Original Article – “Can We Please Stop Telling Pregnant Women This?”

I’m currently 29 weeks pregnant and have already lost track of the amount of times I’ve been told by people that ‘everything will be fine.’

Read complete article at:

Can We Please Stop Telling Pregnant Women This? | The Huffington Post

Dr. Evita Fernandez’s response on the article – “Can We Please Stop Telling Pregnant Women This?”
When I was a young obstetrician and not as wise as I am today, I often spoke these lines “don’t worry- everything will be fine” believing at the time that it was. Indeed the truth.

Today, I LISTEN very very carefully to the unspoken words of the young mother before me. I do my best to understand her fears and help her work through it all. I have learnt to believe in maternal instincts; learnt to listen to women when they express a fear repeatedly. I also know that a pregnancy can go horribly wrong. Sometimes there are tell-tale signs to warn and prepare both sides. Sometimes, one does not get the luxury of time to prepare for a loss or morbidity affecting the mother or her newborn.

It is important for us obstetricians to give women the freedom to ask questions, to clarify doubts no matter how small they may appear and more importantly, to LISTEN and become aware of the unspoken fears.

May this article help us understand a different perspective. May it induce us to reflect and initiate change wherever necessary.

Introduction:

As one of the most fulfilling phases in a woman’s life, being pregnant doesn’t mean that you have to sit and relax throughout the whole pregnancy period. Yes, during your pregnancy, you may feel more tired than before. You may have backache and swollen ankles. But it is very essential for pregnant women to keep active. Exercising during pregnancy will not only help you to stay in shape but also prepare you for labour and delivery. It allows you to return to your pre-pregnancy shape faster.

Exercising during pregnancy doesn’t mean that you have to do complicated workouts. Simple exercises daily are enough to keep you fit and active. So, in order to have a healthy pregnancy, you should consult your doctor or an experienced trainer or join classes on pregnancy exercises.

Exercising and Pregnancy:

Exercising 20-30 minutes 3 or 4 days a week can help you maintain a healthy pregnancy. Walking is one the best exercises which provides a moderate aerobic conditioning without much stress. Swimming, pedalling on stationary cycle, light aerobics and yoga are some of the good exercise choices during pregnancy.

While exercising, it is very essential to stay hydrated. Have plenty of fluids and don’t be overheated. Exercise to the limit you are comfortable and as per your health trainer’s suggestions.

Benefits of exercising during pregnancy: 

• Relieves backache and other discomforts
• Increases your stamina and energy level
• Prevents you from gaining excess weight
• Helps you to sleep better
• Gives a boost to your mood
• Reduces the risk of gestational diabetes
• Reduces constipation
• Helps proper blood circulation
• Gives a healthy glow to your face
• Controls pregnancy related high blood pressure
• Reduces the symptoms of postpartum depression

It is better not to exercise during pregnancy if you have the following problems:

• Cervical problems
• Heart or lung related disease
• Vaginal bleeding
• Previous pre-term labour
• Threatened miscarriage

Do’s while exercising:

• Wear comfortable and loose fitting clothes along with a supportive bra
• Wear well-fitting sports shoes
• Exercise on flat surface to prevent injury
• Choose healthy food and eat at least an hour before exercise
• Drink lots of water before, during and after exercising
• If you are doing floor exercises, get up slowly

Don’ts while exercising:

• Avoid exercises involving extensive hopping, bouncing, skipping and jumping
• Avoid exercises which have chances of you falling down
• Avoid waist twisting movements
• Avoid exercising in hot and humid conditions
• Don’t  hold your breath for a long time
• Don’t do extensive exercises for long periods of time

Conclusion:

So, if you are pregnant, do moderate exercises to stay fit and healthy. Not only you, but your baby also will greatly benefit by the exercises.

Exercise daily and have a healthy pregnancy.

Images Courtesy:

http://kidshealth.org/

http://www.youngandraw.com/

http://cenobgyn.com/

 

Everyone needs to stay hydrated for healthy living. For the body and vital organs to function properly, you need to have lots of water. And if you are pregnant, the amount of water to be taken increases to a great extent.

During pregnancy, your body needs more water to meet the demanding needs of your changing body. So, it becomes very essential for the mom-to-be to remain adequately hydrated. Moreover, water is one of the key components for breast milk and essential for proper lactation.

How much water do you need during pregnancy?

A pregnant woman is required to have approximately three litres of fluid every day. Fluids include water, milk, fruit and vegetable juices, and other non-alcoholic refreshments. Apart from having water directly, your body receives water indirectly from fruits, vegetables, yogurt etc. So, you can have water according to the intake of other fluids, fruits and vegetables.

