Pregnancy 8- 2016 by Justin

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MUST READS

August /September 2016

ON THE COVER

OTHER HIGHLIGHTS

20 Protein-packed meals you’ll love

48 Pastel pregnancy fashion

24 Staying safe

70 Eating safely

Things you’d never think to avoid

10 foods to steer clear of

28 What does labour really feel like?

76 Fun ways to track your pregnancy

32 The happy truth about C-sections

78 Happy babymoon!

34 Common birth defects The latest information and facts

What you need to know about... 40 Attachment parenting 80 Amniotic fluid 92 Baby skin concerns

Your final fling before baby comes

82 What dad can do to prepare for the new arrival

el d o m r e v o c Our loveliys due any day now Shireen

86 Breastfeeding made easy Our top must-have products to make your journey a good one

66 Fertility Boost your chances now

88 Keep baby close Why skin-to-skin is essential!

Cover Shireen of Boss Models Photographer Aubrey Jonsson Stylist Kirsty Stoltz Clothes Flower Crown R200 Lovisa. Dress R1 400 Mandy Manas at Kokobino. Cuff R49.99 (for three) Mr Price.

AUGUST/SEPTEMBER 2016 3

HELLO

TSHOLOFELO MODISE EDITOR

One of the biggest questions on every mom-in-waiting’s mind is about how her baby will make a grand entrance into the world. This question becomes more pertinent as you go through the third trimester. With all the choices available to women these days, it’s almost like walking through a sweet shop wanting to satisfy a craving. You

also can’t help but wonder when it’ll happen, whether you’ll be induced, if you’ll have everyone there (who you’d like to be there), and of course, will it all go to plan? The questions are endless! The truth about birth is that the circumstances are usually quite unpredictable. So, in all your plans, remember to be flexible. Your baby will come into the world the way it should and the most important thing will be that you have a healthy bundle of joy to take home. But, we want you to be prepared for the big day. We take you Through the Stages of Labour on page 28 and give you The Truth

About C-sections on page 32. We love to hear your amazing stories, so in our Real Life section we have a mom tell us about her home birth experience in My Sacred Home Birth on page 62, and speak to birth photographers about the role they play in Capturing A Moment In Time (page 58). Share your stories with us and keep us posted on your journey. Join our Facebook community and also catch us on Twitter.

COME AND CONNECT WITH OTHER MOMS W WWW.PARENT24.COM T @YOURPREGNANCYZA F WWW.FACEBOOK.COM – YOURPREGNANCY M WWW.YOURPREGNANCY.CO.ZA month 9+

Read this

HOLD ON, BABY

Kangaroo care or skin-to-skin care does wonders for your bond with baby. It is also one of the best things for his health.

YOUR BODY AND BABY

HOLD ON,

Skin-to-skin contact with your newborn can help breastfeeding, bonding and more. Discover when and why it’s essential to get up close and personal with your infant after birth

BABY

BY LORI COHEN

hen your baby is b o r n , y o u r instinct may be to get them clean and fresh and then snuggled up in an adorable babygrow and swaddled in a blanket. But, say the experts, placing your naked baby on your exposed chest directly after birth can have numerous physical and emotional benefits for the baby, and mother, that can’t be matched. Called “skin-to-skin” contact, or kangaroo mother care (KMC), it’s encouraged immediately after birth, and well after discharge from hospital, says Vanessa Booysen, neonatal facilitator at the Department of Health’s Newborn Care Project. “The Academy of Paediatrics recommends skin-to-skin, which is placing your naked baby, wearing only a nappy and a cap, on your bare chest for uninterrupted periods of at least 60 minutes, as frequently as possible, during the first 12 weeks and beyond.”

GIVING THEM THE BEST START

Skin-to-skin in the labour ward, directly after birth, is strongly encouraged, even if your baby is full term and healthy. “Evidence-based research has dethroned the concept that swaddling a baby immediately after birth is more conducive to keeping baby warm and calm. A baby can’t regulate his own body temperature; he needs an external heat source, and a mother’s skin

YOU DON’T NEED TO BE CONFINED TO YOUR BED TO DO SKIN-TO-SKIN is the perfect one for the job,” says Vanessa. “During labour and breastfeeding, a mother’s oxytocin secretion regulates her baby’s temperature and enhances the mother’s letdown reflex. During this precious time of skin-to-skin bonding and attachment, the mother and baby exchange sensory information that stimulates and elicits ‘baby’

96 YOUR PREGNANCY

Printed by A division of Novus Holdings

6 YOUR PREGNANCY

behaviour: rooting and searching for the breast and initiating breastfeeding, feeling safe and calm, a more regular breathing pattern, staying warm and maintaining baby’s body temperature and blood sugar levels. Babies who are swaddled immediately after birth have a more difficult time seeking out the breast. A baby needs his hands in front

Editor Tsholofelo Modise Associate Editor Kerryn Massyn Deputy Editor Robyn Lawrenson Specialist Editor Tina Otte Art Director Debbie Farrell Designer Portia Segalo Designer Chané Isaacs Lifestyle & Shopping Editor Joanita Cillié Digital Editor Sophia Swanepoel Digital Assistant Aayesha Fridie MARKETING Marketing Executive Lutho Vuso lutho.vuso@media24.com NATIONAL ADVERTISING Pinpoint: Zoë Smith: zoe@pinpoint.co.za, 082 457 6984 Brigitte Kolver: brigitte@pinpoint.co.za, 083 708 1588 SUBSCRIPTIONS, RENEWALS & ENQUIRIES Call: 087 740 1021, 021 065 0033 Fax: 086 457 5931 Email: subscribe@yourpregnancy.co.za SMS: “YPsubs” to 32361 (R1 per SMS) www.my-mags.com CONTRIBUTORS Adele Ferreira, Alda Smith, Aubrey Jonsson, Sr Burgie Ireland, Cath Jenkin, Craig Bishop, Emielke, Julia Boltt, Kelli Fuchs, Kirsty Stoltz, Lori Cohen, Louise Gilbert, Margot Bertelsmann, Melany Bendix, Neil Kirby, Tracey Hawthorne, Yolandi North, Ziska Baumgarten. PUBLISHING Publisher Nikki Ruttimann Head of Circulation Gadija Gamieldien Circulation Manager Adele Minnaar 011 713 9440 General Enquiries (Cape Town) Anita Grindlay-Whieldon 021 408 1278 Office Manager Maphuti Mongatane 011 713 9961 CORPORATE Published by Media24, Naspers Centre, 40 Heerengracht, Cape Town, 8001 Tel: 021 406 2121 CEO: Media24 Esmaré Weideman GM: Lifestyle Charlene Beukes CFO: Media24 Magazines Raj Lalbahadur Printed by Paarl Media Cape and distributed by On the Dot. Copyright Media24. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic or mechanical, without the prior permission in writing from the publisher. While reasonable precautions have been taken to ensure the accuracy of advice and information given to readers, the editor, proprietors and publishers cannot accept responsibility for any damages or inconvenience that may arise therefrom. Your Pregnancy has the right to make alterations to any material submitted, and cannot be held responsible for the loss of or damage to any material submitted for publication. All prices quoted were correct at the time of going to press, and may vary from shop to shop.

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clearly marked on all the NUK packaging and also on the side of the teat, with “S”, “M”, “L” or “XL”. This symbol represents the hole size and will either be small, medium, large or extra-large cross-cut hole respectively. You should note that the small hole for a size ONE teat is the same size hole as that of a size TWO teat and the same goes for the other holes too. AUGUST/SEPTEMBER 2016 7

INBOX

WINNING LETTER GOT YOU IN MY CORNER

My boyfriend and I recently found out we’re having a baby, and we both felt quite scared since this wasn’t planned. I didn’t know what to do at first; I don’t have any friends with babies, and my boyfriend took a long time to warm up to the idea of being a father. He kept saying how he didn’t feel ready, which only upset me more, because I really want to have this baby. Then, I saw Your Pregnancy on a shelf in the shops, and I was instantly hooked! I didn’t know such magazines existed! Thank you YP for making this a more positive experience for me. Even though I have a long way to go (I’m only eight weeks along) I know I have someone in my corner. I caught my boyfriend having a read, and even though his eyes grew bigger at times, he’s getting a better understanding of what’s coming our way. Thank you! ADRI

WIN A YUMMY MUMMY BODYCARE HAMPER

Our winning letter receives a hamper from Yummy Mummy BodyCare, worth R500. Yummy Mummy BodyCare’s tummy oil and tummy butter are made from natural and organic ingredients – better for you, baby, and the planet! They provide beautiful moisturisation thanks to ingredients like sweet almond and shea butter. It’s your pregnancy essential for tums, bums, and everything else that goes through the nine-month stretch! Available online at yummymummymaternity.co.za. Why we love it: Vitamin E helps stop stretchmarks in their tracks. Lovely zingy lemon scent – from real lemon oil, not artificial fragrance. Sinks in to soothe itchy stretchy skin. Super juicy moisturising, thanks to the ingredients sweet almond and shea butter. SEND YOUR LETTER AND CONTACT DETAILS TO: YOUR PREGNANCY LETTERS. EMAIL: LETTERS@YOURPREGNANCY.CO.ZA

MY LABOUR STORY

My precious son Rourke was born on 6 May 2015. As I look back at the journey of his birth, I’m overwhelmed with respect and appreciation for the doctors and nurses who helped bring my son into the world, and in awe of the miracle of birth. As a first time mom you try prepare yourself with as much knowledge as you can, but as prepared as I was for the 8 YOUR PREGNANCY

birth of my son, the events that took place on that day were nothing like I’d imagined. I was one of those moms who tried not to have a set birth plan, but I really wanted a natural birth. I began having slight contractions early that morning. We live on a farm, an hour from the hospital, so I knew we had to give ourselves enough time, but also didn’t want to rush there

SHARE YOUR STORIES & C0NNECT WITH MOMS-IN-WAITING. SEND YOUR COMMENTS TO LETTERS@YOURPREGNANCY.CO.ZA

unnecessarily. By 9.30am the contractions had increased and I was certain this was the real deal, so we headed off. Once in the delivery room the nurse confirmed I was in labour. We were so excited. This was it! But with all my planning I couldn’t predict that our gynae would be on holiday, that our baby’s heart rate would drop during the contractions, or that I’d dilate too slowly. All these unpredictable factors that occurred resulted in me having an emergency caesarean. In that moment all your planning goes out the window and you put your trust in the doctors and nurses wholeheartedly that they’ll deliver your precious baby perfectly. And they did! When they held up our little baby and announced “It’s a boy!” I felt a love I’d never felt before. It was the most special moment in my life. It may not have been how I’d wanted it to go, but as long as you have a healthy baby it doesn’t matter whether it was a natural birth or a C-section. I look at my son today and the one memory that’s embedded in my heart is not how he came into this world, but the moment they placed him in my arms for the first time. BETH

A SECOND CHANCE

Last year I gave birth to my silent, sleeping baby. It was the hardest day of my life. I couldn’t believe that our precious son wasn’t destined for a life with us. I struggled for months afterwards, but continued to have hope that one day I’d get the baby I longed for. Today I sit here, on the day my son passed

away, expecting another baby. My husband and I are so thankful and excited, but just as nervous. I never stopped buying your magazine; reading it makes me feel like I have more knowledge. My journey isn’t over yet and I still have some hurdles to climb but I know I will get through them. Thanks for the super magazine! MEGAN

BETTER LATE THAN NEVER

Two years ago my husband and I started to try to conceive, but we realised that age wasn’t on our side. We accepted we weren’t going to have a child. It was impossible. One day I was home alone, feeling sick, when I blacked out. I was taken to hospital in an ambulance. I got the shock of my life when the doctor told me I was nine weeks pregnant. It was the happiest news ever! So where there’s a will there’s a way, and at 42 I’m expecting my longawaited baby. Thank you for the great read YP! TUMELO

PREGNANCY PREP

I’m 33 years old and hoping to be pregnant soon for the first time. I recently bought my first copy of YP to help me get clued up on pregnancy and birth. I’ve been scared to become a mother for many years, because I was taking care of my sister, niece and nephews since my parents and my elder sisters passed on. The thought of having my own child to bring up while looking after my family seemed daunting, but I still

INBOX

long to have my own bundle of joy. I find YP so interesting and informative, and I’m looking forward to falling pregnant soon. I’ll be buying every issue from now on! NG LEGWALE

THIRD TIME LUCKY

The thought of my third pregnancy makes me feel natural again. I can’t hold back the excitement. The knowledge of carrying a life with its heartbeat in me really makes me believe I’m a life-giver. The morning sickness and mood swings make it all worthwhile. I feel extra special to be a woman now, and I’m really taking in the special treatment I’m getting from father-to-be. This is my third time around, and it feels like the first! I’m looking forward to delivering a healthy, bouncing baby, and it doesn’t matter if we’re having a girl or a boy. We just want a healthy baby. Thank you YP for the great read. M MOKWELE

TWO LITTLE MIRACLES

I’m one of seven children, and my mother died, leaving my grandmother and I to look after my siblings. Eventually my grandmother got very sick from diabetes, so I was left to care for everyone. I see

this time as the preparation I needed to become a mother. In 2002, I gave birth to my baby boy. In a period of six weeks, he was diagnosed with a rare liver disease called biliary atresia. We went from one hospital to another, until we found Cape Town’s Red Cross Children’s Hospital, where we waited for a liver donor. A year later we found one, and I’m so thankful for that. The experience we went through made me not want to have another child. But even after all that, I’m now expecting and I couldn’t be happier. I always bought YP for my younger sisters to support them through their pregnancies, but now I’m buying it for myself. Thank you so much for all the information. I’m so excited to be pregnant again! NOMBULELO

HOPE IS POWER

The day I found out I was pregnant was the best day of my life and the scariest too, since I’ve had two miscarriages. I prayed to keep my baby safe throughout my pregnancy. I thought my husband would always be there for me and enjoy every moment as much as I did. But he started drinking heavily, and spent most of his time with his friends. I spent a lot

of time crying and praying for answers. I chose to focus on my unborn child’s health to keep me going. Holding my baby for the first time brought so much joy to my life. But blood tests revealed he had jaundice. They took him to NICU, and I was devastated that I couldn’t bond with him. I felt helpless seeing my baby in an incubator. During that time, my husband and I became close again, and gave each other the support we needed. Now my son is home, healthy and growing, and I couldn’t be happier! Thank you YP for the great read. KATLEGO HOPE

FIRST KICKS!

When I fell pregnant I couldn’t wait to feel my baby’s first kicks. I’m at the halfway mark now, and a few days ago I felt my precious unborn baby doing karate in my belly. It was such an amazing experience and now I sit waiting for them all the time! She’s most active when I’m lying in the bath or in bed (funny when I’m trying to relax!). Thank you YP for being so full of information every issue. I have earmarked articles I want to go back to in the future. LAUREN

RULES FOR ALL COMPETITIONS, SUBSCRIPTIONS AND GIVEAWAY PAGES 1 The prize will be awarded to the first correct entry drawn at random. 2 The competition is only open to readers in South Africa. 3 The judges’ decisions are final and no correspondence will be entered into. 4 Staff members of Media24, their advertising, PR, and digital agencies, and their immediate family members, may not enter. 5 Entries must reach us by 30 September 2016. 6 Prizes are not transferable and cannot be exchanged for cash. 7 The winner will be contacted by the sponsor to arrange delivery of the prize. 8 Winners will appear on www.yourparenting.co.za 15 days after the competition has closed. 9 Entry into the competition constitutes acceptance of the conditions. 10 Discounts and gifts only available to subscribers with a South African postal address. 11 Prizes must be claimed within 12 months of the competition date or forfeited. 12 The subscription gift promotion is not valid in conjunction with the Vitality offer. 13 The Vitality subscription offer is only for active Vitality members. 14 Please allow six to eight weeks for delivery after the offer closes. 15 By entering a competition, you agree to receive further communication and direct marketing material from Media24 (Ltd). 10 YOUR PREGNANCY

SEND US YOUR PICS WIN A GIFT CARD!

Send us a beautiful high-resolution photo of you with your gorgeous newborn baby and you could win a Baby City gift card worth R500. Submit your entries, with all your relevant contact details, ID number and baby’s birth date to: Your Pregnancy You’re Here At Last, PO Box 95312, Grant Park, 2051 or email your pics to: letters@ yourpregnancy.co.za

WINNING SHOT Yuvaak and Yesho Dhathadeen with their precious bundle of joy at two months old.

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NAPPY COVER Handmade by Me R360 handmadebyme.co.za

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cravings This spring we have floral fever BABY SHOE Woolworths R110 woolworths. co.za

TRAINERS Mr Price R169.99 mrp.com

HAND AND BODY LOTION Woolworths R59.95 woolworths.co.za 12 YOUR PREGNANCY

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14 YOUR PREGNANCY

snaps WINNING PHOTO!

Mmathapelo Mohlosana looks urban cool!

WIN A CARRIWELL VOUCHER VALUED AT R1 000

Baby Jaxson, born 22 April, meets his brothers

The flexible Gelwire® of the Seamless GelWire® Nursing Bra gives you support, while still being soft and comfortable. The unique GelWire® supports the natural changes in the size and shape of your breasts, without the discomfort of stiff underwire. It’s the only “underwire” bra recommended by lactation consultants. The cup design exposes as much of your breast as you’re comfortable with while nursing; maximising skin-to-skin contact between you and baby. Available in polka, black and white.

The Chetty family share their first moments

Send us a beautiful high-resolution photograph of you with your gorgeous bump or your baby. Send your photo with both your names and date of birth to: Your Pregnancy You’re Here at Last, letters@yourpregnancy.co.za

Kgomotso Morotolo with baby Oagile Gift

Widnie Nonyane can’t wait to meet her son!

Lerato Ngwenya will name her child Thando

Gloria Tshikhudo is 22 weeks pregnant

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BUMP TALK

THE LATEST PREGNANCY

BATHBUNK

THE ULTIMATE BATHTIME ASSISTANT! Bathtime is made easy and efficient with Bathbunk, your handy bathtime assistant that takes the worry out of where to place your precious baby before and after bathtime. Bathbunk can be used for dressing and undressing baby at bathtime, top and tail cleaning, and for towel-drying baby when bathtime is over. Bathbunk is hygienic and mildew resistant, compact and lightweight for travelling, suctions down directly over your bathtub and can carry up to 20kg. Visit bathbunk.co.za for info.

ENTER AND WIN!

Bathbunk is giving away five hampers worth R450. To enter, SMS YPBATH to 33404 with your name, surname, email address, and postal address. Each SMS is charged at R1.50, free minutes do not apply. Entries close 30 September.

CARRIWELL best in maternity bras!

We love Carriwell’s range of maternity and feeding bras. The incredibly flexible Gelwire™ is the healthy alternative to regular underwire, giving you the added shape and support you need, without compromising on softness and comfort. Carriwells’ Organic Nursing Bra is made from highly breathable organic cotton. The super soft design gives support, comfort and shape making it naturally gentler, cooler and more comfortable for you and baby. Both bras are available at Baby City and selected baby and maternity stores, from R450.

ZARA HOME

Zhoozsh up the nursery

If you’re in love with Zara clothing, you’ll fall just as hard for their home range too! Zara Home is now open at the Mall of Africa in Johannesburg, and it’s something to behold. You’ll find beautiful Zara Home décor, including bedding, table and bath linens, furniture, table wear, cutlery, loungewear, a bath and body line, and of course, their stunning Zara Home Kids range. If you want to make baby’s nursery extra special with beautiful pieces, visit Zara Home at the Mall of Africa. Go to zarahome.com for more info. 18 YOUR PREGNANCY

WIN

BUZZ AND TRENDY FINDS

DAD’S CORNER

Evan Elton Sampson’s first baby shot!

Dads, share your tips, photos or stories here and stand a chance of winning a fabulous hamper from Clicks valued at R550!

B.O.N BABY

NATURALLY BEST FOR YOU AND BABY B.O.N’s Natural Baby Range is specially designed to cleanse your precious little one’s delicate skin. The range is made from high-quality, safe and natural ingredients, and natural oils. The gentle formulation is free of harmful surfactants, parabens, harsh chemicals and colourants, making it perfect for your baby’s sensitive skin. B.O.N Baby Natural Baby Cream contains natural oils that lock in moisture and keep baby’s skin hydrated all day long. Better yet, bond with baby and give her a massage using B.O.N Baby Natural Massage Oil! Baby massage has many added benefits for your baby, including improving weight gain, aiding digestion, improving circulation, and easing teething pain, so get going! For more info, visit bonnaturaloils.co.za

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NUTRITION

PROTEIN POWER Since you need almost double the recommended daily allowance of protein when you’re pregnant, be inspired by these protein-packed meals, and get cooking!

All recipes serve two

RECIPES AND STYLING ZISKA BAUMGARTEN PHOTOGRAPHY ADELE FERREIRA

It’s so easy to have eggs for breakfas t, lunch and dinner, beca use they’re simple to cook and eat. Scrambl e them for breakfast or make an om elette for a super fast su pper fix. Har dboiled eggs are a wonde rfully portabl e food – ea them as is w t ith a little sa lt and pepp or add to sa er lads. Other wise make French toas t – a perfec t pick-meup any time of the day!

