At Expat Insurance, we get lots of questions about pregnancy, maternity cover and how we can support.
Well, the good news is we can help with getting you insured so give us a ring on +65 6401 9201
The other thing to note is every insurer has a wait period and almost all of them are 12 months, so best to speak to us sooner rather than later that way we can arrange cover for you. Contact us here .
If you are already pregnant then unfortunately you are unable to take our maternity insurance and there are very limited options to get your unborn child cover but don’t worry, give us a call, +65 6401 9201 and we can talk you through your options.
Our recommendation is to sort your cover out as soon as you decide it’s time to start a family.
Our friends over at the International Medical Clinic and one of their Doctors, Dr Sonali has written this excellent article on all thing’s pregnancy related.
So, if you are thinking about starting a family or you have just found out you have a little one on the way, then give this a read.
If you are thinking about starting a family, it is important for you and your partner to speak to your Doctor about pre-conception health. This focuses on active measures you can take before you start trying to conceive to increase the chances of having a healthy pregnancy and baby.
Your doctor will take a history to determine if you or your partner have any current medical problems which require regular medications or if you have been diagnosed with chronic diseases in particular diabetes, epilepsy hypertension, thyroid disease, asthma, kidney problems and arthritis.
The doctor will want to establish if these conditions are well controlled (as certain chronic conditions or the medication required for them may have an impact on a future pregnancy and require close monitoring).
They will also ask about hereditary conditions such as sickle cell disease, thalassemia or any chromosomal abnormalities.
During the consultation you will discuss any previous pregnancies, and whether there were any complications to you or the baby which may help determine risk in future pregnancies.
It is important to make sure routine screening for cervical cancer and breast checks have been done prior to getting pregnant as many treatments cannot be carried out during pregnancy should an abnormality be detected.
Your doctor will check that you are up to date with your vaccinations, especially for conditions like rubella and chicken pox, and hepatitis B (if you are at increased risk). Also, vaccinations required for travel may be discussed, that may not be recommended during pregnancy.
They will discuss infectious diseases that can be harmful during pregnancy eg Zika virus and malaria, mainly with regards to mosquito bite protection.
Your Doctor can advise on signs and symptoms to seek medical advice for and investigations that can be carried out to check for these conditions but also to avoid high risk zones for specific infectious diseases when considering travel.
You will discuss lifestyle measures which encourage an increased chance of conceiving and also a healthy pregnancy.
Women who are overweight will be encouraged to lose weight before becoming pregnant. A healthy weight reduces the risk of Neural Tube Defects, preterm delivery, gestational diabetes, caesarean delivery, hypertension and thromboembolic disease and is also more likely to promote conception.
Similarly, women who are underweight may find getting pregnant difficult and can also be at risk of more pregnancy-related complications. Men are also advised to maintain a healthy BMI in order to promote conception.
A healthy well-balanced diet along with regular exercise is recommended and your doctor will advise you and your partner to reduce or stop drinking alcohol and stop stopping smoking when trying to conceive.
You will be advised to start pre pregnancy vitamins which include vitamin D and also to start taking folic acid supplementations at a dose of 400mcg per day at least one month (ideally 3 months) prior to trying to conceive which should be continued up to 12 weeks of pregnancy .
This is to reduce risk of neural tube defects (abnormalities to the brain and spinal cord) in the foetus.
It is important to maintain a healthy mental health and this should be discussed in the consultation if there are symptoms of low mood, anxiety or other mental health disorders as this can have an impact when trying to conceive and also during pregnancy.
Congratulations ! You are pregnant. What should you do next?
Your doctor can confirm the pregnancy on a urine test or blood test in the clinic. They will then discuss any signs or symptoms you may start to experience in early pregnancy and what to expect with regards to changes to your body.
They will talk to you about symptoms such as pain or bleeding in early pregnancy which should be highlighted to a doctor as soon as possible.
What foods should you avoid?
There are certain foods you should avoid in pregnancy due to the dangers of toxoplasmosis, salmonella and listeriosis, women should avoid,
- Uncooked meat, fish and eggs
- Pâté, including vegetable pâté
- Unpasteurised milk and soft cheeses, such as Brie, Camembert or blue-veined cheese
- Raw shellfish
- Fish containing high levels of mercury should be avoided, such as shark, swordfish or marlin. Tuna should be limited to no more than two medium-sized cans or one fresh tuna steak per week.
- Unwashed fruit and vegetables
- Liver and liver products should be avoided due to the vitamin A content
- It is important to maintain adequate vitamin D stores during pregnancy and breast-feeding as Vitamin D deficiency can cause impaired fetal growth.
