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Antenatal Care15-17/10

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Discomfort of early pregnancy

• Bladder Issues in Pregnancy (2, 3, 8, 9)-The pressure of your growing uterus and a

heightened metabolic rate cause increased frequency of urination

- The progesterone that is working to ensure you stay pregnant relaxes smooth muscle (like that of your urinary tract). This can increase your chances of developing a urinary tract infection, bladder infection and kidney infection.

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Educational tips related to bladder issues

• Do kegal exercise. • Keep drinking water. • Go to the bathroom regularly, don't try to hold it. • If you feel a burning or stinging sensation when

you urinate, you may have an infection. Seek the advice of your caregiver.

• Don't sit with your legs crossed or wear tight, restrictive clothing. These things may encourage a back-up in your urinary tract causing an infection.

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Fatigue in Pregnancy (1, 2, 3, 7, 8, 9)

• metabolism has increased significantly as body builds the baby, so body's energy demands have greatly increased.

• The changing hormone levels

• the extra effort it takes to carry around the extra weight.

• the difficulty sleeping at night.

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Educational tips• supplement with vitamins to regain your

energy.

• eat a balanced meal every day.

• Take rest times during the day. Sometimes 10 minutes of abdominal breathing with your feet up can be as good as a long nap.

• Drink plenty of water. One of the effects of dehydration is to make you tired.

• Exercise helps keep your energy levels higher during pregnancy.

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Faintness in Pregnancy (1, 2, 7, 8, 9)

• blood volume increases during pregnancy, and the high progesterone levels relax blood vessels to prevent high blood pressure. However, the relaxed and slack vessels can slow down the circulation enough that cause faint when stand up suddenly.

• body temperature. When overheating, blood vessels dilate and move closer to the skin to let some of deep body heat escape. If this happens to already relaxed blood vessels, dizzy, light-headed or faint occurs.

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Educational tips• Take cooler baths and showers that don't raise

your body temperature. • Be sure to do deep abdominal breathing to get your

blood fully oxygenated. • Be sure you are not skipping meals, and have

snacks if necessary. You metabolism is in over-drive and you need to keep your blood sugar levels up.

• Don't stand for long periods of time. Plan your activities in such a way that you can move around and rest.

• Frequent faintness may be an indicator of anemia, low iron levels in your blood.

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Breast Soreness in Pregnancy (1, 2, 8, 9)

•Mammary glands are the only glands that do not mature during puberty. Instead, they mature during pregnancy. This growth and development of the glands can cause the surrounding area to be sensitive to the touch, or sore. This

is normal .

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Educational Tips

• Stand in the shower and let the warm water massage your breasts.

• Be sure to wear a bra with good support, and have the fit checked as your breasts may have grown.

• Try wearing a bra at night, the extra support may feel better.

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Nausea and Vomiting in Pregnancy (1, 2, 3, 4, 9)

• Nausea and Vomiting in pregnancy, commonly called morning sickness, can actually occur at any time of day. Experts are unsure of the exact reasons for it, but believe that it may be due to the rapid fluctuations in blood sugar levels, or a reaction to changing hormones. About half of all pregnant woman experience morning sickness.

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Health education

• Eat smaller frequently meal to keep your blood sugar levels constant.

• Eat something right before you go to bed, preferable a protein food which will take longer to digest.

• If you wake up at night to use the bathroom, stop by the kitchen and eat a small snack to keep your blood sugar level up.

• Avoid foods that trigger nausea for you. • Try eating the foods you crave, within reason. • Keep crackers near your bed for you to eat before

you get up. • Try drinking your fluids after your meal, not during.

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Vaginal Discharge in Pregnancy (4, 5, 6, 7, 8, 9)

• cervix produces fluids during pregnancy that help to keep the vaginal canal clean and infection free. This increased moisture and the change in acid levels of the vagina make the area easily susceptible to infection. The increased moisture also makes the skin of the perineum brittle and susceptible to tearing as your baby is born.

