Dental Care During Your Pregnancy: What You Need to Know

We all know that what you eat during pregnancy affects the growth of your baby. Did you also know that what you eat affects the development of your baby’s teeth? Teeth begin to develop between the third and sixth month of pregnancy and what you eat or don’t eat while pregnant can have long lasting affects on your baby’s teeth. It is important to make sure you are getting the nutrients needed to promote healthy teeth for your baby’s future. Those nutrients are calcium, protein, phosphorous, and vitamins A, C, and D.

Another area that expectant mothers should be aware of during pregnancy is the health of your gums. Research suggests that the bacteria that causes inflammation in the gums causing Periodontal Disease (gum disease) can actually get into the mother’s bloodstream and target the fetus, potentially leading to premature labor and low birth weight babies. When plaque builds up on your teeth making your gums red, swollen, and likely to bleed, it is called gingivitis. During pregnancy, your hormone levels rise greatly making your gums more sensitive to gingivitis and it is common to have what is called “gestational gingivitis”. Regular dental visits and cleanings are imperative to keep this condition from progressing into the Periodontal Disease that can be detrimental to your child.

Lastly, there is understandable concern about the amount of radiation a woman is exposed to during pregnancy. It is important to know, however, that the amount of radiation from digital dental x-rays is very low.

It is actually more risky for a pregnant woman to go without necessary dental care than it is to have a dental x-ray. Untreated dental disease and other issues can lead to problems for you and your baby.

When having a dental x-ray during pregnancy, make sure your dentist is using digital x-rays for the lowest amount of radiation exposure. Also, ask to have two lead aprons placed over your belly just as an extra precaution.

During pregnancy it is important to keep up with your dental care, including regular visits to the dentist. If you are ever worried about treatment, x-rays, or a drug prescribed during pregnancy, discuss those concerns with your dentist and physician. It is important to be well informed of all the risks involved with having or postponing dental treatment.

How To Prepare When You Are Expecting Healthy Twins

If you’re pregnant with more than one baby, a healthy diet and lifestyle will help you cope with your pregnancy and give your babies the best start in life.

The advice for keeping healthy in pregnancy is similar whether you’re expecting twins, triplets or just one baby. Eat well, take gentle exercise, drink lots of fluid and, if you feel stressed, get support from friends and family, or talk to your midwife. It’s also important to attend all your antenatal (*prenatal) appointments so your maternity team can keep a close eye on you and your babies.

From www.nhs.uk

How Can I Avoid Food Poisoning During Pregnancy?

You can avoid food poisoning during pregnancy by:

• not eating some foods – see foods to avoid during pregnancy
• washing your hands before handling food
• thoroughly washing all fruit and vegetables, including prepared salads, before eating
• washing your hands, all surfaces and utensils after preparing raw meat
• thoroughly cooking raw meat so there is no trace of pink or blood
• heating ready meals (*pre-packaged meals) until they are piping hot all the way through – this is especially important for meals containing poultry
• keeping leftovers covered in the fridge and using them within 2 days
• eating food before it has passed its “use by” date
• preventing cross-contamination (when harmful bacteria is spread between food, surfaces and equipment)

There are several types of bacteria that can cause food poisoning. These include:

• salmonella
• campylobacter
• listeria

Salmonella

Salmonella is found in:

• raw meat and poultry
• unpasteurised milk
• raw eggs and raw egg products

Although salmonella food poisoning is unlikely to harm your baby, it can cause severe diarrhoea and vomiting.

To reduce your risk of salmonella infection:

• choose British Lion Code of Practice eggs (in the UK) if you want to have raw or partially cooked eggs – these eggs have a red lion logo stamped on their shell and are considered safe to eat runny
• avoid raw or partially cooked eggs that are not part of the lion code, and avoid food that may contain them, such as homemade mayonnaise – cook these eggs until the whites and yolks are solid
• avoid raw or partially cooked meat, especially poultry

Campylobacter

Campylobacter is found in:

• raw and undercooked meat, especially poultry
• unpasteurised milk
• untreated water

You can reduce your risk of campylobacter infection by:

• washing your hands thoroughly before preparing and eating food, and after handling raw food
• not washing raw poultry
• keeping cooked food away from raw food
• cooking food thoroughly, especially meat and poultry, so it’s piping hot
• keeping all kitchen surfaces and equipment clean, such as chopping boards and dish cloths
• not drinking untreated water from lakes, rivers or streams

Listeria

Listeria can cause an infection called listeriosis. Although the infection is rare, even a mild form of listeriosis in a pregnant woman can lead to miscarriage, stillbirth or severe illness in newborn babies.

