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First Trimester

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This is the time when your baby’s organs are being formed and developed. It is imperative that you are in the best health possible and so allow your baby optimal development. As a result, you are urged to follow a healthy diet, exercise, not smoke nor drink alcohol and follow this healthy plan your whole pregnancy and whilst breastfeeding. Myself or my colleagues are able to provide support to Quit smoking if needed.

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You may not look pregnant yet — but chances are you're feeling it. That's because a flood of pregnancy hormones is prepping your body to play baby hostess for the next nine months — so you could be in line for quite a few aches and pains, from fatigue to bloating. While you might be less than thrilled with some of these symptoms, try to remind yourself that these temporary discomforts are part of the incredible process that's happening inside: You're growing a child! Aside from the obvious (a missed period and a positive pregnancy test) here are some signs and symptoms of early pregnancy that you can expect to start from around the 6th week of pregnancy (or about 2 weeks after your period is due): You're growing a child! The first trimester lasts from week 1 through the end of week 13 of pregnancy. 

Not sure what week you are in your pregnancy? The first step to nailing your current week down is to calculate your due date. Keep in mind that your date might change (especially if you have irregular periods), so try to go with the flow. If you are not sure when your last period was, your GP or Midwife can order a Dating scan.

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Alcohol in Pregnancy

 

It is unknown if there is any safe amount of alcohol in pregnancy despite a recent research article published by some Danish researchers.  While one woman may have many drinks in her pregnancy and have a baby who is unaffected by Fetal Alcohol Syndrome (FAS), another woman may only have a few and have a child who has FAS.  The best way to ensure the safety of your baby is to abstain from alcohol completely during pregnancy.  The links below provide some excellent information on alcohol use in pregnancy, as well as some information on Fetal Alcohol Syndrome. If you feel that you have a problem with alcohol, please talk to your midwife who can help you access help.

http://alcoholism.about.com/cs/preg/a/aa070997.htm

https://www.healthed.govt.nz/resource/alcohol-and-pregnancy-when-you-drink-alcohol-so-does-your-baby

http://www.marchofdimes.com/pregnancy/alcohol_indepth.html

Some information on Fetal Alcohol Syndrome

http://www.fan.org.nz/home

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Antenatal Classes

 

Now is a wonderful time to start thinking about Antenatal classes. These classes are not funded but are important, especially for parents expecting their first baby. They will equip you with knowledge, skills and support, and will give you confidence as you take on the challenges of parenthood. These classes fill up quickly so book yours early (about 20 weeks).

Places you can contact are:

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• Lifecycles

Melissa Dorr

Phone:  021 139 5467

Email: melissa@lifecycles.nz

lifecycles.nz

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• Auckland East Parents Centre (Highland Park)

www.aepc.org.nz​

Phone: (09) 537-0560

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• Parents Centre

parentscentre.org.nz

http://www.parentscentre.org.nz/

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• “Tapuaki”- 6 Week Pacific Parenting and support Education @ Onehunga- (09) 636 6329

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• Hypnobirthing

Claire Bettesworth

Phone:  021 222 9842

aucklandhypnobirthing.co.nz

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• Online AN classes

https://www.hatchedantenatal.co.nz​

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Backache and Joint pain

 

This is due to pregnancy hormones that soften the ligaments.

• Correct your posture: Keep your head up, your chest up, pelvis tilted up and relax your shoulders.

• Wear sensible shoes with a moderate heel.

• Sleep on a good firm mattress; sleep on your side with a pillow between your knees or three-quarters on your stomach with a pillow under one drawn up leg.

• Avoid heavy lifting.

• Massage your back or points with lavender oil diluted with base oil eg. Grapeseed/ Olive/ Almond/ Coconut oil

• Use a heat pad and/or warm bath/ shower

• Try and avoid painkillers when possible. If you are really battling, use Salmon Oil and Panadol combination.

• When standing, rest one foot on another slightly higher surface.

• Sit on a firm stool.

• See a craniosacral therapist, osteopath, physiotherapist or chiropractor.

