In this video, midwife Denise Linay explains the trimesters during pregnancy.
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Wendy Turner-Webster: Although most women who are expecting a child read pregnancy text books avidly, there are still all sorts of questions and anxieties they have about what they should and shouldn't do when pregnant. With me in the studio from the Royal College of Midwives is Denise Linay to answer questions on some of the do's and don't's. Welcome Denise.
Denise Linay: Hello!
Wendy Turner-Webster: Now I've got a whole list of questions here for you which I am sure you're extremely familiar with, but if I can I am going to start with one of the major topics which is diet and food.
Denise Linay: Okay!
Wendy Turner-Webster: What should and shouldn't we eat while pregnant?
Denise Linay: Well, what we should eat while pregnant is a well balanced diet. But the utmost concern to women is what we shouldn't eat when pregnant.
Wendy Turner-Webster: So what are some of the real no-noes?
Denise Linay: Well, things like soft cheeses like Brie and Camembert. Things like stilton where listeria could be a problem and raw eggs where salmonella could be an issue. So things like mayonnaise, that's been made from raw eggs, custard that's been made from raw eggs, that type of thing.
Wendy Turner-Webster: Exactly what harm will that do? How harmful would that be?
Denise Linay: Well, certain things that listeria can cause abortion which is catastrophe for the new mother.
Wendy Turner-Webster: Absolutely, yes.
Denise Linay: So those things should be avoided.
Wendy Turner-Webster: That really is purely for medical reason, isn't it? I mean, what about things like spicy food and you know if anything like that?
Denise Linay: I think when you're pregnant, you are more likely to have heartburn and spicy food could bring on that heartburn, but it is no danger to the mother, just uncomfortable and if you're prepared to see utmost at night waiting for your heartburn to subside then it's up to you. But it won't be of any danger.
Wendy Turner-Webster: I think certainly when you're pregnant, you know what you do and don't want? Don't you me more specifically? If you want ice cream and peanut butter and you have it.
Denise Linay: That's why and certainly some -- when I was pregnant I just wanted the starchy food at the beginning of pregnancy. Things like chips and sausage rolls that type of thing. I think you should go for what your body is telling you to do.
Wendy Turner-Webster: Having said that, I do remember my doctor saying to me, when I first went in and I was pregnant and he said a piece of advice, don't pig out because you feel you can when you're pregnant, because it'd be difficult to lose the weight afterwards and I think we are all guilty, aren't we, wow, this is a good excuse to eat.
Denise Linay: Yes, it is difficult. It can be difficult to lose afterwards. I mean, there is this view that if you are breastfeeding, it would just fall off of you. But the --
Wendy Turner-Webster: It didn't fall off me.
Denise Linay: Right. It didn't fall of me. But when you're breastfeeding you need more calories, so I think you could be breastfeeding and you are ravenous the whole time because you are using out so many calories, so it doesn't necessarily fall off of your breastfeeding.
Wendy Turner-Webster: Okay! Well. What about drink? Before we go into alcohol, are there any soft drinks that should really be avoided while you're pregnant or not?
Denise Linay: I don't think so.
Wendy Turner-Webster: No, you can go with any of those. There's no problem with those. Alcohol though, what about that?
Denise Linay: Well, alcohol is a bit different, and certainly midwives have for number of years been into a situation where we are never sure what to advice women? Certainly now, the advice coming from NICE is that we shouldn't be drinking or women shouldn't be drinking more than 1-2 units per week.
Wendy Turner-Webster: Sorry, what's NICE?
Denise Linay: The National Institute of Clinical Excellence.
Wendy Turner-Webster: Right. Okay! Sorry. They are saying what?
Denise Linay: 1-2 units per week.
Wendy Turner-Webster: Right. Per week not per day, which might be.
Denise Linay: Unfortunately.
Wendy Turner-Webster: No. And does it matter what those units are? Should it be red wine or stout or something.
Denise Linay: No.
Wendy Turner-Webster: No. --
Denise Linay: If you can only have one or two units, you can almost drink something that you really fancy.
