Children are a
blessed heritage,” and the decision to start a family should be a joint
venture by both parents. There is need for some pre-pregnancy preparation
to discuss and understand the implications of having a child. A positive
relationship between partners is a prerequisite. It will eliminate any
psychological stress or conflict which might arise between partners in the
course of the pregnancy. Every child should be a wanted child.
Pregnancy and childbirth are no longer exclusively “women’s affairs.” The
father must be an active participant in the whole process. The husband
must take the responsibility of understanding and adjusting to the various
physiological changes that will take place in his wife – her moods, her
morning sickness, her expanding body
– confident that these are only
temporary changes that must take place to meet the demands of the baby. A
woman who knows that she has the full support of her husband every step of
the way, will fall in love with him all over again, for the security and
dependability he ensures. The quality of the relationship will
psychologically affect the course of the pregnancy.
Some couples suffer from pre-pregnancy stress. Previous abortions or
complications of pregnancy, or abnormal babies, might have them worried.
In such cases, discussing these matters with a doctor would set their
minds at ease. .Where there is a family history on either side, of
hereditary diseases or genetic defects, it would be appropriate to go in
for genetic couselling before deciding on starting a family.
Motherhood:
“Childbirth is an expression of health rather than illness.” So,
Motherhood should be an exciting experience. Our great grand mothers did
not have the advantages we have today, of High Tech hospitals and modern
gadgets. Midwifery was then “a non-medical lay craft,” attended by married
women of mature age, or a traditional birth attendant. The majority of
women delivered normally, though the infant mortality was comparatively
high. Even so, High Tech doesn’t mitigate fears, and every prospective
mother has feelings of anxiety about the outcome of her pregnancy. Worries
increase when other women, with the very best of intentions, insist on
enumerating the likely complications, or grandmas fill one’s ears with old
wives’ tales.
Be Knowledgeable
It is therefore important for the woman to understand her body and all the
exciting changes that will take place, in anticipation of the needs of the
child within her. She should bear in mind that she has been ’fearfully and
wonderfully’ designed to be the bearer of life.
The period of pregnancy is divided into three trimesters. Signs and
symptoms vary with the period of
pregnancy. In the first three months,
though there are no external changes, a pregnant woman exudes a kind of
radiance. The missed period, the feeling of fullness in the breasts, and
the desire to urinate frequently alerts her that pregnancy has begun. Many
women can’t wait to run for a pregnancy test even if the period is delayed
for just a couple of days. To avoid disappointment, it is better to wait
until six weeks after the missed period.
Morning sickness is a positive sign that the foetus is alive. It is seldom
seen in smokers or tobacco users where the foetal outcome is poor. It
starts between the fourth to sixth week after a missed period. Morning
Sickness was first recorded on a papyrus in 200 B.C, by the Egyptians. To
some it is just nausea. Here, the husband could be of help in bringing his
wife a cup of tea and a biscuit, before she gets out of bed. Many women
vomit only in the morning, and the sensation eases off later in the day.
It occurs because of the high levels of hormones in the blood, and can be
minimized by eating small meals at frequent intervals, drinking plenty of
water in between meals, and avoiding greasy, spicy or fried foods.
However, persistent vomiting needs to be treated so as to prevent
dehydration. Medication in the first trimester is to be used judiciously.
The thalidomide disaster of yesteryears still haunts our memory. Excessive
vomiting could be due to a molar pregnancy or multiple pregnancies.
Excessive salivation, and craving for peculiar foods (pica eating) are
also experienced during early pregnancy.
Being aware of the likely changes that will occur will eliminate
unnecessary anxiety and stress. Aches, pains and discomforts are an
inseparable part of pregnancy. Lower back ache is due to altered posture;
pain in the abdominal wall is due to stretching of muscles to accommodate
the growing uterus; pain over the pubis is due to relaxation of the pubic
ligaments. Leg cramps felt in the back of the thighs and calves can be
relieved by bending the feet upwards so as to relax the calf muscles.
