Just when you thought you were sailing through your pregnancy and enjoying the joys of the second trimester, your midwife offers you another lot of routine blood tests at your 28-week check-up. These blood tests are part of your routine antenatal care and your midwife will explain in detail why you are being offered them. As a quick guide, they include:
• A repeat haemoglobin check (to see how your iron levels are).
• A repeat blood group.
• A random blood sugar; this is to have a look at the glucose levels in your body.
The results of these simple blood tests take a day or two to come back and if there are any concerns your midwife or GP will usually ring you directly. If not, when you see your midwife next they can give you a copy of your result to put in your maternity notes. As with any test you have the right to decline these tests, but make sure you fully understand why your midwife is offering them.
Gestational diabetes is a type of diabetes that affects pregnant women, usually during the second or third trimester. It is common and is estimated that 1 in 6 women who give birth in the UK have gestational diabetes. Women with gestational diabetes don’t have diabetes before their pregnancy, and after giving birth it usually goes away. The hormones produced during pregnancy can make it difficult for your body to use insulin properly, putting you at increased risk of insulin resistance. And, because pregnancy places a heavy demand on the body, some women are less able to produce enough insulin to overcome this resistance. This makes it difficult to use glucose properly for energy, so the glucose remains in the blood and the levels rise, leading to gestational diabetes. (www.diabetes.org.uk)
Gestational diabetes often doesn’t have any symptoms, but you may:
• feel tired
• be very thirsty
• have a dry mouth
• wee a lot
• get recurring infections, such as thrush
• have blurred vision
If you have any of these symptoms, tell your midwife or doctor.
If the random blood test your midwife will offer you at 28 weeks comes back higher than the normal range, they will discuss a further blood test with you. It will be recommended that you have another test called a Glucose Tolerance Test, or GTT, normally carried out at your local hospital. During this test your blood is taken when you haven’t eaten anything (usually first thing in the morning); you are then asked to drink a very sugary fizzy drink like Lucozade and a subsequent blood test is taken. The results will determine how your body is coping with high amounts of the sweet stuff and will diagnose whether or not you have gestational diabetes.
Usually the results are given to you on the same day and you’ll have a chance to speak to a diabetes nurse, who will go through your diagnosis with you. It may feel very scary and worrying being told you have diabetes, but with good support, healthy eating (one of the biggest changes you can make to your lifestyle is through diet; see here), exercise and close monitoring of your blood sugar levels, you and your baby will not be affected.
The recommended daily allowance of sugar is six teaspoons (24g), but many of us are consuming at least double that. Sugar isn’t just bad in terms of gestational diabetes (see here); it also affects your skin, mood, weight, sleep, nails, energy levels and hair. But with the help of a few hacks, you can stop the cravings and break that exhausting cycle of sugar highs and lows. It isn’t easy, but the benefits will be felt long after you give birth.
• Cull all sugar-laden products lurking in your cupboards. Look at the labels. There are over 60 names for sugar and most of them end in ‘-ose’. The most common ones are corn glucose syrup, dextrose syrup and corn syrup.
• Swap milk chocolate for dark; it’s mineral-rich, full of antioxidants and contains less sugar.
• It goes without saying that fizzy drinks are a no-no, but so is most shop-bought flavoured water. Make it yourself by infusing water with cucumber, lime, fresh mint, basil or strawberries.
• Eat raw and unprocessed honey, maple/agave syrup, which retain all their natural enzymes. Don’t overdo it, as these still contain natural sugars.
• Fruit contains fructose, but because it’s bound up in fibre it doesn’t cause such drastic blood sugar spikes. Apples, pears and berries are a good bet. Eat with a protein such as nut butter to slow down the release into the blood. Dates are having a moment with health food bloggers, but don’t go crazy as they’re still very high in natural sugar.
• Cinnamon stabilises blood sugar levels and can help curb cravings. Add it to smoothies and sprinkle it on porridge.
• Smoothies are better than juices as they contain fibre. Try to keep fruit percentages low and veg high.
• Have plenty of healthy snacks in your bag/cupboards/fridge at all times.
I was given the diagnosis of gestational diabetes (GD) after a routine 34-week scan. We were devastated, and it was a bit of a horror show at our house for a few weeks as we all went into crisis mode. It was incredibly scary, not helped by the doubling of hospital appointments: our options seemed wiped out and the dream of a natural home birth shattered. I really thought that I had done something to hurt the baby. Because, as mothers, we only hear the worst news, even if it is only a 0.05 per cent risk.
After the initial shock, my natural inclination to fight every battle put things into perspective. There were things I could do and I took every piece of advice going. I was the class geek at the nutritional sessions, scribbling notes. I read every blog on gluten-free food as I figured that I only had six weeks to go, so going without pasta was nothing compared to having a healthy baby.
It was brutal because I am a carb-loving mad pregnant lady. But over time things did become easier. Using equipment to test my blood sugar levels three times a day, I worked out where my levels were and what time of day I could have a piece of fruit without spiking. Few people tell you this, but fruit is literally sugar on a stick. I cut out all carbs, fruit and refined sugar, including diabetic products. Fake sugar is just as bad. And my hard work paid off as I did not need medication. Not being insulin-dependent meant I had options again and I could even negotiate my birth plan.
