Healthy Pregnancy... Healthy Baby

Healthy Pregnancy... Healthy Baby
Healthy Pregnancy... Healthy Baby
Healthy Pregnancy... Healthy Baby
A NEW LIFE
Healthy Pregnancy—Healthy Baby: A New Life was adapted, translated into French and reproduced by the
New Brunswick Department of Health with permission from the Nova Scotia Department of Health
Certain terms, agency names, and governmental procedures have been changed to reflect New Brunswick
policy and practice.
© Crown Copyright, Province of Nova Scotia 2002
Writing: Janis Wood Catano, Grace M. Beazley. Graphic Design: Karen Brown. Illustration: Bonnie Ross.
Printed 2006. Second edition 2008. Third edition 2010. Forth edition 2012.
Many Public Health nurses and nutritionists in the province of New Brunswick have helped in reviewing and
revising the information in Healthy Pregnancy...Healthy Baby: A New Life. Their commitment to the families who
will use this resource has been evident throughout the process and is very much appreciated. Without these
dedicated individuals, this manual would not have become a reality. Thanks are also given to the Public Health
professionals who worked on earlier versions.
As well, we acknowledge the CPHA - Plain Languages Services for their text revision.
Canadian Cataloguing in Publication Data
Main entry under title
A New Life
ISBN 1-55236-448-8 (Parents Guide)
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Also available at www.gnb.ca, keyword – health
É A U CA
Congratulations on your pregnancy!
This is a time of joy and promise. It’s the start of a new life for you, your baby and
your family.
It may also be a time when you have questions and worry.
There are many things you need to know as you live through the coming months.
You won’t find everything you need to know in this book. We suggest you take
prenatal classes and that you read books and magazines. Your library and the
Internet are good places to learn more. In fact, there is so much information around
that you might feel that it’s too much!
Remember that your pregnancy is special and personal. No two pregnancies are the
same. What happens to you will be different from what you read about and different
from what may have happened to your mother, sister or friends. Take time to think
about what you read and hear. Most of the time, your own common sense will be a
good guide. Take your questions to your prenatal class, doctor or public health nurse.
Above all, have fun! Enjoy the changes in your body and your growing baby.
A New Life is also an on-line prenatal program that includes eight learning modules
intended for the mother to be, her partner and her family.
Web Site: http://anewprenatallife.ca
CONTENTS
A Healthy Start
A Healthy Start . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Visiting Your Doctor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What to Expect on Your First Prenatal Visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What is Normal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
3
4
5
Healthy Choices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Eating for Two . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Take Care of Your Teeth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
No Smoking, Baby Growing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alcohol and Pregnancy Do Not Mix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taking Medicines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Using “Street” Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Drugs and Danger to Your Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Caffeine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Infection and Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dangers Around You . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Working When You Are Pregnant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
6
6
7
9
10
10
11
13
14
14
15
16
Share Your Feelings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Talk It Over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sexuality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Take Time for Yourself . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
17
18
19
Buying for Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Car Seats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Baby Furniture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
20
21
Nine Months of Changes
Nine Months of Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
First Trimester: Months 1, 2, 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Second Trimester: Months 4, 5, 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Third Trimester: Months 7, 8, 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25
26
26
28
Relief from Common Aches and Pains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Backache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breast Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cramps in Your Legs and Feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30
30
31
32
33
Feeling Tired (Fatigue) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Flatulence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Frequent Urination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Groin Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Heartburn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hemorrhoids (Piles) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Insomnia (Trouble Sleeping) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Morning Sickness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Shortness of Breath . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Swelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Wetness in Your Vagina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Varicose Veins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Becoming a Father
Becoming a Father . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Father During Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The New Father . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deciding to Breastfeed
34
35
35
36
37
38
39
40
41
42
42
43
44
47
49
50
The Best for You and Your Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breastfeeding Is Best for Babies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breastfeeding Is Good for Mothers and Families . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Common Myths and Concerns about Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
53
54
55
57
Getting Ready to Breastfeed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Breast and How it Works . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Changes in Your Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Setting Goals for Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Support for Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Buying Nursing Bras and Nightwear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
60
60
61
62
63
65
Breastfeeding in the Hospital – Plan Ahead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Questions to Ask before Labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Goals for Breastfeeding in the Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
67
67
68
Your Decision to Breastfeed Your Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
70
Healthy Eating
Healthy Eating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Weight Gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gaining Weight Slowly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
73
73
74
What You Need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Regular Meals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Four Food Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Vegetables and Fruit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Grain Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Milk and Alternatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Meat and Alternatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Extra Calcium, Vitamin D, Folic Acid, and Iron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Calcium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Iron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Folic Acid … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Higher Fiber Foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Oils and Fats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Vegetarian Eating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
75
75
76
76
77
78
78
79
79
80
81
82
84
84
84
What You Do Not Need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Caffeine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Artificial Sweeteners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
“Other” Foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
85
85
86
86
Getting the Foods You Need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loving and Hating Food When You Are Pregnant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Vitamin Pills and Supplements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Check Your Eating Habits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
87
88
95
96
97
After the Baby Comes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Losing Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Choosing a Healthy Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Body Mass Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Making Healthy Food Choices to Help You Lose Weight . . . . . . . . . . . . . . . . . . . . . . . . . . .
98
99
99
100
102
Make Healthy Eating A Habit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
104
Healthy Activity
Active Living and Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
107
Comfort Every Day. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Stand Tall: Posture during Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Getting Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
108
108
110
112
Safe and Comfortable Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Safe and Unsafe Activities During Pregnancy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How to Stay Comfortable When You Are Active . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
113
113
114
Program for an Active Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Staying Safe and Active . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Warm-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Stretch and Strengthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cool-Down . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Prenatal Activity Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exercises to Avoid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
115
115
117
119
124
125
126
Active Living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Guidelines for Healthy Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Walking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
127
127
128
Learning to Relax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finding Positions to Help You Relax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Relaxing Step by Step. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
130
130
131
After the Baby Comes: A Postnatal Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Postnatal Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
After a Cesarean Birth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taking Care of Your Back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
133
134
134
135
Healthy Birthing
Thinking About Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A Message for Birth Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Planning for Your Baby’s Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
139
139
140
How Can I Prepare for Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What Happens during Labour and Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learning to Relax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Positions for Labour and Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Positions for First Stage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Positions for Second Stage – Pushing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Massage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Finding Ways to be Comfortable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Comfort for Back Labour. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breathing for Labour and Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Slow Deep Breathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Faster, Shallow Breathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Panting-and-Blowing Breath . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breathing to Help You Avoid Pushing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breathing While Pushing .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Practicing for Labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
141
141
143
143
144
145
146
147
148
149
149
150
151
152
152
153
Questions about Medical Help during Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What If I Am Still Pregnant After My Due Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What Is Fetal Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What about Pain Relief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Why Would I Need an Episiotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Why Would I Need Forceps or Vacuum Extraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What If I Need a Cesarean . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
155
155
156
157
159
159
160
Time to Get Ready . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pack Your Suitcase Before You Need It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How Will I Know When I’m In Labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
When Should I Go to the Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
161
161
163
164
Your Guide to Labour and Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
First Stage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Early Labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Active Labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Transition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Second Stage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pushing and Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Delivery of Placenta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
165
166
166
168
170
172
172
174
Early Care for Mother and Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mother Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breast Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Baby Blues (Postpartum blues) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Postpartum Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Helping Your Body Feel Comfortable After Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
After a Cesarean Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Vaginal Birth After a Cesarean (VBAC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exercises You Can Do After Child Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exercises You Can Do After a Cesarean Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Baby Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How Your Baby Looks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What Your Baby Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taking Care of Your Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If Your Baby Has Jaundice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Registering Your Baby’s Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Healthy Family
175
175
176
177
177
178
179
181
182
183
184
185
186
187
187
188
Your First Weeks at Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
191
What’s Normal for a Newborn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How Can I Help My Baby Develop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
192
193
Caring for Your Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How Should I Feed My Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Commercial Infant Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Do I Need to Give My Baby Vitamins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Do I Need to Give My Baby Flouride . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How Much Do Babies Sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Why Do Some Babies Have Flat Spots On Their Heads . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Why Is My Baby Crying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What Is Colic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How Do I Give My Baby a Bath . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Can I Prevent Cradle Cap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How Do I Take Care of My Baby’s Cord . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bowel Movements (BMs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Can I Prevent Diaper Rash … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How Many Wet Diapers Can I Expect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
When Do I Take the Baby for Check-Ups and Shots . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
194
194
194
197
197
197
198
199
200
202
203
204
204
205
206
206
207
Keeping Your Baby Safe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Childproofing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Safe Car Seats and Baby Furniture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Preventing Allergies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
208
208
209
209
Buying for Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Clothing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Diapers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bedding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Toys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
210
210
211
211
212
Being a Healthy Mother . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accepting Motherhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Your Body after Childbirth (postpartum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Feeling Tired . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Baby Blues and Postpartum Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What Is Postpartum Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Getting Fit Again . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Going Back to Work/School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Single Parents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
213
213
214
215
217
217
220
220
221
Sex and Birth Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Being a Couple . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Thinking About Birth Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Birth Control Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breastfeeding (LAM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Condom: Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Condom: Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Depo-Provera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Diaphragm or Cervical Cap. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Spermicides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Natural Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Pill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sponge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tubal Ligation (Female Sterilization) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Vasectomy (Male Sterilization) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Withdrawal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
When Accidents Happen (Emergency Contraceptive Pills) . . . . . . . . . . . . . . . . . . . . . . . . . . .
222
222
223
223
224
225
226
227
228
230
231
231
232
234
235
236
237
237
Family and Friends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fathers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Brothers and Sisters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Grandparents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
238
238
239
241
Looking Ahead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
242
A Healthy Start
A Healthy Start
A Healthy Start
Prenatal care is part of a healthy pregnancy.
Good prenatal care includes regular visits to your doctor. You should also
attend prenatal classes. Talk with your public health nurse, hospital, or doctor
to find out how to register for classes.
During your pregnancy, you should feel comfortable asking questions, and you
should feel comfortable with the answers you get.
Your family doctor is a good choice for your prenatal care. If you don’t have
a family doctor, ask friends and family about their doctors.
But don’t wait too long. Early prenatal care and prenatal classes are very
important. If you have good prenatal care, you are more likely to have a healthy
baby.
M
aybe you have already had your first prenatal visit. If not, make an
appointment soon. What you can expect at your first prenatal visit is described
on page 4.
Visiting Your
Doctor
After this, your visits will likely be shorter. The doctor will check your weight,
blood pressure and urine (pee). The doctor will measure the height of your
uterus to see how the baby is growing and will listen to your baby’s heartbeat.
All of these tests show you how healthy you are and measure your baby’s
growth.
Each visit should also include time for you to ask questions. It is a good idea
to take a list of questions with you.
Besides the tests that all women have on their first prenatal visit, your doctor
may order other prenatal tests, such as ultrasound, amniocentesis, or nonstress testing. If your doctor wants you to have any of these tests, be sure
you understand the reason. Continue to ask questions until you are sure you
understand.
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Healthy Pregnancy... Healthy Baby
Questions to ask your doctor:
q What is the test?
q Why do I need it?
q What is the doctor looking for?
q What effects will the test have on me and my baby?
q What will happen if the test results are not normal?
What To Expect On Your First Prenatal Visit
• Your doctor will ask a lot of questions to obtain your medical history.
• You will have a complete physical exam.
• You will have an internal (pelvic) exam.
• The doctor will take samples from inside your vagina to test for cancer and
infection.
• You will need to pee in a bottle (urine test).
• Your blood pressure will be checked.
• You will need to go to a lab or hospital for blood tests. Your doctor will tell
you about the tests you will need.
• Your doctor will need to know if you have had a vaccination for German
measles (Rubella).
• Your doctor will ask you questions about HIV (Human Immunodeficiency
Virus). You may want to have a blood test to see if you are HIV-positive.
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A Healthy Start
How can you know what is normal?
During pregnancy, your body goes through many changes. Most of them are
normal and healthy. They are the kind of things you should talk about with
your doctor or nurse during your visits.
What is
Normal?
But when all that is happening is new, it can be hard to tell what is normal and
what is not.
IMPORTANT
There are some things that you will need to call
your doctor about right away.
• Bleeding from your vagina—even if it’s just a little bit of blood (spotting)
• Pain in your abdomen—more than gas pains
• Fluid coming out of or leaking from your vagina (water breaking)
• Sudden swelling of your hands, feet, or face—swelling that is different
or worse than any you may already have
• Sudden weight gain
• A rash or unusual lesions on your skin
• A bad headache
• Seeing spots, flashes, or blind spots
• Blurred vision
• Feeling dizzy or lightheaded
• Fainting
• Pain or a burning feeling when you pee (urinate)
• Chills or fever
• Throwing up and feeling sick (nausea or vomiting) that is more than
morning sickness
• Fewer baby movements later in pregnancy. You’ll know if there’s a
change as your baby grows.
• Exposure to rubella, hepatitis, or sexually transmitted infections
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Healthy Pregnancy... Healthy Baby
Healthy Choices
When you are pregnant, there are many things to think about and many
choices to make. Should you change what you eat? Should you travel? Is it safe
to take drugs? This section will give you a chance to think about some of these
questions.
Eating for Two
When you eat, you are feeding your baby. The food you eat should supply your
baby with everything he or she needs to grow. The food you eat is important
for your health and your baby’s health.
Pregnancy is not a time to diet. It is normal, and healthy to gain weight when
you are pregnant. Ask your health care provider how much weight you should
gain during your pregnancy.
As your body gets used to being pregnant, you may find that you feel hungry all
the time. If you are hungry, eat. But eat something that’s healthy for you and
for your baby. Celery and carrot sticks, fresh fruit, fruit juice, whole grain toast,
and bran muffins are all healthy snacks.
See Section 5 - Healthy Eating, to learn more about healthy foods for a healthy
pregnancy.
Take Care of
Your Teeth
Y
ou may have heard that you will lose one tooth for every baby. This is not
true. You don’t lose teeth because you are pregnant. You lose teeth because
you don’t take care of them.
Dental care is very important during pregnancy. Pregnancy affects all parts of
your body, including your teeth and gums. Plaque forms on your teeth more
quickly during pregnancy. Your gums can be red and sore. They become
infected. Brushing and flossing your teeth regularly is even more important
now.
Make a special effort to see a dentist while you are pregnant. Be sure to tell the
dentist that you are pregnant.
Think about having regular dental care after your baby is born. Your
teeth, and your children’s teeth, are meant to last a lifetime.
6
A Healthy Start
If you smoke, this is the best time to stop. When you smoke, your baby
smokes too. Stop and think what that means before you light up a cigarette.
Even if you don’t smoke yourself, second-hand smoke from the people around
you can harm your baby.
No Smoking,
Baby Growing
Why should you quit now?
Before they are born, babies need a good supply of oxygen and food. They get
both from their mother’s blood. The chemicals in tobacco smoke make the
mother’s blood less able to carry oxygen. If you smoke, your baby gets less food
and less oxygen. Here are some of the problems caused by smoking:
• You are twice as likely to have a miscarriage as a woman who does not
smoke.
• Your baby is much more likely to be born too early.
• Your baby is more likely to be born small, and small babies are more likely
to be sick.
• You may have problems in labour and delivery.
• Your baby is more likely to be stillborn or die within the first weeks of life.
If you smoke after your baby is born, the nicotine and chemicals go into your
breast milk. Some babies are affected by the nicotine. They are difficult to calm
down. Ask your public health nurse or your doctor about how to breastfeed if
you are a smoker.
Second-hand smoke harms babies before and after they are born.
• Smoking around babies is a risk factor for Sudden Infant Death Syndrome
(SIDS).
• Children who live with smokers are more likely to have
breathing problems such as asthma and bronchitis.
• Children who live with smokers also have more colds
and ear and throat infections.
no
smoking
PLEASE
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Healthy Pregnancy... Healthy Baby
What can you do?
The best thing is to stop now. It may seem that stopping right now would make
your life more stressful. But smoking adds stress to your body. It speeds up
your heart and also your baby’s. It raises your blood pressure. If you stop now,
you can prevent most of the bad effects smoking will have on your baby. As
well, after birth your child will not be exposed to cigarette smoke in the house.
If you live with smokers, let them know what their smoking can do to your
baby. Even if they are not ready to quit, you can reduce the amount of smoke
in the house by having some rules.
• Make your home smoke free by asking people to smoke outside.
• Make your car smoke-free. Smoke builds up very quickly in a small, closed
space like a car.
Smoking is an addiction. No one believes that it is easy to stop but millions of
people have done it. When you are pregnant, it is one of the most important
things you can do for your baby. Talk to your doctor before using nicotine
patches or gum.
If you need help to quit or to keep your home and workplace smoke-free,
contact Public Health Services or the Smokers’ Helpline (1-877-513-5333).
8
A Healthy Start
When you drink, your baby drinks too. This could cause your baby to be
born with Fetal Alcohol Syndrome (FAS) or other health problems called Fetal
Alcohol Spectrum Disorder or FASD. A child with FAS or FASD may have
low birth weight and problems with thinking, speaking, hearing, or learning.
These problems do not go away when the child grows up.
Alcohol and
Pregnancy
Do not Mix
IMPORTANT
There is no amount of alcohol that is known to be safe
during pregnancy. There is about the same amount of alcohol in:
• A bottle of beer
• A glass of wine
• A shot of liquor
Each of these affects your baby in exactly the same way.
So the best choice is not to drink at all when you are pregnant.
If you do drink, you should know that no kind of alcohol is safer than another.
If you have been drinking a lot, counselling may help you stop. For your own
sake, and your baby’s, please look for the help you need. Contact Addiction
Services or ask your doctor or public health nurse about programs in your
community.
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Healthy Pregnancy... Healthy Baby
Taking
Medicines
As soon as you know that you are pregnant, talk with your doctor about
the drugs you are using. This includes: all prescription drugs and all of the
medicine you can buy at the drug store, such as aspirin, pain relievers, cough
and cold remedies, and even vitamin pills.
If you go to more than one doctor, make sure that all your doctors know you
are pregnant. Tell all of them about the medicines that you are using.
To be safe, you should not take any drugs unless your doctor says it’s okay.
If you do need to take medication, follow your doctor’s directions.
Any drug you take can reach your baby. So before you take any medicine,
ask your doctor, pharmacist, and even your dentist these questions:
• What is it?
• What is it for?
• What will it do to me and my baby?
• What are the side effects?
• What is the smallest dose I can take?
• Can it wait until after the baby is born?
Using ‘Street’
Drugs
If you take drugs like marijuana, cocaine, heroin or speed (amphetamines) so
does your baby. Any drug you take reaches your baby. Your baby can become
addicted to these drugs. They can harm both you and your baby.
If you use drugs, it may not be easy to stop without help. For your own sake
and your baby’s, please look for the help you need. Contact Addiction Services
or ask your doctor or public health nurse about programs in your community.
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A Healthy Start
Drugs and Danger to Your Baby
Name of Drug
What are the Risks?
Here’s what we suggest:
Alcohol
Baby may have low birth weight,
problems with thinking, speaking,
hearing or learning. The danger is
higher if the mother drinks a lot and
often.
“Safe” level is not known. The
New Brunswick Department
of Health recommends
NO ALCOHOL during
pregnancy. Talk to your doctor
or Addiction services right away if
you need help to stop drinking.
Amphetamines (speed)
Greater risk of miscarriage, early
birth, low birth weight.
DO NOT USE. Talk to your
doctor or Addiction Services right
away if you are a user.
Antacids
May be safe if not used often.
Use only once in awhile. Do not
take more than what is suggested
on the label. Talk to your
pharmacist about which is best
during pregnancy.
Antihistamines (cold
and Allergy medicines)
Not much is known about the
risks of taking these drugs during
pregnancy.
Talk to your doctor before you use
them.
Caffeine
May harm baby if taken in large
amounts.
Caffeine is found in coffee, tea,
chocolate, cola drinks and energy drinks.
Use only small amounts of any
food or drink that has caffeine.
DO NOT USE energy drinks as they
contain larger amounts of caffeine.
Cannabis (Marijuana,
Hashish)
Baby may not grow in a normal way,
may be smaller than should be, may
have problems with addiction or
withdrawal later.
DO NOT USE. Talk to your
doctor or local Addiction Services
about stopping.
Cocaine, Crack
Risk of miscarriage, early birth, baby
may not grow in normal way.
DO NOT USE. Talk to your
doctor or local Addiction Services
right away if you are a user.
Hemorrhoid
preparations
No known risk.
Ask your doctor or pharmacist to
suggest something that will work.
If you need to use a cream for a
long time, ask your doctor if it is
okay to do so.
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Healthy Pregnancy... Healthy Baby
Name of Drug
What are the Risks?
Here’s what we suggest:
Household chemicals,
paints, liquid cleaners,
fertilizers
Breathing the fumes may hurt the
fetus.
Use with caution. Keep the
windows open or use a fan.
Laxatives
Bulk-forming laxatives such as
Metamucil are safe.
Use other types only if your doctor
says it is okay.
Medicine for Nausea
(morning sickness)
These drugs have different risks to
unborn baby.
DO NOT USE unless your
doctor says it is okay.
Opiates such as heroin
and illegal prescription
drugs (e.g., Percocet,
Talwin, Darvon)
Risk of miscarriage, early birth,
difficult birth, baby born with
breathing problems, signs of drug
withdrawal, slow mental and
physical development.
DO NOT USE. Talk to your
doctor or Addiction Services right
away if you are a user.
Note: Using dirty needles (not
sterilized) to take drugs makes the
risk of getting Hepatitis and AIDS/
HIV higher for both mother and
baby.
Pain Killers
• Non-prescription,
containing ASA
(e.g., Aspirin,
Bufferin, Anacin)
or acetaminophen
(e.g., Tylenol, Atasol)
• Non-prescription,
containing codeine
(e.g., 222s, Tylenol
with codeine)
Sleeping Pills
12
• Safe to use once in awhile.
You should only use these once in
awhile. Check with your doctor
before using them often. Do not
take more than is suggested on the
label. Do not use ASA during the
last three months of pregnancy.
Check with your doctor.
• (Probably) safe to use
sometimes.
The risk to the baby depends on
the kind of sleeping pill. If you
use them often, the baby may
have breathing problems at birth.
Baby may suffer from signs of
withdrawal.
Use only if your doctor says it is
okay. You may need your doctor’s
help to stop if you use sleeping
pills often.
A Healthy Start
Name of Drug
What are the Risks?
Here’s what we suggest:
Tobacco
The more you smoke, the more
risk of miscarriage, early birth,
problems in labour and at birth;
small baby, stillbirth and crib
death. Children who have tobacco
smoke in the house have higher
risk of crib death, breathing
problems such as asthma and
bronchitis. They have more colds
and more ear and throat infections.
DO NOT USE. If you need help
to stop, talk to your doctor or
call the Smokers’ Helpline free of
charge at 1-877-513-5333.
Tranquilizers
If used often, the baby may be born
with breathing problems or signs
of withdrawal
Use only if your doctor says it is
okay. You may need your doctor’s
help to stop if you use these drugs
often.
M
any of us use caffeine without knowing it. Did you know that there is
caffeine in coffee, tea, cola drinks, chocolate, and many medicines?
Caffeine
No one really knows what effect caffeine can have on an unborn baby. We do
know that it is a stimulant. It makes people feel jumpy. For this reason alone
it’s a good idea to limit it.
How much is too much? Although we don’t really know, these guidelines will
help keep you within a safe limit.
• Drink no more than one or two cups of coffee or tea each day.
• Read the labels on foods, drinks and medicines. Choose those that have the
least caffeine.
If you love to eat chocolate, try to replace it with healthy snacks like fresh fruit,
yogurt, or an oatmeal cookie. See Section 5- Healthy Eating to learn more
about choosing good foods and avoiding caffeine.
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Healthy Pregnancy... Healthy Baby
Infection
and Illness
It is common sense to stay away from sick people while you’re pregnant.
Try to avoid people who have colds, coughs, sore throats, flu, contagious
diseases, skin rashes, and sexually transmitted infections.
If you do get sick or if you have signs of the flu, make an appointment to see
your doctor.
Remember—don’t take any medicine on your own. If you have a cold or other
mild sickness, get lots of rest, drink plenty of fluids, and use a humidifier.
Tell your doctor if you have been exposed to any serious illness, including
infections that come from having sex.
Travel
Whether you travel depends on how you feel and how long the journey
will be. When in doubt, check with your doctor.
Car Travel
As long as you are comfortable driving, you can continue to do so. Remember
that you still need to wear both the lap belt and the shoulder belt. If it is worn
correctly, the seat belt will not harm your baby. Here are some tips:
• The lap belt should be snug and low over the pelvic bones. Do not buckle it
across your soft stomach area.
• The shoulder belt should be worn across the chest. You can get an extension
for your seat belt if it is too short.
• Common sense is your best guide when you travel by car.
• Try not to take long trips alone.
• If you do go on a long trip, plan to rest every 160 km (100 miles). Get out of
the car and walk around for a few minutes. Allow plenty of time to use the
washroom.
• When you have a choice, drive on major roads that have more traffic. This
will make it easy for you to find places to stop if you need to use a telephone
or washroom.
• Take a small pillow to support your back. This can make a long drive more
comfortable.
• Think about going by train or air instead. You may find them less tiring than
car travel.
14
A Healthy Start
Air Travel
Most airlines need a letter from your doctor if you want to fly during the last
month of pregnancy. To avoid problems, ask about the airline’s rules before
you buy an airline ticket.
When you fly, your feet may swell. Wear loose, comfortable shoes. Walk in the
aisle at least once an hour. Drink plenty of juice and water to prevent fluid loss.
Travel Vaccines (Immunization)
If you plan to visit a country that requires vaccinations, check with your local
Victorian Order of Nurses (V.O.N.).
When you call, tell them where you plan to travel and that you are pregnant.
They will be able to tell you whether the vaccines you need are safe during
pregnancy.
D
uring pregnancy you may want to be extra careful with certain things that
are around you every day.
Dangers
Around You
Household and Garden Chemicals
Avoid them if you can, but if you must use them, follow the directions on the
label with great care.
If you do any indoor painting, such as the baby’s room, be sure there is plenty
of air flowing through the room. If you can, keep the windows open. Also,
some stores sell indoor paint that is less toxic than normal paint. It costs more
but it may be worth the cost, if you can afford it.
X-Rays
X-rays may damage an unborn baby especially early in your pregnancy. The
best advice is to avoid all X-rays while you are pregnant. This includes dental
X-rays.
If you need to have X-rays, be sure to tell your doctor, dentist, radiologist, or
the person giving you the X-ray that you are pregnant. They will take special
care to protect your baby.
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Healthy Pregnancy... Healthy Baby
Pets
Some pets such as cats, turtles, and iguanas carry infections that could
harm your baby. For example, outdoor cats may carry a germ that causes
toxoplasmosis, which would hurt your baby’s development. Be very careful
when you are touching cats or cat litter boxes. Avoid working in soil where cat
waste (feces) is buried. Have someone else change the litter boxes. Always wash
your hands with soap and water after touching pets.
Working
When You
Are Pregnant
For most jobs, it is fine to work while you are pregnant. You may find that
you need to rest more often and make some changes so you can be comfortable
at work.
Many women need extra rest in the first three and last three months of
pregnancy. Try to nap when you feel sleepy. If there is a place at work where
you can lie down, you may find that resting on your side at lunch or during
a break is a big help.
Computer Screens (Video Display Terminals)
Many people wonder whether the computer screen (or video display terminal)
might be dangerous during pregnancy. So far, research shows that they won’t
hurt you or your baby. Pregnant women who work at computer screens do
NOT need to wear special clothing or lead aprons.
Workplace Dangers
Many workplaces contain things that may cause birth defects or miscarriages.
The main dangers are from chemicals, solvents, gases, metals, and radiation.
If you are concerned about this and wonder if your workplace has these
dangers, talk to your doctor or ask questions in your prenatal class. It’s your job
to know what the risks are in different kinds of jobs.
You could also ask your Health and Safety Committee for information. If your
workplace does not have this kind of Committee, you might want to start one
with your co-workers.
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A Healthy Start
Share Your Feelings
Pregnancy is a time of growth and change. Your body is changing and your
feelings change along with it.
You may find that your feelings change so often - and so quickly—that you
feel as if you are on a roller coaster. One minute you’re up, and the next you’re
down.
These mood changes can be a surprise. But they are a normal way of dealing
with all the changes that come with pregnancy.
You do not need medicine to help you. You need time, patience, love, and
support. Ask the people around you for the help you need. Talk about your
fears and your worries. Share your dreams and plans. If you need a hug or
a back rub or a shoulder to cry on, ask for it. No matter how much people care
about you and want to help, they can’t read your mind. They won’t know what
you need unless you tell them.
Pregnancy is a normal part of life. But it is a time when your life is changing.
Although you may be happy to be pregnant, all the changes can cause stress.
There’s a lot to think about while you’re pregnant. What will childbirth be
like? Will your baby be healthy? Will you be a good mother? A good father?
Will you have to move to a bigger house or apartment? Can you afford it?
Talk it Over
Don’t let things build up. Talk about your worries and take care of problems
while they are still small.
Pregnancy can bring people closer than ever before. Talk things over with
the ones you love.
Communication is important now, while you’re pregnant. It will
become even more important later, when you begin your life with
a new baby. You cannot assume that you and your partner have the
same feelings about parenting. For example, what do you think
is more important— a happy baby or a clean house? What does
your partner think? How do each of you plan to divide up the
housework, the diaper changes, and earning a living?
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Healthy Pregnancy... Healthy Baby
Something you need to talk about is feeding your baby. Did you know that
breastfeeding has many advantages? It’s the safe, natural way to feed your baby.
Breast milk is the perfect food for babies. Mother Nature made breast milk to
meet babies’ needs and to protect them from disease and infection. See Section
4 - Deciding to Breastfeed, for more information.
Talk with the important people in your life about how you plan to feed your
baby—your partner, your mother, your family or a health professional. You
will need help and support as you learn to be a parent. These are the people
you can depend on. Make them part of your plan.
You need to start talking about these things now. Don’t wait until you have
a problem before you share your feelings.
You can handle most things by talking them over with people you trust or by
working them out on your own. If it becomes too much for you and you feel
like there are too many problems, seek professional help or counselling.
Sexuality
As your life, body, and feelings change during pregnancy so will your sexual
feelings and desires.
Is It Safe to Have Sex When You Are Pregnant?
In a healthy pregnancy, sex will not hurt the baby or the mother. Most of the
time it’s safe and normal to have sex.
However, your doctor may suggest that you not have intercourse:
• If the placenta is growing in the lower part of your womb (uterus) near your
vagina. This is called placenta previa.
• If, in the past, you have had a problem with your cervix starting to open up
too early in your pregnancy (this is called incompetent cervix).
• If you have had early labour in the past, and no one knows why
• If you have any signs that you might be going into labour too early
• If you have any signs that you might miscarry
• If your water has broken
• If you have an infection
• If your doctor suggests that you avoid intercourse, don’t forget to ask when
you can start again.
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A Healthy Start
Sexual Feelings
It is normal for your sexual feelings—and your partner’s—to change while you
are pregnant. A lot of things affect how you feel about sex. For example, you
and your partner may have mixed feelings about the way the body changes
during pregnancy. Many men and women think that a pregnant woman’s large
breasts and round tummy are sexy and exciting. Others do not. You may find
that your own feelings about your body change from day-to-day.
Do you want to have sex more, or not at all? Many women find that they are
more sensitive to touch and feel very sexy when they are pregnant. Others find
it more difficult to enjoy sex at this time.
The best thing to do is to talk to your partner. You need to try to understand
each other’s feelings.
As your size and shape change, you might try different and more comfortable
ways to have sex. Why not try new things? Let your partner know what feels
good and what does not. Ask your partner to tell you what he wants and how
he feels. Remember that there are many ways to show love, care, and affection
that don’t involve sexual intercourse. If you or your partner do not want
intercourse, find other ways to be close. Try massage, cuddles, kissing, and
back rubs. Pregnant women often feel a great need to be held and cuddled.
Their partners seem to like it, too.
Enjoy your pregnancy and take care of yourself. Look at it this way: taking care
of yourself is good practice for taking care of your baby.
Give yourself a break:
• Make some time for yourself every day. Stretch out, relax, and think about
your baby.
• Give yourself a day to read, swim, walk, or spend the day in bed.
Take Time
for Yourself
Stay active:
• Do something physical every day. Walking, swimming—even just
stretching—will help you feel better when stress builds up.
Relax
• Lie down, relax your muscles, and focus on deep and slow breathing.
• Do some of the relaxation exercises on pages 130-132 in Section 6 Healthy Activity, every day.
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Healthy Pregnancy... Healthy Baby
Buying for Baby
Car Seats
Although there are hundreds of things you can buy for a baby, it’s good to
know there are only a few that you must get. A car seat is one of them.
The law says that babies must travel in a car seat, even on the trip home from
the hospital.
Even if you do not own a car, you will need a car seat when you travel in a taxi
or ride with friends. You can also use an infant car seat as a baby seat in your
home.
Babies must ride in a rear facing car seat until they are at least one year old
and they weigh 10 kg (about 22 lb). The infant car seat must always face
backwards and be kept in place with a seat belt. The safest place for a car seat
is in the centre of the back seat (except if there is an armrest that folds down).
Infant car seats are not safe unless they are installed and used according to the
instructions that come from the company that made the seat.
Infant car seats must meet the Transport Canada’s safety
standards. Do not buy a car seat unless it has an instruction
booklet and a National Safety Mark to show that it meets these
standards. A plastic infant carrier is NOT a safe seat even if it
has a seat belt.
Be careful about buying a used child seat. Make sure any child seat you buy has:
• Manufacturer’s instructions
• All necessary hardware, straps, buckles, harnesses and chest clip
• Not been in a collision
• Not been recalled
• Not expired (check the expiry date, if one is not visible contact the
manufacturer)
• No discolored (stress) marks or cracks and the sharness is not worn or torn.
Before you buy a car seat, try it out in your car. Make sure that it fits easily into
your car’s seat and that your seat belts will fit around it. Check that it’s easy for
you to use. Read the instructions and practice.
If you have questions, call Transport Canada toll-free at 1-800-333-0371.
WARNING
20
Do not put an infant or child car seat in front of an air bag.
A Healthy Start
You will not need a lot of baby furniture right away. The baby will need
a place to sleep—a crib or bassinet. You will need a place to put baby clothes—
a small chest of drawers or even a box. You do not really need a rocking chair,
but many parents and babies get a lot of pleasure from one.
Baby
Furniture
Any furniture you buy for the baby should be clean, safe and sturdy.
Old furniture is not always safe.
Make sure that:
• All small parts are firmly in place and will not come loose
• No parts are loose, split or broken
• No hardware is missing
• There are no holes or spaces big enough to trap any part of the baby
Making sure the crib is safe
If you are buying a second-hand crib, do a very careful safety check. Used
furniture does not always meet the standards set by the Canada Safety
Association (CSA).
• The slats should be no more than 6 cm (2 3/8 in) apart.
• The mattress should be less than 15 cm (6 in) thick. It must be firm and
should not move around. You should not be able to fit more than two fingers
between the mattress and the side of the crib.
• When the side rail of the crib is up, there should be at least 66 cm (26 in)
between the lowest part of the mattress support and the top of the side rail.
• The tops of the corner posts should be very small and not pointed, so
children’s clothing won’t catch.
• The mattress supports should be firmly attached. The mattress should not
come loose when you push up from under the crib, rattle the crib from side
to side, or thump the mattress from top to bottom.
• The crib must have a label that says the name of the company that made it,
the model number and the date it was made. It is illegal to sell cribs made
before 1986.
• There should be clear, easy-to-understand directions on how to set up the
crib.
WARNING
Because of the risk of SIDS (Sudden Infant Death Syndrome),
soft mattresses, pillows, comforters, stuffed toys, and bumper
pads should not be used in cribs.
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Healthy Pregnancy... Healthy Baby
Safe Playpens
All playpens, new or used, must meet the standards of the Hazardous Products
Act. These are
• Playpens should be stable and sturdy, with no more than two wheels or
casters. These should both be on the same end.
• Sides should be at least 48 cm (18.9 in) high.
• If there is netting on the sides, it must be very fine mesh to keep clothing,
buttons, or hooks from getting caught.
• Edges must not be rough or sharp.
• Hinges should be designed to prevent pinching or a sudden fall.
• There should be no holes that are large enough to trap tiny fingers.
• All small parts should be firmly attached.
More Information:
To find out more about buying baby clothes and toys see Section 8 - Healthy
Family.
22
Nine Months of Changes
Nine Months of Changes
Nine Months of Changes
Pregnancy begins with the joining of an egg and a sperm. It ends with the
birth of your baby. The nine months you are pregnant will be nine months of
change.
While your baby is growing inside, you will be changing too. Your uterus will
get larger as your baby grows. You will produce more blood to carry food and
oxygen to your baby. Your breasts will be getting ready to produce milk. At the
emotional level, you will be getting ready to be a mother, and your family will
be getting ready to welcome a new person.
During these nine months, you are your baby’s world. Make this world the best
it can be.
