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Welcome to pregnancy!

This is the start of an incredible journey. In this section, we provide useful tips on pre-conception. Know what to expect during pregnancy & delivery, month by month pregnancy information and more.
In this section, we provide useful tips on pre-conception, early pregnancy signs, what to expect on your prenatal checks, nutrition during pregnancy, labour and delivery etcs.
Know what to expect during pregnancy, labour and delivery and the months after.

  • 1) What should I do before I get pregnant to ensure a healthy pregnancy for me and my baby?

    When you start thinking about trying to conceive, you should:

    – See your doctor for a prepregnancy checkup. Don’t forget to ask about things like family medical history, risk of birth defects, genetic conditions, and chronic illnesses. Discuss all the medications you take and make sure they’re safe during pregnancy.

    – In addition to eating a healthy diet (lots of leafy greens, lean proteins, and fiber), boost your nutrients with a multivitamin specially formulated for pregnancy — usually called a prenatal vitamin. It’s particularly important to get sufficient folic acid before getting pregnant. This nutrient helps prevent birth defects like spina bifida; because many of these conditions arise very early in pregnancy, you need healthy levels of folic acid right from the start. Look for a multivitamin that contains 400 micrograms of folic acid.

    – If you smoke, quit. Smoking poses a host of risks to a developing baby, including birth defects and low birth weight. It also doubles your risk of having an ectopic pregnancy. You may also find it more difficult to become pregnant in the first place if you smoke, as smoking is strongly linked with infertility in both women and men.

    – Get checked for hepatitis B and C, sexually transmitted infections, and HIV.

    – Get any health problems — like diabetes and high blood pressure — under control. If you areoverweight, talk to your doctor about how to maintain a healthy weight.

  • 2) What are the early pregnancy signs?

    You may experience all or the first signs of early pregnancy, grow hopeful that you are pregnant, and still not be. Or you may have hardly any symptoms and be definitely pregnant. The truth is pregnancy signs and symptoms are mere clues. Do not ignore them but at the same time don’t bank on them either. Further confirmation with a visit to your clinic is very necessary if you suspect a baby is on the way! Here are three categories of first signs of pregnancy which translate to you being possibly or probably or positively pregnant!
    The Possible signs
    These are signs that are experienced by the woman herself but because these are feelings as reported by the woman which are not confirmed by medical evidence, they cannot be considered definite indicators of pregnancy
    a) Absence of or missed menses (amenorrhea) When: Soon after conceptionOther causes of a no-period situation include hidden fear of an unwanted pregnancy, fatigue, stress, hormone problems, illness such as thyroid gland disturbances, extreme weight gain or loss, recent childbirth, breastfeeding, going off the pill and travel
    b) Morning sickness at any part of the day with or without the vomitWhen: as early as 2-3 weeks after the LMPOther causes are infection, food poisoning, emotional distress and a host of other illnesses
    c) Frequent pee When: as early as the first day of a missed period Other causes are UTI, diabetes, stress, diuretics

    The Probable Signs
    These are signs felt by the mother which can be documented when she is physically examined by a doctor i.e. growth of the uterus
    d) Color change in the tissues of the vagina and cervix to purplish blue When: first trimester. The other cause can be pegged to your impending periods
    e) Fluttering in the lower abdomen When: 16-22 weeks Other causes are gas, bowel contractions
    f) Pregnancy tests When: preferably about 10 days after conception. Blood and urine testing are not 100% full-proof in determining pregnancy. (In the recent past, these tests have proven to be 99% accurate in detecting hCG, a hormone produced by the blastocyst [a clump of cells result when the sperm and egg fuse] and later by the placenta.) Hence a positive result following the test is considered as a probable sign and not a positive one. It is advisable to follow up with a visit to the doctor’s office. The most striking changes affected by pregnancy occur in the reproductive organs so the results from a check of these organs can convert a probable pregnancy to a positive one.

    The Positive Signs
    These signs are a direct consequence of an embryo growing inside the mother. Changes in the cervix, vagina and uterus can still be due to other reasons. However the presence of the fetal heart rate and ultrasound images of a live embryo will ascertain a pregnancy and rule out all other possibilities.
    g) Visualization of embryo or gestational sac through ultrasound. When: one to one and a half months following conception
    h) Fetal heartbeat When: 9th – 12th week using a Doppler16th – 20th week using a fetoscope
    i) Fetal Movement (quickening)When: 20th week of pregnancy felt by a third party (doctor)

  • 3) How do I go about calculating my due date?

