CARING FOR WOMEN

EVERY STEP OF THEIR LIVES

CARING FOR WOMEN

EVERY STEP OF THEIR LIVES

CARING FOR WOMEN

EVERY STEP OF THEIR LIVES

CARING FOR WOMEN

EVERY STEP OF THEIR LIVES

CARING FOR WOMEN

EVERY STEP OF THEIR LIVES

CARING FOR WOMEN

EVERY STEP OF THEIR LIVES

WELCOME TO DR PAMELA TAN MEDICAL CLINIC

LEADING FEMALE OBSTETRICS AND GYNAECOLOGY SPECIALIST IN SINGAPORE

Obstetrics

View our list of obstetric services available during your pregnancy, birth and beyond. Find out more.

Gynaecology

Learn about our comprehensive gynecologic care including infertility, bleeding issues and abnormal pap smears, & more.

LIKE YOU, WE CARE

Dr Pamela Tan is an obstetrics and gynaecology specialist practising at Thomson Medical Center in Singapore. Prior to leaving for private practice, Dr Tan was a female Consultant in the Department of Obstetrics and Gynecology, KK Women’s & Children’s Hospital.

She obtained her undergraduate medical degree at the National University of Singapore and her post-graduate MRCOG in London at the Royal College of O&G. She is a specialist accredited with the Specialist Accreditation Board (Ministry of Health) and is a Fellow of the Academy of Medicine, Singapore (FAMS). She is an accredited member of the Society for Colposcopy and Cervical Pathology of Singapore (SCCPS) with a subspecialty interest in colposcopy (for pre-cancer of the cervix and vagina) and vulval disease.

In further pursuing this interest, she was a fellow for pre-invasive disease at the colposcopy and vulval unit at the Whittington Hospital in the United Kingdom. She is a visiting consultant at KK Hospital for colposcopy and is still involved in research on computer imaging analytics for screening cervical cancer in low resource settings in a joint collaboration with the National University of Singapore.

While in the United Kingdom, she was also a fellow at the Assisted Conception Unit in Guys Hospital to learn the latest in reproductive techniques and approaches to infertility. She is accredited to perform advanced Level 3 minimally invasive keyhole surgery such as laparoscopic hysterectomy, myomectomy and cystectomy (womb, fibroids and cysts removal).

Her philosophy to doctoring is one that is focused on building relationships with her patients. She strives to deliver patient care that is warm, caring, professional and well advised. She is a believer of pro natural birthing and providing an optimal birthing experience as desired by her patients.

Dr Pamela Tan is an obstetrics and gynaecology specialist practising at Thomson Medical Center in Singapore. Prior to leaving for private practice, Dr Tan was a female Consultant in the Department of Obstetrics and Gynecology, KK Women’s & Children’s Hospital.

She obtained her undergraduate medical degree at the National University of Singapore and her post-graduate MRCOG in London at the Royal College of O&G. She is a specialist accredited with the Specialist Accreditation Board (Ministry of Health) and is a Fellow of the Academy of Medicine, Singapore (FAMS). She is an accredited member of the Society for Colposcopy and Cervical Pathology of Singapore (SCCPS) with a subspecialty interest in colposcopy (for pre-cancer of the cervix and vagina) and vulval disease.

In further pursuing this interest, she was a fellow for pre-invasive disease at the colposcopy and vulval unit at the Whittington Hospital in the United Kingdom. She is a visiting consultant at KK Hospital for colposcopy and is still involved in research on computer imaging analytics for screening cervical cancer in low resource settings in a joint collaboration with the National University of Singapore.

While in the United Kingdom, she was also a fellow at the Assisted Conception Unit in Guys Hospital to learn the latest in reproductive techniques and approaches to infertility. She is accredited to perform advanced Level 3 minimally invasive keyhole surgery such as laparoscopic hysterectomy, myomectomy and cystectomy (womb, fibroids and cysts removal).

Her philosophy to doctoring is one that is focused on building relationships with her patients. She strives to deliver patient care that is warm, caring, professional and well advised. She is a believer of pro natural birthing and providing an optimal birthing experience as desired by her patients.

Latest Blogs

Keep Calm and Labour On: Your Guide to Pain Management in Labour

 

Active labour, especially in first-time mothers, can stretch up to 18 hours. Pain management during labour is important because pain can contribute to maternal fatigue which is linked to emotional responses such as anxiety and tension. The physiological stress response of adrenaline production comes with harmful effects on the body and may retard the progression of labour. So, what are the ways to make labour more manageable?

If D-day is in a few months or weeks from now, it’s important that you get acquainted with the options available to you. Here’s an easy guide on pain management while in labour.

Non-Pharmacological

The non-pharmacologic approach to pain comes with a variety of techniques. It not only addresses the physical sensations of pain, it also enhances the psycho-emotional and spiritual components of care.

Proponents perceive pain as a side effect of a normal process, not a sign of injury, damage or any abnormality. Instead of making pain disappear, the caregiver assists the woman to cope with it, build self-confidence, and instill a sense of mastery and well-being.

Here are the non-pharmacologic techniques in pain management during labour.

 

1.Breathing Exercises

 

We generally benefit from breathing exercises, but it is particularly helpful for women who are in active labour. Also referred to as patterned or conscious breathing, this exercise is the act of breathing at any number of possible rates and depths. It is considered as one of the most common methods used for natural pain relief during labour and even in delivery.

Some women prefer light or pursed breathing exercise where one inhales through pursed lips and takes in just enough oxygen to fill the chest. Others prefer deep breathing using the diaphragm to breathe in more air. Regardless of technique, the goal is to find a breathing pattern that has a calming and relaxing effect.

