Did you know at birth your baby’s stomach is the size of a chickpea? By day three, it’s about the size of a walnut, and not until day 10 is it as big as a golf ball. This small stomach size equals small stomach capacity – tiny tummies can’t hold much at once. The good news is that if you’re breastfeeding, your body has made your milk in just the right quantity for a growing baby’s stomach size.

Think of colostrum – your first milk – in teaspoons rather than ounces. It’s just the right amount for baby’s little belly. The nutrients in colostrum are perfect for a newborn, too. Colostrum is low in fat, and high in carbohydrates and protein. The antibodies in colostrum act as your baby’s first vaccine – they keep your baby healthy as his immune system is developing. Colostrum is easy for your baby to digest, and has a laxative effect to help prevent jaundice.

Because breastmilk so easy to digest, babies need to nurse often. Newborn babies typically nurse every 1 ½ to 2 hours. Most of the time, though, the feedings aren’t so evenly spaced. Sometimes baby will want to nurse every hour, and sometimes he will sleep for a longer stretch without waking to feed. Eight to twelve feedings every 24 hours is what you should aim for.

If your baby is having trouble latching in the early days, it’s important to get some nourishment into him. But using a breast pump for colostrum isn’t always effective. Because it is thicker than mature milk, and is produced in smaller quantities, colostrum is more easily hand expressed than pumped. Consider hand expressing colostrum onto a teaspoon, and then dribbling this into your baby’s mouth a little at a time. These calories will help sustain your baby as you work on getting him to latch.

With all of this in mind, here are some tips for successfully starting to breastfeed in the early days after the birth:

• Plan your birth for breastfeeding success: Pain medications in labor can result in sleepy baby in the early hours and days after birth. A sleepy baby may not nurse very often. This would be a good time to hand express colostrum and spoon feed it to your baby.
• Spend time skin-to-skin: As soon as your baby is born, ask that they place him skin to skin with you. Stay this way until the first feeding has taken place. Skin-to-skin contact helps baby adjust to life outside the womb and awakens breastfeeding reflexes.
• Nurse early and often: Most babies are ready to nurse about an hour after birth. Ask for help if you need it. Then continue nursing your baby on cue afterwards in order to bring in a strong milk supply.
• Room in: Keep your baby with you as much as possible after the birth. You will get to know your baby’s rhythms and hunger cues, which will help get breastfeeding off to a strong start.
• No supplements or pacifiers (dummies): Unless medically necessary, limit any formula or other supplements. If you do need to supplement, use a spoon, syringe or cup rather than a bottle. Also, try to limit using a pacifier or dummy until breastfeeding is well established. Your baby doesn’t need anything other than your milk at first!

Following some simple steps as you are preparing for breastfeeding will help you set the stage for a strong milk supply and a satisfied and healthy baby. You can also watch some educational breastfeeding videos in our Baby+ App. Click Baby+ iOS or Baby+ Android to install the App, and prepare for the arrival of your little one(s).

What concerns do you have about getting breastfeeding off to a strong start?

Written by Michelle: writer, editor, childbirth educator, lactation consultant, and mother to 4 busy kids

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

Many women find breathing techniques an effective way to manage contractions during labor. By focusing on your breathing, you may find yourself better able to deal with any discomfort caused by the contractions.

How will breathing techniques help me during labor?

When you feel panicked, your breathing can become shallow and rapid. This can limit the amount of oxygen available to you and your baby.

• Focusing on your breathing can help to act as a mild pain relief during the early contractions.
• Breathing techniques can help you to feel in control during labor.
• When you feel scared or stressed, your body initiates the ‘fight or flight’ response. During labor, this can slow down or even stop contractions. Breathing techniques can help to control this response.

Which breathing technique should I use?

