The Healthy Mummy Q&A 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 May 20, 2015, Ali Pickles, Registered Midwife, held a Q&A session and below is the summary of questions and answers:

Q: I have had a really slow weight gain and have been extremely active and healthy. However this morning I woke up and have gained a kilo from two days ago when I weighed myself. I haven’t changed anything at all. Is it normal to have such a jump in weight so suddenly? I am almost 18 weeks now.

A: Very normal, weight does fluctuate throughout pregnancy. Some old wives tales would suggest you are having a boy for this reason! Don’t stress it will slow again and then happen again.

Q: I’m 36 weeks pregnant and my Dr performed a stretch and sweep yesterday and is wanting my baby to hopefully come naturally in the next two weeks before he does a medicated induction. My question is what is the success rate of a stretch and sweep?

A: It all depends on how “ripe” so to speak your cervix is. If you have the right amount of hormones on board to go into labour they are quite effective. They are certainly worth a shot. We certainly do it all the time where I work.

Q: I’m 35 weeks & baby is transverse. My obstetrician showed me one exercise to try today but she isn’t too concerned as I am scheduled for a C-section at 38 weeks. But I am incredibly uncomfortable with Bub positioned how she is. Any advice on how to get bubs to go head down?

A: Look up optimal foetal positioning, there are great exercises under this topic. If you have a fit ball try using that. Avoid sitting for long periods. Watch TV on all fours! I think there is a website called spinning babies that has exercises too.

Q: Wondering if I would usually have to pre-arrange an epidural prior to going to the hospital? I’m currently 26 weeks.

A: it depends if you’re going public or private. Definitely yes in the private you can pre-organise it. With public you need to speak to the clinic midwives and doctors. Word your hubby up for when he rings in to say he is bringing you to the hospital.

Q: Bubs is posterior and I’m being induced in 10 days at 38 weeks. I’ve not googled anything but is her position a problem for labour (will be my 4th natural birth)?

A: Given it is your 4th baby it won’t be as much problem as your first as you have birthed babies before and your body knows what to do and how to push. You may find the labour is more in your back so make sure you keep heat on your back. During contractions get hubby to massage hard with his thumbs in the dimples in your back. Keep upright as long as possible, avoiding lying on your back in labour.

Q: Hoping to have a VBAC with twins, any tips or pointers on how to improve my chances?

A: Hopefully you can prevent your first presenting bubba from being breech. Did your body labour last time? Your doctor may want you to have an epidural so research that. Also research natural ways to get into labour and to help your body such as raspberry leaf tea etc as they will only be able to break your waters to induce you.

Q: I’m only 5 weeks and am so dizzy, the room spins, I also have had occasional palpitations and mild back pain. This is my 3rd pregnancy… Never had this before. Is this normal?

A: It can be normal as your body adjusts to the hormone surges associated with pregnancy and the stretching on your body can sometimes make your body feel a bit like it is in shock. Make sure you get your blood pressure checked next visit.

Q: I have been waking during the night with incredibly painful cramps in my calves – ouch! I’ve heard magnesium could be the answer? Should I check with my obstetrician before taking anything?

A: Leg cramps are very common in pregnancy, here’s a helpful article here. Magnesium can help.

Q: I’m being monitored for low platelets. I have my 20 week doctors appointment on Friday, what questions should I ask about it? There’s lots of conflicting information about it out there. I had pre-eclampsia with my first and not my second if that’s any indication.

A: If you had pre-eclampsia the first time this is how they monitor it second time around. They will monitor your blood pressure, check your wee and your reflexes from time to time too. It is not as common to have it early on in the pregnancy but if they have a platelet level baseline they can see what is normal for you and check if it is dropping.

Q: What’s the earliest you can get the glucose testing done?

A: It depends on the doctor and their blood collection place. You will have to ring your local centre and check. If you have had GDM before I do believe they can do it earlier but it really is up to the centre.

Q: 1st time mummy here and new to the page. I’m curious about ovarian pain and general cramping during early pregnancy. At what point should it be alarmed?

A: How many weeks are you if you don’t mind me asking? It can be really common in early pregnancy due to implantation etc. If you have had your first scan you can rule out ectopic pregnancy. As long as there is no blood loss all should be good.

Q: I am hoping to have my 2nd natural birth, 12 years since my first and would like it to be as calming as possible. I’m having a water birth if all goes well. Can you recommend any good books to read? Also would you recommend hypno-birthing classes?

A: Read up on calm birth. I was a HUGE skeptic however my aunty is a practitioner and convinced me to try it for my 2nd and not sure if it was pure luck but I had 4 contractions and then the baby! 1 hour labour and I have to say my migraines hurt more than childbirth. Start learning the principles and relaxation early so it comes to you naturally in childbirth. Make sure your birthing partner is aware of all your choices too.

Q: This is my 3rd pregnancy and found out we are expecting identical twins. I really want to have a natural birth (1st and 2nd where natural) but everyone keeps telling me I’m crazy… Is it possible?

