Discovering that you are pregnant marks the beginning of an interesting nine-month journey, as you experience your baby’s growth; from two lines on a test strip to a soft and warm bundle of joy in your arms. During this period, your body will go through many changes as the baby inside of you prepares for life on the outside.
The experience of pregnancy is different for different people, and can even differ with each baby that is born to the same woman! It can be an uncomplicated time, with just the presence of a bump letting you know something is going on, or a period of numerous changes – vomiting, food cravings, mood swings, wardrobe changes, swollen feet, and then just not being able to see your own feet after a while…
From the medical point of view, pregnancy is said to last for about forty weeks, calculated from the date of the last menstrual period (LMP – the first day of your last normal menstrual period), or the date of embryo transfer if the conception was by IVF.
The dates can also be determined by an early ultrasound scan. Your baby’s age is expressed in weeks (e.g 26 weeks old), and the Expected Date of Delivery (EDD or due date), is either gotten from the LMP, date of embryo transfer, or an early ultrasound scan. Your pregnancy is said to be at ‘term’, when baby is mature enough to be born – this is usually from the end of the 37th week to the end of the 41st week. At 42 weeks, the baby is said to be post-term.
Even though you are going to do most of the work, it is important to be supported through your pregnancy by a team of medical professionals that you are comfortable with, who are experienced, compassionate, and capable of ensuring that you have a safe delivery of your baby.
Every pregnant woman must be seen at regular intervals throughout the period of her pregnancy whether or not she has any complaints, in order to verify that the baby is growing well, to diagnose any underlying diseases or complications of the pregnancy. She should also be educated about lifestyle changes, what to expect during the pregnancy, and delivery.
Generally, you will be booked (registered) for antenatal care at 12 weeks if your pregnancy is low risk or earlier if it is high risk. You will be asked detailed questions about your previous medical history, previous pregnancies and deliveries, current medications, drug and other allergies, family history, and your lifestyle. All this information is carefully documented. Blood samples will be taken for tests to determine your blood level, blood group, and genotype, and to ensure that you do not have any underlying infection.
The results of these tests will determine if you will require any extra care or medications, for example if your blood level is low, you will additionally be placed on Iron tablets. If there is anything in your medical history that affects your pregnancy, it will be noted and appropriate action taken.
For example, if your blood group is Rhesus negative you will receive an injection to protect your baby at 28 weeks, or if you have had a previous uterine surgery, you might need a Caesarean section for delivery.
From the time of booking till baby is 28 weeks, you will be seen at least every four weeks; from 28 weeks to 36 weeks you will be seen every two weeks; and from 36 weeks till your baby is born, you will be seen once a week. Sometimes antenatal visits are more often than this, if there are specific concerns or other medical issues.
At every visit of your antenatal care the following will be checked – pulse rate, blood pressure, and your weight, to monitor your progress and detect any abnormality. You will also have a urine test (urinalysis) done, as this can give a lot of information about your condition – for example raised levels of white cells, proteins, or ketones in urine can be indicative of a urinary tract infection, pre-eclampsia, and low carbohydrate levels respectively.
Ultrasound scans are done periodically to confirm that baby is growing well. Some of the things checked for include adequate amniotic fluid (the fluid that surrounds a baby in the womb), a normal and well positioned placenta, and a closed cervix (the neck of the womb). You will be placed on routine medications (multivitamin supplements), immunizations, and any other medication if there is a need for it.
You will also attend an antenatal care class with other moms-to-be, where different aspects of pregnancy, labour and delivery will be taught and discussed. Also, information on how to adjust your lifestyle to accommodate the changes in your body, and what you need to do to get ready for baby’s birth will be discussed. You will be able to share with other ladies who have similar experiences and learn some tips on how to cope.
Even though antenatal visits are pre-planned, it is important to know that you must contact your hospital if you have any complaints at any time. Sometimes, you may require an urgent review to address your complaint, so be ready to come into the hospital if the need arises.
Never think that you are asking too many questions, it is better to be certain there is no need for any intervention, and the information you give about any change you experience will only help to ensure that you receive better care.
Pregnancy is measured in trimesters – the first trimester lasts from week 1 to the end of week 12, the second trimester lasts from week 13 to the end of week 27, and the third trimester lasts from week 28 to delivery.