Pregnancy

Pregnancy

                                                                                                                                

                                          "A bundle of joy"
   (Gestation, Cyesis, Fetation, Anti Natal Care,जननी, गर्भावस्था , गर्भा धारण ,जच्चा ,गर्भिणी चर्या ,दौहृदय) 
                                                      "Transition of a woman to mother"               
                         "Woman is the root of progeny; she will protect, if she is protected"


"Giving birth and being
     born is perhaps the most
    profound experience of 
   nature's creation. Good
      physiological and mental 
           health is neccessary to enjoy
         this fruit."


Woman is considered to be the architect of a civilization. She plays a vital role in the making of a healthy society. For the well being of a society, it is essential that a woman's health be also taken care of. That is the reason why almost all the systems of medicines have worked out they own way of keeping a woman healthy. Woman's health is important in relation to childbirth. In modern medicine anti natal care of woman starts after conception, but according to Ayurveda, it begins from the day a girl matures.

Of all the experiences in my life, motherhood has been the most special. Life would not have been quite the same without my bundle of joy. In a woman's life pregnancy is the beginning of a new stage , new hope pride and enrichment, an experience of growth, change and challenge. This is the time when women needs to be prepared mentally and physically to meet the challenges of child birth and for the transition to parenthood. Pregnant woman should always be  in a positive framework of mind.. She should always be stress free.


                                                  
Pregnancy The most vital and delicate period in the life of a woman and her child is the time span between conception and delivery . The food consumed, mental condition, health and ailments during pregnancy directly affect the fetus. Hence the care of pregnant woman is very important. woman's capacity to create, bear and nurture a child is the very essence of her womanhood, her unique and special capacity.

People forget that pregnancy is a partnership. It's a physical process for the mother, but the father too has to be emotionally supportive. A little pampering and back massages by a husband go a long way.

After the confirmation of pregnancy,  you must immediately start taking care of your self and your baby by eating nutritious food, avoiding too much tea, coffee and colas, stopping alcohol and tobacco and indiscriminate use of  medicines and tranquilizers.

              "It's important to remember that pregnancy is a natural event, not an illness."  

The pregnant shape is universally viewed as healthy and beautiful, Its roundness is normal, a sign that you 're growing a baby. Celebrate these curves. Embrace your pregnant self !

Introduction

                               "It is the time when immunity needs to be in top gear"

Pregnancy is the period from conception to child birth. The change in normal food pattern  and attitude is also observed while confirming the pregnancy, the women may become averse to a conventional diet. The craving for special foods, especially sour foods , is also a lead. The lady is considered more beautiful when pregnant. Slight changes in her behavior is also noted. She will have lassitude and tiredness, lethargy and restlessness. We should see pregnancy as a normal and positive maturing experience rather than a psychological and biological crisis.. This is the time to slow down and listen to your self. Pregnancy is one of the life events that provide an opportunity  to provide an healthy lifestyle through healthy food, proper exercise / yoga and meditation. Please continue that discipline throughout your life.

There are rules concerning diet, activities, behavior and mental activity (ahar, vihar, achar and vichar respectively ) to be followed by a pregnant women,

Parents should undergo a through checkup  regarding a diabetes, thyroid problems, hormonal imbalances, and anemia, before planning for conception. RH Factor, HIV status should also be known. Such a planned conception is advised as against an accidental surprise.

Pregnancy occurs when a sperm fertilizes an egg after it's released from the ovary during ovulation. The fertilized egg then travels down into the uterus, where implantation occurs. A successful implantation results in pregnancyIf you are an expecting mother take care of yourself in all aspects. Think about your spiritual health also. Find out some exclusive time for yourself
During pregnancy immune system of the body is relatively weaker.

See pregnancy as normal and positive maturing experience rather as a psychological and biological crisis. This is a time to slow down and listen to your self.

On average, a full-term Pregnancy, which last for nine months, 40 weeks to be precise is divided into three sets of 12 weeks, each being called a trimester.
. Equally important is keeping the expected mother physically and mentally content. and this starts much before she is confirmed pregnant.

Do you know  pregnancy is one of the life events that provide an opportunity to  healthy lifestyle, through healthy food, proper exercise , yoga and meditation.

A pregnant woman is called Dauhrudaya (दौहृदय) meaning woman possessing two hearts (one for her own and other for her foetus).  The desires of the  foetus are said to be expressed through the mother. It is believed that desires if fulfilled results in the birth of a healthy child and the suppression of desires may influence psychology of the mother and child as well.

During pregnancy keep up your normal activities, but do not over work. Normal activities will help keep your muscles toned up, making your delivery easy. Avoid lifting heavy things, as it can lead to a miscarriage. Regular exercise will help you to keep fit

"Most of the common ailments during pregnancy are minor and can be relieved by simple changes in lifestyle."

It is advisable to see an obstetrician who might advice certain routine test before you conceive. For example, testing your blood for Anemia,diabetes, thalassemia, thyroid disorders, hepatitis B etc. 
If there is any history of genetic disorder on either side if family, the matter must be discussed with the doctor.

Expected mother should eat plenty of seasonal fruits and vegetables with balanced food in order to get natural vitamins and calcium for the baby without any deformation in the body.

Planning a healthy baby

 

Planned Pregnancy
Planned pregnancy is advised in a suitable month so that the delivery happens nine months later in winter which is said to be the healthiest season for child birth. Both the parents are told to consume sesame oil, black gram (for females), milk, ghee, (for males for period of forty days before conception in order to improve the quality of reproductive tissues for a healthy progeny.

                            Pregnancy is definitely a time for eating well and gaining weight.

The Girl Child
The  term "healthy pregnancy"  is only possible when a care of a woman's heath is taken right from infancy. A girl who is well looked after  throughout her childhood and teenage years has  fewer problems in pregnancy and childbirth, and is more likely to deliver a healthy baby.

The ideal age
The ideal age to have a child is between 23 to 27 years. It is better to avoid getting pregnant  before the age of 18 or after 35. Babies born to younger mothers  are more likely to be premature. The risk associated with pregnancy and delivery increases after the age of 35. 

An essential vitamin
Take folic acid supplement daily one month before you start planning for a baby. Regular intake of folic acid during pregnancy  greatly reduces the chances of  your baby being born with spina bifida a developmental anomaly affecting a spinal chord. All women of reproductive age should take folic acid daily. Green leafy vegetables, pulses and liver are good sources of this vitamin.

Gap Between babies.
A minimum of 2 years is advisable between babies.I would strongly recommend a gap of 3 years, as it takes time for mother to fully recover from pregnancy.

Family Planning
Seek proper advice on family planning at the first post natal check-up.

                                 Genetic counselling should be done before conceiving.

Genetic counselling
Screening test, blood test, ultrasound, Amniocentesis or CVS
Ideally a couple sharing the same ancestors (as in a consanguineous marriage) should seek genetic counselling before marriage. As the risk of inherited diseases and conditions is higher in such cases.
If there is a history of Epilepsy or severe Myopia in your or your husbands family you may like to consult a genetic counselor. A blood test may be done to get more information.

If you are a diabetic, your condition will need to be assessed before your pregnancy to avoid complications later. To conceive all contraceptives should be stopped. If you are on pill , you should go off it  and switch to the condom  and spermicidal pessaries for 2-3 months, so that all hormones  are out of your system, by the time you conceive.

Remain active and incorporate moderate exercise in your daily routine.
For Spinal bifida, tube defect or Down's Syndrome.

Antenatal or Childbirth Classes
Antenatal classes conducted by medical professionals can be very helpful.

Pre -Conception Care

A few months before you plan to conceive, have a blood test taken  to check if you are Anemic. If you get your anemia under control, it will go a long way  towards producing a healthy baby. So eat food rich in iron. Eating wisely is important, both you and your husband.  A nutritious diet, less stress, less alcohol and cigarettes, less lead exhaust from the vehicles, less caffeine and tea, coffee and cola drinks. No indiscriminate use of drugs, are all factors that will contribute to  a strong and healthy baby, You should check these factors 3-6 months before. conception. As smoking and drinking habit can harm the sperms.Take time to relax.

Precaution

When you visit your dentist  or general physician tell him that your pregnant, because medicines of all kinds should be avoided. particularly in the first three months of pregnancy. 

Biologically it is best to have your baby in 20s. Risk increase in the under 20s and over 40s and slightly in 0ver 30s.

                                  "Pregnant woman should  be positive and happy. Take time off to relax"

A doctor will ask about 
  • previous pregnancies, 
  • miscarriages, 
  • abortions, 
  • about when you had last period, 
  • what contraception you have been using
  • what illnesses you have suffered from etc.
Doctor will prescribe certain tests

Schedule for check up :

  1. Once a month for first seven months, followed by 
  2. Twice a month for two months
  3. Every week in ninth month.



"Pregnancy is a normal phenomenon. When you find out you are pregnant consult with a good gynecologist, whom you trust and feel comfortable with."


                                              "Crucial life moments."

Physiological changes
During pregnancy, a woman's body changes in many ways due to the effect of hormones. For example, you can see some external changes in your body shape and posture including the shape of the breast, texture of your skin and also internal changes in the uterus, cervix area, cardiovascular system, blood pressure (BP), respiratory changes, gastrointestinal systems etc.

"Proper understanding and readiness to take care of your body and mind will keep you away from worries."

Biological Changes
 Changes of hormone like ostrogen and progesteron will affect your mental state.

Psychological changes
Sudden emotional swings are more pronounced in some women. Changes in the hormones estrogen and progesterone will effect your mental state.
Excitement: Hearing the news that you are pregnant when you love being pregnant makes you excited.
Fear and anxiety: Crying: Woman may cry more easily and frequently when they are expecting. Depression can also affect the 10% of woman during and after pregnancy.
Worries:
Nesting instinct: you may feel very energetic and happy to clean the entire house and start making arrangements for the baby to come during the third trimester.
Baby blues: Some women feel confused and develop some negative feelings or mood swings after the joyous event of adding a new baby to the family.
Emotional Distress.
Crying

                                       "Winter is the healthiest season for child birth."

Pregnancy week by week

Pregnancy weeks are grouped into three trimesters, each one with medical miles stones for both mother and baby.




First Trimester
A baby grows rapidly during the first trimester (weeks 1 to 12). The fetus begins developing their brain, spinal chord and organs. The baby's heart will also begin to beat.
Second Trimester


During the second trimester of pregnancy (weeks 13 to 27), Ultrasound is done.This test checks the fetus's body for any developmental abnormalities. One will probably begin to feel the baby move, kick and punch inside the uterus. After 23 weeks, a baby in uterus  is considered "viable". This means that it could survive living outside of your womb. Babies born this early often have serious medical issues. You baby has a much better chance of being born healthy the longer you are able to carry the pregnancy.

Third Trimester
During the third trimester (weeks 28 to 40), your weight gain will accelerate, and you may feel more tired. Your baby can now sense light as well as open and close their eyes.Their bones are also formed. As labour approaches you may feel pelvic discomfort and your feet may swell. Contractions that don,t lead to labor, known as braxton - Hicks contractions, may start to occur in the weeks before you deliver.

                                                    


                                   "10-12 kg is the normal weight gain during pregnancy."
Diagnosis 

*  Missed period : A missed period is one of the earliest symptoms of pregnancy (and may be the most classic one). However, a missed period doesn’t necessarily mean you’re pregnant, especially if your cycle tends to be irregular. Confirmation of pregnancy is done at home. Morning sickness is the one that brings the happy news. The absence of menstruation (after waiting forty days) is traditionally used to confirm conception.

* Pregnancy Test : Purchase a pregnancy kit. Sample Urine. If two red lines pregnancy is positive. It checks presence of human chorionic gonadotropin (HCG) in urine. The developing placenta begins to produce this hormone to prevent menstruation and protect the pregnancy. It should be carried out  two weeks after missed periods. For earlier results blood test is more reliable.
                                                 

*   Blood Test : To confirm pregnancy.  Blood test for presence of  HUMAN CHORIONIC GONADOTROPIN. (HCG)
*   Last menstrual period (LMP ) : By convention, pregnancies are dated in weeks starting from the first day of a woman's last menstrual period (LMP).

*  Expected Date of Delivery (EDD) : 280 days (40 weeks) from the start of the last menstrual period.(9 months + 7 Days). Subtract 3 months from LMP and add 7 days for EDD.

*   At 20 weeks fundus of the uterus is at the level of umbilicus.
  
Blood Test
Hb, T.LC, D.L.C, 

*  Hemoglobin Level : Normal level : 13-15 gm /dl
below 11g/dl is Anemia. Moderate 7.0-10.9g/dl, Severe 4-6,9g/dl, Very Severe less than 4g/dl. Will be prescribed iron tablets.

*   Blood grouping : A, B, AB, O. In case you need a blood transfusion in an emergency.

*   Rhesus Factor (RH factor) : Positive or negative. For instance a woman with Rhesus-negative blood group will be given an Anti-D immunoglobulin injection after the birth of a first baby so that her second delivery will be problem free. (if it is not done  a Rhesus-negative  woman who has not had an anti D injection after her first delivery  or after an abortion  proceeding her first delivery, may have a baby  who will need a complete blood transfusion at birth.

Venereal Disease Research Lab (V.D.R.L.) : Blood test that checks for  the presence of any sexually transmitted disease or venereal diseases like Syphilis. Both the woman and her husband should have the VDRL test. Even if  it turn out that one of them  has the disease, both will receive a course of antibiotics to protect themselves and the baby.

Alpha - FetoProtein Test (A.F.P) : It is a specialized blood test that can reveal if there are any major defects in the baby. It is produced by the baby's liver and passed to the mother's  bloodstream through the placenta. It is most accurate between 16-18 weeks of pregnancy. If the test suggest that baby is not normal, it should be repeated. If the second test gives similar results, the fetus should be checked by the ultrasound scan and amniocentesis.

Urine Test : 
Urine test is routine in pregnancy.
Urine will be analyzed for infection and for glucose which will show up if there is a diabetes. Ketones may show up  if you are vomiting a lot or not eating enough. In late pregnancy albumin or protein in the urine  will indicate Pre - Eclampsia.

Urine test for kidney function.


Internal Vaginal Examination :
An internal examination is done at the start of pregnancy and at its end and some times during its course. At the start of pregnancy it could be done to confirm the pregnancy and exclude any possibility  of abnormalities of pelvis, vagina and cervix.
At the end of pregnancy  it could be done to check the readiness of the cervix or its ripeness.It does not harm the baby. If you are tense during the examination it will help if you breathe out slowly through the mouth, while it is been carried out, and relax your pelvic floor as when you are passing urine.

Ultrasound
In this sound waves are directed to the fetus inside the uterus, and as they bounce off the baby's bones and tissues, a picture of the fetus appears on the T.V screen. The dark areas, which are fluid filled, from the white areas which are solid.
When you go for a ultrasound scan, you must have a full bladder. You will be made to lie down  next to the machine, and an oily substance will be spread over your abdomen. A small flat device will be moved slowly all over your abdomen during the scan.
As a diagnostic tool ultrasound is invaluable. It can diagnose twin pregnancy, babies who are small, the exact position of fetus, and the placenta, the age of fetus, the estimated date of delivery. It also help detect gallstones.
Ultrasound scan in second trimester is vital to rule out any organic defects in the baby as a routine method of investigation. In fact it is mandatory in those with family history of birth defects and mother whose age is above 35 years.

Amniocentesis
This is a procedure where a small amount of fluid taken out from the pregnant mother's abdomen (amniotic sac) to test for chromosomal and other abnormalities. It is not a routine test . Under a local anesthesia a needle is inserted into the mother's abdomen and a little bit of amniotic fluid is withdrawn. This is done along with an ultrasound, so that the placenta and the fetus are not disturbed by the needle.. The fluid which contains fetal cells can then be analyzed for the detection of abnormalities  of the nervous system, mentally handicapped, including Mongolism or Down's syndrome, inherited disorders etc.
Drawback Even though it might be carried out efficiently  under hygienic conditions there is 1-2% chance that it might lead to a spontaneous  abortion.

*  Blood Pressure : Normal 120/80 mm

*  Weight : According to the height.

Eye Examination to check your retina

Baby's Echo cardiogram
To   monitor fetal heart rate.



Pre Natal Diagnosis
Screening Tests
During 40 weeks. That's  because screening tests are non- invasive and increasingly accurate
Blood
Ultrasound To identify whether you're at an increase risk of having a baby with genetic disorder like Down syndrome or a neural tube defect like spina bifida.
Non Invasive prenatal screening (after 9 weeks) NIPT OR NIPS
Did you know that pieces of your baby's DNA circulate in your blood stream ?
Blood screening any time after 9 weeks that analyzes DNA(Its called cell free fetal DNA or efDNA) to pinpoint baby's risk for a number of genetic disorders including Down syndrome. Nipt also shows the sex of a baby, if you want to find out ( but it is banned )
Quad Screening
The results can help you to decide next step, including whether invasive diagnostic tests, which are even more precise but carry some risk are worth that risk.
First Trimester Ultrasound or nuchal translucency screening 
To determine whether more testing is needed. If its positive your Practioner will recommend following up with Amniocentesis or CVS to confirm the result
Nuchal translucency screening (10-13 weeks) NT Screening : 
Done with a highly sensitive ultrasound machine. It is recommended for all women. A specialized ultrasound if you are at an increased risk for having a baby with a chromosomal problem such as Down's Syndrome. It focusses on  a small, clear space in the  tissue at the base of a growing baby's neck called the neural fold. experts have found that  this spot tends to accumulate fluid and as a result, expands in size in babies who have genetic abnormalities like DS
Fetal Echocardiogram at 20 weeks to screen for heart defects if your levels are high

Combine Screening (11-14 Weeks)
NT
Ultrasound results are combined with 1-2 blood tests that measure and compare your levels of 2 hormones hCG and PAPP-A (Pregnancy associated plasma protein A) which are produced by the fetus and passed into the mother's blood stream

Invasive but conclusive diagnostic test such as
Amniocentesis or CVS, is necessary

Integrated Screening Test (in the second trimester to rule our neural tube defect.)

