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Prengnancy

Man only provides the sperm. It is the mother who provides everything else to give birth to that loved creature, your child. The whole process of conceiving and delivering a child is the most natural of all processes. It is, however, so different with every woman that all problems associated with this process must be referred to a doctor or a qualified midwife for advice. This chapter provides only briefly some basic guidelines for pre and post natal care.

Pregnancy can last from 36 to 41 weeks. On an average, a pregnancy takes about 10 lunar months. Only about 4 per cent of the babies are, however, born on the expected due date. Do not upset so long as your loved one does not arrive before 36 weeks or after 41 weeks, both extremes being considered normal.

Pregnancy is the period for gaining weight. In the first three months you gain one or two kilograms (about 2 to 4 Ibs). Later, the gain could be a little less than half a kilogram a week. The total gain should not be less than 10 Kgs. (22 Ibs) and not more than 14 kgs (30 Ibs). Generally you get back to your normal weight within one year. If possible, a woman should be weighed as soon as she knows that she is pregnant. She should gain weight every month and be weighed every month.

Missed periods, breast changes, nausea, morning sickness, increased frequency of micturition, fatigue are some of the early signs of pregnancy .

Professional Advice

Mother-to-be should go to the local health centre or consult a physician as soon as she believes she is pregnant. They will check the progress of the pregnancy and deal with problems if and when they arise. High blood pressure of the expectant mother is dangerous for both the mother and the child. It must be checked at regular intervals. In case of anaemia, iron tablets will have to be prescribed. Two injections against tetanus should be given at correct stages. Malaria tablets should also be given where necessary. These professionals could moniter the growth of the baby and advise her on breast feeding, care of the new-born and timing of the next pregnancy.

A trained birth attendant would know how to keep the birth clean and reduce the risk of infection, how to cut the chord cleanly and safely. Such a trained person knows what to do if the baby is born in the wrong position or if too much bleeding is taking place or if the baby does not begin breathing straight way. She will also know when to call expert medical help. She could help the mother to start breast-feeding immediately after birth and dry and keep the baby warm after delivery. She could help the mother prevent or postpone another pregnancy.

If any complications are feared it may be advisable to move the mother temporarily close to a clinic or hospital so that the mother is within reach of medical help. Such complications may be closely monitored in all cases in which the timing of birth has not been properly planned or where a previous baby weighed less than 2 Kg at birth or where she had a previous difficult or a caesarian delivery or a premature birth or a miscarriage, abortion or a still birth. Special care has also to be taken where the mother-to-be weighs less than 38 kgs before pregnancy or measures less than 145 cm (4 ft. 9 inches) in height. Morning Sickness

A normal healthy body has a greater detoxifying process working during the night. If toxins are not taken care of at night, these make the pregnant women sick the next morning. Vitamin Bb6 especially helps in such detoxifying process. Foods rich in this vitamin are important for avoiding morning sickness. Those suffering from morning sickness during pregnancy should keep a banana or biscuits, cookies, crackers or dry toast by their bed side and eat the same before sitting up in the morning, that, is while still lying in bed. After eating, keep lying for 10 minutes.

This is likely to defeat nausea. Avoid greasy, fried or spicy foods. Get up slowly, avoiding sudden movements. Iron supplements can be left out during this period of morning sickness since they may contribute to an upset stomach. Cases of morning sickness are reported to have been cured by the use of rubber bands applied on the thumbs and the index fingers and by applying pressure on the webs between those fingers. During this period drink liquids between the meals and not with the meals. Eating small meals also helps. Gowen recommends raw peeled almonds as a snack during this period. To some women sipping carbonated water provides relief. Yam or sweet potatoes and ginger also help in this condition and so does chamomile herbal tea, taken in the mornings. Do not take any medication. Talk to other women who have suffered from morning sickness. Once you know it will go away, you come to terms with it. Morning sickness starts in the sixth week and stops after 3 months. Wataru Chashi of the Chashi Institute of New York City prescribes a daily all over massage as a preventive measure. Massaging the entire neck and stretching of the head away from shoulder is specially helpful. Studies show that women having morning sickness generally have a healthy baby.

