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Travel during pregnancy

Travelling during pregnancy is not a tough task to do, neither is it very risky provided the medium you choose is safe. For e.g. travelling by rickshaw during pregnancy especially during the third trimester is a very risky thing to do and doctors recommend to avoid it as much as possible. A bumpy ride can lead to many complications in your term. Hence, choosing the right mode of travel is extremely important. It is required you do some amount of planning and take some precautions during travel. Following are a few tips that will make travelling a little more convenient during pregnancy –

Consult your doctor –
In case you are planning for a long travel it is imperative you consult your doctor. They will conduct a complete check up and asses if there are any complications in your situation. In case your situation is not right for travel they will recommend against it. In case your condition is well enough to travel they will provide you some instructions that will make sure you have a safe travel.

Prenatal test schedule –
Be sure you always make it for your prenatal test. Hence plan your travel keeping these tests in mind. You can discuss the schedule of the tests with your doctor and plan the dates of your travel accordingly.

Carry your reports all along –
When packing your belongings for the travel remember to prepare a list of key names and phone numbers you’ll need in case of emergency. This will help people reach important contacts if you are in trouble. Also if you are in your second or third trimester you should carry a copy of your prenatal chart with you all along. This chart needs to include your age, your last menstrual period, your due date, the number and outcomes of any prior pregnancies, your risk factors for disease, pregnancy-related lab tests and ultrasounds, your medical and surgical history, and a flow sheet of vital signs taken at each visit. Also it is advisable to ask your doctor to recommend someone in the area of your visit in case you are planning an extended stay. This will keep you in routine with your regular check-ups and provide support during emergency.

Carry your medicines –
The most important thing you need to pack in your luggage is a sufficient supply of prescription medications, prenatal vitamins, and even over-the-counter remedies you may need during your trip. This is extremely important if you are travelling to a place that is not well equipped with such amenities. Also you should keep the medicines prescribed by your doctor in the original container; this will help in case your bags are searched. It will show evidently that you are not taking medicines that are not prescribed.

Check flight policies –
In case you are in your third trimester and planning to take a flight to your travel destination it is advisable that you check the airline policy for pregnant women. There are many airlines that do not allow pregnant women to fly during the last week or month of their pregnancy without a note for the care provider. Also many health care providers recommend women not to take a flight after 36 weeks.

The best thing is to avoid long travel during pregnancy to have a hassle free term. Even everyday travel in the car, bus or rickshaw needs to be done with care. Take routes that are not risky and bumpy, also if possible ask the driver to drive slowly.

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Copping with unplanned pregnancy

You may be excited about your pregnancy even if you weren’t planning for one… but the leading consequences may spoil your fun. Maybe you were not intending to have any more children, or you were planning to be more stable financially before planning a family or for some reason a baby at this point of time is not the right thing to happen. There are many mishaps that can lead to unplanned pregnancies like mistakes in judgment, breaking of condoms, failing of birth control pills or failure of tubal ligations and vasectomies.

After coming over the initial shock of finding out that you are pregnant, you encounter tough decision making situations. Do you want to carry this pregnancy? How will you cope with things? Will you be able to handle this untimely responsibility? The most important and tough thing to do at this point of time is not to panic. Even if the situation seems like it needs to be sorted immediately, you actually have a lot of time on you. Calm yourself and collect your thoughts. Before you talk about this to anyone take time to think over it and determine the path you want to take. It would be good to involve your partner in the decision-making, as you two are the ones who are going to have to live with your choices.

A situation like this will always demand for support, so after you have thought about the situation clearly you could look out for a friend or a family member or a counsellor to speak with. The person should understand your perspective, situation and suggest methods keeping your comfort in mind. If not all this at least act as a venting point for you to feel lighter. The counsellor may help you look at things in different light and suggest ways you had not thought of before.

