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For a Healthy Pregnancy and Childbirth

− CONTENTS −

①Everyday life during pregnancy

②Receive a health checkup or expert health guidance

③Risks during pregnancy

④Dental and oral health management during pregnancy

⑤Protect your baby from the harms of tobacco and alcohol

⑥Avoiding communicable diseases during pregnancy

⑦ For those who tested positive for hepatitis virus in the prenatal health examination

⑧Taking medication during pregnancy, after delivery and while breast-feeding

⑨Painless childbirth

⑩Wearing a seatbelt during pregnancy

⑪Physical and psychological changes accompanying pregnancy and childbirth

⑫Your baby's regular physician

①Everyday life during pregnancy

A pregnant mother will experience various changes as the baby in her body develops. In particular, the period until around the 11th week (the third month) of pregnancy and beginning in the 28th week (the eighth month) are times when your body's condition is prone to change, so please be aware of how you go about your work or take breaks (for example, by resting on your side even for short spells while doing household chores or at work), how you eat, and so on. You should be more attentive than usual to your health. Visit a hospital or clinic immediately if you experience vaginal bleeding, a bloated stomach, or abdominal pain; if your water breaks; or if your baby's movements are weak or have stopped.

②Receive a health checkup or expert health guidance

During pregnancy, even if there are no particular concerns, it's important to undergo prenatal health examinations to check on the fetus's growth and your own health condition (such as blood pressure and urine). Municipalities provide subsidies for the cost of these health examinations.

* Ministry of Health, Labour and Welfare brochure on prenatal examinations and related matters

To have a safe and healthy delivery, you need to be careful about your everyday routine, nutrition, environment and many other things. Make sure to follow the advice provided by your physician, dentist, midwife, public health nurse, dental hygienist, dietician and or other medical professional. If you have any worries or concerns about pregnancy or delivery, or you experience stress at home or at work, do not hesitate to consult with these professionals. Maternity classes and parenting classes also provide useful information.

If you return to your parents' home before or after delivery (or to give birth there), contact a childbirth facility there as soon as possible and consult with the maternal and child health official in the municipality where you or your parents live.

* Pregnancy abnormalities (illnesses) like those listed below may be discovered during a health checkup for expectant mothers.

• Miscarriage: This is when pregnancy terminates before the end of the 22nd week of pregnancy. Symptoms may include vaginal bleeding and lower abdominal pain. Even if there is no particular cause for miscarriage in the early stage of pregnancy, it occurs with approximately 10% to 15% of pregnancies. If you experience miscarriage two or more times, you may require a test or treatment.

• Anemia: During pregnancy, you may experience anemia due to thin blood. To prepare for delivery, you should consume a large amount of iron. Severe anemia requires treatment.

• Threatened preterm labor: This is when there is a possibility of going into labor sooner than the normal time (before the 37th week of pregnancy). Symptoms include lower abdominal pain, vaginal bleeding or your water breaking early. In this case, you will be prescribed a regimen of rest, medication and so on.

• Gestational diabetes: This condition resembles diabetes, and it can happen even if you've never been diagnosed with diabetes before. In the case of gestational diabetes, you must follow a certain dietary regimen and manage your blood sugar.

• Preeclampsia (gestational toxicosis): A condition characterized by high blood pressure and the presence of protein in the urine.. Be aware that the condition may suddenly worsen, with symptoms such as severe headaches or eye irritation.

Placenta previa: The placenta is in a lower position than normal and is blocking the cervical opening. The condition may be accompanied by massive bleeding. A Cesarean section is required during delivery.

Abnormal volume of amniotic fluid: The placenta, which supplies the baby with oxygen and nutrition, disconnects from the uterus prior to delivery. Since the baby will have insufficient oxygen, emergency delivery may be required. The primary symptoms are abdominal pain and vaginal bleeding, and may also include diminished fetal movement.

③Risks during pregnancy

If any of the following apply to you, then you are at high risk of experiencing an abnormality (or illness) during normal pregnancy or child delivery. If you have any worries, consult with a physician at a hospital or clinic.

Young of age (under 20), of advanced age for an expectant mother (age 35 or older), low height (under 150 centimeters), overweight (BMI 25 or higher), drinking alcohol, smoking, pregnant with multiple fetuses, giving birth with fertility treatment, afflicted with diseases such as diabetes or kidney disease, experienced problems with past pregnancy or delivery

④Dental and oral health management during pregnancy

During pregnancy, it may become difficult to thoroughly brush your teeth due to physical changes such as morning sickness, and your hormonal balance and diet may also change. Therefore, this is a time that is prone to gum disease and cavities. To keep the inside of your mouth clean, in addition to your regular oral care, arrange to have your mouth cleaned with routine dental checkups and, if necessary, receive dental treatment during stable periods of your pregnancy (around the fourth to eighth months). An unhealthy mouth can have a negative effect on your newborn baby.

⑤Protect your baby from the harms of tobacco and alcohol

Smoking during pregnancy hightens the risk of threatened preterm labor, early breaking of your water and abnormal volume of amniotic fluid, thereby having a negative effect on the fetus' development. We know that smoking to an expectant mother or baby is associated with sudden infant death syndrome (SIDS). Not only the expectant mother, but the baby's father and other people around her should not smoke next to her or the baby.

