When Does Swelling Start During Pregnancy?

While most expecting mamas start to notice some swelling (also known as edema) in their hands, feet and ankles from around 20 weeks through the third trimester, it can occur at any time during your pregnancy.
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Is it normal to swell in early pregnancy?

It’s normal to get some swelling in pregnancy, particularly in your legs, ankles, feet and fingers. It’s often worse at the end of the day and further into your pregnancy. Swelling that comes on gradually is not usually harmful to you or your baby, but it can be uncomfortable. A sudden increase in swelling can be a sign of pre-eclampsia, a condition that needs to be monitored as soon as possible.
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Does everyone swell during pregnancy?

Normal or abnormal swelling? – Most pregnant women have swollen feet and ankles at some point, and this is perfectly normal. However, there are times when swelling could indicate something more serious. Contact your midwife, doctor or hospital immediately if:

swelling is there at the start of the day or doesn’t go down when you rest your face or hands are swollen the swelling is more than you have had before

These are warning signs for pre-eclampsia, which is high blood pressure caused by pregnancy. This is a very serious condition both for you and your baby, so call your doctor or midwife as soon as possible. Don’t wait for your next regular appointment.

1. If one leg is more swollen than the other, this could suggest a more serious problem with one of your veins, such as deep vein thrombosis,
2. Again, contact your doctor or midwife as soon as possible.
3. Most swelling is a normal part of pregnancy and will usually go away after you’ve given birth.
4. However, if you’re concerned about anything, no matter how small or seemingly insignificant, talk to your doctor or midwife.

You can also call Pregnancy, Birth and Baby on 1800 882 436 to talk to a maternal child health nurse.
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When does preeclampsia start?

Overview – Preeclampsia is a complication of pregnancy. With preeclampsia, you might have high blood pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of organ damage. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range.

Left untreated, preeclampsia can lead to serious — even fatal — complications for both the mother and baby. Early delivery of the baby is often recommended. The timing of delivery depends on how severe the preeclampsia is and how many weeks pregnant you are. Before delivery, preeclampsia treatment includes careful monitoring and medications to lower blood pressure and manage complications.

Preeclampsia may develop after delivery of a baby, a condition known as postpartum preeclampsia.
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Can your belly swell at 4 weeks pregnant?

4 Weeks Pregnant: Your Symptoms – Every pregnancy is unique, and what you experience during this pregnancy may be different than what you experienced during a previous pregnancy. To help you feel more prepared for whatever may come, look at this list of possible symptoms of pregnancy at four weeks:

Bloated stomach. Your body is preparing itself to house a rapidly growing baby for the next several months. At 4 weeks pregnant, you might experience a bit of bloating and cramping particularly in your abdomen, as your uterine lining is getting a bit thicker, and the swelling means your womb is taking up more space than usual. Light bleeding or spotting, Some women have some spotting at 4 weeks pregnant, which is called implantation bleeding and shouldn’t be heavy like a period. If you see a lot of blood, if the spotting lasts longer than two days, or if you have any concerns, consult your healthcare provider right away. Moodiness. Other symptoms you might notice at 4 weeks pregnant include mood swings. Triggered by increasing hormone levels, these extreme emotions and wild shifts may be the strongest in the first and the third trimesters. Relaxation exercises, massage, sleep, and following a balanced diet are some of the easiest ways to help yourself feel better. Breast tenderness. Just like your abdomen, your breasts are starting to prepare for the important job of nourishing a new arrival. The number of milk glands increases, and the fat layer also thickens, causing your breasts to become enlarged. Morning sickness, You may or may not have morning sickness at 4 weeks pregnant, as this condition varies from one person to the next, with some feeling only mild nausea and others vomiting. If it’s affecting you, consider yourself in good company: some level of morning sickness impacts approximately 85 percent of women who are pregnant. The good news is that this unpleasant symptom often subsides during the second trimester. Light-colored discharge. When you’re 4 weeks pregnant, increased vaginal discharge is a normal symptom. It should be sticky, clear, or white. If you notice a bad odor or have a sore or itchy vaginal area, consult your healthcare provider. Fatigue. Don’t be surprised if you feel fatigued even at 4 weeks pregnant! Your body is working round the clock to support your little one, and your levels of the hormone progesterone are increasing, which can tire you out.

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Is walking good for swollen feet during pregnancy?

What causes ankle swelling during pregnancy — and what can I do about it? – Answer From Yvonne Butler Tobah, M.D. Various factors contribute to foot and ankle swelling during pregnancy. For starters, your body retains more fluid during pregnancy. Also, your growing uterus puts pressure on your veins, which impairs return of blood to your heart.

