Dr. Nuzhat Aziz, Consultant Obstetrician, Fernandez Hospitals, Hyderabad, talks about the totally unacceptable stigma and shame heaped on women post pregnancy failure and wishes to clear misconceptions surrounding miscarriage.  

#BabyLossAwarenessWeek #PregnancyAndInfantLossRemembranceDay 

It is noticed that like many western countries, India too, is beginning to observe Pregnancy and Infant Loss Remembrance Day on October 15? What is the significance of the Day?

In the year 2002, Robyn Bear, Lisa Brown, and Tammy Novak campaigned for a movement to declare October 15 as an awareness day for pregnancy and infant loss in USA. The aim was to create awareness, to allow people to join in reflection, support and honour those who have suffered a pregnancy loss or infant death. Pregnancy loss may be a miscarriage, stillbirth, an ectopic pregnancy or sudden infant death syndrome. Loss of a baby is devastating to the woman, to her family and all connected with her. The grief they experience is very different and still not acknowledged as other forms of bereavement. Pregnancy loss and stillbirths are still a taboo in many cultures, we struggle to talk about it. Grieving is a part of healing and acknowledging a person’s grief helps them to recover. The concept of observing October 15th as a Pregnancy and Infant Loss day is to create public awareness on this very important social issue. A parallel concept of lighting candles, all monuments lit up at 7 pm was added as the Wave of Light in the year 2004, allowing every individual to take part and join in promoting the campaign.

What is the most common cause of loss of pregnancy?

The most common causes of pregnancy loss differs with the phase of pregnancy. Early miscarriages have genetic abnormalities as a major cause but late pregnancy losses are due to hypertensive disorders, diabetes, fetal growth restriction as major reasons. Neonatal deaths have decreased significantly in the past few years. In developing countries, we still find labour related causes, infection as the main cause of neonatal death.

What are the main causes of Sudden Infant Death Syndrome (SIDS)?

Sudden Infant Death Syndrome is a sudden, unexplained death of a baby. Limited to less than a year of age. The causes are not known, for it happens suddenly in a healthy baby. Few conditions that are found to be associated are baby sleeping on tummy face down position, too soft mattress or fluffy toys, overheating during feeding, previous history of SIDS, mothers who smoke. It is important for mothers to know the best sleeping position, in a place where they can keep a watch on the baby, not feed the baby lying down in bed (when the mother might fall asleep).

What is the rate of miscarriage in India?

The reported incidence in literature stands between 10 to 30% but 15% is the accepted miscarriage rates across the world.

What is the psychological and emotional impact of pregnancy loss, particularly faced by women?

Women are scarred for life by a pregnancy loss. The hope of a baby playing in her arms builds-up with a positive pregnancy test. Pregnancy failure at any point of pregnancy shatters that hope and they experience the worst emotional trauma of a baby’s death. This grief lasts for a long time, and depends on multiple factors and on the emotional support she receives.

There is plenty of shame, stigma and self-blame linked to failed pregnancy. To what extent is a woman responsible?

There is no way a woman can ever be responsible for pregnancy failure. Women blame themselves when a loss occurs- especially in the early weeks of pregnancy. They seem to link intercourse, work or travel as a cause of the miscarriage. It is the responsibility of healthcare workers, her family to negate these feelings. We need to keep reinforcing at every visit that it was NOT her fault.

What is the best way to manage negative symptoms surrounding a miscarriage?

Society has a huge role to play along with her family as she grieves through this loss. Training in bereavement counselling allows healthcare teams to be sensitive, to use appropriate words. Every woman, couple grieves differently. Giving them time, listening to them allows one to look for a need for specialist help. Some may require psychological support and may benefit from referral to psychologist or psychiatrist.

Why is it important to talk and have an open expression about pregnancy loss and miscarriage?

