Pregnancy Dilemmas Answered

Is it safe for me to exercise during my pregnancy?
Yes, exercising when you’re pregnant is good for both you and your baby. The more active and fit you are during pregnancy, the better. Be sensible though, and don’t take up something new and strenuous when you’re pregnant. Walking, swimming, low impact aerobics, yoga, pilates and gentle cycling are usually fine. There are often classes such as aquanatal and antenatal exercise classes held in local venues that are adapted and suitable for pregnancy. Don’t exhaust yourself and anticipate that you may not be quite as energetic as your pregnancy progresses. If in doubt, ask your midwife or doctor. Pregnancy is not the time to start horse riding, roller blading, downhill skiing, scuba diving, circuit training, high impact aerobics or anything else that involves a high degree of balance as the change in your centre of gravity and your weight gain increase the risk of injury. It’s important that you don’t risk injury to your abdomen or compress it too much when exercising – take advice from an experienced instructer.

What are the foods to avoid in pregnancy?
When you are pregnant, it’s even more important than usual to look out for food hygiene:

Wash your hands after using the toilet and before preparing or eating food;
Cook poultry and meat well, especially lamb and pork;
Wash fruit and vegetable thoroughly to remove dirt and pesticides;
Wash your hands after preparing raw meat.

It’s important that you eat a healthy varied diet in pregnancy, with lots of fruit and vegetables and plenty of nutrition without too much sugar and fat. There are also some specific foods that it is wise to avoid:

Liver is not recommended during pregnancy as it contains a type of vitamin A which if eaten in excess, can be linked to birth defects. Another type of vitamin A (beta carotene) found in red, yellow and dark green fruit and vegetables, does not build up in the liver and can be eaten safely.

Raw or lightly cooked eggs: may contain salmonella (a cause of food poisoning). Eggs should be cooked so that the white and yolk are solid. Avoid food containing raw and undercooked egg such as homemade mayonnaise, ice cream, cheesecake or mousse.

Raw or undercooked meat and poultry: may contain toxoplasma. Meat and poultry should be cooked thoroughly so there is no trace or pink or blood.

Pate, liver sausage, or unpasteurised or mould ripened soft cheeses (such as Camembert, Brie and blue veined cheeses): they may contain listeria, a bacterium that can cause miscarriage or illness in newborn babies. Also reheat cook-chill foods and ready-to-eat poultry meals until they are piping hot rather than eat them cold.

Shellfish: risk of food poisoning.

Peanuts and food containing peanut products: if you or the baby’s father or any previous children have a history of hayfever, asthma, eczema or other allergies, avoiding peanuts and foods like peanut butter, groundnut oil and some snacks may reduce the risk of your baby developing a potentially serious allergy to peanuts.

Alcohol: It’s best not to drink any alcohol during pregnancy. Alcohol can increase the chances of miscarriage, and damage to the baby. If you have to drink, keep this to a minimum and no more than one small drink once or twice a week. Too much alcohol during pregnancy is associated with fetal alcohol syndrome that causes a range of abnormalities in the baby.

Junk food: Try to avoid or minimise your intake of junk food. It’s unhealthy because of the often high levels of fat and sugar. Sugar has calories without providing any other nutrients the body needs and adds to the risk of tooth decay (which has certain risks for pregnant women) and obesity (which increases the risk to both the mother and baby in pregnancy). Most of us eat much more fat than we need.

Other things to avoid:

Cat’s faeces: may contain toxoplasma. Avoid emptying cat litter trays while you’re pregnant, or if you have to do it, wear disposable rubber gloves.

Gardening: you may come into contact with toxoplasma in the soil, so wear gloves.

Sheep: they may carry chlamydia psittaci, which if transmitted to a pregnant woman can have severe effects. Make sure you wash your hands if you have been out in the country. Avoid contact to the extent of avoiding contact with clothing that has been worn during lambing.

My mum says she remembers ‘eating for two’ when she was pregnant with me. Do I need to eat more during my pregnancy?

No, there’s no need to ‘eat for two’ when you’re pregnant but eating a well-balanced diet is important for health and particularly important if you are pregnant. This is because your baby can reap the benefits of your healthy diet while he or she is growing during your pregnancy.

You don’t actually need to eat many more calories in pregnancy, and many women use less calories from exercise. So you may find that you don’t need to eat more during the early and middle parts of pregnancy to keep both you and the baby healthy. There are risks from gaining too much weight in pregnancy – speak to your midwife for advice.

Most women gain between 10-12.5 kg (22-28 lbs. or less than 2 stone) during their pregnancy and with a few exceptions (see below) you can continue to eat foods that you enjoy.

Most pregnancy books will have a section on a healthy diet and they will mention the five food groups

  • Fruit and vegetables
  • Meat fish and alternatives
  • Bread, other cereals and potatoes
  • Milk and dairy produce
  • Foods containing fat and sugar

If you don’t eat as well as you could, this is a good time to start thinking about your diet. The overall advice is to eat less fatty, sugary foods and more fruit, vegetables and starchy foods such as cereals.

Is it safe to have sex during pregnancy?
Sex for most couples is an important aspect of their lives together. Some couples experience a new dimension to their sex lives when a woman is pregnant, but for some couples it may be a concern. Worries about safety are normal and in our experience people are afraid of harming the baby or causing a miscarriage. There is no medical evidence that sex in pregnancy harms the baby. Your baby is well cushioned and protected by the muscles of the wall of the uterus and by the bag of waters. There is also a mucus plug, which seals off the neck of the uterus (womb). No injury to mother and baby will occur during gentle loving sex.

However in the following circumstances we suggest caution:

  • If you have a tendency to miscarriage, your doctor may suggest that you avoid sexual intercourse for the first three months of pregnancy.
  • If you have a history of premature labour you might choose to avoid sex during the later stages of your pregnancy.
  • If you have a confirmed low lying placenta which will have been diagnosed following a scan, you doctor may advise you to avoid sexual intercourse during the pregnancy.

Remember there is more to lovemaking than sexual intercourse. Encourage your partner to be imaginative and creative.

I need to talk to somebody about domestic violence
You are not alone. 1 in 3 women experience domestic violence at some stage of their life. It is also common for violence to start or get worse during pregnancy. Midwives are trained to address this issue, with most units routinely asking women about their relationship and safety. Being hurt either physically or emotionally can affect you and your pregnancy. There may be an increased risk of miscarriage, pre-term labour or having a smaller than average baby. Some women use alcohol or drugs as a coping strategy.

It is important that if you are experiencing relationship problems that you continue to attend for antenatal care as there will be support available.

