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PREGNANCY & BIRTH

by

BhargaviSuresh
(M.Sc Human Genetics)

Dedicated to our baby

Index
1. What is Pregnancy? 2. Signs of Pregnancy 3. Warning signs of Early Pregnancy Pregnancy Loss or Ectopic

4. A New Life Begins 5. Risk Factors that may need Special Care in Pregnancy 6. Due Date

7. Prenatal Visits 8. Prenatal Tests 9. Fetal movements 10. Ultrasound 11. Fetal Heart Rate Monitoring
12. A Healthy Lifestyle 13. Changes for Partner & Family

14. Lifestyle Risks 15. Nutrition 16. Changes during Pregnancy 17. Labor 18. Birth Questions that Pregnant woman generally have.

PREGNANCY & BIRTH

About
I am a 23 year old mom-to-be and this is a brief information on pregnancy and birth. Pregnancy is an exciting time of major change. I hope this little information gives answers to very common questions a woman has about pregnancy...

--BhargaviSuresh

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What is Pregnancy?

Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. Childbirth usually occurs about 38 weeks after conception; in women who have a menstrual cycle length of four weeks, this is approximately 40 weeks from the last normal menstrual period (LNMP). The WHO defines normal term for delivery as between 37 weeks and 42 weeks. Human pregnancy is the most studied of all mammalian pregnancies.

Progression

Initiation

The process leading to pregnancy occurs as the result of the female gamete, or oocyte (egg), merging with the male gamete, spermatozoon (sperm). This process is referred to as fertilization or conception. After the point of fertilization, the fused product of the female and male gamete is referred to as a zygote or fertilized egg. Pregnancy begins with Implantation.

The process of fertilisation

Sperm and egg fusion

The fusion of male and female gametes usually occurs following the act of sexual intercourse, resulting in pregnancy. However, the advent of artificial insemination and in vitro fertilisation have also made achieving pregnancy possible in cases where sexual intercourse does not result in fertilization (e.g., through choice or male/female infertility). The first step in a new life begins with fertilization, the fusion of a woman's egg and a man's sperm. Together the sperm and egg join to form cells that will develop over time into a baby. The sex of the baby is decided as soon as the fusion takes place. XX for baby girl and XY for baby boy.

The egg is activated to begin its developmental process, and the haploid nuclei of the two gametes (egg and sperm), come together to form the genome of a new diploid organism. The sperm undergoes capacitation in the female's reproductive tract over several hours, which increases its motility and destabilizes its membrane, preparing it for the acrosome reaction, the enzymatic penetration of the egg's tough membrane, the zona pellucida, which surrounds the oocyte.

Menstrual cycle & Fertility

Menstruation is the shedding of the uterine lining (endometrium). It occurs on a regular basis in reproductiveage females of certain mammal species. The first experience of a menstrual period during puberty is called menarche. Menarche typically occurs between ages 10 and 17. A woman's fertility depends on her menstrual cycle. Changes that occur during each cycle are caused by hormonessubstances made by a woman's body to control certain functions.

Menstruation is the most visible phase of the menstrual cycle used as the limit between cycles. Menstrual cycles are counted from the first day of menstrual bleeding, a point in time commonly termed last menstrual period (LMP). The time from LMP until ovulation is, on average, 14.6[15] days, but with substantial variation both between women and between cycles in any single woman, with an overall 95% prediction interval of 8.2 to 20.5[15] days.

During pregnancy and for some time after childbirth, menstruation is normally suspended; this state is known as amenorrhoea, i.e. absence of the menstrual cycle. If menstruation has not resumed, fertility is low during lactation. The average length of postpartum amenorrhoea is longer when certain breastfeeding practices are followed; this may be done intentionally as birth control.

Nearly 10 days, from 9th to 20th day of menstrual cycle are considered as the most fertile days. Ovulation (release of the ripened ovum from the ovary) occurs between 13th to 15th day of the cycle, for a typical 28 days cycle and 4 days before and 4 days after this period is considered fertile. Egg lives upto about 24 hours and is fertile during this period. Sperm can live for about 5-6 days in the uterus, which increases the chances of conception.

Egg to Zygote

Each month, hormones direct the uterus to build up a lining of bloodrich tissue (endometrium). These hormones also send a signal for an egg to ripen in a follicle- tiny fluid filled clusters of cells in the ovaries. When the egg is ripe, it's released from an ovary and moves into a fallopian tube, one of a pair of ducts that connects the ovaries to the uterus. This process is called Ovulation. Ovulation most often occurs halfway through the cycle on day 14 of 28, for instance.

During sexual intercourse, when a man climaxes, semen spurts (ejaculates) from his penis through a tube called the Urethra. This deposits millions of sperm in a woman's vagina. After ejaculation, the sperm swim up through the cervix, into the uterus and out into the fallopian tubes. Although sperm can live inside a woman's body for up to 6 days, once an egg is released it must be fertilised within 12-24 hours.

Implantation
After an egg is fertilized, it splits into identical cells, which then split again and again 2 cells become 4, 4 become 8, and so on. Within about a week after fertilization, this tiny ball of cells, called a blastocyst , moves through the fallopian tube to the uterus. There it implants and starts to grow. Implantation usually occurs between 9 to 12 days after fertilisation. Implantation bleeding may be observed in some women.

After implantation, this fertilised egg is called an embryo for the first 8 weeks. Then it is called a fetus. The lining of a woman's uterus thickens and grows a rich blood supply to nourish the fetus. As pregnancy progresses, the uterus will expand to make room for the growing baby. By the time the baby is born, the uterus may be 60 times its normal size.

Built-in codes in the cells of the blastocyst signal the cells to changes as they multiply. Some cells grow into an organ called the placenta, which connects the baby to the mother. Some cells grow into embryo. The cells in embryo soon start become different parts of baby. the the to the

Hormones
The hormones in pregnant woman's body play a leading role in reproduction, pregnancy and birth. Each step in the creation of new life is led by these hormones: Estrogen and Progesterone Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH) Gonadotropin-releasing hormone (GnRH) Human chorionic gonadotropin (hCG)

Estrogen and Progesterone are intially produced by the ovaries and they trigger the thickening of the uterus lining during each menstrual cycle and to be shed if pregnancy does'nt occur. After an egg is fertilized, a sharp increase in estrogen and progesterone levels prevents further ovulation. FSH and LH are made by the pituitary gland, a small organ at the base of the brain. FSH causes an egg to ripen each month in one of the ovaries. LH triggers the egg's release. GnRH is also made in the brain, and signals the pituitary gland when to produce FSH and LH. HCG is made by certain cells from the fertilized and quickly dividing egg and spurs increased estrogen and progesterone production during pregnancy. It's the hormone that pregnancy tests detect.