We humans need support, we recover faster when we have family and society support. Death of an adult is followed by emotional support from everyone around us. But when a stillbirth or a miscarriage occurs, its taboo, its hidden and not disclosed. I know several women who left their hometown to escape questions about pregnancy after a baby loss. We hope that having a day of remembrance on October 15 will open these issues, allow couples to talk about their pregnancy loss, educate all on how to acknowledge this grief and facilitate healing.

Why do you think women are not adequately informed and supported by health care professionals following pregnancy and infant loss?

During our training we were not taught how to help individuals who experience any form of loss. As a young obstetrician I know I was not sensitive to the emotions of women and couples as I am today. At Fernandez we invest in “bereavement counselling” and train our residents, nurses and midwives on how to work with mothers who experience loss. Many of us need to learn about silence too. Some women need that space before they start sharing. We need to learn the cues on when to talk and not plug the silence. We simply need to raise awareness on this – among the women and in our own fraternity.

Do you think psychiatric issues following a prenatal loss can be resolved with the birth of a subsequent healthy child?  

Each woman grieves differently, has different coping mechanisms. Many have anxiety, depression for varied periods of time. Couples find it difficult to go through the next pregnancy. Many triggers keep stimulating these emotions. Grieving women experience flashbacks as they visit the hospitals again, or every time the fetal heartbeat in a subsequent pregnancy is heard. When they have a subsequent healthy baby, they do become occupied with baby care. The psychological trauma is lifelong. I remember my friend, who first visited us for a second pregnancy after a first stillbirth. She had a subsequent healthy baby. I can never forget her words. She said every time she sees a 4 year old baby she keeps thinking her baby would have been playing this way (she had a loss 4 years ago). “I always say I have two kids, one is with God” Hence all preventable pregnancy losses should be prevented, to create better families, better society.

How long is recommended a woman should wait following miscarriage before conceiving again?  

We would advise women to plan after evaluating all preventable causes of miscarriage, when she feels she can go through another pregnancy. We suggest after two to three menstrual cycles, but it is absolutely fine if they conceive sooner. There is no scientifically proven time period that is said to be the most appropriate interval.

What are the chances of losing a baby after miscarriage?  

After one miscarriage, the chances of a miscarriage do not increase. The risk increases if a woman has recurrent miscarriages (three consecutive pregnancy losses).

Could stress and lifestyle choices contribute to miscarriage and pregnancy loss? 

Many times, stress is unavoidable. It is important we do not use this as a reason for pregnancy loss because women will experience incredible guilt. Lifestyle choices yes can have an impact; smoking, alcohol, risk behaviour can be modified. Obesity is one important association that can be modified through lifestyle change.

Is there any link of preventing miscarriage to pre-conception planning? In what cases is pre-conception planning advised?  

Preconception counseling or consultation is very important. I would suggest all women to have pre-pregnancy counseling. It allows for a review of her medical history, to optimize medical conditions like thyroid or diabetes or hypertension, to change to safe medications if necessary. It is also used to screen for common medical conditions, and start preconception vitamin folic acid supplements. Folic acid deficiency is known to cause birth defects. We check for vaccination status like Rubella, Covid these days, as it’s always better to plan pregnancy after vaccination. All miscarriages may not be preventable, but those due to preventable factors can be.

What are 5 warning signs of a possible problem during pregnancy?  

1.Bleeding in early pregnancy

2.Abdominal cramps which are rhythmic and regular

3.Decreased fetal movements

4. Hypertension

5. Diabetes.

Disclaimer: This is a reposted article, originally published in *PatientsEngage, on 13th October 2021

Pregnancy can be a roller coaster ride, especially when managing nutrition with essential fat intake, antioxidants, proteins and keeping food cravings in check. More so if you have been diagnosed with gestational diabetes. However, the good news is that you can sustain a healthy pregnancy by keeping your blood sugar levels in check through proper nutrition, daily physical activity and working closely with your doctors (obstetrician endocrinologist and dietitian). The objective is to follow a meal plan that is easy, manageable, keep your blood sugar low, and leaves you stress-free.

What is Gestational Diabetes?