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Healthy Pregnancy... Healthy Baby
First
Trimester:
Months
1, 2, 3
Your baby’s growth
Weeks 1 to 4
Weeks 5 to 8
• 0.5 cm (1/4 in) long — about the
size of a pea
• spine and spinal cord are forming
• digestive system is starting to form
• umbilical cord is forming
• heart is beating by day
25
•
•
•
•
2.8 cm (1 1/8 in) long
weighs 1 g (1/30 oz)
face is forming; eyes are shut
long bones, internal organs, and
brain are forming
• arms and legs are forming
actual size
Second
Trimester:
Months
4, 5, 6
Your baby’s growth
Weeks 13 to 16
Weeks 17 to 20
•
•
•
•
•
•
•
•
•
•
•
15 cm (6 in) long
weighs 115 g (4 oz)
strong heartbeat
active muscles: baby turns, rolls,
kicks, and waves arms and legs
• skin is thin and covered with soft,
downy hair
• fingernails and toenails are forming
• swallows the liquid that is in the
uterus (amniotic fluid)
1/4 actual size
26
actual size
25–30 cm (10–12 in) long
weighs 450 g (1 lb)
heartbeat can be heard
sucks thumb
hiccups
has hair, eyelashes, and eyebrows
mother may feel movement
1/4 actual size
Nine Months of Changes
Changes you may notice during Months 1, 2, 3
Weeks 9 to 12
•
•
•
•
•
•
•
7.5 cm (3 in) long
weighs 28 g (1 oz)
arms and legs can move
has fingers and toes
has fingerprints
can smile and frown
tooth buds are forming
1/2 actual size
During the first three months, your baby
is growing and changing, but your body
does not yet look different.
• Your uterus grows from about the
size of a tennis ball to the size of a
grapefruit
• You may gain or lose up to 2.3 kg
(5 lb)
• You may find there is more wetness
(secretions) coming from your vagina
• Your breasts feel full and tender
• You may need to pee (urinate) often
• You may feel faint, tired, or sick
• You may feel like throwing up
(nausea) or you may throw up
(vomit). This is called “morning
sickness.” It can happen at any time
of the day or night.
Changes you may notice during Months 4, 5, 6
Weeks 21 to 24
• 28–36 cm (11–14 in) long
• weighs about 680 g (1 1/2 lb)
• skin is wrinkled and has a
creamy coating that protects it
• opens eyes
• has a strong grip
• lots of movement: baby wakes,
sleeps, yawns, cries, sucks
thumb
Most women start to feel a lot better. If you were
tired, moody, and had morning sickness, you
may find that they will go away. You may feel
dreamy and calm. As you feel the baby move
and kick, your baby becomes very real.
• You begin to look pregnant.
• You should be gaining about a pound
a week—1.5–1.8 kg (3–4 lb) a month.
• You may notice that your nose is
stuffy. You gums or nose may bleed.
• You may notice some changes in
your skin: a dark line down the
centre of your abdomen (called
the linea negra) and a dark shadow
on your face (called the mask of
pregnancy).
1/8 actual size
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Healthy Pregnancy... Healthy Baby
Third
Trimester:
Months
7, 8, 9
Your baby’s growth
Weeks 25 to 28
Weeks 29 to 32
• 36–43 cm (14–17 in) long
• weighs about 1000–1400 g
(2 1/2–3 lb)
• very active — kicking and rolling
around
• starting to make breathing
movements
• adding body fat and brain is
growing
• 42–45 cm (16 1/2–18 in) long
• weighs 1800–2200 g (3 1/2–4 lb)
• bones in the head are soft and
flexible
• is storing iron in liver
• sleeps and wakes
• responds to sounds
1/8 actual size
1/8 actual size
Changes you may notice during Months 7, 8, 9
By this time your baby is very real, and you are eager for
the birth.
• You may notice stretch marks on your stomach
area (abdomen) and breasts.
• You may notice that you sweat often and pee
(urinate) more.
• You may notice skin changes such as tiny red
spots called “vascular spiders.”
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Nine Months of Changes
Weeks 33 to 36
Weeks 36 to 42
•
•
•
•
• 50 cm (20 in) long
• weighs 3200–3500 g
(7–7 1/2 lb)
• lungs are mature
• has enough body
fat to keep warm
• fingernails are
long
• head is large
• arms and legs are
curled up against
body
• Ready to be
born!
•
•
•
•
•
48 cm (19 in) long
weighs 2200–2700 g (4–5 lb)
getting too big to move around as much
at about 36 weeks will settle into a head-down
position for birth
adding fat, this means skin has fewer wrinkles
brain continues to grow
skin has thick, creamy
coating (vernix)
most of the downy
hair is gone from skin
gaining protection
from germs
(immunity)
from mother
1/8 actual size
1/4 actual size
What you might be feeling during the 9th month (Weeks 36 to 42)
This is it! You are full of mixed feelings. You can hardly wait to see your baby
and you are nervous about giving birth.
• You may feel lots of “Braxton-Hicks” contractions. These are normal
practice for labour. See Section 7 - Healthy Birthing to learn more.
• You may notice that the baby has dropped lower into your pelvis. This
makes it easier for you to breathe. It also means you will pee (urinate)
more often.
• You may have a burst of energy
• Signs that labour is starting:
- backache
- a plug of mucus with a little blood in it comes out of your vagina.
This is called a “show.”
- contractions may get stronger and don’t stop when you move
around
- your water breaks
• You have loose bowel movements
HAPPY BIRTHDAY!
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Healthy Pregnancy... Healthy Baby
Relief from Common Aches
And Pains
When you are pregnant, your body goes through many changes. Some of them
are not comfortable. But most of them are normal. You do not need medicine
or treatment. It’s also nice to know that not all women have ALL of the
problems we talk about here.
In general, if you eat healthy food and stay active you will be more comfortable
during these nine months.
Backache
What causes it?
Poor posture and your growing abdomen can make your back sore.
What can I do about it?
• Stand up straight. Tighten your buttocks and pull in your tummy muscles.
Good posture will ease the strain on your back.
• Do pelvic tilts and abdominal exercises every day. See Section 6 - Healthy
Activity for directions. Doing a pelvic tilt on your hands and knees can help
a lot. Here’s how to do it:
1. Lower yourself to the floor, on your hands and knees. Keep your back flat
and your head level with your back. Do not let your back sag.
2. Tighten your buttocks and abdominal muscles, pulling in your tummy and
curving your back up. Hold for a few seconds.
3. Relax back to where you began. Keep your back flat. Do not let it sag.
4. Repeat a few times.
• Be careful when lifting. See Section 6 - Healthy Activity, for safe ways to lift.
• Use a firm mattress on your bed and sleep on your side with your knees
bent toward your chest. The left side is best because it helps your blood to
circulate.
• Use a heating pad, hot water bottle, warm bath, or ice to reduce the ache.
• Wear shoes with a low heel and good support.
• A back rub from a friend or partner can also feel good.
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Nine Months of Changes
What if none of this helps?
• Talk to your doctor or physiotherapist.
• Do not take any kind of pain medicine without asking your doctor if it is
okay to do so.
What causes breasts to change?
Most breasts start to change early in pregnancy and continue to change until
the baby’s birth. Your breasts may get larger. You may be able to see the veins
in your breasts, and you may notice a tingle in your nipples. The darker skin
around your nipples (the areolas) may get larger and darker, and the little
bumps on them stand up more. Later in your pregnancy you may notice
a sticky, yellow fluid leaking from your breasts. This is colostrum, the fluid
your body makes before it starts to make breast milk.
Breast
Changes
All of these changes are your body’s way to get ready to produce milk for
breastfeeding.
What can I do about it?
Breast changes are a normal part of pregnancy. If your breasts are tender or
uncomfortable, wearing a support bra can help. A good bra is also important
when you are doing exercise or being active. Some women also wear a bra at
night because it feels comfortable.
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Healthy Pregnancy... Healthy Baby
Constipation
What causes it?
When you are pregnant, your bowels slow down a bit and your growing uterus
causes pressure on your bowels. This makes constipation more likely. Women
who take iron pills when they are pregnant may be constipated. It can also be
caused by a change in your eating habits.
You are constipated if your bowel movements are hard and dry or are difficult
to pass. It is not a serious problem. Although it may be very uncomfortable,
it does get better.
What can I do about it?
• Eat high-fibre foods like whole wheat bread, whole grain cereal, bran, beans,
dried fruit, and fresh fruit, prune juice and vegetables.
• Drink lots of water — 6 to 8 glasses a day.
• Stay active. Walk every day or do some other exercise that you enjoy.
• Develop good bowel habits:
- When you have to go, do it. Do not wait.
- Wait until you have to go. Do not try to force it.
- Do not strain. Relax and take your time. Try raising your feet on a stool
or a box while you are sitting on the toilet.
• Try drinking hot or very cold liquid on an empty stomach.
What if none of this helps?
• Talk to your doctor if the problem lasts more than a week or so.
• If you’re taking iron pills because your doctor has told you to, ask if you
should stop taking them.
• Do not take any laxative or other medicine without checking with your
doctor.
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Nine Months of Changes
What causes it?
Cramps in your feet and legs are most common in the last 3 months of
pregnancy. They can be caused by the pressure of your uterus on the blood
vessels and nerves that connect to your legs. They can also be caused by
pointing your toes when you stretch.
Cramps in
your legs
and feet
What can I do about it?
• Stay active. Exercise will provide more circulation to your legs.
• Be careful not to point your toes when you stretch, especially when you first
wake up in the morning.
• Wear comfortable shoes. Avoid wearing high heels.
• Avoid standing for long periods of time.
• Avoid crossing your legs.
• Wrap ice in a wet towel and place it on the cramped muscle. Leave it there
for 10 to 12 minutes to help relax your muscles.
• If you do get a muscle cramp, do not massage, squeeze, or press on it. Blood
vessels bruise easily, and pressure will only make the cramp worse. The best
thing to do is to stretch gently.
For foot cramp:
1. Sit down. Keep the cramped leg straight. Bend the other knee.
2. Slowly flex the toes of the cramped foot towards your nose.
3. Hold your legs this way until the cramp goes away.
For leg cramp:
1. Sit on the floor, near a wall.
2. Using your cramped leg, press the bottom of your foot against the wall.
Keep your other leg bent.
3. With your arms straight, lean back on your hands for support.
4. Pressing your foot into the wall, slowly straighten your cramped leg
until the back of your knee touches the floor.
5. Hold your leg this way until the cramp goes away.
What if none of this helps?
• Talk to your doctor if you have painful cramps often.
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Healthy Pregnancy... Healthy Baby
Feeling tired
(fatigue)
What causes it?
Feeling tired is a normal part of being pregnant. Women notice it most during
the first three months. It is caused by the fact that your body is using a lot of
energy to adjust to pregnancy.
You may also feel tired again during the last two months because you are using
a lot of energy to carry the baby’s weight and your own.
What can I do about it?
• Accept that you need to rest and allow time to rest during your day.
- Rest before you become too tired.
- Rest when you can, even at work. Sit down and put your feet up for a few
minutes. If you have a place to do so, lie down on your side.
- Take naps when you need them. Take a nap instead of a coffee break.
- Go to bed early to get the extra sleep you need.
• Take good care of your health. Eat well and stay active. Regular exercise will
make you feel less tired, not more tired.
What if none of this helps?
• Check with your doctor. Do not take any medication.
• Do not use coffee or caffeine pills to stay awake.
34
Nine Months of Changes
What causes it?
You can have gas at any time while you are pregnant. It happens because your
digestive system slows down when you are pregnant. This gives gas more time
to form. It is also caused by the pressure of your uterus on your stomach and
intestines.
Flatulence
(Gas)
What can I do about it?
• Notice which foods you ate just before you felt the gas pains. Try to eat only
small amounts of foods that give you gas. Many kinds of food can cause gas.
They are different for everyone.
• Try not to be constipated. Follow the advice in the section on constipation.
• Stay active.
What if it does not help?
• Gas may annoy you. In most cases, it is not a serious problem.
• If you have a lot of pain from gas, talk to your doctor.
What causes it?
The urge to pee (urinate) is very common during the first three months of
pregnancy. It is also strong in the few weeks before the baby is born. It happens
because your uterus is pressing against your bladder (the sac that holds pee).
This leaves only a small space in your bladder, and you need to empty it (or
urinate) more often.
Frequent
Urination
(needing to
pee often)
What can I do about it?
• It is good to drink plenty of fluids when you are pregnant, so do not reduce
the amount you drink during the day.
• If you find you have to get up many times a night to go to the bathroom,
try to drink less during the evening.
What if none of this helps?
• Don’t worry. This may annoy you, but it is a normal part of being pregnant.
• If you have any pain or burning when you pee (urinate), check with your
doctor. You may have a bladder infection.
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Healthy Pregnancy... Healthy Baby
Groin Pain
What causes it?
Near the end of the nine months, you may feel a “pull” or “stitch” below
your belly or in your groin. This is caused by the weight of your pregnancy
stretching the ligaments that hold your uterus in place. This kind of pull can
happen when you exercise, cough, or sneeze. It is not comfortable and not
serious. Do not let it stop you from being active.
What can I do about it?
• Stand up straight. Poor posture can cause this pain and make it much worse.
• Do not stand for long periods of time.
• If you get this pain while you are doing exercise, try to notice what makes it
happen, and avoid doing this.
If you get groin pain:
• Do a light, massage in circles around the sore area. Use a very light touch
when stroking downward.
• To stop a sudden pain:
1. Lean against something for support.
2. Use both hands to lift up your belly. This will take the pressure away.
3. Continue to hold your belly until the pain goes away.
• Try lying down on the sore side with your legs bent into your chest.
This takes the stress off your ligaments and may provide quick relief.
• Do pelvic tilt on your hands and knees:
1. Kneel on your hands and knees. Keep your back flat and your head
level with your back. Do not let your back sag.
2. Tighten your abdominal (stomach) muscles, pulling in your tummy
and curving your back upward. Hold for a few seconds.
3. Relax back to your starting position. Keep your back flat. Do not let
it sag.
4. Repeat a few times.
What if none of this helps?
• Talk with your doctor if this happens often and is painful.
36
Nine Months of Changes
What causes it?
Headache
Most of us get a headache once in a while. They do not stop just because you
are pregnant. During pregnancy, some women get more headaches than usual
for them. This is caused by normal changes in the blood vessels. Headaches can
also be caused by fatigue and stress.
What can I do about it?
• Think about the things that give you headaches and try to avoid them.
Eye strain, cigarette smoke, coffee, and fluorescent lights cause headaches
in some people.
• Get plenty of rest.
• Eat many small meals. Do not go for a long time without eating.
• Drink lots of fluids.
If you get a headache:
• Find a quiet place and relax.
• Put a damp cloth on your forehead or the back of your neck. Some people
like a warm cloth, others want a cool one.
• Rub your neck, shoulders, face, and scalp. It’s even better if someone else
does this for you.
• Get some fresh air.
What if none of this helps?
• Do not take any kind of pain medication until your doctor says it is okay.
• Talk to your doctor if it seems like you have a lot of headaches.
• Contact your doctor right away if you have a severe headache,
or a headache that lasts a long time, or if your vision is blurry (fuzzy).
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Healthy Pregnancy... Healthy Baby
Heartburn
What causes it?
Heartburn is caused by acids pushing up out of your stomach. When you are
pregnant, it happens because the stomach muscles relax, making it easier for
food to come back up and your growing uterus pushes up against the stomach,
which forces acids up.
What can I do about it?
• Sit up straight during meals. This gives your stomach as much room as
possible to digest food.
• Eat many small meals instead of a few large ones.
• Eat slowly.
• Avoid foods with a lot of grease or spices.
• Remain sitting up for an hour or two after eating. Lying down after you eat
can cause heartburn.
• Avoid heavy meals for 2 to 3 hours before bedtime.
• Do not drink anything just before or after eating.
• When lying down raise your head and shoulders.
If you get heartburn:
• Take small sips of water or milk.
• Sit up straight or stand. Lying down may make heartburn worse.
• At night, sleep with the head of your bed raised a bit, or use extra pillows.
• Try sleeping on your side.
What if none of this helps?
• Talk to your doctor or pharmacist before you take antacids or any other kind
of medication.
38
Nine Months of Changes
What causes it?
Hemorrhoids are swollen veins in the rectum. They are caused by the pressure
of the baby on the lower part of your body. They may also be caused by
pushing too hard when you are having a bowel movement. Hemorrhoids can
be painful or itchy and may hang out of the rectum. They usually go away after
delivery but will sometimes last for a few weeks after the birth.
Hemorrhoids
(Piles)
What can I do about it?
• Try not to be constipated. See the section on constipation for advice on this.
• Do not sit on the toilet for a long time. Do not push too hard when having
a bowel movement. Putting your feet up on a stool while sitting on the toilet
may reduce the strain a bit.
• Do pelvic floor exercises to improve blood circulation in your pelvic area.
See Section 6 - Healthy Activity for details on this.
• Sitting in a warm bathtub for 15 to 20 minutes may reduce the pain.
• Putting warm pads or ice packs on the hemorrhoids may also help.
What if none of this helps?
• Talk to your doctor.
• Do not use any kind of medication, ointment, or suppository without asking
your doctor if it is okay.
39
Healthy Pregnancy... Healthy Baby
Insomnia
(Trouble
Sleeping)
What causes it?
Some women have difficulty falling asleep and staying asleep when they are
pregnant. During the first three months, this is because your body is getting
used to the changes that come with being pregnant. Later on, the size of your
uterus and your baby’s kicking can make it hard for you to find a comfortable
way to sleep. Insomnia can be more of a problem for women who have
shortness of breath.
What can I do about it?
• Stay active. Walk or exercise every day. It is easier to get to sleep if your
body is tired.
• Avoid caffeine (in coffee, tea, cola drinks and chocolate).
• Try to go to bed and get up at the same time each day.
• Avoid eating large meals near bedtime.
• Try to find a comfortable way to sleep. Use pillows and rolled-up blankets
for support.
• Sleep on pillows that prop you up if you are short of breath.
• Have a warm shower or bath before bed.
• Have a glass of warm milk or hot water with lemon before bed.
• Try going for a walk in the evening.
• Try relaxation exercises. See Section 6 - Healthy Activity, for directions.
• Read a really boring book.
• Get a backrub. It may help you sleep.
What if none of this helps?
• Do not take any sleeping medication unless your doctor says it is okay.
40
Nine Months of Changes
What causes it?
“Morning sickness” is the feeling that you might throw up (nausea). It is also
the act of throwing up (vomiting). Both of these can happen during the first
three months or longer. Although it is called “morning sickness”, it can happen
any time of the day or night.
Morning
Sickness
(throwing up)
Some pregnant women get morning sickness, and others never do. If you are
one of the women who gets it, you may not be able to stop the feeling that
you might throw up (nausea). But you may be able to stop the throwing up
(vomiting) by trying what we suggest here. You may need to try a few things
before you find one that works for you.
What can I do about it?
• You will feel better after you eat, so even though you may not want to, it’s
important to eat. Nausea is much worse if your stomach is empty.
• Try eating a few crackers or dry toast before you go to bed or before you get
up in the morning. Keep them by your bed.
• Instead of a few large meals, try eating small meals or snacks every 2 or 3
hours. A bedtime snack can be helpful. Try peanut butter or a protein rich
food to keep your stomach full for a longer time.
• Try not to eat solids and liquids at the same time. Have soups and drinks
between meals instead of with meals.
• Avoid fried foods.
• Avoid coffee.
• Avoid smoking.
• Get up slowly in the morning. Do not move quickly or suddenly.
• If you feel like you might throw up, sip soda water or ginger ale, or go
outside for fresh air. A short walk might help.
What if none of this works?
• Talk to your doctor.
• Do not take any medicine for nausea without asking your
doctor if it’s okay.
• Try not to worry. Morning sickness does not affect your baby’s
growth or health.
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Healthy Pregnancy... Healthy Baby
Shortness
of Breath
What causes it?
Shortness of breath can happen at any time during pregnancy. As your uterus
grows, it presses against your rib cage. This leaves less room for your lungs to
expand. For many women, shortness of breath stops when the baby gets bigger
and moves down into your pelvis. For most women who are having their first
baby, this happens about two weeks before labour begins.
What can I do about it?
• Very little can be done to prevent shortness of breath. Having good posture
can help. Stand up straight. This will give your lungs room to expand.
• Try sleeping propped up on pillows.
• Try taking slow deep breaths.
• Raise your arms over your head, lifting your rib cage.
• Do not exert yourself too much.
• Wear loose clothing.
• Avoid smoking.
What if this does not help?
Tell your doctor about your problem. Shortness of breath can also be a sign
that you do not have enough iron in your blood.
Swelling
What causes it?
During pregnancy, the amount of blood and other fluid in your body increases.
This is normal. It may cause your feet, face, and hands to be puffy or swell
a little. This is most common during the last three months of pregnancy.
About 8 out of 10 women get some swelling when they are pregnant.
What can I do about it?
• Avoid wearing tight clothes or jewelry—for example, avoid elastic waists,
knee-high stockings, socks with elastic tops, rings, and tight watchbands.
• Try to gain weight in a slow, steady way.
• Avoid standing for long periods of time.
• Do not sit with your legs crossed.
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Nine Months of Changes
• Get as much rest as you can.
- Rest with your feet up many times each day.
- When you are resting, lie on your left side. This can improve your blood
circulation and reduce swelling.
- Try to reduce your workload.
If you have mild swelling in your legs, ankles and feet, do this exercise for 10 to 15
minutes, twice a day:
1. Lie with your head and shoulders propped on pillows.
2. Keep your knees bent a bit, and put your legs on a chair or sofa,
so they are a bit higher than your heart.
3. Curl your toes under and then make them stand straight up.
Repeat this several times.
4. Make circles with your feet. Repeat this several times.
5. Tighten and relax the muscles in your upper legs (thighs).
Repeat this several times.
• If you have mild swelling in your hands, bend your fingers back and then
make them stand straight again. Move your hands in circles.
What if none of this helps?
• Do not take any kind of diuretic (water pills), or other medication unless
your doctor says it is okay.
• If you have pins and needles in your hands, especially at night, talk to your
doctor or physiotherapist.
• Contact your doctor right away if you have sudden or severe swelling in your
hands and face, or if you feel numb in your hands and face.
What causes it?
When you are pregnant, it is normal to have more thin, milky fluid coming
out of your vagina. Sometimes there can be a lot of this wetness. As long as the
fluid is thin and milky, it is normal and you do not need to worry.
Wetness in
your vagina
If the wetness makes you itchy, smells bad or feels like it is burning, you may
have an infection. If this happens, contact your doctor.
What can I do about it?
• Keep the area clean and dry.
• If the wetness is heavy, try wearing a panty liner.
• Do not douche.
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Healthy Pregnancy... Healthy Baby
Varicose
Veins
What causes them?
When you are pregnant, the walls of your blood vessels stretch because they
have to carry more blood. As well, your uterus is growing and this puts extra
pressure on the veins in your legs. Blood circulates more slowly. More blood
stays in pools in your veins. When this happens, it is called varicose veins.
Varicose veins can also happen in the vulva or the rectum (hemorrhoids or
piles) if you sit too long in one place or if you have weak pelvic floor muscles.
If you had varicose veins before, you may find that they are worse when you are
pregnant.
What can I do about it?
• Stay active. Walking and moving improve circulation.
• Stand up straight. Good posture will improve your circulation. See Section
6 - Healthy Activity to learn more.
• Do leg, foot, and pelvic floor exercises often each day. See Section 6 Healthy Activity, for more information.
• Lie down with your legs raised for 10 to 15 minutes often each day. Support
your feet on pillows so that your legs are a bit higher than your heart.
• Do not stand for a long time. Be sure to sit down and put your feet up often
each day.
• If you sit during the day, change position often. Using a footstool may help.
Get up and walk around for a few minutes once an hour.
• Do not sit with your legs crossed.
• Sleep and rest on your left side.
• Avoid tight clothing, especially socks with elastic tops and knee-high
stockings.
• Wear shoes with low heels and good support.
If you get varicose veins in your legs:
• Wear fitted support stockings. Put them on before you get out of bed in the
morning. If you get up first and your legs begin to swell, lie down and raise
your legs for 10 minutes before you put the stockings on.
What if none of this helps?
• Talk to your doctor about it.
• Do not take any medication unless your doctor says it is okay.
44
Becoming a Father
Becoming a Father
Becoming a Father
Fathers can have many feelings about pregnancy and being a parent.
You may find that your feelings are sometimes very mixed. Your feelings
may also change as the pregnancy ends and the baby’s birth gets closer.
It is normal to have questions about becoming a father. You are not
the only man who feels this way. The things you worry about
and the feelings you have may not be the same as someone
else’s, but they are normal.
How You Might Feel
• Excited, proud, and full of hope.
• Concerned about your partner, wanting to protect her.
Is she sick? Will she be okay? What can you do to help?
• Wanting to protect the baby. Feeling love for the baby.
This may happen after the baby becomes real to you for example, when
you feel the baby kicking or hear the baby’s heartbeat. You may find yourself
wondering about what it will be like to be a father. You may also worry
about whether you will be a good father who can take care of the baby.
• Concerned about practical things.
Will there be enough money? Do you need a bigger place to live? A bigger
car?
• Worried about how your life will change.
Will your relationship with your partner change? Will your partner focus so
much on the baby that she won’t have time for you? Will she love the baby
more than she loves you? Are you selfish for even thinking about this?
• Concerned about sex.
Will having sex hurt your partner or the baby? Is it okay to still want sex?
Is it okay not to want it?
47
Healthy Pregnancy... Healthy Baby
What You Can Do
• Talk about how you feel. Your partner is the best person to talk to.
Share your joy and excitement as well as your worry and concern. Listen
when your partner talks about her feelings. Talk about the kind of father you
hope to be.
• Read and learn about pregnancy and birth.
This prenatal book can help you and your partner. Section 1 - Healthy Start,
talks about sexuality and communication. It provides advice on buying safe
furniture for your baby. Section 2 - Nine Months of Changes, gives details
about the baby’s growth and changes during each month your partner is
pregnant. You might go with your partner to one of her visits to the doctor.
Meet the doctor. Ask the questions that you have been thinking about.
Listen to your baby’s heartbeat.
• Make plans together.
Plan for the birth. Decide how you will feed the baby. Breastfeeding is
best, and your partner needs to know you will support her if she decides
to breastfeed. There are many benefits to breastfeeding. See Section 4
- Deciding to Breastfeed, for more details. Talk about how you will
divide the work, responsibility, and fun of a new baby.
Abuse in Pregnancy
Violence against women is a common problem. Abuse often starts or gets
worse when a woman is pregnant. If a woman is abused when she is pregnant,
she is four times more likely to have a baby who does not weigh enough (low
birth-weight baby).
The stress of pregnancy can lead to abuse. Women who are abused are three
times more likely to be injured when they are pregnant. They may also have
a miscarriage.
Questions you need to ask yourself:
q
q
q
q
q
q
q
q
q
Is she afraid of me?
Do I threaten her?
Do I yell at her?
Do I call her names?
Do I throw things?
Do I hit her?
When I get angry, do I put all the blame on her?
When I hit her, do I promise not to do it again?
Does she feel she is alone and has to keep the abuse a secret?
If you said YES to any of these questions, you should talk to someone because
your partner and your unborn baby may be in DANGER.
48
Becoming a Father
How can you help to prevent abuse?
• Learn to talk openly about your feelings with your partner. How is your
relationship changing now that she is pregnant? What can you do about
this?
• Find out who you can talk to in your community. It is important that you
talk to someone about the new feelings you have.
• Get help right away if you think that abuse is part of your relationship.
You, your partner, and your unborn baby deserve a safe start in life!
Stop the hurting, start the healing.
How You Might Feel
• Excited that the baby will be born, at last!
• Worried that you will not get to the hospital in time. Worried that
something bad will happen to your partner or baby.
The Father
during
Childbirth
• Overwhelmed that it is all happening so fast.
• Confused about what is going on, and what you should be doing.
• Hoping that you will be able to help your partner cope with the pain.
• Sure that you are both ready for this experience.
What You Can Do
• Read and learn as much as you can about childbirth.
Go to prenatal classes with your partner. Go on a tour of the local hospital.
Watch a movie about childbirth. It will help you understand what birth can
be like.
• Plan to stay with and support your partner during labour.
Section 7 - Healthy Birthing, tells how you can help your partner get ready
for the birth and help her when she is in labour. Section 6 - Healthy Activity,
explains how you can help your partner learn to relax. The more you prepare
yourself to help your partner, the better you will feel about everything.
• Talk to your partner about your worries.
Sometimes fathers are so worried about the birth that they try not to
think about it. You may have heard that some babies are born by cesarean
section. Reading and asking questions about this may help you feel
better. Talking about your worries and sharing your excitement can
help you feel closer to your partner. Then, you can work together to
handle all that happens.
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Healthy Pregnancy... Healthy Baby
The New
Father
How You Might Feel
• Pleased, proud, and excited.
The birth of a baby is an amazing event. Being part of childbirth and holding
your new baby are very special.
• Amazed by the baby.
You may be surprised at how strong your feelings are. You may have a very
strong need to see, hold, and touch your baby. This is good for you, and for
the baby!
• Sad.
Fathers sometimes worry because they do not feel as happy as they thought
they would.
• Tired and overwhelmed.
Once your partner and baby come home, you may be shocked to see how
much time the baby takes. You may also be surprised to see how little sleep
new parents get. Sometimes a father might feel that mothers are the ones
who know how to look after a baby. It comes as a surprise when your partner
turns to you for support or help.
• Worried about whether the baby is normal.
Many new fathers have no idea what babies are like, or what to expect. They
worry about the baby’s health and about doing something that might hurt
the baby.
• Worried about money.
Your family income might be lower for a while. The cost of diapers, baby
clothes, and food may seem high.
What You Can Do
• Read and learn as much as you can about babies and baby care.
Section 8 - Healthy Family, talks about this, and about how new fathers can
take care of themselves. While your partner is in the hospital, learn together
how to give the baby a bath, feed the baby, and change diapers. Practise
picking up and holding the baby before you go home. The more you know
about normal newborn babies, the less you will have to worry about.
• Try to take a few days off from work to help welcome the new baby.
Learning to care for a baby is a big job. You and your partner will need each
other’s help and support as you learn about your baby and begin to split up
the chores. Your partner will need extra help for a while as she recovers from
childbirth.
• Look on the bright side.
Babies are a big responsibility. They are also a source of joy. Being a father
can fill you with pride, purpose, and joy. It really does change your life. With
love and care, this will be a good change.
50
Deciding to Breastfeed
Deciding to Breastfeed
The Best for You and
Your Baby
You are pregnant. This is the best time to decide how you want to feed your
baby. What you decide depends on your feelings about yourself and what your
partner feels.
Breast milk is the perfect food for your baby. It is all your baby needs for the
first six months of life. The act of breastfeeding will help your baby learn to
love, trust and play. It is good for your baby to have skin contact with you, to
look into your eyes and to cuddle.
Breast milk gives your baby what his body needs to help fight disease
(antibodies). You will give your baby natural “protection” from disease simply
by breastfeeding.
Breastfeeding is good for your baby and will make you feel good about yourself
too!
You may get a lot of advice about breastfeeding from friends or
relatives. Not everyone agrees that breastfeeding is best. You
may feel confused. What should you do? Now is the time to
learn the facts about breastfeeding and the risks associated
with infant formula. Then you can decide what is best
for you, and for your baby.
53
Healthy Pregnancy... Healthy Baby
Breastfeeding
Is Best for
Babies
Here are some reasons why your milk is best for your baby.
Perfect first food
Breast milk was made to meet babies’ first needs. It is easier for babies to digest
than infant formulas (or breast milk substitutes). Babies who are breastfed
usually have less colic, burping, upset stomach, constipation, and diarrhea than
babies who are fed with formula.
Protection from disease, infection, and allergy
Breast milk protects babies against disease and infection. Food allergies may
be less common in babies who have only breast milk for the first 6 months.
Breastfed babies have less breathing problems, diarrhea, vomiting, ear
infections, juvenile diabetes and childhood cancers.
Baby decides how much to drink
Babies breastfeed when they are hungry and stop when they are full. They
decide how much milk to have. Babies who are fed with formula can be coaxed
to take a little more. They may drink more formula than they need.
Good mouth development
A mother’s nipple fits the shape of a baby’s mouth. Babies who breastfeed
usually have good jaw development, and their face muscles are strong.
Comforts and makes babies happy
Babies have a natural need to suck. Breastfeeding helps meet that need.
Close bond between mother and baby
Breastfeeding is more than a way to feed your baby. It creates a bond between
you and your baby. Your warmth and the closeness of your body help to make
your baby feel safe and loved.
Breast milk supplies all of your baby’s food needs during the first 6 months of
life. This is the time of most rapid growth during life. Your healthy baby does
not need any other foods during this time. That means no food or other drink
except vitamin D supplement (page 197). Feeding solid foods too early could
reduce your milk supply and increase the baby’s risk of allergies.
54
Deciding to Breastfeed
Here are more reasons why breastfeeding is good for mothers and their
families too.
Low cost
Breast milk is free! That means it costs a lot less than infant formula (or breast
milk substitutes). You make breast milk, so your only extra expense will be the
extra food you must eat to produce the milk. Even so, breastfeeding still costs
less.
Breastfeeding
is Good for
Mothers and
Families
Always ready and safe
Breast milk is always clean, fresh, and the right temperature. You do not have
to prepare bottles in advance or wash them after a feeding. When your baby
is ready to eat, breast milk is also ready 24 hours a day. That makes night
feedings very easy! If you travel with your baby it is easier too. There is no
formula to prepare and carry, or bottles to wash.
Helps the environment
Breastfeeding is Mother Nature’s way to feed babies. You use less of the earth’s
resources because you do not have to heat, store and wash the bottles for
formula. You will reduce air, land, and water pollution if you breastfeed. Why?
Because using formula uses electricity, paper, plastic and gas (for transportation
to stores).
Feeling good
You are giving your baby the best food you can! Most mothers find
breastfeeding makes them feel really good. While breastfeeding is natural, you
will need to learn how to do it. It may take some time and patience, but it’s
worth the effort. You may have a few problems during the first weeks, and this
is normal. Talk about them right away with your public health nurse, public
health nutritionist, or with someone at your breastfeeding clinic. There are also
other people in your town or city who can help.
Learning about your baby
Breastfeeding helps you learn the signs that tell you what your baby needs.
Then, you can answer her need for food and comfort before she becomes too
upset.
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Healthy Pregnancy... Healthy Baby
Helps mother’s body
When a baby sucks at your breast, your uterus returns to its normal size more
quickly. Breastfeeding may also help you slowly lose some of the weight
that you gained when you were pregnant. Making breast milk uses up fat
stored in your body. Women who breastfeed are less likely to get weak bones
(osteoporosis), cervical cancer, and breast cancer.
Breastfeeding does not guarantee that you will lose all the weight you gained
when you were pregnant. Healthy eating and being active are also important.
See Section 6 - Healthy Activity, to learn more about this.
Working mothers
If you are working, breastfeeding may be harder to do. But women say it can
be done, with planning, and help. When you need to be away from home, you
can express your breast milk manually (using your hands) or with a breast pump
and leave it with your sitter or partner to feed your baby. Breast milk can be
frozen for future use too.
Some mothers have a daycare centre at work, or nearby, so they can breastfeed
during their breaks. You could plan for your partner, family member, or sitter
to bring your baby to you during your breaks at work. Talk to your boss to see
what can be done to make this possible.
If you are a student
Many of the ideas for working mothers can help women who are also students.
Your school, community college, or university may have a student counseling
service that can help you. Find out what is available!
56
Deciding to Breastfeed
A myth is a belief that is not based on fact. New mothers and fathers have
many common breastfeeding questions. We try to answer some of them
here. If you still have questions, talk to a public health nurse, public health
nutritionist, or someone who offers breastfeeding support in your town or city.
Will I be able to breastfeed?
If you WANT to breastfeed your baby, your milk will arrive and your baby will
breastfeed.
Common
Myths and
Concerns
about
Breastfeeding
There are some medical problems that prevent some women from
breastfeeding. Examples are a mother who is addicted to drugs or alcohol, is
having treatment for cancer, or is infected with HIV. A breast reduction may
also decrease milk supply.
Are my breasts too small?
The size of a mother’s breasts does not matter. Big or small, they can produce
all the milk your baby needs. You need to start to breastfeed your baby very
soon after birth. The more often you breastfeed, the more milk there will be.
Are my nipples the right shape?
The shape of your nipples is not likely to be a problem. Your baby’s sucking
will make the nipple and the dark skin around it (areola) softer as you
breastfeed. Your baby will do most of the work if your nipple needs to be
different from its normal shape.
Will breastfeeding make my breasts sag?
This is one of the myths about breastfeeding. The hormones of pregnancy,
not breastfeeding, affect the breasts and may make them sag. A good support
bra will help. You can expect your breasts to return to their normal (or almost
normal size) when you stop breastfeeding.
