The A-Z of Pregnancy Niggles - Part 2

Insomnia

Insomnia in pregnancy can be caused by general discomfort, nocturnal toilet visits, back ache, leg cramps or even anxiety. Do what you can to relieve discomfort; otherwise, the best cure for insomnia is good “sleep hygiene”. Here are some tips: Make your bedroom sleep-friendly. Dark, quiet and comfortable. Your bedroom is for sleep and sex only - not TV, paying bills or doing crosswords. If you can bear it, keep animals out. Adopt a sleep-friendly lifestyle: you need a sleep routine as much as you’re children, as well as regular exercise (but not just before bed) and a balanced diet. Avoid large meals before bedtime. Alcohol, cigarettes and caffeine are an absolute no-no before bed (and generally in pregnancy). Try sipping chamomile tea an hour or so before bed and learn a relaxation technique such as meditation to practice at night. Natural therapists believe some insomnia is caused by an imbalance in the calcium magnesium ratio. A cup of warm milk and honey or molasses before bed or in wakeful times can help. Worst case scenario: Doctors are reluctant to prescribe sedatives or sleeping pills during pregnancy. If the problem gets really bad, it may be worth seeing a sleep therapist – check with your LMC (lead maternity career).

Pelvic Pain

This tends to occur later in the pregnancy as the uterus gets bigger and muscles soften. One of the most common sorts of pelvic pain experienced during pregnancy is frontal pain over the pubis. If you experience this, try to avoid sitting with your legs crossed and visit a physiotherapist for exercises and a “belly belt” to support your pelvis. Spending time off your feet will help. If you are having difficulty moving about or have any numbness or weakness in your legs or buttocks, check with your LMC.

Swelling

Swollen ankles are common in pregnancy and usually pose no health risk. But if you experience sudden swelling in your ankles and/or legs, hands or face, contact your LMC to check your blood pressure, as this could be the first obvious sign of toxemia. If the swelling isn’t a symptom of something more serious, there are several ways you can relieve it. Elevation is one strategy – sit and sleep with your legs higher than your hips. Exercise can provide relief, especially aqua walking. Don’t limit your fluid intake. Keep drinking six to eight glasses of water a day.

Thrush

If you are experiencing itching or soreness and burning around the vagina you may have thrush. It is normally accompanied by a thick white discharge and is caused by the yeast Candida alb cans which occur naturally in the body. Try to reduce the amount of yeast in your diet by cutting out white flour and increase your levels of whole grains, fruit and vegetables. Avoid tight fitting clothes and choose clothes made of natural fibers (such as cotton). Ask your doctor or pharmacist to prescribe a safe treatment cream.

Varicose Veins

Pregnancy hormones render your veins less efficient at propelling blood, so the blood tends to pool. This can cause varicose veins in the legs and vulva. The same hormones also make pregnant women more prone to constipation, so the straining can trigger varicose veins around the anus (piles or hemorrhoids). Iron supplements often taken in pregnancy can also cause constipation. To prevent and relieve them, put your legs up vertically against a wall at least once a day. Even better, get your partner to rub vitamin E down your legs while you do this. Thick elastic compression stockings really help relieve the pain. Witch hazel (hammerless) is a natural therapy for varicose veins. It can be made into compresses, bought as an ointment or cream or taken as a homoeopathic remedy. If your veins become hard or red there may be a small clot – see your doctor because this could be a symptom of an underlying deep vein thrombosis.

Vulvae Veins

Elevation and compression is the answer here. Witch-hazel may help or you can get compression girdles through obstetric physiotherapists.

Hemorrhoids

Avoiding constipation is critical to preventing hemorrhoids. If you notice any changes at all to your bowel routine, take measures early: exercise regularly, increase your fluid intake to two to three liters of water a day, eat plenty of fruit (especially kiwifruit and dried fruit such as prunes and apricots) and vegetables, have plenty of whole grains and try bulking agents such as Metamucil. Talk to your LMC before taking laxatives, because these can bring on premature labor. Tips for treating hemorrhoids include: After you've had a bowel motion, get your bottom in the air by bending over a chair or lying on the bed with a pillow under your hips. Try applying a witch hazel poultice, ointment or cream, or a crushed plantain poultice. You can push the piles back in yourself. Sitting in a warm bath can relieve the pain and if you have minor bleeding and pain, add a handful of Epsom salts to the water. Worst case scenario: Prescription steroid creams may help or in extremely rare situations, you may need an operation to treat severe piles.

