You’ve made it! Congratulations! How you got here is different from woman to woman; it may have been a one-night stand, years of infertility, a sperm donor from a clinic or the bog-standard way of just having unprotected sex with your partner. But whatever your story, you’re here now and you’ve probably got a million thoughts and questions racing through your mind.
SLOW DOWN. It’s only the beginning. You need this whole pregnancy to get your head around the fact that you’re going to be a mother. There will be a baby (or babies) at the end of this journey, so take your time, ask questions and surround yourself in positivity. Everyone will give you their tips, advice and opinions: just take it all with a pinch of salt. Only you know your own mind. Even if your emotions are all over the place (hormones are a funny thing!), take a breather and focus on one thing at a time. Even if that’s what to make for dinner! There’s plenty of time to think about the bigger picture.
Don’t panic about things like ‘what sort of birth do I want?’. You can address these mind-boggling questions when you have more information as your pregnancy develops and you start finding out more about your options. I often tell women you can’t ‘plan’ your birth anyway, so let go of the things you can’t control and just get through these next few weeks. Rest and nurture your changing body: it’s doing an incredible thing growing a tiny human.
When I found out I was unexpectedly pregnant with my first baby at 23, I stared at the pregnancy test for what felt like an hour. I kept turning it over and looking at it, hoping it had miraculously changed from positive to negative. But, of course, it hadn’t: it was a big fat positive. Those two pink lines staring at me on that plastic stick suddenly meant my plans would change for ever. So don’t worry if you too are feeling overwhelmed by what lies ahead. It’s entirely normal, even if this pregnancy was planned. Hopefully this book will support and guide you through it all. Think of it as your go-to for all those niggling questions you may be too afraid to even ask your mum.
One of the most frequent questions I get asked as a midwife is: ‘I’ve been on a bender and didn’t realise I was pregnant! Will my baby be okay?’
Fear not, ladies, you are not alone if you find yourself in this situation. There’s obviously not a huge amount you can do at this stage, but feeling guilty and worrying about it isn’t going to change anything either. Feel reassured that lots of mums start off their pregnancy in exactly the same way:
I had my 30th birthday the weekend before I found out I was pregnant! I was so scared that there would be some lasting effects of the alcohol I drank on my unborn baby. While pregnant I reassured myself by thinking about how I’m sure I wasn’t alone in my circumstances and that managed to tame the guilt I was feeling.
Sophie, mum of two
But as soon as you find out you are pregnant, stop drinking any alcohol. The Chief Medical Officers for the UK (NHS.uk) recommend that if you’re pregnant, or planning to become pregnant, to keep risks to your baby to a minimum the safest approach is not to drink alcohol at all.
Try to let go of the guilt and things you can’t change and focus on the things you can do from now on: eating well, taking the right supplements and resting. I found pregnancy to be the best and biggest detox I’ve ever been on!
Think about ways to live more healthily. If you’re used to exercising, whether that’s swimming, running or cycling to work, and still feel like doing it, then go for it! There is no evidence that suggests that continuing your normal exercise routine is more likely to cause harm to you or your baby. I wouldn’t recommend suddenly taking up a new high-impact sport as your body won’t be used to it, so stick to what you’re used to, especially if it makes you feel good! Endorphins are good for you, after all.
Most importantly, relax and try to enjoy the next few months. This first chapter will take you through those early stages so you can feel more prepared for the next part of your pregnancy.
I’ve compiled a list of things you should be doing by now, but don’t worry if you haven’t done them all yet. Tick the things you can achieve and make a note of the things you will try to do by, say, week 10. Remember, it’s early days and there is plenty of time.
• If you haven’t already, pee on a stick to confirm you’re actually pregnant. If you’re very unsure of the first day of your last period you may need to have an early dating scan, which your GP can arrange for you.
• Make a doctor’s appointment. This should be the first health professional you see. He or she will arrange your 12-week scan and your first midwife appointment.
• Once you’ve worked out your estimated due date, I recommend only telling people on a need-to-know basis (see here). And by that I mean your midwife and partner. I would also strongly recommend you add a week on to your pregnancy when telling friends and family. Only 5 per cent of babies are born on their due date. Your cycle may not even be exactly 28 days so you may not ovulate on day 14. Surprisingly, you are not a bag of microwave popcorn that will pop at 40 weeks.
• Start taking folic acid (400mcg per day) if you haven’t already. Folic acid helps to protect your unborn baby from neural tubal defects such as spina bifida. Once you are 13 weeks’ pregnant there is no need to continue taking the supplement.