EGGS ARE A GOOD, CLEAN SOURCE OF PROTEIN. ORGANIC, CAGE-FREE EGGS CONTAIN HIGHER LEVELS OF VITAMINS AND MINERALS INCLUDING BIOTIN AND CHOLINE. BIOTIN TURNS WHAT YOU EAT INTO ENERGY, WHILE CHOLINE MOVES CHOLESTEROL THROUGH YOUR BLOODSTREAM. CHEESY SOUFFLÉ

4 tablespoons butter (reserve 1 tablespoon to butter ramekins) 2 tablespoons grated Parmesan cheese 1 cup milk 3 tablespoons flour 2 dashes Worcester sauce ½ teaspoon mustard powder ¼ teaspoon salt 4 eggs, separated 1 cup sharp cheddar cheese, grated fresh bread, to serve

20 YOUR PREGNANCY

1 Preheat oven to 180˚C. Butter two oven-proof dishes with a 10cm diameter (or you can use one larger dish of about 20cm in diameter) with 1 tablespoon of butter. Sprinkle 1 tablespoon of Parmesan into each dish and swirl around to coat the bottom and sides of the dish. Freeze the ramekins until needed. 2 Heat milk in a small saucepan over medium heat (or microwave for 2 minutes). 3 In a separate saucepan, heat the butter and flour stirring constantly for 1-2 minutes. Add the warm milk and whisk well. Add the Worcester sauce, mustard powder and salt and stir over heat until sauce comes to the boil. Remove from heat. In a separate bowl, whisk the egg yolks and slowly add to sauce, whisking well. Set aside. 4 Whisk the egg whites until stiff and glossy. Fold about a quarter of the egg whites into the egg yolk mixture first. Then add the rest of the egg whites and cheese and gently stir until combined. Pour mixture into 2 ramekin dishes and bake 25 minutes. Serve immediately.

POULTRY CHICKEN AND TURKEY ARE GOOD SOURCES OF LEAN PROTEIN. CHICKEN IS ALSO AN EXCELLENT SOURCE OF NIACIN AND SELENIUM. CHOOSE SKINLESS PORTIONS IF YOU WANT TO AVOID THE SATURATED FAT UNDER THE SKIN.

CHICKEN LETTUCE CUPS

2 boneless, skinless chicken breasts – fully cooked 1 cup cherry tomatoes, halved 2 spring onions, chopped 1 avocado, peeled and cut into cubes 4-6 large lettuce leaves (iceberg or cos lettuce works best)

For the dressing ½ avocado 1 cup plain yoghurt 3 ¼ cup mayonnaise 2 teaspoons lemon juice 2 tablespoons fresh parsley, chopped 1 tablespoon fresh dill, chopped salt and pepper, to taste

1 Make the dressing by placing all the ingredients in a blender and whizzing at medium-high speed until smooth. (You can mix it by hand using a fork to mash the avocado.) 2 Cut the chicken into bite-sized pieces. Place in a large bowl, add the tomatoes, spring onions and avocado. Season with salt and pepper, then gently fold in the dressing and divide mixture between lettuce leaves. Eat straight away. AUGUST/SEPTEMBER 2016 21

NUTRITION

LEGUMES (BEANS & PULSES) DRIED OR TINNED BEANS, PEAS, LENTILS AND CHICKPEAS ARE AN EXCELLENT SOURCE OF PROTEIN AND FIBRE – VERY GOOD FOR YOU WHILE PREGNANT.

Quinoa can be expensiv e, but a little goes a long way. It’ s a naturally gluten-free, proteinrich seed. It’ s one of the few plant foods that co ntain all esse ntial amino acid s. Quinoa is also high in fibre, mag nesium, B vi tamins, iron, potass ium, calcium , phosphorus , vitamin E and antioxidant s.

BEAN BURRITO BOWL

1 tin red speckled beans ½ cup quinoa (you could also use brown rice) ¾ cup water ½ teaspoon salt ½ cup kale or spinach leaves, washed and chopped 1 tomato, chopped ¼ onion, finely chopped small bunch fresh coriander leaves, chopped

22 YOUR PREGNANCY

1 lime or lemon, zest and juice ¼ teaspoon salt pinch of black pepper 1 avocado, peeled and sliced For the tahini sauce 3 tablespoons tahini (you could also use nut butter) 3 tablespoons water juice of ½ lime (or lemon) ¼ teaspoon onion salt

1 Pour the tin of beans into a colander and rinse well under cold water. Set aside until needed. 2 In a medium pot, bring quinoa, salt and water to a boil. Reduce heat to low and simmer for 15 minutes. 3 Make the tomato salsa by combining the tomato, onion, coriander leaves and the zest and juice of a lime. Season. 4 To make the sauce, place tahini, water, lime juice and salt in a small bowl and mix well. To serve, divide the quinoa, beans and spinach between two bowls. Top with tomato salsa and half an avocado each and drizzle tahini sauce over.

FISH SEAFOOD IS RICH IN PROTEIN AND SAFE TO EAT DURING PREGNANCY AS LONG AS YOU STAY AWAY FROM FISH THAT EAT OTHER FISH. THESE PREDATOR FISH MAY CONTAIN HIGH LEVELS OF MERCURY. HEALTHY OPTIONS INCLUDE SALMON, TROUT, HAKE, YELLOWTAIL, MACKEREL, SARDINES AND TINNED LIGHT MEAT TUNA. SALMON AND TROUT MAY BE EXPENSIVE, BUT THEY’RE A GOOD SOURCE OF PROTEIN, AND FULL OF OMEGA-3 FATTY ACIDS – ESSENTIAL FOR YOUR BABY'S BRAIN DEVELOPMENT.

Nuts like al monds, walnuts, pist achios and cashews ar e good sour ces of plant prot eins. Pumpk in seeds, sunflower se eds and sesa me seeds also pack a protein punc h. So combine yo ur favourite nuts and dr fruit for a cu ied stom trail m ix to keep in your handba g for a quic k pickme-up when you’re feeling tired .

TROUT AND GREENS 6 baby potatoes ½ cup green beans ½ cup tender stem broccoli 2 trout fillet portions 1 lemon olive oil 2 tablespoons pesto salt and pepper, to taste

1 Scrub the potatoes and trim the beans and broccoli. Bring a pot of water to the boil. Once boiling, add a teaspoon of salt and use a slotted spoon to lower the potatoes into the water. Boil for 15 minutes, adding the beans and broccoli in the last 5 minutes. 2 Meanwhile, heat a non-stick frying pan over high heat. Rub olive oil all over trout fillets and season. Place skin side down in the pan and cook for about 4 minutes. Turn and cook for another 3 minutes or until just cooked through. Remove pan from heat and rest for a minute before adding the juice of a lemon to the pan. 3 Drain the vegetables and place in a bowl. Stir through the pesto and divide between two plates. Add a piece of trout to each plate and drizzle the pan juices over. AUGUST/SEPTEMBER 2016 23

TA L K I N G P O I N T

KEEP CALM AND STAY SAFE BY TINA OTTE

Before you even realise you’re pregnant, your body is already protecting the precious life inside you. Here’s how you can help it...

a t u r a l lethargy, nausea and vomiting are some of the first (protective) signs that your body gives you, indicating your pregnancy and stopping you from eating, drinking and doing anything potentially harmful to your developing baby. We all know about the food we need to eat or avoid, supplements to take or avoid, and to steer clear of X-rays

during pregnancy. Smoking and alcohol are well-known teratogens and should be avoided at all costs. But there are other hazards out there to be on the lookout for, which may surprise you.

! KITTY CAT CARE

The simple act of cleaning out your cat’s litter box can pose an unseen threat to your baby. Toxoplasmosis is an infection caused by a single cell parasite called toxoplasma. This parasite is commonly found in the faeces of cats. It can be prevented, tested for and treated if caught during pregnancy. With proper precautions, a healthy cat is not a particular risk to a pregnant woman. The care of a sick cat should be left for someone else, as should the care of a litter box. If a woman becomes infected during pregnancy, her baby can become infected, suffering widespread damage especially to the brain and eyes.

! STAY BALANCED

Yes – you’re looking to baby-proof your house from potential hazards to your baby, but those very same things can cause you a problem while you’re pregnant. Things like loose, slippery rugs with no underfelt need to be moved or removed or make sure they are flat enough not to cause you to trip or slip on them. Any liquids on the floor must be cleaned up immediately, otherwise slipping, losing your balance and falling over is a reality. During pregnancy your centre of gravity shifts, and as a result you’re more likely to walk into things, or misjudge things as your tummy gets bigger. It becomes harder to maintain your balance in the case of a fall than when you aren’t pregnant. And exchange your high heels for flatter shoes, as high heels exacerbate backache, foot strain and problems with balance.

! EXERCISE RIGHT

Although exercise is highly recommended, it must be done under the supervision of a person that knows how a woman’s body changes during pregnancy. Moderate exercise poses no threat to a healthy pregnancy, but remember that you not only have the baby to think about here. The changes in your body influence the impact exercise has on you. Strained joints, backache and breathlessness may all be exacerbated if you exercise incorrectly. While you must do abdominal exercises, you must take care not to overstretch your already expanding recti muscles. Proper exercise can enhance good posture, lead to better breathing and decrease aches and pains typical of pregnancy. Horseriding, kickboxing, martial arts, road cycling and gymnastics are just a few sports and activities that pose a danger to your body and that of your baby. Image: Jupiter Images

a dentist appointment during your first trimester to ensure healthy gums early on.

! WATCH THE MEDS

! DENTAL CARE

So, if you hate going to the dentist, this is one time you can’t put it off, even if it seems there’s no problem. Inflamed gums could be a sign of a condition called gingivitis which, if left unchecked, could lead to periodontal disease. Periodontal disease can lead to infections that could affect you and your unborn baby. Make

Headaches can plague you during pregnancy, and reaching for medication isn’t always the way to go. Taking painkillers such as aspirin and ibuprofen during pregnancy has been linked to a higher risk of miscarriage. Paracetamol is the safest painkiller to take as there’s no evidence an occasional tablet can do any damage. But exercise caution, one study has found that taking paracetamol frequently in the second half of pregnancy could double the risk of having a wheezy baby, which is linked to the development of asthma. Speak to your doctor before taking any pain medication. Try acupressure for natural pain relief.

! STRESS LESS

Stress is up there as a potential hazard to you and your baby. Accumulated stress which becomes distress can cause headaches, pain, and emotional turmoil that your baby feels and has no way of coping with. Long term stress and domestic violence and abuse can prove toxic to your unborn child, and could wire your baby’s brain in such a way, that they’re anxious, fussy and may cry a lot. Any stress-reducing exercises, such as learning relaxation techniques, breathing with intention for peace and calm, walking, swimming or talking things out with a counsellor or significant other is important.

! STRAP IN!

Many women complain about using seat belts during pregnancy. Placing the belts

correctly can go a long way in easing your discomfort. The diagonal strap should cross down between the breasts, and the lap strap should go below the tummy, snugly across the front hipbone on either side. The lap section should lay flat over the thighs and as low as possible under the belly. It should never be allowed to ride upward. Remove all slack from the belt and ensure that it fits close to the body with no twists. As pregnancy progresses pregnant drivers should adjust their seats and steering wheel so that they can easily maintain control of the vehicle as they drive. Mothers should strive to position the seat with as large a distance as possible between the steering wheel and their belly. YP

TA L K I N G P O I N T

WHEN A l ittle IS TOO

MUCH A glass of wine and a ciggie now and again can’t do any real damage, right? Wrong! These toxins can hurt your growing baby. Here’s what you need to know about alcohol and smoking while you’re pregnant

BY TRACEY HAWTHORNE THE LOWDOWN ON ALCOHOL

HOW DOES ALCOHOL AFFECT YOUR BABY? Alcohol is toxic for the unborn baby. It passes from your blood, through the placenta to your baby. Babies exposed to alcohol during pregnancy may end up with permanent brain damage and stunted growth as a result of foetal alcohol spectrum disorder, or FASD. Chanelle Lombard, research 26 YOUR PREGNANCY

“If a woman who drinks during pregnancy also smokes, the combined effect on the unborn child is worse than that of either smoking or drinking during pregnancy.” – Marlene de Vries, FAS Research Study, Stellenbosch University coordinator at the Foundation for Alcohol Related Research (FARR), explains, “The baby’s brain and central nervous system start developing at two weeks, and other organs, like the heart, follow soon after. This means that the baby is vulnerable to damage caused by alcohol exposure during this time. Alcohol consumed during the first trimester may interfere with the formation of the organs and can result in structural damage.” Importantly, though, harm can result from drinking during any phase of pregnancy, not just in the beginning.

WHAT HAPPENS TO A BABY BORN WITH FASD? A baby with FASD may have a range of physical,

neurological and behavioural problems. “Babies exposed to alcohol in utero are born small, struggle to gain weight, often have sleeping or nursing problems, and are easily irritated,” says Marlene de Vries, project coordinator of the FAS Research Study at Stellenbosch University. And the problems only get worse. “Children with FASD often have behaviour problems and problems in social adjustment. They may also have different facial features, and damage to organs including their eyes, ears, heart, and damage to the brain. This causes learning difficulties in school which often leads to dropping out of school early,” says Marlene.

WHAT ARE THE LONG-TERM EFFECTS OF FASD? “Alcohol use during pregnancy doesn’t only affect the person when they’re young. The effects have an influence on how that person functions for the rest of their lives,” says Marlene. “Lifelong issues include problems with school and social skills, inability to live independently, mental health problems such as depression, substance abuse, inability to keep a job and sometimes problems with the law,” adds Chanelle.

ARE THERE OTHER RISK FACTORS FOR HAVING A BABY WITH FASD? Yes, says Marlene: women aged 25 and older; smaller women; unintended

pregnancies, which increase the risk of accidental exposure to alcohol; women who have had several pregnancies; and binge-drinking. “The weekend heavy-drinking culture in South Africa is probably one of the most dangerous drinking patterns for the development of the foetus,” says Marlene.

HOW COMMON IS FASD IN SOUTH AFRICA? South Africa has the highest reported rate of FASD in the world. Foetal alcohol syndrome (FAS), which is the most severe form of FASD, is 30 to 50 times more common than the next most common birth defect, Down syndrome. FASD may affect as many as one in five people in the most at-risk communities.

CAN ANY CHILD BE AFFECTED BY FASD? Yes. No matter the colour of their skin, their gender or religion, or how much money their parents earn, any child is vulnerable.

WHAT IF YOU’RE PREGNANT AND YOU’VE BEEN DRINKING? “Unfortunately, the vast majority of pregnancies (75 percent) in South Africa are unplanned, which means most women only find out about their pregnancy when they’re in their second trimester and the damage has already been done,” says Chanelle. “But it’s never too late for a woman to stop drinking when she finds out about her pregnancy, as this will prevent any further damage.”

WHAT SHOULD YOU DO IF YOU THINK YOUR CHILD HAS FASD? Only a properly trained doctor can diagnose FASD. They’ll do Image: Jupiter Images

some tests on your child and also interview you, the mother.

YOU DRANK DURING YOUR LAST PREGNANCY AND YOUR BABY WAS FINE, WHY CAN’T YOU DRINK DURING THIS PREGNANCY? “Every pregnancy is different and the effects of drinking during pregnancy are also different; there is absolutely no guarantee that drinking even small amounts of alcohol will not seriously affect the health of the unborn baby,” says Marlene. No amount of alcohol during any pregnancy is safe.

IF A WOMAN HAS FASD, CAN SHE PASS IT ON TO HER CHILDREN? No – as long as she doesn’t drink during her pregnancy the baby is safe.

cord, which means your baby gets less blood and oxygen,” explains Dr Josh Matambo of the Essence Women’s Centre in Newcastle, KwaZulu-Natal. “It’s almost like continuously choking the foetus.”

WHAT ARE THE RISKS TO THE BABY? Smoking during pregnancy increases the chances of miscarriage and stillbirth; increases the risk that your baby will be born prematurely and/or with a low birth weight; increases your baby’s risk of developing respiratory (lung) problems, increases the risks of birth defects, and increases the risk of sudden infant death syndrome (SIDS, or “cot death”). In addition, says Josh, “Studies have shown that children of mothers who smoked during pregnancy have a lower IQ.”

WHERE CAN YOU GET HELP? FARR has projects in the Ceres area, De Aar, Renosterberg, Upington and Bethelsdorp. Their Healthy Mother Healthy Baby programme works, in collaboration with local clinics, to help women have a healthy pregnancy. Contact info@ farrsa.org.za or 021 686 2646. For women who have biological or adopted children with FAS, contact FARR’s FASD Support Group on 073 125 3459.

SMOKING AND PREGNANCY

HOW DOES SMOKING AFFECT THE FOETUS? The nicotine (the addictive substance in cigarettes), carbon monoxide and other toxins you inhale when you smoke are carried through your bloodstream and go directly to your growing baby. “Nicotine narrows the blood vessels of the umbilical

WHAT IF YOU ONLY SMOKE A FEW CIGARETTES A DAY DURING PREGNANCY? While it may be so that the more cigarettes you smoke per day, the greater your baby’s chances of developing problems, “there is no safe level of smoking during pregnancy,” says Josh. “Even electronic cigarettes are not considered safe to use in pregnancy.”

IS SECOND-HAND OR PASSIVE SMOKE EQUALLY DANGEROUS? The smoke from a cigarette contains many harmful substances, including tar, carbon monoxide and nicotine; and the smoke exhaled by a smoker is similarly laden with toxins. If a pregnant mother is regularly exposed to secondhand smoke, the same risks to her growing baby will apply.

WHAT IF I GIVE UP SMOKING DURING THE PREGNANCY, BUT START AGAIN AFTERWARDS? “Smoking outside the house will have no effect on the baby,” says Josh. “However, smoking in the same room as the baby, or smoking in the car when the baby is in the car, definitely carries risks.” Babies and children exposed to second-hand smoke may develop asthma and allergies, have more frequent lung and ear infections, and are at higher risk for SIDS.

CAN I USE A NICOTINE PATCH WHILE I’M PREGNANT? Nicotine patches (and chewing gum) release nicotine into the bloodstream to reduce withdrawal symptoms and decrease cravings in smokers who are trying to quit. Their safety in pregnant women has not yet been established, so it‘s always best to speak to your doctor about your options for quitting smoking. Good luck, it will be worth it! YP

FASFACTS FASfacts focuses on preventing FAS in the Northern and Western Cape. Their mentoring programme provides a mentor in the community to help pregnant women to not drink alcohol during pregnancy and breastfeeding. FASfacts also train facilitators in at-risk communities and on farms. Contact 023 342 7000 or 082 800 7313 or visit fasfacts.org.za AUGUST/SEPTEMBER 2016 27

TA L K I N G P O I N T

THROUGH THE

stages OF LABOUR A

What does labour really feel like through the different stages? Here’s what you can expect… BY TINA OTTE

s you approach labour, your body and your baby will give you some subtle, and some very obvious, clues that things are about to happen.

PRE-LABOUR CLUES

Your cervix will begin to soften and open slightly. Contractions are short, mild and irregular and may be felt as a little backache or as period pain low down in the abdomen. There’s often increased vaginal discharge. Other signs include sudden weight loss and nagging backache. Emotionally, you may sense that something is different, but often deny that it may be the start of labour. You may feel a nesting instinct kick in, and start to clean, paint or wash baby clothes, or you may find that you become more lethargic and sedentary, wanting to rest more. You may experience intuitive feelings, recognising subtle body changes. Don’t start anything strenuous. Pace yourself and rest as much as you can. Eat snacks of high-energy fruit and carbohydrates. Drink enough water. When resting focus on relaxing and breathing deeply as you start to tune into your body. 28 YOUR PREGNANCY

STAGE ONE

EARLY LABOUR

ACTIVE LABOUR

Your cervix continues to thin out (efface) and open up (dilate). Contractions are five to 20 minutes apart and last from 20 to 50 seconds. They’re usually not painful, but they do get your attention. Vaginal discharge increases and you may have a mucus show tinged with a bit of blood. Your bag of waters may break now or later. Lower back pain may persist or increase with contractions. You may experience mixed feelings at this point. You’re excited that labour has started in earnest, but also apprehensive that labour may be harder than you anticipate. Excitement and anticipation, restlessness and nervousness, wanting to walk around, making eye contact, needing companionship and distraction. You may want to leave for hospital already, or you may want to be in the comfort and familiarity of your home and these strange sensations grip you. Eat lightly and sip clear fluids. Rest, sit in a rocking chair, or take a slow walk. Distract yourself between contractions by reading, talking, listening to music or making phone calls – all obviously depending on what time of day or night it is.

The cervix is completing thinning out and continues to open. Contractions are getting longer, stronger and closer together – three to five minutes apart, lasting 50 to 60 seconds. Your vaginal discharge becomes more profuse. The bag of waters may break now if they haven’t already done so. Your labour may experience a plateau, which means contractions continue, but dilation may cease or pause for a while. You’ll be alert and concentrating during contractions and sleepy and tired between them. Your endorphin levels are very high. You may feel frustrated that labour has slowed, but try and relax – your body is taking a breather before taking the next step. You most likely want to avoid conversation, rest quietly between contractions and become passive finding your own position, often sitting with head on arms needing non-disruptive support from birth companions. Remember to breathe through every contraction. Change positions frequently in order to help your baby get into a good position and keep as upright as possible, using gravity to get your baby to

move down into the pelvis. Emptyyourbladderhourlyand rest between contractions. Use the visualisation techniques you would have learnt in childbirth class. Continue to breathe in a way that keeps you focused. Remember that the uterus needs lots of oxygen to work efficiently and your pain will be less if you breathe with awareness.

