The Healthy Mummy Q&A Session Summary – 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 April 8, 2015, Ali Pickles, Registered Midwife,  held a Q&A session and below is the summary of questions and answers:

Q: DVT in pregnancy? Is it common? I’ve had excruciating calf pain since last night, doesn’t ease when I walk or flex my foot towards me. Should I be worried?

A: They aren’t exactly common but women do get them. Do you have any hot red spots on your legs?

Q: Not that I’ve noticed. It’s just intense deep pain. Constant. Nothing seems to relieve it. And only one leg.

A: I’d say it could be more related to the veins in your legs and circulation in pregnancy. Check out the blog for the article I did on varicose veins for relief.

Q: I am finding it so super hard to breath like someone is sitting on my chest I’m 28 weeks with number 2. The only way I am comfortable is laying reclined on our lounge.. is there anything I can do – I’m so uncomfortable!

A: That’s also completely normal I wrote an article recently on breathlessness in pregnancy which also should be on the blog.

Q: How common is diarrhoea in pregnancy? I’m 33 weeks and I have had it throughout, I have also lost weight. I have it first thing in the morning and almost after every meal.

A: It’s very common especially towards the end. It’s probably more related to digestion and your body slowing everything down. Keep up your fluids and make sure you follow a balanced pregnancy diet.

In pregnancy women can develop sensitivities to food and can mimic the symptoms of irritable bowels etc. Keep up pregnancy vitamins and your little bubba will be fine.

Q: I’m 30+1 weeks and bubby is laying oblique to the left side. Could this cause any problems with labour and delivery?

A: Not at this stage. If the bub’s back rests against your back this is a posterior position and can make for a longer labour. Look up optimal foetal positioning, there are some great natural exercises you can do to help.

Q: Pain relief during labour…I’m just a little bit nervous about my first labour. Do you have any recommendations or suggestions?

A: My advice with pain relief is go into it open minded. Don’t get fixated on pain. Labour is different for everyone and everyone handles it differently. Many women say “I have a low pain tolerance” but yet they surprise themselves and do so well. Start with the easy stuff and work yourself up. Don’t get clouded by other people’s advice like “oh the gas never worked” etc. This is your birth experience.

Q: Glad to hear I can work my way up from the easy stuff if needed instead of having to go straight to the stronger ones. I’d been told that if I wanted the stronger drugs I had to decide fairly early on and that made me a bit nervous.

A: Trust your gut, you may not need anything but gas and a hot shower. If you do there is nothing wrong with that either.

Q: Anything I can do to relieve hip pain – it’s mainly when I sleep and lying on my side, that hip gets sore then I swap to the other side and the same thing, so end up tossing from one side to the other all night!

A: Hip pain in pregnancy can be nasty. I struggled with it with all three of my babies. Physio, lots of pillows in bed, heat packs, walking in water. I ended up loving the SRC pregnancy shorts if you haven’t tried them.

Q: Just wondering how successful you think I might be at attempting a VBAC? I had a CSec – it wasn’t classed as emergency but it was discovered 5hrs in established labour that my daughter was breach. Being 42weeks gestation I was advised to have a CSec to make sure she had a safe arrival. I’d love to give a VBAC a go but don’t want to get too excited if it’s not a possibility. I have a high bmi – 43.5 so wondering if this will play a major part in the decision or not?

A: Just wondering if you had begun dilating? VBACS can be very successful if you have a very supportive team around you, including midwives, doctors, partner etc. Make sure you weigh up all your options and speak to your doctor. Weight can impact it more if they cannot monitor your baby properly etc but it can be done. Go for it girl, you have nothing to lose as back up plan they can always take you for a caesar!

Q: I was 4cms and 50% effaced when I arrived at hospital. 5hrs later I was still the same dilation but had fully effaced.

A: It’s worth a try. Your body has proven it can labour and start to dilate.

Q: I’m almost 27 weeks and in my last pregnancy bub came early due to low fluid. What is the chance of it happening again and should my ob be monitoring it more often? What can I do to reduce the chance of it happening again?