• If you’re suffering from morning sickness (see here) and are finding it hard to get all the right goodness into your diet because you’re surviving on cheese on toast, you may want to think about taking some multivitamins. Check the list of ingredients carefully, as some vitamins, such as Vitamin A, aren’t recommended in pregnancy.
• You may also want to take extra iron at this point. That tiny fetus and developing placenta have a very clever way of stealing all your iron stores from you, and if you’re still finding it hard to keep anything down, an extra iron tablet a day could make all the difference to your energy levels.
• Early pregnancy can be hard, both physically and emotionally. Motivating yourself to do any exercise can be challenging, especially when all you want to do is curl up and eat crisps. But exercise can be anything from swimming and cycling to pregnancy yoga, gentle running or even just a good walk. So get moving. (See here and here for more on this.)
• Avoid that litter tray. If you have a cat that uses a litter tray the good news is you can – and should – pass over that job to your partner. Cat poo can contain a parasite called toxoplasmosis. Although very rare, it can cause a miscarriage. If you do any gardening, remember to wear gloves in case you come into contact with cat poo and always wash your hands thoroughly.
• Fill out an FW8 form, which your GP or midwife will give you. This entitles you to free prescriptions until your baby’s first birthday. You will then be sent a card that you show to the pharmacy every time you collect a prescription.
• Find an NHS dentist. More good news – you also get free dental care and treatments up until your baby turns one. This is especially important as you’re more likely to suffer from bleeding and swollen gums in pregnancy. So there’s no better time to get that toothache looked at!
• If you are working, find out what Maternity Pay you’re entitled to. Legally you don’t have to tell work you’re pregnant yet (and you may want to wait until after your 12-week scan) but planning your finances in advance is a really good idea. Check out www.gov.uk/pay-leave-for-parents to calculate what you’re entitled to.
• And last, but not least: go easy on yourself. Your body is doing a huge amount of work, even in these early weeks, so don’t be surprised at how exhausted you may be feeling. Getting home from work and having a kip on the sofa is absolutely fine: your body obviously needs it. And if, like me, you have young children to tend to while attempting to make a nutritious evening meal (fish fingers are totally acceptable, by the way) see if your partner can get home a bit earlier than usual to share the load. Remember that this phase of exhaustion won’t last for ever and never underestimate how incredible you are!
Confused? It’s not surprising that women are often left feeling overwhelmed by all the information thrown at them. I’ve simplified the four different types of antenatal care you can expect to receive here in the UK to help you navigate your way towards choosing what’s right for you and your baby.
• Midwifery care: For women who are low-risk (see here for more on what this means). You are looked after by your own midwife or team of midwives. This is sometimes called ‘one-to-one’ care or team ‘midwifery’ care. It’s not offered in all parts of the country, so speak to your GP about your options. Midwives see you for all your routine antenatal appointments and care for you during your labour and postnatally. You still have standard scans carried out by sonographers at the hospital.
• Shared care: This is the most common. Women are cared for by their GP and community midwife during pregnancy, with visits to the hospital limited to scans or investigating problems. Care is transferred to the hospital for the birth (including home birth), and back to the doctor/midwife afterwards.
• Consultant care: Women with pre-existing medical problems and women who are over forty may have regular checks with a hospital-based consultant and all their care may need to be carried out in hospital. There are some conditions, such as diabetes, that require the care of two specialists: an expert in the medical condition as well as an obstetrician.
• Independent midwives: Some women prefer to be cared for by an independent midwife who charges a fee for care during pregnancy, at the birth and afterwards. See: www.independentmidwives.org.uk
The exact number of antenatal appointments you have and how often you have them will depend on your situation. If you are expecting your first child, you are likely to have up to ten appointments. If you have had children before, you should have around seven appointments.
So, as soon as you have got over some of the shock that you are pregnant, make an appointment to see your GP, who can discuss what antenatal care is available in your area and set you up with dates for your various next steps. They will also assign you a hospital – usually the one closest to where you live, but the options vary depending on where you’re located. Your ‘booking’ appointment with your midwife will then be arranged – usually by 10 weeks into your pregnancy.
Visit these websites for more information on next steps:
www.nice.org.uk/guidance/cg62/chapter/appendix-d-antenatal-appointments-schedule-and-content
www.nhs.uk/conditions/pregnancy-and-baby/pages/antenatal-midwife-care-pregnant.aspx
Keeping such an exciting secret can be really difficult. It can feel exhausting constantly deceiving people as to why you’re not drinking, staying out late or eating certain foods. Even so, many couples choose not to tell anyone until they’ve had their 12-week scan and have been reassured that all is well.
