EXPECTING THE FIRST BABY

EXPECTING THE FIRST BABY: INTRODUCTION

The advent of a first pregnancy produces a certain degree of emotional changes in the mind of the pregnant woman. Pregnancy can induce a feeling of gladness, joy and excitement in a woman but these may counter balanced by fear of unknown and discomfort that may accompany the pregnancy.
Pregnancy is a life enriching experience. It is a glorious priviledge and a promising experience from the almighty God. The nine months pregnancy which starts with conception and continues through the developments of the foetus (baby in the womb) and finally ends at birth is wonder of creation.
If during the 9 months period the expectant mother and father know what to expect, there would be less anxiety and unnecessary worries and fears. This underscores the importance of regular attendance at the Antenatal clinic. A good antenatal care will allay most fears expressed by the expectant couple.
Aims of Antenatal Care
This include:
To promote and maintain good physical and mental health during pregnancy
To ensure a mature, live, healthy baby
To prepare the expectant mother for labour, lactation, and for subsequent care of child.
To detect early and treat appropriately high risk conditions that would endanger the life or impair the health of mother or baby
For the above reasons a pregnant mother is advised to register for antenatal care in good hospital be it private or government as early as possible in pregnancy. Pregnancy involves changes in mind, body and emotions, these changes are effected by hormones of pregnancy. Hormones are chemical substances that are released to the blood stream in response to some stimuli and they activate body functions.
Symptoms of pregnancy
The following are some early symptoms of
pregnancy:
The absence of menstruation
Tender, swollen breasts are usually early signs of pregnancy
Nausea (feeling vomiting) and vomiting especially morning sickness. There may be dizziness – morning sickness occurs in about 50% of pregnant woman during the 4th month of gestation. It is characterized by early morning vomiting
Bladder irritability – usually consists of increased frequency of urination.
Note the symptoms are not conclusive as  non
pregnant women (particularly women that are
desperately), sometimes complain of such
symptoms therefore laboratory test is necessary
to confirm presence of pregnancy either by
Pregnancy test (P.T) or Ultrasound scan.
Pregnancy test results are more reliable if the tests are
done on urine collected after two weeks of the missed
Period (menstruation). Early morning urine is required.
The test is either positive or negative.
Ultrasound scan can detect pregnancy as early as a week after the
Missed menstruation.

Antenatal.
After confirmation of pregnancy, it is necessary to register in the hospital for antenatal care. It is recommended that antenatal care should be started immediately pregnancy is confirmed. On your first visit to the hospital, a full general history is taken, with the aim of recording any condition which may affect the pregnancy. It is important to tell Doctor of any medications you have taken. This is because wrong medication in pregnancy can harm the developing baby. The safe thing in pregnancy is to abstain from drugs, except prescribed or with the permission of the doctor.
The duration of pregnancy is 280days counting from the first day of the last period. This is the equivalent of 40 weeks of gestation or nine (9) calendar months. During your antenatal visit to the hospital, you will be examined by the doctor and laboratory tests ordered to ascertain your health status. You are likely to be asked of your last menstrual period (LMP) which is the date of your first day of the last menstruation. From your LMP your expected date of delivery (EDD) will be calculated. The period of pregnancy is divided in to 3 trimesters with each attendant signs and symptoms.

