Common pregnancy-related issues you need to be aware of

Many women find pregnancy a thoroughly enjoyable experience and suffer very few unpleasant symptoms, but there are those who discover that being pregnant can lead to some incidental uncomfortable effects. Very few of these pregnancy-related issues threaten the fetus or the expectant – but the more enjoyable a pregnancy, the better for both the mother and child.

Pregnancy lasts for approximately forty weeks. This time is commonly divided into three periods, or trimesters: from the first day of the last menstrual period to week 12; from week 12 to week 28; from week 28 until delivery.

Most of the discomforts that occur during pregnancy are the result of hormonal changes within the body, nutritional deficiencies, and profound anatomical changes. This health topic addresses some of the most common pregnancy-related problems and offers natural remedies as well as helpful hints and suggestions for maintaining maximum health during pregnancy. For a healthy pregnancy and birth, it is necessary to consult and work with a qualified healthcare professional, be it a physician, nurse practitioner, or midwife. It is also wise to work with your healthcare practitioner on a birth plan. This allows you to decide in advance what you want and what you would choose from among your options before, during, and after labor.

Pregnancy Self-Test

Over-the-counter pregnancy test kits are sold in most drug stores. You should always see your healthcare provider confirm a positive result.

Anemia

During pregnancy, blood volume increases by 40 percent. The increase in volume is largely due to an increase in plasma rather than in red (or white) blood cells.

Anemia is most likely to develop in the second trimester of pregnancy. It can cause fatigue, a rapid heartbeat, and paleness of the skin, gums, and around the inside of the eye. There may also be cravings to eat substances other than food, such as coal, dirt, ice, starch, or hair. This is called pica and is normally a sign of nutritional deficiency.

Anemia is unlikely to affect the developing baby. The fetus depletes the mother’s iron resources and does not suffer any deficiency itself.

Recommendations:        

• Make sure you have enough folic Acid, Vitamin B12, and other B-complex vitamins in your diet.
• Eat foods rich in iron, such as green leafy vegetables, raisins, organically raised red meat and liver, and bread and pasta made from whole grain flour.
• If your healthcare provider prescribes iron supplements, take them with Vitamin C to help the absorption of this mineral. Iron supplements can also cause constipation, so eat plenty of high-fiber foods and increase your fluid intake.

Asthma

Many women who have asthma reduce their use of asthma medication when they become pregnant to avoid harming the fetus and as a result, their asthma symptoms become worse. It currently appears that there is more danger to the developing fetus from frequent asthma attacks than from taking asthma medications. Inhaled medications are normally preferred during this time because they are more localized in action. Asthma sufferers should be checked at least every four to six weeks by a physician during pregnancy.

Recommendations:

• Avoid anything that might trigger an attack. Keep your bedroom, at least, as a place you can go to relax and get away from any airborne pollutants than can trigger an attack.

Backache

Backache is common during pregnancy due to the considerable anatomical changes and stresses in the body. The increase in body weight, the muscle-relaxing effects of the hormone progesterone, and the shift in one’s center of gravity contribute to the problem.

Recommendation:

• Do not stay in any one position for a long period of time.
• Pay attention to your posture. Keep your shoulders relaxed and your back as straight as possible at all times.
• Swimming is a good way to relieve the strain on the back and on all other parts of the body.
• Include two or three minutes of gentle stretching exercises in your daily routine.
• Make sure your mattress is firm enough to support you and sleep with a pillow supporting your back. Sleep on your side, not your back.
• Do not wear high heels.
• Learn how to lift correctly, putting less pressure on the back.
• When your back hurts, try soaking a small towel in cider vinegar. Squeeze off any excess and lie down on your side in bed. Spread the towel directly across your back. Relax this way for fifteen to twenty minutes.

Bladder Discomfort/Infection

During pregnancy, the bladder is pressed upon by an expanding uterus and must, in general, deal with far more fluids. You may not always empty fully, so infections of the bladder are very common. These should always be treated.

