Month: December 2020

Pain relief options during labor and delivery

Posted on December 10, 2020   by   - Blog

pain relief options during childbirth

Childbirth is usually quite painful. When your due date is nearing it is wise to be informed about the various pain relief options available. It is not necessary that you have to choose one of them if you plan to go through the process without any medications, as it is solely your decision. But during labor, if you feel that the pain has become overwhelming, and need some medication to help reduce the intensity of the pain you may ask your doctor or nurse for the option that you feel may be suitable for you.

There are a range of options available that provide relief to different extents.

Medical options for pain relief during labor or childbirth:

Nitrous Oxide

Also known as the laughing gas, is inhaled via the face mask. One will have to inhale the gas as the contractions begin. It does not provide full relief from the pain but can help reduce the intensity of the pain the woman goes through for each contraction.

The best thing about this is that the woman who is going through the labour process can use and control it. When the contraction begins you need to take a deep breath and will take around 20 seconds to experience its effect.

It does not have any side effects on the baby but some may experience nausea. Some do not experience any pain relief when using nitrous oxide.

Pethidine

It is a pain reliever. It is injected into the body via a vein or into a muscle like the thigh or buttock. The effect may last for 2 to 4 hours. But in some cases, there may be a lack of relief. Some may experience nausea. If the pethidine injection was taken close to the delivery time the drug may have an effect on the baby. In such cases, they will give another injection which will reverse the effect. It may also affect the suckling for the first feed for baby.

Epidural

It is the most effective of all options used. The anesthesia is injected into the spine. It is used for both vaginal and c sec. It may take around 15 minutes to feel its effect. Once it comes into effect you will experience your whole lower body feel numb. Your baby will in no way be affected by the use of epidural. The only issue seen in some women is that they may have trouble pushing the baby for vaginal delivery.

Using epidural may affect your blood pressure and it needs to be constantly monitored along with the baby’s heart beat too. A urinary catheter will be inserted as you may not be able to tell when you need to urinate.

Due to the absence of pain, you may not be able to push effectively, due to which the baby may have to be delivered with the help of vacuum or forceps. Some may experience itchiness from the use of epidural.

Another option is a combined spinal epidural where you continue to feel your lower body and can move them a bit. But if you still feel the labor pain and it becomes unbearable more of it will be injected via the catheter.

 

Non-medical options:

  • Breathing techniques.
  • Hot or cold packs, massage or warm shower.
  • Listening to music for a calming effect or distraction.
  • Immersing your body in water.
  • TENS -Transcutaneous electrical nerve stimulation – A device used to stimulate the nerves in the lower back. It can be controlled by our hands. There are no side effects to the mother or baby.

All these options may not give complete pain relief during labor but can help to lower the intensity of the pain. Some of these do have side effects like nausea, dizziness, not being able to move due to numbness, etc.

Labor pain varies for every person and is highly unpredictable. You may have planned to go through it without any medication but if at any point you feel you are not able to handle it or need any form of support or help there is nothing wrong in asking for it.  It is always best to know about the options available, the pros and cons of each and then proceed with the delivery so you will be prepared.

Early miscarriage

Posted on December 10, 2020   by   - Blog

Early Miscarriage

Miscarriage is something most women worry about during pregnancy. The risk is usually high during the first three months which reduces drastically after 20 weeks. Usually, one in five pregnancies ends in miscarriage.

In many cases, women may not have even known they were pregnant, instead, the miscarriage may be mistaken for a period. A chemical pregnancy is when an early miscarriage occurs shortly after implantation. There are chances that a late or heavy period could have been a chemical pregnancy. If your period has occurred around 2 weeks late, one cannot confirm if it was a miscarriage or not. It can only be confirmed by checking the pregnancy hormone hCG (human chorionic gonadotropin) in the blood. Chances of early pregnancy loss increase as women get older.

If there is severe pain and you experience dizziness or fainting along with abnormal bleeding, then there is a chance of ectopic pregnancy and you will need to seek medical help immediately as it is risky.

