Advice for Pregnant Women
Unsolicited advice is usually both unwanted and inaccurate.
Everyone has a certain amount of knowledge about pregnancy but it is not until a woman has had a baby that she can talk with any conviction or authority about the signs, symptoms or the finer details of what happens to a pregnant woman. It necessarily follows, therefore, that the majority of girls obtain, or are given, information about pregnancy which is really just a reflection of their mother’s experiences of pregnancy. These may have been easy or difficult, good or bad, happy or unhappy, but however, they are interpreted they will be transmitted to her children. Pregnancy is no exception to the general principle that a child’s ideas are gradually molded and modified by the things that are read or learned during childhood and adolescence. By the time she is ready to start her first baby, a girl will have a fairly definite idea of what it is all about. She may wish to have more information but the basic ground work has nevertheless been systematically laid down over the preceding years and the careful or thoughtless way in which she has been consciously or unconsciously influenced will show in her approach to her own pregnancy.
The public media
Over the past twenty years or so the public media have responded to the general public’s demand for more information about medical science with a number of extremely good programs on radio and television and a mass of articles in journals and magazines. Radio and television, however, have yet to treat pregnancy as an educational subject. The accent has been more on delivery than on the importance of antenatal care and general basic advice, and written articles can only cover small aspects of pregnancy at any one time. Unfortunately, it is only the relatively small proportion of the population who is either pregnant or who has someone in their immediate family circle who is pregnant that is really interested in a fundamental knowledge of pregnancy.
It is because there are so many gaps in the average woman’s knowledge concerning pregnancy that she is so vulnerable to unsolicited advice and if such advice worries her there is no comprehensive work to which she can turn to relieve her anxiety. This particular blog is a genuine attempt to provide information in an unbiased manner although there will always be differences of opinion upon certain matters and undoubtedly in some places, this blog is either imperfect or will subsequently be shown to need modification. It is nevertheless intended to be fair and impartial; written in the hope that it may provide some guidance to those who require it and some helpful support to those who may be unduly anxious, particularly those who have heard hair-raising stories of difficulties and problems in pregnancy or delivery.
There are many authoritative blogs on pregnancy or different aspects of childbirth that give very sound advice and useful information. Antenatal classes, relaxation classes, natural childbirth (National Childbirth Trust) and psycho prophylaxis classes all provide an immense amount of invaluable advice and information. Do not listen to unsolicited and often potentially harmful advice.
How much rest should you have when you are pregnant? It is impossible to say because it varies with so many personal factors. The ideal is 8 hours in bed at night and 2 hours in bed in the afternoon. This, however, is almost impossible to arrange especially in early pregnancy, because those who are pregnant for the first time are frequently going out to work and those who are pregnant on subsequent occasions have to look after their children. Bearing in mind then that the ideal is 10 hours’ rest in every 24 hours, you should get as much rest as you can. Remember that in the early part of pregnancy you may feel unduly tired or lethargic and there is simply no point in trying to fight it. You can either give in to it and rest, in which case you will feel much better, or try to resist it with the inevitable result that you become bad-tempered and even more tired. If you have previously arranged to do things and feel too tired, you should have no hesitation in canceling your arrangements. This can, however, be very difficult unless your husband or partner appreciates the problem, so it is up to you to see that he knows about your needs.
After the end of the 14th week of pregnancy, you will feel much better, much less tired and much more energetic. You should still, however, have an adequate amount of rest.
In the last three months of pregnancy you will need more rest and during the last 6 weeks especially you should rest as frequently as possible with your feet up. When you are pregnant you should always avoid sitting with your knees bent and never with one knee crossed over the other. So long as you are fit and well there is no reason why you should not take a reasonable and normal amount of exercise but remember that you do not have to take exercise in order to become a healthy mother or to have a healthy baby. If you want to go for a walk, go for a walk. If you don’t want to, then don’t.
Tiredness is one of the natural phenomena of pregnancy. This usually commences shortly after the first missed period and is characterized by a definite lassitude and tiredness during the day as well as at night. Ten hours’ rest is usually advised throughout the whole of pregnancy. The majority of pregnant women will not be able to sleep for 10 hours, but the important factor is rest rather than sleep. The natural tiredness normally occurring in early pregnancy will usually ensure an adequate amount of sleep and it is frequently more severe in subsequent pregnancies than in the first. It usually begins about the 6th week and continues until about the 14th week during a first pregnancy, but may last until the 20th week during subsequent pregnancies.
A woman can be told how long she should spend in bed or resting during the day but no one can predict, or demand, a certain number of hours of sleep. As pregnancy advances sleep usually becomes lighter. The pregnant woman finds it more difficult to get to sleep and then she tends to wake more easily and, therefore, to sleep for shorter periods. There are various reasons for this. The enlarged abdomen produces generalized discomfort. Fetal movements may disturb her just as she is falling asleep. The increased weight of the advanced pregnancy on the abdomen makes it difficult to find a comfortable position. The irritable bladder may wake her during the night. Congestion in the nose and heartburn are two of the more annoying side effects of pregnancy which may also disturb sleep.
It does not matter what time you go to bed as long as you are going to stay there for 8 hours. Resting during the afternoon is almost as important as sleep at night and, ideally, the rest should be in bed, but if this is not possible then it should be taken on a couch. It is surprising how much refreshment can be gained from even the shortest sleep.
The secret of sleeping during the afternoon and also at night is that of relaxation. On the principle that physical relaxation results from mental relaxation, conscious relaxation will gradually induce somnolence and then sleep. The cultivation of both physical and mental relaxation is an enormous asset. The majority of people who cannot sleep during the afternoon, or have difficulty in sleeping at night, are mentally overactive, worried or concerned, and of course, finally, they become worried because they cannot sleep.
