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Ae are all familiar with the adage: ‘Be good
to your baby before it is born’. This aphorism
serves to emphasis the importance of medical care
during pregnancy (known as antenatal care). However,
in reality, the best time to start taking care of
your unborn baby is even before you conceive! Such
care is called pre-pregnancy or pre-conception care.
Why is this care so important? Remember, that the
foetal organs are actively developing during first
12 weeks of pregnancy (this crucial period is called
‘organogenesis’.)
The embryo is highly susceptible to external insults
during this time, so that any damage can lead to
crippling birth defects.
The beauty about pre-pregnancy care is that it is
so simple: all that is involved is visiting your
doctor before you are planning to get pregnant,
rather than after you've missed your menstrual period!
The doctor normally undertakes the following procedures:
(1) takes a medical history; (2) carries out a physical
examination; and (3) performs some simple laboratory
tests. These procedures are inexpensive and easy
to conduct and signify examples of preventive medicine
at its best!
Pre-pregnancy care also leads to other benefits.
For instance, it allows the doctor (duly assisted
by you) to identify problems and rectify them. If,
on the other hand, these problems were to be spotted
only after you became pregnant, detailed testing
can become very difficult, because the very presence
of the delicate embryo, can impede testing. The
harsh reality is that not all problems are preventable,
but you can, nevertheless, increase your chances
of having a healthy baby by identifying the risks
you face and trying to eliminate them, if possible.
After all, most doctors go in for a battery of tests
before performing major surgery, to make sure that
the patient is healthy enough to withstand the stress
generated by the operation and the anesthesia. Pregnancy
can also stress the body, and it is important to
screen the woman for potential problems before she
embarks on one of the most important journeys she
will ever make!
The most important precaution to be taken is to
ensure a regular intake of a vitamin called folic
acid. Folic acid greatly reduces the chances of
your baby being born with spina
bifida or anencephaly
(without a brain) if taken before you become pregnant
and during the first six weeks of pregnancy. This
vitamin is now routinely prescribed in many countries
in the West to prevent many birth defects.
Most women are aware of the importance of regular
medical care during pregnancy and you should plan
to register with a reliable obstetrician as soon
as you find out that you are pregnant. This ensuing
pre-natal care will then simply be an extension
of your pre-pregnancy care. While modern obstetric
care can ensure that pregnancy and childbirth are
very safe for both mother and baby, unfortunately,
today doctors have ‘medicalized’ pregnancy
to such an extent that what is otherwise a normal
event has been converted to one which needs rigorous
and frequent medical assistance.
Every mother naturally wants a normal baby, and
technology can be very useful in reassuring her
that all is well. However, it's easy to misuse technology.
One particularly disturbing trend stems from the
fact that many obstetricians nowadays overuse medical
technology; such overuse can often prove detrimental
to both the mother and the baby. Common tests which
are misused include: blood tests for TORCH (Toxoplasmosis,
Rubella, Cytomegalovirus;
Herpes) infections; ultrasound scans;
and foetal monitoring. Another area of misuse relates
to the tests available for screening the baby for
a possible birth defect. Many doctors routinely
subject their patients to a ‘triple test’
during the pregnancy to screen for birth defects.
While this is an easy test (it’s a simple
blood test which measures the levels of 3 hormones
in the blood) to carry out unfortunately, it has
still not been standardized for Indian women. Such
a drawback leads to a large number of tests yielding
abnormal results, even though the babies are completely
normal. An ‘abnormal’ result creates
a lot of anxiety
And then the doctor needs to perform a battery of
other tests to
confirm that the baby is, in fact, normal to reassure
the mother.The
second tier of tests can be expensive, and risky
as well, because
some of them can cause the mother to miscarry. Thus,
it is not
uncommon for a mother to lose a healthy baby because
of a test
which was not really required in the first place!
Related Sites :
www.Women.com
www.PregnancyToday.com
www.PregnancyCenter.com
www.PregnancyCalendar.com
The foetal monitoring procedure has also been overused
over the past few years. While this procedure was
initially designed to serve as a tool to monitor
the well-being of the foetus and to help reduce
the need for medical intervention, today it is often
used to justify an LSCS (Caesarean section) in order
to forcibly take out a baby ‘in foetal distress’!
A much simpler alternative would be to opt for ‘kick
counts’ — a baby which moves actively
is sure to be healthy!
Antenatal classes conducted by medical or paramedical
professionals can be very helpful. Here, you not
only to learn a lot about pregnancy and childbirth,
but also you get an opportunity to interact with
other women in various stages of their pregnancy.
The friendships developed during this period can
be very supportive and helpful!
Despite tremendous advances in medical science,
labour and childbirth are still events which many
women dread. Moreover, the rituals associated with
childbirth in hospitals have unfortunately been
designed for the doctor's convenience, rather than
the patients'! In this context, the harmful practises
include: forced induction of labour; routine use
of enemas and intravenous drips, foetal monitoring,
making the patient lie down (rather than allowing
her to walk about) — it's a long list! Don't
let the hospital/clinic staff patronize you —
you need to assert your rights! It's very useful
to draw up a birth plan (which includes things you
will allow and those you won't ) and make sure your
doctor agrees with the procedures. The presence
of a doula has been
proven to be your very helpful for women in labour.
