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Things to Watch Out for During Pregnancy

Addressing risk factors as early as possible will make your pregnancy safer and healthier. Many can be identified before you become pregnant or early on in your pregnancy. The following risk factors are common and easily identifiable. Early detection and management may prevent complications so it is important to discuss them with your doctor right away.

An easy pregnancy and a healthy baby are what every expectant mother wants. Not all pregnancies proceed smoothly, however. Fortunately, many risk factors can be identified before you get pregnant, or early in pregnancy. While some risk factors cannot be changed (e.g. height, age), extra care and attention may prevent complications, or will at least help with early detection and management.

The following are some common and easily identifiable risk factors in pregnancy. If one or more of these risks applies to you, it's best to discuss it with your midwife or doctor now - even if you're not yet pregnant. Addressing risk as early as possible will make your pregnancy safer and healthier, giving your baby the very best start in life.

Poor pregnancy history

Complications with previous pregnancies often mean increased risk for the next pregnancy. If you think you may be at risk it is very important to start your antenatal care either before or just after you become pregnant.

Some past events that are important to talk about with your midwife are:

Premature delivery: Early delivery may have many causes, but take heart - in many cases, your midwife or GP can help minimize the risk of another premature labour by helping you avoid risky circumstances that may have occurred before.

Previous low birth-weight baby: If you had a baby who weighed under 4.5 pounds, be sure to tell your midwife, as she and an obstetrician will need to monitor you closely. Extra tests and scans will show how the baby is growing.

Miscarriage and stillbirth: Having three or more consecutive miscarriages, or a stillbirth, means an increased risk of the same. While the cause for these unfortunate events is not always known, your GP can refer you for tests, such as genetic screening, helping to identify contributing factors.

Caesarean section

Women who have had a Caesarean section ('C-section'), are more likely to need another. Therefore, if you have had a C-section, your birth plan should include delivery in a healthcare facility equipped to perform Caesareans. Although a home birth may seem attractive for many reasons, it is too hazardous for you and your baby.

Shorter height

Women who are noticeably short may have problems with delivery. This is particularly true if the baby's father is much larger - it simply makes for a bigger baby. So, if you are under five-foot and the baby's father is tall, or has a rugby-player's build, let your midwife know!

Weighty issues

Weight can also be a concern. Ideally, you should address the fact that you are underweight or overweight before you conceive. However, if you are already pregnant and your weight is not within a healthy range - as determined by your doctor or midwife - you may be referred to a dietician. If your midwife establishes that you are underweight, you may also need extra scans to monitor the baby's growth.

The effects of age

These days, women are having babies at all ages. Some ages are associated with increased health risks during pregnancy and certain women need special attention.

Teen mothers: Women who give birth in their teens may have special needs. For example, anaemia is more common in teen mums.

Thirty-five and above: Many women are choosing to have babies later in life. While there are advantages to waiting, women over 35 do need more careful medical attention during pregnancy. The risk of birth defects increases after 35, and while the pregnancy may proceed easily, you will need a few extra tests and close monitoring.

Multiple pregnancies

If you have already had four or more children, you may be at a higher risk for events such as high blood pressure, premature delivery, excessive bleeding, retained placenta, precipitate deliveries (the baby is delivered too quickly) and, after the birth, anaemia. You will need good nutrition and more rest, and your midwife should explain which signs of high blood pressure to look out for.

Abnormal position

If your baby is lying sideways or upside down inside you, the risk of needing a C-section is higher, although it is not necessary for all breech babies. Fortunately, most babies turn to the proper position before 36 weeks; otherwise, you may be referred to an obstetrician who - if it is safe to do so - will try turning the baby for you. If this is not possible, you will be offered a C-section, but be sure to discuss this option in detail with your midwife and obstetrician - knowing the why-and-how of what's involved means you'll be more relaxed and comfortable when the time comes to have your baby!

Psychological distress

The World Health Organization acknowledges that all women need some emotional support during pregnancy. However, you may need a bit more if you are unhappy or distressed about something - perhaps you are unemployed, are worried about being a mum, or are having problems with your partner. Even moving house recently can significantly affect your ability to cope with daily tasks. There's no reason to suffer in silence. Talking to someone - a friend, your midwife, a doctor - can lend a fresh perspective. And by keeping anxiety to a minimum your body can focus on creating the new life inside you.

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