Group B Streptococcus bacteria are found in the genital track of some women. (GBS in not a sexually transmitted infection). Around 10 to 30% of women in Australis are affected. Normally the bacteria is harmless and these women do not experience any symptoms. However when pregnant, up to 70% of women who gave GBS will pass the bacteria on to their baby during the birth process. For this reason all pregnant women who carry GBS are given antibiotics in labour.
When you are in labour, you will be offered intravenous antibiotics. The antibiotics will decrease the chances of your baby becoming ill.
Around 36 weeks of pregnancy your obstetrician, midwife or doctor will ask for a vaginal swab to be taken. You will be informed of the result at your next appointment.
Only 4 out of 1000 babies will become ill with GBS. This will usually happen within the first 7 days.
Gestational diabetes is what you get during pregnancy. The hormonal changes in your body during pregnancy can result in high blood glucose (sugar) levels. Your body may not be able to make enough insulin or use it correctly during your pregnancy. This type of diabetes usually goes away after your baby is born. Having gestational diabetes puts you at a greater risk of type 2 diabetes as you get older.
Women with gestational diabetes are advised to see a dietitian and a diabetes educator as well as their doctor.
This one-time five-minute procedure is designed to remove just the uterine lining—the endometrium—which is the part of your body that causes heavy bleeding. No incisions are required, leaving your uterus intact. For 9 out of 10 women, their heavy periods are dramatically reduced or stopped altogether.
There is no medication considered to be 100% safe for long-term use in pregnancy. Each medication carries risks and benefits. Therefore, it is recommended that you:
- Limit the use of medication unless you are severely impaired or the medication is recommended by your doctor.
- Minimise the number of days or doses taken.
Between 11 – 15 kg
Fresh ginger is good for soothing an upset stomach, a few slices in hot water is effective
Rest is one of the key factors, stress and tiredness can make morning sickness worse.
Drink little but often to prevent dehydration and vomiting.
Also eat little but often, as having an empty stomach can make you feel queasy. Your blood sugar levels need to be kept balanced, try eating dry crackers, foods that are high in carbohydrates and low in fat work well. Keep away from spicy, sugary and fatty foods.
A simple snack, such as plain biscuits, by your bedside, could be helpful to have just before you get out of bed.
Acupressure or acupuncture can also be of help, tiny needles can hit a certain nerve centre in the body, and this can be extremely effective in treating nausea.
There are medical interventions that can help, you will need to talk to your specialist regarding ones that would be best for you.
Bio-Oil and Palmers cocoa butter formula is good. Start rubbing it in all areas as soon as you find out you are pregnant and continue after you give birth.
Best to avoid alcohol but if having a drink limit alcohol drinking to 1 or 2 standard drinks of alcohol once or twice a week.
Around 15- 18 weeks, when the placenta has moved, you will feel more movement. It starts of feeling like butterflies in the stomach.
When we lie on our back the large blood vessels that run close to our spine can be compressed by the pregnant uterus. In the third trimester this can decrease blood flow to the baby. At the same time, blood flow to your head will be decreased and you may feel dizzy and lightheaded. While there is no evidence that lying on your back sometimes is harmful, blood flow to the baby will be maximised if you tilt your abdomen even slightly to the left or the right.
Assuming you have a normal healthy heart, either the right side or the left is fine. Before the third trimester most women can lie comfortably on their back as blood flow is not significantly affected.
Folic acid is a B vitamin that has been shown to reduce the risk of spina bifida. 1 mg
(1000 micrograms) is recommended during the month prior to pregnancy and for the first 2 months after conception to reduce this risk. More folic acid may be recommended if you have a personal or family history of spina bifida including a prior affected child.
A prenatal vitamin is a general multivitamin with 800-1000 micrograms of folic acid, as well as calcium and iron. Most women continue their vitamins after the second month to help reduce anaemia and make up for any imperfections in diet. If you are not anaemic and eat a well balanced diet, stopping prenatal vitamins at 2 months of pregnancy is acceptable.
After 12 weeks the baby begins to make bone and will draw the necessary calcium from your bones. To prevent bone loss 1000-1500 mg of calcium is recommended. This equates to 4-5 servings of milk, yoghurt or dairy. Since this is difficult to consume, take a calcium supplement (usually 500-600 mg) to make up the difference. Don’t take calcium and iron (in the multivitamin) at the same time as they can offset each other’s absorption.
If you eat fish 3 times weekly you are getting plenty of Omega-3 fatty acids, or Essential
Fatty Acids (EFAs). If not, take a supplement containing 200mg of DHA (from fish oil or flax seed oil). There is a growing body of evidence that EFA deficiency may contribute to a number of pregnancy complications including preterm labour and pre-eclampsia. EFAs may help fetal eye and brain development, may improve mum’s skin, hair and nails and are also passed into the breast milk.
Outdoor cats can be exposed to Toxoplasmosis and can pass this parasite to humans through the faeces. One could acquire it by changing the litter box of an infected cat. If your cat goes outside, have someone else change the litter box when you are pregnant, or wear gloves and wash your hands well. If your cat lives inside and only eats processed cat food she cannot get the disease. Cuddling your cat is safe and will not expose you to the disease. Dogs are not affected. Toxoplasmosis can be harmful to a developing fetus but is very rarely seen.