There are a number of different techniques available, each claiming to be effective during birth. In fact, it doesn’t matter which breathing technique you use, as long as you ensure it is rhythmical. There is no need to spend vast amounts of money on classes to learn a particular technique, as long as you feel comfortable teaching yourself. You could try:

• Counting as you breathe – by counting the length of your inhale and exhale, you can control your breathing. To feel calm during a contraction, you should aim for a longer exhale than inhale. This will help to relax you.
• Visualisation breathing – think of your happy place. As you breathe in, imagine sucking things in, and then visualise blowing them away as you breath out.
• Nose to mouth – try breathing in through your nose, and out through your mouth.

The breathing techniques taught at antenatal yoga, pilates and meditation can also be used during labor. The breathing technique should make you feel relaxed and calm. These techniques are great to use throughout the pregnancy to ward off stress.

The pushing stage

Once you reach the pushing stage, you may find that you change how you breathe. You may prefer a pant-like breathing technique while pushing. That’s fine, just go with whatever feels natural at the time. The midwife will be there to offer any support or guidance.

Teach your birth partner the breathing technique you would like to use during labor. They will be able to remind you of the breathing pattern each time you experience a contraction. You may find you forget all your carefully thought out plans when the day arrives!

Written by Fiona, proud owner of a toddler, @fiona_peacock

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

The mucus plug (also known as the operculum) is a thick glob of cervical mucus that blocks the cervical canal during pregnancy. The mucus plug prevents bacteria from getting inside the uterus and keeps the uterus sterile for the developing baby. Before the baby is born, the mucus plug is expelled to allow the baby to pass through the cervix.

What does a mucus plug look like? The mucus is usually thick, clear and sticky. It can look similar to nasal mucus, but is usually thicker. Towards the end of the pregnancy, as the cervix starts to efface in preparation for labour, the mucus may be tinged pink or slightly bloodied. It is sometimes known as a “bloody show”. Some women lose their mucus plug all at once, but for most it is a gradual process.Many women don’t even notice it happening due to the increase in vaginal secretions.

I’ve passed my mucus plug, is labour imminent? I hate to disappoint you, but passing the mucus plug is not a clear indication that labour is about to start. In fact, some women pass their mucus plug weeks before going into labour. However, passing the mucus plug does mean that your body is starting to prepare for labour. If you have passed your mucus plug before going into labour, your cervix will continue to secrete mucus and then plug will rebuild itself. Amazing, right? Some women even report losing their mucus plug more than once. Some women will only lose their mucus plug when they are in the throes of labour, and this is totally fine too.

Should I call my healthcare provider? If the mucus is clear, tinged pink or slightly bloodied, then there is no need to contact your healthcare provider. There is also no need to keep a sample of your mucus plug to show to your healthcare provider at your next appointment. However, you should mention to your healthcare provider that you have passed the plug when you next see them. If your mucus plug is bright red in colour, or excessive in quantity (more than two tablespoons), you should contact your healthcare provider immediately. These symptoms can be indicative of more serious conditions including placenta previa or placental abruption. If you see blood-tinged mucus before the 36th week of your pregnancy, you should contact your healthcare provider immediately.

Written by Fiona, proud owner of a toddler, @fiona_peacock

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

Pre-eclampsia affects as many as 10 per cent of pregnancies. It is a serious condition that can affect both mother and baby. Pre-eclampsia can reduce blood flow to the placenta. If your baby does not receive enough nutrients and oxygen through the placenta, growth may be restricted. Pre-eclampsia usually occurs during the later half of the pregnancy. Women are most at risk of developing the condition after week 27.

If left untreated, pre-eclampsia can become eclampsia. Eclampsia is a serious condition that can, in rare cases, be fatal. The earlier pre-eclampsia is diagnosed, the easier it is to treat and manage. It is important you stay on the look out for symptoms of this condition.

What causes pre-eclampsia?

