• GOD could not be everywhere and therefore He made

mothers• No other relation in this world

is as beautiful, pure & selfless as that between a mother and

her child

Pregnancy

A female undergoes many changes when she is pregnant

In this presentation

• Symptoms• Food & Diet• Self-care• Medical care• Exercise• Post delivery care

SYMPTOMS

Nausea, Vomiting & Acidity

Common in first 3 month

Have freq small meals

Take medicines regularly

Toast, biscuits to decrease nausea

Avoid oily food

Drink plenty of liquids

ConstipationCommon in pregnancyAvoid straining or sitting long time on a toilet

Drink plenty water Avoid fatty foods

Eat grain, fruits, vegetables

Dizziness

Sit Stand up slowly or you

may feel giddy

Turn to a side

Backache - postures

Leg cramps

• Occur suddenly • Mostly in last months• Massage area• Point foot & toes towards

face• Increase calcium in diet,

e.g. milk, milk products• Exercise regularly

Breast discomfort

• Tender & sensitive• Aerola darker• Increased breast size• Check for inverted nipple• Wear comfortable & supportive bra

Sleeplessness at night

• Decrease stress• Avoid tea/coffee/aerated drinks in

evening• Have a cup of warm milk before

sleeping• Have a warm bath before sleeping• Do not sleep in afternoon

Itching & Stretch marks

• Heaviness, pressure or itching sensation on tummy

• Also on breasts, bottoms, thighs• Coconut oil, Vit E oil or stretch

creams• Stretch marks fade into fine silvery

medals of motherhood

Avoid

Smoky atmosphereSmoking

Hard drinks

Avoid

Soft drinks

Lifting heavy

weights

High heels

Cravings

• Normal

• Do not eat unhealthy food

• Do not eat road-side food

• Eat frequent small meals

Mood swings• Decrease stress• Talk to friends & relatives• Explain your mood changes to your spouse• Read good books• Listen to music• Avoid horror movies,

depressing T.V. progs

Swelling of feet

• Do not keep feet hanging for long

• Rest legs on a stool/chair while sitting

• Keep a pillow below feet while sleeping

• Get urine tested

• Remove all jewellery

FOOD & DIET

Balanced diet

•You are the only source of food for your baby

• Diet should include

•Iron

•Calcium

•Proteins

•Vitamins

Proteins

Pulses, dal

Egg

Groundnut, channa, (chikki)

Milk, cheese, dahi, paneer

Dry fruits

Meat, fish

Soyabeans, flour, tofu

Cereals

Mix different cereal & pulses e.g. idli, dosa

Rotis-add soya/nachani flour to wheat flour

Dalia

Make parathas by mixing different flour like besan,

wheat or jowar e.g. mooli, gobi

Fruits & Vegetables

Rich in vitamins, fibre & minerals

2-4 servings daily

3-5 servings daily

Calcium

3 glasses of milk a

day in any form

Cheese

Curds

Paneer

Milkshakes

Buttermilk/lassi

Rasgulla

Calcium

Green leafy vegetables

Pulses esp. Ragi (nachni)

Fish

Iron

Green leafy vegetable-chutney, soup, sabzi

Raisins

Jaggery - chikki

Pulses

Fats

• Oil, ghee & sweets in small quantity

• Fats help in absorption of Vit. A, D, E, K.

• 1 tablespoon of ghee = 15gms = 135

calories

• Visible fat intake should be increased

during pregnancy and lactation to 30 gm

& 45gm resp.

Sweets

• Sweets in small quantity• Avoid sugar, use jaggery instead

Avoid tea/coff

ee, cakes,

chocolates,

mithai

Have raisins, chickoo

, honey, dates

Water & Salt

• Take at least 8 -10 glasses of water

• In case of high blood pressure - Reduce

salt intake

• Eat at regular intervals

• Do not fast or feast

Tips - Diet

• Use jaggery instead of sugar

• Steaming is best method of cooking

• Frying, reheating cause loss of nutrients

• Do not use sugar substitutes

Tips - Diet

• Avoid excess of oil/ghee in cooking

• Avoid excess of chilly & salt

• Avoid maida & sugar base products e.g. cakes, bread,

jam, jalebis

• Have a balanced diet

• Have frequent small meals

SELF CARE

When should you gain weight ?