Some mothers resume smoking after giving childbirth. Even after delivering the baby, you should refrain from smoking for the sake of yourself and your baby.

In addition, alcohol can have a deleterious effect on the fetus' development (especially the brain). Do not drink alcohol anytime during pregnancy. Even after delivery, you should refrain from drinking alcohol while you are still breast-feeding your baby.

⑥Avoiding communicable diseases during pregnancy

During pregnancy, immunity is reduced, making you more susceptible to communicable diseases. You may also be unable to take effective drugs during pregnancy out of concern for their effect on the baby. Wash your hands regularly, and also gargle and take other such measures to prevent infection.

If some sort of microbe (such as bacteria or a virus) is transmitted from the mother to the baby, in rare cases it could have an effect on the baby. A health checkup for expectant mothers can also check for the presence of communicable diseases. You can also receive treatment to prevent your baby from becoming infected, so you should make sure to receive an examination.

There are also as yet undiscovered communicable diseases and those which have been identified but are generally not screened for. If you come into contact with the saliva or excrement of a child or animal, wash your hands thoroughly.

* For precautions regarding diet during pregnancy, please read 'Preventing Food Poisoning During Pregnancy' carefully.

* National Institute of Infectious Diseases

* Prevent Infection of Babies and Mothers

⑦ For those who tested positive for hepatitis virus in the prenatal health examination

If you test positive (+) for HBs antigen, it means you are infected with the Hepatitis B virus. Similarly, a positive (+) result for HCV antibodies indicates an infection with the Hepatitis C virus. In both cases, you might not experience any symptoms, yet there's a possibility of developing hepatitis, liver cirrhosis, or liver cancer in the future. It's crucial to see a doctor and undergo detailed examinations.

You may be eligible for subsidies for the initial detailed examination, regular check-ups, and treatment of hepatitis. Please consult with your prefecture or the liver disease consultation and support center for more information.

The Ministry of Health, Labour and Welfare's website also provides details on these subsidies.

* Virus Hepatitis Patients Severe Complication Prevention Promotion Project (Ministry of Health, Labour and Welfare)

* Liver Disease Consultation and Support Center (National Center for Global Health and Medicine)

⑧Taking medication during pregnancy, after delivery and while breast-feeding

If you are going to take medication while pregnant or breast-feeding, make sure to speak with a physician, dentist or pharmacist. Since it is dangerous to stop taking medication or to change the way you take it or the dosage without consulting a health professional, make sure you closely follow your physician's instructions for how to take your medication and in what amount.

* Pregnancy and Medication (Ministry of Health, Labour and Welfare)

* The National Center for Child Health and Development provides information on taking medication while pregnant, so speak with your regular physician about it.

* The Pharmaceuticals and Medical Devices Agency website has a search feature so you can search for the package inserts of individual medications.

In addition, before receiving a uterotonic or other such medication used during childbirth, make sure to receive a thorough explanation from a physician on its necessity, the effects, the side effects and so on.

⑨Painless childbirth

During vaginal delivery, anesthetics can be used to alleviate the pain of contractions

If you're considering painless childbirth, check the website provided below or otherwise gain a solid understanding of how your hospital or clinic handles this procedure. Then speak with your physician to select a delivery method.

* Japan Association for Labor Analgesia "Information on Painless Childbirth" and more (jalasite.org

⑩Wearing a seatbelt during pregnancy

Wearing a seatbelt is a legal requirement in any seat of a motor vehicle, including the rear seats. Even if you are pregnant, wearing a seatbelt properly can protect you and your baby from harm in the event of a traffic accident. However, since each pregnancy is different, confirm with a physician on whether wearing a seatbelt will be detrimental to your health.

To reduce the effect on the fetus during an accident, while you are pregnant, where a seatbelt not only over your lap, but also over your shoulder. Make sure to fasten the seatbelt properly so that it is not pushing into your enlarged belly.

* Tokyo Metropolitan Police Department 「' The Right Way to Wear a Seatbelt When Pregnant '

⑪Physical and psychological changes accompanying pregnancy and childbirth

You may be worried by changes in your body and lifestyle caused by pregnancy and childbirth. In particular, after childbirth, you may feel down, cry easily or feel uncertain. In many cases, this is a temporary thing, but feelings of unhappiness or panic, or uncertainty about raising a child, may continue for two weeks or longer. Postpartum depression reportedly occurs in 10% to 15% of mothers after childbirth. After childbirth, a mother tends to focus on her baby, which can hinder her recovery from an abnormal physical and mental state. In addition, the father and other people around the mother will tend to make the baby their first priority and overlook changes in the mother. If you feel uncertain during pregnancy or after childbirth, or you wonder whether you are experiencing postpartum depression, do not worry in solitude. Consult with a physician, midwife, public health nurses at children and family centers, local child-rearing consultation organizations, or consider taking advantage of services such as postnatal care.

Postnatal care involves support for the mother's physical and mental well-being, parenting support, and assistance with breastfeeding, among other services.

Also, if you feel unusual during pregnancy or childbirth, you may require continued treatment or medical examinations after childbirth. Even if you think you are making good progress, receive an examination by a doctor just in case.

⑫Your baby's regular physician

During pregnancy, get a recommendation by your obstetrician or otherwise find a regular pediatrician who can see your baby at any time, even for a minor cold or fever.