The Placenta

The placenta is the lifesupport system for the fetus. It has small finger-like growths that tuck into the wall of the uterus. On one side of the placenta, the umbilical cord connects the placenta with the fetus.

Inside the cord are three blood vessels. One delivers blood enriched with oxygen and nutrients from the placenta to the fetus. Harmful agents, such as drugs or viruses, also can be transferred to the fetus this way. The other two blood vessels carry blood filled with water products from the baby back to the placenta.

The placenta filters waste products from the baby's blood and deposits them in the mother's blood. The mother's body then disposes off them. Blood itself is exchanged between mother and fetus. not the

After the baby is born, the placenta is expelled, which is why it is sometimes called the afterbirth.

Amniotic Fluid

The baby grows safely inside the amniotic sac. This sac is formed by two membranes: the amnion and the chorion. Inside the sac, a liquid called amniotic fluid collects to support and protect the fetus. This fluid starts forming around the tiny embryo a few weeks after conception.

At first, it's made up mostly of fluid from from the mother's body. Because the fetus swallows some of this fluid , new fluid is needed all the time. As early as 11 weeks of pregnancy, the baby's kidneys start to put out urine. After 20 weeks of pregnancy, this urine makes up most of the amniotic fluid.

The fluid also has cells that have been shed from the skin of the fetus. These cells have all of the baby's genetic material. That's why amniotic fluid is sometimes used for prenatal testing.

Cushions the fetus in jerks or accident. Creates pressure to push out on the walls of your uterus. This gives the fetus room to grow. Provides a safe, warm place for the fetus to exercise muscles and practice the movements he or she will need after birth. Fetus breathes in and swallows amniotic fluid. This helps develop the baby's ability to breathe and swallow. Protects the fetus from infection.

Functions of Amniotic fluid:

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Signs of Pregnancy

First sign of pregnancy is probably missing the menstrual period Spotting or having a very light menstrual period Feeling nauseated or queasy Having tender or swollen breasts Feeling very tired Urinating frequently Being moody Feeling bloated

Warning signs of Early Pregnancy Loss or Ectopic Pregnancy


Medical help is required if any of these symptoms exist:

Cramps or abdominal pain

severe

Spotting that lasts more than 1 day Bleeding Faintness or dizziness

An Ectopic Pregnancy occurs outside the uterus and could be a medical emergency.

Types of Ectopic pregnancies

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A New Life Begins

Stages of Pregnancy

Growthand ChangesoftheFetus

The Length of Pregnancy

A typical pregnancy lasts for 280 days, or 40 weeks, counting from the first day of the last menstrual period. A normal pregnancy can last anywhere from 37-42 weeks. Since most women ovulate 2 weeks after their period begins, the actual pregnancy is 2 weeks less.

The average pregnancy of 40 weeks is divided into three trimesters. Each trimester lasts about 13-14 weeks (or about 3 months): 1st trimester: 0-13 weeks

2nd trimester: 14-28 weeks 3rd trimester: 29-40 weeks

The First Trimester: 0-13 Weeks

The placenta develops. The major organs and nervous system form. The heart starts beating. The lungs begin to develop. Bones appear. The head, face, eyes, ears, arms, fingers, legs and toes form. Hair starts to grow. Buds for 20 temporary teeth develop.

The Second Trimester: 14-28 Weeks

The organs develop further and begin to function. Eyebrows, eyelashes fingernails form. and

The skin is wrinkled and covered with a waxy coating (vernix). The genitals develop. Fine hair (lanugo) covers its body. The fetus moves, kicks, sleeps and wakes. The fetus can swallow, hear, pass urine and suck its thumb.

The Third Trimester: 29-40 Weeks

The fetus kicks and stretches. (This activity may slow down as the fetus grows and space in the uterus decreases). Lanugo disappears. With its major development finished, the fetus gains most of its weight about half a pound (1pound = 0.453kg) each week until the 37th week. Bones harden, but the skull remains soft and flexible for delivery.

Let us see how the baby looks in different developmental stages

2 Weeks

3 Weeks

The first 2 weeks of pregnancy does not mean the woman is pregnant. The ovulation occurs at 14 days i.e.at 2 weeks. Blastocyst is formed. Amniotic sac and fetal pore appear. Pregnancy lasts about 38 weeks from conception.

The blastocyst formed is multiplying. HCG hormone starts forming from the placenta and tells the ovaries to stop releasing eggs. Amniotic fluid is starting to form. A positive pregnancy test can be observed.

Blastocyst

3 weeks old

4 weeks

5 Weeks

Baby is in the size of a poppy seed. Marks the beginning of the embryonic period. Fetus is very vulnerable. Amniotic sac, amniotic fluid and yolk sac are present.

Fetus is in the size of a sesame seed. It is made up of ectoderm, endoderm and mesoderm.

6 Weeks

Baby's heart is beating about 100-160 times. Nose, ears and mouth are beginning to shape.

4 weeks old

5 weeks old

6 weeks old

7 weeks old

8 weeks old

9 weeks old

10 weeks old

11 weeks old

14 weeks old

17 weeks old

20 weeks old

24 weeks old

28 weeks old

32 weeks old

36 weeks old

38 weeks old

40 weeks old

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Risk Factors That May Need Special Care in Pregnancy

Medical

Obstetric

High blood pressure Heart, kidney, lung, thyroid, connective tissue, or liver disease Sexually transmitted diseases (such as HIV or hepatitis), urinary tract infections caused by a virus or bacteria Diabetes Asthma Severe anemia Epilepsy disorders Obesity or other seizure

Mental health problems

Problems in past pregnancies Being younger than 15 years or older than 35 years during pregnancy Previous birth defects Multiple pregnancy (carrying more than one baby) Bleeding, especially during the second or third trimester Pregnancy-induced high blood pressure (preeclampsia) Abnormal fetal heartbeat Intrauterine growth restriction (the fetus does'nt grow at the rate it should)

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Due Date

The day your baby is due is called the estimated date of delivery, or EDD (also known as estimated date of confinement or EDC). Although only about 1 in 20 women deliver on their exact due date, the EDD is useful for a number of reasons. It is used as a guide for checking the baby's growth and the pregnancy's progress.

