March 01 2017
Top ten pregnancy questions answered by our midwife and sonographer Becky Rutherford
As well as being an ultrasonographer here at the London Ultrasound Centre, I am also a qualified midwife. I am always being asked questions about what women should and shouldn’t be doing during their pregnancy. Here are the top ten questions I am always asked, and the answers I give.
1. When should I be having scans during pregnancy?
The NHS offers you two basic scans; the ‘dating’ scan and an ‘anomaly’ scan. Dating scans are generally carried out when you are between 8-14 weeks pregnant and do exactly what they say. During the scan we are checking that there is just one baby there or confirming a multiple pregnancy. Your due date is calculated by measuring your baby from head to bottom (this measurement is called a CRL which stands for crown rump length); also during this scan we check that baby is developing as expected and look at his or her limbs, skull, brain, abdominal wall and some of the organs such as the stomach and bladder.
The anomaly scan is carried out later in pregnancy between 18-21 weeks and looks at your baby in much closer detail to assess growth and to check that baby is continuing to develop normally.
In addition to these scans at the London Ultrasound Centre, we also offer a range of other scans for your peace of mind including early pregnancy scans, cervical scan, gender identification scan, welfare scans and 4D.
2. What screening tests should I know about during pregnancy?
Screening tests in pregnancy assess the risk of your baby having a chromosomal abnormality.
The Combined Test (CBT) – This is the most commonly used screening test in the UK for assessing the risk of Downs Syndrome, Edwards Syndrome and Patau’s syndrome. It is carried out between 11-14 gestation and involves an ultrasound scan and a blood test. This test is offered to all women within the NHS (thelondonultrasoundcentre.co.uk/first-trimester-nuchal-scan)
Non-Invasive Prenatal Test (NIPT) – This screening test has been found to be more accurate for assessing the risk of Down’s Syndrome and can be carried out earlier than the Combined Test from 10 weeks. It is not currently available within the NHS although some hospitals are using it in trials for women who have a high-risk result for the CBT. As with the CBT it also looks for Downs, Edward's and Patau's. The London ultrasound Centre offer NIPT which involves just a blood test although a scan at around 12 weeks is also still recommended. (thelondonultrasoundcentre.co.uk/private-pregnancy-harmony-non-invasive-prenatal-downs-syndrome-safe-genetic-DNA-blood-test)
Amniocentesis test – This is a diagnostic test and involves a medical procedure to take a small sample of amniotic fluid from around your baby to be analysed in a lab. This procedure is carried out by a doctor specialising in fetal medicine. This test is usually carried out from 16 weeks if you have had a high-risk result from a screening test as mentioned above. (thelondonultrasoundcentre.co.uk/amniocentesis-test)
3. How do I work out my due date?
A due date for a pregnancy is calculated by counting 280 days (40 weeks) from the first day of your last menstrual period. However, this is based on everyone having a 28-day cycle and ovulating on day 14. To accurately date a pregnancy a dating scan is recommended between 10-14 weeks.
4. When will I feel my baby move?
Most women begin to feel their baby’s movements around 18-20 weeks into their pregnancy. If it is your first baby it might be a bit later but on the other hand, if it is your second or subsequent baby you may notice them much earlier! If you haven’t noticed any movements by 24 weeks then you should contact your doctor or midwife. A lot of research has been carried out over recent years regarding the importance of keeping an eye on your baby's movements during pregnancy and you can read the latest advice here: kickscount.org.uk
5. What exercise can I do during pregnancy?
It is absolutely fine to exercise during pregnancy if you are feeling up to it, and it can be very beneficial. Of course, there are some sports that should be avoided for obvious reasons; (for example, rugby is not a great idea). Any exercise that you are used to doing when you are not pregnant is fine to continue with. It is not advisable to start any new sports or training during pregnancy though so have a chat with your Dr or midwife first. And don't forget to keep well hydrated and listen to your body at all times. This is also a great time to start practising pelvic floor exercises. The muscles of the pelvic floor stretch a lot during pregnancy under the weight of the growing baby; they run from the front of the pubic bone in a hammock style to the base of your tail bone. If these muscles become weak they can lead to embarrassing leakages of urine when you laugh, cough or sneeze so get squeezing. To engage the pelvic floor muscles you need to squeeze them as if you are trying to stop yourself from passing urine. I always tell women to imagine they need to pass wind but Brad Pitt has just walked in the room.... there you go... you would find those pelvic floor muscles pretty quick!
