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The First Trimester

The First Trimester

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Happy, anxious, nervous, scared, overjoyed and excited. These are just a few of the emotions you may experience when you first find out you are pregnant. If it is your first time you are definitely going to feel a bit confused and will resort to googling everything related to pregnancy. We have broken down everything you need to know about the first trimester of pregnancy in this blog. 

So what is the first trimester of pregnancy?

It is the earliest phase in your pregnancy. It starts on the first day of your last period and ends on the last day of the 13th week. During your first trimester of pregnancy, a lot of changes happen to you and the baby. So keep reading to find out what is in store for you

What are the changes happening in your body?. 

Due to the hormones released by the body,, many changes will occur during pregnancy. These changes help prepare you for the 9 months of pregnancy.

first trimester of pregnancy
  1. Swelling of breasts– caused by the mammary glands enlarging to prepare for lactation as a result of increased oestrogen and progesterone hormones secretion.
  2. Peeing more often – you will start peeing more often as your uterus grows and presses against your bladder.
  3. Darken and enlarged areolas – this is the pigmented area around your nipple. They may also become covered with small, white bumps called Montgomery’s tubercles (enlarged sweat glands).
  4. Mood swings – you may begin to experience severe mood swings which is caused by the surge in hormones. 
  5. Morning sickness – occurs due to increased hormone levels that is needed to sustain the pregnancy. Contrary to the name, nausea can occur at anytime of day. 
  6. Constipation – occurs as the growing uterus presses against your rectum and intestines.
  7. Heartburn and indigestion – the increased levels of progesterone can slow the muscular contractions in our intestines. 
  8. Extreme tiredness – caused as a result of the physical and emotional demands of pregnancy. 
  9. High heart rate-  caused by the increased cardiac output to supply enough blood to both you and your baby.
  10. Slight bleeding – About 25% of pregnant women have slight bleeding during their first trimester of pregnancy. Early in the pregnancy, light spotting may be a sign that the fertilized embryo has implanted in your uterus. If you have severe bleeding please seek medical advice urgently.
  11. Weight gain – this is due to a 40-50% increase in volume of blood in the body during pregnancy and storage of fat in the body which is later used for milk production. 

It is important to note that some symptoms of pregnancy continue for several weeks or months. Others are only experienced for a short time. Some women experience many symptoms, and some experience only a few or none at all. Everyone is different but that’s to be expected -you are unique! 

Now lets have a look at the changes your baby will go through. 

The most development occurs during the first trimester. During the first 13 weeks, your baby develops from a fertilized egg (embryo) into a fully-formed fetus. All major organs are formed during the first trimester of pregnancy. By the end of the first trimester of pregnancy, the fetus weighs approximately 0.5 to 1 ounce and measures, on average, 3 to 4 inches in length.

Here is what exactly happens: 

(Source: Johns Hopkins Medicine)

The fetus is most vulnerable during the first 12 weeks. During this period of time, exposure to drugs, radiation, tobacco and other toxic substances can affect the formation of the major organs and body systems. 

So what do you need to know while visiting the doctor during the first trimester?

As soon as you find out you are pregnant, make an appointment with your VOG doctor so you can start caring for the baby. You should see your doctor once a month but it is better to discuss this with your VOG doctor. 

During your first visit the doctor may: 

  • perform an ultrasound to confirm the pregnancy
  • perform a Pap test
  • take your blood pressure
  • test for sexually transmitted infections, HIV, and hepatitis
  • estimate your date of delivery or “due date,” which is around 266 days from the first day of your last period
  • screen for risk factors like anemia
  • check thyroid levels
  • check your weight

If you experience any of the following please seek medical help immediately: 

  • Severe abdominal pain
  • Heavy bleeding
  • Severe dizziness
  •  Rapid weight gain or too little weight gain

It is also recommended you start building out your birth plan early on during your pregnancy. To know more about how to create your birth plan click here. You can also consult a VOG doctor at any time and from the comfort and safety of your home via the oDoc app.

