The idea that pregnant women first of all need to rebuild their nutrition has firmly entered the minds of every woman, especially mothers and mothers-in-law are zealous in this: now there are two of you, you need to eat for two. The first thing I would like to start discussing the topic of "menus for pregnant women" is a strict and categorical statement: there is no need to eat for two.

And in general, changing a woman's diet during pregnancy is an important matter, but this must be done, like everything else during this period, with caution. In fact, if a woman has adhered to the principles of healthy eating before, then she will not have to seriously change her diet.

Separately, I would like to say about those women who, before pregnancy, were actively engaged in their figure: they went to fitness, went on a diet, took a variety of dietary supplements. They will need to turn to a nutritionist for drawing up a menu for pregnant women, since it is simply impossible to predict the reaction of an organism, accustomed to stress and restriction of nutrition, to a sharp change in diet.

When compiling an approximate menu for a pregnant woman, you must take it into account. calorie content, as well as the content of proteins, fats and carbohydrates. The ratio between these three components and in normal times is the basis of proper nutrition, but even during pregnancy, it is absolutely impossible to turn a blind eye to it.

Protein are known to be the main material for the construction of cells, tissues and organs. Therefore, they are especially necessary during pregnancy: it is from proteins that the baby's body will be "built".

Carbohydrates- this is the main source of human energy, and without them any activity is simply unthinkable. A lack of carbohydrates leads to increased fatigue. In addition, it is carbohydrates that form a person's feeling of satiety.

Fats are also used as a source of energy, in addition, they contribute to the absorption of certain vitamins and minerals. Fat is the most nutritious component of food, so it should be consumed with caution.

The menu for a pregnant woman should be 30% fat, 20% protein and 50% carbohydrate. Separately, you need to remember that carbohydrates are simple (sugars) and complex. Simple carbohydrates are very quickly broken down into components, including glucose, which immediately enters the bloodstream. Moreover, during pregnancy, sugars are broken down faster than usual, which provokes an abrupt change in blood glucose levels.

The increase in glucose levels in turn triggers the release of insulin, which is produced in the pancreas. Frequent and sharp surges in glucose seriously increase the load on the pancreas.

Please note that all of the above applies to both the mother and her unborn child. As a result of such loads, the expectant mother may develop, and the baby may become overweight. Both will seriously complicate the delivery process. Diabetes, in most cases, goes away after childbirth, but the complications caused by it can stay with you forever.

Thus, sweets and flour, the main source of sugars, must be abandoned almost completely. Whole grain cereals and vegetables should take their place. The calorie intake of pregnant women and their menu should be 2000-2500 kcal.

Features of nutrition of a pregnant woman

What rules must be followed when drawing up a menu for a pregnant woman? Almost all of them, as already mentioned, are comparable to those that we know from a balanced diet.

First of all, it is worth adhering to the principle of fractional nutrition: that is, to eat not standard 3 times a day, as we were taught earlier, but at least 5-6 times a day. Of course, the portions should be smaller than in the case of three meals a day. This approach will eliminate the feeling of hunger, which means gaining excess weight.

All vegetables are best consumed fresh... Thermal treatment is not excluded, of course, but most of the nutrients are lost. It is also worth realizing that freshly prepared food is always healthier and tastier than the one that was in the refrigerator and was warmed up.

The last rule is difficult to fulfill in the modern rhythm of life: a woman can hardly prepare herself fresh food while at work. But at least on weekends and holidays, it makes sense to allow yourself to eat fresh food.

For pregnant women, more than for someone else, the need to eat with feeling, sense and consistency, and not on the go, as is now customary, is relevant. Food should be chewed thoroughly.

What should a pregnant woman eat? First of all, vegetables and fruits, almost any. Salads, cold cuts, stewed vegetables, vegetable soups - all this will be appropriate in your "pregnant menu".

You can not refuse from animal food. For the unborn child, they are simply vital animal squirrels... So meat, fish, dairy products should also be present in your diet. Of course, they shouldn't be too greasy.

You can't do without, of course, a variety of cereals. Especially those made from whole grains. They are unusually rich in carbohydrates and micronutrients. Unfortunately, they cook much longer than flakes or crushed cereals. To speed up the cooking process, you can soak the cereal before cooking overnight.

Fasting days for pregnant women

A menu for overweight pregnant women and those who gain weight during pregnancy is a separate topic. In the conventional sense, it is impossible to lose weight and diet during pregnancy. And I want to stay in shape, and for pregnancy, excess weight will not be a plus. How can you solve this problem without harming your health and the health of your baby?

The ideal option would be to introduce fasting days for pregnant women into your diet. The menu on such days, of course, is not very diverse and nutritious, however, it does not harm the health of the mother and baby either. Of course, if they are carried out wisely and without exaggeration.

Experts recommend carrying out such fasting days every 10 days. Please note that there are contraindications for fasting days. Therefore, be sure to consult with your doctor about whether you need to carry out "unloading" and how useful it will be.

There are three different options for fasting days for pregnant women:

• kefir - 1.5 liters of kefir per day;
• apple - 1.5 apples per day;
• cottage cheese - 600 fat-free cottage cheese and tea without sugar: 2 glasses.

Absolutely no!

It's time to talk about what it is categorically impossible to eat for pregnant women. When composing a diet during pregnancy, keep in mind that the menu for the day should be completely free of coffee, chocolate, smoked meats, fatty foods, pickles, and so on. Ideally, a woman's diet should not contain food containing chemical preservatives and dyes, flavor enhancers, and the like. The latter, unfortunately, is difficult to implement, but it is still worth striving for.

Under the strictest prohibition is alcohol... And not only because of the harmful effects of directly alcohol-containing. Wine raises blood pressure and beer increases kidney strain.

Separately, it is worth talking about allergens... These traditionally include chocolate, citrus fruits, strawberries, nuts, seafood, and various exotic products. All pregnant women should avoid these foods. If a woman or her relatives have an identified allergy, then those allergens that cause a reaction in them should also be discarded.

Reading such lists, women are often discouraged: it turns out that practically nothing is allowed for pregnant women. But, firstly, this is not at all the case, women can do very, very much, all of this is listed above. And secondly, remember one little trick: everything listed above, except, perhaps, alcohol, categorically cannot be consumed systematically, and a single use of any product simply physically cannot have a detrimental effect on the development of the fetus. So sometimes, rarely and very little, you can still afford your favorite dish.

It also happens that a pregnant woman, especially in the early stages, is drawn to various strange dishes, including those that are not recommended. So the question arises: what to do?

It makes sense to listen to the wishes of your body, but it is far from always necessary to fulfill them literally. It is better to think about why a woman is drawn to this particular product. As an example, you can understand the craving for pickles, since it has long been included in all the jokes. Salt retains water in the body, so maybe it is in the water that your body needs?

How to prepare meals for pregnant women?

Menus and meals for pregnant women should not only be made from the right products, but also properly prepared. Best to steam or bake in the oven... These two methods of preparation ensure the preservation of the greatest amount of nutrients.

In second place is cooking and stewing... This is a more aggressive treatment, but still quite acceptable for pregnant women. Moreover, both methods allow you to prepare a lot of delicious dishes.

Subject to certain rules, a pregnant woman can afford to use and fried food... In order to preserve as many useful substances as possible, and at the same time not to get harmful ones, it is necessary to follow certain rules. In particular, the food should be chopped as small as possible and fried quickly - within 3-4 minutes.

An example of a day menu for pregnant women

If you wish, you can make yourself a menu for pregnant women for a week or for every day. This is relevant if you doubt that you can immediately get used to a new diet. But, as a rule, you need it only for the first month, maximum two. Then the woman will probably get used to the maternity menu.

