Pre-Birth Information
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Illness and Medical Pre-Birth Information
COVID-19 Vaccination is recommended by the Ministry of Health for all pregnant and breastfeeding women.
Illness:
While pregnant you may get sick. Flu, headaches, stomach bugs, aches and pains can still occur and are rarely a problem for the baby. Please see your GP for any illness or issue that is not pregnancy related.
You may take 2 paracetamol every 6 hours for severe pains or headache. Make sure you also drink several glasses of water and rest in a dark room to aid your body to heal. Good healthy food, rest and time usually cures most minor aches and pains.
Paracetamol (PANADOL) is safe in pregnancy: take 2 every four to six hours as needed (but no more than 12 tablets in a 24-hour period).
If you have a cold, sniffle or sore throat you should:
- Drink hot water with lemon and honey
- Keep your fluids up
- Eat healthy food
- REST
- Increase your vitamin C intake (preferably in food form such as citrus fruit).
You may take throat lozenges but NOT cough medicine.
NO flu and cold tablets are safe in pregnancy.
You may use a saline nasal spray from the Chemist.
PLEASE HAVE YOUR FLU VACCINATION DURING PREGNANCY. Flu can be fatal for pregnant women. The vaccination is safe and free in pregnancy. Your GP will do this.
If you think you have caught the flu (which is much worse than a cold) you MUST see your GP.
If you have the flu or a stomach bug (vomiting and diarrhoea) please text your midwife and change your appointment if you have one at clinic. It is important to NOT infect all the other mothers and babies. We will rearrange your check up for the following week.
Whooping cough vaccination:
The Ministry of Healthy strongly advises pregnant women to have the whooping cough vaccine (called Boostrix) at 16 weeks with every pregnancy, even if your older child is only two years old. This is free through your GP. Ideally your close family members such as partner and parents should also have it updated.
Prescriptions:
Midwives can prescribe drugs or medications that you need related to your pregnancy only. If you need other medications you will need to see your GP.
Test results:
Any abnormal or concerning test results (scan, blood or other) will be highlighted to us immediately from the testing station. I will then phone you IMMEDIATELY to discuss the results, the implication and what we need to do from there.
Therefore, NO phone call means all is well. I will print out all your results at your next antenatal appointment, go through them with you and staple them into this book. Please do not phone your midwife to ask after results. Rest assured you will get a phone call if there is a problem.
Screening in pregnancy:
You will be given a form for routine blood tests early in pregnancy. This will look at your blood group, haemoglobin, iron stores, HBA1c, syphilis, rubella immunity, HIV, antibodies, platelets, as well as a mid-stream urine test to look for urine infection.
You will be offered the option of first trimester screening for Downs Syndrome and related anomalies to be done at 12 weeks. This involves a nuchal translucency scan and a blood test on you. The most accurate timing for this to occur is from 12 weeks to 13 weeks. It is not mandatory and is a screening test rather than a diagnostic test. If your results come back high risk, we will discuss further testing through Auckland City Hospital (amniocentesis or CVS sampling). If you miss the time span for the first trimester screening you may want to do the MSS2 which is a blood test from 14 weeks to 20 weeks for the same conditions. It is less accurate however.
At 20 weeks:
You will be offered an anatomy scan where the skilled sonographer looks at everything on the baby to check all is well. You may be able to find out the sex of your baby at this scan but it is not always possible.
At 24 weeks:
You will be offered another blood test to see how things are going. This will include checks for urine infection, haemoglobin (Hb), platelets, antibodies, iron stores and an oral glucose challenge test (polycose test) for diabetes. This involves drinking a sweet liquid that is rather like flat lemonade. You will then have to wait exactly one hour before your blood is taken.
If the polycose is high I will ask you to do a glucose tolerance test (GTT) which is a two-hour sugar test with another drink and two blood tests 2 hours apart. This test needs to be booked in advanced and you will have to fast from midnight. If you had diabetes in a previous pregnancy this test will be done instead of a polycose.
If the GTT is high then you have Gestational Diabetes and will be referred promptly to the diabetes team at Waitakere Hospital. I will still be involved in your care but you will need lots of testing, scans and possibly induction of labour near your due date.
At 32 weeks:
You may be offered a growth scan to check the size of the baby if I have any concerns.
At 37 weeks:
You will have one last blood test for antibodies, platelets and haemoglobin (Hb) as well as urine.
From 20 weeks of pregnancy:
I will show you how to test your own urine for sugar and protein when you come to clinic for your regular appointment.
From 28 weeks:
I will start measuring your baby’s growth with a measuring tape. I will also discuss being aware of your baby's pattern of movements at this time.
Some mothers will require extra tests and scans if they develop complications or problems. I will discuss the implications of these if and as they are needed.
Important Dates
Babies begin to move at different times. Some mothers feel movements from 18 weeks but some not until 24 weeks. Anything in between is normal. Babies do not really have a pattern of movements until 28 weeks, so if you have a very active baby before then, but one day realise you haven’t felt any movements please do not be worried. This is quite normal until 28 weeks.
Around 20 weeks:
You should phone and book your antenatal classes if you want to do them. You do not have to do them but they are very helpful and a lot of fun especially if this is your first baby.