TRANSITION

ADVANCED LABOUR Your cervix is almost fully open. Contractions are close now – two to four minutes apart lasting 50 to 90 seconds. You’ll sense a change in the feel of contractions as their function changes from pulling open the cervix to more pushing down to get the baby out. Oxytocin (the hormone that causes contractions) levels are very high. You may start to feel the urge to push (this doesn’t happen to every woman). You’ll feel pressure and fullness in the vagina, rectum and groin area. It’s common to shiver and shake and feel nauseous, due to high adrenalin and endorphin levels. Adrenalin gives you your second wind and enhances your concentration now. It also makes you very aggressive to others and protective towards the baby who’s about to be

TA L K I N G P O I N T born. Some women become grouchy and confused and extremely discouraged. At this stage it’s normal for a woman to express fear of dying. You may feel out of control and unable to cope. Remember this is the hardest time before the dawning of the second stage. Deal with one contraction at a time! Each contraction is one closer to seeing your baby. Relax as much as possible between contractions to conserve your energy for pushing. Pant or blow if you feel the urge to push before it’s time.

SECOND STAGE

PUSHING AND BIRTH The character of the contractions changes and feels more manageable. They’re two to five minutes apart, lasting 50 to 60 seconds. The uterus pushes down with each contraction. The baby moves down the birth canal and pressure and burning is felt in the perineum as the head stretches the vagina. The uterus takes time to rest between first and second stage. This is normal and may take up to 30 minutes before getting going in earnest again. The contractions of second stage are often referred to as mothermaking contractions. You become calmer as your second wind kicks in and a sense of purpose takes over. You experience intense concentration, alert and eager as the birth of your baby approaches. You may feel tired and discouraged if pushing is taking a long time. Only push with contractions: rest between them. Try short, sharp pushing techniques, rather than long periods of breath holding that will tire you quickly. Get into a 30 YOUR PREGNANCY

comfortable optimal position for pushing, the more upright the better.

THIRD STAGE

DELIVERY AND PLACENTAL EXPULSION The uterus contracts to expel the placenta. The breast become loaded with colostrum, ready to feed your baby and your skin temperature rises in order to keep your baby warm on your body. You may be asked to help with a few more little pushes to get the placenta out. You may feel cramping as the uterus contracts and it is common to shake or experience chills. You will feel relieved and happy, wanting to hold your precious baby. Don’t be surprised by the utter exhaustion (physical and emotional) that you will feel. Endorphin levels and oxytocin levels are still very high. Take this opportunity to place your baby skin-to-skin on your body. Push as directed to assist with the expulsion of the placenta. Relax your legs and perineum if you need to be repaired due to a cut or tear. You should try and breastfeed your baby in order to help the contractions of the uterus. Breastfeeding causes oxytocin to be released which causes the uterus to contract tightly and expel any unwanted leftover tissue.

STAGE FOUR

THE FIRST HOUR AFTER BIRTH

Your uterus is resting now, but you may feel mild contractions as it begins to shrink back to its non-pregnant size. Vaginal discharge is heavy and bloody. Contractions will resurface during breastfeeding. You may still experience chills and shakes. Your vagina will feel tender and uncomfortable. You are likely to feel many d i f f e r e n t emotions as the dust settles. You may feel elation, joy and extreme love for your baby. Perhaps disappointment and exhaustion if labour was longer and harder than you expected or did not go according to your expectations. If you feel v e r y little

after the event of labour, do not be concerned. Once you have had a chance to rest and recover, you will start to feel a bit like your old self. Rest, relax and take it easy. Focus on your baby and offer your baby the breast. Breathe through the uncomfortable examinations that you may need to endure. You may be offered a cup of tea and may be surprised to find that you are ravenous. Share this special time with your partner as your new family is born. YP

Image: Jupiter Images

TA L K I N G P O I N T

THE TRUTH ABOUT

BY CATH JENKIN

C-SECTIONS Giving birth can be a scary experience, no matter how you do it. But many expectant parents are doubly fearful of having a caesarean birth, as it’s two processes in one – childbirth and a surgical procedure! Here’s what to expect if you’re having a C-section

32 YOUR PREGNANCY

WHY ARE YOU HAVING A C-SECTION?

C-sections are performed by choice or for a specific purpose. If you’re delivering your child through a private healthcare facility, your gynaecologist may ask you if you’d prefer to have a C-section, or if you’d like to give birth naturally. In a public healthcare setting though, C-sections are only performed for medical reasons or emergencies. If your baby is large, breech, or if you are HIV-positive, it will be recommended that you have a C-section. Almost all multiple baby births now take place by C-section. If you’ve had a baby via C-section before, your doctor or clinic sister may also recommend that you have your next child this way, but that will be determined based on your experience and medical history.

AN EMERGENCY C-SECTION

If there’s any sort of medical emergency during labour, moms may have to have an emergency C-section. You will be monitored throughout your labour, and though you may be determined to stick to your birth plan, remember that your health and your baby’s health are of prime importance. If your labour has stalled, or if your baby isn’t getting enough oxygen or their heart rate slows down, you could be admitted to a surgical theatre for an emergency C-section.

WHAT TO EXPECT

Dr Sarah Jackson, specialist obstetrician and gynaecologist at the Netcare Park Lane Clinic, says doctors should talk you through what will take place during the procedure. “There may be a delay in the C-section being Image: Jupiter Images

performed, as the hospital staff may need to attend to any emergencies first,” says Sarah. “The doctor will explain the anaesthetic to be used and how the baby will be taken out through a small incision made in the mother’s lower abdomen. A spinal block is usually used during a C-section, so moms won’t be able to move their legs for a few hours after the operation. After your delivery, you’ll be taken to the ward with other moms and their babies, and can expect to be discharged after two days.” In a private hospital, you’ll stay three days or more, until your doctor is satisfied that you and your child are recovering well from surgery and birth.

PREPARING FOR YOUR C-SECTION

Recovering from a C-section can take longer than recovering from a vaginal birth, so you’ll need extra hands at home, ready to assist when you’re discharged. But before you even head to the hospital, don’t forget to pack comfortable pyjamas with button-up tops, as these are easier for breastfeeding, and clothes, nappies and blankets for your baby. For moms having a C-section, Sarah also recommends that you pack “netting panties – these are more comfortable as they don’t rest on the wound”.

AT THE HOSPITAL

Once you’re all booked in for your C-section, you may feel nervous. Remember, you’re in good medical hands! You should be able to have someone with you in the operating

MAKE YOUR CAESAREAN SECTION MORE PERSONAL Your child’s birth is a magical moment, so don’t let the idea of it also being a surgical procedure dissuade you from making it special. Here’s how you can make it a little more personal: It’s possible for you to breastfeed immediately, or shortly after, you’ve given birth. Ask your doctor to facilitate this as part of the post-operative routine. You could request that a birth photographer be present, or ask your birth partner to snap a picture on their cellphone as your baby is lifted from your belly. If possible, you can request low lighting or even to play music during the surgery. Just check with the hospital and your doctor to ensure this is okay. Ask your doctor to hold off on clamping your baby’s umbilical cord for the first few minutes, so long as your baby is breathing well. This can have substantial health benefits for both you and your baby. theatre: your husband, partner or birth partner. They’ll need to wear hospital scrubs and ensure that they abide by all hospital rules relating to the surgical theatre.

HOME RECOVERY

Once you’ve been discharged, your recovery won’t be over. That’s why it’s vital to have

extra hands on deck at home, to help you care for your newborn baby and take care of yourself. For feeding, you’ll need help with lifting your baby up, as the wound from your C-section needs to heal. Support your abdomen with extra pillows or cushions and take all the medication as it’s prescribed to you. Keep an eye on your wound, and head directly to the hospital if you experience any sign of infection or fever. You’ll have a follow-up appointment with your doctor two to four weeks after you’ve given birth, so that they can check your wound is healing well. You’ll also have a six-week check-up after you’ve given birth, so don’t forget to keep to those appointments.

HOW DOES A C-SECTION AFFECT YOUR MILK FLOW?

The medications you’re given to use during your recovery shouldn’t affect your ability to breastfeed, but you may need to get experimental with your feeding position. Painkillers and related medication could make your baby extra sleepy though, but the medicines given to you won’t have a harmful effect on your child. Try to feed as regularly as possible, to establish a good milk supply – it’s recommended that you breastfeed every two to three hours while establishing breastfeeding. The more traditional cradle hold could be difficult and painful for you as you recover, but many moms find that lying on their side , or using the rugby ball hold, while feeding helps for the first few days. YP

I’VE HAD TWO C-SECTIONS, CAN I HAVE ANOTHER?

The build-up of scar tissue from C-sections is a cause for concern among doctors and gynaecologists, so you’ll need to be assessed by your doctor before having a third or further C-section. Remember that your doctor or clinic sister is the best person to talk to about any concerns or worries you have. AUGUST/SEPTEMBER 2016 33

TA L K I N G P O I N T

BY TRACEY HAWTHORNE

UNDERSTANDING BIRTH DEFECTS Most babies are born perfectly healthy, but for a small percentage, things go wrong. Many congenital disorders, or defects that happen in the womb, have no known cause. Here’s what you need to know about the five most common ones

bnormalities that your baby has at birth are known as birth defects or congenital disorders. Some, such as club foot,

34 YOUR PREGNANCY

are immediately visible, while others show up later in life. Some, such as congenital heart defects, may be hidden. “There’s a chance for relatives of someone affected by a birth defect to have a child with the same condition,” says Helen Malherbe, chair of the Genetic Alliance South Africa, a nonprofit organisation that unites support groups around congenital disorders. “But, these people can have children who don’t have birth defects.”

CLEFT LIP/PALATE

About nine weeks into pregnancy, the separate parts of the baby’s upper lip and palate join together to form the lips and the roof of the mouth. When these parts don’t join together, clefts or gaps occur. A cleft palate and cleft lip can occur together or separately. About one in 700 babies is born with a cleft lip and/or palate.

TREATMENT

Every case of cleft lip and palate is different. Surgery is usually needed to repair the cleft, and professional help with speech and hearing may also be necessary.

FOR ADVICE AND SUPPORT The Smile Foundation offers facial surgery and treatments. Contact 0861 ASMILE (276 453) or visit smilefoundationsa.org. Cleft Friends is a parent support group. Contact 071 201 6085 or 082 393 1206 or visit cleftfriends.co.za.

CLUB FOOT

Club foot is a birth deformity where one or both feet are twisted in and down, so that the sole can’t be put flat on the ground. Although it isn’t painful for baby, they won’t be able to walk properly unless it’s treated. About one in 500 South African Image: Jupiter Images

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In South Africa, only about 50 percent of women without medical aid get antenatal care during the first 20 weeks of pregnancy. This means that many conditions can’t be picked up early enough to diagnose or treat. babies is born with club foot. (South Africa has a higher rate than the world average.) “Doctors are still working out what causes club foot,” says Karen Moss, director of support organisation Steps. “It can run in families, but sometimes it’s an isolated case with no history in the family. If a family already has a baby with club foot, or a parent has club foot, the chance of having a child with club foot increases.”

TREATMENT In most cases, the Ponseti Method works well. This is very specific gentle manipulation of the baby’s foot and ankle, from when the baby is two weeks old. The manipulation is done slightly differently each time, to stretch different parts of the foot. A full plaster-cast (groin to ankle) is then applied to hold the foot in position. Most clubfeet are corrected within four to six sessions. After the casting phase, the baby wears a brace at night until age four.

FOR ADVICE AND SUPPORT Steps offers support and education for families, and info on clubfoot diagnosis and treatment. Contact (021) 462 7357 or visit steps.org.za.

SPINA BIFIDA

Spina bifida means “split spine”. It’s a defect that happens in the womb when the spinal column doesn’t close all the way. In serious cases, parts of the spinal cord and nerves may poke through the open part, causing nerve damage and other disabilities. It’s unknown what causes it.

TREATMENT Taking folic acid as a supplement before and during pregnancy can reduce the risk of having a baby with spina bifida. Folate is a B vitamin (B9) found in green vegetables, such as asparagus and broccoli, liver and kidney, nuts, lentils and seeds, and oranges. Folic acid is the synthetic form of the vitamin. In South Africa, staple foods such as wheat flour and maize meal are fortified with folate. 36 YOUR PREGNANCY

For children born with spina bifida, treatment depends on the severity and position of the defect. In some cases, no treatment is required. In more severe cases, surgery is needed, as well as treatment for bowel and bladder problems.

FOR ADVICE AND SUPPORT Contact the Association for Spina Bifida and Hydrocephalus South Africa on 083 440 1907 or visit asbah-sa.org.

DOWN SYNDROME

Down syndrome happens when something goes wrong at conception with a chromosome, which is a structure in human cells that carries genetic information. About one in 500 babies is born with Down syndrome, but this figure increases in older mothers. Down syndrome babies look slightly different – they may have a rather flat face with a small nose, small skin folds on the inner corner of their eyes, and broad hands with short fingers. They often have intellectual disabilities and other health problems involving their heart, thyroid, gastrointestinal tract, vision and hearing.

TREATMENT Surgery and medication, hearing aids and spectacles can help with some problems. Children with learning difficulties may need extra help at school.

FOR ADVICE AND SUPPORT Contact Down Syndrome South Africa on 0861 369 672 or visit downsyndrome.org.za.

CONGENITAL HEART DEFECTS

Congenital heart defects (CHDs) are problems with the structure of the heart. These are the most common birth defects (occurring in one in 100 babies) and the leading cause of infant death. So far, 47 different CHDs have been identified. Some are very severe, while others are so mild they may go unnoticed. “A surprising number of babies are born with little holes in their hearts that just close over time,” says Andrea Slater, whose son Hudson died of a CHD at four months old, and who’s now the driving force behind The Hudson Initiative, a campaign to make South Africans more aware of CHDs

and to introduce compulsory testing for newborns. Although some babies may be diagnosed with a CHD during the pregnancy or at birth, sometimes the diagnosis isn’t made until months later.

TREATMENT The earlier CHD is detected and treated, the more likely the child will survive with fewer long-term health problems. Successful treatment may require highly specialised care, and more than half of children born with CHD will need at least one surgery in their lifetime. Severe CHDs are very expensive to treat, and can put strain on families. Family education is an important part of successful coping.

FOR ADVICE AND SUPPORT Contact The Hudson Initiative on 060 689 0169. Heart Kids South Africa promotes awareness of CHDs. Contact them on 074 120 0279 or visit heartkids.co.za. YP

SCREENING FOR BIRTH DEFECTS No test is 100 percent accurate in detecting birth defects, although these are useful. ULTRASOUND An ultrasound done at 11-14 weeks of pregnancy measures the fluid-filled space at the back of the growing baby’s neck. A second ultrasound, done at about 20 weeks, may detect major structural or physical birth defects. BLOOD TESTS Maternal serum screening measures certain chemicals in the mother’s blood and indicates if additional testing is necessary. Non-invasive prenatal testing (NIPT) examines the DNA of the growing baby identifies any concerns. AMNIOCENTESIS A hollow needle is inserted into the womb to extract amniotic fluid, which is screened for abnormalities. These tests aren’t routinely available in all South African hospitals. If any serious problems are detected, women should talk to their doctor about their options. For advice and support, visit Genetic Alliance South Africa at geneticalliance.org.za.

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TA L K I N G P O I N T

BY MARGOT BERTELSMANN

HELP YOUR BIG KID COPE WITH BABY Y They’re feeling as apprehensive about the new arrival as you are! Here’s how to help

ou’re pregnant again and you’re over the moon! But, your eldest child isn’t showing as much enthusiasm as your mom, your colleague and even the cashier at Pick n Pay are... “Why is this?” you wonder, a little bit put out. “Why can’t my little sunbeam be as excited about the news as I am? Why rain on my parade?” Imagine for a moment your husband came home bubbling over with excitement. He’s just met The Most Amazing Woman! He’s so sure you’ll love her too, he’s asked her to move in with the two of you. Your reaction? Hell to the no, right? It’s the same for your little one. You can’t expect your two-yearold to be excited by the arrival of someone they can only possibly see as a rival for your time, attention and even love. So share your whooping squeals of joy with your girlfriends, by all means. But when you’re with your green-eyed eldest, try these strategies both before and after new baby’s arrival, instead.

ACKNOWLEDGE THEIR FEELINGS

A toddler might not

38 YOUR PREGNANCY

understand when you tell him a new baby is coming. But say this anyway: “Mommy (and Daddy) are getting a new baby. Our hearts are going to grow so we will love you as much as the new baby. But you were here first!” Also acknowledge that your child may not like it: “Mommy will be busy with that new baby and that can be hard. But we’ll make special time to spend together, just the two of us, too.” Your child is part of the family and has the right to be informed, and to hear the news from you, not from others. Once the baby’s here, continue to state your love for your eldest, and also verbalise it when you see him taking strain: “I see you’re feeling angry that Mommy is feeding the baby again.” Merely the sense of having one’s feelings seen and understood is massively reassuring – to adults, and children, too.

SPREAD THE LOVE

In his online course on managing children’s anger, Artie Wu of Preside Meditation (presidelife.com) has this advice: Work hard to avoid the misconception that there’s anything – good

READER’S TIPS!

Samira “I ‘borrowed’ a friend’s baby for a few visits so that Iman (three years) got the chance to see and hold a newborn before her own sister was born. Kids don’t know how much a little baby cries and sleeps, and how little they can actually play with them.” Jonno “We decided to buy Luke a big-ticket gift and pretended it was from his brother. Luke wasn’t even two, so he didn’t realise the train set was actually from us. Some people say this is deceptive, but I feel like it formed a positive impression of Robbie on Luke’s mind from day one. They’re very close today.”

or bad – that your children can do to affect how much you love them. Consistently emphasise the message that you love your child to the maximum, as much as you’re capable of love, full to your personal “love brim”, as it were. Say, “There’s nothing you can do to make me love you less. No matter how naughty you’re being or how angry you’re feeling, my love for you doesn’t change.” Similarly, “You don’t have to be good to make me love you more. It’s impossible for me to love you any more than I do – I love you as much as it’s possible to love.” Knowing that love is constant, and equal for both siblings, regardless of feelings or behaviour, can allow a jealous child to work through his anxieties sooner.

DON’T BRIBE

It’s tempting to oversell the upside to getting a sibling. But there’s actually precious little that’s “better” in your eldest child’s life for the first few months of the new baby’s life. It’s months before they can play together in any meaningful way. The new baby makes noise, takes Mommy’s attention away, and is the centre of visitors’ attention. Would you love that, if it were you? So don’t tell your child how much he or she will love the little rival... your child may be feeling anything but love. Rather let the love between the siblings develop gradually, in its own way, over the first few months and years. It will! And don’t ask your child if he’d like a brother or sister. He has no choice in the matter,

REACH FOR THE BOOKS! BOOKS TO HELP PREPARE YOUR CHILD FOR BABY The New Baby, Mercer Mayer, R65 My New Baby and Me, Dian Smith, R276 (a record-keeping book for your older child) No Hitting!, Karen Katz, R75 BOOKS TO HELP YOU PREPARE FOR LIFE WITH SIBLINGS Loving Each One Best: A Caring And Practical Approach To Raising Siblings, Nancy Samalin, R329 Welcoming Your Second Baby, Vicky Lansky, R191 Siblings Without Rivalry: How To Help Your Children Live Together So You Can Live Too, Adele Faber and Elaine Mazlish, R313 All available at takealot.com says counselling psychologist Robyn-Leigh Smith, so don’t give him the illusion of choice. Instead, allow your child to feel important by “helping” you with babycare tasks (if he wants to – don’t force it), and bond with him over how lovely it is to have a big child who can do big-boy things.

DON’T DISRUPT ROUTINE

Tempting as it may be to have your eldest out of nappies, sleeping in a big bed, off bottles, or in nursery school in the mornings by the time the new baby comes, it may not be realistic. In fact, it’s quite likely that a toddler may regress to wetting the bed or wanting his bottle or dummy back. These things might give him comfort or make him feel like he’s also special and small. He’s telling you he needs to be looked after, just like the baby. These are outwards signs of stress in a child and it might be best to indulge him for a while and give loads of gentle encouragement instead of forcing the issue. Similarly, sending your child off to school just as a new baby enters the house can look and feel a lot like rejection. It might be better to leave everything as constant as possible for the first few months of the new Image: Jupiter Images

baby’s life instead.

TEACH GROUND RULES

“Be gentle”, “no hitting” and “no biting” will become your faithful refrain. While some fighting between siblings is inevitable, you can lay down ground rules. Try to teach your toddler healthy ways of expressing his frustration. Physical play is a great way to let off steam.

DON’T WORRY

Siblings, at their best, can be lifelong friends, blessings, advocates and companions. You’re not doing your child a disservice by adding another member to the family, so ditch the guilt and get on with adjusting to your new normal. Everybody makes a few mistakes along the way, too – this is a learning curve for all of you – so dust yourself off and move on when those happen. If your family is struggling with sibling rivalry issues, see a family therapist – it could save you years of heartache. Government and NGO resources such as Ububele (ububele.org), an NGO based in Alexandra, Johannesburg, which provides free family counselling, or FAMSA (famsa.org.za), are free. YP

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TA L K I N G P O I N T

40 YOUR PREGNANCY

HOPELESSLY

DEVOTED TO YOU…

Yes, attachment parenting is about breastfeeding and co-sleeping, but there’s more to it beyond the baby years. It’s a way of parenting for life. We take a closer look at this sometimes controversial parenting style

BY CATH JENKIN

h o o s i n g parenting approaches and philosophies is almost a political act these days, with parents on either side of strictly demarcated battle zones defending their choices over others’. So-called “attachment parenting” is a point of friction for many. In essence, it’s an approach that puts children at the centre, and has recently become renowned for its adoption by celebrity parents.

