A new beginning...

Pregnancy can get overwhelming, but the physical, hormonal and emotional changes can be tackled better if it is planned properly, suggests Dr Prathima Reddy

health

God could not be everywhere and therefore he made mothers” — Rudyard Kipling. This is so true. Where would we be without our mothers!

Throughout history, mothers have been revered, worshipped and given a cult-like status and yet they have also been reviled and demonised depending on the era and the country they lived in. The modern mother has a more complex role than ever before. She dons several hats now, mother, wife, provider, the boss at work, keeper of sanity at home, and of course, juggler par excellence of all these and more jobs. The thought of becoming a mother and a new arrival in the family is always exciting. Couples and their families look forward to this joyous event and the birth of a baby is cause for celebration. It is a known fact that a planned pregnancy is safer than an unplanned
one. Despite this, four in 10 pregnancies are unplanned. Here are a few things you ought to do and know before you get pregnant:

Visit your doctor

“Pregnancy is not a disease so why should I see a doctor before I get pregnant. After all, my mother and grandmother hardly saw doctors”. True, pregnancy is not a disease, but optimal outcomes for the mother and the baby can only be achieved by taking the best possible care before, during and after the pregnancy.

Your doctor will take a detailed history regarding your health — present and past — and any medical conditions that you may have. He or she will inquire about any diseases in both families and seek relevant details of your past pregnancies. The doctor will also discuss the medications that you are taking, vaccinations and supplements.

Medical & hereditary conditions

Some of the medical conditions that can affect pregnancy are Hypothyroidism (problems with the thyroid gland), Epilepsy, Diabetes and Hypertension. It is important that pre-existing diseases are well controlled, and tests are done to confirm that you are healthy.

A detailed personal, family and past pregnancy history will help screen for hereditary and genetic conditions for which you and your partner may need genetic counselling.

Vitamins & supplements

Folic acid is a B vitamin which is vital for the healthy development of the baby’s nervous system. It helps prevent serious abnormalities of the brain and spinal cord such as anencephaly and spina bifida in about 70% of women who take it. This has to be taken as a daily supplement of 400 mcg for at least three months before you get pregnant. If the pregnancy is unplanned, take it as soon as possible and continue until the
12th week of pregnancy. You may also need Vitamin D supplementation, check with your doctor.

Diet & exercise

Trying to change lifestyle habits is difficult for most people. However, planning a pregnancy is a good motivator, since you will be doing this for the health of your baby as well as yourself. Start by eating healthy. Include protein foods such as pulses, beans, nuts, chicken, meat, fish and eggs. Rice, cereals, pasta and potatoes make up the starch component in your diet. Aim to include at least five portions of fruits and vegetables daily. Dairy products such as milk, curd and paneer should form a part of your diet. Drink plenty of water and avoid carbonated drinks and processed products.

If you do not exercise regularly, this is the best time to start — for both you and your partner. Regular exercise will improve your health, reduce your risk of having gestational diabetes during pregnancy, reduce stress, and help you cope better with the pregnancy and labour. Walking, swimming and yoga are recommended. Avoid contact sports and sports in which there is a risk of falling or losing your balance.
If you are overweight or obese, it may be a good idea to reduce your weight before you embark on pregnancy. Being overweight or obese can increase your risk of high blood pressure, gestational diabetes and blood clots during pregnancy. It can also contribute to difficult vaginal deliveries as the baby may be big.

Medications & vaccinations

Most of the development of the baby takes place in the first three months of the pregnancy. Hence it is important to avoid all (including over the counter medication), except essential medication in this period. If you are on regular medications for a medical condition, be sure to tell your doctor that you are planning a pregnancy or are pregnant. They may need to be modified. Vaccinations to be considered pre-pregnancy are Rubella vaccine (against German measles or Rubella infection), Hepatitis B, Chicken Pox and Influenza. Td and Tdap (Tetanus, Diphtheria and Pertussis) are to
be given during pregnancy.

Smoking/alcohol/substance abuse

It would be best for you and the baby if you and your partner stopped smoking. Continuing to smoke pre-pregnancy can reduce your fertility. Smoking during pregnancy can cause miscarriages, preterm birth, low birth weight and still birth. Babies whose parents smoke are at a higher risk of chest infections, cough and Sudden Infant Death Syndrome. 

Alcohol can damage sperm production and excessive drinking can lead
to impotence. Prior to and during the pregnancy, it is best not to drink
at all. Psychoactive substance use must be discontinued while trying for a pregnancy and throughout the pregnancy.

Mental health

Pregnancy itself is rather overwhelming. Not only because there are so many physical and hormonal changes, but also because there seems to be a complete emotional makeover. If you go through periods of anxiety and depression, you need to talk to your doctor about this. If you are already on medication, your doctor will tell you if it is safe to continue the same or change to a safer drug. Regular follow up with the counsellor or
psychiatrist is recommended, especially during and after the pregnancy.

During the pregnancy

Your doctor will advise about the scans and blood tests that will be performed routinely in pregnancy. He/she will also advise you regarding specific concerns or conditions pertaining to your pregnancy.

(The author is director, Fortis La Femme Hospital)

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