12
Sep

Why Cocaine Should Always Be Avoided

I wanted to learn as much about cocaine as I could after learning that it is one of the most popular drugs in the world. I had already vowed to never take drugs myself, but I still wanted to arm myself with some information on it so I could help anyone that might not have the same willpower to resist something that can be really tempting to some people. I did some research, and I found an article that said click here for some facts about cocaine that might not be readily known by most people in the world.

It certainly opened my eyes, I will say that much. I read some facts that I had never heard about, and some of them are quite scary. Cocaine can lead to instant death, and it can also cause people to have hearing issues. Continue reading

15
Jan

Teenage Pregnancy

Even with a steadily declining adolescent birth rate, two in five young women will become pregnant before age twenty, and four out of five of those pregnancies will be unintended, including about half of those among married teenage girls. Whatever their circumstances, though, the news that they are pregnant usually comes as a shock, and often not a welcome one.

The unforeseen development typically throws young lives into turmoil, at least for a time, forcing the girl to make perhaps the most agonizing decision of her life. Does she carry the baby to term, as 50 percent of pregnant teenagers elect to do? Or does she terminate the pregnancy?

It is hoped she knows she can count on her mother and father for guidance and support as she confronts these choices. Youngsters who fear meeting with rejection or abuse at home may try to keep the pregnancy a secret as long as possible. As a result, they often don’t receive adequate prenatal care and counseling during the crucial early months of fetal development.

One-third of girls aged fifteen to nineteen, and one-half of girls under fifteen receive no prenatal care at all during their first trimester. The lack of medical attention can lead to problems later on. If they go forward with the pregnancy, the pregnancy could be complicated with an increased risk for mother and baby. And if they choose to abort, the earlier the procedure is performed the safer it will be.

However, anxiety over Mom and Dad’s reaction isn’t the only reason a girl may hide the fact that she is pregnant. “Young women can be in terrible denial,” explains Dr. Claire Brindis, “simply refusing to accept the reality of their condition.” Psychologists call this dissociation. Since today’s baggy fashions make it easier for a girl to go for months, or perhaps through her entire pregnancy, without anyone noticing her expanding abdomen, don’t go by appearances alone. If you suspect that your daughter might be pregnant but is trying to hide it, act on your intuition—but tactfully, perhaps with words like these: “Honey, you’ve been complaining of feeling tired and nauseous the last week or so, and you’re going to the bathroom a lot. Are you all right? You remind me of what I felt like when I was pregnant.”

Parents’ Common Reactions

A tearful “I’m pregnant!” isn’t easy for any mother or father to hear. Worry, disappointment, anger—all are understandable responses. Most likely this isn’t what you had in mind for your daughter. Meanwhile, a similar scene is probably being played out at the home of the boy involved (if the boy even tells his parents).

Give yourself and your spouse permission to be upset for a day or two. Talk things over together. If you blurt out an incredulous “What on earth were you thinking?!” or “How could you be so irresponsible?!” so be it; you’re human. But then shut the door on anger and lock it away. Hurling blame at your teenager isn’t going to change anything; it’s time to sit down as a family and calmly discuss what to do next.

“A parent’s most important role is to listen to the young woman or the young couple as they sort through their options,” says Denver pediatrician Dr. Roberta Beach. “We know that in the long run teenagers usually feel satisfied with whatever choice they made, as long as they feel that the decision was theirs and that their family supported them.”

First Things First: Verify the Diagnosis

A skipped period and a positive result on a home pregnancy test are usually what prompt a young woman to believe she’s pregnant. The home test, while generally accurate, isn’t as reliable as the laboratory test the doctors do to confirm a pregnancy. So the first step is to make an appointment with your daughter’s pediatrician or gynecologist.

Next Step: Reaching a Decision

The doctor’s office just called: The pregnancy test came back positive. Now where do we go from here? There are three options: abort, give birth and raise the baby or give birth and place the child up for adoption. Parents certainly have a right to voice their opinions; if circumstances allow, the young man and his family should be invited to take part in the decision-making process too. But legally, the ultimate verdict belongs to the expectant mother.

For some young women, the decision about what to do is never in doubt. Perhaps they are personally opposed to abortion. Or they know deep in their hearts that they are not ready to have a child this early in life and therefore wish to have an abortion.

Most girls, though, agonize over this difficult decision, which is further complicated by the fact that abortion is one of the most politically and emotionally charged issues of our times.

Depending on where she lives, she may face the harrowing prospect of having to travel dozens or even hundreds of miles just to find an abortion provider and once there she may need to wind her way through a gauntlet of taunts and threats by antiabortion demonstrators.

If you and your daughter feel that you might benefit from hearing an objective viewpoint, arrange a consultation with the pediatrician. In a nonjudgmental fashion, he or she can help you to evaluate the pros and cons of each option. Once the young woman has made up her mind, most pediatricians can refer her to health-care practitioners who provide abortion services, or to an obstetrician or adolescent clinic to begin prenatal care.

