Welcome to pregnancy! A journey that will bring much joy and excitement to your life.
This section aims to educate women on what they can do and what they can expect before their pregnancy, during their pregnancy, labour, delivery and after delivery.
#1 Before pregnancy: Steps to take before conceiving
• Go for a pre-pregnancy checkup. Inform your doctor about your family medical history, genetic conditions, chronic illnesses (if any) and medications you are taking so as to make sure they are safe during pregnancy.
• Eat a healthy diet containing fruits, vegetables, high quality protein and fiber. Ensure that your diet is rich in folic acid before you conceive and during pregnancy to minimize risk of birth defects. You can get your folic acid intake through a prenatal vitamin or through folic acid-rich foods (e.g. fortified whole grains and cereals). Intake of folic acid should be between 400-600mg daily before pregnancy and around 800mg during pregnancy.
• Quit smoking (if you smoke). Smoking has been known to reduce fertility for both men and women. Smoking also has adverse effects on the development of babies, i.e. babies being born smaller, babies being born prematurely, underdevelopment of vital organs, etc.
• Visit your doctor and get your health conditions (i.e. diabetes, high blood pressure, obesity, etc.) under control.
#2 Am I pregnant? The early signs of pregnancy
• Missed period – the most telling sign that would prompt women to check if they are pregnant
• Cramping that resembles menstrual cramps
• Spotting – slight bleeding due to the fertilized egg being attached to the wall of the uterus.
• Morning sickness – It can strike at any time in a day (not necessarily in the morning only) and you might feel nausea with or without vomiting due to pregnancy hormones.
• Fatigue – Higher levels of progesterone, a hormone during early stages of pregnancy can make you feel more tired than usual.
• Constipation – Higher levels of progesterone results in food passing more slowly through your digestive system.
• Increased frequency of urination – You might find yourself making more trips to the toilet.
• Tender and swollen breasts – Hormonal changes in early pregnancy might make your breasts feel more tender, sensitive or sore. Your breasts could also feel heavier and fuller.
• Food cravings or aversions – Hormonal changes can result in changes in food preferences.
• Mood swings due to hormonal changes.
• Dizziness and fainting – Blood vessels dilate during pregnancy, causing blood pressure to drop and hence, you might be lightheaded and experience dizziness.
These are some of the early signs of pregnancy but not every symptom will occur in every pregnancy as it differs from person to person. Also, some of the signs are also not unique to pregnancy and could be an indicator that you are getting sick. If you experience a few of the symptoms, see a gynaecologist to check if you are pregnant.
#3 First trimester (Week 1 to Week 13): Changes in my body
Every woman goes through a different pregnancy journey and different women will experience different changes. Some of the changes include:
• Light spotting – some pregnant women experience slight bleeding due to the implantation of the embryo onto the uterus.
• Tender breasts – Hormonal changes in early pregnancy might make your breasts feel more tender, sensitive or sore. During this process, your milk ducts are being prepared to feed your baby after delivery.
• Constipation – Higher levels of progesterone results in food passing more slowly through your digestive system, giving more time for the nutrients to be absorbed into the bloodstream and to reach your baby. However, this could also lead to constipation. To relieve constipation, it is important to include high amounts of fiber in your diet and to drink lots of water.
• Heartburn – Progesterone relaxes the stomach valve between your stomach and esophagus, allowing stomach acid to leak into your esophagus and causes heartburn. A way to mitigate heartburn is to eat small and frequent meals while avoiding food that can intensify your heartburn. Common food that might intensify heartburn are fried food, carbonated drinks, citrus fruits, etc.
• Food cravings or aversions – Hormonal changes can result in changes in food preferences.
• Increased frequency of urination – As your uterus enlarges, it places pressure on your bladder and increases your urge to urinate.
• Dizziness and fainting – Blood vessels dilate during pregnancy, causing blood pressure to drop and hence, you might be lightheaded and experience dizziness. Avoid standing for long periods of time to prevent dizziness. If you have been in a lying down or sitting position, avoid standing up abruptly and rise to stand on your feet slowly.
• Fatigue – Higher levels of progesterone, a hormone during early stages of pregnancy can make you feel more tired than usual. Get as much rest as possible and include some physical activity (i.e. a brisk walk) into your routine.
