Preparing for labor and childbirth is an exciting and transformative time in a woman’s life. Bringing a new life into the world is a remarkable journey that requires careful preparation, both physically and emotionally. From understanding the stages of labor to learning about pain management options and how to care for your postpartum body, knowing what to expect can help alleviate anxiety and empower you to make informed decisions.
As the due date approaches, it’s natural to have questions and concerns about what to expect during labor and how to ensure a smooth delivery. Dr Wong Boh Boi, Singapore’s Baby Whisperer, is here to provide you with expert guidance and answers to the questions asked in the webinar “Pregnancy Made Easy: A Journey of New Discovery,” on how to prepare for labour and delivery as well as how to care for your body and your baby postpartum.
Prenatal and postpartum topics and related questions you’ll find this article:
- Early Pregnancy Preparation
- What You Should Know About Antenatal Classes
- How to Manage Uncomfortable Pregnancy Symptoms
- Dealing with Pregnancy Complications
- Must-Do Pregnancy Exercises
- Pregnancy Nutrition Tips
- Pregnancy Weight Guide
- Safety Dos and Don’ts While Pregnant
- Managing Stress and Emotions During Pregnancy
- Coping with Labour
- Caring for Your Postpartum Body
- Common Concerns About Foetal and Infant Development
Early Pregnancy Preparation
We just learned that my wife is expecting. What is the first thing to do?
Everybody reacts differently, avoid overreacting. It is a joyful happy moment. Show affection. Hold hands and give hugs. Support, encourage and reassure her as she may be anxious.
Help her make appointment with OB-GYN. Help her make changes to her lifestyle. Try to eat healthy foods, which can help her eat well. Encourage her to take breaks and naps. Take walks together. Attend antenatal classes together.
What You Should Know About Antenatal Classes
What are some good things to start learning before the first child is out?
Join the well-established antenatal classes with your partner. Pick up knowledge and practical skills to be more well equipped in taking care of yourself and the baby. Good communication with your partner e.g., who is going to help u when baby is born? Mentally, physically, and emotionally prepared for the baby is born. Learn to connect with your baby in the womb.
Where do we look out for these classes?
There are a lot of these classes for preparing you and your partner. Join the evidence-based classes with accurate information and updated evidence based skills. As there is quite a lot of uncertainties and learn know how to deal or cope. Most classes are fun and interactive, meeting other couples and build your own social group.
Are these courses conducted in Chinese?
Most are in English, but those who are more comfortable in Mandarin can join a one-to-one class. Or the trainer will spend extra time to discuss what’s not sure in the class and further support is given.
What’s the best time to attend to classes with my spouse? Is 8 months too late?
As early as over 20 weeks gestation, while some suggest when you are around 30-32 weeks pregnant. It is never too late to attend classes as the special program prepare both of you in everything you want to know about pregnancy and learn to cope in labour and pick up good skill and confidence in care and understand and meet your baby’s needs.
How to Cope with Uncomfortable Pregnancy Symptoms
Should I worry if my first trimester pregnancy symptoms are mild?
It’s possible to be pregnant and have no pregnancy symptoms, but it’s uncommon. Half of all women have no symptoms by five weeks of pregnancy. Monitor and talk to your doctor if your concerns amplify.
May I ask if there is any solution to soothe or reduce the frequency of nausea?
Sip water, and avoid taking large quantity of fluids with solids like rice and soup or water mixed, as this can cause the contents to swell. Suck a piece of raw ginger or ginger tea. Avoid foods or smells that seem to make your nausea worse.
Pay attention to nausea triggers. Avoid shifting positions too quickly. Talk to your OB-GYN if the nausea gets worse.
I experience reflux or indigestion. Is it considered morning sickness?
Indigestion (dyspepsia) and heartburn are very common during pregnancy. An increase in oestrogen and progesterone levels may cause morning sickness. As progesterone also relaxes the stomach and intestines, it can result in excess stomach acids leading to gastroesophageal reflux. Monitor and if getting worst seek your doctor’s advice.
Currently I am 10 weeks pregnant and I have been taking Diclectin, two tabs every night. How should I taper off the dosage?
Diclectin is considered safe during pregnancy to treat nausea. Take it when necessary. Gradually reduce to one tab and monitor.
How does acid reflux or heartburn feel like during pregnancy? How do we know it’s happening?
Symptoms of heartburn is a burning pain in the chest that usually occurs after eating and may occur at night. Pain that worsens when lying down or bending over. A bitter or acidic taste in the mouth.
Heartburn a burning sensation or pain in the chest. feeling full, heavy, or bloated. burping or belching. feeling or being sick.
Acid reflux refers to the LES not tightening as it should. This allows the stomach acid to travel from your stomach up to your oesophagus. (Gastroesophageal reflux disease, or GERD, is a severe form of acid reflux.
I feel mild headache every day from the morning to till I sleep at night. What can be the reason?
During the first trimester, your hormone levels skyrocket, which can lead to daily headaches. Other common causes include dehydration, abruptly stopping your caffeine intake, increased stress, and poor sleep. If headache persists, see your doctor to check your blood pressure, blood for hemoglobin (Hb), and eyes.
My feet were swelling after 12 hours of travelling by car. I’m 20 weeks pregnant and my blood pressure is normal. Should I worry?
Your feet swelling was likely caused by poor circulation due to the progesterone relaxing hormones and the pressure of your baby in the womb. There is a condition known as preeclampsia, the real cause of which is unknown but is usually associated by three factors: rising blood pressure, proteinuria, and swelling. So check with your OB-GYN.