Signs of miscarriage:

  • Spotting or Bleeding in the form of small lumps of blood (not necessary that a light spotting or bleeding may be a miscarriage)
  • Cramping or back pain.
  • The sudden disappearance of morning sickness.
  • If you have had a miscarriage before 8 weeks it may seem like a period but if it is later there will be large blood clots or tissues.

Cause of miscarriage in the first trimester

  • The most common cause is chromosomal abnormality due to which the fetus may not have developed properly.
  • Placental issue where the placenta may not have developed properly.
  • Another cause can be deficiency of the pregnancy hormone progesterone.

Cause for miscarriage in the second trimester includes:

In the third trimester loss of pregnancy is not considered as miscarriage but a stillbirth.

Early pregnancy loss can be diagnosed by taking an ultrasound of the uterus or checking the level of hCG (human chorionic gonadotropin) in the blood which is the pregnancy hormone.

When do you need to contact a doctor?

You have to contact the doctor if there are blood clots or tissue along with uterine contractions. If the doctor confirms that a miscarriage has occurred, they may ask for an ultrasound scan to ensure all the tissue has gone or not. It may take two weeks for the tissue to go completely and the doctor may also prescribe medicines to increase the uterine contraction to completely clear the tissue from the uterus.

If after miscarriage the pregnancy tissue still continues to remain in the uterus or does not get cleared the treatment required is Surgical management of miscarriage (SMM) by gentle suction. General anesthesia is provided for this procedure. The surgery is done via the vagina.

Recovery:

Avoid the use of tampons and sex for some time to prevent infection. You may need to take a pregnancy test after two weeks to ensure if the hormone levels are back to normal. You will need to contact the doctor if bleeding continues to be heavy, cramping or fever continues to persist.

Losing a pregnancy especially when you were hoping for it can be upsetting. Miscarriage is not your fault. Take support from your partner, family or even the doctor or a counselor. Many have continued to have successful pregnancies even after a miscarriage.

Pregnancy and Fasting

Posted on December 10, 2020   by   - Blog

Fasting during pregnancy

There is no proper evidence on if fasting during pregnancy may affect the mother or child, and more research is required to correctly identify if fasting has any positive or negative impacts on pregnancy or baby weight. But most would suggest to avoid it as pregnancy is a time when we need to focus on the mother and baby’s health by having proper nutrients, as well as help, increase the baby weight. When fasting you may not have much energy as you will be low on food and water as compared to other days. In the end, fasting is a personal choice but always do consult with your doctor before planning to fast.

An expectant mother who has high blood pressure, heart problems or diabetes must avoid fasting. The health of mother and baby must be of prime importance. Fasting during the first trimester doesn’t usually have many risks as the fetus will require just a small amount of energy at this stage.

Sometimes fasting may help reduce the risk of developing gestational diabetes.

Factors to look into before starting to fast when pregnant

  • First and foremost, the mother should be healthy.
  • The number of hours you will be fasting and the climate of the place, ie if it is summer chances are the duration of fasting will be longer and you may be tried sooner than in winter as the climate is hot.
  • At which stage of pregnancy you are currently in.

Steps to take care when fasting:

When fasting during the non-fasting hours make to include these in your diet –

  • Have lots of water and include fruits and vegetables which are high on water content.
  • Follow healthy eating habits and include lots of fiber to prevent constipation.
  • Avoid heavy physical activities that can tire you easily to avoid losing your energy and take more rest if possible.
  • Avoid salty food and caffeinated drinks.
  • There is an increased chance of acidity so avoid acidic foods.
  • Also, keep track of your baby’s movements if you are in the final trimester.

 

How to break the fast?

  • When breaking the fast always start with small meals.
  • Have more of whole grains and proteins which release energy slowly as well as lots of water to keep you hydrated.
  • Have a mixed but balanced diet which will include all the sets of nutrients required for the baby.

