chatwithketch

Q: During my first and second trimester, I used to have active sex, but not now anymore, since 8 months upward. During the earlier stage, I do use missionary position, and my hubby do sleep on me sometimes, hope it can have caused any issue for the baby ma’am? However, I don’t feel anything of such, but I am just thinking about the baby’s condition inside me. So that it won’t cause any deformity whatsoever. I’m disturbed whenever I think about those early active sex activities.

In addition, I have not used any folic acid since inception of the
pregnancy, may God forgive me. If at the
nine months now, that I am even expecting that I should have deliver, and have
not yet. Can I go for folic acid? Does it have any contribution anymore?

Thank you ma’am

A: Sex is generally considered safe during pregnancy. Except the doctor has noted some medical issues that may cause some restrictions on sexual intercourse, couples can generally continue to have sexual intercourse during pregnancy.

Having said that, it doesn’t mean that every woman wants to indulge 😀 Unfortunately, no. Some women experience increased libido, some decreased libido and some are just completely exhausted by their itinerary (wife, worker, sister, daughter, intending mother, worries about the pregnancy or intending birth, care of already existing children, if she has them etc) that sex is the farthest thing on their minds, most times. So, where’s the solution or compromise? Communication lines between couples have to be open. The husband needs to understand what’s going on in the mind and body of his wife. Providing emotional and tangible support by helping her out with some chores/activities, providing a daily evening massage….which becomes something wifey can look forward to, can help create the right mood. Remember that for women, sexual Intercourse starts from the emotional before it gets to the physical 😀 Couples can also explore different positions or other means of sexual intimacy apart from sexual intercourse.

Some issues that may cause a doctor to issue some restrictions on sexual activity include:

·       Threat of a miscarriage

·       History of pre-term labour

·       Unexplained bleeding in pregnancy

·       Cervical incompetence (where the mouth of the womb is open leading to a risk of miscarriage) etc

If you’re not sure whether you belong to any of these groups or not, please ask your obstetrician.

Now, there also some risky activities during sexual intercourse in pregnancy:

·       If you indulge in oral sex, hubby please do not blow into your wife’s vagina as this can lead to an air bubble being lodged in a blood vessel causing problems in mother and/or baby

·       Having STI with an infected partner can lead to STI in pregnant mum. This infection can be transmitted to the baby. So, hubbies be sure that you stay faithful

·       Anal sex is also discouraged.

World Health Organization recommends that pregnant women receive folic acid and iron tablets daily. Folic acid prevents neural tube defects which may occur during the first 28days of pregnancy. This is usually the period when quite a number of women do not even know they are pregnant. Thus, women who plan on getting pregnant should start on folic acid supplements at least 3 months before their planned date to safeguard against neural tube defects. If you haven’t started this earlier, start taking them as soon as possible. Where in doubt, speak to your doctor.

All the best 😀

Q: Good morning Doctor. I have been a keen fan of your page, and I must confess, you are doing a great job. May God replenish you.

I want to ask medically, reason why I am yet to deliver my baby, which the
scan gave me EDD of first week of December. We are now running to the third week. Delivery had not taken
place. I only feel pressed sometimes, feeling that the baby is preparing to
come. (Amusile in yoruba). However, I am yet to see coming of water (omira).
When I was dissatisfied with this condition, I try to think back to when last I
saw my period. I was able to remember its April, meaning that December is possibly my 9th month not November as said by the test and scan.

I also want to know, can the scan be questionable as regard the month of a
pregnancy?

Can my own counting, since I saw my period last, be relied on and dispose
that of the scan result?

Lastly, what can be medically wrong Ma? Or is it normal to use up to
two-three weeks after the EDD given by the scan test, without delivery.

Please kindly give me detailed knowledge about this Ma. I will appreciate
it, and it would reduce my worries.

Thank you ma’am

A: Dating pregnancy is best done with the use of the last menstrual period. That is the first day of the woman’s last normal menstrual flow. However, if she is not sure of her dates, then a scan can be used. To date pregnancy, a first trimester scan gives the most appropriate approximation. The earlier it is, the more accurate it is likely to be.