15
Jan

Placenta Accreta – Symptoms And Risk Factors

During pregnancy, an exchange between mother and baby needs to occur in order to deliver essential oxygen and nutrients to the growing fetus. The placenta is the organ that is the interface between maternal and fetal blood. It acts as the baby’s lungs, digestive system and kidneys, as well as supplying vital pregnancy hormones, until birth occurs. The placenta must act as this interface without actually invading the mother’s uterine muscle. When pregnancy occurs, the lining of a woman’s uterus becomes the decidua. One of the functions of the decidua is to prevent the placenta from invading the uterus. If the decidua is too thin (deficient) it can allow the placenta to embed too deeply. If this occurs, the placenta can’t detach from the uterine wall after the birth of the baby. This is called placenta accreta, and it’s reported to occur in about 1 in 7000 pregnancies.
What Is Placenta Accreta?
The placenta normally attaches to the uterine wall by projections called chorionic villi. How severe placenta accreta is depends on how deeply the chorionic villi have penetrated.
  • Placenta accreta: the chorionic villi attaches to the muscle of the uterine wall and occurs in about 75% of all cases of placenta accreta
  • Placenta increta: the chorionic villi extends into the muscles of the uterus and occurs in approximately 15% of cases
  • Placenta percreta: the chorionic villi extends through the entire wall of the uterus and often into nearby organs. This is the deepest form of attachment, occurring in approximately 7% of cases.
Most medical professionals use the term placenta accreta when referring to any of the three variations. After the birth of your baby, high levels of oxytocin normally trigger the uterus to contract down and the placenta to shear off the uterine wall. If the placenta is too deeply embedded, it can’t detach or may only partially detach. The problem occurs when the maternal blood vessels that are open can’t be shut off. Massive bleeding will occur until the placenta is removed.
What Are The Risk Factors For Placenta Accreta?
Placenta accreta is more likely to occur in a woman who also has placenta previa. Placenta previa is when the placenta attaches low in the uterus and grows over the cervix. Placenta previa is linked to previous uterine surgery, most notably c-sections. If you’ve had a previous c-section and you have placenta previa in your current pregnancy, the risk of placenta accreta is 25%. If you’ve had two or more c-sections and currently have placenta previa, the risk increases to 40%.
Placenta accreta without placenta previa is rare, but other risk factors that increase your risk for placenta accreta are:
  • Your placenta has attached over a uterine scar
  • You’ve had a dilation and curettage (including after a termination) involving your uterus lining being scraped
  • You are over the age of 35
  • Increased number of pregnancies beyond 20 weeks
  • Maternal smoking
  • Unexplained elevated maternal serum alpha-fetoprotein (protein found in the blood)
  • Uterine fibroids
  • Asherman’s syndrome (causes uterine scar tissue or adhesions to form).
Placenta Accreta Symptoms
If you have risk factors for placenta accreta, it’s likely your doctor will make sure you have a thorough ultrasound to check for the placenta’s position – especially if you’ve had a previous c-section. Often the most consistent signs of a placental problem during pregnancy is vaginal bleeding that occurs into the second trimester and beyond. However, bleeding doesn’t always occur, and the first sign of placenta accreta can happen during birth.
If you do have risk factors for placenta accreta, you may choose to have screening done:
  • Ultrasound from 15 weeks of pregnancy can identify placenta accreta, although the best results are around 20 weeks, as the ultrasound is more sensitive at this time. The placenta will have a ‘swiss cheese’ appearance if placenta accreta has occurred.
  • Blood testing for maternal serum alpha-fetoprotein (MSAFP) levels. This is a protein found in the blood, at highest concentrations in the baby. Due to the decidua being thin, this allows leakage of fetal alpha-fetoprotein into the mother’s blood. If these levels are raised with no other obvious cause, placenta accreta is the likely diagnosis.

Treatment For Placenta Accreta

The major risk factor for placenta accreta is massive, life-threatening blood loss, because the uterus can’t contract down and shut off the blood vessels. More than half of all women will need blood transfusions if placenta accreta occurs during birth.

If it does occur during birth, there are three treatment options available:

  • An emergency hysterectomy (the most likely outcome)
  • Very rarely would the placenta be forcibly removed, as this increases the risk of massive bleeding and subsequent hysterectomy
  • Conservative management, which leaves the placenta in place. Drugs are used to contract the uterus and prevent infection, as well as blocking certain arteries to minimise bleeding. The placenta is reabsorbed by the body — studies have shown it’s successful in about 80% of cases. It’s considered a very controversial option due to the risk of bleeding and infection.

If placenta accreta is diagnosed before the birth, then management can be carefully planned. The usual outcome is an elective c-section at around 38 weeks of pregnancy. The risk of complications from placenta accreta are lessened if the surgery is planned rather than performed in an emergency. At the time of the c-section, the uterus will be surgically removed (hysterectomy). Counselling and planning is an important part of the diagnosis of placenta accreta during pregnancy. While placenta accreta can occur in the absence of uterine scarring, it’s most likely to happen after a previous c-section. Research has shown between 60-80% of placental accretes occur in women who had a previous c-section. … While women are also experiencing higher numbers of other risk factors – such as increased maternal age, more likelihood of having uterine procedures for fibroids – the ever increasing rate of c-sections are having an impact. Avoiding c-section in the first instance would increase your chances of avoiding this serious, life-threatening complication in future pregnancies. – See more at: http://www.bellybelly.com.au/pregnancy/placenta-accreta/

15
Jan

The 3 Best and Worst States In The US To Have A Baby

Chances are where you grew up, where you went to school and where you’re able to find work will take part in dictating where you raise your family. Most of us don’t have the luxury of researching the most family friendly states, and simply picking up and relocating based on the results. Nonetheless, the research is out there, and where you live matters when it comes to having a baby. Of course, there are many factors which impact how your birth unfolds, your baby’s health, your postpartum experience and birth costs. We also know the US has some of the highest maternity care costs without the best outcomes. A birth in the US can cost over $10,000 for a vaginal birth and over $15,000 for a c-section birth. Compare that to the Netherlands where the average birth costs just $2,824 and we might assume that extra costs would equal better outcomes. However, when it comes to US maternity care, the exact opposite is true. The US ranks as one of the worst developed countries to give birth in. However, it’s hard to discount statistics which show some really big disparities among birth outcomes and costs throughout the US. WalletHub‘s annual rankings show which states rank best and worst in the US, and it’s always very eye opening to see what’s happening with birth in the United States.
How Did They Rank States?
WalletHub looked at three major categories to rank states: budget, healthcare and baby-friendly environment. They looked at the cost of maternity care, cost of living, infant death rate, rate of pre-term births, air pollution, number of childcare centers, and more. Every birth and every maternity care provider are unique. A low ranking doesn’t guarantee a bad birth experience or difficulty finding appropriate care for your baby, nor does a high ranking guarantee a positive experience. What this information can do, however, is help us look at what is working overall for some states and what needs improvement in others. It can help you personally plan for maternity care costs and learn about the importance of choosing a maternity care provider you trust. So, which states rank best? The best state in the United States to have a baby is…
#1: Vermont
For the second year in a row Vermont ranks as the best state for having a baby. While it wasn’t number one in every category, overall it scored best. While Vermont did rank seventeenth when it comes to budget, it ranks first when it comes to healthcare. It also ranked fifth for baby-friendly environment. Vermont ranks third for lowest infant death rate, second for maternity care providers per capita and number one for pediatricians per capita – making it a solid choice for the best state to have a baby.
#2: North Dakota
This state ranks well in each of the three major categories. While it doesn’t rank as high as Vermont in healthcare, it ranks lower in budget coming in tenth. Also ranking tenth in baby-friendly environment means North Dakota has lower air pollution than some other states and more resources available for new families.
#3: Oregon
Oregon doesn’t rank amazingly well when it comes to budget – coming in 34th place. However, they rank second in healthcare. The healthcare category takes into consideration maternal and fetal mortality and morbidity, available healthcare providers and rates of pre-term births – making it a very important category.
Which States Rank The Worst?
As mentioned, the rankings don’t mean it’s impossible to have a positive and safe birth experience, nor does it mean you’ll have a lack of postpartum support and healthcare. What it does mean is that a state, overall, has areas that need to be improved. It means you might have to budget more for maternity care and less care providers per capita can impact quality of care. Pennsylvania – my home state – ranks 50th out of 51 (50 states plus the District of Columbia) in this study. Yet, I was fortunate to have four positive and affordable birth experiences. However, according to this study, it isn’t necessarily the most common outcome for women in my state. #1 Worst State To Have A Baby: Mississippi
Mississippi ranks as the worst state to have a baby. This state ranked 51st in the healthcare category meaning it has high pre-term birth rates, high infant mortality rates and less healthcare professionals per capita. Mississippi has the highest infant mortality rate in the US. While ranking 51st in healthcare overall and infant mortality, it doesn’t have the lowest pediatricians per capita, or the lowest midwives/obstetricians per capita which means there are areas of healthcare this state needs to work on.
#2 Worst State To Have A Baby: Pennsylvania
My home state ranks as the second worst state in the entire country. To be honest, when I read this I really wondered how. I had four certified nurse midwife attended births with great outcomes, adequate postpartum support and access to pediatric care for my children. However, statistics don’t lie. We have one of the lowest numbers of pediatricians per capita – evident in our local mother to mother boards where finding a great pediatrician and getting into the practice is like hitting the lottery. As an at will employment state, obtaining maternity leave can be a stressful situation for the many mothers that need to return to work after having a baby. In fact, when it comes to being baby-friendly we rank as the worst state (including the District of Columbia).
#3 Worst State To Have A Baby: West Virginia
When looking at the budget category, West Virginia is comparable to the best states, ranking thirteenth. However, the lower budget doesn’t translate to better healthcare outcomes or a baby-friendly environment. It ranks 50th for baby-friendly environment which means a lack of social support in the postpartum period. West Virginia also has one of the highest infant death rates in the US, ranking 47th.
What Does This Mean For Me?
Chances are this information isn’t going to result in you uprooting your life before having your next baby. What it can do is help you budget for your next baby. It’s also important to realize that while you can’t change your state’s ranking, you can make decisions that can improve your chance for a positive birth experience and outcome. The maternity care provider you choose, where you choose to give birth and being an active participant in your healthcare can help you and your family grow in the healthiest way, regardless of where you live. … The US has a long way to go when it comes to maternity care. We have wonderful models, such as New Zealand’s model of maternity care and with this information we can hope each state – and the country as a whole – takes a look at what needs to change.
15
Jan