Gestational diabetes is a condition that occurs during pregnancy and in most cases, disappears after childbirth. In this condition, the mother experiences high blood sugar levels. Hormonal shifts during pregnancy can reduce insulin effectiveness,  meaning glucose levels stay high in the blood instead of being taken to the cells for energy. Approximately 4 to 14 out of 100 pregnant women develop gestational diabetes. The risks of gestational diabetes can include complications for mom and baby – a large baby can increase the risk of needing a cesarean section, and uncontrolled blood sugar may put the mother at higher risk of high blood pressure. Medical Nutrition Therapy is the first step in the management of this condition. A balanced diet with optimum calories is essential. The goal is to gain weight according to prenatal BMI, avoid excessive weight gain, and control blood sugar levels.

Here are 7 must-eats to include in your Gestational Diabetes Meal Plan…

1. High-fibre foods/Complex Carbs

• Include whole grains, fruits, and vegetables in your daily diet to ensure adequate fibre intake. Include one serving of whole beans and legumes like moong, moth, chana, rajma, lobia, green peas etc.
• A variety of cereals and millets with high-fibre content are recommended. You may prefer brown rice, whole wheat, and millets like jowar, bajra, foxtail etc.
• Take a blend of wheat flour and soya bean flour OR wheat flour and roasted channa flour in the ratio of 4:1 to improve the protein quality. Avoid all refined, processed grain, maida products and bakery products.
• You may enhance the fibre content by blending cereals and millets or by adding vegetables in cereals and millets as in the preparation of vegetable – rotis, rice and porridge.

2. Protein-rich food

Vegetarians may prefer milk, yoghurt, cheese, beans, pulses, soya nuggets, tofu, and paneer. Non-vegetarians can include eggs, fish, and chicken. It is preferable to use low-fat milk-toned (3% fat) or double toned (1.5% fat).

3. Vegetables

Vegetable salads must be a part of your daily diet. Your diet must include green leafy vegetables, cucumber, tomatoes, carrot, peppers, lettuce, spinach, cabbage, cauliflower, brinjal, capsicum, bottle gourd, ridge gourd. Avoid potatoes, sweet potatoes, colocasia, beetroot and yam.

4. Fruits

Fruits offer a great variety of vitamins, nutrients and fibre and can be consumed daily as a snack. The options are endless: sweet limes, oranges, guava, musk melon, apples, papaya, kiwi, watermelon, etc.

However, they must be consumed in quantities as prescribed by a nutritionist and must be consumed as whole fruits and not fruit juices

5. Nuts & Oil seeds

Nuts and oil seeds like flax seeds, almonds, walnuts, and groundnuts can be a part of your diet in quantities prescribed by the nutritionist. Avoid coconut or groundnut chutneys.

6. Cooking oil

Make sure to use oil in limited quantities – 2 tablespoons or 30ml of oil per day is recommended.

Preferably use groundnut, rice bran, til or soya bean oil. Limit saturated fats like full-cream milk, dairy cream, ghee, salad dressing, red meat etc.

7. Fluids

Take fluids in plenty and do so frequently. The minimum intake should be 2-3 litres per day. Tea and coffee consumption must be in moderation.

Gestational diabetes is manageable with timely intervention and medical nutrition therapy. Apart from having a dedicated meal plan, it is important to adhere to scheduled meal timings. It is recommended to eat small frequent meals every 3 hours. Avoid all types of sweeteners even honey, jaggery and sweets and desserts and all high fats, salts, and sugars (HFSS). Observe control on serving size, as a greater quantity of food intake can raise blood sugar. 45-minutes of daily physical activity is a must. You may do so with small breaks and break it up into 10–15-minute sessions half an hour after every meal.

To summarize, the four key factors in the management of blood sugar are meal timings, the quantity of food, quality of food and physical activity. A healthy and safe birth experience is possible even with gestational diabetes.

Please consult with your nutritionist to develop a diet plan that is customized to your nutritional needs.

3 healthy recipes, just for you!

