All images by Xue Qi Ow Yeong for RICE Media.
What happens when ambition collides with rising expenses and societal expectations? It’s no surprise that many Singaporeans are choosing to forgo having children, prioritising career success and enjoying the DINK (dual income, no kids) lifestyle instead.
But as older millennials reassess their life choices, some are rediscovering the pull of parenthood, drawn to the raw, primal fulfilment that raising a child can offer.
Yet for older mums, there’s the looming spectre of subfertility—the difficulty of achieving pregnancy, which is also intertwined with metabolic health. While high costs and long work hours dominate the headlines, an overlooked challenge lies in the physical and emotional hurdles of starting a family.
Recent studies note that 49 percent of Singapore’s pregnant women are overweight, which can result in conditions like gestational diabetes. A significant number of our mums experience antepartum or postpartum depression, and studies show that distress during pregnancy can impact the neurodevelopment of children.
A timely initiative, Healthy Early Life Moments in Singapore (HELMS), seeks to address this gap.
While most interventions are offered only after a woman conceives, HELMS is the first-ever programme in Singapore to intervene at the preconception stage. It targets issues like metabolic and mental health, and continues to support mother-child dyads (the bond and relationship between a mother and her child) until the child is 18 months old.
By offering personalised guidance through the labyrinth of preconception, pregnancy, and postpartum life, HELMS aims to ease the journey for aspiring mothers, one baby step at a time.
BMI Blues
Time flies when Yang Shang, 36, plays with children. She knew from a young age that she wanted to become a teacher.
“Children bring happiness. Every day, I look forward to waking up and nurturing them,” she shares.
When she became a mother at 31, the smile of her newborn made all the challenges of pregnancy feel worthwhile.
However, after delivering her first child in 2019, her doctor admonished her that her high BMI could lead to pregnancy complications—and that her child might develop health issues down the road.
She vividly recalls the anguish she felt when she was dealt this haymaker.
Feeling overwhelmed, Yang Shang found solace in an article she stumbled across in the newspaper about HELMS.
She looked up HELMS online and found out that she qualified for HELMS based on her BMI and metabolic challenges.
“I used to drink teh C (tea with evaporated milk) every day, thinking that it wasn’t high in calories, but the HELMS programme informed me that teh C’s milk is high in sugar and fat.”
After enrolling in the programme, HELMS medical experts helped her wean off her favourite sugary treats so that her foetus would be less likely to develop diabetes.
“I’ve been drinking teh O kosong (tea with no milk or sugar) ever since.”
She still poses questions to the HELMS platform, usually about the nutritional content of groceries she browses and receives prompt replies.
“Medical literature might be boring, but the health tips in the form of cartoons that HELMS sends me via WhatsApp are cute and make for memorable reads.”
These amusing illustrations weren’t just informative; they were a splash of humour in an otherwise nerve-wracking journey. While Yang Shang’s first pregnancy was marked with moments of uncertainty, she felt uplifted and empowered throughout her second.
“We manage many expectant mothers who are overweight, and the mental health of these women before and after delivery is becoming an increasing concern,” says Dr Fabian Yap, a co-lead of the HELMS programme at KK Women’s and Children’s Hospital. With a focus on holistic support, HELMS welcomes women aged 21 to 40, and the average age of participants is currently 33.
As of 31 Jan 2025, 404 participants have been enrolled, and 56 have delivered.
“We want to reduce conditions like gestational diabetes, and maternal depression and anxiety, and improve fertility. The fertility rate of Singapore has fallen to an all-time low of 0.97, which is quite alarming,” says Dr Yap.
U-Turning Late
For Yuan Ping, 36, and her husband, their 20s and 30s were all about climbing the corporate ladder and fulfilling their wanderlust with trips to faraway locales like Turkey and Canada.
“My mum always said motherhood is very difficult, so I decided early on not to have children. I didn’t want to be a regretful parent,” Yuan Ping shares, adding that challenges like climate change and rising inflation further cemented her decision.
But as friends around her began building families, Yuan Ping couldn’t help but notice their jubilation. A bubbly optimist who works in healthcare, she started yearning for her own bundle of joy.
“The media often emphasises how costly and challenging having a child is, but seeing my friends manage both financially and emotionally gave me the confidence to try,” she says.
Her optimism, however, was crushed with disappointment again and again. Every month, Yuan Ping’s hopes soared, only to be dashed when the pregnancy test remained negative. The waiting game was exhausting, and time felt like her enemy. They tried for about a year to no avail, exacerbating her anxious thoughts.
“I started questioning if something was wrong with me. It felt so unfair to my husband if I couldn’t conceive,” she recalls.
Frustrated by vague answers from search engines and online forums, Yuan Ping stumbled upon an Instagram ad for HELMS in mid-2023. She saw how the initiative offers personalised support for women navigating the complexities of conception and pregnancy.
Through HELMS, Yuan Ping discovered that her menstrual cycle was shorter than average. Besides being armed with this insight, she also received tailored advice from gynaecologists and tips for a healthier lifestyle.