Warning Signs

Contact your lead maternity career (LMC) straight away if you have any of the following: Vaginal bleeding Burning or stinging when passing urines Sever abdominal pains, cramps or contractions Sever headaches or visual disturbances Fever Persistent vomiting Waters leaking Less than 10 baby movements per day (in later pregnancy)

MINOR PREGNANCY COMPLAINTS - Part 1

The A-Z of Pregnancy Niggles - Part 1 They’re known as the ‘minor complaints of pregnancy’, but they’re all pretty horrible The vast majority of pregnancy complaints pose no risk to your health, but that doesn’t stop them being a burden – especially if you suffer from several at once. The cure-all for most pregnancy complaints is the birth of your child. But until then, what can you do? If you’re worn out and hurting, it’s hard to feel thrilled about being pregnant. Here’s help with misery-making aches and pains. Anemia (Iron Deficiency) It’s quite normal for your iron levels to drop a little during pregnancy, and you may feel fatigued, experience faintness and have paler skin. Adjust your diet so that you increase your consumptions of iron rich foods; red meat, fish or pumpkin seeds, and Vitamin C; citrus fruits, berries, green peppers and broccoli. Also consult your doctor to see if you are in need of an iron supplement. Backache Poor posture is a big contributor to back ache in pregnancy – and it only gets worse as your stomach expands and your back takes on the extra pressure. Try to get your back and abdominal muscles in good shape before pregnancy. Keep active – this will help keep your muscles and joints strong. Yoga, aqua jogging and swimming are excellent for strengthening and soothing the whole body during pregnancy. Practice good posture whenever you can, tucking your pelvis under slightly to prevent the sway back that can occur in late pregnancy. See an obstetric physiotherapist for pain relieving exercises, techniques and massage relief (this applies also to leg cramps, pelvic pain and carpal tunnel syndrome). Use a pelvic support belt (your LMC or Physiotherapist can help) or try wearing tight fitting lycra to help stabilize your pelvis. In very rare cases, back pain can be the sole symptom of labor. If back ache comes and goes in regular waves, contact your LMC. Breast Sensitivity You may experience sensitivity or a tingling sensation as your breasts begin to lactate. From about 16 weeks of pregnancy your breasts begin to produce a thin milky, yellow fluid called colostrums that may leak a little during pregnancy and stain your clothes. Wear a supportive non-wired maternity bra during the day as well as at night, and avoid drinks containing caffeine which can cause water retention. Sunflower seeds, sesame seeds, linseed, tofu, yogurt and milk can help balance your hormones and relive breast tenderness. Remember to use breast pads to protect your clothing from potential stains. Constipation A common side effect of pregnancy, constipation is caused by a change in hormone levels which relaxes the muscles in the intestinal walls and causes food to work much harder through the digestive system. Increasing your water intake is the easiest way to ease constipation, combined with a diet rich in fresh & dried fruit (prunes, figs and raisins), vegetables, and bran - try breakfast cereals such as ‘All-Bran’ or ‘Bran flakes’. Exercise will also help and it only takes 20 minutes of brisk walking every day. Cramps You can identify a cramp by a dull sudden pain followed by a dull ache, typically found in the legs and feet. Many natural therapists believe leg cramps can be caused by an upset in the calcium magnesium balance of the body (although doctors dispute the link) and may recommend cell salt magnesium phosphate or occasionally calcium phosphate. Always check with your LMC or a qualified practitioner before taking natural remedies when pregnant. You could try eating more calcium-rich foods such as dairy foods, nuts and hummus. When a cramp occurs, stretch the cramping muscles and apply warm, moist heat such as a flannel. Once the cramp has subsided, massage to promote circulation. An obstetric physiotherapist can help with stretching exercises to relieve and prevent cramps. Carpal Tunnel Syndrome Many pregnant women get a ‘pins and needles’ like pain in their hands at night. This is caused by the swelling of the fibrous cuff that runs over the nerves on the wrists. Your hands can get very hot, tingly or even numb. A physiotherapist can provide you with a splint to keep your hands straight at night and take pressure off the nerves. Try to avoid delicate movements of the wrists such as sewing or typing which can put subtle strain on the area. Fatigue Fatigue is common in the first and third trimester – the former caused by hormonal changes, the latter caused by discomfort and broken sleep for toilet visits. Rest is best. Try to get to bed earlier and keep your workload and stress to a minimum. Accept offers of help and take five or 10 minute breaks whenever you can. If you have the luxury of lots of time on your hands, try not to collapse completely as this can leave you feeling even more fatigued and possibly even depressed. Make an effort to keep moving. Keeping fit and strong will help you sleep and keep you feeling positive (by releasing stress-relieving, mood-lifting hormones). Walking is the most convenient type of exercise, but swimming, aqua jogging and yoga are also excellent. Heartburn Indigestion is common in pregnancy as digestive acids from the stomach reflux into the esophagus because of the relaxing effect of pregnancy hormones on the sphincter muscle. Eat frequent small meals instead of three larger ones each day and try not to drink with meals, especially the evening meal. Drink half to one hour before or after meals. Sit up when you are eating. Avoid eating immediately before going to bed. Eat fewer yeasty foods. Try sipping chamomile tea and avoid drinking caffeinated tea, coffee, Milo, hot chocolate and soft drinks, especially in the evening. Sleep with the end of the bed elevated so your head is higher than your feet. Have a glass of milk or plain unsweetened acidophilus yoghurt before bed. Slippery Elm capsules are thought to also be an excellent remedy for heartburn. Avoid spicy or very rich, fatty foods. Worst case scenario: Talk to your LMC about the possibility of trying over-the counter antacids for relief – most are safe in pregnancy but tell the pharmacist you are pregnant and seek advice on the appropriate ones. There is a very small chance heartburn could be a symptom of an ulcer or high blood pressure, so your LMC can help rule this out.