If you do not feel able to discuss your problem with a health professional you can always contact the national domestic violence helpline 0808 2000 247.

Why do women get constipated when they are pregnant?
It is quite common to become constipated when you are pregnant. The pregnancy hormones which soften all your muscles and ligaments make the muscles of your intestines relax so that they cannot move food through your intestines as quickly as usual. Another reason is that as your pregnancy progresses and the womb gets bigger it can put pressure on the bowel and make it difficult for it to work properly. The iron tablets that are prescribed for anaemia can also cause constipation. Here are some suggestions that may improve the symptoms of constipation

  • Make sure that you have lots of fibre (wholemeal bread, cereals, jacket potatoes and plenty of fruit and vegetables in your diet
  • Drink as much as you can, especially water and fruit juice. Some women find that drinking tea and coffee can make constipation worse
  • When you are opening your bowels (passing stools), try and relax as much as possible. Take your time
  • Take regular exercise

If it becomes a serious problem than you will need to speak to your doctor or midwife who can prescribe some gentle laxatives that are safe to use in pregnancy

My friend suffered from severe morning sickness – Hyperemisis Gravidarum – in her pregnancy – can you give me some more information on this subject please?
Hyperemisis Gravidarum (HG) is exaggerated nausea and vomiting experienced by a pregnant woman. This condition affects around 3 in 1000 women who are pregnant. Unlike morning sickness which usually reduces at around 12 to 14 weeks, HG may continue up to 20 weeks of pregnancy and in some rare cases for the duration of the pregnancy. If the condition is severe, it may require hospitalisation, and treatment with fluids and medication to alleviate the sickness. The cause of HG is not fully understood however there are links to hormonal changes that occur while you are pregnant.

Self help tips include:

  • Rest and reduce your stress levels
  • Try and eat little and often instead of 3 large meals
  • Try not to eat and drink at the same time
  • Try ginger type foods such as biscuits, tea or stem
  • Acupressure wrist bands

I have had conflicting reports about whether or not it is OK for me to continue to take painkillers or other medicines occasionally in early pregnancy.

Always check with your doctor before taking any medicines in pregnancy, even medicines that you were prescribed before you were pregnant, drugs that you have bought in the pharmacy or common household medicines like creams, painkillers, or hayfever medications.

Paracetamol is generally safe in pregnancy, but speak to your doctor, midwife or pharmacist to check before taking any medicines in pregnancy. Even common painkillers such as aspirin or ibruprofen or hayfever medicines can have an effect on your pregnancy, so do check before self-medicating.

Make sure your medical care giver is aware that you are pregnant, and they will be able to prescribe the appropriate drugs, and weigh up the risks and benefits of treatment, making the best decision for you and and your developing baby. Pharmaceutical companies and the doctors that prescribe drugs have a duty of care to the patient in making sure that the drugs they prescribe are safe and appropriate for that person, and will always take into account factors such as age, weight and whether the person is pregnant or breastfeeding, for example. When prescribing and taking drugs, it is important for the care-giver to weigh up the risks and benefits of the patient taking the drug. There may be risks of not having medicines for certain conditions that can be more serious than the risks of medciines.

Remember, if you are ever unsure about any care that you receive, do not feel you are being a nuisance by asking plenty of questions to ensure you know what is happening to you – it’s your body after all!

When will my sickness stop?
Pregnancy sickness affects approximately half of all pregnant women, and is often one of the first signs that may tell a woman she is pregnant. It is thought to be due to high levels of the early pregnancy hormone HCG (the same hormone responsible for that little blue line on the pregnancy test!), and therefore, most pregnant women report that it eases around the twelfth week of pregnancy, and gets progressively better as the weeks pass by. However, although pregnancy sickness is often seen as a normal part of pregnancy, it does need to be monitored to ensure that the health of the mother and baby are not being compromised. Symptoms such as weight loss, a rapid pulse, concentrated small amounts of urine when going to the toilet, dry ‘furred’ tongue, general listlessness and excessively dry skin, all indicate that pregnancy sickness is becoming out of control. If you have two or more of these symptoms, it is very important that you contact your midwife or GP and see them straight away. If pregnancy sickness is allowed to progress to severe dehydration, it can cause damage to the liver and kidneys. Remember, you do not have to suffer in silence and there are safe medicines to take that can be prescribed by your doctor if necessary, so make an appointment to see someone as soon as you can.

Can I have a spray tan at a salon in pregnancy?
While you are pregnant, anything you place on in or around your body has the potential to be absorbed into your own bloodstream and ultimately your baby can also be affected. This is why drug manufacturers always advise you to avoid using preparations during pregnancy and whilst breastfeeding.

Self-tanning products are not drugs and come under the category of personal care products which do not need to be tested for safety and can include many different chemicals, some of which are potentially harmful to you and your baby. While some may be perfectly safe to use, do bear in mind that they won’t have been tested for safety on pregnant women. So it is advisable to err on the side of caution and avoid using these products during pregnancy.

Is it OK to take Pregnacare tablets alongside other medication?
Pregnacare and similar supplements specifically designed for pregnant women contain carefully formulated levels of essential vitamins and minerals which are beneficial in pregnancy. They are safe to take and may help a healthy pregnancy. Always check other medications with your doctor and pharmacist.

I have lost a lot of weight and am now pregnant am anxious not to put it back on. What should I be eating? I have been following the Atkins diet, is it safe to carry on?

It is important to maintain a healthy weight in pregnancy and also to eat a balanced diet. As you have experienced, Atkins is effective at producing weight loss, but it is advised not to follow such a diet in the long term or during pregnancy. Your body will need carbohydrates, but it is about trying to eat the better ones which are called complex carbs such as wholemeal bread and pasta, jacket potatoes, brown rice and lots of fruits and vegetables.

Where possible you should try to avoid sweet sugary foods and anything with white flour eg cakes, biscuits etc.

You should try to reintroduce carbohydrates from the complex carbs group as it will not cause such a dramatic change in your blood sugar/insulin levels.

Both you and your baby will require a balanced intake of food based on all the food groups. That is: proteins (chicken, fish, pulses), starchy food (carbohydrates), dairy (milk/cheese), good fats (oily fish), and at least 5 portions of vegetables and fruit each day. Also try to drink at least 8 glasses of water.

My breasts are no longer sore. Am I miscarrying?
As you probably know, one of the first signs of pregnancy is painful/ sore breasts, rather like what happens prior to a menstrual period.

This sensation occurs in the first part of your pregnancy, the first trimester, caused by hormones and preparing you for breastfeeding. If your breasts are no longer sore, this isn’t a cause for alarm, but is probably due to things settling down as you get further into your pregnancy. Speak to your midwife or doctor if you have any other concerns.