Patterned breathing can help you cope with various types of pain, anxiety and fear. In the first stage of labour, these breathing techniques can promote physical relaxation by reducing muscle tension. Consequently, this also promotes emotional relaxation. One study even states that “breathing techniques in labour have a positive influence in the development of confidence and feeling of empowerment in the expectant mother.” Effective use of these techniques contributes to better outcomes and higher patient satisfaction during the birth experience.

VIDEO: https://www.youtube.com/watch?v=_UNtEozszIo

 

2. Warm and Cold Therapy

 

Warm and cold therapies are basic measures for pain management. Both provide pain relief but in different ways. They may both be applied on the same area intermittently or be used at the same time but in different areas where the mother feels discomfort.

Warm compresses can be dry and wet. A dry warm compress can be through a hot water bag or electric heating, while wet warm compresses can be through gauze compresses, packaged heating and bathing/showers. Warm compresses are applied in the lower back, waist, groin and perineum. According to a study, warm compresses help the muscles relax thereby decreasing or eliminating the pain. It can also facilitate the supply of blood flow.

Local cold therapy also comes in dry and wet forms. Dry cold compresses can be in the form of ice or gel packs and wrap-around packs that come with a Velcro belt. Meanwhile, a cold washcloth is used for wet cold compresses. Application can decrease muscle spasms and muscle temperature. It also creates a numbing effect that decreases sensation and pain awareness.

 

3. Acupuncture and Acupressure

 

Acupuncture involves the insertion of fine needles into specific points in the body to correct the imbalance of energy, while acupressure uses pressure applied on similar points.  As part of Chinese complementary therapies, these two have been practised for thousands of years, and are now backed by scientific studies. Acupuncture and acupressure have become widely recognized as effective methods of pain relief.

A Cochrane review showed that acupuncture during labour can limit the use of pharmacological analgesia and epidural anaesthesia. It can also trigger the release of several brain chemicals, such as endorphins which block pain signals.  Furthermore, women receiving acupuncture in labour appear to experience additional benefits such as shorter labours and reduced rates for instrumental vaginal birth. However, most labour wards in singapore are not open to acupuncture conducted in labour.

Alternatively, certain pressure points are also found to significantly reduce pain intensity during labour. A study suggests that the LI4 (Large Intestine 4) pressure point can alleviate the pain without causing adverse effects on you and your baby. A randomised trial also showed that applying pressure on BL34 (Bladder 32) can alsoimprove labour pain and even delivery outcome.

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4. TENS (Transcutaneous Electrical Nerve Stimulation)

 

It is nerve stimulation through a device that delivers safe pulses of electrical currents that can help control labour pain. The electrode pads are placed on acupuncture points on the lower back.  The currents block the pain signals at it passes through the nerves to your brain.  It can reduce the severity of labour pain and it can delay your need for pharmacological analgesia. The gate control theory of pain asserts that non-painful input closes the “gates” to painful input, which prevents pain sensation from traveling to the central nervous system. Therefore, stimulation of the nerves in another mechanism may be able to suppress pain. The TENS machine eg babycareTENS for labour may be available online or rental from some antenatal or obstetric providers. It may be particularly helpful for early labour and back pain in labour caused by the baby’s position pressing on the sacral nerves. Alternatively, strong counter pressure in the back with massage may also help.

5. Hydrotherapy

 

Hydrotherapy means immersion in water and come out of the tub to birth. It should not be confused with a water birth, which means to labour and birth in the water. This pain relief option provides physiological and psychological benefits which is highly sought after by mothers who plan to have a natural birth.

For some people, water can be a calming presence. It is also an evidenced-based intervention for pain and anxiety management, which explains why hydrotherapy is introduced in several healthcare institutions in Singapore as an option for pain management during labour.

One study finds that as the mother relaxes through this method it helps reduce the duration of labour and decreases the need for epidural analgesia.

6.Continuous Labour Support

 

A trained birth attendant (Doula)  or partner can provide non-medical labour support to assist with pain management. While you can enlist the help of a doula, your partner can also learn how to provide effective emotional and physical support through the Bradley method in pre-natal classes. Having a birth coach has been shown to reduce the use of epidural analgesia.

Your social environment plays a powerful role in influencing your thoughts and emotions. Your support system can help you look at labour pain as a productive and purposeful pain. With pain intensity increasing by the minute, dealing with it can be hard while you are in labour. But with continuous labour support you are more empowered to use your inner capacity to cope. Research shows that this can decrease your need for pain interventions. When done correctly, this can improve your experience with labour pain.

7.Hypnobirthing

 

Mental imagery is also a powerful tool in managing labour pain. By applying this method, you can prepare your mind to respond the way you want in situations that you can’t control. Through this you can rehearse the stages of labour, train your mind to stay calm during contractions, and stay focused and alert for long periods of time. The Mongan method is the most commonly used hypnobirthing method for self-hypnosis and guided imagery techniques with the aim of being in a deeply relaxed state. There are several antenatal classes that teach this technique.

Mentally rehearsing an event with emotional, visual, and auditory detail rewires your brain. It cannot tell if you have physically done it or just imagined it. So, when the event comes, your brain goes on autopilot and recollects how you have mentally rehearsed things to happen and goes about getting it done.

While it is true that labour may not always go the way you have rehearsed it, this technique can better equip you to deal with any necessary intervention with strength and clarity. This can be possible after you have fostered a connection with your internal strengths and resources.

 

8.Music Therapy and Aromatherapy

 

Music therapy is found to reduce pain and anxiety during labour. It is a cost-effective intervention that doesn’t need any training to be used.

A person’s familiarity with music and preference is strongly linked to how relaxed they feel when listening to music. One study showed that people who listen to music that they enjoy experience increased levels of natural “feel good” hormones. These are also referred to as the body’s “pleasure hormones” because it can improve your mood and happiness.