 

Exercises to ease back pain:

 

• Lie on your back with your knees bent and your head on a pillow. Put one hand under the small of your back. Pull in your tummy muscles until your back flattens against your hand. Don’t hold your breath. Count to four and relax.

• Kneel on all fours and hump your back like a camel, firmly pulling in your tummy muscles and then relax. Don’t hollow your back.

• https://www.youtube.com/watch?v=did4yD8Ofoc; https://www.youtube.com/watch?v=S3xXurLpfDk;  https://www.youtube.com/watch?v=33LLeqyVbG0

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Bloating and cramping

 

Bloating is caused by the increase of a hormone called progesterone.  This hormone is responsible for relaxing smooth muscle in the body which means that when you eat, your food takes longer to pass through your gastrointestinal tract, causing you to feel bloated and windy.  To help with this, you can try to eat several smaller meals a day rather than 3 large ones.  Ensure that you are eating a well balanced diet with plenty of fibre and water to help avoid constipation.  Try to avoid foods that cause you to be windy and try to take your time eating meals and chew your food well as this will aid in your digestion.

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Breast changes

 

Some changes that may be experienced are tenderness of the breasts, growth in size of the breasts or feelings of fullness, darkening of the areola (area around the nipples), or you may not notice any change. By the end of the first trimester, you may even notice that your breasts look very veiny as well.   Pregnancy hormones are responsible for some of these changes.

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Constipation

 

Pregnancy hormones can slow down the muscles in the bowel causing constipation in some women. It will help to:

• Make sure you include plenty of fibre in your diet, e.g. fresh fruit and vegetables, wholemeal breads and breakfast cereals, dried fruit, nuts and legumes (kiwi fruit eaten with the skin is very effective; avoid bananas)

• Drink plenty of water and fluids

• Exercise regularly

• Take a fibre supplement such as Metamucil or Phloe

• Laxatives should be avoided until discussed with your Doctor or Midwife

• Constipation can sometimes be caused by taking Iron tablets

• 2 Tablespoons of Chia seeds or Flaxseed daily daily in water ort in a smoothie

• Dandelion leaves are full of nutrients, can be added to your daily salad. Dandelion root can relieve constipation

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Drugs in Pregnancy

 

Use of illegal drugs in pregnancy (such as marijuana and pills as examples) can have long lasting effects on your baby.  Read here for more information:

http://www.mamamaternity.co.nz/mama-maternity-abc/planning-your-pregnancy-care/tobacco-alcohol-and-drugs/

Need help to stop using?

http://www.drughelp.org.nz/?gclid=COWGgqrU_LACFWaXpgody01VQA

http://www.drugfoundation.org.nz/

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Feeling extra sleepy

 

Fatigue can be one of the earliest symptoms that you are pregnant and tends to be worst in the first trimester.  The good news is that fatigue generally eases off in the 2nd trimester and but will reappear again in the 3rd trimester but isn’t usually as bad. Progesterone is the hormone that can be blamed for this.  Additionally your body is working hard to build up its own blood volume and this causes increased work for the heart and other organs.  In order to combat fatigue, it is best to limit caffeine, eat a balanced diet including meat and iron rich foods, get as much rest as you can and also try to enjoy light exercise such as walking.

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Food cravings or aversions

 

Some women experience food cravings during pregnancy. We don’t really understand the reason for this, but the cravings are often for foods that we seem to need. Good old pregnancy hormones can also are responsible for causing you to suddenly “go off” a food item you used to love or start eating something more often than you used to. Generally, cravings and aversions will stop by around the end of the fourth month, so in the meanwhile, here are a few tips to help you deal with cravings and aversions:

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• Cravings

-try to feed your cravings but in moderation.  Instead of eating a huge bowl of ice cream, perhaps a small scoop in a cone would be sufficient

-when a craving strikes, especially if it is one that isn’t so healthy, try some light exercise to distract you

-enjoy your cravings in moderation.  You can eat one bad meal once in awhile as long as you are having a balanced diet the rest of the time

-Pica is a craving for dirt, ash, chalk or clay and may indicate a deficiency of iron in your body. If you experience intense cravings to eat non-food items such as those listed here, contact your care provider as you may need to have a blood test taken.