Wendy Turner-Webster: Absolutely, yes. But I am sure I was told to avoid spirits. No, you like, you couldn't have a gin and tonic -- yes, I was specifically told. Who would have told me that? Not to have the gin and tonic.
Denise Linay: I don't know.
Wendy Turner-Webster: I missed out - see, I couldn't had my gin and tonic.
Denise Linay: You could have had two gin and tonics a week.
Wendy Turner-Webster: Absolutely. Well, there is something you live and learn. Okay! What about exercise. I mean it's a marvelous excuse not to exercise being pregnant, isn't it? Someone lazy like myself, it's fantastic.
Denise Linay: But then you can have the same problem about putting on the extra weight I mean if you are somebody that exercises 3-4 times a week, then you shouldn't give that up just because you're pregnant.
Wendy Turner-Webster: But I am assuming, you can't really go down to the gym and get on a treadmill, can you?
Denise Linay: Yes, you can, you can.
Wendy Turner-Webster: And rowing machine?
Denise Linay: Yes. If is always comfortable for you.
Wendy Turner-Webster: Really.
Denise Linay: And if you're used to that level of exercise than there's no reason why you can't carry on until you start feeling uncomfortable in doing that.
Wendy Turner-Webster: Right.
Denise Linay: What you shouldn't be doing is embarking on a new regime of exercise.
Wendy Turner-Webster: You suddenly start aerobic classes, isn't a good idea?
Denise Linay: Yes, just because you're pregnant and you want to keep your weight down, that wouldn't be a good idea. And certainly non-weight bearing exercise would be preferable, things like swimming, things like running a marathon, because there is the pressure on the joints which can be disadvantageous when you're pregnant.
Wendy Turner-Webster: If you're going to recommend an ideal exercise, would it be swimming?
Denise Linay: I should. I think so. Swimming will be an ideal exercise.
Wendy Turner-Webster: What about something like yoga and those sort of very gentle thing?
Denise Linay: If you're used to. Because I have done yoga, it can be quite strenuous and if you're used to it then yes, but not if you --- you don't want to start on something like that just because you're pregnant -- something that you're used to.
Wendy Turner-Webster: Yes. And does the advice change throughout the pregnancy, the first month to the ninth month?
Denise Linay: No, it's really what your body is comfortable with because you do see women down the gym that are heavily pregnant and they are fine.
Wendy Turner-Webster: So it's really go with your own body, isn't it?
Denise Linay: Almost definitely. Of course if the pregnancy becomes complicated in some way and your doctor or midwife is advocating that you rest, then you shouldn't be going down the gym and exercising for hours at that time.
Wendy Turner-Webster: So another lifestyle question, what about smoking, I mean I think I know the answer because that is the total no surely.
Denise Linay: Yes, smoking is associated with so many complications of pregnancy and also illness and even death in the newborn that we would advocate that mother should try to give up smoking if they are smokers to start with.
Wendy Turner-Webster: And what if someone said to you, well, you know just one every other day just keeps me less stressed or something.
Denise Linay: If you are only smoking one of the other day, you want to give up totally.
Wendy Turner-Webster: Does it surprise you, if you see an obviously pregnant woman smoking and if I see it I always find it quite shocking.
Denise Linay: Well, it's an addiction. Isn't it? It's going to be very difficult to give up smoking for some people and the stresses of being pregnant often maybe it's not good time to give up.
Wendy Turner-Webster: Of course yes. I've got a friend who remember she is bit older than me and she remembers having a baby and this was in the 60s, breastfeeding the baby and holding in one hand and having a cigarette in the other and really it was at a time when it wasn't as shocking then to do that and of course often times change.
Denise Linay: No, I mean certainly now, even if you were a smoker, you would always -- women would tend to go out of the room to have their cigarette, certainly not be smoking while they're breastfeeding.
Wendy Turner-Webster: Absolutely, yes. Oh! Wow! An obvious lifestyle one is drugs but again that's - could be an addiction.