As pregnancy is a difficult thing to hide, sooner or later you will have to tell it out. But you can choose the people you want to tell to and not everybody has to know. Your husband may not be the first person you wish to tell. You can let him know when the right time comes and he is ready to talk about it. But the longer you hide the truth the tougher it will be. It is also better to let him know earlier and let him adjust to the situation with time. Not letting him know earlier can also get him angry. Whenever you choose to break the news to your husband, prepare yourself for the reaction. Try and approach the situation as a shared responsibility that the two of you will have to deal with.

It is important to remember that an unplanned pregnancy does not eliminate you from ruling your own life. The odds that you were trying to avoid by avoiding a pregnancy could also get you a number of advantages. It is a big event for your body and it definitely will affect your lifestyle for good. For starters you can now start taking extra efforts to nourish yourself better than you did before. This definitely is a development for good as a healthy body helps live a healthy life. Given it’s an unplanned pregnancy you could be facing more challenges than just physical changes. Find out ways in which you can still accomplish the goal of your life along with your baby. Also the coming of the baby will change the bonds you share with your partner for good, helping you to live a happy and supportive family life.

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Baby Movements

Pregnancy for first timers is a time full of excitement, confusion and nervousness. When you feel the flutters of your baby for the first time in your tummy you can actually feel the life moving within you. Also they are a reassurance of the baby’s development within you.

When will I feel the first movement of my baby?

The feeling of the initial flutters in your womb is a landmark in you pregnancy term. In case of first pregnancy you will not realise that those gentle fluttering sensations in your belly are your baby’s movements. These feeling are known as quickening. You may start getting aware of them when you are 18 to 20 weeks pregnant or later. During the second pregnancy some women can feel the movements as early as 13 weeks. You are most likely to feel the movements of your baby when you’re in a quiet position, either sitting or lying down.

What does the baby kicking or movements feel like?

Every pregnant woman has a different explanation to how the movements of the baby in the womb feel. Some say it feels like butterflies, nervous twitches or a tumbling motion. Initially you may find it difficult to determine the movements of your baby. Women in their second pregnancy are more efficient at realizing these sensations. They can easily distinguish them from the sensations due to gas, hunger pangs and other internal motions. However, in the second and third trimesters you will be able to distinguish the movements like strong kicks, jabs and elbows.

What does my baby do in there?

With the help of Ultrasound scans we come to know of what the baby is doing and when. Most of the movements begin much before you can get aware of them.

•    During the seven to eight weeks your baby starts with general movements like bending sideways and startling
•    In the ninth week your baby hiccups, moves an arm or leg on its own and sucks and swallows
•    In the 10th week of pregnancy your baby begins to flex and rotate his head, bring his hands up to touch his face, open his jaw and stretch
•    At 11 weeks the baby can yawn
•    14 weeks, the baby can move his eyes

Slowly and steadily your baby’s movements begin to get strong enough to feel it. Soon you’ll get used to him/her thumping or kicking as he stretches out his limbs. Also it is important to know that the baby may not always keep moving. There are times when the baby just wants to rest or sleep. Towards the end of pregnancy your baby will rest for around 45 minutes at a time.

How often should I feel the baby kicking?

During the early stage of your pregnancy you may not be able to make out the movement of your baby. But around the second and third trimester you can start feeling the sensations really strong. As per research around the third trimester your baby kicks around thirty times in an hour. Also babies have a certain period during which they are most active as they alternate between wakefulness and sleep.

I haven’t felt my baby kick today, should I be worried?

In case you are concentrating on something else; it is possible that you miss to notice the baby’s movements. If you want to reassure the movements of your baby, you can try the following methods –

•    Try putting up your legs and relaxing. Babies sometimes tend to sleep when you keep moving around. They may tend to wake up when you stop.
•    Lie down on your side and stay still. This also helps you to focus on the movements of your baby.
•    Drink something really cold. The change in the temperature felt by your baby will instigate it to move away from it.
•    Play loud music, slam the doors or something that makes a loud noise and check if the baby responds to it or not

In case your baby starts moving then may be all is well. But remember to keep an eye on the movements from now on. Also do not put off seeking help for such problems.

