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Flying in pregnancy

Flying is not harmful to you or your baby, but discuss any health issues or pregnancy complications with your doctor before you fly. The likelihood of going into labour is naturally higher after 37 weeks (around 32 weeks if you’re carrying twins), and some airlines will not let you fly towards the end of your pregnancy. Check with the airline for their policy on this. After week 28 of pregnancy, the airline may ask for a letter from your doctor confirming your due date, and that you aren’t at risk of complications. Long-distance travel (longer than five hours) carries a small risk of blood clots (deep vein thrombosis, or DVT). If you fly, drink plenty of water and move about regularly – every 30 minutes or so. You can buy a pair of graduated compression or support stockings from the pharmacy, which will help reduce leg swelling.

 When is travel, not recommended during pregnancy?

Travel is not recommended if you have certain pregnancy complications, including preeclampsia, premature rupture of membranes, and preterm labour.

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toxoplasmosis and pregnancy

When shall I, as a pregnant mother, worry about toxoplasmosis?

In general, if you have had the disease before, you and your current fetus are protected by your natural immunity from previous infection, but some experts suggest waiting 6 months after the first infection before allowing any woman to become pregnant.

How can Toxoplasma cause harm to the fetus inside the womb? 

Toxoplasmosis infection during or shortly before pregnancy can be transmitted to the fetus inside the womb. You may not suffer from any symptoms, and in most cases, fortunately, the fetus does not develop any diseases either, but the infection sometimes may cause the occurrence of some serious problems for the newborn, such as blindness and delayed mental development.

How can Toxoplasma cause harm to the fetus inside the womb? 

Toxoplasmosis infection during or shortly before pregnancy can be transmitted to the fetus inside the womb. You may not suffer from any symptoms, and in most cases, fortunately, the fetus does not develop any diseases either, but the infection sometimes may cause the occurrence of some serious problems for the newborn, such as blindness and delayed mental development.

How is Toxoplasmosis transmitted? 

Cats play an important role in transmitting infection, as the infection is transmitted to cats by devouring mice and rodents, then cats transmit the parasite through their droppings. You can get the infection by touching your hands to your mouth after changing your cat's litter box without washing your hands, handling vegetables and fruits that have been contaminated from soil in contact with cat litter, or eating uncooked meat such as beef and smoked poultry.

Should I get rid of my house cat if I am pregnant or intend to be pregnant?

No, but you have to follow some instructions to reduce the risk of infection:

  • Avoid changing the cat litter box as much as possible, and if necessary, wear a hand glove and then wash your hands well after changing the box. 
  • It is necessary to change the box daily, as Toxoplasma parasite cannot develop into the infectious phase within 1-5 days after its appearance in the cat's litter. 
  • Completely avoid feeding the cat uncooked meat. 
  • Keep the cat always indoors. 
  • Do not buy a new cat while you are pregnant.

What else should I do to avoid toxoplasmosis infection?

You must

  • Wash vegetables and fruits well before eating them. 
  • Use hand gloves when washing vegetables and fruits. 
  • Cook meat well and do not eat smoked meat.
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Postpartum depression

In the first 3 months after delivery, 18.4% of pregnant women and 19.2% of newborn mothers suffer from depressive symptoms, 12.7% of whom have major depressive symptoms that require treatment in the antenatal phase and 7.1% in the postpartum phase. In the UK 20-40% of women with depression seek professional help, and out of 100,000 pregnant and newborn women (in the first six months after childbirth) 0.2% of them will experience suicide. Depressive disorders are the primary cause of disease burden in women of reproductive age worldwide, and they are the most common mental illness in the postpartum period. The effects of these disorders shall not underestimated, which are not limited to the woman herself, but may rather extend to the child and the wider social environment.

Effects of postpartum depression on mother and baby

Common prenatal depressive symptoms may lead to premature birth, intrauterine growth retardation, and in mothers, may also be associated with insufficient maternal weight gain, maternal non-compliance with regular visits and examinations, and increased tendency to misuse medical drugs or other non-licensed substances.

Depressed mothers who have children between the ages of 6 and 12 months may suffer a lack of language and visual communication. As for the children, we may notice: sleep and breastfeeding problems, avoidance behavior represented by looking away, body disposition, lack of ability to self-modify mood, in addition to nutritional and metabolic disorders.

In the long term, a loss of connection (between mother and child) may extend into adulthood and can lead to a decline in the cognitive, emotional, linguistic and social capabilities of the child, and some studies indicate the possibility of a higher risk of mood disorders at the age of 16 up to 4 times more.

Symptoms of postpartum depression

Postpartum depression must be differentiated from Baby Blues disorder, i.e. transient postpartum depression, which affects 50% to 80% of mothers in the first 10 days following childbirth, as well as postpartum depression from postpartum puerperium which occurs rarely in 0.1 to 0.2% of mothers, but because of its danger on both the mother and the newborn, it requires immediate treatment in a specialized hospital if possible.

As for the symptoms of postpartum depression, mothers with postpartum depression often suffer from fears of failure, the fear that they will be “bad mothers” unable to meet the needs of the newborn, who is described as “tough and needy” in turn, interpreting the child's symptoms and breastfeeding problems that often appear in the context of this disorder as if they were an affirmation of fears of failing to meet the demands of motherhood, deepening this cycle of fear and exhaustion.

Against a background of personal and social expectations for a time of happiness, the mother’s adverse feelings are associated with more personal and social rejection and prohibition, which is not so severe in the case of depressive disorder not related to pregnancy or childbirth, as it is often difficult for mothers to express their negative feelings towards the child or their fear of failure to perform their maternal mission.

Mothers are exposed to a special kind of burden when they experience obsessive thoughts and motives that include harmful behavior to the child, as one study indicates that thoughts that include killing the child may occur by more than 60% among mothers with major depression, more than twice as frequent among mothers with puerperal or bipolar disorder (<28%). However, this study finds that behavior consistent with these ideas (actually harmful behavior for the child) is almost limited to patients with delusions, that is, with puerperal symptoms, but other studies indicate a tendency to be negligent in assessing the threat to the safety of infants of depressed mothers, where attempts to kill the child may arise from altruistic points of view (fear for the fate of the child, evaluation of the mother... (fear for the fate of the child due to the mother’s poor evaluation of herself and her ability to perform the maternal mission), and the mother’s fear of separation from the child and the presence of connection disorders in the mother may play a role in this.

The risk of a child being killed in the context of postpartum depression is highest in the first year, and suicide attempts are rare during pregnancy and lactation.

Despite the prevention, women with mental disorders are considered to have a high degree of suicidal risk in the postpartum stage. One study indicates that the risk of suicide is 72 times higher in the first year of the child, for women who had to be hospitalized for mental disorder in the postpartum period. It is remarkable that women resort to unusual suicide methods in severity and danger.

As for the puerperal disorder following pregnancy, it is represented by certain psychological symptoms such as delusions, hearing self-thoughts out loud, believing that thoughts are withdrawn, in addition to audio or other hallucinations, and in most cases these symptoms appear in the first two weeks after delivery.

Other negative symptoms may appear, such as “poverty of sentiment” (the lack of emotional expression) or “fatigue of sentiment” (a less severe degree of lack of emotional expression), in addition to inappropriate sentiment (showing an emotion that does not fit the topic at hand, such as laughter when mentioning the death of a loved one, for example)

From a taxonomic point of view, postpartum puerperium appears to be more likely a reversal of bipolar disorder, as it can be seen in 25% to 50% of women with bipolar disorder (manic-depressive disorder).

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