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Family planning: crucial steps

26 September 2018

"Congratulations, you will have a baby!" This news becomes a real surprise for somebody. For others, it's a long-awaited event. Both of these occur in the physician's practice. But the best thing is when the couple planned a pregnancy and did everything they needed to give birth to a healthy baby. Therefore, we talked with the gynecologist-endocrinologist Natalia Silina, the founder of the educational project for women "Dr.Silina's School of Women's Health" on how to get prepared and what will happen to young parents after the birth of a baby.

 

What would you advise to a woman to do right now, if she wants to make sure she's healthy and to give birth to a healthy baby?

  • She should visit a gynecologist, to begin with. It is better to do this in the first phase of the cycle - that is, right after the menstruation, and the woman should abstain from sexual life two days before the visit. The doctor will check whether there are any visible irregularities or some problems with the function of the uterus, ovaries, fallopian tubes. Another important criterion for women's health is her menstrual cycle. If there are no deviations in it, then, accordingly, there is no reason to suspect that this woman may have problems with getting pregnant. If the woman is not planning to become a mother yet and wants to wait with the pregnancy, it is also necessary to get examined and check her ovarian reserve, the stock of oocyte cells. It tends to decrease with age.

What's the best age for pregnancy?

  • Talking from a medical point of view, the best age for the first pregnancy is 22-25. However, from the psychological side the most suitable time is when a woman is willing and ready to become a mother. If she is not genuinely willing to get pregnant, but does it, because "it is necessary", then, of course, the maternity will not make her happy. She should be aware that the baby's birth will change her life. Similarly, it can change the relationship with a partner, and not always for the better. Therefore, one should take responsible approach to both giving birth to children and bringing them up. One should get prepared for that.
     

Both man and woman in the couple should get prepared? Or, possibly, family planning is more important for a woman, as the pregnancy affects her in the first place?

  • Preparation is equally important for both women and men. The family planning system is, above all, a system of preventive activities to avoid deterioration of health. This set of activities includes not only the proper choice of contraception, but also the preparation of a couple for the future pregnancy, preventive oncological screening. Women need to undergo screening for breast cancer and cervical cancer, check for hepatitis, HIV, diabetes mellitus, and thyroid gland malignancy. Men have to get screened for prostate cancer. All this is necessary in order to minimize the risks that can occur during pregnancy and give birth to a healthy child.

You should start taking 400 μg folic acid 3 months prior to conception planning. Recent studies have revealed that vitamin D deficiency plays a certain role in complications during pregnancy. But the lowered level of this hormone increases the risk for a woman to develop obesity and cardiovascular disease even regardless of pregnancy. I recommend taking a blood test for vitamin D (25-on) for all women regardless of age and consult your family doctor, rather than Google, about the results.

How should the couple get prepared for giving birth?

It is worth visiting a family doctor who will collect the health and say whether the couple is healthy. The man should go to the andrologist and check whether everything is ok with his prostate. Both partners should take tests for hepatitis and HIV, to see whether there are protective antibodies to the TORCH infections in their blood (this is a group of infections that can cause abnormalities in the fetus when the woman gets initial exposure to them during pregnancy).

If a woman did not have rubella during her childhood and is not vaccinated, then it is better to do it. It is also necessary to check the level of sugar, to normalize your weight, to make sure everything is in order with the work of the thyroid gland. If there is an irregularity, then you need to address them before pregnancy. The first three months when the baby is in the womb, their thyroid does not work, so the babies have to rely on mother's hormones. Therefore, the thyroid in the mother should work like a clock.
 

What can you say about giving up alcohol and cigarettes before pregnancy?

  • The couple should give them up three months before the pregnancy. It is especially important for men to avoid beer, as it decreases the spermatozoid mobility.
     

What time before the delivery is the best to get enrolled at the courses for moms-to-be? Which ones are the best?

  • When the couple had visited doctors, checked that everything was OK with them, and the woman became pregnant, they should immediately start looking for courses for pregnant women. It is not enough to just listen about the delivery and anesthesia during it. Choose the courses where you will be told about proper breastfeeding, what the baby's first year of life will be like, what happens at this time with the mom - how her body is recovering, what the father should do during this time. Moreover, the courses should teach the basics of sexual education for children.
     

