Sickle cell disease is a blood disorder usually passed down from parent to child. People with sickle cell disease have abnormal hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen to the body.

In an adult red blood cells can live up to 120 days before they wear off or die, but in a sickle cell patients it takes about 10 to 20 days. It takes a shorter time. This is the cause of the anemia in sickle cell. There is also jaundice due to the excessive breakdown of the red blood cells. The cells that are sickle shaped can stick to each other occlude vessels and cause crises, pain and also reduce blood flow to certain organs. Symptoms depend on the organ affected.

Before pregnancy/marriage… Go for #genetic counseling you and your spouse. It’s best if both of you do not carry the gene. If both couples carry a trait the likelihood of having offspring with sickle cell is high. People can either be carriers, sickle cell or Non carriers. Your doctor will explain more what it means to be AA-no trait , AS&AC – trait/ carrier’s , SS&SC-sickle cell disease., among others. Based on his/her findings he will counsel couple so they can make an informed decision.

Women with sickle cell disease can get pregnant but should make sure they are fit. They should they go for preconception care where the doctor confirms they are fit. If there is a deficiency it is corrected first and all infections treated as well. It’s advisable for them to take a form of contraception to avoid unplanned pregnancy.

During pregnancy you will need close monitoring. Take prescribed medications, rest exercise. Enough fluids and avoid stress. Foods rich in iron, vitamins and protein in recommended. Report to the hospital immediately you feel sick. Prompt treatment is essential. Regular antenatal visits is beneficial.

Delivery should be in a #hospital with specialized care and monitoring. Plan your delivery together with your midwife and as well cooperate with her.

After #birth continue to take your prescribed medication and rest. Let people help you. More fluids, go for follow up clinics

They need support from relatives and spouses to stay healthy. It is not a communicable disease and can be managed with close monitoring and dedicated medical staffs. In case there is crises send client to the nearest facility as soon as possible.

Midwives in the periphery compound should refer clients to hospitals for specialized antenatal care. They should as well be handed over to community health workers for home visits and other support they may need.

If you already in the marriage/relationship you can still go for counseling if both couples are carriers or one has sickle cell. Children with sickle cell have specialized clinics in most hospitals and can be managed effectively. Thanks. Kindly #SHARE

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Sometimes as an expectant or new mum you are caught up with lots of voices and advice from different sources.

Give this! Do this, do that! It can be really frustrating

I have seen women have complications due to pressure from people around them

Babies have equally suffered due to wrong information!

The point you should always remember is that everyone is different

What works for you may not work for others

Ask your doctor or midwife before following advice or instruction from your “home doctors”.

Things can go wrong if you just follow any advice without verifying from your doctor!

Get the right information from health care professionals and a support group that is monitored

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🔴During pregnancy you may realize that your feet and arms are swollen. It does not occur in every woman. Your ring, bracelets or anklets become tight on you.

🔴Some may be due to the natural changes that occur during pregnancy. In this case you realize though your hands and feet are swollen, your BP and urine protein and other vitals are normal. You may not need any treatment. It will go away after pregnancy

🔴On the other hand, you have swollen hands and feet. It comes along with other signs and symptoms like #headache, #highblood pressure, #protein in urine and #epigastricpain.

🔴It’s important to report swollen hands and feet to your health care provider to rule out other conditions like pre eclampsia. The earlier it is detected the better the out come.

🔴To reduce the swelling…. It is advice that…

1. Do not assume a particular position for a long time. Sit-walk-rest. Mix your activities

2. When sitting you can rest your feet on a small chair

3. During sleep rest the legs on pillows. The next morning you will realize it has reduced

4.Your nutritionist will also advise on dietary changes.

You may not be able to tell whether it’s the normal one or not. Talk to your doctor about swollen hands and feet. If diagnosed with pre eclampsia kindly adhere to treatment. It is the leading cause of maternal health complications In Ghana.

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At term your baby should be head down. The presenting part of the baby should be the head. In medical terms “occiput anterior” . If the head is delivered first the rest of the body easily follows

But unfortunately it is not the case for everyone. Some baby’s present even at term with either the buttocks, hand, foot, shoulder and in some cases in a transverse lie.

This makes normal delivery in some cases a bit difficult.

Thanks to our midwives and doctors. A lot of these cases are detected earlier through palpation of the abdomen. Scan is also requested and that also helps to diagnose most of these cases before the birth of your baby.

If a breech birth is diagnosed earlier, within the second trimester. There is a likelihood for the baby to turn into the right position before birth. Your midwife will teach some exercise that will be helpful to you.

If detected late or the baby does not change position at term, It’s important to discuss mode of delivery with your healthcare provider.
Natural delivery may be allowed depending on findings like baby’s weight, mothers parity, skill of the healthcare provider among others.

In some cases a caesarian section will be requested to save both the life of the baby and mother.

It’s dangerous to allow traditional birth attendants to try to turn the baby. It has led to serious problems and even death of some mums. Do not allow this!

Cooperate with your health care provider to provide the best solution.

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Don’t leave your pregnancy to chance.

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EDD: 08/1/2024
God’s time: 08/12/2023
At week 30, a few minutes after I had visited the washroom around 1:30 am and had gone back to sleep, I felt my bed was wet. I initially thought I had passed urine but I checked and it was odorless and colorless. This liquid kept gushing from my vagina . Hubby and I were confused and got alarmed.