• 1st trimester :1kg

• 2nd trimester :5kg

• 3rd trimester :5kg

• Total :11kg minimum

Cleanliness

• Trim nails regularly as they grow faster

• Bathe regularly - prevents infection• Keep vaginal area clean• Brush regularly after meals

Cleanliness

• Breast care - wear well fitting bra

• Wear low heeled shoes

• Do not wear tight clothes

• Wear clothes according to the climatic conditions

Sex & pregnancy

• Depending on your health, speak to your doctor

• Growing abdomen, increase breast sensitivity – change position

• Avoid sex if you have– Unexplained bleeding – Placenta previa (low placenta)– History of miscarriage/preterm labour– Pregnant with twins or triplets

• Sexual intercourse or breast stimulation can start

labour

Work & Pregnancy• Age (older mothers may have more

problems)• General health (anaemia, DM, high BP)• Pregnancy progress (weight of the baby, complications)• Prior pregnancy problems (bleeding, preterm, growth retardation)

Work & Pregnancy

• Type of work you do (sedentary, tours, sleep)• Hours of work (regular, irregular)• Work risk factors (travel, food habits, stress, chemical)

Pregnancy & work

• Morning sickness • Don’t skip meals • Drink lots of water• Moderate exercise• Posture at work

• Plan timely departure• Avoid taking stress• Maternity Leave• Getting enough sleep

Travel after doctors advice

• Avoid long journeys• Avoid crowded

transport

Safe in 4-6 months only

MEDICAL CARE

Medications

• Folic acid in 1-3 months

• Iron & calcium supplement - from fourth month & continued after delivery

• Injection tetanus toxoid

• Anti D in Rh negative mother

Blood Tests

• Hemoglobin• Blood group• Infection – STDs, TORCH, HIV, Hepatitis B• Diabetes• Fetal abnormalities

Urine Test • Infection• Protein

Sonography

• Age of fetus

• Abnormalities

• Placenta site

• Due date

• Weight of fetus

SEX DETERMINATION IS ILLEGAL

Immunization

• Inj. T.T.• 2 doses• After 5th month• 4 weeks apart

Doctor visits

• Once every month up to 6 months of pregnancy

• Once every 15 days in the 7th & 8th month

• Once every week in the 9th month

• In cases of any emergency

Medical emergency

• Pain may occur regularly at repeated intervals

• Leaking of watery fluids from vagina, even if there is no pain

• Swelling of feet or hands• Bleeding from vagina• Decreased/Absence of fetal

movement

Labour pains

False Labour True Labour

Timing of Contractions

Irregular, no increase in frequency

Regular, 4-6 min apart, increase in frequency

Strength of Contractions

Weak; not stronger with time

Stronger with time, feels vaginal pressure

Pain with Contractions

Felt in the front only

Starts in the back & moves to the front

Position Change & Hydration

Contractions stop/slow if you walk/lie down/ change position/ increase fluid intake

Contractions continue in spite of position changes/ increase fluid intake

Going to Hospital

• Keep your bags ready as you near delivery time

• Relax • Remove all jewellery• Remove nail polish, contact lenses• Have only light food if labour pains

have started• Carry all your reports, files and

medicines

EXERCISE

Exercise

• Walk• Under Doctor’s guidance• Yoga & Relax • Prevent fall/accidents

POST DELIVERY

Breast Feeding

• Feeding position

Breast Feeding

• Breast care – Clean areola and nipple before

and after feed– Wear well-fitting bra

• Feeding intervals – every 2 hourly

• Cracked nipples – hind milk, ghee, breast cream

Contraception

• Lactational amenorrhoea

• Spacing

• Contraceptives – condom, POP, IUCD

Contraceptive methods• Spacing methods (Temp)

