Frequently Asked Questions
Dr Bronwyn understands the many questions involved with pre- planning pregnancy, fertility and giving birth – especially with so many different stories floating around from friends, family members and articles online.
Whether it’s trying for the first time or planning for your fourth baby, Dr Bronwyn will help you by addressing specific issues, treat your individual situation, settle and reduce your stress to achieve the best outcome possible for you and your baby.
After having helped so many women, she has seen it all. Here are some of the most common questions patients have had to put you at ease.
Pre-planning and Pregnancy
How long does it usually take to fall pregnant?
All pregnancies are different. Depending on your health, age and many other factors some ladies fall pregnant straight away while others take many months to conceive. Research shows that the probability of conception after six months is up to 80% and after 12 months is up to 90%.
What are some of the things that increase the risks of infertility?
- Increasing age
- Tobacco smoking
- Sexually transmitted infections
- Health problems that cause hormonal changes
- Poor diet
- Athletic training
- Being overweight or underweight
Is my medical problem going to affect me falling pregnant?
It is important to understand a medical problem may impact on your pregnancy but also how your pregnancy may impact on your own health. We advise seeing you before conceiving to ensure the correct medications and that you are in the best possible health to help to achieve our desired outcome…healthy mum and baby.
We were not expecting it to take this long for us to conceive?
There can be several reasons why a couple may have difficulty falling pregnant. A number of tests can be done to work out the cause and correct it, but in some, very frustrating situations, it is not possible to explain the reason precisely.
What are some of the reasons it’s not happening easily for us?
Where an egg is not matured and released at all by the ovary or is not matured and released at a regular time.
Where there is tissue, similar to tissue lining the inside of the uterus, occurring in places other than the uterine cavity. This can cause adhesions and distortion of anatomy as well as inflammatory changes that can affect fertility.
A blockage or damage to the specialised cells lining the fallopian tubes can occur from previous infection or surgery which then stops the passage of sperm or eggs.
Some differences in the shape and size of the uterus may contribute to difficulties falling pregnant or staying pregnant.
Some medical disorders can affect your hormone function in turn affecting your fertility. More commonly we see thyroid and weight related conditions having an impact here, but other conditions can be important as well.
For men, low sperm counts or abnormalities in the movement or shape of sperm can affect fertility. There are other factors that may be involved and these need to be ruled out as well.
What can I do right now to improve my chances?
1. Start tracking your menstrual cycle
Ovulation occurs 14 days before you start bleeding. This varies depending on the length of your cycle but in an average 28-day cycle, it occurs between day 12 and 14. Sperm can survive for up to five days and the egg can be fertilised up to 12 hours from ovulation so you should be having intercourse every other day from day 8-16 of your cycle.
2. Take Folate one month before and 3 months after you conceive
It is most important to take Folic acid as it has been shown to reduce the incidence of foetal spine abnormalities or spina bifida. This is especially important in the early weeks when most people don’t know they are pregnant yet, so start taking it as soon as you start trying.
3. Managing your weight range
Being overweight or underweight can affect your chance of falling pregnant, increase your risk of miscarriage and increase your risks during pregnancy.
4. Healthy Balanced Diet
Ensure you have adequate vitamin and antioxidant levels along with a balanced diet with a mixture of fruit and vegetables. Prenatal vitamins will also help to ensure this but should not be a substitute for a balanced diet.
5. Keep up your fitness levels
Pregnancy can be physically demanding on a woman’s body. Help manage your changing body shape as well as the demands of pregnancy, birth and early parenting by having a good level of fitness.
For every expecting mother, it’s always a relief when you have a better understanding on what to expect especially if it’s your first time.
What are the stages of birth?
Understanding the stages of birth will better equip you with knowledge of the changes occurring in your body so you feel more in control and respond better to what is happening.
This is when the cervix starts to soften, thin out and open. It is complete when the cervix is fully dilated, around 10cm. This can go on for hours.
In early labour you may have:
- Blood stained mucus called a show.
- Lower back pain.
- Period like pain that comes and goes.
- Loose bowel motions.
- An urge to vomit.
- Sudden gush or slow leak of fluid from vagina which is clear or slightly pink: if it is green or bloody you should contact the hospital immediately.
Things you can do:
- Listen to and trust your body, it knows what to do.
- Stay at home as long as you are happy there.
- Have regular snacks so you are building your energy stores.
- Rest as much as possible.
- Try relaxing in a bath or shower.
- Go to the toilet regularly and empty your bowels if you can.
Eventually you will start feeling more restless and tired, any pain will be more intense and the time between each wave of pain will be shorter, this signals you are moving closer to the second stage.
When to go to hospital:
- If is not always clear if labour has started. If you are not sure, call the hospital and talk through your symptoms to gain some guidance.
- Your waters break.
- If you have greenish discharge vaginally.
- You have vaginal bleeding that is not a show.
- Small vaginal bleeding mixed with lots of mucus is called a show and is a sign that labour is progressing normally. You may also get a show if you have had a vaginal examination.
