Swollen Legs in Pregnancy

Why Do the Legs and Feet Swell During Pregnancy?
During pregnancy your body itself moves to collect more water than it would at other times, and changes in your blood chemistry help this. Also, the growth of your uterus puts pressure on veins in your pelvis which means that the return of blood to your heart will be slowed slightly. This slowing will in turn create slight pressure in your veins and cause some fluid to leak into the surrounding tissues of your legs and feet and causing swelling.


Is Swelling of the Legs and Feet Harmful to Me or My Baby?
Swelling of the legs and feet, and sometimes even the arms and hands, is common in pregnancy so do not be alarmed if you experience this. However, there are some signs of swelling that you should take seriously. Call your GP or midwife for further information and assistance if you notice:

• Swelling in your face or around your eyes.
• Excessive swelling of your hands (more than just a tightness of your rings).
• Excessive and/or sudden swelling of your legs and feet (comes on within hours).
• Swelling more in one leg than the other (a noticeable difference in the two).
• Pain in your extremities (particularly calves or thighs).

Are Swollen Legs and Feet Painful?
Most women who have experienced swollen legs and feet during pregnancy will agree that though they are uncomfortable, they are not actually in pain. Thankfully there are some steps you can take to relieving swollen legs and feet.

• Rest on your left side in bed or on the couch
• Sit with your feet and legs up whenever you can.
• Drink plenty of water and urinate as often as possible.
• Stretch your legs and feet whenever possible.
• Do not stand for long lengths of time without a break.
• Exercise (including walking and swimming) and eat a healthy diet.

pregnant and still have periods?

Once your body starts producing human chorionic gonadotropin (hCG) - the pregnancy hormone - and pregnancy is established, your menstrual cycle is interrupted and normal periods will stop.

However, many women do experience bleeding during early pregnancy that may look very much like a normal period. This sort of bleeding is known as "breakthrough" bleeding and is caused by the hormones that control your normal menstrual cycle breaking through.

Bleeding is also thought to occur when the fertilised egg implants into the lining of the uterus (womb). This usually happens at about the time your period would have been due. There is some research that suggests that bleeding around this time is more likely to be due to breakthrough bleeding than implantation bleeding. Either way, bleeding at this time can make establishing your due date difficult, since doctors often use the first day of your last period to determine your due date. If that's in any doubt, measuring how big your uterus is may help them determine how far along you are. And if that's inconclusive, a dating scan can measure the size of your baby and clarify exactly when he is due.

Many women who have vaginal spotting in early pregnancy go on to have their baby without any complications, but bleeding can also be a cause for concern. It may be the first sign of a miscarriage; if so, your symptoms would probably go on to include heavy cramping and bleeding that is much heavier than a normal period.

If you have sharp pains in your lower abdomen, especially if the pain is only on one side, you should see your doctor straightaway as you could have an ectopic pregnancy. Because of these potential complications, if you bleed at all in early pregnancy, it's best to notify your doctor. She may suggest getting a blood test to check your hormone levels or refer you for an early ultrasound to evaluate your condition more thoroughly.

Exclusively breastfeeding

The first 6 months of life

Increasing optimal breastfeeding practices could save an estimated 1.5 million infant lives annually. Up to 55 percent of infant deaths from diarrheal disease and acute respiratory infections may result from inappropriate feeding practices. Optimal feeding for sustained child health and growth includes initiation of breastfeeding within the first hour of life, exclusive breastfeeding for six months, timely complementary feeding with appropriate foods, and continued breastfeeding for two years and beyond.

During the first 6 months of life, infants should be exclusively breastfed. This means that the healthy baby should receive breastmilk and no other fluids, such as water, teas, juice, cereal drinks, animal milk or formula. Exclusively breastfed babies are much less likely to get diarrhoea or to die from it than are babies who are not breastfed or are partially breastfed. Breastfeeding also protects against the risk of allergy early in life, aids in child spacing and provides protection against infections other than diarrhoea (e.g. pneumonia). Breastfeeding should be continued until at least 2 years of age. The best way to establish the practice is to put the baby to the breast immediately after birth and not to give any other fluids.

Advantages and Benefits of breastfeeding are listed below. Some or all of them may be explained to mothers using simple language.

If breastfeeding is not possible, cow's milk or milk formula should be given from a cup. This is possible even with very young infants. Feeding bottles and teats should never be used because they are very difficult to clean and easily carry the organisms that cause diarrhoea. Careful instructions should be given on the correct preparation of milk formula using water that has been boiled briefly before use.

Confinement Pregnancy

Pregnancy can be described as the process of childbearing. While people usually think of pregnancy as taking 9 months, the larger process of childbearing can be divided into three stages:

preconception, or the period before pregnancy

prenatal, the time from conception to birth

postpartum, or the time right after the baby's birth

The prenatal stage, or pregnancy itself, is measured from the beginning of a woman's last normal menstral period (LMP). Usually, pregnancy lasts about 40 weeks, or roughly 9 calendar months. Although women experience many of the same physical changes, no two pregnancies are alike.

