After the embryo has implanted in the lining of your womb, the foetal brain, lungs, central nervous and intestinal systems, start to form. By the end of week six, the embryo measures about 4 MM and the heart starts to beat. At this juncture, an ultrasound scan through the vagina can detect the heart beat and confirm that the pregnancy is in the right location. The fetus is too small to be seen clearly by the abdominal scan at this stage.
The doctor counts in terms of weeks, not months. The "standard" is 40 weeks though babies are considered full term once they reach 37 weeks
The dating scan to ascertain the baby's heart beat and confirm the estimated due date
The head is growning to accomodate the enlarging brain
Eyelids are present in the shape of folds. By the end of week 12, they will meet and fuse, remaining closed until the end of week 24
External sex organs are well diferentiated by week 12
Limbs continue to develo and nails appear on the digits. The moving limbs can be "seen" on a scan but movements cannot be felt yet.
The fetus will go through rapid growth. By week 12, most of the major organ systems would have developed and the fetus measures about 6 CM from head to the buttock. The folloing changes are observed:
Mother's blood is measured for PAPP-A and hcG
Ultrasound:For nuchal translucency(NT) measurement which measures the thickness of the fluid filled area at the back of the baby's neck. Nasal bone (NB) presence or absence is also noted
Hormonal changes during pregnancy which differs from person to person in severity
TipsDue to hormone changes, you may need to take deep breaths and may become more aware of your breathing.
Due to hormonal changes in pregnancy, dizzy spells may occur when brain is not getting enough blood and therefore enough oxygen.
TipsHormone changes may lead to swollen, tender and bleeding gums when you brush your teeth.
Tips
Mild supra pubic pain is a common complaint and may be due to ‘growing’ pains as the uterus enlarges
Tips
You may be able to tell the baby's gender. His/Her limbs are now fully developed and can move vigorously
Hair on the head develops while fine hairs on the body (lanugo) appear
After 24 weeks, the baby is considered to be potentially viable. A baby delivered prematurely beyond 28 weeks has a fairly good chance of survival. By the end of the 28 weeks, the baby should weigh about 1.2 KG
Detailed ultrasound scan (TIFFA Scan) - Between 18-22 weeks to ensure baby is growing well and there are no major physical defects
Blood InvestigationsSensation of fluttery movements inside your tummy as you feel the baby move for the first time, before progressing to kicks usually appreciated anywhere between 18-24 weeks of pregnancy.
Strain on your back caused by the growing belly
TipsProgesterone hormone slows down the digestive system and movement of intestines. Iron Supplements may Worsen it.
TipsDrink plenty of fluids. Eat high fibre foods like whole grain breads, cereals, fruits and vegetables
Growing belly stretching the skin over the abdomen
Tips
Cramps, may be due to the increasing weight of the baby, affecting circulation in the legs
Tips
Side effect of pregnancy, raised red lines on tummy, thighs, breasts and buttocks due to weight gain
TipsKeep skin well moisturised, Avoid rapid weight gain, by eating well balanced diet
Water Retention
Tips
Lanugo starts to disappear and the skin becomes pinkish. The baby appears rounder. His/Her movements are more varied and may alternate between a state of rest and active moving
By now, the baby has fully formed and the head is more proportionate to the size of his/her body. The lanugo would have completely disappeared and the baby’s skin is now smooth
As the due date approaches, the baby’s head will begin to descend into your pelvis – a phenomenon known as “engagement”. The baby’s weight continues to increase such that he/she usually weighs more than 2.8 KG at the time of delivery
Pressure of growing belly initially and then later the baby’s head pressing on bladder along with water retention, may lead to frequent urination
Tips
Hormonal changes and increasing abdominal pressure can lead to lumps at the anus
TipsGradually enlarging uterus pushes on stomach and causes acidic contents to flow back into food pipe
Tips
Extra weight of baby putting pressure on veins causes bluish, enlarged veins on back of calves, legs or thighs
If organization is your style, be sure to pack your bag early by the 36th week or so as to not get flustered about it towards the end. Some may prefer to pack two bags, one for the labour room and one to use after the delivery during the hospital stay
There is no need to stop breastfeeding just because you are returning to work. With a bit of planning, your baby can still be fully breastfed and receive the best nourishment. Here are some tips to help you juggle with resuming to breastfeed:
If you have problems with lactation or are worried, speak to your doctor, lactation consultants or even mothers who have balanced breastfeeding and work
Expressing breast milkYou can express your breast milk manually by using your hands or with a manual or electrical breast pump
How to express breast milk with a breast pump?
