Pregnancy, Pregnancy Problems

Urine Infections in Pregnancy

Burning, stinging, smelly urine? Yeah, pregnancy is all about the glamour! Unfortunately, women are more likely to get urine infections when they are pregnant. Find out more about what causes them, what you can do to prevent them and what treatments are available.

woman wc sign

Why urine infections are common in pregnancy

During pregnancy, you have many different hormones at different levels in your body. These hormones help your body to nurture and develop your baby. They also help prepare your body for birth. One of the hormones involved is called Relaxin. This hormone is brilliant at relaxing (yes, really) the small vessels in your body. These vessels might be blood vessels or the tubes which carry your urine from your kidneys to your bladder or from your bladder to the exit! Relaxed blood vessels make it easier to send more blood flow to the baby to help them grow. Relaxed tubes for urine make it easier for bacteria to enter these tubes and cause urine infections. You can also find more information on the effects of Relaxin in my article on pelvic pain in pregnancy.

How do I know if I have a urine infection?

urine pain

The symptoms of urine infections include:

pain when passing urine;

smelly urine;

cloudy urine;

lower back pain on one or both sides of your back;

feeling generally unwell;

and needing to pass urine urgently but only passing small amounts when you do.

That last one can simply be because your baby is bouncing about on your bladder and making you think it’s full. However, if you have any of the symptoms of a urine infection, you should get a urine sample checked by your midwife or doctor. You can also have a urine infection without any symptoms, which is why your midwife checks your urine sample at every appointment just in case.

When the midwife checks your urine, she is looking for things like proteins, nitrites and leucocytes. Proteins can show up because the bacteria are made of proteins, nitrites because some bacteria produce these, and leucocytes because your body is producing them to fight off the infection.

Treatment for urine infections in pregnancy

The standard treatment for a urine infection is antibiotics. You will be asked to provide a urine sample which will be sent to the hospital laboratory. They will check which antibiotics work best to kill the bacteria. However, you can be started on antibiotics before the results come back, as there are general groups of antibiotics we can start with. The doctor will contact you within a couple of days if we need to change the antibiotics or if your sample actually showed that you have no infection.

It is important to complete the whole course of the antibiotics and to provide a sample at the end of the antibiotics to confirm that the infection has gone. Untreated urine infections can occasionally spread up into your kidneys and make you very ill, even possibly needing hospital care, so please ask for help if you think you have an infection.

Ways to prevent urine infections

toilet roll

So how can you reduce your risk of a urine infection, even if you do have that troublesome Relaxin hormone floating around your body?

  • Good Hygiene.
    • Make sure that you are keeping clean. When you go to the loo, wipe from front to back. You can even get wet wipes to use after you’ve used the toilet just to keep everything fresher.
    • Change any pad or liners regularly. You do tend to have a heavier discharge during pregnancy, so you may be using liners or pads to keep your underwear clean. Just remember to keep changing these if they become wet or soiled.
  • Keep drinking
    • Drinking plenty of fluids is really important. It keeps you and baby hydrated, which regulates your own and the baby’s heartbeats. It also means that you are passing urine a lot. This might be inconvenient but passing lots of urine means you are flushing out any nasties before they can start an infection.
  • Good sexual health
    • Mother told you to wee after sex and she was right. Any sexual intercourse can introduce bacteria into the area, some of which might want to set up shop and cause you an infection. By passing urine, then perhaps using a wet wipe or two, you are going to help flush them out of the area before they do.

Other things to consider

Some women find out during their pregnancy that they have a bacteria called Group B Strep in their urine or around their vagina. If it is in the urine it should be treated as usual but this bacteria can also impact upon your labour, birth and baby. I will be writing another post on Group B Strep and will link to it as soon as I have, but in the meantime, here is the link to the Royal College of Obstetricians and Gynaecologists patient information on Group B Strep.

 

Urine infections

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Labour and Birth, Pregnancy

Gifts for Midwives

Block letters spell thank you

Maybe you’ve had a baby recently and want to express your thanks to the midwife who cared for you. Maybe you are a student midwife who has come to the end of a placement and wants to show appreciation to your midwife mentor. Perhaps you have a friend or family member who is a midwife. Whatever the occasion, here are some ideas for gifts for midwives that may help if your mind has gone blank.