I keep trying to sleep on my side to prevent squashing my vena cava as advised but find myself on my back when I wake up. I’ve tried using pillows but they get dislodged. Could my baby be suffering from lack of oxygen without my knowing it?

Providing that your pregnancy is progressing well and you have no underlying conditions where your placenta is not fully functioning, such as pre-eclampsia, I would not worry too much about finding yourself in this position. You are obviously aware of the issue and are doing your best to accommodate it.

You are quite right in mentioning the large blood vessel, and it is generally not recommended to lie in a supine (flat) position but most people do a fair amount of moving in their sleep, so you probably are not on your back all night.

It is also likely that you would move yourself into a better position during sleep, if the one you were in was impairing your circulation.

There are other signs of a healthy baby that you can look to for reassurance, for instance, feeling your baby move and observing your baby’s growth from the size of your expanding abdomen.

My abdomen is really itchy. Is this normal?
Some women do experience itchiness in pregnancy, which is likely to be associated with hormonal changes, or the fact of your skin growing and stretching over your abdomen.

In some rare situations, women develop a condition called obstetric cholestasis, in which the liver is not functioning optimally, and which would require medical attention.

However, assuming that your condition is not serious, your GP might be able to prescribe you with an anti-histamine cream for the discomfort, should you want this kind of remedy.

Can I use my inhalers in pregnancy?
As far as your inhalers go, as long as they have been prescribed by your GP for you, knowing that you are pregnant, they should be quite safe to use, and unlikely to harm your baby. If you have a medical condition like asthma, it is important you follow medical advice through your pregnancy, as an asthma attack could harm both you and your developing baby. There are simple remedies you can take for colds, for example, you can try a steam inhalation to relieve some of the congestion and warm freshly squeezed lemon juice and honey to soothe the throat. Otherwise, remember to drink plenty, do gentle exercises and enjoy the fresh air.

Can I have holiday vaccinations in pregnancy?

If you are travelling abroad, it is important you check with your doctor before you book your holiday. There may be some destinations best avoided, because of the risks of food poisoing, malaria (many anti-malarial drugs cannot be taken in pregnancy or insect repellents used) or the need for certain vaccines not advised in pregnancy.

If you’re travelling by air, it is important to take precautions to help prevent deep vein thrombosis, a type of blood clot more common in pregnancy that can be life-threatening.

Do periodic calf exercises. Move around the cabin. Avoid dehydration by drinking plenty of water. Minimise alcohol and coffee intake Wear well-fitting elastic below-knee compression stockings. These can be obtained from chemists and supermarkets and you should get advice about the appropriate size.

You will find a guide to calf exercises from the following web page:

www.patient.co.uk/showdoc/23069201/

Live vaccinations are not given during pregnancy, so you will need to find out from your travel agent which vaccinations are needed for your destination. If live vaccines are required you may be able to obtain an exemption certificate form your GP to get around this issue. The Maternity Alliance has made information available about this:

www.ivillage.co.uk

Also, from the NHS there is guidance about the vaccine requirements for different countries.

www.fitfortravel.scot.nhs.uk

Keeping you and your baby safe whilst on holiday: you should follow the same advice that you obtained when you first visited your midwife about such things as foods to avoid and exercises/activities.

I have been in contact with scarlet fever. I am 10 weeks pregnant. Should I be worried?
I assume that you have had the condition diagnosed by your GP. If so they would have told you that scarlet fever is a bacterial infection usually spread by airborne droplets (produced when an infected person sneezes or coughs). It usually begins with the affected child having a sore throat, with a sunburn-like rash developing a day or so afterwards, which gives the condition its name.

Scarlet fever can be treated by penicillin, but it usually resolves without medication.

As far as I am aware there is no clinical evidence of there being any threat to your unborn child by your coming into contact with this infection. However it is always worth having a word with your GP about it to allay your concerns. In any case, as scarlet fever is a notifiable disease, if you have diagnosed it yourself, you should inform your doctor. Scarlet fever is an increasingly rare condition and consequently there is a limited amount of literature available about it, but you can have a look at www.nhs.uk

Can I use insect repellents in pregnancy?
Insect repellent contains a chemical called DEET (diethyl-3- methyl benzamide) which in high doses is considered harmful to a baby, especially in the early stages. As no one is sure what is a “safe/low” level compared to a high level it is usually recommended to avoid using insect repellent. There are natural alternatives which contain citronella that is safe to use in pregnancy though. You may wish to avoid travelling to an area of the world where malaria or yellow fever is common.

Is it OK to drink tea and coffee in pregnancy?
Both tea and coffee contain caffeine and you should limit the amount you have each day, but don’t need to cut it out entirely. Caffeine to excess is linked with a slightly higher risk of miscarriage and low birth weight. Traditional tea is safe within moderation. The Food Standards Agency recommends that pregnant women limit their consumption of caffeine to 200mg per day, which is equivalent to two mugs of tea per day. You will still be taking in significantly less caffeine by drinking your normal cup of tea than if you were drinking a typical instant coffee and much less than if you were drinking a ‘coffee-shop-coffee’. You might also want to try herbal teas that don’t contain any caffeine.

I have been in contact with someone with chicken pox. Is this a problem?
If you know for sure that you have had chicken pox, you have nothing to worry about since you will have antibodies to the disease which will be transferred to your baby, therefore protecting him. Coming into contact with chicken pox is only a concern if you have never had the illness yourself. If you are not sure, ask your GP or Midwife for a blood test to check your immunity. They can do this by checking the bloods taken when you were first pregnant. Most British women are immune. If you are not, depending on the stage of pregnancy, a vaccine can be given to protect your baby.

Have I put on too much weight? What is normal?
It’s good to be thinking about healthy eating during pregnancy and to be having regular gentle exercise.

Most women will gain around 10 -12.5 kg or about 2 stone during their pregnancy and need about 300 calories a day extra to keep a healthy weight. So around 2100 – 2500 calories a day should be enough to ensure your baby is able to grow healthily.

Dieting during pregnancy is not usually recommended but if you eat a well-balanced and nutritious diet, avoid fatty, sugary foods, you may find that you will only gain the minimum amount. If you feel that you need to lose weight, discuss this with your GP who may be able to refer you to a dietician.

Walking is the best form of exercise and is a good starting point for someone who hasn’t been exercising regularly. Now is not the time to start a more rigorous regime.

The Baby Centre www.babycentre.co.uk has lots of good information about healthy eating in pregnancy.