• Stay off your feet. Avoid standing for long periods. When you can, sit with your feet up and occasionally rotate your feet at the ankles and gently flex your feet to stretch your calf muscles. Better yet, lie down with your legs elevated.
• Sleep on your left side. This takes pressure off the large vein that returns blood from the lower half of your body to your heart (inferior vena cava). It also might help if you elevate your legs slightly with pillows.
• Wear compression stockings. Your health care provider might recommend wearing supportive tights or stockings during the day.
• Be physically active every day. Take walks, ride a stationary bike or swim laps in a pool.
• Stand or walk in the pool. Although there’s little research on the use of water pressure for foot and ankle swelling, standing or walking in a pool seems to help compress tissues in the legs and might provide temporary relief from swelling during pregnancy.
• Wear loose clothing. Tight clothing can restrict blood flow. Don’t wear socks or stockings with tight bands on the ankles or calves.

Some research suggests that foot massage and reflexology, which involves applying pressure to certain areas of the feet, hands and ears, might help decrease foot and ankle swelling during pregnancy. Also, swelling doesn’t mean cutting back on how much you drink.

1. The Institute of Medicine recommends about 10 cups (2.4 liters) of fluids a day during pregnancy.
2. Although mild foot and ankle swelling during pregnancy is normal, sudden swelling that is painful — especially if it’s in one leg only — could be an indication of a blood clot (deep vein thrombosis).
3. A sudden increase in swelling also might mean that your blood pressure is higher than normal.

Both conditions require prompt evaluation and treatment. With Yvonne Butler Tobah, M.D.
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How much weight do you lose after giving birth?

How long does it take to lose baby weight? – Even standard, non-baby-related weight loss is gradual and can take time. And after birth, your body needs extra time to recover, so be patient with yourself. Rapid weight loss after pregnancy isn’t typical. It may take up to a year to return to your pre-pregnancy weight (if that’s your goal), but you can expect some weight loss up front.

How much weight do you lose after giving birth? Once baby has been delivered (along with their accompanying placenta and amniotic fluid), most women lose an average of 10 to 13 pounds. First week after delivery: You’ll probably continue losing weight with the loss of retained fluids. Six weeks after giving birth: Depending on whether you had a cesarean (C-section) or vaginal birth, weight loss will vary based on activity level and diet. However, it’s recommended that you don’t lose more than a pound or two per week. More than that may be unsustainable and can lead to health issues.

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How much water should a pregnant woman drink?

How much water should I drink during pregnancy? During pregnancy you should drink 8 to 12 cups (64 to 96 ounces) of water every day. Water has many benefits. It aids digestion and helps form the amniotic fluid around the fetus. Water also helps nutrients circulate in the body and helps waste leave the body.

See for more on what to eat and drink while pregnant. Published: October 2020 Last reviewed: October 2020 Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read, This information is designed as an educational aid for the public. It offers current information and opinions related to women’s health.

It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read, : How much water should I drink during pregnancy?
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What triggers preeclampsia?

Who’s affected? – There are a number of things that can increase your chances of developing pre-eclampsia, such as:

having diabetes, high blood pressure or kidney disease before you were pregnanthaving an autoimmune condition, such as lupus or antiphospholipid syndrome having high blood pressure or pre-eclampsia in a previous pregnancy

Other things that can slightly increase your chances of developing pre-eclampsia include:

a family history of pre-eclampsiabeing 40 years old or moreit’s more than 10 years since your last pregnancyexpecting multiple babies (twins or triplets)having a body mass index (BMI) of 35 or more

If you have 2 or more of these together, your chances are higher. If you’re thought to be at a high risk of developing pre-eclampsia, you may be advised to take a 75 to 150mg daily dose of aspirin from the 12th week of pregnancy until your baby is born.
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What puts you at risk for preeclampsia?

Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy.5 Other factors that can increase a woman’s risk include: 5

• Chronic high blood pressure or kidney disease before pregnancy
• High blood pressure or preeclampsia in an earlier pregnancy
• Obesity. Women with overweight or obesity are also more likely to have preeclampsia in more than one pregnancy.6
• Age. Women older than 40 are at higher risk.
• Multiple gestation (being pregnant with more than one fetus)
• African American ethnicity. Also, among women who have had preeclampsia before, non-white women are more likely than white women to develop preeclampsia again in a later pregnancy.6
• Family history of preeclampsia.7, 17

Preeclampsia is also more common among women who have histories of certain health conditions, such as migraines, 8 diabetes, 9 rheumatoid arthritis, 10 lupus, 11 scleroderma, 12 urinary tract infections, 13 gum disease, 14 polycystic ovary syndrome, 15 multiple sclerosis, gestational diabetes, and sickle cell disease.16 Preeclampsia is also more common in pregnancies resulting from egg donation, donor insemination, or in vitro fertilization.
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Am I bloated or just pregnant?