MORNING SICKNESS - PART 2

Morning Sickness isn’t a particularly good name for the nausea that often occurs within the first trimester of pregnancy, as you can experience it anytime of the day! Many women experience a metallic taste in their mouths and find a reduced tolerance for certain types of food and beverages – especially coffee. For most women the symptoms consist of mild seasickness but for others it can mean persistent vomiting from morning till night. Caused by a drop in blood sugar levels or fluctuating pregnancy hormones, there’s no one miracle cure. Ginger is one well known remedy – due to its anti emetic qualities. Ginger tea is ideal and can be brought from a variety of health shops, but even ginger biscuits or ginger beer may even be enough for mild cases. Apart from ginger there are a wide variety of traditional remedies that might do the trick and the best solution is to try the various methods until you find one that suits you: · Start the day with a dry cracker, a piece of dry toast or a plain biscuit · Eating little meals often (every two to three hours) · Drinking Milk · Drinking lots of fluids · Fizzy Drinks · Bland non greasy foods, i.e. baked potatoes, rice or pasta · Rest – tiredness can increase feelings of nausea · Avoiding rich, fried or spicy foods · Ask someone else to cook · Seasickness bands (activate an acupressure point on your wrists and can easily be brought from your local chemist) If nothing makes you feel better, hang onto the fact that morning sickness is consider a sign of a healthy pregnancy and that it usually disappears at about 14-16 weeks.

MORNING SICKNESS - PART 1

The first signs of pregnancy

For many women, one of the first signs of pregnancy is a feeling of sickness in the pit of the stomach. No, it's not dread or fear (usually!), its morning sickness! Although many women sail through pregnancy without feeling ill, about half of all pregnant women report some feelings of nausea. This can range from a few days of mild queasiness to frequent vomiting that goes on for months. Anyone who's suffered from bad morning sickness can vouch for the fact that the name's a misnomer – it's not just in the morning that the nausea that characterizes the first few weeks of pregnancy can strike. It can occur at any time of the day. Morning sickness usually makes an appearance about six weeks after the last menstrual period, and for most women it subsides, sometimes literally overnight, at the end of the first trimester (14 weeks). For a few, however, it lasts for nine months, or makes an unwelcome return in the last few weeks of the pregnancy. Some pregnant women find their senses of taste and smell will be more acute than normal, with some previously innocuous smells, such as cooking smells or perfume, turning their stomach instantly. Some report a sudden aversion to foods or flavors they previously enjoyed, such as coffee, vinegar or pepper, but this is a highly individual reaction. Many notice a metallic taste in their mouth. Some are mystified to find that they feel simultaneously slightly sick and ravenously hungry!

What can you do?

Eat small snacks often. A drop in blood sugar levels can trigger nausea, so try to eat something every two or three hours. If you're caught without food or can't stomach anything solid, eat a glucose lolly. Although morning sickness can occur at any time of the day, it's more common in the morning because you haven't eaten for a while so your blood sugar is low. If you wake up feeling yuck, try nibbling on a couple of crackers or eating a banana before you gets out of bed. Having a late-night snack before you go to bed may also help. Choose bland, high-crab foods such as whole meal toast, crackers, plain biscuits, rice and potatoes. Eat non-acidic fruits and vegetables. Avoid fatty meats and fried foods. Follow your body's lead when it comes to deciding what you can stomach, although aim for as healthy, balanced diet as possible. You may also experience cravings for unusual foods or those you don't normally enjoy - it's okay to indulge these within reason. Try to get a good night's sleep and if possible, nap during the day. Most women feel extremely tired during the first weeks of pregnancy and this may make the nausea worse. Drink lots of water, fruit juice or skim milk. Avoid coffee and alcohol. Try acupuncture - some women swear by it. If you normally get carsick or seasick, try avoiding long car journeys or boat trips at this time - the motion can exacerbate the morning sickness. Avoid cigarette smoke and exhaust fumes as they can trigger nausea.

Warning signs

In rare cases acute morning sickness (hyper emesis gravid arum) may lead to dehydration and low blood pressure. You may require medication to help control the nausea or, if it's really bad, you may be admitted to hospital to receive fluids by intravenous drip. Tell your doctor or LMC if you vomit more than three times a day for three days, or can't keep anything at all down for 48 hours.