General Gifts for Midwives

Cards

Midwives love getting ‘Thank You’ cards. It helps us to feel we are making a difference and helping people, which is definitely our ultimate aim. Even if it is just a small card with 3 lines written in it, it can make a difficult day seem not so hard and put a smile on a stressed face. We love to remember your birth or experience with you. Cards can also be used as part of the revalidation process. Revalidation is how midwives renew their professional registration with the Nursing and Midwifery Council. It requires us to provide evidence of feedback on our work, so your card can help us to do this.

Mugs

Stethoscope next to coffee cup

Who can survive the day without a bit of caffeine? Midwives are no exception, so coffee cups or mugs are always a great idea. We may not get a chance for lunch or tea, but sometimes we do get to stop for a drink. Finding a suitable mug in the work kitchen can be a challenge, so a unique mug which is easy to find is a big plus. Some people like thin china mugs, while others prefer enormous chunky mugs. There are so many options in terms of designs such as pictures or slogans. Let your imagination run free.

Chocolates

Chocolates are always a good idea. When we have a busy shift and no time to stop for lunch, a quick scoff of a truffle or fudge can stop the hunger pains for a short time. There are also so many options, from biscuits to selection boxes and more. You’re bound to come up with some original choices.

Fruit

Let’s be honest, we shouldn’t really survive on caffeine and chocolates. Most of us want to try something healthier so a basket of fresh fruit is a refreshing option and can be pretty quick too for those busy shifts.

Equipment Gifts for Midwives

Ever a practical person, a midwife is always happy to receive practical gifts.

Person taking blood pressure

Wheels

I’m sure you’ve seen your midwife with a wheel in her pocket. These tiny plastic whirlygigs can help us figure out when your baby is due or what your Body Mass Index is. Because they are used so often, they do wear out or crack and break. Why not see if you can find a new one for your midwife? Try searching for a pregnancy calculator wheel or BMI calculator wheel on Amazon, the Goodies for Nurses website or the Funky Midwife website.

Pens

I have no idea where all the pens of the NHS go, but there seems to be an epidemic of disappearing writing utensils! We write a lot. Sometimes it feels like we write more than we provide care, which isn’t good at all. However, it does provide you with another gift option. We will always appreciate a lovely pen and if it is not just a standard biro, we’re more likely to chase it if the doctor tries to walk off with it! In order to meet our standards for record keeping, it needs to have black ink and a rollerball or ballpoint pen is less messy than a fountain pen.

Watches

Although Infection Control policies prevent us from wearing any wrist watches, we still need to be able to count seconds and minutes. You’ll probably have seen some midwives with fob watches, which are pinned to our uniforms. Most of the time we buy the cheapest as we have to provide these ourselves. However, there are so many amazing designs out there for fob watches! Having a unique one would always make putting on the uniform a little more fun. Watches need to have second hands on them so that we can measure you and your baby’s heartbeat if our other equipment isn’t available. If we work night shifts a glow in the dark or backlit watch might be really useful.

Hand Creams

Woman applies hand cream

Hopefully, you’ve seen us wash our hands. A lot. As an integral part of care and infection control, we wash our hands more often than you can count. This is good for you, but not great for our skin. It doesn’t have a chance to replenish those lovely nourishing oils between washes, so our skin is often dry and can even crack, peel and itch. Not so glamorous. This is why gifts of good quality hand creams can be a lifesaver for a midwife. Little bottles we can keep in our pockets or bags or larger ones we can leave by the sink are all very much appreciated.

Alcohol Gels

Another thing you might see midwives use is alcohol-based hand gels. These are really useful for disinfecting our hands quickly if soap and water and a clean towel aren’t available. There are actually quite a number of different brands offering hand gels these days. Some have lovely scents, whilst others are said to be more gentle on skin, or even just a pretty colour. As a small but much-appreciated gift, they are definitely worth considering.

So there we are. Just a few suggestions for simple and inexpensive gifts for midwives. Thank you for thinking of your midwife and considering a gift for her. Please know that we really do love sharing the whole pregnancy experience with you and are very happy if we know you have had a good or great pregnancy and birth.

Any other gift ideas I’ve not mentioned? Why not write me a comment below?

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Pregnancy, Pregnancy Problems

Pelvic Pain in Pregnancy

Just when you thought pregnancy couldn’t get any more glamorous, you find yourself struggling with pelvic pain. You start walking with a John Wayne waddle and even the simplest of tasks is accompanied by sharp stabs of pain in your pelvis. What is going on, and how can you solve it or at least soothe it?

