Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts

Wednesday, December 24, 2014

My Pregnancy Journey - 38 Weeks

dear and i had mcdonald's breakfast this morning before his only appointment prior to the scheduled gynae visit at 12 noon. time check at 0930am and we were wondering if baby would have arrived should we have gone for the previously planned caesarian on christmas eve morning. this was in place due to baby shifting back to breech position a few weeks back. we went on to discuss plans for tomorrow, christmas day. options were to go window shopping at newly opened shopping malls, one km or seletar, or we could spend a day at jurong bird park. what helped made the decision for the latter was when we saw the newspaper ad for sintex warehouse sale at jalan ahmad ibrahim. since the sale location is near bird park, we could conveniently do both. little did we expect a huge surprise awaits us.

since i was not having any contraction symptoms, thought we would be ending this 2nd last pre-natal visit with "see you next week!". as we proceed with the usual OBS scan, dr claudine exclaimed "aiyo! you know what this boy do?". both dear and i froze for that second. "alamak! you tell me how?" she asked as she moved the scanner nearer my ribcage - we saw baby's head. she then provided the 2 available options, to arrange for caesarian tomorrow or to wait and hope baby turns down by 29 Dec. after much discussion on the pros and cons and also the possibilities of ending up with an emergency caesarian, dear and i decided to welcome our baby boy on christmas day. 2 of the main concerns were my water bag may break while baby is breech, his limbs might fall out or if baby fortunately heads down, and we induce the birth, there is a higher chance of ending up with an emergency caesarian.

as we trudged home trying to digest the fact that baby will be here tomorrow, there are last minute preparation to be done, eg. installation of the car seat and informing parents and close friends of the news. mixed feelings of excitement and anxiety, excited to finally meet our baby and at the same time worried of the new challenges ahead. nevertheless, i pray for a smooth delivery, a healthy and strong baby.

Christmas Eve Dinner - last meal before welcoming our Christmas baby

Thursday, December 18, 2014

My Pregnancy Journey - 37 Weeks

Admission Letter from Gynae

finally received the legendary blue letter from dr claudine, she has not been able to pass a verdict on which form to issue me due to our mischievous baby. he turned down at 32 weeks and went into breech again during 34 weeks, which we then scheduled a caesarian section on christmas eve morning, the latest date the surgery can be performed. wonder if our boy was pulling a fast one on us or that our daily counseling worked, he was back in the head-down position at 35 weeks. dr claudine decided to go through the consent form and delivery charges with us after she comes back from her 2 weeks break.

Addendum to Consent Form - Normal Labour

the form consists of 3 parts :
  • labour risks
  • labour care and possible other procedures
  • acknowledgement section

Estimation of Doctor's Fees - amount before GST

1. doctor's professional fees
  • normal vaginal delivery $2100 - $2700
  • vacuum / forceps $2700 - $3300
  • lower segment caesarian section $3300 - $4000
2. doctor's daily attendance fees $200 - $240 per trip, usually 2-3 trips
3. anaesthetist $600 - $800 per trip, caesarian section 25% surgeon's fee
4. paediatrician $600 - $800

Low Vaginal Swab

went through the microbiological examination for group B strep and results would only be available the following week. a vaginal swab is taken and sent to the laboratory. the cells from the swab are transferred onto a dish or ‘plate’ containing agar (a growth medium) and after 24 and 48 hours incubation, the plate is examined to see if GBS has grown.

whatever the result of a group B strep specific test, it is good news. if test result is negative, that is great. if test result is positive, that is also good news – although it means the baby is at a raised risk of developing group B strep infection, it also means the risk is known so steps can be considered that have been proven to be hugely effective at minimizing that risk.