Recommendations:

• Avoid sugary foods. Infectious bacteria thrive on sugar.
• Increase your fluid intake. Do not cut back on liquids because of urinary frequency.
• Eat plain natural yogurt every day. This helps maintain the correct balance of natural “friendly” bacteria in the system.
• Wear cotton underwear. Avoid wearing anything tight or containing synthetic material next to your skin.
• Do not douche.

Bleeding Gums

During pregnancy, increasing estrogen levels cause the gums to swell and become somewhat softer than normal, and the circulation of blood to them increases. This makes the gums more prone to bleeding and infection, especially if good oral hygiene is not maintained.

Recommendations:

• Be sure your diet contains enough calcium and high-quality, complete proteins such as soy products.
• Increase your intake of foods rich in Vitamin C, as a deficiency in this vitamin, can contribute to bleeding gums.
• If you smoke, quit – preferably before you get pregnant. Cigarette smoking reduces the oxygen supply to the developing fetus and also drains vitamin C from the body.
• Brush your teeth three to four times daily (remember to rinse your mouth well), and massage your gums with clean fingers when necessary. Floss your teeth daily.
• See your dentist at least once during the pregnancy, and be sure to inform the dentist that you are pregnant. Do not permit him or her to take any dental X-rays while you are pregnant.

Constipation

Hormonal changes during pregnancy have a relaxing effect on the muscles, including those of the digestive tract. The increasing level of progesterone in your system makes the bowels less efficient. The normal rhythmic contractions of the intestines slow down, and the result can be constipation. This happens most often in the third trimester.

Recommendations:

• Eat fresh and dried fruit such as prunes, raisins, and figs.
• Eat fresh vegetables and salads containing a variety of raw green and colored vegetables daily.
• Increase the amount of fiber in your diet. Whole-grain bread, cereals, and bran are helpful. Begin by taking 2 teaspoons of bran in a glass of apple juice twice daily. The bran may cause some gas until your system is used to it, but after that, you should not have any difficulty.
• Drink six to eight  8-ounce glasses of liquid, including water, each day.
• Walk at least a kilometer a day.
• Set a regular time each day for bowel movements. This is very helpful for digestion and elimination. Elevate your feet and legs during elimination to relax the anal muscles.
• If your healthcare provider prescribes iron supplements, be aware that they can cause constipation. Increase your fluid intake and eat a diet high in fiber.
• Do not take over-the-counter laxatives unless specifically recommended by your healthcare provider.

Coughs and Colds

Coughs and colds are common during pregnancy and are often more difficult than usual to shake off. Once you have a cold, there is little you can do but let it run its course, so prevention is most important.

Recommendations:

• Eat a healthy diet and increase your consumption of foods containing vitamin C.
• For congestion, make a steam inhaler using essential oil of eucalyptus, lavender, or lemon.

Depression

Depression is fairly common during pregnancy. It can come and go, but because of shifting hormone levels, it is not uncommon to experience at least one bout of depression at some point during the forty weeks of pregnancy. Mood swings are common too. It is not unusual to find that you are more emotional and volatile during pregnancy. It helps if people around you are sympathetic to this and know what to expect.

Recommendations:

• Do not continue to feel depressed without seeking help. Having someone to talk to and knowing that you are not alone in experiencing these feelings can help you to cope during times of depression.
• Exercise can help lessen depression.
• Be open about your fears and concerns relating to having a child. Pregnancy and childbirth are profound experiences, and many women experience feelings of anxiety about the responsibilities attached to these events. Pregnancy is a complicated emotional experience, and you should be aware that it is normal not to be happy all the time.
• If you become pregnant while taking antidepressants, consult your physician about the possible effect on the development of the fetus. Research has not found that tricyclic antidepressants or imipramine cause birth defects, but anti-anxiety drugs such as alprazolam and diazepam and monoamine oxidase (MAO) inhibitors may increase the incidence of cleft palate and cleft lip.

