The Healthy Mummy Pregnancy Group Q&A Session – Ali Pickles, Midwife

ali pickles q & aIn The Healthy Mummy Pregnancy Support Group we hold Q&A sessions each week or two with experts to talk about relevant topics to do with healthy pregnancy.

On March 11, 2015, Ali Pickles, Registered Midwife, held a Q&A session and below is the summary of questions and answers:

Q: I’m really worried that I’m going to be extremely physically unfit for my labour because I have quite bad pelvic girdle pain & SPD, which means I can’t really find many exercises I can do other than walk in the pool. Can you please give me any ideas you might have for getting my heart rate up that doesn’t involve much leg work?

A: Swimming is probably the best option for you. Have you tried anything that works on your upper body?

Q: Thanks for advising upper body work- did you mean weights? Sorry, keen for any new ways to keep fitter for labour.

A: I wouldn’t suggest physical weights but using your own body weight. Women’s push ups, dancing around your lounge room, even pilates or yoga may help.

Q: I am 26 weeks pregnant with my 3rd and have what I think are irregular contractions not Braxton Hicks. I’m thinking they are contractions as I get the dull backache and then my belly goes tight and pain either in my pelvis or my bum. I’m also dealing with SPD so that’s uncomfortable. Just wondering when should I be concerned with the contractions?

A: Are the tightenings regular or just random?

Q: They come at intervals, lasting up to 2 hours. I get them if I walk, stand or do anything a bit strenuous. I get them daily – mid morning, late arvo and late in the evening.

A: Not sure how long this has been happening for you but have you spoken to your doctor about them? Have you lost any fluid? Sometimes the pressure and weight of the growing baby can cause them and if they go away that’s a good thing.

The more babies you have the more your uterus can contract at different times. I’d mention it to your doctor or midwife at the next appointment and they may do an ultrasound to measure the length of your cervix.

Q: Yes I mentioned it to my Dr last week at my appointment and he suggested I come in again next week to see if they are continuing, which they are. I don’t think I am losing fluid. I feel as though my undies are more damp but Mr Dr said that may just be an increase in discharge as it’s slightly sticky.

A: It is normal for an increase in mucous during the pregnancy. Try and rest when you get them and try to lie down if you’re walking to see if they ease. Speak to your doctor again next appointment.

Q: I was wondering what are the best sugar levels I should be sitting at while pregnant as I have gestation diabetes? And I’m seeing that when I eat carbs my sugars spike. Is there any advice you can give me as I don’t do well with needles (phobia) and want to avoid insulin. I’m 30wks.

A: Diabetes Australia is an excellent resource to tap into. They cover all types of diabetes but also have a fantastic section on GDM. Where I work we tell women between 4-6 mmol/L is acceptable however the range does depend on the circumstances and the doctor’s choice.

Q: I’m pregnant with number 4 and I’m suffering from morning sickness pretty badly and I’m so exhausted. Just wondering what foods or small meals will help as I’m finding it very hard to eat one whole meal through out the whole day?

A: Some great morning sickness friendly ideas here

Here’s a review of our Healthy Mummy Pregnancy Smoothie which is great for snacks and morning sickness.

Q: Gall bladder issues and pregnancy. What should I be doing? I’m 22 weeks?

A: The gall bladder is a tricky one. Research foods that are gentle on the gall bladder, make sure you drink lots of water. Some women develop stones and other issues with the gall bladder that is unexplained.

Q: I’m pregnant with number 1. This past week my feet have been quite sore at the end of the day, and I’m noticing a lot of little veins in my legs, particularly towards the bottom/ankles. I didn’t expect this until a bit further on. Is it normal? I’m 19+4?

A: Veins in the legs can be sore at any time in the pregnancy, it is mainly to do with circulation. Here is an article that may help how to cope with them.

Q: I’m 32 weeks pregnant with #6 and this is definitely my fittest, healthiest pregnancy to date. I have extremely fast labours – between 45 minutes to 2 hours max….so I’m just curious as to whether being so fit will possibly make me labour even quicker….there isn’t much time to cut out. I’m not looking at giving up exercise or anything just trying to be prepared?

A: Wow #6 go you!!!! Labour time is tricky. Sometimes it’s mind over matter. You see women have fast labours for baby number two then they come in for number three and they are so stressed about the quick labour it actually takes all day for labour to kick in properly. Try to remain calm about it but the amount of exercise you do shouldn’t be a factor.

I know the feeling I have 45 minute births too, I made it to the hospital…JUST!! My cousin had her baby in the car recently, my uncle was so excited as he did the delivery. Maybe pack an emergency kit of towels and garbage bags to line the car seat and floor just in case.

Q: I am curious to know your experience with women who have had a planned c-sec with their first and a VBAC with their 2nd? I am pregnant with my 2nd, there will be a 15 month age gap and I am keen for a VBAC with this one if possible.

A: VBACs are very successful. We have a high rate of them at our hospital. Depends what your first caesar was for. The more difficult thing about a VBAC is the only way they can induce you is to break your waters, so you can’t have the hormone drip to get you going, so the worst case scenario would be your body doesn’t go into labour and you have to have a caesar. You will regret it if you don’t try and if you don’t have a high risk pregnancy I say GO FOR IT!! Your scar should be healed enough in this time and they monitor you closely.

