Pregnancy brings changes to the body, emotions and life of every woman. With some women this stage of their life passes by easily while with others there are a number of unpleasant issues.
Normal pregnancy lasts for 40 gestational weeks – 9 calendar or 10 lunar months.
To give birth to a healthy baby and to be vibrant and feeling good during this period you have to prepare thoroughly. Consult your doctor and inform yourselves through reliable sources. Proper physical and mental condition are key. Vital signs such as body weight, blood pressure, blood sugar, as well as thyroid hormones should be within the healthy levels.
Pre-conception exams and check-ups
Even if you don’t have any established medical conditions, it is recommended to carry out a few tests. Typical ones would include:
- complete blood count (CBC)
- Vitamin D, Vitamin B9 (folic acid), Vitamin B12 levels
- kidney function – creatinine and urea
- glucose levels on an empty stomach (typically done in the morning)
- liver function – ASAT & ALAT
- iron levels;
- TSH hormone index
Urine should be tested for protein, bacteria and glucose.
When the results are NOT within the norms
If there are some abnormal levels within your test, you need to consult with your doctor whether it would be recommended to postpone conception until you improve your results. Otherwise you risk hurting yourself and your future child.
Chronic diseases and pregnancy
When there is an established chronic condition, it is recommended to discuss possible pregnancy with your doctor. Diseases such as diabetes, hypertension, epilepsy, rheumatoid arthritis, depression and others should be carefully monitored.
Some women might notice the first symptoms within a few days after the conception, while for others it might take weeks to notice anything different with their body. Symptoms vary in intensity, frequency and duration. It is important to know that they can look like PMS symptoms or might signal a disease. That is why, if you notice any of the symptoms listed below, it doesn’t necessarily mean that you are pregnant. TO find out if that is certainly the case, you can do a pregnancy test or visit your OBG doctor.
Here are the most common early symptoms of conception:
- Your menstrual cycle is delayed or not present
If you are of a reproductive age and our menstrual cycle is delayed with a week or more, you are most probably pregnant, unless you have irregular menses.
At the beginning, hormonal changes might increase the size of your breasts and make them tense, and the nipples sensitive. Any discomfort would most probably disappear in few weeks when your body adapts to the change.
- Nausea with/without vomiting
Nausea that can appear any time of the day often appears one month after conception. Some women, though, experience discomfort quite early while with others it is absent.
Frequent urination could also be a signal that you are carrying a baby (especially if there’s no burning sensation or pain which would indicate infection). It is caused by both hormonal changes and the pressure from the growing uterus on the bladder.
Fatigue is also one of the most common early symptoms. Progesterone levels increase at the beginning of the pregnancy which can lead to sleepiness.
How to calculate your due date?
Calculating the due date is quite provisional since it depends on the length of the period and its regularity. One of the most common methods to calculate it is by adding 280 days to the start of your last menstruation. Other OBG specialists subtract 3 months from the first day of your last period and then add 7 days. For example, if the first day of our last period was May 13, the due date is February 20.
Eating and nutrition during pregnancy
A woman’s diet while pregnant plays a key role for fetus development and for a healthy future of the child. During pregnancy appetite, as well as tastes and smells change. It is not uncommon to see women develop appetite towards foods they generally dislike. Carbohydrate intake is increased represented by desserts and pastries. It is important to note that, after conception, women should strive for balanced meals and consume foods rich in folic acid, calcium, iron and zinc.
A woman’s calorie intake is about 2100 kcal/day when not pregnant. This intake must be increased by 300 kcal a day in the second and third trimester. Protein intake needs to be increased with 30 g in order to reach 76 g a day for pregnant women during the second half of their pregnancy. Daily intake should be 1 g per kg body mass. Proteins are extremely important during the embryo period. Pregnant women’s diet should incorporate 300-400 g of carbohydrates per day.
The following minerals also play a significant role:
- Calcium – intake should ne increased up to 1.5 g/day in the last months of the pregnancy and during lactation period. Should calcium be insufficient, the fetal needs are compensated by demineralization of the mother’s skeleton.