Gestational Diabetes

This is a form of diabetes that occurs only during pregnancy. It affects 3 to 5 percent of women. It occurs because insulin, which regulates blood sugar, does not work as efficiently during pregnancy due to hormones secreted by the placenta. Blood sugar can become high, and although this condition rarely causes harm to the mother, the baby’s birth weight often increases, and the baby may be born with a low blood sugar level. A problem may arise if the baby’s birth weight is excessive enough to make delivery complicated. Macrosomia (heavy birth weight), a potential complication, is defined as a birth weight of over 4.5 kilograms.

Women are normally tested for blood sugar levels around the twenty-eighth week of pregnancy. The Glucose Tolerance Test involves drinking a glass of very sweet liquid containing glucose and testing the blood sugar level at different intervals to see how your body has processed the sugar. Symptoms of gestational diabetes may include frequent urination, excessive thirst, and increased fatigue, but it is also likely that there will be no symptoms at all.

Recommendation:

• Eat little and often. Do not miss meals, even if you are experiencing nausea.
• Discuss your dietary intake with your healthcare provider.
• Avoid foods rich in sugar, and remember that some carbohydrates increase blood sugar levels more than sugar.

Dizziness

During pregnancy, especially during the second trimester, blood pressure often drops as the expanding uterus presses on major blood vessels. The blood supply also has extra work to do, and at times the blood may pool in the lower part of the body, leaving the brain a bit short of oxygen for brief moments. These factors can cause dizziness.

Recommendations:

• Do not change positions quickly. Always go from lying down to sitting to standing slowly. Take your time and focus on what you are doing.
• If you have to stand for long periods, keep moving and flexing your muscles to make sure the blood is circulating properly.
• Do not take hot baths.
• If you feel dizzy, sit down somewhere safe. Try lowering your head to your knees until the feeling passes.
• If you have diabetes, make sure your blood sugar level is well controlled.

Eclampsia and Pre-eclampsia

Pre-eclampsia is a complication of pregnancy characterized by high blood pressure, edema (swelling due to fluid retention), and an excess of proteins in the urine. It may develop in the second half of pregnancy or later. The cause is not known, but if you have suffered from this complaint during a prior pregnancy, you are at increased risk of having it again in subsequent pregnancies. Other risk factors include multiple births, kidney disease, diabetes, lupus, long-term high blood pressure, and heredity. A small percentage of women who develop pre-eclampsia do go on to develop eclampsia, with seizures and/or coma.

Recommendations:

• Get adequate rest. Rest is vitally important if you develop this condition.
• Make sure that your physician or midwife is aware of any risk factors you may have for pre-eclampsia.

Ectopic Pregnancy

An ectopic pregnancy, sometimes called a tubal pregnancy, is a situation in which a fertilized egg becomes implanted in a fallopian tube rather than in the uterus. The result is that the pregnancy is not viable because there is no room for the fetus to grow. This can happen if the fallopian tube is blocked due to inflammation, scar tissue, or endometriosis, making it impossible for the egg to pass into the uterus. Other possible causes for ectopic pregnancy include anatomical abnormalities such as a misshapen fallopian tube.

The easiest way to diagnose an ectopic pregnancy, after a pelvic examination, is to measure levels of chorionic gonadotropin (hCG), a hormone produced by the placenta that increases in quantity until the end of the first trimester. If the hCG level is not increasing, a physician may decide that the pregnancy is not proceeding as it should and order more tests, such as an ultrasound, to find out where the fetus is growing.

Considerations:

• There is no known way to salvage an ectopic pregnancy. The fetus must be removed to preserve the life of the woman. This is usually done surgically and laparoscopically.
• You are more at risk for this condition if you have had a previous ectopic pregnancy or a previous/current pelvic inflammatory disease (PID). Discuss these risks with your healthcare provider.