Listeria can be found in unpasteurised milk and in many chilled foods, including:

• pâté
• mould-ripened soft cheeses and soft blue-veined cheeses
• cooked sliced meats
• smoked salmon

You can reduce your risk of listeriosis by:

• not eating certain foods while pregnant, such as some soft cheeses and all types of pâté – see foods to avoid during pregnancy
• not drinking unpasteurised milk – only drink pasteurised or UHT milk
• heating ready meals or reheated food until they’re piping hot all the way through
• making sure your fridge is set at 5C or below and working correctly
• not using food after its “use by” date

Read the answers to more questions about pregnancy.

Further information:

• Why can’t I eat soft cheeses during pregnancy?
• Should I limit caffeine during pregnancy?
• Listeriosis
• Food safety
• Have a healthy diet in pregnancy
• Foods to avoid during pregnancy

Editor’s Note:

* Clarification Provided for our U.S. Readers

From www.nhs.uk

Video: Breach Births – Choices for Moms to Be

This film explores the choices women need to make when faced with the dilemma of a breech pregnancy. A baby is in the breech position if it is lying bottom or feet first. Roughly 3 in every 100 babies are in the breech position at full-term.

Editor’s Note: Video Highlights

No-one expects their baby to be breech. Know that there is no particular reason why this happens and there are choices that are available to you.

First Option to Consider: External Cephalic Version (ECV)

• ECV – performed by doctor or midwife
  • Using hands externally to manipulate baby by gently pushing on mom’s tummy to try and move baby to a heads down position
  • First step is an injection that relaxes the muscles in the womb, improving the likelihood of success in turning the baby
  • Next step is typically to lift baby’s bottom out of the pelvis and attempt to turn one way. If unsuccessful, an attempt is made to turn the other way
  • Procedure can vary in degree of discomfort from mildly uncomfortable to somewhat painful depending on position of baby.

If ECV is Successful

• Vaginal birth or Cesarean section – for other reasons
• It is rare that the baby will reverse and turn back

If ECV is Unsuccessful

• Planned Cesarean section – will take time for body to recover from procedure – cannot drive for period of time
• Vaginal breach birth (baby is born vaginally in breach position)

There’s always the possibility that your baby will turn spontaneously before the birth

Discuss your options with your GP or Midwife to determine the best for you and your family

From www.nhs.uk

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Choosing a C-Section: What Is It and When Is It The Best Option?

A caesarean section, or C-section, is an operation to deliver your baby through a cut made in your tummy and womb.

The cut is usually made across your tummy, just below your bikini line.

A caesarean is a major operation that carries a number of risks, so it’s usually only done if it’s the safest option for you and your baby.

Around one in every four to five pregnant women in the UK has a caesarean.*

Why caesareans are carried out

A caesarean may be recommended as a planned (elective) procedure or done in an emergency if it’s thought a vaginal birth is too risky. They’re usually performed after the 38th week of pregnancy.

A caesarean may be carried out because:

• your baby is in the breech position (feet first) and your doctor has been unable to turn them by applying gentle pressure to your tummy, or you would prefer they didn’t try this
• you have a low-lying placenta (placenta praevia)
• you have pregnancy-related high blood pressure (pre-eclampsia)
• you have certain infections, such as a first genital herpes infection occurring late in pregnancy or untreated HIV
• your baby isn’t getting enough oxygen and nutrients – sometimes this may mean the baby needs to be delivered immediately
• your labour isn’t progressing or there’s excessive vaginal bleeding

If there’s time to plan the procedure, your midwife or doctor will discuss the benefits and risks of a caesarean compared with a vaginal birth.

Asking for a caesarean

Some women choose to have a caesarean for non-medical reasons. If you ask your midwife or doctor for a caesarean when there aren’t medical reasons, they will explain the overall benefits and risks of a caesarean compared with a vaginal birth.

