THEY ARE DR. CHRISTOPHER GLANTZ, FROM THE UNIVERSITY OF ROCHESTER MEDICAL CENTER, AND OUR "SECOND OPINION" PRIMARY-CARE PHYSICIAN, DR. LISA HARRIS, FROM OUR LADY OF LOURDES MEMORIAL HOSPITAL. NOW, ANNA, I HAVE TO DO SOMETHING HERE. GUYS, THIS IS A PROFESSIONAL DRIVER UNDER A CLOSED COURSE. DON'T TRY THIS AT HOME, BUT I'M GOING TO TAKE A BIG RISK.

 

>> ANNA SPROUL-LATIMER: OKAY.

 

>> DR. PETER SALGO: I'M A DOCTOR. I CAN DO THIS.

 

>> ANNA SPROUL-LATIMER: DO IT.

 

>> DR. PETER SALGO: YOU'RE PREGNANT, AREN'T YOU?

 

>> ANNA SPROUL-LATIMER: I SURE AM.

 

>> DR. PETER SALGO: OH, THANK GOODNESS. [ CHUCKLES ]

 

>> ANNA SPROUL-LATIMER: I'M NOT JUST DOING THIS TO HIDE AN -- I DON'T KNOW...

 

>> DR. PETER SALGO: [ CHUCKLING ] OKAY.

 

>> ANNA SPROUL-LATIMER: ...MASSIVE WEIGHT GAIN.

 

>> DR. PETER SALGO: ALL RIGHT, WELL, YOU'RE EXPECTING -- WHAT? – YOUR SECOND CHILD.

 

>> ANNA SPROUL-LATIMER: I AM, YES. A GIRL.

 

>> DR. PETER SALGO: A GIRL?

 

>> ANNA SPROUL-LATIMER: YEAH.

 

>> DR. PETER SALGO: AND YOU'RE DUE WHEN?

 

>> ANNA SPROUL-LATIMER: END OF OCTOBER.

 

>> DR. PETER SALGO: ALL RIGHT, SO, THE CLOCK IS TICKING. THIS IS NOT YOUR FIRST PREGNANCY, RIGHT?

 

>> ANNA SPROUL-LATIMER: NO, IT SURE ISN'T.

 

>> DR. PETER SALGO: HAVE A BOY?

 

>> ANNA SPROUL-LATIMER: I DO. A SON NAMED JACK.

 

>> DR. PETER SALGO: OKAY, AND HOW OLD IS HE?

 

>> ANNA SPROUL-LATIMER: HE'S 20 MONTHS.

 

>> DR. PETER SALGO: ALL RIGHT. SO, LET'S DISCUSS YOUR FIRST PREGNANCY, IF WE MAY.

 

>> ANNA SPROUL-LATIMER: SURE.

 

>> DR. PETER SALGO: WHAT WERE THE FIRST MONTHS OF THAT PREGNANCY LIKE?

 

>> ANNA SPROUL-LATIMER: YOU KNOW, I DON'T THINK THEY WERE ANYTHING TOO BAD. I GAINED WEIGHT PRETTY FAST. I GAINED ABOUT 13, 14 POUNDS IN MY FIRST TRIMESTER, WHICH, UNFORTUNATELY, I'VE DONE AGAIN THIS TIME. BUT, YOU KNOW, IT WASN'T SO BAD. I HAD A LITTLE BIT OF BACK PAIN, COMING INTO THE SECOND TRIMESTER, BUT NOTHING THAT I THOUGHT WAS UNUSUAL. OF COURSE, I GOOGLED EVERYTHING.

 

>> DR. PETER SALGO: DOES ANYTHING IN HER STORY CONCERN YOU AT THIS POINT, PANEL? LISA?

 

>> DR. LISA HARRIS: THE FACT THAT SHE GAINED QUITE A BIT OF WEIGHT RAPIDLY.

 

>> DR. PETER SALGO: WHY DOES THAT WORRY YOU?

 

>> DR. LISA HARRIS: WELL, AGAIN, IT INCREASES YOUR RISK, AND YOU HAVE TO START WONDERING ABOUT COMPLICATIONS WITH PREGNANCY.

 

>> DR. PETER SALGO: BUT PREGNANT WOMEN GAIN WEIGHT, DON'T THEY?

 

>> DR. CHRISTOPHER GLANTZ: THEY CERTAINLY DO. IT'S SO COMMON THAT, YES, IT DOES RAISE SOME RISK, BUT IT'S SO COMMON THAT IF YOU WENT TO PIECES EVERY TIME YOU SAW SOMEONE WITH INCREASED WEIGHT GAIN, YOU'D BE INSTITUTIONALIZED BY THE END OF THE WEEK.

 

>> DR. PETER SALGO: STAY OFF THE INTERNET AND DON'T WORRY QUITE SO MUCH ABOUT EVERY POUND. IS THAT THE FEAR?

 

>> ANNA SPROUL-LATIMER: YEAH, AND YOU KNOW, PERSONALLY, I HAD BEEN ON AMPHETAMINES FOR ADHD. SO I STOPPED THEM WHEN I GOT PREGNANT, AND ONE OF THE THINGS THAT HAPPENS WHEN YOU STOP TAKING AMPHETAMINES IS THAT YOU GAIN WEIGHT. SO THERE ARE A LOT OF REASONS WHY I WAS NOT NECESSARILY ALARMED, ALTHOUGH I WAS CERTAINLY VERY ALARMED ON BEHALF OF MY VANITY.

 

>> DR. PETER SALGO: BUT THE PREGNANCY GOES ON, AND WE'RE NOW AT ABOUT 28 WEEKS OR SO. WHAT HAPPENS?

 

>> ANNA SPROUL-LATIMER: WELL, MY DOCTOR TELLS ME THAT I'M MEASURING LARGE. AND THEN I WENT IN FOR MY ULTRASOUND. I HAD POLYHYDRAMNIOS -- TOO MUCH AMNIOTIC FLUID. AND I ALSO -- THE DOCTOR OBSERVED THAT MY PLACENTA WAS ALREADY AT GRADE 3, WHICH IS, I UNDERSTAND, BAD. BUT I DIDN'T UNDERSTAND WHAT ANY OF THESE THINGS MEANT AT THE TIME. SO I WAS CONFUSED, AND OF COURSE, I DID A LITTLE MORE GOOGLING. AND I WAS CONVINCED THAT THE GRADE-3 PLACENTA WAS A HUGE PROBLEM. BUT I ACTUALLY THINK THAT MY DOCTORS WERE MORE CONCERNED ABOUT THE POLYHYDRAMNIOS.