The really good news is that if you continue to eat healthily after the birth of your baby and breastfeed, you are more likely to lose the extra weight as breastfeeding uses up your fat stores more readily.

My midwife couldn’t find my baby’s heartbeat at 12 weeks. Is this normal?
At under 13 weeks it is often difficult to hear the baby’s heart beat, especially if the mother is a little overweight. The little hand-held sonic aids we use are very basic and not particularly sensitive. There is no harm in contacting your midwife again prior to your next appointment and asking her to have another attempt at listening to your baby for you. You don’t have to wait until your next appointment – your midwife is there to provide you with reassurance.

Can I wax my bikini line in pregnancy?
Waxing in pregnancy is generally safe, as there is no evidence to suggest otherwise. For some women hair growth increases in pregnancy. If you treat yourself at home always read the directions carefully. Make sure you tell your beauty therapists you are pregnant if you go to a salon.

I used peroxide bleach on my hair today and am scared it will harm my unborn baby?

There is so much information about what is and is not safe during pregnancy, you can often feel unnecessarily worried or guilty about something if you are unsure, yet most things are safe in pregnancy, you just need to be a little cautious, use your common sense, and you will not go far wrong. There has not been a lot of research into this area, yet women have been dying their hair during pregnancy for a long time, and there has been no link found between dying your hair and causing harm to the baby. The chemicals found in modern hair dye are not thought to be highly toxic, either to the mother or the baby, and the method by which you or your hairdresser dyes your hair means that there is little chance of a high level of the chemicals being absorbed by your body anyway. The less contact the dye has with your scalp, the less chance you have of the chemicals being absorbed, so highlighting your hair is less risky than having a full colour. The main problem with dying your hair in pregnancy is that it may look different to how it normally does after a colour or treatment. Your hair changes in thickness and amount in pregnancy, as well as how it actually absorbs dye, due to all the hormones produced, and so a colour that you have been having for a long time before pregnancy may suddenly appear to be completely different with the affect of having a baby on board.

Is it safe to eat all kinds of yoghurts during pregnancy?
Live yoghurt is perfectly fine to eat during pregnancy; the bacteria it contains are the ‘friendly’ bacteria that are thought to be beneficial to your digestive system.

You should also ensure that you wash all fresh fruit and vegetables, and all food is cooked or reheated thoroughly. Avoid shark, swordfish and marlin and limit the amount of tuna you eat to no more than two fresh steaks a week (weighing about 140g cooked or 170g raw) or four medium-size (140g) tins of tuna a week as these foods can contain high levels of mercury, which is harmful to the unborn baby

I am about 6 weeks pregnant and am having some pretty bad pain on the right side of my abdomen. What is causing this?
Abdominal pain in pregnancy is a common complaint, however, it is important that you seek advice from your midwife or doctor as well as taking our advice here. This will enable you and your care-givers to rule out any underlying problems that could be affecting you or the baby.

The most common reason for abdominal pain in early pregnancy which is not accompanied by bleeding or a watery loss from your vagina, is the stretching of the muscles holding your womb in place. If this is your first baby, these muscles have never ‘stretched’ before, and so some discomfort is to be expected as the changes in your body take place. The second most common reason for pain like this in pregnancy is a urine infection and it would be worth having your urine checked to rule this out – if you do have an infection this can be treated effectively and safely with antibiotics. Your midwife or doctor can arrange this. A more serious, yet less common cause for this pain could be your appendix, as appendicitis is more common in pregnancy. There is also a small risk that your baby may have implanted outside the womb, called an ectopic pregnancy.

Whatever is causing this pain, you need to go back to your doctor, and tell him or her that you are really worried, and would like further investigation. You should never feel that you are being a nuisance, as you know your body best of all, and are aware when something is not quite right. It may be worth asking to see a different doctor next time, and taking a friend or relative with you for support. It is also important to remember that you must be nice to yourself! Relaxation, such as taking a warm bath or lying on the couch with a magazine as much as you can will help – sometimes pain like this cannot be explained, and maybe just your body’s way of telling you to slow down as it prepares itself for its most important job ever.

Is it OK to do breaststroke in pregnancy?
Swimming is an excellent form of exercise during pregnancy, however your sports therapist is correct in that you should avoid breaststrokes. This is because the motion can put extra strain on the lower back. Many women complain of lower back pain or pelvic pain in pregnancy, breaststrokes can make the problem worse therefore it is better to avoid this. But do continue to swim if that is your chosen form of exercise/relaxation.

My left breast is leaking. Is this normal?
This is very common and normal and is caused by increases in hormonal production. There are other changes you might notice, such as an increase in size, and an increase in the pigmentation, or colouring, of the areolas, the darker areas around the nipples. The secretion of small amounts of milk from the breasts is also normal. This is the colostrum, the first milk that you produce for your baby. At this s point, It may help to wear a properly fitted and supportive bra. Reputable department stores or specialist shops supplying maternity wear will be able to provide advise on the type of bra suitable, depending upon what stage you are in your pregnancy.

What can I do about swollen ankles?
The swelling you describe is called oedema. This is swelling usually in the hands and feet. It can get worse throughout the day if you stand for long periods of time. It can be very uncomfortable To help reduce the discomfort try some of the following: Drink plenty of water, as this will help you release excess fluids. Try exercising such as walking or swimming. Avoid salty foods, which makes the body retain water. Try wearing support tights. When resting, keep your feet elevated but not crossed legged. Herbal teas with dandelion helps release water as do pineapples.

Oedema is usually harmless, but if you also have a high blood pressure reading it could be cause for concerns. Ask your midwife or doctor to check your blood pressure regularly.

Is it OK to vacuum in pregnancy?
During pregnancy, your pregnancy hormones cause softening of your ligaments and muscles to help your baby to be able to fit through your pelvis. That combined with the change in weight distribution as your tummy gets bigger can mean you may be at increased risk of injury. But if you are not overweight and if you are generally fit, active and healthy I would expect that you should be able to continue to do most household tasks, as long as they don’t involve lifting heavy weights or holding awkward postures for minutes at a time. If you can, why not ask you partner or other family members for some additional help?

If you are suffering any back pain or pelvic discomfort, speak to your midwife or doctor. If necessary they can refer you to a physiotherapist for advice and treatment.

I am really constipated and straining a lot. What can I do?
Constipation in pregnancy is quite common. The hormone progesterone which helps to loosen up the pelvis to help make room for the baby to be born also causes unwanted side-effects which include heartburn, varicus veins, haemmorrhoids, and constipation.

