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abdomen.

      •Q2. Will making love during late pregnancy initiate labour? This is partly true, because the release of the hormone oxytocin can initiate contractions, but it won’t induce labour before Baby and your body are ready.

      •Q3. What causes bleeding after making love? This can be caused by a raw patch in your vaginal wall, or by a low-lying placenta. The former should heal spontaneously, but if it’s related to an infection, it will need treatment. A low-lying placenta needs to be diagnosed by your doctor, who might ask you to avoid lovemaking for a while. If bleeding doesn’t stop or there are any other symptoms, like a change in Baby’s movements, fever or pain in the womb area, immediately report this to your doctor or midwife, who will determine whether it’s safe for you to make love for the rest of your pregnancy. You should also tell your doctor if you notice any abnormal discharge, a change in Baby’s movements or pain in your womb, or if you feel unwell in any way.

      •Q4. What do I do about pain during lovemaking? Pain during sex is seldom an indication that something’s wrong, although if there are other worrying symptoms, you should see a doctor. If you’re anxious, the pain could be caused by tension of your vaginal muscles, or because there’s inadequate lubrication. Relax now you know it is mostly safe and use an approved lubricant to ease any discomfort.

      •Q5. What do I do if we’re not making love at all anymore? Ask yourself why not. You may be tired due to pregnancy hormones or perhaps you’re insecure about your changing body. Make an effort to set time aside for intimacy, and remember that most men find a woman’s changing shape attractive. Communication is key – let him know that you’re keen to make love and that it’s safe to do so, and this can be overcome.

      CHAPTER 6

      Skin health, beauty and concerns in pregnancy

      While for many women the effects of pregnancy on the skin are positive, with people commenting on how they are glowing, some are troubled by niggles or conditions they never expected.

      COMMON SKIN CONCERNS

      It’s easy to become concerned and unhappy if pregnancy wreaks havoc on your skin. There are five common pregnancy skin problems which many women experience.

      1.Stretch marks

      Stretch marks are mostly caused by genetics, but diet and hydration of the skin also play a role. They occur due to tearing of the collagen bundles just below your skin. To help keep them at bay, you need to enhance the elasticity and cell strength of your skin. After pregnancy, the stretch marks will fade somewhat, which makes them less visible. Unfortunately, they will never disappear completely.

      Self-help tips:

      ✓Take the tissue salt remedies Calc fluor and Ferrum phos three times daily throughout pregnancy to help with skin elasticity and strength.

      ✓Apply a nourishing lotion or natural, vitamin E- and A-enriched tissue oil to areas more prone to stretch marks, like the abdomen, breasts and thighs. If you’re allergic or sensitive to skincare products, look for lotions or oils tested for sensitive skins and made by a reputable company. Remember to make sure the product is safe to use in pregnancy; read the label carefully, or contact the company to find out.

      ✓Make sure you don’t carry excess weight before pregnancy and keep active to stay toned and supple while expecting your baby.

      See your midwife or doctor:

      You could discuss persistent stretch marks that leave severe scars after birth, but there is very little to be done about them, short of surgery – which will leave scars too and may not eradicate the problem entirely.

      2. Itching

      Itching is very common, especially on the abdomen and the breasts, but also sometimes in areas like the buttocks, labia, upper arms and thighs. No-one really knows why itching occurs in pregnancy, though changing hormones and stretching skin are often considered the culprits. Fortunately, although distressing and uncomfortable, it’s mostly not serious.

      Self-help tips:

      ✓Stop using harsh soaps, skincare products and detergents for a few days to see if you’re sensitive to one of these.

      ✓Use a natural, vitamin E-enriched tissue oil.

      ✓Add a pot of rooibos tea or a handful of bicarbonate of soda to your bathwater.

      ✓Dab dry cornflour on the itchy areas.

      ✓Eat more sweet potatoes, carrots, good quality fish and dark, leafy green veggies, as the high amounts of vitamin A and vitamin D in these food sources could help.

      ✓Take the tissue salt Nat mur and homeopathic calendula tablets.

      See your midwife or doctor:

      •If you experience severe itching on your hands and soles of your feet, your tummy and later the rest of your body.

      •If you feel ill and nauseous, your urine is dark and your stools are a pale colour, you are very swollen or if your skin seems sallow or yellowish.

      3.Hyper-pigmentation

      Up to 70% of women get hyper-pigmentation, or darkening of the skin, during pregnancy. It is also normal for freckles, moles and blotches to become bigger or darker. This is generally caused by high levels of the hormones progesterone and oestrogen, and by an increase in melanin levels during pregnancy. Symptoms usually disappear a few months after birth.

      If you have hyper-pigmentation, you may experience a darkening of:

      •The areolae around your nipples.

      •Certain patches on your face, especially around your mouth (called chloasma), and over your nose and cheeks (almost like a butterfly shape).

      •The line from the pubic bone to the navel in the middle of your belly (called the linea nigra).

      •Areas like the genitals, inner thighs and under arms.

      •Any areas exposed to the sun.

      Self-help tips:

      ✓Avoid prolonged exposure to the sun; use a hat and pregnancy-safe sunscreen during the day – zinc preparations are very effective.

      ✓Stay away from sunbeds.

      ✓Don’t use bleaching creams or herbal preparations that might harm your baby.

      ✓Use gentle, preferably organic, skin creams so you don’t irritate the areas of pigmentation.

      See your midwife or doctor:

      •Most medication for pigmentation can’t be used during pregnancy. If you have severe hyper-pigmentation that doesn’t fade within a few months after birth, ask your doctor to prescribe a treatment.

      •Ask your doctor to remove any moles that are bothering you.

      4.Acne

      Many pregnant women struggle with acne – especially intense women who stress easily! Pregnancy acne is also more prevalent in brunettes and darker skinned women. Pimples may be distributed over any part of the body but the face, back and upper arms are common areas.

      Self-help tips:

      ✓It’s important to nurture yourself and relax as much as possible, because of the link to stress.

      ✓Cut down on red meat and fermented foods like pickles, which increase acidity levels in the body.

      ✓Eat more fruit and vegetables, and include cooling digestive spices like dill, fennel and mint in your diet.

      ✓Do not mix fruit with other foods, to help counteract acidity.

      ✓Keep your meals simple, with not too many ingredients at one time.

      ✓Drink eight glasses of water a day and avoid caffeine drinks.

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