The exact cause of pre-eclampsia has not yet been determined, although it is believed to be related to placental malfunction. You have an increased risk of developing pre-eclampsia if:

• This is your first pregnancy.
• Your mother or sister has previously been diagnosed with pre-eclampsia.
• You have had pre-eclampsia before.
• You are over age 40.
• You had a pre-pregnancy BMI of over 30.
• You are carrying multiple pregnancies.

Symptoms of pre-eclampsia

Pre-eclampsia requires immediate treatment, so it’s important you know how to spot the signs. Contact your healthcare provider if you are experiencing any of the following symptoms:

• Excessive swelling, or edema, of the hands, feet or face
• High blood pressure
• Protein in your urine
• Severe headaches
• Visual disturbances
• Pain in the upper abdomen
• Nausea and vomiting

Your healthcare provider will run a series of tests to diagnose pre-eclampsia.Your urine and blood pressure will be tested, and you may require blood tests as well.

Treatment for pre-eclampsia

If you are admitted to hospital with pre-eclampsia, it is unlikely you will be discharged before the birth. Although some of the symptoms are treatable, the disease itself is progressive. The only way to treat pre-eclampsia, is to deliver the baby. Your healthcare provider will treat the symptoms of the condition with medication, bed rest and monitoring, until it is safe for your baby to be born.

At each antenatal appointment, your blood pressure will be taken, and a urine test will be performed. These tests aim to detect pre-eclampsia early. Often, there are no other symptoms, so it is vital you attend all of your antenatal appointments. If you are forced to cancel an appointment, make sure that you reschedule it straight away.

After the birth

You will be required to stay in hospital for a few days after the birth, so your blood pressure can be monitored. Most women find their blood pressure normalises within weeks of giving birth.

Do you enjoy this App? Good news! You can now also download our new Baby App for iPhone / iPad or Android. Click Baby+ iOS or Baby+ Android to install the App, and prepare for the arrival of your little one(s).

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

Water births are becoming increasingly popular for labouring women. Historically, water births have been used across the world. Women have given birth in the sea, rivers and steam baths throughout history. In recent years, water births are being used more frequently on labour wards, and in hospital births, too.

Advantages of a water birth

• Water aids buoyancy, and allows labouring women to change position more easily.
• Warm water on the lower back can help to relieve labour pains.
• Some women report enjoying the privacy provided by the pool. The pool effectively puts distance between the labouring woman and the midwife, which some women say helped them to relax.
• Research identified a surge in oxytocin immediately after entering the pool, this hormone stimulates contractions.

Some women choose to use a birthing pool for pain relief during the first stage, but then opt to exit the pool for the second and third stages. Other women give birth to their babies in the pool.

Water temperature

While you are in labour, the temperature of the water must be between 35°C and 37°C (95°F to 98.6°F). For the second stage of labour, the water will be kept at 37°C (98.6°F). The pool is kept at body temperature, to prevent the baby from breathing in water. Once born, it is thought to be the cold air that causes a baby’s breathing instinct kick in. By keeping the water at 37°C (98.6°F), the baby will not try to inhale until they are taken out of the water.

When should I get in the pool?

Some healthcare providers advise women to wait until they are 5cm dilated before entering the pool. Others are happy for the labouring women in their care to get in the pool as soon as active labour begins. Water births offer a form of pain relief, and many women find relief when they enter the pool. This may encourage you to get in earlier than intended on the day. Speak to your healthcare provider to find out if there are any regulations in place at your birthing centre.

Can I have a water birth?

This will depend upon your local healthcare provider and birthing facility. If you are giving birth at a hospital without a birthing pool, you will need to check in advance whether they will allow you to provide your own. If you are planning a homebirth, you will need to provide your own pool. These can easily be rented or purchased online. Some hospitals and birthing centres have pools now, so you may be able to use one of these. Speak to your healthcare provider for more details.

