Pregnancy 101

HOW DO I KNOW IF I AM PREGNANT?
"For most women the first sign that you're pregnant is when your period is late," says gynaecologist and obstetrician, Dr Robyn Spring. "You may also notice that your breasts become tender and they may change slightly in appearance, for example, your nipples might become darker." After the first few weeks, Dr Spring says, many women experience varying degrees of nausea, tiredness and even headaches. "You may also find that you suddenly start to avoid particular smells and tastes." If you're in any doubt, do a pregnancy test. A missed period is not always a sign of pregnancy. Sometimes it can be caused by illness, shock or even jet lag. And some women find, to their amazement, they continue to have periods during their pregnancy.

I CONTINUED TAKING THE PILL WITHOUT REALISING I WAS PREGNANT. WILL MY BABY BE OKAY?
"Yes, the hormone levels in most contraceptive pills are usually not high enough to cause problems," says Dr Spring. Theoretically, certain contraceptive pills, such as ones containing anti-androgenics, may carry a slight risk. If you are concerned, speak to your doctor or clinic sister.

IF I'M HEALTHY, DO I STILL NEED TO SEE A DOCTOR DURING MY PREGNANCY?
It's a good idea to have at least one check-up with your clinic sister or your doctor. Even if you think you're healthy, certain blood tests can identify potential problems such as anaemia, a lack of rubella (German measles) antibodies, or the fact that you are Rh-positive and your baby is Rh-negative (which can be life-threatening for your baby or for any subsequent children you may have if you do not have the necessary treatment). You may even discover that you're carrying twins, which will mean that you will need to be more closely monitored during your pregnancy.

I ONLY HAD SEX ONCE; CAN I BE PREGNANT?
The short answer, yes. Statistically your chances are reduced but anytime you have unprotected sex (and sometimes even if you do use protection) you run the risk of falling pregnant.

WHY IS GERMAN MEASLES DANGEROUS DURING THE FIRST TRIMESTER?
It's not just an old wives' tale. Being exposed to German measles during your pregnancy, particularly during your first trimester (the first three months), can be very dangerous for your baby. Dr Spring explains that this is because the virus that causes German measles, the rubella virus, can cause a large number of foetal defects, ranging from miscarriage to heart defects. She says the risk is so high that women are usually offered the option of a termination if they contract German measles in their first trimester.

One reason why it's so serious during the first three months is because this is precisely when your baby is being formed. If anything goes wrong at this stage the results can be life-threatening. Dr Spring points out though that you will usually have a routine blood test at your first antenatal visit to determine whether or not you have antibodies for German measles.

"If you don't have any rubella antibodies, there's not much you can do about it at this stage, except be very careful whom you come into contact with, especially during your first trimester," says Dr Spring. "It's probably best to avoid friends with small children, children's birthday parties, etc. Once your baby is born, you can be vaccinated against rubella." Ideally, you should speak to your doctor before you fall pregnant so that he can check to see whether you have sufficient antibodies.

WHY DO I NEED TO TAKE FOLIC ACID?
"Folic acid is one of the building blocks of DNA, and it takes a lot of DNA to form a baby so you'll need a good supply of folic acid!" says Dr Spring. Folic acid is found naturally in liver, dark green vegetables such as spinach and broccoli, fruit, nuts and seeds. Unfortunately, folic acid is largely destroyed through cooking, and since our bodies can't store folic acid we need a good daily supply. Most of us don't get enough folic acid in our diet, so it's a good idea to take a supplement. It is particularly necessary for the development of the baby's central nervous system, especially in the first few weeks of your pregnancy. A lack of folic acid can result in the foetus developing neural tube defects such as spina bifida, which occurs when the bones, usually at the bottom of the spine, don't join properly and expose the spinal cord.

AND WHICH EXERCISE IS THE BEST?
The fitter you are, the more stamina you're likely to have during labour. "If you are generally fit and active, then continue with your normal exercise routine, but keep in mind that you are pregnant and your exercise tolerance will lessen," says gynaecologist Dr Robin Spring. "Keep your pulse rate at about 140bpm (beats per minute) while you're exercising, but this will obviously depend on your resting pulse rate and level of fitness. If you use a personal trainer or attend an exercise class of any sort (Pilates,aerobics, step, etc.), inform your instructor of your pregnancy so he or she can, if necessary, modify your exercise programme."

Generally, it's a good idea to avoid abdominal exercises and strenuous weightlifting.

"Cycling, skiing and horse riding are also usually best avoided after 20 weeks of pregnancy as you run the risk of losing your balance," advises Dr Spring. "But keep up your cardiovascular workout and focus on strengthening your leg muscles as they take a lot of strain during pregnancy." If the thought of exercise has never been appealing though, then start slowly with a routine. "Walking, swimming and riding a stationary bicycle are great ways to gradually increase your fitness level when you're pregnant." However, if you have any complications during your pregnancy, it's important to get your doctor's advice before you do any kind of exercise.

WILL HAVING A NATURAL BIRTH RUIN MY SEX LIFE?
"No, absolutely not", says Dr Spring. "But if you have an instrumental delivery (if forceps are used, for example), the chances of damage to your pelvic floor will be higher." She explains that the vagina is covered by skin, which heals in the form of scar tissue. "This can initially be rather sensitive but it will improve over time. Like any scar tissue, the more you use it or massage it, the less sensitive it becomes."

She adds that pelvic floor exercises can also help to restore the tone of your pelvic floor muscles, which may become slightly stretched during labour.

IS IT TRUE THAT YOU'RE MORE LIKELY TO HAVE A BOY IF YOU HAVE SEX ONLY ONCE DURING YOUR FERTILE PERIOD, AND A GIRL IF YOU HAVE SEX MORE OFTEN?
"Yes", says wellknown child and health expert, Dr Miriam Stoppard. "This is because the female sperm live longer and swim slower than male sperm. If you have sex a few days before you ovulate, the longer-living and slower female sperm will be waiting for the egg. If you have sex just before ovulation the faster, pushier male sperm will win the race." However, she says you essentially have a 50/50 chance of having either a boy or a girl.

IS IT TRUE THAT YOU CAN DETERMINE THE SEX OF YOUR BABY BY THE SHAPE OF YOUR TUMMY AND THE WAY YOU'RE 'CARRYING'?
"No", says Dr Stoppard. "The shape of your bump is related to your body shape and muscle tone and not the sex of the baby inside your womb."

IS IT SAFE TO HAVE SEX WHEN I'M PREGNANT?
Absolutely, says Dr Spring. "The baby is very well 'shock-absorbed'!" She says many women find themselves more sexually aroused during pregnancy.

"You may however need to try several different positions to find one that is most comfortable, especially as your tummy grows."

It's quite safe to have an orgasm while you're pregnant, although in late pregnancy an orgasm may set off Braxton- Hicks contractions. It's also safe to masturbate. However, says Dr Spring, if you develop complications such as placenta praevia or have any unexplained bleeding, then you will probably be advised to avoid sex. "Many women don't realise that having sex during late pregnancy (particularly if you're near or past your due date) may bring on labour. This is because sperm contains a substance called prostaglandin which can cause the cervix to begin opening." Prostaglandin is used to induce labour, so you have been warned!