I’m starting to really enjoy maternity leave. Three-month-old babies are sociable, cuddly, delightful, and mostly over the crying stage. I’ve gained some confidence and experience and am now able to go with the flow a lot more. My baby brings me so much pleasure every day and even though being a mum can be very hard work and the nights are still challenging, I’m beginning to enjoy so much more of it.

I finished working on a thesis just before I went on maternity leave. I was thirty-four weeks pregnant when I submitted it for examination. The examiner’s comments have come back and as expected I will have to trawl through my thesis and make the changes that they want done. As I contemplated this daunting task, a huge part of me just didn’t want to give up my time with my baby. Am I getting into the mummy groove finally, or am I stuck in a mummy rut? What do you think?

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I go back and re-read this book any time I’m starting to doubt what I’m doing with my baby’s sleep. Pinky is a lactation consultant and somewhat of a baby sleep and parenting guru. She has written a wonderful book on gentle and nurturing ways of helping your baby sleep. She explains the science of infant sleep, your child’s development, how to develop sleep associations and how to help soothe your baby to sleep. I found her book both informative and reassuring. I would highly recommend it to all parents who are struggling with their child’s sleep, especially those (like me) who become riddled with self-doubt and confusion. Read it to regain your confidence and reconnect with your baby.

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Before I had a baby, I had things under control. I went to work at a certain time and returned home (mostly) within a certain time. I cooked dinner several nights a week. I paid my bills, did my taxes, caught up with friends, wrote a thesis, travelled. I knew that if I did A then B would be the effect.

I read baby books before my baby was born. I thought I had it all worked out. Yep, I was confident about this parenting thing. How hard could it be?

I didn’t realise that babies literally didn’t come with an instruction manual. Surprise surprise – they are all individuals just like we are! Or perhaps the manuals I was reading were for some other model of baby. Suddenly A might lead to C or Z or even F! and never consistently! I tried to make it better by reading more, getting more advice, only to become totally confused and riddled with self doubt.

Some of the hardest things that were beyond my control were sleeping and crying patterns. It got to the point where every evening I kept waiting for the bomb to drop. For weeks I couldn’t sleep, cursed by insomnia as well as sleep deprivation, my heart pounding as I lay there desperately trying to get some precious shuteye before my “shift” started.

I’ve realised now that my illusion of being in control before children was false, of course. We just think we’re in control and most of the time life plays along with this (just like easy babies play along with some parents’ thinking that they managed to train their babies into a nice sleeping routine).

Most importantly, I’ve remembered a saying from the very wise Victor Frankl, a psychiatrist who survived a Nazi concentration camp. He said “Everything can be taken from a man or a woman but one thing: the last of human freedoms to choose one’s attitude in any given set of circumstances, to choose one’s own way.” In other words, what I do have control over is how I approach the journey of parenthood. And that makes me somehow feel even more in control than I did before.

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I gave up a lot of things during pregnancy. Alcohol, sushi, doing backbends during yoga, surfing, running after 6 months, and towards the end of my pregnancy I gave up wearing anything that wasn’t stretchy.

Since Star was born I’ve been enjoying more and more of the things that I used to do before pregnancy. Some of these are trivial, like being able to sleep on my back again, and having a sip of champagne or a cold chicken sandwich. Others are things that I feel make me “me” and which I hold very sacred, like the sound of my runners pounding the running track again. On the weekend, we took Star, now 2 months, to the beach for the first time. As I heard the sound of the pounding surf and caught my first glimpse of that wide expanse of beach and the foaming sea, I felt something well up deep inside of me. “I remember this!” it seemed to say. “This is part of me. I’m coming back”. The question is, Am I still the same person? And am I just the sum of my parts? And underlying that are the questions of what identity is, and who am I really?

The first few weeks of parenthood have the ability to completely wipe out your sense of who you used to be – you know, the independent, capable, high-achieving person who contributed to society and had a full night’s sleep every night. After that you have to gather up what’s left of the chaos and start to piece yourself together again. I know I will never be the same person again. Physically I now have a Caesarian section scar, my boobs are huge and will eventually become floppy when I wean my baby, and I am not sure if my jelly belly will ever completely go away. But when I look at myself in the mirror that’s when I see the change the most – in my eyes I see a different person – some nights a desperate exhausted mother, other times confident, mature and knowing.

