Articles about Pregnancy

By Sanja Nel – dietitian, SACLC

We all know the saying: “you are what you eat.” During pregnancy, we can take it a bit further: your baby is what you eat. Your baby’s body is literally constructed using the proteins, fats, minerals and other substances that you take in. Therefore, a healthy diet during pregnancy is absolutely essential for a healthy baby.

A simple approach to healthy eating

To ensure that you get in all the nutrients that your body needs, you need to eat a variety of foods from all the major food groups:

Carbohydrate-rich foods are an important source of energy for you and your growing baby. And any pregnant woman will tell you – you need all the energy you can get! Low-GI carbs will give you energy that lasts the whole day, and prevent the energy slumps, moodiness and headaches that come with low blood sugar. Whole-wheat bread and crackers, brown rice, oats, durum-wheat pasta, quinoa, sweet potatoes and mealies are just some good sources of low-GI carbs. As a bonus, these whole-grain products are all high in fibre, which can help to ward off constipation.

Protein-rich foods provide the building blocks that are used to construct your baby’s body. During the second half of your pregnancy, when baby is growing rapidly, you will need to eat more protein than previously; and if you are carrying twins you will need even more protein. Most animal foods are rich in protein, including meat, poultry, fish, eggs, milk and dairy products. For a vegetarian alternative, look to plant proteins such as nuts, beans and lentils. You should try to include some form of protein with every meal.

Fruits and vegetables are important for your own health more than anything else. Getting your five-a-day will help to keep your immune system strong and your colon happy.

A balanced meal could be made up of a low-GI starch, a protein, a fruit or vegetable and a bit of healthy fat. This will ensure that you get in a good mixture of nutrients.

Energy requirements, appetite and weight

During the first trimester, your energy requirements stay more or less the same. Many women also struggle with nausea and food aversions during this time. During the second and third trimesters, however, you need to take in more energy to help your baby grow. You may also notice an increase in your appetite, and you should start to put on weight at a rate of 1-2 kg per month. All of this is normal and healthy; pregnancy is definitely not the time to attempt a weight-loss diet!

Supplements

Some nutrients are required in such large amounts during pregnancy that it is nearly impossible to get enough from your diet alone, so it is advisable to supplement them. The two most important nutrients to supplement are folic acid (folate) and iron. Folic acid is critical in the first trimester to ensure that the baby’s brain and spinal cord develop properly, and it is important during the rest of the pregnancy to support growth. Iron is needed to produce extra red blood cells, both for yourself and your baby.

The minimum supplements that you should be taking is folic acid (preferably starting even before conception) and iron from the second trimester onwards. However, there are many studies that show that a combined multivitamin-mineral supplement gives the best possible outcomes for both mom and baby, so the best is to take a pregnancy-specific multivitamin. If you suffer with nausea you may want to stick to folic acid in the first trimester, since multivitamins can make the nausea worse. You should start taking a multivitamin no later than the second trimester. Add a pregnancy-specific omega-3 supplement at least from the third trimester, to support baby’s brain and eye development.

Food safety

During pregnancy, your immune system is not as strong as usual, so you can get sick more easily. This is especially true for foodborne illnesses, so food safety and hygiene are very, very important during pregnancy. Animal foods are at especially high risk of containing harmful germs. For that reason, it’s important that all animal foods should be well cooked – including eggs, meat and fish (so no sushi – sorry). All the milk you drink should be pasteurised, and you should avoid soft and blue cheeses. Any foods that you eat raw – such as fruits and vegetables – need to be washed well.

Harmful things to avoid

There are a few things that are downright dangerous for your baby, that you should avoid or limit during pregnancy:

  • No amount of alcohol is known to be safe for the developing foetus.
  • If you haven’t quit yet, now is the time.
  • Caffeine should be limited to no more than two cups (of tea, coffee or cola drinks) a day. Rooibos tea is caffeine free, so you can drink that as much as you like.
  • Medicine, including any herbal or traditional remedies, should be discussed with your healthcare provider. Even something as simple as a headache tablet can be harmful at certain times during pregnancy – so please, please talk to a medical professional before you take anything.

Your baby’s health starts right here, right now, with every bite you put in your mouth. Choose the healthiest options to give your baby the best possible start in life.

(This article is also available in an audio format)

In the second half of pregnancy, your bed will be a busy place. Pillows will be flying and sheets will be askew, all because of your partner’s passionate efforts to … find a comfortable sleeping position.

As your partner expands, she finds it harder and harder to sleep. So she flips. And flips. Of course, when she was just your unpregnant bedmate she did this too. But now she is flipping for two, and the after-shocks could leave you sleepless.

So do you suffer in silence or is there a way out? There is always a solution, very effective but slightly harsh – move into the spare room or onto the couch. What! I can hear you say, yes that’s right, different rooms – she will then have enough room for all her pillows, and you will get the sleep that you are craving. Butt, different bedrooms are what grandparents do! Just reassure her this is not a permanent solution, just temporary to give her the space she and her preggy tummy are craving. She will heave a sigh of relief as she really does feel guilty disturbing you all night long! But if you are going to be the supportive partner you strive to be, you need to be well rested. This is probably not something you want to make a habit out of, but if you have a big day coming up at work or you are just unbearable exhausted, it might be a good idea. You might both be more comfortable. It can be beneficial to invest in a variety of pillows. She can mix and match until she finds the perfect sleeping combination. On nights when she is tossing and turning, you will help one another by snoozing separately. Reassure her that it is because the bed isn’t big enough for all of you and her pillows, you still find her and her beautiful preggy tummy sensational!

