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What to Expect When You’re Expecting

It’s a great feeling when those months of pre-pregnancy planning finally pay off with a positive pregnancy test. You’ve been taking your folic acid, you’ve stopped taking any medications that may be harmful to your baby, you’re eating a healthy diet and you’ve finally missed your menstrual period! Here’s a guide on what to expect over the next 40 weeks.

FIRST TRIMESTER – WEEKS 0 TO 12

Your pregnancy is calculated from the first day of your last period and your baby is conceived approximately 14 days later. When you miss your first period, you are already four weeks pregnant. Once the fertilized egg has implanted in the uterus, cells begin to divide and the development of your baby begins in earnest!

MOM

You may not even suspect that you are pregnant but there’s a lot going on and you’ll probably feel more tired than usual! Your body begins to produce more hormones to sustain your pregnancy and you may feel emotional and even shed the occasional tear.

Morning sickness

Some women sail through the first few weeks of pregnancy without any nausea, others suffer mildly and a small number experience extreme nausea, vomiting and weight loss. In most cases your morning sickness, a misnomer as it can occur at any time of day, will be manageable. Try drinking small amounts of sweet tea and eat dry toast or a biscuit before your get up. Eat small, regular meals throughout the day to keep your blood sugar levels up. Ginger in any form can be helpful at combating the nausea. Try ginger biscuits or ginger tea. If you are unable to keep anything down, you must see your doctor.

BABY

Your baby’s development is remarkable in the first trimester. By the sixth week the nervous system is formed and by eight weeks you can see a heartbeat on an ultrasound scan. Your baby’s heart beats at 180 beats per minute, pumping blood around its tiny body. By week 12 the placenta is fully formed and takes over the production of hormones for baby’s growth. At the end of the first trimester baby is fully formed and measures about 6cm from crown to rump. Baby is already active and stretching in the womb, but you won’t feel these stretches just yet.

Take care

It’s important to avoid all medications, food and other substances that could harm your baby during development. Alcohol and smoking should be stopped before conception. Cut down on your caffeine intake, use plastic gloves or wash utensils and surfaces thoroughly when working with raw meat (especially chicken) to prevent a salmonella infection, eat only well cooked meat and don’t eat raw eggs. Consult your doctor before taking any medication.

SECOND TRIMESTER - WEEK 13 TO 27

Feelings of sickness and fatigue start to disappear and you’ll begin to enjoy your pregnancy. Clothes may start feeling a little tight as your bump grows. You may feel anxious about your rapidly changing shape, but as long as you’re eating a healthy diet you shouldn’t gain too much weight.

MOM

By 16 weeks you’ll probably notice an increase in your appetite and you’ll get that pregnancy ‘glow’. You may start to feel a little breathless as your ‘load’ increases. Try to get some extra rest every day. Between 16 and 22 weeks you may feel your baby’s movements for the first time. At first these feel like a butterfly fluttering about but soon they’ll become more definite. Your doctor may be able to tell your baby’s sex at your 20-week scan. It’s also time to shop for maternity clothing and start planning baby’s layette. Discuss birth options with your doctor.

Constipation

Although your digestive system does slow down as hormones relax the muscles of the intestines during pregnancy, you shouldn’t let constipation get out of hand. Make sure you eat five or six portions of fruit and vegetables each day and increase your water intake. You can also add some dried fruit, especially prunes, wholemeal bread, hi-fibre cereals and some bran muffins to your diet. Ask your Link pharmacist about a probiotic as these can help to restore intestinal balance and can help to regulate your system. Avoid laxatives unless advocated by your doctor.

Heartburn

Pregnancy hormones relax the valve at the top of your stomach, allowing the acidic contents to push up into your oesophagus. This, combined with the added pressure of the uterus pushing upwards, can create a burning sensation in the mid-chest region. To avoid heartburn, eat smaller meals throughout the day and avoid spicy or fatty foods as these can trigger it. Avoid eating just before you go to bed. If heartburn is worse at night, prop yourself up with a few pillows. Ask your Link Pharmacist about a gastric-antacid that is safe to use during pregnancy.

BABY

At 20 weeks your baby measures about 20cm from crown to rump but they’re still tiny, weighing about 300g. Baby will be inhaling amniotic fluid and practising breathing. By 24 weeks their eyes will open and the heart rate drops to about 150 beats per minute. Your baby can also cough and hiccup. You may become aware of their sleep and awake patterns. By the end of month six, your baby weighs about 700g.

Take the tests

As you head into the final three months, you will start to prepare your home for your new arrival. The third trimester is an exhilarating time but can be taxing on your body. You also need to book your bed in hospital or make final arrangements for a home birth. Getting the nursery ready is an exciting time for a mom-to-be.

