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Pregnancy Clinic

Wednesday, 10 March 2010

Dr. Peter Boylan, Consultant Obstetrician/Gynaecologist, Holles Street Maternity Hospital, where he was master from 1991 until 1998. He is also the author of 'The Irish Pregnancy Book', which is a guide for expectant mothers.

Based on his 30 years experience of helping mother in his clinics, Dr Peter Boylan explains clearly what happens in pregnancy, how mother and baby's health develops and what to expect in labour and delivery.

Grainne Ryan - Public Health Nurse

Presenter of Baby on Board Series 2. Grainne is a public health nurse and midwife and mother of three children. Areas of interest child development, parenting issues, adolescent development and post natal depression. Grainne works and lives in Ennis Co. Clare.

Annemarie Farrell

Annemarie is pregnant on her first baby, and although she's in her forties, she hasn't found the process too difficult, and she only has 7 weeks left!

Dr. Boylan, what changes can women expect to happen during the second trimester? - for the better / for worse?


This is actually the time when women feel more energetic. The baby isn't too big so there's not a huge amount of discomfort, they've gotten over the sickness period (hopefully) and they can feel the baby kick and move around.

Grainne, what do you find women have concerns about during the second trimester?


Most common concerns are heartburn, backache, movement of the baby, concerns about feeding baby and antenatal classes.

Constipation

Dr. Boylan, why is constipation a problem during pregnancy?

The hormones are causing all the muscles in the body to slow down, including muscles that bring food through the digestive system.

What can women take to ease constipation?

They should eat a high roughage diet and drink plenty of fluids.
If it gets very bad they can take over the counter constipation remedies, ask your pharmacist for advice as some products like Senokot can be quite strong.


Varicose Veins:-

40% of all pregnant women suffer varicose veins!

According to Dr. Boylan people at risk are women who have a family history of it. Standing and being overweight will only make it worse, but won't cause it. If you have it in one pregnancy you are likely to have it in any further pregnancies, but they will disappear after the pregnancy.

Grainne:- Who is at risk?

. Multiple Pregnancies
. Family History
. Being Overweight
. Standing / Sitting for long periods

Heartburn

Dr. Boylan, heartburn, very common. What can people do to ease it? / What can they take?

Heartburn is very common and caused by the muscles in the oesophagus relaxing and opening up more. This muscle is normally closed, not allowing the acid back up the oesophagus.
To ease it women should eat bland food, (nothing spicy) and they can take Gaviscon or Rennie.

Grainne, does a pregnancy pillow help with heartburn?

Anything that will help pregnant women lie upright will help heartburn.

Back Pain

Back pain is another side-affect of being pregnant - does it last beyond pregnancy?

Between 35%-61% report back ache during pregnancy. It is due mainly to the altered posture due to increasing weight in the womb and increased laxity of supporting muscles as a result of the hormone relaxing. Back pain during pregnancy can be particularly debilitating since it can interfere with a woman's daily activities and sleep patterns. However it doesn't last beyond pregnancy.

Grainne, Does it last beyond pregnancy?

Post partum back ache is common again this is due to the hormones of pregnancy, labour and often incorrect lifting of baby. How long it lasts will depend on a number of factors.

1. History of pre-pregnancy backache,
2. Type of delivery
3. Weight gain
4. How soon you start to strengthen the abdominal muscles after delivery.

Grainne, Does your weight affect the level of back pain you have?

Increased weight can affect back ache as women's centre of gravity shift to accommodate the growing baby. She leans forward to compensate for extra weight in front it puts pressure on the lower back.

Any magical cure?

. Exercise in water, massage or back care classes may help ease backache during pregnancy.

. Watch your posture, walk tall with bottom and stomach tucked in and don't slouch when you sit.

. Wear flat shoes, or shoes with a small heel.

. Be careful when lifting - bend at your knees and keep the load close to your body.

. A warm bath can ease aches; a hot water bottle pressed against your back is great.

. Seek advice from a physiotherapist.

Itching

Dr. Boylan, why do women experience desperate itching during pregnancy?

Skin is stretching and hormonal changes increase the blood flow.

Is there anything that can help?

Dr. Boylan:- There is nothing worrying about itching, but all you can do is use any moisturiser. There is an uncommon condition where itching is a symptom of liver problems, but this would be accompanied with other symptoms such as jaundice.

Grainne's advice on itching:-

Itching can be made worse by hot weather, so if your environment hot or it is really hot outside, try and wear loose cotton clothing. Avoid going out in extreme heat. Wet wipes on the affected areas of the skin to help.

Invest in a gentle moisturiser. Look for products with soothing ingredients, such as calamine, alovera or tea tree oil.

Calamine lotion from the fridge can give a cooling effect.

Temporarily avoiding your usual scented bath products and soap may help as can washing in cool water. Bread soda in the water may help reduce itchiness.

Baby Brain

Dr. Boylan:- Is there any truth to the idea that women get forgetful during pregnancy?

Yes there is, I've had some women tell me that they get lost on their way home from work!

Its not just tiredness, it's a mixture of hormones and psychological factors. Women at this stage become preoccupied with the baby, and it's on their mind all the time, regardless of what is going on.


The Second Trimester:-

Grainne, are stretchmarks avoidable?

Stretch marks from when your skin is stretched rapidly as happens during pregnancy. The amount of stretch marks you get depends on how elastic your skin is. The elasticity of your skin depends usually on your genetic make up.

Keep in mind the more weight you gain during pregnancy the more likely you are to have stretch marks. Normally the skin is elastic and capable of stretching quite a bit however some women may notice a drastic change. There are many lotions on the market to help stretch marks. Some may moisturize the skin and reduce itching.

Increased Risk:-

. Multiple births
. Excessive weight gain
. Stretch marks on body ( during puberty)
. Stretch marks from previous pregnancy


Dr. Boylan, what do the women who attend with you have concerns about?

At this stage of the pregnancy things are generally not too bad, for reasons about. Women in their first pregnancy especially aren't worried. However women on their second or third baby are more anxious about giving birth.

Is there a particular set of concerns that women in their second trimester have?

All the things that we are talking about mainly, heartburn and constipation.

It's supposed to get better during the second three months, is this the case?

Yes, the sickness and the tiredness eases off, and there is an increase in energy.

What about food? Should they be eating more or the same as they were before they became pregnant?

They shouldn't increase their intake on purpose if they aren't hungry, but continue with a good balanced diet and eat if you are hungry.

Cravings


Do cravings kick in at this stage?

They can start anytime and there's no real explanation as to why women get them.

What's the most unusual craving you ever heard of?

Some women crave petrol fumes, and one of the most unusual I've heard of is ice cream with anchovies!

Prices/Stockists/Relevant Information:-

2As1 Antenatal is run by registered nurse, midwife & mum of three, Susan Mac Nicholas. Susan conducts One-Day Intensive Antenatal Classes in both Dublin & Meath for expectant couples covering the later stages of pregnancy, labour, birth and the early stages of parenthood. Please see www.2as1.ie for further information-

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