Nesting Instinct

much as i have been packing, cleaning, washing and putting baby stuff in place consistently since 31 weeks, something seems to need to be done everyday.

duckie - 1st toy from mummy & daddy
mini cot 23"x42" at my in-laws'
luxury cot 130x70cm at my parents'
recycling a cupboard that mum wanted to discard for storing of baby's daily necessities

Thursday, December 11, 2014

Singapore Cord Blood Bank - SCBB

Cord Blood Donation Process
  1. Speak with the delivering doctor on the intention to donate cord blood.
  2. Call SCBB at 63945011 for a pre-screening and appointment after 32 weeks of gestation.
  3. Meet the SCBB nurse coordinator to sign the volunteer information and informed consent form and complete the maternal risk questionnaire.  
  4. Affirm the volunteer information and informed consent form in delivery suite/labour room.
  5. Collection of maternal samples - approximately 30ml of blood.
  6. After the baby is delivered, the umbilical cord is clamped and cut, the cord blood is then collected before the placenta is delivered.
  7. The collected cord blood and the mother’s blood samples will be brought to SCBB laboratory for evaluation and processing.
For more information, please visit http://www.scbb.com.sg/Pages/Home.aspx

whether to store or donate our baby's cord blood has been on my mind since 1st trimester. read up on the benefits of storage with private banks and always wondered if our child would need it. finally reached a decision during early 3rd trimester when both dear and myself find it unnecessary since it would not be helpful if there is unfortunately a genetic issue.

procrastinated the donation registration due to the seemingly troublesome pre-screening. upon confirmation from 2-3 friends that it was a relatively short and fuss-free process, i skipped the discussion with gynae portion as she was not in town till coming friday and called SCBB line on tuesday afternoon. the phone conversation took about 15 minutes, had to answer some background/health related questions and made appointment to sign necessary documents.

the face-to-face meeting is usually fixed in conjunction with gynae appointment. however, mine was done near home this afternoon as they do not work weekends and my upcoming gynae visit happens to be on saturday. doreen, nurse coordinator for SCBB, was friendly and helpful. though i have to mention that she rushed through the pretty lengthy questionnaire and shorten the meeting to only 20 minutes, she had all areas covered. managed to also find out that if in case immediate family (eg. parents/siblings) needs a transplant, we can check if the donated cord blood is still available, using either of the parent's IC no. to track.

hope the donation will be a success and save another person's life.

Sunday, December 07, 2014

My Pregnancy Journey - Part 12

Birth Plan

there are occasions when i popped random questions at my gynae when they come to my mind, such as "can episiotomy be performed if i opt for natural delivery without epidural?", but never gotten down to write my birth plan till now at 36 weeks. will discuss with her during my next visit at 37 weeks to ensure that we are on the same page and make necessary changes if needed.

What Is A Birth Plan?

A birth plan is a sheet communicating your concerns and wishes for the nurses, midwives and doctors caring for you in labour and birth. It describes how you would like labour and birth to be managed, the kind of support you would like, such as a doula, and your preferences for comfort measures and interventions. It also includes your wishes if things do not go as expected, and for breastfeeding and postpartum care.

Why Write A Birth Plan?

You may feel that you do not really know what to expect in labour. Even so, there is value in creating your birth preference sheet.
  • When crafting your birth plan in pregnancy, you find out about options for labour and birth. This reflection and information gathering prepares you to make considered decisions in labour and birth. You also feel more confident as birth approaches!
  • A birth plan is more than a checklist; it is a vehicle of discussion with your doctor. As you and your doctor go over the draft, you are able to discuss specific wishes; your doctor gains insight into your concerns and gives feedback.
  • Your birth plan allows you to communicate with the labour ward staff, enabling them to support you in the way you want.
  • In labour, you would not want to be answering questions. Having a birth plan ensures that those around you know your preferences.
  • This is especially true if you have less common wishes for your birth such as allowing your baby to descend gently without prolonged periods of pushing or ‘cheerleader-style’ coaching from those caring for you in the crowning stage. Other requests may include your desire to give birth in an upright position or skin-to-skin contact with your baby immediately after a C-section.

How Do You Create A Birth Plan?

① Research & Reflect - Become informed about all available forms of comfort measures and pain relief. Find out about the benefits and drawbacks of each alternative. Read about routine procedures and when these are medically necessary. Take independent childbirth classes, learn new skills. Use your new found knowledge to work out your philosophy towards your birth. All the requests in your birth plan need to be consistent with the kind of birth you want. For instance, if you would like minimal interventions, think about how this can be achieved and what you would need to do to reach this outcome.

② Draft - Write a draft.

③ Dialogue With Your Doctor - Discuss the draft with your doctor. During these discussions, you will learn how compatible your wishes are with your doctor’s and hospital’s practices. Stay flexible, but aware of your goals for your birth.

④ Your Final Birth Plan - Towards the end of your pregnancy, you will arrive at a final version, a product of your research, reflection, and dialogue with your doctor.

