PREGNANCY: A PERSONAL PERSPECTIVE


INTRODUCTION

For a few years now I’ve been compiling what seems to be my personal experiences during my pregnancy months and delivery.

I have taken time to observe my bodily changes, my weight gain, my weird eating habits, the daily discoveries of my new state, and the helplessness of receiving every form of advice that comes from women (related persons, strangers, passersby, the list goes on) and sometimes men!

In my state of amazement and recordings I decided not to write about just myself but also inculcate the experiences of other women around the world.

Pregnancy: A Personal Perspective is a book that describes the consistent changes occurring in the bodies and minds of mothers living in different spaces and climes in this universe.

It is a book filled with true stories of mothers around the world who have experienced pregnancy and childbirth. The illustration is written to enlighten, educate and encourage other mothers-to-be in their daily discoveries to give life to a newborn.

It is not a book of directives or instruction but one that intends to work hand-in-hand with the recommendations of a health-care-provider.

Feel free to inbox any questions on grey areas.

I hope you find the book most revealing, compelling and educative.



Sandra Ukele.



Chapter 1.

What is Pregnancy?
Pregnancy is the term used to describe the period in which a foetus develops within a woman's womb usually lasting 40 weeks or a little over 9 months. This is measured from the last menstrual period to the delivery date. This is the normal life cycle of a given foetus considering all circumstances remaining normal ( no emergency, no surprise, no falls, no preterm delivery, no accident, no incident).

The book wishes to describe pregnancy from every mother's point of view, be it: good, bad, stressful, challenging, exasperating, fun, long-sought-after or otherwise.

The knowledge acquired during this miracle period is what we seek to share.
Every mum has a story to tell of how she experienced her 9- month waiting period to achieve the goal of giving life to another.

This book wishes to explore the different stages of pregnancy as viewed from various perspectives of select women, medical practitioners, traditional midwives, fathers and others who find themselves assisting or caring for a pregnant woman.

I never knew much about preconception care until my Aunt who is a registered nurse educated me.

She told me of the importance of folic acid, B-complex, ferrous and calcium to a woman’s body. She spoke of how to replenish the cells of the body especially after menstruation. So I found myself taking folic acid, B-complex, calcium, ferrous, after every menstrual cycle. This would follow me through into pregnancy.
I begun discovering changes in the shade of my blood. It was always bright red compared to when I was unaware of these vitamins it stayed dark brown.
Bose Iheanacho (Mrs).

Mmm...for me, I never took too much cognizance of prenatal care. I took life as it came.
However, I remembered taking anti-malaria tablets and calcium immediately after my wedding.

Nsikan, M.O.

As for me, I gulped down tablets, caplets and softgels of prenatal vitamins so many years before I got pregnant.

I swallowed ferrous, B-Co, folic acid, calcium, cod-liver oil softgels. I believed I was prepping my body for pregnancy since I was heading for 30.
At some points I concentrated just on the cod liver oil capsules. I would burst the gel in my mouth and allow the oil to drip through my mouth, throat and down to my stomach.

August, Willis.

PRECONCEPTION CARE
A preconception care visit can help women initiate necessary steps toward a healthy lifestyle before they conceive.
Women can help promote a healthy pregnancy and birth of a healthy baby by considering the following steps before they become pregnant:

- Increase their daily intake of folic acid (one of the B-vitamins) to at least 400 micrograms daily.

- Ensure their immunizations are up to date.

-Avoid smoking of harmful substances, drinking of alcohol and indiscriminate use of drugs.

-Train for a healthy weight.

-Enquire about family medical history and that of the father-to-be.

-Fortify the body against diabetes, fibroid, cancer, depression, high blood pressure and other medical conditions that affect pregnancy.

-Ask for medical assistance against depression, anxiety or other mental health challenges that affect pregnancy.

-Plan a healthy nutrition table for baby and you.

-Develop a plan for a healthy reproductive lifestyle.

PRECONCEPTION MEALS
In order to stay healthy and strong throughout pregnancy it is crucial to plan ahead for a nutritious diet.

There is a basic responsibility to check what enters the mouth (all in the name of food) and what comes out of it.