Denise Linay: Yes. And the only drugs that you should be taking throughout your pregnancy are ones that are prescribed by your doctor.
Wendy Turner-Webster: And really I suppose if somebody is truly worried about either drugs or drink or smoking they should really go and see their doctor and get some proper advice and help.
Denise Linay: Yes, or speak to their midwife who can refer to them other agencies.
Wendy Turner-Webster: What is morning sickness? And why do some people get it so badly and others just sail through their pregnancy relatively morning sickness free.
Denise Linay: Well, up to 80% of women do suffer from some sort of morning sickness or nausea and we're not really sure what causes it but it's believed to be as a consequence of the various hormones in early pregnancy, particularly a hormone called Human Chorionic Gonadotropin which is important for the placenta to embed into the uterus.
Wendy Turner-Webster: Is it usually in the very first stages of pregnancy or can you get it throughout?
Denise Linay: You can get it throughout.
Wendy Turner-Webster: But it's more common initially, isn't it?
Denise Linay: Yes, because of that Human Chorionic Gonadotropin that hormone tends to diminish after about the 14th week, so the morning sickness tends to go away at that stage.
Wendy Turner-Webster: It can be very debilitating, can't it for some people, especially it you are trying to work?
Denise Linay: Of course, certain types of that sickness can be life threatening if not treated.
Wendy Turner-Webster: Really.
Denise Linay: Yes. But in majority of women, it tends to be just nausea and maybe sickness in the morning and for some women it can be quite comforting because if you've got that feeling of nausea when there is no other obvious signs that you're pregnant, it's a continuous reminder that you're pregnant.
Wendy Turner-Webster: Oh! Really? Is that, I haven't thought of it like that. Is there anything that you would recommend to counter act it, to make you feel better basically and what kind of things could you take?
Denise Linay: The usual remedy for morning sickness is the dry biscuit on waking. Things like ginger ale often recommended that type of thing. Certainly if it is more severe than that you need to be speaking to your midwife or your doctor about taking some sort of drug that would stop the morning sickness.
Wendy Turner-Webster: So it's like a stomach settler type of thing.
Denise Linay: Yes.
Wendy Turner-Webster: Okay! I was lucky actually I didn't really suffer from morning sickness too badly, so I was very thankful for that. Okay! What if, you've had an abortion before or even multiple abortions, how will that affect a pregnancy?
Denise Linay: Well, maybe one or two abortions shouldn't affect the pregnancy. If you're getting to the stage of multiple abortions, that could have a detrimental effect on the cervix because it can cause the damage to the cervix. In situations like that the cervix can become incompetent, which is the term that's used, so it won't retain the pregnancy.
Wendy Turner-Webster: So you miscarry?
Denise Linay: You miscarry or you go in to preterm labor, but it can be remedied, if you get to fourteen weeks by having a suture put around the cervix to keep the cervix closed.
Wendy Turner-Webster: What's that exactly -- just to?
Denise Linay: It's just a suture, just like a purse string.
Wendy Turner-Webster: Oh! I see.
Denise Linay: It's just tied around the cervix and keeps it together and then as you approach term it will be removed and so the cervix can open naturally.
Wendy Turner-Webster: And you mentioned something called preterm labor, just explain that to me again?
Denise Linay: Well, when you go into labor before a term.
Wendy Turner-Webster: I see.
Denise Linay: We classify term as being anywhere between 37 and 42 weeks of pregnancy so anything before 37 weeks classed as preterm labor.
Wendy Turner-Webster: And of course one of the major worries that a pregnant has is the fear of miscarriage, and in those initial first weeks or first months, if you bleed, does that necessarily mean, that's going to be trouble.
Denise Linay: No.
Wendy Turner-Webster: Just explain that to me because I know some people do bleed and perhaps even don't think that they are pregnant at first.
