expecting: health and wellness

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EATING WHEN YOU ARE EXPECTING
For the first trimester, you don’t have to add any calories to your diet.  For the rest of your pregnancy, the number people usually say to add is 300—for most people I know, we probably ate a bit more or a bit less depending on the day and how we were feeling. 

One thing to keep in mind is that your body needs iron, as it will store your baby’s iron supply for the first 6 months.  Eating foods rich in iron like steak 

Some iron in vitamins is constipating—Solgar makes a “non constipating iron” and Floradix makes a drinkable iron & vitamin combination.  Check with your practitioner to see which is right for you.

Drinking enough water is essential. New research as of March, 2010, indicated that pregnant women as a whole need more water, and that other drinks are not a substitute. Make sure you are drinking water that is free of chemicals. Some practitioners are even recommending adding a "pinch of sea salt" to aid absorbtion but you MUST check with your practitioner about that. Previous recommendations to "drink to thirst" may not be enough.

FOODS TO AVOID & LIMIT WHILE PREGNANT

  • Swordfish
  • Shark
  • King mackerel
  • Tilefish
  • raw fish and shellfish
  • oysters and clams
  • Refrigerated smoked seafood

Try to have less than 12 ounces a week of:

  • Shrimp
  • Canned light tuna (limit albacore tuna and tuna steak to no more than 6 ounces a week)
  • Salmon
  • Pollock
  • Catfish

Buy cheese carefully from a fromagerie that you trust.  Avoid unpasteurized products, especially soft cheeses like:

  • Brie
  • Feta
  • Camembert
  • Blue cheese
  • Mexican-style cheeses: queso blanco, queso fresco, queso de hoja, queso de crema and queso asadero

Caffeine
Large amounts of caffeine can cross the placenta and affect your baby’s heart rate.  More than 200 milligrams a day can be harmful (researchers are exploring links between increased caffeine intake and low fetal birthweight among other issues).  A regular 10 oz cup of coffee has about 180 milligrams.

Herbal Teas
Even though herbal teas can be caffeine-free, teas and herbs (which have, historically, been used medicinally) can cause contractions.  Definitely avoid chamomile, and any tea with red raspberry leaf.

BE COMFORTABLE WHEN YOU SLEEP

Invest in a body pillow.  I loved the:  Snoozer Full Body Pillow The J shape gives you a place for your head or you can put the J part between your knees.

Stay comfortable walking—you may buy your first pair of stylish clogs (yes, they can be found!) or cork soled sandals.

Book in advance:  If you can find and hire a post-partum doula who will come for 10-15 hours after the baby is born-- it is 100% worth it for a million reasons (help with nursing like correcting a latch that seems fine, help with slings, teaching about things you just don't know will come up).  I5 hours was the minimum in NYC, I did fine with 10, but honestly, the first 5 were invaluable.

Try to meet other pregnant women who live fairly close to you.  You might meet them in a birthing or baby preparation class, an on-line local parent group or a place that offers classes in your neighborhood.   This is a good time to practice talking to other pregnant women— lines like, “Hi, when are you due?” are simple and easy conversation starters. 

BE COMFORTABLE WHEN YOU WALK
Many women buy their first pair of Dansko Clogs when they are pregnant. These are a bit softer than wooden clogs. Make sure you have good supportive shoes—pregnant women tend to trip more easily as their pregnancy progresses due to the increased relaxin (a hormone) that the body releases.

APPOINTMENTS WITH YOUR PRACTIONER

After your first visit, most women see their practitioner every 4 weeks until 32 weeks, then every 2 weeks until 36 weeks, and then every week.

Bring any questions you might have-- anything you are feeling, eating, thinking that you might want to ask about.
Bring your partner if you can.  Especially with your first baby-- it always helps for two people to hear things the OB/Midwife says, both to remember, keep things in perspective, and be clear about guidelines and expectation.

ULTRASOUNDS / SONAGRAMS
Sometimes your practitioner will give you an ultrasound (also called a sonagram) to see the fetus and your uterus.  This usually allows your them to check the date of conception or the age of the fetus as measurements around this time are fairly similar.  (Of course, not every fetus measures exactly the same on each day-- but it’s close.)

