Ask the doctor - aromatherapy in pregnancy

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I’m 31 weeks pregnant and hope to use aromatherapy oils to relax during labour. Which are safe? Also, what do you think about raspberry leaf tea?

Aromatherapy during pregnancy is fine under the advice of an experienced therapist – find one in your area from the Complementary & Natural Healthcare Council register at www.cnhc.org.uk. Aromatherapy oils used to prepare for labour include rose, petitgrain and lavender, but stronger oils may be used during labour itself. Taking raspberry leaf tea or tablets daily, during the last eight weeks of pregnancy only, can help to soften the neck of the womb in preparation for delivery and ease childbirth. Mothers who have taken raspberry leaf often say their contractions were relatively pain free and their baby was born within just a few hours of labour starting. It is thought to work by strengthening the uterine muscles to increase the force of the contractions.
Dr Sarah Brewer, Prima (Sept 11)

I’m about to start fertility treatment. Is it a good idea to take supplements?

When planning a pregnancy, it’s important to avoid all but the most necessary medications, including over-the-counter treatments and supplements. It is, however, important to take folic-acid supplements, as these can reduce the risk of developmental problems, such as spina bifida. Other vitamins and minerals are also important for fetal health, including vitamin B12, but some should be avoided, such as excess vitamin A. It’s therefore best to choose a multivitamin supplement especially for pregnancy, such as Pregnacare (£5.35 for 30 tablets from www.vitabiotics.com). Your fertility specialist will also be able to advise you.Although I’m over 40, I’d like another baby now my older kids have left home. But as my periods are erratic, I never know whether I’m late or not.
Dr Sarah Brewer, Prima (Aug 11)

Will a home pregnancy test still work?

To increase your chance of conception you could use an ovulation predictor kit. If you suspect you may be pregnant (tender breasts, tiredness, frequent urination, nausea, red/pink spotting as the fertilised egg implants) then take a pregnancy test. I like the Clearblue Digital Pregnancy Test with Conception Indicator (£9.99 for one stick, £13.99 for two sticks, from pharmacies) can tell you if you are pregnant and when you conceived. As well as detecting the presence of the pregnancy hormone, hCG, it also measures its concentration. If the test is positive, the word ‘Pregnant’ will be indicated along with an estimate of how many weeks since conception. If the result is negative, you’ll see a ‘Not Pregnant’ reading on the screen. For more information, including ovulation predictor kits, visit clearblue.com/uk.
Dr Sarah Brewer, Prima (Nov 10)

I'm expecting my first baby, and my husband promised to stop smoking. He threw away his cigarettes the day he heard I was pregnant, but three months later he's started again. How can I encourage him to quit?

It always saddens me that 72% of smokers try to give up with willpower alone - because 97% are smoking again within a year, and the knowledge that they have 'failed' can make it harder to try again. Yet everyone is entitled to take advantage of the smoking cessation services available free on the NHS, and these increase the chances of success four-fold. Maybe it would help if you explained to him that, while 90% of Britons see smoking as a lifestyle choice rather than an addiction, two-thirds of doctors now see it as a real medical condition. As well as moral support, smoking cessation services o er a wide range of prescription aids. These include nicotine replacement therapies (in the form of gum, patches, inhalators, etc), which allow you to deal with the psychological addiction to smoking before you tackle your nicotine addiction, and drugs like Champix, which reduces your craving for cigarettes.
Dr Sarah Jarvis, Good Housekeeping (Jul 10)

I was diagnosed with lupus in my 20s. Now 35, I want to have a baby, but I've heard lupus can cause miscarriage.

A high number of lupus sufferers are prone to miscarriage, as certain antibodies in their blood cause the blood to thicken, which blocks the blood supply to the baby, so the baby can't get the nutrients it needs to grow normally. High blood pressure is a real risk and can lead to pre-eclampsia, but careful monitoring and treatment during pregnancy can keep it under control. For more advice, see your specialist before trying to conceive.
Dr Louise Selby, SHE (May 10)

Although I'm not yet ready for a baby, I'm getting anxious about leaving it too late. Is there any way of checking my fertility? A friend suggested an ovarian reserve test - is it worth the money?

