Obstetrician and gynaecologist Dr Philip Zinn answers some important questions you may not always think of asking at your appointments.
Which situations should I consider an emergency?
- Vaginal bleeding
- A gush or recurring trickle of clear fluid from the vagina
- Intermittent cramps, especially if they’re regular and get stronger and closer together
- When experiencing constant or severe abdominal or lower back pain
- Increasing cramping and diarrhoea – this can be a sign of an impending miscarriage or preterm labour
- An obvious decrease in foetal movement during the third trimester
- A sudden increase in swelling, especially in your face
- A persistent headache, which doesn’t respond to paracetamol
I had an abortion previously. Will this affect my pregnancy?
A spontaneous abortion won’t affect a future pregnancy unless there’s a recurring cause. The majority of abortions are sporadic and don’t bring about the need for special tests, but if there are other medical conditions or if it’s happened many times, then testing may be necessary. This should be discussed before or very early on in pregnancy. An uncomplicated first trimester abortion procedure, which is performed safely, won’t affect a future pregnancy. A late abortion procedure could influence the strength of the cervix in a future pregnancy.
Should I get genetic counselling?
If there’s a known or suspected familial condition that could jeopardise the health of the baby, counselling can be useful.
In many conditions, the genetic signatures are unknown and can’t be tested for in advance, but advice can be sought from your doctor or a clinical geneticist.
Couples who experience recurrent miscarriages can be tested for abnormal chromosomes and if found, the risk of recurrence and diagnostic options can be discussed.
I had a couple of drinks a few times before I knew I was pregnant. Could the alcohol have harmed my baby?
Clear evidence for the effect of low levels of alcohol in pregnancy has been lacking. We are aware that heavy drinking (five or more drinks in a session) around the time of conception increases the risk of miscarriage and foetal abnormalities. Some pregnant women may be more vulnerable to the effect of alcohol and we know that alcohol crosses the placenta. The principle of avoiding or reducing alcohol intake to a minimum when planning a pregnancy is the best advice.
Can being anaemic during pregnancy be dangerous for the baby?
Anaemia is caused by an iron deficiency, but supplementing during pregnancy is usually sufficient. Anaemia is identified through a haemoglobin test, routinely done at your first prenatal doctor’s visit, and may be repeated at a later stage of pregnancy.
What will happen if I accidentally sleep on my stomach? Will my baby be okay?
Your baby is well protected in your uterus. We all move around regularly while we sleep, so don’t worry. Your body will tell you when you need to move.
I sometimes have trouble breathing, even when I’m not exerting energy. Why does this happen, and does it mean my baby isn’t getting enough oxygen?
Provided you’re healthy and not anaemic, shortness of breath is common during pregnancy. The high progesterone levels in your body as a result of the pregnancy make you feel as though you can’t breathe deeply enough. If you experience a significant change that worries you, get it checked. The
pressure of a growing tummy on your rib cage also influences your breathing during the later stages of pregnancy. If your baby is moving around regularly, rest assured that all is well.
Is it true that I should avoid long car trips on bumpy roads?
A bumpy road isn’t dangerous during pregnancy, only uncomfortable. However, long car trips can cause blood clots to form in the deep veins of your legs (deep vein thrombosis) because you sit still for a long time. Foot exercises, thrombosis prevention stockings, staying hydrated, and regular stops along your journey can prevent this.
What is Group B Strep?
Group B Streptococcus (GBS) is a very common colonising bacterium of the colon and vagina. It’s present in about 20–30% of women and may come and go; it’s asymptomatic and is not an infection. It is the most common cause of pneumonia in newborns and can lead to septicaemia and meningitis. During labour, the baby can breathe the bacteria in while moving down the birth canal. Some doctors screen for this at around 36 weeks gestation, but it’s not routine. GBS testing must include a swab sample from the lower vagina and rectum. You can ask your doctor for this test.
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