But sometimes a problem aired is a problem shared. Some women find that telling closest friends who have had a baby already reassures them that certain things are ‘normal’. Some people are also more open to telling close friends/family before the 12-week scan because if anything does go wrong and they miscarry, those are the very people they would call on for support.
Whatever you choose to do, make sure you and your partner are both happy with the decision. Pregnancy can make those closest to you react in all sorts of funny ways, including being miffed at who was told first. And of course there will always be those friends who are struggling to conceive. But try not to let this worry you too much; this is an exciting time for you.
Don’t panic! Morning sickness permitting (see here), you can still eat most of your favourite foods while pregnant, with a couple of tweaks here and there. There’s no need to go mad memorising endless lists; just be sensible and realistic.
Bear in mind that we’re all different shapes and sizes, and some of us are more active than others. So any recommendation about the quantity of calories you need when you’re pregnant is based on averages and your lifestyle. You don’t need any more calories than normal until you reach the third trimester; even then you only need 200 extra per day.
• Beware rare: Cook everything thoroughly, including meat, eggs and seafood. Steak and prawns are still on the menu, but only if they’re well done. And remember: no runny eggs with your soldiers!
• Check your cheese: Most cheeses are fine in pregnancy. Just avoid soft blue cheeses such as Gorgonzola and mould-ripened cheeses like Camembert, Brie and chèvre (soft goat’s cheese). This is because these ‘wetter’ cheeses are more likely to breed listeria, a type of bacteria that can give you food poisoning. Bake them, though, and problem solved – so pop them on a pizza or bake a Camembert whole.
• Park the pâté: All pâté, even vegetarian pâté, is off the menu as they are also considered a high-listeria risk.
• Curb your caffeine: Drinking two cups of tea OR one cup of coffee a day keeps you under the recommended limit. But watch out for extra shots if you grab your coffee on the go: buy it from a coffee shop or café and you could be drinking more caffeine than you think.
• Think fish: Oily fish such as salmon, fresh tuna and mackerel are good for you, but limit them to twice a week. This is because bigger fish like these eat smaller fish so build up higher levels of mercury. Limit tinned tuna to 4 tins (160g each) per week for the same reason.
• Supermarket-safe zone: Cured meat like Parma ham and chorizo and cured fish such as smoked salmon are fine as long as you buy them from a supermarket. This is because the big stores freeze everything, which kills any possible parasites. Delis and restaurants may not freeze things first, so if in doubt, don’t – or ask.
• Leave the liver alone: Admittedly not many people eat liver nowadays but you may eat liver pâté or take cod liver oil, which are also no-nos. Liver is rich in Vitamin A (preformed or retinol), which can cause birth defects, so best leave well alone.
• Say bye bye to alcohol: The chances are you’d probably heave at the thought of drinking a glass of your favourite Soave at the moment, but once the seasick feeling has settled things may change. The recommendation from the RCOG (Royal College of Obstetricians and Gynaecologists) is that during early pregnancy, the safest approach is to abstain from alcohol entirely. After the first trimester, if you do decide to have an alcoholic drink, keep within the recommended amounts: women are advised not to drink more than one to two units more than once or twice a week.
• Don’t go nuts about not eating nuts: It’s absolutely fine to eat peanuts during pregnancy, unless of course you’re allergic to them yourself. There’s no evidence that eating peanuts, or foods containing peanuts, while you’re pregnant affects, whether or not your baby develops a peanut allergy.
Why is it called ‘morning sickness’ when I feel sick all day? It is estimated that around three-quarters of women experience feeling nauseous in early pregnancy, usually starting at around six weeks. It can strike at any time of day, so the term ‘morning’ is a bit misleading if, like me, you only feel sick in the evenings. It’s probably one of the worst early symptoms of pregnancy as it can really make simple things difficult, such as enjoying meals, travelling to work and sitting through those all-important meetings. It can also make trying to hide your pregnancy from others difficult – depending on their nosiness!
But why do I feel so sick? A little bit of biology here to help you understand why you may be feeling so green around the gills. It is not exactly clear why women experience morning sickness, but it is thought to be connected to the hormones being produced in large quantities in your body. Production of these hormones, HCG (human chorionic gonadotrophin) and oestrogen is then taken over by the placenta once it has grown enough to take over nourishing your baby. So try to remember that it is a good sign and trust your body to do its job caring for your tiny little baby. However, if you’re one of those lucky women who don’t experience a second of sickness, don’t worry that all is not well, because your body will still be doing a great job at making sure everything is developing normally. You’re just lucky!