SHOWERED WITH LOVE

If you’re planning a baby shower , LeeAnn Yare has tips to make your party run smoothly The date and time: Six to eight weeks out from the due date seems about right for a baby shower – before you become too tired and scratchy! Invitations: Simple, ready-made invitations from a stationery shop are easy and hassle-free. Stick on wee magnets so the guests can pop the invitations on the fridge door! The food: Finger food is always a winner – it’s easy to eat and mingle at the same time. Don’t be scared to ask guests to bring something along, and remember to provide a non-alcoholic drink option and make sure food options are safe for pregnant people. The location: It’s nice to host it at home, but you could always use a friend or family member’s house, or reserve a large table at your favorite café where there are no dishes to do afterwards. Gorgeous Gifts There’s so much to choose from! Here are some possibilities: Play mats, baby books, photo albums, mobiles, blankets, a gorgeous teddy, wooden letters for the baby’s name, cute clothing, and practical items such as Treasures nappies, linen, bibs, and bath time essentials will be welcomed by new parents. Several family members or friends can get together and buy a bigger budget item such as a car seat, high chair or bassinet. Games and Activities Guess the circumference of the mum-to-be’s bump. Everyone cuts a length of string. The closest one wins! Guess the date and time of the birth along with the baby’s birth weight. Ask guests to bring along a baby photo of them and see if you can guess who’s who! See who can write down the most baby names all beginning with one letter of the alphabet. Celebrity baby quiz: cut out pictures from magazines and paste those on a board, the guests have to match up the baby faces with the mothers’ faces. Provide a plain white singlet and some fabric pens for each guest, and have them create a special or funny message such as ‘the best thing since sliced bread’.

THE PERFECT MATERNITY BRA

Time to go maternity bra shopping? Most women go up one cup size during pregnancy and their breasts continue to grow during the first month after baby is born – however this varies greatly from one woman to the next. Have a fitting for a maternity bra two to three weeks before your baby is due. It’s important to wear a good-fitting and comfortable bra, especially during the first three months of breastfeeding. Here’s what to look for:

Back strap

The wider the better for maximum support – look for straps with three hooks across. During the first few weeks of breastfeeding your breast size varies greatly from day to day. You need to be able to loosen and tighten your back strap accordingly, and so four to six rows of hooks are ideal.

Shoulder straps

Choose firm, wide, cushioned shoulder straps that are not too stretchy.

The Cup

Cups made from stretchy but firm cotton are best because cotton is a natural fiber that allows your skin to breathe – and it’s soft. Seams should not run across the nipple area, and lace on the nipple can irritate. The fabric support that sits around the breast and under the window flap needs to be stretchy. The window flap should expose quite a lot of the breast so that baby is able to easily latch on.

Clips

You need to be able to operate your clip with one hand. The best clips are the ones that slot in vertically. Slide-on ones are impossible to do one-handed. Velcro “clips” may open up of their own accord. Don’t: - Wear under wire bras. The under wire can cut into the breast, constricting milk flow. - Wear a bra at night. If your breasts are unbearably heavy or leaky and it’s too uncomfortable to wear no bra at all, loosen the back strap to keep your breasts as free from constriction as possible. Or opt for a maternity cami. - Wear an ordinary bra and hitch it up over your breasts to feed – it also restricts milk flow. Do: - Wash your bra at the end of the day. - Have two or three maternity bras so a clean, dry one is always on hand.

WRONG WAY ROUND

If you find out that you’re expecting a breech baby before delivery it may be possible to turn your baby. An obstetrician will try to convince your baby to go head-down at 37-40 weeks. The process is called external cephalic version (ECV), and works in about two-thirds of cases, although it’s less successful in first-time pregnancies. An obstetrician tries to change the breech baby’s position by pressing on the mother’s abdomen. If it doesn’t work, women can try a traditional Chinese technique called moxibustion. This is where a cone of moxa (dried mugwort) is lit and held as close as is comfortable over the Bladder 67 acupressure point on each foot for about five minutes twice a day. The technique can be used on its own or in combination with acupressure or acupuncture, although that suggestion is more likely to come from a midwife than an obstetrician. If your baby refuses to turn, in most cases you will be offered a caesarean section.

Try things at home

There are also things you can try at home to turn your breech baby: Spend time on all fours. This allows gravity to bring the baby’s head down. For example get down on the floor each day and read the paper or a magazine while on all fours. Gentle lateral lunges. These can widen the pelvic outlet and help the fetus turn. Ironing board. Lie on a plank or ironing board placed at a 45 degree angle, head down and knees bent for 15 minutes three times a day. Gravity encourages the fetus to move toward the top of the uterus and turn under. Warmth and cold. Place an ice pack on the top of your uterus and a warm pack at the bottom. The fetus will move towards the heat. Singing and talking. Make a tape of your voice singing and talking to the baby. Play it back through headphones placed near your pubic bone to encourage the fetus to move towards the pleasant sounds. Visualizations. Use positive mental power while performing the above procedures and visualize the fetus turning in your uterus.

Different types of breech:

Frank : bottom down and legs bent or extended up towards the face Complete–baby : is sitting cross-legged Footling : one or both the baby’s knees or legs are closest to the birth canal

SEX OF BABY

To know or not to know

Should you find out the sex of your baby? Parents talk about their choices. One decision many pregnant couples grapple with is whether to find out the gender of their child. Auckland radiologist Richard Davis is asked to spill the beans with 50-60 per cent of his patients. Although most find out purely for curiosity’s sake, some couples need to know for medical reasons, he says. Either way, in scans done earlier than 18-20 weeks it’s very difficult to be accurate, but by the time a woman is 20 weeks pregnant, the baby’s genitalia can be seen clearly in 99 per cent of cases. It’s impossible to tell if the baby is turned away, too low in the pelvis or the mother is too large for the beam to penetrate far enough. Dr Davis often deals with couples where only one partner wants to know. He writes the sex on a piece of paper and gets the partner who doesn’t want to know to hand it to the other. He was once asked if he could tell the color of the baby’s skin, and sometimes gets phone calls from mums who want to find out, but don’t want their partners to know they know. “I prefer not to, but I have been known to use passwords or hum tunes (to convey the information).”

