Dr. Yuvakshi Juneja
Obstetrician and Gynecologist
Q. What is the difference between a Gynecologist and an Obstetrician?
A. The Gynecologist deals with women related problems while an Obstetrician deals with pregnancy and delivery. In India this difference is not that relevant as most doctors in this field specialize in both the areas.
Q. When should a girl start wearing a bra?
A. Initially the breasts are made of fatty tissues only. Once glandular tissues start growing then a girl will start feeling uncomfortable and will require support from a bra.
Q. What should one look for in a bra?
A. The bra you wear should give your breasts good support. It should be of the right cup size and chest size. The right cup size is very important.
Wearing the right bra size is even important during pregnancy as it adds support to your breasts. Post-partum it is even more important as an ill-fitting bra could lead to collection of milk in the wrong places and subsequently abscess.
Q Should a woman visit a Gynecologist just before marriage?
A. Premarital counseling for contraceptives is very important.
Q. Should one go through a gynecological check up before conceiving?
A. Ideally a complete check up should be done once a woman decides to start a family. But this rarely happens. Most women only come for a check up after conceiving.
Q. Are there any pregnancy tests available in the market that a woman can use herself to find out whether she is pregnant or not? How reliable are these tests and how soon can they detect a pregnancy?
A. Yes there are a lot of such tests available with chemist shops. These tests are almost 99% reliable. A pregnancy can be detected within 48 hours of missing a period.
Q. What is the ideal weight gain during pregnancy?
A. In the first three months generally women tend to loose weight. Subsequently they should gain 1/2 kg per week, ideally, that is about 11 to 12 kgs through the pregnancy.
Q Should a pregnant woman drive?
A. As such there is no problem in driving during pregnancy. Only in the later months it becomes uncomfortable and may not be safe in small cars where the distance between the stomach and steering wheel is very less.
Q. What kind of exercises are advisable during pregnancy?
A. Any kind of exercise is good for the body during pregnancy, if you are used to it. Exercises for the back and the pelvic floor muscles help in labour and also help in maintaining a good posture. If you are not used to exercising, walking is also very good.
Q. Are deep breathing exercises required? Where can one learn them?
A. Deep breathing exercises help during labour especially during bearing down. Most obstetricians tell their patients how to practice deep breathing. Some places also give classes.
Q. When should one start exercising after delivery?
A. If you have had a normal delivery you can start almost immediately. In case of a Caesarian you should start only after two months.
Q. How much more is the diet requirement of a pregnant woman?
A. In the normal course Indian women requires 1800 calories daily. During pregnancy this increases by another 300 calories. Not only the diet should be increased but what component of the diet to increase is also important. The requirement for calcium, proteins and iron is much more. All vitamins and supplements are also needed more. Milk and milk products should be taken at least 2-3 times a day. Fresh fruits and green vegetables should be increased. Carbohydrates and fats do not need to be increased.
The meals need not be large meals but their frequency should increase. Instead of having three large meals you can have three light meals with 2-3 snacks in between. The last meal you eat at night should be light and should be eaten early.
Q. Is the diet requirement of nursing mother the same as that of a pregnant woman?
A. A nursing woman needs even more nutrition as compared to a pregnant woman. The requirements of calcium are higher, so milk and milk products need to be increased.
Q. Why does one need to take prophylactic doses of Iron and Calcium? What is the best way to take these tablets?
A. In most Indian women the store of both Calcium and Iron is low. During pregnancy the requirement is much more. Despite increasing intake of calcium and iron in the diet the requirement is still not met. Therefore doctors prescribe for prophylactic doses of Iron and Calcium. These are best taken some time before a meal as some food elements in our diet interfere with the absorption of these supplements into the body.
Q. What precautions are advisable during pregnancy?
A. Food- Taking food from outside should be avoided unless you are very sure of the quality of food. Raw foods such as salads, curds should not be consumed from outside. Similarly avoid eating non-vegetarian food prepared outside.
Also avoid drinking water outside. At home also drink only filtered water.
Travel- Do not travel by three wheelers and two wheelers. In fact travelling by bus is safer. Any long journey should be preferably conduced during the middle trimester of the pregnancy.
Hygiene- Look after your body’s hygiene especially keeping your breasts and external genitalia clean.
Sleep- Avoid late nights. Get lots of sleep one hour in the afternoon and eight hours at night. Working women who may not be able to rest in the afternoon must at least put up their feet during the day, if possible.
Medication-No self-medication should be taken at all. Whenever you go to a doctor, apart from your obstetrician always inform him that you are pregnant, so that he can take that into account before prescribing medicines. N x-ray exposure unless absolutely necessary and approved by your obstetrician.
Q. What are the common problems seen during pregnancy?
A. Spotting – bleeding in the early part of to the pregnancy could be a sign of an early abortion. During the later part it could be due to placental problems. You must contact your obstetrician immediately.
Nausea –Vomiting, feeling of nausea and not wanting to eat is a common occurrence during the first three months. But if you vomit frequently and are unable to keep the food down, do inform your obstetrician.
Urine Infection- The chance of urine infection is much more during pregnancy as he passage tends to be dilated. This infection could move up to the kidneys as the pressure from the uterus and hormonal changes make the passage susceptible.
Anemia- Some women develop anemia despite taking iron supplements.
Blood pressure-Pregnancy related blood pressure usually develops after 20 weeks (5 months)
Q. Should the mother and the newborn go through a confinement period of 40 days as dictated by tradition?
A. The newborn and the mother are both prone to infection. In the olden days antibiotics and other such cures were not available, so a confinement period was the only way to combat infection. Though now there are enough medicines to take care of infections there is still no harm in being cautious by keeping the mother and the newborn away from infections.
Q. When is the right time for a second pregnancy?
A. Ideally you should wait for 2-3 years before going in for the second baby. Your body needs to recover from the pregnancy and nursing. Also you need time to look after your first child.
Q. Are husbands allowed into the delivery room?
A. In most private establishments husbands are allowed to be present during the delivery.
Q. Why is a local anesthesia given during Caesarian?
A. A spinal/regional analgesic is considered safer as the baby doesn’t get the drugs. Also it is used when an emergency operation needs to be done and the mother is full stomach.