To manage swelling, try the following:
- Circulation exercise from an antenatal class
- Physical activity and low-impact exercise like walking
- Put your feet up whenever possible
- Use accurate acute pressure point to release swelling of feet, hands, and legs
- Get a professional massage to improve circulation
- Avoid prolonged standing or sitting in one position
- Reduce salt intake
- Seek help from your doctor if swelling persists or gets worse
How do I reduce water retention on the ankles?
The usual causes of water retention on the ankles are: gravity, or standing up for long periods of time, allowing fluid to “pool” in the tissues of the lower leg; and hot weather, which makes the body less efficient at removing fluid from tissues.
To manage this, do regular physical activity and avoid long periods of standing. Raise your legs or the swollen area on a chair or pillow. Do gentle exercise, like walking, to improve your blood flow. Wear wide, comfortable shoes with a low heel and soft sole. Wash, dry, and moisturise your feet to avoid infections. Low dietary salt intake is advisable.
I get leg cramps more often at night from pregnancy. When I move my leg at night, it is so painful that I can only wait until the pain passes. What causes leg cramps? How to prevent it?
Generally, cramps commonly happen at night in late pregnancy. Cramps usually happen at night. They are more common in your second and third trimesters. The risk of having night leg cramps also increases with age.
The causes include changes in blood circulation and stress on your leg muscles from carrying extra weight. Your growing baby also puts pressure on the nerves and blood vessels that go to your legs. Some studies suggest a nutrient imbalance may cause or exacerbate cramps. Low calcium when acid builds up in your muscles can also cause cramps. The causes include the result of tired muscles and nerve problems, kidney failure, and diabetes.
To prevent leg cramps, try stretching your leg muscles before you go to bed and drink plenty of water. Performing a calf stretch before getting into bed at night may help prevent or ease leg cramps. Stay hydrated. Exercise and avoid inactivity and damage to tissues.
To ease a cramp, pull your toes up towards your ankle, rub the muscle, massage the area, walk around, or apply a heat pack. Try also straightening your leg and gently flexing your ankle and toes back toward your shins several times. You can do this in bed, but you may find you get faster relief if you get up and do it on your feet chilling effect.
Can pregnant women take matcha tea for relaxation and turmeric tea for anti-inflammation?
Green tea, including matcha, is considered safe for pregnant women. The anti-inflammatory properties of the antioxidants are beneficial, but there are risks of blocking iron and folate absorption.
Turmeric is safe to consume during pregnancy in small amounts. Curcumin has been shown to ease swelling and inflammation in pregnant women, and it can also relieve joint pain and back pain.
I’m having sciatic nerve pain in my right buttock. What can I do about it?
Lay down on the left side to help relieve pressure on the sciatic nerve. Avoid standing for long periods of time. Go for a swim. Take warm showers or use a warm compress to help relieve pain. Avoid lifting heavy objects. Seek your doctor’s advice.
How to ease backaches?
As your baby grows, your center of gravity shifts forward. So practise good posture. Lift properly.
Get the right gear. Wear low-heeled, not flat, shoes with good arch support. Include physical activity in your daily routine.
Sleep on your side. Try heat or cold massage.
Is nosebleed a common symptom?
Nosebleeds are quite common in pregnancy because of hormonal changes. The blood vessels in your nose expand due to the pressure of all the new blood moving throughout your body. Your blood supply increases by as much as 50% when you’re pregnant. The blood vessels in your nose are incredibly delicate and break easily. There’s nothing to worry about as long as you don’t lose a lot of blood although can be frightening.
Does massage help relieve constipation?
Abdominal massage can help relieve constipation, reduce discomfort, and encourage regular bowel movements. It can be done lying, sitting, or standing, so try a few different positions to find out what works best for you. However, be cautious if you have a sensitive uterus, as massaging the abdomen can increase risk of contractions.
Exercise, have adequate water intake, and increase fibres in your diet. Seek doctor for some mild laxative.
Dr Wong Boh Boi explains some of the most common pregnancy complications
Dealing with Pregnancy Complications
I constantly have high heart rate even up to 130 bpm. What should I do?
Your heart works harder to pump the extra blood throughout your body and to the foetus.
One reason your heart rate is elevated is that the uterus is expanding and pushing up into the abdomen. This squeezes the lungs a bit, reducing the space they have for oxygen exchange. An even bigger cause for shortness of breath is progesterone, a hormone that increases during pregnancy.is extra work can result in heart palpitations. Another reason could be overdoing caffeeine.
If dizzy, your heartbeat might feel like a strong pulse in your neck or a fluttering, racing beat in your chest. You may also feel discomfort in your chest, weakness, shortness of breath, faint, sweaty or dizzy. If your doctor is not worried, then just monitor.
Avoid sudden changing positions. Monitor to ensure not anaemic.
A high heart rate can also mean the heart muscle is weakened by a virus or some other problem that forces it to beat more often to pump enough blood to the rest of the body. Other possibilities include anaemia, an underlying infection, elevated thyroid hormone, or reaction to medication. Finding the cause and treating the condition would likely bring the heart rate back to a normal rate. Seek doctor’s advice.
Is it normal to have low heart rate during pregnancy?
Cardiovascular changes take place from the first trimester onwards; however, heart rate changes occur later and rises progressively towards an average of 91 bpm (range 68–115) at around 34-week the heart usually beats between 60 and 100 times per minute.
