Sleeping on the back, long distance travel during pregnancy could cause death —Expert

Pregnant women often get many pieces of advice and admonishments from well-meaning people all around them to help get safely through pregnancy and delivery but how can a pregnant woman ideally stay healthy in this period of several changes? The family physician at Vine Branch Fertility Centre, Ibadan, Dr Oyebola Olawuyi, gives expert advice. VERA ONANA brings the Excerpts:

What is the first thing a woman should do when she thinks she is pregnant?

The first thing a woman should do is a pregnancy scan. She has to do an early pregnancy scan to confirm the pregnancy. To be sure that there is something viable growing in the uterus and of course, she must thereafter look for a good hospital to register after the pregnancy has been confirmed by an ultrasound scan.

 

A pregnancy lasts for at least nine months, how can a woman stay healthy during this period.

Pregnancy is not a disease or sickness. It is a physiologic change but it comes with a lot of change in the woman’s body which may generally make her uncomfortable but it is not something that she cannot bear. Once she registers in a good hospital and she keeps up with her clinic appointments, the doctor is able to do all the regular checks and anything that needs to be sorted out medically is sorted out. However, to stay healthy during pregnancy, the most important thing is to conform to whatever the doctor says during the antenatal clinic.

This is because, during the antenatal clinic, health talks are given by the midwives and then the pregnant woman sees the doctor. It is in a pregnant woman’s best interest to do whatever the doctor advice her to do.

Also, she must stay off self-medication most especially in the first trimester. In the first 13 weeks of pregnancy, she must never take medication without the doctor’s prescription. This is a very delicate stage of the pregnancy. So, a pregnant woman must avoid self-medication at all costs to ensure that nothing happens to the baby.

 

Why is the first trimester very important?

It is so significant because organogenesis takes place in the first trimester. It is the period when all the organs of the unborn child are formed…the eyes, ears, nose, all of it. The body organs develop at this stage so if the mother takes any medication that is harmful or injurious at that stage, the child might be born with a deformity and no mother wants a deformed child like a child that is born blind or deaf. That is why the first trimester is very important compared to someone that is almost 9 months pregnant and everything is formed. Also, asides from deformities, there is a risk of miscarriages at that period. So, it is a very delicate time and a pregnant woman must be very careful in the first trimester.

 

What should a pregnant woman eat?

A general healthy eating habit is important. There are really no restrictions as such but a pregnant woman must eat moderately and eat healthily. The regular carbohydrate, fruits and vegetables, lots of water and a lot of rest. There are really no food restrictions. Whatever food restrictions that are meant for somebody that is not pregnant are also meant for a pregnant woman. For instance, restrictions like no taking of alcohol, smoking, no taking of excessive sugar and salt. So, whatever applies to a non-pregnant woman still applies to a pregnant woman. The important thing is to eat thoroughly balanced diet and frequent small meals because a pregnant woman should not eat heavy meals especially as the pregnancy advances.

 

What is the implication of eating heavy meals?

Pregnant women usually have issues with heart burns, indigestion. So they are advised to eat frequent small meals.

 

Does it mean the general conception of “eat for two” is erroneous?

It is nonsense. There is no such thing as eating for two. It is all rubbish. Frequently eating a thoroughly balanced meal in small portions is all a pregnant woman needs especially as the pregnancy advances. Eating heavy is not good.

 

While it is important for pregnant woman to eat fruits, there was a report of a woman who almost had a miscarriage after eating bananas. What could have happened?

I think she probably ate it wrong. Fruits are best eaten on an empty stomach. First thing in the morning you should take fruits both for pregnant and non-pregnant women because that is when one enjoys the health benefits of fruits. It is not to be eaten after meals and a pregnant woman is not supposed to consume anything in excess most especially very ripe bananas, there is a tendency for it to cause stomach upset. So, if the fruit is consumed wrongly, at the wrong time for instance, in excess and if it is overripe, that could result in stomach upset. But if the fruit is eaten first thing in the morning on an empty stomach, the benefits will be better enjoyed and it is not likely to cause any stomach upset or problems. Except maybe the fruit is already contaminated and was not properly washed or is already spoilt. So, in that case, the woman may have consumed it wrongly, maybe excessive consumption of overripe bananas after the meal.