This is so true as the body will draw on body stores built during preconception days to present when pregnancy poses at the door.

The following are some of the meal facts to reconsider when planning pregnancy:

Caffeine: Reduce the quantity of caffeine you take in preconception months. Caffeine intrudes in the absorption of minerals.

Alcohol: Alcohol in diet cuts down a woman's fertility chances.

Folic acid: Swallow at least 400mcg (microgram) of folic acid daily in preconception days. Folic acid develops the brain and central nervous system of the foetus. So immediately you plan to get pregnant folic acid should be your first companion.

Dropping the Pill: A research shows that for women taking the pill, there is a depletion in the vitamin B6 stores overtime. Therefore, replenish your stores by consuming foods rich in vitamin B6 before coming off the pill.

Zinc Content: Your partner must increase his intake of zinc, selenium and vitamin E-rich foods. These are super fertility boosters for men.
As pointed out, pregnancy is no more a 9-month affair it is now a 12-month activity with an accompanying 3-month preparation.

PRENATAL CARE
Prenatal care involves making periodic medical visits to a health care provider during the time of your pregnancy.

It is a calendar devoted to caring for the pregnant person and the growing foetus.

Usually most prenatal care providers, health care centres accommodate both parents at visits to the office.

You may of course come to your appointment by yourself. You could also wish to bring another person close to you with a special interest in your condition.
The first visit is very necessary as to gain a picture of your general condition while going into pregnancy.

Feel free to ask questions about any reservations or confusions.

FAQs About Pregnancy

I may be pregnant how do I know for sure?

For you to determine whether you are pregnant or not you need to run a pregnancy test.
The pregnancy test could be a home pregnancy test kit, one you can easily find at your local pharmacy.
Or you could go for a urine test at a laboratory or hospital. These places should give you an accurate computerized result of your status.
If you are pregnant, the hormone, Human Chorionic Gonadotropin (hcg) would be found in your blood.

Help I'm feeling nervous about my pregnancy. I am 20 and my boyfriend got me pregnant. I tried to get rid of it but I was discouraged by practitioners. I don't know what my neighbors would say. My mum is really angry at me. I have left her house. What should I do?

Pregnancy is not an evil thing.  There are people wanting to have a child not minding who with. So congratulations on that, you are in for a good news.

But, pregnancy period is the least time you want to become stressed. Whether psychologically, physically or emotionally.
Therefore, I understand why your mum is upset.

Basic questions: Is your boyfriend willing to take responsibility for the child, does he have an apartment?  These are questions that may be borthering your mum and neighbors for your age.

Now that I am pregnant I am beginning to notice changes in my body. I'm I normal?

The moment you become pregnant rapid changes begin to occur in your body. From your blood, to your breasts, to hair, nails, cervix, abdomen and others continue to change in your physiology. (Visit 'First Signs of Pregnancy')

PREGNANCY CARE

Many women plan to eat healthy immediately they conceive. One should understand that conception is not the only time to eat healthy, everytime is. You eat healthy as a child, youth, you eat healthy as an adult, you eat healthy as an aged. What goes into the mouth determines what the body delivers on.

Having a healthy pregnancy is one of the tremendous ways to experiencing a balanced child birth.

Obtaining an early and regular prenatal care improves your chances of a healthy pregnancy.
This 3-month preparation must cover eating right, planning a healthy nutrition roaster that would cover dairy, fruits, nuts, cereals, vegetables and fluids.

Engaging in proper fitness programs, such as walking, swimming, aerobics. However, remember to consult with your care giver before embarking on any program.

Taking the recommended dose of prenatal vitamins, avoiding harmful substances, over-the-counter (OTC) drugs, self medication and others.

Researching about family health history.

Going for diagnostics tests such as ultrasound, chorionic-villus sampling, amniocentesis.

PERSONAL HISTORY

You will be asked to present your medical history and that of your baby's father.

A questionnaire is presented to  you containing such  questions as medications, sexually-transmitted-diseases, genetics, abortions, other children: twins, triplets; existent diseases or a family history of certain illnesses are all discussed.

You will be asked about your previous pregnancies (including miscarriages) and about lifestyle, job description.

