On 11th October 2018, Cloudnine conducted a Facebook Live on The Three Trimesters on its Facebook page @CloudnineCare. It was helmed by Dr Anita Balakrishna, Obstetrician & Gynaecologist at Cloudnine Hospital, Old Airport Road, Bangalore. The interaction, which skimmed various aspects of the three trimesters of pregnancy, saw tremendous participation among Facebook users.
Highlights are included below.
Specialist Details: Dr. Anita Balakrishna
Specialty: Obstetrics & Gynaecology
Clinical Focus and Expertise: Infertility evaluation, infertility treatment, high-risk pregnancy care, breast care, hysterectomy, laparoscopy, sexual health, reproductive medicine
Pregnancy is a significant physiological event – a journey to be cherished and celebrated. However, there are many myths and fears associated with pregnancy, with many women viewing it as a disease rather than a positive physiological development. Pregnancy is divided into three trimesters, with the first trimester lasting the first 14 weeks, the second spanning from week 14 to 28, and the third, from week 28 to 40. If you suspect pregnancy, or if you have missed your period, you can seek confirmation via a home pregnancy test. An obstetrician can then validate your pregnancy by conducting a thorough examination and confirming viability via an ultrasound scan.
A typical pregnancy comprises 4 scans:
To Consult: The Best Pregnancy Doctor in Chandigarh
Live Questions & Answers
Q1. What is the typical sequence of prenatal check-ups?
In the first two trimesters – or until your 28th week – you may be advised to come in every month for a prenatal check-up. After that, you may be required to see your doctor every two weeks until the 36th week. In your last month of pregnancy, you will likely be required to visit every week. These check-ups are done to see if your baby is growing at a normal rate, and to check if there are any medical complications that warrant early intervention or treatment.
Q2. Is slight spotting in the 5th week of pregnancy normal?
Yes, it is normal. You may notice dark brown or starch- coloured spotting in the first trimester. This should settle down by the 12th week. You may be given progesterone support or aspirin tablets to help minimise spotting. You may also be advised a scan to pick up on any abnormalities. In this phase, rest is advised. It is difficult to predict or preempt miscarriage, so you may be asked to come to see your doctor regularly in this trimester. The highest rate of miscarriage is in the first trimester.
Q3. What are the symptoms of pregnancy?
Missed periods are the most common symptom. Other than this, you may feel tiredness, drowsiness, mild back ache, increased urination, gastritis, nausea, increased vaginal discharge and cramps. Cramps mainly occur due to an expanding uterus. Nausea and gastritis usually occur in the 7th or 8th week and often worsen, reaching their peak around the 12th week. They then gradually settle down by the 16th week. If you are persistently vomiting and feel dehydrated, see a doctor.
In the second trimester, you may experience constipation, backache and dizziness. As your baby continues to grow inside you, your body’s calcium demands increase, your ligaments loosen and your muscles start to cramp.
In the third trimester, symptoms like breathlessness, frequent urination and increased pulse rate are common. You may also find it harder to sleep on your back, and prefer to lay on your sides instead.
Q4. What is the ideal pregnancy diet?
Pregnancy boosts your metabolism, so you may feel hungry more frequently. Eating small portions every two hours is a good way to satiate your hunger without gaining excess weight. A sample meal plan is included below.
Sometimes, the long break between dinner and breakfast might lead you to vomit early in the morning, prompting tiredness and exhaustion. This is why it is important to always have a light snack on your bedside table. In addition, it is important to note that morning sickness isn’t just restricted to the morning. In fact, it is often heightened in the evening and continues through the night, which is why regular eating is prescribed.
Q5. What are the dietary supplements to be taken in the third trimester?
Make it a point to have lots of fluids and keep yourself hydrated. A minimum of 5 litres of water over a span of 24 hours will ensure that you don’t feel tired or suffer from constipation. The fruit is a nourishing source of fibre, as a sprout. In the third trimester, your body’s protein requirements increase and it is important to include more wheat and cereals in your meals. Avoid too much rice, as a carb-heavy diet will promote weight gain. It’s best to avoid coffee during pregnancy. However, a small cup in the morning is considered safe. Remember to watch your calorie intake to avoid having your baby be born with obesity issues.
Q6. Can one lose weight during pregnancy?
Excessive vomiting and diarrhoea can sometimes lead to unhealthy weight loss. However, weight gain is usually observed from the 20th week onward. A healthy pregnant woman should gain approximately 2 kilos per month during pregnancy and about 12-12.5 kilos overall. Anything beyond that can lead to complications in delivery.
Must Read: What to Do in Your Last Trimester?
Q7. What are the precautions to be taken in the 8th month?
Be more aware of fetal movements. Count the kicks in your belly for an hour after every meal. At least 4 movements in one hour are considered healthy. Also, take care of your vaginal hygiene. Sexual intercourse is not recommended in the last 6-8 weeks of pregnancy. This is to avoid any rupture of membranes, and in turn, an early delivery. Continue with your prenatal exercises. You’ll find many workshops on Cloudnine, many of which begin in the 5th month. Pelvic floor exercises, stretching, squatting, household work and walking are all good for your body.
