Question: I’m really worried about having a big baby, my midwife said that my bump
is very big at 24 weeks. is there anything i can do to help prevent having a big
Answer: I am not sure of what to make of the said comment by your midwife. Let me
put it this way: It is not possible to forecast the eventual size of the baby at
24 weeks gestation. Babies do end up with different sizes at Term but this divergence
in size and weight does not become apparent until around 26 weeks at the earliest.
In fact, babies are roughly the same size in the first half and the first few weeks
of the second half of pregnancy.
If the womb measures bigger than expected for a woman at your stage of pregnancy,
there are two possible explanations: Wrong dates or increased amniotic fluid. I take
it there is no doubt about your dates. That means, in your specific case, there are
two possible explanations for that comment: Either the midwife's measurements are
erroneous or you have increased amniotic fluid. Your midwife or doctor should be
able to clarify the picture for you.
With regard to your last question; you should never take any steps to try to limit
the size of the baby. You can only do harm. Just maintain a healthy diet. In any
case, as explained above, this is quite likely a non-issue here.
Pregnancy after a measles infection
Question: After getting measles, if i want to conceive when is the right time (how
many months gap should be there?) S. (India)
Answer: There is absolutely no need to have an enforced interval before trying for
a baby after a measles episode. The viral infection clears completely from your system
and you are left with protective antibodies that you will have for life. There is
no risk to your baby however soon you conceive after a measles episode.
’Back to back’ baby and delivery issues
Question: Is a back to back birth dangerous for mother or baby? D.M. (UK)
Answer: I am not entirely sure I understand your question. Do you mean a situation
where the baby is lying with its back to the mother's back? If that is the question
then the answer is no. This position is neither dangerous to the mother nor the baby.
However, if the baby were not to rotate to a more favourable position during labour
then there a few issues that the mother ought to know.
Labour might be prolonged
There is tendency to have much more back-pain during labour with this position
Increased likelihood of requiring intervention with either instrumental delivery
(forceps or ventouse) or caesarean section. This, if it happens, is due to poor labour
progress and not due to fetal problems.
Head not engaged
Question: At my last scan my midwife said my baby’s head was 4 fifths in the birth
canal what does this mean? L.Q. (UK)
Answer: In examining a pregnant abdomen, one of the parameters looked for is the
leading part of the baby. If this is the head, as appears to be the case with you,
a midwife or doctor needs to assess whether it is descending into the pelvis. To
achieve this, the head is mentally divided into 5 parts. In summary, if most of the
head is inside the pelvis, it will be said to be engaged.
If your midwife said the head was 4/5th in the birth canal (pelvic cavity), it simply
means only one fifth can be felt abdominally. In other words, it is engaged.
Causes of anencephaly
Question: What causes anencephaly? I had a child with anencephaly 28 years ago and
I was diagnosed at 32 weeks, this was very traumatic for me. I wondered if there
was anything that I could have done, or, not done to prevent this. J.M. (UK)
Answer: I'm sorry to hear of your quite traumatic experience all those years ago.
You may know that anencephaly is not as uncommon as one might be tempted to think.
The lack of knowledge about the condition in the general public is mainly due to
the fact that the diagnosis is, nowadays, made quite early in pregnancy and most
mothers opt for termination of pregnancy. It is no consolation but clearly a lot
less traumatic compared to a case like yours where the diagnosis was made so late.
You will also be aware that anencephaly is just one form of the neural tube defect
(NTD) spectrum, albeit the most severe one and invariably lethal. In the vast majority
of cases, there is no obvious underlying cause. In some cases, there is an underlying
chromosomal disorder. In summary, there is really no question of you having done
or failed to do anything. Anencephaly is already established at 6 weeks of gestation.
You could not have influenced anything at all, one way or another.
Clearly the pain never goes away. However, I hope you can allow yourself to achieve
peace on this matter. In short; it was never your fault (or anybody else's).
Question: I am 8 weeks pregnant and I have had brown bleeding for the past 3 weeks,
I had a scan and was told everything was fine, I am now experiencing bright red bleeding
with little clots which is like a period, what should i do? M.C. (Ireland)
Answer: The progression of the vaginal loss to what sounds like fresh blood is rather
worrying. Of-course you have been going through a threatened miscarriage. This new
situation does not change the diagnosis but is certainly not a reassuring development.
Since the clinical picture has changed, it is important that you have a repeat scan
to check the current status. there is really nothing you or your doctors can do to
influence the situation but I think you will agree with me that it is always best
to know where you are. You may also want to know that roughly 9 out of 10 threatened
miscarriage cases resolve successfully and carry on.
In most pregnancies, the baby’s back tends to be on the side or to the front. If
the baby’s back lies towards the mother’s back, it could mean a prolonged, more painful
labour sometimes requiring assistance at delivery.