BODY CHANGES DURING PREGNANCY
CHILD BIRTH EXERCISES: COMFORT MEASURES

Lesson Duration: 1 hour 10 minutes

Overall Objective:

To educate the client about the normal changes in pregnancy and thus facilitate a positive attitude towards pregnancy.

Objectives

Clients will be able to:

1. List 2 signs of pregnancy.
2. Briefly discuss how 2 emotional changes in pregnancy can affect the client and her partner.
3. Describe how 2 minor discomforts of pregnancy can be relieved.
4. State the 4 danger signs in pregnancy and what must be done if they occur.

Resources

• Chart showing a positive pregnancy test.
• Flip Chart showing the signs of pregnancy (if available).
• Handouts:
  1. Signs of Pregnancy.
  2. Danger signs in pregnancy and what to do if any occur (See Antenatal Health Watch).
  3. How Your Baby Grows.
  4. Pregnancy Baby Book.
  5. Becoming a Dad.
• Pencils for clients.
• Writing pads or paper for clients.

Introduction:

“Mistaken Identity”
A 37 year old woman was told that she had fibroids and high blood pressure. She thought that she would not “get” pregnant. The woman’s abdomen grew and she felt movements in her abdomen. She thought the growth was due to the fibroids and that the movements were “gas;” she was pregnant. The undetected pregnancy continued. When she felt the labour pains she again thought the pains were due to the fibroids. The client went on to deliver a 5 pound, 6 ounces baby girl at home.

Review vocabulary

Body

Role Play: “Da Beauty Parlor”
Trainer lists signs of pregnancy and briefly explains each:

• More spit is produced and accumulates in the mouth.
• Abdominal enlargement - as the foetus grows, the uterus or womb increases in size from about the size of a pear to that of a watermelon.
• Quickening — the first movement of a foetus in the uterus that is felt by the mother. It is usually experienced at about 16 weeks for women who have given birth to a live child after at least 2 pregnancies, and between 18 to 20 weeks for women having their first pregnancy.

Feeling and observing foetal movements.

Trainer will ask 2 to 3 clients how they felt when they found out that they were pregnant (allow a 2 to 3 minute discussion).

Trainer will state 2 emotional changes that occur in the pregnant woman and 2 emotional changes that occur in her partner

Maternal Emotions

Frequent mood swings occur possibly due to hormonal changes or fears about pregnancy and/or responsibilities of motherhood (may be tearful).

Cravings for junk food and non-food items such as starch (this may result in an unhealthy diet).

Paternal Emotions

Fathers may also experience some signs of pregnancy which may be caused by strong identification with the expectant mother, or feelings of being “left out of things.”

Fathers can cope with these feelings and at the same time take some of the emotional load off the expectant mother by sharing experiences of pregnancy, labour, birth and care of children.

Sexual interest is generally decreased during the first 3 months and last 3 months of pregnancy for the mother-to-be because of discomforts. In men, sexual interest may decrease because of fear of injuring the baby. Sexual interest in and attraction to other partners may increase. (Trainer will discuss additional ways of experiencing sexual intimacy.) Please note that if sexual intercourse is discontinued the woman still needs love and physical affection. Additionally, the man still may have his sexual needs. These may be met in alternative expressions of intimacy.

Trainer advises clients to:

• Accept expressions of emotion, for example, crying, among others, as legitimate ways of “venting”.
• Avoid upsetting situations as much as possible.

Mention Myths “old wives tales” about pregnancy

• If you eat certain foods your baby will be marked with it.
• If you look at a deformed person, your baby will be deformed.

Trainer uses flip chart to show size and development of the foetus during the 3 trimesters.

First Trimester (0 - 13 weeks)

• All organs are formed.
• The baby is most vulnerable to drugs taken by the mother and to certain diseases.

Second Trimester (14—26 weeks)

• The foetus begins to appear human. You begin to feel foetal movements (like the fluttering of a butterfly).
• The foetal heartbeat can be heard.

