Wellness Check-up: A Must A healthy mom, both in mind and body, is better outfitted to make parenting a joyful experience

for herself and for her new baby. Thus, postpartum care must be given top priority. Around six weeks after delivery, schedule a visit to your doctor. This will enable you to determine if you are recovering as well as you should be. Moreover, this will be a good time to address whatever concerns you may have. This is no time to be lazy, much less be fearful of what may transpire. A standard check-up will merely involve the following: Your current weight and blood pressure will be checked. This is to make sure that your recovery is progressing well. In the event that you encountered blood loss during delivery or were anemic during your pregnancy, blood tests and a pap smear may be conducted. Your breasts and abdomen will be examined. Breasts are checked to determine if you have abnormal nipple discharge or lumps in your breast. Breastfeeding moms also need to verify with the doctor the presence of clogged ducts or infection. Abdomens on the other hand are checked to see if your uterus has gone back to its normal size, which should be the case after six weeks. If you underwent an episiotomy, your perineum will be checked to see if it is healing properly. The internal exam that will be conducted ensures that vaginal bruising, cervical tears, or scratches are on their way to recovery from the trauma of childbirth. Your ovaries will also be assessed, as well as your vaginal muscle tone. This check-up will also be a good time to ask about other issues or concerns that are important to you, such as when you can resume sexual activity or take contraception. Coupled with this new phase are numerous challenges. Keeping this appointment with your doctor will guarantee that you will be in tip-top shape to face the adventure of being a parent with vigor and vitality. After all, it is a lifetime responsibility, and it is best to arm yourself with the best of health and happiness right from the start.

Nutrition During the Postpartum Period The new mother needs a balanced diet in order to regain her strength. Client teaching is a priority at this time. Most facilities provide written information about proper nutrition after delivery. The hospital dietitian is also a valuable resource. Teach the client that her diet should be high in fiber and fluids. This diet will prevent constipation. If the woman has a good understanding of basic nutrition, it may be sufficient to advise her to decrease her daily caloric intake by 300 kcalories and resume her prepregnancy level of other nutrients. The 300 kcalories a day that provider for the needs of the fetus are no longer necessary. The woman will return to her prepregnancy weight more quickly if she reduces the daily intake of calories. Teach the breastfeeding mother to consume an additional 500 kcalories per day, to drink additional 8 glasses of fluid a day (1,000 mL), and to consume 65g of protein and 1,000mg of calcium. Most physicians request that the new mother continue to take prenatal vitamins with iron for 3 months. These will balance the nutrients used up by milk production and breastfeeding. The prenatal vitamins help ensure that the womans system is balanced.

PRENATAL/ANTENATAL CARE refers to the medical and nursing care recommended for women before and during pregnancy.

The aim of good prenatal care is to detect any potential problems early, to prevent them if possible (through

recommendations on adequate nutrition, exercise, vitamin intake etc.), and to direct the woman to appropriate specialists, hospitals, etc. if necessary.
Nutrition Before Pregnancy A lack of adequate nutrients in the diet during pregnancy has been linked to an increased of low birth weight infants, gestational hypertension, and poor fetal brain development. Although major congenital anomalies occur in 2% to 3% of live births, neural tube defects (NTDs -

An NTD is an opening in the spinal cord or brain that occurs very early in human development) are among

the most common. The brain, spinal cord, and protective bone structures of the skull and vertebra are formed within the first 28 days after conception. Research has shown that without adequate amounts of folic acid (400mcg), the brain fails to develop normally, resulting to anencephaly (when

the cephalic (head) end of the neural tube fails to close, usually between the 23rd and 26th day of pregnancy, resulting in the absence of a major portion of the brain, skull, and scalp), and the vertebrae fail to close, resulting in spina bifida whith meningomyelocele. Because many pregnancies are unplanned, and NTDs occur within the first month after conception (which is before the recognition of pregnancy), NTDs are best prevented by adequate folic intake throughout the reproductive years.

Nutrition During Pregnancy 300 kcalories: The addition of two milk servings and one serving of meat will meet the need for increased calories as well as calcium and potassium. Expect steady weight gain during the second the third trimester. Well-balanced diet or else, malnutrition to baby. Malnutrition could result in life-long complications in the baby. Increase protein intake to 60 to 80g/day. Protein is essential to support the increased metabolic needs of pregnancy and to aid the growth of the maternal and fetal tissues. It also aids in increased energy levels, muscular contractions and immunity. Lack of protein = increased incidence of low birth weight infants, pregnancy induced hypertension and poor fetal brain development. Increase iron intake or else, mothers red blood cells and the red blood cells of the fatus will be unable to carry adequate amounts of oxygen to perfuse all tissues. The developing fetus requires iron for red blood cell formation and to store for use during the first 6 months of life when the diet of milk may be low in iron. Vegetarians: The nurse must provide these women with more in-depth information or refer them to a dietitian. Many health care providers prescribe multiple vitamins with calcium and iron. Avoid high-carbohydrate and high-fat foods. They usually lack vitamins and minerals. Teach good food choices. Adequate fluid intake is important for the pregnant woman. Drinking 1.5 to 2L of water, milk or juice every 24 hours is recommended. It is best to limit caffeine-containing beverages. Women in low socioeconomic levels may have difficulty buying adequate amounts of milk and high-protein foods. These women should be referred for assistance from programs such as WIC. Health History Unless a health history has been obtained prior to pregnancy, it must be done at this time. It includes identifying all past medical issues that could have an impact on the pregnancy. A menstrual history will be obtained, including any past pregnancies. The womans gravid (G-number of pregnancies), para (P-number of deliveries after 24 weeks gestation), and the outcome of the pregnancies will be recorded. Possible outcomes include abortion (A-the loss of pregnancy before the 20th week), preterm delivery (P-delivery after the 24th week but before the 38th week), term delivery (T-delivery between 38 and 42 weeks), postterm delivery (delivery after 42 weeks gestation), and whether the infant lived (L-live birth).

Laboratory Tests Related to Pregnancy Laboratory values often change while a woman is pregnant, usually lower. Laboratory tests can provide valuable data for assessing a womans health. Nurses should be familiar with values that are normal during pregnancy.

Exercise Exercise is increasingly recognized as an important part of a health maintenance program. Healthy, active women are more likely to have healthy infants. Women who are overweight and sedentary are more likely to encounter problems in themselves such as gestational diabetes, and in their children. Its important to maintain activity throughout pregnancy. Kegel Exercises They are promoted during the prenatal period. These help women identify muscle groups that are affected by delivery and that need conditioning after birth. They are important after birth in regaining muscle tone. They can be done while standing, sitting and lying down. It is important to emphasize taking full, smooth breaths during the exercise. Leg raises: to strengthen abdominal muscles Prenatal Classes Are advisable for all mothers, not just those in their first pregnancies. Pets (Cats because of the potential for being infected with toxoplasmosis when handling cat feces)