Wednesday, 12 April 2017

EASTER & EGGS.

HAPPY EASTER TO YOU ALL.
At Easter I think of the holidays of my childhood, my father always cooked a leg of Lamb on the spit with brown sugar and Anchovy rub on the skin. I remember the delicious smell it gave off as it cooked making my mouth water. I loved those family lunches.

During your pregnancy there are some foods that you MUST avoid eating because they could cause food poisoning, and the presence of bacteria, chemicals or parasites in the food could harm your unborn baby.

SOFT CHEESES & PATE
Don't eat mould-ripened cheeses such as Brie or Camembert, and others with a similar rind including Goat cheese, soft blue veined cheeses, Danish Blue, Gorgonzola and Roquefort.
Any cheeses that are made from mould can contain the listeria bacteria which causes listeriosis.
Even a mild form of this infection during pregnancy may lead to miscarriage, stillbirth or severe illness of the newborn.

RAW EGGS.
Don't eat raw or uncooked eggs or foods that contain them, such as homemade mayonnaise may contain Salmonella which causes food poisoning.

UNPASTEURISED MILK.
Don't eat anything that is unpasteurised during your pregnancy because of bacteria infections.

RAW MEAT.& RAW FISH SUCH AS SUSHI.
Don't eat raw or undercooked meat and fish as they may contain parasites, or toxoplasmosis-causing parasites. This includes cured/fermented meats such as salami, chorizo, pepperoni and parma ham.

VITAMIN A.
Too much Vitamin A can harm your baby so avoid foods that are high in Vitamin A such as liver, high does vitamin supplements, fish liver oil and any supplements containing vitamin A.

 CAFFEINE.
Limit to 1 cup of caffeine daily. Too much can cause low birth weight.

There are may different cultural taboo foods during pregnancy! My advice is that they are taboo for a reason. Don't risk the health of your unborn baby.  HAPPY HOLIDAYS.



Friday, 10 February 2017

Am I pregnant or not? A February Question.

We are already 6 weeks into 2017! Amazing how times flies when you are going about your daily life.

I am often asked by people whose period is a few days or weeks late ''Am I pregnant?" It is a difficult one to answer without more information.

1. Have you had sex in the past few weeks? if No, then you are not pregnant. To be pregnant one has to have sex when the woman is fertile, i.e and egg has been released. A woman's body usually tells her this is about to happen by producing a different kind of mucous, sticky, stringy and opaque. This helps pull the sperm from her partner towards the waiting egg for fertilisation.

2. How many days is your cycle? If 28 days then your fertile days are usually 12-16th of your cycle so if you have had sex then, yes you could be pregnant.

3. If your cycle is longer 30-32-35 days each month then your fertile days may be between the12-18-20th of your cycle. However if you have sex a day or two before your period is due and you are usually regular then you are unlikely to be pregnant.

4. BUY A PREGNANCY TEST and use it according to the instructions.. IF it shows you that you are indeed pregnant then go to a Dr for confirmation between 6-8 weeks gestation.(Gestation means weeks of foetal growth and starts from the 1st day of your last menstrual cycle the month before your missed one. If the first day of your last period was 2nd December and you have a 28 day cycle then your next period was due on December 30th.. so you would be 7 weeks pregnant this week.

5. How reliable are the pregnancy tests bought in shops? Manufacturers make them to be reliable but the human error factor has to be taken into consideration. Is the test within it's sell by date? package unopened? If yes, then it should be reliable if you are using it at the right time to test. Some are for the first week of a missed period, others for week 2.. so please check. The day your period should have started is day 1. 

6. CAUTION-IF you use a test that states it is for 2nd week of pregnancy and you test your urine in the first few days of a missed period it will give you a negative reading, not pregnant, BUT you may actually be pregnant if you tested again the following week when your hormone count would be up. SO LOOK CAREFULLY AT THE INSTRUCTIONS before buying/using a pregnancy test. 

7.It is often better to take 2 different tests, each a week apart, to make sure you are or are not pregnant.  IF one test is negative and then other one positive then you should go to a Dr or clinic for blood test confirmation. 

8. If the first test is negative but the second one positive you are most likely pregnant and need confirmation by a Dr as well.

9. In other words if in doubt go to a clinic/Dr for confirmation. 

When we get the result we are hoping for, positive or negative, we often put our heads in the sand. 