So, did you find out? Mothers spill the beans…

Jacqui Primus: With our first baby we found out at the 20-week scan. It was important to us that we could name her and call her by her name – they can hear in the womb. When I got pregnant a second time my midwife asked me if I was going to `open the wrapping before Christmas’. I told her, ‘Of course. What’s the surprise? It’s either going to be a boy or a girl.’ But then my husband decided he wanted a surprise, so we haven’t found out. It was a pain in the butt, really. I couldn’t get organized; I didn’t know what color to paint the baby’s room. Kate Harrower: Our first we kept as a surprise and we didn’t want to find out the sex for our second. Either. But towards the end of my third trimester the report from my 20-week scan arrived in the mail. It wasn’t supposed to have been sent to our house. Of course we opened it and it said the fetus was male. We were really annoyed we’d been told. Two weeks later, Kate gave birth to a girl. Katie Dilks: Our first baby was conceived after two miscarriages. We were just so happy to be pregnant we really didn’t care what the sex was, so we didn’t find out. With our second we didn’t really mind if we knew or not, so when we were at the 20-week scan I said, just for fun, “What do you think it is?” Even though we were told she’d be a girl we didn’t really take it as gospel as we knew they sometimes get it wrong. In this case, they got it right.

HOW WILL I COPE WITH TWO?

Discovering you’re pregnant again can bring a whole lot of concerns along with delight. Here are 20 of our favorite tips for coping with the arrival of a second baby. 1. Prepare your firstborn for the new arrival while you are pregnant. Start by pointing out other families with babies, so your child sees it as normal. 2. Let your first child come to your visits with your midwife, feel the baby move, and look at the scan. If they feel part of the process, your child can get excited and be less resentful when the new baby arrives. 3. Tell your older child about how the baby will need help and might do silly things like cry a lot. It will help them feel slightly superior and, hopefully, tolerant of the needs of a new baby. 4. If your older child is moving out of his cot, does it well in advance of the new baby’s arrival? Consider putting the cot away for a few months. Once it reappears, your firstborn will have moved on from thinking about it as his bed. 5. Try to greet your firstborn on his first visit to you in hospital without the baby in your arms. This means you can cuddle him wholeheartedly, without asking him not to squash the baby. 6. To combat the feeling that the newborn is getting all the gifts, many parents organize a present for their firstborn from the new baby. 7. Don’t be surprised if your child rejects you when his sibling arrives. Continue to give him lots of attention. Just when he is being his least appealing is probably when he needs you most. 8. If your older child is resentful because you’re feeding the new baby and aren’t available for play, say “I know you wanted me to play now, but the thing about babies is they can’t wait for their food like big people. Soon the baby will be asleep and we can play.” Make sure you follow through. 9. Remember that older children can take time to adjust to the new baby. Don’t make them feel guilty about feeling jealous. 10. If your child regresses and wants the bottle or nappies again, just go with it. Wanting to be babied again is common and normal. 11. Praise your child for any nice thing he does for the baby. Tell visitors the best person with the baby is your child and they will soon start to feel this way. 12. If he can’t take many whole days off work, consider whether Dad could work reduced hours so that, in the first weeks, he can give the older child breakfast while Mum and baby sleep in and be home again in time for the feed-bath-bed routine. 13. Getting a routine running. It can help the older child feel more secure and that not everything in their life has changed. 14. It will give you an important break if you get into a pattern where both children have a sleep at the same time; for example, after lunch. 15. Being strict about evening bedtimes will leave you with some down at the end of the day. It’ll help preserve your sanity and patience with the children. 16. Keep mealtimes easy by having food that you can quickly throw together for a toddler’s dinner. Feeding your baby at the table while the older child eats can work well. 17. Aim for your baby to have a sleep around 4.30pm. It will give you the chance to get dinner made and the older child fed. 18. A wheeled bassinet, hammock, swing or buggy that you can have near you in the kitchen can save running to and from the bedroom if your baby is crotchety. 19 If you’re worried about containing your older child while you breastfeed, consider putting a chair his bedroom so you can close the door and feed in there while he plays with his toys. 20. Remember that with a second child you’ll have the luxury of experience and less of the angst and worry. You have already survived sleep deprivation, and are probably used to less sleep and very little “I time”.

Best books about preparing for a second baby:

From one child to two: What to expect, how to cope and how to enjoy your growing family, by Judy Dunn (Ballantine Books, 2005) Three shoes, one sock and no hairbrush: Everything you need to know about having your second child, by Rebecca Abrams (Cassell Illustrated, 2001) Welcoming your second baby, by Vicki Lansky (Book Peddlers, 2005) Raising Happy Brothers and Sisters, by Jan Parker and Jan Stimpson (Hodder Mobius, 2004)

GETTING PREGNANT - FERTILITY BOOSTERS

8 tips to fast track your fertility

If you are thinking about getting pregnant, or are already trying but nothing’s happened yet, there’s a few things you can do to get your body in prime baby-making condition. We’ve compiled this quick checklist with the help of fertility specialists Dr Neil Johnson from Fertility Plus and naturopath Loula George, so mums – and dads-to-be – can follow these eight steps to fertility fitness.

