Pregnant? This Caffeine Shot is for You…Maybe

by Melissa Garvey, ACNM Writer and Editor

The American College of Obstetricians and Gynecologists released a Committee Opinion this month entitled Moderate Caffeine Consumption During Pregnancy. The Committee Opinion examines a long-standing debate: is maternal caffeine consumption related to spontaneous miscarriage?

Caffeine raises a woman’s levels of catecholamines—hormones released into the blood in response to stress—and crosses the placenta to her unborn child. Sources of caffeine include coffee, tea, soft drinks, and chocolate.

Most studies on the relationship between caffeine and miscarriage have significant limitations, including small sample size and recall bias. The new Clinical Bulletin explores the results of several recent, higher-quality studies. The good news is that they found no link between moderate caffeine consumption and miscarriage. However, the results regarding higher levels of caffeine consumption are not black and white. The Committee Opinion states:

“Moderate caffeine consumption (less than 200mg per day) does not appear to be a major contributing factor in miscarriage or preterm birth. The relationship of caffeine to growth restriction remains undetermined. A final conclusion cannot be made at this time as to whether there is a correlation between high caffeine intake and miscarriage.”

Nutrition research can be especially challenging due to the difficulty of isolating various nutrients and controlling for confounding factors. For example, are the women consuming large amounts of caffeine in these studies getting a good night’s sleep? Are they using caffeine to keep up with a high-stress job?

What are your thoughts on this Committee Opinion? If you’re expecting, will it change your caffeine habit? Midwives, will this affect the advice you give to your patients and clients?

Midwife Develops iPhone Application for Expectant Parents

by Melissa Garvey, ACNM Writer and Editor

If you’re an ACNM member, you may remember Sandie Mulcrone, CNM, from the Spring 2008 and Spring 2009 issues of Quickening. I first interviewed Sandie after she successfully pioneered her way to a new hospitalist position at Advocate Christ Medical Center in Oak Lawn, IL. One year later, Sandie contacted me to share how she started her own business to improve women’s access to breastfeeding equipment. This summer, she’s at it again with yet another pioneering idea: iBabySono.

iBabySono is an iPhone application that allows expectant parents to store, sort, display, and share their baby’s ultrasound photos via iPhone, Facebook, and other online channels. Parents simply download their ultrasound pictures, then use iBabySono to upload the images and create virtual scrapbooks, calculate baby’s age, post images to Facebook, and send e-mail attachments to friends and family.

“Expectant moms and dads are experiencing one of the most exciting times of their lives,” says Sandie. “This is their future, a little person who represents their hopes and dreams. iBabySono lets them share that excitement and that joy with everyone they love from the earliest possible stages of their baby’s development.”

iBabySono is $2.99 in the iTunes app store and comes with a $10 discount for use at Sandie’s business, Perinatal Home Medical Supply.

What are some of your favorite apps for expecting and new parents or families?

Managing Depression during Pregnancy and Lactation

by Melissa Garvey, ACNM Writer and Editor

Between shifts at the information booth and shadowing the photographer, I was lucky enough to sample a few of the great education sessions on tap at this year’s ACNM Annual Meeting. I was most looking forward to meeting fellow bloggers Mary Murry, Amie Newman, and Amy Romano, but I also managed to slip into “Psychiatric Medications in Pregnant and Breastfeeding Women: Risks and Benefits,” which was taught by Beth Conover, MS, APRN, CGC, from the Nebraska Teratology Information Service.

Beth addressed a number of psychiatric conditions and medications, and designed her presentation for health care providers. But, as a health care consumer, the information on managing depression struck me the most. Did you know that during pregnancy, symptoms of depression affect 10 – 20% of women? Here’s what I learned, which I suspect is relevant to many of my fellow midwifery care consumers out there.

According to Beth, untreated depression may increase a woman’s risk for miscarriage, pregnancy-induced high blood pressure, preterm delivery, or low birth weight. There are numerous lifestyle adjustments and therapy options that may be sufficient to keep depression at bay. However, some women require medication to treat their depression. Untreated depression during pregnancy carries risks; medication during pregnancy carries risks. In fact, just by being human, every woman has a 3% chance of having a baby born with a congenital anomaly (aka something unusual or different at birth). There are no zero-risk options.

The good news is that there are low-risk, relatively safe options proven to help women with depression cope and even thrive through their preconception, pregnancy, and postpartum experience. If you’re interested in the specific risks and benefits of a particular psychiatric medication during pregnancy and breastfeeding, Beth recommended perusing the Organization of Teratology Information Specialists’ FAQ sheets in English and Spanish (and, as always, you should consult your health care provider).

Another tip Beth gave is not to rely solely on the FDA codes that rank medications as category A, B, C, D, or X. Risk classifications are based on the best data available, which are often results from studies on animals. They don’t always accurately reflect risk status either. For example, birth control pills are in category X not because they are likely to cause serious harm to a developing fetus, but because they aren’t prescribed during pregnancy. (If a woman is pregnant, why would she need birth control?) It can also take a long time for a medication to move to the category that best reflects the current available scientific evidence.

Now it’s your turn. What sessions did you attend? Which were your favorites?

The Evidence is In: Texting Helps Teen Moms

by Melissa Garvey, ACNM Writer and Editor

In February, ACNM signed on as an outreach partner with Text4Baby and I posed the question, “Do you expect Text4Baby to make a meaningful difference in the lives of women and their babies?” I found the answer this week on MTV’s 16 and Pregnant. Watch the clip below for an inside look at how Text4Baby is, without a doubt, making a difference.

MTV Shows

Text “BABY” to 511411 to sign up for free.

How Pregnant Women and New Moms Should Prepare for H1N1 Flu

Midwives, pregnant women, and new moms, watch this webcast for the latest on what you should know about H1N1 flu. Features questions from the public and answers by experts from ACNM, CDC, and NIH.