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Problems 84 OTHER SYMPTOMS You should contact your GP if you have a sudden ‘acute’ illness like diarrhoea, vomiting, abdominal pain or a high fever. DEEP VEIN THROMBOSIS (DVT) DVT is a serious condition where clots develop, often in the deep veins of the legs. It can be fatal if the clot travels from the legs to the lungs. Flights over five hours where you sit still for a long time may increase the risk. Pregnant women and women who have recently had a baby are amongst those more at risk. If you intend to travel by air, consult your GP or midwife before the trip. Get advice on in-seat exercises to keep your circulation active. After the 28th week of pregnancy, most airlines require a letter from your GP or midwife to say that you are fit to travel. If you develop swollen painful legs or have breathing difficulties after the trip, go to your doctor or your nearest Accident and Emergency department immediately. HIGH BLOOD PRESSURE AND PRE-ECLAMPSIA During pregnancy your blood pressure will be checked at every antenatal appointment. This is because a rise in blood pressure can be the first sign of a condition known as pre-eclampsia – often called pregnancy-induced hypertension (PIH) or pre-eclamptic toxaemia (PET) – which can run in families and affects 10% of pregnancies. Your urine will also be checked for protein. If you do have pre-eclampsia, you will probably feel perfectly well. Some women experience such symptoms as headaches, visual disturbances, swelling and abdominal pain. Pre-eclampsia can still be severe, however, without any symptoms at all. Although most cases are mild and cause no trouble, it can get worse and be serious for both mother and baby. It can cause fits in the mother (eclampsia) and affect the baby’s growth, and be life-threatening if left untreated. That is why routine antenatal checks are so important. Pre-eclampsia usually happens towards the end of pregnancy, but problems can occur earlier. Rarely, it can happen after the birth. The earlier in pregnancy it starts, the more severe it is likely to be. If it does get worse, the treatment ranges from rest at home or in hospital to drugs to lower the high blood pressure, or, occasionally early delivery of the baby. VAGINAL BLEEDING Bleeding from the vagina at any time in pregnancy can be a danger signal. In early pregnancy, bleeding may be a sign of an ectopic pregnancy or a miscarriage (see pages 104–5), although many women who bleed at this time go on to have normal and successful pregnancies. If you have bleeding with pain, contact your GP straight away. Bleeding after about five months may be a sign that the placenta is implanted in the lower part of the uterus (placenta praevia) or that it has started to separate from the uterus (placental abruption). Both of these can be dangerous for you and the baby, so contact your midwife or doctor immediately. The cells on the surface of the cervix often change in pregnancy and make it more likely to bleed, particularly after intercourse. This is called a cervical erosion. Vaginal infections can also cause a small amount of vaginal bleeding. Some causes of vaginal bleeding are more serious than others, so it’s important to find the cause straight away. The most common sort of bleeding in late pregnancy is the small amount of blood mixed with mucus, known as a ‘show’. This is a sign that the cervix is changing and becoming ready for labour to start. It may happen a few days before contractions start or during labour itself. You should always report this to your doctor or midwife as soon as it occurs. SEVERE ITCHING AND OBSTETRIC CHOLESTASIS Although itching is very common in normal pregnancy, severe generalised itching, without a rash, particularly in the last four months of pregnancy, may be the only sign of an uncommon condition called obstetric cholestasis. This is a potentially dangerous liver disorder which seems to run in families, although it can occur without any family history. It is important to contact your doctor if you have troublesome itching because obstetric cholestasis may lead to premature labour, stillbirth or serious health problems for the baby, and to an increased risk of maternal haemorrhage after the delivery.