If you’re anxious about giving birth, you should be offered the chance to discuss your anxiety with a healthcare professional who can offer support during your pregnancy and labour.

If after discussion and support you still feel that a vaginal birth isn’t an acceptable option, you’re entitled to have a planned caesarean.

What happens during a caesarean

Most caesareans are carried out under spinal or epidural anaesthetic. This mean you’ll be awake, but the lower part of your body is numbed so you won’t feel any pain.

During the procedure:

• a screen is placed across your body so you can’t see what’s being done – the doctors and nurses will let you know what’s happening
• a cut about 10-20cm long will usually be made across your lower tummy and womb so your baby can be delivered
• you may feel some tugging and pulling during the procedure
• you and you birth partner will be able to see and hold your baby as soon as they’ve been delivered

The whole operation normally takes about 40-50 minutes.

Occasionally a general anaesthetic, where you’re asleep, may be used, particularly if the baby needs to be delivered more quickly.

Read more about how a caesarean is carried out.

Recovering from a caesarean

Recovering from a caesarean usually takes longer than recovering from a vaginal delivery. You might need to stay in hospital for three or four days, compared with one or two days for a vaginal birth.

You may experience some discomfort in your tummy for the first few days, and you’ll be offered painkillers to help with this.

When you go home, you’ll need to take things easy at first. You may need to avoid some activities such as driving for six weeks or so.

The wound in your tummy will eventually form a scar. This may be red and obvious at first, but it should fade with time and will often be hidden in your pubic hair.

Read more about recovering from a caesarean.

Risks of a caesarean

A caesarean is generally a very safe procedure, but like any type of surgery it carries a certain amount of risk.

It’s important to be aware of the possible complications, particularly if you’re considering having a caesarean for non-medical reasons.

Possible complications include:

• infection of the wound or womb lining
• blood clots
• excessive bleeding
• damage to nearby areas, such as the bladder or the tubes that connect the kidneys and bladder (ureter)
• temporary breathing difficulties in your baby
• accidentally cutting your baby when your womb is opened

Read more about the risks of a caesarean.

Future pregnancies after a caesarean

If you have a baby by caesarean, it doesn’t necessarily mean that any babies you have in the future will also have to be delivered this way.

Most women who have had a caesarean section can safely have a vaginal delivery for their next baby, known as vaginal birth after caesarean (VBAC).

However, you may need some extra monitoring during labour just to make sure everything is progressing well.

Some women may be advised to have another caesarean if they have another baby. This depends on whether a caesarean is still the safest option for them and their baby.

For more information, the Royal College of Obstetricians and Gynaecologists has a leaflet on birth options after previous caesarean section (PDF, 357kb).

Editor’s Note: *clarification provided for our US readers.

*1 in 3 pregnant women in the U.S. has a caesarean

From www.nhs.uk

How to Cope With Pregnancy Morning Sickness

What is Morning Sickness

Nausea and vomiting in pregnancy, also known as morning sickness, is very common in early pregnancy. It’s unpleasant, but it doesn’t put your baby at any increased risk and usually clears up by weeks 16 to 20 of pregnancy.

Some women get a very severe form of nausea and vomiting called hyperemesis gravidarum (HG), which can be very serious. It needs specialist treatment, sometimes in hospital. Find out more about hyperemesis gravidarum.

With morning sickness, some women are sick (vomit) and some have a feeling of sickness (nausea) without being sick. The term “morning sickness” is misleading. It can affect you at any time of the day or night, and some women feel sick all day long.

It’s thought hormonal changes in the first 12 weeks of pregnancy are probably one of the causes of morning sickness.

Symptoms should ease as your pregnancy progresses. In some women, symptoms disappear by the third month of pregnancy. However, some women experience nausea and vomiting for longer than this, and about 1 woman in 10 continues to feel sick after week 20.

How common is morning sickness?

During early pregnancy, nausea, vomiting and tiredness are common symptoms. Around half of all pregnant women experience vomiting, and more than 80% of women (80 out of 100) experience nausea in the first 12 weeks.

People sometimes consider morning sickness a minor inconvenience of pregnancy, but for some women it can have a significant adverse effect on their day-to-day activities and quality of life.

