Pregnancy

The average duration of pregnancy is forty weeks which is ten lunar months or two hundred and eighty
days or approximately nine calendar months and one week. The date on which the baby is due to be
born is called the expected date of delivery (EDD). This calculated as being forty weeks after the first day
of the last normal menstrual period. When the pregnant woman reaches her EDC (Estimated date of
confinement: The due date or estimated calendar date when a baby will be born or she is said to be at
term. After conception, the fertilized ovum is implanted into the inner lining of the womb, and the site
of implantation the “afterbirth” or placenta develops. The placenta is essential for the survival of the
unborn baby because the baby is being incubated inside a sack of fluid within the mother’s womb and
therefore it can not breathe in the normal way, nor can it forage for food. The baby is isolated in the
fluid contained in the bag of membranes. The baby’s blood flows along the umbilical cord from the baby
to placenta, and then back to the baby. Likewise, the mother’s blood flows through cavity in the wall of
the womb next to the placenta. In this way oxygen and foodstuff pass from the mother’s blood to the
baby’s blood through the placenta, and carbon dioxide and other excretory products pass from the
baby’s blood to the mothers. The baby is entirely dependent upon the mother and the placenta for
survival.

The womb grows in size as pregnancy continues and at term, it is a large powerful, muscular organ,
ready to expel the baby during labor. During the last twelve weeks of pregnancy the mother feels the
womb contract from time to time, but these are not painful contractions. They are known as Braxton-
hicks contractions, and they indicate that the womb is toning itself up in preparation for the hard work it
will have to do during labor.

If the baby is born before the thirty-fifth week of pregnancy its chances of survival are rather poor. From
the thirty-fifth week up to the thirty-eight week there is a sharp improvement in the survival rate.

Abortion or miscarriage is defined as “the expulsion of the products of conception” (i.e., the baby and
the placenta) before the end of the twenty-eighth week of pregnancy”. Abortion is the correct medical
term for miscarriage.

Premature labor is defined as “expulsion of the products of conception after the end of the twenty-
eighth week of pregnancy” and before term.

Vocabularies: find out the meaning of these words below:

- Womb
- To incubate
- Average
- Duration
- Membrane
- Approximately
- EDC and EDD
- Placenta
- At term
- Labor
 - Cavity

Questions

1. Does the baby breathe within the womb?

2. How does it receive its foodstuff and oxygen?
3. What is a placenta?
4. What is the difference between abortion and premature labor?

Grammatical review

Prefix pre means before

Example:

- Premature
- Prenatal
- Preoperative
- Preview
- Pre-prandial
- Pretest
- Premenstrual
- Presurgical
- Premedication

Substitution drill

1. The date on which the baby is due to be born is called EDC.

is expected to be born
is expected to be delivered
2. The baby is dependent upon the mother and the placenta for survival.
needs oxygen and foodstuff
should be born at term
depends on the mother and the placenta
3. The womb grows in size as pregnancy continues.
becomes thicker and heavier
has more muscles
may contract

Conversation

Doctor : I am sorry to tell your wife needs an immediate operation

Mr. Joko : does she need a blood transfusion?

Doctor : Yes, but you have to sign the consent form prior to the operation.

Mr. Joko : am I allowed her now?

Doctor : yes, but don’t stay too long. She has bled a lot and she is too weak to talk.

Mr. Joko : what should I do then?

Doctor : you’d better fetch the blood. A nurse will go along with you to the blood bank.

Vocabularies: find out the meaning of these words below:

- Immediate
- To sign
- To fetch
- A lot
- Consent form
- Prior to
- To bleed, bled, bled
- Blood bank

Exercise: complete the sentences with the appropriate verbs from the list

Born Operated Flows Contracts Expel breathes

a. The blood ______________ from the heart to the body tissues and vice versa.
b. A woman with placenta previa is generally _______________
c. During labor the mother feels pain because the womb ______________
d. At term the womb is very muscular in order to ___________________ the baby during labor.
e. The fetus ________________________ in when it is distress.
f. The man was ________________ in a cave.
Sign of pregnancy

All these signs are normal:

- The woman misses her period (the first sign)

- “morning sickness” (nausea or feeling you are going to vomit, especially in the morning). This is
the worse during the second and third months of pregnancy
- She may have urinated more often
- The belly gets bigger
- The breast gets bigger
- “mask of pregnancy” (dark areas on the face, breasts, and belyy)
- Finally, during the fifth months or so, the child begins to move in the womb.