 

Source

  1. Bhargava, H. D. (2020, July 16). First trimester of pregnancy: What to expect, Baby Development. WebMD. Retrieved December 15, 2021, from https://www.webmd.com/baby/guide/first-trimester-of-pregnancy#3 
  2. Healthline Media. (2017, November 9). The first trimester of pregnancy. Healthline. Retrieved December 15, 2021, from https://www.healthline.com/health/pregnancy/first-trimester#other-considerations 
  3. The first trimester. Johns Hopkins Medicine. (n.d.). Retrieved December 15, 2021, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-first-trimester 
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Your Little Girl’s First Period

Your Little Girl’s First Period

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Wonder what to tell your child about periods? Here’s some help to get you started.

The earlier you have the ‘period’ talk with your child, the better. She needs to know about the menstrual cycle and all the changes that puberty brings. A one-time tell-all discussion might be too much for her to take in, so plan a series of conversations revolving around this subject. But most importantly, the conversations you have with your daughter about menstruation can lay the groundwork for future talks about dating and sexuality.

Alright, so where do you start?

What’s a period?

A period is the part of the menstrual cycle when a woman bleeds from her vagina for a few days.

What does it mean to get the first period?

Puberty is when a girl’s body changes from looking like a child to looking more like an adult, producing adult-level hormones. Every month, starting around the first period, estrogen and progesterone hormones prepare her body for a possible pregnancy. As a result, it causes the lining of her uterus to build up to provide comfortable housing for a fertilised egg to begin development. 

Approximately after a month, if the egg hasn’t been fertilised, the buildup of tissue in the uterus will break down and bleed. This blood is what is seen during a period. The cycle repeats every month and is called a menstrual cycle. 

It’s normal for a cycle not to be regular after the first period. Periods may be hard to predict. It usually occurs every 3 weeks (28 days). However, irregular periods are common for the first 1 or 2 years after the first period.

When do most girls get their first period?

Puberty often begins when the child is around 11 years old, although anywhere between 8 and 14 years is considered the “normal” age. It’s generally one of the most memorable events in a young girl’s life. On average, a first period occurs when a girl is about 12 years old.

How can you keep her informed about knowing when her first period is coming?

signs of the first period

How to prepare for her first period?

It’s always good to be prepared, especially as the first period is unpredictable. Here are a few steps to make sure she’s ready when her first period occurs.

  • Being able to talk with a trusted adult and ask any question she has
  • Always carry sanitary pads, tampons, or any other menstrual products 
  • Keep an extra pair of pants
  • Look for places in her school where she can get sanitary products in case of an emergency.
  • Explain some of the pros and cons of types of menstrual products
  • Emphasising that periods are natural
  • Use clear, concrete words for body parts and body functions

How can you keep her informed about knowing when her first period is coming?

Key takeaways

Most girls will get their first period sometime between the ages of 10 and 15. However, a first period can occur as young as 8, so it’s always better to be prepared. The age of the first period can be impacted by genetics, diet, environment, weight, and other factors.

You can help your child prepare for her first period by having an open and direct conversation about periods and what she needs to expect. It would also be a good idea if she could have a few extra menstrual products in her bag for emergency purposes. It’s important to be ready and educated about the first period as it is a great way for your child to approach this growing-up milestone.

If you have any concerns regarding menstruation, you can speak to a VOG doctor via  the oDoc app from the comfort and privacy of your home. GPs and Family Physicians are also available to consult.

Download oDoc today on the App Store or Play store.

References

  1. Tween and teen health, Mayoclinic (2020)
  2. All about periods, KidsHealth (2018)
  3. When will I get my periods, KidsHealth (2018)
  4. At What Age Do Most Girls Get Their First Period?, Healthline (2021) 
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Birth Plans – what you need to know

Birth Plans – what you need to know

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Yes, Birth Plans are a thing and it is also very useful to have one. 

If you are approaching your third trimester the chances are you have already given a lot of thought to childbirth and all the options available to you. It is vital you write your preferences down and share what your preference for labour and delivery is with a loved one. This should be done well in advance because whilst you are going through labour it will be quite a task to make decisions in the middle of, you know, all the pain and hormones and stuff. Having a birth plan in advance will help you focus on the most important thing on the day – bringing your new baby into the world. We have broken down everything you need to know while creating your birth plan. 

Before we proceed, let’s go through the basics quickly. 

