Pregnancy
week by week -
Week 21,
Must-ask
Questions this
Week (Week 21)
Is it
safe to fly during
pregnancy?
Not every mom
to be should necessarily
make plans to
fly during pregnancy.
Your doctor is
likely to dissuade
you from traveling
if you are at
risk for preterm
delivery, you
have poorly controlled
diabetes or you
have been diagnosed
with placental
problems. Lack
of oxygen should
be least of your
worries; commercial
flights are fully
pressurized in
that the air within
the cabin has
more oxygen than
the air outside.
It is not the
same with smaller
planes though.
Some health and
safety tips you
should keep in
mind:
• Avoid
flying during
the last month
of pregnancy when
the risk of labor
is highest (even
airlines may not
permit you to
fly with or without
doctor's certificate)
• Don't
travel to areas
where proper medical
care is not available
• Ensure
that your immunizations
are up-to-date.
Talk to your doctor
if they are not
• Keep your
options open.
Problems may arise
at any point of
pregnancy so it
is best to take
out cancellation
insurance on any
airplane tickets
just in case you
are unable to
make the trip
• Cancel
your trip if you
are experiencing
cramping or bleeding
unless your doctor
is aware of your
symptoms and has
given you the
permission to
travel anyway
• Carry
a copy of your
medical records
with you and keep
your doctor's
name and number
handy
• Make sure
your health insurance
is valid to cover
your baby as well
should you give
birth unexpectedly
• Wear support
stockings to prevent
any fluid build
up in your legs
and make a point
of getting up
and moving around
to help decrease
the amount of
swelling in your
ankles and feet.
Moving around
will also prevent
clots
• Get up
and walk around
at least once
an hour, if flying
conditions allow
it to prevent
clots and reduce
the chances of
swelling in your
legs and feet
Are safety
checks safe at
the airport?
That is one travel-related
worry you can
strike off your
list right away;
the metal detectors
won't pose any
risk to you or
your baby.
What are
the keys to staying
comfortable when
flying?
It can be quite
challenging to
try and stay comfortable
if your find yourself
packed into an
airline seat like
a pregnant sardine.
Some tips to help
you cope with
travel:
• Try to
book an aisle
seat so that you
can stretch your
legs and make
those trips to
the washroom more
easily
• Try to
book a seat near
the front of the
aircraft to enjoy
a smoother ride
• Drink
plenty of fluids
to avoid dehydration
• Carry
a healthy snack
with you so you
won't have to
go hungry or rely
on the airline
for nourishment
if your flight
is unexpectedly
delayed or if
you get hungry
in between
Are seat
belts a must when
traveling by car?
Seat belts provide
important protection
to you and your
baby. It is not
enough to rely
on an airbag for
protection. Airbags
work with seatbelts,
not replace them.
A pregnant woman
who is not wearing
a seatbelt can
be thrown into
a rapidly opening
air bag, something
that can be harmful
or even fatal
to mother and
baby. Some tips
on buckling up
safely:
• Make sure
that the shoulder
belt is positioned
between your breasts
and away from
your neck. Don't
place the shoulder
belt behind your
back or under
your arm
• Make sure
the lap belt is
snugly positioned
across your hips
and pelvis, below
your belly. If
the belt is too
loose or too high,
you can risk broken
ribs or injuries
to your belly.
Do not assume
that seat belt
is not necessary;
if you can sustain
such injuries
with a belt on,
imagine how hard
you would hit
the dashboard
or the steering
wheel if you were
not wearing the
belt
• Try to
keep your seat
at least 10 inches
back from the
dashboard
Some
Basic Pointers
(Week 21)
Meconium
It refers to undigested
debris from swallowed
amniotic fluid
in the fetal digestive
system. Meconium
is made mostly
of mucosal cells
from the lining
of the baby's
gastrointestinal
tract. It is bacteria-free
and so it is sterile.
It is greenish
black to light
brown in color
that your baby
passes from its
bowels before
delivery, during
labor or after
birth. Passage
of meconium into
the amniotic fluid
may be caused
by distress in
the fetus. Meconium
during labor is
a sign of fetal
distress. If a
baby has had a
bowel movement
before birth and
meconium is present
in the amniotic
fluid the fetus
may swallow the
fluid or inhale
it into its lungs;
baby could develop
pneumonia or pneumonitis
from this action.
For this reason
if meconium is
seen at delivery
an attempt is
made to remove
it from baby's
mouth and throat
with a small suction
tube.
Varicose
veins
Varicose veins
occur to some
degree during
pregnancy; pregnancy,
increased age
and pressure caused
by standing for
long periods of
time usually worsen
the condition.
Varicose veins
are blood vessels
engorged with
blood. They occur
mostly in legs
but can also be
found in the vulva
and rectum. The
change in blood
flow and the pressure
from the uterus
make varices worse,
causing discomfort.
They become move
obvious and painful
as pregnancy advances.
With increasing
weight and continuous
standing, the
situation may
worsen. Symptoms
vary; for some
a blemish or purple
blue spot on the
legs with little
or no discomfort,
except at the
end of the day.
