Early Pregnancy

I’M PREGNANT!! NOW WHAT….

Questions I am often asked about early pregnancy, with answers.

Make sure your diet is varied and includes adequate amounts of the following:

  • fruit and vegetables
  • breads and cereals
  • dairy foods for calcium
  • lean meats, chicken and fish for iron

You don’t have to eat more but you do have to eat more variety.

Lentils, beans, tofu, eggs and soy milk can replace animal foods in a vegetarian diet. If you do not eat animal foods you will need to take a vitamin B12 supplement, as this vitamin is needed for the baby’s brain development.

Listeria and toxoplasmosis are uncommon infections that can be passed onto your unborn baby. To reduce your risk of listeria:

  • Wash your hands before preparing food.
  • Ensure chopping boards and cooking utensils are clean when preparing food.
  • Wash vegetables and fruit before eating.
  • Avoid cold sliced meats, e.g. ham and salami, cold cooked chicken, pate, uncooked seafood, soft-serve ice-cream, pre-prepared salads and cheeses such as brie, camembert, feta and ricotta.

Listeria is killed by cooking, so make sure that when you reheat food, it is very hot.

To reduce your risk of toxoplasmosis:

  • cook meat thoroughly
  • wash vegetables
  • wear disposable gloves if handling cat litter or gardening
  • wash your hands after gardening or touching pets.

Folate (or folic acid) is a vitamin found in a variety of foods. It’s recommended you take a folate supplement for a month before you get pregnant and for the first three months of pregnancy, to reduce the risk of spinal problems such as spina bifida in your baby. As well as eating foods rich in folate, a daily supplement containing 500mcg (0.5mg) of folic acid is recommended.

If there is a family history of cleft lip, spinal problems or you are taking an anti-epilepsy medication, this dose may need to be greater. Please discuss this with me.

Yes!! Exercise will not harm your developing baby as long as you exercise at a safe level. It is more risky for your baby if you are overweight. Moderate exercise, regularly, is preferable to occasional intense exercise.

A reasonable level of fitness will prepare you both physically and emotionally for labour. Fitness refers to your stamina, strength and flexibility. The best way to get fit is through regular physical activity at an intensity that pushes you to work at a moderate pace, but not to the point of being out of breath.

To achieve and maintain a reasonable level of fitness aim for one of the following:

  • a session of moderate-intensity exercise on all or most days of the week
  • at least 150 minutes of exercise over a week
  • 10,000 steps per day.

Your body’s temperature is naturally slightly higher when you are pregnant. While it is very uncommon, intensive exercise may cause your core temperature to rise to an unsafe level for your baby. Take these simple precautions:

  • Limit the effort of your exercise to ‘moderate intensity’.
  • Drink water before, during and after exercise.
  • Wear lightweight clothing.
  • Exercise in a cool ventilated environment (no spas or saunas).
  • Avoid exercise if you have a fever.

Some sports and activities need to be avoided in pregnancy. These include:

  • sports or activities where there is a risk of collision, tripping or falling, or heavy body contact
  • competitive sports where you have to reach, stretch or leap beyond safe limits
  • activities an unsafe environment, such as high temperatures (spas or ‘hot’ yoga) or involve heavy equipment (weightlifting, water and snow skiing, scuba diving)
  • repetitive high impact exercise, or with lots of twists and turns, high stepping or sudden stops that cause joint discomfort.

 

If you are new to exercise, start slowly and progress at your own pace, and at an intensity that makes you feel good.

‘Morning sickness’ can occur at any time of the day. The cause is unknown although it has been linked to changes in the levels of various hormones during pregnancy. It usually starts at about the sixth week of pregnancy and settles by about the fourteenth week. Some women will not be affected by morning sickness, but in others it can be so bad they have to be hospitalised.

Generally the baby is unaffected by morning sickness unless your symptoms are severe and prolonged.  However, it is probably a good idea to see a health professional if you were not eating well before pregnancy, you have lost a lot of weight quickly, you are dehydrated or you are worried about your health and how you are feeling. Here are some things to try:

Drink plenty of fluids

It is important to drink plenty of fluids as dehydration makes nausea and vomiting worse.

  • Drink small amounts often.
  • Sometimes other fluids are managed better than water. Try flat lemonade, Lucozade, sports drinks such as Gatorade, diluted fruit juice, cordial, weak tea, clear soup or Bonox/Bovril.
  • Suck on ice or icy poles if other fluids cannot be managed.
  • Some people find ginger helps relieve nausea. Try dry ginger ale or ginger tea. To make ginger tea, soak three or four slices of ginger in boiling water for five minutes. Sip slowly. Ginger tablets are also available from your local pharmacy.
  • Eat small amounts of food more often, rather than large meals.
  • Avoid having an empty stomach. Snack in between mealtimes, e.g. biscuits, fruit, toast.
  • Salty foods may help.
  • Avoid fatty, rich or spicy foods like takeaways, curries, hot chips, chocolate.
  • Make the most of your best time of the day – eat well when you feel best or whenever you feel hungry during the day.
  • If the smell of hot food makes you feel ill – try eating cold food instead. If possible, avoid cooking and ask for help from friends and relatives.
  • Choose simple dishes that are quick and easy to prepare. If you spend too much time preparing food you may not feel like eating.
  • Get plenty of rest.

of women suffer from excessive and prolonged vomiting, called ‘hyperemesis’. If left untreated, hyperemesis can lead to dehydration. It is important to see your doctor if symptoms are severe.