Heart rate of over 100 beats per minute to be too fast. Contact your doctor if you have any signs or symptoms: Difficulty breathing. Shortness of breath with exertion or at rest. Heart palpitations, rapid heart rate or irregular pulse.
Can I do some exercise to increase my heart rate?
Moderate exercise is usually safe during pregnancy but talk to a doctor before trying a new or difficult routine.
Eat a healthy diet as well. Talk to a doctor about how best to nourish the body during pregnancy.
Get proper prenatal care. Manage anxiety and mental health.
I was diagnosed with high prolactin levels (1000+) prior to pregnancy. I am now six weeks pregnant. Should I worry? What can I do to alleviate this?
Higher-than-normal levels of prolactin during pregnancy may increase the risk for miscarriage, though the link is not well established. The normal levels for pregnant women fall between 80 and 400 ng/mL (80 to 400 µg/L). Mildly elevated would be around 400-1000 mU/L, and should be repeated before referral. Your doctor will monitor and advice you accordingly.
You may need to find ways to reduce your stress and keep your blood sugar at consistent levels. Red clover, fenugreek, or fennel can raise your prolactin levels. Avoid eating anything with these ingredients if you have high prolactin level.
How to avoid placenta previa? Is it common?
Placenta previa is more common among women who have had a baby or a previous C-section delivery. Some of the possible causes and risk factors of placenta previa include low implantation of the fertilised egg, abnormalities of the uterine lining, such as fibroids, and scarring of the uterine lining (endometrium).
I’m taking bromocriptine to control the size of my pituitary tumour and prolactin level. What can I do to increase breastmilk when I stop bromocriptine near labour?
Bromocriptine prevents the secretion of prolactin, thereby preventing or suppressing milk production. Prolactin levels usually fall within the first two to three weeks of treatment. Any changes to our body’s systems typically takes up to three months. Talk to your doctor.
I was detected with low red blood cells, haemoglobin, and haematocrit, which didn’t improve much after taking two months of iron supplement. Any advice on how it may affect pregnancy and childbirth and how to treat it quickly?
Usually, low haemoglobin or low haematocrit means that you are not producing enough red blood cells or accelerated destruction of red blood cell. Discuss with your doctor to see a specialist if you are very concerned.
Must-Do Pregnancy Exercises
What exercise should I be doing before I get pregnant so that the damage to my body is minimal?
Regular exercise, and making movement a part of your routine before you begin trying to conceive, has many benefits for your physical and mental health. Studies show that if you exercise intensely for more than five hours per week, conception may be delayed. Intense training with a low BMI can alter your menstrual cycle and even stop ovulation. Avoid running, yoga inversions, and high-impact exercise. It is better to check with your doctor.
My wife has some pain in the lower back, glutes, and hamstrings. What stretching exercises can she do to alleviate the pain? What can I do to help her?
Sciatica can occur as your growing baby and expanding uterus put pressure on your sciatic nerve leading to discomfort and pain. Management includes massage, physical therapy. Self-treatment includes exercises to help stretch the muscles of the leg, buttocks, and hip to decrease the pressure on the sciatic nerve. Be guided by the professionals.
What stretching exercises are recommended for neck and lower back aches?
Maintain good posture. Give yourself a warm or cold compress. Stretching and exercises (be gentle and guided by your professional instructors). Massage. Talk to your doctor about OTC pain medication.
Can I start pelvic floor exercise when pregnant? How to do it?
As soon as you are diagnosed pregnant, and your OB-GYN never mentioned that you cannot do stretching exercise as there is no contraindications. E.g., placenta previa, sign of premature labour etc.
What is the appropriate exercise for different stages in pregnancy?
If there are no medical indications, try walking, gentle swimming, and guided prenatal stretching exercises that are safe and especially developed to aid delivery.
What kind of exercises/activities can I do to reduce posture-related problems?
Pregnant mums often over-exaggerate the lower back’s natural curve, which can lead to a weakening of those muscles due to the relaxing hormones, as well as becoming more rounded in the shoulders, leading to upper back pain.
Keep your body in alignment while sitting and try not to slump or slouch. Use a sturdy chair with low-back support and tilt your pelvis forward to prevent the swayback position. Your knees should be slightly lower than your hips and your feet should touch the floor.
There is routine low impact exercise specially designed to correct posture. Be mindful and conscious of your daily activities as poor postures can affect your whole back.
How long should a pregnant woman walk for exercise?
(CDC) recommends that if you’re pregnant or postpartum and healthy, you should aim to exercise 150 minutes each week. This can be split up into five 30-minute sessions of moderate-intensity moves, such as brisk walking.
Are prenatal barre and yoga both safe?
Barre is low impact and can be modified to accommodate every stage of your pregnancy. However, during the first trimester take a break. Please be much gentler with your body and avoid twisting poses that compress the belly.
Yoga is ideally not recommended till after 15 weeks pregnant. Yoga is a great exercise to do during pregnancy as it doesn’t put too much strain on your joints. However, listen to your own body during exercise. Avoid over stretching.
Can we do Pilates when pregnant in the second trimester?
Yes, and be guided, except those who have medical concerns. Avoid exercises that raise your body temperature and that require you to lie on your back to prevent possibly obstructing the blood flow to your growing baby.
A pregnant mom should not intentionally raise her body temperature during exercise. After 12 week of gestation, stop engaging in lying on your back exercises to avoid possibly obstructing the blood flow to your growing baby. After 20 weeks of pregnancy, try not to spend the entire night on your back. Try hug a booster.
