Pregnancy and Maternity - Women's Health Campaign

WOMEN’S HEALTH CAMPAIGN

PREGNANCY AND MATERNITY A go-to guide for women to become holistically healthier. A must-have manual for those around them to become better allies.

ABOUT US

Holisticly is a progressive health and technology company focused on empowering people from all around the world to live consciously, healthily, and enthusiastically. Our international team of experienced researchers, practitioners, and creators work closely to bring you high-quality, extensively researched content that can expand your knowledge about different aspects of holistic, preventive, and integrative health. You can be confident that you are making sound decisions about your health based on facts, studies, and scientific research, as our number one priority is to consistently provide scientifically proven content.

Holisticly has created this Women’s Health Awareness Campaign in partnership with the World Health Innovation Summit (WHIS). The aim is to increase public visibility and increase awareness of how women can achieve a healthier lifestyle and be aware of their rights.

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SHORT GLOSSARY

WOMEN’S HEALTH CAMPAIGN

SHORT GLOSSARY Placenta Placenta

The placenta is an organ that develops in the uterus when a woman is pregnant. This structure is responsible for providing oxygen and nutrients to the growing baby and removing waste products from the baby’s blood. The placenta is attached to the wall of the uterus, and a baby’s umbilical cord grows from it.

Cervix The cervix is the lower, narrow end of the uterus that forms a canal between the uterus and the vagina. The cervix acts as a door to the uterus, in which the sperm can travel and fertilize eggs before a pregnancy.

Cervix

Pregnancy Trimesters We currently refer to the stages of pregnancy through its trimesters. A pregnancy has three trimesters, and in each of them the fetus presents different developments.

First trimester: 0 to 13th week Second trimester: 14th - 26th week Third trimester: 17th - 40th week A full term pregnancy has 40 weeks, and infants delivered before the end of the 37th week are considered preterm.

PREGNANCY

WOMEN’S HEALTH CAMPAIGN

Pregnancy Holistically, how can I plan for my pregnancy?

Lifestyle choices not only improve your chances of getting pregnant, but also improve the chances of experiencing a healthier pregnancy.

Some lifestyle choices which directly impact pregnancy include:

Practicing healthy nutrition and monitoring vitamins and minerals Proper nutrition can help mothers-to-be handle the extra demands pregnancy presents to their bodies by helping them maintain a healthy weight and impacting the future health of their babies. Nutrients particularly important during pregnancy are folic acid, iron, iodine, vitamin B12, calcium, and omega-3 fatty acids. It is a good idea to discuss supplementation and adequate nutrition with your doctor.

It’s also important to keep in mind that both men and women should nutritionally plan for pregnancy, as some nutrients can also improve sperm quality.

Maintaining a healthy weight A healthy weight increases your chances of both getting pregnant and having a healthy baby.

Maintaining a healthy weight during pregnancy is crucial for a woman’s health. Being overweight or obese raises the risk of pregnancy problems such as high blood pressure, gestational diabetes, deep vein thrombosis, and miscarriage. The best way to keep a healthy weight is by following a balanced and nutritious diet and engaging in regular physical exercise.

WOMEN’S HEALTH CAMPAIGN

Pregnancy Quitting smoking Smoking during pregnancy has been linked with a variety of health problems, from premature birth and low birth weight, to miscarriage and sudden infant death syndrome (SIDS). For that reason, quitting smoking can be a game-changer for your baby’s health.

Although quitting smoking is a very difficult process, many organizations provide tips and encouragement to ease the process of quitting.

It’s okay to ask for help if you need it!

Avoiding alcohol Drinking alcohol increases the time it takes to get pregnant and reduces the chances of having a healthy baby.

Fetal alcohol syndrome is a condition in a child that results from alcohol exposure during the mother's pregnancy, causing irreversible brain damage and growth problems to the growing baby.

No amount of alcohol is safe during pregnancy, and even light drinking can be harmful for the baby.

The importance of folic acid and iodine supplements for pregnant women Folic acid is probably one of the most important vitamins to consider when it comes to pregnancy.

