To experience a problem-free nine months, it is helpful to plan your pregnancy and take care of your health in advance. Many couples don’t realise that the first two weeks of fetal development occur even before the urine pregnancy test will appear positive. During the first trimester, the embryo of a few cells develops into a fetus and this is the one period when the fetus is most vulnerable to infections and adverse medications. Mothers should ensure that they stay healthy and well by practicing good hygiene, eating well, resting adequately and staying away from crowded places. Some medications can be taken during pregnancy, including panadol and common antihistamines. Antibiotics can also be taken, if needed. Bleeding and menstrual pains in this trimester can signal a risk of miscarriage. These symptoms may be triggered by infections, lower hormonal levels or excessive activity and dehydration. Treatment should be tailored depending on the cause and often given prophylactically. Excessive nausea, vomiting and fatigue can lead to poor intake of food and fluids which will compound the severity of symptoms. Taking more Vitamin B6, using travel bands and eating more easily digestible foods in small quantities are simple ways of reducing nausea.
|Backache||............||Watch your posture and utilise abdominal bands|
|Difficulty sleeping||............||Magnesium supplements, better positioning, small cushions|
|Water retention||............||Increased consumption of proteins, less salt, less carbohydrates. Raise feet and have a lymphatic massage|
|Lower genital tract infection||............||Use feminine washes, increase consumption of lactobacillus|
If you are experiencing any bleeding and/or menstrual cramp discomfort during early pregnancy, then it is best to avoid physical exercise of the high-impact variety ie running or aerobics. Sexual intercourse is also likely to increase uterine contractions. However, if a woman is feeling well and has always been active, simply slowing down to approximately two thirds of pre-pregnancy activity levels should be acceptable. A mother’s blood volume will increase dramatically in the first three months, which will render physical exertion more tiring. Prenatal pilates or yoga are good exercise during pregnancy. Low-impact activities like cycling, walking and swimming are also recommended. Whatever your choice, perform them in moderation and if you experience painful uterine contractions then stop, rest, hydrate and observe for 30 minutes or so. If the contractions ease or cease, you should be fine.
Labour and delivery can be unnerving for first timers, so the key to a smooth delivery is an open mind and a positive approach. Trust that your obstetrician has both your interests and desires at heart and she or he will guide you through your journey. Consider what both of you would like to see in the labour process, and trust that your baby will be well monitored throughout that process. Pain relief can be the key to relaxation for some mothers. Women in labour should not try and avoid pain relief at all costs, as it can lead to unnecessary physical and emotional distress.
First-time mothers and those who have had previous pregnancy losses are usually anxious, especially in the first trimester as they cannot tell how their pregnancy is progressing. The gynaecologist has to be patient and carry the woman and her partner through this phase. Where there is excessive anxiety, additional support from a counselor or psychiatrist may be necessary to avoid antenatal or postnatal depression from setting in.
Post-natally, do not over-exert physically in the initial few weeks, as this may lead to increased post-partum bleeding and reduced breast milk production. It is important to realise that the muscles and ligaments take a while to get stretched out to contain the pregnancy. Performing pelvic floor exercises and core exercises to regain core stability is key to a good recovery. Excessive weight lifting could also lead to vaginal weakening and prolapse. Excessive fatigue can also lead to postnatal blues. It is not necessary in my opinion to abstain from bathing in the first month. Hygiene is extremely important, whether a woman is pregnant or not. Just dry up quickly after a bath and dry your hair. Overall, the general rules for post-natal care are to rest, eat, breastfeed, keep positive and maintain hygiene to assist recovery.
The hormonal changes experienced in pregnancy will revert to normal after around six weeks. Physical changes will reverse over a longer period. These will require the mother to tone up her pelvic and abdominal muscles and lose the excess weight she might have put on during the pregnancy. Aiming to reverse all these changes in six months is usually achievable!
Diet is important during recovery. Eat a good selection of proteins, vitamin C and Zinc for growth and repair of tissues and adequate good carbohydrates for energy to look after the baby and yourself. You should supplement your calcium intake as well as continue with a nutritious diet. This is particularly important for those who breastfeed, as ultimately the baby’s only source of nutrition is from the mother. So if the mummy diets, the baby gets skimmed milk.
|Dr Ann Tan, PBM|
|Obstetrician & Gynaecologist|
|MBBS (S'PORE), MRCOG (LONDON),|
|M MED (O&G) FAM (SINGAPORE)|