Medical Care during Pregnancy
Gestational diabetes can develop during pregnancy. It usually goes away after birth. For most women, following a diabetic diet and getting regular physical activity can control this condition. Some women with gestational diabetes will need to manage it with insulin injections. Your health care provider, in consultation with a registered dietitian or diabetes educator, can help you manage gestational diabetes.
A small amount of vaginal bleeding in the first trimester does not mean you are having a miscarriage, but vaginal bleeding in the second and third trimester should be considered serious. If you have vaginal bleeding any time in your pregnancy, stop whatever you are doing and talk to your health care provider.
What your caregiver needs to know if you have vaginal bleeding:
- What colour is it? Pink, brown, or red?
- When did it start?
- What were you doing when it started?
- How much is there? For example, is it spotting the size of a quarter, or soaking your underwear?
- Did it happen after intercourse or a vaginal examination?
- Are you having cramps, pain, or any other symptoms?
With placenta previa, the placenta is either partially or completely blocking the cervix. This condition may cause vaginal bleeding. If you have a placenta previa at the time of birth, a caesarean birth will be recommended.
High Blood Pressure/Pregnancy Induced Hypertension
High blood pressure is also known as Pregnancy‑Induced Hypertension (PIH). It can lead to toxemia and pre‑eclampsia. About 7 in 100 pregnant women will develop high blood pressure. If it is not treated, it can harm both you and your baby.
Signs of high blood pressure in pregnancy:
- swelling in your hands and face
- rapid weight gain
- unusual headaches that don’t go away
- blurred vision
- spots or stars in front of your eyes
- pain in the upper right side of your abdomen
Immediately contact your health care provider or call HealthLink BC at 8‑1‑1, if you have any of these symptoms.
Premature Rupture of Membranes (PROM)
PROM is when the bag of water – also called amniotic sac or membranes – breaks or leaks before you are in labour or before your due date.
If your membranes break or leak:
- use a sanitary pad
- note the colour and amount of the fluid
- contact your health care provider
- do not take baths, put in a tampon, or have sex
The type of treatment will depend on:
- how many weeks pregnant you are
- how much fluid was lost
- whether you develop an infection
By about 32 to 36 weeks, most babies will move into the birth position. This is usually head down, meaning that the largest part of the baby is born first. In the breech position, the baby’s buttocks or legs are facing down and will be born first.
You may discuss the option to do external cephalic version (ECV). ECV is when the health care provider uses their hands on the outside of your belly to try to turn the baby to a head down position.
If ECV does not work, talk to your health care provider about the possibility of a breech vaginal delivery.
If none of these options are available or successful, you will need to have a caesarean birth.
Rh Factor and Blood Type
Blood tests will tell your blood type and Rh factor, but there is no way to find out your baby’s blood type until after birth. If you are Rh‑negative and your baby is not, you could develop antibodies – similar to having an allergic reaction – to your baby’s Rh‑positive blood. This can happen if your blood and your baby’s blood mix at birth, during an amniocentesis test, or if bleeding occurs in your pregnancy. This can cause serious illness or even death for your next baby. Because it can be prevented, it is seldom seen today. If you are Rh‑negative, you will receive an injection of Rh‑immune globulin (RhIg). This will prevent your body from forming antibodies and causing possible harm to your next baby.
The RhIg will be given:
- at about 28 weeks gestation
- after birth if your baby is Rh‑positive
- after an amniocentesis
- if you have any vaginal bleeding