Responses from Dr. Danielle Wurtz, DO

What are realistic expectations after having a baby?

“I always tell first-time parents in the first two weeks, if you can keep your baby alive and brush your teeth, you’re winning. And the second one is optional. It’s such a big change. Newborns having a schedule is definitely fake news.”

What are the most common old wives’ tales you hear?

“Sometimes it’s more of the silly things, things that I wish were true. Where heartrate can predict the gender, but when babies are little they have fast heartrates then it slows down as they grow. That’s normal and doesn’t matter for gender. Or the ring on the string, I hear about that one too.” 

“Then we hear about heartburn and that means the baby has hair. But, no, the poor mommies just have heartburn no matter what. The baby is taking up room and in pregnancy your GI system completely slows down. It also causes constipation.” 

What about dietary restrictions and common myths?

“I actually see more of that with breastfeeding. People think they can’t eat spicy stuff or that if they eat something it will make the baby’s stomach upset. But think about how many different nutrition and dietary cultures with spicy food or garlic? You will learn with your baby what is fine and different flavors are good exposure to a variety of different nutrition. The real exception is cow’s milk and dairy, that’s a whole other twist. There are allergies and intolerances where it’s not a true allergy but it can still make the baby uncomfortable. We see that in adults too.” 

What about rumors that pregnant women shouldn’t reach or lift? 

“Exercise is good, you can lift things. Don’t start training for an ultra marathon or anything, but it’s good for the body to move. Especially if you already train. If you’ve done something [exercise], you are encouraged to continue. In the first trimester, there’s nausea and overwhelming fatigue so it can be harder to move, but if you have the energy it can be good for you and for baby.”

What’s proper weight gain?

“It’s very patient-dependent. Usually, 20-30 pounds is what’s considered healthy. There can actually be weight loss in the first trimester, and that’s normal even if you don’t have nausea and vomiting. Some get more medically sick and it needs to be addressed. I try to steer patients against the ‘eating for two’ mindset and focus on eating healthy.”

Is it a “good sign” to be nauseous? 

“Again that’s patient-dependent. Some people get carsick and some don’t, it’s just how your body is built. Even pregnancy to pregnancy with the same woman it can change. It really just is that moment in time and there aren’t necessarily consistencies. It can be hard if you are sick then start to feel better but it’s too early to feel the baby kick or any movement. It feels good to feel good but our mommy brains find things to worry about.”

What’s something you want your patients to focus on?

“A big focus is staying positive and talking about mental health. Not just during pregnancy but after. It’s a lot more common to talk about postpartum depression or anxiety. It can take up to 18 months for hormones to go back to normal, which is such a long period of time. So we want to focus on our mental health and what’s normal even after baby has been born. The stressors that moms carry around can have long-term effects. Where we can manage those, medications can actually be healthier for babies.”

What’s something that’s important to you during birth? 

“The golden hour after birth and getting skin-to-skin time is important. Once baby is stabilized we try to leave them on mom’s chest to do assessments just because of the health benefits that mom and baby get. That comes from places outside of the U.S. where the healthcare is not as robust and there are more preterm births. Babies who were put on mom’s chest right after birth, they were doing better than they should have been doing. That’s where that information came from. I focus on it even with a c-section. The baby can feel your heartbeat and listen to mom’s voice. Those are things that are comforting and helps with temperature control and their breathing. Eye meds, vaccines, everything can wait. People will ask ‘Wait how big is the baby?’ and we say ‘We’ll tell you later; the baby is healthy sized.’” 

What is the partner’s role?

“It’s very couple dependent. I’ve delivered babies where dads want to be super involved and do the coaching, they’re holding legs, they’re rubbing backs. But if they’re uncomfortable, I have two patients, not three, so I ask them to sit. I once caught a dad during an epidural and it wasn’t their first child. They can be as much involved in that labor process as the mother would like them to be. It’s great when they’re there and able to provide that mental and physical support.  

How common are epidurals? 

“On average I deliver 20 babies a year, including c-sections. There are probably three or four unmedicated. Some will take a pain med during early stages. It might work well the first time, it usually does not work well the second time. But if we’re actively transitioning and going to have a baby soon, we don’t want the baby to have that in their system. I’ve heard women felt like they remembered more and knew what was going on with an epidural and one mom who pushed for three hours without [any medication]. It’s all about patient preference; the prize at the end is the same. Unless that baby is crowning they still have time for an epidural. I’ve had moms who were at a 10 and we put something in because dilating might be complete but we still have a lot of work to do. The rule too is ‘Not your vagina, not your choice,’ for other medical providers or support people in the room. This is not a badge of honor competition for me as a physician, it’s just my job to support.” 

Why do epidurals sometimes not work?

“If you go to a regular anatomy book, you know there are nuances between each person. Sometimes it goes in at the certain level of the spine and it works beautiful. Sometimes someone is built a little different and it hits a little different or on one side vs. the other. I also have a lot of moms who have a hot spot – just one little spot where they feel pain. It used to be common they would turn down the epidural when it was time to push. Sometimes if mom feels blind I can use a mirror or use other tricks to help. There are lots of different ways to push, not just laying flat on their back with legs in the air. If they want the epidural turned down we will do that, but it’s not the only choice.” 

When should patients see their provider about trying to get pregnant?

“I really enjoy preconception counseling but I don’t know that it happens as often as I would like. If someone is trying and nervous, give it six months and come talk to me. It’s actually good to take prenatal before you try to conceive, but also we can talk about your age and how long it takes to get pregnant. A young, healthy 20s mom it can take up to 12 months and it’s considered a normal range. As we age, that egg supply is less and our hormones are changing. We also talk about the risks of complications, which goes up especially after 35 then at 40 we hit a whole new ballgame. Really it’s all about family history, patient specifics, and managing for those variables.”