WHAT IS IT?

Attachment parenting is intended to let parents raise emotionally secure and well-rounded children. Its four main principles include feeding on demand, co-sleeping, keeping a child physically near to their caregivers as much as possible, and always responding to a child’s cries. Advocates of selfsoothing or the “cry it out” Image: Jupiter Images

methods at sleeptimes have criticised these principles, as this approach does, indeed, demand a high level of parental attention. But attachment parenting also continues beyond the baby days, and sets the tone for your relationship far into your child’s life. Famously advocated by Dr William Sears in his The Baby Book, published in 1993 and adopted by celebrity parents including Alanis Morissette and Mayim Bialik, attachment parenting is also sometimes criticised as setting impossible standards for modern-day parents.

FEEDING ON DEMAND

A demand-based feeding schedule for a baby is nothing like a routine. Instead, mothers breastfeed as and when the baby requires or demands it. This approach often endorses extended breastfeeding and eventual self-weaning, too.

BENEFITS FOR MOM: Reduces muscular tension. Allows the baby to be positioned at the correct height. A safe support for your newborn baby. Reduces abdomen pressure.

TA L K I N G P O I N T

CO-SLEEPING

Parents across the globe have had their babies sleeping in the same bed for as long as parents have been parenting. But a more modern way of life has demanded that children sleep in their own rooms or cribs and what works for one family may not work for another. Co-sleeping also comes with some warnings and precautions that must be heeded by parents, so it’s good to investigate it before committing to it.

BABYWEARING

Those cute baby slings are very much on trend right now, but they’re really an adaptation of wrapping your baby into a blanket around your body. They do make life a little easier, though, especially when you need your hands free to do other things during the day. They can also be very helpful when you need to breastfeed.

RESPONSIVENESS

Rather than letting a baby self-soothe or waiting for them to cry it out, attachment parenting emphasises the importance of having a caregiver respond to a child’s cries every time, to prevent a full-scale bout of tears. This can be demanding for parents, but it’s adopted to ensure that your baby feels secure, and advocates have often reported that, as a result of this approach, babies actually cry less often.

A NATURAL PROGRESSION

Shannon Richards is a keen advocate of attachment parenting. As mom to two girls, Shannon found that adopting the attachment parenting approach came

42 YOUR PREGNANCY

on parental responsiveness and a gentle approach. When it comes to disciplining an older child, the philosophy Attachment parenting can seem to be quite of attachment parenting mother-focused, especially because of its focus doesn’t include smacking or other physical punishments. on breastfeeding. But it’s very possible to include As Shannon says, “Not fathers in the approach too. We’ve got some tips physically punishing our on how to do that: girls came naturally to us as Encourage skin-to-skin contact with dad. a family as well, as physically Pick tasks or duties that dad can do, like bathing harming our children was or bedtime stories. something neither of us were comfortable with. We Baby slings fit dads just as well as they do moms! discipline gently, which Encouragement and support of mom as involves distraction, fair she breastfeeds is a vital element of consequences, and not attachment parenting. expecting too TIP much from ATTACHMENT them. We felt like the naturally to her. Shannon PARENTING AND a c c e p t fourteenth explains, “Before I had SMACKING DON’T MIX – that they time that children I was adamant that are two night, and I wouldn’t breastfeed for BUT YOU DON’T HAVE TO and four I seriously more than nine months, BE AN ATTACHMENT PARENT years old, considered I’d never bed share, and TO CHOOSE GENTLE and are sleeping on my babies would start DISCIPLINE METHODS learning the carpet in solid foods at four months OVER HITTING to be alive. her room. That old. I’d never seen a baby We try to teach made me pause wrap before and hadn’t by example and and rethink. This was heard the term ‘attachment kindness, and most of the absurd! That night I bundled parenting’. When I had my time, they follow suit.” up my baby and we snuggled first daughter, the advice of Tamarin Brunton, a up in our bed. Since then, we friends, neighbours, mom Durban-based business have slept next to each other and in-laws all started to feel owner and single mom, says, most nights and, when her unnatural. Breastfeeding was “My approach to parenting baby sister joined us, they easy for me, so why should just felt like instinct to me slept on either side of me. It’s I put my baby onto a bottle and, as a single parent, not for everyone, but is what when I had plenty of milk? my focus is always on my feels normal for us! When When I got to nine months, 12 daughter when she’s with Lily was a year old I stumbled months seemed close, and I me. Now that she’s older, across the term ‘attachment decided to just push through. I find that she feels parenting’, and realised that I Before I knew it, I was quite secure to set her could, perhaps, fall into that breastfeeding a two-year-old own boundaries and is box. To me though, it was just with a big pregnant belly. It comfortable in many social parenting. I was doing what wasn’t a conscious decision situations. What has been felt normal!” or taking a stand, it was what hugely beneficial is having came naturally to me.” my circle of family and ATTACHMENT friends support this choice BEDTIME FOR PARENTING IN and approach.” EVERYONE OLDER CHILDREN “Now that we’re reaching Similarly, Shannon found But beyond breastfeeding, the stage of weaning from that co-sleeping worked co-sleeping and the days of extended breastfeeding, I’m better for her family. She tells having infants in the house, being led by my daughter us that “after six months of attachment parenting can towards it – and she even trying to follow ‘the rules’ I continue as a philosophy and potty-trained herself!” YP stood over the cot for what approach, because it focuses

HOW CAN DAD BE A PART OF ATTACHMENT PARENTING?

EXERCISE

Closer ONE STEP

TO TONED

Lack of flexibility in your muscles and ligaments will add an unnecessary burden to the adaptations your pregnant body has to make to accommodate a growing baby. Keeping toned and strong does plenty to help your body and your mind cope with pregnancy FLEXIBILITY

Flexibility of a joint is related to the ability of the surrounding muscles to stretch and then to relax. Muscles tend to shorten when they are not used or when they are compensating for postural imbalance, such as during pregnancy when your centre of gravity changes. Your flexibility increases with stretching exercises, lengthening your muscles and making them more pliable. Stretching is natureâ&#x20AC;&#x2122;s prescription for relaxing the body, and it relieves stress as well.

STRENGTH

Strength is defined in a variety of ways and is affected by the kind of muscular contraction involved as well as the speed of those contractions. Strength can be increased during pregnancy if the level and the length of the exercise/workout is extended very gradually. Doing toning and weight-bearing exercises increases strength. Cultivating strength and flexibility go hand in hand, but cultivating stamina, which involves endurance exercises (like swimming or walking) should also be included.

PHYSICAL = MENTAL

When you stretch, take it only as far as is comfortable. Never overstretch or push 44 YOUR PREGNANCY

into or past pain. Your tissues and joints are softer during pregnancy due to the hormones relaxin and progesterone, and you donâ&#x20AC;&#x2122;t want to tear or injure anything. The benefits of improved muscle tone and strength are numerous. A strong body helps to carry the added weight of pregnancy. It will improve your balance and stability, increase your energy levels and improve your sense of well-being and self-esteem. Physical strength gives you better endurance and tolerance. Both will help you deal with birth and early motherhood. As with everything you do in pregnancy, moderation is the key. Do not overwork or strain your muscles.

THE EXERCISES

You will need a wall, a chair, some small pillows, water and a towel. Women carry a lot of tension (never mind everything else) in their shoulders, so doing these stretches daily will alleviate a lot of pain and discomfort.

SEATED SHOULDER STRETCH WITH CHAIR This exercise stretches out and releases tight shoulders and opens up your chest. It is an ideal stretch for any time during pregnancy, but especially during the third trimester, and also when you are breastfeeding.

Place a chair about 50cm from a wall. Sit on the front portion of the chair with your knees as far apart as is comfortable. Turn your feet out slightly. Extend your arms straight up the wall, allowing your forehead to touch the wall and making sure your buttocks are pressed firmly into the chair. Inhale as you stretch upward; exhale as you press gently forward towards the wall. Keep your arms straight while stretching towards the wall. Hold for a slow count of eight. Push back from the wall, lean back in the chair as you drop your arms to your sides. Relax and breathe normally. Repeat four times.

A STRONG BODY HELPS TO CARRY THE ADDED WEIGHT OF PREGNANCY. IT WILL IMPROVE YOUR BALANCE AND STABILITY, INCREASE YOUR ENERGY LEVELS AND IMPROVE YOUR SENSE OF WELL-BEING

(A)

CHEST & SHOULDER STRETCH WITH CHAIR

This stretches the muscles of the chest and shoulders, and helps to relieve upper back pain and roundness.

(B)

Pad the seat with cushions/pillows if needed. Sit on a small pillow or blanket to raise buttocks and extend arms behind you, resting them on the chair. Your feet should be widened slightly with your legs straight and the front of the thighs firm. Gently brace your back by pulling your abdominal muscles in towards your spine. Inhale and press the back of your legs and buttocks to the floor. Exhale, lift chest, and roll shoulders up and back. Breathe normally and hold for a slow count of eight. Release by removing arms from chair, bringing them down to your sides. Repeat four times.

DOWNWARD DOG POSE WITH CHAIR

This well-known yoga pose will relieve lower back tension; strengthen arms and back and stretch hamstring and calf muscles. Tight hamstrings are one of the biggest causes of backache.

ALTERNATE LEG STRETCH WITH CHAIR

This exercise stretches the back of your legs, shoulders and buttocks.

Push chair securely to the wall. Hook thumbs around front edge of seat and place palms on top of chair seat. Straighten arms and walk feet backward. Place your feet parallel and hip-width apart. Tighten front thigh muscles as you straighten your legs and lift your coccyx towards the ceiling. Inhale and push down on the chair to stretch arms and shoulders. Exhale and lengthen entire back away from hands. To release bring feet forward slightly, bend knees and slowly uncurl. Repeat four times.

Place your chair about one and a half metres away from the wall. Stand with your back to the wall, and place your left heel against the wall while you extend your right leg and foot in front of you (A). Stretch arms forward and grip the top of the chair. Stretch the back of your leg by pulling up your front thigh muscle and lifting your buttock bones. As the stretch becomes easier, push the chair forward and stretch until your chest becomes parallel with the floor. Release and repeat on the other side (B). Do this four times on each leg. AUGUST/SEPTEMBER 2016 45

EXERCISE Remember that too many repetitions done quickly may cause muscle cramps, so donâ&#x20AC;&#x2122;t overdo it

LEG EXTENSIONS

This will strengthen the muscles of the front of your thighs and help to support your knees. This exercise can be done standing or sitting on a chair. Sit upright in a straight-backed chair (or place a pillow behind you for support) and slowly bend and straighten each leg. Brace your back by pulling your belly button to your spine. Do two sets of 16 repetitions on each leg.

CALF RAISES

This strengthens the calf muscle and increases circulation to your legs. Itâ&#x20AC;&#x2122;s particularly helpful if you suffer from swelling and varicose veins.

PRESS UP

This exercise will strengthen the pectorals (chest muscles) and tone the triceps (muscles at the back of your arms). Kneel on all fours, with your hands slightly wider than your shoulders and your fingers facing forwards, your knees slightly apart, and placed directly under your hips. Tighten your abdominals to keep your back from arching and lengthen your spine, keeping your neck and back in a straight line. Ensure that your body weight stays over your hands. Bend your elbows and lower your chest and face towards the floor, exhaling as you go down. Pause. Inhale and exhale as you slowly start to push your body up towards starting position. Do two sets of eight reps. Should this position become too uncomfortable as your pregnancy progresses, do this standing, placing your hands directly in front of your face pressing against a wall. Brace your abdominals and allow your elbows to bend as you sink your body towards the wall, exhaling as you do this. Pause at the bottom and then push back to starting position. Do four repetitions. 44 YOUR PREGNANCY 46

Stand one pace back from a wall, with your feet placed hipwidth apart and your knees soft. Move your body weight slightly forward and place your hands on the chair. Keep your head up and look straight ahead. With your weight evenly spread between both feet, slowly rise up onto your toes. Lift the arch of your foot as high as you can. Hold, and then slowly lower both heels to the floor. Do two sets of eight repetitions.

SQUAT

Tone your legs and bum with this easy move. Your lower body muscles are working harder than ever to support your growing belly. Strengthening them can assist. Stand with your feet wide apart. Hold a dumbbell in each hand, arms extended in front of you. Make sure to keep your back straight and then bend your knees. Do 12 repetitions.

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Annabella Maternity 082 972 1110 Colleen Eitzen 031 717 2760 Exact 0860 576 576 H&M 086 0690 707 Jo Borkett 011 462 0604 Koko Bino 011 783 6223 Legit 0800 203 925 Mr Price 080 021 2535 Nine West 011 783 2356 Woolworths 0860 022 002 Yummy Mummy Tummy 0860 YUMMY MUMMY Zara 011 302 1500

OPPOSITE PAGE Necklace R39.99 Mr Price. Top R345 annabellamaternity.co.za. Belt R129 Jo Borkett. Dress R1 029 Zara. LEFT Earrings R149 H&M. Choker R59.99 Mr Price. Lace floral dress R1 599 Jo Borkett. RIGHT Necklace R49.99 Mr Price. Linen jacket R790 yummymummytummy.co.za. Pastel maxi dress R1 400 Mandy Manas at Kokobino.

BEAUTY

FLAWLESS BEAUTY 1

To set a picture-ready canvas, get busy with our favourite perfecting makeup products

2 3

4 8

5 6

9 10

1 REAL TECHNIQUES Foundation Brush R139.95 takealot.com 2 REVLON Photoready Airbrush Effect Foundation R269 leading pharmacies and retailers 3 GLOMINERALS Sheer Tint Base R468 021 552 6999 4 WET â&#x20AC;&#x2DC;N WILD Coverall Concealer Palette R69.95 clicks.co.za 5 HANNON Two in One Foundation R220 hannon.co.za 6 BODYOGRAPHY Oil Free Natural Finish Foundation R350 placecol.com 7 CATRICE Camouflage Cream R52.95 dischem.co.za 8 PHYSICIANS FORMULA Argan Wear BB Cream R274.95 dischem.co.za 9 ELIZABETH ARDEN Flawless Finish R450 leading retailers 10 JUICE BEAUTY SPF 30 Tinted Mineral Moisturiser R530 naturescolours.com 11 RVB LAB The Make Up Smoothing Makeup Base R395 dischem.co.za 52 YOUR PREGNANCY

Photographer: Aubrey Jonsson

The product most recommended by gynaecologists for pregnancy stretch marks. Ipsos, 2016

“The one thing my pregnant friends and I discussed at length was stretch marks – once you’ve got them, they’re there for good! I used Bio-Oil throughout, morning, noon and night... in fact, I haven’t stopped using it since Liam’s birth. Now that I’m pregnant with twins, I’m going to be using it more than ever! What’s also nice is that it’s not oily – you can put it on and then get dressed immediately and it doesn’t stain your clothes. You’ve no idea how many friends and family I’ve told about Bio-Oil!” Tracy with Liam

Bio-Oil® helps reduce the possibility of pregnancy stretch marks forming by increasing the skin’s elasticity. It should be applied twice daily from the start of the second trimester. For comprehensive product information, and details of clinical trials, please visit bio-oil.com. Bio-Oil is available at pharmacies and selected retailers at the recommended selling price of R89.99 (60ml). Individual results will vary.

y c n a n g e r P r GET A You

R E V O E K A M readers to r u o f o o in tw We roped pregnancy looks ir update the

Want a Your Preg nancy makeove r? Email phone nu y mber, yo our ur week of pregn ancy, an d recent preggie pic yourpreg to letters@ nancy.co .za. Title it “I want a makeo ver”

before after STYLIST’S COMMENT “Siposethu’s usual daywear is a pair of leggings, a T-shirt and a blazer. She works in retail and needed a fun and flirty outfit for the weekend. I choose an asymmetrical floral print top and paired it with a pair of ultra comfy preggie jeans. The top can be worn with jeans or leggings and once she’s had her baby, can worn as a dress. I finished off the look with a pair of ballet flats.”

SIPOSETHU SAYS “It was nice to wear such bright colours for a change, since I’ve stuck to dark colours during my pregnancy. My hair and makeup made me feel glamorous, something I haven’t felt in some time! Being pampered felt really great, and I really loved the whole experience.”

54 YOUR PREGNANCY

SIPOSETHU SIPIKA 34 WEEKS PREGNANT Earrings R39.99 Woolworths. Asymmetrical floral top R699 Mandy Manas at Kokobino. Jeans R680 at Execubump.co.za. Lace ballet pumps R99.99 Mr Price.

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MAKEOVER

before

LEE CHILOANE

STYLIST’S COMMENT

“Lee is finishing her studies and needed a chic evening look. She’s wearing the ‘Rona’ dress by South African designer Colleen Eitzen. This isn’t actually a maternity dress, but the drape and fabric it’s made of will suit most preggy ladies. The asymmetrical cut gives Lee a modern look. I accessorised with a chunky necklace and a pair of block heeled velvet pumps to keep the look luxe.”

LEE SAYS

“The clothes were comfortable and fit perfectly, and I felt very classy in them. The makeup didn’t feel heavy and I felt like I was the most beautiful mother-to-be. The whole crew was so welcoming, the gifts I received certainly made me feel special, and being on set with the camera flashing my way reinforced my confidence as a woman. I had the best experience! Thank you YP!”

31 WEEKS PREGNANT Chunky necklace R59.99 Mr Price. Draped dress R749 Colleen Eitzen. Velvet pumps R1 029 Zara.

after Stockists Colleen Eitzen 031 717 2760 Execubump 011 326 6076 Koko Bino 011 783 6223 Mr Price 080 021 2535 Woolworths 0860 022 002 Zara 011 3021500

Stylist Kirsty Stoltz Photographer Aubrey Jonsson Make-up and hair Kelli Fuchs-Rosen from One League using Mac Cosmetics

LOOK WHAT ELSE OUR TWO LUCKY MAKEOVER MOMS WENT HOME WITH! A STUNNING GIFT HAMPER FROM PIGEON AND LANSINOH TO THE VALUE OF R800 Get off to a good start with Pigeon and Lansinoh’s Breastfeeding Kit and give Dad a chance to breastfeed when expressing with the Pigeon Manual Breast Pump. The Pigeon Breast Pads keep you dry and comfortable, while the Lansinoh Nipple Cream will soothe sore, cracked nipples. The Therapearl 3-in-1 Breast Therapy helps relieve any engorgement or pain. Available from baby stores, Dis-Chem, selected pharmacies and retail outlets. Visit sp-africa.com for more. 56 YOUR PREGNANCY

REAL life

BY ALDA SMITH

CAPTURING A MOMENT IN TIME

We caught up with Alda Smith and Marysol Blomerus, two working mothers with three children each, who are pioneering the growing art form of birth photography in SA

irth photography is recording a story that can only be told once. For most parents, the birth of their child is one of the most important experiences of their lives, and yet many only have blurry cellphone shots to remember it by. Birth photography gives parents beautiful, emotional pictures of the first time they meet their child.

BECOMING BIRTH PHOTOGRAPHERS “I

stumbled

58 YOUR PREGNANCY

into

birth

photography almost 10 years ago when I attended the birth of my friend’s child,” remembers Marysol. “I happened to have my camera with me, and she asked me to take some photos. There, I found the hybrid of the ultimate documentary experience, and in 2008 I founded Blomerus Birth Photography.” Alda says, “I actually thought I’d made birth photography up! I was having my third child in 2013 and wanted a photographer. Little did I know I would go

on to start Love Alda Birth Photography & Mentoring that year and become a copioneer for birth photography in South Africa. Marysol and I laugh that had we met in time we would’ve hired each other for our births, but we had our third babies two weeks apart and grew an industry side by side.” “We met at a birth event and I was actually relieved to have found Alda,” recalls Marysol. “It’s important for a birth photographer to have a back-up in the event of overlap, illness or emergency.

Before she came, there was no one else. I loved her work and we hit it off from day one.” “We were both hesitant about being competitors,” admits Alda. “The industry was still in its infancy. It was hard enough getting into hospitals let alone booking clients. We had many open conversations about choosing to work together.” “To lay aside being competitors and choose collaboration instead was a choice we both made,” agrees Marysol. “We each have our separate business models and

styles, but we believe when the tide rises all boats float.” Alda says, “Our businesses have grown from it to the point that sometimes we have waiting lists. We support each other as back-ups and champion each other’s successes.” “Like when Alda was appointed to represent Nikon as a South African birth photographer,” continues Marysol. “I was so happy for her. She worked so hard and her success benefits the whole industry. For a brand like Nikon to appoint its first professional birth photographer is very validating for all of us.” “How to grow the industry has always been our heart,” says Alda. “More parents want to have their children’s births documented and we are excited to see professional birth photographers starting businesses across the country after registering at the South African Birth Photographers Association (SABPA).” Marysol adds, “We cofounded SABPA with a spirit of collaboration instead of competition. It was Alda’s brainchild and she could have gone it alone but she invited my voice into the process. And I really appreciated that.”

