First-time mom: a complete guide to help you on this journey

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When pregnant, many questions may arise, especially when talking about a first-time mother. But that doesn't mean that anyone who has a child knows everything about it, right? Each pregnancy is unique, as is the care of each child. With that in mind, it is interesting to know a guide to stay on top of all the steps.

With the right information, it is easier to enjoy these unique moments with maximum peace of mind. Therefore, it is worth checking below questions answered by Dr. Flavia Burim Scomparini (CRM-SC: 22716), gynecologist and obstetrician and Dr. Clay Brites (CRM-PR: 16787), pediatrician and child neurologist.

Content Index:

• Pregnancy
• Childbirth
• Post childbirth
• Breast-feeding
• Daily care
• Books for first-time moms

Pregnancy

It is possible to have doubts when facing the first symptoms of pregnancy and it is common that they continue to increase over the months, right? Thinking about it, see some questions related to pregnancy answered.

What are the early symptoms of pregnancy?

Dr. Flavia: Early pregnancy promotes several changes in the woman's body. Nausea and vomiting are widely known by the population, but it is worth remembering that other symptoms such as cramps and drowsiness are also quite common. In addition, increased progesterone hormone levels may lead to constipation, difficulty with gastric emptying after meals (full stomach sensation) and increased gastro-oesophageal reflux. Progesterone elevation also promotes ligament and joint looseness, which facilitates torsion, so caution is advised when using high heels, for example.

Read also: Motion sickness: characteristics, treatments and when to worry

What happens if a pregnant woman takes birth control pills?

Dr. Flavia: The consequences of using hormones (pills) during early gestation will depend on how long use has continued. In general, if used for a short period there are no sequelae to the fetus. If prolonged use may alter genital formation, especially in the case of a male fetus, since the hormones contained in oral contraceptives are female hormones.

How is the calculation of weeks of pregnancy done?

Dr. Flavia: The calculation is made either by the date of the first day of the patient's last menstruation, or by the length of the embryo on the first ultrasound performed. The date of the last menstruation can be used as a reference in patients with regular menstrual cycles and when the calculation by this parameter is less than the ultrasound error margin. In general, ultrasound performed up to 12 weeks gestation has an error of less than 7 days.

What is prenatal care like?

Dr. Flavia: Prenatal care for low-risk single-pregnancy patients is performed with monthly consultations for up to 32 weeks, followed by biweekly consultations for up to 37 weeks and weekly until the date of delivery. Remember that prenatal care is only completed after the postpartum period and should therefore include at least 1 postpartum consultation.

Is sex in pregnancy released?

Dr. Flavia: Patients who do not have a medical contraindication to engage in sexual activity may remain sexually active until delivery. Some contraindications to sexual intercourse include first trimester bleeding (threatened miscarriage), low insertion placenta, short cervix leading to increased risk of prematurity, among others.

What can be a bleeding during pregnancy?

Dr. Flavia: Bleeding can have different causes depending on the stage of pregnancy. Bleeding that occurs early in pregnancy may represent gestational sac detachment (threatened miscarriage), ongoing abortions, and in the case of patients who have not yet had ultrasound, may be a tubal pregnancy.

Read also: Obstetric violence: physical and psychological aggression in pregnancy

Bleeding that occurs at the end of pregnancy is generally related to placental changes such as low insertion placenta or placental detachment. These medical diagnoses are considered serious and should be ruled out through immediate medical evaluation.

Is it necessary to take vitamins?

Dr. Flavia: According to the Ministry of Health, every woman on a pregnancy schedule should have daily supplementation with 400mcg / day folic acid to reduce the risk of neural tube closure defects. This same supplementation should be maintained for at least 12 weeks of pregnancy.

Another mandatory supplementation is iron, especially from the second trimester of pregnancy, when the risk of anemia increases and when we have the approach of delivery in which there will be moderate blood loss.

Vitamin D, iodine and omega 3 supplementation is also quite frequently used by Brazilian obstetricians.

It is noteworthy that balanced diet is capable of ensuring adequate intake of many nutrients, and individualization in the evaluation of each woman will be essential. Patients who do not consume milk and milk products, for example, may require calcium supplementation, while the others get it through diet.

Read also: Labor: Know the stages to identify the signs

What changes in a woman's body?

Dr. Flavia: The woman goes through many transformations during the pregnancy period. In early pregnancy, the general symptoms are most evident from hormonal changes. We noticed mood swings such as irritability and easy crying, changes in sleep pattern, changes in bowel habits, and constipation is quite common. The action of progesterone may further lead to increased gastric reflux and the sensation of heartburn and burning.

