Pregnancy brings with it a set of challenges, and for a diabetic woman, these only increase further. Earlier, the risks of dealing with pregnancy and diabetes as a combination were too high. However, over the last few decades, things have changed. The age at which women are choosing to have a baby has gone up. On the other hand, the age of onset of diabetes has come down drastically.
These days, there are many diabetic women who go through pregnancy smoothly without major complications. Of course, there is extra care and precaution required, but it is not something that cannot be planned and managed well between the doctor and the mother-to-be.

The following are some rough guidelines for a pregnant diabetic woman.
Potential complications

It increases the risk of polycystic ovaries, thereby making it difficult to conceive.
Fluctuating sugar levels can be a reason for not being able to conceive, as the body does not see itself as healthy.
It increased the chances of miscarriage.
There are higher chances of birth defects in the developing baby due to very high sugar levels in the first trimester.
Preparation
If you are planning for a pregnancy, meet with your doctor to review your sugar levels. Chalk out a plan with your doctor, taking into account your diet and nutrition, exercise, lifestyle, and medications.

Diet: Ensure you cautiously decide what and how to eat ahead of your pregnancy. Moving away from refined carbohydrates and processed foods towards wholesome food items like whole grains, fresh fruits and vegetables will make a difference.
Exercise: Build an exercise routine to suit your body and keep yourself active. It is very important to stay active so that diabetes is under control.
Lifestyle: Quit smoking and reduce alcohol use. This helps in managing stress also, which can help keep diabetes under check.
Medications: Check with your doctor on the medicines you are taking and if dose adjustments are required to get sugar levels under control, plan them out.
During pregnancy, constant monitoring and vigilance is required to ensure diabetes is under control.

Let your gynecologist know about your condition (stable/fluctuating), and if you are doubtful about them being able to handle your condition, do not hesitate to change.
Many consider switching to oral medications as the risk of transmission to the baby is less and the control over sugar levels is better.
Constant monitoring for daily blood sugars is essential.
A regular, healthy lifestyle in terms of eating and sleeping should help keep the sugars under check.
Constant monitoring of the baby is essential to ensure its normal growth with no developmental defects.
Read up and train yourself on how to deal with low or high sugar levels. Happy sugary pregnancy!

Diabetes During Pregnancy - Know The Best Ways To Control It!

There are some commonest misconceptions about infertility and these misconceptions should be eliminated as soon as possible so that the actual facts can be known. There are many online sites where you can find detailed information on the scientific explanations regarding infertility and you can follow them.

List of myths and facts regarding infertility

1. Myth: The menstrual cycle of a woman is for 28 days.
Fact: Normal cycle ranges between 21 to 36 days.

2. Myth: A woman can have pregnancy on the day one of menstrual cycle.
Fact: The released eggs remain viable for almost 12-14 hours and a woman can get pregnant after an intercourse done two days after ovulation and five days before ovulation.

3. Myth: Infertility occurs due to stress.
Fact: Ovulation can surely get delayed due to hormone suppression, but infertility does not occur due to stress.

4. Myth: Sperms stay active for few hours.
Fact: Sperms stay alive at least for five days.

5. Myth: Men with a higher sexual drive will have a normal sperm count.
Fact: There is no relation in between fertility and virility. Sometimes, it has been found that men having a higher sex drive do not produce sperms.

6. Myth: Women have to wait for three months to conceive after stopping the usage of contraceptive pills.
Fact: As soon as a woman stops pill usage, hormonal levels go back to normal condition, as a result of which ovulation begins immediately.

7. Myth: Only females have infertility troubles.
Fact: Both women and men suffer from infertility troubles as per the current scientific studies.

8. Myth: Ovulation occurs in a woman on the 14th day of menstrual cycle.
Fact: Ovulation can be calculated by counting 14 days backwards from the past menstrual cycle's last day.

9. Myth: Daily sex can increase conceiving chances.
Fact: During ovulation, having sex each day, especially in between 12 to 16th day of the cycle can be the best timing.

10. Myth: Fertility troubles occur at 35.
Fact: Peak fertility timing in a woman's life is 20 and this might continue until late 30s. Fertility troubles might even arrive at a younger age. With age, conception chances get declined, especially after 35.

