Sexual Dysfunction
The number of patients attending a doctor with acknowledged sexual dysfunction will
depend on the cultural background of the patients and the perceived attitude of the
doctor. Many patients present with gynecological symptoms even when their problems
are psychosocial or psychosexual. If the doctor is not aware of this, patients may be
inappropriately managed.
• Not all doctors have the time or ability to deal with sexual problems in depth but
a sympathetic approach will help to resolve many problems. In other more complex
cases, referral to a psychosexual counselor will be appropriate.
• Psychosexual therapy requires good rapport between the therapist and the patient
or couple and this may take time to achieve. Such therapy can be very time
consuming and progress may be slow.
• An understanding of both male and female sexual function and dysfunction is
necessary when providing counseling to the patient or to the couple.
• The gynecologist must be aware of the concerns regarding sexual function of a
patient who is advised to undergo surgical treatment - particularly vaginal surgery.
Adequate explanation must be given to the patient who may not express her
concerns directly.
Male sexual dysfunction
Normal male coital function requires arousal through mental, visual or tactile stimulation, erection (a parasympathetic function), penetration, ejaculation (a sympathetic function) and resolution.
Low sex drive and failure of arousal
• Congenitally diminished testicular function (as in Klinefelter's syndrome). Treatment with testosterone is likely to be beneficial if circulating levels are low.
• Psychiatric problems such as anxiety, depression and stress.
• Psychosocial and psychosexual problems due to marital disharmony or to latent or
overt homosexuality. Counseling may be beneficial.
• Medications such as sedatives, tranquillizers and hypotensive drugs can reduce sex
drive.
Impotence
• Congenital neurological problems such as spina bifida.
• Acquired neurological problems due to traumatic spinal tract damage or to a tumor.
Psychiatric problems are commonly related to anxiety, depression or stress, or may
follow an industrial or road traffic accident which leads to compensation orientated
sexual dysfunction.
• Psychosocial and psychosexual maladjustment or malorientation.
• Medical disorders, e.g. diabetes, hyperprolactinaemia, myxedema or liver failure.
• Drugs such as alcohol and psychotropic, anticholinergic and hypotensive medications. It is important to warn patients that sexual dysfunction is a possible side-effect of certain drugs.
• Psychoemotional problems following vasectomy.
• Disorders of the urogenital tract such as infection or Peyronie's disease. In Peyronie's disease a fibrous plaque develops between the fascia and the tunica albuginea of the corpora cavernosa causing angulation of the penis and pain on erection.
Management
• Appropriate counseling and treatment of medical problems or alteration of drug
therapy.
• In a few patients surgical implantation of a penile prosthesis may be helpful.
Ejaculatory problems
• Congenital abnormalities such as hypospadias or phimosis.
• May be due to drugs which affect neurological control.
• Premature ejaculation is a common problem which can sometimes be treated effectively by squeezing the glans penis gently when the desire to ejaculate is felt, until
the desire disappears. This process is repeated up to five times before ejaculation
is allowed to occur. Treatment with clomipramine (25-75 mg a day) may also be
helpful.
• Ejaculatory incompetence may occur with anxiety and stress.
• Retrograde ejaculation can occur, particularly after prostatectomy. Ejaculation with
a full bladder may overcome the problem.
Female sexual dysfunction
Normal female sexual arousal occurs more through mental and tactile stimulation than
by visual stimulation. During arousal lubricating secretions are produced. Intercourse
can be pleasurable in the absence of orgasm which does not occur in all women.
Local problems
• An imperforate hymen or vaginal atresia will prevent penetration.
• Superficial or deep dyspareunia may lead to apareunia.
Dyspareunia may be due to failure of arousal.
• Superficial dyspareunia may be due to infection such as candidiasis or trichomoniasis, or to atrophic vaginitis, or may occur following surgery such as an episiotomy or posterior repair.
• Deep dyspareunia may be due to pelvic inflammatory disease or endometriosis.
General problems
• Libido may be reduced by general debilitation or by oestrogen lack as in hypogonado- trophic hypogonadism, gonadal failure or hyperprolactinaemia.
• Drugs do not affect sexual function in women as much as in men, but libido may
be reduced by oral contraception, phenothiazines and drugs of addiction in some
women.
• Psychiatric problems such as anxiety, depression and psychosis commonly cause
sexual dysfunction and require appropriate management and treatment.
• Psychosexual problems are a common cause and common result of marital dishar-
mony. Management includes counseling of both partners often over a period of
weeks or months.
History
• Obtaining a good history from a patient with sexual dysfunction is an art.
• A sympathetic unhurried, uncritical approach is essential.
Examination
• Thorough general and pelvic examination to exclude organic problems.
• The woman's response to pelvic examination may be a helpful indicator of the
nature of the problem.
Management
• Depends on the problem.
• Local and general medical problems should be treated appropriately.
• Referral to a psychosexual counselor or psychiatrist may be required.
Thursday, August 28, 2008
Wednesday, August 27, 2008
Saying NO
Perhaps, the best strategy that I have learned in the past year to manage my time and my life is learning how to say “NO”. Saying no is not bad when used in appropriate circumstances. There are times when we must say no. No to others, sometimes no to ourselves and definitely no to our children. I used to have a difficult time saying no to others, thus depleting myself of what rightfully belongs to me: my time, possessions and self-worth.
Why did I have trouble saying “NO” for the longest time?
I believe my foremost reason is the fear of rejection; I was so afraid of what others will say or even think and how others will view me. Another reason is probably the mistaken notion that I can do the task and fit it in my schedule no matter what. What am I a super woman for? Another reason is not wanting to hurt other people and hating the feeling that I have been mean when I say no to others.
What made me change and what helped me learn this crucial skill?
Perhaps, going through several earth-shattering and life-threatening personal emotional crisis (midlife???) has helped me truly look deep inside myself and reflect on what is important to me. Learning to say no helps us learn to be kind to ourselves. It also teaches people around us, even those we really love and truly important to us (such as our family), to respect personal/individual boundaries. I also realized that anyone who depends on someone else’s approval for his/her own happiness is doomed to a life of misery. And surely, I don’t want to be miserable for the rest of my life. I hate hurting other people’s feelings but I have forgotten that my feelings are quite important too. There is no greater sin than not loving myself.
So, yes. I have learned how to say NO. And it feels soooo good!!!!
Why did I have trouble saying “NO” for the longest time?
I believe my foremost reason is the fear of rejection; I was so afraid of what others will say or even think and how others will view me. Another reason is probably the mistaken notion that I can do the task and fit it in my schedule no matter what. What am I a super woman for? Another reason is not wanting to hurt other people and hating the feeling that I have been mean when I say no to others.
What made me change and what helped me learn this crucial skill?
Perhaps, going through several earth-shattering and life-threatening personal emotional crisis (midlife???) has helped me truly look deep inside myself and reflect on what is important to me. Learning to say no helps us learn to be kind to ourselves. It also teaches people around us, even those we really love and truly important to us (such as our family), to respect personal/individual boundaries. I also realized that anyone who depends on someone else’s approval for his/her own happiness is doomed to a life of misery. And surely, I don’t want to be miserable for the rest of my life. I hate hurting other people’s feelings but I have forgotten that my feelings are quite important too. There is no greater sin than not loving myself.
So, yes. I have learned how to say NO. And it feels soooo good!!!!
Saturday, August 23, 2008
TEAM BUILDING
Room 706-707 Don Santiago Building
Taft Avenue, Manila 1000
(632) 523-8271 loc 48
Program Title: GO TEAM… MY TEAM! A seminar workshop on team building
I. Overview
A Rhythms facilitated team building workshop is an effective, time efficient yet enjoyable way to bring about organizational integration and performance improvement.
We do away with ineffective gimmicky team building activities and the ‘paralysis through analysis’ profiling of individual personality types. Instead paraticipants attending our team building workshop, will critically focus on how their organization operates, what it does, why it does it, where things are done, how they are done, who does what, and to what effect.
Using a variety of innovative and fun techniques, delegates will quickly grasp the ‘big picture’ then step-by-step, drill down to where improvements can be made.
Participants will find the workshop challenging, exciting, thought provoking and rewarding. Ultimately they will leave the workshop with ideas for improvement and an enthusiastic fresh perspective on:
• The world of work
• Their roles
• Their business process including inputs and outputs
• How and why things are measured, plus the effect on people and the effectiveness of such measurement
• Group interactions
• Team-work
• The goals of the organization and most importantly
• Areas for individual, inter-groups and organizational performance improvement
II. Goal and Aim
Our team building workshop has a simple, doable and achievable goal and aim.
• Our goal is to achieve improvement in the way all members of the team/organization (whether management or rank and file) view and do their jobs. This brings about the productivity improvement benefit that all organizations desire.
• Our aim is to inspire action that improves the way the organization operates and the way staff interact.