Edema (Swelling) of the Hands and Feet

The rise in estrogen in the body during pregnancy increases the tendency to retain fluids. This can cause some swelling of the hands and feet, and is considered normal – but it must be monitored continually because it may be an indication of a more serious condition called pre-eclampsia.

Recommendations:

• Early in the pregnancy, remove any rings you wear on regular basis. Do not wait, or the rings may have to be cut off,
• As soon as you notice your hands, legs, or feet getting puffy or larger than usual, tell your healthcare provider. While some swelling is acceptable, the condition should nevertheless be evaluated by a professional, as edema can also be the first sign of pre-eclampsia, a potentially serious complication of pregnancy.
• Avoid salt and all highly processed foods, while maintaining a well-balanced high protein diet. Do not take diuretics (water pills)
• Wear loose, comfortable clothing and properly fitting shoes.
• When you are relaxing, sit with your feet elevated.
• Walk one kilometer each day. This helps to keep edema under control.

Gas (Flatulence)

Gas, like other digestive upsets, is a common complaint during pregnancy. Even foods that cause no difficulties at other times may begin to cause trouble.

Recommendations:

• Keep a food diary to help you determine which foods, or combinations of foods, seem to be causing the gas. Avoid suspect foods.
• You may have to adapt your usual diet during pregnancy. Many foods liked before may suddenly seem unappealing.
• Eat four to five small meals a day, instead of three big meals. Chew your food slowly and well. Do not overtax your digestive system.
• Eat four or more servings of fresh fruits and vegetables every day.
• Cook vegetables quickly instead of boiling them for periods of time.
• Drink as much water as you can.
• Get adequate exercise. A walk is an excellent way to alleviate gas.
• To reduce gas-causing sulfur compounds in beans (garbanzo, pinto, navy, and so on). Use the following cooking method:
  • Place 1 cup of beans in 5 cups of water and bring them to a boil.
  • Boil the beans for one minute.
  • Then drain them and add 5 cups of fresh water. Bring the water to a boil and continue cooking the beans according to the directions.
  • Note that cabbage, cauliflower, and broccoli can also cause flatulence.

Groin Spasm, Stitch, or Pressure

When the round ligaments connecting the corners of the uterus to the pubic area kink and go into spasm, it feels like a “stitch” on the right side. In the later months of pregnancy, lower groin pressure may develop.

Recommendations:

• Exercise daily, using exercises recommended by your health care provider. This can help alleviate this condition.
• During spasms, breathe deeply and bend toward the point of pain in order to allow the ligament to relax. Rest in bed on one side until the spasm is over.

Heartburn

Heartburn occurs more often than normal during pregnancy. This is because the expanded size of the uterus promotes the reentry of stomach fluids into the esophagus, and hormones present during pregnancy tend to soften the sphincter muscles.

Recommendations:

• To prevent heartburn, do not consume spicy or greasy foods, alcohol, coffee, baking soda, or antacids containing sodium bicarbonate.
• Remain active and upright, especially after meals.
• When heartburn strikes, try drinking a glass of warm soy milk.
• Do not eat or drink anything except water for a few hours before going to bed or taking a nap.
• A high carbohydrate diet can help if heartburn is a problem.

Hemorrhoids

Hemorrhoids are common during pregnancy. A number of factors contribute to the development of hemorrhoids, including constipation and the pressure exerted by the uterus as the fetus gains in size and weight.

Recommendations:

• Increase your intake of roughage. Eat plenty of raw vegetables, fruits, dried fruits, bran, and whole-grain bread. These fiber-rich foods help to soften stools and make elimination easier. Hard stools can be very painful to pass and can cause bleeding.
• Drink six to eight 8-ounce glasses of liquid each day, including water, juices, and herbal teas.
• Walk one kilometer a day to help digestion and elimination.
• Do not strain to have a bowel movement if you are constipated.