Q: I’ve just found out I’m pregnant and I have a 1 year old Bub. I am unfortunately still 30kg overweight and have been struggling to lose it to be generally healthy! I have lost 5kg but am I able to safely lose weight while pregnant and not get harassed by my ob about being heavy?

A: I wouldn’t be setting goals to lose weight in pregnancy but trying to maintain your weight by eating healthily and exercising appropriately. After you have had the baby is the time to worry about weight loss. The health of you and your baby is most important and rapid weight loss in pregnancy can pose other issues you want to avoid. Try The Healthy Mummy Pregnancy Eating & Exercise Guide for some healthy pregnancy meal plans and exercise tips.

Q: So if I keep doing what I’m doing – eating very well and exercising and if I lose a little weight from this continuously it’s okay? I just don’t like the pressure of being overweight from a lovely surprise pregnancy but also just want to be healthy for a vbac as well. I laboured for 10 hours, no progression from for 4 cm and bubs was very distressed. Is it possible to go for vbac without induction?

A: Yes if you lose a little bit slowly that’s fine don’t aim for more than 500g a week if you can help although some weeks people fluctuate due to fluid retention etc.

Also in answer to your question yes it is possible to VBAC without induction you may find you are in pregnancy longer e.g. 40-41 weeks so prepare your partner – you may be cranky at that stage and just want out! If VBAC is something you passionately want make sure he is prepared to remind you of that when you’re over being pregnant.

Q: What are the chances of having another 9.5lbs baby? I’m 17 weeks pregnant with baby no. 2 and I’m already concerned. The first birth had a few complications.

A: Did you have gestational diabetes? Unfortunately unless there is something wrong with your placenta the baby should be a similar size. If you had a shoulder dystocia the first time and you were full term maybe speak to your doctor about inducing you a week or two earlier to try to avoid another large baby. If that wasn’t a concern and your body dilated fine then you should be able to have another large baby naturally.

Q: No gestational diabetes, not over weight etc. No dystopia, I was 11 days over due though. Will they induce due to past experience?

A: The two hospitals where I work take past experience into account when discussing inductions so make sure you voice your concerns.

Q: I am 18 weeks pregnant with my first. And this morning I experienced some light spotting. My doctor had me go for a scan and everything looks normal. I won’t get in to see her now until tomorrow to follow up on results. I have heard that this can be common with some pregnancies. Just wondering what can cause this and if there is any need to worry?

A: It can be quite normal and can occur the whole way through the pregnancy. If you lose about a 1/4 cup or a clot bigger than a 20c piece then contact the doctor. It can depend on where the placenta is located and sometimes little blood vessels burst too from the pregnancy. If the ultrasound is good and it’s only spotting and no major abdominal cramps just carry on as normal but on lighter duties.

Q: Can you tell the ladies here why you recommend our Pregnancy Smoothie and Pregnancy Eating & Exercise Plan Book?

A: I highly recommend the Healthy Mummy Pregnancy Smoothie and the Healthy Eating Pregnancy Plan as the hard work is done for you. All you have to do is focus on shopping for ingredients, preparing food and then incubating those healthy bubbas! The Smoothie compliments the pregnancy multivitamins you may already be taking and can help fill you up on essential vitamins to help boost your energy supplies, decrease nausea and assist medical conditions associated with pregnancy.

Q: I am currently 37 weeks and 4 days. I have been getting intense lower back pain that radiates up my back and across my chest. Is this possibly a sign that labour might not be far away?

A: It can be early labour but that can go for an unknown amount of days. Is your blood pressure ok? No headaches or swelling? Try a heat pack and when the pain comes in regular waves it could be a more active stage of labour. If all is well, stay home as long as you can. Have a warm bath, try to relax and keep hydrated. Good Luck!

There is an old wives tale that helps kick start labour. The “3 HOTS”. Hot curry, hot bath and lots of hot sex if you can be bothered. Stay away from caster oil – all it will do is give you a nice dose of the runs and make you feel yuck!!

Q: At what point during pregnancy should you start paying attention to baby’s movement on a daily basis?

A: Baby movements are a tricky one too. Some women can feel them at 16 weeks others not until 24 weeks. It depends on the location of the placenta. If it is on the front it will act like a bit of an insulation so feeling maybe a bit more limited. If this is your first pregnancy you’re not used to what a bubba feels like at first so it can take a while.

From about 24 weeks you should be able to feel flutters a few times a day. If you are concerned have an icy cold glass of water and lie down, see if that helps make the movements more obvious. After 28-30 weeks any concerns about lack of movements need to be rung through to your doctor or hospital.

Q: I had an emergency c-section with my son, he wasn’t big, 3.5kg, I had an epidural after 7hrs, fully dilated after 18hours, I managed to push him nearly out, then my son got stuck, failed forceps 3 times… What would my chances be of having a VB? I’m really scared to try again and think an elective c-section might be best?

