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The Maternity Series By Tanvi Parker

Menstruation and Pregnancy

Menstruation is the technical term for periods or monthly cycle. The inner lining of the uterus thickens every month and prepares itself for pregnancy. This lining is rich in blood vessels. If pregnancy does not occur, then the thickened lining is shed and accompanied by bleeding.

Assuming an average menstrual cycle is 28 days, the below table of the events of the menstrual cycle, shall help in planning for or avoiding pregnancy:

Cycle days (approximate)

Events of the menstrual cycle

Days 1-5

The first day of menstrual bleeding is considered Day 1 of the cycle.
Your period can last anywhere from 3 to 8 days, but 5 days is average.
Bleeding is usually heaviest on the first 2 days.

Days 6-14

Once the bleeding stops, the uterine lining (also called the endometrium) begins to prepare for the possibility of a pregnancy.
The uterine lining becomes thicker and enriched in blood and nutrients.

Day 14-25

Somewhere around day 14, an egg is released from one of the ovaries and begins its journey down the fallopian tubes to the uterus.
If sperm are present in the fallopian tube at this time, fertilization can occur.
In this case the fertilized egg will travel to the uterus and attempt to implant in the uterine wall.

Days 25-28

If the egg was not fertilized or implantation does not occur, hormonal changes signal the uterus to prepare to shed its lining, and the egg breaks down and is shed along with lining.
The cycle begins again on Day 1 menstrual bleeding.

The menstrual cycle, thus, includes several phases. The exact timing of the phases of the cycle is a little bit different for every woman and can change over time.

A pregnancy occurs during ovulation, when an egg is released from the ovaries and is fertilized in the presence of a sperm. Thus, a couple can attempt to conceive between 12-24 days of the menstrual cycle.



Pre-natal health screening

The following tests are conducted in a prenatal screening:

Female:

  • Complete Blood check
  • Thyroid Functions Tests
  • Blood Glucose-Fasting and post Prandial
  • Vitamin D
  • Prolactin levels

Male:

  • Semen Analysis

Disclaimer: The above are the general tests conducted in a prenatal screening. The finalist of tests shall be prescribed by a clinical professional on case to case basis.



Schedule for Antenatal Gynaecologist Visits

Up to 32 weeks- Monthly

32-36 weeks – Fortnightly

37-38 weeks- Weekly

38+ weeks- Twice weekly

Disclaimer: The above schedule is the general antenatal OPD schedule. The same can be modified by a clinical professional on case to case basis.



Planning to get pregnant

The timing to get pregnant cannot be predicted as it is different for every couple.

Many factors can affect a couple's chances of conceiving, such as:

  • Age
  • General health
  • Reproductive health
  • Frequency of sex

Age: Women become less fertile as they get older. One study (NHS, UK) found that among couples having regular unprotected sex:

  • aged 19 to 26 – 92% will conceive after 1 year and 98% after 2 years
  • aged 35 to 39 – 82% will conceive after 1 year and 90% after 2 years

The effect of age on men's fertility is less clear.

General health: Good physical and mental health is of both men and women is essential for a better rate of conceiving. Good balanced diet, regular exercise, no smoking and drinking, good sleep and less stress helps in conceiving earlier and healthier.

Reproductive Health: A good reproductive health is as essential as good general health. A regular menstrual cycle as well as hormones like the thyroid and pituitary hormones, oestrogen, progesterone, follicle stimulating hormone, luteinising hormone, prolactin and oxytocin play an important role in the health of female reproductive health. Testosterone is the main hormone for male reproduction. The quality of egg and sperm also determine the overall reproductive health.

Frequency of sex: Having regular sex means having sex every 2 to 3 days throughout the month. Some couples may try to time having sex with when the woman ovulates (releases an egg). However, many studies advise that this can be stressful, and it isn't recommended.



Breastfeeding Myths

Myth - Babies need extra milk in the first few days as mom only produces a little.
Fact - First milk, colostrum is produced in small amount because that’s all the baby needs.

Myth - Big breasts make more milk.
Fact - Milk production is independent of the breast size. Mother is able to make enough for the baby.

Myth - Breast feeding in lying down position can cause ear infection.
Fact - Technically, baby is lying down in every position. Lying down position is comfortable for moms who had C-section of difficult delivery.

Myth - Mom should not feed the baby when she is ill.
Fact - During common illnesses like cough and cold, fever or even in diseases like typhoid and T.B., mother can breastfeed her baby with proper precautions.

Myth - Decrease in baby’s feeding frequency implies that mom has less breast milk and should start top feed.
Fact - With age, the frequency of breastfeeding decreases. If baby passes urine more than 6-7 times a day and gains more than 500 grams in a month, mil is enough.