What is a Birth Plan?

A Birth plan is a written, typed or even drawn document which states your preferences during labour, delivery and after childbirth. It’s similar to a wish list, for example, where you can list out who you want with you in the room while you are in labour, or if you want pain meds, dimmed lights in the room, background music and other preferences. You can add anything you wish to make your delivery day as comfortable as possible. 

However, it is important to keep in mind that unexpected things can happen during labour so it might be quite difficult to follow your birth plan to the T. 

So how do you create a birth plan?

First, start with the basics. Include your

  • Name 
  • Age 
  • Brief medical history like chronic medical conditions, medicine allergies etc.

Here are a few other things you should consider when adding to your birth plan: 

Location

Where do you want to give birth? At home or at the hospital?

State your location so everyone is aware of where they need to take you when the labour pain starts.

Atmosphere

Who do you want around you when you are giving birth? Do you want a spacious room so you can walk around? Do you want a TV to help you calm down? Would you like music to be playing in the background – if so what playlist?

Listing these preferences out will help your loved ones set the atmosphere to your liking. 

Birthing positions 

Would you like to give birth on a birthing bed or stool or ball? 

There are many positions you could try if you opt for a birthing bed. Some are listed below. 

  • Lying down: On your back, with your head flat or elevated, and your legs elevated
  • Side-lying: With one leg elevated (this is good if you’re tired or if your blood pressure levels are fluctuating)
  • Kneeling: On the lower part of the bed with your arms or upper body resting on the upper section (this posture helps ease the backache)
  • All fours: With your stomach facing down, supported by your hands and knees (helps ease backache)
  • Squatting: On your feet, with support from bed or partner (this position takes advantage of gravity and shortens the depth of the birth canal)

It is good to know the different options so you can experiment with these during childbirth easily. Please note that in Sri Lanka these positions are not practiced regularly but do talk to a VOG if you’d like to explore these positions.

Pain management 

An important component of childbirth is pain management. It is common to be confused about whether or not you should take an epidural. Please note that whatever you choose in the birth plan, you can always change your mind on the day. It is advised you discuss the pain management options available to you with your VOG doctor well before your due date. A few examples of questions you can ask are listed below: 

  • What are my choices?
  • What is the risks of taking an epidural?

 

Delivery

Expecting mums, it’s never too early to discuss this with your VOG doctors. Have a think about if you’d like a normal vaginal birth or a C-Section. Other important things to consider are: 

  • Would you like your partner to cut the umbilical cord? 
  • Would you like to opt for an episiotomy (an incision through the area between your vaginal opening and your anus to make your vaginal opening larger for childbirth) or only do it if medically required? 

Feeding after the baby is born

How do you want to feed your newborn – breastfeed or bottle-feed? It is important to let your doctors and caregivers know this beforehand. 

The above list might seem obvious, but under the pressure of labour, the raging hormones and pain, it will be difficult to communicate your choices. So we encourage you to build your birth plan well in advance and share it with your partner and most importantly your VOG doctor so they know what your preferences are when it comes to labour and delivery.   

If you would like to discuss your birth plan or would like some guidance on how to build it, you can speak to a VOG doctor via oDoc from the comfort and safety of your home.

Source

  • Dailey, K. (2012, June 8). How to Create a Birth Plan. WebMD. Retrieved November 19, 2021, from https://www.webmd.com/baby/guide/how-to-create-a-birth-plan#1

  • NHS website. (2021, November 18). How to make a birth plan. NHS UK. Retrieved November 19, 2021, from https://www.nhs.uk/pregnancy/labour-and-birth/preparing-for-the-birth/how-to-make-a-birth-plan/

  • Dorfner, M. (2018, November 7). The Importance of a Birth Plan. Mayo Clinic. Retrieved November 19, 2021, from https://newsnetwork.mayoclinic.org/discussion/the-importance-of-a-birth-plan/

  • Slide show: Labor positions. (2021, February 23). Mayo Clinic. Retrieved November 19, 2021, from https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/multimedia/labor/sls-20077009?s=9

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Sexually Transmitted Infections And Diseases: What You Need To Know

Sexually Transmitted Infections and Diseases

Sexually Transmitted Infections And Diseases: What You Need To Know

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What are STIs and STDs?

