Pregnancy Concerns and Questions

Whooping Cough and Pregnancy

Whooping Cough and Pregnancy

Whooping Cough and Pregnancy Pertussis (whooping cough) is caused by the bacterium Bordetella pertussis. There is no evidence that if you develop whooping cough in pregnancy your baby will be harmed while it is inside you. The risk to your baby has to do with once...

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Headaches in pregnancy

Headaches in pregnancy

Sadly, headaches can be common in early pregnancy. Why this is so is not known for certain. It is thought it may be because of hormone changes and increased blood volume in pregnancy. As well though pregnancy can be a time of anxiety and stress, fatigue, poor sleep,...

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Miscarriage

Miscarriage

What is a miscarriage? Miscarriage which is also called spontaneous abortion is defined as the loss of a pregnancy before 20 weeks of gestation. In the first third of pregnancy, a miscarriage is called a first-trimester miscarriage. A miscarriage that occurs in the...

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Travel in Pregnancy

Travel in Pregnancy

When is it good to travel? The best time to travel is when you are between 20th to 32nd weeks of your pregnancy. At this time of your pregnancy, you should out the other end of all the initial pregnancy concerns with miscarriage, nausea, etc and have completed all the...

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How do I stay healthy during my pregnancy?

How do I stay healthy during my pregnancy?

Pregnancy is an exciting time when you have new life (your baby) developing and growing in your uterus. I am regularly asked “what can I do?”, “what can’t I do?”, “what can I eat?”, “what can’t I eat?” etc. A mother-to-be wants to look after her precious cargo in her...

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Can I exercise in pregnancy?

Can I exercise in pregnancy?

Exercise and Activity Walking is an excellent idea. As well, antenatal exercise classes are available through the hospital and privately. You can inquire about the hospital classes when you book. See also in link section exercise in pregnancy. Working Normally I am...

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When will my baby turn head down?

When will my baby turn head down?

As you progress through pregnancy the baby’s position becomes a more important consideration. At about 30 weeks about 25% of babies are not in a “cephalic” (head down) position. It is normal for the baby to turn head down even by about 34 weeks. So don’t worry! It is...

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Do pregnancy hormones cause anxiety?

Do pregnancy hormones cause anxiety?

A patient recently asked me: “Do pregnancy hormones cause anxiety?”. The answer is no. Pregnancy hormones do not cause anxiety. This patient, who is 11 weeks pregnant, had an extra reason for pregnancy anxiety. She had required progesterone pessary support to maintain...

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I will be vlogging soon.

I will be vlogging soon.

I have always been keen for my patients to have good quality, accurate information about pregnancy and childbirth. As well, I have always been keen to help my patients avoid believing nonsense on pregnancy topics. Before the internet incorrect information was conveyed...

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No need for facemasks

No need for facemasks

As it is no longer mandated by NSW Health that face masks must be worn for patients and doctors for consultations in private practice we have decided to cease advising patients and their husbands/ partners that’s face masks must be worn for consultations. I have for a...

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Engagement of your baby’s head

Engagement of your baby’s head

What does engagement of my baby’s head mean? Your baby’s head is engaged when the widest diameter of the head passes through the brim of your pelvis. A pregnant woman will often know this because of a very intense feeling of fullness in her pelvis. Some women have...

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The short cervix dilemma

The short cervix dilemma

Paula’s first pregnancy was managed as a public patient. She told the first time we met my management of her second pregnancy that a short cervix had been diagnosed in her first pregnancy at 23 weeks gestation. She said she was kept in hospital on bed rest for 5...

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Can a pregnant woman eat sushi?

Can a pregnant woman eat sushi?

Sushi has become a very popular healthy meal option over recent years. I am often asked by a pregnant patient can she still eat sushi while pregnant? It depends on what is in the sushi. Any sushi with raw or undercooked seafood should be avoided. Eating raw or...

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Can pregnant women eat pineapples and papayas?

Can pregnant women eat pineapples and papayas?

While many say eating pineapples and papaya should be avoided in pregnancy because they can trigger miscarriage and the onset of premature labour, this opinion are based on theoretical consideration and some laboratory animal studies. I am not aware of any clinical...

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Being Overweight and Pregnant

Being Overweight and Pregnant

Management of childbirth in the excessively overweight patient was a topic of discussion at a recent department meeting at one of the hospitals I attend. Obesity is increasing in incidence in the community. Now approximately 50 per cent of women who become pregnant...

