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25 MARCH 2018 HEALTHCARE INNOVATIONS


HEALTHY EATING IN PREGNANCY I sometimes come across women who believe its OK to eat what they like during pregnancy — they see it as a time to pamper themselves and splurge out on food. It should, however, be the exact opposite.


Women who are privileged to nurture a new life within them should do exactly that and provide the best they can for their growing baby. What you eat in that nine months can make a real difference to the life of your child.


WHAT SHOULD I EAT? It’s vital to eat a balanced diet and incorporate at least five portions of fruit and vegetables a day. There should be a good balance of protein (e.g. meat, fish and eggs) and also carbohy- drate (e.g. rice, pasta, potatoes and yam). The carbohydrate shouldn’t be in excess as this can cause too much weight gain. Scientists


Nutrient Calcium


have found this gives the best chance of ob- taining most of the vitamins and minerals a growing baby needs. However, in addition, if possible it’s advisa-


ble to take pregnancy-specific vitamins which contain at least 40 micrograms or 800 IU of vitamin D. Many pregnant women have been found to be deficient in vitamin D. Vitamin D is essential for bone growth in the baby in the womb, and deficiency in the mother is as- sociated with conditions such as rickets, also known as bow legs, in the young child. Oily fish, rich in omega-3 fatty acids,


is an excellent source of protein needed to build healthy brain cells and nerves. If such fish isn’t available or is disliked, a supplement can be taken, but be cautious of vitamin A which should be minimized during pregnancy as it can affect the growing eyes of the baby.


SOME OF THE MAIN VITAMINS NEEDED DURING PREGNANCY Sources


Milk and dairy products; soya milk (forti- fied); bread, beans, green vegetables and dried fruit


Iron Folic acid (vitamin B9)


Vitamin B12 Vitamin C Vitamin D


Meat, eggs, beans, pulses, nuts, dried fruit


Green leafy vegetables, such as spinach and salads, and fruit such as oranges


Meat, fortified cereals, milk and dairy products, fish, eggs and yeast extract


Potatoes, tomatoes, peppers, green vegeta- bles, fruit and fresh juices


Oily fish such as herring, mackerel, salmon and sardines


SPECIALIST CLINICS 21


Sexual health after childbirth Many women suffer in silence after child- birth due to complications from tears. It’s normal for women to suffer tearing during childbirth and it’s common to feel pain and swelling for up to 10 days after. It isn’t normal to have an increase in


pain or burning, abnormal discharge or a new bulge. Any of these symptoms should be reported to your midwife or doctor as they show that you’re not healing in the right way. Unfortunately, many women don’t


speak up as they feel embarrassed or don’t know they can get help. Such feel- ings and discomfort may then affect their relationship with their partner or lead to poor body image. This can then have fur- ther knock-on effects on their mood and enjoyment of motherhood, and stop them from returning to normal sexual function or delay having another child. Many women can get reassurance from


their doctor that all is well and informa- tion about the correct recovery process. A small proportion of women who have


had stitches after delivery may have prob- lems with the stitches dissolving too ear- ly or with an infection. These problems can be treated with antibiotics and the wound can be restitched (perineal repair) if necessary. This can be performed soon after the problem occurs or can be done later. There can also be some misalign- ment with the healing process which can also be treated with perineal revision. In some women, the healing can cause gran- ulation tissue (a form of scar tissue ) to develop which can easily be removed to reduce any pain being experienced. This procedure is called a perineal re-


vision and can be performed days after childbirth or, in some cases, years after delivery, often with a dramatic improve- ment on sexual health. Consult your doctor if you think this may be affecting you.


WHAT’S A HEALTHY WEIGHT GAIN? Most women will gain between 12 to 14kg during pregnancy. However, those who start off pregnancy with a BMI of more than 30 should aim to be weight-neutral, which means not putting on any weight. The best way to keep on top of weight gain is by doing some gentle exercise if you don’t usually exercise, or maintaining a regular exercise regime under the advice of your doctor.


ARE THERE RISKS IF I PUT ON TOO MUCH WEIGHT OR IF I’M OVERWEIGHT? Unfortunately, there are risks with being overweight during pregnancy. There’s a higher chance of blood pressure disorders, diabetes and large babies. Pregnant women who are overweight are also in danger of de- veloping clots in the legs and lungs. Overweight women have


an increased


chance of difficulty in labour. Large babies can result in a condition called shoulder dystocia, where the baby’s shoulders get stuck after the head is delivered. There’s also a greater risk of bleeding, due to the muscles of the womb not contracting properly. Overweight women are more likely to need a Caesarean section and have an increased complication rate.


CAN EXERCISE HELP? Exercise is essential in having a good preg- nancy. It also helps to keep your weight at a healthy level. Regular walks are often enough but planned activities such as swimming are great for keeping in good shape.


Meet the expert


Dr Karen Joash, BSc (Hons), MSc, MBBS, MR C O G , i s a consultant o b s t e t r i c i a n and gynaecol- ogist based in London, who’s pa s s i o n at e about delivering


the highest quality of care to all women. She wants all women to be empowered to take care of themselves and their family by having the best health education. Her aim is to help women achieve the type of delivery that’s tailored to their indi- vidual desires. In addition to early preg- nancy problems and acute gynaecology, Dr Joash is also skilled in the manage- ment of menstrual disorders, hormonal disturbances, premenstrual disorders and fibroids.


For more information about Dr Karen Joash London Practice T: 020 3291 1981 drkarenjoash.com


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