Another research also claims that music can affect a woman’s perception of pain and anxiety during the active and latent phase of labour. This study revealed that the active phase and second stage of labour were significantly shorter for participants that were subjected to music.

If you consider music as part of your birth plan, now would be the time to start making that feel-good playlist to serve as a soothing soundtrack to help you manage labour pains.

Similarly, calming smells using essential oils like lavender, chamomile and bergamot can help relax the body during labour while peppermint is good for reducing nausea. Most labour wards will permit gentle calming music and aromatherapy.

Medical Pain Management Techniques

 

There are two type of medication that can a help ease labour pain: Analgesics and Anaesthetics. Analgesics lessen the pain, while maintaining feeling or muscle movement. Anaesthetics relieve the pain by blocking all sensation of it.

Furthermore, the pain relief provided by these medications can either be systemic, regional, or local. Systemic medications affect the entire body, while local medications affect a small area. Regional medications, on the other hand, affect a region of the body, like the waist down.

Under the two main classifications are different pain relief options which include the following:

1.Epidural

Labour epidural has long been considered the gold standard in labour analgesia as it is the most effective and gives the mother time to rest before the pushing stage of labour. It is administered as an infusion of local anaesthetic into the epidural space in the spine. It is normally given when you enter active labour the effects are felt within 5-20 minutes. You will experience some loss of feeling in the lower areas of your body so you will no longer be mobile, but you remain awake and alert to be able to bear down or push your baby out. Often you will have a urinary catheter inserted to drain the urine passively as you will not feel when your bladder is full.

It does not increase your risk of having a caesarean section but may prolong the second stage of labour as there is decreased sensation that the cervix is fully dilated and reduces the urge to push. Occasionally, the epidural dosage is reduced during this time so that pushing is more effective and that reduces the chance of an instrumental forceps or vacuum delivery. Some patients have a drop in blood pressure or develop shivering or fever while on the epidural. Very rarely do patients get a headache or suffer nerve injury (less than 0.1%). Contrary to popular belief, epidurals do not cause back ache but backache is common after any pregnancy irregardless of epidural usage.

2. Laughing Gas

It is made up of sedating gas that is mixed with oxygen. It will not eliminate labour pains, but it can make it more bearable. Since the effects are mild and short-acting, it is considered a very safe option. You can use it through a tight-fitting mask or mouthpiece when you feel that you need it. Right at the start of the contraction, deep inhalations of this “laughing gas” are used until the contraction starts to subside. However, it can make you drowsy, light-headed or nauseous if inhaled too rapidly or too long hence you are advised to stop once you feel light headed and in between contractions.

3.Opioid Injections

Upon request, opioid injections are often administered into the thigh or buttock to block the pain receptors to your brain. It will take 10-20 minutes before you can feel any effect.

The drug can potentially cause the baby’s heart rate to drop. Rarely, it can even cause drowsiness or breathing problems in the newborn if birth occurs close to the time of administration and in some cases, an antidote is needed to reverse the side effects. Hence it is usually not given when the patient is more than 5 cm dilated.

Isn’t it fortunate that you are now giving birth at a time where you can make the labour experience less stressful than movies make it out to be? However, even with all these pain management options at your disposal, it is still important that you work closely with your doctor in finding one that suits you best.

To know more on this topic and for other related concerns, book your appointment with Dr. Pamela Tan toda

A Mommy’s Guide to All Financial Aspects of Pregnancy in Singapore

Expecting a baby can be a beautiful experience, but it is also one that is peppered with anxiety. As an expectant mother eases into nesting, she can have a mountain of concerns running through her mind. One that usually demands attention is financial preparedness. Pregnancy and delivery in Singapore don’t come cheap. However, a woman can prepare for it and save herself from added stress once she learns about the help available to her and her baby.  

The Harmful Effects of Financial Stress in Pregnancy

  Worrying about finances and how they will be able to keep up with the changes to come not only bothers the mind, but also has detrimental effects on the baby. One study shows that women who feel anxious or stressed about finances during pregnancy are more likely to have babies with low birth weight. Furthermore, babies who are underweight are more likely to need expensive intensive care during the first weeks and months of life. They also have an increased risk of developing chronic medical issues, respiratory and digestive problems, obesity and heart disease. This sheds light on the importance of financial preparedness to ensure that financial stress does not have a chance to interrupt the baby’s growth and development in the womb.  

The Cost of Antenatal Visits

  After a positive pregnancy test, you are advised to go for regular check-ups. Antenatal appointments are very important throughout your pregnancy because it helps you monitor your health and that of the baby. These check-ups usually start from the 6th-8th week of pregnancy. It is advisable that you go for check-ups at least once a month. In the last trimester, these visits would have to increase to twice or more every month. During the entire pregnancy, you can expect to have at least 10 or more prenatal visits. Each of these visits is a chance for you to discuss any concerns with your doctor. However, you might be concerned about how these appointments can get expensive. The costs of these antenatal visits vary from $500 – $800 at public hospitals for all 10 visits, to around S$140 – S$250 per visit at a private hospital, with the total cost roughly around S$1,800-S$2,500. If you include the cost of prescribed supplements or prenatal vitamins, these visits may cost you about S$500 to S$700 more. In addition to these visits, you must also factor in the different tests to your list of expenses. These include the following:

  • Scan during the initial visit to confirm the due date, whether a mother is carrying multiples (twins/triplets/quadruplets), if it is an ectopic pregnancy, and to check the baby’s heartbeat.
  • Full blood count to check for anaemia (low blood count which can leave one tired and less able to cope physically if too much blood is lost during or after delivery)
  • A urine test every visit to check for the presence of protein (an early sign of pre-eclampsia or a urinary tract infection) and urine sugar to screen for diabetes
  • Blood screening to check for thalassaemia (a common genetic blood disorder in Singapore)
  • Blood grouping in case a blood transfusion is required
  • Hepatitis B and syphilis screening
  • Rubella antibody screening (optional)
  • HIV screening (if infection is present, this can have significant implications for your baby)
  • Down syndrome screening
  • First Trimester Pre-Eclampsia Screening (includes specific blood test for PIGF, blood pressure measurement, ultrasound examination) if there are signifcant risk factors
  • Ultrasound scan (anomaly scan) at 20 weeks to check for major structural abnormalities
  • Oral glucose tolerance test at 24-28 weeks to screen for gestational diabetes
  • Lower vaginal swab around 36 weeks for Group B streptococcus screen

Doctors may suggest these screening or diagnostic exams, but some expectant mothers may not have to undergo all of them. However, a more extensive screening and monitoring is required for high risk pregnancies. After week 13 some private gynaecologists in Singapore offer prenatal packages which includes consultation, ultrasound, additional scans and tests. Sometimes, these may even include supplements. However, these packages usually do not include a screening test for Down syndrome in the baby which usually cost around S$300 – S$350 for a OSCAR first trimester screen to up to $1250 for a non invasive prenatal test (NIPT).   Each hospital offers different antenatal screening ultrasound packages grouped according to each trimester. You can check out Thomson Medical Centre’s package, here. Whether you choose to go to a private or public hospital, the expenses for some of the tests can be subsidised by the CPF (Central Provident Fund). Through the MediSave program, you get to save some of your budget for other needs. We will discuss more on these government subsidies below.  

The Cost of Labour and Delivery

  Your choice of hospital is an important decision when you are considering the cost. The total expenses will depend on whether you choose a private or a public institution. As expected, private hospitals will be costlier. In choosing one, you need to factor in the cost of the delivery room, the need for birthing assistance, or specific requests like a water birth. Furthermore, your choice of doctor will also significantly affect the total cost. It depends on whether that doctor practices in a private or public institution.  Hospitals may show you labour and delivery packages, but these usually do not include the doctor’s professional fee.  

Room Rates

  Room rates vary for each institution and the cost also varies for each accommodation. At Thomson Medical Centre they offer the following:

  • Premier Single – S$638.00 without GST (S$682.66 with GST)
  • 1 Bedded Room – S$530.00 without GST (S$567.10 with GST)
  • 2 Bedded Room – S$288.00 without GST (S$308.16 with GST)
  • 4 Bedded Room – S$209.00 without GST (S$223.63 with GST)

The choice of hospitals will ultimately depend on the patient’s preference, budget and the level of comfort and privacy a woman wishes.  

Deliveries

Vaginal Deliveries

The cost of a normal (vaginal) delivery ranges from S$840 to S$9,775 depending on the hospital and ward. The highest median cost is at S$9,775 at Gleneagles (Private), and the lowest is at S$840 at the National University Hospital (subsidized Ward C). If you have the extra cash to make your labour and delivery experience more special, several hospitals in Singapore offer packages to let you do so in style. This could mean suite rooms, private nurse service, celebratory dinner or cocktails, and complimentary massages.  

C-Section

A caesarean delivery costs much more than a normal delivery because it is a surgical procedure, which means it will take longer to heal. Your hospital stay may be up to 3-4 days for further monitoring. The cost of a C-section in Singapore ranges from S$1,115 to $16,314 depending on the hospital and type of ward you choose. The highest median cost for a C-section is S$16,314 at Mt. Elizabeth Hospital (Private). The lowest median cost of a C-section is around $1,115 at the National University Hospital (subsidized Ward C). C-section deliveries with serious complications often range from S$1,491 to S$17,220. The Highest median cost is S$17,220 at Gleneagles Hospital (Private), while the lowest median cost is S$1,491 at the National University Hospital (Ward C). The total cost will also be affected based on your choice between an epidural or general anaesthesia. Some women may also opt to get a ligation along with a C-section.  

Baby Admission

  In some cases, the baby may require a separate admission due to medical reasons. It could be due to a preterm birth or low birth weight. This will mean additional expenses, but you can claim a certain amount from MediSave to cover the cost. If the baby needs to be admitted in the NICU (Neonatal Intensive Care Unit), the charges are linked to the category charges of the mother. For example, if you are admitted as a Class A mother for a private room, then your baby’s NICU stay will also be charged under class A. However, the quality of care for the babies in Singapore’s NICUs is the same, even if the cost varies significantly.  

Maternity Insurance

  Maternity Insurance is an add-on to your basic health insurance policy that covers expenses related to childbirth. It is common practice for insurance companies to cover pre- and post-hospitalisation expenses along with the coverage for room and nursing charges. It often costs less for a woman to carry a separate policy from her husband or partner when it comes to maternity coverage add-ons. Prenatal insurance, on the other hand, offers a different kind of security for mothers who want to be fully prepared. It provides financial assistance for those who suffer from complications during pregnancy. It also includes coverage for newborns with congenital disorders. Example of top Maternity Insurance Policies in Singapore include: OCBC MaxMaternity Care Pacific Prime Maternity Insurance AXA Mum’s Advantage Company insurance, especially comprehensive covers provided by some large multi-national companies under Bupa, CIgna or Now health etc, may provide for maternity benefits for employees or their spouses.

