If there are complications of pregnancy

Pregnancy and childbirth is a long process, mostly not associated with health problems, and for spouses these 9 months of waiting are filled with joy and happiness. Usually, pregnancy develops without complications, and the changes that occur while the body of the expectant mother grows and adapts to new conditions do not affect health, and a healthy boy or girl is born. But in some cases, complications may arise that affect both spouses.

The couple may not want to read this chapter until the man and his wife are experiencing problems. If the man does not want to read this chapter, the information will simply be there. It is intended to provide the knowledge to discuss the problem and how to solve it with the doctor.

If a man helps his wife cope with one of these complications, it will bring them closer together. A man is a very important participant in pregnancy, and his support can be the key to the birth of a healthy child. If a complication occurs, a man will understand how important he is to his wife and the growing child. Helping his wife can be part of pregnancy. If one of the described complications occurs in a woman, a man should be supportive and positive.

Some complications, such as gestational diabetes or gestational hypertension, are not uncommon and can cause significant discomfort to the expectant mother.

If a couple has questions, they shouldn't be afraid to ask for help. They can call their doctor or go to a prenatal appointment to discuss them. Although they may feel it's easier to ask relatives or friends, they shouldn't rely on their medical advice. The family doctor has likely encountered these situations many times. Another good source of information is a nurse or physician assistant. They often have more time to talk with the couple.

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Should I call a doctor?

A man and his wife may not know what can cause serious complications during pregnancy and when it is important to call a doctor.

If a woman experiences any of the symptoms described below, a doctor should be called immediately. The main danger signs are described below:

• vaginal bleeding
• severe swelling of the face or fingers
• severe abdominal pain
• regular contractions of the uterus
• loss of fluid from the vagina (usually a stream of fluid, but sometimes it is weak or feels like constant wetting)
• the woman feels strong changes in the baby's movements or lack of movement
• high temperature (above 38.7 °C)
• chills
• severe vomiting or inability to swallow food or liquids
• blurred vision
• painful urination
• prolonged or severe headache
• an injury or accident that has injured the woman or caused one of the spouses to have concerns about the child's well-being, such as a fall or a car accident.

Whenever either spouse has questions about the health of the expectant mother, they should call the clinic! This will not be a nuisance to doctors - they answer such questions every day. The spouses are patients, and it is easier for doctors to answer every question than to get an expectant mother with serious pregnancy complications because she did not call the clinic "because she did not want to bother the doctors." There may be situations when a woman will ask a man to call the doctor for her. This is normal. This is one way to support her.

If a man calls a clinic, he should be prepared for the nurse or doctor to ask to speak directly to the woman. When the doctor asks questions directly to the woman, rather than having the man relay the answers, he will be able to communicate better and answer questions more easily. A man can be helpful by calling and asking for someone to help. It is also okay for both spouses to be on the phone.

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If the news is bad

When a pregnancy complication occurs, there is always a chance that the outcome will be unexpected, the problem will be more complex than expected, or the couple's hopes for the future child will be dashed. If a couple faces such a situation, it will be more difficult to cope with than they thought. No one imagined that this would happen to them.

The best advice we can give if this happens is to try to cope with it together. This is a time to turn to each other for support. Whether it is the loss of a child or the loss of hope for a child, you should give yourself time to mourn it. The emotions associated with pregnancy can be too much for both spouses. This is a time to take care of your spouse and yourself.

You can ask other family members (if the spouses want it) for their help and support. If necessary, you can find outside support, for example, from a psychologist, rabbi or priest to help you get through this. Friends and relatives often want to help, but this can be unpleasant for the spouses. You should let them know about this.

A man can help by answering the phone and checking the answering machine. Spouses can also limit visits to the house if the woman asks for it or if they both feel that they do not want to communicate with people. During this difficult time, it is important to take care of your spouse.

The family may need help if they already have other children. This will give the man the opportunity to spend more time with his wife.

Many couples say that some of their most cherished memories of pregnancy are related to the changes they made in their lives. Most of these changes remain a part of their lives even after the baby is born.

Pregnancy complications

In this section we discuss various problems that may arise. In order for the doctor to deal with the problem, he needs to know about it. That is why it is important for a woman to undergo an examination at each prenatal consultation. This way, the development of the pregnancy and any complications, if any, can be monitored.

