Healthy Beginnings

The Society of Obstetricians and Gynecologists of Canada (SOGC), is one of Canada's oldest national specialty organizations. Established in 1944, the Society's mission is to promote excellence in the practice of obstetrics and gynaecology and to advance the health of women through leadership, advocacy, collaboration, and education. The SOGC has over 3,500 members, comprised of obstetricians, gynaecologists, family physicians, nurses, midwives, and allied health professionals working in the field of sexual reproductive health. A leading authority on reproductive health care, the SOGC produces national clinical guidelines for both public and medical education on important women’s health issues.

Acknowledgements vii

Foreword ix

About the SOGC and the authors x

Chapter One Planning a healthy pregnancy 1

It all begins with an egg 3

How your body supports new life 4

Visit your health care provider before you get pregnant 5

Learn about pregnancy 6

Pregnancy and the environment 8

Your medical history 10

Are you at your healthy weight? 10

Medicines and pregnancy 12

Immunizations and infections 13

Lifestyle and sexual history 13

If you have been pregnant before 14

Keep track of your monthly cycle 15

What if I am using the “pill,” the “patch,” or the “ring”? 16

What about other forms of birth control? 16

Let’s talk about nutrition 17

Guidelines from Health Canada 22

Foods to limit or avoid during pregnancy 23

Other important nutrients 25

Nutrition tracking 32

Vegetarian diets 33

Exercise 33

Workplace 34

Smoking 34

Alcohol 36

Cannabis 37

Other drugs 38

My pregnancy journal 39

Chapter Two Off to a great start: the first trimester 41

Your changing body 43

Your growing baby 44

Choosing a health care provider 44

How often should I expect to visit my health care provider? 45

Your first prenatal visit 46

About weight gain 46

About vitamin supplements 48

Discussing your pregnancy 49

Our heritage and our health 50

You are expecting twins . . . or more! 51

Prenatal classes and preparing for birth 51

Travel during pregnancy 52

Sex during pregnancy 54

Exercise during pregnancy 55

Rules to follow when you exercise 57

Kegel exercises strengthen your core and pelvic floor muscles 59

What are these tests for? 59

Genetic screening 61

Tests that check your baby’s health before birth 62

Infectious diseases to be aware of in pregnancy 67

About dental health 71

Common discomforts in early pregnancy 71

Diabetes 76

Your emotions during pregnancy 78

Abuse during pregnancy 80

Miscarriages do happen 82

My pregnancy journal 84

Chapter Three Gentle growth: the second trimester 87

Your changing body 89

Your growing baby 90

About fetal movement 91

Weight gain during the second trimester 91

About work 91

Common discomforts during the second trimester 92

When there are complications in the second trimester 96

Preterm labour 99

Labour and checking for preterm labour 102

Preterm babies 102

My pregnancy journal 104

Chapter Four The home stretch: the third trimester 107

Your changing body 109

Your growing baby 110

Your prenatal care 110

When there are complications in the third trimester 112

What to expect during labour and birth 114

Writing your birth plan 116

Common things included in a birth plan 117

Feeding your baby 124

Breastfeeding—the natural and healthy way to feed your baby 126

Breastfeeding myths—true and false 127

My pregnancy journal 131

My pregnancy journal 132

Chapter Five Getting ready for baby’s birth 135

Your changing body 136

Your baby at full term 137

Common discomforts in late pregnancy 138

Overdue babies 139

My pregnancy journal 142

Chapter Six Your time is here 145

When labour begins 146

The importance of labour support 148

The stages of labour 150

The first stage of labour 150

Medication-free ways to make labour easier 153

Special Breathing 153

Body positions during labour and birth 158

Hydrotherapy 159

Using your voice during labour 160

Transcutaneous electric nerve stimulation (TENS) 160

Using medication for pain relief 161

The second stage of labour 162

Making room for the birth 164

The third stage of labour 165

After the birth 166

The fourth stage of labour 167

Bonding with your baby 167

Apgar score 168

Medical help during labour and birth 169

Postpartum hemorrhage 174

How long will you stay in hospital or birthing centre? 174

If things do not happen as you planned . . . 176

Saying goodbye to a baby 177

My baby’s journal 179

Chapter Seven Taking care of yourself 181

Your changing body after the birth 182

The baby blues 183

Normal vaginal discharge 184

Having sex again 185

Common discomforts after giving birth 186

Your body shape after pregnancy 189

Menstrual periods 190

Birth control choices 190

If you have completed your family—sterilization 194

My personal journal 195

Chapter Eight Taking care of your newborn 197

First impressions of your baby 198

How to handle your baby safely 199

What to expect at your baby’s first check-up 204

Getting your baby immunized 205

Vaccination questions and answers 207

Jaundice (yellowish skin and eyes) 207

Circumcision 209

Newborn care 211

Sleeping in a safe environment 218

Feeding your baby 219

Breastfeeding 220

Breastfeeding positions 222

How to get started 224

Breastfeeding tips 226

Expressing breast milk 227

Common breastfeeding problems 228

Spitting up (reflux) 232

Why babies cry 233

What about soothers (pacifiers)? 236

Parenting classes 237

Chapter Nine Finding help 239

Key resources and services 240

Other reading 249

Labour action list 251

Index 255