PREGNANCY IS NOT A DISEASE- ENJOY IT

This Handbook on pregnancy is primarily for those who are pregnant or are planning to become pregnant. It contains basic ideas about care during pregnancy including some warning signs which should not be ignored. Various important aspects of health during pregnancy has been covered including importance of healthy diet and regular exercise. Common discomforts during pregnancy have a1so been covered.

Recommendations and information in this Handbook are appropriate in most cases, however they are not a substitute tor medical diagnosis/consultation with your doctor.

If you are thinking about becoming pregnant, the most important thing you can do for the health of your future child is to plan well ahead. That means getting your body in the best condition possible. The more fit you are before you become pregnant, the better the chances that your child will be born healthy.

While you are pregnant, your body provides nourishment to the fetus and a safe place for it to develop and grow. Just as you will naturally want to feed and protect your infant after it is born, many things that you do during your pregnancy can benefit the fetus. On the other hand, many things you do while you are pregnant can harm your fetus. For example, eating a nutritious diet and exercising regularly are beneficial for both you and your fetus; smoking cigarettes and drinking alcohol are harmful. This book will help you understand what you can do to give your child the best possible start in life.

Several months before you get pregnant, make an appointment with your doctor. Even if you are healthy and your pregnancy is not complicated, you will need to have medical care throughout your pregnancy to monitor your condition and that of your developing fetus.

Several months before you start trying to get pregnant, look at your lifestyle to see if you have any habits such as smoking. drinking alcohol or using other drugs that could harm your fetus. The first weeks of pregnancy are especially important

Eating a healthy diet of fruits, vegetables, and whole grain breads and cereals will help you get your body ready for the demands of pregnancy It is especially important at this time to start taking 5mg every day of Vitamin B called folic acid it helps prevent your baby from having birth defects that can occur early in pregnancy.

Exercise regularly. Moderate exercise, such as brisk walking for half an hour three to four times, 1 week, will make you feel better and more comfortable through out your pregnancy and may make your pregnancy and delivery easier. If you have not been very active, it's a good idea to begin an exercise program now, before you get pregnant.

Each cigarette you smoke during pregnancy deprives the fetus of oxygen it needs to develop and grow. It is best to quit smoking before you get pregnant, but quitting at any time during pregnancy is beneficial.

Drinking alcohol at any time during pregnancy can cause brain damage and other birth defects in your fetus. Doctors recommend that you do not drink any alcohol at all if you are pregnant or are trying to become pregnant.

If you use any illegal drugs, stop using them several months before you get pregnant and don't use any during your pregnancy. If you think you may be addicted to alcohol or another drug, talk to your doctor immediately.

Some prescription and over-the-counter medications can also harm the developing fetus.Tell your doctor about any medications you are taking. You should not use any drug, including aspirin, during pregnancy without your doctor's OK.

The effects of consuming caffeine during pregnancy are not known for sure.Heavy intake of caffeine (the equivalent of more than three cups of coffee a day) may increase the risk of miscarriage.

Your best bet is to eliminate caffeine during pregnancy or reduce your consumption to one or two cups of coffee a day. Tea and soft drinks have about half as much caffeine per serving as coffee.

1. You have or think you may have an inherited disorder or birth defect.

2. You are pregnant or planning to be pregnant after age 35.

3. You have a child or other relative who has mental retardation, an inherited disorder, or a birth defect.

4. You have had two or more miscarriages or babies who died in infancy.

5. You are worried that your job, your lifestyle, or your own health may pose a risk to a fetus. For example, exposure to radiation (such as from x-rays), alcohol, or infections can harm the fetus and cause problems during pregnancy.

6. You would like to be tested for a genetic disease that runs in your family or want more information about birth defects that occur frequently in your ethnic group. You and your partner are first cousins or other close blood relatives; you are at increased risk of passing on a genetic disease to a child.

Once you consider the information the genetic counselor gives you, you and your partner may want to consider adoption rather than take the chance of having a child with a life-threatening condition.