You may be advised not to have a water birth if you are a high risk pregnancy. You may be encouraged to give birth on dry land if you:

• Have herpes, because it transfers easily in water
• Are being induced
• Have had a previous ceasarean birth
• Are in preterm labour
• Have experienced excessive bleeding

When things don’t go to plan

Unfortunately, some women are asked to leave the pool during labour. There are a number of reasons why this could happen to you, including:

• Your baby showing signs of distress for a prolonged period of time
• The presence of meconium in your amniotic fluid
• Vaginal bleeding during labour
• If you develop a high temperature or high blood pressure

If, on the day, you find that you are asked to leave the pool, don’t panic. Or indeed, if you find that you don’t enjoy labouring in the pool and would like to get out. Stay calm, and remember your birth plan was just that, a plan. Your healthcare provider is there to ensure both you and your baby are safe and well.

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

The mucus plug is a thick column of cervical mucus which sits in the cervical canal during pregnancy, essentially forming a blockage. The mucus plug stops bacteria from getting into your uterus, and helps to keep your uterus sterile during pregnancy. Before the birth, you will lose your mucus plug, allowing the baby to pass through the cervix during labour.

Your mucus plug is made of a sticky, clear mucus, like nasal mucus, but often thicker. Towards the end of the pregnancy, you may start to lose some of your mucus plug. Some women lose the entire plug in one go, but others report the process taking up to a few days. The mucus plug is odourless but may not be the most attractive sight to behold.

What is a bloody show?

A bloody show is simply another name for a mucus plug. You may find that the mucus appears pink or brown tinged with blood, and this is why it is commonly known as a bloody show. There is nothing to worry about if your mucus plug is tinged with blood, in fact it is quite normal. It’s also normal to have a clear plug, you may also have heard it called a ‘show’.

Passing your plug

Passing your mucus plug is not always a clear indication that labour is imminent. In fact, if you pass your mucus plug over 24 hours before labour starts, your body will create a new mucus plug to take its place. Some women lose their mucus plug weeks before labour begins, however, it does mean that your cervix is starting to prepare for the birth.

Though it doesn’t mean the onset of labour will happen any minute, it does mean you should start preparing for labour. Is your hospital bag packed? Have you finished the nursery? Now is the time to finish off any loose ends around the house, and get ready to welcome your baby within the next few weeks.

You may notice you have passed a small amount of mucus after a vaginal exam or after having sex, this is usually nothing to worry about.

When to tell your healthcare provider

You can mention the plug to your healthcare provider at your next appointment, but there’s usually no need to contact them specially for this reason. However, you should contact your healthcare provider if:

• you notice blood-tinged mucus before your 37th week of pregnancy
• the mucus plug is bright red
• you pass more than two tablespoons of mucus

Written by Fiona, proud owner of a toddler, @fiona_peacock

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice.  All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

What causes round ligament pain?

Some women experience aching in the lower tummy during pregnancy. This aching is completely normal and is caused by your expanding uterus. Pregnancy hormones cause your muscles and ligaments to become more flexible. This allows them to continue supporting your uterus as it balloons in size. The round ligament holds your uterus in place, and is put under increased pressure as your uterus grows.

Round ligament pain will be most noticeable when you change positions too quickly, especially if you have been in the same position for a long period. It may also ache when you cough or sneeze.

Many women find that the discomfort worsens during the last few weeks of pregnancy. As the baby’s head engages, you may find that the ache becomes more obvious. This discomfort should disappear straight after childbirth though.

Coping with the discomfort

Unfortunately there is no cure for round ligament pain. However, you may find the following tips useful:

• Slow down – take your time getting out of bed, climbing out of cars and standing up. By taking things slow, you allow your muscles time to adapt as you change position.
• Try Yoga – attending a prenatal yoga course will help you to learn positions that will strengthen your muscles. There are a number of yoga positions that are particularly helpful for easing the discomfort caused by round ligament pain.
• Rest – make sure you are getting enough rest. Relax comfortably as often as you can to ease the strain on your body.
• Bend and flex – if you are about to sneeze, cough or laugh heartily, try bending and flexing at the hips.
• Have a massage – prenatal massage can be a great way to tackle the aches and pains during pregnancy. Tell your masseuse that you would like a massage to help with the discomfort of round ligament pain.
• Get support – Placing a pillow between your knees when lying down may also help.