 

Benefits of water during pregnancy:

• As water is one of the main sources for carrying nutrients and oxygen to your organs, cells and tissues, staying hydrated during pregnancy ensures that your baby is receiving the required nutrients for proper growth.
• It helps in preserving the required amount of amniotic fluid and helps in the kidney function of the foetus by facilitating the waste your baby’s kidney filters.
• Drinking enough water lets you keep hydrated as dehydration during pregnancy leads to headaches, dizziness, cramps and nausea.
• Water can help prevent constipation and haemorrhoids.
• Drinking adequate water helps in preventing morning sickness, indigestion, acidity and heartburn.
• Keeping hydrated means it keeps your urine diluted which not only helps in keeping all things in order but also keeps Urinary Tract Infections (UTIs) at bay.
• During the third trimester, hydration becomes especially important as dehydration can cause contractions leading to preterm labour.

How to know that you are hydrated?

During pregnancy, the best way to know that you are hydrated is to check the colour of your urine. If the colour is pale or straw-coloured, then you are adequately hydrated. But if it is dark, it means you need to have more water. So, keep a water bottle handy which will remind you to keep hydrated.

Images Courtesy:

http://www.pregnancyexercise.co.nz

https://www.pureitwater.com

https://www.pureitwater.com

Pic courtesy: http://blog.cloudninecare.com/trimester-wise-pregnancy-tips/

 Having a life growing inside you is nothing less than a miracle! Experiencing the entire process month by month is simply astounding. But then pregnancy comes with its own challenges and complexities that are only experienced as the time flows in the 9-month course. This blog post offers you elaborate trimesterwise tips for expecting moms.

Before we go into the pregnancy tips, let’s have a quick look at the biological changes that take place during pregnancy.

The First Trimester (First three months)

 Pic courtesy: http://www.pregmed.org/the-first-trimester-of-pregnancy

The fetus has started taking human shape with all the internal organs showing up. You will experience the following changes:

• You will feel your uterus has ascended above the pelvis region
• You will now feel less to no morning sickness and will put on weight. Ahh! This can give you mixed feelings!!
• The fetus has now evolved into a fully formed body with fingers, toes and ears, with the body covered with fine hair
• You can now press your stomach to feel your baby’s movement 

The Second Trimester (3rd to 6th month)

Pic courtesy: http://www.slideshare.net/TerroWhite/stages-of-pregnancy-tips-facts-warnings

 By now your uterus has been steadily preparing itself for labour. You will experience the following changes:

• You will feel painless contractions known as the Braxton Hicks contractions
• Every week you will put on 1/2 kg of weight
• You may experience constipation and indigestion
• Your uterus has now risen 5cm above the pelvis
• By the 16th week, you can clearly feel your baby’s movement

The Third Trimester (6th to 9th month)

Pic courtesy: http://www.citranatal.com/pregnancy/third-trimester

You are now in the last phase of your pregnancy and your baby has now fully grown. You will experience the following changes:

• Because of the consistent weight gain, you have now become breathless
• The movement as the baby’s head drops to the pelvis — you’ll have a thud-like feeling
• The weight of your baby should be 2.7-3.5 kg
• You will experience difficulty in sleeping
• Your breasts will now start secreting transparent colostrum i.e. protein-enriched pre-milk
• Your placenta has now enlarged up to 20-25 cms and holds 1.1 ltr of amniotic fluid

TIMESTERWISE NUTRITION TIPS

First Trimester (First three months)

Pic courtesy:http://www.momjunction.com/articles/first-trimester-diet-essential-foods-you-should-include_00116232/

 Add Folic Acid to your pregnancy diet

Folic acid/Folate is Vitamin B that plays an important role in the development of baby’s skull and brain including its spinal cord.

What to eat –

• Vegetables such as spinach, ladies finger, broccoli, cabbage
• Pulses that include lentils, beans and chick peas
• Others include oranges, eggs, brown rice, baked potatoes, asparagus, corn, brown breads etc.

Tip – Do not cook the above veggies, as folic acid is lost during cooking, instead boil and have them.

Add calcium to your pregnancy diet

Someone on a public health forum had posed this question – “I don’t really like milk… is it such a big deal if I don’t get enough calcium while I’m pregnant?” And the collective response was a big YES.

Calcium plays a crucial role in developing the baby’s bones, teeth, muscles, nerves and heart. When the growing baby does not get the required amount of calcium then it starts extracting it from the mother’s bones. Doctors recommend consuming 1,000 mg of calcium every day.

 What to eat –

• Dairy products that ensure less to no fat such as low fat curd, skimmed milk
• Green leafy veggies such as cauliflower, broccoli and watercress (Jalkumbji)
• Dry fruits including almonds, apricots and figs (anjeer)
• Others include tofu, small fish with edible bones, cereals and oranges

Tip – The best way to confirm calcium usage is by consuming Vitamin D. So try to eat foods rich in Vitamin D such as boiled egg, asparagus, fish etc.

Second Trimester (From 3rd to 6th month)

 

Pic courtesy: http://www.fitmommacleanbaby.com/

 Add Vitamin C to your diet

Vitamin C helps in forming collagen. It is the most widely available protein in the human body, mostly the component of tendons, bones, cartilage and skin.

What to eat –

• Citrus fruits including lemon, orange, grapefruits
• Other fruits such as pumpkin, pineapple, guavas, berries, kiwi
• Vegetables such as broccoli, spinach, sprouts, bell peppers

Add Omega-3 to your diet

Since Omega-3 (DHA) helps in the development of nervous, immune systems and brain, so it becomes highly necessary for you to start consuming foods laden with omega-3 as you enter your second trimester. 

