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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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Watch as two dads look back on their newborn adoption process. They reminisce about discovering their newborn was on his way — and how Renown Health subsequently helped them navigate the process.  During Memorial Day weekend, Chris Mulhern and his husband, Jeffrey Bodimer, learned a set of birth parents chose them to parent their unborn baby boy. After writing a letter to the birth parents, they were chosen over other applicants in a private adoption. The adoption agency took care of many details, like connecting Mulhern and Bodimer to the birth mother and dad. In fact, they could participate in nearly all the phases of the pregnancy. The mother's prenatal care and delivery took place at Renown Health, where Mulhern and Bodimer attended her appointments and took childbirth classes. "Our experience was wonderful at Renown," says Mulhern. "We thought it was absolutely incredible how nice and accepting everyone was." The Nuances of Newborn Adoption Their son, Bradley, was born via cesarean section. And the adoptive parents got to see him an hour after he came into the world. The labor and delivery nurses even helped coordinate everything between them and the birth mom. Mulhern and Bodimer stayed in a room at The Inn at Renown. The closeness of the facility on the Renown campus made it possible to feed Bradley every two hours. Incredible Nurses "They were great, the nursing staff. If we weren't sure about doing something right, about burping him right they would say 'It's okay. He's not going to blow up. He will eventually do it'," says Mulhern. The nurses also made arrangements for the two dads to participate in skin-to-skin contact with their newborn baby. Experts agree parents and babies should be in direct contact for at least the first 1–2 hours after the birth. Taking Baby Home Chris and Jeffery took Bradley home after three days at Renown. “It was the most joyful thing to be chosen as his parents, even before we met him,” says Chris.

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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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Medical emergencies like strokes and heart attacks still happen, even in a pandemic. That’s why Renown Health is always ready to provide emergency care to patients in need, and being admitted at Renown does not put patients at risk of getting COVID-19. When to Get Emergency Care Resources like Renown Virtual Visits have allowed us to stay home while making routine visits with our primary care physician. But, if you are feeling any of the following symptoms, please call 911 or have someone you know take you to the emergency room. Symptoms that may require emergency care: Heart attack Stroke symptoms Difficulty breathing Chest pain Seizure Sudden loss of consciousness Severe abdominal pain Serious allergic reaction Fighting the Good Fight for Our Patients Renown Health provides a clean and safe environment 365 days of the year, 24 hours a day. Alongside regular sanitation practices, Renown is dedicated to protecting patients from infectious disease while providing emergency care. Staff, Care Providers and Visitors Wear Masks Every staff member, care provider and visitor is wearing a mask. Additionally, providers are following guidelines from the Centers for Disease Control (CDC) on wearing protective equipment, such as masks and gloves. Respiratory Illness Screenings for Everyone Care providers and staff members are participating in respiratory illness screenings. Therefore, any care provider or staff member with a fever, cough, difficulty breathing or severe respiratory illness is not on a Renown campus. Visitor Restrictions are in Place Visitor restrictions are in place to prevent the spread of infectious disease by practicing physical distance. Because of these restrictions, Renown is only allowing one visitor per patient for with extenuating circumstances. Staying healthy and safe means caring for yourself in emergency situations, too. Please do not hesitate to call 911 when you or a loved one are in need of emergency medical care. Virtually Visit a Renown Urgent Care Login to MyChart to “get in line” for a virtual urgent care visit between 8:30 a.m. to 10:30 p.m. Monday-Friday and 9:30 a.m. to 4:30 p.m. Saturday and Sunday. Login to MyChart

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There are many lenses through which to view health. As you would expect, medical providers typically focus on the health of individual patients. For example, doctors consider a person’s symptoms, their current lifestyle, their past medical history, and their family’s history to diagnose medical conditions and recommend treatments. The Public Health Perspective Public health professionals look beyond the health of an individual and instead focus on the health of an entire community or population of people. They strive to achieve “the greatest good for the greatest number.” As the CEO of a health system, I feel fortunate to have education and training in both medicine and public health. As Renown Health’s leader, it is my responsibility to care for the people and communities we serve. That involves bringing world-class staff and innovative medical care to northern Nevada. We also focus on prevention by looking for ways to improve health outside of our facilities. That means partnering with local organizations to address the social, economic, and environmental factors that shape our health. Or working with local government to create policies that help to prevent disease and injury. In order to make a genuine and long-lasting impact on health, we must foster a community that helps our neighbors live well. Public health is especially important during times of crisis, such as the COVID-19 pandemic that we’re experiencing now. During these times, health systems must be able to swiftly shift focus from prioritizing the needs of individual patients to considering what is best for our local population. For example, we may need to temporarily limit hospital visitors or educate the public about how to socially distance in order to stop the spread of disease. Being prepared to make this shift and having strong relationships with our local health department and community organizations help us better serve the public. In both good times and bad, I am thankful that my public health background provides me with the perspective to look beyond our health system and embrace the health our community.

