Pregnancy

This pregnancy was confusing! Chike wondered what would make a pregnant woman want to eat paper. His wife, Louis had developed an insatiable desire for books, but not in a good way.

Speaking to their family doctor, Chike complained his wife eats the paper. Ripping away pages, one by one, putting them in her mouth and chewing greedily on them.

Apart from her voracious appetite for books, his wife Louis was otherwise normal. In fact, she’d just given birth to their first daughter.

During the pregnancy, everything was normal; there was no complication or usual discomfort. Everything about her diet remained regular (except the paper consumption, of course).

He had no idea when it began nor how to stop it. He had first noticed it when she was consuming just bits of paper, loose pages, cutouts of newspapers, small flyers, and the likes. At that time, he thought it was just a phase that would soon pass away. However, Chike gradually watched his wife progress from bits of paper to whole books!

At this point, he decided to seek help

“What is happening?”, Chike asked the doctor. “Is this going to hurt her?”, “Is she depressed?”, “Should I be worried?”.

The questions kept on coming.

The desire to eat non-food items or things not normally considered to be food is known as PICA.

It is an eating disorder that makes people to eat things with no nutritional value such as paper, cloth, dirt, ashes, string, wool, starch, matches, cardboard, hair, laundry detergent, chalk and soap, talcum powder, gum, metal, pebbles, charcoal, paint chips, ice, among other things.

DIAGNOSIS

There are no laboratory tests to detect PICA. Instead, diagnosis is made through a patient’s medical history.

For efficiency, this diagnosis should be followed by lab tests for anemia and digestive tract blockages which may arise from the substances consumed.

AFRICAN WOMEN AND PICA

In Nigeria, most cases of PICA are usually unnoticed.

Therefore, it is unclear about how many people are affected by pica. However, one study reported that pica was a normal occurrence for pregnant women in Malawi, as this is how they know they are pregnant. Similar studies also reported a high prevalence of pica in Tanzania (63.7%), Kenya (73%) and Nigeria (50%).

SIGNS & SYMPTOMS OF PICA

Some of them include:

• Stomach upset
• Stomach pain.
• Bloody stool
• Constipation
• Diarrhea
• Bowel problems

HEALTH IMPLICATIONS

Repeated consumption of non-food items for a long period of time could prove dangerous. This is because some of these items have toxic, poisonous and bacterial content. Some health implications include;

• Lead poisoning
• Intestinal blockage or tearing
• Teeth injuries
• Infections
• Iron defi

RISK FACTORS

Some risk factors of pica include;

• Mental health disorders like autism, schizophrenia, e.t.c
• Iron-deficiency anemia
• Malnutrition
• Pregnancy

TREATMENT

The first course of treatment for pica is checking for nutritional deficiencies.

At times, the development of pica is an indication that your body is trying to compensate for a mineral or vitamin lack. Thus, using vitamins or nutritional supplements to treat such deficiencies usually helps resolve the pica. 

However, if pica is not caused by malnutrition or does not stop after nutritional supplementation, other forms of management need to be considered. There are a variety of behavioral therapies available.

Your health care providers will be in the best position to recommend one.

In Conclusion

A majority of pica cases go unreported in Africa, because most people who have this disorder tend to be secretive about it. The onus thus is in the court of health-care providers to pay key attention to any tell tale signs or even inquire specifically about any abnormal eating habits. Find out about foods to avoid during pregnancy

In Nigeria, pregnancy is usually seen as a woman’s domain. Their partners are sometimes uninvolved in their pregnancy journey.

After all, apart from the baby-making process, it is the women who do most of the work growing and birthing the baby. Their partners don’t throw up every morning, afternoon or evening.

In addition, there’s no one kicking in their belly, and there are no midnight cravings.

Many mothers with Nigerian partners feel that their partners do not understand the changes that come with pregnancy. To some others, the fathers don’t even make an effort to get involved.

If this is your situation, we absolutely understand. All you want is to feel supported and understood. You want your partner to actively participate and to see the pregnancy as real as you see it.

If your partner does not seem to show as much interest as you would like, don’t give up. Chances are he doesn’t even know what to do, but you can easily show him.

Here are the best ways to get your partner more involved in your pregnancy:

1) Invite Your Partner To Your Appointments

It is increasingly common for fathers-to-be to attend ante-natal appointments these days. In one of the foremost government run maternal hospitals in Lagos, fathers are required to attend the first antenatal clinic.