 

>> DR. PETER SALGO: SO, LET'S STOP RIGHT THERE, BECAUSE WE'VE GOT DOCTORS WHO MIGHT HAVE BEEN CONCERNED, WERE THEY YOUR DOCTORS. POLYHYDRAMNIOS, GRADE-3 PLACENTA.

 

>> DR. CHRISTOPHER GLANTZ: WELL, THE PLACENTAL GRADING HAS KIND OF GONE OUT OF FASHION, ACTUALLY. IT USED TO BE A THOUGHT THAT IT RELATED TO THE MATURITY OF THE PLACENTA, AND A GRADE 0 WAS THE LEAST MATURE, GRADE 3 WAS THE MOST MATURE. SO IF YOU HAD A GRADE 3 EARLY, YOU MIGHT THINK, "IS THE PLACENTA GROWING UP TOO FAST, SO TO SPEAK, AND IS IT GOING TO REACH THE END OF ITS LIVELIHOOD, WHICH IS USUALLY NINE MONTHS?" IN REALITY, IT DOESN'T SEEM TO BE SUCH A GOOD PREDICTOR OF ANYTHING. THE POLYHYDRAMNIOS -- THE EXTRA FLUID -- I THINK WOULD BE MORE OF A CONCERN FOR ME, BECAUSE THAT IS ASSOCIATED MORE STRONGLY WITH CERTAIN BIRTH DEFECTS, GENETIC ABNORMALITIES, AND SO ON. AND SO THAT'S WHERE MY MAIN INVESTIGATION WOULD GO.

 

>> DR. PETER SALGO: AND WHAT DID THEY TELL YOU? WHO DID THEY REFER YOU TO? DID YOU CHANGE PROVIDERS?

 

>> ANNA SPROUL-LATIMER: SURE. WELL, I KEPT SEEING MY NORMAL PROVIDER, WHO IS EXCELLENT -- FANTASTIC SERVICE. BUT THEY ALSO REFERRED ME TO A HIGH-RISK MATERNITY SPECIALIST. SO, FOR THE LAST, OH, NINE WEEKS OF MY PREGNANCY OR SO, I WAS SEEING TWO SPECIALISTS A WEEK.

 

>> DR. PETER SALGO: AND DID THEY CONTINUE TO TEST YOU? WHAT KIND OF TESTING DID THEY DO?

 

>> ANNA SPROUL-LATIMER: THEY DID A NON-STRESS TEST -- I THINK, ONCE A WEEK. I'M HAVING TROUBLE REMEMBERING. IF IT WAS ONCE OR TWICE.

 

>> DR. PETER SALGO: WHAT IS THAT?

 

>> DR. CHRISTOPHER GLANTZ: A NON-STRESS TEST IS AN INDIRECT WAY OF SEEING HOW THE BABY IS DOING. OBVIOUSLY, THE BABY IS SEVERAL LAYERS UNDER THE SURFACE, AND YOU CAN'T EVALUATE IT DIRECTLY. SO WE TEND TO LOOK AT HEART-RATE PATTERNS. IF THE HEART-RATE PATTERN SEEMS NORMAL, WE ASSUME THE BABY IS GETTING ENOUGH OXYGEN, GETTING ENOUGH NUTRITION.

 

>> DR. PETER SALGO: BECAUSE THE HEART RATE IS ACTUALLY VERY RESPONSIVE TO SMALL CHANGES IN OXYGEN?

 

>> DR. CHRISTOPHER GLANTZ: CORRECT, CORRECT.

 

>> ANNA SPROUL-LATIMER: HMM.

 

>> DR. PETER SALGO: SO, SHE'S GETTING THE BABY'S HEART RATE LOOKED AT, AND SHE'S CHANGED OR SHE'S ADDED --

 

>> ANNA SPROUL-LATIMER: THREE ULTRASOUNDS EVERY WEEK WITH A HIGH-RISK MATERNITY SPECIALIST.

 

>> DR. PETER SALGO: A HIGH-RISK MATERNITY SPECIALIST. THEN WHAT HAPPENED?

 

>> ANNA SPROUL-LATIMER: WELL, AROUND WEEK 37, I WENT IN TO THE DOCTOR, AND MY BLOOD PRESSURE CAME BACK VERY, VERY HIGH IN ONE READING, AND MY DOCTOR IMMEDIATELY FLAGGED THAT UP. SHE BEGAN ASKING ME QUESTIONS ABOUT HAVE I BEEN EXPERIENCING ANY OTHER SYMPTOMS. AND SHE SAID, PARTICULARLY, HAVE I HAD ANY PAIN RIGHT HERE. AND I FELT SO EMBARRASSED, BECAUSE WITH ALL OF MY GOOGLING, THAT WAS SOMETHING THAT I HAD NOT BROUGHT UP TO HER, WAS THAT I ACTUALLY HAD QUITE SEVERE PAIN RIGHT HERE AND HAD FOR A WHILE. BUT SINCE ABOUT WEEK 20 OF MY PREGNANCY -- UNFORTUNATELY, IT'S STARTING AGAIN NOW -- I'VE HAD REALLY BAD BACK PAIN. AND IT WAS TO THE POINT WHERE, IN ORDER TO DRIVE COMFORTABLY, I HAD TO SLING MY RIGHT ARM OUT OF THE SUNROOF OF MY CAR AND DRIVE LIKE THIS JUST TO SORT OF --

 

>> DR. PETER SALGO: ALL RIGHT, JUST STOP. THIS IS GETTING WORRISOME.

 

>> DR. LISA HARRIS: I THINK THAT'S PART OF THE ISSUE WITH GOOGLING, BECAUSE EITHER YOU BECOME OVERCONCERNED OR YOU BECOME UNDERCONCERNED.

 

>> ANNA SPROUL-LATIMER: RIGHT.

 

>> DR. LISA HARRIS: AND YOU DON'T REALLY BRING UP THOSE CONCERNS TO YOUR PROVIDER, AND WE HAVE TO START TRYING --

 

>> ANNA SPROUL-LATIMER: SO I'M A TOTAL NEUROTIC. I HAVE BROUGHT UP EVERYTHING ELSE.

 

>> DR. PETER SALGO: EXCEPT THE RIGHT-SIDED PAIN.

