Pregnancy and Birth
If you are planning to become pregnant, you should start preparations at least 2-3 months beforehand. Beforehand, you should definitely see a gynecologist and have some tests done. For example; If you have anemia, it is detected and treated, your missing vaccinations are completed and folic acid is started at least 2 months in advance. We need to have your dental check-ups and if there are medications you use regularly, we need to schedule them. If you have a missed period, you should not use any medication without taking a pregnancy test and consulting your doctor. It is recommended that your partner also quit or minimize their use of alcohol and cigarettes.
PREGNANCY TRACKING
When your period is delayed, it is useful to consult an obstetrician without delay because not all pregnancies may be healthy. For example, being late in the diagnosis of an ectopic pregnancy can be life-threatening. Again, the risk of miscarriage can be determined by the doctor and the risks can be reduced.
When you first apply to us, your weight and blood pressure are measured after taking a detailed history of you and your partner. Then it is checked whether your pregnancy is in the womb and is healthy. Since gestational sac or baby heartbeats may not be seen on abdominal USG in the early period, vaginal USG may be required. This USG does not cause the slightest harm or risk to you or your baby. At your first control, you will be given detailed information and your vitamin will be prescribed. If it is already a planned pregnancy, you are already taking folic acid. This increases your baby’s chances of being healthy. You will be asked for your required basic tests.
In your second control, the baby’s heartbeat is tried to be detected. Your follow-up interval is determined according to your situation.
Between 11-13 weeks, your baby’s neck thickness and nasal bone are examined with USG and a double test is requested. This test is performed by couples who want to investigate whether their baby has a genetic abnormality and if there is, who want to have their baby aborted or who want to have this test. In other words, we inform the patient about these issues, and the parents make the decision.
16-18. Couples who want to have a triple test can be done in weeks. Amniocentesis can be performed in pregnant women who have a high risk of genetic abnormalities in these screening tests, if they request it. Amniocentesis detects abnormality, but there is a risk of causing abortion such as 1/200. Detailed information is given to the pregnant woman about these risks and a decision is made on how to proceed. In recent years, the chromosome structure of the baby can be determined from the mother’s blood. Since this test is a simple blood test, it does not carry a low risk like amniocentesis and is quite successful. The only downside for now is that it’s expensive. During these weeks, the pregnant woman is examined with detailed USG and any abnormalities that may be present in the baby are tried to be determined.
Between 20-24 weeks, the baby is evaluated with USG again. From the beginning of pregnancy and especially after the 20th week, the weight and blood pressure of the pregnant should be measured at every control.
Between 24-28 weeks, 50 g or 75 g sugar loading test should be done. In risky pregnant women, this test is done at the beginning of pregnancy and can be repeated. These tests are very important in terms of detecting gestational diabetes, which is a very important risk for pregnancy, as there is no harm to the pregnant woman and baby.
In the 28th week, blood incompatibility injection can be done in pregnant women who have blood incompatibility and are deemed necessary. After the 28th week, the controls are no longer monthly but every 2 weeks.
From the 36th week to the 40th week, the controls are done weekly. If the delivery does not occur at the 40th week and everything is normal (water, NST), delivery can be expected by following the pregnant woman at 3-day intervals.
The weight of the baby close to birth and your pelvis structure are evaluated, and if there is no obstacle to normal birth, priority is given to vaginal (normal) birth. These situations may vary depending on the characteristics of the patient. Each pregnant is special and may have different characteristics. What I have told so far is valid for normal pregnant women who do not have risk factors. Follow-ups are different in pregnancies called risky pregnancies.
As a result, every pregnant woman is very valuable to us. After evaluating you, we create a follow-up plan suitable for you and try to carry out pregnancy follow-up and delivery in the most healthy way in the light of science and in line with your wishes.
I Want To Give Birth Without Pain
Now, for expectant mothers, being afraid, hesitant and brooding about how I’m going to give birth is over. Today, with a thin needle applied to the waist region, the expectant mother can actively participate in the birth. Thus, the birth takes place more comfortably and easily. The mother can hold, love and feed her baby right after birth, as she is not in pain, exhausted, or tired. With this method, postpartum pain is also completely eliminated. In cases where cesarean section is required, a comfortable operation can be performed by giving a little more medication in the same way without the need for any additional intervention and general anesthesia.