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Perineum trauma with childbirth

Perineum trauma with childbirth

All women who have a vaginal delivery have the wish that their perineum will remain intact with the delivery of their baby. This is not always the case. Many women experience perineal trauma with childbirth, either perineal tearing or an episiotomy or both. The most...

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Covid – should you be concerned?

Covid – should you be concerned?

Today a nurse from a public hospital attended for routine antenatal visit. I asked about Covid cases at her hospital and whether see had to nurse these patients. She said there were many in-patients with Covid and that she did have to nurse patients with Covid. She...

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Three adverse pregnancy developments

Three adverse pregnancy developments

Suzi booked with me for management of her first pregnancy. She was 30-year-old and had no significant medical history and surgical history. Her initial routine pregnancy blood test results were normal, including her platelet count which was 190 x 10^9/L. Suzi had the...

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Internet and social media use in my medical practice

Internet and social media use in my medical practice

Before the popular use of the internet had I was giving patients at their antenatal first visit with me several pages of the most popular pregnancy questions and answers. This was motivated by a desire for my patients to have correct pregnancy knowledge, rather than...

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Omicron – should you be concerned?

Omicron – should you be concerned?

Many patients are asking me about Covid and should they be concerned. I suspect this is because of the increasing number of Omicron cases (22,577 new cases today in NSW) and the often-conflicting messages from politicians, journalists, and doctors and nonsense...

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CHANGES TO COVID checking OF PREGNANT WOMEN 31st Dec 2021

CHANGES TO COVID checking OF PREGNANT WOMEN 31st Dec 2021

Both hospitals have updates their COVID check policies for pregnant women and their husbands/partners. SYDNEY ADVENTIST HOSPITAL (SAN) There have been some changes announced to the management of pregnant women which will take effect at the San, from today. Routine PCR...

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Travel insurance and pregnancy

Travel insurance and pregnancy

Patients frequently ask for my permission to travel overseas during pregnancy. I usually make the comment, “Make sure you have appropriate travel insurance cover for pregnancy”. I had never thought more about travel insurance in pregnancy until recently when I read a...

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COVID vaccination hesitation in pregnancy

COVID vaccination hesitation in pregnancy

The large majority of patients tell me at their antenatal visit how they are fully COVID vaccinated, had their first shot or have their appointment for their first shot. CONGRATULATIONS! There is a small minority who have decided not to be vaccinated while pregnant or...

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Increased risk of COVID infection in pregnancy

Increased risk of COVID infection in pregnancy

While most patients are either already vaccinated against COVID or keen to be vaccinated ASAP, there are some patients who are hesitant. My understanding, after discussion with hesitant patients, is this hesitancy has a lot to do with believing nonsense negative...

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I strongly encourage you to get vaccinated against COVID

An increasing number of patients are asking me about COVID vaccination in pregnancy. I strongly suggest you arrange to be vaccinated against COVID. Safety of COVID vaccination in pregnancy Some patients are saying they are worried about safety especially for their...

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From tragedy to triumph

From tragedy to triumph

When I first met Lauren, my heart went out to her because of her tragic pregnancy history. With her first she miscarried at 9 weeks She lost her second baby at 17 weeks. A boy. She presented to hospital with ruptured membranes. In view of the presentation, she agreed...

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COVID vaccination now recommended for pregnant women

RANZCOG statement extract: "RANZCOG and ATAGI recommend that pregnant women are routinely offered Pfizer mRNA vaccine at any stage of pregnancy. This is because the risk of severe outcomes from COVID-19 is significantly higher for pregnant women and their unborn baby....

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“I have itchy hands and itchy feet”

“I have itchy hands and itchy feet”

Contents Labour pain relief Caesarean section deliveries Who administers the spinal and epidural anaesthetics? Effectiveness How are regional spinal or epidural anaesthetics given? What are the benefits of regional epidural anaesthetics? What are the...

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Diabetes in pregnancy

Diabetes in pregnancy

There are two types of diabetes encountered in pregnancy. On most occasions it is gestational (pregnancy induced) diabetes. This is diabetes that has its onset in pregnancy and usually resolves after delivery. Gestational diabetes is a relatively common adverse...

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COVID-19 vaccination in pregnancy. 

