Nutritious dietGenerally, most of the mothers–to–be in India are given high calorie food like wheat flour with lots of dry fruits and desi–ghee. There is a concept and belief that the mother must eat food for two, which is all wrong. Ideally she should increase her daily calorie intake by another 300 calories. (The calorie intake should be about 2200–2500 calories) She should also increase milk intake to about 600 ml a day along with dal, fish, meat, eggs and plenty of fresh fruits and green vegetables in her diet.
| Food. | Food You Need Extra. | Calories (kcal). |
| Milk. | 100 gram. | 83 |
| Pulses. | 15 gram. | 52 |
| Cereals. | 35 gram. | 118 |
| Sugar. | 10 gram. | 40 |
| Fat. | - | - |
| Total. | - | 293 |
Weight should be watched closely during pregnancy. The normal weight gained by a woman during her pregnancy is accepted as being about 10 kg or about 22 pounds. This may differ from women to women and the maturity of the baby. It may be roughly as 10 per cent at the tenth week, 20 per cent at the twentieth week, 30 per cent at the thirtieth week and 40 per cent at term. If the mother’s weight fails to increase there is risk that the baby will be small in size or there is the risk of intrauterine death. If she gains excessive weight there is a risk of developing toxemia in pregnancy and also obesity with its complications after pregnancy.
Dietetic iron is not sufficient to meet the daily requirement especially in the second half of pregnancy hence supplementary iron is given to all pregnant mothers from 20 weeks onwards. Your physician will prescribe whatever is required. (The requirement increases by about 20 mg/day). If any essential vitamins are lacking in the food, they are given daily from the 20th week onwards.
Vaccinations
Tetanus Toxoid
This vaccine is very vital not only to the mother but also to the fetus. Incase the the woman has been immunized in the past, she has to take a booster dose of 0.5 ml which is given in the last trimester.
If the woman has not immunized in the past, then she has to be given two shots of the Tetanus Toxoid, first at 16–20weeks and the second at 20–25 weeks.
Other vaccines like Cholera and Typhoid should be taken if there is an epidemic.
Vaccination against Yellow Fever is needed only if the mother is traveling overseas to certain countries.
Visits To Your Obstetrician
Antenatal care
The main purpose to have your regular checkup is to ensure a normal pregnancy with the delivery of a healthy baby from a healthy mother. The to–be–mothers can have these check–ups at an antenatal clinic or at her family physician's clinic. By doing this you make sure that nothing goes wrong during the pregnancy and labor. These check–ups also answer your questions to certain conditions that appear at every stage of pregnancy.
The woman should visit her physician preferably within the first 8 weeks of pregnancy. The check up is done at intervals of 4 weeks from the first visit. The first hospital visit should also occur between 12 and 16 weeks.
Calculation of the EDD (Expected Date of Delivery)
The EDD is calculated by adding 9 months (+) or (–) 7 days (by the English calendar) after the 1st day of the last menstrual cycle before conception.
For Example. A woman had her first day of the last menstrual period on 1st June. By adding 9 calendar months it comes to 1st of March and then add 7 days i.e. 8th of March, which becomes the expected date of delivery.
Details required will be
- Place of residence.
- Emergency contact number.
- Age, marital status, duration of marriage and gravidity (history of previous pregnancies).
- A full menstrual history.
Medical and surgical, family details, smoking, alcohol and drug ingestion, inoculation risk
Clinical Examination
Weight, height, blood pressure, urinalysis for protein, blood and glucose
General
Chest, Heart, Breasts, etc.
Abdominal
Masses, Tenderness, Fundal height
Pelvic
Routine vaginal examination is usually not required
Routine investigations to be done are
Examination of the blood. for Hemoglobin, determination of blood group and Rh factor. Also test for VDRL (Venereal disease).
Urine Examination. for sugar, protein and pus cells.
Cervical cytology (to study the structure and function of the cervix).
The Ultrasound Test
Ultra–sonography is performed during 16–18 weeks of gestation. A second scan may be carried out at 32 to 36 weeks of pregnancy, but not indicated in the absence of any risk markers.
Ultrasound is a most useful means in antenatal care. It gives vast information about the growing baby, the placenta and the umbilical cord. Its importance are as follows.
Accurately ascertainments the gestational age of the baby (menstrual history can be unreliable in up to 45% of women)
Locating the cause of bleeding and/or abdominal pain during early pregnancy
To check for fetal size and liquor volume when the uterus is small or large
For excluding multiple pregnancy
For establishing the maturity of the baby
Looking for fetal defects when serum AFP (alpha fetoprotein concentration) levels are found to be high
For a detailed examination of the baby when the risk of congenital anomaly is high or an amniocentesis or chorionic villus sampling is being planned
Monitoring fetal growth in high–risk pregnancies
For determination of fetal presentation when the same can not be made out on palpation
For ascertaining the placental health
Antenatal Advice
A woman is given health education and advice on, diet, hygiene, dental care, rest and sleep, care of the breasts, smoking (avoid it), coitus. Also advised are investigations and maternity benefits which are very important for herself and her baby.
Clothing
The woman should wear loose and comfortable fitting clothes. Tight clothes can make movement difficult. Tight clothing might worsen indigestion and heartburn due to the reflux of acid, on the other hand they increase the chances of fungal infection or Candidacies in the vagina. Gowns and loose flowing robes are probably the best in pregnancy.
Footwear
Avoid the use of high–heeled shoes. They can strain the back and throw one off balance. So, shoes with low heel or flat heel are the best.
Rest and sleep
The woman should continue her usual day to day activities during pregnancy. She should always take some rest as soon as she feels tired. Women who are working should take maternity leave at least 6 weeks before her expected date of delivery. All pregnant women should avoid strenuous work especially in the first trimester and the last 6 weeks.
Sleep should be for 10 hrs. at night and 2 hrs. in the day.
Traveling
A pregnant woman should travel only when required. She should avoid traveling in the 1st and 3rd trimester. Traveling should be done without any stress and strain on the pregnant mother. She should avoid traveling on roads that might cause a lot of jerking.
She should not fly after 28th week.
Exercise
Walking is good exercise for the pregnant mother. It helps improve the circulation in the legs and tones up the body and mind. She should walk in free, unpolluted air for 1hr daily.
Regular antenatal exercises under the supervision of a trained physiotherapist is recommended. This helps the woman to relax and prepare herself for childbirth. It also teaches how to breath and relax during labor and thus makes the woman more comfortable during delivery.
Breathing exercises
Slow deep breaths followed by shallow and fast breathing. Do not hold breathing.
Coitus
Intercourse should be avoided during the first trimester and during the last 6weeks of pregnancy.
Smoking, Alcohol and Medicines
Smoking
Quit smoking. Smoking during pregnancy is very dangerous for the mother’s health as well as the development of the baby. Smoking mothers have smaller babies. There is also a higher risk that the baby will be premature and underweight. Babies of women who smoke are, on average 200 gm (7 oz) lighter than they should be.
The nicotine and carbon monoxide that the woman inhales goes from her bloodstream into the babies’ and due to this the baby gets less oxygen and cannot grow well.
Alcohol
Drinking alcohol during pregnancy can affect the development of the baby adversely, especially during the early weeks.
Dental Care
Consult your dentist at the earliest, normally in the 2nd trimester. Also tell the dentist that you are pregnant before he prescribe the medicine.
Also stay away from radiation sources such as x–ray examination rooms, radiation therapy rooms and industries which make use of radiation sources. Thus it is very important for a pregnant women to take care of herself and her infant, ultimately Giving birth to a new life in turn signifies the birth of a new you.