If you do get pregnant, your doctor may recommend testing at an early stage in the pregnancy to determine if the fetus has the disorder. You and your partner can then decide if you want to continue the pregnancy. If a test finds that the fetus has a serious disorder and you decide to continue the pregnancy, your doctor can help you plan for the care of a child with special needs

About once a month, one of your two ovaries releases an egg into a fallopian tube. The egg travels down the fallopian tube to the uterus (the hollow organ in which a pregnancy develops). If you have intercourse around this time, sperm can travel up through your uterus and into the fallopian tube, where one or more sperm can fertilize the egg. After an egg is fertilized by a sperm, it travels to the uterus where it may implant itself in the lining. If a fertilized egg implants in your uterus, you are pregnant.

Most women recognize a missed period as the first sign of pregnancy. But if your menstrual cycles are not regular, you should be aware of other possible early signs of pregnancy, such as the following:

1. Nausea
2. Breast tenderness or swelling
3. Spotting or very light bleeding from your vagina
4. Flu like symptoms such as fatigue or loss of appetite
5. Increased sensitivity to odors

Even before you miss a period, as early as 11 to 12 days after conception, your doctor can give you a blood test to detect the presence of a hormone in your blood that indicates you are pregnant. However, most women are not tested until after their period is at least a few days late; by that time this pregnancy hormone can be detected in a sample of urine.

You can have the urine test in your doctor's office or do it yourself at home with a pregnancy test. If you follow the directions on the package carefully.the home test is 95 percent accurate. If your home test shows you are pregnant, make an appointment with your doctor to confirm your pregnancy and begin prenatal care. The earlier in pregnancy you begin seeing your doctor for regular checkups, the better for you and the fetus.

If the home test shows you are not pregnant but you continue to have signs of early pregnancy and you do not get your period at the expected time, see your doctor. You could have a medical condition that requires treatment.

Pregnancy is divided into three stages called trimesters. Each trimester is about 13 weeks long. A normal pregnancy lasts about 40 weeks from the time of a woman's last period. Your body goes through many changes as the fetus develops and grows. Most of the changes described below are typical, but your own experience will be unique.

The first trimester of pregnancy is the most important time in a fetus's development. By the end of the first trimester, all the fetus's major organs (including its heart, lungs, and brain), arms and legs are formed. During this time, it is especially important to protect the fetus from things that can be harmful, such as alcohol and other drugs.

Your Changing Body : Your body undergoes many changes during the first months of pregnancy. You will not have a period, but you may have some spotting around the time you would have had a period. You may feel tired and sleepy during these early months.

Your breasts may begin to enlarge and become tender. This tenderness usually goes away by the end of the first trimester. The areola, the dark area around each nipple, may become darker.By the end of the third month of pregnancy, you will probably have gained about 2 to 4 pounds enough to make your clothes feel tighter.

Many women may feel nauseous or vomit during the first trimester. Some women also experience strong dislikes of certain foods, drinks, or odors; cravings for certain food or drinks; and heartburn, indigestion. flatulence, or bloating. You may feel the urge to urinate frequently as your enlarging uterus puts pressure on your bladde.

The Developing Fetus: As soon as the fertilized egg implants itself in the wall of your uterus, the lining of the uterus (endometrium) thickens and covers the egg.The placenta (the organ that links your blood with that of the fetus and provides it with nutrients) develops inside the uterus. The fetus is connected to the placenta by the umbilical cord.The fetus is contained in a thin membrane called the amniotic sac, which is filled with a watery liquid called amniotic fluid. This fluid surrounds the fetus and provides a cushion that protects it from outside pressure or movement.

The fetus grows rapidly. By the end of the first month, the head and trunk are formed. Fingers and toes develop. By the third month,hair begins to grow and buds for teeth appear. At the end of the third month. the fetus is about 4 inches long and weighs about 1 ounce.

Many women find that the second trimester of pregnancy is the easiest and most comfortable. Your morning sickness has probably stopped by now, your risk of having a miscarriage is lower, and you have more energy than you did during the first trimester.