These first ultrasounds are usually trans-vaginal, which means that the doctor or ultrasound technician will cover a transducer (basically a thinner rod shaped smooth wand) with KY Jelly (many times it really is KY Jelly) and either hands it to you to insert or gently inserts it for you.  This allows a good look at a very new fetus.

You can usually hear the heartbeat around 6 weeks, though that part of the ultrasound is much stronger so they don’t keep the sound on for you to hear for very long.  Still, that first galloping sound (a fetus has a heart rate anywhere from 120 to 160 beats a minute) is amazing to hear.


OTHER TESTS YOUR PRACTIONER WILL GIVE YOU

FIRST TRIMESTER
The Nuchal Translucency Screening
The Nuchal Translucency Screening is done between 11 and 13 weeks. This Nuchal is given to test the fetus for chromosomal abnormalities such as Down’s Syndrome, Trisomy 18 and Trisomy 13. A combination of an ultrasound and blood work, this test measures the amount of fluid behind the back of the neck of the fetus.  The ultrasound technician will take measurements and then send you for blood work (blood from your arm).  The Nuchal is a non-invasive test.  The results of the Nuchal come back as a percentage possible for those syndromes.  If high, you may wish to do further testing.
Chorionic Villus Sampling (CVS)
The Chorionic Villus Sampling (CVS) test can be done between 11 and 13 weeks than the to check for chromosomal abnormalities.  This can be done to cross check Nuchal results if needed.  If you suspect chromosomal abnormalities, the benefit of the CVS is that it is conclusive (keeping in mind false positives that always exist in diagnostic tests) and can be done much earlier than the amniocentesis.   For a CVS test the doctor inserts a tiny needle and draws cells from the chorionic villi on the placenta.  As with amniocentesis, there is always a risk, though small, of miscarriage after the procedure.  Talk with your practitioner about your specific need for this test.

SECOND TRIMESTER

Amniocentesis
If you are choosing to have an amniocentesis, you will get it around 16 weeks.  You will go for a genetic screening before.

The genetic screening is very detailed and will ask about your family history of births, deaths, relatives with mental challenges, miscarriages, still born births, and more.  If you are choosing to have an amniocentesis this may be a bit jarring—just keep in mind that the genetic counselor asks the same questions of everyone. 
If you are not choosing to have an amniocentesis, you may have been sent to have one.  This can happen after the nuchal translucency or the 20 week ultrasound if there are any “markers” or indications that there may be something that needs further examination.  In this case it will be a fairly quick decision to have the amnio.  The genetic counseling session can be jarring. In my case, my 20 week ultrasound showed something called choroid plexus cysts, which in 1% of cases can be an indication of I don’t even remember what—but it was scary and they scheduled an amnio for the next day (which my husband couldn’t even attend—since it was the very first day of school!).  

After your amniocentesis you are supposed to take it easy for 24 hours—no lifting, etc.  I found that I was sore and really took advantage of being able to rest on the couch while my family helped take care of my toddler. 

Waiting for the results can be the longest days of your pregnancy, and for some people, the longest days of their life so far.
 

GTT = Glucose Tolerance Test
The point of the GTT (or OGTT since this is oral) is to make sure your body is digesting and processing the sugars you eat. 

When you go for the glucose tolerance test you will have to drink a full (but not huge) syrupy sweet thick drink.  You have 5 minutes to drink it—take your time, taste it on your tongue—this is the first sign to your body to release insulin to break down the sugars.  

You can pass or fail.  Failing means you have to do the GTT, which involves the same process but you get blood drawn three times in the next three hours.  If you fail that, you will work with your practitioner (and maybe a nutritionist) to create a diet for the rest of your pregnancy that limits your carbohydrate and sugar intake so you protect yourself and your baby.

20 Week Anatomy Sonagram


At 20 weeks you will have an anatomy sonagram. The ultrasound technician will measure the length of different parts of the baby (arm, leg, head) as well as look at the 4 chambers of the heart which are now visible.  If you want to find out the gender of your baby, most technicians can see during this scan.
 


 

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