Quad Screening (14-22 Weeks)
Blood test that measures the level of 4 substances produced by the fetus and passed into  the mothers blood stream, alpha fetoprotein (AFP), hCG, estriol and inhibin A. High level of AFP may suggest the possibility but by no means the probability

Level 2 Ultrasound (18-22 Weeks) Anatomical scan
To make sure everything is growing and developing as it should be.
Hard Markers
Soft Markers : For chromosomal abnormality, choroid plexes cyst, Echogenic foci or Pyeleclasia.
Spotting of heartbeat, curvature of spine, face , arm, legs. Baby sucking thumb, genitals can be seen.


Diagnostic tests
Chorionic Villus Sampling (CVS) : Safe and reliable. (10-13 weeks)
1st trimester pre-natal diagnostic test that involves taking a small tissue sample from the finger like projection of the placenta called chorionic villi (to detect chromosomal abnormality.)
Side effects : Risk of infection with CVS. For Rh negative patients Rh immunoglobin RhoGAM is given
Amniocentesis performed after 16-20  Weeks
A hollow needle is inserted through your abdomen through the wall of uterus or into the fluid filled Amniotic sac.
Drawback- pain and cramping. 1-2 tbsp fluid sent to lab for analysis.
ultrasound will detect the location of placenta. Result comes in 1-2 weeks.
side effects : As chorionic villi are of fetal origin, drawbacks are miscarriage, vaginal bleeding which last for 3 days.





" Giving birth and being born is perhaps the most profound experience of nature's creation. Good physiological and mental health is necessary to enjoy this fruit"



Signs & Symptoms

A woman with swollen feet, hands and face will also need to follow  simple medical advice, so that other complications do not crop up. As a result of tremendous changes occuring in the body , discomfort, muscle pulls, bleeding gums and cramps, are some of the accepted problems a pregnant woman is likely to encounter.

First Trimester
DIGESTIVE PROBLEMS
●  Nausea & Vomiting / Emesis Gravidum (Morning sickness) 
The miraculous biochemical changes associated with fetal development generate heat in the body and hence cause Nausea. Vomiting can be throughout the day. Sometimes it is very distressing as the woman finds it hard to eat anything  and routine smells of seasoning, cooking etc. may make her nauseating. It persist for four months. With pregnancy there is increased intestinal tone and gastric mortality. This slows down the passage of food through the digestive system and increases the possibility of the absorption of nutrients. Vomiting may also caused by a rapid rise in hormones in early pregnancy.

Severe vomiting is called hyperemesis. A woman is really ill, hospitalization may be required, since she cannot retain any food. It is a symptom of disturbed relationships and if a women can get away from anyone who is causing her stress, the vomiting will ease off. Feed on sweet fruits, glucose. Intravenous glucose drip  is given. The body needs sugar for its daily requirement. In  the absence of adequate intake of sugar the body starts to make acids known as ketones. When these shows up in urine, it is a sign that vomiting is severe, and hospitalization is necessary.

 Heartburn  & Acidity / Gastritis : This is common from mid pregnancy onwards. When  the baby is growing bigger, the uterus pushes the stomach to cause heartburn. Also the Hormones released during pregnancy can sometimes relax the valve between your stomach & esophagus. When stomach acid leaks out, this can result in heartburn. It occurs especially before bed time or immediately after food. Small amount of food  from the stomach reenter the food pipe since the stomach valve relaxes and also because of the pressure the growing baby exerts against the stomach. If this happens several times in a day, a burning sensation is felt in the food pipe. To avoid  it happening, the stomach should not be completely full or empty. In an empty stomach, acid formation causes this feeling. Sips of cold milk should relieve this burning.
To sleep on a full stomach will also cause discomfort. It is good idea to stay propped up during the night if it gets very bad.  few extra pillows or cushions will help you stay more upright while you sleep, and it can be quite comfortable. Better still eat dinner by 7-8 pm.
Avoid taking spicy or vinegary foods, excessive salads and green leafy vegetables and alcohol. Have four moderate meals, instead of two large meals, in a day.

*   Flatulence  : Flatulence or wind, is not harmful, but embarrassing. Try keeping away from company when you are passing wind. Avoid gassy foods like beans, peas, rich food and excessive amount of greens.

*   Diarrhea : This sometimes occurs in pregnancy and it should be reported to the doctor if it persist for more than a day or two. Iron tablets can cause it in some women. In such cases it can be remedied by simply changing the brand of iron tablets. iron tab should not be taken in empty stomach.
Many women who add lot of fruits and vegetables in their diet find that their stool is little loose or that they pass stool twice a day.This should not be confused with diarrhea.

*  Constipation  :   Progesteron Hormone changes during early pregnancy can slow down your digestive system. As a result, one may become constipated. As the uterus expands, because of the pressure effects women find herself more often constipated.

In pregnancy a muscle relaxing hormone called relaxin is secreted by the body, which relaxes, among other things as the digestive system. Relaxing of the digestive system leads to its sluggishness. It therefore requires greater amounts of bulk in it , so as to aid the movement of food through alimentary canal. Constipation is therefore common in pregnancy.

Another reason for the clogged works. your growinguterus puts pressure on the  bowel, cramping its normal acti

The downside you end up with that  what amounts to a waste product traffic jam, with nothing going anywhere anytime soon. 
If you find that you have developed a tendency towards constipation, eat less bread, rice and maida. Eat more chapattis, preferably made of un - sieved flour, pulses or dals. Increase the intake of fruits , salads and vegetables.
Lady's finger / okra  or Bhindi can be eaten. Dried figs are also very good. and easily available in dry fruit shops. An increase in fluid intake helps; so drink more water, drink 3 glasses of water on waking up in the mornings.
Isabgol can be taken regularly. It is available in packets in chemist shops. Follow the instruction on packet. Avoid laxative pills.


*  Bloating
*  Bumpy areolas : Tiny bumps on areolas called Montgomery's tubercle.
Rising Temperature : If you have been using a special basal  body thermometer to track your first morning temperature you might notice that  it rises around 1 degree when you concieve and continue to stay elevated throughout your pregnancy.


* Piles or Hemorrhoids These are resultant of increasing pressure over the engorged veins around the anus and constipation. If constipation lingers over a period and is not treated, it can cause veins around the anus to protrude, from straining that  accompanies constipation, leading to piles or permanently protruding veins around the anus.
If piles occur, keep constipation in check and avoid spicy food.


 
*  Frequent Urination : The growing uterus presses on the bladder causing increased frequency of the urge to urinate. In addition immune system of the body is relatively week, hence the mother is more prone to contract infections especially of urinary tract. if there is burning sensation while passing urine or lower abdominal pain it may be U.T.I, It is better to see a doctor.


*   Hardening of the lower abdomen

 Breast changes :  Breast changes are one of the first noticeable signs of pregnancy. Even before you’re far enough along for a positive test, breasts may begin to feel tender, swollen and generally heavy or full. The nipples may also become larger and more sensitive, and the areolar  may become darker. A change in the color of nipples to black. The tenderness passes by mid pregnancy.
The dark areas around the nipples, the areola, get darker, this is permanent change in most women. Stretch marks on the breast may occur in woman with large, heavy or sagging breast.. Hence in case of a dramatic increase in  breast size, you must wear a well-fitted cotton bra, that supports the weight of the breast. (A nylon bra tends to sag with the weight),This will not only prevent stretch mark, but prevent sagging too.

Tiredness: Some women find extreme exhaustion during initial days of pregnancy. This is very common in the first month of pregnancy as the body is equipping itself to accommodate to a new life. Reassurance is necessary. Tiredness is a sign that you need to slow down and take it easy.  Try and get at least, ten hours of sleep daily. If you cannot manage it at night, sleep a few hours in the
afternoons. Also try to go to bed sooner at night. In some cases tiredness may be caused by anemia. It is better for a pregnant woman to sleep on her left side.

Food aversions :. Craving for a sour taste is very common such as towards tamarind and unripened mango. As inclination for mud, ash and raw rice are also observed. 


  Leg cramps : 
Leg cramps may occur suddenly in pregnancy and be quite painful. They mostly occur in the last months of pregnancy. Sluggish blood circulation, lack of calcium and lack of Vitamin B are thought to  cause these cramps.
As the muscles in your uterus begin to stretch and expand, you may feel a pulling sensation  that resembles menstrual cramps. Painful cramps occur in the calf muscles because of changes in the metabolism of calcium and increased relaxation of smooth muscles of blood vessels influenced by the increased progesterone levels.
Massaging the area when cramps occur is relieving. Also point the toes inwards towards the face when the cramp occurs. Some one can hold painful area on leg with one hand  and with the other  hand guide the toes to point towards the face.
A hot water bottle should also help. One can take it to bed at night, if cramps tends to occur at night.
One can increase the intake of milk products so that the body can get the much needed calcium.  Cottage cheese, milk, curd,  and greens of radish, turnip, cauliflower,  buttermilk, methi, dhania, pudina, and all variety of curry are good.
Whole and split (Chilka) dals are good source of Vitamin B. Whole moong, whole Masoor, whole Urad, split moong  are some examples.
Exercising to get the circulation going in the legs should also help. When you have to sit for long periods, draw the letters of the alphabet (A,B,C,D) with your toes, in the air. Before sleeping, walk across about a six foot long area, on your toes, then on your heels and lastly on the sides of your feet. Done everyday before sleeping at night, it has given relief to a lot of women.
Take extra salt, especially at night, in case cramps occur when you are trying to go on a salt free diet.

*  Insomnia : Insomnia  is another common symptom of early pregnancy. Stress, physical discomfort, and hormonal changes can be contributing causes. A balanced diet, good sleep habits and yoga stretches can all help you get a good night’s sleep.

*  Acne : 
Many women experience acne during pregnancy. It's most common during the first and second trimesters. An increase in hormones called androgen can cause the glands in your skin to grow and produce more sebum — an oily, waxy substance. This oil can clog pores and lead to bacteria, inflammation, and breakouts. These hormones can make your skin oilier , which can clog pores. Pregnancy acne is usually temporary and clears up after the baby is born.

                                                 
      


*  Fainting & Dizziness: Some women experience dizziness or mild fainting spells owing to more blood flow towards uterus and legs and reduced blood flow to the brain. Because of lowering of blood pressure not enough oxygen reaches the brain. Sometimes this causes fainting or dizziness. Dizzy spells may also be caused by anaemia.
In first three months of pregnancy, the blood pressure is  lower than normal. This is why some women complain of dizziness. when they first become pregnant. Some of them might actually lose consciousness for a moment or two. This is not harmful to the baby or  the mother, except that the mother might injure herself if she falls to the ground in a faint.
In case you have a tendency towards dizzy spells fainting avoid crowded and smoky atmosphere and long journeys. Avoid moving too suddenly from a lying or sitting position.

*  Varicose veins : These are dark swollen veins that might appear on the legs during pregnancy, and sometimes remain forever afterward veins are a common, usually harmless part of pregnancy for some women. They happen when the uterus applies pressure to the large vein (the inferior vena cava) that carries blood back to the heart from your feet and legs.
The veins in the legs do the job of carrying impure blood back to the heart for purification. In some women with weak venous valves, the veins lessen their tone during pregnancy. Due to this laxity, they cannot push back the blood through the congested pelvic area, so that the blood tends to pool in the legs, causing the appearance of varicose veins. Varicose veins can become itchy, uncomfortable, or even painful. 
To prevent this appearance , avoid standing for long periods without moving. Do not cross your legs , when sitting on a chair, since this reduces circulation in the legs. Put your feet up on a stool whenever possible. At least once in a day, place your legs higher than the hips. Sit on a chair, put your feet on a table, or lying down on a floor, place your feet on a stool or low chair or bed. When sitting, write alphabets A,B,C etc. with your toes in the air.

 Pile mass (vericosity in the veins around the anus). They can be seen as tortuous veins mostly on the calves and around the ankle, Practice Apana Vayu mudra.

                                                



                                                    
Second Trimester

Most woman find this trimester to be little easy to pass, as most of their easier bothering symptoms will recede especially nausea and fatigue. Some of the symptoms like leg cramps, constipation etc may still remain. 

*   Quickening : The baby starts moving!

*    Enlarged uterus, softening of genital organs and  an internal vaginal examination the cervix will be  seen to have a purplish velvety look, typical of pregnancy.

*  Aches and Pains : As the uterus expands stretching pains are experienced in the back, groins and near the pelvic bones. The pressure of the head of the fetus and loosening of the joint also contribute to the development of these aches and pains. 

*  Shortness of Breath: Increasing pressure of the uterus transmits its effect on all the organs including the lungs. Hence mother find it hard to breathe sometimes especially when going uphill.
As the pregnancy advances, the uterus presses towards lungs. This results in shortness of breath and panting when you climb even  a steps, or the need to take a deep sigh frequently. This is more so in case of a twin pregnancy, or if you are fairly short, so that the uterus feels very large. The discomfort will be more when you sit on something low, when you slum on shoulders or when you lie down. If you sit up straight, it will relieve the discomfort. It is nothing to worry about, the discomfort will vanish with the birth of the baby.

*  Stretch marks and other skin changes:  (Striae Gravidarum) Kikkisa

                                                 


                                               
The skin is made up of elastic and non-elastic fibres. when stretching beyond the normal limits occur, as in pregnancy, the non-elastic fibres tend to break, causing stretch marks. At first these marks may occur as streaks. After birth they take on a kind of purple or brown shade and finally end up as whitish streaks. Excessive water retention (which does not occur as a result of drinking excessive water).  These marks may appear on tummy, breast, bottom and thighsThese marks are as result of expanding uterus. Besides hormonal changes that encourage water retention. Gentle massage with sesame oil on the stretched abdomen, it is very relaxing. It usually appear in the  second half of pregnancy suffered by almost half of the pregnant mothers. Most of them fade after delivery. They also cause mild to moderate itching and scratching worsens the scene. 

Darkening Pigmentation
With pregnancy it is common to develop a darkening of certain areas of the body, like the darkening of the nipple and areola ; or the darkening of a line  starting from below the navel and ending at the pubic hair or the development of the dark patches on the face. 
These are caused by the pregnancy hormone. These hormones tend to make the skin cells containing dark pigment  enlarge, so that any birthmark, freckles, moles or scars tend to become darker after the third month of pregnancy.
These changes mostly disappear after birth, but in some cases they remain. These are normal accomplishment of pregnancy and therefore no cause for worry.

*  Chloasma / Melasma : Mask of Pregnancy or Dark patches on skin
                                               




Pregnancy hormones cause increased pigmentation on the areas like nipples, forehead, cheeks (called Chloasma) .They also fade after delivery.. Oil can be used to lighten the discoloration.
These brownish bluish grayish discolouration appears in a mask like, confetti pattern on around 50 to 75 percent of moms to be particularly those with darker complexion (since they have more pigment in their skin to start with), as well as those who have a genetic predisposition to it  (if your mom had it , there is a good chance you'll have it, too).

Since exposure to sunlight can make chloasma worse, be faithful about applying sunscreen with an SPF of at least 30 and avoid direct sun when possible. Fill up on folic acid, too since a foliate deficiency can be related to hyperpigmentation.. Home made lemon juice can be tried, or apple cedar vinegar or even meshed banana. 

Chloasma usually fades away within a few months after delivery. Bleetching cream or Retina A but not when you are breast feeding. Treatment like laser or peel can be tried.

*   Linea Nigra / Black Line : The line on a center  of the abdomen (called Linea nigra) show increased pigmentation. They also fade after delivery and the oils can be used to lighten the discoloration. Pregnancy hormones are responsible for the darkening of the  linea alba, the white line you probably never noticed that runs between your belly, button and you pubic area. During pregnancy, it's renamed the linea nigra or black line, and may be more noticeable in dark skinned women than in those who are fair skinned. It usually starts to appear during the second trimester and most often will begin to fade a few months after delivery.                                             

                                                  
                                                        
Adventures in Baby Growing: The Mysterious Linea Nigra


*   Other skin Pigmentation : Many women also find that  Freckles and moles become darker and more noticeable and that darkening of the skin occur in high friction areas such as  between thighs


*   & Numbness : Tingling and numbness of the fingers and a feeling of swelling in the hands are common during pregnancy. It may be felt more in the morning, when your wrist have accumulated fluid during the night. It is caused by the pressure of the nerves and tendons by the accumulated fluid in hands and wrists. These symptoms are due to swelling of tissues in the narrow passages in wrist, as they disappear after delivery. To relieve the discomfort , hold your hands above your head for a few minutes and point your fingers toward your ceiling and open and close your fists alternately. Try and control the swelling in your body by reducing salt in your diet.


 *   Itching : Some pregnant woman develop an itchy skin, and find red bumps appearing on the abdomen and breast. This is primarily due to stretching of thew skin  and can be aggravated by heavy perspiration or stress. For temporary relief  try an oil massage. Women with large breast often find that it affects them just under the breasts. Calamine lotion may have a soothing effect. About 20% of all pregnant woman have some kind of itching. And many pregnant woman also get itchy palms and soles of their feet.

*   Cholestasis : Only in rare cases do pregnant women develop a condition called cholestasis of pregnancy, which is itching along with nausea, loss of appetite, vomiting, jaundice and fatigue This condition is a sign of a serious liver problem. In  general itching most often goes away after delivery. In the mean time, one can relieve itching with moisturizers. Using moisturizing and gentle soaps, avoiding hot showers can reduce drying of the skin.

*    Teeth & Gums
During pregnancy the gums soften and are therefore more likely to catch infection and start bleeding. Infection in the gums can mean infection in the teeth also, and consequent tooth decay. Plague is a layer of bacteria that grows on gums and teeth. Bacteria in plaque thrives on the pieces of food stuck between the teeth, and feed on sugar. If you eat a lot of sugary foods you increase the amount of plaque in your mouth. If you eat less sugar, bacteria will not get such a good chance to grow and multiply. Plaque left on teeth can eat into the enamel, which is the surface of the tooth. If this is continued, the tooth will keep on decaying, until it affects the nerve inside, in the center of the tooth, causing toothache.
In order that plaque does not get a chance to form, it is important to brush your teeth regularly and to keep your mouth clean. The good old Indian habit of swishing the mouth with a few times with fresh water after a meal is good. That apart, brush before sleeping. The best thing is to brush after every meal.
In pregnancy your gums and teeth are in a more delicate condition, so a soft brush is preferred to a hard one. A brush with a small head will reach all the corners and surfaces of your teeth more easily. Change your toothbrush when the bristles begin to look droopy or flat. Bit of food left between the teeth can irritate the gums and cause them to bleed. you can visit your dentist if you have bleeding gums. Use dental floss.