Ask your partner if he can take time off work to accompany you to some of your visits. Seeing your midwife or health care provider will provide your partner with the opportunity to ask any questions he might have.

Furthermore, if you plan to have him as a birthing partner, it is a good time for him to get familiar with your doctors and hospital.

2) Exercise With Your Partner

Exercise is an important part of your pregnancy.

It would help you stay fit and maintain a healthy pregnancy weight. Having your partner exercise with you will help you stay motivated.

As a bonus, it would provide a perfect bonding time for you, your partner, and your baby. There are plenty exercises you could try, from swimming to yoga and even walking.

Just do what works best for the three of you.

3) Get Your Partner Involved in Decision Making

Most of the time, and for many couples, the brunt of decision making about the pregnancy and birth falls on the woman.

Expectant mothers tend to be more overwhelmed with planning and preparation. However, involving him when making decisions will make him feel valued.

Discuss your ideas and plans with him, even the minor ones. Ask for his opinion on things, especially when making big decisions. Invite him to go baby shopping with you and encourage him to pick his favourite items too.

This will get him excited and motivate him to show more interest.

4) Ask Your Partner To Decorate The Nursery With You

This is one way to make him feel important and needed in this entire pregnancy process.

You can let him pick the colours or props for the nursery. He will also be able to help with any heavy lifting of shelves, tables or cribs. Both of you could plan a weekend to design the nursery together.

This would not only tick a big task off your list, but will also create a bonding time for both of you. Going through the process of designing the nursery and having it ready and waiting will make the pregnancy feel real for him.

5) Encourage Your Husband To Touch Your Bump

As the mother, you get the opportunity to carry your baby wherever you go.

However, your partner does not. While it would be easy for you to naturally bond with your baby, it will be more difficult for your partner.

Help him by encouraging him to bond with your baby before birth.

Let him know when the baby starts kicking and give him plenty opportunities to feel these kicks. You can also encourage him to talk to the bump too, and this will earn you a few extra kicks.

6) Give Your Partner Attention

It is very easy for the focus to shift from your relationship with your partner to your relationship with your baby. Babies after all are always the center of attention. However, this might make your partner to feel left out during the pregnancy as it may seem that he has become second fiddle.

Don’t let this happen.

While you need to pay attention to your growing baby, you should not forget your partner. Your relationship is now more important than ever, as a baby is on the way.

Go on lots of dates.

You could try seeing a movie, going to the beach, taking walks, eating out, or even going on a vacation together if you can afford it. Now is the best time because once the baby comes, it will be more difficult.

7) Create Your Birth Plan Together

You would need a birth plan to make your labour and delivery process as smooth as possible.

Even though you are the one popping out the baby, your partner plays a major role too. Let him in on your birthing preferences, and what you expect of him during and after the birth. This will help him advocate for your wishes while you are in labour.

Avoid just telling him what you want.

You will get him more involved if you ask for his opinions too. Prepare the plan together, and you will prepare him for birth. Encourage him to pack a hospital bag too, he will need it. What goes in the bag? Things like snacks, socks, a toothbrush, music and headphones. Things to make his stay with you in hospital more comfortable. Being involved like this will help him understand better what is at hand.

8) Attend Birthing Classes Together

This is especially important if you plan to make him your birthing partner.

Unlike you, your partner probably has no idea what the entire birthing process will involve. These classes would teach both of you about the birthing process, birthing choices and what to expect with a newborn baby. He’ll learn to bath a baby, change diapers, how to tell if the baby is hungry etc. It will make life for you as a new mum easier. It will also give your partner the opportunity to bond with other expectant fathers as well.

A Final Note

Pregnancy and childbirth can be overwhelming for you and your partner.

Despite popular opinions, most Nigerian men actually want to do their best to support both mother and child. The only problem is they do not know what to do or how to go about it.

Help your partner. Show him what he needs to do and how to do it. Don’t stop at pregnancy. His support is also needed in your breastfeeding journey and your child’s development. Furthermore, In the light of the toll of the current COVID -19 pandemic and it’s effect on your care during pregnancy, you need all the help you can get at home. Involve him in even the little decisions and you will be surprised at how involved and interested he would get.

Malaria is one of the most common health challenges for pregnant women in Nigeria. Although malaria is life-threatening, it is preventable. Malaria in pregnancy is curable with the use of simple behaviour changes and medication.