In our part of the world, Nigeria, especially, people tend to think that pregnancy going beyond its due date is related to witchcraft or having run-ins with ‘bad’ people. I’d like to state unequivocally that this is not witchcraft 😀

Usually pregnancy lasts for 40 completed weeks plus or minus 2 weeks. This is usually through pregnancy dating using ultrasound scan in the first trimester. Generally though, from 37 weeks, your baby is good to be born…all things being equal. Therefore,, if a woman gets to 40 weeks without any sign of labour, she is tentatively given 2 more weeks, especially if there are no other risk factors present in the pregnancy. This is called watchful waiting and during this period, the baby’s kicks are counted, baby’s heartbeat is monitored and indeed, baby’s growth and other parameters are monitored. From the 41st week, if she does not spontaneously go into labour (without help), then there is a plan made for induction, having fully informed the woman of all possible scenarios. Some women do not like the idea of induction and so, having discussed with the medical team, may opt for a sweep of the membranes. This involves the separation of the membranes (the ‘bag’ in which the baby lies) from the lower part of the womb (uterus). This releases prostaglandins, which help stimulate labour.

When a pregnancy goes beyond the Expected Date of Delivery (EDD) which is 40 weeks, it is called a post-dated pregnancy. If the pregnancy lasts beyond 42 weeks, it is called post term.

It is not really clear why some pregnancies become post-dated but some associated risk factors include previous post dated pregnancy, first pregnancies, mothers with high BMI and advanced age.

The main challenge with allowing a baby to remain in the womb beyond the 42nd week is that of the placenta no longer being able to supply sufficient amounts of oxygen to the baby. This can lead to brain damage or even death of the baby. The second issue is the threat of the baby having its first poop inside the womb and then aspirating (breathing in) same.

So, have a long chat with your medical team and discuss options available and the ones you are comfortable with.

All the best! Let’s know when the baby is born! Lots of love and hugs.

Have a good night, people 😀

Do you need a special diet while on thyroid hormone medication? This Harvard article says, ‘Limit foods high in soy protein, because large amounts of soy might interfere with the absorption of thyroid hormone’. Want to know more? Please click on this link: https://www.health.harvard.edu/healthbeat/healthy-eating-for-a-healty-thyroid

Q: Good day doc, how long does one need to wait after a CS before trying for another baby? Thank you sir.

A: Thanks for writing in. This is a common question amongst women who have had a Caesarian Section. How soon can I get pregnant again? This is an especially important question as the argument about how much time the body needs to heal rages. It only makes sense that the longer the body is allowed to heal, the better the wound healing. Different schools of opinion exist from 6 months to 1 year to at least 2 years. However, generally, a gap of 6 months is considered fair to have given the body sufficient time to heal.

Can you deliver normally? I prefer to ask, ‘can you deliver vaginally? There is nothing abnormal about having a baby through Caesarian Section. You’re as normal as the woman next door and you feel the same maternal urge as she does…maybe, even more 😀 It’s because we think C-section is abnormal that women who would benefit from this procedure turn it down and then end up dying because they wanted to do it ‘normally’! We need to change this mind set! For women who think ladies who had C-section are lesser mortals than them because they had a vaginal delivery, try cutting up yourself with a knife and then sewing it back up and you would know who’s more super-human! By the way, just in case you wondered, I’m not taking it personal because I had a C-section. I had all three of my children vaginally but would most certainly have opted for a C-section if I was advised to do so. But I digress….

So, can you deliver vaginally? This is possible. Your chances of a successful VBAC increase if:

• You’ve had a previous successful vaginal delivery
• You and baby are healthy with pregnancy progressing normally
• You’ve had only previous Caesarian Section with a low transverse incision on the uterus (womb)
• Spontaneous onset of labour on or before the your EDD

Now, these are general rules of thumb. Your specific medical history may be different, requiring a different approach. So, be sure to discuss the options open to you with your doctor.