I don’t expect to return to the old “me” as I used to be. I know I am now responsible for a tiny human being as they grow and develop, and that responsibility will never cease. For the rest of my life I will consider someone else’s needs as well as my own. But I do wish to restore those parts of me that I felt made the most difference. Physical fitness and challenge, time-out while running, easing into a yoga pose, paddling madly to catch a wave. It will take a bit more planning to be able to incorporate these into my life as a mother, but if I don’t make the effort I fear that large and vital parts of me will disappear and I will be left an empty shell. And an empty shell cannot make for a good mother.

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I’m a huge fan of physical activity overall, and I didn’t want to stop being active during pregnancy. Fortunately, we know now that exercise during pregnancy is safe and carries many benefits for mother and baby. Research suggests that exercise during pregnancy can:

  • reduce the risk of developing gestational diabetes mellitus by 50%
  • reduce the risk of pre-eclampsia
  • ensure weight gain is healthy and not excessive
  • improve maternal well-being
  • reduce physical complaints such as back pain and insomnia
  • reduce the risk of premature birth
  • reduce the risk of operational delivery
  • shorten labours, including the pushing stage
  • decrease the need for pain relief during labour
  • decrease risk of maternal cardiovascular disease in the long term
  • decrease post-partum Body Mass Index.

It seems that regular aerobic exercise, the kind that gets you breathing faster, helps to build a healthier and more efficient placenta.

Babies born to mothers who exercised during pregnancy are also thought to settle more easily and be more intelligent at 5 years.

Personally, I couldn’t have got through my pregnancy without exercise. I made exercise a priority because (1) I wanted to maintain my fitness so I could get back into running post-partum; (2) I wanted to gain weight in a healthy weight and not “balloon out”; (3) I wanted a healthier baby. Exercise improved my mood and self-esteem, often increased my energy levels, allowed me to connect with nature, improved back pain, helped my sleep, helped me keep weight gain slow and steady as is recommended, and generally made me feel and look fabulous during pregnancy. I think it’s vital that you have a set of personal reasons as to why you want to continue on with physical activity during pregnancy, or perhaps start doing some if you are currently inactive. Do consult with your health provider as soon as you know you are pregnant, and read on about safety of exercise during pregnancy.

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For many of us, the thought of going without alcohol for nine months is daunting. After all, drinking is such a social activity and wine is such a lovely accompaniment to a good meal…

I certainly found that avoiding alcohol was one of the most challenging aspects of being pregnant. I certainly loved my cocktails with the girls, bubbly for any occasion, beer on a hot summer’s day, and a crisp glass of sauvignon blanc with seafood – before pregnancy, that is. I chose not to drink at all during pregnancy, and while this was difficult, it is what is currently recommended by the experts (that is, there is no safe level of drinking during pregnancy).

Alcohol passes straight into your unborn baby’s bloodstream and is toxic to her brain and other cells. Babies born to mothers who drink at high levels during pregnancy suffer from Fetal Alcohol Syndrome, which is characterised by facial abnormalities, growth retardation in utero, and a range of effects on the brain including small brains, mental retardation, learning disabilities, seizures and ADHD (Attention-Deficit Hyperactivity Disorder).

Given that alcohol can readily induce these effects in a baby, and that nobody can guarantee that even small amounts of alcohol are not harmful, I found it easier on my conscience to abstain completely – and this is what I recommend to my pregnant and preconception patients.

When you are stone cold sober and others around you are imbibing in alcohol, you get to make some interesting observations – such as how silly you might have looked at times when you were inebriated, or how you may have relied on alcohol as a relaxant after work or on weekends. It makes you more self-sufficient – you have to find other ways to relieve stress and have a good time.

Do try not to fall into the trap of having calorie-laden soft drinks as an alcohol substitute. I certainly went through a lot of ginger beer and lemonade initially because I just wanted to nurse a drink in my hand! This can predispose you to excessive weight gain and gestational diabetes. Try half strength fruit juices or just plain water instead. I did love sparkling mineral water but this could deplete your calcium stores and gives you a whacking dose of sodium, so it’s to be enjoyed in small quantities.