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• Aversions

Aversions can be very hard to cope with, especially if you are suffering from morning sickness.  It can sometimes seem that there is simply nothing that you want to eat or can even imagine putting in your mouth.  If you are suffering from strong aversions to foods, don’t worry too much.  Just eat what you can knowing that this symptom of pregnancy should pass once you hit the second trimester.

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Headaches

 

It's not unusual to get headaches when you're pregnant, especially in the first trimester. They may be caused by the hormonal changes in your body. They can also be caused by lack of sleep, tension, increased hunger, dehydration, sinus congestion, and allergies.

There are plenty of pregnancy-safe steps you can take to prevent and battle the most common pregnancy headaches:

 

• For tension headaches and migraines:

Lie in a dark, quiet room. If you're at work, try to close your eyes and put your feet up for 15 minutes. Use an icepack or cold compress on the back of your neck for 20 minutes while you relax.

 

 

• For sinus headaches:

Try steam inhalation to relieve congestion and use a humidifier to add moisture to the air. Hot and cold compresses applied alternately to your sinuses several times a day can provide relief. Drinking plenty of fluids will also help to get the mucus flowing. If it persists, check with your doctor to see if a sinus infection may be causing your headaches.

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• For all headaches:

Paracetamol is safe for use in pregnancy. Take 1gram (2 tablets) 6 hourly. Do not take more than 4 grams in 24 hours! If you feel you need stronger medication, see your GP. Evidence shows that regular exercise can reduce the frequency and severity of migraines and reduce the stress that can cause tension headaches.

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Most headaches during pregnancy are unpleasant but harmless. But a headache could be a sign of a more serious problem. If you're having a migraine or other severe headache for the first time ever, you might need a full medical evaluation to be sure nothing else is going on...

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Healthy eating and weight gain in pregnancy

 

It is normal for women to gain some weight during pregnancy due to the growth of the baby, placenta and amniotic fluid. However, too much extra weight during pregnancy can lead to adverse outcomes for the mother and/or baby. The amount of weight that women can expect to gain during pregnancy varies depending on the woman's existing weight and height. Achieving an optimal amount of weight gain during pregnancy is associated with improved outcomes for mothers and babies regardless of the mother’s body mass index (BMI).

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http://www.calculator.net/pregnancy-weight-gain-calculator.html

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Healthy Weight Gain Tips for Pregnant Women

          

• In the first 12 weeks you don’t need to eat any more food than you would usually eat when not pregnant, but it is important that you eat nutritious food. The total amount of extra food you need each day after the 12th week of your pregnancy is about the same energy value as a wholemeal cheese and tomato sandwich, or a wholemeal peanut butter sandwich and a banana, if you are of normal weight.  It you were obese before pregnancy, the extra energy you require is about one slice of wholegrain bread or two apples per day.

• Drink water rather than sweetened drinks or fizzy drinks.

• Drink low-fat [trim (green top) or calcium-extra (yellow top)] or light blue milk instead of full-fat (blue or silver top) milk.

• Choose wholegrain bread instead of white bread.

• Eat a healthy breakfast every day, such as wheat biscuits or porridge with low-fat milk, or two slices of wholegrain toast instead of processed cereals.

• Have at least 4 serving of vegetables and 2 servings of fruit every day.  Buy vegetables and fruits that are in season, or buy frozen vegetables to help reduce cost, wastage and preparation time.

• Prepare and eat meals at home.  Have takeaways no more than once a week.

• Choose healthy snacks such as unsweetened low-fat yoghurt, fruit, cheese and crackers, a small bowl of cereal, home-made popcorn, or a small wholegrain sandwich

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Following are some links to websites with great information related to eating in pregnancy.

http://www.kiwifamilies.co.nz/articles/nutrition-in-pregnancy/

http://www.whattoexpect.com/pregnancy/eating-well/pregnancy-diet.aspx

This website has excellent information related to all sorts of eating issues including eating while travelling, food safety and handling, a guide to eating right in pregnancy

http://www.foodsmart.govt.nz/information-for/pregnant-women/

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Are you vegetarian and wondering what to eat during your pregnancy?

