The legal age of marriage in India is 18 for girls and 21 for boys. Unfortunately, 15 per cent of girls are married off before they turn 16, cutting short their education and negatively impacting their mental and physical maturity. Educated and professional women tend to get married 8-10 years later. In both scenarios, once the ceremonies are over, the in-laws and the couple anxiously await the arrival of their child.
Women produce only one egg a month. It survives 12-24 hours after it is released from the ovary. Sperms survive a few more hours. This means the fertile period may be consistently missed if sex is infrequent - say 3-4 times a month. Timing plays a significant role in conception.
A healthy 20-year-old woman has a 33 per cent chance of getting pregnant in the first month after marriage, provided she has not missed sex during the ovulation date. Since this occurs 14 days before the next period (not 14 days after the previous one, it might take a few months for pregnancy to occur. The chance of immediate pregnancy falls to 20 per cent after the age of 30.
Even though the woman nurtures and delivers the baby, male factors are also important for pregnancy. The sperm quality and motility should be checked. They are negatively affected by age. A couple can become pregnant in four to five months if the man is 25, but this timeline increases to two years if the man is 40. The chances of pregnancy are also reduced if the man has other health issues, is obese, has a sedentary lifestyle with little or no exercise, and uses tobacco.
If both partners are young and healthy, it makes sense to wait for a year with regular, unprotected intercourse before embarking on fertility tests and treatment.
If you want a healthy baby, the mother-to-be needs to make sure her immunisations are up to date, especially against hepatitis B, and German measles (rubella). If these have been missed, "catch up" immunisations can be provided. It is also better to get vaccination shots against infectious diseases such as chicken pox, typhoid and hepatitis A. They are not mild infections when developed during pregnancy.
Folic acid is essential to prevent miscarriages as well as brain and spinal cord defects in the baby. While folic acid is present in food, it is destroyed by cooking. So 5mg tablets of folic acid need to be taken once a day as soon as you decide to have a baby. Apart from folic acid, iron and calcium supplements can be started after the fifth month of pregnancy.
Unsightly stretch marks can appear on the abdomen as the skin stretches to accommodate the growing baby. The nipples can also crack with breastfeeding. To prevent these, oil the body (especially stomach and nipples) with a mixture of 250ml sesame oil, 250ml coconut oil and 100ml castor oil. Leave the oil on for 10 minutes before washing it off.
For a normal delivery, a woman needs core strength and strong thigh muscles. If there is no medical or obstetric contraindication (hypertension, placenta praevia, threatened abortion), the mother-to-be should walk for 30 minutes morning and evening in the fresh air. (Even a terrace will do.) Wear flat shoes with rubber soles. This will help you maintain balance and prevent slips and falls.
Chemical preservative-laden, artificially coloured food and cola drinks should be avoided. As far as possible, medicines should also be avoided. In the early months, the baby's organs are developing rapidly, and subtle damage can occur even if the medication is labelled "safe". Always check with the obstetrician. Colds and coughs can be tackled with hot water gargles and steam inhalations. Body ache responds well to external applications of ointment and steam inhalations.
The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in