Q8. How can I make my delivery easy?
Start by taking care of your health and nutrition. Avoid riding 2-wheelers. Take cars and cabs instead to avoid hypertension and hyperglycaemia.
Q9. Why does my abdomen start aching with upper arm exercises, and what can be done about it?
It is unusual for such pain to occur before the fifth month. However, once the uterus starts expanding down into your ribs, you may experience certain discomfort. Another cause of belly aches is acidity – which is why eating small portions at regular intervals becomes important. If you experience acidity into your 7th month, try having 2 spoons of ice cream at night and walking around for half an hour after every meal.
Q10. I am 6 months pregnant with a single umbilical artery, but all my reports are normal and my baby is healthy. My doctor has suggested Lonopin 40 injections daily. Are these safe?
A single umbilical artery alone does not put your baby at any risk. By the end of your 3rd month, any abnormalities would already have been picked up by your doctor. A single umbilical artery means that your baby only has one artery instead of 2-3, which is not an issue. Lonopin 40 is generally suggested if the doctor predicts a growth restriction.
Q11. Is it safe to roll over in bed in the third trimester?
This is not recommended. You can sleep on your back with your knees folded, or on your right or left, but it’s always advisable to seek some support with your hands while getting up, to avoid sudden abdominal stretches. Rolling over in bed is bad for you and your baby because it can put undue pressure on the abdomen.
Q12. Is intermittent brown discharge normal in the second trimester?
light brown spotting in the first trimester is completely normal. This can sometimes even continue until the 21st week, especially if you have had prior complications. Such spotting generally settles down by the 28th week.
Q13. What are the risks of delivery between the 30th and 40th week? Are there any additional risks if the baby is in a breech position?
A breech position does not pose any risks. A baby could be in this position due to a contracted pelvis, or if the head is too large, or if a fibroid or placenta serves as an obstruction. Usually, it is a matter of time before a baby returns to the head-down position. In a normal term pregnancy, the safest time to deliver a baby is between 37 and 40 weeks. A baby is only delivered before 37 weeks if there are medical complications involved. If your baby remains in the breech position until the end of the 40th week, you may have to opt for an elective caesarean section.
Q14. What are the causes and treatments for leukorrhoea?
Leukorrhoea starts at puberty and persists throughout a woman’s reproductive cycle. It is regarded as a normal physiological process, and completely harmless unless it gives off a foul smell or causes itching. Leukorrhoea is governed by the menstrual cycle, the first half of which is dominated by oestrogen. As a result, a thin, transparent white vaginal discharge is secreted. This discharge aids in conception because it makes it easier for the sperm to swim through the cervical canal. After ovulation, the discharge becomes thick and white. If you notice a discharge that is yellowish or greenish, instead of white, or if it contains any blood, have yourself checked for a vaginal infection. During pregnancy, you may find an increased amount of white discharge, due to elevated oestrogen levels.
Q15. Can a pregnant woman have an occasional glass of wine?
Alcohol, in general, should be avoided during pregnancy.
Q16. How common is breathlessness during pregnancy, and how should one deal with it?
As your baby grows, he or she requires more oxygen for blood circulation. This puts added pressure on your pulse rate, resulting in breathlessness and palpitations.
Q17. Do papayas and pineapples lead to miscarriage?
Raw papaya is not safe for pregnancy as it contains papain and pepsin, which can cause uterine contractions. However, ripe papayas do not pose any harm. There is no scientific evidence to suggest how safe or unsafe pineapples are during pregnancy.
Q18. Can you suggest a good pregnancy skincare routine?
Pregnancy causes pigmentation, stretch marks and redness in the skin. Apply coconut oil and moisturiser regularly to keep itching at bay.
Q19. Is it safe to travel during the first trimester?
Yes, it is fine to travel if your body can take it. If you have had any complications in previous pregnancies, it’s better to wait and travel only in the second trimester. Also, avoid riding bikes in the first trimester.
Q20. Are painkillers advisable during pregnancy?
The only painkiller safe to take is paracetamol. You can use a pain relief spray and get massages to relieve backaches.
Q21. I’ve had vanishing twin syndrome and my doctor has already told me I will have a C-section. However, I want a normal delivery. What should I do?
If your doctor has advised you to have a C-section, it could be due to other factors like hypertension or anything else. However, you can request your doctor to consider a normal delivery before evaluating a C-section.
Q22. Is it okay to eat Chinese food during pregnancy?
Yes. However, try avoiding spicy food as this could lead to acidity, gastritis and vomiting – which could further trigger headaches. If you crave Chinese food, it is a good idea to cook it at home. Homemade noodles with eggs and vegetables are healthy and tasty!
Q23. What multivitamins should be started in the 2nd trimester?
If you maintain a balanced and nutritious diet, you do not need an additional supply of vitamins. The only additional supplements you may need are iron and calcium (up to 1.5 grams each, per day). You may also be advised to take a multivitamin to augment your vitamin B intake. Dry fruit and fish are priceless sources of omega-3 – and must be included in your diet.
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