REPRODUCTIVE FUNCTION IS TRULY ONE OF LIFE’S GREAT WONDERS.YOU’LL FIND YOURSELF BEING THE SUBJECT OF MUCH POKING AND PRODDING OVER THE NEXT 9 MONTHS, AND UNDERSTANDING EXACTLY HOW YOUR BODY FUNCTION’S WILL BECOMEA FOCUS OF YOUR WAKING HOUR’S. TRUST ME. OVULATION Around the middle of your cycle, a ripe egg or ovum is released from one of your ovaries. This is called ovulation. The egg is released into the fallopian tube and is stroked down its length by the 'fingers' which help to direct the egg down into the tube.

At the same time, the lining of your womb begins to thicken and the mucus in the cervix becomes thinner so that sperm (if you had intercourse) can swim through it more easily. Ovulation is characterised by an increase in the levels of a hormone called Luteinising Hormone produced by the brain and responsible for the release of eggs from the ovary every month (hormonal surge ) and a small increase in temperature. Once released, your egg can survive up to 24 hours.

EJACULATION During sexual intercourse, sperm are ejaculated from your partner's penis into your vagina In one ejaculation, there may be more than 300 million sperm. The sperm are ejaculated into the vagina at a speed of up to 500 cm (200 inches) per second. Once inside your body, the sperm begin the hard work of locating your egg and fertilising it.

FERTILISATION Once your egg has been released and your partner has ejaculated sperm into your vagina, fertilisation can occur

anytime thereafter in the fallopian tube. When ejaculation occurs, some of the sperm will leak out of your vagina again. Some sperm will find their way and begin to swim up through your cervix. At the time of ovulation the mucus in the cervix is thinner than usual to let the sperm pass through more easily. The sperm swim into the womb and so into the fallopian tube. One sperm may then join with the egg and fertilise it. Conception is said to have taken place.

IMPLANTATION During the week after fertilisation, your fertilised egg moves slowly down the fallopian tube and into your womb. The fertilised egg is growing already. Your fertilised egg attaches itself firmly to the specially thickened womb lining and this process is called implantation. Thereafter, your fertilised egg (your baby) continues to grow and the womb expands to accommodate the growing baby.

FINDING OUT YOUR PREGNANT Most women choose to go and see their

doctor quite quickly after they have had a positive pregnancy test. The advantage of going to see your doctor is that you will be given advice and support right from the start. Your doctor is likely to take your blood pressure, weigh and measure you and also tell you about the antenatal (prebirth) services in your local area. The other advantage of going to the doctor early is that you will be given a form that you can send away to get free prescriptions and dental care. SIGNS OF PREGNANCY Morning sickness: Can be one of your first signs that you are pregnant. This doesn’t always mean that you’ll get ill only in the morning. This can occur, morning, noon or night-time. It will normally happen in the first

trimester or your pregnancy and end by the following, this isn’t the case in all pregnancies though. Some women will continue with it until the extreme end of pregnancy. Needing to pass water more: You may find that you have to get up in the night to do so. An increased vaginal discharge: Without any soreness or irritation. ‘Going off’ certain things: Like tea or coffee, tobacco smoke, alcohol, certain smells and even fatty foods. Changes in your breast: These often become larger and very tender and may tingle. The nipples may darken and stand out.

Feeling tired. Being constipated. Food cravings. HOW THE BABY DEVELOPS Weeks 4-5 The embryo now settles into the womb lining. The outer cells reach out like roots to link with the mothers blood supply. The inner cells form into 2 then later on into 3 layers. Each of these layers will grow to be different parts of the baby’s body. One layer becomes the brain and nervous system, the skin, eyes and ears. Another layer becomes the lungs, stomach and gut. The third layer becomes the heart, blood muscles and bones. The fifth week is the time of the first missed period when most women are only just beginning to think that they

may be pregnant. Yet already the baby’s nervous system is starting to develop. A groove forms in the top layer of cells. The cells fold up and round to make a hollow tube called the neural tube. This will become the baby’s brain and spinal cord, so the tube has a ‘head end’ and a ‘tail end’. defects in this tube are the cause of spina bifida. The actual size of the embryo at this stage is 5mm.

Weeks 6-7 There is now a large bulge where the heart is and a bump for the head because the brain is developing. The heart begins to beat and can be seen

beating on an ultrasound scan. Dimples on the side of the head will become the baby’s ears and also thickenings where the baby’s eyes will be. On the body, bumps are forming which will become muscles and bones. And small swelling’s (called limb buds) show where the arms and legs are growing. At seven weeks the embryo has grown from 5mm to about 10mm long.

Weeks 8-9 A face is slowly developing. The eyes are more obvious and have some colour in them. There is a mouth with a tongue. There are now the beginnings of hands and feet, with ridges where fingers and

toes will be. The major internal organs are all developing- the heart, brain, lungs, kidneys, liver and gut. At nine weeks the baby has grown from 10mm to about 22mm.

Weeks 10-14 Just 12 weeks after conception the fetus is fully formed. It has all its organs, muscles, limbs, bones and its sex organs are well developed. From now on it has to grow to mature. The baby is already moving about but the movements cannot be felt just yet. By 14 weeks the heartbeat is strong and can be heard by using an ultrasound detector. The heartbeat is very fast about twice as fast

as a normal adults heart beat. At 14 weeks the baby has grown from 22mm to about 85mm.

Weeks 15-22 The baby is now growing quickly. The body grows bigger so that the head and body are more in proportion and the baby doesn’t look so top heavy. The face begins to look much more human like and the hair is now beginning to grow aswell as the eyelashes and eyebrows. The eyelids still stay closed over the eyes. The lines on the skin of the fingers are now formed, so the baby already has its own individual fingerprints. Finger and toenails are also beginning to grow and

the baby also has a firm hand grip. At about 22weeks the baby becomes covered in a very fine, soft hair called ‘lanugo’. the purpose of this isn’t known but it is thought that it may be to keep the baby at the right temperature. The lanugo disappears before birth, though sometimes just a little is left and disappears later. Between 16-22 weeks you will be able to feel your baby move for the first time. At first you feel a fluttering or bubbling or a very slight shifting movement, maybe like indigestion. Later you cant mistake the movements and you can even see the baby kick about, often you can guess which bump is a hand or foot. At 22 weeks the baby has grown from 85mm to 27cm.