At 1:45a.m I called my Gynae and he confirmed it was my water that was broken. He advised me to be stable and report to the hospital later in the morning.
We got to the hospital around 6:30 am and I was examined and diagnosed with “premature raptured membrane ” . I was admitted on strict bedrest. I kept losing liquor and contractions were aborted every day because they were recurring. I was given injection to help build baby’s lungs and antibiotics.

After managing the condition for 5 weeks at the hospital, I was scheduled for a CS at 36 weeks. When I got to 35 weeks 5 days, I went into active labor again around 7a.m. Contractions couldn’t be aborted, I was going to be prepared for the theater when my gyn decided to check for dilation. At 8:15a.m I was 5cm gone and was given the chance for vaginal delivery. I was immediately transferred to the lying ward for monitoring. I began to have the urge to push and was again transferred to labor ward. At 8:45a.m through the mercies of God, after 2 pushes my 💙 Prince Charming💙 arrived weighing 2.1kg. Even though he born preterm, his vitals were fine and there wasn’t the need to go to NICU but was rather monitored until we were discharged the following day. Thanks to Midwife Sally and her team for the various teachings that enlightened my knowledge about pregnancy and delivery.

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One of the important things to do as a mum before leaving the hospital is to make sure you have inspected your baby before going home.

Here are a few things to note

🔴Make sure baby is able to breastfeed before going home.

🔴Check the back of the baby to make sure there is no dimples, holes or any thing abnormal (Spina bifida)

🔴For girls make sure the vestibule has two holes. The vagina and the urethra.

🔴In boys make sure you can feel the testis within the scrotum

🔴Your baby should not have fever, jaundice or any ill health while you are going home

🔴Make sure your baby has passed the first stool, meconium before going home

🔴The hands and limbs should be equal

🔴Make sure there is no abnormal discharge from the nose, eyes and ears.

If you suspect any other abnormal thing do report to the hospital.

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Please my baby doesn’t like to suck my breast for milk, rather he will prefer I pump and take it from the feeding bottle. Any assistance to help him suck the breasts please?

The reason is when I delivered him breast milk wasn’t flowing so I had to feed with SMA until breast milk flowed.
This usually occurs when you introduce bottle feeding early to the baby.

Baby gets confused and refuses to take the breast. Baby may also refuse the bottle at a point
It’s Important to introduce a baby to breast immediately after birth and continue with exclusive breastfeeding for the first six months.
For the first three weeks after birth only give breastmilk. Delay in introducing bottles or a pacifier at least for the first month if you have no issues
Before a baby is born, colostrum is readily available.
The more you breastfeed the more breastmilk will be produced
Eat more, take lots of fluids and rest
To reverse nipple confusion, gradually stop giving bottle to the baby
Stay with baby more often
Make feeding time a happy time for baby

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After the birth of your baby, your placenta is expected to follow within the first 30 minutes

If it delays in detaching and its self from the uterine wall, we say the placenta is retained and further steps have to be taken to bring it out.

A retained placenta will prevent the uterus from contracting and retracting. This means blood vessels in the uterine wall cant be occluded and will continue to bleed. Lots of blood is sent to the uterus during pregnancy and that is what makes it even more dangerous. Bleeding will occur since the uterus is not contracting

It has to be manually removed by your doctor or midwife so the uterus can contract.

Depending on how severe it is you may be sent to the theater and removal done under anesthesia.

Its one of the reasons why choosing a facility where the staff are skilled with facilities ready for emergencies is of extreme importance

In situations like this you will need the whole team, gynecologist, midwives, anesthetist, theater nurses, blood bank staff etc

If you are in a small facility, early referral is needed to save the mums life on time

Blood transfusion will also be done if bleeding if severe

Always cooperate with your health care provider in situations like this as every minute counts!

Do not leave your pregnancy to chance!

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Amniotic fluid around your baby is just as important as the air you breath to the baby.

Significant reduction in the amount of the water called oligohydraminous can lead to malformations in the baby

Too much of it suggests other complications too

It has to be adequate for the baby to form properly

When your waters break before labor sets in, it can lead to infection or other problems

At any time when your waters break do report immediately

Pregnant? Do not leave your pregnancy to chance!

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Midwife Sally what causes the water around a baby to become greenish and why do midwives/doctors consider it as an emergency?

During pregnancy the baby is surrounded by fluid/water which is called #liquor. It protects the baby in utero.

#Meconium is the first stool of the baby and it is also greenish in color

In utero a healthy baby will not poo into the liqour that surrounds it.

Several factors can cause your baby to go into distress in utero. Once your baby does not get enough oxygen in utero, with time if no intervention is given. The anal sphincter muscles and the other sphincter muscles of the baby will relax.

Baby will start to poo into the amniotic fluid, and also aspirate. Meconium liqour can also get into the respiratory system. It gives the liqour that greenish color

If your waters break and the liqour is greenish in color it shows that your baby may be deprived of oxygen and is struggling to survive. Delivery has to be as soon as possible to prevent further complications.

The more greenish or thick the liqour is the worse the complications can be.

Always cooperate with your midwife or doctor to expedite delivery. The earlier baby is delivered the better complications are reduced.

In some cases an emergency Caesarian section can be done to save the baby. Other investigations will be done to ascertain whether baby Is really in distress or not.

If you get into labor pay attention to the liqour around the baby, if it’s greenish in color immediately alert the medical staff or report immediately to the hospital. That is possible if your water has broken.

Once baby is born, they may need additional care at the neonatal intensive care unit or help with breathing.

Midwives are always be ready to resuscitate new borns that need help with breathing.

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