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PREGNANCY

One of the greatest gifts given to the female body by Allah is the ability to produce, carry and subsequently raise children. Pregnancy is an amazing period of a woman's life. The following article aims to identify and explain common questions about the pregnant period, and how to ensure the best for both mother and child.

Table of Contents

Introduction
Common signs of Pregnancy
Antenatal care
Safeguarding baby’s health
Common problems during Pregnancy
Common complications
Diet Planner
Quran
The virtues of pregnancy
Forbidden for Wife to hide about pregnancy from Husband
Why the Baby Cries when Born
What To Do Upon Birth
Seek Allah's protection for children
How to congratulate new parents and how they should respond
Scholars view on aborting a pregnancy in the early stages
See also
References

Introduction

The idea of pregnancy may prove frightful for some women, if not all. Every mother wishes to ensure that her child will receive the best possible care whilst inside the womb, and this can be achieved in a number of ways;

By the mother herself – by leading a healthy lifestyle

By the Healthcare Team who provides the ‘Antenatal Care’ scheme

By the family – through support and assistance

Pregnancy usually lasts for a time period of 40 weeks, but this can vary from woman to woman, and is dependent upon a number of factors such as whether the mother smoked during pregnancy or if there is a family history of premature babies, etc..

Common signs of Pregnancy

To begin with, it is important for every individual to recognize the usual signs and symptoms of pregnancy. In the first 10 weeks of pregnancy women may experience any of the following ^[1]:

Absent periods (most common)

Nausea/Vomiting

Increase in the frequency of urination

Increase in temperature

Headaches

Fainting

Sweating

If you have experienced any of the above and you suspect pregnancy, it is best to go to your G.P. (General Physicians) straight away, where a pregnancy test can easily be conducted; otherwise one can purchase Pregnancy Kit from a pharmacy.

The pregnancy test itself measures the level of a hormone excreted in the urine and produced solely in pregnancy, which is known as Human Chorionic Gonadotrophin (HcG). HcG can be detected in the urine by the 8th day of pregnancy^[2]. However the outcome of an early pregnancy test can be affected by medications such asThiazide.

Diuretics/Hormones/Steroids/Thyroid drugs, so if you are on any medications it is best to remind your doctor as to what you take.

Antenatal care

Once it has been confirmed that a woman is indeed pregnant, it is important for that individual to notify and stay in contact with the health professionals responsible for the care of mother and baby, so that they can track progress of the pregnancy. The health professionals who are usually responsible for this care include the local G.P, a community midwife, a health visitor and the occasional visit to the local hospital consultant. These professionals are there to provide the best possible healthcare for mother and baby throughout the pregnancy, in order to ensure the optimum outcome for both. This is commonly known as Antenatal care. During the pregnancy the healthcare team will routinely take histories, perform examinations, screen and assess mother and baby using a variety of methods such as ultrasounds and blood/urine analysis ^[3]. Ultrasound Scans may be performed at any point if there are any concerns.
It is vital to attend all scheduled appointments so that all concerned are up-to-date with the mother and baby’s progress.

Safeguarding baby’s health

Assessing the progress of the baby using the variety of methods described previously is essential in identifying and acting upon any recognized abnormalities. Nevertheless, it is just as critical for the mother to provide the optimum environment in which her baby can develop. This can be achieved in a variety of ways;

DIET- it is very wise to eat foods rich in Folate (spinach, sprouts, asparagus, blackeye beans), and when planning pregnancy to take Folic Acid supplements before conception up until the 13th week of pregnancy, in order to reduce the risk of Neural Tube defects. It is also best to avoid high intake of Vitamin A and Liver. ^{[1] [3] [4]}

SMOKING - the disadvantages of smoking are numerous and well known. During pregnancy it is thought that smoking increases the risks of miscarriage/having a small baby/premature labour, as well as having other toxic effects on mother and child.

EXERCISE - excessive exercise and build up of heat are best avoided, especially during early pregnancy, as an increase in the mother’s body temperature can increase the risk of neural tube defects. However, moderate physical activity in a healthy woman with a normal pregnancy is beneficial (increases Oxygen capacity and stamina, etc). ^[2]

MEDICAL HISTORY- it is essential for anyone who already suffers from a medical condition, to control it well, and communicate any problems to the health professional concerned.

