VHM-2014-2015-lores - page 33

fter practicing
medicine in Detroit
for 20-plus years,
Dr. Pamela Bock moved to
Vail in 2008. An expert in
women’s health, infertility
and adolescent gynecology,
one of her favorite moments
over the course of her job
is delivering babies. Below,
she answers questions
from expecting mothers.
I was out of shape
when I got pregnant,
and I spent most of the
first trimester feeling
miserable. Now that I'm
feeling a little bit better,
what sort of activities
can I engage in to get
myself back into shape?
We recommend that people
start gradually, sometimes
just 10 to 15 minutes a day. You
want to work up to 30 minutes
at least 5 times a week, if not
every day. That’s a good thing
to aim for, and start slowly. A lot
of people ask about the heart
rate. If you can talk comfort-
ably while you’re doing your
exercise, then that’s good.
Walking is underrated. It’s
something women can do
throughout their pregnancy.
Swimming, it’s very soothing
because you have the buoyancy.
If you’re already a runner, you
can run. But pregnancy is not the
time to start to learn how to run.
Light weight lifting is fine, but
we don’t like you to do anything
too strenuous on your back in
the second and third trimesters.
Pilates and yoga are good, too.
There are a lot of benefits for
women who stay active: They
have shorter labors, and they
tend to tolerate the labor better
as well as keep up with the de-
mands of the pregnancy. Listen
to your body, and make sure you
consider hydration and sunblock.
What is the best thing
or things I could be
doing for myself and my
baby while I'm pregnant?
Nutrition is the big one —
eat well. Get enough fiber,
fruits and vegetables. Also, get
enough rest. Exercise. And social
support: The dad or partner being
involved is always very positive.
Are there any
challenges specific
to Vail's altitude when it
comes to being pregnant
and giving birth?
On the plus side: living at
this altitude, most women
are pretty healthy and into ac-
tive sports. We have a healthy
population. There are some
studies that say babies at a higher
altitude are a lower birth rate,
but the bottom line for me is
patients are active and healthy.
They’re very much a part of the
pregnancy and are very, very
invested in it, more than I’ve
seen in other communities.
On the down side, we do
have to caution people on how
active they can be. We coun-
sel people as far as skiing or
snowboarding, to avoid that.
They might not only hurt them-
selves, but also hurt the baby.
As for the challenges, because
we are higher, we’re prone to
dehydration. And we need
more sun protection, too,
especially during pregnancy
due to the hormones that cre-
ate a mask of pigmentation.
It's hard to navigate
all of the information
out there and know
what's a good source and
what isn't. Are there any
online or book sources for
general pregnancy info
that you recommend?
We give women "What
to Expect When You're
Expecting" and I also like the
Mayo Clinic's "Guide to a Healthy
Pregnancy." Another one is “The
Mother of All Pregnancy Books.”
And as far as websites, the Mayo
Clinic has a good and reliable
women’s health section, as does
the National Institute of Health.
But, if you’re a patient with
Colorado Mountain Medical,
you can sign up for the Patient
Portal. It enables you to message
your doctor directly. If you’re my
patient and you have a question,
you can just send it to me, I pick
up the message and respond to
it, say perhaps that it’s nothing
to worry about, or you should
come in. So many times people
sit home and wonder, “Should I
call or shouldn’t I?”My advice is,
when you’re asking that ques-
tion, the answer is you should.
The Patient Portal gives you a
way to do that without leav-
ing a message with a nurse.
I have visions of giving
birth without having
any pain medications, but
I don't know how realistic
it is. What do you suggest
a woman consider when
making this decision?
Giving birth is like taking a
road trip: You know where
you’re headed, but you don’t
know what’s going to happen
along the way. Birthing plans are
great and you can investigate
what you’re interested in, but it
concerns me when someone is
very rigid one way or the other.
You can have a guideline, but
be flexible. You just never know,
and the endpoint is a healthy
mom and healthy baby.
There are lots of options for
pain management. We have IV
meds that can be given, which
help with the pain. And an
epidural, which is administered
in the spine, will make it so you
don’t feel the contractions.
One of our practitioners
does hypnobirths, which is
more like guided imagery, and
people use that as a manage-
ment for their pain. Also, there
are the Bradley and Lamaze
methods, which are more holistic
approaches. And sometimes
doulas come to the hospital
with patients, and help coach
them, educate them on the
transitions. I love it when a
doula is a part of the situation,
because they’re experienced
and can be very helpful.
How well equipped
is the VVMC Women
and Children’s Center?
It’s very nice. They are all
private rooms, so you can
labor, deliver and recover in the
private rooms. We have all the
modern conveniences to keep
you comfortable, plus 5 doctors
who work in obstetric care.
It used to be, you had to be
37 weeks — what we consider
full term— to give birth in Vail.
But our neonatal center can
handle births from 34 weeks and
beyond. That was a big step, to
have that kind of backup.
A Q&A with one of Vail's resident experts
Dr. Pamela Bock
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