This is another one of those questions that I get asked daily. There are a few doctors in Muscat who have a very good reputation and although there is no doubt that they earned it through skill and expertise, the main reason they are so popular is because of their excellent bedside manner. Ten questions you need to ask YOURSELF about which doctor you should choose. - What do you expect from you doctor in a consultation? (This is the most important question and ideally you should have at least 5 answers before proceeding with the next questions.)
- Does your doctor acknowledge you and address your concerns during a consultation?
- What, in your opinion, is the role of the doctor in YOUR pregnancy?
- What are YOUR beliefs about pregnancy and birth – does your doctor share your beliefs?
- If you have fears surrounding pregnancy and birth – what does your doctor do or say to alleviate those fears?
- Does your doctor say or do anything that exacerbates your fears?
- Does your doctor encourage you to take responsibility for your health and advise you on complimentary services to make your pregnancy healthy and enjoyable?
- Does your doctor address you by name and does he/she remember who you are at subsequent consultations. If he/she doesn’t – do you expect that they will remember your concerns when called to attend you in the middle of the night?
- Are you afraid to change doctors for fear of “hurting their feelings”
- What is your gut feeling?
First Impressions
In a modern world where everything is easy and disposable, why would you even consider using cloth diapers that need WASHING? Eeeuw! I get an image of dirty smelly diapers soaking in buckets next to the loo , not to mention the hassle of daily washing and drying. Why bother?
Well, there are several reasons to bother, but the health benefits rank top of my list.
Lets start with the chemicals that are used in disposable diapers – those lovely white throw away nappies don’t start off white. DIOXIN is a highly toxic by-product of the bleaching process and is the most toxic of all cancer-linked chemicals. Dioxin has been known to cause birth defects, skin disease and liver damage.
Without doubt this is one of the first questions that most newly pregnant expat couples ask me. Most of you want to book the first flight home to be near family and friends and close to a hospital or clinic that you are familiar; within a system that you understand. However, travelling home to have your baby brings a whole new set of restrictions. You will have to leave Oman no later than 34 -35 weeks into your pregnancy and if you husband travels later, there is the possibility that he would miss the birth. If you give birth in Oman your only choice is to give birth in one of the private hospitals. There are no birth centers or active birth units and home delivery is not an option. Although there are several to choose from, the two main hospitals are Muscat Private and Star Care. For the purpose of this article I will focus on these two only. Read through the facts and then use them to prepare yourself according to what is available. Antenatal Care - facts about private hospitals in Oman - Some people complain of "assembly line" prenatal care. Many doctor's offices are overcrowded and you do not get the personalized care and attention that you were expecting considering that this is the happiest most important time of your life.
- The visits with the doctor often last mere minutes. These types of appointments can leave you wondering what the point of the office visit was. Besides having standard tests done at each visit there doesn't seem to be much more to appointments.
This does not mean that they do not care. There is a very standard set of blood tests, scans and routine checks that are done at every appointment and at set times during your pregnancy (click here for details) and the results of these will notify the Doctor of any risk factors or concerns. Take time to read, know and understand the many aches and pains that are normal and expected throughout pregnancy (click here for details) and use your discretion when finding information online.
Round Ligament Pain in Pregnancy
Your uterus is normally the size of a pear. Thick ligaments, one of which is called the round ligament, hold your uterus in suspension within your abdomen. As the uterus grows, these ligaments become very long and thin, stressing and tensing like rubber bands.
The ligaments pull and tug on nearby nerve fibers and sensitive structures, causing pain. The severity of pain can worry you. Although round ligament pain is uncomfortable, it is also very normal.
A ligament spasm, an involuntary contraction or cramp, usually triggers a sharp pain. These spasms are found more frequently on the right side than the left because of the normal tendency of the uterus to turn to the right.
You may feel round ligament pain as a short jabbing sensation or a sharp, stabbing pain if you suddenly change position, such as when you're getting out of bed or out of a chair or when you cough, roll over in bed, or get out of the bathtub. You might also feel it as a dull ache after a particularly active day – when you've been walking a lot or doing some other physical activity.
You may feel the pain starting from deep inside your groin, moving upward and outward on either side to the top of your hips. The pain is internal, but if you were to trace it on your skin, it would follow the bikini line on a very high-cut bathing suit.
Resting comfortably should help ease your symptoms.
You can also try flexing your knees toward your abdomen to get some relief or try lying on your side with a pillow under your belly for support and another one between your legs. A warm bath may help, too.
If you find that you're more prone to round ligament pain when you're particularly active, cut back to see if that helps. Then, when you feel fine, you can gradually increase your activity until you find the level of exertion that's comfortable for you. Yoga exercises help a lot as the postures work to strengthen the supporting muscles and ligaments thus relieving the tension on the round ligament.
Morning Sickness In order to manage morning sickness it is important that you understand why you are feeling so totally awful. Some women experience nausea throughout the day. Often the nausea induces actual vomiting.
