An adequate diet is perhaps more important during pregnancy than at any other time in a woman's life. Because an expectant mother actually shares everything she consumes with her unborn baby, she must eat enough healthful foods to supply both herself and her child with the nutrients each needs. For this reason, most women are advised to eat an additional 200 to 300 calories a day during pregnancy and to gain at least 25 pounds. Usually, an expectant mother gains little or no weight during the early weeks of pregnancy. By the end of the third month, however, she is likely to gain at a steady rate of about one pound a week until term.
According to the Recommended Dietary Allowances established by the National Academy of Sciences, pregnant women require considerably more protein than non-pregnant women. Women who normally consume about 45 grams of protein a day are advised to increase their daily intake by 30 grams during pregnancy--the amount of protein in four cups of milk (whole or skimmed) or yogurt or four ounces of natural cheese, canned tuna or chicken. A 25-to 50-percent increase in most vitamins and minerals is also recommended. To meet these nutritional requirements, pregnant women should eat a varied diet, including the daily consumption of foods from each of four basic food groups--high-protein foods, such as meat, poultry, fish and legumes; dairy products, such as milk, cheese and yogurt; grain products, such as breads, cereals and rice; and fruits and vegetables.
Because a woman's blood volume doubles during pregnancy, extra iron is essential to produce healthy red blood cells. Since sufficient quantities of iron to meet this need are not obtained in an average diet, doctors usually prescribe iron supplements during pregnancy in doses of 30 to 60 milligrams a day. Without supplementation, the woman risks becoming anemic, which increases susceptibility to infection and illness. In fact, most doctors advise expectant mothers to take multi-vitamin and mineral supplements during pregnancy to ensure an adequate supply of nutrients. The supplements generally include folic acid, and, in the last trimester, calcium. In some women, special vitamin and mineral supplementation may be necessary. Vegetarians, for example, may require supplementary zinc, chromium and vitamin B12.
Like drugs, vitamin and mineral supplements should not be taken without consulting a doctor. Similarly, pregnant women should not limit their consumption of specific foods, such as salt or fluids, unless so directed by their doctors.
Substances to Avoid
All drugs consumed by an expectant mother are carried to the fetus to some degree. Because many of them are known to be potentially harmful to an unborn child, and others may be risky, self-medicating should be completely avoided. This means that any drug, prescription or non-prescription, should be taken only under a doctor's supervision as soon as pregnancy seems likely; the chances of a drug's damaging a fetus are greatest in the first 10 weeks.
Among the currently available prescription drugs that have been found to be potentially harmful to the fetus are the steroidal hormones, estrogen and progestin (which were once used to prevent miscarriages), and barbiturates, amphetamines and tranquilizers. Non-prescription drugs that may cause problems in expectant mothers and/or their babies include aspirin and drugs containing iodine. These drugs are contained in many over-the-counter products, including cold and cough remedies, sleeping aids and medications that control nausea and vomiting. Many of these drugs also contain alcohol and caffeine, substances that can create adverse effects when large amounts are consumed during pregnancy.
Alcohol has been linked to physical deformities, brain damage and growth problems among babies born to women who drink as little as two alcoholic beverages a day. For this reason, the National Institute on Alcohol Abuse and Alcoholism advises pregnant women to avoid alcohol completely.
The consumption of excessive quantities of caffeine, which is present in coffee, tea, cola and chocolate, may be associated with increased risk to the fetus. It is wise, therefore, to limit its use during pregnancy.
Although studies of the effects of smoking during pregnancy have focused on only a few of the 4,000 substances contained in cigarette smoke, smoking has been clearly linked to low birth weights and increased rates of infant death. Smoking also increases the risk of miscarriage and other complications. Women who smoke should, therefore, seriously consider stopping or, at least, cutting down during pregnancy. Smoking marijuana during pregnancy has not been extensively studied. The substance does, however, have proven effects on a number of body systems and therefore may present risks to the fetus.
Common Problems
A number of minor digestive problems may also occur during pregnancy. Often, simple modifications in diet can relieve them. Morning sickness, the nausea that frequently occurs during the early months of pregnancy, may be controlled by eating hard candy or crackers when arising or eating frequent small meals throughout the day. Constipation may be relieved by eating more fresh fruits and vegetables and drinking more fluids; diarrhea, an unusual complaint, may be aided by eating more binding foods, such as rice and dry toast. Hearburn, which occurs during the later states of pregnancy, drinking milk before eating and sleeping with the head of the bed elevated. When symptoms are severe or persistent, the doctor should be consulted. If medications are prescribed, they should be taken only as directed.
Summing Up
Diet plays an important role in the health of pregnant women and their babies. To meet the increased demand for protein, vitamins and minerals, most expectant mothers should eat an additional 200 to 300 calories of nutritious foods a day. Most doctors recommend a weight gain of at least 25 pounds by term. Vitamin and mineral supplements, particularly iron and folic acid, are commonly prescribed to help ensure satisfying the pregnant woman's increased nutritional needs. Pregnant women should avoid excessive smoking, regular use of alcohol and excessive amounts of caffeine. Self-medicating should be avoided completely; instead medical problems should be brought to the attention of a doctor, whose directions regarding medications should be followed carefully.
Hospitalization - Admission Procedures
The procedures you follow on admission to a hospital vary from one hospital to another, but basically the process is the same in most institutions in the United States.
Care of the Dying - Role of Friends
The friend can show appreciation of the work being done by the family and offer to stay with the patient if the family needs a little time away from home.
Care of the Dying - Death of an Older Child or an Adolescent
From the age of three years onward, a child begins to understand the concept of death and dying. The dying child feels protective toward his or her parents. Although the child desperately needs to talk about what is going to happen, he or she may never get close to the subject. The child may attach himself or herself to a nurse or physician while still relying on the parents. By doing this, the child is sharing the emotional responsibility. The parents may find this difficult to accept, but must realize that someone else can perhaps give more help by listening dispassionately to the child's fears and anxieties.
