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Antenatal care

Self care a priority

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Contents • Are u a smart mom?• General information about pregnancy• Do’s and don’ts• Problems of pregnancy and solutions • Sleep• Exercise• Nutrition• References

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Are you a smart Are you a smart mom?mom?

Are you a smart Are you a smart mom?mom?

Answer these and know.Answer these and know.

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• Everyday, you take– A multivitamin– A prenatal vitamin containing folic acid– Only a shower

• You have had complete physical examination– In past 6 months– Since you decided to get pregnant– More than 6 months ago

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• You work out– A few times a week, for about an hour– Everyday for 2hrs or more– You are fanatic– Every other day for an hour, daily when you

can fit in– When heel freezes over

• You or any family member smoke near to you – Occasionally– >5 cigarettes per day– never

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• How would you describe your body?– You could stand to loose 10kgs– Your doctor says you are underweight, but you

like the way you look– You are in recommended weight levels for your

height

• Your idea of good night sleep is– <6 hrs– 6 – 8hrs– Atleast 8 hrs– Nodding off on the couch during afternoon

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• How much coffee do you drink each day– 1-2 cups– 3 cups or more– None but 1 gallon of diet coke or tea

• The food you eat most is– Grains or dairy– Fruits and vegetables– Meat, poultry and fish

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• How many glasses of water, milk and/or juice do you drink daily?– 3 or less– 4-7– 8 and more

• Your blood pressure is– Low to normal– Borderline high– Really high

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Mark each 18 or more yes

7 good

5-6 sufficiently good

4-5 needs improvement

<4 poor status

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1st month of pregnancy (signs)

You were two weeks pregnant when you missed your first period.

Your pregnancy test turned positive about 10 days later.

You may feel nausea (morning sickness) any time of the day.

You may feel tired. Your breasts may begin to feel tender You may urinate more often.

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Do’s- 1st month of pregnancy

Make an appointment to start prenatal care with your doctor as soon as you think you are pregnant.

Check with your doctor or clinic before taking any medicine.

Take your prescribed vitamins. Eat a balanced diet, including cereals and

grains, fruits, vegetables, dairy products and meat and beans.

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Drink six to eight glasses of water, juice, and/or milk every day.

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Don’ts

Avoid x-rays while you are pregnant. Avoid tobacco, alcoholic drinks and other

drugs unless prescribed by your doctor. Limit drinks that have caffeine (colas,

teas, coffee).

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3rd month of pregnancy (signs)

You may have gained about 2 to 3 pounds.

You may begin to feel more hungry. You may be able to feel your uterus above

the pubic bone. Your uterus may harden from

contractions. You may be constipated. You may sweat more. ·You may be happy or sad for no reason.

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Don’ts

Avoid using paints, pesticides and spray cans.

Avoid alcoholic drinks, tobacco, caffeine and other drugs unless prescribed by your doctor.

Take only medicines prescribed by your doctor.

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6th month of pregnancy (signs)

You continue to gain about 3 to 4 pounds a month.

You may develop stretch marks on your stomach, hips and breasts.

You may feel the fetus kicking strongly now.

The uterus may be felt above the navel. Tightening and relaxing muscles in your uterus (Braxton-Hicks contractions) are preparing you for labor.

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Your back may hurt. Wear low-heeled shoes or flats. Your appetite is good. Nausea is rare, though heartburn may

follow heavy, greasy or spicy meals. You look healthy. Your skin has a special glow and your

eyes sparkle.

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Do’s

Exercise can help to prevent backaches. Continue your prenatal checkups with

your doctor as scheduled even if you feel great.

Eat a balanced diet, including cereal and grains, fruits, vegetables, dairy products, and meat and beans.

Drink six to eight glasses of water, juice and/or milk each day.

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Take needed rests lying on your left side. You may be constipated. Continue exercise,

drink plenty of fluids and eat fruits and vegetables

Know the importance of wearing non-restrictive clothing.

Use your seat belt properly. Place the lap belt under your abdomen as low on your hips as possible and across your upper thighs. Position the shoulder belt between the breasts.