| Place of Storage | Recommended Storage Duration |
| Expressed milk at room temperature of 250C | 4 hours |
| Expressed milk in a cooler with ice pack at 150C | 24 hours |
| Breast milk freshly expressed and stored in the fridge at 40C | 48 hours |
| Frozen milk in 2-door fridge stored at -50C to -150C | 3 - 6 hours |
| Frozen milk in deep freezer at -200C | 6 - 12 months |
| Thawed breast milk stored in the fridge at 40C | 24 hours |
Regular, painful uterine contractions starting in the lower back and spreading to abdomen and back of legs. Not relieved by rest, will increase in intensity as well as frequency
Vaginal BleedingMild bloody discharge or ‘show’ – could be due to dislodgement of mucus plug from the mouth of the uterus and can herald onset of labor
Reduced Fetal MovementsThough intensity of rolling movements may reduce as baby grows, frequency should be maintained
Leaking of WaterSudden gush or continuous slow trickle of clear fluid may denote rupture of your bag of membranes
Well now that you are pregnant, you will be likely to get a lot of advice (wanted and unwanted) from all quarters as to what you should eat or not eat, do or do not etc. Some of the advice may be helpful definitely but what we should keep in mind is that each pregnancy is unique and what works for one person may not necessarily work for another.
Additional calories required in the first trimester are minimal if you are a healthy person and even in the second and third trimesters a woman requires only about 300 calories additionally per day (over the 1800 to 2200 cal requirement for non pregnant women). SO…DO NOT EAT FOR TWO.
The extra calories needed in the first trimester will be provided by a glass of milk!!! So do not think that being pregnant gives you license to indulge in whatever you want as you will have to struggle postpartum to lose all the unwanted weight.
Your caloric needs may differ according to your pre-pregnancy weight and health.
Quality rather than Quantity:Eating better is not equivalent to eating more. Making the 300 extra calories count and contribute is what is important as they can come from two doughnuts or an egg and cheese sandwich for example.
Limit intake of junk food, frozen dinners or takeaways as they will provide only empty calories which will make you pile on weight rather than helping the baby grow.
Eating Healthy:It is important to include a variety of foods from the three major food groups, namely:
In addition we should also include,
| Nutrient | What it does | Food Sources |
| Folate | Helps prevent neural tube defects (malformations of the brain and spinal card) in fetuses and anemia in pregnant women | Dark green leafy vegetables, citrus fruits and juices lentils, fortified foods |
| Iron | Aids in the formation of red blood cells and prevention of anemia in pregnant mothers | Red Meat, chicken, eggs, fortified cereals, green leafy vegetables, legumes, nuts and dates |
| Vitamin C | Enhances iron absorption | Citrus fruits and vegetables |
| Calcium | For building baby's strong bones and teeth | Dairy foods such as milk, yoghurt, cheese, leafy green vegetables such as broccoli, kale, spinach, nuts & tofu (calcium-fortified) |
| DHA (Docosahexaenoic acid) | One of the omega-3 fatty acids that is important for brain and eye development | Fish, plant sources including a wide variety of seeds and nuts such as flaxseeds and walnuts |
| Vitamin A | For normal growth and vision | Eggs, milk, red and yellow fruit, red and green vegetables |
| Food Groups | Recommended Numbers of Servings Per Day |
| Rice and Alternatives (Do include the recommended whole-grain serving as part of the Rice and Alternatives serving needs) | 6-7 |
| Whole-grains | 3 |
| Fruits | 2 |
| Vegetables | 3 |
| DHA Meat and Alternatives | 2 1/2 |
| Milk (Do include the recommended milk serving in addition to the Meat and Alternatives serving needs) | 500 ML |
| Rice and Alternatives | Vegetables |
|
|
| Fruits | Meat and Alternatives |
|
|
* Rice bowl ** 250 ML mug *** 250 ML cup ^ 10-inch plate
Some pregnant women take smaller but more frequent meals. If you need a small snacks in between main meals, here are some ideas:
Cereal 'n' milkHave whole-grain cereal or oats with low-fat milk. Top with some sliced fruit
Handful of NutsHave a handful of mixed nuts for a quicksnack or mix some ready-to-eat cereal, dried fruit and nuts in a sandwich bag for a snack on-the-go!
