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RSI in pregnancy

RSI in pregnancy and with a new baby
Please note. The first port of call for any medical problem or health issue relating to pregnancy should always be a qualified physician; e.g. your GP or obstetrician. Musculoskeletal disorders themselves do not directly affect the baby's health and the child need not miss out on anything important when growing up.

Most women nowadays plan their pregnancy. Many will consider carefully how to prepare themselves preconceptually in order to achieve the best possible outcome and will change their diet, give up smoking and adopt a generally healthier lifestyle.

Certain drugs can have harmful effects on the foetus at any time during pregnancy. Your GP can advise you on whether to alter any prescription drugs and unnecessary self-medication should be avoided. Non-steroidal anti-inflammatory drugs (NSAIDs) may cause problems during different stages of pregnancy, including delivery.

Although pregnancy is clearly a topic associated with women, some of the parenting issues raised may also relate to men. They may need to help partners suffering from RSI or may themselves have an injury which restricts their ability to get involved, at a time when some fathers feel a little left out anyway. Be sure you consider the added difficulties you may face and discuss them with a doctor and physiotherapist.

Plan for support. Relatives, friends and local community groups may all be able to help.

During pregnancy
Inform your doctor and any other medical practitioner of your pregnancy. This is vital and will affect the treatment for your RSI. For example, you cannot go into a heated hydrotherapy pool whilst pregnant. Your obstetrician, health visitor, midwife etc. all need to know about your RSI condition too. The hospital can then be made aware of any extra help that may be required during delivery or immediately after the birth. Potential difficulties in the maternity unit could include trying to ring the bell for attention, not being able to turn on taps in the washing areas or problems lifting or holding the baby.

During your first pregnancy you may be unprepared for the effects on your body and worry about what is happening with your RSI. Fatigue is a problem for most mothers and the tiredness can become quite debilitating if you have a musculoskeletal disorder. Keep up any treatment that has been prescribed and get lots of rest.

Upper back and neck symptoms may worsen as the advancing pregnancy puts more strain on your spine. Be careful not to let your abdomen pull your lower spine too far forward. Your back was not designed for bending in half either so use your knees. Wearing flat shoes may help and activities like walking and swimming will keep you flexible. Discuss with your physiotherapist whether there are any special exercises or stretches you could do. Additional treatment can be sought from an osteopath or chiropractor whilst antenatal yoga classes may help with posture and relaxation.

All mothers get occasionally unhappy or confused during this period of great change but do keep your doctor informed of any problems. Don't assume that everything is due to your RSI. There could be something that your medical adviser needs to investigate.

It has been known for women to experience a remission during pregnancy, especially in the first trimester, but symptoms often then reoccur 2-3 weeks after delivery. On the other hand certain conditions e.g. carpal tunnel syndrome can be adversely affected by fluid retention due hormonal changes associated with pregnancy. Again things will usually return to 'normal' once the pregnancy is over.

After the birth
There are lots of helpful tips that mothers have developed to cope with their condition and to make the most of the time with their new baby. Your local RSI support group may be able to put you in touch with other parents with RSI.

Don't buy any equipment without trying out it out first. For example; baby buggies with swivelling wheels may be easier to manoeuvre. In the home you might need to experiment with the most suitable stairgate. It will obviously need to be secure from a young child's prying fingers but still operable by a parent with reduced strength and grip in the hands.

Internet shopping and home delivery services can save carrying heavy bags. In the house duplicate changing equipment and spare clothes on all levels will save carrying the baby up and down the stairs.

The main areas of difficulty in caring for babies and young children centre on breast-feeding, lifting, putting to bed and playing physical games and activities.

Feeding
Breast feeding can be difficult at the best of times, let alone if you have weak or painful arms and hands. Make sure you are in the most comfortable position possible. The chair you choose should be straight-backed - tuck a cushion behind your waist to prop you up. Your feet should be on the floor, with your knees slightly bent. Rest the baby on a small pillow - this is more relaxing than direct pressure on your arm. Bending the wrists may still exacerbate any underlying carpal tunnel syndrome or wrist tendinitis and some doctors recommend that you lay on your side with the baby next to you.

Lifting
Resist the temptation to lean over the baby's cot. Instead, keep your back straight, bend your knees and squat down to the level of the baby. Drop-sided cots make this easier. Grasp the baby firmly with one hand behind the waist and one hand behind the head and rise up slowly from the bent-knees position. Whatever you are doing, get into this habit of squatting down to their level.

Playing with young children
From birth to adolescence, playing with your children is vital as an aid to learning and in developing your relationship with them. Time spent together is invaluable and there are many ways in which non-physical activities e.g. talking and singing can be part of this experience. Reading with children is pleasurable and educational and a reading stand can be used if holding a book is painful and difficult. If you are tired, children's tapes and videos can be a good substitute, especially if you are able to sit and cuddle your child. Lying or sitting on the floor has the advantage of allowing babies and toddlers to use you as a climbing frame and can be great fun for all concerned. Swimming can be therapeutic for parents as well as great fun. Many places have baby and toddler swimming pools where the water is warmer and can ease painful, stiff joints. It is important to focus on the positive things you can do, to relax and enjoy the experience, letting your imagination and creativity flow.

> The National Childbirth Trust (External link)
> Disability, pregnancy & Parenting International (External link)
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RSI.org.uk