Physical examinations shall be carried out to include the careful assessment of parts of your body like breasts, throat, liver, bladder, lungs, heart, kidneys, blood pressure and uterus. This is done in line with your developing pregnancy.

Right from the first day of your prenatal visit to the final day of delivery different laboratory and imaging tests will be conducted to know:

your medical state and that of the foetus,

determine if the mum is bearing more than one foetus,

locate any IUD in place,

determine any impending defects on the baby

ascertain the due date and many more.

A number of laboratory tests are done to obtain information needed to monitor your health and that of your developing baby.
These tests shall include:

A urine test for the presence of protein, glucose and nitrates to keep track of kidneys function.

A blood test to check for a number of different things:

- red blood cell level to see if you and your baby are getting enough oxygen (Hematocrit-HCT)

-your blood type and whether or not you carry the Rh-factor

-whether or not you carry antibodies to Rubella (German Measles)

- syphilis or other sexually transmitted diseases.

Any other test that might be specially indicated to your particular circumstance (at your request) or at the suggestion of your medical team.

Making the prenatal visits the mother-to-be should feel free to ask any question about her condition, the baby's health or any other ambiguous topic she is uncertain about.

Moreso any peculiarities, pain, discomfort, bodily changes or abnormalities she may be experiencing should be overtly discussed with the professional health care provider.

Preconception and prenatal care can help prevent complications in pregnancy and help inform women about important steps to take in protecting their foetuses and ensuring a healthy pregnancy.

With regular prenatal check ups women can:

Reduce the risk of pregnancy complications (pre-eclampsia).

Following a healthy, safe diet; getting regular exercise as advised by a health care provider and avoiding exposure to potentially harmful substances such as lead and radiation can help reduce the risks and problems-associated with pregnancy.

This will promote foetal health and development.

Controlling existing conditions that might befall the mother such as high blood pressure, diabetes, cancer, HIV, fibroid; is important to prevent serious complications and their effects.

Reduce foetus exposure to complications.

Tobacco and alcohol use during pregnancy have been indicated to increase risk of Sudden Infant Death Syndrome (SIDS).

It has been discovered that alcohol use also increases the risk for foetal alcohol spectrum disorders which can cause a variety of problems such as abnormal facial features, having a small head size, poor coordination, poor memory, intellectual disability and problems associated with the heart, kidneys or bones.

In addition ingesting 400 micrograms (mcg) of folic acid daily reduces the risk of neural tube defects by 70 per cent.

Most prenatal vitamins contain the recommended 400 micrograms of folic acid and other vitamins that pregnant women and their developing foetus need.

Although a related form called folate is present in orange juice and green, leafy vegetable ( such as kale, spinach, ugu); folate itself is not absorbed as well as folic acid.

Prenatal care can help ensure the medication women take are safe.

Women should not take certain medications including some acne treatment and dietary herbal supplements during pregnancy because these can harm the foetus.

PREGNANCY PERIODS
Pregnancy is divided into 3 periods tagged trimesters. These 3 trimesters refer to the developmental stages of both foetus and mum throughout the lifetime of the pregnancy.

FIRST TRIMESTER
The first Trimester is counted from the first day of conception to the 12th  week. This is the most trying and delicate of all trimesters.

 Most women experience morning sickness in this trimester.
The first trimester involves the growth of the baby's body structure, the development of the central nervous system and organs.

From the moment the sperm joins to egg the cells begin to divide rapidly. Those that will become the placenta grow against the uterine wall.

The placenta connects to the little developing form through the umbilical cord to carry nourishment from the  body to the baby. It will also carry off wastes from the baby so that the  body can dispose of them.

In the first trimester the baby begins to form it’s brain, spinal cord, eyes, heart, lungs.

As the 8th week approaches the baby’s ears are starting to develop. Each ear begins as a little fold of skin at the side of the head. Tiny buds that eventually will grow into arms and  legs are forming. At this time, the brain and spinal cord are already well formed. Head is larger in proportion to the rest of the body. At the end of week 8 your baby is about an inch long. The little buds that will become fingers already have finger prints.

By the 12th week baby’s fingers, hands, arms, toes and feet are fully formed. The external and intetnal sex organs are developing meaninfully.
If your baby is a boy, his testicles already contains  sperm. If it’s a girl her ovaries contain ova.

