Pregnancy Care Video

A female village health worker (VHW) and a woman in the first month of pregnancy are talking.

VHW on screen: Congratulations!!!! My name is Kannamma and I am going to give you some useful information on caring for yourself and your baby during the next few months

WHY PREGNANT WOMEN NEED SPECIAL

CARE

VHW walking towards a chart of nutritious balanced diet

VHW on screen : In the next 40 weeks your body will undergo various physical changes. To cope with these changes it is important that you eat well, take adequate rest and exercise regularly. Only a healthy mother can bear a healthy child.

NUTRITIOUS DIET

Visual of Nutrition Chart. Fresh fruits, vegetables, dairy.

VHW voice in background : A well-balanced and nutritious diet will help your baby to grow well - physically and mentally. Besides plenty of fresh fruits, vegetables and water, your baby’s growth also depends on adequate supply of the following:

What is a Balanced Diet?

FRUITS + VEGETABLES

DAIRY – MILK, YOGHURT, EGGS

WHOLE GRAINS – WHEAT, RICE

•Iron – Supports increased blood supply. Helps growth of placenta and fetus– Natural sources of Iron : Spinach (Visual of spinach, figs other iron rich foods)

VHW voice in background : Iron supplement supports the increased blood supply in your body. It helps with the growth of the placenta and the fetus. If you are experiencing morning sickness wait until the second trimester to begin iron tablets.

•Folic Acid/ Vitamin B– Prevents birth defects

VHW voice in background: Folic Acid is a type of Vitamin B. It prevents birth defects. It is usually available in tablet form.

•Vitamin C– Helps in absorption of Iron and folic acid

Food sources rich in vitamin C are fruits such as lemons, oranges, papaya and tomatoes. Taking iron and folic acid tablets along with vitamin C-rich foods is a good way of ensuring that these nutrients are absorbed.

•Calcium – Helps the growth of your baby’s bones. (Visual of diary and other calcium rich

foods)VHW voice in background: Besides taking calcium supplements you should increase the intake of milk, yogurt, cauliflower, corn all of which are rich in calcium

EXERCISE AND ACTIVITIES

• VHW on screen : Exercise is very important to keep good health during pregnancy because it strengthens muscles. It can help reduce occurrence of backache, constipation, bloating and swelling. It also helps for quicker recovery after delivery.

•Walking VHW voice in background: Walking is a simple, safe and effective way to exercise. This is safe to do through all 9 months of pregnancy.

•Household ChoresVHW voice in background: Pregnant women can do routine household chores that do not involve lifting heavy weights or frequent bending at the waist. Sweeping, mopping are all good exercises.

Scene of 2 pregnant women sweeping and mopping. They are doing these activities very fast. Vidya, stops them to speak to them

VHW on screen with other two women: While exercising, remember to stop if you get uncomfortable. Breathe regularly and do things slowly and with a steady step. The main purpose of exercising during pregnancy is to keep your muscles strong and your body as flexible as you can.

VHW voice in background: Reading material on slide

Certain activities that should be avoided during pregnancy.

–Lifting heavy weights or bending frequently at the waist

–Lying down on the back for more than a few minutes

–Smoking, drinking alcohol, chewing tobacco

MOTHER’S EMOTIONAL HEALTH

& ROLE OF FATHER

VHW voice in background reading material on slide:

Emotional well being of the mother is required for good health of the baby

–Often pregnant women are under emotional stress regarding the gender of their baby

–Expectations and behavior of other family members can also cause stressful situations for the mother.

VHW on screen interspersed with visuals and clips of healthy, playful, laughing babies with their parents: At this time, your husbands involvement in your pregnancy will help you to overcome such stresses

– Explain to him the physical changes your body is going through, the pains, the discomforts you experience. This is the only way a man can participate in the development of his child. Let him feel the kicks of the baby. Allow your husband to play the father’s role even before your baby is born

– Knowing the discomforts of pregnancy will encourage him to lend a helping hand and share the experience of giving birth to your child

– Remember that whether it’s a girl or a boy, it is your child……she is God’s gift to you.

– Delivering a physically and mentally healthy baby should be your and your husbands goal

EARLY PREGNANCY THE FIRST TRIMESTER

You and your baby

VHW voice in background: : During the first trimester the baby has a tiny beating heart and fingers. By the end of the third month the fetus is 2 1/2 to 3 inches long and is fully formed. He has begun swallowing and kicking (though you may not yet feel it!). The organs and muscles are beginning to function.

