Chapter – 6
A Healthy Pregnancy
Warning! Drinking alcohol before pregnancy can cause pregnancy.
- Unknown author
You should start taking care of yourself long before you start trying to get pregnant. For some women, getting their body ready for pregnancy takes a few months. For other women, it might take longer.
Every day, according to World Health Organization, 800 women die from preventable causes related to pregnancy and childbirth. 99% of these deaths occur in developing countries. Maternal death is higher in women living in rural areas and poor communities. Young adolescents (under 15) face a higher risk of complications and death as a result of pregnancy than other women. Most of these deaths are preventable.
Why do women die?
Women die as a result of complications during pregnancy and following child birth. The major complications that account for nearly 75% of all maternal deaths are:
- Severe bleeding (mostly bleeding after “childbirth”).
- Infection (usually after childbirth)
- High blood pressure during pregnancy (pre-eclampsia and eclampsia).
- Complications from delivery.
- Unsafe abortion.
The remainders are caused by associated with diseases such as malaria and AIDS during pregnancy (WHO).
Whether this is your first, second or third baby, it is important to take certain steps, before, during and after pregnancy. Here are some steps you can take.
- Eat a healthy diet – including plenty of vegetables (green- for iron), fruits, whole grain and protein.
- Exercise regularly – at least 30 minutes / day, most of the days of the week.
- Consume 400 micrograms of folic acid (it prevents birth defect) or take a prenatal vitamin daily that contains folic acid and iron.
- Stop smoking if you smoke. Smoking leads to smaller size baby.
- Stop drinking alcohol. Drinking during pregnancy can cause fetal alcohol syndrome (growth retardation, heart defect, cleft palate, abnormal facial features).
- Do not do illegal drugs – they can cause miscarriage, low birth weight and premature birth.
- Make sure you have taken all your vaccinations – like rubella, chicken pox, tetanus.
Regular prenatal care
Prenatal care refers to the regular medical checkups that a women has throughout the nine months of pregnancy. With regular prenatal care, you can reduce your baby’s risk for potentially serious health problems. During prenatal visits, your doctor will monitor the status of your pregnancy (how far along), how the fetus is growing, your blood pressure and weight, presence of protein and sugar in your urine (for pre-eclampsia and diabetes) and will prescribe your prenatal vitamins. It is important that you see your doctor or nurse regularly until you deliver.
Screening tests
Screening tests evaluate the risk of having a baby with certain birth defects. Women over age of 35 have a higher risk of having high blood pressure, diabetes (gestational diabetes), and miscarriage, still birth and birth defect like Down syndrome. The common screening tests used in pregnancy include ultrasound and certain blood tests to detect birth defect.
Healthy eating for a healthy pregnancy
While you are pregnant, you will need additional nutrients to keep you and your baby healthy. But this does not mean you need to eat twice as much. You should eat only about an extra 300 calories per day (1 cup of cooked rice = 200 calories). Don’t go on a diet during pregnancy, because your fetus might not get enough of the essential nutrients such as protein, vitamins, and minerals. To help ensure that you are getting enough nutrients, you should take a prenatal vitamin and eat a wide variety of healthy foods every day.
- Fruits and Vegetables
Try to eat 7 serving of fruits and vegetables (3 fruits + 4 vegetables every day).
- Whole grains
Try to eat 6-9 serving of whole-grain or enriched bread and cereals every day.
- Dairy products
Try to eat 3-4 serving of milk and milk products each day (milk, yogurt, cheese). Dairy products are good sources of Vitamin A and D, protein and vitamin B.
- Protein
Pregnant women should get enough protein – 50 grams per day. Protein – rich foods have vitamins and irons. Eggs, milk products, nuts, beans, peas, fish and meats are good sources of protein.
- Folic acid
Pregnant woman need 400 micrograms of folic acid every day to help prevent birth defects such as spina bifida, cleft lip, and congenital heart disease. Orange juice, spinach, and legumes are good sources of folic acid.
- Iron
Pregnant women need twice as much iron as other women. The fetus needs iron from the mother to make blood cells. Too little iron can cause anemia – which is quite common among pregnant women in developing countries. Good sources of iron are – meat, fish, poultry, dried fruits and iron – fortified cereals.
- Calcium
Pregnant women should get 1,000 milligrams of calcium a day. Milk and milk products (cheese, yogurt), green leafy vegetables and calcium fortified milk and cereals are good sources of calcium. Calcium is needed for the bone growth of the fetus.
Most of the time, it is easier to take a prenatal tablet or capsule containing enough of folic acid, iron, and multi vitamins.
How much weight should you gain during pregnancy?
The amount of weight you should gain depends on your weight before you became pregnant and your height. Most doctors recommend an average weight gain of 20 to 25 lbs. (9 to 12 Kg.) during pregnancy. If you were underweight before becoming pregnant, you can gain little more.
Exercise and Pregnancy
When you are pregnant, exercise is one of the best things you can do for your physical, emotional and the health during your pregnancy.
- Exercise can help ease and prevent the aches and pains of pregnancy including backaches and exhaustion.
- Active women seem to be better prepared for labor and delivery. The recover more quickly.
- Exercise may lower the risk of high blood pressure and diabetes during pregnancy.
- Fit women have an easier time getting back to a healthy weight after delivery.
- Regular exercise improves sleep during pregnancy.
Low-impact exercise that produces moderate exertion is the best type of physical activity while you are pregnant.
For the best pregnancy out-come, get regular pre-natal care, eat a healthy diet, take prenatal vitamins and Iron, do moderate intensity exercise, and deliver your baby in a hospital. Even normal pregnancy can go wrong at the last moments, especially at the time of the delivery. A baby who is deprived of oxygen even for few minutes can die or develop long-term neurological problems. There should be skilled personnel available to take care of the baby, immediately after birth (like resuscitation – oxygen, intubation, and breathing). Time is critical. Don’t take chance. Deliver your baby where skilled personnel are available – both for the pregnant mother and the new born baby.
Saheb Sahu, M.D., F.A.A.P., MPH.