Try to see these turbulent nights as training for parenthood. If you think it is hard to sleep while your partner tosses and turns, wait until your baby arrives. Soon you will long for those nights when the solution to your sleep deprivation was as simple as changing beds. The moment you become a parent, you will develop a sensitivity so acute that you will awaken at the slightest sound from your newborn.

Eventually, of course, both you and your baby will sleep through the night. In the interim, learn to take naps without guilt, buy a few extra pillows, and change the sheets in the guest bedroom.

What you’re going through

Well, it’s almost over. In just a few weeks, you’re finally going to meet the child you’ve talked to and dreamed about, and whose university education you’ve planned. But be prepared, the last month of pregnancy is often the most confusing for expectant fathers. At times you may be almost overcome with excitement and anticipation. At other times you may be feeling so scared and trapped that you want to run away. In short, all the feelings – good and bad – that you have experienced over the last eight months are back. But now, because of the impending birth, they’re more intense than before. Here are a few of the contradictory emotional stages you may find yourself going through during the final stages of the pregnancy –

  • On the one hand, you may be feeling confident about your readiness to be a dad. On the other hand, you may be worried and unsure about whether you’ll be able to handle your dual roles as husband and father.
  • All you’ll probably want to do at the end of the day is go home and relax. But with your partner less and less able to handle physical tasks, you may be greeted at the door with a list of chores that need to be done
  • You and your partner may be feeling an exceptionally strong emotional bond with each other. At the same time, your sex life may have completely disappeared
  • As your partner gets more and more uncomfortable, she may feel less and less like going out with friends, so the two of you have to enjoy some quiet, private time before the baby comes. But it may also be an unwelcome opportunity to get on each other’s nerves

By this time your attention – and that of your friends and family – is focused squarely on your partner and the baby. Since you’re the person she’s closest to and sees most often, your partner is going to be increasingly dependent on you – not only to help her physically, but to get her through the last-month emotional ups and downs.

Staying involved

The bottom line is that during the last few weeks of her pregnancy, your partner is likely to be miserable and uncomfortable. And although there is not a whole lot you can do to ease her burden, here are a few suggestions that might make the final stretch a little more bearable – for both of you –

  • Answer the phone. You might consider changing your voicemail to something like: “Hi. No we don’t have a baby yet, and yes, Jane’s fine. If you are calling about anything else, please leave a message and we will call you back”. It is better than answering the same question twenty time a day
  • Stay nearby whenever you can. Try to come home a little earlier from work, give away those rugby tickets and postpone that long business trip
  • Stay in touch. A couple of quick calls to her every day can make her feel loved and important. They will also reassure her that you are alright
  • Stay as calm as you can. She’ll be nervous enough for both of you
  • Be patient. She may do some pretty bizarre things, and the best thing you can do is bear with her
  • If she wants it, give her some time to herself. And if she wants time with you, make sure you’re there for her

(This article is also available in an audio format)

Congratulations! She is having a baby! This mere statement throws your world upside down and makes you feel sick to your stomach. Sure you agreed that you were ready to have children, but you weren’t quite ready for this reality check, she really is pregnant and she is going to have a baby. She is so excited and engrossed with this thought every second. For you – it seems to be different, panic rises up in you as you consider the extra finances that you will now need to find, the cost of education…. During the next nine months, there will be moments when you are frustrated, confused or angry. You may tire of hearing about your partner’s discomforts. You might feel left out because she and the baby are getting all the attention. Towards the end, you may feel fatigued because you are doing many of the tasks she did before she was pregnant.

Whenever you find yourself struggling in one of these situations, take a moment and remind yourself of the Golden Rule for Expectant Dads: “It could be worse – YOU could be pregnant.”

Let’s be honest. Guys have the easier half of the pregnancy experience. Look at your contribution to this pregnancy versus her contribution – yours is 5 minutes of pleasure, hers – changing body, nausea, mood swings, labour, breastfeeding…So, whenever you catch yourself throwing a pity party, think of the Golden Rule for Expectant Dads. It could be worse – you could be pregnant!

You should repeat this rule to yourself often. In addition, there’s one thing you must never say to your partner. “I know what you are going through.”

Despite what newspapers claim, no man has ever physically experienced pregnancy, labour or childbirth. Nor would we want to! Therefore we would be wise to avoid claiming we know how she feels. This is one problem that you don’t need to solve and that you don’t even need to fully understand.

Her body carries the baby. She is the one who has to watch what she eats, watch what she drinks, and watch her weight, stress levels, and energy. She has to go to the doctor, take tests and medication, and ultimately she is the one who goes through labour and birth.

Every pregnant woman wants two things from her partner: involvement and support. Your diet won’t help or hurt the baby, but joining your partner in healthy eating will ease her dietary transition. You can’t push during labour, but you can learn how to be her labour support person. While she is pregnant we all need to make our partner feel loved. She will feel vulnerable and her body image will suffer during these nine months, so no matter how unnatural it feels to you, now is the time to be romantic and supportive. The bottom line is that the more you can focus on trying to make her comfortable and content during these nine months, the happier you both will be.

(This article is also available in an audio format)

By Hayley Joy Weinberg – from Hayley Joy Boutique, who creates clothes for plus-size, odd-size and regular size women. The styles and fit are beautiful and flattering for pregnant women of all shapes. Her boutique is in Dunkeld, JHB.

