Exercising During Pregnancy

All women who are pregnant without complications are encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy.

There are many benefits from exercising regularly during pregnancy. These include physical benefits and the prevention of excessive weight gain, as well as benefits for psychological wellbeing.

Before you start any exercise program you must speak to your obstetrician to make sure that you do not have any health issues that may stop you from participating in regular exercise during your pregnancy.

For those women that may be worried there is no actual evidence to suggest that regular exercise during a healthy pregnancy is harmful to the woman or her baby, therefore you are encouraged throughout your pregnancy to participate in regular aerobic and strengthening exercises.


Suggested exercise activities during your pregnancy

It is recommended that you are active most days if not every day. However, if you are currently inactive or overweight, you should start with 3-4 days per week on non-consecutive days.

There are two types of exercises that you are encouraged to do whilst pregnant, aerobic and strengthening exercises.

Aerobic exercises involve continuous activities that use large muscle groups and raise the heart and breathing rates.
Some examples of aerobic exercises include:

·      Brisk walking
·      Stationary cycling
·      Swimming and other water based activities like aquarobics (avoid heated spas & hydro pools)

Strengthening exercises suggest being performed 2 times per week, on non-consecutive days, this covers the main muscle groups of the body.

You can use light weights, body weight or elasticised resistance- bands.
Some examples of Strengthening exercises include:
·      Pelvic floor exercises
·      Yoga, stretching & other floor exercises
·      Pilates
·      Pregnancy exercise classes

Important tip: pelvic floor exercises are vital to begin conditioning the pelvic floor muscles from the start of your pregnancy as these muscles are weakened during your pregnancy and during vaginal birth.

It is important to continue with these throughout your pregnancy and resume as soon as you are comfortable after birth (consult with your obstetrician).


Exercises to Avoid

A list of exercises you should avoid include:
·      Abdominal trauma or pressure activities such as weightlifting or heavy lifting
·      Contact or collision sports such as martial arts, soccer, basketball (other similar sports)
·      Hard projectile object such as hockey & cricket
·      Falling such as skiing & horse riding
·      Extreme balance such as gymnastics
·      Major changes to pressure such as scuba diving
·      High-altitude training over 2000m
·      After your first trimester you should not perform any exercises lying flat on your back
·      It is also recommended to avoid walking lunges & wide squats as they can cause injury to the pelvic connective tissue.

If you are not sure whether a certain activity is safe during your pregnancy, you must check with
your obstetrician at your antenatal appointments.
 

Warning signs when exercising during pregnancy

If you experience any of the following during or after physical activity, stop what you are doing and contact or obstetrician or GP, or in an emergency go straight to your booked hospital.

·      Headache
·      Dizziness or feeling faint
·      Heart palpitations
·      Chest pain
·      Swelling of the face, hands or feet
·      Calf pain or swelling
·      Vaginal bleeding
·      Contractions
·      Deep back, pubic or pelvic pain
·      Cramping in the lower abdomen
·      Walking difficulties
·      An unusual change in your baby’s movements
·      Amniotic fluid leakage
·      Unusual shortness of breath
·      Excessive fatigue
·      Excessive muscle weakness.

For any further questions please speak to your obstetrician at your antenatal appointments.

Miscarriage

The loss of a pregnancy can be a very difficult time for a woman and her family. 
Miscarriages are more common than you may think, and something that no woman should feel embarrassed or ashamed about as miscarriages affect about 1 in every 5 pregnancies.

What is a miscarriage?

Miscarriage is very common in the first few weeks of pregnancy.
They can occur so early in a pregnancy that a woman may not know that she was pregnant. However most occur within the first 10 weeks of gestation. Once a healthy pregnancy has reached 10 weeks, the risk of a miscarriage decreases but can still occur.

When a miscarriage occurs, eventually the pregnancy tissue will pass out of the body. Some women will feel cramps, period-like pain and in most cases there will be vaginal bleeding (you must consult with your obstetrician).

Causes of a miscarriage

The cause of a miscarriage is often unknown. Generally,  at least half of all miscarriages occur because the fetus was not developing properly. In this case, miscarriage is nature’s way of dealing with an abnormal embryo. Nothing can be done to prevent miscarriage from occurring if a pregnancy is developing abnormally.

