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Healthy Mom, Healthy Baby

Toscani
Parents-to-be Tatum and Nick Toscani admire baby items at the Berry Women’s Center Gift Shop at MVH.

Tatum Toscani and her husband, Nick, were thrilled when they discovered in February that they were expecting their first baby. They shared the news with friends and family, began thinking about colors for their nursery and even came up with a few baby names. But along with the excitement, there was a serious realization: Tatum was now responsible not only for her own health, but also for her child’s.

“I want to do everything I can to have a healthy pregnancy,” says Tatum, 24, who is a pulmonary nurse. “There’s a lot to learn and keep track of, but it’s worth it.”

When questions arise, Tatum often refers to her copy of What To Expect When You’re Expecting, a book that has provided guidance for pregnant couples since it was first published in 1984. She seeks advice from her sister-in-law, whohas given birth to two daughters at Miami Valley Hospital. And, perhaps most importantly, Tatum regularly visits her obstetrician/gynecologist, Luis Morales, MD, and follows his recommendations closely.

“Tatum is doing everything right during this pregnancy,” says Dr. Morales, whose medical practice is located at the Berry Women’s Center at MVH. “She became my patient long before trying to conceive – before she was even married, in fact. All women should establish a relationship with an OB/GYN by the time they are 18, regardless of whether they are planning to have children. It is key to maintaining overall health and detecting problems early, when they are easiest to treat.”

Preventing Problems by Planning Ahead

Tatum told Dr. Morales about her plans to become pregnant during her annual checkup in December 2010. He prescribed a prenatal vitamin containing folic acid to help prevent open spinal bifida, a birth defect in which the spinal cord or its coverings do not develop properly.

"It's essential for a woman to have a sufficient amount of folic acid in her body before she becomes pregnant," says Dr. Morales, who is also a clinical assistant professor atWright State University Boonshoft School of Medicine. “Often, by the time a woman realizes she is pregnant, she is six or seven weeks along, and it’s too late – the defect is already present.”

Tatum began seeing Dr. Morales for regularly scheduled prenatal appointments in March. One of the first things he told her was to modify her exercise routine. “I’ve always been active – I love to run and rollerblade – but once I got pregnant I had to find less intense activities,” she says. “So now I walk a lot and use the elliptical machine.”

This commitment to exercise will serve Tatum well as her pregnancy progresses. “Regular, sensible exercise has many benefits for pregnant women,” says Evangeline Andarsio, MD. “For example, exercise can strengthen muscles used during labor and delivery and increase a woman’s energy level throughout pregnancy.”

Dr. Andarsio is the founding physician of the shared OB/GYN practice arrangement with Dr. Morales and Vicki Rager-Colon, MD. Patients are followed by their individual physician throughout their pregnancy but also have the option to meet with the other physicians.

Morales HS
Luis Morales, MD
Andarsio HS
Evangeline Andarsio, MD
Rager Colon HS
Vicki Rager-Colon, MD
Sexton HS
Chris Sexton, RN
Erbes HS
Kathy Erbes, RN

Exercise, along with a balanced diet, also ensures that pregnant women do not gain more weight than necessary. “Our ‘gold standard’ for weight gain during pregnancy is between 25 to 35 pounds,” says Dr. Andarsio, who is also, a clinical assistant professor atWSU Boonshoft School of Medicine. “A good prenatal vitamin can help ensure that a pregnant woman gets enough protein, calcium, vitamins and iron.”

Tips, Tricks and Old Wives Tales

Information about diet and exercise during pregnancy – not to mention morning sickness, stretch marks and swollen feet – is readily available on the Internet. Unfortunately, this information is not always reliable.

“I encourage my patients to share their questions with me,” says Dr. Rager- Colon, who says she’s dispelled many myths over the years. “Some have asked whether raising your hands above your head will cause the umbilical cord to get wrapped around the baby’s neck,” she says. “That’s not true.”

Most OB/GYN practices have a physician on call at all times to answer questions as they arise. Many questions concern the safety of certain over-thecounter and prescription medications. Some are safe only after the 12th week of pregnancy, some only until the 20th week, and others not at all.

An OB/GYN can also help patients who smoke kick the habit before or after they become pregnant. Doing so is critical for a woman’s own health and her baby’s. Smoking while pregnant can cause serious developmental problems and increase a child’s risk of Sudden Infant Death Syndrome during the first months of life.

Dr. Rager-Colon says the physicians in her practice stay abreast of new health recommendations to keep their patients well informed. In recent years, the Centers for Disease Control began recommending that women of childbearing age be up to date on their DTaP vaccine for protection against diphtheria, tetanus and pertussis (whooping cough). Another recent recommendation is that pregnant women get a flu vaccine. Both whooping cough and the flu can be life-threatening for babies, but vaccinating the mother can provide protection for a baby after it is born.

The Importance of a Delivery Plan

As a woman’s due date approaches, her OB/GYN may begin talking to her about a delivery plan. This can involve discussing everything from when medication might be used to hasten labor, to pain relief during labor, to whether dad wants to cut the umbilical cord. “Planning ahead is wise, but I encourage patients to be as flexible as possible,” Dr. Morales says. “Labor is a dynamic process, and things can turn upside down within minutes, requiring a change in the delivery plan.”

Tatum hasn't finalized her delivery plan, but she knows one thing for sure: she will be having her baby at MVH. She isn’t alone. In 2010 more than 4,600 women delivered their babies at the hospital.

“When it comes to maternity services, MVH simply has more experience, expertise and options than any other hospital in the area,” says Chris Sexton, RN, service line director for Women’s Health at MVH.

Kathy Erbes, RN, director of operations for Berry Women’s Services, agrees. “We have it all: the region’s only high-risk maternity center and only accredited Level IIIB neonatal intensive care unit (NICU) all in the same facility. Our NICU has proved to be a life-saving feature for hundreds of babies who were born prematurely or born with special medical needs that could not be met any place else.”

Chris adds that the hospital’s highly trained specialists are dedicated to ensuring that every delivery is a “special delivery.” As Chris explains, “A mother will always remember the day her child was born. Our physicians and nurses are honored to be a part of that special day and committed to providing the best care possible.”

For Tatum and Nick Toscani, all of this is very reassuring news at a special time in their lives. “Our baby will be the first grandchild on Nick’s side of the family, which adds to the experience,” says Tatum. “We’re extremely excited.”

Expanding Our Expertise

Recognizing the need to provide state-of-the-art maternity services to the growing areas south of Dayton, Miami Valley Hospital South (MVHS) – located near the intersection of Wilmington Pike and Clyo Road in Centerville - will open a full-service maternity center in later this summer. The public is invited to tour the new center during an open house set for August 19 between 2:00 pm and 4:00 pm.

The MVHS maternity center will be a Level II center, meaning it is intended for use by moms who are on track to have normal or low-risk childbirth. But it will also be the only maternity center south of town that can provide mothers and babies with access to the Level IIIB maternity center and Level IIIB NICU at the main hospital in case of complications.

MVHS Expansion

This new center will feature 16 private rooms for moms who choose traditional birthing options and five labor and delivery rooms with birthing tubs.

All expectant parents are invited to take part in MVH childbirth education classes, which meet at the Berry Women’s Center at MVH and at Miami Valley Hospital South.

Learn more about maternity services at MVH.