Government Subsidies

MediSave

MediSave is Singapore’s national savings scheme which helps CPF members to put aside part of their income into their MediSave Accounts for future personal or their immediate family’s hospitalisation. Expectant mothers can also use it for pre-delivery and delivery expenses through the Maternity Package. The MediSave withdrawal limit for pre-delivery expenses have been doubled from S$450 to S$900 for mothers who have delivered on or after 24 March 2016. This can cover expenses for consultations, tests, ultrasound scans, and medications. For delivery expenses the claimable MediSave amount is between S$750 and S$2,150, depending on the type of delivery procedure. The MediSave limit for a normal vaginal delivery is $750 while a C-section is SS2,150 and a C-Section with ligation is S$2,600. For each hospital day you get to claim S$450 to cover the cost of accommodation. MediSave can be used from the birth of your first child onwards. Both parents’ MediSave can be used for the fifth and subsequent childbirth; however, it is only applicable if the combined balance is at least S$15,000 at the time of the delivery. This is to make sure that you will still have enough funds for future hospitalisation needs, especially after retirement. In exceptional cases, the grandparent’s MediSave can be used too.  

Baby Bonus

The Baby Bonus Cash Gift is cash that is given to parents of newborn babies. The amount they receive depends on the birth order of the child. The claimable amount has been enhanced. For the first and second child, it was previously S$6,000 for those born between 26 August 2012 and 31 December 2014 (for each child). It has been increased to $8,000 (inclusive of S$2,000 Baby Bonus Plus) for babies born on or after 1 January 2015 (for each child). For the third and fourth child, the claimable amount is S$10,000 under the Baby Bonus Plus Scheme. The 5th and subsequent children did not have any claimable amount in the previous arrangement, but with Baby Bonus Plus, they can now claim a total of S$10,000. Learn more about MediSave and the Baby Bonus scheme, and how you can claim it, here. There is a bevy of resources in Singapore that you can tap for financial assistance and preparedness. Dr. Pamela also offers a maternity antenatal package that is available in her Seng Kang clinic and a promotional upgrade from 4 bedded to 2 bedded room for some deliveries in Thomson Medical Center. Book a consultation today and prepare your body, your baby, and your wallet for D-Day!  

Disclaimer: While all efforts are made to ensure that the information presented here are accurate at the time of publishing, we are not liable for any updates. The prices that are specified in this page are still subject to changes. It is advised to confirm with the primary sources.

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Male Nesting: A Dad-To-Be’s Guide Through Pregnancy and Fatherhood

Expecting a baby can be two different stories for an expectant mom and a dad-to-be. A drastic change is about to come into the family as a unit especially for first-timers. But, men should understand that these changes have taken over a woman’s body so much so that some may find pregnancy not so magical after all. This is where a man should step up to meet his partner halfway and involve himself in the process.

Your Participation Is Important

Research has shown that most new moms have a better experience during pregnancy when dads are actively involved. This makes your role essential and one you should never take for granted. Today, not only does your involvement benefit the mother and the child, but it also benefits you and how you develop your identity as a parent early on.

Always remember that the health of your baby depends on the health and well-being of the mother. Your participation as a partner is important even if you are not the one going through the physical changes.

Some may come into the process all ready and excited. But, you shouldn’t be guilty if you still feel rather clueless on what to do. Having found your way here, means that you are making an effort towards the right direction.

Male Nesting

Nesting is not only for women since expectant fathers go through it too, but it may manifest in different ways. The instinct to provide and protect could be expressed by babyproofing the house, considering buying a family-friendly car, or working harder at the office.  As a matter of fact, what you are doing now is an effort in that direction.

According to family therapist Mary Dodge to ParentMap, “Nesting’s both an expression of anxiety and an attempt at mastery of a new role.”

Men and Pregnancy

Behind all the excitement over a pregnancy is the reality of physical changes, financial preparation, and emotional preparedness among many others. You become an effective support system when you know what to expect within the coming months and the role you play in it.

Here’s a simple guide on how to support your pregnant partner:

Go With Her During Antenatal Visits

The pregnancy experience can be similar in a lot of ways and unique for several reasons. Your involvement can help you understand what is going on beyond what you can see, and empathize with what your partner is going through.

The main goal of these monthly visits is to prevent health problems in both the baby and the mother. These visits are also opportunities for you to gain foresight on what you need to prepare. Furthermore, this effort will also help you to be more open-minded and understanding to your partner’s emotional state and physiological needs.

Listen-and-Talk-Pregnancy-Guide-for-Men-Dr-Pamela-Tan

LISTEN AND TALK. If you can learn how to support each other now, your relationship will be stronger when the baby arrives.

Listen and Talk

Pregnancy and childbirth can be a lot to handle, especially for first-time moms. The least that you can do is to be a reliable confidant whenever she wants to vent. She may feel anxious or lonely, especially when she starts her maternity leave from work. Encourage her to talk to you, to family, or her friends.

It is also normal to have worries of your own. It’s also healthy that you share these concerns with your partner. After all, you are in this together. This type of exchange will help you open up more to each other. This develops a healthy discussion on matters that concern your changing family dynamic. If you can learn how to support each other now, your relationship will be stronger when the baby arrives.

It’s also important that you talk and ask other people (e.g. your parents or friends who are fathers) for advice. As an expectant father you may struggle with the need to balance your own transition to fatherhood and that of your partner. Through this process, you may feel that your status and feelings are overlooked – which may create conflict with your other roles. If you find yourself in that state, never hesitate to ask for support and advice.

Help Her out

Hormonal changes can make a pregnant woman tire easily.  So, you have to be pitch in with the household chores. The physical changes your partner is going through may make it harder for her to perform her usual tasks. For example, lower back aches are common during the third trimester, so you might have to do the heavy shopping yourself. You can also support her by eating healthy too so that it will be easier for her to follow through with the doctor’s diet restrictions.

Your positive participation can help allay your partner’s stress, and it has profound benefits to her health and that of the baby’s. All these efforts to help out are significant expressions of love and care, telling your partner that she is not alone. 