The second trimester is a comparatively easier period when early symptoms
disappear. There is a feeling of well being. After the sixteenth week she
can look forward to the exciting feeling of “quickening.” It is the first
subjective recognition of life within her. Though just a twiddle like the
fluttering of a tiny bird, it ushers in a conscious relationship between
her and her child. As the foetus grows movements become more appreciable.
Pregnancy is bedeviled by ”minor” discomforts like heartburn,
breathlessness which is usually of emotional origin, occasional spells of
faintness and dizziness and sleeplessness due to the discomfort of the
enlarging abdomen. Pigmentation of the skin on forehead and face,
darkening of the areole around the nipples, and a dark line extending from
the navel to the pubis also become visible.
Piles, constipation and some vaginal discharge can be quite worrisome. It
is therefore good to be under the care of an obstetrician and have regular
antenatal check ups through out pregnancy. This will ensure optimal health
of mother and foetus, detection of complications, treatment of medical
diseases, and education about pregnancy, labour and breast feeding.
At the initial antenatal visit, the diagnosis and duration of pregnancy
will be established. A detailed history of both personal and family
history is taken. Blood pressure is recorded, Blood tests like haemoglobin
levels, blood group and Rh factor, VDRL, screening for Diabetes are done.
Many hospitals offer screening for HIV too. Urinary and vaginal infections
are also treated. Urine is tested for Albumin and sugar at each visit.
Antenatal visits are usually once a month during the first 28 weeks, once
a fortnight for two months, then weekly thereafter, or as ordered by the
doctor.
Rh Negative mothers are given Anti-D globulin early in the third
trimester, which significantly reduces the risk of Rh immunization in the
child.
Sonography is a very useful diagnostic tool to establish age and viability
of the foetus, and to monitor the foetus periodically through pregnancy.
It will also confirm that the pregnancy is intrauterine and not in the
tubes.
Electronic Foetal monitoring has become possible throughout pregnancy.
This allows greater supervision of women and babies at risk, and timely
intervention when necessary, and the cardiotocograph shows the foetal
heart rate pattern in relation to uterine activity. These gadgets have
revolutionized the management of pregnancy and labour.
Be Alert.
Bleeding is an abnormal sign and must be reported. In the early months
bloody discharge with abdominal pain may be a sign of impending abortion.
Smelly, yellow discharge with itching could be due to a vaginal infection
which needs treatment.
In the later months, abdominal contractions could be the onset of
premature labour. However even in a normal pregnancy, painless
contractions called Braxton Hick’s sign may be felt from time to time,
which last for a few seconds.
Diminished foetal movements or excessive movements must also be reported
to the doctor. If the movements in the third trimester are less than 10 in
24 hours, it is a distress call from the foetus.
Sudden increase in abdominal size or diminished growth must also be
referred to the doctor.
Swelling of feet, headache, blurring of vision and high B.P. if left
untreated, may proceed to fits. Many women through ignorance think it is
due to some evil possession, and allow themselves to be branded with a hot
iron rod or administered to by a priest. Precious time is lost this way,
endangering the life of mother and child, as this is Toxaemia of
pregnancy. Painless bleeding or bleeding with severe abdominal pain in the
last trimester must be promptly attended to in a hospital.
Diabetes: Mothers who are known diabetics should ensure that their blood
sugar is under control for at least six months prior to pregnancy. They
need to be carefully monitored through out pregnancy. If not controlled,
the foetus may grow large but unhealthy, and may have several defects, or
could be still born.
Certain mothers develop diabetes during pregnancy, which subsides after
delivery. This is called Gestational Diabetes. Diet, medication and
exercise will ensure a normal baby. Similarly, women with heart disease
will also need specialized care.
Sometime towards the end of the pregnancy, depending on the position and
size of the foetus or on its wellbeing, the doctor will be able to predict
whether one can expect a normal pregnancy or caesarean would be
preferable. This information will help prepare the couple mentally for
whatever decision is taken.
Be Active.
Pregnancy is not an illness, and so a mother must carry on with her
routine work, though strenuous work or lifting weights is not advisable,
Exercise must be moderate. A brisk walk, for half an hour or so, is good
for circulation. Special attention should be paid to posture to keep the
abdominal muscles firm. Wrong postures can hollow the back and make the
abdomen sag.