If you have tried the above and are still suffering, ask your healthcare provider for advice. They may be able to advise you on a suitable pregnancy girdle or belt to help support your bump. The girdles or belts available these days are easily disguised under clothing, and may offer some relief.

When to call your healthcare provider

You should contact your healthcare provider immediately if the aching is accompanied by any of the following symptoms:

• Vaginal bleeding
• Sharp pain
• Cramping
• Fluid loss from your vagina
• Fever or chills
• Feeling faint
• Painful urination

Written by Fiona (@Fiona_Peacock), mother, writer and lover of all things baby related.

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

Your birth plan is your way of communicating the type of birth you would like, to your birth partner and healthcare provider. During labour, you may not be at your most communicative, so the birth plan will act as a reminder of your wishes. You may find it useful to write your birth plan with the assistance of your healthcare provider, as this will give you the chance to ask questions.

The best time to write a birth plan is once you are armed with information. This might be straight after an antenatal class, or a meeting with your healthcare provider, or simply an evening spent on the internet. Make sure you have fully researched all of your options before settling on any decisions.

What should be in my birth plan?

Your birth plan should cover a number of important topics, including:

• Birth partner – who is your birth partner(s)? Will they be present for the entire process?
• Location – will you give birth at home, in a midwife lead centre or in a hospital delivery suite?
• Type of birth – do you want an active birth with the use of a birthing ball or rope to pull on, or would you prefer a water birth?
• Pain relief – research this topic carefully before making any decisions. Would you prefer to have a natural birth or an epidural? There are lots of different pain relief options available.
• Interventions – would you rather avoid the use of interventions such as induction or episiotomy, or are you happy following your healthcare provider’s wishes on the day?
• Special needs – is there anything your healthcare provider should be aware of? For example, have you experienced pelvic girdle pain during the pregnancy, or have you previously struggled with postnatal depression?
• Baby – do you want to have immediate skin to skin with your baby? Would you like to hold the baby for a set amount of time before anyone else gets a cuddle?
• Third stage – would you like a natural or managed third stage? Do you want Daddy to cut the umbilical cord, or would you prefer to leave it attached until the blood has finished pumping through it?
• Feeding – do you plan to breastfeed? Would you like assistance and support to help you with this process?

Once you have researched and answered the above questions, you can start writing your birth plan. This will help your healthcare provider to best meet your needs on the day of the birth. Talk through your choices with your birth partner – it may come down to him or her on the day because you’ll be otherwise engaged!

Most importantly, remember that this is just a plan of how you would ideally like to give birth, it is not a guarantee. Your healthcare provider will try their best to offer you the birth you want, but it is not always possible. If, on the day, things do not go the way you planned, try not to worry. Focus on the task in hand, and remember, it will all be worth it when you are holding your baby for the first time.

Need help writing a birth plan? Consider using our Pregnancy App to plan.

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

During pregnancy, your pelvic bones and rib cage open up slightly to allow for the expanding baby inside you. The placenta produces relaxin, a hormone that softens your ligaments and allows your joints to loosen. With all of these changes taking place in your body, it’s no wonder that nature has a few glitches. Twenty per cent of pregnant women will experience some degree of pelvic girdle pain (PGP).

What causes Pelvic Girdle Pain in pregnancy?
The exact cause of PGP in pregnancy is unknown. It is unclear whether too much relaxin is to blame, or whether it is simply that some women are less able to cope with their changing postures. The sooner that PGP is diagnosed, the better, as this will allow you to start treating it.