         "Eat fewer sweets and more of salads and fruits. Remember that your gums softens, not the teeth. If you brush adequate you can save your teeth."

When the body needs extra calcium to form the  baby's teeth and bones and  and there is not enough in mothers body, the womb will steel from the mother's bones, making them brittle. The teeth themselves are unaffected. They have to be protected by proper cleanliness.

*   Backache : The weight of the baby is supported by the backbone, with the assistance of the muscles of the back and abdomen. When these muscles are weak, the pressure on the backbone is greater and causes discomfort. Bad posture also causes backache. So to correct your posture , pull your tummy in , tuck your bottom in and try to keep your back straight.You can practice this by standing with your back to the wall and pressing the whole length of your spine against the wall and trying to maintain the posture. Rest should help your backache. Don't let yourself over tired. Lie down more often. Lying on your back a small pillow or cushion in the hollow  of your back and bend your legs at the knees, with feet flat on the floor. If you prefer to lie on your side, take a pillow between your knees and another between your tummy and the bed. Lie on the hard bed, so that your backbone  has adequate support. Place hard wooden board under your mattress.

Severe low backache may be caused by a lack of  calcium or by a baby's position. The doctor would recommend supplementary calcium.

Upper backache may be caused by poor posture or heavy breast. Correct your posture  and wear a good  well fitting cotton bra, adjusted at the straps to carry the weight of the breasts.

*   Nasal Congestion : Mucous membranes inside the nose and sinuses often swells up during pregnancy, on account of certain hormones that also soften up the vagina and the mouth of the womb, in preparation for the birth. Some women therefore develop a permanent cold in late pregnancy. However, this will not interfere with your ability to do breathing exercise at the time of labour.

Red Palms (Palmer Erythema) & Soles : If your hormones are at work again  (plus an increase in blood flow) and they are causing red itchy palms (and sometimes soles of the feet) in more than 2/3rd of white women and 1/3rd of women of color. There is no specific treatment, but some women find relief by soaking their hands and feet in cold water or apply an ice bag for a few minutes a couple of times a day. Steer clear of any thing that heats up your hands and feet (such as taking hot bath, washing dishes, wearing wool gloves). It disappear soon after delivery.




*   Avoid swollen hands & feet.
                          

Pregnancy can bring with it swelling of hands, feet, ankles and face. This is called Edema. Since the body retains extra water. In pregnancy a little bit of swelling is normal. Swelling can also be caused by hot whether, tight or ill fitting shoes or exertion; but this kind of swelling generally disappears overnight, when you are comfortable and it is cooler.
Several swellings of hands and feet  that does not go away  at night could be a symptom of the onset of toxemia and should be reported to a doctor.
Increase your protein intake  and reduce salt intake. Salt encourages retention of water in the body. Avoid foods with a high concentration of salt e.g. pickles and salted fish.
Avoid standing for long periods of time without rest. Sit whenever possible, and if possible, put your feet up on a stool.


Changes in the growing fetus:
The second trimester is the most eventful. The vital organs of the fetus like heart, kidney ,liver etc. are formed by forth month. . Babies first movement begins in forth month and gets more conspicuously noticed by fifth month. Second trimester is also vulnerable as most abortions and miscarriages happen during these months. Hence one need to be vigilant at any untoward symptoms like
*   Abdominal contractions with or without pain
*   Menses like cramps
*   Sharp abdominal pain which may cause diarrhea or nausea
*   Dull or strong back pain
*   Bleeding from vagina including spotting
*   Any other discharge from vagina.

Pregnancy Depression
Your pregnancy mood swings. Fluctuation in your hormone can play a role. You can boost your mood by talking, moving, and eating well. one can try meditation ,other relaxation therapies, yoga, acupuncture, music therapy, bright light therapy. can also be surprisingly effective in reducing symptoms of depression. by increasing the level of serotonin - the mood mood regulating hormone in the brain. Exercise besides being good for your body and health, exercise has been shown to be  a potent mood booster, releasing feel good endorphin. Healthy eating is another option. omega 3 fatty acid rich food
  
    "When you become pregnant you must consult an obstetrician. Under medical guidance you will go through pregnancy and birth with fewer complications."

Third Trimester
 Swelling : Swelling in the legs increases by the end of the pregnancy. Any swelling around the eyes, ankle and in the joints noticed suddenly with rapid weight gain should warrant immediate medical attention as it may indicate Pre-eclampsia.

*  Hemorrhoids : These are resultant of increasing pressure over the engorged veins around the anus and constipation. 

Tender Breast:  As the pregnancy advances, breast increases in size and feel full This is how the nature is preparing the mother to nurse the newborn. Consequently they may be slightly painful and uncomfortable. For some woman, Colostrum begins to leak during this trimester. This is the first milk that the body secretes for the baby. It is thick, yellowish fluid that contains antibodies to protect the newborn babies from infections.. Now and after delivery, the nipples need to be washed with plain water often. Avoid soap as it can create painful cracks, which can disturb feeling. Gentle massage with oil heals the crack.

*   Pain under breast: Pain under the breast or just below the rib common as pregnancy advances say after six months. The reason being that as the baby grows, it extends upwards to below the breast and tends to push up your organs like liver, stomach etc, towards the chest cavity. You will find stretching your arms up, straight above your head, help relieve discomfort, since it lifts the rib cage of the growing uterus. Also sitting straight rather than slouching forward will be more comfortable.

Flatulence / Gas Formation & Bloating : Pregnant woman experience more gas formation during gestation due to increased progesterone, the hormone which helps in relaxation of muscles throughout the body..

Heartburn  & Acidity /Gastritis : When  the baby is growing bigger , the uterus pushes the stomach to cause heartburn. Also the Hormones released during pregnancy can sometimes relax the valve between your stomach & esophagus. When stomach acid leaks out, this can result in heartburn. It occurs especially before bed time or immediately after food.

*  Loss of appetite
Nimbu pani /lemon sherbat / lemonade

*  Hip pain : It is common during pregnancy and tends to increase in late pregnancy. It can have a variety of causes, including: a - pressure on your ligaments, b - sciatica, c - changes in your posture, d - a heavier uterus.

*  Palpitation : During pregnancy woman develops palpitation, due to involvement of stomach. You might feel that your heart is beating unusually fast. This is called palpitation. Sometimes you might feel your heart missing a beat. It happens because your heart does lot of extra work when you are pregnant.. It needs to pump enough blood around your body to supply  both  you and your baby with oxygen and nutrients. Also your blood supply increases in volume by about 40% to keep pace with the  increased demands.. To cope up with  this  extra  volume of blood, the heart actually enlarges, so that it is more powerful. This enables it to pump through the extra blood without speeding up  the rate of  heartbeat..
Thus it is not surprising to occasionally notice a difference in the way your heartbeat sounds.However palpitations are nothing to worry about.

*   Pain in Groin & Sides of Abdomen : In late pregnancy it is common to have pain in the pelvic region, since the joints of the pelvic  girdle soften in preparation for birth, avoid standing for long time. The pain might also result from stretching of the round ligament, which holds the uterus in place.

Gestational diabetes It is a condition characterized by a high blood sugar (glucose) levels that are first detected  during pregnancy. Usually seen in the third trimester.

* Gestational Hypertension : 

                                                

Changes in the baby:


Ever growing baby finds the space inside the uterus less and less to move as the days of delivery are nearing. As a result, kicks and movements might decrease in number and frequently which should in no way worry the mother. As the due date is nearing  baby prepares itself to come out  by moving down to its birth position. this may be felt as a dropping. Consequently pressure on lungs and rib cage reduce causing relief in breathing. As the expected date of delivery (EDD) nears, the cervix becomes thinner and softer called (effacing). This is a normal, natural process that helps a birth canal (vagina) to open during the birthing process, The last month should be well monitored in skilled hands to make the exertion of nine months turn into a blissful success. 

Weight gain during pregnancy

Weight gain should be gradual and regulated by consciousness. Hence diet and exercise should be methodical in monitoring the weight gain.9-15 kg gain, it should be gained in last trimester. Uncontrolled weight gain  increases the threat of gestational diabetes and hypertension. Increase around 300-500 calories per day.

                 

Behavioral changes

Abnormal Craving : Desire for a abnormal foods like coal,  soil and  kalam is called Pica. Generally it is due to lack of minerals like iron or calcium in the body. Correction of iron and vitamin deficiency.
It should not be confused with a desire for a particular kind of  food like chocolates in pregnancy. 
Caution : Excuse for eating an excess of fattening and sweet things, since heavy food always leads to heavy weight, and heavy weight leads to complications.

Mood Extremes : Mood swings are common in pregnancy owing to the hormonal changes associated with it.

Sleeplessness : Stress and worry can cause it. If you are worried about your pregnancy or approaching birth, discuss it with your spouse or doctor. It is likely that once you have voiced them, the worries will disappear.
Restrict your fluid intake at night or in the late evening. Recite a prayer or a poem in your mind or your favorite song. Avoid tea & coffee. A hot cup of milk just before retiring to bed will help you to relax. A warm salt bath is also relaxing. Do deep breathing or shavasana. a corpse pose.
If you sleep in the afternoon, it would help, if you stopped your afternoon nap, so that you can sleep better at night. Instead of nap  in the afternoon you can just relax for about half an hour with music or book, putting your feet up as you do so.

Conditions Needing Special Attention

*   Vaginal Bleeding : In early pregnancy, vaginal bleeding may be caused, because the level of your pregnancy hormone is not sufficient high to stop your periods. The bleeding will be scanty and occur when a period would  have been due, such bleeding is not miscarriage.. The doctor will prescribe an injection of Progesterone hormone and advice bed rest.
Late in pregnancy, bright red bleeding, is serious. It can caused by the placenta , the organ that nourishes the baby, detaching from the wall of  the uterus. Advised to go to hospital for bed rest. Lying down increases the blood flow to the uterus and if the placenta is not firmly rooted, give it a chance to root itself firmly to the wall of uterus. 
Sometimes the bleeding is caused by the placenta lying too low between the baby's head and the mouth of the womb. This is called placenta previa, and means delivery by cesarean section. It could also mean bed rest at home or hospital before the birth of a baby.

*    Anemia : Hemoglobin levels tend to drop in pregnancy. If hemoglobin falls as low as 9 grams per 100 ml a woman is considered Anemic. Woman feels tied, exhausted, irritable, lethargic, weak and overworked. She might also experience shortness of breath and dizzy spells. She should increase her daily intake of iron, other options are iron injections and tablets. Food rich in iron are green cabbage leaves, cauliflower leaves, mustard leaves or Sarson, leafy greens, ganth gobhi, mint or pudina, dhania or coriander leaves, jaggery, eggs, liver etc. Although spinach has iron, most of it cannot be used by the body, because other substances present in spinach block absorption of iron by the blood.
If a women avoids putting on too much of weight in pregnancy, she will need less hemoglobin, to sustain her body.

*   Diarrhea : This sometimes occurs in pregnancy and it should be reported to the doctor if it persist for more than a day or two. Iron tablets can cause it in some women. In such cases it can be remedied by simply changing the brand of iron tablets. iron tab should not be taken in empty stomach.
Many women who add lot of fruits and vegetables in their diet find that their stool is little loose or that they pass stool twice a day. This should not be confused with diarrhea.

*   Urinary tract infections :  An infection in a urinary tract causes inflammation of a bladder and urethra. This is called cystitis. The first symptom is desire to pass urine more frequently, sometimes only minutes after having already done so. . Most of the time you will not be able to pass much urine. perhaps only a trickle or not at all.. This can be accompanied by burning sensation.. The urine passed is dark yellow in colour and sometime stained with blood.
In addition immune system of the body is relatively week, hence the mother is more prone to contract infections especially of urinary tract. if there is burning sensation while passing urine or lower abdominal pain it may be U.T.I, It is better to see a doctor.
The infection is easily caused in women because of a female anatomy; since the opening of urethra, vagina and anus are  all very close together.. Germs from the stool get transmitted very easily to the urethra and vagina. It is treated by antibiotics.To relieve a symptoms of cystitis immediately, drink  glass of water every half an hour to dilute the urine. and to help flush the infection through, before it gets a chance to take a hold. Any watery liquid will do for example, a lemon or barley drink, weak tea, lassi etc. Or soda-.bicarb dissolve in water or syrup Alkacitron. It makes urine alkaline which is inhospitable to germs, therefore less painful when passes 3 glasses of water on waking up in the morning. Second be more hygienic. Every time you pass a stool, wash the anal area not only with water, but with soap and water, and do not bring your hand forward towards your urethra as you do so. Better still, wash from behind. During your bath, use soap and water to wash the vaginal area .Similarly wash your anus thoroughly.

*   Vaginal Discharge : It is normal to have increased vaginal discharge in pregnancy, because at the mouth of the womb increase their output. The discharge is actually cleansing the vagina and keeping it free of infections, as well as lubricating the tissues of the vagina as they become thicker softer and more elastic in preparation for birth.. During subsequent pregnancies the discharge will be less.. Make sure you wear cotton underwear to allow your skin to breath..
If you notice a change in the discharge from white to yellow or green and if it is causing itching or irritation, becomes thicker or smells unpleasant, you probably have an infection.. It is a minor harmless infection called thrush, candida or moniliasis.
It is easily treated with creams or pessaries. Sometimes antibiotics are given.

*    High Blood Pressure : Any physical movement such as running are jumping can temporarily raise the blood pressure, but it returns to normal after a period of rest. 
Excessive weight gain could raise blood pressure also a stressful lifestyle. It is therefore important to rest when you feel you are getting tired. and tense. Rising blood pressure leads to toxemia, which need special attention and care.

*    Toxemia and Pre-eclampsia :  Toxemia usually occurs only during the last few weeks of pregnancy and is recognized by three typical symptoms. Any of these symptoms  appearing by itself does not mean you have toxemia. It is only when they appear together that they spell toxemia. The first symptom is raised blood pressure. The second sign is swelling of hands, feet and face. The third sign is the appearance of protein in the urine..
These are warning signals, if they are not treated , convulsions may occur. The toxaemia has then become a serious condition known as Eclampsia. Vigilant prenatal health care can prevent this condition. Once a woman is excreting a high proportion of protein in her urine, the pregnancy is not likely to continue for longer than two weeks. 
A well balanced diet with more protein and less carbohydrates and salt, reduces the incidence of toxemia. Rest will also help. If symptoms persist early delivery of the baby. Complete bed rest in the hospital is advised.  Following are signs of eclampsia: headache, flashing lights, nausea, vomiting and pain in abdomen . Toxaemia and eclampsia should not be taken lightly.

*    Rhesus Negative : All blood is either rhesus negative or rhesus positive. You run a risk only if you have a rhesus- negative blood group, while your husband  has rhesus  positive blood group. A routine blood test at the beginning of the pregnancy will show whether you are rhesus positive or negative. There is no symptom of rhesus incompatibility that you will notice.
An injection of anti-D immunoglobulin can be given to a rhesus negative mother immediately, after the birth of a rhesus-positive baby. This injection is a serum which is to be given 48 hours after the birth of a baby. A fresh injection is given after every delivery, miscarriage or abortion.

*   German Measles, Rubella : This is a mild but very infectious disease that last only 12 to 24 hours. It is caused by a virus, and  may cause a slight rash and fever. If you fail to see a doctor when the rash occur, a blood test taken two weeks later will show a high level of antibodies from recent infection and confirm the diagnosis. 
Rubella has grave consequence for the unborn child. If you suffer from it in first three months of pregnancy it may cause deafness, blindness and congenital heart disease. Late in pregnancy, the risk is much less, and could be restricted to deafness.The virus could also cause a miscarriage, low birth-weight babies or still born. If one catch rubella in the first three months of pregnancy, your doctor will advice a medical termination of pregnancy.
If you have been in contact with someone who has measles or has recently had measles, or who develops measles within two  or three days of seeing you, consult your doctor. A couple of blood tests done two weeks apart will help the doctor decide whether patient should be continued or terminated.
Mothers should immunize their daughters against rubella when they are around 10 to 14 years of age.
If you are not sure whether you have had rubella, a blood test for rubella antibodies will make it clear. If a blood test shows that you have never had rubella, you can be immunized  after your baby is born, to avoid worry in future. However the inoculation should not be taken in pregnancy, and once taken in non pregnant state , conception should be avoided for three months afterwards.

Importance of 3-in-1 vaccination during pregnancy

Let’s look at the three diseases that it covers and why a 3-in-1 vaccination is indispensable for you and your baby’s health. The 3-in-1 vaccination covers Pertussis along with Tetanus and Diphtheria and lets you protect you and your baby against 3 diseases.  According to CDC, the 3-in-1 vaccination is safe to be given during pregnancy and can go a long way in helping your baby develop the antibodies to fight illnesses till the time they cannot get vaccinated. With these vaccinations, as a mother, you will also be able to protect yourself and ward off any serious diseases that you could pass on to your child. However, it is also important to not panic over the mild side effects of vaccinations, that lead to minor manifestations like pain, redness or swelling where the shot was given, muscle aches, fatigue, and fever. These symptoms usually go away on their own.

Getting administered with the 3-in-1 vaccination gives you the peace of mind that you are doing enough to protect yourself and your baby. Please contact your gynecologist for more details about 3-in-1 vaccination during pregnancy.


Tetanus
Tetanus is one of the worst bacterial diseases that can lead to severe complications in both the baby and the mother. Caused by the toxin of a bacterium called Clostridium tetani, which is found in the soil, it can lead to severe morbidity in the mother and mortality in the baby. As one of the most popular vaccinations in the world, Tetanus enters the body through an open wound or cut and affects the brain and nervous system. Gradually, it leads to severe muscle spasms that can make even opening the mouth extremely painful, making swallowing and breathing very difficult. It has an extremely high fatality rate and kills one out of five people infected with the disease*. In the case of neonates, it enters the body through the infection of the umbilical cord, especially when the stump is cut with a non-sterile instrument. It is one of the most important vaccinations for children and is covered within the 3-in-1 vaccination.