Weeks 23-30 The baby is now moving about vigorously and responds to touch and sound. A very loud noise close by may cause baby to jump and kick. It is also swallowing small amounts of the amniotic fluid in which it is floating and passing tiny amounts of urine back into the fluid. Sometimes the baby may get hiccups, and you can feel the jerk of each hiccup. The baby may also begin to follow a pattern for waking and sleeping. Very often this is a different pattern to yours, so when you go to bed at night the baby wakes up and starts kicking. The babys heartbeat can now be heard through a stethoscope. Your partner may even be

able to hear it by putting an ear to your tummy. At around 26weeks the baby’s eyelids open for the first time. The eyes are almost always blue or dark blue. It is not until some weeks after birth that the colour of the eyes change. At 30weeks the baby has grown from 27cm to about 33cm.

Weeks 31-40 The baby is growing plumper. So the skin which was quite wrinkled before is now smoother. Both the vernix and the lanugo begin to disappear. By about 32weeks the is baby usually laying head down ready for birth. Sometime before birth

the head may move down into the pelvis and is said to be ‘engaged’ but sometimes the baby’s head does not engage until labour has started.

REMAINING FIT DURING PREGNANCY Staying fit throughout your pregnancy is good for you, not only will it help you keep your body toned but it also can help when it comes time to push that baby out. Every pregnant lady wants to be able to go back to her pre-pregnancy weight after the toddler is born, but the sole way to do that is to make sure you can.

By excising or working out every day you are making certain you don’t add fat to your body. During labour it’ll be much, much easier to move the baby if you’ve been strengthening your leg and stomach muscles. Who knows, it may even make labour a little bit shorter. Isn’t that what we all want? Plus when you are tired and just feeling a little bit blue, just by exercising you actually increase your energy. Here are a few quick things you can do to stay fit in pregnancy, without really having to break out a sweat. I’m sure by now you’ve heard of yoga, this is a very good thing for you to practice, especially if you haven’t often been in the best of shape. Not to fret, there are beginning levels here, you don’t have to jump into the human pretzel right away. Try purchasing a set of little weights that you can use throughout the building, like hand weights or wrist weights that can

use while walking. Instead of just laying on the couch while you rest you can be lifting small weights. Get a chair and try doing a couple crunches, 5 to 10 in the beginning to make certain you don’t pull anything. Don’t be concerned you can always add to it as the weeks go on. Try running, walking or jogging outside. Not only will this boost up your energy but it’ll also help get your spirits up, especially if you’ve been indoors all day. Remember, if you are going for a walk to always carry a drink with you. You don’t want to dehydrate out there. Always make sure that you are wearing sensible shoes, before you leave the house. If you didn’t always run, ask your doctor if you can. Sometimes a doctor may suggest you hike around the block at first and increase it from there, if you didn’t always do it before you were expectant.

If you can you may want to try going for a swim or try bicycling. However, if you detect that you are mishap prone you may want to remain away from the bike. A bike accident is something that can easily happen, even when you’ve always road a bike. Swimming can help you unwind and stay cool. Take a dip in the pool near you, they may even have a swim class for pregnant women in your locale. This would be a great way to meet other moms. Whenever you are doing exercises, make certain you aren’t overdoing it. If you believe you could be stop immediately and take a break. You never want to do anything that’ll hurt the pregnancy. TAKING CARE OF YOURSELF Taking care of yourself is the first and best way to take care of your future child. Your most important role during pregnancy is looking after your own well-

being and maintaining a healthy diet to provide for the needs of the little one growing inside. If you’ve never paid an ounce of attention to your diet, now is the time to start. Eating healthy is essential in meeting the rapid growth needs of your baby, maintaining your health, and preparing you for breastfeeding. As a pregnant mother, you should eat a variety of foods from three important food groups: Carbohydrates (e.g. brown rice and wholemeal bread) Proteins (e.g. eggs, meat and fish) Fats (e.g. olive and sunflower oils) You need all these because each food group offers a different type of nutrition.

For instance, meat is rich in protein and iron but has no vitamin c. broccoli has lots of calcium and vitamins but no protein. Eat plenty of fruit and vegetables: As these provide the vitamins and minerals, as well as fibre which helps digestion and prevents constipation. Eat them lightly cooked in a little water or raw to get the most out of them. Frozen, tinned and dried fruit and vegetables are also good. Try and aim to eat at least five portions a day.

Starchy foods like bread, potatoes, rice, pasta, chapattis, yams and breakfast cereals: Are an important part of any diet and should, with vegetables form the main part of a meal. they are satisfying, without containing to much calories, and

are an important source of vitamins and fibre. Cut down on fat and fatty foods as well: Most of us eat far more fat than we need to. Fat is very high in calories and too much can increase the risk of heart disease, and it can contribute to being over weight. Avoid fried foods, trim the fat off meat, use spreads sparingly and go easy on food like pastry, chocolate and chips which contain a lot of fat. Try to cut down on sugar and sugary foods: Like sweets, biscuits and cakes, also cut down on the sugary drinks like coke. Sugar contains calories without providing any other nutrients the body needs. It also adds the risk of tooth decay. Dairy foods like milk, cheese and yogurt:

Are important as they contain calcium and other nutrients needed for your baby’s development. Choose low-fat varieties wherever possible, for example semi-skimmed milk or skimmed milk, low-fat yogurt and half-fat hard cheese. Try and aim for two-three servings a day. Food hazards during pregnancy: Listeriosis- caused by the bacteria listeria monocytogens, sometimes found in unpasteurised milk, soft cheese, pates, cooked chilled foods, rare meat and pre-prepared coleslaw. Toxoplasmosis- caused by an infection from parasite called toxoplasma gondii, sometimes found in raw or rare meat, particularly lamb. Salmonella- the salmonella bacteria is traced to eggs and chicken. It is therefore advisable to avoid foods that contain raw egg and always make sure you cook chicken and eggs thoroughly.