Being pregnant is a beautiful thing, and should be embraced as such – especially when it comes to dressing for the office. Rather than trying to cover it up, be comfortable with your soon-to-be changing shape, and these handy tips below should help you feeling confident and ready to tackle the corporate world in all your preggy glory.

One of the most important things to bear in mind when dressing for the office during pregnancy is to pick fashion styles that are generous in their sizing, so that you can grow into them as your baby bump grows. The reality is that you never know how you are going to carry, so your choice when selecting clothing styles should be around comfort first, before super fashionable. It’s worth remembering that most women don’t go straight back to their original weight after the baby is born, so you will probably be wearing your maternity wardrobe a little longer than 9 months. Buy your maternity wardrobe in three month increments.

Your choices in the first three months should be styles that ease you into this new, ever changing body. Start by buying elasticised waist pants and skirts, so that you get used to an unstructured look and feel. Swop straight cut top styles for slightly swingy cuts so that you start getting used to wearing looser fitting styles. If you are a Plus-size, then you will already have good basics in your existing wardrobe. These should be suitable as maternity wear for your first three months.

In your second trimester, stick with the elasticised waists, but now you will need to buy something a little looser. This is when you need to try and buy adjustable waistbands. Your legs are not going to get much bigger, but your tummy is going to start expanding rapidly, so the adjustable waist allows for you to expand comfortably. Your tops will almost be too tight now, so this is when you need to start buying add-ons that you can layer over your existing tops. For example, a funky sleeveless gilet or overtop, depending on whether the under garment has sleeves or is sleeveless, goes a long way to stretching your existing wardrobe. The Plus-size wardrobe is getting a little tight by now, so you need to start buying tops that are much more roomy, and that allow you to start layering in order to look fashionable as well as respectful.

By your third trimester you are all about tummy and probably breasts. As long as your pants and skirts have adjustable waistbands, they should be fine to wear right through, but your tops are going to need to be upgraded to ‘BIG SWING’. Bear in mind that your tummy will cause your tops to rise up a lot in the front (up to 15cm sometimes) so you need to choose tops that are shaped in the front and that are generously swung. There are quite a few regular sized ranges that include these generously swung styles, so choose pieces that allow you to keep expanding. The Plus-size body will now be mostly about tummy, so as long as your tops have enough swing, you will be able to go through to the end of your pregnancy.

Invest in good maternity basics, and these will allow you to stretch your new wardrobe further. Plain colours are a better option as they are less recognisable, and paired with the right accessories, you’ll have a variety of outfits to go with any mood. A couple of fabulous scarves and you already have whole new outfits. Add some affordable printed over garments and it’ll make a basic two piece look brand new.

You can take the same top and make it work for the office as well as being able to casual it down. For casual wear, a printed swing top with legging and boots works like a charm. For work, replace the leggings with smarter straight leg pants and possibly a loose fitting jacket. One top, two very different looks.

The smartest way to stretch any wardrobe is to invest in good accessories. Beautiful scarves tied in various ways draw attention to your face, so you can wear the same basics and nobody will notice – they will be marvelling at what’s around your neck. Interesting jewellery pieces, make for good talking points, so choose with a view to keeping the attention at face and chest height. Fun, colourful handbags are also a great talking point and accessory to any outfit.

With all of this, if your company has a corporate identity, you need to explain to them that with your body changing shape through this magnificent process of pregnancy, you’d feel more comfortable and confident if you can dress as best for your shape during this time – and get their permission to be able to dress as close to the corporate identity as is possible, in a way that is most comfortable for you.

Some other general and super handy tips are:

  • Swop structured non-stretch jackets, for unstructured stretch jackets that will grow with you and your baby bump.
  • Swop formal pants and skirts with zips and buttons, for stretch pants and skirts with elasticised waists.
  • If you have been wearing tailored shirts that you tuck in, you need to invest in loose fitting shirts that are longer, so that they can hang over the tummy. A-line styles work best as they have the swing over the tummy that is required.
  • If you absolutely need to wear a tailored jacket, then invest in a jacket that is a swing style.
  • If you need to wear tailored pants and skirts, take them to a tailor and have extenders put into the waistband.

(This article is also available in an audio format)

By Tina Otte – registered nurse and midwife, internationally certified childbirth educator 

Until recently, the prevailing scientific habit has been to treat the earliest period of human development – from conception to birth, as an insensitive, unconscious, period of physical growth.

The belief which has blocked understanding is that no intelligence is possible and no learning or memory can occur until after birth, when the construction of the brain is more advanced. If this were the case, it would follow that unborn babies cannot care about anything, know anything, or learn anything.

Newborn babies have been (and still are) getting a raw deal. Belief still exists that baby brains are not yet grown and therefore not much use at birth. In spite of abundant new research and knowledge about infant senses, we find that obstetricians, paediatricians and other professionals remain unconvinced. Birth practices today remain largely the same: bright lights, cold rooms, procedures that are painful for the baby, procedures that are invasive and uncomfortable and all too often professionals blunder through the birth process violating a baby’s senses, believing that they don’t exist. Parents today are in danger of blundering through pregnancy, unaware that the baby’s senses are already working.

Now the nine months of gestation are the focus of intense interest and excitement, the subject of an exploding number of journal articles, books and conferences. The foetus is no longer considered as an inert being “the larval stage of human development, but an active and dynamic creature, responding and even adapting to conditions inside and outside its mother’s body as it readies itself for the particular world it will enter”.

The pregnant mother is not just a passive incubator – but a powerful and often positive influence on her child before it is born.