Exercise

According to the American Journal of Obstetrics and Gynecology, 1985, moderate exercise, during pregnancy, may reduce the chance of having a miscarriage or a premature baby. Exercise strengthens the pelvic and abdominal muscles which help make the birth easier.

Regular exercise during pregnancy is essential. Walking is the best exercise in that body condition. Brisk and strenuous exercise should be avoided when tired, take a casual stroll. While sitting on a chair keep your knees wide apart and cross your legs at the ankles and not at the knees. Join an exercise class for pregnant women if available nearby.

A woman should not work full time after the 30^th week of pregnancy. During the last three months the heart is working 33% harder than normal. It needs some relief. Avoid high heeled shoes in pregnancy because they shift the body weight forward, thus placing additional strain on the spine and back. Avoid prolonged sitting. Get up slowly after lying down. During pregnancy you need 9 to 10 hours of sleep. Try to lie on your left side with your knees bent inwards Mid-day rest is the answer to fatigue in early pregnancy. Do not wear undergarments tight about the waist. Link has been established between fetal anomalies, childhood malignancies and X-Ray examination during early pregnancy. X-ray examination must therefore be avoided. Exposure to smoking, active or passive, must also be avoided. Such an exposure could lead to even a still birth. Drinking alcohol and using narcotic drugs has similar consequences and must be shunned. Do not take any medicines during pregnancy unless prescribed by a doctor who is aware of your pregnancy position.

During pregnancy, the presence of breast milk is no cause for alarm. Wash away any dried milk with warm water so that your nipples do not become itchy, irritated or sore. If the gain in weight is less than 10 kgs or inside of your eyelids is pale or there is unusual swelling of legs, arms or face, medical advice may be sought immediately.

There are occasions when faintness comes while lying on your back. It only means that the uterus has fallen against the main blood vessels at the front of your spine and has interfered with enough circulation to those vessels. The drop in circulation makes you faint. Solution is very simple. Lie on your side and not on your back. The weight of the uterus shifts and normal circulation is restored.

Nutrition

Proper nutrition is very important for a good pregnancy. It was in 1941 that evidence was provided for the influence of pre-natal diet on the health of the new born infant. During pregnancy, iron, vitamin C and calcium are required in larger quantities. Take food rich in these minerals and vitamin C. Milk and milk products are good, fruits and vegetable juices may also be taken. Vitamin C may, however, have to be taken as an added insurance only when recommended by a doctor. Drink lots of fluids. Do not restrict salt too much during pregnancy unless so directed by the doctor, you may have to add 15 to 20% to your calories because of the pregnancy. Iron rich foods may be necessary to keep red blood cells properly oxygenated. 500 to 1000 mg. Of extra calcium is also necessary. Muscle cramps are generally due to insufficient calcium intake or insufficient exercise.

Smoking, alcohol and even strong drugs must be avoided. Bananas are reported to improve the complexion of the child and parched gram and almonds during pregnancy add to the intellect of the child. Intake of milk and pulses is very necessary during pregnancy. These have high food value. Vitamin C and bioflavonoids (also called Vitamin P) when taken regularly during pregnancy, reduce the risk of abortion considerably even in habitual cases. Vitamins C and P make the pregnancy very easy. These vitamins are contained in the white underskin and the segment parts of the citrus fruit and not so much in its juice. Lemon, grape, plum, grapefruit, apricot and cherry contain vitamin P. Avoid vitamin supplements. Draw vitamins and minerals from natural foods.