WHY PELVIC PAIN HAPPENS

Woman in pain

Your pregnancy causes an increase in various hormone levels in your body, and the hormone responsible in this case is Relaxin. Relaxin does exactly what the name suggests. It relaxes things like your blood vessels and your ligaments.

Relaxed blood vessels are great as because they relax they can hold more blood and send that blood to the baby to help him or her grow. Relaxed ligaments is also a good thing when you consider the process of labour. You have to get a baby out of an area not used to dealing with things that size! By relaxing the ligaments which hold and stabilise your pelvis, the exit area gets wider and giving birth gets easier.

Unfortunately, the downside of relaxed ligaments is the reduction of stability in your pelvis. If this happens very early in pregnancy, it can bring a lot of pain and discomfort. This pain might be around the edges of your pelvis or at the back near your coccyx. Pelvic pain commonly occurs at the front of your pelvis, where the two bones are joined by a pad of cartilage called the pubic symphysis. The only cure is the end of the pregnancy when the Relaxin hormone levels drop back to normal.

Pelvic bones
Pelvic Bones

HOW TO MANAGE PELVIC PAIN

If giving birth is the only cure for pelvic pain, then the key is learning to manage it while it lasts. Here are some tips and tricks I know women have found helpful.

Be ladylike

Woman sitting at window

Have you ever noticed how the Queen sits so elegantly? She is a great example of good pelvic alignment. Since the focus of pelvic pain for many women is the pubic symphysis, keeping your hips aligned and stable is really key.

Try to keep your knees together and your hips at the same level. This is something most of us forget to do on a daily basis. We put one leg into the car, then sit then pull the other leg in, or get out of bed one leg first then the other. We sit on the sofa with our knees curled under us.

Instead, try to sit sideways on the car seat with both legs outside. Then once you are seated, swing your legs in together. When getting out of bed start by keeping your knees together and rolling onto your side. Drop both ankles over the side of the bed and push yourself up using your arms. Sit on the sofa with your feet both touching the floor or out on a footrest in front of you.

Speak to the Professionals

Physiotherapists are the experts in healthy movement and support of joints and ligaments. There are always local specialist physiotherapists who have a great deal of experience in treating and helping pregnant women. They have great advice for back and pelvic pain, separated abdominal muscles and pelvic floor exercises as well as so much more. Please speak to your Midwife or GP and get a referral to the physio service in your area. Even if the pain isn’t too bad at the moment, sometimes the referral can take a couple of weeks and things may be worse by then.

Heat helps

Heat can be very soothing for pelvic pain. Use it as an excuse for an extra long shower or an extra daily long bath. You can also use heat packs or hot water bottles. These are good for positioning directly over the painful points. However, please be careful not to burn yourself and give yourself short breaks without the heat packs so you don’t overheat the area.

Feet in bathtub

Extra support

There are lots of options for extra support to help reduce pelvic pain. These include tubigrips, support belts and taping. All of these offer different levels of support and none will cause any harm to the baby.

Tubigrips and support belts can be supplied by a physiotherapist or sourced online. Tape can also be bought online and applied by yourself or a partner.

Tubigrips can help you feel like your hips are being held in and comfortably surround your whole tummy and back.

Support belts can be found on Amazon in various styles. Some will sit just underneath your bump and give the feeling of lifting it up off the pelvic bone. Others are adjustable with straps across or over your bump. Which style is best for you is a matter of personal preference.

Taping is another option for providing abdominal support. This involves using kinesiology tape in various lines across or around your abdomen. Kinesiology tape is used by sports people and physiotherapists to help provide flexible temporary support to joints, ligaments and muscles. The Rock Tape brand has suggestions for tape positions in pregnancy on its Youtube channel here. Try searching on Pinterest for kinesiology taping in pregnancy as this will also provide lots of great positioning suggestions. Have a look at Amazon for a selection of tape options to buy.

Pain relief

Although taking painkillers regularly throughout pregnancy is not ideal, you may need to consider this if the pain is very bad.  ALWAYS discuss this with a pregnancy professional such as an Obstetrician, Midwife or GP.

Worst Case Scenarios

It is very uncommon for pelvic pain to be completely overwhelming. Usually, measures such as those outlined above will help you manage until the baby arrives. Unfortunately for a very small minority of women, the pain is so bad that they need to use crutches or a wheelchair to get around. If this is you then please keep in touch with your pregnancy professional and make sure you are linked in with the local physiotherapy service. For a small number of women, the obstetrician may be willing to discuss starting labour off early to stop the pain. This is always only done after long discussions regarding the health and well-being of both mum and baby.

