Warning Signs in Pregnancy

Call your midwife immediately if you are experiencing any of the following symptoms;

• A headache that doesn’t go away, or gets worse.

  • Starts suddenly and causes severe pain. 

  • Doesn’t go away with water or medication.

• Episodes of dizziness or fainting.

• Fluid or blood leaking before the baby is born. 

  • Or filling more than one pad an hour after the baby is born. 

• Thoughts of hurting yourself or baby. 

  • Feelings of hopelessness, extreme worry, overwhelming thoughts, or feeling out of touch with reality. 

• Vision changes.

  • Bright spots, flashes, blind spots, or blurriness. 

• Fever or temperature of 100.4°F (38°C) or higher.

• Trouble breathing or shortness of breath. 

  • Chest or throat may feel tight. 

  • Trouble catching your breath. 

• Chest pain or a fast heartbeat. 

  • Tightness or pressure in the chest. 

• Severe belly pain that doesn’t go away. 

  • Sharp, stabbing, or cramp-like sensation. 

• Severe nausea and vomiting (not morning sickness). 

  • Unable to eat for 24 hours or drink for 8 hours.

• Slowing or stopping the baby's movements.

• Any swelling, redness, or pain in extremities.

• Swelling of face or hands.

• Overwhelming fatigue or exhaustion. 

  • Unable to complete daily tasks. 

• Or any time you are worried or concerned about you or your baby’s wellbeing. 

References

ACOG. (2020). Urgent maternal warning signs. Retrieved from: https://safehealthcareforeverywoman.org/council/patient-safety-tools/urgent-maternal-signs/#link_acc-43-45-d 

Delaney, S. (2020, Mar 12). Warning signs in pregnancy. [webinar] Midwives College of Utah. Retrieved from: https://prezi.com/v/1n_pscl5efvc/mdwf-2010-warning-signs-in-pregnancy/

Hygiene in Pregnancy

Dental Hygiene: Research has demonstrated that there is an evident relationship between oral health and hygiene and infant health. The following are some guidelines for good dental hygiene: 

• Brush your teeth with fluoride toothpaste twice a day for two minutes. 

• Floss your teeth once a day.

• Maintain regular dental cleaning every six months and attend to dental problems as they arise. 

Vaginal Hygiene: The vagina is equipped to be self-cleaning, with the use of natural discharge. This discharge can look different depending on where you’re at in your cycle and changes often in pregnancy. Healthy discharge doesn’t have a strong smell or color and shouldn’t cause itchiness or soreness. When the vagina is healthy it's full of good protective bacteria. This good bacteria helps keep out any bad bacteria that might cause issues like infections or inflammation. It also helps the vagina’s pH balance, which is naturally acidic, even. 

• Washing Your Vagina: 

  • Soaps, perfumes, antiseptics, oils, gels, and douching products are never a good idea for washing the vaginal area. These products can kill the good bacteria and through your pH balance off. 

  • When washing your vagina simply use clean running water once a day. Some people find washing more often during their period is needed. 

• Perineal Hygiene During Sexual Intercourse:

• Using a condom during sex can prevent STIs like chlamydia, gonorrhea, genital herpes, genital warts, syphilis, and HIV. 

• Some lubes can affect the bacteria and pH balance of the vagina. 

• Clothing and Vaginal Health: 

  • Try to avoid underwear fabrics like lace, nylon, and spandex. Cotton underwear is the best option for vaginal health as it allows airflow and it absorbs excess moisture. Also, health-wise, no underwear is a valid and healthy option. 

• Toilet Habits: 

  • When wiping, go from front to back. Never back to front, as this can drag bad bacteria into the vagina. 

Tips for Infection Prevention:

• Use proper handwashing. Hand washing means using clean running water and soap to scrub your hands for 20 seconds or sing the Happy Birthing song twice. Use proper handwashing after coughing, sneezing, blowing your nose, using the restroom, handling animals, or have been in a public place. Use alcohol-based hand sanitizer when hand washing is not available. 

• Keep fingernails trimmed and clean. 

• Take regular showers and practice body and facial hygiene. 

• When coughing or sneezing direct it into your elbow and face away from people around you. 

• Considerations during COVID19 pandemic:

  • Wash your hands or use hand sanitizer frequently. 

  • Wear a mask when in proximity to other people not of your household. 

  • Stay home if you or your family is sick. 