Does breastfeeding take a lot of time?
Some people say that breastfeeding “ties you down.” In fact, many women like
the fact that breastfeeding gives them more freedom than formula feeding! All
new mothers are limited by feedings, the baby’s demands and being tired. The
first few weeks with a baby are filled with change and joy. This is true for all
new mothers!
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Healthy Pregnancy... Healthy Baby
Do I need to eat special food?
No. All you need to do is eat healthy food and drink enough fluids. When you
eat well, using Canada’s Food Guide as your guide, your body will be healthy and
you will be able to nourish your baby.
What about smoking and breastfeeding?
When you are pregnant, you should stop smoking. After your baby is born,
the harmful effects of smoking get passed along to your baby in breast milk.
Heavy smoking (more than 20 cigarettes a day), may make your baby feel like
throwing up (nausea), throw up (vomit), have stomach cramps, and the runs
(diarrhea). Smoking will also decrease the amount of milk you produce. The
smoke from your cigarettes will increases your baby’s risk of ear infections,
colds and Sudden Infant Death Syndrome (SIDS). But, if you do smoke, it
is still better to breastfeed than to feed your baby formula. You should know
that your baby is more likely to be a smoker when he grows up, if you or your
partner smoke.
Will breastfeeding keep me from getting pregnant?
Breastfeeding is not an effective method of birth control unless you follow all
the steps of the LAM method. See LAM (Lactational Amenorrhea Method) on
page 224 in the birth control section in Section 8 - Healthy Family. Although
you may not have a menstrual period while you are breastfeeding, you could
become pregnant. You must use some form of birth control (contraception) if
you do not wish to be pregnant.
Birth control pills can decrease the amount of milk you produce. Talk with
your doctor or public health nurse about the kind of birth control to use while
you are breastfeeding. If you decide to use birth control pills, watch for the
signs of less milk, such as smaller breast size, or more demand from your baby
(outside of growth spurts).
Will my partner be left out?
No. At first, when you and your baby are building the milk supply, there are
many things he can do to help you. He can also build a close relationship with
your baby. For details, see page 64.
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Deciding to Breastfeed
What about my other children?
Older children will wonder about breastfeeding if they haven’t seen it before.
They may want to talk to you and be near you while you are breastfeeding.
Make a snack for them and have them sit next to you to eat it. Suggest that they
bring you a book to read or that they do something quiet nearby. Give them
special toys at this time. Talk to them about what is happening while you feed.
If older children feel left out or jealous this is normal. Make sure they know
that you love them and they are important to you.
If your children are old enough, they can help to care for the new baby.
Teach them to hold or burp the baby. Ask your child to sing while you change
the baby’s diaper and to pass you things you need. They could answer the
telephone when you are breastfeeding. If your older children have a good
experience now, they may decide to breastfeed your grandchildren!
What about going back to work?
In New Brunswick many mothers have maternity leave for 4 to 6 months, or
longer. On the other hand, women who go to school, have a casual job, or are
self-employed may not have paid leave. They may need to return to school
or work within the baby’s first month of life. If you must go back to work or
school, you can still breastfeed with help from your partner, sitter, relative or
friend. For more information about pumping and storing breast milk, talk to
your health care provider.
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Healthy Pregnancy... Healthy Baby
Getting Ready to Breastfeed
Once you know you will breastfeed, you can prepare yourself. The time to do
this is now, when you are pregnant. It is also the time to think about who will
support you and answer your questions. You can prepare your partner to be
involved; there are many ways he can help. Near the end of your pregnancy,
you should think about buying a nursing bra and nightgown for nursing.
The Breast and How It Works
The breasts are organs of the female body. This section describes the parts of
the breast and how your breasts change during pregnancy and when your body
makes milk (lactation).
Parts of the breast
• The breast is made of skin, chest muscles, blood vessels, nerves, fatty tissue,
and milk-producing tissue.
Areola
Montgomery
glands
• The areola is the darker circle of skin that spreads around the nipple.
• Inside the breast, milk glands (or lobes, which are made up of smaller
lobules) contain tiny milk-producing bags (alveoli).
• These tiny bags produce and release breast milk.
• Milk tubes (or ducts known as lactiferous ducts) carry the milk from the
alveoli to the nipple.
Nipple
• Each nipple has 15 to 25 tube (or duct) openings from the tiny milk bags.
• The bumps you see on the areola are called Montgomery glands. They
produce an oil that makes the nipple and areola less dry. This oil also helps
to prevent germs from growing on the nipple and areola.
Milk ducts
Aveoli or lobules
60
Deciding to Breastfeed
Changes in Your Breasts
1. Before pregnancy
Your breasts were getting ready to breastfeed even before you thought about
being a mother. Milk glands started to grow during your teenage years.
2. During pregnancy
Hormones make your breasts change during pregnancy. The breast, areola,
and nipple get bigger. The nipple and areola also become darker in colour.
Milk glands and tubes (ducts) increase in number and grow in size. If you have
some hair around your nipple, do not worry. This will not affect breastfeeding.
3.When you are breastfeeding (during lactation)
You will notice a big change in your breasts when your baby is born. Once
the placenta leaves your body, hormones tell the alveoli to produce milk. Your
breasts will get bigger as milk fills the milk ducts. The amount of swelling is
not the same for all women. Your breasts may feel full, or even a bit tight.
If you breastfeed often, these feelings tend to go away.
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Healthy Pregnancy... Healthy Baby
Setting
Goals for
Breastfeeding
The best time for your baby’s first feeding is within the first hour of birth.
The World Health Organization and UNICEF say that it is good to breastfeed
until the child is at least two years old.
Now is a good time to set some goals for breastfeeding. By making your own
goals for breastfeeding, you are learning what you need to do.
You are also finding out how you are going to do it. If you set goals, you can
then decide how to reach your goals.
Your breastfeeding goals
Read this list of breastfeeding goals and check off the ones you want to aim
for.
o I will breastfeed my baby.
o I will create a breastfeeding support group while I am pregnant.
o I will find out about breastfeeding at the hospital where my baby will
be born.
o I will tell the hospital staff that I plan to breastfeed my baby.
o I will read about setting breastfeeding goals for the time I am in
hospital (on page 68) and try to reach these goals.
o I will create a baby-feeding plan that says that my baby will not be
given any bottle or pacifier (see page 69 for a sample).
o I will accept that breastfeeding may take time, patience, and effort.
o I will make the first few weeks a learning time for both my baby and
me.
o I will involve my partner so that breastfeeding will succeed in our
family.
o I will try to learn as much as I can about breastfeeding so I can be sure
of myself.
o I will try to quit smoking now.
o I will breastfeed our baby as long as I can, because it will help our baby
grow.
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Deciding to Breastfeed
Breastfeeding is Mother Nature’s way to feed your baby. But, this does not
mean you will know how to do it right away. Most mothers need facts and
support to breastfeed. This is most true during the first month or two.
Building
Support for
Breastfeeding
How can breastfeeding support help me?
It is a good idea to think about getting support ahead of time and to find
friends, family members, professionals, and support groups to help you. Why is
this a good idea?
• You will have someone to talk to about breastfeeding your baby. This person
can give you help in person or by telephone.
• You will have someone to lean on any time of the day or night. You may
need it most often during the night!
• You will have people checking to see if you and your baby are fine. This may
happen in person or by telephone.
• You will have help with some of the baby care. For example, a support
person may take your baby for a walk while you relax in the bath. The
support person could look after the baby while you have your hair cut.
• You will have someone to help with meals, housework, and maybe even
shopping. This person may help a little bit or a lot. It depends on what you
need and how helpful she can be.
• If you have other children, you will have help in caring for them. You can
also involve older children in helping out, if you think it will work out.
• You will have someone to invite you, your baby, and the rest of your family
for a meal or an outing.
• You will have a babysitter so you and your partner can go out.
Remember, friends and family will offer advice, whether you ask for it or not.
Some advice will be helpful. Some of it may leave you feeling confused because
the ideas do not agree with each other. Do not be afraid to ignore advice if you
do not find it helpful!
Who can provide support for breastfeeding?
The time to think about who can help you with breastfeeding is NOW,
when you are pregnant. Then you will be ready when your baby is born!
• Find one or two mothers who have enjoyed breastfeeding their babies. It
is good to choose people who live near you. Ask them if they will give you
moral support or help with any problems you might have when you are
breastfeeding your baby.
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Healthy Pregnancy... Healthy Baby
• Talk with your partner about ways to share “the load” once your baby
arrives.
• Find out if there is a breastfeeding support group where you live. Ask your
public health nurse, public health nutritionist or look in the telephone book.
Maybe you can join a group and learn from mothers who have breastfed
their babies. Go to one or two meetings while you are pregnant.
• Find other new mothers to talk with and who will agree to do child-care for
you (and you will do it for them). Find out how you can offer to give each
other time off when you need it.
• Check to see if there is a parent-child drop-in centre, mother-baby group,
or exercise program you can join close to where you live.
• Talk about breastfeeding with your public health nurse or public health
nutritionist. Your hospital or other agency may offer breastfeeding support
in the community.
A Word to Partners
As the partner of a breastfeeding mother, you can be part of breastfeeding.
When your partner is pregnant, you can learn together why breastfeeding
is good for your baby, for the woman, and for your family. Talk about your
concerns at your prenatal class or with a public health nurse or public health
nutritionist. Share your feelings about breastfeeding before your baby is born.
Here are some ways that partners can help with breastfeeding.
• Support the new mother and baby as they learn to breastfeed. It takes time
for a woman and baby to know each other and to learn about breastfeeding.
• Help the new mother with words and actions. Help her to sit in a
comfortable way for feeding. Bring her a snack or drink during the feeding.
Play music that she likes. Use your own ideas to make her feel special.
• Take a few days off from work to help out. You will both need each other’s
help as you get to know your baby and share the chores.
• Remind the mother of breastfeeding tips that you have both learned.
• Help with baby care. You can take the baby to her crib before and after
a feeding, and burp the baby. Babies love to be held, rocked, and talked to.
• Lie down or sit with the mother while she breastfeeds the baby.
• Comfort your baby when she is fussy or crying a lot. One way is to lay her
on your chest with her ear over your heart. The rise and fall of your chest
usually puts the baby to sleep. You have special ways to comfort your baby.
Both mother and baby will benefit from the efforts you make.
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Deciding to Breastfeed
Nursing bras
Nursing bras are made to provide women with support and comfort when they
are breastfeeding. They also make it easy to breastfeed. You can wear a normal
bra as long as it does not have under wire. They may clog or plug your milk
ducts. Some mothers with heavy breasts find a normal bra gives more support.
The ones that open and close at the front are best. Some women prefer to not
wear a bra at all.
Buying
Nursing
Bras and
Nightwear
When you are pregnant, your breasts get bigger, and if you have to buy new
bras, you might want to buy nursing bras. You can wear them while you are
pregnant and also for breastfeeding. You will need 2 or 3 bras. You can buy
them in a department store or maternity store. Have them ready to go into the
suitcase you will take to the hospital.
What makes a good nursing bra?
The bra should fit well, be easy to adjust, and not be tight. It should have
seamless cups (without plastic liners). The flaps should be large. You will need
to pull them down for easy feeding and to allow most of the breast to be free.
The bra should give firm support and have wide straps that do not stretch. It
should be made of cotton or cotton-polyester so you can wash it. Try the bra
on before you buy it. Make sure you can hook and unhook the flap with one
hand.
What size should I buy?
You need to know the band size and the cup size to buy the correct nursing bra.
1. Band size
Use a tape measure to find your band size. Measure around your rib cage just
below your breasts. This chart gives the bra band size:
If your Rib cage measures:
27 in
29 in
(69 cm)
(74 cm)
31 in
(79 cm)
33 in
(84 cm)
35 in
(89 cm)
37 in
(94 cm)
Then your Band size is:
32 in
34 in
(80 cm)
(85 cm)
36 in
(90 cm)
38 in
(95 cm)
40 in
(100 cm)
42 in
44 in
(105 cm) (110 cm)
39 in
(99 cm)
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Healthy Pregnancy... Healthy Baby
2. Cup size
Use a tape measure to find your cup size. Measure around your chest over
the largest part of your breasts. Add an extra inch to include nursing pads (see
below) when you measure your cup size. Now, subtract the number you got
for your breast size from the number you got for the band size. The difference
between these numbers tells you what cup size you need. This chart shows you
what your cup size will be:
Difference
Cup size
1 in
(2.5 cm)
A
2 in
(5.0 cm)
B
3 in
(7.5 cm)
C
4 in
5 in
(10.0 cm) (12.5 cm)
D
DD
Example—If the band size is 34 in (85 cm) and the breast measurement is 37 in
(94 cm), the difference of 3 in (7.5 cm) = C cup.
Why do women use nursing pads?
Some mothers wear nursing pads in their bra to protect their clothing from
milk that might leak from their breasts. You have three choices:
1) Buy nursing pads that you can wash and use again,
2) Make your own nursing pads, or
3) Buy disposable nursing pads. Be sure the pads do not have a seam across the
nipple because this can make your nipples sore.
To make your own nursing pads, use small squares of white flannel or diaper
flannel, old cloth diapers, soft face cloths, unscented sanitary napkins, or
disposable diapers with the plastic lining removed. You can also use quilted
pads that are used to remove make-up. This is a smart and low cost way to get
nursing pads.
Nursing nightgowns
You do not need to buy special nightgowns as long as you can put the baby to
your breast in a comfortable way. You will need 2 or 3 nightgowns or pajamas
with front openings. T-shirts are good because you can lift them up with no
trouble. There are special nightgowns with slits hiding inside folds. They look
nice and do make it easy to breastfeed.
Your night clothes should be washable. Be sure to pack them in the bag you
take to the hospital.
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Deciding to Breastfeed
Breastfeeding in the Hospital
– Plan Ahead
All hospitals are not the same. Find out if there is support for breastfeeding
at the hospital where your baby will be born. Ask about this when you are
pregnant. Then you will know what to expect.
When will I be able to breastfeed?
It is best if you can breastfeed your baby within 1 hour of birth. Most babies
are quiet and awake for about 3 hours after they are born. During this time,
your baby may be ready to start feeding. Not all babies will do this but you
can still enjoy this first quiet time together.
Questions to
Ask before
Labour
Will someone help me the first time I breastfeed?
Ask if someone who has experience will be there to help you get started.
Does the hospital allow babies and mothers to stay in the same room?
It is good for babies and mothers to be together 24 hours a day. It allows
breastfeeding to have a good start. It is often called rooming-in.
Does the hospital offer breastfeeding classes?
When you are in hospital, the nurses can answer your questions
and help you with breastfeeding. Ask for as much help and
information as you need. As well, you may find it helpful to
attend breastfeeding classes where you can talk with other
mothers about breastfeeding.
Does the hospital staff give breastfed babies
water or soothers (pacifiers)?
Breastfed babies should not be given fake nipples.
Sucking the nipple of a bottle or a soother and
sucking the breast are very different. If babies
have a bottle or soother, they may prefer to
suck them, and not the breast. This can make
a baby refuse your breast.
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Healthy Pregnancy... Healthy Baby
There is no need to give water, sugar and water, or formula to healthy babies
who breastfeed. If the doctor says the baby needs liquid, it can be given to the
baby by cup or in a syringe.
Does the hospital have a support group or 24-hour breastfeeding phone
line?
If it does, make sure you call someone as soon as you have questions about
breastfeeding your baby. Keep the phone number handy. Many problems seem
to come up in the middle of the night. It is important to phone the number for
advice when you need it.
Goals for
Breastfeeding
in the
Hospital
You and your baby need to get off to a good start. Here are some
breastfeeding goals for your time in the hospital:
My baby and I will get to know each other right away
Your baby should be put to your breast within 1 hour of birth. This allows you
to have skin contact. It is the start of a special time between you. Your baby
may not feed at this time but you can still enjoy the time together.
My baby and I will learn the correct position for breastfeeding
Being in the correct position is important for breastfeeding. If the baby is in
a bad position, you may get sore nipples. Both of you need lots of practice
so you can do it right. Be sure to ask the nurses in the hospital to check your
breastfeeding position.
My baby and I will develop good latch-on skills
It’s important for your baby to latch onto the breast the right way. Your baby
gets milk by pressing on the areola, not by sucking your nipple. Nurses can
help you and your baby learn the right way to latch-on.
My baby and I will try more than one position for breastfeeding
You do not need to sit up each time you breastfeed your baby. Lying down is
a very good way to feed the baby at night because you can rest. It is also a good
way for you to rest during a daytime feeding. Ask the nurses to help you and
your baby try different positions.
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Deciding to Breastfeed
My baby and I will go to breastfeeding classes in hospital
If the hospital offers them, breastfeeding classes can be helpful. This is
a chance to have your questions answered. You can also talk to other new
mothers about what they have learned about breastfeeding.
I will learn to express breast milk while in hospital
Using your hand to pump out breast milk is called “hand expressing”. It is a
good thing to learn when you are in hospital. You may need to use this skill
when you go home. During your first week at home, you may need to make
the areola of your breast softer so that the baby can latch on. The areola can be
hard if your breast is full of milk. After you learn to express milk, you should
wait for 3 or 4 weeks before you empty your breast to replace a feeding.
Example of a Baby Feeding Plan
My Breastfeeding Plan
My goal is to breastfeed my baby and I would like my nurse to help me
reach this goal. Please help me by doing these things:
o Do not give my baby a bottle.
o Do not give my baby any fluids or extra feeding without my consent.
o Do not give my baby a fake nipple or soother.
o My baby will stay in my room with me most of the day.
o My baby will be brought to me during the night for feeding.
o If my baby cannot breastfeed, my nurse will explain all other options to
me, such as cup feeding, finger feeding, and lactation/nursing aids.
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Healthy Pregnancy... Healthy Baby
Your Decision to Breastfeed
Your Baby
When you decide to breastfeed your baby, you are making the best choice
because breast milk is the perfect food for babies.
The special bond that you and your baby have will grow every day. As you both
learn how to breastfeed, you will find even more joy.
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Healthy Eating
Healthy Eating
Healthy Eating
What did you feed your baby today?
When you are pregnant, the food you eat feeds your baby, too. What you
eat at this time can have a big effect on your baby’s growth and health.
Healthy eating can also improve your own health
when you are pregnant. It can help you prevent
or control some of the uncomfortable things that
happen, such as feeling like you are going
to throw up (nausea), constipation, and
heartburn.
Your eating habits affect your family’s
eating habits. If you start good eating
habits now, your baby and your whole
family will be healthier.
Healthy eating is good for you, good
for your baby, and it tastes good, too!
Canada’s Food Guide will help you plan
meals and snacks that give you all you
need to nourish yourself and your baby.
It is natural, normal and healthy to gain weight when you are pregnant.
The weight you gain helps create a healthy baby. It also keeps you healthy and
gets your body ready for breastfeeding. This is not a time to lose weight.
Weight Gain
Most healthy women need to gain between 11.5 and 16 kilograms (kg) or
25–35 pounds (lbs).
If you were very thin before you got pregnant or if you are a teenager, you may
need to gain a bit more, usually between 12.5 to 18.0 kg (28-40 pounds).
If you were heavy before you got pregnant, you may need to gain a bit less,
usually between 7.0 to 11.5 kg or 15 to 25 lbs.
If you were very heavy before you got pregnant, you may need to gain a bit
less; usually between 5.0 to 9.0 kg or 11 to 20 lbs.
Your public health dietitian, or your doctor can tell you what weight gain is
right for you.
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Healthy Pregnancy... Healthy Baby
Here’s where the weight goes when
a woman gains about 13 kilograms
(kg) or 28 pounds (lbs) by the end of
pregnancy.
Gaining
Weight
Slowly
3.5 kg (7 1/2 lbs)
Baby
3.5 kg (7 1/2 lbs)
Stored fat
3.0 kg (6 1/2 lbs)
Extra blood
and fluid
1.0 kg (2 1/2 lbs)
Uterus
1.0 kg (2 1/4 lbs)
Waters
around
the baby
0. 5 kg (1 lb)
Breasts
0. 5 kg (1 lb)
Placenta
13 kg (28 lbs)
TOTAL
When you are pregnant, when you gain weight is just as important as
how much weight you gain.
Most women do not gain much weight during the first three months. About
0.5 to 2 kg (1 to 4 pounds) is normal. Although still very small, your baby is
growing very quickly. Healthy eating is very important during the first
3 months.
For the next 6 months, the baby will grow bigger and stronger. You should
expect to gain about 0.2 to 0.5 kg (0.5 to 1 pound) a week.
This steady, slow weight gain is a sign of a normal, healthy pregnancy. If you
find you are gaining a lot more, or a lot less than 0.2 kg to 0.5 kg (0.5 to 1
pound) a week, talk to your public health dietitian, or to a doctor.
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Healthy Eating
What You Need
When you are pregnant, every day you should have:
• Regular meals and snacks
• Food from each of the 4 food groups
• Foods that have iron, calcium, and folic acid
• Foods high in fibre
It means that you should limit
• Caffeine
• Artificial sweeteners
• Foods that do not nourish your body.
It means that you must not drink alcohol. See Section 1 - Healthy
Start, for more information.
Balance is the key to healthy eating. You need to eat many kinds of
foods, but not too much of any one thing.
No food is perfect all by itself. You need many kinds of healthy
foods to be healthy and to have a healthy baby.
Eating regular meals and snacks is important. Both you and your baby need
a steady supply of food to stay healthy. It is hard to get this if you miss meals.
Try to make a habit of eating regular meals. If you find it hard to eat three
meals a day, try to have more small meals and more snacks. The important
thing is to stay with a pattern of eating that you enjoy. It should also be one
that gives you and your baby the food you need.
Regular
Meals
Pregnant women need to eat when they get up in the morning. The night is
a long time to go without food. Your body slows down while you are asleep,
and you need healthy food to get moving again.
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Healthy Pregnancy... Healthy Baby
The Four
Food Groups
The Four Food groups in Eating Well with Canada’s Food Guide are:
• Vegetables and Fruit
• Grain Products
• Milk and Alternatives
• Meat and Alternatives
You should eat different kinds of foods from each of these food groups every
day.
The Food Guide suggests how many servings people should have from each
food group. Pregnant women need to add an extra 2 to 3 Food Guide Servings
each day. The amount you need from each group depends on how much
weight you need to gain, how active you are, your age, and your own style of
eating. We suggest that you listen to your body—eat when you are hungry and
stop when you are full.
The foods you eat now will create a healthy baby. If you are a vegetarian or if
you are allergic to milk, talk with a public health dietitian about what you can
do to make sure that you and your baby are getting the food you need.
Vegetables
and Fruit
What foods are in this group?
This group includes all vegetables and fruit. They can be fresh, cooked, frozen,
canned or dried. It also includes fruit and vegetable juice. When you drink fruit
juice, be sure that you are getting real juice and not fruit “drinks,” which are
mostly sugar and water.
Why do I need them?
Vegetables and Fruit give you
• Folic acid, which helps build red blood cells
• Vitamin A, which helps build bones and teeth and keeps eyes and skin
healthy
• Vitamin C, which keeps your gums and blood vessels healthy and helps you
fight infection
How much do I need?
• Teens (14 to 18 years): at least 7 servings of vegetables and
fruit each day.
• 19 and older: at least 7 to 8 servings of vegetables and fruit
each day.
• Eat at least one dark green and one orange vegetable each day.
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Healthy Eating
How big is a serving?
A serving is:
• 125 mL (1/2 cup) fruit or vegetables (fresh, frozen, or canned)
• 250 mL (1 cup) leafy vegetables (lettuce, spinach)
• 125 mL (1/2 cup) 100% fruit or vegetable juice (fresh, frozen, or canned)
• 1 medium-size fruit or vegetable (like a potato, green pepper, tomato, peach,
apple, orange, or banana)
• 60 mL (1/4 cup) dried fruit
What foods are in this group?
This food group includes grains, cereals, and flour. It also includes all the foods
made from these, such as bread, oatmeal, bran muffins, rice, shredded wheat,
noodles, and pasta. Whole grain breads and cereals are high in fibre.
Grain
Products
Why do I need them?
Grain Products give you:
• Carbohydrates, which give you energy and help your body use fats
• B vitamins, which help your body use energy from foods and keep your eyes,
skin, nervous system, and appetite healthy. B vitamins are also important for
normal growth and health
• Iron, which keeps blood healthy
• Fibre from whole grains keep your bowels working well
How much do I need?
• Teens (14 to 18 years): at least 6 servings of grain products each day
• 19 and older: at least 6-7 servings of grain products each day
How big is a serving?
One serving is:
• 1 slice of bread (35 g)
• 175 mL (3/4 cup) cooked cereal
• 30 g cold cereal
• 1 small roll or muffin
• 125 mL (1/2 cup) cooked brown or white rice, bulgur, quinoa,
macaroni, spaghetti, noodles, or couscous
• 1/2 hamburger or 1/2 hot dog bun
• 1/2 bagel (45 g)
• 1/2 pita or 1/2 tortilla (35 g)
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Healthy Pregnancy... Healthy Baby
Milk and
Alternatives
What foods are in this group?
This group includes all forms of milk — whole, partly skimmed, skim,
evaporated, and powdered, as well as milk products like cheese, yogurt, frozen
yogurt, milk puddings, and cream soups and sauces. It also includes fortified
soy beverages.
Why do I need them?
Milk and alternatives give you
• Calcium, which builds bones and teeth and keeps them strong. It also helps
nerves to work well and your blood to clot
• Vitamin D, which also builds strong bones and teeth
• Protein, which helps to build and repair all parts of your body and fight
infection
How much do I need?
• Teens (14 to 18 years): at least 3 to 4 servings of milk and
alternatives each day
• 19 and older: at least 2 servings of milk and alternatives each day
How big is a serving?
One serving is:
• 250 mL (1 cup) of milk
• 175 mL (3/4 cup) yogurt
• 50g (11/2 ounces) of firm cheese (such as cheddar cheese)
• 125 mL (1/2 cup) canned milk (evaporated)
• 250 mL (1 cup) fortified soy beverage
Meat and
Alternatives
What foods are in this group?
Besides meat, this group includes fish, chicken, eggs, dried peas, beans and
lentils, peanut butter, nuts, tofu and seeds.
Why do I need them?
Meat and alternatives give you
• Protein, which builds and repairs all parts of your body and helps fight
infection.
• Iron, which keeps blood healthy.
• Folic acid, which helps build red blood cells.
How much do I need?
• You need at least 2 servings of meat and alternatives every day.
• Eat 2 Food Guide Servings of fish each week.
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Healthy Eating
How big is a serving?
A serving is:
• 75 grams (2 1/2 ounces) / 125 mL (1/2 cup) of cooked fish, shellfish,
poultry, or lean meat. This is about the size of a deck of cards.
• 30 mL (2 Tbsp) of peanut butter
• 175 mL (3/4 cup) dried peas, beans, or lentils
• 60 mL (1/4 cup) nuts or seeds
• 2 eggs
• 150 g or 175 mL (3/4 cup) of tofu
Although water is not a food group, it helps to keep your body healthy.
Water
• It helps keep your body temperature normal.
• It moves vitamins and minerals to where your body needs them.
• It helps your bowels to work well, prevents constipation, and lets the fibre
in your food do its job.
Fresh, clean drinking water is part of healthy eating during pregnancy. You
need 6 to 8 glasses of water a day. Make sure you do not drink so much water
that you have no desire for food.
Making sure your water is safe
If your city or town supplies water to your house, you can be quite sure that it
is safe for you and your baby.
If you get your water from a well, you need to have it tested. It may contain
things that could affect you and your baby.
Contact your local Public Health office, Health Protection Branch to learn
more about testing your well water.
C
alcium, vitamin D, folic acid and iron are very important for your baby’s
growth. You need more than usual while you are pregnant. The best way to be
sure you are getting enough is to eat many kinds of foods from each of the four
food groups every day.
Extra
Calcium,
Vitamin D,
Folic Acid,
and Iron
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Healthy Pregnancy... Healthy Baby
Calcium
Why do I need calcium?
You need calcium to stay healthy and to help your baby have strong bones and
teeth.
What foods contain calcium?
Milk, milk products like cheese and yogurt, or milk alternatives — like fortified
soy beverage are common and good sources of calcium. You will get the
calcium you need if you have 2- 4 servings (depending on age) of milk and
alternatives each day.
Make sure that you include at least 500 mL (2 cups) of milk or fortified soy
beverage. It is enriched with vitamin D, which your body needs in order to use
the calcium in foods. Some cheeses and yogurts are now enriched with vitamin
D.
If you do not like milk products or cannot eat them, talk to a public health
nutritionist or dietitian about other ways to get the calcium you need. Sardines
and salmon (with the bones), oysters, tofu, sesame seeds, almonds, baked beans,
and broccoli contain calcium. Be aware that they do not have nearly as much
calcium as milk and alternatives. Nor do they all contain vitamin D. This
means you will have to eat a lot more of them to get the calcium you need.
Easy Ways to Add Calcium
Use skim milk
powder when
cooking
Five tablespoons of dry milk powder gives you the same calcium as one cup
of milk.
Use cheese
Try cheese for a snack. You can also grate it into salads, casseroles, and
sandwiches. Make cheese sauces for vegetables and pasta. Try low fat cheese.
Use yogurt
When cooking, use plain yogurt instead of sour cream. Use yogurt to replace
some or all of the mayonnaise in salad dressing, dips, or sandwich fillings.
Use milk instead of
water when you can
Make hot cereals and cream soups with milk, not water. Add extra milk
powder for even more calcium.
80
Add skim milk powder to puddings, custards, cheese dishes, scrambled eggs,
meat loaves, muffins, bread, chowders, and milk soups for extra calcium.
Mash potatoes in their cooking water, add 45–60 mL (3 to 4 tablespoons) of
skim milk powder, and then mash again.
Healthy Eating
Iron
Why do I need iron?
You need iron to build red blood cells. They carry oxygen and iron to your
baby. Babies need to have a good supply of iron in their bodies when they
are born. The iron they are born with has to last them until they are about 6
months of age.
What foods contain iron?
Some good sources of iron are:
• Meat and alternatives, like lean red meat, clams, lentils, legumes, dried peas
and dried beans
• Whole grain breads, cereals and wheat germ
• Dried fruit, like raisins, dates, apricots, prunes, and prune juice.
Vitamin C helps your body to use the iron in vegetables, fruit, grain products
and legumes. Try to eat foods with vitamin C at the same time you are eating
non-meat foods rich in iron. Some foods high in vitamin C are oranges and
grapefruit and their juices, tomatoes and tomato juice, cabbage, cauliflower,
and broccoli.
Easy Ways to Add Iron
Use dried fruit
Dried fruit, like apricots, dates, raisins, and currants, make good snacks.
You can also add them to cereal, applesauce, salad, muffins, sweet loaves,
and cookies.
Drink prune juice
Prune juice is also a good source of iron. Try mixing it with other juices to
add taste and extra iron.
Use beans
Dried peas, beans, and lentils — homemade or canned — are good sources
of iron. Baked beans, chili con carne, split pea soup, and lentil soup taste
good, are popular, and good sources of iron. If you make homemade soup, try
adding a can of kidney beans or chick peas for extra iron.
Use whole grains
Switch from white to whole wheat breads. Add oatmeal to meatloaf and
meatballs. Use bran flakes in baking, instead of corn flakes.
Use wheat germ
Add wheat germ to meat loaves, hamburgers, muffins, breads, and cookies.
You can also use it as a crunchy topping on casseroles and fruit crisps, or
sprinkle it on salads and cereals.
Avoid coffee or tea
at mealtimes
These make it harder for your body to use iron. Wait at least an hour after
meals before having coffee or tea.
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Healthy Pregnancy... Healthy Baby
Folic Acid
Why do I need folic acid?
Folic acid is a vitamin that works with iron to keep your blood healthy.
You need folic acid to build healthy blood and tissue for your baby.
Research has shown that women need more folic acid than we thought before.
Taking folic acid before you get pregnant and during the first three months
you are pregnant will help prevent problems in your baby. The most common
problem it prevents is spina bifida. Your body does not store folic acid, so you
need to be sure to get enough every day.
The New Brunswick Department of Health suggests that all women who could
become pregnant (from the time they start having periods until the end of
menopause) do two things:
• Eat food sources of folic acid every day, and
• Take 0.4 mg of folic acid every day as a supplement
What foods contain folic acid?
Many kinds of food are good sources of folic acid.
• Vegetables and fruit, such as broccoli, dark greens (romaine and spinach),
green peas, brussels sprouts, tomatoes, sweet potatoes, oranges, grapefruit,
cantaloupe, and citrus juices. Orange juice is a low-cost, quick way to get
folic acid each day.
• Meats and alternatives like peanuts and peanut butter, other nuts, dried peas,
and dried beans
• Whole grain breads, cereals and wheat germ
Folic acid is destroyed by heat, air, and water. Be sure to keep fruit and
vegetables cool in the fridge until you use them. Eat some fruit and vegetables
raw. When you cook, use as little water as possible. Try steaming your
vegetables instead of boiling them.
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Healthy Eating
Easy Ways to Add Folic Acid
Use spinach
Try a spinach salad, or add spinach to your salads. Use it with lettuce, or
instead of lettuce in sandwiches. Add it to soups, stews, and casseroles.
Eat raw fruit and
vegetables
Try raw broccoli, cauliflower, carrots, and green pepper with a dip. Add
fruit and vegetables to your salads. Tomatoes are good with most salads, and
oranges taste great with spinach. Oranges are a very good source of folic acid.
Add vegetables as
often as you can
Try making stew with tomato juice. Add tomatoes to macaroni and cheese.
Add an extra can of tomatoes to your chili or spaghetti sauce.
Drink citrus juices
Orange juice is always good. Try mixing it with grapefruit or pineapple juice
for a change of taste. Be sure that you get real juice. Fruit drinks and drink
powders do NOT contain folic acid.
Use wheat
germ
Sprinkle it on salads and cereals. Add it to meat loaf and casseroles. Add some
in when you bake bread, muffins, or cookies.
Use whole grain
flour
Make baked goods rich in folic acid by using whole-wheat flour, oatmeal, and
wheat germ for cookies, fruit crisps, muffins, granola, or fruit loaves.
Use nuts
Snack on peanut butter and crackers or whole wheat toast. Snack on peanuts,
almonds, and walnuts. Add them to salads. Put them into casseroles and
vegetable dishes. Add chopped nuts to cookies, muffins, and bread when you
bake.
Eat beans, peas,
and lentils
Try pea soup, bean soup, lentil soup, bean salads, and canned or homemade
baked beans.
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Healthy Pregnancy... Healthy Baby
Higher Fibre
Foods
Choosing foods that are high in fibre is healthy at any time.
Higher Fibre when you are pregnant
Constipation is a common problem for pregnant women. Fibre is a natural
laxative. It helps prevent constipation. When you eat foods higher in fibre,
be sure to drink lots of fluid to keep the fibre soft.
Higher fibre foods include:
• Whole grain breads and cereals
• Vegetables and fruit
• Dried peas, beans, and lentils
Staying active is also good if you want to prevent constipation. See page 32
in the Section 2 - Nine Months of Changes, for more information about
constipation.
Oils and Fats
Vegetarian
Eating
• Include a small amount — 30 to 45 mL (2 to 3 Tbsp) — unsaturated fat
each day. This includes oil used for cooking, salad dressing, margarine and
mayonnaise.
• Use vegetable oils such as canola, olive and soybean.
• Choose soft margarines that are low in saturated and trans fats.
• Limit butter, hard margarine, lard and shortening.
If you are vegetarian, you can still nourish yourself and your baby in a healthy
way. There are a few things you should know.
• Be sure to eat enough. When you are pregnant, you must get enough food
energy (calories) to meet your own needs and the needs of your baby.
Because vegetarian food often contains fewer calories, you may need to eat
more than usual to get the energy you need.
• Be careful to get enough protein. Protein from plants needs to be mixed the
right way if you are to meet your food needs and your baby’s. Good quality
protein is very important when you are pregnant.
• Make sure you are getting enough vitamins and minerals. If you are a strict
vegetarian and avoid all foods that come from animals, you may need extra
calcium, iron, zinc, vitamin D, or vitamin B12 when you are pregnant.
If you have any questions about vegetarian eating during pregnancy, talk with
your local public health dietitian.
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Healthy Eating
What You Do Not Need
In this section, we’ll be talking about caffeine, artificial sweeteners, and “other”
foods.
These foods are sometimes called “empty calories.” They do not nourish your
body but they do make you feel full. This leaves less room for the healthy foods
you and your growing baby need.
Here are some good reasons to limit caffeine while you are pregnant.
Caffeine
• Caffeine enters the baby’s blood, and the baby cannot get rid of it very well.
• Drinks that contain caffeine, like coffee, tea and colas, may take the place of
better drinks, like milk or fruit juice.
• Caffeine makes you pee (urinate) more often. If you have a problem with
having to go to the bathroom often, caffeine will make it worse.
• Caffeine makes it hard for your body to use calcium and iron. Both of these
are very important for your baby’s growth and health.