When should I see the doctor?
You need to contact you care provider when your baby does not move and respond to the noise or some other stimulus and when there is noticeable decrease in the movements of your baby. Decrease in the body movements of the baby may be the sign that he/she is not getting enough nutrients or oxygen through the placenta. In case this is detected you will be advised to take the required treatment for it.

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Sex during Pregnancy

A major doubt that women have during pregnancy is ‘is sex during pregnancy safe?’ For most of the couples their sexual relationship changes during pregnancy. Some may consider this the best time for making love while others may consider this a source of worry and fear.

Sex during pregnancy is safe only if your pregnancy is progressing normally. This implies that you are at low risk of complications like miscarriage or pre-term labour. You can discuss this issue with you care provider in detail. He/she will let you know of any complications your case faces and take measures to reduce any mishap.

But you may not always want to have it. Many women around this time feel that their desire for sex fluctuates during certain stages in the pregnancy. The hormonal changes, fatigue and nausea may keep the thought of sex way away from your mind. During the second trimester, due to increased blood flow to the sexual organs and breast you may feel the urge to have sex. However, by the third trimester, due to the additional weight, back pain, difficulty in sleeping, and other symptoms your desire for sex may again seem to dim.

It is important that around this time you and your partner share a good understanding and open lines of communication regarding your sexual relationship. Discuss about other ways to satisfy your need for closeness, such as kissing, caressing or holding each other. Also you may have to experiment with other positions for sex to see which is most comfortable.

Many women can also lose the drive for sex during this time as they are preoccupied with the approaching date of delivery and the happiness of becoming a parent.

You may want to discuss with your care provider safe positions for sex during this time or research the best practices for sex to avoid any unwanted situations. You should avoid sex at this time if complications have been identified in your case by your health care provider. Common risk factors include:

•    If you have a history or threat of miscarriage
•    In case you have a history of pre-term labor or signs indicating the risk of pre-term labor
•    You experience unexplained vaginal bleeding, discharge or cramping
•    Leakage of amniotic fluid, a fluid that surrounds the baby
•    In case you experience a condition called placenta previa, wherein placenta is down so low that it covers the cervix
•    Also if you are experiencing a condition called incompetent cervix in which the cervix is weakened and dilates prematurely, increasing the risk for miscarriage or premature delivery
•    If you are carrying multiple foetuses

Sex during pregnancy is not harmful for the baby directly. The baby is completely protected by the amniotic sac and the strong muscles of the uterus. Also a thick mucus plug covers the cervix to keep the baby away from any kind of infection. Moreover the penis does not come in contact with the foetus during sex.

Also many women are worried about intercourse or orgasms leading to contraction. But in case of pregnancy with low risk the answer is no. The contraction that you experience after the orgasm is completely different from the contraction that happens during labour. Never the less it is advisable to cross check with your care provider to ensure that you pregnancy is in the low-risk category. Your doctor may recommend you to stop having sex during the final weeks of pregnancy for safety. This is because the semen that contains a particular chemical may actually stimulate contractions.

In case after the orgasm you feel severe contraction for more than 30 minutes, you need to consult your doctor as it can induce labour. Cramping is serious when accompanied with bleeding. Hence you need to look out for pink spotting. Also if you waters break call the doctor immediately.

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Ease Labour Pain

Labour pain is a much discussed topic during pregnancy. Many women seem to get worried thinking of the pain and other complication that may arise around that time. Since ages women have gone through this immense pain with the help of natural methods to cope with it. But lately there have been a few more additions to the list of measures a pregnant woman can take to ease the labour pains. The main factors that influence the pain you experience during pregnancy are –
•    Body build up
•    Hormonal level during pregnancy
•    Position of the baby in the womb

The position of the baby influence the labour pain you experience the most as an undesired position will call upon a number of complications.

A few ways in which you can help yourself to go through the pain until child birth are as follows –

Cope with labour pain with heat –
Heat helps to a great extent to bear the pain. You can warm you back, tummy or groin with a hot-water bottle or wheat bag. A wheat bag is made of cloth and is filled with wheat husks. You need to heat the bag in the microwave for a few minutes. You can easily adjust this bag for your requirement as it can mould itself as per your body shape and keep you warm for an hour or more. In case you use a hot water bottle, you need to fill it with hot water and carefully wrap it in a towel before using it.

