Tuesday, April 27, 2010

Confinement Centre (陪月中心)

It is a new trend to stay in the confinement centre during your confinement period.
There are many confinement centres in Butterworth and Bukit Mertajam.
Some of the centres are operated by the experienced nurses and some of them are operated by traditional confinement ladies.

Despite of these confinement centre service, some of the new mothers still prefer to stay at home and employed a confinement lady to take care of them.

Today, I want to make some comparisons between confinement centre care and home care.

The advantages of Confinement Centre care :

1) More cost effective compared to home care. The confinement centre usually provide package of services which include food, lodging, herbal treatment, massage service and baby formula milk powder. The cost to employ a confinement lady to your house for 1 month is quite expensive nowadays.
2) Some of the confinement centres even equipped with medical facilities such as Infrared lamp, photo light for the jaundiced baby.

The disadvantages of Confinement Centre care :

1) The quality of the service is depent on the operator.
2) The risk of infection to your baby is higher in the confinement centre compared with home care. In the confinement centre, many babies stay together within the same room. If one baby is sick, your baby maybe infected as well.
3) The chance of depression is higher. You feel sad because you stay away from your family for 1 month. You may have problem to adjust yourself to the new environment in the confinement centre.

Well, the choice is yours. From the medical point of view, my opinion is home care is still better than confinement centre care.

What is your opinion? Leave some comments please!

Reply To Jess

Jess Said,

Dr. Jason, I am quite confused with my expected due date calculation. My last menses is on 25th july 2009 and thus my EDD should be on the 1st may 2010. but according to my gynea calculation my EDD is on 18th may 2010. He did the calculation by depending on the fetus size through ultrasound scanning. which calculation is more reliable? Please advise.


Hi, Jess,

Since the first day of your last menses was on 25/7/2009, so it was correct to say that your expected date of delivery was on 1/5/2010, based on Naegeles’ s calculation formula.

However, Naegeles’s calculation formula is only useful and accurate if your menses is regular and the menses interval is 28 days apart.

If your menses is not regular, or the menses interval is not 28 days apart, this calculation formula is not inaccurate.

In your first 3 months ( 1st trimester ) of the pregnancy, ultrasound scan is very reliable to accurately calculate the actual date of expected date of delivery.

If your expected date of delivery (EDD) based on Naegeles’ formula is within 1 week from the ultrasound scan date, the doctor will usually refer your EDD to the Naegeles’ calculation.

However, if the calculation date is more than 1 week compared with the first trimester ultrasound scan date, the doctor will usually follow the ultrasound scan date.

Since your delivery date is approaching, I wish you a safe labour and happy motherhood.


Wednesday, April 21, 2010

Reply To Hooi Hooi

Dr, I am HooiHooi. I search frm internet, knowing that got a thing call 耻骨联合分离症 (Diastasis of Symphysis Pubis). Read through the symptoms, quite similar to those I faced these few months. I know as you mentioned, it is due to our pregnancy hormone and baby's weight. What else can we do during natural birth process to minimize the pain? The pain will still continue after give birth?


Hi, Hooi Hooi,

As the doctor taking care of your pregnancy, I am glad that you have taken extra effort to read and learn more about your pregnancy. A better informed pregnant mother usually has a better pregnancy outcome and I would like to share with you my own experience.

Diastasis of Symphysis Pubis is a common problem during pregnancy. It is estimated about 30% to 40% of pregnant mothers suffer from this condition. Luckily, most of them only troubled by mild pain and usually it will recover within 2 weeks after the delivery.

Symphysis pubis is located just above your private part, about 3 cm above your clitoris. Symphysis pubis is a joint to merge the two pelvic bones from both side.

During the pregnancy period, your body produces a hormone (relaxin hormone). The function of this relaxin hormone is to soften your skin and muscle. Your skin must be softened so that it can be stretched to accommodate the growing baby. This relaxin hormone also soften your vaginal muscle so that the birth tunnel can be stretched to allow the baby to go through during normal delivery.

Unfortunately, this relaxin hormone not only soften your tummy skin and vagina tunnel, it also causes other structure in your body to soften as well. For examples:

1) The gum in your mouth is softened. As a result, some pregnant mothers complain of toothache and gum bleeding while brushing the teeth.

2) The skin inside the nose. Some of you may experience bleeding from the nose during pregnancy.

3) Diastasis of symphysis pubis as mentioned by you. This condition is caused by softening of the symphysis pubis joint. Due to the joint softening, it can’t hold your pelvic bones probably. As a result, every time when you walk or exercise, you will experience pain above your private part. To make the problem worse, your baby will grow in weight as pregnancy advance. The weight of the baby will compress downward and worsen the pain in symphysis pubis.

