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CARE OF THE MOTHER DURING PREGNANCY
Antenatal care is not only to ensure the good health of mother during pregnancy and childbirth, but also to ensure good health of the baby on birth.
As soon as a woman misses per period and she suspects that she is pregnant, a woman should visit a doctor. During the first visit, the doctor will take a detailed history and do a thorough clinical examination. Pregnancy may be confirmed by a urine test.
Expected date of delivery (EDD)
If the woman has regular 28-day menstrual cycle, then the EDD is calculated by adding 9 months and 7 days to the first day of the last menstrual period for e.g. if the last menstrual date of the pregnant woman was 20 th January 2002, then her EDD would be (20+7=27 th and January + 9=October) 27 th October 2002.
Diet in Pregnancy
Proper nutrition and diet is important for good development of a strong and healthy baby. Caloric requirement is higher during pregnancy and breast-feeding. A balanced diet containing a variety of foods is required. A pregnant woman should have at least 400-500 calories/day in addition to the daily intake. The pregnant woman and lactating mother should also consume extra iron and calcium to build up the hemoglobin of both the mother and the child and for making the bones stronger in the baby respectively. The expectant mother should consume additional folic acid supplementation to reduce the risks of growth retardation and malformations in the baby. Additional vitamin supplements to help in the growth of the fetal tissues are also needed.
It is important to eat at least 3 good meals a day. In addition the woman should have milk, fruits, biscuits, yogurt, chana, etc. The intake of cakes, chocolates, fried foods like potato fries, samosa, etc should be reduced. Extra salt should be avoided.
Tea/Coffee/Colas intake should be minimized because these contain caffeine, which can lead to frequent urination, heartburn, anxiety, sleep disturbances and also hamper iron and calcium absorption. Alcohol should be avoided as it leads to congenital anomalies in the child.
Weight gain during pregnancy
Weight gain varies from woman to woman and from pregnancy to pregnancy. Average weight gain in pregnancy is about 10 to 12 kg and may be a little more in multiple pregnancies. Excessive weight gain is not desirable because it puts more strain on the back and leg muscles and makes it more difficult to knock off the excessive weight after delivery. Also it may lead to difficult delivery. The woman puts on 1-2 kg of weight in the first 3 months, 4-5 kg in the nest 3 months and 4-5 kg in the last 3 months.
Clothing and shoes
Loose clothes are recommended to reduce discomfort and well-supporting and comfortable bras are to be used. High-heeled shoes should be avoided as it changes the center of gravity of the body and the pregnant woman due to the protruding abdomen has a tendency to fall. Hence only flat shoes with soles that are non slippery are to be used.
Work and Travel
A woman should continue with her routine throughout pregnancy, but should not undergo severe stress or fatigue. There should be adequate rest periods in between work. Women with problems in previous pregnancy such as threatened abortion /preterm delivery should minimize physical activity.
In the first trimester, long distance travel is to be avoided to prevent miscarriage. Auto rickshaw and two wheeler rides should be kept to the minimum. Flying in a pressurized aircraft entails no risk. During long journeys, one should keep changing positions and stretching intermittently to maintain blood circulation. It is also advisable to avoid travel in the 9th month of pregnancy.
Sex during pregnancy
Sex is permissible in pregnancy, but preferably avoided in the first trimester and during the last 6 weeks. Pressure on the abdomen during coitus is to be avoided. Sex is contraindicated if there is a previous history of pregnancy loss.
Exercise in Pregnancy
Exercise improves blood circulation, strengthens muscles, keeps the body supple and flexible and improves recovery post delivery. Exercises to the point of exhaustion are to be avoided. Sit-ups and double leg lifting that cause a severe strain on the abdominal muscles are to be avoided. Sudden jerky movements should not be made.
Practice of yoga during pregnancy is very useful. Asana are useful for physical mobility whereas the Praanaayams (relaxation techniques) are useful in labour and helps in easy delivery. Asanas like sukhasana, padmasana, parvatasana are useful. Stretching asanas like yastikasana and Talasana (without raising toes) are also useful. For relaxation, Shabasana, Dhradasana and Nispandabhava can be done.
Sleep
It is advisable to sleep on one side especially the left with the hips and knees slightly flexed to ensure maximum blood supply to the baby. Avoid sleeping on your stomach and in later months of pregnancy do not sleep on your back.
Medicines and vaccinations during pregnancy
In pregnancy, medicines should be taken under guidance of a doctor especially in the first trimester. Iron and calcium (also known as ANC pack) should be started as soon as the first trimester nausea and vomiting settles down and should be continued throughout pregnancy and lactation. Folic acid should be started even before conception and should be consumed daily throughout pregnancy. Tetanus toxoid vaccine should be administered during pregnancy at an interval of 4 to 6 weeks starting from 7 th month onwards.
Doctor visits
A routine check up once a month till the 6th month, a visit every fortnight in the 7th and 8th month, and once week in the 9th month should be followed.
Warning signs
Doctor should be consulted urgently if the woman has
Last created on 07-05-2004
Last updated on 18-11-2006