In your experience, it is common that both partners attend the courses?

  • Yes, men also attend them. Four years ago, when I just started the courses in my Dr. Silina's school of female health, there were just a few men. And now the majority of pregnant women attend them with partners.
     

In your opinion, why there are more men now?

Modern men begin to realize that their happiness depends on the happiness of their female partner. If you want to be cared for, you have to show care and support themselves. It's you who are building these relationships, setting goals and moving together to implement them. I see that the level of consciousness and maturity in men has increased significantly.
 

Who is he, this conscious and mature father-to-be? How old is he? What features does he demonstrate?

  • This is a man who clearly understands his role in the family, knows what his partner loves and needs. He is interested in the changes that happen to her during pregnancy. He knows if he wants to participate in childbirth. If he wants to, he realizes that he goes there not to control the medical staff, but to serve his beloved woman.

He takes an equal share of responsibilities in bringing the child up. When the baby cries at night, he can get up, take them in his arms, calm down, giving the partner the opportunity to sleep at that time. When a child is ill, he also cares. When children whine, cry or get sick, it is a huge burden for the mother. Therefore, he has to share these moments with her.

As for the age of maturity, it's difficult to say something definitely. There are men who are not ready for the birth of children even at 45. They are kids themselves, who do not know what they want to achieve in life. They consider their partner to be just another mom who will take care for them. And there is an opposite situation: a 25-year-old guy clearly knows what he wants from life and what kind of woman he wants to be with him.
 

You mentioned partner delivery. Is it worth insisting that the partner should take part in them?  

This idea should not be imposed or forced on a man. If a man decides to attend partner childbirth, he must clearly understand that it will be the act of serving his beloved woman. He goes there not to control, but to give her water, to do a massage, if she wants, to shower her with a warm shower, to engage and to empathize. A woman during childbirth should be relaxed and feel absolute safety. There must not be a single dash of adrenaline in the air, because it suppresses oxytocin production in a woman during childbirth. Therefore, if a man is going to be there full of adrenaline, then he should better stay away.
 

There are different versions on how participation in childbirth affects men and their attitude to a partner. In your opinion, can a partner childbirth affect the relations adversely?

  • If the husband was not ready to participate in the partner delivery and did not understand what will happen there, of course, he may experience various psychological traumas. But if you knew what to expect, participation in childbirth would only strengthen relations. After all, the man will understand what his wife has to go through to give birth to a baby.

It all depends on the husband's psychological type. There are men who are extremely worried when they see that their beloved woman is in pain, and they cannot help in any way. Then they feel great frustration and do not know what to do about it. Obviously, this will not have a positive impact on their psyche.
 

Let's talk about sexual education for children. How should the parents provide this knowledge to prevent the children from getting misguiding information from their friends or videos in the Internet?

  • Parents themselves should understand what is happening to their child in each age period. And then talk about it with a child. They must tell a girl about the onset of menstruations, the boy - that he can have a pollution. Children should know about it no later than nine years. The fact that their body hair starts to grow, their voice changes, the smell of sweat may appear, should be told at the same age. And at that, always talk about both sexes. For example, tell the boy: Look, your body is changing, and the similar thing happens in the girl's body". If you have a girl, convey a similar message. I would recommend that parents use the book "Adult Answers to Children's Questions About This" for their children's sexual education. It is very simple, there are good illustrations. So, parents will feel comfortable to use the book.
     

When it is necessary to start talking with children about contraception?

  • It is worth telling about infections in general. To tell that there are those transmitted by air, either through dirty hands, or during sexual intercourse. Explain how to protect yourself from various infections. For example, if you saw a person who coughs, it is better to keep away, especially if they do not wear a mask. Explain, that it is necessary to wash your hands regularly - after attending the WC, before eating. As for sexually transmitted infections, tell them that condom is protecting against them. Moreover, there are pills that prevent a woman from getting pregnant. But it is very important to take them only upon the doctor's appointment. And there are pills that are used for emergency contraception, but only in case of any incident. For example, if the woman experienced violence or if the condom was torn. Then you have to take such emergency measures. This pill can be used once, but not regularly. It can lead to menstrual irregularities and increases the risk of ectopic pregnancy if used frequently.