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    By situation · 17 tips

    Pregnant

    From the first weeks to going home with the baby, in time order. Tips about work and money are not included here.

    1 Just found out you're pregnant

    Pregnancy and childbirth: from the first positive test to discharge paperwork

    Start taking 0.4 mg of folic acid every day when you begin trying to get pregnant, and keep taking it until the end of the first 3 months of pregnancy

    Taking one folic acid tablet a day from before pregnancy through early pregnancy cuts the chance of a neural tube defect in the baby by about 70%. Neural tube defects are birth defects such as anencephaly and spina bifida. For someone who has already had one baby with such a defect, the chance of another affected baby falls to about one third of what it was.

    • High value
    • Evidence A
    • Buys life
    • For: Pregnant or trying
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    At the first prenatal checkup, get tested for HIV, syphilis and hepatitis B; even if HIV is found, there is free blocking of transmission to the baby

    At your first prenatal checkup, get tested for HIV, syphilis and hepatitis B. You don't pay out of pocket for the initial HIV screening. Finding one is not the end of the road. If HIV is found, the state provides treatment and counseling free. If syphilis is found, it is treated early with penicillin. If hepatitis B is found, the baby gets the vaccine and immune globulin together right after birth, which blocks the disease from passing from mother to child.

    • Top value
    • Evidence A
    • Buys life
    • For: Pregnant or trying
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    Don't smoke a single cigarette or drink a single sip during pregnancy, and don't let anyone at home smoke indoors

    Smoking in pregnancy raises the chance of premature birth, a baby that is too small, and cleft lip and palate. It doubles the risk of abnormal bleeding during pregnancy and delivery. The risk of sudden infant death is higher both when the mother smokes in pregnancy and when the baby breathes smoke after birth. It is never too late to quit.

    • High value
    • Evidence A
    • Buys life
    • For: Pregnant or trying
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    If you're pregnant, you don't have to send the cat away: have someone else scoop the litter every day, cook meat through, and wear gloves when handling soil

    Toxoplasma is a parasite. Catching it for the first time during pregnancy can cause a miscarriage, and the baby's eyes and brain may be damaged. Having a cat at home does not make a person more likely to catch it, so the cat does not have to go. What matters more is not eating undercooked meat and washing your hands after touching soil; as for the litter, it is enough to have someone else scoop it every day.

    • Moderate value
    • Evidence B
    • Buys life
    • For: Pregnant or trying
    Don't get hurt by the medicine cabinet at home

    After 20 weeks of pregnancy, don't take painkillers like ibuprofen on your own

    After 20 weeks of pregnancy, taking ibuprofen-type drugs may harm the baby's kidneys and reduce the amniotic fluid. Among the reports received in the U.S., there were cases of newborn death. Low-dose aspirin prescribed by a doctor is not included.

    • High value
    • Evidence B
    • Buys life
    • For: Pregnant or trying

    2 During pregnancy

    Pregnancy and childbirth: from the first positive test to discharge paperwork

    If you have risk factors for preeclampsia, start one low-dose aspirin a day after 12 weeks of pregnancy, as your doctor directs

    Preeclampsia is a kind of high blood pressure disorder in pregnancy. You are at high risk if you had it in a previous pregnancy, are carrying more than one baby, have chronic high blood pressure, had diabetes before pregnancy, or have kidney disease or an autoimmune disease. For high-risk women, one low-dose aspirin a day from 12 weeks, as the doctor directs, lowers preeclampsia by about 15%, and premature birth and death of the baby around birth each by about 20%. Others should not take it on their own.

    • Moderate value
    • Evidence A
    • Buys life
    • For: Pregnant or trying
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    At 24 weeks of pregnancy or later, get screened once for gestational diabetes, and don't begrudge the sugar drink

    Gestational diabetes is high blood sugar that first appears after you become pregnant. After 24 weeks, half a morning, one sugary drink and a few blood draws can find it. If it is not found and not managed, the risks of an overly large baby, a difficult birth, a cesarean section, preeclampsia and low blood sugar in the newborn all go up.

    • Moderate value
    • Evidence A
    • Buys life
    • For: Pregnant or trying
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    Memorize this “go to the hospital now” list; it applies throughout pregnancy and for a year after birth

    If any one of these appears, go to the hospital the same day; don't wait at home overnight. A headache that won't go away or keeps getting worse, changes in vision, a fever of 38 ℃. Severe swelling of the hands or face, trouble breathing, chest pain or a racing heart. Severe belly pain that doesn't ease, the baby's movements stopping or clearly decreasing, vaginal bleeding or leaking fluid. One arm or leg both swollen and painful, thoughts of hurting yourself or the baby. This also applies within a year after birth.