Also, should encourage your husband to participate
in this adventure as actively as possible !
Yet another minus point pertains to the application
of anaesthesia for pain relief, which has become
the norm nowadays. We have mindlessly aped this
Western ‘advance’, much to the detriment
of both the mother and the child. While techniques
for pain relief a valuable resource, can be they
should be used only when absolutely necessary.
We are witnessing a virtual epidemic of Ceasarean
sections today. Whereas a CS once used to be the
method of last resort to deliver the baby, it has
at present, tragically, become the norm in some
hospitals, accounting for 50 per cent of all births.
The reason, of course, is obvious: a CS is financially
much more lucrative to the doctor than a normal
delivery. As a senior obstetrician wryly put it:
‘The only indication for a normal delivery
today seems to be if a patient delivers before the
doctor reaches the hospital!’
The alarming spurt in CS has taken on the dimensions
of a major scandal today, which needs to be tackled
actively. What steps can you take if you don't want
to end up as another statistic? It would be a prudent
idea to find out the rates your doctor charges for
a CS and for a normal birth. You can also ask him
what proportion of his patients successfully delivers
normally. Other patients in the clinic, as well
as the hospital nursing staff, can prove to be valuable
sources of information, which you should effectively
tap to alert you to a "knife-happy" obstetrician,
from whom you need to stay away!
A significant recent development is that many women
in the West are turning back to natural childbirth
once again, often either at home or what are known
as ‘birthing centres’. In other words,
they would like to keep as far away from a hospital
as possible! Despite the fact many doctors scare
women into believing that the hospital is the safest
place to deliver a baby, recent international studies
have shown that the home is often much safer and
much more congenial for normal births. For example,
Holland, where over 60 per cent of births occur
at home, under the supervision of midwives, can
justifiably boast of having one of the world's lowest
neonatal mortality rates! The midwifery model seeks
to remind women that childbirth is a natural process
for healthy women and women need to learn (or rather,
relearn!) to trust their bodies!
There are several ‘dos’
and ‘don'ts during labour and birth; for instance:
- Do walk around.
- Do learn to manage your labour pains without
resorting to unnecessary medication.
- Do ask to hold your baby as soon after birth
as possible, so that you start immediate bonding.
- Do ask that your baby be allowed to remain
with you.
- Do leave hospital as soon as possible (in
2-3 days).
- Do have your husband with you.
- Do have a doula with you.
- Do use pain relief medications very sparingly.
On the other hand:
- Don't take an enema.
- Don't lie in bed constantly.
- Don't allow an episiotomy (i.e., surgical
incision into the perineum and vagina).
- Don't allow the doctor or other medical staff
to cut the umbilical cord, until it stops pulsating.
- Don't allow them to start an IV drip, routinely.
- Don't allow them to take your baby away.
- Don't allow them to give the baby top feeds
(i.e., food other than mother’s milk).
The last point needs a little elucidation. While
everyone knows that breast milk is best for baby,
unfortunately, many mothers still persist in giving
their babies manufactured products. Why not give
your baby ‘the real thing’, rather than
a substitute ? It's a shame that most women who
would never dream of wearing imitation jewellery
don't mind feeding their babies an imitation substitute!
Tips for a Healthy Pregnancy
The following pointers would prove useful during
your pregnancy.
- Learn as much as possible about the wonderful
ways in which your body is changing and about
how your baby is growing. Talk to your mother,
your friends, and other women about pregnancy,
labour and birth. Attend pregnancy-related classes,
read the relevant books, and watch videos about
normal pregnancy and childbirth.
- Eat a well-balanced diet and drink lots of
water.
- Avoid substances that may be dangerous for
you and your baby such as cigarettes, alcohol
and street drugs.
Do not take any medications, even over-the-counter
varieties, unless you have discussed them with
your doctor and taken his approval.
- Remain active! Continue with the exercise
programmes that you were following before you
became pregnant, modified, if needed, according
to the recommendations of your doctor. If you
were not exercising at all before becoming pregnant,
consider going in for walking or swimming. Start
with short periods of exercise, and gradually
increase the amount of time.
- Get plenty of rest. Listen to your body to
determine if you need short breaks during the
day as well as to determine how many hours of
sleep you need at night.
- Talk to your baby and enjoy your growing bond
with him. Research now shows that babies can
react to the sense of touch as early as ten
weeks of pregnancy! A little later, they can
react to light, your voice, music, and other
sounds.
- Try to minimize the stress in your life by
practising stress management techniques such
as slow and deep breathing, yoga and relaxing
various muscle groups when you feel stressed.
- Plan your baby's birth. For most women, the
process is normal, natural, and healthy. nd
healthy.
- Enjoy this special time in your life! Your
husband and, your family and friends can help
you make the most of this wonderful transition.
Have confidence in your body's ability to grow,
nourish, and give birth to this baby just as
women have done for centuries. centuries.
- During pregnancy, many women are highly motivated
to remain as healthy as possible, so that they
can give their baby the best start in life.
Pregnancy is an excellent opportunity to develop
good health habits; you can use these habits
to keep yourself healthy for the rest of your
life!
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