 

 

When should I stop fasting:

  • If you feel week or dizzy or have nausea.
  • Your weight has reduced after you started fasting.
  • You have any signs of contractions.
  • If you are urinating less as it is a sign of dehydration.
  • When you are passing dark colored urine which can make you prone to urinary tract infections (UTI).

If you suddenly feel dizzy or faint break your fast by having water with sugar or salt.

For any more details on fasting when pregnant kindly contact us.

 

Travelling when pregnant

Posted on December 9, 2020   by   - Blog

Travelling during pregnancy

It is better to avoid travelling during the initial and final stages of pregnancy. Most women experience nausea during the first 3 months. They also experience tiredness during this stage of pregnancy. Chances of miscarriage are higher during this period. In the final stages of pregnancy, travelling may be extremely uncomfortable. So it is best to travel during the second trimester, 4 to 6 months.

If you are going through a healthy pregnancy, there will not be much complications to travel.

Travelling by car when pregnant:

If you are planning to travel for long hours in the car you have to take breaks in between. Do take bathroom breaks and short walks to increase blood circulation in your legs. Always wear your seat belt. It needs to be strapped across the lap and the belt across your shoulder should pass between the breasts. In case of sitting on the front seat, the seat needs to be pulled max to the back, and if you are driving the car move the seat far from the steering wheel. This is to reduce the impact of the airbag in case any collision occurs.

Always keep a list of emergency numbers in case any issue comes up in between the travel.

Travelling by air when pregnant:

Most flights do not allow women more than 35 weeks pregnant. If you have crossed 29 weeks they may ask for a letter from your doctor. The safest time to travel is between 18 and 24 weeks. If you are travelling in the third trimester it is best to avoid long distance flights in case any medical emergency occurs. Always wear your seat belt when seated. Do not be seated continuously for the whole flight, instead take short breaks to walk to increase circulation in your legs. Keep yourself hydrated by drinking water frequently.

Try booking a seat in the front row where you may have more leg space and also on the aisle side so it will be easier to get up and move. If you come across any breathing difficulty during the travel you may check with the attendants to provide oxygen.

If you are in the later stages of pregnancy better to keep a travel health insurance and make sure it covers for your baby too in case you give birth during the trip.

Travel by air needs to be avoided when:

  • Your doctor has advised to avoid any travels or to take rest.
  • You are going through a high risk pregnancy.
  • If you have crossed 36 weeks.

Travelling by ship when pregnant

If you are planning to travel on a ship it should be noted most do not allow after 28 weeks of pregnancy and a note from the doctor is also necessary.

 

What steps need to be taken before planning for a trip or travel?

Whenever planning to go for a long trip make sure to have a discussion with your doctor and consider their opinion on whether it is safe to travel or not. It varies for each pregnancy.

  • Always travel with a copy of all your records.
  • Do keep all your medicines handy in your hand luggage.
  • In case of travelling outside the country it good to have the number of the doctor who works at the location you are visiting in case of any emergency.
  • Avoid travelling to locations where diseases like Zika and Malaria are prevalent.
  • Drink water frequently and keep yourself hydrated.
  • Also when travelling ensure that the food and water you are having is healthy and safe. Avoid raw or undercooked food. Drink bottled water in case you are not sure of the source of water that is available to you.
  • Before travelling you may also check with the doctor if you need to take any vaccines like for flu.(influenza).
  • Avoid medications for traveler’s diarrhea as it is not safe for pregnant ladies. Avoid any medicine which may not have been suggested by your doctor.
  • Do keep some healthy snacks with you which you can have in between to make sure your sugar levels do not go down suddenly or if there may be a delay in the availability of food and you may be hungry.

 

For more details, you can contact us.

Vaccinations during pregnancy

Posted on December 9, 2020   by   - Blog

Vaccinations in pregnancy

When vaccinated during pregnancy, the expecting mother’s antibodies are transferred to the baby and protects both mother and child during the pregnancy and the baby during the first few months after delivery. But not all vaccines can be taken when pregnant.