 India is presently fighting a war against malnutrition and in a bid to promote “balanced diet”, the entire month of September is celebrated as National Nutrition Month. It is the most awaited time of the year for all practicing Dietitians- nutritionists in India to conduct and use various forms of media and programs to emphasize the importance of nutrition

A qualified Dietitian-Nutritionist is trained to provide customized dietary advice. Every diet prescription is based on an individual’s anthropometry, biochemical, clinical, and dietary profile. We also look at the socio-economic status and the affordability to provide nutrition advice. It’s not true that only exotic fruits or grains have great benefits! The locally available seasonal foods are what provides the best nutritional benefits. So, one can always go local for poshan.

When we talk about a healthy diet for pregnant women, we suggest the following:

• Eating healthy during pregnancy is crucial for both mother and her baby. Sometimes cravings hit you and you end up eating foods that you have been avoiding the whole
• Using the right combination of food groups plays a major role in providing the balanced nutrition for the better growth of the baby
• Balanced diet requires inclusion of varied food groups that provide all essential nutrients like complex carbohydrates, proteins, vitamins, minerals
• A balanced wholesome diet should include three major meals and 2-3 smaller meals (health snacks) to meet the day’s nutritional
• The healthy snacks in between major meals help distribute the calories and promote better digestion and absorption of nutrients
• Snack on foods that that are rich in protein, calcium and fibre that is going to keep you full for a longer period and to meet the nutrient gaps in the major meals

 From the Department of Clinical Nutrition and Dietetics, we thought of bringing to you some easy and nutritious recipes that will cater to your snacking needs.

#1 Mexican Gram Chaat

When we think about grams it’s not always boring! Mexican gram chaat recipe is a good blend of complex carbohydrate, protein, and fibre with loads of antioxidants that helps in managing your cravings without cutting down on taste!

Ingredients

Boiled black eyed bean/lobia-20gms

Black chana – 20 gms

Rajma -20gms

Sweet corn-10 gms

Cucumber diced (with skin, no seeds) -10gms

Tomatoes diced (without seeds)-10gms

Coriander -chopped

Crushed pepper – to taste

Salt – ¼ tsp

Method

• Soak all the grams/legumes overnight
• Pressure cook all grams/legumes (with salt) along with sweet corn and keep aside
• In a bowl toss all cooked grains with tomatoes, cucumber, and seasoning (salt and pepper). Mix well
• Garnish with chopped coriander and serve with a fresh lemonade.

Total no. of servings: 2

NUTRITION FACTS -per serving

Calories -115 kcal | Protein-6.5gms | Carbohydrate- 22gms | Fibre -5gms

Ideal category: Moms-to-be, Breastfeeding moms or for someone looking for snacks rich in protein or fibre

 

#2 Thalipeeth

Traditional Indian foods are also a treasure trove when it comes to nutritional values. While talking about traditional food, let us introduce this Maharashtrian wonder- Thalipeeth.

The flour for thalipeeth is called bhajanee!! The flour is prepared from roasted grains, legumes, and spices. The rest of the  ingredients include grains such as rice, wheat, bajra and jowar , legumes such as chana, and urad and spices, most commonly coriander and cumin seeds.

This traditional recipe has a twist of its own. Healthy fibre and protein-rich millet thalipeeth is a guilt-free snack which replaces your regular munching. It is a good breakfast option too!

Ingredients

Jowar flour -60gms

Onion -1tsp of (finely chopped)

Coriander leaves – few (chopped)

Jeera -¼ tsp

Sesame seeds (roasted) – ¼ tsp

Green chilies -2 nos (finely chopped)