• Mood swings – Pregnancy might cause you to swing from being delighted to being worried, energetic to being exhausted and sometimes, you might experience varying emotions all at once. It is important to remind yourself that feeling this rush of emotions is normal and overcome this phase with support from your family and loved ones.
#4 Second trimester (Week 14 to Week 27): Further changes in my body
Some of the first trimester body changes may ease (i.e. you will likely feel less nauseous, less fatigue, breasts may feel less sore, etc.). Other changes may arise as your pregnancy continues and levels of pregnancy hormones increase.
Changes might include:
• Nasal congestion due to increased blood flow to your body’s mucous membranes. You can consult your doctor if you find the congestion unbearable for some medications that are safe to use during pregnancy.
• Sensitive and/or bleeding gums – Hormonal changes send more blood to your gums, increasing their sensitivity and causing them to bleed easily. You can use a softer toothbrush and floss gently so as to maintain good dental hygiene while being gentle on your gums and teeth.
• Mild swelling of ankles and feet – To reduce the swelling, try to be active by raising your legs and feet whenever possible. When resting at night, lie on your side to reduce pressure placed on your major blood vessels. Try to avoid prolonged periods of standing or sitting as well.
• Spider veins appearing on your skin due to the increase in blood flow to send blood to the developing baby. Varicose veins might also appear due to increased pressure on your legs from your growing baby. You can stop varicose veins from getting worse by moving about while completing daily activities and by propping up your legs on a stool or elevated surface when you have to sit for prolonged periods of time.
• Leg cramps – due to hormones, weight from the baby and also, a shortage of calcium and magnesium. Continue to eat a healthy and well-balanced diet.
• Lower back pain – As your baby grows, the extra weight will put pressure on your back, making it sore. To ease the pressure, be sure to sit up straight and use a chair that provides good back support. You should also sleep on your side with a pillow tucked between your legs. Avoid wearing high heels and wear comfortable shoes with good arch support. Do not lift or move heavy items as well.
• Quickening (baby’s movements) – Delicate flutters of movement in your abdomen, although the feelings of movement may vary between women.
• Skin changes – Pregnant women are often described to have “The Pregnancy Glow” because their changing hormonal levels make their face look flushed. Brown marks might appear on the face and a dark line might appear down the middle of the abdomen because of an increase in melanin. Make sure to wear sunscreen with at least SPF30++ to protect your skin that is more sensitive. Stretch marks will also appear as your skin expands to accommodate your growing baby. Stretch marks will gradually change from red to purple to tan or white after birth. However, there are some women who are unable to lose their stretch marks.
• Weight gain – As your baby grows, you should be gaining about 0.2-0.5kg per week.
#5 Third trimester (Week 28 to ~Week 40): The last lap!
• Abdominal pain caused by the stretching of your round ligaments that support your lower abdomen to accommodate your growing baby.
• Backache – As your baby grows and your baby bump increases in size, it puts your centre of gravity forward and you may experience backache in order to support your baby bump.
• Fatigue – You may experience increased tiredness as your body continues to undergo changes during the pregnancy. Get as much rest as possible and continue to have a healthy diet.
• Heartburn – As the baby grows, your uterus will push your stomach upwards, causing the contents to flow backwards to the esophagus.
• Varicose veins – May appear in your lower body because of the increased blood flow that your body pumps to the baby. If you did not have varicose veins before pregnancy, there is a high possibility of them disappearing after delivery.
• Stretch marks – caused by the physical stretching of the skin to accommodate the growing baby. Moisturise to reduce itchiness (if any).
• Braxton Hicks contractions – Your uterine muscles are “practicing” and flexing in preparation for the delivery. They often start as a painless tightening that begins at the top of your uterine muscles and spread downwards. As you near your delivery date, they will become more frequent and intense.
• Reduced ability to control bladder – The growing baby puts pressure on the bladder and will cause you to urinate more frequently.
• Breast changes – Your breasts will be working to prepare for the arrival of your baby. Your breasts may continue to grow and secrete a milky substance (colostrum) from your nipples.
#6 Preparing for the delivery
Tip: Pack a delivery bag in advance!
