{"id":1719,"date":"2010-12-13T09:44:14","date_gmt":"2010-12-13T09:44:14","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/advice\/"},"modified":"2023-08-22T09:38:31","modified_gmt":"2023-08-22T08:38:31","slug":"advice","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/obstetrics\/subsequent-check-ups\/advice\/","title":{"rendered":"Advice"},"content":{"rendered":"

Nutrition<\/strong><\/h3>\n

In principal, women who live in Western Europe and who eat a regular healthy diet<\/strong>, take up sufficient nutrients<\/strong>, and so dietary measures are not necessary. An exception to this might be vegans and Islamic women who fast<\/strong> during Ramadan. Consultation with a dietician is then desirable. Slimming diets are advised against.<\/p>\n

As bowel movements are often slower during pregnancy, an increased fluid intake<\/strong> is advised. It is recommended to take some of this extra fluid in the form of milk and dairy products. As the iron requirement increases during the second and third trimester of pregnancy, sufficient iron-rich foods<\/strong> must be eaten during this period.<\/p>\n

Hygiene<\/strong><\/h3>\n

Pregnant women are advised not to use vaginal douches<\/strong> and gels<\/strong> as part of their personal hygiene and also not to wash the vulva with soap. Showers and baths are permitted. There is no objection to using a sauna, as long as the temperature is not set too high and the pregnancy is more advanced than 16 weeks. There are indications that if the body temperature of pregnant women becomes too high during the first trimester of the pregnancy, it can have a teratogenic effect on the embryo.<\/p>\n

Postnatal Care<\/strong><\/h3>\n

In the Netherlands, a maternity assistant is in principle available for all pregnant women to assist with parturition and to care for mother and child during the postnatal period. Postnatal care can be requested from a regional postnatal care centre or from a private postnatal care centre. In principle, postnatal care is only refused if the woman, following parturition on a medical indication, decides to go home against the express advice of the treating gynaecologist.<\/p>\n

The pregnant woman can choose from two types of postnatal care:<\/p>\n

    \n
  • Complete daily postnatal care:<\/strong> The maternity assistant provides assistance during parturition and is present at the new mother\u2019s home throughout the entire day for a period of about 1 week. Besides nursing duties she also performs household tasks.<\/li>\n
  • Postnatal care visits:<\/strong> In addition to assistance during parturition the maternity assistant is present in the family home during a period of 1 week for several hours per day (spread over the morning and afternoon<\/em>). She only cares for the mother and child.<\/li>\n<\/ul>\n

    Postnatal care should be requested before the 16th week of pregnancy.<\/p>\n

    Antenatal Classes<\/strong><\/h3>\n

    The best-known pregnancy class is the antenatal exercise class. Pregnant women start the classes in the 28th to 30th week<\/strong> of pregnancy. In these classes, the focus is not physical exercise but on relaxation<\/strong> and breathing exercises<\/strong> and learning pushing techniques<\/strong>. Plenty of attention is given to making the pregnant woman aware of what is happening to and in her body.<\/p>\n

    Pregnancy yoga<\/strong> is a yoga course of 4 to 5 months<\/strong> that aims to achieve optimal relaxation of the woman during parturition by means of relaxation and breathing exercises. The underlying philosophy of this approach is that an optimal state of relaxation in the woman facilitates parturition and makes it less painful.<\/p>\n

    Haptonomy<\/strong> courses attempt to facilitate a pain-free birth by means of information<\/span>, gymnastics<\/span> and relaxation<\/span> and breathing exercises<\/span>. In addition to this, an effort is made to obtain as much intimate contact as possible between the parents and the child at an early stage of pregnancy.
    \nClasses are given to groups of pregnant women, helping the participants realise they are not alone in the symptoms and uncertainties they experience.<\/p>\n

    Alternative Birthing Positions<\/strong><\/h3>\n

    Every pregnant woman with an uncomplicated pregnancy can give birth in any position<\/strong> she wishes. The horizontal<\/span> and a semi-sitting position<\/span> seem to be the most commonly used positions at present. If a woman prefers to give birth in the sitting position, then various birthing stools<\/span> are available. Squatting is a way of giving birth without using a birthing stool. It is a birth position that few Western European women can maintain without support. Giving birth in the semiprone position<\/span> is experienced as pleasant by some women.<\/p>\n