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We get it – the entire world has been overwhelmed with COVID-19 vaccine information, questions and celebrations around vaccines developed to combat COVID-19 induring the past several months. It’s hard to know where to start in digesting all this news and information. But one thing is clear: healthcare experts agree that the authorized COVID-19 vaccines are safe, effective and recommended to help end this pandemic. If you are passionate about stepping up in your community to encourage the vaccination efforts, we’re offering a few ideas on how you can be an ambassador. Find the Facts Content on the vaccine is abundant, but and there’s a few resources that we can all rely on to help digest the information: The Centers for Disease Control (CDC) updates its website content around the vaccine regularly, and also offerings information in Spanish. Health departments across the U.S. are leading the way in distribution logistics planning, and partnering with other providers, like such as hospitals and pharmacies, to distribute give people doses. Their websites are great resources to understand options where you live. Locally, check out washoecounty.gov/health/programs-and-services/environmental-health/covid-19-guidance for vaccine updates in Washoe County. Many providers like Renown Health and other providers are sharing content around their recommendations for the vaccine. Get answers about the vaccine types from one of our pharmacists, read common concerns addressed by experts and view videos from many doctors and other specialists on our YouTube Channel.

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Getting the COVID-19 booster is the best way to protect yourself from severe illness or death due to COVID-19, and both the CDC and the FDA have approved booster shots for people ages 18 and older. So, with the holidays right around the corner and infection rates on the rise both in Nevada and nationally, the best thing you can do to prevent the continued spread of this deadly virus is to get boosted today. The Basics: Who: It is recommended that everyone 18 years or older get a COVID-19 booster shot. When: At least 6 months after completing your primary COVID-19 vaccination series. What: Any of the COVID-19 vaccines authorized in the United States. The CDC allows for mix and match dosing for booster shots. How: To make an appointment for your COVID-19 vaccine booster, please visit vaccines.gov today. Appointment Reminders: Don’t forget to bring your CDC vaccination record card to your appointment. Refresh yourself on the potential side effects and remember that these are normal signs your body is building up protection. Commonly Asked Questions: Q: Does anything change if I received the Johnson & Johnson as my first COVID-19 vaccine? A: If you received the Johnson & Johnson COVID-19 vaccine, you are elidable for a booster two months after completing your primary vaccine. Q: Is the formula the same for the boosters as it was for the primary vaccine? A: COVID-19 booster shots are the same formulation as the current COVID-19 vaccines. However, in the case of the Moderna COVID-19 vaccine booster shot, it is half the dose of the vaccine people get for their primary series. Q: Am I still considered “fully vaccinated” if I don’t receive a COVID-19 booster shot. A: Yes, everyone is still considered fully vaccinated two weeks after their second dose in a two-shot series, such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as the J&J/Janssen vaccine. All information courtesy of the Center for Disease Control and Prevention. All information courtesy of the Center for Disease Control and Prevention

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Getting a shot can be scary for kids and anxiety-inducing for parents and caregivers. With flu shot season well underway and children's COVID-19 vaccine clinics in full swing, we wanted to share ways to reduce the stress for you and your child. Plan Ahead and Be Honest A few days before the scheduled appointment, casually mention to your child that you’re both going to the doctor’s office (or vaccine clinic, or pharmacy) soon for their vaccine. Explain to them that this will help protect them and will only take a second. Being honest is important, telling your child that it will hurt for a moment. If possible, try and schedule the vaccine at a kid-specific vaccine clinic, your pediatrician's office or a school-based site. Remember that words are powerful. Take notice if you are using a word that might make them more upset, such as prick, jab, needle or shot. You can interchange words such as vaccine, immunization or injection. Bring Toys Don’t be afraid to let your child bring one of their favorite toys or stuffed animals to the appointment. This can make them feel more comfortable and provide distraction. Ask for Pain Reliever/Numbing Agent If you know from past experience (or suspect) that your child has a needle phobia, talk to the vaccination location ahead of time and ask if they can use a pain reliever or numbing agent before administering the vaccine. Distract. Distract. Distract. Sing a song, tell them a joke, make a funny face. If you can pull your child’s attention away from the needle and make them laugh, they won’t focus all their energy on worrying about the shot. Lead By Example If you haven't gotten your flu shot, COVID shot or COVID-19 booster yet, ask the facility ahead of time if you can also get a shot before your child. Show them that the shot is no big deal and that they will have no problem getting it themselves. Celebrate Don’t be afraid to celebrate this victory with your child once it is over – bring them to the park, go out for an ice cream cone, let them pick what’s for dinner. This reward will show that you’re proud of them for being brave and may also make the next time your child is due for a shot easier.