 

http://www.health.qld.gov.au/nutrition/resources/antenatal_veget.pdf

http://www.vegsoc.org/document.doc?id=9

 

Vegan?

 

http://www.vrg.org/nutrition/veganpregnancy.htm

http://www.vegan-momma.com/vegan-pregnancy.html

http://www.health.qld.gov.au/nutrition/resources/antenatal_vegan.pdf

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Increased frequency of urination

 

In early pregnancy, frequent urination is caused by hormonal changes, but in later pregnancy it can be related to the increasing size of the baby pressing on your bladder. You may find it more difficult to empty your bladder completely in late pregnancy. In the last few weeks of pregnancy you may 'leak' some urine when you cough, sneeze or lift something.

You can discuss pelvic floor exercises with your midwife or doctor. Continue to drink lots of water during the day, but you may wish to limit your fluid intake in the evening before bed.  You may find it helpful to limit drinks with caffeine in them as caffeine can make you pee more.  Make sure you fully empty your bladder when you go to the toilet.  Try leaning forward when you pee or, when you think you have finished, try to pee again.  Do alert your midwife you feel burning or stinging while passing urine, you have a fever or abdominal pain as these could be signs of a urinary tract infection (UTI).

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Increased salivation

 

It is quite normal for some women to experience an increase in the amount of saliva, or spit, they produce.  Increased salivation can be very unpleasant and can contribute to feelings of nausea and heartburn.  To help with this, you can try to increase your fluids, brush your teeth often and suck on lozenges or chew some gum.  Fortunately, this symptom tends to disappear by the 2nd trimester.

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Increased sense of smell

 

It is very usual for women to notice that their sense of smell becomes much more sensitive during pregnancy.  Sometimes, this can be quite overwhelming, especially if you are dealing with other symptoms like nausea and headaches.

If your sense of smell is causing you problems, especially with day to day activities such as cooking, then here are a few ways to help:

– Cook things that you can tolerate the smell of (or better yet, get your partner to cook for you while you relax in another room)

– Get plenty of fresh air, leave the windows open a bit to keep clean air coming into your home or office

– reduce the amount of scented products you use for personal hygiene and when cleaning the house

– stay away from smoking areas

– you can always use a few drops of mint or lavender on a handkerchief and keep this in your purse for times when your senses are assaulted by smell (for example you can breathe into the handkerchief when passing through the mall food court area).

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Leg cramps

 

These are possibly due to a lack of calcium, magnesium or iron.

• Ensure adequate intake of calcium and magnesium. Cal-Mag tablets are recommended.

• Massage your legs with lavender oil diluted with base oil eg. Grapeseed

• Flex foot up and push into heel

• Check your iron level and supplement if necessary

• Soak in a bath with 1 or 2 hands of Epsom salts (can get at supermarket)

• Herbs containing Calcium and MAgnesium, like Stinging Nettle, Oatstraw and Raspberry as infusions

• Stinging Nettle is a vitamin and mineral rich herb, perfect for pregnancy. It supports kidneys and the bladder and acts as a tonic. Helps to relieve Braxton hicks and leg cramps. Also supports the uterus, increse available Haemoglobin and protects agains anaemia, fluid retention and poor digestion- dose up to 3 cups per day

• Crampbark tincture: 2.5ml 3 times daily

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Listeria

 

Listeria is a common bacterium (bug) which is widely found in dust, soil, water, plants, sewage and animal droppings. Listeria is only dangerous to pregnant women, their babies and people with a lowered immune system. If a pregnant woman develops an infection caused by Listeria (listeriosis), it can cause miscarriage and stillbirth. Newborn babies who develop listeriosis can have difficulty breathing; develop a chest infection and an inflammation of the coverings of the brain (meningitis). This can sometimes cause death. Listeriosis may cause no symptoms at all or you may feel like you have a mild dose of the flu. Listeria can be transmitted to pregnant women by infected food. The bug has been found in a variety of foods at all stages of preparation, from raw to well-cooked left-over’s.