Pregnancy is not just the nine month wait for the life event of birth, but a crucial period unto itself – “a staging period for wellbeing and disease in later life.”

The false assumption that prenates cannot learn is still given credence in academic circles, permeates the fundamental assumptions of developmental psychology, obstetrics and neonatology, still casts a shadow over nursing, midwifery, and childbirth education, and still confuses each new generation of pregnant parents.

Potentially, babies have a lot to tell us and they are busy communicating with the psychologists, obstetricians, neonatologists, nurses, midwives, childbirth educators, and parents who will listen to them. Babies have been demonstrating awareness, vulnerability to influence, and intelligence.

For over two decades we have had proof that full-term newborns, prematurely born babies and even babies in utero are capable of classical conditioning and habituation. More recently, with refinements in both learning theory and experimental methodology, newborns have demonstrated tactile, auditory, and olfactory learning, imitation learning, and verbal learning.

Recognition learning of musical passages, stories, voices, native language sounds and even children’s rhymes has been shown at birth and during intra-uterine life. The latest in the series of important experiments by Anthony DeCasper and colleagues, involved French mothers who repeated a child’s rhyme three times a day from week 33 to 37 gestational age. After four weeks of daily rhymes, babies recognized the rhyme they had heard but showed no recognition of a different rhyme.

An additional reason for parents to begin active parenting at conception is the discovery that babies in the womb are also developing more rapidly than previously thought possible. From the second month of pregnancy, experiments and observations reveal an active prenate with a rapidly developing sensory system permitting exquisite sensitivity and responsiveness. Long before the development of advanced brain structures, prenates are seen interacting with each other and learning from experience. They seem especially interested in the larger environment provided by mother and father, and react to individual voices, stories, music, and even simple interaction games with parents. The quality of the uterine environment is determined principally by parents.

A parent can influence the environment of their unborn child significantly by becoming aware of and minimizing negative influences, and by adding quantity and quality stimulation, which will develop the child’s intellectual levels, vocal and musical language skills, sensory sensitivity, as well as many other benefits that will affect the life of that child. Learning takes place in the months before birth, whether we are consciously involved in the process or not. Learning had already started a few weeks after conception when baby responded to touch and later to smell and taste and even later to sound and (mostly after birth), to seeing. What is remarkable is that your baby’s ability to read and write and reason six and a half years later when he enters grade one is substantially developed from conception to 14 months old!

The womb is a child’s first classroom, the pelvis his first cradle!! He drifts, kicks and paddles inside the womb, sucking up nutrition through his umbilical straw and then gathering more groceries from the placenta via his mother’s blood stream. He inhales and exhales the warm, salty amniotic fluid that he floats in, gulping it down, tasting and smelling it. With gradually opening eyes and curled hands, he investigates the limits of his watery, twilight world. He listens to muffled conversations from the outer world and hears the musical counterpoint of his mother’s heart, lungs, stomach and intestines. He knows his mother in every way, months before he meets her face to face. Indeed the unborn child is an active, sensitive and responsive human being long before his birth, and parents can play a vital role in providing an optimal sensory environment for him, before he is born.

The opportunities for parents to form a relationship with the baby in the womb are significant and remarkable. This contrasts sharply with the previous view that prenates did not have the capacity to interact, remember, learn, or put meaning to their experiences. Only a decade ago, doctors typically told pregnant mothers and fathers that talking to a baby in the womb was useless and unrealistic. Now there is mounting evidence for memory and learning in utero and for communication before the stage of language. These abilities of unborn babies underlie the successes reported in a series of scientific experiments with prenatal stimulation and bonding.

“When we hold our babies for the first time, we imagine them clean and new, unmarked by life, when in fact they have already been shaped by the world, and by us. It’s a koan of parenthood, one worthy of long contemplation: We are meeting someone we know well – for the very first time.”- Annie Murphy Paul from her book ORIGINS 3

(This article is also available in an audio format)

What are stretch marks?

Stretch marks are fine lines on the body, which are reddish or purplish in colour when they first develop and become devoid of colour later on. Between 75 and 90% of all pregnant women develop stretch marks during pregnancy.

Why do they develop?

In the course of pregnancy, women rapidly gain weight and their abdomen distends to accommodate the growing baby. These changes induce excessive stretching of the skin. Although, skin is fairly elastic, the overstretching weakens the underlying supportive dermis, by damaging its collagen fibres and proteins. This leads to dilation of blood vessels and results in red or purple coloured stretch marks. The hormones oestrogen and relaxin present during pregnancy are also thought to play a part in stretch marks

Who will get them?

This will depend on the amount of weight gain, your genetic history, and whether or not you make a concerted effort to prevent stretch marks.

Factors responsible for stretch marks

  • Genetics
  • Ethnicity / skin tone – 90% of white women develop stretch marks
  • Nutritional history – a sensible diet helps the elasticity of the skin
  • Skin conditions – dryer skin is less elastic than oily skin and hence more prone to stretch marks
  • The amount of weight gained during pregnancy

Guidelines to limit their appearance

  • Eat a healthy, diverse and balanced diet that keeps your weight gain within the recommended range. Excellent nutritional status is vital for your developing baby, but it also contributes to the strength and health of the body’s largest organ: the skin
  • Take your nutritional supplements to ensure proper nutritional status
  • Drink plenty of water – it is critical to healthy skin. The greater amount of water the skin can absorb the more elasticity it will retain
  • Do regular exercise to keep your skin supple and free from toxins. This will help toning the skin of your body and increasing its elasticity
  • Keep your skin liberally moisturised with oil. Apply an oil that possesses natural ingredients that are proven to reduce the appearance of stretch marks during and after pregnancy while strengthening and deeply softening your skin

Massage your body areas where stretch marks are more likely to form – abdomen, thighs, breasts. This will increase the circulation to the areas decreasing the likelihood of stretch marks.