Learning how to breathe and relax will help you during labor.

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Don’ts

Don't stand for long periods of time. Don’t wear tight clothes Wear flat & non slippery sleepers. Use ramps instead of staircase.

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7th month of pregnancy (signs)

You may gain weight faster because the baby's greatest growth period has begun.

Your uterus is moving closer to your rib cage.

You may notice kicking against your ribs. You can see your abdomen move as your

baby moves. You may feel awkward and tire more

easily.

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You may feel false labor contractions, also called Braxton-Hicks Contractions.

Your breasts may leak You may notice a loosening in the pelvic

bones when you walk.

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Do’s

Call your health care if Braxton-Hicks Contractions are more than five contractions in an hour.

Practice daily relaxation, breathing exercises and get plenty of rest.

Communicate to your baby each day by talking or singing. Your baby can hear and recognize your voice at birth.

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Plan special times with your partner. Take extra time to do things you want to

do. Think about things you will need the first

six weeks, like convenience foods, paper plates, disposable diapers and/or diaper services.

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8th month of pregnancy (signs)

You may have trouble sitting or lying down for long periods of time.

You may have a problem breathing when the baby pushes against your lungs.

Your uterus is now near your rib cage. You can feel parts of the baby through

your abdominal wall. You may need to urinate more often (as

the baby's head crowds your bladder).

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You may have heartburn. You may sweat more easily. You may have some leakage of colostrum (the

fluid that will feed your baby until your milk comes in) from your breasts as

they begin to produce milk. Your vaginal secretions increase.

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Do’s

Take your prenatal vitamins and iron. Keep up your walking and stretching

exercises. Practice the exercises from your childbirth

class. Practice the relaxation techniques during Braxton-Hicks Contractions (the normal

tightening or releasing of the uterine muscles). Review what happens in labor and delivery. Make financial arrangements with the hospital.

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Call your health care provider

if you have bleeding or a gush of fluid from your vagina cramps stomach pains or a dull backache blurry vision or spots before your eyes a feeling that baby is pushing down, a

noticeable decrease in the baby's movements, or

more than five contractions in one hour.

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9th month of pregnancy (signs)

Your fatigue, lower back aches and false labor pains may increase.

Your abdomen is getting bigger and your belly button may stick out.

You may have mild swelling in your hands and feet.

You may feel pressure low in the pelvis as the baby settles into position for birth.

The Braxton-Hicks Contractions may be more frequent.

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good position for sleeping is on your side with pillows under your tummy, behind your back and between your knees.

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Practices Practices

STANDING POSTURE-STANDING POSTURE- Place foot parallel to floor Place foot parallel to floor Arms perpendicular to floorArms perpendicular to floor Keep neck and head straightKeep neck and head straight

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SITTING POSTURESITTING POSTURE Sit on clean floorSit on clean floor Let your pelvis touch the floorLet your pelvis touch the floor Sit like butterfly style Sit like butterfly style

ON CHAIRON CHAIR Support your pelvis and back with that of Support your pelvis and back with that of

chair’s backchair’s back Put your feet either on floor or short Put your feet either on floor or short

lagged stoollagged stool

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LYING ON BEDLYING ON BED Hard bed preferredHard bed preferred Sidewise lyingSidewise lying 1-2 pillows use under head and knees1-2 pillows use under head and knees

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Dealing with small Dealing with small problemsproblems Cramps Cramps

Taking other persons help put hand parallel to Taking other persons help put hand parallel to feet pushing it towards stomach holding the feet pushing it towards stomach holding the leg tightlyleg tightly

Patient has to put pressure in opposite to the Patient has to put pressure in opposite to the other personother person

Have 3 glasses of milk per dayHave 3 glasses of milk per day

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Varicose veinsVaricose veins

Walk regularlyWalk regularly

After long hours of sitting or standing walk After long hours of sitting or standing walk a littlea little