Common problems during Pregnancy

During pregnancy the body undergoes a number of changes in order to accommodate the growing foetus. The mother therefore experiences a number of symptoms, which are perfectly normal in pregnant women.

The most obvious change is that of weight gain, as the womb increases in size. By term (40 weeks) it is usual to put on 1kg of weight ^{[1] [3] [5]}

CARDIOVASCULAR SYSTEM- pulse rate increases by about 15 beats per minute. Many women experience lower leg and ankle swelling due to an increased pressure on the inferior vena cava (a blood vessel which returns blood to the heart). This can be relieved by rest and elevating the legs.

GASTROINTESTINAL SYSTEM- heartburn/nausea/vomiting are all common problems, therefore it is best to avoid spicy foods/cigarettes/large meals, as they can all irritate the stomach ^{[1] [6]}. As the movements of the bowels decrease during pregnancy, constipation may also be encountered. To prevent this a high-fibre diet and increase in fluid intake is suitable.

GENITO-URINARY SYSTEM- as the womb enlarges it places pressure on the bladder, which can increase the urgency and frequency of urination. ^{[1] [4] [6]}

RESPIRATORY SYSTEM- a rise in the amount of air inhaled and exhaled is normal, to compensate for foetal demands, breathlessness is also common. ^{[1] [6]}

SKIN- some women experience an itch/itchy rashes/increased pigmentation around eyes, cheeks, nipples and lower abdomen. Stretch marks may also become apparent over the lower abdomen as the womb enlarges. ^{[1] [6]}

MUSKULOSKELETAL SYSTEM- Backache is an extremely common symptom, and is most obvious in the lower back, due to the swayed-back posture adopted by most pregnant women. It may be useful to lie on a firm mattress, wear flat shoes and try standing up straight. ^[1]

OTHER CHANGES– it is worth to note that the breasts and nipples also enlarge in preparation of breastfeeding. Headaches, sweating, fainting and palpitations are more apparent in pregnancy, and may be alleviated by upping oral fluid intake and taking more showers. Almost one-third of women experience painful leg cramps (worse at night) in the second half of pregnancy; raising the foot of the bed by 30 cm may help with this complaint. ^[1] [3] ^[6]

Common complications

It is only to be expected that where there is a major change to the body, the risk of complications is also increased. This can be the case in pregnancy. Although, most pregnancies go without any major problems, some have higher chances of contracting certain conditions. However, with modern-day diagnostic techniques swift action can be taken to control such setbacks during the pregnancy period and thereafter.

A list of the most common complications:

PRE-ECLAMPSIA (Pregnancy-induced Hypertension with Proteinuria) - this condition is defined as a high blood pressure on at least 2 occasions in the second half of pregnancy ^[2]. It occurs in 5-10% of pregnancies ^[3] [5]. Risk Factors include; Past/Family history of pre-eclampsia, Pre-existing high blood pressure, pre-existing diabetes, age under 20 or over 35 years, past migraine and renal disease ^{[1] [3] [5] [6]}. Pre-eclampsia can show no symptoms at all, which is why your blood pressure and urine are routinely checked at antenatal visits. Sympyomatic pre-eclampsia may present with headaches/chest or stomach pain/vomiting/visual disturbances/swelling ^[1] [5]. Treating this condition prevents foetal/maternal illness from the subsequent condition ‘Eclampsia’ where seizures are encountered, or even stroke/heart, liver or kidney failure ^{[1] [5] [6]}. Although women may be given certain medications to control the high blood pressure, delivery is the only cure.

IRON-DEFICIENCY ANAEMIA- in pregnancy the rate of iron-absorption increases by 9 times, to meet foetal demands, therefore it is important for pregnant women to increase their iron-intakes. Anaemia is defined as a haemoglobin level below 11g/dL. Risk factors include; pre-existing anaemia, twin pregnancy and poor diet ^{[1] [5] [6]}. Antenatal screening also routinely measures the haemoglobin levels, in order to identify any anaemic episodes. Treatment usually involves oral iron tablets, however if anaemia is severe, a blood transfusion may be required ^[1].

