Contractions, baby movements and how to hold on to your bladder control: midwife Natasha Cullen of Beloved Bumps answers the most commonly asked questions for expecting and new mothers
Pregnancy and birth are pretty scary experiences, whether you’re a new mum or a seasoned parent of all ages and stages. And with any scary or new experience comes lots of questions, concerns, and personal worries. So, to help put you at ease and steer you in the right diection, we asked Natasha Cullen, an expert midwife from Beloved Bumps, all the big questions that you need to know. Got a different question about pregnancy or birth? Ask us, and we’ll get you the answers!
Your pregnancy & birth questions answered
1. “What do real contractions feel like? And when should I go to hospital?”
Labour can start at any time, but is considered ‘full term’ when you are past 37 weeks. Contractions tend to start very sporadically, and may be period pains, back pain, or you may just feel a bit ‘off’ and sick. These then gradually become more regular over time, until you notice that there is a pattern to them (ie. Every hour). If this is your first baby then going into labour can take days… and yes I mean days. And they can start and stop over that time. Eventually, they will become closer together, and start becoming much more regular – cue the contractions timer app on your phone! They then will become longer and stronger, you will realise you won’t be able to talk through the contractions any longer and they will be lasting anywhere from 40-60 seconds. When you are timing them every 3-4 minutes, and they are lasting 40-60 seconds, and you are having to breathe through the contractions then you can pretty much guarantee that you are going into active labour! So, when do you go to hospital? We advise to wait at least an hour into these regular contractions, and if you can manage two hours then great!
2. “Can I exercise during pregnancy?”
Absolutely! Regular exercise has lots of benefits such as improving your posture, strengthening your body for labour, reducing backache, reducing stress and boosting your energy levels. If you were active before you became pregnant then continue at a level that is comfortable for you. If you weren’t doing any exercise then don’t start anything strenuous – something like pregnancy yoga, swimming or even long walks is great. It will help keep you fit, fight fatigue and give you a better night’s sleep. Og course, when exercising, listen to your body – if it doesn’t feel right, don’t do it.
Years ago, I remember telling women that we advised not to exercise during pregnancy, and just to have gentle walks! However, times have changed, and it has now been found that exercise and fitness in pregnancy has huge benefits. It can help to prevent excessive weight gain, reduce your chance of gestational diabetes, lower blood pressure and risk of pre-eclampsia, reduce the risk of depression, stress and anxiety, improve sleep quality and lead to faster labour time and post-delivery recovery.
Pregnancy is physically demanding on your body, and can cause postural changes and muscular imbalances. Pregnancy hormones such as relaxin reduce joint stability, especially in the pelvic region. As your uterus and baby grow, they weaken your abdominal and pelvic floor muscles, pushing down on your lower spine and possibly causing back pain. It is a great idea to sign up to prenatal exercise classes that can teach you specific exercises that are safe in pregnancy – in pregnancy it is important to strengthen your abdominals and entire core, including your pelvic floor.
There are some exercises that are not advised during pregnancy, such as those involving balance (like skiing), or contact (like rugby). And if you start to feel unwell, or have any bleeding, chest pain, reduced movements from baby, or contractions, then stop exercising, rest, and contact your doctor.
3. “How do I know if I’ve broken my waters?”
Your waters can break at any stage – they don’t necessarily break before labour starts. If you suspect that they have broken, make a note of the time, put a pad in your underwear and observe for any loss. If the pad is becoming wet then call your doctor and you will need a check-up. The timing is important so note it down.
4. “I’m 38 weeks pregnant and my baby isn’t moving as much as before. Is this because he is running out of space?”
No! But any decrease in movement should call for an appointment with your obstetrician to monitor the baby. This is something I am hugely passionate about: it is really important to keep an eye on babies’ movements. Please do not rely on home dopplers for reassurance – they do not give you any indication on whether baby is well or not, just that it is alive (and you may even be picking up your heartbeat not your baby’s).
By the end of your pregnancy, you will have learnt an important thing about your baby’s movement – that there is no set number of ‘normal’ movements. From around 16 weeks you may start to feel your baby move, and these movements will increase until around 32 weeks. From 32 weeks your movements will stay roughly the same until you give you birth.
There are some myths around baby movements in pregnancy. The biggest one is that movements slow down at the end of pregnancy because babies run out of room. Another one is that and if baby has 10 movements a day, it’s considered normal. Both are incorrect.
Feeling movements is a reassuring sign that your baby is well. So, if the movements start slowing down, it could be a warning sign that all may not be well inside, so contact your doctor immediately.
5. “I gave birth a few weeks ago and am leaking urine when I cough. Can this be fixed?”
I can’t stress enough the importance of doing your pelvic floor exercises as soon as you can after birth – which is why Beloved Bumps includes a pre-and postnatal fitness class in the course. Think of an activity that you do every day – breastfeeding, making a cup of tea, eating breakfast – and do them at this time. This will strengthen your bladder muscles and improve bladder control.
6. “I’m nine weeks pregnant and really struggling with morning sickness. What can I do to feel less sick?”