Other information

Why not have a look at the helpful physiotherapist videos at Best Beginnings or on your Baby Buddy app?

You can also find more sources of information on the useful links page, including the NHS website and the Royal College of Obstetricians and Gynaecologists website which has guidance on many subjects.

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Pregnancy

What to expect at a pregnancy booking appointment

First Impressions

So you’ve made it to 8 weeks or thereabouts! Well done to you and to little one! Now you get to meet your community midwife for your pregnancy booking and it all feels a little more real.

 

 

First things first – don’t be scared!

Community midwives are a great support during your pregnancy and they are all well trained in being lovely. She will know that you might be feeling anxious and will be keen to put you at ease and get excited with you about your pregnancy.

 

Take someone with you.

You don’t have to take anyone with you, especially if your appointment is at a time that only just fits in with your job. However, if you are apprehensive then taking a friend along is perfectly ok with us! The friend might be your partner or a family member or just a friend who has been through it before themselves.

 

It takes a little while. 

This is not a quick appointment where you’ll be in and out in 10 minutes. Be prepared for it to take up to or even slightly more than an hour. You may need to consider this when paying for parking or considering taking children with you. Bring a drink and snacks for yourself if you need to, we understand how hungry pregnant ladies get!

 

Brush up on your family history.

Part of the booking appointment involves taking a detailed history of your health. However, we will also want to know about your partner’s medical history and any medical issues on both sides of the family. If you aren’t sure, chat to your parents and your partner’s parents. Ask about their health, their brothers and sisters and their parents. Do they take any regular medication? Was anyone born with problems with their eyes, hearing or hearts? Does anyone have to eat special diets or are there any twins in the family?

 

 

Check local maternity unit options.

Depending on where you live, there may be several options for where you can have your baby. You can discuss this with your community midwife. Have a look at the Birth Choices website which provides information on the size of maternity units close to you, as well as available facilities and user feedback.

 

Planning your care. 

Once your midwife has taken your history and recorded details of any medical issues or past pregnancies, she’ll be able to give you an idea of your individual pregnancy care plan. That includes when you will have a scan and whether you will need to see a doctor who specialises in pregnancy (an obstetrician). You’ll have a clearer idea of when your next appointment is and you’ll get your own copy of your pregnancy notes.

 

Your notes – becoming attached to them.

The booking appointment enables us to create a set of pregnancy notes for you. These notes include all the information you have provided and gives you other information about your local maternity services. They also include telephone numbers to use if you have any concerns and are therefore useful for you and us! If you go anywhere while you are pregnant – abroad, just within the UK or just 20 miles down the road, take them with you. Should you need urgent care, the notes provide any maternity unit with important information about you and your pregnancy. Don’t leave the house without them!

 

Blood tests.

You will probably need to have some blood taken for various tests at the beginning of your pregnancy. I will write another post about the tests themselves later on. Just be warned that your community midwife will likely be eyeing up your veins at some point during the booking appointment. Don’t worry if you are scared of having your blood taken. Midwives do it every day and are very good at it. We will do our best to put you at ease, letting you sit or lie down. Calm, gentle conversation can also be wonderfully distracting. If your partner is with you, this could be a perfect time for them to practice helping you stay calm!

 

Meeting your midwife
What happens at your first appointment in pregnancy

 

So there you have it, a general guide to your first appointment with your midwife. It seems like a lot to fit into just one hour. Your head will definitely be bursting with information by the end. You can ask any questions you can think of before you leave. Don’t worry if some pop up in the following days. Make a note of them and when you see your midwife again you’ll be ready to find out the answers.

 

Most midwives will have several booklets and leaflets to give you. This is great as you can read the information in your own time at home. You can also find helpful information on the NHS Pregnancy pages or by downloading one of the many available pregnancy smartphone apps. My recommendation for the smartphone app would be Baby Buddy, which is a UK based app run by a charity, so they aren’t trying to sell you anything or get your name on a mailing list. They just want to give you accurate up-to-date information to help you have a healthy pregnancy.

For further reading around pregnancy care, see my useful links page

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Labour and Birth, Pregnancy

5 Pro tips for surviving early labour

So, the time has arrived.

