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Women's concerns regarding pregnancy

After marriage, when the time comes for conceiving, many questions might arise in women. It might concern their own health and fitness to give birth to a baby. Sometimes, it might be about the health of their offspring. Following are some common concerns for which answers are indicated below:

Q: What is the prime age to plan for a baby?

A: It is better to plan for the first baby as early as possible after marriage. Infertility issues are on the rise even in Kerala. As age advances, chance of getting pregnant decreases. Yet, teenage pregnancies should be avoided as there is chance of low birth weight babies, premature delivery, anemia in mother etc... It is better to have babies before the age of 35 because there is more risk for babies to have chromosomal anomalies as maternal age advances.

Q: If there is a family history of mentally challenged kids, is there possibility for such an offspring?

A: It depends on the type of disease that caused mental retardation. Autosomal Recessive x linked recessive disorders, fragile x syndrome, phenylketonuria etc, which run in the family can lead to a repetition for many generations. Hence it is better to evaluate the mentally challenged child already in your family, arrive at a diagnosis with medical help and plan your next pregnancy suitably. If already pregnant, prenatal diagnostic test can be done to assess the fetus and make a decision accordingly.

Q: Are there chances of an abnormal child in the marriage of blood relations?

A: Till now, there has been no known statistical study about the birth of abnormal children in blood relation marriages. Yet, there have been numerous clinical conditions ranging from simple errors of metabolism to chromosomal anomalies which can result in an abnormal child. In case, there are diseases running in the family, it can affect the child like Thalassemia, Sickle cell Anemia etc., but there are a lot of blood relation (consanguineous ) marriages where absolutely healthy babies have been born. If there are diseases running in the family, we can do prenatal diagnosis tests to check for any anomalies in fetus.

Q: Should one consult a doctor before planning for a baby and go under his / her guidance? Some people are given folic acid to develop a healthy egg. If i don’t take it, will my baby be unhealthy?

A: If the mother is not a ‘high-risk’ patient, it is not necessary to consult a doctor before conceiving. ’High risk’ patient is on who has some regular medications which are teratogenic ( medilcines for seizure disorders or heart diseases). Patients with seizure disorders who are on medications have increased risk of neural tube defects. Such women should definitely take folic acid one month pre conceptionally and throughout the pregnancy period. All women have a small risk of having babies with neural tube defects. So it is better to take folic acid in the first 3 months and one month pre-conceptionally.

In case a person doesn't take folic acid, her future child need not necessarily have neural tube defects.

Q: Some people are advised complete rest during pregnancy. What health conditions call for such situations? Can this be anticipated before pregnancy?

A: In modern obstetrics, no case calls for absolute bed rest. If a patient is having short cervix; cervical insufficiency for which cervical encircle(stitching cervix) is done; or if placenta is found completely covering the cervix; twin pregnancy with short cervix, leaking before reaching term, associated uterine prolapse etc., complete bed rest is advised in such cases.

Complete rest may also be advised for women who have undergone a procedure called conisation(removing a part of cervix) for malignancy of cervix.

Q: I have hypothyroidism. What are the risks of me getting pregnant?

A: Hypothyroidism can result in irregular menstrual cycles which can cause infertility or delay in conceiving. But once it is diagnosed and medications have begun, the patient has a very good chance to get pregnant. Hypothyroid patients getting pregnant have increased chance to have recurrent abortions in first trimester. They can also have fetal hypothyroidism, fetal goiter, babies with low IQ, in case the mother is not given medications during pregnancy.

Hypothyroidism is usually diagnosed in early pregnancy as blood levels of thyroid is routinely checked for all women ante natally( during the first visit). Medications should be started accordingly. There are lots of hypothyroid women in our medical institutions who have given birth to absolutely fine babies because they were adequately treated. Our hospitals also conduct universal screening for babies to check thyroid level, after 48 hours of birth.

Q: Ever since early teenage, I have been having irregular menstrual periods. Will this affect my chances of getting pregnant? Will it affect the baby's health?

A: Irregular cycles could be due to a number of reasons. Fibroids, polyps, endometriosis, tuberculosis, hypothyroidism are a few of the causes. Ofcourse, there is a chance of delay in getting pregnant, if it is not treated. But once you get pregnant, there is no chance that your irregular periods would affect the baby’s health.

Q: 2-3 years back, in my early twenties I was detected with fibroids? Now having got married, will they affect my chances of getting pregnant? Will it result in any complications?

A: Complications of fibroids depend upon the type and location of fibroids. Submucus fibroids can cause difficulty in conceiving. Intramural fibroids can cause recurrent abortions, but there are lots of women with fibroids who deliver without complications. If fibroids are more than 7 cm size, it will definitely affect pregnancy. If doctor advises surgery, it can be done between 4th and 6th month of pregnancy or after the delivery.

Q: Lots of semen flows out of my vagina after sexual intercourse with my partner. Will this affect my chances of pregnancy?

A: It is perfectly normal that semen flows out after sexual intercourse. Sperms consist only a small amount of the ejaculate. Yet, if you can lie still on the bed for 10-15 minutes on the bed after intercourse, it would help the sperm to easily pass through the cervical canal and reach the eggs.

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