First-time mom: a complete guide to help you on this journey

When getting pregnant, many doubts can arise, especially when we talk about a first-time mother. But that doesn’t mean that those who already have a child know everything about the subject, right? Each pregnancy is unique, as is the care of each child. With that in mind, it is interesting to know a guide to stay on top of all the steps.

With the correct information, it is easier to enjoy these unique moments to the fullest and with peace of mind. Therefore, it is worth checking below questions answered by Dr. Flavia Burim Scomparini (CRM-SC: 22716), gynecologist and obstetrician and by Dr. Clay Brites (CRM-PR: 16787), pediatrician and child neurologist.

Pregnancy

It is already possible to have doubts when faced with the first symptoms of pregnancy and it is common for them to continue to increase over the months, isn’t it? With that in mind, here are some questions related to pregnancy answered.

What are the first symptoms of pregnancy?

Dr. Flavia: Pregnancy in its early stages promotes several changes in the woman’s body. Nausea and vomiting are widely known by the population, but it is worth remembering that other symptoms, such as cramps and drowsiness, are also quite frequent. In addition, increased hormone levels of progesterone can lead to constipation, difficulty with gastric emptying after meals (feeling of a full stomach) and increased gastro-oesophageal reflux. The elevation of progesterone also promotes laxity of ligaments and joints, which facilitates sprains, so caution is recommended when wearing high heels, for example.

What happens if a pregnant woman takes birth control pills?

Dr. Flavia: The consequences of using hormones (pills) during the initial phase of pregnancy will depend on how long the use was maintained. In general, if the use is made for a short period, there are no sequelae for the fetus. If the use is prolonged, we may have alterations in the formation of the genitals, especially in the case of a male fetus, since the hormones contained in oral contraceptives are female hormones.

How are weeks of pregnancy calculated?

Dr. Flavia: The calculation is made both by the date of the first day of the patient’s last menstrual period, and by the length of the embryo in the first ultrasound performed. The date of the last menstrual period can be used as a reference in patients with regular menstrual cycles and when the calculation by this parameter is less than the ultrasound margin of error. In general, ultrasound performed up to 12 weeks of gestation has an error of less than 7 days.

How is prenatal care?

Dr. Flavia: Prenatal care for patients with a single pregnancy and low risk is performed with monthly consultations until 32 weeks, followed by fortnightly consultations until 37 weeks and weekly visits until the date of delivery. It is worth remembering that prenatal care is completed only after the end of the puerperium and, therefore, should include at least 1 consultation after delivery.

Is sex in pregnancy allowed?

Dr. Flavia: Patients who do not have a medical contraindication for the practice of sexual activity can remain sexually active until delivery. Some contraindications to sexual intercourse include first trimester bleeding (threat of abortion), low insertion placenta, short uterine cervix generating an increased risk of prematurity, among others.

What can be bleeding during pregnancy?

Dr. Flavia: Bleeding can have different causes depending on the stage of pregnancy. Bleeding that occurs at the beginning of pregnancy may represent detachments of the gestational sac (threat of abortion), ongoing abortions and, in the cases of patients who have not yet undergone ultrasound, it may be a tubal pregnancy.

Bleeding that occurs at the end of pregnancy is usually related to placental changes, such as a low-attached placenta or placental abruption. These medical diagnoses are considered serious and should be ruled out through prompt medical evaluation.

Is it necessary to take vitamins?

Dr. Flavia: According to the Ministry of Health, every woman who is planning pregnancy should perform daily supplementation with folic acid 400mcg/day to reduce the risk of neural tube defects. This same supplementation should be continued at least until 12 weeks of pregnancy.

Another mandatory supplementation is iron, especially from the second trimester of pregnancy, when the risk of anemia is accentuated and when we have the approach of childbirth in which there will be moderate blood loss.

Supplementation of vitamin D, iodine and omega 3 is also used quite frequently by Brazilian obstetricians.

It is worth mentioning that a balanced diet is capable of guaranteeing the adequate supply of many nutrients, and individualization in the evaluation of each woman will be fundamental. Patients who do not consume milk and dairy products, for example, may require calcium supplementation, while the others obtain this mineral through their diet.

What changes in a woman’s body?

Dr. Flavia: The woman goes through many transformations during the pregnancy period. At the beginning of pregnancy, the general symptoms are the most evident due to hormonal changes. We noticed mood changes, such as irritability and easy crying, changes in sleep pattern, changes in bowel habits, constipation being quite common. The action of progesterone can also lead to increased gastric reflux and heartburn and burning sensations.

