Life Carstenhof Hospital gynaecologist speaks pregnancy awareness

The Department of Health values Pregnancy Awareness Week’s role in promoting healthy pregnancy and safe motherhood.

This year, the week was observed from February 10-16, and it is crucial that expectant mothers seek antenatal care as early as possible, and definitely within the first trimester.

Childbirth can be a rollercoaster of emotions and physical changes. Dr Madein Mugwede, a specialist gynaecologist and obstetrician at Life Carstenhof Hospital, explains that it can trigger a range of feelings, from excitement and joy to fear, anxiety, and depression.

According to Mugwede, most new mothers will experience post-delivery ‘baby blues’, which typically manifest as mood swings, crying spells, anxiety, and difficulty sleeping.

These symptoms usually begin within the first two to three days after delivery and may last up to two weeks.

“Some mothers experience a more severe form of postpartum depression, which can start during pregnancy and continue after delivery. It is important to seek medical attention to manage these symptoms, as rare cases of an extreme mood disorder called postpartum psychosis may also develop after childbirth.”

She emphasizes that these conditions are not character flaws or weaknesses but complications of childbirth that require prompt medical intervention.

“Pregnancy Awareness Week presents an opportunity to raise awareness and educate mothers on safe pregnancies and when to seek urgent medical attention. Anxiety and depression also contribute to infertility, and about 40% of women who experience infertility have a psychiatric diagnosis of anxiety or depression.

“Mental health medication, although necessary and helpful in managing mood symptoms, can also impact negatively on fertility.”

Mugwede explained that during the first antenatal visit, a comprehensive risk assessment is conducted to determine whether a woman has a high or low-risk pregnancy.

Women with low-risk pregnancies are seen monthly, while those with high-risk pregnancies are seen more frequently, every two weeks to weekly, depending on their condition.

“The first trimester can be challenging, as many women experience nausea, vomiting, and loss of appetite. It is essential to avoid trigger foods, such as fatty foods, and consume a balanced diet with sufficient foods from each food group (protein, carbohydrates, fats, and minerals) in appropriate proportions.

“Fruits and vegetables should always be washed before consumption, and uncooked foods should be avoided to prevent salmonella and listeriosis.”

She advises pregnant women to avoid alcohol consumption to prevent among other problems fetal alcohol syndrome, a condition that predisposes the baby to severe mental problems.

Smoking should also be avoided as it affects the function of the fetal placenta, causing both fetal and maternal complications.

“Elicit drug use should be avoided as it affects placental function, and the baby may suffer from withdrawal symptoms after birth, leading to an increase in morbidity and mortality,” she added.

“It is always advisable to disclose your pregnancy to a pharmacist before purchasing any over-the-counter drugs or when self-medicating. They will advise whether the medication is safe. You can also call your doctor for advice before purchasing any medication.”

Couples trying to conceive are advised not to use vaginal lubricants, as they affect sperm motility, which may negatively affect natural fertility by affecting fertilisation.

While most vitamins come from the food we consume, it is also important to take supplements before and during pregnancy.

“Prenatal vitamins are made for people who are pregnant or trying to get pregnant. Folic acid is the most important vitamin for pre-pregnancy health as it helps to reduce the risk of brain and spinal defects called neural tube defects.

“A significant number of women suffer from iron deficiency, and supplementing iron helps to prevent low blood levels in the mother during and after pregnancy. Iron is important for the development of the placenta and baby.

“Calcium is essential for bone growth, and during pregnancy, it helps to prevent an increase in blood pressure, which some women are at risk of. Omega-3 fatty acids, a type of fat found naturally in many kinds of fish, also help promote a baby’s brain development.”

Mugwede said a caesarean section (C-section) is a safe mode of delivery but has associated risks that can occur during the procedure, such as excessive bleeding, or during recovery, such as wound infections.

“Before such a procedure, it is essential to discuss all the potential risks and benefits with your healthcare provider to make an informed decision.”

While the first sign of pregnancy is usually a missed period, the following physical changes occur in the following weeks:

– Tender breasts – hormonal changes make the breasts sensitive and sore, but the discomfort decreases after a few weeks as the body adjusts to the hormonal changes.

– Nausea with or without vomiting – morning sickness is usually due to the rising hormone of pregnancy called beta HCG in the first trimester. Its levels drop significantly at the start of the second trimester and hence the nausea subsides.

-Fatigue – caused by a rising progesterone level.

– Food aversions – some women become more sensitive to certain odours and the sense of taste might also change.

Early antenatal care attendance provides:

– The opportunity to exclude and manage existing medical conditions which can be aggravated by the pregnancy, such as hypertension, diabetes, infections and anaemia
– Free HIV testing and voluntary counselling (VCT)
– Early recognition of danger signs in pregnancy and post-delivery
– Birth preparedness and complication readiness
– Self-care including nutrition and high standard of hygiene
– Information on the role of the father, the male partner, and the family.

Pregnant women need to know their rights, including:

– The right of a woman to choose her companion who will support her during pregnancy and childbirth, and who will accompany her to the antenatal care clinic as well as she goes into labour.
– The right of the woman to be treated with respect, dignity and confidentiality
– The right of the woman to ask questions and also to get an explanation about her condition

Related article: You’re Pregnant! Now what?