Wherever possible purchase free-range eggs and chicken. Botulism- the outline toxin is found in improperly tinned or preserved food such as cured ham or pork. A LITTLE OF WHAT YOU FANCY You may think food cravings during pregnancy are just an indulgence but, alternative therapist, Pat Thomas believes they have a purpose. Food cravings and aversions are a normal part of life, but seem to intensify during pregnancy. Nutritionists believe that the craving is not for the food itself, but for what it contains and the effect it has on your body. Cravings can also be the result of a dietary imbalance. A high grain diet often produces wild cravings for fats and sweets. Those high in protein can bring on cravings for sugar, and high sugar

consumption can make some individuals crave salt. A craving is not a bad thing; it's a message from your body. If you are in tune enough, you will be able to respond to it appropriately. If a craving is allowed to turn into a regular binge, it could affect your health and the health of your baby. Here are some common cravings and what they may be telling you: Apples Calcium, magnesium, phosphorous, potassium. This is a pretty healthy craving. If you have a high-fat diet, your body may be craving the pectin for its ability to lower cholesterol. Melon Potassium and vitamin A are its main nutrients. Canteloupes are also high in vitamin C, calcium, magnesium, phosphorous, biotin, and inositol - so go ahead, give

into it. Cheese Calcium, phosphorous and aluminium. Eat more broccoli and other green vegetables as a lower fat alternative. Eggs Full of protein but also sulphur, amino acids, selenium and, in the yoke, fat. The white contains useful fat-dissolving choline. Often it's not the eggs, but the accompaniments (bacon, sausages etc) which are unhealthy. Vary your protein sources to include oily fish like salmon and mackerel and dried beans to ease the craving. Milk Calcium is the obvious choice. But milk also contains useful amino acids such as tryptophan, leucine and lysine. As long as you're not allergic, allow yourself an extra glass.

Olives, pickles Sodium - your pregnant body needs more of it. Your body may also crave salt to balance excessive sugar intake. Peanut butter/nuts B-vitamins, protein and fat. You need more of each when you are pregnant. A diet rich in oily fish will help diminish the craving and be lower in calories.

Weight gain during pregnancy: Weight gain during pregnancy is not only inevitable, it's also necessary. While the phrase 'eating for two' shouldn't be taken literally (you only need approximately 200 extra calories a day), while you are pregnant you are the soul provider of the vitamins, minerals and nutrients your baby needs to grow. Throughout the duration of your pregnancy your body naturally puts the

needs of your baby before its own. For this reason, it is essential that you eat a nutritious, well balanced diet not only to ensure that your baby develops healthily, but also to ensure that your body is nourished enough to carry, deliver and care for a new baby. There was a time when a lot of emphasis was placed on maternal weight gain during pregnancy. This was mainly because midwives used this as an indication of baby's growth and development. However, since the introduction of more sophisticated and accurate measures such as ultrasound, this practice has tailed off. Now, while an eye is kept on weight increase, it is no longer carefully monitored, unless a specific health problem dictates otherwise. When you attend your first antenatal appointment, the midwife is likely to measure your height and weight and use

this to calculate your BMI (body mass index). This figure will help the midwife to establish whether your pre-pregnancy weight was healthy for your size and enable her to make recommendations relating to your ideal weight gain over the course of your pregnancy. Recommended weight gain: There are four major BMI categories in which you are likely to fall:

Underweight - BMI less than 18.5 If you are classed as being underweight your health care provider is likely to recommend that you gain between 28 and 40lbs during your pregnancy. Even if you have been particularly conscious about your figure prior to pregnancy it is important to put this weight on as it will help your baby to grow healthily and provide you with the energy stores you

need to delivery and feed a new baby. Research has suggested that women who do not follow a healthy pregnancy diet and fail to put on sufficient weight are more likely to deliver smaller babies who require more medical attention. If you are finding it difficult to put on weight then you should discuss this with your health care provider.

Normal - BMI 18.5 - 25 - If your pre (or early) pregnancy weight is classed as 'normal' this means that your weight is in the ideal range for your height and you should aim to gain between 25 and 35lbs during the course of your pregnancy. You should aim to gain approximately 5lbs in the first trimester and then about 1lb per week for the rest of your pregnancy. It is important to aim for a steady weight increase as this will ensure your baby receives

the spread of nutrients he or she needs. If you notice any sudden increases or decreases in your weight then you should notify your health care provider as this could be a sign of complications. Many women find it helpful to keep a weight diary throughout their pregnancy so that they can monitor both their own and their baby's progress. Weigh yourself on the same day each week mornings tend to be best - and remember to account for small fluctuations due to water retention.

Overweight - BMI 25 - 30 - If you are classed as being overweight you will need to put on less weight during pregnancy as you are already likely to have sufficient energy stores to help ensure your baby has all the nutrients needed. For this reason you are likely to

gain between 15 and 25lbs during pregnancy. If you were trying to lose weight before you fell pregnant any strict diets should be abandoned, pregnancy is not the time for calorie counting. Instead you should focus on a healthy diet and plenty of gentle exercise to help control weight gain - talk to your doctor before starting any exercise program.

Obese - BMI 30+ - If you are classed as obese with a BMI of 30 or more you should expect to gain less than 15lbs during pregnancy as you already have the maternal energy reserves to help your baby develop. If you had a poor diet before you became pregnant you should focus on eating healthily and taking part in gentle exercise such as walking or yoga. This will also help reduce the risk of developing gestational diabetes,

high blood pressure or complications with delivery. If you are concerned about your weight or your diet your doctor will be able to advise you. The above advice only applies to those carrying single babies, for those expecting twins or multiples you should expect to put on more weight simply because you have double the baby to nourish and carry. Your weight gain is made up of this: Baby 2.5 - 4kg ( 5 - 9 pounds ) Placenta 500 - 1000g ( 1 - 2 pounds ) Amniotic fluid 1.5 - 2.5kg ( 3 - 5 pounds ) Extra weight of uterus, breasts and energy stores of fat 2-5kg (4-11 pound)

Extra weight of blood 2-4kg (4-9 pound) KEEPING BABY SAFE DURING PREGNANCY There are things you can do today to keep your baby safe. Help prevent problems by following this simple advise. Look after your teeth Have dental check-ups. ( free dental treatment on the NHS for all pregnant women) It’s worth a visit as research has found that mums-to-be who suffer chronic gum disease may be more likely to have a baby that’s born too early. The likely culprit is a labour - inducing chemical found in mouth bacteria. Clean your teeth twice a day as this will prevent you from getting gum disease. Stop smoking Smoking when pregnant, not only are you

putting your own health at risk but that of your unborn child too. Imagine your womb filling up with noxious smoke. This is the environment you are creating every time you light up a cigarette. Smoking while pregnant deprives your unborn child of oxygen and also puts risk for problems such as miscarriage and premature delivery. Your best bet is to quit smoking the minute you find out your pregnant. Cut out the alcohol Pregnancy is a time when you are better off giving up drinking altogether. There may be a difference between one glass of wine and alcohol abuse, but nobody really knows. Drinking excessive amounts of alcohol during pregnancy is known to cause physical defects, learning disabilities and emotional problems in children. Women who have the occasional glass of

wine a week don’t appear to have any more problems than women who don’t have a drink at all. Medication during pregnancy Do not expose yourself or your baby to medications without checking with your doctor or midwife first. Taking painkillers like aspirin and Ibuprofen during pregnancy has been linked to a higher risk of miscarriage. Paracetamol is the safest painkiller for mums-to-be, but don’t over do it.

Common medications to avoid during pregnancy include: Certain antibiotics Antidepressants

Antihistamines antinausea pills Aspirin Cortisone Cough syrup Diet pills Tranquillizers Vitamins in excess quantities Cut out the caffeine ‘java junkies’ who cant seem to live without the stuff, be warned! Some studies suggest that drinking 4 or more cups of coffee a day may increase the risk of miscarriage, premature birth, stillbirth and cot death. If you really cant live without those cups of coffee try to cut down or even better,

find a substitute for those daily cups of fresh coffee, try decaffeinated. FEELING ATTRACTIVE AND LOOKING GOOD All pregnant women have to grapple with body issues. The concept of being seen in public with an oversize middle is daunting. But there’s no reason why you cant get sex appeal or fashion goals. When you are pregnant, people don’t give you a hard time for having a big tummy. You may think you look overweight, but everyone else see’s a women who is going to have a baby. Here are the simple facts: you are pregnant, your tummy and body are expected to grow big. The times have changed and privately or publicly, many modern pregnant women are starting to think of themselves and being pregnant, as being sexy. To them, the tighter the clothes, the better. It’s all about being excited about pregnancy, feeling attractive and

looking good. Fashion advice We can all use a little fashion advice now and them, but remember it’s important to do what feels right to you. Look for clothes that make you feel special and good about yourself. When you do feel confident, strong and beautiful on the inside, you will look great on the outside too. Once you do find the clothes you are most comfortable in, no doubt you’ll wear them over and over again. As your pregnancy progresses, look for leggings and jeans with a waistband that cradles the tummy or big enough to stretch over your tummy. Try to avoid wearing restrictive clothing, especially tight belts. Personal beauty Pregnancy is a great time to treat

yourself to a new beauty routine and perhaps even a day to a health spa, if its not to much of a strain on your budget. Make-up is perfectly fine during pregnancy, and there is no need to give it up if it’s part of your normal routine. No doubt you will find yourself making some adjustments, your hair and skin are also undergoing tremendous changes as your pregnancy proceeds. What about my hair, can I dye it? This is the question that tops the list of most pregnant women, is whether or not it is safe to dye your hair. No one actually knows whether using chemical dyes during pregnancy is completely safe or not. The decision is yours but experts recommend that you wait until after your first trimester. NOW LETS TALK ABOUT SEX It is perfectly normal and safe!

If you're having a normal pregnancy, sex is considered safe during all stages of the pregnancy. A normal pregnancy is one that's considered low-risk for complications such as miscarriage or pre-term labour. Expectant parents often worry that sex can be harmful during their pregnancy. They fear that intercourse could hurt the baby, or even cause a miscarriage. Some are afraid that the baby somehow "knows" that sex is taking place. The baby is well protected by a cushion of fluid in the womb and by the mom’s abdomen and is completely safe. The partner sometimes worries that intercourse might cause discomfort or pain for the pregnant woman. Worries like this are common and completely normal, but most of them are unfounded. In actuality, sexual desire may increase in some women, due to the changes of pregnancy that leave the vulva engorged and the breasts extra sensitive.

If your pregnancy is considered to be high risk, you may need to be more cautious than other women. In this case, your health care provider may advise you to avoid intercourse for all or part of your pregnancy. Pregnancy and sex Many expectant mothers find that their desire for sex fluctuates during certain stages in the pregnancy. Also, many women find that sex becomes uncomfortable, as their bodies get larger. You and your partner need to keep the lines of communication open regarding your sexual relationship. Talk about other ways to satisfy your need for intimacy, such as kissing, caressing, and holding each other. You also may need to experiment with other positions for sex to find those that are most comfortable. Many women find that they lose their desire and motivation for sex late in the pregnancy - not only because of their size but also because they're

preoccupied with the impending delivery and the excitement of becoming a new parent. There are many reasons why sex during pregnancy can be more enjoyable, even if you are doing it less. There is an increase in vaginal lubrication, engorgement of the genital area helps some people become orgasmic for the first time or multi-orgasmic, the lack of birth control, or if you have been trying for awhile, a return to sex as pleasure as opposed to procreation. On the other hand there are reasons why sex might not be as pleasurable: fear of hurting the baby, nausea, fatigue, awkwardness, etc. Safe positions Positions that work before pregnancy and early in pregnancy can be uncomfortable or even unsafe at later stages of the baby’s development. For example, a woman should avoid lying flat on her back after the fourth month of pregnancy, because the weight of the

growing uterus puts pressure on major blood vessels. Safe sex positions The spoon position can be very cosy and intimate. to try it, lie on your side with your body curled in a C-shape, and have your partner curl around you, facing your back. He can enter you from behind while both of you are lying on your sides.

This position works especially well during late pregnancy, since it allows you to set the pace. Make sure, however, that he doesn't enter you too deeply.

A good choice for late pregnancy, this position lets you control the depth and intensity of the thrust and keeps weight off your belly. You and your partner lie down side by side, facing each other. He slips his leg over yours and enters you from an angle. You can keep your legs straight or bend them back, whatever is more comfortable for you. To vary things, lie on your back and have your partner lie beside you on his side. Put your leg closest to him over his legs. He can then enter you from the back and side.

You can be on all fours on the bed, staying steady, or lean down onto pillows with your partner kneeling and entering you from behind. Or try bending over the bed, supported as needed by pillows, with your partner standing and entering you from behind. This position allows your partner to thrust deeply, so be sure to let him know what is comfortable for you.

In this position, you straddle your partner while he is sitting on a comfortable chair or on the edge of the bed. (You'll probably be most comfortable straddling if your feet touch the floor.) You can also sit in an armchair or on the end of the bed with your partner kneeling in front of you. You can wrap your legs around your partner.

Lie face-up on the edge of the bed, with

your legs spread and your feet on the floor. Your partner should stand or bend over you to enter you. This position allows him to thrust more deeply so you'll have to tell him how gentle and slow you want him to be.

Most missionary positions aren't comfortable for expecting moms, but many women feel most comfortable in missionary positions. This one works well for pregnant women. You lie on your back, knees back and opened, with your feet on the bed or resting on your partner's chest, or with your legs straight up and resting against your partner. Your partner kneels between your legs to enter you, putting no weight

on your abdomen.

PREPARING FOR BIRTH Nobody really likes to talk about it, but lets face it, birth is painful. From your friends you’ll probably hear birth stories ranging from ‘ it wasn’t that bad’ to ‘never again’. but these assessments of the event will do little to educate you on what to expect during birth and how best to deal with it. The question that confronts all first-time pregnant women and their partners is whether or not to attend antenatal classes.

You should attend these classes as these help you to prepare for labour and childbirth. These are run by qualified midwives. The topics discussed at antenatal classes: Information about the process of labour and child birth. ‘what to expect’ details of medical procedures and interventions. Suggestions about possible physical preparations for labour and childbirth. Advice on relaxation techniques. The opportunity to learn about and experiment with different birth positions. A guide to pain relief The chance to try out massage skills and breathing techniques.

Some indication of the changes you might experience after the birth and into early parenthood. Developing a birth plan A birth plan is a way of communicating with the midwives and doctors who care for you in labour. It tells them about the kind of labour you would like to have, what you want to happen and what you definitely want to avoid. It's not written in tablets of stone because the best birth plans acknowledge that things may not go according to plan. You need to write the plan in such a way that your midwife doesn't feel she has her hands tied. She may need to recommend a course of action which is not what you had originally hoped for, but which is in the best interests of your baby. Before writing your birth plan Talk to your partner or the person who will be your birth companion. What sort of

labour and birth would they like you to have? How do they see their role? Then jot down your ‘birth wishes’ just as they come to mind and write a birth plan together so then you know what each other wants to happen during labour and childbirth.

What to include in your birth plan: Do you want your partner or chose companion to be with you during labour? Do you want your partner or chosen companion with you for certain procedures? E.g. caesarean section or forceps delivery. Is equipment such as birthing balls, mats and a birthing chair available to

you if you want it or can you bring your own? How do you want your baby heart to be monitored if everything is straightforward? E.g. hand held device (sonic aid) or whether you want electronic monitoring using a belt strapped around your waist. Do you prefer to be cared for and delivered by woman only? Is it important for you to be able to be mobile while in labour? What position you would like to be in for birth? Would you like to use a birthing pool for pain relief? What type of pain relief you would like during labour? E.g. pethidine, gas and air, epidural or no pain relief.

Are epidurals available at all times if you decide you would like one? Do you want your baby delivered straight on to your tummy or would you like baby to be cleaned first? How do you wish to feed baby once arrived? E.g. breastfeed or bottle feed. Do you want you baby to have vitamin k and by which route? E.g. by mouth or injection. Do you prefer quiet and dim lights? Do mind if students are present? Routine tests Routine antenatal tests help your doctor or midwife assess your health and monitor your pregnancy for signs of possible problems. Blood tests:

Initial tests will determine whether or not you are immune to rubella; assess your haemoglobin and blood-cell concentrations and hopefully rule out any sexually transmitted diseases such as syphilis and hepatitis. Your blood will also be assessed to determine your blood type and RH factor. Whether or not you are anaemic, if you are you will be given iron and folic acid tablets to take. You will also be tested for hepatitis B, this is a virus that can cause liver disease and may infect your baby if you are a carrier. Urine tests: This is so that your midwife can test your samples for signs of kidney infection, glucose ( a sign of diabetes) and albumin ( a protein that indicates pre-eclampsia). Ultrasound:

Everyone loves to see the baby on the ultrasound. The purpose of the ultrasound is to provide the doctor with a good survey of the baby and the conditions in your uterus. A simple ultrasound can provide a wide array of valuable information about the age of the fetus, location and size of the placenta, whether the size of the fetus is right for its age, rate of growth, amount of amniotic fluid in your uterus and number of fetuses. Blood pressure: Your blood pressure will be taken at every antenatal visit. A rise in blood pressure later in pregnancy could be a sign of pre-eclampsia. Height: Your height will be recorded on the first visit because it’s a rough guide to the size of your pelvis.

Weight: You will be weighed from now on. Your weight gain will probably be checked regularly, although this is not done everywhere. You will also get the choice to do a screen test to see if your baby has down’s syndrome. Many women have these tests done while a lot chose not to have the screen test. For the next 40 weeks, counting from the first day of your last menstrual period, your pregnancy will be referred to in 3 parts, these are called trimesters. The first trimester lasts 12 weeks, the second from week 13 to the end of week 27 and the third from week 28 to week 40. FIRST TRIMESTER Many of the physical changes that occur

during the first 3 months are not visible. Your metabolic rate is increasing because all the systems in your body must work harder to accommodate the developing baby to grow and to grow the placenta. During these first weeks, your body begins to produce more blood to carry nutrients to the fetus. Your heart multiplies its efforts to accommodate this increased blood flow, and your pulse quickens by as much as 10-15 beats per minute. Your pulse rate will continue to rise until you are in the middle of the second trimester. After a few weeks of pregnancy, you may not recognise your breasts. Not only are they enlarging and very sore and tender, thanks to the increased amount of progesterone and oestrogen your body is producing, but you will probably notice other changes as well. The areola (pigmented circle around the nipple) is

darkening and spreading and also may notice little bumps on the areola. Occasional headaches trouble many women in early pregnancy. The cause is uncertain, but like so many other discomforts of the first trimester, changes in your hormone level and increased blood circulation may be factors. Other possible causes are the stress and fatigue that often accompany the emotional and physical adjustments to pregnancy. The increasing size of your uterus in the first 3 months, along with more efficient functioning of your kidneys, may cause you to feel the need to urinate more often You may not feel like eating much. This may mean that you don’t gain weight, or you may even lose it. Stave off hunger by eating little and often. This will also help nausea and

dizziness and provide your body with the nutrients he needs to grow. You don’t need to boost your calories yet, but do eat a healthy diet. These weeks are crucial for your baby’s developing organs. Weight gain up to week 12 should be no more than 5lb ( 2.3kg ). Mid to late pregnancy is when you really start to gain weight, as your body lays down fat stores. SECOND TRIMESTER By now you’re probably feeling pretty good about yourself and your pregnancy. The second trimester is often known as the ‘golden period’ of pregnancy. Many women report a surge of energy and emotional boost. Your hormones have begun to level off, and the nausea, fatigue and other challenges of early pregnancy have gone. You’re ‘showing’ and the whole world begins to know that

your pregnant. The second trimester is the beginning off real expansion. Stretch marks begin, sometimes invisibly. Everything grows: moles get bigger, skin tags get bigger, even warts can get bigger. Thanks to oestrogen, everything has a better blood supply. This also may explain why your gums may bleed after brushing your teeth. Your uterus will grow to the height of your tummy button. The skin on your grown tummy may start to itch. You may feel pain down the side of your tummy as your uterus stretches. Take rest breaks during the day if you are feeling tired; don’t push yourself. You may get leg cramps, especially at night, if you’re not getting enough calcium. During the latter part of the second trimester, and even more so in the third, lying comfortably in bed becomes a

battle that distracts many women. If sleeping on your back was your preferred position, giving it up can be a traumatic struggle. Losing sleep while tossing and turning trying to adjust to your new shape is very common. I found the best position for sleeping during pregnancy was lying on my side (the left was ultimately preferred, but either is fine) with a pillow between my legs. Many women experience lower back pain starting in the second trimester of pregnancy. Wearing flat shoes and adopting a correct posture are the simplest and most effective solutions, but you could also try a pregnancy support girdle, it helped me. The second trimester is the most stable time of your pregnancy. You are feeling well, despite some minor discomforts, and are ready to conquer the world. Slow

down don’t forget you are still pregnant. There are activities about which you must think twice, and some that you are best avoiding altogether. Whether it’s moving boxes, picking up armloads of heavy shopping bags, or carrying older children, none of this is a good during pregnancy. Now that you are showing , it may be a good time to break the news of your pregnancy to your employer. Most women choose to keep pregnancy private until the second trimester. This approach gives you time to plan your announcement, negotiate the best maternity leave, and to protect your job. Towards the middle or end of this trimester, you will feel the baby’s movements. You will also feel some pains related to the growth of your uterus and your entire mid-portion. Heartburn, constipation, backache,

forgetfulness and difficulty finding comfortable sleeping position are all annoyances that will pass. During the second trimester the fetus is growing rapidly and appears to be fully formed. At this time the fetus has rudimentary use of all its senses: touch, taste, smell, hearing and vision. THIRD TRIMESTER As the third trimester arrives you are well on your way to the finish line. Weeks 28-40 mark a period of rapid growth, at this stage your baby will gain nearly half its birth weight and cause your uterus to expand to more than a thousand times its original size. You are most certainly uncomfortable, uncommonly tired, and probably pretty nervous too. The looming question as you peer at your tummy button is ‘how is this watermelon-like creature ever going to get out of there’. at this point you

body may be warming up with Braxton hicks contractions, causing you a lot of discomfort as your uterus contracts and tightens. Headaches may also occur more frequently in the third trimester. Try to get enough rest and relaxation, especially if you are feeling quite tense and emotional. Backaches can also occur as your growing tummy affects your posture. During this last stage of pregnancy you should try and stay close to home or at least near a medical facility. As your date approaches, you will see more of your doctor or midwife, and you will get frequent updates on your progress towards delivery. During this visit they will try to feel which position the baby is in, head up or head down. The midwife may also take measurements of the height of the

fundus. (the height of the fundus is the measurement of the growth of the uterus and where it is situated in your tummy. Your midwife will use a tape measure to measure your tummy from the top of the pubic bone to the fundus, or at the top of the uterus). WORK DURING PREGNANCY Its shocking to think that pregnancy discrimination still exists, but it does. In the UK it is illegal to sack or refuse to promote someone simply because she is pregnant. Employers must treat pregnancy the same as any other medical condition. Most pregnant women are able to work as long as they want to. However, a very few jobs may be unsafe or ill advised when you’re pregnant. If you work with chemicals or other dangerous substances, for example,

or if your job title includes you climbing stairs, or lifting anything heavy, you will have to switch to something more appropriate for your condition. Your employer has a legal obligation to make sure the work that you do, and your working conditions will not put your health or baby’s health at risk. You are entitled to paid time of work to attend antenatal appointments and classes (you may need to prove this with a note from your doctor or midwife). Maternity leave: You can choose when to start your maternity leave. It can be at any time in, or after, the 11th week before your baby is due. However, your maternity leave will start automatically if you're off work for any reason to do with your pregnancy

from the fourth week before your baby is due. You must produce a medical certificate (MATB1), if your employer asks for one, showing when your baby is due. You can get your MATB1 from your midwife or GP. Once your employer has received your notice that you want to take maternity leave, they must write to you within 28 days and tell you the date your maternity leave runs out and therefore the date when you are expected to return to work from maternity leave. If you decide you want to return to work earlier than the date your maternity leave is due to end, you must give your employer eight weeks’ notice of your new date of return to work. As from April 2007 you are now entitled to 39weeks maternity leave will full pay. COMMON PROBLEMS DURING

