A helpful Guide to pregnant and expectant mothers

The first hint that a bundle of joy is on the way is a missed period. If you are clock-work regular and 10 days have gone by, you can suspect that you are pregnant. If you miss a second period, it is almost certain that you are going to be a mother soon. However, we must remember that two out of three women have delayed periods for other reasons like stress, shock, exhaustion, excessive exercise, anemia, fad dieting or simply because of common cold.

There are other signals that herald the happy event. Your breasts enlarge and feel tender and slightly heavy, and your nipples might tighten and tingle. The nipples and areola (the brown circle around it) puff out and are speckled with tiny nodules and increase in diameter as the network of minute milk glands proliferate. Frequent urination and nausea are other indications of early pregnancy.

Making Sure

These days it is relatively easy to do so, since there are any number of do it yourself urine - pregnancy kits which are available at the chemist's. It can detect a period as early as two days after a period has been missed. Read the instructions carefully but don’t be surprised if you are unsure of the result. Although, the test results are almost always positive, or more commonly, it is possible not to be pregnant when the result is negative. Why does this happen? It is because the urine may have been dilute or the test is not done properly, or there is a urinary tract infection, and these can give false positive/negative results. Repeat the test if it is not as was expected, and if your period has not started within a week.

A pregnancy blood test can give you a quick and accurate answer, two days before your period is missed. This sensitive test measures the presence of Human Chronionic Gonadotropin (Beta HCG) which is produced by the embryo. As the embryo grows rapidly the HCG level doubles every 2 or 3 days. Sometimes doctors need to do two HCG level tests 3 days apart to determine the viability of pregnancy.An ultra sound test can also confirm the pregnancy, but there is no need to do one at this stage.

So, now that you are sure that you are pregnant and have been receiving congratulatory messages from everyone, you should make sure that you are taking good care of yourself and remain healthy all through your pregnancy. Pregnancy is not an illness, however there is bound to be some minor discomfort like morning sickness, sleeplessness, nausea, cramps, even back aches! Most of these are normal, but when it becomes chronic and more pronounced it is better to consult your doctor.

Taking these discomforts one at a time

 Breathlessness – Later in pregnancy you may find yourself huffing and puffing because your womb presses harder on the lungs. You need to take it easy and not rush about, take a few deep sighs, sit on a straight backed chair. Make yourself comfortable with extra pillows around you when you sleep or lie down. Try not to climb up too many steps, and if you have no other go do it few at a time, taking rest and then go on.

However, if the condition becomes serious and you find yourself gasping for breath each time you climb stairs it is better to mention this to your doctor and ask his advice.

Backache - This is not inevitable. Once you leran to walk straight and balance yourself it becomes part of your routine for the next 9 months. Use your stomach muscles to pull and push as you feel  comfortable and make sure that you wear low heels at least while at home.For a nagging backache or  a catch just below the waistline. kneel down on all fours to releve the pressure that might have built up on the lumbar area. A massage with hot water towels on the back ( but never on the stomach) will definitely bring relief.

Constipation – During the early months, three is a good chance that you have sluggish bowel movements. It gets aggravated if you are taking iron tablets and is usually relieved by mid-term pregnancy .

However, there is a chance that it might come back in the final months of your pregnancy when the baby’s head hard presses at the bowels. Eating high fiber food and drinking lots of fluids helps in overcoming this. Two glasses of water especially warm water before breakfast stimulates the bowel action. Try to keep your bathroom habits regular and you could take your doctor’s advice to make some changes in your iron tablet. Never take a laxative without the approval or suggestion of your doctor.

Cramps – Sometimes pregnant women get cramps in the legs, calf or thigh right in the middle or late pregnancy. This could be caused by a Vitamin B or Calcium deficiency, your posture or sluggish circulation. Sometimes, shooting pains in the leg may occur during the final months of pregnancy when the baby’s head presses on the pelvic nerves which run down the back of the leg. Wear low heeled shoes during that period.

Try to keep walking within your room on your toes and on your heels and on the side of your feet, doing this slowly before going to bed. Point the toes inwards when the cramps start and hold the foot in your hand and bend it upwards to tense the calf muscles. Gentle Massaging the area also helps. Shooting pains can be relieved by shifting position or by lying on your back and drawing your knee towards your chest gently for a few minutes.

Discharge – Sometimes, increased vaginal discharge can be seen and to a certain extent it is normal. Usually white or pale yellow in color, it represents increased secretion of mucus from the glands of the cervix and vagina. It can be washed off easily, but you can use a sanitary napkin to make you feel more comfortable.

In case the discharge is foul smelling and itchy or thick it could be due to some infection and this should be brought to the notice of your doctor for which he might prescribe some medication.Any vaginal discharge that is reddish in color or even mild bleeding, no matter how scanty should be reported to the doctor immediately!