But it makes sense to divide the menu for a pregnant woman by trimester. Indeed, at different times, a woman needs a different amount of nutrients. As an example, we will give one menu per day for different trimesters. Based on these menus and explanations to them, you can create a menu for yourself.

Folic acid (vitamin B9) is considered one of the main vitamins for a pregnant woman. Folic acid deficiency can cause early birth or mental underdevelopment of the fetus. On the other hand, B9 prevents anemia in the expectant mother and her child, and is responsible for the normal condition of the skin and mucous membranes.

Therefore, in the diet of pregnant women, especially in the first half of pregnancy, fish, meat, raw vegetables and fruits, and dairy products must be present.

NB! Folic acid is destroyed during heat treatment, but it is better preserved in meat products and milk.

It is very difficult to maintain a healthy diet when the body refuses to accept even the most ordinary foods - it is not up to it now, it is fighting nausea and dizziness.

In these first weeks of pregnancy, the need for salty, spicy, etc. can be satisfied (of course, within reasonable limits) without damage to health.

In the fight against toxicosis, only natural, natural remedies are good. No medicine! Only the right foods and diet. It is recommended to consume the most easily digestible foods. In the morning, while still in bed, you can eat light yogurt or an apple.

A person is being formed at full speed. He really expects his mother to help him with building materials! Among the most important substances now are calcium and phosphorus. They are found in the most optimal ratio in milk and dairy products.

7-8 weeks.

Pregnant women are nowhere without milk, because pure milk is calcium, phosphorus, folic acid and other B vitamins, vitamin E, fluoride, complete protein, animal fats.

Moreover, it is in milk that calcium and phosphorus are contained in that ideal ratio of 2: 1, in which both elements are best absorbed. Unfortunately, not all people can consume milk due to the fact that their body lacks an enzyme responsible for the absorption of milk and dairy products. Kefir and live yogurt combine all the best properties of milk, multiplied by the ease of assimilation by the body.

10 week.

Iron is part of hemoglobin and ensures the normal process of hematopoiesis. What both mom and child need now! Iron from animal products is best absorbed. There is especially a lot of iron in cottage cheese. Calcium and fluoride will help your baby's teeth develop. Fluoride is found in meat, fish, milk, herbs, and fruits.

11 week.

Zinc is responsible for the development of the organs of smell and taste, the reproductive system and hematopoiesis. Most zinc is found in cheese, seafood, meats, legumes, and nuts. Strengthens the immune system, helps the process of hematopoiesis in the mother's body and the work of her heart muscle vitamin E. Vegetable oils, wheat germ, soybeans, broccoli, Brussels sprouts, leafy greens, spinach, whole grains, eggs.

12 week.

The risk of premature rupture of the placenta is significantly reduced with an increase in dietary intake of vitamins C and E. Iodine is necessary for the normal functioning of the thyroid gland. With hypofunction of the thyroid gland, growth retardation is observed due to inhibition of metabolism. The main source of iodine is seafood.

13 week.

During the first trimester, the expectant mother is unlikely to gain more than 1-3 kg in weight. But from this week on, you will have to closely monitor your weight and, of course, your diet. "To overdrive" or "not to pick up" is equally harmful. And this is the main problem for the next three trimesters.

If in the first trimester, when drawing up her daily diet, the expectant mother constantly had to take into account the hormonal vagaries of her body and fight toxicosis with all her might, then starting from the second trimester the situation will change somewhat.

The two main reasons for the deterioration of digestion during pregnancy are dysbiosis and compression of the abdominal organs due to an increase in the volume of the uterus. In the event of constipation, in no case should laxatives be used. This problem should only be solved with diet.

Fresh, stewed, baked vegetables and fruits and herbs will become especially relevant. Eating 30 grams (2 teaspoons) of bran daily will help the intestines to get rid of all the excess.

Already now you should start switching to a new diet. If in the first trimester it was possible to maintain four meals a day, then from the second trimester to the end of pregnancy, you need to eat more often, but in smaller portions.

FOOD FOR PREGNANT WOMEN

What are the basic principles of a healthy diet for a pregnant woman?

Rational nutrition contributes to the normal development of pregnancy, the fetus, and is also the prevention of the development of large fetuses, which significantly complicate the course of pregnancy, childbirth, the postpartum period, neonatal and postnatal development of newborns.

In the first half of pregnancy, no special diet is required. The food should be varied, containing a sufficient amount of proteins, carbohydrates, fats, salts and vitamins. In the first months of pregnancy, spicy and salty dishes are not excluded, if necessary, in the second half, predominantly dairy-plant foods are recommended. Meat and fish should be eaten 3-4 times a week. Spicy and spicy foods are prohibited, carbohydrates, flour products, starch and liquids are reasonably limited.

What amount of proteins, fats, carbohydrates and microelements should be in the daily diet of a pregnant woman?

The amount of proteins and fats is introduced into the daily diet at the rate of 1.5-2 g per 1 kg of a woman's body weight. Carbohydrates, as the main energy material and a source of fat formation, should be no more than 500 g per day (with obesity, the amount of carbohydrates decreases to 300-400 g per day). For the prevention of late toxicosis of pregnant women, table salt in the second half of pregnancy should be limited to 5 g per day, liquid up to 1-1.2 lava in the last weeks - up to 0.8 liters per day. The amount of trace elements, sources of which are milk, cottage cheese, eggs, liver, meat, bread, nuts, buckwheat and barley groats, beets, peas, in the second half of pregnancy should be: calcium - 1.5-2 g, phosphorus - 2 g, magnesium - 0.5 g, iron - 15-20 mg per day.

What is the importance of vitamins for a pregnant woman?

In the diet of a pregnant woman, vitamins are especially necessary, which are part of a number of enzymes and perform the function of catalysts for metabolic processes in the body. In case of a lack of vitamins entering the body of a pregnant woman with products of dairy and vegetable origin, ready-made dosage forms should be prescribed.

What is the value and daily requirement of vitamins A, PP, C, E for a pregnant woman?

Vitamin A (carotene) affects the uterine mucosa, promotes its regeneration, which is especially important in the postpartum period. The daily dose is 5000 ME, in the last months of pregnancy - 10,000-20,000 ME.

Vitamin PP (nicotinic acid) is involved in the metabolism of sex hormones, in small concentrations it has a depressing effect on the contractile function of the pregnant uterus. The daily dose is 18-25 mg.

Vitamin C (ascorbic acid) is a powerful catalyst of redox processes in the body, potentiates the action of estrogens, enhances the effect of pituitrin and mammophysin on uterine contraction. The daily dose is 100-200 mg.

Vitamin C is involved in the regulation of calcium and phosphorus metabolism, is used in obstetric practice for the prevention of rickets in the fetus. The daily dose is 1000 ME.

Vitamin E (tocopherol) plays an important role in the normal course of pregnancy (fertility vitamin), its lack leads to dysfunction of the genitals, sometimes to fetal death and miscarriage. The daily dose is 20-25 mg.

What is the value and daily requirement of B vitamins for a pregnant woman?

Vitamin Bj (thiamine) is involved in the regulation of estrogenic hormone metabolism, the synthesis of acetylcholine, promotes proper metabolism in the nervous system, liver, and regulates water-salt metabolism. The daily dose is 10-20 mg.

Vitamin B2 (riboflavin) contributes to the normal course of pregnancy and childbirth, is used to prevent threatening abortion, and enhances redox processes in the body. The daily dose is 2-3 mg.

Vitamin B6 (pyridoxine) is essential for the exchange of essential amino acids (histamine and tryptophan). The daily dose is 5 mg.