Exercise of feetExercise of feet

Don’t keep one leg over other Don’t keep one leg over other

Keep your thighs and legs a little highKeep your thighs and legs a little high

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Acidity Acidity

Small frequent mealsSmall frequent meals

Use of pillow under head while sleepingUse of pillow under head while sleeping

Take meal before 2hrs of going to bed at Take meal before 2hrs of going to bed at nightnight

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Constipation Constipation

Take 6-8 glasses of water per dayTake 6-8 glasses of water per day

Early morning take 1 glass ofwarm waterEarly morning take 1 glass ofwarm water

Take more of vegetables like cabbage, Take more of vegetables like cabbage, spinach etcspinach etc

Walk every morning and eveningWalk every morning and evening

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Swelling of hand and feetSwelling of hand and feet

Monitor blood pressure regularlyMonitor blood pressure regularly

Lie towards left sideLie towards left side

Don’t take raw saltDon’t take raw salt

Exercise on timeExercise on time

Wear long socks before getting off the bedWear long socks before getting off the bed

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Sleeplessness Sleeplessness

Walk regularly in the eveningsWalk regularly in the evenings

Have a glass of warm milk before going to Have a glass of warm milk before going to bedbed

Wear loose clothesWear loose clothes

Take less of coffeeTake less of coffee

Use pillow under kneesUse pillow under knees

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FluidsFluids

• Drink plenty of fluids, especially Drink plenty of fluids, especially water, during pregnancy. water, during pregnancy.

• A woman's blood volume increases A woman's blood volume increases dramatically during pregnancy, and dramatically during pregnancy, and drinking enough water each day can drinking enough water each day can help prevent common problems such help prevent common problems such as dehydration and constipation.as dehydration and constipation.

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ExerciseExercise

• Regular exercise can help:Regular exercise can help:• prevent excess weight gain prevent excess weight gain • reduce pregnancy related problems, like reduce pregnancy related problems, like

back pain, swelling, and constipation back pain, swelling, and constipation • improve sleep improve sleep • increase energy increase energy • improve outlook improve outlook • prepare for labor prepare for labor • lessen recovery time lessen recovery time

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SleepSleep• It's important to get enough sleep during your It's important to get enough sleep during your

pregnancy. pregnancy. • Lying on your side with your knees bent is likely to Lying on your side with your knees bent is likely to

be the most comfortable position as your pregnancy be the most comfortable position as your pregnancy progresses. progresses.

• It also makes your heart's job easier because it keeps It also makes your heart's job easier because it keeps the baby's weight from applying pressure to the the baby's weight from applying pressure to the large blood vessels that carry blood to and from your large blood vessels that carry blood to and from your heart and your feet and legs.heart and your feet and legs.

• Lying on your side can also help prevent or reduce Lying on your side can also help prevent or reduce varicose veins, hemorrhoids, and swelling in your varicose veins, hemorrhoids, and swelling in your legs.legs.

• Lying on your left side optimizes blood flow to the Lying on your left side optimizes blood flow to the placenta and, therefore, your baby.placenta and, therefore, your baby.

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DAILY FOOD DAILY FOOD CHOICES DURING CHOICES DURING

PREGNANCYPREGNANCY

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Food GroupFood Group Minimum Minimum Daily Daily ServingsServings

Example of Single ServingExample of Single Serving

Bread, Cereal, Bread, Cereal, Rice, Pasta Rice, Pasta

99 1 slice bread; 1 cup cold cereal; or 1 slice bread; 1 cup cold cereal; or 1/2 cup cooked cereal, rice or 1/2 cup cooked cereal, rice or pastapasta

VegetablesVegetables 44 1 cup salad greens, 1/2 cup other 1 cup salad greens, 1/2 cup other cooked vegetables, 1 cup raw cooked vegetables, 1 cup raw vegetables, or 3/4 cup vegetable vegetables, or 3/4 cup vegetable juicejuice

FruitFruit 33 1 medium apple, banana or orange, 1 medium apple, banana or orange, 1/4 cup dried fruit, or 3/4 cup 1/4 cup dried fruit, or 3/4 cup 100% juice100% juice

Poultry, Fish, Poultry, Fish, Dry Beans, Meat, Dry Beans, Meat, Eggs and NutsEggs and Nuts