The due date also affects the timing of prenatal tests. In some cases, the test results depend on the stage of pregnancy. Finally, the EDD gives a rough idea of when the baby will be born. Most women go into labor within about 2 weeks of their due dates either before or after. There are a number of methods to figure the due date. They often are used together to help predict when the baby will be born.

*** Date of Ovulation


The best way to figure the age of a fetus (and thus the due date) is to know the date of ovulation. However, a woman rarely knows her exact date of ovulation unless she uses an ovulation prediction kit. Women may use these kits when they are trying to get pregnant.

*** Date of Menstruation


The due date is most often figured out by counting from the first day of the last period. This method isn't exact, though. The length of the menstrual period affects the due date. These cycles differ from one woman to another and from one month to the next.

It is a good idea to note the date of the last menstrual period on the calender to avoid forgetting the date.

To get an idea of the due date:

take the date that the last normal period started add 7 days then count back 3 months Ex: the first day of last period was January 1st. Add 7 days to get January 8th. Then count back 3 months. The due date is October 8th. This technique is based on a 28 day cycle, with conception occurring 2 weeks afterward, which does not apply to all women.

*** Size of the Uterus

At about 12 weeks of pregnancy, the top of the uterus (fundus) has grown up and out of the pelvic cavity and can be felt above the pubic bone. At 20 weeks, it reaches the navel. At term, when the baby is fully grown, it will be under the rib cage. Even early in pregnancy, the size of the uterus can help show how long the pregnancy is.

*** Ultrasound
Ultrasound uses sound waves to create a picture of the uterus and the fetus growing inside it. The size of the fetus can be measured to figure its age. During the first half of pregnancy, ultrasound can be used to set the age of the fetus within a week or so. Later on, htis method is reliable.

*** Fetal Heartbeat


The doctor also may be able to tell how far along the pregnancy is by hearing the fetal heartbeat. By about 12 weeks, the doctor may be able to hear the baby's heart by using a Doppler ultrasound device. This device uses a form of ultrasound to convert soundwaves into signals that can be heard.

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Prenatal Visits

The timing of prenatal visits depends on the health and special needs in pregnancy. Healthy women with more no known risk need fewer visits than women with obstetric problems. As long as the mother and baby are both doing well, checkups often follow a basic schedule. From the first prenatal visit to 28 weeks of pregnancy, checkup for every 4 weeks is done.

From 28 to 36 weeks of pregnancy, checkup every 2-3 weeks. After 36 weeks of pregnancy until birth, weekly checkup. Following items checked at each visit:

are

Height of the uterus to gauge the baby's growth Face, ankles, hands, and feet for signs of swelling Fetal heartbeat (after about the 12th week) Position of the fetus (later in the pregnancy)

Weight Blood pressure Urine to detect protein and sugar

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Prenatal Tests

Lab Tests
To confirm the findings of a home pregnancy test, the blood or urine may be tested for the hormone human chorionic gonadotropin (hCG). Also, the doctor can order lab tests to check for any diseases or infections. These tests may include:

Urine tests. Urine is collected to look for sugar, protein


and bacteria. Their presence can signal diabetes or a bladder or kidney problem.

Blood tests. Blood is


checked for anemia and infection. All women are tested for HIV (human immunodeficiency virus) infection. Most women are also tested for syphilis and hepatitis B virus surface antigen and other sexually transmitted diseases (STDs). Blood type and Rh factor are also noted.

Pap test. The cells from


the cervix collected during a pelvic exam may be examined for signs of infection, cancer, or conditions that could lead to cancer. Samples also may be collected to check for infections, such as chlamydia or gonorrhea.

Glucose screening test.


This test measures the glucose level in the mother's blood to test for gestational diabetes.

Human immunodeficiency virus testing. There are


several types of HIV tests. The most common test called ELISA searches for HIV antibodies in your blood. If this test result is positive, another test called the Western blot is used to confirm the results.

Group B streptococci (GBS) testing. The cells


from the mother's vagina and rectum are tested for GBS infection, which can be passed to the baby during delivery.

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Fetal movements

In mid pregnancy, a new sensation: a gentle flutter of the baby moving inside will be felt. The first time the feeling of the baby move is called Quickening, and it's likely to be one of the most thrilling moments of pregnancy. It usually occurs between 16 and 20 weeks of pregnancy. In first time mothers, it is felt towards the end of 20 weeks.

The feeling may vary from woman to woman. During the second half of pregnancy, the baby's soft movements will become stronger and more lively a sign of fetal well being. Kick counts may be recorded to gauge the baby's movements.

Kick Counts / Fetal movement Counts

The pregnant woman are asked to keep track of baby's movements. Each baby has its own level of activity, and most have a sleep cycle of 2040 minutes. A time has to be chosen when the fetus is usually active, and the time taken for the fetus to make 10 movements has to be noted.

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Ultrasound

Ultrasound is energy in the form of sound waves. It creates pictures or sounds of the baby from sound waves. No harmful effects to either the mother or the baby have been found. In case the mother is at risk, the doctor may suggest an ultrasound exam every 2-4 weeks to check the rate of growth.

When is it used?
Ultrasound can provide useful information about the fetus's health and wellbeing, such as the following:

Amount of amniotic fluid in the uterus Number of fetuses Some birth defects Length of the cervix In the first trimester, it may be used to help find out the reason for bleeding or pelvic pain To confirm the dates of pregnancy.

Age of the fetus Growth of the fetus Location of the placenta Fetal position, movement, breathing and heart rate

How is it done?
The doctor or a technician will perform the ultrasound exam by using a device called a transducer. It directs the sound waves into the body. There are two types of transducers: one that is moved around by the hand on the outside of the abdomen and one that is placed in the vagina.

Abdominal ultrasound

The mother will lie with abdomen exposed from the lower part of the hips to ribs. The technician puts gel on the abdomen to improve the contact between transducer and the skin surface. It is then moved on the abdomen, when the sound waves sent out from it enter the body and reflect back when they make contact with the internal organs and the baby. They are changed into pictures that appear on a screen that looks like a TV.

Vaginal ultrasound

The vaginal transducer is inserted in the vagina to help view the pelvic organs and the baby. Ultrasound with a vaginal probe may feel like the exam for a Pap test. It differs from an abdominal ultrasound as it looks at the pelvic organs from inside the vagina. Used to detect placenta previa, pelvic pain, abnormal bleeding, fibroids , polyps , ovarian cysts or tumours, infertility, assessment of early pregnancy.