Consider these dos and don’ts

① Layout - Organise your plan as a chart or using bullet points. Use short paragraphs and clear sub-headings.

② Language & Choice of words - A long list of demands for your doctor and his staff may be frustrating for them. Opt for an easy-to-read style and use words that are neither passive (“if it is possible, could I have…”) nor aggressive (“do not perform unnecessary vaginal exams…”). Go for a friendly, respectful tone. Keep a copy in your patient file, pass one to labour staff, and keep a copy handy for yourself.

③ Sample Birth Plan - Point-Form Birth Plan
  • Introduction about you and your partner, your feelings, your background – state strong feelings for example, about having an unmedicated birth.
  • Your goals, wishes and other concerns – mention any fears or past experiences.
  • Your preferences for managing labour pain – think of your preferences as being on a scale, with one end being ‘feeling no discomfort at all’ and the other end being ‘no medical pain relief, only comfort measures such as using a birth ball’.
  • Interventions – when labour progresses normally, are interventions necessary for safety? What are your views on monitoring the baby/contractions, using drugs to speed up labour, intravenous fluids, having an episiotomy, vacuum or forceps birth or coached pushing as the baby emerges?
  • Preferences for unexpected events – consider how you can still meet many of your goals for example, in a C-section or with kangaroo care.
  • Postpartum care – mention rooming-in or dietary needs.
  • Newborn care & breastfeeding – mention your wishes for skin-to-skin contact after birth, plans for newborn procedures and breastfeeding.

Show your birth plan to your gynae and ask her to go through it with you during one of your antenatal appointments, ideally before you are 36 weeks pregnant. Discussing your plan with your gynae will give you the chance to ask questions and find out more about what will happen when you go into labour. Also, by listening to your preferences, your gynae will get to know you better and understand what is important to you

Though a birth plan is helpful, labour and birth are unpredictable. Your midwife may need to recommend a course of action at any time which is not what you had originally hoped for. But this will always be in the best interests of you and your baby.
You may choose not to write a birth plan or defer birth decisions to your doctor. Even so, you already have some beliefs and expectations regarding your birth and writing your birth plan on paper is merely a way of communicating those goals to your birth team. The information-gathering, self-awareness and reflection you go through in creating your birth plan are all as vital to having a fulfilling birth as the birth plan itself!

Sunday, November 30, 2014

My Pregnancy Journey - Part 11

Swelling Ankles and Feet

wonder if i am lucky to be experiencing these only at 35 weeks. may have been self-inflicted as i was involved in sitex show for the past 5 days. ankles and feet swelled badly the day i got home after set up and the back pain is affecting my movements, both walking and sitting. resorted to raising my legs when i sleep and the swell subsided after 2 days.

Why are my ankles and feet so swollen

What you are experiencing is edema – that is when excess fluid collects in your tissue. It is normal to have a certain amount of swelling during pregnancy because you are retaining more water. Changes in your blood chemistry also cause some fluid to shift into your tissue.

In addition, your growing uterus puts pressure on your pelvic veins and your vena cava, the large vein on the right side of the body that carries blood from your lower limbs back to the heart. The pressure slows the return of blood from your legs, causing it to pool, which forces fluid from your veins into the tissues of your feet and ankles.

Swelling is common, about half of all pregnant women experience swelling around their ankles, particularly in the last few months of pregnancy. It may be particularly severe for women with excessive amniotic fluid or those carrying multiples. The swelling in your legs usually gets worse as the day progresses, especially if you are on your feet a lot. Gravity makes the fluid build at the lowest point. Hot weather and being tired can also make swelling worse. You may find your fingers, face and lower back become swollen too.

Your swelling is likely to become temporarily worse in the first three or four days after your baby's birth. As your body recovers after birth, all the extra tissue, blood vessels and fluid needed during pregnancy now need to be dissolved and expelled. You may find yourself urinating frequently and sweating a lot in the first days after childbirth.

When should I be concerned about swelling

Call your gynae if you notice swelling in your face or puffiness around your eyes, more than slight swelling of your hands, excessive or sudden swelling of your feet/ankles or moves up your calf and leaves an indentation when pressed. This could be a sign of preeclampsia, a serious condition.

