Getting pregnant is an exciting, totally new period in one’s life! Whether you are 20, 30 40 or even 50 years of age, it brings out emotions which may vary from happiness, anxiety, excitement, fear, jubilation etc., depending on whether you got pregnant when you had planned it, or got a positive pregnancy test when you were desperate having undergone various treatments, or when you got pregnant when you did not want to. However, and whenever you get pregnant and look forward to having the baby, your baby is precious! You want a baby that is healthy and would be healthy in future too. There is enough scientific evidence today which shows that babies who do well within the uterus have a healthier life as they grow. And those babies who lag behind the normal growth pattern whilst within the uterus, have a higher possibility of developing diabetes and high blood pressure when they become adults. Hence, the focus today is on taking the best possible care of yourself and your baby during your pregnancy. This is the 9-month window of opportunity which is available to you to give the best to your baby. It is important for you to limit preventable problems such as anemia, uncontrolled diabetes, high blood pressure, thyroid disorders, bowel infections leading to typhoid and jaundice, malaria and dengue and above all smoking, alcohol and drugs, all of which can affect your baby adversely.
So, how should you go about doing what is right? First of all, plan your pregnancy, which means decide when you would like to get pregnant rather than let a pregnancy just happen, only because you did not feel like using a contraceptive! When you plan a long journey, you make all arrangements in advance to ensure that all goes well, rather than when you are already on your journey. Similarly, when you plan a journey of 9 months for yourself and your baby, you need to make sure that all is well before you get pregnant and not after you are already pregnant! Unfortunately, most couples do the latter!
Gynecologists strongly recommend that you get yourself evaluated to make sure that you do not have diabetes, any thyroid disorder, anemia, any infections which can be transmitted to the baby, any vitamin deficiency such as folic acid deficiency which can seriously hamper the development of the brain and spinal cord of the baby, etc. It is necessary to do so because all these conditions can affect the actual development of the anatomy of the baby. If you are on anti-tuberculosis drugs, on anti-epileptic medications, on steroids or any other essential medications, you need to check with your gynecologist if any change of therapy is required before you get pregnant. This is because some of these may not be the best form of medication during pregnancy and a change of drug or dosage may be required. Your gynecologist would do the necessary investigations, evaluate your health and finally would give you a green signal to go ahead and plan a pregnancy. Stop that contraceptive only after you have reached your optimum health.
Fertility is at its peak between the ages of 20 and 30 years of age. So, make sure that you are on folic acid at least 3 months prior to planning a pregnancy. As age advances beyond 30 years, fertility potential gradually reduces and it gradually takes longer to conceive. And after the age of 35 years it starts getting difficult with a very low probability after 40 years of age. Hence it is strongly recommended, that if you are planning a family, doing so within 30 years of age will save you from a lot of anxiety and stress from fertility issues, later. This is especially true for those women who wish to postpone their marriage or pregnancies due to their careers. In recent times, we also come across situations where young women have not yet found suitable partners in life, or situations where due to medical, social or financial reasons, women are unable to plan a pregnancy, and advancing age causes them great anxiety! There is a solution for such situations. It is possible for such young women to freeze their eggs or embryos to be utilized later when they are ready to be pregnant. Unfortunately, such awareness is limited and young women decide very late when the best quality eggs have already been depleted. Women are born with a limited number of eggs in their ovaries and with every menstrual period about 20-25 eggs develop, of which only one egg is good enough to make a baby. As age advances, and when all eggs are released, a woman reaches menopause which is around the age of 47 years in Indian women. Around 10 years prior to this age, i.e. by the age of 37 years, the best eggs have already been released and the eggs which are released between 37 to 47 years of age have a lower fertility potential. This is the reason why, as age advances, especially after 40 years of age, the chance of miscarriages and abnormalities in the baby increases. For example, between the ages of 20-30 years the chance of getting pregnant is 20% each month, and for 40 years and above the chance is only 