Your Changing Body : You should begin to feel the fetus moving and kicking inside you by about the 16th week of pregnancy. Tell your doctor when this first happens because it helps him or her predict your due date. Your abdomen will increase more rapidly in size now.Your breasts are still enlarging, but they are probably less tender. Your nipples may get darker and you may have a dark line that runs from your navel to your pubic hair. You'll probably be less hungry now.

You may feel a sensation of pulling or tugging in your lower pelvis as some supporting tissues stretch. You may have indigestion, heartburn, flatulence or constipation as your uterus grows larger and pushes on your digestive organs. You may start to feel some pain in your lower back as it works harder to support your heavier abdomen. You may have trouble finding a comfortable position for sleeping.

The Developing Fetus: The fetus now sleeps and wakes, passes urine into the surrounding amniotic fluid, and can hear sounds. Around the fifth month, the fetus has a growth spurt. Its internal organs are maturing and it is more physically active. By the end of the sixth month, the fetus will be about 11 to 14 inches long and weigh about 1 to 11/2 pounds.

You will now start to think ahead and prepare for labor and delivery. You will probably feel less comfortable now as the fetus grows from about 3 pounds to its birth weight of about 6 to 9 pounds and your uterus grows even larger.

Your Changing Body : You will probably have more trouble getting around, exercising,and sleeping comfortably and you may feel more tired. Your ankles and other parts of your body may retain fluid. Close to the end of your pregnancy, your breasts may leak a small amount of fluid in preparation for breast-feeding. In the ninth month, you may feel mild cramps (called Braxton Hicks contractions} that can last from 30 seconds to 2 minutes.These are sometimes mistaken for labor pains.

The Developing Fetus: During the last months of pregnancy.the fetus kicks and stretches, sucks its thumb and opens and closes its eyes. Its bones are hardening as they absorb calcium from your body. (So don't forget to take in 1,200 milligrams of calcium every day to make sure the fetus gets enough calcium) The fetus moves into position for birth-head down with arms and legs curled in front.

As soon as you think you may be pregnant, see a doctor to confirm the pregnancy. It is very important to see a doctor as early as possible in your pregnancy and then regularly throughout your pregnancy so that he or she can monitor your health and that of the fetus.

The first appointment with your doctor after your pregnancy is confirmed will be longer that other visits and will probably include the following:

Medical History Your doctor will ask about your general health and about any previous pregnancies you have had. He or she will want to know if you have any harmful habits, such as smoking or drinking, or if you have a health condition, including an infection,that could affect your pregnancy or delivery.

Physical Examination The doctor or nurse will measure your height, weight, and blood pressure. The doctor will give you a regular physical examination, he or she will determine the size of your uterus and check to make sure its bottom portion (the cervix) is strong enough to hold a pregnancy. If you haven't had a pap smear in the last year, you will have one during this first prenatal checkup.

Determining your due date A pregnancy usually lasts from 37 to 42 weeks, but doctors set the due date at 40 weeks from the first day of a woman's last menstrual period. If you are not sure of the date of your last period, or if your doctor thinks your uterus is larger or smaller than expected, he or she may recommend that you have an examination called an ultrasound to see how large the fetus is. The size of the fetus helps the doctor estimate your due date.

Tests At this first prenatal visit, you will have several tests, including blood tests and urine tests to check for infections or other conditions that can affect your pregnancy.

You will schedule your prenatal visits for once a month until the 28th week of pregnancy, every 2 to 3 weeks until the 36th week and then once a week until delivery. Plan for each visit by writing down questions for your doctor and bringing them with you. At most appointments, the doctor will check your weight and blood pressure, check the size of your uterus (by measuring it from the bottom to the top of your abdomen), listen to the fetus's heartbeat, and ask about anything unusual you may be feeling. You will be asked to leave a sample of urine at the doctor's office at each visit for testing. Urine tests can detect signs of possible problems during pregnancy,such as diabetes or high blood pressure.

Doctors can check the health of the fetus by listening to its heartbeat with an ultrasound transducer (a hand-held device that emits harmless sound waves through your abdomen) or with a stethoscope held against your abdomen. Sometimes the doctor has to use more sophisticated equipment to make sure the fetus does not have a problem.

