Dr Ahmed Ismail

Consultant Gynaecologist & Fertility Expert

Sunday Mirror - The 10 pregnancy questions you’re too afraid to ask
05 May 2010

Pregnancy is a beautiful time, but that doesn’t mean it’s not also plagued with questions you feel too embarrassed or guilty to ask. So we’ve asked the experts for you…

1) Should I neaten up my pubic hair before I have people examining me down there?
Having a stranger investigate your bits is never a fun five minutes, but don’t worry that a hairy barnet-below will bother the person examining you. Mr Ahmed Ismail, director of Queensway Gynaecology Clinic, London, says, ‘As a doctor, I’ve seen it all and nothing I observe will affect the treatment given to a patient. It’s more important to be clean, both for you and in respect for whoever is examining you.’ If you’re more comfortable after a tidy-up, it’s OK to wax, the only thing is your skin’s likely to be more sensitive than usual, so be ready to wince.

2) If I’m lying on a bed for hours then being told to push, isn’t it going to get messy?
Erm, yes. NCT antenatal teacher, Gillian Fletcher, explains, ‘This is pretty much part and parcel of giving birth. While you’re pushing, the anus will be under pressure. The midwife usually puts a pad across that area, or if you’re in a pool they’ll use a sieve to get rid of anything – most women are so focused on pushing they hardly notice. The midwife isn’t going to be embarrassed, and she’ll deal with it discreetly. Years ago, women routinely had an enema to clear their bowels before labour, but it makes faeces more liquid, which can be just as problematic.’ The good news is most women need the loo in early labour, while they’re still able to walk, so there tends not to be too much later.

3) I got drunk in the weeks before I realised I was pregnant and now I’m terrified. Will my baby be OK?
First off, stop stressing. ‘There’s no point getting anxious about things you can’t change – stress isn’t good for you,’ says Gillian. Easier said than done? Well, here’s some good news. ‘It’s highly unlikely an isolated incident of over-indulgence in very early pregnancy will have an effect,’ says Mr Ismail. ‘Experts are more concerned about regular intake throughout pregnancy, which may have a devastating effect on foetal wellbeing in the womb, during delivery and after delivery.’ Everyone has regular scans to check the baby’s wellbeing, the important thing for you is to follow drink and dietary advice from now on.

4) I’ve been told to have pads in my hospital bag for post-labour bleeding. Will normal sanitary towels do?
No, they won’t. ‘A lot of women are surprised how heavy the bleeding is, especially if you’re breastfeeding,’ says Gillian. ‘The hormone that lets down breast milk also helps the uterus lining to shed, so it’s a good idea to change your pad before you do a feed.’ The heavy bleeding usually only lasts a week to 10 days, then most women have a lighter discharge for about six weeks.

5) Should I buy something to wear for the birth, or do you get given a gown?
You’ll be given a gown in hospital, but some people prefer clothes that smell of home. Gillian advises, ‘Long T-shirts are good for covering up and still allow the midwife to get to your arm to take blood pressure and examine you. Cheap, Ugg-style boots are a good idea too, in case you’re padding around.’ Whatever you buy, make it cheap – it’ll get messy and probably get binned afterwards.

6) I haven’t been doing my pelvic floor exercises. Will I regret it?
Mr Ismail thinks you might. ‘These are extremely important because they decrease the chance of problems in and after labour – there’s no excuse! But it’s never too late to start. Pick it up as soon as you can, and keep it going for as long as possible. You’ll appreciate the benefits when you resume your sex life, and doing the exercises lessens the chances of post-birth stress-incontinence.’

7) I’ve been invited to a breastfeeding class before my baby is due, but I can’t believe it’ll be difficult. Surely it comes naturally?
Baby. Nipple. Milk. What could be easier? But chuck sore nipples, wrong positioning and helpful mum-in-law observations into the mix and confidence is easily shattered, especially at a time when your hormones are spinning. It’s a good idea to get groundwork in before the baby arrives, plus meeting women at the same stage as you can help to build up a support network in case you do run into problems later. ‘A lot of women think if you’ve not cracked it by day two, you’re not going to,’ says Gillian, ‘But sometimes it takes a while for you and your baby to understand each other. With the right support, most women can breastfeed for as long as they want. Often it will come naturally, but if not, having a chance to talk things through is helpful.’ If you’re struggling to breastfeed after the birth, the NCT Breastfeeding helpline can help on 0300 33 00 771.

8) Once I’ve pushed out a baby, is sex ever going to be the same again afterwards?
It certainly can be. ‘For straightforward vaginal deliveries, (provided you do those pelvic floor exercises) you should enjoy a full recovery fairly quickly. Some women even report having better sex after a baby,’ says Mr Ismail. ‘But sometimes stressful births cause problems for the mother, from minor injury which can be painful, through to major muscle damage. These can almost always be put right, and gynaecologists specialise in this type of restorative surgery, so seek help if you need it.’

9) Is my belly button going to become an ‘outy’? Will it go back to normal afterwards?
It doesn’t take much to batter bedroom confidence – even funny tummy buttons don’t help. ‘Most people will get this because the abdominal muscles get so stretched, but yes, it goes back again eventually,’ says Gillian. Depending what shape yours is, it may go out or go flat, and there’s not much you can do except cover it with clothing. Some women stick it down with a plaster to flatten it.

10) I’m coming out of my first trimester and I’m so tired and sick all the time. I feel like a wuss, everyone else seems to manage. Are they just hiding it better?
‘A lot of women really underestimate how tired they’ll get, and people aren’t always honest about how bad they feel,’ says Gillian. This can be particularly difficult in the weeks before you want to tell friends and colleagues. It usually gets better in the second trimester, but it’s not unusual for symptoms to continue, and not just in the morning either. ‘Sometimes people are afraid to complain, but if you speak up, you often find other women felt exactly the same,’ adds Gillian.

  • Mr Ismail is a consultant gynaecologist and obstetrician at Queensway Gynaecology Clinic, Harley Street

For more information or an appointment at Queensway Gynaecology Clinic call:

Landline: 0207-935 55 40 / 0207-935 66 00

Mobile:
English: 077 409 444 73 / 077 457 481 88 / 077 450 461 44
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Arabic: 077 409 444 73 / 077 457 481 88

Email: info (at) queensclinic.co.uk

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