blog

Expectations

I’m writing today shortly after returning from a trip to Portugal. I went to enjoy the sun, spend time with family and friends and walk part of St James’ path with my father. Unexpectedly, my trip didn’t end up as I had planned – it rained every single day and my father had a nasty accident on the day of my arrival.

I was reflecting on this and thinking how similar this was to the experience of some women in pregnancy. Pregnancy is a time of many changes, many decisions and lots of expectations. Regardless of whether your pregnancy came unannounced or you have been trying for years and conceived after many cycles of IVF, pregnancy may not always go the way you expected. With the right support, however, you can still have a great pregnancy and a happy baby.

Although nothing really went as expected during my trip, I felt blessed to be there at the time my father needed me most. The rain made me enjoy alternative indoor activities with my children and I realised that learning to adjust to unexpected events can only make them better and more resilient adults in the future.

At SHEcares we are happy to help you navigate your expectations in pregnancy, take care of you and your baby’s safety, and deal with any unexpected circumstances. We are here for you, whatever happens!

I am returning to London with a warm feeling in my heart and a large smile in my face. I left my father making a good recovery and had a great time with family and friends despite the rain.  Now I only have the amusing job of dealing with others’ expectations, seeing me return from a trip to sunny Portugal as pale as I went!

Take care!

Susana Pereira

“What matters to you?” day, 6th June

Next week on the 6th of June is “What matters to you” day. The aim of this day is to shift the focus within healthcare from “what is wrong with you” to “what matters to you”. This simple change of questioning is based on a theory suggested by Dr. Michael Barry and Susan Edgman-Levitan in their 2012 New England Journal of Medicine article to improve shared decision making in healthcare, calling it “the pinnacle of patient centred care”.

Although a very simple question, “What matters to you” is also very powerful. I have been using it for a long time now and found that it has made such a huge difference to me and the people I care about, that I felt compelled to help roll it out on a larger scale at Kingston Hospital.

At SHEcares our main focus is what matters to you and we will try to do whatever it takes to help fulfil your needs. For example, I scanned a patient recently who desperately wanted to share her scan moment with her partner who was working abroad and therefore not able to attend. We arranged a video call so that he could enjoy and be ‘present in the moment’ with her for the scan; seeing the images live and participating in the discussion.

It could be that what matters to you is to have a second opinion by tomorrow, bring your 80-year-old auntie to your scan, or that you get a scan picture of your baby to share with your friends on social media. We don’t mind what it is, as long as it matters to you, we shall do our best to accommodate it.

At SHEcares we have also been thinking about what matters to us. It matters that the service we provide is of very high quality, that we contribute positively to the safety of your baby and that we help you enjoy your pregnancy. We also care about the sustainability of what we do, finding a fair price that acknowledges the expertise we provide, whilst at the same time being affordable for you.

Come and tell us what matters to you! We are committed to providing you with the expert care you need and at the same time listening and understanding the hopes, thoughts and wishes you and your family have for your pregnancy.

We hope to meet you soon.

Susana Pereira

How safe is flying in pregnancy?

We are asked many times about the safety of air travel during pregnancy. We love travelling ourselves and being pregnant shouldn’t stop you from travelling either, whether you are considering to do so for work or pleasure.  There are, however, a few things to think about before you go.

The flight itself…

There are no major risks associated directly with air travel during pregnancy, even at advanced gestation. Although there is a reduction in the partial pressure of oxygen during the flight and a small exposure to radiation, this should not cause a problem for you or your baby if you are a healthy woman.

During flights there is usually little space to move your legs, therefore the risk of developing clots in your legs (DVT – deep vein thrombosis) or lungs (PE – pulmonary embolism) is increased, especially during pregnancy or in the early postpartum period. The risk is higher for long-haul flights.

The best way to reduce this risk is to wear graduated elastic compression stockings and keep well hydrated. Ask for an aisle seat and take regular walks through the cabin. You will probably need these to use the toilet anyway! For those with a significant risk, treatment with low-molecular-weight heparin (LMWH) should be discussed with your doctor for the day of travel and a few days thereafter.

Having your baby on board…

This is what you and all the air companies want to avoid! It forms the basis of many airline carrier policies that prohibit pregnant women who are over 36 weeks gestation from flying. However, we know that 8 out of 100 babies will be born prematurely (before 37 weeks) and unless you have had a premature baby before, you may not be aware of this risk. You can know your individual risk of premature labour by having a cervical length scan, ideally between 20 and 24 weeks. If your cervix is found to be long and closed the risk of preterm labour is significantly reduced.

Risk of bleeding…

Bleeding in pregnancy is not normal and although in many cases cannot be anticipated, there are a few situations that can be predicted and therefore major risks avoided. If you are considering flying early in your pregnancy, an early scan is recommended prior to travel to confirm the location and viability of the pregnancy. This can reduce the chance of having a miscarriage on board or facing an ectopic pregnancy and its treatment away from home. If you are in later pregnancy, excluding a placenta that is covering the cervix (placenta previa) is also a good idea as this can significantly increase the risk of bleeding.

Your destination…

Last but not least is to consider where you are heading to! Always think whether the place you are visiting is safe and somewhere you would feel comfortable and well cared for if anything was to happen.

Avoid places where there is a high risk for Zika infection as this carries a risk of brain injury to the baby (microcephaly) . As you may know infection by the Zika virus is caused by being bitten by a mosquito from infected areas, so the safest thing is to not visit these areas altogether. Click here for further information on Zika.

It is also very important to check that you have insurance cover for healthcare whilst pregnant. This is especially important if you are travelling outside Europe and we’d recommend contacting both the airline and your insurance company to let them know that you will be pregnant whilst travelling. Finally, always carry your maternity notes and scan reports with you! They are essential for anybody providing care for you.

At SHEcares we are happy to discuss your individual risk or any concerns you may have. Some airlines will request a letter from a midwife or doctor confirming that there are no anticipated complications for flights taken after the 28th week of pregnancy and we will be happy to provide you with this.

Have a good flight!

Susana and Kristina

Further reading:

RCOG information on air travel in pregnancy