 

>> ANNA SPROUL-LATIMER: SWOLLEN ANKLES, SWOLLEN FEET. YEAH, EVERYTHING. UGH. JUST SWEATING, DID I HAVE A THYROID ISSUE BECAUSE I WAS COLD ALL THE TIME, BUT NEVER THIS BACK PAIN, WHICH HAD THEN MIGRATED. SO IT FELT LIKE SOMEONE WAS PUTTING A VISE ON MY ENTIRE RIGHT SIDE OF MY BODY. SO I WENT TO THE HOSPITAL. THEY TOOK MY BLOOD PRESSURE AGAIN. IT WAS NOT HIGH THE SECOND TIME THEY TOOK IT IN THE HOSPITAL. AND SO THEY DECIDED TO SEND ME HOME AND WAIT AND SEE, BUT THEN THEY SENT ME WITH THIS GIGANTIC GALLON JUG IN WHICH I WAS SUPPOSED TO COLLECT ALL OF MY URINE.

 

>> DR. LISA HARRIS: AND KEEP IT REFRIGERATED.

 

>> ANNA SPROUL-LATIMER: AND THIS WAS SUPPOSED TO BE MY LAST DAY IN THE OFFICE. BUT I DECLINED TO GO TO WORK WITH MY PEE JUG.

 

>> DR. PETER SALGO: THAT "VANITY" WORD AGAIN?

 

>> ANNA SPROUL-LATIMER: [ LAUGHING ] YES.

 

>> DR. PETER SALGO: SO, WHAT'S GOING ON HERE? RIGHT-SIDED PAIN, HYPERTENSION -- HIGH BLOOD PRESSURE -- COLLECTING THE URINE. HELLP.

 

>> DR. CHRISTOPHER GLANTZ: HELLP, EXACTLY.

 

>> DR. PETER SALGO: THAT'S A PUN -- A MEDICAL PUN. GO AHEAD.

 

>> DR. CHRISTOPHER GLANTZ: WELL, IT'S SOUNDING VERY SUSPICIOUS FOR PRE-ECLAMPSIA, WHERE THE BLOOD PRESSURE GOES UP AND YOU OFTENTIMES SPILL SOME URINE -- UH, PROTEIN. MIGHT SPILL URINE, TOO, BUT PROTEIN INTO THE URINE. HELLP IS SORT OF A SUBSET OF PRE-ECLAMPSIA THAT'S MORE SEVERE.

 

>> DR. PETER SALGO: PRE-ECLAMPSIA IS DANGEROUS TO BOTH THE BABY AND TO MOM, RIGHT?

 

>> DR. CHRISTOPHER GLANTZ: IT IS DANGEROUS TO BOTH BABY AND MOTHER.

 

>> DR. LISA HARRIS: ECLAMPSIA IS WORSE, BUT YEAH.

 

>> DR. CHRISTOPHER GLANTZ: ECLAMPSIA IS WORSE, BUT THAT'S THE "PRE" PART – YOU KNOW, IF YOU WAIT...

 

>> DR. PETER SALGO: YOU'RE ENGAGED TO BE ENGAGED. BUT PRE-ECLAMPSIA.

 

>> DR. CHRISTOPHER GLANTZ: RIGHT. IF PRE-ECLAMPSIA IS HIGH BLOOD PRESSURE AND PROTEIN IN THE URINE, ECLAMPSIA WOULD BE WHEN IT PROGRESSES TO WHERE YOU START HAVING SEIZURES OR CONVULSIONS. THAT, OBVIOUSLY, IS MUCH WORSE. SO I WOULD BE VERY WORRIED ABOUT THIS. HOW THIS FITS IN WITH THE EXTRA AMNIOTIC FLUID, I'M NOT SURE, BECAUSE THAT'S NOT USUALLY CHARACTERISTIC OF PRE-ECLAMPSIA. IT MIGHT BE OF DIABETES OR SOMETHING, WHICH ALSO INCREASES THE RISK OF PRE-ECLAMPSIA.

 

>> DR. LISA HARRIS: DO YOU WANT TO JUST REVIEW WHAT "HELLP SYNDROME" ACTUALLY STANDS FOR?

 

>> DR. CHRISTOPHER GLANTZ: HELLP SYNDROME IS ONE OF THOSE CUTESY ACRONYMS THAT EVERYTHING HAS TO HAVE THESE DAYS. THE "H" STANDS FOR "HEMOLYSIS," WHICH MEANS BREAKDOWN OF THE RED BLOOD CELLS. THE "EL" STANDS FOR "ELEVATED LIVER FUNCTION TESTS" – BUT THEY DROPPED OFF THE "FUNCTION TESTS" BECAUSE IT DIDN'T FIT THE ACRONYM -- MEANING THAT THE LIVER HAS BEEN INVOLVED AND IT'S PRODUCING SOME ABNORMAL ENZYMES. AND THE "LP" IS "LOW PLATELETS." SO IT'S H-E-L-L-P.

 

>> DR. PETER SALGO: OH, BOY. SO, HERE THEY ARE. THEY TELL YOU WHAT? THEY TELL YOU TO DO WHAT? WHAT DID THEY TELL YOU ABOUT WHAT THEY'RE GOING TO DO WITH YOUR PREGNANCY, GOING FORWARD?

 

>> ANNA SPROUL-LATIMER: WELL, I PEED INTO THIS JUG. I BROUGHT IT TO THE LAB ON A FRIDAY NIGHT. THEN, THE WEEKEND HAPPENED. AND THE TESTING DIDN'T HAPPEN, I THINK, UNTIL MONDAY. MY DOCTOR CALLED ME AT NOON ON THAT MONDAY AND SAID, "WELL, THERE'S A LOT OF PROTEIN IN YOUR URINE.I'M GOING TO DIAGNOSE YOU WITH PRE-ECLAMPSIA NOW. YOU NEED TO COME IN TO THE HOSPITAL TODAY, AND WE WILL START AN INDUCTION OF LABOR."

 

>> DR. PETER SALGO: SO, YOU WEREN'T GOING TO MAKE IT TO 40 WEEKS.

 

>> ANNA SPROUL-LATIMER: NO.