Watch the weight

A body mass index of between 20-25 kg/m2 is ideal for getting pregnant. Being over or underweight can interfere with the body’s balance of hormones and can even stop ovulation altogether.

The importance of diet

Fresh unrefined organic foods and purified water are the way to go, says naturopath Loula George, who advises people to take four months preparing their bodies for pregnancy. “Avoid sugar, coffee and alcohol as these contribute to nutrient loss. And avoid all chemical additives and highly processed foods.” To ensure you’re getting all the important vitamins and minerals, George recommends taking supplements. Antioxidant nutrients vitamins A, C and E, zinc and selenium, plus dandelion tea and garlic can help you to detoxify and eliminate heavy metals and chemicals. Zinc and selenium are also vital for men to produce healthy sperm. Dr Johnson says women planning a pregnancy should definitely take folic acid which reduces the baby’s risk of neural tube defects and “there is some evidence that some outcomes might be improved with well-tested multi-vitamins such as Elevit."

Get some exercise

“Two hours a week or half an hour per day is good, and that will help to normalize your weight,” says George. “It’s important to make sure you get enough and not too much.”

Smoking, alcohol and drugs – just say no

The evidence is clear that women who smoke are less fertile than women who don’t, says Dr Johnson. “If you’re compromising the oxygen-carrying capabilities of your blood and putting toxins in your blood stream it’s not going to be very good, and that goes for recreational drugs also. They can have an adverse effect on men’s fertility too. If both the man and the woman are just a little bit sub-fertile it decreases their chances even more.” Loula George agrees, “Avoid all drugs. This includes social drugs such as alcohol, caffeine and nicotine which have all been linked to reproductive and fetal ill health, and medicinal drugs except if they are medically prescribed and where they cannot be safely replaced with a natural alternative.” Some experts believe women coming off the pill should wait two to three months before trying for a baby to give the uterine wall time to adjust.

Clean bill of health

All women looking to get pregnant should consider having a routine pre-natal blood test which includes a rubella immunity check. Both partners should also have a routine medical check with a GP to screen for genitor-urinary infections, and to review any existing medical conditions which may impact on the pregnancy or the developing embryo says Dr Johnson.

Reduce chemicals, toxins and radiation

Male sperm counts have reduced by 50 per cent in the last 50 years because of our exposure to chemicals and toxins, says George. “It’s everywhere. From lead in our houses and the old leaded petrol, to arsenic in treated timber.”

Sex and the cycle

“There is ignorance among couples about simple things like when is your most fertile time,” says Dr Johnson. “The change in vaginal mucus is the best way to detect ovulation. If a woman has a regular cycle she tends to ovulate around the 13th or 14th day prior to her next period and for a longer cycle of around 35 days that would be day 21. Having sex every day for five days before and on the day of ovulation will optimize chances of conception. Some people think that having too much sex affects the quality of the sperm but that’s another myth.” And while not scientifically proven, some experts say certain positions may help. Missionary or from behind allows the deepest penetration which means the sperm is deposited right next to the cervix. The female orgasm may play a role too, as the contractions that accompany it may help carry the sperm further into the womb.

Stress – release the pressure

While exercise is a great stress-reliever, sometimes it isn’t enough to counter deep-seated stress-related issues. George says: “Stress can be a problem for those who’ve been trying to conceive for a while. We look at ways of minimizing those things that cause stress – are they working too long hours, or juggling too many things – and basically making room for a baby. We tell people to stop trying in those four months and that in itself takes the pressure off. “ Neil Johnson is a fertility specialist for Fertility Plus and Auckland Gynecology Group and an associate professor at Auckland University and Loula George is a naturopath specializing in fertility for the past nine years.

BECOMING A FATHER

There are two little words which could change a mans life forever: “I’m pregnant.”

Planned or unplanned, pregnancy is a huge upheaval for men as well as women. However while women often share their concerns and talk to others about every tiny detail, men often end up never expressing their fears. Common concerns for expectant fathers are generally about money, not knowing “what to do” when the baby arrives and the loss of their freedom. Then, of course, there’s the scary prospect of the labor and delivery. It’s normal to feel apprehensive about the birth. The woman you love will be in immense pain, but there’s nothing you can do about it. One of the best things a man can do – both for himself and his partner – is to be prepared! To help we have put together a 3 step plan to ensure your partner will be the kind of labor coach you can rely on.

Become a hunter and seek information:

There are countless books about pregnancy, childbirth and child-rearing. Reading up not only helps fathers feel a part of the process – it makes your pregnant partner feel loved and supported, too.