It is very important to ensure you drink plenty of clear fluids such as water and juices, avoid tea and coffee as these do not help to hydrate you. Increase the fibre in your diet by eating plenty of fruit, vegetables, and wholemeal bread and cereal to stimulate your bowels. Take regular exercise like walking and if the constipation is not improved, see your doctor or midwife who will be able to recommend a gentle laxative that is suitable to take during pregnancy.

Some women who take an iron supplement find it causes constipation. If that is the case, you may wish to talk to your doctor or midwife about trying an alternative preparation.

Is it safe to fly while pregnant?
Most airlines are happy to carry pregnant women up to about 28 weeks without any problem. It may be necessary to get a letter from your midwife or GP to confirm that you are healthy and fit. Pregnancy puts women at increased risk of thrombosis (blood clot) and flying increases this risk further. Wearing support stockings helps reduce the risk and these are easily available. It is also a good idea to ensure you move around during the flight to keep your circulation going and drink plenty of water to prevent dehydration in the dry atmosphere of the plane.

My scan gives me a different due date from my LMP. Which is right?
Before ultrasound scans were available to date a pregnancy, the first day of the last period was used to inform women and caregivers when a woman could expect her baby to be due. To confuse you even more pregnancy from this date actually lasts forty weeks, or ten months, rather than the nine months that everyone talks about. Women were often asked for this particular date, as it was believed that most women could remember, or even had a written record, of when their period started, but often could not remember the actual date of conception. Therefore, the due date was calculated by adding forty weeks to this date, and this is when women were told they could expect their baby. However, this process of dating a pregnancy was based on a general assumption that every women had a twenty eight day cycle, bled for 4 days when on a period, had regular periods and conceived on day fourteen of their cycle. We now know that this is not true, and our menstrual cycles are as individual as everything else about us. Therefore, this method of dating a pregnancy, is not entirely accurate, but is a good estimation, which is why it is still used by GP’s and midwives when meeting women for the first time in pregnancy, as it identifies women who are far on in their pregnancy and therefore need antenatal care quickly. Unless there is a problem, all babies develop at exactly the same rate in pregnancy, and so a dating scan early on is a very accurate way to calculate when a baby is due. As the baby gets bigger, it gets less accurate, so it is thought that the earlier scan is the most reliable. Therefore, your routine scan is probably the best date to go by in terms of accuracy – but remember that babies often come when they want to and ignore the due date entirely! Only about 4% of babies come on their due date.

Can my baby hear in the womb?
Your baby is able to hear sounds from the environment all around from about 32 weeks, which means he/she will pick up the shooting noises too. You are quite right, in that there is no specific research regarding clay shooting and babies hearing, but it is known that loud sounds can increase the fetus’s heart rate. For example standing near a loud speaker at a concert. What is also important is your response to the noise. If you remain calm and relaxed, it is less likely to “frighten” your baby. I imagine you are use to these noises, so the likelihood is, that your baby will be too. However, to be on the safer side, you may want to consider minimising your involvement in this sport until your baby is born.

Most babies have a special hearing test within 5 days of birth. It is important to identify children with hearing loss as early in life as possible.

I have a low lying placenta. What does this mean?
This means that the placenta is near the neck of your womb.(cervix) Placenta praevia happens in about 1 in 250 pregnant women. In most cases, with advancing pregnancy, as the uterus grows it pulls the placenta up with it and away from your cervix. In some cases, this does not happen and there may be some bleeding as a result. You will be offered a re scan at around 34 weeks or earlier if you have any bleeding to check the placental site. Very occasionally the placenta doesn’t move and this may mean staying in hospital for some time and extra close monitoring of you and your baby. Ask your midwife for more information.

My blood pressure is up. Is this a concern as I really should be at work?
High blood pressure can be a concern in pregnancy. This will be picked up at your regular antenatal and GP appointments. If your blood pressure is high, your midwife might want to see you more often and do blood tests for your kidney and liver function.

You might be advised to take more rest or even to take time off work.

Sitting all day with your feet down does increase the chance of leg and foot oedema (swelling). So put your feet up whenever you can. Do some foot and leg exercises like circling or moving your feet up and down. Maybe you have a good friend (or helpful partner?) who would be willing to give you a gentle leg and foot massage. Just firmly stroking from the foot up to the knee stimulates the circulation and is very relaxing and soothing. If you are sitting for any length of time, try to keep your feet and legs moving, contracting and relaxing your calf muscles to keep your circulation stimulated.

Try lying on your left side in bed. This encourages blood flow from your legs back to your heart and kidneys better – therefore improving circulation and kidney function.

I’ve been told my baby is breech, what does this mean?
Breech position is when your baby is bottom first instead of head. Many babies adopt a breech position during pregnancy and later turn around. Some babies, for whatever reason stay in the breech position. If this is the case your midwife and obstetrician will discuss with you the safest and best way for you to deliver your baby. They may arrange an ultra-sound scan to see how big your baby is, they may encourage you to think about caesarean section or they may agree to vaginal delivery depending on your circumstances. Some obstetricians may turn the baby around during late pregnancy. They do this during an ultrasound scan so that they can see into the womb. If you choose to have the baby vaginally it may be a more complicated birth than when the baby is born headfirst. You may be advised to think about having an epidural during labour, this is to prevent you wanting to ‘push’ too early in labour. The epidural may also be helpful if the doctor needs to deliver the baby using forceps.For women who are having their first baby, if it has been confirmed that your baby remains in the breech position by the 36-37th week of pregnancy, it may be that your obstetrician advises you to consider a planned (elective) caesarean section to prevent any birth injury. Talk to your midwife and doctor about how you feel too, this is important.

What are the causes of miscarriage?
Most miscarriages occur in the first 12 weeks but later fetal loss can occur. Sadly about 1 in 4 pregnancies ends in miscarriage, which can be extremely traumatic for all involved. Even with very early miscarriages, we know people have their hopes and expectations for their unborn child, and it is a real bereavement that people grieve for. Insensitive comments and a lack of understanding can cause much distress at such a vulnerable time. The common reaction of &lsqou;Why me?’ is often felt and many couples feel that it is important to find out the reasons behind their loss, even though no explanation may ever be found. Women and their partners may blame themselves or something they did just before or during the pregnancy, even though this is unlikely to be the cause. It is important not to blame yourself or your partner and to allow time to grieve for your loss.