Risk Factors

- Age (the risk increases in women older than 30 years of age, with a significant increase in women over 35; at age 40 the rate of miscarriage  increases to about 1 in every 2 pregnancies).
- Previous miscarriages
- The use of some medications (speak to your obstetrician about what you are taking)
- Use of alcohol, cigarettes and/or drugs
- Previous surgery, abnormalities or trauma to the uterus
- Fetal chromosome abnormalities
- Some medical conditions in the mother, such as poorly diabetes, fibroids or thyroid problems, can lead to miscarriage. Rare medical conditions which affect blood clotting can also cause miscarriage. Women who have three or more miscarriages in a row should be checked for these conditions.

Diagnosing Miscarriage

Women seek medical care at different stages of a miscarriage; sometimes the miscarriage has already happened and sometimes it has only just begun.

Although signs and symptoms may vary, they may include vaginal bleeding, abdominal cramps and pain, and the passing of tissue.

To confirm that you have had or are having a miscarriage your obstetrician will look at a number of things, including:

- your symptoms; such as pain and bleeding
- examination results
- ultrasound and blood test results

After an examination has been done by your obstetrician, then they can advise on what steps need to be taken next.

Preventing miscarriage

Miscarriages can happen to the healthiest of women; however, being healthy will increase your chances of a healthy pregnancy.
What you can do to limit this is to follow the advice for a healthy pregnancy:
- don’t smoke
- limit your caffeine intake
- avoid alcohol
- try to avoid contact with others who have a serious infectious illness

The Emotional Impact

There are a wide range of emotions that women may feel after having a miscarriage. A miscarriage may cause intense grief and depression, that could be for a brief or long lasting amount of time. 
It has been reported that many women feel:
- emptiness & failure
- anger & guilt
- disbelief & sadness
- disappointment & loss.

Women will often struggle with feelings of self-blame & wonder whether they could have done anything to cause or to prevent their pregnancy loss.
Grief is a normal and valid reaction for the woman and her partner. They need to allow time to grieve and come to terms with the loss. The time it takes to grieve and understand varies for each individual.

Doctors agree that a miscarriage is almost never caused by anything the woman did or failed to do. In most cases the next pregnancy will be a success.

If you feel you need to speak to someone but don't know where to turn, just visit the Beyond Blue website or call them on 1300 224 636.

After a miscarriage

- Rest for a few days
- Avoid using tampons and having sex for about 2 weeks
- Depending on your obstetricians advice you may consider becoming pregnant any time after the normal menstrual cycle has resumed.

It is normal to seek help from a physiologist or counsellor if you are finding it hard to come to terms with the loss of your pregnancy.
Please see our 'Useful Link' page for links that may help you. 
https://www.stela.com.au/useful-links-1/

 

CST is the new pap smear and why do I need it?

If you’re female, you’re going to need numerous CST (Cervical Screening Tests) over your lifetime. But what is a CST? And are CST's necessary?

WHAT IS A CST?

The Cervical Screening Test is a simple procedure to check the health of your cervix. If you have ever had a Pap test before, the way the test is done will feel the same.

The Cervical Screening Test replaces the two-yearly Pap test for people. If you're aged 25 to 74 you should have your first Cervical Screening Test two years after your last Pap test.

The Cervical Screening Test is more accurate at detecting human papillomavirus (known as HPV). 

HPV is a common virus that can cause changes to cells in your cervix, which in rare cases can develop into cervical cancer.

WHY HAS SCREENING CHANGED FROM 2 TO 5 YEARS?

The Cervical Screening Test is more accurate at detecting HPV. The Pap test used to look for cell changes in the cervix, whereas the new Cervical Screening Test looks for the HPV which can lead to cell changes in the cervix. 

Because of this, it is safe for you if your test does not indicate (show) you have a HPV infection to wait five years between tests. Even if your test shows you have HPV it usually takes 10 or more years for HPV to develop into cervical cancer and cervical cancer is a rare outcome of a HPV infection. 

WHEN WILL I GET THE RESULTS OF MY PAP SMEAR?

The results of your CST will generally be returned within two weeks.

HOW OFTEN DO I NEED TO HAVE A CST?

Once you have had your first Cervical Screening Test, you will only need to have one every five years instead of every two, if your results are normal.

DO CST HURT?

While the process certainly isn’t overly comfortable, your CST should not be painful. The whole process is over very quickly and you’ll be able to re-commence your day’s activities.

I’M TOO SCARED TO GET A CST

While a CST can sound a little scary, it’s truly not that bad, and will be over before you know it. If you’re really nervous about it though, don’t be shy to speak to the friendly and compassionate staff at Stela Obstetrics and Gynaecology about the process and how they can help you. It’s such an important part of monitoring the health of every woman. There’s also no need to be embarrassed about getting a CST Dr Suzana is highly experienced at taking CST's; it’s a very normal part of her job and she will help you to feel comfortable and relaxed.