Resources:

• The V Book, by Elizabeth Stewart (Bantam Books, 2002)

• CDC: Hygiene Etiquette & Practices- https://www.cdc.gov/healthywater/hygiene/etiquette/index.html

• CDC: Handwashing & Nail Hygiene- https://www.cdc.gov/healthywater/hygiene/hand/index.html

• NHS: Keeping Your Vagina Clean & Healthy- https://www.nhs.uk/live-well/sexual-health/keeping-your-vagina-clean-and-healthy/

• NHS: How to Keep Your Teeth Clean- https://www.nhs.uk/live-well/healthy-body/how-to-keep-your-teeth-clean/#:~:text=Brush%20your%20teeth%20with%20fluoride,brushing%20stops%20plaque%20building%20up. 

• Women's Health: Douching- https://www.womenshealth.gov/a-z-topics/douching

References

Boggess, Kim. (2008). Maternal Oral Health in Pregnancy. Obstetrics & Gynecology, 111, 976-986. https://doi.org/10.1097/AOG.0b013e31816a49d3 

Lewis, F.M.T., Bernstein, K.T., Aral, S.O. (2017 April). Vaginal microbiome and its relationship to behavior, sexual health, and sexually transmitted diseases. Obstetrics & Gynecology, 129(4): 643-654.

Prenatal & Postnatal Care 2e. "Conditions Affecting Oral Health" (pp 250-251).

Work In Pregnancy

Laws and Rights 

• When to Notify Your Employer: There are no laws on when to announce your pregnancy. Some parents wait until after the first trimester, others notify right away. Either way is completely fine. Just remember that you want your employer to hear the news from you and not around the workplace. 

•  Employee Rights: Thanks to the passing of The Pregnancy Discrimination Act of 1978, parents have protected rights in the workplace. This act prohibits discrimination on the basis of sex, pregnancy, childbirth, or medical conditions for any employment-related purposes. Fringe benefits like insurance are also protected by this act. 

• Programs to Support Workers During Pregnancy and Postpartum:

  • Family and Medical Leave Act: Allows eligible employees to take 12 unpaid work weeks off in a year for the birth of a child or care of a newborn. 

Safety Considerations

• Being on your Feet for Long Hours: Besides being tiring, long hours on your feet can reduce blood flow and cause varicose veins or other discomforts. Take frequent breaks for sitting, and consider wearing compression stockings to increase blood flow. 

• Lifting: Research shows that bending at the waist more than 20 times per day or lifting objects more than once every 5 minutes, may increase risks for some adverse birth outcomes. Take breaks whenever possible and sit down frequently. When you are lifting remember to use proper posture and avoid bending at the waist. The CDC recommends following these simply lifting in pregnancy guidelines: https://blogs.cdc.gov/niosh-science-blog/files/2013/05/ClinicalGuidelinesImg-NewLogoFinal.jpg 

• Possible Exposure: Some workplaces have exposure to certain elements that may be harmful to your pregnancy. This could include chemicals, toxins, sickness, trauma, or undue stress. I encourage conversations with your employer about reducing or eliminating exposure to these elements. 

• Stress and Emotional Considerations: Pregnancy is a time of great change and transition both physically and emotionally. These changes can impact everyone differently and it's important to listen to your body and do what you feel is best for you and your family. 

FAQ

• Can I keep working in pregnancy? Yes! Many parents continue working throughout pregnancy. However, listen to your body and do what feels right for you, your baby, and your family. 

• When should I cut back/stop working? The short answer is whenever it feels right to you. Some people work right up until birth, others prefer to take a few weeks off before their due date. 

•  How long should I plan to take off work after birth? My recommendation is also to take as much time as is reasonable for your family. Many family’s take around 6-12 weeks off work.

Resources:

1. March of Dimes: Being Pregnant at Work: https://www.marchofdimes.org/pregnancy/being-pregnant-at-work.aspx#

2. Mayo Clinic: Working During Pregnancy: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20047441#:~:text=Most%20women%20can%20continue%20working,task%20might%20jeopardize%20your%20pregnancy.

3. Stanford Children’s Health: Work and Pregnancy: https://www.stanfordchildrens.org/en/topic/default?id=work-and-pregnancy-85-P01244

4. Family and Medical Leave Act: https://www.dol.gov/agencies/whd/fmla/faq#13 

References

Pregnant at Work: https://www.pregnantatwork.org/healthcare-professionals/

National Institute for Occupational Safety and Health (NIOSH). (2019 Nov 15). Reproductive health and the workplace. Retrieved from https://www.cdc.gov/niosh/topics/repro/physicaldemands.html

U.S. Department of Labor. (n.d.). Family and Medical Leave Act. Retrieved from https://www.dol.gov/agencies/whd/fmla 

U.S. Equal Employment Opportunity Commission. (1978). The Pregnancy Discrimination Act of 1978. Retrieved from https://www.eeoc.gov/statutes/pregnancy-discrimination-act-1978