Salt to taste

Oil -2.5ml

Method

• In a bowl take jowar flour, add onions, coriander, green chilies,
• Mix everything well then add water in parts so that it forms into a soft smooth dough
• Take a thick butter paper and brush with oil. Take a small portion of dough and flatten it on butter Gently press with your fingers and flatten the dough to get a flat bread. While flattening, sprinkle a few drops of water also on the dough.
• Spread a bit of oil on the The tawa must be hot. So, you can keep it on medium to high flame. Regulate the flame as required.
• Lift the butter paper and gently place it with the thalipeeth side touching the
• Now carefully peel the butter paper from the rolled thalipeeth
• Sprinkle some oil on thalipeeth. Cover with a lid and let the thalipeeth cook for 2 to 3 minutes or until the base is golden and You can brown the base more if you want.
• Remove and serve the thalipeeth hot

Total No. of servings: 2

 NUTRITION FACTS -per serving

Energy-193kcal | Protein-6 grams | Carbohydrate-43 gms | Fibre-2.7gms | Iron-3.18gms

Ideal category: Pregnant Diabetics, Type II Diabetics, Anemics, Menopause, Elderly, Weight Loss

 

#3 Paneer Salad

Try this super healthy salad rich in antioxidants and protein as a refreshing mid-morning or evening snack which will take care of your hunger providing you with a combination of healthy fibre, protein, and vitamin C!

Ingredients

Paneer-30gms (slightly sauteed)

Cucumber -50gms

Carrot -20gms

Bell peppers-20gms (Red, green, yellow)

Olives- 10gms

Lime vinaigrette dressing -5ml (Olive oil -1tsp+ Lime – 1 wedge)

Salt and pepper to taste

Method

Mix all the ingredients in a bowl along with lime vinaigrette and salt and pepper. Serve.

Total No. of servings: 1

NUTRITION FACTS -1 serving

Energy: 103.5 kcal | Protein:2.8gms | Fat :3.7gms | Carbohydrates: 4.gms

Ideal category: Moms-To-Be, Weight Loss, Morning Sickness, Diabetes, Hypertension

Try these recipes at your home and do not forget to leave your feedback! How did you find our ordinary recipes to add an extraordinary benefit to your daily routine? Have wonderful, nutritious, healthy days all through the year!!

Pregnancy changes your body in many ways. A healthy pregnancy diet should include a well-rounded first-trimester diet plan as well as vitamin and mineral supplements to ensure that the baby is receiving the correct balance of nutrients required to grow healthily. It is also important to note that in the first trimester, your baby is quickly developing some of the most vital organs —  brain, spinal cord, heart, arms, and legs.  It is essential to consume the right foods, so that you and your baby both stay healthy.

To meet the nutrient requirements essential for good health, you need to eat a variety of foods from each of the five food groups daily, in the recommended amounts. Here are 5-nutrient-rich foods to include in your first-trimester diet plan: 

1.Cereals

8-9 servings of cereals should be consumed per day of which a major portion should be whole grains. Whole grains have more vitamins and minerals than processed grains, as well as fibre. Fibre helps in maintaining proper bowel function and lowers the risk of developing constipation. You may consume it in the form of brown rice, whole wheat, broken wheat, millets (ragi, jowar, bajra, foxtail, millets, quinoa), oats, and whole grain bread

2.Pulses/Legumes & Meat/Fish/Poultry

Focus on having 2- 3 servings every day. You may include chicken & fish (lean meat), whole eggs, beans/legumes/sprouts (Bengal gram, green gram, kidney beans, black beans, black-eyed beans, peas etc.), lentils/pulses/dals and soybean products. Inclusion of a cereal -pulse blend enhances the protein quality. Take a blend of wheat flour and soya bean flour or wheat flour and roasted channa flour in the ratio of 4 :

3.Dairy Products

As dairy products contain calcium and protein, 5 servings (each 100ml ), approximately 500 ml per day are necessary during the first trimester. Calcium is needed for the healthy development of the baby’s teeth and bones. You may consume low-fat or non-fat dairy products like cheese, yoghurt/curd, milk and paneer.

