There are few human processes that carry with them as many associated emotions as falling pregnant.

A pregnancy is divided into three trimester periods that are used to describe prenatal development. Pregnancy is different for every woman. Knowing what to expect will help you get ready for the months ahead.

Some women glow with good health and vitality during the first three months; others feel nauseous and exhausted.

The first trimester is often associated with the onset of morning sickness (usually from six weeks) and carries the highest risk of miscarriage (the natural death of the embryo or foetus).

As you enter your second trimester, the morning sickness and fatigue of the first three months should fade, leaving you feeling more energetic and like yourself again. The second trimester is when many women feel their best. Take advantage of this time to start planning for baby’s arrival. The baby’s development is rapid in the second trimester.

The third trimester comes with the challenges of carrying around the extra weight of your baby. Make sure you get enough rest and good quality nutrition. You’ll start thinking about your birth options at this time too.

All mothers desire the best for their children. Start before your baby is born by making wise lifestyle choices…

Early antenatal care

Check in with your gynaecologist or obstetrician early in your pregnancy for a risk assessment (at about seven to eight weeks).
This allows for a personalised approach and identification of any risk factors or early concerns.

Routine blood tests

Blood tests will be done at your first visit with your doctor or midwife. They are a routine part of antenatal care. Among these will be tests for checking your blood group, whether you are rhesus positive or negative, your immunity to rubella (German measles), for syphilis and hepatitis B, and for HIV. These tests are important as they allow for early intervention once abnormalities or presence of disease is picked up. Mothers-to-be who test HIV positive should start antiretroviral treatment straight away so they can reduce their chances of passing the virus to their babies.

Dietary guidelines

Improve your diet by eating twice as well, not twice as much. Right from conception your baby is in a critical period of growth, where he or she is largely dependent on your nutrition. Eat a wide variety of foods and eat regularly, without skipping meals, especially breakfast – morning sickness is often worse when your tummy is empty.

• You need 1 200 mg of calcium every day to build your baby’s teeth and bones. Not getting enough could harm you, too – too little can cause bone density loss and tooth damage in mothers. Dairy products are great sources,or canned salmon, fortified cereals and spinach.
• At least 85 mg a day of vitamin C may help you avoid preterm delivery, since vitamin C strengthens the amniotic membrane. Foods rich in vitamin C also enhance the absorption of iron, which is essential for the oxygen carrier haemoglobin. Up your Cs with guavas, broccoli, cranberries, citrus fruits and juices, kiwi, mangoes and tomatoes.
• The fat in fish aids the development of the baby’s brain tissue and central nervous system. The best sources are the cold-water variety: pilchards, sardines, haddock and mackerel. Canola or flax oil, and linseeds are also excellent.
• Most doctors recommend a daily prenatal multivitamin to cover you for any vitamin and mineral shortfalls.
• Folic acid before and during pregnancy can reduce neural tube defects by up to 70%. Start three months before you plan to fall pregnant.
• Food hygiene is vital. Food-borne illnesses can cause harmful infections as well as congenital disease, prematurelabour, miscarriage and foetal death. Avoid meats, fish and poultry (including eggs) that aren’t fully cooked; thoroughly rinse fresh fruits and vegetables; and wash hands, food preparation surfaces, cutting boards, dishes, and utensils that come in contact with raw meats with hot, soapy water.

Time to quit

Smoking is hazardous to an unborn baby as it decreases oxygen and blood supply to the foetus, and puts the baby at risk for growth restriction, low birth weight and respiratory problems. Plus, heavy smoking (more than 10 cigarettes a day) is associated with an increased risk of pregnancy loss, confirms a study in the New England Journal of Medicine.

It’s best to avoid alcohol altogether since it’s known to be an agent that causes malformation of an embryo. Foetal Alcohol Syndrome (FAS) is a birth defect caused by heavy alcohol consumption (usually in a binge pattern) during pregnancy. It is characterised by growth retardation, facial and neural abnormalities as well as malformation of other organ systems. The prevalence of FAS in certain areas of South Africa is the highest in the world.

Rest body and mind

Your mental health is just as important as your physical well-being – especially while preparing to be a parent. Rest as much as you can, particularly in the third trimester.

• If you already have small children in the house, try to rest when they have their nap.
• Never say no to an offer of help.
• If you feel increasingly anxious or stressed, contact the South African Depression and Anxiety Group (www.sadag.org) for support, advice, free telephonic counselling or a referral to a psychologist in your area; or the Postnatal Depression Support Association (www.pndsa.co.za).

Regular exercise

Regular exercise can give you the strength and endurance you’ll need to carry the baby weight and help you handle the physical stress of labour. It boosts the circulation of blood and oxygen, and it will also make it much easier to get back into shape after your baby is born. Exercise boosts mood and can help to ward off depression.

You can usually continue to do the exercise you did before pregnancy, but check with your doctor, and avoid high-risk activities or contact sports.

Your pelvic floor is one of the key areas of focus during pregnancy as this is one of the muscle networks most impacted by the baby’s weight and childbirth. Pilates, aqua aerobics, low-impact walking or swimming are great choices.

Be sure to choose a qualified instructor with training specifically for pregnant women.

About the Author:Dr Noluthando Nematswerani is a Discovery Health Clinical Specialist. For more information on Discovery, visit www.discovery.co.za.

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