Doing yoga and Pilates can be good for you and your baby. However, be aware of which positions to avoid during your pregnancy. Avoid over stretching exercise.
At which trimester of pregnancy should we start switching to low impact exercise?
From second to third trimester (weeks 14 to 40), you can carry on exercising if you feel well and comfortable. Stay active right up to the birth of your baby. Keep doing low-impact activities, such as walking and swimming.
Do gentle stretches to reduce aches and pains.
What about exercise for ladies with placenta previa?
Avoid moderate and strenuous exercise, heavy lifting (e.g. more than approximately 20 pounds), or standing for prolonged periods of time (e.g. more than four hours).
Do not have intercourse after 28 weeks of pregnancy. Do not put anything, such as tampons or douches, into your vagina.
Use pads if you are bleeding and call your healthcare provider, OB-GYN, or nurse advice line.
Do low impact exercises apply to first trimester as well? Is jogging recommended or not recommended?
Yes, Jogging can continue in healthy and non-complicated pregnancy. (No medical complication). Monitor should you feel tightening during jogging stop.
What is recommended for exercise duration?
For most pregnant women without any medical indicators, 30 to 150 minutes of moderate-intensity exercise is recommended on most days of the week. Try to monitor your own comfort and capability. Avoid over stretching.
When I stand up from sitting or lying position, it feels like my pelvic muscles are pulling downward. What type of exercise can I do to prevent this?
Pelvic floor muscle exercises is a series of exercises designed to strengthen the muscles of the pelvic floor. Do these exercises at least three times each day. You may find it easier to start your programme when you are sitting or lying down. If you are performing a Reverse Kegel, be sure you keep your pelvis and spine still. These can be performed while sitting and standing as well.
My gynae said to jog or climb the stairs to build stamina for delivery. But should I do low impact exercise instead?
Pregnant women are recommended to do at least 150 minutes of moderate intensity exercise a week.
In general, average jogging speed can be defined as 4 to 6 mph. Provided you aren’t experiencing complications, exercise—including running—is safe during pregnancy.
Pregnant women without medical complications can also consider climbing stairs. However, it should not be done regularly and those with a history of miscarriage or threatened preterm birth need to minimise it to ensure health. Climbing the stairs is a cardiovascular workout that may make you gasp and struggle for your breath initially, but you will build stamina and strengthen your bones and muscles when you do it consistently. Regularly climbing stairs during pregnancy benefits expecting women by keeping them active and improving blood circulation.
How much exercise can an expectant mother in the second and third trimester do a day? Can she go jogging?
In the second trimester, at least 30 minutes of moderate-intensity exercise is recommended for most of the week. Walking is a great exercise for beginners. It provides moderate aerobic conditioning with minimal stress on your joints.
In the third trimester, it is important to exercise within your limits in a manner that is safe for both you and your child. Guidelines recommend 20 to 30 minutes of moderate exercise every day, or 150 minutes a week.
Pregnancy Nutrition Tips
I am in my second term. Is it okay to take folic acid, DHA, and calcium at the same time?
Yes. However most prenatal supplements have low amounts of calcium because calcium may interfere with iron absorption.
What can we do to prevent gestational diabetes especially for older women?
It’s more common in older age. People with gestational diabetes must maintain tight control of blood sugar through diet and physical activity. Sometimes medication is needed, too. Left untreated, gestational diabetes can cause a baby to grow larger than average. Reduce high glycaemic foods and fruits.
Is it true that pregnant women should avoid sweet food, processed food, oily food, and dairy in order to give birth to a healthy baby?
High simple sugar intake during gestation may contribute to an excessive gestational weight and risk of Gestational Diabetes Mellitus (GDM). High-fat greasy foods are more difficult to digest and can increase risk of preeclampsia and preterm birth. High levels of fatty foods may trigger stomach pain, cramping, and diarrhoea.
All of these can increase your risk of excess weight gain, gestational diabetes, and complications. These can have long-term health implications for you and your child.
Can I take primrose oil, L-cystine, and glutathione supplements during my first trimester?
Evening primrose oil contains essential fatty acids, which are precursors to prostaglandins, that can soften and prepare the cervix for labour.
Taking evening primrose oil at 37-38 weeks, avoid taking supplements and multivitamins containing vitamin A (retinol) – as too much of it can harm your baby’s development. You should also avoid liver and liver products (including fish liver oil), as they are high in vitamin A.
Folic acid is a B vitamin that every cell in your body needs for healthy growth and development.
Evening primrose oil can have a blood-thinning effect, which could make it harder for blood to clot. That could increase the risk for postpartum haemorrhage, especially among women with pregnancy conditions like placenta previa. Side effects are temporary gastrointestinal symptoms such as abdominal pain, fullness, or nausea.
Women who are pregnant or breastfeeding should not use cystine supplements. Although there were no statistically significant adverse effects of the medication in the mother or foetus. Very high doses (more than 7 grams) of cysteine may be toxic to human cells.
Glutathione, not sure is safe during pregnancy and while breastfeeding. side effects are temporary gastrointestinal symptoms such as abdominal pain, fullness, or nausea, trouble breathing, allergic reaction like rash.
Inform your doctor about any supplements you’re taking so doctor can help to check on any potential side effects, even if they’re natural.
Is it better to drink low sugar maternal milk?
No Added Sugar variant is best for women who worry about being overweight or are concerned about Gestational Diabetes Mellitus or GDM.
Are pregnant ladies able to go for a prick test or allergy test to know what we can eat and cannot eat for the baby?