Treatments for morning sickness

If you have morning sickness, your GP (*doctor) or midwife will initially recommend that you try a number of changes to your diet and daily life to help reduce your symptoms. These include:

• getting plenty of rest – tiredness can make nausea worse
• if you feel sick first thing in the morning, give yourself time to get up slowly – if possible, eat something like dry toast or a plain biscuit before you get up
• drinking plenty of fluids, such as water, and sipping them little and often rather than in large amounts, as this may help prevent vomiting
• eating small, frequent meals that are high in carbohydrate (such as bread, rice and pasta) and low in fat – most women can manage savoury foods, such as toast, crackers and crispbread, better than sweet or spicy foods
• eating small amounts of food often rather than several large meals – but don’t stop eating
• eating cold meals rather than hot ones as they don’t give off the smell that hot meals often do, which may make you feel sick
• avoiding foods or smells that make you feel sick
• avoiding drinks that are cold, tart (sharp) or sweet
• asking the people close to you for extra support and help – it helps if someone else can cook, but if this isn’t possible, go for bland, non-greasy foods, such as baked potatoes or pasta, which are simple to prepare
• distracting yourself as much as you can – the nausea can get worse the more you think about it
• wearing comfortable clothes without tight waistbands

If you have severe morning sickness, your doctor or midwife might recommend medication.

Anti-sickness remedies

If your nausea and vomiting is severe and doesn’t improve after you make changes to your diet and lifestyle, your GP (*doctor) may recommend a short-term course of an anti-sickness medicine that is safe to use in pregnancy.

This type of medicine is called an antiemetic. The commonly prescribed antiemetics can have side effects. These are rare, but can include muscle twitching.

Some antihistamines (medicines often used to treat allergies such as hay fever) also work as antiemetics. Your doctor might prescribe an antihistamine that is safe to take in pregnancy. See your GP if you would like to consider this form of treatment.

Ginger eases morning sickness

There is some evidence that ginger supplements may help reduce nausea and vomiting. To date, there have not been any reports of adverse effects being caused by taking ginger during pregnancy.

However, ginger products are unlicensed in the UK, so buy them from a reputable source, such as a pharmacy or supermarket. Check with your pharmacist before you use ginger supplements.

Some women find that ginger biscuits or ginger ale can help reduce nausea. You can try different things to see what works for you.

Find out more about vitamins and supplements in pregnancy.

Acupressure might help morning sickness

Acupressure on the wrist may also be effective in reducing symptoms of nausea in pregnancy. Acupressure involves wearing a special band or bracelet on your forearm. Some researchers have suggested that putting pressure on certain parts of the body may cause the brain to release certain chemicals that help reduce nausea and vomiting.

There have been no reports of any serious adverse effects caused by using acupressure during pregnancy, although some women have experienced numbness, pain and swelling in their hands.

When to see a doctor for morning sickness

If you are vomiting and can’t keep any food or drink down, there is a chance that you could become dehydrated or malnourished. Contact your GP (*doctor) or midwife immediately if you:

• have very dark-coloured urine or do not pass urine for more than eight hours
• are unable to keep food or fluids down for 24 hours
• feel severely weak, dizzy or faint when standing up
• have abdominal (tummy) pain
• have a high temperature (fever) of 38C (100.4F) or above
• vomit blood

Urinary tract infections (UTIs) can also cause nausea and vomiting. A UTI is an infection that usually affects the bladder but can spread to the kidneys.

If you have any pain when passing urine or you pass any blood, you may have a urine infection and this will need treatment. Drink plenty of water to dilute your urine and reduce pain. You should contact your GP within 24 hours.

Risk factors for morning sickness

A number of different factors may mean you are more likely to have nausea and vomiting in pregnancy. These include:

• nausea and vomiting in a previous pregnancy
• a family history of nausea and vomiting in pregnancy, or morning sickness
• a history of motion sickness – for example, in a car
• a history of nausea while using contraceptives that contain oestrogen
• obesity – where you have a body mass index (BMI) of 30 or more
• stress
• multiple pregnancies, such as twins or triplets
• first pregnancy

Visit the pregnancy sickness support site for tips on dealing with nausea and vomiting, and advice for partners too.

Find maternity services near you (in the UK)

Editor’s Note: *clarification provided for our US readers.

From www.nhs.uk

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