It helps prevent birth defects of the brain and spine and simultaneously reduces the risk of the baby having a neural tube defect. It also supports the general growth and development of the placenta.

The recommended intake of folic acid during pregnancy is 600 micrograms per day. Food alone is not able to provide that amount, which is why folic acid vitamin supplements are always needed.

Folic acid is most helpful in the first weeks after conception, and since it can take a while to notice the signs of pregnancy, future mothers are sometimes not yet aware of their pregnancy.

For that reason, it can be difficult to keep to the recommended intake at exactly the right time, and, when planning a pregnancy, it is a good idea for mothers to start taking folic acid supplements.

Iodine is also important for the baby’s development, especially in relation to the brain and nervous system.

Almost all women planning a pregnancy should try to supplement their diet with 150 micrograms of iodine each day, however it can be contraindicated in autoimmune conditions of the thyroids.

Therefore, before taking iodine supplementation, it is important to always consult a doctor.

WOMEN’S HEALTH CAMPAIGN

Pregnancy How does age impact the chances of getting pregnant?

A woman is born with all the eggs she’ll ever have, which is typically around 1 million. Both the quantity and the quality of the eggs diminish over time from the commencement of the first menstruation cycle onwards.

Because of this, age is a major factor in terms of fertility.

A woman's best reproductive years are in her 20s, and after that, fertility gradually declines in the 30's, particularly after the age of 35.

It is a common misconception that women have a 100% chance of getting pregnant every time they ovulate, but the reality is that every menstrual cycle is slightly different and that there are a wide variety of factors that impact any attempt to become pregnant. For example, certain eggs may have abnormalities, fertilization needs to happen within a narrow window of time after ovulation. With this in mind, as a woman ages, her chances of natural pregnancy in each cycle drops from around 25% at the age of 25 to less than 5% at the age of 40 in every cycle.

EGG AND EMBRYO FREEZING Even though research shows that women today are healthier and taking better care of their health than ever before, age-related infertility is becoming more common. For a number of different reasons, in today’s society many women wait until their 30s to begin their families.

Egg freezing allows women to preserve their own eggs. The eggs are frozen when they are young and healthy to help achieve pregnancy at a later time.

Embryo freezing, on the other hand, uses in vitro fertilization to create embryos, and preserves them for future use. Different to egg freezing, embryo freezing requires sperm from a partner or a donor and requires close coordination with them.

WOMEN’S HEALTH CAMPAIGN

Pregnancy What should I expect in relation to my body weight during pregnancy? Should I eat for two?

The amount of weight that you will gain during pregnancy is a relative matter and depends on the weight you had before you became pregnant. For example, women who are underweight before their pregnancy starts will gain more weight than a woman who used to have an average weight in relation to her height. In the same vein, overweight women generally gain less weight when pregnant.

Contrary to common belief, pregnant women don’t need to eat for two, and this reasoning may be one of the reasons behind excessive weight in many pregnant women. According to the European Food Safety Authority (EFSA), during the first trimester, no extra calories are needed.

During the second and third trimesters, 260 and 500 extra calories should be added per day, respectively. That’s approximately the amount of calories in a small sandwich or an avocado toast, and should come from healthy snacks such as fresh fruit, nuts, and yogurt.

Men’s weight and pregnancy It is a common misconception that only women’s weight matters before or during pregnancy. A man’s weight also affects a couple’s ability to have a baby, and men who are overweight or obese have worse sperm quality and are not as fertile as men with a healthy weight.

WOMEN’S HEALTH CAMPAIGN

Pregnancy Should I exercise during pregnancy?

Is most cases, it is safe to continue or start regular physical activity during pregnancy, and does not increase the risk of miscarriage, low birth weight, or early delivery. Regular physical exercise during pregnancy actually has many potential benefits and can help reduce pregnancy symptoms, back pain, constipation, decrease the risk of gestational diabetes, and promote a healthy weight gain.

Exercises that are recommended during pregnancy include, amongst others: strengthening exercises and muscle strengthening yoga pilates swimming walking or nordic walking cycling Warning signs that you should stop exercise include bleeding from the vagina, chest pain, headache, muscle weakness, and dizziness. Also, some conditions such as severe anemia, preeclampsia, and other complications, can have a direct impact on physical exercise and should be discussed with your GP or health care provider.