With the enlargement of the uterus and womb, other changes begin to settle. The breathing pattern changes, the gastric capacity is reduced and the body's center of balance changes, forcing the pregnant woman to walk in a characteristic way so as not to be unbalanced: legs slightly apart and hips forward.

Breast and vulva changes also reflect the body's preparation for delivery. The breasts become more sensitive, the areola increases its pigmentation, may appear bluish blood vessels on its surface, in addition to protrusion of the nipple. The vulva also becomes darker, with slightly parted lips. Vaginal secretion also increases by hormonal action.

Can pregnant women practice physical activities?

Dr. Flavia: Pregnant women can and should practice physical activity regularly. As long as there is no medical contraindication to this, all scientific evidence is favorable to the practice of aerobic and muscle strengthening exercises.

A unique moment, pregnancy can be full of doubts, but with a calm and with the right professionals, this can be a quiet phase.

Childbirth

The moment of childbirth frightens many moms, who are not sure which type to choose, how the recovery will be and all the other details. But rest assured, the answers to various questions are here.

How many weeks on average does birth take place?

Dr. Flavia: Most patients will deliver between 39 weeks and 41 weeks, so the expected date of birth (PPD) is calculated for 40 weeks.

What are the signs of labor?

Dr. Flavia: Labor is defined by the presence of regular uterine contractions, with an average interval of 3 minutes, capable of causing modification in the cervix. These contractions usually begin with mild intensity, are most noticeable in the lower back and uterine fundus, and radiate to the lower abdomen. Regularity begins at long intervals, 15 to 20 minutes, and then at shorter intervals, 3 to 5 minutes.

It is worth remembering that fluid loss due to bag rupture may occur even outside labor and is also an indication for immediate medical evaluation and possible hospitalization.

How to choose the type of delivery?

Dr. Flavia: The birth route in Brazil is not a patient choice but a medical indication. In the private system we have the possibility to take into account the patient's wishes, but in the public system, normal delivery is the first route, and cesarean section is an alternative for cases where normal delivery is not possible.

Is there a difference between normal, natural and humanized childbirth?

Dr. Flavia: Yes. Normal birth is the broad name we give to vaginal birth. It can be natural and humanized at the same time.

Natural childbirth is one in which no interventions or use of medications to stimulate birth are performed.

Humanized childbirth is the term we use for childbirth that respects the mother's preferences and the baby's time. In humanized childbirth, for example, the baby goes straight to the mother's lap and stays in contact with her skin for the next hour. The pediatrician assesses the newborn still in the mother's arms, and the clamping and cutting of the umbilical cord is done after the pulse stops.

What are the best positions for normal childbirth?

Dr. Flavia: Each patient will choose the position in which they feel most comfortable for the moment of expulsion. There is not a single position.In my professional practice, I love the use of the delivery bench, because it mimics the squatting position while facilitating the descent of the baby through the birth canal by the action of gravity.

What to do when the bag breaks?

Dr. Flavia: The first advice I give my patients is to be calm. Bag rupture may occur hours before the baby is born and does not mean that the baby will be born in the next few minutes.

When a large amount of clear liquid with a bleach-like odor comes out, if the patient is without pain, she can take a bath and go to the maternity for calm assessment. In cases where the patient was already having contractions, it is recommended to go immediately to the maternity for evaluation, since we have no way of knowing whether or not there may already be cervical dilation.

What if the bag doesn't burst naturally?

Dr. Flavia: In cases where the patient remains in labor and the bag does not rupture, the doctor may artificially rupture the membranes at the appropriate time. In some cases, this intervention is not necessary, and even the baby may be born with a full pouch, as in the case of impellate births.

When do I need to induce labor?

Dr. Flavia: Induction of childbirth can have numerous indications. Gestational age greater than 41 weeks is one of them. Above this gestational age, we have no further benefit in waiting for the spontaneous triggering of childbirth, so in these circumstances we advise that hospitalization and medication induction of labor be performed.

Other indications are gestational diabetes, high blood pressure, low birth weight or reduced amniotic fetuses, ruptured pouch and no spontaneous contractions.

What causes a premature birth?

Dr. Flavia: Vaginal and urinary tract infections are important causes of premature births and should be treated carefully when identified. Other causes include short or incompetent cervix (which begins to dilate as fetal weight increases), multiple pregnancies, high-blood pressure (Doppler) of the baby, or decompensated gestational diabetes with fetal repercussions.

Childbirth is a unique moment, so it is important to choose a professional who identifies with the pregnant woman. After all, he or she will be responsible for bringing the baby to the world.

Post childbirth

The baby was born, now what? The mother's body changes, there is postpartum rest and several other questions that may arise related to the woman. See the answers to some of them:

When should I go back to the obstetrician?

Dr. Flavia: The first postpartum consultation is usually between 7 and 10 days. A second assessment is made at the end of the puerperium, about 40 days after birth.