- Iron – during the second and third part of the pregnancy the intake is 30 mg/day (15 mg/day for not pregnant women). If there is iron deficiency anemia present, the dosage should be increased to 35-120 mg/day
- Salt – should be moderate. Foods that are low on salt might be harmful since they affect the holding of fluids during the period after conception.
They are prescribed very frequently during pregnancy. But all nutrients should be well-balanced – food in general, microelements, and vitamins important for experiencing a smooth pregnancy. It is not recommended for women to take vitamins without consulting first. OBG specialists advise that Individual habits and diet should be considered.
Vitamin B9, or folic acid, plays a really important role. Intake should start at least 3 months prior to a planned pregnancy, and continue throughout the pregnancy and breastfeeding. Rich in folic acids foods are spinach, lettuce, green peas, parsley, broccoli, liver, soft cheeses, citrus fruits, oats, wheat sprouts. Folic acid should be taken as food supplement because it is easily damaged by light and heat.
Folic acid is essential not only for the mother but for the fetus as well. Insufficiency might lead to difficulty in conception, carriage, spontaneous abortion, placental abruption, preeclampsia and premature birth. Not enough folic acid can cause delay in the development of the fetus (fetal hypotrophy) and risk for neural tube defects, spina bifida in particular. The recommended daily dose of folic acid is 0.4 mg.
Omega-3 fatty acids are also beneficial for the pregnancy, DHA and EPA in particular.
DHA (docosahexaenoic acid) plays a major role in the development of the brain and eyes of the fetus. It can be found in seafood, especially fatty fish, as well as in eggs. Fish, though, might contain high levels of mercury, so their consumption should not be increased. The best way to obtain DHA is through food supplements.
EPA (eicosapentaenoic acid) – facilitates the development of the heart and immune system.
Vitamin D3 – this fat-soluble vitamin is synthesized in the skin through exposure to sunlight. 10-20%, though, should come through food. It is contained in egg yolk, seafood, some cheeses, and fats. This is an essential vitamin both for the mother and the baby. Lack of it could cause:
- fecundation difficulties – the fusion of male and female gametes;
- difficulties in calcium processing by the baby which could later cause skeletal development issues, bone deformities, rickets;
- impairment in the development of sexual hormones in the fetus;
- preeclampsia – high blood pressure in the mother.
Iodine – extremely important after conception. Facilitates the proper development and function of the thyroid hormones. It is contained in iodized salt, seafood, eggs, yoghurt, raw walnuts. Iodine deficiency might cause:
- improper development and cretinism;
- low birth weight;
- premature birth.
Vitamin E (tocopherol) – while in small amounts, it is important for development of sex hormones, fertilization and carriage of the baby. It can be found in leaf vegetables (cabbage, spinach, parsley), dairy products, vegetable oils, fish, beans, carrots, some fruits (pear, apples). Tocopherol is quite unstable in natural environment, so it is important to obtain it through food supplements.
Vitamins you should take with caution
One should not prescribe themselves any drugs or supplements before conception and during pregnancy. Vitamins should also be taken with caution. For example, if Vitamin E overdose can damage the embryo, lead to deformities in the fetus and endanger the pregnancy.
Special vitamins for pregnant women
OBG specialists advise that vitamins and microelements in the food are not sufficient for the normal development of pregnancy.
Many doctors report excessive multivitamin consumption by the general public. For pregnant women, though, there are specially developed products giving them everything they need in the optimum concentration. A typical example would include the following:
- Folic acid – 400 μg (micrograms);
- Vitamin Е – 10 μg;
- Fish oil, rich in omega-3 fatty acids;
- Vitamin D3 – 5 μg;
- Iodine – 150 μg.
Pregnancy and sports
Pregnancy is not a disease and carrying a child is not supposed to involve being bedridden all the time. Of course, in some rare cases, according to your doctor’s assessment, this might become obligatory. It is important to know that maintaining physical activity is extremely important for the health for the mother and baby alike. There are some beneficial exercises for pregnant women, yoga and swimming are also recommended. Excessive physical straining should be avoided, you can have walks but keeping them a bit shorter. It is recommended that you consult with your OBG doctor if you plan any sports activities during that period.
