Dear Doctor,

I’m pregnant with my first child but I’m worried because of all the things that could go wrong. I’m in my third trimester and so far so good. I’ve heard about still births and I would like to know what causes that and what I should avoid. Is exercise good at this point in my pregnancy or will it harm the baby?

Zahara

Dear Zahara,

Still birth is the death of the baby inside the mother’s womb. Typically, it is the death of the fetus at around 20 to 28 weeks of pregnancy. It is different from a miscarriage, where the baby dies during early pregnancy.

Still birth can occur due to many reasons. Defects in the placenta, chromosomal   abnormalities in the fetus, high blood pressure or uncontrolled diabetes in the mother, use of alcohol or tobacco during pregnancy, certain drugs like prescription pain killers, illegal drugs, and etcetera, are some of the causes of still birth. Having your first pregnancy over 35 years of age, African American ethnicity, obesity, having AB blood group, and history of still births in previous pregnancies, are other risk factors.

A cautious mother-to-be can sense still birth, if there is total cessation of the fetal movements. It is confirmed by ultrasound. The only treatment options are either to induce labour (if near term) and remove the dead fetus or remove it surgically.

Regular antenatal checkups help to check any risk factor likely to cause a still birth. It also helps to monitor the growth of the fetus. Thus it would be helpful in preventing a still birth. As an individual, a pregnant woman should be careful to avoid the risk factors for still birth. These include good control of high blood pressure and diabetes, avoid smoking and alcohol and go for regular antenatal check up.

Physical exercise is good during pregnancy. Exercise helps to prevent excess weight gain. It also helps in prevention and better control of diseases like hypertension and diabetes, which can potentially cause a still birth. Most importantly, regular exercise done from the second trimester onwards helps to make the joints of the lower limbs flexible. This in turn facilitates the woman to deliver her baby smoothly, without any difficulty. However, the exercise should not be strenuous or tiring. If exercise is started at this time, the obstetrician can be consulted and quantity should be increased gradually. Swimming, brisk walking, indoor stationary cycling, low impact aerobics, and yoga, are all good exercises to be done during pregnancy. Also, one should avoid exercises or movements that put abdominal muscles under strain.                                          

   Dr.Rachna  Pande is a specialist in internal medicine.