How can I get through the next six weeks? It really is miserable feeling sick and some women may actually vomit too. If you’re still in the early stages of pregnancy and for whatever reason don’t want to tell friends and family yet, you need to know how to hide the symptoms and deal with them. Lots of women I have looked after in pregnancy all agreed that the best thing to do was eat – they all felt that if their stomach was empty the nausea was worse. So even if you wake up not feeling sick, make sure you eat something straight away. A banana, piece of toast with honey, or a digestive biscuit are all good things that are easy to digest. Lots of women find having snacks in their bag to nibble on if they’re commuting is helpful, as feeling like you’re going to vomit while stuck on the underground or on the bus is no fun. And always ensure you have a bottle of water handy: small sips are vital to head off dehydration. See here for more tips from a health writer who might be able to help you through this tough time.
All I’m eating is beige food. How can I ensure I’m getting the right nutrients to my baby? I remember being told that those first 12 weeks of pregnancy feel like one long hangover: you’re tired; you eat the wrong foods and feel a mix of nauseous and bloated. So it can be difficult to eat healthy foods when most of them make you gag. Try to remember that this won’t last for ever and in your second trimester (13–28 weeks) you’re likely to start eating well again, as you begin to feel much better. If you manage to get one piece of fruit or veg into your daily diet then you are doing better than most. Remember: if you’ve eaten a good pre-pregnancy diet then you’ve laid down the important pre-conception nutrients in your system. So try not to worry too much as you’ll make up for it later in pregnancy when your body will be saying ‘I’m starving’ and you can really start to enjoy the taste of flavoured foods again. I couldn’t wait to enjoy eating meals with flavours and spice in them, having previously lived on jacket potatoes and chunks of cucumber.
I’m vomiting up to 20 times a day and can hardly keep anything down, including water. Is this normal? This is hyperemesis gravidarum, which means excessive vomiting in pregnancy. The severity of the vomiting can cause dehydration, weight loss and a build-up of toxins in the blood or urine called ketosis. It affects nearly 4 per 1,000 pregnant women and can cause women to vomit blood. If you’re experiencing excessive vomiting and are unable to keep even water down, it’s best to go straight to your GP, where you will be asked to provide a urine sample and have a blood test to make sure you’re not too dehydrated. In some cases it may be recommended that you are admitted to hospital to have IV (intravenous) fluids, such as saline, and kept in for observation. Some women are also prescribed anti-sickness medicine to take until the symptoms have improved. Even though hyperemesis is truly horrible and makes you feel awful, it is very unlikely that any harm will come to your baby.
The term ‘morning sickness’ is a something of a misnomer. As anyone who has suffered from this debilitating affliction will tell you, it rarely limits itself to the hours before noon. The harsh truth is, it can strike at any time. For most women it starts around week 6 and usually tails off around weeks 12–14 but, for an unfortunate few, it can carry on throughout the pregnancy. Here are a few pointers and easy recipes to help get you to the other side:
• Eat little and often to keep your blood sugar stable as low blood sugar can make you feel weak, dizzy and even faint.
• Try to stay one step ahead of the nausea. Plant a snack next to your bed so you can eat it as soon as you wake up (or in the middle of the night).
• Rest or nap whenever you can to keep your energy reserves up.
• Suck ice cubes, ice lollies or frozen watermelon and orange segments.
• Eat something nice and filling before you go to bed: a warm bowl of porridge or some cereal.
• Ginger and fennel have been used for centuries to settle the stomach. Chew fennel seeds or add chopped ginger to warm water with lemon.
• Keep it simple and carb-heavy: plain mash, dry toast, crackers, rice cakes.
• Try to up your zinc intake: walnuts, pumpkin seeds, oatmeal, cashews, wholemeal bread, eggs, red meat.
• Have mints with you at all times.
• Sniff lemons.
• Acupuncture can help, or try acupressure wristbands.
• Eat what you can. Now is not the time to beat yourself up over family-sized packs of salt-and-vinegar chipsticks for breakfast. Needs must and all that.
• If you really can’t stomach the thought of food, make sure you keep sipping water to stay hydrated and stave off hyperemesis (see here).
Sliced avocado and a hard-boiled egg.
Half an apple, sliced, spread with a couple of teaspoons of cashew butter.
1–2 tablespoons hummus with cucumber sprinkled with pumpkin seeds.
FULL OF VITAMIN C, LYCOPENE, B6, MAGNESIUM AND ANTIOXIDANTS
Method: Chop 6 large tomatoes, 1 white onion and 1 red pepper into big chunks. Generously cover with olive oil and roast at 200°C (180°C fan oven) for 30–45 minutes or until the edges start to blacken. Remove from the oven and put in saucepan. Add 500 ml vegetable stock, then stir in basil until it wilts. Blitz with a hand-held blender. Season and serve.
CONTAIN ESSENTIAL FATTY ACIDS, FIBRE, FOLATE, VITAMIN E, IRON AND POTASSIUM
Pop them in your bag, stash them next to your bed, pile them up in the fridge. Or, for best results, do what I do and freeze them – they melt in the mouth. Method: Blitz 100g pecans with a cup of oats, then add in 2 medjool dates, 2 tbsps coconut oil and 1 tbsp cashew butter. Roll into balls and dust with shredded coconut. Freeze for best results – they defrost in seconds.
‘I ate anything ginger-flavoured – the teabags were particularly good and the ginger crystal chews. I don’t know whether it really helped – maybe it was just psychological – but needless to say I can’t stand the smell or taste of it now!’
‘I only wanted savoury foods and found peanut butter on rice cakes really helpful, especially to take into work for a snack at my desk. It seemed to help sickness mid-morning once my breakfast had been digested.’
‘My sickness was mainly in the evening, so I just ate a small meal and went straight to bed. Not very sociable for my poor husband, though!’
‘I wore travel-sickness bands that you wear on your wrist and a small button pushes on a certain acupressure point. The only problem is if you’re trying not to tell anyone you’re pregnant you’ll have to wear long-sleeve tops so as not to show the bands. But they really seemed to help.’
I was one of the lucky few who hadn’t experienced any morning sickness and prided myself on the fact. Fifteen weeks into my pregnancy my partner and I treated ourselves with a trip to Barcelona to see in the New Year. When we landed I started to feel a bit dodgy but put it down to the flight, but on board the bus to the hotel a wave of dizziness and heat washed over me. Before we had a chance to escape I opened my handbag and threw up inside it. We made a quick exit with a bag full of sick and didn’t look back. I spent the rest of the weekend airing out my bag and hanging my head in shame. I never boasted about anything pregnancy-related again!
Rochelle, mum of one
It’s amazing how early on your body gives you signs that you might be pregnant. Women often give me a whole range of reasons for how they just ‘knew’ that they were pregnant, even before taking a pregnancy test. And one of the most common early pregnancy symptoms is changes to your boobs. You may notice tenderness around that area, especially if anyone tries to touch them, or a tingling sensation around the nipple. So sorry to your partner, but no chance of a quick fondle tonight; these puppies are a no-go area. It can feel a bit like an exaggerated version of how your boobs feel before a period and some women find they have to sleep in a sports bra at night as it’s painful to lie on their front. Whatever your experience, when it comes to your boobs, it’s important to start thinking about their important role in pregnancy and beyond.
Extra blood flow in your body caused by the hormone oestrogen makes your breast tissue swell, so don’t be surprised if you go up a cup size in the first 12 weeks of pregnancy. Other changes to your boobs include increased visibility of blue veins, a darkened areola (the round bit of tissue your nipple sits on) and more prominent nipples. During pregnancy you will have up to 50 per cent more blood volume in your body, hence why your breasts may resemble an aerial photo of London. As your ribcage expands to make room for the baby, you may find that you need a bigger back size too. So don’t have a breakdown when the lady says you’ve gone up from a 32B to a 36B. You won’t have a broad back for ever, promise.
If your boobs do go through a period of rapid growth, you may find that they feel itchy as the skin stretches. Try not to scratch them too much, as that can leave horrible red marks, which can become sore. The best thing to do is to invest in a lovely pregnancy moisturiser to leave you smelling gorgeous. It’s never too early in your pregnancy to start looking after your skin.
It’s also worth remembering that this feeling of tenderness/soreness/don’t EVEN try to touch them won’t last for ever. Usually, once the hormones have done their super-amazing bit in early pregnancy, i.e. keeping that tiny bean alive and kick-starting the functions of the placenta, things should calm down.
My body didn’t seem to get the memo in puberty about boobs – I was always so flat-chested the boys at school called me pancake tits. So when I became pregnant my once non-existent chest started to grow, and I could finally wear bras that were a 32B! I felt womanly and sexy for the first time in my life. God bless pregnancy hormones.
Becky, mum of one
As your regular bras are not designed to provide the support and comfort you need as your boobs grow heavier and become more sensitive, you need to think about getting fitted for new bras for your pregnancy. You may find you have growth spurts throughout the 9 months, so it’s important to get measured at least twice while you’re pregnant to ensure you’re wearing the right size bra. I recommend getting measured at around 12–15 weeks and again at 34 weeks. Most high-street department stores offer a free measuring and fitting service and can guide you as to which bra is best for your shape. Maternity bras are designed to accommodate your changing shape, your expanding ribcage, and the increased strain on your chest muscles. As an added bonus, when maternity bras are worn regularly, they can help prevent stretch marks because they provide the right kind of support. Yay! You can also save money by buying maternity bras that can be used as nursing bras too. Double bonus. So remember, ladies: invest in your breasts!