LABOR

WOMEN’S HEALTH CAMPAIGN

Labor As a pregnant woman, what can I be sure of in relation to labor?

Labor is a natural process composed of a series of continuous, progressive contractions of the uterus, allowing the fetus to move in the birth canal. It could take’ before hours.

Labor could take only a matter of minutes, or take hours and you won’t know exactly what will unfold for you until it happens. However, it is helpful to understand how the process works and what you might expect.

Stages of labor Stage One: Early Labor and Active Labor The first stage of labor starts when you begin to feel persistent contractions that become stronger, more regular, and more frequent over time. It causes the dilation and effacement of the cervix, that means the cervix opens, shortens, and thins to allow the baby to move through the birth canal.

Early labor is characterized by irregular contractions, when the cervix dilates and effaces. It can last from hours to days, and for many women it isn’t necessarily uncomfortable. Your healthcare provider will instruct you on when to leave for the hospital or birthing center.

Active labor is the second part of the first stage, when contractions become stronger, more regular, and frequent. It usually lasts between 4-8 hours, but can last for longer depending on the person and the number of previous pregnancies.

In this stage of labor, you might start to feel cramps, nausea, and pressure in your back.

If you are not in the hospital or birthing center yet, now it’s time to go!

In the last part of active labor, contractions will come closer together and can last anywhere between 60 - 90 seconds. This part can last between 15-60 minutes.

WOMEN’S HEALTH CAMPAIGN

Labor

Stage Two: Delivery The delivery stage means the time to push has arrived. This second stage of labor lasts from when the cervix is fully dilated to the birth of the baby.

Healthcare providers will help you with the pushing, talking you through how and when to do it. You may experiment with different positions until you find what feels the best, such as squatting, sitting, or kneeling. This stage can take anywhere from a few minutes to a few hours.

When your cervix is fully dilated, your baby will move further down the birth canal towards the entrance to your vagina and out of it. After your baby’s head is delivered, the rest of the baby’s body will follow shortly.

Stage Three: Delivery of the placenta The third stage of birth is the delivery of the placenta, and this usually happens within 30 minutes after the baby is delivered. All your attention will now be on your baby, but you will continue to have mild, less painful contractions. This will help move the placenta into the birth canal and out through the vagina. Your healthcare provider will examine the placenta to make sure it’s intact and remove any remaining fragments to prevent bleeding and infection.

After you deliver the placenta, your uterus will continue to contract to help it return to its normal size.

WOMEN’S HEALTH CAMPAIGN

Labor

What are the different types of analgesics and anesthesia available for pain management during labor?

- Analgesics are pain relief medications that may be used during labor in small amounts.

Anesthesia, on the other hand, is designed to cause a loss of sensation in areas of the body.

Different types of anesthesia include: General anesthesia Induces sleep and is used for emergencies during labor. Although it is safe, this type of anesthesia makes it impossible to see your newborn immediately after birth.

Local anesthesia Can be used during delivery to numb a painful area or after delivery when stitches are necessary.

Regional anesthesia Regional anesthesia includes epidural, spinal, or a combination of epidural and spinal. This type can “block” pain in a wide region of your body while you stay awake. It can also be used if a cesarean birth becomes necessary.

- Pain relief medication: Nitrous Oxide (laughing gas) is an analgesic inhalation which can help dull pain and manage anxiety. Buscopan, on the other hand, can also be used during labor to relax the cervical musculature, and therefore leading to quick dilatation of the cervix and shortened labor.

Together, you and your healthcare provider can decide on what is the best choice for you and your baby. Remember, only you can judge your need for pain relief.

WOMEN’S HEALTH CAMPAIGN

Labor

What are some non-medical measures I can take for pain management?

As part of a natural childbirth, wished by many mothers-to-be, non-medical ways of managing the pain have successfully been used by many women, helping them feel more comfortable and in control during labor and birth. These include:

Relaxation This includes learning how to relax various muscle groups in series, improving the ability to detect and release tension.

