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Q: Why is it important to take folic acid before becoming pregnant?

A: Folic acid is especially important if you are pregnant or planning to become pregnant. Folic acid plays a crucial role in the healthy development of your baby and helps to prevent birth defects such as spina bifida.


If you are planning to become pregnant, you should take folic acid for at least 12 weeks before conceiving. After that, continue to take folic acid for the first 12 weeks of your pregnancy.


The recommended amount to take is 400 micrograms as a supplemental tablet. A folic acid supplement is important because although folic acid can be found in many foods that you may eat every day, it would be difficult to achieve the additional 400 micrograms.

 

Q: When do prenatal classes start?

A: Many prenatal classes start around weeks 31 to 32. In most courses there are about six weekly classes, each one concentrating on a different aspect of late pregnancy, labour/birth and sometimes baby care. These classes can also be a great place to meet other pregnant women in your area.

 

Q: When will my baby’s head engage?

A: During week 37-38, later if this is not your first baby, the baby's head should engage - move down into your pelvis into the birth-ready position, easing the pressure on your internal organs and ribs. However, this now places pressure on your bladder instead so you may be constantly running to the washroom.

 

Q: How will I know if I am in labour?

A: The three main signs are

  1. A show - when the plug of protective mucus in the neck of the womb comes away and passes down your vagina.
  2. Water breaking - this can be a little trickle or a gush of amniotic fluid as your baby's amniotic sac ruptures.
  3. Contractions - becoming stronger and closer together. They tend to start gently, build up to a peak of intensity then die away and form a pattern, i.e. every 25 minutes.
 

Q: What do contractions feel like?

A: Every woman feels contractions differently. In early labour they may feel similar to period pains or be confined to mild backache.


When the muscle of your uterus tightens you may feel a cramping spreading around your lower abdomen like a tight band.


Very often a contraction feels like a wave of discomfort right across your abdomen which reaches a peak for a few seconds and then diminishes.


At the same time you can feel a hardening and tightening of the uterine muscle, which is held at the peak of its intensity for a few seconds before the muscle begins to relax.

 

Q: How long does labour last?

A: Every woman's experience of labour is different and it is impossible to predict how long it will last.

 

Q:  What happens during labour?

A: Labour is divided into three stages:

  • First stage - during which muscular contractions work to pull open the cervix.
  • Second stage - where you will push your baby out.
  • Third stage - the delivery of the placenta.
 

Q: What is cervix dilation?

A: The cervix is a thick walled canal about 2 cm long and is normally firmly closed. In the last few weeks of pregnancy, hormones will be softening your cervix in preparation for birth.


The intense contractions of first stage labour are needed to dilate and thin the cervix enough for your baby's head to pass through it. Your cervix will dilate about 4 cm during the latent phase, 8 cm in the active phase and then pain increases as it becomes fully dilated during transition. Eventually the whole cervix opens to become one with the body of the uterus, creating a continuous canal through which your baby can emerge.

 

Q: What is transition?

A: Transition is the most intense phase of the first stage of labour. Your contractions will be lasting around 60-90 seconds with intervals of only 30-90 seconds.


It is the stage during which you will feel most discomfort and when you may feel a strong urge to push. Do not do so, however, unless you are told that you are fully dilated.
 

Q: What types of pain relief will be available to me?

A: The most popular choices are outlined below:

  • Epidural - injection of local anaesthetic into the fluid surrounding the spinal cord. May require you to stay in bed, but some centres have a new 'walkabout' type. An epidural is administered by an anaesthesiologist.
  • Massage - usually firm circling strokes around the lower back, also kneading shoulders. Administered by a partner.
  • Water - birthing pool if possible, but a deep bath helps and even a shower aimed at lower back is useful. Water relaxes and calms and the buoyancy helps. Anecdotal reports say it 'really helps take the edge off' and 'helped me cope'.
  • Deep breathing/relaxation.
 

Q: What will happen after the birth?

A: Within one minute of your baby being born, a healthcare professional will assess your baby with five simple tests. This is called the Apgar score and is used to evaluate the condition of a newborn baby. Scores are given out of ten and a score of seven or over indicates that a baby is in a good condition. A baby with a low score (between four and six) may need resuscitation or help with breathing. With a score under four, a baby may need life-saving techniques to be carried out.


The tests carried out are as follows and for each test there is a possible score of zero, one or two.

  • Heart rate - absent, slow, more than 100 beats per minute
  • Breathing - absent, slow, good/crying
  • Muscle tone - limp, some tone, active motion
  • Response to stimulus - none, some response, sneezes or coughs
  • Colour of body - pale/blue, blue/pink, pink all over

If all is well you will be given your baby to hold right away.  Don't be alarmed at how your baby looks after the birth as babies are often covered in blood and a little bruised from the journey when they first arrive.


