Every parent looks forward to holding their child after nine months of anticipation. But sometimes life don’t happen the way we want it to be. Pregnancy loss is an emotionally challenging journey which some parents have to tread, often due to unforeseen circumstances. Unplanned pregnancy loss can be a traumatic experience while a planned pregnancy loss is also a choice no parents ever want to make. Pregnancy loss can be a lonely and upsetting experience. Unfortunately, it's one that many women experience. So how does one deal with the loss of their unborn child? How can couples support each other during this trying period? In this Nectar Circle, we will be speaking with Pregnancy Loss Coach, Vernessa Chuah, on pregnancy loss and how to cope with it. Pregnancy loss is apparently a common phenomenon but a stigma that most people try to avoid. If you have any questions or have gone through a similar experience, do consider joining this session to learn more about how you can support yourself and your partner, or even a friend, better through this difficult journey. About the Speaker: Vernessa is a pregnancy loss coach passionate about learning and sharing. Having gone through three pregnancy losses herself, her vulnerability has inspired her to help women who are going through pregnancy loss, or who are working to heal from it. She strongly believes in supporting women through their miscarriage, abortion and infertility journeys. She holds a pregnancy loss circle for the community, and guides women to move forward with the trauma, grief and loss. Related resources: Key takeaway infographics
What You Should Know About In-Vitro Fertilisation (IVF) In-Vitro Fertilisation, known as IVF in short, is an assisted reproductive technique (ART) that is often the last glimmer of hope for couples trying to conceive. While it sounds very complex and intimidating for many, it is generally a very safe procedure. Also, it is only recommended after a proper fertility assessment has been conducted by the fertility specialist. 1. What is the IVF Treatment Process Like in Singapore? IVF literally means that fertilisation of the woman’s egg happens outside the human body, as compared to natural conception where the sperm fertilises the eggs in a woman’s womb.Since the sperm and egg meet outside the body, the IVF process will consist of steps taken to retrieve the egg from the woman and the sperm from the man before the sperm and egg meet in a test-tube for fertilisation to happen. Here’s what a couple goes through during the IVF process: Step 1: Egg Stimulation The ovaries are first stimulated using an injection with hormones to produce many eggs at once. The injections can be administered by the patient at home, and starts from Day 2 of the menstrual cycle. It takes 10-12 days from the first injection to the time the eggs are retrieved. Step 2: Assess Egg Maturation On Day 8/9 of the cycle, the gynaecologist then performs a simple ultrasound scan to check on the maturity of the stimulated eggs. Step 3: Egg Retrieval Once a mature egg is observed, it will be extracted from the woman in a day surgery procedure within the IVF centre. This procedure is done under anaesthesia. From the first injection to the retrieval of eggs, the duration is approximately between 10- 12 days. Step 4: Fertilisation with Sperm The collected eggs and sperms are fertilised in an IVF laboratory by an embryologist. Eggs that have been successfully fertilised are known as embryos. These embryos are then grown for 5 days, during which the abnormal or unhealthy ones are weeded out. An embryoscope may be used to create a time-lapse video over these 5 days to monitor the development of the embryos in the IVF laboratory. Step 5: Freezing of EmbryosEmbryos that are determined to be optimal are then frozen, before being transferred back into the woman’s womb 1-2 months later. The woman will need to take hormone tablets daily before the transfer is performed. Step 6: Transfer of EmbryosThe embryo will be transferred back into the woman’s womb in a simple procedure that is done in the IVF centre. This transfer process will take around 20-30 min and does not require anaesthesia. Step 7: Check if IVF is Successful 2 weeks after the transfer of the embryo into the woman’s womb, a pregnancy test will be done to check if the woman has successfully conceived. What a Woman Undergoes for IVF Self-administer hormonal injections daily from Day 2 of menstrual cycle to stimulate the maturation of eggs. On Day 8 or 9 of the cycle, a visit to the gynaecologist for a first ultrasound scan to assess if the eggs are ready to be retrieved (if not, a second ultrasound 2-3 days later might be required). Retrieval of the eggs from the woman under anaesthesia. This is done in the IVF centre using a probe with a needle attached and typically takes 20-30min while the woman is asleep. Transfer healthy embryo(s) back into woman’s womb. What a Man Undergoes for IVF Collection of Sperms 2. What are the Chances of Pregnancy with IVF? The success rates of IVF range between 50-60%. In recent years, freezing the embryos before putting them back into the woman’s body has been found to increase success rates of IVF. The underlying theory is that embryos that have survived the freezing process are more resilient and therefore have a higher chance of resulting in pregnancy. Transferring frozen embryos is now commonly practised by many IVF clinicians. “Is IVF Really Meant for Older Women?”Age is one of the most critical factors that affect the success of the IVF procedure. While doctors observe that most women coming for IVF are in their late 30s to 40s, the use of IVF is not limited to older women. Younger women, who want to conceive faster or who have blocked fallopian tubes can undergo IVF earlier to help them conceive. “ONE or TWO Embryos?In Singapore, a maximum of 2 embryos can be transferred at any one time in most situations. If 2 embryos were transferred and the woman gets pregnant, chances of her delivering twins are less than 10%. 