There are few things you can do to reduce the pain :

  • Use a pillow between your legs when sleeping; body pillows are a great investment!
  • Use a pillow under your 'bump' (pregnancy tummy) when sleeping
  • Keep your legs and hips as parallel/symmetrical as possible when moving or turning in bed
  • Some women also find it helpful to have their partners stabilize their hips and hold them 'together' when rolling over in bed or otherwise adjusting position
  • Some women report a waterbed mattress to be helpful
  • Silk/satin sheets and nighties may make it easier to turn over in bed
  • Swimming may help relieve pressure on the joint
  • Keep your legs close together and move symmetrically (other sources recommend a very small gap between the legs with symmetrical movement)
  • When standing, stand symmetrically, with your weight evenly distributed through both legs
  • Sit down to get dressed, especially when putting on underwear or pants
  • Avoid 'straddle' movements
  • Swing your legs together as a unit when getting in and out of cars; use plastics or something smooth and slippery (like a garbage bag) on the car seat to help you enter car backwards and then turn your legs as a unit
  • An ice pack may feel soothing and help reduce inflammation in the pubic area; painkillers may also help
  • Move slowly and without sudden movements
  • If bending over to pick up objects is difficult, there are devices available that can help with this
  • Really severe cases may need crutches, although these should probably only be used as a last resort
  • Some women report that pelvic binders/maternity support belts are helpful for pelvic pain
  • In severe cases, pain relief medicine may be helpful.

Friday, April 16, 2010

Sex During Pregnancy

IT IS common for women who are pregnant for the first time, to wonder whether sexual intercourse will affect the developing baby.

The common questions asked by the concerned pregnant mothers include :

1) Whether sexual intercourse will harm the baby ?

Routine sexual intercourse is safe during pregnancy because the baby is protected by surrounding waterbag.

Orgasm may cause some uterine activity which, however, does not harm the foetus.

It is safe for women with a normal pregnancy to have sexual intercourse during pregnancy even right up to the time when labour starts for a normal healthy pregnancy.

2) Will it causes infection ?

The labour door is tightly sealed by mucus plug to prevent any bacterias from infecting the baby. It is unlikely for the bacterias from vaginal to ascend into the worm. Furthermore, the waterbag provides necessary protection to the baby from infection.

However, certain sexualy transmitted diseases, eg : HIV, Hepatits B, Syphilis and Herpes may potentially infecting the baby if your spouse is carrying the disease.

The Mucus Plug in the cervix

3) Can sexual intercourse leads to miscarriage or premature labour?

Orgasm may induce some uterine activity, but the contraction is not strong enough to cause miscarriage or premature labour.

4) What is the ideal position for sexual activity during pregnancy ?

As the abdomen increases in size with advancing pregnancy, the woman may be uncomfortable with the traditional man on top position.

It is advisable to find alternative positions. By trying out various other positions, the couple will find one that they are both comfortable with.

5) In what conditions sexual intercourse is not encouraged?

1) Women who have recurrent bleeding during pregnancy. The cause of bleeding may be due to placenta located too near to the cervix ( Placenta Previa ).

2) Women who have prematured ruptured of waterbag.

3) Women with high risk of premature labour with history of weakness in the cervix

Sex during pregnancy may enhance the relationship with the spouse or partner during the pregnancy and after childbirth.

However, It is important to confirm with your doctor on a regular basis that there are no pregnancy problems and that the pregnancy is normal before engaging in intimacy.

Tuesday, April 6, 2010

Reply To Jeannette

Hi Dr Jason,

I found your email from your blog. I'm writing to you in regards of my ovulate period. My period was overdue by 3 weeks ago. But, pregnancy test is negative. However, i'm currently have popping in the ear.

I have history of delay of ovulation due to stress but no more than 3 weeks. Please advise.

Thank You.

Yours sincerely


Hi, Jeannette,

3 weeks delay is definitely a long duration, particular for a person with regular menses period.

You need to repeat your urine pregnancy test if the earlier test is more than 1 week now. Sometimes, in a very early pregnancy, urine pregnancy test may not be accurate. Just purchase from pharmacy the urine test and do again.

If the urine test is still negative, most of the time your problem is due to hormonal imbalance. Women menses are controlled by a group of hormone. In certain situation, the hormone production ratio is imbalanced. As a result, your menses cycles will be affected.

There are many conditions that cause hormonal imbalance :

1) Stress in your daily life

2) Travelling to other country with different climate and weather.

3) Sickness ; eg: Flu, diarrhoea, bladder infection

4) Lack of sleep

If the urine pregnancy is still negative and you hope to get your menses soon, you can consult a doctor to perform a detailed checking, including an ultrasound scan.

Some hormone pills may help to induce your menses to come early.