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Bleeding during pregnancy

Bleeding during pregnancy is not always a sign of a complication. Any bleeding should be reported to your doctor; he or she will likely refer you for an ultrasound. An ultrasound will not stop the bleeding, but it will give you reassurance. About 20% of women experience bleeding during early pregnancy. Light bleeding (spotting) that occurs in women after vigorous physical activity or after intercourse is not uncommon.

Bleeding in late pregnancy is a cause for concern, so you should call your doctor immediately. The problem may not be too serious, but you need to make sure.

SUPPORT FROM THE SPOUSE. The woman may be advised to rest in bed, but there is no surgery or medicine that can stop the bleeding. The doctor will prescribe medication based on the pregnancy history. Going to the prenatal clinic together and discussing the problem will be helpful. The woman can ask the man to call the doctor or go with her to the next consultation. If the bleeding occurs after intercourse, she can ask the man to be present so that they can discuss it with the doctor.

Ectopic pregnancy

An ectopic pregnancy is quite rare, occurring in about 1 in 100 pregnancies. It occurs when the fertilized egg implants outside the uterus, usually in the fallopian tube. One of the main signs of an ectopic pregnancy is pain; if the pain is severe and causes concern for the man or his wife, a doctor should be called.

Diagnosing an ectopic pregnancy is complicated and may require multiple tests and time. Tests include ultrasound and laparoscopy (microsurgery). It may take days or even weeks to get an answer.

SUPPORT FOR THE SPOUSE. An ectopic pregnancy prevents the pregnancy from being carried to term. The pregnancy cannot be transferred from the tube to the uterus. Surgery is usually performed to solve this problem. In some cases, a drug called methotrexate is used. It is not available everywhere and cannot be used if the tube is damaged.

In the case of an ectopic pregnancy, the pregnancy is lost. Both spouses will likely be sad if this happens to them. They should try to get through this problem together.

In addition, an ectopic pregnancy most often requires surgical intervention. The woman will most likely need the help and support of a man during recovery. She lost the pregnancy and underwent surgery. Physical and emotional support from a man during this difficult time will be necessary for her.

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If a woman fell

Falls are the most common cause of minor injuries during pregnancy. Fortunately, falls usually do not cause serious harm to the fetus or mother. The baby's movements after the fall are evidence of this. Vaginal bleeding or severe abdominal pain after a fall may indicate a problem; fluid leaking from the vagina indicates rupture of the membranes.

If a woman has fallen, she should contact her doctor: the expectant mother may need observation or examination. If she has fallen very badly, her doctor may refer her for an examination of the baby's heartbeat or an ultrasound to make sure the baby is not injured.

SUPPORT FROM A SPOUSE. Falling can be painful and frightening for a pregnant woman. She will worry about whether she has harmed the baby or whether she is okay. In this situation, the confidence and support of a man is very important. The house should be checked to see if there is any way to prevent falls. If a woman does household chores, this increases the risk of falling.

Gestational diabetes

Some women have diabetes that only appears during pregnancy; this is called gestational diabetes. The condition occurs when the normal hormonal changes associated with pregnancy, combined with diet, lead to high blood sugar levels. This can result in a larger baby, make the pregnancy more difficult, and cause the baby to have problems such as heart problems.

Gestational diabetes occurs in about 10% of pregnancies. After delivery, almost all women who had gestational diabetes return to normal.

If the doctor finds abnormal sugar levels in the woman's urine during routine procedures (this is one of the reasons why the expectant mother's urine is tested at every prenatal visit), other tests will be done. Gestational diabetes is diagnosed with special blood tests.

SUPPORT FOR WOMEN. One of the best ways to manage gestational diabetes is to eat right. The amount of food consumed at any one time should be limited, and a dietitian can help plan 3 main meals and 3 snacks. If a woman does not eat right or if she eats too much at one time, it can raise her blood sugar levels.

The couple continues to eat together, but the woman's portions become smaller and she may eat earlier or later than usual.

A man should help his wife choose food that is healthy for her (and for him!) She should avoid sugar and sweets, and keep fat intake to a minimum. Artificial sweeteners should not be used. At each meal, a woman should eat dairy products, proteins, fruits, vegetables, cereals and limited amounts of fat. This diet plan is good for men too. Snacks should contain fiber and proteins; the last snack of the day should also contain milk and fat, which is designed to keep the woman's blood sugar level constant at night.

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Hypertension during pregnancy

Hypertension is another condition that some pregnant women experience (hypertension is also called high blood pressure). Most women who suffer from hypertension during pregnancy do not have high blood pressure before the pregnancy, and the problem usually goes away after the baby is born. In some cases, the woman may have had hypertension before she became pregnant.