4.Vegetables & Fruits

You must have around 3.5  servings of vegetables daily. Vegetables contain essential vitamins like folate and minerals like iron and fibre. You can include vegetables like spinach, amaranth, gogu, fenugreek, tomatoes, sweet potatoes, carrots, pumpkin, gourd, squash, cauliflower, capsicum/ bell peppers, green beans, broccoli, corn, and peas. Daily consumption of fruits is necessary during the first trimester.  Whole fruits provide fibre and are preferable in comparison to juices. Fruits are a rich source of vitamin C, fibre, folate, vitamin A and potassium. We recommend oranges, sweet lime,  guava,  apples,  bananas, grapefruit, melon, berries, ripe papaya, pomegranate, watermelon. Make sure to include at least one vitamin C rich fruit in your daily meal plan.

5.Fats and Oils
Limit intake of foods containing saturated fat  and  include healthy fats to your plate. Total quantity of cooking oil to be used is 5-6 teaspoons (30 ml) per day. Preferably use plant based oils (groundnut, rice bran, sesame ,soya bean oil, sunflower,corn or olive oil. Include nuts such as cashew nuts, walnuts, almonds, pistachios, groundnuts, flaxseeds and sesame seeds(til) that are good sources of essential vitamins, minerals, fibre and essential fats (MUFA & omega -3 fats) in your diet. Other sources of healthy fats are avocado and some types of fish like salmon, herring, tuna( Have 1-2 servings a week  of these fish to get essential omega-3 fatty acids.)

The recommendations are based on Dietary Guidelines for Indians, ICMR, 2011.  Number of portions will vary if a woman has BMI > 35 kg/m2 or < 18 kg/m2.

Nausea and morning sickness during the first trimester can make it difficult to eat but you must try your best to. Proper nourishment can lower the risk of postpartum complications. A healthy balanced diet during pregnancy should be rich in good quality proteins, essential fatty acids, iron, calcium, B complex vitamins and vitamin C with optimum calories. Folic acid is especially important during the first trimester. Although weight gain during pregnancy is normal it should be based on your pre-pregnancy body mass index (BMI). There’s no weight gain recommended in the first trimester; a healthy weight gain is recommended in  second and third trimesters. If you are starting pregnancy at a healthy weight, a weight gain of 0.42  kgs per week is recommended  in the second/third trimester. The focus is on having a balanced and nutrient-rich diet.

Pregnancy brings with it great many food cravings. While we wish we could live on cakes and other delicacies forever, it is also important to consume a healthy dose of immunity-boosting foods. Pregnancy is known to weaken a mother’s immune system, which makes the moms vulnerable to infections like common cold, UTIs, Covid-19 etc. Prevention is better than cure. Since most medication is to be avoided during pregnancy, catching an infection can be somewhat daunting. Luckily, nature has provided us with an abundant supply of “Immunity-boosting foods” that help our bodies stay strong from within.

Here is a food list of 6 superfoods that you can include in your pregnancy diet.

1. Garlic
   Research suggests that the antimicrobial allicin found in garlic is known to strengthen immunity and decrease the risk of developing common cold. Garlic is also great for gut microbiota and is, therefore, a highly recommended superfood.
2. Milk
   Lactoferrin is a compound found in milk that boosts immunity by interrupting the interactions between viral cells and body cells to lower the impact of viruses on the body. Expecting mothers can consume dairy in the form of buttermilk, ghee, yoghurt, whole milk etc for a steady dose of calcium.
3. Vitamin C- Rich Foods I
   t is well-known that vitamin C is vital for a healthy immune system, but it is important to note that we only need moderate amounts of it. Many fruits and veggies are rich in vitamin C: oranges, guava, kiwi, strawberries, spinach, broccoli, tomatoes. Two of our favourites are Guava and Kiwi fruit, both rich sources of Vitamin C. One kiwi provides around half of your daily vitamin C requirements, and it is much more delicious than a tablet!
4. Vitamin E- Rich Foods
   Vitamin E helps with cognitive function and development. Mixed nuts and oil seeds are powerful sources of antioxidants that help protect your immune cells from damage. Food rich in vitamin E are almonds, olive oil, sunflower seeds, hazelnuts, peanut butter.
5. Zinc Rich Foods
   Zinc plays an important role in maintaining our body’s immune system. Low levels of zinc can lead to a higher susceptibility to various infections. Zinc is found in a variety of foods- whole grains, milk products, lean meats, poultry, eggs, seafood (oysters, shellfish), beans, chickpeas, nuts (such as cashews and almonds), seeds and soy products. Take your pick!
6. Gut-Friendly Foods
   Eating foods rich in probiotics, such as carrots, sweet potatoes, bananas, oats, barley, legumes, nuts maintain a healthy gut microbiota. This is essential to prevent constipation, a common pregnancy concern. A healthy gut equals better immunity.