What is postpartum rest like?

Dr. Flavia: The mother's recovery will depend greatly on the mode of delivery and any interventions that may be required. Patients who achieve vaginal delivery without laceration, for example, have no restriction on mobilization and diet. Patients undergoing cesarean section, in turn, should remain in relative rest for the first 12 hours. After this period, light walks through the maternity room and corridor are encouraged to stimulate bowel function and to prevent thrombosis.

The postpartum period, the name given to the 42 days after the birth, is the period for the return of the woman's body to its pre-gestational conditions. During this period, should the patient avoid physical activity and sexual activity?

When is it possible to have sex again after childbirth?

Dr. Flavia: After 42 days, if there has been no medical contraindication, the patient will be released for a return to sex life.

Is there a chance of a pregnancy during quarantine?

Dr. Flavia: The risk is considered negligible, but the risk of uterine infection (endometritis) is greatly increased in patients who resume vaginal sex prior to medical clearance.

Is postpartum bleeding normal?

Dr. Flavia: Yes. Postpartum bleeding, which we call loaching, occurs in all women, regardless of the mode of delivery. This bleeding originates from the blood vessels that were exposed after the detachment of the placenta.

When does a woman get her period again?

Dr. Flavia: A breastfeeding woman may remain without menstruation for an indefinite period as prolactin, the hormone responsible for milk production, is able to inhibit the ovulatory cycle. Most women start menstruating again after the baby is introduced when the frequency of breastfeeding is reduced.

How long does it take for the body to return to normal?

Dr.Flavia: The puerperium, which by definition lasts 42 days, is the period when a woman's body restores pre-gestational conditions, but that does not mean that within that time the woman's body will return to exactly the same way it was. before pregnancy. Abdominal muscle tone and skin elasticity, for example, may take longer to reestablish.

Is it normal to be very tired during this period?

Dr. Flavia: Yes. The sleep deprivation and psychological distress to which mothers are subjected completely justify a sense of exhaustion that is established in this postpartum period.

Is constipation common?

Dr. Flavia: In the early days after delivery this is a fairly common complaint, as is abdominal distension generated by gas accumulation.

When is it possible to perform physical activities?

Dr. Flavia: Normal birth, being less aggressive to the woman's body, allows the patient to resume her physical activities after the end of the postpartum period. Cesarean delivery requires a period of up to 60 days for the resumption of physical activities.

Even just having a child, it is important that the mother also be careful with herself and respect the limitations of this period. Just like the baby, she also needs attention.

Breast-feeding

Breastfeeding is a period that can raise many questions, whether it is breastmilk, how much to breastfeed, breast care, and more. At this point, it is important to be calm and have the right information.

When does the baby's first breastfeeding happen?

Dr. Flavia: We call Golden Hour the baby's first hour of life and it is at this time that the first breastfeeding should occur.

Is it possible to get pregnant while breastfeeding?

Dr. Flavia: Yes, exclusive breastfeeding has a contraceptive effectiveness close to 80%, that is, for every 100 women who rely on this method alone to prevent a new pregnancy, up to 20 women can become pregnant within 1 year.

Does breastfeeding hurt?

Dr. Flavia: Breastfeeding does not cause pain, but the baby's first days of life and first breastfeeding are commonly accompanied by jaw fissures caused by improper handling of the newborn. The cracks can be quite painful?

How is it possible to prevent mastitis?

Dr. Flavia: Mastitis is the name given to mammary inflammation due to bacteria entering the milk ducts. The main gateway for bacteria in the ducts is the fissures, and the correct attachment of the baby to the breast is one of the main forms of prevention.

In the case of nipple cracks, we recommend extra care with breast cleaning. One way to facilitate crack healing and thus reduce the risk of mastitis is by applying the antibody-rich breast milk itself to the areola and nipple.

Other important forms of prevention are breast milking, so that milk does not accumulate and stasis in the breasts, and the choice of an appropriate bra, capable of ensuring good breast support.

What should women avoid eating while breastfeeding?

Dr. Flavia: We advise breastfeeding women to avoid consuming difficult-to-digest foods known as excess gas-forming foods such as beans and chickpeas. Foods containing gluten or lactose should be avoided by intolerant patients. The consumption of alcohol is also quite questionable and should be avoided ?.

Is it possible to take birth control during this period?

Dr. Flavia: Yes. During lactation we recommend using non-hormonal contraceptive methods or progesterone alone (such as some pills, quarterly injectables, Mirena and contraceptive implantation).

How long should the baby be breastfed?

Dr. Flavia: Exclusive breastfeeding is recommended until 6 months. After this period food introduction will occur and breastfeeding may be reduced. The Ministry of Health recommends breastfeeding for at least 24 months.

