Dear Doctor,

I’m 23 years old and a few weeks pregnant with my first child but I do not know what to expect. I live alone and don’t have many people to talk to. What are some things that I should avoid or get into? How soon should I start antenatal? Is there something I can take that won’t make labour too painful? I’m so scared.

Mable

Dear Mable

Congratulationson your first pregnancy. A new life has started growing inside you. There is nothing to be apprehensive about as it is a normal biological phenomenon. However, you have to be careful, particularly during the first three months.

The first trimester is the time when the body of the baby is formed; it grows in size and weight in 2nd and 3rd trimesters. Avoid alcohol, tobacco, junk food and unnecessary medicines as these can cause defects in the body of the foetus.  Avoid lifting heavy weights, strenuous work and long travel, because they carry risk of causing a miscarriage. Avoid sex if possible, because it can introduce germs causing pelvic and or urinary infections. One should give utmost attention to personal hygiene, especially like keeping the genital parts clean and dry. During pregnancy, a woman is more susceptible to develop fungal infections of the pelvic parts due to changes in hormone levels, and this infection can spread to the urinary tract causing frequency of urination and painful micturition. Good hygiene minimises the risk of acquiring these infections. Also, drinking an adequate amount of water cleanses the infectious microbes out of the body, hence reduces chances of urinary tract infection. It is also important to avoid hot sauna baths, as they can raise the body temperature and harm the growing foetus. Tight clothes and high heeled shoes are harmful as they put stress on the uterus and can cause harm to the baby.

Regarding diet, it is advisable to take small frequent meals. This keeps the body well-nourished even in the face of vomiting during pregnancy. The diet should include fresh green vegetables, fruits, whole grains, nuts, milk and milk products and healthy meat products. Avoid ready to eat processed foods. Regular exercise keeps the joints supple, which is helpful during labour. One can do brisk walking, yoga, aerobic exercises, and etcetera, but only if the doctor says so.

 You should go for antenatal care as soon as possible. The doctor will examine you clinically, do uterine ultrasound and if necessary, other special tests to check whether the baby has any abnormality. Blood pressure and blood sugar are examined at the first visit and then at every antenatal visit. This is done to ensure that one does not have hypertension or diabetes.

Even if these problems exist, they can be controlled very well. Otherwise, there is risk of miscarriage, intrauterine death or the child may be born with abnormalities. Tests are also done at first visit to exclude infections like rubella, toxoplasmosis, among others, which can cause miscarriage or cause the baby to be born with abnormalities. If everything is normal, then once a month antenatal is okay, around full term, once a fortnight antenatal visit is done.  The growth of the baby and health of the mother is assessed in these visits.  Normally, a woman can gain eight to ten - kilogrammes of weight during pregnancy. Avoid becoming overweight.

It is vital to take folic acid supplements right from the beginning. These prevent anaemia and also neural birth defects in the baby. Calcium and iron supplements can be started on advice of the doctor, as need of these minerals is increased during pregnancy and subsequent lactation. If not fulfilled, one can have backache, joints pain, early softening of bones and chronic anaemia.

Ensure that you have a health insurance and enough savings as after delivery, expenses will shoot up. Look for a dependable caretaker once the baby is born, it will be a 24 hour job.

Dr. Rachna Pande is a specialist in internal medicine.

rachna212002@yahoo.