Question: Hello, I am after some professional advice..... I am 40 years old and have two beautiful, healthy boys (4 and 15 months.
I suppose I should be happy that our family is complete but recently I feel an increasing sadness that I will never be pregnant again, never breastfeed and never hold a newborn baby. I think about having another baby every day now, but in many, many ways it just wouldn't be practical - my age and my husband's age (he's 53), financially we are stretched as it is, the fact we have no help as such, and I suppose more importantly, the fact that I have Arthritis - it seems to be Lupus, although it hasn't been confirmed yet. It is a very mild form (now) and I am not on any medication. The arthritis first started in my last pregnancy and caused a lot of acute joint pain in the 5th month and then 3 months after the birth (although we didn't know then it was arthritis). I had suffered a miscarriage before this pregnancy and now I'm wondering if it was caused by the Arthritis although I'd had no symptoms then.
So as you can see, there are quite a lot of reasons why having another child would NOT be a good idea. What should I do - ignore this strong feeling and just be happy that I have two healthy children? Medically, what would you advise? Thank you for your time. E.S. (Greece)
Answer: This, in my view, is more of a psychological conundrum rather than obstetric. There are really two issues that I can comment upon from an obstetric point of view: Your age and the presumed diagnosis of lupus-type arthritis.
At 40 years of age, you really do need to think carefully about whether to pursue a pregnancy. You clearly appear to be doing a lot of thinking. The age related concern is mainly based on the significantly increased risk of all manner of pregnancy complications ranging from miscarriage to such things as molar pregnancy, pre-eclampsia and many others. The most worrisome for many prospective mothers is the increased risk of fetal abnormalities and especially chromosomal disorders such as Down’s syndrome. These are real issues and you will be best advised to give them clear headed thought. The issue of arthritis is probably still unclear. The evolution of your condition makes me think it is probably unlikely to be lupus. However, for the sake of your immediate issue calling for a decision, the arthritis does not present a strong case against embarking upon a pregnancy. Were you to do this in the current circumstances where the diagnosis remains unclear, I would strongly suggest that you take low dose Aspirin (75mg daily) starting soon after you confirm the pregnancy. Remember, don’t take this before you conceive as it actually reduces the chances of a successful conception. My best wishes going forward.
Question: My question is - i am 38 weeks pregnant and i am carryig excess fluid - this level is increasing not decreasing. My dr has stated all along that i wont go this long - but here i am !! He has booked me in for a sweep this week - but i cant be induced due to a previous section - what is the liklyhood that they will do the sweep given the increased fluid - AFI is 28.9 - and what happens if this doesnt work - they are very worried about placental abruption, prolapsed cord and heamorraging. How much longer will they let me go?? Thanks. B.S. (UK)
Answer: Vaginal bleeding in early pregnancy, regardless of the amount, should be regarded as a threatened miscarriage until proven otherwise. Even if the bleeding stops, it is important that viability is verified. I would suggest therefore that you bring this to the attention of your doctor or your local hospital’s early pregnancy assessment unit. My best wishes.
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Question: I am 6 weeks pregnant and have been taking a prenatal vitamin every day since before conception. I have also been taking fish oil concentrate plus GLA. But I am now very worried, as I have just read that pregnant women should not take borage seed oil, which is contained in the capsules i have been taking. I will stop taking them now, but feeling very anxious that i may have harmed my little fetus. Can you offer me any more advice? Also, should I continue taking omega 3? and if so, can you recommend a safe one during pregnancy? Thank you. L. (UK)