3. How Many IVF Cycles do People Usually Need? Not more than 3-4 IVF cycles are required, in fact, on average, most couples get pregnant in less than 3 cycles. As mentioned earlier, each IVF cycle includes the retrieval of eggs for fertilisation. Depending on your age, one IVF cycle typically produces multiple embryos, good enough for 2-3 transfers. If the first transfer of embryo is unsuccessful, the remaining embryos can be used for subsequent transfer(s) without having to repeat the IVF cycle. This definitely helps make things easier for the woman. With each repeated IVF cycle, the challenge to get pregnant increases. However, if IVF fails persistently, the gynaecologist will need to conduct further assessment to determine the causes. Other times, there could also be instances of early miscarriage, which could be due to a variety of factors. 4. How do We Prepare for IVF? Emotional Tenacity While most of the procedures in IVF are performed on the woman, IVF is still very much a couple’s journey. The husband plays an important role in providing encouragement and support, as the medications can sometimes result in mood swings in his wife. Both husband and wife also have to be emotionally prepared for the IVF outcome since a success rate of 50-60% means chances of success and failure are almost the same. Lifestyle Modification Before you start on IVF, it is important to have a good diet and also abstain from smoking and drinking. Stress should be significantly reduced and the need for long-term medications might need to be reviewed (depending on your doctor’s assessment). The woman should also try to not fall sick during the period leading up to her IVF cycle; in some cases, the IVF procedure will be postponed if the woman falls ill. Also, after the embryo transfer, the woman should refrain from exercise or strenuous activity while waiting to test for her pregnancy. How much does IVF Treatment Cost in Singapore? Financial Planning In Singapore, IVF can be performed in the public and private healthcare sectors, though the waiting time often tends to be shorter in the private sector. The average cost of an IVF cycle in the private sector would be approximately $13,000 to $15,000. This includes: Fees charged by the IVF laboratories (between $8000- $10,000) Medication fees (between $2000- $5000) Singaporeans can make use of their Medisave to pay for the cost of IVF in any centre (private or public), subject to the withdrawal limits, stated below: 1st Cycle – $6,000 2nd Cycle – $5,000 3rd & Subsequent Cycles – $4,000 A lifetime Medisave withdrawal limit of $15,000 per patient for ART applies as well. 5. Who Can I Consult for IVF Treatment in Singapore? There is a specialized group of gynaecologists, who are IVF-accredited, that can perform IVF for you. These gynaecologists have gone through rigorous training and are mandated to perform a stipulated number of IVF procedures under supervision before they are accredited as IVF clinicians. However, the fertility journey does not start with In-vitro Fertilisation (IVF). These fertility specialists will conduct a detailed fertility assessment to determine the causes of infertility before recommending the most suitable fertility treatment option unique to your condition. Always keep an open mind and most importantly, seek help early to maximize your chances at pregnancy. Common FAQs: What is IVF? In-Vitro Fertilisation, known as IVF in short, is an assisted reproductive technique (ART). IVF literally means that fertilisation of the woman’s egg happens outside the human body, as compared to natural conception where the sperm fertilises the eggs in a woman’s womb. What are the Chances of Pregnancy with IVF? The success rates of IVF range between 50-60%. How Many IVF Cycles do People Usually Need? Not more than 3-4 IVF cycles are required, in fact, on average, most couples get pregnant in less than 3 cycles. Can I implant more than 2 embryos for my 1st IVF? The maximum number of embryos is 2 per IVF cycle. There are requirements for a couple to meet before more embryos can be implanted. How can I prepare people around me when doing IVF? IVF is a journey that requires plenty of commitment and sacrifice from a couple, especially for a lady. This is why it is important to have supportive people around you throughout this time that can help you out or look for alternative help where needed. What kind of lifestyle should I adopt when planning on IVF? Couples should adopt a healthy lifestyle. This includes getting your pre-existing health conditions corrected before starting on IVF. Couples are also encouraged to stop smoking and drinking alcohol. For those planning on taking traditional medicine, do consult your doctor before doing so. *Content is republished with permission from SMG Women’s Health.