Heat reaching the region under pain in any form is useful. Hence massage is also an effective way of providing warmth. You ask someone to rub your back; this will make your skin warm and stimulate your body to ease the pain.  Also taking bath in warm water will help you warm up and bear the pain. Make sure most of the warm water runs over your bump or your back where you feel the pain more.

During delivery when the baby’s head is being born, you ask the doctor to place a soft warm cloth over your perineum i.e. the area between your vagina and anus. This will help you feel comfortable.

Massages –
As mentioned above massage also helps create warmth in the body that triggers the body to release pain easing substances. Massage for a pregnant woman is very important not only to help her bear the pain but to help the circulation of blood as well. A foot massage is an effective way of relieving the stress. It helps to make the labour period shorter as well. Start doing light foot massage for 6 weeks.

A low waist massage will also do you a lot good. The massage needs to be done with medium pressure using essential oils mixed in almond oil or olive oil. The medium pressure massage helps to divert the body’s senses to a new pressure and ease the pain of labour. Also the massage helps to release hormone called endomorphin which is natural pain killer and 200 times more effective than any of the sedative you could take.

Adopt the right position –
The position of the pregnant woman throughout pregnancy should be right. This will help to release stress of all the muscles in the body. Instead of lying all the time on the bed, consider sitting upright on a straight but comfortable chair with the tummy moved a bit towards the front of the chair. This position helps to bring the child in the correct position in the womb and helps to engage the head of the chid in the pelvis in the right way.

Breathing exercise –
During the pain you can focus on your breathing to cope with the contraction. Take a deep breath when the contraction begins and release it slowly to relax. Breathe in through the nostrils and breathe out through your mouth keeping your cheeks and mouth very relaxed.

Do not worry about how deep you breathe. Keep it rhythmic and continuous. Concentrate as much as you can on breathing when the contraction begins to come up.

Have someone to support you through the labour –
It is better if you have someone supportive during labour to stay with you and comfort you. This will help you to give birth more quickly and easily. As per research it is much better to have another woman with you during labour to help you. However there has not been much evidence to show that it is helpful to have your husband with you during childbirth.

A few hospitals may not allow the family members to be around during child birth and you need to rely on the support provided by the hospital staff. In case your hospital allows you to take a birth partner along then you need to think carefully of whom you would take along with you. Take someone who will not panic and trusts you. This can be your husband, sister, mother or mother in law.

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Post Delivery Care

After the delivery of the baby, postpartum period begins and ends when the mother’s body reaches the condition of the pre pregnancy stage. Normally the postpartum period lasts for six to eight weeks.

During the postpartum period the mother goes through many changes. She meets the challenge of facing physical and emotional difficulties with the newly assigned responsibility of being a parent and nursing a child. It may take time for you to learn how to nurse your new born and function as a new set of family. At this time not only the care of the child but the mother as well is very important. She needs to take this time to rebuild her strength to take on the new responsibilities’ better in the near future. For this she requires a lot of rest and good nutrition to regain strength especially in the first few weeks after delivery.

Rest –
Babies have different sleep patterns as compared to adults. Typically every baby gets up in every three hours and requires feeding, changing and comforting. For parents with the first baby, this could be an overwhelming experience for the mother. She may feel extremely exhausted as a proper eight hours sleep for her is a distant dream for a while now. This poses a challenge before her to find some time for rest. The following tips may help the new born mother to find some time for some forty winks-

•    The first week may be tough on the mother as she is quite weak and has just become aware of the new responsibilities, also she is experiencing a number of changes in her body. It is important that around this time the mother should be relieved of all responsibilities other than feeding the baby and taking care of herself. Ask a close family relative to help you in this time of need.

•    To catch up on your sleep make sure you sleep when the baby sleeps. These can be a number of small naps throughout the day but they add up and give you the much required rest you want.