Toxoplasmosis and Pregnancy – Do I Need To Get Rid Of My Cat?

During a pre-natal appointment with your healthcare provider, you may be asked if you have a cat. If this is your first pregnancy, you may wonder why a midwife or doctor would ask you about what pets you have. For those who do have a cat, you’ll likely be informed about toxoplasmosis. Toxoplasmosis is an infection humans can contract from a microscopic parasite – toxoplasma gondii. For most people that acquire this infection, their immune system is able to handle it, and it’s often a mild or asymptomatic infection. During pregnancy, however, this infection can be more serious, as it can pass via the placenta to your unborn baby. Around 15% of childbearing aged women are immune to toxoplasmosis. For these women, their unborn babies are likely protected from contracting this infection. But what about babies whose mothers aren’t immune to toxoplasmosis? Here are 5 things you need to know about toxoplasmosis and pregnancy:
#1: Toxoplasmosis Can Be Spread By Cats Cats are known to bring unpleasant gifts back to their owners, such as rodents or birds they have killed. When a cat eats an animal that is infected with toxoplasma gondii parasites, it pass through to their faeces. Cats and kittens can shed millions of these microscopic parasites for up to three weeks after they are infected. While mature cats can contract toxoplasmosis, they are less likely than younger cats to contract and spread the parasites. While indoor cats use litter boxes to contain their faeces, outdoor cats use garden soil and sandboxes for elimination. Gardening, unwashed produce and playing in a contaminated sand box are ways you might be exposed, in addition to cat litter boxes.
#2: You Don’t Need To Get Rid Of Your Cat While cats can spread toxoplasmosis, petting or being near your cat is not how you contract the illness. In order to contract toxoplasmosis, you need to come into contact with contaminated faeces, then touch your eyes, mouth, nose or other opening to your body (such as a open sore or cut). Make sure you use caution when gardening. Wear gardening gloves and be conscious of touching your face before washing your hands. Always wash your hands after gardening or putting your hands in a sandbox, and be sure to avoid contact with your face before washing. Many healthcare providers recommend making another person responsible for emptying your cat’s litter box. If you’re unable to get someone else to do it, use caution when cleaning the box. Use gloves if possible, immediately wash your hands and be very conscious not to touch your face while handling the box, liter or faeces. Change the litter box daily, as the parasite doesn’t become infectious until 1 to 5 days after shedding in the cat’s feces. If possible, keep your cat indoors, and feed your pet well cooked meat. If your cat eats rodents, birds or undercooked meat, their risk of contracting toxoplasmosis increases. While you don’t need to get rid of your cat, it’s not advised to get a new cat during your pregnancy.
#3: Toxoplasmosis Can Be Contracted From Other Sources While cats play a big role in spreading toxoplasmosis, you can contract toxoplasmosis from certain foods.
Here are ways to reduce your risk of exposure from food sources:
  • Be sure to cook whole cuts of meat to at least 145 degrees Fahrenheit (63 degrees Celsius)
  • Cook ground meats to at least 160 degrees Fahrenheit (71 degrees Celsius)
  • Poultry (ground or whole) should be cooked to at least 165 degrees Fahrenheit (74 degrees Celsius)
  • Freeze meat for several days at sub-zero temperatures before cooking to reduce the risk of infection
  • Thoroughly wash and/or peel fruits and vegetables
  • Wash cutting boards, counters and utensils that come into contact with raw or undercooked meat and unwashed fruits and vegetables
#4: Treatment Is Available If You Contract Toxoplasmosis The saying is true, an ounce of prevention is worth a pound of cure. The best way to protect yourself and your unborn baby is to take precautions in order to avoid exposure and infection. However, sometimes even with prevention, there can be simple slip ups, and infection occurs. If you become infected, there are medications available. You and your unborn baby will be monitored to ensure you’re both well. In some situations, even with treatment, toxoplasmosis can harm babies, and they may be born infected with toxoplasmosis. In the US, it’s estimated around 400-4000 babies are born with a toxoplasmosis infection every year. Symptoms may be mild or asymptomatic, however in severe cases, stillbirth, brain damage and other devastating effects occur. For this reason, it’s important to take precautions seriously, while understanding that the chance of infection is low. You don’t need to be overly concerned or immediately rehome your cat — you just need to be cautious.
#5: You Can Breastfeed If You Had Or Contract Toxoplasmosis Among babies of healthy women, the possibility of toxoplasmosis infection being contracted via breast milk is not likely. Some studies have found an association between toxoplasmosis and infants who consumed unpasteurized goat milk, but there are no studies showing the parasite toxoplasma gondii is transmitted via breast milk. In theory, a woman with a bleeding nipple or breast inflammation within the several weeks immediately following acute toxoplasmosis (when the parasite is still circulating her bloodstream) could transmit the parasites to her infant. However, there are no cases or studies documenting this occurring, meaning the likelihood of human milk transmission is very small. Due to the lack of evidence of possible transmission via breast milk, there’s no evidence to suggest a woman shouldn’t breastfeed if she has toxoplasmosis. … While toxoplasmosis is a real concern, basic hygiene and proper food preparation offer a sufficient precaution to help protect you and your unborn baby. There’s little reason to rehome your cat, in order to protect yourself from infection.
15
Jan