Plan-Together-Pregnancy-Guide-for-Men-Dr-Pamela-Tan
PLAN TOGETHER. Going to her pre-natal visits is like scoring VIP tickets where you get to ask the doctor straight away.

Plan Together

If your partner is keen on doing a birth plan, it is important that you also take part  in the planning. Your involvement in the planning will help  you become an effective support system and advocate during the labour and delivery process. This will also help you to be more prepared and less anxious when the big day arrives. It is also important to attend to arrangements needed for preparation when baby comes home like preparing the nursery, washing all the baby clothes and nursing equipment, installing the car seat or getting the confinement nanny in.

Read or Attend Supplementary Classes

You may feel a bit mystified by all the changes that are happening inside your partner’s belly. Fortunately, there are several resources to educate you. Going to her pre-natal visits is like scoring VIP tickets where you get to ask the doctor straight away. On your own time, you can also peruse magazines, books, or blogs. You may also attend childbirth classes along with your partner.

A well-prepared father has a positive effect on his partner’s birth experience. Knowing what to expect can reduce your fear of seeing your partner in pain during the labour process.

man-and-pregnancy-guide-dr-pamela-tanMen and Fatherhood

Experience may be the best teacher, but that will come afterwards.  For now, preparedness will help you handle your new responsibility better. You extend your circle of concern from your wife to your new bundle of joy.  Now you get to wear another hat for another role, and here are some tips you should keep in mind:

Change Your Habits

Did you know that your habits may indirectly affect your baby even in utero? Cigarette smoking, for example, can be detrimental to your baby. Your second-hand smoke can pose the following risks:

Check your lifestyle and see what you need to change to ensure that you create a safe and healthy environment for your family.

Know Child-Care Basics

Supporting your wife also means knowing the basics of child-care. Fortunately, for you today, there is a variety of sources to help you out. You can read about it or learn from classes, friends, or family. Fathers must learn how to at least prepare formula milk, change a dirty diaper, or bathe the baby. In this way, you can take over when your partner needs to rest.

Check Out Benefits Offered By The Government

The Singapore Government offers a paid paternity leave for two weeks. You can check here, to see if you are eligible and to choose among the different arrangement options.

The government also offers a Baby Bonus Scheme which will help families defray the costs of raising a child. It comprises a Child Development Account (CDA), a cash gift, and a special co-savings scheme for children. You can learn more about it, here.

Baby Proofing

While your partner may be able to cover certain aspects of this, it is up to you to do some serious handiwork. Baby proofing your house may include the following:

  • Installing smoke detectors
  • Installing a baby camera
  • Blocking all open outlets with safety plugs
  • Latching closed any drawers, doors, or cupboards that could be within baby’s reach

If you are an expectant dad, know that you don’t have to sit on the sidelines because you can be a proactive participant during the entire pregnancy process. If you have questions, feel free to send them here.

Decoding The First Signs of Pregnancy

Pregnancy is one of the interesting processes that could happen to a woman’s body. While there are expected milestones for the next nine months, the experience may vary for each expectant mom. In fact, each pregnancy may bring a different set of experiences for a woman.

If this is your first time, these changes can be uncomfortable, while some ladies might even miss the very first signs of pregnancy entirely. However, there is something to be said about knowing if you are pregnant the earliest time possible. It allows you and your baby to receive the right diet, the right care, and proper monitoring.

So, if you are trying to get pregnant or if you are reeling from certain changes happening to your body, these are the initial signs of pregnancy to watch out for even before you get to a pregnancy test.

Light Spotting

 

Also referred to as implantation bleeding, light spotting occurs when a 6-12 day-old fertilized egg attaches itself to the interior lining of the uterus.This may be mistaken as menstrual bleeding since some occurs a few days before the next menstruation cycle, but it is not as heavy.

Spotting can be determined as something that is present only when wiping, while bleeding refers to the kind of flow you experience during menstruation.To determine if it is indeed implantation bleeding, you should take into consideration other accompanying signs such as, light or faint cramping, headaches, breast tenderness, mood swings, nausea, or  lower backaches.

Key differences between implantation bleeding and menstrual bleeding include the following

  • Color: Women are familiar with the color of their period as it ranges from bright to dark red. Implantation bleeding, on the other hand, is typically light pink to dark brown in color.
  • Clotting: Some amount of clotting is present during with menstrual bleeding, but implantation bleeding doesn’t come with any at all.
  • Amount: It is normal for women to soak pads and tampons during their period, but it is different with implantation bleeding. The word “bleeding” is actually misleading because implantation bleeding is actually very light, almost like a stain rather than a full flow.
  • Length of Time: Typically, a woman’s period can range from 3-7 days, while those on birth control tend to bleed for a shorter time. Implantation bleeding can last for a few hours to less than three days, and it doesn’t require any treatment.

Light spotting isn’t as cumbersome as other early signs of pregnancy. It does not require any medical intervention, however, it is important that you closely observe it.

Mild Cramping

 

What is tricky about interpreting this symptom is that it can be confused with ovulation cramps and menstrual cramping. The mild cramping sensation you feel when ovulating occurs when the follicle – a sac in your ovary that carries the eggs – ruptures and releases an egg. This is called “mittleschmerz,” which is a German word that means “middle” and “pain.” It often occurs mid cycle, or two weeks prior to your period, although most women don’t feel it at all. Meanwhile, menstrual cramps strike 24-48 hours before your period and goes away once menstruation starts. The pain can be range from mild to severe depending on the level of prostaglandins – a hormone-like substance that causes uterine muscle contractions.