•Baby has tiny beating heart and fingers

•Baby has begun swallowing

•Organs and muscles are beginning to function

Early Signs of Pregnancy THE FIRST TRIMESTER

• Tiredness & Morning Sickness

VHW voice in background: Besides missing their menstrual period most women experience other physical changes. Tiredness, nausea, vomiting, lack of appetite is a fairly common problem in the first trimester. Due to morning sickness some women are not able to gain weight. This is common. Try to eat small portions frequently instead of taking big meals. Snack on fresh fruit and vegetables.

• Frequent urinationVHW voice in background : Frequent urination is due to increased intake of water and decreasing capacity of the bladder as your uterus pushes against it. In the months to come frequency of urination will increase. But you should continue to drink plenty of water and other fluids to avoid dehydration and urinary tract infection.

• Abdominal cramps & Tenderness of BreastVHW voice in background : Abdominal cramps may occur frequently due to expanding uterus. Your breasts will also start feeling tender as your body prepares to produce breastmilk to nourish your baby. These changes will continue throughout pregnancy.

• ConstipationVHW voice in background : Due to the hormonal changes experienced by your body, the normal function of your bowels can slow down. Drink plenty of fluids and eat fiber rich foods like fruits and vegetables to relieve constipation

• Vaginal Discharge and BleedingVHW voice in background : A thin, milky-white discharge is normal throughout pregnancy. Light spots of bleeding are also common in the first trimester but they could be signs of miscarriage. Call you doctor in case of any bleeding.

The Second TrimesterYou and Your Baby

VHW voice in background: During the second trimester your baby is covered with a layer of thick hair. The heartbeat can be heard clearly using a doppler. By the end of the sixth month eyebrows and eyelids are visible. Your baby's lungs are filled with amniotic fluid, and he has started breathing motions. If you talk or sing, he can hear you. You will experience increased appetite starting in your 2nd trimester and it is important to eat nutritious food appropriately. Weight gain of about 1 pound per week is normal.

• Baby has thick layer of hair

•Heartbeat can be heard clearly

•Eyebrows and Eyelids are visible

•Breathing motions have started

•Increase in appetite during 2nd trimester

Common Discomforts during the Second

Trimester

•Leg Cramps– Occur usually at night time–Caused from fluid accumulation and tiredness–Exercise regularly to reduce cramps

VHW voice in background: Leg cramps occur usually at night time during 2nd and 3rd trimesters due to fluid accumulation and fatigue. Regular exercise by walking can reduce the occurrence of cramps. Stretching the legs and rotating/flexing at the ankles and toes can reduce pain and prevent cramps. Swollen veins, usually in the ankles and legs, may also occur during pregnancy. This condition can cause lot of pain in the legs. It is important to exercise moderately and rest legs often by not standing for long periods to help reduce pain.

•Pelvic, back and hip pain: – Expanding uterus and change in posture causes pain–Rest frequently. Change your position often

VHW voice in background : Backaches can occur due to the expanding tummy and resulting change in posture. Occurrence can be reduced by not sitting or standing for long periods of time. Sleeping on the sides rather than the back is important during 2nd and 3rd trimesters. It is also important to not carry very heavy weights. If older children need to be carried, it is important to use the arms for lifting and not use the back muscles.

•Stretch marks and other skin changes VHW voice in background: Stretch marks usually appear on the growing belly and breasts. It cannot be avoided. However, applying oil or lotions can reduce the discomfort of itching that happens when skin stretches. Other commonly occurring skin change is appearance of pimples on the face. This is temporary and is also due to pregnancy hormones.

•Hemorrhoids and constipationVHW voice in background : Rectal bleeding can occur sometimes due to swelling of veins. Preventing constipation effectively prevents hemorrhoids.

•Nosebleeds and bleeding gumsVHW voice in background : High levels of pregnancy hormones can cause nasal stuffiness and bleeding. It is not a matter of concern if it is not heavy. Lean forward and pinch your nose gently for a few minutes to stop bleeding. Blow gently when clearing your nostrils. During pregnancy, hormones also cause swelling of gums, which may cause bleeding. Poor dental health puts a woman at increased risk of giving birth prematurely. It is therefore important to brush regularly and maintain good dental hygiene.

