Be­com­ing a moth­er can be one of the most ex­cit­ing times of a woman's life; how­ev­er it can al­so be one of the most stress­ful. Preg­nan­cy is a time of great change. You may ex­pe­ri­ence many phys­i­cal and emo­tion­al changes which can be con­fus­ing and dis­tress­ing. It can al­so be a chal­leng­ing time for your part­ner. Your part­ner may be un­cer­tain about how to help dur­ing preg­nan­cy, be con­cerned about fi­nan­cial mat­ters and how your preg­nan­cy may af­fect your re­la­tion­ship.

By know­ing what to ex­pect, what to do and what NOT to do, a cou­ple can feel more em­pow­ered to make healthy choic­es dur­ing their preg­nan­cy. Be­low are some com­mon ques­tions that pa­tients have about preg­nan­cy.

How will I know if I am preg­nant?

The symp­toms of preg­nan­cy vary from woman to woman and even from one preg­nan­cy to the next.

�2The most com­mon in­di­ca­tor that you may be preg­nant is that you miss your pe­ri­od. Some women can bleed while they are preg­nant, but typ­i­cal­ly the bleed­ing will be short­er or lighter than a nor­mal pe­ri­od.

�2Your breasts may be ten­der to touch, sore or swollen. You may al­so no­tice that you feel more tired than usu­al.

�2 Nau­sea (feel­ing up­set) and vom­it­ing may start 2 to 8 weeks af­ter be­com­ing preg­nant.

�2 Pass­ing urine more of­ten than usu­al is al­so a com­mon symp­tom of preg­nan­cy.

�2 If you think you are preg­nant the first step is to do a home urine preg­nan­cy test. Most preg­nan­cy tests can­not de­tect preg­nan­cy un­til one week af­ter your missed pe­ri­od so if you do one ear­li­er than this and get a neg­a­tive re­sult, you should re­peat it a few days lat­er.

�2 If you are preg­nant or are un­sure about the re­sult you should vis­it your doc­tor. A blood test can al­so be done to de­ter­mine if you are preg­nant.

What can I do to avoid/help "morn­ing sick­ness"?

Al­though com­mon­ly re­ferred to as "morn­ing sick­ness", the nau­sea and vom­it­ing of preg­nan­cy can oc­cur at any time of the day- not just the morn­ing. There are sev­er­al lifestyle and di­etary changes that can help.

�2 As soon as you wake on morn­ings, have a few crack­ers and then rest for about 15 min­utes be­fore get­ting out of bed.

�2 Eat small fre­quent meals in­stead of 3 large meals for the day. Avoid spicy, fat­ty and fried foods. It is best to stick to foods which are high in car­bo­hy­drates such as bread and crack­ers.

�2 The age old rem­e­dy of gin­ger tea has ac­tu­al­ly been proven to help de­crease the nau­sea and vom­it­ing of preg­nan­cy. Gin­ger cook­ies and crack­ers may be just as ef­fec­tive.

�2 If you are vom­it­ing it is im­por­tant to stay hy­drat­ed. Try to drink small amounts of flu­ids of­ten. Wa­ter and co­conut wa­ter are good. Try to avoid high­ly car­bon­at­ed (bub­bly) drinks, sug­ary drinks and milk.

�2 If you can­not tol­er­ate flu­ids, or vom­it blood you should see your doc­tor as soon as pos­si­ble. There are a num­ber of med­ica­tions that can be used that are safe to both you and your de­vel­op­ing ba­by.

What Vi­t­a­mins should I be on?

�2 If you are plan­ning to be­come preg­nant or as soon as you know that you are preg­nant you should start us­ing Folic acid. Folic acid is a Vi­t­a­min which helps de­crease the risk of the ba­by de­vel­op­ing a de­fect in the spinal cord. Folic acid sup­ple­ments may al­so de­crease the risk of cleft lip and palate and heart de­fects in the ba­by. For healthy pa­tients it is rec­om­mend­ed that you have 400mcg of Folic acid every day for the first 12 weeks of preg­nan­cy. Some pa­tients may need high­er dos­es and pro­longed use de­pend­ing on their med­ical his­to­ry.

