Healthy mum, healthy pregnancy
ParentsCentre's expert Dr Stuart Flanagan continues his series of articles by highlighting how to ensure a healthy pregnancy. Dr Flanagan is an experienced physician who also works as a contributor and medical adviser for a number of BBC projects - you can download his biography at the bottom of this page. He will be writing monthly articles for the site, including bedwetting, Sudden Infant Death Syndrome, discussing contraception with teenagers, acne in adolescence and common diseases in childhood.
Healthy mum, healthy pregnancy
Staying as healthy as you can during your pregnancy will gives you the best
chance of delivering a healthy baby at full term. Mum's health will be
looked after by her doctor and midwife, but there's plenty every mother can
do help things go to plan from the earliest days.
Knowing that you're pregnant
For most women, the earliest sign that you're pregnant is that your periods
have stopped. You may also have feeling of nausea and morning sickness, or
tender, swollen breasts. The easiest way to confirm pregnancy is a urine test.
Over-the-counter home pregnancy testing kits can give fast and accurate
responses, and your GP or Family Planning Clinic can also test you a few days
after your first missed period.
When is my baby due?
The traditional method of calculating the due date is nine months and one week
after the first day of your last period. However, if you became pregnant
shortly after stopping the pill, or have irregular periods, an ultrasound
examination may help to predict the due date more accurately.
Antenatal care
Once you've discovered that you are pregnant, it's important
to seek medical advice so that your pregnancy will be a safe and happy one for
mum and baby. Routine tests and check-ups are usually carried out by your
doctor or midwife. Some GP surgeries run antenatal clinics, or you may attend
the outpatients' obstetrics department at your local hospital. Here,
you'll see a doctor or midwife who will carry out routine tests every month
until the 28-week stage. Then you'll attend fortnightly until the 36-week
stage, after which you'll be seen weekly until the delivery day.
Antenatal clinics
"Blood pressure checks and urine tests to detect glucose or protein will also be part of your check-ups."
The first antenatal appointment is usually at the booking-in clinic. The
doctor or midwife will confirm the pregnancy with a urine test and do some
blood tests to check your blood group and to see if you are anaemic or low in
iron. Other routine bloods include tests for syphilis and immunity
against rubella. You may also be offered a test for HIV. Blood pressure
checks and urine tests to detect glucose or protein will also be part of your
check-ups. Glucose in the urine may be the first sign of diabetes, which will
require closer investigation and treatment. Protein in the urine in the context
of high blood pressure can be evidence of a condition called pre-eclampsia,
which may require admission to hospital for monitoring.
Ultrasound scans
The first ultrasound scan of your developing baby is one of the most exciting
moments of any pregnancy. Ultrasound is a very safe way of finding out lots
about how your pregnancy is progressing. Some women may require a pelvic
ultrasound early in the pregnancy. Later in the pregnancy, the scan involves
smearing some gel across your tummy and placing the scanner on your abdomen to
get a picture of the uterus using soundwaves. It can tell us about foetal
length, heartbeat (or heartbeats if there are twins/triplets), position, sex,
expected date of delivery and any abnormalities.
Other tests
Other tests may be discussed at your antenatal clinics, but these will depend
on your circumstances. These can include an amniocentesis test, which takes a
sample of fluid from around the foetus to test for Down's syndrome and
other genetic abnormalities.
Staying healthy in pregnancy
Smoking
Stopping smoking before, during and after pregnancy is one of the best gifts
any parent can give their new baby. Smoking during pregnancy has been shown to
cause low birthweight, premature birth, and miscarriage and stillbirth. Your
doctor will be happy to offer advice and practical help like nicotine gum for
mum or dad when they decide to stop. Don't forget that it's never too
late to stop.
"Supplement your diet with a good multivitamin that includes your daily requirements of folic acid, zinc and selenium."
Diet
Pregnancy is a good opportunity for mum to review her diet and think about
improving her nutritional intake, which is now helping her baby to develop and
grow in the womb. A well-balanced diet will include a selection from all the
main food groups - carbohydrates, proteins and fats, and vitamins and minerals.
Carbohydrates include bread, potatoes, rice and pasta. Proteins include fish,
white and red meat, eggs, milk and other dairy produce. Fats come from butter,
milk and dairy products. Most vitamins can be found in the most common fruit
and vegetables.
A balanced diet doesn't need to be expensive. A bowl of cereal flavoured
with some slices of banana for breakfast will get the day off to a good start,
filling you up for the morning as well as providing energy and vitamins. A
light pasta or rice dish at lunchtime should keep you going until your evening
meal, which might include some vegetables, meat or fish. Vegetarian mums
won't lose out as long as they replace their protein intake with beans,
mushrooms, cheese and eggs, and include an iron supplement.
If you feel peckish between meals why not snack on an apple, orange or pear
instead of a biscuit? That's not to say chocolate, ice cream or sweets are
banned, but keep your treats special and perhaps indulge once a week instead of
every day. Supplement your diet with a good multivitamin that includes your
daily requirements of folic acid, zinc and selenium. You should also limit your
alcohol intake to no more than eight units spread across the week.
Exercise
"Twenty minutes of gentle swimming three times a week will build stamina for your delivery day."
Some mums may be concerned that taking exercise in pregnancy could put them
at risk of miscarriage or causing harm to their baby. In fact, if your
pregnancy is progressing normally, there's no reason why you shouldn't
simply modify your usual exercise regime, or even start a new exercise
programme.
Swimming is a very effective way of exercising gently and effectively. It will
help to build muscle strength and keep your joints supple. Twenty minutes of
gentle swimming three times a week will build stamina for your delivery day.
Set aside time afterwards to warm down with rest period. However, don't
wind down with a steep in the sauna or in a hot shower - the warm temperatures
will cause sweating which can cause an imbalance in your body fluids and may
raise your blood pressure. Make sure you drink a bottle of water after
exercise, which will replace lost fluids.
Sex
Sexual intercourse won't be harmful to your developing baby during
pregnancy. As long as the male partner isn't carrying any sexually
transmitted infections such as chlamydia, your baby isn't at risk. However,
some mothers will be advised against intercourse in certain circumstances,
particularly if the placenta is lying over the neck of the womb, or you are at
risk of bleeding after sex. Your doctor will advise you if they have
concerns.
As the baby develops and mum's tummy grows, you may need to find some new
positions which make sex more comfortable. Indeed, if your baby is a few days
overdue you might be advised to make love with your partner, as the
man's semen contains prostaglandins which can help to ripen the cervix and
induce labour in the overdue pregnancy.
In my next column I'll be looking at some of the most common complaints
that occur during pregnancy and how best to deal with them.
Dr Stuart
Flanagan's biography
- download (.doc)
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