 

Are there any healthy sleeping positions for a pregnant woman?

We advise that as the pregnancy advances, pregnant women should lie either on their left side or their right side. They are not supposed to lie on their stomach or lie on their back. It is better to interchange the sides. Though, the baby would not be harmed if the mother sleeps on the back because babies are well protected and insulated in the amniotic fluid. However, the mother faces grave danger. The weight of baby could compress on the major blood vessels in the body and cause a cardiovascular compromise for the mother. It could impede or obstruct blood flow because the heavy womb would compress the blood vessels if a pregnant woman lies on her back. These blood vessels are situated deep within the abdomen. The abdominal aorta is a major blood vessel that if compressed could prevent blood flow to major organs in the mother. So, the baby would be fine bouncing even but the mother would have problems if she lies on her back especially when she is heavy. During early pregnancy, like in the first three months, there may not be any effect if she lays on her back but the moment the pregnancy progresses; it is safer to lie on the side.

 

There is an advocacy for exercise during pregnancy, how safe is it?

Exercise is safe and it is advocated for everybody. Like I said earlier, pregnancy is not a disease. So, even pregnant women require exercise. It doesn’t have to be strenuous; it just has to be something the pregnant woman can tolerate. There are special exercises that are designed for pregnant women that a pregnant woman can read about. Exercise is recommended, it is not unsafe. It is important however that pregnant women discuss their exercise routine with their physicians so that they can work out a suitable pattern and they won’t end up doing anything dangerous.

 

For women that have terrible morning sickness episodes, how can they deal with it and stay healthy?

This morning sickness varies from individuals to individuals. Some have it mild; others severe and some people do not even have it at all. For some people that are carrying multiple pregnancies, it could be more pronounced in them. But, there are various ways of dealing with it. There are things that could help suppress the salivation. There are also drugs, tablets, that a doctor can recommend and they are very effective. Some doctors may even recommend other things like bitter kola, a particular type of crackers biscuits that could also help. However, whatever she takes must be recommended by her doctor.

 

Is it safe for a heavily pregnant woman to travel long distances?

No, it is not advised at all, it is not safe, it is not healthy. I would not advise it. If any travelling has to be done, it must be done before she becomes heavy. Sitting for long hours is dangerous in many ways. Blood clots may develop; she may enter into unplanned labour. It is not safe most especially when she has to sit down for hours. If at all she must travel, a heavily pregnant woman should not do more than five to six hours of travel and the trip should be preferably by air.

Also, she must always take precautions while travelling. There is a compression stocking that should be worn on the legs if she has to take any long distance journey. It is recommended that she puts them on and they are readily available. Long trips are really dangerous for a heavily pregnant woman. They have a tendency to form blood clots and while sitting down for long hours, this clot may dislodge and block a major vessel in the lungs and she could suddenly develop breathing difficulties and could die suddenly. This is why it is not advisable at all but if at all she must embark on such a journey, we recommend compression stocking which will help to reduce the formation of blood clots. It is a preventive measure but we would advise that she should not even travel until she has delivered because it could lead to death.

 

What is the importance of attending antenatal clinics

Basically, pregnant women must always stay in touch with their doctors that are the most important. They will hear a lot of different things from different groups, mothers, grandmothers, a lot of things that could be confusing and some of these things may be harmful but they would not know. So, it is good for them to take that advice to their doctors so they can discuss and weigh the options and then agree on what to do.

It is equally important for pregnant women to keep their antenatal appointments even if they think they are well because some problems do not show up until later. Not registering for antenatal is totally not safe at all. During antenatal, the doctors can check and make sure everything is fine until the very end. Anything could go wrong progressively but if they do not present at the clinic, how would these problems be detected and managed? Some of those problems could lead to the death of the mother or the baby or even both of them. So women that do not even register for antenatal are taking a very big risk. This is why some mothers die avoidable deaths.