Also, if you notice that one leg is significantly more swollen than the other, especially if your calf or thigh is red, tender and lumpy. This could signal a blood clot in your vein - thrombosis.

What can I do to minimize the swelling

It may not be possible to prevent some swelling from developing. But you can prevent it from becoming severe. Severe swelling can make your legs painful and your skin tender. You can help relieve the increased pressure on your veins by lying on your side. Since the vena cava is on the right side of your body, resting on your left side works best.

Try to eat a balanced diet so that you put on a healthy amount of weight during pregnancy. Your diet should include a small amount of lean protein such as meat, poultry, eggs, beans and pulses, with each meal.

Eat at least five portions of fruit and vegetables every day. Aim to reduce how much salt, sugar and fat you have and drink plenty of water to help your kidneys to filter the excess fluid.

Some foods may help to maintain good kidney function and make you wee more (natural diuretics). These include celery, watercress, parsley (in small amounts), apples and citrus fruits. Onions and garlic may help to improve your circulation

Try to avoid eating pre-packaged, highly processed foods that contain both salt and other additives, as these can make fluid retention worse. Opt for foods which are naturally rich in vitamins C and E.

Good sources of vitamin C include:
  • citrus fruits
  • green and red peppers
  • melons
  • potatoes
  • tomatoes
  • strawberries
  • cabbage
  • broccoli
Foods rich in vitamin E include:
  • vegetable oils (especially corn, soy and wheatgerm oil)
  • sunflower seeds
  • wheatgerm
  • sweetcorn
  • cashews and almonds
  • corn oil margarine

What tips can I try to ease swelling

Rest as much as possible, putting your feet up by resting them on a stool or pile of books. Try not to cross your legs or ankles while sitting, as this restricts your blood flow. Sit down when you can, and if your work involves standing for long periods of time, move about from one foot to the other to increase blood flow. Take regular breaks from sitting or standing. A short walk will help keep your blood from pooling in your lower extremities.

Stretch your legs frequently while sitting. Stretch your leg out, heel first, and gently flex your foot to stretch your calf muscles. Rotate your ankles and wriggle your toes. Ask your partner to massage your feet and legs gently, using both hands and working upwards from feet to knees, using a base oil such as grapeseed. However, if your legs are excessively swollen and the skin is very tight, this may be too painful for you.

Avoid using aromatherapy essential oils for massage, but you can add them to a bowl of water and soak your feet in the mixture. Cypress oil is particularly good for circulation and varicose veins. Lavender and camomile oil may ease your discomfort and make you feel more relaxed.

You could try placing green or white cabbage leaves on the swollen area to draw out excess fluid and relieve your discomfort. The leaves should be wiped clean but not washed, and may be cooled in the refrigerator, but not in the freezer. Wrap the leaves around the most swollen parts of your legs and feet to make a compress. Leave them until they become wet, then repeat with fresh leaves until the pain is reduced. Repeat this as often as necessary until you feel more comfortable.

Dandelion tea, a herbal remedy, may help to prevent fluid retention, but do not take this if you have a gall bladder condition. Always drink herbal teas in moderation during pregnancy.

Acupuncture may help. The theory is that it re-balances your internal energies and aids your circulation and kidney function. Osteopathy and chiropractic treat misalignment in your skeleton, which may be placing stress and tension on specific areas of your body, restricting your blood flow.

Foot massage may help to relieve your swollen ankles, and reflexology may ease swelling and the discomfort it causes. Choose a registered reflexologist who is qualified and insured to treat pregnant women.

Wear comfortable shoes that stretch to accommodate any swelling in your feet. Do not wear socks or stockings that have tight bands around the ankles or calves. Try waist-high maternity support stockings. Put them on before you get out of bed in the morning so blood does not have a chance to pool around your ankles.

Drink plenty of water. Surprisingly, this helps your body retain less water.

Exercise regularly, especially by walking, swimming, or riding an exercise bike. Or try a water aerobics class – immersion in water may temporarily help reduce swelling, particularly if the water level is up near your shoulders.

Sunday, November 16, 2014

Maternity Shoot @ Dakota Crescent













































location Dakota Crescent
photos by Kiat Ng

Sunday, November 09, 2014

Dec 2014 Mummies @ Caribbean Keppel Bay





location provided by Terence Wong & Mindy Fang
photos by Kiat Ng



thank you Mark for helping us with the couple shots. =)