5 % each month! Between the ages of 20-30 years the chances of Down syndrome (a birth defect associated with mental and physical challenges) is about 1 in 800, whilst in women above 40 years it rises to 1 in 50! Thankfully, there are tests available today, which can determine most of the physical abnormalities by ultrasound in babies from 10 weeks of pregnancy upwards, with most of them being picked up by 20 weeks of pregnancy. Besides ultrasound, there are lab investigations which can detect hormonal and vitamin deficiencies, infections and quite a few genetic disorders which can be transmitted to the baby. A perfect example of such a genetic disorder is that of Thalassemia Major, a preventable condition in the baby. If both the parents are carriers of this disease, i.e. they have thalassemia minor, then one out of the 4 children born to the couple would suffer from the disease, one would be totally unaffected and 2 would be carriers like the parents. The difference between a carrier and a sufferer is tremendous! A carrier of thalassemia only has mild anemia throughout life, whilst a sufferer needs a blood transfusion every 3 weeks throughout his/her shortened lifespan! Hence it is so important today to determine one’s thalassemia carrier status even before getting married, so that one is aware whether one is getting married to another carrier or not. If you are a carrier and married to a person with normal status i.e. he is not a thalassemia carrier, then you really don’t have to worry, because the chances of you having a baby with thalassemia major is nil!
The right nutrition is really important during pregnancy. Every cell in the baby requires amino acids which are the basic elements of proteins. These are the building blocks which are required to create the various organs of the body. If the protein intake is sufficient, the number of cells created is sufficient, and the organ created is stronger. After birth, the cells only get bigger but they really don’t increase in number. The number of grey cells in your baby’s brain depends on the right mixture of yours and your husband’s genes, the right environment within the uterus and the right nutrition. It is possible for us to add that extra bit to optimize the health of our babies.
The forty-week period of pregnancy is divided into 3 trimesters, the first trimester ending at 13 weeks, the second ending at 28 weeks and the third at 40 weeks. The first trimester is a period of nausea, lack of appetite, vomiting, tiredness, lethargy, which soon moves into the happy phase of the second trimester, when you start eating well and feel on top of the world. As you move into the 3rd trimester, the baby grows and your abdomen grows, you start feeling uncomfortable during various movements but still love it every time the baby kicks! It’s an experience which you can share with your partner and though he cannot feel it within him, he can experience it when he puts his hand on your tummy.
During this period, your obstetrician calls you in, every 2-4 weeks to keep a check on you and your baby’s health. This is done by a physical examination, lab investigations and ultrasound. All the care remains the same whether you are 20 or 50 years of age, the only difference being that as you grow older there are higher chances of you developing high blood pressure and diabetes through the pregnancy. Even though pregnancy is a physiological function of the body, it does cause some stress on the heart and the normal functioning of the body. There are certain medical situations in a woman which complicate the pregnancy and convert the pregnancy into a high-risk category, which means that the pregnancy and delivery in such a woman may increase the risk to her or her baby’s life.
The question of an IVF pregnancy being high risk or not is debatable. The pregnancy itself is not a high-risk pregnancy unless it is a multiple pregnancy, which occurs more frequently with Assisted Reproduction. Yet we find that many such pregnancies though normal, are subjected to an Elective Caesarean Section, only because this baby is precious! But I argue, is not every baby precious? Then why not an elective Caesarian Section for every pregnancy? Labor is the same for all pregnant women whatever their age, though we find that older women have a higher chance of caesarean section because they have a higher chance of having a high-risk pregnancy. The complications during labor and delivery are the same at every age, but they may be slightly higher in older women due to pregnancy induced hypertension and diabetes.
In summary, be prepared in advance for this 9 – months long journey, get the best care that you and your baby deserve during pregnancy and labor, because both of you need it, and both of you are worth it!
With over 3 decades of experience, we at Gynaecworld completely understand a woman’s world and are here to look after the medical hurdles that come your way. You are the center of all our efforts!!!
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