Special cases

Detailed/ Comprehensive ultrasound exam is done


to look at specific areas of concern, such as the baby's heart or spinal cord. This exam may be done if the fetus is at increased risk for births defects based on family history or other test results. It is also used to screen for birth defects in early pregnancy.

Sometimes a special ultrasound test called Doppler flow is used to check the blood flow in the umblical cord. This test is also called Doppler velocimetry. It uses a special kind of ultrasound that allows the doctor to both see and hear the wave form produced by ultrasound.

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Fetal Heart Rate Monitoring

There are three methods of fetal heart rate monitoring:

1. Auscultation involves
listening to the baby's heartbeat at certain times

Electronic Monitoring
2.

Fetal

uses equipment to record the heart rate on an ongoing basis

3. Biophysical profile
uses a combination of values to assess the fetus

Auscultation

The baby's heartbeat can be heard with auscultation. It is done with Doppler ultrasound. Doppler ultrasound changes sound waves into signals that can be heard. With Doppler ultrasound, a small, handheld device is pressed against the abdomen to detect the baby's heart beat.

Electronic Fetal Monitoring

Fetal heart rate is assessed to monitor the fetal well-being before labor starts: 1. Non-stress test 2. Contraction stress test Both these tests measure the fetal heart rate in response to some form of stimulus and use the Doppler ultrasound device.

When the fetal heartbeats are reflected, they make sounds that can be heard. These signals are shown on a graph.

Biophysical Profile
It assesses fetal well being in these five areas:

The nonstress test Breathing movements Body movements Muscle tone Amount of amniotic fluid (Amniotic fluid index is measured using ultrasound)

4D Ultrasound images of the fetus

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A Healthy Lifestyle

A healthy lifestyle during pregnancy is the best thing for the mother and the baby.

Exercise
Exercise during pregnancy can benefit the mother's health in the following ways:

Increases energy Relieve constipation, leg cramps, bloating and swelling Lift the spirits Helps to relax

Improves posture Promote muscle tone and stamina Control gestational diabetes Improve sleep Prepares the mother for labor and delivery Helps in getting back in shape after delivery Relieve pregnancy related aches and pains Makes muscles sronger

Warning Signs when to Stop Exercise

Dizziness or faintness Increased breath Chest pain Trouble walking Calf pain or swelling Headache Vaginal bleeding shortness of

Uterine contractions that continue after rest Fluid gushing or leaking from the vagina Decreased fetal movement

Uneven or rapid heart beat

Infections

Viruses such as German measles (rubella), and chickenpox (varicella) can cause miscarriage or birth defects if a woman is infected during pregnancy. Most women are immune to these diseases or have a vaccination against them before they become pregnant.

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Changes for Partner and family

Pregnancy is a special time for a couple. The old roles are shifting and the new roles of mom and dad are to be adapted. Pregnant woman spends a lot of time thinking about the baby, but time should be made for her partner too. Sharing the feelings and talking to one another and giving support to one another is very important for a couple.

Couple can go to prenatal visits and tests together. Other siblings and parents need to be involved in the discussions about the pregnancy and baby.

Sex:

Feeling more or less desire for sex during pregnancy are common. During the first and last months, nausea and fatigue may get in the way. Should be open and honest with the partner.

Talking can bring the couples closer and avoid hurt feelings and loneliness. Having intercourse or orgasm will not harm the baby. The fetus is safe in the uterus and will not be harmed by sexual relations. The amniotic sac protects the fetus and the cervix shields the baby from germs.

Unless the doctor has told not to, having sex throughout pregnancy is safe. As the belly grows, though, certain positions may be more comfortable for the mother: the sidelying position, the woman-ontop position, the man-behind position.

Doctor may advise to limit or avoid intercourse if these conditions exist:


Preterm labor or birth Placenta previa Infection Vaginal bleeding Discharge fluid of amniotic

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Lifestyle Risks

Teratogens are agents that cause birth defects when a woman is exposed to them during pregnancy. They include certain medications, chemicals and infections. They can prevent the fetus from growing normally and can cause defects of the brain or body. Their effect depends on the level of exposure and when in pregnancy it occurs. Tobacco, alcohol and illegal drugs are also harmful.

If a woman is addicted to harmful substances, it may be hard to stop. It is important for a woman to try to quit for her sake and the sake of her baby. Certain medications (including prescription medications) and drugs are known to be harmful to the baby if exposed to them during pregnancy. If often depends on the amount exposed or when in pregnancy the fetus is exposed.

The following are to be avoided:


Alcohol Androgens and Testosterone Coumarin by-products Carbamazepine Anti-folic aid drugs Cocaine Diethylstilbestrol (DES) Lead

Lithium Organic mercury Phenytoin Streptomycin and Kanamycin Tetracycline Thalidomide Trimethadione and Paramethadione Valproic acid Vitamin A and it's byproducts (isotretinoin, etretinate or retinoids)

Smoking

If a woman smokes when she's pregnant, her baby is exposed to harmful chemicals such as tar, nicotine and carbon monoxide (CO). Nicotine causes blood vessels to constrict, so less oxygen and nutrients reach the fetus. CO lowers the amount of oxygen the baby receives.

Women who smoke during pregnancy are more likely to have certain problems:

An ectopic pregnancy Vaginal bleeding Problems with the way the placenta attaches to the uterus A still-birth A low-birth-weight baby (<5.5 pounds) Breathing secondhand smoke raises the risk of asthma and Sudden infant death syndrome (SIDS)

Alcohol

The degree of harm depends on the amount of alcohol consumed. It's best to stop drinking before getting pregnant because the effect is greatest during early pregnancy, when many of the baby's organs are forming. When a pregnant woman drinks alcohol, it quickly the fetus.

The same amount of alcohol that's in her blood is in her baby's blood. In an adult, the liver breaks down the alcohol. But a baby's liver is not yet able to do this. Thus, alcohol is much more harmful to a fetus then it is to an adult. It increases the chance of having a miscarriage or a preterm baby. Alcohol abuse during pregnancy is a leading cause of mental retardation.

Drinking in pregnancy causes fetal alcohol syndrome. These babies have:

Small bodies (even with special care, their growth doesn't catch up) Problems with joints and limbs (such as clubfoot) Heart defects Abnormal facial features Behavioral problems, including hyperactivity, anxiety and poor attention span Low IQ

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Nutrition

A well balanced diet is crucial to good health. It is even more important during pregnancy, when there are added demands on the body to meet the needs of the growing fetus. A good diet can help ensure the health of the mother and the growth of the baby. A few extra calories will be needed.