An ultrasound examination is a painless and safe procedure that uses sound waves to create a picture of the inside of your uterus on a video screen. An ultrasound can help your doctor determine the age of the fetus, its position, how quickly it is growing, if it has a visible birth defect (such as a missing arm of leg), and if more than one fetus is present. During an ultrasound examination, you lie on an examining table and the ultrasound technician moves a device called a transducer that transmits sound waves into your abdomen and uterus that reflect back off the fetus and are converted into an image on a nearby screen.

You are your foetus's source of nourishment, so eating right is very important. You should take plenty of fresh fruits and green vegetables. Folic acid, a type of Vitamin B is essential for the development of foetus. Its deficiency increases the risk of birth defects. When you are planning for pregnancy start taking 5mg of folic acid tablets. Foods like green leafy vegetables, legumes (dried beans, peas), citrus fruits (like orange and grape} are rich in folic acid. Foetus also needs calcium, which can be provided by about 1 liter of milk, (f you are not taking adequate calcium in diet then supplement in form of tablet or syrup is required. You need to take one capsule/tablet of Iron everyday till delivery. Your stool will be black in colour when you are taking iron preparation. Proteins are building block of body cells and are necessary during pregnancy. Meat,eggs,fish and legumes are rich source of protein.

If you exercised regularly before pregnancy, exercise will continue to help you control your blood pressure, reduce stress, tone your muscles, and improve your mental and physical well-being. Exercise can also keep you from gaining too much weight and can help reduce constipation, which often accompanies pregnancy. If you did not exercise before becoming pregnant,you can begin a moderate walking program (three to five times a week for 30 minutes at a time), but nothing more strenuous. Starting an intensive exercise program during pregnancy may increase your risk of injuries such as sprains. Whether or not you exercised previously, talk with your doctor about exercising during pregnancy. In addition to your other activities, you should also do exercises called Kegel exercises which strengthen the muscles around your bladder to help improve their tone, Kegel exercises can also help prevent the leaking of urine that can occur later if these muscles are weakened during childbirth. For Kegel exercises, you tighten the same muscles you would tighten to stop the flow of urine. Do these exercises several times a day, whenever you think a bout it.

As your body undergoes dramatic changes during pregnancy, so may change your feelings about your sexuality. Many women have less sexual desire when they are pregnant, while other women feel sexier. Your sexual relationship with your partner is likely to change in some way. Some women, especially if they are experiencing morning sickness, fatigue and breast tenderness-may be less interested in sex during the first trimester but regain their enjoyment during the middle 3 months when these symptoms subside.

Your partner may also feel less interested or more interested in sex at this time. His image of you as a sexual partner may conflict with his image of you as a mother, or he may be focusing on his role as an expectant father and all the responsibilities that brings. Neither you nor your partner should feel guilty about being less interested in sex during this time. The most important thing is to be open with each other and communicate your feelings. You both may need some time to accept each other's attitudes and be comfortable with them. Having sexual intercourse during pregnancy will not harm the fetus. Most couples can continue to have intercourse right up to the onset of labor. As your abdomen enlarges, you may find intercourse more comfortable in position that place less pressure on your abdomen, such as side by side, you on top, or your partner entering you from behind. If you have a complication that may cause labor to begin early,your doctor may recommend limiting or avoiding intercourse and nipple stimulation. These activities can cause contractions of the uterus that may bring on labor.

It's usually safe to travel during pregnancy. If you are planning a trip, weeks 14 to 28 are probably the best time because you are not likely to have morning sickness and you will not be so large that you have trouble getting around comfortably. In the eighth and ninth months it's a good idea to avoid travel in case labor begins.Travel by commercial airline is considered safe till 36 weeks of pregnancy. Here are some things you can do to make travel during pregnancy more comfortable:

1. Plan your trip so that you will be able to get up and walk around every hour of two; this keeps your blood circulating and prevents swelling in your feet and legs.