If for some reason sleep is difficult to discuss this with your doctor. Most doctors agree that sleeping pills should be avoided if possible, but it is better to have a good night’s sleep with a mild and safe sleeping pill than to fail to sleep altogether and be a neurotic wreck the next day. Doctors will avoid the administration of sleeping pills in early pregnancy, but many pregnant women have great difficulty in sleeping towards the end of their pregnancy and then sleeping pills are occasionally indicated. These must be prescribed by your doctor and taken according to his instructions. Many sleeping tablets are available which are completely harmless during pregnancy if taken in the prescribed dose, but there are others which should not be taken during pregnancy. Never, therefore, take sleeping pills without first consulting your doctor.
Dreams in pregnancy
Most women dream more when they are pregnant than they are accustomed to. The reason for this is not known but it is probably associated with a change in the sleeping pattern which results in lighter sleep and ‘waking dreams’. Certainly, in the second half of pregnancy sleep may be disturbed not only by fetal movements but also by the difficulty in maintaining a comfortable position in bed or by increased frequency of micturition. All these factors may contribute towards an increased frequency of dreams. There are many old wives’ tales suggesting that frightening or disturbing dreams may affect a baby either physically or mentally. This is not true. No importance should be attached to this phenomenon and such dreams certainly have no profound meaning or significance.
Exercise in pregnancy
Most people understand exercise as meaning physical activity over and above their normal daily duties. This is not strictly true. Most women have a home to look after and either a job to do or other children to take care of, and these duties in themselves require a considerable amount of work and exercise. It is difficult to imagine a more vigorous exercise than scrubbing. a floor or even polishing a table. There is no reason why a woman progressing through a normal pregnancy should not continue with her normal household duties. If, however, complications arise, then her activities may be restricted by her doctor.
For a pregnant woman who goes out to work, the kind of work must be considered. For instance, there is a world of difference between being a shorthand typist sitting at a desk all day and being a conductress on a double-decker bus running up and down stairs all day. Common sense can decide how long most women should continue with such occupations during pregnancy. The maternity allowance is payable after the 29th week of pregnancy (See also Maternity Benefits), but it is obviously inadvisable for women to continue some energetic occupations until this stage of pregnancy and lighter or more acceptable work must be found for them.
It is stressed throughout this blog that pregnancy imposes a certain amount of extra work, both physical and metabolic, upon the body, so that rest is essential. This does not mean that normal duties should not be continued, but extra duties which involve tiredness, fatigue or unnecessary physical exercise should be avoided.
Many women are accustomed to a certain amount of physical exercise or sport such as tennis, golf, cycling, swimming, walking or gymnastics and if they are used to this before the onset of pregnancy there is no reason why they should not continue during the pregnancy provided it progresses normally. They must, however, avoid undue tiredness and exhaustion. They should consult their doctor as to when they should start giving up their particular sport because they must not continue merely as a matter of principle. A woman should not commence such extra physical exercise for the first time during her pregnancy. It cannot be too strongly emphasized that if you go around your normal daily duties you have adequate exercise. Extra exercise is not necessary. The main need during your pregnancy is rest, not physical exertion.
There is really no limit to the amount of walking you may do during pregnancy. Ordinary daily duties involve a good deal of walking and if you feel like going out for a walk to get some extra exercise, there is no reason why you should not do so. You should not, however, go on hiking expeditions. By walking you are both enjoying yourself and helping to keep your body fit, but you are not doing anything specific for the benefit of your pregnancy or your unborn baby. Always stop when you become tired. You must never allow yourself to get exhausted.
Swimming does not harm pregnant women. It is a mistake to suggest you should not swim while you are pregnant. Certain precautions, however, must be observed. Women who are not used to physical exercise or who do not swim frequently should avoid going in the water during the early part of pregnancy at the time when they would normally have been having a period, that is at the 4th, 8th and 12th week of pregnancy. This precaution is less important if you do take frequent physical exercise or swim at least once or twice a week, but even then it is important that you should never become overtired. Swimming in very cold water is not advisable especially as there is more likelihood of cramp during pregnancy. Diving from heights of 3 ft or less is not harmful to any experienced swimmer but high diving must be avoided by all women throughout their entire pregnancy.
Apart from simple, ordinary, common-sense restrictions, dancing can be continued until the onset of labor. The amount of energy and exercise involved depends on the type of dancing and both exercise and energy should be restricted as pregnancy advances. Acrobatic dancing is, of course, forbidden at any stage during pregnancy.
No harm will result from riding a bicycle at any stage of pregnancy. However, even in early pregnancy reflexes are not as rapid as usual and any accident may result in a miscarriage. Women who cycle in early pregnancy should be ultra-careful. They should not become overtired and should certainly not take part in rallies or races of any kind. As pregnancy advances a woman’s balance becomes affected and this together with the gradually enlarging abdomen makes cycling increasingly difficult. It should be discouraged during the second half of pregnancy for, although it is highly unlikely that a baby will be injured even if there is a direct blow to the abdomen, an accident might predispose to miscarriage or premature labor.
You should not ride horseback at any time in pregnancy. Not only is the actual exercise undesirable, but there is always the risk of damage or injury resulting from a fall.
Water skiing and snow skiing
Water skiing is inadvisable in pregnancy as a forcible fall may cause miscarriage or premature labor. Snow skiing is inadvisable, especially for the inexperienced. Even those experienced may find their balance affected during pregnancy and should not be too adventurous.
This is also better avoided during pregnancy, mainly because a woman’s judgment is impaired and this might adversely affect her reactions, with dangerous results. Underwater diving is rigidly forbidden in the later stages of pregnancy. Underwater swimming using a snorkel is allowed providing the swimmer is familiar with the apparatus.