Your baby may also have a strangely shaped head after the pressure of traveling down the birth canal.  The bones on the top of the head (fontanelle) have not yet fused together so the head may be more 'pointy' than you expect.


The eyes are blue at birth and it is not until about six months that 'true' eye colour will be seen.


The first moments you spend with your baby may be a time you want to cherish as it may be something you and your partner remember forever.

 

Q: How soon can I take a pregnancy test?

A: You'll probably miss your first period about two weeks after the egg has been fertilized. Many of the pregnancy testing kits you can buy over-the-counter at the pharmacy can be used just a few days after your period would usually have started.


Always follow any pregnancy tests to the letter and always confirm the result with your healthcare professional.

 

Q: What is morning sickness?

A: Morning sickness is one of the first signs of pregnancy.  It is usually caused by the high levels of hormones flooding the body and actually means that the pregnancy is progressing normally.


Although it is called morning sickness, it can strike at any time of the day and many women report feeling sick towards the end of the day.


It can occur more frequently when you don't eat enough, so always keep some snacks, such as dry crackers or fresh fruit, close at hand.


For most women, morning sickness lessens from about month three of pregnancy when your body has become used to the high levels of pregnancy hormones.
 

Q: When will I have my first ultrasound?

A: Around week 12 of your pregnancy, you will usually be offered an early ultrasound scan. This is to check:

  • The placenta's position in the womb.
  • Your baby's position.
  • Your baby's size, probable due date and possibly the sex.
  • The thickness of skin fold (Nuchal fold) at the back of your baby's neck, which can be used as an assessment of the likelihood of your baby having Down's syndrome.
 

Q: Are there any foods I should be avoiding now that I am pregnant?

A:There have been concerns about the safety of eating certain foods during pregnancy because they contain bacteria like listeria and salmonella, or they may have high levels of vitamin A, which is potentially harmful to the unborn baby. Therefore the following foods should be avoided:

  • unpasteurized cheese i.e. brie, camembert, stilton and Danish blue
  • pâté
  • raw fish
  • raw or soft boiled eggs
  • raw or lightly cooked meat
  • liver and foods made from liver
  • cod liver oil
  • chilled meals or ready-to-eat chicken unless reheated until piping hot
 

Q: What is Toxoplasmosis?

A: Toxoplasmosis is an illness caused by infection from an organism which may be found in raw meat, cat feces and soil, which can affect a pregnant woman and in rare instances, her unborn baby. To avoid Toxoplasmosis:

  • Pay particular attention to hygiene.
  • Do not eat any raw or undercooked meat and always wash hands thoroughly after handling raw meat.
  • Always wash vegetables and salads carefully to remove any soil and dirt which can carry the infection if it has been fouled by cats.
  • Goats' milk may occasionally carry toxoplasma. Any goats' milk in the diet should be pasteurized, sterilized or UHT (ultra-heat-treated).
  • Awareness of contact with cats and kittens should be paramount. Cat litter trays need to be kept clean. Where possible, someone else should clean out the soiled litter tray and if this isn't possible rubber gloves should be worn. Then wash gloves and hands thoroughly. Avoid contact with stray cats and kittens.
  • Also, always wear gloves for gardening to protect hands from contamination where soil may have been fouled by cats.
 

Q: I suffer with indigestion and heartburn, how can I relieve this?

A: As your baby grows, there is less and less room in your abdomen, sometimes placing pressure on your stomach, which can cause indigestion or heartburn. To help avoid or relieve the symptoms:

  • Avoid foods which upset you the most.
  • Eat smaller meals more often.
  • Sit up straight to avoid pressure on your tummy.
  • Try not to lie down too soon after eating and, when you are resting, it can help to be propped up.
  • Ask your healthcare professional about suitable antacids if symptoms persist.
 

Q: When will I feel my baby move?

A: The first time you feel your baby move tends to happen between 16 and 20 weeks, and it can be exciting and extraordinarily touching.


Your baby has in fact been moving before, but you can now feel it because your growing womb is touching your abdominal wall. Women often say the earliest movements they feel are like having a butterfly in their tummy while others say it's like having gas.

 

Q: What is Pre-eclampsia?

A: Pre-eclampsia is a disorder of the placenta characterised by high blood pressure and protein in the urine of the mother.  It is not known exactly what causes Pre-eclampsia but it affects one in 50 women and appears in the last trimester of pregnancy.


It will be checked for in your prenatal appointments, one of many reasons why it is important to attend all appointments and report any unusual symptoms or concerns to your healthcare professional.  Signs to watch out for are sudden swelling of face, feet, ankles and fingers, headaches and visual impairment.


Although Pre-eclampsia can be treated with rest, relaxation and drugs to lower blood pressure, it can be harmful for both mother and unborn baby if left untreated.  It is essential to get all signs or symptoms checked out.