OBGYN Margit Lister with Intermountain Health Care shares four questions your gynecologist wants you to ask.
1. How can I maximize my health?
This tells me that this patient is motivated, ready to make a change and interested in moving forward with her life. If we could get a small portion of the population to start being involved in their healthcare, if would save thousands of health care dollars. The healthy population consumes 2 % of all health care dollars. 10% of the population consumes 72% of the healthcare spending. If we could motivate this portion of the population to ‘maximize’ their health it would have a huge impact in health care spending.
2. “How do I make this change?”
Now I know that the patient really is interested in listening and working to make a difference in her life. My real dilemma is that I can tell her all the things she needs to do, but it is ultimately up to her to walk out of my office and make a difference.
First health risk to change would be “stop smoking’. This is not anything new. We all know the risks of smoking and how it increases health care spending in the long run. Increased risk of cancer (lung, bladder, cervical), heart disease, lung disease and for women, increased in wrinkles, shorter years of childbearing, and early menopause.
Second health risk to change is getting to a normal BMI. BMI stands for body mass index. It is a measure of your body fat based on your height and weight. Normal BMI is 19-24. I would ask my patients “Do you know your BMI?”, “Do you know what is normal?” Then we can review that there is no “magic bullet’ to weight loss. If it sounds too good to be true, it probably is!
Third health risk to change is regular exercise. Start small. Find something that you will do for the REST OF YOUR LIFE, not until you get to the dress size you want or the number on the scale. Exercise needs to be a part of your daily living. Get outside and get moving!
3. “How can I minimize my risk to my baby?”
This is great time to talk about minimizing her health risks for her and her unborn child. Patients are more motivated to make a change if they know it will impact the lives of their children. Let’s talk about the same three risks.
Smoking; if all women would quit smoking, this would decrease the infant death rate by 5% and decrease the low birth weight babies by 10%. SIDS death would also decrease. During pregnancy, women who smoke cause the baby to not receive oxygen and nutrients for about 45 minutes after she smokes. This causes an increase in ectopic (pregnancies outside the uterus) pregnancies, placenta implantation or early separation problems, preterm birth, low birth weight, and still birth. Children from mothers who smoke during their pregnancy are more likely to have asthma, infant colic and childhood obesity.
Obesity in pregnancy: This is a topic women don’t seem to understand how detrimental this is to getting pregnant and her unborn child. Women who are obese (BMI of 30+) are at a higher risk for conceiving naturally or with in vitro and increased risk of miscarriage once she is pregnant. They are more likely to have a baby with a birth defect, a still birth, a large baby, diabetes during pregnancy, preeclampsia and a cesarean delivery. With a cesarean delivery, they are more likely to have increased blood loss, longer surgery, wound separation and infection, and uterine infections. I don’t mind weight loss in pregnancy as long as ‘weight loss’ is not the goal, but living a healthy lifestyle is.
Exercise is safe in pregnancy! You don’t have to be on an elliptical machine or treadmill for 30 minutes. Just walk, swim, move, and be active!
4. “How can I minimize my risk for preterm birth?”
Preterm birth is the leading cause of neonatal mortality in the US. Preterm birth accounts for 35% of all U.S. health care spending for infants. To reduce this risk, stop smoking! But if you have had a previous preterm birth, we now have medications that can help prevent a recurrent preterm birth, as your doctor about your options at your first prenatal visit.