III. Key Features
• Uses an 'open systems' model of your organization
Your organization is a complex system, irrespective of its function and size. During the team building process we use a simple open systems model of your organization to explore structural relationships, develop organizational awareness and show cause and effect relationships, in order to bring about the performance improvements you are looking for.
• The team building workshop is scaleable
This means you can concentrate on a group, or a number of groups. Using the open systems approach to model effective team building, you can include representatives from either management and/or employees. It's a simple matter of identifying where you wish to bring about change (improvement), apply the open systems model, diagnose it, then explore the results using the various team building exercises and activities devised to specifically explore, analyze then improve productivity.
• Customization of the team building workshop to your organization
Customization is key to successful performance improvement outcomes. The pre-workshop delivery phase requires modeling of your organization, the use powerful trending techniques on key performance indicators (can be internal and or external indicators,) the identification of 'special interest groups' (SIGs) to be role played, the guest speakers, to deliver short sharp 'buzz sessions' and so on.
IV. Benefits
• Demonstrably better, more relevant and practical team building methodology that is easy to organize and deliver
• Content is relevant, interesting, challenging and rewarding, it taps into real world workplace experiences of employees, no contrived irrelevant team building exercises, activities and simulations.
• Universal relevance to any organization. Anyone in any organization can contribute, the more diverse the backgrounds the better potential for true team building.
• Makes use of the people with the experience at all levels and utilizes this diversity of interests and experiences to shape solutions and improvements.
• Valuable information, based on the sensitivities of all involved will flow out of the workshop. Look out for many areas for performance improvement to be offered up - from all hierarchical levels represented in the workshop.
• Identifies the challenges faced by the organization, internally and externally.
• Gains consensus through role playing special interest groups (SIGs) (the 'Executive' group, the 'Customers' group, the (other) 'Stakeholders' group, the 'Employees' group etc.
• Encourages self-criticism.
• Helps develop group and individual opinions by testing ideas, then transforming them.
• Can identify future leaders or provide a training ground for future leaders.
• Can identify hidden talent and talents within the group.
• Develops trust, responsibility and loyalty.
• Often produces solutions to previously insoluble problems.
• No irrelevant and ineffective gimmicks.
• Adaptable to needs and vocabularies of any group of employees.
• Easy to target key result areas, where performance is below what is required.
o Old technology, old procedures, old policies, old methods, or
o New technologies, new procedures, new policies, new methods
V. Sample Program of Activities:
NOTE: This represents a sample team building day/activity for 15 to 25 participants.
This is only an outline --- threaded throughout the day are personal time, group shares, fun, and surprises.
Activities may not necessarily be given in this order and may be tailored according to specific needs of the organization
Course No. Hot and Cold… warm up and ice breakers
Introduction of Workshop, participants, facilitators and speakers
Course No: Barangay Ginebra… Team and teamwork
Activities and games to define your organization: its functions, strengths, weakness and the role you play
Course No: My Coach (eg Coach Jawo) … Top 10 Ways to Motivate & Success Coach Your TEAM"
Different leadership styles and creative problem solving, sparking employee/colleague motivation
Course No: "IBA ako… ibahin mo ako…”
Activities to build relationships, trust and appreciate individual differences
Course No: Gaya-gaya, Puto maya : Don't do as I do. Do as I say.
Activities to build, improve and maintain effective communication skills
Course No: Ang Aking Paglalakbay
Activities for personal insight and growth, stress management, anger management (bellydance, yoga, relaxation techniques)
Course No: Go Team… My team!
Team building program finale: appreciating our strengths and weaknesses, and taking our team to the next level
***** please inquire re package and individual module Rates
Team Building Programs Include:
Handouts & manuals, activity equipments, e-mail follow-up consultations up to 6 months, & fun and effective power-packed day/s!
Improve your team’s communication skills, initiate creative problem solving, and build trust for a cohesive team with good leadership!
VI. Workshop Delivery
We are situated at Room 706 Don Santiago Building Taft Avenue, Manila and will deliver the workshop, ourselves or use a partner organization or any part of Manila or province by arrangement.
A. Duration
There are a range of options in respect of duration. 1, 2 or 3 day workshops, or
A project based approach, with an initial workshop following on from which ad hoc debriefing / progress workshops to coordinate activities flowing from 1. above, such as site visits to other locations, progressing various improvement activities and so on.
B. Location
We will deliver the workshop:
-in our wellness center
- On your premises, if you have suitable facilities available. Essentially you provide your in-house facilities, book our accommodation and we deliver.
- On suitable premises in a location near to you, with suitable facilities. Essentially you book our and (optionally) your accommodation, we travel and deliver.
- Other areas: Essentially you book our and your accommodation, we travel and deliver.
C. Methodology
The essential facilities we use are: White board, Flip charts and board and overhead slide projection facility, games and outdoor activities
We are goal driven and in order to do this we need to know from the onset what it is your organization seeks to do better. In order to achieve change in your group we need to know the answer to the following question.
What is it you seek from our team building workshop?
This may appear a trite question, but we are surprised by the number of people unable to give an answer to the question.
Consider:
Transfer of knowledge or sharing of knowledge and information...To practice problem solving...To develop skills...To change attitudes...To examine a problem...Etc.
D. Cost
Workshop cost is usually computed on a per head/day basis excluding meals, transportation and accommodation
Cost is also dependent on the number of participants, duration of workshop and specific needs of organization
Rates are negotiable and discounts can be given.
OUR STRESS MANAGEMENT COURSES ARE ALSO AVAILABLE AS CUSTOMISED…
1-to-1 Life Skills Coaching/Relationship Coaching/Spiritual counseling - Private groups – Organization or Corporate in-house Seminars or Workshops
For further inquiries you may contact:
Dr. Faye Cagayan (632) 523-8271 loc 48
Email: cagayanmsfs@druginfo.ph http://www.docfaye.multiply.com/
Taft Avenue, Manila 1000
(632) 523-8271 loc 48
Program Title: GO TEAM… MY TEAM! A seminar workshop on team building
I. Overview
A Rhythms facilitated team building workshop is an effective, time efficient yet enjoyable way to bring about organizational integration and performance improvement.
We do away with ineffective gimmicky team building activities and the ‘paralysis through analysis’ profiling of individual personality types. Instead paraticipants attending our team building workshop, will critically focus on how their organization operates, what it does, why it does it, where things are done, how they are done, who does what, and to what effect.
Using a variety of innovative and fun techniques, delegates will quickly grasp the ‘big picture’ then step-by-step, drill down to where improvements can be made.
Participants will find the workshop challenging, exciting, thought provoking and rewarding. Ultimately they will leave the workshop with ideas for improvement and an enthusiastic fresh perspective on:
• The world of work
• Their roles
• Their business process including inputs and outputs
• How and why things are measured, plus the effect on people and the effectiveness of such measurement
• Group interactions
• Team-work
• The goals of the organization and most importantly
• Areas for individual, inter-groups and organizational performance improvement
II. Goal and Aim
Our team building workshop has a simple, doable and achievable goal and aim.
• Our goal is to achieve improvement in the way all members of the team/organization (whether management or rank and file) view and do their jobs. This brings about the productivity improvement benefit that all organizations desire.
• Our aim is to inspire action that improves the way the organization operates and the way staff interact.
III. Key Features
• Uses an 'open systems' model of your organization
Your organization is a complex system, irrespective of its function and size. During the team building process we use a simple open systems model of your organization to explore structural relationships, develop organizational awareness and show cause and effect relationships, in order to bring about the performance improvements you are looking for.
• The team building workshop is scaleable
This means you can concentrate on a group, or a number of groups. Using the open systems approach to model effective team building, you can include representatives from either management and/or employees. It's a simple matter of identifying where you wish to bring about change (improvement), apply the open systems model, diagnose it, then explore the results using the various team building exercises and activities devised to specifically explore, analyze then improve productivity.
• Customization of the team building workshop to your organization
Customization is key to successful performance improvement outcomes. The pre-workshop delivery phase requires modeling of your organization, the use powerful trending techniques on key performance indicators (can be internal and or external indicators,) the identification of 'special interest groups' (SIGs) to be role played, the guest speakers, to deliver short sharp 'buzz sessions' and so on.
IV. Benefits
• Demonstrably better, more relevant and practical team building methodology that is easy to organize and deliver
• Content is relevant, interesting, challenging and rewarding, it taps into real world workplace experiences of employees, no contrived irrelevant team building exercises, activities and simulations.
• Universal relevance to any organization. Anyone in any organization can contribute, the more diverse the backgrounds the better potential for true team building.
• Makes use of the people with the experience at all levels and utilizes this diversity of interests and experiences to shape solutions and improvements.
• Valuable information, based on the sensitivities of all involved will flow out of the workshop. Look out for many areas for performance improvement to be offered up - from all hierarchical levels represented in the workshop.