�2 You will have blood tests in preg­nan­cy that will de­ter­mine if you need any ad­di­tion­al vi­t­a­mins. There are many preg­nan­cy mul­ti­vi­t­a­mins avail­able on the mar­ket. Your doc­tor may rec­om­mend one af­ter the first trimester. Some of them may cause nau­sea, vom­it­ing or con­sti­pa­tion. When you are tak­ing these Vi­t­a­mins it is best to take it with wa­ter or juice to aid in the ab­sorp­tion of iron from the Vi­t­a­min. Avoid tak­ing it with milk.

�2 Do not use your nor­mal mul­ti­vi­t­a­min through­out the preg­nan­cy as they may con­tain lev­els of Vi­t­a­mins that can be harm­ful to the de­vel­op­ing ba­by.

�2 Do not use cod liv­er oil sup­ple­ments dur­ing your preg­nan­cy, al­though they con­tain omega 3 fat­ty acids they may al­so con­tain lev­els of Vi­t­a­min A that are harm­ful to the ba­by.

What foods should I avoid in preg­nan­cy?

There are lots of mis­con­cep­tions about what foods can af­fect the ba­by. The ta­ble be­low shows which foods should be avoid­ed and the ra­tio­nale.

�2 One of the biggest mis­con­cep­tions about eat­ing and preg­nan­cy is that the preg­nant pa­tient has to "eat for two", this of­ten re­sults in pa­tients overeat­ing and eat­ing un­health­ily re­sult­ing in too much weight gain dur­ing the preg­nan­cy. Many pa­tients are hap­py to know that eat­ing pep­per does not af­fect the ba­by in any way.

Is it safe to use a seat­belt dur­ing preg­nan­cy?

Many pa­tients re­quest a doc­tors let­ter to ex­empt them from wear­ing seat­belts dur­ing the preg­nan­cy be­cause of the mis­con­cep­tion that wear­ing seat­belts in the preg­nan­cy may be dan­ger­ous. I al­ways ad­vise them that what is dan­ger­ous is NOT wear­ing your seat­belts. Re­search has con­sis­tent­ly shown that the best way to pro­tect your grow­ing ba­by is to pro­tect your­self. The seat­belt must be prop­er­ly po­si­tioned with the lap belt se­cured be­low the bump, low and snug on the hip bones. Nev­er wear the belt across or above your bel­ly. The shoul­der belt should fit snug­ly be­tween the breasts. If you are in­volved in any kind of ve­hic­u­lar ac­ci­dent you should seek med­ical at­ten­tion as soon as pos­si­ble- even if you feel fine, to en­sure that all is well with both you and ba­by.

What med­ica­tion can I use in preg­nan­cy?

�2 As a gen­er­al rule you should al­ways con­sult your doc­tor or phar­ma­cist be­fore us­ing any med­ica­tion in preg­nan­cy. This is be­cause some drugs can ad­verse­ly af­fect the de­vel­op­ing ba­by es­pe­cial­ly when tak­en in the ear­ly weeks of preg­nan­cy. If you are on med­ica­tion for any med­ical prob­lem you should see your doc­tor as soon as you be­come preg­nant to see whether the drug should be dis­con­tin­ued or changed to one which is safer in preg­nan­cy.

�2 Even over the counter drugs can be dan­ger­ous in­clud­ing ibupro­fen (Advil, Motrin) and naprox­en. Herbal med­ica­tion and reme­dies may al­so be harm­ful and should be avoid­ed in preg­nan­cy.

�2 Some med­ica­tions are known to be safe. Ac­eta­minophen (Parac­eta­mol, Panadol, Tylenol) is safe to be used for headaches, back­ach­es and oth­er aches and pains that are com­mon in preg­nan­cy.

�2 Do not use mul­ti symp­tom reme­dies as these con­tain a va­ri­ety of med­ica­tions some of which may not be safe in preg­nan­cy.

�2 As a gen­er­al rule for preg­nan­cy if you are not sure if some­thing is safe for you and your ba­by � then avoid it un­til you ask your doc­tor or health pro­fes­sion­al. In the next ar­ti­cle we will con­tin­ue to look at preg­nan­cy do's and dont's in­clud­ing sex, ex­er­cise, trav­el and sleep.

If you have any ques­tions that you would like an­swered per­tain­ing to preg­nan­cy please email me at askdr­reiaz@out­look.com.

Dr. Reiaz Mo­hammed, MB.BS (UWI), MRCOG (UK)

Spe­cial­ist Ob­ste­tri­cian & Gy­ne­col­o­gist

Gulf View Med­ical Cen­tre.