By Dr Welma Lubbe – Author of Prematurity adjusting your dream, www.littlesteps.co.za

Premature birth means a baby is born before 37 weeks of the pregnancy is completed and in South Africa this occurs at a rate of 12% and in the public sector even as high as 25%.

What can be the causes of premature labour?

This early arrival can be due to medical conditions as well as lifestyle conditions. Medical conditions may include (but are not limited to) conditions such as maternal infection, low lying or ruptured placenta, premature rupture of membranes (waters breaking early), abdominal injury and foetal abnormalities. Pregnancy induced hypertension, resulting in pre-eclampsia and HELLP syndrome is a major cause for preterm birth. Multiple pregnancies also increase the risk for prematurity due to limited space in the womb, twin-to-twin transfusion in identical twins and intra-uterine growth retardation, which is also a risk for singleton pregnancies. A previous premature delivery and medical interventions, such as cervical cerclage or progesterone supplements may also cause premature birth. Other risk factors include previous preterm birth, miscarriage, multiple abortions, short period between pregnancies, obesity, diabetes and in vitro fertilization and the list goes on.

Premature births may also be the result of lifestyle factors such as mothers holding high profile and stressful jobs or jobs that require long hours of standing. Late or no antenatal care is a huge contributor to the problem, smoking, drugs and alcohol consumption during pregnancy and illegal drugs as well as a dangerous physical environment, such as exposure to lead paint, crowding and pollution are also contributing factors. Domestic violence, lack of social support and stress are all factors that increase the risk for preterm birth. And sometimes babies just arrive early for reasons not known.

Warning signs of preterm labour

When a little person plans to arrive early, her mom will experience the normal signs of labour, which include contractions every 10 minutes or more often, a change in vaginal discharge, such as water or bright red blood draining, pelvic pressure which may be described as a feeling that the baby will ‘fall out’. Low, dull backache (which may be common in many pregnancies), period-like cramps and abdominal cramps with or without diarrhoea are also regarded as warning signs.

Prevent preterm labour

Mothers can lower the risk for premature delivery in some cases, but it cannot be prevented all together. There are a few precautions moms can take:

Control medical conditions

Problems such as high blood pressure and diabetes can be identified, monitored and controlled through antenatal care.

Healthy lifestyle

By not smoking, consuming alcohol or using drugs, risk factors are lowered. Dads should also stop smoking, since the nicotine inhaled through passive smoking is not good for the mom or her baby and has been shown to lead to intra-uterine growth restriction. Follow a healthy eating and exercise plan and relax! Stress hormones can cross the placenta and affect your unborn baby. A pregnancy massage may help you carry your baby full term, since it aids in decreasing stress hormone levels and this is a wonderful way in which dad can be involved in the pregnancy. Mothers who receive massage therapy during pregnancy feel less anxious after a massage session, and a foot massage has shown to lower the mother’s heart rate, blood pressure and respiration. Massage increases foetal activity and moderate exercise produces an increase in foetal heart rate and breathing, which is excellent for development of the foetus.

Prevent and treat infections

Vaginal and urinary infections can all cause premature labour. Have any symptoms of a vaginal and urinary infection checked out and treated, if necessary. In addition women are more susceptible to gingivitis (gum infections) during pregnancy due to hormonal changes. These infections can also cause preterm labour therefor regular dental cleanings can be very beneficial in preventing preterm labour.

Good hydration

When you become dehydrated the concentration of oxytocin can rise in your blood thus causing contractions, so remember to takes lots of fluids, especially during the summer months.

Prenatal appointments

By keeping regular prenatal appointments your doctor or midwife can help screen you for risk of preterm labour and treat it as early as possible if you do develop signs of premature labour.

Avoid oxytocin and prostaglandin

Oxytocin is the hormone that initiates contractions and is also released by means of breast or nipple stimulation, semen and having an orgasm. If you are at risk for preterm labour use a condom during sex or avoid it all together.

What can you do if you experience preterm labour?

Be aware of the early signs of labour and make sure that you are able to monitor contractions and the movements of the baby at home. Contact your doctor immediately in case of an infection to prevent infection-related premature labour. Avoid high stress levels, such as work-related stress when pregnant, especially from the second trimester onwards. When receiving infertility treatment, request the implantation of only one embryo to decrease the risk of a multiple pregnancy, which often results in premature birth.

If you have five or more contractions in an hour, or the time between the beginning of one contraction and the beginning of the next is less than 15 minutes, stop what you are doing, empty your bladder, and drink some fluids and rest lying down on your left side for an hour. Put a small pillow under your hip to support your back, if needed and feel for the uterus tightening. If this uterine activity persists while you are resting, then you may be in preterm labour and you should contact your healthcare professional.

From how many weeks does baby have a good chance of survival outside the womb?

Completed weeks of gestation at birth (based on last menstrual period) Estimated chance of survival
21 weeks and less 0%
22 weeks 0-10%
23 weeks 10-40%
24 weeks 40-70%
25 weeks 50-80%
26 weeks 80-90%
27 weeks >90%
30 weeks >95%
34 weeks >98%

If baby is born too soon, what does it mean for you and your baby?