Sexually Transmitted Infections (STI) and Sexually Transmitted Diseases (STD) are usually acquired by sexual contact. The bacteria, viruses or parasites that cause sexually transmitted diseases may pass from person to person in blood, semen, or vaginal and other bodily fluids. However, these infections can be transmitted nonsexually as well. For instance, from mothers to their babies during pregnancy, childbirth, breastfeeding, blood transfusions or shared needles.

What is the difference between STIs and STDs?

It is the fundamental difference between an infection and disease. Most diseases start with infections. Infection occurs when the bacteria or virus first enters the body and multiplies, progressing it into a disease. Likewise, sexually transmitted diseases initially begin as sexually transmitted infections. 

There are more than 20 known types of STDs/STIs. In Sri Lanka, annual estimates of detected STI cases vary from approximately 60,000 to 200,000, of which government clinics report only 10-15%. About half of these are detected in people aged 15-24. Luckily, most STDs can be treated and cured.

What are the most common STIs/STDs in Sri Lanka?

  • Genital herpes
  • Gonorrhoea
  • Non-gonococcal urethritis (NGU)
  • Syphilis
  • Genital warts
  • Chlamydia infection

What are the most common symptoms of STIs/STDs?

Why is it important to prevent STIs/STDs?

Most STDs can be cured or treated with medication. However, the consequences of ignoring it can include infertility, cervical cancer,  pregnancy complications, congenital disabilities, pelvic inflammatory disease and an increased risk of HIV transmission.

How can the transmission of STIs/STDs be prevented?

The only effective way to completely prevent the transmission of STIs/STDs is abstinence. However, for sexually active persons, consistent and correct use of condoms is highly effective in preventing such infections or diseases.

Questions to ask your doctor?

There has almost always been a stigma around any STD, and it usually trickles down to anyone diagnosed with it. People also feel ashamed that they are somehow damaged. It is important to remember that only a few STDs could be life-threatening. However, with proper treatment, most of it has minimal health impacts. You can have a good life despite having an STD. The majority of it is treatable, and some are even curable. Those STDs for which there is not yet a cure, such as HIV, can still be manageable if adequately taken care of.

Here are a few questions you could ask your doctor:

  1. Should I be checked for STIs?

  2. Can I get an STI by open-mouth kissing?

  3. What if I am pregnant?

  4. Can STIs/STDs cause other health problems in women/men?

  5. How can I prevent having STIs/STDs?

Suppose you are experiencing any of the symptoms mentioned above or need any information on STIs and how to protect yourself or get tested. In that case, you can consult a Sexual Health specialist or an on-demand GP via the oDoc app.

Reference:

  1. What you need to know about sexually transmitted infections, MedicalNewsToday (2021)

  2. Sexually transmitted infections (STIs), World Health Organisation (2019)

  3. What is a sexually transmitted infection?, FPA Sri Lanka (2017)

  4. Types of Sexually Transmitted Infections, Healthy children.org (2015)

  5. How to Reduce Shame and Stigma When You Have an STD, Everydayhealth.com (2019)

  6. How Can You Tell If You Have HIV? HIV.gov (2020)

  7. STD vs STI: Common Types, Symptoms, and Treatment, State Urgent Care (2019)

  8. Sexually transmitted infections (STIs), NHS (2021)

  9. HIV/AIDS in Sri Lanka, The World Bank (2012)

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Am I Just Having “Baby Blues” Or Do I Have Postpartum Depression?

postpartum depression

Am I Just Having “Baby Blues” Or Do I Have Postpartum Depression?

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You’ve just given birth. You’ve created a new life. Your body and mind have gone through a huge transformation over the last nine months. And now you have this whole other tiny human being that you need to care for and nurture. Obviously, you cannot go back to regular scheduled programming and you shouldn’t have to!

Even if you’ve been waiting so long for your baby and it is everything you’ve ever wanted and dreamed about, you are still bound to feel overwhelmed, emotional and maybe even moody. Let us shout it from the rooftops: THIS IS COMPLETELY NORMAL AND VERY COMMON FOR NEW MOTHERS.