We no longer have biscuits, chocolate, cake, crisps or even jam in the house. Unless I need it for a recipe I don’t buy it. If it’s not in the house, we can’t eat it. But I don’t feel guilty if I do have a big bowl of pasta as a treat. As a family we are all healthier for the diagnosis and I am actually so grateful for the wake-up call.
Looking at how your body absorbs iron from the food you consume is a really useful way of knowing how your body is coping with the extra stress of pregnancy. Placentas are very clever at working out what nutrients from food your baby needs to help him or her develop and grow. This, however, may leave your own body with very little iron, even if you eat a ton of red meat and leafy green vegetables. Without enough iron in your blood, the organs and tissues in your body won’t get as much oxygen and you may feel really tired and even breathless.
If you are experiencing tiredness, breathlessness or palpitations always speak to your midwife.
There are several different types of anaemia, but iron-deficiency anaemia is the most common type in pregnancy. About one in seven pregnant women in the UK develop this type of anaemia and you’re more likely to develop it if you’re carrying twins or more. Your iron levels will have been checked at your booking appointment around 10 weeks into pregnancy. Us midwives like to check that all is hunky dory now so that you and your baby are in good shape for the rest of your pregnancy and birth. If your iron levels are on the low side, don’t worry as there are lots of way you can increase them.
Look again at your diet. Are you really making sure you’re eating the right foods and avoiding the wrong foods? Yup, certain foods and drinks can actually make it harder for your body to absorb iron. These include:
• Tea and coffee because of the tannins they contain, so avoid having these with your meals or just afterwards.
• Wholegrain cereals are a good source of iron, but they also contain phytates that can affect iron absorption, so try to limit these.
• Calcium-rich products, such as milk or yoghurt, also affect iron absorption, so avoid these if you’re having an iron-rich meal.
And foods that contain high levels of iron include:
• Red meat, fish and poultry contain iron in a form called haem iron, which your body can easily absorb.
• Foods such as pulses, dried fruit, fortified cereals, wholegrain bread and dark-green leafy vegetables contain iron that is called non-haem iron. This is harder for your body to absorb.
• Vitamin C helps your body to absorb the non-haem iron in food, so drink a glass of orange juice with your cereal. Or combine fruit or vegetables that are rich in vitamin C with ingredients containing non-haem iron.
Sometimes diet alone may not increase your iron levels, and your midwife may recommend that you go to your GP and ask for iron tablets. These are free on prescription. The best time to take them is on an empty stomach, and don’t forget the glass of orange juice – it helps your body absorb the iron. Iron tablets do have some unpleasant side effects, which can include:
• Constipation
• Nausea
• Sickness
• Diarrhoea
• Heartburn
• Tummy ache
The tablets may also make your poo darker than usual and even appear black, but try to stick with them and give your body a chance to adjust. Remember that all this preparation now is putting your body in the best possible shape not only for birth but for your post-birth recovery. You don’t want any more reasons to feel tired with a newborn baby than necessary.
It’s really important to take note of your baby’s movements from this stage of your pregnancy until you give birth. You can even download an app to help you keep track of your baby’s movements and patterns. The Kicks Count charity have also put together a great guide to ensure you are aware of what’s normal and what’s not: www.kickscount.org.uk
• There is no set pattern of what is normal as every baby is different, so it is important to get to know your baby’s individual pattern. Movements will gradually increase up to 32 weeks, when they will stay the same until birth.
• Babies’ movements do not slow down as you reach the end of pregnancy.
• During both day and night, your baby has sleep periods that mostly last between 20 and 40 minutes, but no longer than 90 minutes. Your baby will usually not move during these sleep periods.
• There is no set number of kicks that you should be feeling. What is important is that you know what is normal for your baby. There is a common misconception that you should be feeling 10 kicks over a set period, but this is no longer recommended as all babies are different. Babies’ movements can vary from 4 to over 100 every hour, so counting to 10 kicks would be irrelevant for most of the population.
• If you notice your baby’s movements have slowed down, call your midwife or maternity unit. Do not consume large quantities of something, such as ice-cold water, to prompt your baby to kick as this may lead to indigestion or gurgles you may mistake for movements and give you false reassurance.
• If you are unsure whether or not your baby’s movements have slowed down, take some time to focus on them. If you’re still unsure, call your midwife or maternity unit. Remember that midwives and doctors will never think you’re wasting their time if you notice a change in your baby’s movements. Always go and get your baby’s heartbeat checked at your local hospital/maternity unit asap and don’t wait until the next day.
At some point you will stop being able to fit into your normal clothes; things will get a bit tighter and a bit uncomfortable – and when you are pregnant it’s important to be comfortable both in, and with what, you are wearing. Here are some top tips from pregnancy style blogger, Zoe. www.dresslikeamum.com
• It is worth investing in a few key versatile maternity pieces that can be dressed up and down and worn with what you already have, such as jeans, tights and leggings. If you want to invest in more maternity clothes, make sure that you can breastfeed in them afterwards; you will still be wearing them a few months after the baby arrives, so you want them to last.