THE HARDEST PART OF BEING A BIRTH PROFESSIONAL

“It can get difficult living on-call, and when you do run out, not knowing when you’ll return,” says Alda. “Since we’re each mothers of three kids, childcare and really supportive husbands are vital. We have each missed big moments from Christmas morning to kids’ birthdays in order to be there for our clients’ once-in-a-lifetime Image: Jupiter Images

experiences. It really is a labour of love.”

THE BEST PART OF THE JOB

“There is absolutely nothing like when a baby is born,” beams Marysol. “It is such a rush and so moving. Life really gives you no other experience quite so poignant. It may be tiring, but it never gets old.”

MARYSOL ON WHAT BIRTH PHOTOGRAPHY IS NOT... IT’S NOT EXPLICIT

“When birth photography first started in South Africa, many of my prospective clients worried it would be gross. Now the demand is increasing every year because the imagery is breathtaking. “Birth photography is about the moments of love connection in birth. It can be raw and real, but it’s not grotesque. It’s about a father’s facial expression when he sees his baby for the first time or a mother’s tears when she hears that first cry. It should tell your baby’s

birth story with integrity and tenderness. Some people are comfortable and open with some nudity in their birth stories, in which instance the photographer may be less conservative in her approach, but a strict privacy and publishing code would still

apply if the photographer is professional.”

IT’S NOT INTRUSIVE

“Privacy (or the lack) thereof, is the number one argument that birth facilities, healthcare providers and even fathers sometimes would cite for not

WHAT TO ASK WHEN SELECTING A BIRTH PHOTOGRAPHER Does the photographer tell the whole story? Anyone can have a handful of amazing images, the skill lies in the story the whole way through. Before you make your investment ask to see a complete C-section or natural birth, or a daytime versus nighttime birth. If the photographer doesn’t have these because she is still building her portfolio, that’s an important disclosure and conversation that needs to be had with her prospective client. Does the photographer have experience in birth photography (both natural and C-section)? Does the photographer have a good rapport with the medical professionals and institutions in your area? Is the photographer a member of the SA Birth Photographers Association at sabirthphotographers.com? Does the photographer have client references? Does the photographer have a birth code of conduct and an understanding of hospital and theatre regulations and will she share a copy with you? Has the photographer’s work been published before? Will the photographer provide you with a proper birth photography contract? Will the photographer be 100 percent on-call and ready to attend your birth at any hour?

REAL life wanting a birth photographer present. It’s not until they actually experience a professional at work that they realise that not only is a good birth photographer not intrusive, she can actually contribute to holding the birth space for parents.”

IT’S NOT POSED

“This point ties in with birth photography being nonintrusive. I’m a firm believer in the ‘fly-on-the-wall’ approach when it comes to birth photography and most birth photographers have a photojournalistic approach and style. This gives birth photography its storytelling quality. It also means that the photographer truly captures moments and never directs in any way.”

IT’S NOT ABOUT A SHOT-LIST

“Birth knows no time. It’s unpredictable. It’s a journey. A story. Not a shot-list. A shot-list (a list of poses you’d like) would by default lead to intrusiveness. A shot-list would mean posing and directing. My advice is always to see how the journey unfolds and capture it truthfully and with integrity. We’re simply capturing the story, not creating it.”

IT’S NOT CHEAP

“Since a birth photographer doesn’t have that scheduling component, she’s on-call weeks on end. Petrol is always in her vehicle, her bag is packed with expensive gear that she risks travelling with at odd hours of the night. She has back-up gear just in case something goes wrong with her primary equipment, since there’s 60 YOUR PREGNANCY

I’M A FIRM BELIEVER IN THE ‘FLY-ON-THEWALL’ APPROACH WHEN IT COMES TO BIRTH PHOTOGRAPHY no do-over for your baby’s birth. She’s skilled in the toughest kind of low light and unpredictable photography. When your birth is over, her work just begins with editing and post-production. She’s doesn’t charge by the hour because no woman having a baby deserves that kind of pressure. Even for a scheduled C-section, she’s on-call because often babies still decide to come spontaneously. For all these reasons, there’s a wide range of price points of a birth photographer in South Africa, to suit each client’s budget, but its unrealistic to expect her to be ‘cheap’. If she is, you should be concerned.” YP

ALDA NOTES THE BONUSES OF HAVING A BIRTH PHOTOGRAPHER CAPTURE YOUR BIRTH We hire photographers for graduations and weddings, yet few have the foresight to hire a photographer for what will probably be one of the most important, if not the most important, day in their lives. Babies only take that first breath once – there are no do-overs. Traditionally the partner or husband took some snapshots of the birth or first moments, but expecting them to capture all the key moments in a beautifully composed manner is unrealistic. Freeing them from camera duty allows them to be more supportive and connect with the birth. A good birth photographer will photograph a birth in a manner that tells the whole story from labour or going into theatre, to the first hello and baby’s first hour or two in his new environment, and not only highlight random moments. A professional birth photographer captures moments that you might miss, like your partner’s facial expression, or grandmother-to-be sitting anxiously in the waiting room. Birth photography allows you to see your child’s birth from a different, wider perspective and parents often discover breathtaking details which they miss at a time when they are inwardly focused. Many mothers, especially those who had C-sections, find that they feel their birth photos helped them connect with the birth process, even if their bodies didn’t go through actual labour. Clients who have had difficult births have told me their photos were redeeming and restoring. Birth photography allows you to one day tell your children about their birthdays. They can see how much they were loved from the moment they took that first breath. Birth photography allows loved ones to be there or included – even if they aren’t.

REAL life

MY SACRED HOME BIRTH Sofia Puente chose to birth her third child at home, in a warm birthing pool, surrounded by her loved ones

BY SOFIA PUENTE WITH JULIA BOLTT

Sofia’s son Mateo was born at 4.57am at home, with his family 62 YOUR PREGNANCY

n my daughter ’s s e c o n d birthday, I told my husband how perfect our family was with our two girls. That evening, my jaw dropped when I found out I was pregnant with my third child. A few weeks later, I was sitting in one of my favourite parts of my home – an open space with a couch, looking out onto our beautiful herb and vegetable garden. It felt like a very peaceful space. It was then that I could see myself in a birth pool, where our rug currently lay. I could envision my mantelpiece transformed into a birth altar, with candles, photos and symbols of encouragement on it. I could imagine the fireplace lit, crackling gently, and the scent of tea tree and lavender oil floating in the room. And so started the journey of my pregnancy, not only for me and my husband, but also for my two daughters.

Special belongings were collected to create a peaceful birth altar

I learnt so much about myself and my body with the birth of my two daughters, Isabella and Asara, and so I knew I was ready for a home birth. I was incredibly fortunate to meet my midwife, Sharon Marsay, who specialises in home births. She was connected with a gynaecologist and a doula who collaborate very closely with her and support moms who want to take a less mainstream birthing choice. For my previous two births, my labour slowed down significantly when I entered a hospital environment. The sterile smell, the clinical and unfamiliar setting makes my oxytocin run for the hills! I love my home, and the thought of being able to go to my own bathroom, move around in my own bedroom or lounge, listen to music that I like, surrounded by candles, calmness and my own tribe of women and caregivers made me feel empowered, at ease and ready for the experience. Birthing at home meant I wouldn’t have any unnecessary interventions and no pressure to medicate. Being at home unleashed my love hormones – I was excited, relaxed, focused and very present in the moment. Two weeks before our baby arrived, my family and I prepared the sacred birth space. We hired a birth pool, and prepared the room with all the things we needed – from candles to water pipes and

urns and wood for the fire, to warm blankets, baby clothes, delicious labour food, artwork made by the girls, coconut water and towels. On 23 November 2015, at 2.15am I woke up feeling uncomfortable and restless. I woke up my husband Marc, and he ran me a warm bath. He lit some candles and he put some “happy music” on. It didn’t take long for me to realise I was experiencing strong surges* (contractions). We called the midwife, who then called the two doulas. As I walked downstairs, the surges were getting very powerful and strong. My seven-yearold had woken up, and she accompanied me and held my hand while we waited for our birth team to arrive. I couldn’t get into the pool before the midwife arrived. Marc filled the pool, warmed some coconut mash potato for me to eat, lit all the candles and ensured the space was dark, calm and ready. My body felt so strong. At times I was on all fours, which seemed to ground me. Other times I’d swing my hips from side to side and roar like a lioness, or I’d squat. My body was free to roam and move in whichever way was instinctive – I had no machines attached to me, beeping and distracting me with numbers, graphs and data. At 3.30am I remember my midwife and the two doulas quietly entering the house.

Birthing in water is known to help relieve pain, and help “centre” a woman

COULD YOU HAVE A HOME BIRTH? If you want a home birth, you’ll go through a rigorous series of checks with your midwife to make sure you’re a candidate. Conditions like high blood pressure, diabetes or a multiple birth would exclude you from having a home birth. You will also need to see a doctor in your back-up hospital at least once during the pregnancy, so that if you need to be transferred, you’re already in their system, with access to emergency care. Your registered midwife must bring along equipment for the most common obstetric emergencies, including drip sets, catheters and medication for bleeding, as well as oxygen and resuscitation equipment for immediate medical care and to stabilise the mom and baby until transfer to your back-up hospital can take place. Throughout the labour I could feel their strong presence. They were focused but gentle, not interrupting or distracting me while I was experiencing a surge. The pool was ready – I remember feeling like a goddess when I entered the warm water. It felt good to honour nature and my body; to surrender and to trust my body and all the mental and emotional preparation I’d done. It felt so good to be in a sacred space with my chosen tribe – my daughter, my midwife, my husband and the doulas. I roared with power, calling upon my inner strength. At 4.57am our son, Mateo, was born in the water. The room was still and we marvelled at what just happened. Many of my girlfriends comment on how brave or

crazy I was to have a home birth. I don’t think I’m brave or crazy or a hippie. I went on an incredible journey with my partner, my midwife and gynaecologist, where I was so well informed and educated every step of the way. It was hard work. My midwife walked a physical, emotional and spiritual journey with me over the nine months I was with her – challenging me on every level, from mindful eating, connecting with my body, baby and my partner, releasing deep fears and ensuring that we as a family were well prepared for a home birth. Would I do it again at home? In a heartbeat! *In hypnobirthing, women prefer to use the word “surge”, or “wave”, than contraction. AUGUST/SEPTEMBER 2016 63

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STAY A STEP AHEAD THIS WINTER PAGE 28

BEAUTY! WE’RE LOVING PASTEL

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GOING IT E ALON WHAT YOU NEED TO KNOW ABOUT BEING A SINGLE MOM

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month BY month YOURIVE IT DEFIN CY

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PAGE 80

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THIS ONEâ&#x20AC;&#x2122;S FOR DAD! HOW HE CAN PREPARE FOR THE NEW ARRIVAL

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SKIN-TO-SKIN: IT BENEFITS BABY AND YOU PAGE 88

fertility

FALLING PREGNANT

BY TINA OTTE

WAYS TO BOOST YOUR FERTILITY

You’ve made the decision – it’s baby time! To ensure your chances of conceiving are as good as possible, follow these 10 steps to keep your body in peak condition

QUIT SMOKING, TODAY!

This is a no-brainer. “In women, smoking can delay pregnancy by up to a year. Smoking reduces the quantity and quality of a female’s eggs. It increases the risk of tubal pregnancies and miscarriages. In male fertility, it reduces the movement and concentration of sperm. It also has the risk of reducing the sperm count of the male offspring and an increased risk of birth defects. During in vitro fertilisation (IVF) procedures it reduces the chances of success by 40 percent,” says specialist gynaecologist Dr Chris Venter of Vitalab Centre for Assisted Conception in Johannesburg.

TIME TO LOSE (OR GAIN) WEIGHT

Obesity and metabolic syndrome have a huge impact on your fertility – for both men and women. If you’re serious about conceiving and you’re overweight or obese, it’s time to get your weight within an acceptable range for your height and body type. “Obesity in particular will reduce ovulation, leads to poorer quality embryos, and will increase the risk of

66 YOUR PREGNANCY

miscarriages,” says Dr Venter. Equally, if your weight is below a BMI of 18, consider trying to gain weight before conceiving to give yourself the best possible chance. Whether you’re gaining or losing, consult a dietician for a balanced healthy eating plan.

EAT FOR THE A-TEAM

Regardless of your weight, “the healthier both you and your partner are, the better your chances of good fertility and a healthy pregnancy are,” advises nutritionist Melanie Alpers. She recommends a diet that includes lots of dark green leafy vegetables, raw nuts, brown rice and seeds and olives for magnesium, calcium, zinc, iron, folic acid, selenium, manganese,

essential fatty acids and Vitamin E; natural dairy products such as Bulgarian yoghurt with fresh fruit – particularly all the berries (which are high in antioxidants and Vitamin C); and all the orange, red and yellow varieties of vegetables and fruit plus sardines, avocado, lentils, eggs and chickpeas for vitamin A and B complex.

CUT BACK ON BOOZE

We all look forward to that glass of wine at dinner, but if you’re serious about boosting your fertility, it’s time to say goodbye. “Conception is a critical period of development and is very sensitive to external affects. Abstaining from alcohol in total is advised, as there’s no clinically proven

safe lower limit in pregnancy,” says Dr Jana Rossouw, specialist gynaecologist and obstetrician at Tygerberg Hospital.

STRETCH YOUR LEGS

Not only will exercise help you maintain a healthy weight, but it has the added benefit of helping you manage your stress better. Don’t be put off if you’re not that active. “We recommend 30 minutes of walking a day. Walking is excellent, it’s not too hard on any of the ligaments or joints and it’s not harmful to pregnancy at all. Your level of exertion depends on how athletic you already are,” says Dr Rossouw. However, don’t go overboard – too much exercise can hurt your chances of conception.

FERTILITY FLATLINERS SAY NO TO DRUGS. If you want to make a baby, any kind of recreational drug use is completely off the table. EAT YOUR CARBS. “The Banting diet is not recommended in pregnancy, as a healthy and balanced diet covering all the food groups is needed to supply in the needs of the growing foetus. We don’t have enough research yet to show what the long-term outcomes of pregnancies are that were exposed to the Banting diet,” cautions Dr Rossouw. “There are no safety studies on low-carbohydrate, high-protein or high-fat diets,” warns Dr Venter. RETHINK THAT TRIP. If you’re planning to visit a malaria area, don’t try to fall pregnant at the same time, because the drugs that you will take for malaria prophylaxis might be harmful to any pregnancy. Malaria can cause devastating illness in pregnancy and it’s advised not to visit these areas when planning a pregnancy.

FACT

You’re more fertile before you ovulate. Once the egg leaves your ovary, sperm has about 12-24 hours to get to it for conception to happen. But sperm can live inside you for several days! Basically, the more swimmers you’ve got in there ahead of time, the higher your odds are of making a baby.

CHECK YOUR MEDS

If you’re taking any kind of chronic medication, whether it’s for diabetes, hypertension, cholesterol or any other chronic condition, it’s important to talk to your healthcare provider before trying to conceive. “Most medications may be safe, but some are very harmful to the developing foetus. These drugs will have to be stopped and changed to alternative options before you stop your contraception. Do not change your own medication – instead consult your healthcare practitioner,” advises Dr Rossouw.

DITCH THE CAFFEINE

This is a tough one. You’ve already said goodbye to junk food and alcohol, and now caffeine? “Although caffeine content in coffee varies, the general guidelines state that two cups of instant coffee or one cup of filter coffee per day is likely a good cut-off. Luckily, decaf will still satisfy the taste without the caffeine,” says Dr Rossouw.

GIVE YOUR BODY A BOOST

If you’re not a regular vitamin-taker – or even if you are – now’s the time to up your supplementation. Taking a good multivitamin, omega-3s and vitamin C will get your body into tip-top shape, and don’t forget to add a folic acid supplement as soon as you start thinking about conceiving. Assuming Image: Jupiter Images

you eat a relatively healthy diet, 400mcg of folic acid is recommended. However, avoid high doses of vitamin A – this is known to cause birth defects.

GET MORE SLEEP

There’s a vast field of research about how important sleep is to your overall health, although personal requirements vary. “The important principle is to sleep enough to wake up feeling refreshed and not groggy due to over-sleeping. Sound sleeping habits like going to bed every night at a similar time, avoiding electronic media and bright screen devices for a few hours before bedtime and taking a bath to relax will set the tone for a good night’s sleep. Also, try avoiding a heavy meal before bedtime or caffeine-containing drinks,” recommends Dr Rossouw.

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Easier said than done, but managing your stress levels is important for fertility. Try some yoga, get a massage, practise meditation, spend time with friends, get some exercise, eat well and make sure you get enough quality rest. YP

THE HEALTHIER YOU ARE, THE BETTER YOUR CHANCES OF GOOD FERTILITY

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month 1

YOUR BODY AND BABY

BY MELANY BENDIX

UNDERSTANDING

CONCEPTION

What do you really know about conception? You’d be surprised at some of the facts, so we break it all down for you

octors work out your due date starting from the first day of your 40-week pregnancy. Here’s what you may not know, though: the first day isn’t the day the lucky swimmer beat millions of others to burrow into your egg – it’s the first day of your last period. That’s because ovulation takes place around two weeks after this, and that’s really the first step in conception – that mindblowing process that results in the creation of a human being in just 38 weeks (give or take). Here’s how it all happens.

OVULATION

Women are born with all their eggs in two baskets, the ovaries. These two-millionplus eggs are all immature and stay that way until puberty. From then, every month one lucky little egg – or, less commonly, more than one – will mature and break free from its follicle, the fluidfilled sac where it’s grown. The mature egg is released from the ovary – think of it as a graduation of sorts. This process is called ovulation and usually takes place around two weeks before your period begins. The day of ovulation 68 YOUR PREGNANCY

is the last day in what’s called the “fertile window” – the six-day period in a regular 28day menstrual cycle in which you’re able to conceive a baby. So if you want to try for a baby, this is the time.

HORMONES RISE

The mature egg may have left its follicle, but the follicle’s job isn’t done yet. It turns into something called the corpus luteum, which releases a hormone that thickens the lining of your uterus to get it ready for the arrival of a fertilised egg.

EGG TRAVELS TO FALLOPIAN TUBE

Meanwhile, the egg has begun making its way from the ovary to the fallopian tube. And here it sits and waits, hoping that a single sperm will make its way up the fallopian tube to fertilise it. If no swimmers make it, the egg moves to the uterus and disintegrates. Your hormone levels will go back to normal and your body will shed the thick lining of uterus; that’s your period.

FERTILISATION

But if you’ve got the timing right and one brave swimmer makes it all the way into the

fallopian tube and burrows into the egg; that’s fertilisation. Your egg will instantly change so that no other sperm can get into it. At that exact moment of fertilisation your baby’s sex is determined: if the sperm carries a Y chromosome, it’s a boy; if it’s an X chromosome, you’ll have a girl. This moment

also determines if you’ll have one baby, or identical twins. All this happens around two weeks after your last period.

IMPLANTATION

Within 24 hours of being fertilised, your egg starts dividing into many cells –

HOW (MORE THAN ONE) BABY IS MADE NON-IDENTICAL TWINS If you’re having non-identical (fraternal) twins, that process began at ovulation when your ovaries over-performed and released two mature eggs instead of only one. These two eggs were then fertilised by two different sperm that both made it up the fallopian tubes simultaneously. Non-identical twins are also called dizygotic, because they develop from two different zygotes (fertilised eggs). This means they don’t share the exact same mix of genes and can be of the same or different genders (girl-girl, boy-boy, or girl-boy). It’s also possible to have non-identical triplets if your ovaries release three mature eggs, but this isn’t common with natural conception and usually only occurs when ovulation is induced with fertility treatment.

IDENTICAL TWINS If you’re having identical twins, that was determined at the moment of fertilisation. If the fertilised egg splits into two separate cells, congrats, you have double trouble! Identical twins have the same genes and are the same gender, although in extremely rare cases they can be different genders. Identical twins are also known as monozygotic twins, because they come from one zygote. Triplets, quads or more multiples can also be monozygotic, if the fertilised egg splits into three, four or more at the time of fertilisation.

Image: Jupiter Images

FACT

Long-term hormonal birth control won’t affect your fertility. In fact, most women begin ovulating within three months of stopping birth control.

CAN TWINS HAVE DIFFERENT FATHERS? The short answer: yes. It’s extremely rare, but it can happen if a woman releases two mature eggs in one ovulation cycle. If she then has sex with two men within a very short period of time (while ovulating), two different sperm from the two different men can fertilise two different eggs to conceive one set of non-identical twins. Because they don’t share the exact same genes, it’s possible for these twins to look markedly different. the first step to becoming a teeny human being. It does this for three to four days as it slowly makes its way through the Fallopian tube to your uterus. This is where its next very important job must take place: attaching to the lining of the uterus. This attachment is called implantation and it means conception has occurred and you’re pregnant! This usually happens within six to 12 days of ovulation. At this stage your uterus will be quite thick and a plug of mucus will seal off the cervix. You may notice a bit of spotting and, less often, cramping at this time. This is known as implantation bleeding and is normal.