Diphtheria
In the last few years, vaccination against diphtheria has significantly reduced its mortality** and morbidity by a huge extent and now, the 3-in-1 vaccination is allowing mothers to protect themselves from it along with two other deadly diseases through one shot. Diphtheria is a serious bacterial infection that goes on to affect the mucous membranes of the nose and the throat, and eventually lead to breathing problems, heart failure, paralysis, and even death. In many third world countries, it remains to be an important disease for child mortality, making it extremely important for mothers to get themselves immunized during pregnancy. In fact, in India, it continues to occur among young children and teenagers despite the Universal Immunization Programme’s efforts. A lot of it is due to the lack of immunization facilities, missing out on the booster shots, and due to the lack of data regarding coverage of booster doses of Diphtheria, Pertussis, and Tetanus vaccine. The best way to prevent it is by administering mothers with the vaccination during pregnancy.

Pertussis
Popularly called Whooping Cough, Pertussis is a highly contagious respiratory infection that affects a lot of children in India. It is caused by the bacterium Bordetella pertussis and is often transmitted from one person to another through coughing and sneezing. It is a significant cause of pneumonia, convulsions, brain damage, or death and the chances of transmission from mother, older siblings, family members or other caregivers is extremely high. 90% of infants less than 2 months of age with Pertussis require hospitalization. In the first six months of its life, a baby is highly susceptible to Pertussis, and even healthy babies have a huge risk of getting infected. This is a time when the baby’s immune system is developing and babies younger than 2 months only have the antibodies, they get from their mother to build an immunity against this disease. This is why it is necessary for you to get the whooping cough vaccine during pregnancy and transfer the protective antibodies to your baby. 

Anti - Tetanus Injections
Anti -Tetanus injections are given routinely to all pregnant woman. It protects the mother and the baby  both from the tetanus injections for up to several months after the birth. It is usually given in two doses in 26th week and six weeks later.


Medical Termination of Pregnancy
Amniocentesis or AFP test may suggest the baby has  a severe abnormality of the spine & brain. or German Measles or Rubella in the first three months of pregnancy , it can physically and mentally handicap the child. Chickenpox can do similar things.. In such cases doctor will advice abortion, than to live with an abnormal child. for the rest of your life

Maternity Dress
                                   




Other conditions

                               


*   Spotting : Some women may experience light bleeding and spotting  in early pregnancy. This bleeding is most often the result of implantation. Implantation usually occurs one to two weeks after fertilization.

*  Bleeding per vagina: : During pregnancy if a women bleeds per vagina, it can be placenta previa or abruptio placenta. If spotting or bleeding occurs alongside your cramps, it could signal a miscarriage or an ectopic pregnancy.

*  Backache : Backache and muscular spasm is caused by relaxation of pelvis, faulty posture lordosis, constipation, urinary tract infection and deficiency of calcium. Hormones and stress on the muscles are the biggest causes of back pain  in early pregnancy. Later on, your increased weight and shifted center of gravity may add to your back pain. Around half  of all pregnant women report back pain during their pregnancy.

*  Headache : They’re usually caused by altered hormone levels  and increased blood volume. 

*  Pregnancy induced hypertension : Hypertension, sometimes develops during pregnancy A number of factors can increase your risk, including: a - being overweight or obese. b - smoking, c - having a prior history or a family history of pregnancy induced hypertension.

*  Anemia : Pregnant women have an increased risk of anemia, which causes symptoms such as lightheartedness and dizziness. The condition can lead to premature birth and low birth weight . Prenatal care usually involves screening for anemia.

*  Depression : Between 14 and 23 percent of all pregnant women develop depression during their pregnancy. The many biological and emotional changes you experience can be contributing causes. Be sure to tell your doctor if you don’t feel like your usual self.
.
* Diarrhea:  Diarrhea and other digestive difficulties occur frequently during pregnancy. Hormone changes, a different diet, and added stress are all possible explanations. If diarrhea lasts more than a few days, contact your doctor to make sure you don’t become dehydrated. 

* Stress and Pregnancy: While pregnancy is usually a happy time, it can also be a source of stress. A new baby means big changes to your body, your personal relationships, and even your finances. Don’t hesitate to ask your doctor for help if you begin to feel overwhelmed.

*  Pruritis Vulvae : Vaginal candidiasis is more common in pregnancy due to high acidic pH of vaginal secretions and frequent presence of sugar during pregnancy. Treatment: Anti - fungal tube locally.


Threatened Abortion : Complete Bed Rest. Tab Folic acid 5 mg OD. Tab Calmpose 1 HS. Tab Duvadilon T.D.S. Inj Prolutin depot 500 mg IM. Weekly. Tab Progesteron.

                                                   "Consult a Gynecologist."

Complications

*   Pre-eclampsiaIt consist of hypertension and proteinuria.
*   Eclampsia
*   Hypertension
*  Toxemia
*  Abruptio Placenta
*  Placenta previa
*  Diabetes
*  Thyroid

Stress & Pregnancy

Pregnant woman should realize that all the symptoms of pregnancy are temporary and her consulting doctor can recommend ways to cope with them. Hormonal changes may be partly responsible  for the mood swings are common and normal. So a woman should not be over concern about them. Positive constructive activity such as listening to soothing music, avoid loud and rock music. Reading good literature or any other constructive hobby.
Stress reduction techniques such as : 
*   Biofeedback
*   Meditation
*   Guided mental imagery
*   Yoga / Pranayama
*   Childbirth education classes
*   Relaxation techniques
                                           
                                      "A baby must be designed by choice not by chance."

Pregnancy Care

Nature is the best friend and mentor.

Lifestyle

                                           "Get fit for pregnancy and stay fit."

Do's

The posture of the sleep- the keeping of the left hand as a pillow- this is advised in pregnancy.
*  Expected lady to be free from undue stress, anxiety, fear, anger etc. negative emotions and replace it with kindness, love, joy, gratitude etc need to be inculcated.
*  Educating the expected lady to be free from undue stress, anxiety, fear and anger etc. negative emotions and replace it with positive emotions like kindness, love, joy, gratitude etc needs to be inculcated.
Preferring home made, fresh, healthy food
*  Use soft bed to sleep.
*  Preferring home made fresh healthy food, which one is accustomed,

*  Being physically active  helps to shape  the pregnancy better.
*  Drink adequate water. 
* Sleep :The pregnant woman requires a minimum of 8 hours sleep. One can take few naps in afternoon as well. It is better for a pregnant woman to sleep on left side.
*  Cooked vegetables are better for digestive process than raw.
*  Maintain hygienic measures with cloths and body, Since the body is sensitive and getting sick is easy and thus may jeopardize pregnancy
*  Pregnant mothers should seek out gentle leisure activities for relaxation and calmness so as to impart mental and spiritual stability.to the unborn child. The whole family atmosphere should be congenial and healthy.
*   Food should be consumed in a blissful state of mind  and stress, anxiety, anger, negative emotions should be controlled.
*  Read good books, listen to good music. Attend very good talk and sessions and always get surrounded by good people, Then you will become very positive you will start thinking positive
*  Pregnant woman should be massaged on the back and abdomen.
*  Always be happy, and be in serene atmosphere.
*  Being creative and engaging in productive but light activities is highly advocated.
*  Wear comfortable cloths.
  In the later stages have a regulatory Vata movement that is essential for a smooth delivery.
*    Anointment with cooling agents like musk, sandalwood is also beneficial.
 Footwear : Your footwear should be flat. You might need shoes a size larger.

De-Stress
This can be done with techniques like slow and deep breathing, yoga

Get Plenty of Rest
Listen to your body as it will tell you how many hours of sleep you need at night, and when you need to take short breaks during the day.

Remain Active
If you are not exercising at all before you became pregnant, this is the time to start walking or swimming. Start with short periods of exercise. Regular and monitored exercise will reward you with a better posture, less back pain, less stress, anxiety, depression and constipation,better digestion and more energy Once you are in labour 

Apana Mudra :  


  • For safe painless delivery a pregnant lady should practice this Mudra daily for 10 minutes a month before the due date.



Don'ts

*  It is advisable to prevent jerky movements, avoid excessive long journey travel and to accept the hormonal and other changes with awareness.
*  No medication during the whole period of pregnancy is best recommended.
*  Excessive physical exertion. and Lifting heavy weight. Moderate exercise permissible.
The expected mother should hear or sing melodious songs, read sacred books or beautiful literature which is not stressful, 
*  Wear comfortable cloths., try to be happy, be in a serene atmosphere.
Being creative and engaged in productive but light activities is highly advocated.
*  Excessive bathing is not permissible during pregnancy but is advised at term gestation. Turkish bath or steam bath is contraindicated to pregnant women in first and third trimester and also at near term.
* It is advisable that the pregnant women should be massaged at the back and abdomen.
*  Smoking must be banned in whole house 
*  No alcohol consumption or else it results in Foetal alcohol syndrome (FAS) or foetal alcohol effects (FAE) and this means expected child could be born not only with physical malformation, learning disabilities.
*  Harsh and violent activities and emotions like anger and fear.
* Taking intoxicating substance.
*  Suppression of natural urges, fasting, squatting and any abnormal posture.
*  Riding vehicle on uneven path.
*  Excessive walking any physical strain.
*  Use of uneven beds.
*  Avoiding strong massage.
*  Woman should avoid situations that create anger and frustration ,circumstances that provoke unnecessary stress and tension in the body and avoid habit which are not beneficial for health,
*   Smoking must be banned in whole house.
*   Alcohol : Drinking alcohol during pregnancy is to be avoided.  Or else it results in Foetal alcohol syndrome (FAS) or foetal alcohol effects (FAE) and this means expected child could be born not only with physical malformation, learning disabilities.
*   Drugs : cocaine, heroin, methadone, crack ecstasy, LSD, and PCP etc. It can cause serious harm to a developing fetus and to the pregnant mother. Long tern developmental problems can be avoided such as chronic diarrheas', irritablity, excessasive crying, neurological and behavioral problems, motor development deficits and low intelligence and is sure way to prevent miscarriage, premature labour and still birth. 
*   Food should be consumed in a blissful state of mind and stress, anxiety, fear, anger, negative emotions should be controlled.
*  Coitus in first and last trimester of pregnancy may cause abortion.
*   Excessive physical and mental exertion should be avoided always.
Pregnant women should stop eating pickles, salted foods, soda drinks and food which causes flatulence. 

Truth about Don't.

*    Physical or psychological trauma may cause abortion.
*    Riding vehicle or lifting heavy articles may cause sudden increase in the intra- abdominal pressure and even may result in intrauterine death of the foetus and thus cause abortion.

 Simple Exercises In Pregnancy

              
Some Simple Exercises
During pregnancy , certain exercises should be done, keeping in mind  the limitations and the needs of the pregnant body. The following exercises are recommended.
*  Regular simple and not vigorous exercises should be done all throughout pregnancy
*   Exercise is the most essential part in pregnancy care as it not only keeps mother in shape but also ensures childbirth an uncumbersome journey.

*   Thirty minutes of light exercises daily are beneficial. It helps to lower risk of gestational diabetes and hypertension. It keeps mother in healthy shape and weight after delivery.
*  Normal low impact activities like walking, swimming, light exercises are preferred.
*  Strong stretching of muscles and deep bending of joints are preferred.

  Kegel's Exercise : 
- Important sets of exercises, which helps to ease the labour, are called Kegel's exercise. This aims at strengthening of pelvic floor  muscles, which in fact has the greatest stress of contraction and relaxation during pregnancy. and more so during childbirth. The muscles which one uses to stop the urine flow and release while urinating are pelvic floor muscles.

- Tighten the pelvic floor muscle for five seconds, and then relax. Repeat it 10 times in a day. 


 

Neck Exercise And shoulder rotation    
Benefits :
In order to mobilize and strengthen the neck  and shoulder muscles, we do the following exercises.:
They also help relieve tension on the neck and shoulder muscles.
Position :
Sit cross-legged with the back straight, keep the head and the neck in one straight line.
Steps :

                       

1 . Incline the head downwards so that the chin moves towards the chest.
                                  
2 . Then straighten the head again, and take it backward with your mouth open, so that your chin now  points at the ceiling. Close your mouth, feeling the stretch in front of the neck and hold the position for count of six.
                           
3 . Bring the head back to starting position, turn on your right and then to your left. While doing so ,try align your chin in line with your right and left shoulders alternatively.
Do three times.

Shoulder Rotation
Benefits :
Good for upper back , helps relieve pain in upper back and nape of neck.
Sit cross - legged with the back straight , keep the head and neck in a straight line. Steps :
1 . Bring shoulders forward. 
2 . Raise shoulder up towards your ears.
3 . Thrust shoulders backwards, so that the chest juts out - wards.
4 . Bring shoulders back to the starting position.
Now repeat this movements in one fluid motion, so that you  make a circle with your shoulders.. Now make similar circles in the opposite direction.
Make five circles in each direction.

Shoulder and Breast Uplift Exercise
Benefits : 
It prevents round shoulders and humped back.
The exercise also provides a support and uplift to the breasts, maintaining their form in long run.
It should be continued postnatally for about 3-6 months after you stop feeding the baby.
Position : 
Sit cross-legged with back straight. Keep the head and neck in a straight line.
Steps : 
1 . Place one palm at the center of the back below the head and neck with fingers pointing downwards.
2 . Incline the neck slightly forward.
3 . With the palm of the other hand  hold the bent elbow  of the arm that is placed on your back of your head, trying  to align the palm and elbow in one straight line behind your head.
4 . Hold the position for at least six counts,
5 . Release.
6 . Repeat with the other hand.
Do a total of eight times. That is ,four times each arm.

Deep Breathing
Benefits :
It is not a simple exercise. You are also exercising all the muscles of your carriage.
It provides more oxygen to you and your baby.
Besides when you breath in , the diaphragm presses on abdominal organs massaging and invigorating them.
Position :
Sit cross legged with the back straight. Keep the head and neck in a straight line.
Steps :
First practice Step A for three days and then go on to step B. Avoid step B if you have threatened miscarriage or bleeding , or if you have had a stitch put in the mouth of the womb.
Step A 
1.  Exhale slowly through pursed lips, to the maximum.
2 . Let your lung naturally fill up with air when exhalation is complete.
3 . Breath normally for about three breaths.
4 . Repeat the first three steps.
Do three times.
Step B
1 . Exhale slowly through pursed lips, to the maximum.
2 . Let your lung naturally fill up with air when exhalation is complete.
3 . Hold your breath until as long as you can comfortably can and watch the seconds hand  on your watch as you do so. Alternatively, count mentally.
4 . Exhale.
5 , Repeat three times.
Over a period of time  you will notice that  the time for which you can hold your breath has increased.
It is best to do this exercise early in the morning when there is less dust and vehicle exhaust in the atmosphere.

Pelvic Floor Exercise
Benefits :
The uterus is supported by the pelvic floor muscles, and this exercise will help strengthen and maintain the shape of these muscles now and after delivery. In pregnancy it helps to hold the extra weight of the growing uterus.
After delivery it will help you regain your prepregnant tightness. Still later in life you will probably not need an operation for a prolapse uterus, when the pelvic floor muscles sag and are therefore unable to hold up the uterus in its place.
You do this exercise beginning now, always for the rest of your life.
Position :
Sit cross-legged. Can also be done while standing or lying down. Start with Step A. After three days start Step B. After three more days graduate to Step C.
Steps :
A 1) Exhale. Leave your pelvic floor absolutely relaxed, as when passing urine.
A 2) Now imagine that you interrupt or stop the flow of urine  for a while, by a slight contraction of muscles.
A 3)  Repeat the above steps three times. The pelvic floor muscles are used during this exercise.
B 1)  Exhale and relax the pelvic floor.
B  2) Imagine that you want to pass urine badly, but you are at a public toilet and have to wait in a queue; and as you wait, you have to control the passing of urine by a strong contraction of your muscles.
B 3)  Hold the contraction for the count of six  and release. Exhale and repeat the contraction twice.
You anus might also contract slightly, that does not matter, since your anus, vagina and urethra are in one band of muscles. You might feel a slight tightening above the pubic hairline. You should not feel tightening around the navel of the abdomen. If you do, it is a sign that you should locate the contraction backwards towards the anus instead.
You are now ready for the final step of your exercise.
C 1) Exhale, Inhale.
C 2) Contract your pelvic floor muscle a little bit. Count six.
C 3) Contract your pelvic floor muscle slightly more. Count six.
C 4) Contract your pelvic floor muscles the maximum you can. Count six.
C 5) Relax your pelvic floor muscle slightly.
C 6) Relax your pelvic floor muscle slightly more. Count six.
C 7)  Relax your pelvic floor muscle totally.
Exhale and repeat again.
Repeat five times.
At the start contracting will be easier than relaxing in stages. However after about a week  of practice, you will gain muscle control.
If you develop an ache  in the muscle, it is because these muscles  are not used to being exercised.The pain is like the pain you would get in your arm if you played badminton after many days. So do not stop the exercise, but do it in one continuous contraction for the count of six , instead. Repeat at least five times.
Precautions :
At the start : Always exhale before starting this exercise.
At the end : When you finish this exercise five times, contract your muscles slightly, after the totally relaxed stage of this exercise.
Ankle Movement
                           

Benefits :
This exercise has its base in yoga. It exercises the ankles, a part of body  not generally exercised.. It feels good; since the strain of the extra weight in pregnancy is carried by this area of the body.
Position :
Sit with one leg outstretched, the other leg bent at the knee, and the lower part of the bent leg (just above the ankle) resting on the thigh of the outstretched leg.
Rest your back against the wall if you like.
Steps :
1 . Hold the bent leg just above the ankle with one hand, with the other hand rotate the foot from the ankle.
2 . Rotate the foot five times clockwise and five times anti - clockwise.
Repeat with the other leg.
                      


Mochi / Cobbler Pose

                       



Benefits :
Relaxes and stabilizes the pelvis. Exercises the pelvic joints. Also stretches the inner thigh  and the pelvic floor muscles.
Position :
Sit cross legged
Steps :
1 . Bring the soles of your feet together in front of you, so that you form a namaste with your feet.
2 . Now with your hands  hold the soles of your feet together, and drag them towards along the floor towards you body.
You will feel a stretch on your inner thigh.
Do once and stay in position as long as you comfortably can. 

 ●     Butterfly Pose   Baddha Konasana  :  ( तितली आसन )
                                     
                                          

Technique : Sit in starting position. Bend both the knees and drop the knees on the floor  on both the sides. Hold the toes by interlocking the fingers, move the knees both in upward and down ward direction in normal breathing.

Benefit : 

  • Butterfly pose  is good to keep the lower spine fit. 
  • Improves sitting balance & posture. A good stretch for inner thighs, groins and knees improving flexibility in the groin and hip region.
  •  Helps in intestine and bowel movement. Removes fatigue from long hours of standing and walking. 
  • Offer relief from menstrual discomfort and menopause symptoms. 
  • Helps in smooth delivery if practiced regularly until late pregnancy.
  • It strengthens the pelvic muscles

Pelvic Lift
                        

Benefits
Strengthens the back muscles and relieves lower backache or feeling of congestion in the groin.
Position :
Lie down flat on your back. Bend both legs at knee and place feet flat on the floor.
Steps :
1 . Now put your weight on both feet and raise your hips off the floor.
2 . Once raised, stay in position for at least ten counts.
3 . Then gently lower your self back to the floor.
Do once or twice.
 Helping in lifting the pelvis  may be taken from someone if you are unable to do so independently. Someone can stand by your side  next to your hips and place both arms around your lower back and help you rise off the floor.

Knee Chest Position
                                   

                       
                     


Benefits : 
When you are upright all day, the organs hang from the spine  as a flag hangs  from a pole.When you position yourself for this exercise by going on all fours, the organs hang from the spine  like clothes from a line. Hence this exercise relaxes the back.
When you do this exercise, the weight of the pregnant uterus is shifted away from the pelvic floor and the spine, it will also take care of backache and radiating pain in the hips and legs.
This exercise also feels good , if you have a gastric problem and are wanting to burp to relieve your self.
Position :
Kneel on the floor. Then go forward on all fours, by placing your palms on the floor  in front of you. Keep your knees and hip  in one line and your palms and shoulders in another line , keep your head down and back straight.
Keep your head down all the while. Raising your head will tend to encourage  the hollowing or caving in the back. If the back is allowed  to hollow. it can give rise to backache.
Stay for a while in this position. Steps :
1 . Go down, putting your elbows in place of your palms and point palms towards opposite elbow.
2 . Rest your head on your arms.
If your stomach hit against the thighs, seperate your knees a bit , so the your stomach fits in the hollow between your thighs.. Secondly guard against the hollowing of the back. If hollowing occurs, correct it by gently pulling in your stomach.
3 . Stay in the position as long as you comfortably can. Breathe normally. While in position you will feel a rush of blood towards  the face which will make your face warm, do not worry.
To be done once. The longer the position is maintained, the greater the benefit derived from it.
Precautions :
If you have high blood pressure, stay in the all four positions, but avoid getting the head down.

Leg Lift
                       

Benefits :
In pregnancy there is a tendency towards varicose veins in the legs. Varicose veins are dark and protruding veins that appears as a result of the pressure of the head on the pelvis.
This exercise gives relief to the legs by assisting the blood to flow  back towards the heart, and gives a soothing effect to the legs.
Position :
Lie on your side with one arm stretched outwards under your head, and the palm of the other arm placed in front of you. Place a pillow between your abdomen and the floor.
Steps :
1 . Raise the upper leg higher than your hip.
2 . Hold for the count of six.
3 . Gently bring back to the starting position.
Repeat three to four times with each leg.

Curling leaf
Benefits : Take off the strain from the back while you are getting up  and reduces the possibility of backache.
Position : 
Lie flat on your back. Bend the left leg at the knee, with the foot next to the knee of the outstretched leg. Stretch the right arm straight outwards behind your head.
                
Steps :
1 . Put the weight of your body on the foot of the bent left leg.
2 . Roll your body in the opposite direction that is, to the right.
3 . Simultaneously, as you roll on to the right side, bring your left palm to rest on the floor, in front of your abdomen.
4 . Now strengthen your left leg and rise up with your weight supported by both palms.
Repeat with the other leg. 
Practice four times till perfected. Then use simple as a way of getting up. 
                   

Leg Swing
Benefits :
There are three pelvic joints in the pelvis which spreads slightly apart during delivery. The present day lifestyle of sitting on chairs all the time makes the joints inflexible, by bringing some movements in the ligaments that holds these joints.
Position :
Stand with your hands on your hips and feet placed normally.
Steps :
A  1 . Tilt very slightly to the left side and swing the right leg forward and then backward. Four times.
A   2 . Repeat with the other leg.
The swing forward and backward should not be exaggerated. About one foot forward  and the one foot backward is fine. Done over enthusiastically, it could cause an ache in the sacroiliac joints that have already been softened by hormones in preparation for birth.
If you tend to loos balance, pause in the starting position. between each forward and backward swing.



                     



B  I . Stand with hands on hips.
B  2 .Swing one leg outward sideways and bring back to the starting position. Repeat three times.
B  3. Repeat with the other leg.


 
                 

Pelvic Tilting
                       

Benefits :
This exercise relieves lower backache and also helps retain abdominal tone, so that after your baby is born, the abdomen will tone up faster and more easily.
Your bony pelvic basin houses your reproductive organs like your ovaries and uterus. As the uterus balloons up with pregnancy, it spills out of the pelvis basin, putting its weight on the abdominal wall. The baby lies on the abdominal wall as though lying on a hammock. This weight on the abdominal  wall puts pressure on the lower back muscles which begin to pain. It also causes the abdominal wall to stretch to its maximum and loose its tone and elasticity, giving rise to stretch marks.
The pelvis tilt exercise tilts the pelvis in a way that the contents of the pelvis  that press the abdominal wall, are pushed inwards, so that their weight is taken by the bony pelvis during the duration of  the exercise. This gives respite to the abdominal wall from stretching and relieves backache.
Position A Stand normally.
Steps :
1 . Exhale.
2 . Inhale, and as you do so, bend slightly at the knees.
3 . Draw you abdomen inwards towards your backbone, flattening the curve at the center of the back as you do so.
4 . Hold the position for the count of six.
5 . Release and go back to the starting position.
Repeat five times.
Position B 
If you are fairly advanced in pregnancy, you could do this exercise in a lying position.
Lie down flat on your back. Bend legs at the knees and place feet flat on the floor.
Steps :
1 . Place a folded hand towel or napkin in the hollow of your back.
2 . Exhale or sigh out. Then breath normally.
3 . Tighten the buttock muscles and draw in the lower abdomen.
4 . Simultaneously flatten the hollow of your back against the floor and press on the folded towel.
5 . Hold for count of six.
6 . Release. 
7 . Exhale and repeat the above steps.
Do five times.

Walking for Cramps and Aches of the Foot
                         

                     


Benefits :
Cramps can sometimes occur due to lack of circulation. This exercise  gives the circulation of blood in your lower limbs a boost.
Position :
Stand normally. You should have about  six feet of open space for walking.
Steps :
1 . Walk across the six-foot space on your toes.
                       

2 . Then walk back on your heels.

                      

3 . Finally walk on the sides of your feet.
Do once every day before bed time.
Sometimes cramps can also occur  due to a lack of calcium or vitamin B. If cramps do not get alleviated with the walking, check your diet. Sometimes a little discomfort may be felt in a legs since these muscles are not generally exercised. It will disappear as the muscles get used to this exercise.Do not stop the exercise.

Squatting
                     

  


                     

                    
                   
Benefits
While squatting, the pelvic inlet or outlet and canal are at their widest. Those using the squatting type toilet are at an advantage  as it exercises your joints and muscles without having to do much. Use it more frequently if you have one in the house.
Squatting correctly positions the growing baby and the uterus. It also cures constipation. 
In the last four weeks of pregnancy it encourages the fixing or engagement of the baby's head , when the baby is lying in the head down position.
Steps :
Squat as when using an Indian toilet.If you are well advanced in pregnancy with a big stomach, follow these steps.
1 . Stand normally, with your back to a wall.
2 . Now stand on your toes.
3 . Go down into a squat with the weight of your body on the toes of your feet.
4 . Do not go into a complete squat, remain in a slightly raised position.
5 . The wall will support your back. Keep knees as wide apart as possible.
6 . Stay for at least a minut in the final position.
Precautions :
Do not do this if you have a Shirodkar"s  stictch in your cervix, or bleeding in pregnancy or low lying placenta. Also avoid it if you have severe or painful varicose veins or piles.                                                     

Yoga

Not to forget the yoga, which is a critical practice that can help both mother and child and , and enhance the metabolism and mental health of mother and new born.
                                      

*   Yoga can be an ideal way to stay in shape during your pregnancy. It keeps you fit and tones your muscles, and improves your balance and circulation,with little impact on  your joints
*   Not to forget the yoga which is a critical practice that can help both mother and child and enhance metabolism and mental health of the mother and newborn. Yoga can be an ideal way to stay in shape during your pregnancy. It keeps you fit, tones your muscles, and improves your balance and circulation,

   
Padmasana

                                                   
                                                       
Sit erect with both legs placed straight forward. Bend the right leg on the knee joint. place the right foot at the left groin with right sole turned upwards and the heel in front of the pelvic bone. Place the left foot on the right groin in the same fashion. Straighten up with both hands placed on thighs. close the eyes and meditate. maintain this posture for one minute.


Trikonasana  (Triangle pose)
                                              
     Bring your legs apart so your feet are wider than your shoulders
     Raise both arms out to the side up to shoulder height so that they are parallel to the floor, Palms turned down.
     Turn your left foot 90 degrees outwards
     Keep both hips facing forwards
     Turn your right foot slightly towards the left foot and keeps the hips forward
     Press your hips to the right and place your left hand on your thigh above your knee
     Bring your right arm so it is straight with fingertips towards the sky


Staff Pose /  Dandasana
                                                        
                                                      

Sit flat on the ground with both legs stretched out. Clasp the fingers of both the hands together and let them rest on the thigh. When you inhale lift the hands up still clasping the fingers together. The hands should touch the ears. And as you exhale, lower the hands down still clasping the fingers..
Note: When in the posture, the spine should be erect., The practice should be started in early stages of pregnancy.. The knee should not be bend.
Benefits : Helps strengthens the thighs, hips, pelvis and the lower back.

Diamond Pose / Vajra Asana

                                                        

                                                           


Any asana that is used to raise the energy in the body  can be called as Vajra asana.(Vajra is the weapon of Hindu god Indra.). To start, get slowly and comfortably on your knees and your palms resting on your ground. Next join your feet together from the tip of the toe to the heels. Slowly and gently sit on your feet. While sitting you will realize that the heels are separating out. This is natural. Let your buttock rest on your gap  between the heels.
Note : If you do not have a practice of sitting in this posture, you might feel very uncomfortable  and painful on the frontal side of ankles. To ease the pain, you can place a thin bed sheet rolled under the ankles.
Precautions : To start with, you can sit for a minute. Go slowly increase the timing of the practice. Starting the practice with 5-10 minutes, might reduce the blood circulation in the legs making them torpid  might in turn cause your balance while walking soon after.
Benefits : This asana helps improve digestion and improves blood supply to the abdominal region.

Cat Pose / Marjarasana


                                                    


                                                   


Get on to the knees and place the palm flat on the ground . The palms must be parallel to the thighs and should be at right angles to the body. Inhale and look up skyward. and curve the spine as much as possible towards the ground. Now exhale and look towards  the thighs pushing the spine up towards the sky. Repeat the exercise 5-10 times.
Note : Each person has her own comfort and discomforts that it may cause to you.
Precautions : If you feel tied relax. Do not push your self to the practice.
Benefits : The asana helps relax and strengthen the spine. It also relieves backache.


Malasana (Squatting position)
                                                     


Squatting is one of the most effective ways to tone the entire lower body. As the pelvis descends it encourages the downward flowing energy of Apana Vayu and thus helps in constipation.

Mountain PoseParvatasana
            
                                                            


Pavanamuktasana (Wind releasing posture)
                                 

     Lie flat on your back with your hands placed by your side
     Fold back the legs and let your feet be flat on the floor
     Interlock fingers of your hands and place them a little below the knee

     Bring the thighs up near the chest
     Breath out  raise your head and shoulders and bring your nose to your knees. Now the final position is attained.


Pad Uttanapada (Supported with wall)
     Lie down in Savasana, legs together, hands by the side of your body, palms facing the floor.
  Now start raising your legs and hold them at 30 degrees. Continue normal deep breathing. With right leg up, the left foot starts travelling down slowly, till the left heel touches the floor.
   Start raising your left foot till it joins your right foot at 30 degrees. Now left leg remains up and right foot starts travelling down till the right heel touches the floor. Relax.

   Now start raising your right foot till it joins your left foot, knees straight toes outstretched and slowly bring both feet down till both heels touch the floor and relax.            

Tadasana  ( Palm tree pose)
Supported with wall






Ardha m
Matsyendrasana Sitting half spinal twist : 
  
      Sit in stretch leg position
      Hands besides your body
      Now fold your right leg at the knee and keep it under your left thigh.
      Keep your left foot outer side of the right knee by keeping the support of your right hands.
      Stretch your right hand up while inhaling and then lock your left leg by catching your left ankle.
      Twist your body left side, look back.
      Feel the stimulation on your pancreas.
      Stay in normal breathing Release the posture after sometimes.

                                                 


Ardha Ustrasana

                                                        



Squatting
                                      









Yoga Nidra (योग निद्रा )
 At the end of each prenatal yoga class, one has to relax the muscles and restore the resting heart rate and breathing rhythm. Try to listen to your own breathing, pay close attention to sensations, thoughts and emotions or repeat a mantra or word to bring about a state of self awareness. and inner calm.

                             "Mainstay in pregnancy care - Diet - Exercise - Routine."
Mudra
Ashwini Mudra



Formation :
Sit in a meditative pose like Padmasana, Sukhasana or Vajrasana. Draw the lower part (anus) upwards while exhaling, and loosen it downwards while inhaling. This is called Ashwini mudra. One can also lie on the back and do this mudra. One should  perform this mudra  when the stomach is empty. One can perform this mudra  for 20 to 25 times and than gradually reach 75 to 100 tomes.

Effect :
Blood circulation to the anal part becomes proper and it attains health. Vitality increases many fold.

Benefits :
  • Ashwini mudra successfully  avoids and cures diseases associated with piles and constipation.
  • It also relieves problems caused by gas.
  • Anal part is maintained healthy.
  • During pregnancy this mudra eases child birth.

Pranayama

Cooling Pranayama
* Sheetali Pranayama (शीतली प्राणायाम)



Apart from keeping the body cool, regular practice of Sheetali
Pranayama reduces hypertension and hyper- acidity. It is calming to mind. Sheetali is ideally practiced in summer months to cool the body and refresh the mind. It should be practiced only on empty stomach.
To practice Sheetali, first sit on a ground or on the chair  depending on your comfort. Now fold the tongue like a crow's beak and slightly protrude the tongue outside.. The folded tongue leaves the hole in between. Place your palm on your knees. Close your eyes, inhale through the mouth and exhale through the nostrils.  This is one breath. Continue the practice. Inhale from the mouth and exhale from the nostrils. up to five times. The body cools with great intensity and it is immediate.
Practice of Sheetali helps tighten the gums and reduce ailments concerning the teeth. Condition like bleeding gums, smelly gums etc.


*  Shitkari Pranayama  ( शीतकारी प्राणायाम)
                                    
                                 


Sit in a comfortable place, either on a mat spread on the ground or on a chair. Place the tongue between the two rows of teeth and open the mouth wide. Now close your eyes and breath in through the mouth and out of the nostrils. While breathing in , the air rushes in through the sides of the mouth, between the two rows of teeth. Perform this practice up to five times.
Ujjayi Pranayama

                                                 


It requires you to take in air slowly through your nose. Filling your lungs, and exhale completely until your stomach compresses. Sit in Vajrasana, Sukhasana or Padmasana. Keep the spine erect. Inhale and raise the head up . Now exhale and just bend the head without bending the neck. This locks the chin and this lock is called 'Jalandhar bandha' (जालंधर  बंद ) . The Jalandhar band will create a slight constriction in the wind pipe causing it to streamline the flow of air. This prolongs the time one takes to breathe in and out. Though the volume of air taken in and out is same, the time taken is more thus streaming the breathing process. This process of streamlining the breath calms the mind and reduces anxiety and stress, which are common during pregnancy.

Alternate Nostril Breathing / Nadi shodhana


                                                       

                                                      
Nadi is a Sanskrit word meaning “channel” or “flow” and shodhana means “purification.” Therefore, nadi shodhana is primarily aimed at clearing and purifying the subtle channels of the mind-body organism, while balancing its masculine and feminine aspects. Benefit : 

Benefits

  • Infuses the body with oxygen
  • Clears and releases toxins
  • Reduces stress and anxiety
  • Calms and rejuvenates the nervous system
  • Helps to balance hormones
  • Supports clear and balanced respiratory channels
  • Helps to alleviate respiratory allergies that cause hay fever, sneezing, or wheezing
  • Balances solar and lunar, masculine and feminine energies
  • Fosters mental clarity and an alert mind
  • Enhances the ability to concentrate
  • Brings balance to the left and right hemispheres of the brain

Lamaze

Lamaze, a technique taught in the west to pregnant mothers preparing for child birth, is nothing but a form of pranayama.

                                                  

Bhramari Pranayama (भ्रामरी प्राणायाम )


                                               

"Bee Breath Or Bhamari Pranayama
                      

                          
This exercise has its base in yoga and is relaxing both to the mother and the baby.
Position :
Sit cross- legged with the back straight. Keep the head and the neck in a  straight line.
Place your thumb firmly on the small triangular  flap before the ear orifice.
In this way you block out the distraction of sounds.
Place the two fingers after your thumb lightly on your eyes.
Place the next two fingers one above and the one below the lips.
Steps :
1 . Breath in.
2 . As you breath out or exhale say the word "AUM" 
Repeat five times without without a break.
If while doing this exercise you feel breathless, take a pause by taking a sigh, that is , a deep inhalation and exhalation , in between the AUM breath.






Bhasthrika Pranayama (भस्त्रिका प्राणायाम )


                                               

Meditation
*  Do meditation. Relaxation  
                            

It is very important for a women to remain as relaxed as she can throughout pregnancy. A good time to practice relaxation is when you know  you are not going to need to rush off in ten minutes, when all your work is done, when you do not expect to be called or made to answer the telephone or door bell.
Lie down quietly and allow your mind and body 5-10 minutes  to quieten down. Use this time to also shift around and find a comfortable position to relax in, taking cushions, pillows, sheets or blankets as required. Once settled, allow your thoughts to pour in . Close your eyes and watch your thoughts in a detached way, as though you are watching a movie on the screen. Be detached, do not judge your thoughts, simply watch them.. For about 10-15 minutes watch your thoughts. Then try to do some conscious relaxation.
After relaxation do not get up suddenly. First become aware of  your surroundings. Remember the room in which you are lying, and the furniture/ door / windows in it. Slowly move your hands and feet. Rise gently.



      
                                   "Mainstay in pregnancy care - Diet - Exercise - Routine."

Diet In Pregnancy & After


 Pregnancy diet  should be light, nutritious and easily digestible. Pregnant ladies should eat delicious foods like barley porridge, and barly bread. Pure home made curries cooked in olive oil / refined oil should be used.
                        



Diet Through Pregnancy

Make sure you drink  at least 10 glasses of water in a day. and eat enough seasonal fruits, green leafy vegetables (remember to wash well) sprouts, pulses and grains. If you like milk and milk products, meat, fish and eggs, indulge yourself. However, while you need extra nutrition, overeating is not advised.

If you don't like milk or eggs or if your elder child has allergy, avoid these items.

Eating for two
There is a common belief that in pregnancy a woman should eat for two people. It is not necessary to eat as much food as two people would normally consume, but t is essential to eat the right foods. One need to eat the nutritious food . Everything that you eat should have good food value, that is one should eat for two but not twice as much.
                            


A Parasite
A baby inside is like parasite; that is; it takes several nutrients that it requires, regardless of whether you have enough of them or not. It takes for instance, enough iron to store in its liver for the first three months of its life, not to mention the iron it uses up for formation of its blood.
Then it takes calcium from your body to form its bones and the foundation of its teeth. If you do not consume enough calcium, it is going to take calcium away from your bones.You cannot afford to let this happen, for you will need good health and strength to look after your baby after it is born. So you must make it a point to eat well.

Food you need

Folic Acid
An essential vitamin
Regular intake of folic acid during pregnancy  greatly reduces the chances of  your baby being born with spina bifida a developmental anomaly affecting a spinal chord. All women of reproductive age should take folic acid daily. Green leafy vegetables, pulses and liver are good sources of this vitamin.

Iron
                        

                 

Iron is present in green leafy vegetables. It is good idea to keep pudina or dhania (mint and coriander) chutney handy. Make small quantities of it and store in a covered bottle in the refrigerator. Prepare it every third or forth day. Two teaspoonful of chutney a day  will meet a good part of your daily iron requirement. You can use it instead of butter to spread on bread when making a sandwich. Iron is also present in kismis or raisin. It is present in gur or jaggery also and powdered brown sugar (Shakkar) also. It is present in any dish cooked in an iron pan. However food cooked in an iron pan gets black.
Dried fish is especially rich in both iron and calcium. So are yeast, table radish leaves, ganth gobi leaves, leafy vegetables, cauliflower or greens etc.
The iron in spinach is not easily absorbed. Vitamin C promotes iron absorption.
Soyabean, kabuli chana or whole bengal gram, kala chana, horse gram or kulthi dal, rajma or kidney beans, sabut moong or green gram are also rich in both iron and calcium. 
Also if you do not sieve the atta or flour before making chapatis you will get iron and vitamin B from it. Clean wash , and dry wheat for this purpose, before sending it to the flour mill. If you lack the time , buy the cleaner, more expensive wheat.

Calcium
                 

You get calcium from milk and milk products. You must drink about three  glasses of milk  in a day. You can have milk in whichever form you like.You can have it as curd, cheese, paneer, custard, buttermilk or lassi, even curry made from curd.
Green leafy Vegetables : curry leaves, chooli, leaves of Shalgam, radish leaves,methi,, pudina, green coriander. Calcium is also present in green leafy vegetables. But if you have gas or flatulence, heartburn or sour burps, you should not have too much of green leafy vegetables. About one teaspoonful at a time  is enough.
Grain & Pulses : Ragi, soyabean, rajma, black gram.
Animal sources : Fish, egg. Eggs and lime are good source of calcium. Lack of calcium in a long run makes you week. It can also cause severe backache or cramps. It causes irritability, for its lack causes the nerves to twitch. It is good idea to take  a hot cup of milk before you sleep.

Protein
Protein is a body's building material. You need protein  not only to build a baby's body but also to look after the wear and tear and maintenance of your own body. If you have an egg  a day  and pulses and dals with your meals, you should get enough proteins.
However if you are a pure vegetarian, and do not eat eggs at all, you must take care to see that your diet contains adequate protein. Dals are good source of proteins, but not the best. The best source  is a mixture of dal and wheat. A combination of dal and wheat is complimentary, since together pulses and wheat provide a mixture of all essential amino acids or proteins.. A mixture of dal and rice  is also a good source of protein.
For non-vegetarians who eat meat at least thrice a week, the protein intake is adequate. But if you eat meat only, when you eat out or entertain a parties, you should consider yourself vegetarian.
Another good source of protein is milk and milk products, that is paneer, curds and so on, Nuts like peanuts or moong phali, almonds or badams, cashew nuts or kaju,s etc.are good source of protein. Badam traditionally is considered superior to other nuts, but nutritionally it is of no superior value.Nuts also have a fair amount of fat.
Channa too is a very good source of protein, be it channa dalbesan, or the roasted channa. Channa is a good thing to keep handy to eat between meals.You can eat it instead of  biscuits or fried namkeens. It will be better for your figure as well as for your nutrition. 
Another good source of proteins is soybean and soyabean products. All you have to do is soak soya nuggets or flakes in warm salt water. Prepare your favourite masala, it could be onion, capcicum, tomato.Then squeeze the nuggets or flakes. thoroughly and add them to the masala when it is done.It makes a nutritious dish. You could also add the nuggets or flakes to whatever vegetable is made, to increase its quantity and nutrition.Or soak syabean overnight and cook them the next morning. Or soybean flour can be added in chapati.


Wholesome foods
A cereal, pulse and vegetable mixture  makes a very wholesome meal. For example, Dosa or idli with sambhar and coconut chutney..
Another such combination can be made  with parathas. If you make a dough half of besan and half of wheat flour and add to it choped radish or mooli leaves or green cabbage leaves, it will make quite a wholesome meal. Also a paratha made up of mixed flour of wheat, horse gram or kala channa and barley or jowar with radish or cabbage leaves chopped in it is good. These parathas are the meal in themself and can be eaten with curds as breakfast, lunch and dinner.
Pickles have a high concentration of salt and are to be avoided,  if you are getting swollen hands and feet. Butter should be avoided if you are overweight.
Another nutritious food is sprouted whole moong dal. It is best eaten raw. Cooking reduces its food value. It has proteins and vitamin B & C. Clean wash and soak the dal at least 4-5 hours in summer and 8-10 hours in winter. You can soak it overnight. Then drain the water and place it in a large jar. Tie up a cloth over the mouth of the jar, pour water and drain out, not leaving any water in the jar. Repeat twice during the day. In a day or two it should sprout.  It can be added to chopped salad, to cucumber cubes or grated radish. It can be sprinkled on vegetables or added to sandwiches fillings. It can be made savoury by itself, by adding lime, chopped onions, coriander, green chillies and salt. You can sprout any dried beans or pulses in a similar fashion, for example kala channa, rajma etc.
Potatoes area highly misunderstood vegetable. Although do have a carbohydrates they are 99.9% fat free and 100% cholesterol free. They have B and C vitamins and some proteins. Boiled potatoes are a good and cheap source of nutrition. Potatoes become fattening only when they are fried. At tea time one can have boiled potatoes with salt, chopped onions, lemon juice and chopped mint or coriander leaves added to them. Potatoes contain more moisture or water than cereals; therefore they contain fewer calories as compared to cereals.
If you keep boiled potatoes in a fridge, they can be handy, when you need a quick bite. Do not skin or cut potatoes before you boil them, that way you loose nutrition, boil them in jacket.When boiled , the skin should not break.
Then there is a highly recommended category of seasonal fruits and vegetables, guavas, oranges, water melons and bananas, cabbage and carrots eaten raw will give you vitamins and minerals.


Vegan Diet 
Vegetarian Pregnancy
A balanced vegetarian diet that contains grains, pulses, vegetables, fresh and dry fruits and sprouts, nuts, milk and milk products can meet all the requirement of a pregnant mother.

Vegan Diet 
Vegan diets exclude consumption of all foods of animal origin, except breast milk.. These diet does not include cow, buffalo or other mammalian milk. Such a diet may not provide some nutrients specially Vitamin B 12. Deficiency of vitamin B 12 cause Anemia and damage to the brain and nerve.

Tea, Coffee & Cola Drinks
If possible avoid it. Excessive amount of tea, coffee and cola drinks should be avoided. They contain caffeine and other related substances like tannic acid, which impair  and upset digestion.
Caffeine is a diuretic, that is, it causes more urine to be passed. This also washes away essential salts and water soluble vitamins. Further it reduces absorption of iron and calcium. It can also cause sleep disturbances, anxiety and heartburn.
The amount of caffeine present in a cup of tea  or coffee depends on the quality used and the amount of time taken to brew it.
Cut down the amount of tea and coffee you drink. The caffeine in coffee can lead to a premature delivery and lowered birth weight.

To Avoid Putting On Too Much Weight
You must make sure you do not eat out  of compulsion when you get  tense. Instead, have a warm water bath with a spoonful of salt  added to it. It is greatly relaxing. Or, start some activity like tidying your cupboard, baking a cake, embroidery, or making pickles.
Avoid white sugar as far as possible. Palm sugar and sugar made from powdered jaggery have nutritional elements in them; but white sugar is so over processed that 99%  of its non-carbohydrate constituents are taken away from it. and it ends up as plain energy- giving carbohydrate.
Sugar does not need to get digested and is immediately absorbed by the body, giving tremendous lift of energy. This lift lasts until the sugar gets used up, and immediately one feels like eating something sweet again, to get over the low feeling that follows. So you develop a sweet tooth. What you do is that  you inhibit the body's ability to produce very necessary energy from all other foods.. The body takes energy from sugar instead. The energy is converted into fat. This would also apply to women who have several cups  of  sweet tea or several glasses of cold drinks in a day.
If you feel you are developing  a sweet tooth, the first thing to do  is to have a naturally sweet things instead. Example jaggery, raisins, mango, chikoo, honey, dates, custard apple etc. These sweet things will also give  you nutrition, along with the sweetness. Avoid chocolates, sweets lollipops, ice- creams, cakes, pastries etc.Then switch to substituting a sprouted moong dal etc.
Gradually wean yourself away from your addiction for sweet  things. Make it a slow but sure process.Be gentle but firm,with yourself and you will find that  you have retained  your taste buds by the end of it, and your desire for sweets will have diminished.
Don't use sweetex or other sugar substitutes. Remember you are trying to cultivate a new taste. It is hard to stop craving for sugar if you take artificial sweeteners.
Avoid excessive oil in your cooking. Reduce the number of deep fried things you eat. For example, chips and pakoras puris and fried namkeen, fried papad etc. When you have made a vegetable, there should not be  oil left in the serving dish after the vegetable has been eaten. If there is any that is the sign that  the oil used was in excess, Also when you make curries, there should not be oil floating on the surface of the curry.
Kidney beans or rajma, chick pea or kabuli channa, Kala channa, all kind of pulses or dal  can be boiled with salt, turmeric, garam masala, onion, ginger and a teaspoonful of oil, and eaten with vegetables and chapati. Avoid fried masalas in them.
Thick rich masala curries are fattening. So are white souce, thick soup, mayonnaise and food laced with thick creamy sauces.
All highly refined foods should be avoided, because most of the goodness or nutrition has been taken away from them. Maida and sugar based foods would come under this category; also samosa, cakes noodles, white bread, jalebis, jams, rice, kachoris, mathris etc.
Interestingly, khoya, besan and paneer based Indian sweets also give protein, apart from being loaded with sugar. Bengali mithai, ladoos, rasgullas, chhena murgi, khoya barfi, patisa are some examples.
If you tend to eat a lot at meals, fill yourself with lassi, raw vegetables and fruits instead. Do not add ghee to your dal or chapatis.

Body weight
Excessive weight gain at this time is associated with toxaemia. How much weight should a women put on in pregnancy is a matter of great interest and controversy. Earlier the permitted weight was 10 kg. Then it became 12.5 kg, and now it is accepted that it may be a little higher then 12.5 kg.
If at the start of pregnancy you are underweight, you can take the advantage of putting on more weight then a woman who started pregnancy being overweight. if you have a tendency to gain weight more rapidly then other women, you will have to be careful with the weight increase.Do not diet in pregnancy.

Diet in labour
There is a widely held belief that if you have a glass of milk with ghee, or have almond or badam milk before going to hospital, it helps. However, once labour is established (i.e.when one contraction lasts a whole minute) your digestion slows down  greatly and the body concentrates on birth.
At this stage of established labour, if you have eaten something heavy, it will remain in the stomach and make you feel like vomiting. On other hand light things eaten in labour will get digested and will have passed through the stomach, giving your body energy.
Therefore, if you have started labour and are hungry, eat something light like glucose biscuits, sago, beaten rice, toast, with jam. In other words, eat carbohydrates and avoid fat and protein.
Above all, learn to listen to your body; if you feel like eating, eat something light. If you do not feel like eating, do not eat. You can have sips of water with sugar, glucose or honey mixed in it, if you feel you need some energy.These things do not need time to get digested. and get absorbed immediately by the body giving you instead energy. Mishri, toffees. sweets, lollipops can also be had. Tea, coffee or Nimbu pani should be avoided as they cause lot of acidity, which can be a problem., if anesthesia has to be administered.
If your labour is well established , you will simply not have the  desire to eat, even if your favorite dish is placed before you.

Diet When Breast Feeding
Remember when you are pregnant or when feeding the baby, you need good nutrition; so it is wrong time to diet. A women who is feeding the baby needs more calories than a woman who is pregnant. In pregnancy a women needs 300 more calories than she normally would, where as a women feeding a baby would need 550 more calories.
Most women who feed their babies do feel ravenously hungry; a fact that shows you the importance of listening to your body and having faith in it. If you feel hungry, you must eat. A new born baby  needs about 120 calories per kilo per day, and weighs about 3 kolos. Therefore  the baby should get about 360 calories from milk .The mother uses more than 400 calories to nourish the baby.
In fact  a lot of weight that you put on in pregnancy  consist of deposits of fat, placed by nature, to be used up while feeding. If you continue to eat wisely, you can loose weight while feeding.
A women feeding a baby should avoid too many spices, since these could give a peculiar smell to the milk, making it repulsive to the baby. She should drink plenty of fluids in any form, be it a milk, soup, nimbu pani, or lassi to make up for the loss of fluid in milk. Less water does not reduce the amount of milk produced, but it makes  the mother's urine very concentrated and therefore unsafe.
A women feeding a baby  can have a normal non-spicy diet with greater concentration on pulses green vegetables and milk.

Our Traditional Recipes
A word about our traditional recipes  of ladoos, panjiri, dry fruit or mewa, jaggery, or whatever else you may make, to feed a women who had just delivered a baby. They contain ingredients that are traditionally believed to be beneficial to a woman who has just delivered a baby.
The point is to have the traditional recipes in moderation. Eat about 2-4 tablespoons of panjiri or half or one ladoo with your early morning tea, when you know that activity will follow; or after a period of activity. Do not eat it as pudding after dinner and go to sleep. That is the best way to put on weight. Over eating of anything heavy can make you put on weight, so why blame panjiri ?
An interesting example illustrating the wisdom of our traditional practices comes to mind. In parts of south India, a woman who has delivered a baby is given water to drink, in which an iron rod  has  been boiled. This makes it a wonderful iron drink, a mineral women woman can always use, On account of monthly periods and childbearing women generally lack iron  and therefore are often prescribed  iron tablets.
Clarified Butter or Ghee
Ghee is highly overrated. Having a spoonful of ghee every day before the birth of baby is said to lubricate your vagina, nerves, making birth easier. This is totally false. The ghee eaten goes straight into the stomach where it gets absorbed by the digestive system.To make yourself supple  and flexible you need exercise, not ghee.
Ghee will make you fat. Be active, so that your joints  are not stiff. Three joints in the pelvis  bones spread apart to permit the birth of  the baby. If you are sitting on sofas all day and then lying on bed , it  can make the delivery difficult, even though you may have had spoonfuls of ghee every day. Ghee along with inactivity will mean extra weight and stiff joints, making delivery difficult.
Earlier woman worked in fields, milked cows, churned butter or ground wheat, hence they could digest the ghee. Perhaps ghee was valued since it has Vitamin A and D that help your bone in various ways. Vitamin A for instance helps fight infections.
Instead of eating ghee, you can massage the perineum and the whole vaginal area with coconut oil daily in the last month of pregnancy.

Tips for weight control

Tips on weight Control
            

Learn to relax before a party.When you are relaxed you will not have an urge to reach out for snacks.When you are jittery, you will tend to eat more. Lack of sleep and rest, the caffeine in coffee and colas can make you jittery. Apart from jitters, anxious about some problem, you tend to find comfort in food. It is therefore important to eat  at regular hours and not mnch between meals. If you reach out for food everytime you feel anxious, you will aggravate your weight problem and looking at  your overweight itself will lead you to further despair. It will give you  a poor self image and lack of confidence.
You should be in control of your food  and not let your food control you.This does not mean that you should starve yourself for long periods and then overeat. If you do starve yourself, you are most likely to overeat, because when no food has been eaten the blood sugar level drops and you crave for food. Never skip a meal. Regular eating habits protect you from hunger pangs that make you reach out for the wrong food.. More important , regular food intake  makes the body function more efficiently.
Eat slowly, take at least twenty minutes over your meal. It takes twenty minutes for the stomach to tell the brain  it is no longer hungry. Chew slowly, at least twenty times and savour each mouthful. It will give you greater satisfaction from your food.
Do not talk about your efforts  to change your food habits, as people will try and  talk you out of it. If you are compulsive eater , keep the right kind of snacks around moong sprouts, boiled potatoes, carrots, cucumber, seasonal fruits, channa.
Do not go where you know you will find temptation. At weddings and parties, do not stand near the table laden with fattening food. At home serve yourself in a thali and eat, rather then dipping into  dishes  just to taste. or just to finish little bit of rice or chapati.or give the others company, or to finish leftover, to finish a dish full of expensive ingredients, or to clean up your child's plate, the list is endless.
Weigh yourself regularly on the same weighing scale. Don't fool yourself that a few kilos here and there  is not much. Think of the stuff you buy in the market. Five kilos is a lot of weight.
Learn to drink plain , clean sparkling water, instead of tea, coffee,sherbets,colas etc. Set yourself if a goal  as to what weight  you want to achieve. Then work towards it steadily. Do not encourage people  to pamper you with food.
     
                                                       "Dieting makes you fat "

Frequent dieting gives the body starvation signals, and when the food is once again  available body reacting by overstoring, being unable to differentiate between  a weight loss regime and serious food deprivation.. Rate of breakdown of food  is considerably reduced while dieting, as this is one of the survival tactics the body uses when the food is scare. This sluggish metabolism makes weight loss more difficult.
Constant moderate eating habits with occasional indulgences on weekends, is the best path to try and follow. 

                                        "Consult a nutritional expert or dietician."


And lastly, if you are putting on weight in leaps and bounds, although you are not eating much, get your self checked by a doctor for any physical problem like malfunction of the thyroid gland.

To get maximum goodness from your food.
Clear vegetable soup  is very nutritious. All the vitamins minerals, proteins etc from the vegetables are passed into the soup. Thick soups are not good , as flour and fat are used to thicken them.
Greens  like palak, methi, sarson, bathua, cholai should be washed first and then chopped . If you cut them first  and then wash them  you will loose most of the water soluble vitamins while washing.
Keep your vegetables away from heat and light. Heat and bright sunlight destroy some of vitamins. Further destruction comes with cooking , so that by the time you eat it, a fair amount of vitamins are lost. Boil potatoes whole.
With fruits and vegetables, avoid peeling if possible or peel lightly e.g. carrots, apples, pears. Wash vegetables and fruits before peeling, not afterwords.
Do not overcook vegetables; keep them crunchy. Try and cook just before eating in order to avoid reheating. Avoid storing vegetables in refrigerator for more than 24 hours.When you reheat food , first leave it outside the fridge  for about half an hour  so that the change of temperature is not too sudden. Avoid cooking vegetables to death. Steaming in pressure cooker protects vitamins.
It is best to use stainless steal utensils for cooking, since it is the metal that does not react to the food, like many other metals do. If you do not have them the next best thing is to transfer food into stainless steal of plain glass bowls as soon as it is cooked.



Tips on weight Control
            


Method of Cooking
Steaming is the best method of cooking, as loss of nutrient is minimal. 
Baking comes second.
Boiling is good only if the water in which the food is boiled is also consumed. 
Frying, over cooking  and reheating causes a loss of nutrients and are best avoided.

Diet

 Note : Pregnancy is the only time women are not advised to diet even though they are obese. Weight gain by mother is an indication of healthy baby. Normal person should gain 11-16 kg of weight.
In the later stages have a regulatory wind (Vata)  movement that is essential for a smooth delivery.
The diet advised during this period should therefore be nourishing but of cooling nature.  Foods cooling in potency( sheet veerya) or exothermic food: Diet in pregnancy should be 300 Kcal extra, ideally light, nutritious,easily digestible and rich in proteins. Mother is advised to take frequent meals in small quantity.

Nutrition

 Folate or Folic Acid : Daily requirement - 400-800 micro gram Green leafy vegetables, asparagus, cereals, dried beans, peas, citrus fruits, ,berries, mushroom, corn, carrot, cauliflower, brinjal.

 Calcium :  Daily requirement - 100 - 1300 mg Dairy products - milk, curd, cheese, salmon, spinach, broccoli, almonds. Calcium: Milk and milk products, methi, drumstick, leafy vegetables, beetroots, figs, grapes, water melons, millers, Sesame, black grams and fish.

*   Iron : Daily requirement - 27 mg Spinach, beetroot, apple, banana, cereals, beans, pumpkin, tomato, asparagus, lentils, mushrooms, watermelon, grapefruit, oranges, strawberries. Whole grains, lean red meat, poultry and fish. Methi, mint, and other green leafy vegetables, Sesame, millets, (ragi)  grams, green grams, black grams, soy bean, dates, mangoes, eggs,meat, animal liver .

*   Vitamin C : Daily requirement - 80-85 mg Orange, tomato, strawberry, kiwi, grape fruit, cabbage, baked potato with skin, raspberries, bell peppers.

*   Vitamin A : Daily requirement - 770 micro g Carrots, milk, sweet potato, dark green vegetables, dried apricot, tomato, peaches, liver, eggs.

*   Vitamin D : Daily requirement - 600 I U  Sunlight, boiled egg, cereals, Salmon

*   Fiber : Leafy green vegetables, beans, broccoli, cabbage, carrots, french beans, green peas, spinach, whole grains, Fruits - peaches.pear, berries, apples, dry fruits

Protein : Daily requirement - 71 g  Lentils, milk, peanuts, lean meat, poultry, fish, egg, cheese.


Do's

*   Meat soup during pregnancy is advised.
*   Fresh salad should also be  made a part of the diet of expecting mothers.
*   Sattu (flour of roasted cereals) is very nutritious for pregnant women.


*   Almond Milk : Take 2 almond soaked in water,1 cardamom, crush the seed well, 2 strands of saffron / kesar powder . After badam has soaked in for  15 minutes powder it after peeling it. crush the white seeds well. Take a glass of milk heat it to near boiling point . Put the crushed badams (almond) cardamom, and kesar into the hot milk. Add teaspoonful of sugar, stir well. Your favorite drink is ready. If you prefer it cold chill it  and than drink. Taken before bed time, it provides very peaceful, nice sleep. It also helps to heal boils in the mouth or throat area.. For those who have acidity or ulcer in the stomach, if taken regularly it helps  to provide the healing touch. It is also very helpful in reducing dry cough. In pregnant women the saffron has good effect in preventing and checking the spread of infection.
*   Milk, Sharavari ( Asparagus racemes) roots,
*    Fruits : Fresh and dry fruits like mango, figs, pomegranates, orange, almonds, dates, apricots, are highly beneficial for pregnant women. 
Honey and apricot is adviced in pregnancy as it is very effective nerve tonic, increases blood and cures constipation.
*   Green gram soup are ideal food. 
*   Juice of pomegranate is advised, not only because it helps in combating nausea, but also because *   Pomegranate improves bio-availability and absorption of essential components of food in the system and thus aids proper nourishment.
*   Diet rich in ghee, milk proteins, green leafy vegetables, fruits etc.
*   Wheat, flour of parched rice,  
*   Curd mixed with sugar
*   Sugarcane is the good source of iron
*   Green leafy vegetables for fiber to avoid constipation
*   Lots of fruits
*   Honey,sugar
*    Include more raisins, banana,
*    Milk and ghee stand out as the  most common in the pregnancy diet.. The idea is to provide optimum amount of fat and protein  to the baby.. You can consume ample amount of milk and 2-3 teaspoons of ghee. Also it provides right amount of calcium and vitamins  for the pregnant mother  helping in sustaining a comfortable lactation.
*    Rice, pulses, dal soup
*   Satvic food do not cause constipation or  indigestion and they create a more settled state of mind. These food help the mother enjoy ideal health and vitality and also help in the growth of the baby. It includes: food such as milk, rice, wheat, and ghee (clarified butter), fresh leafy green vegetables fruits and grains.
*    Fat, salt and water  should be reduced in the diet from seventh month on wards.
*   Make sure you drink enough milk., but avoid  drinking milk immediately after taking an iron supplement as calcium may interrupt iron absorption.
*   Cook food in iron utensil and avoid too much cooking.
*   Green leafy vegetables, mustard leafes, turnip green, cereals and sprouted pulse
*   Spinach : Regular use of spinach prevents thretened abortion and haemorrhage.
*  Take vitamin rich food like orange, tomatoes, lemon etc.
Include more fresh fruits, vegetables, pulses and whole grains.
*   Eggs
*   Rice gruel with ghee is the recommended diet.
*    Jaggery,
*    Sunflower seeds, pumpkin seeds, ground black sesame seeds, flax seeds
*    Cabbage and mung dal.
*    Turmeric, saffron and cinnamon
*     Licorice tea
*    Lemon:


 Lemon should be taken during pregnancy as it helps in developing the baby's bone . Lemon also aids in digestion of heavy meals by producing the necessary enzymes and in the assimilation of protein, zinc and vitamins.
*   Fruits: And Dry fruits like Mango, Banana,Figs, Pomegranate, Oranges, Almonds, Dates, Apricot are highly beneficial for a pregnant woman. guava, dates, grapes pomegranate .
*   Nuts : Almonds, Dates: To improve the blood of  mother and fetus. 3-6 dates soaked over night in cow,s milk should be consumed in next morning.
 Walnut
*   Green leafy vegetables rich source of folic acid.
*   Dairy products: Calcium supplements.
*   Cereals,whole grains : Proteins and carbohydrates. Regular use of spinach prevents threatened abortion and hemorrhage.
*  Honey and apricot is advised in pregnancy as it is very effective nerve tonic, increases blood and cures constipation.
*    Meat Soup: Use of meat soup is good for nutrition.
*    Lamb/ Sheep Liver: (कलेजी ) Rich source of Proteins, iron,  vitamin B 12, and omega 3 fatty acid.
*  Calcium supplementation: produce a beneficial effect in reducing the risk of pregnancy induced hypertension.
*   Barley porridge and barley bread
Fresh salad should also be made a part of diet of expecting mothers.
*  Citrus fruits like  orange,lime ,sweet lime and pears,apple pomegranate etc are advised.
Sattu : Flour of cereal is very nutritious for pregnant women and fetus.
Fish,meat rice,ragi
*  Tender coconut
*  Moringa oleifera / drumstick.

Avoid
Don't

*   Avoid cold food.
*   Avoid and beverage which has excessive salinity and alkalinity.
*   Avoid which is preserved, colored, precooked,, fried, frozen, tinned, charred, junk food should be avoided or minimizes.
*  Pregnant women should  avoid consuming black seed (kalonji) and its oil.
* Pregnant women should strictly avoid those foods and drugs which have emmenagogue and strong diuretic effect like horsegram (Dolichoas biflois) kulthi dal.
*  Do not eat spicy food.
*   Avoid Papaya.
*   Junk food like caramel candy  (बुड्डी  के बाल) , potato chips etc.
*   Pulses, heavy and sour substances, deep fried foods.
*   Caffeine containing products like coffee, tea. cola and chocolate.
*   Deep oil fried items.
*    Food containing artificial colors, flavors, especially ajinomoto ( monosodium glutamate) and saccharine.
*   Avoid heavy (Guru),Hot (ushna) and pungent (katu) food and over eating.
*   Stale and contaminated foods.
*   Stored and packed foods
*   Strong and irritating foods like sesame seeds, stale food.
*   Pregnant women should stop eating pickles, salted foods, soda drinks.
*   Food which is preserved, colored, precooked, fried,, frozen, tinned, charred, junk food should be avoided, or minimized.
*   Foods  which causes flatulence : potato, cabbage, cauliflower, arbi, rajma, chana, lobia etc.
*   Not to consume excessive fermented  drinks
*   Salt Restriction; Food and beverages which has excessive salinity.
*   Kalonji Onion / Black seeds : Pregnant woman should avoid consuming black seed and its oil.
Papaya and Pineapple are not advised during pregnancy.
Horse gram: (Dolichoas bifloios) Pregnant woman should strictly avoid  those drugs which have emmenagogue and strong diuretic effect like horse gram
*   Over ripened bananas are not advised as it may cause constipation
*  Pungent food and heat generating food articles are not recommended in the diet.
*  Lobiya (Cowpea or black eyed beans)
* The food which are difficult to digest and produce gasses and bad humour should also be avoided.
*  Junk food
*  Caffeine containing products like coffee,tea,cola and chocolate,some over the counter medicine.
*  Deep oil fried items
*  Food containing artificial colors, flavors especially ajinomoto ( mono sodium glutamate)and saccharine 
*  Unpasteurized food like raw cheese, mozzarella etc.
*  Stale and contaminated foods
*  Stored and packed foods
*  Sea food like shell fish, tropical fish,and sushi etc.
*  Sesame seeds,
*  Stale foods etc
*  Over the counter medicines
*  Food containing artificial colors flavours especially Ajinomoto (Monosodium glutamate) and Saccharine.
*  Unpasteurized foods like raw cheese, Mozarella etc.
*  Stored and packed foods.
*  Sea food like shellfish, tropical fish ,and sushi etc.
*  Papaya and Pineapple are not advised during pregnancy.
*  Over ripened bananas are not advised as it may cause constipation
*  Pungent food and heat generating food articles are not recommended in the diet.


  • Cigarettes, gutka, alcohol and hard drugs. Avoiding these for at least up to 9 months of pregnancy reduces the risk to your fetus.
  • Pregnant women and nursing mothers with a family history of allergy of allergy should avoid  eating peanuts and peanuts in order to reduce the chances of allergy in the baby.
  • Avoid high salt and a variety of packaged wafers, available in the market. Cut down on salty snacks, biscuits, pappad, pickles and artificial sweeteners. Avoid Ajinomoto in Chinese food.

Do Not Take Any Medication
Even over the counter drugs without discussing them with your doctor for approval. On the other hand take medication that your doctor has prescribed for you. For instance one or more shot of Tetanus Toxoid may be given to protect you and the baby against Tetanus.  Inform your doctor if you are on  an ongoing medication.., say for epilepsy, so that she can work out the effect it may have on your baby  and substitute it with an another version.

Truth about Don't.

*   Overeating may increase the body weight of the mother and the fetus, thus resulting in pregnancy toxemia.

                                 "Mainstay in pregnancy care - Diet - Exercise - Routine."

Herb

*  Amla (Emblica officinalis)  : Indian Gooseberry. It prevents congenital and genetic defects in fetus because of its scientific mutagenic activity. The fifth month for example is believed to be the stage of fetal growth for the development of brain tissues and therefore the dietary advice at that stage includes commonly accessible fruits like Amla (Phyllanthus emblica) which contribute to brain tissues.
                                                            
                                                       


*   Shatavari :  ( Asparagus racemosus)It is considered a general tonic and a female reproductive tonic. Its powder can be taken along with milk.Shtavari is safe for pregnancy.
Ashwagandha As general tonic.
Guduchi (Tinospora cardifolia) Amruthballi (अमृतबेल) Consume during 4-5 month of pregnancy as that is the period when the brain tissues are formed. For Fever 1 teaspoon of decoction of Amruthballi  with equal quantity of honey brings down the fever.
Saffron : One pinch of saffron added with milk when consumed regularly in the ninth month, promotes relaxation of uterine muscles.
 Curry Leaves ( Murraya koenigii ) : Paste of curry leaves along with milk is given in a dose of 5-10 gm for 3 days on ninth month.
Coriandrum sativum (धानिया ) For vomiting 5-10 gm seeds, soaked in 200 ml of rice washed water and made in to a paste is given along with sugar.
Punarnava Hogweed : (Boerrhavia diffusa) : Part used is root as general tonic.
*  Bala ( Sida cardifolia) ,  Shatavari ( Asparagus racemosus) and Sthira (Desmodium gangeticum) are recommended to be consumed throughout pregnancy as they help to protect the foetus and prevent miscarriage. Decoction of sida cardifolia along with barley water in a dose of 100-200 ml on consumption takes care of Oedema. Or decoction of deep  fried cumin (Cuminum cyminum) or Jeera  in a dose of 100-200 ml. Or decoction of (coriandrum sativum) (धनिआ ) along with barley water in a dose of 100-200 ml.
*   Musali
*  Tribulus terrestris: To prevent retention of water during pregnancy,  use of this herb is beneficial as it is a safe diuretic.
    BasilSmall amount of basil can be taken as antispasmodic
Cissus quadrangularis Hadjod Asthisamharaka : A Panacea for bone health.
*   Garcinia (Kokkam) is boiled and given in the eight month of pregnancy. This is aimed at regulating and easing the Vata movement for an easy delivery through mild laxative.

Vaccination


Immunization of Mother : Inj Tetanus Toxiod 0.5 ml two doses

                                     "Consult a Gynecologist / Obstetrician."

Treatment

                         "Diet, exercise and cleaniness are considered to be utmost importance."

Medicines : 
Avoid taking medicines on your own.
Caution
*  Do not take iron and calcium together since calcium hinders the absorption of iron.
Medicine.
*  Avoid strong medication.
*  Strong purgatives are contraindicated in pregnancy as it aggravates the peristaltic movement of intestine and because of close approximation, it can irritate the uterus causing abortion or preterm labour.
*   No medication in first trimester of pregnancy as they have the potential to cause irreversible damage to the baby, s developing organs.