Myths & Facts About Infertility

When endometrial tissue that usually grows inside the uterus, starts growing outside uterus, it is called Endometriosis. Pain during or before periods, pain during intercourse, pain while urinating or bowel movements, heavy bleeding, infertility are some of the symptoms of endometriosis.

Treatment of endometriosis usually depends on the following factors:

Age of female
Severity of symptoms
Duration of the symptoms
Future plans for children/ fertility
Associated pathologies
Accordingly the doctor might choose any of the treatment options like:

Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain  relieving medications like Nonsteroidal anti-inflammatory drugs (e.g. Diclofenac) or anti-spasmodics(e.g.drotaverine)
Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may recur. Some of the hormone therapies include: 
Hormonal Contraceptive pills: Useful in controlling the hormones that are responsible for endometrial tissue growing outside the uterine cavity.
Medroxyprogesterone: This helps to counter effect estrogen hormone which is responsible for endometrial tissue growth.
Gonadotropin-releasing hormone (GnRH) agonists: Gonadotropin hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence symptoms. It can cause absence of menstruation in some females which is reversible.
Danazol: It is synthetic androgen, suppresses growth of endometrial tissue temporarily.  However, Danazol may not be a favourable option because of its side effects. Females should avoid pregnancy while on this drug.
Dienogest: This newer progesterone molecule, which does not have major side effects and is apporved for use in endometriosis.
Other medications like selective progesterone receptor modulators, immunomodulators, anti angiogenic factors are being evaluated.
Conservative surgery: If you are trying to conceive, then surgical excision or ablation of endometrial tissue is one treatment option.Suboptimal surgery with conservation of maximum ovarian tissue is considered suitable in such cases.
Hysterectomy: In severe endometriosis cases where female has completed her family, hysterectomy is offered wherein the uterus, cervix & if required ovaries can be removed.

Endometriosis - Ways To Manage It Well!

Pregnancy brings with it the need to be extra careful about the overall well-being of the mother-to-be. Extreme caution has to be taken in managing health, as antibiotics and a lot of other treatment modalities are best avoided during pregnancy. With diabetes becoming common in the younger ages and women choosing to delay pregnancy, there are multiple women who are diabetic and choose to get pregnant later in life.

With diabetes being a chronic and a lifestyle condition, it definitely has its effects on pregnancy. However, the key is to manage diabetes cautiously in such a way that its effects on pregnancy, both the mother and the developing baby, are minimal. The increased blood sugar levels from the mother pass on to the baby, so keeping a close watch on the blood sugar levels is very important.

The maximum effect of diabetes on the baby is during the first few weeks of pregnancy. It is when the vital organs (brain, heart, lungs and kidneys) are forming, and high blood sugar levels can be harmful. This is slightly tricky as most women realise they could be pregnant only after about 6 weeks. If pregnancy is planned, it is best advisable to keep a check on sugar levels much ahead of the pregnancy.
The baby could be used to high levels of sugar while in the womb, and once delivered, it could have too low sugar levels. This needs to be monitored.
Preeclampsia, which is increased protein in the urine and high blood pressure, can happen during the second trimester. This may require the baby to be delivered prematurely.
Babies born to diabetic mothers are often bigger. The baby s pancreas is used to higher sugar levels and so the extra sugar gets converted to fat, which is the reason for the bigger babies. This may also necessitate C-sections.
Pregnancy can induce the development of diabetic retinopathy, which may prevent vaginal delivery, as the woman may not be able to exert the required pressure.
Abnormal calcium and magnesium levels, which need to be monitored for a while after birth
Most diabetic women reach full term if the sugar levels have been under good control.
Diabetic pregnant women are high at risk. However, with advanced medical care, these risks and complications are managed very well producing healthy babies from normal deliveries with effectively no harm to the mother s health. Once a diabetic woman tests positive, it is advisable to seek medical help to plan diet/meal plan, physical activities, exercise regimen, lifestyle changes, and medication dose adjustments. This is not a one-time activity, but needs to be closely monitored with daily blood sugar levels throughout the pregnancy. 