Silicone breast prosthesis disrupts breastfeeding?

Dr. Flavia: The inframammary incision, which is the most widely used today, does not necessarily interfere with breastfeeding by not directly sectioning the ducts. Reduction mastoplasty and periareolar incision prostheses have a greater negative influence on breastfeeding.

Is there a duration time for each breastfeed?

Dr. Flavia: The concept of free demand advocated by pediatricians nowadays implies that the baby should have free time to breastfeed. In general, we indicate at least 20 minutes of breastfeeding in each breast.

How is it possible to increase milk production?

Dr. Flavia: Adequate water intake is one of the main ways we can increase milk production.Other widely used ways are through the patient's prolactin-enhancing medications such as metoclopramide and domperidone. Milk is ejected by another hormone, oxytocin, so labor is believed to be a strong ally of breastfeeding.

Breastfeeding is the moment the baby feeds, but it also gains affection and comfort from its mother. So be calm and patient and do not over cover yourself if the milk is not enough or other problems appear.

Daily care

Everything went well with pregnancy, so now is the time to move on to daily baby care.

When should the first visit to the pediatrician be?

The date of this first consultation is indicated 7 to 10 days after birth. Dr. Clay further says that parents should list all questions before attending the appointment.

How to deal with reflux?

Dr. Clay: After the feeding, keep the upright child leaning on you until you burp. When lying down always place the child on his or her back.

How is the navel care?

Dr. Clay: Always wash it in the baths and clean its base and around it twice a day with a cotton swab to remove skin remnants or secretions.

What is the recommended sleeping position for the newborn?

Dr. Clay: On your back or in your back.

How many hours of sleep is indicated?

Dr. Clay: The newborn should sleep up to 20 hours a day.

What should the baby bath look like?

Dr. Clay: It should be bathed with glycerine soap once a day. More baths may eventually be given, but should only be with water.

When is it possible to start the tours?

Dr. Clay: Ideally, they should be done only after 3 months of age so that the baby has received the first vaccines and reduce the risk of getting seasonal infections.

What to do when my baby has cramps?

Dr. Clay: Put him in the ventral position on his arms and support his abdomen. To reduce seizures, massage the belly a few times daily and warm it with a lightly ironed warm towel.

Is pacifier use recommended?

Dr. Clay: Only until 18 months and if the child really feels the need.

Remember that crying is a baby's way of communicating, so you don't have to despair when it happens. After all, this is the way he expresses hunger, sleep and even his feelings.

First-time mom: best books

1. What to expect when you are waiting: pretty much a guide, this book is a great choice for first-time moms. It presents information on how to choose the ideal doctor, childbirth and what are the rights of pregnancy and more.
2. The maternity book: This is a guide book that talks about childbirth, breastfeeding, sleep, baby feeding and goes through school and into adolescence.
3. Welcome, baby: This is a series divided into three books. Each volume covers a different age range, ranging from zero to five years old. With simple language, Ana Escobar explains doubts that may arise in the care related to the little ones. As the author is Brazilian, our culture is taken into consideration.
4. Beautiful motherhood: written by Bela Gil in this book, she wanted to share the experience of being a mother, starting with pregnancy, expecting childbirth, the dilemmas of breastfeeding, and going to the care of the baby and herself.
5. When the body consents: Written together by a journalist, her pregnant daughter and therapist, and a midwife, this book is ideal for moms who want to have a natural and humanized birth. This is because he talks about what happens in the body, gives hint to arouse the sensations of pregnancy and even gives movement tips for birth.
6. Motherhood and the encounter with one's own shadow: Made especially for women, this book focuses on the postpartum period, the period right after the birth of the baby. It has a sensory and intuitive dynamics.
7. French kids don't do morning: Written by an American journalist living in France, the book shows the difficulties the author suffered when imposing limits on her daughter, seeing around her, that the French children did not tantrum. In the book, she tells the tips of French creation.
8. Visible women, invisible mothers: Due to theories and solutions that disrespect or go against the mother's opinion, this book has several articles that seek to clarify several doubts so that moms can face the period without fear and without trauma.
9. To educate feminist children: This letter-sized work presents practical tips for parents and encourages daughters to be independent, strong, and strive for what they want. All this far from gender stereotypes.
10. Baby Food: An Introduction to Real Food: With the help of doctors and nutritionists, Rita Lobo wrote this book to clear up doubts that are common when feeding the baby.

There are a wide variety of books that can be read to answer questions about this gigantic world of motherhood. These are just a few pointers, but if you still have questions, you can consult other books and should always talk to your doctor.

Mothers, do not feel pressured and do not take into account the possible opinions and criticisms of others. Each woman has her own way of being a mother and raising children, and that's fine.

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