•    Reduce the physical exertion as much as you can. Keep your baby near to you as in keep your baby’s bed near to yours. This will help you save steps and time and make it easy for you to reach the baby when required.

•    A new member in the house calls for many people to visit you to see the baby and mother. However, mothers should not feel obligated to entertain the guest and should excuse themselves for a nap or to feed the baby.

•    Get some fresh air. As per the advice of your care provider you can start taking small walks or start postpartum exercises to flex your muscles. This will help you feel fresher.

Nutrition –
During pregnancy and birth a mother’s body goes through several changes. After delivery it is important for her to regain strength and restore the lost nutrients. This is not just achieved by plenty of rest but she needs to follow a healthy and balanced diet as well. This will promote her recovery and healing.

The weight you gain during pregnancy helps you to store the resources you require for recovery after pregnancy and to breastfeed the baby. The mother should not stop taking a healthy diet after the delivery as it helps her to be healthy and take care of the baby as well.

Mothers need to include in their diet food items that represent all the major nutrient groups like carbohydrates, fats, proteins, vitamins and minerals. In the busy schedule the new mom may forget to have her meals properly, hence you need to plan simple and healthy meals that are required to fill up your nourishment quota.

•    Have more of whole-grain foods which include oatmeal, whole-wheat flour, whole cornmeal, brown rice and whole-wheat bread.

•    Include a variety of vegetables in your diet like dark green and orange coloured vegetables, legumes starchy vegetables and others

•    Fruits too form an essential part of your diet

•    Do not forget to add fats to the diet but in limits. Include fat sources from fish, nuts and vegetable oil and avoid saturated fats like butter, ghee etc.

•    The intake of calcium is very important for the new mom. Include milk and milk products contain calcium and vitamin D required for the wear and rear of the bone tissues.

•    Add low fat or lean meats and poultry in your diet as well

Also continue to have more water daily. You need to increase the fluid intake as you may get extremely thirsty while nursing the baby. Also remember to consult your doctor for additional information on the kind of precautions you need to take after birth.

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Spotting during Pregnancy

Spotting in pregnancy can be referred to light bleeding similar to the monthly menstrual period. This may happen at any time during pregnancy, mostly during the first trimester. Spotting during pregnancy can also lead to complications; however there are rare chances of such happenings. Some pregnant women experience lower backache or stomach-ache along with spotting. Nearly 20% of the women complain of vaginal spotting or bleeding during their first three months of pregnancy.

A woman may also bleed lightly for around 7-10 days after she conceives and that can be due to the implantation of the ovum that is located in the uterus. As any sort of bleeding is a potent alarm of having miscarriage, thus any kind of bleeding you experience should be reported to your care provider immediately.

Types of Spotting –
The phenomenon when a little bit of blood passes from the reproductive track to the opening called vagina is called spotting. Most of the times it does not reach the inner garments or underwear, it can be wiped with a tissue after defecation or micturition. The blood that spots may be pink-tinged mucus, rusty brown or bright red; this depends on the condition and the degree of spotting. Spotting may occur in some cases only once, however it may last for several hours or even several days

Normal Spotting –
This kind of spotting occurs at the end of a woman’s menstrual cycle. Bleeding of 1-2 days after 3-5 days is considered normal, but if it occurs later than that, this may imply that the woman has some pathologic problem. Another normal circumstance for spotting is when it occurs in the middle of a woman’s menstrual period or around 10-14 days prior to the beginning of the next menstrual cycle. This kind of spotting happens during the ovulation period.

Implantation spotting is that which occurs during seven days before the menstrual cycle is due and stays for less than a day. This is a result of fertilized egg travelling into the uterine lining. Also you can experience spotting when the levels of hormone estrogen rise slightly and the hormone progesterone falls before the corpus luteum takes over the task of producing progesterone. Remember that spotting which continues for more days is not an implantation spotting.