When a woman's blood pressure rises, the blood vessels in the uterus that supply nutrients and oxygen to the unborn baby constrict. These contractions can slow the fetus's development. High blood pressure also increases the risk of placental abruption (separation of the placenta from the uterine wall before delivery).

Hypertension can also lead to other complications: about 20% of all women who suffered from it before pregnancy are prone to preeclampsia.

This condition is treated with bed rest, increased fluid intake, and avoiding salt and foods high in sodium. If these changes in diet do not work, blood pressure lowering medications may be prescribed. Women who do not respond to these will likely be hospitalized.

SUPPORTING THE SPOUSE. A man should help his wife avoid foods containing large amounts of salt and sodium, and ensure that she drinks more. Regular blood pressure measurements are a good way to encourage a woman to follow these recommendations.

If a woman has been advised to stay in bed, she should be helped in every way possible. The ways in which she can be helped are described later in this chapter, in the section on bed rest. It is necessary to help her comply with the doctors' instructions, and also to make it possible for her to rest by taking over household chores and not encouraging her to do anything that is contrary to the medical advice given by the doctors.

Miscarriage

A miscarriage is the termination of a pregnancy before the 20th week of gestation (premature termination of a pregnancy after the 20th week is called stillbirth). The embryo or fetus is born before it can survive on its own outside the womb.

A miscarriage is an unpleasant event for any married couple. Many couples mistakenly blame themselves for it. It is not the spouses' fault, and a man should not blame himself or his wife for it.

The main reason for early miscarriage is abnormalities in embryo development. Research has shown that in more than half of all miscarriages, the embryo had chromosomal abnormalities. Miscarriage can also be caused by external factors - radiation or certain chemicals (drugs or medications). In some cases, the combination of sperm and egg of the spouses leads to genetic abnormalities, which results in miscarriage.

The first sign that a miscarriage is likely is vaginal bleeding followed by cramps. If a woman experiences these symptoms, she should call a doctor immediately! Unfortunately, there is not much that a man, his wife, or a doctor can do to prevent a miscarriage: there is no operation or medicine that can stop it.

SUPPORT FROM YOUR SPOUSE. Most doctors recommend rest in bed and no straining. Some prescribe the hormone progestrogen, but not all doctors agree with its use. Ultrasound and blood tests can help the doctor determine if there is a risk of miscarriage, but these are not completely accurate results. In most cases, miscarriage occurs regardless of what is done.

This can be a traumatic experience for both partners. The woman will need the man's support, and he will need hers. It is important to share your feelings of loss and sadness and not blame each other for it. Very often, one or both spouses believe that they are to blame for the miscarriage.

At this time, it is very important to help each other. The man should explain to the woman that this is not her fault. The spouses have a hard time coping with this loss, and the feeling of guilt is completely unnecessary.

Placenta-related pathologies

The placenta ensures the transfer of nutrients and oxygen from the expectant mother to the fetus and removes metabolic waste products from the fetus. The most common pathologies associated with the placenta are placenta previa, placenta abruption, and placenta accreta.

PLACENTA PREVIA. When the placenta previa occurs, it partially or completely covers the cervix. The placenta can separate from the uterus when the cervix dilates (opens) during labor, causing heavy bleeding. Placenta previa occurs in 1 in 200 pregnant women during the last trimester of pregnancy.

In the case of placenta previa, the baby is most likely in the wrong position. For this reason and to avoid bleeding, the doctor almost always recommends a cesarean section. The symptoms of placenta previa vary, but one of the characteristic signs is painless bleeding.

SUPPORT FOR THE SPOUSE. If the doctor has determined that a woman has placenta previa, she will need to avoid certain types of activity. Most doctors recommend avoiding intercourse, travel, and palpation. Placenta previa is a very serious complication and can lead to heavy bleeding. If the woman has been given instructions because she has placenta previa, she should be helped to follow them.

ABRUPTIA OF THE PLACENTA. Abruption of the placenta is the separation of the placenta from the wall of the uterus before labor begins. Normally, it does not separate from it until the baby is born. Separation of the placenta before the baby is born can be dangerous for both the mother and the baby.

Placental abruption occurs approximately once in 80 births. The main symptom of placental abruption is heavy bleeding from the vagina. In case of very heavy bleeding, the woman may go into shock due to blood loss. Other symptoms such as pain or severe cramps are also likely. In some cases, ultrasound can diagnose this problem.