 

>> DR. PETER SALGO: AT THIS POINT, WE'RE GOING TO HALT JUST FOR A MOMENT. PANEL, EVERYBODY, STAY RIGHT WHERE YOU ARE, BECAUSE WE'RE GOING TO BE RIGHT BACK AND YOU'RE GOING TO BE ABLE TO GET YOUR SECOND OPINION, AS WELL. BUT, FIRST, HERE IS THIS WEEK'S "MYTH OR MEDICINE."

 

>> ANNOUNCER: PRE-ECLAMPSIA IS A SERIOUS HEALTH CONDITION FOR PREGNANT WOMEN, AND IF UNTREATED CAN CAUSE SEVERE HEALTH PROBLEMS FOR BOTH MOM AND BABY. AND ALTHOUGH BED REST AND CAREFUL MONITORING CAN REDUCE RISKS, THEY DO NOT PREVENT THE PROGRESSION OF THE DISEASE. DOES THIS MEAN THAT PRE-ECLAMPSIA IS ONLY CURED BY DELIVERING THE BABY? IS THIS MYTH OR MEDICINE?

 

>> LORALEI THORNBURG: PRE-ECLAMPSIA IS CURED AT DELIVERY -- THIS IS BOTH MYTH AND MEDICINE, AND I'LL EXPLAIN WHY. I'M LORALEI THORNBURG, ASSOCIATE PROFESSOR OF OB-GYN IN THE DIVISION OF MATERNAL-FETAL MEDICINE AT THE UNIVERSITY OF ROCHESTER. SO, PRE-ECLAMPSIA IS A CONDITION THAT COMPLICATES PREGNANCIES. TYPICALLY, WOMEN PRESENT WITH HIGH BLOOD PRESSURE AND PROTEIN IN THEIR URINE, AND IT CAN HAVE SERIOUS EFFECTS FOR BOTH MOM AND BABY. THINGS THAT WOMEN WANT TO WATCH OUT FOR, WHEN LOOKING FOR PRE-ECLAMPSIA, ARE THINGS LIKE BAD HEADACHES; SEEING LITTLE FIREFLIES, WHICH WE CALL SCOTOMATA OR "FLOATERS," IN FRONT OF YOUR VISION; NEW SWELLING, ESPECIALLY IN YOUR HANDS OR FACE, THAT'S GETTING WORSE INSTEAD OF BETTER. OTHER THINGS INCLUDE PAIN IN YOUR RIGHT SIDE OR IN THE MIDDLE OF YOUR BELLY; BABY NOT MOVING WELL. SEIZURES IS ONE OF THE FINAL STAGES OF PRE-ECLAMPSIA, CALLED ECLAMPSIA. AND OBVIOUSLY, IF THIS WERE TO HAPPEN, YOU WOULD IMMEDIATELY WANT TO SEEK MEDICAL ATTENTION. THE CURE FOR PRE-ECLAMPSIA IS DELIVERY. HOWEVER, UP TO A THIRD OF PRE-ECLAMPSIA OCCURS AFTER DELIVERY. SO JUST BECAUSE YOU DIDN'T HAVE PRE-ECLAMPSIA DURING YOUR PREGNANCY OR DURING THE TIME OF DELIVERY, YOU CAN GET PRE-ECLAMPSIA IN THE SIX TO EIGHT WEEKS FOLLOWING DELIVERY, BEFORE ALL THE HORMONES AND EVERYTHING HAS GONE BACK TO NORMAL. AND THAT'S MEDICINE.

 

>> ANNOUNCER: NOT SURE IF IT'S MYTH OR MEDICINE? CONNECT WITH US ONLINE. WE'LL GET TO WORK AND GET YOU A SECOND OPINION.

 

>> DR. PETER SALGO: WE'RE BACK WITH ANNA, WHO'S KINDLY AGREED TO JOIN US. THANK YOU VERY MUCH.

 

>> ANNA SPROUL-LATIMER: SURE THING.

 

>> DR. PETER SALGO: IT WAS TWO YEARS AGO. YOU WERE 37 WEEKS PREGNANT.

 

>> ANNA SPROUL-LATIMER: JUST ABOUT TWO YEARS, MM-HMM.

 

>> DR. PETER SALGO: AND YOU WERE HAVING SOME PROBLEMS WITH POLYHYDRAMNIOS -- LOTS OF FLUID -- AND THEN YOUR DOCTORS TOLD YOU YOU WERE PRE-ECLAMPTIC, WHICH IS NOT SO GOOD. COME INTO THE HOSPITAL, AND THEY WERE GOING TO INDUCE LABOR. DID I GET THAT PART RIGHT?

 

>> ANNA SPROUL-LATIMER: THAT IS TRUE.

 

>> DR. PETER SALGO: OKAY. RIGHT NOW, WHAT ARE HER CHOICES? IS INDUCTION OF LABOR HER ONLY CHOICE?

 

>> DR. CHRISTOPHER GLANTZ: IN MOST -- IT'S THE STANDARD CHOICE. INDUCTION OF LABOR WOULD NORMALLY WORK. IT WOULD ACHIEVE A VAGINAL DELIVERY. UNFORTUNATELY, WE DON'T REALLY UNDERSTAND WHAT CAUSES PRE-ECLAMPSIA, AND THE ONLY WAY WE KNOW TO CURE IT IS TO DELIVER, WHICH, WHEN YOU APPROACH TERM, IS NOT A BIG ISSUE.

 

>> DR. PETER SALGO: BUT SHE'S 37 WEEKS. NOW, IF I CAN DO THIS IN MY HEAD, 4 INTO 37 IS 9 AND A LITTLE BIT MORE. SHE'S NINE MONTHS. ISN'T SHE FULL-TERM?

 

>> DR. LISA HARRIS: SHE'S NOT FULL-TERM.

 

>> DR. PETER SALGO: EXPLAIN THIS.

 

>> DR. LISA HARRIS: SO, YOU HAVE TO CONSIDER THAT THERE'S SOME VARIABILITY AS TO WHEN PREGNANCY ACTUALLY BEGINS, AND WE TRY TO DO THIS BY DATES OF THE LAST PERIOD, AND THEN GET A LITTLE BIT MORE SOPHISTICATED BY LOOKING AT ULTRASOUND TO TRY TO DETERMINE THE APPROPRIATE DATES. SO WE SAY IT'S ABOUT 40 WEEKS. BUT WE DO KNOW, AND PARTICULARLY FOR PEDIATRICIANS, THAT INFANTS THAT ARE BORN BETWEEN 34 AND 37 WEEKS ARE THE ONES THAT WE TEND TO HAVE THE MOST COMPLICATIONS WITH.