Implantation cramps, on the other hand, are more mild and intermittent, occuring on and off for one to three days. This happens as the embryo implants itself into the lining of the uterus. It takes about a week for the fertilized egg to burrow its way into the thick, rich lining which causes the mild pain. This typically occurs about a week before you would expect your period (for those with a normal 28-30 day cycle), which is why some women confuse it with ovulation or menstrual cramps.

To relieve the discomfort you can do the the following:

  • Try sitting, lying down, or changing positions.
  • Try to do relaxation exercises.
  • Soak in a warm bath.
  • Place a warm water bottle wrapped in a towel on the area.

Tiredness

 

Feeling tired or exhausted is a common early sign of pregnancy. Some women may feel fatigued for the first 12 weeks or throughout the pregnancy, while others may hardly feel tired at all. You can get 10-12 hours of sleep but still wake up feeling lethargic. This can be frustrating especially when you can’t seem to get things done.

Hormonal changes are the likely cause of fatigue. Increased progesterone levels are responsible for making you feel sleepy. In addition, your blood sugar levels and blood pressure also lowers to provide blood flow to the baby.

As the second trimester rolls around, there is a good chance that your energy level will increase making you feel like your old self. Most call this stage “the happy trimester” and would take advantage of it to finish important tasks before energy levels are likely to decrease again during the third trimester. However, don’t be alarmed if you still feel fatigued during the second trimester.

So, if you notice your afternoon energy drop to be out of the ordinary, this could be your body’s way of telling you that a baby could be on board.

To cope with the constant feeling of tiredness, you just need to make sure that you adjust your schedule to allow yourself to get ample rest. Avoid drinking fluids several hours before bedtime to minimise on the number of times you have to get up at night to use the bathroom. It also helps that you choose a healthy, balanced diet because your level of nutrition can go a long way in supporting your energy levels. Make sure that you get enough calories, protein, and iron.

Nausea (with or without vomiting)

 

Along with constantly feeling tired, you may also experience light-headedness or dizziness. Commonly known as “morning sickness,” this occurs during the first week after conception as blood vessels dilate and your blood pressure drops. Not every women will experience nausea the entire duration of the first trimester. However, in some cases, it can start earlier and can last longer too.

Another reason behind this is the presence of a certain pregnancy hormone which is produced soon after the fertilized eggs attach to the uterine lining. Women with this hormone in their system experience severe nausea and vomiting (hyperemesis gravidarum), which would require medical intervention.

Estrogen is also another hormone that increases during early pregnancy which could cause nausea. Stress and fatigue brought by the string of changes pregnancy does to the body can also contribute to queasiness.

To prevent or manage nausea during pregnancy you can try the following home or natural remedies:

  • Eat smaller meals more frequently throughout the day instead of three big meals.
  • Avoid foods or smells that can trigger your nausea.
  • Stash soda crackers by your bed and eat a couple before getting up. Allow some time for it to be digested before slowly getting up.
  • Suck on hard candy.

Shortness of Breath

 

Feeling like you are short of breath is a common symptom of pregnancy. It can begin before any upward displacement of the diaphragm due to a growing uterus. During the first trimester, increased levels of progesterone causes the lungs to increase its demand for oxygen. There is an increase in lung capacity which increases oxygen-carrying capacity to provide nourishment for the growing fetus but your respiratory rate (breathing cycles per minute) only changes slightly. This will make you feel like you are short of breath.

To relieve shortness of breath, give your lungs as much breathing room as possible. You can do this by standing up straight, sitting up tall, and sleeping propped up on pillows to expand the space in your abdominal cavity. It also helps to slow down when you feel that your heart and lungs are working harder.

Tender or Swollen Breasts

 

Changes to the breasts can start as early as one to two weeks after conception. In fact, this is one of the top three things women complain about in early pregnancy. The formidable duo – estrogen and progesterone – are the main culprits behind breast tenderness. In addition to that, the fat layers in your breasts thicken, you grow more milk glands, and blood flow increases. These changes may give your cup size a favorable boost, however it does not always leave you with a pleasant experience. But, more importantly, it also serves a purpose of preparing your breasts for breastfeeding in a few months.

To take care of tender or swollen breasts, it helps that you wear a supportive bra. A full-coverage bra can offer adequate support in lifting the breasts and relieving the pressure. You must also avoid underwire bras because it has the potential of digging into the skin. Furthermore, a cold compress or a warm shower can help relieve some tenderness. Warm water, in particular, can help ease the tension and relax the muscles around your chest.

Frequent Urination

 

A lot of women complain of having to spend a seemingly endless loop to the loo. This heightens during the first two to three weeks of your pregnancy. The reason behind this is because the blood flow to a pregnant woman’s kidneys increase by up to 30-60%. This makes the kidneys produce up to 25% more urine soon after she conceives.

Frequent urination can also be attributed to hormonal changes. Once the embryo is implanted into the uterus, your body produces the pregnancy hormone hCG. This triggers a woman to urinate frequently. Furthermore, the spike in progesterone levels can also result in this sensation.

Unfortunately, your urge to pee often will not only be an early sign of pregnancy. As the uterus expands to accommodate the growing baby, it presses down on your bladder, urethra and pelvic floor muscles. This means that your bladder can no longer expand to the same level of fullness as before, therefore it has to be emptied more often.

To reduce the hassle of having to go to the bathroom several times, especially during sleeping hours, avoid drinking too much water a few hours before bedtime.

Besides the usual missed period to signal that something is up, these signs should compel you to take that pregnancy test. Once you have confirmed it, your pregnancy calendar should now be lined with regular prenatal visits. The earlier you know, the earlier you can get professional help and regular monitoring. We hope that this knowledge will help you prepare for what is to come if you are still planning for a baby or if you are already experiencing some of these signs now.