So even before the baby is born, the promise of the future generation is already present in those tiny cells.

SECOND TRIMESTER
The second trimester starts counting from the 13th week to the 28th week. In this season your 'baby bump' begins to show.

People can now narrow their eyes and say, "Ohw she is pregnant, I didn't know...did you?" 🤰
An imaginary response follows: 'No. I didn't either'...(shoulders shrugged).🤷

Preggo should be feeling stronger now having been able to overcome the challenges of dizziness, tiredness, nausea or vomiting (morning sickness), constipation or diarrhea that characterized the first trimester. All of these symptoms are fading away.

You wake up one day and discover all the morning sickness is a thing of the past; when it stopped you did not know.

In the 13th  week your baby's heartbeat can be heard using a special stethoscope. Compared to the rest of body, the baby’s head seems very large at this point.

By the end of the 16th week baby is about 7 inches long; already has eyebrows and lashes and can suck his or her thumb.
In the coming weeks he is busy developing muscles and exercising them. Although he has been moving for some time now, it is during the 20th week that most mothers feel the baby move for the first time. The time when you begin to feel your baby move is called
'quickening.’

During the second trimester between weeks 18 and 20 an ultrasound should be conducted.
This imaging test will determine the condition of the baby, position, possible birth defects and even the sex of the baby ( for those eager to know the sex of their baby!).

At week 24 foot prints and finger prints of baby have formed. Baby can now sleep and wake up regularly.

Baby’s skin is wrinkled and covered with a heavy, protective, creamy coating called vernix caseosa.

According to research findings from the NICHD Neonatal Research Network the survival rate for babies born at 28 weeks( second trimester) is 92 per cent.
But babies born at this time will likely still experience serious health complications such as respiratory and neurologic problems.

THIRD TRIMESTER
This is the last phase of the trimesters. It begins to count from the 28th week to the 40th week. The baby continues to grow and exercise.

Baby continues to grow after 36 weeks of gestation but at a slower rate. Even a few weeks' less time in the uterus can have a dramatic effect on the size of your baby.

A baby born between the 38th and 42nd weeks of pregnancy is 'term baby' or 'full term' infant. If the baby is born before the 38th week the word "preterm" can be used. At 42 weeks of pregnancy and after this time, 'post term' is used.

When a baby is born before the end of pregnancy, many people use the term premature and preterm interchangeable. There is a difference.

An infant that is 32 weeks gestational age but has mature pulmonary or lung function at the time of birth is more appropriately called a "preterm" infant than a premature infant. 'Premature' best describes an infant that has immature lungs at the time of birth.

A few interesting facts about birthweight have been identified.

-Boys weigh more than girls.

-Birthweight of an infant increases with the increasing number of pregnancies you have or the number of babies you deliver.
These are general statements that don’t apply to everyone, but they appear to apply in many cases:

The average baby’s birthweight at full term is 3.2kg to 3.4kg.

Pregnancy from a personal definition could be said to be a state of a woman holding a foetus in her womb to be delivered within 40 weeks after conception.

In the first trimester the woman begins to experience feverish conditions, headaches, weakness, sensitivity to smells and odours, inadequate sleep, nausea or vomiting, dizziness, swelling of the breasts and pains around the nipples.

All these symptoms are as a result of the numerous hormonal changes going-on simultaneously in the woman's body.

The feverish conditions can be mistaken for malaria parasite ( a condition prevalent in West Africa.) or typhoid fever or such other conditions that display feverish conditions as a symptom.

Presumably this is why most expectant mothers complain of 'malaria' in the early stages of pregnancy before even noticing they are pregnant.

Some Early Signs of Pregnancy

Fatigue
Almost every pregnant person complains of general body weakness, tiredness and inadequate sleep or rest during the first trimester.

Sensitivity to Smells
Pregnant mums turn sensitive to strong odours in the first trimester. Immediately they perceive a scent or aroma they begin to feel nauseous. In fact some even perceive what you can't imagine and they go: "do you perceive that smell?" They look at you anticipating a nod of agreement.
I mean every fragrance either irritates them or they fall in love with.
These strong responses to smells, fragrances, aromas or odours is consequent to the rapid hormonal changes occuring in their bodies.