Abnormal Spotting –
This sort of spotting lasts for several days. Spotting days before your menstrual period is due is unusual. The reasons for abnormal spotting can be different for different women. The major reason why you could experience spotting several days before the menstrual cycle is reduced levels of the hormone called progesterone. Progesterone helps to maintain the uterine lining, when the hormone level drops the woman has menstrual period. Women with deficiency in the hormone progesterone experience spotting several days before their menstrual period is due. This is also a reason for minor infertility and early miscarrying. Uterine fibroids that are harmless can also be a reason for spotting. Other reasons for abnormal spotting include disease like endometriosis and contraceptive pills intake.

Spotting occurs during the early stage of conception when the fertilized ovum is placed on the wall of the uterus. Spotting also forms the early sign of pregnancy, hence it should be looked out for. After the 37th week of pregnancy spotting is considered a sign that the cervix has started becoming softened. Spotting is a significant sign of getting premature labour or the detachment of the placenta from the uterus.

Causes of Spotting –

Infection –
Many a times spotting is also related to vaginal infections like yeast infection, bacterial vaginosis or sexually transferred disease (STD). These conditions cause the cervix to become irritated or swollen that can lead to spotting especially after sexual activity.

Miscarriage or Ectopic Pregnancy –
Spotting during the early stage of pregnancy can also be considered as a potent sign of miscarriage or ectopic pregnancy, especially if you also experience abdominal pains or cramps.

Placental Problems or Premature Labour –
Spotting or bleeding during the second and third trimester of pregnancy is a sign of complications like –
•    Complications related to the placenta
•    Complications related to the Placental abruption
•    Any kind of miscarriage
•    Premature labour

Normal Labour –
Around the 37th week of pregnancy there might be a mucus discharge tinged with blood signalling that the mucus plug has dislodged and the cervix has started to soften to prepare for the baby’s delivery. However, you are required to report any kind of bleeding you experience around any stage of pregnancy.

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Pregnancy Sleep

Difficulty in sleeping comfortably is a common phenomenon every woman faces during pregnancy. There are number of reasons that lead to this. Your body is facing major changes and adjustments as the little life develops within you. Factors like stress, anxiety, hormonal alterations and physical discomforts affect your sleep to a great extend. Having a peaceful and sound night sleep seems like a distant memory as you progress in pregnancy. However, getting enough sleep is a priority.

Loo Trips –
Shortly after you realise you are pregnant you will also find yourself visiting the loo more often. This is because to support the growth of your baby the body increases the amount of blood and other fluids. Also the kidney works more to flush the waste out of the body. All these factors contribute to your regular visit to the loo.

Your urge to visit the loo will vary at different times during the pregnancy period. In the first three months your loo trips are frequent as the growing uterus puts pressure on the bladder. However, around the fourth month as your uterus rises into the abdominal cavity the pressure on the bladder is released, but this is for a short while. In the ninth month again you begin to feel the urge to visit the loo frequently as the baby drops back down into your pelvis.

An effective way of reducing the bathroom trips is by drinking a lot of water during the day time and reducing fluid intake towards the night. You can also avoid taking diuretics like coffee, tea and alcohol (which need to be avoided during pregnancy) as they make you want to use the loo even more.

Remember since everyone’s body is different; don’t expect that the frequency at which you need to visit the loo is the same as the other pregnant women.

Morning Sickness –
The name could be deceiving, morning sickness is not just limited to the morning time. It can be difficult to handle it in the morning, but nausea at night time can make it difficult to sleep. Although it is common to face nausea in the early stage of pregnancy, it can occur at any stage.

Heartburn and indigestion
The other factors that could keep you from a peaceful sleep are heartburns and indigestion. This is a common phenomenon in pregnancy. Heartburn is a burning sensation that you feel in the lower area of the chest. This leaves an unpleasant taste in your throat and mouth. You experience heartburn and indigestion as the digestive system slows down during pregnancy, this leads to delay in cleaning of the stomach.

Leg cramps
During the course of pregnancy you are bound to experience painful cramps in the muscles of your leg due to the extra weight you are carrying. This is common to occur during the second and third trimester, which keeps you away from a sound sleep.
Leg cramps also occur due to the expansion of uterus that tends to pressurize the nerves and veins leading from your trunk to your legs. Also the presence of too much phosphorus and less calcium and potassium in the blood can lead to leg cramps.

