Pregnancy: a physiology not pathology
Reproduction is one of the basic characteristics of living things. It is the process in which the living beings produce off-springs. Pregnancy is the time period since the male sperm and female egg mate producing a zygote to the birth of the new off-spring. This time period varies from species to species. In medical terms gestational period is often used to describe this time period. In human beings this time is 40 weeks ideally but commonly one or two weeks plus or minus.
Pregnancy is such an state in which the female keeps another living being within her and the requirements of that new conception are fulfilled through the mother thus making lots of changes in her body physically and functionally. Despite this all the changes occurring in body are within physiological range usually thus making pregnancy a physiological process. If certain things go out of the normal range it means that pathology has occurred in that system but yet we cant label the whole process of pregnancy as a pathology.
Almost every system is affected in pregnancy and a know how regarding that is necessary so as to differentiate between the normal and abnormal. First of all if we see through this journey as a whole the most prominent change which is evident to every one is the weight gain and a bump of abdomen. Actually the uterus is the organ which provides accommodation, protection, nutritive and growing environment to the conceptus. The walls of uterus have a thick layer of elastic tissue which help it to expand to such an extent that a fetus can survive in it. As the uterus expands giving the fetus place to live and grow it causes the abdomen to expand as well causing a prominent forward bulge of the tommy. Average weight gain within pregnancy is about 9-12kg. These both things cause many postural changes in female body making back aches common complaint. To take care of posture and exercises can help relieve this problem. The point here is that neither too much exercise nor total lack of physical work should be promoted.
There is a misconception that the pregnancy means complete bed rest however it is not true. Complete sedentary life style during pregnancy leads to complications in normal labour leading to cesarian section. Probably the increased number of cesarian sections is due to the above mentioned cause. On the other hand few people especially having the life below average socio-economic status keep an extra burden of physical work on the lady in family way which causes negative effects on the lady as well as the fetus. Hence a balance between the the two things is quite necessary.
Important concern of pregnancy is to nurse the lady while she is on her back means the supine position or she is lying in lateral position. Answer is that she should be nursed on her lateral side and the supine position should be avoided. The logical reason behind is the pressure exerted by the gravid uterus on the inferior vena cava in supine position which causes decreased blood flow to the uterus and placenta compromising fetus. This pressure can be avoided when patient lies on her side instead of lying straight on the back.
Pregnancy is associated with nausea and vomiting being more pronounced in the first three months of pregnancy but in few cases it can be for whole of the duration. If prolonged It may result in decreased food intake, decreased energy levels, discomfort and finally lack of proper nutritious requirements for baby and mama. Consultation of doctor is necessary in such cases to avoid possible complications related to excessive vomiting.
There is increased estrogen and progesterone levels and release of oxytocin levels. Estrogen promotes maternal blood flow . Progesterone causes laxity of the ligaments which can also make the female prone to sprains and strains. Oxytocin is the hormone responsible for the initiation and progression of the labor as well as helps in breast feeding.
Pregnancy is a hypercoaguble state that actually is a protective measure of the body for preparation of hemostasis during and after delivery. In this state the blood has more tendency to coagulate which can lead to venous thrombosis especially of lower legs. To avoid this complication average amount of exercise and avoiding to keep the legs hanging still for long is required.
Other changes which are usually encountered are reduced cardiac output, increased respiratory rate, increased insulin resistance,iodine deficiency and decreased blood pressure along with o long list including each organ and organ system. But the good news is that in an uncomplicated pregnancy all of these changes resolve with minimal residual effect making pregnancy a physiological phenomenon rather than a pathology so instead of getting worried feel positive and enjoy the journey of motherhood. As soon as you will get the baby the changes of the body will begun to reverse back making you a smarter and healthier mum soon.
dr saadia hafeez