Let’s consider the causes, treatment and prevention of malaria in pregnancy.

What Causes Malaria?

Malaria is caused by a parasite carried by the female anopheles mosquito. These mosquitoes transmit the parasite to humans when they bite us. They prefer to bite at dusk and dawn.

So far, the strains of malaria parasites identified include Plasmodium Malariae, Plasmodium Ovale, Plasmodium Vivax and Plasmodium Falciparum. Plasmodium Falciparum is the most lethal strain. Plasmodium Vivax on the other hand is the most common and has a tendency to remain latent in the liver and placenta causing relapses of malaria..

During pregnancy, women have a decreased immunity that places them at a higher risk of contracting malaria. In addition to this, the weather condition in Nigeria also plays a major part. During the rainy season, mosquitoes grow faster and the spread of malaria increases. First time

Pregnancy and Malaria

Malaria is common in pregnant women. Their immune system during pregnancy does a poor job of protecting mums from the infection. Once they get into the blood stream, the parasites love to hide and multiply in the placenta. ⠀

Immunity is lowest during pregnancy in the second and third trimesters. Therefore, extra caution is needed at these times.

Signs and Symptoms of Malaria

The basic signs and symptoms of malaria include:

• Headache
• Nausea
• Vomiting
• Fever
• Diarrhoea
• Muscle aches
• Sweats
• Tummy aches
• Weakness / Fatigue
• Chills

Note that some mums may have the parasites and don’t experience symptoms. They can still pass malaria one to their babies.

Risk factors of malaria in pregnant women

• Living in a region where malaria is common
• Living in dirty environment : A dirty environment provides a good breeding space for mosquitoes. If a pregnant woman is living in an area that is dirty and/or there collections of stagnant water around, she has a very high risk of contracting malaria. Mosquitoes bread in stagnant water collected in disused containers, vehicle tires, clogged up gutters and so on.

• Blood transfusion: Receiving blood from someone who has malaria or has just been treated for malaria puts the pregnant woman at risk for malaria. The baby also has a chance of contracting the malaria from the mother’s blood in severe cases.

How Is Malaria In Pregnancy Treated?

Malaria treatment for pregnant women should be done under proper medical guidance. Your treatment depends on your age, pregnancy stage, and severity of symptoms.

Your doctor is in the best position to tell you what drug to use at that particular time. This is because certain malaria medications are unsafe in the first trimester. So be sure you are not pregnant or in the early stages before taking them ? Others, if taken too close to delivery can cause jaundice in the newborn. However, the WHO recommends sulfadoxin- pyrimethamine as a drug of choice for prevention and artemisinin based combination for treatment of pregnant women with malaria.

Please, avoid over-the-counter drugs at all times. Ensure that your doctor is well informed regarding all matters pertaining to your health during your pregnancy .

Prevention

• Stay in a clean environment. Eliminate stagnant water completely and make sure that your garbage is properly disposed.

• Use of long acting insecticide treated mosquito nets while sleeping and mosquito repellent is encouraged.

• When you’re using mosquito repellents, ensure you use in the appropriate quantity specified by the manufacturer. An excess use of repellent does not equal an extra kill effect on the mosquitoes, rather, you are placing your health at a higher risk.

• Wear light-coloured clothes as much as possible. This is because mosquitoes are more attracted to dark colours. Ensure your dresses are full-length and long-sleeved especially at night.
• The World Health Organisation recommends intermittent preventive treatment in pregnancy (IPTp) for all pregnant women. This is with a medication called sulfadoxine and pyrimethamine(SP) (Fansidar) for mums who don’t react to sulfur. From the second trimester, this is to be taken twice in pregnancy for regular mums and 3 times for HIV positive mothers. This treatment reduces the number of episodes of malaria. It reduces the chances of anaemia in mum and baby as well as infant death. Your doctor will advise on the dosage and timing.

Effects of Malaria on Pregnancy

• Anaemia : The parasite makes us ill by destroying the oxygen carrying red blood cells starving the tissues of the fuel they need to function and thrive. This explains the weakness and fatigue associated with malaria
• Miscarriages ⠀⠀⠀
• Low birth weight: Malaria can cause poor growth and malformations in the baby
• Still birth
• The new born also has a risk of coming down with malaria after getting infected through the placenta.