And please, remember to discuss contraception/family planning options with your doctor during your 6 weeks appointment if you’ve had a baby. I’ve had quite a number of people writing in to ask if breast feeding protects against pregnancy and if it was possible for them to get pregnant even before their periods return or if it was safe to breastfeed a baby while pregnant (The answers by the way, are yes to getting pregnant while breastfeeding, yes to possibility of getting pregnant before periods return and yes to breastfeeding while pregnant); this means that there are probably a couple of people getting pregnant earlier than they had planned. Let’s take the right decisions.
Don’t forget to visit my blog, http://www.chatwithdrketch.com to search for any health/wellness topic you want information on. If you can’t find the answer you need, bring it here 😀

Have a great week ahead, y’all 😀

Q: Hello Doc, how are you doing? Kudos to you for the way you help people with various issues. Please Doc I would need your help in tackling my issue. I gave birth to my 1st child 3 weeks ago and unfortunately we lost her the next day. it was a natural birth…..it was really devastating but I am strong
now. My hubby and I would like to try again and I don’t know how soon we can
begin the process. Thank you ma’am and looking forward to hearing from you. God
bless

A: Condolences on the loss of your baby! I can’t imagine what it must have felt like going through this experience! I’m glad you feel much better and I’m rooting for you! By His grace, you will soon have a precious bundle of joy in your arms J

There are no standard answers really, as to when to start. Some doctors still advice people to wait 3 to 6 months before trying again so that it’s easier to date the pregnancy etc. Others will just ask you to wait until you’ve had one menstrual period. Be sure to ask your doctor to explain the reason for any recommendation he eventually comes up with so that you understand every step of the process.

What to do before you start trying again? Be sure to eat healthy…lots of fruits and vegetables and exercise. Limit caffeine and keep your weight within normal limits. You can start taking folic acid supplements now, even before you get pregnant.

The basic rules of trying to get pregnant also apply: make sure you have sexual intercourse at least 3 times a week (with ejaculation of a significant quantity of semen).

It is normal to feel worried and a bit scared going into another pregnancy, but you have to trust that all will work out well this time. Surround yourself with good professionals (OBGYN) and loving family/friends. Then relax and enjoy the ride J

Please write in anytime and let me know if there are other questions you have.

Have a great night y’all 😀

Q: Hello ma’am. Please ma’am, my daughter is about 4yrs + and she is just having temperature, cough and catarrh

A: Generally, cough could be due to common cold, allergies or other irritants in the environment, croup, whooping cough etc.

Generally, cough could be due to common cold, allergies or other irritants in the environment, croup, whooping cough etc.

First, if your baby’s cough is due to a cold, you really don’t need to give your baby any drug. A cold is a viral infection and once it causes an infection, it will run its course before it stops. And so, with or without drugs, a cold will go. It would usually last for about a week to 10 days and then disappear. There’s no need for antibiotics for a viral infection. Indeed, taking antibiotics when they are not needed leads to antibiotic resistance where the antibiotics can no longer properly do their jobs when they are really needed to fight infections.

Then some of the ingredients in the cough syrups can also cause a baby’s heart to beat faster, may cause convulsions and basically do not treat the cause of the cough. They are actually not supposed to be used for children younger than 2 to 3 years of age.

Now, what can you do in the meantime?

Let your baby sleep in your arms or in a semi-upright position. You can prop him up with lots of pillows at night.

Offer your baby fluids and if there is congestion in the nose, use a saline spray. You can ask your doctor or pharmacist for this.

An air humidifier also moistens the air and makes it easier for your baby to breath. If you don’t have this, you can let your baby breath in steam from a hot shower.

A suction bulb can also help remove mucous from your baby’s nose.  You can ask for one in the hospital or a pharmacy.

Please see your baby’s doctor if this cough continues and/or your baby develops a fever and this cough lasts more than 2 weeks.  If your baby also has difficulty breathing, cannot breathe or feed, you should also see his/her doctor.

Have a great night, y’all 😀

 ##HLWDK

Q: Dear Doctor, I have been a dirt clay addict for almost four years of my teen, could this mean I am likely to suffer from being infertile? Please help I want to stop.