The main method of treatment is extraction of the baby. However, the timing of delivery varies in each individual case; sometimes a cesarean section is recommended, but it all depends on the specific situation.

SUPPORT FROM THE SPOUSE. It is known that the risk of placental abruption increases if the woman smokes or drinks alcohol, so it is necessary to stop doing both (this is also necessary for other reasons). Cocaine use can also lead to this pathology. Placental abruption is unpleasant because it implies serious problems. That is why in this situation the woman needs support. It is also important to follow the instructions of doctors. The woman may be hospitalized or will not be allowed to do certain activities. She needs the help of a man, and this help should be provided.

WHEN THE PLACENTA MELTS AWAY. Sometimes during labor, the placenta does not separate after the baby is born, as it usually does a few minutes after birth.

When the placenta or part of the placenta does not detach, it is called placenta accreta.

The most significant problem in this case is heavy bleeding after delivery. If the placenta does not come out on its own, the doctor will have to separate it in a procedure called dilation and separation. If the placenta has grown through the wall of the uterus, a hysterectomy may be necessary, but this is rare.

SUPPORT FROM THE SPOUSE. If the placenta accreta occurs, there is often heavy bleeding, which can lead to anemia. Anemia is a decrease in the number of blood cells, causing fatigue and lack of energy. The woman will likely need to take iron supplements. In severe cases, a blood transfusion may be needed. Recovery from anemia caused by placenta accreta is usually longer and more difficult. The woman will need support from her husband in more activities; she may be advised to stay in bed.

Preeclampsia

The condition preeclampsia used to be called toxemia of pregnancy or simply toxemia. It is a serious problem that only occurs during pregnancy. Preeclampsia can develop after the 20th week of pregnancy, although most cases occur after the 30th week. If left untreated, it poses serious risks to both mother and baby.

Fortunately, most cases of preeclampsia are mild and treatable. In mild preeclampsia, blood pressure increases gradually (hypertension, described above). The only visible symptom of preeclampsia may be swelling of the legs, arms, and face.

Following all of your doctor's recommendations is the best way to avoid developing this condition. If you follow your doctor's instructions, you can usually treat preeclampsia before it becomes serious.

Certain signs indicate a worsening condition. A doctor should be called immediately if a woman has preeclampsia, increasing pain in the right hypochondrium, headache, sees spots, or has other visual hallucinations.

In cases of mild preeclampsia, the doctor will likely recommend that the woman rest in bed until her blood pressure stabilizes or until she gives birth. She may be advised to drink plenty of fluids and avoid salty foods and foods high in sodium. In some cases, the pregnant woman may be prescribed medications to lower her blood pressure.

If the condition worsens, the expectant mother will be hospitalized for bed rest and observation. Blood tests may be performed. The unborn child will also be monitored and assessed; in particular, a biophysical profile or passive test may be performed.

ECLAMPSIA. Fortunately, preeclampsia rarely gets worse, but if it does, it can quickly develop into a serious condition called eclampsia. Eclampsia is accompanied by seizures or convulsions, and the woman may go into a coma (a seizure is a loss of body control, like fainting; often the person shakes; a convulsion is a violent spasm). Both seizures and convulsions can harm the expectant mother or her baby.

The woman may be given medications to control seizures, including magnesium sulfate or an anticonvulsant such as phenobarbital. She may be hospitalized for a thorough evaluation.

If these measures do not help and the woman's condition does not improve, it will be necessary to induce labor so that the mother does not develop complications such as convulsions, stroke, liver and kidney damage. In this situation, it is important for the man to actively participate in the decision.

SUPPORTING THE SPOUSE. As we mentioned when discussing gestational diabetes, the man should help his wife avoid foods that contain a lot of salt or sodium. She should drink plenty of fluids. If the woman is advised to stay in bed, the man should help her with everything and be supportive. Ways to do this are described in the section on bed rest. If the woman’s condition worsens and she is admitted to the hospital, the man should let her know that he will do whatever is necessary to support her. Ask your wife what she would like to take care of – perhaps something she wanted to do before the baby was born. If she is advised not to work, she should be helped to understand and accept the changes that are necessary.

Preterm labor and premature birth

In some situations, a pregnant woman may show signs that she may be in preterm labor. Preterm birth means that the baby is born more than 4 weeks early; this is also called preterm labor. About 10% of all babies are born between 34 and 36 weeks of pregnancy, and most of them are normal and healthy.