Last week a pregnant nurse patient and a pregnant GP patient asked me whether they could have the COVID-19 vaccine while pregnant. In the vaccine rollout they are category 1b because of their professions. I advised them, with there being no local COVID-19 cases for so...

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Perseverance

Perseverance

I first met Alison for management of her most recent pregnancy. I took a past obstetric history from her… 2003 14wks MC D&C 2003 12wks MC D&C 2004 36wks Bleeding in pregnancy, spontaneous onset of labour, SVD*, healthy boy Birth weight 3515gms. 2005 8wks MC no...

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Antenatal visits COVID update

Antenatal visits COVID update

In view of the AMBER alert reintroduced by the NSW Government only your husband/ partner can accompany you for your antenatal visit. Children, other family members and friends are not allowed to be in the office including in the waiting room.

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Northern Beaches COVID outbreak

Northern Beaches COVID outbreak

This has resulted in new restrictions at Norwest Private and Sydney Adventist Hospitals. These include: Both have reintroduced mask wearing Screening on entry to both hospital, social distancing and hand hygiene practices will continue As well at the San Maternity...

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Low platelet count (thrombocytopenia) in pregnancy

Low platelet count (thrombocytopenia) in pregnancy

Ede recently saw me for management of her second pregnancy. Her pregnancy was progressing well. She had her routine blood testing at 27 weeks. The results were normal except her platelet count was  below the normal range  at 131 x10^9/L  (normal range  150 – 450). Her...

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Norwest Private Hospital COVID update

Norwest Private Hospital COVID update

Norwest Hospital COVID update Norwest announced today the Hospital will again allow siblings to visit Maternity for one hour once a day, The San Hospital had not changed their policy - Partner only and no children

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COVID and baby photos with me

COVID and baby photos with me

It is popular for patients to ask for a photo of me with baby, mum, and dad immediately after birth, or while in hospital postnatally or at the 6-week postnatal visit. Sadly, for the present unless I am wearing a face mask, this is not possible. Social distancing is...

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NSW COVID-19 alert now amber

NSW COVID-19 alert now amber

NSW Health on 24th July has upgraded NSW COVID-19 alert to amber (moderate transmission risk) Consequently… In hospital… All staff must wear a surgical mask if social distancing not possible (viz. within 1.5m of patients). Husbands/partners must bring and wear their...

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COVID -19 outbreak in NSW in July 2020

COVID -19 outbreak in NSW in July 2020

Sadly, there are now more COVID -19 infections in NSW. These are community spread cases and so pose a risk to the general community. It is reported the origins of the outbreak are in Melbourne. It is reported this has happened because of gross quarantine mismanagement...

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It is safe to fall pregnant

It is safe to fall pregnant

There has been a lot of fear in the community about conceiving doing the COVID-19 (coronavirus) pandemic. I am pleased to advise as a specialist obstetrician doctor that I consider it is safe to conceive and embark on that very wanted pregnancy. Each day there is...

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Keep calm and stay at home

Keep calm and stay at home

There is so much anxiety and fear in the community, including amongst my patients, about COVID-19 (coronavirus). It is impossible to turn on the radio, TV or social media without being confronted with negative COVID-19 information. My daughter refuses to watch the...

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Coronavirus statistics interpretation

Coronavirus statistics interpretation

When I went to the Birth Unit yesterday morning one of the midwives told me she had been distressed by what the on-call anaesthetist had told her was the predicted death rate from coronavirus for people of her age. I told her that I did not agree with what he said....

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Some of my thoughts about the coronavirus pandemic

Some of my thoughts about the coronavirus pandemic

Some of my thoughts about the coronavirus pandemic Every patient who attended for an antenatal visit quizzed me about coronavirus. They were all anxious, especially being pregnant. This was just a small sampling of the bigger Australian community. There is so much...

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How to minimise your risk of getting coronavirus

How to minimise your risk of getting coronavirus

How to minimise your risk of getting coronavirus Washing your hands often especially before eating, drinking and touching your face. Soap and water washing for 20 seconds and thorough drying is best. Otherwise use a hand sanitiser with at least 70% alcohol.* Cover...

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Office coronavirus precautions

Office coronavirus precautions

You can only attend your appointment if you do not have now or have not had within the last 2 weeks a cold or flu-like symptoms (such as fever, sore throat, nasal congestion, cough, shortness of breath). You can only attend for your appointment if you have not been in...