    To calculate your due date, you need to add 266 days or 38 weeks to the date when you conceived or assuming that your menstrual cycles are 28 days in length, add 280 days or 40 weeks to the first day of your last menstrual period. If your cycles are longer or shorter your doctor will decide to adjust your due date slightly. Likewise if your cycles are erratic, your due date may be adjusted as your pregnancy progresses and your doctor is better able to judge your stage of pregnancy by tracking baby’s development. (Fetal development occurs in a predictable and timely fashion so an ultrasound can be very helpful in dating a pregnancy.) Bear in mind your due date is only an estimate. A healthy pregnancy can last anywhere from 38 to 42 weeks. Even though your chances of delivering on the due date are considerably slim – 5% – your chances of giving birth during the week prior to or following your due date are considerably higher: about 85%.

  • 4) What should I expect from my first prenatal checkup?

    Your first prenatal visit may be one of the longest. During your initial prenatal checkup, you can expect your doctor to

    • Confirm your pregnancy with a urine test, blood test and/or physical examination

    • Take a general medical history or review the findings from your preconception checkup. You will be asked about your periods and recent birth control methods

    • Estimate your due date by considering factors as the types of pregnancy symptoms you are experiencing and when they first occurred, the date of your last normal menstrual period, the results of ovulation predictor tests you used or any temperature charts you kept, and changes to the cervix and uterus

    • Take an obstetrical history (assuming you have had other pregnancies)

    • Conduct a general physical exam (heart, lungs, breasts, abdomen and so on). Breasts are examined to check for lumps

    • Conduct a pelvic exam (a visual examination of your vagina, and cervix as well as a bimanual exam of your pelvic organs)

    • Do a blood test to determine blood group and to check for anemia, hepatitis B, HIV, syphilis, and antibodies to rubella as well as certain genetic disorders (e.g. sickle-cell anemia) if your history warrants it

    • Take a vaginal culture to check for the presence of infection, if warranted

    • Check your urine for infection, sugar and protein

    • Weigh you to establish a baseline weight

    • Take your blood pressure

    • Provide you with advice on nutrition and lifestyle issues

    • Answer any questions you may have

    • Talk to you about how you are feeling about being pregnant

    You can expect to see your doctor on a monthly basis until you reach week 28, at which point you will start to come in for checkups every 2-3 weeks. Once you reach week 36, you will generally be seen on a weekly basis.

  • 5) What Vitamins Should I Take and When?

    As soon as you find out you are pregnant, start taking one prenatal vitamin daily which contains between 400 to 800 mcg of folic acid. If you are trying to get pregnant, start that prenatal vitamin preferably at least one month prior to becoming pregnant. This will help prevent problems with neural tube defects, such as spina bifida. For those women who have had a child with prior neural tube defects, you will need to take a total of 4000 mcg of folic acid daily.
    Your doctor will test you for anemia during your pregnancy. And like many pregnant women, if you do become anemic, you will be asked to take an iron tablet daily. Taking it with a little bit of Vitamin C (like orange juice) will help iron absorption.
    If you don’t eat enough dairy, a calcium supplement is also recommended. Both pregnant and non-pregnant women require at least 1000mg of calcium daily.

  • 6)Understanding Nutritional Needs of pregnant Mums | The Asia Parent

    Understanding your nutritional needs during pregnancy
    Pregnant mums, your bodies are working overtime to nurture that precious little life growing inside of you. You need to be able to support your own body and the growing baby’s development through proper nutrition. Read on to find out more.
    The moment that you first find out that you are pregnant, is a life changing one.
    A pregnant mum needs to make sure that the growing baby is getting the right nutritional support needed for his development. She also needs to ensure that her own body is strong and healthy enough to support the baby’s growth.
    However, a lot of pregnant mums can, at times, be unaware of their own nutritional needs.
    We spoke with Dr Lee Keen Whye, Consultant Obstetrician and Gynaecologist at the Gleneagles Medical Centre and founder of Singapore O&G Ltd., to better understand some of the specific nutrition-related issues that pregnant mums should be aware of.
    According to Dr Lee, not all pregnant mums take good care of their nutritional needs — this is not because for lack of wanting to do the right thing, but rather a lack of information and understanding.
    One example he gives is that of pregnant mums practising unsupervised self-medication of Traditional Chinese Medicine (TCM).
    Dr Lee says that while most pregnant mums question the doctor several times about the side effects of common cold and fever medication, they hardly ever ask about the side effects of TCM concoction that they consume. “In some cases, the unsupervised concoctions may do more harm than good to the baby and the mother.”