By prioritising the well-being of mother and child—and recognising that mental and metabolic health are intertwined—HELMS helps improve women’s health even before pregnancy to reduce the likelihood of complications and break the cycle of chronic disease.
Simple notifications from her Oura Ring too, became gentle reminders that she wasn’t alone in her journey. The Oura Ring that HELMS issued her helps track her physical and mental health, including mood, sleep, and diet, and it prompts her when she might need to walk around or grab a bite.
Yuan Ping conceived a child shortly after.
“I’m personally very grateful to the HELMS programme, which held my hand through my pregnancy and childbirth up till now,” says Yuan Ping, who delivered in March 2024.
Yuan Ping’s husband Ikli shares that he too felt supported by HELMS, saying: “New fathers like me might not know what to do and what to expect, so we might have many questions.”
The 35-year-old nurse felt a sense of comfort as he learned many do’s and don’t’s, while accompanying Yuan Ping to HELMS consultations.
He recalls browsing many expensive prenatal vitamins, wondering which to buy for Yuan Ping. Fortunately, HELMS took care of that by giving Yuan Ping prenatal vitamins to boost her fertility.
“The HELMS staff come across as very passionate about their jobs,” he remarks.
“When my baby is crying and I don’t understand what she’s going through, I can just text my question to the HELMS coordinator.”
Feeling More Assured the Second Time Round
For Yu Ru, 36, her first pregnancy was fraught with uncertainty.
She posed these questions in Telegram and WhatsApp chat groups, waiting for someone to respond with legitimate answers and useful tips.
In these chat groups and the physical world, she encountered other mothers who also experienced confusion.
“I remember moments of self-doubt. Pregnant women need comprehensive support during their pregnancies so that they know the right things to do to deliver their children safely and smoothly.”
After her doctor flagged her high BMI and cholesterol levels as risks for a second pregnancy, Yu Ru turned to HELMS for guidance.
The programme gave her actionable advice, from dietary changes to regular health check-ups. She even began documenting her meals.
“During my first pregnancy, I worried constantly about potential complications. But this time, HELMS gave me the tools and knowledge to feel confident and in control,” says Yu Ru, who is now expecting her second child in April 2025.
The Importance of Postpartum Support
Following a few months of prenatal supplements and vigilant monitoring by HELMS clinical team, Hana received the news she had long been waiting for through the HELMS app: her once-irregular period had become regular.
“I felt closer to my dream of becoming a mum,” shares Hana, 37, who has always enjoyed playing with her sister’s children.
After five months of participating in the HELMS programme, Hana conceived.
While her pregnancy was relatively smooth, she emphasises that the post-delivery period can be just as—if not more—challenging for new mothers.
“When I found it difficult to connect with my son, I began to blame myself a lot,” she admits. “Especially when he wouldn’t latch and during moments when I struggled to soothe him.”
In those stressful times, Hana found solace in the reassuring words of Dr Chua Mei Chien from the HELMS programme.
“Dr Chua reminded me not to put so much pressure on myself. She reassured me that my baby was developing well despite the latching difficulties and that he was hitting all his growth milestones,” she explains.
“Some mums might feel judged by their doctors for their diet or lifestyle choices, but I never felt that way.”
The constant encouragement made all the difference.
“Dr Chua often told me I was doing a great job,” Hana recalls. “It’s hard because some mums are reluctant to seek help. Mental health can feel like a taboo topic, and postpartum mums might already feel inadequate. They fear hearing another voice telling them they aren’t good enough.”
Beyond her paediatrician’s support, Hana also expresses deep gratitude for her boss, who gave her the time and space to ease back into the office.
“Employers can make a huge difference by being more understanding and flexible with mums returning to work,” she says. “It really helps with their mental health.”
A Future of Supported Motherhood
Besides the blistering pace of urban life, many women are also deterred from having children by the mental and physical challenges of pregnancy—it’s a delicate phase in life where a lack of medical support and knowledge can lead to a baby being lost or being born with health problems.
And then there’s the internet, which can feel like a minefield for someone with amplified feelings of uncertainty. With so much conflicting advice, questionable tips, and panic-inducing headlines, what’s meant to be a resource ends up creating more confusion and anxiety. Sorting through it all can make the already tough experience feel even more isolating, leaving women unsure of who or what to trust.
For Yuan Ping, Yang Shang, Yu Ru, and Hana, it wasn’t just the medical advice they received from HELMS that made a difference—it was the reassurance that someone was there, truly listening, during a time when uncertainty can feel suffocating.
And it’s not just about the process of conceiving and giving birth; it’s about confronting the quiet, unspoken fears—the ‘what-ifs’ that linger, threatening to overshadow the hope.
Initiatives like HELMS aren’t offering a one-size-fits-all solution—they’re making space for those unsaid worries and quietly shifting the conversation around parenthood.
By recognising that the path to parenthood is not just physical but deeply emotional, they’re giving voice to the complexities many women face. It’s a shift in the narrative that moves away from simply surviving the process to embracing the possibility of joy amidst the struggle.