Insomnia

Insomnia is very common during the last weeks of pregnancy when finding a comfortable sleeping position is difficult. Needing to get up to urinate can disrupt a night’s sleep. Deficiencies of the B vitamins also can cause insomnia. The emotional changes that accompany pregnancy often contribute to sleep difficulties as well.

Recommendations:

• Increase your intake of foods rich in B vitamins.
• Take a warm (not hot) bath with a soothing oil (such as lavender) added to the water.
• Consider taking up yoga or some other form of meditation. These can help you to relax and may be useful during, and after labor.
• Do not force yourself to sleep if you are not really tired. Read, meditate, or do something else non-strenuous until you feel sleepy.
• Try drinking a cup of hot herbal tea with honey or lemon before bed or in the middle of the night. Herbal teas such as chamomile, marjoram, lemon balm, and passion flower are known for their sleep-inducing qualities.
• Avoid stimulants.
• Do not eat heavy meals before bedtime.
• Arrange pillows behind or under your abdomen to relieve breathlessness;

Leg Cramps

Leg cramps during pregnancy are often a result of nutritional deficiencies, electrolyte imbalances, and/or circulatory changes, in addition to the strain placed on the legs by the extra weight.

Recommendations:

• Increase your calcium and potassium intake by eating foods such as almonds, bananas, grapefruit, oranges, salmon, sardines, sesame seeds, soy products, and low-fat yogurt to help avert leg cramps. Adequate calcium is also needed to help prevent high blood pressure and for fetal development.
• While sleeping or sitting, elevate your legs so that they are higher than your heart.
• Do not stand in one place for too long. Shift your weight from one leg to the other every few minutes.
• Walk at least a kilometer a day to stimulate the circulation of blood through your legs.
• Make sure your levels of calcium, magnesium, and potassium are correctly balanced.
• To relieve cramps, flex your feet with your toes pointing upward.
• When experiencing a cramp, apply a hot water bottle or heating pad to the cramping area and apply pressure with your hands.

Miscarriage (Spontaneous Abortion)

Some pregnancies are not carried to full term, resulting in a miscarriage. Spontaneous abortion is the technical term for a miscarriage. It is also defined as the loss of a pregnancy before twenty weeks. The most likely reason for a miscarriage is a chromosomal abnormality in the fetus that makes it unlikely the fetus would survive. Other reasons for a miscarriage include hormonal imbalance, cervical incompetence (the cervix opens and thins before the pregnancy has reached full term, ectopic pregnancy (implantation of the fertilized egg outside the uterine cavity, most commonly in one of the fallopian tubes), infection, glandular disorders, diabetes, and pregnancy-induced hypertension (high blood pressure). Miscarriages generally are not caused by exercise, sexual activity, heavy lifting, or falls.

Recommendations

• Taking raspberry leaf tea during the last few months of pregnancy is thought to help strengthen the uterus and minimize the risk of miscarriages.
• If you experience bleeding or cramping during pregnancy, contact your healthcare provider immediately and follow his or her advice.
• Do not minimize any feelings of grief, depression, or guilt you may experience after having a miscarriage. Your healthcare provider can refer you to a grief counselor or someone who will understand how you feel. It is also important to talk to your doctor about the possible reason for the miscarriage so that he or she can reassure you about the outcome of a subsequent pregnancy. It is quite normal to be able to cope with a miscarriage without experiencing any emotional trauma.
• Bleeding is not necessarily a sign of impending miscarriage, but it should be taken seriously. A pelvic examination will probably be necessary to determine if your cervix has started to dilate and if the membranes surrounding the fetus have broken. If both of these conditions are present, it is certain that you will have a miscarriage.
• Premature labor is the onset of rhythmic uterine contractions before fetal maturity. It usually occurs between the twentieth and thirty-seven weeks of gestation.
• Decaffeinated coffee, rather than regular coffee, is thought to be a contributing cause of spontaneous abortion during the first trimester.

Morning Sickness

Approximately 50 percent of all pregnant women experience some degree of nausea and vomiting between the sixth and twelfth week of pregnancy. This is normal. Although it is commonly called morning sickness, it can occur at any time of day.