 

>> DR. PETER SALGO: WE WORRY ABOUT IT.

 

>> DR. LISA HARRIS: YEAH.

 

>> DR. PETER SALGO: BUT SINCE PRE-ECLAMPSIA CAN PROGRESS TO LIFE-THREATENING PROBLEMS -- AND BY THE WAY, HELLP IS NO WALK IN THE PARK...

 

>> ANNA SPROUL-LATIMER: RIGHT.

 

>> DR. PETER SALGO: ...WE GOT TO DO SOMETHING. ALL RIGHT? SO, THERE ARE SOME WOMEN, BY THE WAY, WHO, WITHOUT PRE-ECLAMPSIA AND WITHOUT ALL OF THIS, DECIDE A LITTLE EARLY TO JUST HAVE A C-SECTION OR INDUCE LABOR, RIGHT?

 

>> DR. CHRISTOPHER GLANTZ: THERE ARE CERTAINLY PLENTY THAT REQUEST IT. FOR MANY YEARS, THE AMERICAN COLLEGE OF OB-GYN, OUR PROFESSIONAL ORGANIZATION, HAS RECOMMENDED HIGHLY AGAINST THAT. BUT PEOPLE HAVE A TENDENCY TO KIND OF LOOK THE OTHER WAY. I MEAN, THE FACT IS, MOST BABIES BORN TWO TO THREE WEEKS BEFORE THEIR DUE DATE WILL DO WELL. BUT IF YOU LOOK AT THE WHOLE POPULATION, BABIES BORN TWO WEEKS BEFORE DON'T DO AS WELL AS BABIES BORN, SAY, WITHIN THE WEEK.

 

>> DR. LISA HARRIS: THAT'S RIGHT.

 

>> DR. CHRISTOPHER GLANTZ: BABIES BORN THREE WEEKS BEFORE DON'T DO AS WELL AS BABIES BORN TWO WEEKS BEFORE, SO THERE ARE ADDITIONAL RISKS.

 

>> DR. PETER SALGO: I DO WANT TO JUST PAUSE HERE A MINUTE. I WANT TO GET BACK TO YOU.

 

>> ANNA SPROUL-LATIMER: SURE.

 

>> DR. PETER SALGO: I KNOW, IN THE POPULAR MEDIA, WE HAVE HEARD, MORE RECENTLY THAN I WOULD CARE TO HAVE HEARD, ABOUT WOMEN WHO HAVE DECIDED TO GIVE BIRTH EARLY, EITHER WITH A CESAREAN OR DELIVERY, BECAUSE IT DIDN'T FIT THEIR SCHEDULE, THEY DIDN'T WANT TO GET TOO BIG, THEY DIDN'T WANT STRETCH MARKS. AND APPARENTLY, THEY'RE FINDING DOCTORS WHO WILL DO THIS. IS THAT ETHICAL FOR THE DOCTOR? AND IS IT A REASONABLE THING TO ASK FOR?

 

>> DR. LISA HARRIS: WELL, PERSONALLY, I'D SAY -- I'M NOT GOING TO COMMENT WHETHER OR NOT IT'S ETHICAL -- I THINK THERE'S ENOUGH DATA TO SHOW THAT THERE ARE SIGNIFICANT COMPLICATIONS BOTH FOR THE MOTHER AND FOR THE INFANT. CERTAINLY, THE FEDERAL GOVERNMENT GOT INVOLVED A FEW YEARS AGO, IN PARTNERSHIP FOR PATIENTS, TO TALK ABOUT CEASING ELECTIVE DELIVERIES PRIOR TO 39 WEEKS. AND MANY HOSPITAL SYSTEMS HAVE BECOME INVOLVED IN THAT NOW.

 

>> DR. CHRISTOPHER GLANTZ: I'VE ACTUALLY BEEN QUITE INVOLVED IN THIS. I'M BEEN INVOLVED IN THE MARCH OF DIMES AND THE DEPARTMENT OF HEALTH AND, MOST RECENTLY, WITH SOME OF THE CDC EFFORTS. THERE'S BEEN A GROUNDSWELL AGAINST DOING ELECTIVE DELIVERIES BEFORE 39 WEEKS. 39 WEEKS -- WITHIN A WEEK OF THE DUE DATE -- ELECTIVE DELIVERIES, THE OUTCOMES ARE ABOUT THE SAME AS THEY ARE FOR SPONTANEOUS LABOR. BUT BEFORE THEN, IT'S CLEAR THAT THE OUTCOMES ARE NOT AS GOOD. AND ALL THESE PROFESSIONAL ORGANIZATIONS HAVE BACKED INITIATIVES THAT HAVE BEEN ADOPTED NATIONWIDE, AND WE'VE ACTUALLY MADE A LOT OF PROGRESS.

 

>> DR. PETER SALGO: NOW, YOU'RE CHECKED IN TO THE HOSPITAL. THIS IS NOT AN ELECTIVE THING FOR YOU. YOU'RE IN TROUBLE.

 

>> ANNA SPROUL-LATIMER: YEAH.

 

>> DR. PETER SALGO: YOUR PREGNANCY IS IN TROUBLE.

 

>> ANNA SPROUL-LATIMER: THE BABY HAS TO COME OUT.

 

>> DR. PETER SALGO: RIGHT, AND THE INDUCTION IS A MONDAY?

 

>> ANNA SPROUL-LATIMER: YES, IS A MONDAY NIGHT.

 

>> DR. PETER SALGO: AND YOU WERE GOING TO BE INDUCED. THAT IS, YOU'RE GOING TO GET CHEMICALS TO INDUCE LABOR.

 

>> ANNA SPROUL-LATIMER: CORRECT.

 

>> DR. PETER SALGO: AND WHAT DID YOU SAY?