Bathing and showering during labor may also help relieve pain and tension.

Hot or cold therapy Warm towels or cold packages may help relax tense or painful areas.

Positioning and movement This can help many women that find moving around or changing their positions during labor helpful to relieve discomfort. Your healthcare provider can help you find comfortable positions that are safe for you and your baby.

Meditation or focused thinking Meditation helps your mind focus on an object or task, such as breathing instead of the discomfort. Breathing techniques use different patterns and types of breathing to help direct your mind away from discomfort.

Learning about labor This can make you feel more in control and less frightened about what is going to happen. You can learn more about labor by reading online in trustable websites, attending antenatal classes, or talking with your doctor and asking questions.

Consult and ask your healthcare provider about all these techniques before labor.

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Labor

What are different types of birth?

Vaginal deliveries In a vaginal birth, the baby is born through the birth canal. Benefits of vaginal delivery include shorter hospital stays, lower infection rates, and quicker recovery. For the babies, being born vaginally induces a lower risk of respiratory problems.

Cesarean section/C-section A C-section is the delivery of a baby through a surgical incision in the mother’s abdomen and uterus. A C-section can be scheduled in advance, or can be done as a response to complications.

In the past, going through a C-section meant not being able to give vaginal birth deliveries in the future. Today, thanks to advances in surgical technique, vaginal birth after a C-section is possible in many cases.

Where can I give birth?

You can give birth at home, in a birth center, or in a hospital. Your options about where to have your baby will depend on your needs, risks, and where you live.

In that way, if you are healthy and your pregnancy presents no risks, you can decide between any of these places, however if you have a medical condition, it is safest to give birth in a hospital, where specialists and treatments are available.

It is important that you have all the information to make educated choices about this topic. It is up to you, and you are free to change your mind at any moment.

WOMEN’S HEALTH CAMPAIGN

Labor

What happens after labor?

You and your body will change after labor. Here are some things you might notice:

Bladder control After having a baby, it is quite common to leak a bit of pee when laughing, coughing, or moving suddenly. Pelvic floor exercises can help with this.

Always talk with your GP or healthcare provider if you have any questions or concerns about this.

Bleeding You will bleed from your vagina after birth. Don’t worry, as this is a normal part of the process. It usually lasts a few weeks, and will decrease until it finally stops. You may also feel cramps similar to period pains.

It isn’t recommended to use tampons until after your 6-week postnatal check, because they could increase your chances of developing an infection.

Breasts Right after giving birth your breast will produce a liquid called colostrum for your baby. On the third or fourth day, you will start to produce milk. Wearing a supportive nursing bra may help.

Always speak with your doctor if you have any discomfort.

Periods It is hard to know exactly when your period will start again after pregnancy, and this is different for every woman.

If you fully breastfeed your baby, without any bottle feeding, your period may not start again until you start to reduce breastfeeding.

Abnormal Symptoms Some symptoms are not normal and you should always contact your GP or healthcare provider if you feel pain in the calf muscle of one leg, pain in your chest or difficulty breathing, heavy blood loss from your vagina, headaches or vomiting, or develop a high temperature.

WOMEN’S HEALTH CAMPAIGN

Labor

What is a birth partner?

A birth partner is someone who will support you during labor and birth. Whoever your birth partner is - be it the baby’s parent, a close friend, partner, relative, or a professional companion, like a doula - there are many practical things they can do to help. The most important thing they can do is just be with you. To get the most out your birth partner: talk with them about the type of birth you’d like and the things you prefer not to do, so they can help support your decisions ask for your partner to keep you company, and help pass the time during the early stages ask them to hold your hand, wipe your face, or give you sips of water let them comfort you as your labor progresses and your contractions get stronger allow them to be the bridge between you and your healthcare provider, explaining to them what you need and helping them communicate with you

WOMEN’S HEALTH CAMPAIGN

Labor

What is a birth plan?

The use of a birth plan is something helpful to discuss with your healthcare providers about what you want and your needs during labor. It should be made well before delivery, and you can always ask about any routine procedures used in labor by your physician, its reasons, and any information that will help you determine if it is necessary for you.

