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KELLY WALKER - PRIVATE MIDWIFE
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Changes in Pregnancy

Menstrual Cycle
Your pregnancy is calculated by using the First Day of Your Last Period and adding 9months and 7 days. Some people experience some spotting in the first 12weeks which can be mistaken for another period or for the already aware, may cause anxiety or concern about the baby. Any bleeding should be reported to your midwife or GP for review.

Breasts Changes
Breasts are likely to swell as early as 4wks and throughout the pregnancy. They may feel tingly or tender as they prepare for milk production. You may notice colostrum which is a thick yellow pre-milk, as early as 24weeks. The colour of the areola (nipple) may darken as a result of pregnancy hormones. There is no need to do any preparation to the nipples for breastfeeding other then becoming comfortable handling your breasts in private, doing breast self checks in the mirror regularly and perhaps having a breast examination with your midwife or care provider, especially if you notice any unusual lumps or discolouration.

Skin and Hair
Hormones of pregnancy can make your skin complexion break out more than usual or make it become the most glowing it has ever been! The best advise is to have a clean diet and drink lots (and lots) of fresh water! Use minimal products on the skin and protect it from the sun with a big brim hat. Hormone changes can cause the skin to become hyper-pigmented causing dark blotches especially on the face. This is called chloasma or pregnancy mask and affects darker skin women more often. As the beautiful belly swells a line down the centre through the belly button may appear which is a normal hyper-pigmentation called the linea nigra. These complexion and pigmentation changes are usually temporary and subside days to weeks after pregnancy.

Stretch marks on the belly or arms and legs can occur as baby grows and weight is gained. Best advise for avoiding strecth marks is to have a healthy diet and lots and lots and LOTS of fresh water! The integrity of your skin begins with what we put in our body so good building blocks for you and baby are essential. Massage with a simple natural oil (i.e. olive, coconut, apricot kernel) can stimulate circulation and add to the skins suppleness and may reduce stretch marks. 

Your hair may appear thicker and more lustrous during your pregnancy as the pregnancy hormones reduce hair loss. Enjoy this while you can but don't be scared if you experience significant hair loss in the first few months after baby is born. Any concerns contact your midwife or GP.

Some women may experience pruritus or itching of the skin in pregnancy which can be a great nuisance and should be discussed with your midwife or care provider. In some cases it is caused by  problems with your liver enzymes and some easy investigations and tests will be done to rule out cholestasis of pregnancy. In general hot itchy skin is normal as you gain pregnancy weight and your temperature is raised with your increased metabolism. A nice way to cool off and reduce itching is to apply cool facecloths, perhaps soaked in cold chamomile tea to irritated areas.

Nausea
Otherwise known as morning sickness, besides fainting, this is one of the oldest ways we knew one of our sisters was with child! Nausea is very common in the first trimester and sometimes some occasional vomiting may occur to. This common complaint is due to a combination of pregnancy hormones playing havoc on your digestive system and emotions. The peak usually occurs around 6-18wks when baby is going through major organogenesis and may be a protective factor so mums avoid toxic foods and vapours.

If you are unable to keep down food or fluid for more than 24 hours or the nausea and vomiting is occurring with flu like aches and pains or diarhaea please immediately contact your midwife or care provider for advise incase you are at risk of dehydration or its a virus or infection.

To reduce the unsettling nausea you can try these suggestions  -  avoid triggers like strong smells, try to soothe gastric irritation by having something small to eat before you get out of bed like a cracker and a peppermint tea, eat small meals frequently, reduce spicy/fatty/sugary foods because they increase stomach acid, suck on peppermint tea ice cubes, take ginger in any form, use reflexology points that soothe the stomach and liver and/or consult with a homeopath for a gentle remedy. Please discuss over the counter preparations with a midwife, GP or pharmacist first.

Nose, teeth & gums
During pregnancy your body is becoming flush with extra blood, produced for baby to grow and thrive. The mucous membranes in the nose or gums are easily irritated and you may experience bleeding from the nose, or from the gums during teeth brushing. Discuss with your carer if it is ongoing. Your teeth can also become very sensitive.

Spotting may occur after lovemaking for a few women because of the increased blood flow to the vagina and cervix. If this occurs you must contact your midwife or hospital women's care unit to rule out bleeding from the placenta. 

Constipation
Constipation is very common due to the muscle relaxing pregnancy hormones slowing down your digestive system. It is easily treated by increasing your dietry fibre and your fluid intake. Boost your fluids with lots of fresh water and decaffeinated herbal teas. Steamed veggies, prunes, fresh figs and apples will help increase your dietry fibre. Remember if you are using psyllium husk, LSA, chia seeds or any dried fruits - yes they have fibre and great micronutrients but you will have to drink more fluid for their digestion.

Nutrition, exercise and weight gain
Hopefully once you have overcome the nausea somewhere between 10 and 16wks you are acutely aware of your bodies needs and you are eating to suit you hunger with optimum food that will help build your baby. Its all about quality not quantity! Im not going to give great detail on the best foods available because you will each have great local sources of organic protein, veggies, fruit and grains that you can web or community research. But try to avoid processed sugar, deep fried fatty or prepackaged food as much as you can - these food are not best for sustaining a pregnant woman and her growing baby. 

Folic acid supplements taken 1 month before and during the first 3 months of pregnancy is recommended to reduce spinal cord abnormalities in the baby. See your midwife, GP or pharmacist for dose and product advise.

Iodine and vitamin D supplements are also becoming more recognised as important for baby development and pregnancy health. Because of each women's different diets, food sources and lifestyles. Please discuss with your midwife or GP what your requirements might be. 

A basic aerobic fitness regime is great for maintaining circulation, reducing anxiety, reducing swelling in the legs, reducing growing aches and pains of pregnancy and especially great for preparing you for labour and birth! Aim to get at least 30minutes a day walking, swimming or dancing. Cycling, skipping, jogging, rowing and stair climbing are good up until 26-30wks when your increased size can make these activities uncomfortable. Yoga is fantastic for stretching and bringing oxygen rich blood into all the tight areas of your growing body, just remember to let your teacher know you are pregnant and dont over extend your self. 

Weight gain in pregnancy is expected to be roughly between 11-16kg in total. Your midwife or GP can refer to a dietician if you feel like you need extra support with meal planning. This is a great time to get advise from a professional if you are lost for ideas on food or supplements during a busy schedule or if you are getting conflicting advise.