Denise Linay: We certainly have women that go through whole pregnancy having small breakthrough bleed when their period would have been due. I think more importantly as women have bleeding at the first few weeks and that might be as a consequence of a threatened abortion, a threatened miscarriage, abortion is a medical term, and women may feel that because they've had that threatened miscarriage in the early weeks, that they are at risk in the later part of pregnancy but that isn't necessarily so. And the chances are if you have had a threatened miscarriage, you go on and have a normal healthy baby.
Wendy Turner-Webster: Is there anything that you should avoid? Is there anything, I don't know very common also somebody -- something to avoid a miscarriage is what I am trying to say, is there any types of -- we talk before about foods or exercise, is there some no-noes that you've really should avoid to avoid a miscarriage?
Denise Linay: Well, I think, nothing so much -- speaking about drinking, smoking, drugs and certain foods, certainly one of the things that we didn't mention was uncooked meats and they can contain an organism that can cause toxoplasmosis which can result in miscarriage. Pregnant women also often should be advised not to deal with cat litter.
Wendy Turner-Webster: Yes. Now that one of my questions because I remember when I was pregnant working with animals and I had to avoid both sheep and cats.
Denise Linay: Yes. Cats is -- because again this toxoplasmosis, which you can find in raw and uncooked meats and so you should avoid changing cat litter unless you are wearing gloves.
Wendy Turner-Webster: Right. But let's be clear, it doesn't that you suddenly have to get rid of your pet cat.
Denise Linay: Oh! Certainly not and I certainly didn't get rid of mine.
Wendy Turner-Webster: And what about the sheep, do you know about that?
Denise Linay: I think that's --
Wendy Turner-Webster: Or is it newborn lambs or something.
Denise Linay: It's newborn lambs --
Wendy Turner-Webster: Yes.
Denise Linay: I never worked in a hospital that dealt with a farming community - it was never an issue.
Wendy Turner-Webster: Never really an issue.
Denise Linay: For me --
Wendy Turner-Webster: Okay! Perhaps somebody can get some specific advice on that if they're worried. And of course bringing it to a more personal level, what advice would you give ladies who are concerned about making love during their pregnancy.
Denise Linay: To carry on. There's no reason why you can't carry on having a normal sex life while you're pregnant. The baby is perfectly protected inside the uterus and if however there is a history of certain miscarriage or preterm labor or bleeding then you maybe advised to refrain. The another positive thing is that during pregnancy the blood flow to the pelvis is increased, so sexual pleasure can be increased.
Wendy Turner-Webster: Am I right in saying or is this a myth that around the due date having sex can induce labor?
Denise Linay: Unless you really put that way but certainly semen contains progesterone which can help ripen the cervix.
Wendy Turner-Webster: That's where I am getting it from.
Denise Linay: Yes.
Wendy Turner-Webster: Perhaps I put it slightly more simply than that.
Denise Linay: So if somebody is coming up to term and they want to induce their labor naturally then midwifes would often tell them to go home and have sex.
Wendy Turner-Webster: And curry, or is that a myth? We hear it so often though, friend of mine said it the other day, curry and sex at the same time.
Denise Linay: No bit messy.
Wendy Turner-Webster: Yeah. Absolutely. Okay! Let's get on to a very common problem and I know I suffered from it dreadfully, lower back pain. Any hints on what you can do to combat that?
Denise Linay: Well, lower back pain is a consequence again of hormones that do terrible things to pregnant woman's body. But they cause softening of the ligaments around the pelvis and their prime purpose is to make sure the pelvis can expand slightly when the baby is delivered, but it can cause pain certainly when you're carrying around the baby and also there's kind of a change in position - you tend to see pregnant women push themselves on and like that. So that's what can cause the low back pain. And really it's the only things you can do is to limit your activity, your body would tell you when to stop, wear a low shoes and to rest and to try and correct any changes in posture that --
Wendy Turner-Webster: Yes and get yourself into a comfortable position when you can. What about specifically massage and yoga or anything like that.
Denise Linay: It's possible. Yes, I think you need to seek advice on that because certainly you wouldn't go, you need to be careful who you got the massage from, you need somebody that's competent in massaging a pregnant woman.