The good news is that it usually only lasts the first 12 – 16 weeks of pregnancy and there are ways of coping with it, even though some may not be effective for everyone.
What causes the nausea?
I was asked recently for my thoughts on using a TENS machine in labor.
TENS stands for transcutaneous electrical nerve stimulation which means that it delivers little pulses of electrical energy that can be adjusted to a suitable frequency and strength.
In order to manage childbirth pain well you need to understand how your body processes pain and how your mind perceives it, as well as what is happening to your body in labor.
WHAT CAUSES THE "PAIN"
Most childbirth pain originates in the stretching of the cervix, vagina, and surrounding tissues as baby passes through. Uterine contractions work to pull the cervical muscle up out of the way so that the baby's head can then be pushed through. (Think of a turtleneck sweater being slowly stretched as you pull it over your head.) The muscles and ligaments in the pelvis are richly supplied with pressure and pain receptors in the nerves, so the stretching produces powerful sensations that may be interpreted as pain, especially if there is tension in the surrounding muscles. The contraction begins, tissues stretch, and the tiny pressure receptors in the nerves are stimulated, sending lightning-fast impulses along the nerves to the spinal cord. Pain receptors are stimulated as well if the surrounding muscles are tense.
In the spinal cord these impulses must pass through a sort of gate that can stop some impulses and allow others to pass through into the brain, where they could be registered as pain.
HOW DOES THE TENS MACHINE WORK?
The TENS machine slows and sometimes BLOCKS these impulses from reaching the brain where they are registered as pain. When the TENS machine is used effectively for more than an hour, the pulses stimulate your body to release its own, natural, feel-good substances, called endorphins.
DOES IT ACTUALLY WORK?
So today I want to chat a bit more about establishing breastfeeding and why I stress the importance of taking ONE DAY at a time.
Firstly you need to know that I believe in demand feeding for the first week (which goes against some other schools of thought) - but let me explain why. I will also show you in graph form how a typical feeding pattern looks to give you a better idea of how your day and night will be divided up. Remember that I am referring to the FIRST WEEK here, the second week will have a few variations that I will discuss in another blog post.
Birth preparation is crucial for a healthy outcome. However it is important that we differentiate between outcome and mode of delivery.
A good outcome is a healthy, happy mom and baby. Mode of delivery is either vaginal or caesarian section. Most moms who come to me, do so because they desire a natural birth, free of unnecessary intervention. My job is to assist them to prepare themselves mentally, physically and emotionaly for this. Part of this preparation is keeping an open mind about things that happen that are out of our control.
An example of this might be the postion of the baby's head not being ideal causing unexpected problems in labour. Often we think that if the baby's head is down (as opposed to to the buttocks being down or breech presentation) then everything is perfect. But the position that the head enters the pelvis is more important and this is where delays and possible problems occurr. Ideally the baby should be in an ANTERIOR position.
 This is what an anterior position looks like. The body of the baby is nestled on the curve of the belly and as he moves down into the pelvis his head will flex as he tucks his chin in. A well flexed head usually provides evenly distributed pressure over the cervix which helps it to dilate. Ideally he will postion the crown of the head over the cervix. This is usually the best position for birth.
Today is the 26th October which means that E’s baby is 1 day “overdue” and A’s baby is 6 days “overdue.” Both of them are feeling tired and heavy and are pretty much over pregnancy! I am set to be with both of them during labour and delivery so although I hope that it happens soon for them, I am fervently praying that they go into labour on different days or things are going to get rather tricky for me!!! But that is another problem altogether. Let’s talk a little about “post dates” and the inevitable need or desire for an induction of labour (or IOL in medical speak.) According to the American College of Obstetricians and Gynaecologists (ACOG) there are 5 medical reasons for an IOL.
Failing any of these reasons you really should just be patient and wait it out. Yes, I know – it’s very easy for me to say that but part of labour preparation is about letting go of control. In my yoga classes you will often hear me say that your baby knows exactly how and when to be born. I really believe that.
Despite their prevalence, it is always devastating when a woman experiences a miscarriage. While a miscarriage can cause a woman to feel alone and isolated, it is important to remember that a large portion of women will experience at least one miscarriage during their reproductive years. If you have had a miscarriage, take the time to understand better why these occur and why it is not your fault.
Why did it Happen - Was it My Fault?
When you conceive and a baby is created, it takes half its genes from the sperm and half from the egg that ovulated that month. At the exact time of conception, the cross-over of these genes takes place. Sometimes, for no reason other than bad luck, some information is lost and the pregnancy is destined from that point not to be.
It might be that this lost information is not needed for many weeks, and the pregnancy will continue as normal until that time. When the needed information is not there, it is then that the baby dies and you begin to miscarry. Sometimes when this happens, the miscarriage doesn't happen right away. This is called a 'missed' miscarriage and may not be picked up until some weeks later, following a slight loss of blood or period-type pains.
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