You may never have had a blood test before and suddenly you’re pregnant and we want your blood! There are numerous routine blood tests offered to you that your midwife will explain about at your booking appointment. They are important, providing us with vital information about you while we care for you. It may seem like a lot of blood when you see all the bottles (usually five), but just one prick of the needle will fill the lot. Midwives are used to taking blood on a daily basis, though, so the good news is we’re highly skilled at doing it – so it’s quick and painless for you. If you’re a bit funny about having blood taken, there’s no better time to start overcoming these feelings because you’ll be offered more blood tests at the 12-week scan and later at 28 weeks (see here). It’s a good idea to eat something prior to the booking appointment and have some water handy. All of these blood tests are optional, so of course you can decline. Think carefully about why you wouldn’t want to have them, though. I know it can feel a bit overwhelming with all the screening tests you are offered at your booking appointment, so take the time to read all the information leaflets your midwife gives you. Ask questions and make sure you understand the explanations given to you so you are making an informed choice.
So what are all these tests for?
• Blood group. It’s important to know your blood group in the unlikely event you need a blood transfusion during pregnancy or birth. Blood group O is the most common. Groups A, B and AB are less so. You may already know your blood group, especially if you have donated blood, but we still need to have it on your hospital notes.
• Rhesus factor. If you’re rhesus positive (RhD positive), you have a particular protein on the surface of your red blood cells. If you’re rhesus negative (RhD negative), you don’t. If you’re RhD negative and the father of your baby is positive, there’s a good chance your baby will be RhD positive, too. In this case, if some of your baby’s blood enters your bloodstream, your immune system may react to the D antigen in your baby’s blood. It will be treated as a foreign invader and your body will produce antibodies to defend against it. In order to prevent this from happening you will be offered an injection of Anti D or immunoglobulin at 28 weeks. If you have any bleeding in pregnancy, it may also be recommended that you have an additional dose of Anti D as well as the routine one at 28 weeks. So if you go into hospital with bleeding always make sure you tell the midwife or doctor that your blood group is RhD negative. If your partner knows he is also RhD Negative you do not have the Anti D injection.
• Iron levels. A blood test can tell you if your haemoglobin levels are low, which is a sign of iron-deficiency anaemia. Your body needs around 14.8mg of iron per day to produce haemoglobin to carry oxygen around the body in your red blood cells. This keeps you feeling well, alert and not low in energy. If you’re anaemic due to iron deficiency, you need to think about the best foods to eat to boost your iron stores. Think Popeye: spinach, red meat, chicken, wholegrains (see here). You will be able to have your haemoglobin levels checked again at 28 weeks (see here).
I know my haemoglobin levels are always a bit low but iron tablets make me constipated. What else can I try?
There are other options available if you choose not to take iron tablets. Products such as Floradix and Spatone are great alternative options, available from all major health-food shops. Remember that iron is absorbed better with vitamin C, so take this with a glass of fresh orange juice for an extra boost.
• Hepatitis B. You could be a carrier of the hepatitis B virus and not even know it. A blood test is often the only way to find out for certain. If you pass the disease on to your baby either before or after he or she is born, his or her liver could be seriously damaged. Babies at risk of catching hepatitis B virus from their mums can be protected with a vaccination and antibodies, given as soon as they’re born.
• Syphilis. This sexually transmitted disease is fairly rare nowadays. However, if you have it and it isn’t treated during pregnancy, it could cause abnormalities in your baby. Syphilis can even cause a baby to be stillborn. It is easily treated with penicillin.
• HIV/AIDS. All pregnant women are offered a blood test to detect HIV and AIDS, but you can decline if you want to. If you discover you have the infection, steps can be taken to almost eliminate the chance of the virus being transmitted to your baby during pregnancy, birth and afterwards.
Group B strep is a normal and healthy bacteria that lives naturally in the gut flora in about 20 per cent of women. It is usually harmless, although it can pose a risk to your baby if it is passed on during childbirth. The NHS don’t routinely test for Group B strep unless you have had an infection like a UTI (urine infection) or require a vaginal swab in pregnancy. For more information speak to your midwife.
The 12-week scan, or nuchal translucency scan, is organised by your midwife or GP to take place between 11 and 14 weeks and it is usually performed at the hospital at which you are ‘booked’. If everything in your pregnancy has gone smoothly up until now, this will be your first scan and the first glimpse of your baby and his or her little beating heart as well as a few somersaults – if you’re lucky! As well as this, your baby will be measured and the approximate date that you will deliver will be calculated (EDD or estimated delivery date). This date is more accurate than the one worked out from your last menstrual period or LMP, so it is better to stick to this, although bear in mind that the majority of women do NOT deliver exactly on time.