THE FIRST HORMONE

Get ready! Your body is about to be flooded by a bunch of different hormones for the

FIRST TRIMESTER ESSENTIALS

next 38 or so weeks. Some will make you glow; others will make you cry and scream, often at the same time. The first pregnancy hormone is called human chorionic gonadotropin (hCG) and it’s in your blood from the time of conception, which is why this is the hormone tested for in pregnancy tests. Home pregnancy tests will detect the presence of hCG in your urine, while blood tests detect hCG in your blood. It usually takes a few days for hCG levels to be high enough to be detected, though, and this is why you can have a “false negative” if you do a home test too soon after conception. But if you see those two pink strips appearing boldly on that stick, you can almost be sure the incredible process of conception has been successful. YP

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month 2

YOUR BODY AND BABY

STEER CLEAR OF THESE

10 F

DS!

To protect your and your baby’s health, make sure to avoid these top 10 food nasties – better yet, cut this page out and stick it on the fridge! BY MELANY BENDIX

UNPASTEURISED DAIRY PRODUCTS

Say goodbye to all your soft, smelly cheeses, such as brie, camembert and blue cheese - feta, too, if it hasn’t been pasteurised. That’s because unpasteurised cheeses, milk and other dairy products are more likely to grow bacteria such as listeria. Pregnant women, as well as newborns and people with vulnerable immune systems, are more susceptible to getting infected by this nasty little germ. It can cause an illness called listeriosis, which is usually mild for you (causing flu-like symptoms) but it can harm your baby and, in rare cases, even lead to miscarriage or death. Here’s the good news: nowadays many soft cheeses and feta are made with pasteurised milk, in which case they are perfectly fine to eat. Always check the label to be sure and practise this golden rule: if in doubt, leave it out.

70 YOUR PREGNANCY

FISH HIGH IN MERCURY

Bigger fish live longer and are higher on the food chain, and the more other fish they eat, the more mercury is accumulated in their meat. Mercury is a neurotoxin that can build up in your bloodstream and can damage your baby. However, seafood is a great source of protein, iron and zinc – all crucial for your baby’s growth, while Omega 3 fatty acids found in fish help your baby’s brain development. So eat fish in moderation, just make sure it’s the kind that’s low in mercury and high in omega-3 acids, such as anchovies, herring, sardines and trout. An ongoing study by marine scientist Brent Newman at the CSIR found swordfish, kingklip, cape salmon and yellowfin tuna to be the South African fish with the highest mercury contents. UK guidelines allow up to four tins of tuna a week for pregnant women.

SUSHI (BUT NOT ALWAYS)

In Japan and other eastern countries sushi is considered healthy in pregnancy. But in the West it’s previously been advised against because raw fish such as salmon can contain small parasitic worms, which have the potential to make you quite ill (nausea, abdominal pain, vomiting) and in very rare cases can be fatal. So should you or shouldn’t eat sushi? The latest word from the UK’s National Health Service’s advisers is that eating sushi while pregnant is “usually safe”. Follow these basic rules and you should have no trouble: If it’s raw fish, make sure it’s been frozen first, as this should kill off worms. If it’s cured fish, such as smoked salmon, it doesn’t need to be frozen because smoking, pickling and salting should kill off worms. If it’s shellfish, only eat it if it’s been well cooked.

RAW SHELLFISH

Raw shellfish, such as oysters, mussels, scallops, clams, shrimp, crabs and crayfish, may contain bacteria, viruses and toxins that can make you quite ill. If you eat shellfish, always make sure it’s been thoroughly cooked.

RAW OR UNDERCOOKED EGGS

Raw or undercooked eggs may carry the salmonella bacteria. Salmonella poisoning is unlikely to harm baby, but it will make you unpleasantly ill with vomiting, diarrhoea, abdominal pain, headaches and high temperatures. So lay off the eggs benedict and – get ready for horrible news – avoid foods such as meringues, chocolate mousse and tiramisu, which all contain uncooked eggs. Most commercial mayonnaises are made with pasteurised eggs and are okay to eat, but check the label to be sure.

PROCESSED/ DELI MEATS

Polony, salami, ham, hot dogs... they all carry a risk of listeria. It’s a low risk, but rather be safe than sorry and either avoid these meats or heat them to over 73°C to kill off any bacteria.

LIVER

Too much liver and foods rich in liver, such as pâté and some sausage, are a no-no, because they contain high levels of retinol, which is a type of vitamin A. Too much retinol can build up in your body, which can be harmful to baby. But don’t avoid vitamin A completely – it’s important to keep your skin, eyes and immune system healthy. Get it in good amounts by eating a balanced diet that includes butter, eggs, cheese, oily fish and vegetables such as carrots and broccoli.

RAW AND UNDERCOOKED MEAT AND POULTRY

Say goodbye to rare steaks – undercooked meat and poultry has a risk of carrying listeria, salmonella and the toxoplasma parasite (also found in cat litter). This last one can lead to toxoplasmosis, which is a flu-like illness that may be mild for you, but potentially serious for baby, even causing miscarriage or death.

LIQUORICE

Liquorice in its pure root form is a uterine stimulant that may lead to premature contractions, while a 2013 study found that overconsumption of natural

Image: Jupiter Images

liquorice (the sticky black kind) might also be dangerous during pregnancy. The study, conducted in Edinburgh and Helsinki, where eating this kind of liquorice is as common as eating chocolate, found it can decrease the strength of the placenta, which in turn can allow harmful hormones into your baby’s system. A few Liquorice Allsorts now and then is unlikely to cause problems.

SUGAR

Various studies show that moms who consume excessive amounts of sugar during pregnancy give birth to babies “addicted” to sugar, which puts them at risk of health problems such as diabetes. Excessive sugar intake also increases your risk of gestational diabetes. Remember, you don’t have to be diabetic or even prone to diabetes to suffer from gestational diabetes, so reduce your risk by laying off the sugar! YP

AVOID DRINKING...

...coffee, tea and soft drinks that contain caffeine. Excessive caffeine (three cups of coffee a day, or more) can decrease blood flow to the placenta and affect baby’s growth. It’s also a diuretic that causes your body to lose water and fluids containing essential vitamins you and baby need. Try cut out caffeine entirely, but if you really need your daily fix, don’t go over the recommended maximum of 200mg a day.

month 3

YOUR BODY AND BABY

FACT

At three months along, you will find out your estimated date of delivery (EDD). However, only five percent of babies are delivered on their predicted due date.

THE LOWDOWN ON MISCARRIAGES

Miscarriage is a word all pregnant women fear. What does it mean, how common is it, and what can you do if it happens to you? BY TINA OTTE

miscarriage means losing a pregnancy b e f o r e 20 weeks’ gestation. Sometimes called a spontaneous abortion, an embryo or foetus is delivered before it has any chance of surviving outside the uterus. It’s believed that 50 percent of pregnancies miscarry after the conceptus (products of conception) have implanted in the wall of the uterus. These episodes are believed to be a “heavy, late period” and are not recognised by a woman as a pregnancy that has been lost. Around 15 to 20 percent of recognised pregnancies that make it past six weeks after the last period may miscarry. The highest risk time for miscarriage is between 12 and 14 weeks of pregnancy.

WHY DO MISCARRIAGES HAPPEN? A miscarriage can happen for many different reasons. The 72 YOUR PREGNANCY

most common finding of early miscarriage is an abnormality in the development of the embryo. Research has shown that over 50 percent of these miscarriages have genetic or chromosomal abnormalities. These abnormalities are not thought to have any bearing on the health of future pregnancies. External factors known as teratogens (radiation and some chemicals, drugs or medications) can also cause miscarriage. A total of 90 percent of women go on to have a normal healthy pregnancy after a single episode of miscarriage. Recurrent miscarriages will however need investigation and evaluation.

OTHER CAUSES INCLUDE Unusual infections like toxoplasmosis, listeria and syphilis. Genital or uterine infections. Uterine abnormality. Deficiency in progesterone. in early pregnancy. Maternal antibodies that disrupt the growth of the embryo and developing placenta. Maternal smoking. Alcohol consumption. Use of recreational drugs.

WARNING SIGNS Vaginal bleeding (light bleeding is fairly common in early pregnancy, but heavy painful blood loss isn’t).

Abdominal cramping or pain. Backache. Chills and or fever.

IF YOU THINK YOU’RE MISCARRYING If you suspect you’re having a miscarriage, talk to your doctor immediately. In most cases there’s sadly nothing that you can do to stop it from happening. Ultrasound scans and blood tests may be done to assist your doctor in determining the next course of action. If you expel all of the products of conception and bleeding and cramping stops – it may be all over. If everything isn’t expelled, it’s necessary to have a D&C (dilatation and curettage). This involves minor surgery to clear the uterus of any leftover products that could cause pain, bloating, infection and bleeding. If you’re rhesus negative, you’ll need to receive anti-D immunoglobulin after miscarriage. If possible, the miscarried embryo/ foetus will be evaluated for chromosomal abnormalities to give insight into why you miscarried.

CAN YOU PREVENT MISCARRIAGE? There’s nothing you can do to prevent miscarriage, but you can lower your chances. Planning before conception goes a long

way! Get fit and healthy before you fall pregnant. Visit the dentist, lose weight, stop smoking and drinking and start exercising. Take folic acid. Once pregnant, continue with your healthy lifestyle, and discuss medications with your doctor. Rest and relax when you need to, and have a positive state of mind. For many women, losing a pregnancy is devastating and self-blame is common. Many women question whether they played any part in causing a miscarriage (a bumpy car trip, a little alcohol, sexual intercourse, and so on) and whether there was anything she could have done to prevent it. Talking about it (many women hold their feelings in) is important and some counselling may be necessary. From the causes mentioned, it should be clear that there is really nothing that she could have done to cause the miscarriage. She’ll need reassurance and information.

COPING AFTER A MISCARRIAGE There’s no way to know how you feel after a miscarriage, because we all deal differently with the grief that often comes with miscarriage. The loss of a baby is always devastating, especially if getting pregnant has been difficult. You may be unprepared for the pain and

anguish you feel. Feelings of isolation, anger and jealousy towards women with healthy pregnancies are normal. You may feel numbed by the shock of the loss and worry that you don’t feel enough grief. The process of grieving has different stages through which everyone moves at a different pace. Initially one may feel shock, disbelief and denial. This is followed by severe emotional distress including anxiety and depression. Then you may experience anger, guilt and jealousy. The acute grief will give way to mourning, regret and eventually you’ll feel resigned to what happened, although the feelings of loss may never go away completely. Sadness and depression are common and may present in atypical ways, like poor sleep patterns, poor appetite, an inability to concentrate and non-specific aches and pains. You may need professional help. Talk to your doctor and follow their advice if they refer you to a psychologist or psychiatrist. When you feel emotionally ready to try again then your body will almost certainly be ready too. Physically, there is no evidence that

YOU MAY BE UNPREPARED FOR THE PAIN AND ANGUISH YOU FEEL. FEELINGS OF ISOLATION, ANGER AND JEALOUSY ARE NORMAL waiting a long time before trying to conceive improves the outcome. Preparing for the next pregnancy involves wellness and common sense. Start folic acid, stop smoking, ensure a healthy diet, consider nutrient supplementation, reduce or stop alcohol consumption, avoid all nonessential drugs, control any medical conditions (such as for diabetes or hypertension) ensure immunity to rubella, start a moderate exercise programme. If you have had a miscarriage, remember, the statistics are on your side and the chances of you falling pregnant again with a healthy baby are high. YP

I’VE HAD TWO MISCARRIAGES. CAN I FALL PREGNANT AFTER A MISCARRIAGE?

For most women who’ve had a single sporadic miscarriage, the chances of another miscarriage in the next pregnancy is much the same as anyone else in the general population. There is an 80 percent chance that the next pregnancy will succeed. If you’ve had more than one miscarriage, you still have a very good chance of having a healthy baby. Studies have found that 75 percent of women who get pregnant after two or more miscarriages go on to carry healthy babies to term. If a heartbeat is seen with ultrasound at eight weeks’ gestation, there’s a 98 percent chance of carrying your baby to term.

Image: Jupiter Images

smile s

month 4

YOUR BODY AND BABY

BY TINA OTTE

THE UTERUS TOP 10 AMAZING FACTS The increase in size, weight and volume of the uterus during pregnancy is phenomenal. It grows from non-pregnant, to pregnant at term, like this:

SIZE: 7.5cm x 5cm x 2.5cm to 30cm x 23cm x 20cm WEIGHT: 50g-60g to 900g-1 000g VOLUME: 6ml to 5 000mls (holding capacity of the cavity)

TWO

The uterine muscle is the only muscle in the body that has the ability to contract and retract. This means that during a contraction, when the muscle shortens, it won’t lengthen to the same degree once the contraction has passed. This will continue until the muscle has “bunched up” at the top of the uterus. Once there, it gathers its strength to contract and expel the baby.

The uterus has an extremely rich blood supply in order to nourish the foetus during pregnancy. During late pregnancy up to one litre of blood per minute passes through the uterus.

The nerve supply to the uterus is complex and isn’t yet fully understood. The pain receptors respond loudly to a diminished supply of oxygen and to the sensation of stretching. As it’s necessary for

the cervix to stretch in order to open, you’ll have to learn how to work with your body to ease the discomfort during labour. As far as the oxygen supply is concerned, you can understand why it’s so important for you to breathe through your contractions, be it your natural breathing, or patterned breathing techniques.

FIVE

The walls of the uterus are made up of two distinct tissue layers and a third covering layer. All three layers are suited to maintaining pregnancy and then accomplishing labour and birth.

74 YOUR PREGNANCY

THE UTERUS CONTRACTS PAINLESSLY ALL THE WAY THROUGH PREGNANCY, BUT THESE CONTRACTIONS ARE USUALLY ONLY FELT BY THE MOTHER DURING THE SECOND HALF OF THE PREGNANCY.

The uterus holds the promise of life, and is a soft, warm and safe place for your baby to grow in. Here’s why you should love your uterus as much as we do! According to obstetrician and author Dr Gordon Bourne, it takes an average of 150 contractions to deliver a first baby, 75 for a second or third child, 50 for a fourth or fifth and 30 to 40 for subsequent children. SEVEN

EIGHT

Braxton Hicks contractions are mild and irregular, but although they remain painless, they gradually increase in frequency and intensity as the pregnancy nears term. The uterine muscle tightens for about 30 to 60 seconds and then relaxes. These contractions facilitate blood and oxygen to the placenta and the growing baby. After 30 weeks they start to increase in intensity and are now thought to be brought about by the increase in the level of prostaglandins, and the fact that the uterine muscle becomes increasingly sensitive to oxytocin as labour approaches. These contractions prepare the uterus for labour.

During the first stage of labour the uterus thins out and opens up the cervix. During the second stage, it expels the baby, with voluntary effort from the mother. During the third stage, the uterus contracts tightly to peel the placenta off its walls and squeeze down firmly so the amount of blood lost from the placental wound site is very little.

WITHIN FIVE DAYS YOUR AMAZING UTERUS HAS MADE A RAPID RECOVERY AND IS BACK WHERE IT STARTED, AT THE BEGINNING OF YOUR PREGNANCY. BY DAY 14 IT’S THE SAME SIZE AS IT WAS BEFORE YOU FELL PREGNANT. THE REST OF YOUR BODY TAKES A LITTLE LONGER TO RECOVER, HOWEVER!

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month 5

YOUR BODY AND BABY

FACT

Babies move more when you’re sitting quietly, lying down, or in the bath, so if you want to feel baby move, these are the perfect moments.

ON TRACK!

BY MARGOT BERTELSMANN

Beautiful, fun or whimsical ways to document this most meaningful time in your life

IT FEELS LIKE A LIFETIME, BUT THESE 40 WEEKS THAT YOU’RE PREGNANT PASS IN A BLUR. SO, SPEND A LITTLE TIME NOW INVESTING IN A THOUGHTFUL RECORD OF THIS SPECIAL TIME. YOU’LL BE SO GLAD YOU DID! YOUR BUMP’S RIGHT THERE... USE IT!

Use washable khoki to count off the days, weeks or months by drawing actual lines on your nekkid belly. Let your partner in too: Dad can kiss your bump, balance his beer, or participate in the pic in whichever way you can think of...

YOU’LL BE AMAZED AT HOW THAT BELLY OF YOURS COULD STRETCH FEELING SHY?

If you’re not comfortable showing that much skin, you can make or order a pregnancy tracker T-shirt. Visit diymaternity.com to have one made, or order a pregnancy calendar T-shirt online at Amazon. Wear it for a photo every week as you cross off another mini milestone in your pregnancy!

NOT ARTY?

COLLAGE PIC

Whatever style you use – humorous or pensive, slapdash or carefully curated – you might consider taking the same snap in the same pose and location week after week so that you can see your bump “grow” over a 40-week photo collage. You’ll be amazed, one day looking back, at how that belly of yours could stretch. Remember to add a photo at the end of you, in the same pose, with your newborn in your arms!

If your heart and soul crave the beautifully prepared artwork you see here, but your hands can only draw stick figures, have no fear. Help is at hand in the form of printables – check out caravanshoppe.com for a start. They’ll mail you the template artwork and you just fill in the specifics.

76 YOUR PREGNANCY

NEED TO KNOW

ve we just lo this idea

Can’t get enough info in? Bring the board! Using an old-fashioned chalkboard allows you to record stuff you’d like to remember, later. Consider writing down what foods you’re craving, how much you weigh, what baby weighs or what size he’s estimated to be, the date of your last ultrasound, when you found out the sex, and so on, with every week’s or month’s pic.

The soluble elastin in Dermastine preserves the natural fibres of the skin Jeune Maman is especially formulated for use during pregnancy

CAMERA SHY? If you’re not keen to appear in the photo, there are other ways to symbolise the time-to-baby’s-arrival passing. Use a jar filled with marbles like such: place one marble a week (or day, if you can find a large enough container and 280 marbles!) into the jar and document it filling up. Alternatively, transfer the marbles from one jar to another so you can keep visual track of how much time has passed and how far you still have to go. This also works well for any older siblings who wonder impatiently when they will meet their baby brother or sister. You could also remove a green marble and replace with a red one each week or day (using only one jar). Or make a ball consisting of 40 elastic bands and take a picture of your older child removing one a week. It doesn’t matter whether you follow a single theme throughout your pregnancy, or do something different every month (or week). And it doesn’t have to impress any artists, in-laws, Facebook friends, or anybody but yourself. Whichever way you choose to mark your pregnancy, remember to add one vital finisher to the series: the final pic of you plus your gorgeous new baby. Now paste it all into your baby’s scrapbook and treasure it. Perhaps you’ll pass it on to your baby at her 18th birthday! YP

Image: Pinterest ; Jupiter Images

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month 6

FACT

YOUR BODY AND BABY

At six months’ gestation, your growing baby is about the size of a cabbage!

HAPPY BABYMOON Find out when it’s best and safest to have your final fling before baby comes BY MARGOT BERTELSMANN

ost trends are hohum; but a select few are decidedly ho-ho-ho(liday), chief among which this new gem: the second-trimester babymoon. In this stroke of genius, couples expecting their first baby wait until the crazy fatigue and nausea of the first trimester has passed, but before the bloated and cumbersome feeling of the last stretch overtakes them. They take their last little just-thetwo-of-us mini break right in the middle of the happy, horny middle bit. It’s an excellent idea, agrees couples counsellor Marinda Barnard. “The arrival of a newborn changes everything you know about yourself, each other, and the life you have built up together so far. It involves a fundamental shift in two people’s identity and thinking – from being adults, individuals, or part of a couple, to becoming parents.” You know change is imminent, so a break together to luxuriate in the delight of each other can be dreamy. Importantly, it will also serve as a hook to pull you back together, reminiscing fondly over this time, once you have had your first big post-baby blow-up argument and you are looking for reasons to persevere 78 YOUR PREGNANCY

with your relationship rather than kicking your (clueless) partner to the kerb...

KNOW YOUR STUFF As you plan your perfect getaway, there will be some restrictions due to your pregnancy. Check these out:

TRAVEL RESTRICTIONS

Pregnant women are usually not allowed to board international flights from 32 weeks of pregnancy, depending on airline and country regulations. Local air travel should be easier, though

WHERE TO GO WHETHER IT’S BEACH, BUSH OR BACKYARD, A BABYMOON IS WHERE THE HEART IS

BEACH! With the South Coast a six-hour drive away for Gautengers and the Garden Route a couple of hours’ mission for Western Cape residents, you could do worse than a few days off in a picturesque seaside town. Southbroom or Pennington on the South Coast, Mtunzini, or Arniston or Nature’s Valley in the Western Cape are excellent places to start your search.

BUSH! It doesn’t have to be camping inside the actual Kruger (although parts of the Kruger Park are malaria-free) – smaller and private game reserves abound inland in South Africa. The Pilanesberg Game Reserve is just a two-hour drive away for most Gautengers, and is malaria-free. Choose from several luxury lodges such as Bakubung or Madikwe. Gondwana Game reserve is on the Garden Route, four hours from Cape Town and is tres luxe. Or try the malaria-free Hluhluwe-Umfolozi in KZN.

BROKE? If your rand isn’t stretching as far as your stomach these days, consider a new outlook rather than a scenic lookout. With Mr Delivery on speed dial, some carefully chosen movies on rental and a full service massage treatment at your local spa, you can recreate the feeling of being on holiday without ever having to fill up your car with petrol. Spend a weekend on lockdown (switch off your phone, tell your family you are on a mini-break) and we defy you not to feel like a new person come Sunday night.

your doctor or airline might refuse to let you fly after 36 weeks. Some airlines ask for a doctor’s letter confirming your good health. Even some ocean cruise liners restrict pregnant travel to the second trimester. Car travel is an option, especially if you can share the driving. Put your feet up on the dashboard (without your partner complaining for once!) to avoid swollen ankles. Take regular breaks where you get out of the car and walk around to help with your circulation and to guard against oedema. Also, that toilet will be calling your name, of course...