Given Demands

It is advised to abstain from strong and harmful drugs at early stage of pregnancy. They could knock-off the foetus leading to miscarriage.
Instances where pregnant mums think they are down with malaria and rush off to treat such with tough anti-malaria medicines or over-the-counter (OTC) drugs without doctor's prescription should be strongly avoided.

Self medication should be discontinued during pregnancy and strong pain killers must be discouraged once conception is confirmed.

Through medical advancement it has been discovered that the general well being at the beginning of and during pregnancy can have a major effect on the mother-to-be and her developing infant.

The following are some of the steps to take before conceiving:

1.Maintain a healthy weight.
Being overweight or obese raises your risk of gestational diabetes and consequently your child's risk of heart abnormalities and birth defects.

2.Cross check your Diet
What you eat before you get pregnant- refined carbs such as soda, cookies, fruit drinks, pretzels, white bread- may increase your baby's risk of birth defects says a March of Dimes study of 900 non-diabetic women.

Those who ate the largest amount of refined carbohydrates during the 3 months before conception doubled their baby's risk, compared with women who ate the least.

Researchers speculate that starchy or sugary foods raise a mother's blood glucose. This can lead to cell damage and deplete the foetus stores of inositol.
Inositol is a chemical 'mesenger' between cells.
In animal studies, a lack of inositol has been implicated in neural tube defects such as Spina bifida.

To reduce this risk, cut back on the refined carbs listed and find time for veggies, fruits, whole grains, beans and include at least the recommended 400 micrograms (mcg) of folic acid.

3. Go for Medical Tests
Going for a general physical examination before you becoming pregnant could prevent any New Medical problem that might arise in your pregnancy.

A breast exam should be part of this test. Other lab tests you might consider during this period would include rubella, blood type, Rh-factor.

If you have gone above 35 a mammogram and vaginal screening tests are good options.

Also if you have been exposed to HIV or hepatitis (see Hepatitis) consult you caregiver.
If you have other chronic medical problems such as anaemia, recurrent miscarriages your health care provider might suggest other specific tests.

4. In Vitro Fertilization (IVF) 
Befor you begin another conception program step on the scale. If you are obese (30 per cent above your ideal weight), your odds of having a successful pregnancy are low.

In a South Carolina study of 372 women undergoing IVF. Those who were obese were 32% less likely to get pregnant than were women at  healthy weights.
Also, in a study 6123 Ivf women, London researchers found that those who were obese had a 43% higher miscarriage rate than their healthy weight counterparts.

Obesity cause hormonal imbalance that make it harder to conceive and carry to term with IVF, explains infertility researcher Paul Miller, MD:
"By losing just 5% of your body weight before trying IVF can significantly improve your chances of getting pregnant.”

5.Examine Your Blood Sugar Level
Blood Sugar Levels need to be at healthy states for the next 5 to 6 months before contracting conception. Unhealthy sugar levels may lead to increased risks of birth defects. If you have a family history of diabetes and are overweight, you are more at risk.

6. Manage Polycystic Ovary Syndromes
Contrary to rumour, high protein diets offer no advantage to women who have a hormonal imbalance called polycystic ovary syndrome (PCOS) and are trying to get pregnant.

High carbohydrate diets work just as well, says experts at Pennsylvania State College of Medicine. They studied 26 obese, infertile women with PCOS and found that 8- to 10- pound loss in 1 month on either diet lowered the women’s blood levels of male and fat-cell hormones. Elevated levels of either hormone may suppress ovulation.

Before a woman conceives she must begin to prep her body to receive such prenatal vitamins that would nourish both herself and the unborn baby.
Such prenatal vitamin include folic acid, vitamin B-complex, ferrous, calcium and vitamin C every month. This is especially true after menstruation.

These vitamins replenishes the lost blood cells to menstruation, prevent anaemia, supply of calcium which will deplete in stores once pregnancy kicks in.

Pre natal vitamins aids a mother-to-be remain youthful, beautiful and vibrant.
 Adequate folic acid in a mother's blood stream has been linked to preventing a foetus from neural tube defects such as Spina bifida.







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