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You can still have a healthy pregnancy and baby if your pregnancy is high-risk. Learn what steps you can take to give your baby the best start possible. A “high-risk” pregnancy is one that threatens the health or life of the mother or her fetus. Women with high-risk pregnancies should receive care health care specialists to ensure the best possible outcomes. Some examples of a high-risk pregnancy include: Maternal age, women 35 and higher or 17 and younger Lifestyle choices, including smoking, drinking alcohol and illegal controlled substances Existing medical history, chronic hypertension, diabetes and breathing issues Multiple gestation, pregnancy with twins or triplets Overweight and underweight  Remember: You can still have a healthy pregnancy and baby if your pregnancy is high-risk. Some ways to promote a healthy pregnancy: Schedule an appointment with your OBGYN Eat a balanced diet Avoid substances Prenatal care Healthy weight gain Reduce stress Exercise  Pregnancy & Childbirth at Renown | 775-982-KIDS (5437) When you are expecting a new baby, you can depend on Renown Children’s Hospital for all your mom and baby healthcare needs. We can help you find the right doctor and tell you what to expect during your stay. We offer childbirth education classes and tours to help you prepare. Be sure to check out our virtual tours of our Labor Assessment Area.

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Deciding you’re ready to start a family is a big decision for any couple. So once you’ve decided – what are the next steps for both moms and dads-to-be? And what should you know if you’re struggling to conceive? Dr. Myron Bethel, OB/GYN with Renown Women’s Health, offers key insights about fertility. What’s the first thing couples should do when they decide to start a family? For the mom-to-be, it’s important to meet with your obstetrician before you get pregnant. This appointment gives you an opportunity to discuss your family medical history, any past or current health problems, immunization history, medications you’re taking and any issues with previous pregnancies. Your doctor can also provide helpful tips to ensure your body is ready for a healthy pregnancy and help guide you on how to monitor your period, basal resting body temperature and other important factors to help you get pregnant more quickly. How can couples who are trying to get pregnant make sure they’re healthy to conceive? Of course it’s important to maintain a healthy lifestyle all the time, but it’s especially important if you’re trying to get pregnant. There’s no magic pill or single food, but women should start focusing on nutrients they’ll need during pregnancy. Before trying to conceive, start taking folate and folic acid to help prevent birth defects. You can get good sources of these nutrients from cereal, spinach, beans, asparagus, oranges and peanuts. Lifestyle changes can also help improve fertility. For both men and women, extra weight can reduce fertility. Both sexes can increase their chances of conception by not smoking, not drinking alcohol and exercising regularly. And for men specifically, take a daily vitamin containing zinc and selenium to support healthy sperm. What is the average timeline for conception, and what do you suggest for couples who may be struggling to conceive and start a family? First, remember getting pregnant can take longer than you expect. Do not to get stressed out about it or place blame. Seventy percent of couples conceive within six months and 85 percent within one year of trying to get pregnant. To help improve your chances of pregnancy, monitor your ovulation closely. You can do this by tracking your period, watching your body closely and logging symptoms, logging your basal body temperature or using ovulation kits. If you still aren’t sure when you’re ovulating, try to have sex every other day to improve your chances of conception. If you’ve been trying for nine months to a year, you can talk to your OB about options and discuss meeting with a fertility specialist.