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Coronavirus and pregnancy

Coronavirus and pregnancy

Is a pregnant woman more at risk of being infected with coronavirus? In pregnancy a woman’s body has immunologic and physiologic changes which might make her more susceptible to viral respiratory infections. This logically would include coronavirus (COVID-19). But...

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I want an iron infusion

I want an iron infusion

It is becoming more popular for pregnant women to request an iron infusion because of tiredness in pregnancy. The iron infusion will only benefit if there is an iron deficiency, which can be checked by a blood test. Most tiredness in pregnancy is not due to iron...

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Urinary incontinence and pregnancy

Urinary incontinence and pregnancy

Urinary incontinence is a common and distressing pregnancy and postpartum problem. It is usually urinary stress incontinence. Stress incontinence happens when the bladder sphincter muscle does not function well enough to hold in urine in the bladder. Recently I was...

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Eight pregnancies, two babies

Eight pregnancies, two babies

I first met Laura in 2013. She saw me for management of her third pregnancy. Her first two pregnancies had been unsuccessful. She had had two early first trimester miscarriages. She was not aware of a reason why she miscarried. Her third pregnancy was also not...

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Caesarean section by choice

Caesarean section by choice

When asked: “Can I have a Caesarean section?” I always answer: “YES”. There is an increasing number of women who choose to have an elective Caesarean section as the mode of delivery, rather than a vaginal delivery. The request is usually made at the first antenatal...

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Severe diabetes and pregnancy

Severe diabetes and pregnancy

Desiree saw me initially for management of her first pregnancy in 2015. She had been an insulin dependent diabetic since she was five years old and was requiring 30 units of insulin per day when I saw her for her first antenatal visit. She also had a history of...

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A sudden turn of events

A sudden turn of events

A patient booked with me for management of her 4th pregnancy management. The pregnancy progressed well until 38 weeks and 3 days gestation. That evening she became aware of painful vein swelling in her left thigh. Her GP arranged a doppler ultrasound scan the next...

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Do I look ok?

Do I look ok?

Physical appearance is an important matter to many women and being pregnant can cause major concern because of the associated changes in body shape. There are some pregnant women who enjoy the physical appearance changes that come with being pregnant, while others...

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When do I need my diabetes check in pregnancy?

When do I need my diabetes check in pregnancy?

I am often asked early in the pregnancy about when to have gestational diabetes mellitus (GDM) screening, with the patient under the impression that is should be done as soon as possible. This is not the case. GDM screening is usually done at 26 to 28 weeks pregnancy....

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Breast cancer in pregnancy

Breast cancer in pregnancy

It was Monday afternoon last week. Rebecca attended with her husband Russell for her antenatal visit at 38 weeks 6 days gestation. She had had a right breast biopsy the previous Thursday and was anxious to find out the result. The result had just come through. I had...

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“I have been having hypo’s more often.”

“I have been having hypo’s more often.”

Sherree saw me for management of her first pregnancy. She had been a diabetic for five years before her pregnancy. Before her first visit with me, she had an appointment with her endocrinologist. Prior to being pregnant, he had managed her diabetes with oral...

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Never quit

Never quit

This is an amazing and wonderful story of a fabulous couple who after 15 years of trying to have to baby and despite a very challenging high-risk pregnancy because of severe preeclampsia have been blessed with was a beautiful baby boy. Irene and her husband married in...

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Is my baby the right size?

Is my baby the right size?

I am frequently asked: “Is my baby the right size?”, “When does my baby put on the most weight?” and “How big is my baby likely to be at birth?” At each antenatal visit, I do ultrasound scanning of the unborn baby. There is no patient expense for this service. As well...

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Please don’t ‘Dr Google’

Please don’t ‘Dr Google’

An anxious patient contacted me on Thursday evening. She had a pregnancy-related discomfort and decided to search on Google for the reason. She became concerned about what she read. She came to the conclusion from what she read that she had a particularly serious...

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Never quit

Never quit

A patient recently saw me for her postnatal visit. A postnatal visit is always a wonderful visit of celebration - the end of a successful pregnancy and the birth of a new baby. This was a very special postnatal visit because of this patient’s obstetric history. In...