Around 24 weeks:
You should look at the IRD website regarding Paid Parental Leave (PPL) and begin the process of applying for this. Your medical certificate proving pregnancy and your EDD is at the back of this book.
From 28 weeks:
Your baby should move regularly. Most move a little after breakfast, lunch and dinner, and when you lie down at night. Get to know YOUR baby’s movements and tune into them.
From 28 weeks:
It is very important that you do not sleep on your back anymore. The weight of your uterus can prevent adequate blood and oxygen getting to your unborn baby. It is fine to sleep on either side, and to be sure you don’t roll over in your sleep; a small pillow behind your back will help. A pillow between your knees helps also.
Around 32 weeks:
Purchase or arrange hire of your baby car seat or capsule.
I will have given you a handout called Labour and Birth Planning and now is a good time to start researching and making your decisions. We will have a birth planning session around 32-34 weeks to formalise what you want to do.
From 36 weeks:
You should have your hospital bag packed and ready.
Diet
HEALTHY EATING AND HEALTHY WEIGHT GAINS IN PREGNANCY
So, let's begin this exciting journey!! And start with the basics - FOOD! We all love food. It is important to eat well to maintain a healthy environment for both you and your growing baby. The first 8 weeks of pregnancy is when your baby’s systems including the cardiovascular, gastrointestinal and skeletal systems are developing.
A scary thought: RESEARCH IS INDICATING NOW THAT YOU ARE WHAT YOUR MOTHER ATE DURING HER PREGNANCY!
None of us like talking about weight and weight gains and fat percentages (as we just want to grow a healthy baby). It is, however, vitally important to maintain a healthy environment for your precious wee baby to grow in. Being under weight is just as detrimental to a healthy baby as being overweight. Let's face it very few of us are actually happy with how we look! But pregnancy isn’t just about you anymore, it’s about a healthy and well-baby, developing and growing in the very best environment we can give him/her. Excessive weight gain and obesity can cause major complications in pregnancy. It increases your chances of miscarriage and still birth. It increases your chances of having excessive oedema (swelling), high blood pressure, pre-eclampsia (toxaemia) a very large baby (which can cause birth injuries for both of you), a very small baby (deprived of essential nutrients), Gestational diabetes, haemorrhage after birth, the need for induction, the need for a Caesarean section and/or instrumental delivery and it even increases your chances of having complications if you need an anaesthetic. Your baby will also be at an increased risk of being obese in childhood and of developing diabetes.
Your expected weight gain in pregnancy differs depending on your current BMI — and to a certain degree your ethnicity. BMI stands for Body Mass Index. BMI is a measure of the proportion of body fat to total body weight, and it is calculated using your weight and your height. There are increased risks for women that are over and underweight when carrying a pregnancy, not only during the antenatal period but during your labour and birth, postpartum periods and later on in life for you and your baby. If your BMI is over 35 or you gain too much weight in pregnancy you may be unable to birth at Waitakere Hospital or a primary birthing unit such as Birthcare. You will not be able to have a water birth and you will need continuous fetal monitoring in labour which limits your ability to mobilize freely.
A BMI result looks something like this:
- < 18.5 — underweight
- 18.5-24.9 Normal weight
- 25-30 Overweight
- > 30 Obese
- >40 Morbidly obese
Weight gain in pregnancy is attributed to the following:
- Fetus 3-3.6 kg
- Fluid 0.9-1.8 kg (Liquor, tissue fluid)
- Placenta 0.7 kg
- Uterus 0.9 kg
- Extra blood vol. 1.3-1.8 kg
- Breast tissue 0.9-1.3 kg
- Fat 2.7-3.6 kg
The above equals a total of approx. 11-14 kg. This is the recommended weight gain during your pregnancy. However, depending on your booking BMI your weight gain can look something like
- BMI <20 Your weight gain should be - 12.5-18 kg
- BMI 20-26 Your weight gain should be - 10-15 kg
- BMI 26-29 Your weight gain should be - 7-10 kg
- BMI >29 Your weight gain should be approx. 6 kg
REMEMBER most of your weight gain occurs in the last trimester from 28 weeks till birth. Information supplied By Helen Allen (Specialist Obstetrician and Gynaecologist WDHB, Diabetic Team)
During your first trimester there is no need to increase the volume of the food you eat and remember you are NOT eating for two, you are eating for yourself and a healthy pregnancy. A healthy plate of food should look like the following: half a plate of vegetables, quarter plate of carbohydrates and quarter of a plate of protein. Each meal should be low carbohydrate and high protein. Also remember hydration, 2-3 Litres of plain water per day. Start with your protein, move on to your non starchy vege, leaving your starchy vege for last. This is the part you need the least amount of.
Make every mouthful count: everything you put in your mouth should nurture and nourish your body and that of your growing baby. Aim to eat mostly vegetables and protein. Fruit should be only 2 portions per day as it is high in sugar. Aim for only two portions of carbohydrates a day. Increase your water intake to 8 glasses per day, and stop all fruit juices and fizzy drinks. Avoid processed foods.