7 Reasons Why Belly Size Doesn’t Always Equate To Baby Size

Most pregnant women will agree that the moment their bump is noticeable, everyone they meet has an opinion about the size of the baby. There you are, feeling immensely proud of your baby bump until someone comments on how big or how small it is – and then the worry creeps in. Is the baby going to get bigger? Have I been eating too many chocolate biscuits? And the most important question – will the baby ‘fit’ when it’s born? But there’s really no need to worry. Pregnancy bellies come in many different shapes and sizes.
There are plenty of reasons why you appear to carrying a small or large baby – here are 7 of them:
#1: Your Height If you’re tall and have a long abdomen, your baby has a lot of growing space. Your uterus will tend to grow upwards rather than push outwards. Result: your belly will look smaller. If you’re a shorter woman, there’s a smaller space between your hip and your lowest rib. That means less room for the baby to grow upwards, so your uterus will push outwards instead. Result: your bump will show earlier and look bigger.
#2: If You’re A First Time Mother-To-Be A woman having her first baby tends to have a more compact bump because the large abdominal muscles haven’t been stretched before. They are usually toned and tight, holding the baby snug and high. This can make you look smaller than you might expect at a given point in your pregnancy.
#3: Baby’s Position Babies are pretty active in the uterus. They move around and change position frequently, especially up to the end of the second trimester. During the last trimester, babies usually favour a head-down position, but can move their backs from one side to another, or even move into a posterior position (baby’s back against mother’s back). Your belly will change shape and size depending on the position your baby is in.
#4: You’re Running Out Of Room When you’re housing a baby, placenta, cord and fluid, your internal organs have to fit somewhere. As the uterus grows, the intestines can be pushed behind it, making your belly look very round and ‘all baby’. Or your intestines might move to the sides of your uterus, making your belly appear big and ‘to the sides’.
#5: Previous Pregnancies Alter Your Shape Pregnancy stretches the abdominal muscles so that the growing baby can be accommodated. These muscles stay flexible after the birth and don’t regain their previous tone. During your next pregnancy, you might notice your bump showing much earlier and looking bigger. This doesn’t mean your baby is larger – your body has been altered by your previous pregnancy. A woman who is very athletic and fit, and regains muscle tone between pregnancies, can appear to be ‘carrying small’ for subsequent babies. The muscles are able to hold baby quite snug and tight and her belly might appear more compact.
#6: The Amount Of Amniotic Fluid The amount of fluid surrounding your baby can fluctuate. While too much or not enough amniotic fluid can point to problems, it’s common for the levels to change every hour or so. In the first 20 weeks, most of the amniotic fluid is produced from your own body fluids. In later pregnancy, your baby is producing the larger amount of amniotic fluid, mainly from lung secretions and urine output. So, depending on how pregnant you are, if you or your baby are producing plenty of fluid, your belly might alter in shape or size.
#7: Baby’s Size Okay, so it’s a bit obvious but you might actually be having a big or small baby. Genetics play an important part in the baby’s size. If both parents are tall, then the baby will probably have the same traits. If both are average size, the baby is more likely to be petite and not very long. Babies tend to be in the same weight range as their parents, too. So if you and your partner were about 9 lbs. at birth, you’re not likely to give birth to a tiny 6 lb. bundle. Birth order can also make a difference in how big your baby is likely to be. Subsequent babies tend to be larger at birth than their older siblings were. Boys are generally bigger at birth than girls as well … but guessing the gender of your baby from the size and shape of your belly is a whole other discussion! … The truth is, no-one can judge the size of your baby simply by looking at your belly – not even your doctor or midwife. As your body changes at each different stage of pregnancy, you can’t compare yourself with other women. Remember, every pregnancy is unique. Unless you have a medical condition, such as diabetes, or you’ve been suffering from severe and prolonged morning sickness (hyperemesis gravidarum), the size of your belly shouldn’t be a concern.
15
Jan

What Does IOL Stand For In Pregnancy?

When you’re pregnant, you find yourself in a whole new world of terminology, jargon and acronyms. It can be so confusing trying to work out what it all means, and sometimes you can’t help but feel like a newbie at it all. Amongst all the incomprehensible doctor shorthand, you may notice the letters IOL on your medical records. So what does IOL stand for in pregnancy? If you see the letters IOL, it simply means induction of labour. Perhaps you’ve had an IOL for a previous pregnancy, or perhaps you’ve been scheduled for one in your current pregnancy.
Your hospital may offer several forms of IOL, including:
#1: Cervical Ripening Gels, Tablets and Pessaries If a woman’s cervix is closed and not ready for labour, it can be ripened with synthetic hormone (prostaglandin) first. Prostaglandins can be administered via a gel, pessary or tablet, and just one dose is given to try and start labour. The dose may be repeated if nothing progresses after so many hours. Gels and pessaries are inserted into the vagina, and tablets can be taken orally. Some hospitals allow women to go home after the application of prostaglandins, then return when labour is established.
#2: Synthetic Oxytocin The most common method of induction is via an IV drip containing a synthetic version of the labour hormone, oxytocin. The drug is commonly known as Syntocinon in Australia, and Pitocin in the US. To begin the induction, the pregnant woman is admitted to hospital, then hooked up to the IV. She will then be monitored as the contractions begin, as her labour is now classed as high risk. Unfortunately the monitors can restrict movement and further interventions are common.
#3: Artificial Rupture Of Membranes (AROM) If a woman’s cervix is partially open, her doctor can rupture the membranes (also called an amniotomy). Using an amnihook (which looks like a long crochet hook) inside the vagina, the doctor will break the bag of waters surroundingthe baby, in the hope it triggers labour.
#4: Foley Balloon Catheter The Foley balloon catheter was originally designed to empty a patient’s bladder. It can be slowly inflated and manually dilates the cervix. It’s a safer, recommended option for women who’ve had a previous c-section, and can be used on anyone who has a partially open cervix. Because it doesn’t involve medication, it’s has fewer risks for both mothers and babies. … While inductions of labour are a very common procedure, they do come with risks, especially if medications are used. Some of these risks are serious, others not so much. However, many inductions do result in further interventions, including emergency c-sections. In Australia and the US, one in three babies are born by c-section, which is double the recommended level from the World Health Organization. Reducing the number of inductions of labour will highly likely reduce the number of c-sections performed. It’s important to make sure you’re aware of all the risks as well as the benefits, so you can make a decision which will offer the best outcome for you and your baby.
15
Jan