Caffeine during pregnancy may cause intrauterine growth restriction. The National Institute of Clinical Excellence guidelines in the UK recommend limiting caffeine intake to 300mg per day during pregnancy. .
This is equivalent of 3 mugs of instant coffee, or 4 cups of tea. The use of herbal preparations and teas have limited data in their safety in pregnancy as well.
How much pregnancy weight gain is normal?
For women with a normal pre-pregnancy weight, a weight gain of 11-16 kg over the pregnancy is normal. The National Institute for Health and Care Excellence advises that pregnant women only need an extra 200 calories per day in the last three months of pregnancy.
No extra calories are needed until that point.
Can you still exercise?
It is advised that women who are currently exercising regularly can continue to do so once pregnant, but those who are inactive could start a gentle regular exercise programme. They should avoid high impact sports and activities where they could be at risk of sustaining significant trauma.
The use of sauna’s and steam rooms are advised against as well as other activities like diving.
What medication is safe to take?
It is important to speak to your doctor about medication you are already taking and any topical lotions you are using as some of these may not be safe in pregnancy.
You will be advised against using over the counter medications unless you have checked this with a pharmacist or doctor.
Panadol is a safe analgesic in pregnancy in usual doses but we do not advise using ibuprofen or neurofen.
Certain antibiotics can be used in pregnancy only when prescribed by a doctor.
What is the advice regarding smoking and alcohol?
You will be advised to stop smoking completely as it is associated with a large number of adverse effects to the baby including Intrauterine growth restriction, miscarriage and stillbirth, premature delivery and placental problems.
High levels of alcohol consumption during pregnancy can also cause problems such as intellectual impairment, facial anomalies and behavioural problems.
NICE guidelines state there is no clear safe level of alcohol in pregnancy
and that the safest advice is to avoid alcohol completely if possible in pregnancy, at least during the first trimester as there appears to be a small increased risk of miscarriage associated with drinking alcohol.
Is it safe to have sex during pregnancy?
Sex is safe for most couples during pregnancy. If, however you have had heavy bleeding in pregnancy or are told you have a low lying placenta or are at risk of premature labour your Obstetrician may advise a period of abstinence.
What do you need to consider at work?
Most pregnant ladies can continue to work as usual with no problems. However, if you are in contact with children for work it important to be aware that certain childhood rashes can be harmful to pregnant ladies e.g. rubella, chickenpox (if the mother has not had chickenpox before), measles and parvovirus.
Avoid toxic substances and other environmental contaminants harmful materials at work or at home, such as synthetic chemicals, metals, fertilizer, bug spray, and cat or rodent faeces.
Is it safe to travel in pregnancy?
There is no evidence that flying is associated with an increased risk of miscarriage or premature labour. Most airlines will let you fly until 36 weeks, but some have an earlier cut off at 32 weeks, so it is important to check this with the airline.
Pregnancy puts you at an increased risk of blood clots and therefore it is important to consider the duration of the flight. Drink plenty of fluids to avoid dehydrated when flying and to keep mobilising regularly on the flight.
In car travel it is important to have seat belts, with belts that go above and below bump rather than over it!
What happens next?
You will be advised to have antenatal blood tests which can often done when you are referred to an Obstetrician (these blood tests can also be done with the GP) who will see you in the clinic between 6-10 weeks.
Your Obstetrician will do an initial scan to make sure that the pregnancy is developing within the womb, to check the foetal heart beat and also to date the pregnancy.
The initial antenatal blood tests include checking your blood type, your Rhesus status, blood count, thyroid levels, hepatitis B, HIV, syphilis screen and Rubella immunity status, along with bloods to check for other viruses.
Your Obstetrician will discuss with you the plan for your pregnancy and the important routine screening tests which are required at the different milestones.
You will be offered a combined test to test for chromosomal abnormalities including downs syndrome which is a blood test and a scan usually done between 10 and 14 weeks.
You will have regular visits with your obstetrician to make sure the pregnancy is developing normally and for routine screening which usually involves blood pressure checks, urine tests, foetal measurements and scans.
During your pregnancy you can also consult your General Practitioner at any time in between the appointments with your Obstetrician for any pregnancy related concerns as well as the usual non pregnancy related medical issues and your GP can liaise with your Obstetrician if it is deemed necessary.
I would like to wish you all the very best for a happy and healthy pregnancy.
If you would like to speak to Expat Insurance about maternity cover and what the options are then please do give us a call on +65 6401 9201
You can download a copy of this article for reference by clicking on the link All About Pregnancy