Many of us use caffeine and do not know it. Did you know there is caffeine in
chocolate, and in many soft drinks and medicines? Read the labels on food and
choose products that have the least caffeine.
If you want to replace coffee or tea with herbal teas, you need to be aware that
not all herbal teas are safe during pregnancy. If you use herbal teas, use the safe
ones. Safe herbal teas are: rosehip, lemon balm, citrus peel, ginger, and orange
peel. Check with your doctor or public health dietitian before you use other
herbal teas.
One way to cut down on caffeine is to know when you use it and think about
what you could have instead.
For example:
• Do you need two or three cups of coffee each morning? Try to stop after
one cup.
• Do you have the habit of drinking coffee or tea on your breaks at work?
Drink water, fruit juice or milk. Or eat an apple. Make sure that the foods or
drinks you have instead of coffee will nourish your body.
• Do you drink coffee or cola, or eat chocolate, to boost your energy? Getting
plenty of rest, eating well, and doing exercise will increase your energy
during the day.
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Healthy Pregnancy... Healthy Baby
Artificial
Sweeteners
T
he two most common artificial sweeteners are aspartame and sucralose.
These are known as Equal, Nutrasweet, and Splenda. Small amounts of these
sweeteners will not hurt you or your baby.
Two other artificial sweeteners, saccharine and cyclamate, should be used only
if your doctor says it is okay.
If you use artificial sweeteners, think about the kinds of foods and drinks that
contain them. Most of them do not nourish you or provide the kind of energy
that you and your growing baby need. Be very careful that these products do
not replace better foods. Now is the time to make healthy food choices. Milk,
juice, and water are healthy choices. They are also cheaper than sugar-free cola.
An apple or orange is a better snack than sugar-free jello.
‘Other’ Foods
‘Other’ foods are sometimes called junk foods because they have a lot of
sugar and fat. They do not nourish your body in a healthy way. They give you
calories but nothing else. Candy, chocolate bars, cake, donuts, soft drinks, fruit
drinks, French fries and chips are considered unhealthy foods.
When you are pregnant, you should make sure that the foods you eat nourish
both you and your growing baby. Do your best to limit unhealthy foods and
desserts. For example, if you go to a fast food restaurant, have a cheeseburger
but do not have French fries. Order a salad and drink milk, not pop.
Replace ‘other’ foods with healthy food. Try:
• An apple instead of a chocolate bar
• Orange juice instead of orange pop
• Cheese and crackers instead of cheese flavored snacks (Cheezies™)
• Milk instead of coffee
• Peanuts instead of chips
• A whole grain muffin instead of cake
• Bread and peanut butter instead of bread and butter/margarine
The key to healthy eating is to have a balance of many kinds of foods. Before
you eat something that you know is not healthy, ask yourself “Have I eaten all
or most of the food from the food groups listed in Canada’s Food Guide?”
86
Healthy Eating
Getting the Foods You Need
It is good to know what you should be eating. But it may seem hard at first to
fit all the details about food groups, extra iron, calcium, folic acid, low fat, and
high fibre foods into the meals you prepare every day.
We are here to help! In this section, sample menus show you how to get the
foods you need.
According to Canada’s Food Guide every day you need at least:
Teens (14 to 18)
Adults (19 or older)
Vegetables and Fruit
7
7 to 8
Grain Products
6
6 to 7
Milk and Alternatives
3 to 4
2
Meat and Alternatives
2
2
Pregnant women
Include and extra
2 to 3 Food Guide
Servings each day
3 Iron-rich Foods
3 Calcium-rich Foods
3 Folic Acid-rich Foods
3 Vitamin C-rich Foods
3 Oils and Fats: 30 to 45 mL (2 to 3 Tbsp) unsatruated fat each day such as canola oil,
olive oil, soybean oil or soft margarines low in saturated and trans fats.
Check the foods you eat every day against this list.
You need AT LEAST the number of servings in the table above.
How well does what you eat compare with what you need?
87
Healthy Pregnancy... Healthy Baby
Menus
T
he menu sheets on the next few pages can help you to plan meals so you
and your baby will be nourished and have the energy you need.
The first two menu sheets have been filled in. They contain meals and snacks
that most people know about. They are easy to make, and do not cost a lot.
They give you the right number of servings from each food group as well as the
extra calcium, vitamin D, folic acid and iron that you and your baby need.
Once you have seen and tried the first two menus, fill in the blank menu sheets
to keep track of your own eating for a few days. Do your menus provide all the
foods you and your baby need? If they do, congratulations! Keep up the good
work!
If they do not, please keep trying. Use the sample menus for a few days to help
you understand healthy eating. Then start making small changes so you are
using different kinds of food. For example, replace the apple on the sample
menu with an orange or a pear. Try green beans instead of peas, or broiled
pork chops instead of roast beef.
As you keep track of what you eat, be aware that you do NOT have to eat
something from each food group at every meal. Instead, you should eat the
correct number of servings from each food group during the whole day.
When you look at these menus, it may seem like they have more food than you
could eat in one day. Please remember that the serving sizes are small. Your
goal should be to eat many different foods from each of the four food groups.
This means that you should try to eat smaller servings of many kinds of foods
rather than large servings of just a few.
88
Healthy Eating
Sample Menu #1
How many servings
from each food
group?
What did you eat?
How much?
What food groups did
it come from?
Breakfast
orange sections
bran muffin
milk
scrambled egg
1 orange
1 small muffin
250 mL (1 cup)
1 egg
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
1
1/2
Morning Snack
pineapple juice
graham crackers
--peanut butter
125 mL (1/2 cup)
3 crackers
--15 mL (1 tablespoon)
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
0
1/2
Lunch
carrot sticks
apple slices
whole wheat bread
milk
tuna
125 mL (1/2 cup)
1 medium (1/2 cup)
2 slices (35 g x 2)
250 mL (1 cup)
75 grams (2 1/2 ounces)
Vegetables and Fruit
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
2
1
1
Afternoon Snack
Grapes
--Cheese chunks
---
125 mL (1/2 cup)
--50 grams (1.5 ounces)
---
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
0
1
0
Dinner
broccoli
rice
whole wheat roll
milk
small steak
125 mL (1/2 cup)
125 mL (1/2 cup)
1 small (35 g)
250 mL (1 cup)
75 grams (2 1/2 ounces)
Vegetables and Fruit
Grain Products
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
1
1
1
Evening Snack
Banana
whole grain cereal
toast
milk
---
1 small
30 grams (3/4 cup)
1 slice
250 mL (1 cup)
---
Vegetables and Fruit
Grain Products
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
1
1
0
89
Healthy Pregnancy... Healthy Baby
Count the number of servings from each food group to see if this menu gives you and your baby
the foods you need.
You get
You need at least
Teens (14 to 18)
Adults (19 and older)
Vegetables and Fruit
7 servings
7 servings
7 to 8 servings
Grain Products
8 servings
6 servings
6 to 7 servings
Milk and Alternatives
5 servings
3 to 4 servings
2 servings
Meat and Alternatives
3 servings
2 servings
2 servings
Pregnant women
Pregnant women
include an extra
2 to 3 Food Guide
Servings each day.
oIron from whole grain bread and cereals, Meat and Alternatives, and dried fruit
oCalcium and vitamin D from Milk and Alternatives
oFolic acid from Vegetables and Fruit, Meat and Alternatives, and Grain Products
oVitamin C from Vegetables and Fruit
oOils and Fats: 30 to 45 mL (2 to 3 Tbsp) unsatruated fat each day such as canola oil,
olive oil, soybean oil or soft margarines low in saturated and trans fats.
Sample Menu #2
What did you eat?
How much?
What food groups did
it come from?
Breakfast
prunes (stewed)
whole wheat toast
milk
peanut butter
125 mL (1/2 cup)
1 slice (35 g)
250 mL (1 cup)
30 mL (2 tablespoons)
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
1
1
Morning Snack
vegetable juice
whole grain crackers
-----
125 mL (1/2 cup)
crackers (30 g)
-----
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
0
0
Lunch
tossed salad
whole wheat roll
milk
split pea soup
250 mL (1 cup)
1 small
250 mL (1 cup)
250 mL (1 cup)
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
1
1
90
How many servings
from each food
group?
Healthy Eating
What did you eat?
How much?
What food groups did
it come from?
Afternoon Snack
fruit and milk smoothie
oatmeal carrot muffin
milk
---
1 banana
1 small
250 mL (1 cup)
---
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
1
1
0
Dinner
brussels sprouts
cauliflower
applesauce
noodles
milk
broiled chicken
125 mL (1/2 cup)
125 mL (1/2 cup)
125 mL (1/2 cup)
125 mL (1/2 cup)
250 mL (1cup)
75 grams (2 1/2 ounces)
Vegetables and Fruit
Vegetables and Fruit
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
1
1
1
1
Evening Snack
orange juice
whole grain bread
--peanut butter
125 mL (1/2 cup)
1 slice (35 g)
--15 mL (1tablespoon)
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
1
1
0
1/2
How many servings
from each food
group?
Count the number of servings from each food group to see if this menu gives you and your baby
the foods you need.
You get
You need at least
Teens (14 to 18)
Adults (19 and older)
Vegetables and Fruit
8 servings
7 servings
7 to 8 servings
Grain Products
6 servings
6 servings
6 to 7 servings
Milk and Alternatives
4 servings
3 to 4 servings
2 servings
2 servings
2 servings
Meat and Alternatives 3.5 servings
Pregnant women
Pregnant women
include an extra
2 to 3 Food Guide
Servings each day.
oIron from whole grain bread and cereals, Meat and Alternatives, and dried fruit
oCalcium and vitamin D from Milk and Alternatives
oFolic acid from Vegetables and Fruit, Meat and Alternatives, and Grain Products
oVitamin C from Vegetables and Fruit
oOils and Fats: 30 to 45 mL (2 to 3 Tbsp) unsatruated fat each day such as canola oil,
olive oil, soybean oil or soft margarines low in saturated and trans fats.
91
Healthy Pregnancy... Healthy Baby
What did you eat?
Breakfast
Morning Snack
Lunch
Afternoon Snack
Dinner
Evening Snack
92
How much?
What food groups did
it come from?
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
How many servings
from each food
group?
Healthy Eating
Your own menu #1
Count the number of servings from each food group to see if this menu gives you and your baby
the foods you need.
You get
You need at least
Teens (14 to 18)
Adults (19 and older)
Vegetables and Fruit
__ servings
7 servings
7 to 8 servings
Grain Products
__ servings
6 servings
6 to 7 servings
Milk and Alternatives
__ servings
3 to 4 servings
2 servings
Meat and Alternatives
__ servings
2 servings
2 servings
Pregnant women
Pregnant women
include an extra
2 to 3 Food Guide
Servings each day.
oIron from whole grain bread and cereals, Meat and Alternatives, and dried fruit
oCalcium and vitamin D from Milk and Alternatives
oFolic acid from Vegetables and Fruit, Meat and Alternatives, and Grain Products
oVitamin C from Vegetables and Fruit
oOils and Fats: 30 to 45 mL (2 to 3 Tbsp) unsatruated fat each day such as canola oil,
olive oil, soybean oil or soft margarines low in saturated and trans fats.
What did you eat?
Breakfast
Morning Snack
Lunch
How much?
What food groups
did it come from?
How many servings
from each food
group?
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
93
Healthy Pregnancy... Healthy Baby
What did you eat?
How much?
Afternoon Snack
What food groups
did it come from?
How many servings
from each food
group?
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Dinner
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Evening Snack
Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives
Your own menu #2
Count the number of servings from each food group to see if this menu gives you and your baby
the foods you need.
You get
You need at least
Teens (14 to 18)
Adults (19 and older)
Vegetables and Fruit
__ servings
7 servings
7 to 8 servings
Grain Products
__ servings
6 servings
6 to 7 servings
Milk and Alternatives
__ servings
3 to 4 servings
2 servings
Meat and Alternatives
__ servings
2 servings
2 servings
Pregnant women
Pregnant women
include an extra
2 to 3 Food Guide
Servings each day.
oIron from whole grain bread and cereals, Meat and Alternatives, and dried fruit
oCalcium and vitamin D from Milk and Alternatives
oFolic acid from Vegetables and Fruit, Meat and Alternatives, and Grain Products
oVitamin C from Vegetables and Fruit
oOils and Fats: 30 to 45 mL (2 to 3 Tbsp) unsatruated fat each day such as canola oil,
olive oil, soybean oil or soft margarines low in saturated and trans fats.
94
Healthy Eating
Y
ou may find that when you are pregnant there are some foods that you
love. You may even “crave” these foods. This means you want them often, and
cannot seem to get enough of them. There may be other foods that you hate.
Just thinking about them can make you feel sick
No one knows why this happens. There is no physical reason for loving or
hating certain foods.
Loving And
Hating Foods
When You
Are Pregnant
In other words, you do not want chocolate because your body “needs”
chocolate for some reason.
If you crave something that is good for you and your baby, like milk or fruit, go
ahead and enjoy! Just make sure that you leave enough room each day for other
good foods.
If you crave less healthy foods, like candy or chips, look for foods that are sweet
or salty, and healthy. Instead of candy, you could eat raisins, date squares,
muffins, and quick breads. Instead of chips, you could eat a small amount of
peanuts or salted almonds.
The same advice applies to foods you hate. If you really do not like fried foods,
do not worry. Broiling or baking is much better for you!
If you hate a healthy food that you and your baby need, try to find a ways to
put it into other foods. Or eat other kinds of foods that you like from the same
food group. For example, if you hate milk, try yogurt or cheese. You could also
put powdered milk into other things you cook, like muffins or meat loaf. If
this does not work, look for other ways to get calcium, such as salmon, tofu, or
broccoli. If you hate the smell of fish cooking, try to have someone cook it
for you.
If you are very concerned about foods you love or hate, ask your doctor
or a public health dietitian for advice.
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Healthy Pregnancy... Healthy Baby
Vitamin
Pills and
Supplements
M
any people think that if they take a vitamin pill or supplement, they do
not have to worry about what they eat. This is not true. Your body needs more
than 50 kinds of vitamins and minerals every day. Work on this. No vitamin or
supplement can replace a healthy diet.
When you are pregnant, you need to study your eating habits and make
changes where you can. Your doctor, public health nurse or dietitian can help
with this.
If for some reason you cannot change what you eat so you can be healthy, you
may need to take supplements.
Do not take vitamin pills or supplements on your own. Always talk to your
doctor, public health nurse or dietitian.
If you and your doctor or public health dietitian thinks you need a supplement,
treat it like medicine. Follow the directions and keep it away from children.
Be sure to ask these questions:
•
•
•
•
•
What is it?
What’s it for?
What will it do to me and my baby?
What are the side effects?
What is the smallest amount I can take?
Remember that even the best supplement cannot replace healthy eating.
96
Healthy Eating
N
ow that you know what you should be eating, check to see how well you
are doing.
If you can say YES and put a check mark next to each of these questions, you
are doing well! Your eating habits will help you create a healthy baby and a
healthy family.
Check Your
Eating Habits
If you cannot put a check mark next to all the questions, do not give up.
Change is not always easy. It takes time. Look at the things you need to change
and think about how you can start changing them.
On most days, do you:
q Eat many different kinds of foods from each of the four food groups?
q Eat whole grain bread and cereal?
q Eat at least 7 servings of vegetables and fruit?
q Eat/drink foods rich in calcium?
q Eat/drink foods rich in folic acid?
q Eat foods rich in iron?
q Have at least one food rich in vitamin C?
q Eat regular meals and snacks?
q Eat healthy snacks?
q Drink 6 to 8 glasses of fluids?
q Limit caffeine?
q Limit the amount of ‘other’ foods?
q Limit artificial sweeteners?
q Keep active?
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Healthy Pregnancy... Healthy Baby
After the Baby Comes
Healthy eating does not stop when your baby is born. You will still need food from each of the four food
groups every day.
Teens (14 to 18)
Adults (19 or older)
Vegetables and Fruit
7
7 to 8
Grain Products
6
6 to 7
Milk and Alternatives
3 to 4
2
Meat and Alternatives
2
2
Breastfeeding women
Include an extra
2 to 3 Food Guide
Servings each day
Healthy eating will help you and your family stay healthy and active. Canada’s Food Guide can help you
make healthy choices.
Remember to:
q Eat many different kinds of foods.
q Focus on cereals, breads, other grain products, vegetables, and fruit.
q Choose low-fat dairy products, lean meats, and foods that are made with little or no fat.
q Maintain a healthy weight by being active and eating healthy food.
q Limit salt, and caffeine. Avoid alcohol.
q Drink water often.
Enjoy a
VARIETY
of Foods
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Healthy Eating
Every mother loses weight as soon as her baby is born. You lose the weight
of the baby, the weight of the placenta, and the weight of the waters around the
baby (amniotic fluid).
Losing
Weight
During the next few weeks, you will also lose the weight of your uterus as it
returns to its normal size. The extra blood and fluid you needed when you were
pregnant are not part of your body anymore.
If you are breastfeeding, do not try to lose weight by eating less. When you
start to breastfeed, you will use up the fat your body stored when you were
pregnant. This fat will help you prepare for breastfeeding.
If you have eaten healthy food during your pregnancy and continue to do so,
it will not be hard to lose the extra weight. Many women find that they lose the
weight gained during pregnancy by the time the baby is eight months old. This
may seem like a long time, but remember, you were pregnant for nine months!
Your body needs time to get back to normal.
Getting back to your “normal” weight does not mean you will look like you did
before you were pregnant. Healthy eating and active living will help with this.
Join an exercise program for new mothers. See Section 6 - Healthy Activity, to
help you get started.
After the baby is born, many women want to “get back into shape” right
away. This is fine as long as you do not risk your health by trying to be very
thin, very fast.
Before you think about losing weight, think about your goal. What is a healthy
weight for you?
Choosing
a Healthy
Weight
The Body Mass Index (BMI) is an easy way to find the high and low weight
(weight range) that is best for you. When you know this, you can decide
whether you need to lose weight. You may be surprised to find that your
weight is not a problem. You may just need to exercise more so you can have
the shape you want!
The BMI works for men, too. This BMI chart does NOT apply to pregnant
women or mothers who are breastfeeding.
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Healthy Pregnancy... Healthy Baby
Body Mass
Index
How to Find Your Body Mass Index (BMI)
1. Find your height ( in or cm).
2. Find your weight (lb or kg).
3. Use a straightedge to locate the point on the chart where your height and
weight intersect.
4. Read the number on the dashed line closest to this point.
This is your BMI.
Example:
This person is 173
cm (68 inches) tall,
and weighs 69 kg (152
lb) and has a BMI of
approximately 23.
My BMI is
.
Source: Canadian Guidelines for Body Weight Classification in Adults,
Health Canada
100
Healthy Eating
Canadian Guidelines for Healthy Weights
(for adults 20 to 65 years of age)
Underweight
BMI less than 18.5
Normal Weight
BMI between 18.5 and 24.9
Overweight
BMI
between 25
and 30
Obese
BMI more than 30
May cause health
problems for some
people
Good weight for most
people
May create
health
problems
for some
people
Greater risk of
health problems
Are you Underweight?
You may not be eating enough or you may be too active for the amount of food
you eat. Or it could be a mixture of both.
My Contract for
Body Balance
Are you Overweight?
I want to reach
or keep my BMI
within the range of
18.5 to 24.9. I will
do this by having
goals for healthy
eating and healthy
activity.
Be careful. You may be at risk for certain health problems. Do not gain any
more weight.
My Healthy
Eating Goal is:
Are you Normal weight?
Congratulations. You are at a healthy weight. Stay with your healthy lifestyle.
Are you Obese?
You are at higher risk for health problems. You need to change your eating
habits and lack of activity. You may be choosing the wrong foods or not getting
enough exercise, or both.
If your BMI is below 18.5 or above 24.9 you may want to see a doctor or
dietitian for advice.
My Healthy
Activity Goal is:
A balance of healthy eating and regular activity can help keep your BMI within
18.5 and 24.9.
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Healthy Pregnancy... Healthy Baby
Making
Healthy Food
Choices to
Help You
Lose Weight
If you need to lose a few pounds to reach a healthy weight, do it slowly.
Remind yourself that it took nine months to gain the weight.
Keep eating the correct number of servings from each of the food groups.
To change your weight, choose food that has fewer calories. The best way to
lose weight is to take calories, not nourishment, out of what you eat. To cut
calories, make healthy choices from the four food groups and limit the foods
you eat from the “other” group.
If you want to learn more, talk with a dietitian at your local Public Health
Office.
Regular activity will help you to use calories, tighten muscles, and feel great.
Tips to help you make Healthy Choices
• Increase the amount of whole grains, vegetables and fruit that you eat.
• Use skim milk, 1%, or 2% milk. Use 2 % milk instead of cream in
coffee or tea.
• Use low-fat milk products, like yogurt and cheese.
• Use lean cuts of meat and trim off fat before cooking. Remove the skin
from chicken before you cook it.
• Drain off fat when you are cooking meat.
• Eat more peas, beans, and lentils. Cook them with little or no meat and
do not add fat.
• Bake, broil, roast, or steam foods. Do not add extra fat when you are
cooking.
• Limit fried foods.
• Limit high-fat snacks. Choose pretzels instead of potato chips, frozen
yogurt instead of ice cream, and fresh fruit instead of cookies.
• Cut back on added fats. Use only a little butter, margarine, or
mayonnaise. Try lower fat substitutes.
• Cut back on high sugar foods like jam, sugar, honey, candy, pop, and
fruit drinks (such as fruit cocktails and fruit punch).
• Cut back on fatty lunchmeats like salami, bologna, and hotdogs. Look
for low-fat products.
102
Healthy Eating
• When you buy food in packages, read the Ingredient List and Nutrition
Facts Table. Ingredients are listed in order of their weight. If fats are
listed in the first three ingredients, the product could be high in fat.
Names for fat include saturated fat, trans fat, hydrogenated vegetable
oil, palm oil, coconut oil, tallow, and any word ending in “glycerides” –
such as monoglycerides and diglycerides.
• Look on cheese and yogurt labels for the percentage of milk fat (MF).
Choose cheese that has less than 20% MF and yogurt that has less than
2% MF.
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Healthy Pregnancy... Healthy Baby
Make Healthy Eating A Habit
Healthy eating is a good habit. It means that you can enjoy many different
kinds of foods that taste good and nourish your body. It means that you avoid
alcohol and limit foods with fats, caffeine, salt, and sugar.
Good eating habits can help your family stay healthy for life. Right now is
a good time to make healthy eating a habit.
Once your new baby arrives you can learn more about breastfeeding and
healthy food for children by calling your local Public Health office.
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Healthy Activity
Healthy Activity
Active Living and Pregnancy
Active living offers something for everyone.
Active living means that you make some kind of physical activity a part of your
daily life. It means doing things that are fun, healthy, and make you feel good.
What you decide to do depends on your life and your body.
Active living can help you to:
• Reduce stress. Being active helps your body and mind relax.
• Stay comfortable. Being active can prevent backache and constipation.
• Manage your weight during pregnancy.
• Keep or improve your level of fitness. When you are fit, labour and delivery
are not as hard. It will also be easier for you to get your muscle tone,
strength, and figure back after your baby is born.
• Have more energy. Being active makes you feel more alive.
Unless you have medical reasons for not being active, you should make exercise
and physical activity part of your life. It will help you feel and look better when
you are pregnant, and after the baby is born.
This section offers a safe program to help you exercise your whole body within
your own limits.
If you already have an active life, ask your doctor, physiotherapist, fitness
instructor, or public health nurse for advice about exercise and pregnancy.
If you have not been doing regular physical activity, talk to your doctor,
physiotherapist, or fitness instructor before you begin. Then start slowly and
increase in a way that suits you.
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Healthy Pregnancy... Healthy Baby
Comfort Every Day
As your size and shape change during pregnancy, you may find that even
standing and sitting seem awkward.
You can adjust your movements to make the everyday activities safe and
comfortable.
Stand Tall:
Posture
during
Pregnancy
Good posture is the key to comfort when you are pregnant. By standing
correctly, you can carry the weight without hurting your back or your stomach
(abdominal) muscles.
Check Your Posture
Here’s what you can do:
Try to avoid a posture where:
Tuck your chin in. Make your
neck longer. Think about being
taller.
Your neck sags. Chin juts
forward. Body slumps.
Roll shoulders back. Lift up your
rib cage. Relax your arms at the
sides of your body. Relax your
shoulders.
Tighten your stomach
(abdominal) muscles. Make
your lower back flat. Tuck your
buttocks under.
Relax your knees.
Balance your weight on the center
of each foot.
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Your shoulders slouch. Rib cage
is cramped. Arms turn in.
Your stomach (abdominal)
muscles are loose. Lower back
is hollow. Hips and pelvis tip
forward.
Your knees are stiff and locked.
Your weight is on the inner
edges of each foot.
Healthy Activity
Good posture when you walk
Keep your back straight and your head up. Think about having a string tied to
the top of your head, pulling your head up and making your spine straighter.
Tips for standing tall
If you must stand for a long time, raise one foot on a stool or the rung of
a chair. This will give your back some relief.
When using a broom or a vacuum, stand with one foot forward and knees bent.
This makes it easy for you to shift your weight and turn.
Looking after your back every day
Taking care of your back can be something you do every day, now and after
your baby is born.
Ironing
When you iron, rest one foot on a small stool.
Laundry
Try not to bend and twist when you move clothes from a washing machine
with a top lid into a dryer that has a front door. Instead, put the clothes on top
of the dryer and then move them into the dryer.
When you hang clothes on a line, put the laundry basket at the same level as
your waist, not on the floor.
Making Beds
Bend your knees, or place one knee on the bed.
Carrying Groceries
Balance the load by carrying the same weight in each hand. Hold heavy bags
close to your body. Support heavy bags by bending your arms.
When you take groceries from the trunk of the car, put one foot or knee on the
bumper.
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Vacuuming
Balance yourself with one foot in front of the other. Keep your knees bent a bit
and shift your weight from your back foot to your front foot. Try to maintain
a pelvic tilt so you will not hurt your back.
Get down on your knees to reach under furniture.
Sleeping
Your mattress should be firm. Sleep in a way that does not put strain on your
neck and back.
• If you sleep on your side, bend your knees and put a pillow between your
legs.
• If you sleep on your back, put a pillow under your knees. Do not use this
position later in pregnancy because the weight of the baby will put pressure
on one of your main blood vessels.
Avoid lying on your stomach. This puts too much stress on your neck and back.
Getting Up
(from the floor or
out of bed)
A
s your baby grows during pregnancy, you may find it hard to change
position. For example, it may be a challenge to get out of bed or to get up
off the floor if you have been doing exercises. Try to move slowly. Always be
careful when you change position. This will help to prevent muscle strain and
dizziness.
To get up from the floor:
•
•
•
•
•
•
•
•
•
110
Bend your knees.
Push your feet into the floor.
Lift your buttocks a bit and roll to one side.
Use your arms to slowly push up to a sitting position.
Roll onto your knees.
Move one knee forward placing your foot flat on the floor.
Straighten your back.
Place your hands on the bent knee for support.
Stand, using your leg muscles to push yourself up.
Healthy Activity
To get out of bed:
•
•
•
•
•
•
Move close to the edge of the bed.
Bend your knees and roll to one side.
Use your arms to slowly push up to a sitting position.
Swing your legs over the side of the bed.
Rest for a moment. Take a couple of breaths.
Tighten your stomach (abdominal) muscles and stand up slowly.
Lifting
To lift with ease, bend your knees.
Try to avoid heavy lifting when you are pregnant. Let someone else take out
the garbage and carry the groceries.
If you have a toddler or small child, it may be impossible to avoid lifting. To
make it easy and safe, instead of lifting a toddler from the floor, help her to
climb onto a sofa or a stool and lift her from there. Or sit on a sofa or chair and
let her climb onto your lap.
Learning how to lift the right way can save you a lot of back pain, now and
after your baby is born. The key is to lift with your leg muscles, not your
back. Never bend from the waist. Bend your knees and lift with your legs. You
should also try to bring the load as close to your body as you can, before you
lift.
When you must lift something, here’s how to do it:
• Stand with your feet apart
• Tuck in your buttocks and tighten your stomach (abdominal) muscles
• Bend your knees
• Pull the object close to your body
• Lift with your legs
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Sitting
(and getting up
again)
Good Sitting Posture
• Sit up straight, with your back and the upper part of your buttocks resting
against the back of the chair. Do not sit on the edge of a chair and slump
against the back.
• Your feet should be out in front of you. They can be flat on the floor or on
a stool. If you sit with your legs crossed, you are blocking the blood flow to
your legs.
• Use a stool to raise your legs and feet when you are sitting. This is a good
time to do foot and ankle exercises to improve blood circulation. Move your
ankle around in circles. Stretch each foot up and down.
• Use little pillows to support your neck and lower back.
To Sit Down
• Tighten your stomach (abdominal) muscles by pulling them in and up.
Tuck your buttocks under.
• Use your leg muscles to lower yourself into the chair. Hold the armrests if
you need support.
• Slide back into the chair.
To Stand Up
• Slide forward to the front of the chair.
• Stay upright. Do not lean forward.
• Tighten your buttocks and use your legs to raise your body.
• Hold the armrests for balance.
Choose a chair or rocker that makes good sitting posture easy.
• The seat should be high enough so that your feet are flat on the floor.
It should be deep enough to support the length of your thigh, but shallow
enough to let your back and the upper part of your buttocks rest against the
back of the chair.
• The back should be high enough to support your shoulders. It’s even better
if it can support your head.
• The armrests should be at a height that allows your arms to be comfortable
when you are sitting in the chair.
If you can’t find the perfect chair, you can make any chair more comfortable by
using pillows, a foot rest, or a footstool for support.
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Healthy Activity
Safe and Comfortable Activity
Safety and comfort are important no matter what kind of exercise or activity
you do.
By being careful, you can still do most of the things you enjoy.
Dress in loose, lightweight clothing.
Safe and Unsafe Activities during Pregnancy
These are Safe and Fun
Be Very Careful with These
Avoid These —
Not Safe during
Pregnancy
• Walking
• Aquafit (exercise in
a swimming pool)
• Swimming
• Stationary bike
• Cross-country skiing
on flat ground
• Snowshoeing
• Low-impact aerobic
classes
• Prenatal exercise classes
with trained teachers
• Yoga
• Tai chi
• Tennis and other racquet sports. Decrease
these sports. Stop after your 6th month.
• Golf. Adjust your swing. Do not twist or
jerk.
• Bowling. Do not bend too far forward or lose
your balance.
• Downhill skiing
• Contact sports
such as basketball,
volleyball, hockey
• Scuba diving
• Horseback riding,
especially jumping
• Heavy
weightlifting
• Softball or
baseball
• All terrain vehicle
(ATV)
Tips to help you stay comfortable and
active
• Weight training. Do not lift weights while
lying on your back. Use low weights and
high repetitions. Lessen the weight as you
become bigger. Use weight machines. Avoid
free weights. Do not hold your breath.
Always breathe out when you are lifting.
• Running (high impact). If you are not a
regular runner, do not start to run or jog
when you are pregnant. If you already run
or jog, talk to your doctor about running
during pregnancy. Listen to your body, and
your doctor, when you run during the last
three months of pregnancy.
When you are running:
– Keep your feet wide apart.
– Keep your feet close to the ground. Do
not bounce or run on uneven surfaces.
If you have any pain, stop and find a new
activity.
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How To Stay
Comfortable
When You
Are Active
Dress in layers so you can take clothes off as you get warm.
Wear a bra with good support and non-elastic straps.
Wear shoes with good heel and arch support.
Go to the bathroom before you begin to exercise.
Review the Guidelines for Healthy Activity on page 127.
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Healthy Activity
Program for an Active
Pregnancy
Prenatal activity makes you stronger. It also helps your body to stretch and
relax. Women who are active have healthy pregnancies and births, and a quick
recovery after the birth.
This program includes:
• Warm-up
• Exercises to make your muscles strong, and to stretch your muscles
• Cool-down
You can also do these exercises after your baby is
born. They will help your body get back to normal
and will give you the energy you need to enjoy your
new baby.
It’s a good idea to do these exercises as often as
you can. Once a day is great! Find a friend, get
the little ones to ‘help’ you, or do them alone.
You’ll start to feel good sooner than you
think.
Ease into exercise
•
•
•
•
•
Start by doing each exercise 3 to 5 times. Build up to 5 to 10 times each.
Begin and end your program with a few easy stretches.
Take a few deep breaths and relax between exercises.
Avoid high-bounce exercises. No-bounce is much better.
Keep the water temperature in pools, whirlpools, and hot tubs warm (26 ºC
to 28ºC) (No warmer than your skin temperature). Avoid saunas and steam
rooms.
Staying Safe
and Active
Listen to your body
•
•
•
•
•
Drink plenty of water while exercising.
Do not get too hot or too tired.
Rest when you need to.
Breathe normally. Do not hold your breath.
If you have any pain, stop the exercise and check with your doctor.
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Pace yourself
• Avoid too much exercise during the first three months.
• If you were not active before you became pregnant, increase your level
slowly.
• You should be able to talk while you are doing any exercise. If you can’t talk
with comfort, you are exercising too hard.
• If you have shortness of breath, slow down or stop the activity.
• Drink plenty of water during cardiovascular exercise. When your body
temperature rises, so does the temperature in your uterus. Drinking extra
water will keep your whole body at a good temperature.
WARNING:
After cardiovascular (aerobic) exercise, do not lie flat on your
back or on your right side until your body has cooled down.
• You may have to change how active you are as you get bigger.
• From the fourth month on, do your exercises standing, sitting or lying on
your side. Try not to be flat on your back for more than five minutes. The
baby’s weight can press on your blood vessels and reduce blood circulation
to you and your baby.
Stop exercising and talk with your doctor if you have:
• Any bleeding or a gush of water from your vagina
• Many contractions after exercising. It is normal to feel a bit of tightness
(contraction) in your uterus after exercise. But if the contractions keep
coming, talk to your doctor right away.
• Persistent severe headaches or blurred vision
• Sudden swelling of the ankles, feet, calves, or face
• An infection
• Severe nausea or vomiting
• A decrease in your baby’s movement
• Unexplained pain in your abdomen
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Healthy Activity
Warming up involves stretching. Slow stretching before you start will make
you more flexible and prepare your muscles for more activity.
Warm-Up
1. Upward Arm Stretches
What does this do? It exercises your shoulder, arm, and trunk muscles. It lifts
your ribs and lets you breathe better. Here’s how to do it:
• Keep your back straight while sitting or standing.
• Raise both arms over your head.
• With fingers stretched out, reach one arm, then the other, toward the
ceiling.
• Repeat.
• Lower your arms and relax.
2. Elbow Circles
What does this do? It relaxes your shoulder muscles. Here’s how to do it:
•
•
•
•
•
Stand or sit up straight.
Bend your elbows and touch your shoulders with your fingers.
Make a large circle by moving your elbows forward, up and back.
Repeat 5 times.
Relax with your arms at your sides.
3. Neck Stretches
What does this do? It stretches and relaxes your neck muscles. Here’s how
to do it:
•
•
•
•
•
•
Stand or sit up straight.
Bring your ear toward your shoulder.
Breathe in and out deeply. Feel the muscles stretch.
Repeat on the other side.
Repeat 3 to 5 times.
Relax.
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4. Head Turn
What does this do? It stretches and relaxes your neck muscles. Here’s how to
do it:
•
•
•
•
•
Stand or sit up straight.
Turn your head to one side. Look over your shoulder.
Turn your head to the other side.
Repeat 3 to 5 times.
Relax.
5. Calf and Hip Stretch
What does this do? It stretches the muscles in the back of your legs and hips.
Here’s how to do it:
• Stand in front of a wall, with one foot in front of the other, toes pointing
straight ahead. Put the palms of your hands flat against the wall.
• Keep your back leg straight and your heels firmly on the floor. Do not arch
your back.
• Bend your front knee slowly and lean toward the wall. Move slowly. As you
feel the stretch in your back leg, bend your knee a bit to avoid strain.
• Repeat with your other leg.
• Repeat 3 to 5 times.
• Relax.
You can increase the stretch by increasing the distance between your back leg
and the wall, and by pushing your hips toward the wall.
6. Tailor Sitting
What does this do? It stretches the inside of your legs. Here’s how to do it:
When you do this, never use your hands or elbows to press your knees toward
the floor. This can stretch your pelvis too much.
• Sit on the floor with your back straight and your shoulders level.
• Put the soles of your feet together and pull your heels in toward your body.
Let your hands relax.
• Slowly relax both knees toward the floor. Go as far as you can but stop if you
feel any pain.
• Hold the pose while you count to 5 or 10.
• Relax. Bring your knees back up to where you started.
• Repeat 3 to 5 times.
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7. Leg Stretching
What does this do? It stretches your leg muscles (hamstrings). Here’s how to
do it:
• Sit in a chair. Tighten your stomach (abdominal) muscles. Keep your back
straight. Place a small roll behind your back. (Use a rolled up towel).
• Straighten out your right leg. Hold the pose while you count to 5 or 10.
• Relax.
