Pregnancy health centre

Answer:

A typical pregnancy is nine months long, but to give your baby a healthy start, think of it as twelve months, including the three months before you get pregnant. This means that when you start thinking about trying to conceive, you should:

Go and see your GP and say that you are planning a pregnancy. He or she will discuss such issues as the importance of taking a daily dose of folic acid from the time you start trying to fall pregnant until the twelfth week of pregnancy, the importance of not smoking, and how much alcohol is safe in pregnancy. He or she will also advise you about any medication you take and if it safe in pregnancy.

In addition to eating a healthy diet (lots of leafy greens, lean proteins, and fibre), make sure you take sufficient folic acid before getting pregnant. This nutrient helps prevent birth defects like spina bifida; since many of these conditions arise very early in pregnancy, you need healthy levels of folic acid right from the start. The recommendation is to take 400 mcg (micrograms) of folic acid each day starting from the moment you start trying to become pregnant, and to continue for the first three months of pregnancy. This can be prescribed by your GP, but if you have to pay prescription charges, it may be cheaper to buy folic acid over the counter.

If you smoke, you should stop. Smoking poses a host of risks to a developing baby, including birth defects and low birthweight. It also doubles your risk of having an ectopic pregnancy. You may also find it more difficult to become pregnant in the first place if you smoke, as smoking is strongly linked with subfertility in both women and men.

Get any health problems, like diabetes and high blood pressure, under control. If you are seriously overweight, talk to your doctor about how to maintain a healthy weight.

Answer:

While pregnant get all the essential vitamins and minerals you need by eating a healthy balanced diet.

Fill your plate with leafy greens, fruits, vegetables and whole grains (like wheat breads and cereals). Get plenty of calcium rich foods like broccoli and low-fat milk and yoghurt, to help build your baby's bones and teeth. Stick to lean meats like chicken and turkey.

Foods to avoid during pregnancy include:

• Fish that may contain mercury. High levels of mercury can damage a baby's developing brain and nervous system. But don't cut out fish completely, they give you important omega-3 fatty acids. Cut out fish like swordfish, merlin and shark. If you love your tuna, you can still eat it, just cut back to no more than two tuna steaks or four tins of tuna (each of 140g drained weight) per week. You can eat fish like salmon, cod, haddock, mackerel, along with shellfish like shrimp, crab and scallops making sure it’s cooked thoroughly - don’t eat raw shellfish. For a more detailed list of fish and their mercury levels, go to the Food Standards Agency website.
• Raw fish. Sorry, sushi and sashimi lovers.
• Unpasteurised soft cheeses like Brie, Camembert, Feta, Gorgonzola and Roquefort. They may contain bacteria called listeria that can cross the placenta, potentially causing miscarriage or leading to a life threatening infection.
• Unpasteurised milk, which can also contain listeria.
• Cold ready-to-eat meats, like hot dogs and luncheon meats; these can also contain listeria. Reheat these foods until they are steaming hot.
• Uncooked or cured eggs and meats, like prosciutto, runny eggs, and sauces made with raw eggs (like some hollandaise sauces).
• Alcohol. There is no known safe level of exposure to alcohol for a foetus. The National Institute for Health and Clinical Excellence recommends avoiding alcohol in the first three months of pregnancy in particular because of the increased risk of miscarriage. The NHS advises not to drink more than one to two units of alcohol once or twice a week, and not to get drunk. Prenatal exposure to alcohol can interfere with healthy development and lead to the foetal alcohol syndrome, one of the most common causes of mental retardation and the only one that is completely preventable.
• Caffeine. While some studies show that moderate caffeine intake during pregnancy is OK, others have found a link to miscarriage, and large amounts of caffeine have been linked to premature birth and low birthweight. The NHS says it’s not necessary to cut out caffeine completely but don’t have more than 200mg a day, equivalent to two mugs of instant coffee. One mug of filter coffee contains around 140mg of caffeine, a mug of tea contains around 75mg of caffeine. Remember that cola drinks and chocolate also contain caffeine.

Answer:

Do this. Don't do that. Wait, no, do this! Don't do that! It seems that the list of things you should and shouldn't do in pregnancy just keeps getting longer. Here are some key dos and don'ts:

DO:

• Exercise. Light to moderate exercise during pregnancy is good for you, strengthening your back and abdominal muscles, improving your balance and helping to speed your recovery after delivery. (See more about this in question 4 below.)
• Have sex. Unless you have a high-risk pregnancy and your doctor has advised you against it, sex during pregnancy is safe. The baby is protected by your amniotic fluid. But, especially in later pregnancy, avoid lying flat on your back during sex; the uterus can compress the blood vessels in the back of your abdomen and leave you light-headed or nauseous.
• Wash your hands before preparing food, before meals, after handling raw meats and after using the toilet.
• Clean the house. Sorry, most household cleaning products, including bleach, are safe for use during pregnancy. Just make sure the room is well ventilated, read warning labels, and avoid mixing chemicals (like ammonia and bleach), good advice for cleaning safety whether you're pregnant or not.
• Travel by plane, it depends. According to the Royal College of Obstetricians and Gynaecologists, evidence suggests there is no reason why women with uncomplicated single pregnancies should not travel by air up to a certain stage of their pregnancy. The RCOG advises that women should avoid air travel at and after 37 weeks of gestation as the chance of going into labour is significantly increased. For women with uncomplicated multiple pregnancies the safest time to fly is before 34 weeks. But make sure you tell the airline and your travel insurance company about your pregnancy, in case they have their own rules.
• Stay hydrated during the flight by drinking plenty of fluids, and keep your seat belt on! And no matter whether you're travelling by car, train, bus or plane, get up and move around every so often and make sure you stretch your legs and back.
• See your dentist. The good news is this is free on the NHS during pregnancy and for a year after the birth of your baby. Preventive cleanings and annual examinations are a very good idea during pregnancy, as your rising hormone levels can cause bleeding gums and irritation. Since gum infections have been associated with premature births, keeping your mouth healthy is important.
  

DON'T:

• Change the cat's litter tray. No, this isn't just an excuse to get out of an unpleasant task; cat faeces can transmit an infection called toxoplasmosis, which can lead to severe problems for a baby including permanent visual impairment, mental retardation and convulsions.
• Use saunas, hot tubs, and tanning booths. Excessive heat can cause overheating, which may harm an unborn baby, dehydration and fainting, and in pregnancy skin is often more sensitive meaning it is more likely to burn in response to UV exposure, which in turn can increase the risk of skin cancer.
• Paint. Let somebody else paint the baby's room; pregnant women shouldn't be exposed to toxic substances and chemicals, which include paint and cleaning solvents.
• Get an X-ray. Unless you absolutely have to, avoid tests like X-rays and mammograms while pregnant, which can be dangerous to your growing baby. If you absolutely must have an X-ray, make sure that your doctor or dentist knows you are pregnant so they can take extra precautions.
• Ride a big dipper or rollercoaster.  Though no studies have been done to document this, there is concern that the rapid stops and jarring forces of rides like this could cause placental abruption (premature separation of the placenta from the uterine wall). Play it safe and stick to the Ferris wheel or gentle carousel until the baby's born.

Answer:

Exercise during pregnancy is generally considered safe for most healthy women and can even relieve some of the discomforts of pregnancy. Some forms of exercise that are particularly good for pregnant women are walking, swimming, stationary cycling and yoga. The American College of Obstetricians and Gynecologists recommends that you focus on non-weight-bearing activities and those that don't require an enormous amount of balance (so some of those extremely challenging yoga postures may be out until after the birth). Wear loose-fitting, lightweight clothing while exercising, get plenty of fluids, and don't work to the point of exhaustion. When you reach your second and third trimesters, don't do exercises that require lying on your back, and never do workouts that pose a risk of trauma (injury) to your abdomen while pregnant. And always check with your doctor or midwife about any programme before getting started. Some women, such as those with pre-eclampsia, preterm labour and hypertension or heart disease, may be advised not to exercise or be advised to pursue very limited physical activities while pregnant.

Answer:

• Pregnancy may come with a host of uncomfortable symptoms, but you don't have to suffer in silence. Here are some tips for preventing some of the most common symptoms of pregnancy, or at least easing some of the discomfort.
• Nausea and vomiting: get up slowly in the morning; movement can make nausea worse. Don't let your stomach completely empty: eat five or six small meals throughout the day. Drink plenty of fluids, get lots of fresh air, and avoid foods that trigger symptoms. And trust your instincts. If something smells good to you and the thought of it doesn't make you nauseous, you can probably manage to eat it.
• Leg cramps: exercise regularly, get plenty of fluids, and avoid sitting in the same position for a prolonged period of time. Stretch your legs before going to bed by straightening your heel first and wiggling your toes. Massage your legs and apply heat to relieve a cramp.
• Heartburn: avoid foods that trigger symptoms - common culprits are greasy or fatty foods, garlic, spicy foods and drinks containing caffeine. Eat smaller meals, and avoid bending or lying down right after a meal.
• Haemorrhoids: drink plenty of liquids, eat a high-fibre diet, exercise regularly, and avoid long periods of standing or sitting. To relieve haemorrhoid pain, apply cold compresses. Your GP will also be able to prescribe creams or suppositories that will help soothe the symptoms.
• Backache: Wear low-heeled shoes with good arch support to avoid straining your lower back muscles. Avoid lifting heavy objects or standing for long periods of time. Make sure your mattress is firm, and that chairs you sit in have good back support (a small pillow placed in the small of your back can help). Don't take medication for back pain unless your midwife, doctor or pharmacist says they are safe. Try a heating pad, warm water bottle or cold pack instead.

