Second trimester (15-28 weeks)

 

You are now entering the most comfortable stage of your pregnancy. Your stomach is growing and you will most likely start to feel your baby move (First time pregnancies usually around 20-24 weeks; subsequent pregnancies could be earlier). Your morning sickness should be lessening and you will be starting to show. You can start taking a multivitamin and keep up with your calcium intgake. From 20 weeks consider taking Salmon Oil/Omega 3 supplements. These are very effective for relieving joint pain in pregnancy, improving the neuron receptors in your baby’s brain and improving baby’s visual acuity.

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Anatomy scan

 

The anatomy scan is done between the 18th and 20th week of pregnancy.  It is an option to have this scan and also optional to find out the sex of the baby.  This scan is longer than the nuchal 12 week scan and thoroughly looks at all the organs, especially the heart.  It also looks at the position of the placenta which is important.  Sometimes the placenta will be low-lying and you will need a follow up scan at 32 weeks.

The overall opinion is that a scans in pregnancy are safe although excessive scans in the first 10 weeks has the most potential for side effects because of the developing baby. Your Midwife can give you a referral for the scan. Unfortunately Ultrasound scans are not free of charge. Please discuss your options with your Midwife.

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Exercise

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Exercising is an important way of staying healthy during pregnancy. Benefits of exercise during pregnancy include maintenance of weight gain and cardiovascular fitness. It strengthens your muscles allowing you to carry the extra weight, improves your joints and makes it easier to deliver your baby. Some important points to consider:

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• Try and exercise for 30 minutes most days.

• Swimming, yoga and walking are good pregnancy exercises.

• Don’t suddenly start doing vigorous exercise you weren’t doing before you became pregnant.

• Drink plenty of water to prevent dehydration.

• Do not overdo it and become too hot.

• Be careful of injuring your back. The hormone Relaxin loosens your joints making it easier to hurt yourself.

• If you are attending an exercise class, tell the instructor that you are pregnant.

 

Contraindications to exercise during pregnancy include vaginal bleeding, swelling, abnormally high or low blood pressure, abdominal pain, fatigue or lack of adequate weight gain!

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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

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

• Constipation can sometimes be caused by taking Iron tablets

www.whattoexpect.com

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Sex

 

During pregnancy some women have a strong sex drive while others do not.  Either way it is up to you how long and how often.  It is generally safe but we do recommend being very gentle and finding comfortable positions.  In pregnancy the cervix may bleed easier so sometimes there is a small amount of blood after sex.  Please still contact your midwife about the bleeding as it may need investigation and you may need an anti – D injection if you are a negative blood type. Some positions to try are: side lying and sitting on top of your partner.

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Bladder infection (UTI and Cystitis)

 

This occurs when bacteria infect your bladder and cause inflammation (swelling, often with irritation) of the bladder lining.  It is more common in pregnancy and can easily progress to kidney infection (pyelonephritis). Contact your midwife ASAP if any symptoms!

Signs and symptoms:  burning or stinging when passing urine; need to pass urine more often; passing only small amounts of urine at a time; fever, feeling unwell, chills, vomiting; blood in the urine; smelly or cloudy urine; pain in lower back and/or very low stomach.

Self Care: drink 2-3 glasses of water at start of symptoms and continue to drink as much as possible; go to bed or rest; avoid caffeine and fizzy drinks; do not have sex until symptoms are gone; start vit.C tablets up to 2000mg a day and cranberry tablets or cranclense to reduce infection; see herbalist for herb tea or tincture that is safe to use in pregnancy.  If pain becomes severe and radiates around your back then you may have a kidney infection and need antibiotics so call your midwife ASAP!

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Heartburn

 

Heartburn (also called acid indigestion or acid reflux) is a burning sensation that often extends from the bottom of the breastbone to the lower throat. It's caused by some of the hormonal and physical changes in your body. During pregnancy, the placenta produces the hormone progesterone, which relaxes the smooth muscles of the uterus. This hormone also relaxes the valve that separates the oesophagus from the stomach, allowing gastric acids to seep back up, which causes that unpleasant burning sensation. Progesterone also slows down the wavelike contractions of your oesophagus and intestines, making digestion sluggish. Later in pregnancy, your growing baby crowds your abdominal cavity, pushing the stomach acids back

 up into the oesophagus.

Many women start experiencing heartburn and other gastrointestinal discomforts in the second half of pregnancy. Unfortunately, it usually comes and goes until your baby is born. Though you may not be able to eliminate heartburn entirely, you can take steps to minimize your discomfort:

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• Avoid food and beverages that cause you gastrointestinal distress. The usual suspects are carbonated drinks; alcohol (which you should avoid anyway during pregnancy); caffeine; chocolate; acidic foods like citrus fruits and juices, tomatoes, mustard, and vinegar; processed meats; mint products; and spicy, highly seasoned, fried, or fatty foods.

• Don't eat big meals. Instead, eat several small meals throughout the day. Take your time eating and chew thoroughly.

• Avoid drinking large quantities of fluids during meals — you don't want to distend your stomach. (It's important to drink eight to ten glasses of water daily during pregnancy, but sip it between meals.)

• Try chewing gum after eating. Chewing gum stimulates your salivary glands, and saliva can help neutralize acid.

• Don't eat close to bedtime. Give yourself two to three hours to digest before you lie down.

• Sleep propped up with several pillows or a wedge. Elevating your upper body will help keep your stomach acids where they belong and will aid your digestion.

• Gain a sensible amount of weight, and stay within the guidelines your healthcare provider suggests.

• Wear loose, comfortable clothing. Avoid any tightness around your waist and tummy.

• Bend at the knees instead of at the waist.

• Don't smoke — in addition to contributing to a host of serious health problems, smoking boosts stomach acidity. (Ideally, smoking is a habit you should break before getting pregnant. If you're still smoking and are having trouble quitting, ask your caregiver for a referral to a smoking-cessation program.)

• An over-the-counter antacid  like Quickies, Mylanta or Gaviscon is fine to take. Magnesium or calcium may ease discomfort. Try a squeeze of lemon in a glass of water to ease the discomfort.

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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)

• Don’t stand or sit with your legs crossed for long periods of time and stretch your calf and leg muscles during the day and before bed. Rotate your ankles and wiggle your toes when you are sitting.

• Try to take a walk each day, even if it is only 10 minutes it can help.

• Also lie on your left side to improve your circulation and rest when you are tired with your legs elevated.

• Sometimes wearing supportive stockings may help which are available online or at pharmacy.

• A warm bath before bed is a great way to help relax your muscles and helps you sleep better as well. Of course drinking plenty of water is a necessity. 

• You can take a magnesium supplement in addition to your prenatal vitamin (if you are taking one). Magnesium has been proven to be beneficial in the treatment of leg cramps.

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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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• 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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Have a look at the following websites:

http://www.pregnancy-info.net/omega3.html

http://pregnant.thebump.com/pregnancy/nutrition-exercise.aspx?MsdVisit=1

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

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