MALARIA AREA

Avoid travel to malaria areas, and if you absolutely have to travel to affected areas, first consult with your doctor about what medications, if any, would be safe and appropriate for the area you are visiting. Next, take precautions such as covering your skin and using a good insect repellent religiously. If you need any other vaccines to travel to your destination, check with your doctor first if it’s safe to have them. But one vaccine you can and should take is the flu vaccine – which can help you avoid a badly timed bout of flu!

SPA WITH RESTRICTIONS

Lovely getaway locations often come with Image: Jupiter Images

TAKE YOUR DOCTOR’S DETAILS WITH YOU WHEREVER YOU GO, AS WELL AS ANY RELEVANT MEDICAL INFORMATION

ScarScience

IMPROVE YOUR SCARS 1 WITH SCIENCE

ScarScience TM is a scar management system proven to be significantly effective in clinical trials lovely in-house spas. But before you indulge, be sure to let your therapist know you’re pregnant. Rather skip the essential oils or aromatherapy massage, don’t allow your therapist to use products containing retinoids during your facial, and don’t use heat treatments such as saunas, steam rooms and hot stone massages.

KNOW THE AREA

Take your doctor’s details with you wherever you go, as well as any relevant medical information, but also make sure you know where the nearest hospital, clinic or GP practice is to your destination. If you have any pregnancy complications that need attention while you’re away, you’ll know where to go. YP

SECOND TRIMESTER TREATS FOR YOU The Caribbean Collection Exfoliating Shower Gel R39 Picknpay.co.za

Placecol Vitamin C Radiance Therapy R295 placecol.com

HOW SCARSCIENCE TM WORKS ScarScience TM is based on a four-pillar approach to ensure that healing occurs and a “good scar” is formed. ScarScience TM is convenient and easy to use. It is a scientifically formulated programme and is recommended for surgical scars (eg. new mothers who have had aCaesarean section), ensuring visible results.

Scar Management Programme Ref: 1. Widgerow AD, Chait LA, et. al. New Innovations in Scar Management. Aes Plas Surg. 2000:24;227-234.

Mandy’s Hair Removal Lotion R69.95 dischem.co.za Part of Litha Healthcare Group Limited

ScarScienceTM is distributed by Litha Pharma and is available at Dis-Chem and leading pharmacies. For more information visit: www.scarscience.co.za or call + 27 (0)11 516 1700 LP. 665/04/2014

month 7

YOUR BODY AND BABY

AMNIOTIC FLUID

THE HIGHS AND LOWS

Amniotic fluid is your unborn baby’s first form of protection. But what happens when this vital fluid in which your baby floats works against you? BY MELANY BENDIX

80 YOUR PREGNANCY

was in my last trimester of an otherwise healthy pregnancy when a routine scan picked up a worrying dip in amniotic fluid. I was told to prepare for a possible induction or even a caesarean, as too little amniotic fluid could be dangerous for the baby. I was a bit scared, but mostly confused, as it wasn’t clear why my baby had suddenly started producing too little amniotic fluid. (For the first four months of pregnancy the placenta produces amniotic fluid, after that it’s the baby’s job.) My confusion wasn’t because I had bad doctors. Rather, a decrease – or increase – in amniotic fluid can be difficult to explain if there’s no obvious cause. “This is because it’s not a diagnosis in itself,” says Dr Catherine Elliott, a gynaecologist and obstetrician who specialises in high-risk pregnancies, “but rather a sign that we need to look more closely at the pregnancy.” Often it’s no cause for concern and doctors will only monitor you more closely to ensure there’s no immediate danger, but in some cases a decrease or increase in amniotic fluid can indicate something more serious.

FACT

In early pregnancy, a lack of amniotic fluid could be a sign of certain birth defects in the baby, or that you have a tear in the sac that holds the amniotic fluid.

WHAT IS TOO HIGH OR LOW? Polyhydramnios (pol-e-hy-DRAM-nee-os), also called hydramnios, is defined as an amniotic fluid index of greater than 25 centimetres when the deepest pools in each quadrant of the uterus are added together, or when the deepest pool of amniotic fluid is measured as greater than 8cm. Oligohydramnios (oli-go-hy-DRAM-nee-os) is defined as an amniotic fluid index that is less than expected for gestational age – usually this means a volume of less than 5cm. “Not enough fluid is often associated with poor placental function and a small baby who’s not getting enough to grow to potential, while too much fluid can overstretch the uterus, increasing the risk of premature rupture of membranes, pre-term labour and premature delivery,” explains Your Pregnancy’s expert gynaecologist Dr Bronwyn Moore.

POLYHYDRAMNIOS (TOO MUCH)

Too much amniotic fluid is called polyhydramnios (or hydramnios) and is more common in multiple pregnancies, where mom is diabetic or when gestational diabetes develops. “Polyhydramnios has also been associated with chromosomal abnormalities and most foetal structural (organ) abnormalities, the most common being those that prevent swallowing or circulation of the amniotic fluid, such as intestinal atresia (blockages),” says Dr Elliott. Or it could be a sign of heart failure in the foetus or a sign of foetal infections, she adds. What polyhydramnios means for your baby really depends on the underlying cause, stresses Dr Elliott. “If the amniotic fluid volume Image: Jupiter Images

is greater than expected, then there is a risk of preterm labour and/or pre-term rupture of membranes, and in some cases cord prolapse. It may be tricky for the foetus to maintain the correct position and the foetus may lie transverse or breech.” In severe cases, there may be a risk of abruption placenta (separation of the placenta prior to delivery). “This can have catastrophic consequences,” says Dr Elliott. Problems may continue after birth, she adds: “After delivery, the uterus, which has become used to the increased stretch, may find it difficult to contract – a condition called uterine atony.”

OLIGOHYDRAMNIOS (TOO LITTLE)

There are also many possible causes of oligohydramnios – too little amniotic fluid. Dr Elliott says these range from genetic kidney conditions to baby not receiving enough nutrients from the placenta to produce sufficient amniotic fluid, as is the case in conditions such as foetal growth restriction or a maternal condition such as pre-eclampsia. Another cause is that, unlike with the dramatic water-breaking scenes in

the movies, sometimes you could be totally unaware that your waters have broken (called a pre-labour rupture of membranes) and you could simply be “leaking” amniotic fluid. If oligohydramnios develops in the first or early second trimester, it’s usually more serious. “Adequate amniotic fluid is critical for foetal lung and limb development. So it can lead to severe consequences, such as pulmonary hypoplasia (underdevelopment of the baby lungs) or malformed limbs,” explains Dr Elliott.

If oligohydramnios develops late in the third trimester, the pregnancy may progress normally, or your health care provider may advise you to have an induction or a caesarean section. What’s very important to remember is that the majority of women who develop oligohydramnios in the last trimester continue to have normal pregnancies. I was one of these many fortunate cases who, aside from regular monitoring, was able to carry on as normal, go into labour naturally and deliver a very healthy baby with no need to panic. YP

GOLDILOCKS LEVELS The amniotic fluid performs important functions: it cushions and protects the foetus, allowing foetal movement and muscle development; it reduces cord compression, especially in labour; and is vital for foetal lung and gut development, among other functions. This is why it’s so important to monitor amniotic fluid regularly throughout pregnancy, to ensure your baby has perfect Goldilocks levels (not too much, not too little). Gynaecologist/obstetrician Dr Bronwyn Moore explains the basics of monitoring: “During your pregnancy your healthcare worker will use various markers to monitor the progress of your pregnancy. One of the most important is the size of your uterus, measured from pubic bone to the top of the uterus, known as the height of fundus (HOF). How big your uterus is depends on how many babies you’re carrying, the size of your developing foetus and the amount of amniotic fluid. A uterus that is bigger or smaller than expected will alert your healthcare worker to a possible problem with amniotic fluid volume and will need further investigation. “Commonly, a sonar scan is then performed to assess what’s going on inside the uterus. The size of the foetus can be estimated and the amount of amniotic fluid determined. Experienced sonographers can judge the amount of fluid while conducting routine scans, but if it’s felt that the amount of fluid is abnormal then it can be formally measured by doing an AFI (amniotic fluid index). Here the uterus is divided into four and the deepest pool in each quadrant is added together. This total value is then compared to normal values. Too much or not enough amniotic fluid is associated with specific pregnancy problems, and these possible causes would need to be looked for and excluded.” AUGUST/SEPTEMBER 2016 81

month 8

YOUR BODY AND BABY

FACT

At around eight months’ gestation, your baby can differentiate between sweet and sour tastes.

JUST FOR YOU, Dad!

BY ROBYN LAWRENSON

Here’s some reading material for him, with tips to help prepare the home (and yourself) for your new arrival! PRACTICALITIES YOU CAN HANDLE

BABY-PROOFING Your baby will be crawling before you know it, and Mom will be happy you had the foresight to get the baby proofing done early. Put on the pool net, secure the plug covers, move cleaning materials and medicines to upper shelves, and get the baby gate ready. Some of these require money so doing it early will ease the strain on your budget later.

STEP UP THE HOUSEHOLD CHORES Your partner’s pregnancy literally gets in her way, and she doesn’t have the energy to clean and tidy like she did before. Offer to wash dishes, cook meals and try your best to at least tidy up after yourself. CHANGE YOUR POLICIES It’s time to alter your wills to include your baby, speak to your medical aid about adding a child, and think about a life 82 YOUR PREGNANCY

Image: Jupiter Images

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month 8 insurance policy if you don’t already have one. FIT THE CAR SEAT There’s always the chance baby might come early, so have his car seat ready and waiting securely in your car, at least two weeks before the due date. LEARN HOW TO OPERATE THE PRAM Even the latest designs can be tricky to assemble if you’ve never done it before, so work out how to get the pram up and going, and give mom a demonstration, too. READ THE BOOK SHE’S LEFT ON YOUR BEDSIDE TABLE… … or at least a section of it, then talk about it with her. Your partner likely has piles of books and magazines that she’s poring over, so show an interest and get reading! GO TO ANTENATAL CLASSES WITH HER This goes without saying – this is your baby too, after all! She wants to know you’re as clued up as she is, and you’re in this parenting journey together. YP

WAYS DAD CAN REALLY HELP WITH BREASTFEEDING 84 YOUR PREGNANCY

YOUR BODY AND BABY

THINGS NEW DADS NEED TO KNOW ABOUT NEW MOMS

SHE DOESN’T FEEL ATTRACTIVE Her clothes don’t fit, her body is flabby in places it was never before, and she’s leaking constantly. How would you feel? Make a point to tell her she’s beautiful, and remember to tell her what a great job she is doing. Comforting words soothe a new mom more than you know.

SHE WILL TAKE OUT HER FRUSTRATIONS ON YOU Newborns come with so much more than their cute gurgles and squishy cheeks. The sleepless nights, constant nappy changing, and crying on end would get anyone’s nerves shot eventually. New moms can’t become angry with their babies, so they’ll most likely direct their anger at you. Make sure you’re helping as much as you can, communicate with her and encourage her daily. This sketchy time will soon pass, so hold on tight.

YOU MIGHT FEEL LIKE A THIRD WHEEL FOR A WHILE Your partner is going to be obsessed with your baby, so let her be. It’s her natural instinct to check on him fanatically, question every cry and squawk, and stare at him at length. You might feel a bit spare for some time, but the more you show her love through acts of service, the more she’ll appreciate you. Promise!

SHE WANTS TO BE PROTECTED Now more than ever, your partner is going to need to feel safe. Even if that means knowing when to put a halt on the endless visitors! Make your home a safe and comfortable space, and tone down any

talk about crime and major news events. She’s going to feel extremely sensitive, and now that you have a baby to protect and take care of, the last thing she wants to hear about is how the world can sometimes be a scary place.

SHE WON’T ALWAYS KNOW WHAT SHE WANTS! Communication will keep you going through these first few weeks. Brace yourself! Because she’s just given birth, her body is going through major physical and hormonal changes. One of the best ways you can help is by asking exactly what she needs. And even if she doesn’t know, offer her tea, a foot rub, a warm bath, or to take the baby for a while.

NEW MOMS CAN’T BECOME FRUSTRATED WITH THEIR BABIES, SO THEY’LL MOST LIKELY DIRECT IT AT YOU

Set her up. Warm her gel pads, fetch the feeding pillow and prop her up comfortably.

2 3

Burp and change baby after feeding.

Share the load – if she’s pumping, take a few feeds and bond with baby.

Bring her a drink and snack.

Let her rest afterwards while you soothe baby to sleep, or hold him if he’s not ready for a nap yet. Attend a breastfeeding class with her, so she feels supported by you.

Reduce stress in the home – limit visitors in the very beginning, and don’t expect her to get up and make tea for people.

Prepare and clean the breast pump in between feeds. Make sure she has some form of entertainment, like a new TV series to watch, a book or magazine to read, or her phone or iPad.

Occupy pets and other children so she can focus on the baby.

SUBSCRIBE NOW TO Subscribe to YOUR PREGNANCY magazine and never miss an issue! Get the latest news, must-have information and expert advice delivered right to your door with our hand delivery option! THE HOUR AFTER BIRTH AND WHAT TO EXPECT

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“I BIRTHED MY SECOND BABY AT HOME”

STAY A STEP AHEAD THIS WINTER PAGE 28

GOING IT ALONE WHAT YOU

IS ESSENTIAL!

THE HAPPY TRUTH ABOUT C-SECTIONS

KIN

PAGE 96

PASTEL PREGNANCY FASHION

H AT ALL DWOE S LA BO UR ABOUT REALLY PAINFEEL LI KE? RELIEF WE BREAK TOP 10 FOODS TO AVOID

NEED TO KNOW ABOUT BEING A SINGLE MOM

BABY SKIN CONCERNS ATTACHMENT PARENTING

SAFE

THINGS YOU’D NEVER WHAT NOTHINK TO AVOID

LABOUR ROOM LINGO THE WONDERS OF THE PLACENTA BLOOD PRESSURE

WHAT YOU NEED TO KNOW ABOUT AMNIOTIC FLUID

IT DOWNSTAY IN G FOR YOU

GET TO GRIPS WITH...

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KEEP BABY CLOSE WHY SKIN-TO-S

FUN WAYS TO TRACK YOUR PREGNANCY

BEAT THE FLU

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Discovery Vitality members can subscribe to Your Pregnancy magazine for only R131 for six issues! Visit discovery.co.za, click on Vitality and then Vouchers and subscriptions, then click on Buy now under Magazines. Remember you can pay using your Discovery Card, Discovery Miles or a combination of both. The number of magazines you can subscribe to annually at a reduced rate depends on your Vitality status. The Discovery Vitality offer is only available to active Vitality members. You cannot receive the Your Pregnancy discount if you take up the Vitality magazine offer. Discounts available to subscribers with an SA postal address only. Discovery Vitality (Pty) Ltd is an authorised financial services provider. Registration number: 1999/007736/07. Terms and conditions apply. Terms and conditions apply. This special offer is valid until 30 September 2016 and applies to South African residents only. There is no discount on postage and VAT.

month 9

YOUR BODY AND BABY

buys

BEST BREASTFEEDING These are our top picks of breastfeeding essentials to make this journey a great one, for you and babyâ&#x20AC;¦ BY ROBYN LAWRENSON 86 YOUR PREGNANCY

Chicco manual breast pump R699.99 Baby City, Baby Boom, Game and selected pharmacies

Carriwell seamless adjustable nursing bra R430 baby retailers

Pigeon electric breast pump Pro R2 199.99 takealot.com and baby retailers

Chicco boppy pillow R799.99 Baby City, Baby Boom

Annabella poncho R479 Annabella maternity. co.za

Lonzi and Bean MilkiMum top R425 lonziandbean. com Tommee Tippee bottle brush R109.99 baby retailers

Breastfeed with Confidence with a Breastfeeding System which has stood the test of time! Pigeon’s New Generation Manual & Electric Pro Breast Pumps are designed to enhance and support your Breastfeeding Journey.

Carriwell therapeutic breast soother R178.95 Baby City

NUK breast milk bags R239.99 leading retailers

Tommee Tippee microwave steam steriliser R469.99 baby retailers

Annabella breastfeeding pyjamas R759 Annabellamaternity.co.za

Development based on the 3 Key steps in Pigeon’s Recent Breastfeeding Study for successful pumping:

Fit Gentle stimulation Expression

Medela sterilising bags R320 takealot.com

S Chicco breast pads 60s R99.99 Baby City, Baby Boom, Game and specialist baby stores Image: Jupiter Images

VISIT OUR ONLINE BREASTFEEDING ADVISOR™ http://ba.pigeon.com.sg Available from Baby Stores, Your Local Pharmacy or Retail Outlet Selian Agencies c.c., Protec Park, Oranje Rivier Drive, Terenure Ext.42, Tel: 011 393 1328, email: info@sp-africa.com Follow us on: www.sp-africa.com www.pigeon.com

month 9+

YOUR BODY AND BABY

HOLD ON, Skin-to-skin contact with your newborn can help breastfeeding, bonding and more. Discover when and why it’s essential to get up close and personal with your infant after birth

BY LORI COHEN

hen your baby is b o r n , y o u r instinct may be to get them clean, snuggled up in a babygrow and swaddled in a blanket. But, say the experts, placing your naked baby on your exposed chest directly after birth can have numerous physical and emotional benefits for the baby, and mother, that can’t be matched. Called “skin-to-skin” contact, or kangaroo mother care (KMC), it’s encouraged immediately after birth, and well after discharge from hospital, says Vanessa Booysen, neonatal facilitator at the Department of Health’s Newborn Care Project. “The Academy of Paediatrics recommends skin-to-skin, which is placing your naked baby, wearing only a nappy and a cap, on your bare chest for uninterrupted periods of at least 60 minutes, as frequently as possible, during the first 12 weeks and beyond.”

THE BEST START

Skin-to-skin in the labour ward, directly after birth, is strongly encouraged, even if your baby is full term and healthy. 88 YOUR PREGNANCY

“Evidence-based research has dethroned the concept that swaddling a baby immediately after birth is more conducive to keeping baby warm and calm. A baby can’t regulate his own body temperature; he needs an external heat source, and a mother’s skin is the perfect one for the job,” says Vanessa. “During labour and breastfeeding, a mother’s oxytocin secretion regulates her baby’s temperature and enhances the mother’s letdown reflex. During this precious time of skin-to-skin bonding and attachment, the mother and baby exchange sensory information that stimulates and elicits ‘baby’ behaviour: rooting and searching for the breast and initiating breastfeeding, feeling safe and calm, a more regular breathing pattern, staying warm and maintaining baby’s body temperature and blood sugar levels. Babies swaddled immediately after birth have a more difficult time seeking the breast. A baby needs his hands in front of his face to breastfeed well,” she says. While that first snuggle feels awesome, it really has a profound impact on your chances of succeeding at breastfeeding. Research shows that infants held for more

BABY

than 50 minutes after birth were eight times more likely to breastfeed spontaneously. “The emotional benefits of skin-to-skin are so profound that we encourage skin-to-skin, even if you aren’t planning on breastfeeding,” says Vanessa.

GETTING IT RIGHT

“You don’t need to be confined to your bed or a chair to do skinto-skin. As long as your baby is secured with a KMC wrap and is positioned correctly, you can walk around, do house chores or sit in front of your computer, and still enjoy the benefits of skin-to-skin, while providing a very necessary and profound experience of touch, smell, taste, sight, and sound to your baby,” says Vanessa.

CORRECT POSITION

Remove your bra and place your baby skin-to-skin, with just a nappy, cap and booties or socks, with his tummy placed onto the upper part of your chest. You must be able to kiss your baby’s head – this way you can tell if he’s high enough on your chest. Baby’s head is turned sideways, with his one hand in front of his face, and the other one at the back of his head. Use a KMC wrap or shirt to secure your baby on yourself. You can make your own wrap using an old cotton sheet. “Cotton works better than a stretch material as we need to secure the baby’s head so that it

WILL I BE ALLOWED TO DO SKIN-TOSKIN IN A GOVERNMENT HOSPITAL?

The Minister of Health and his advisers’ committee, the National Perinatal Morbidity and Mortality Committee, has made KMC mandatory in all government hospitals, so directly after birth babies are placed skin-to-skin on their mother’s chest in labour ward. “Our challenge still remains to educate mothers to do it in the ‘fourth trimester’, the post-natal period, and in private hospitals where babies are often separated from their mothers and taken to a nursery,” says Vanessa Booysen of the Department of Health’s Newborn Care Project.

CAN THE BABY’S FATHER DO SKIN-TOSKIN TOO? Absolutely, particularly if you have had a caesarean and need to remain in theatre after the birth. “Early morning skin-toskin with dad in bed while mom makes coffee is also an excellent bonding time for baby and dad,” says Vanessa.

doesn’t flop back. Check baby’s chin is lifted on your chest, to ensure an open airway for easy breathing,” says Vanessa. YP

FACT

Placenta encapsulation, whereby the placenta is steamed, dehydrated, ground, and placed into pills, is a centuries-old practice, and presumably has health benefits for the mother.