2. Ask your doctor for a copy of your pregnancy medical records to take with you.

3. Wear comfortable, loose clothes.

4. Drink plenty of water to avoid dehydration.

5. Do not take any medicine for motion sickness, insomnia, or any other travel-related condition unless your doctor says it is OK

6. If you want to travel late in your pregnancy, check with your doctor first.

7. If you are travelling by car.always wear your seat belt.

Most of the changes your body undergoes during pregnancy are normal and healthy, but some may cause you temporary discomfort. Many of these common discomforts can be prevented or relieved with simple measures. Still, it's important to tell your doctor about any pain or other symptoms you are experiencing, no matter how minor they may seem to you. In some cases, these symptoms may mean you have a serious problem that requires careful monitoring or special treatment during your pregnancy.

For many women, tenderness and swelling of the breasts are the first signs of pregnancy that they notice even before they miss a period.This tenderness often subsides as the pregnancy continues.

What to do: A properly fitting bra with good support may help relieve the soreness. If you are planning to breast-feed, you may want to purchase nursing bras and wear them during the last months of pregnancy.

Indigestion occurs when food and acids from your stomach back up into your oesophagus (the tube that leads from your mouth to your stomach). This often occurs during pregnancy because hormones relax the muscles between the stomach and oesophagus. Your enlarging abdomen can also contribute to indigestion by pressing on your stomach and oesophagus. Signs of indigestion include heartburn (a feeling of discomfort, fullness, or burning in your upper abdomen},nausea,or bloating.

What to do: To avoid indigestion, eat several small meals during the day instead of three large ones. Avoid foods that cause gas or irritate your stomach, including spicy foods or acidic foods such as citrus fruits. Don't lie down for at least an hour after you eat and don't exercise for at least 2 hours after you eat.

Rapidly rising levels of the female hormone estrogen in the first three months of pregnancy cause nausea and vomiting in many women.The nausea usually goes away during the second trimester. These symptoms are often referred to as "morning sickness" because they usually occur in the morning (although they can occur at any time during the day or night).

What to do: Because the nausea is most likely to occur if your stomach is empty,taking the following steps may help you avoid it:

1. Get out of bed slowly in the morning;sit on the edge of the bed for a few minutes before getting up. Have some biscuits available at your bedside and eat one or two as soon as you get up.

2. Eat dry toast, crackers, a peeled apple every few hours during the day.

3. Drink plenty of beverages or soups throughout the day but avoid those that are either very hot or very cold.

4. Avoid odors that make you feel nauseous.

5. Avoid foods that are greasy, fried, or highly seasoned, especially those containing pepper, chilies, and garlic.

6. Do not take medicine without your doctor's OK.

7. Contact your doctor if your nausea or vomiting becomes severe.

About half of all pregnant women experience some constipation, Hormones released during pregnancy slow the movement of food through your digestive tract

Constipation is often most severe during the last trimester, when your enlarged uterus puts pressure on your rectum, making it difficult to pass stool.

What to do: You can avoid constipation by eating a high-fiber diet and drinking plenty of liquids.Eat a bowl of high-fiber cereal such as corn flakes for breakfast and lots of fruits and vegetables throughout the day. Drink at least eight glasses of water each day. If you have severe constipation, talk to your doctor about using a natural fiber laxative.

Constipation can put pressure on veins in the rectum, causing hemorrhoids (swollen veins in the rectum that may protrude and bleed).

What to do: Because eating plenty of fiber-rich foods and drinking fluids help relieve constipation, doing so can also help prevent hemorrhoids.Try not to strain during bowel movements.and do not use over-the-counter hemorrhoid medications without talking to your doctor.

Most women feel more tired than usual during pregnancy-especiaily during the first and third trimesters.

What lo do: Get enough sleep throughout your pregnancy, and rest.ifonlyforafewminutes.wheneveryoucan.

Lower back pain is a common problem during pregnancy as the growing uterus puts strain on the lower back.
What to do: To prevent or relieve lower back pain:

1. Do not wear shoes with heels higher than 1 inch.
2. Bend your knees when lifting do not bend from the waist.
3. Avoid lifting children and other heavy objects.
4. Rest one foot on a stool or box if you hay to stand for a long time.
5. Sleep on your side with your upper knee bent and supported by a pillow.