• You should already have invested in some decent maternity bras (see here) but make sure you reassess the situation as your pregnancy progresses. And buy some nursing bras too.
• Long vests or Lycra dresses are great for wearing under things to help give you more shape and elongate your body. You can even wear your normal T-shirts or tops with a longer vest underneath so that your bump is covered. These are also great for when you are breastfeeding.
• When you’re shopping for clothes, think ahead to when the bump has gone. Buy things that you can wear to breastfeed in and post-pregnancy. Shirts are great: if you get them a size or two up you can wear them buttoned up to start with, then towards the end they can be worn open with a top underneath.
• Look through your wardrobe and don’t assume you won’t be able to fit into any of your clothes, as you might be surprised what fits. Tops that are looser at the bottom are good as you can wear a vest or belly band/boob tube over your bump and then it won’t matter if your top finishes a bit higher up than in your pre-pregnancy days.
• If you are pregnant in the winter invest in a large, warm scarf so that you can wear your normal coats (unbuttoned, when necessary!) and use the scarf to cover your belly. Or consider wearing a cape, where there is plenty of room for a growing bump.
• Get some cool, comfortable trainers – you need to be kind to your feet. From now on they will be carrying more weight, both while you are pregnant and once you are carrying the baby in your arms. Plus, chances are you will be doing a lot more walking and pram-pushing, so you might as well be comfortable and look cool doing it.
• Shoes, bags, jewellery, make-up and accessories are all things you can wear and buy regardless of the size of your bump – embrace them all. Large statement necklaces look great with a pregnant belly, as does a smiling pregnant woman wearing bright-red lipstick.
• Being pregnant and dressing a bump does not mean you have to change your style. There are a lot of things changing inside your body so it is important to feel like yourself on the outside. Do not compromise your style because you are pregnant; stick to what you usually wear but just bump-proof it.
• It is too easy once the baby arrives to forget about yourself, including what you like to wear. Just because you’re a mum now, you don’t have to dress ‘mumsy’: you will feel better about yourself if you are feeling confident in what you are wearing.
There’s no subject matter in this book that I’m going to skirt around because it might make you (or me) blush a little, so let’s get straight down to business and talk about sex. Sex is such a funny old thing, isn’t it? We’re still embarrassed of talking about it openly, so much so that when I talk to women post-natally about contraception I don’t know who is blushing more, me or the woman. And it’s pretty silly, really, as sex is the reason why you’re pregnant in the first place. I mean, if it wasn’t for sex I would be out of a job and the world would be a very strange place.
During all three of my pregnancies, once the hideous morning sickness had gone, I was up for it. And by ‘it’ I mean sex. I could have pounced on my husband at any given opportunity. Poor man, he was totally perplexed by the whole matter. In our normal non-pregnant relationship he would have to do a lot of subtle hinting, and like most couples with young children we would have to schedule in the moment when we might be keen; usually if we had a child-free night away or on a mini-holiday. The classic ‘I’m too tired’ line was often thrown about by either one, or both, of us. But in pregnancy this seemed to be totally irrelevant and I couldn’t have been less subtle. Pregnancy hormones made me like a dog on heat. And I’m definitely not alone. Speaking to friends the consensus was that, yes, pregnancy made them all much more horny than ever before!
I get so horny when I’m pregnant – it’s fantastic! This lasts into the third trimester, and only fizzles out when I feel too huge to be physically comfortable. I am able to climax really easily too. Good job, really, as being pregnant also means I’m permanently knackered so it tends to be very short and very sweet, then straight to sleep!
Louise, mum of two
I was rampant throughout my pregnancies! I experienced multiple orgasms and we did it a lot more often than when I wasn’t pregnant. We even did it twice a day up until I went into labour and I was 10 days overdue.
Sarah, mum of one
It’s no surprise that you may find yourself fantasising more about Ryan Gosling, when you consider all those extra hormones swirling around your pregnant body. You have higher levels of the hormones oestrogen and progesterone, which in addition to supporting your continuing pregnancy also increases lubrication in your vagina, blood flow to the pelvic area and the sensitivity of your breasts and nipples; all of which can make you feel like one horny mama.
You may, however, find that your partner might not be as keen to jump into bed. Often men worry about damaging you or the baby (!) during sex. Rest assured, boys, your manhood is never big or long enough to reach where the baby is growing. A simple biology lesson could be useful here – the cervix remains completely closed during pregnancy to prevent the baby from falling out. If, however, your partner is still uneasy about the whole concept, you could stick to foreplay instead. Here are some things to look out for when you’re having sex while pregnant:
• You may experience mild contractions during sex and when having an orgasm (or Braxton Hicks), but these contractions are false alarms, and are not powerful enough to start labour, unless it’s imminent. These contractions may continue for about half an hour after sex and your uterus will feel rock-hard. They are not dangerous for you or the baby.
• Your uterus may experience spasms during sex, which are different from contractions. This is normal and not harmful.
• You may get cramps during and after an orgasm. Sometimes this is combined with a backache. This, again, is totally normal.
If you experience any fresh bleeding during or after intercourse always speak to your midwife or call your local maternity assessment unit.