Frequently Asked Questions About Pregnancy (cont'd)
Dr. Abraham-Hebert answers more pregnancy questions:
Q: What happens to the abdominal organs later on in pregnancy as the uterus grows higher and higher into the abdomen?
A: Dr. Abraham-Hebert: As the uterus grows, the top half of the uterus expands. As it expands or stretches, it actually pushes all the organs that used to occupy that space higher and higher into your upper abdomen. That's why your digestive system, your small and large intestines, are pretty cramped. That's why you have a lot of the indigestion, the heartburn, the feeling of fullness immediately. It's a lot of pressure.
Q: It is said that pregnancy puts added stress on your heart. What cardiovascular changes occur during pregnancy and how is the heart able to deal with them?
A: Dr. Abraham-Hebert: During pregnancy, the blood volume increases dramatically, probably by about 40 to 50 percent. That's a large blood volume for a woman, but amazingly, the body compensates very, very well.
During early through middle pregnancy, a woman running up a flight of stairs will notice that her heart's pumping away and she'll get a little lightheaded. Her cardiovascular system is taking some time to compensate. As the pregnancy progresses, she will have to be aware of these changes and actually slow down so that the symptoms have some time to settle down a little bit. The increased blood volume is a pretty big load on the heart and lungs. But women are made to actually compensate for that.
Q: What is it that makes a woman's body able to compensate for that?
A: Dr. Abraham-Hebert: About 10 to 15 different hormones cause the actual increase of the blood volume and control the compensation mechanisms that the organs, including those of the cardiovascular system, use to accommodate those changes.
The lungs also go through many changes. The diaphragm actually rises. The diameter of your chest increases outwardly. Despite those adjustments, though, you often feel out of breath and you may feel that you can't take a deep breath or that you feel a little bit more out of breath. The hormones again have a big role to play in that and cause those changes and the compensating mechanisms as well.
Q: I've read that the lungs actually work more efficiently in pregnancy. How is it that they're able to work more efficiently for that brief period in a woman's life?
A: Dr. Abraham-Hebert: It used to be thought that the actual lung volume or capacity was lower or less efficient during pregnancy. But in reality. studies have shown that there's actually an increase in the volume of the lungs. The efficiency is definitely greater, although a pregnant woman is actually more prone to getting lung infections that stay a little bit longer.
Q: What are the additional nutritional needs of pregnant women?
A: Dr. Abraham-Hebert: Even prior to pregnancy and during the very early stages of pregnancy, it's very important to have a balanced nutritional plate. The caloric requirements of the body increase to about 300 to 500 extra calories a day all throughout pregnancy. And breast feeding requires an additional 200-calorie increase on top of that.
In early pregnancy, nutrition has a big impact on fetal development. Amazingly, the body compensates and takes the fats, carbohydrates and proteins from whatever you give it, but if you have a healthier, balanced diet there are fewer problems in development. There's an increased need of folic acid — this has been in the media for quite a while. Studies have shown that folic acid actually decreases spinal problems and genetic problems.
Since nutrition is so critical, especially during the early stages of pregnancy, we tell women to actually start on prenatal vitamins even before conception, and to continue that all the way through pregnancy. But it's very vital in the very early stages of pregnancy, during the first four to eight weeks of early fetal development.
Q: We've heard a lot about the dangers of smoking and drinking to the growing fetus. What are the dangers of those to the mother's body during pregnancy?
A: Dr. Abraham-Hebert: Tobacco is extremely dangerous to both mother and fetus. It affects their respiratory systems greatly. It puts the mother at greater risk of getting infections and pneumonia, it worsens asthma, and depending on the time of year, these can be greatly increased.
Smoking can affect the mother's cardiovascular system as well, including how efficiently the heart is pumping. It can also affect skin changes and general well-being or mood. Smoke affects the weight of the fetus as well, causing a lot of low-birth-weight babies. Even though some women may think, "OK, I don't want to gain a lot of weight during pregnancy" and keep smoking, it actually affects the fetus, not just the mother's weight.
Alcohol has been well studied. Even small amounts and regular doses can cause fetal alcohol syndrome, which is a horrible outcome for the baby. These are two drugs that are so dangerous to moms and babies.