Breathing exercises can be practised by sitting in on an arm chair with
hands over abdomen, and breathing in slowly, feeling the abdomen rise,
then exhaling gently through the nose, as the diaphragm rises into the
chest. This should be repeated six times a day, and is in preparation for
the slow conscious breathing which will be required in the first stage of
labour.
Relaxation techniques and abdominal exercises as ways to diminish the
discomfort of labour, are now taught in antenatal clinics. Many husbands
accompany their wives to these classes and also learn these techniques
(Dick Read method), so that they can help their wives practise at home.
Sleep is important. Lying down for a couple of hours in the afternoon, and
going to bed early, ensures enough rest for the mother. Rising from bed
should be done gradually and not in haste.
It is wise to restrict long distance travel in the first and last
trimesters, as there is fear of abortion in the former, and risk of
premature labour in the latter. Besides, travelling may expose the mother
to infections like colds or coughs.
Eat Wisely:
A normal mixed diet of high protein, less fat and carbohydrate, with a
glass or two of milk per day is advised. There is no need to over eat for
two. The foetus will get enough nutrition and its health will be
determined by the quality of food eaten by the mother. Overeating
especially starchy food and sweets will only increase one’s girth, which
will be difficult to shed post-natally. Fresh fruit, green leafy
vegetables and salads are nutritious. Eating too little is also not
advisable, as the body will break down stored fats, increasing ketones in
the blood. Constantly high ketones will lead to mental retardation of the
child. Supplements of Calcium and Folic acid will have to be taken, as the
former is required for bone and tissue growth, and the latter will prevent
defects of the brain, spinal cord, congenital heart disease and cleft
palate. Iron is also necessary to prevent anaemia of pregnancy. These
supplements must be taken regularly.
Salt should be kept to minimal, but water should be drunk copiously.
Alcohol is to be strictly avoided as it causes a spectrum of foetal
disorders like abnormal facial features, slow growth, brain defects that
interfere with learning, memory, communication skills and vision.
Smoking also produces babies that are small for dates, with low I.Q. and
learning disabilities.
Snacks from wayside vendors, uncooked or undercooked foods could be
teeming with bacteria, and should be avoided.
Be Cheerful and Well groomed.
This is the time to look and feel feminine. There is nothing more feminine
than a pregnant woman. Good and comfortable clothing, not too tight or
restrictive under garments, sensible low-heeled shoes, hair well combed,
and a smiling face, gives the husband pride in his wife. There are many
flattering outfits for pregnant mothers sold in various boutiques today.
If planning to breast feed, the nipples should be massaged daily with
olive oil, and pulled outwards. Prevention of striae on the abdomen can
also be prevented by rubbing oil over the abdomen from the seventh month
onwards.
Vaginal douching is highly dangerous and should not be done. Genital
cleanliness can be maintained by washing with soap and water, after each
visit to the toilet.
A calm temperament and a cheerful countenance make the mother as well as
those around her feel good. It is known that emotions of the mother are
felt by the child in the womb. Anger, sadness, rejection of the foetus
translate as primal pain in the foetus. Unless one wants to have a cranky,
irritable baby who grows into a troublesome, unsociable adult, it behoves
the mother to be in a cheerful frame of mind at all times.
The husband should be involved in the welfare of his wife, and all that
she feels and experiences during pregnancy. He must be patient and
empathetic.
Be Thankful:
Finally, the power of pray in healing psychological stress has been proved
beyond doubt. Both parents should praise God daily for the gift you are
about to receive, and pray for a smooth delivery and a normal child. A
couple I read about, placed both their hands on the mother’s abdomen every
day, and prayed for the welfare of the unborn child.
Pregnancy and childbirth can be a happy and relaxing experience in which
the husband plays an active and supportive role, whether you choose to
have a natural birth at home or in a hospital where modern technology is
available. Hospitals now encourage husbands to stay beside they wife
during labour and delivery, so that this will be a participatory event,
and will strengthen the bonds of love between them. A man who has
witnessed the ordeal a wife has to go through, will be more appreciative
of her role as partner and mother.
Look here for more about relationship during pregnancy:
