THREE TRIMESTERS OF PREGNANCY

CONGRATULATIONS!! You are pregnant. An expecting mother needs utmost, gentle and continuous care through all stages of her pregnancy .

VAATSALYA CLINIC -the woman and child care clinic conveniently located at at Mahim , offers the most comprehensive and best OBSTETRIC, GYNEC and PEDIATRIC care to women and children in all stages of life. Our Gynecologist DR MAULIK JOSHI and Pediatrician  DR SHAIVALI JOSHI take the time to listen to you, answer your questions and make sure you leave the clinic feeling satisfied,informed and cared for.

At VAATSALYA CLINIC; We provide comprehensive ante /prenatal care and a healthy delivery for your baby. Pregnancy is a time of anticipation, excitement, preparation, and even uncertainty among new parents-to –be. It certainly helps to be prepared ahead to allay some worries. Here are some guidelines to help you.

WHAT DOES YOUR OBSTETRICIAN (DR MAULIK JOSHI) DO?
His role begins at conception and usually ends in the weeks following birth. He will provide prenatal care to pregnant women with the goal of reducing the risk of prenatal complications, overseeing the health of both the mother and the foetus, and educating patients about nutrition, health and safety during pregnancy.

UPT-URINE PREGNANCY TEST
Prenatal care begins with the confirmation of pregnancy usually using a urine test that screens for elevated levels of the pregnancy hormone, HCG.

A physical exam and blood testing may follow, as well as a doctor-patient interview about past pregnancies and family history. Often, routine check-ups to monitor the growth and health of the foetus and the mother continue once every four weeks for the first two trimesters and once every two weeks for the final trimester.
Obstetricians provide due dates as estimations only. Some children are born prior to their due date, and others are born after their due date. Few are born on their original estimated dates of arrival. In some cases, complications or pre-term labour can lead to an early delivery.

What are the three “trimesters” of pregnancy?

The three trimesters refer to the three-month divisions of the whole pregnancy period. Certain tests have to be done at specific times during the pregnancy and the trimesters help us to identify these timelines. First trimester: 1-14 weeks
Second trimester: 14-28 weeks
Third trimester: 28-40 weeks

What is the significance of the “trimesters”?

The first trimester is the period when the foetus is developing and pregnancy is getting established. It is also a time when you may feel tired, sleepy, and nauseous and have vomiting. Spontaneous miscarriages are most likely to happen in this trimester and hence, many parents prefer to cross this stage before announcing the pregnancy.

The second trimester is the period when the baby is developing further and also growing. You will begin to feel your baby’ movements and hence this is the “good” period of your pregnancy. Your baby bump is growing and the pregnancy glow is evident.

The third trimester is the period of maximal growth of your baby. Your body also starts preparation for the labour and birth. You may experience some “aches and pains” during this phase as the weight of your baby puts pressure on your abdomen and pelvic areas. It may be difficult to sleep and find a comfortable position towards the end – but just wait it out, this will culminate in the birth of your baby and that is the most wonderful experience that you and your partner are waiting for ….

FIRST TRIMESTER-( week 1 to 12)

Early signs of pregnancy:

Breast tenderness
Nausea/Vomiting
Light cramping
Change in Vaginal discharge
Food aversions
Positive home pregnancy test
Warning signs:
Heavy vaginal bleeding and cramping

Treating early pregnancy morning sickness:
Morning sickness is feeling sick to your stomach (also called nausea) and vomiting that happens in the first few months of pregnancy. Even though it’s called morning sickness, it can last all day and happen any time of day.
At least 7 in 10 women have morning sickness during the first trimester (first 3 months or about 12 weeks of pregnancy). It usually starts at about 6 weeks of pregnancy and is at its worst at about 9 weeks. Most women start to feel better in their second trimester. But some may have morning sickness throughout pregnancy
Mild morning sickness doesn’t harm you or you.
In some, morning sickness becomes severe (called Hyperemesis Gravidarum), it can lead to weight loss and dehydration (not having enough water in your body). These problems can be harmful during pregnancy. If you have severe morning sickness, you may need to stay in the hospital for treatment.

What can you do relieve or prevent morning sickness?
Here are some things you can do to help you feel better and may even prevent morning sickness:

1. Keep snacks by your bed. Eat a few crackers or bites of a dry toast before you get up in the morning to help settle your stomach.
2. Eat five or six small meals each day instead of three larger meals. This may also help keep your blood sugar levels steady, increasing your energy over the course of the day.
3. Eat foods that are low in fat and easy to digest, like cereal, rice and bananas. Don’t eat spicy or fatty foods. Salty foods may help sometimes
4. Eat healthy snacks between meals. An empty stomach may make the nausea worse. Try snacks that are high in protein, like milk or yogurt.
5. Drink plenty of fluids, especially water.
6. Avoid food or smells that upset your stomach.
7. Take your prenatal vitamin at night or with a snack. Sometimes vitamins can upset your stomach.
8. Sour foods. Sucking on or just smelling a slice of lemon may also help, as may drinking lemonade.

SECOND TRIMESTER -(week 13 to27)

Lower back pain/Round Ligament Pain and Discomfort

As the pregnancy continues into the second trimester, lower pelvic pain, hip pain and lower back pain can occur. This can all be normal discomfort in pregnancy.
Our recommendations on pain relief during pregnancy include:

Pregnancy support belt/ pregnancy girdle

Prenatal yoga or stretching
Hands and knees position with a heating pad on your low back helps

Heating pad, warm bath or shower to help relax the muscles

Increase water intake to make sure muscles stay hydrated

Change position frequently

Sleep with a pillow between your knees

 

Feeling your baby kicking inside /Foetal Movement

Around 18-22 weeks we anticipate you to be feeling foetal movement. It will begin as intermittent flutters and progress to pronounced rolls, squirms and kicks or punches. Usually around 24-26 weeks family and friends can also feel external foetal movement.
A healthy baby to give you approximately 6-10 movements in one hour. If you and have not felt 6-10 movements in a full hour, please call the clinic.

Anatomy /Anomaly Scan

Between 19-21 weeks pregnant we recommend an ultrasound to evaluate the pregnancy progress. Included in this ultrasound is evaluating for physical abnormalities. This examines the brain, face, heart, fingers, toes and everything in between. As is consistent with all ultrasounds there are limits to technology and there is a risk that not all abnormalities will be identified.

Gestational Diabetes Testing
It is recommended to screen pregnant women for Gestational Diabetes between 24 and 28 weeks pregnant. We do this with a simple blood test. First you will drink an orange beverage consisting of 50 grams of sugar. We ask that you complete drinking it in 5 minutes or less. We then let you relax in the waiting room for 1 hour. After that hour, we draw your blood.
There is no recommendation to fast prior to this screening test, however, we always recommend a healthy pregnancy diet consisting of fruits, vegetables and protein.

Signs of Preterm Labour
Between 24-35 weeks pregnant there is a risk for preterm labour. If you feel you are experiencing severe symptoms please contact the Dr for further instructions.
Regular Painful Contractions, approx. 6 contractions in 1 hour

Rupture of membranes, “water breaking”

Heavy vaginal bleeding

Severe intermittent or spasmodic back ache.

RhoGam
If your blood is RH negative, you will be given RhoGam. If an RH negative mother is exposed to blood from an RH positive baby, it causes the mother to create antibodies against the RH factor. The job of these antibodies is to attack the RH factor. Often this does not cause problems in the current pregnancy, but it can cause problems in future pregnancies.
RhoGam is given to prevent these antibodies from forming. Since we do not know if the baby is RH negative or positive, we treat all mothers who are RH negative in pregnancy.
When the baby is born, we will check the baby’s blood type. If the baby is RH positive, you will need to get another shot of RhoGam after the baby is born.

THIRD TRIMESTER –(weeks 29 to 40)

The third trimester is the final stage of pregnancy. Discomforts that started in the second trimester will likely continue, along with some new ones. As the baby grows and puts more pressure on your internal organs, you may find you have difficulty breathing and have to urinate more frequently. This is normal and once you give birth these problems should go away.
The end of your pregnancy is in sight. Soon your baby will arrive. Feelings at this stage of pregnancy tend to vary from tiredness and worry to excitement about the baby. During pregnancy, the skin around your bump grows faster than any other skin on your body, which can result in stretch marks. Belly oils and other stretch mark creams keep it extra-moisturized, which keeps the tearing that causes stretch marks to a minimum.

By about 32 weeks the baby is usually lying with its head pointing downwards, ready for birth. Your baby continues to be very active at this stage, and you’ll probably be aware of lots of movements. Leg cramps at night are common around 29 to 32 weeks pregnant.
By 36 weeks your baby’s bones are starting to harden, even though the skull bones will stay soft and separated to make the journey through the birth canal easier. You may be aware of your uterus tightening from time to time. These are known as ‘Braxton Hicks’ contractions.
At 37 weeks, your pregnancy is considered full-term. In the last weeks, the baby’s head should move down into your pelvis. When your baby’s head moves down like this, it is said to be ‘engaged’. Most women will go into labour between 38 and 42 weeks of pregnancy

A few of the real signs of labour to watch out for include:
Lightening: By about week 36, you may find yourself waddling as your baby drops in your pelvis.
Bloody show: This stringy mucus tinged pink or brown with blood is a sure sign labour is well on its way. You also may or may not notice the discharge of your mucous plug (which seals off your uterus from the outside world).
Labour contractions: Compared to Braxton Hicks contractions, these intensify, rather than diminish, the more you move around.
Your water breaking: This may not even happen, however, until you’re already at the hospital.
Your doctor will likely tell you when it’s time to call or head to the hospital — likely around the time active labour starts. Congrats! Baby is on the way.

Third Trimester To-Dos

Keep track of foetal movement. From about week 28 on, you’ll want to count baby’s kicks regularly and note any changes in activity, especially during month 9.
Schedule your third trimester check-ups. Expect tests for glucose levels, anaemia and group B strep in months 7 and 8. In month 9, your practitioner will perform an internal examination of your cervix to see if effacement and dilation (the thinning and opening of your cervix) have begun. If you’re classified as “high-risk,” your doctor may also schedule a biophysical profile or nonstress test in the last few weeks just to be sure everything is proceeding as expected.
Take a hospital tour. If you haven’t already, month 7 is a great time to take a tour of the hospital where you plan to give birth.

Meet your baby’s Paediatrician

During the third trimester; it is important to meet your paediatrician DR SHAIVALI JOSHI. You want to have a paediatrician you can trust and reach in emergencies. Your Paediatrician will see your new-born during hospital stay and thereafter.

Learn about the stages of labour. Get prepared for baby’s birthday by learning what to expect during early, active and transitional labour as well as pushing baby out and delivering the placenta.
Pack your hospital bag.
Arrange for cord blood banking. If you’re considering cord blood banking be sure your practitioner is aware of your plans.
The day will come when, yes, you’ve done it! All those months of hard work lead to this, and now it’s time to enjoy your new family!

The moment you look into your newborn’s eyes, it will all have been worth it.