Fibroids And Pregnancy – 8 Things You Need To Know

Many women of childbearing age are diagnosed with gynecological concerns such as fibroids, PCOS and endometriosis. These frustrating issues take on a whole new level when you discover you’re pregnant. If you’ve been told you have fibroids, you may wonder how they may impact your pregnancy. Will you experience a high risk pregnancy? Will fibroids put you and your baby at risk for serious complications? For some women, fibroids have little to no impact on their daily life, fertility or pregnancy. But for others, fibroids can have a major impact.
Fibroids and Pregnancy
Here are 8 things you need to know about fibroids and pregnancy:
#1: Fibroids Are Common Fibroids are non-cancerous masses of compacted muscle and fibrous tissue, found inside or outside the uterine wall. A fibroid tumor may also be referred to as a leiomyoma or myoma. With as many as 50-80% of women having fibroids, the condition is actually quite common.
#2: Fibroids Can Vary In Size Some fibroids are as small as a pea, while others can be as large or larger than a grapefruit. While most fibroids wont grow in size, around one third may grow in the first trimester of pregnancy. Fibroids which grow during pregnancy are the most problematic, as they can result in miscarriage. Given the varying sizes and number of fibroids, symptoms can vary greatly from woman to woman. The location of the fibroid(s) can have an impact too.
#3: Fibroids Can Be Asymptomatic Or Be Problematic Women with fibroids may have no noticeable symptoms, before, during or after pregnancy.
For other women, their fibroids come with such symptoms such as:
  • Abdominal Pain
  • Frequent urination, or urge to urinate
  • Heavy vaginal bleeding
  • Pelvic pressure and pain
  • Constipation
It’s important to contact your healthcare provider any time you have vaginal bleeding or pain, as they can also be symptoms of other concerns. Reproductive and women’s health specialist, Doctor Andrew Orr, recommends women have fibroids removed prior to pregnancy if possible, in order to reduce the chances of miscarriage. Fibroids can result in ectopic pregnancy, and if a fibroid grows, it can harm a foetus, even causing a miscarriage. #4: You May Not Need Treatment – But You Do Need To Consult A Specialist For most women, fibroids don’t require any treatment. For some women, fibroids are surgically removed, either prior to or after pregnancy. This is especially the case for women with large fibroids which cause pain, heavy bleeding or if the fibroids are impacting fertility (e.g. the fibroid is blocking fallopian tubes). You aren’t able to have uterine surgery to remove fibroids during pregnancy, so if you’re experiencing pain due to the fibroids, your healthcare provider will likely recommend a treatment plan and pain medication which is safe during pregnancy. Doctor Orr says that during pregnancy, it’s more a case of treat, monitor and see. “It really depends where the fibroids are located — intrauterine [inside the uterus] fibroids are the biggest concern. Therefore, it’s important for pregnant women with fibroids to consult a specialist to assess their unique situation, and not try to self treat.”
#5: Complications Are Possible, But Not A Guarantee For women with smaller fibroids that don’t grow, there’s little — if any — expected risk during pregnancy. Even for women with large fibroids, they can be low risk, but the size and location of the fibroids is the issue. Depending on the size and location of the fibroids, there is an increased risk of miscarriage, in-uterine growth restriction, preterm birth, breech position, c-section, heavy postpartum bleeding or even hysterectomy.
#6: Fibroids Can Change During Pregnancy Doctors aren’t certain why, but pregnancy hormones may cause your fibroids to grow or shrink. Your maternity care provider may monitor your fibroids to see if their changes increase your risk of complications. If a fibroid is located near the bottom of the uterus, close to the cervix, growth could block the baby’s passage into the birth canal. If your midwife or doctor has any concerns, they will monitor you and make birth recommendations accordingly.
#7: Uterine Fibroids Don’t Automatically Mean A C-Section While there is an increased risk of needing a c-section, many women with fibroids are able to have uncomplicated vaginal births. Unless the size and location of your fibroids is blocking the cervix, or the size and location impact baby’s ability to move into the optimal position, an uncomplicated vaginal birth is likely. As fibroids change in size and as the uterus grows, even if a fibroid appeared to be a concern in early pregnancy, monitoring might show as the pregnancy continues, it becomes less of a concern. If your healthcare provider recommends a c-section during early pregnancy, it’s a good idea to ask for monitoring towards the end of your pregnancy, so you can make an informed decision before scheduling it. Your situation may change and surgery may longer be needed.
#8: There Are No Miracle Cures The internet is full of miracle cures for everything; however when it comes to fibroids, you should never self treat or consult doctor Google, because there are no miracle cures. All you can do is leave the medical needs to your healthcare provider, and continue to be vigilant about your diet. “Diet can be a factor with fibroids, because high insulin levels cause high estrogen levels, and that’s what the fibroids grow from – a high estrogen environment. So adopt a low GI diet all the way, as soon as possible in your conception journey. There are other things you can do to help during pregnancy, but this would require a professional consultation,” says Doctor Orr. Healthy eating is very important during conception and pregnancy – science has discovered what we eat impacts the health of our unborn children, and not just ourselves. By eating a healthy diet, eliminating sugar and processed grains (bread, cereals, pasta, processed foods), you can not only help to prevent and minimise problems associated with fibroids, but other pregnancy complications like gestational diabetes. Not sure where to start? Here are 13 healthy breakfast ideas. … Pregnancy is a time of excitement, but also a time where common concerns can become worrisome. Fortunately, for most women, fibroid tumors are unlikely to cause complications during their pregnancy and birth.
15
Jan

Pelvic Exam During Pregnancy – Is It Really Necessary?

