Pregnancy care

Overview

Pregnancy is one of the most joyous experiences in a woman’s life. It is followed by concerns and expectations both for the expecting mother and the unborn baby. It does not matter whether you are a first-time mother or have children, it is important to take care of your health as well as the health of your baby.

What is pregnancy?

Pregnancy occurs when a fetus develops inside a women’s uterus or womb. Full-term pregnancies last 40 weeks.

Pregnancy starts when a fertilized egg implants in the uterus lining. Early diagnosis and prenatal care are important for a successful pregnancy. You need to monitor your pregnancy, your health, and the health of your unborn baby to avoid complications.

Prenatal care

Prenatal or antenatal care is the health care recommended during pregnancy. Pregnancy brings changes in women’s bodies. The hormonal changes impact a woman physically as well as emotionally. Staying healthy in pregnancy is important both for the would-be mother and the baby.

Prenatal care starts from the pre-pregnancy stage. This is the stage when a woman plans to get pregnant. It consists of regular medical checkups and lifestyle changes that benefit both the mother and the baby.

Prenatal care reduces risks and complications of pregnancy. This helps in a healthy birth. It reduces the risks of low birth weight and birth complications.

Ideally, prenatal care starts 3 months before you are planning to conceive.

• Take folic acids. Doctors recommend 400 micrograms per day.
• Consult your doctor about your daily medications, vitamins, or supplements.
• Plan the pregnancy.
• Manage diabetes.
• Take care of other health problems.
• Maintain healthy body weight.
• Stop smoking or drinking alcohol.
• Reduce anxiety and stress.
• Consult the doctor regarding immunizations.
• Discuss your partner’s health and family health history.
• Consult a caregiver.
• Take adequate nutrition and vitamins.

Prenatal diagnosis

Diagnostic tests:

• Blood pressure.
• Weight and height.
• Medical history.
• Fetal heart rate monitoring.
• Urine tests.
• Blood tests.
• Blood glucose tests for gestational diabetes.
• Pelvic exam.

Prenatal visit schedules:

First visit – during pregnancy detection or at 12 weeks of pregnancy, whichever is earlier.

Second visit – 14-26 weeks.

Third visit – 28-34 weeks.

Fourth visit – within 36 weeks till delivery.

A prenatal ultrasound test is done to:

• Confirm pregnancy.
• Check pregnancy risks like ectopic pregnancy, molar pregnancy, etc.
• Check for fetal malformations.
• Assess fetal body growth.
• Calculate due date for birth.

Other tests to check complications in pregnancy and fetal growth:

• Amniocentesis to check amniotic fluid.
• A chorionic villus sampling (CVS) to see chromosomal abnormalities such as Down syndrome.
• Fetal echocardiography for monitoring baby’s heart.
• Blood tests for chronic illnesses.
• Nuchal translucency test to check risks for Down syndrome.

During the pregnancy

A pregnant woman should schedule regular health appointments with her OB/GYN doctor.

Health visit schedules:

• Once every month for the first six months.
• Every 2 weeks in the 7^th and 8^th
• Every week in the ninth month.

During these visits, the doctor checks:

• Screening tests for anemia, HIV, and blood type.
• Blood pressure.
• Weight gain.
• Fetal growth.
• Baby’s heart rate.
• Diet.
• Exercise routine.

In the later visits, the doctor checks:

• The baby’s position.
• Gives instructions regarding birth.
• Counsels about postpartum care after birth.

Tips for staying healthy during pregnancy

Staying healthy is important both for the mother and the baby.

Visit the doctor regularly for prenatal checkups

Go for regular prenatal health visits. Talk to your healthcare provider about complications or concerns regarding the pregnancy. Prenatal checkups are important to rule out pregnancy complications.

Eat healthy and nutritious foods

Avoid certain foods like raw meat, sushi, unpasteurized milk, uncooked eggs, etc. They may cause food poisoning. Stay away from junk foods. Eat iron-rich foods, green vegetables, whole grains, legumes, dairy products, eggs, lean meat, and proteins.

Drink a lot of water. Include fresh juices in your diet.

Take your vitamins

Remember to take your daily multivitamins like iron, folic acid, calcium supplements to stay healthy and fit.

Avoid alcohol and smoking

Alcohol intake during pregnancy is associated with FASD (fetal alcohol spectrum disorder). This increases the risk of physical and behavioral problems, hearing and vision problems, poor memory, learning disabilities, and low birth weight in children.