Two vaccinations can be taken when pregnant. One is for flu and the other for whooping cough (also called Tdap).

• The flu(influenza) shot protects the mother and baby during the flu season. The baby is also protected after birth from flu associated complications. Do not take the nasal flu vaccine as it contains live virus.
• Tdap is to protect the baby from whooping cough(pertussis). It is one of the major causes of death in babies younger than two months. This is vaccination is usually taken between 27 and 36 weeks of pregnancy.

There are few other vaccinations that are taken before you plan your pregnancy (and should not be taken once pregnant). You will have to talk with your doctor regarding this in detail. The vaccinations are

  • Hepatitis B
  • Rubella

When pregnant, we should only take vaccines that contain killed or inactivated viruses. The vaccines that must be avoided when pregnant are

  • chicken pox
  • measles
  • shingles
  • travel vaccines – They are vaccinations taken before travelling to protect from any local diseases prevalent in those destinations like yellow fever, typhoid fever.

Hence some vaccinations need to be taken before you plan your pregnancy, some when you are pregnant and a few others after you have delivered your baby (this is mainly if any remaining doses of vaccination are left to be taken). Discuss with your doctor in detail before planning to take any vaccination.
To know more in detail contact us.

Headaches during pregnancy. Whether to worry?

Posted on December 7, 2020   by   - Blog

Headaches in pregnancy

Headache is a common issue during pregnancy, it is more common during the first trimester and third trimester. In the first trimester, it can occur due to sudden surge of hormones, blood volume and weight changes. During the third trimester, it can be related to posture, muscle tension due to carrying additional weight or diabetes. Preeclampsia or High Blood pressure can also be another factor. If you need to have medicines due to excessive pain, you will need to check with your doctor.

Types of headache in pregnancy

Headaches during pregnancy can be categorized into two-

  • Primary headaches – due to tensions or having migraine attacks.
  • Secondary headaches – due to high blood pressure.

Migraines may be accompanied by nausea, seeing flashing light, blind spots.

Causes for headache during pregnancy

• Lack of sleep
• Dehydration
• Stress
• Low blood sugar
• Caffeine withdrawal
• Some food items also trigger headaches like chocolate, dairy, yeast, peanuts, etc.
• Bit more serious causes for headache which occurs in the second and last trimester can be low blood pressure, blood clots, bleeding, stroke, sinus infection, heart issues or meningitis.

Treatment for headaches during pregnancy

Natural remedies for headache include:
• Warm bath
• Have lots of water
• Trying to maintain a good posture
• By using essential oils like peppermint, rosemary.
• Having a well-balanced meal and try to control sugar levels by having smaller but frequent meals.
• Take rest and follow some relaxation techniques.
• Exercise
• For sinus headache use a heating pad where it pains.
• Use an ice pack or cold compress on your neck for tension headaches.
• Avoid food items that trigger headaches.

You may have medications, but only after consulting with your doctor. Paracetamol is generally fine, but avoid having aspirin or ibuprofen.

When is it necessary to see a doctor?

• When headache continues to exist, frequency keeps increasing and remedies do not have an effect on it.
• If you have blurry vision accompanied with headache.
• Puffiness of your face or swelling of hands and feet.
• If you have a seizure, or faint when having a headache.

Diagnosis for the headache

The doctor may suggest some tests to help identify the reason for the headaches.
• Blood test
• Blood sugar levels
• Scan of head and heart
• Check on eye health

It is best to maintain or have a track of when and how frequent or long your headaches last. Do include any other symptoms that were present when you had a headache like nausea, sensitivity to light or smell, blurry vision, etc. Have an account of the food you had on the day or day before the headache occurred. This will help the doctor to identify if there is a pattern and even suggest treatments.

Should I be concerned or worry about the headaches?
Headache during the end of pregnancy should be taken seriously as it may be an indication of an underlying problem, especially high blood pressure. This may in turn cause other complications in the pregnancy. So do make sure to check with the doctor and follow all routines and medications as prescribed by the doctor.