– Barrier methods•Male Condoms

– IUD– Hormonal methods

•COC, Mini pill, EC, Injectable, • Terminal methods

(Perm)– Male

sterilization– Female

sterilization

Male condom

Male Condoms

• Fitted on erect penis before intercourse & to be withdrawn carefully

• Protection against pregnancy, STD, HIV

• Easily available, safe and inexpensive• Can Slip off or tear during

intercourse• Effectiveness

– Used correctly, - 90% effective – With spermicide (kills sperms) are

95% effective

Intra Uterine Device (IUD)

1st, 2nd, 3rd generation

IUD

• Most effective reversible methods of contraception

• Copper/Levonorgestrel added to the IUD

• Inserted into uterus & kept for required period (3-5 yrs),

• Safe in smoking, breast feeding • Can cause heavy menstruation,

spotting, expulsion, infection, unusual vaginal discharge

• Effectiveness – Approx . - 99%

Combined Oral Contraceptive (COC,

OCP)• 2 hormones, oestrogen &

progesterone

• Orally - 21/24 consecutive days followed by 7/4 pill-free days

• Next pack on day after the 7/4 pill-free days

• Effectiveness - more than 99%

• Not to be used while breast feeding

Combined Oral Contraceptive

• Reduces menstrual cramps and PMS (premenstrual syndrome),

• Improves menstrual regularity, lowers risk of anaemia,

• Less chances of PID (pelvic inflammatory disease).

• Long term use - decrease the incidence of ovarian and endometrial cancer

• Nausea, vomiting, weight gain, breast discomfort, moodiness, pimples, vaginal infections

New generation OCP(drospirenone+ethinyl

estradiol)• Reduces pimples, oily skin

& male pattern hair growth

• No weight gain

• No increased blood pressure

• No changes in blood glucose or cholesterol levels

Mini pill

• Only progesterone given in small doses throughout the cycle

• Effectiveness -Approximately 95%

• Can be used during breast feeding & in women with cardiac problems

• Spotting, Breakthrough bleeding

Emergency contraceptive pills

• Progesterone alone• Orally within 72 hours of unprotected

sex• Back up

– Sex without using a contraceptive, – Failure of a contraception method

(e.g. tearing of condom or having missed 2 or more contraceptive pills)

• NOT TO BE USED AS REGULAR BIRTH CONTROL

• Effectiveness– 95% effective < 24 hrs– 85% between 25 - 48 hrs – 58% if taken between 49 - 72 hours

• Safe to use for almost all women

•Nausea, vomiting, lower abdominal pain, breast

discomfort, headache

•Pregnancy due to failure/taken by pregnant

woman – No effect on foetus

•Nursing Mothers - No adverse effect on foetus

•Drug interaction - No significant interaction

EC DOES NOT CAUSE ABORTION

Emergency contraceptive pills

Injectable contraceptive

• Intramuscular single progestogen injection

• On or before 5th day of menstrual cycle, 3 monthly

• Delayed after > 5 days, barrier contraceptives to be used for 7 days

• Can be given at any time after delivery or abortion & during breast feeding

• Disruption of normal menstrual cycle, no menses, bleeding between menses, spotting

• Effectiveness - 99%

Terminal methods

Male sterilization

Piece of the tube that carries sperms is removed

Male sterilization or vasectomy

• Male is not immediately sterile & contraceptives to be used for 1st 20 ejaculations/3 months (whichever comes first) until absence of sperms

• Does not affect male sex hormone secretion

• Effectiveness – almost 100% effective

Female sterilization

• After delivery/at time of abortion/when desired

• No long term side effects• Effectiveness - 99.5%

Female sterilization

Laparoscopy Mini

Laparotomy

BEST WISHES FOR A HAPPY & HEALTHY

PREGNANCY