Restless leg syndrome or RLS –
This is a condition wherein your legs feel an uncontrollable urge to move around when you are sitting or lying down. On moving the legs you feel immediate relief from crawling, tingling and burning sensation of the legs. However, this relief is short lived as the sensation tends to reoccur when you sit or lie down. RLS prevents you from falling asleep and if you do fall asleep it keeps you away from falling into deep sleep.

Best position to sleep in –
It could be difficult to find a position comfortable to sleep in. However, the best position for a pregnant woman to sleep in is to lie on her side. Lying on the sides keeps the additional weight you carry off the vena cava, which is a major vein that returns blood from the lower body to the heart. Also sleeping on the side helps to improve blood circulation to the heart and provides maximum blood flow and nutrients to the Foetus.

When sleeping on the side consider lying on the left side. This is the most favourable position for pregnant women. This not only helps the blood flow but also the kidneys to efficiently eliminate waste products and fluids from your body. This in turn reduces the swelling in your ankles, feet and hands.

Sleep positions to avoid –

Sleeping on your back is a position that women need to avoid during pregnancy as the baby’s weight presses the vena cava. Also a lot of weight is put on your back and intestines. These factors can cause discomfort and increase chances of developing backaches, indigestion, impaired breathing and circulation, etc. during pregnancy.

Also avoid sleeping on the stomach as it applies pressure on the foetus.

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VBAC – Vaginal Birth After Caesarean

What is VBAC?
Pronounced as ‘veeback’, VBAC is an abbreviation for vaginal birth after caesarean. This is used to describe the situation when a woman gives birth vaginally after having had at least one baby born by C-section. In this case you plan to get in to labour to produce the baby vaginally and go through what is called a “trial of labour.”

The main difference between a normal delivery and VBAC is the frequency and the detail to which your labour will be checked. The care provider will continuously offer electronic foetal monitoring that helps to know the baby’s heart rate and your contractions, these need to be measured all the time.

Women who have undergone only one cesarean delivery can consider VBAC as a safe option for their next delivery. The other cases when you can opt for a VBAC are –
•    If you have only one low, side-to-side scar from a C-section
•    In case you’ve undergone 2 caesareans before, but also had a vaginal delivery
•    The hospital you choose to deliver at has all the tools, equipment and a trained staff to handle the task and perform a quick C-section in case of any emergency

It is safe to plan a VBAC when you are older than 35, the fetus is large or if the pregnancy exceeds 40 weeks. However considering a VBAC is unsafe when you have two c-section scars and no vaginal delivery before. Also any scarring above the lower, thinner part of your uterus can make VBAC a dangerous option to opt for.

Advantages of VBAC –
Opting for a vaginal birth after caesarean has its own set of benefits when compared to another C-section –
•    A successful VBAC helps you sidestep a major abdominal surgery and the risks associated with it
•    You will avoid another scar on your uterus. This is important for women planning a future pregnancy.
•    Less risk of infection as compared to C-section
•    You have less pain after birth and spend fewer days in the hospital
•    Your baby experiences less trouble in breathing normally
•    You play a more active role during the delivery of your child

Disadvantages of VBAC –

The disadvantages that VBAC holds are similar to any vaginal delivery –

Short term effects –
•    Pain due to bruising and stitches in the area between your vagina and back passage
•    Urine leaks until the area round your vagina recovers

Long term –
•    Vaginal birth can increase the chances of the uterus slipping into your vagina (prolapse). However, there are a number of factors related to that other than vaginal birth like the kind of vaginal birth you had, the deliveries you’ve gone through, if you mother or sister suffered from prolapsed etc.

Also pregnancy can weaken your pelvic floor, which implies that you need to continue with pelvic floor exercises.

Risks included in VBAC –
The major risk associated with VBAC is Uterine Rupture. Although this risk has even less possibilities than 1% and has even remote chances of happening in case you had a “bikini-cut” c-section the first time.