Abnormal vomiting – severe, continual nausea and vomiting after the twelfth week – occurs in approximately 1 in 300 pregnancies. This is called hyperemesis gravidarum, and it can result in dehydration, acidosis, malnutrition, and substantial weight loss. If the condition persists, it can endanger the fetus. The reason for abnormally severe nausea is not clear, but an association has been made between it and very high levels of the hormones estrogen and chorionic gonadotropin (hCG), a hormone produced by the placenta that increases in quantity until the end of the first trimester. Other possible causes of abnormal vomiting include bile duct disease, drug toxicity, pancreatitis, low blood sugar, a molar pregnancy (a rare condition in which an abnormal mass rather than a fetus grows inside the uterus), problems with the thyroid, and inflammatory bowel disorders.

Recommendations

• Ginger, taken in capsule or tea form, is helpful for relieving nausea. Other beneficial herbs include catnip, dandelion, peppermint, and red raspberry tea.
• Keep crackers or whole wheat toast near your bed and eat some before arising.
• Eat small, frequent meals and snack on whole-grain crackers with nut butter (not peanut butter) or cheese.
• Do not go without food or drink because of nausea.
• Do not sit up or get out of bed quickly.
• Keep in mind that morning sickness usually does not last beyond the first thirteen weeks of pregnancy. If you suffer from persistent nausea or vomiting later in pregnancy, consult your healthcare provider. With appropriate treatment, the prognosis is good.

Nosebleeds and Nasal Congestion

During pregnancy, increased blood volume often causes some of the tiny capillaries in the nasal passages to rupture, causing a nosebleed. Inner nasal passages normally swell as well. A lack of vitamin C and bioflavonoids may be a contributing factor. These conditions disappear with the birth of the baby.

Recommendations

• Increase your intake of foods rich in vitamin C, including broccoli, cabbage, grapefruits, lemons, oranges, peppers, and strawberries.
• If congestion is a problem, eat fewer dairy products and supplement your diet with calcium and magnesium. Dairy products tend to stimulate the secretion of mucus.

Sciatica Irritation

The sciatic nerve is the longest nerve in the body. It arises from the sacral plexus, in the lower back, threads downward through the pelvis through an opening called the greater sciatic foramen, and runs through the hip joint and down the back of the thigh. Irritation of this nerve is common during pregnancy and usually disappears with the birth of the baby.

Recommendations:

• Ask your healthcare provider to recommend a registered physical therapist or a chiropractor who has been specially trained to deal with pregnancy problems. A competent practitioner is best able to deal with this problem.

Skin Problems

Common skin problems during pregnancy include pimples, acne, red marks, and a mask of pregnancy (dark blotches on the skin of the face). These skin changes usually disappear with the birth of the baby.

Recommendations:

• Keep your skin clean
• If you wear makeup, use only water-based, hypoallergenic cosmetics if your skin is broken out.
• Folic acid, one of the most essential nutrients during pregnancy, should also help with skin problems.

Soreness in the Rib Area

Soreness in the rib area during pregnancy is common. It is caused by the pressure of the expanding uterus.

Recommendations:

• Change positions frequently.
• Keep in mind that this problem is temporary. It often disappears in the last six weeks of pregnancy, once the baby drops into position to be born.

Stretch Marks

Stretch marks are wavy stripes appearing on the abdomen, buttocks, breasts, and thighs. They start out reddish in color and gradually turn white. They are caused by rapid weight gain such as that typically associated with pregnancy and appear when the skin becomes overstretched and the fibers in the deep layers tear. Once they appear, they are permanent, but they do become much less noticeable with time.

Recommendations:

• Apply cocoa butter and/or elastin cream topically as directed on the product label. These substances are very good for stretch marks.

Sweating

While you are pregnant, your body makes sure that its temperature is perfect for your baby’s development. In addition, as your size increases, the amount of effort it takes to walk, climb stairs, and do many everyday things also increases. As a result, you may find yourself sweating more than you did before.