• Identifies the challenges faced by the organization, internally and externally.
• Gains consensus through role playing special interest groups (SIGs) (the 'Executive' group, the 'Customers' group, the (other) 'Stakeholders' group, the 'Employees' group etc.
• Encourages self-criticism.
• Helps develop group and individual opinions by testing ideas, then transforming them.
• Can identify future leaders or provide a training ground for future leaders.
• Can identify hidden talent and talents within the group.
• Develops trust, responsibility and loyalty.
• Often produces solutions to previously insoluble problems.
• No irrelevant and ineffective gimmicks.
• Adaptable to needs and vocabularies of any group of employees.
• Easy to target key result areas, where performance is below what is required.
o Old technology, old procedures, old policies, old methods, or
o New technologies, new procedures, new policies, new methods
V. Sample Program of Activities:
NOTE: This represents a sample team building day/activity for 15 to 25 participants.
This is only an outline --- threaded throughout the day are personal time, group shares, fun, and surprises.
Activities may not necessarily be given in this order and may be tailored according to specific needs of the organization
Course No. Hot and Cold… warm up and ice breakers
Introduction of Workshop, participants, facilitators and speakers
Course No: Barangay Ginebra… Team and teamwork
Activities and games to define your organization: its functions, strengths, weakness and the role you play
Course No: My Coach (eg Coach Jawo) … Top 10 Ways to Motivate & Success Coach Your TEAM"
Different leadership styles and creative problem solving, sparking employee/colleague motivation
Course No: "IBA ako… ibahin mo ako…”
Activities to build relationships, trust and appreciate individual differences
Course No: Gaya-gaya, Puto maya : Don't do as I do. Do as I say.
Activities to build, improve and maintain effective communication skills
Course No: Ang Aking Paglalakbay
Activities for personal insight and growth, stress management, anger management (bellydance, yoga, relaxation techniques)
Course No: Go Team… My team!
Team building program finale: appreciating our strengths and weaknesses, and taking our team to the next level
***** please inquire re package and individual module Rates
Team Building Programs Include:
Handouts & manuals, activity equipments, e-mail follow-up consultations up to 6 months, & fun and effective power-packed day/s!
Improve your team’s communication skills, initiate creative problem solving, and build trust for a cohesive team with good leadership!
VI. Workshop Delivery
We are situated at Room 706 Don Santiago Building Taft Avenue, Manila and will deliver the workshop, ourselves or use a partner organization or any part of Manila or province by arrangement.
A. Duration
There are a range of options in respect of duration. 1, 2 or 3 day workshops, or
A project based approach, with an initial workshop following on from which ad hoc debriefing / progress workshops to coordinate activities flowing from 1. above, such as site visits to other locations, progressing various improvement activities and so on.
B. Location
We will deliver the workshop:
-in our wellness center
- On your premises, if you have suitable facilities available. Essentially you provide your in-house facilities, book our accommodation and we deliver.
- On suitable premises in a location near to you, with suitable facilities. Essentially you book our and (optionally) your accommodation, we travel and deliver.
- Other areas: Essentially you book our and your accommodation, we travel and deliver.
C. Methodology
The essential facilities we use are: White board, Flip charts and board and overhead slide projection facility, games and outdoor activities
We are goal driven and in order to do this we need to know from the onset what it is your organization seeks to do better. In order to achieve change in your group we need to know the answer to the following question.
What is it you seek from our team building workshop?
This may appear a trite question, but we are surprised by the number of people unable to give an answer to the question.
Consider:
Transfer of knowledge or sharing of knowledge and information...To practice problem solving...To develop skills...To change attitudes...To examine a problem...Etc.
D. Cost
Workshop cost is usually computed on a per head/day basis excluding meals, transportation and accommodation
Cost is also dependent on the number of participants, duration of workshop and specific needs of organization
Rates are negotiable and discounts can be given.
OUR STRESS MANAGEMENT COURSES ARE ALSO AVAILABLE AS CUSTOMISED…
1-to-1 Life Skills Coaching/Relationship Coaching/Spiritual counseling - Private groups – Organization or Corporate in-house Seminars or Workshops
For further inquiries you may contact:
Dr. Faye Cagayan (632) 523-8271 loc 48
Email: cagayanmsfs@druginfo.ph http://www.docfaye.multiply.com/
Tuesday, August 19, 2008
Preparing for Childbirth
FAQs About Your Pregnancy
Welcome dear mothers to this new phase of your life!
It is always a joy to know we are accomplishing God's purpose for us as women. And as stewards of this new life within us, there are some things you, my dear mom to be, should know...
What is prenatal care?
This is the standard of care that you, a mom-to-be should be receiving from me or other health care providers (obstetrician, family physician, midwife, traditional birth attendants/hilot/kumadrona).
Is prenatal care important? What is its purpose?
Yes! Prenatal care is very, very important. It ensures that you and your baby will be as healthy as possible by following some simple guidelines and checking in regularly with me, your obstetrician.
What happens during prenatal visits?
I will be asking you about your medical history as well as your partner’s and family’s. I will also ask how you have been feeling and changes that are occurring in you. Your weight and your vital signs (cardiac rate, pulse rate, breathing) will be taken especially your blood pressure every visit.
On your first visit, I will do a general physical examination with breast, abdominal and pelvic exam to check the size and shape of your uterus and a Pap smear to check for infections and abnormal masses of the cervix (the opening of the uterus). Subsequent visits may not be as intensive but will still require attention to your personal physical, emotional and psychological details
Urine and blood tests will be requested on the first visit and again later as needed. Urine tests are done to check for infections, high sugar levels (which can be a sign of diabetes) and high protein levels (which can put you at risk for preeclampsia, a type of high blood pressure in pregnancy). Blood tests are done to check for low iron levels (anemia) and infections as well as other bleeding problems.
An ultrasound may be requested to help me accurately date your pregnancy - when your baby is due or to check on your baby's growth and position in your uterus. An ultrasound uses sound waves to create an image of your baby on a video screen. This examination in general does not cause abnormalities in your baby.
Other tests may be needed/requested if you or your baby are at risk for any problems.
What is my usual schedule for prenatal visits?
If you are age 18 to 35 and healthy you will probably have a "low-risk" pregnancy. If so, our scheduled check up will be
* once a month for the first 28 weeks (seven months)
* every two or three weeks from the 28th to the 36th week (eighth month)
* weekly from the 36th week until delivery (ninth month)
If you have a "high-risk" pregnancy, you will need to see me more often.
What conditions are considered high risk?
Pregnant women experiencing these complications are advised not to travel, exercise or have sex, etc. Some of these complications include:
* Cervical problems, such as 'incompetent cervix'
* Vaginal bleeding
* Multiple foetuses
* If you are aged 35 years or over and pregnant for the first time
* Gestational diabetes, past or present
* High blood pressure, past or present
* Pre-eclampsia, past or present
* Abnormalities of the placenta, past or present
* Prior miscarriage
* Prior ectopic pregnancy
* Signs of premature labor
Are there foods I should avoid?
It is quite important to eat a balanced diet for you and baby. There are a few foods that you should be more careful about eating while you are pregnant. Meat, eggs and fish that are not fully cooked could put you at risk for an infection. Wash all fruit and vegetables. Keep cutting boards, dishes and utensils clean. General hygiene such as hand washing is still the rule of the day. Eat 3 to 4 servings of dairy foods each day. This will give you enough calcium for you and your baby. Do not drink unpasteurized milk or eat unpasteurized milk products. Soft cheeses such as Brie, feta, Camembert and Mexican queso fresco may have bacteria that can cause infections.
It would be nice if you refrain from caffeinated and carbonated drinks but If you drink coffee or other drinks with caffeine, do not have more than 1 cup each day.
It is okay to use artificial sweeteners such as aspartame (some brand names: Equal, NutraSweet) and sucralose (brand name: Splenda) while you are pregnant, but you should try to take them in moderation. If you have a genetic disease called phenylketonuria, or PKU, you shouldn't use aspartame at all.
What vitamins should I take?
It is best that you have started taking folic acid before you get pregnant to prevent neural tube defects (problems in your bay’s brain or spinal cord). You should take 400 mcg (0.4 mg) of folic acid every day for the first 12-16 weeks of your pregnancy. Any prenatal vitamin supplement will do but an additional iron and calcium supplement is necessary especially if you are not able to eat a balanced diet.
How much weight gain is considered normal during pregnancy?
About 25 to 30 pounds. If you don't weigh enough when you get pregnant, you may need to gain more. If you're very heavy when you get pregnant, you may need to gain only 15 to 18 pounds.
Pregnancy isn't the time to start dieting just so to prevent having a cesarean section due to a big baby! It's best to gain about 2 to 3 pounds during the first 12 weeks and about 1 pound a week after that.
Is it okay to take medications?