• Repeat with your other leg.
The next group of exercises (#8 to #18) will help your body adjust to
pregnancy and get ready for childbirth.
When you are doing any exercise, do no lie on your back for more than
5 minutes unless you have pillows under your head and shoulders.
Stretch and
Strengthen
Remember
• Start by doing each exercise 3 to 5 times. Over time, you can increase to
5 or 10 times.
• Breathe normally. Never hold your breath.
• Stretch slowly and avoid bouncing.
8. Pelvic Tilt
What does this do? It helps prevent backache and makes your back and
stomach (abdominal) muscles stronger. Here’s how to do it:
•
•
•
•
•
Lie on your back, with knees bent, feet flat on the floor.
Tighten your stomach (abdominal) muscles.
Tighten your buttocks and press your lower back into the floor.
Hold for a few seconds. Breathe normally.
Slowly relax.
Pregnancy puts a great strain on your abdomen. The next three exercises will
help to make your stomach (abdominal) muscles stronger. This will help you
when you are pregnant and when you are giving birth to your baby.
Before you do any abdominal exercise, you need to know whether your
stomach (abdominal) muscles might be separated. This happens to about one
out of three pregnant women. Ask a friend, your partner, doctor, or teacher
in a prenatal class to help you check for this.
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Here’s how to check:
• Lie on your back with your knees bent, feet flat on the floor.
• Tuck your chin in. Slowly raise your head and shoulders until you can see
your abdomen.
• If you have muscle separation, you will see a bulge just above or below
your belly button. If you are not sure what you see, feel the centre of your
abdomen. If you can feel a soft place between two bands of firmer muscle,
then you have a separation.
Here’s what to do if you have an abdominal muscle separation:
If you have a separation, you need to support your abdomen while doing
exercises. You can do this by:
1) Lacing your fingers together across your abdomen, or
2) Crossing your arms and putting a hand on either side of your abdomen.
There is no agreement about whether women should stop abdominal exercises
if they have muscle separation. You can do the pelvic tilt and pelvic floor
(Kegel) exercises (described on page 121).
For exercises #9 and #10, later in pregnancy, you may want to put pillows
under your upper back, so you are lying on a slant. This lets you do abdominal
exercises and place less strain on your trunk.
9. Curl-ups
What does this do? It strengthens your stomach (abdominal) muscles. If you
have a separation, support your abdomen with your hands. Here’s how to do it:
• Lie on your back, knees bent, feet flat on the floor, arms across your
abdomen.
• Tighten your abdomen and buttocks. (This is the pelvic tilt. Hold these
muscles firm while doing this exercise.)
• Tuck in your chin.
• Lift up your head and shoulders while breathing out.
• Slowly lower your shoulders and head to the floor.
• Relax.
• Repeat.
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10. Diagonal Curl-ups
What does this do? It strengthens your muscles along the side of your
abdomen. Here’s how to do it:
NOTE: Do not do this exercise if you have an abdominal muscle separation.
• Lie down, knees bent, feet flat on the floor.
• Tighten your abdomen and buttocks. (This is the pelvic tilt. Hold these
muscles firm while doing this exercise.)
• Tuck in your chin.
• Lift your head and shoulders.
• Reach your arms across your body toward one knee.
• Curl up as far as you can, breathing out. Hold the pose while you count to 5.
Breathe normally.
• Slowly lower your shoulders and head to the floor.
• Relax.
• Repeat, going from side to side.
The next two exercises (#11 and #12) will help make your pelvic floor
muscles stronger. What are pelvic floor muscles? They are the muscles that go
from your pubic bone in front to your tailbone in the back.
When you are pregnant, these pelvic floor muscles must be strong enough to
support your uterus. During childbirth you need to be able to control these
muscles, so you can relax them when the baby is being born.
Doing this exercise often will keep your pelvic floor muscles strong. This kind
of exercise is sometimes called Kegel exercise or hidden exercise. You can do
this any time — when you brush your teeth, when you are watching TV, when
you are standing in line at the store. In fact, you can do these exercises when
you are sitting, lying, or standing.
Doing 5 contractions, 10 times a day is not hard. You will benefit now and for
the rest of your life.
11. Basic Pelvic Floor Exercise (Kegel exercise).
• You can be in any position: lying, sitting, standing, or on your hands and
knees.
• Tighten the muscles around your bladder, vagina and rectum. Feel them
pulling up inside.
• Hold for a count of five.
• Relax and repeat.
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12. The Elevator
• You can be sitting, standing, or lying down. When you are learning this
exercise, it is best to lie down.
• Imagine that you are an elevator.
• Slowly tighten your pelvic floor muscles, pulling them tighter and tighter at
each floor.
- First floor, make them tight.
- Second floor, a bit tighter.
- Third floor, tighter.
- Fourth floor, hold for a few seconds.
• Breathe normally.
• Now, come back down the elevator.
- Third floor, release a bit.
- Second floor, release a bit more.
- First floor, relax.
• Repeat.
13. Pelvic Rock
What does this do? This exercise can help you reduce lower back pain. Here’s
how to do it:
• Kneel on your hands and knees.
• Hold your back flat. Do not arch your back or let it go hollow. Keep your
head level with your back.
• Tighten your stomach (abdominal) muscles pulling in and up.
• Tuck in your buttocks.
• Slowly relax your abdomen and buttocks. Keep your back flat. Don’t let it
sag.
• Repeat slowly.
14. Side-Lying Leg Lifts
What does this do? It helps make all your upper leg and hip muscles strong.
Helps with blood circulation in your legs. Here’s how to do it:
•
•
•
•
•
Lie on your side on the floor. Support your head with your arm on a pillow.
Bend your bottom knee and hips forward for support.
Keep your upper leg in a straight line with your body.
Steady yourself by placing your upper hand in front of your body.
Tighten your stomach (abdominal) muscles and buttocks. (This is the pelvic
tilt. Hold these muscles firm while you do this exercise.)
• Keeping your knee straight and your foot bent, raise and lower your upper
leg a few times.
• Lower the leg one last time and relax.
• Roll on to your other side and repeat with your other leg.
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15. Ankle Circles
What does this do? It helps with blood circulation to your legs. Helps reduce
swelling in the ankles. If your ankles continue to swell, lie down and raise your
ankles above your hips to do this exercise. Here’s how to do it:
• You can do this exercise lying down or sitting up.
• Straighten one leg.
• Make slow, complete circles with your foot, going one way first, then the
other. Repeat several times.
• Repeat with your other foot.
16. Push-Offs
What does this do? It helps to strengthen your upper back.
Here’s how to do it:
•
•
•
•
Stand facing a wall.
Keep your body straight from shoulders to feet.
Keep your heels flat on the floor.
Push off from the wall by bending and straightening your arms.
17. Imagine a Chair
What does this do? It makes your upper leg muscles strong. Here’s how
to do it:
Warning:
Do not do this exercise if you have knee problems.
• Stand with your back against a wall and your arms relaxed at your sides.
• Tighten your stomach (abdominal) muscles and tuck in your buttocks.
(This creates good pelvic tilt.)
• Bend your knees and slide down the wall.
• Stop when you find a ‘chair’ that is at the right level. You should be
comfortable.
• Slowly slide back up until you are standing.
• Repeat.
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18. Squatting
What does this do? Makes your thigh muscles strong. Here’s how to do it:
Warning:
Do not do this exercise if you have knee problems.
• Keep your feet flat on the floor and wide apart.
• Go into a squat, as far as you can. Make sure you feel comfortable. Rest your
elbows on your knees, if you can.
• Maintain a pelvic tilt by making the curve of your lower back flat. Keep your
spine as straight as you can while you do this.
• Hold the pose while you count to five.
• Push up slowly, using your leg muscles. Keep your back straight.
Cool-Down
Like the warm-up, this part of the program helps your body stretch and
relax. Our cool down is the same as the warm-ups. You can find the details in
the Warm-up section. Here is the list:
•
•
•
•
•
•
•
Upward Arm Stretches
Elbow Circles
Neck Stretches
Head Turn
Calf and Hip Stretch
Tailor Sitting
Leg Stretching
Once you know how to do the prenatal exercises, use the chart on the next page
to remind you of the correct order. Start by doing each exercise 3 to 5 times.
Slowly work up to 5 to 10 times each.
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Prenatal Activity Chart
Warm-Up
1 Upward Arm Stretches
2 Elbow Circles
3 Neck Stretches
6 Tailor Sitting
4 Head Turn
5 Calf and Hip Stretch
7 Leg Stretching
Stretching and
Strengthening
Exercises
8 Pelvic Tilt
9 Curl-ups
11 Basic Pelvic Floor Exercise 12 The Elevator
10 Diagonal Curl-ups
13 Pelvic Rock
14 Side-Lying Leg Lifts
Cool-Down
Go back and
repeat your
warm-up.
(#1 to #7)
15 Ankle Circles
16 Push-Offs
17 Imaginary Chair
18 Squatting
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Exercises to
Avoid
Most exercises are safe when you are pregnant. But there are a few you
should avoid because they put too much strain on your back and abdomen,
or may throw you off balance.
To be safe, avoid:
•
•
•
•
•
•
•
Trunk rotations with straight legs in a standing position
Double straight-leg raises while lying on your back
Straight leg sit-ups
Exercises where you lift your lower back off the floor
Shoulder stand with bicycling
Deep knee bends — up and down
Touching your toes from a standing position without bending your
knees
If you do not know whether an exercise is safe, check with your doctor or
physiotherapist.
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Active Living
As well as doing a daily exercise program, walking, riding a bike and swimming
are part of an active life.
If you were active before you got pregnant, try to stay active during your
pregnancy. Be sure to read the section that tells you what is safe and unsafe
during pregnancy.
If you have not been physically active before, you can start with walking,
swimming and special prenatal exercise classes. You will find a sample walking
program on page 129.
Common sense is important. Listen to your body. If you have pain, are tired
or have shortness of breath, slow down or change to a different activity.
Find an activity you enjoy and have fun!
Follow the Guidelines for Staying Comfortable and Active on page 114.
Choose an activity that you enjoy and try to do it for 10 to 15 minutes at
a time, 3 or 4 times a week.
Guidelines
for Healthy
Activity
Warm up before your activity.
Use the exercises in the Warm-up section on page 117.
Begin slowly.
Cool down after your activity.
Gradually slow down. Do not stop suddenly.
See the Cool-down section on page 124.
Use the “talk test.”
If you are moving at the right pace, you should be able to talk during your
activity. If you can’t talk, you are doing too much. Slow down!
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Don’t forget to eat and drink.
Have a small snack, like whole wheat bread or a muffin about one hour or
90 minutes before you start. This will give you energy and avoid using up food
your baby needs.
If the weather or the room is hot, drink small amounts of water every 5 minutes
while you’re active.
Avoid activities that involve
• Jumping
• Twisting
• Rapid jerking
• Sprinting
• Quick starts
Walking
W
alking is easy and it is one of the best things you can do when you are
pregnant. It is safe and natural, and there is almost no risk that you will hurt
yourself.
Brisk walking is a healthy thing to do. More than half of your body’s muscles
are used when you walk. It trains your heart, lungs, and muscles to work better.
Regular, brisk walking can reduce blood pressure, improve digestion, and
help prevent constipation. It also helps your body use more calories. If you eat
healthy food, walking will help you maintain a healthy weight and feel good
about your body.
Walking has other benefits as well.
• Walking makes your mind feel fresh. You will have more energy and feel less
tired.
• Walking takes away stress and tension.
And whether you do it alone, with friends or with family, walking is fun!
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Level 1: Just Starting
Week
How Long?
How Often?
How Far?
1
10 min
2 days/week
1 km
2
10 min
3 days/week
1 km
3
15 min
3 days/week
1.2 km
4
18 min
3 days/week
1.4 km
5
20 min
3 or 4 days/week
1.6 km
6
20 min
4 days/week
1.6 km
7
25 min
4 days/week
2 km
8
30 min
4 days/week
2.4 km
9
32 min
4 days/week
2.8 km
10
35 min
4 days/week
3.2 km
Level 2: For Active People
Week
How Long?
How Often?
How Far?
1
20 min
3 days/week
1.6 km
2
22 min
3 days/week
2 km
3
25 min
3 days/week
2.4 km
4
30 min
3 days/week
3.2 km
5
30 min
4 days/week
3.2 km
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Healthy Pregnancy... Healthy Baby
Learning to Relax
When you relax, you let go of tension in your body (muscles) and in your mind.
Learning to relax:
• Helps you save energy
• Makes you feel good
• Helps make your baby’s birth easy
Learning to relax is one of the best ways to have a comfortable labour.
There are many ways to relax. If you have found something that helps you to
relax, use it.
When you relax:
• Make sure all parts of your body have support and feel comfortable
• Let go of all muscle tension
• Clear your mind
• Breathe slowly and take in the same amount of air as you give out.
Learning to relax is a life skill. If you learn it now, you will have it for the rest
of your life.
Finding
Positions
To Help You
Relax
You never know what will feel good during labour. We suggest you learn to
relax in different positions.
There is only one position to avoid when you relax. Do not lie flat on your
back. This is because the weight of your uterus presses on your blood vessels
and can reduce blood flow to you and your baby.
Many women enjoy these positions when they relax:
Side lying, with one pillow under your head and another pillow between your
knees. Both knees should be bent a bit. Lying on your left side helps improve
blood circulation to you and your baby.
Side lying with one arm behind. One pillow supports your head and shoulders.
Put another pillow under your upper leg. Lying on your left side helps improve
your blood circulation.
Back lying, with at least two pillows under your head and shoulders and
another pillow under your knees. Do not lie this way later in pregnancy,
because the weight of the baby will put pressure on one of your main blood
vessels.
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Healthy Activity
When You Practise Relaxation
It can be helpful for your labour partner to check your muscles for tension
while you are learning to relax. They can gently touch or lift parts of your
body. For example if your arm or leg is limp and relaxed, your partner puts it
gently back on the pillow. If your arm or leg feels tense, your partner strokes
or touches it gently until it relaxes. A warm, soft touch can help you relax more
deeply. Many people are able to ‘let go’ of their muscles when they feel a light
touch.
Breathe slowly and deeply while you learn to relax.
As you tighten your muscles, do so just enough so that you can feel them.
As you relax, think about letting go of tension in your muscles.
Your labour partner may want to use a calm, soothing voice to help you relax.
This will help you learn how to relax, and you may find that just the tone of
voice will help you relax. This can make you feel safe and calm when you are
trying to relax during labour. We suggest that your partner read “Relaxing Step
by Step” to you while you learn to relax.
To learn to relax, you need to feel and then release muscle tension. You do
this by making your muscles tight and then letting them get loose, one by one.
Tighten as you breathe in. Let go as you breathe out.
Relaxing
Step by Step
You may want to start at your toes and move up to your face. You can also start
with your face and move down to your toes. Try it both ways to see what you
like better.
Find a comfortable position, making sure all parts of your body have support.
• Breathe in and tighten your ankles and pull your feet back toward your body.
Breathe out, letting go.
• Breathe in and tighten your legs.
Breathe out, letting go.
• Breathe in and tighten your buttocks and pelvic floor muscles.
Breathe out, letting go.
• Breathe in and curl your hands into a fist or straighten your fingers.
Breathe out, letting go.
• Breathe in and bend your wrists.
Breathe out, letting go.
• Breathe in and pull your shoulder blades together.
Breathe out, letting go.
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• Breathe in and wrinkle your face so it is as small and tight as it can be.
Breathe out, letting go.
• Continue to breathe slowly, taking in the same amount of air when you
inhale and letting out the same amount when you exhale… in and out, in and
out, in and out ...
• Let your whole body go ... close your eyes ... rest. Breathe in and out, in and
out.
• As you relax more deeply, your body will feel heavy, as if it is sinking into the
floor. Let it go. Breathe in and out, in and out.
• Continue to breathe in and out, in and out, in and out. Let the sound and
feeling of your breath keep your mind clear and calm.
• You may fall sleep. Let yourself go. Breathe in and out, in and out, in and
out.
• When you are ready to move, do it slowly. Make fists with your hands and
stretch the fingers out. Make circles with your feet and ankles. Move your
legs. Sit up slowly. Rest for a moment, and then stand up.
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After The Baby Comes:
A Postnatal Program
Doing exercises after the baby is born is important. They will help your body
adjust and go back to the way it was before you were pregnant. The time after
the baby is born is called the “postnatal” time. Postnatal exercises can:
• Improve your blood circulation
• Help your body heal faster
• Restore muscle strength
• Build up your energy
• Help your bowels and bladder return to normal
• Help you feel better and more relaxed
You can start doing postnatal exercises as soon as your baby is born. See
Section 7 - Healthy Birthing, for postnatal exercises you can do in hospital.
Once you return home, do your prenatal exercises again. Start slowly. Your
strength will come back with time.
Healthy activity is important after the baby is born. You can run or swim. Make
sure that your stitches have healed and all bleeding has stopped. Do not try to
do too much. Listen to your body. If you have any pain or more bleeding, call
your doctor for advice.
Check with your doctor before you begin a sport or activity you used to do.
Within 8 weeks you should be able to do all your favourite activities.
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Postnatal
Program
In the first week home:
Warm-up
Do the warm-up exercises that make you feel comfortable.
Strengthening Exercises (illustrated on page 125)
•
•
•
•
Pelvic Tilts
Pelvic Floor Exercises
Curl-ups*
Diagonal Curl-ups*
Cool-down
Repeat the Warm-up exercises (illustrated on page 125)
Relaxation
• Lie on your back with your knees bent. Relax your arms at your sides.
• Straighten one leg, pressing your knee into the floor and pointing toes
toward your head.
• Press your lower back into the floor.
• Pull your shoulder blades together.
• Tuck your chin in and push your head into the floor.
• Stretch your arms down.
• Hold the pose while you count to 10.
• Relax slowly and completely. Breathe slowly and deeply.
• Repeat, using your other leg.
In your second week at home add the other stretching and strength exercises
from your prenatal list of exercises.
* If you had a cesarean birth, read the next section before you do these
exercises.
After a
Cesarean
Birth
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You can — and should — begin postnatal exercises while you are still in
hospital. Section 7 - Healthy Birthing, has breathing and other exercises that
will help.
When you go home, you can follow the same postnatal program as other
mothers, with only one change. Do not do the abdominal exercises (Curl-ups,
and Diagonal Curl-ups) until 3 to 6 weeks after your baby is born.
Healthy Activity
To make sure you do not hurt your back, keep your good posture and be
careful when lifting.
Remember: to lift with ease, bend your knees.
When you pick up your baby or toddler, follow the advice on safe lifting in the
section called Comfort Every Day. Do not carry a baby or toddler on your hip.
Taking Care
of Your Back
while taking
care of your
baby
You can also protect your back by making sure your baby’s crib mattress is as
high as it can be. Lower the side rail when you pick up the baby or change the
sheets.
Use a table as high as your waist when you change diapers or give your baby
a bath. If you do not have such a table, kneel down to do these things.
The handles on your stroller should be at waist level. Stand up straight and use
your arms to push.
Be sure you have good support when you breastfeed or give your baby a bottle.
When you are sitting
• Support your lower back with a pillow
• Support your arms with pillows or chair arms.
• Raise your feet on a small stool.
Breastfeeding when you are lying on your side
• Place a pillow between your legs and behind your lower back.
• Do not twist your back.
When you use an infant carrier such as a Snugli™, carry the baby above
your waist.
When you put the car seat into the car — or take it out — you need
to protect your back. You can protect it by resting one knee on the
seat or putting one foot on the floor of the car. Turn to face the
car seat when you buckle the baby into his seat.
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Healthy Birthing
Thinking About Childbirth
Childbirth is a normal, natural event. Even so, many women feel both worry
and excitement when they think about giving birth.
It is helpful to learn about childbirth. Knowing what to expect will make you
feel ready. If you know how to breathe, relax, and be comfortable while giving
birth, you may decide that you can do it!
Learning about childbirth will also help you to make plans for your baby’s
birth. Most hospitals want to meet the needs of the whole family. You can learn
about family-centred care and about other choices when you go to prenatal
class. You may want to visit your hospital, and talk with your doctor. When
you know what your choices are, you can make the choice that is best for you.
When YOUR baby is being born, childbirth becomes very special.
When you know more about childbirth, you may find that you worry less.
The goal is to relax and to have confidence in yourself.
A birth partner is someone that a woman chooses to help her during labour
and birth. The birth partner stays with a woman and offers support when she is
having the baby.
A Message
for Birth
Partners
If you are a birth partner, you can help by:
• Going with the mother to at least one prenatal visit.
• Visiting the hospital together before labour and birth.
• Reading and learning about ways to help her during childbirth. This
section is a good place to start.
• Going to prenatal classes with her.
• Taking time to practice with her how to breathe, relax, stay
comfortable and change positions.
• Giving active support to help her breathe, relax and stay comfortable
during labour.
Anyone can be a birth partner — a husband or partner, family member,
or friend. You don’t need any special skills. You just need to be there and
to care.
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Planning for
Your Baby’s
Birth
The first step in planning for birth is to find out what choices are offered
in your community. Talk with your doctor, your public health nurse, or your
prenatal class leader. Visit the hospital for a tour. You can also learn a lot by
reading.
Once you know what your choices are, you can start thinking about the kind of
care you would like during labour, birth, and afterward. You may want to make
a list. Or, you could just keep the ideas in your mind. If you want to make sure
things happen, be sure to share and discuss your plans with your doctor and the
hospital staff.
All women hope and plan for a normal, safe birth. But no one knows what will
happen during your labour. If problems arise, you may not be able to have
things as you had hoped. Even so, the time you spend thinking about, planning,
and talking about birth is a good way to create a happy experience.
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How Can I Prepare
for Childbirth?
In this section, we talk about ways you can get ready for childbirth.
Labour and birth are hard work. Being comfortable takes thought and effort.
There are two keys. The first is knowing about labour and working with it.
The second is learning about and practising as many ways to be comfortable as
you can. You never know what will feel good during labour, so we suggest you
learn a few ways. That way you can use all of them, if you need to.
F
or nine months, your baby has been growing in your womb (uterus).
The uterus is made of very strong muscles. They stretch as your baby grows.
The tip of the uterus, called the cervix, opens into the vagina. When you are
pregnant, the cervix is thick and stays closed with a mucous plug (this is circled
in the drawing).
When you are in labour, the muscles of the uterus tighten and relax. This
allows the cervix to open and helps the baby move out of the uterus and down
the vagina. Your uterus tightens (contracts) and then relaxes, over and over,
until your baby is born. This tightening and relaxing is called “contractions.”
What
Happens
during
Labour and
Birth?
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Labour is divided into three stages.
First Stage
The cervix gets thin (effaces) and opens up (dilates). During the first stage of
labour, your cervix slowly opens from 1 centimetre to 10 centimetres. The first
stage often lasts for 12 to 18 hours.
Second Stage
When your cervix has opened to 10 centimetres, the doctor or nurse will say
it is “fully dilated” This means it is large enough for the baby to pass through.
This takes between 11/2 and 2 hours.
Third Stage
1 centimetre
3 centimetres
The placenta (or afterbirth), which has given the baby food in the womb,
comes out. This takes about 15 to 30 minutes.
By learning how to breathe, relax, and be comfortable during labour, you can
be ready for all 3 stages.
5 centimetres
8 centimetres
10 centimetres
(actual size)
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This is one of the best ways to help yourself work with contractions during
labour. You will find details on how to relax on page 130 in Section 6 - Healthy
Activity.
Learning
to Relax
You do not know what will feel good during labour, so we suggest that you
practise relaxing in many positions. Try to practice the positions of labour and
birth shown. There is only one position to avoid. When you are relaxing, you
should not lie flat on your back. This is because the weight of your uterus will
press on your blood vessels and can reduce blood flow to you and your baby.
Now is a good time to practise all of the positions you can use during labour.
If you practise, then they will feel comfortable to you.
Doing the exercises in Section 6 - Healthy Activity, will help to stretch your
body and make it strong. Then, these positions will feel good to you.
Positions for
Labour and
Birth
Here are some things to remember for when you are in labour:
• Walk as much as you can for as long as you can. Walking helps make your
contractions less painful and stronger. You need strong contractions to help
the baby be born.
• Sit up or stand up for as long as you can. Your uterus works best while you
are upright.
• Keep moving. Try not to stay in any one position for long. Your labour
partner may have to remind you about this and help you to change position.
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Positions for First Stage
Walking
Standing
Kneeling
• Leaning
forward
while
standing.
• On hands and knees
• Leaning forward
onto chair
Semi-sitting
• In chair with feet up
• Propped up with
pillows
Sitting upright
Side-lying
• Tailor sitting
• Leaning forward
into the support person
and held under the
arms
• Leaning onto the back
of a chair
• Leaning onto back of
the toilet
• With leg on pillows
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Rocking
Healthy Birthing
Positions for Second Stage— Pushing
Squatting
• Supported squat
• Support for buttocks
Semi-sitting
Side-lying
• With leg on pillows
• With leg supported by partner
Kneeling
• On hands and knees
• Leaning forward onto chair
• Leaning forward onto lap
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Massage
You do not know what kind of massage is going to feel good when you are in
labour. We suggest that you try many kinds of massage. Then, when the time
comes, you will have some choices.
Some tips for the person giving the massage:
• You need to relax and breathe. Being calm will help the woman stay calm
too.
• Start with a gentle but firm touch.
• Put your whole body into the massage, not just your hands and arms. You
might find that it helps to rock back and forth as you massage.
• In some of the positions shown for labour and birth, the woman in labour
leans or rests against her labour partner. Most of these positions are good for
massage.
• Massage is more than a back rub. You can also massage, arms, legs, inner
thighs, hands, feet, neck, face, and scalp.
Effleurage
Different ways to do massage
Using fingertips: You can stroke the stomach area (abdomen), lower
back, or thighs using your fingertips, with hardly any pressure. You
can do this in curves, circles, or figure eights — whatever feels good.
Counter pressure: This is a firm, steady pressure to the lower back.
Use the heel of your hand and lean with all of your body weight.
Making small circles with your hand as you press can also help. It’s
good to use counter pressure during contractions. It can help to ease
back labour, when the mother is feeling the contractions in her back.
Push on the part of the back where the woman says she hurts.
Counter pressure
Stroking
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Stroking: Use slow, easy, gentle strokes with your whole hand. You
can stroke in any direction and on any part of the body. Apply very
little pressure, and allow your hand to fit into the shape of the body.
Healthy Birthing
Many women find the tips in this section are helpful. Try them all and try
other things, too. Find what you like best.
Heat and cold
Finding
ways to be
comfortable
Wiping your forehead with warm or cool cloths can help you relax.
Try a warm bath or a warm shower.
It may also feel good to hold a hot water bottle against your lower back or
lower stomach (abdomen). Some women find an ice pack is better than a hot
water bottle.
Music
Bring a CD player with headphones or “iPod” to the hospital. You may find
that music helps you relax and feel at home. If you have been listening to nice
music while you practice breathing and relaxation, hearing that music may help
you relax again.
Focus points
Women need to concentrate during contractions. The best way to do this is
to find something to focus on. Your focus point can be a picture, a toy, your
partner’s face, or a crack in the wall. It can also be something inside yourself.
You can think about a peaceful place, recall a happy time, or imagine your
uterus opening up to let your baby out. You may find that your focus point
changes as labour continues. For example, early in labour, you may find it helps
to look inside yourself. When labour gets more intense, you may need to focus
outward and look at your partner’s face.
Fluids
During labour you need to keep drinking to replace the fluids you lose.
Drinking also helps keep your energy high. Drinking clear liquids will help you
feel more comfortable by taking away your thirst. Clear liquids include: water,
apple juice, tea without milk, jello, and popsicles. If you have a very dry
mouth, sucking on ice chips, a wet washcloth, or a sour lollipop may help.
Be aware that every labour is different. There is no right way or wrong
way for you to be when you are in labour. Try as many ways to be
comfortable as you can until you find the ones that you like best.
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Comfort for
Back Labour
Most women feel contractions in their lower abdomen. But about one out of
four women will feel them in her back. This is called “back labour.” It happens
when your baby’s back is pressing against your back. You will feel the pain just
below your waist and it will stay with you for most of the first stage of labour.
All of the tips for dealing with labour will help with back labour. Here are some
that might help the most:
Move into positions that take the baby’s weight off your back
• Get down on your hands and knees
• Lean forward while standing or sitting
• Lie on your side
• Sit on the floor with your partner so that your backs are touching.
Then rock side-to-side or forward and back.
Massage
• Firm massage to your back, hips, and thighs.
• Firm counter-pressure with palm, fist, or heel of the hand into the place
where you are feeling the most pain.
Heat and cold
• Place a hot water bottle or ice pack against the place where you feel the most
pain.
• Stand in a shower with the water hitting your lower back.
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Breathing is something we do not think about very often. But during
childbirth, paying attention to how you breathe can make a real difference.
Learning to breathe in new ways can help you relax during labour. Your
breathing can help you work with your contractions.
Breathing for
Labour and
Birth
There are three levels of breathing used during the first stage of labour:
• Slow, deep breathing
• Faster, shallow breathing
• Breathing that involves panting-and-blowing.
Most women begin with slow, deep breathing and keep on using it for as long
as it feels good. It is the most restful and least tiring way to breathe. You should
move to the faster, more shallow breathing only when you feel you need to.
The way you use your breathing will be your choice. We suggest you use these
tips in the best way to help you during childbirth.
Your normal breathing may be faster or slower than someone else’s. Begin by
trying to relax and to breathe in a way that feels comfortable to you.
Slow, Deep
Breathing
To use slow, deep breathing during labour:
• When a contraction begins, take a relaxing breath — breathe in through
your nose or mouth and out through your nose or mouth. Whether you
breathe through your nose or mouth is up to you. Do what feels most
comfortable and natural.
• Breathe in slowly, feel your abdomen rise and your chest expand.
• Breathe out slowly, feel your abdomen and chest relax and fall. Keep your
mouth slightly open and soft. When you breathe out, it should sound like a
small sigh.
• Repeat until the contraction ends.
• When the contraction ends, take another relaxing breath.
Slow, deep breathing pattern
relaxing
breath
contraction
0 15sec 30 45 60
length of contraction
75
90
How to practise slow, deep breathing:
You or your partner can place a hand on your abdomen or chest. Watch how
your body rises and falls with each breath. Your partner can also make sure that
your arms and shoulders are relaxed at all times.
In labour, you will use this kind of breathing during contractions that last from
about 30 to 60 seconds.
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This is the kind of breathing you can use when your contractions become
Faster,
Shallow
Breathing
more intense. It can also be used when you find it hard to stay relaxed while
using slow, deep breathing. Faster, shallow breathing is done more quickly and
higher in your chest than slow, deep breathing.
To use faster, shallow breathing during labour:
• When a contraction begins, take a relaxing breath — breathe in through
your nose or mouth and out through your nose or mouth.
Faster, shallow breathing pattern
relaxing
breath
contraction
0 15sec 30 45 60
length of contraction
75
90
• Keep on breathing in through your nose or mouth and out through your
mouth at the speed that feels comfortable. As the contraction gets stronger,
switch to faster, shallow breathing.
• As your contraction gets stronger and your breathing gets faster, start to
breathe in and out through your mouth. Keep your mouth soft and relaxed.
• As your contraction begins to end, slow your breathing down and go back to
breathing in through your nose or mouth and out through your mouth.
• When the contraction ends, take another relaxing breath.
How to practise faster, shallow breathing:
Start by practising the faster, shallow parts of this breathing first.
Take a relaxing breath and then begin breathing in and out through your
mouth. Use light, shallow breaths.
Try breathing at different speeds until you find one that is comfortable for you.
Practise this breathing until you can stay relaxed and comfortable for 60 to 90
seconds.
When you are comfortable with the fast, shallow part, you can start with slower
breathing, then speed up, and then slow down again.
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This helps you to relax when the contractions are longer and stronger and
you cannot relax with other breaths.
Panting-and-blowing breath is done through your mouth. The basic pattern is
this: you take several fast, shallow breaths in and out, and then you blow out.
Pantingand-Blowing
Breath
These shallow breaths make a very quiet “heh” sound. You can do this at a
speed you like. Many women find it comfortable to use “Heh, heh, heh, blow”
(3 pants to 1 blow). You can also try other patterns, like “heh, heh, blow”
(2 pants to 1 blow) or “heh, heh, heh, heh, blow” (4 pants to 1 blow). Try
them all so that you can choose the one that works best for you.
To use panting-and-blowing breath during labour:
• When the contraction starts, take a relaxing breath—in through your nose
or mouth and out through your nose or mouth. Place your tongue behind
your upper teeth.
• Take several fast, shallow breaths, in and out through your mouth. Relax
your tongue. Blow out through your mouth.
Pant-blow breathing pattern
relaxing
breath
• You can use the speed you like, for example, “heh, heh, heh, blow.”
• Repeat until the contraction ends.
• When the contraction ends, take another relaxing breath.
contraction
0 15sec 30 45 60
length of contraction
75
90
How to practise using panting-and-blowing breath:
This kind of breathing is used during “transition,” a part of labour that
comes toward the end of the first stage. When you are at this stage of labour,
contractions can last for about 90 seconds. They may come very close together.
Practise until you can stay relaxed and comfortable for 90 seconds while doing
panting-and-blowing breath.
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Breathing
to Help You
Avoid Pushing
Sometime, near the end of the first stage of labour, women want to push the
baby out. There are times during labour when you might want to do this, but
your doctor or nurse will tell you NOT to push.
When you are asked NOT to push during labour:
• If you feel you want to push during a contraction, lift your chin and shift
from panting-and-blowing breath to simply blowing out. Do this until the
urge passes. Then return to your panting-and-blowing pattern. For example:
“heh, heh, heh, blow; heh, heh, heh, blow; blow, blow, blow, blow; heh, heh,
heh, blow.”
Breathing to avoid pushing
relaxing breath
How to practise breathing to avoid pushing:
contraction
0 15sec 30 45 60
length of contraction
75
90
Breathing
While Pushing
• When you practice your panting-and-blowing breath, have your partner
say “urge to push.” Then, change to blowing out for a few seconds until
your birth partner says “urge passes.” Then return to panting-and-blowing
breath.
Once your cervix is fully open, the doctor or nurse will ask you to push
when you feel the urge. You might want to push more than once during each
contraction. We have given you two kinds of breathing to use while pushing.
Practise them both, and during labour use the one that works best for you.
When pushing during labour:
• When a contraction begins, take a relaxing breath — in through your nose
or mouth and out through your nose or mouth.
Breathing for pushing pattern
relaxing
breath
contraction
0 15sec 30 45 60 75
length of contraction
152
90
• Use the kind of breathing that feels comfortable until you feel the urge to
push.
• When you feel the urge:
– Relax your pelvic floor muscles
– Tuck your chin in and curl your upper body forward
– Purse your lips and breathe out very slowly as you bear down and push
– Keep bearing down and letting the air out slowly until the urge to push
leaves
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Healthy Birthing
• Hold your breath and bear down while you count to 6. Take a quick breath
and bear down for 6 seconds more. Repeat until the urge to push leaves.
• Return to the breathing pattern you like, until you feel another urge to push.
• When the contraction ends, take another relaxing breath.
How to practise breathing for pushing:
Have your partner say “urge to push.” Start to do the breathing for pushing
until your partner says “urge passes.” Then return to the breathing pattern you
like. Pushing contractions can be as long as 90 seconds.
Don’t actually push when you practise this. Focus on letting your pelvic floor
muscles relax, and imagine the baby moving down and out.
In the next section, “Practising for Labour,” we provide details on how you and
your partner can practise breathing patterns and ways to be comfortable so that
you will be ready for labour.
D
oing this kind of practice is a chance for you and your partner to really try
all the new skills you have been learning.
Before actors present a play, they do a rehearsal. That’s what you and your
labour partner will be doing.
Practising
for Labour
Your partner will talk to you and pretend you are having contractions. You will
practise breathing and relaxing during these pretend contractions. Your partner
also checks to be sure that you’re relaxed. If you are tense, gentle stroking or
touching can help you relax.
Try to practise all the different breathing patterns. The goal is for you to find
them normal and natural when you use them during labour.
During this rehearsal, you can also use focus points to help you concentrate,
and massage to help you relax. If you want to use “Your Guide to Labour and
Birth” on pages 165-174, do so.
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For your labour rehearsal:
• Find a comfortable position.
Remember to practise in a number of positions, so you will be able to
breathe and relax when you are standing, sitting, or walking.
• Practise breathing with pretend contractions.
Use a clock or a watch with a second hand to keep time. Begin with
contractions that are about 30 seconds long and go as high as 90 seconds.
• In practice and in labour, start and end each contraction with a relaxing
breath.
Breathe in slowly and deeply through your nose or mouth.
Breathe out slowly through your nose or mouth.
Whether you breathe through your nose or your mouth is up to you.
Do what feels most comfortable and natural.
To practise breathing through a contraction:
•
•
•
•
•
•
•
154
Note the time.
Say, “contraction begins.”
Take a relaxing breath.
Do your breathing pattern.