Many pregnant women develop cramps in their legs during the last 3 months of pregnancy,usually while they are lying down.

What to do: Stretching your calf muscles right before you go to bed and first thing in the morning may help prevent cramping in your legs. If you get a cramp in the middle of the night, get up and walk around slowly until it goes away.

You may find that your ankles and feet swell as your pregnancy progresses.This swelling is caused by the increasing pressure your enlarging uterus puts on the veins that carry blood from your legs to your heart.

What to do: To help improve the circulation of blood in your legs, try to lie down and put your feet on a raised pillow several times throughout the day, of sit with your feet elevated as often as possible. It may also help to limit the amount of salt (by avoiding pickle, processed cheese etc.) in your diet and wear support stockings.

Hormonal changes during pregnancy can cause sore, swollen gums.sometimes so severe that eating is painful.

What to do: See your dentist at least once during your pregnancy for a checkup and cleaning. To prevent gum swelling and pain, brush and floss your teeth at least twice a day.Try to limit sweets and avoid snacking throughout the day. If your gums hurt or bleed when you brush your teeth, see your dentist right away. You may need a special cleaning or treatment. If not treated, some forms of gum disease can lead to loss of teeth.

Although most of the discomforts you experience during pregnancy are normal and no cause for concern, some may indicate serious problems. Call your doctor immediately if you experience any of the following:

Any prolonged or sharp pain in your pelvis or abdomen during pregnancy may be a sign of trouble. Abdominal pain can also be a sign of a condition other than pregnancy that requires immediate treatment.

Bleeding and cramping in early pregnancy can be signs of miscarriage. Vaginal bleeding may also be a sign that your pregnancy has developed outside of your uterus, which can be very dangerous.

Gaining more than 2 pounds a week during pregnancy and sudden swelling of your feet, hands, and face can be signs of high blood pressure. If not treated, high blood pressure can worsen and cause dangerous problems for both you and your fetus.

Headaches, blurred vision, or pain in the upper right abdomen may be signs of high blood pressure, which can be dangerous during pregnancy.

Although many infections, such as the common cold, cause no problems during pregnancy, some infections can result in serious complications, including birth defect, miscarriage, premature delivery and death to the fetus. Call your doctor immediately if you think you have an infection; do not try to treat it yourself.

A miscarriage is the spontaneous termination of pregnancy before the fetus is old enough to survive outside the uterus. Miscarriage is very common-it occurs in 15 to 20 percent of all early pregnancies. The most common causes of miscarriage are abnormalities in the genetic material inside the cells of the fetus. Most of these abnormalities prevent the pregnancy from developing properly and result in a miscarriage, usually before the eighth week of pregnancy.

The main signs that you are about to have a miscarriage include cramps in your pelvic area and vaginal bleeding. In many cases, the fetus has died days or weeks before a miscarriage occurs. Some women discover that the usual symptoms of pregnancy, such as breast tenderness and nausea, begin to subside even before their miscarriage is diagnosed. Blood tests and an ultrasound examination can determine if the fetus has died.There is nothing you can do to prevent a miscarriage that is about to occur. If you have a miscarriage at home, it is important to save all of the tissue that passes out of your body and bring it to your doctor in a clean glass jar. The tissue will be examined to make sure you have eliminated all of it.lf any tissue is still in your uterus, your doctor may have to remove it in a surgical procedure called D&C The tissue may also be examined in a laboratory to help determine the cause of the miscarriage.

After a miscarriage, you can try to become pregnant again as soon as you have had one normal period. Your risk of miscarriage depends on the cause of the first one. A single miscarriage does not reduce your chances of having a healthy pregnancy the next time. A series of several miscarriages in a row may indicate a problem in you or your partner that does not affect either of you but can affect your eggs or your partner's sperm. In this case your doctor may recommend testing and treatment to help you have a successful pregnancy in the future.