    • Top value
    • Evidence A
    • Buys life
    • For: Pregnant or trying
    Caring for a newborn

    If you are vegetarian while pregnant or breastfeeding, take vitamin B12 every day; the child's solid foods need animal foods, and if you insist on fully vegan, see a doctor first

    Vitamin B12 is found almost only in meat, eggs and dairy, so a fully vegan person has to rely on fortified foods or supplements. If the mother is fully vegan and does not supplement, a breastfed child is easily short of it. Problems mostly show up at 4 to 8 months of age: failure to grow, delayed development, and, if it drags on, nerve damage that may not be reversible. The child's solid foods need an animal food every day.

    • Moderate value
    • Evidence B
    • Buys life
    • Disputed
    • For: Pregnant or trying, Child under 3
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    If flu season comes while you're pregnant, get one inactivated flu vaccine shot, which can be given at any stage of pregnancy; don't use the nasal spray

    Pregnant women who get the flu are more likely to be hospitalized than women who are not pregnant. A flu shot during pregnancy cuts the woman's own hospital stays for flu by about 40%. In the baby's first 6 months, confirmed flu is about half as common and hospital stays for flu about 70% fewer. No increase in miscarriage, stillbirth or malformations from the shot was seen.

    • High value
    • Evidence A
    • Buys life
    • Disputed
    • For: Pregnant or trying
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    From 28 weeks of pregnancy on, go to sleep on your side, left or right, and don't go to sleep lying on your back

    From 28 weeks of pregnancy on, going to sleep lying on your back goes with about 2.6 times the risk of the baby dying in the womb (stillbirth), compared with going to sleep on your side. Left and right are the same; just pick the side that is comfortable. If you wake up in the night and find yourself on your back, don't panic; roll back onto your side and go on sleeping. This figure comes from recall after the fact, and is disputed.

    • High value
    • Evidence B
    • Buys life
    • Disputed
    • For: Pregnant or trying

    3 Giving birth

    Pregnancy and childbirth: from the first positive test to discharge paperwork

    If your water breaks, lie down where you are, raise your hips, and call 120 (China's ambulance number); don't walk around or take a bath

    When the water breaks, you don't pack your things slowly and then set out. The right thing is to lie down on the spot, raise your hips on something, and call 120 (China's ambulance number). Standing and walking makes the fluid drain faster, and the umbilical cord may be swept down with it. That is an emergency that can kill the baby.

    • Top value
    • Evidence B
    • Buys life
    • For: Pregnant or trying
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    If you want labor pain relief (无痛分娩), say so directly; it does not raise the risk of cesarean section

    Painless labor (无痛分娩) means an anesthetic injection in the lower back that damps down the pain of giving birth. It works better than other pain relief methods and does not make a cesarean any more likely. The claim that “after the epidural your back hurts for life” has no basis either. It now has its own billing item, set up to make hospitals more willing to offer it.

    • Moderate value
    • Evidence A
    • Saves time
    • For: Pregnant or trying
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    Don't ask for a cesarean section without a medical reason, and don't have surgery just to pick a date

    The World Health Organization says that once a place's cesarean rate goes above 10%, there is no evidence that deaths of mothers and newborns keep falling. When a cesarean is needed, it must be done. Having one to pick a date or because you fear pain means taking on one more major abdominal surgery.

    • Moderate value
    • Evidence A
    • Buys life
    • For: Pregnant or trying

    4 Around discharge

    Pregnancy and childbirth: from the first positive test to discharge paperwork

    Don't refuse the newborn heel-prick blood screening and hearing screening

    One heel-prick blood sample and one hearing test can find hypothyroidism, phenylketonuria and hearing impairment while the baby looks completely normal. By the time symptoms show, the damage to intelligence can no longer be made up.

    • High value
    • Evidence A
    • Buys life
    • For: Pregnant or trying, Child under 3
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    Don't skip the checkup at 42 days postpartum; in some places it is also a screening for postpartum depression

    This checkup costs nothing. According to locally published service lists, it includes a blood count, a vaginal discharge exam, and one postpartum depression screening. Serious problems can occur at any time within a year after birth, so don't assume you are safe once the postpartum month is over.

    • Moderate value
    • Evidence A
    • Buys life
    • For: Pregnant or trying
    Pregnancy and childbirth: from the first positive test to discharge paperwork

    Once you resume sex after giving birth, use contraception; breastfeeding is not contraception; if you want another baby, wait at least 18 months before getting pregnant

    You can get pregnant again as early as 3 weeks after giving birth, even while breastfeeding and without a period. Breastfeeding works as contraception only if all three hold: exclusively breastfeeding, no period yet, and the baby under 6 months. If you get pregnant again less than half a year after giving birth, the risk of preterm birth in the next baby is about 40% higher. The World Health Organization recommends waiting at least two years after a birth before getting pregnant again.

    • Moderate value
    • Evidence B
    • Buys life
    • Disputed
    • For: Pregnant or trying

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