Overall, just remember that a balanced nourishing diet containing whole grains, lean proteins, dairy products, nuts /seeds and fresh fruits, veggies together serve as the best recipe to boost immunity during pregnancy.

Consult the qualified dietitians at Fernandez Hospitals to build an optimal, nutritious diet plan based on your specific pregnancy needs.

Lockdown Time? – That doesn’t sound right. We’d rather say: “Quality Time!”

We can either look at the glass as half full or half empty. It is the best of times, it is the worst of times. That’s how the pandemic has been. A mixed bag of everything. From crisis to opportunity. From tragedy to triumphs. Somehow, each one has been sailing through – trying to survive, staying safe and keeping up the hope.

Particularly, if you are an expectant parent, it sure is a different dimension for you. This time of your life is evidently the most exciting one, and it sadly collides with the global pandemic and the subsequent lockdown. I’m sure you had several plans to spend this special time outdoors. But here you are, confined to your home. Is it really that sad, though? Not really!

As parents-to-be, you should consider this time as a rare and extraordinary opportunity. You wonder, “How?” Well, picture this: under normal circumstances, you would have been working, probably exhausted and stressed out by the end of the day with little or no scope of having value-added time. Now, with you being home, you have plenty of time at your hand. You can use this time positively to create a lasting and permanent effect on your soon-to-be-born child. After all, this journey is a joint enterprise between the three of you.

Positivity, first!

Firstly, the aura of positivity in this relationship is something that the two of you can create. It is for  both of you to decide what you want to offer to your child, who is a silent but active participant in your relationship now. Because of the tough times we are in, it is natural to respond with panic and stress. But remember that your baby growing in the womb internalizes these emotions and responds accordingly. Your unborn baby experiences and understands love, joy, closeness and warmth. It also understands fear, anger and frustration. It is up to the both of you to decide what you want to offer to your baby.

Invest in yourself.

Mommies, this is the time for you to pamper yourself and practice some self-love. This will help boost your confidence, self-esteem and it will help you enjoy the effects of oxytocin.

Baby bonding time.

Here are a few ways to “tune in” and connect with your baby:

* Sing/listen to music. This is a great way of relaxation. You could listen to some quiet chants, sounds of nature, instrumental music or any other soft music you resonate with.

*  Have daily conversations with your baby. Tell your baby that he or she is wanted, loved, and welcomed. Read stories and speak out lines of positive affirmations.

* Start a scrapbook. Write a baby journal or create a scrapbook and pen down your thoughts and feelings during this time. This could include the various names that you are considering for your baby and anything else you want to communicate. It can also include your pregnancy photos and pics of other important people in your baby’s life. You could also write letters and share them when your baby gets older.

*  Both of you can record messages to your baby..

* Decorate your baby’s room together. This is a very good pre-birth bonding activity.

* Massage is a great way of relaxation. Whether it is a gentle tummy rub or a light touch massage by your partner, do it more often to comfort and reassure each other.

* Exercise and staying fit helps in building up your endorphins which will help you during your labour and birth. Maybe you can alternate between light and moderate physical activities that each of you love.

* Calm down and enjoy some quiet moments and practice your breathing techniques during this time to connect with your baby.

Surround yourself in a cocoon of love, joy, peace and happiness as never before and watch your baby reciprocate to you. Make the best of this time.