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Nausea/vomiting

 

Although nausea is more common in the morning and early stages of pregnancy, it can happen at any time of the day, or any stage of the pregnancy. It usually starts at about the sixth week and settles by about 14 to 16 weeks. The cause is unknown, though it has been linked to the changes in hormone levels during pregnancy. Suggestions that may help:

• Eat small meals and snacks frequently; feeling empty or hungry can make the nausea worse

• Drink plenty of fluids to avoid dehydration; try cordial, juices, soups, icy popsicles or jelly, lemonade, dry ginger ale, soda or mineral waters

• Avoid anything that may trigger your nausea such as: rich, spicy or fatty foods and strong food smells, coffee, tea, alcohol or tobacco smoke

• Sudden movements such as jumping out of bed or racing to the shower can make you feel sick too

• Get plenty of rest as nausea is often worse when you are tired

• Eat protein before going to bed, or if up during the night.

• Do low impact exercise, such as walking or yoga, after eating.

• Eat foods rich in B group vitamins such as pork, poultry, fish, bread, whole cereals, vegetables, eggs, soya beans.

      ginger helps some women; try ginger biscuits, tea or tablets (check dosage with pharmacy or naturopath).

• Eat a plain biscuit (or ginger biscuit) or piece of toast before getting out of bed in the morning

• Get up slowly so your body doesn’t change position too quickly

• If nothing works, you feel exhausted, or you are vomiting and losing weight, see your doctor or midwife. There are medications available for controlling morning sickness that are safe in pregnancy...

• Ginger helps some women. Try Ginger biscuits, tea or bubble tea

  • 1 teaspoon ginger in a cup of boiling water and sipped through the day​

  • 10 drops of Ginger tincture up to 10 time a day

  • 250mh of powdered Ginger root, 4 times daily

  • Peppermint tincture, 1.5mls-4mls daily

  • Liver herbs, such as Mary's thistle, Meadowsweet and Dandeleion root

• If nothing works, you feel exausted, or you are vomiting and losing weight, see your doctor or midwife. There are medications available for controling nausea that are safe in pregnancy.​

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Here are some websites with some tips to cope with nausea and vomiting in pregnancy and also a great site about HG:

http://www.babycentre.co.uk/pregnancy/antenatalhealth/morningsicknesswhy/

http://www.bpac.org.nz/magazine/2011/november/docs/bpj_40_pregnancy_pages_24-29.pdf

http://www.helpher.org

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The Pelvic Floor

 

The pelvic floor is made up of muscles, ligaments and tissue that form a broad sling, stretching from the pubic bone at the front of the body, to the base of the spine at the back. They support the bladder, bowel and lower uterus, and give you control when you empty your bladder and bowel.

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Being pregnant can place large amounts of stress on your pelvic floor and its muscles. Your pelvic floor can become weak and stretched from as early as 12 weeks into your pregnancy. Pregnancy symptoms such as constipation can stretch and weaken your pelvic floor further. This can lead to stress incontinence, (you leak a little urine when you cough or laugh, sneeze, jump or run), and decreased satisfaction during sex.

 

Pelvic Floor Exercises:

Research has shown that antenatal pelvic floor exercises reduce the risk of incontinence during and after pregnancy. It is a good idea to start pelvic floor exercises now.

• Imagine that you are trying to stop yourself passing wind and at the same time trying to stop the flow of urine. The feeling should be of squeeze and lift.

• Hold for as long as possible, up to 10 seconds, breathing normally, and then relax.

• During these exercises try not to tighten the buttocks, squeeze the legs together or hold your breath.

• Repeat up to 10 times at least 3 times per day.

• You can do these while washing up, driving your car, watching TV, etc. No one will know you are doing them.