*   Except Tab Folic acid 5 mg once a day
Second trimester
*  Tab Ferrous Sulfate  12 weeks onward. Once daily (65 mg elemental iron) Ferrous Sulphate is as effective as twice daily (130 mg elemental iron) dose regimen in prevention of Anaemia in pregnancy.  Once daily dose possesses fewer side effects and guarantees better compliance.
*  Tab calcium : Add 500 mg Calcium carbonate three times a day.  
*  Vaccination : Inj Tetanus Toxoid

Nausea & Vomiting /Morning Sickness : 
Do's
  • Drink a light lemon juice with sugar and salt. (शिकंजी )
  •  Carbohydrates generally stay down more easily. eat two spoons of glucose / sugar or sharbat. Eat bread, biscuits, rice, chapati, potatoes etc. Do not worry too much about weight gain
  • Simply dietary habits including lemon, pomegranate, sour fruits also prevent the morning sickness.or coriander soaked in hot water for few hours then squeezed well, filtered, crystal sugar and powdered cardamom added to be consumed 2-3 times a day  helps in nausea, vomiting and helps nourish.
  • Consume Pomegranate or drinking a pomegranate juice is a very effective remedy to overcome this natural response
  • Water  boiled with coriander seeds. Such food are not only strengthening but also exothermic (cooling or sheeta).
  • Sniff a slice of lemon.
  • Drink a cup of hot milk before going to bed. 
  • Ginger tea.
  • Nibbling on a biscuit or toast (without butter)  in the morning, before you get out  of bed helps. Also lie still for about ten minutes before getting out  of bed. Have breakfast one hour after waking up.
  • Take cold sweeten milk in small quantity
  • Cardamom powder licked with honey or Cardemum peel water.
  • Eating small meals frequently 5-6 times a day.
  •  Cold drink  made of ginger and cardamom.
  •  Eat a nutritious diet of fruits and vegetables.
Avoid
  • Avoid tea, coffee, fruit juice, fried, spicy food and alcohol.   
  • Resist eating too much at once. A midnight snack is easier to keep down. .Keep a snack by your bedside and have it in the night..
  • Discard tight clothing. Your clothing's should be comfortable around the stomach and bust.
  • Avoid fried and spicy food.


Loss of appetite & Aversion of food
*   Dip a small piece of ginger in lemon juice and keep it in mouth with a little black salt.
*   Powder coarsely 1:3:5 cumin seed, fennel and coriander seed and 1 tsf of sugar, mix them in 250 ml of water. Boil and reduce it to half., filter it. Take this twice a day. This stimulates appetite.
*   Take 1 tsf juice of pomegranate or lemon, add black salt and honey to it. Make a paste and lick it 3  times a day

Flatulence / Gas Formation & Bloating : 
Taking smaller meals, eating slowly, chewing food thoroughly is the best way to get rid of gas formation.
Taking sips of  cumin seeds (jeera) water eases bloating due to gas formation.
*  Avoid certain food beans, peas, whole grain, rajma, gram, Lobia, broccoli, asparagus, potatoes, arbi, cabbage, sprouts trigger gas formation.

Constipation

Drink plenty of water.
*  Eat lots of fiber in form of fruits and vegetables.
*  Adding green leafy vegetables in the routine diet also eases constipation.
*  Have  pomegranate, banana, ripe guava along with seeds.
High fiber rich diet such as plenty of fruits, leafy vegetables, cereals, grains
*  Take black salt  + Ajwain with tepid water.
*   Raisins consumed before going to bed.
*  Increasing fluid intake at least.8-10 glasses of water.
*  Before going to bed  drink a cup of hot milk.
*  Soak a teaspoon of Isabgol in little water for 4-6 hours.
*  Milk / warm water  and drink before going to bed.
*  It is preferable to avoid drinks which dehydrate and increase constipation like coffee, tea, alcohol and cola
*  Gulkand (गुलकंद): Sweet preserve of rose petals)
*   Lemonade : (Shikanji)
*  Prune juice ; Try drinking it each morning
*  Strong purgatives are contraindicated in pregnancy as it aggravates the peristaltic movement of intestine and because of close approximation, it can irritate the uterus causing abortion or preterm labour.

Diarrhea

*    Tab Furoxone TDS
*    Oral re- hydration solution (O.R.S)
*    Boil 20 grams of the fruit rind of pomegranate with 80 ml of water and reduce it to 1/4th. Take it thrice a day.
*   2 grams unripe (Aegle marmelos) bilwa fruit and kernel of mango and cold water.

Dizziness
 It is advised to raise the leg end of the bed and sleep.
*   It is preferable to avoid sitting or standing for prolonged time.
*   Rest also improves symptoms by increasing blood flow to the brain.


Varicose Veins 
*   Keeping the legs raised when sitting or sleeping.
*   Walking regularly.
*   Avoiding standing or sitting for prolonged hours.
*   Use medical compression stocking below knee.
                                                  
                                                         


Leg Cramps
It is advisable to take only natural sources of calcium like milk, leafy vegetables, fruits, ragi, sesame seeds.
*  Stretching the leg and drawing the foot inwards towards oneself helps to relieve the cramps.
* A gentle massage with Dhanwantharam thaila or Pinda Taila  followed by warm fomentation  helps to relieve pain. It also improves blood circulation.

Aches and Pains :
*  Rest 
*  Gentle massage with oils (maha narayana taila) and mild fomentation will relieve the pain. 

 Shortness of Breath:
*  This will ameliorate by taking deep and long breaths
*  Maintaining good posture always to give lungs a room to breathe.
*  In the night, mother can sleep with few pillows at the back or lying to the side to enable free breathing.
* Lying to the left side usually relieves pressure on the blood vessels of the uterus and helps in improving the circulation of  oxygen and nutrients to the growing baby.  hence this posture of the sleep is preferred throughout the pregnancy.


Heartburn/ Acidity/ Gastritis : 
*   The diet should comprise of sweeten milk, coconut water and soup of bottle gourd.
*   Two Tbsp. of ash guard (Kooshmaanda) juice should be consumed with sugar candy every day  in the morning every day.
*   Two tbsp. of Yashtimadhu powder  should be boiled with 4 parts of milk and 8 parts of water and reduced to half. Take it twice a day before food.
*   Amla powder with water or honey two times a day.
*  Astringent fruits: Amla, harad and behad (Triphala powder) can be taken.
*  Amla powder
*  Brew some warm ginger tea, or sip a glass of ale or pop a ginger candy.

Edema / Swelling : 
*   Drinking more fluids cereals like barley etc.
*   Keeping the legs elevated help to reduce the swelling.
*   Avoid tight clothing, especially around the ankles or calves.
*   No rings in finger.
*   Try not to stand for long periods.
*  Sit with your feet elevated whenever you can.
*  Eat plenty of proteins such as lean meats, pulses, cheese and eggs.
*  Drink plenty of fluids.
*  Moderate exercise can help.
*  Try a wedge shaped pillow  under the mattress at the foot of the bed. If the swelling is excessive or if your hands and face begin to swell, contact your doctor immediately.

Hemorrhoids :
*   Preventing constipation by drinking sufficient fluids, vegetables and fruits go a long way in allaying this agony. 
*   One should not take irritant laxatives or purgatives. 
*   It is preferable to take Isabgol Or Triphala at bed time if the problem is most bothering.

Backache :
*   Massage and hot fomentation.
*  To treat calcium deficiency eat lot of leafy green vegetables, tomatoes.

Anemia
*   Iron and folic acid tab
*   Amla in any form
*  Green leafy vegetables.
*  Eat a ripe banana with 1 tsp of honey twice a day.
*  Drink milk twice a day. Keeping on wholesome diet.
*  A cup of beetroot juice, or 1 cup of apple juice.
*  Food such as pomegranate, spinach, dates, . Bimbi ( Garcinia grandis) Kundru is also good sore of iron eaten as vegetables.
*  Dates : To improve blood of a mother and foetus, 3-6 dates (khajoor) soaked overnight in milk, should be consumed the next morning.
                                         

                                            

*    Fruit juice of grapes.
*    Regular consumption of Amla along with honey. 
*    This fruit such as apple, dates, pomegranates, banana etc.
*    Food improves the bio - availability and bio assimilation of iron from normally consumed like green leafy vegetables
*    Iron and folic acid tab along with vitamin C
*    Dhatri Lola are far more effective 
*    Sugarcane juice along with Amla.
*    Soak raisin overnight  and have them in the morning empty stomach.
*    Honey helps in increasing hemoglobin in blood.

Loss of appetite
*  Nimbu pani /lemon sherbat / lemonade
*  Appetizer : Ginger + rock salt + lemon and jaggery


Palpitation
*   During pregnancy if woman develops palpitation , due to involvement of stomach.
*   Mild exercise are usually sufficient for this symptoms.
*   Hold your arms over your head to give your lungs some room. 
*   Sit up straight, pop your self upright with pillows
*   Lie on your left side
*   Avoid overexertion.
*   Luke warm water with rose essence (ark gulab is advised.)

Vaginal candidiasis : 
*  During pregnancy immune system will be slightly weaker, hence the woman is prone for infection like vaginal Candidiasis.
*  So regular bath and other hygienic measures need to strictly observed

Stretch marks / Straie gravidarum
*   Apply a paste of sandlewood (Santalum album) and usheea (Vetivera zizanoides) (Khus Khus) on the stretch mark.
*   Apply a paste of sandlewood with coconut oil or butter and camphor on the marks.
*   Do not stretch even if you have an urge to do so.

Gingivitis :
* As the gums are slightly tender during pregnancy owing to hormonal changes they tend to bleed easily.
*  Use soft tender brushes and brush with mild toothpaste.
*  Flossing should be done very gently.
*  Gum massage regularly.
*   Rinsing the mouth with Listerine mouth wash. or triphala water, neem bark, after brushing helps to keep the mouth healthy and clean.

Pregnancy induced hypertension :   Calcium supplements produces a beneficial effect in reducing the risk of pregnancy induced hypertension.

High BP Less salt, Low BP More salt.

Teeth & Gums
Home remedies: After a meal, rinse your mouth with warm salt water. Brushing with a neem twig from Neem tree  can be done once a day.. Another good things for teeth and gums is a mango leaf. Roll a mango leaf and chew on it  for some time.  Discard the pulp and most of the juice. With a little of remaining juice , massage your gums with a finger tips, it will make your gums tighten and your teeth shine. It is perfectly safe for fillings too.

Ayurveda

"A baby must be designed by choice not by chance and future parents are adviced to undergo Panchkarma ( Purificatory proceedures) under medical supervision. The recommendation of total detoxification of expected mother and the expected father too."

Garbharakshini Gulika: 1 tab twice daily from third month throughout pregnancy.
Sujat cap throughout the pregnancy.
Bakajeerakadi kashaya : 3 tsp with 6 tsp of milk on empty stomach twice daily during eight month. It kelps to ease the delivery and reduces number of false pains.

For itching
Genital area
Douche twice a day with:
Boiled Rice washed water with salt
Alum water (Alum dissolved in water).
Triphala powder wash (Triphala powder boiled with water)

Application for breast Areola
*    Masse cream locally
*   Coconut oil
*   Ghee
*   Salt water

Threatened Abortion : Complete Bed Rest. Tab Folic acid 5 mg OD. Tab Calmpose 1 HS. Tab Duvadilon T.D.S. Inj Prolutin depot 500 mg IM. weekly. Tab Progesteron

From the forth  to seventh month medicinal supplements  such as Ashwagandha (winter cherry), Guduchi ( Tinospora cardifolia). Ashwagandha and Guduchi are given to strengthen the uterine muscles and also to nourish the embryo. 
Medicated ghee is usually advocated  to keep the baby nourished. Eye and other sense organs develop from the develop from the forth month so diet is more important.

Fat, salt and water  should be reduced  in the diet  from the seventh month  onwards

Rice gruel with  ghee is recommended diet.

Small amount of basil can be taken  as anti spasmodic.

.Asthisamharaka
A Panacea for bone health.
Name : Cissus quadrangilaris, hadjod, ( joining bone) devil,s backbone, or adamant creeper or bone vine, miracle healer. Vajra balli, Mangara balli, Pirandai,Kandvel
It is a potential and effective bone builder supplement. In pregnancy it is consumed for bone health. Tablets are made from it.
Used fo joint injury, broken  bone care and healing ligament properties.
It is used for fixing bone fracture. Stem paste mixing with egg albumin and applied on the affected part.
By boiling its leaves and stems, a curry is prepared to consume, which is believed to cure osteoarthritis.It has hot potency which alleviates Vata and kapha dosha. It posses dry light and mild laxative attributes. It is an appetiser, digestant, an aphrodisiac and a bone healer.Uses
Rich in calcium, it is advised to use during pregnancy, child birth and for weakness due to menopause ( or menorrhagia)
To treat bone fractures, the crushed stems are used as a poultice over bone fracture,


Regimen such as purgation, venesection, wet cuoing treatments are contraindicated during pregnancy as these may induce pre-mature labour or miscarriage.

             "Tridoshas (three balancing forces) should not be vitiated to maintain a good health."
.
          "EVERYTHING THAT AFFECTS THE MOTHER HAS AN IMPACT ON BABY."


                                       "NATURE IS A BEST FRIEND AND MENTOR."

Pregnancy Beliefs

                   


There are numerous dos and don'ts, advices and instructions that are given to a pregnant woman by relatives and others, especially in India. Expected mom has to eat for two - This is probably one of the first tips that a pregnant lady hears when she announces her pregnancy. In reality and especially during the beginning of pregnancy the quality of what one swallows is far more important that the amount. In fact increase in diet can make one gain weight quickly without any particular effect on the baby's health.




Having a spoonful of ghee every day before the birth
False
Ghee is highly overrated. Having a spoonful of ghee every day before the birth of baby is said to lubricate your vagina, nerves, making birth easier. This is totally false. The ghee eaten goes straight into the stomach where it gets absorbed by the digestive system.To make your self supple  and flexible you need exercise, not ghee.

Ghee will make you fat. Be active, so that your joints  are not stiff. 



Push when in labour

False

When in labour, never push  until the doctor or nurse asks you to. If you begin to push  when the mouth of the womb is not fully dilated , there is a danger of the baby’s head  hitting against an unopened cervix (mouth of a womb) , so that the baby’s head and cervix become swollen and tender.


Walk when in labour

True

The best thing you can do is to walk when in labour.Gravity hasten the baby’s decline, and therefore shortens labour.. Also when you lie down on your back, the weight of your baby and uterus press on a major blood vessel called the vena cava,  hence reducing the supply of blood  and oxygen to you and your baby.


Eat for two

False

One does not need to eat for two people, but it is important to eat wisely in pregnancy. The baby grows like a parasite in that, it takes all that it needs, whether the mother has enough or not. So if you don’t eat well, you might end up with  a run down feeling, which comes from lack of iron in the blood.


The pain is unbearable

False

In case of unbearable pain , nature’s safety mechanism  makes one pass out i.e.lose consciousness. In labour women are rendered un consciousness by drugs, but never by pain.The right attitude to contractions can make it pretty easy to bear.


Have a spoon of ghee daily to lubricate your nerves

False

To make yourself supple, you need exercise, not  ghee. Ghee will make you fat Be active so that  your joints are not rusty and creaky.


The umbilical cord is attached to the mothers navel

False

The umbilical cord is attached to an organ inside the womb, called the placenta. (The placenta is also called the after birth, since it is delivered after the baby.).The organ prepares and passes the food and nutrition to the baby, through the umbilical cord, which on the other end  is attached to the baby's navel.


If you sit cross-legged on the floor, it flattens the baby’s head

False

The best thing you can do is sit cross-legged, as it exercises the pelvic joints, the very joints that ‘opens up’ when the baby is born.

With regular exercise, the joints become flexible and open easily at birth. Little wonder women doing physical labour deliver easily. The baby is safe ensconced in the womb and gets no direct pressure on its head.


Baby get suffocated if you pull in the stomach

False

The baby does not suffocate, since it gets oxygen through the umbilical cord, which is attached to its navel, and the placenta on the other end. If you pull in your stomach, the weight of the baby is born by the pelvic bones, so that the stomach muscle gets a respite from constant stretching.


Have a glass of milk and ghee or have badam milk before going to hospital.

False

If you have started labour, and feel like eating,eat something light.Once labour has established, if you have something heavy  like badam, ghee, milk you will feel like vomiting.


Be happy read good books

True

If you are afraid or under stress, the chemistry in your body changes, as different hormones are released. The baby living within, senses these changes. Is therefore important to drive to be happy.


Bind abdomen after delivery

False

If you make a jumble of your clothes  and fling them in the cupboard, they’ll fall on your face when you open it next. If you push your muscles back with a girdle, they will flop out again. It is important instead to do mild exercise for the first 40 days and move vigorous ones later to build back tone  in your muscles.


If one moisturizes the skin well there would be no stretch marks

False

If only it was so simple, in fact it's all about hormones. If one already tends to have stretch marks on the breasts or thighs then there is a good chance that one will have them on your stomach too. But this should not prevent one from moisturizing the skin very regularly, in order to limit the damage.


At end of pregnancy, one should indulge in some physical activities to give birth more quickly

False

Giving birth is a natural process that will start when the time comes. Indulging in cleaning or other activities at the end of the third trimester will not facilitate the delivery in any way.



It is true that before the baby is 6 months old, less than 2% of mothers, who breast feed exclusively are likely to conceive before they menstruate on. 

False

But it is a misconception that a nursing mother will never get pregnant.



Also remember that if you have twins, your chances of having them again are higher compared to other couples.

False


Pregnancy Tips
Weight Gain Goal
Gaining too few pounds or too many can put your pregnancy and your body at neccessary risk. The right amount of weight at the right time on the right foods is vital to your body's growth and well being in utero and beyond. Some extra fat after delivery will help to breast feed your baby.

Bingeing & Purging
Darning pregnancy seems to increase risk of miscarriage and premature birth. and post partum depression



                                         " जननी जन्मभूमिष्च स्वर्गादापि गरीयसी" 
                               "Mother and motherhood are greater than heaven."

 Medicine as suggested above should only be taken under the consultation and supervision of registered medical practitioner.


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