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This is a fantastic book that doesn’t dumb down the importance of being active during pregnancy, and goes into great detail about the safety and appropriateness of many different sports and activities. It explains the benefits of exercise during pregnancy, precautions, and has recommendations as to what to start if you were fairly inactive before getting pregnant. It then discusses a whole heap of different activities (including hiking, surfing, swimming, snowboarding, horseriding…) and whether or not they are appropriate in pregnancy depending on the trimester you are in and your current level of expertise. No absolute recommendations are made (except, notably, for diving, which is not recommended at all during pregnancy) – just levels of risk to consider ie low, medium or high. I really like the fact that it allows you to make an informed decision about what you want to do during pregnancy and gives plenty of practical advice about making exercise safer and more comfortable. It doesn’t just tell you that walking, swimming and yoga are excellent exercise during pregnancy and leave it at that. As with many books that I recommend, I like the fact that it’s written by a medical doctor and hence, in my opinion, gives a balanced view to the picture. I highly recommend this inspiring book to all women, even those who didn’t do any exercise before pregnancy.

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One of my biggest fears was developing “cankles” in pregnancy. You know, when you don’t know where the calf ends and the ankle begins? I felt there was enough to deal with having a giant bump, bigger boobs and thighs and bum that are definitely more generous than before. I didn’t need my body image completely shattered by developing cankles as well!

Well, I was lulled into a false sense of security because for the first 36 weeks of pregnancy I was cankle-free. My feet remained slim, my ankles svelte, and my ego huge. Then suddenly, for no reason (apart from my ballooning uterus obstructing blood flow back to the heart, I suspect) I suddenly turned into the Elephant Woman. I had joined the 75% of women who develop the dreaded cankle during pregnancy.

Walking, swimming and drinking lots of water have been recommended as good cankle prevention exercises, and they probably helped me up to that point. Beyond 36 weeks, what worked best was compression. I threw my dignity away and wore support stockings – the kind you get from the pharmacy to prevent clots in the leg during air travel. They looked awful but felt good and kept my feet to a manageable size. Putting my runners on and going for a long walk also helped – probably because there was lots of compression happening inside my now snug sneakers. I was already spending lots of time with my feet up and this didn’t make much difference, although spending time with my legs dependent (or below my knees ie sitting or standing for too long) did make the cankles worse.

If you do develop swelling, and this is sudden, or is generalised (eg in the face and hands as well as the legs), or if you feel unwell and “off” with the swelling, get yourself checked out straight away, as it could be a sign of pre-eclampsia – a medical condition during pregnancy that can be very dangerous for both mother and baby. Otherwise, good luck and here’s to your ankles looking lovely during pregnancy ☺

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Let’s face it, pregnancy often feels like an endless list of restrictions, and nine months is a long time. There’s alcohol and smoking and caffeine; modifying your workout routine; “listening to your body”; and all sorts of old wives tales about not having sex, or eating too much, eating too little, not enough fish, too much fish… .It can drive a pregnant woman crazy!

Then there’s the listeria thing, and if you’re like most women, this would create the most restrictions in your life. It can seem at times that there is NOTHING that you can safely eat. Especially at lunch. Take my friend, newly pregnant, who went to a café, and tried to order a meal.

Waiter: “How about a chicken and avocado roll?”
Friend: “Can’t have cold chicken – sorry” (She could have had it toasted, but only if she was sure that it was heated up to the right temperature”
Waiter: “Smoked salmon then?”
Friend: “No can do, no cold seafood either”
Waiter: “Prosciutto and salad?”
Friend: “I love prosciutto, but no cured meats…”

Argh!! Is it worth it? Are  we too paranoid about listeria and other bugs that can “harm our baby”?

I am a strong believer in making informed decisions. This means knowing exactly what you are dealing with and how it works and how to prevent it and what the risks actually are. It’s all our choice in the end – there are no laws about these things. Bear in mind though that this time it doesn’t just affect you, it affects a wee little human inside of you.