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  • 7) What should and shouldn’t I eat while I’m pregnant?

    a) Get all essential vitamins and minerals daily. That means sticking with the prenatal vitamins you started prior to becoming pregnant, as well as eating a healthy diet.

    b) Fill your plate with leafy greens, fruits, veggies, and whole grains (like wheat breads and cereals). Get plenty of calcium-rich foods like broccoli and low-fat milk and yogurt, to help build your baby’s bones and teeth. Stick to lean meats like chicken and turkey

    c) Foods to avoid during pregnancy include:

    i. Fish with lots of mercury. High levels of mercury can damage a baby’s developing brain. But don’t cut out fish completely — they give you important omega-3 fatty acids. Cut out fish like swordfish, tilefish, and shark. If you love your tuna and snapper, you can still eat it — just cut back to no more than one serving a week. You can eat up to two servings of fish like salmon, catfish, mahi mahi, and cod, along with shellfish like shrimp, crab, and scallops.

    ii. Raw fish. Sorry, sushi and sashimi lovers.

    iii. Unpasteurized soft cheeses like brie, Camembert, feta, gorgonzola, and Roquefort. They may contain bacteria called listeria that can cross the placenta, potentially causing miscarriage or leading to a life-threatening infection.

    iv. Unpasteurized milk, which can also contain listeria.

    v. Cold ready-to-eat meats, like hot dogs and luncheon meats; these can also contain listeria. Reheat these foods until they are steaming.

    vi. Uncooked or cured eggs and meats, like prosciutto, runny eggs, and sauces made with raw eggs (like some hollandaises).

    vii. Alcohol. There is no known safe level of exposure to alcohol for a fetus. Prenatal exposure to alcohol can interfere with healthy development and lead to fetal alcohol syndrome, one of the most common causes of mental retardation and the only one that is completely preventable.

    viii. Caffeine. While some studies show that moderate caffeine intake during pregnancy is OK, others have found a link to miscarriage, so it’s particularly important to steer clear of caffeine during the first trimester. Large amounts of caffeine have been linked to premature birth and low birth weight, so do your best to switch to decaf. If you can’t cut it out entirely, limit intake to 300 milligrams per day or less (1-2 cups of coffee).

  • 8) What causes morning sickness? And when will it end?

    As most pregnant women discover, “morning” sickness can strike any time of the day or night, with queasiness that can be triggered by hunger, the smell of the neighborhood hot dog stand, or just getting out of bed in the morning. Fortunately, it usually ends sometime during the third or fourth month. One thing that can be said about pregnancy nausea: Two or three months of feeling crummy can really help you appreciate feeling the surge of energy and appetite that comes when it’s over.
    To keep early morning sickness at bay, many women eat saltines or wheat crackers before getting out of bed. Eating six mini-meals throughout the day rather than three larger ones makes digestion easier and can help prevent hunger-triggered nausea. Fruit smoothies are also a good choice, as they’re rich in nutrients and, because they’re cold, they often don’t have a strong scent to upset your stomach. If your prenatal vitamin is making you sick, try taking it with food, and talk to your doctor if you’re having trouble keeping it down. There are medications as well as new vitamin options that are designed for women who are suffering from severe morning sickness.

  • 9) Labour & Delivery: How Will I Know When to Push?

    Once your cervix is completely dilated (open to 10 cm), you will be encouraged to start pushing. If you have not received pain medication, the urge to push is usually strong. Pushing will give you a burst of energy. For most women, it feels better to push than not to push. Pushing is done instinctively and as hard as the mother feels necessary.

    If you have had an epidural, you will be numb. You will not have the urge to push and your muscle coordination will be a little more difficult to organize into effective pushing. You may have to rely on your nurse, nurse-midwife, or doctor to help guide your pushing efforts. Most women with epidurals push very effectively and will not need the assistance of forceps or a vacuum extractor to deliver their babies. If you are very numb, sometimes the nurse or doctor will encourage you to rest comfortably while the uterus continues to push the baby downward. After a while, the epidural will be a less powerful, you will feel more able to push, the baby will be further down the birth canal, and delivery can proceed nicely.

  • 10) Labour & Delivery: Assisted Delivery

    Sometimes, the baby needs extra help in getting out. Even though you may be pushing with all the strength you can muster, your energy may have waned, and because of fatigue, your pushing may not be strong enough to deliver the baby. Alternatively, it may be a tight fit or the baby may need to be rotated to a better position in order to squeeze out. After two to three hours of good pushing, your doctor may opt to guide the baby out with an instrument while you continue to push.

    The instruments that may be used in these situations are the forceps and the vacuum extractor. They should not be used unless the baby can be seen and reached easily. Your doctor will not “pull” the baby out. The baby will be guided while you continue to push.

  • 11) Labour & Delivery: Episiotomy

    An episiotomy is a cut at the base of the vagina to make the opening for the baby larger. In the past, doctors believed that every woman needed an episiotomy to deliver a baby. At present, episiotomies are performed only in certain cases, including the following:
    – when the baby is having distress and needs help getting out fast;
    – when there is tearing of the tissues upward into sensitive areas such as the urethra and clitoris; and
    if after pushing for a long time, there is no progress in stretching or toward delivery.
    Small skin tears are less painful and heal faster than an episiotomy; therefore, an episiotomy may not be performed, but the mother may still need a few small stitches.

    For repair of an episiotomy or tears, doctors use sutures that dissolve so that they won’t need to be removed. As you are healing, you may notice them at times; you may also notice intermittent itching as the skin heals.

  • 12) Labour & Delivery: Emergency Childbirths