WHAT YOUR BABY EXPERIENCES WITH SKIN-TO-SKIN

His heart rate stabilises, as he’s calmer by hearing the familiar, safe sound of your heartbeat, and is less likely to cry. He can smell, see and hear your voice, which stabilises his breathing patterns and oxygen levels in his blood. His body temperature will stabilise. Mothers can control the infant’s temperature better than an incubator. Your skin chest temperature can rise by two degrees centigrade if baby is cold, thus warming up the baby, or fall by one degree if your baby is hot and needs to be cooled down. His immune system will be boosted. The bacteria on the mother’s chest is family-friendly bacteria and this enhances the baby’s gut colonisation, stimulating the immune system. “Depriving babies of skin-to-skin care in this critical fourth trimester leads to forming alternative stress pathways in the brain, which can lead to conditions like ADHD, colic, sleep disorders, and have lifelong emotional and psychological effects on the child,” says the DoH’s Vanessa Booysen. He’ll be more settled when he sleeps and more alert when awake. It’s all about the secretion of hormones. If we feel safe, secure and loved, we secrete good-feeling endorphins that enhance our physical and emotional wellbeing. If we’re afraid, alone, insecure or threatened, we secrete fight and flight hormones, like adrenalin and cortisol, which aren’t good for us. So, skin-to-skin enhances good, deep sleep patterns improving the quality and quantity of sleep, resulting in a “refreshed” baby, who is more alert when awake. He’ll feel less pain from injections and interventions; important for infants who are in the neonatal ICU (NICU). Because he’s close to the mother’s breast, he has free access to breastmilk and breastfeeding. Breastmilk has a tranquillising, pain-reducing effect on the baby. Your baby will gain weight faster and better. KMC helps stimulate your breasts and produce more milk. Babies are given skin-to-skin contact are more likely to breastfeed more frequently and for longer, improving your milk volume due to the frequent stimulation and prolactin secretion.

WHAT YOU EXPERIENCE WITH SKIN-TO-SKIN CONTACT

Parents, (especially mothers) are less depressed as skin-toskin increases the levels of maternal oxytocin, which serves to restore mom’s pre-pregnancy hormonal levels and reduces the risk of postpartum depression. Feeling more connected to your baby will also help you learn your baby’s unique cues for hunger or when they need to be changed. Skin-to-skin contact can reduce your blood pressure, lower your stress hormones, reduces postpartum bleeding by helping the uterus shrink to its pre-pregnancy size, increases pain tolerance and improves breastmilk volume and production.

Image: Jupiter Images

your baby

YOU’RE A MOM

SPECIAL DELIVERY! BY LORI COHEN

ou’ve stocked up on size 1 nappies and can’t wait to meet your newborn. But your first encounter with their, er, sticky discharges can be a shock (more on that later), and you’re bound to worry about their “number twos” for the next few weeks. So, what should a new parent know about poop?

90 YOUR PREGNANCY

WHAT TO EXPECT YOUR BABY’S FIRST STOOL WILL BE BLACK!

You’re expecting something in a familiar chocolate shade, but out comes a tar-like substance instead. What’s up

It’s a messy subject, but if you’re a parent of a newborn you’ll need to know what to expect when it comes to your infant’s bowel movements

MECONIUM IS A STICKY, BLACKISH SUBSTANCE THAT THE BABY PASSES FOR THE FIRST FEW DAYS OF LIFE

FACT

By around day five, your baby’s poos should be a mustard-yellow colour (or a very light green or orange colour).

with that? “Meconium is a sticky, blackish substance that the baby passes for the first few days of life until full feeding and normal stool pattern is established,” explains paediatric gastroenterologist Dr Louise Cooke. “It consists of what the baby has swallowed in utero (amniotic fluid) and cells shed from the gut mucosa (lining). It is sterile, as the baby has not yet been colonised by microbiotia, which will happen after passage through the birth canal and with feeding,” she says. Place petroleum jelly on your baby’s bum when you put on their first nappy and the “glue-poo” will wipe off easily. Once feeding is established the meconium changes from black and tarry and becomes greener, then yellowish. “Breastfed babies’ stools often become yellow, rather than brown, and will only become brown when formula or solids are introduced,” says Dr Cooke.

CHECK WITH YOUR DOC IF… Your baby doesn’t pass any meconium within the first 24 hours of life. “Delayed passage of meconium can be an indication of a variety of problems, including Hirschprung’s disease, which is a condition where there’s a failure of the correct nerve formation in the intestine, or meconium ileus, which is associated with cystic fibrosis, an inherited disorder associated with malabsorption and lung problems,” says Dr Cooke. An infant that also Image: Jupiter Images

TOP TIP

Don’t comment on your baby’s poo as smelly or unpleasant when changing their nappy. You don’t want them to learn to associate a natural process with something that’s negative or unappealing.

vomits up greenish bile or has a distended abdomen could indicate one of these obstructive conditions, which requires medical evaluation. Sometimes the lack of “action” can merely be caused by a meconium plug, which is usually passed after a glycerine suppository has been inserted.

WHAT TO EXPECT NOT ALL BABIES POOP THE SAME, OR AS MUCH

Whether you breastfeed or formula feed your infant will determine what they deliver into their nappy in terms of colour and consistency. So a runny, yellow poo with a seedy texture doesn’t mean your baby necessarily has diarrhoea – this is normal for a breastfed baby. “Breastfed babies can pass up to seven stools a day (one per feed), or as few as one per week. Formula-fed babies vary too – you can expect anything between one and five stools a day. The stools tend to be firmer (pasty, peanut butter consistency), while breastfed babies can have quite loose stools,” says Dr Cooke. A formula-fed baby’s stools may appear yellowish brown, to brown to greenish brown. Formulas that are

casein dominant may make babies constipated, explains Dr Cooke. Confusing much? Don’t worry, you will know your own baby’s pattern of stooling after the first few days or weeks. You should know that, along with all the other advantages of breastfeeding, breast milk is the easiest milk for newborns to digest, and least associated with any issues of constipation or allergy. Stools are also less smelly as they don’t have all the additives of formula. Breast milk also allows for colonisation of the gut with good organisms that will prevent diarrhoea and establish a healthy immune system, says Dr Cooke. “If a baby is gaining weight and seems satisfied after feeds, it suggests stools are normal and absorption is adequate, so there’s no need to worry about loose, frequent breastfeeding stools,” she adds.

CHECK WITH YOUR DOC IF…

MY TWO-MONTHOLD BABY HASN’T PASSED A STOOL IN FOUR DAYS. HE’S BREASTFED. SHOULD I WORRY, AND WHAT CAN I DO?

DR LOUISE COOKE SAYS: “In a case like this we would compare if there has been a change in the child’s preceding stool pattern and level of comfort. If your baby has always passed infrequent stools, but is thriving, and none of the red flags mentioned are there, then there’s no need to worry. If this is a new pattern, and associated with discomfort, vomiting, or distension, then you should get your baby seen by a doctor.”

There is mucous or blood in the stools, if they become hard or pellet-like, if the stool has a white shade, is oily and very offensive-smelling, if your baby hasn’t defecated as often as usual or struggles or strains to pass a stool, or appears to be in pain. In a well child, blood in a hard stool could indicate a fissure, and blood in a loose or normal stool could be an allergy, she says. YP AUGUST/SEPTEMBER 2016 91

your baby

YOU’RE A MOM

YOURandBABY’S SKIN how it changes As your baby’s skin adjusts to the outside world, you may notice some changes. Most of them are normal, but here’s a quick guide to help you spot when there’s a problem

BY TINA OTTE

ust like your baby’s body and senses develop and respond to the world, so too does his skin. As his skin develops and grows, you may find your baby experiences rashes or spots. Keep these points in mind…

AT BIRTH

When your baby enters the world, he may be covered in a fine white substance that looks and feels like melted cheese. This is called vernix and is normal. During his first bath, the vernix will be washed off. You may notice a few white spots on your newborn baby’s face but these are no cause for alarm. Called milia, these little white spots will clear up on their own – no special treatment required.

RASHES

Almost every baby experiences a rash at some point. Whether 92 YOUR PREGNANCY

WHAT it be heat rash, nappy rash, HIVES CA N I DO ABOUT a skin allergy or something Hives can be an indicator UNSIGHTLY CRADLE CAP? serious, the best way to deal for an allergy. These small, Cradle cap won’t bo ther your with it if you’re concerned baby at all, but it ca raised patches develop n be rather is to see your doctor or ugly to look at. Yello very quickly, and very w, greasy and paediatrician. A nappy scaly patches will de often, are caused by an velop on the top of your baby’s head rash is quite normal, and allergy in food. Hives , and it may even look like your baby is no reflection on your has dandruff. can be treated using Cradle cap is easily parenting skills! Although treated though, antihistamine creams or by ensuring that yo uncomfortable for your u wash your medicine, but if repeated baby’s hair regularly baby, nappy rash will heal with a episodes occur, you may mild baby shampoo after a while, as long as you . need to ask your doctor about keep his genital area as dry as allergy testing. possible – let him go nappyfree for some time during on your baby’s hands, feet or WHEN TO WORRY the day. Heat rash can also mouth. Measles symptoms If you’re in any way concerned be unsettling, as the little red often show up as a high-grade about a rash, get in touch with bumps seem to spring up out fever, with small white spots your doctor or visit your of nowhere. Most commonly, appearing in your baby’s clinic. Most importantly, if the heat rash occurs in areas that mouth. If you’re concerned rash is accompanied by other are covered or clothed, so the that this is what you’re dealing symptoms, like a fever or first step in treating it is to cool with, go to your doctor or extreme drowsiness, it’s vital your baby down. Loose-fitting clinic immediately. your baby receives immediate clothes and ensuring that medical attention. YP your baby’s room is the right ECZEMA temperature will help to avoid Eczema is an uncomfortable heat rash. If it does happen, skin condition that’s very MY BABY HAS make sure your baby doesn’t often connected to a milk or PIMPLES. WHAT CAN scratch the affected area and egg allergy. It can, however, I DO ABOUT THEM, do your best to keep the region be a long-term condition AND WHY DOES SHE free of clothing. Your doctor that your child will carry HAVE THEM? may prescribe a cream or lotion into adulthood. Don’t panic It’s actually quite common if there is severe itchiness. just yet though, as eczema for newborn babies to is highly treatable. The most get pimples during their THAT’S NOT A RASH common form of it, atopic first month of life. There’s Of course, rashes can be a cause eczema, is easily treated using no need to whip out the for concern, and they should a mild moisturiser and creams pimple creams and potions be if they’re accompanied by prescribed by your doctor. and these are definitely not a fever or other symptoms. Eczema can be very itchy, recommended. Just make Chickenpox symptoms, for but it’s important to prevent sure that you wash your example, usually begin with your baby from scratching, baby’s face with water a fever and then a nasty rash as that could lead to scars. If and a mild moisturiser, of little red blisters follows. you’re concerned that your and this little bout of baby Hand, foot and mouth disease baby has eczema, head to your acne will clear up within a starts with a fever, sore throat doctor or clinic as soon as few weeks. and small blisters that appear you can.

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Q&A

YOUR QUESTIONS ANSWERED

TINA OTTE is a mother, a mid-

wife, a childbirth educator and an author. She’s been involved in the pregnancy and birth field for more than 30 years. The more I work with pregnant women, the more I realise birth is unique for each one of us. Every birth is different and yet every birth is similar. That may sound like a contradiction, but although the process of labour and birth is the same, the way a woman perceives it is very subjective and unique. I never tire of hearing the many birth stories told to me. I learn

I’m 30 years old and five weeks pregnant. I recently had a scan done, but my uterus was empty. How is that possible? My doctor talked about an ectopic or early pregnancy. I sometimes get period-like pains that come and go. I don’t have any infection. I’m so confused and stressed now. I can’t sleep and feel stressed. What could be the problem?

TINA SAYS It’s quite difficult to advise you, without knowing your history. Did you do a home pregnancy test? Or was it a blood test at your clinic or doctor? Before becoming too stressed at this very early point in your possible pregnancy, I think you should contact your caregiver for

94 YOUR PREGNANCY

so much from them and so will you as you read about the experiences of other readers and mothers who thankfully share their stories with us. Today’s woman is blessed to have many choices and options open to her. Childbirth has never been safer. It’s your responsibility to seek out more information and gain as much knowledge as possible during your pregnancy. I have found over many years of teaching childbirth education classes that not all women like to make decisions, preferring to have them made for them. Others are fiercely protective of their right to informed decision-making. This is an emotive time and so it should be. Giving birth to your baby is one of the most awesome experiences of your life and you’ll never forget it. The team at Your Pregnancy goes a long way to assist you in getting the information you need to make sense of what’s about to happen to you. Enjoy this issue as I am sure you will, and remember that giving birth should be a life event to be savoured, not a medical procedure to be feared!

A Q DR MERWYN JACOBSON REPRODUCTIVE SPECIALIST

KARIN STEYN COUNSELLING PSYCHOLOGIST & HYPNOBIRTHING PRACTITIONER

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NURSING SISTER

With love,

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another visit, and scan and confirm your pregnancy. If there’s any fluid or blood loss along with the cramping you’re describing, or acute pain on your side, you should seek help immediately.

I’m five weeks pregnant, and I’m craving seafood and eggs, even though I’ve heard they’re unsafe to eat in pregnancy.

TINA SAYS You may certainly eat fish, provided that it’s properly cooked. Fish has great health benefits for you and for your developing baby. Oily fish such as salmon, sardines, pilchards and herring, to name a few, contain Omega 3 fatty acids and other

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vitamins and nutrients. Shark, swordfish and marlin contain high levels of mercury, so avoid these. Fish such as haddock, hake, tinned tuna and cod are good fish to eat.

I’m 40 weeks pregnant and have been leaking water and mucus for a few hours. I’m not in pain, so should I consult my doctor?

TINA SAYS These are some of the classic signs of the beginning of labour. Go into the hospital where you’re planning to have your baby and be checked to confirm whether you’re indeed at the start of labour, as you’re at term. Lucky for you that your pains haven’t started, but you’ll soon feel contractions. Sometimes they are there, but you may not recognise them as the start of labour, if they are very mild. Go into your doctor immediately to be checked.

My baby is currently five weeks old and was born with jaundice. What causes this exactly?

TINA SAYS Jaundice is a yellowish colouring of the skin and the whites of the eyes which becomes visible on the second or third day of life and begins to decrease between the fifth to seventh days. Jaundice first appears on the face, then chest and tummy, then arms and legs. It’s likely to occur more often in premature infants. Nearly 50 percent of all newborns develop jaundice. It’s a temporary condition and is usually not dangerous to most infants. Jaundice is caused by the production of excessive

amounts of a pigment called bilirubin in the blood. Bilirubin is a breakdown waste product occurring naturally when red blood cells containing haemoglobin break down at the end of their lifespan. Bilirubin is removed from the blood stream by the liver and excreted in the stool. The level of bilirubin is likely to rise if: A baby has a blood type incompatibility with the mother. A baby has a lot of bruising to their scalp or face from delivery. A baby is premature or small and the function of the liver is immature. The outflow of bilirubin via the bile ducts is obstructed. Caesarean babies are more likely to become jaundiced. Physiological jaundice is so common in newborns that it is also known as “normal jaundice”. It doesn’t cause major problems, but babies are usually sleepier and may feed erratically. It usually starts from day three onwards. Jaundice usually settles within one week and requires little or no therapy. Some jaundice is related to rapid breakdown of red cells. These conditions may be more serious and will be monitored more carefully. This includes rhesus or blood group incompatibilities or congenital abnormalities of the shape or metabolism of the red blood cells. I’m concerned that your baby is still yellow at five weeks, so please go to your clinic and get his blood tested again. There are home treatments that you can do to treat this, but your baby may need to be hospitalised for treatment with phototherapy.

A WORD FROM ALDA ALDA SMITH is one of SA’s Nikonassociated birth photographers and mentors. She captures beautiful birth memories for parents, and provides parents and birth professionals with compassionate guidance from her private practice in Cape Town. She’s the co-founder and chair of the South African Birth Photographers Association.

Rise and flaws of the birth menu As a mother who felt unheard with the birth of her first child, I advocate birth plans (or birth preferences) to clients. Even though birth rarely goes to plan, I still recommend having one as it lays the ground for honouring parents’ choices in birth and makes them feel less vulnerable. Because, if you don’t make choices in birth, they’ll be made for you. Many books have been written about taking back the power of childbirth and while I support the notion and feel frustrated when a mother’s birth plan isn’t read and respected, I do think it’s also given rise to what I call a “birth menu culture”. In an effort to combat the lack of compassion in birth, women are presented with a whirlpool of options and choices relating to birth environment, pain management, as well as baby and mother care. This vast menu of choices can put unnecessary stress on parents who often don’t know how to interpret choices in relation to their own situation. The reality is also that for every couple of candlelit, unmedicated water births, there’s an unexpected birth where interventions and a change of plans are required. It’s here where the birth menu culture fails parents. A deviation from or complete disregard for the birth plan or simply too many birth choices sometimes

leads to a stand-off in the labour ward or theatre, deep disappointment and trauma, or both. It would seem that the very damage we’re trying to combat by encouraging parents to take back the power of birth and the offering of choices might be causing pain and disappointment. How to bridge the flaws of the birth menu culture: 1 Knowledge is power, so write a birth plan with what is really important to you and what are simply nice-to-haves. Simplicity is key, so don’t overplan something that’s by nature unpredictable. 2 Choose a birth team who will help you interpret the options you have in relation to your unique situation with integrity, authority and compassion towards you and your baby. 3 Work towards a healthy baby, but also towards your own happiness, because the two are intertwined. 4 Try not to be influenced by the “trophy birth”. Every birth is unique and how you became a mom isn’t as important as the fact that you did. 5 It’s okay to feel upset when things don’t go according to plan – even if you end up with a perfectly healthy baby. Your emotional wellbeing is just as important as your physical wellbeing, so reach out if you need help in making peace with your birth experience. AUGUST/SEPTEMBER 2016 95

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LAST LAUGH

THREE’S A PARTY

Having a third child means I’ll have near-Godlike status in the park, but it’s goodbye fantasy Aston Martin... BY CRAIG BISHOP

Illustrator: Susan Newham

did hear Liz’s first scream. I’ll admit that now. But I’m a superb judge of my wife’s ululations. I know the difference between a “Jen’s pregnant!” shriek and a poopocalypse wail. I was standing in the garden, scorching Cape Town evening, height of water restrictions, outside the kids’ bedrooms windows, one ear pricked for the first shuffle and moan from Sam. Aged one now, he’s the bad sleeper. His sister, Caro, at two and a half, is the dream sleeper and always has been. Anyway, the kids are down, and I’ve fled with the bona fide excuse that the garden needs watering desperately. I’m praying that if Sam does wake up, I’m far enough away from the windows that Liz will have to attend to him, and accept (during the later argument) that I really didn’t hear Sam crying, what with the sprinklers, the hadedas, the general 7pm suburb hubbub. Honest, guv. Earlier, I’d been to the corner shop to get milk, potatoes and a pregnancy test. Silly, I thought. Liz’s nausea was just a tummy bug, surely? Everyone’s had it recently. Liz’s WhatsApp family group has been daily clogged with family members’ 98 YOUR PREGNANCY

harrowing tales of sitting on the great white porcelain throne. Besides, we’ve barely got the time or energy these days to pass each other the milk or potatoes, never mind sex. Anyway – shattering my guilt-ridden garden zen, Liz comes running into the garden wrapped in her bath towel, and only her bath towel, brandishing the pee stick. “I’m bloody pregnant,” she snarls. “Didn’t you hear me? When the hell did that happen?!” I’m not sure if Liz is more agitated that she’s pregnant, or because I didn’t come running when she shrieked. So I hold my sprinkler limply. I’m weak in the legs, which is ironic, considering it must have been a quickie knee-trembler a few weeks ago that got her pregnant. It’s also precisely 48 hours after we both solemnly agreed that two was a perfectly sensible number. Fast-forward three hours. We’re both sat gibbering on the bed, occasionally staring at the pee stick. I’m a bundle of man nerves. We’re alternating between deep breaths and goofy grins. Of course you want to shout it out to the world, but it’s early days yet, and besides, Liz had two miscarriages before Caro was born and another before Sam.

WE’RE ALTERNATING BETWEEN DEEP BREATHS AND GOOFY GRINS I suddenly realise I’ve left the sprinkler on. I rush outside. The Yesterday, Today and Tomorrow bush looks like an SAS soldier on stake-out duty in a tropical swamp. Neighbours driving past in their cars are aghast. “Aghast, No. 9! There’s a drought, you know,” I’m sure the local community Facebook group will say tomorrow. I kick the sprinkler into a new position and rush back inside. Two hours later, I’ve left the bloody sprinkler on. That’s it. I’m social media toast. Someone must have called the council. Lacy curtains are twitching across the street.

But it occurs to me, three kids will give me near-guru status in the park. I say “near”, because there’s always someone who had triplets, or had twins when she thought they were going for their third. You simply can’t outcool these moms in the park, even as a stay-at-home dad plus three. I quickly Google “Bugaboo Triple”, which gives me instant pram-envy. But the cost! Looks like I won’t be trading in my old SUV for a soccer-mom van. I’ll be trading it in for a new pram. All I know is, I’ve forgotten the sprinkler on again. Talk about raining on Liz’s parade. YP

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