It is not uncommon to lose weight whilst you are unwell. A small amount of weight loss is unlikely to harm your baby. For prolonged vomiting with continued weight loss, seek further advice from your doctor. Also, your dietitian may recommend some supplements to help prevent weight loss. Weight can be regained quickly once you begin to eat normally again.

Gradually increase your intake until you are able to eat a well-balanced diet.

As your appetite improves, you will be able to manage greater amounts and a wider variety of foods. Aim to eventually choose foods according to the healthy food guide and drink at least 8 to 10 glasses of water each day.

 

Are there any alternative and complementary approaches?

There are alternative and/or complementary treatments that some women find useful such as acupuncture, massage or hypnotherapy. There is very good evidence to support the effectiveness of some of these treatments. There are also some alternative treatments for which the evidence will vary. Generally, at the very worst, a therapy that hasn’t been shown to work is likely just to be ineffectual and expensive but some can actually be harmful to your pregnancy or may impact on other medicines you are taking.

Pregnancy hormones can slow down the muscles in the bowel and in some women this can cause constipation.

Things to try:

  • Include plenty of fibre in your diet. Fibre is contained in fresh fruit and vegetables, wholemeal breads and breakfast cereals, dried fruit, nuts and legumes.
  • Take a fibre supplement such as psyllium.
  • Drink plenty of water and other fluids.
  • Exercise regularly.

One in four women will bleed in early pregnancy, many of whom go on to have a healthy baby. However, if you have any bleeding at any time during your pregnancy, contact a health professional, so that appropriate investigation and treatment can be started.

Miscarriages happen to even the healthiest of women; nevertheless, being healthy will increase your chances of a healthy pregnancy. The best that you can do is follow the advice for a healthy pregnancy:

  • don’t smoke
  • avoid alcohol
  • where possible, avoid contact with others who have a serious infectious illness.

 

If you have previously had a miscarriage, your next pregnancy is likely to be normal. If you have had two to three miscarriages in a row further tests are recommended.

Have Questions?

A laparoscopy is an operation used to look inside your abdomen. A thin instrument called a laparoscope (similar to a telescope) is inserted through a tiny cut in your belly button to help us examine and operate (if needed) in your abdomen without making large cuts. Laparoscopy is often performed as a day procedure. Why is a laparoscopy performed?

To diagnose certain problems it is necessary to look directly into the abdomen at the reproductive organs. Common reasons for undergoing a laparoscopy include the assessment of painful or heavy periods, pelvic pain (as may occur with endometriosis or adhesions), pelvic masses (such as ovarian cysts) or as assessment of fertility. Endometriosis, pelvic adhesions, pelvic inflammatory disease, ovarian cysts, non-functioning fallopian tubes and some fibroids can be diagnosed and appropriately treated.

What are the alternatives?

Similar procedures may be performed by open surgery (laparotomy). This is a much more invasive procedure, involving a higher risk of complications, longer time in hospital and longer recovery after discharge. However, in certain situations a laparotomy may be the most appropriate procedure.

How is laparoscopy performed?

Laparoscopy is normally performed under a general anaesthetic in the operating theatre. Instruments may be inserted into the vagina or rectum to assist in the procedure. A small cut is made in your belly button. The abdomen is inflated with gas and a laparoscope is inserted to look at the internal organs. A further 1-3 small cuts are made in your abdomen, depending on what needs to be treated. After the procedure, the instruments are removed, the gas released and the cuts are then closed with dissolving stitches. The procedure itself takes approximately forty five minutes or more, but you can expect to be in theatre and recovery for a number of hours.

Hysteroscopy is a way to look inside the uterus. A hysteroscope is a thin, telescope-like device that is inserted into the uterus through the vagina and cervix. It may help us to diagnose or treat a uterine problem. It is often combined with a curettage, which samples the lining of the uterus. Why is a hysteroscopy performed?

To diagnose certain problems, we need to look directly into the inside of the uterus. Common reasons for undergoing a hysteroscopy include the assessment of heavy periods, abnormal vaginal bleeding, fibroids, polyps, or as part of the assessment of fertility.

What are the alternatives?

This depends on the nature of your problem. An ultrasound scan can provide some helpful information. A small sample of the lining of the uterus may be able to be taken in the outpatient clinic to help rule out some problems, however, a hysteroscopy may be the only way to diagnose certain conditions.

How is a hysteroscopy performed?

Hysteroscopy is minor surgery that may be done in a clinic or an operating room. It is performed under local or general anesthesia. The cervix is widened (dilated) and a telescope is passed to look at the inside of the uterus. A sample of the lining is often taken to be examined more closely. It is also possible to remove a polyp or a fibroid with a hysteroscope. This procedure does not involve any cuts or stitches to the abdomen. It takes approximately ten minutes but you can expect to be in theatre and recovery for a number of hours.

You can make an appoint in two ways:

  1. Request an Appointment via this website, by clicking here
  2. Call us on (03) 8376 6230.
  • A referral letter from your GP (couples trying to conceive may use a joint referral: this must name both partners)
  • Copies of any blood tests your GP has recently arranged for you
  • Copies of imaging reports and ideally the images themselves of any investigations you have recently undertaken
  • Copies of your medical records/operation reports from any gynaecological surgery you have had in the past
  • A completed new patient registration form
  • A signed consent form for a transvaginal ultrasound (if required).

Sometimes it can be helpful to take a family member or friend with you when you meet with a specialist. You may feel more confident if someone else is with you, a relative or friend can help remind you about things you planned to share with or ask the doctor, and he/she also can help you remember what the doctor says.