Mother and Baby

Wednesday Lunch Club Q+A With Obstetrician And Gynaecologist Roger Marwood

Missed our Wednesday Lunch Club with obstetrician and gynaecologist Roger Marwood? Don’t worry, you can read all of the expert advice he shared here

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Every week at Mother&Baby we bring you the Wednesday Lunch Club – a chance to get brilliant advice for your pregnancy and parenting questions from a top expert. 

This week, obstetrician and gynaecologist Roger Marwood was on board to answer questions. Roger’s a consultant obstetrician and gynaecologist at the Chelsea and Westminster Hospital in London. He has 40 years of experience working in a busy NHS hospital and has personally supervised around 20,000 pregnancies and countless deliveries. He’s also a past president of the Royal Society of Medicine and has worked extensively for the Royal College of Obstetricians and Gynaecologists.

Roger and his daughter Rebecca Maberly work together to help pregnant women on their website Doctor and Daughter. So whether you’ve got a question about a pregnancy complication, labour or post-birth recovery, Roger’s the perfect person to ask.

If you missed the chat, here’s what happened…

I am 23 weeks pregnant and my three-year-old son was in direct contact with a child infected with chicken pox 10 days ago. As I haven't had it and I'm not immune to it, I have sent him over to my mum three days ago. How long do you think I should keep him there and how dangerous is it for me if I get infected?

Roger Marwood: You need to have a blood test to prove if you are immune or not. The incubation period is up to 21 days. We recommend you speak to your GP. If you are not immune then he or she may suggest some preventative treatment. As a general rule, chicken pox in the middle part of pregnancy is not normally seen as a serious problem.

One in 30 women develop a form of mild diabetes (glucose intolerance) during pregnancy

I'm having trouble getting pregnant. During recent checks, I have discovered a second dermoid cyst of only about 1cm in length and width on my ovary – the first was removed two years ago from the other ovary after it had reached 9cm/ 12cm. I'm wondering if it is worth taking it out before it gets any bigger? Could it be hindering pregnancy? And does pregnancy causes it to grow more quickly?

Roger Marwood: This is quite common and 10 percent of dermoids are bi-lateral (on both sides) but if it is only 1cm then you have nothing to worry about as far as fertility is concerned. Dermoids grow very slowly and this has probably been growing since you were born. We do not recommend surgery until or unless it is 5cm or more. Its size and growth are unaffected by pregnancy so do not worry about it growing more quickly if you get pregnant.

With my first baby I suffered a third degree tear which was operated on badly and 12 months on I’m still unable to have sex with my partner as it's uncomfortable. What can I do? We want to try for another baby but obviously can't. I would also like to know if it would be possible to consider a natural birth again if I can get pregnant.

Roger Marwood: We would advise you to see a consultant gynaecologist to investigate your symptoms. It is very likely that things can be corrected with fairly simple methods and you should be able to resume a normal sex life. As far as a natural delivery is concerned, advice will be determined by whether or not your sphincter has been significantly damaged. This may require some special tests. Please talk to your GP about a referral.

I'm expecting my second baby in a week and it's breech. As my first baby was delivered by emergency C-section and it's looking likely that I'll have a C-section for this baby. Will the obstetrician re-open the same scar? How will that affect healing?

Roger Marwood: Repeat C-sections are normally done through the same incision, both in the skin and in the uterus. Healing should be unaffected by this and recovery should be a little quicker. As a generalisation most repeat C-sections are less traumatic, both physically and emotionally, than the first one.

Type-1 diabetes runs in my family but I've never had it. Could I be at risk of gestational diabetes because of this?

Roger Marwood: One in 30 women develop a form of mild diabetes (glucose intolerance) during pregnancy. Most maternity units recommend a screening test for diabetes based on a blood sugar test. If you are at extra risk then a full glucose tolerance test is the best way to make the diagnosis.

I'm really scared about giving birth and about tearing in particular. What can I do?

Roger Marwood: Many women are worried about this, but the chances of serious damage to the pelvic floor is less than five per cent. However, if this is your first baby it is more likely than not that you may need a few stitches after the birth. These usually heal very nicely and are unlikely to affect your life in the future.

Pethidine is a very useful painkiller which can be safely given for one or two doses

I wanted to ask about pethidine. I've heard different things about whether it's helpful or not and wondered what the current thinking is about it?

Roger Marwood: Pethidine is a very useful painkiller which can be safely given for one or two doses. However, it does not take the pain away completely and may make you feel sick and sometimes makes you and the baby a bit sleepy. Occasionally the baby can be slow to breathe and needs some gentle resuscitation.

I didn't practice pelvic floor exercises in pregnancy. My baby's now two months old – is there any point in starting?

Roger Marwood: Yes, it’s never too late to start. Try and aim to do it whenever you remember, try and use something like washing your hands or changing your baby's nappy as a reminder and try to get into a routine.

Wondering how to do pelvic floor exericises? Find out here.

I'm due in two months and am really worried about the pain of labour. How soon after arriving at hospital can I have an epidural?

Roger Marwood: Once the midwife has established that you are in the active stage of labour then it is likely that you will be able to get the pain relief of your choice. You need to be at least 3cm dilated and don't forget that up to 20 percent of women find that they are able to cope without major pain relief and you might be one of these.

My due date is this Friday and my tummy feels really tight, often during the day and all night. It's been like this for a couple of days. I don't feel any pain, it's pretty uncomfortable though. Is that normal?

Roger Marwood: This is quite normal. You are having contractions and are probably going to go into labour quite soon. Providing the baby is moving well and you are comfortable there is no cause for concern.

Anyone suffered from SPD? I’ve got it, really painfully, now at 38 weeks. How does it affect your labour as I would like a natural birth again?

Roger Marwood: This will not affect your ability to dilate and push out a baby and you should recover a few weeks after birth. As it is your second baby, the birth may be quick. I hope you get some advice from other women who have also experienced SPD.

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