Check with me before taking any medicine, including over the counter drugs like aspirin and other pain relievers, cough medications and decongestants. Even medicine you can buy without a prescription can cause birth defects, especially if it's taken during the first 3 months of pregnancy. Medications are not necessarily bad. There will be drugs that you may need to take otherwise the illness that you have, if not treated with drugs, may cause problems in the baby. Rest assured that drugs that you will be prescribed will be those considered safe in pregnancy as shown by medical evidence.
Can I still work while pregnant?
Of course!! In general, if your pregnancy is uncomplicated, you can continue working. However, this depends also if you have any problems with your pregnancy, what kind of work you do and if you're exposed to anything at work that could harm your baby. For instance, lifting heavy objects or standing for long periods can be hard on you. Radiation, lead and other heavy metals, such as copper and mercury, could be damaging to the baby. Working in front of a computer screen is not thought to cause harm to an unborn baby.
What exercises can I do?
Exercising during pregnancy makes labor and delivery easier. Walking and swimming are great aerobic choices. I would recommend sayuntis- a belly dance routine I specifically designed for you, my expectant mom, as a low impact and fun exercise to prepare you for childbirth.
Unless you have problems in your pregnancy, you can probably do whatever exercise you did before you got pregnant. You may feel better if you're active. Try to get at least 30 minutes of exercise each day. Talk to me first about any special conditions that you may have.
If you didn't exercise before pregnancy, start slowly. Don't overdo exercise. If you can't talk easily while exercising, you are straining yourself and working too hard. Don't get overheated. Drink plenty of water so that you don't get dehydrated. It's best to avoid anything that could cause you to fall or hurt yourself.
What conditions will prevent me from exercising?
There are some conditions that make exercise contraindicated in pregnancy like having premature labor contractions, preeclampsia, bleeding conditions in pregnancy such as placenta previa. Other medical conditions such as heart disease, thyroid problems and diabetes may pose a problem. It would be best to consult first so we can discuss what exercise or physical activity regimen is best suited for you.
Can I travel?
Generally speaking, yes. The safest time for a pregnant woman to travel is during her second trimester, provided she isn't experiencing any complications. If you are pregnant and considering travel, you must consult with me, especially if your pregnancy is high-risk. Take into consideration the standard of medical care at your chosen destination, just in case you need help. Consider also immunizations when the place you are going to is endemic for certain diseases. Check with airlines regarding maximum age of gestation where travel is allowed- it’s usually up to 28-30 weeks AOG.
Is it okay to have sex?
Yes, unless I believe you're at risk for problems such as presence of infections, bleeding and premature contractions. Don't be surprised if you're less--or more--interested in sex. (most probably less interested) You need to find or try different positions, such as lying on your side or being on top as you get bigger. If you have oral sex, tell your partner not to blow air into your vagina. This could force air inside you, which could cause an air embolism.
What discomforts will I feel and what can I do to feel better?
Here are the most common discomforts and some advice on how you can feel better.
Morning sickness. This may happen anytime during the day (or night). Try eating frequent, small meals, (every 2 hours) and avoid greasy foods. Keep crackers by your bed to eat before getting up. Avoid scents that trigger a nauseous reaction.
Inform me if morning sickness is so severe that it causes you to lose weight, look dehydrated and feel weak.
Tiredness. Sometimes tiredness in pregnancy is caused by anemia, so have your complete blood count done. Get enough rest. Take a daytime nap if possible.
Leg cramps. Gently stretch the calf of your leg by curling your toes upward, toward your knee. Drink milk and take calcium supplements. Exercise!
Constipation. Drink plenty of fluids. Eat foods with lots of fiber, such as raisins and bran cereal. Don't take laxatives without consulting first. Stool softeners may be safer than laxatives.
Hemorrhoids. Don't strain during bowel movements. Try to avoid becoming constipated. Clean yourself well after a bowel movement (wet wipes may be less irritating than toilet paper). Take several warm soaks ( hot sitz baths) a day.
Frequent urination. You may need to urinate more often as your baby grows because he or she will put pressure on your bladder. This can't be helped. Report to me if urinating becomes difficult and painful and comes in trickles.
Varicose veins. Avoid clothing that fits tightly around your legs or waist. Rest and put your feet up as much as you can. Move around if you must stand for long periods. You may need to use support hose.
Moodiness. Your hormones are on a roller coaster ride during pregnancy. Plus, your life is undergoing a big change. Don't be too hard on yourself. If you feel very sad or think about suicide, talk to me ASAP. Exercise and dance!
Heartburn. Eat frequent, small meals often. Avoid spicy or greasy foods. Don't lie down right after eating. If this occurs frequently, consult me.
Infections/vaginal itchiness/discharge. The amount of discharge from the vagina increases during pregnancy. Yeast infections, which can also cause discharge, are more common during pregnancy. It's a good idea to consult before taking any medication.
Bleeding gums. Brush and floss regularly, and see your dentist for cleanings. Don't put off dental visits because you're pregnant, but be sure to tell your dentist you're pregnant.
Stuffy nose. This is also related to changes in the levels of the female hormone estrogen. You may also have nosebleeds.
Edema (retaining fluid). Rest with your legs up. Lie on your left side while sleeping so blood flows from your legs back to your heart better. Don't use diuretics (water pills). If you're thinking about cutting down on salt to reduce swelling, talk with me first. Your body needs enough salt to maintain the balance of fluid and cutting back on salt may not be the best way to manage your swelling.
Skin changes
Stretch marks appear as red marks on your skin. Lotion can help keep your skin moist and may help reduce the itchiness of dry skin. Stretch marks really can't be prevented and may be genetic but they often fade after pregnancy.
Other skin changes may include darkening of the skin on your face and around your nipples, and a dark line below your belly button. Staying out of the sun or using a sunscreen may help lessen these marks. They'll probably fade after pregnancy.
Call me …
Most pregnancies proceed without any problem. But problems can happen unexpectedly. If you have any of these warning signs, please call me :
* sudden weight gain of more than two pounds within one day
* swelling of the face, ankles, legs, or feet
* severe or repeated headaches that last more than two or three hours and are not relieved with the medication I have recommended
* fainting
* blurred vision, flashes of light, or spots before your eyes
* pain or burning with urination
* marked increase in thirst
* greatly increased or decreased urination
* unusual smelling vaginal discharge
* light vaginal bleeding or spotting
Go to the hospital immediately if you have any of these very dangerous warning signs:
Signs Of Premature Labor
Pregnancy takes about 40 weeks. If contractions cause the cervix to open earlier than normal — between the 20th and 37th week — labor may be premature. This may result in the birth of a premature baby. Babies born before the 37th week may have trouble breathing, eating, and keeping warm. The signs of premature labor include one or more of these
* uterine contractions every 10 minutes or shorter
* repeating or constant menstrual-like cramps in the lower abdomen
* abdominal cramps with or without diarrhea
* pelvic pressure that feels like the fetus is pushing down on your vagina and your hips or pelvis is splitting
* increase or change in vaginal discharge
* sudden gush of watery fluids from the vagina (water breaking)
* feeling like the fetus is "balling up"
Signs Of Other Serious Problems
* heavy bleeding from the vagina
* constant severe lower abdominal pain or cramps on one or both sides
* dimness or blurring of vision that lasts two or three hours
* dizziness and/or double vision
* severe or continued vomiting
* chills and/or fever of 101°F or more
* fever of 101°F or more with pain or burning during urination
* sudden severe swelling or puffiness of the face, hands, legs, ankles, or feet, especially if you have a headache or vision change
* after six months of pregnancy, you notice a significant decrease in the movement of the fetus
* after six months of pregnancy, you think the fetus hasn't moved in eight hours or more
You may not like it but if you want to stay healthy for yourself and your baby throughout pregnancy there are...
Definite Don'ts in Pregnancy
* Don't smoke. Smoking raises your risk for miscarriage, premature birth, low birth weight and many other problems.
* Don't use recreational drugs. Cocaine, heroin, marijuana, metamphetamine or shabu, ecstasy, etc increase your risk of miscarriage, preeclampsia, premature birth and congenital/ developmental defects. And your baby could be born addicted to the drug you've been taking.
* Don't drink alcohol. Drinking alcohol during pregnancy is the major cause of preventable birth defects, including mental slowness.
* Don't clean your cat's litter box, or eat raw or undercooked red meat. You could get toxoplasmosis, a disease that can cause birth defects.
* Don't sit in the sauna or hot tub. This raises your risk of miscarriage and birth defects.
* Don't douche. Douching could force air into the vagina, which can cause an air embolism.
* Don’t feel sad or ugly or unloved. This may be one of the most tiring and confusing moments of your life due to changes in hormones, physique, etc yet this is also a time to appreciate God’s most precious gift. Remember that there are a lot of people around you who cares for you and your baby… including ME!!!
Please remember that it takes teamwork to have a healthy pregnancy and a healthy baby.
