What after pregnancy?

Pregnancy is a matter of joy for many women. It is even more joyful when it has been planned, keeping in mind the health of both partners, their career goals, economic stability etc. Pregnancy is often smoother when people are aware of what it entails.

Before planning a pregnancy, a woman should check for her fertility period, get necessary vaccinations and tests (Measles, HIV, Hepatitis B, Syphilis, RH Incompatibility and Rubella) and evaluate risks after taking detailed family history for hereditary diseases such as thalassaemia and haemophilia. There is higher risk of contracting a congenital disease if the previous baby or any other family member already has it and if the woman is older than 35 years.

A woman can check for pregnancy with a home pregnancy test kit, which is easily available in the market. If the test is positive, confirm it with a general physician. It is fairly common for a pregnant woman to experience all/ some/ none of symptoms such as these: vomiting, nausea, aversion or cravings for particular foods, mood swings and irritability, fatigue, dizziness, breast tenderness, increase in vaginal discharge and frequent urination. They may not happen simultaneously but may be spread across the length of the pregnancy. There is no reason to worry. It is also possible that many of these symptoms may not occur.

Pregnancy is a time for a woman to be more in sync with her body. It is important to have a nutritious and balanced diet. Remember, it is not just about the baby, the pregnant woman’s health is equally important!

It is important for the woman to maintain correct posture and protect the feet and joints, wear comfortable shoes and clothes, rest with the feet up, and continue antenatal exercises. It may be a good idea to rest as much as possible and avoid standing for too long and rest the legs. Walking and exercising are considered healthy, and advised for an easier delivery process, unless prohibited by the doctor for health reasons. It is also better to stay away from alcohol, smoking and drugs during pregnancy.

Prenatal visits to the doctor are recommended every 4-6 weeks in the first trimester. Routine blood tests during the first trimester may be done to check for anaemia and immunity to rubella as these can be treated during the course of the pregnancy. It is also recommended to do an HIV test even if the woman is at low risk because detection and treatment of HIV during pregnancy can prevent transmission of the virus to the child. An ultrasound is taken at around 18-20 weeks to check and confirm a due date of delivery, check for twins or multiples and general check-up. Around the 24^th to 28^th week a diabetes test is also administered to identify women who are at a higher risk of having a special form of diabetes called gestational diabetes which develops in some women during pregnancy. Between the 35^th and 37^th week, a prenatal Group B Streptococcus (GBS) test is done to detect a bacterium group called group B in the vagina, urinary opening or rectum, which if present can infect the baby at birth. In case the test is positive, the woman is given antibiotics when she is in labour.

One common question that is frequently asked on the TARSHI helpline is whether it is advisable to have intercourse during pregnancy. Penile-vaginal intercourse is sometimes not advisable in the first three and the last two months of a pregnancy as the foetus maybe dislodged in the uterus. However, pleasure can be given and received through other activities like massaging and touching. The couple can try out different positions as the pregnancy proceeds to see what the pregnant woman is comfortable with, in consultation with her doctor. It is important for any sexual activity to be consensual. Unless there are clear instructions from the doctor to abstain, as in the case of a difficult pregnancy, there is no reason why a woman cannot be sexually active throughout her pregnancy. Activities like mutual masturbation and oral sex may be engaged in until the end of term.

A woman has the right to know about all screening and diagnostic tests that may be advised. If the tests indicate the existence of a particular impairment of the foetus, she has the right to terminate the pregnancy within a safe period. However, please keep in mind that all impairments are not disabling. It is important for a woman to be well informed about drugs, tests and treatments. She has a right to receive information about the pregnancy and the qualifications of those involved in her health care. She has a right to receive all care in privacy, accept or refuse procedures, drugs, tests etc, choose another caregiver in case she is dissatisfied with the present one, be informed about whether she has been enrolled for a research study and have unrestricted access to all records about her pregnancy.

If a woman is pregnant in her late thirties and forties, she may be treated as at high-risk. There is a higher risk of having a baby with Down’s syndrome and there may be other age related conditions such as hypertension and diabetes, but with due care and support many older women can stay healthy during pregnancy and childbirth. Women with chronic illness or disabilities also have the right to make choices as women without disabilities. Pregnancy is not a disease, although it may be a difficult process for some women.

There are many books, websites and videos that provide information about pregnancy. However, they may differ in accuracy and it is important to refer to information that is positive and affirmative of women and pregnancy.

Useful Websites:

www.about.com,
www.gynob.com,
www.innerbody.com,
www.kidshealth.org,
www.maternitywise.org,
www.motherfriendly.org,
www.1to9months.com,
www.tarshi.net