Preterm infants usually experience challenges that include continuing their normal development outside the supportive environment of the womb and with immature organs. Stressors such as noise, bright lights, pain and disruption of sleep and rest, result in them not being able to reach physiological stability, such as a normal heart rate, breathing and temperature regulation.

They also experience behavioural problems, including difficulty with self-regulatory activities, sleep and calming. Medical complications due primarily to the immature lungs and brain include: temperature instability, feeding difficulties, breathing problems (respiratory distress syndrome), tachypnoea (fast breathing), retinopathy, necrotising enterocolitis and jaundice. They are also at higher risk of longer hospitalisation and re-hospitalisation after discharge.

Preterm infants may or may not experience long-term challenges. The smaller the infant is at birth, the bigger the possible challenges and risks. Some developmental problems include mental and neurological problems such as problematic feeding (especially problematic for the mother), cerebral palsy, visual acuity and blindness, hearing and motor deficits, poor emotional regulation, emotional vulnerability and difficulties with self-regulation and self-esteem.

In the longer run, challenges may even include attention span difficulties and language delays which can lead to learning disabilities, lower IQ (which can be improved by doing skin-to-skin and breastmilk feedings), impaired executive function, attention deficit disorders, lower fatigue thresholds which may influence daily activities and lead to easy distraction, impulsiveness, concentration difficulties, spatial orientation disturbances and language comprehension and speech problems.

(This article is also available in an audio format)

Question

I am experiencing terrible heart-burn. Is there anything I can do to relieve it?

Answer

Over half of all pregnant moms get heartburn, an uncomfortable burning sensation that occurs when acid from your stomach’s digestive juices escape through the relaxed stomach valve and bubble up into your oesophagus. It’s due to pregnancy hormones relaxing the valve that usually stops the acid from welling back up. It may get worse later in pregnancy, as your growing bump also puts extra pressure on your stomach

What to do

  • Eat smaller, more frequent meals. This will limit the amount of food in your stomach
  • Don’t drink a lot with your meals or you’ll swallow more air, which will aggravate heartburn
  • Cut down on alcohol and caffeine – they relax the muscle that usually holds the acid in
  • Avoid foods that trigger heartburn – fatty and fried foods, tomato sauce, and spicy foods are often the culprit
  • Tempting though it is to lie down after eating, make yourself sit in a comfortable upright position
  • Before going to sleep, prop yourself up with pillows behind your head and one under your knees
  • Avoid wearing clothing that is tight around your middle
  • Take an antacid if necessary

Question

I am pregnant and not sleeping well at all. Help is needed- please?

Answer

This is nature’s way of preparing you for what is ahead – lots of broken sleep. It gets more difficult to sleep the further you go into your pregnancy. No position seems to be comfortable for very long. Again this is nature’s way of helping you prepare for your birth. If you didn’t get uncomfortable and look forward to this this pregnancy ending – it would be quite a traumatic adjustment when you went into labour.

Some sleep accessories and a night-time routine may help. To get your body more relaxed and ready for sleep, before getting into bed –

  • Take a warm shower and do some slow stretches to ease tension in your neck, shoulders and back. Do a hula dance and sway your hips from side to side, forward and back and in a circle. This moves around the baby and changes the area that it is placing pressure on in your pelvis
  • Take a warm bath and let the water relax your tired muscles. Have someone help you out the bath as a long soak can make you feel light-headed
  • Do some slow deep breathing
  • Ask your partner to give you a massage
  • To help get into a more comfortable position
  • Use a preggy roll or lots of pillows for support of your legs, tummy and head
  • Use an extra blanket or sleeping bag to add a layer of softness between you and your mattress
  • If you wake up and can’t get comfortable
  • Take a stroll around your home after you have been to the bathroom
  • Rest in a reclining chair
  • Listen to some relaxing, quiet music or some nature sounds
  • Dream about your precious baby that will soon be there

Question

Is it safe to travel long distances by car while I am pregnant?

Answer

It is fine to travel, but a few important factors must be taken into account

  • Frequent stops – every 1 to 2 hours should be made for walking and stretching to prevent blood clots in the legs due to long periods of inactivity
  • You should empty your bladder regularly and drink frequently to prevent a urinary tract infection and becoming dehydrated
  • Remember to still snack frequently and don’t go for long periods without anything to eat

Question

Why do I need various scans done during my pregnancy?

Answer

  • 6-8 weeks
    • A scan to confirm the viability of the pregnancy – check baby’s heart beat and that the foetus is within the uterus
    • Detect any gross abnormalities
    • Confirm the expected due date by measuring the baby from head to bottom up to 14 weeks
  • Nuchal scan 11 – 13 weeks
    • A nuchal scan measures the amount of fluid at the back of the baby’s neck. Higher than average levels can indicate a risk of Down’s syndrome. This measurement gives an indication of the risk, which can be further refined with a blood test. The blood test will only be conducted if the nuchal measurements indicate a need for a more accurate assessment
  • Foetal anomaly scan 18 – 24 weeks
    • This assessment uses the capabilities and safety of an ultrasound scan to give the baby a full check-up. It is the first real opportunity to assess the baby’s organs and well being. It is a detailed review of the baby’s anatomy, including the head, spine, heart and kidneys
  • 4 D bonding scan
    • A chance to see lifelike images of your baby. Good to have between 24 and 32 weeks

Question

Is it safe to wear a seat belt during pregnancy?