Why Does Birth Pain Occur?
Contractions of the uterus and cervix, stretching of the tissues of the pelvis and perineum are the sources of pain in childbirth. This labor pain can be even more severe, especially in first births and in expectant mothers whose menstruation is painful. This pain in labor; It depresses the morale of the mother and also affects the duration of delivery with the effect of fatigue and tension. For this reason, painless delivery is preferred in the last period.
Below are the images taken from the Four-Dimensional Ultrasound:
The severity of the pain; The size of the baby, the position of the baby, the width of the pelvis, the strength of the contractions are thought to depend on past experiences and even prejudiced conditioning. Therefore, it is difficult to predict how much pain the patient will experience before giving birth. Sometimes pain is tolerable and controllable, sometimes various pain relief methods are needed. There are many non-medical methods that can help with labor pain, such as breathing, relaxation techniques, warm showers, massage, supportive nursing care, position changes (standing, sitting, walking, rocking), using a birthing ball. However, for some women, these methods may not be enough.
What is Epidural Anesthesia?
Epidural anesthesia is the elimination of pain sensation as a result of preventing pain stimuli from reaching the brain by administering a local anesthetic substance around the membrane called “dura” that surrounds the spinal cord by an experienced anesthesiologist. Epidural anesthesia is a type of regional anesthesia and can be successfully applied in both normal and cesarean delivery.
HOW SHOULD I FEED IN PREGNANCY?
The main purpose of nutrition during pregnancy is the normal growth and development of the baby in the womb and the mother’s vitamin, mineral and iron stores to be sufficiently full, but to avoid excessive and unnecessary weight gain. This is only possible with a balanced diet of the mother.
In order to have a comfortable pregnancy and delivery, it is necessary to gain 7-14 kilograms in an average pregnancy. The recommended weight to be gained by the patient is calculated according to the patient’s body mass index.
Foods rich in folic acid should be given weight in the first 3 months. These foods are concentrated in dark green leafy vegetables, legumes and grain products, peanuts, and liver.
Simple sugary foods should be avoided (desserts, cakes, pastries, white bread, pasta, rice..) instead of pulpy foods, whole wheat bread, dried legumes, vegetables and fruits should be preferred.
Eating fish at least 2 days a week and 2 walnuts daily provides Omega 3 support.
Daily consumption of walnuts, figs, unroasted almonds, dried apricots, and black grapes with seeds helps to balance sugar and strengthens iron stores.
Some herbal teas should be avoided, it has been proven to trigger premature birth. (sage, lemon balm, mixed herbal teas, chamomile, basil, rosemary…)
Caffeine level taken during pregnancy should not exceed 300 mg/day. Excessive coffee and brewed tea should not be consumed (2-3 glasses of clear tea, 1 glass of coffee can be drunk daily). Ginger, linden, rosehip, mint-lemon teas are safe when taken in reasonable amounts (1-2 glasses a day).
Smoking and alcohol should never be consumed. Smoking negatively affects the baby’s intelligence development, weight gain, and increases the possibility of postpartum asthma and chronic infection.
Alcohol, even in small amounts, can harm the baby.
An average of 2.5-3 liters of water should be consumed per day, especially in the last 3 months, the mother’s fluid intake is effective on the baby’s amniotic fluid.
Protein should be taken in the size of 4 meatballs daily (meat-fish-egg and chicken (organic products should be preferred)
Instead of products with additives and sweeteners, natural, fresh daily products should be preferred.
1300 mg of calcium should be taken daily, yoghurt, milk, kefir (if you ferment yourself, it is very effective for constipation and has the highest calcium, it is also very effective in increasing your baby’s height), soy milk, spinach, legumes, figs and apricots, hazelnuts are effective sources of calcium.
Iron should be taken daily in the form of a vitamin supplement after 4 months. In addition, iron, red meat, liver, orange-yellow fruits, molasses, legumes are intense.
