Some Tips

While various sources of information are available online, perhaps this is one of the most comprehensive one, lots to learn and know for the pregnant mummy to stay healthy and feel well, a long list of items that will take some time to read, but i have finished reading, just need to refer back when necessary:

Common complaints during pregnancy

ParentsCentre's expert Dr Stuart Flanagan continues his series of articles by highlighting how to deal with various health issues you may experience during pregnancy. Dr Flanagan is an experienced physician who also works as a contributor and medical adviser for a number of BBC projects.

Healthy mum, healthy pregnancy

Staying as healthy as you can during your pregnancy will gives you the best chance of delivering a healthy baby at full term. Mum's health will be looked after by her doctor and midwife, but there's plenty every mother can do help things go to plan from the earliest days.

Knowing that you're pregnant 

For most women, the earliest sign that you're pregnant is that your periods have stopped. You may also have feeling of nausea and morning sickness, or tender, swollen breasts. The easiest way to confirm pregnancy is a urine test. Over-the-counter home pregnancy testing kits can give fast and accurate responses, and your GP or Family Planning Clinic can also test you a few days after your first missed period.

When is my baby due? 

The traditional method of calculating the due date is nine months and one week after the first day of your last period. However, if you became pregnant shortly after stopping the pill, or have irregular periods, an ultrasound examination may help to predict the due date more accurately.

Antenatal care

Once you've discovered that you are pregnant, it's important to seek medical advice so that your pregnancy will be a safe and happy one for mum and baby. Routine tests and check-ups are usually carried out by your doctor or midwife. Some GP surgeries run antenatal clinics, or you may attend the outpatients' obstetrics department at your local hospital. Here, you'll see a doctor or midwife who will carry out routine tests every month until the 28-week stage. Then you'll attend fortnightly until the 36-week stage, after which you'll be seen weekly until the delivery day.

Antenatal clinics 

"Blood pressure checks and urine tests to detect glucose or protein will also be part of your check-ups."

The first antenatal appointment is usually at the booking-in clinic. The doctor or midwife will confirm the pregnancy with a urine test and do some blood tests to check your blood group and to see if you are anaemic or low in iron.  Other routine bloods include tests for syphilis and immunity against rubella.  You may also be offered a test for HIV. Blood pressure checks and urine tests to detect glucose or protein will also be part of your check-ups. Glucose in the urine may be the first sign of diabetes, which will require closer investigation and treatment. Protein in the urine in the context of high blood pressure can be evidence of a condition called pre-eclampsia, which may require admission to hospital for monitoring.

Ultrasound scans 

The first ultrasound scan of your developing baby is one of the most exciting moments of any pregnancy. Ultrasound is a very safe way of finding out lots about how your pregnancy is progressing. Some women may require a pelvic ultrasound early in the pregnancy. Later in the pregnancy, the scan involves smearing some gel across your tummy and placing the scanner on your abdomen to get a picture of the uterus using soundwaves. It can tell us about foetal length, heartbeat (or heartbeats if there are twins/triplets), position, sex, expected date of delivery and any abnormalities.

Other tests 

Other tests may be discussed at your antenatal clinics, but these will depend on your circumstances. These can include an amniocentesis test, which takes a sample of fluid from around the foetus to test for Down's syndrome and other genetic abnormalities.

Staying healthy in pregnancy 

Smoking 

Stopping smoking before, during and after pregnancy is one of the best gifts any parent can give their new baby. Smoking during pregnancy has been shown to cause low birthweight, premature birth, and miscarriage and stillbirth. Your doctor will be happy to offer advice and practical help like nicotine gum for mum or dad when they decide to stop. Don't forget that it's never too late to stop.

"Supplement your diet with a good multivitamin that includes your daily requirements of folic acid, zinc and selenium."