Postpartum Recovery How to Care for My Delivery Wound? If you have had a vaginal delivery, the average recovery period from swelling, soreness, and stitches is around 6 weeks. A caesarean section will require around 12 weeks of complete healing. If you have had stitches from an episiotomy, this may take 7-14 days to heal. Prevent your wound and stitches from getting infected by cleaning the area with warm water or antiseptics after using the toilet. Refrain from wiping with dry toilet paper as this could irritate the area. Contact your doctor if the pain worsens as this could be a sign of infection. If you have stitches from a C-section, the recovery period may be longer. While the surface stitches will heal within 1 week, the stitches in your muscle layer will not completely heal until around 3 months. Contact your doctor if you notice any signs of infection around the area such as redness, swelling or pus, or if you develop a fever. What Changes do Mums Face Post-delivery? In the immediate days and weeks postpartum, most of your time and attention will be focused on tending to your newborn’s needs. However, it is important to get sufficient rest and nutrition as your body recovers from the childbirth process.During this period, you will notice the following changes in your body: Postpartum Bleeding (Lochia) Hormonal Changes Cramps Weakened Bladder Muscles Constipation and Haemorrhoids Emotional Changes Breastfeeding Your Baby If possible, it is advisable to start breastfeeding post-delivery when your newborn is placed on your chest. Breastfeeding requires patience and practice, and it is normal for newborn babies to have trouble latching or staying onto the mother’s nipple. Women are advised to breastfeed exclusively if possible for the first 6 months after giving birth. How to breastfeed? It is important for your newborn to latch properly in order to successfully breastfeed. Once your baby’s mouth is open wide, bring your baby forward towards the breast instead of leaning over and placing the breast into his/her mouth. The baby’s mouth should cover both your nipple and areola, with the baby’s chin and tip of the nose touching your breast. Watch for a suckling motion in your baby’s cheek, jaw and ear and a swallowing sound which indicates proper extraction of breast milk. A breastfeeding session may take up to 40 minutes during the first few months. Find a comfortable position for yourself and your baby, supporting the back of your baby’s head during feeding with your hand or a pillow. Watch this step-by-step video guide on the latching technique for proper breastfeeding. How often should I breastfeed? New mothers should try to nurse frequently (8 – 12 times every 24 hours) as regular nursing produces more milk. As the frequency varies between babies, feeding on demand rather than on schedule may result in more successful feeds. Allow your baby to fully finish from one breast before offering the second one. Within the first week, you may need to gently wake your newborn as he or she may fall asleep during feeding. What to do with sore breasts and nipples? As your body produces milk for breastfeeding, your breasts will become heavier and sore.The heaviness should subside within several weeks after delivery. If your breasts feel hard, swollen and painful, they may be engorged. If you are experiencing trouble expressing milk or if your baby is not latching correctly, contact a lactation consultant through your obstetrician for help. Confinement Confinement is observed in some Asian cultures in the immediate period after birth for both the new mother and baby. This period is observed by the Chinese for 30 days, Malays for 44 days and Indians for 40 days, with the aim of allowing the mother to recover from childbirth. Traditionally, both mother and baby stayed indoors during the confinement period in order to prevent them from falling sick. Confinement Care There are several confinement practices new mothers are encouraged to observe, according to their traditions. These may include avoiding “cool” elements such as taking cold baths and turning on the air conditioning and fans around the house. Women may also be advised to bathe in herb-infused water and avoid washing their hair during confinement. These practices are thought to help the body retain its heat and avoid future problems such as arthritis and rheumatism. Nutrition According to each ethnicity, there are certain confinement diets comprising dishes that can help new mothers boost their immunity and regain their strength. These include dishes with “heaty” ingredients such as tonics brewed with herbs, pig trotters in ginger and vinegar, and papaya fish soup which is believed to increase breast milk supply. Foods which are “cooling” should be avoided, such as cold drinks, cucumber, pineapple, sugarcane, etc. as these can prolong the recovery. New mothers should also avoid intake of caffeine and alcohol for the period of breastfeeding as these substances can be transferred into the breast milk. Tips for a Restful Confinement During the first few months, accept help from your spouse, family members or hire a confinement nanny to help you with tasks such as caring for your newborn, household chores and confinement meal preparation. Avoid straining yourself by doing rigorous activities until you have received the green light from your doctor to resume your normal daily activities. If you have had a C-section, you may have to wait a longer period before resuming your daily routine. Do not be too focused on losing the pregnancy weight immediately. Some of this will be naturally shed from breastfeeding and the demands of caring for your baby. It is important to eat nutritiously and try to get some rest in between caring for your baby to help you regain your strength. *Content republished by SMG Women's Health.
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