Women who get early and regular prenatal care have healthier pregnancies and healthier babies. It is important that you as well as your partner and I communicate well and work together. It is your responsibility to try to stay as healthy as you can and learn what is normal and what is not. Watch out for changes in your body that may be warning signs.
It is my duty on the other hand to help you understand your pregnancy, identify problems before they become serious, and to provide care when you need it.
Remember, the things you tell me are confidential.
That means that I can’t tell anyone else what you say without your permission. So don’t be afraid to talk to me about issues that might be uncomfortable or embarrassing. It’s OK to tell me if you smoke, drink alcohol or take any drugs, or about your sexual activities (past and present) or if your partner hurts or scares you. I need to know all about you and your lifestyle so that I can give you and your baby the best care. Consider me as part of your family - an ate or tita.
By the way, my dear mom to be, be sure to have a dental checkup early in pregnancy to help your mouth remain healthy. You may even want to see your dentist more often than usual.
With love,
Doc Faye
Welcome dear mothers to this new phase of your life!
It is always a joy to know we are accomplishing God's purpose for us as women. And as stewards of this new life within us, there are some things you, my dear mom to be, should know...
What is prenatal care?
This is the standard of care that you, a mom-to-be should be receiving from me or other health care providers (obstetrician, family physician, midwife, traditional birth attendants/hilot/kumadrona).
Is prenatal care important? What is its purpose?
Yes! Prenatal care is very, very important. It ensures that you and your baby will be as healthy as possible by following some simple guidelines and checking in regularly with me, your obstetrician.
What happens during prenatal visits?
I will be asking you about your medical history as well as your partner’s and family’s. I will also ask how you have been feeling and changes that are occurring in you. Your weight and your vital signs (cardiac rate, pulse rate, breathing) will be taken especially your blood pressure every visit.
On your first visit, I will do a general physical examination with breast, abdominal and pelvic exam to check the size and shape of your uterus and a Pap smear to check for infections and abnormal masses of the cervix (the opening of the uterus). Subsequent visits may not be as intensive but will still require attention to your personal physical, emotional and psychological details
Urine and blood tests will be requested on the first visit and again later as needed. Urine tests are done to check for infections, high sugar levels (which can be a sign of diabetes) and high protein levels (which can put you at risk for preeclampsia, a type of high blood pressure in pregnancy). Blood tests are done to check for low iron levels (anemia) and infections as well as other bleeding problems.
An ultrasound may be requested to help me accurately date your pregnancy - when your baby is due or to check on your baby's growth and position in your uterus. An ultrasound uses sound waves to create an image of your baby on a video screen. This examination in general does not cause abnormalities in your baby.
Other tests may be needed/requested if you or your baby are at risk for any problems.
What is my usual schedule for prenatal visits?
If you are age 18 to 35 and healthy you will probably have a "low-risk" pregnancy. If so, our scheduled check up will be
* once a month for the first 28 weeks (seven months)
* every two or three weeks from the 28th to the 36th week (eighth month)
* weekly from the 36th week until delivery (ninth month)
If you have a "high-risk" pregnancy, you will need to see me more often.
What conditions are considered high risk?
Pregnant women experiencing these complications are advised not to travel, exercise or have sex, etc. Some of these complications include:
* Cervical problems, such as 'incompetent cervix'
* Vaginal bleeding
* Multiple foetuses
* If you are aged 35 years or over and pregnant for the first time
* Gestational diabetes, past or present
* High blood pressure, past or present
* Pre-eclampsia, past or present
* Abnormalities of the placenta, past or present
* Prior miscarriage
* Prior ectopic pregnancy
* Signs of premature labor
Are there foods I should avoid?
It is quite important to eat a balanced diet for you and baby. There are a few foods that you should be more careful about eating while you are pregnant. Meat, eggs and fish that are not fully cooked could put you at risk for an infection. Wash all fruit and vegetables. Keep cutting boards, dishes and utensils clean. General hygiene such as hand washing is still the rule of the day. Eat 3 to 4 servings of dairy foods each day. This will give you enough calcium for you and your baby. Do not drink unpasteurized milk or eat unpasteurized milk products. Soft cheeses such as Brie, feta, Camembert and Mexican queso fresco may have bacteria that can cause infections.
It would be nice if you refrain from caffeinated and carbonated drinks but If you drink coffee or other drinks with caffeine, do not have more than 1 cup each day.
It is okay to use artificial sweeteners such as aspartame (some brand names: Equal, NutraSweet) and sucralose (brand name: Splenda) while you are pregnant, but you should try to take them in moderation. If you have a genetic disease called phenylketonuria, or PKU, you shouldn't use aspartame at all.
What vitamins should I take?
It is best that you have started taking folic acid before you get pregnant to prevent neural tube defects (problems in your bay’s brain or spinal cord). You should take 400 mcg (0.4 mg) of folic acid every day for the first 12-16 weeks of your pregnancy. Any prenatal vitamin supplement will do but an additional iron and calcium supplement is necessary especially if you are not able to eat a balanced diet.
How much weight gain is considered normal during pregnancy?
About 25 to 30 pounds. If you don't weigh enough when you get pregnant, you may need to gain more. If you're very heavy when you get pregnant, you may need to gain only 15 to 18 pounds.
Pregnancy isn't the time to start dieting just so to prevent having a cesarean section due to a big baby! It's best to gain about 2 to 3 pounds during the first 12 weeks and about 1 pound a week after that.
Is it okay to take medications?
Check with me before taking any medicine, including over the counter drugs like aspirin and other pain relievers, cough medications and decongestants. Even medicine you can buy without a prescription can cause birth defects, especially if it's taken during the first 3 months of pregnancy. Medications are not necessarily bad. There will be drugs that you may need to take otherwise the illness that you have, if not treated with drugs, may cause problems in the baby. Rest assured that drugs that you will be prescribed will be those considered safe in pregnancy as shown by medical evidence.
Can I still work while pregnant?
Of course!! In general, if your pregnancy is uncomplicated, you can continue working. However, this depends also if you have any problems with your pregnancy, what kind of work you do and if you're exposed to anything at work that could harm your baby. For instance, lifting heavy objects or standing for long periods can be hard on you. Radiation, lead and other heavy metals, such as copper and mercury, could be damaging to the baby. Working in front of a computer screen is not thought to cause harm to an unborn baby.
What exercises can I do?
Exercising during pregnancy makes labor and delivery easier. Walking and swimming are great aerobic choices. I would recommend sayuntis- a belly dance routine I specifically designed for you, my expectant mom, as a low impact and fun exercise to prepare you for childbirth.
Unless you have problems in your pregnancy, you can probably do whatever exercise you did before you got pregnant. You may feel better if you're active. Try to get at least 30 minutes of exercise each day. Talk to me first about any special conditions that you may have.
If you didn't exercise before pregnancy, start slowly. Don't overdo exercise. If you can't talk easily while exercising, you are straining yourself and working too hard. Don't get overheated. Drink plenty of water so that you don't get dehydrated. It's best to avoid anything that could cause you to fall or hurt yourself.
What conditions will prevent me from exercising?
There are some conditions that make exercise contraindicated in pregnancy like having premature labor contractions, preeclampsia, bleeding conditions in pregnancy such as placenta previa. Other medical conditions such as heart disease, thyroid problems and diabetes may pose a problem. It would be best to consult first so we can discuss what exercise or physical activity regimen is best suited for you.
Can I travel?
Generally speaking, yes. The safest time for a pregnant woman to travel is during her second trimester, provided she isn't experiencing any complications. If you are pregnant and considering travel, you must consult with me, especially if your pregnancy is high-risk. Take into consideration the standard of medical care at your chosen destination, just in case you need help. Consider also immunizations when the place you are going to is endemic for certain diseases. Check with airlines regarding maximum age of gestation where travel is allowed- it’s usually up to 28-30 weeks AOG.
Is it okay to have sex?
Yes, unless I believe you're at risk for problems such as presence of infections, bleeding and premature contractions. Don't be surprised if you're less--or more--interested in sex. (most probably less interested) You need to find or try different positions, such as lying on your side or being on top as you get bigger. If you have oral sex, tell your partner not to blow air into your vagina. This could force air inside you, which could cause an air embolism.
What discomforts will I feel and what can I do to feel better?
Here are the most common discomforts and some advice on how you can feel better.
Morning sickness. This may happen anytime during the day (or night). Try eating frequent, small meals, (every 2 hours) and avoid greasy foods. Keep crackers by your bed to eat before getting up. Avoid scents that trigger a nauseous reaction.
Inform me if morning sickness is so severe that it causes you to lose weight, look dehydrated and feel weak.
Tiredness. Sometimes tiredness in pregnancy is caused by anemia, so have your complete blood count done. Get enough rest. Take a daytime nap if possible.
Leg cramps. Gently stretch the calf of your leg by curling your toes upward, toward your knee. Drink milk and take calcium supplements. Exercise!