Diet 

Pregnancy is a good opportunity for mum to review her diet and think about improving her nutritional intake, which is now helping her baby to develop and grow in the womb. A well-balanced diet will include a selection from all the main food groups - carbohydrates, proteins and fats, and vitamins and minerals. Carbohydrates include bread, potatoes, rice and pasta. Proteins include fish, white and red meat, eggs, milk and other dairy produce. Fats come from butter, milk and dairy products. Most vitamins can be found in the most common fruit and vegetables.

A balanced diet doesn't need to be expensive. A bowl of cereal flavoured with some slices of banana for breakfast will get the day off to a good start, filling you up for the morning as well as providing energy and vitamins. A light pasta or rice dish at lunchtime should keep you going until your evening meal, which might include some vegetables, meat or fish. Vegetarian mums won't lose out as long as they replace their protein intake with beans, mushrooms, cheese and eggs, and include an iron supplement.

If you feel peckish between meals why not snack on an apple, orange or pear instead of a biscuit? That's not to say chocolate, ice cream or sweets are banned, but keep your treats special and perhaps indulge once a week instead of every day. Supplement your diet with a good multivitamin that includes your daily requirements of folic acid, zinc and selenium. You should also limit your alcohol intake to no more than eight units spread across the week.

Exercise 

"Twenty minutes of gentle swimming three times a week will build stamina for your delivery day."

Some mums may be concerned that taking exercise in pregnancy could put them at risk of miscarriage or causing harm to their baby. In fact, if your pregnancy is progressing normally, there's no reason why you shouldn't simply modify your usual exercise regime, or even start a new exercise programme.

Swimming is a very effective way of exercising gently and effectively. It will help to build muscle strength and keep your joints supple. Twenty minutes of gentle swimming three times a week will build stamina for your delivery day. Set aside time afterwards to warm down with rest period. However, don't wind down with a steep in the sauna or in a hot shower - the warm temperatures will cause sweating which can cause an imbalance in your body fluids and may raise your blood pressure. Make sure you drink a bottle of water after exercise, which will replace lost fluids. 

Sex 

Sexual intercourse won't be harmful to your developing baby during pregnancy. As long as the male partner isn't carrying any sexually transmitted infections such as chlamydia, your baby isn't at risk. However, some mothers will be advised against intercourse in certain circumstances, particularly if the placenta is lying over the neck of the womb, or you are at risk of bleeding after sex. Your doctor will advise you if they have concerns.

As the baby develops and mum's tummy grows, you may need to find some new positions which make sex more comfortable. Indeed, if your baby is a few days overdue you might be advised to make love with your partner, as the man's semen contains prostaglandins which can help to ripen the cervix and induce labour in the overdue pregnancy.

Morning sickness 

Feeling nauseous and sick in the early stages of pregnancy is extremely common, affecting about 80 per cent of women. Morning sickness usually occurs during the first three months of pregnancy, although for a few women it may persist for longer.

Although it is usually referred to as morning sickness, the symptoms can also last throughout the day. Symptoms can vary in severity - most sufferers will feel nauseous but may not be sick, whereas some women may find they are unable to keep any foods down. This form of morning sickness occurs rarely and is called Hyperemesis Gravidarum. It will require hospital admission to settle the symptoms.

Morning sickness is caused by the hormones of pregnancy which are helping in the development of the baby and placenta. Although the symptoms are unpleasant, the sickness won't harm the developing foetus. There are a few tried and tested tips which have should alleviate morning sickness:

> eat small frequent meals - an empty stomach will make you feel nauseous. 

> dry carbohydrate snacks and nibbles will help throughout the day - dry crackers, toast and plain biscuits. 

> don't jump out of bed too quickly - take your time. 

> keep well rested throughout the day when you can. 

> keep well hydrated with water or juices - avoid alcohol and caffeine as they will dry you out. 

> If your symptoms persist and you continue to feel unwell, see your doctor. 