GESTATIONAL DIABETES- this is a relatively common disorder, affecting 1-2% of pregnant women. Here the diabetes typically develops toward the last 3 months of pregnancy ^[3] ^[5]. This is caused by the hormonal changes during pregnancy, which subsequently affect carbohydrate breakdown and usage within the body ^[3]. Risk Factors include; Family history of diabetes, obesity, past history of unexplained stillbirth, previous baby over 4.5 kg ^{[3] [6] [7]}. Gestational diabetes is associated with large babies, congenital malformation (e.g. Cleft Palate), pre-eclampsia and increased risk of miscarriage. Maternal complications include; coronary artery disease, infection and thromboembolism (blood clots) ^{[3] [6] [7]}. Antenatal checks measure glucose levels in order to pick up any changes which may lead to this condition. If GD is confirmed, the control of the blood-glucose level throughout pregnancy is essential in terms of management, and insulin is usually required, as well as advice from a dietician ^{[1] [6] [7]}. Ultrasound may also be recommended to assess foetal growth ^[3]. If pregnancy is otherwise ok, normal vaginal delivery is permitted between 38-40 weeks gestation ^{[6] [7]}.

VENOUS THROMBOEMBOLISM– the risk of developing a blood clot in the legs or lungs in pregnancy increases by six-fold ^[1]. It occurs in approximately 1% of pregnancies, and is the leading cause of maternal death in the U.K, therefore it is vital to recognise the signs and symptoms. Risk factors include; obesity, past history of blood clot, older age (over 35), prolonged immobility, pre-eclampsia. Deep Vein Thrombosis = blood clot in legs, signs and symptoms = calf pain & tenderness, leg swelling; management = giving a drug known as Heparin throughout pregnancy (it breaks up the clot and prevents further clotting) ^{[1] [3] [7]}. Pulmonary Embolism = blood clot in the lung; signs and symptoms = chest pain, coughing up blood, breathlessness, fever, cough; management = Heparin until at least 3 months after the onset of the clot.
In some patients who are at a high risk of developing a clot, Heparin may be given throughout pregnancy ^[1] [6]. In women who are at a low risk, heparin may be administered during labour, C-Section operation, or when inducing labour ^[1][3].

MISCARRIAGE– unfortunately, 30-40% of pregnancies miscarry (abort), usually in the first 3 months of pregnancy ^[1]. Risk factors for miscarriage include; smoking, infections (especially those of the genital tract), previous history of miscarriage and previous premature birth ^[3]. Some women may also miscarry due to physiological incompetencies, e.g. the cervix may be incompetent, there may be abnormalities of the womb, or it may be due to maternal disease (diabetes mellitus/SLE) ^[1]. Signs and symptoms of miscarriage may be quite vague and include vaginal bleeding (very common), lower abdominal discomfort, backache and generally unwell ^{[3] [7]}. Sometimes, symptoms may be mild but no foetal products are released, this is known as ‘threatened abortion’ and 75% of cases settle with rest ^[1]. In other cases, some of the foetal products may be retained and therefore an evacuation procedure may be used to take out the retained tissues, or drugs may be administered to cause contractions of the womb, so that the retained tissues are released.
Miscarriage is obviously a sorrowful event with many women needing time for grieving, and many hospitals now have specialist midwife co-ordinators to deal with such issues, to therefore try and prevent such events in the future. ^[a]

Diet planner

A healthy pregnancy diet will promote your baby's growth and development.There is no magic formula for a pregnancy diet. In fact, during pregnancy the basic principles of healthy eating remain the same i.e., get plenty of fruits, vegetables, whole grains, lean protein and healthy fats. However, a few nutrients in a pregnancy diet deserve special attention.

The food pyramid is broken down into six categories:

1. Bread, cereal, rice, and pasta (6-11 servings, pregnant women need at least 9)-
This group provides your body with complex carbohydrates that give you energy. They are a good source of vitamins, minerals, and fiber. When choosing a food from this group look for foods that are whole-grain, such as whole-wheat bread, and try to avoid foods that are loaded with fat and sugar.