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Vaccines that provide protection against the COVID-19 virus are bringing us closer to the end of this deadly pandemic. Two different COVID-19 vaccines are currently available in the U.S. today: one from Pfizer and the other from Moderna. Kate Ward, PharmD, BCPS, Director of Clinical Pharmacy at Renown Health and Adam Porath, PharmD, Vice President of Pharmacy at Renown, share what you need to know about these vaccines. When two COVID-19 vaccines were approved by the U.S. Food & Drug Administration (FDA) in December 2020, it was cause for celebration. Why? Because according to the CDC, the vaccines are 94 percent or more effective in providing protection against the COVID-19 virus! Many people are seeking information about the new Moderna and Pfizer vaccines. Below, our pharmacy leaders provide answers to some commonly asked questions. How do the COVID-19 Vaccines Work? The Pfizer and Moderna vaccines are both mRNA vaccines that help your immune system develop antibodies against the COVID-19 virus. The vaccines use messenger RNA, or mRNA, to show our bodies’ protein-making cells how to make the spike proteins of the COVID-19 virus. Our immune system reacts to these spike proteins by creating antibodies that can recognize and destroy them. So when a person is exposed to the virus in the future, they will be less likely to get sick. What are the Differences between the Pfizer and Moderna Vaccines? The Pfizer and Moderna COVID-19 vaccines are very similar, with just a few small differences worth noting. The main difference between the two vaccines is when you should receive your follow-up dose. Patients who receive a first dose of Pfizer should receive their second dose about three weeks later. Those who receive a first dose of Moderna should receive their follow-up vaccination roughly four weeks after their first dose. People 18 years and older can receive the Moderna vaccine while people 16 years and older can receive the Pfizer vaccine. Dosage for the Moderna vaccine is 0.5 ml (100 mcg). Dosage for the Pfizer vaccine is 0.3 ml (30 mcg).

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Renown Health is one of the country’s first health systems to lift visitor restrictions for patients with COVID-19 and encourage the family to be at the patient’s bedside. Read Darlene and Dave’s story to understand why we’re updating our visitor policy. Dave and Darlene Randolph found joy in exploring antique shops and garage sales to find damaged or discarded vintage pieces. Dave would spend many hours scraping, cleaning, sanding, and refinishing items, transforming them into functional, beautiful pieces of furniture. Every piece in their home rekindles a memory and has a story to tell. On Thanksgiving, when Dave was too ill to gather around their antique dining room table, Darlene called the ambulance. Ailing with COVID-19 for two weeks, Dave had not been improving. When the EMTs reached her home and asked Darlene what underlying conditions he had, she said, “all of them.” David was seriously ill. Hospitalized for COVID-19, their communications options were limited. The only way Darlene could communicate with Dave was on a video call or by telephone. Dave spent 17 days hospitalized at Renown Regional Medical Center in Reno. Darlene spent 17 days waiting by the phone for more information on his condition. Darlene said he had “up days and down days,” but thought he might be home, sitting at their antique dinner table for Christmas. Sadly, Dr. David Randolph lost his battle with COVID-19 on December 13, 2020, and died as he slept in a hospital bed. When Darlene wrote his obituary for the newspaper, she gave thanks to the “tremendous nurses and doctors at Renown Regional Medical Center, for providing his care during a time when the family could not be with him.” Taking Action to Inspire Change Darlene wished she could have been there. Over their 45-year marriage, she had always been there. Darlene said, “I had always been at his bedside, as his advocate, to help communicate and straighten things out.” As a registered dietician, she worked in hospitals, knew the protocol, and knew that Renown had a restricted visitor policy to stop the virus’s spread- to other patients, staff, and their family members. Still, she wished she could have spent more time with him. On Christmas Eve, she sat down and wrote to Renown leadership. “As the wife of a COVID patient who recently passed away in your hospital, I want to express my thanks to you and your staff for the care he received in the last days of his life. I am aware that the nurses and staff are working under dangerous conditions and risking their health and lives by caring for multiple COVID patients. The staff is gracious, concerned, and doing everything they can.” She continued, “I know procedures are changing every hour to try to stay ahead of this dangerous virus, and I am sharing my experiences, hoping they will be helpful when establishing policies that impact families.” Darlene explained that despite receiving assurances that Dave’s nurse or a doctor would call daily, sometimes they would forget. She explains in her letter, “how important it is, in these times when the family cannot visit, and has only infrequent communication and is anxiously waiting at home for information about their loved one, how much it means to get a call from someone caring for him at the hospital. If there is a way you can help assure nurses have time to make calls or assist patients in making calls because it is an important part of patient care.” A Person-Centered Visitor Policy After receiving her letter, Renown leadership called Mrs. David Randolph to thank her, offer his sympathies and ask if Renown could help in any way. Darlene asked if he might reconsider allowing families to visit hospital patients during treatment for COVID-19. As the COVID-19 situation has evolved, the policy has as well. Renown hospitals and medical practices now encourage limited visitors for all patients, including those diagnosed with COVID-19. Renown also has extra safety measures to protect the health of patients, visitors and healthcare employees. Darlene is very pleased that her letter inspired this shift in visitor policies for patients with COVID-19. She says, “I have always tried to think of ways I could help other families. Especially those senior couples where one has been hospitalized and the other is home. My wish is to help others.” Renown Health Visitor Policy Renown Health patients may identify two healthy adult “patient supporters” to accompany them on their hospital stay. For more details, visit our Patient Supporter Guidelines page.

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