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Posted at: Jun 8, 2019, 12:37 AM; last updated: Jun 8, 2019, 12:37 AM (IST)

Carry an easy load

What every pregnant woman needs to know for a safe and healthy birth

Dr Seema Sharma and Dr Ritambhara Bhalla

Pregnancy can be a difficult phase in a women’s life, especially for first-time moms, as the anxiety of unknown can cause stress. Here is a simple guide to some healthy practices that can make birth safer for both mothers and babies.

Physical activity

Most pregnant women with uncomplicated pregnancies should do some simple exercises every day. Moderate-intensity exercise (being able to carry on a normal conversation during exercise) for 30 minutes is recommended but only after consultation with your gynaecologist and under a trained instructor. 

There are some misconceptions that bed rest is must for pregnant women as it can reduce the risk of miscarriage, pre-term birth or improves pregnancy outcome in twin or multiple pregnancies or impaired foetal growth. Moreover, bed rest has some known potential harms. It promotes loss of trabecular bone density, increases venous thromboembolism risk, produces musculoskeletal deconditioning, and in some cases cause significant psychosocial strain.

Bed rest is advised to pregnant women diagnosed with symptoms of heart disease, high blood pressure, having any risks of premature labour (incompetent cervix, multiple pregnancy, ruptured membranes), pre-eclampsia (characterised by high blood pressure, usually occurs after 20th week), etc. 

Warnings signs to discontinue exercise

  • Vaginal bleeding 
  • Regular painful contractions 
  • Headache
  • Dizziness
  • Chest pain 
  • Calf pain or swelling 

Supplements

A standard prenatal multivitamin with iron and folic acid satisfies the daily vitamin and mineral requirements of most pregnant women. It should contain 15 to 30 mg iron to prevent anaemia.  

Indigestion

Indigestion, also called ‘dyspepsia’, is the most common problem during pregnancy.  It occurs due to significant physical and hormonal changes and the effects of progesterone and estrogen hormones which are manifold during pregnancy. Indigestion becomes more common as pregnancy advances. As many as eight in 10 women may have indigestion during their pregnancy. Some common symptoms include feeling of pain or discomfort in the stomach, morning or evening sickness, nausea, constipation, lack of appetite. 

Life changes

Eat healthy, small, frequent meals with adequate protein, carbs and fats. Don’t overeat or ‘eat for two’. Excessive weight gain is one of the risks during pregnancy which increases future risk of cardiovascular disease and diabetes. Both excessive weight gain and obesity have been associated with a Caesarean delivery. Average weight gain of eight to 12 kg is advised depending upon the BMI.

  • Get adequate rest but not too much. Try to keep your daily routine normal with some modifications.
  • Don’t smoke or drink alcohol if you’re pregnant or planning to conceive.  This is harmful for the foetus. 

Be cautious against infection

Some infections are potentially harmful in pregnancy. Hence, try to minimise the risk of these infections. Pregnant women should avoid contact with people with fever, etc. that are contagious and should practise good hygiene.

Sexual activity

Theoretically, sexual intercourse may stimulate labour due to physical stimulation of the lower uterine segment, endogenous release of oxytocin as a result of orgasm, direct action of prostaglandins in semen, or increased exposure to infectious agents. However, in the absence of pregnancy complications (e.g. vaginal bleeding, ruptured membranes), there is insufficient evidence to recommend against sexual intercourse during pregnancy.

Time to avoid these

Exposure to hair dyes or hair grooming/styling products results in limited systemic absorption, unless the integrity of scalp skin is compromised by any disease. Opt for plant-based hair dyes, if possible. 

Avoid hot tubs and saunas during the first trimester because maternal heat exposure has been associated with an increased risk of neural tube defects. 

Use organic cosmetics as skin may be more sensitive in pregnancy. Some nail polishes have toluene, formaldehyde, etc. These toxins may be inhaled when applied or absorbed from the nail bed.

Common complaints

Some common problems during pregnancy are constipation, cramps, headaches, stretch marks and swollen ankles. Pregnant women should consume more dietary fibre and fluids. Most pregnant women also note gingival changes and/or gingivitis (gum disease). It may result in gum bleeding, ulceration and pain. 

Sleep during pregnancy, especially late pregnancy, is fragmented and characterised by increased waking after sleep onset, greater amounts of light sleep, and less deep sleep. This may be due to anxiety, restless legs or leg cramps, low-back pain, physical limitations in achieving a comfortable position. In obese pregnant women it may be due to obstructive sleep apnea.  

Some dos and don’ts of using technology

Cell phones and other wireless devices emit radio waves. Radiations from mobile phones, computers, and wireless routers are likely to have an impact on the growing foetus. Expecting mothers should have limited exposure to radiation. Studies say exposure can linked to behavioural problems like ADHD and impaired memory.  Constant and continued exposure can interfere with cellular receptors of the human body and may increase risk of cancer.

  • Don’t put cell phones and laptops on your body
  • Avoid cordless phones
  • Make short and to the point calls or choose texts over calls. This reduces radiation exposure.

Pre-delivery requirements

What should be ready in your bag 

Have everything ready to go when you’re eight months pregnant, since you could go into labour at any time before your due date. 

Pack two small bags for the hospital — one for the items you’ll need during labour, and another for items that you will need after birth. Pack maternity gowns, disposable underpants, lip balms, hairbands, comfortable shoes, toiletries, baby blankets. Always carry all your investigation reports before leaving for the hospital.

For effortless labour

  • Try and let labour begin on its own, unless doctor decides otherwise. 
  • Walk, move around, and change positions throughout labour. 
  • Continuous emotional and physical support in labour makes birth safer and healthier for mother and baby.
  •  Avoid interventions that are not medically necessary.  
  • Avoid giving birth on the back and follow the body’s urges to push. 
  • Keep mother and baby together — it’s best for mother, baby and breastfeeding.

Travel guide for moms-to-be

For road travel pregnant women should wear three-point seat belts. The lap belt is placed across the hips and below the uterus; the shoulder belt goes between the breasts and above and lateral to the uterus. For air travel, most airlines allow women with single foetus to fly up to 37 weeks and up to 32 weeks with twin pregnancies. Foetal heart rate is not affected during flight if the mother and foetus are healthy. But consult with your gynaecologist.  

Immunisation

Influenza vaccination is recommended for pregnant women during the influenza season, regardless of stage. Tetanus and diphtheria immunisations and boosters should be up-to-date. The tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is administered in the third trimester of each pregnancy to protect the infant from pertussis, regardless of prior vaccination.

— Dr Sharma is a high-risk pregnancy specialist and Dr Bhalla is a gynaecologist and obstetrician, Cloudnine Group of Hospitals, Chandigarh

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