Firstly, I’ve seen Listeria in action and it’s awful. Being a doctor, we see the worst case scenarios, but the point is, this actually happened to someone, and she lost her baby.  I wouldn’t wish Listeriosis on my worst enemy.

So how common is it? The Victorian government’s infectious disease website (www.health.vic.gov.au/ideas) says it’s relatively uncommon. Listeriosis is an uncommon disease in humans. In Australia in 2003 the rate was 4.6 infections per 100 000 births per year for maternal-foetal infections. That year there were 250000 registered births which means there were 11-12 cases of Listeria infections in the whole of Australia. So, not common. However, outbreaks do occur, as happened in August 2009 with the tragic case of the contaminated chicken wraps that were served on Virgin blue flights. 13 people developed listeriosis. Of these, 8 were pregnant women, and there were 3 foetal deaths.

What does one do when the risk is low but the consequences potentially fatal? You need to consider the benefits of taking the risk. In other words, is it worth it?

There are great resources on the web regarding advice on how to avoid listeria and other problematic food-borne infections in pregnancy. The Food Standards website had the most informative brochure (see link below). Instead of just following the blanket rules of “no soft cheese, no pate” etc, I found it helpful to learn a little bit about Listeria and how it grows. It made it a bit easier to make food choices when the rubber hit the road. Here are some pointers from their brochure that I wasn’t aware of before:
•    Store leftovers for up to 24 hours only
•    “Processed” (packaged) food may be safer than unprocessed because of the heat treatment required
•    Deli foods are not safe because there is no guarantee as to how long cold foods have been left standing and refrigerated
•    If it’s steaming hot, it is most probably safe

See the brochure for more information.

Basically, if fruits/vegetables/cold meats have been prepared and left to refrigerate for more than 24 hours there is a risk that Listeria may have multiplied significantly. This includes vegetable garnishes, salads, even “fresh fruit” juices at juice bars (Have you ever noticed how the fruit is cut up and left out in a fruit bar before juicing? It also may have been left in the fridge for much longer before being put on “display”).

For me personally, the benefits of avoiding Listeria as much as I can far outweigh the small pleasures I might gain from having a cold chicken sandwichor the convenience of a pre-prepared salad. I try to focus on what I can have in pregnancy (even though at times this seems like very little…) and eat at home as much as I can. If I’m out I can still enjoy a dining experience – grilled wagyu beef at a Japanese BBQ restaurant was one recent guilt-free gastronomic adventure. I also have a little book in which I have written down all the things I’m going to eat as soon as this baby is born. Some examples are a ham sandwich with mustard, sushi, potato salad, poached eggs with hollandaise sauce… you get the drift. Eventually these nine months will be but a memory and I’ll be able to eat all the sushi I can muster. Bring on the post partum seafood buffet!

Food Standards Australia

New Zealand Food Safety Authority

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More like my Whole Pregnancy Bible! I came across this book before I fell pregnant, and it has seen me through the preconception period and entire pregnancy. If patients come in to see me and are thinking of conceiving or are pregnant, I always refer them to this handbook. I refer to the chapters on nutrition extensively during my consultations with pregnant or preconception patients.

I really admire Joel Evans. He’s an obstetrician who adopts a truly holistic approach to his practice which incorporates nutrition, mind-body medicine, and complementary therapies. He comes across as an extremely gentle, caring and nurturing caregiver from his writing. I also like the fact that he is an obstetrician and hence all his advice is very safe.

The handbook explains mind-body medicine, and covers pre-conception and pregnancy health comprehensively, with chapters devoted to nutrition, living and working while pregnant, exercise during pregnancy, medical complications of pregnancy, and common symptoms during pregnancy. The pregnancy timeline was particularly useful, as are the chapters on early pregnancy and late pregnancy. Dr Evans also provides suggestions for treating common pregnancy ailments using both safe Western medical treatments, gentle changes in lifestyle, and safe complementary treatments where appropriate (such as acupuncture or herbal treatments).

I cannot recommend this book highly enough to anyone who is thinking of falling pregnant or is already pregnant. It is a wonderful read and contains so many pearls of wisdom.

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