Allergy skin pricks test is for yourself.
Baby reacting to some foods you eat through breast feeding may be different e.g., u eat a lot of gassy food then after breastfeeding your baby is gassy.
Nursing mum stop taking daily products because of this reason thus I always suggest continuing to take but in very small amount to build up tolerance. Oral tolerance is an active process of local and systemic immune unresponsiveness to orally ingested antigens such as food.
it is possible to acquire tolerance after sensitization has occurred.
Dr Wong Boh Boi shows the weight gain guidelines for pregnant women of normal weight prior to getting pregnant
Pregnancy Weight Guide
Should I be concerned if I am in the third trimester but I have only gained 6 kg so far?
Your OB-GYN will monitor your baby’s growth in the womb. As baby is growing well accordingly to gestation and is healthy, there will not be much concern. However, gaining too little weight can cause problems such as premature birth and a baby with a low birth weight. It can also be that your body isn’t storing enough fat. Lack of weight gain can be related to your diet and weight before you become pregnant.
I am overweight and taking thyroid medication as prescribed. I’m only on my first trimester. What can I do to ensure a healthy pregnancy and healthy baby?
It’s safe to take thyroxine medicine during pregnancy. Taking thyroid medications over or under dosage can affect weight gain. Talk to your specialist. He or she will monitor and ensure you are receiving the correct dosage. Your OB-GYN will also monitor you and your baby during pregnancy as the medication is used to control your thyroid condition.
I suffer from Hyperemesis, so I did not put on any weight. I’m already in week 30 and my weight is at pre-pregnancy level. Do you have any advice to share?
Hyperemesis gravidarum symptoms include extreme nausea and vomiting during pregnancy. It can cause weight loss of more than 5% of body weight. There is an increased risk that your baby may be born with a low birthweight. Check with your doctor and monitor baby’s growth in your womb carefully.
Avoid consuming big quantities, and focus on regular small frequent high-quality food. Avoid taking liquid together with food. Avoid extremely oily or spicy foods.
Is losing weight by 3-4 kg in first trimester common? My intake of food is lesser due to nausea and I’m worried I’m passing down less nutrient to the foetus. Any way to curb nausea or morning sickness?
A loss of appetite because of the morning sickness is a common cause of pregnancy weight loss in first trimester. Take frequent small high-quality foods. Seek advice from your OB-GYN.
I have Gestational Diabetes and been losing weight since the start of my third trimester. Is that normal?
Losing weight in the second or third trimester could mean that you are not taking in or passing along enough nutrients for your baby to grow at a healthy rate. Talk to your doctor and seek advice.
I’m in my third trimester, 35 weeks, with no weight gain in the past two months. I have GDM, and doctor says my baby is slightly overweight already. Is this a concern?
The weight loss may be due to lower levels of amniotic fluid, more bathroom breaks, and increased physical activity. If baby is growing well and baby’s weight is not affected there is no need to worry.
Take some high-quality protein foods. Rest and relax. Try to reduce stress. Let your doctor monitor you.
Is it normal to not gain any weight by week 14?
Don’t worry. It is normal to not gain a lot of weight in the first trimester. Tiny foetuses have tiny nutritional needs. The same isn’t true if you’re falling short of your recommended weight gain by the second trimester. As your baby gets bigger, calories and nutrients will be increasingly in demand.
Safety Dos and Don’ts While Pregnant
I understand that pregnant women shouldn’t carry heavy stuff. How many kilos are considered safe for a pregnant woman to carry?
There’s no clear safe and appropriate weight limit for all pregnant people. Carrying too heavy object it causes pain or discomfort when you lift. You can’t lift it without holding your breath or straining your pelvic floor muscles. Prolonged standing or heavy lifting can cause an increased chance of miscarriage or preterm delivery. Changes in a pregnant woman’s hormones impact ligaments and joints in the spine.
The American Medical Association (AMA) guidelines do not differentiate weight limits regarding duration of exposure. Lifting more than 20 to 23 kg is permitted repetitively for the first half of pregnancy (up to Week 20) and intermittently through Week 30. Between Weeks 20 and 24, repetitive lifting up to 23 kg permitted. AMA recommends that you don’t lift anything heavier than 51 pounds in your third trimester, and anything heavier than 31 pounds during your last week of pregnancy.
I’m a stay-home mum with a one-year-old baby and currently 2nd trimester pregnant. Are there any best poses to carry a baby while pregnant?
Carrying a toddler while pregnant with baby number two is totally fine. When you pick your toddler up, lift with your legs so you don’t strain your back. You’ll probably be most comfortable holding your toddler on your hip, below your bump.
As the AMA recommends, don’t lift anything heavier than 51 pounds in your third trimester and anything heavier than 31 pounds during your last week of pregnancy.
I’ve been told to avoid reaching upwards to take things or else the umbilical cord can get twisted. Truth or myth?
There is no evidence that reaching upwards can cause the umbilical cord to be twisted. However, reaching upwards to lift things off the shelf may cause back strains and sprains, which are the most common cause of upper back pain. You can injure muscles, tendons, or ligaments.
Is it okay to take a hot bath or a dip in the hot springs when pregnant?
Avoid overheating. When you take a hot bath, your body is unable to lose heat effectively by sweating. A significant rise in your core temperature (39°C) could be harmful in pregnancy, particularly in the first 12 weeks. Late trimester soaking in a warm tub (38°C) may help to reduce aching and stiff muscles for 10 minutes.
By which trimester of pregnancy should we sleep on our left side for better blood flow to baby?