Answer:

Pregnancy doesn't equal a get-out-of-jail-free card for a caloric spending spree. Weight gain during pregnancy is a lot like Goldilocks and the Three Bears: you don't want too much, you don't want too little, you want "just right". If you gain too much weight, you're at risk for conditions like gestational diabetes; too little, and your baby may be born at a low birth weight. What's "just right" for you?

Most women gain between 10 - 12.5 kg (22-28ils) in pregnancy. Most of this is gained after 20 weeks of pregnancy.

If you are overweight before becoming pregnant you should try to limit the amount of weight gained. If you are underweight prior to pregnancy you should try to build yourself up and your midwife will be able to guide you about what your ideal target should be.

The average woman should gain about one to two kg (two to four pounds) during her first three months of pregnancy and just under 0.5 kg (one pound) a week for the remainder of her pregnancy.

Answer:

You'll be seeing your GP and midwife regularly over the next nine months, with one or more visits to the obstetrician’s clinic depending on how your pregnancy is going. But how do you know when to speak to your midwife or GP between antenatal checkups? What's normal and what's not? If you're pregnant and experience any of the following symptoms, seek medical advice immediately:

• Unusual or severe cramping or abdominal pain
• Significant slowing in the baby's movements
• Shortness of breath or difficulty breathing
• Any bleeding
• Signs of premature labour, such as regular pains or tightening in the lower back or abdomen or significant fluid discharge
• Pain or cramping in the arms, legs or chest
• Fever over 38°C
• Severe or persistent diarrhoea or vomiting
• Fainting spells or dizziness
• Blurred vision or spots in front of your eyes
• Swelling in your hands, fingers or face

Answer:

A birth plan for labour and delivery is a clear statement about how you want the birth of your baby to go. It’s difficult to know in advance what kind of experience you'll have, but it is a good idea to consider some of the choices you might face. It’s better to do this in advance than during labour.

Try and make sure your birth plan doesn’t seem like a list of demands, but explains the things that matter to you. And remember that even with the best of intentions, things don’t always go according to plan.

Answer:

You know that breastfeeding is best for both you and your baby. It helps protect your child against a host of diseases in infancy, childhood, and even later on in life, everything from ear infections, diarrhoea, and respiratory illnesses and possibly even diabetes, obesity, and eczema. Plus, it also protects you: breastfeeding mothers have a lower risk of breast and ovarian cancers.

However, breastfeeding doesn't always come naturally. It's easy to get discouraged early on, especially if you expect your baby to just latch on and start suckling, only to find he has a "difficult latch" or you've developed mastitis (an infection in the breast). Here's where you need preparation before you start to breastfeed, and support while you're doing it. Your midwife is the best person to discuss breastfeeding with, and to help you solve any problems when you start. You can also contact one of the breastfeeding support groups, such as the National Breastfeeding Helpline, the Association of Breastfeeding Mothers, the National Childbirth Trust or the La Leche League for information about support groups near you.

Answer:

Some degree of depression during or after pregnancy is perfectly normal. In fact, researchers believe it's one of the most common complications associated with pregnancy. It's normal to feel tearful and down two to three days after the birth and for these feelings to last a day or two or even a week. This is the result of exhaustion and hormone surges. This phase is often called “the baby blues”.

Postnatal depression is thought to be caused by a combination of the fluctuating hormone levels associated with giving birth, the major transition to parenthood (or to having more than one child), and other life stresses that accompany pregnancy, childbirth, and parenting. If you have other major stressors affecting your life at the same time, or if you've been prone to depression in the past, you may be particularly vulnerable to postnatal depression. Symptoms can include feeling sad and hopeless; crying often; withdrawing from friends and family; eating or sleeping too little or too much; feeling worthless or guilty; and even being afraid of hurting yourself or the baby.

Treatment for the “baby blues” isn't usually necessary, but support can be invaluable. Your midwife, family, partner and support groups can all help you get through this temporary phase.

But if the feelings linger, or become severe, it's important to get treatment for postnatal depression. You should tell your midwife, GP or obstetrician if you think your feelings are getting more severe. In many cases, some treatment from your GP may be all that is necessary. You can also get support from the National Childbirth Trust and the Association for Postnatal Illness.

A condition called postnatal psychosis is a rare but more severe form of depression. It develops in about one or two mothers in every 1,000. Symptoms can include irrational behaviour, confusion and suicidal thoughts. Women with postnatal psychosis often need specialist psychiatric treatment. The symptoms will become evident to your midwife or GP and specialist help can be sought that will successfully treat the condition.