Baby is now past 37 weeks and could arrive at any time.

You’ve had some tightenings and even very painful Braxton Hicks contractions but then everything stops.

Your hopes are dashed.

The following night, things start up again.

Painful tightenings get closer and closer, sometimes taking your breath away.

You’re up pacing the house in the wee small hours but then morning comes and the contractions fade as the sun rises above the horizon.

You can feel like you’re going crazy. No sleep and no progress can really bring you down.

What do midwives recommend for those long relentless hours?

  • Rest:

This is really really important. There is no easy way to tell how long this will last but in the worst case scenario, you may still have some days to wait until labour becomes consistent. Take whatever rest you can, in large and small amounts spread throughout the day. If you have older children, enlist family and friends to entertain them for a while so you can nap. It’s not easy, but perhaps it is mother nature’s way of preparing you for the sleepless nights to come when baby arrives!

  • Eat:

Get plenty of good nutrition on board. Labour is extremely hard work and you need to have a good supply of energy to help keep your contractions strong and effective. When labour really kicks in, you might not feel like eating so think like a marathon runner and eat as preparation.

  • Try out your pain relief strategies:

Some people go into labour knowing exactly how they will cope with the pain. Others have no idea what they want to try or what will or won’t work. There are so many strategies to choose from, it’s an entire post of its own (coming soon). However, these early painful episodes can be useful in figuring out whether your partner is any good at massaging, or whether the TENS machine you hired online is just going to drive you crazy.

  • Bathe or shower:

Water is well known to relieve labour pain, although you may have to wait until you get to hospital to try out the wonderful wide, deep birthing pool. Luckily, you can definitely try a comforting bath or stand under a cozy warm shower at home at this early point. For some, this may settle the pains down, which will give you a chance to rest. For others, the warm soothing waters can relax them enough to help the contractions get stronger.

  • Check your bags are packed and ready:

Another good idea is to take the time to make sure you’ve got everything packed ready for the hospital. There are tons of great lists online of what to pack and my own list is on its way. While the pains are reminding you of their purpose in bringing baby ever closer, use that focus to ensure nothing gets left behind.

However long these times last, please remember that the baby at the end is definitely worth everything you’re going through. You are stronger and fiercer than you know and you can do this!

Are you worried that the pains are too early or might be real labour pains? Please contact your local maternity unit as soon as possible.

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Pregnancy

You’re pregnant!

Is it really true?

Maybe you’re feeling a little sick, perhaps your boobs are incredibly sensitive or maybe your period just hasn’t arrived. You’re incredibly tired or constantly on the loo or unable to stomach your usual morning coffee. Perhaps you’ve got all these symptoms or perhaps you have none.

Whatever makes you suspect pregnancy, you potter off to your local supermarket or pharmacy and head for the aisle with the pregnancy tests. Some people may hide under an impressive sunhat and dark glasses, paying via the self-checkouts and praying to whoever that they don’t run into someone they know. For others, its a team trip. Your best friend, partner or mum comes along, and you discuss the pros and cons of each type of test.  You then proudly take it to the staffed checkouts and smile broadly at the cashier.

 

Test Options

Tests come in many different packages and seem to offer a myriad of different options. Some proclaim they can tell you incredibly early on, whilst others tell you in words instead of faint lines, to avoid confusion.

Whichever test you choose, they are all looking for the same thing: human chorionic gonadotropin (hCG). This hormone is produced by the growing embryo and is, therefore, a good indicator of pregnancy. The levels being produced by the embryo increase steadily in the first few weeks of pregnancy. If you are using a pregnancy test in the very early weeks of pregnancy (2 – 4 weeks) it is better to use the first urine passed in the morning. This will have higher levels of the hormone and therefore give a more accurate result.

Pregnancy tests these days are very reliable. Most GPs and midwives will not require a laboratory test to confirm what your home test has told you. However, it is worth waiting until you are at least 6 weeks pregnant before you book an appointment with your GP or midwife. This is because there is a higher risk of miscarriage around the time your next period is due. Hopefully this little one will cling on and keep growing well. Good luck!

Did you know?

Before the wide availability of over the counter pregnancy tests, you had to provide a urine sample to your GP. That urine was sent to a hospital laboratory where there were lots of frogs sitting around in cages. A small amount of the urine was injected into a frog and if you were pregnant, the hCG in your urine would cause the frog to produce eggs within 24 hours! Congratulations!

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