Causes include:

  • Genetic problems. The most common cause for miscarriage is a genetic abnormality in the embryo. This is usually a random, or one-off, problem in the egg cell or sperm cell and the pregnancy cannot survive. It can happen to anyone, though the risk does increase, as a woman gets older. Less commonly, some couples carry a genetic condition, which carries an increased risk of recurrent miscarriage, and in this instance genetic counselling could be helpful.
  • Hormonal problems. The body may not produce enough of the hormones needed to sustain the pregnancy, even though there may be nothing wrong with the baby. These problems occur more often in women with irregular menstrual cycles.
  • Immunological problems, including Antophospholipid Syndrome(APS), also called Hughes Syndrome or ‘Sticky Blood’. In this condition, problems within the blood vessels, which supply the placenta, can cause miscarriage, late fetal death or pre-eclampsia. Research is ongoing into the possible causes and treatments and more information can be found on the website: www.hughes-syndrome.org
  • Infections such as rubella (German Measles) or toxoplasmosis can cause a miscarriage if a woman becomes ill in the first stages of pregnancy
  • Abnormalities in the cervix or uterus. If the cervix (neck of the womb) is weak, it may start to open as the uterus (womb) becomes heavier later in pregnancy and this can lead to miscarriage. An irregular-shaped uterus may mean there is not enough room for the baby to grow. Large fibroids (a benign muscular lump) may cause miscarriage in later pregnancy.
  • An existing medical condition such as diabetes or thyroid disorder can cause problems if not controlled in early pregnancy
  • Environmental factors such as excessive alcohol, heavy smoking and drug taking appear to increase the risk of miscarriage

Other complications

A pregnancy which develops outside the uterus, usually in the fallopian tube, is called an ‘ectopic’ pregnancy. This can become life threatening if the fallopian tube perforates, and is a medical emergency. Signs include abdominal pain, bleeding (often watery) and faintness. A pregnancy test may show only a weak positive or even negative result.

A less common complication is a molar pregnancy (also called a Hydatidiform Mole). In this situation, the lining of the uterus develops very rapidly though the pregnancy itself doesn’t. This condition may be diagnosed after a miscarriage and requires follow-up by a specialist centre.

Most women who miscarry are more likely to have a successful pregnancy next time than another miscarriage and this point needs to be re-enforced. If, however miscarriage occurs three or more times in a row, investigations and, where appropriate, treatment should be offered by a specialist unit. Only about half of those with recurrent miscarriage will have a clear diagnosis, but even those without diagnosis or treatment have a good chance of a successful pregnancy in the future.

Information and support is available from an excellent organisation called The Miscarriage Association. Their website has up-to-date advice and links to other relevant help. They also produce leaflets on many aspects of miscarriage.

Now that I am pregnant, when is a good time to tell my employer?

When you discover that you are pregnant it is tempting for you and your partner to want to tell everyone you know. You may wish to consider carefully when to tell your boss. You may wish to wait until you have passed the 12-week milestone and you feel more comfortable with the pregnancy. Some people might want to wait until a bit later as they are concerned about their career prospects or whether in fact they want to go back to work after the baby is born. However there are also some other issues you may want to think about. The time when you may most want to keep the news to yourself may be the time when you feel very tired, experiencing morning sickness and in need of emotional support and understanding. This is when you could probably do with some help and support and a slight change of duties if your job involves standing lifting or carrying. If you have any concerns about your working conditions it is better to tell your employer sooner rather than later and they can assess any potential risks to either you or your baby. This is particularly important if your role could expose you to any chemicals or other risks that could harm your unborn child. They can then either change your work to reduce the risk and may temporarily change your working patterns and your hours. You have certain legal rights, and your employer cannot disadvantage you because of your pregnancy.

When will I get a bump?
Every woman’s bump starts to show at different stages. Your uterus which is home to your baby for the next 37-42 weeks is usually hidden in your pelvic area. As your uterus grows it will gradually emerge. For most women this happens around 12-16 weeks. But for some it is not until 18-20 weeks that a bump becomes obvious.

I am incredibly anxious about the birth. What can I do?
We are sorry to hear of your anxieties about your labour, however, you may be surprised to find out that it is not uncommon. The positive thing about it is that you are facing up to it at this stage, when there is time for you to address and resolve the problem.

You might benefit from a course of natal hypnotherapy, which will help with mental preparation for birth. You should discuss a birth plan with your midwife, knowing that things do not always go the way that we desire, but that that does not mean they turn out necessarily to be worse than we plan.

Have you really thought about where you want to have your baby?

You might want to consider having a home birth if the hospital environment makes you feel nervous. The advantage of this is that you would be in familiar surroundings, with people you want to be there. You may be more relaxed than in the very medicalised environment that most hospitals offer.

You may find a midwife-led unit provides you with more reassuring home-from-home care than a doctor-led labour ward. If you think you would feel more secure in a hospital, you should arrange, with you midwife, to look around the labour ward and see one of the rooms, so that it will not feel alien to you when the time comes.

Choose the best birth companion possible, this may be your partner, but it may also be a close female friend or relative.

The book I am reading says my baby shouldn’t be head down until 34 weeks. My baby is already ‘cephalic’ at 28 weeks. Is this OK?

Please be assured that this is absolutely normal. Cephalic means that the baby is lying head down and the vast majority of babies are in this position for most of the pregnancy.

Sometimes a baby stays in the breech (head up) position and if this continues until 37 weeks or later, the baby is less likely turn.

Generally we don’t expect the baby’s head to engage (go down into the pelvis) until about 36 weeks with a first pregnancy, but if it was a little earlier or later we wouldn’t worry.

Could I feel my baby moving at 16 weeks?
Each woman notices her baby’s first movements at different stages. Women often start to feel flutters at around 16-17 weeks, but we are all different, so don’t be alarmed if you don’t notice them until 20 -22 weeks. As the baby grows, these flutters will change to become quite recognised kicks.

Everyone says I look small. I am worried by this?
It is so very common for women to be concerned about these personal comments during pregnancy! People will either say that you are too small or too large or the baby is too low or too high but never for a moment do they think about how worrying it is for you.

If your doctor and midwife have been checking the size of your uterus (womb) and you have had a scan measuring the size of your baby then rest assured that your baby is okay. Probably your tummy muscles are firm which may make you look smaller when you are standing. The only accurate way to assess the size of your baby is by scan or physical examination when you are lying down.

Fundal height measurements can fluctuate between 2 and 4 cms higher or lower than the average for many reasons with the baby still being absolutely normal and healthy. There is often a slight discrepancy in the way different people measure or it will vary depending on the way the baby is laying at the time of measurement. The important thing is that the measurement continues to increase at a steady rate. If growth does seem to have slowed down, your doctor or midwife can arrange for you to have a growth scan.

