Annually, about 500,000 women die of causes related to pregnancy and over 60 million women suffer from severe complications during pregnancy. 30 % of them will have lesions and infections for the rest of their life. Many women in the third world are trapped in a vicious circle of pregnancies, births and lack of care, that leave them exhausted and diseased. In fact, pregnancy can be harmful and even dangerous.
1.Planning. The couple should decide before how many children they will have. In developing countries it is a common thing to see mothers with small children, breastfeeding a baby and in the same time being pregnant. A good planning would allow the passing of sufficient time between one birth and another, alleviating the women and permitting them to recover.
2.Diet. Before getting pregnant, a woman needs a minimum of four months to recover from the effects of harmful chemicals and accumulate the nutrients the child will require during pregnancy. E.g., the risk of spina bifida (due to wrong jointing of the neural spine) is significantly reduced when the mother has enough amounts of folic acid. As the neural tube of the baby closes at 24 to 28 days after conception, much earlier than many women even find they are pregnant, some start taking folic acid when planning to have children.
Iron, too, is essential. During pregnancy, the woman needs a double quantity of iron. If she has low levels (as it happens in developing countries), the woman can get anaemia due to lack of iron, a condition aggravated by the frequent pregnancies, as the woman does not have time to recover. Good sources of folic acid and iron are leaver, beans, green vegetables, dry fruits and enriched cereals. Iron is better absorbed in the presence of vitamin C, abundant in fresh fruits.
The diet must contain fruits, vegetables (especially those green dark, orange or red), pulses (bean, soy, lentil and chickpea), cereals (wheat, corn, oat, rye, preferable integral or enriched) and animal food (fish, chicken, beef, cheese and milk, preferable skimmed). Fats, refined sugars and salt should be consumed in low amounts. The pregnant woman must drink a lot of water and avoid foods and beverages containing caffeine and additives (like colorants and artificial aromas). Substances which are not comestible, like starch and clay can cause malnutrition and intoxication.
3.Infections. The urinary, cervicovaginal, and gastrointestinal infections can get worse during the pregnancy and increase the risk of premature birth and preeclampsia. It is better to treat any infection before the pregnancy.
4.Prenatal attention. The regular visits to the medic during pregnancy reduce the risk of death. If this is not possible, like in developing countries, midwifery services, that offer a minimum preparation, are necessary.
The prenatal visit to the medic can warn about pregnancies that require special care, like multiple pregnancy, hypertension, heart or kidney problems and diabetes. In some countries, the pregnant women get vaccine of tetanic toxoid, to avoid the neonatal tetanos. Between the 26th and 28th week of pregnancy, a check for the presence of Streptococcus B is made. If these bacteria are present in the thick intestine, they can infect the child during birth.
The mother must inform the doctors about all her medical history and to ask them all that she feels it's necessary. There are emergency situations for a pregnant woman: vaginal haemorrhage, sudden inflammation of the face, strong and continuous aches of the head or fingers, sudden sensation of decreased or foggy vision, strong abdominal pains, persistent vomits, shivering or fever, changes in the fetal movements frequency or intensity, liquid loss through vagina, pain during the urination or incomplete discharge of urine.
5.Alcohol and drugs. The consumption of alcohol and drugs (including tobacco) increase the risk for the baby to be born mentally retarded, with physical anomalies and even behavioral changes. There are cases of drug-addicted mothers that gave birth to children with syndromes of withdraw. Even if some believe that a cup of wine from time to time does not harm the child, doctors recommend total abstinence during pregnancy. Future mothers also must be careful not to inhale "second hand smoke" (not to be passive smokers).
6.Medicines. No drug should be taken if there is not any recipe indicating it and a medic assessing the risks. Even some vitamin supplements can harm. E.g., an excess of vitamin A can induce fetal malformations.
7.Weight gain. The pregnant woman must avoid taking extreme measures. A newborn with a low weight has a 40 times higher risk of dying than a newborn of average weight. On the other hand, eating for two just fuels the obesity. The normal weight, better perceived starting with the second trimester, points that the pregnant woman is eating the right quantity for satisfying the increased necessities of her organism.
A good weight increase is of 9-12 kg (22-30 pounds) at the end of the pregnancy. Still, teenage mothers and low-weight mothers should increase weight by 12-15 kg (30-38 pounds), while overweight mothers should increase weight just by 7-9 kg (18-22 pounds).
8.Hygiene and other details. The pregnant woman can bath or take a shower without any problem, but vaginal showers are not recommended. Contact with persons suffering from viral infections, like smallpox, should be avoided. To avoid toxoplasmosis, contact with not well-cooked meat and cat excrements should be avoided. Basic hygiene rules are essential, like hand or raw food washing. Sexual relations are not a problem, except in the last weeks of the pregnancy, in case of vaginal haemorrhage, contractions or previous abort.
9.Pregnant women must avoid excessive exposure to X-rays, toxic chemicals and environmental risk factors. The use of aerosols and other domestic chemicals should be limited. Extremely high temperature and exercising should be avoided, (they heat the woman's body), also too much time on foot and extreme efforts. The security belt should be fixed loose.
10.The pregnant woman should decide before if she gives birth at home or at the hospital, through normal birth or caesarean section. She must also know, to a certain point, how she will be helped by the medic or midwife. Once informed, the woman must choose aspects of the birth, like posture, episiotomia, forceps, analgesics and the electronic fetal monitoring. If the birth becomes complicated in the house, the woman must know to which hospital or clinic she will go, or concrete measures to be taken in case of excessive bleeding. As many women giving birth die because of the haemorrhage, blood supply must be available.