Symptoms of Pelvic Girdle Pain in pregnancy
PGP usually causes aches and pains in the general pelvic area. Hip pain, back pain and buttock pain can also be symptoms of this disorder. Some women described the symptoms as feeling like a pulled muscle or severe muscle ache. If you think you may be experiencing PGP, speak to your healthcare provider as soon as possible.

Treatment for Pelvic Girdle Pain in pregnancy
Depending on the severity of your condition, you may be referred to a specialist for expert advice on how to deal with the discomfort caused by PGP. In the meantime, the following points may help you to manage any discomfort:

• Wear flat, comfortable shoes
• Ensure your back is well supported when sitting. A straight back is much better than a slump
• Sleeping with a pillow between your knees may help to keep your pelvis correctly aligned in the night
• If climbing the stairs is painful, try taking them one at a time
• Don’t lift any heavy objects – unfortunately this includes toddlers who might be looking up at you wanting a cuddle
• Don’t partake in any one sided activities such as vacuuming or decorating
• Slow down. Taking your time getting into cars, walking to work and getting out of bed reduces the risk of causing further damage

Birth and Pelvic Girdle Pain
PGP should not affect the type of birth you have. Unless you have particularly severe PGP, you should be able to give birth naturally. You may find that a water birth provides extra support during labour, and takes pressure off your hips. Speak to your healthcare provider to see if a water birth is an option for you.

Most women find that the pain disappears straight after the birth. For a very small number of women, symptoms may persist. If you find you are still suffering in the weeks following the birth, speak to your healthcare provider.

Written by Fiona (@Fiona_Peacock), mother, writer and lover of all things baby related.

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

Just over two per cent of women choose to have a home birth in the UK, and in the US this number drops to less than one per cent. Women who choose home birth often say they feel more comfortable at home, and wanted the birth to take place out of a medical setting. If you are planning a home birth, there are a number of points to consider.

How to plan a home birth:

1. The location – you need to decide where in your home you’d like to give birth. You will need a private room, so if your living room looks out onto the street and doesn’t have any curtains – it might not be the right option! If you’re planning to give birth in a pool, you’ll need strong floorboards so a downstairs room will probably be best, ideally close to some taps!
2. The audience – who do you want to be there? Do you want a doula, or your mum or best friend, as well as your partner? If you have any children, do you want them to witness the birth too? Remember, space will play a factor in these decisions, so consider it carefully before setting up the Facebook Event!
3. The props – the healthcare provider will provide a home birth kit with all the bits they need, but there are things you’ll need to provide yourself. You’ll need some plastic coverings or dust sheets to protect your cream carpets, and plenty of clean towels for after the birth.
4. Setting the scene – one of the great things about having a home birth, is that you can control the ambience. Do you want candles, fairy lights, music or silence? Try to have all bases covered in case you change your mind on the day.
5. Ice, ice baby – you will need plenty of ice cubes and drinks of water to keep you hydrated during the birth. Electrolyte replacement drinks are also a good idea for if your energy starts to lag part way through the labour. Some women like to graze on snacks throughout the labour so make sure you have something suitable in, just in case.
6. Pain relief – If you think you may require painkillers, you may be able to get opiates (such as pethidine) prescribed in advance by your healthcare provider. If you want to use paracetamol, a TENS machine or a birthing pool as pain relief, you will need to organise these yourself.
7. Tidying up -The downside of a home birth is that there are no hospital cleaners to come and sort out the mess for you afterwards. Luckily, your birth partner is on hand for that job. While you get to know your new baby, your birth partner can quickly dispose of any mess, deflate the pool and get things looking habitable again – ready for the swarm of visitors over the coming weeks.

If you are deemed to have a high risk pregnancy, you are unlikely to be granted a home birth. If you are having a low risk, healthy pregnancy then your healthcare provider should see no problem in granting you a home birth. If there were any complications during the birth, you would be transferred to hospital immediately – so it’s important to have a skilled midwife present. If you have any worries or concerns about planning a home birth, speak to your healthcare provider. They will be able to reassure you and answer any questions you may have.