Statistics from the Journal of Human Reproduction show that a woman's fertility drops by up to 50 per cent after the age of 35 and by 95 per cent beyond 40, so your concerns are understandable. There are a number of tests that measure 'ovarian reserve', or the quantity and quality of eggs remaining in the ovaries. The most wellknown is the Day 3 FSH Test. This is a simple blood test that measures the levels of the hormone FSH on day three of your menstrual cycle - a raised level of the hormone is thought to be an indication of a low ovarian reserve and low fertility. The trouble with this test, and others, is that they just look at the one area - and fertility problems can be due to a number of factors, including poor egg quality, low egg numbers and physical blockages. Your GP will only offer you fertility tests if you have been trying to conceive for at least 6 months (12 months if you are under 35). If you decide to go private, it can cost up to £300 and you may end up none the wiser. The good news is that lots of women in their late thirties have healthy babies. But the reality is that the sooner you start trying, the greater the chance of success.
Dr Louise Selby, SHE (Apr 10)

I'm in my early 40s and expecting my first child. I'd like to take raspberry leaf tea to help with the birth. Does it really work and when should I start taking it?

Raspberry leaf tea is traditionally taken towards the end of pregnancy to help soften the neck of the womb in preparation for delivery. It's thought to strengthen the longitudinal muscles of the uterus to increase the force of contractions and to reduce the duration and pain of childbirth.
There is little research into its effectiveness, however. A trial involving 192 women having their first baby looked at the effects and safety of taking 1.2g raspberry leaf tablets, twice a day, from the 34th week of pregnancy until labour. They found a significant shortening of the second stage of labour (pushing the baby out) of 9.59 minutes, and lower rate of forceps deliveries in those taking the supplements (19.3 per cent) compared with controls (30.4 per cent). It didn't shorten the length of the first stage of labour (dilation of the cervix). Raspberry leaf should only be taken during the last six weeks of pregnancy (from 34 weeks). It should not be taken during early pregnancy and is best taken under the supervision of a qualified medical herbalist or a midwife.
Dr Sarah Brewer, Prima (Apr 10)

Epilepsy drugs and pregnancy

I’m 33 and have had epilepsy for the past 18 years. I’d like to have children soon, but I’ve heard that epilepsy drugs can cause foetal abnormalities. I don’t dare to stop my medication, though – my life was miserable before I took them. My GP says I’d be better off not having children. What can I do>

Your GP is quite wrong. While there are indeed risks associated with taking epilepsy medicine when you're pregnant, some medicines carry fewer risks than others. You certainly need to talk to a neurology specialist before you go ahead. They may well want to make sure you're on the safest possible combination of medicines. You have a right to see a specialist and this may take some time, so I suggest you go back to your GP as soon as possible and ask for a referral.
Dr Sarah Jarvis, Good Housekeeping

I’m 34 years old, and seven weeks pregnant with my first baby. My doctor has advised me about a blood test to screen for possible problems, but says I won’t find out the results until I’m 16 weeks pregnant. Is there any way I can get my baby checked out sooner?

You should be able to get a special ultrasound scan called a nuchal thickness or nuchal translucency scan. This is done at between 11 and 14 weeks, it's just as accurate as the blood test, and you'll find out about any risks within days. Unfortunately, the test isn't available across the whole country on the NHS. Ask your GP for an NHS referral, if possible, or a private referral. One word of warning, though. Both the blood test and the nuchal translucency tests are screening tests, which means they will tell you how high your risk of abnormalities is, but can't confirm whether your baby is affected. For a definite answer, you'll need to have an amniocentesis, a test which does carry a small (up to one in 100) risk of miscarriage. If you want to find out more about different tests and the risks they carry, my book, Pregnancy For Dummies, covers all the latest advances.
Dr Sarah Jarvis, Good Housekeeping

Pelvic floor exercises and pregnancy

I’m 36 and pregnant with my first child. I’d like to get my pelvic floor into good shape to cut my risk of suffering stress incontinence after I have my baby. However, I’m worried that exercising my pelvic floor muscles too much will make the delivery itself slower and more difficult for me. Should I wait until after the birth?