One serving equals:

1 slice of bread

1 ounce of cold cereal

½ cup cooked cereal, rice, or pasta

2. Vegetables (3-5 servings, pregnant women need at least 4)-
Vegetables are a good source of many vitamins, such as vitamins A and C, and minerals such as iron and magnesium. They are also great for you because they are low in fat and high in fiber. To ensure that you get a wide variety of these vitamins and minerals choose an array of vegetables such as:

dark-green leafy vegetables (spinach, broccoli)

starchy vegetables (potatoes, corn, peas)

deep-yellow or orange vegetables (carrots, sweet potatoes, squash)

legumes (chick peas and all types of beans)

One serving equals:

1 cup of salad greens

½ cup of other cooked or raw vegetables

3/4 cup vegetable juice

3. Fruits (2-4 servings, pregnant women need at least 3)-
Like vegetables, this group also provides many vitamins and minerals such as potassium and vitamin A. Choose from fresh, frozen, canned, and dried fruits such as melons, berries, and citrus fruits. Another good choice is natural, unsweetened, fruit juices. Fruit drinks, which contain excess sugar and artificial flavors, should be limited.

One serving equals:

1 medium apple, banana, or orange

½ cup chopped, cooked, or canned fruit

½ cup fruit juice

1/4 cup dried fruit such as raisins

4. Milk, yogurt, and cheese (2-3 servings, pregnant women need 3)-
Dairy products are a significant source of calcium and other nutrients such as protein and phosphorus. Calcium is very important during pregnancy and breastfeeding. When meeting your daily dairy requirements, try to choose low-fat, skim, or part-skim varieties of your cheeses, milk, and yogurt.

One serving equals:

1 cup milk or yogurt

1 ½ ounces of cheese

5. Meat, poultry, fish, beans, nuts, and eggs (2-3 servings, pregnant women need 3 servings)-
This groups provides protein, vitamin B, iron, and zinc that the fetus needs to develop. To reduce unnecessary fats, choose lean meats and cut off fat and skin before cooking.

One serving equals:

2-3 ounces cooked lean meat, poultry, or fish

1 egg

2 tablespoons peanut butter

6. Fats, oils, and sweets (sparingly)-
These are full of unneeded calories and fat. You should get no more than 30% of your calories from fat. Choose low-fat salad dressings, and limit butter, margarine, and gravies. Eat high sugar foods and desserts sparingly ^[b]

Quran

It is He who created you from one soul and created from it its mate that he might dwell in security with her. And when he covers her, she carries a light burden and continues therein. And when it becomes heavy, they both invoke Allah, their Lord, "If You should give us a good [child], we will surely be among the grateful." Qur'an surah Al-A'raf 7:189

The virtues of Pregnancy

It was narrated that Ma‘qil ibn Yasaar said: A man came to the Prophet (blessings and peace of Allah be upon him) and said: I have found a woman who is of good lineage and beautiful, but she cannot have children; should I marry her? He said: No. Then he came to him a second time and he told him not to marry her. Then he came to him a third time and he said: “Marry the one who is loving and prolific (could bear many children), for I will be proud of your large numbers before the nations.” Abu Dawood, 2050; al-Nasaa’i, 3227; classed as saheeh by al-Albaani.

Woman dies in childbirth, she will die as a martyr. This is indicative of the virtue of her condition. The Prophet (blessings and peace of Allah be upon him) said: “The woman who dies in pregnancy or childbirth is a martyr.” Sunan an-Nasa'i 3163 and Abu Dawood, 3111; classed as saheeh by al-Nawawi in Sharh Muslim, 13/62. And he said: the one who dies in childbirth, i.e., she dies with something (the child) inside, not separated from her. ^[c]

Forbidden for Wife to hide about pregnancy from Husband

Allah said: "...it is not lawful for them to conceal what Allâh has created in their wombs" Qur'an Al-Baqarah 2:228

Why the Baby Cries when Born

Narrated Sa'id bin Al Musaiyab: Abu Huraira said, "I heard Allah's Apostle saying, 'There is none born among the off-spring of Adam, but Satan touches it. A child therefore, cries loudly at the time of birth because of the touch of Satan, except Mary and her child." Then Abu Huraira recited: "And I seek refuge with You for her and for her offspring from the outcast Satan" (Quran 3.36) Sahih al-Bukhari 3431 (Vol.4:641)^[d]