Folic acid (Vitamin B family) is very important for easy pregnancy. It abounds in fresh vegetables, legumes, milk egg and brewer's yeast 75% of this is lost in cooking lasting more than 15 minutes. Large volume of research shows that antibiotics can cause folic acid deficiency. Birth control pills also cause folic acid and vitamin B6 deficiencies. It is therefore, desirable to get on a programme of good nutrition before getting pregnant. British Medical Journal reports on how folic was given to a group of women who had delivered malformed babies in previous pregnancies and with folic acid, the incidence of deformity was reduced considerably. W.H.O. estimates that outside U.S.A. one-third of all pregnant women in the world have folic acid deficiency.

Requirements of proteins, folate and some important minerals during pregnancy can be roughly summed up as follows:

		Non-pregnancy requirement	Additional for pregnancy status
Protein	- g	50	+ 10
Folate	- mcg	180	+ 220
Calcium	- mg	800	+ 400
iron	- mg	15	+ 15
Zinc	- mg	12	+ 3
Iodine	- mcg	150	+ 25

Following special foods help during pregnancy:

1. Roasted peanuts with jaggery (Gur) and cow or goat milk help considerably.
2. Thyme and its tea, in cases of normal births, speed up delivery and make it easy.
3. Four or five grams of dry ginger with liquorice (Mulathi) taken with milk at night would reduce the risk of abortion.
4. Molasses, parsley and amaranth taken during pregnancy ensure easy confinement and a healthy child.
5. Vitamin E supplements of i.u. 400 help in cramps during pregnancy. These supplements are not recommended as a routine.

Craving for clay or chalk etc. during pregnancy should be curbed. Giving boiled beans with sugar helps in this. Drinking a large draught of cold water and sometimes even licking of a little honey help to curb this craving (American Medical Association ?Book of Women Care' page 89).

In later stages of pregnancy caffeine is not excreted from a women's body. This retained caffeine reaches the fetus and excessive use could be harmful. In the last 3 months, tea, coffee and other caffeine drinks must be restricted.

The husband and family of a pregnant woman should ensure that she has more of the family food everyday and more rest than usual during the day time, especially in the three months before the birth.

Pregnancy problems

Dr. M. Stoppard in her "Every Woman's Medical Handbook" deals with various pregnancy problems as under:

1. Abdominal pain: There could be so many causes of abdominal pain in pregnancy. A hot water bottle or heating pad will generally relax muscles. Do not take pain killer. If pain is severe or persistent, please consult your doctor.
2. Backache: Concentrate on good posture. Watch your footwear. Check your mattress. Exercise to strengthen the spine. If the baby is in the occipite posterior, get down on all fours to take the pressure off the back.
3. Constipation: Take plenty of dietary fiber and lots of fluids. Regular exercise, no laxatives. Dried fruits and bran are indicated.
4. Cramps: massage the affected part firmly. For leg cramps, flex your feet hard, pushing your heels away from you.
5. Cravings: Eat whatever you feel like but no fattening things.
6. Fainting: If you feel faint, lie down with your feet slightly elevated. Avoid standing for long periods and do not rush around.
7. Flatulence: Avoid fried foods. Peppermint and hot milk drinks may help. Try not to gulp air. Chewing gum causes you to take in air.
8. Fluid retention: If there is swelling of feet, rest with your legs up and avoid standing. Avoid salty foods.
9. Heart burn: Avoid fatty foods and acidic fruits. Have a hot milk drink before going to bed. Raise the head end of the bed to prevent reflux. Try not to take antacids.
10. Hemorrhoids: Eat a high fiber diet to keep your stools soft and easy to pass. If the hemorrhoids itch, apply soothing cream or ice packs. Don't have hot bath.
11. Insomnia: Wear natural fabrics in bed to avoid overheating at night. No sedatives. Loose and light clothing, a hot drink or an unexciting book could also help.
12. Rashes: Keep yourself clean and well dried. Apply talcum powder to folds of skin.
13. Rib pain: Prop yourself up so that the ribs are not compressed. The pain will disappear when the baby drops into the pelvic cavity.
14. Sweating: Wear light natural fibers and don't exert too much.
15. Vaginal discharge: Wear a panty liner for comfort. See your doctor if you notice any brown or irritating discharge.
16. Edema: Headache, blurring of vision, severe vomitting, high fever and watery discharges need urgent medical advice.
17. Fetal movement: Absence of fetal movement for 48 hours should be reported to the doctor.