Proper pregnancy planning and having the needed resources along with emotional support is essential during early pregnancy. For all your concerns, from pre-conception health screening to pre-natal visits, and everything in between, book a consultation with Dr. Pamela Tan today.

Dr. Pamela Tan, gynecologist and obstetrician based in Singpore, consults at Thompson Medical Center, Crawfurd Medical Centre, and Sengkang Island Family Clinic.

10 Tips-Choosing Obstetrician Gynaecologist Singapore Infographic

Having a good obstetrician-gynaecologist (OB-GYN) is very important.  Knowing that you are in the hands of a specialized physician gives you that feeling of security.Whether you come in for a gynaecological concern, planning to start a family, or reaching milestones in pregnancy, it’s worth having someone who can care for you according to your needs.

If this is your first time to visit an OB-GYN in Singapore and you’re still not sure who to approach, here are some important factors to consider in choosing one.

10 Tips-Choosing Obstetrician Gynecologist|Singapore(Infographic)

Please include attribution to Dr Pamela Tan with this graphic.

 

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What You are Missing Out On When You Skip Regular Visits to Your Female Gynaecologist

What are the things that you could not go a day without? Could it be your daily Facebook scroll, your morning coffee, or perhaps that 30-minute run?

We have set certain routines whether they may be good for us or not. But above all the humdrum of our daily habits, there are certain things that we must impose on ourselves. We can say that this is part of “adulting” or to a certain stretch, surviving.

So, let’s be honest.  On top of all those important routines, have you ever penciled in a visit to your gynaecologist? It’s understandable why this can easily be missed or tossed to the backburner when you generally feel nothing wrong, especially when it comes to your lady parts. So why waste time and money, right? Wrong.

We are not even going to sugarcoat it, but failing to put importance on female reproductive health can have serious consequences.This is not to scare you ladies, but to shed light on health promotion and disease prevention.

If you simply dust this off, then here’s what you are missing when you don’t go on regular gynae visits:

A better understanding about your body

A gynae visit may seem like a daunting experience, especially for those who are doing it for the first time. To allay your anxiety about the whole thing, think of these visits as a way for you to know more about your body. When you have a professional looking into your situation, you have someone who knows what to give your body and when.

Changes in your body, especially for those facing puberty or menopause, may come with varying symptoms. You may find these changes rather difficult to understand or cope with, therefore it helps to have someone who specializes on the matter with whom you can consult.

A common gynaecological problem that a lot of women today are suffering from is PCOS (Polycystic Ovarian Syndrome). It is a benign condition that is caused by elevated androgen (male hormone) levels. This causes women to skip menstrual periods, gain weight, and even make it harder for them to get pregnant.

A lot of women are not aware that they have this problem, and a consultation with an ultrasound can detect it. Once it is confirmed, a gynaecologist can also advise you on the right treatment, lifestyle changes, and dietary changes to correct the problem and improve the symptoms.  

It’s one thing to ask your mom or a friend about certain matters, but you get deeper into things, and you also get the right help,  when you ask someone who is in authority.

An in-depth discussion on birth control options

With most couples in Singapore pushing their plans to start a family much later, it helps that professional help is sought. A gynaecologist is the right person to help you find the appropriate birth control method. No two women are alike, so what worked for someone you know may not necessarily be effective, or safe, for you. A doctor who is familiar with your sexual health history, medical history, family history and lifestyle can guide you with the method that would be appropriate.

Like other medications, birth control also comes with potential risks and side effects. For instance, you will not be advised to use certain hormonal methods of birth control if you have a history of breast cancer. Health and lifestyle factors are also important considerations because these can influence how a woman’s body reacts to birth control (e.g. smoking increases a woman’s risk for developing blood clots while on birth control). In addition to this, birth control pills may also interact with certains medications that you are taking.

Therefore, it is not advisable to simply rely on advertisements or word-of-mouth in making these decisions. Rather, it is important that you are properly examined by a gynaecologist before using any birth control methods. Otherwise, you would be missing out on sound advise and proper monitoring.

Regular screening

Regular visits to the gynaecologist is one of a woman’s important yearly checkups. This allows you to be evaluated by undergoing the appropriate screening tests. Breast examinations and pelvic examinations are just some of the health assessments done in a well-woman checkup

What many may see to be a waste of time having found no need to see their gynaecologist is actually a good investment for your health. There are several health conditions, such as cervical or ovarian cancer, that doesn’t show symptoms early on. This makes regular screening very helpful in detecting anything that are out of the ordinary. Early detection gives you a good chance of managing the problem, better yet, preventing it.

A regular pap smear, blood workup, or mammogram are just some of the screening exams available for women today. Not making the time may cause you to miss out on your chances of avoiding preventable diseases that could even cost you your life.  

Vaccinations

Vaccinations are now widely available for women to prevent the common diseases they are at risk of. HPV (human papillomavirus) for instance, is the type of virus that causes no symptoms and may simply go away on its own. However some may cause most cervical cancers, as well as other neoplasms that develop in the vulva, vagina, oropharynx (back of the throat), and the anus. The HPV vaccine can help shield yourself from these potential problems.

The importance of vaccines is also emphasized for pregnant women. A consultation will help you to be aware of the kinds of vaccines that you must have and when to get them. Making sure that your vaccines are up-to-date will help protect you and your baby from serious diseases.

It is time for women to be proactive with their health since there are several solutions available today that can help prevent or even protect you from several diseases. Gynaecological problems are some of those insidious conditions that slowly gets worse over time if you allow them to linger. It is up to you to act on it now. As the the old adage says, “prevention is better than cure.”

Share your concerns with someone who understands your struggle. Book your appointment with a female gynaecologist in Singapore today at the Dr. Pamela Tan Clinic.