A: Your chances are very good for a VBAC. Hopefully this bubba doesn’t get its little head in the wrong direction like its sibling and you will be fine. Your body knows how to labour and cervix to dilate and that is half the battle.

Q: Can you tell me some ingredients I can add to my Healthy Mummy Pregnancy Smoothie to help with constipation?

A: Psyllium husk is great, wheat, corn, rice bran are also good. Adding berries is another way to incorporate fibre into Smoothies. Start slow though – don’t want to cause bloating from too much fibre.

Q: I have been told by my obstetrician that I have a low placenta and therefore shouldn’t have sex with my husband. Is there anything I can do to move it or make it higher e.g. exercises?

A: Unfortunately you will just have to find other ways to have mummy and daddy time together. Having a low lying placenta can cause bleeding from having sex which is something your doctor would rather avoid. It’s fixed there and won’t move. I would be gentle on the exercise too.

Q: What are your thoughts on acupuncture to induce labour?

A: I personally have never tried acupuncture for inducing labour and haven’t really had anyone mention they have tried it. I have used it for other heath issues and found it beneficial.

Q: Just wondering your thoughts on this: 1st baby 40+1 pre eclampsia during labour had a PPH of just under 1 litre. 2nd baby induced at 21+1 with Misoprostol bleeding once water broke with EBL of at least 1.5 litres with blood transfusion required. Am I likely to have bleeding again or do you think it’s been my circumatances that have caused it?

A: Sorry to be the bearer of bad news but if you have had bleeds with the first two babies/births then the risk remains for the next baby. Work on boosting your iron levels with foods. Read this article for some ideas.

Q: I thought that might be the case. Would a c-section be any safer or not really?

A: A c-section still poses the same results. You can still have a postnatal bleed because it has to do with the uterus contracting down once the placenta is removed.

Q: I’m pregnant very early with baby number four. I already feel so exhausted and have no energy and in the last few days I’ve had pain on the side of my stomach. Should I be worried and is there anything I can take or eat that will bring back my energy levels?

A: Here is a story about boosting energy levels with food. Stabbing pains can be the muscles of the uterus stretching. Try a hot pack. If your blood pressure is normal then it shouldn’t be anything serious. If you are concerned speak to your doctor.

Q: I am 38 weeks and 2 days. And I have been losing my mucous plug for the past 2 days, non stop. Just wondering when this will stop? I have also been having extra pains below, from my bum, to the lower front, and the pains will last from 1 minute to longer but aren’t constant, along with a lot more period like cramps that are mild. Are these contractions? I don’t think they are Braxton Hicks because I can’t even move to shake them off. I’m getting pressure a lot as well but my little one isn’t even engaged. Also been getting really sharp digging pains under my right boob is that normal? This is my second pregnancy, but with my son I saw the mucous and an hour later my waters broke. And not 100% sure what to expect this time. I had my antenatal appointment on Tuesday, and don’t go back till next Tuesday?

A: The mucous plug can keep coming our until you have the baby. The amount you pass is different for each person. Sounds like your body is preparing for labour but when is the million dollar question. There can be practice contractions. The body is very good at teasing in the early stage of labour. Don’t be too worried if bub isn’t engaged – 2nd plus time around babies don’t tend to be engaged like they do first time around. Rib pain can be because of the baby. Once again if your blood pressure etc is all normal just try to relax, have a bath and wait for the real fun to begin!

Q: Just wondering if my doctor is suggesting early induction due to my history of pre eclampsia, at what stage is this most likely to occur? I’m 30+5 now and wondering how many weeks I have to finish preparation and hopefully get some rest with Miss 5, Mr 7 and husband working offshore for 4 weeks at a time?

A: Anytime from 37 weeks if your blood pressure and pathology results are behaving.

Q: I’m 30 weeks pregnant and have been told I am suddenly measuring small by my ob after being on track with this pregnancy and my last. I am going for a growth scan next week but am so worried. Is this something that happens often? Just unsure how worried I should be… Is there anything I can do to promote healthy growth?

A: Baby growth can be in spurts so wait for the next growth scan before you get too concerned, you may be stressing and everything will be fine.

This Facebook page and the resources Rhian has provided for you girls is absolutely fantastic. I wish I had of thought of it myself! I fully commend Rhian and her team for all their hardwork in putting this together for you.

Research is proving that our society is becoming larger and many hospitals do not cater for women over 100kg. Providing women with information that is accurate and easy to understand is an amazing tool for you girls. You should be so proud of how far you have all come especially those who originated from the original Healthy Mummy site.

Remember pregnancy isn’t a time for rapid weight loss. Embrace those buns in ovens you are cooking, be proud of your healthy mummy tummies and remember to support each other afterwards. Anxiety and depression is a part of many women’s lives and being a part of this group is going to help many women with the pressures of being anxious.

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Disclaimer: Always speak to your doctor before changing your diet,taking any supplements or undertaking any exercise program in pregnancy. The information on this site is for reference only and is not medical advice and should not be treated as such, and is not intended in any way as a substitute for professional medical advice..

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