Answer

Definitely wear your seat belt during pregnancy. It can save your life as well as your baby’s. Position the lower strap low over your hips, under your preggy bump. The shoulder portion should ride over your shoulder and chest. A seat belt adjuster may help to keep the straps in the correct position. Place your seat as far back as is comfortable and ensure you can reach the pedals safely. This places maximum distance between your preggy bump and the steering wheel. Do not let your tummy touch the steering wheel while driving. Try to be at least 20cm from the steering wheel.

A new life begins

A woman’s egg is fertilized by a man’s sperm in the fallopian tube. During the next few days, the fused egg and sperm move through the fallopian tube to the lining of the uterus. There it implants and starts to grow. The cluster of cells that reaches your uterus will become the foetus and the placenta. The placenta functions as a life-support system during pregnancy. It delivers oxygen, nutrients, and hormones from mother to foetus.

Pregnancy is a time of major change. From the very start, your growing baby alters your body and the way you live. For your entire pregnancy, the baby depends on you for all the things it needs to grow and thrive. Although each pregnancy is unique, the growth and development of a foetus take place in a fairly standard pattern.

0 – 4 weeks of pregnancy

Common signs of pregnancy

  • missed menstrual period
  • sore or tender breasts
  • tiredness
  • frequent urination
  • nausea
  • bloatedness

The most common sign of pregnancy is when you do not start menstruating at the normally expected time. There are a number of home pregnancy tests on the market or alternatively you can have a BHCG blood test done at the nearest laboratory. As most of these tests are quite accurate you do not need to visit a doctor or midwife until you are 8 weeks pregnant. Miscarriages occur in 1/5 of pregnancies (1 in 20).

Baby

Seven days after the egg is fertilised, about the time of implantation in the lining of your uterus, the egg begins to produce a hormone called HCG. It now develops into an embryo and begins to form a placenta – the vital link between mom and baby. The heart develops and begins to beat. At 4 weeks the embryo is about 4mm long and weighs less than 1g.

Boy or girl

The father’s sperm determines whether your baby will be a boy or girl. The egg carries 2 X chromosomes, but the sperm carries an X or Y chromosome. If a Y chromosome sperm fertilises the egg it will be a boy, if it is a X sperm it will be a girl. There is a 50% chance of either sex.

5 – 8 weeks of pregnancy

During these weeks, the placenta is starting to grow and secrete its own hormones. You may start to experience nausea especially in the mornings, breast tenderness and an urge to empty your bladder more frequently. Ensure that your diet contains adequate amounts of iron, folic acid and calcium. If you are not nauseous you can start taking vitamin supplements recommended for pregnant women.

Weight gain

During pregnancy an ideal weight gain is 12,5kg. In order to best prepare your body for this weight gain use an oil to rub in frequently to your skin in susceptible areas for stretch marks like the abdomen, breasts and thighs. Moisturised and well hydrated skin will be better able to accommodate the stretch it will have to endure.

  • Average baby – 3,4kg
  • Placenta – 0,6kg
  • Amniotic fluid – 0,8kg
  • Uterus increase – 0,9kg
  • Breast increase – 0,4kg
  • Blood volume – 1,5kg
  • Fat – 3,5kg
  • Extracellular fluid – 1,4kg

By 8 weeks of pregnancy you can now have a blood test to determine whether you are expecting a boy or girl! The advantage of this test is that it is available a lot sooner and generally a more accurate test than ultrasound which depends on the position of the baby. It detects the sex of the baby by characterising minute quantities of foetal cellular material which is released into the maternal bloodstream as part of normal foetal development.

Issues to decide

  • The birth place
  • Your caregiver – midwife, GP or obstetrician
  • Routine tests

Danger signs

Signs of premature labour

  • Low dull backache
  • Vaginal bleeding
  • Lower abdominal cramps

Baby

Dramatic changes occur during this stage. The nervous system is starting to develop with the growing of the notochord and the neural folds. Formation of the heart and the gut is also in progress. An embryo during this period will normally have a crown to rump length of 2,5cm. The following are present – a primitive brain, a heart, arm and leg buds and beginnings of eyes and ears.

9 – 12 weeks of pregnancy

Your body is starting to change. Breasts may still be tender and you may need to empty your bladder frequently. You may still feel nauseous.

Baby

By twelve weeks the foetus’s limbs and internal organs are fully formed and is now about 8,5cm long. The heartbeat can be heard using a doptone. It beats much faster than yours – about 140 beats per minute. For the rest of the pregnancy the foetus only grows and matures – the organs are all now perfectly formed. The placenta is mature and provides all the nutritional needs of the foetus. The external sex organs are sufficiently developed to enable the sex determination on a scan. Skin becomes downy as hair starts to grow.

13 – 16 weeks of pregnancy

Your uterus is now easily palpable above the pubic bone. Your breasts are enlarging and the areola (the dark area around the nipple) may become darker. You may notice a line on your abdomen – the linea nigra – which will disappear after pregnancy. Some women may experience some pigmentation on their face as well. Pressure on your bladder may now be less as the uterus has moved higher up into the abdomen, out of the pelvis.

Baby

At 12 weeks the placenta is fully formed – it is the baby’s main link with its mother during pregnancy. It controls body functions and provides vital food and oxygen.

At 16 weeks the foetus is about 14cm long. The legs are starting to grow longer than the arms. Fine hair (lanugo), and vernix caseosa (white greasy substance) is starting to cover your baby’s skin. Some of it is still present at birth, and it protects the baby’s skin, which is very thin.