Written by midwife, Brenda Manning There is absolutely no need for an internal pelvic exam during a normal pregnancy. The average healthy woman can manage her entire pregnancy without one. Most women will be offered a pap smear at the first consult if they haven’t had one recently, but they can decline and say that they’d prefer their regular GP to do it for them. Pelvic exams are not needed to determine dates either, if the woman can give a good menstrual history. If she cannot give an accurate date of her last menstrual period, then she can request an early ultrasound. Depending on the gestation of the baby, an internal ultrasound may be used, but you can say no if you wish. If the doctor suggests he or she needs to examine you to determine that everything is normal, then you can state that you have no problems with menstruation, intercourse, frequent UTIs, abnormal vaginal discharge or any other gynaecological problems, therefore there is no reason to suspect any abnormalities. You would be wise to have an exam to exclude abnormalities if: You do have a history of gynaecological problems You have a history of infertility problems If your mother used diestriol during pregnancy with you If you have painful intercourse
Pelvic Exams and Strep B Testing
The 37 week swab for group B strep is not a reason for a pelvic exam. You can just ask for the swab kit and take the swab yourself (in the consultants toilet). Once completed, you can present him/her with the swab, all sealed and ready to go to pathology.
Internal Exams and Induction of Labour (IOL)
If a woman requests an induction of labour then she will need to consent to a vaginal exam so that the doctor or midwife can decide what form of induction will the best for her. Obviously the waters can’t be broken if the cervix is closed. “I had SO many [internal exams] with my daughter’s labour – 10+ with my induction that I could remember and there may have been a few more. They were horrible and totally unnecessary in my mind. They did nothing to help me, nothing to help the midwives and doctors, other than one after 35 hours of labour when I was told that I was 9cm dilated with an anterior lip and it was time for a caesarean. I also vomited during one of them it was so painful to have during contractions and I swore if I ever laboured again I wouldn’t have so many, that I would refuse until I wanted one, not the doctors/midwives for curiosity sake which is what it felt like to me. Pity I never went into labour with my son, but when I spoke to the midwives before he was born they noted that I wasn’t happy with vaginal exams and would only have them if absolutely necessary.” — Tanstar, BB Forum Member
Pelvic Exams and Labour
Internal exams may not be medically necessary for many women, they are done mainly as an information seeking procedure to ascertain things like: If a woman is actually in labour To positively identify the presenting part of the baby i.e. head or bottom To determine whether the head is engaged if there is doubt To ascertain whether the forewaters are intact or to rupture them artificially To exclude cord prolapse (cord coming out first) following rupture of membranes, especially if the presenting part of the baby is ill-fitting To assess the progress or delay in labour To apply a fetal scalp electrode To confirm full dilation In the presence of twins to ascertain the lie of the 2nd twin and puncture the amniotic sac This may look like a long and useful list of things that internal exams can do, but they do not always produce accurate results. If a vaginal exam is worth doing at all, then its worth doing properly – i.e. with preparation done thoroughly and not a rushed procedure. Beware of the casual ‘quick feel’ just to see where baby’s head is. It’s often misleading or inaccurate with the results and it would have been more productive to take the time to do a proper exam, even if it meant some discomfort and moving from a comfortable position to get accurate and relevant information. “I had one during labour – my Ob/Gyn asked if I wanted one to see how far along I was. The midwife said I didn’t have to if I didn’t want to. It bloody hurt! I thought I tried to kick the Ob/Gyn – my husband says I didn’t, but he was ready to! I wish I’d listened to the midwife. Having read up (after the fact) on BellyBelly and other places, I wouldn’t agree to a vaginal exam during a future pregnancy or labour unless there was a compelling reason.” — Malakili, BB Forum Member If you have a pelvic exam, make sure that:
  • You understand why the exam is being done and what the examiner hopes to ascertain from it
  • The procedure is explained to you and you are asked if you consent to it or not
  • Inform the examiner if you have a latex or any other contact allergy You have an empty bladder
  • You are warm
  • You are comfortable
  • You are adequately covered
  • Privacy is ensured
  • Ask for extraneous people to leave the room
Lie flat and squarely on your back with your bottom on the bed. Breathe deeply throughout the exam, and try to relax your pelvic floor muscles. Ask the examiner to explain clearly to you what he finds on exam. “I was happy to have both of them (exams), but was p*ssed off about the S&S (stretch and sweep, which was also performed at the same time). I didn’t ask for it, didn’t want it, didn’t like it and it wasn’t necessary.” — Snacks, BB Forum Member
Be sure to read our article about informed consent during pregnancy and labour.
As a midwife, there are several reasons I would do a vaginal exam and several reasons why I wouldn’t. I would do a vaginal exam if:
  • If the woman requested the exam because she needed to know what was happening
  • If the woman felt she needed to focus and couldn’t, because she was afraid she was giving labour too much or too little attention too early
  • If the woman was Group B Strep positive and thought she’d ruptured her membranes, so we could begin the antibiotic regime (if she wants to do so – antibiotics have implications for the mother’s and baby’s gut)
  • If the woman was feeling despair that she couldn’t continue without analgesia and we’d exhausted all options
  • If the woman was labouring at home but planning to go to hospital for the birth If the woman was deciding whether or not to have pain relief i.e. how close to birthing she was
  • If the dilation would decide what course of action the woman would take next, i.e. go for a walk on the beach, get in the pool, collect the kids from school, call the babysitter, notify the mother or birth supports, get hubby home from work, send hubby to work!
“(My doctor) was very rude and I hated the whole experience. He found me to be 7 centimetres dilated when he did the exam and I was not having any pains at all. He sat there with his hand up me while exclaiming to the nurse, ‘oh my god, you wont believe it’, and to me, ‘are you sure you don’t feel any pain?‘. Made me extremely uncomfortable, he didn’t remove his hand until I asked him to.” — Scorpio Queen, BB Forum Member
I wouldn’t do an internal exam if:
  • If the woman asked me not to
  • If the woman was a sexual abuse survivor and was not comfortable with an exam
  • If I thought the woman was in the latent phase/early stages of labour, as it would only discourage her.
  • I’d encourage her to rest instead.
  • If I wanted to know if the cervix was fully dilated. I’d just wait and see!
  • If I thought the baby was in posterior position – there is nothing I can do about it if it is!
  • Unless my findings were going to alter what we were doing
“I think a good midwife can tell by looking at a woman how dilated they are… so they are a tad over-rated. Far too many are done just in case… just to check. Stop poking babies on the head!” — yogababy, midwife and BB Forum Member
It’s inappropriate to do an internal exam:
  • Because the shift is changing and, “we want to know where you are at”
  • Because the staff want to know where you are at in your labour but don’t have the time to sit and observe or be with you
  • Because “the anaesthetist is going home and doesn’t want to be called back in an hour to give you an epidural” (unless you have indicated you are considering one)
  • Because the Registrar is going off duty and wants to hand over your care to the incoming Registrar
  • Just to check how you’re doing
  • Because it’s hospital policy to do routine 4-hourly vaginal exams Because your obstetrician wants to be present for birth but doesn’t want to be standing around waiting for hours, or to miss the whole thing (unless you specifically want your obstetrician present).