I have been told I have PGP – what is it?
PGP stands for Pelvic Girdle Pain. This means that the joints in the pelvis are unstable and painful. It used to be known as SPD, (Symphysis Pubis Dysfunction). The name has been changed to reflect the fact that the pain is not always limited to the symphysis pubis which is the joint at the front of the pelvis. Pain can be felt in any of the pelvic joints; the symphysis pubis, the sacro-iliac joints at the back or in either or both of the hips. Some women also feel pain in their groin, legs and back.

Most PGP is caused by an underlying mechanical problem in the pelvis. For example, one joint may become stiff or stuck so others may compensate by moving too much. This can lead to pain. In pregnancy the normal movements of the pelvis can change because the pregnancy hormones relax the ligaments. This can lead to increased pain and discomfort. As the pregnancy progresses the increased weight and changes in posture can place even more stress on the pelvic joints, causing more pain.

Many women with PGP have difficulty walking and doing normal activities because of the pain and instability of the joints. Climbing stairs, turning over in bed and pushing a supermarket trolley can be particularly painful.

The severity of symptoms varies greatly from woman to woman. Some will only have mild symptoms whilst others will be severely affected. It is a significant problem and should not be dismissed as part of the normal aches and pains of pregnancy. It can be treated with physiotherapy.

How are due dates calculated?
If mothers are sure about their first day of last period (LMP), quite often practitioners calculate the expected date of delivery (EDD) based on that. Many places do offer early scans to double-check the date as well. There may be a variation due to different length of menstrual cycles for different women or not remembering it well. If the gap between the estimated date, from mother’s period and the estimated date from the scan, is more than about 10-12 days, they normally stick to the early scan date, as they may be more reliable in certain circumstances. Ultrasound scanning can be more accurate if it is performed early in pregnancy.

I have terrible spots. Why?
Many women find during pregnancy that the general condition of their skin improves; unfortunately this is not always the case.

The hormones of pregnancy can often cause an increase in the production of the skins natural oil sebum. Over production of sebum can clog up the skin pores which become infected so causing the spots typical of acne. However, your skin should improve as your hormones settle in the first few weeks following the birth of your baby.

In the mean time regular cleansing of the skin and avoiding oilbased products may help, if you wish to use any acne creams it would be best to seek the advice of your GP first.

I am always feeling down and depressed all the time . What can I do?
Early pregnancy can be a difficult time, your body is being flooded with hormones affecting everything from your mood, to your sleeping pattern, to your appetite. Digestive problems are very common, from mild nausea to morning sickness that lasts all day, extreme tiredness is another problem many women report during early pregnancy. Pregnancy will also bring changes to your lifestyle, adjusting and preparing for a new baby, although an exciting time can also seem rather daunting.

Often symptoms of nausea, sickness, tiredness and exhaustion begin to ease after 12-14 weeks of pregnancy. Hopefully as your pregnancy progresses, these ‘down’ feelings will subside and you will begin to feel more positive. However depression can occur in pregnancy and as at any other stage in your life seeking help to deal with depression is very important. Discussing your feelings with your Midwife or GP would be the first step.

Why do I get leg cramps?
Leg cramps are most likely because your leg muscles are tired from carrying around extra weight. Leg cramps can start to plague you during your second trimester and get worse as your pregnancy progresses and your belly gets bigger. They may be aggravated by the pressure your expanding uterus puts on the blood vessels that return blood from your legs to your heart and the nerves leading from your trunk to your legs. While these cramps can occur during the day, you’ll probably notice them most at night.

Try these tips for keeping leg cramps at bay:

  • Avoid standing or sitting with your legs crossed for long periods of time.
  • Stretch your calf muscles (see below) regularly during the day and several times before you go to bed.
  • Rotate your ankles and wiggle your toes when you sit, eat dinner, or watch TV.
  • Take a walk every day, unless your midwife or doctor has advised you not to exercise.
  • Avoid getting too tired. Lie down on your left side to improve circulation in your legs.
  • Stay well-hydrated during the day by drinking water regularly.
  • Try a warm bath before bed to relax your muscles.
  • There’s some evidence that taking a magnesium supplement in addition to a prenatal vitamin may have some benefit. But check with your Obstetrician or midwife before taking any kind of supplement during pregnancy.

If you do get a cramp, immediately stretch your calf muscles: Straighten your leg, heel first, and gently flex your toes back toward your shins. It might hurt at first, but it will ease the spasm and the pain will gradually go away. You can relax the cramp by massaging the muscle or warming it with a hot-water bottle. Walking around for a few minutes may help, too.

If your muscle pain is constant and not just an occasional cramp, or if you notice excess swelling or tenderness in your leg, call your practitioner. Slight swelling to the hands and feet in pregnancy is expected.

How long should I take folic acid for?
Folic acid is advised to be taken in early pregnancy (up to 12 weeks) as it may help in preventing neural tube defects. Since neural tube gets formed mainly in the early stage of pregnancy, it is recommended to take the supplements up to at least the 12th week of pregnancy. If you are concerned about having healthy food intake, you can try to have dark green leafy vegetables which are a good source of folic acid, all through your pregnancy.

What can I take for hayfever?
Speak to your doctor or pharmacist for advice. Many people prefer to avoid any medications in pregnancy at all especially in the first 3 months but if your symptoms are making life miserable, there may be other options.

You can reduce hay fever symptoms by small changes in the way you do things through the hay fever season, by understanding more about pollen release, and reducing your exposure to pollen, without significantly disrupting your life.

Understand when pollen levels are high and low, watch the pollen forecast. The pollen count is measured as the number of pollen grains in a cubic metre of air, sampled over 24 hours. It is usually given as low, moderate, high, or very high. Most sufferers will start to experience symptoms at moderate levels.

Watch the weather. Rain will wash pollen out of the air and stop plants releasing pollen. However the pollen builds up in the plants if it is not released, and so as soon as the sun comes out more pollen than normal will be released. The pollen level on this day will be higher than the pollen level on the same sort of day after several sunny days in a row.

Watch the time of day. Grass pollen is released in the mornings from about 7.30am on a dry warm morning, however dewy mornings delay the time of release. Light to moderate winds blow the pollen around, and increase the chance of breathing it in. Still sunny days cause the pollen to rise high into the atmosphere, reducing the chance of breathing it in. The pollen falls back to earth when the atmosphere cools, typically between 8-10pm in the countryside, but slower in a city where more heat is retained in the concrete and brick. Inner city areas can have the pollen fall peak at midnight, and it may continue until 2pm.

Reducing your exposure to pollen can be done in several ways keep windows and doors closed when pollen levels are high avoid cutting the grass or walking through cut grass keep the house as dust free as possible, to control pollen levels on high pollen days change your clothes and wash your hair when you come in, as you will be bringing pollen into the house on these days. Cover your bed and pillows with a spare sheet during the day, and roll it up carefully before going to bed. This will keep your bed as pollen free as possible. Dry clothes indoors, as pollen can stick to clothes hanging outdoors to dry wear wraparound sunglasses to keep pollen out of your eyes avoid areas where pollen is being released, such as unmown grass in the mornings, or near to pollen-releasing plants.