REDUCE:
- All juices: drink water
- All fizzy drinks, even diet ones
- Coffee (1-2 cups per day maximum)
- Sugar in all forms, even honey.
- All carbs (bread, pasta, rice, starchy veggies)
- Processed meats such as ham and luncheon, bacon etc.
- All fatty foods
- Sweets and biscuits
- ALL PROCESSED FOODS
INCREASE:
- Leafy greens (cabbage, spinach, kale, lettuce, silverbeet, sprouts, chard, broccoli, brussels sprouts, watercress, bokchoy, peas, cauliflower, asparagus, kelp, puha, peppers, celery, courgettes/zucchini, salad greens etc (wash well before eating and cook minimally))
- Keep starchy veggies to a minimum (carrots, potatoes, kumara, corn, pumpkin). Only one serve per day of these.
- Protein: builds your baby’s brain and muscle tissue and eases hunger pains.
- Water: at least 8 glasses per day. Baby needs it as much as you do.
- Fibre: helps keep you full and helps you avoid constipation as well as having good nutrients.
- Eggs: excellent for you and baby. One a day is great, but two is better.
Most of your meals should consist of veggies and protein. Use fruit and carbs for snacks.
SOURCES OF PROTEIN:
- Nuts and seeds: almonds, brazils, walnuts, cashews, peanuts, sesame seeds, pumpkin and sunflower seeds, chia seeds. Pine nuts.
- Tofu and tempeh
- Hummus: but ONLY if you make your own as it can be risky for listeria
- Legumes
- Quinoa
- Beans: garbanzo, soybeans, pinto, refried, black, green, butter
- Mushrooms
- Oats/porridge
- Avocado
- Asparagus
- Artichoke
- Greek yoghurt
- Cheese and cottage cheese
- Eggs
- Fish: salmon, tuna, sardines, white fish
- Chicken: no skin and not fried
- Lean red meat: lamb, beef, goat, veal, venison, liver
- Turkey
SUPPLEMENTS:
- folic acid (until 14 weeks) and iodine — both prescribed by your midwife.
- Fish oil capsules (or flaxseed or hemp if you are vegetarian)
- Vitamin B complex (helps with moods and brain development)
- Iron (Thompsons organic iron, Spatone sachets, Floradix liquid, iron melts)
- Vitamin D (take up to 5000iu per day)
- Calcium tablets
- Magnesium (helps with good sleep and preventing muscle cramps - 300mg at night
- Zinc (especially helps with skin and morning sickness)
- Spirulina Plus (high in iron and Vit K)
REMEMBER:
- 8 glasses of water per day - if you don’t like it plain, add lemon or cucumber slices
- For constipation eat two ripe GREEN kiwifruit per day. High in all sorts of vitamins and fibre
- Sprinkle on your food for extra goodness: pumpkin, sesame, sunflower seeds, pinenuts, slivered almonds, goji berries, acai berries, LSA, cottage cheese, avocado or coconut oil
- Soak chia seeds in water overnight and add a good dollop of the jelly to pretty much anything for easy fibre and nutrients. It’s pretty tasteless and you will barely notice it
- Good quality virgin coconut oil added to things has some major benefits
- Drink 10ml good quality cider vinegar in warm water each morning to cure and prevent UTIs, thrush, constipation, bad breath etc.
Meal and snack ideas:
Breakfast ideas:
Porridge with a grated apple and pinch of cinnamon stirred in or banana and sultanas, mushrooms on wholegrain toast with a side of tomatoes, eggs any style, baked beans on toast with some avocado or cheese, Greek yoghurt with kiwifruit and some nuts/seeds sprinkle.
Snack ideas:
A handful of raw nuts (peanuts, almonds, cashews, brazils, walnuts, pinenuts), a LITTLE bit of dried fruit (as its high in sugar – dates, goji berries and acai berries are the best), chia pudding made with coconut milk, tuna and crackers, veggie sticks with healthy dip, a boiled egg, yoghurt with sliced kiwifruit, avocado on crackers/wholegrain bread (add tomato and pepper for a taste explosion!), a few unflavoured rice crackers with dip, peanut butter on wholegrain bread (try banana sliced on top for something really different and delicious). Fresh or frozen blueberries.
A healthy smoothie for anytime:
Use a combination of any of the following, mix it up for something different each day.
- Start with a cup of one of the following: low-fat milk, soy/almond/coconut milk, orange juice or water
- Throw in a few ice cubes (makes it super cold and crunchy, excellent if you have morning sickness as this freezes your tastebuds and makes you less likely to vomit)
- Add a handful of frozen berries (blueberries, mixed or strawberries)
- One banana
- One Weetbix or ¼ cup of rolled oats IF you are not keeping much food down, as this adds fibre and is filling
- ½ teaspoon of spirulina powder
- A handful of washed fresh kale or spinach leaves (you won’t even taste it but what a super charged addition!)
- 2 teaspoons of chia seeds
- 2 tablespoons of Complan or protein powder IF vomiting is an issue as it adds nutrients for the baby when you are not keeping much down.
Blend really well and enjoy. Keep in an insulated cup for sipping over the next hour or three.