I live in the tropics where it was 34 degrees today,, it is always sunny and humid, wonderful. I hope that if like one of my daughters you are snowed in, that you are wrapped up warm and able to go outside and make a snowman/woman.



Friday, 9 December 2016

December Madness!

Madness, in the sense that everyone is shopping! People are spending an average of 20 minutes queuing for their Christmas purchases. The shops are full of tinsel and wrapping paper, Christmas bargains and hoards of people.

If heavily pregnant one often feels claustrophobic in crowds. The feeling of people brushing against your pregnant belly as they pass can make you feel really odd. My advise is DON'T go shopping after 3PM, especially at weekends.  If you do venture out make sure that you can see an exit close by so that you can escape if you need to. 

Escape to a cafe and put your feet up to reduce the swelling. During the later months of pregnancy you are prone to ankle, leg and foot swelling, especially at the end of the day after a busy day walking around in the humidity of Singapore.  So FEET UP! 

Why do you have swelling in pregnancy?
As your baby grows, your womb (uterus) puts pressure on the blood vessels in your pelvis. This particularly affects the large vein on your right-hand side which receives blood from your lower limbs (inferior vena cava). This pressure slows blood circulation in the area and causes the blood to pool. 
Pressure from this trapped blood forces water down and out through tiny vessels (capillaries), and into the tissues of your feet and ankles. This water is normally absorbed by your body, but because you're pregnant, you retain more water, which adds to the swelling.

You can help reduce the swelling by not standing for long periods, wearing comfy shoes, no straps that will dig into your feet when they swell, and as said, put your feet up above the level of your heart for 30 -60 minutes a day.

HOWEVER if as well as swelling of your ankles feet legs and hands you have bad headaches, or see flashing lights before your eyes with blurry vision, pain below your ribs or vomiting then SEE YOUR DR. IMMEDIATELY this could be PRE-ECLAMPSIA a rare, serious condition of the mother in the 3rd trimester of pregnancy.

MERRY CHRISTMAS and a HAPPY NEW YEAR 2017 to you all. 
May all your labour and births be clam and gentle.





Tuesday, 27 September 2016

Autumn winds. September. 2016.

 
Everyone here in Singapore is worried about the Zika virus. Our strain seems to be different from the one causing problems in Brazil and Florida. Most of the island has reported cases and I believe to date 16 pregnant women have been infected from mosquito bites. 

Is the danger of Microcephaly as great as reported? So far none of the pregnant women here have been in their first trimester of pregnancy.  According to the World Health Organisation It seems as if somewhere between 1-13% of women who get infected in the first trimester run the risk of endangering their foetuses. 

What about those mothers-to-be who get infected during their second and third trimesters? It seems that we can only diagnose the virus when one has symptoms, checking for antibodies is not possible yet? Frequent monitoring and ultrasound scans are done, but until the birth one won't know for sure if the baby has been infected. 

PREVENTION is the main line of defence. 
Cover up when outside and use mosquito repellent that has 20% or less DEET to make sure it will do the trick. Fog your houses and gardens monthly and make sure that windows and doors remain closed. If mosquitoes do get into your condo/house you can all sleep under mosquito netting. It is quite fun, rather like sleeping in a grand tent. Some of them are soaked in mosquito repellant some are not. But they do help. 

I know people who's families are so anxious for them that they have left Singapore and fled to temperate climates for refuge. Of course that is one option. 

Dengue and Zika are both dangerous but the locals here live with the danger by taking sensible precautions. If you are pregnant or trying to start a family, or thinking of doing so in the next 6 months then please cover up and don't spend hours walking around in the Botanic gardens or the jungle. For the time being anyway.

On a lighter note there are only 89 days to go until Christmas. Yeah!!

Wednesday, 13 July 2016

PATIENTS REQUIRED!!

It is mid Summer already and as temperatures rise so do peoples tempers!

 When you are given an appointment time to see your OBGYN in his clinic the idea is that you will be seen on, or around, your allocated appointment time. Clinic's start on time provided that the Dr hasn't had to attend a birth or emergency on his way to start the clinic. If that happens, as it does occasionally, then that clinic starting late will soon get backed up. Please be patient and be prepared for some delay.