Food pyramid

Getting the Nutrients needed by the mother

Calories to help nourish the growing baby. Iron and folic acid to help make the extra blood needed in pregnancy. Protein to help make blood and build the baby's tissues and muscles. Calcium to help build the baby's bones and teeth.

Protein

Protein provides the nutrients the body needs to grow and repair muscles and other tissues. It is the building block for the baby's cells. Pregnant woman need 60 grams of protein per day. Protein comes from animals meat, fish, poultry and dairy products.

These animal foods are rich in protein:


Beef, pork and fish Chicken Low-fat milk

Grains & legumes are good sources of proteins. Dairy products and eggs are also good sources of protein for vegetarians.

Vitamins and Minerals


Vitamins (A, D, E, K, B and C) and minerals (iron, magnesium, potassium, calcium, phosphorus, sodium, zinc, etc.) are required for the maintanance, health and proper functioning of the body.

Green leafy vegetables, egg, fish, meat, pulses and fruits are sources.

They help in the health and maintainance of skin, hair, blood, bones and metabolism of the mother and fetus during pregnancy.

Carbohydrates

Food sugar carbohydrates is the body's main source of energy. There are two types of sugar: simple sugars and starches. Simple sugars are found in table sugar, honey, syrup, fruit juices, hard candies and many processed foods. They provide a quick energy boost.

Starches are a more complex form of sugar. They provide longer-lasting energy than simple sugars. They are foundin bread, rice, pasta, fruits and starchy vegetables such as potatoes or corn. They also contain fiber. Fiber helps flush out the digestive system and helps prevent constipation. It also helps rid of excess fat and cholesterol in the body.

20-30 grams of fiber per day is needed. They are good sources of fiber:

Fruits (dried fruits, berries, oranges and apples & peaches with skin) Vegetables (such as dried beans and peas) Whole-grain products (such as whole-wheat bread or brown rice)

Fats

Fats help the body use vitamins A,D,E and K, as well as proteins and carbohydrates. Fat that is not used by the body is stored as fat tissue. This tissue is converted into energy when the body needs more calories than taken. Those fat stores will play a role in making breast milk for the new born.

Different types of fats in diet:

Saturated fats come mainly from meat and dairy products. They are solid chilled. ex. Butter, lard, shortening, palm oil, coconut oil, etc. Trans fats are a kind of saturated fat. Trans fats are made when liquids are turned into solid fats like shortening and hard margarine.

This is done to make foods last longer and for better flavor. ex. Vegetable shortening, some margarines, crackers, cookies, potato chips, etc.

Unsaturated fats tend to be liquid and come mostly from plants and vegetables. ex. Olive, canola, peanut, sunflower and fish oil.

Water

Most people dont think water as a nutrient. It serves many purposes in the body:

Builds new tissue Allows nutrients and waste products to circulate within and out of the body Aids digestion Helps form amniotic fluid around the baby

Nearly 3/4th of the body weight is water. Water is lost through sweat, urine and even breathing. Drinking water throughout the day is very essential for a pregnant woman to replace the water lost from the body. Other liquids like fruit juice can stand in for some of the water needed each day.

Iron

Iron is used to make hemoglobin. This protein in red blood cells carries oxygen to the organs, tissues and baby. Just like other cells in the body, blood cells die and are replaced in a constant process. The iron from the blood cells is used to make more hemoglobin.

A pregnant woman may not have enough iron stored in the body to make the extra blood she and her baby needs, causing anemia. Woman need more iron in their diets during pregnancy to support the growth of the baby and to produce extra blood. Getting plenty of iron when pregnant is a must.

Iron rich foods include lean beef and pork, organ meats, dried fruits and beans, whole grains and dark leafy greens. Vitamin C helps the body absorb the iron in food. However, calcium can block absorption. For this reason, iron and calcium should not be taken at the same time. It is a good idea to take iron in the morning and calcium at night.

Folic acid

It is used to make the extra blood the body needs during pregnancy. Lack of folic acid or not getting enough folic acid in diet before conception and in early pregnancy increases the risk of birth defects such as neural tube defects (defects of the spine and skull, like Spina Bifida).

Pregnant woman (or woman planning to) should consume 0.4mg of folic acid a day. Pregnant women with twins or who have certain medical conditions may need increased amounts of folic acid. Woman who has a hild with neural defect should take 4mg folic acid daily from at least 1 month before conception upto 12 weeks of pregnancy.

Calcium

It is used to build the baby's bones and teeth. If the mother doesn't get enough of calcium from food, the baby will get the calcium it needs from the mother's bones. That can lead to osteoporosis (fragile bones). It may also cause loss of teeth. Pregnant woman should get 1000mg of calcium (3 cups of milk/day) per day. (1300mg for <19years).

Milk and dairy products like cheese and yogurt are the best sources. Others include:

Fortified orange juice Nuts and seeds Sardines Salmon with bones Turnip greens, kale, mustard, collard, drumstick leaves and spinach.

In case of lactose intolerance (trouble digesting milk products), calcium may be observed in other ways. Pills or drops with an enzyme that help the body break don milk sugar can be taken. Taking an antacid with calcium is another way to boost up calcium intake. Iron prevents it from being absorbed, so both should not be taken at the same time.

16
Changes during Pregnancy

During pregnancy, the uterus grows from the size of the fist to a size able to hold a baby upto 10 pounds. It grows to about 60 times it's normal size. Other parts of the body also are changing. Many of these changes are triggered by pregnancy hormones. These hormones nurture the fetus and prepare the body for childbirth and breastfeeding. They also can cause physical and emotional changes.

Physical Changes

Backache

It is one of a pregnant woman's most common problems, especially in later months. Strain on the back muscles from carrying extra weight, posture of the woman, stretched and weakened abdominal muscles (which support the spine) are causes of backache.

Exercises to stretch and strengthen the back muscles can help reduce this pain.

Breast Changes
Early in pregnancy, the breasts begin changing to get ready for feeding the baby. For many woman, tingling, tender, swollen breasts are the first clue that they are pregnant. By 6 weeks of pregnancy, breasts may grow a whole bra-cup size. Most women's nipples stick out more during pregnancy.

Some women have nipples that are flat or even recessed (inverted nipples). By the end of the first trimester, the breasts may start leaking. This fluid, called colostrum, is normal. Colostrum nourishes the new-born until the breasts start making milk a few days after birth. It is rich in fat and calories and contains water, proteins, minerals and antibodies that protect against disease.