Other women with
bulging veins
will require elevation
in the evenings.
Following pregnancy,
swelling should
subside but they
won't disappear
completely. Various
methods including
laser treatment,
surgery can get
rid of these veins.
The procedure
is called vein
stripping, which
should be done
after and not
during your pregnancy.
Following measures
may help keep
veins from swelling
much:
• Use medical
support hose -
get your doctor
to recommend you
something appropriate
• Wear clothing
that does not
restrict circulation
at the knee and
groin areas
• Spend
as little time
on your fee as
you can. Lie on
your sides or
keep feet elevated
when possible
- this enables
veins to drain
easily
• Wear flat
shoes
• Don't
cross your legs;
this cuts off
circulation, and
worsen the problem
• High impact
exercises such
as step aerobics
or jogging can
traumatize the
veins. Low impact
exercises such
as biking, prenatal
yoga may be a
better choice
Blood Clots in
Legs
Swelling in your
legs and feet
is common, especially
when the day is
over. A serious
complication is
a blood clot of
the legs or groin.
Symptoms are swelling
of the legs accompanied
by leg pain and
redness or warmth
in the affected
area. This problem
has many names
including venous
thrombosis, thromboembolic
disease and lower
deep vein thrombosis
(DVT). It may
happen at other
times as well
but pregnancy
is a time when
it is more rampant.
This is due to
the weight of
the uterus and
changes in the
blood and its
clotting mechanisms.
The decrease in
blood flow is
called stasis.
If you had a clot
before in your
legs or anywhere
else, inform your
doctor on this
vital information.
There is a difference
between DVT and
superficial thrombosis.
The latter is
often at the surface
of the skin and
can be felt on
the surface; it
is treatable with
a mild pain reliever,
elevation of leg,
support stockings
and heat. If condition
does not improve
DVT must be considered.
This is a more
serious condition;
it requires diagnostic
procedure and
treatment.
Symptoms can differ
depending on the
location and severity.
The onset can
be rapid with
severe pain and
swelling of the
leg and thigh.
Inform your doctor
early on in pregnancy
about previous
clots. The greatest
danger is pulmonary
embolism in which
the clot breaks
off and travels
from the legs
to the lungs.
It is a rare problem
and although it
is serious it
is preventable.
The leg may occasionally
appear pale and
cool but the affected
portion is tender,
hot and swollen.
Often the skin
is red; squeezing
the leg or calf
area is painful
and walking only
aggravates the
pain. One way
to tell if you
have this problem
is to lie down
and flex your
toes toward your
knee. If you feel
tenderness at
the back of the
leg, then it is
an indication
that you have
this problem.
Check with your
doctor if this
occurs. In the
non-pregnant woman
diagnosing the
problem can be
done via an X-ray
accompanied by
an injection with
dye into leg veins
to detect the
clots. This test
is not usually
performed on a
pregnant woman
because of exposure
to radiation and
dye; ultrasound
is used instead.
Treatment involved
hospitalization
and heparin therapy,
where heparin
a blood thinner
is administered
intravenously.
It can be taken
in the form of
a pill. It is
safe during pregnancy
and is not passed
on to the baby.
Extra calcium
must be taken
if heparin is
given. Mother
must be in bed
with the leg elevated
and heat applied.
Mild pain reliever
is given. Recovery
including hospitalization
ranges from 7-10
days. Heparin
is given after
this until delivery;
following pregnancy
she may have to
continue with
the therapy depending
on the severity
of the clot. If
a woman has clot
problems in one
pregnancy, it
is likely that
she will need
therapy in subsequent
pregnancies. Heparin
can be given through
daily self-administered
injections or
in-dwelling IV
catheter under
doctor's advice.
There is an alternative
treatment, but
that is not advisable
as it passes through
the placenta and
can be harmful
to the baby. This
oral medication
can be given post
pregnancy to prevent
blood clots for
weeks to months
depending on the
severity.
Your
Nutrition (Week
21)
Some women experience
cravings during
pregnancy. Food
cravings have
long been considered
a nonspecific
sign of pregnancy.
Cravings can be
good and bad.
If the food you
crave is nutritious
and healthful,
eat it in moderation.
If you crave for
foods high in
fat and sugar
or loaded with
empty calories,
watch out! Indulge
a little but don't
let yourself go.
Try substituting
with something
more nourishing
such as a fruit
or low-cal flavored
yoghurt instead
of giving in to
your whim. Hormonal
and emotional
changes are responsible
for cravings.
On the reverse
side of the coin
is food aversion.
Some foods that
you used to enjoy
before becoming
pregnant now make
you sick in the
stomach. This
is common. Again,
hormones are to
be blamed; hormones
affect the gastrointestinal
tract which can
affect your reaction
to some foods.
What foods do
pregnant women
crave? Recent
research indicates
the top three
cravings as below:
| Chocolate
33% |
| Sweets
of some
sort 20% |
| Citrus
fruits and
juices 19% |
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