10 What you need for the baby This is a list of essential items you need to get before your baby is born, and some others that you may want to think about. You may be able to borrow some of these items and then pass them on later to another baby. Look out for secondhand equipment too but do check that it is safe. Ask your health visitor if you’re in doubt. NAPPIES CHOOSING NAPPIES There is a range of nappies to choose from. Disposable nappies are costly but they save time and are useful if washing and drying are a problem where you live. Washable cloth nappies are cheaper to use, even taking into account the cost of washing them at home or getting them washed by a laundering service. They are more environmentally friendly and are easily laundered in a 60 degree wash. You can get shaped washable nappies with velcro or popper fastenings and waterproof wraps. For cloth nappies you will need: • nappy pins; • nappy liners – either disposable or cloth, which you can wash and use again; • plastic pants – about four pairs, either tie-on or elasticated. Tieon ones fit small babies better. Some cloth nappies have the waterpoof wraps attached; • a bucket with a lid and nappy sterilising powder or liquid for sterilising nappies. CHANGING NAPPIES You’ll need: • • • cotton wool – always choose white, and rolls are cheaper; a plastic changing mat; baby lotion or baby wipes – water is fine and cheap for cleaning your baby’s bottom, but lotion or wipes can be convenient, especially when you’re out; • baby barrier cream to help prevent nappy rash – though the best way to prevent this is by changing and cleaning your baby’s bottom well and often; • a changing bag to carry all the nappy-changing equipment when you go out. A carrier bag will do but you can get special changing bags that include a changing mat. Safety: The safest place to change a nappy is on a mat on the floor. If you use a higher surface keep your hand on your baby at all times in case he or she rolls off. NAPPY SERVICES AND NAPPY COSTS There may be a nappy laundering service near you. They deliver freshly laundered nappies to your home and take away the soiled ones to wash each week. They supply everything you need – wraps, liners and storage bin. See page 150 for suppliers. The approximate cost of buying and washing cloth nappies for 2 1 ⁄2 years ranges from £185 to £352, depending mainly on nappy type. (This is based on an estimated cost of £1 per week using your own washing machine. Nappy laundry services cost from £6 to £9 per week.) The cost of disposable nappies over the same period ranges from £463 to £732. 85
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Pre the nancy gbook Your complete g
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Pre the nancy gbook Your complete g
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11 LABOUR AND BIRTH Getting ready f
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Your pregnancy at a glance 16-20 we
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Introduction Every parent is differ
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Your health in pregnancy • Eat pl
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Your health in pregnancy VEGETARIAN
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Your health in pregnancy S MOKING W
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Your health in pregnancy P HYSICAL
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Your health in pregnancy Foot exerc
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obstetrician. If you do catch toxop
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2 Conception To understand about co
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Conception T HE WOMAN’ S MONTHLY
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Conception T HE BEST TIME TO GET PR
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Conception K NOWING THAT YOU’ RE
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How the baby develops WEEKS 4-5 Wee
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How the baby develops WEEKS 15-22 T
Page 35 and 36: 4 Deciding where to have your baby
Page 37 and 38: Deciding where to have your baby HO
Page 39 and 40: Deciding where to have your baby B
Page 41 and 42: 5 Feelings and relationships From t
Page 43 and 44: Feelings and relationships WORRYING
Page 45 and 46: Feelings and relationships FAMILIES
Page 47 and 48: Feelings and relationships C OPING
Page 49 and 50: 6 Mainly for men Some pregnancies h
Page 51 and 52: Mainly for men PRACTICAL SUPPORT Yo
Page 53 and 54: 7 Antenatal care and antenatal clas
Page 55 and 56: Antenatal care and antenatal classe
Page 69 and 70: The feeding question B REASTFEEDING
Page 71 and 72: The feeding question Support contac
Page 73 and 74: The feeding question HOW OFTEN AND
Page 75 and 76: The feeding question B OTTLE FEEDIN
Page 77 and 78: The feeding question The temperatur
Page 79 and 80: 9 Problems Your body has a great de
Page 81 and 82: Problems FEELING HOT IN PREGNANCY D
Page 83 and 84: Problems can empty it properly. The
Page 85: Problems VAGINAL DISCHARGE Almost a
Page 89 and 90: What you need for the baby O UT AND
Page 91 and 92: 11 Labour and birth This chapter de
Page 93 and 94: Labour and birth PAIN RELIEF IN LAB
Page 95 and 96: Labour and birth • your contracti
Page 97 and 98: Labour and birth AT THE HOSPITAL Go
Page 99 and 100: Labour and birth • The heartbeat
Page 101 and 102: Labour and birth You can have your
Page 103 and 104: Labour and birth treatment takes ab
Page 105 and 106: Labour and birth A vaginal breech d
Page 107 and 108: When pregnancy goes wrong been due.
Page 109 and 110: 13 The first days with your new bab
Page 111 and 112: The first days with your new baby c
Page 113 and 114: The first days with your new baby b
Page 115 and 116: Babies who need special care I NCUB
Page 117 and 118: The early weeks: you L OOKING AFTER
Page 119 and 120: The early weeks: you T HE ‘ BABY
Page 121 and 122: 16 The early weeks: your baby The b
Page 123 and 124: The early weeks: your baby Sadly, w
Page 125 and 126: The early weeks: your baby CHANGING
Page 127 and 128: The early weeks: your baby WASHING
Page 129 and 130: The early weeks: your baby W HERE T
Page 131 and 132: as green, leafy vegetables and brea
Page 133 and 134: Rights and benefits How much is it?
Page 135 and 136: Who gets it? Pregnant women and new
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Rights and benefits You must have n
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• your baby is born before your M
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Rights and benefits (MAT B1 form),
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Rights and benefits Giving notice f
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Rights and benefits If you return t
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• state that this is an applicati
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USEFUL ORGANISATIONS Some of these
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In Northern Ireland: Northern Irela
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INDEX A abnormalities tests to dete
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The Pregnancy Book “It contains e
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