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Erin E. LeGrand D.O., FACOOG Central Oregon Obstetrics and Gynecology

Q Nearing the end of my third trimester, I am certain that I want a natural childbirth. However, I have no idea if this will be feasible, not knowing how painful things can get. Are the pain management drugs harmful to the baby and if so, are there methods that are safer than others?

A There is no way to know how you will tolerate the pain of labor until you are in the moment, as there are many factors that affect this. Every labor is different, some fast and some slow. Your delivery team will try to help you through the natural childbirth process if that is what you want. The options for pain management are IV medications and an epidural. Both are safe, but the IV medications can sedate the baby, so we try not to give these too close to the time of delivery.

Q I have heard that some women save their placenta and have it made into capsules after giving birth to help with things like baby blues, pain and milk production. Do you support this? How does this work with our local hospital?

A Recently, this has been a common practice for women. The hospital will release the placenta to you after delivery in most instances, and you just have to sign a form. There are no placebo-controlled studies showing benefits to ingesting the placenta, and there was even one case of a baby becoming ill because of a bacteria that was ingested through the encapsulated placenta by the mother. This is not a practice I recommend personally, but I support my patients that wish to do it.

Q There are so many prenatal vitamins on the market that it is challenging to know which is best. Do you recommend anything in particular or any additional supplements?

A Most prenatal vitamins have the adequate amount of nutrients. You just want to make sure it has at least 400 mcg of folic acid. Because certain high-risk pregnancies have different needs, I recommend you talk to your OB provider about specific supplements. Prenatal vitamins should be started at least one month prior to conception.

Q My daughter is almost nine months old and I am still experiencing discomfort during intercourse. It is starting to affect the way I feel about my body as well as my marriage. Is there anything I can do?

A This is a very common complaint that many women are afraid to bring up. There are hormonal changes after delivery, especially while breastfeeding, that affect the vaginal tissue and lead to dryness and painful intercourse. Sometimes over-the-counter lubrication is enough, but often women need to use vaginal estrogen until they are done breastfeeding. This is a prescription that is safe and effective - talk to your OB provider for more information. You should also have an exam to rule out any other cause of painful intercourse.

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