Is my baby growing well?

One thing women often mention during their appointments is that they have been told by their friend/sister/aunt/work-mate/lady in the coffee shop that their bump is big or small for how many weeks pregnant they are. It has made me realise that the size of your bump, or what we really mean, baby, is a topic of much discussion and potentially concern.

It is true, the size of your baby is very important. Midwives and Obstetricians want to know that your baby is growing well, getting all of the nutrients they need and not growing more than they should be either. This is why your bump is measured regularly from 24 weeks and the measurement plotted on a growth chart.

Why is it so important though? Well, if your baby is smaller than expected, it could be a sign that your placenta is not working as effectively as it should be. You may be thinking “I’d like a smaller baby; it’ll be easier when I give birth!”, however, if a baby is not reaching is true growth potential, it means that it will have less reserves for labour. This can have implications for how you birth your baby.

In serious cases, your baby will prioritise ‘feeding’ the most vital parts during development. This means that areas that are not essential to survival, e.g. muscles, legs, arms etc, will receive less nutrients and so will not develop further. Your baby may stop moving, as it does not have the energy to do so. In the very worst case, if left, this can lead to stillbirth.

Your placenta not working effectively can be ‘just the way it is’, which is not your fault and you can’t change, but there are things you can do to help prevent this. The most important thing is to stop, or at least reduce, smoking. Switching to vaping over cigarettes or rolling tobacco has also been shown to be of benefit. Ask your midwife to be referred to a local smoking cessation service if this affects you, as evidence shows that having this specialised support can really help you in achieving your aim of giving up smoking.

At the other end of the scale, baby growing too much could be a sign that your baby is being exposed to too much sugar and therefore is putting on too much fat. This can be as a result of diabetes and is also not very good for baby’s, as if can affect their ability to balance their own sugar levels once they are born.  Diabetes is a serious condition and it is really important to diagnose so that treatment can be given to maintain sugar levels within the normal range, both for you and your baby.

Another reason your bump may be measuring smaller or larger than it should be is the amount of amniotic fluid (waters) around your baby. Certain conditions can cause you to have less (oligohydramnios) or more (polyhydramnios) fluid. In either case, it is important that this is diagnosed so that appropriate care plans can be made to keep you and your baby safe.

Whilst the national recommendation is to measure your bump (symphysis fundal height measurement) regularly, evidence shows that this is not necessarily very effective at picking up problems, as it can be affected by how the measurement is taken and also maternal factors like the amount of fat your have on your tummy, or if you have fibroids. The most accurate way of estimating your baby’s weight is with an ultrasound growth scan, such as the fetal wellbeing scans with SHEcares.

Routinely, growth scans are not offered to low risk women during pregnancy by the NHS unless they have specific risk factors. If you would like to read more about fetal wellbeing scans with SHEcares, please visit: fetal well-being scan (15-18 and 23-40 weeks) – scans & holistic expert care in pregnancy (she-cares.co.uk)

Time to talk? Midwifery and Obstetric online consultations

Feeling snug at home and not much like venturing outside at the moment? We know how you feel!

For some, this may be due to the wet and miserable weather we are having, but for others, the current situation with COVID is causing anxiety. This may mean that coming to the hospital to discuss thoughts, feelings, birth preferences, or get that little bit of extra advice due to health conditions just doesn’t feel inviting.

In response to this, we have launched our new service at SHEcares for online consultations with either an Obstetrician or Senior Midwife. These are perfect for asking any questions you have, or further exploring your options for your ideal birth. All from the comfort of your sofa.

If you have any concerns about you or your baby, always call your maternity care provider, but for more information about online pregnancy consultations with SHEcares, please visit our website here.

We wish you a lovely week,

Kristina and Susana

 

COVID 19 and pregnancy

Pregnancy can be an exciting and scary time in equal measures for most women. There is the balance of looking after yourself and your growing baby, with all the other priorities of life. The current COVID situation has the potential to make this even more difficult and stressful than usual.

Although COVID 19 is a relatively new virus, data has been collected since it was discovered on it’s affects on different groups of people; pregnant women being one of them. So far, healthy, pregnant women, with no underlying medical conditions, don’t seem to be at any greater risk of catching COVID than any other healthy person. Similarly, they don’t seem to be made more ill by the virus.

Therefore, the advice is to follow government recommendations to keep your distance from others, work from home if possible and wash your hands regularly. If you can’t work from home, your employer must carry out a risk assessment with you to make sure that you can safely carry on working.

Those with underlying health conditions should discuss these further with their maternity team, but in general, the above recommendations will always apply. It is also very important to continue with your antenatal care.

For more information, visit: Coronavirus infection and pregnancy (rcog.org.uk)

Stay safe!

Kristina and Susana

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