Say “contraction ends.”
Take a relaxing breath.
Practise all the breathing patterns until you feel relaxed and comfortable
doing them. Have labour “rehearsals” as often as you wish.
Healthy Birthing
Questions about Medical Help
During Childbirth
Most births are normal and safe. But no matter how well you prepare, you
cannot be sure that all will be as you planned.
Ask questions now. If you talk to your doctor when you are pregnant, you will
feel more relaxed talking to him/her if you need medical help during labour.
To choose what is right for you and your baby, you need to know what to
expect.
Very few women have their babies on their due date. A normal pregnancy
lasts between 38 and 42 weeks. If labour does not begin around this time, your
doctor will watch you carefully.
Induction
Helping to get labour started is called “induction.” Labour is induced for
certain reasons:
What if I am
still pregnant
after my due
date?
• The mother has a medical problem such as heart disease, diabetes, or high
blood pressure.
• The baby has some problem and needs to be born soon.
• The doctor decides that your pregnancy is “post-term.” This
means that you have been pregnant longer than is safe for
you or your baby.
• Your water has broken but labour has not started.
Labour is “induced” with medication. You may be
given medicine to help your cervix open, or to make
your uterus start contractions. Some women get
medicine to do both.
Talk with your doctor if you have more questions
about this.
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What Is Fetal
Monitoring?
Fetal monitoring is a way to check on the effect that labour has on the baby’s
heart rate.
There are different kinds of fetal monitoring. The kind of monitor used when
you are having a baby depends on what the nursing staff and the hospital have.
It also depends on whether any problems arise during labour. Here are 3
common ways to do fetal monitoring:
1. Fetoscope
A fetoscope looks like a stethoscope. The nurse or doctor will use a fetoscope
to listen to your baby’s heartbeat.
2. Doppler Ultrasound
This is a small ultrasound machine that the nurse or doctor holds in their
hands. It is pressed against your abdomen to hear the baby’s heartbeat. Your
baby’s heartbeat will be checked depending on the stage of labour you are in.
3. Electronic Fetal Monitors
Your baby’s heart rate and your contractions can be recorded using a machine
called a fetal monitor.
There are two kinds of electronic fetal monitors:
• The external monitor is held in place by two belts wrapped around your
belly.
• The internal monitor uses a small clip that is passed through the open cervix.
The clip is attached to the baby’s head or some part of the baby’s body. This
does not hurt the baby.
Some hospitals use an external electronic fetal monitor for about 20 minutes
when you first arrive. Then they use a fetoscope for the rest of labour.
Some kind of fetal monitor will be used from the start to the end of labour to
check on the baby’s health.
If you would like to know more about fetal monitoring, or about how it is
done in your hospital, talk to your doctor, hospital nurses, or the leader at your
prenatal class.
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Healthy Birthing
Everyone feels the pain of labour in a different way. Learning to breathe,
relax, and change to comfortable positions may be all you will need to help you
during labour. Some women find that these are not enough. They want other
kinds of pain relief. Having a trusted person to support them during labour
helps women manage labour pain better. Most women find that they feel better
during the early and late stages of labour when they are walking, standing,
leaning, or sitting. A rocking chair can be very comforting. Remember to take
short rests, eat light snacks, and drink plenty of juices and water.
What about
Pain Relief?
Not all kinds of pain relief are offered in all hospitals. Talk to your doctor
during your pregnancy to find out what he or she suggests, and to find out
what is offered in your hospital. Visit the hospital and ask questions.
Here are some of the kinds of pain relief that women have during labour:
Narcotic Analgesics (Pain Killers)
This kind of medicine is usually given (injected) with a needle in the hip
muscle or by an intravenous line. It is the most common kind of medicine for
pain relief in labour. You will feel the effects about 15 to 20 minutes after the
injection. You will also feel sleepy.
Many women find that this kind of medicine makes them feel more
comfortable during labour. Others find they do not work well. Some women
may feel like throwing up (nausea) or they may throw up (vomit).
Analgesics can build up in your system and affect the baby’s breathing after
birth and can have an effect on the breastfeeding process. For this reason,
the amount that you are given depends on the stage of labour and your
baby’s condition. If your baby is sleepy at birth, the doctors can give the baby
medicine to wake up.
Entonox/Nitronox
Entonox/Nitronox is a mixture of oxygen and nitrous oxide. You breathe it
through a face mask or tube that you hold yourself. You inhale slowly and
deeply when a contraction begins. You continue to breathe Entonox/Nitronox
during the contraction.
This medicine is used mostly during transition (the end of the first stage of
labour), when contractions are very strong. It is also used to help with pushing
during second stage. It can be given safely at the start of the first stage as well.
It can help you to relax. You will feel like you are floating. You may feel dizzy.
Some women feel like they might throw up (nausea). Others throw up (vomit).
It does not harm the mother or baby. The effects go away when you breathe
normal air.
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Healthy Pregnancy... Healthy Baby
Local Anesthesia
These drugs are injected around your vagina (the perineum) to numb the area.
This is like the freezing you have when you go to the dentist. This medicine is
used during birth if you are going to have an episiotomy (a small cut to make
your vaginal opening wider) or if you need forceps or vacuum extraction.
When the medicine is first injected you may feel some stinging. Later, you will
feel nothing.
Epidurals
This kind of pain relief involves injecting medicine into your lower back. The
drugs take away most of the feeling between your waist and the tips of your
toes. An epidural is a local analgesia that allows you to stay awake during birth.
The doctor can give you the right amount so that you will be able to feel when
you should push during the birth.
An epidural may be used if your labour is not progressing, if you are really tired
(exhausted), or if you need to have the baby by cesarean or with forceps. An
epidural can slow labour down if it is given before labour is really started. Most
doctors avoid this by waiting until your contractions are regular and your cervix
has opened to at least 3 centimetres.
Only a specially trained doctor can give an epidural. Because of this, not all
hospitals offer this kind of pain relief. Women sometimes have a bad headache
after having an epidural.
TENS (Transcutaneous Electrical Nerve Stimulation)
TENS is a safe way to reduce pain. It uses a mild electric current to fool your
nerves so you feel less pain. It is safe for both the mother and the baby. The
TENS machine is connected to your skin by electrodes placed on your belly or
back.
To use TENS during labour, a physiotherapist needs to show you how to use
the machine. Talk with your doctor or a physiotherapist if you want to know
more.
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Healthy Birthing
An episiotomy is a cut made between the vagina and rectum. It is done to
make more room for the baby to be born. The cut is usually done right before
the birth. The area where the cut is made may not have much feeling in it
because of pressure from the baby’s head. You will also get a local anesthetic.
After the baby is born and the placenta is out, the cut is sewn with stitches that
dissolve as the cut heals.
Why Would
I Need an
Episiotomy?
Most doctors only do an episiotomy if it is necessary, for example during a
forceps delivery or if the mother is having a hard time pushing the baby’s head
out. Talk with your doctor if you would like to know more.
Some women need help to get their baby out. Some reasons why this might
happen are:
• If the baby’s heartbeat slows down or is not regular.
• If the baby is in a position that makes birth difficult.
• If the mother is just too tired to push any more.
Why would I
need Forceps
or Vacuum
Extraction?
When any of these things happen, the doctor may use forceps or vacuum
extraction.
• Forceps look like two spoons joined together. They are placed on either
side of your baby’s head to gently help the baby out.
• In vacuum extraction, a soft plastic cap is placed on the baby’s head and
gentle suction helps the baby out.
Both forceps and vacuum extraction may leave marks on the baby’s head. This
is not serious. The marks soon fade.
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What If
I Need a
Cesarean?
A cesarean is an operation that is done when it is not safe for your baby to
be born through your vagina. Even though you may be planning for a vaginal
birth, you should learn about cesareans in case your baby needs to be born this
way.
A cesarean may be planned ahead of time or it may be needed because
something happens that was not expected. You and your partner will decide
with your doctor whether to have the operation. It is important to remember
that you have NOT failed. The goal is a healthy mother and a healthy baby.
Sometimes the only way to proceed is with a cesarean birth.
The most common reasons for having a cesarean are:
• Labour is not moving along in a normal way
• Changes in the heart rate show that the baby may be in trouble, or is
tired
• The placenta is bleeding or coming away from the wall of the uterus
• The baby is in a position that makes birth through the vagina difficult
• The mother has a health problem, like diabetes, high blood pressure,
heart disease, or active herpes
If you need a cesarean, the way it is handled depends on the hospital where you
give birth and the doctor who does the surgery. Talk with your doctor about
your choices.
• You will most likely have an epidural. This is a kind of freezing drug (from
the waist down). You will be awake when the baby is born. It is not likely
that you will have drugs to put you to sleep (general anesthetic).
• Your partner may or may not be with you during the birth.
• You will most likely have a “bikini cut”. It is done across and low down on
your abdomen.
After a cesarean, the baby will get special attention from the doctors and
nurses. Then the baby will be wrapped in a warm blanket and given to you and
your partner to hold.
Most mothers find that it takes them longer to heal from a cesarean than from
a vaginal birth. This is because you have had an operation. Having a baby to
look after and love will help you to feel better quickly.
To learn more about getting better after a cesarean birth or about having a
vaginal birth after a cesarean, see Early Care for Mother and Baby, page 175.
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Healthy Birthing
Time to Get Ready
No pregnancy lasts forever. Now is the time to pack your suitcase and get
ready for the real thing — your baby’s birthday.
T
hink about packing two bags: one with things you will want during labour,
the other with things you will need during your time in hospital. It should
contain clothes for you and your baby to wear home.
Here are the kinds of things you might want to pack.
Pack Your
Suitcase
Before You
Need It
For labour
q Your copy of this book
q Lip gloss or lip balm
q Sour candy to suck on during labour
q Socks (for cold feet during labour)
q Talc, corn starch, or body lotion without perfume (for massage)
q Focus point (to look at during contractions)
q Watch with a second hand (for timing contractions)
q Notebook and pen (for writing down the time of contractions and
questions for staff)
q Coins for phones and vending machines
q Music and a CD or MP3 player (with headphones)
q Playing cards, books
q Camera and film
q Bathing suit or T-shirt and shorts for your partner to wear while
helping you in the shower
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Healthy Pregnancy... Healthy Baby
For your time in hospital
q Robe
q Slippers
q Nightgowns or pajamas (front opening for breastfeeding)
q Several maternity or nursing bras
q Personal items like a tooth brush, toothpaste, shampoo, brush, comb,
deodorant, face soap, skin lotion
q Books or magazines
q Birth announcements to fill in and mail
q Loose, comfortable clothes to wear home
q Sanitary pads (maxi or super absorbent)
q A package of infant baby diapers
q Do not take valuable items or large amounts of money to the hospital.
For your baby to wear home
q Diapers (with pins and waterproof pants if using cloth)
q Undershirt
q Stretch suit or nightgown
q Hat
q Blanket
q For cooler weather: sweater and socks; blanket or bunting bag
REMEMBER:
162
You will need to put your baby in a safe infant car seat for
the ride home, see Car Seats, page 20.
Healthy Birthing
During the last few weeks of your pregnancy, your body will give you signs
that the time is near. For example, you might have
• Increased discharge from your vagina
• Pains in your lower back
• Lightening (your baby dropping down into your pelvis)
How Will I
Know When
I’m in
Labour?
• A need to urinate often
• Pressure in your pelvis and legs
• More swelling in your legs and ankles
• Lots of energy or feeling restless
• Feeling of tightness in your uterus
With all of this, it can be hard to know whether what you feel is labour or not.
Even if you’re not in true labour, you can be sure that your body is getting
ready for your baby’s birth.
Find out in advance whether your doctor or maternity nurse wants you to call
for advice when you have questions about whether you are really in labour.
True labour
False labour
• Contractions are regular, about
15 to 20 minutes apart, and last
for about 30 seconds.
• Contractions are not regular:
sometimes they are close
together, sometimes farther
apart.
• Contractions slowly get closer
together.
• Contractions remain far apart.
• Contractions slowly get stronger
and longer.
• Contractions stay the same
strength.
• Contractions are felt more in the
back or lower abdomen.
• Contractions feel like the
abdomen is getting tighter
around the baby.
• Contractions get stronger even
when you walk or change what
you are doing.
• Contractions stop when you walk
or change what you are doing.
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Healthy Pregnancy... Healthy Baby
When Should
I Go to the
Hospital?
If you are having your first baby, you should leave for the hospital when your
contractions are regular, strong and painful, and about 5 minutes apart. Your
doctor will give you advice about this.
If you live a long way from the hospital where you plan to deliver your baby,
you may need more time to get there. Also, you need to allow more travel time
if road conditions are bad.
If you think your water has broken, call your doctor. Do so, even if there are
no other signs of labour. Find out if your doctor wants you to call him or her
before you go to the hospital.
My hospital labour and delivery number is: ____________________________
How to time a contraction
When timing a contraction, you are looking for two things:
• The length of the contraction. This means the amount of time between
when the contraction starts and when it ends
• The frequency of the contractions. This means the time between the start
of one contraction and the start of the next one.
To time contractions
• Use a watch with a second-hand or count the seconds out loud.
• Write down the time when a contraction begins. Usually you can feel the
top of your abdomen get tight. Write down the time when the contraction
ends. The abdomen gets soft. This is the length of the contraction.
• Write down the time when the next contraction begins. The time between
the start of one contraction and the start of the next is the frequency, or how
far apart the contractions are.
0
1
Frequency
2
3
4 min.
3 minutes rest between contractions
0
164
15sec
30
Length
45
60
0
15sec
30
Healthy Birthing
Your Guide to Labour
and Birth
This guide provides information on
• What is Happening
• How You May Feel
• What You Can Do
• What Your Partner Could Do to Help
Read the rest of this section before labour starts. Take it with you to the
hospital. It might help you and your partner keep track of your labour and stay
as comfortable and clear as you can.
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Healthy Pregnancy... Healthy Baby
First Stage
Early Labour
What is happening
How you may feel
Your cervix is thinning and opening
from 1 cm to about 4 cm
Excited
Your contractions
• Feel like menstrual cramps, gas,
backache, or pressure in your
pelvis. You may also feel tightness
in your lower back, hips, and groin
• Each last about 30 to 60 seconds
• Begin mild and slowly get stronger
• May start out at about 30 minutes
apart, but get closer until they are
about 5 minutes apart
A pink mucous called “show” comes
out of your vagina. (Sometimes this
happens sooner.)
Your water may break.
You may urinate often or have
diarrhea.
Slow, deep breathing pattern
contraction
0
15sec 30
166
45
60
75
90
Glad that labour is starting
Afraid
Talkative
Eager to have your baby born
Healthy Birthing
What you can do
How your labour partner can help
Carry on with what you would
normally do. Stay upright as long as
possible.
Stay with her. Talk to her.
Walk.
Shower.
Relax in a warm tub if your water
hasn’t broken.
Rest. At night, sleep if you can.
Go to the bathroom as often as you
need to.
Eat and drink as you feel the need.
You need to keep your energy high.
Even if you do not feel hungry, try
to eat a light meal. Be sure to get
enough to drink.
Breathe normally until walking or
talking during a contraction becomes
uncomfortable. Then begin slow,
deep breathing as you need it.
Go to the hospital when your
contractions are coming every 5
minutes (for a first baby). If you have
had a baby before, go when your
contractions are 10 minutes apart.
You may also call the hospital for
advice.
Help her to walk, relax, rest, and pass
the time.
Remind her to go to the bathroom.
She will be more comfortable if her
bladder is empty.
Suggest that she eat and drink.
Time her contractions (See page 164:
How to time a contraction.)
Help her through contractions by:
• Breathing with her
• Helping her find comfortable
positions
• Using heat, and cold to help her
be comfortable
Make sure her bags are packed and
ready to take to the hospital.
Call the doctor and take her to the
hospital when it is time.
Go to the hospital if your water
breaks.
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Healthy Pregnancy... Healthy Baby
First Stage
Active
Labour
What is happening
How you may feel
Your cervix is opening to about 4 cm
to 8 cm.
Tired
Your contractions:
• Are stronger, more intense,
and you feel them more in your
abdomen. You can feel them rise
to a peak, hold, and then stop
• Last about 45 to 60 seconds
• Are about 3 to 5 minutes apart
The “show” may increase until it is
heavy and dark.
Your water may break
You may have some nausea, leg
cramps, or backache. You may sweat
a lot.
Faster, shallow breathing pattern
contraction
0
15sec 30
168
45
60
75
90
Quiet
Tense
Discouraged
Serious
Focused only in labour
Nauseous (feeling like you might
throw up)
Hot or cold
Healthy Birthing
What you can do
How your labour partner can help
Concentrate. Focus on breathing and
relaxation.
Stay with her.
Change positions often. Try the
comfort positions you practised.
Walk.
Drink clear liquids to keep your
energy up. Sucking on ice chips or
a wet washcloth can help if your
mouth feels dry.
Keep your bladder empty. Go to the
bathroom once an hour.
During contractions:
• Focus on one contraction at a time
• Continue with your slow, deep
breathing until it is no longer
comfortable. Shift to faster,
shallow breathing when you need
to
Talk to her. Tell her that she is
doing well.
Time the contractions.
Help her through contractions.
Breathe with her. Help her to focus.
Do things to comfort her such as
massage, back rubs, cool cloths on
her forehead.
Help her to move and find
comfortable positions.
Offer her ice and clear liquids.
Help her to use vaseline or lip balm
if her lips are dry.
Help her to relax and rest between
contractions.
Between contractions
• Relax
• Move around
• Change positions
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Healthy Pregnancy... Healthy Baby
First Stage
Transition
What is happening
How you may feel
Your cervix is opening from about
8 cm to 10 cm.
Afraid
Your contractions
• Are 1 to 2 minutes apart
• Last for 60 to 90 seconds
• Are very strong, intense, and
sharp. They rise to a peak quickly,
hold, and then ease up. They may
have double peaks, when they
begin to ease up and then rise
again
You may feel great pressure on your
rectum or vagina.
You may feel like you are going to
throw up (nausea). You may even
throw up (vomit).
You may have leg cramps, shaking,
or backache.
Pant-blow breathing pattern
Your face may be red and sweaty.
Your feet may be very cold.
You may be sleepy between
contractions.
contraction
0
15sec 30
170
45
60
75
90
Overwhelmed
Exhausted
Restless
Surprised by the urge to push
Confused when told not to push
In a bad mood with the doctor,
nurse, or partner
Have a hard time relaxing and
breathing
Healthy Birthing
What you can do
How your labour partner can help
• Focus on breathing and relaxing.
Think about how close you are to
holding and seeing your baby.
Stay with her.
• Change positions often. Try the
comfort positions you practised.
• Drink clear liquids.
• Suck on ice chips, sour candy, or a
wet washcloth if your mouth feels
dry.
During contractions
• Focus on one contraction at a time
• Do faster, shallow breathing as
you need to
• Change to panting-and-blowing
breath when you cannot relax with
other kinds of breathing
• Blow out if you need to stop
yourself from pushing
Between contractions
• Relax
• move around
• change positions
Talk to her. Reassure her. Tell her
that she is doing well.
Remind her that transition is hard,
but short. It means that labour is
almost over.
Help her to stay calm and relaxed by
staying calm and relaxed yourself.
Time the contractions.
Help her to focus.
Help her through contractions.
Breathe with her. If necessary, take
her face in your hands and look into
her eyes. Tell her, “Look at me.
Breathe with me.”
Remind her not to push too soon.
Help her with panting-and-blowing
until the urge to push passes.
Give clear, simple directions.
Do things to comfort her such as
massage, back rubs, cool clothes to
her forehead.
Place a warm, wet washcloth against
her perineum (the area around her
vagina). This will help her to relax
and let go of her pelvic floor muscles.
Help her to move and to find
comfortable positions.
Offer her ice and clear liquids.
Help her to use vaseline or lip balm
if her lips are dry.
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Healthy Pregnancy... Healthy Baby
Second Stage
Pushing and
Delivery
What is happening
How you may feel
Your cervix is fully open and your
uterus is starting to push the baby
down through your vagina.
Excited
Your contractions
• Are 2 to 3 minutes apart
• Last for 60 to 90 seconds
• Are very powerful
You may have a strong urge to push
with the contractions.
You may find yourself grunting or
making noises while pushing.
You may feel pressure in your
rectum and groin as the baby
moves down the birth canal. When
the crown of the baby’s head can
be seen, you may have a burning
feeling.
Breathing for pushing pattern
contraction
0
15sec 30
172
45
60
75
90
Your backache may go away.
Impatient
Tired
Happy that labour is almost over
Overwhelmed by the urge to push
Amazed at the effort of pushing
Sleepy and peaceful between
contractions
Healthy Birthing
What you can do
How your labour partner can help
Your nurse or doctor will ask you
not to push until your cervix is fully
open. When you are asked not to
push
Talk to her. Support her. Praise her.
• Blow out until the urge passes
When your cervix is fully open
(10 cm), the nurse or doctor will ask
you to push when you feel the urge.
Pushing may feel very good, if your
perineum is relaxed.
When you push
• Push from a position that feels
comfortable to you: partly sitting,
lying on your side, kneeling,
squatting, or partly sitting with
your knees bent
Use the breathing for pushing
pattern that works best for
you.
Help her to imagine the baby
moving down the birth canal.
Help her find a comfortable position
for pushing. Hold and support her in
this position.
Help her to curl forward while
pushing.
Breathe with her. Help her by
panting-and-blowing with her when
she is asked not to push.
Let her know it’s okay to make
noises when she needs to.
Use massage to help her relax.
Remind her to relax her pelvic floor
muscles.
Tell her when you can see the baby’s
head. She may want to touch it so
she can believe that birth is almost
here. Welcome the baby into the
world!
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Healthy Pregnancy... Healthy Baby
Third Stage
Delivery of
the Placenta
What is happening
What you can do
After the baby is born, your uterus
rises higher in your abdomen.
It becomes very round and the size of
a grapefruit.
Relax.
The doctor will give you a needle
(injection) to help the uterus push
out the placenta. Putting the baby to
your breast will also help the uterus
to contract. The doctor or nurse
may support your abdomen as the
placenta comes out.
There may be a gush of blood as the
placenta comes out.
If you had an episiotomy, the
medicine you were given to freeze
you will still be working, so it won’t
hurt while the doctor is stitching
your incision (cut).
How you may feel
Excited, thrilled
Happy, grateful, glad that it is over
Proud, fulfilled
Tearful
Hungry and thirsty
Exhausted
Focused on the baby;
needing to know that he
or she is okay.
174
Bear down to push the placenta out
the doctor or nurse asks you to.
Lie back, hug and enjoy your baby
and your new family.
Breastfeed your baby.
How your labour partner can help
Assure her that the baby is fine.
Offer her something to drink
Hold, hug, and enjoy the baby
together.
Be aware of your own feelings. You
may feel many emotions — joyful,
tired, tearful, and glad that it is over.
Pat yourself on the back for doing
such a good job.
Healthy Birthing
Early Care For Mother
and Baby
The first few days after your baby’s birth are filled with excitement, change,
and questions. In New Brunswick, a public health nurse will visit you in the
hospital. If she has not seen you in the hospital, she will call you at home. You
may be able to be part of the Early Childhood Initiatives Program.
After you go home, get more information and support from your local Public
Health Office, Telecare, or the hospital.
Whether you had a vaginal or cesarean birth, you will notice many changes
in the hours and days after your baby’s birth. Your body gets better in about
six weeks. It will slowly return to how it was before you were pregnant.
Emotionally, you start getting used to being a mother and getting to know and
love your new baby.
Mother Care
By resting enough, you and your baby will move smoothly through these
changes.
When you are in the hospital, the nurses will check your temperature, pulse,
and blood pressure. They will also check your abdomen to see that your uterus
is firm and is getting back to its normal size. If you had an episiotomy, nurses
will check to see that it is healing well.
As your uterus returns to the size it was before you got pregnant, you may feel
sharp cramps in your abdomen. These are called “after pains”. If you breastfeed
your baby, you may notice them most while your baby is feeding. The baby’s
sucking makes the uterus get tight, and helps it return to
normal. Many new mothers find that the breathing
exercises they used during labour can help them with
the “after pains”, too.
The doctor or nurse will ask you about the amount and
colour of the discharge from your vagina. This is called
“lochia” and looks like a menstrual period. For the first
few days after childbirth, it is bright red, heavy, and
may have clots. During the next few days it changes
to a brown or pink and then becomes light yellow or
clear. This can take a few weeks.
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Healthy Pregnancy... Healthy Baby
The nurses will also remind you to urinate and will be there if you need help.
They will ask if you have had a bowel movement and suggest you drink lots of
water to prevent constipation.
Although you need rest, you also need to move around. In the hospital,
you need to get up and walk. You can also begin gentle exercises soon after
childbirth. A mixture of rest and activity will give you the energy you need to
take care of your baby and yourself.
Talk with your nurse or doctor if you have any questions about your body,
your baby or your new family.
Breast Care
F
or the first few days after birth, your breasts will feel soft and will produce
colostrum — a sticky, yellow fluid.
Your milk usually comes in about 2 to 4 days after your baby is born. Your
breasts will feel warm, firm, and tender. If they become very full and sore,
feeding your baby will help. If the baby does not want to feed when you need
relief, you can express milk from your breasts. This is easy to do when you take
a warm shower. You can also put warm cloths (compresses) on your breasts to
ease the discomfort.
When you take a bath, wash your breasts with plain water only. Do not use
soap. Pat your nipples dry. Let them dry in the air after each feeding.
You can prevent dryness and skin rashes by rubbing a small amount of breast
milk onto your nipples and the dark circle around them (areola).
Wear a cotton bra that fits you well and does not have elastic straps. The bra
should not have a lining made of plastic or rubber.
To learn more about breastfeeding your baby, see Section 4 - Deciding to
Breastfeed.
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Even if you decide not to breastfeed, your breasts will produce milk.
A good support bra will help you feel more comfortable.
Mothers who decide not to breastfeed do not need medicine to dry up the milk.
Avoid doing things that will cause your breasts to produce milk, such as:
• Rubbing your breasts with a face cloth, your hands, or clothing
• Letting hot water fall on your breasts when you are in the shower. To avoid
this, shower with your back to the water
If your breasts become sore and swollen, ice packs and pain pills may help. The
milk in your breasts will be absorbed by your body. Try not to express milk.
Soon after your baby’s birth —in 2 or 3 days — you may find yourself not
feeling as happy as you think you should. You may feel tired, moody, tearful,
helpless, or overwhelmed.
Baby Blues
(Postpartum blues)
These feelings are called “postpartum blues.”
They are normal. Many new mothers feel this way. Most find that these
feelings pass quickly. Resting and spending time with your baby will help.
To learn more about postpartum blues, see page 217 in Section 8 - Healthy
Family. Talk about this with your partner, friend, support people and/or family.
F
or most women, the “baby blues” go away in a week or two. But in some
cases, women go on to have postpartum depression. No one knows what
causes it. The change in hormones and a family history of depression may be
the reasons. If you have postpartum depression, you may feel very sad, angry,
moody, helpless and lonely. You may not be able to sleep. Your energy may be
low. You may think about hurting yourself or your baby.
Postpartum
Depression
You are not alone. Talk to you doctor or health care provider. This is an illness
that can be treated. Most women improve within 3 months.
IMPORTANT
See your doctor right away, or go to your hospital
emergency centre if you start to think about hurting your
baby or yourself. Make sure that someone stays with your baby.
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Helping your
body feel
comfortable
after birth
Care of the perineum
Whether or not you have stitches from a tear or episiotomy, your perineum
(the area between your vagina and rectum) may be swollen and sore. To feel
better, try:
Ice packs: Ice packs wrapped in towels will help reduce swelling and pain in
your perineum.
Warm baths: Soak at least 6 times a day in warm water. Do pelvic floor
exercises while you are soaking. You may want to put epsom salts or baking
soda in the bath water.
Rinsing carefully after going to the bathroom: Pour warm water over your
perineum. Squirt water from a squeeze bottle while you are sitting on the
toilet. Pat yourself dry with clean wipes, moving from front to back. This keeps
the area clean and stops infection.
Sitting carefully: Sit down on both hips evenly. Make your pelvic floor
muscles tight as you lower yourself. Relax them when you are sitting. Tighten
them again as you get up. Sit on firm chairs, not a soft couch or chair.
Pelvic floor exercises: Start doing these soon after your baby is born. If you
tighten and relax these muscles, healing will be faster.
Hemorrhoids
The pressure of bearing down during labour can cause hemorrhoids. If you
had them during pregnancy, giving birth can make them feel more swollen and
sore.
You can help the pain by:
• Using an ice pack wrapped in towels
• Soaking in a warm tub
• Keeping your bowel movements soft. Drink lots of fluids (6 to 8 glasses
a day) and eat fruits, whole grains, and other high-fibre foods
To learn more about hemorrhoids and relief from them, see Relief for
Common Discomforts on page 39 in Section 2 - Nine Months of Changes.
Hemorrhoids can hurt quite a bit. But they often go away as your body
recovers from pregnancy and birth.
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After a cesarean, the care you receive in hospital will be a bit different. If you
have questions, talk to your doctor or to the nurses.
You may also find that you have feelings you did not expect. If you had been
planning a vaginal birth, you may feel sad. Talk about how you feel with your
partner, your doctor, your nurse, or someone you trust. Your feelings are
normal. Here are some tips for healing after a cesarean:
After a
Cesarean
Birth
Physical care
After this kind of birth, the incision (cut) will be painful, and it will hurt when
you move. If you need pain medicine, your doctor will order it for you.
For the first 24 hours after the birth, you may have a needle in your arm and
a tube that provides fluids. This is called an intravenous drip (or IV). It helps
you get enough fluids. You may also have a tube in your bladder to let you pass
urine (pee). The hospital will offer you food and drink. It’s good to eat, if you
feel hungry.
To make it easy to have a bowel movement after the operation, drink plenty
of liquids (6 to 8 glasses a day) and walk as much as you can. Your doctor may
suggest medicines such as a stool softener or mild laxative. When you have
a bowel movement, support the place where you were cut with your hands
while you bear down gently.
Breathing exercises
Breathing exercises are the first step to feeling better. Start them soon after
the operation and continue for the next several days. This will keep your lungs
clear and make your healing easy and faster.
When you do breathing exercises, support the place where you were cut with
your hands or a pillow.
Here’s what you can do once an hour:
Take 2 or 3 slow, deep breaths. Feel your chest expand.
Huff. Huffing is like saying “ha” quickly. Open your mouth and relax
your jaw. Tighten your abdomen and force the air from your lungs.
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Caring for your incision (cut)
For 2 to 6 days, the cut or incision will be covered with a bandage. When you
are in the hospital, your nurse will change the bandage and clean the cut. If
it is healing well, most doctors suggest that you take a shower as soon as the
bandage is gone. Ask your nurse if it is okay to shower.
Some stitches dissolve on their own. Others must be taken out by the doctor or
nurse a few days after the operation. Some doctors use metal clips or staples to
close the incision. These need to be taken out a few days after the operation.
The incision will be sore at first. As it heals, it may feel numb, itchy, tight, or
tender. This is a normal part of healing.
Your doctor or nurse will tell you how to take care of your incision after you
leave the hospital. In most cases, it will not need any special care after you go
home.
When you are feeding your baby, place a pillow between your baby and the
incision. You will both be more comfortable.
Rest
After a cesarean birth, your body must heal from both childbirth and an
operation. Give yourself time to get your strength back.
Rest is an important part of feeling better. Try to rest when your baby sleeps.
Accept help when people offer it. Limit visitors. Put a sign on the door of your
house or apartment: “Mother and Baby Sleeping.”
mother
and
baby
sleeping
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If you have had a cesarean birth, you may be able to have a vaginal birth with
future babies. You should discuss this with your doctor.
A vaginal birth after a cesarean (VBAC) may be possible if:
• Your next pregnancy is normal in all ways
• The cut in your uterus from the first cesarean runs from side to side rather
than up and down. Be aware that the scar on your skin may be up and down
even though the cut in your the uterus is from side to side.
Vaginal
Birth after
a Cesarean
(VBAC)
• You are pregnant with only one baby, not twins or triplets
• The reason for your first cesarean does not happen again. For example,
if you had a cesarean because your baby was lying sideways in your uterus,
if this baby is in a normal position (head down), you could give birth through
your vagina
A VBAC is safe, although there is a small chance that the uterus could tear (rip)
during labour. This would happen where the cut from the first cesarean was.
On the other hand, among 1,000 women in New Brunswick who have a VBAC,
only 2 or 3 will have a tear in their uterus during labour. If this happens, you
will need a cesarean again.
The benefits of a birth through the vagina:
• A lower risk of infection and bleeding
• Fewer problems from anesthesia
• A shorter time in hospital
• An easy and faster recovery from child birth
Talk with your doctor if you want to learn more about VBAC.
Not all hospitals offer vaginal birth after a cesarean. Talk with your doctor
about what is offered in your town or city or about going to a hospital that has
this choice for your next birth.
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Exercises you
can do after
Child Birth
After your baby is born, being active will help your body return to normal.
Exercise will:
•
•
•
•
•
•
•
•
Speed up healing
Improve your blood circulation
Make your muscles strong
Keep your pelvic organs toned
Give relief from hemorrhoids
Help your bowels and bladder to work well
Give you energy
Help you to feel better and more relaxed
If your hospital offers a postpartum exercise class, try to attend. It will give you
a chance to move around. This will help you get back into normal life.
You have seen the exercises in this section. Most of them were part of your
prenatal program. Start them as soon as you can after birth and do them
when you return home. You will find details about the exercises in Section 6 Healthy Activity.
Start gently and allow your muscles to get stronger slowly. Start by doing each
exercise 3 to 5 times. Slowly increase to 5 to 10 times each.
On the day of delivery — in bed:
• Do foot and ankle circles
• Do pelvic tilts (lying on your back with your knees bent)
• Do pelvic floor exercises
After 24 hours add:
• Stomach (abdominal) muscles tightening (lying on your back with your
knees bent)
After two days add:
• Curl ups — Before you do curl-ups, check to see if you have an abdominal
separation as you learned in Section 6 - Healthy Activity. If you do, you must
support your abdominal muscles while you exercise.
• Diagonal curl-ups
• Alternate arm stretches
• Elbow circles
You may want to relax as part of your exercise program using the relaxation
tips in Section 6 - Healthy Activity. Being relaxed matters as much now as it
did when you were pregnant.
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After an operation, being active will help you heal as much as rest does.
You should begin breathing exercises (see page 179) in the first few hours after
your ceasarean. Continue to do them while you are in the hospital.
Within the first 24 hours after birth, the nurses will help you to sit on the side
of your bed, stand up, sit in a chair and to take short walks. This may not be
easy, and you may think they are asking a lot of you. But it is important to be
active. It helps you heal from the operation.
Exercises you
can do after
a Cesarean
Birth
Moving and exercising will:
•
•
•
•
•
•
Speed up healing
Give you relief from gas
Help your blood circulation
Help your bowels and bladder return to normal
Give you more energy
Help you to feel better and more relaxed
If your hospital offers a postpartum exercise class, try to attend. It will give you
a chance to move around and will help you return to normal life.
You have seen the exercises in this section. They were part of your prenatal
program. Start them as soon as you can and do them at home. You’ll find
details about the exercises in Section 6 - Healthy Activity.
Start gently and allow your muscles to slowly get stronger. Start by doing each
exercise 3 to 5 times. Slowly increase to 5 to 10 times each.
Days 1 and 2
Do these lying in bed:
• Foot and ankle circles
• Pelvic floor exercises
• Pelvic tilt (lying on your back with your knees bent)
• Abdominal tightening (lying on your back with your knees bent)
• Leg bending:
– Lie in bed with head and shoulders raised on pillows
– Bend your right knee, keeping your left knee straight
– Bend and straighten your left knee several times
– Change legs and repeat
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Days 3 and 4
Do these sitting or standing:
• Foot and ankle circles
• Pelvic floor exercises
• Pelvic tilt
• Abdominal tightening
Do this lying down:
• Leg bending
Baby Care
D
uring the first few days after birth, your baby is learning about life outside
your womb. Breathing, eating, and the feeling of air are all new.
The hospital staff will check your baby’s breathing, heart rate, and
temperature. They want to be sure the baby can suck well. They will check to
see if the baby is wetting diapers and having bowel movements.
Right after birth, your baby will be given an Apgar score. This score is based
on your baby’s heart rate, breathing, muscle tone, reflexes, and colour. Later,
a doctor will give the baby a complete exam.
Immunizations during childhood help prevent certain diseases in the child’s
life. After birth, if you agree, your baby may receive his first hepatitis B vaccine.
To learn more about immunization, see page 207 in Section 8 - Healthy
Family.
The law says that an ointment must be put in your baby’s eyes to protect
against infection. This will be done soon after birth. The ointment may make
your baby’s eyes look puffy. Your baby will also be given vitamin K before you
leave the hospital.
Before you and the baby go home, your baby’s heel will be pricked with a
needle. A blood sample will be taken and tested for Phenylketonuria (PKU)
and thyroid problems. If these problems are found early enough, your baby will
not suffer damage to his development.