Wendy Turner-Webster: Now it just reminded me of another thing, am I right in saying that when you're pregnant there are some essential oils that are to be avoided.
Denise Linay: Yes, there are. I am not sure what they are.
Wendy Turner-Webster: No and I couldn't tell you what they are but I know-- I am pretty sure that's true, so possibly if one is thinking of getting a massage, let's say that the person who is doing it will probably know that, that is a point, isn't it?
Denise Linay: Yes.
Wendy Turner-Webster: And Cramp especially at night in your legs, not to have more salt.
Denise Linay: No. it's actually thought to be as a result of fluctuating calcium and magnesium levels, not sodium levels. Although there was some research done back in the 1940s and they suggested salt would help, of course it was a different diet then and there is no evidence to suggest now that salt would help.
Wendy Turner-Webster: So what do you have to do, sort of put up with it?
Denise Linay: Well, again gentle leg exercises maybe elevating the foot of the bed slightly, so your legs are slightly raised and that type of thing.
Wendy Turner-Webster: Now we talked about exercise earlier and obviously going down to the gym and that shouldn't be a problem and swimming which is very good exercise, of course what most of the gym complexes have is steam, sauna, Jacuzzi, of course, if you go to the gym, you love and enjoy, what if you're pregnant?
Denise Linay: I think you should avoid sauna and any type of activity that makes you sweat and --
Wendy Turner-Webster: Sweat profusely --
Denise Linay: Yes. And certainly there is some research that does suggest that if you've never took part in this sort of activity before and then undertake it during pregnancy, it can cause congenital abnormalities in the baby.
Wendy Turner-Webster: Would that go also lumping together steam and jacuzzi with that, then?
Denise Linay: Anything that causes to heat up unnaturally and certainly in some health clubs, they don't allow pregnant women to use saunas and --
Wendy Turner-Webster: Certainly I've seen those warning signs up there that say that. Talking about exercise again, are there any specific exercises we hear about pelvic floor for instance, that you should be doing whilst you're still pregnant to make it easier either during the birth or afterwards, is there anything you can do to help yourself.
Denise Linay: Well, pelvic floor exercises are extremely important in the postnatal period, primarily to stop developing stressing consonants as a consequence of the birth. They can be quite difficult to learn, so having a newborn baby and then having to learn to do pelvic floor exercises may not be the best combination.
Wendy Turner-Webster: You got the time and the energy.
Denise Linay: So it would be useful if you did learn to do those exercises to strengthen your pelvic floor, prior to having the baby, and it is something that women should be undertaking all the time, not just in the postnatal period.
Wendy Turner-Webster: What are your general sort of tips for people who are getting stressed by the fact that they are pregnant? Do you come into contact with people who -- it's absolutely sort of -- especially if it's their first child, you can read all the textbooks in the world, can't you but --
Denise Linay: Well, maybe that's the problem. Maybe they are reading too many textbooks.
Wendy Turner-Webster: Yes. What would you say, just perhaps -- sometimes you know too much, don't you?
Denise Linay: I think women need to enjoy their pregnancy and reading too much and all the things could go -- and a majority of women have a normal healthy pregnancy and a normal healthy baby at the end of it and life is too short to worry about everything that could go wrong.
Wendy Turner-Webster: Absolutely, and I remember my obstetrician saying to me now that you mustn't forget this is a pregnancy not an illness.
Denise Linay: That's right.
Wendy Turner-Webster: Of course there is one thing that my husband kept reminding me of throughout.
Denise Linay: Yes. We do want to be treated in a special way, don't we when we are pregnant.
Wendy Turner-Webster: Absolutely.
Denise Linay: Because as soon as the baby comes along, you come second.
Wendy Turner-Webster: Well, the focus does indeed shift from you to baby.
Denise Linay: Just make the most of those precious nine months.
Wendy Turner-Webster: Absolutely yes, well you have given us very good answers to our list of questions, Denise thank you very much.