The whole experience of pregnancy has changed, especially in the urban areas.  The profile of the pregnant woman has changed.  She is older, less healthy, obese, and more stressed.  Most first time mothers in the metros are over the age of 25.  Quite often, they are working in stressful jobs.

These factors impact the pregnancy in a big way.  Principally, women tend to postpone pregnancy, since it does not fit in with their lifestyles.  They do not have any reliable help to look after the baby after birth.

This is where planned pregnancy comes into the picture.  Most women and their husbands have a notion that planning merely involves 'not wanting a baby.'  This is not so.  When the couple decides to have a baby they should enter the pregnancy with the woman physically and mentally fit.
A visit to a doctor is called for, to test the following:
nBlood pressure
nWeight
*Examining the use of medications, which are not safe during pregnancy.
* Genetic factors, which may come into play
* Anaemia
* Blood group including the much talked about Rhesus (Rh) factor.
* Blood sugar.

Of these, of particular concern for women in India in any socio-economic background is Anaemia.  This is prevalent across all classes of women, because of scant attention to eating a healthy diet.  Women start out anaemic and the problem escalates during pregnancy. Latest figures indicate as many as 90 per cent of Indian women and children are anaemic!

These factors should be attended to, before the couple make the decision to  have a baby.  A visit to any physician, not necessarily an obstetrician, will enable identifying problems in these areas.
Entering a pregnancy with a pre-existing health problem, for example, bad posture because of inability to take rest during the day, impacts the baby.  It has been scientifically established that babies born to such mothers are smaller than normal.

It is important to stress that good physical health and exercise is all that is called for during pregnancy.  By now, we all know that the 'eating for two' myth has been shattered.  Even normally a woman puts on 10 kg during pregnancy, which she has to shed.  So, any further weight that she puts on is that much more that she has to shed after the baby is born.

During pregnancy, there is also a great risk of Gestational Diabetes. Family history, obesity, and age at start of pregnancy are the important causes of this condition.  This is usually detected by a routine test carried out by the Obstetrician in the 26th week of pregnancy.  The pregnant woman is then referred to specialists. Diet and exercise sometimes help, but insulin injections are also an alternative.

In fact, all women (pregnant or otherwise) should be screened for diabetes.  This is because India is a country where the incidence of diabetes is rising alarmingly.  There are predictions that by 2020 we may be the diabetes capital of the world.  Further, if testing is done prior to pregnancy, corrective action can be taken. Another concern for pregnant women is a malfunctioning Thyroid. 

Yes, during pregnancy a woman needs special care but with such care, pregnancy and motherhood can be a most fulfilling time.

With inputs from Dr Usha Sriram, endocrinologist, Chennai.