WHAT TO DO UPON BIRTH

Rights after the child is born

Tahneek: It is Sunnah (recommended) to do tahneek (little of the dates put in childs mouth) for the child when he is born, Sahih Al Bukhari, 5153; and Sahih Muslim, 2144
Naming: The child should be given a good name, such as ‘Abd-Allaah or ‘Abd al-Rahmaan. Sahih Muslim, 2132, 2315
Shaving: It is Sunnah to shave the child’s head on the seventh day and to give the weight of the hair in silver in charity. Tirmidhi, 1519; classed as hasan by Shaykh al-Albaani in Saheeh al-Tirmidhi, 1226
Aqeeqah: “Every child is in pledge for (sacrificial animal) which should be slaughtered for him on the seventh day, his head should be shaved and he should be named.” Abu Dawood, 2838; classed as saheeh by Shaykh al-Albaani in Saheeh al-Jaami’, 4541

Two sheeps for a boy and one for a girl. Tirmidhi, 1513; Saheeh al-Tirmidhi, 1221; Abu Dawood, 2834; al-Nasaa’i, 4212; Ibn Maajah, 3163
Circumcision: “The fitrah (natural state) is five things, or five things are part of the fitrah: circumcision, shaving the pubic hair, plucking the armpit hair, clipping the nails and trimming the moustache.”Sahih al-Bukhari, 5550; Muslim, 257

Seek Allah's protection for children

The Prophetﷺ used to seek Allah's protection for Al-Hasan and Al-Husain by saying: (Dua to safeguard from Evil Eyes) "U'eezukumaa bikalimaatil-laahit-taammati min kulli shaytaanin wa haammatin, wa min kulli 'aynin laammatin".

Translation: "I seek protection for you in the Perfect Words of Allah from every devil and every beast and from every envious blameworthy eye." Sahih Al Bukhari Vol 4:119 ^[e]

How to congratulate new parents and how they should respond

Dua to be read (whether it is male or female child) جَعَلَہُ اللّٰہُ مُبَارَکًا عَلَیْکَ وَ عَلٰی اُمَّۃِ مُحَمَّدٍ ﷺ"(Ja’lahullahu Mubarakan Alika wa a’la ummati Muhammad)” meaning May Allah bless this child on you and on the ummah of Muhammad (May Allah honour Him and grant Him Peace) Authenticated by yahya al hujuoori from Tahqeeq kitabo Usool ul Amaani bi Usooli At –Ta’hani by Imam suyuti. Kitab ud Dua, Tabrani Vol 1: 294 and 945, . Al-ayal, Ibn e Abi duniya Vol1: 366 and 202

Scholars view on aborting a pregnancy in the early stages

The Council of Senior Scholars issued the following statement:

It is not permissible to abort a pregnancy at any stage unless there is a legitimate reason, and within very precise limits.
If the pregnancy is in the first stage, which is a period of forty days, and aborting it serves a legitimate purpose or will ward off harm, then it is permissible to abort it. But aborting it at this stage for fear of the difficulty of raising children or of being unable to bear the costs of maintaining and educating them, or for fear for their future or because the couple feel that they have enough children – this is not permissible.
It is not permissible to abort a pregnancy when it is an ‘alaqah (clot) or mudghah (chewed lump of flesh) (which are the second and third periods of forty days each) until a trustworthy medical committee has decided that continuing the pregnancy poses a threat to the mother’s wellbeing, in that there is the fear that she will die if the pregnancy continues. It is permissible to abort it once all means of warding off that danger have been exhausted.
After the third stage, and after four months have passed, it is not permissible to abort the pregnancy unless a group of trustworthy medical specialists decide that keeping the foetus in his mother’s womb will cause her death, and that should only be done after all means of keeping the foetus alive have been exhausted. A concession is made allowing abortion in this case so as to ward off the greater of two evils and to serve the greater of two interests. Al-Fataawa al-Jaami’ah, 3/1056 ^[f]