Pregnancy is a miraculous event which has supported the birth of new life on earth for all mankind for well over 200,000 years.
In 2020, a total of 1 003 307 births were registered in South Africa from a total population of 60 000 000 people and while birth fatalities decrease year on year, unfortunately some mothers will experience complications during their pregnancy which can put both them and their unborn baby at risk.
While more common pregnancy issues such as high blood pressure, urinary tract infections, obesity and leg cramps are frequently discussed, some of the unspoken complications which can arise need to be highlighted so as to reduce the number of fatalities and promote a healthier pregnancy into safe and joyous new motherhood.
Important Pregnancy Facts to Know:
Knowing what to expect during your full pregnancy term is essential for managing both your own and your baby’s health. Early pregnancy checkups and correct prenatal care goes a long way to identify any issues you may not be aware of and support you in experiencing a healthy pregnancy and birth. This is especially true for pregnancies termed ‘high risk’, which encompasses women aged 17 or younger, women aged 35 or older, those who are under or overweight prior to pregnancy, or mothers carrying more than one fetus.
Your first trimester of pregnancy may be both exciting and challenging as you experience your body changing. You will become more easily fatigued and your breasts will become tender and swollen. You may experience food cravings, heartburn, nausea and/or vomiting, often referred to as ‘morning sickness’, and constipation.
It is important during this time to avoid smoking and e-cigarettes, alcohol, raw or undercooked meat and eggs, unpasteurised dairy, raw sprouts, certain seafoods and too much caffeine.
The danger signs during pregnancy we should be alert to are fast or difficult breathing, severe abdominal pain, fever and extreme fatigue, severe headaches with blurred vision, convulsions, and vaginal bleeding.
Bleeding in Pregnancy
In the first few weeks of your pregnancy you might experience light bleeding or ‘spotting’ caused by the developing embryo planting itself in the wall of your womb. This usually occurs around the time your period would have been due and between 6-12 days after conception. Typically light, and called ‘implantation bleeding’, it commonly occurs over a few days and is not something to be concerned about.
The main sign of a miscarriage is vaginal bleeding however and if it lasts longer than a few hours, and is accompanied by abdominal pain, cramping, fever, chills or contractions, contact your doctor or gynecologist immediately.
Most miscarriages occur before the 12th week of pregnancy and are accompanied by bleeding, discharge, pain or cramping in your abdomen or lower back. Bleeding during miscarriage can appear brown and resemble coffee grounds or it can be pink to bright red, getting heavier over time.
Eventually the pregnancy tissue, fetus, and placenta will pass naturally either over a few days or as long as 4 weeks.
Be gentle with yourself if this is your experience. Take time to acknowledge your loss and find support with other women to talk about your feelings. On the other hand, if you know of a new mom who has recently miscarried, avoid any clichéd comments and unsolicited advice and recognise that grief doesn’t have a time limit.
The good news is that miscarriage is usually a one-time occurrence with most women who miscarry go on to enjoy a healthy pregnancy if they fall pregnant again.
Hyperemesis Gravidarum
Considered a ‘high risk’ pregnancy, Hyperemesis Gravidarum (HG) came into the media spotlight when Kate Middleton, the Duchess of Cambridge spoke about her experience, which caused severe and debilitating vomiting during all three of her pregnancies to Prince George, Princess Charlotte and Prince Louis.
Characterised by extreme, persistent nausea and vomiting throughout pregnancy, hyperemesis gravidarum has been shown to increase the risk of preeclampsia, stillbirth, and preterm delivery.
Worldwide, between 0.3-11 per cent pregnant women experience hyperemesis gravidarum (HG) which is said to be caused by rapidly rising serum levels of hormones such as HCG (human chorionic gonadotropin) and estrogen.
HG can make you feel very unwell and may cause you to lose weight with symptoms starting around the four-to-six-week mark. Along with avoiding high fat foods, Kate Middleton used mindfulness and meditation to manage her symptoms and the simplest coping tactics rely on keeping hydrated, discovering which foods will stay down and spending lots of time resting.
The good news is that women with HG have lower rates of miscarriage, said to be due to the increased levels of pregnancy hormone HCG.
Ectopic Pregnancy
An ectopic pregnancy occurs when a fertilised egg is unable to reach the uterus and attach properly to the lining of the womb, instead implanting itself either within the fallopian tube which carries the egg from the ovaries to the uterus or in other parts of the body.
An ectopic pregnancy cannot proceed normally and the fertilised egg will not survive outside of the uterus; the growing tissue may also cause life-threatening bleeding, if left untreated.
An ectopic pregnancy may seem normal in the beginning however it is usually accompanied by symptoms such as tummy pain on one side, vaginal bleeding or watery discharge, pain in the tip of your shoulder and discomfort when using the bathroom with risk of rupturing around 6-16 weeks.
In most cases medical intervention is necessary with blood tests and ultrasound confirming the diagnoses. Treatment is administered either via a surgical procedure or with medication.
Depression in Pregnancy
Anxiety and depression are the two most common psychological illnesses that may arise during pregnancy, and while it is normal to feel emotional during pregnancy due to the natural rise in our body’s hormone levels, some mothers are sensitive to these hormonal shifts which can lead to the onset of anxiety and depression.
Perinatal depression occurs both during and after pregnancy and if left untreated can put you at risk of prematurity and low birth weight for your baby and its future development. This is because studies suggest that stress in the womb can affect a baby’s temperament and brain development. It can also interfere with your own ability to look after yourself during your pregnancy or bond naturally with your newborn following birth.
Symptoms can range from mild to severe, but they can be treated. Look out for signs such as:
- Having recurrent thoughts of death or suicide.
- Having a depressed mood throughout the day for longer than 14 days
- Feelings of guilt, hopelessness or worthlessness.
- Difficulty thinking, concentrating or making decisions.
- Loss of pleasure or interest in usual activities throughout the day, sleeplessness and loss of appetite for longer than 14 days.
If you feel stuck in emotions of sadness or irritability, talk to a medical professional who can support you through these feelings and assess the correct treatment, if necessary, for you.
For women with a psychological diagnosis who are considering falling pregnant, or already are pregnant, there are many treatment options available from your medical practitioner that are safe for pregnant women.
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