How to stay healthy during pregnancy

- It’s very important to eat well. The body needs food rich in the proteins, vitamins, and minerals
especially irons.
- Use iodized salt to increase the chances that the child will be born alive and will not be retarded
(but avoiding swelling of the feet and other problems, do not use very much salt).
- Keep clean. Bathe or wash regularly and brush your teeth every day.
- In the last month of pregnancy, it is perhaps best to avoid sexual contact to keep from breaking
the bag of water and causing an infection.
- Avoid taking medicine if it all possible. Some medicines can harm the developing the baby. As a
rule, only take the medicines recommended by a health worker or doctor (if a health worker is
going to prescribe a medicine, and you think that you might be pregnant, tell him so). You can
take aspirin or antacids once in a while if you need them. Vitamins and iron pills are often
helpful and do no harm when taken in the right dosage.
- Do not smoke or drink during pregnancy. Smoking are bad for the mother and harm the
developing baby.
- Stay far away from children with measles, especially German measles.
- Continue to work and get exercise, but try not to get too tired.

Minor problems during pregnancy

1. Nausea or vomiting
Normally, this is worse in the morning, during the second or third month of pregnancy. It helps
to eat something dry, like crackers or dry bread before you get out of bed in the morning. Do
not eat large meals, but rather smaller amounts of food several times a day. In severe cases,
take an antihistamine. When you go to bed and when you get up in the morning, avoid greasy
foods.
2. Burning or pain (in the pit of the stomach or chest)
Eat only small amounts of food at one time. If possible, drinks milk. Avoid taking antacids. It
helps to suck hard candy. Try to sleep with the chest and head lifted up some with pillows or
blankets.
3. Swelling of the feet
Rest at different times during the day with your feet up. Eat less salt and avoid salty foods. Tea
made from corn silk may help. If the feet are very swollen, and the hands and face also swell,
seek medical advice. Swelling of the feet usually comes from the pressure of the child in the
womb during the last months. It is worse in the women who are anemic, malnourished, or who
eat a lot of salt. So, eat nutritious food with little or no salt.
4. Low back pain
This is common in pregnancy. It can be helped by exercise and taking care to stand and sit with
the back straight.
5. Anemia and malnutrition
Many women in rural areas are anemic even before they are pregnant, and become more
anemic during pregnancy. To make a healthy baby, a woman needs food rich in protein and iron.
If she is very pale, and weak or has other signs of anemia and malnutrition, she needs to eat
more protein. She can get this by eating beans, groundnuts, chicken, milk, cheese, eggs, meat,
fish, and dark green leafy vegetables. She should also consume iron pills, especially if it is hard to
get enough nutritious foods. This way she will strengthen her blood to resist dangerous bleeding
after childbirth. If possible, iron pills should also contain some folic acid and vitamin C.
6. Swollen veins (varicose veins)
These are common in pregnancy, due to the weight of the baby pressing on the veins that come
from the legs. Put your feet up often as high as you can. If the veins get very big or hurt, wrap
them with elastic bandage. Take off the bandages at night.
7. Piles (hemorrhoids)
These are varicose veins in the anus. They result from the weight of the baby in the womb.
8. Constipation
Drink plenty of water. Eat fruits and food with a lot of natural fiber, like cassava or bran. Get
plenty of exercise. Do not take strong laxatives.

Talk on pregnancy
Situation; dr. Maria, an expert from Australia talks to the junior nurses

Nurse A : doctor, yesterday the young mothers were very excited. I wonder about
what we’ll do on the first visit.
Dr. maria : well, just the routine, honey. You weight them. If they are underweighted
tell them to eat more food. The best food!
Nurse B : what about a blood test?
Dr. maria : absolutely!! Test their blood to see if there is anemia or weak blood. One
finger should be pricked and a few drops of blood taken. Also, the mother’s
urine is tested for sugar and protein. If a pregnant woman has an extra sugar
in her blood, she may have diabetes. She needs special care.
Nurse A : what if she has protein in her urine?
Dr. maria : oh that …. She may be developing a condition called pre-eclampsia… do not
forget …must measure their blood pressure… if it is too high then pre-
eclampsia may occur later……that’s a danger to the baby...
Nurse A : how do we keep it low?
Dr. maria : resting!! By resting often! May be rest in the hospital
Nurse B : when my sister got pregnant, her feet and hands were swelling
Dr. maria : that’s normal…. but severe swelling may be a sign of pre-eclampsia. Then
feel the abdomen to check the baby’s growth and position from about five
months you listen to the heart beat of the fetus with a fetoscope…held
against the mother’s abdomen.
Nurse A : yes…. It’s very exciting for me too. I am happy to be a nurse to help them.