Air-conditioning can help filter pollen out of the air. This can help at work, at home, or in the car. Keep windows and vents closed when driving. Many newer cars can befitted with pollen filters in the air intake, if so use them and change the filters as directed.. Ionisers can also help. Keep away from pets who have been outside and avoid grooming them yourself, as they will carry pollen on their fur. Avoid smoky or polluted atmospheres which can make irritation worse. Do not rub your eyes. It only causes further swelling and redness.

It still would be advisable to review your hay fever with your GP in view of your pregnancy.

Do I have gestational diabetes?
In most women, gestational diabetes causes no symptoms. Some women do get symptoms of high blood sugar, such as increased thirst, increased need to pass water and increased hunger, although these are also common later on in pregnancy anyway. Tiredness is a common symptom of most pregnancies.

Gestational diabetes usually does not occur until the later half of pregnancy and, if present, is usually detected between 24 and 28 weeks gestation. Glucose found in the urine can be a marker for gestational diabetes but the only way to confirm gestational diabetes is with a glucose tolerance test. This needs to be carried out after eight hours without food. The woman is given a solution of glucose to drink, and then blood samples are taken and analysed at different intervals to see how the body deals with the glucose over time. It takes approximately 2 hours. Because you are at an increased risk of developing gestational diabetes you should be offered one of these tests routinely between 24-28 weeks. It might be worth mentioning it to your midwife at your next visit if she doesn’t.

Can you tell me about VBAC?
A couple of factors that are relevant to your thoughts on next deliveries are the reasons for the Caesarian Section this time. Did you ever go in to labour or was this an elective section? Did you get stuck in labour or was it performed because your baby was distressed?

It is often useful to “debrief” after delivery so it may be worth you contacting your Midwife or Consultant to have an opportunity for discussion of what happened and to formulate ideas for other deliveries.

There is an excellent website that will clarify many of your concerns – www.vbac.org.uk But a lot depends on local availability too.In general, about 70% of mothers can have a vaginal delivery after 1 Caesarian section, usually conducted in hospital for closer observation of the labour. The recognised risks are that of rupture of the old scar as there is a slight weakness there and the need for a repeat section. However some mothers do have VBAC at home usually under the care if an Independent Midwife.It may be appropriate for you to book a Domino delivery so your Community midwife goes into hospital with you, and as she will know you well, and you her, this can inspire greater confidence and control for your labour.

Is it safe to clean the oven while pregnant? I am 32 weeks pregnant and cleaned the oven using an oven cleaner product. I have now heard that this is very toxic? Will this cause harm to my baby?
Some chemicals can cause harm to the unborn child, and it is important to remember than chemicals are not usually tested for safety on pregnant women. .

We don’t know enough about the wide variety of commonly used household chemicals and cleaning products to give them a clean bill of health. If you’re using them, keep the products to a minimum, make sure the area is well ventilated, follow the instructions and wear gloves as you could have increased skin sensitivity during pregnancy . Avoid direct contact with products that have strong fumes and extensive warning labels, such as certain oven cleaners and bathroom tile cleaners. Avoid pesticides, insecticides, and fungicides. To inhale fewer fumes, keep your windows open and avoid inhaling them too much. And buy products that are not in aerosol cans.

The Health and Safety Executive booklet New and Expectant Mothers at Work offers detailed guidance on assessing health and safety risks from chemicals and other factors in the workplace. (It is available from The Stationery Office bookshops or call 020 7873 0011.)

I’m 7 weeks pregnant and used a bikini hair removal cream without thinking about it yesterday. It contains thioglycolate and alkali, is it likely to have done any harm or if not is ok to continue using it?

I have not found any evidence to suggest particular problems in using depilatory creams, particularly if you use them already.

However always read manufacturers instructions. Your skin can become more sensitive in pregnancy.

Hair growth may be worse, thicker and more of it, because of pregnancy. Try not to worry about it. Also the smell of these products is fairly unpleasant and could make you nauseous.

It may be worth discussing it with your Pharmacist if you are very keen to use a product, as they will be able to advise on ingredients.

Also it may be worth visiting a reputable beautician to take advice on this as they may have safe alternatives for during pregnancy.

For the past 4 weeks or probably longer, I have been eating a mug full of crushed ice cubes about 4 times a day. Is there any significance in this or is it just a strange craving?

This does sound like a craving, many pregnant women seem to enjoy crunching on ice. Whether it is the extreme cold or the texture I don’t know. No one knows for sure what causes food cravings. Many women find that their senses of taste and smell are changed by pregnancy. For example, some women experience an odd metallic taste in their mouths very early in pregnancy (maybe the first sign of pregnancy for an ‘experienced’ mother!), whilst others find that taste and smell are dulled by that nasal stuffiness. It could be that these changes also affect food likes and dislikes.

Some people think that cravings happen in response to temporary deficiency of specific nutrients. There is probably some truth in this, but it is not the whole story. We only need minute quantities of each vitamin and mineral, certainly not enough to justify a continual craving for just one food.

Rather than develop a food craving, many women find they suddenly go off certain foods or drinks like coffee and alcohol, maybe, or fried foods or very rich foods. This is often related to pregnancy sickness, but may also be the body’s way of ensuring that they eat and drink wisely.

A craving for non food items, such as soap or toothpaste, is known as ‘pica’. Pica is potentially very harmful if indulged.

But, generally there’s no harm in giving into food cravings, especially if doing so helps you through pregnancy sickness. However, try to indulge only in moderation. If you eat a lot of one food, you are probably not eating much of anything else and may, over time, become deficient in important nutrients. The ice is likely to be keeping your fluid intake at a good level and may even stimulate your baby to move in response.

I am currently 32 weeks pregnant. When I was walking around the shops today I kept having twinges at the bottom of my back and then had an aching pain across my stomach which lasted for around 20 minutes. Also my stomach kept going hard. Do you know why this was happening?
It rather sounds like you were experiencing Braxton Hicks contractions, a normal occurrence at this stage of pregnancy. They are painless tightening of your womb muscles, but can still feel uncomfortable.

It is quite common for exercise to bring them on, such as the walking around the shops. You should find that if you rest for a while they ease off. As your pregnancy progresses, you will find that they become more frequent and intense especially towards the end of it. But if you are concerned do contact your midwife or the maternity unit for advice.