Recommendations:

• Wear loose, light, comfortable clothing. Choose clothing made of “breathable” natural fibers such as cotton or linen.
• Do not use a hot tub during pregnancy. This increase in body temperature can cause fetal distress. For the same reason, be careful about strenuous exercise, especially in hot weather.

Varicose Veins

Varicose Veins are enlarged veins close to the surface of the skin that often emerge during pregnancy. In some cases, they disappear after the baby’s birth.

Recommendations:

• As often as possible, sit with your feet elevated, higher than your heart.
• Change positions frequently. Do not stand for long periods of time or sit in cross-legged positions.
• Wear support hoses if your healthcare provider recommends them. Keep them near your bed and put them on before you get out of bed.
• Walk one kilometer each day to promote circulation.
• Do not wear elastic-topped knee socks, garters, belts, or high-heeled shoes.

Nutritional Health in Pregnancy

During pregnancy, it is more important than ever to have a balanced diet that is high in nutrients and fiber and low in bad fats and cholesterol.

Recommendations:

• Eat a well-balanced, nutritious diet, and be sure to get moderate exercise, fresh air, and plenty of rest.
• Do not consume junk food, fried foods, or too much coffee.
• Avoid eating rare or undercooked meat, poultry, or fish. Do not eat grilled meats. Grilling has been shown to produce carcinogens in meat.
• Do not use any medications while you are pregnant without consulting your healthcare provider. The first trimester is arguably the most important stage of development for your child. There are many drugs that may affect that development, so if you are planning to become pregnant – or if you are already pregnant – consult your physician about the possible consequences of any drug, prescription or otherwise, that you may be taking. If it is possible and does not harm your health, you should not take any medications during the first trimester of pregnancy.
• Do not smoke, consume alcohol in any form, or use drugs, except as prescribed by your health care provider.
• Do not take supplements containing the amino acid phenylalanine. Phenylalanine may alter brain growth in the fetus. Also avoid food products containing the sweetener aspartame, which contains high levels of phenylalanine.
• Do not take mineral oil, which blocks the absorption of fat-soluble vitamins. Consult your healthcare provider about the use of any supplements and over-the-counter medications.
• Avoid activities that may endanger the abdomen, or that involve jarring, bouncing, or twisting movements. Also, avoid activities involving rapid starts and stops, because the body’s center of gravity changes during pregnancy, and it is easy to lose your balance.
• Do not use an electric blanket. Several experts warn that the invisible electromagnetic field emanating from an electric blanket may increase the risk of miscarriages and developmental problems.
• Take warm, rather than hot, showers or baths. Anything that increases the core body temperature for any length of time may cause neural defects in babies such as anencephaly and spina bifida. Anencephalic babies do not develop a brain and rarely survive. Spina bifida is a defect of the spinal column that can affect the baby to varying degrees, depending on the severity of the condition.
• Lack of zinc, manganese, and folic acid, as well as amino acid imbalances, have been linked to fetal deformities and mental retardation.
• Both partners should give up alcohol, cigarettes, and drugs – legal or otherwise – at least three to six months before they decide to conceive. Marijuana, heroin, morphine, and tobacco all reduce levels of male sex hormones and increase the risk of birth defects.
• Men should make sure to have an adequate intake of selenium, zinc, vitamins C, and carotenoids.
• Taking the drug phenytoin (Dilantin) or phenobarbital, used to control epileptic seizures, creates four times the usual risk of producing a baby with heart defects. In addition, the antibiotics ampicillin or tetracycline may cause heart malformations. Ask your physician for a detailed list of teratogenic agents and drugs (chemicals that cause birth defects). These include, but are not limited to, the following:  
  • Some ACE inhibitors.
  • Some acne medications.
  • Some antibiotics.
  • Some blood thinning medications.
  • Some cancer drugs.
  • Some hormone preparations.
  • Some seizure medications.
  • Some thyroid treatment drugs.
  • Chronic (long-term) alcohol intake.
  • Cocaine.