PREGNANCY Slow growing babies: Many of the tests in pregnancy check the growth of your baby. If you smoke heavily midwives will be monitoring your pregnancy closely. Blood pressure checks may also pick signs of trouble. If there is a concern about your baby’s health there will be further test to be carried out and monitoring will be more frequent. Vaginal bleeding: This may also be known as spotting, but be sure that is what is happening. There is a difference between strongly bleeding and spotting. Spotting is lightly bleeding kind of like your period, the blood can be red, pink or even brown. If you are bleeding actively with any discomfort then call out your doctor, if you can’t get a hold of him go immediately to the emergency room. Bleeding can be a

number of things from implantation, ectopic pregnancy, labour, infection or even miscarriage. Always let your doctor know, so other problems can be ruled out, you’ll feel better too. Dehydration: While you are pregnant it is easy to become dehydrated, particularly if you have morning sickness or just don’t drink those 8 glasses of water. If you find yourself pale, dry mouth or unsteady, you could be dehydrated and should be seen by a physician. Dehydration can cause premature labour and/or problems on the pregnancy. Stomach pain or cramping: Awaiting the pregnancy it may be hard to decode the difference between a growing pain and an actual stomach pain/cramping. However, if you do get a pain of any sort rest. After a few minutes if it doesn’t subside, call your physician

and explain the cramp to him. Don’t be anxious about it if you find out you only had gas or were having Braxton hicks contractions, at least you understand everything is okay with pregnancy. high blood pressure and pre-eclampsia: During pregnancy your blood pressure will be taken at every antenatal appointment, this is because a rise in blood pressure can be the first sign of a condition known as pre-eclampsia. Your urine will also be checked for protein. If you do have pre-eclampsia you will probably feel perfectly well in yourself. Some women experience such symptoms as headaches, visual disturbances, swelling and tummy pain. If you do have any of these symptoms get in touch with a midwife or doctor straight away and get yourself checked out, as this can cause fits in mothers and affect the baby’s growth if you do have preeclampsia.

Deep vein thrombosis: DVT is a serious condition were clots develop, often in the deep veins of the legs. It can be fatal if the clot travels from the legs to the lungs. If you develop swollen painful legs or have breathing difficulties after a trip, go to your doctor or your nearest accident and emergency department immediately. GETTING READY FOR THE BIRTH Are you so done with pregnancy you could stick a fork in yourself? The last few weeks are always the longest — but they can also be the busiest. So much to do, so little time (or so much time…)Eager to see your feet again? Desperate to sleep on your stomach — or just plain desperate to sleep? Tired of those midnight (and 2 a.m. and 3 a.m. and 4 a.m.) bathroom runs? Welcome to the end zone — the point in your pregnancy where time seems to slow

down, and the waiting becomes interminable (especially if your ninemonth pregnancy is now entering your tenth month). Looking for something to do while you wait (besides bite the nails on your twiddling thumbs)? Pass the time productively by getting as much done as you can before the big day (or night) arrives. Here's a handy roundup of everything you need to check off your list before that D-day dawns. Planning on delivering in a hospital ? You could just show up — but it’s better to come prepared.. Leave the frantic, lastminute dashes to the hospital to the sitcom casts (it won’t be half as funny on your reality show). For a less stressful delivery, it helps to plan ahead. Things to pack in your hospital bag: Two copies of your birth plan, if you wrote one Toothbrush and toothpaste

Dressing gown Shampoo Shower gel Flannel Slippers Nighties Two to three nursing bras Sanitary towels Knickers Loose comfortable outfit to wear during day Clothes and nappies for baby Change or phone card for the hospital payphone Breast pads

Clothes for coming home in Clothes for baby coming home Book or magazine to read A shawl to wrap baby up in Pain relief: Think about pain relief beforehand and write down your preferences in your birth plan. But try to keep an opened mind, as you don’t know how you’ll feel on the day. TENS machine: Sends electric pulses to pads on your back. The pulses block pain signals to your brain and stimulate your own painkilling hormones. Gas and air (entonox): This is a mixture of oxygen and another

gas called nitrous oxide. Also known as laughing gas, this is inhaled through a mouth piece or mask. You can use it at any point in labour. This wont remove the pain, but it can help by reducing it and making it easier to bear. Pethidine: Stronger painkillers that are injected, or given intravenously, during the early stages of labour. They take about 20 minutes to work and last up to 4 hours. Diamorphine: More powerful than pethidine, this injection blocks the transmission of pain signals to your brain and is less likely to cause nausea and vomiting than pethidine. Epidural:

An epidural is a special type of local anaesthetic. It numbs the nerves which carry the feeling of pain from the birth canal to the brain. So for most women an epidural gives complete pain relief. It usually takes 20minutes for the procedure to be complete then another 15-20 minutes for the epidural to work. Self-help: Using relaxation, breathing, keeping mobile, having a partner to support and massage you, and having confidence in your own body will all help. HOW TO RECOGNISE WHEN LABOUR STARTS You’re unlikely to mistake the signs of labour when the time really comes, but if your in any doubt, don’t hesitate to contact the hospital. Signs of labour

Regular contraction: You may have been feeling contractions (Braxton hicks when your tummy tightens and then relaxes) throughout pregnancy. Lately you will have become a lot more aware of them. When they start to come regularly, last more than 30 seconds and begin to feel stronger, labour may have started. ( gradually they will become longer, stronger and more frequent) Backache: You will get a aching, heavy feeling, which some women get with their monthly period. A SHOW: You will get this either before labour starts or early in labour. The plug of mucus in the cervix which has helped to seal the womb during pregnancy comes away and comes out of the vagina. You

don’t lose a lot of blood with a show. The ‘show’ is a small amount of sticky pink mucus. Waters breaking: The bag of water in which the baby is floating may break before labour starts or during labour. If the waters break before labour it may be a slow trickle or a sudden gush of water that you cant control. More frequent urination and bowl movements: If you think you couldn’t fit anymore trips to the toilet into your day I’ve got bad news for you. When the baby drops, it presses directly onto your bladder, and so can expect even more frequent urges to urinate. Also a kind of natural cleansing of the bowels can occur at this time in preparation for delivery. The hormones acting on your intestines cause some women to have diarrhoea or

even abdominal cramps. Going into hospital when you are in labour may be frightening, but attending antenatal classes and visits to the hospital should help. Before going to the hospital don’t forget to ring them to let them know your on your way. Once you arrive take your notes to the hospital admissions desk. You will then be taken to the labour ward, were you can get changed into your nightdress to feel more comfortable. The midwife will ask you about what has been happening so far and will examine you. This will include: Taking your pulse, temperature and blood pressure and check your urine. Feel your abdomen to check the baby’s position and record or listen to