A: Low fluid is usually individual for each pregnancy. Who knows what might have caused it and it may not be an issue this time. The doctors will still monitor closer though and check the levels from time to time.

Q: I’m 36 weeks and have GD. My sides are killing me and are so bruised from so many injections and they keep upping my dose. What would happen if I just stopped the injections??? I honestly am having a terrible time doing injections.

A: My advice is trust your doctor. Don’t stop your insulin, your body needs it. It isn’t a nice experience. If you do decide to stop for your own decisions, you are going to have to be very very strict with your diet. Your bubba relies on the insulin as well.

Q: I have been getting vision spots on my outer eyes and my vision is definitely nowhere even close to pre pregnancy. I also get movements in my stomach that I can only describe as very erratic/seizure like at times, is all of this normal? I am almost 35 weeks and have an appointment with my ob on Friday?

A: That’s probably one to discuss at your appointment. You may need your blood pressure checked. Have you got more swelling in your hands and feet etc. My third had movements like that. I used to describe them as it felt like when you rubbed a dog’s tummy and its legs moved. Doctors told me it was normal and she made funny movements like that at times after, was funny to watch!

Q: I had an ultrasound yesterday at (10w 5d). I’m 11 weeks tomorrow and the yolk sac was still there. Just wondering when it usually disappears? And when it does, does morning sickness go too?

A: The yolk sac generally can stay up to around 15 weeks. Morning (all day) sickness generally subsides week 15 onwards. Not for all girls unfortunately.

Q: I am now 26 weeks pregnant and I have a 1.5 year old and 2.5 year old. After giving birth to my second baby I have been experience severe tailbone pain. I have had an x-ray and MRI before becoming pregnant again but everything showed up as The pain has definitely gotten worse with this pregnancy and I cannot even sit down anymore without a donut cushion which doesn’t give much relief. Do you have any advice about where I can go from here and what might be causing this?

A: Sounds like pressure on your coccyx. Have you seen a physio? Even a chiropractor that specialises in pregnancy may help. It is normal but not hugely common. The lax joints in pregnancy are usually the cause. Try eating foods that have anti-inflammatory effects.

Q: I’m 8 weeks, and for the last few weeks have been experiencing a sharpish pain on the inside of my left hip bone. It’s in the same place as, and feels exactly like ovulation pain, and comes and goes. Any ideas what could be causing it?

A: Sounds like pelvic girdle pain. Very normal cause by ligaments and hormones. Anti-inflammatory foods will help you too.

Q: I would love to know what you recommend regarding VBA2C? I’m 23 weeks with my 5th baby. My first two babies (second baby I had shoulder dystocia) were vaginally born, third was c-section because he was footling breech and 4th was c-section because doctors were worried about uterine rupture. I just wanted to know what would your thoughts be on it as a midwife?

A: VBAC2 is a tricky one and you really need to listen to your doctors. Most won’t risk it however I have seen it happen successfully. Having your 5th baby poses risks like bleeding etc anyway so I don’t think the doctors would put yours or your babies health at risk.

Q: The doctors at the hospital I plan to birth at have ok’d a VBA2C if I choose to. I’m just trying to source as much information/opinions as possible to be able to make an educated decision.

A: That’s awesome. There isn’t a lot of information on it as it’s not very common but I think it is becoming more common. It has been successful where I work and they monitor you closely. Any sign of concerns they will just take you for a Caesar.

Q: What are your experiences with water births? I am hoping for one this time around so crossing my fingers I don’t need to be induced again.

A: Water births have been documented as wonderful, unfortunately they are being phased out mainly because hospitals are so worried about litigation and don’t have the equipment to get women out of the water quick enough in an emergency. Unfortunately as health professionals we have to abide by OHS regulations and simply are not supposed to pull a lady out of the bath although many of us have for one reason or another. Many hospitals will let you labour in the bath but not birth. Research shows the benefits of water birth are fantastic for both mother and baby and the UK TV show “One Born Every Minute” makes it look so blissful. I wanted one myself but the closest hospital that offered it near me was over 2 hours away.