You will also be offered screening to assess the risk of certain chromosomal disorders that may affect your pregnancy. If you choose to undergo this then the back of your baby’s neck will also be measured (nuchal translucency) and this combined with a blood test will be used to assess your risk (see below).
The scan is usually performed by a sonographer (person trained in scanning) or a doctor. Often in bigger hospitals there may be more than one person present, particularly if someone is being trained, so don’t be too surprised if there is more of an audience than you’d expected! If this is the case then be prepared for the scan to take a little longer. Some women enjoy this as they get to see their baby for longer and often also get more pictures as the trainees are so grateful for your patience! However, if this does not appeal to you, please say so as it’s important that you feel comfortable with what’s going on.
To begin the scan you will be asked to lie down on a couch and expose your tummy area. Scanning gel (often very cold!) will be applied to your tummy and a probe will be used to see your pregnancy. Don’t be too alarmed if the sonographer or doctor stops being so chatty at this point as it can take a bit of concentration to orientate themselves in your womb. Once they have a good view they will show you your baby and point out the flickering of its heartbeat before performing the rest of the scan. This usually involves a survey of the rest of your womb to confirm how many babies there are and to check that the spine, limbs and organs are all developing well. They won’t, however, be able to tell you the baby’s sex as it’s a little early. If you do wish to find out, then this is usually offered at the 20-week scan (although bear in mind that identifying the sex via a scan is not 100 per cent accurate. They will then measure the back of the baby’s neck as part of the combined test to assess risk of chromosomal disorders.
At the end of your scan, you will be given a copy of the report to put in your hand-held notes and your risk of chromosomal disorders will be explained to you. In some cases the results may not be available immediately and will therefore be sent to you in the post with an explanation of what they mean and if any further tests are needed. You will also be given a chance to buy some pictures of your baby, but costs vary from hospital to hospital.
So, what are these chromosomal abnormalities?
Chromosomes are the units that contain our genetic material. Most humans have 46 chromosomes or 23 pairs of chromosomes. Chromosomal abnormalities occur when a baby has extra chromosomes that give rise to syndromes causing different disabilities. The chromosomal abnormalities that are looked for are called Down’s (or trisomy 21, so three copies instead of two copies of the 21st chromosome), Patau’s (or trisomy 13, an extra copy of the 13th chromosome) and Edwards’ syndromes (or trisomy 18, an extra copy of the 18th chromosome). The majority of these cases occur spontaneously, i.e., are NOT inherited, although the risk of your pregnancy being affected does increase with age.
The risk to your pregnancy is calculated using the measurement of the back of your baby’s neck combined with the results of a blood test. The majority of women are found to be low-risk; however, please remember that this is a screening test, so even if your risk comes back as a 1-in-a-million chance, that still does not mean that there isn’t any chance of your pregnancy being affected.
If your risk is greater than 1 in 150, then you will be offered more testing. This is usually in the form of an amniocentesis, which involves taking a sample of the fluid surrounding your baby to confirm whether he or she is affected or not. If this is recommended to you, then it will probably be done at a later date, which often gives you time to process the information as it can be a lot to take in at once. Remember that 1 in 150 is still less than a 1 per cent chance of your baby being affected, but understandably women often still want further testing to know what is happening with their baby and to guide their future decisions about the pregnancy.
The dating scan is an exciting experience and is usually the first time you will actually get to see the baby growing inside of you and start to feel that your pregnancy is actually real. It can also be a scary, anxious time, filled with anticipation, often with lots of things going on which you may not have time to process. Try to enjoy the experience and remember, the sonographer or doctor performing the scan is there for you, to explain things – so if there is anything you want to know or don’t understand, please ask!
Sukhera Furness, obstetrician
Without a doubt there will be the dreaded invitation to that party, wedding or work event that you just can’t face attending at this stage of pregnancy. However, you may still be keeping this pregnancy a secret until you’ve had your 12-week scan, so what do you do?!
I remember feeling as if the entire world was having BBQs, endless engagement parties and, of course, weddings the summer I found out I was pregnant. Some events we managed to avoid due to ‘other commitments’, but the big ones, like our friends’ weddings, were near-impossible to avoid. My husband saw it as a perfect opportunity to get absolutely wasted, with me, of course, as designated driver. Joy. So how do you manage to not get drunk but appear drunk, especially when you’re feeling tired and nauseous too?