Food Cravings – It is by now legendary for pregnant women to have food cravings. You tend to have sudden food cravings and urges to eat certain spicy tasting food like pickles or chutneys at any odd time of the day. This is perfectly alright as long as your diet is balanced and your cravings are not for weird food stuff or any other stuff like coal, chuna ( limestone) or mud.

Such a tendency needs to be checked out with a doctor. This condition is called pica (Pica is a condition characterized by an appetite for substances largely non-nutritive).

Heart burn and Indigestion – In the early months of your pregnancy, you may feel uncomfortable, burp loudly or even get a tight burning sensation behind your breastbone. All this is because of the upward pressure of the womb and also because your digestive system works less effectively during pregnancy.

Drinking half a glass of warm milk half an hour before eating helps a lot, also sipping warm water often, as often as you can.eat smaller meals and stay off foods that are difficult to digest and also produce a lot of gas like Onions, Beans, peas and fried stuff.An antacid tablet or milk of magnesia, again on the prescriptions of a doctor, may help.

Mood Swings – This is a very normal thing since you have to get used to the added responsibility of having and looking after the little one. This seems like an overwhelming task and many women are totally unprepared for this until they find themselves pregnant and the facts begin to hit them hard. So mood swings are normal, you feel happy, panicky, grumpy, weepy in turns until you come to turns with your status.

These also could be because of your hormones which reach dizzy heights since you are anxious about the future. Try to share your thoughts with your doctor and with your husband, mother or anyone who you feel close to.

Morning sickness – Contrary to its name, this actually occurs at any time of the day which can affect two out of three women in the first two to 6 weeks of pregnancy .It may occur even before the missed period is detected. This condition seems to be caused primarily by increased amount of estrogen in the stomach muscles and the intestinal tract. It is a feeling of mild nausea combined with a lack of energy and also a loss of appetite.

Sometimes, it gets worsened by nervousness and anxiety about the pregnancy. However, not all women vomit out all day, only one in three women is sick enough to do so. Ordinary morning sickness even with occasional vomiting does not require medical attention since it is mostly a passing phase. If you vomit persistently and are feeling drained of energy it is better to tell your doctor. Keep some crackers and biscuits ready by your bed side and eat them before getting out of bed. Eating small meals during the day may help, skip fried and fatty food which only adds on to the misery of morning sickness.

Skin Changes – This includes patches on the body and facial skin, darkening of the nipples and the development of a dark vertical line stretching from side to side on your tummy which may never completely vanish. You also may see silvery stretch lines on your breasts, stomach, and thighs, all of which is natural. The more weight you gain the more marks which cannot be prevented. Expensive creams may help to the extent that they prevent the skin from drying out and causing itchy sensation.

Plain coconut or olive oil can also be used to apply on the tummy, breasts and thighs which help you in keeping the skin moisturised and not develop flaking of the skin due to dryness.

Varicose veins – this is another condition that develops in some pregnant women. You may feel a dull ache in your legs after which the veins stand out. This because of your growing womb which is pressing hard on the arteries and veins in the lower half of the body. Circulation slows down, the blood pools, the veins need to work harder to return the blood to the heart. At such times sit more often and keep moving your legs up and down and keep them straight on a chair in front of you.

Try not to cross your legs. Sleep with your feet on a cushion and gently massage the swollen veins upwards to empty them out. Moving your legs as you lie down can really help in relieving the stress.

Tingling and numbness - This feeling may attack your hands and feet when you wake up because there is pressure on the nerves and tendons due to accumulated fluid. When this becomes constant, try holding your hands above your head for a few minutes. Point your fingers to the ceilings, open and close your fists alternatively and you are bound to feel better in time.

 Blood Pressure - This will have to be measured each time you visit your gynaecologist and is normally slightly lower during pregnancy that is about 120/70. An elevation of over 140/90 may warn of toxaemia, which is a serious complication. You may have to be treated or just rest in bed until your blood pressure steadies down.

Itching - One out of five women develops an annoying itch and small red bumps on the stomach specially during very hot and humid summer days. This seems to be related to increased hormonal secretion and stretching of the skin. Wearing loose and comfortable clothes preferrably made of cotton allows your body to breathe freely. It is advisable to steer clear of any lotions such as cortisone lotions, calamine lotions or any other skin lotions unless advised by the doctor.

 Some Danger signals that need to be attended immediately - First of all when you have any of the following symptoms, get into bed and lie down curtailing all movements and call the doctor immediately.

