Q. I have just become pregnant, and I remember that my mother
had very bad stretch marks after her pregnancies. I would
like to do everything that I can to prevent this from happening
to me. What do you suggest is the best cream or lotion that
I can use to stop the stretch marks?
A. Sorry, it looks like the odds are stacked against you
here. Skin type is dependent on genetic factors, so it is
likely that you will be prone to stretch marks just like your
mother was. Other factors that may affect the severity of
the stretch marks are the size of the pregnancy (having twins
does not help!), obesity, the number of pregnancies that you
have, and the abdominal muscle condition. The best thing that
you can do is to watch your weight gain during the pregnancy.
The average weight gain is between 8 –12 kg (I strongly
discourage weight reduction programs during pregnancy); and
keep your tummy muscles conditioned by doing some simple tummy
tightening exercises (swimming is excellent for this). Studies
have shown that lotions and potions will not do a great deal
to help. There are a variety of these on the market, some
of them claiming to perform miracles at exorbitant prices.
A good emollient cream or oil will be as good as any of the
designer label products. Vitamin E oil or good old olive oil
are excellent for moisturizing the skin. Vitamin E is available
in capsule form at your local pharmacy.
Pierce the capsule and apply the oil twice daily to the abdominal
area. Avoid direct sunlight once any stretch marks have occurred.
Stretch marks will burn and scar much easier than the non-stretched
skin. A good sun block or cover up will prevent this.
Q. I am 8 weeks pregnant and have experienced some light
bleeding. I have been to an obstetrician in Denpasar who has
told me that I must have total bed rest and avoid sexual intercourse
for the rest of the pregnancy. I am concerned that this may
be a strain on my relationship. What is your advice?
A. Oh really? Did he suggest that you file for divorce now
or later? Many women bleed during the first 3 months of pregnancy.
Most of the time there is no need for concern. The bleeding
may be caused by the embryo embedding itself into the uterine
wall, we call this an implantation bleed, or normal first
trimester bleeding. It may also be caused by miscarriage (threatened
or inevitable), or pregnancy occurring in the fallopian tube
– “tubal pregnancy” (the tube in which the
fertilized egg travels from the ovary to the uterus). Occasionally
the bleeding is not related to the pregnancy, i.e. vaginal
infection, conditions of the cervix. A quick examination and
ultrasound scan by your obstetrician or birth practitioner
(midwife), should be able to give you a better idea of what
is happening. It sounds to me like your doctor is treating
you for what he feels is a threatened miscarriage. Total bed
rest will not prevent miscarriage; it will only delay it.
I would suggest having a few quiet days at home and avoiding
strenuous exercise, until things settle down. Avoid sexual
intercourse (deep penetration) for the meantime. Once the
bleeding has settled down there is no reason why you should
not return to a normal sexual relationship. If the bleeding
is accompanied by SEVERE OR WORSENING PAIN, FEVER, or INCREASED
BLEEDING, seek medical attention immediately.
Q. I am an Australian girl married to a Balinese man, and
his family are quite shocked that I am continuing my exercise
routine during my pregnancy. Everything I have read says that
this is OK. How do I convince my in-laws that I am doing the
right thing and not harming the baby? What is the best kind
of exercise to do?
A. Yes, us “Bules” do some pretty crazy things
in the eyes of the local people! I suggest that you explain
to your in-laws (gently) we do things a little differently
and that you are not harming the baby in any way. Perhaps
you can show them some pictures from your antenatal books
that show pregnant women exercising. I usually encourage my
patients to continue with any exercise that they have been
doing before pregnancy. This of course, would exclude rigorous
or high-risk sports such as aggressive martial arts, water
skiing, bungy jumping etc. During the first three months or
so, fatigue can be a problem, so don’t push yourself
beyond your limits. Once the pregnancy develops and your belly
grows, your center of balance is thrown forward quite considerably.
Be aware of this in your exercise routine, or may end up flat
on your face! Non weight bearing sports are the best. Swimming
is excellent, Tai Chi or other slow body movement forms are
great. Yoga is wonderful for pregnancy, however some positions
are not recommended. A qualified instructor or good book should
tell you which positions are safe.
Q. I am 9 weeks pregnant and I really need to color my hair
very soon. Is it safe to use hair dyes during pregnancy?
A. There is no simple answer to this. Generally hair dyes
are considered safe however some studies have shown that some
hair dye ingredients are teterogenic (cause fetal defects)
in animals. These animals however are exposed to very much
higher doses of the chemical than you would ever find in a
commercial hair dye. If you wanted to be safe I suggest waiting
until the end of the first trimester (first 12 weeks of pregnancy)
as this is the most crucial time of babies development, then
dye your hair.
Q. My favorite food is Chinese and I am concerned that the
high MSG content of this in restaurants and take-aways may
not be good for the pregnancy. Do you have any information
on this?
A. There is no specific contraindication to MSG during pregnancy.
MSG occurs naturally in many foods (i.e. tomatoes), and is
used as a flavor enhancer for many food products. Some people
develop a reaction to this food additive, such as severe headaches,
nausea, dizziness and sleep disturbances. If you do not experience
any of these symptoms then I would suggest that no great harm
would become of you consuming this during your pregnancy.
On an overall health perspective MSG in large amounts is not
good for you. Perhaps you could try preparing your favorite
dishes at home without MSG added.
Q. I am an American married to an Indonesian lady who is
currently 5 months pregnant. Since the pregnancy has been
showing she insists on binding her belly up with a long sash
that she wraps many times around her middle. This is something
that I have never seen in the West. What is its purpose? And
could it be doing any harm?
A. This is a cultural act more than anything else. Just as
you have never seen Western women do this, your wife has been
used to seeing every pregnant woman wear a belly binder during
pregnancy. The purpose of the binder is to support the abdomen
as it grows larger. It is questionable wether it actually
assists the abdominal muscles in containing the pregnancy.
The binder is not harmful as long as it is not applied too
tightly thereby hindering the circulation to the lower limbs.
If your wife feels comfortable wearing this device and as
she feels it is culturally correct I would let her continue
to wear it.
So there you have it, the trials and tribulations of reproducing
our own kind! ‘Til next edition, stay happy, stay healthy
and stay young!
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
