Our doctor looks at your pregnancy problems and gives you all the tips and advice that you need
A: The issue about sleeping on your back revolves around the pressure the baby growing in your uterus is putting on the blood vessels that run around the front of your spine. Too much pressure can reduce the flow of blood back to your heart, and may cause a drop in your blood pressure. For most women this isn’t a problem, since they have extra blood vessels that allow the blood to flow freely back to the heart. But for a minority of women it can cause problems after 28 weeks.
One way to see if you’re affected by this is to lie on your back on the floor and see whether you feel light headed. If not, then it’s probably fine to sleep on your back. But if you do feel a bit light headed it is better to sleep on your side – the advantage being that the blood flowing from the placenta, and from your lower limbs, can come back to your heart very easily, allowing your blood to circulate through your lungs and return to the uterus and the placenta.
But please don’t worry too much about this. Remember that during sleep everybody turns in bed and so it’s common for many pregnant women to lie on their backs at some time during the night with no adverse effect on the baby.
A: Although there is no way of knowing for certain what will happen on the day, on balance it is most probable that your second baby will be born more easily than the first. Usually the cervix opens and dilates more rapidly, so the first stage is faster, as the second stage as your baby descends may be easier too. If your second baby is considerably bigger than your first, or is in an awkward position, these generalisations may not apply. Your labour will also be affected by how you feel. Emotionally you may feel very different than you did when you were 15. Physically you may feel stronger and more confident.
Second births are often influenced by prior experience so if your first labour was not straightforward, or if it was frightening or traumatic, you may be nervous this time around. It may help to talk through your first experience with your midwife and other supporters, including your partner. If you feel comfortable where you are giving birth and are supported by people who you trust, labour is more likely to go smoothly.
A: During this pregnancy please ensure that between 25 and 30 weeks you have a glucose test for latent diabetes. Large babies may result from the mother having diabetes.
It may also be worth considering what you are eating. Many nutritionists think that reducing fast-burning foods (fruit juices, colas, sweets and chocolates, white bread, biscuits and cakes, as well as sugar in tea and coffee) is a powerful way to reduce a baby’s excessive weight gain during gestation. This is because high sugar levels cross the placenta and cause a baby to produce insulin and growth hormone, which increases weight. Changing your eating patterns may help.
Some women naturally have pregnancies over 40 weeks. When there is an irregular menstrual cycle, this can mean that ovulation and conception are one to two weeks later than in a standard 4 week cycle, but labour may be late with a standard cycle. Medical science does not yet have an explanation. The onset of labour is influenced by your body and your baby, with your baby probably having the greatest influence.
Complementary therapy such as acupuncture or homeopathy may help to bring labour on, provided your baby and your uterus are ready. I recommend meeting a complementary practitioner 4 to 6 weeks before birth.
If you go past your due date, and an early scan has suggested that your dates are correct, please talk with your midwife or obstetrician about inducing labour one week after you are due. They will assess your baby’s size and may check the ripeness of your cervix. I wish you all the best.
A: Cravings are very common in pregnancy, when appetite, taste preferences and smell tend to alter. In most cases, however, the underlying cause for craving is not pregnancy but nutrient deficiencies: our bodies tend to crave what they need. And in pregnancy, the most common cravings are for sweets, crisps and junk foods. This is because these foods provide ‘quick fixes’. But because these foods do not address the underlying causes, cravings are likely to come back again and again.
Your craving for sweets may come about because you are tired or are not eating frequently enough for your needs, or because you feel nauseous. The sugar gives a pick-me-up and quells nausea but has short term results.
Cravings for salty or spicy foods may indicate a mineral deficiency. It is easy to obtain supplements formulated for pregnancy, and taking these may help to quell cravings. You could visit a nutritional therapist for advice on whether you are nutrient deficient.
You may be caught in a self-perpetuating cycle, where satisfying your cravings reinforces them. One way to address this is to try following a meal plan for the week, with a focus on unprocessed whole foods, wholegrains such as brown rice and wholemeal bread, fresh vegetables, salad, fish, nuts and pulses, and fresh fruits. Eat every 3 to 4 hours, or eat small portions more regularly if you are often hungry. Avoid high-sugar foods, which include sweets, concentrated fruit juices, sweet breads like croissants and cakes. This may be a challenge at first, and if you slip up be easy on yourself: let it go, and recommit. I hope you’ll find that after a week of eating nutritiously and regularly, your cravings will reduce.
It’s also worth bearing in mind that cravings reflect emotional moods. Did you have similar cravings before pregnancy? Your relationship with food reflects your emotions and your self esteem; for instance, it’s common to eat sweet foods as a way of feeling better or happier and to avoid feeling uncomfortable or sad. If feelings, concerns, or memories do trouble you, you might consider asking a friend or professional for support as you acknowledge and work with these. If you do this you will feel lighter, freer and more confident after your baby is born. If you have previously has an eating problem, such as anorexia or bulimia, or you have been overweight, please take care not to use pregnancy as an excuse to eat excessively.
I wish you all the best and hope you notice a change for the better as you change the way you eat.
A: Decorating the baby’s nursery is for many women, an exciting and enjoyable thing to do. It’s natural for women to ‘nest’ in the run up to labour. By all means, go ahead but do take some precautions. There are two main issues: the possibility of straining your body; and ensuring you’re not in contact with toxic material.
I suggest you ask someone to help with anything that involves lifting or pushing, and do ask another person to do the jobs that involve standing on ladders or fiddling with electrics. And listen to your body. If you feel yourself getting tired, take a break and try not to miss meal times. If you get over tired it may take you longer than usual to bounce back and this could bring you down emotionally. So please do take it easy.
If the job requires removing paint, stripping wood or sanding paint – ask someone else (if you need to remove or sand down paint applied pre-1970 – some paints contained leads, which is now known to be toxic). Avoid contact with oil based paint, polyurethane floor finishes, spray paints, turpentine, white spirit and pain removers. And whenever you are working, open doors and windows to keep the room well ventilated. If you take precautions there is no reason why you can’t go ahead and enjoy yourself. Have fun!
A: One of the beauties of being human is that no two people are the same and every woman has different breasts. Although most women do experience breast growth during pregnancy, it’s not universal. And it’s important to remember that the size and shape of your breasts, nipples and areola (the red area around the nipples) bear no relation to the amount of milk you will produce. All breasts contain roughly the same number of milk producing cells and when you start feeding your baby, milk production will increase or decrease to meet her needs – your body responds naturally.
Occasionally, feeding is affected by nipple shape, not breast size. If your nipples do not protrude or are inverted your baby may have difficulty latching on. Usually this problem is overcome with massage or by using a nipple shield. Breast pump manufacturers also produce thimble like devices that fit over the nipple to draw it out and this can be used 10 minutes before a feed. If you are concerned, ask your midwife to check your nipples. Some recommend using massage and shields for a week before the birth.
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