 

Anaemia is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet the needs of the body.  Anaemia may be caused by
i) blood loss; ii) decreased red cell production; or iii) increased red cell destruction.

The diagnosis of anaemia is based on the haemoglobin concentration in the blood. Haemoglobin is the protein in the red cells that carries oxygen to the tissues. Iron is required for the synthesis of haemoglobin. In addition, vitamin B12 and folic acid are also needed to produce red cells. A lack of any of these can lead to anaemia, the most common being iron-deficiency anaemia. Requirements for iron in pregnancy are three times higher than in non-pregnant women and the requirement increases as pregnancy advances. Worldwide, one third of pregnant women are anaemic.

Following conditions put the mother at a greater risk of anaemia:

• Pre-pregnancy anaemia
• Malnutrition
• Inadequate spacing between pregnancies
• Pregnancy with twins or triplets
• Inadequate iron supplementation

All pregnant women should be screened for anaemia. If anaemia becomes severe, it might be harmful to the mother as well as the baby. Poor work capacity, susceptibility to infection, heart failure, premature and low birth weight babies, excessive bleeding after delivery are some of the complications associated with anaemia in pregnancy.

Here is how you can prevent and treat anaemia:

• Ensuring normal haemoglobin level before conception
• Iron-rich foods: dark green leafy vegetables, red meat, eggs, peanuts, dried beans and peas, iron-fortified foods, dried fruits such as apricots and raisins. It is advisable to take a pregnancy specific diet.
• Pairing iron-rich food or iron tablets with a food or drink high in vitamin C (lemon juice, citrus fruits, or strawberries) can enhance the absorption of iron
• Calcium, on the other hand, decreases iron absorption and should not be taken in combination with iron-rich food or tablets
• Folic acid and vitamin B12 should also be supplemented if found deficient
• Women who are intolerant to oral iron tablets may be advised iron injections

• Women suffering from severe anaemia may need blood transfusion

While most of us enjoy a good night’s rest of clean 8 hours, pregnancy can be a time of sleeplessness, discomforts, and health issues. Sleeplessness, snoring, nausea, morning sickness, leg cramps, heartburn etc. are some common problems that affect almost all pregnant women. Due to the lack of sleep, most expectant mothers suffer from fatigue or a sense of feeling low etc. As the pregnancy progresses, women find it difficult to sleep due to uncomfortable sleeping positions. Each trimester brings in different types of sleep problems.

Here are ten tips that will help enhance your sleep quality:

• Minimize fluid intake before bedtime: It is very essential for a pregnant woman to remain hydrated. So, drink plenty of water during the day and cut down your fluid intake before going to bed. This will minimize frequent urinations during the night.
• Exercise regularly: To improve circulation of blood, it is very essential to keep moving. You can do pregnancy exercises under a trained pre-natal expert. Proper circulation of blood will reduce leg cramps letting you sleep well at night and elevate your mental health.
• Drink warm milk: Studies have shown that drinking a glass of milk before going to bed provides good sleep.
• Have nutritious food: Foods rich in carbohydrates help in promoting sleep. Eat a healthy and well-balanced diet throughout your pregnancy.
• Avoid heavy meal: Before going to bed, avoid having a heavy meal. During the day, have small meals but frequently.
• Avoid caffeinated drinks: During pregnancy, it would be best to avoid caffeinated drinks, alcohol etc. Besides ensuring better sleep it will also be good for your baby’s health.
• Take a warm bath: Before going to bed indulge yourself in a warm bath. It will help you feel refreshed and sleep properly.
• Use pillows: You can use pregnancy pillows while sleeping. Lot of pillows help create cushioning and padding for comfort.
• Relaxation techniques: Use relaxation techniques at home or join yoga or birthing classes to learn other relaxation techniques to improve your sleep.

• Sleep in comfortable positions: Try to sleep comfortably and after the 20th week of pregnancy, sleep on the left side to ensure proper circulation of blood to the placenta.