Frequent Urination

It caused by the pressure on the bladder as the uterus enlarges during the pregnancy. 

1. Recommend urinating as soon as you feel the urge.
2. Increase liquid intake during the day and try cutting back on fluids after dinner to reduce urination at night.

 Constipation

Constipation during pregnancy can be caused by the iron supplementation or the enlarged uterus make the small intestine shift and suppress the rectum, which slows down the bowel movements. 

1. Drink enough water. About 2000cc a day.
2. Get adequate exercise. Walk in the morning and evening.
3. Eat fibrous vegetables, fruits, and whole grains.
4. Get into the habit of having a daily bowel movement.
5. Take a stool softener prescribed by a doctor if necessary. Do not take over-the-counter medication on your own. 

Nausea and vomiting

In the early stage of pregnancy, the hormonal change results in nausea and vomiting. But symptoms will naturally disappear at the end of the third month for most cases, and only very few will last until delivery. 

1. Consume dry starchy foods, such as crackers, toast, or cereal, in the morning before you get out of bed.
2. Eat small frequent meals and avoid an empty stomach.
3. Try not to drink soup or water during meals, don’t lie down flat or move vigorously after eating.
4. Avoid food that is oily, not easy to digest or with heavy seasonings.
5. If vomiting occurs with morning sickness, rinse your mouth with water to get rid of the taste. You may drink some water to wash the gastric acid away from the esophagus to reduce the burning sensation. 

Cramps, swelling on the lower limbs and varicose veins 

1. Keep the lower limbs warm.
2. Increase intake of calcium-rich foods, such as milk, dark green vegetables, dry beans, and anchovies.
3. When having cramps, try to straighten the legs. Massage your sole and push toward the calf with hands.
4. Do not eat food with high sodium content.
5. It is better to rest sideways on the left and elevate your legs to improve blood circulation. 

Hemorrhoids

Diarrhea, constipation, and straining during bowel movements which can increase pressure on veins, or the enlarged uterus may block blood flow through veins, which contributes hemorrhoids in pregnancy. 

1. Develop the habit of regular bowel movement and avoid constipation. Avoid squat hard, or sitting or standing for a long time.
2. Take a warm sitz bath.
3. A stool softener or topical cream may help to relieve the pain, consult your health care provider when the pain is severe.
4. Opt for more whole grains, fresh vegetables and fruits, water in your diet to prevent constipation.

Backache

As the baby grows, the mother's belly enlarges, to maintain balance, the mother's posture shifts, which leads to lower back pain.

1. Maintain proper posture. Keep the back straight and do not slouch.
2. Try not to carry anything heavy, stand, or sit for a long time or get too tired.
3. Use a maternity support belt to support the belly and lighten the load on the back.
4. Use a hot compress, massage for waist or back to increase blood circulation.

Heartburn

During pregnancy, the hormone progesterone causes the esophageal sphincter to relax which allows stomach acid to pass into the esophagus and results in a burning sensation.

1. Take multiple meals with a small amount of food for each meal. Avoid eating too fast or too much.
2. Avoid eating desserts and greasy, heavy, or fried food.
3. Avoid wearing tight clothes or belts to decrease the chances of gastroesophageal reflux.
4. It is appropriate to keep a semi-Fowler's position after dinner instead of lying down immediately.
5. You can take antacids or antiemetic (anti-sickness) drugs under a doctor's guidance.

Tooth and Gum Disease

Tooth decay, gingivitis, gingival hyperplasia during pregnancy, the periodontal (gum) disease worsens because during pregnancy, the Estrogens in the body increase, causing swelling of the mucous membranes, which is prone to bleeding from the mouth or gums.

1. Practice good oral hygiene.
2. Visit your dentist regularly (teeth cleaning to remove plaque and - tartar for pregnant women) and talk to your dentist as soon as any oral health conditions occur.
3. Use the soft-bristled toothbrush and brush gently.
4. Include enough fresh fruit and vegetables in your diet to ensure adequate vitamin C intake to protect your gum health.

Stretch marks have a lot to do with genetics and physique. Your uterus expands when the fetus grows along the pregnancy journey.  Your abdominal circumference is getting bigger too. When the skin pulled tight, the connective tissue, like collagen and elastic fiber, will be stretched to beyond its elasticity limit. Another possible reason is the increased level of epinephrine and steroid during pregnancy may weaken the expansion ability of the connective tissue. Stretch marks are more likely to develop in multiple-pregnancy than single-pregnancy. They often develop in areas like belly, breasts, buttocks, and thighs. Often starts as reddish wavy stripes, but after pregnancy, the marks gradually fade to white or grey lines. Unfortunately, once the stretch marks has developed, there is almost no way to get rid of them.