- Your contractions are regular, last more than 30 seconds and are closer than 5 minutes apart.
- You need pain relief.
- You do not feel the baby moving.
- If at any stage you are worried or unsure about what is happening.
This is the period of time from when the cervix is fully dilated to when the baby is born.
During the second stage you may have:
- Longer and stronger contractions.
- Increased pressure in your bottom.
- The desire or urge to push.
- Nausea and vomiting.
- Stretching and burning feelings in your vagina.
Things you should do:
- Allow your body to do what is needed, Stay calm and let go
- Concentrate on your contractions and rest in between.
- Try different positions.
- Keep your fluid levels up.
The pushing phase varies for each woman and when the urge arrives it can be overwhelming.
- You may feel pressure, a strong urge to go to the toilet, stretching and burning in your vagina or the baby’s head moving down.
- The best thing you can do is breathe, relax, and follow your body’s urge to push.
- Trust and listen to us and we will guide you.
- This begins after your baby is born and finished when the placenta and membranes have been delivered.
- During this stage you may feel more contractions to expel the placenta and a feeling of fullness in your vagina.
What if my labour needs to be induced?
Induction of labour is the process whereby labour is encouraged to start artificially.
This can be done in a number of ways including:
- Sweeping the foetal membranes: with the aim of initiating natural labour.
- Artificially breaking the waters.
- Cervical ripening with medication – prostaglandin E2.
- Cervical ripening with a balloon catheter.
- Intravenous oxytocin.
Before deciding how labour is to be induced you will have a vaginal examination and based on this one or a combination of the above techniques will be recommended.
What can I expect when going through labour?
Every woman’s labour has the potential to be completely different. Dr Bronwyn will help prepare you both physically and emotionally so when it begins you feel as ready as can be. You will always be fully informed throughout the labour and delivery so you have to ensure your best possible experience along with a clear understanding of what is happening at every moment of your labour to birth.
When in labour, what pain relief options do I have?
The options for pain relief include:
- Being active, moving around, changing positions.
- Touch and massage can reduce muscle tension and act as a distraction during contractions.
- Music may also help you relax and as a distraction.
TENS or Trans-Electrical Nerve Stimulation
- A small portable battery operated device worn on the body that transmits electrical pulses to the body.
- Despite not a lot of evidence some women find them useful.
Gas: mixture of nitrous oxide and oxygen
- Inhaled during a contraction can help take the edge off the pain. You may feel lightheaded, nauseous with a very dry mouth.
- A strong painkiller given by injection to help reduce pain but doesn’t take it away altogether. It can take several minutes to work and can make your baby sleepy and contribute to breathing problems in your baby if given within two hours of birth.
- This is a local anaesthetic, injected into your back altering your sensation from the waist down. A thin tube is left in your back allowing it to be topped up.
- It takes the pain of contractions away for hours so during a long labour it can allow you to sleep and recover your strength. It can be increased in strength if you need an emergency caesarean and can be helpful if your blood pressure is high by reducing it. An epidural does not directly affect your baby or increase your chance of needing a caesarean section but it can make the pushing phase of your labour longer.
- Your anaesthetist will talk to you about the risks in your individual situation.
What if my baby needs help being born?
Sometimes your baby will need help to be born. This help may vary from relatively simple procedures such as breaking your waters or performing an episiotomy (a cut in the tissue between the vagina and anus to make the opening bigger), or more assistance with forceps or a ventouse (vacuum cup) to more medically demanding procedures such as caesarean section.
Can I have skin to skin?
Our aim is to facilitate skin-to-skin contact. This is allowing your naked baby to be placed on your bare skin and you both covered with a warm blanket.
You must remember there are situations where this will not be possible due to either maternal or neonatal complications and this is in the best interest of both mother or baby or both.
Things to Bring into Hospital
For The Mother
- Your Antenatal card
- All current medications
- Medicare / Health Insurance cards
- Comfortable clothing & shoes for daytime (keep in mind tops that you can feel comfortable to breast feed in i.e. button down)
- Nightwear – dressing gown, slippers
- Underwear & Maternity bras (extra underwear)
- Maternity pads (at least one full packet)
- Toiletries including soap, shampoo, tooth paste and tooth brush.
- Nursing pads
- Clothes for labour (old t-shirt, warm socks, old underwear, or you can wear hospital gown if prefer)
- Oil or Moisturiser (if you wish for massages from your partner)
- Heat / Cold pack
- Snacks such as muesli bars
- Lip balm
- speakers (if you wish to have music whilst in labour)
- Oil burner and essential oils of your choice (if you wish to bring one in it must be an electric burner, cannot have naked flame in hospital)
For Your Baby
- Bunny rugs aand baby clothes if you do not want to use hospital supplies
- Nappies an outfit, socks and blanket for bringing baby
- Car seat installed in car ready for drive home
It is advised to have your bag packed and ready from approx. 36 weeks. It would also be advisable to leave valuables at home rather than taking it to the hospital.
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