22 2-3 ounce cooked lean poultry, fish 2-3 ounce cooked lean poultry, fish or meat; 1/2 cup dry beans, 2 eggs or meat; 1/2 cup dry beans, 2 eggs or 2 tbsp peanut butteror 2 tbsp peanut butter

Milk, Yogurt and Milk, Yogurt and CheeseCheese

33 1cup milk or yogurt, or 11/2 oz 1cup milk or yogurt, or 11/2 oz low-fat cheeselow-fat cheese

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Nutritional Recommendations Nutritional Recommendations for Healthy Pregnancyfor Healthy Pregnancy

• The pregnant women must drink a minimum of 8-10 cups to The pregnant women must drink a minimum of 8-10 cups to water daily. This is needed for clear urination. water daily. This is needed for clear urination.

• Intake caffeinated beverages should be limited during Intake caffeinated beverages should be limited during pregnancy. pregnancy.

• It is always better to avoid carbonated fluids a the time of It is always better to avoid carbonated fluids a the time of pregnancy. pregnancy.

• Fibrous fruits, grains and leafy vegetables should be kept in a Fibrous fruits, grains and leafy vegetables should be kept in a pregnant woman's diet. These are need to avoid constipation. pregnant woman's diet. These are need to avoid constipation.

• Intake of Vitamin is must during pregnancy. However, excessive Intake of Vitamin is must during pregnancy. However, excessive intake of Vitamin A has often led to defective births. So, consult intake of Vitamin A has often led to defective births. So, consult your doctor, before you go in for a particular vitamin. your doctor, before you go in for a particular vitamin.

• The body also requires minerals a the time of pregnancy. The body also requires minerals a the time of pregnancy. • Avoid tobacco during pregnancy. Avoid tobacco during pregnancy. • Wash the fruits and vegetables properly before eating. Wash the fruits and vegetables properly before eating. • It is always better to stay away from the items with fermentative It is always better to stay away from the items with fermentative

effects. effects.

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Certain Foods to avoidCertain Foods to avoid

• Avoid food-borne illnesses, such as listeriosis and Avoid food-borne illnesses, such as listeriosis and toxoplasmosis, which can be life-threatening to toxoplasmosis, which can be life-threatening to an unborn baby and may cause birth defects or an unborn baby and may cause birth defects or miscarriage.miscarriage.

• soft, unpasteurized cheeses like goat, blue cheesesoft, unpasteurized cheeses like goat, blue cheese• unpasteurized milk, juices, and apple ciderunpasteurized milk, juices, and apple cider• raw eggs or foods containing raw eggs, raw raw eggs or foods containing raw eggs, raw

cookie dough, homemade ice cream, raw or cookie dough, homemade ice cream, raw or undercooked meats, fish (sushi), or shellfishundercooked meats, fish (sushi), or shellfish

• processed meats such as hot dogs and deli meats processed meats such as hot dogs and deli meats (unless they are reheated until steaming) (unless they are reheated until steaming)

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References References • Larissa Hirsch, MDLarissa Hirsch, MD- October 2008- October 2008• Maternal exercise Maternal exercise during pregnancyduring pregnancy

, physical fitness, and fetal , physical fitness, and fetal growthgrowth(American Journal of (American Journal of Epidemiology, 1993 - Oxford Univ Press)Epidemiology, 1993 - Oxford Univ Press)

• AI Meleis, LM Sawyer, EO Im, DAKH Messias, K … - AI Meleis, LM Sawyer, EO Im, DAKH Messias, K … - Advances in Nursing Science, 2000 Advances in Nursing Science, 2000

• WHO WHO antenatal care antenatal care randomisedrandomised trial for the evaluation of a new model of routine trial for the evaluation of a new model of routine antenatal careantenatal care-J Villar, H Ba'aqeel, G Piaggio, P -J Villar, H Ba'aqeel, G Piaggio, P Lumbiganon, JM … - The Lancet, 2001 - ElsevierLumbiganon, JM … - The Lancet, 2001 - Elsevier

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