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We asked, you answered: Moms and dads who have been there, done that offer up 10 pregnancy surprises. These are the things they wish they knew before, during and after their pregnancy. Check out these real examples of insights that would have proved helpful and enlightening to these parents and parents-to-be. When you’re pregnant or considering becoming pregnant, it seems the unsolicited advice runs rampant. You’ll hear people tell you what kind of Boppy Pillow to buy. You’ll have people tell you that you should “definitely” have a natural birth or a pool birth or a doula or a therapy dog present. And you’ll definitely hear about what kinds of foods to induce labor, what kind of tea to drink to reduce nausea during your pregnancy and what kind of underwear for less “chafing.” But something you might not hear as often: Some of the symptoms and side effects, both before and after giving birth, that were totally unexpected. These are the ultimate pregnancy surprises. So we asked the question of moms and dads who have been there, done that: What do you wish you had known would happen during your pregnancy — you know, during the time you were supposed to be all sweet and beautiful and glowing? Here is Part 1, featuring 10 real-life, crowdsourced pregnancy surprises from parents. And yes, there are multiple parts to this post, because people are passionate about sharing their wisdom! We’ll publish the second part later this month. Pregnancy surprises: What do you wish you had known about pregnancy? “The only symptom I never heard anyone talk about is extra blood flow making me feel all sorts of weird feelings in my head. I feel like I’m in a dream half the time. I looked it up online when it started happening, and tons of women have the same symptom.” — Anna K. “For me it was an after-birth surprise. I had no clue your tummy doesn’t just spring back to where it was pre-pregnancy. It was a rude awakening in the hospital when I had to have my husband go home and get a pair of maternity sweatpants to get dressed to go home in. I’d hoped to dress in my old cute jeans…. nope!” — Suzanne M. “I didn’t know that while you’re pregnant, friends and strangers would tell you their nightmare delivery stories. Oh — and that complete strangers will, uninvited, touch your baby bump. I didn’t know that you’re in the safety zone while pregnant and that men and women openly adore you. I didn’t know that besides the mother, the nurses do most of the work. I didn’t know that even though they’ve obviously seen hundreds of deliveries, nurses and doctors cry too once your baby is out. I didn’t know even though I thought they must be crazy to send a tiny human home with me, that you instinctively know how to parent. I didn’t know what it meant to love something more than myself and how that changes everything.” — Cathy B. “I had no idea the weird things that it does to hair. My bangs stuck straight out for months, and I just had to go with it. There wasn’t enough product that would make them lie down.” — Heidi P. “That you may not go home with your child if there are any complications. That was a sad day. But 22 years later, we are blessed, because everything turned out fine.” — Kristine F. “I didn’t know people would opine out loud to you, that you must not have purposely gotten pregnant with Baby #2 or 3, etc., implying you failed basic high school biology and that you should have known better than to have more than one kid.” — Jessica L. “I didn’t know that near the pregnancy’s end, as the hips widen, that those bones could begin to separate. I was sore and achy. And I wish I’d slowed down and rested more in the last few weeks.” — April C. “I had heard about food cravings, but no one told me food aversions were also a thing. I bought a whole load of groceries for the week, and by the time I got home, I suddenly couldn’t even look at the ground turkey (that’s not an exaggeration), let alone cook it and eat it. I didn’t throw up necessarily, but my body told me to avoid most meats and vegetables. I pretty much lived on plain bagels and cereal for half my pregnancy.” — Danielle S. “Morning sickness is SO not just in the morning! All-the-time sickness is what I experienced. And why didn’t anyone warn me about butthole pain during and after birth?” — Stephanie C. “The juiciness. Every possible secretion was in hyper drive.” — Jane F. Giving Birth at Renown At Renown Regional Medical Center we have the skill, expertise and technology — along with a friendly environment — to make your experience a memorable one. Pre-register for childbirth, take virtual tours of our rooms and facilities, and learn more about our labor and delivery offerings at the link below. Explore Our Services

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By taking our pregnancy and birth class, you will gain the tools necessary to have a safe and empowering birth experience for both you and your baby. Chris Marlo, Childbirth Educator at Renown Health explains why birth classes are important. For questions regarding classes or tours, contact Chris Marlo: chris.marlo@renown.org 775-982-4352 What is a Certified Childbirth Educator/Doula? If you are expecting a baby, Renown has a wide variety of classes to help prepare you for birth. Classes are taught by certified childbirth educators and doulas. A certified childbirth educator is a trusted resource who has a passion for educating expecting parents about childbirth, and will provide you with non-biased, evidence-based information. A doula is a professional labor assistant who provides physical and emotional support during pregnancy, childbirth and postpartum. As you prepare for birth, our certified educators will guide you each step of the way and ensure you receive the quality care you deserve. Why Should I Take Pregnancy and Birth Classes? For expecting parents, taking a childbirth education course is an important step in preparing for their new arrival. We cover topics such as labor and delivery, postpartum care, breastfeeding, nutrition, pain management techniques, and more. Our experienced instructors will provide you with the information you need to make informed decisions during your pregnancy and childbirth. With our classes, you can be sure that you have all the knowledge necessary to have a positive experience before, during, and after your baby’s arrival. Our classes will help ease your fears as we practice breathing, relaxation and the many tools you can utilize for birth. At Renown we understand that there is no right way to give birth, and our educators will offer a supportive environment where questions are encouraged, and everyone is respected. Childbirth Class Options: Baby and Family Suites Tour & Virtual Tour Breastfeeding Basics and Beyond Class Breathing & Relaxation Techniques for Birth Pregnancy and Birth – 5 & 7 Week Series Pregnancy and Birth Class Additional Resources: Baby Safe Class Babysitter Class Grandparents Virtual Class Infant CPR & Choking Class Newborn Care Nurturing Your Newborn Preparing for Postpartum Virtual Class