When Pelvic Exams Are Contraindicated (Not Recommended)
  • If the woman refuses the procedure for reasons of culture or FGM etc
  • When there is a placenta praevia
  • With extreme care when there is any abnormal vaginal bleeding pre-natally
  • Unnecessarily if the woman is GBS positive with ruptured membranes
  • If the woman has an active gential herpes lesion
There was an article in a medical journal, the Lancet, some years ago written by an obstetrician. He wrote that he couldn’t see the whole point of information seeking vaginal exams, especially trying to work out what position the baby was in (i.e. posterior, transverse). He noted that there were only 3 diagnoses which counted. Either the baby is: 1. Coming out soon 2. Coming out later 3. Not coming out at all He’s surely onto something! People make it all so complicated when its all fairly simple.
Who’s Having Pelvic Exams?
Midwife, Alan Rooney says: “I’ve never had a homebirth mother request a vaginal exam. I think that, in hospitals, many mothers expect to be given a vaginal exam. In my experience, when I have admitted a woman in labour, a frequent question I get is, ‘Do you need to do an internal?’ or ‘When are you going to do the internal?’, or some such question. I do not believe that women are happy to have vaginal exams, but I think that most women accept them as an expected part of pregnancy. I’m sure if they were given all the facts, then a lot more women would be saying no to vaginal exams. The risk of infection is quite low from a vaginal exam, but there is still a risk. And the more often someone goes sticking their fingers in, the higher the chance of introducing an infection. This is more of a concern if the waters have broken, as not only can you give the mother an infection, but you could also give the baby one.”
If You Want to Avoid Pain Relief Or Interventions – Avoid An Unnecessary Pelvic Exam!
BellyBelly’s Creator, Kelly Winder, says: “Vaginal exams can be the final breaking point for women in labour. If they have an exam to find out how far along they are and end up disappointed at the result, it can be the reason they choose to either give up, have that epidural or other intervention. This is because they feel they have nothing left to keep on going – the dangling carrot has gone. After hearing a number and not ‘you’re almost ready to push!’, they believe the end is far in sight, and the battle of willpower to keep going can feel overwhelming.” Kelly continues, “These labouring women may have no idea that if they were left alone to do what they need to do, they may dilate much faster than they think. Whatever time it took them to get to four centimetres dilated, for example, does not mean they have double or more the time to go – early labour tends to be much slower. We must have faith in our bodies to know the way, not two fingers. No-one knows how quickly or slowly a woman will dilate, but knowing an actual number (and knowing that you’re not there yet) can severely throw a labouring woman off track. Sure it could motivate you too, only if you’re almost there – but why risk it? A client of mine had an internal exam and was found to be four centimetres dilated. She was devastated after labouring all day, and it took so much work to bring back her focus, allowing her body to labour without distraction and stress. Not long after that, the unimaginable happened – her parents turned up uninvited and again she had lost focus! Again we dealt with that, and after a few good hours of hard work in the bath, focusing on the CalmBirthing techniques she had been learning, she had her baby soon after. Not bad for someone who was four centimetres only a few hours earlier. She could have given up and opted for pain relief thinking she would have many hours to go – but she dilated quickly after the internal exam with the right support, one-on-one by her side. It’s so unfair for a labouring woman to have to go through all that, the feeling of defeat or seeing a mountain in front of her when she have already worked so hard. This is why I believe it’s best not to know how dilated you are or to have internals unless there’s a really compelling reason. On top of that, if you’re not dilating fast enough for the hospital or doctor’s liking, then they’ll be quick to recommend using the syntocinon drip (artificial oxytocin, used to induce labour) or rupture your membranes to speed it all up. I highly recommend couples hire a doula to help them navigate this and many other issues that may potentially arise during labour.” “I felt that I had too many but seeing as everything now is hazy, I wonder if they were necessary? I only wanted one in particular when I was 7cms and 3 hours later I wanted to know if I had progressed. Turns out I hadn’t and I chose to have an epidural.” — Tanstar, BB Forum Member
What If I Don’t Want A Pelvic Exam?
A labouring woman should expect that she will need a vaginal exam prior to receiving pain relief (other than gas). If the hospital doesn’t do waterbirths, then they may not let her in the pool or bath without an exam, as they’ll be anxious that she’ll give birth there. Sometimes its a bit of a trade-off to get what you want. Plenty of women have never had a vaginal exam during labour, simply by refusing to consent. This is the most powerful tool. If a woman is not convinced that there is a good reason for the exam as per above, then she can just say NO. Ask what the reason is for the vaginal exam, what information they hope to obtain and how will it alter labour management. If the woman has ruptured membranes she can state that, ‘every vaginal exam I have increases my risk of infection, so is it really crucial that I have one now’? It might be a bit heavy for you but it works. You could explain to the doctor or midwife that you are very uncomfortable with the concept and don’t want to be stressed any more than you are already. If denying consent is too difficult or the staff pressure you, then if you protest enough they will cease. Hysteria or (fake) tears almost always work! If refusing is too difficult or confronting then use delay tactics, they work very well. ‘After this next one i’ll move to the bed’ (next 5 or 6 pass) ‘I must to go to the loo first’ ‘I want to have a quick shower first’ (stay in the shower) ‘I can’t cope with the idea just now, let me think about it’ ‘I want to wait until my husband/sister/doula is here’ ‘I am wet from the bath/shower, I want to dry off/am cold’
Evasion is very effective also:
  • “I can’t lie on my back, it’s killing me’”
  • “I have to pee” (hiding in the loo)
  • “I don’t want to get out just now” (under the shower)
  • “I can’t move just now” (being slow to get out of the bath/pool)
White Lies
Recently, a woman giving birth told staff she had severe vaginismus and the whole idea of a vaginal exam was simply out of the question. She had no vaginal exams done at all. Another woman told the staff she was Muslim – as they had no female registrar present, a vaginal exam was out of the question. Another very young woman told me boldly that she just ’didn’t DO vaginal exams’! She also managed to escape the syntometrine injection for the 3rd stage (placenta) by stating emphatically that: ‘Oh no, I couldn’t possibly have that (drug), I don’t DO needles!” She managed to scoot around hospital policy very neatly by just stating the obvious, that she didn’t DO these things and wasn’t about to DO them now! No one seemed offended about it and I had a secret smile – I really admired her simplicity! How can you argue with such simple logic? It’s like telling a vegetarian that they must eat meat right now for ‘their own good’ when they never eat meat normally. They’d say the same thing wouldn’t they? “I can’t do that! I don’t DO meat!”
What If My Doctor Or Midwife Tells Me I Have To Have A Pelvic Exam?
Again ask why – ask specifically, is there a problem? What is the reason for the vaginal exam, what info they hope to obtain and how will it alter the labour management? It’s very important to always remember: when you’re a patient in a hospital, you don’t have to do anything. All treatment is by patient consent only. Hospital policy is not law, and a procedure being done against your will provides grounds to sue. Medical professionals need your permission to do anything to your body. If you aren’t convinced there is a good reason for a procedure, then you are within your rights to decline it.
15
Jan