your baby’s heart Probably do an internal examination to find out how much your cervix has dilated, as then the midwife will be able to tell you how far your labour has progressed. These checks will be repeated at intervals throughout your labour. Always ask about anything you want to know. If you and your partner have made a birth plan make sure you give this to your midwife so then she knows your wishes during labour. Labour is divided into three stages. Each of these stages is explained below. The average time for each stage is given only as an indication. Labour usually lasts between 12-14 hours, in a woman's first pregnancy and tends to be shorter (6-8 hours), in subsequent pregnancies. Labour is so different for everyone and can be a lot longer or shorter than the

average time. However, the information below will give you an idea of the general pattern so that you will know what to expect and be prepared for labour and delivery. TYPES OF DELIVERY Induction: The main reason for induction is that your baby is overdue, and many doctors prefer to induce labour once your baby is between one and two weeks late. This is because the placenta works less efficiently as the pregnancy goes on, and the bones in your baby's head may become harder and less able to 'mould' during the descent down the birth canal. Other reasons why you may be induced include: Pre-eclampsia Multiple-births

Labour is progressing too slowly Waters break early leaving the baby exposed to infection Diabetes - baby is growing too large Placenta is detached from the wall of your uterus Caesarean section: If either you or your baby is at risk, doctors will advise a caesarean. The operation usually takes around 45-60 minutes, but the baby is delivered between the first 5-10 minutes. The rest of the time is taken to stitch mum up. Situations include: Foetal distress: Your baby's heartbeat is slowing and it might become dangerous. Failure to progress: Labour is

taking a long time and you are exhausted. Placental problems: e.g. placenta praevia where the placenta blocks the cervix or is starting to peel away from the womb (placenta abruptio). Cord Prolapse: the umbilical cord moves into the birth canal in front of the baby cutting off the oxygen supply. Pre-eclampsia: this can only be relieved by delivering your baby. Your baby has a medical condition which may put them at risk, e.g. premature or heart problem. There may be other reasons for you being offered a caesarean, including having had a previous caesarean; if you are expecting two or more babies; doctors believe your pelvis is not big

enough for your baby's head to pass through; your baby is lying on an awkward position or thought to be in distress (not getting enough oxygen); or you have a medical condition that could put your baby at risk. Whatever the reasons, it's essential that you feel fully informed and understand all the reasons for the operation, so ask as many questions as you need before making a decision. You can always ask for a second opinion - for example some obstetricians are willing to let you try delivering twin babies or a breech baby (feet or bottom first) vaginally, while others will prefer to offer a caesarean. Even in an emergency situation, make sure you (or at least your partner) understand what is happening.

Forceps: Forceps are like metal tongs with two large spoon shaped edges that fit around the baby's head. They are inserted into the vagina to grip the baby's head and speed up delivery. This technique may be used if the baby's heartbeat slows down during a slow delivery of the head, or to ensure its safe delivery during a breech birth. Forceps are used when the mother is unable to push because she has had an epidural injection or because labour is not progressing well or if the baby is in distress. Forceps deliveries are becoming less common, as many doctors prefer the alternative technique of vacuum extraction which works in a similar way. Where delivery is delayed and the baby's head remains high up in the pelvic cavity, Caesarean section is likely to be

considered a safer option. Forceps can bruise your baby's head, and his/her head may appear elongated or an odd shape, but any bruising or swelling will usually subside within a few days and will have disappeared within a couple of weeks. The first stage (dilation of cervix to 10cm): Yours cervix needs to dilate to 10cm before your baby can start to move down the birth canal. Contractions of the powerful muscles at the top of the uterus open up the cervix (neck of the womb). Your progress during this stage is assessed according to how many centimetres dilated your cervix is. Once your cervix is dilated to 10cm you will then probably feel the urge to push and you will begin the second stage of labour. You will be discouraged from pushing during this stage since pushing

before the cervix is fully opened wastes energy and may tear the cervix. You can help by keeping active and moving around, as your baby's head pressing on the cervix encourages it to open. There are many different positions that you can adopt to ease the discomfort. Some women prefer to stand up and move around as this helps to strengthen contractions and accelerates labour. As the contractions proceed, you may instinctively choose a sitting or kneeling position. During this stage, the heart rate of the mother and baby are monitored roughly every 15 minutes. This alerts the midwives if the baby becomes distressed. If the baby's heart rate becomes too fast or too slow, the doctor may decide to deliver by caesarean section. The second stage (the pushing stage of birth):

During this stage you will push your baby down the birth canal and your baby will actually be born. Once your cervix is 10cm dilated, you will probably feel overwhelming urges to 'bear down' and push your baby out with each contraction. Your baby's head is pressing on your rectum, which gives you a sensation of needing the toilet but don't let that worry you - push when you need to and remember each push is bringing your baby nearer. Each contraction is a squeezing of the uterus which pushes your baby down the birth canal. If you are able to stay on all fours for the delivery, your baby's head will stretch the tissues at the back of your vagina more gently and you're less likely to tear. Otherwise you will probably be placed in a semi-upright position (between sitting up and lying down) propped up by pillows. This is to make good use of gravity and reduces the risk of tearing. It also puts less strain on your

back and pelvis. On average it will take one to two hours for your baby's head to reach the opening of your vagina, known as 'crowning', when the midwife will tell you to stop pushing as she eases the baby's head out to avoid a tear. Then the shoulders are born one at a time, and with a great slippery rush, the rest of the body is delivered, and you can hold your new baby. Once the umbilical cord has stopped pulsating, it is cut and clamped. Your baby's heart rate will continue to be monitored during this stage to check that the baby is not in distress. Third stage (delivery of the placenta): Average time: Few minutes to over an hour. After the baby has been born, the placenta needs to come out of the uterus. This is painless, and you may be

offered an injection to speed up the delivery. Your uterus will continue to contract to expel the placenta. During the first or second contraction after delivery, the placenta usually detaches from the uterus, and a gush of blood soon follows. Usually the mother can push the placenta out on her own. But the doctor or midwife will be able to help with pressure on your abdomen if you are having difficulty. As soon as the placenta has been delivered you will be given oxytocin to help the uterus contract. Contraction is essential to prevent further bleeding from the area where the placenta was attached to the uterus.



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