Postpartum “baby blues” are extremely common. You’re operating on very little sleep, your hormones are on a rollercoaster, you’re adjusting to the realities of parenting a new baby so it’s no wonder you’re experiencing mood swings!

postpartum depression

But still you might be worrying about whether it is normal to feel this way. You might be wondering if this low feeling will go away in a few days or if you have something more serious, such as postpartum depression.

Symptoms of “baby blues”

  • Anxiety
  • Irritability and grumpiness
  • Exhaustion
  • Feeling joy and happiness one minute and then sadness the next
  • Unsure of your ability to take care of your baby
  • Trouble eating and taking care of your own health

How long are “blues” expected to last?

One important distinction between the “baby blues” and postpartum depression is that the “baby blues” are temporary. You are most likely going to experience “blues” for the first few days after giving birth. Symptoms that last more than two weeks might signal that you could have potentially developed postpartum depression and it is time to have a discussion with your doctor.

Symptoms of postpartum depression

  • Anger and irritability
  • Extremely low energy and wanting to sleep all the time
  • Feeling numb and disconnected from the people around you
  • Feeling you’ve failed as a mother
  • Thoughts of self-harm and thoughts of harming your baby
  • Crying excessively
  • Trouble bonding with your newborn

Postpartum depression does share many of the same moodiness as “baby blues” but symptoms are usually more intense and disturbing.

baby blues

Treatment for “baby blues”

Just because postpartum blues are very common doesn’t mean it’s easy to go through. Here’s what you can do to cope.

  • Assure yourself that what you’re feeling is completely normal and is experienced by all new mothers
  • Sleep as much as you can, which means sleeping when the baby is sleeping, or having your partner or family member look after the baby for an hour while you nap
  • Eat healthily and regularly
  • Exercise can do wonders! Even if its just a walk outside.
  • Talk about what you’re going through with loved ones or other mums
  • Don’t be hard on yourself if you don’t have the energy to do housework or other chores. You just had a baby!

Treatment for postpartum depression

If your baby “baby blues” don’t ease up after 2 weeks or if you’re experiencing symptoms of postpartum depression, don’t wait till your next check up with your doctor. Get in touch right away.

You may feel ashamed or embarrassed that you’re feeling this way, especially after this magical thing has happened in your life but you’re not alone with these feelings. 1 in 5 women experience postpartum depression after childbirth. Your doctor may recommend medication and/or therapy. You can also make healthy choices in your lifestyle such as:

  • Talk to people you trust about what you’re going through
  • Cut back on other errands. Use your energy to take care of basic needs for you and your baby
  • Build community by speaking to other mothers, joining a depression support group or just reach out to trusted friends and family. Fight isolation.
  • Rest whenever you can. Reach out to close friends and family to take the baby shift so you can sleep for a few hours. This does not mean defeat.

Causes of postpartum depression

The exact cause isn’t clear but experts say that postpartum depression may be triggered by both physical and emotional factors.

  • Hormonal changes – While you’re pregnant, your levels of estrogen and progesterone are higher than usual. After you give birth, these hormone levels drop significantly. Such a drastic change in hormones can contribute to postpartum depression.
  • Sleep deprivation
  • Not eating meals at regular hours or eating an unhealthy diet
  • Social isolation
  • Underlying medical conditions
  • Alcohol and drug abuse

Risk factors of postpartum depression

Any new mother can experience postpartum depression after childbirth, even if its not their first baby. However, your risk increases if:

  • You have a history of depression
  • You’ve had postpartum depression after a previous pregnancy
  • You’ve had family members who’ve had depression or other mood disorders
  • You’ve experienced stressful events recently
  • You have difficulty breastfeeding
  • You have a weak support system
  • The pregnancy was unplanned or unwanted

Speak to a doctor on oDoc if you think you might be having the above symptoms. This is a judgement-free zone where your doctors will NOT shame you and will only help you to feel better. Click here to download the app. 

References:

  • Is It Postpartum Depression or ‘Baby Blues’?, 2021, WebMD
  • Do I have Postpartum Blues or Postpartum Depression, 2020, VeryWell Family
  • Everything You Need To Know About Postpartum Depression, 2016, Healthline
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