Constipation. Drink plenty of fluids. Eat foods with lots of fiber, such as raisins and bran cereal. Don't take laxatives without consulting first. Stool softeners may be safer than laxatives.
Hemorrhoids. Don't strain during bowel movements. Try to avoid becoming constipated. Clean yourself well after a bowel movement (wet wipes may be less irritating than toilet paper). Take several warm soaks ( hot sitz baths) a day.
Frequent urination. You may need to urinate more often as your baby grows because he or she will put pressure on your bladder. This can't be helped. Report to me if urinating becomes difficult and painful and comes in trickles.
Varicose veins. Avoid clothing that fits tightly around your legs or waist. Rest and put your feet up as much as you can. Move around if you must stand for long periods. You may need to use support hose.
Moodiness. Your hormones are on a roller coaster ride during pregnancy. Plus, your life is undergoing a big change. Don't be too hard on yourself. If you feel very sad or think about suicide, talk to me ASAP. Exercise and dance!
Heartburn. Eat frequent, small meals often. Avoid spicy or greasy foods. Don't lie down right after eating. If this occurs frequently, consult me.
Infections/vaginal itchiness/discharge. The amount of discharge from the vagina increases during pregnancy. Yeast infections, which can also cause discharge, are more common during pregnancy. It's a good idea to consult before taking any medication.
Bleeding gums. Brush and floss regularly, and see your dentist for cleanings. Don't put off dental visits because you're pregnant, but be sure to tell your dentist you're pregnant.
Stuffy nose. This is also related to changes in the levels of the female hormone estrogen. You may also have nosebleeds.
Edema (retaining fluid). Rest with your legs up. Lie on your left side while sleeping so blood flows from your legs back to your heart better. Don't use diuretics (water pills). If you're thinking about cutting down on salt to reduce swelling, talk with me first. Your body needs enough salt to maintain the balance of fluid and cutting back on salt may not be the best way to manage your swelling.
Skin changes
Stretch marks appear as red marks on your skin. Lotion can help keep your skin moist and may help reduce the itchiness of dry skin. Stretch marks really can't be prevented and may be genetic but they often fade after pregnancy.
Other skin changes may include darkening of the skin on your face and around your nipples, and a dark line below your belly button. Staying out of the sun or using a sunscreen may help lessen these marks. They'll probably fade after pregnancy.
Call me …
Most pregnancies proceed without any problem. But problems can happen unexpectedly. If you have any of these warning signs, please call me :
* sudden weight gain of more than two pounds within one day
* swelling of the face, ankles, legs, or feet
* severe or repeated headaches that last more than two or three hours and are not relieved with the medication I have recommended
* fainting
* blurred vision, flashes of light, or spots before your eyes
* pain or burning with urination
* marked increase in thirst
* greatly increased or decreased urination
* unusual smelling vaginal discharge
* light vaginal bleeding or spotting
Go to the hospital immediately if you have any of these very dangerous warning signs:
Signs Of Premature Labor
Pregnancy takes about 40 weeks. If contractions cause the cervix to open earlier than normal — between the 20th and 37th week — labor may be premature. This may result in the birth of a premature baby. Babies born before the 37th week may have trouble breathing, eating, and keeping warm. The signs of premature labor include one or more of these
* uterine contractions every 10 minutes or shorter
* repeating or constant menstrual-like cramps in the lower abdomen
* abdominal cramps with or without diarrhea
* pelvic pressure that feels like the fetus is pushing down on your vagina and your hips or pelvis is splitting
* increase or change in vaginal discharge
* sudden gush of watery fluids from the vagina (water breaking)
* feeling like the fetus is "balling up"
Signs Of Other Serious Problems
* heavy bleeding from the vagina
* constant severe lower abdominal pain or cramps on one or both sides
* dimness or blurring of vision that lasts two or three hours
* dizziness and/or double vision
* severe or continued vomiting
* chills and/or fever of 101°F or more
* fever of 101°F or more with pain or burning during urination
* sudden severe swelling or puffiness of the face, hands, legs, ankles, or feet, especially if you have a headache or vision change
* after six months of pregnancy, you notice a significant decrease in the movement of the fetus
* after six months of pregnancy, you think the fetus hasn't moved in eight hours or more
You may not like it but if you want to stay healthy for yourself and your baby throughout pregnancy there are...
Definite Don'ts in Pregnancy
* Don't smoke. Smoking raises your risk for miscarriage, premature birth, low birth weight and many other problems.
* Don't use recreational drugs. Cocaine, heroin, marijuana, metamphetamine or shabu, ecstasy, etc increase your risk of miscarriage, preeclampsia, premature birth and congenital/ developmental defects. And your baby could be born addicted to the drug you've been taking.
* Don't drink alcohol. Drinking alcohol during pregnancy is the major cause of preventable birth defects, including mental slowness.
* Don't clean your cat's litter box, or eat raw or undercooked red meat. You could get toxoplasmosis, a disease that can cause birth defects.
* Don't sit in the sauna or hot tub. This raises your risk of miscarriage and birth defects.
* Don't douche. Douching could force air into the vagina, which can cause an air embolism.
* Don’t feel sad or ugly or unloved. This may be one of the most tiring and confusing moments of your life due to changes in hormones, physique, etc yet this is also a time to appreciate God’s most precious gift. Remember that there are a lot of people around you who cares for you and your baby… including ME!!!
Please remember that it takes teamwork to have a healthy pregnancy and a healthy baby.
Women who get early and regular prenatal care have healthier pregnancies and healthier babies. It is important that you as well as your partner and I communicate well and work together. It is your responsibility to try to stay as healthy as you can and learn what is normal and what is not. Watch out for changes in your body that may be warning signs.
It is my duty on the other hand to help you understand your pregnancy, identify problems before they become serious, and to provide care when you need it.
Remember, the things you tell me are confidential.
That means that I can’t tell anyone else what you say without your permission. So don’t be afraid to talk to me about issues that might be uncomfortable or embarrassing. It’s OK to tell me if you smoke, drink alcohol or take any drugs, or about your sexual activities (past and present) or if your partner hurts or scares you. I need to know all about you and your lifestyle so that I can give you and your baby the best care. Consider me as part of your family - an ate or tita.
By the way, my dear mom to be, be sure to have a dental checkup early in pregnancy to help your mouth remain healthy. You may even want to see your dentist more often than usual.
With love,
Doc Faye
Belly dance in Pregnancy (Sayuntis)
SAYUNTIS (ANG SAYAW NG BUNTIS)
Belly dance, yoga, meditative and fun movements in pregnancy
Ma. Stephanie Fay S. Cagayan, MD, FPOGS, FPSSTD
Belly Dance has long been recognized as a form of birth dance. For thousands of years this dance has been a favorite of women all over the world because of its joyous, celebratory and non-judgmental nature. This type of exercise program guides a pregnant woman through healthy, gentle, non-strenuous movements which will help her cope with the changing condition of her body, her view of the labor process and her overall awareness of self essential for birthing. Sayuntis (coined from the phrase “sayaw ng buntis”) is belly dancing adopted for the pregnant woman. It is similar to other exercises in that it burns fat and conditions the body. But unlike other exercises in pregnancy, Sayuntis enhances femininity and inner beauty, providing us with a new dimension of creativity and spontaneity, and helping us to face pregnancy with empowerment and joy.
Dr. Ma. Stephanie Fay S. Cagayan, an obstetrician gynecologist and a fellow of the Philippine Obstetrical and Gynecological Society as well as an associate professor of Pharmacology and Toxicology at the University of the Philippines College of Medicine along with her student mentee Ms. Joy Santos, created and prepared Sayuntis because she believes that the female body is greatly endowed with the capability to deliver a baby and to nurture life in this world. Her fascination and passion with belly dance began during her endless quest of self knowledge, development and empowerment when she experienced burn out in her profession and vocation of healing. From then on, she got hooked and tried to learn more about the dance and in the process discovered its benefit for self-healing as well as birthing. Herself a mother of three, she teaches that despite medical advancement, it is still much better to deliver naturally via vaginal birth. Sayuntis aims to awaken this unique feminine power of childbirth through belly dancing indigenized into our own culture.
Sayuntis incorporates indigenous dances like the pangalay, a native dance of the Samal and Tau Sug communities in Jolo, Sulu during the pre-Islamic and pre-Christian times. Central to Sayuntis is the principle of Hara, the Japanese term for belly and is considered the core energy centered in the abdomen. Anatomically, hara is the physiologic center of gravity, located approximately three finger widths below and two finger widths behind the navel. The hara also emphasizes that the center of all the movements of Sayuntis is the baby inside the mother. The belly dance movements in Sayuntis also incorporates the four elements of nature, namely: Hampas sa Lupa (earth-based movements ie. pelvic movements), Kumpas ng Hangin (air-like movements ie. hand movements), Agos ng Batis (water-like movements ie. Undulations), and Alab ng Apoy (fire-based movements ie. shimmy).