Vitamin B12 (cyanocobalamin) is effective in treating anemia caused by diseases of the gastrointestinal tract and liver, enhances the release of growth hormone. It is used for fetal malnutrition. The daily dose is 0.003 mg.

Chapter 10. Care of pregnant women, women in labor, parturient women and gynecological patients (A. L. Kaplan, V. I. Kulakov)

Pregnancy

Pregnancy- the period during which a fertilized egg develops. This process is accompanied by a variety of changes throughout the woman's body. The main condition for the normal course of pregnancy and the prevention of possible complications is adherence to a rational regimen. During pregnancy, they carry out all the hygiene measures that are mandatory for a woman, but with some changes and additions in each individual case.

Bandage it is used from VI-VII months of pregnancy to maintain the abdomen, prevent the divergence of the fibers of the deep layers of the skin and the appearance of pregnancy scars, a significant divergence of the rectus abdominis muscles. Put on and lace up the bandage, be sure to lie on your back; it should not squeeze the stomach too much. As the volume of the abdomen increases, the lacing needs to be adjusted. A bandage matched to the size and volume of the waist is recommended to be worn after childbirth to prevent sagging of the abdominal wall; it helps to maintain the correct position of the internal organs, to prevent their prolapse. Elastic bands that hold the stockings are attached to the bandage.

Varicose veins peripheral veins are observed in pregnant women mainly on the legs, less often on the external genitals and in the vagina. The reasons are pathological changes in the walls of the veins, damage to the venous valves, and sometimes their disappearance. In case of varicose veins in the legs, it is necessary to bandage the leg with an elastic bandage in the direction from the foot up the lower leg, and if necessary, then further along the thigh, or use a special elastic stocking.

Weighing allows you to timely notice the retention of fluid in the body of a pregnant woman; weighing is carried out at each visit of a pregnant antenatal clinic or feldsher-obstetric station, at least 1 time per month in the first half and every 2 weeks (at least) in the second half of pregnancy. A woman should be weighed naked, leaving only her shirt on; the pregnant woman must first urinate; on the day of weighing, a pregnant woman should have a chair (on her own or after an enema). In the first weeks of a normal pregnancy, body weight does not increase, and sometimes even slightly decreases, especially with nausea and vomiting. From the 16th week of pregnancy, there is an increase in body weight; from the 23-24th week, the increase weekly reaches 200 g, and from the 29th week it does not exceed 300-350 g; a week before childbirth, body weight usually decreases by 1 kg, which is associated with the loss of fluid in the tissues. Throughout pregnancy, a woman's body weight increases by 10 kg (mainly due to the weight of the fetus, amniotic fluid and placenta).

Listening to the fetal heartbeat(auscultation) is performed with an obstetric stethoscope. The heartbeat can be heard starting from the end of the V lunar month of pregnancy (20 weeks), but with an increase in the gestational age, the heartbeat is heard more and more clearly. It is better heard closer to the head and from the side where the fetal back is facing: in the head presentation - below the navel, in the pelvic presentation - above the navel, in the transverse position of the fetus - at the level of the navel on the right or left, closer to the head. The fetal heart rate at the end of pregnancy usually corresponds to 120-140 per minute. Fetal heartbeat is more accurately and earlier determined using electrocardiography and electrophonocardiography of the fetus.

Miscarriage- early termination of pregnancy (up to 28 weeks). Predisposing factors: general diseases of the pregnant woman, diseases and anomalies in the development of the ovum, insufficient function of the ovaries (corpus luteum) and other disorders of the nervous and endocrine nature; the possibility of early termination of pregnancy as a result of injury (fall, bruises) is not excluded. However, trauma usually leads to miscarriage in women who have predisposing conditions. Ordinary domestic injuries in themselves are rarely accompanied by abnormal pregnancy. A miscarriage without any intervention is called spontaneous, spontaneous, in contrast to an artificial miscarriage caused by various interventions; carried out outside a medical institution - an out-of-hospital miscarriage. With spontaneous threatened miscarriage the pregnant woman complains of small, sometimes cramping pain in the lower abdomen; bloody discharge is absent. Particular attention should be paid to such complaints from women who have had spontaneous miscarriages in their history. Rest, stationary regime, complete abstinence from sexual activity for a more or less long period, the use of progesterone can sometimes preserve the pregnancy. As an antiplasmic agent, suppositories with papaverine are prescribed at 0.02-0.03 g twice a day; no-shpu, vitamin E, 1 teaspoon 2 times a day. At incipient miscarriage along with cramping pains in the lower abdomen, there are also minor spotting, which indicates the onset of detachment of the ovum. At this stage, miscarriage is limited to bed rest (hospital, maternity hospital); sometimes further detachment is prevented and the pregnancy is maintained. To reduce the excitability of the muscles of the uterus, no-shpa, progesterone, suppositories with papaverine are prescribed. Do not apply ice to the lower abdomen - this enhances uterine contractions.

If the detachment of the ovum continues, bleeding intensifies, blood clots are released, that is, there is a progressive miscarriage, then in most cases it proceeds as incomplete miscarriage: part of the ovum leaves, and part of it lingers in the uterus. As a rule, such a patient is immediately sent to the hospital, where she is removed (scraped) the remains of the ovum; the remnants of the ovum lingering in the uterus prevent the uterus from contracting and support further bleeding.

Mention should be made of the so-called complete miscarriage... In this case, the ovum came out of the uterus, the bleeding stopped and the uterus contracted. However, small pieces of the placenta may remain in the uterine cavity, which will further lead to prolonged bloody discharge, the formation of so-called placental polyps. In such a case, it is necessary to check the curettage of the walls of the uterine cavity, the patient must be urgently hospitalized; in all cases of miscarriage, the patient should be urgently sent to the hospital.

Ectopic pregnancy, in most cases, tubal, in the first weeks almost does not manifest itself with characteristic symptoms. A woman with suspected ectopic pregnancy needs to be urgently hospitalized. A tubal pregnancy is diagnosed with ultrasound. Termination of a tubal pregnancy can proceed as a tubal abortion: a pregnant woman complains of cramping pains in the lower abdomen, pain on palpation of the abdomen, especially on the side of the pregnant tube due to irritation of the peritoneum; there are dark bloody, smearing discharge from the genitals. When a pregnant tube ruptures, a different picture is noted: the rupture of the tube in most cases is accompanied by shock and internal bleeding - the patient suddenly has acute pain in the lower abdomen, a short-term fainting occurs; there is a sharp pallor of the skin, the lips are pale, slightly cyanotic; pupils are dilated; the abdomen is slightly swollen and painful when touched; pulse is frequent, very weak filling; body temperature is normal, the patient complains of tinnitus, flickering in the eyes; in some cases, there is pain radiating to the shoulder and scapula. On palpation of the abdomen - a sharp soreness in the lower section, a symptom of Shchetkin is expressed; with percussion of the abdomen - muffling of the percussion sound in the iliac and above the bosom. The poured blood accumulated in the Douglas space protrudes the posterior fornix of the vagina - an extrauterine blood tumor. The presence of blood in the rectal-uterine cavity (Douglas space) is established by puncture through the posterior fornix. Only timely gluttony - removal of a ruptured tube or tube with a fertilized egg with simultaneous blood transfusion (during and after surgery) - saves the patient's life.

