Q & A with Dr. Neharika Malhotra (Session 2)

Dr. Neharika Malhotra (Session 2 on pregnancy)

1. What remedies do you recommend to ease morning sickness? Morning sickness in pregnancy can be really disturbing and affect your lifestyle drastically. However small and simple steps can help you to deal with this. Apart from this your doctor can also give you medications (eg. Doxylamine, pyridoxine) to ease your ailment.

  • Eat little and often

Having an empty stomach can make sickness worse. Eating little and often can help keep your sugar levels on an even keel. Keep bland snacks handy for nibbling on throughout the day.

  • Eat protein-rich foods

Eat simple, high-protein foods, and those that are rich in vitamin B, such as nuts. Try to avoid rich, spicy, acidic, fatty or fried foods that might trigger nausea.

  • Breakfast in bed

Getting straight out of bed on an empty stomach can result in you rushing to the bathroom! Have a snack, such as dry toast, in bed and eat it slowly before getting up.

  • Get plenty of rest

Stress and tiredness can make pregnancy sickness worse. Make sure to get plenty of rest and relaxation when you can.

  • Try ginger tea

Used in moderation ginger can help to ease nausea. You can make ginger tea using the peeled grated root, or try taking ginger syrup, capsules or tablets.

  • Try a complementary therapy

Some therapies, such as reflexology and aromatherapy, may help you to cope with sickness. Make sure you go to a qualified therapist, experienced in treating pregnant women.

2. Are there any restrictions on sex during pregnancy? Rest assured, having sex cannot harm your baby. During intercourse your baby stays cushioned and safe in the amniotic fluid. Also, the cervix is closed and has a mucus plug, which makes it impassable. Your husband will not be able to penetrate deep enough to reach your baby. And although orgasms can trigger uterine contractions, these do not cause any harm and are different from contractions during labour. It is absolutely safe to have sex even in the first trimester in a normal pregnancy.

However, it is advised not to have sex if you:

  • have abdominal pain or cramps
  • are pregnant with twins or multiple babies

3. What position should a pregnant woman sleep in? The best sleep position during pregnancy is “SOS” (sleep on side). Even better is to sleep on your left side. Sleeping on your left side will increase the amount of blood and nutrients that reach the placenta and your baby. Avoid sleeping on your back as this can cause problems with backaches, breathing, the digestive system, haemorrhoids , low blood pressure and cause a decrease in circulation to your heart and your baby. This is a result of your abdomen resting on your major blood vessels (the aorta and vena cava). These suggestions may not sound completely comfortable, especially if you are used to sleeping on your back or stomach. Keep in mind that you may not stay in one position all night, and rotating positions is fine and you do not need to be alarmed if you are sleeping on your back when you get up. It’s normal and you will be fine.

4. What is the normal amount of weight to gain during pregnancy? Moderate weight gain during pregnancy is normal as your baby’s growth and development will depend on it. The extra kilograms will eventually be lost after delivery to reach your pre-pregnancy weight after some time. You as a pregnant woman can gain an average of 12 kg (8-16 kg) to account for the baby’s weight and other tissues and fluids accompanying pregnancy. You should neither worry about that nor lower your caloric intake unless there is pre-pregnancy obesity or a high weight gain. Here’s where the weight gain goes

  • Baby: 2 – 3.4 kg
  • Placenta: 0.5 kg
  • Amniotic fluid: 4.0 – 5.9 kg
  • Larger uterus: 0.5 – 1.1 kg
  • Larger breasts: 0.5 – 1.4kg
  • Increased blood volume: 1.0 – 1.8 kg
  • Increased fat stores: 1.0 – 3.6 kg

The pattern of you to gain weight is as follows:

  • In the first trimester, you do not need to gain much weight, only about 0-2 kg
  • In the second and third trimester, steady weight gain is important for baby’s growth and development, which can be about 1–2 kg/month

Few tips to follow to control your weight gain during pregnancy:

  • Eat small, frequent meals distributed throughout the day; breakfast, snack, lunch, snack, dinner
  • Increase your fluid intake, especially of water
  • Eat more fruits and vegetables, which increases the feeling of fullness yet are relatively low in calories with no fat
  • Reduce to a minimum your intake of fried and sweet foods
  • Try to cut down on junk and fast foods as they are high-calorie foods with no nutritional benefits for you or your baby
  • Consume good quality proteins beneficial for building cells and tissues, like meats (all kinds), eggs, dairy products and legumes
  • Increase your intake of high-calcium foods like milk and dairy products. These are not only rich in calcium but are high in proteins
  • Do not always give in to you increased appetite especially if your food intake has increased remarkably, because this will put you at a higher risk of pregnancy complications