How Can High Diabetes Affect Your Pregnancy?

Having a baby is nothing less than a dream come true, but it comes with its own share of problems for new mothers. A lot of women today are opting for a C-section, or a Cesarean surgery to deliver their babies. While it is safe for most, at times certain complications can arise as a result of the operation.

As if life for mothers wasn t tough already, post Cesarean wound infection is another concern some new mothers have to face. It usually occurs due to a bacterial infection in the area where the incision was made during surgery. If you have recently had a C-section, look out for signs in the first couple of weeks such as fever (100.5 F to 103 F), wound sensitivity and pain in the lower abdomen area. Other symptoms include swelling at the incision point or in the legs, discharge from the wound, smelly vaginal discharge or blood clots and difficulty in passing urine. If you notice any of these signs, act fast and visit your gynaecologist at the earliest, to avoid complications from the infection.

Why does it happen?
There can be various reasons that an infection happens, just like on any other part of the body where a wound is exposed. Generally, it is more prevalent among obese or overweight women or those taking any form of steroids. Other causes include, an incision closed with staples or nylon sutures, in cases of an emergency C-section, or from an infection of the amniotic sac.

Types and Treatment
C-section wound infections are of two types that is Cellulitis or wound abscess and thrush.

Cellulitis and wound abscesses are caused by bacteria and are treated with antibiotics. If you re in the hospital, you will be given the antibiotics intravenously, but if not, they can be taken orally as well. In case of abscesses, the pus is first drained out and smeared with antiseptic before being covered with gauze, after which the wound will heal on its own.
Thrush is caused by a fungal infection and is normally seen in women taking steroids or in those who have a weak immune system. Anti-fungal drugs are provided to combat the issue.
How can it be prevented?
Here are some things new moms can do to prevent the C-section wound from getting infected:

Regular follow-up visits with your obstetrician
Practising good hygiene and healing
Stay hydrated and drink plenty of fluids
Avoiding any strenuous exercises that may put pressure on the abdomen area and stitches
Resting as much as possible
Remember, even if you do develop an infection, it can be treated if addressed in time. New mothers need to take extra care of themselves, as a healthy mom, makes a happy mom!

Post Cesarean Wound Infection - How It Can be Prevented?

Health advice for a breastfeeding mom

Breastfeeding mothers need to be conscious and aware of their diets. How the mother eats is how the child gets its nutrition. While they do not need any major changes from what they were eating during the pregnancy, a few adjustments are advised. A few basic adjustments in daily routine are enough. They are:

1. Eat very well - Eat a balanced diet to suit your health. Remember, first it is important to meet your nutritional needs. Only when you are eating well would the quality and quantity of your milk be ideal for your baby. Do not diet under any circumstance. We understand you wish to lose all the pregnancy weight soon, but remember, you child is your priority now. When you diet, your body will start drawing on its reserves. This will affect milk production. By dieting, you will also lack the amount of stamina you need to take care of your baby. Be aware that feeling extra hungry during breastfeeding is normal. Your body is working around the clock. Eat small meals at regular intervals to keep your hunger satisfied, your weight concern at bay and your body strong.

2. Don't count your calories - Not until you are breastfeeding. You need at least 500 calories more than you did when you were not breastfeeding. Don't let this shock you, your child will be feeding off you. There are other ways to regulate your weight and lose the extra pounds gained during pregnancy, do not compromise on food at all.

3. Do not rush to exercise - Consult your doctor and ask for suitable exercises for your body. You might have stitches which are yet to dry, so don't be hasty. Get your workout regime planned professionally and under guidance.

4. Do not avoid fats - Eat healthy foods and opt for good fats. Foods that are good for you and for milk production are a big yes. Foods which do not contribute in any positive way can be done without. They will only harm you in the long run.

5. Avoid alcohol - Stay away, and if you do want to indulge consult your doctor. An occasional drink is usually okay, still it is better you abstain altogether until you stop breastfeeding. And if you do have a drink, feed at least after two hours.

If you would like to consult with me privately, please click on consult.

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Advice For A Breastfeeding Mom

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