• Firstly (depending on your changing shape), choose your outfit wisely. I wasn’t showing around my stomach area at 10 weeks, but my boobs were massive, so I went for a dress that didn’t show my growing cleavage but was comfortable. If I had worn a maternity-style dress I think it would have made me look more pregnant than I was and a lot of friends might have become suspicious.
• Don’t overdo the ‘oh I’m not drinking because I’m on antibiotics/driving/on a detox’ story. It doesn’t work and draws more attention to you and the situation. Take a glass of bubbles and always make sure you have an alcoholic-looking drink in your hand.
• If you’re ordering drinks at the bar, try to get your trusty partner to get yours and order one that can be passed off as a gin and tonic. I’m sure there are hundreds of bartenders who have been asked to make a lemonade look like a G&T by putting it in a shorter glass and adding a slice of lime.
• Don’t forget to eat! Go for the nibbles/canapés provided (but be careful of anything that might have been prepared hours before, especially meat, fish and soft cheese). The food will keep your energy up as you won’t have the buzz that alcohol gives you at these long events, and hopefully keep any waves of nausea at bay.
• Remember that the more the event goes on, the more drunk your friends will become, and the less likely they will be to notice that you’re stone-cold sober. It’s quite hard to act drunk when you’re sober (unless you’re a great actress), but be prepared for some sober dancing. Again, this is really hard because you’re feeling self-conscious and you’re beginning to flag, but everyone else will be having a great time, so try to manage a few obligatory wedding-dance moves to cheesy tunes.
• Make a plan with your partner on when you want to leave by; that way there won’t be a big discussion in front of friends when he’s having a great time and you’re ready for your bed. Set a time beforehand. Make the departure very brief, i.e. only say bye to the hosts/bride and groom. That way there’s less chance your friends will notice you’re leaving earlier than anyone else.
• And you can be pretty sure your partner will be feeling a million times worse than you the next day. Win–win!
Not many people are really ever ‘ready’ to be parents even if it is planned, so you need to start dealing with this life-changing event sooner rather than later. If you’re anything like me, then at this point in time you’ll be excited but also worrying about how this is going to impact your life. Can I still go out with my friends this week? Will that special item I’ve been saving up for that I’ve wanted for ages have to go on hold in order to pay for the new pram? Will I have to get rid of my current car and replace it with something ‘more practical’? Am I capable of looking after a little human? You’re not alone. Mum-to-be is probably thinking about all that stuff too.
1 Talk to each other. The important thing here is that you both talk about your worries and anxieties. You’re both probably feeling lots of the same things, although all those pregnancy hormones can make everything seem more overwhelming for your partner. Be there for each other – remember that you’re in this together.
2 Avoid arguments. All those hormones may also mean you are sometimes the focal point of pregnancy outbursts. Defuse the situation before it erupts since stress and anger aren’t good for either of you (but especially her and the baby). Suck it up/bite your tongue/take it on the chin.
3 Phone a friend. You may have friends who already have kids. If you do, then you have a ready-made support network of people who have done this before you. Ask them for advice about things you’re not sure about. Men aren’t always that great at talking about the touchy-feely things, but if you can move past the initial awkwardness, then you may be surprised about how good it can feel to share frustrations and worries with someone other than that special lady in your life.
4 Be there when it counts. Try to make every effort to go to antenatal checks with your partner. Hearing the heartbeat of your baby or seeing it on the scan for the first time is truly amazing. Experiencing this together will help you to bond and make the fact that you’re having a baby seem so much more real. Having your support will make her feel more at ease. You won’t understand all that happens in these checks, so ask some questions. Standard ones to cover (while looking at the screen and holding your partner’s hand):
• So what position are they in?
• What are the different colours on the screen?
• What size is the baby?
5 Stop being lazy. You may not be a culinary genius, but I’m sure you have the ability to follow a recipe from one of those 20 or so beautifully shot cookery books that adorn your kitchen shelves. So cook some nutritious meals for both of you on a weekly basis.
I’m not saying that you should become a personal maid, but doing a bit more around the house is going to have several benefits
• You can prove that you’re capable of maintaining the house
• She doesn’t have to get stressed out about the state of the house
• She can’t have a go at you for not doing anything to help
Note: You should expect to be told that you haven’t done things to her standards and you may still get a talking-to. At this point I refer you back to point 2.
6 Read all about it. Swot up on what her body is going through. You don’t have to study for a PhD but to know a little more than you do right now is no bad thing.
7 Be a team. She’s going to be making some lifestyle changes over the coming months and you need to support her in them. And by support I mean make those changes too.
If you manage to do all this, I assure you that your life will be easier and it will help you mentally prepare for your new life as a parent.