• There are some Youtube videos you can watch: https://www.youtube.com/watch?v=z8ik-Oje-k4&t=128s; https://www.youtube.com/watch?; v=V9W6aVHOQk4;https://www.youtube.com/watch?v=djKV4Vvsnwo 

 

Relaxing Your Pelvic floor

It is just as important to learn how to relax your pelvic floor as it is to tighten it. When your baby's head "crowns" or emerges from your vagina, during the second stage of labour, your muscles need to relax. A relaxed pelvic floor during the second stage of labour can help prevent tearing or episiotomy. Also, if your muscles cannot relax properly, your pelvic floor exercises won't be working as effectively and strongly as they should, and your muscles will tire quickly. After you have tightened your pelvic floor muscles, make sure you relax them fully before tightening them again. For some women, a gentle push out at the end of each pelvic floor contraction will help. Getting your breathing right will help with this.

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Piles/ Haemorrhoids

     

These are swollen veins in the lining of the anus. They feel like small bumps surrounded by pads of skin.

Causes: Increased weight of the baby, straining as a result of constipation.

To limit damage: Drink lots of water, keep bowels regular, exercise, insert whole peeled clove of garlic into rectum, use witch hazel compress, that is pour witch hazel on a gauze pad and place over haemorrhoid. If these natural remedies don’t work, I can prescribe treatment.

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Screening in Early Pregnancy

 

In the first trimester of pregnancy, it is likely that you will be offered some tests.  You may be offered a blood test to check the levels of the pregnancy hormone hCG.  This test is helpful if you are uncertain of when you may have conceived or it seems that you might be at risk of miscarriage.

Additionally, you will likely be asked to have a blood test that looks at a variety of aspects of your health, including your blood type, a complete blood count and your immunity to some diseases such as hepatitis b and syphilis.

Click on this link for more information about what is tested for: http://www.everybody.co.nz/page-0b755006-b9db-4151-99b9-966d7c2e23c6.aspx

At the end of the first trimester, you will be offered the opportunity to have an ultrasound scan and blood test which will help to determine the chances of your baby having a chromosomal disorder such as Down Syndrome (Trisomy 21), Edwards Syndrome (Trisomy 18) and Patau Syndrome (Trisomy 13).

This website provides excellent descriptions of the testing that is carried out and what may happen next if your baby is found to be at increased risk for a chromosomal issue. http://nsu.govt.nz/current-nsu-programmes/antenatal-screening.aspx?gclid=CLnjiI3S_rACFWaXpgody01VQA

http://www.lpch.org/diseasehealthinfo/healthlibrary/genetics/trisomy.html

Trisomy 13

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002625/

Trisomy 18

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002626/

http://www.trisomy18.org/site/PageServer

Trisomy 21 Down Syndrome

http://www.mosaicdownsyndrome.com/

http://www.nzdsa.org.nz/

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Smoking

 

It is well known that smoking is harmful to a person’s health, however, it also a problem for your baby as well.  Each time you smoke while pregnant, your baby is deprived of oxygen and nutrients and its heart rate rises to try and move more oxygen around its body.  It is directly exposed to nicotine and carbon monoxide.   Smoking in pregnancy increases your risk of a miscarriage.  Babies of smoking mothers tend to be smaller because the chemicals in cigarette smoke cause constriction of the blood vessels in the placenta, reducing flow of nutrients and oxygen to the baby.  Once the baby is born, it may suffer withdrawal from the nicotine.

Here is some information on how smoking affects mum and baby:

http://www.helpwithsmoking.com/smoking-and-pregnancy/effects-on-foetus-pregnancy.php

http://www.everybody.co.nz/page-9ed182c5-be8d-4661-adb3-d92ea256efe7.aspx

A baby is also at risk after it is born, it its parents continue to smoke.  The risk of cot death (or Sudden Unexplained Death in Infants or SUDI for short) is very high in infants whose parents smoke.

Quitting smoking

Pregnancy is a wonderful time to quit smoking as the health benefits not only affect you, but also your baby.