1. Any kind of bleeding or Blood discharging from your vagina
2. Strong abdominal pain, that is not relieved by a bowel movement.
3. A sudden trickle or rush of water from the vagina ( not urine )
4. Mistiness or blurring of vision, specially if you see spots or wavy lines.
5. Continuous heavy headache – above or behind the eyes, or over the back of your head.
6. High fever of over 100 or more unconnected with cold or any other normal symptoms.
7. Too frequent urination or burning sensation while urinating
8. Swelling of fingers, hands, face and ankles especially when it suddenly makes an appearance.
9. Severe nausea with vomiting more than 3 times an hour.
10. Absence or change of fetal movement (which normally start from 16 to 20 weeks) for over 24 hours.
11. Any accident or trauma or regular menstrual like cramping before your due date.

Some sensible guidelines

Diet

Eat a high quality balanced diet in small quantities and more often. You normally gain at least 10 – 12 kgs by the end of your pregnancy which is considered normal and only a little of this is fat. Most is your baby, your larger womb, extra blood and fluids. Although your energy needs are not much more than your pre-pregnancy state, your requirements for body building and protective foods nearly doubles, especially during the latter part of pregnancy. Restricting weight may result in low birth weight and smaller babies have a greater chance of birth defects and other health complications. Drink at least 8 glasses of water and other fluids like butter milk and fresh fruit juice although eating whole fruits is a better option because of the fiber content.

Eat more protein and drink more milk, especially if you have a baby under two, or have recently had a miscarriage. Your doctor may also prescribe vitamins, calcium and iron supplements which you have to take regularly.

Ideally your weight gain should be as follows

0-14 weeks – No gain

14-20 weeks – 25 per cent gain

20-30 weeks – 50 per cent gain

30-36 weeks – 25 percent

36 – 40 weeks – Minimal gain

It is not necessary to eat for two and a gain of over 15 kilos is considered unhealthy unless your doctor says so. Avoid all junk food , tea or coffee which should be restricted to not more than 2 cups a day. When you have a sudden spurt of weight gain, make your doctor aware of it so that he can give you the necessary advice regarding your diet.

Alcohol and Smoking

Stop drinking alcohol, there are no ways about this. The placenta is not a magic barrier, so whatever you imbibe including alcohol trickles straight onto your baby’s blood stream. Children born to alcoholic mothers commonly suffer from low birth weight and IQ. It has been found that moderate drinking – even a couple of drinks a day has a definitive damaging effect on the fetus..What’s more, alcohol also provides empty calories. It adds weight without providing nourishment, and saps the appetite for nutritious food, because it damages liver and drains you of precious B12 Vitamins which are soluble.

And when you are befuddled with alcohol, you become unsteady o your feet which combined with that bump on your belly can cause you to trip and fall or have some accident which may prove fatal.

As far as smoking is concerned, if you are used to it, now is the time to give it up. Smoking is dangerous for both you and your baby. Nicotine reduces the blood supply to the fetus and carbon monoxide, which is poisonous, enters the baby’s circulation because it is attracted by the pigment of fetal blood.

Smoking also reduces the oxygen supply to the baby, constricting the blood vessels in the placenta, leading to physical and mental abnormalities. Women who smoke during pregnancy run an increased risk of delivering an undersized or pre mature bay and the more you smoke the smaller the baby! And, if you are a chain smoker smoking 2 or more packets of cigarettes a day, your chances of still birth and abortion soars.

Check-Ups

Start doing regular check ups when you first miss your periods. Follow this up once a month until the 28th week, then weekly till D-day which is technically the 40th week. See your Obstetrician at regular scheduled periods and notify him or her immediately of any unusual symptoms .Keep a close watch on yourself and be aware of anything that makes you feel uncomfortable.

Seek a second opinion if something doesn’t seem right and you instinctively feel that you have not been given the right kind of attention and care.

Clothes and Appearance

Wear simple clothes preferably cotton and made of natural materials that are loose and comfortable. Cotton as I said earlier is the best as it allows your skin to breathe. Synthetic tights and panties are unhygienic and can harbor bacteria. In fact it is better to avoid wearing synthetic underwear at any time. Take care with your foot wear.

Pick footwear for comfort and safety. It is best to slip into broad toed shoes or sandals, with heels that are less than an inch high. Put away all your stiletto heels, ballet slippers and pointed toed shoes away at least for the time being. Tell yourself that you are looking good since many pregnant women begin to hate their appearance, after they reach the 4th or 5th month of pregnancy.

Tell yourself that you should bloom and look your best no matter what. Avoid make up altogether if you can since it might cause your skin to break out with all the hormonal changes that are taking place within your body. Don’t perm or use hair color until after your delivery.

Drugs and Medication

Inform your obstetrician of any current medication prescribed by any other doctor. If you visit another doctor for a condition unrelated to your pregnancy, check out the prescription with your doctor. Never swallow any tablets, pills, potions, laxatives, herbal remedies, homeopathic or Ayurvedic without consulting your doctor.