Therefore, it is recommended to start with prevention by managing weight gain during pregnancy. Keep the weight gain within the normal range by gaining no more than 2kg per month. The total weight gain should be around 11-14kg throughout the pregnancy. At the beginning of pregnancy, you can apply the maternity moisturizer and massage gently on tights, belly, and chests twice daily, morning and night. It helps to reduce skin tension and increase the elasticity of epidermis and dermis. It also helps reduce the opportunity of stretch marks development by stretching the skin further. Besides, applying lotion and massage helps to moisturize the skin depending on the skin condition, and carry out the touch stimulation and fetal education at the same time.

Clothes

• Choose loose and sweat-absorbent materials to keep yourself comfortable and clean.
• Wear low heeled and slip-resistant shoes to prevent falls.
• Wear a bra to support and protect the breasts. 

Rest and sleep 

• Sleep at least 8 hours daily, and it would be ideal to have a 30-minutes nap during noontime.
• Pay attention to the physical and mental conditions during the day and take short breaks.
• It is better to sleep sideways toward the final stage of pregnancy. Elevate your feet when resting to help improve blood circulation for the lower limbs and reduce swelling.

Exercise

• Avoid climbing or lifting heavy loads.
• It is safe to attend to most of the household activities but refrain from any work that makes you tried.
• Walking is the best exercise, and you may do some prenatal exercises according to the medical professional's evaluation and guidance.

Sex

• Generally, it is safe to have sex during pregnancy. But if a pregnant mum has a history of going into premature labor or miscarriage, it's better not to have sex during the first three months and the last two months.
• If there is cervical incompetence, a placenta previa, or vaginal bleeding and labor pains before full-term, sex should be prohibited.During sexual activity, if the pregnant woman shows a strong uterine contraction, abnormal bleeding, severe abdominal pain, etc., the couple should stop having sex and go to see a doctor immediately.

Urination and Bowel Movement

• It is better to have a daily bowel movement.
• Do not hold the urine. Go as necessary and do not decrease water intake.
• Eat more vegetables and fruits and drink more water to regulate bowel movement.

Oral Hygiene

• It is recommended that women should receive oral health treatments before pregnancy. Develop good oral hygiene routine during pregnancy, including brushing teeth before bed, Brush your teeth at least twice daily with fluoridated toothpaste, eating less sugary food or snacks, and rinse the mouth often to protect your teeth from any damage. Get regular dental check-ups with your health care at a dental hospital. Use dental floss (toothpick) or interdental brush at least once a day to clean the gaps between teeth. Do not share toothbrushes. Visit a dentist if there is any discomfort.
• Why do pregnant women have a higher incidence of dental decay? Does gum health worsen? Pregnancy causes changes in hormones and eating habits that may cause tooth decay or gum diseases to worsen. Therefore, regular dental health check-ups are very important. It recommends having your routine dental check-ups at dental hospitals every three months during pregnancy (say 12th week, 24th week, and 36th week).

Shower and Bath

• Avoid hot springs during pregnancy.
• Take showers instead of baths, especially during the last two months.
• The volume of vaginal discharge increases, and it will be good to keep the perineum clean and dry.

Environmental and work exposures

Risks from some workplaces might affect the health of developing fetuses. Therefore, pregnant mums should understand how to prevent danger in the workplace. Should there be any potentially hazardous substances and exposures at work, please consult your doctor.

According to the International Agency for Research on Cancer (IARC) under WHO, cigarette smoking and second-hand smoke are level 1 carcinogens. If you smoke, please quit now.

Women who smoke or inhale second-hand smoke during pregnancy tend to have a high concentration of nicotine or nicotine metabolites such as cotinine residues in their bodies. Growing in the wombs of mothers who smoke will pose negative impacts on the baby's nervous and digestive systems as well as vision developments at various degrees. It increases the risk of miscarriage, birth defect, premature or low birth weight. And these children will be at higher risk of developing leukemia when they grow up.

If the parents are used to smoking indoors or next to their baby, the concentration of nicotine in the baby will be nearly 50 times higher than that of a non-smoker's baby. And even if the parents only smoke at the balcony, the nicotine concentration in their baby is still seven times higher than that of a non-smoking parents' baby.

Smoking or secondhand smoke will not only increase the lead concentration in blood in pregnant women but also pass it through the placenta to the fetus, affecting the fetus's brain development. Nicotine, on the other hand, causes damage to the "neurotransmitter" in the fetus' developing ears, causing hearing problem in children.