The safest position to go to sleep is on your side, either left or right. Research suggests that, after 28 weeks, falling asleep on your back can double the risk of outcome.
Is using makeup products such as foundation and eyebrow pencil okay? Which brands do you recommend?
It is safe to use cosmetics during pregnancy. Choose lead-free lipstick products.
Avoid retinol. This form of vitamin A (also known as retinyl palmitate, retinyl acetate, retinoic acid and tretinoin) can be found in foundations and lipstick, specifically those labelled as “anti-aging.”
Can I play tennis while pregnant?
Tennis is a relatively low-risk sport for pregnancies. It is a non-contact sport with low risk of trauma. Most healthy, pregnant women with no medical complication will be able to continue to play safely with some modifications.
Can I still have sex with my husband during early pregnancy?
Sexual activity won’t affect your baby if you don’t have complications such as preterm labour. If you’re comfortable, most sexual positions are okay during pregnancy.
However, there are some positions you may want to avoid. Missionary position (with mum on the bottom) isn’t a good idea as it compresses blood flow to mum and baby, particularly after the twentieth week. Some find prone positions (lying flat on the stomach) uncomfortable.
But unless your healthcare provider has told you not to have sex, there’s no reason to avoid it.
Is it safe to have sex in the second trimester?
It is safe to have sex during pregnancy unless your doctor or midwife have advised you not to.
I’m scared to orgasm during my pregnancy because I heard my uterus might cramp up. Is that harmless?
For women with low-risk pregnancies, orgasms won’t harm your developing baby, increase the risk for miscarriage, or lead to preterm labour. Find out if you need to take any precautions during sex while pregnant. Your doctor may advise against sex and orgasms if there is a concern.
What are your travelling tips during pregnancy? I will be on a plane for more than 10 hours.
Air travel before 36 weeks of pregnancy is considered safe for people who aren’t dealing with any pregnancy problems. It’s a good idea to talk with your health care provider before you fly occasional air travel is almost always safe.
For your pre-flight diet, avoid gassy foods (beans, cabbage, broccoli) and carbonated beverages. On the plane, buckle up and keep your seatbelt fastened. Get plenty of fluids during the flight. Exercise your legs. Shift your sitting positions.
Can we take chicken essence or other Chinese medications during pregnancy?
No concerns with drinking Essence of Chicken during your pregnancy. A study has shown that if a postpartum mum consumes three bottles a day, then lactation increases by 45%. Additionally, despite popular view, there is no scientific evidence to show that Chinese Angelica Root (当归 Dang Gui) aids lactation.
With TCM medication, ideally don’t take strong herbs in the first trimester as these can cause miscarriage. Ten days before delivery and 10 days after delivery, avoid taking strong herbs as this can increase risk of postpartum haemorrhage and heavy lochia.
Always be guided by your doctor.
Can I drink collagen rich drinks during pregnancy?
Collagen protein for blood sugar management, minimising nausea, and growing baby’s cells and the placenta. It also supports mama’s joints, pelvic floor tissue, skin elasticity, and postpartum hair and healthy glow. Increased collagen and elastin promote skin regeneration that can improve your skin’s appearance and reduce stretch marks. Moderation and choose one which is evidence base.
Managing Stress and Emotions During Pregnancy
How to feel less stressed out given that this is my first pregnancy?
Exercise can help reduce stress and reduce or prevent common pregnancy discomforts. Cut back on activities you don’t need to do. Seek help e.g. partner can help with chores around the house. Learn to do relaxation breathing and stay calm. Communicate with your partner and doctor if you are concerned about your pregnancy.
Is a foot massage or prenatal massage safe?
Yes, except for pregnant women with certain medical conditions. Prenatal massages are usually considered safe after the first trimester, if you get the green light from your doctor.
Avoid deep massage and strong pressure on the legs. Avoid massaging the breasts and abdomen. Avoid pelvis, wrists, hands, and ankles pressure points that pose a possible risk of blood clots during pregnancy.Ensure you get your massage done by an accredited masseur.
Everything sounds traumatic. I’m not sure I want to be pregnant anymore.
Be well prepared. Join antenatal classes which provide expecting parents with the confidence and knowledge to give their newborn a good start in life. They offer evidence-based knowledge and hands-on experience that can boost the expecting parents’ confidence and reduce a lot of confusion and fear.
How do I handle my temper during pregnancy?
Good physical care of yourself and getting plenty of rest and sleep may help to keep troubling emotions in proportion. Eat well. Avoid getting very hungry (a lack of food can lead to an undesirable outburst).
Get exercise, as it is a great stress reliever and mood booster.
Talk to your loved ones. Talk to a health counsellor.
Coping with Labour and Childbirth
What can I do to prevent preterm labour?
Have regular check ups with your doctor in your pregnancy for prenatal care. Take care of any health problems, like diabetes, high blood pressure, or depression. Don’t smoke, drink, or use illegal drugs.
Avoid vigorous exercise and rubbing your abdomen. Take adequate rest and learn to relax.
How to encourage natural labour on week 39 to avoid being induced?
Try nipple stimulation after 37 weeks gestation. Take long walks, have sex frequently, and exercise.
My EDD is getting nearer, about 10 days. Any way to ease labour pains?
Stay calm. Massage, water therapy, and do breathing exercises. Walks, changing positions during labour, and moving around can reduce pain.
How much faster does dilation happen if it is not the first vaginal birth?