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Exercise and sport in pregnancy

Exercise and sport in pregnancy

Chantell saw me for her postnatal visit this week. Chantell is a first-time mum who is also a group fitness instructor. Prior to her pregnancy, she took lots of group fitness classes at the gym, with her favourite being combat classes. When she saw me for her first...

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Pre-eclampsia

Pre-eclampsia

I was in the special care nursery to visit the babies of two patients I recently delivered. Both patients needed delivery at 35-weeks pregnancy because of pre-eclampsia. Pre-eclampsia is one of the commonest complications of pregnancy. While in most patients it is...

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From despair to excitement

From despair to excitement

Last week was a very busy week. Wonderful patients had successful pregnancy outcomes of beautiful babies. I saw lots of antenatal patients for mid-pregnancy routine checks. I saw patients for their first pregnancy visit who were both excited and nervous. I saw...

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Your baby will prefer your music and your food!

Your baby will prefer your music and your food!

In the excellent video clip titled ‘Importance of the early years’ by Professor Glover of Imperial College London UK which I mentioned in my previous blog ‘Foundations of childhood behaviour’ Professor Glover also states “We now know that towards the end of pregnancy...

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Foundations of childhood behaviour

Foundations of childhood behaviour

Last weekend my wife and I spent time with old friends from our time living in Oxford UK, Dave and Di Nutt. Dave is now a psychiatrist and neuropsychopharmacologist working at Imperial College London UK and is a world authority on brain function specialising in the...

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The fish that got away

The fish that got away

The husband of a pregnant patient who attended with his wife today for an antenatal visit commented after a question from his wife: “You must have to spend a lot of time reassuring your patients because of old wives tales told to them.” The answer is: “Yes”. It is...

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Miscarriage – Karyotype checking

Miscarriage – Karyotype checking

I saw a couple today for follow up after her third miscarriage. I met her for the first time for her first antenatal visit of this most recent pregnancy. She was nine weeks pregnant by dates at the time of her first antenatal visit. She was well and excited. All was...

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Will the grieving stop?

Will the grieving stop?

A patient sent me a Facebook message the other day. Her son had tragically died in utero at 37 weeks gestation 7 years ago. After delivery, the cause for his death was very apparent. The umbilical cord was tightly tied around his neck twice. There was so much...

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Can I stop getting stretch marks?

Can I stop getting stretch marks?

Stretch marks are due to tearing of the deeper (dermis) layer of the skin. Usually stretch marks appear as angry red lines While common in pregnancy, not every pregnant woman gets them. As well they can occur at other times when not pregnant such as with rapid growth...

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Can I stop the swelling of my hands and feet?

Can I stop the swelling of my hands and feet?

Swelling of hands and feet is common in pregnancy. Swelling is due to pregnancy hormones resulting in fluid retention in the body. It usually occurs in the feet/ankles and hands/wrists. It can also be noticed in the vulval area, in the face and in the general body....

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Grieving after a miscarriage

Grieving after a miscarriage

In a health topics Q & A website where I was invited to be a health expert I was asked the question: “How do you recover from a miscarriage? My family thinks I should "be over" my miscarriage by now, but I'm still grieving. Is this normal?” This is a very relevant...

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Sciatica pain in pregnancy

Sciatica pain in pregnancy

Sciatica pain is due to compression sciatic nerve In pregnancy this can be caused by the pressure of the gravid uterus and in advanced pregnancy of the baby on the sciatic nerve. I once had a gynaecology patient who had severe sciatica and a large fibroid uterus...

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Can pregnant women eat pineapples and papayas?

Can pregnant women eat pineapples and papayas?

While many say eating pineapples and papaya should be avoided in pregnancy because they can trigger miscarriage and the onset of premature labour, this opinion are based on theoretical consideration and some laboratory animal studies. I am not aware of any clinical...

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Is there such a thing as a fear of being pregnant?

Is there such a thing as a fear of being pregnant?

I find that most women, to some extent, have a fear of being pregnant. This is often because pregnancy is something new, they have no experience and they are not in control over it to a large extent. So fear can be regarded as a normal reaction. But as well a woman’s...

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Coping with grief

Coping with grief

It was 4.00pm Monday afternoon. I was in consultation with a gynaecology patient in my office when my mobile phone rang. It was a call from the Birth Unit midwife. A patient who was 32 weeks pregnant was attending a routine antenatal class at the hospital and...

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