– If a person is sexually active and has certain symptoms, such as bloating, pregnancy is possible. But since many other factors can result in bloating, the cause may not always be clear. People who track their menstrual cycle may notice if they have missed a period, which can help determine if pregnancy is a possibility.
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Can a baby bump show at 1 month?

Will you have a belly at one month pregnant? You may experience some bloating at the beginning of pregnancy, and your clothes might fit a little snugly, but you probably won’t be showing a baby belly at one month pregnant.
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Can I lay on my back with my legs up while pregnant?

The best advice if you’re expecting – So what’s an already uncomfy expectant mother to do? After 20 weeks of pregnancy, try not to spend the entire night on your back, Dr. Zanotti advises. She suggests putting a pillow between your back and the mattress as insurance.

• That way, even if you do roll over, you’re on a bit of a tilt.
• As long as you’re not flat on your back, you’re going to be fine,” she says.
• Even if you can be on a 20- to 30-degree angle, that’s going to relieve any potential pressure on your inferior vena cava.
• I think most people, even if they were back sleepers, can be comfortable sleeping with just that bit of an angle.” While it’s sensible to be cautious, Dr.

Zanotti says it’s also important to comfort those who already have enough on their minds. “I’ve had patients who’ve woken up on their back and they’re worried they’re going to cause their child brain damage. That has not been shown,” she says. “We don’t see a higher risk of autism or developmental disorders in those who’ve slept on their back for a little bit.”
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What causes pregnant woman’s feet to swell?

Can Pregnant Women Do Anything to Reduce or Prevent Swollen Ankles? I already feel uncomfortable and self-conscious as my pregnancy progresses, but now my ankles are the size of my knees! Why does this happen and what can I do about it? – Sonya Those swollen ankles are a normal, if frustrating, woe for many expectant women.

1. During pregnancy, the extra fluid in the body and the pressure from the growing uterus can cause swelling (or “edema”) in the ankles and feet.
2. The swelling tends to get worse as a woman’s due date nears, particularly near the end of the day and during hotter weather.
3. Although sudden swelling in the face or hands may be a sign of a condition known as preeclampsia, mild swelling of the ankles and feet is usually no cause for concern.

To help reduce and/or prevent those annoying swollen ankles, try these simple steps:

Avoid standing for long periods. Prop up your feet when sitting and avoid crossing your legs. Stretch often when sitting for long periods. Lie on your left side when sleeping. Put maternity support stockings (that go to your waist) on before getting out of bed in the morning. Drink plenty of water. (This may sound odd, but if your body feels it is dehydrated, it will try to retain even more fluid.) Swim or stand in a pool up to your neck. Exercise regularly. Try to stay cool in humid or hot weather.

Call your health care provider if you notice swelling of your face, around your eyes, or more than mild swelling of the hands. Also let your doctor know right away if you have sudden swelling anywhere or if one leg is more swollen than the other. : Can Pregnant Women Do Anything to Reduce or Prevent Swollen Ankles?
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Where not to massage a pregnant woman feet?

Safe Techniques for Pregnancy Massage – There are more than 80 types of massage taught in roughly 1,300 massage therapy programs in the U.S. Examples of common types of massage include:

Deep-tissue massage, with firm strokes pressing deep into musclesSwedish massage, with long strokes to muscles and attention to joint mobilityShiatsu, with pressure and tapping on acupressure points to stimulate the body’s natural energy (called qi)

From a scientific standpoint, the mechanisms that make massage therapy work are still largely unknown. More research is needed to understand how applying different types of manual pressure to the body can:

Relieve painStimulate the release of certain hormones like serotoninImprove sleep Promote the physiological response of relaxation

Pregnancy massage experts adapt their techniques to address the changes a woman’s body goes through during pregnancy. For instance, blood volume increases dramatically – as much as 50% – during pregnancy. Blood flow to the legs often becomes sluggish. And the levels of anticoagulants in the blood – designed to prevent hemorrhaging during delivery – naturally rise.

These circulatory changes put a pregnant woman at risk of blood clots in the lower legs, typically in the calves or inner thigh. To be safe, pregnancy massage experts avoid deep massage and strong pressure on the legs. Using strong pressure could dislodge a blood clot. Instead, they use very light, slow strokes on the legs.

Types of massage to avoid on the legs include deep-tissue massage, deep acupressure, shiatsu, cross-fiber friction, and percussive tapping. Very light pressure on the abdomen is advised, if the belly is massaged at all. Some massage therapists avoid massaging the abdomen.
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Why do they say 40 days after birth?

Discussion – The qualitative research conducted in Nepal highlighted that (a) birth was perceived as ‘polluting’; (b) postnatal women were perceived as being ‘polluted’; and therefore isolated and (c) cleansing rituals were required for mothers after the resting/isolation period.

