NOW THAT YOU ARE PREGNANT
Getting pregnant maybe as normal a process as your next sneeze (maybe not as easy though), there are certain AVOIDABLE complications that can occur with each pregnancy and THIS is why PRENATAL CARE is important.
In summary, prenatal care is aimed at ensuring a happy, healthy mummy and baby (of course daddies are not left out too). Science have backed up the fact that mothers who receive prenatal care have a lower risk of pregnancy complications.
Ideally, your prenatal care should start while you are PLANNING to have a baby with a proper medical evaluation from your GP or OBGYN. The need for folic acid supplementation (RDA 400 µg) at least 3 months before pregnancy cannot be overemphasized (for reducing the incidence of open neural tubes defects and heart abnormalities in your baby).
WHAT TO EXPECT AT YOUR FIRST PRENATAL VISIT
The aim of your first visit (aka booking visit) is to identify any risk factors that could potentially influence your pregnancy and also establish a plan-of-care (POC) for mothers with a high risk pregnancy.
Expect your doctor to ask questions about any symptoms you are feeling, how the pregnancy is affecting your day-day activities, outcomes of all previous pregnancies and any potential birth plans. Your doctor will also like to know your medical, surgical, family and social history. This will be followed by a complete physical examination.
Now is the time to ask the atypical pregnancy questions that you REALLY want to know (cue-bowel movements during delivery, recommended sexual positions during different pregnancy stages, easing indigestion in pregnancy amongst many others).
Some laboratory tests will be conducted which will help identify any underlying factors which may affect you or your pregnancy.
I will advise that you have a copy of all tests done with you at all times (you never know when or where that water will break).
Tests include but not limited to:
· Complete blood count: gives an overview of your blood, especially needed to rule out anemia
· Blood group and Rhesus typing: this helps to rule out ABO/Rh incompatibility
· STD screening: Syphilis, Chlamydia, Gonorrhea, Herpes simplex virus, HIV
· Hepatitis B surface antigen test
· Serology tests to detect antibodies against Rubella and HIV
· Gestational diabetes screening (last trimester)
· Group-B streptococcus screening (last trimester)
· Urine tests: to rule out a urinary tract infection, subclinical kidney diseases
· PAP smear: cervical cancer screening
. Various screening tests can be done in the first trimester to rule out open neural tube defects and other genetic anomalies.
SUBSEQUENT VISITS
Except otherwise advised by your OBGYN, the standard schedule of prenatal visits is:
· Every 4 weeks till you are about 32 weeks along;
· Every 2 weeks from 32 to 36 weeks;
· Every week after 36 weeks till your baby arrives.
Your weight, blood pressure and pregnancy height will be measured at every visit. Your baby’s heartbeat will be listened to by the nurse/doctor and your urine tested (ALWAYS remember to down about 500mls-1 litre of water before each visit else…. Do not say you were not told.)
MUMMY’S WEIGHT AND BABY’S HEALTH
According to the American College of Obstetrics and Gynaecology (ACOG), a woman with a singleton pregnancy (that is one baby) is recommended to gain between 11.5-16kg (25-35lbs) during the course of that pregnancy.
Caveats to this recommendation include:
· Underweight mummies: 12.5-18kg (28–40lbs) weight gain recommendation.
· Obese mummies: 7-11.5kg (15–25lbs) weight gain recommendation.
Why this recommendation?
Well……. It is a proven scientific fact that pregnant women who are ≥15% below their ideal body weight have the risk of a small-for-gestational age baby (i.e. malnourished baby) and preterm delivery with its subsequent complications.
Obese women and those with excessive maternal weight gain during pregnancy carry a risk for a macrosomic baby plus its subsequent complications.
Where Does All The Weight Go?
Is that swelling normal?
While it is common occurrence to find that most pregnant women have some form of lower extremity swelling especially during the late stages of pregnancy, extreme caution should be taken if this swelling is noted in the upper body or face especially if there is an associated high blood pressure as this could be the first sign of a dangerous condition known as Preeclampsia.
COMMON COMPLAINTS IN PREGNANCY
· Excessive salivation- the cause is unknown though it has been linked to nausea/vomiting.
· Pica- ingestion of non-nutritive substances such as clay, starch, ice, …
· Increased urination- this is especially common towards the late stages of pregnancy as the enlarging uterus and baby reduce the ability of the bladder to expand.
NB: if there is any painful urination or blood in urine, kindly see your GP as this may be a sign of an infection.
· Varicose veins- enlargement and dilation of peripheral veins especially in the lower limbs due to a combination of pregnancy related factors. Elevation of the legs and use of thigh high compression stockings can help manage this.
· Joint and back pain: results from hormonal changes on the ligaments and postural changes due to the protruding abdomen. A maternity girdle and low-heeled support shoes may reduce the back pain. Exercise and physical therapy may be helpful.
· Breast soreness: usually a result of breast engorgement. Wearing a well-fitted brassiere worn 24 hours a day will bring some relief.
GOOD-TO-KNOW
· Bathing: Swimming and bathing are not contraindicated during pregnancy. However, you may have impaired balance and at risk for a fall especially in the last trimester.
· Dental care: there may be an enlargement of the gums and bleeding gums in pregnancy.
· Drugs: The greatest effect of a drug is normally during the period your baby is forming its organs (weeks 2–10 after your last normal menstrual period). Drugs with the potential for addiction such as heroin, methadone, and benzodiazepines can cause major problems for the baby, including withdrawal.
· Nicotine and cigarette smoking: this should be highly discouraged in pregnancy as smoking during pregnancy is associated with increased risk of a stunted baby growth as well as many conditions affecting the baby.
· Alcohol: should be discouraged in pregnancy because of an increased risk of fetal alcohol syndrome.
· Exercise: 30 minutes or more of moderate-intensity physical activity (aerobics/pregnancy yoga,…) is recommended on most days of the week for pregnant women without any medical or obstetric complications. (please check with your GP on the safety of exercise for you).
NB: Exercise may actually reduce pregnancy-related discomforts and improve maternal fitness and sense of self esteem.
· Immunization: “Benefits of vaccinating pregnant women usually outweigh potential risks when the likelihood of disease exposure is high, when infection would pose a risk to the mother or fetus, and when the vaccine is unlikely to cause harm.”…CDC
See your OBGYN for routine vaccinations in your area.
· Intercourse: sexual intercourse during pregnancy have no adverse outcome however, if cramping, spotting, or bright red bleeding follows coitus, sexual activity should not occur until you are evaluated by your GP/OBGYN. If you are experiencing preterm labor or vaginal bleeding, you should not have coitus until you are evaluated by your GP/OBGYN.
· Nutrition: Your nutrition from the moment your baby is conceived is important in the development of your baby and his/her future well-being. Emphasis on a balanced diet and supplementation of iron, folic acid, zinc and calcium is needed during pregnancy. Recommended dietary intake of a pregnant woman with an average body weight of 58kg is approx. 2800kcal/day. Consumption of fewer calories could result in inadequate intake of essential nutrients.
· Travel: Travel (by car, train, or plane) does not adversely affect a pregnancy, but separation from your GP/OBGYN may be of concern. Extra caution should be taken when driving/riding especially where there are potholes because of the risk of a placenta abruption/tear.
There you have it folks.
#stayhealthy
