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DO’S AND DON’TS OF PREGNANCY

What to Strive For During Pregnancy
DO:
Develop a positive attitude. Pregnancy is for most women a happy, healthy time in which their bodies function the way they were designed to do. It is a time of looking forward not only to having an adorable baby, but also to starting an exciting, and challenging phase of life. Even though it can be a little scary because it is a new experience, most fears can be overcome, by thinking of it as a great adventure with a great reward at the end. Maintaining a realistic but optimistic attitude goes a long way in helping you through the pregnancy and birth even when everything does not go exactly as you expect. Please trust your body and your intuition. Trust your healthcare providers so that they can work with you to make your pregnancy, birth and early parenting experiences the best that they can be. Learn all you can about pregnancy, birth, and parenting. Read, take classes and watch DVD’s. Your healthcare providers want to help you become a well-informed consumer so let them know what you need to know during your visits. Ask questions!!

Eat well. Good nutrition is important for a healthy mom and baby. Eat a well-balanced diet with adequate protein, fruits, vegetables, whole grains, and calcium. Most need extra calcium and magnesium supplements for bone health along with Vitamin D3. In addition to a balanced diet women should take a prenatal vitamin throughout the pregnancy. Some women may also need additional iron supplementation or an increase in iron rich foods. Optimal weight gain varies depending on your starting weight. A weight gain of about 15 pounds is recommended for those who are overweight at the beginning of pregnancy. The average weight for height woman should plan to gain 25-35 pounds. Those who are underweight need to gain approximately 28-40 pounds during pregnancy to ensure optimal nutrition for the fetus as well as building their own reserves.
Exercise. Along with eating well, regular exercise is an important part of being healthy. With a normal pregnancy it is safe and helpful to exercise throughout your pregnancy, though some forms of exercise might not be appropriate during late pregnancy (i.e., kickboxing). Check with your healthcare provider especially if beginning an exercise program. You need to pay special attention to hydration, heart rate and body temperature, but, if done appropriately, exercise can help you have an easier pregnancy and labor! If you are able to talk through your activity, that exercise activity is appropriate.
Women who exercise routinely will have:
• less interventions during birth
• fewer Cesarean births
• shorter labors
• less risk for gestational diabetes
• lower rates of depression
General Exercise Guidelines:
• Thirty minutes of moderate exercise almost every day is appropriate for a normal pregnancy. (If you were inactive pre-pregnancy, you will need to start at a much slower level).
• Make sure you balance exercise with periods of rest and relaxation.
• Listen to your body; it is possible to hurt yourself, even with gentle exercise. As your belly grows, your center of gravity changes, joints soften, and positions or exercises that were easy become challenging. Listen to your body if it says “I need a break.” Avoid long periods in the supine position (lying directly on your back).
• Pay special attention to hydration, heart rate and body temperature. If you start to feel overheated, you should slow down and stop.
• No directed abdominal exercises after 20 weeks of pregnancy. As your baby and belly grow, abdominal muscles separate and focused strong abdominal exercise will exacerbate the separation.
Enjoy sex during pregnancy. Enjoyment of sex during pregnancy is a healthy, satisfying part of a couple’s total relationship. Female orgasm during late pregnancy will cause uterine contractions, which are harmless to the baby and will not cause premature labor. (If orgasm did cause labor, induction of labor would be a simple, fun procedure!) Different positions for intercourse will need to be used as the woman’s abdomen enlarges. Any position which is comfortable is safe. Increased or decreased desire in women is normal both during pregnancy and the postpartum period.
Intercourse should be avoided under the following conditions:
• After the membranes (bag of water) have ruptured – there is danger of infection.
• When bleeding or premature labor occurs, or if you have been told that there is a medical reason to avoid sex (such as with Placenta Previa)
• Women who have had repeated miscarriages (more than 2) should avoid intercourse during the time they usually miscarry.
• The only sexual activity reported as dangerous is blowing air into the vagina of a pregnant woman. This can detach the placenta from the uterine wall and/or cause an air embolism. If you have questions about sex, please feel free to discuss them with the nurse-midwives.
Travel if you wish. All types of travel are permitted during a normal low risk pregnancy. In pregnancies after 36 weeks, you should consider the fact that you may end up giving birth in an unfamiliar place with an unfamiliar provider. Try not to travel more than one hour away from your planned facility for your birth. Air travel is permitted as long as the airplane cabin is pressurized. Most airlines require a letter from your provider after 34 weeks gestation. Travel to high altitude locations is also permitted up to approximately 6000 feet. Be sure to drink plenty of water and walk around intermittently during the trip (every 60-90 minutes)
Prepare your birth plan. You may develop a birth plan during your childbirth education class with your partner. Please be realistic and limit to two pages. Decide who you want to be with you and what each person will do to help. Be sure to tell your healthcare provider of any special procedures that you would like or want to avoid. Be sure when you complete your birth plan or “wish list” you discuss it in detail with your healthcare provider(s).
Purchase and properly install an infant car seat. Most if not all states have child seat safety laws. Please obtain an infant car seat by 36 weeks so you may safely transport your newborn to and from home.
Choose a pediatrician or family practice doctor. The following are some sample questions to ask:
• Where is the office located in relation to your home? The ease of travel to the office at any time and especially in an emergency is very important.
• If the doctor is a family practice physician, ask him/her what arrangements he has made in case of an admission to a hospital. Does he/she routinely see newborns?
• Where does the doctor have hospital privileges? What are the special practices, if any, of that hospital’s pediatric unit, i.e., open visiting or rooming-in?
• Does the doctor have staff privileges at the hospital where you might go for the birth of your baby? If not, who will see your baby?
• What is the size of the practice? How long do you have to wait to obtain an appointment? How much time is designated for each appointment?
• Who are the other persons who may be associated with the physician, another physician you might see, and/or a pediatric nurse associate who can answer many of the daily parental concerns? Is there a telephone hour?
• What are the arrangements for covering emergency calls, including nights and weekends?
• What are the various costs for care: office visit, immunization, telephone consultation, emergency visits?
• What are the doctor’s views on infant feeding? (Bottle and breast feeding as well as how to start the intake of solid food.)
• Is the doctor supportive of breastfeeding?
• What is the doctor’s management for newborn jaundice?
• How many times does the physician expect to see the baby for normal health maintenance?
• What are the doctor’s responses to your questions? If invited into the office, take the opportunity to observe doctor-child interaction. Did you feel comfortable talking with the physician?
• Discuss circumcision vs. no circumcision and his/her views on immunizations.
• Ask your friends who they use and what they think of their relationship with their pediatrician or family practice doctor.