Changes in breast:

Fat builds up, making bra too tight. Blood flow inreases, causing bluish veins to appear just under the skin. Number of milk glands increases to increase milk production. The nipples and areolas darken and grow larger and stick out. Small glands (Montgomery's tubercles) keeps nipples and areolas soft and supple.

Early in pregnancy, colostrum is thick and yellow. As birth draws near, it becomes pale and has almost no color.

Congestion Nosebleeds

and

During pregnancy, the hormone levels increase and the body makes extra blood. Both these changes cause the mucus membranes inside the nose to swell up, dry out and bleed easily. Stuffy or runny nose or nosebleeds may be noticed.

Constipation and Gas


Constipation occurs due to infrequent bowel movements with stools that are firm or hard to pass. When that happens, gas can build up in the belly and cause bloating and pain. Hormone progesterone and iron supplements may worsen the condition. Exercise, drinking plenty of water and eating high-fiber foods may help.

Leg Cramps
During late pregnancy, a sharp, painful cramp in the calf are thought to be caused by the amount of calcium or potassium in a woman's diet, but it is not true. Clear cause is not known.

Hemorrhoids
Pregnant woman who are constipated often have hemorrhoids. These are painful and itchy varicose veins in the rectal area. The main causes are the extra blood in the pelvic area and the pressure the growing uterus puts on the veins in the lower body. Applying ice to relieve pain, drinking plenty of water and eating high-fiber foods can cause relief.

Frequent Urination
During pregnancy, the kidneys work hard to flush out the waste from the body. This causes frequent urination. Other causes are pressure on the bladder by the growing uterus, caffiene and weight of the uterus and 'lightening' (due to pressure of the baby's head against the cervix and bladder).

Headaches
Pregnancy hormones, hunger and stress are common causes.

Mouth and Tooth changes


Watering in the mouth, swelling and bleeding of gums are common. There is an increased risk of cavities and gum disease.

Heartburn and Indigestion


Pregnancy hormones, which relax the muscle valve between the stomach and the esophagus is the main cause.

Insomnia
After the first few months of pregnancy, it is hard to sleep at night due to larger abdomen.

Lower-Abdominal pain
As the uterus grows, the round ligaments are pulled and stretched, causing pain. These pains are common between 18 and 24 weeks of pregnancy.

Fatigue
Tiredness is common in early and late pregnancy. The pregnancy hormone progesterone may cause tiredness. Exercise and healthy diet may help boost the energy.

Nausea and Vomiting


Also known as morning sickness, increasing levels of hormones during pregnancy are the main cause.

Numbness Tingling Shortness of Breath

and

Skin and Hair changes


During pregnancy, the body produces more melanin. Acne, Chloasma (brownish marks around the eyes and on nose and cheeks), Linea nigra (an extra pigment that causes a faint line running from the belly button to the hair), Red palms and spider veins, Skin tags, Stretch marks and Thicker hair are the common changes.

Linea nigra

Swelling
Some swelling (called edema) in the hands, face, legs, ankles and feet are normal during pregnancy. It is caused by extra fluid in the body.

Vaginal Discharge
It often increases during pregnancy. A sticky, white or clear discharge is normal. Douching should not be done when pregnant.

Varicose Veins
The weight of the uterus pressing down on a major vein can slow blood flow from the lower body. The result may be sore, itchy, blue bulges on the legs called varicose veins. These veins can appear near the vagina or rectum.

Emotional Changes, changes in the body shape and size and physical differences from the first time pregnancy are common. Children need to be made aware of the baby, new family member and should make them welcome the new sibling.

17
Labor

A pregnant woman's body has gone through some big changes during the past 40 weeks. It will go through a few more nearer to birth.

Once labor really starts, things may move quickly. Water may break, contractions will come faster and more often and the baby will be born within hours.

Getting Ready
Labor may go more smoothly if planned ahead of time. Practicing exercises such as breathing, relaxation, stretching or medication.

It is safe to pack a bag for the hospital, a few weeks before the due date. A bag for labor and another bag for needs after delivery need to be packed.

Transportation, distance, time of the day and other concerns such as family members are need to be taken care of.

Labor

Certain in the body signal that labor is near. But some women do not have any of these signs before labor begins. The medical term labor includes contractions in the uterus and cervix before the baby is born, baby's birth and the delivery of the placenta.

The first stage of labor begins with the cervix beginning to thin out (efface) and open (dilate). The first contractions may be felt at this stage. During contractions, pain or pressure occur start in the back and moves around to the lower abdomen. Belly will tighten and feel hard. Between contractions, the uterus relaxes and belly softens.

These contractions are doing vital work. They help open (dilate) the cervix. They also help push the baby lower into the pelvis. As labor proceeds, the contractions last longer, become more intense and occur closer together. Certain physical changes are key signs of progress toward birth.

With the first baby, labor lasts longer for 6-12 hours. After the first baby, labor is shorter, about 4-8 hours. The first labor has 2 different phases: [1] early labor (cervix dilates to 4cm), [2] active labor (cervix dilates from 410cm). At the end of the first labor, the body is ready for the baby's birth and the mother starts pushing.

True versus False Labor

During the last month or two of pregnancy, many woman have periods of false labor. False labor pains are called Braxton Hicks contractions. They often occur in the afternoon and evening, after physical activity and sexual intercourse. The time between contractions will help tell if it is true or false labor.

Labor signals that need attention:

Symptoms of labor before 37 weeks of pregnancy. Water (the fluid-filled amniotic sac that surrounds the baby during pregnancy) breaks. Have vaginal bleeding. Have constant, severe pain, with no relief between contractions. Have fever or chills. The baby seems moving less. to be

These following conditions are needed to be considered by the doctor during labor:

Heart rate and blood pressure. This will give


clues on how well the body is handling the stress of labor.

Dilatation of the cervix.


From time to time, the doctor will examine the cervix to see if it is dilated.

Fetal

Contractions.

The time and length of contractions help to monitor the progress of labor.

An electronic fetal monitor or a special stethoscope called a fetoscope is used to check the baby's heartbeat often during labor.

heart

rate.

The First Stage of Labor


The first stage of labor, before the delivery has two distinct phases:

Walk, have a shower, try to relax and rest, and sleep if you can.

Early labor (cervix dilates from 0-4cm)

Active labor (cervix dilates from 4-10 cm)

Mild contractions begin. They are 5-15 minutes apart and each one lasts 60-90 seconds. Contractions gets closer together gradually. They become less than 5 minutes apart towards the end of early labor.