Know what to expect:

It’s a good idea to attend as many antenatal classes as possible – you’ll gain a great appreciation for what labor and birth entails, from start to finish. Sometimes it can happen fast, but rarely, for most labor is a journey – and it’ll be helpful to understand that this journey comes in three stages:

First stage - This is the longest stage of labor and on average can last between 8-16 hours. During this phase the cervix complete opens in preparation for the baby to pass down the birth canal. Known as the ripening of the cervix, where regular contractions of the muscles of the uterus cause the cervix to become thin and flat and will begin to stretch until fully dilated -full dilation is estimated to be 10cm. Contractions are their strongest near the end of this stage – don’t be alarmed if harsh words may are voiced during this time! Second Stage - The second stage begins as the cervix is fully dilated and the baby’s head begins to pass out through the cervix and down the birth canal. This can last from minutes to hours — the average is about an hour for a first-time pregnancy (longer if she's had an epidural) — and ends with a moment that's made up in equal parts of relief and breathtaking beauty: the birth of your baby. Third stage - It's not over yet! The final stage which begins immediately after the birth of your baby is the delivery of the placenta. This can take anywhere between one to 30 minutes later. Apart from understanding the process it’s good to visually prepare for the journey – watch a video of a vaginal or c-section birth. It will enlighten you on the messy and unglamorous side of labor.

Be Prepared:

Understand your role as coach Your LMC is there to ensure your partner and baby does well during labor and birth. But you have a big role in helping your partner get comfortable and in communicating her wishes. Discuss the birth plan with your partner and ensure you understand her preferences regarding things like pain relief and intervention. It’s also a good idea to develop a good rapport with your LMC, as during labor you may need to voice your partners preferences if she in not in the right frame to do so herself. Know how to time the contractions Make sure your watch has a readable second hand, and time your wife's contractions from the beginning of one contraction to the beginning of the next. If they're eight to 10 minutes apart and last 30 to 45 seconds each, your partner is likely in early labor. Your doctor or midwife can help you make the decision over the phone about when to come in. As a general rule-of-thumb, if the contractions are less than five minutes apart, last a minute or more, and continue in that pattern for an hour, you should get to the hospital. But some situations call for getting to the hospital sooner, so be sure to talk to your LMC ahead of time about what's right for you. Remember to pack a few things for you: You'll probably be spending the night at the hospital too, so don't forget to pack a few things for yourself: A clean shirt, comfortable shoes, and toiletries should do the trick.

Be prepared for the wait:

Giving birth is a long, hard job and most women are in labor for quite a few hours even before they go to hospital. So prepare something to focus on apart from the time between contractions – watch a movie, listen to music. Truth is, however, that the labor soon pales in comparison to the stress and upheaval of living with a newborn baby. Wonderful though those early days are, the lack of sleep takes its toll, the change in lifestyle is immense and it’s likely both new parents will be on an emotional rollercoaster. Some men feel clumsy around newborns simply because they lack confidence. The secret is to be as hands on as possible right from the start. By interacting with their babies, fathers learn they’re not as inadequate as they feared and develop strong attachments to their newborns. Remember, new mums are learning, too.

ANTENATAL TESTS

Why test?

If you’re over 35 and therefore have an increased risk of having a child with a disability, or if there is a history of inheritable disability in your family, or if you are just a plain worrier, then you may want to have a test to check your baby. Before having any tests however you should consider how you would respond if the baby has a significant abnormality and what you would gain from having the tests. There are five common antenatal tests, each with advantages and disadvantages to be considered.

Anatomy Scan

The ultrasound anatomy scan is routinely offered. The purpose of the scan is to look for structural abnormalities in the brain, face, spine, heart, stomach, bowel, kidneys and limbs. The scan will also confirm due dates, multiple pregnancies and whether the baby is developing at the expected rate. The scan is non-invasive, it allows you to see your baby, and many problems may be picked up. If necessary you are referred to a specialist for further testing. Due to the position of the baby or the limitations of the technology, many things may not be identified during the scan and a clear scan does not guarantee a baby in good health.

Maternal Serum Testing

A simple blood test may be conducted around 15 weeks to analyze the amount of maternal serum alpha-fetoprotein (AFP) and specific hormone levels in the mother’s blood. If the levels are higher than expected for your age, height, weight and other factors, then you may be considered to have a higher risk of having a child with an abnormality. The tests give indicators of chromosomal abnormalities such as Down syndrome and neural tube defects such as spinal bifida. They involve no risk to the mother or fetus. Maternal serum test results are not conclusive. They only give you an idea of the risks of abnormality. If your level of risk is higher than for most women, your LMC will probably suggest a more invasive test, such as amniocentesis, to clarify the results.

Nichol translucency thickness test or Nichol fold

An ultrasound scan takes accurate fetal measurements including the space at the back of the fetus’ neck known as the Nichol fold. This measurement along with your age and the baby’s gestational age are entered into a formula and your baby’s chances of having an abnormality are calculated. In general, the thicker the fold at a given gestational age, the higher the chance of a problem. Babies with abnormalities such as Down syndrome tend to have more fluid in this tissue at the back of the neck in the first trimester, meaning that the measurement will be larger. The Nichol fold test is non-invasive, painless, and is performed early in the pregnancy, usually between 11 and 13 weeks. The results are available immediately. The test has limitations. It only shows the chance of having a baby with Down syndrome or similar disability i.e. results can show either a 1:300 chance or more than 1:300 chance of a baby with Down syndrome. With results of more than 1:300 an amniocentesis is generally recommended.