The uterus rupture takes place around the site of your c-section incision and results in severe blood loss and oxygen deprivation for your baby. The risk of uterine rupture increases when labour needs to be induced or augmented. Experts are of the opinion that it is better to leave the attempt of a VBAC if oxytocin needs to be used to start the contractions and keep them going. You could land up with hours of labour pain and take recourse to a C-section. An unsuccessful VBAC that needs C-section to handle the situation after the labour pain begins carries more risk than a planned C-section. The surgical complications like excessive bleeding leading to blood transfusion or a hysterectomy and infections in the uterus and the incision are at risk of cropping up. These complications augment in case of an emergency caesarean.

Recovery from VBAC –
A recovery from VBAC is similar to your recovery from a vaginal birth. After a vaginal birth the mother and the child are discharged from the hospital within 24 to 48 hours. On the contrary, recovery from a C-section will take you anywhere from 2 to 4 days along with a long period of precautions to take especially with a few activities until the incision heals. The risk of catching an infection during both a vaginal and caesarean delivery is less, still you are provided with a list of infection signs you need to watch out for during the first few weeks post delivery.

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Caffeine and Pregnancy

Intake of caffeine needs to be under strict observation when trying to conceive and during pregnancy. There have been a number of experiments to prove the hazards caffeine holds against child development.

What does Caffeine do?

Caffeine is a stimulant and a diuretic (a drug that increases the rate of urination). Being stimulant caffeine increases your blood pressure and heart rate; this is dangerous for a pregnant woman. As it causes loss of body fluid through frequent urination this leads to dehydration, again a dangerous condition for an expecting woman.

Since the baby gets all its nutrition for the mother, caffeine to can cross the placenta and enter the baby’s body. You can control the amount of caffeine that enters your body, but your baby can’t. The child’s metabolism is still developing and finds it difficult to completely metabolize caffeine. As caffeine is a stimulant it can change the sleep pattern of the child and even the normal movement pattern around the later stage of pregnancy.

As per a number of researches conducted by experts all across the world caffeine has the potential to cause birth defects, preterm delivery, reduced fertility and increase in risk of low-birth weight offspring along with other reproductive problems.

How much caffeine is safe to take?
It is advisable that you completely avoid the intake of caffeine when planning to conceive and during pregnancy. But in case that is not possible you can stick to not more than 200mgs of caffeine each day; this amounts to 2 cups of tea or instant coffee.

Having more than 200 mgs of caffeine each day during pregnancy can elevate the risk of a miscarriage or the baby being born with low birth weight. A low birth weight implies that the child has some health problems that can prove troublesome in future.

What food items contain Caffeine?
Caffeine is not just a component in coffee or tea, but it is also found in food items like green tea, colas and chocolates. Also over the counter products like headache and cold tablets and allergy medicines contain caffeine. It is any ways advised to seek your care provider’s instruction before consuming any over the counter product. Below is a list that will give a fair understanding of the caffeine content in various food products –

•    1 mug of instant coffee = 100mg
•    1 cup of instant coffee = 75mg
•    1 cup of brewed coffee = 100mg
•    1 mug of brewed coffee = 150mg
•    1 cup of tea = 50mg
•    1 can of cola = 40mg
•    1 can of energy drink = 80mg
•    1 x 50g bar of plain chocolate = up to 50mg
•    1 x 50g bar of milk chocolate = up to 25mg

A few tips to avoid caffeine –

Women who find it difficult to keep away from caffeine can try brewing tea or coffee for a shorter time. This reduces caffeine by as much as half. Also you can opt for decaffeinated tea now available in the market.

Women who are quite addicted to coffee and cola will find it difficult to withdraw from casual sips. This will lead to symptoms like headaches, fatigue, lethargy etc. You can try to gradually reduce you consumption little by little each day. Find a substitute like drinking a glass of fresh juice or a cup of soup instead.

Make sure you read the labels of the food items you by carefully to check the amount of caffeine it contains or if they are decaffeinated or not.

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