Contractions get stronger. They come at 3min apart and last for about 45 seconds. They become more intense in case water breaks. Little bleeding may be observed from vagina, as cervix opens. Baby's head seems to press down the backbone and this gives back pain. Legs may cramp, nausea and vomiting may occur.

How long it lasts?

About 4-8 hours, on average.

What you can do?

Ask someone to massage the back. In case of leg cramps, ask to have your feet flexed. If you feel like lying down, lie on your side. Being flat on the back will add to pain and cut down on the oxygen the baby gets. Ask for pain relief if wanted. If you feel the urge to push, tell the doctor. Don't give in the urge just yet- your cervix isn't fully dilated. Pant or blow to keep yourself from bearing down.

With doctor's advice, walk along. Urinate often. An empty bladder gives more room for the baby's head to move.

Work with the labor coach through each contraction. Take the contractions one at a time. Focus on the breathing and relax.

Helping Labor Along


Labor induction may be done in case:

Water has broken Pregnancy is postterm (>42 weeks) Having high blood pressure Health problems such as diabetes that could effect the baby Chorioamnionitis (an infection in the uterus) Baby has growth problems

Pain labor

relief

during

There are 2 types of painrelieving drugs analgesics & anesthetics. Analgesia is the relief of pain without total loss of feeling or muscle movement. Anesthesia blocks all feelings including pain. In most cases, analgesia is given to women in labor or after surgery or delivery, whereas anesthesia is used during and right after a surgical procedure such as cesarean delivery.

18
Birth

Many women are nervous about the prospect of delivery. For instance, if the baby has a problem exiting the birth canal, a cesarean delivery may be needed. No matter how the birth proceeds, a healthy baby is the main goal.

Delivery

The second stage of labor, as the baby's birth is called, starts when the cervix has opened fully to 10cm. With each contraction, the urge to bear down increases. Doctor examines if the cervix is fully dilated and if its done, then you will be shifted to the delivery room.

Once the doctor gives you the go-ahead, bear down with each contraction or when you are told to push. As the baby moves down the birth canal, the doctor will tell how to help your baby along. The vagina is a very elastic organ. Sometimes, a few good pushes is all it takes before a baby is born. Other times, it may take hours before the baby is born.

When the baby's head appears at the opening of the vagina, burning and stinging feeling occurs as the perineum stretches and bulges. This is normal. Sometimes it is hard for the baby's head to fit through without tearing the skin at the opening to the vagina. To help prevent these tears, the doctor may perform an episiotomy. This is a small cut to widen the opening of the vagina.

Episiotomy may also be needed if the baby needs to be delivered quickly. The area is numbed with a local anesthetic before the cut is made. However, most women will not need it. After the head emerges from the birth canal, the baby's body turns. First, one shoulder slips out, and then the other. After the shoulders are delivered, the rest of the baby's body follows quickly.

The Second Stage of Labor


Once the cervix is fully dilated, you can begin to push the baby out. After the baby is born, the placenta will be expelled. The Second Stage

You feel pressure and stinging in the vagina as the baby's head crowns. The baby's head emerges. The doctor guides the baby's shoulders and body out of the birth canal. This second stage lasts from 20 minutes to 3 hours or more.

Contractions may slow. They are 2-5 minutes apart and last 60-90 seconds. Contractions usually are regular. You feel the urge to push or bear down with each contraction. You feel great pressure on the rectum from the baby's head.

The Third Stage of Labor: Delivery and Afterbirth


The Third Stage

Contractions keep coming. They are less painful, though. The placenta peels away from the wall of the uterus. The placenta and amniotic sac are pushed out through the vagina. Contractions cause uterus to get smaller. the

The doctor cuts the umbilical cord. If you had an episiotomy or tear, it's stitched closed. You may shake or shiver. The third stage of labor lasts from a few minutes to about 20 minutes.

Afterbirth
After the newborn is delivered, one more part of labor remains. Delivery of the Placenta (often called the Afterbirth) is called the Third stage of labor. This last stage of labor is the shortest of all.

Forceps and Vacuum Extraction

In some cases, the doctor may nees to help delivery along by using forceps or vacuum extraction. This is done in about 1 in 10 vaginal deliveries for various reasons like the slow down in baby's heartbeat or if the woman could not push or the baby's position makes delivery harder.

Forceps are two large spoons inserted into the vagina. The doctor places the forceps around the baby's cheeks and jaw and gently guides the baby's head out of the birth canal. In vacuum extraction, the doctor inserts a special suction up into the vagina and presses it to the baby's head, that holds the baby's head and a handle assists the baby out.

Cesarean Birth

In 1 in 4 cases, a baby is born by cesarean delivery. This means the baby is delivered through an incision in the mother's abdomen and uterus. A cesarean birth may be planned ahead of time because of certain problems. Also, issues may come up in labor that make a cesarean birth a safer choice than a vaginal birth.

A cesarean birth may be needed in the following situations:

Umbilical cord problem Placenta problems Labor fails to progress Labor is too stressful for the baby.

Previous cesarean birth Certain medical conditions (like an active genital herpes infection) Multiple pregnancy Large baby or a small pelvis Breech position

A cesarean birth proceeds as follows:

To numb pain during surgery, an epidural, a spinal block or general anesthesia is given according to the woman's choice. She will monitored to track her breathing, heart rate and blood pressure. Oxygen is given during surgery. A nurse prepares the woman for surgery.

The woman's abdomen will be washed and if needed, hair between the pubic bone and navel may be trimmed. A catheter will be inserted into the bladder to keep it empty so that it is not injured during surgery. The abdomen will be cleaned with antiseptic. A 4-6 inch incision is made from side to side, just above the pubic hairline.

The doctor spreads aparts the abdominal muscles and cuts through the lining of the abdominal cavity. When the doctor reaches the uterus, another cut is made in the uterine wall. This can be either transverse (done in the lower, thinner part of the uterus and causes less bleeding and heals with a stronger scar) or vertical (done in case of placental previa or unusual position of the woman).

The woman should ask the doctor which type of incision was made, so that she will know if she will be able to give birth to her next baby vaginally. The doctor lifts the baby out through the incisions and the umbilical cord is cut and the placenta is removed. The uterus and abdominal wall are closed with stitches that dissolve in the body and dressing is done.

Risks in a cesarean delivery include:

Infection in the uterus, pelvic organs or abdominal incision. Blood loss, but rarely enough to require a blood transfusion. Blood clots in the legs, pelvic organs or lungs. Injury to the bowel or bladder.