If you are mentally and physically relaxed, childbirth will be less painful. Try to urinate as soon as possible after delivery. You may need to urinate frequently in the first few days. This is the way your body eliminates any fluids. Do not worry about your first bowel motion. This does not normally occur for about two days after delivery. Breast feeding may be associated with pains when uterus contracts to pre-pregnancy size. Start exercise even before you get out of bed. To strengthen your abdominals, lie on the bed, with your knees and your hands flat on your stomach. Squeeze buttocks together and press your back into the bed.

Baby's feelings during the first few minutes of his life are very important. Upon delivery, place the new born on the mother's abdomen to reassure it that the environment is warm and friendly. Caressing and touching of its back by the parents will relay love and affection to the baby. In the first few days rock the baby often. It has lived in a moving environment for nine months. The stillness after birth frightens it. Carry it around in order to soothe its body panic.

Question of regaining your figure after delivery is very important for you. During the pregnancy, stretch marks in the shape of wavy strips appear on the abdomen, thighs and sometimes even on breasts. This is mainly due to rapid and excessive weight gain. Watch your weight. Do not gain more than 10 Kgs (22 ibs) if you want to get back to your original weight afterwards. Simultaneously continue to massage the vulnerable parts of your body with oil. Moreover, from the seventh month when breasts begin to enlarge, use nursing bras and wear them day and night.

Girls who are healthy and well fed during their own childhood and teenage years, have fewer problems in pregnancy and childbirth. So special attention should be paid to the health, feeding and education of adolescent girls. The first pregnancy should wait until at least the age of 18.

Avoiding births by having an illegal abortion can be very dangerous Illegal abortions carried out by untrained persons in India kill an estimated 30-50,000 women every year. Government has made provision for medical termination of pregnancy under supervision on request.

Last 8 to 10 weeks

Important of the last 8 to 10 weeks of pregnancy is sought to be highlighted by the investigations undertaken by the psychologist Anthony De Casper of the University of North Carolina at Greensboro. He is investigating the ability of the new borns to digest the sounds voices and even information "they" heard during the final weeks of pregnancy. Among other things he created an experiment in which babies less than 2 days old could "tell" which sounds they preferred to hear. They showed sucking preference when "known" sounds were made. Many mothers have stated that their new born babies seemed to prefer the same type of music that was played during their late pregnancy.

The premise of their research gets support from the epic Mahabharata in which it is mentioned that when Abhimanyu was in the womb of his mother in later part of the pregnancy, his father Arjuna described the intricacies of the fort Chakravyuha to his pregnant wife, telling her how that fort was to be entered and how it could be exited. When Arjuna was describing the route of exit, Abhimanyu's mother had fallen asleep with the result that though she heard all other details, she did not hear the latter part to know how to exit therefrom. Abhimanyu, in womb, in later part of the pregnancy, heard and digested all that information. When fighting on battle ground of Kurukshetra he used that information for entering that human fort but did not know how to exit and was killed. The trend of the research of Anthony De Casper draws lot of validity from the above mentioned story from the Indian epic Mahabharata. Whatever be the case, it does no harm of the expectant mother lives the last two months of her pregnancy the life that she would like her child to lead after birth. Leading a highly intellectual, spiritual, virtuous life, getting inspired by the lives of greatmen, following a regulated life with exercise and nutrition, playing music and practising fine arts or whatever else be the liking of that expectant mother, you could charter the life and style of your healthy child. Try it, plan and lead a good style of your healthy child. Try it, plan and lead a good life. You would not a loser whatever be the result of De Casper's investigations.