What to eat –

• Salmon, flax seeds, soybean, walnuts, pumpkin seeds, spinach

Add magnesium to your diet

Magnesium also largely helps in the development of baby’s bones.

What to eat –

• Seeds such as pumpkin and sunflower seeds
• Dry fruits such as avocado, almonds, raisins, cashews
• Vegetables such as legumes, kidney beans
• Other sources include banana, oatmeal, soybean and nuts

Third Trimester (From 6th to 9th month)

Pic courtesy: http://www.fashionlady.in/extremely-important-must-have-foods-every-trimester/17136

In this trimester, the baby grows completely so the intake of nutrition also increases. Therefore, mom needs to have an extra of 2300 calories on a daily basis.

What to eat –

Try to consume 250ml of fruit juice on a daily basis. You should also consume low fat milk/yoghurt of the same quantity. Add wholemeal toasts with low fat cheese spread to your breakfast. And if you are a non-vegetarian then you should have 40gms of meat with raw vegetables regularly.

So those were some trimesterwise tips for expecting Moms.
Hope you found this post useful!

What is Intrauterine insemination ?

The technique of Intrauterine insemination (IUI) is a widely popular assisted reproductive technique due to its simplicity and affordability. The IUI procedure involves introducing washed and actively motile sperms directly into the uterine cavity (womb), at or around the time of ovulation, with the aim of increasing the chances of pregnancy. The purpose of IUI is to increase the number of active sperms reaching the egg in the fallopian tube, bypassing the vagina and cervix, thus, shortening the distance to be travelled by the sperms.

IUI is a simple procedure and can be performed whether or not the woman is receiving medication for egg formation. However, stimulation of egg development by medication does improve success rates, as more than one egg will develop. Monitoring by USG is essential to track follicular growth and to time the ovulation. Once the follicle reaches maturity, the patient is given hCG injection (human chorionic gonadotropin) for ovulation, which usually takes place within 24 to 36 hours of the injection.

Pic courtesy:  http://thefertilityblogs.com/trying-to-conceive/third-party-reproduction/what-is-an-iui/4201/

Who are eligible for IUI procedure?

To consider IUI :

• The female partner should be ovulating normally or should be able to ovulate with medication for ovulation
• She should have open fallopian tubes or at least one fallopian tube should be patent and

healthy

• The male partner should have satisfactory sperm counts, motility and morphology

IUI not indicated in following conditions

• Female partner with

– tubal block on both sides

– inability to develop eggs

– age > 40 years

– advanced stages of endometriosis

• Male partner with azoospermia (absence of sperms in semen) or very low scores of sperm count, motility and morphology.

What is the procedure for IUI?

The total procedure has three components. One is semen collection, second is semen preparation and the third is deposition of active sperms in the uterine cavity. The entire procedure takes approximately 1 – 3 hours.

Semen collection and preparation

A short period i.e. 2 days of ejaculatory abstinence is advised prior to the scheduled IUI. At the predicted time of ovulation, the male partner is asked to collect semen into a sterile container and submit it in the laboratory for sperm preparation. Here semen analysis is performed to check for initial parameters. Then it is processed. Best quality active sperms are separated and made into a small quantity (0.25 ml). Rest of the seminal fluid containing dead sperms, bacteria and other components which can cause painful contractions of the uterus, is discarded. Post-wash active sperm count is noted for sample adequacy for insemination. Minimum count of five millions of active sperms is acceptable. Success rates are low with lower counts.

Actual IUI procedure

Once the specimen is ready, the female partner is called for IUI procedure to the insemination room. She is made to lie down on the couch with legs flexed. A speculum is introduced into the vagina to expose the cervix and it is gently cleaned. Prepared sperms are loaded into a slender semi flexible sterile catheter with a plunger. It is then passed through the cervix into the uterine cavity and the sperms are injected by pushing the plunger.

How much time does the actual IUI take and will it cause any pain?

Actual IUI (deposition of active sperms into the uterus) procedure takes only a couple of minutes. The procedure is usually painless, although 10% of the women may experience a menstrual cramp like pain. There may be a little vaginal spotting or discharge after IUI.

 

Is rest necessary after IUI?

The female partner will be asked to lie down for a few minutes after IUI (10 – 15 minutes). Then she can resume her regular activities. The sperms will not escape from the uterine cavity if she gets up.

Is intercourse advised after IUI ?

Yes, this will increase the chances of conception.

How many sittings of IUI are performed in one cycle?

Usually one single properly timed insemination is sufficient.

How many cycles of IUI are recommended?

Four to six cycles of IUI may be tried as there is no improved success seen later.

Chances of success with IUI

Average success rate ranges from 15-20 % in a single cycle. The success rates may be high in stimulated cycles and if the total sperm count is more than 20 million/ml.

What are the risks involved with IUI?

Procedure related complications are infrequent. They include infection where women can suffer with lower abdominal pain, vaginal discharge.