After Delivery

The baby will be held with his head down to keep fluids from getting into the lungs. The baby's nose and mouth are cleared of fluid with a small bulb syringe. The doctor will put a clamp on the umbilical cord close to the baby's abdomen and the cord will be cut. If you wish to store or donate cord blood, it will be collected now.

Then the baby is given to the mother to hold. The baby is examined and weighed and assured he is in good health.

Baby Bonding
This is the most precious moment of happiness to the parents and the new mother and father welcome their little bundle of joy.

It is time for the bonding with other siblings and the rejoicement of the family members too.

Questions that Pregnant women generally have...

1. Are Hot Tubs, Baths and Saunas Safe?

A warm bath can be safe and relaxing during pregnancy. But it is not safe to exercise until overheated during pregnancy. Should not get overheated in a hot tub, very hot bath or sauna. During pregnancy, core body temperatureshould not increase above 102.2F (39C) for more than 10 minutes.

2. Is it safe to travel during pregnancy?


Before planning a trip, it's a good idea to check with the doctor about safety measures to take during travel. Most woman can travel safely until close to their due dates. If travel poses a risk, it is wise to change plans in case of conditions that require bed rest like placental previa, marginal placental abruptions, previous abortions, etc.

The best time to travel is mid-pregnancy (14-28 weeks of pregnancy). After 28 weeks, it's often harder to move around or sit for a long time.

Choosing the mode of travel and the duration of travel is important. The fastest way is often the best.

3. Is it safe to use hair dye during pregnancy?

Many woman worry that using hair dye during pregnancy may be harmful to their babies. But hair dyes are believed to be safe to use during pregnancy.

4. Does Caffeine cause problems during pregnancy?

There is no proof that small amounts of caffeine (for instance, 1 or 2 cups of coffee) harm the fetus. It is a stimulant and a diuretic (it increases urine production). It may be helpful to avoid it in the afternoon and evening if it keeps away from sleeping at night. It is found in coffee, soft drinks, some teas and chocolate.

5. Is it safe to eat fish during pregnancy?

Fish and shell fish are important parts of a healthy and balanced diet. They are good sources of protein and other nutrients. Fish that have high mercury levels like shark, swordfish, king mackerel or tilefish should not be eaten. These large fish contain high levels of methylmercury. It is safe to eat 1 or 2 servings of salmon, sardines, herring or bluefish per month.

6. What is Listeriosis?

It is caused by bacteria found in certain foods which are unpasteurised like milk, hot dogs, luncheon meats and smoked seafoods. It causes flu-like symptoms such as fever and chills. It can lead to miscarriages and cause problems to baby. Avoiding such foods and maintaining hygiene can help in preventing it.

7. Where does the weight come from?

The average new born weighs 7.5 pounds (1 pound= 0.45 kg). Yet, most mothers-to-be are advised to gain 25-35 pounds when they are pregnant. For a woman who gain 30 pounds during pregnancy, a break down of the weight gain is given below:

Baby-----------7.5 pounds Amniotic fluid---2 pounds Placenta-------1.5 pounds Uterus------------2 pounds Breasts-----------2 pounds Body fluids------4 pounds Blood-------------4 pounds Maternal stores of Fat, Protein and other nutrients --- 7 pounds

8. What are the warning signs of a Urinary Tract Infection?

Pain when urination Feeling like you urinate right away Blood in the urine Fever Back pain must

9. What is Banking Cord Blood?


The blood in a baby's umbilical cord contains stem cells. These cells can be transplanted into a person with matching genes to treat diseases such as leukemia and other forms of cancer. The cord blood is collected after the baby is born and the umbilical cord has been clamped. This is also known as Stem Cell Banking.

10. Is it advised to drink saffron milk during pregnancy?

During pregnancy, elders advise to drink a glass of saffron milk every day to ensure a fair baby. This is a myth and there is no scientific evidence to support. The complexion of your baby purely depends on genetics and not the kind of food you consume during pregnancy. If you or your husband is fair, then your baby may inherit a fair complexion. There is no harm in drinking saffron milk. You can start taking it at any time during pregnancy. Milk is an excellent source of proteins and calcium, and saffron is therapeutic in nature. It's an antispasmodic, so during pregnancy, it may help relieve renal colic and stomach ache. It improves digestion and increases the appetite of a pregnant woman. It also controls blood pressure and mood swings during pregnancy. However, as saffron induces body heat, just add 1-2 strands in a glass of milk during pregnancy. It may be a uterine stimulant in high doses though it is safe in normal culinary use.

11. Is it safe to eat Papaya and Pineapple during pregnancy?

Papaya enzymes should not be taken during pregnancy due to an increased risk of miscarriage. In addition, papain may interfere with anticoagulants and antiplatelet medications. Fresh pineapple contains an enzyme, Bromelain. Bromelain also interferes with blood clotting and blood-thinning drugs, as well as a number of sedatives and antibiotics. Consult a health care professional before supplementing with papaya or pineapple enzymes if you are currently taking any medications.

12. What is the effect of Solar and Lunar Eclipse on pregnant woman?
'There are many old wives' tales, which attribute birth defects to various causes. Birth defects are NOT caused by eclipses, sewing during pregnancy, riding in autorickshaws, sleeping in any particular position or eating some foods'.

13. Is it safe to drink Coconut water during pregnancy?


Tender coconut water is one of the richest sources of electrolytes. It is high in chlorides, potassium, and magnesium and has a moderate amount of sugar, sodium and protein. Potassium helps regulate blood pressure and heart function. It is a good source of dietary fibre, manganese, calcium, riboflavin and Vitamin C. A natural isotonic beverage with similar levels of electrolytes as the human body, coconut water helps prevent dehydration and relieves exhaustion by replenishing the natural salts lost by the body.

It is fat free and naturally sterile and so perfect for drinking while travelling without the fear of contamination. It is a natural diuretic and so increases the flow of urine; this helps prevent urinary tract infections (UTI) as well as reduces the incidence of kidney stones, relieves constipation, improves intestinal function and promotes digestive health. Constipation, sluggish digestion and heartburn are common problems during pregnancy and can be helped to some extent by drinking coconut water. Coconut water contains high levels of lauric acid which has anti-fungal, anti-bacterial and antiviral properties which protect the body against various infections and boosts the immune system. With such wide ranging nutritional benefits it is no wonder that coconut water is recommended for pregnant women.

To conclude...
Hope this brief matter becomes useful to pregnant woman like me and I wish all moms-to-be happy deliveries and healthy babies...

BhargaviSuresh