17 – 20 weeks of pregnancy 

At 20 weeks your uterus is just below the umbilicus. Sometimes it may be noticed that the umbilicus gradually flattens as your uterus grows. You may start to feel movement (quickening). First time mothers usually become aware of the movement at a later stage. It sometimes feels like “fluttering butterflies in your stomach”

Relationships

It is important to talk things over together with your partner about your feelings and not to get trapped in your separate worlds. You are both becoming parents, and the transition is easier if there is understanding between you.

Baby

At 20 weeks your baby’s head is about 1/3 of the size of the body. The baby weighs about 225-500g and is about 20-30cm long. Eyebrows and eyelashes are starting to grow. Breathing movements can be seen on ultrasound. As the baby matures, breathing becomes more regular, although he can’t breathe in air. This is like a rehearsal for the moments after birth. The foetus is also swallowing amniotic fluid and passing urine. The skin is starting to form fingerprints.

Baby’s movements

Each baby tends to have its own characteristic rhythm of activity and moves most energetically at a particular time of the day. You won’t feel all the movements your baby makes – sucking, the fluttering of hands and breathing movements are all too slight to notice. A baby might be inactive for several hours at a time when he is probably sleeping.

21 – 24 weeks of pregnancy

By 24 weeks the top of your uterus has grown to just above your belly button. You are probably gaining between 240g and 480g a week. Now that your physical and emotional adjustments of early pregnancy are over, you may be feeling good about yourself and starting to really enjoy your pregnancy.

Lovemaking can take on a new aspect of enhanced enjoyment – you no longer have to be anxious about falling pregnant. When you make love, it is more comfortable to experiment with different positions where your partner’s weight is not bearing down on your growing abdomen.

Baby

The baby now has sleeping and waking cycles. The bones are starting to harden. By 24 weeks the baby is about 36cm long and weighs 680g. By 24 weeks the baby’s organs of balance inside the ear have developed. The baby has delicate eyebrows and eyelashes now. The baby can suck and sometimes sucks its thumb.

25 – 28 weeks of pregnancy

You may start to experience some backache because of the softening influence of pregnancy hormones on your ligaments – exercise will help to strengthen these muscles. Braxton-Hicks contractions may be noticed – these are irregular hardenings of your uterus. They are usually not painful, and become more frequent closer to the end of the pregnancy. These Braxton Hicks are the practice contractions preparing for labour. Heartburn may become a real problem now – so eat smaller meals more often and try to avoid fluid with your meals.

Common fears for mom

  • Will I be a good mother?
  • Will my baby be normal?
  • Will I survive the pain of labour?
  • Will I love my new baby as much as my toddler?

Baby

After 28 weeks your baby is able to survive should it be born prematurely. Fat is being deposited under your baby’s skin. The eyelids can open and your baby can distinguish your voice from others. The uterus is a noisy environment – mom’s heartbeat, blood flowing through the placenta, mom’s tummy rumbling.

Decisions to make

  • Choose your childbirth educator
  • Draw up a birth plan

29 – 32 weeks of pregnancy

This is the beginning of the third trimester. Your belly is now growing and you may become breathless even with little exertion. It is important to be aware of your baby’s movements – this is your only way of knowing that your baby is fit and healthy. Each baby has its own movement pattern – if this decreases drastically – consult your caregiver or hospital immediately.

Try to sleep on your side. If you lie on your back, ensure that you sleep on at least 2-3 pillows otherwise the weight of your pregnant uterus and your baby presses down on your main blood vessels which slows down the blood flow to your baby.

Danger signs

  • Severe headaches
  • Abdominal pain
  • Draining of fluid from the vagina
  • Blurred vision
  • Vaginal bleeding
  • Baby not moving nicely

Baby

Baby measures about 28cm from crown to rump. He weighs about 2kg

33 – 36 weeks of pregnancy

The uterus now pushes right under the lungs causing you to experience shortness of breath and to become easily tired. Your baby’s movements can become fewer but bigger movements. If you are having a home birth, the necessary steps for preparation of equipment should now be taken.

Baby

The head and body are now in the same proportions as at birth. Lanugo, the very fine downy hair covering your baby may start to disappear. The baby is moving, blinking, passing urine, swallowing the amniotic fluid and hiccuping. Her muscles are strong as you can feel from the vigorous kicking and thrusting of her arms and legs.

Issues to see to

  • Pack your bags for hospital
  • Book your bed at the hospital
  • Ensure your medical aid knows about your pending baby
  • Decide on a birth partner

37 – 42 weeks of pregnancy

These last few weeks usually feel the longest. The baby’s room is ready and you are getting anxious. It is important to keep your mind occupied during this period. Plan a couple of interesting things to do. If you are expecting your first child, go out and enjoy a candle light dinner – remember this is the last few weeks of not having extra responsibilities

Signs of labour

  • a gush of water from the vagina as your membranes rupture
  • continuous slow leaking of fluid from the vagina
  • regular tight contractions of your abdomen – these contractions need to become regular, stronger and last a longer time span.

When to go the hospital

  • when your contractions are about
    • 5 minutes apart
    • lasting 45 seconds long
    • good strong regular contractions
  • when your waters have ruptured

Baby

At 39 weeks your baby is now a term baby and ready to be born at any stage. The baby may still be covered with vernix and is putting on weight every day. The intestines contain the first bowel movement called merconium a black greenish stool.

Your baby should be lying in a normal position – head down. If baby is lying breech – bottom first, you may consider having your baby turned. This is known as ECV (external cephalic version). Not all practitioners are skilled to do this procedure and you may ask your caregiver to refer you for this procedure to someone else if he is not willing to offer you the service.