    Sexuality<\/strong><\/h3>\n

    Pregnancy can affect a couple\u2019s sex life<\/strong> in a positive or negative manner. From a medical viewpoint, there is no reason to avoid sexual intercourse or orgasm during a healthy pregnancy. An orgasm causes uterine contractions<\/span> that some women experience as Braxton-Hicks<\/strong> contractions or mild abdominal cramps.
    \nIn highly pregnant women, the abdomen can get in the way when attempting sexual intercourse in the face-to-face position. Alternative positions during intercourse such as coitus from behind (spooning<\/em>), can then be suggested.<\/p>\n

    Sporting Activities<\/strong><\/h3>\n

    In general, a pregnant woman can practice any amateur sport for which she had already trained before the pregnancy, as long as:<\/p>\n

      \n
    • The pregnancy proceeds unhindered.<\/li>\n
    • There is no major risk of falling or being knocked down.<\/li>\n
    • No complaints develop.<\/li>\n
    • The sport is not practised to the level of extreme tiredness.<\/li>\n<\/ul>\n

      As the pregnancy advances<\/strong> and the woman\u2019s weight increases<\/strong>, the ability to undertake physical exercise decreases<\/strong>. In the last trimester of pregnancy, the increasingly heavy uterus reduces the woman\u2019s sense of balance<\/span>. Also, the increased mobility in the pelvic and vertebral joints reduces the locomotor stability and places an extra burden on the muscular system. The woman falls more easily and this can be a reason for stopping certain sports. It can also be a reason to stop riding a bike.
      \nSome sports, such as horse riding and scuba diving, are advised against. The Undersea Hyperbaric Medical Society has drawn up recommendations concerning women and diving. It advises against diving during pregnancy, as the unborn child runs greater risks of decompression disease (Caisson\u2019s disease<\/em>) and increased partial oxygen pressure of the diving mother, and because insufficient data are available to determine a safe diving depth and diving time for pregnant women.<\/p>\n

      Workload<\/strong><\/h3>\n

      Pregnancy is not an illness and therefore does not constitute a reason to stop working. However, pregnancy is a physical condition that places a burden<\/strong> on the body. This often manifests as tiring more easily. This tiredness can form a hindrance to working and may require an adaptation of the duties performed or the work times. Specific protection with respect to changes in the work are necessary for women who work with harmful substances (e.g. radiographers<\/em>).<\/p>\n

      Flying<\/strong><\/h3>\n

      The greatest risk of (intercontinental<\/em>) flying is the occurrence of complications without the possibility of adequate help within a short space of time. In-flight parturition is an event that must be avoided. All airlines have guidelines for the acceptance of women who are more than 35 weeks pregnant<\/span>. When deciding whether or not to accept a woman who is more than 35 weeks pregnant as a passenger, factors such as the duration of the flight<\/em>, the number of stopovers<\/em> and parity<\/em> play a role. After the 38th week of pregnancy, pregnant women are generally only accepted if there is an urgent necessity for them to fly. In such cases the duration of the flight may not be more than two hours and before the flight an examination must take place to determine whether parturition has already started. Women with a history of premature birth are advised against flying after the 32nd week of pregnancy.<\/p>\n

      Vaccinations<\/strong><\/h3>\n

      In principle, vaccinations during pregnancy are advised against unless these are strictly necessary. After the administration of any live vaccine, pregnancy should be avoided until 2 to 3 months after vaccination. If travel vaccinations and advice with respect to travel prophylaxis are necessary, the guidelines of the municipal health expert should be followed.<\/p>\n","protected":false},"excerpt":{"rendered":"

      Nutrition In principal, women who live in Western Europe and who eat a regular healthy diet, take up sufficient nutrients, and so dietary measures are not necessary. An exception to this might be vegans and Islamic women who fast during Ramadan. Consultation with a dietician is then desirable. Slimming diets are advised against. As bowel […]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[57],"tags":[138],"class_list":["post-1719","post","type-post","status-publish","format-standard","hentry","category-subsequent-check-ups","tag-obstetrics"],"acf":[],"yoast_head":"\nAdvice - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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