However, having a baby quite a long time before this time can lead to problems, especially if the baby is born before the 32nd week of gestation. Premature birth can be dangerous because the lungs and other organ systems may be underdeveloped and not ready to perform their functions on their own. In most cases, it is better for both mother and baby if premature birth can be prevented to avoid increasing the risk of complications.

If a woman is going into preterm labor, it is important for the doctor to try to stop the contractions. Most doctors recommend bed rest and plenty of fluids as the first step. Medication may be prescribed later. Why is bed rest prescribed in the first place? It is often helpful as a measure to prevent preterm labor. Before medications, bed rest was the only way to prevent preterm labor, and it is still effective.

There are medications that a doctor can use to stop preterm labor, depending on the pregnancy history. Even if a woman is prescribed medication, she will most likely be advised to stay in bed. Medications that relax the uterus and stop contractions include magnesium sulfate, beta-adrenergics, and sedatives or narcotics.

SUPPORT FOR THE SPOUSE. If the woman has been advised to stay in bed, the man should help her in any way possible. They are described below. Sometimes it is useful to understand that every day that the baby is inside the womb is a day that the man does not have to enter the neonatal intensive care unit!

Bed rest

To increase a woman's chances of having a healthy baby, bed rest is recommended. The three most common reasons for this recommendation are the risk of premature birth, preeclampsia, and placenta previa.

Nowadays, 1 in 5 women spends at least 1 week in bed during pregnancy. If the condition is severe or the woman cannot stay in bed at home, she may be hospitalized.

Why is bed rest necessary? First of all, when a woman is in a lying position, the baby does not press on the cervix, which can help with the risk of premature birth. Secondly, when a woman lies on her side, this improves blood flow to the uterus, and therefore the baby receives more nutrients and oxygen. A woman can turn from side to side, but she cannot lie on her back, since this compresses the vena cava and, therefore, reduces the blood supply to the baby.

Bed rest can be a major change from the couple's normal lifestyle. The woman will not be able to work and will also have to give up other activities; such changes can cause stress. It can be hard for a woman to force herself to stay in bed, but a man should remind her that home is better than hospital!

A woman who has been advised to stay on bed rest should ask her doctor about what she can and cannot do. Sometimes she cannot get out of bed except to eat, go to the bathroom, and attend prenatal visits. In some cases, bed rest may be less strict. She may be allowed to sit up or be a little more active for part of the day. She may also be prescribed medication.

Bed rest is usually recommended towards the end of pregnancy, and most women are forced to do it right up until the birth! This can be no fun for either partner, especially when they remember that they will have a lot of new responsibilities once the baby is born. And it really isn't much fun if your doctor recommends no sex during bed rest.

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Spouse support

A man should maintain a positive outlook if his wife is advised to stay in bed. This advice is good for both spouses! The goals of resting in bed are a healthy baby and a healthy mother. If the woman feels depressed at this time (which is a normal reaction), the man should remind her that everything is being done to give the baby the best start in life. There are some things a man can do to help his wife accept this necessity more easily. He should be there for her when he is at home. It is very lonely to lie in bed alone all day. Encourage her friends and relatives to call or come over if the woman is feeling well enough to do so. If they offer to help around the house, accept the help! Most people enjoy helping out. They can be asked to do some shopping, dry cleaning, laundry, babysitting, or cooking.

A man should take on the housework. If a woman worries about a dirty toilet or unwashed dishes, it can hurt her. At the same time, you should remind her that you are doing the best you can, and the house is unlikely to look as shiny as she would like.

If a man is thinking about what to give his wife, he should choose something that will help her while away the long hours in bed. A new CD, rented video tapes, a nice set of stationery and stamps, a new book or a book on tape will help her pass the time.

Emergency surgery during pregnancy

An emergency situation can occur even during pregnancy. In such a case, the intervention must be carried out in the best way for the woman and her developing fetus. Some surgeries may be necessary. For example, appendicitis, removal of bladder stones, ovarian cysts, bone fractures and dental problems.

Anesthesia or pain relief is likely to be necessary for the surgery. You should ask your doctor to use it as little as possible. It is best for both you and your baby to avoid general anesthesia in the first trimester and in general. If general anesthesia is necessary, your baby will be closely monitored during the surgery.

In an emergency, the doctor will do everything to preserve the health of the mother and child. If the spouses are faced with this problem, they should make decisions together with the doctor. It should be understood that problems such as appendicitis and bone fractures require attention and cannot wait until the end of pregnancy.

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