Since these are suggested guidelines, you may have some other criteria upon which you are making your decision. You need to feel comfortable with the physician you choose for your baby.
What to Avoid During Pregnancy
DON’T:

• Take any medications (prescription or over-the-counter) without consulting your healthcare provider.
• Consume excessive amounts of caffeine. Recent studies have shown small amounts of caffeine are not harmful.
• Drink alcohol. The current recommendation is that no amount of alcohol is proven safe during pregnancy.
• Smoke. In addition to the risks of tobacco related disease for the mother:
• Babies born to mothers who smoke average 6 ounces less at birth than babies of nonsmoking women (a lot when only considering 7 or 8 lbs.!)
• Nicotine restricts the blood vessels and oxygen circulation of the mother.
• Increased carbon monoxide in the mother reduces oxygen levels in the fetus’ blood.
• Vitamin metabolism is disturbed in both mother and fetus.
• Incidence of low birth weight babies greatly increases for those who smoke one pack or more per day.
• There is a direct correlation that exists between smoking during pregnancy and the increased incidence of premature rupture of membranes, preterm labor, placenta abruption and stillbirth.
• Behavioral effects on infants of smoking mothers, determined by developmental testing, are noted as long as 8 months after birth.
We urge you and/or your partner, if either or both of you smoke, to register in a Smoking Cessation Program in your area. IT is the best thing to do for you, your partner, and your baby.