Prenatal care should be understood in a broad sense - as a woman's hygiene and at the same time as prenatal, so-called antenatal, protection of the health of the baby. It is wrong to talk about the hygiene of a pregnant woman in isolation from the hygiene of a woman before pregnancy, starting from her early childhood. The most favorable age for the first pregnancy in terms of the health of both the mother and her unborn child is 20-25 years. Too early onset of sexual activity and especially early pregnancy are unfavorable for both the mother and her unborn child. During the first intercourse, the hymen ruptures and bleeds. Sometimes this bleeding is significant and, in very rare cases, may require medical attention. After the first intercourse, you should take a break for 2-3 days. Sexual excesses adversely affect the state of the nervous system of both spouses. Sexual intercourse during pregnancy should be limited in the first 2 months and, if possible, excluded in the last month of pregnancy. Frequent sexual intercourse in the first months of pregnancy can lead to miscarriage, and in the last month, pathogenic microbes may enter the vagina, which threatens the danger of infection during childbirth. The body of a woman during pregnancy is the environment in which the fetus develops from the embryo. From this environment, the fetus extracts the nutrients necessary for its growth and development, and here it gives the final metabolic products formed in it. The body of a pregnant woman provides the growing fetus with the necessary nutrients and at the same time detoxifies and removes the final metabolic products of the fetus.

By sanitary work carried out in the antenatal clinic, at work, in the agro-industrial complex, the nurse makes sure that every pregnant woman attends a consultation, a paramedic and obstetric center from the first weeks of pregnancy, which makes it possible to timely identify a possible pathology. Pregnancy is a new qualitative state of the body, which during this period requires some changes and additions in carrying out hygienic measures. A healthy woman who follows a rational regimen that combines work with rest (see. Labor protection of pregnant women), eating normally (see. Nutrition for a pregnant woman), using enough fresh air, copes well with pregnancy. If the proper regimen is not observed, physiological pregnancy can imperceptibly acquire a pathological course. Careful observation of a woman from the first month of pregnancy can promptly identify certain deviations in her state of health, predict possible pathology during pregnancy and timely preventive and therapeutic measures to prevent pathology. This is what doctors, midwives and nurses who work in maternity hospitals and antenatal clinics in cities do, and in the countryside - midwives and nurses of feldsher-obstetric centers with periodic consultation with a doctor.

Gymnastics of a pregnant woman and physiopsychoprophylaxis improve the general condition of a woman, strengthen the nervous system, help prevent toxicosis, improve and facilitate the course of labor, promote a favorable course of childbirth and the postpartum period. Gymnastics strengthens the abdominal muscles and increases the elasticity of the pelvic floor muscles, which improves labor force during childbirth, prevents prolapse and prolapse of the internal genital organs. With the help of physical education, a woman learns to control breathing during childbirth; gymnastics helps to enhance oxidative processes in the body, which contributes to the normal development of the fetus. The combination of systematic physical education and psycho-preventive preparation of a pregnant woman for childbirth ensures a painless course of childbirth. Systematic control over the conduct of physiopsychoprophylaxis begins in the antenatal clinic, and after assimilation is further carried out at home by the pregnant woman herself. The method of psychoprophylaxis is based on the elimination of labor pains by positively affecting the higher parts of the central nervous system. The goal of physiopsychoprophylactic preparation for childbirth is to remove the psychogenic component of labor pain, to eliminate the idea of ​​the inevitability of labor pain, an oppressive feeling of fear. A woman is brought up to have a calm and active behavior during childbirth. Physical exercises and physiopsychoprophylactic preparation for childbirth are shown to all women. Healthy pregnant women can engage in physiopsychoprophylaxis on their own at home, and pregnant women with various diseases in the compensation stage are under the supervision of a doctor and a visiting nurse who monitors the well-being of the pregnant woman at each visit and brings this to the attention of the doctor.

Helminthic invasion negatively affects the condition of the pregnant woman (anemia, general malaise) and the fetus; can lead to pathological changes in the placenta, which, along with anemia, causes oxygen starvation of the fetus, termination of pregnancy. At the first visit to the consultation, the feces are examined for eggs of worms and, if necessary, they are treated.

Clinical examination- a method by which preventive medical examinations of the population are carried out to identify patients, register them, systematic observation and recovery.

Clinical examination of pregnant women is carried out by antenatal clinics at the place of residence, and in rural areas - by district and district hospitals and polyclinics. Consultations register all pregnant women in their area and provide systematic dispensary supervision for them. The most important task of the antenatal clinic is the early registration of all pregnant women and the detection of pregnancy complications (toxicosis, narrow pelvis, abnormal fetal position, bleeding, etc.), as well as diseases of internal organs (cardiovascular system, respiratory system, liver, kidneys, etc.) etc.). During pregnancy, a woman should visit a consultation 10-14 times (in the first half of pregnancy, once every 3 weeks, from the 20th to the 32nd week of pregnancy - 2 times a month, after the 32nd week - every 10 days, and necessary and more often).

Basic female consultation provides not only advisory and medical, but also methodological assistance to all polyclinic institutions, including medical and sanitary units.

Workshop obstetric and gynecological sections organized in the territorial basic antenatal clinics. The shop doctor - obstetrician-gynecologist gets the opportunity to systematically go to industrial enterprises, to state farms, to study the working conditions of women, to work in close contact with the administration, party and trade union activists.

Outgoing antenatal clinics- a modern form of service for women - workers in agricultural production. The task of these consultations includes a qualified examination by specialists of pregnant and gynecological patients, conducting the necessary laboratory tests for preventive examinations, dispensary observation of certain groups of gynecological patients, identifying and timely hospitalization of women with complicated pregnancy.

Teeth, oral cavity... Timely treatment of sick teeth and oral cavity in a pregnant woman is of particular importance, since foci of infection in the oral cavity are a source of constant infection and intoxication of the body and can cause infectious complications in childbirth and in the postpartum period. During pregnancy, in some women, there is a significant depletion of the body in calcium salts, which also affects the condition of the teeth, leading to their rapid destruction. In the antenatal clinic, all pregnant women must be examined by a dentist and carried out the necessary treatment.

Card file for pregnant women is conducted for the early and systematic identification of pregnant women and women in childbirth who do not appear in the consultation at the appointed time. The card file is available in the office of each district doctor and consists of the main medical document - individual cards of pregnant women (registration form No. 96). Pregnancy cards are placed in a special box according to the dates of the next appointment. Cards of pregnant women with any diseases or complications are marked with a colored flag, as these women need to be given special attention and be examined more often. The cards remaining in the card-index cell at the end of the working day signal about the pregnant women who did not show up for the appointment; the latter are subject to urgent patronage. A card file for gynecological patients is made up of control cards of patients undergoing dispensary observation (registration form No. 30). The cards are arranged according to diseases, and within the groups - according to the dates of the appointed attendance, which allows you to immediately identify the patient who did not appear at the appointed time and carry out the necessary patronage. The file is kept by a nurse and systematically checked by a doctor.

Blood... A clinical blood test is performed several times during pregnancy, especially in the second half of pregnancy; repeated blood tests make it possible to timely identify diseases that require special treatment. All pregnant women twice (in the first and second half of pregnancy) take blood from the cubital vein for serological examination (Wasserman, Sachs-Georgi reaction). Treatment of patients identified in this way is carried out in a venereal dispensary with the obligatory involvement of the father of the unborn child in the treatment.

In all patients, the blood group and Rh affiliation must be determined; with Rh-negative blood, the mother often has hemolytic disease of the newborn. If a pregnant woman detects Rh-negative blood, it is necessary to examine the blood of her husband. If the father has Rh-positive blood and the fetus has inherited the Rh-affiliation of the father, then with such a pregnancy, a Rh-conflict arises between the mother and the fetus: the fetus may die in utero, be born prematurely or with signs of hemolytic disease. To increase the resistance of the fetus to the harmful effects of Rh antibodies and improve placental circulation, all pregnant women with Rh-negative blood are treated with desensitizing treatment (at 12-14, 22-24, 32-34 weeks of pregnancy). Therapeutic and prophylactic measures are designed to create the most favorable conditions for the development of the fetus: food should be rich in proteins, vitamin C (up to 1 g per day during pregnancy with short interruptions).