A: Eating clay and other non-food items is referred to as pica consumption. Ingestion of clay is known as geophagia. Sometimes, this is associated with deficiencies of certain minerals or vitamins in the body, but some other times, you just can’t find anything that you can attribute the craving for. People eat clay for different reasons. Some claim to like the taste and the texture. More commonly, some pregnant women claim that it helps them to prevent the nausea and vomiting of early pregnancy.

Indeed, some new ‘regimens’ claim that clay has a detoxifying effect on the body when ingested. Well, I haven’t seen any evidence for this claim. There is however, evidence that some of these clay products eaten may be contaminated with arsenic or lead leading to arsenic or lead poisoning with attendant complications.

So, to answer your question simply, will this habit make you infertile? Maybe not, but it’s definitely not healthy. So, please see your doctor to confirm if you’re iron-deficient. If this is the case, correction of this may solve the problem. Otherwise, your doctor will work with you to find the reasons why you crave clay and alternatives to this.

For more on pica consumption, please click on this link: https://chatwithdrketch.com/2014/05/19/daily-health-tips-if-i-drink-water-when-i-am-pregnant-will-my-baby-be-born-with-a-cold/

Have a good night, people 😀

Q: Hi doc! I am kindly asking is it right to be given twice the yellow fever injection because l was given last year August which will last for 10yrs.Is there a difference between yellow fever for ten years and life time? Thanks in advance

A: Hallos! Thanks for writing in.

Previously, the yellow fever vaccine was taken every ten years but since 2016, that regulation has changed. From 11^th of July 2016, the WHO, on its website, states that the certificate of vaccination against yellow fever is valid for life for everyone vaccinated and that this validity refers to existing and new certificates. For the latter, the lifetime validity starts 10 days after date of vaccination. This has effectively cancelled out the need for re-vaccination.

So, there is no difference. The vaccination that used to be received and was valid for 10 years is now valid for the duration of your lifetime. If you had received the vaccination before, you don’t need to modify your certificate. The old one is still valid and will be recognized by countries that require proof of this vaccination.

I hope this helps.

All the best!

Have a good night y’all 😀

Q: Good morning ma’am. Please ma’am, I am worried. I am 37weeks pregnant now and last night I had a reddish spots on my panties, though it was very small but I am still worried. I didn’t see it when I wiped earlier this morning. I don’t know if it is a problem. Help me with an advice even though it was just a stain. God bless you ma’am

A: Bleeding during pregnancy can be worrying whether it’s a little or a lot. But, it may not necessarily be the sign of a problem.

Bleeding can occur in early pregnancy, close to or about the same time as the menstruation would and thus be mistaken for a period. This bleeding could be due to implantation as the fertilized egg implants itself in the uterus (womb). Other causes of bleeding in early pregnancy include ectopic pregnancy, miscarriage and infections.

For more information on ectopic pregnancy and miscarriage please click on these links:

https://chatwithdrketch.com/2014/08/07/daily-health-tips-what-are-my-options-after-ectopic-pregnancy-and-failed-ivf/

https://chatwithdrketch.com/2014/12/14/daily-health-tips-miscarriage-and-infertility-re-visited/

At 37 weeks, your pregnancy is considered full term. So, it may even be ‘show’ that you saw. Show is a mucous plug that may be tinged with blood and is a sign that your cervix (neck of womb) is getting ready for labour. Placenta previa is likely to cause bleeding from sometime around the second trimester of pregnancy, but of course, every episode of bleeding in pregnancy, irrespective of trimester, should be checked out in the hospital. Depending on the severity of the bleeding and the age of the pregnancy, the doctor would decide whether bed rest or emergency Caesarian section would be applicable. If bed rest is recommended, sexual intercourse and physical exertion including exercise, at this time may not be wise. Please discuss this with your doctor.

For more on placenta previa, please click on this link https://chatwithdrketch.com/2015/03/09/daily-health-tips-can-placenta-previa-recur-in-my-pregnancy/

So, I suggest you go see your doctor immediately.

All the best!