Finally, not eating more than everything else psychologically or under pressure from the environment, but consuming balanced and only beneficial nutrients facilitates birth and also protects you from depressing weights after birth. The excess weight you will gain may not be beneficial to the baby, but may be harmful. It will make it difficult for you to return to your ideal weight after birth and may cause unwanted deformations in you.
HOW CAN I PASS NAUSEA IN PREGNANCY?
Nausea during pregnancy is a very common condition that can prevent the first 3 months of pregnancy from being comfortable. Although the severity of nausea and vomiting varies in pregnant women, this difficult situation disappears or loses its severity after 3 months with the regulation of hormones.
The following points should be noted:
1. Thanks to a small and frequent (6-8 meals) diet, the stomach does not remain empty and the feeling of nausea caused by hunger decreases.
2. Keep dry foods such as crackers and cereals at your bedside, especially to suppress morning sickness
3. Watery foods increase nausea. Prefer dry foods rather than foods such as soup
4. Choose lean white cheese toast, pretzels, boiled vegetable dishes and pasta, potatoes, rice, vegetables and fruits, mixed nuts
5. Staying away from oily, spicy dishes and fried foods, eggs and fish for a while will relax you.
6. Do not consume orange and fruit juices while hungry
7. Prefer boiled and steamed dishes
8. Ginger can reduce nausea, it is okay to consume 1-2 glasses during the day
9. Despite all these, you should consult your doctor in persistent vomiting and it should be investigated whether there is any other underlying cause with the examinations to be made. In necessary cases, anti-nausea medication or serum support can be given by your doctor.
10. The following foods should be preferred.
o Toasted white bread, pretzels and biscuits
o Dry cereal
o Toast with nonfat feta cheese and tomato
o Low-fat rice and pasta
o Boiled or baked potatoes
o Fat-free yoghurt, cheese and olives
o Boiled or grilled meat or chicken
o Low acid fruits (banana, peeled apple..)
EXERCISE IN PREGNANCY
Pregnant women can continue the exercises they are accustomed to during pregnancy. The important thing here is that they do not get into the tempo they are not used to and do not force themselves. It is important to reduce exercises in the last stages of pregnancy.
Short and light exercises such as walking, swimming, pregnancy yoga should be preferred instead of challenging and heavy exercises, and plenty of fluids should be consumed before and after exercise. If there is a risk of preterm labor, water leakage or miscarriage, the exercises should be interrupted UNTIL YOUR DOCTOR SEES APPROPRIATE. The benefits can be listed as follows:
1. Increases body resistance during pregnancy, reduces fatigue
2. Reduces waist and back pain during pregnancy
3. Facilitates childbirth
4. Reduces the formation of varicose veins
5. Reduces edema
6. Reduces constipation and gestational diabetes
7. Strengthens muscles for childbirth
8. Accelerates getting in shape after birth
TRAVEL IN PREGNANCY
Expectant mothers can travel, except for those who are unlikely to have a miscarriage or Preterm Birth.
The most important problem that may occur during travel is edema in the feet and legs. For this reason, sitting for a long time should be avoided, you should take short walks every 1.5 – 2 hours.
If you are traveling with your own vehicle, you can take a break every two hours, and if you are traveling by bus, you can get off and take a short walk as the bus takes a break. If you are not likely to stop, you can wear compression stockings. In the meantime, you should take care not to neglect to eat little and often, to consume liquids and to meet your toilet needs.
If you are driving yourself, which you should not do in the coming weeks, you should wear the seat belt and pass it under your abdomen. If you are going to travel by plane, it would be more appropriate to get your health report from your doctor in order to avoid a situation such as not being able to board the plane, and not to choose the plane after the 36th week.
WHAT IS PENTRALITY, WHAT DOES IT EXPERIENCE?
The first six to eight weeks after birth is called the puerperium. This period is very important and necessary controls should be made, the necessary medical and psychological support should be given to new mothers and postpartum education should be provided.
WE CARRY OUT YOUR NORMAL BIRTH AND cesarean section BIRTHDAYS IN CONTRACTED HEALTH INSTITUTIONS.
Mersin Gynecology and Obstetrics Specialist Op. Dr. You can click here to see Özgü Keskin Yılmaz’s short video titled “Hair Coloring During Pregnancy”.