And of course the so called hard drugs are to be kept away for all times. These include not only the illegal drugs but also prescription sleeping droughts and other pep pills.

This also includes using anti afeing creams ( which contain Vitamin A) and any other chemical based everyday cosmetics that is used by many women like hair dye,face bleach or any whitening cream that has strong chemicals in them.At least for the period during pregnancy it is better to keep all such stuff away instead of regertting later.

Exercise and Sports

This is something that needs to be done regularly since it helps you during the last phase of your pregnancy and helps in easing pain and making the process of delivery much more smoother and easy. Walk for at least 30 minutes each day or break it into two sessions of 20 minutes twice a day. It helps tone your muscles, boost circulation, and ease breathing. You can ask either your husband or any other family member to accompany you !

Gardening, is an especially good way to get exercise and can also be a fun leisure activity. It is a myth that sitting cross legged flattens the baby’s head since there are no scientific facts to prove this. In fact it exercises the pelvic muscles and joints and eases delivery. The rule of the thumb is to continue any simple sports in which you have participated regularly, prior to pregnancy – like golf, swimming, dancing, aerobics – unless your doctor has advised you to the contrary.

Exercise helps you feel better both in body and mind. Ask your doctor or ante -natal instructor to suggest suitable work outs. However, never perform exercises aimed at increasing the mobility of the back because this can cause some discomfort and problems. Also, don’t over exert, stop when you are tired. Sports that involve violent motions like tennis, diving, badminton are to be definitely avoided. Your expanding tummy may cause you to lose balance and make you unsteady on your feet.

Travelling

It has been advised by most doctors that it is better to travel by train rather than bus, that is if you ned to travel long distance.Travelling by car is fine, however, a long car trip can be tiring, so keep wiggling your toes and stop to rest and walk every two hours or so.The IATA rules accept expectant mothers for flights upto 35 weeks of pregnancy, but keep hydrated and move around whenever possible. You can drive ypourself as long as you don't get exhausted . Wear a safety belt, but low on the abdomen to prevent pressure on the fetus.

Make sure that you dont travel for more than 4 hours at a stretch after seven months and if you are planning to give birth in another city, move there by the end of 7th month. Also, dont fly if you are in early pregnancy as the altitude changes can provoke labor and pain which may result in a mis carriage. Second trimester is the best time to travel since it has least risk.

Knowledge

It is Important to Learn all you can about pregnancy, labor and delivery, child birth, child bearing and child rearing to dispel all your fears and misconceptions. Also get as much information as possible from your doctor and other sources like your own mother who would have gone through the experience probably more than once. Don’t listen to any negative or horror stories told by unfeeling friends or insensitive family members. And many doctors are of the opinion that pregnant mothers should not read medical text books which are meant for doctors with stress on abnormal and frightening complications.

Instead gain knowledge through books that are meant to guide and help you through this period and also are meant to instill confidence in you.

Routine Work

You can continue doing your regular household chores without batting an eyelid! Work out a way so that you can do your chores sitting. Lifting heavy things is not advisable but it can done if you take care. You should squat, knees bent, then rise with a straight back. Lift children by squatting down to them or go on all fours. Continue to do all your routine jobs as long as you feel healthy. The belief that a woman should stop doing work six weeks before delivery is now a thing of the past. When to quit is an individual decision and that’s what most doctors advice the would be mothers. However, don’t lift heavy articles if you have had a miscarriage in the past.

However, consider how much money is required and whether you enjoy working and also whether your job is physically and mentally demanding and your boss and your colleagues are accommodating and co operative, whether you feel uncomfortable and tired before taking any major decision about quitting your job. Medical opinions state that the longer you work and keep yourself actively engage , the better it is for you emotionally!

Avoid driving during rush hours when you may need to apply brakes suddenly as the steering wheel pushes against your abdomen and you are breathing in a greater volume than normal fumes from other cars. Also, don’t take long and bumpy auto rickshaw rides. However, quit working with pesticides, anaesthetic gasses, X rays that can harm the fetus. Discuss your job and the work environment with your doctor.

If you have to be on your feet a great deal of the time, ask for lighter duties or for rest period in between when you can put your feet up and relax for a few minutes.

Conclusions

Finally, Waiting for your little one is a period of immense joy and expectation for you, your husband and family, especially when it is the first time round, so make the most of it. Laugh and think positive thoughts. Read cheerful and knowledgeable books that help you gain confidence, watch some good movies. Happiness releases endorphins, which are good for you. Don’t allow your -self to get stressed and take things slow and steady instead of rushing about. Rest when you are tired and grab every chance to get some shut eye while you can – you may regret the lost opportunities later on !