5. Can an expecting mom follow her usual beauty regime (Dye her hair? Use sunless tanner? Get a massage, visit the spa?) Fake tan products are generally safe to use during pregnancy; they contain Dihydroxyacetone (DHA), which is not absorbed into the body when applied to the skin as cream, mousse or wipes. But avoid spray tans as the effects of breathing in the spray are not known. You should stay away from tanning pills, they might be toxic to your baby (they are banned in several countries but they are sold online). Solarium’s /Tanning Beds: we do not know whether they may affect the unborn baby, but they have been related to skin cancer, so better avoid them. The risk of overheating during pregnancy should also be considered.Anyhow, keep in mind that your skin is more sensitive while pregnant, therefore some products may cause skin irritations, or you may get burnt more easily. You can indulge yourself at a spa, get a massage, make a facial, get a manicure or pedicure. There are certain things, though, that you should avoid while visiting a spa:

  • saunas
  • steam rooms
  • tanning beds
  • hot springs
  • whirlpools, hot tubs and spa baths

All the above mentioned pose a risk of overheating, dehydration and fainting; there is a slight possibility that excessive heat may affect your baby’s development. Sunscreens are perfectly safe for use in pregnancy. Some of them do not penetrate the skin and others get absorbed but in very low amounts. Sunscreens containing titanium dioxide and zinc oxide may be preferred as they are powerful physical sun blockers and do not penetrate the skin. Acne medication and anti-ageing creams are related because they can both contain retinoids (a type of vitamin A). Retinoids are known to cause birth defects when taking orally. The main concern is the acne drug isotretinoin, which can be extremely harmful for the baby if taken during pregnancy. Retinoids are also used in some anti-ageing creams as they can speed up skin’s renewal, so stay away from them. It is not clear whether the chemicals used for hair dying are completely safe during pregnancy, although the risks are likely to be low. To be extra cautious, it is usually advised to avoid them during the first trimester. To limit exposure to chemicals, you may prefer highlights.

Vegetable dyes may be a good alternative, but be aware that many of those contain the same chemicals than the regular ones.

6. Is it possible to have periods during pregnancy? No. You can’t have your menstrual period while you’re pregnant. Bleeding occurs during pregnancy for various reasons, some serious and some not. Some women have light bleeding or spotting in the week before their period is due and they may mistake that for a period. It’s generally a lot lighter than a typical period and lasts just a day or two. This spotting has been called “implantation bleeding” because of the idea that it might be caused by the fertilized egg burrowing into the blood-rich lining of the uterus. One can have spotting after a Pap smear, vaginal exam, or sex. This is because there’s more blood going to your cervix during pregnancy. Bleeding can also be a sign of something seriously wrong, such as an infection, placental problems, miscarriage, or an ectopic pregnancy, which can be life-threatening.

11. Is it normal to be depressed during pregnancy? Depression in pregnancy is a mood disorder just like clinical depression. During pregnancy, hormone changes can affect chemicals in brain, which are directly related to anxiety and depression.These can be exacerbated by difficult life situations, which can result to depression in pregnancy. Symptoms persisting for more than 2 weeks, should be taken seriously and an expert advice must be taken. Indulging in activities like Antenatal Yoga, breathing and relaxation exercises, meditation can help deal with mood fluctuations.

12. Is it true that a woman loses control on her bladder after pregnancy? The tissues and muscles that support your uterus (womb), bowel and bladder can become stretchier in pregnancy. This is due to pregnancy hormones and the weight of your growing baby. These muscles and tissues are called your pelvic floor. When you give birth to your baby, your pelvic floor muscles get stretched even more, which will further weaken them. Having a weak pelvic floor makes it harder for you to squeeze the muscles and sphincters at the bottom of your bladder. This means that you may have trouble controlling when you wee. You may leak wee when you cough, sneeze, laugh or move quickly. Lifting things can also make you wee. The amount lost can vary from a few drops, to enough to wet your clothes. For some, the problem goes away within a few weeks of giving birth. For others, it can linger for months, or become a long-term problem.If you’re still experiencing leaks when you have your postnatal check at about six weeks to eight weeks after your baby is born, tell your doctor. Stress incontinence isn’t something you should accept as being part and parcel of having children. You can recover your bladder control by doing regular pelvic floor exercises.These are a proven and effective way of preventing and treating incontinence. You will need to do pelvic floor exercises at least three times a day, for at least three months. After a while, doing them should become second nature. Pelvic floor exercises are something that you should make part of your daily life, at least two or three times a week. If you stop doing the exercises, your muscles can weaken, and you may find that your bladder control problems return. If you’re still experiencing leaks when you have your postnatal check at about six weeks to eight weeks after your baby is born, tell your doctor. Stress incontinence isn’t something you should accept as being part and parcel of having children. Also Check out Q & A with Dr. Neharika Malhotra (Session 1).

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