Do moderate exercises

Stay physically active during pregnancies. Regular physical activities help babies to gain ideal weight. It reduces risks for:

• Bloating, back pain, or cramps.
• Gestational diabetes.
• Depression.
• Preeclampsia (high blood pressure during pregnancies)
• Cesarean section.

Physical activities help during labor and postpartum recovery. Join a yoga class or go for short walks in a local park. It’s rejuvenating and helps remain active during pregnancies.

Rest and sleep

Now that you have done your share of exercises, it is time to take some rest. Sleep helps your body to rest and is important for a baby’s growth. Sleep for seven to nine hours a day.

Limit exposure to toxic substances

Limit your exposure to certain toxic chemicals and substances. It causes birth defects. Hormonal changes during pregnancy make your skin sensitive to sunburn. If you are going out during the day, wear good sunscreen.

Reduce stress and anxiety

Anxiety and depression are common in pregnancies. Consult a doctor and seek medical help. Visit for regular checkups. Feeling overwhelmed in pregnancy is normal. Talk to a family member or friends and seek mental support.

Possible complications during pregnancy and delivery

Some women experience complications during pregnancies. These complications impact the health of the would-be mother as well as the baby. Some mothers have health conditions or diseases before pregnancy. This leads to complications during pregnancy or delivery. Proper prenatal care and consultations minimize and manage these risks.

Common complications include:

High blood pressure

High blood pressure is common in pregnancies. It increases the risk of preeclampsia, preterm delivery (babies are born small). Doctors prescribe medications to manage the pressure.

Gestational diabetes

It occurs when the body is unable to process the sugar properly. This causes high sugar levels in the blood. This condition generally resolves after the baby is born. Patients are prescribed medications or insulin to control their diabetes.

Preterm labor

Labor before the 37^th week of pregnancy is called preterm labor. During this time, the baby’s organs like the brain or lungs are not developed properly. Doctors recommend bed rest and medications to stop early labor.

Preeclampsia or toxemia

It causes high blood pressure and problems in the kidneys. Typically, it occurs after 20 weeks of pregnancy. Doctors try to induce early labor in 37- 40 weeks of pregnancy. If delivery is too early, doctors give medications to lower the blood pressure.

Anemia

Anemia is a condition where the red blood cells are lower than normal. Patients feel weak and have pale skin. Doctors give iron supplements and folic acid for anemia.

Infections

Bacterial and viral infections complicate pregnancies. Doctors advise patients to wash and clean their hands and take vaccinations for immunization. Common infections include:

• Yeast infection.
• Urinary tract infection.
• Cytomegalovirus.
• Influenza.
• Toxoplasmosis (bacteria found in soil, raw meat, or cat feces).
• Hepatitis B (sometimes spread to babies after birth).
• Zika virus.

Breech position during labor

A baby is in a breech position when the feet are near the uterus instead of the head during delivery. It can cause distress to the mother and the baby during birth. Doctors may recommend patients against vaginal births. If the baby is in a breech position during delivery, a cesarean section is recommended.

Placenta previa

The baby’s placenta covers the cervix partially or completely. This can cause serious bleeding during and after delivery. Doctors may recommend a cesarean delivery.

Low birth weight

Low birth weight can be caused by premature birth, fetal growth problems, lack of proper care or nutrition during pregnancy, alcohol or drug abuse, infections, or other health problems.

Low birth weight can cause respiratory or heart problems, learning disabilities, and a lack of immunity to fight infections.

When to call a doctor?

If you experience these symptoms, do not hesitate to call the doctor:

• Vaginal bleeding.
• Abdominal pain.
• Dizziness.
• Severe headaches.
• Blurriness.
• Continuous vomiting.
• High fever.
• Sudden inflammation of the face or hands.
• Less movement of the baby in the third trimester.

Preparation for cesarean section

Preparation tips for cesarean delivery:

• Stop eating or drinking after midnight.
• Arrive early in the hospital.
• Change to the hospital gown.
• The nurse preps the surgical site.
• A healthcare provider collects urine and blood samples.
• You may be asked to take a clear liquid antacid medication.
• An IV (intravenous) is placed in the arm.

Cesarean Procedure

• An anesthesiology specialist places the blood pressure, pulse, and respiration monitors.
• A surgical staff inserts the foley catheter into the bladder.
• A sterile solution is used to clean the abdomen. Sterile dressings are placed.
• You will get spinal or general anesthesia. In general anesthesia, you will be asleep during the entire surgery. Spinal anesthesia is administered waist down. A screen will be placed waist-down. So, you cannot see the surgery.