Smoking and pregnancy
Getting pregnant is a good time to quit smoking. The consensus is that these two are completely incompatible.
It is worth noting that smoking:
- decreases oxygen levels essential for fetal development;
- increases miscarriage risk and giving birth to an underweight child;
- increases the risk of giving birth to a baby with respiratory problems;
- increases birth defect risks;
- affects heart function of both the mother and the baby.
Anything a future mother puts in her body goes into the placenta through the bloodstream. Most scientists agree that there’s no safe limit for alcohol consumption, and that wine and beer are as harmful as spirits.
Alcohol impairs oxygen and nutrients delivery to the fetus thus compromising its development. Alcohol abuse might lead to miscarriage, premature birth and to endanger the cognitive development of the baby.
Consult with your doctor if you need help to quit drinking.
Recommended tests and exams
Don’t skip your OBG appointments even if you feel good. Every appointment with your monitoring doctor would include:
- body weight check, belly circumference measurement, arterial pressure check-up;
- fetal development monitoring through fetal biometrics.
Your gynaecologist will guide you through the exams you need to undergo to ensure you and your future baby are in good health.
The most important tests after conception are:
- determining your blood type and rhesus factor;
- biochemical screening – special genetic at an early stage could diagnose some fetus malformations (Down syndrome, Edwards syndrome, Patau syndrome and others). Amniocentesis might be ordered by a specialist;
- fetal morphology scan – a comprehensive, highly-specialised ultrasound scan of all the major organs of the fetus;
- complete blood count (hemoglobin, hematocrit, erythrocytes, leukocytes, blood sugar, erythrocyte sedimentation rate – ESR);
- test for infections – syphilis, AIDS, hepatitis B;
- urine test;
- microbiological vaginal secretion test – it is usually ordered at the beginning of the pregnancy and in cases when there is a report for discomfort, burning sensation, vaginal discharge etc.;
- Papanicolaou test (PAP test).
- toxoplasmosis – for pregnant women that have cats as pets;
- rubeola – when there has been a contact with infected person;
- gestational diabetes.
Varicosis during pregnancy
The risk for varicose veins to appear, or to aggravate existing ones during pregnancy is higher, especially for women with hereditary predisposition. Change of hormones affect vessel walls negatively. The pressure from the growing fetus also increases vascular pressure which could lead to varicose veins.
It is recommended that you keep an out for redness, stiffness and pain along your veins (this is an indication for thrombophlebitis or varicophlebitis). Sudden appearance of swelling and redness in the legs, combined with high temperature and fever, is a symptom for a clogged vein in the leg. If you notice any of these symptoms you should seek medical help.
Specialists advise future mothers to follow a routine involving specific activities and diet. They recommend avoiding standing up or sitting down still for long periods of time, standing in the heat, eating unhealthy foods, smoking and wearing uncomfortable clothes and shoes. It is advisory to wear compression socks and stockings recommended by varicosis specialist.
Constipation during pregnancy
Constipation is quite common during pregnancy. It could affect women that haven’t had such a problem before. The cause is changes in the hormones that affect the gastrointestinal system function. Increased progesterone, important for a having a normal pregnancy, decreases muscle contraction and intestines become lazy.
During the second part of the pregnancy intestines are pressured and repositioned by the increased uterus leading to difficult peristalsis.
3 or 4 days without bowel movement is considered as constipation (when enough food has been consumed).
To avoid constipation, you should:
- consume foods high in fibre, celluloses and pectine – apples, plums, figs, leaf vegetables, yoghurt;
- drink enough water – around 2.5 l (water, fruit juice, soup, syrups);
- exercise – walking, practicing yoga and swimming for example have a positive effect
When constipated, you might be prescribed some laxatives.
There are some over the counter natural products that do help with constipation. A typical example would contain plum and/or fig juice and wild fennel and mint oils. Usually they should be taken with plenty of fluids.