Before we sow a seed or reap a plant in an area, we have to consider so many things such as soil, water, sunlight, rainfall, fertiliser and so on; but it is unfortunate that before a woman who is going to be a mother, she herself or her family most of the time is not aware at all about the external or internal environment that can have a negative impact both for the pregnant lady and her unborn baby.

To rear a healthy baby from a healthy mother, it is imperative that a pregnant woman should get adequate care and attention from her family as well from the care providers. There are some diseases which may be transmitted hereditarily or transplacentally (HIV, Hepatitis) or during birth process (HIV, genital warts, herpes). These women must be counselled and taken care before, during or after delivery.

The whole nine months of total pregnancy period can be broadly divided into 3 trimesters each consisting of three months.

1st trimester: During this time acidity, heart burn, nausea, vomitting and sometimes constipation can place a woman in a difficult situation. At this time she needs care, proper attention, sympathy or empathy from family members as well as from medical practitioners. When she develops severe vomiting, constipation and or extreme acidity, she must attend a qualified doctor who can advise her for pregnancy as well as prescribe treatments for these minor ailments. It is better to do blood and urine tests and if necessary an ultrasound scan and HIV testing. She needs to do some specific screening tests as nuchal translucency, pregnancy associated plasma protein (PAPP) and other non-invasive perinatal testing (NIPT) to rule out some congenital or genetic diseases. The mother must be supplemented with rest, balanced diet.

2nd trimester: Baby is gradually growing bigger in her womb at this stage. Better to do an ultrasound now for anomaly scan at 20 or 22 weeks , also for confirmation of the estimated date of delivery for those who have irregular cycles or conceived after withdrawal of oral pills. Other than balanced diet, she needs to be supplemented with iron, vitamins and calcium to meet up the extra requirements.

3rd trimester: According to the World Health Organisation (WHO), a pregnant lady must pay visits to a doctor for at least 4 times during the pregnancy period. Mild leg oedema or some palpitations are quite common at this time but if she develops unusual enlargement or small abdomen, severe headache, blurring of vision, per-vaginal bleeding, high temperature, and convulsions she must be transferred to a well-equipped hospital immediately.

It is the combined effort of all of us, be it husband, relatives midwives, or doctors to take care of a pregnant woman so that she can deliver the baby in a suitable environment. Only at that time we can utter proudly like the famous poet Sukanta Bhattacharya, "this world is best suited for newborn baby, this is my promise to newborn".

The author works at Widad University College, Kuantan, Pahang, Malaysia.

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