Pharmacists are uniquely positioned to give advice and allay fears. In recognition of Reproductive Health Awareness Month, a Johannesburg gynaecologist shares her insights so you can help guide expectant parents through the basics of health during pregnancy. 

“While it is natural for parents-to-be to feel somewhat anxious, understanding some of the factors that can affect the health of the mother and the unborn baby can greatly contribute to making this a most special time,” said gynaecologist, Dr Bronwyn Moore, who practises at Netcare Park Lane Hospital. 

“Women who have chronic medical conditions, such as hypothyroidism, hypertension, diabetes or epilepsy prior to falling pregnant will need to consult a healthcare professional about how best to manage their condition during pregnancy.  

“When falling pregnant, it is imperative that one does not just stop taking prescribed medication without the sanction of a healthcare professional, as this could place both the mother and her baby’s health at risk. The type of medicine may need to be adjusted, opting for drugs that are safer for pregnancy. Pre-existing health conditions often require close monitoring during pregnancy, so it is important to ensure there is ongoing support from one’s healthcare professional,” Dr Moore said.  

GESTATIONAL DIABETES & GESTATIONAL HYPERTENSION 

Certain medical conditions can develop during pregnancy. Two examples that expectant mothers should be particularly aware of are gestational diabetes and gestational hypertension.   

“Gestational diabetes occurs when a pregnant woman who was not diabetic before pregnancy develops high blood sugar during pregnancy, as the body is unable to manage glucose appropriately. The condition is more common in the second half of pregnancy, in women with a family history of diabetes, and who start pregnancy overweight. Excessive weight gain in pregnancy is also a risk factor.  

“Symptoms include thirst, fatigue, and frequent urination, all of which are common symptoms in normal pregnancy. Urine testing performed regularly during pregnancy looks for warning signs of gestational diabetes and expectant women may have to have a glucose tolerance test at the lab. Diagnosis and treatment are important as gestational diabetes can cause serious complications. Dietary changes and exercise can help to regulate blood sugar levels, and prescription medication is available to help manage the condition.”  

Dr Moore warned that high blood pressure can also develop. By definition, pregnancy-induced hypertension starts after week 20 of the pregnancy. “Pregnancy-induced hypertension can lead to preeclampsia, which may place the health of both mother and baby at significant risk.” She explained that at regular check-ups during pregnancy, doctors will check expectant patients’ blood pressure and test their urine for any signs of the condition so that it can be appropriately managed should it develop. “Be on the lookout for severe headaches, visual changes, and excessive swelling, as warning signs,” Dr Moore said and stressed the importance of explaining to patients that they should call in for advice should these occur.  

HEAT 

Women who are pregnant are particularly sensitive to heat, and they are advised to avoid taking hot baths and spending long periods of time in hot closed environments. Both may lead to a drop in blood pressure, leaving the mom-to-be feeling faint, light-headed, and nauseous.  

A rise in core temperature caused by a fever or spending time in saunas or steam rooms can be harmful to the developing foetus. Paracetamol and lukewarm baths can be used to bring down a temperature and encourage expectant women to give the steam room a miss.  

NUTRITION & HYDRATION 

“Good nutrition and adequate hydration are essential for mother and unborn baby, although the old maxim that a pregnant woman is ‘eating for two’ should not be taken as licence to consume too many calories,” Dr Moore said.  

“During pregnancy, the volume of blood in the body increases and for this reason, pregnant women require additional iron in their diets. Iron can be obtained either from a supplement or food sources, such as green leafy vegetables, red meat, and beans. Most pregnancy multivitamins contain extra iron to meet the increased need.” However, Dr Moore cautioned that pregnant women should consult their doctor before taking additional supplements: “because too much iron may be harmful”.  

She also warned that pregnant women must not eat raw protein, including raw or undercooked meat or fish, and foods or condiments made using raw eggs, including homemade mayonnaise or ice cream. “Eggs should be thoroughly cooked and firm. Women who are pregnant should avoid shellfish, herbal teas, certain soft cheeses and pâtés, as well as alcohol, during pregnancy. 

Dr Moore also recommended drinking at least eight glasses of water every day. “Fruit juices are high in sugar and should only be consumed in moderation.   

“When a woman is pregnant, she needs to be hyper-vigilant about what she consumes or comes into contact with, as there are a surprising number of substances that can be harmful at this time.” Dr Moore recommends that pregnant women always consult a doctor before taking any medication including, but not limited to, so-called ‘natural’ or homoeopathic remedies, over-the-counter medications, supplements, or even using topical lotions. 

TRAVEL 

According to Dr Moore, it is advisable for patients to avoid unnecessary travel while pregnant, particularly in the first and third trimesters. During the third trimester, it is a good idea not to travel far away from the chosen place of delivery. Patients should consider that an unexpected preterm delivery may mean that their baby would require expert neonatal care. As such, should they choose to travel advise them to make sure this care is available, that it will be funded by their medical aid or travel insurer, and make sure they realise that they may not be able to return home for a number of weeks.”   

Dr Moore cautioned that pregnant women should not undertake international air travel after 34 weeks or local air travel after 36 weeks. Remind patients they will need a letter from their doctor stating their fitness to fly once they are 28 weeks pregnant, and for long flights, it is possible that they may require a blood-thinning injection to reduce the risk of deep vein thrombosis. 

“It is particularly important for pregnant women to avoid visiting countries where the Zika virus is present, as this can be detrimental to the development of the unborn baby. Malaria areas should also be avoided,” Dr Moore added. 

CATS 

Lastly, Dr Moore highlighted the need to caution expectant mothers, especially those who have never had a cat before falling pregnant, against coming into contact with cat faeces in cat litter boxes or even in garden soil, as feline excrement carries a parasite that causes toxoplasmosis, a condition that can lead to miscarriage. 

“Pregnancy should be a beautiful experience, and this time of preparation for motherhood is precious beyond measure.” Dr Moore believes that with a little caution, continuous support from a team of healthcare professionals and adequate rest, pregnancy need not be stressful.