Generally it is recommend staying close to home after 36 weeks, and not leaving the country in the third trimester (after 26-28 weeks) unless absolutely necessary. Flying is safe in pregnancy but may increase your risk for blood clots, so wear support hose on long flights and move about the cabin once an hour. With long road trips make frequent rest stops to stretch your legs and maintain circulation.
Exposure to very high temperatures (more than 103 degrees F) for long periods of time in baths, hot tubs or saunas can increase the risk of spina bifida during the first 2 months of pregnancy. Normal temperature baths (98-101 degrees) are safe and can be very relaxing. If you are concerned, put a thermometer in your bathtub.
Inhaling volatile paint fumes is not good for any human, pregnant or not. While normal casual exposure to paint does not cause birth defects, use good judgement if you are painting and make sure the room is well ventilated.
Sex is safe in pregnancy unless you have complications such as bleeding, preterm contractions or a low-lying placenta. While sex may make you have mild contractions, it will not make an otherwise healthy pregnant woman go into premature labour.
Staying active is great for you and the baby. If you have an uncomplicated pregnancy you can continue your current exercise regimen with a few modifications. When doing cardiovascular exercise (walking, running, biking, elliptical trainer) a good guideline is to keep your heart rate at a maximum of about 140 beats per minute. This will allow blood flow to go to the uterus as well as your large muscles. If you are working out with weights, modify exercises that require you to be flat on your back or flat on your stomach after 12 weeks. Cut out abdominal exercises, they won’t be effective. If you are not a regular exerciser, walk for 20-30 minutes 3-5 times a week, and consider a prenatal yoga or pilates class (we can recommend one). Occasionally complications such as bleeding, preterm labour or high blood pressure will prevent you from being able to exercise, but for most women regular exercise is a great way to prevent excessive weight gain, reduce stress, and keep the physical strength necessary to deliver and take care of a new baby.
We need an average of only 300 extra calories daily during pregnancy “Eating for two” will result in excessive weight gain. Most women will lose only 7-9 kg in the first few weeks postpartum, with the rest stored as fat, so weight gain of 9-14 kg is ideal.
Eat small frequent meals to avoid heartburn and hypoglycemia. Eat what you enjoy, but make healthy choices and go easy on sugars and starches to prevent excessive weight gain and gestational diabetes.
Unpasteurised cheeses and deli meats can carry Listeria, a bacterium that can cause miscarriage and fetal infection. It is wise to avoid regular intake of unpasteurised dairy products or deli meats for this reason. Listeria is killed by high temperatures so deli meats heated in the microwave until steaming are certainly safe.
Raw fish and meat can carry parasites and other microbes that could cause potential harm to the mother and fetus. While these infections are extremely rare, it is wise to avoid raw meat and fish for this reason.
Caffeine is safe in small quantities (1-2 caffeinated beverages daily). There is no scientific evidence that nutrasweet (aspartame) or other sugar substitutes are harmful in pregnancy.
This is a personal choice, the recommendation is normally when you have reached 12 weeks.
Pregnancy is measured from the first day of your last period. There are 40 weeks in the average pregnancy, your due date will be based on the measurements from your first ultrasound.
The first trimester includes up to 13 weeks, the second trimester is 13-28 weeks, and the third trimester is 28 weeks until delivery.
Your doctor will explain why you need an assisted birth and what your options are. They will also observe your bump and examine you internally, to check your baby’s position and make sure that an assisted birth is the right thing to offer you.
Dr John will then decide which instrument to use and talk this through with you.
If your doctor thinks that an assisted birth is possible, but could be difficult, you will be moved to the operating theatre. This is in case a caesarean is needed. Assisted birth is less likely to be successful if:
- your body mass index (BMI) is over 30
- your baby is large
- your baby is lying back-to-back
- your baby’s head is not low down in the birth canal
Whether you’re in a delivery room or in theatre, your legs will be placed in stirrups or supports at either side of the bed, and the end of the bed will be removed.
You’ll need an empty bladder, so a thin tube (catheter) attached to a bag may be put in your bladder to empty it. This may be a bit uncomfortable.
You’ll be given pain relief, which may be an injection inside your vagina (a pudendal block), an epidural, or a spinal anaesthetic. Your baby’s heartbeat will be monitored throughout.
A paediatrician is likely to be called to the delivery room. This is normal for an instrumental birth, so try not to worry.
It’s not always possible to avoid an assisted birth, but you can reduce your risk when planning your baby’s birth and when you’re in labour.
If your pregnancy is going well, you should have the option to give birth at home or at a birth centre. Planning to have your baby in either of these places increases your chance of having a straightforward labour and birth, without instruments and other interventions.
Once you’re in labour, taking these steps will reduce your risk of needing instruments to help your baby to be born:
- Having continuous support from a birth partner or doula.
- Having an upright position during labour or lying on your side for the birth rather than on your back.
- Not having an epidural.
- If you’ve had an epidural, waiting for at least an hour after you are fully dilated (so that the head can descend further into the birth canal), or until you feel the urge to push, before trying to push your baby out. Using a hormone drip can help too.
Your midwife and doctor may recommend an assisted birth if:
- Your baby is distressed during the pushing stage of labour.
- You are exhausted and can’t push any more.
- Your baby isn’t making progress through your pelvis as would normally be expected.
- There’s a medical reason why you shouldn’t push for too long, such as if you suffer from heart disease.
- Your baby’s head needs gently turning, so she’s facing the right way to be born.