What is the information for this topic?

Pregnancy is a very complex topic. This section is an overview of the three stages of pregnancy.

Stage I: Before pregnancy

Preconception care. The health of the mother and father before conception occurs is as important as the woman's health during pregnancy. Lifestyle habits, such as smoking, drinking alcohol, drug abuse or addiction, and using certain medications, can all interfere with normal growth. Healthy habits can help promote growth.

It is a good idea to schedule a preconceptional visit with a healthcare provider. During this visit, questions will be asked about the woman's health and lifestyle and often those of her partner, too. The provider will discuss pregnancy risk factors. These questions include:

family and medical histories

a history of any medications taken

diet

lifestyle issues

the course of any past pregnancies

Stage II: During pregnancy

Conception. A finely-tuned sequence of events must take place for pregnancy to occur. A woman's fertility depends on her menstrual cycle. A basic knowledge of how reproduction works will help a woman know the days of the month when she is the most fertile - in other words, when she is most likely to get pregnant. It will also explain the rapid changes that take place during early pregnancy.

Early signs of pregnancy.The first sign of pregnancy that many women notice is a missed menstral period. However, not all women have regular periods. Menstrual periods can be affected by stress or illness, so it is best to watch for a number of other signs and symptoms of pregnancy, such as:

light spotting of blood

tender breasts

tiredness

nausea

a need to urinate often

food cravings

darkening of the line between the navel and the nipple

Diagnosis of Pregnancy. Pregnancy can be confirmed by the time a period is missed. During early pregnancy, HCG, a hormone that is made by the growing baby is in the mother's blood and urine. While home tests for pregnancy work fairly well, very accurate tests can be done by a healthcare provider.

Growth and development. During pregnancy, the baby grows in the mother's uterus, which is a muscular organ located between the bladder and the rectum. The lining of the uterus thickens and its blood vessels enlarge to nourish the growing baby. The placenta is the channel through which oxygen, nutrients, and other substances pass from mother to baby.

The process of growth and development has three phases called trimesters.

weeks 0 through 13, known as the first trimester

weeks 14 through 27, known as the second trimester

weeks 28 through 40, known as the third trimester

Stage III: After birth

Being a new parent is exciting and demanding. It causes major changes in life. There are changes in a woman's body, her emotions, her relationships and how she lives. Being aware of what is happening both physically and emotionally can prepare a woman to better face the ups and downs of the first few months after a baby is born. Taking care of physical and mental well-being is a key factor. Many issues surface at this time, including:

work

childcare

family planning

Two to 6 weeks after the birth of the baby, a woman should visit a healthcare provider to:

learn how well her body has recovered from the changes of pregnancy and birth

discuss any questions or concerns about birth control, sex, or emotions

Forceps Delivery

Forceps are instruments designed to aid in the delivery of the fetus by applying traction to the fetal head. Many different types of forceps have been described and developed. Generally, forceps consist of 2 mirror image metal instruments that are maneuvered to cradle the fetal head and are articulated, after which traction is applied to effect delivery.

Forceps are sometimes described as 'stainless steel salad servers' or 'large sugar-tongs'. They come in two intersecting parts, and have curved ends to cradle the baby's head.

The ventouse has a cup attached to a small vacuum pump. The cup, which fits on top and slightly towards the back of your baby's head, may be made of metal or silicone plastic. The soft cups are less likely to cause damage to your baby's head, but the metal cups are less likely to slip off and have to be reattached. The type of cup used may depend on the baby's position.

Forceps have 4 major components, as follows:

• Blades: The blades grasp the fetus. Each blade has a curve to fit around the fetal head. The blades are oval or elliptical and can be fenestrated (with a hole in the middle) or solid. Many blades are also curved in a plane 90° from the cephalic curve to fit the maternal pelvis (pelvic curve).
• Shanks: The shanks connect the blades to the handles and provide the length of the device. They are either parallel or crossing.
• Lock: The lock is the articulation between the shanks. Many different types have been designed.
• Handles: The handles are where the operator holds the device and applies traction to the fetal head.

Your midwife or doctor will explain to you why they think a forceps delivery is necessary. You'll have to put your legs in stirrups or supports at the side of the bed (the 'lithotomy' position) and the end of the bed will be removed. A thin tube called a catheter, attached to a bag, will be put into your bladder to empty it (this procedure can be slightly uncomfortable), and your legs will be draped in sterile green sheets. Your doctor will need to make a cut (episiotomy) through the back of your vagina to enlarge the opening so that the forceps can be put round your baby's head. Once the forceps are in place, the doctor will pull while you push during a contraction to help your baby move down through the birth canal and be born. Women have reported greater discomfort associated with forceps than ventouse delivery.

It's usual for a paediatrician (baby doctor) to be called to the delivery room for any birth which requires instruments, so don't worry too much if one suddenly appears.

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