6. Is it safe for me to fly during pregnancy?
The answer to this is generally yes. Up to 28 weeks into your pregnancy most airlines are happy to have you if your pregnancy is healthy and uncomplicated. After 28 weeks you may find that the airline will require a fitness to fly letter that you will need to obtain from your GP or midwife. Pregnant women are at a higher risk of developing blood clots in the deep veins of the legs during flights so it is advisable to wear flight socks that are knee high support socks that help with the circulation of blood. Keep mobile as much as possible during your flight and remember to keep well hydrated.
7. What foods should I avoid during pregnancy? Can I eat prawns?
There are some foods that absolutely must be avoided in pregnancy. These are:
● Mould-ripened soft cheese such as Brie, Camembert unless they have been cooked.
● Soft blue cheese such as Gorgonzola and Roquefort unless they have been cooked.
● Pate including vegetarian pate.
● Raw or partially cooked eggs.
● Liver or liver products.
● Raw or undercooked meat.
● Game as this may contain traces of lead from lead pellets.
● Shark, swordfish and Marlin.
● Tuna and other oily fish should be limited to no more than two portions per week.
● All fruit and vegetables should be thoroughly washed.
● Caffeine should be kept to a minimum of no more than 200mg per day.
Shellfish such as prawns are fine as long as they are thoroughly cooked. You can find more info here: nhs.uk/conditions/pregnancy-and-baby/pages/foods-to-avoid-pregnant.aspx
8. Can I use over the counter medication during pregnancy?
The current advice from the Royal College of Midwives is that all pregnant women should avoid the use of over the counter medications and should seek advice from their GP, midwife or a pharmacist first. Paracetamol is thought to be safe for use during pregnancy.
9. When will my morning sickness end?
Morning sickness still remains a bit of a mystery but is thought to be caused by the high levels of the hormone HCG that is produced during pregnancy. Morning sickness should really be renamed as pregnancy sickness because it can occur at any time of the day and can leave you feeling pretty miserable. It is thought to peak at around nine weeks into the pregnancy and tends to ease from around 16 weeks. Some women are just nauseous, some vomit and some can even be affected by a severe form called Hyperemesis Gravidarum. If you have severe symptoms and notice your passing less urine that is dark in colour, you are not able to control vomiting or feel weak and faint then contact your doctor or midwife.
There are things that you can do to ease the symptoms; the two things that are evidence based are eating/drinking things containing ginger and using acupressure or acupuncture such as travel sickness bands. However, tiredness can make you feel worse so get plenty of rest and keep well hydrated and try to eat little and often.
10. Is it safe to have sex during pregnancy?
The question that everyone is always too embarrassed to ask! Sex during pregnancy is perfectly safe; if you are experiencing any complications such as bleeding during early pregnancy or you have a very low lying placenta that is causing bleeding then some doctors will advise you to avoid intercourse. Later in pregnancy, you should also avoid intercourse if your waters have broken. Some women just don’t feel comfortable about having sex when they are pregnant and it is important to remember that your choice should always be respected. Other than that though you are good to go.
Becky Rutherford is a midwife sonographer specialising in obstetrics and gynaecology at The London Women’s Clinic in Harley Street and The London Ultrasound Centre. She provides support for women undergoing fertility treatment and carries out obstetric scans. Passionate about normalising birth and empowering women to make informed choices, in her spare time writes a blog about birth and midwifery.