Have you got a question about your pregnancy health?

Then read on, as our obstetrician answers your pregnancy health questions

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What are the chances of you having twins or a multiple birth?

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You can usually feel your baby move at around 20 weeks pregnant

Q: I’ve been reading a lot about cord blood storage. Opinion seems to be divided as to its effectiveness. I was wondering if it is really worth it?

A: Blood collected from the umbilical cord immediately after birth contains multipotential stem cells, which can be used to treat certain blood diseases by a stem cell transplant. Obviously it needs to be stored for many years. It is best collected by a technician not involved in the care of mother or baby, but in some kinds of birth such collection is impossible, and some hospitals can’t deal with this anyway. The Royal College of Obstetricians & Gynaecologists doubts the benefits of cord blood storage when there are no family or medical indications and there are definite practical, ethical and financial hurdles to overcome. Access the RCOG website (www.rcog.org.uk), type in ‘cord blood storage’ in the search box (top of page on right) and click on ‘cord blood banking’ in the list that appears for a helpful, non-jargon-filled article

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Q: I’m 8 weeks pregnant, and I’m wondering if we should find other homes for our pets – we have two dogs and three cats! I’ve read some articles that suggest there are some dangers posed to babies by cats and dogs – is it true?

A: Pets and babies have grown up together for centuries and the overwhelming evidence is that this is a mutually beneficial arrangement. However, pregnant women should avoid contact with anything contaminated with cat faeces, like litter trays, for fear of toxoplasmosis, and animals should be wormed in case of round worms.

Although any animal prone to unpredictable behaviour will have to go, children almost always benefit from having animals around in terms of socialisation skills. Dogs often seem to think that the baby has been produced solely for them to have something to guard, although cats may feel that their importance is being neglected and withdraw from the family, bottle-brush tail disdainfully erect. When you’ve got the baby settled, if you’re not exhausted, it is worth spending a while playing with the animals to prove to them that they are still quite special!

Q:  My husband is a twin. There’s no history of multiple births on my side of the family, but I was wondering what the chances are of us ending up with twins, or more!

A: It is only a family history of twins on the mother’s side that slightly increases the chance of multiple births. In your case, the twin rate would be the same as the average for spontaneous conceptions (without the help of IVF). It is about 1 in 80, and for triplets it is supposed to be 1 in 80 x 80 = 3,600, but that is fairly approximate.

Q:  My first baby is 2 now, and I’m thinking about trying for another. What is the ideal age gap between siblings?

A: There isn’t a gap that is going to suit everyone, but there are two things worth considering. If the last delivery was by Caesarean, you should wait six months before getting pregnant, and many would recommend a year. This is to make sure the womb has healed before it gets stretched again. The other thing, for comfort and to reduce exhaustion, is to try to avoid being heavily pregnant until the previous child is old enough not to be carried everywhere. You will find people who recommend having children close together to encourage bonding, or far apart for high achieving – or the other way round! Just go with what you feel is going to suit your family best.

Q: I have polycystic ovary syndrome, and take Metformin, which gives me periods every eight weeks. I was told by my GP when I was 20 that I should start a family as soon as possible, and I’m 27 now. How long should I realistically leave it, and can I do anything to improve my chances of conception?

A: Women with polycystic ovary syndrome (PCOS) tend to be subfertile because they may not ovulate every month or at all. They may menstruate infrequently too, although lack of periods doesn’t necessarily imply lack of ovulation. Metformin is an anti-diabetic drug, but it also helps to sort out the disordered hormones that you get with PCOS. I don’t know what your periods were doing without Metformin, but clearly an eight week cycle still isn’t the usual arrangement. At the age of 27, my advice would be to start trying for a baby now. If you are unsuccessful after 12 months, seek medical help. You may be prescribed a mild fertility pill such as chlomiphene (which you can take as well as Metformin). Good luck!

Q: My baby is still breech at 38 weeks. Are there any ways I can encourage him to turn?

