Pregnancy

Starting off in your first pregnancy is a truly exciting and sometimes overwhelming experience. I will give you short guidelines about what to expect from your doctors visits. Before considering a pregnancy it is important to see your gynaecologist first.

PREPREGNANCY COUNSELLING

EXERCISE AND LIFESTYLE: Try to use the time while planning a pregnancy to get as healthy as possible. Eat regular healthy meals with lots of fruit and vegetables. Cut out the junk food. An occasional alcoholic drink before that you conceive is fine but it is better not to drink alcohol while you are pregnant so get into the habit now. Exercise is good in pregnancy. You feel better and it helps for the labour. Try to get into an exercise routine beforehand. Walking, swimming and Pilates are all good. If you are a seasoned runner you can continue running in pregnancy until you do not feel comfortable. Be sensible and listen to your body. It is also important to consider the type of work that you do. Working long hours late in pregnancy is not good. Standing for long stretches of time e.g. a hairdresser becomes difficult. You will need to take fewer clients as time goes on.

VITAMINS: It is important to start taking folic acid before pregnancy. Folic acid prevents neural tube defects which are rare defects of the brain and spine. Spina Bifida is the most common. Studies have shown that taking folic acid before conception reduces the risk. The amount found in most prenatal vitamins i.e. 700 ug is adequate. You may need extra if you are vegetarian or taking epileptic medication.

RUBELLA VACCINE: Rubella or German measles is a mild childhood disorder but has devastating effects if contracted in early pregnancy. At one time all girls were vaccinated at school in the last year of Primary School. This seems no longer to be the case so it is vital that you have yourself tested for antibodies before you become pregnant. If you do not have antibodies you need to have a Rubella vaccination. You must then wait for three months before trying to conceive.

AGE: Women are planning pregnancies later and later. The main concern is that fertility decreases dramatically after 35 years. If you are older your gynaecologist will want to discuss the increased risk of Down's syndrome, Diabetes and Hypertension in older women.

SMOKING: Smoking is a poison with many severe effects on the pregnancy and must be stopped. It always surprises me that parents that are very protective over their children would consider giving them a poison before they are born. Passive smoking is also a problem so give up as a couple. You do not want to smoke with an infant in the house either. Smoking increases the risk of Sudden Infant Death Syndrome or cot deaths.

MEDICATION: The gynaecologist will want to know what medications you are on and give advice about continuing or not. Medications such as thyroid medication and asthma medication should be continued but epileptic medication, blood pressure treatment or antidepressants may need to be changed. If you are diabetic it is vital that your control is excellent before you conceive.

GENETIC DISEASES: Your gynaecologist will need to know before you conceive if there is any family history of disease. Luckily haemophilia, cystic fibrosis, muscular dystrophy are all rare but some people will need genetic counseling before they conceive.

PAP SMEAR: The gynaecologist will do a speculum examination. A Pap smear will be done. This is a screening test that will pick up abnormal cells of the cervix long before it becomes a cancer. A bimanual internal examination will determine the size of your uterus and if there is any enlargement of the ovaries. In most cases an ultrasound of the pelvis will be done to rule out abnormalities of the uterus or ovaries.

Once you have seen your gynaecologist and been given the go ahead you can stop contraception. If you are on the oral contraceptive pill, stop it with a menstruation. Make sure you are taking your taking your prenatal vitamins. You do not have to wait after stopping the pill to start trying. In the beginning do not worry about timing of ovulation. If you have a normal sex life and have intercourse at least three times a week there is no need for timing. It is better to carry on as normal without stress or anxiety. Eighty five percent of couples conceive in the first year and only then would investigations start. The only reason to go back to the gynaecologist before this would be if your menses are very erratic or extremely painful. If you are older than 38 it would be good to go back after 6 months to make sure that you are ovulating.

Contact Details

Dr. Alice Shaw
Pr No.:1606263


dralice@aliceshaw.co.za
Tel: 044 384 0926
Fax: 044 384 0970