Labour is a tough ordeal on its own and you would not want unnecessary stress from forgetting to bring something important to the hospital. This list may help but it is not completely exhaustive as you might have other things that you deem essential for your delivery!
• Gynae’s letter
• Hospital admission form
• NRIC admission form
• NRIC of parents
• Original Marriage Certificate to register the name of your baby
Things for the new Mother:
• Warm socks
• Eye mask to help you sleep
• Noise cancelling earphones/ear plugs
• Maternity / Heavy flow pads
• Disposable underwear
• Nursing bras
• Nightgowns (that opens in front if you are planning to breastfeed)
• One outer presentable robe (for when visitors come)
• Massage oil
• Lip balm (Lips can get dry and crack during delivery)
• Toiletries (Toothbrush, toothpaste, body wash)
• One set of clothing for the trip home (something loose and comfortable)
• Comfortable footwear (e.g. flip-flops)
#7 Labour & Delivery: Signs that I’m going into labour
These are some possible signs that a woman might experience before going into labour. It is not an entirely exhaustive list as different women experience different signs.
- Rupture of Membranes aka ‘Breaking of Waters’ – The amniotic sac ruptures and amniotic fluid flows out from your vagina. Some indicators would be that you cannot control the flow, the flow cannot be absorbed with a panty liner and it does not smell like urine.
- Diarrhoea – The production of prostaglandin will stimulate your bowels to open more frequently. Hence, you might have diarrhoea closer to labour as your body empties your bowels to make way for the baby.
- Regular contractions – The rule of thumb is: stronger, longer and closer together. If you are experiencing mild contractions, there is no need to start timing the contractions immediately. If you feel that the contractions are getting stronger, longer and closer together, you can start timing them. To time your contractions, count the number of seconds between the start and the end of the contraction. You can also time the amount of time between the start of each contraction. A good sign that you are in labour is when your contractions last for roughly a minute and they are around 3-5 minutes apart.
- Change in vaginal discharge colour – As your cervix begins to dilate in preparation for delivery, the thick mucus plug which sealed off your cervix during pregnancy might become loose and discharge from your vagina. The mucus plug could be watery or sticky and have a brown or pinkish-red tint to it.
- Lightening – The process of your baby moving away from your diaphragm and closer to your pelvis in preparation for birth. You will be able to breathe more easily as compared to before but you will feel more pressure on your bladder.
Go to the hospital immediately if:
- You are bleeding or experiencing bright-red discharge.
- Your water breaks and the fluid looks green or brown or anything besides clear or pink.
- You feel your baby is not moving.
- You cannot stop vomiting.
- You feel the urge the push.
#8 The different types of delivery methods
- Vaginal Delivery – Your baby is born through the birth canal. Advantages of a vaginal delivery include shorter hospital stay and recovery time for the mother, lower infection rates and a lower risk of respiratory problems for the newborn.
- C-section – The delivery of a baby through a surgical incision of the mother’s abdomen and removing the baby from her uterus. Factors that may result in a C-section are multiple babies (twins, triplets, etc.), previous C-sections, baby is not in the right position (e.g. bottom first or sideways) and the presence of fibroid or any other large obstructions.
- Vacuum Extraction (Assisted Delivery) – A doctor attaches the vacuum (soft or rigid cup with a handle and a vacuum pump) to the baby’s head to guide the baby out of the birth canal.
- Forceps (Assisted Delivery) – A doctor uses forceps (a tool shaped like tongs) to guide the baby out of the birth canal.
#9 After delivery: Should I breastfeed my baby?
Breastfeeding is a personal decision that every woman gets to decide for herself and her baby. Research has also shown that breastfeeding your newborn has abundant benefits
Some benefits are:
- Ideal nutrition for babies – mix of vitamins, protein and fat which is everything required for a baby to grow.
- Breastmilk comes in a form that is more easily digested than milk powder formula.
- Breastmilk contain antibodies that help your baby fight off viruses and bacteria. Your breastmilk is also able to change according to what your baby needs.
- Breastfeeding allows the mother to forge a closer bond with her child.
- Breastfeeding burns extra calories, benefitting the mother by helping her to lose weight gained from pregnancy.
Breastfeeding is a skill that has to be learnt. Seek guidance from your Gynae, a lactation consultant, or even your family members (i.e., mother, sister) who have breastfed before!