Today women have access to more care, better information and more options in their child-bearing years than their grandmothers could have ever imagined. Doctors say it’s changing the way women have children – for the better.
Genetic Testing
Shailen Shah, MD
Today parents can learn more about their unborn child than ever before, says Shailen Shah, MD, a maternal-fetal medicine specialist at Virtua Health.
“The menu of genetic tests has skyrocketed,” says Shah. “The most common test we use today is a cell-free DNA test, commonly known as testing for Down Syndrome, but it also tests for other common genetic disorders.”
The test is simple, but the implications are not. Before testing, couples should ask themselves what assurance they need about their child’s health. What risks can they live with? What would they do with the results? Do they want the testing at all? And they don’t have to make these decisions alone. Genetic counselors educate patients on the pros and cons of undergoing testing, counsel them through testing options and explain results.
“The tests we’re using now are highly accurate,” says Shah. “We’re seeing only 1% false positive rates, compared to between 5 and 10% a decade ago.”
He says other in-office tests may not be as accurate as the cell-free DNA one, and new parents should discuss false-positive rates with their doctor.
“These tests are not meant to scare parents,” says Shah. “They’re often my most powerful tool to reassure parents that everything is healthy and normal.”
Cancer Diagnosis
Elyce Cardonick, MD
Cancer patients are told it’s not safe to conceive a child while undergoing treatment. But what happens when a mother is diagnosed with cancer while pregnant?
Recent studies show that doctors can treat cancer in a way that’s safe for both mother and baby, says Elyce Cardonick, MD, director of the Cancer and Childbirth Registry at Cooper University Health Care.
“It seems shocking, but mammograms, biopsies, surgeries, chemotherapy, MRIs and CAT scans can be used to treat cancer without harming the baby,” says Cardonick.
Roughly 1 in 1,000 women are diagnosed with cancer while pregnant, she says, and emerging studies have found no long-term effects of certain cancer treatments on a baby’s development.
“We’ve found that babies born prematurely have a significantly higher risk of neurodevelopmental issues than those with chemotherapy exposure,” she says.
Chemotherapy cannot be used during the first trimester and is stopped 3-5 weeks before birth. For many patients, the decision is not as simple as delaying treatment until they give birth.
“When it comes down to it, the way to have a healthy baby is to have a healthy mom,” she says. “By putting off treatment, you’re allowing cancer to grow, which can put moms at an advanced, more serious stage after birth. For the baby, it can cause low birth weight, lower oxygen levels and premature birth. But the data is reassuring – we can treat the mother’s cancer while keeping the baby safe.”
High-Risk Management
Robert Berk, MD
High-risk pregnancies are any pregnancies that are out of the norm, especially those with underlying medical conditions, like gestational hypertension or gestational diabetes. Both are brought on by pregnancy, and if not treated, can cause issues later in life. Carrying twins or triplets and being what is considered an advanced maternal age (typically 35 and over) also puts women at higher risk.
“While there are similarities between the same high-risk conditions, everyone’s body reacts and performs differently, and we personalize care for each patient,” says Robert Berk, MD, an OB/GYN at Capital Health.
For some, that may mean more frequent office visits, additional testing to evaluate the baby’s well-being, fetal heart monitoring and regular ultrasounds. Some recommendations apply to every mother, such as reducing the risk of obesity through diet and exercise – plus, controlling blood sugar, and avoiding alcohol and smoking.
“All of that doesn’t have to start when you become pregnant or start trying for kids,” says Berk. “Couples with concerns should make an appointment before conception to create a game plan that helps them realize a healthy pregnancy, no matter what risk factors arise.”
Postpartum Care
Benjamin DiJoseph, DO
Maternal care doesn’t end when the baby is born, says Benjamin DiJoseph, DO, an OB/GYN at Inspira Medical Group.
“New mothers need a lot of support during these months, both physically and emotionally,” he says.
This care involves different follow-ups, such as testing and treatment for women facing high-risk factors and treatment for vaginal tearing or a C-section.
“We talk to mothers about everything from breastfeeding to contraception,” says DiJoseph. “But one of the most significant changes in care is careful screening for postpartum depression, which didn’t often get the attention it deserved years ago.”
Screenings continue for weeks after delivery to ensure issues don’t develop after leaving the hospital.
“Addressing these health concerns helps new mothers get proper care for themselves and give proper care for their babies, so they can bond and truly enjoy this newborn stage,” he adds.