Q: I had a miscarriage in December and it was a missed miscarriage. I want to have another baby, but will public hospitals support my anxiety around wanting to see the baby more regularly then at the usual 12 and 20 week marks?

A: A private Dr yes but can’t vouch for a public doctor. Miscarriages sadly are very common and I’m sorry to hear of your loss. I would try and talk to your GP and see what they have to say and they may send a letter to the hospital supporting you.

Q: Also, this appointment is to book my required induction, will my Dr perform an internal or anything? I’m not really sure what to expect at this appointment and am slightly anxious as my husband leaves Monday for 3 weeks.

A: Make sure the doctors know your husband is going away, there are circumstances they may induce earlier. I can understand your anxiousness. They may do an internal to see if your cervix is soft enough. They may not either given you are only 35 weeks.

Q: Is there any movement in the 42 week rule? I seem to like being overdue but really want to avoid being induced. What are the risks?

A: We had someone recently go to 43 weeks, she fought with doctors and won! Baby was born healthy but she didn’t dilate and ended up an emergency Caesar. Dates can be unreliable really. In the animal kingdom we don’t induce so depends how comfortable you feel about it

Q: Any other remedies for sciatic pain? Have tried heat packs warm baths, showers, Panadol etc. This is my second pregnancy and I suffered badly first time around, now 23 weeks and not getting any sleep.

A: Sciatic pain is awful! You are doing everything I would suggest. More anti-inflammatory foods in your diet. More rest during the day if you can. Sleep in a recliner. More pillows.

Q: Regarding reflux at the moment, so yuck! What am I able to safely take or is there anything that can ease it food/drink wise? It happens with whatever I eat, even when I don’t eat (between meals!)

A: Reflux is common in pregnancy and can be quite debilitating for some. Try eating small meals, and eat slowly. Try peppermint tea, drink plenty of water but sip slowly, take antacids, have ginger, know your triggers such as chocolate. Green apples are good too.

Q: I have pretty bad hypoglycemia/insulin resistance and even keeping a strict diet that has always worked pre-pregnancy (complex carbs, moderate protein, high good fat and eating something at least every 2 hours), my blood sugar is still dropping frequently, and if it happens more than twice in a day, for the rest of the day even after eating and stabilizing I still feel the typical low blood sugar symptoms – shaky, anxious, dizzy, fast heartbeat that comes and goes. I’m assuming pregnancy changes how the body reacts, but I’m not sure how to tweak my diet to get it any better??

A: That’s probably a good question for a diabetes educator or dietician sorry.

Q: I’m 18 weeks with my 2nd pregnancy and was thinking of having an elective C-section however the midwife said it’s not as good for the babies’ health as they don’t get the bacteria like they do from normal delivery. Anyway problem is I hate labour and am stressing about it because my son was 10lb 5 and I don’t think I can do it again so am thinking of an epidural. I sound pitiful but I’m worried about epidural side effects and problems and wonder if they are common? And if the pain is hugely reduced? I had gas and pethidine the first time.

A: Lots of choices you have to make there. Go with your gut. There are risks for everything to do with having a baby. Your anxiety and health related to that is extremely important. If you think that it’s going to impact you so significantly having a vaginal birth then you need to speak to your doctor and weigh up the pros and cons. Yes there are less bacteria but if you’re breastfeeding they will get them anyway. Your mental health is far more important. It affects you, your relationship and bonding with your baby. Caesars have their negatives in terms of recovery but if this is a risk you are willing to take that’s your decision no one else’s. Speak to your partner – what does he think? The epidural option is a good one if you don’t want to feel the labour but if it’s the actual birth that freaks you out again then you need to make that decision.

Q: I’m with my 5th baby and they have said my baby would be born with shoulder dystocia. I am not sure I understand what this is and what does it mean for my baby?

A: Wonder what made them say that. You can’t predict that unless the last four babies have done this. This is where the baby’s shoulders get stuck and they need to do different manouevres to help the baby come out.

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