With the enlargement of the uterus and womb, other changes begin to take place. The breathing pattern changes, gastric capacity is reduced and the body’s balance center changes, forcing the pregnant woman to walk in a characteristic way so as not to lose balance: legs slightly apart and hips forward.

Changes in the breasts and vulva also reflect the body’s preparation for childbirth. The breasts become more sensitive, the areola increases its pigmentation, bluish blood vessels may appear on its surface, in addition to the nipple protrusion. The vulva also becomes darker, with the labia minora slightly parted. Vaginal secretion also increases by hormonal action.

Can pregnant women practice physical activities?

Dr. Flavia: Pregnant women can and should practice physical activity regularly. As long as there is no medical contraindication for this, all scientific evidence is favorable to the practice of aerobic exercises and muscle strengthening.

A unique moment, pregnancy can be full of doubts, but with enough calm and with the follow-up of the right professionals, this can be a peaceful phase.

childbirth

The moment of childbirth scares many moms, who already don’t know which type to choose, what the recovery will be like and all the other details. But rest assured, the answers to many questions are here.

How many weeks on average does childbirth take place?

Dr. Flavia: Most patients will have their delivery between the 39th week and the 41st week, so the estimated date of delivery (DPP) is calculated for 40 weeks.

What are the signs of labor?

Dr. Flavia: Labor is defined by the presence of regular uterine contractions, with an average interval of 3 minutes, capable of generating changes in the uterine cervix. These contractions usually start with light intensity, being more noticeable in the lumbar region and uterine fundus, and radiating to the lower abdomen. Regularity starts with long intervals, 15 to 20 minutes, and then moves to shorter intervals, 3 to 5 minutes.

It is worth remembering that the loss of fluid due to the rupture of the bag may occur even outside of labor and is also an indication for immediate medical evaluation and possible hospital admission.

How to choose the type of delivery?

Dr. Flavia: The mode of delivery in Brazil is not a patient’s choice, but a medical indication. In the private system, we have the possibility of taking the patient’s wishes into account, but in the public system, normal delivery is the first route, with cesarean section being an alternative for cases in which normal delivery is not possible.

Is there a difference between normal, natural and humanized childbirth?

Dr. Flavia: Yes. Normal delivery is the broad name we give to vaginal delivery. It can be natural and humanized at the same time.

Natural childbirth is one in which interventions or medication are not used to stimulate birth.

Humanized childbirth is the term we use for childbirth that respects the mother’s preferences and the baby’s time. In humanized birth, for example, the baby goes straight to the mother’s lap and remains in contact with her skin for the next hour. The pediatrician assesses the newborn while still in the mother’s arms, and the umbilical cord is clamped and cut after the pulsation has stopped.

What are the best positions for normal delivery?

Dr. Flavia: Each patient will choose the position in which they feel most comfortable for the expulsive moment. There is no single position. In my professional practice, I really like the use of the birthing bench, as it mimics the squatting position while facilitating the baby’s descent through the birth canal by the action of gravity.

What to do when the bag breaks?

Dr. Flavia: The first advice I give to my patients is that they stay calm. The rupture of the water can occur hours before the baby is born and does not mean that the baby will be born in the next few minutes.

Upon noticing the outflow of a large amount of clear liquid, with an odor similar to bleach, if the patient is pain free, she can take a shower and calmly go to the maternity ward for evaluation. In cases in which the patient was already having contractions, it is recommended to immediately go to the maternity hospital for evaluation, since we have no way of knowing whether or not she can already have cervical dilatation.

What if the water doesn’t burst naturally?

Dr. Flavia: In cases where the patient remains in labor and the bag does not break, the doctor can artificially rupture the membranes at the appropriate time. In some cases, this intervention is not necessary, and the baby may even be born with an intact pouch, as in cases of enveloped delivery.

When is it necessary to induce labor?

Dr. Flavia: Induction of labor can have numerous indications. Gestational age greater than 41 weeks is one of them. Above this gestational age, we no longer benefit from waiting for the spontaneous onset of childbirth, so in these circumstances we advise that hospitalization and drug induction of childbirth be performed.

Other indications are: gestational diabetes, increased blood pressure, fetuses with low birth weight or with reduced amniotic fluid, rupture of the water and absence of spontaneous contractions.

What causes a premature birth?

Dr. Flavia: Vaginal and urinary infections are important causes of premature births, so they should be treated carefully when identified. Other causes include: short or incompetent cervix (which begins to dilate as…