According to Maha Al Musa (2007), a renowned bellydance teacher for pregnant women, our birthing energy – the force that supports our journey through the labor process -- is strongly related to our sexual energy—that succulent force of creativity, inner power, desire, and primal instinct. When we dance in pregnancy, we “internalize the movements and emotions of our sexual selves to connect to our wisdom and instinctual nature as women.” When we prepare ourselves emotionally, physiologically, and mentally in giving birth, our body welcomes it more freely and birthing becomes a real celebration right from the very beginning.
Sayuntis and belly dance of pregnancy connects us to our deepest subconscious, makes us more aware of ourselves and our self-conceived inhibitions, and moves us not to denial, but a total acceptance of who we are and the infinite possibilities of what we can do. It also helps us become more accepting of our emotions and provides an outlet to express our feelings. Awareness and openness reclaim the sacredness of childbirth as a natural process that the female body is made to perform, rather than a stressful event that we should face with dread. In the end, this whole openness to self and the process of childbirth will help us to have better birth outcomes. When we dance in pregnancy, we allow the natural energy to flow in and out of us, thus, allowing us to face childbirth with less fear and anxiety, possibly with more joy, celebration and acceptance. However, pregnant women should first seek prenatal consult and approval of health care provider before undertaking an exercise regimen in pregnancy
The following are benefits of Sayuntis or belly dance in pregnancy
1. Promotes good posture
2. Helps maintain general fitness
3. Improves abdominal control and awareness, hastens delivery
4. Many movements useful for relieving back ache and discomforts during pregnancy and labor
5. Helps maintain pelvic floor tone through connection with deep abdominals, prevents pelvic organ prolapse
6. Promotes balance and coordination
7. Non jarring/non contact activity
8. Fun and social, emotionally uplifting
9. Body shape no boundary
10. May help with constipation
11. promotes letdown reflex during postpartum period
Precautions with Belly Dance in Pregnancy
1. Avoid or take care with movements that accentuate a deep lumbar curve
2. Avoid back bends
3. Maintain a neutral pelvic tilt (ie keep your bottom tucked under)
4. Be aware of the softening of the ligaments in your body, especially the pelvic region, and therefore the increase risk of ligament strain
5. Avoid sharp changes of direction
6. Avoid jumps
7. Take care with hip twists (avoid or soften them)
8. Avoid sharp movements - you may need to soften your hip drops/ lifts/ flicks
9. Make sure you know how to co-contract your deep abdominals and pelvic floor muscles for stability and support
General Guidelines for Exercise in Pregnancy (ACOG)
1. Monitor your heart rate and keep it below 140 beats per minute.
2. Don’t overheat – don’t exercise on hot humid days, keep up fluid intake.
3. Avoid exercises involving sudden movements, breath holding, lying on your back.
4. Vigorous exercise should be preceded by a warm up and followed by a cool down.
5. Stop exercising if you develop pain, bleeding, faintness or otherwise feel unwell.
6. Have a small snack an hour before exercise.
7. Avoid activities where there is a risk of falling or violent body contact.
8. Limit periods of strenuous exercise to 15-20 minutes.
9. Restrict sessions of strenuous exercise to 4 times weekly.
Contraindications to undertaking exercise in pregnancy
1. Persistent bleeding in the second and third trimesters
2. Pre-eclampsia or pregnancy-induced hypertension
3. Preterm labour (previous/present)
4. Intrauterine growth restriction
5. Cervical weakness/cerclage
6. Placenta praevia
7. Preterm prelabor rupture of membranes
8. Multiple gestation (individualized and medically supervised)
(for orders of the book Sayuntis with its with accompanying instructional video, please call Rhythms Health and Wellness Counseling Services 302-5327 or 09175500522 or email cagayanmsfs@druginfo.ph or text 09189382741)
Belly dance, yoga, meditative and fun movements in pregnancy
Ma. Stephanie Fay S. Cagayan, MD, FPOGS, FPSSTD
Belly Dance has long been recognized as a form of birth dance. For thousands of years this dance has been a favorite of women all over the world because of its joyous, celebratory and non-judgmental nature. This type of exercise program guides a pregnant woman through healthy, gentle, non-strenuous movements which will help her cope with the changing condition of her body, her view of the labor process and her overall awareness of self essential for birthing. Sayuntis (coined from the phrase “sayaw ng buntis”) is belly dancing adopted for the pregnant woman. It is similar to other exercises in that it burns fat and conditions the body. But unlike other exercises in pregnancy, Sayuntis enhances femininity and inner beauty, providing us with a new dimension of creativity and spontaneity, and helping us to face pregnancy with empowerment and joy.
Dr. Ma. Stephanie Fay S. Cagayan, an obstetrician gynecologist and a fellow of the Philippine Obstetrical and Gynecological Society as well as an associate professor of Pharmacology and Toxicology at the University of the Philippines College of Medicine along with her student mentee Ms. Joy Santos, created and prepared Sayuntis because she believes that the female body is greatly endowed with the capability to deliver a baby and to nurture life in this world. Her fascination and passion with belly dance began during her endless quest of self knowledge, development and empowerment when she experienced burn out in her profession and vocation of healing. From then on, she got hooked and tried to learn more about the dance and in the process discovered its benefit for self-healing as well as birthing. Herself a mother of three, she teaches that despite medical advancement, it is still much better to deliver naturally via vaginal birth. Sayuntis aims to awaken this unique feminine power of childbirth through belly dancing indigenized into our own culture.
Sayuntis incorporates indigenous dances like the pangalay, a native dance of the Samal and Tau Sug communities in Jolo, Sulu during the pre-Islamic and pre-Christian times. Central to Sayuntis is the principle of Hara, the Japanese term for belly and is considered the core energy centered in the abdomen. Anatomically, hara is the physiologic center of gravity, located approximately three finger widths below and two finger widths behind the navel. The hara also emphasizes that the center of all the movements of Sayuntis is the baby inside the mother. The belly dance movements in Sayuntis also incorporates the four elements of nature, namely: Hampas sa Lupa (earth-based movements ie. pelvic movements), Kumpas ng Hangin (air-like movements ie. hand movements), Agos ng Batis (water-like movements ie. Undulations), and Alab ng Apoy (fire-based movements ie. shimmy).
According to Maha Al Musa (2007), a renowned bellydance teacher for pregnant women, our birthing energy – the force that supports our journey through the labor process -- is strongly related to our sexual energy—that succulent force of creativity, inner power, desire, and primal instinct. When we dance in pregnancy, we “internalize the movements and emotions of our sexual selves to connect to our wisdom and instinctual nature as women.” When we prepare ourselves emotionally, physiologically, and mentally in giving birth, our body welcomes it more freely and birthing becomes a real celebration right from the very beginning.
Sayuntis and belly dance of pregnancy connects us to our deepest subconscious, makes us more aware of ourselves and our self-conceived inhibitions, and moves us not to denial, but a total acceptance of who we are and the infinite possibilities of what we can do. It also helps us become more accepting of our emotions and provides an outlet to express our feelings. Awareness and openness reclaim the sacredness of childbirth as a natural process that the female body is made to perform, rather than a stressful event that we should face with dread. In the end, this whole openness to self and the process of childbirth will help us to have better birth outcomes. When we dance in pregnancy, we allow the natural energy to flow in and out of us, thus, allowing us to face childbirth with less fear and anxiety, possibly with more joy, celebration and acceptance. However, pregnant women should first seek prenatal consult and approval of health care provider before undertaking an exercise regimen in pregnancy
The following are benefits of Sayuntis or belly dance in pregnancy
1. Promotes good posture
2. Helps maintain general fitness
3. Improves abdominal control and awareness, hastens delivery
4. Many movements useful for relieving back ache and discomforts during pregnancy and labor
5. Helps maintain pelvic floor tone through connection with deep abdominals, prevents pelvic organ prolapse
6. Promotes balance and coordination
7. Non jarring/non contact activity
8. Fun and social, emotionally uplifting
9. Body shape no boundary
10. May help with constipation
11. promotes letdown reflex during postpartum period
Precautions with Belly Dance in Pregnancy
1. Avoid or take care with movements that accentuate a deep lumbar curve
2. Avoid back bends
3. Maintain a neutral pelvic tilt (ie keep your bottom tucked under)
4. Be aware of the softening of the ligaments in your body, especially the pelvic region, and therefore the increase risk of ligament strain
5. Avoid sharp changes of direction
6. Avoid jumps
7. Take care with hip twists (avoid or soften them)
8. Avoid sharp movements - you may need to soften your hip drops/ lifts/ flicks
9. Make sure you know how to co-contract your deep abdominals and pelvic floor muscles for stability and support
General Guidelines for Exercise in Pregnancy (ACOG)
1. Monitor your heart rate and keep it below 140 beats per minute.
2. Don’t overheat – don’t exercise on hot humid days, keep up fluid intake.
3. Avoid exercises involving sudden movements, breath holding, lying on your back.
4. Vigorous exercise should be preceded by a warm up and followed by a cool down.
5. Stop exercising if you develop pain, bleeding, faintness or otherwise feel unwell.
6. Have a small snack an hour before exercise.
7. Avoid activities where there is a risk of falling or violent body contact.
8. Limit periods of strenuous exercise to 15-20 minutes.
9. Restrict sessions of strenuous exercise to 4 times weekly.
Contraindications to undertaking exercise in pregnancy
1. Persistent bleeding in the second and third trimesters
2. Pre-eclampsia or pregnancy-induced hypertension
3. Preterm labour (previous/present)
4. Intrauterine growth restriction
5. Cervical weakness/cerclage
6. Placenta praevia
7. Preterm prelabor rupture of membranes
8. Multiple gestation (individualized and medically supervised)
(for orders of the book Sayuntis with its with accompanying instructional video, please call Rhythms Health and Wellness Counseling Services 302-5327 or 09175500522 or email cagayanmsfs@druginfo.ph or text 09189382741)
REBORN
I am the same woman
Yet I am not.