A: Some babies will turn spontaneously even in late pregnancy, although this is usually after 38 weeks and with first babies. Some babies who remain in the breech position can be turned by a doctor placing their hands on your womb – a technique called external cephalic version (ECV). ECV needs to be conducted by an expert, usually in a hospital setting as an out-patient after 36 weeks. Sometimes it is even carried out at the beginning of labour. It carries no guarantee of success, however, and is not appropriate for everyone.

Q: My partner and I are thinking of starting a family, but when I’m not on the Pill I suffer dreadful period pains. Is this an indicator of endometriosis and can this make getting pregnant more difficult?

A: I think you are worrying much too much! It is true that women with endometriosis tend to have painful periods and can also be slightly subfertile, but most women with painful periods do not have endometriosis. Indeed, painful menstruation usually suggests that ovulation is taking place – completely painless periods may indicate that the ovaries might need some help to release eggs.

Unless you have any other symptoms, I really don’t think you need any tests or investigations. If you want a baby, start trying – 90% of women will get pregnant within 12 months. If you happen to be in the remaining 10% this is the time to seek help.

Q: I’m 20 weeks pregnant and have just felt my baby moving for the first time. Ever since, my lower stomach has felt like its tightening and then going back to normal. What is happening? Am I having Braxton Hicks or is it just the baby moving around?

A: 20 weeks is probably a little early to start feeling Braxton Hicks contractions, which become more noticeable during the last 10 weeks of pregnancy. They are said to be painless, but a lot of women do find them quite uncomfortable. I don’t think the movements of the baby in your womb are causing the feeling of tightness in your lower abdomen either.

It is most likely that your tummy muscles are being stretched by the bulge behind them, and are responding with occasional involuntary spasmodic contractions. The symptom that you describe is extremely common. I remember my wife during her first pregnancy saying, “If only my tummy muscles would realise that they are beaten and give up the struggle!”

Q: I’ve suffered from thrush since my early 20’s and now that I’m pregnant I’m concerned this may harm my baby?

A: If you have a tendency to suffer from thrush, I am afraid that the chances are that your attacks may be more frequent or more severe while you are pregnant. This is because your immune system will have been compromised to a certain extent by your pregnancy.

Most creams and pessaries for thrush are perfectly safe to use during pregnancy, thought the manufacturers of the drug Fluconazole (sometimes sold as Diflucan) recommend you avoid this while pregnant as prolonged high doses may cause problems with the unborn baby.

I wouldn’t worry too much if you’ve taken a capsule before you knew you were pregnant, but to be on the safe side, I would recommend you stick to creams and pessaries, for the remainder of your pregnancy.

Occasionally, a baby born to a mother with vaginal thrush may catch this fungal infection in its mouth. This is easy to see and easy to treat. More serious thrush infections in newborn babies are very infrequent indeed although premature infants may be more vulnerable as an additional complication of the life supporting measures that such babies may need.

Q: I’m 11 weeks pregnant and am suffering from morning sickness most days, However, I’m also experiencing chronic heartburn and indigestion, along with dizziness, claustrophobia and difficulty breathing if it’s hot or stuffy. This is starting to scare me. Is this normal?

A: Morning sickness, heartburn and indigestion are three of the so-called minor problems in early pregnancy and they are largely the result of altered hormones. The sudden increase in oestrogen levels make you feel sick and relaxes the stomach and intestines. Vomiting obviously makes the heartburn worse.

Morning sickness usually resolves itself by around 14 weeks but, in the meantime, don’t let yourself get hungry – always keep a packet of biscuits in your handbag to nibble as soon as you get peckish. Ginger biscuits are generally said to be the best.

However, if you really aren’t coping and simply can’t keep anything down, talk to your GP. Preparations such as Gaviscon can be used for heartburn.

The other symptoms of claustrophobia, dizziness and breathing difficulties sound more like mild panic attacks. By this stage of pregnancy the initial excitement of expecting a baby may have worn off and consciously or subconsciously you have realised that huge changes will be happening to your body (for a few months) and your life forever!

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Put like that it’s amazing that every pregnant woman isn’t panicking hysterically most of the time! If these symptoms are a real problem don’t hesitate to discuss them with your doctor or midwife.

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