When should you go for cesarean delivery?

A cesarean or C-section delivery is an open surgery where the baby is surgically removed from the mother’s womb or uterus. A C-section is of 2 types:

• Planned C-section
• Emergency C-section

In a planned cesarean delivery, the mother is prepared for a C-section in advance. She won’t go into labor. An emergency C-section is done if the mother has developed complications during natural birth or the baby is at risk.

Reasons for cesarean delivery:

• Mothers have infections like HIV or herpes which can pass on to the baby during vaginal delivery.
• Diabetes or high blood pressure.
• The placenta is blocking the cervix.
• Multiple births.
• The baby is in a breech position.
• The baby is in distress.
• Vaginal delivery is not progressing.
• The baby has irregular heartbeats.
• Placenta has separated from the uterus.
• The baby has birth defects.
• Mothers who had a C-section in the past may not be able to give births naturally next time.
• The mother developed a problem during vaginal delivery and switched to an emergency C-section.
• CPD (cephalopelvic disproportion) where the mother’s pelvis is small for delivering the baby vaginally or the baby’s head is too large.

Surgery options

Childbirth is a natural phenomenon but there are chances of complications. You may decide to give birth privately at your home in the presence of certified midwives and doctors or give birth in a hospital. It is better to talk to your doctor and team of midwives about the need to transfer to a hospital if there are any complications. There are birthing centers led by a group of midwives. They provide private rooms for vaginal delivery.

Birthing centers

Pros

• Home-like environment.
• Water-birth option.
• Good for low-risk pregnancies.

Cons

• Minimal medical intervention.
• Risky for unexpected delivery complications.
• Not good for high-risk pregnancies.

Big hospitals

Pros

• Good access to epidurals, a neonatologist (for newborn care), anesthesiologists, and specialist services.
• Patients can have C-sections.
• Postpartum care for mother and baby in nurseries.

Cons

• High cost.
• Lack of personalized care.
• Long waiting period.

Cost of surgery

The cost of cesarean deliveries depends on:

• The health of the mother.
• Complications during pregnancy or surgery.
• Hospital stays.
• Surgeon’s fees.
• Fees for the surgical team.
• Post-delivery care for mother.
• Neonatal care.

Post-op care and things to keep in mind

Postpartum care is as important as prenatal care. It is the time after the baby is born. The postpartum period lasts 6-8 months. This involves the emotional and physical care of the new mother.

If you have a vaginal delivery, you may go home after one or two days depending on your condition. C-sections need longer stays.

• Get enough rest. Sleep while your baby is sleeping. Keep the baby’s crib near you for nighttime feedings. Ask your partner or someone to help and take care of your baby while you are asleep.
• Maintain a healthy diet during breastfeeding to provide enough nutrition to your baby. Drink fluids, fresh fruits, vegetables, and low-fat foods.
• Follow breastfeeding instructions. The first few days can be difficult both for new mothers and babies.
• Take appropriate vaginal care if you had a tear or soreness during vaginal delivery. New mothers can experience pain and frequent urge to urinate.
• Avoid lifting heavy objects especially if you had a cesarean section.
• Wash your hands before feeding your child and after changing diapers.
• Do not use tampons for 4-6 weeks post-delivery.
• Take your vitamins and medications.
• Go for walks.
• Visit your healthcare provider for checkups.

Delivery complications

A pregnancy can develop complications during delivery.

• Prolonged labor.
• The breech position where the buttocks are near the cervix.
• The umbilical cord wraps around the baby’s neck, arm, or legs as it moves through the birth canal.
• Umbilical cord prolapse occurs when it protrudes through the vagina.
• Perinatal asphyxia is where the baby does not get enough oxygen in the womb or during labor.
• Abnormal bleeding during birth.
• Abnormal heart rate of the baby. This may need an emergency C-section.
• Early water breakage inducing labor.
• Shoulder dystocia where the infant’s head is out of the vagina but the shoulder is stuck inside during delivery.

Best option

Pregnancy care is vital both for the mother and the baby. Once you become pregnant, the next step is to visit an OB/GYN and plan the pregnancy. Goficure’s medical team will assist you right from your first trimester to delivering the baby. Goficure’s dedicated Medi-Pal will assist the patient in scheduling appointments, planning the delivery, and recovery after pregnancy. Treatment will be hassle-free and arrangements will be made for quick recovery and follow-up consultations.

References