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Health education

• Wear cotton panties. • Do not wear tight clothing around the crotch. This

forces the fluids back up the vagina. • If possible, go pantyless in the evenings or at

night to allow the vaginal skin time to dry out. • Try cleansing with warm water and a cloth only. • If you do get infection, contact your caregiver right

away to start treatments. infection can be transferred to the baby during birth.

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Moodiness in Pregnancy (1, 2, 8, 9)

• fluctuating hormone levels make you more susceptible to moodiness when you are pregnant. Near the end of pregnancy, your altered body image, fatigue and concerns about the upcoming labor can add to the moodyness.

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Health education

• Allow yourself time to cry, you may find yourself with renewed energy afterwards.

• Seek out support from friends and family. Have at least one person that you can share your concerns with.

• Slow down your schedule; be sure to give yourself enough time to rest.

• Be extra careful about eating well, poor nutrition will only make it worse.

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Weight Gain in Pregnancy (3-9)

• If you weighed an average amount before your pregnancy, you should gain between 12.5 and 17 kgs, gaining 1 to 2.5 kg in the first trimester and about kg per week for the rest of your pregnancy.

If you were underweight you should gain 14 to 20 kgs. And if you were overweight you should gain 7.5 to 12.5 kgs. If you're having twins you should gain about 17 to 22 kgs.

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Baby 3.5 Kg

Uterus 1 Kg

Placenta ,5 Kg

Blood volume increase in mother

1.5 Kg

Amniotic fluid ,5 Kg

Fluids in mother's tissues 1.5 Kg

Breast tissue increase ,5 Kg

Increased fat stores in mother 3.5 Kg

Total Average 12.5 Kg

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On a Trimester Basis

• First trimester: ,5 Kg per month

• Second trimester: ,25 Kg per week

• Third trimester: ,5 Kg per week

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Health education• Instead of focusing on how much weight you are

gaining, focus on eating well and getting adequate exercise.

• Don't jump right into maternity clothes, which will be too big early in your pregnancy. Instead buy some clothes that are a size larger than you usually wear. Better yet, borrow them from a friend.

• Don't use pregnancy as an excuse to feed your appetite rather than your hunger. Overeating will make you feel sluggish and heavy, and it will not help your baby.

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Blotchy Skin in Pregnancy (4-7)

• Your skin may appear darkened or blotchy on your face, breasts and abdomen. This is due to the high hormone levels. Some experts feel this is normal, others believe it may signal nutritional deficits.

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Health education• Avoid spending time in the sun, which

makes the blotches darker and more pronounced.

• Check your diet for adequate levels of folic acid. The blotches will go away after your baby is born, but if they bother you cover them with a concealer.

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Heartburn and Indigestion in Pregnancy (4-9)

• Your growing uterus putting pressure on your digestive system, along with your sluggish digestive system, may cause you to feel uncomfortable after you eat.

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Health education

• Eat small frequent meals. This will decrease the pressure on your digestive system and may make digesting easier. Also prevent dips in blood sugar that may cause indigestion. Drink more water and eat adequate amounts of fiber to help move the food through the digestive system.

• Go for a walk after dinner. Walking is a natural way to aid digestion.

• If you are finding yourself frequently sick after eating, talk to your caregiver. You may have developed a lactose intolerance (having problems after eating dairy foods) or be having gall bladder problems (uncomfortable after eating fatty foods).

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Constipation in Pregnancy (6-9)

• Your heightened progesterone level will cause the smooth muscle of your body, such as that of your digestive system, to relax and become sluggish. Add to this the pressure on your intestinal tract from the growing uterus.

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Health education

• Try pelvic rocking or going for a walk. Both will stimulate the digestive system.

• Check your diet, are you getting enough fiber and water?

• Put a low stool under you feet in the bathroom. This will put you in more of a squat position which opens the outlet of the pelvis by as much as 15%.

• Try eating raw fruits.

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Pelvic Pressure in Pregnancy (6-9)

• Your enlarging uterus puts pressure on your pelvis. The sciatic nerve can be affected as the pelvis relaxes and stretches. This would feel like pain that starts in the pelvis and continues down the thigh.

• Sharp pains on either side of your abdomen are most likely the stretching of the ligaments that support your uterus.

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Health education

• Use heat to dull the pain, and massage to relax it away.