Besides, there is a threat of third-handed smoke. The research confirms smoking at home causes high concentration residues of toxic substances in the home, even if it’s a long-extinguished cigarette. These substances will stay in the home in the form of particles that clings on a variety of surfaces (such as furniture like table and chairs, floor, wall, kitchen, bathtub, toilet, etc.). They also can be attached to dust or become volatile toxic compounds that drift into the air after days, weeks, and months. Even if the smoker does not smoke in front of the child, the toxic particles of third-hand smoke will remain for a long time. Hence the person who is in and out of the space exposes to the smoke as well. These substances contain at least 11 highly carcinogenic compounds that cause cognitive impairment in children and increase the risk of asthma, otitis media, and leukemia.

Regardless of the amount of alcohol consumed, it increases the risk of getting cancer, and that has confirmed by the Committee on Carcinogenicity (CoC). During pregnancy, no matter how much alcohol you drink, you are putting your health at risk. In addition to causing pregnancy bleeding and miscarriage, uterine and vaginal infections, habitual abortion, placental abruption, and stillbirth, excessive alcohol also affects the growth of the fetus in the womb.  

Heavy drinking during pregnancy is associated with Fetal Alcohol Syndrome (FAS), a disorder which occurs in infants. Babies with FAS have:

• Low birth weight.
• Diminished growth.
• Poor fine motor coordination skills.
• Low IQ.
• Behavioural problems.
• An increased risk of Attention Deficit Hyperactivity Disorder (ADHD).

Your doctor or specialist should know if your child has FAS through a series of physical examinations. There is currently no medical treatment for this disease, and the management of FAS lies in special education programmes and behaviour therapy for the child.

FAS is a tragic but preventable disorder. It can be avoided if you don't consume any alcohol at all – while you're pregnant or even if you are trying to get pregnant. If you think you may have an alcohol addiction, then you may want to think about getting help.

Interestingly, women who are expecting often lose their taste for alcohol, so giving up might be easy even for regular drinkers. However, if you are still struggling to get your alcohol intake down to zero, here are some practical tips which may help you during pregnancy.

• Opt for a mocktail
• Drink juice when you are out partying
• Invite your friends to your home rather than going out
• If your other half enjoys a drink after work, ask him to switch to a non-alcoholic beverage so that you can join in as well
   

Reference: HealthHub

1. 1. Importance of safe use of medicines before and during pregnancy
      
      Improper use of medicines may also lead to premature babies, underweight babies, and stillborn births, and in less desirable cases teratogenicity and birth defects. However, in patients with existing medical condition, premature withdrawal or negligence of due medical treatment may result in long-term complications on both the mother and the baby. Pregnant women should always seek medical advice prior to consume or discontinue any medications.
      
      If you are trying to get pregnant soon, ask your doctor or pharmacist's advice before taking any medication and do not arbitrarily use drugs or take herbal or folk remedies unnecessarily.
      
      If you have taken any medication, including prescription or over the counter drugs or dietary supplements when you are or might be pregnant or you may have gotten pregnant as no contraceptive method used, please tell your doctor or pharmacist.
       

   2. Medicines that can be used during pregnancy
      
      The following list of medicines appeared to have no known harmful side effects during pregnancy when taken according to instructions. Note that no drug can be considered 100% safe to use during pregnancy. Always consult a doctor or pharmacist before taking any medications, especially in the first trimester.
      

   3. Alternative therapies for morning sickness symptoms
      

   4. Medicines that should be avoided in pregnancy
       

   5.  Alternative therapies that should be avoided in pregnancy
      

Pregnant women are advised to seek doctors' or pharmacists' advice before starting on any supplements.  

Reference: National Healthcare Group Pharmacy

• Suspected pregnant woman or expectant mums should avoid dyeing or perming hair, or the use of nail polish, polish remover or other nail art products.
   
• Do not use makeup or skincare products with unknown origins, unclear labels, or have excessive exaggerated effect claims.
   
• During pregnancy, acne may occur due to the change in hormone levels. Try to simplify the make-up and skincare regimen, and use topical acne products to help treat acne. Besides, light make-up, instead of the strong one, is recommended.
   
• Try not to use makeup products with excessive colors, strong fragrances, or complicated ingredients during pregnancy.

• During pregnancy, it is easy to have spots on your face, and the color of any original spots will also darken. At this time, you should protect yourself from the sun using appropriate measures and supplement them with sunblock. Also, you can use normal whitening skincare products in moderation. However, a three-in-one spot removing cream (retinol + hydroquinone + steroid) is not suitable for use during pregnancy.
   
• During pregnancy, the skin gets dry and itchy easily, and rashes may occur. Besides wearing breathable loose clothes, staying in cool places, and applying only mild shower products, you should also go to a dermatologist as soon as possible if conditions are severe, and take proper medication according to the doctors' prescription.
   
