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Pregnancy Day by Day : Welcome to your First Trimester (part 27)

- 7 Kinds Of Fruit That Pregnant Women Shouldn’t Eat
- How to have natural miscarriage
- Foods That Cause Miscarriage
- Signs Proving You Have Boy Pregnancy
You are 9 Weeks and 3 Days 214 days to go…

You don’t need to shop for a maternity wardrobe just yet, but it might be time to purchase some bigger bras.

Your baby today

The shoulders, elbows, and wrists are flexed leaving the hands in front of the face. It’s far too early to be aware of them but several fetal movements will start to become apparent on an ultrasound scan at this stage.

If your normal bras are starting to feel a little uncomfortable, it’s time to go for a fitting. If you have not done so already, get yourself measured professionally. Wearing a good and supportive bra during pregnancy is essential to prevent backaches and sagging breasts.

Whenever you feel you need a new bra, get measured properly to ensure that you’re wearing the right size. Although your breasts may be growing very quickly at this time, you should find that by the end of the first trimester the growth has stabilized. There is then unlikely to be much more breast growth until you’re in your third trimester and after the baby is born.

Wearing underwire bras during pregnancy is not recommended because they can dig into the developing breast tissue and damage it, and may even cause problems with milk production; the wires digging into the skin can also be uncomfortable. Non-underwire bras with wide supportive straps, such as sports bras, are good in pregnancy.

Look for maternity bras that double as nursing bras, which unhook at the front, for after the birth. There are some very pretty and feminine styles available.

Pica means craving inedible substances and comes from the Latin for magpie, a bird that scavenges indiscriminately.

If you like crunching coal or sniffing your hot-water bottle, you have pica. While licking the toothpaste is fairly harmless, you should resist eating toxic items such as chalk, glue, and soap. Pica could be a sign that your diet is deficient in some way, so seek advice. Taking an iron or vitamin supplement could help.

… Nutrition
Vegan needs

If you are a vegan and pregnant, you may have to work a little harder than most women to get the right nutrients. You need to make sure you obtain adequate B12 and since there are no natural sources of vitamin B12, it needs to be obtained from fortified foods such as:

  • Yeast extracts

  • Vegetable stock

  • Veggie burgers

  • Textured vegetable protein.

You also need zinc, an important nutrient in pregnancy—necessary for growth and energy and supporting the immune system. Zinc can be found in the following foods:

  • Beans

  • Legumes

  • Nuts

  • Seeds—pumpkin seeds are a particularly rich source.

Like most vegans, you probably already eat many of these foods.

Your First Prenatal Visit

Your first prenatal appointment usually takes place between 8 and 12 weeks. At this visit, your prenatal records will be started and you will have a chance to discuss any concerns or issues with your doctor.

At your initial visit, you will meet your doctor who will be handling your care. She will ask you questions about your past and present health and about medical conditions in your family. You will also have a physical examination and blood and urine tests. Your due date will be estimated based on the date of your last menstrual period (see Take folic acid).

Medical history

The doctor will take a full medical history to check if there are any health problems, which will help her identify your pregnancy as high or low risk.

If there is a problem, she will explain how this could affect your pregnancy. If you have an existing condition, she’ll discuss how your pregnancy may affect your health and if your treatment needs to change. Inform the doctor of any medications you’re taking; certain ones, such as some of those for high blood pressure, may need to be changed .

Family history

The doctor will ask about any health problems in your own and your partner’s family. This is important because some conditions can be passed on, and testing may be available to identify if your baby is affected. You will also be asked possibly embarrassing, but important, questions about sexually transmitted diseases, past drug use, and terminations. It’s important that you reveal your history so that your doctor can identify and prevent potential problems. If your partner is unaware of a past event and you feel sensitive about this, arrange to tell the doctor when he isn’t present.

Physical examination

You will have a physical checkup, although the nature of this varies from doctor to doctor. The examination may include a check of your skin, thyroid, heart, lungs, breasts, abdomen, and limbs.

Height and weight

A baseline height and weight measurement will be taken to calculate your body mass index (BMI). A low or high BMI increases your risk of complications and your doctor may monitor your weight gain.

A baseline weight measurement is taken at your first appointment.

