Floundering because this is your first pregnancy? Two ob-gyns give their take on common pregnancy posers…

Pregnancy-12 burning new mum- and dad-to-be questions — answered!-Main
There are many perks to being pregnant — radiant skin and thicker tresses aside, you’ll also enjoy little kicks and nudges to remind you that a human being is growing inside you.

Your pregnancy also marks your transition from a woman into a mother and your hubby into a father. This journey will also be filled with many firsts, some of which can puzzle, especially if you’re a first-timer. Fear not, SmartParents asked the experts ― ob-gyns Dr Christopher Chong and Dr Anthony Siow ― for advice on common questions newly expectant parents ask…

Questions from new mums

1) I’m in my first trimester and have been cramping and spotting. Are these symptoms related to implantation bleeding?
Dr Siow: If the cramps are not severe enough to prevent you from moving around, and the spotting is not amounting to fresh menstrual bleeding, then the pregnancy is usually all right. However if the symptoms persist for more than a few days, it will be good to see your doctor for a review.

Dr Chong: Any spotting and bleeding in pregnancy is abnormal till proven otherwise. And any form of bleeding can also indicate the possibility of a miscarriage, infection, polyps in the cervix or a hormonal imbalance. While implantation bleeding is common, it happens around the time of your period ― it occurs in about 15 to 20 per cent of pregnancies, with little risks for the majority of cases. We’ll still need to be very careful and see the gynae for an assessment. Most importantly, we must be able to see the foetus during the ultrasound scan. If your baby is seen and bleeding stops, usually nothing will happen.

“Any form of bleeding can also indicate the possibility of a miscarriage, infection, polyps in the cervix or a hormonal imbalance.”

2) In general, can I safely take over-the-counter meds when I’m pregnant?
Dr Chong: The general guide is that if one is unwell, especially in pregnancy, it is best to consult a doctor instead of self-medicating. Also, while dietary supplements are typically safe products, we are unclear of their ingredients and production, hence it’s best to check with your gynae.

Dr Siow: In Singapore, almost all over-the-counter medicines are safe if you do not have any allergies. The few medicines that can cause problems in pregnancy are only available with a medical prescription. However, this does not apply to Traditional Chinese Medicine, as these can be bought without medical prescription and are not controlled by specialist ob-gyns.

3) What can increase my chances of getting a C-section?
Dr Chong: If you have been diagnosed to have any of the following conditions:

* Narrowed pelvic bones.

* You are carrying a big baby.

* You’ve had a previous C-section.

* You’ve a low-lying placenta (placenta previa).

* Any retardation in foetal growth.

* Maternal medical problems.

* Foetal malposition – your baby is lying in a breech or transverse position.

* Polyhydramnios (Excessive levels of amniotic fluid in the water bag).

4) How much weight will I gain during my pregnancy?
Dr Siow: The usual weight gain in pregnancy is around nine to 14kg. Underweight women with a Body Mass Index (BMI) of less than 18 are expected to gain 12 to 18kg while overweight women — with a BMI of over 25 — are expected to gain seven to 11kg.

Dr Chong: Any excessive weight gain during pregnancy may require a check for gestational diabetes because it will often result in bigger babies. As such, some end up with a C-section as the foetus is deemed too large for normal delivery.

5) Is it safe to get vaccinated while I’m pregnant?
Dr Siow: Vaccination with dead viruses like the flu shot and tetanus, diphtheria and pertussis — called Tdap — are safe in pregnancy. However vaccinations that consist of live virus like the mumps, measles and rubella should be avoided.

Dr Chong: While it is recommended, the vaccination rate amongst expectant mums in Singapore isn’t as high. Being a first-world country, the risk of getting infected is much lower than that of poorly developed countries. Having said that, a pregnant woman should get vaccinated as she’ll have a lowered resistance. During your last trimester, you should get jabs for tetanus, diphtheria and pertussis.

Pregnancy-12 burning new mum- and dad-to-be questions — answered!2

6) Are there any recommended tests that I’ll need to take during my pregnancy?
Dr Siow: In the first trimester, your blood will be tested to check your blood group, and you’ll be screened for infections via a urine test, your blood count will also be assessed and a screening test done to check for Down syndrome. In the second trimester, you’ll get a blood test to screen for diabetes, as well as an ultrasound screening to check on the baby’s growth. In the third trimester, there’s a screening test to exclude vaginal infections to prepare the patient for vaginal delivery.

7) What foods are off-limits when I’m pregnant?
Dr Chong: Lifestyle habits like smoking and drinking are discouraged. Otherwise, you should also refrain from taking unknown herbal medication, raw food, ripened soft cheeses such as Brie, unpasteurised milk, as well as fish with high mercury content such as shark and swordfish.

“Keep a lookout for mood swings and low moods and importantly, seek professional help if she is not coping well.”

8) How can I prevent stretch marks?
Dr Siow: Stretch marks occur when the skin is over-stretched and tears. It’s often not preventable ― it depends on how tight your skin is. Applying stretch mark creams and coconut oil may help reduce stretch marks ― consuming vitamin A may be useful, too.

Questions from new dads

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9) When can I find out my baby’s sex?

Dr Siow: You can find out the sex of your baby from as early as week nine of the pregnancy with a blood test from the pregnant mother, called Non-Invasive Prenatal Screening test.

10) How can I ease my wife’s morning sickness?
Dr Chong: Bring her to see the gynae for medication and if necessary, injections or a drip for hydration for bad cases. For mild cases, exercise can get rid of gas, which causes increased vomiting episodes. Let her eat small amounts of food more frequently rather than huge amounts at one go. Satisfy her craving while avoiding the smell or foods that can trigger her vomiting. Most of all, be sympathetic and spend more time together, and avoid crowded areas for walks.

11) How can I help my wife avoid postnatal blues?
Dr Chong: Spend more time with her. Help her in whatever way you can. Let her vent when she needs to, don’t take it to heart. Help with looking after the baby, so mummy gets enough rest. Most importantly, give her tender loving care.

Dr Siow: Be supportive during her pregnancy and attend pregnancy classes with her, especially if it's the first pregnancy. You should also go for a hospital tour to prepare her both mentally and psychologically for the changes that follow after the arrival of your newborn. It’s good to plan to be around to help out and show care and love, especially in the first week after delivery. This will give her some time to rest and cope with the demands of babycare. Allowing your wife to have her way when it’s reasonable and always encourage and compliment her will also help. Plus, keep a lookout for mood swings and low moods and importantly, seek professional help if she is not coping well.

12) What are some common pregnancy terms I should know?
Dr Siow: You should take note of the following common terms:

* Breech presentation: Baby's position where the backside or legs are the parts that will be delivered first.

* CTG (cardiotocography): A short tracing of the baby’s heart beat and pattern.

* Show: A sticky blood stain discharge that is expelled when the cervix dilates.

* Cervical dilation: The process where the neck of the womb opens slowly to allow the baby to be delivered.

* Episiotomy: A surgical cut at the entrance of the vagina to expand the birth canal for the baby to be delivered.

* Amniocentesis: An injection into the baby’s water bag to draw some fluid for examination. Amniocentesis detects chromosome abnormalities like Down syndrome, neural tube defects, and genetic disorders.

Photos: iStock

Both Dr Christopher Chong and Dr Anthony Siow are consultant obstetrician-gynaecologists at Gleneagles Hospital.

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