A: Of course it’s possible. Congratulations!! I would have a vaginal birth if I had twins (I secretly envy you) I always wanted twins. If you have had normal births before I’d say you’re crazy to have a caesar however be prepared they may want you to have a epidural.

Q: I’m 25 weeks and since 12 weeks any time we have sex about 24 hours later I have what is exactly like a large portion of the mucus plug come loose. I’m sure its not normal after sex cervical mucus, it’s very different, there is no blood in it however.. I’ve minimized how often we do this now just to be safe.. is it anything I should be worried about?? Also if you get braxton hicks more often are you likely to go earlier, or is that an old wives tale?

A: Unless your doctor has told you not to have sex keep doing what ever feels right. Pregnancy hormones can make you want it more. Mucous coming away is normal. As long as your placenta is not low lying and no blood enjoy!!!! Braxton hicks and bub coming early is a wives tale.

Q: I have been having episode where my left leg goes numb during the night while I’m asleep. It appears to occur when I’ve been lying on my back?

A: Completely normal, you have a big vein running through the middle of your back. When you lie on your back when pregnant it can block it off and cause numbness. It can also restrict blood flow for you and bub. If you can lie slightly on your side or pop a pillow under one hip this helps significantly.

Q: I have a physio appointment in June to get a support belt. I am 27 weeks and when I walk in shopping centres and so on I get pains in my lower abdomen like stitches when you exercise, only in two spots always the same never moves but it gets worse if I keep walking. Should I be worried? This is my 3rd pregnancy.

A: Unstable pelvis is very common in pregnancy especially the more pregnancies you have. If you can get your appointment brought forward I would given you’re already in pain.

Q: I am 36 weeks with gestational diabetes and trying to hand express. Just wondering if everyone has success in doing this and how long it should take from the colostrum to come through? Will it take a few days before I can express anything? Only saw the lactation consultant today but have not had any success yet. I’ve had no leaking or signs of colostrum yet. Concerned about my “technique” and wondering if there are any videos of hand expressing available?

A: Hand expressing is a tricky one. Not everyone can do it. It can take up to 5 mins to get 1 drop of liquid gold. Hold your breast in your hand and with your thumb and forefinger squeeze down towards the nipple and pause just before the nipple for about 10 secs.

Q: I know they say you should sleep on your left side but I find myself sleeping on my right mostly. Should I just go with it?

A: Right side is also fine just not flat on your back.

Q: Just wondering what I can do for severe hip and pelvic pain, especially after walking for a while and while turning over in bed at night. Are there any stretches etc that might help?

A: The stretches in the new Healthy Mummy Pregnancy Eating & Exercise Guide have been amazing for me. They are yoga based so get your heart rate up nicely too.

Q: I’m 37 weeks pregnant and not had any colostrum leaking as of yet. Should I be worried? Is there something I should be doing to bring in the colostrum in preparation for my baby?

A: No not everyone leaks. Your hormones will help you. Skin to skin contact as soon as hub is born if all goes well. Trying to feed bub in the first hour of birth will also help.

Q: I am 25 weeks pregnant with twins. There is a 55% chance of me having to have a caesar. I am focusing on having a vaginal birth though. I know why they recommend an epidural, however, is there a way I can have a partial epi? Because if I am able to have a vaginal birth I would prefer to not birth lying down but I know if you have an epi you have to lie on your back.

A: Partial epidurals depend on the hospital. Patient controlled epidurals are definitely the go and I know our hospital prefers them. Most major hospitals will have a pain relief education or an anaesthetic group practice that hold education sessions you can go to and find out more information.

Q: I’m suffering from carpal tunnel which is keeping me up every night at the moment. Are there any natural remedies I can try?

A: Eating a balanced diet to prevent weight gain such as the Healthy Mummy Pregnancy Eating Plan and including a small amount of lean protein such as meat, poultry, eggs, beans and pulses. Aim to reduce how much salt, sugar and fat you have. Drink plenty of water too. Eating foods high in vitamin B6 will help to promote a healthy nervous system. e.g. sunflower and sesame seeds dark, green vegetables, such as broccoli, kale, garlic, hazelnuts, avocados and oily fish such as salmon.

Q: I’m 31 weeks pregnant and I’ve been getting really sharp pains in my lower abdomen. This is my 4th pregnancy my first two came at 38 weeks and my 3rd came at 35 weeks. Obgyn made me do a scan on Thursday for my cervical length but it was all good, but I’m still getting those pains. I feel like I need to go into the fetal position for it to calm down a bit. What could be causing it? Could it mean that I might go into labour soon? Also someone mentioned to me that my cervical length to change in no time is that correct?

A: Usually it’s caused by the increased weight of the uterus. Try some hot packs and rest if you can. It is all part of the stretching and can be an early sign of labour however this can go on for days or even another couple of weeks.

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