• Change your position, you may be able to get the baby to move and thereby change the way he puts pressure on your pelvis.

• Try pelvic rocking or the double hip squeeze.

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Stretch Marks in Pregnancy (6-9)

• There is no way to prevent stretch marks. They are scar tissues caused by the over-stretching of the skin. You may experience them on your abdomen, breasts or upper legs.

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Health education

• Eat foods rich in vitamin E and Vitamin C. These nutrients are necessary for healthy skin.

• Keeping your skin moisturized won't prevent stretch marks, but it can prevent some of the dry itchiness some women feel as the skin stretches.

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Backache in Pregnancy (7-9)

• the changing center of gravity by pulling the shoulders back, which puts pressure on the lower back. Wearing shoes with a heel will further exaggerate this arching, causing worse backaches.

• The ligaments that hold the uterus in place are attached to the back. As the uterus grows, this added weight pulling on the back may cause backaches.

• When your baby begins to descend into the pelvis, the head can cause pressure on the pelvis which may be felt as a backache.

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Health education

• Check your posture to be sure your back is not arched.

• Try pelvic rocking, it stretches the muscles of the back and re-aligns the uterus.

• Have someone massage, or just put pressure on your lower back.

• Avoid shoes with heels.

• Be sure to rest when you have been on your feet for an extended period of time.

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Sleepless Nights in Pregnancy (6-9)

• When your body is large and you cannot find a comfortable position in bed, sleep becomes difficult. In addition to the physical discomfort of the growing baby, you may wake up several times a night to use the bathroom.

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Health education

• Try pelvic rocking just before you go to bed. It pulls the uterus into a better position so the bladder is not as compressed.

• Use lots of pillows to support your back and legs.

• Try propping your upper body up more by using more pillows.

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Hemorrhoids in Pregnancy (6-9)

• Hemorrhoids are varicose veins of the rectum. You may experience them from straining too hard when using the bathroom. They can be uncomfortable or itchy when you sit.

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Health education

• Put a low stool under your feet while you use the toilet.

• Be sure you are getting adequate water and fiber in your diet.

• Avoid constipation, which will cause you to push harder when going to the bathroom.

• Try walking as natural stimulants for the bowel. • Ice the sore area for some comfort and relief. • Try taking shallow, warm baths to soak the area

for some comfort and relief.

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Contractions in Pregnancy (6-9)

• you will experience uterine exercise as Braxton-Hicks contractions. These are usually not a problem, as they are mild contractions that don't usually last for very long. They may seem to have a regular rhythmic pattern, such as every 10 minutes, but they will not get more intense, closer together or longer like labor contractions will.

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Health education

• Changing your activity may stop Braxton-Hicks contractions.

• Eat something. Your body can start contractions if the baby needs food.

• Drink water. Dehydrations can start contractions that look like labor, but are non-productive (they don't open the cervix).

• Ignore them. They are not an indicator of when you will begin labor, so if possible, just ignore what is happening and go about your regular routine.

• Relax and do abdominal breathing. • differentiate between pre-labor and contractions

that will become labor.

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symptoms that require immediate attention

• Severe or sharp upper- to mid-abdominal pain, with or without nausea

• • Vision disturbances, such as double vision, blurring, dimming, flashing spots, or lights that last for more than two hours

• • Swelling or puffiness (also called oedema) of the hands, face and eyes

• • Severe headache that lasts for more than two or three hours

• • Light or heavy vaginal bleeding • • A sudden increase in thirst accompanied by little or no

urination • • Painful or burning urination accompanied by a

temperature, shivering and backache  

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symptoms that require immediate attention-Cont.

• • Sudden, noticeable weight gain of more than two pounds not related to eating, with or without swelling of the hands and feet, headache, or visual disturbances

• • Severe vomiting: more than two to three times a day in the first trimester, onset of vomiting later in pregnancy, or vomiting accompanied by pain and/or a temperature

• • Fainting or dizziness • • Fever • • Pain, such as severe lower abdominal pain on

either or both sides • • Absence of, or slowing down of your baby's

movements for more than 24 hours after 22 wk