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

The placenta is an organ that grows specifically to facilitate this pregnancy, and is attached to the uterine wall. It provides hormones and nutrients to the baby, and is connected to the baby by the umbilical cord. As pregnancy progress, the uterus grows and stretches and this moves the placenta away from the cervix. If this does not happen, the placenta may remain near to or covering the cervix. This condition is known as placenta previa.

The exact causes of placenta previa are unknown. However, the risk of developing placenta previa is slightly greater for women:

• aged 35 or over
• who have experienced previous placenta previa
• who have had previous caesarean births
• who are carrying twins or more
• who smoke
• who use cocaine
• who have suffered miscarriages in the past

How is placenta previa diagnosed?

The location of the placenta will also be noted during your 18-21 week scan. If the sonographer thinks your placenta is low-lying, you will be offered a second scan later in the pregnancy. This will typically happen at around week 32. At this second scan, around 90% of women will discover that the placenta has moved to where it should be.

If your placenta is still low lying at the second scan, you will be monitored by your healthcare provider until the birth, or until the placenta moves. You may be:

• put on bed rest
• put on pelvic rest (this means no sex, no orgasms and no vaginal exams)
• admitted to hospital for the last few weeks of the pregnancy
• Advised to take it easy (no heavy lifting or activities that may put you under unnecessary strain)

Your treatment will depend upon the severity of your condition. There are three different diagnoses:

• Low-lying placenta – the placenta is close to, but not covering, the cervix
• Partial placenta previa – part of the cervix is covered by the placenta
• Total placenta previa – in this instance, the entire cervix is obstructed by the cervix

The risks associated with this condition include bleeding, reduced fetal growth and separation of the placenta from the uterine wall. Your healthcare provider will assess your risk factors and advise on the best course of treatment.

Will I be able to have a normal birth?

If the placenta is near or covering the cervix at the time of the birth, you will be unable to have a vaginal delivery. You will instead deliver by caesarean surgery. Placenta previa is a rare condition which is only present in 0.5% of births.

You should contact your healthcare provider immediately if you experience vaginal bleeding.

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

When you are pregnant, you think that you can eat just anything you want. Your main excuse is that you are eating for two. Although that is true, you only really need 200 extra calories a day in the third trimester in order to support the growth and development of your baby. You need to be careful about how much weight you gain during pregnancy. Gaining too much or too little can be harmful to both you and your baby.

How much weight gain during pregnancy is acceptable?

Ask your healthcare provider how much weight you should gain. In general, you should gain approximately 2-4 pounds in the first trimester and 1 pound for each week after that. A woman of average weight should gain about 25 to 35 pounds during pregnancy. Underweight women should gain 28 to 40 pounds while overweight women need to gain only 15 to 25 pounds.

If you’re expecting twins, you should ideally gain 35 to 45 pounds during your pregnancy. Weight gain during pregnancy is especially important when you are expecting twins since your weight affects the weight of your babies. Twins are usually delivered early, so they benefit from some extra weight at birth. You may need to consume 3,000 to 3,500 calories a day.

What happens if you gain too little or too much weight?

Women who gain too much weight have a higher chance of a Caesarean delivery. They also tend to retain much of their weight after pregnancy and start with a higher weight in their following pregnancies. This can be a problem with women who are already overweight, as this increases their risk of complications, such as preeclampsia and gestational diabetes.

Children whose mothers were overweight during pregnancy are also more likely to become obese themselves. In addition, obesity may lead to problems with breastfeeding due to poor milk production and difficulty with positioning.

On the other hand, underweight women are at high risk of delivering a preterm infant or a low birth weight baby. This also causes health problems that may be harmful to the baby.

Weight gain during pregnancy should be slow and steady. Do not worry too much if you gain a little more or a little less than you should in a week – look at the big picture and overall weight gain.

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.