Blood pressure

A baseline blood pressure measurement will be taken at your first visit. Blood pressure usually goes down at the start of pregnancy, rises around week 26, and by the 32nd week, returns to its original prepregnancy value. So if your initial blood pressure measurements are in the normal-to-high range, they are likely to rise to above normal during the third trimester and need treatment.

Your blood pressure will be recorded at each appointment and any changes will be investigated.

Routine blood tests

You will be asked to provide a sample of your blood, which will be tested to screen for several conditions and to determine your blood group and immunity to certain conditions.

Complete blood count

This is a screening for anemia, which occurs most commonly from low levels of iron in the blood. If you’re anemic, you’ll be advised to eat iron-rich foods  and may need an iron supplement.

Blood group

This determines your blood group (A, B, O, or AB) and if you’re Rhesus positive (Rh+) or Rhesus negative (Rh-). If you’re Rh- and your baby is Rh+ you could develop antibodies against your baby’s blood that cause anemia in your baby. Your immune system is unlikely to come into contact with your baby’s until labor so this isn’t usually a problem with first pregnancies. To prevent problems in subsequent pregnancies, Rh-women are routinely given Rh immune-globulin injections at 28 weeks and within 72 hours of giving birth to stop antibodies from forming. It’s also given after any procedure such as amniocentesis, or if you have vaginal bleeding.

A blood sample identifies your blood group and tests for a range of conditions.

Rubella

This blood test checks your immunity to rubella. Rubella infection in pregnancy can cause serious problems for the baby. If you aren’t immune, you can’t be vaccinated in pregnancy, but will usually be vaccinated after delivery so you’re protected in future pregnancies.

Hepatitis B

This test identifies women who are actively infected with hepatitis B, a viral liver disease that can be passed to the baby during pregnancy and labor.

Syphilis

The blood test checks if you have ever had syphilis. Active syphilis can cross the placenta and cause serious complications in your baby.

HIV

You will be offered a test for human immunodeficiency virus (HIV). If you have HIV, you can reduce the chances of passing this on to your baby by taking antiviral agents and not breast-feeding.

Sickle-cell disease or thalassemia

You are tested to see if you are a carrier of sickle-cell disease or thalassemia, genetic disorders that affect the oxygen-carrying ability of red blood cells. These are most common in people of African, Hispanic, or Mediterranean origins. If you are found to be a carrier, your partner will need to be tested; if he too is a carrier there is a chance that your baby could develop the disease.

Routine urine tests

Your urine is checked for protein, which may indicate infection or, less commonly, kidney disease. If protein is found, a urine sample is sent to the laboratory for culture to look for bacteria. Around 15 percent of women have bacteria, but no signs of a urinary tract infection. If bacteria is found, you may need antibiotics to stop kidney infection, which is more common in pregnancy and can cause complications. If no infection is found, further tests will check your kidney function.

Getting your results

If all is well, you will be given the results of your blood test at your next prenatal visit. If there is any concern, the doctor will contact you earlier to discuss the results.

Future prenatal care
What is coming up

If your pregnancy is low risk, you will have around 14 prenatal appointments. They’ll start out at 4-week intervals and gradually increase to weekly by your third trimester. After the first appointment, your next prenatal visit will be 4 weeks later.

At each appointment, your doctor will do routine checkups to assess both your health and the well-being of your baby. These checkups will include taking your blood pressure and checking your urine for protein, the presence of which could indicate an infection that needs treating or, later in pregnancy, preeclampsia. You will be weighed regularly and given guidance if you’re putting on too much or too little weight.

After around 12 weeks, the doctor will start to listen to your baby’s heartbeat with an instrument known as a handheld sonic aid. From around 20 weeks, your doctor will measure your abdomen to monitor the growth of your baby.

Additional tests
Extra screening

Some additional tests may be offered depending on your doctor and your individual circumstances.

  • Cervical cultures:

    Because both chlamydia and gonorrhea can be symptom free, it’s worth getting tested if you think you’re at risk, since these can cause problems if passed on to your baby.

  • Hepatitis C:

    You may be offered screening for this condition if your history puts you at a higher risk.

  • Varicella:

    If you’re unsure whether you’ve had chickenpox (varicella), a test can confirm this. If you’re not immune and are exposed to the infection during pregnancy, treatment can prevent severe chickenpox in pregnancy.

  • Toxoplasmosis:

    This identifies if you have ever been infected with toxoplasmosis. Past infection protects you from infection in pregnancy, which could harm your baby.

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