Constipation 

Although it's something not many women like to discuss, constipation is actually one of the most common complaints in pregnancy, affecting around half of pregnant women. The growing uterus puts pressure on the lower bowel (or rectum) and the hormones of pregnancy reduce the transit time of food in the gut.

The result of this is that your food takes longer to travel to your rectum, so when it does arrive, the stool is hard and difficult to pass. As a consequence you may find bowel motions more infrequent, and may suffer from lower abdominal pains.

Although it's something not many women like to discuss, constipation is actually one of the most common complaints in pregnancy, affecting around half of pregnant women.

To prevent constipation, try to include plenty of high fibre foods in your diet.  These include fresh fruit and vegetables, cereals and wholegrain bread. If you are suffering from constipation, prunes can be a very effective laxative. Drink plenty of water, which will help to keep the stools soft. Regular exercise will help to stimulate the bowel and aid digestion. 

Some over-the-counter agents are safe to use in pregnancy - Fybogel will help to bulk the stools, and Senna is a well-tolerated stimulant laxative. If you still have problems, see your GP, who will be able to advise regarding prescribed laxatives.

General aches and pains 

Like everyone else, pregnant mums can suffer from headaches and other aches and pains. However, before you reach for your usual painkillers, you should be aware that not all analgesics can be used in pregnancy.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen are not safe to use in pregnancy. They may cause miscarriage in the early stages, or induce early labour in the later pregnancy, and may interfere with kidney function. Aspirin is not recommended for pain relief as it can increase the risk of bleeding.

Codeine-based analgesia can cause breathing problems for baby in later stages of pregnancy and should only be taken in the early stages under a doctor's supervision. However, Paracetamol is safe for short-term use throughout pregnancy. Always consult your pharmacist regarding painkillers if you think you may be pregnant. Don't forget that a warm bath or gentle upright massage can be soothing for a sore back or aching muscles.

Colds and coughs 

If you come down with a cold during your pregnancy, be sure to consult your pharmacist before taking any over-the-counter preparations. Many will contain antihistamines or Codeine, which are not advised in pregnancy. Try some simple therapies such as gently inhaling a salt water steam preparation to reduce congestion, or simple linctus for persistent coughs. Paracetamol will help to relieve headaches.

Skin changes/rashes 

Pregnant mums can also be affected by the rashes which affect any patient, such as eczema and psoriasis.

Many women will experience changes in their skin during pregnancy - most of these changes are termed 'physiological', which means they are entirely normal and indeed associated with being pregnant. These include:

hyperpigmentation - or darkening - of the nipples and genital area. 

Linea Nigra - a dark, sometimes hairy, line which runs from the belly button to the pubic area. 

Striae Gravidarum -stretch marks around the abdomen as it expands. These usually start off pink and become white or shiny after delivery. 

varicose veins on the legs. 

Pregnant mums can also be affected by the rashes which affect any patient, such as eczema and psoriasis. Moisturiser creams such as Calamine lotion are safe to use to sooth the skin. Your doctor will advise regarding steroid creams.

There are a few distinct rashes which occur only in pregnancy and are termed specific dermatoses of pregnancy. These include:

PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy) 

This is the most common skin condition in pregnancy and essentially the name refers to red, raised itchy bumps which appear on the abdomen and thighs. It usually occurs late in pregnancy, but causes no harm to mother or baby. Topical steroid cream will help to reduce the inflammation and itch.

Prurigo Gestationis 

This rash appears as red itchy dots mostly spread across the arms, legs and trunk. The rash can appear in mid- or late pregnancy. Simple antihistamine therapy will relieve the itch and the rash will disappear within a few weeks after delivery.

Mum can also suffer from itching without a rash - this is called pruritis and can occur as a result of mild jaundice. Mum may notice some yellow discolouration of the eyes and skin. This is due to intrahepatic cholestasis - the liver does not process bile quite so efficiently in pregnancy and so the breakdown products can build up in the skin, causing jaundice and itch.

If you have any unusual rashes or skin changes it is always best to seek medical attention.