Pregnancy Week 13 - A Father's First Glimpse of His Baby

Dear Baby,

The entire household revolves around you and your mamma right now. We have just returned from the doctor. We went there to get some blood tests done. You are fine and dandy at thirteen weeks.

Your mamma is looking adorable with her protruding tummy. She is starting to feel better, less nauseous and is moving into the second trimester, where women are supposed to glow!

We went to the hospital last week to have the first scan. You were all over the place at first, but then settled down with your back towards us, obviously upset at being poked and prodded. A little later you turned towards us and we could see your face clearly - your eyes, mouth and I think the nose. We could see the outline of your head, your right arm above your body and your legs curled up in front. Your spine was also visible as small white patches.

You are three to four inches long and growing like a weed. The next scan will be done at around 18 weeks I think.

Your dad,

Nikhil.

BABY NOTES

How can fathers be involved during pregnancy?

Although most men are happy to know that they are going to be dads, this role may not come automatically to them. You must remember that since your husband is not carrying the child, he may not immediately feel that special bond that you and your baby share and may even feel a bit left out. Besides, he may be worried about the added responsibility that a baby brings, especially if you were working before your pregnancy and do not plan to return to work after you’ve had the baby. Both parents may also have to make adjustments to their working lives. The best way to deal with this is to talk to each other about your feelings and worries.

In India, fathers traditionally played a limited role during pregnancy, often doing little more than taking their wives for check-ups. However, this is changing, with more fathers becoming actively involved, particularly in urban areas. In the West, fathers commonly attend antenatal or parentcraft classes with their wives and are also present in the labour room during birth. Such classes are now available in parts of India too, and some hospitals allow husbands to be present during childbirth, although policies and facilities vary.

I feel fathers should be encouraged to participate as much as possible. They can accompany their wives to scans and antenatal appointments, feel the baby's movements, talk to the baby and help prepare for the birth. This will not only get the father involved and help him understand what his wife has to go through, but more importantly, it will enable him to form a bond with the baby.

Whether the father is present during childbirth is something the couple should discuss beforehand, taking into account their wishes, medical circumstances and hospital policies. The few moments right after the birth of your baby are magical and, wherever possible, your husband ought to be a part of them.

What blood tests are done during pregnancy?

Certain blood tests are carried out during pregnancy to ensure that all is well. Samples of your blood are taken to determine your blood group and Rh factor, check for red-cell antibodies and carry out a complete blood count (CBC). They are also taken to test for anaemia, blood sugar levels, syphilis, hepatitis B, HIV, sickle-cell disease and thalassaemia. Rubella immunity may also be checked, depending on local screening practices and your medical history. Some tests, such as those for gestational diabetes, may be carried out later in pregnancy.

Why is HIV testing important during pregnancy?

HIV (human immunodeficiency virus) is the virus that can cause AIDS if left untreated. It is transmitted through sex without a condom with a person who has transmissible HIV, sharing contaminated needles or syringes, or transfusion of infected, unscreened blood. HIV testing is routinely offered during pregnancy, even if you have no symptoms or known risk factors.

HIV can be passed from a mother to her baby during pregnancy, childbirth and breastfeeding. HIV in babies is a serious condition, so it is important that you are tested for this infection. Treatment of an HIV-positive mother with antiretroviral therapy (ART) greatly reduces the likelihood of the infection being passed on to the baby. With effective treatment and an undetectable viral load, the risk of transmission during pregnancy and childbirth can be reduced to less than 1%. Treatment also greatly reduces the risk during breastfeeding, although it does not eliminate it completely. Infant-feeding recommendations vary, so mothers living with HIV should discuss their options with their medical team. The sooner appropriate treatment is started and continued, the better.

What is Rh incompatibility during pregnancy?

Rh incompatibility occurs when the mother’s and baby’s blood are incompatible or mismatched. This happens when a mother’s blood is rhesus-negative but her baby is rhesus-positive. However, this does not automatically cause problems. If the baby’s blood enters the mother’s bloodstream, her immune system may produce antibodies that can destroy the baby’s red blood cells.

If you are Rh-negative, you will be closely monitored. You may be given an injection called anti-D immunoglobulin, usually around Week 28, although some hospitals give two doses at Weeks 28 and 34. This helps prevent your immune system from developing antibodies against your baby’s blood. Additional injections may be needed if you experience bleeding or an abdominal injury during pregnancy, or within 72 hours after childbirth if your baby is Rh-positive. You may also have some extra blood tests to ensure that you are not developing rhesus antibodies. If antibodies have already developed, your baby may need closer monitoring, as anti-D cannot reverse this process. With appropriate screening and treatment, complications can usually be prevented.

What is pre-eclampsia and what are its warning signs?

Fluid retention is common in pregnancy. However, high blood pressure, particularly when accompanied by protein in the urine, could be an indication of pre-eclampsia. This condition usually develops after Week 20 of pregnancy and can sometimes occur even without protein in the urine, if other organs are affected.

A woman who is developing pre-eclampsia may suffer from severe or persistent headaches, sudden swelling of the face, hands or feet, rapid weight gain due to fluid retention, vomiting, severe pain just below the ribs, visual disturbances such as blurred vision or flashing lights, and difficulty breathing. She may also feel very unwell. However, some women experience no noticeable symptoms, which is why regular blood pressure and urine checks during pregnancy are important. If you experience any of these warning signs, seek medical attention immediately.

Pre-eclampsia is a serious condition and, if left untreated, may lead to seizures (eclampsia), a stroke or damage to the liver and kidneys. It can also affect the baby's growth. Women at increased risk may be advised to take low-dose aspirin from around Week 12, but only under medical supervision.

If detected during the early stages, close monitoring of the mother and baby and medication to control blood pressure may be recommended. In severe cases, medication may also be given to prevent seizures. In later pregnancy, however, if there is a risk to either the mother or the baby, labour may be induced or a caesarean section may be necessary. Pre-eclampsia can sometimes develop even after childbirth. It remains a significant cause of maternal mortality and hence has to be taken seriously, although regular antenatal checks and timely treatment can greatly reduce the risks.

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