MOM

You’ll be feeling slightly more uncomfortable as your bump continues to enlarge. You’ll probably need to urinate more as your heavy uterus pushes down on your bladder. Hormones also soften your ligaments and joints in preparation for labour so you may experience aches and pains. Insomnia may plague your last six weeks as finding a comfortable position in bed can be difficult. Try to rest throughout the day if you are battling to sleep at night. After your seventh month you can start packing your labour, hospital bag and baby bag.

Braxton Hicks contractions

From about 20 weeks will notice that your uterus contracts periodically. These are known as Braxton Hicks contractions and they ensure a good blood supply to the uterus and your baby. In later pregnancy they become much stronger, in preparation for labour. Severe cramps or regularly contractions should be reported to your medical caregiver.

Leg cramps

Leg cramps can wake you from a deep sleep. The pain is usually in the calf muscle and can be particularly excruciating! Stand up and push your heel down towards the floor, toes up. Walk around a little to improve the circulation in the leg. Do tell your caregiver at your next appointment, he or she may want to increase your calcium intake or may suggest magnesium tablets. Some women find that a banana (rich in potassium), every other day, helps to combat the cramps.

Backache

Backache is very common during pregnancy. Considerable strain is placed on your body and this together with the softening of ligaments caused by pregnancy hormones, can result in lower back pain.

To relieve backache, bend at the knees, not from your waist. Sit or kneel as much as possible while doing chores around the house. Make sure your office chair is at the right height, don’t lean over your bump to get to the computer and place a pillow in the small of your back to support it. Your caregiver may suggest some exercises to help alleviate the pain. If pain is severe or never seems to abate, even after rest, you must consult your doctor.

BABY

During this trimester baby gains weight quickly in preparation for birth. By week 28 your baby’s body will look more in proportion to their head. Greasy vernix covers their body and protects their skin. Most babies will settle into a ‘head-down’ position in preparation for the birth.

Some still move around while there is still space and others remain ‘breach’ until birth. By week 36 your baby’s lungs are almost fully developed. They will gain about 140g per week in the last month.

Take the class

Child Birth Education classes usually run for six to eight weeks in the evenings or Saturday mornings. They help to prepare you and your partner for labour and birth and are worthwhile, even if you are planning on a C-section.

By Gina Hartoog. Resources: Johnson’s Mother & Baby (Dorling Kindersley, 2006); Healthy Pregnancy (Southern Book Publishers,1996); Tina Otte’s Pregnancy and Birth Book (Struik, 1997).

                                                                                                     

Tests and scans in pregnancy: What is offered?
Test name	Stage	How is it done?	Why?
Nuchal fold   test	Between 11 and   14 weeks	Ultrasound scan to     measure a fold of     skin at the back of   baby’s neck	Thick fold may indicate     Down syndrome. If     suspected, amniocentesis   offered
CVS (chronic     villus   sampling)	From 11 weeks	A tiny piece of the     placenta is extracted   and analyzed	Detects Down syndrome/ chromosome disorders
Triple Test	Between 15 and 17 weeks	Blood test – hormone levels measured/ ultrasound dates the pregnancy	Analysis of levels estimate possible Down syndrome/ spina bifida. Levels high, amniocentesis offered.
Amniocentesis	Around 16 weeks	Sample of amniotic fluid taken from uterus with a fine needle	Results indicate Down syndrome/other chromosome disorders. Results take a few weeks.
Cordocentesis	Around 19 to 24   weeks	Blood collected from umbilical cord	Detects chromosomal abnormalities or rhesus disease after 20 weeks. Results take a few days.
Routine   anomaly scan	Between 18 and 21 weeks	Detailed ultrasound	Checks for defects/ general health of baby/ placenta
Foetal nonstress test (NST)	From 28 weeks	Mother attached to foetal heart monitor – foetal movements/ heartbeat recorded for 30 minutes.	Heart rate increases with movement – good sign. Also indicates inadequate oxygen supply/other types of distress.

PREGNANCY SUPPLEMENTS

Eating a well balanced, healthy diet is essential in pregnancy, not only for your baby’s health and development but also for your own well-being.

In addition to this you should take a Vitamin and Mineral Supplement especially designed for pregnancy to further ensure that your growing baby gets all the nutrients he or she needs. These are available in tablet or capsule forms and usually contain the recommended dose of Folic acid which helps to prevent neural tube defects like spina bifida.

You can also try a powered drink that is mixed with water and provides vitamins, minerals and energy. Choose one that is designed specially for pregnancy and breastfeeding. Check with your doctor or caregiver before taking these.

Your doctor may also suggest extra Calcium supplements and an Omega 3 supplement. Avoid high levels of Vitamin A as this can adversely affect your baby. If your prenatal vitamins make your nausea worse, you may need to switch brands.

Ask your Link pharmacist, clinic sister or Link pharmacy staff for further advice.

Source: www.webmd.com