I walk with speed and purpose
But that purpose now has changed.
The speed, it has slowed down a bit
I walk taller and stronger
Still big but lighter, nimbler
With more grace so it seems.
My eyes
They differ too
Crows’ feet they’re not
Crinkling at the sides they twinkle.
Are they laugh lines?
They look out at the world
With more softness and compassion
I feel every sound, every motion
Every emotion.
I still feel pain a lot
Yet I know now that
in pain there is joy.
I embrace everything
Knowing that as tide
Ebbs and flows
The pain, the sadness
They too shall pass
And with nightfall comes day
With every dark comes light
As promised.
Yet I am not.
I walk with speed and purpose
But that purpose now has changed.
The speed, it has slowed down a bit
I walk taller and stronger
Still big but lighter, nimbler
With more grace so it seems.
My eyes
They differ too
Crows’ feet they’re not
Crinkling at the sides they twinkle.
Are they laugh lines?
They look out at the world
With more softness and compassion
I feel every sound, every motion
Every emotion.
I still feel pain a lot
Yet I know now that
in pain there is joy.
I embrace everything
Knowing that as tide
Ebbs and flows
The pain, the sadness
They too shall pass
And with nightfall comes day
With every dark comes light
As promised.
MY FAMILY
MY FAMILY
I praise and thank you Almighty Father for the gift of family
This group of people who individually and collectively
Allow me to be myself and yet in many ways
Define who I am and give me purpose in this life.
Thank you for my dear husband Allan
I have known him since we were quite young
Studying in the same primary school
Interacting yet not quite aware of how fate
Will play its hands quite soon enough.
We went our way yet met again
Not quite knowing and yet somehow feeling
That in our hearts we were meant to be.
I am quite so lucky finding my spouse, my best friend; yes, my soul mate
All rolled into one
In this lifetime at that.
And no, it’s not luck
It was You, O God all the time.
So much different yet so much the same
We have great fights and passionate love
We grew together, walking our paths individually yet not apart.
He completes me.
Bless him and protect him.
Thank you Lord for the fruits of my womb
Bien Emile
He is mostly the reason why I am who I am now.
I call him my catalyst in almost all my major life events and changes.
His vibrant self, his music, his passions- cooking, singing, improvising
All gifts from You O God.
I trust in You completely to make him
Realize his full potential.
Beatrice Anne
This wonderful, intelligent, beautiful
Generous and kind child/girl/lady
I liken her to a flower whose petals are just beginning to open
And I see so much of myself in her.
Give her wisdom to separate the chaff from the grain
To choose wisely and well.
Basil
Forever my baby
With his never-ending smile and laughter
May he remain a child forever- pure, untainted, empathic
Yet with the wisdom of old.
I thank You Lord and I praise You
You chose to bless me and love me unconditionally
By allowing me to be a steward to these individuals
Despite and in spite of ME.
I praise and adore Your holy name forever.
I praise and thank you Almighty Father for the gift of family
This group of people who individually and collectively
Allow me to be myself and yet in many ways
Define who I am and give me purpose in this life.
Thank you for my dear husband Allan
I have known him since we were quite young
Studying in the same primary school
Interacting yet not quite aware of how fate
Will play its hands quite soon enough.
We went our way yet met again
Not quite knowing and yet somehow feeling
That in our hearts we were meant to be.
I am quite so lucky finding my spouse, my best friend; yes, my soul mate
All rolled into one
In this lifetime at that.
And no, it’s not luck
It was You, O God all the time.
So much different yet so much the same
We have great fights and passionate love
We grew together, walking our paths individually yet not apart.
He completes me.
Bless him and protect him.
Thank you Lord for the fruits of my womb
Bien Emile
He is mostly the reason why I am who I am now.
I call him my catalyst in almost all my major life events and changes.
His vibrant self, his music, his passions- cooking, singing, improvising
All gifts from You O God.
I trust in You completely to make him
Realize his full potential.
Beatrice Anne
This wonderful, intelligent, beautiful
Generous and kind child/girl/lady
I liken her to a flower whose petals are just beginning to open
And I see so much of myself in her.
Give her wisdom to separate the chaff from the grain
To choose wisely and well.
Basil
Forever my baby
With his never-ending smile and laughter
May he remain a child forever- pure, untainted, empathic
Yet with the wisdom of old.
I thank You Lord and I praise You
You chose to bless me and love me unconditionally
By allowing me to be a steward to these individuals
Despite and in spite of ME.
I praise and adore Your holy name forever.
Saturday, August 16, 2008
Placenta previa
1. WHAT IS PLACENTA PREVIA?
It is a condition in pregnancy where the placenta is abnormally located (located over or very near the internal os)
2. WHAT
Four Types or Degrees
totalis – internal cervical os is totally covered
partialis – internal os is partially covered
marginalis – edge of placenta is at the margin of the internal os
low-lying placenta – placenta is implanted in the lower uterine segment such that the placental edge actually does not reach the internal os
3. WHAT IS VASA PREVIA?
Is a condition where there is abnormal insertion of umbilical cord
velamentous insertion when some of the fetal vessels in the membranes cross the region of the cervical os below the presenting fetal part
membrane rupture accompanied by tearing of fetal vessel causes the bleeding
4. WHAT CAUSES PLACENTA PREVIA
advancing maternal age
multiparity
multiple gestation (40%)
prior caesarean delivery (risk inc. progressively as parity and number of prior CS deliveries inc. (8 fold with parity > 4 and >4 prior CS)
smoking: CO hypoxemia/placental hypertrophy
5. WHAT
preterm delivery is a major cause of perinatal death
fetal growth restriction even with term infants (decidualization of lower segment not as good as upper segment)
fetal anomalies
6.WHAT
painless bleeding without warning near the end of the 2nd trimester or after
initial bleeding rarely profuse and ceases spontaneously only to recur (good prognosis, you can opt not to deliver right away)
causes of hemorrhage:
formation of the lower uterine segment and dilatation of the internal os resulting in tearing of the placental attachments
bleeding may be augmented by the inherent ability of the myometrial fibers of the lower uterine segment to contract and constrict the torn vessels so it may continue even after delivery of the placenta
associated with placenta accreta, increta, or percreta because of the poorly developed decidua in the lower uterine segment
coagulopathy is rare even with extensive separation from the implantation site – thromboplastin escapes thru the cervical canal rather than beng forced into maternal circulation
7. HOW DO WE DIAGNOSE?
AVOID INTERNAL EXAM
simplest, most precise and safest method is transabdomninal ultrasound
improved diagnostic accuracy with transvaginal ultrasound (visualization of the internal os)
the concept of placental migration:
movement? No, never had actual circumferential villus invasion that reached the internal cervical os
placenta that lie close to the internal os, but not over it, during the 2nd trimester or early 3rd trim are unlikely to present as previas by term
likelihood that placenta previa persists after ultrasound diagnosis before 28 wks is greater in woman who had a prior CS delivery
8. HOW IS PLACENTA PREVIA MANAGED?
Delivery is done via caesarean section – transverse vs vertical is dependent on whether the lower segment is well formed, location of the placenta anteriorly or posteriorly and whether the baby is in transverse position or not
preterm fetus with no active bleeding = expectant management (hospital vs home), bedrest, give steroids for lung maturity of baby, try to bring as close to term as possibe
profuse bleeding, term = delivery
bleeding over implantation site on delivery = oversewing, packing, bilateral uterine or internal iliac ligation, hysterectomy if conservative management not possible
placenta previa implanted anteriorly over a previous scar with inc. likelihood of accreta = hysterectomy
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