The normal rate of cervical dilatation in active phase is 1.2 cm/hour in primigravidae (women who are pregnant for the first time) and 1.5 cm/hour in multipara (a woman who has had more than one pregnancy). If the rate is <1 cm/hour, it is considered prolonged. The majority of second and subsequent labours are much quicker than the first.
Second time vaginal delivery hurts less than the first time, but the pain after giving birth is twice as bad as the first time.
I am around 148 cm tall. Is it possible to give birth naturally, or better to opt for a C-section?
Mothers with a small stature (less than 145–150 cm) have a higher risk of prolonged or labour blockage due to cephalopelvic disproportion. There are reports that shorter maternal height has been associated with lower mean birth weight, lower frequency of spontaneous onset of labour, and higher Caesarean section. However, discuss with your doctor as some small, shorter mum can have vagina birth.
Will a C-section increase any complication for future pregnancy?
Research shows that getting pregnant less than six months after a C-section can increase your risk of complications, such as ruptured uterus or a low-birth-weight baby.
Any way to prevent tears during childbirth?
Perineal message from 36 weeks of gestation helps to stretch your perineal.
To prevent tears, you must learn to cooperate with your deliverer (DR) and stay calm. During the second stage of labour, which is the pushing stage, aim for more controlled and less expulsive pushing.
During crowning, it’s good to slowly pant the baby’s head out rather than putting great force and push the baby out. Ask your doctor or midwife to apply a warm compress to your perineum as your baby begins to crown.
Deliver in an upright, non-flat position.
How to minimise serious perineal tear?
Do daily perineal massage and application of warm compresses or lubricating the perineum. Birthing in the side-lying position has been shown to reduce perineal tearing by allowing the presenting part to descend more slowly.
During the expulsive stage, manual control of foetal head flexion also helps. Talk to your doctor about what can be done to minimise perineal tear.
Is epidural recommended?
Epidural analgesia is an extremely effective and popular treatment for labour pain. There is no credible evidence that an epidural slows down labour or increases your risk of having a C-section.
An epidural might be recommended in certain situations, such as for intense labour pain and you feel exhausted or out of control. An epidural can help you rest and get focused.
For every mum the pain threshold varies. It’s a personal decision. Discuss with your OB-GYN during visits.
Does epidural cause long term side effect such as backache?
It’s very rare for an epidural to cause long-term or chronic back problems. It’s normal to experience temporary back pain or tenderness at the site of your epidural. This usually goes away within a few days. Lasting or recurring back pain is not typical. It may occur, however, because of damage to the spine, nerves, or other structures.
Though very rare, an epidural procedure can lead to some long-term complications, including chronic pain and permanent neurologic deficit due to spinal cord or nerve root damage from the epidural injection.
Which is a better pain killer during labour: epidural or laughing gas?
This depends on one’s pain tolerance. Discuss with your doctor.
Nitrous oxide can certainly make you feel better during labor, but it won’t completely block the pain like an epidural will. On a scale of one to 10, if an epidural is the gold standard of pain relief at a 10, nitrous oxide is more like a three or four.
An epidural is a type of local anaesthetic. It numbs the nerves that carry the pain impulses from the birth canal to the brain. It should not make you sick or drowsy. In most cases, an epidural gives complete pain relief.
Other forms of natural special breathing technique and relaxation and medication injection will also help you to cope with labor pain.
Episiotomy or natural tear—which is better?
Perineal tear (or laceration) is preferred. Healthcare providers don’t recommend routine episiotomies and prefer that you tear naturally. Tears tend to be more often surface layer injuries than episiotomies. Sometimes, tears are so minor that they don’t require repair, which means you won’t feel the discomfort of stitches on your perineum.
A midwife or obstetrician may do an episiotomy to try to prevent a third or fourth-degree tear if you’re likely to tear.
From 36 weeks gestation onwards, you can learn to do perineal massage which may reduce the risk of tear.
Dr Wong Boh Boi makes a few suggestions on how fathers can be better prepared and involved in the arrival of the baby
Caring for Your Postpartum Body
How to deal with back pain after delivery C-section??
Correct your posture. Try not to bend over when lifting and picking up your baby. Keep your back straight while breastfeeding.
Choose gentle exercises. Allow yourself to rest. Take a hot bath. Get a massage. Take pain medication to ease spasms.
What I should/shouldn’t I be eating after a C-section?
After a Caesarean section, about one to two days, the digestive capacity is still weak, so eat easily digestible foods. Avoid anything that takes a longer time to digest.
Do not eat greasy foods. Moreover, fermented and fried food can cause heartburn and indigestion. Items like carbonated drinks, citrus juices, coffee, tea, and spicy food should be avoided as these increase bloating and gas.
Is there any way to regain the uterus fast after giving birth?
Natural involution of uterus takes place usually within six weeks postnatally and your uterus will be back to the original size or the size of your fist. To enhance the process after delivery, performing pelvis floor exercise helps to strengthen the pelvic floor and aids recovery to prevent any complications like stress incontinence, haemorrhoids, and vaginal wall laxing.
Avoid vigorous exercises like planking and doing abdominal crunches as these can over stretch your recti and lead to recti diastasis. Some postnatal guided exercise aids to strengthen the abdominal muscles.
Resume normal activities and wear a proper corset recommended by your doctor especially for C-section cases. Breastfeeding the oxytocin helps uterus to contract and recover faster.
If I have haemorrhoids, will these gradually go away once I give birth?