A birth plan can also help cater to any personal needs you may have and can help you answer questions you might have, such as: Routine procedures during labor How do they affect my confidence and wellbeing?

Are they essential? Can they be delayed?

Will I be able to walk around during labor?

Will my cultural and religious beliefs be respected?

Medications and complications Which medications will be used in each case?

What are the reasons for the use of each medication, and at what point in the labor they are used?

Can drugs be delayed until you feel the need for them?

Protocols What are the protocols if the pregnancy lasts more than 40 weeks? Will they induce labor? If so, what methods are used?

What happens in case of premature birth?

During labor and birth, your birth partner will be there, making sure all of the discussed options are being followed as much as possible, and your wishes are being taken into consideration.

Remember: almost any birth decision can be changed, at just about any time before delivery! Trust your feelings and intuition.

BREASTFEEDING

WOMEN’S HEALTH CAMPAIGN

Breastfeeding How does my birth experience affect the initiation of breastfeeding?

Initiating breastfeeding is easier when birth takes place in a supportive environment where interventions and drugs are minimized.

It is important to learn about the physiology of birth and breastfeeding as the more knowledge you have, the more you will be able to manage your labor and be helped by medical professionals. Also, when interventions are necessary, you will be better prepared to minimize their effects.

C-sections and breastfeeding Breastfeeding after cesarean birth is an important way for you and your baby to get to know each other. Breastfeeding can give you the satisfaction of knowing that you are giving your newborn the very best - something no one else can do - even though you are recovering from a major surgery.

However, in the case of a mother who for any reason may not be able to breastfeed their newborn, this does not mean that the bond you have with your child is impacted or less than that of any other loving mother and their child.

When is the best time to start breastfeeding my baby?

You can breastfeed your baby as soon as you like. Ideally, your baby will have their first feed within the first hour of birth. In most cases, your baby will instinctively move toward your breast and begin breastfeeding by themselves.

Current research strongly supports placing your baby on your chest, skin-to-skin, immediately after birth. Some of the benefits associated with this type of contact are: an increased likelihood of effectively breastfeeding for a longer period of time a decreased likelihood of experiencing maternal stress and postpartum hemorrhage the infants experiencing a better stability of their cardiorespiratory system, gaining higher glucose levels, and better temperature control a generally higher quality of breastfeeding with a more organized breastfeeding pattern and improved overall success

WOMEN’S HEALTH CAMPAIGN

Breastfeeding

How long should I breastfeed for?

According to UNICEF and the EFSA, breastfeeding should be exclusive for the first six months, when feeding infants nothing but breastmilk guarantees them a food source that is uniquely adapted to their nutritional needs. After the six months, appropriate complementary foods to breastfeeding should be added for up to 2 years or longer.

What are the benefits of breastfeeding?

Breastfeeding is generally encouraged as the default choice for an infant’s nutrition. However, the decision to breastfeed is individualized and it is made by the parents usually in the prenatal period.

Breastfeeding presents benefits to both the mother and the infant.

For the baby: stronger immune system less diarrhea, vomiting, constipation, gastroenteritis, and gastroesophageal reflux fewer colds and respiratory illnesses like pneumonia reduced risk middle ear infections reduced risk of bacterial meningitis better vision and less retinopathy of prematurity lower rates of infant mortality lower illness overall and less hospitalization reduced risk of obesity and cardiovascular disease later in life For the mother: lower risk of breast and ovarian cancer lower risk of osteoporosis lower rate of cardiovascular disease and obesity breastfeeding helps the uterus contract after pregnancy lower risk of postpartum depression The longer an infant is breastfed, the greater the protection from certain illnesses and long-term diseases.

ABORTION

WOMEN’S HEALTH CAMPAIGN

Abortion What is abortion?

Abortion is a procedure that ends a pregnancy.

It is carried out by either taking medicines or undergoing surgical procedures.