Smoke change is a free service for pregnant women and their partners to assist them in changing their lives by quitting smoking.

http://www.changeforourchildren.co.nz/our_kites/smokechange

http://www.quit.org.nz/46/staying-quit/tips-for-quitting

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Supplements

 

There are all kinds of ideas out there about supplements and things that you need to take in pregnancy.  Iodine and folic acid are two such supplements that are highly recommended in New Zealand (and across the world) for the health of your baby.

• Iodine

Why do we need to take iodine in pregnancy?  Find the answers here…

http://www.health.govt.nz/our-work/preventative-health-wellness/nutrition/iodine

http://www.foodsmart.govt.nz/whats-in-our-food/chemicals-nutrients-additives-toxins/food-additives/iodine/

• Folic Acid

Information about the importance of folic acid supplementation in the first trimester can be found here:

http://www.health.govt.nz/our-work/preventative-health-wellness/nutrition/folate-folic-acid

http://www.foodsmart.govt.nz/whats-in-our-food/chemicals-nutrients-additives-toxins/food-additives/folate/

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Multivitamins

 

Do I need to take a multivitamin?

The Ministry of Health currently recommends that women who are pregnant take folic acid from one month before conceiving up until the end of the 12th week of pregnancy and iodine from when you become pregnant until you stop breastfeeding.  If your diet is well rounded and you eat from all of the food groups, you are unlikely to need further supplementation than the folic acid and iodine.

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Toxoplasmosis in Pregnancy

 

Toxoplasmosis is an infection that can threaten the health of an unborn child. It is caused by a parasite called Toxoplasma gondii. The parasite multiplies in the intestine of cats and is shed in cat faeces, mainly into litter boxes and garden soil. You can get the parasite by handling cat litter or soil where there are cat faeces. You can also get the parasite from eating undercooked meat (such as rare beef) from animals infected with the parasite. Toxoplasmosis during pregnancy is rare but can cause serious problems for an unborn baby, such as damage to the baby’s brain and/or eyes. It can lead to miscarriage or stillbirth.

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• What happens if I have it?

Healthy adults usually do not suffer ill effects from toxoplasmosis and many times do not have enough symptoms to suggest infection. If you become infected while pregnant, your unborn child may also become infected. Infected babies may not develop any disease, or they may become very ill, with serious damage to the brain and eyes.

If you have been infected previously (at least 6 to 9 months before your pregnancy) with toxoplasma, you will develop immunity to it. The infection will not be active when you become pregnant, and so there is rarely a risk to your baby.

Blood testing for detecting past or recent exposure to this parasite is available, but is not routinely done. If you are not tested and you don't know if you're immune or not, or if testing does not show immunity from previous infection, you can still take steps to protect yourself and your unborn child.

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How can I avoid toxoplasma during pregnancy?

Here are some tips to help you avoid exposure to toxoplasma during your pregnancy:

• Do not allow your cat to go outside your home where it may come into contact with toxoplasma. If possible, have someone else take care of your cat while you are pregnant.

• Have another family member change the cat litter box and then disinfect it with boiling water for 5 minutes.

• If you must handle the chore of changing the litter box, wear rubber gloves to avoid contact with the litter and wash your hands thoroughly afterwards.

• Use work gloves when gardening and wash your hands afterwards. Cover children's sandboxes when not in use (cats like to use them as litter boxes).

• Control flies and cockroaches as much as possible. They can spread contaminated soil or cat faeces onto food.

• Avoid eating raw or undercooked meat (or poultry) and unwashed fruits and vegetables.

• Wash your hands thoroughly before you eat and after handling raw meat, soil, sand or cats.

• Avoid rubbing your eyes or face when preparing food, and wipe the counter clean afterwards.

• Avoid eating raw eggs and drinking unpasteurized milk.

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Varicose veins

 

These are bulging blue veins near the skin’s surface, mainly found on the back of the calves, behind the knees and on the inside of the thighs. They are due to an increased blood supply and increased pressure that stretches the small veins; they bulge and become varicose veins.

Causes: Pregnancy hormones, inherited from your mother or grandmother, increasing weight of your baby.

To limit damage: Avoid standing still for any period of time, wear support tights, rest with feet raised above hips, gentle daily walks