These teratogens which affect the development of the baby, include drugs taken by men during the time of conception.

• Excessive intake of vitamin A has been linked with cleft palate, heart defects, and other congenital defects. Foods containing natural beta-carotene are not harmful because the body converts beta-carotene to vitamin A only as needed, and not in amounts that may be toxic to the body.
• One of the best things you can do for your child is to breastfeed your baby for at least the first three months or life-longer if possible. Mother’s milk is not only the most nutritious food for a baby, but it also provides crucial disease-fighting agents. A new mother should consume 500 more calories per day when nursing than she ate during pregnancy. The diet should include a substantial amount of liquids and extra portions of calcium-rich foods. If nursing is not possible and you must bottle-feed, use a well-balanced soy-based product. Cow’s milk does not supply a human infant with enough iron, linoleic acid, or vitamin E, and babies who are fed cow’s milk have a greater chance of developing allergies to milk and dairy products later in life.

Birth Plan

Formulating a birth plan while you are pregnant is a good way to ensure that your wishes regarding labor and childbirth are clearly stated and respected. It allows you to decide in advance what you want and what you would choose from among the options you may face during the birth of your child. It is a good idea to work on drawing with your healthcare provider and your partner in your plan. The following are a number of things you should ask about, and decide upon, in developing a birth plan:

• Where will you have your child, and what options are open to you in that facility? For example, do you wish to simply stay in bed during labor, or would you rather walk around or take a shower or sit in a tub?

• If you have chosen to have the baby in a private home, who will be there and what additional facilities might you need?

• If you are in hospital, can you wear your own clothes? Listen to music? Watch a video? How many people will be allowed to stay with you? How many people do you want to be with you? Do you want them to take photographs or videotape the birth?

• Do you want an intravenous (IV) line inserted during labor? In many places, this is considered a routine
• procedure. However, it often is not necessary. Do you want to be given drugs (usually oxytocin [Pitocin) to speed up labor? Oxytocin is often given through the IV and can make labor more painful

• What type of medication (if any) do you want? If you decide against any pain medication at the time you write your birth plan, will it still be available should you change your mind at any time during labor?

• If you do decide to use drugs for any pain you might experience, what are the potential side effects? Is it safe for the baby if you breastfeed immediately after using pain medication? Does your physician or midwife use homeopathic and/or natural remedies for pain?

• What methods will be used to monitor the baby during labor?

• Do you have to have your baby in the lithotomy position (flat on your back with your feet in stirrups)?

• Will you have an episiotomy? (This is an incision made to enlarge the vaginal opening either so that forceps can be used to hasten delivery or to prevent tearing in this area, which takes longer to heal than an incision does).

• Probably the most important question: Are you willing to have a cesarean section, and under what emergency circumstances do they perform this operation? If you had a cesarean for a previous delivery, will you be supported through a vaginal birth after a cesarean (VBAC) this time?.

The World Health Organization (WHO) has stated that no area in the world is justified in having a cesarean rate greater than 10 to 15 percent. Cesarean births cost more than twice as much as vaginal births. It takes much longer for the mother to recover, and she has to remain in the hospital for an extra two days, on average. The most common reason for performing a cesarean is that the mother had one for a previous delivery. But VBAC is possible, and this is something that you should discuss with your physician or midwife.

The risk of rupturing the previous incision is very small. The reasons for emergency cesarean usually fall into the following categories:

• The umbilical cord presents before the baby;

• The baby is a breech presentation (coming down the girth canal feet first, buttock first, or sideways, instead of head down),

• The placenta breaks up before the baby is born, or the baby’s head is too big to fit through the pelvis (a very unusual event).

Many problems can be corrected before or during labor without resorting to a major operation such as a cesarean section. Consult a reputable physician for further medical assistance.