Finally,

Take care of your surroundings and ensure that your environment is clean at all times. Please try and get your doses of preventive anti malaria medication during ante natal care. Not all fevers are malaria. It’s important that ill mums get tested to be sure before taking malaria medication. Call or visit the clinic whenever you feel unwell. Please avoid the use of over-the-counter drugs at all costs.

In Nigeria they are fondly called ‘Ejima’ in Igbo , ‘Ibeji’ in Yoruba, ‘Dan tagwaye’ in Hausa. Everybody loves twins.

Seeing them in those beautiful matching outfits definitely triggers those ‘feel good’ hormones in all of us. This article contains everything you need to know about Twins and Multiple Pregnancies.

What Is A Multiple Pregnancy?

A multiple pregnancy is one with more than one baby growing in the mother’s womb.

How Does A Multiple Pregnancy Happen ?

There are two main types of twins; Identical and Non-identical (fraternal) twins.

During a woman’s menstrual cycle, an egg is usually released.

Identical twins arise when a fertilized egg divides into two in the early stages of pregnancy. Conversely, non-identical twins are formed when more than one egg is released during a cycle. Seperate sperms then fertilise each egg is then fertilized by seperate sperm.

Most times, identical twins are have the exact same copies of genes. However, fraternal twins are not genetically identical.

What Causes This?

1. Fertility Drugs: The use of fertility drugs to induce ovulation. This can result in more than one egg released from the ovaries leading to their fertilisation.
2. Assisted Reproduction/In-vitro fertilisation (IVF).: This results in multiple pregnancy when more than one egg is transferred to the womb.
3. Maternal Age: Women above 35 are more likely to give birth to twins. This happens because women of this age often release more than one egg in a single menstrual cycle.
4. Maternal Height and Weight: Taller and heavier women tend to give birth to twins more often.
5. Genes: This relates more the woman’s genes; a woman is likely to have twins if she is a twin or has siblings/cousins who are twins.

How Can You Stay Healthy During A Multiple Pregnancy?

1. Eat Nutritious Food: As an expecting mum of two or more, you need to eat more protein and stay hydrated. Also, you will also need to eat some extra calories so that your babies will feed well .
2. Exercise: Consult your doctor to know which exercise is good for you at each stage of your pregnancy. Nonetheless, you need to avoid strenuous activities.
3. Rest : Do so much as you can. This will require support from family snd friends
4. Attend Clinics Attend these regularly as directed by your doctor so that your well being and that of the babies can beclosely monitored.

What Are The Risks?

1. Early Labour and Preterm Babies: Sadly, this is quite common in multiple pregnancy. Most pregnancies last for about 37 weeks. The duration for multiple pregnancies is about 35 weeks.
2. Hyperemesis Gravidarum (HG): This is excessive vomitting in pregnancy . It can throw the fluid and electrolyte balance of a mother off requiring hospital admission.
3. Diabetes: Gestational diabetes is more likely to develop in women with multiple pregnancies. Unfortunately, this may cause respiratory distress in growing babies.
4. Preeclampsia: This refers to high blood pressure (hypertension) that occurs in pregnancy. Preeclampsia is more common in multiple pregnancies than single pregnancies.
5. Delivery: The choice of delivery depends on the number, size, position, and health status of the babies. Often times, a Caesarean section is advised for women with multiple pregnancies.
6. Placenta Abruption: Most times, multiple pregnancy affects placenta function. A placenta abruption occurs when the placenta becomes separated from the inner wall o the womb before delivery.

How Will They Be Delivered?

Most twins in recent times are born by a pre-planned caesarian section. Depending on their size. health status of (mum and babies) and position, they can be delivered vaginally.

How Do I Feed Them?

It is perfectly possible to feed twins exclusively on breats milk with the right support and positioning. Most twins are nursed in tandem using a rugby position. Here mum positions babies with their heads infront beside her breast and legs pointing backwards under her armpits. This mimics how one carries a purse or rugby ball. You will need nourishing food , hydration, and good social support. Don’t hesitate to request for what you need. Get a good breast pump so others can help with feeding. It is not uncommon for families to supplement with formula.

In Conclusion,

Having twin babies is a delightful experience although it comes with its own pecularities.

While expecting multiple babies, it is advisable to attend clinics regularly. This allows your doctor monitor the health of you and your babies effectively.

Finally, the complications of multiples can be reduced and managed better when you visit your physician regularly.