I received my 33 Weeks newsletter from Baby Center a couple of days ago. They talked about the CTS symptoms I just wrote about and how to reduce pain. Well, I’m not experiencing any pain at the moment, just tingling and weakness, but they did give some tips on reducing the symptoms:

• Whenever you feel a twinge at night, shift your sleep position and try to prop your arm up with a pillow or two.
• Don’t sleep on your hands. If you wake up with pain or numbness, try gently shaking your hands until it goes away.
• When you’re working at a computer, adjust your chair height so your arms are straight from elbow to fingertips as you type. Consider trying a special ergonomic keyboard and take frequent breaks to stretch your hands.
• Avoid tasks that require forceful, repetitive hand movements. If your job requires this kind of movement, try wearing wrist or hand braces (available at medical supply stores and some larger drugstores).
• Consider doing yoga, which can help relieve the pain and increase wrist strength.
• Talk to your healthcare provider if none of the above help.

I have been taking yoga classes but I was taking them before the CTS symptoms started so I don’t know if the yoga is the reason why I don’t experience any pain or if I just naturally happen to have it a little easier with the CTS symptoms.

The newsletter also talks about ways you can prevent perineum tearing during the delivery. I guess my fascination with this topics lies in the fact that one of my most feared aspects of labour is the idea of tearing or requiring an episiotomy. According to the newsletter, many midwives recommend massaging the perineum (the skin around your vagina) to help prevent tearing during delivery. After reading through the description of the massage, I’m not sure if I’m all that keen to try it, though.

Here’s what the Medical Moms have to say about reducing the risk of tearing:

Erica Breneman
Obstetrician in Oakland, California, and mother of one

Having a provider who doesn’t routinely cut episiotomies definitely decreases the chance of large tears. Eating a healthy diet makes tissue stronger. Some people advocate gentle perineal stretching for the last six weeks of pregnancy, which may help some. Women are also less likely to tear after the first vaginal delivery.

MaryJane Lewitt
Certified Nurse-Midwife in Atlanta, Georgia, and mother of two

To reduce the risk of tearing during birth, the best thing you can do ahead of time is eat nutritiously and drink lots of water. Some people also recommend perineal massage and continued sex with your partner. I think the most important thing is to have a healthcare provider who’s skilled in perineal massage while you’re pushing and knows various techniques to support the perineum during birth.

Samantha Maplethorpe
Family Physician in Issaquah, Washington, and mother of three

Listen to your body. I let women labor down as long as possible. Your doctor should help you to stretch your perineum, position yourself, control your pushing, and deliver your baby in a manner that avoids tears if possible. But sometimes it’s impossible to avoid tears. We know that episiotomies are not the answer to avoiding tears. These cuts just create a weak point for further tearing, just like a snag in pantyhose.

Click the link to read more about episiotomies at Baby Center.

There was also some useful information on monitoring the baby’s movements, which most books recommend to start doing after 28 weeks. I’ve seen quite a lot of references on this topic and none of them seem to be in agreement on just how many movements you should detect and what time frame you should be recording the movements. I think the important part is to know when your baby is most active and use that time of day as your means of monitoring your baby’s movements.

According to Baby Center, your baby should be moving as frequently as he has for the last month or so. Every baby has her own pattern of activity and there’s no correct one. As long as you don’t notice any major changes in your baby’s activity level, chances are she’s doing just fine.

For an added sense of security, many practitioners recommend that after 28 weeks, you monitor your baby’s movements at least once or twice a day. There are lots of different ways to do these “kick counts,” so check with your caregiver about how she wants you to track your baby’s movements.

Here’s one common approach: Choose a time of day when your baby tends to be active. (Ideally, you’ll want to do the counts at roughly the same time each day.) Sit quietly or lie on your side so you won’t get distracted. Time how long it takes for you to feel ten distinct movements — kicks, twitches, and whole body movements all count. You should feel at least ten movements within two hours. (Don’t worry; it probably won’t take that long. Sometimes you’ll feel ten kicks within the first ten minutes.) If you don’t feel ten movements in two hours, stop counting and call your midwife or doctor.

Ask your practitioner what kinds of changes she’d like you to be on the lookout for. In general, you should let her know anytime you’ve noticed an absence or slowdown of fetal movement. Your baby may simply be in a different position, but she might also be in distress. Your caregiver may have you come in for a non-stress test or biophysical profile to check on your baby.

I found this particular piece of advice from Baby Center to be quite informative. Had I followed some of the advice I’ve read, I think I would have been calling my doctor just about everyday to inform him that my baby wasn’t moving enough.