No, not at all! You're quite right to say that regular pelvic floor exercises can help to prevent, as well as treat, stress incontinence after you give birth. There's also evidence now to suggest that doing them before you deliver can actually help speed up the second (pushing) stage of labour. So it's a good idea to get started with pelvic floor exercises as soon as you can.
Dr Sarah Jarvis, Good Housekeeping

Oily fish and pregnancy

I’m trying to get pregnant and I’ve heard eating oily fish is good for the baby’s brain. But I’ve also heard it contains mercury, which can be poisonous. So should I eat it or not?

It's terribly confusing when you get conflicting advice like this - especially when you want to do the very best for your unborn child. In fact, both stories are true - to an extent. A recent study has indeed shown that eating fatty fish, which is rich in omega-3 fatty acids, can help your child's development. However, some forms of fatty fish, such as tuna and swordfish, have been found to contain mercury, which can delay your child's development. Overall, it's likely that the benefits of fatty fish far outweigh the risks in pregnancy. As a compromise, though, the Food Standards Agency recommends that you should limit your intake of tuna to one steak or two cans a week. But you can still get plenty of omega 3s from eating mackerel, sardines and salmon.
Dr Sarah Jarvis, Good Housekeeping

Which aromatherapy oils can help during labour?

My daughter wants to use aromatherapy oils to help her relax while giving birth. Which ones are safe?

Products combining rose, petitgrain and lavender are often used to prepare for labour. During labour itself, she can use a massage oil made from 12 drops lavender, 12 drops clary sage and 4 drops jasmine or rose in 100ml of carrier oil, to help strengthen uterine contractions and promote feelings of wellbeing. These products are available in chemists such as Boots. I would also recommend raspberry leaf tea or tablets, which help to soften the neck of the womb in preparation for delivery. They should be taken daily during the last eight weeks of pregnancy only. It is thought to work by strengthening the longitudinal muscles of the uterus.
Dr Sarah Brewer, Prima

My fertility needs a boost 

I have mild polycystic ovaries and a health-food shop suggested I take saw palmetto. Isn’t this used for male prostate problems?

With polycystic ovarian syndrome (PCOS), the ovaries are enlarged by multiple small cysts containing under-developed eggs. Saw palmetto helps neutralise the effect of excess male hormones, and has been used to treat unwanted hair and reduced fertility in PCOS – but only take it under the advice of a medical herbalist. To find one, contact the National Institute Of Medical Herbalists (nimh.org.uk or call 01392 426022). The herb agnus castus is often used by those with PCOS to boost fertility but should be stopped immediately if you fall pregnant. Also try a multivitamin supplement with boosted levels of B-group vitamins.
Dr Sarah Brewer, Prima

Acupuncture aid? 

My husband and I are about to go through our third cycle of IVF and I want to do everything I can to increase our chances of success. What are your thoughts on acupuncture?

The British Acupuncture Council (BAC) recommends that women trying IVF should consider fertility-focused acupuncture. It is thought it may make the lining of the uterus more receptive to receiving an embryo, help regulate the menstrual cycle and encourage better egg quality. However, a recent study from the US suggests that acupuncture may reduce your chances of getting pregnant and that more research is needed. But even in the light of this report, the BAC still maintains that acupuncture helps hundreds of women to conceive.

So the jury is still out. If you’d like to investigate further, contact the Kite Clinic in London. One of Europe’s leading alternative health clinics, it offers fertility treatments for both men and women (kiteclinic.co.uk; 020 7408 0341). Or check BAC’s website acupuncture.org.uk to find a clinic in your area.
Dr Louise Selby, SHE

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The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit netdoctor.co.uk