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Renown Health has long supported northern Nevada’s LGBTQ+ community Pride events with sponsorship, and we’ve collaborated with local and regional LGBTQ+ organizations as an ally. Renown’s Pride Committee works to deepen and broaden our external and internal efforts around LGBTQ+ community engagement, advocacy, and healthcare issues related to sexual and gender minorities, which is part of the greater Diversity, Equity and Inclusion efforts Renown is undertaking. According to Harvard Chan School, data shows that nearly a sixth of LGBTQ+ adults feel they were discriminated against based on their sexual orientation and gender identity. As a result, this brings to light the important need for education within the healthcare setting. Renown Health is bridging the gap for our LGBTQ+ population, and we know more work needs to take place in order to become an inclusive organization. Below are a few ways we’re working on improving our response to LGBTQ+ needs, and celebrate, respect and honor our diversity by being inclusive. Diversity, Equity and Inclusion The Diversity, Equity and Inclusion subcommittee was formed to heighten the awareness and develop a plan on how to better serve all of our diverse populations, including our LGBTQ+ patients. As the largest healthcare provider in northern Nevada, we knew that we could do a better job. The subcommittee provides us a forum to discuss ideas and develop plans to provide better care to these populations. Updated Medical Records with Preferred Name and Pronouns Of course healthcare is personal. We meet patients at their most vulnerable states. And relating to every person by the correct pronoun shows we respect their gender identity. A new medical records update supports our doctors, nurses and care team in capturing this vital information. We are now able to capture every person’s preferred name, sex and sexual orientation to better care for them. Kathleen Zaski BSN, RN, Manager of Clinical Informatics and IT Applications at Renown explains why this is so important. “Your name and identity are core to who you are as a person, and here at Renown, we aim to take care of you as a whole person and to provide the highest level of quality care to our community – all while ensuring the experience is exceptional and tailored to the individual. In other words, having the patient’s preferred name and pronoun in the medical record is important to validate their identity, and show we care, in an already high stress environment. Specifically, giving our providers easy access to the patients preferred name and pronoun in the medical record, allows them to properly address their health concerns. This also helps the health care provider foster a closer relationship with the patient. Studies have found this actually increases the quality of care by creating a more open and comfortable environment.” Gender Neutral Restrooms Mitch Harper, Senior Program Development Manager at Renown, recognizes there’s still so much more to improve upon in becoming an inclusive organization. “At the end of the day, it’s about creating a safe and welcoming environment for our community and our employees. Access to basic human services shouldn’t be contingent on an individual’s skin color, ethnicity, sex, gender identity, sexual orientation, age, disability, or beliefs. Ensuring that private restrooms are equally available to everyone on our campus is just one way we can provide a more inclusive, caring space for the people we serve.” Updated restroom locations: Roseview Tower: 10 Sierra Tower: 14 Tahoe Tower: 14 Helping to Lead and Influence Change Sean Savoy, Manager of Spiritual Care at Renown "The foundation of spiritual care is compassion – being with people in need by caring, supporting, and showing empathy, and promoting a sense of well-being. Being a member of the LGBTQ+ community informs that deep sense of compassion and empathy in a very special and unique way. Our human value, social validity, the very reality of who and what we are, even our right to exist, love and just be, are often called into question. This, in turn, can cause many of us to question ourselves and wonder about our self-worth. This experience should engender compassion and empathy so that we can better recognize, listen to and meet others’ needs to help them achieve inner peace, explore coping strategies to overcome obstacles during illness or crisis, and even find new balance by re-conceptualizing themselves in the context of health and illness. I have found that the intersectionality of my gay and spiritual selves has been a blessing in my life." Matthew Maloy, Team Lead Applications Specialist at Renown “I am a Team Lead Epic analyst in the IT department that is responsible for clinical based workflows for ED, Trauma, and Critical Care and have worked at Renown for 15 years. Being a part of the LGBTQ+ community influences my daily work by ensuring the Electronic Health Record reflects best practices such as giving clinicians the ability to document a preferred name, and displaying that throughout the medical record for consistency. Having the ability to influence decisions that move our community toward human value for all of us is a priority in my daily work.” Our Mission Renown Health’s mission is to make a genuine difference in the health and well-being of the people and communities we serve, including the LGBTQ+ community. We continue to build relationships to improve care, fostering better health outcomes for ALL of our patients by creating a more inclusive health system.