• Women can use products that contain alpha-hydroxy acid and salicylic acid during pregnancy. However, chemical peels with high concentrations do not recommend.
   
• During pregnancy, it suggests avoiding performing any non-urgent aesthetic treatment (laser, intense pulse light, radio-frequency resurfacing or photo facial), or plastic surgery (including micro-plastic surgery) as they may expose you to unnecessary risks.
   
• Mothers with keloid should discuss their conditions with doctors before giving birth so that the doctors may choose an appropriate approach to avoid visible scars.

A common question, especially for first time parents, is “What do I need to pack for the hospital?”

Do not be daunted by the huge size of this suggested list — you do not have to bring all the things that are listed here.

The idea here is to have a comprehensive list that you can pick and choose from. This enables you to customise your own list of the things so that you can feel comfortable at the end of the day.

Here are some suggestions:​

1. For Mom

Toiletries: 

• ​​Lotion 

• Toothbrush and toothpaste 

• Hairbrush/comb 

• Shampoo/soap 

• Towel/facecloth 

Clothing (You will be wearing a hospital gown during your delivery) 

• Two loose-fit nighties — preferably the breastfeeding kind (if you are not keen to use the hospital gown which are made for breastfeeding) 

• A pair of slippers​ 

• A few underwear items

• Socks 

• Nursing bra 

• Clothing to wear upon discharge from the hospital 

Birth plan: 

• if you do have one
   

2. For Your Partner: 

• Some reading material when your spouse is sleeping or resting 

• Toiletries 

• Change of clothes 

• Sweater 
   

3. For Baby: 

• One baby outfit upon discharge 

• Receiving blanket 

• One pair of socks or booties 

• One pair of mittens 

• Cap 
  

After Delivery: 

• Name list of people to call once baby arrives. You will inevitably forget to call someone. 

• Digital camera/camcorder — to capture all those precious moments. 
   

Do Not Bring: 

• ​Valuables

• Jewelry 

• Laptop computer 

What documents should I bring along? 

In addition to the above-mentioned items, you should bring along your outpatient appointment booklet, identity cards of both mum and dad, marriage certificate and admission form.

Reference: HealthHub

Pregnancy and childbirth are parts of the natural biological process. Uterine contractions will cause pain or back ache. The contractions make the uterus soft and expand. Therefore, they are also a normal biological change, which signals the baby is about to leave the uterus and will arrive in the outside world soon. The pain brings discomfort and may cause fear to those who are not familiar with the contractions. The contraction is an indicator of vaginal delivery. It causes the cervix to thin and dilate and helps the baby to descend into the birth canal. Don't panic over the labour pains as they are part of the labouring process, and there are many ways to help you manage the pain. Keep your mind relaxed by staying calm and thinking positively. Let your body guide you through the labouring process so that your muscles will relax and have a smooth delivery.

The cervix dilates gradually, and the baby turns gradually out of the uterus. The length of the labor process depends on the number of births the mother has given, the time separation from the previous birth, the emotional condition, the fetal position, the size and shape of the pelvis, and uterine contractions. Therefore, labour may take a while. Typically, it takes 12 to 18 hours of labour for the first child and approximately 8 to 10 hours for the second one. Patience is required. In recent years, expectant mothers have better nutrition status, they tend to exercise less often and their babies are relatively large, delivery may be prolonged, which will require the expectant parents to be more patient. The expectant parents should start receiving prenatal education a few months before the due date to understand the changes during labour, ways of relieving pain naturally, and the different types of pain relievers. It won’t be as effective to learn about pain management techniques after the contraction starts.

The following are the basic ways of relieving pains and discomfort during labour.
 

• Maintaining a healthy body and mind: keep nutrition in balance, stay fit and happy.

• Face the fear before childbirth: Understand your fear and get to know the information related to childbirth. Learn to deal with fear surrounding childbirth and to prepare yourself mentally in a more positive way.
   
• Be fully prepared before labour: Fully understand the pre-delivery and labour process. Expectant mothers should learn various techniques to help yourself relax, prepare your favourite music, and make the right decisions that will put you at ease. You should also choose and communicate with  your companion during labour that meets your expectations and with the companion learn the proper ways to massage and touch your body.
   
• Responses during labour: Expectant mothers should believe that you are capable of giving birth and accept that it takes a while to go through the process. Try to relax your body and let the contractions start naturally. You may use various approaches to ease the pain and move freely before going into labour or choose positions that make yourself feel comfortable. You should have consistent supporter or companionship. During the second part of the labour process, you should not lie flat, but feel your body and push voluntarily.