Periods of Pregnancy
First trimester (0 - 3months)
Second trimester (4 – 6 months)
Third trimester (7 – 9 months)
FIRST TRIMESTER
The following complaints are common in the
First trimester of pregnancy
Morning sickness characterized by early morning vomiting
Constipation: purgatives are not advised early in pregnancy. Constipation is better prevented by taking enough fluids (water) and plenty of roughages (i.e. fresh fruits and vegetables).
Excessive salivation. This occurs from 8weeks of gestation. It may accompany heart burn.
Frequency of urination – this is usually painless. This happens because the growing uterus is still situated within the pelvis and impinges on the urinary bladder. The symptoms usually resolve before the end of 1st trimester
Leucorrhoea – this is the increased white non itchy vaginal discharge in pregnancy.
Fainting – avoid long period of standing and you should see your doctor
Tiredness – this is common in the 1st & 3rd trimesters.  This is due to weight gain and other changes in pregnancy.
Bleeding – Any form of bleeding is a n emergency. Report to your doctor immediately, if it occurs at anytime in pregnancy. Absolute bed rest may help stop the bleeding and the pregnancy can go on normally. Exodus 23 v26 assures us that “There shall nothing cast their young”
SECOND TRIMESTER
Nausea and vomiting and tiredness of 1st trimester disappear but there may be stomach disturbance.
Fetal kicks/movements are now felt by the mother.
The breasts enlarged and the nipples become darken.
Skin changes due to pigmentation sometimes there is generalized itching.
THIRD TRIMESTER
Lack of sleep
Back ache
Heart burn – this is a burning sensation in the central part  of the chest.
Varicose vein.
Mood swing.
USEFUL TIPS IN PREGNANCY
Consult a doctor early enough and keep antenatal appointments
Feed well, balanced diets
Begin to set items for your baby and delivery pack after the first trimester
Rest daily for at least on hour in the afternoon
Take a lot of water daily. Eat plenty of roughages – fruits and vegetables
Maintain love to your husband and be faithful to marriage vows as much as it is healthy to you. It will keep you happy and emotionally stable during pregnancy
Avoid being overworked or upset
Maintain personal hygiene
Wear sensible clothing
Don’t despise your doctor’s advice but earnestly pray in faith on his alarming comments.
Avoid self medication.
Avoid consulting quak doctors and maternity homes.
Avoid bending down or carrying heavy load.
LABOUR
Labour is the natural process which produces the birth of a
baby and expulsion of placenta and membranes through the
birth canal. Normal labour occurs when the process is
completed sponteneously (by the natural unaided efforts of
the mother ) and no complications arise.
During onset of labour, certain changes take place which are
useful to determine the approach of labour. These are:-
Lightening
false pains
Frequency of urination
Slight taking up of cervix
Lightening is the sinking of the uterus which takes place two or three weeks before delivery. When lightening occurs, the pregnant mother feels less pressure on the upper part of her abdomen and more discomfort in the lower abdomen as the head of the foetus descends towards the birth canal. Walking becomes more difficult at this stage and virginal secretion may become profuse.
False pains:- these are erratic and irregular pain. They may be unduly troublesome.
Frequency of urination:- this is due to pressure of the fetal head on the bladder limiting its capacity and requiring it to be emptied more often.
Taking up to the cervix:- occurs because cervix is being drawn up and merged into lower segment.
Signs of True Labour
Labour Pains: these are due to uterine contractions which are now felt by the woman as tightening, discomfort or actual pain. During the contractions the uterus feels hard to touch. The pains come at regular interval and often accompanied by back ache.
Dilation of cervix: this can be confirmed by the midwife or attending doctor.
Show:  this is the blood stained mucoid discharge seen few hours before or within few hours after labour has started. The mucus is the thick tenacious substance which formed the cervical plug during pregnancy
Rupture of the membranes which is seen as leaking or discharging clear fluid from the vaginal. The fluid that is coming out is called liquor amni or amniotic fluid
Rupture of membranes some times occurs a few days before labour begins or may not
occur until the end of the second stage of labour. Whenever membranes ruptured you
must go to the hospital immediately. First time mothers must prepare to go to
hospital when labour are coming about once in five minutes.
True labour is characterised by regular pains which may occur at interval of five to 15
minutes. In the process the cervix (Gate to womb) dilates progressively to open for
baby. There is a rest period between the labour pains which lasts a t least a minute
and gives the mother a brief relaxation, while permitting the flow of oxygen to the
fetus by way of placenta. During uterine contractions, the uterus rises in abdomen,
the change in shape can be observed at the start and end of each labour pains.

Stages Of Labour
Labour is divided into three stages:
First Stage Of Labour:- this is the period between the onset of true labour and the complete dilatation (opening) of cervix. It may last for about 11 hours in the first pregnancy and it is relatively shorter for those who has delivered previously.
Second Stage:-  this is the period between the complete dilatation of cervix and the delivery of the foetus (baby). It last about 45 minutes in first time and 15 minutes in those with previous births
The contractions and hence labour pains are more intense and
frequent at this stage, occurring at intervals of two to three minutes.
There also, is a conscious desire on the part of the mother to expel the
baby. This she felt as if she wants to pass stool. During this series of
labour pains, the baby is finally delivered