Haemorrhoids are the swollen vein in the anus that developed during your pregnancy that can make having a bowel movement extremely unpleasant. These will go away on their own after you give birth, especially if you’re careful to avoid constipation. Your doctor may prescribe some cream or suppository. Pelvic floor exercise helps.
In most cases, thyroid developed during pregnancy stays forever. Any way that this can be reversed after pregnancy?
Hypothyroidism may last up to a year after your baby is born. However, in some women, hypothyroidism doesn’t go away. Talk to your specialist and get his/her advice. According to a study, subclinical hypothyroidism during pregnancy is likely to resolve in two-thirds of women after pregnancy.
Is it true that Diastasis Recti can only be recovered by massage and clinical treatment?
Applied correctly, Massage Therapy can be used as a successful foundational treatment modality to rehabilitate a Diastasis Rectus Abdominis. Physical therapy involving gentle strength exercises can improve it as well. Requiring surgery is rare.
How early can we start the exercise after giving birth?
Uncomplicated vaginal delivery, safe to begin exercising a few days after giving birth or you feel ready. If you had a C-section, extensive vaginal repair, or a complicated birth, talk to your O&G or health care professional before you start an exercise program.
Is postpartum massage useful and advisable?
Massage has long been used as a therapeutic way to promote relaxation, pain relief, and stretching exercises. For mums who have had a traumatic birth or a C-section, it is best to consult your doctor before having a massage.
Post-natal massages can commence anytime between the fifth day to under three months after normal delivery. For Caesarean section, post-natal massage can only be performed after the incision has closed properly. usually about two to four weeks after delivery.
Common Concerns About Foetal and Infant Development
By which week must we sleep on our left side? Is it true if we sleep on our back, it will obstruct blood flow to baby?
It’s safest for you and your baby to sleep on your side by the 28-week mark, as it helps you both get the blood flow you need. Sleep on your side can offer benefits in terms of sleep apnoea and chronic lower back pain relief.
Is NICC test important for pregnancy?
NICC® is a simple, safe and accurate test for common chromosomal abnormalities detection. It’s a highly accurate screening test that provides a stronger risk indication than other traditional screening procedures with a sensitivity rate of >99.9% for Down Syndrome, Edwards Syndrome and Patau Syndrome. Talk to your doctor if you have any concerns.
At how many weeks of pregnancy can the baby hear music and mummy’s voice?
Babies can begin hearing sounds and voices around the 18-week mark.
Listening to music during pregnancy will not only have a soothing and uplifting effect on the pregnant woman, but also a positive influence on the unborn baby. Slow, rhythmic, soft music influences the brain development.
Reading to your baby in the womb promotes brain activity and can promote early literacy skills and language development. Literacy skills continue to develop while reading to your baby after they are born.
Will frequent drinking of tonic products such as chicken essence make the baby darker?
Chicken essence is considered safe when taken in moderation. No evidence that the essence makes baby’s skin darker.
There haven’t been enough studies conducted on herbal supplements or botanicals with medicinal properties for doctors to recommend them during pregnancy. Always check with your doctor for advice.
What can I do to increase foetal weight?
High quality protein promotes baby’s growth. Good sources of this include lean meat, poultry, seafood, eggs, beans, peas, and nuts, seeds, and soy products. Take. in milk and dairy products if you are not allergic. Drink avocado and orange juice.
Rest on your left side whenever possible. Reduce stress.
My baby is measuring one week bigger but is boney. any tips on fattening baby up?
One week bigger is quite normal. Every baby is different. As long as your doctor is not worried, then it is fine.
If your doctor is worried, do talk to him/her on how to improve the weight gain of the baby in the womb. There are many causes and reasons your doctor will find and manage accordingly.
Rest and relax, and have a good protein diet.
I was jaundiced as a baby. Is this hereditary? Can I prevent my baby from developing jaundice?
Most babies have physiological jaundice. There are many types of jaundice, thus, your paediatrician or neonatologist will investigate and treat accordingly.
The most common is physiological jaundice occurring from the second or third day after birth. Jaundice is harmless usually after phototherapy with a special type of light (not sunlight). It can help to break down the serum bilirubin that causes the jaundice and remove the bilirubin from your baby’s blood.
We also must ensure adequate milk intake to hydrate the newborn, as dehydration can make the condition worst. Let your dr take care of it accordingly. There’s nothing to be worried about too much.
Should baby sleep in a different room from parents?
This depends on your personal preference. According to the American Academy of Paediatrics (AAP), the best place for a baby to sleep is in the parents’ bedroom. The baby should sleep in his/her own crib or bassinet (or in a co-sleeper safely attached to the bed).
Baby-Friendly Hospital Initiative (BFHI) studies show that having the baby sleep in the same room as parents promotes good bonding and establishes breast milk production. Official guidelines tell parents to keep babies in the parent(s) room until they are 6 months old.
About the Expert:
Dr Wong Boh Boi Founder @ParentCraft & Senior Lactation Consultant Dr Wong has over 30 years of experience in lactation consultancy, antenatal and baby care and possesses multiple professional certifications and qualifications, specialising in nursing, lactation, midwifery, childcare and enhancing brain development in babies. Dr Wong has one philosophy that she aims to live by everyday – to empower every mother to breastfeed if she wants to. Breastfeeding is thought to be a natural act for mothers and babies, but it comes with practice and through bonding between the mother and the baby. Whether you are a first-time parent or already a “trained” parent, we aim to help every parent build confidence as you embark on your parenthood journey from pregnancy to childbirth and beyond, by sharing comprehensive and intimate information about pregnancy, childbirth, breastfeeding and baby care.