Every women should have the right to decide freely and responsibly – without discrimination, coercion, and violence – the number, spacing and timing of their children, as well as to have the information and means to do so, not to mention the right to attain the highest standard of sexual and reproductive health. In order to achieve a high level of sexual and reproductive health, women should always have access to legal, safe, and comprehensive abortion and post-abortion care. Ensuring that women and girls have access to abortion care that is evidence-based – which includes being safe, respectful and non-discriminatory – is fundamental to meeting the United Nation’s Sustainable Development Goals (SDGs) relating to good health and well-being (SDG3) and gender equality (SDG5).

Is abortion safe?

According to the World Health Organization (WHO), abortion is a common health intervention.

Whether an abortion is ’safe’ depends on the method, appropriate pregnancy duration, and necessary doctor skills. If there is an absence or lack of these elements, an abortion cannot be considered safe.

Abortions can be done using medical abortion or outpatient procedures. Any other procedures, such as the insertion of objects or substances into the uterus, dilation, the ingestion of harmful substances or external forces also configure unsafe abortions and can lead to health risks and long-term complications. Health risks include long-term physical, mental and emotional damage, and even, in some cases, death.

Unfortunately, almost half of all abortions are unsafe, usually taking place in developing contries.

A lack of access to safe, timely, affordable and respectful abortion care poses a risk to not only the physical, but also the mental and social wellbeing of women and girls all around the world.

WOMEN’S HEALTH CAMPAIGN

Abortion What are the barries to safe abortion?

The barriers for safe abortions include: Restrictive laws Even though abortions are still restricted in many countries, abortion rates are similar in countries where abortion is legal and in those where it is restricted. According to the WHO, the numbers are 40 per 1,000 women and 36 per 1,000, respectively. The biggest difference between the two settings is the access to safe procedures.

In some settings, abortion is legal but is contingent on certain requirements such as mandatory waiting periods, mandatory counseling, the provision of misleading information, third-party authorization and medically unnecessary tests. All of these factors delay care and can lead to unsafe abortion scenarios.

Stigma Social and cultural beliefs linked to abortion can make women reluctant, or even women women from seeking the safe care they need.

Poor Availability Of Services And/Or High Cost If women cannot gain access to, or afford, safe abortion servies, they are also prevented f rom receiving the proper health services they require.

What are the main complications associated with abortion?

Most women will not experience any problems following safe, professional abortion procedures.

However, there is a small risk of complications arising, such as: infection of the womb/uterus some of the pregnancy remaining in the womb excessive bleeding damage to the womb or cervix Abortions are safest, and happen with less pain and bleeding, when carried out as early as possible in pregnancy. Having a professional abortion will not affect your chances of becoming pregnant again and having normal pregnancies in the future.

However, psychological consequences such as grief and feeling of emptiness are always to consider.

WOMEN’S HEALTH CAMPAIGN

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Available from: https://my.clevelandclinic.org/health/articles/4450-pregnancy-epidurals--pain-relief-options-during-delivery Cleveland Clinic (2018) Benefits of Breastfeeding: For Baby and Mom. Available from: https://my.clevelandclinic.org/health/articles/15274-the-benefits-of-breastfeeding-for-baby--for-mom Extend Fertility (n.d.) Fertility Statistics by Age. Available from: https://extendfertility.com/your-fertility/fertility-statistics-by-age/ Extend Fertility (n.d.) Embryo Freezing. Available from: https://extendfertility.com/services/embryo-freezing/ Extend Fertility (n.d.) Our Egg Freezing Process. Available from: https://extendfertility.com/services/egg-freezing/ European Food Safety Authority (2017) Dietary Reference Values for Nutrients Summary Report. Available from: https://efsa.onlinelibrary.wiley.com/doi/10.2903/sp.efsa.2017.e15121 https://www.efsa.europa.eu/sites/default/files/2017_09_DRVs_summary_report.pdf Hamdan, A. and Tamim, H. (2012) The Relationship Between Postpartum Depression and Breastfeeding. 43(3) pp. 243-249. Available from: https://pubmed.ncbi.nlm.nih.gov/22978082/ John Hopkins Medicine (n.d.) Labor. Available from: https://www.hopkinsmedicine.org/health/wellness-and-prevention/labor#:~:text=Labor%20is%20a%20series%20of,the%20estimated%20date%20of% 20delivery.

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