SandwichesToast wholemeal bread and include different fillings (e.g., baked beans, low-fat cheese, an omelette)
Fruit KebabsThread some cubes of different fruit to sticks and serve with a small tub of low-fat yoghurt
Corn-on-the-CobBrush olive oil over steamed corn
Homemade MilkshakeBlend the fruit of your choice with low fat milk for a delicious smoothie
Sundal
| BMI (Pre-Pregnancy) | Recommended Weight Gain (During Pregnancy) | Recommended Weight Gain for Twin/Multiple Births |
| less than 18.5 | 12.7 – 18.1 KG | Discuss with your obstetrician and/or dietician |
| 18.5 – 24.9 | 11.3 – 15.9 KG | 16.8 – 24.5 KG |
| 25.0 – 29.9 | 6.8 – 11.3 KG | 14.1 – 22.7 KG |
| >= 30 | 5.0 – 9.1 KG | 11.3 – 19.1 KG |
Smoking: Not only active smoking, but even passive smoking is to be avoided in pregnancy. Nicotine crosses the placenta, constricting the baby's blood vessels and depriving the baby of oxygen and nourishment. Smoking also increases problems during pregnancy such as miscarriages or premature labor.
Alcohol: Pregnancy is a time when it is better to give up alcohol totally. Drinking excessive amounts of alcohol during pregnancy is known to cause learning disabilities, physical defects, and emotional problems in children. The implications of drinking even the smallest quantities of alcohol are not known. So, our best bet is to be wise and refrain.
Caffeine: There are some studies that suggest that drinking more than four cups of coffee a day may increase the chances of miscarriage. The stimulant caffeine which is found in coffee, tea, soft drinks, and chocolate may interfere with iron utilization. Decaffeinated coffee, herbal tea or fruit juices may be substituted. Drugs and
Do not expose yourself to any medications without consulting with your doctor beforehand. This is because both prescription and over the counter drugs are potentially harmful to the baby in pregnancy.
If you are physically fit and were following a regular exercise routine prior to pregnancy, it should generally be possible to continue with it along with a few modifications throughout the nine months.
Do not try to exceed pre pregnancy levels.
After the first trimester try and avoid exercises that require you to lie flat on your back or stand in one place for long periods of time.
When you exercise remember to drink plenty of fluids to stay hydrated.
Do not over exert yourself and listen to your body if it signals that it is fatigued.
Always perform a few gentle stretches before starting to exercise as this will prevent your muscles from over stretching.
If you are feeling too warm or hot, decrease the intensity of exercise as the baby can suffer developmental harm if the core temperature increases above 100 degrees Fahrenheit.
When doing floor exercises, rise gradually to avoid a sudden, rapid decrease in blood pressure, which may result in a momentary black out.
STOP exercising if you experience dizziness, shortness of breath, vaginal bleeding or abdominal cramps.
The most comfortable exercises for pregnancy are walking, yoga, pilates, swimming, low impact exercises, stationary cycling, tennis or golf. Swimming is one of the best forms of exercise in pregnancy as our weight is supported by the water and it is difficult to strain muscles and joints. Be sure to include exercises for the muscles of the pelvic floor in your daily routine.
K.M SPECIALITY HOSPITAL &
Bloom – Centre for Woman & Child Wellness
No. 453/454, R.K. Shanmugam Salai, K.K. Nagar,
Chennai - 600 078