Vaginal Heaviness During Pregnancy | Causes & Relief

Vaginal Heaviness During Pregnancy
There’s no question — pregnancy is an exciting time for most women, but it can bring with it some major discomforts. From morning sickness to an aching back, sleep deprivation and constant tiredness, pregnancy can take a lot out of you. While it’s pretty amazing how your body changes shape and adjusts to the growing person inside, there are some less glamorous side effects you don’t often hear about. One of those is pelvic pressure and vaginal heaviness during pregnancy. Many pregnant women experience pelvic pressure, especially in their last trimester. While this symptom can be anything from mild to downright impossible to live with, unfortunately it’s a normal part of pregnancy.
What Causes Pelvic Pressure?
During your third trimester, your body releases a hormone called relaxin in relatively high levels. The purpose of relaxin is to loosen the ligaments in your pelvis so the joints can separate slightly. This allows flexibility in the pelvis for your baby’s head to pass through during birth. The weight of your baby added to the effects of relaxin on your pelvic floor tends to cause those muscles to stretch and weaken, all of which contribute to feeling pelvic pressure during late pregnancy. Over the course of your pregnancy, your blood volume increases by about 50%. The increased blood flow can cause your vagina and labia to become swollen and feel tender. Your pelvic area can feel full and heavy, especially if you are standing a great deal. This extra blood volume also increases the pressure in your veins, especially the veins in your legs. These veins have to work harder against gravity to push the blood back up to your heart. Your uterus is also adding its own pressure onto the vessels in your pelvis. Progesterone is adding its part by relaxing your blood vessels to accommodate all of the extra blood. The result is varicose veins. We usually think of varicose veins as those spidery purple marks on the skin, but varicose veins can happen in the rectum (haemorrhoids) or the vagina and vulva, and sometimes around the uterus and ovaries. These swollen veins can cause a heavy sensation in the pelvis and a persistent intense ache. And of course, your growing baby is adding to all of the pressure. By the time you reach full term (which is from 37 weeks of pregnancy to 42 weeks of pregnancy), your baby’s average weight is between 2.5-3.5 kilograms (5.5-6.6 pounds). This weight is pressing down into your pelvis, along with the weight of the placenta, cord and amniotic fluid. As your baby moves about, it can create more pressure as ligaments become stretched. Because of the effects of relaxin, those ligaments allow the uterus to sag down, adding to the pressure. At some stage before labour begins, babies tend to descend into the pelvis (known as lightening). This is more likely to occur with first babies, but it can also happen right up to when you’re in labour. Your baby’s head can feel as though it’s between your legs and contributes to the ‘pregnant waddle’ you may have heard about. There is added pressure to your cervix and generally everything feels ready to fall out!
Spleen Qi Deficiency
In Chinese medicine, vaginal heaviness is said to be caused by spleen Qi deficiency. BellyBelly’s Chinese Medicine expert, Doctor Chris Tang says, “Spleen Qi deficiency is one of the most common pregnancy syndromes in Chinese Medicine. Symptoms associated with it involve tiredness, fatigue, poor digestion, swelling, fluid retention and a general feeling of heaviness all over the body. If left untreated and the syndrome progresses, it can lead to spleen Qi sinking. This can lead to extreme fatigue, a sinking feeling in the uterus, haemorrhoids and a prolapsed uterus or anus. Causes of spleen Qi deficiency can be due to a pre existing condition prior to pregnancy, poor diet, overexertion with lack of rest and poor sleeping habits.” How does Chinese Medicine remedy splee Qi deficiency? Doctor Tang says, “Women with this condition need to address it early and make sure they rest properly. The spleen and stomach thrive on warm and cooked food, so cutting out raw and cold natured food is essential. Acupuncture and moxibustion can really help in warming and tonifying the spleen, and help raise the sinking Qi.”
Treatment For Pelvic Pressure
Pelvic pressure and discomfort can be felt at different stages of pregnancy, but usually it peaks during the last weeks before birth. While nothing can really make the pressure go away except giving birth there are a few things you can do to relieve the sensation: Lying on your left side to encourage your baby to adjust position Sitting with your feet elevated to improve circulation Resting with your hips elevated on cushions Warm baths Pelvic massage from a pregnancy trained practitioner Wearing a pregnancy belt can help support the pelvis Heat packs Knee lifts to relieve stretching ligaments Pelvic rocking or swaying Hip squeeze exercises Acupuncture Sex can relieve the pressure caused by vaginal swelling Body therapy such as osteopathy or chiropractic (make sure the practitioner is trained for pregnancy) Gentle exercise such as swimming, water exercises, cycling or walking Pregnancy yoga Pelvic floor exercises to strengthen the muscles and support the area It’s very normal in late pregnancy to feel pressure in your pelvis. Using these methods can help relieve the sensation. However, you should always discuss any discomfort or pressure with your care provider, and make sure the treatment method is safe for you. If you feel any pain, cramping or experience spotting before 37 weeks of pregnancy, it’s important you contact your care provider immediately. These may be signs of labour beginning. Here are 7 signs of labour if you’d like to be prepared.