WHERE TO GET YOUR CST IN MELBOURNE

Dr Suzana Kotevska is a highly experience obstetrician and gynaecologist, and she strives to ensure all her patients feel completely at ease and relaxed at their consultation. Apart from English, Dr Kotevska also speaks Macedonian, Serbian, Bulgarian, Bosnian and Croatian which allows her to provide excellent and personalised care to women of many backgrounds.

 

 

What is an Obstetrician?

Choosing an obstetrician can be one of the most difficult decisions for a woman to make. It is essential that a woman chooses an obstetrician that aligns with her individual preferences. Before choosing an obstetrician, there are a number of questions you need to ask. So let’s start with the basics.

WHAT IS AN OBSTETRICIAN?

An obstetrician is a doctor who specialises in pregnancy, childbirth and a woman’s reproductive system. Obstetricians specialise in taking care of women from conception through to delivery, covering all aspects of the pregnancy journey.

It must be noted that obstetricians provide a number of services for women during pregnancy, which include:

  • Monitoring the health of your child by conducting regular tests
  • Regularly assessing patients for health conditions that may cause problems during pregnancy, which include high blood pressure, diabetes and any other genetic disorders
  • Providing diet, exercise and medical advice for patients to ensure they remain healthy during pregnancy
  • Providing care for common symptoms of pregnancy which include morning sickness, stomach pains and other common complaints

HOW TO CHOOSE AN OBSTETRICIAN

As mentioned, it is pivotal that women choose a doctor who aligns with their individual preferences. You may need to ask yourself questions such as:

  • Will I be more comfortable with a male or female doctor?
  • How much can I afford to spend for treatment?
  • Will my doctor support my desire to aim for a drug free birth?
  • Will my doctor support my birthing preference (e.g. hypnobirthing)?

It is essential that you ask yourself necessary questions such as these before choosing an obstetrician to support you during your pregnancy journey.

WHEN SHOULD I FIRST VISIT AN OBSTETRICIAN?

Well it’s simple, as soon as you believe you may be pregnant! Here it is recommended that women undergo an initial physical examination to ensure you receive the care you require. Traditionally, most doctors won’t schedule a visit until around the two month mark of your pregnancy journey, although it is recommended that you schedule an appointment to visit your doctor immediately if you are experiencing symptoms such as vaginal bleeding, abdominal pain, or severe nausea and vomiting.

The sooner you schedule an appointment with your obstetrician, the smoother your pregnancy journey will be, as they will assist you in determining the most effective treatment plan for you.

Early pregnancy indications

Missing a period

One of the earliest indications that a woman is pregnant is missing a period. However, there could be other reasons for menstruation to be delayed, such as stress, illness, excessive weight gain or anorexia, or coming off of an oral contraception pill. In some women polycystic ovarian syndrome can be a condition that causes irregular periods and sometimes very infrequent periods.

Breast tenderness

Some women, especially multi-gravidas, know that they are pregnant just by the give away sign of breast tenderness. As early as a few days after conception the breasts begin to enlarge in order to get ready for breastfeeding. They feel heavier and sore, especially on touch. There is sometimes a tingling sensation and this disappears several weeks later.

Morning sickness, nausea and vomiting

Feeling nauseous is a quite common complaint in early pregnancy and is experienced by the majority of women in early pregnancy, especially around five to six weeks. For most women this symptom disappears at around 14 to 16 weeks of pregnancy. However, there are a small number of women who have hyperemesis throughout the pregnancy.

Tiredness

Many women feel very tired during pregnancy, especially at the beginning. They find that they need much more rest and they need to take a nap several times during the day. However, the frequency of napping lessens after 14 weeks.

Changes in taste and smell

Certain foods can cause sudden queasiness or you may start to crave particular foods. Sometimes women may have a metallic taste in their mouths.

Constipation

Constipation is a common symptom in early pregnancy. However, this can be a continuing symptom throughout the pregnancy. This is caused by the high levels of progesterone which relaxes the bowel and slows the digestion.

Mood swings

Pregnant women can be overtly emotional. This is a secondary effect from a flood of pregnancy hormones.

Frequent urination

Early in the pregnancy there is pressure from the enlarging uterus onto the bladder and this is literally reducing the capacity of the woman’s bladder. At about 14 weeks the uterus rises up into the abdomen and most women start having the urge to urinate frequently which can be annoying. This is a very good time for you to start doing your pelvic floor exercises if you haven’t already started.