Coombs' test is used to detect antibodies in the mother's blood. When antibodies appear in the mother's blood, the most severe forms of fetal disease occur long before childbirth. In about 30% of newborns from such mothers, hemolytic disease begins in the prenatal period.

Bleeding early in pregnancy cm. Miscarriage.

Bleeding in late pregnancy can be associated with placental abruption at the beginning of labor, with its low location in the uterus, or with placenta previa, if the placenta is located above the internal os of the uterus (while bleeding usually appears without any perceptible labor activity, without contractions), or is associated with premature detachment normally located in the uterus of the placenta (in this case, there are usually contractions). All women in labor with bleeding should be urgently hospitalized in the nearest hospital, accompanied by a nurse, or a doctor or a midwife is urgently called to them.

Mammary gland... During pregnancy, the mammary glands are prepared for the upcoming feeding of the child so that the mammary glands develop correctly, the nipples are strengthened and cracks do not form on them. Every day, with cleanly washed hands, it is necessary to wash the mammary glands with water at room temperature with soap (preferably baby) and wipe with a shaggy towel. With dry skin on the nipples, they should be lubricated with sterile petroleum jelly. With flat or inverted nipples, they perform a kind of gymnastics of the latter. To do this, the nurse thoroughly washes her hands (nails should be cut short), lightly sprinkles the fingers and nipples with sterile talcum powder, grasps the nipple at its base with two fingers and pulls it out in the direction from the areola to the top of the nipple with simultaneous light massage; this is done every day once or twice a day for 5 minutes. If the massage does not lead to the goal, it should be stopped and subsequently used when feeding the baby, if necessary, with a special pad. Air baths for the mammary glands are very useful for 15-20 minutes. It strengthens the nipple and skin; it is desirable to carry out air baths in the morning and in the evening.

Urine... During pregnancy, the kidneys function with great stress, since they remove metabolic products from the body of both the pregnant woman herself and the growing fetus. Therefore, the urine of a pregnant woman must be examined each time she visits an antenatal clinic. In the case of the appearance of protein in the urine, the pregnant woman is taken on a special account, and with an increase in protein, she is necessarily hospitalized.

Pregnant clothes should be comfortable, light and loose. You should not wear tightening belts, round garters, tight bras. Stockings should be held in place with long elastic bands attached to a belt or bandage. It is better for a pregnant woman to wear loose dresses or a sundress with straps so that the weight of the clothes falls on her shoulders. Cleanliness of clothing during pregnancy is especially important. Shoes should be comfortable and low-heeled.

A bra for a pregnant woman should be sewn from a coarse material or lined with canvas and not squeeze the mammary glands too much. This contributes to the coarsening of the skin of the nipples, which to a certain extent prepares them for feeding. The bottom edge of the bra should be at least 5-6 cm wide. The mammary glands in the bra should be slightly raised and moderately pressed. A bra of the same cut is recommended for women in childbirth. The bra with straps should be fastened in front so that it is convenient to expose the mammary glands when washing and feeding the baby. Bras should be kept clean, so keep several of them and change often.

Maternity and childcare leave granted for a duration of 56 calendar days before delivery and 56 calendar days after delivery with payment of state social insurance benefits for this period. In the case of a complicated course of pregnancy and childbirth or the birth of two or more children, leave after childbirth is granted for 70 calendar days. Since the duration of maternity leave is calculated in calendar days, this leave includes not only working days, but also weekends and holidays.

Postpartum leave calculated from the day of delivery, including the day of delivery. After childbirth, at the request of a woman, with a total length of service of at least one year, a partially paid leave is provided to care for a child until the child reaches the age of one year, with the payment of state social insurance benefits for these periods. Mothers enrolled in vocational and technical educational institutions, courses and schools for advanced training and personnel training are granted partially paid leave regardless of their length of service. In addition to these leaves, a woman, upon her application, is granted additional leave without pay to care for a child until the child reaches the age of one and a half years. Additional unpaid leave is counted towards the total and continuous length of service, as well as the length of service in the specialty and, in particular, the length of service that gives the right to annual leave. Before maternity leave or immediately after it, a woman, upon her application, is granted annual labor leave, regardless of the length of service in this enterprise, as well as, if desired, unpaid leave.

Labor protection of pregnant and breastfeeding women... Pregnant women from the 5th month of pregnancy and breastfeeding women are allowed only light work (excluding overtime and night work). Women cannot be sent on business trips without their consent. When transferring to lighter work, the pregnant woman retains the average salary based on the last 6 months. Dismissal from work of a pregnant or breastfeeding woman is prohibited. Breastfeeding mothers and women with children under the age of 1 year are provided, in addition to the general break for rest and nutrition, additional breaks for feeding the child - at least every 3 hours, each lasting at least 30 minutes. In the presence of two or more children under the age of 1 year, the duration of the break is set at least 1 hour. Breaks for feeding the child are included in working hours and are paid according to average earnings. The timing and procedure for granting breaks are established by the administration together with the factory, factory, local trade union committee, taking into account the wishes of the mother. It is forbidden to refuse to hire women and reduce their wages for reasons related to pregnancy or breastfeeding. The dismissal of pregnant women, breastfeeding mothers and women with children under the age of 1 year is not allowed on the initiative of the administration.

Patronage of pregnant women has the purpose of monitoring them at home. The tasks of patronage include: clarification of the general condition and complaints of a pregnant woman, postpartum woman or a patient with gynecological diseases; familiarization with the life of a pregnant woman and a postpartum woman, teaching her the rules of hygiene and caring for a newborn; education of sanitary and hygienic skills and assistance in improving the hygienic situation, based on specific living conditions; checking the execution of the assigned mode; sanitary and educational work. With the patronage of pregnant and postpartum women, it is necessary to pay special attention to balanced nutrition and adherence to all doctor's recommendations. The data obtained during the first patronage, the sister enters in detail in the patronage sheet, which she pastes into the individual card of the pregnant woman. In case of repeated patronages, the sister notes in the patronage certificate everything that has been done to eliminate the deficiencies noticed, and reports her observations to the doctor.

Nutrition for a pregnant woman ... Proper nutrition during pregnancy is essential for maintaining the health of the woman in labor and the normal development of the fetus. In the first half of a normal pregnancy, a special diet is not required. Food should be varied and tasty. Nutrition in the second half of pregnancy should take into account the physiological characteristics of the body. The diet must include proteins up to 100-120 g per day. Of the products containing complete proteins, kefir, yogurt, milk, cottage cheese, eggs, cheese, lean meat (100-120 g per day), fish (150-250 g per day) should be recommended. The amount of carbohydrates in the diet should not exceed 500 g per day, and with an overweight pregnant woman - 300 g. It is necessary to include in the diet fruits, berries, vegetables, and bread. Fats are recommended in the amount of 100-110 g per day, mainly in the form of butter, sour cream and vegetable oils. The amount of liquid is limited to 1-1.2 liters, and the amount of table salt, especially in the second half of pregnancy, is up to 8-5 g per day. During pregnancy, food should contain vitamins A, B, C, D, E. Vitamin A increases the body's resistance to infection. It is found in the liver of fish. Carrots contain carotene, which is converted into vitamin A in the body; you can also use a ready-made synthetic preparation in the form of pills or liquid. Vitamin B 1 prevents the development of vomiting in a pregnant woman. Lack of vitamin B 1 in the body leads to rapid fatigue, the development of neuromuscular weakness, weakness of labor. Contains vitamin B 1 in black bread, yeast and beans; you can also use ready-made preparations in the form of pills. Vitamin C (ascorbic acid) contributes to the maintenance of pregnancy; with a lack of this vitamin in the body of a pregnant woman, abortion often occurs. Vitamin C is found in large quantities in rose hips, black currants, cabbage and other vegetables, berries and fruits that a pregnant woman should consume widely. In the absence of such an opportunity (in winter, spring), it is recommended to take vitamin C in the form of ascorbic acid with glucose or in the form of proprietary tablets. Vitamin D, otherwise called antirachitic, prevents the development of rickets in the fetus, plays an important role in the regulation of calcium and phosphorus metabolism in a pregnant woman. Contained in fish oil (apply 1 tablespoon 2 times a day before meals). Vitamin E contributes to the preservation of pregnancy, especially indicated for women with a history of premature pregnancies; contributes to the normal development of the embryo and fetus. Contains vitamin E in sprouted wheat grains, salad. There is a ready-made complex of vitamins specially for pregnant women - gendevit; it is taken 2-3 pills a day. Food should be taken in small portions, in the first half of pregnancy 4 times with three-hour breaks: first breakfast - 25-30% of the diet, second breakfast - 10-15%, lunch - 40-45%, dinner - 10-15%. In the last months of pregnancy, food is taken 5-6 times a day, dinner - 1-1.5 hours before bedtime (tea with milk, a glass of milk or yogurt with a roll or cookies). Night break - 8-9 hours.

Treatment-protective mode in the care of pregnant women, women in labor and parturient women, in addition to observing the strictest asepsis and antiseptics, it includes the creation of a favorable, calm, benevolent environment, timely accurate painless fulfillment of all appointments, an attentive and attentive attitude to the patient's requests, a calm tone in conversation, taking care of the cleanliness around the patient , in the ward, clean linen, delicious food, etc .; the hustle and bustle of the work of medical personnel is excluded. All these are the most important tasks of a nurse working in an obstetric hospital, an antenatal clinic and a polyclinic. Positive emotions contribute to an increase in the body's reactivity, faster recovery. And, conversely, negative emotions lower the overall tone, reduce the body's resistance to infection. There are known cases of miscarriage, premature birth due to severe nervous experiences. Pregnant women, especially with pathologically proceeding pregnancy, postpartum women after a great physical and mental stress, such as childbirth, need favorable conditions for rest and sleep. Sleep restores the working capacity of a tired, exhausted organism. It is necessary to eliminate the noise in the department, the knock of heels, the creak of doors, etc .; it is necessary to maintain the appropriate temperature in the ward. The postpartum woman should be provided with at least 8-9 hours of good sleep during the day, with the obligatory continuous night sleep of at least 6 hours. All manipulations, diagnostic and therapeutic procedures should be carried out by a nurse painlessly. It is necessary to try to ensure that every pregnant woman is timely prepared in the antenatal clinic, at the feldsher-obstetric station for a painless course of childbirth by conducting special classes - conversations using the method of psychoprophylactic training. To learn by themselves and systematically familiarize junior medical personnel with the principles of the medical and protective regime - these are the tasks of the nurses of the antenatal clinic, the maternity hospital and the feldsher-obstetric center.

Gestational age... The duration of a woman's pregnancy is on average 280 days, that is, 40 weeks, or 10 obstetric (lunar) months. The gestational age in the first months is established by simply counting the time that has elapsed since the last menstrual period. To calculate the term of labor from the first day of the last menstruation, count 3 months ago and add 7 days. For example, the first day of the last menstruation is December 10, 1987: count 3 months ago (November, October, September), it turns out - September 10; add 7 days - it turns out September 17, 1988. This will be the expected date of delivery, which in some cases may fluctuate between September 10 and 20. For a more accurate calculation of the duration of pregnancy, along with the anamnesis data, they use the determination of the size of the pregnant uterus, the height of the bottom of it above the symphysis, the position of the head, its size, the length of the fetus and the circumference of the abdomen of the pregnant woman.

Up to 3 months, the uterus is still in the pelvic cavity - pregnancy is determined by vaginal examination. Starting from the 4th month of pregnancy, the bottom of the uterus leaves the small pelvis and at the end of the 4th obstetric month of pregnancy (16 weeks) it stands three transverse fingers (5 cm) above the pubic joint; at the end of the V obstetric month of pregnancy (20 weeks), the bottom of the uterus is in the middle between the bosom and the navel (11 cm above the bosom); at the end of the 6th obstetric month of pregnancy (24 weeks) - at the level of the navel (22 cm above the bosom); at the end of the VII obstetric month of pregnancy (28th week) - 26 cm above the bosom; at the end of the VIII obstetric month of pregnancy (32 weeks) - 30 cm above the bosom; at the end of the IX obstetric month of pregnancy (36 weeks) - 36 cm above the bosom. By the end of the X obstetric month of pregnancy (40 weeks), the bottom of the uterus drops to approximately the level at which it stood at the end of the VIII obstetric month, that is, 30 cm above the bosom.

Toxicosis of pregnant women- multisymptomatic disease, manifested by impaired metabolic functions, cardiovascular system, kidney, liver, central and peripheral nervous system; often occur against the background of existing chronic diseases of internal organs.

Early toxicosis may appear from the first days and weeks of pregnancy and disappear in the second half. Some early toxicoses of pregnant women do not completely disappear and persist until the end of pregnancy. Early toxicosis of pregnant women can be manifested by dermatoses, a rash similar to urticaria, itching of the external genital organs, eczema, herpes. Early toxicosis includes vomiting, salivation. Many women already from the first days and weeks of pregnancy develop intolerance to certain smells, taste sensations (aversion to certain foods and the need for others). Vomiting of pregnant women- the most common form of manifestation of toxicosis; in most cases does not require special treatment. More severe forms are accompanied by a rapid decrease in body weight, dry skin, frequent pulse, low-grade fever. Indomitable vomiting- severe form of early toxicosis of pregnant women; vomiting is repeated 20 or more times a day and leads to depletion of the body, and in some cases, especially if untreated, it can lead to death. Due to starvation, severe dystrophy develops in pregnant women with indomitable vomiting, urine output decreases sharply, protein, hyaline and granular casts, and acetone appear in the urine. From the mouth of such a patient, the smell of acetone is felt (it smells like apples), the general condition is greatly deteriorating. A pregnant woman with excessive vomiting should be hospitalized without fail. If treatment is not started immediately, the patient is at risk of death due to deep (irreversible) changes in organs (kidneys, liver). Sometimes the only salvation can only be the timely termination of pregnancy.

Drooling (ptyalism) is manifested by almost continuous salivation, often causing irritation and maceration of the chin skin, significant weight loss. A graduated glass mug with a lid is used to measure the daily amount of saliva excreted (and vomit). The nurse records the amount of collected saliva (and vomit) in the medical history; large fluid loss is compensated by drip infusion of fluid (glucose, vitamins, isotonic solutions).

Toxicosis of pregnant women late... At dropsy of pregnant women fluid accumulates mainly in the subcutaneous fat layer. The accumulation of fluid depends on the violation of water-salt metabolism and an increase in capillary permeability. The disease begins in the second half of pregnancy. First, there is a pasty, and then swelling of the feet and legs. With edema, body weight per week increases by 500-700 g or more. With a mild form of dropsy of pregnant women, bed rest and a diet with fluid and salt restriction, the inclusion of high-grade proteins (boiled lean meat, boiled fresh fish, cottage cheese, kefir), vitamins, light dairy-plant foods, and control of urine output are shown. With the wrong regimen of a pregnant woman, dropsy can turn into a more severe stage of toxicosis - nephropathy.

Pregnancy nephropathy (pregnancy kidney)- a disease accompanied by edema, the appearance of protein in the urine, an increase in blood pressure. Treatment for nephropathy is aimed at increasing urine output, reducing and completely eliminating edema, lowering blood pressure, improving cardiac activity, preventing seizures. Intravenous infusions of glucose are used, inside - calcium chloride, intramuscularly - magnesium sulfate. Intermittent sleep treatment is performed.

Diet for nephropathy consists in excluding table salt, limiting fluid (up to 500 ml per day until the edema disappears); in food - at least 100 g of proteins (cottage cheese or lean meat in boiled or steam form, or boiled fish), animal fats or vegetable oil in an amount of 50 g per day; a sufficient amount of sugar and vitamins. The use of soda is prohibited, which is replaced, if necessary, with magnesium compounds. The nurse very closely monitors the general condition of the patient, the symptoms of nephropathy (blood pressure, albuminuria, edema, the state of the vessels of the fundus according to the opinion of the ophthalmologist). Timely recognized nephropathy with proper care of the nurse for the patient (diet, treatment, medical and protective regimen) can be suspended.

Preeclampsia... If the therapeutic and prophylactic measures have not stopped the nephropathy, then the amount of protein in the urine increases, edema increases, blood pressure rises, complaints of pain in the epigastric region, headache, "veil" before the eyes are often added; at this stage, hemorrhage into vital organs, premature placental abruption and other complications dangerous for the pregnant woman and the fetus are possible. Treatment of preeclampsia is reduced to an appropriate regimen - the patient is placed in a separate ward, providing her with peace and individual constant care of a nurse. The windows in the ward are covered to avoid sudden light irritation. Magnesium sulfate is administered, a diet is strictly observed (see above), treatment with prolonged sleep is carried out, and the necessary care is provided; this prevents the transition of preeclampsia to the convulsive stage of eclampsia. All manipulations and injections should be performed by a nurse under anesthesia.

Eclampsia- the most severe stage of late toxicosis. The growing phenomena of preeclampsia as a result of increased intracranial pressure are accompanied by severe headache, sometimes vomiting, impaired vision, agitation. Eclampsia cramps begin with twitching of the facial muscles; first there is a blinking of the eyelids, then fibrillar twitching of the facial muscles occurs, then the cramps spread to the muscles of the trunk and extremities, turning into tonic cramps of the muscles of the whole body. The muscles of the neck are tense, the veins in the neck are dilated, a sharp cyanosis of the face and upper limbs appears (due to respiratory distress); consciousness is lost; pupils are dilated. A convulsive attack can last from 30 s to 1 min, then the convulsions gradually stop, the patient makes a deep, prolonged exhalation, foam comes out from the mouth, sometimes stained with blood due to biting the tongue, then breathing is gradually restored, cyanosis disappears, after a while consciousness returns. The amount of protein in the urine rises sharply. Sometimes, with frequent seizures, the blood supply to the central nervous system progressively worsens and the patient, without regaining consciousness, may die from asphyxia, cerebral hemorrhage or pulmonary edema. Eclampsia can occur in pregnant women, women in labor and postpartum women in the first days of the postpartum period.

The nurse is obliged to stay close to the patient. Before the onset of a seizure, the patient has increased agitation, slight twitching of the eyelids, the pulse becomes more tense, and blood pressure rises. At this point, the handle of a spoon wrapped in gauze (to avoid biting the tongue) should be inserted into the patient's mouth from the side between the molars; the spoon should be kept in the mouth until the end of the seizure. If possible, the patient is immediately given anesthesia. Before the arrival of the doctor or midwife, in order to prevent the next seizure, the nurse injects the patient intramuscularly with 20 ml of a 25% solution of magnesium sulfate (this can be repeated every 4 hours, but no more than 4 times a day). If this drug is not available, 1 ml of 1% morphine solution can be injected under the skin. It is impossible to transport a patient with eclampsia. The nurse, while staying with the patient, is obliged to ensure everything possible to create a therapeutic and protective regime (see. Treatment-protective mode).

Prevention of toxicosis in pregnant women includes the correct and qualified management of a pregnant woman from the first weeks of pregnancy; rational nutrition, abstinence from abundant intake of fluids and food, restriction of salt, regulation of physical and mental work, staying in the fresh air, good night's sleep, implementation of all recommendations of the antenatal clinic. Those who have suffered toxicosis must be under dispensary supervision after childbirth.

Toilet of the external genital organs during pregnancy, it is done with warm water and soap (preferably baby). Beforehand, you must thoroughly wash your hands. They wash over the basin by pouring water from a jug or from a kettle with their left hand, or in a bath with warm water from a hose; the movements of the washing hand are made from the bosom to the anus (but not in the opposite direction).

A lying pregnant woman is washed away by a nurse: an oilcloth is laid under the woman and an individual vessel is placed; use sterile cotton swabs on the forceps. In the second half of pregnancy, a woman is washed lying down from Esmarch's mug with a not very strong stream. When washing away, water should not flow into the vagina, only the external genitals are washed away.

Nutrition during pregnancy is one of the most important conditions for the full development of the fetus, a favorable course of pregnancy and its outcome. Normal conception, pregnancy and breastfeeding are natural physiological processes that often do not require medical intervention. The only thing that expectant mothers should understand is that the life and health of their unborn child will depend on how they eat for all 9 months. Some simply do not realize this, so in the future there are serious problems with the development of the fetus. Moreover, improper and unbalanced nutrition of the expectant mother during gestation will affect the well-being of the baby after many years.

There are too many temptations in the modern world, but sometimes you should forget about your desires and completely focus on the child. To alleviate nutritional problems in the early months of pregnancy, doctors may prescribe special foods, such as protein vitamin and mineral complexes, which are able to supply the body with all the necessary substances.

1 trimester - features and eccentricities of pregnant women

Relatives can help with a pregnant woman's diet. The 1st trimester is one of the most important periods in the formation of the fetus. It is during the first months of pregnancy that you will have to completely abandon all bad habits. In fact, this had to be done a few months before conception, even during pregnancy planning.

When it comes to food, a sudden change in habits and the transition to completely healthy foods can be stressful for the body, and this is completely unnecessary. For example, do you like to eat fried potatoes and cannot imagine your life without them? Great, eat to your health. Such eccentricities are fully supported. In any case, if a pregnant woman wants something unusual, then she definitely needs to be given it. Small whims in food are permissible, because the body is rebuilt in connection with pregnancy - this concerns the fact that a child needs a huge amount of useful minerals and vitamins. There may not be enough of them, therefore, the woman's body with such "wishes" signals that there is a lack of any substances. As you can see, the diet for pregnant women is quite simple in the first months. Many don't even change their habits.

What are we eating?

A pregnant woman's menu is quite unpredictable. Of course, everything is selected individually, but there are some general patterns for all expectant mothers.

It is very important to listen to even the slightest eccentricities in food, because the desires of pregnant women sometimes speak volumes. For example, if you want seaweed, then there is an acute lack of iodine in the body. An increased interest in dairy products (milk, cheese, cottage cheese, etc.) is a sign of insufficient calcium levels. It is necessary for the full development of the fetus, therefore, its deficiency must be eliminated without delay. A lack of vitamin C, for example, is evidenced by cravings for fresh vegetables and fruits, potatoes and pickles. During this period, many people want to eat nuts, fish and green peas - such food preferences are a clear sign of a lack of vitamin B1 in the body. Fruits, as well as orange and red vegetables, are excellent sources of vitamin A (i.e. carotene). The good news for banana lovers is that they are rich in vitamin B6 and essential potassium.

The correct diet for pregnant women should in no way exclude the use of meat. Situations are often observed when such a useful product is refused due to toxicosis. This phenomenon worries women during the first few months of pregnancy. In any case, it will pass quickly enough, and the use of such products will not cause any trouble at all.

The first half is the correct ratio of beneficial micro and macro elements

In the first few months of pregnancy, the internal organs of the unborn baby begin to form, which is why it is so important to adhere to the advice of specialists regarding nutrition. Firstly, it is preferable to eat 4 times a day, and this should be done in such a way that about 30% of the total energy value of the daily diet was eaten for breakfast.

Then it is followed by a second breakfast - this is another 15%, lunch takes 40%, dinner is only 10%. But at 9 o'clock in the evening you can drink a glass of kefir - this will be the remaining 5%.

Such proportions should be calculated for a diet with an energy value of 2400 or up to 2700 kcal. In order to avoid possible problems in the future, you need to properly plan your meals during pregnancy.

Doctors are advised to follow a diet, which will necessarily include all the necessary proteins, carbohydrates, fats, micro- and macroelements, minerals, and vitamins. A pregnant woman's diet per day should include an average of 75 g of fat, up to 110 g of protein, as well as approximately 350 g of carbohydrates. It is these proportions that are able to provide the body of a pregnant woman with everything necessary for the normal physiological development of the fetus.

Contraindications during pregnancy

The diet for pregnant women should completely exclude alcohol and cigarettes - it would seem that everyone knows this, but some young ladies simply cannot give up such harmful habits.

Sometimes it is not enough to know that in the future, bad habits can lead to improper physiological development of the baby, to problems with the cardiovascular system and mental development.

In the first months of pregnancy, drug abuse should be avoided, unless the attending physician sees it as necessary. Avoid any contact with patients, because during pregnancy, a woman's immunity is too weakened, which can lead to sad consequences. You should not eat poor quality foods. The best option would be to eat freshly cooked meals, fresh vegetables and fruits. Food poisoning is not a good prospect.

The most interesting thing is that the spicy lovers are a little unlucky. They will not see such spices as mustard, horseradish, pepper and vinegar soon. It is important that there is absolutely no canned food on the pregnant woman's menu. You can use only those that are marked "Baby food" and "Preservative free is guaranteed."

Required doses of minerals

The most common problem that pregnant women face is a lack of iron in their blood. It is this component that is responsible for normal blood circulation and tissue respiration. In order to replenish the required daily dose (up to approximately 20 mg), it is enough to include egg yolk, liver, oatmeal and buckwheat porridge in the diet.

If there is a desire to eat lime, salt, chalk and more, then this is a clear sign of a lack of calcium salts in the body. Therefore, first you need to revise your diet. In this case, pregnant women are prescribed special vitamins, phosphorus, calcium and iron preparations. An approximate diet for a pregnant woman should include 1500 to 2000 mg of calcium per day. This dose is almost double the adult's daily requirement. In order to satisfy this need, you will have to intensively eat dairy products, especially milk. For example, 100 ml of pasteurized milk contains approximately 130 mg of calcium. The most valuable in this regard are cheeses - just 100 g of cheese can contain up to 1000 mg of calcium.

Strict rules must be followed regarding the consumption of table salt. For example, in the first few months it is possible to allow up to 12 g per day, a little later it is already possible only up to 8 g, but in the last two or three months only up to 5 g.

Nutrition during pregnancy - basic rules

It is important to ensure that all food prepared is of the highest quality. Many doctors recommend eliminating sucrose from the diet. For the most part, it is found in confectionery. A good substitute would be glucose, honey, fructose, as well as any confectionery that is made on their basis.

It is very important for a pregnant woman to ensure that the amount of energy that comes with food is in line with the expenditure. That is, it is normal that the expectant mother is gaining pounds, but this recommendation will protect her from excess weight that may remain after childbirth.

The diet of a pregnant woman must be completely balanced: an excess of nutrients can also disrupt the full physical development of the fetus, metabolism and the function of the endocrine glands. As a result, a baby with overweight and inharmonious development of internal organs may be born.

If we look at the problem from the other side, then malnutrition can harm the unborn child even more than overeating. A deficiency of at least one useful element (for example, calcium) in the diet of a pregnant woman can negatively affect the health of the baby. In the absence of the necessary macro- and microelements, vitamins and minerals, miscarriage or premature birth can occur. Prematurity is very dangerous for a baby's life: it can affect mental retardation, the occurrence of various anomalies, deformities, and developmental delays.

Standard in weight gain during pregnancy

An approximate diet for pregnant women should only be calculated based on their individual needs. An interesting fact is that all women gain weight almost the same. For example, the rate of increase in body weight is from 8 to 10 kg. This is approximately 300 or 350 g per week during the second half of pregnancy. Most often, many girls begin to eat uncontrollably, explaining that they need to eat for two. It is not right! You cannot gain too many extra pounds already in the first half of the term. It is important to monitor the health benefits of the foods you eat and not overdo it. If you follow a few simple rules, a diet for pregnant women for weight loss may not be needed in the future.

Second half of pregnancy

Nutrition during pregnancy at this time is somewhat different - it is recommended to eat 5-6 times a day. This is slightly more than in the first half, but one condition remains unchanged - hot spices, seasonings and coffee will have to be abandoned. There is an approximate list of foods that must be taken in food. For example, you need to eat cottage cheese about 150 g, butter and vegetable oil - from 30 g to 40 g, 1 egg, 500 g of milk and 50 g of sour cream. As for bakery products, the norm of wheat and rye bread is 150-200 g each, buns or cookies can be eaten 100 g, no more than 60 g of pasta is recommended. In addition to water and juice, you can drink tea and cocoa.
An hour before bedtime, it is recommended to drink a glass of kefir. As for the intake of meat and fish, you should write the diet for pregnant women in such a way that these two types of products are necessarily for breakfast and lunch. But for dinner, it is worth giving preference to dairy and plant foods, and you should have dinner a few hours before bedtime so that the body does not feel heaviness.

Health problems in expectant mothers

One should not dismiss the possibility that a pregnant woman may have a simple intolerance or allergic reactions to staple foods. In this case, you need to fully coordinate your diet with the antenatal clinic doctor, who will further lead the pregnancy. Nutrition during pregnancy (menu) will be calculated in such a way as not to provoke allergies to certain foods, but at the same time to satisfy the needs of the developing fetus as much as possible. For example, if there is no way to refuse something, then such food products will be consumed in small doses, which will gradually increase. Allergenic foods are diluted in boiled water and taken in a teaspoon once a day. Gradually, the dosage and concentration will increase to two and then three spoons. Such training involves a gradual increase in dosage so that in the future it will be possible to eat even those foods that are allergic.

Proper nutrition during pregnancy is monitored by a doctor and in cases where the pregnancy proceeds with any complications, for example, if a girl is obese, chronic diseases or other abnormalities.

What to do with late toxicosis?

The most common problem is the appearance of late toxicosis - in this case, doctors recommend a fasting diet. The diet for pregnant women includes an apple diet - it means that the girl eats about 300 g of baked, ripe or raw apples five times a day. As a result, you get 1.5 kg per day. There is a watermelon diet, built on the same principle, but in the end, 2 kg of watermelon comes out per day. In any case, such diets are chemically and energetically deficient enough, so they are prescribed no more than 1 time per week.