I
IMPORTANT: If you go home early (as part
of an early discharge program) or
leave the hospital before 48 hours,
your baby will still need to be tested.
Before you leave, arrange a time to
come back to the hospital to have
your baby’s PKU test done.
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New parents are often surprised by the way their baby looks. When you
were pregnant, you may have been thinking and dreaming about a girl with
blond hair like her father. Or a little boy with black hair and brown eyes.
How Your
Baby Looks
Part of being a parent is letting go of this “dream” child. You need to accept
and love your real baby. Love does not turn on and off like a switch. It grows
over time. As you spend time touching, hugging feeding, and just looking at the
tiny hands and feet, you will find a lot to love.
Size
Most full-term babies weigh about 3500 grams (71/2 lbs) and are about 50 cm
(20 inches) long. They lose a bit of weight soon after birth.
Head
Your baby’s head may seem too big for such a tiny body. It may also have an
odd shape from the pressure of childbirth. You will notice a soft spot on the
top of the head. Your baby may have a lot of hair, or almost none.
Skin
Your baby’s skin may be dry and flaky. This is normal and will change soon.
You may also notice something that is creamy white on the baby’s skin. This is
called “vernix”. It helped to protect the baby’s skin in the uterus. It is good for
the skin after birth, too. You do not need to scrub it off.
Face
Most newborns have small, flat noses, small chins, and short necks. This makes
it easy for them to breastfeed.
Body
Your baby will have a round chest and tiny little hips. The legs and arms will be
bent a bit and the hands curled into fists. Many babies like to sleep with their
legs tucked up, the way they were for the last nine months. To reduce the risk
of Sudden Infant Death Syndrome (SIDS), babies should sleep on their backs.
Cord
After the cord has been cut, it is grey and soft. It will be closed with a plastic
clip. The clip will be taken off on the second day after birth. During the next
few weeks, the cord will dry up, get small and dark, and fall off.
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What Your
Baby Needs
Newborn babies need to eat and to sleep. They need warmth and comfort.
They need to be clean and safe.
You cannot predict what they will do. They have not settled into a routine of
sleeping, waking, and eating.
Babies learn about the world by having their needs met. Babies need to be fed
when they are hungry.
They need to be held close, treated gently. You need to keep them safe, warm,
and dry. They need to see loving faces and hear gentle voices.
These first few days are a time when you, your baby, and your family meet each
other. You will learn how your baby looks, smells and sounds. You will start
to learn what she likes and dislikes, and your baby will begin to learn the same
things about you.
Feeding Your Baby
Newborn babies don’t eat much during the first few days. Because of this, they
may lose a bit of weight and then begin to gain it back. Most babies are back to
their birth weight within 10 days.
When you are breastfeeding, your breasts will produce “colostrum”. This is
a special kind of early milk for your baby. It is all your baby needs for the few
days before your body begins to produce milk.
While you are in hospital, the nurses can answer your questions and help you
with breastfeeding.
Ask for as much help and advice as you need. Some hospitals also offer classes
to help you start breastfeeding.
You may also have questions about formula feeding, and how to prepare (make)
formula. If so, be sure to ask for help and advice.
For more information about feeding your baby, see pages 194 to 197 in Section
8 - Healthy Family.
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You will learn new skills to care for your baby. You will learn how to give
a bath, change diapers, dress the baby, and feed him.
When you are in hospital the nurses will answer your questions and help you
learn to take care of your baby. Use this chance to ask about anything that
puzzles or concerns you. Some hospitals offer baby care classes to help new
mothers feel sure of themselves.
Taking Care
of Your Baby
You can learn more about baby care in Section 8 - Healthy Family, or by
talking with your public health nurse.
D
uring the first few days, some babies get “jaundice.” Their skin and eyes
look yellow. The yellow colour is caused by something in the baby’s blood
called “bilirubin”. You may see the yellow colour on the third or fourth day.
It may get stronger on the fourth or fifth day, and be gone within two weeks.
If Your Baby
Has Jaundice
Most of the time, jaundice is not serious. But it can be, sometimes. If your
baby’s eyes or skin look yellow, the doctor may order a blood test. If the test
shows that there is a high level of bilirubin in the blood, the baby will be
treated with phototherapy. This means that they are undressed, their eyes are
covered, and they are put under ultra violet lights. The light helps to break
down the bilirubin in the baby’s body. It will not harm your baby in any way.
If it is treated, this kind of jaundice has no long-term effects on the baby’s
health.
If you are breastfeeding you should still feed your baby during the
jaundice treatment.
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Registering
Your Baby’s
Birth
Before you and your baby leave the hospital, you will need to fill in forms to
register your baby’s birth.
When you have done this, you can give the forms to the maternity unit at the
hospital. They will be sent to the Vital Statistics Office, which will send you
a birth certificate for your baby. You should get this 6 to 8 weeks after Vital
Statistics receives the forms.
If you complete the forms at home, mail them to:
Vital Statistics
435 King Street
Fredericton, NB
E3B 5H1
You must also register your baby with Medicare New Brunswick. You should
do this as soon as you can, so that your baby’s medical expenses are covered.
When you are in hospital, you will get a form to register your baby
for a Medicare number. When Medicare New Brunswick gets your
form, it will send you a Medicare card for your baby. Keep this card
in a safe place. It is the baby’s Medicare number for life. You will
have to renew it every 3 years. Medicare New Brunswick will send
you the forms. If your address changes, please inform Medicare
New Brunswick of your new address.
If you have questions about your baby’s birth certificate or
Medicare numbers, contact your local Service New Brunswick
Office or call 1-888-762-8600.
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Healthy Family
Your First Weeks at Home
Welcome home and welcome to life as a parent!
After a few days in the hospital, you may be looking forward to going home
and being a family.
On the other hand, many new parents are worried about looking after the baby
on their own. A new baby seems so tiny and helpless. You may wonder how
you will manage.
There are many places to learn about baby and childcare. Family, friends,
public health nurses, and community groups can help. So can books. You may
want to get a childcare book you enjoy reading. It can come from your local
library or bookstore.
In this section we talk about baby’s first six weeks. We focus on taking care
of your baby, taking care of yourself, and getting used to life as a family.
During these first weeks as a parent, you may feel excited and tired. Do not
forget that being a parent is something we need to learn. It’s a new skill!
No one is born knowing how to be a good parent. You will learn over time.
It is on-the-job training!
Relax. Get as much rest as you can. Focus on loving and
looking after your new baby.
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What’s Normal for a Newborn?
New babies seem helpless, but they can see, hear, smell, taste, and feel. When
they are born, they have what they need to live, to grow, and to learn about the
world.
What can babies see?
Newborns can see light and dark, shapes and patterns. They can focus and see
clearly when things are 18 to 25 cm (7 to 10 inches) away. When you hold your
baby in your arms, this is about the distance between her face and yours. Babies
like to look at faces more than anything else.
During the first few months, you may notice that your baby’s eyes wander
or cross once in a while. Many babies do this until they learn to control the
muscles around their eyes. If you are worried about your baby’s eyes, talk to
your doctor or to your public health nurse. You can do this when you take the
baby for a checkup.
What can babies hear?
Newborn babies have excellent hearing. In fact, while they are still in the
womb, they can hear their mother’s heart beating. They can also hear
noises from outside the womb.
Babies like to listen to voices, music, and humming sounds like a
washing machine or a dishwasher.
Sudden loud noises may make a baby cry or wake them up if they
are sleeping. Even so, there is no reason to try to keep the house quiet
for the baby. Babies get used to normal noises. They do not pay a lot of
attention to them.
What kind of sounds can babies make?
New babies can cry. After a few weeks, they can gurgle and make small sounds
in their throats. Later, they begin to coo and babble and laugh.
The best way to help babies speak is to talk to them. Sing and talk to your baby
as much as you can. Talk while you are feeding, washing, and dressing him.
Talk about what you see when you are on a walk together. What you say does
not matter. The baby needs to hear your voice.
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What kind of movement is normal for a newborn?
Newborns have some control over their muscles. They can move their arms
and legs, hold your finger, and turn to face the breast or bottle.
Babies’ heads wobble. You need to support the head when you pick up
a baby. Your baby will not be able to balance her head alone until she is about
4 months old.
Babies’ bodies, minds, and feelings all grow at the same time. Even in the
first weeks of life, you are teaching your baby about life.
When you respond to your baby’s cries you are teaching her that when she
needs something, someone will come and help her.
How Can I
Help My Baby
Develop?
When you talk and sing to your baby, you are helping him to develop hearing
and language skills.
When you smile and make faces at your baby, you’re helping her to control her
eye muscles so she can focus and see clearly.
When you blow bubbles on your baby’s tummy, rub and kiss his little hands
and feet, stroke his soft head and cheeks, you’re helping him to learn how his
body feels and what it can do.
As you play with your baby, love your baby, and look after your baby, you are
helping him to develop into a happy, healthy little person.
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Caring for Your Baby
Caring for a baby takes skill and practice. No one is born knowing how to
bathe, dress, feed, and diaper a baby. Most parents learn these skills as they
go along.
Don’t worry if you feel awkward and uncertain at first. Before you know it,
looking after your baby will seem natural, you will hardly remember that it was
something you had to learn.
For the first six months of life, breast milk is all your baby needs. If you
How Should
I Feed My
Baby?
decide to use formula, that is all your baby needs for the first 6 months.
Babies can have trouble with solid food if they have it before 6 months.
Breastfeeding
Breastfeeding gives your baby the healthiest possible start. Section 4 -
This means that for now, you only have to decide whether to give you baby
breast milk or formula. Your local Public Health Office, prenatal instructor,
or your doctor can give you advice and information to help you decide.
Deciding to Breastfeed, explains why breastfeeding is important and talks about
building breastfeeding support. Now is the time to start calling on that support.
Breastfeeding is Mother Nature’s way to feed your baby. But that does not
mean that you will naturally know how to do it. Most mothers need advice and
support. This is most true during the first month when everything is new.
Love and support from you partner and your family can help you. Friends who
have enjoyed breastfeeding their babies can also help. So can a public health
nurse, public health nutritionist, doctor, and support groups like La Leche
League and Family Resource Centres.
You need to take care of yourself while breastfeeding. Get plenty of rest, eat
well, and drink lots of fluids. Eating healthy food will help you feed your baby
and keep your energy high. While you are breastfeeding, you need the same
amounts and kinds of food as you did when you were pregnant. This means
that each day, you need at least:
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Teens (14 to 18)
Adults (19 or older)
Vegetables and Fruit
7
7 to 8
Grain Products
6
6 to 7
Milk and Alternatives
3 to 4
2
Meat and Alternatives
2
2
Breastfeeding women
Include and extra
2 to 3 Food Guide
Servings each day
Tips to help you breastfeed
• Do not do too much during the first few weeks. Focus on relaxing and
getting used to breastfeeding. If you can, ask friends or relatives to help
with cleaning the house or cooking, so you can spend these first weeks
taking care of yourself and your baby.
• At first, breastfeed whenever the baby wants to feed. This is called
“nursing on demand”. The more your baby nurses (or drinks breast
milk), the more milk your body will produce. Feeding the baby small
amounts often is the best way to establish a good milk supply.
• During these first weeks, your milk supply will change all the time to
meet your baby’s needs. At first you may need to nurse every 2 or 3
hours. The time between feedings will increase until your baby wants
to nurse every 3 or 4 hours. Most babies grow a lot when they are 10
days old and at 3 and 6 weeks and again when they are 3 months and 6
months. When this happens, your baby will need to nurse more often.
• Do not give your baby a bottle of milk. If your baby has milk from a
bottle, she will drink less breast milk. If your baby is not drinking your
milk, your body will not make milk. It is better to wait until you have
nursed for at least 6 weeks and have a good supply of milk before you
give your baby any bottled milk.
• If you find that you need to give your baby breast milk other than at the
breast before the first 6 weeks, talk with your doctor, public health nurse
or a public health nutritionist about the best way to do this.
How to breastfeed your baby
Your baby gets milk by sucking on the breast, not the nipple. The baby uses its
lips, gums, tongue, cheeks, jaw muscles, and hard and soft palates to feed. It is
good exercise! It can help make the baby’s gums, jaws, and teeth healthy and
strong.
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When you are breastfeeding, you should be sitting in a comfortable way and
you should be in a position that allows your baby to “latch on” to your breast.
Doing this will keep things going well for you both. Good position and good
latching can also prevent problems later on.
When you breastfeed, you need to relax. There should be no tension in your
shoulders or back. Make sure that your arms and back have support so you will
not strain your muscles. You may want to use pillows and a footstool for more
comfort. If you are sore from childbirth, you may need help to put the pillows
in the right place.
Once you are in a good position, you can offer your baby your breast. Babies
often nurse better when they have skin contact with their mothers. Many
babies find the nipple easily, latch on to the breast, and seem to know what to
do. Others need some help. Here are some ways to help your baby latch on:
• Have your baby at the level of your nipple before you begin. Use pillows or
a rolled blanket to get your baby at the right level.
• Support your breast with your free hand by making your hand look like the
letter “C”. This means that your thumb is on top of your breast, and your
fingers are under it, far behind the darker skin around your nipples (areola).
• Help your baby’s mouth to open wide. To do this, lightly touch your baby’s
lips with your nipple. Move the nipple from the baby’s upper lip, to lower
lip, and back again.
• When your baby’s mouth is open as wide as a yawn, pull the baby close to
you. Your nipple should be centred upward in your baby’s mouth. Baby’s
chin should touch the breast first.
• Make sure that the baby’s mouth is wide open and the baby’s lips are curled
out and that his chin touches your breast.
• Allow your baby to suck at the first breast for as long as he or she wants.
Then you can offer the second breast, if she is still hungry. Babies will often
leave the breast on their own when they are full or need to burp.
If your baby takes only the nipple, gently break the suction and start again.
Break the suction by placing your clean finger into the corner of baby’s mouth
and pressing against your breast. If you allow your baby to suck without getting
a good latch, two things may happen. One, your nipples may get sore. Two,
your baby may not get enough milk.
Breastfeeding is a special time for you and your baby. Relax and enjoy it. If you
have questions or concerns, talk with your public health nutritionist, public
health nurse or doctor.
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Healthy Family
Commercial Infant Formulas
If you decide to use a commercial formula, your doctor may suggest a brand.
There is not much difference between them.
You must prepare infant formula correctly. Germs can spread and your baby
can get sick if you do not.
Commercial
Infant
Formulas
To learn more about how to prepare formula, contact your local public health
office.
If either parent has milk allergies in the family, talk to your doctor about how
to tell if your baby has this kind of allergy.
Vitamin D
• Health Canada recommends that all breastfed babies be given a daily
Vitamin D supplement of 10 ug (400 IU).
• You should start giving your breastfed baby Vitamin D at birth. You should
continue:
– until your baby is getting at least 10 ug (400 IU) per day of vitamin D
from food (such as drinking 2 cups (500 ml) of milk or formula a day), OR
– until the breastfed child is one year old.
Do I Need
to Give
My Baby
Vitamins?
To learn more about breastfeeding and Vitamin D, talk to your health care
provider.
IMPORTANT: Babies fed commercial formula should not be given any
extra vitamin supplements.
Fluoride
Fluoride helps make strong bones and teeth. Your baby should not need to
have a fluoride supplement. If your family has poor dental health or if you want
to know whether fluoride is right for your baby, talk to your dentist.
Do I Need to
Give My Baby
Flouride ?
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How Much
Do Babies
Sleep?
New babies nap and sleep when they need to. They do not know about
being “awake” or “asleep.” Each new baby develops a pattern of sleeping and
waking. As you learn about these patterns, you will know when your baby is
sleeping, awake or lying there quietly.
Something you can do to help your baby learn the difference between sleeping
and waking is to put him to bed when he is very sleepy and get him out of bed
when he is awake. This will help him connect the bed with sleep.
All new parents are tired. It may be months before you will be able to get more
than a few hours of solid sleep.
Here are some things you can do to make night feedings easy.
• Make sure the baby is comfortable when you put her to bed. She should be
fed, burped, and dressed in comfortable clothes. Be sure the room is warm
and dark enough. (You may want to leave a dim light on so you can see
during the night.)
• The baby will wake up because he is hungry. The night is too long for
him to not have food. Make night feedings as quick and quiet as you can.
The baby will go back to sleep faster if he stays sleepy and calm during the
feeding. You do not need to go to the baby every time he makes a noise, but
do go as soon as you are sure he is crying. Do not give him a chance to be
wide awake. Have everything you need ready, such as a diaper. If you burp
the baby and change the diaper half way through the feeding, the baby can
go back to sleep right away at the end.
To reduce the risk of Sudden Infant Death Syndrome (SIDS):
• Always place your baby on her back to sleep
• Do not use a soft mattress, pillows, a comforter, stuffed toys, or
bumper pads in the baby’s crib. These items stop air circulation around
your baby’s face.
• Keep your baby warm, but not hot
• Create a drug and smoke free home for your baby
• Breastfeeding offers some protection against SIDS or crib death.
Fewer breastfed babies die from SIDS.
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Healthy Family
Babies who lie in one position for a long time can develop flat spots on their
heads. This happens because the baby’s skull bones are very soft in the first
year of life. As well, babies have weak neck muscles. They may turn their heads
to one side when lying on their backs.
Why do some
babies have
flat spot on
their heads?
To prevent your baby from getting flat spots on his head:
• Change where you put him in the crib each day. For example, one day
place his head at the head of the crib, and the next day place his head at
the foot of the crib.
• Avoid leaving your baby a long time in car seats, swings, and baby seats
where his head will be in the same place
• Change the way you hold him for feedings. If you use different
positions, this will put less pressure on one spot on your baby’s head
• Move toys and mobiles to different places so your baby will turn his
head in many directions
• Put him on his tummy and side to play with him when he is awake.
This is also good for your baby’s development.
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Why Is My
Baby Crying?
All babies cry and most babies cry a lot. They cry because crying is the only
way they have to let you know that they need something. Babies cannot say
“Please change my diaper” or “Feed me” or “I want to have fun.” All they can
do is cry.
When your baby cries, try to find out why. The chart on the next page can
help. As time goes by, you will know what different cries mean and what to do.
The key is to watch and learn your baby’s signals.
Don’t be afraid of “spoiling” your baby by going to him when he cries. Babies
cry because they need food, love, hugs or a smile. When you respond to crying,
you are helping your baby learn that the world is a good place to be. He is
learning that help comes when it is needed. A baby whose needs are met will
feel safe, secure, and loved, not spoiled.
Sometimes, no matter what you do, your baby keeps crying. This can be hard
to deal with.
WARNING:
Babies can be hurt if you treat them roughly or shake them.
Shaking your baby can cause death or permanent damage to
your baby’s brain. Make sure all the people around your baby
know about “shaken baby syndrome.”
It is easy to say “stay calm,” but it can be very difficult to do. If you feel angry
and are afraid you might hurt your baby:
• Put your baby safely in his crib and leave the room
• Do something to get rid of the anger. Run, jump, yell, or hit a pillow
• Call for help. Call a friend, family member or help line. Sometimes just
talking to another adult can help you feel better.
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Healthy Family
My baby is crying?
What can I do?
Hungry or thirsty
• Feed the baby, especially if more than 2 hours have passed since the last
feeding.
Uncomfortable
•
•
•
•
•
•
•
Not feeling safe
(Insecure)
• Wrap the baby up in a light blanket.
• Help the baby feel safe by moving slowly and calmly. Do not rush or move
quickly.
• Hold the baby close and cuddle.
Lonely or
bored
•
•
•
•
•
•
Too tired
• Move the baby to a quiet place.
• Give the baby something to suck — your breast or a soother (if you are
formula feeding).
• Try quiet motion — rocking, patting, riding in a car or carriage.
• Turn on the dishwasher, clothes dryer, or washing machine. Babies often
enjoy these kinds of sounds. They remind them of the sounds they heard in
their mother’s body before they were born.
• Take a warm bath with your baby (make sure you have someone to hold the
baby while you get in and out of the bathtub).
Fussy time of day
• This often happens late in the afternoon or early evening. Try the ideas for
helping an overtired baby.
• Try to plan ahead to make this time of day calmer. For example, get supper
ready ahead of time and plan activities to keep your other children busy.
• Ask for help during busy times. Ask your partner or someone else to take
the baby or to do the chores so you’ll be free to care for the baby. You can
also use a snuggler (Snugli™) so you can hold your baby close and still have
your hands free. Babies who are held and cuddled for longer periods cry
less.
Burp the baby.
Check diaper pins.
Change wet or dirty diaper.
Change the baby’s position.
Gently rub the baby’s back.
Make sure the room isn’t too warm or too cold.
Make sure the baby is not wearing too many clothes, or not enough.
Talk or sing to your baby.
Move the baby to a room with other people.
Play music.
Rock the baby.
Take the baby for a walk.
Give the baby a toy or mobile to watch.
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Healthy Pregnancy... Healthy Baby
What is
Colic?
Colic is not a disease. A baby with colic cries a lot more than other babies.
Nothing seems to comfort the baby or stop the crying. It is painful for the baby
and very hard for parents. If your baby has colic, do not blame yourself. It is
not your fault.
No one knows what causes colic or why only some babies get it. Colic is most
likely to occur in the evenings. It starts during the first few weeks of life and,
in most cases, ends when the baby is 3 or 4 months old.
Check with your doctor or public health nurse to make sure there is not some
other reason for the crying.
If your baby has colic, get as much rest and help as you can. Let other people
help with the baby, meals, and other children. Remind yourself that this will
not last forever.
A baby with colic:
• Cries as if in pain after a feeding
• Pulls his knees up to his chest as with a bad stomach ache
• May pass gas or vomit
• Does not stop crying for long, no matter what you do
You may find these ideas helpful if your baby has colic:
• If you are using a commercial formula, check to be sure the nipple is full
of milk so your baby does not swallow too much air during feedings.
• Burp before, during, and after each feeding.
• Try to stay calm and keep your baby calm. Play soft, soothing music.
Hum or sing. Walk or rock your baby. Rub the baby’s back for comfort
and to help pass gas. Lay your baby on his tummy and rub his back. Or,
lay your baby on his back and rub his tummy. Place a warm cloth on the
tummy or bath the baby in the tub.
• Use an infant carrier that straps on your shoulders (SnugliTM). It allows
you to carry and comfort your baby when you have to do other things.
• Take the baby for a car ride or go for a walk using the carriage.
Sometimes the noise and movement help.
• If you smoke, the nicotine goes into the baby with your breast milk.
This may be making the baby upset. You may want to stop or reduce
your smoking. Or you could only smoke after you feed the baby.
• Do not change your baby’s commercial formula without first talking to
a health professional.
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Healthy Family
New babies like to be warm, dry and wrapped up. When you begin to give
your baby a bath, she may cry until she gets used to it. This is normal. Do not
worry about it.
Most babies begin to enjoy their baths after a few months. It becomes a time
for play and exercise, tickles and giggles. It can be fun for all the family.
How Do I
Give My
Baby a Bath?
Babies do not need a bath every day, but you should keep their faces, hands,
bottoms, and the folds in their neck, groin, and legs clean. It is not safe and you
should NOT clean inside the baby’s ears and nose, or under a boy’s foreskin.
Making the Bath Safe
• Do not leave your baby alone in the bath or on the table. Do not turn your
back for even a second. Have all you need for the bath with you and ready
before you start. If you have to look away or reach for something, keep one
hand on the baby.
• Put water in first. Then put the baby in the water. Never add hot or warm
water after the baby is in the tub. Test the water in the tub with your wrist
or elbow. It should feel warm, not hot. If it feels fine to you it will be fine for
your baby.
• When you have put all the water in the bath, be sure that the water in the
tap is cold. This way, the baby won’t be burned if the tap is turned on by
accident.
• Hold the heavy parts of your baby— his head and hips — when you lift the
baby in or out of the bath. Use both hands and hold the baby close to your
body. Babies are slippery when wet!
Bath Time Tips
Before you begin your baby’s bath, be sure you have all the things you will
need. They are:
•
•
•
•
•
•
Basin or tub
Mild soap with no perfume (scent)
Towels
Washcloth
A soft hairbrush
Clean clothes and diaper
Choose a room that is warm, with no drafts. Spread out a large
towel to lay the baby on. Take off your rings, watch, or other
jewelry. Wash your hands and fill the basin with lukewarm water
— not hot. Test the water with your wrist or elbow.
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Healthy Pregnancy... Healthy Baby
When you give your baby a bath, start at the top and move toward the feet.
Use only clear water when you wash your baby’s face. Use a mild soap on the
rest of her body and be sure to rinse well. You need to be sure to rinse the folds
on the baby’s neck, groin, and legs.
After the bath, wrap your baby in a towel and dry gently. It is best not to use
baby powder.
Can I Prevent
Cradle Cap?
During the first few months, babies sometimes get cradle cap. This is
a yellow, dry crust on the scalp.
To prevent cradle cap:
• At bath time, rub your baby’s head using small circles. Dry the head by
rubbing with a towel.
• Brush baby’s hair and scalp every day.
• If you use soap or shampoo to wash your baby’s head, rinse well. Make
sure every bit is removed.
If your baby gets cradle cap:
• Do not try to pick it off.
• Rub mineral oil, baby oil or vegetable oil into your baby’s scalp.
• Leave for 15 or 20 minutes.
• Shampoo the scalp. Rinse well with clear water. Then gently brush or
comb the baby’s hair to remove the crusts.
How Do
I Take Care
of My Baby’s
Cord?
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During the first week, your baby’s cord will get smaller and darker. It will
dry up and fall off. All you need to do is keep the skin around it as clean and
dry as you can. Moving the cord or cleaning around it will not hurt the baby.
In the past, parents were told to gently clean the base of the cord two or three
times a day with a bit of cotton dipped in rubbing alcohol. The goal was to
keep the cord dry during the baby’s bath. This meant it was easier to give
sponge baths, rather than tub baths.
Healthy Family
Today there are more ideas about how to care for the cord. No one knows for
sure what is best. You will get information on how to take care of your baby’s
cord while you are in the hospital.
Giving your baby a bath in a tub and drying the skin around the cord is safe.
It will not stop the cord from dropping off.
Fold the top of the baby’s diaper down. The air around the cord will keep it
dry. Be sure to change the baby’s diapers often.
If you do use alcohol to clean the cord and your baby boy has been
circumcised, be careful to keep the alcohol away from his penis.
IMPORTANT
Call the doctor if:
• The skin around the cord becomes red or inflamed
• It smells bad
• It is leaking pus or fluid
A
baby’s bowel movements (BM) change colour and texture over time. They
are also different for babies who breastfeed and those who have formula.
The first BM is black, sticky, and does not smell very much. During the first
week, the BMs can be greenish black, greenish brown, brownish yellow,
greenish yellow, or yellow. You may also notice some mucus.
Bowel
Movements
(BMs)
It is normal for babies to grunt and get red in the face when they have a bowel
movement.
Not having a BM each day does not mean that your baby is constipated. Babies
are constipated when their BMs are hard and dry. If this happens, call your
health care provider. Breastfed babies are hardly ever constipated because
breast milk contains enough water to keep their BMs soft.
When a baby’s milk or food is changed, the bowel movements will change
as well.
IMPORTANT
Call your doctor if:
• BMs are watery and have a strong smell. This
could be “the runs” (or diarrhea). The runs can
make your baby very sick very quickly.
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Healthy Pregnancy... Healthy Baby
Can I Prevent
Diaper Rash?
Diaper rash is very common. It can be just a few red spots (a mild case). Or it
can be blisters and sores (a severe case). Diaper rash is caused by many things:
• Urine and bowel movements in diapers
• Rubbing against a wet diaper
• Allergic reaction to laundry soap, foods, disposable diapers, or diaper wipes
• A skin infection, but this is less common
To avoid diaper rash:
• Change diapers often. Use a clean cloth to wash and dry the baby’s bottom
each time.
• If you use cloth diapers, wash them well. Rinse the diapers twice and put
1/2 cup (125 mL) of vinegar in the rinse. Do not use bleach, i.e. Javex™ or
fabric softeners like Downey™.
• If you use cloth diapers, use “breathable” diaper covers.
If your baby gets diaper rash:
• Leave the baby’s diapers off as much as you can. Lay him on his tummy
on top of a few diapers or a soaker pad. Dress the baby in a shirt and cover
him with a sheet to keep him warm.
• Change diapers often. Be careful to use clean cloths to wash and dry the
baby’s bottom each time.
• Use rubber pants as little as possible.
• If you use disposable diapers, change to another brand or try cloth diapers.
• Rub a zinc-based ointment on the diaper rash. Ask your doctor, public
health nurse, or pharmacist to suggest a good brand.
Call the doctor if:
• The diaper area smells like yeast
• Diaper rash still won’t go away, after you have tried all these tips.
How Many
Wet Diapers
Can I Expect?
B
abies use between 6 and 10 diapers each day. If you change the wet diaper
right away, you can prevent diaper rash.
If your baby has less than 6 wet diapers a day, or if the pee (urine) is dark
yellow and has a strong smell, it likely means that your baby needs more fluids.
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Healthy Family
Most babies go for their first check-up when they are 2 to 6 weeks old.
When Do I
During a check-up, the doctor will weigh and measure the baby and check to
Take the Baby
see how your baby is developing.
for CheckImmunizations are also part of babies’ health care. It is important that your
baby is immunized on time and on schedule for the best protection. In New
Ups and Shots
Brunswick, your baby gets the shots (immunizations) listed below.
(Immunizations)?
Child’s Age
Name of Vaccine
The vaccine protects your child from:
Birth
Hepatitis B
Hepatitis B
2 months
DTaP-IPV-Hib,
Diphtheria, Tetanus, Pertussis, Polio, and Haemophilus
influenzae type b,
Hepatitis B,
Pneumococcal disease
Hepatitis B,
Pneumococcal conjugate
4 months
DTaP-IPV-Hib,
Pneumococcal conjugate
6 months
DTaP-IPV-Hib,
Hepatitis B
Diphtheria, Tetanus, Pertussis, Polio and Haemophilus
influenza type b,
Pneumococcal disease
Diphtheria, Tetanus, Pertussis, Polio and Haemophilus
influenza type b,
Hepatitis B
12 months
Measles, Mumps, Rubella, Varicella (Chickenpox),
MMRV,
Meningococcal conjugate C, Meningitis Type C,
Pneumococcal disease
Pneumococcal conjugate
18 months
DTaP-IPV-Hib,
MMRV
Diphtheria, Tetanus, Pertussis, Polio and Haemophilus
influenza type b,
Measles, Mumps, Rubella, Varicella (Chickenpox)
6 months to
18 years
Influenza (yearly)
Influenza
4 years
DTaP-IPV
Diphtheria, Tetanus, Pertussis, Polio
Grade 7
HPV (girls only)
Human Papillomavirus
Grade 9
Tdap,
Meningococcal conjugate
ACYW-135
Tetanus, Diphtheria and Pertussis
Meningitis
After they have all their baby shots, children need a booster shot at age 4, before they start school.
Talk with your doctor or public health nurse to learn more about check-ups and immunizations.
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Keeping Your Baby Safe
Making your baby’s world as safe as you can is part of being a parent.
To keep your baby safe, you need to watch him. Never leave an infant alone —
even for a second — except in a safe crib or playpen.
Childproofing
A
nother way to keep your baby safe is to childproof your home. New babies
will not crawl around on the floor or put things in their mouth. But it is wise
to prepare for when this happens. Start now. Make your home safe before your
baby learns to roll over, sit up, or crawl.
Check the floor, shelves, tables, and cupboards.
REMOVE:
• Small things that a baby can swallow or put into his ears and nose
• Sharp or rough things that can cut or scrape a baby
• Plants low enough to be pulled over or eaten
• Lamp cords long enough for a child to get tangled in or cords that a baby
can use to pull something down on himself
• Cords for blinds or drapes from baby’s reach by tying them up. Make sure
not to put your baby’s crib near a window with blinds that have cords or near
a window that does not have a window guard.
Start to buy:
• Safety gates for stairs
• Covers for electric plugs (Be sure they are not small enough for the baby to
swallow.)
• Locks for cupboards
• Hooks to keep drawers closed
WARNING:
208
Because of the risk of Sudden Infant Death Syndrome
(SIDS), you should not use a soft mattress, pillow, comforter,
stuffed toys, and bumper pads in the baby’s crib.
Healthy Family
A safe infant car seat is one of the first things you should buy for your baby.
See page 20 in Section 1 - Healthy Start, to learn more about this. The law
says that babies must always ride in an approved infant car seat. This
includes the trip home from the hospital. Your baby’s car seat should:
• Face backward
Safe Car
Seats
and Baby
Furniture
• Be fixed in place with the seat belt and have the harness fastened across the
baby’s chest
• Support your baby’s head and neck. You can use a rolled up blanket for
this.
The safest place for the baby’s car seat is in the centre of the back
seat. Never put an infant seat in front of an air bag.
Buying safe cribs and playpens is also important. See Section
1 - Healthy Start for details on safe car seats, cribs, and
playpens.
All the things you buy for your baby should be safe and
well made. This includes strollers, high chairs, clothing,
toys, and soothers.
Talk with your public health nurse, Consumer and
Corporate Affairs Canada, St. John Ambulance or the Red
Cross to learn more about child safety.
Parents need to protect their babies’ health. This is just as important as
keeping your baby safe from accidents. If people in your family have allergies,
you may want to make it less likely that something in your home will trigger an
allergic reaction in your baby. Ask your doctor or public health nurse for more
details on preventing allergies.
Preventing
Allergies
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Healthy Pregnancy... Healthy Baby
Buying for Baby
Clothing
T
he kinds of clothes, bedding, and diapers you choose for your baby will
depend on how much you have to spend and where you live.
You may buy your baby new things, or you may choose to have second-hand
things from a store that sells them, or from people you know. Check to be sure
that they are safe, well made, and easy to keep clean.
The clothes your baby needs depends on the time of year and the way you
will do laundry. If you have your own washer and dryer and can do laundry
each day, you will need fewer clothes than if you have to go out to do your
wash. Be sure to wash all clothing and cloth diapers before your baby wears
them. Try to avoid laundry powders and fabric softeners such as Bounce™ or
Downey™. They may cause a rash on your baby’s skin.
Buy baby clothes that are:
• Soft and comfortable. Cotton works well.
• Easy to wash using a washing machine and dryer. Avoid clothes that
need to be washed by hand.
• Easy to get on and off. Baby clothes should open up in the front and
have large armholes. Sleepers and nighties with snaps and zippers are
easier to handle than those with ribbons or ties.
• Loose clothing allows air to circulate. Your baby is less likely to get
a skin rash. When you buy sleepers, make sure that the part where the
feet go are big enough for baby’s toes.
Basic baby clothes include:
•
•
•
•
•
•
4 to 6 undershirts
6 sleepers or nightgowns
1 sweater
1 snowsuit (if your baby is born in winter)
1 hat
Socks or booties
Babies grow quickly. Do not buy too many clothes in very small sizes.
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Healthy Family
You can choose whether to use cloth or disposable diapers.
Disposable Diapers
Cloth Diapers
• Most expensive kind of diaper
• Come in many styles, such as
flat squares, fitted diapers with
Velcro closings, etc.
• Very easy to use
• Good to use if you do not have
a washer and dryer
• May cause diaper rash
• Some babies get a skin rash from
the plastic cover
• Buy only one package at first,
in case your baby cannot wear
them.
Diapers
• Many people use a diaper service
to wash the diapers. (Ask your
public health nurse if there is
one in your area)
• You will need to buy at least
24 diapers
• You will need diaper pins, unless
the diapers have Velcro closings
• You will need waterproof pants
to cover the diaper
• You will need a diaper pail to
soak the dirty diapers
You can find advice on buying a safe crib on page 21 in Section 1 - Healthy
Start. Once you have a safe crib, you will need bedding. Cotton fabrics are
comfortable for babies. Here’s what you should have:
Bedding
• 3 or 4 fitted crib sheets
• Waterproof mattress cover
• 2 baby blankets or quilts (for the crib)
• 4 to 6 receiving blankets (to wrap the baby in)
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Healthy Pregnancy... Healthy Baby
Toys
Babies are learning about the world and themselves. They need things to
look at, things to listen to, and things to feel. New babies do NOT need many
toys.
Babies can look at hanging mobiles, pictures, and toys. They can also look at
your face and your smile.
Babies like to listen to music and rattles. They can also listen to your voice, as
you sing and talk to them.
Babies can feel soft toys and pieces of cloth. They also like to feel the warmth
of your body as you hold them close. They like to learn about their own bodies
as you pat and stroke them.
People who love and look after them are the best “toys” a baby can have.
When you do buy toys, be sure that they are safe and correct for your baby’s
age and size. They should have no parts small enough to swallow, no pieces
that can come off, no strings long enough to choke or tangle, and no strong
smells.
Safe toys are:
•
•
•
•
Well-made
Sturdy
Washable
Smooth, with no sharp points or rough edges
Do a careful check of all new toys before you give them to your baby. Check
often for wear or damage. You can find out more about toy safety from
Consumer and Corporate Affairs Canada. Look for the phone number in the
Government of Canada section of the Blue Pages of your phone book.