What Do I Do When My Bag of Waters Break?

It is common to be in labor without your water breaking.  Actually, only thirty percent of women experience their water breaking before the start of labor.

What Is My Bag of Waters?   The bag of waters—or amniotic sac—is a bag or “membrane filled with fluid that surrounds your baby in your uterus during pregnancy.”  The bag of waters is very important to your baby’s health.  The fluid protects your baby and gives your baby room to move around.  The bag itself protects your baby from infections that may get into your vagina.

  Is it urine or is it amniotic fluid? If you are leaking, it can be difficult to determine if your membranes are leaking or if it is urine.  In most cases, it is probably urine.  There are several ways to tell the difference, but there is no definite answer.  When in doubt, smell it! Urine has a distinct smell and color.  You will leak urine when your bladder is full, when coughing , sneezing or laughing; even when you are exercising.  

Only 3 percent of pregnant women will go into premature labor (before 37 weeks) as a result of ruptured membranes.   In most cases your membranes will rupture as you are nearing the end of your pregnancy, and this is definitely one of the early signs of labor.  If your water does break in public, and you have visions of a huge gush of water running all over the floor, then you have probably been watching too many movies.  It is most likely going to occur as a slow trickle, or at most, a small gush of fluid of colorless and odorless amniotic fluid. 

It is common to be in labor without your water breaking.  Actually, only thirty percent of women experience their water breaking before the start of labor.

What Should You Do When Your Water Breaks ?  First, don’t panic!  Follow the instructions your healthcare provider discussed with you if and when your water breaks.  Immediately after your water breaks, know that nothing should be placed in your vagina at this point.  This will help prevent infection.

  •  Wear a maxi pads, not tampons, to keep the amniotic fluid from wetting your clothes
  • Keep your vaginal area clean
  •  When you go to the bathroom,  be sure to wipe from front to back
  •  Sexual intercourse is officially off-limits  

Call your healthcare Provider immediately if:  

  • Your due date is more than 3 weeks away from today
  •  The water is green, or yellow, or brown, or has a bad smell
  •   You have a history of genital herpes, whether or not you have any herpes sores right now
  •  You have a history of Group B strep infection (“GBS positive”)
  •  You don’t know if you have GBS or not
  •  Your baby is not in the head-down position, or you’ve been told it is very high in your pelvis
  •  You have had a very quick labor in the past, or feel rectal pressure now
  •  You are worried.
  •  If you feel something in your vagina, or see any of the umbilical cord at the vaginal opening, get medical help immediately  

Call your health care provider within a few hours if:

 •Your due date is within the next 3 weeks and

 • You are not in labor and the fluid is clear, pink, or has white flecks in it

 • Your baby is in the head-down position

 •Some health care providers will want you to come in to the office to confirm that the bag of waters has broken and listen to the baby’s heartbeat as soon as you notice that the bag of waters has broken.  Others will suggest you stay home for several hours to wait for labor to start.  

What Do I Do Until Labor Starts?   Most women will go into labor within 48 hours.  If you are waiting for labor to start and your bag of waters has broken:  

• Put on a clean pad  

•Do not put anything in your vagina

 •Drink plenty of liquids—a cup of water or juice each hour you are awake

 •Get some rest

 •Take a shower

 •If there is any change in your baby’s movements, call your health care provider right away  

Check your temperature with a thermometer every 4 hours—call right away if your temperature goes above 99.6.   For more information regarding this topic visit:

  www.acnm.org  

www.webmd.com

 

2011 in review

The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

A San Francisco cable car holds 60 people. This blog was viewed about 2,300 times in 2011. If it were a cable car, it would take about 38 trips to carry that many people.

Click here to see the complete report.