 

>> ANNA SPROUL-LATIMER: WELL, WHAT HAPPENED WAS THAT THERE ARE FOUR DOCTORS IN MY PRACTICE WHO ROTATE THROUGH DELIVERIES, AND THE ONE WHO WAS ON DUTY DID A CERVICAL EXAM TO SEE HOW DILATED I WAS. AND SOMETHING THAT I HAVEN'T TOLD YOU GUYS YET IS I'M A VERY NEUROTIC PERSON, TO THE POINT OF, LIKE, HAVING ANXIETY ISSUES, ESPECIALLY ABOUT PAIN. AND THE BEST WAY I'VE FOUND TO DEAL WITH THIS IS BY SORT OF OWNING UP TO IT -- AND, WELL, A COMBINATION OF THAT AND COMPLETELY BURYING MY HEAD IN THE SAND WHEN I'M AFRAID OF SOMETHING, WHICH IS KIND OF WHAT I HAD DONE WITH CHILDBIRTH. I HADN'T REALLY THOUGHT ABOUT WHAT I WANTED FOR CHILDBIRTH BEFORE RIGHT THIS INSTANT. MY DOCTOR DID A CERVICAL EXAM. AND IT WAS NO MORE PAINFUL THAN A REALLY ENTHUSIASTIC PAP SMEAR, BUT SHE WAS CHECKING TO SEE HOW DILATED I WAS. I HATED IT. IT WAS AWFUL. IT WAS REALLY PAINFUL, AND I WAS THINKING, "OH, MY GOSH, I'M ALREADY, LIKE, TOWARD MY LIMIT. AND I UNDERSTAND THAT LABOR IS A WHOLE LOT WORSE." ANYWAY, I -- THEY PUT THE CERVIDIL IN TO DILATE MY CERVIX FURTHER. I WAS, I THINK, ABOUT ONE CENTIMETER. AND THE CRAMPING ASSOCIATED WITH THAT WAS ALSO UNBEARABLE FOR ME.

 

>> DR. PETER SALGO: OKAY.

 

>> ANNA SPROUL-LATIMER: SO I SPENT A VERY WEEPY, SLEEPLESS NIGHT, CRYING AND WONDERING WHAT MY OPTIONS WERE AND WHETHER I REALLY HAD TO GO THROUGH WITH THIS.

 

>> DR. LISA HARRIS: INDUCTION IS NOTHING LIKE NORMAL PREGNANCY AND A NORMAL DELIVERY. WHEN YOU'RE IN LABOR, YOUR HORMONES KICK IN, IN A WAY THAT MAKES IT A LITTLE BIT MORE BEARABLE, HAVING DONE BOTH. WHEN YOU'RE GETTING PITOCIN AND CERVIDIL, THERE'S NO BREAK. IT'S LIKE, ALL OF A SUDDEN, YOU'RE AT THE TOP OF AN EXTREME CONTRACTION WITH EXCRUCIATING PAIN, AND THEN IT GOES AWAY. AND BEFORE YOU CAN CATCH YOUR BREATH, YOU'RE BACK AT THE TOP OF AN EXTREME INDUCTION.

 

>> DR. PETER SALGO: THIS SOUNDS LIKE A WHOLE LOT OF FUN -- NOT.

 

>> DR. LISA HARRIS: IT ISN'T, IS IT? AND IT'S SOMETHING THAT YOU HAVE TO BE --

 

>> ANNA SPROUL-LATIMER: JUST TO BE CLEAR, I WAS NOT CONTRACTING AT THIS POINT. THIS WAS LIKE CHILD'S PLAY IN THE CHILDBIRTH SPECTRUM OF PAIN, BUT IT WAS A LOT FOR ME ALREADY.

 

>> DR. PETER SALGO: SO YOU DECIDED, EVENTUALLY, TO DO WHAT?

 

>> ANNA SPROUL-LATIMER: GET A C-SECTION. I DECIDED IT THE NEXT MORNING.

 

>> DR. PETER SALGO: SO YOU DECIDED CESAREAN?

 

>> ANNA SPROUL-LATIMER: YES.

 

>> DR. PETER SALGO: NOW, IS THAT A RATIONAL CHOICE -- SOMETHING THAT A DOCTOR SHOULD ALLOW THE PATIENT TO DECIDE? "I DON'T WANT LABOR. I WANT A C-SECTION."

 

>> DR. CHRISTOPHER GLANTZ: AGAIN, THE AMERICAN COLLEGE OF OB-GYN WOULD PROBABLY NOT SAY THAT WAS SUCH A RATIONAL CHOICE UNDER THE CIRCUMSTANCES DESCRIBED. WHAT THEY HAVE SAID IS, THEY'RE VERY CLEAR THAT PEOPLE -- IF A WOMAN'S CONCERN IS PAIN, WE HAVE WAYS OF DEALING WITH PAIN.

 

>> DR. LISA HARRIS: THAT'S RIGHT.

 

>> DR. CHRISTOPHER GLANTZ: THEY COULD BE NARCOTICS, THEY COULD BE AN EARLY EPIDURAL. IF THAT'S THE REAL CONCERN HERE, WE HAVE VERY GOOD WAYS OF RELIEVING THAT PAIN. AND RATHER THAN SUBSTITUTE A SURGICAL SOLUTION FOR A NATURAL DELIVERY, THEIR RECOMMENDATION WOULD BE TO GO WITH PAIN RELIEF.

 

>> DR. LISA HARRIS: BUT I THINK, IN PARTICULAR -- WE TALK ABOUT INFORMED CONSENT -- THE CONCEPT THAT HAVING A C-SECTION IS JUST AN ALTERNATIVE TO NORMAL LABOR AND DELIVERY, IT'S MAJOR, MAJOR SURGERY, FRAUGHT WITH MANY COMPLICATIONS. AND I DON'T THINK THAT PHYSICIANS THAT OPT FOR THAT ARE REALLY DOING A GOOD JOB OF EXPLAINING THE POTENTIAL COMPLICATIONS TO THE PATIENT AND THE BABY.

 

>> ANNA SPROUL-LATIMER: CAN I CUT IN THERE?

 

>> DR. PETER SALGO: DOES THAT MAKE YOU UNCOMFORTABLE TO HEAR THIS?

 

>> ANNA SPROUL-LATIMER: IT DOESN'T MAKE ME UNCOMFORTABLE, BUT I DO WANT TO DEFEND MY DOCTORS A LITTLE BIT. THE PREVIOUS THURSDAY, WHEN I HAD ORIGINALLY BEEN -- MY DOCTOR HAD ORIGINALLY DECIDED TO ADMIT ME TO THE HOSPITAL, I HAD ASKED ABOUT C-SECTION -- LIKE, WHAT'S GOING TO HAPPEN NOW. SHE HAD TALKED ME THROUGH INDUCTION, AND I SAID, "IS IT A POSSIBILITY THAT I MIGHT WANT A C-SECTION AT SOME POINT?" AND SHE HAD GIVEN ME THE – I KNOW THE ACRONYM IS ACOG -- A-C-O-G -- THE PAMPHLET ON ELECTIVE C-SECTION, SAYING BASICALLY EVERYTHING THAT YOU GUYS HAVE SAID HERE, WHICH WAS THAT IT'S NOT GENERALLY THE RECOMMENDED OPTION – THE POTENTIAL SIDE EFFECTS ARE A LOT WORSE. AND KNOWING THAT, I HAD BEEN OKAY WITH ACCEPTING THAT INDUCTION WAS PROBABLY WHAT I NEEDED TO DO. BUT THERE IS ONE THING THAT I HAVEN'T MENTIONED YET, THAT WAS KIND OF THE DECIDING FACTOR THAT GOT ME OFF THE FENCE THE NEXT DAY, WAS THAT THE ATTENDING PHYSICIAN TOLD ME THAT MY PELVIC OPENING WAS VERY SMALL AND MY BABY'S HEAD WAS QUITE LARGE, AND THE INDUCTION HAD A HIGH CHANCE OF FAILING. THIS IS SOMETHING THAT HAS HAPPENED IN MY FAMILY. AND IT HAPPENED, JUST A FEW MONTHS PRIOR, TO ONE OF MY BEST FRIENDS. SHE HAD BEEN LATE AND DID AN INDUCTION BECAUSE OF THAT. THE INDUCTION DID NOT WORK. IT WAS HORRIBLY DISTRESSING FOR HER, VERY PAINFUL. AND THEN SHE HAD A C-SECTION THAT WAS TRAUMATIZING FOR HER, BECAUSE SHE WAS SO EXHAUSTED, SHE WAS SO DEPLETED. SHE FELT PERSONALLY DISAPPOINTED, EMOTIONALLY DEFEATED. AND THAT WAS A NIGHTMARE FOR ME.

 

>> DR. PETER SALGO: SO YOU FELT EMPOWERED TO MAKE A DECISION.

 

>> ANNA SPROUL-LATIMER: MM-HMM.

 

>> DR. PETER SALGO: YOUR PHYSICIANS WENT ALONG WITH THAT DECISION.

 

>> ANNA SPROUL-LATIMER: YES.

 

>> DR. PETER SALGO: SO CHOICES, CHOICES, CHOICES. CHOICES ON THE PART OF PHYSICIANS, CHOICES ON THE PART OF PATIENTS, AND CHOICES BY PHYSICIANS TO ALLOW PATIENTS TO MAKE DECISIONS WHICH ARE COMPLEX MEDICAL DECISIONS. WELCOME TO THE 21ST CENTURY.

 

>> DR. LISA HARRIS: CORRECT.

 

>> DR. PETER SALGO: I WANT TO LEAVE A LITTLE TIME HERE, BECAUSE YOU'VE GOT TWO WONDERFUL EXPERTS. YOU'RE COMING UP ON PREGNANCY AND DELIVERY NUMBER 2.

 

>> ANNA SPROUL-LATIMER: MM-HMM.

 

>> DR. PETER SALGO: THIS IS YOUR CHANCE TO ASK ANY QUESTIONS YOU LIKE FOR YOUR SECOND OPINION. SO THE FLOOR IS YOURS.

 

>> ANNA SPROUL-LATIMER: SURE. WELL, CURRENTLY, MY PLAN IS TO HAVE A C-SECTION AGAIN. MY DOCTORS HAVE TALKED ABOUT PERHAPS SCHEDULING IT FOR WHEN I'M 39 WEEKS UNLESS PRE-ECLAMPSIA COMES BACK. WHAT DO YOU GUYS THINK OF THAT?

 

>> DR. LISA HARRIS: I GOT TO TELL YOU MY PERSONAL STORY. I WAS PRE-ECLAMPTIC WITH HELLP SYNDROME AND HAD AN INDUCTION AT 35 WEEKS...

 

>> ANNA SPROUL-LATIMER: WOW.

 

>> DR. LISA HARRIS: ...BECAUSE OF THE SEVERITY OF THE PRE-ECLAMPSIA. THAT FAILED. WE LOST FETAL HEART TONES AND HAD AN EMERGENCY CESAREAN SECTION. AND WITH THE SECOND CHILD -- AND THERE WERE A LOT OF COMPLICATIONS BOTH FOR ME AND FOR MY CHILD IMMEDIATELY AFTER THAT SURGERY. SO, WITH THE SECOND ONE, I'M THINKING, "WELL, IF I'M PRE-ECLAMPTIC AGAIN, WE'RE JUST GOING TO DO ANOTHER C-SECTION." BUT WE ACTUALLY DID A VAGINAL BIRTH AFTER CESAREAN, AND IT WAS WONDERFUL. AND THE PAIN THAT YOU THINK YOU'RE -- YES, THEY HAVE WONDERFUL DRUGS.

 

>> [ LAUGHTER ]

 

>> ANNA SPROUL-LATIMER: WHICH I TOOK IN ABUNDANCE, YEAH.

 

>> DR. LISA HARRIS: AND BEFORE YOU KNOW IT, THE BABY IS THERE, AND YOU DON'T HAVE ALL OF THAT POST-OPERATIVE REPAIR.

 

>> ANNA SPROUL-LATIMER: WHICH WAS NOT SO BAD FOR ME. I DON'T WANT TO, LIKE, TELL EVERYONE IN THE AUDIENCE THAT IT'S DEFINITELY NOT GOING TO BE FOR THEM, EITHER. OBVIOUSLY, A LOT OF SEVERE COMPLICATIONS.

 

>> DR. PETER SALGO: ANY COMMENTS ON HER QUESTION?

 

>> DR. CHRISTOPHER GLANTZ: WELL, I THINK THAT, IN THE '90S, THERE WAS A VERY STRONG ENTHUSIASM FOR TRYING TO AVOID HAVING A REPEAT SECTION. AND, UNFORTUNATELY, ONE OF THE PROBLEMS IS, IF YOU DO TRY LABOR AFTER A PREVIOUS CESAREAN SECTION, THE SCAR ON THE UTERUS IS NEVER QUITE AS STRONG AS IT WOULD BE BEFORE IT WAS SCARRED. AND THERE IS A POSSIBILITY OF THAT COMING APART, WHICH IS A CATASTROPHE. THE FACT IS, MOST WOMEN WHO DO TRY LABOR, THOUGH, ARE SUCCESSFUL, AND THEY AVOID ANOTHER CESAREAN, WHICH IS A MAJOR SURGERY, AS LISA SAID. AND I THINK THAT'S -- HONESTLY, IN MY OPINION, THAT'S A GREAT THING. HOWEVER, WHAT I THINK IS NOT NECESSARILY WHAT EVERYONE ELSE DOES. AND WHAT IS HAPPENING IN THE POPULATIONS THESE DAYS IS, ONLY ABOUT 15% OR 20% OF WOMEN WHO HAVE HAD A PREVIOUS CESAREAN OPT TO TRY LABOR AGAIN. SO YOU'RE IN THE MAJORITY HERE.

 

>> ANNA SPROUL-LATIMER: I JUST HAD A WONDERFUL EXPERIENCE. I MEAN, I HATE SAYING THAT. I HOPE IT DOESN'T CONSTITUTE ANY KIND OF MEDICAL RECOMMENDATIONS. OBVIOUSLY, I'M A TOTAL DOOFUS ABOUT THESE THINGS. BUT IT WAS MY DREAM EXPERIENCE.

 

>> DR. PETER SALGO: "DOOFUS" IS IN THE MEDICAL TEXTBOOK, TOO, SOMEWHERE.

 

>> ANNA SPROUL-LATIMER: I WAS FULLY PRESENT, JUST REALLY THERE EMOTIONALLY AND PHYSICALLY FOR THE BIRTH OF MY CHILD. I CRIED AND THEN TRIED NOT TO CRY, 'CAUSE I WAS AFRAID I WAS JIGGLING MY INNARDS AND WOULD MESS UP THEIR REPAIR ACTIVITY. BUT IT WAS JUST A PHENOMENAL EXPERIENCE.

 

>> DR. PETER SALGO: I WANT TO THANK YOU FOR BEING HERE, ANNA.

 

>> ANNA SPROUL-LATIMER: THANK YOU.

 

>> DR. PETER SALGO: THANK YOU FOR BEING HERE, AS WELL. I WANT TO THANK YOU FOR YOUR INSIGHT, BY THE WAY, INTO THE CASE AND YOUR INSIGHTS INTO HER CASE. I'D LIKE TO KNOW WHAT YOU THINK ABOUT TODAY'S DISCUSSION AND ANNA'S SECOND OPINION BY TWEETING US OR BY COMMENTING ON OUR FACEBOOK PAGE. AND NOW HERE'S THIS WEEK'S "SECOND OPINION 5."

 

>> DR. MIRANDA HARRIS-GLOCKER: HELLO. I'M DR. MIRANDA HARRIS-GLOCKER, AND I'M HERE TO TELL YOU FIVE THINGS TO KNOW WHEN CONSIDERING YOUR DELIVERY OPTIONS. THE FIRST IS YOUR SUPPORT SYSTEM. FOR C-SECTIONS, MOST HOSPITALS ALLOW ONLY ONE SUPPORT PERSON TO BE WITH YOU IN THE ROOM. IF YOU HAVE A VAGINAL DELIVERY, YOU MAY BE ABLE TO HAVE MORE THAN ONE. WHOMEVER YOU CHOOSE, BE SURE YOU AND THEY ARE UP FOR A PERHAPS-LONG PROCESS AND ABLE TO BE SUPPORTIVE AND ENCOURAGING OF YOU THROUGHOUT THE ENTIRE EXPERIENCE. THE NEXT IS MEDICAL PAIN MANAGEMENT. THERE ARE SEVERAL OPTIONS FOR PAIN MANAGEMENT DURING THE LABOR PROCESS. EACH OF THESE OPTIONS ARE ADMINISTERED AT DIFFERENT PORTIONS OF YOUR LABOR. IT'S BEST TO TALK TO YOUR DOCTOR ABOUT EACH OF THESE OPTIONS AND FIND OUT IF ANY ARE RIGHT FOR YOU. THE THIRD IS THE ROUTE OF DELIVERY -- VAGINAL OR C-SECTION. IT IS ALWAYS THE GOAL OF ANY OBSTETRICAL PROVIDER TO HAVE A VAGINAL DELIVERY FOR A PATIENT. HOWEVER, THERE ARE SEVERAL CONDITIONS WHERE THE VAGINAL ROUTE OF DELIVERY IS CONTRAINDICATED AND A C-SECTION MAY BE NECESSARY. ANOTHER IS TO INDUCE LABOR OR LET THINGS HAPPEN NATURALLY. NEWER EVIDENCE INDICATES NATURAL LABOR IS TRULY BEST FOR BOTH MOM AND BABY. GOING PAST YOUR DUE DATE IS VERY COMMON. INDUCING LABOR, ESPECIALLY IN FIRST-TIME MOMS, HAS BEEN SHOWN TO LEAD TO HIGHER C-SECTION RATES. SO IF EVERYTHING LOOKS GOOD, JUST LET NATURE TAKE ITS COURSE. LASTLY, KNOW YOUR OPTIONS AFTER DELIVERY, SUCH AS SKIN-TO-SKIN CONTACT OR HAVING A CHILD BATHED FIRST, BREAST VERSUS BOTTLE-FEEDING, AND WHO YOU WOULD LIKE TO CUT THE UMBILICAL CORD. AND THAT'S YOUR "SECOND OPINION 5."

 

>> DR. PETER SALGO: THANK YOU SO MUCH FOR WATCHING. AND REMEMBER, YOU CAN GET MORE SECOND OPINIONS AND PATIENT STORIES ON OUR WEBSITE AT SECONDOPINION-TV.ORG. YOU CAN ALSO SEND US YOUR SHOW IDEAS AND SHARE YOUR OWN HEALTH STORY. MAYBE -- JUST MAYBE -- WE'LL INVITE YOU TO BE ON THE SHOW WITH US. YOU CAN CONTINUE THIS CONVERSATION ON FACEBOOK AND TWITTER, WHERE WE ARE LIVE EVERY DAY WITH BREAKING HEALTH NEWS. I'M DR. PETER SALGO, AND I'LL SEE YOU NEXT TIME FOR ANOTHER "SECOND OPINION."

 

>> ANNOUNCER: "SECOND OPINION" IS BROUGHT TO YOU BY BLUE CROSS BLUE SHIELD – ACCEPTED IN ALL 50 STATES. BLUE CROSS BLUE SHIELD – LIVE FEARLESS.

 

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