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Healthy Family
Being a Healthy Mother
The first weeks after childbirth are a time of change. There are many new
things to adjust to.
The best things you can do for yourself are:
• Get as much rest as you can
• Eat healthy, good foods
• Accept the help that people offer
• Talk about your feelings with your partner and other people you care
about.
Taking good care of yourself is part of taking care of your baby.
Childbirth affects all parts of your life. It affects your:
Accepting
Motherhood
• Body. You will leave behind the stress of pregnancy and start to deal with
the physical demands of caring for your baby.
• Feelings. You may feel joy, excitement, fear, confusion, and love. Your
feelings are very strong and change very quickly.
• Social life. You see that your role in society has changed. There may be
tension between your new role as a mother and other roles, in the workplace
and in your family.
• Mind. You are leaving behind who you used to be and you are starting
a different stage of your life. It is a time of change, and it may not be easy.
All of these changes seem to come at once. They are all mixed together. You
may not know why you feel so swamped you just know that you do. And you
may be surprised that you feel this way!
All of these feelings happen at a time when you are so tired. Some people feel
tired deep in their bones. Everything seems worse when you are tired.
Talking with your partner about your feelings is important. If you feel tired,
lonely or angry, say so. You may find that he feels the same way. Talk about
what is bothering you. You need to know what the problem is before you can
start to solve it.
Talking with other new mothers can also help you. When they tell you about
their lives, you will hear that you are NOT the only one who feels this way.
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Your Body
After
Childbirth
(Postpartum)
Your life will get better. Your baby will begin to sleep at regular times.
You will learn to give him a bath, dress him and feed him. You and your
partner will be able to talk to each other without the baby crying or one of you
falling asleep. And one day your baby will smile just for you, and you will know
that being a mother is the best thing in the world.
The time after childbirth is called postpartum. It affects your body in many
ways.
During the first 6 weeks after childbirth, your body is going through
many changes:
• Your uterus is getting back to the size it was before you were pregnant.
• While you are breastfeeding, your body is getting used to making milk.
• You are losing the extra fluid your body made while you were pregnant.
• Your hormones are changing from the high levels of pregnancy to
a lower level.
• You are recovering from the physical effort of giving birth. If you had
a cesarean, you need to recover from the operation (surgery). If you had
a vaginal birth, your stitches may be healing (if you had stitches).
Don’t forget that you were pregnant for 9 months. It will take a while for your
body to feel “normal” again.
Most women have a postpartum checkup about 6 weeks after giving birth. Your
doctor will check to see if your uterus has gone back to its normal size and
shape and that any stitches have healed. You will also have your blood pressure
taken and may be asked to provide blood and urine (pee) for lab tests.
This checkup gives you a chance to ask questions or talk about problems with
your doctor. It is also a good time to talk about birth control.
Vaginal Discharge (Lochia)
After childbirth, discharge from your vagina continues for several weeks. It will
change from bright red to a pink or brown colour, and then it will be clear.
You should have sanitary napkins at home. Buy them before you go into the
hospital.
If the discharge changes from a small, brown discharge back to a bright red
flow, this may mean that you are being too active. Try to rest more often.
Talk to your doctor if your discharge becomes very heavy, has clots, or smells
bad.
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Getting Your Period Again
While you breastfeed your baby, you will not have regular periods for 4 to 12
months. If you are giving your baby formula, you will likely have your period
6 to 12 weeks after your baby is born. Your first period after delivery may be
heavy and last longer then normal.
When your period returns, it may not be regular for a while. This is normal.
You should be aware that you can get pregnant during this time. You should
use birth control. For more information on this, go to the section called Sex
and Birth Control on page 222.
It’s hard to believe that looking after a tiny baby can take so much time and
energy. Many new mothers spend their first few weeks feeling very tired.
Feeling tired
Here are ways to help you cope:
• Get as much rest as you can.
Nap when your baby naps. Unplug the phone. Put a note on your door:
“Mother and Baby sleeping. Do not disturb.”
Try to make night feedings easier. We provide advice on this on page
198 in the section called How Much Do Babies Sleep?
• Get organized.
Keep things simple. Think about all the things you have to do. Make
a list that says “must do” and “should do”. Focus on the “must do’s.”
Do not do things that can wait until tomorrow.
Do things when you have the energy, not when you think it’s “time.”
This may mean setting the table for supper at 10 am or making your
lunch right after breakfast.
Talk with your partner about ways to share the load.
Be aware that it may take longer than you thought it would to get
organized. It can take time to create new routines for yourself, your
baby, and the rest of the family.
• Get as much help as you can.
If people offer to help, accept.
If someone asks you if there’s a baby gift you’d really like, ask for a day
of house cleaning, diaper service for a week, a prepared dinner, or an
evening of babysitting.
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• Be realistic.
Know that it is okay if you can’t do things as quickly as before you had
a baby. You may find that it takes twice as long to do housework or
laundry.
Try not to measure the work you are doing at home against what
you may have done at work before you had your baby. They are very
different and really cannot be compared.
• Build a support network.
Look for other new mothers to talk to, exchange childcare, or help out.
Check to see if your neighbourhood has a parent drop-in centre. Some
church and community groups offer mother-baby groups or exercise
programs.
• Take care of yourself.
This is not selfish. It is necessary.
Try to arrange for time to be alone, to go for a walk, or relax in the
bathtub.
• Stay active.
Do postpartum exercises. You may feel so tired that this idea makes you
laugh. But exercise will increase your energy.
• Eat healthy food.
Continue to make the healthy food choices you made when you were
pregnant.
• Do something for yourself every day.
Wash your hair, watch a TV show, read, talk to a friend.
• Give yourself credit for doing a good job.
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For most women, having a new baby is a happy time. But this is not always
true. New mothers may feel both happy and sad.
About 80 per cent of all women, on the second or third day after the baby
is born, may notice they:
•
•
•
•
•
•
•
Feel disappointed
Feel sad and tearful
Feel irritable
Feel overwhelmed, and worried
Feel very tired, and cannot sleep well
Have mood swings
Cannot focus
The Baby
Blues and
Postpartum
Depression
This usually goes away within 1 to 2 weeks, but for 1 out of 10 women,
something called postpartum depression begins.
Postpartum depression (PPD)may begin a few weeks after birth or at any
time during your baby’s first two years. It typically begins between 6 weeks and
6 months postpartum. It is extremely common; affecting, approximately 15%
of new moms. Some issues can contribute to having a history of depression,
for example, increased stress, lack of social support and having a history of
depression. A woman who has this kind of depression feels sad, anxious and
worried. She feels this more strongly than other women, and her feelings can
affect how she cares for her baby and herself. PPD can prevent mothers from
interacting with their babies in a way that can lead to long term developmental
delays in their children
What is
Postpartum
Depression?
A woman with postpartum depression may feel:
• Very sad
• Overwhelmed
• Weepy and cry a lot
• Lonely and helpless
• Guilty
• Worthless
• Angry
• Confused
• Exhausted
• “Not herself”
• Worried
• Very sensitive
• Tense
• She may not be a
very good mother
• Irritable
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She may also feel that she:
• Eats too much or not enough
• Cannot focus
• Has low self-esteem
• Has panic attacks
• Has daydreams that make her feel afraid
• Has thoughts of hurting her baby or herself
• Is not interested in things that used to bring her pleasure
• Is not confident
If you have any or many of these signs, be aware that this illness can
be treated, and you are not alone.
• Know that your feelings may have many emotional and physical causes.
• You may need professional help.
• Talk with someone who will listen.
• Accept help from others, and ask for help when you need it.
• Try to find some time for yourself.
• Do not think you have to be the perfect mother and have the perfect
baby.
A website that can give more advice and help for women who may have PPD is:
A New Life: http://anewprenatallife.ca/
Look under Healthy Family
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When to Go For Help!
See your doctor right away or go to the hospital emergency room
if you have:
• Daydreams that make you feel afraid, or
• Thoughts of hurting your baby or yourself
If other feelings of depression last longer than 2 or 3 weeks contact:
• Your family doctor/obstetrician
• Local emergency room
• Public Health Services
• Chimo Provincial Crisis Line (506) 450-4357
• Local Mental Health Clinic, private counselor, psychologist, or
psychiatrist
• Tele-Care 811
Tips for Good Postnatal Health
After your baby is born, here are some ways to help yourself:
• Get as much sleep as you can.
• Eat many small meals instead of three large ones
• Accept that you need help: go to your friends, neighbours, and family.
• Do not let motherhood take over your entire life. Being a little bit selfish
can be a good thing.
• Find time for yourself without guilt. Learn to relax into motherhood.
For example, take a nice long bath.
• Read all you can on the subject.
• Express your feelings. Write them down. Tell people how you feel.
• Find someone who wants to listen. It’s good to find someone who is
going through the same thing. Just talking about it may help.
• Join a group of new parents in your community. Share your problems
with someone who will not judge you.
• Do not isolate yourself.
• Make a real effort to talk with your partner. Hold on to the love and
friendship that you have.
• Solve the problems you can and accept the others.
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Getting fit
again
It’s normal for you to want to look like you did before you were pregnant. But
give yourself some time. You were pregnant for 9 months. Your body will not
return to “normal” right away.
Eating healthy food and being active will help you to feel fit. See Section 5 Healthy Eating and Section 6 - Healthy Activity, to learn more. See page 182
in Section 7 - Healthy Birthing, for postpartum exercises you can begin in the
hospital.
In some places, the YM/YWCA and other organizations offer postpartum
exercise programs. They are a good place to get fit, and a good place to meet
other mothers and babies.
Good health matters as much now as it did when you were pregnant. Eat
healthy food, rest, stay active, and avoid drugs and smoking. Taking care of
yourself is one of the best ways to take care of your baby.
Going Back
to Work/
School
Many new mothers have 6 to 12 months maternity leave. Others go back
to work or school much sooner, and you may be thinking about it. You do not
want to decide on this too quickly.
When making your plans for going back to work, you will need to
think about:
• Child care
• How your workplace supports parents when their children are sick
• Maternity/paternity benefits
• Maternity rights
• Whether or not you are ready to return to work or school
There is no “best” time to return to work or school.
Every mother, baby, and family are different. Each will need to decide how to
balance work, study, and being a parent.
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If you plan to return to work or school, you will need to find good child care.
This may not be easy, so it’s wise to allow plenty of time to search. Talk to
friends and neighbours about the childcare they use.
You can also contact groups like the YM/YWCA, churches, and early
childhood development associations.
You can find out more about childcare centres, choices, and services from the
Department of Social Development.
Whether you planned to be a single parent or not, you should be aware that
you are not alone.
Being a new parent, finding a balance between work and home, dealing with
money, and finding time for yourself are problems for all mothers. They can be
even harder when you are alone.
Single
Parents
All the advice for new mothers applies even more to you. Single mothers must
take care of themselves, find a good support network, and try not to do too
much.
We suggest that you find community services that can help you and your baby.
Talk to your public health nurse, the Department of Social Development, or
the Family Resource Centre.
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Sex and Birth Control
Your sex life is another part of your life that will change as you adjust to being
parents. Learning to share and care about each other in a new way can deepen
your relationship, and allow you to find each other again.
Being a
Couple
A
new baby turns a woman into a mother, a man into a father, and a couple
into a family. But the “couple” is still there.
Some couples have trouble working out a new relationship that feels good
to both of them. You are not alone. As it was during pregnancy, good
communication is the key. Talk about how you feel. Be as open with each other
as you can. A sense of humour helps, too.
Most new mothers are ready to have intercourse when their stitches have
healed and the discharge from their vagina is clear. Couples often try new
positions to help them cope. Many new mothers are so tired that they lose
interest in sex. Many new fathers feel the same way. If mothers are going
through postpartum blues, this will also reduce their interest in sex.
We all need to be touched and held. Many new mothers find that caring
for the baby meets their need to be touched. They find that they have little
left for their partner. This can upset a man who is used to a close and warm
relationship.
Why do babies seem to wake up just when you start to make love? This makes
some people think they should forget about sex. Remember that your baby will
soon be sleeping all night, or at least long enough for you to enjoy yourselves.
All of these feelings will pass. Talk to each other. Say “I love you” often.
Try to keep romance alive by spending time alone with each other. Going
for a walk, driving in the car, or going out for coffee can help remind you
that you are friends and lovers as well as parents.
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Right after childbirth, birth control may be far from your thoughts. Most
new parents feel that they have plenty of time before they need to start
thinking about birth control again.
But the time will come, sooner than you think, when you will want to have sex
again. It’s a good idea to be ready.
Thinking
about Birth
Control
Women need to know that after childbirth you can produce eggs (ovulate), and
get pregnant, even though you have not had your period. About half of all new
mothers produce an egg before they have a period.
It takes your body 1 to 3 years to recover completely from pregnancy. That’s
why it is a good idea to delay pregnancy at least 2 years after childbirth.
The time to think about birth control is now — before you need it. If you wait
for your 6-week-postpartum checkup, it may be too late.
Condoms are the safest method of birth control for the first few weeks after
childbirth. After your 6-week checkup, you may want to use a different
method. On the next pages we provide details about birth control methods to
help you choose one that will work for you and your partner.
Choosing a method of birth control may take some thought. Talk about it
with your partner and ask your nurse, nurse practitioner or doctor for more
information.
Birth Control
Methods
When you are trying to decide, ask yourselves:
• How well does the method work? Do I feel confident using it?
• Is this easy enough that I will use it every time?
• Will I enjoy sex less if I use this method? Could using it become part of
lovemaking?
• Do I have enough privacy to use this method? Do I need to use the
bathroom to insert something? Is my bedroom close enough?
• Do I have all the facts and skills to use this method properly?
• Can I afford this method? Do I need to pay for something once, or will
I need to keep spending money?
There are many things to think about and discuss. The information about
some of the birth control methods on the next pages might help you choose
a birth control method. Do not forget that if you try one method and you are
not happy with it, you can always try another. For more information on sexual
health, contraception or sexually transmitted infections, you may consult the
following website: www.sexualityandu.ca.
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What is it?
LAM stands for Lactational Amenorrhea Method. It means that you use
breastfeeding as a method of birth control. Lactational means breastfeeding.
Amenorrhea means having no monthly period.
LAM makes use of the normal things that happen in a woman’s body after
childbirth and when she breastfeeds. The baby’s sucking prevents her body
from releasing an egg (ovulation). If a woman does not release an egg, she
cannot become pregnant.
How well does it work?
This method works well if used correctly. It will work ONLY if all these
factors apply to you:
• Your baby is under 6 months old.
• Your monthly periods have not returned.
• Your baby is ONLY breastfed and is not receiving any other foods or
liquids.
• Your baby breastfeeds on demand during the day and every night (mimimum
of 6 feedings every 24 hours).
LAM does not protect you from sexually transmitted infections (STIs). You
and your partner should use a condom. Talk to your nurse, nurse practitioner
or doctor for more information about this method of birth control.
Are there any side effects?
There are no side effects to this method of birth control. But if your period
returns, no matter how old your baby is, start using another method of birth
control right away.
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What is it?
The male condom is a thin cover made of latex rubber or other thin plastic.
The man puts it on his penis before intercourse. It prevents pregnancy by
stopping the man’s sperm from reaching the woman’s egg.
Condom:
Male
How well does it work?
If used correctly, and each time you have sex, condoms work quite well.
Condoms work even better when they contain a spermicide (a chemical that
kills sperm) or if the woman also uses foam. For more information talk to you
health care provider.
Condoms are the only form of birth control that can protect you from sexually
transmitted infections (STIs).
How is it used?
The male condom is unrolled onto the erect penis before it enters the vagina.
When using a condom, you need to be very careful that it does not slip off
while you are having sex. After the man ejaculates, remove the condom while
the penis is still erect. One of you will need to hold it at the base to prevent
leaking. Do not use a condom more than once. If you use a lubricant with a
condom, be sure that it is water-based. Do not use Vaseline™ with a condom.
Are there any side effects?
Male condoms have no side effects. A few men and women have problems
with the latex. They can choose to buy non-latex condoms. Condoms are an
excellent form of birth control for the time right after your baby is born.
Will it affect our sex life?
Some couples do not like using a condom because they have to put it on when
they are in the middle of making love. Some men feel that it dulls the feelings
they have in their penis. A drop of lubricant inside the condom can help the
man feel more pleasure when he is using a condom.
How can I get it?
You can buy male condoms at any drug store. Check the “best before” date on
the package, and do not buy them if they are expired. Also, do not buy a large
box if you may not use them before they expire.
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Condom:
Female
What is it?
A female condom is a lubricated pouch made of a thin plastic. It has a thin,
flexible ring at each end.
How is it used?
Like a male condom, the female condom prevents pregnancy by stopping
sperm from reaching the egg.
The closed end of the condom is put into the vagina and held in place by the
inside ring. The open outside ring rests on the outside of the vagina.
How well does it work?
Female condoms can work well if used correctly. For more information talk to
your health care provider.
You must use a NEW condom each time you have sex.
Both the male and female condoms are the only forms of birth control that can
protect you from sexually transmitted infections.
Are there any side effects?
If you are allergic to latex, you can use the female condom because it is made of
a thin plastic called polyurethane.
Will it affect our sex life?
Using the female condom takes practice. You might need to help your partner
put his penis into the condom.
You might need to put extra lubricant inside the condom or on the man’s penis.
This will make it more comfortable for both partners.
How can I get it?
Female condoms are sold in drugstores. You do not need to have a
prescription.
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What is it?
Depo-Provera
Depo-Provera is an injection or “shot” of the hormone progesterone. It is
given once every 12 weeks to prevent pregnancy. It stops your body from
making an egg each month.
You can use Depo-Provera when you are breastfeeding. It is best to wait until
you have a good milk supply and you are settled into breastfeeding before you
start Depo-Provera.
How well does it work?
Depo-Provera works well when used correctly. For more information talk to
your health care provider.
Depo-Provera does not protect you from sexually transmitted infections.
You and your partner should use a condom.
How is it used?
Depo-Provera works right away if you get it within 5 days after your
period starts. It provides complete birth control for 12 weeks. You must
get a Depo-Provera shot every 10–13 weeks to stay protected. Follow the
recommendations provided by your doctor or nurse practitioner. It can be
given 5 days after childbirth, or 5 days after an abortion or miscarriage.
Are there any side effects?
For the first few months, the side effects are irregular periods, spotting, extra
bleeding, or missed periods. It is normal for some women to have no bleeding
at all after 6 to 12 months. Some women have sore breasts, get depressed or
gain weight because they want to eat more (increased appetite). Once DepoProvera is injected, any side effects will last until the shot wears off.
After you stop taking Depo-Provera, your body may not produce eggs again
for 6 months to 2 years. You need to be aware that it could take that long to get
pregnant again. You will also need to use other birth control if you do not want
to get pregnant.
You should NOT use Depo-Provera if:
• You are pregnant or think you might be
• You have abnormal bleeding from your vagina
• You have a family history of breast cancer
Using Depo-Provera for a long time can reduce calcium in your bones.
Ask your doctor about calcium pills and foods that have lots of calcium.
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Will it affect our sex life?
Depo-Provera works well to prevent pregnancy, so some women find they
enjoy sex more because they do not have to worry about this.
How can I get it?
You need to get a prescription from your family doctor or the doctor at a
Sexual Health Centre. Take the prescription to a drug store. Each shot costs
about $40 and $45. If you have a Social Development Health Card, it covers
the cost of Depo-Provera. A public health nurse at the Sexual Health Centre or
your doctor will give you the Depo Provera shot.
What is it?
A diaphragm is a round piece of thin latex rubber surrounded by a firm rim.
A cervical cap is a small latex rubber dome with a firm rim. Both must be used
with jelly that kills sperm (spermicide). Both are put into the vagina before you
have intercourse. They cover the cervix (the end of the uterus that juts out into
the vagina).
Diaphragm
or Cervical
Cap
CONTRACEPTIVE JELLY
The muscles of your vagina hold the diaphragm in place. The cervical
cap stays in place on your cervix by suction. A diaphragm or cervical cap
AND spermicide work well together to stop the sperm from meeting the egg.
The spermicide kills the sperm and the diaphragm or cap stop the sperm
from getting into the uterus.
How well does it work?
A diaphragm or cervical cap must be fitted to your body. You must use it
every time you have intercourse.
The diaphragm or cervical cap works well when it is used correctly and
when it is used every time you have intercourse.
A diaphragm or cervical cap will not protect you from sexually transmitted
infections. You and your partner should use a condom.
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How is it used?
A diaphragm or cervical cap must be fitted by a doctor or nurse. They can also
show you how to put it in and take it out. To be sure that your diaphragm or
cervical cap fits correctly, your doctor should check it at least once every two
years, if you gain or lose 5 kg (11 pounds), and after each pregnancy.
The diaphragm or cervical cap must be used with a jelly or cream that kills
sperm (spermicide). It must be put into your vagina before every act of
intercourse. It must be left in place for 6 to 8 hours after having sex. If you have
intercourse more than once, you need to put more cream or jelly (spermicide)
into your vagina.
A diaphragm or cervical cap must be cleaned with soap and water after each
use. You should hold it up to the light to see if there are any holes or if it has
torn. You should not use Vaseline™, as it may damage the rubber.
Are there any side effects?
If they are used correctly, diaphragms and cervical caps have no side effects.
They can be uncomfortable if they are not put in place correctly.
Some people are allergic to latex, or to the spermicidal jelly or cream.
Some women may have bladder infections when they use a diaphragm or
cervical cap.
Will they affect our sex life?
When they are in the right place, a diaphragm or cervical cap cannot be felt by
either partner.
How can I get one?
You must go to your doctor who will tell you what size you need. The doctor
will give you a prescription that you must take to a drug store.
Have a pap test done as recommended by your doctor or nurse practitioner.
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Spermicides
What is it?
Spermicides (foams, creams, films, suppositories, gel, and tablets) contain
chemicals that:
SPERMICIDE
FOAM
• kill sperm before they reach the egg, or
• create a barrier to block sperm from moving through the cervix.
How well does it work?
Used on their own, spermicides do not work as well as some other kinds of
birth control. Spermicide works much better if it is used with a barrier method
of birth control, like a condom.
Spermicides will not protect you from sexually transmitted infections. You and
your partner should use a condom.
How do I use it?
You can buy spermicides at the drug store. Follow the directions and pictures
inside the package or on the box. The directions are different for different
products. Read and follow the directions each time you have intercourse.
Spermicides must be left in place at least 6–8 hours after you have intercourse.
Do not douche, or have a bath for at least 6–8 hours afterwards. You may wash
the outside of your pubic area if you wish.
Does it have any side effects?
There are no serious side effects, but some people are sensitive or allergic
to the products. Spermicides can cause itching, smelling or burning. If this
happens, stop using it so you do not get an infection.
Will it affect our sex life?
Some spermicides add moisture to your vagina. Some people find this messy.
Others find the extra moisture is good during intercourse.
Where can I get it?
You can buy spermicides in any drug store. You do not need a prescription.
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What is it?
Natural family planning methods are based on what we know about woman’s
natural cycles. These methods depend on not having sex on the days when you
could become pregnant.
Natural
Family
Planning
If you would like to learn more about natural family planning, talk with your
nurse, nurse practitioner or doctor. There are several natural family planning
methods to choose from. It is very important that you use the method properly.
It is best to learn about them from people who are trained to teach them.
Natural family planning methods will not protect you from sexually
transmitted infections. You and your partner should use a condom.
What is it?
An IUD is a small piece of plastic that a doctor puts into your uterus. It works
by stopping the fertilized egg from implanting inside the uterus.
IUD
How well does it work?
The IUD does not work as well as the pill, but is still very good. For more
information talk to your health care provider.
An IUD will not protect you from sexually transmitted infections. You and
your partner should use a condom.
How do I use it?
The IUD must be put in your uterus by a doctor while you are having your
period. You may feel some discomfort when this is being done, and some
cramping afterward. Most IUDs can be left in place for 5 to 7 years. You will
need to visit your doctor for a checkup at least once a year.
You also need to check that the IUD is still in place by feeling for the thread in
your vagina. You should do this at least once a month. Most women do it right
after their period ends.
Are there any side effects?
Most women do not have problems. However, you may have some spotting or
feel a bit of pain for a few months after you get the IUD. Some women have
more cramps and heavier periods.
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Contact you doctor or nurse practionner if you have
• Severe cramps
• Severe bleeding
• Vaginal discharge or smells that are not normal
Will it affect our sex life?
If the IUD is in the right place, neither you nor your partner should notice it at
all.
How do I get it?
You will need to go to your doctor’s office or a family planning clinic. After
childbirth, your doctor can insert an IUD when you go for your 6-week
checkup, as long as your uterus is healing and there is no sign of infection.
The Pill
What is it?
All birth control pills contain hormones that are like the ones your body
produces during pregnancy. These work to prevent the ovary from releasing an
egg.
How well does it work?
If you follow the directions, the pill works very well. For more information talk
to your health care provider.
The pill will not protect you from sexually transmitted infections. You and
your partner should use a condom.
How do I use it?
• Begin taking the pill on the first day of your period.
• If you don’t start the pill with your period, use condoms for that month.
• Take the pill at the same time each day. Many women find it easy to take the
pill at night before they go to bed.
• If you miss a pill, or if you think you missed a pill, continue taking one every
day AND use a condom for the rest of the month.
• If you have bleeding while taking the pill, call your doctor but do not stop
taking the pill.
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• The pill does not work as well if you have diarrhea or vomiting.
• Use a back-up form of birth control if you are taking antibiotics. If you are
taking other medicines, ask your pharmacist if they will stop the pill from
working.
Are there any side effects?
With the kinds of pills used today, most women do not have side effects.
The most common are feeling like you might throw up (nausea), cramps, sore
breasts, headaches and feeling moody.
Your health care provider could suggest you stop smoking before giving you a
prescription for the pill.
Contact your doctor if you have any of these side effects:
• Headaches
• Blurred vision
• Leg cramps
• Bleeding from your vagina in the middle of the month (when you are not
having your period).
Do not stop taking the pill “to give your body a rest” unless you want to
become pregnant.
Will it affect our sex life?
Some women say that they enjoy sex more while they take the pill because they
are not worried about getting pregnant.
How do I get it?
You need to visit your doctor or nurse practitioner to get a prescription.
If you do not have money to pay for it, talk to your doctor or nurse practitioner
about the Compassionate Pill Program.
Breastfeeding and the pill
With today’s low-dose birth control pills, you can take the pill while you are
breastfeeding. It is best to wait until you have a good milk supply and you are
settled into breastfeeding before you start the pill. There is still some concern
about this, and you will need to talk to your doctor if this is what you want
to do. Some birth control pills are better than others for the breastfeeding
mother.
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Sponge
What is it?
This is a soft piece of foam that contains spermicide (chemicals to kill sperm).
It can only be used once (disposable). The sponge is put into the vagina. It
covers the opening to the uterus, killing the sperm and stopping them before
they can enter.
The sponge will not protect you from sexually transmitted infections. You and
your partner should use a condom.
How well does it work?
Out of 100 women using the sponge, between 10 and 40 will become pregnant.
The sponge works much better if you use a condom at the same time.
How do I use it?
The sponge is put deep into the vagina to cover the cervix. The spermicide
in the sponge is released for up to 12 hours while the sponge is in place. The
sponge must be left in for at least 6 hours after intercourse. It should not be left
in for more than 12 hours. Each sponge can be used only once. You cannot use
the sponge during your period.
You need to take the sponge out by yourself. To do this, you put a finger into
one of the slots and pull gently while bearing down. Or you can use your index
and middle fingers like tweezers to gently squeeze the sponge. Then you pull it
out gently while bearing down.
Are there any side effects?
Sometimes a man or woman is allergic to the spermicide or to the sponge itself.
After childbirth, you must talk to a doctor or nurse practitioner before using
the sponge.
If you are breastfeeding, talk with a health care provider before using the
sponge.
Do not use the sponge if you have ever had toxic shock syndrome. Do not take
a bath in a bathtub while the sponge is in place.
Will it affect our sex life?
If the sponge is in the correct place, neither partner feels it.
How can I get it?
You can buy it at the drug store.
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What is it?
Tubal ligation is an operation to cut and tie the tubes that carry the egg from
the ovary to the uterus. These tubes are called the Fallopian Tubes. When the
tubes are cut, the egg and the sperm cannot join.
Tubal ligation is a permanent form of birth control.
Tubal
Ligation
(Female
Sterilization)
How well does it work?
Tubal ligation works better than any other form of birth control.
Tubal ligation will not protect you from sexually transmitted infections. You
and your partner should use a condom.
How is it done?
The surgeon makes a small cut in the lower abdomen, removes a piece from
each tube, and ties off the ends. The operation is done when you are asleep
(general anesthetic) or when your lower body is frozen (local anesthetic).
Are there any side effects?
There are no side effects, but all surgery carries some risk.
Will it affect our sex life?
Some women find that not having to worry about pregnancy makes them more
interested in sex.
How can I get it?
You will need to talk to your doctor.
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Vasectomy
(Male
Sterilization)
What is it?
A vasectomy is an operation that cuts and ties the tubes that carry the sperm
from the testicles to the penis.
When he has sex, the man still feels orgasm and still ejaculates, but the fluid
contains no sperm.
How well does it work?
A vasectomy does not work right away. There may still be some sperm in the
tubes, and the fluid that comes from his penis must be tested several times after
the surgery to be sure it contains no sperm.
When the fluid is free of sperm, a vasectomy is almost 100% effective.
Like tubal ligation, vasectomy is a permanent method of birth control.
A vasectomy will not protect you from sexually transmitted infections. You and
your partner should use a condom.
How is it done?
A vasectomy is a minor operation. It is done with freezing (an anesthetic) in the
man’s scrotum. Sometimes it is done in a doctor’s office. Sometimes it is done
in a hospital. Men do not need to stay in the hospital after the operation. Most
men take a few days to rest at home.
Are there any side effects?
There are no side effects but all surgery carries some risk.
Will it affect our sex life?
Vasectomy does not affect the way a man performs or how he enjoys sex.
How can we get it?
You will need to talk to your doctor.
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What is it?
Withdrawal
Withdrawal is when the man removes his penis from the woman’s vagina
before he comes (ejaculates). To work, no fluid must enter the vagina.
How effective is it?
It does not work very well, for two reasons:
• The man must have a lot of self-control. He must withdraw when he is
having the most pleasure.
• There may be sperm in the fluid that comes from his penis BEFORE he
ejaculates. This fluid can enter the woman’s vagina as soon as the penis is
near her vagina AND before the penis enters the vagina. This fluid may also
contain sexually transmitted infections (STI’s).
Withdrawal will not protect you from sexually transmitted infections.
Even if you use birth control, accidents can happen. People make mistakes.
If you had sex without using birth control or if your birth control fails, you
can still prevent pregnancy by taking ECPs — Emergency Contraceptive Pills.
They are also known as “Morning After Pills”.
You need to take ECPs within 3 days (72 hours) of having sex without birth
control. The sooner you take them, the better they work.
If more than 72 hours have passed, a doctor can insert an emergency IUD.
If this is done 5 to 7 days after sex, you may not get pregnant.
When
Accidents
Happen
(Emergency
Contraceptive
Pills)
ECPs do not protect you from sexually transmitted infections.
You can get ECPs from Sexual Health Centre, doctor’s offices, emergency
rooms or pharmacies. ECP is available without a prescription from pharmacies
in New Brunswick.
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Family and Friends
A new baby creates new lives for many people. All of you will be learning to
look at yourselves and each other in new ways. It takes time, patience, and love
for a new family to settle into a new life.
Fathers
Many new fathers feel forgotten. When the woman was pregnant, everyone
asked about her. Now everyone wants to know about the baby. Where does the
partner fit in? New fathers may also feel that no one appreciates them. You feel
tired, too. You have new things to worry about and new duties. You may be
asked to do things that your own father did not do, like changing diapers, doing
laundry, and getting up at night. As well, you have to go to work every day and
earn a living!
You are not alone. Most new fathers feel confused for a while.
It is not easy, but it’s normal.
Here are some things that might help you:
• Take care of your health.
You need strength and energy to take care of your partner and your
baby. Eat well. Be active and stay fit.
• Help and support your partner.
This may be a hard time for both of you. Remember that she has had the
physical stress of pregnancy and childbirth. It takes time to recover. She
needs your love and support. A new baby almost doubles the amount of
housework to be done. You will need to do your share of the housework
and take time to care for the baby.
• Talk about your feelings.
It’s easy to hide from your feelings, especially when they are not happy
ones. If you feel tired, lonely, worried, or left out, tell your partner.
Do not be surprised if she says that she feels the same way. Talk about it.
Listen to her. Say what you feel. When both of you have your feelings in
the open, you can begin to solve problems together. This is not always
easy, but it is worth the effort.
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• Be an active father.
The more you offer, the more you get. Do your share of the daily work
of looking after the baby. Try to spend time alone with your baby.
Go for walks together. Give her a bath. Let her know who Daddy is.
• Accept that no one is perfect.
You will make many mistakes. So will your partner. Don’t worry. This is
how people learn to be parents.
• Face the fact that life will be different from now on.
This doesn’t mean that it will be worse. Right now, it’s easy to focus on
how hard it is to have a new baby. But it is not all bad. Your new life as
a father will bring joy, pride and a deep sense of purpose. So relax and
grow into your new life. Life will be different. But so will you.
H
aving a new baby is very exciting for most children. But it can also cause
mixed feelings. The new baby is the new focus in the family. Many older
children feel a bit jealous and left out.
Brothers
and Sisters
Here are ways to help your older children adjust to a new baby:
• Help them learn about babies before the baby comes.
Take them to visit friends with small babies. This can help children
learn that a new baby will not be able to play with them for a while.
Show them books with pictures and stories about babies.
Talk about all the things they can do that babies cannot do. Your “big”
children can walk and talk and sing and play. Help them to feel pleased
and proud of themselves.
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• Make changes and plans ahead of time.
If you plan to move an older child to a new room, or to buy a new bed
and give the crib to the baby, do it a few weeks or months before the
baby comes. Then your children will not link these changes with the
new baby. They will not feel that the baby is taking things away from
them.
No child likes it when Mommy goes away. Let your children know what
will happen and who will take care of them while you are away having
the baby. Leave a list of meals, nap times, bedtimes, likes and dislikes
for the person who will be looking after your children. Try to keep
their lives as normal as you can while you are away. If it is allowed, have
your children visit you and the baby in hospital. Do not be upset if your
children are not very happy with you when you come home. It may take
time for them to accept that you left them.
• Give children time to get used to the new baby.
This is a big change! Be patient. Older children often try to get attention
by acting like a baby. Do not punish them for this. Let them know that
you love them just the way they are.
Bring a present from the baby home from the hospital with you.
Try not to make too big a fuss over the baby. Don’t use the baby as a
reason for not doing something for the other children. Try not to say
“Be quiet, you’ll wake the baby” or “Be careful of the baby” too often.
Let your children help with the baby if they want to. But don’t force
it. And don’t put your children in a situation where they could hurt the
baby, even by accident.
Each parent should try to spend time alone with older children. They
need to know that they are still special and loved.
Many parents don’t feel instant love for a new baby. Neither will
brothers and sisters. Bonding with a new baby takes time. Children who
feel loved will find it easier to love their new sister or brother.
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Just as you are learning to be parents, your own parents are learning to be
grandparents.
Grandparents
They will be finding out what style of grandparenting feels right to them.
• Some grandparents are thrilled! They want to help and are looking forward
to babysitting and spending time with their grandchild.
• Some may find that a grandchild means they are getting old. They may not
like this idea very much.
• Others may be happy about the birth, but are not able to spend much time
with you or your baby.
No matter what kind of grandparents your parents are, it helps to respect how
they want to be involved with the baby.
Some new parents love to have help and advice from grandparents. Others find
being around them is stressful. Don’t forget that this is your baby. You have
the right to parent in your own way. This may not be the way your parents
raised you, and it may be hard for them to accept this.
Once again, talking about your feelings may help. Being silent and feeling bad
is not the best way to get along with each other.
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Healthy Pregnancy... Healthy Baby
Looking Ahead
This book has covered 9 months of pregnancy and the first 6 weeks of your
baby’s life. We hope that it has been helpful and that you feel on your way to
a happy and healthy family life.
Being a parent lasts longer than 6 weeks. There is a lot to look forward to:
baby’s first smile, first tooth, first step, and first word.
You will want to know more about what to expect, and about your baby’s
health, and growth as you move into the toddler and preschool years.
Find out if your community has:
• playgroups,
• parent resource centres,
• mother/baby exercise programs,
• parent/baby drop-in groups, and
• other places where you can meet other parents.
These kinds of programs also give your baby a chance to
learn and play.
Talk to your public health nurse about what your local
Public Health Office has to offer. Look for childcare books
in the library and in bookstores.
As a parent you will grow, change,
and learn along with your children.
You have a lot to teach them and
they have a lot to teach you. Enjoy
each other, love each other, and
grow together in good health.
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