preparing for your baby
In the months leading up to the birth of your baby you will fluctuate between periods of confident anticipation and nagging doubt, heady moments of excitement and grey hours of boredom, exuberant energy and foot-dragging weariness. These are all part of the momentous experience that will come your way probably no more than two or three times in your life. The information on the following pages will help you to understand the changes that are going on in your body.
You are told how to calculate when your baby is due, and how to prepare for the birth by making regular visits to your doctor or clinic, by eating sensibly, and by following a routine of simple exercises. You learn how to minimise the physical problems of pregnancy, how to stay at your best, and what clothes to wear. You will find reassurance in the techniques used by doctors to monitor the health of an unborn child, and in the exposure of old wives’ tales. The rest you will discover for yourself – the moments of heightened experience when the doctor confirms that you are pregnant, when you feel your baby’s first kick, and when you recognise the first signs of labour. But to go back to the beginning…
Are you pregnant?
If you have not had a baby before, you may have difficulty in deciding whether you are pregnant. There are some changes in your body that you may notice yourself and others that can only be detected by your doctor.
Changes you may notice yourself – Changes in menstruation. Once an egg becomes fertilised there is no more menstruation. If you have been having a regular monthly period, its absence may be the first indication of pregnancy. Try to remember and make a note of the first day of the last normal menstrual period. Your doctor will need to know this to enable him to work out when your baby is due. It will also be helpful to the doctor if there is some record of the dates of the last two or three periods before this, especially if you do not menstruate exactly every 28 days.
A lack of periods in not a certain symptom of pregnancy. Women who very much desire to be pregnant of conversely, those who very much fear one, can miss a period due to psychological reasons. However, if menstruation is more that two weeks over due and and intercourse without contraception has taken place, it is natural to suspect the possibility of pregnancy. It is possible to bleed from the vagina and still be pregnant. Such bleeding is not normal menstruation, and in the first three months of pregnancy there may be a slight blood loss which is usually less than a normal menstruation period. If this happens a doctor should be consulted.
Changes in the breasts – early in pregnancy the breast become very sensitive, with a tingling sensation around the nipple area. Soon after this they may become heavier as well. These changes are often noticed within a few weeks of a missed period. The nipples become more prominent and, later, there is a darkening of the pigmented area around the nipple. These are natural changes in the breast due to the increased blood supply.
Nausea and vomiting – the early days of pregnancy are commonly associated with nausea. This is often misnamed “morning sickness”, but for almost half the number of expectant mothers the sickness does not occur in the morning at all.
Few women escape this problem completely, most suffer nausea and some suffer vomiting as well. However, once the immediate wave of nausea has passed, the expectant mother does not feel ill, as with nausea due to other causes. Most women are not greatly inconvenienced and are able to carry on with their daily tasks. Usually the nausea ends by the 12th or 14th week of pregnancy.
Changes in urination – many women notice that they pass urine more frequently in the early weeks of pregnancy. This is due to irritation of the bladder produced by an increased blood supply in the pelvis. A little later the growing womb presses on the bladder, and this may also cause increased frequency of urination. By the time the womb grows up into the abdomen (14 to 16 weeks) this symptom usually becomes less marked.
Mucus discharge – there is usually an increase in the normal amount of mucus produced at the neck of the womb, and this shows itself as a discharge at the vulva. This is normal, provided it is not irritating or offensive, if it is, consult your doctor.
All these symptoms are normal and indicate the body’s reaction to pregnancy. In some women they are minimal and pass almost unnoticed, in others symptoms become severe. Consult a doctor whenever you are worried about such symptoms, for he can often bring relief by methods which are quite safe for you and the child.
Changes a doctor can detect – in the first few weeks of pregnancy, the growth of the embryo is so minute that it does not enlarge the womb very much. In consequence, a doctor cannot tell a lot by examination of the size of the womb. Only after about eight weeks of pregnancy does this give positive information. However, the increase in size even at this stage is not such that the womb has brown out of the pelvic bowl in to the general abdominal cavity, and so any early examination to confirm pregnancy usually involves a vaginal assessment.
The doctor passes one or two gloved fingers into the vagina and gently examines the womb. Some women are nervous about this, but a properly conducted vaginal examination is not painful and has no effect on the growing baby. After 12 weeks the womb is enlarged sufficiently for the doctor to feel it through the stomach wall. The breast symptoms you have observed may also be confirmed by the doctor. Otherwise, if there is doubt about pregnancy, the doctor will carry out a pregnancy test, which depends upon hormone concentrations in the urine.
An early morning specimen of urine is commonly asked for, since it is at this time that the hormone is most concentrated. With modern methods, home pregnancy tests can be reliable before you have even missed a menstrual period. Before this time, however, a test may yield a false negative results even though there is a perfectly normal pregnancy. This is because there is not yet enough hormone in the urine to yield a positive result.
Ultrasound can also be used at a very early stage, and in skilled hands can detect the unborn child.
In the last decades much has been learned about how the baby develops in the womb, and there are now several tests that hospitals can make to ensure that the baby is developing normally. Many expectant mothers will encounter one or more of these tests during pregnancy.
Ultrasound - Sound waves above the frequency which can be heard by the human ear are passed into the body, and echoes from reflecting surfaces are picked up. By moving the source of the sound waves and the receiver, a composite picture can be built up on a screen like a television screen. This enables the growing baby and his placenta – the spongy structure through which he obtains nutrition – to be seen from several angles.
This is a perfectly safe procedure, much research having been conducted to confirm that it does not harm the unborn child. Because of its safety, this type of investigation may be repeated at intervals, enabling variations of growth to be checked.
In addition, the number of babies inside the womb can be determined by this method much earlier than by manual investigation by the doctor. The position of the placenta may be important, particularly if in rare cases it is low-lying, and certain malformations of the unborn child can be also picked up on ultrasound.
Amniocentesis – the baby develops inside a pool of fluid, called amniotic fluid, which is partly by the baby himself. In consequence, the products of his own metabolism and his cells are in this fluid and may be examined from a sample. When amniocentesis is necessary, a small sample of the fluid is obtained by a hollow needle passed under local anaesthesia into the sac that enclosed the baby.
In early pregnancy, examination of the baby’s cells or of the chemicals in the fluid itself can yield much information about possible abnormalities of the brain or spine. One problem that may be encountered is down syndrome, which occurs most frequently in children of mothers aged over 35, and amniocentesis is usual offered when women of this age become pregnant. It is normally done at about four months; before this, neither cells nor ‘tell-tale’ chemicals are present in sufficient quantities.
In the middle stages of pregnancy, amniocentesis may be performed on women who have rhesus negative blood to indicate treatment needed for the baby.
In the later part of pregnancy, tests can give information about the maturity of the baby. Some labours have to be induced for medical reasons, but doctors must be sure that the essential body systems are mature enough to allow the baby to be born. The chemical content of amniotic fluid can be checked as a guide to the maturity of the baby’s lungs. Other tests check cells shed from the baby’s skin. If such tests as these reveal immaturity, they warn the obstetrician of the need for extra paediatric help at the birth
Preparing for your Baby