Morning sickness in the early weeks of pregnancy is not only hard because you feel terrible, but also because you’re probably trying to hide it from colleagues and friends (it’s normally at its worst until around 12 weeks, and you may have decided to keep your pregnancy secret until after your first scan).
While there’s no ‘cure’, there are a few things you can do to help ease the nausea:
- Eat little and often, instead of three large meals.
- Have something like biscuits or crackers by your bed to eat before you get up in the morning.
- Stay hydrated! Especially if you are throwing up – it’s important to stay on top of your fluid intake.
- Rest – if you’re tired, you may feel even more ill. This may mean that you have to take a few days off work, but put yourself as the priority.
- Avoid spicy and oily food.
- GINGER! Put it in your food, slice it up and pop it in hot water, eat ginger biscuits… try it however you possibly can!
- Wear anti-sickness wristbands (the ones you wear for travel sickness). But, be prepared to fend off questions about why you are wearing them!
If your morning sickness is accompanied by severe vomiting, lasts longer than 12-14 weeks, causes weight loss or dehydration, and you can’t keep any food down, you may be suffering from hyperemesis gravidarum (HG). HG sometimes requires treatment so if you are experiencing severe symptoms please let your doctor know.
7. “I am 20 weeks pregnant and noticing that I get a lot of discharge – is this normal?”
Your vaginal discharge will change in pregnancy – not only the amount, but also the consistency, thickness and frequency!
The increase in discharge can be blamed on the step-up in production of oestrogen which causes more blood to flow to the area. The discharge, or leucorrhoea, is a mild or musky smelling milky fluid that not only protects the birth canal from infection, but also maintains a healthy balance of bacteria in the vagina.
Towards the end of your pregnancy, it can sometimes be difficult to distinguish your discharge from urine. It could also become very thick and mucousy which is a ‘show’ – this is a sign that your body is preparing for labour.
How to cope with the discharge? You can use panty liners in your underwear, but otherwise you really don’t need to do anything. Do not rinse out your vagina as this can upset the natural bacteria balance which could lead to inflammation or infection.
When should you see your doctor? If the discharge becomes coloured, such as yellow or green, if there is a strong or foul smell to it, or if there is any itching in the vagina – these may be a sign of infection. Yeast infections are very common during pregnancy but are easily treated.
8. “I have really sore nipples but I’m sure my baby is latched correctly. What’s going on?”
I recently did a breastfeeding visit with a lady who needed some help latching her baby to the breast without the use of nipple shields. By the end of my visit, it was clear that she was really confident with her position and the baby’s latch was great. But, two days later, I heard from her again – her nipples had become very red and sore, and she was on the verge of giving up breastfeeding.
I visited her again at home and noticed that her nipples were pink and that the baby had a white coating on his tongue that didn’t go away when I wiped it. When the baby was feeding on the breast, the position and latch were perfect. Both of these were a clear sign to me that that mum and baby had thrush – something that is common in pregnancy (in the vagina) and also postnatally, when it can present on the nipples and the baby’s mouth.
The classic symptoms of nipple thrush are: pain with feeding that can last for a while after the feed, sharp or burning pains in the breast, pink/shiny nipples, or itchiness/tenderness of the nipple. It will only be diagnosed if any of these are present on both breasts. If you have never had pain-free breastfeeding then the pain may still be due to position and attachment – but if you have been feeding well with no pain and it suddenly develops, then thrush could be the cause.
The baby will have a white coating on the tongue, cheeks, roof of the mouth or on the gums. There may be a white film on the lips too. This does not go away with wiping – sometimes milk can leave the same look, but this will be easily removed. The baby may be irritable when feeding, and sometimes thrush can also cause nappy rash.
The treatment is to have an antifungal cream for your nipples that you apply after each feed, and a doctor can prescribe drops for your baby’s mouth – both of you need to be treated so you don’t pass the infection between each other. If the pain in your breasts is bad, then you can take paracetamol until the worst is over, and ‘air’ your nipples. Cutting down on the amount of sugar you are eating can also help, as well as taking probiotics and eating natural live yoghurt.
Got more questions you’d like to ask the midwife? Send us a DM on Instagram!
About the midwife, Natasha Cullen
If you’re pregnant in Singapore and looking for prenatal and postnatal education and support, you need to know about Beloved Bumps. We love that its courses are all about empowering parents with knowledge and helping them to build a strong support network: you won’t just learn about labour and birth, pregnancy fitness, postnatal wellbeing, and breastfeeding and bottle feeding – you’ll receive expert, unbiased advice in a relaxed setting where you can make great connections with other parents.
Beloved Bumps’ founder, midwife and mum Natasha Cullen, grew up here in Singapore and trained and worked in London, and she’s passionate about helping pregnant women make informed choices and understand what is happening at each stage of labour. “I do not judge anyone on what kind of birth they plan to have, pain relief they want or how they would prefer to feed their baby,” she says. “It’s important to me to help people in any way I can, and you can’t beat being both a woman’s advocate and cheerleader!” Cheers to that, we say. Here she shares some of her invaluable pregnancy and birth knowledge by answering the top five questions she’s encountered after helping thousands of women!