Dr. Reagan Saig received her bachelor’s degree from the University of Tennessee, medical degree from the University of Tennessee Medical School in Memphis, and completed her residency at the University of North Carolina at Chapel Hill. She is a member of the Phi Beta Kappa Honor Society, was inducted into the Alpha Omega Alpha Honor Medical Society, and is a recipient of the Golden Tarheel teaching award from the University of North Carolina at Chapel Hill. Dr. Saig practices with Tennessee Women’s Care, PC at Baptist Hospital and Centennial Medical Center. Her interests are in obstetrics and minimally invasive gynecologic surgery utilizing both laproscopic and robotic technolgies. She enjoys running and reading books in her spare time. Her husband, Joe, and she reside in Nashville, TN.
Q: I’m 39 years old and have recently gotten married. We are talking about starting a family. What should we be talking about at my age and what are the risks to the baby and myself?
A: Congratulations on your recent marriage! First of all, you are not alone. Many women are choosing to start a family later in life. In fact, one in five women have their first child after the age of 35. However, studies have shown that there are risks associated with attempting conception after this age.
First, there is a decline in fertility as compared with women in their twenties. If you cannot conceive after the six months of trying, you should have a consultation with your physician.
Additionally, the risk of having a baby with a chromosomal defect increases after the age of 35. (Chromosomes are coiled DNA that contain genes.) The most common of these defects is Down Syndrome. The reason for this is that women are born with all of the eggs they will ever have. With time there is a higher likelihood of DNA changes within the eggs. This also increases rate of miscarriage.
Lastly, there is an increased risk of maternal complications in pregnancy. These include, but are not limited to gestational diabetes, hypertension (or high blood pressure) in pregnancy, cesarean section, preterm delivery, and low birth weight.
In spite of these challenges, women over the age of 35 frequently have healthy pregnancies. I encourage you to have a preconceptual visit with your OB/GYN and to start taking a prenatal vitamin with 800 mcg of folic acid. Establishing early prenatal care and diligent follow up throughout pregnancy is also important.
Another great resource for this question can be found on the March of Dimes website.
Q: How do I know what is safe to use and what isn’t during pregnancy? For example, can I use over the counter pain relief, yeast infection medicines, etc?
A: This is a great question, and one that’s commonly asked! Below, I have listed common symptoms and remedies that are safe and unsafe.
- Pain relief: AVOID: ibuprofen (advil or motrin), naproxen (aleve), or aspirin. SAFE: acetaminophen (tylenol)
- Allergies: SAFE: any antihistamine that is not combined with ibuprofen, naproxen, or aspirin such as chlorpheniramine (chlor-trimetron), loratadine (claritin), diphenhydramine (benadryl)
- Common cold or cough: SAFE: Dextromethorphan (robitussin, triaminic,delsym) or guaifenesin (mucinex or robitussin) In general, decongestants in small amounts such as pseudoephedrine or phenylephrine (sudafed) are likely safe, but ask your OB/GYN prior to taking.
- Yeast infections: SAFE: miconazole (monistat), fluconazole (diflucan), clotrimazole (lotrimin or mycelex)
- Gas: SAFE: simethicone (mylicon or Gas-X)
- Heartburn or reflux: SAFE: Antacids such as tums, rolaids, maalox or mylanta. Antihistamines such as cimetidine (tagamet), ranitidine (zantac), or famotidine (pepcid). Proton pump inhibitors if the above are not working such as omeprazole (prilosec), lansoprazole (prevacid), and esomeprazole (nexium)
- Constipation: SAFE: psyllium (metamucil), benefiber, methylcellulose (citrucel), colace, dulcolax, milk of magnesia, magnesium citrate, miralax.
- Hemorrhoids: SAFE: tucks or preparation H
- Diarrhea: SAFE: loperamide (imodium)
- Sleep agents: SAFE: diphenhydramine or doxylamine (benadryl or unisom)
A great resource if you have other questions or concerns is the Organization of Teratology Specialists website under “Resources.” Here, they have listed fact sheets for multiple over-the-counter and prescription medications that are factual and informative.
Q: What’s the one question everyone’s afraid to ask?
A: “When/how often should I see a gynecologist?” Young women should see a gynecologist during her teens to discuss birth control and STD prevention. Annual screening should be performed for gonorrhea and chlamydia for sexually active women until age 25. HIV testing is important for sexually active women as well. Annual screening is recommended for women over 25 and more than one partner per year. Pap smear screening begins at age 21 regardless of sexual activity, unless a woman has an irregular menstrual cycle.
Q: What pre-pregnancy things can I do to prepare?
- Start taking prenatal vitamins. Any prenatal vitamin is okay, as long as the vitamin has 800 mcg of folic acid per day.
- Stop any habits that are harmful to your unborn baby; such as cigarette smoking, consumption of alcohol, or illegal drugs.
- Ask your doctor if current medications you are taking are safe in pregnancy.
- Make sure your immunizations are up to date.
Q: Is it okay to use hair dye during pregnancy?