Amniocentesis

The first step in an amniocentesis is an ultrasound scan to check the position of the fetus and placenta. A needle is inserted through the abdomen and into the uterus to draw out some of the amniotic fluid which surrounds your baby. The procedure takes about one minute. Amniocentesis is 99 per cent accurate in picking up a wide range of genetic abnormalities, such as Down syndrome, and can also pick up problems such as spinal bifida. The test must be taken in the second trimester, usually between 15 and 18 weeks, and the results take two to take two to three weeks. If a problem is found you are faced with the difficult decision of whether or not to have a late abortion. There is also a 1: 200 risk of miscarriage after amniocentesis.

Chorionic Villous Sampling (CVS)

Guided by an ultrasound scan, some of the chorionic villi, the tiny projections on the placenta, are removed either through cervix or through the wall of the abdomen and tested for abnormalities. CVS is a technique requiring a high level of skill and is only available in some centers. Results are usually available within seven to 10 days. The test is slightly less accurate than an amniocentesis in detecting general genetic disorders and chromosomal abnormalities and so is used only for detecting specific disorders such as cystic fibrosis, if this has been a problem in your family. The advantage of CVS is that it can be done early, it is usually performed between weeks 10 and 12, and that it is very accurate for some specific conditions. However, CVS cannot diagnose some abnormalities such as spinal bifida or structural problems, and that there is an increased risk of miscarriage compared with amniocentesis.

BABY GEAR

Shopping for Baby Gear

Stocking up on cute baby clothes and baby gear is one of the great pleasures of expecting your first child. It can be expensive – but it doesn’t have to be. If you plan ahead and follow some simple guidelines it’s quite possible to get what you’ll need on a shoestring. First tip for baby gear on a budget is to hold a morning tea-baby shower. It’s a good way of gratefully accepting small gifts from family and friends and getting some basics together. Draw up a list of what you need and make suggestions if necessary. Secondly, accept all offers of hand-me-downs, or if the offers aren’t forthcoming, politely ask family or friends, you’ll be surprised how willing people are when it comes to a newborn baby. However remember to make a detailed list and take good care of everything, that way you can ensure everyone gets back what was offered once your baby has outgrown. When borrowing or buying second hand clothing Plunked recommends that you should wash and air everything and look out for buttons or ribbons that can be chewed or pulled off. And finally when its time to hit the shops, be prepared - get armed with a little research and shop with a definitive list.

Clothing

Angela Baldwin, Plunket’s General Manager of Clinical Services suggests that a newborn baby doesn’t need a complete range of clothing – just enough to keep them warm and dry. Most babies double their birth weight and grow 15cm in the first five to six months, so they tend to outgrow everything quickly. Angela suggests buying stretch-and-grows without the feet – which will last longer – by just adding booties. At least four stretch-and-grows, about $6.99 each Three cotton singlet, about $8.99 each Three woolen singlet, about $14.99 each Four pairs of booties/socks, about $3.99 each Woolen mittens, about $4.99 Bonnet for summer, woolen hat for winter, about $4.99 Four jackets and jumpers, about $9.99 each Wraps (for feeding, kicking on the floor etc) cotton/muslin, from $12.99 for three, brushed cotton, $10.99 each; wool, $19.99 each Six bibs, toweling, from $1.50 each

Nappies

Under those clothes there's one more thing you'll need - nappies. At Treasures, we understand that you want a nappy that won't cause your baby any discomfort or irritation. That's why Treasures Ultra nappies are not only absorbent with excellent leakage protection but also extra soft and comfortable on baby's sensitive skin. An average baby will be in Treasures Ultra Newborn for up to 12 weeks and will use approximately 6-7 nappies per day. That's a lot of nappies so it may pay to start gradually building up your stocks now, especially if you'll be dropping to one income after your baby's born.

Bedtime

A cot – about $200 new or $50 to $60 second-hand. Check the paint is not lead, scrub it down and check the latest safety standards. A firm mattress varies from $60 to $220, with foam being cheaper than inner sprung. A water-resistant under blanket. Tightly woven wool is the most comfortable $19.99, toweling under blanket from $16.99, but you can also use a mackintosh sheet with a towel or old blanket over the top, DON’T USE PLASTIC! A lower sheet. This can be made by cutting up an old sheet, or will cost about $17.99. A light woolen blanket, from $19.99, (or use a single blanket cut down). You may need an oil heater or similar, to keep baby’s room at a constant 18 to 20 degC. These can be bought second hand.

Bath time

A plastic baby bath, $19.99, will make bath time easier, but you can use a full-size bath or wash your baby in the basin or sink. Soft towels and muslin cloths (about $6.99 for seven), or buy the fabric and make some yourself. Baby soap and a protective barrier cream A change mat, from about $15.99, is useful, but you can use a folded towel or similar.

Transport

Newborn car seat. About $50 to hire, plus a $50 refundable bond. Reclining stroller. About $149 new or $40 to $60 second hand. When baby is bigger, the small folding type (about $45 new) is useful, especially for getting on and off buses.