Babies Tale

Most women want to know they are pregnant as soon as possible, especially if they have had problems conceiving. Over-the counter pregnancy tests available now can tell you whether you are pregnant or not as soon as, or even before, your period is due. They are quite accurate. You can buy them at larger grocery stores and at pharmacies. Each box usually contains two tests, so if the first isn’t positive, you can repeat it a few days later to make sure. They are not cheap, so it may be wise to wait for your period, and take the test if you are late.

“When my period was overdue I did a home test and it was positive. Then my doctor did one and it was negative. We were both disappointed. But my period didn’t start, and I felt pregnant. So I did another home test, which was positive. I called my husband and asked him to come home from work to make sure I wasn’t imagining it. He did and agreed it was positive. But the next test from the hospital was negative too-until the doctor called and said they had made an error. It seemed crazy to us that a home test was so much better than the hospital one!”

Having your pregnancy confirmed early lets you, if you haven’t already, stop all drinking of alcohol, take care of your diet, and get the soonest possible prenatal appointment. Once you know you are pregnant, talk things over with your healthcare professional and explain any preferences you have for the kind of birth you would like, which hospitals you prefer, whether you would like a hospital delivery or a home birth if that can be arranged. Your doctor will know the options in the area and will be able to discuss with you what is best. In practice this is not always the case, and older mothers in particular may find they are only offered a hospital birth or are under strong pressure to have the baby in the hospital. In some areas, your choice of hospital is limited.

The vast majority of births take place in hospitals, and most people still have their prenatal appointments under an obstetrician’s care. Although things seem to have improved in prenatal care, the majority of women find the wait for office appointments is still a problem. There are usually no facilities for occupying the attention of older children and toddlers. In some managed care systems, women complain that they are seen by someone different each time and may not even see the professional they were supposed to see. Many women find the care impersonal and offhand. But despite these kinds of problems, on the whole, older pregnant women do not find themselves much of an oddity at prenatal clinics.

“I realized I could be the mother of the woman sitting next to me, but it didn’t seem to matter. We were both going through the same thing. I was never once made to feel that I was old or doing anything unusual by the other women or by the office staff. I’d guess the average age of mothers at my clinic was 30 to 35. My doctor does specialize in women with potential difficulties and older mothers, and I live in a major metropolitan area. I think all that makes a difference. Still, I was surprised at the number of older women I saw.”

Routine Prenatal Tests

Ideally, you will have seen your doctor before you conceived, or as soon after conception as possible. At your first appointment, your healthcare provider will take your medical history, together with any details of previous pregnancies. You will be weighed. You are likely to be given an internal examination to confirm the pregnancy, check the womb is the size it should be for your dates, check for any abnormalities of the pelvis and check that the cervix (neck of the womb) is tightly closed. A cervical smear (Pap smear) is also usually taken. Lab tests may be done now or at a later visit.

If you have had a history of miscarriage the doctor may agree not to examine you internally at this stage if you wish, though there is no particular evidence to suggest this might cause a miscarriage.

A blood test is also taken to find your major blood group, particularly whether you are rhesus positive or negative. About 85% of the population is rhesus positive. If you are rhesus negative and your baby is rhesus positive, and it is a second or subsequent pregnancy, there is a small chance that you may make sufficient antibodies to rhesus-positive blood to damage your baby’s blood cells. Because of this, if you are rhesus negative, blood samples will be taken at various times throughout your pregnancy to check on antibody levels, which only rarely become too high. Very rarely a baby suffering from rhesus incompatibility may have to be delivered by Cesarean section and receive a blood transfusion.

Rhesus incompatibility is becoming rarer because most rhesus-negative mothers now have an injection of Rh-immune globulin, which prevents them from producing antibodies. If this is done after every delivery or abortion, future babies are safe from rhesus incompatibility.

Your hemoglobin level is checked to make sure you are not anemic (this test will be repeated later in the pregnancy). You are also screened for immunity to rubella (German measles) and for any sexually transmitted diseases.

Your breasts are usually examined at the first visit to check for lumps. They are not being checked to see whether you can breastfeed. No matter what size or shape your breasts or nipples are, you should be able to breast-feed successfully. If your nipples are inverted, you will still be able to breast-feed; you may just need a little extra help at first in getting the baby to latch on properly.

At every visit you will be weighed to check the growth of the baby and to see that your weight gain is satisfactory. Your urine is tested at every visit-the first time it will be screened for any infection. At every other visit it will be tested for the presence of protein in the urine, which could indicate you have pre-eclampsia and to check that you are not developing diabetes.

The abdomen is measured at every visit to check that the womb is growing in size according to your dates. After 20 to 24 weeks your baby’s heartbeat can be monitored with a stethoscope. Your blood pressure is also measured at every visit, because high blood pressure can indicate a number of problems, including preeclampsia. Your ankles and fingers will be checked for puffiness, a sign of water retention.

Pre-Eclam Psia

Pre-eclampsia, also called toxemia of pregnancy, is a disorder of unknown cause. Symptoms include water retention and high blood pressure. If the condition is allowed to progress unchecked, the blood pressure rises further and the mother suffers headaches and even seizures (eclampsia). Pre-eclampsia puts the baby at risk. The baby may not get enough nourishment. Mothers with pre-eclampsia have an increased risk of going into premature labor.

Doctors look carefully for signs of pre-eclampsia or toxemia, because it can be prevented if caught early, and the risk to the unborn baby can be reduced. Although the cause of pre-eclampsia is unknown, it has been linked to poor nutrition in some cases. Older mothers are at greater risk of developing this condition, so it’s important to keep all your regular prenatal appointments.

Pre-eclampsia is usually treated with bed rest. Women with this condition are often admitted to the hospital so they and the baby can be monitored. Usually complete rest takes care of the problem. If it does get worse, the baby may have to be born early by Cesarean-section delivery (C-section).

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