Third Trimester (27—40 weeks)

• The foetus gains most of its birth weight.
• The foetus usually settles into a head down position in the mother’s pelvis. The foetus moves in response to sound, among others (if the foetus moves less than 11 times in 12 hours notify the Midwife or Doctor).

Minor Discomforts of Pregnancy

Trainer asks 2 clients to name 1 minor discomfort of pregnancy.
The Trainer states four minor discomforts of pregnancy and methods of relief.

Nausea and vomiting or “morning sickness” is caused by the hormonal change

Remedies:

• Brush teeth and rinse mouth frequently.
• Eat small, frequent meals.
• Avoid going long periods without food.
• Drink fluids between, but not with meals.
• Avoid greasy, fried or highly spiced food.
• Avoid unpleasant odours.
• If the mother-to-be is unable to retain food for 24 hours or more and experiences weight loss, she is to notify the Midwife of Doctor.

Urinary frequency and urgency

The urge to urinate more often than usual, during the first 3 months of pregnancy, is due to pressure of the enlarging uterus which is now directly over the bladder.
Urinary frequency during the last month of pregnancy is due to pressure from the foetus descending downward into the pelvis.

Remedy: Do not drink fluids less than 2 hours before going to bed.

Increased vaginal discharge

There is increased vaginal discharge from the end of the first trimester to the end of the pregnancy (itching, burning, rash or unpleasant odour may indicate an infection). It is caused by hormonal changes and increased blood flow.

Remedy: Take normal showers.

Round ligament pain or “stitch in the side”

Sharp pain in the lower abdomen and groin. It is caused by tension on a pair of ligaments that hold the uterus in place.

Remedy: Bring the thigh up to the abdomen on the affected side.

Acid indigestion or “heartburn”

Remedy: Eat small frequent meals
Avoid fried foods

The minor discomforts of pregnancy are not illnesses, so the mother can use various, safe home remedies to increase her comfort.

Danger Signs in Pregnancy

Facilitator will tell clients that if they have the following symptoms, they must go to hospital for assessment, as these are danger signs in pregnancy.

• Hypertensive Disorder.
• Swollen hands or face especially in the morning.
• Unexplained weight gain of more than 2 pounds per week.
• Severe, persistent headache.
• Spots in front of eyes.
• Blurred vision.
• Persistent, severe abdominal pain.
• Fits and unconsciousness.
• Premature rupture of membranes, where the “waterbag” bursts before the ninth month.
• Severe vaginal bleeding.
• A noticeable decrease or absent foetal movements. Less than 11 movements in 12 hours.

Summary

Signs of pregnancy include:

1. Stopping of the menstrual period.
2. Increased production of saliva.
3. Abdominal enlargement.
4. Foetal movements.
5. The mother-to-be may have mood swings and feel fearful.
6. Minor discomforts may also be felt.

Danger signs are:

1. Hypertension.
2. Severe, persistent headache.
3. Change in vision.
4. Severe abdominal pain.
5. Fits, unconsciousness.
6. Rupture of the “waterbag” before time.
7. Severe and continuous bleeding from the vagina.
8. Foetal movements stopped.

Danger signs and illness must be reported to the Midwife or Doctor immediately.

Vocabulary (in alphabetical order)

Amenorrhoea:

• The absence or stopping of the menstrual periods.

Blurred Vision

• Everything looks indistinct or hazy.

Convulsions

• “Fits".

Fertilization

• Sperm joining egg.

Fibroids

• Non-cancerous growth in the womb.

Heartburn

• “burning” sensation or pain behind the breast bone near the heart, but having nothing to do with the heart.

Hypertension

• “High blood pressure” (high blood).

Multigravida

• A woman who has been pregnant two or more times

Pregnancy Test

• Methods used to indicate whether a woman is pregnant. The test becomes positive within the first month of pregnancy.

Primigravida

• A woman whose present pregnancy will be her first birth.

Quickening

• The first movement of foetus in the uterus that is felt by the mother. Usually experienced after sixteen (16) weeks of pregnancy, although it may occur earlier.

Trimester

• 9 months of pregnancy is divided into three (3) parts each 3 months long.