We don't deliberately run late just to irritate you or your husband. It is not some plot against you personally and shouting abusively at the staff will not make you feel better or change the fact that your Dr is running late. Remember that you get more bees with honey! If you were in labour and about to give birth you would want your Dr to make you his priority. 

We had a case in June where our staff were brought to tears by abuse from a new patient who had been waiting longer than the 20 minutes she had been told was the average waiting time with no emergency. She shouted and threatened and behaved very badly illuminating cultural differences.  She left the clinic staff feeling hurt and frustrated that they couldn't satisfy her needs.  I don't know how she felt as she left but she won't be forgotten.

I am always amazed that work places need to post signs saying that they have the right to refuse service to people that physically or verbally abuse their staff. People, keep your tempers in check. We all have feelings.

I suggest that you expect some waiting time when you make your Dr's appointments. Be prepared to wait your Dr is worth it.

Enjoy the rest of the Summer & stay cool.

Monday, 6 June 2016

June V-Bac

Greetings it is June already! Where is 2016 going to?

I was chatting to a pregnant woman this morning who is booked to have Cesarean Section in 2 weeks time for her 3rd baby. She was telling me how sad she felt that this time she had no choice.  For the birth of her 1st baby her first labour lasted 30 hours before she had an Emergency Cesarean Section for failure to progress. For her 2nd baby 2 years later instead of labour she choose to have a booked C'Section(Cesarean Section) rather than take the chance of the same scenario happening all over again.  Having had 2 C'Sections in a row she was now given no choice but to have a 3rd. If only she had known she was going to have a 3rd baby she would have chosen differently and and tried a V-Bac.

Vaginal Birth After Cesarean or V-Bac used to be called 'Trial of Scar' in London when I was working as a midwife. Mothers-to-be who had had just 1 previous C'Section could try for a 'Natural' labour as long as the gap was more than 12 months and the scar looked to be strong enough to withstand labour. If all went well then the baby was born vaginally with no danger to mother or baby. Having then had a natural labour the 3rd baby could also be born naturally and so on.

Of course not all Dr's will even today give you an option to try a Vaginal birth after Cesarean section.  It really varies from Dr to Dr and by individual case. So if you would like to have a natural birth after having had a Cesarean then you may need to ask around for an sympathetic Dr to look after you during your pregnancy and see how it pans out.

I suggested that at least all 3 of her babies will have been born the same way and could all compare notes later on! I know that my 2 daughters like the fact that they were both born in similar circumstances and their babyhoods too were similar!

If you are travelling out of Singapore for the Summer holidays have a safe journey and a good break from routine.

Sincerely
Kiki

Tuesday, 3 May 2016

Spring is here and it is time to prepare for labour.

When I think of Spring I think of Cherry blossom and lambs being born, and that puts into my mind Ante or Pre natal classes.

Classes offer a chance for you and your partner to prepare for your upcoming labour and the birth of your baby. If you were running a marathon you would have spent at least a year preparing for the run in order to make sure you had the skills and stamina to get your gold medal. Logically then preparing for labour should be taken as seriously.

Choosing which classes to attend is important. I have some couples who when pregnant say I am going to have a C'section because I don't want to go through labour. But after they have attended 1 or 2 different types ofAntenatal class they are both so excited they decide to have a natural birth without any drugs, and usually do so with ease.

Mind over Matter is the key to successful preparation. Practice the skills until they become second nature. Your mind always controls how your body reacts to feelings such as contractions, to thoughts, beliefs, etc For example fear causes the flight or fight response in the body pumping Adrenalin into the blood stream and this tenses all the muscles, increases the heart rate and makes us run or freeze.

Imagine this reaction during labour. How can your uterine muscles contract and open your cervix easily without pain if your body has frozen and it tense and stiff making it a struggle? To enable opening your body must remain relaxed and floppy allowing the uterine muscles to do their job which is to lift, push down and open your cervix.

Your Antenatal classes shouldn't frighten you, but should make you feel empowered and excited about the up coming labour. As I aways say Knowledge Breeds Confidence.

Here in Singapore there are many different types of classes to choose from.  Hospitals all have their own classes and then there is Mother and Child in Tanglin Mall which offers you  fully comprehensive courses that cover everything you will need both Pre and Postnataly. And for those who prefer a gentler approach there is Hypnobirthing.  This is taught here in many guises so look at the course content to make sure it is what you are looking for. They all differ.

The Sun has got it's hat on.  Yeah.