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Renown Health is closely following the national outbreak of the monkeypox virus and urging healthcare providers to be alert for patients with illnesses associated with a rash. In working with the Washoe County Health District (WCHD), Renown is closely monitoring the spread of monkeypox in the community and looking to prevent and reduce the spread of monkeypox. To help to ease worries, we consulted with Paul De Leon, Infection Preventionist at Renown Health. What Exactly is Monkeypox? Monkeypox is a rare viral illness caused by the monkeypox virus — the same family of viruses that causes Smallpox. Although symptoms are similar to Smallpox, monkeypox symptoms are milder and rarely fatal. However, it's important to mention that this virus can be more severe for these susceptible groups: Immunocompromised Pregnant women A fetus or newborn baby Women who are breastfeeding Young children Those with severe skin diseases such as eczema How is Monkeypox Transmitted? The monkeypox virus is not easily transmitted but occurs through sustained person to person close contact with an infected individual. Monkeypox can also be transmitted through direct contact with infectious rash, scabs, or body fluids. Monkeypox can also be spread through prolonged intimate physical contact, such as kissing, cuddling or sex. Lastly, monkeypox can be spread through contaminated linens or bedding. Transmission through respiratory secretions is uncommon but has been reported after prolonged face-to-face contact with symptomatic individuals. In addition, pregnant women can spread the virus to their fetuses through the placenta. Monkeypox Testing If you think you have monkeypox, contact your primary care physician or other medical providers to obtain testing. Notify the provider ahead of time before entering the physical office. Signs & Symptoms This current outbreak of West African monkeypox does not have the typical presentation of classic monkeypox. Symptoms usually appear one to three weeks after infection and include: Pimple-like rash or blisters on the face, inside the mouth, and on other areas of the body, like the hands, feet, chest, genitals, or anus. The rash will go through serval stages, including scabs, before healing and may be painful or itchy. Other symptoms of monkeypox can include: Fever Headache Muscle aches and backache Swollen lymph nodes Chills Exhaustion Respiratory symptoms such as sore throat, nasal congestion, or cough Symptoms of monkeypox may occur before or after a rash with some individuals only report experience a rash. Individuals with monkeypox are infectious once symptoms begin and remain infectious until lesions form scabs, scabs fall off, and a fresh layer of skin forms. The illness typically lasts 2-4 weeks.

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Pictured above: A section of Renown’s Labor Assessment Area.  When patients expecting a new child are about to give birth, nerves can be especially heightened. Questions flood their minds: Is the baby actually on the way? What’s going to happen next? Are we ready to push?   Lucky for them, at Renown Health, the guesswork can finally end with Renown’s Labor & Delivery unit Labor Assessment Area. This unique space is a triage area that helps make more precise labor diagnoses by determining exactly what stage expectant parents are at in the labor process.  Funded by a state grant more than a decade ago, the six-bed Labor Assessment Area sees 500-600 patients per month – from patients entering the unit directly, unsure if they are in active labor, to patients who are sent over from elsewhere experiencing labor symptoms, such as high blood pressure and water breaking. The area also serves as a pre-operation space for patients getting ready for procedures such as C-sections. The six cubicles that are enclosed with doors and curtains ensure each patient gets the private, one-on-one care they need. Furthermore, rather than sitting in a waiting room, this area allows expectant parents a comfortable place to prepare for labor.  “We are a unit that prides ourselves on getting patients into beds very quickly,” said Debbie Hawley, Associate Nurse Manager in Renown’s Labor & Delivery unit. “This area has allowed us to triage more effectively and allow more patients to collaborate with their provider in a quick manner.”

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