THE THIRD TRIMESTERYou and your baby

VHW voice in background : In the third trimester the baby’s body develops its shape and form. Fingernails cover his fingertips and layers of fat are piling on. He has probably turned head-down in preparation for birth. As he becomes more crowded, you may feel him move around less. However, it is important to monitor your baby’s movements everyday until delivery. Baby’s movements are usually felt when the mother is resting, often after a meal.

A normal birth occurs between 38th and 42nd weeks of pregnancy. At the end of the 9 months the baby will usually turn into a head down position. This will result in discomfort during the pregnancy

Common Discomforts during the Third Trimester

•Infrequent Contractions. VHW voice in background: During the 3rd trimester often contractions are felt. These are only mild ones and may cause slight discomfort. These usually do not last long and are not regular.

•Breathing difficultyVHW voice in background : Since your uterus is now just below your rib cage, and your lungs have less room to expand.

•Mild swelling of your feet and ankles VHW voice in background : Pregnancy causes more fluid to build up in your body. This, plus the extra pressure that your uterus places on your legs, can lead to swelling in your feet and ankles. Visual of swollen feet and ankles

•Difficulty Sleeping and finding a comfortable position. VHW voice in background : Lying on your back interferes with blood circulation, and lying on your stomach isn't possible. Sleep on your side, using pillows to support your belly and between your knees. Visual of a comfortable sleeping position

•Frequent UrinationVHW voice in background : Caused by your enlarged uterus and the pressure of the baby's head on your bladder.

Signs of Labor

VHW voice in background: Signs that labor is not far off include the following

•Dropping or lighteningVHW voice in background : The fetus settles into your pelvis. Visual of a baby head down

•Effacement & dilationVHW voice in background : Your cervix begins to thin and open

•ContractionsVHW voice in background : Tightening and loosening of muscles in your belly become more frequent and stronger, perhaps a little painful. You may also feel cramping in the groin or rectum or a persistent ache low in your back. •Breaking of the bag of water:VHW voice in background : Your "bag of waters" may break. In most cases, rupture of the membranes occurs once labor has already started. In some women, this happens before labor starts. Call your health professional immediately or go to the hospital if you think your membranes have ruptured prior to labor.

Other Emergency Situations

VHW on screen : If you experience – Vaginal bleeding– Gush or trickle of fluid from the vagina– Swelling of face or hands– Lack of fetal movement for more than 24hours

in 3rd trimester

then consider it an emergency situation and consult your doctor.

Common Pregnancy Myths

•Certain fruits and vegetables are bad for you and your baby:VHW on screen : It is important for you to eat everything in appropriate amounts. All fruits and vegetables produced by nature are good for you and your baby’s growth. You may have heard your grandmother say that eating papaya or pineapple can lead to miscarriage. There is no scientific evidence of this. However, you should avoid foods that do not suit you or cause discomfort. For example, due to pregnancy hormones and sensitivity of the digestive system some foods can cause gas. Many women complain about gas after eating cauliflower. Avoid it only after knowing for sure that it does not suit you.

•Color and texture of what you eat will affect the complexion of the baby:VHW on screen: Women will tell you that eating apple will ensure baby’s fair skin. Eating iron tablets will lead to a dark baby because iron tablets are black in color. There is no truth in this. It’s in nature’s hands to decide your baby’s gender and physical looks. But it is in your hands to decide how healthy your baby is born. Iron, Calcium, Vitamin A, Vitamin B, and fluids are very important for your baby.

•Guessing the gender of the baby:VHW on screen: Another common myth related to pregnancy is the ability to guess the gender of the baby. Many believe that shape of the pregnant woman’s belly, food cravings, morning sickness and other such factors will indicate whether the baby is a girl or a boy. It is important to know that it is impossible to guess the gender of the baby using such information. While it is not possible to select the gender of the baby, ensuring good health for the baby is entirely in our hands. The primary focus of the expectant parents should be to bring a healthy and happy person into this world.

•Weight gain in mother is weight gain in baby:VHW on screen: A common misconception in pregnancy is that if mother puts on weight then baby is growing well. A healthy weight gain in mother depends on many factors like body frame, height and pre-pregnancy weight. The baby will only take what it needs to grow well. If you are eating very oily and greasy food, chances are high that the fat is accumulating on the mother’s body. The baby may not be getting the nutrition that it should from a well balanced diet.

VHW on Screen:

Congratulations to both of you once again.

Enjoy this process of creating a miracle…the Miracle of giving birth to a human being.

Be healthy and stay happy!!!!!