Pregnancy Questions

Exercise during pregnancy is known to have many positive effects for both you and your baby. It can prevent you from gaining too much weight, strengthen your heart and lungs and prepare your body for birth. If you are healthy then there should be no reason why you should not exercise. There is no evidence to suggest that regular exercise during a healthy pregnancy is harmful to you or your unborn baby. However, before starting a new exercise regime or activity it’s a good idea to discuss this with your doctor or midwife. Your healthcare professional can advise relevant prenatal classes/exercises. 

Aim for 30 minutes of moderate physical activity most days a week. Your heart rate and breathing should be up but you should not feel out of breath. It is particularly important that you do not get too hot during exercise. Also ensure you drink plenty of water. This can be aerobic exercise such as walking or swimming (avoid breaststroke kicks if you have pelvic pain) or strengthening exercise such as yoga, pilates and resistance exercise. When going to classes it’s best to tell the instructor that you are pregnant so that you can have pregnancy options to some exercises. If you’re unsure if you should be doing a certain type of exercise- ask your doctor or midwife.

You may feel more discomfort during exercise in your third trimester due to changes in your body. You should stop exercising straight away if you experience:

• chest pain
• feel faint or dizzy
• notice a decrease in fetal movements
• start to bleed or leak amniotic fluid
• start having contractions
• pelvic, lower back or joint pain
• sudden swelling

Pelvic girdle pain can be described as pain in the pelvis, lower back and surrounding areas, including radiating pain to the upper thighs and perineum. This happens due to the hormones of pregnancy relaxing the ligaments in the pelvis, the increased joint mobility during pregnancy and the weight of the baby growing in the uterus creating extra pressure on the pelvis. It is common, affecting 1 in 5 women. It generally occurs later in pregnancy but can also occur earlier in the pregnancy. 

You should tell your doctor or midwife as this can be very painful. Although pelvic pain will not harm baby, your comfort matters and measures should be taken to improve your experience of pregnancy.  You may be referred to a physiotherapist or other allied health practitioners who will guide you with how to mobilise (move) without aggravating the pain, as well as give you some specific exercises to improve muscle tone and strength. 

To help relieve symptoms stand tall with your bump and bottom tucked in a little, change your position frequently, try to keep your legs together when getting out of the car or when turning over in bed (try sleeping with a pillow between your legs when side lying) in bed. Avoid heavy lifting and going up and down stairs too frequently if you have pelvic dysfunction. Avoid any high impact exercise as this may increase pelvic pain. Other treatment suggestions include warm baths, support garments/belts and heat packs.

Taking regular acetaminophen can be helpful in managing the pain short term, but you should still discuss your discomfort with your doctor or midwife. 

As your baby and uterus grow some women feel pain in their lower abdominal area, this is known as broad ligament pain. It can occur on one side or both and may feel achy, crampy or like sharp pain. You may notice it when you change positions suddenly, get up from lying down or when you cough, sneeze or laugh. It can last for a second, a minute or a few hours. To reduce the pain try putting your feet up, use heat packs and try to avoid sudden movements. If the pain increases in intensity or does not go away then let your doctor know.

There are routine tests that are offered to all pregnant women to check on you and your baby’s wellbeing. Some tests are offered to all women and some tests may only be required if you are at risk of a certain infection or condition. Depending on the results of these tests, further testing may be required. Once again your doctor or midwife will discuss this with you.

Routine screening tests include-

Blood tests:

• Blood group, rhesus factor and antibody testing 
• For anaemia- it is not uncommon for women to develop iron deficiency anaemia during pregnancy
• Screening for previous or current infections &/or immunity to- syphilis, rubella, hepatitis B, hepatitis C and HIV.

Ultrasound scan: 

• To assist in determining your babies due date (in the first trimester), position of baby and placenta, baby’s development, confirmation of a singleton/multiple pregnancy, fetal conditions etc.

Urine tests:

• Testing for the presence of blood, proteins, glucose

Genetic testing:

• Information will be given to you about genetic testing - to obtain detailed information about yourself and your baby/babies. You will be presented with options which will include Maternal Serum Screen, NIPT (non-invasive prenatal testing), genetic carrier blood/saliva screening. Your caregiver will support you to make decisions that are right for you.

Diabetes is a condition where a person has too much sugar (glucose) in their blood. This increase in blood sugar happens because the hormone 'insulin', which normally moves the sugar from your blood to the cells of the body is not achieved effectively (insulin resistance). Gestational diabetes is a form of diabetes that occurs with pregnancy and usually resolves after birth. If you have gestational diabetes during pregnancy your caregiver will outline what further screening you will need in the months after birthing, to check that your diabetes has resolved.

A routine test for gestational diabetes is done at about 24-28 weeks of pregnancy, The Glucose Tolerance Test (GTT). You may find that your doctor or midwife asks you to test earlier than this if you have any risk factors for gestational diabetes. If gestational diabetes is diagnosed then your doctor or midwife may refer you to a specialised diabetes team. This team will ask you to monitor your blood glucose levels multiple times a day. This is done by using a small device to prick your finger, getting a drop of blood which then goes into a machine (Glucometre) to read the amount of sugar in your blood. The team will discuss diet, physical activity and body weight to help manage diabetes. If diet and exercise alone are unable to adequately control blood glucose levels then tablets or insulin injections may need to be used as well.

If the diabetes is managed well during your pregnancy and there are no other problems, most women will go to ‘full-term’ and await spontaneous labour. However some women with gestational diabetes may need to have their labour induced prior to their due date. If there are concerns that your diabetes is not well controlled or concerns about your baby’s size, you may have additional ultrasound scans during your pregnancy.

During labour an external heart rate monitor is used to continuously check your baby’s wellbeing, as well as regular monitoring of your blood sugar levels. After birth you will generally be told to stop taking any diabetes medication, but may be asked to continue monitoring your blood glucose levels. Your baby will be closely monitored to ensure their blood glucose levels remain stable and do not drop too low.

If you are intending to breastfeed it’s advisable to do this as soon as possible after birth. Immediate and uninterrupted skin to skin contact with you baby will prove helpful in supporting your first breastfeed. It is important that you expand your knowledge about early breastfeeding to give you and your baby the best chance of a positive experience.