Consent was obtained from each participant, this was particularly important within a culture where most women have to ask their husbands. Although, the husband’s permission is needed, during the interviews and focus groups the discussions were ‘organic’, i.e., women openly spoke of their beliefs and practices.

Dr. Higgins Talks About Swelling During Pregnancy

There was a major overlap with existing literature, with the themes of the qualitative study (cord cutting and placenta, purification, naming and weaning ceremonies, rest and seclusion, nutrition and breastfeeding) echoing what researchers had found in other countries.

Cord cutting & placenta rituals;

In Nepal, it is considered lucky to cut the umbilical cord on a coin, The treatment of umbilical cords is very ritualistic, and various household tools are used to cut and tie the cord. The qualitative research suggests that in rural areas the cord is often cut with a sickle or an unsterilized knife, a practice noted in similar communities in Bangladesh,

Poor cord hygiene is a common issue in many low-income countries and particularly in births taking place outside of health facilities. For instance, in India the tool used is related to the trade among the caste; for example the use of a scythe by farmers, however tetanus is reported in new-borns, In Bangladesh, the cord is only cut after the placenta is delivered; the ‘cord cutter’ remains ‘unholy’ and cannot go for prayer for 41 days.

The mother is already considered unclean due to having recently given birth, so she can cut the cord, as can a child that has not begun to pray as (s)he is also considered to be unclean, In Nepal the placenta is generally buried, to protect the baby.

If the placenta is retained the practice is to try to make the woman vomit to help expel it; while in other low-income countries accounts exist of massaging and sitting on the abdomen, The practice in Mayan Yucatan is to treat a retained placenta with abdominal massage, applying hot water and alcohol, and then covering the woman with blankets,

In Malaysia, the midwife massages the mother’s abdomen after the birth to facilitate the expulsion of the placenta, All of these are low-cost, but not necessarily low-risk, interventions to address the problem of a retained placenta. However, the placenta’s “low-resource” practices mentioned are not without risk, indeed as the literature shows sepsis remains the major cause of neonatal mortality in Nepal and the second leading cause of maternal mortality.

WHO recommendations for achieving a clean birth include a clean surface for delivery, clean hands of the birth attendant, clean cutting of the umbilical cord, clean perineum, clean cord tying, and clean cord care, since use of household tool and substances may lead to sepsis, It has been estimated that these clean birth practices can avert 20–30 % of newborn deaths due to sepsis and tetanus,

In the literature, many cultures link the baby’s demeanour and future with the placenta. Placenta, the Latin word for cake, is referred to in France as a baked good; the ‘other’ bun in the oven, Furthermore, a placental recipe from 1983 published in the magazine Mothering mentions the oxytocin contained within the placenta might prevent postpartum haemorrhage; placentaphagy benefits are known,

1. However, we found no evidence of this in our study in Nepal.
2. There are also rituals associated with placental burial.
3. For example, placentae are buried at a junction in Mexico, similar to the Newari community in Nepal,
4. One possible explanation can be identified from Indian, Semitic myths; old Jewish texts tell pregnant women not to stand alone at the crossroads as they may ” see the foetus taken away by evil powers “.

It seems a crossroad is the place where spirits dwell, Perhaps burying the placenta at a crossroad diverts evil spirits away from the new baby towards the ‘useless’/less important placenta. Similar to Nepal, in Lao the placenta is considered a dirty object to be buried and a fire is lit over the buried area in order to prevent spirits and animals from reaching it.

(b) Resting and Seclusion

From the data it seems that women were housebound for a number of days after the birth and the length of this period of seclusion varied by caste or ethnic group. This is a phenomenon found across the globe, including in high-income countries in the recent past.

• The length of time a woman is secluded or rested varied across different countries and the principles underpinning this isolation (to heal vs.
• Being unclean) also seem to differ greatly.
• After the period of seclusion there is often a ceremony to purify women to publically accept them back into daily life.

The literature supports the concept of a resting – a lengthy lie-in or lying-in period, a period of seclusion, as women need to rest in order to heal, yet it may mean that they are neglected. In Greece, birth customs include women and babies resting and being isolated for 40 days after birth, a period that is still observed,

The 40-day period is called the lochial period, from ‘lochia’ the normal vaginal discharge of cell debris and blood after birth. The Bible says “40 days” for the vaginal discharge resulting from involution and can also be described as the red lochia, lasting 4–6 weeks, The lochial period is a time when the “woman can be cherished and pampered without feeling inadequate or shamed”, noted Mead and Wolfenstein, some 60 years ago,

As mentioned in the interviews, in remote rural parts of Nepal women are isolated made to birth in the cowshed ‘chhaupadi’; women menstruating or in labour are thought to be ritually polluted and must be kept at a distance from the family in these sheds,

• Women in Zaire and India are also secluded in a hut,
• For Muslims the period of postnatal seclusion traditionally lasts 40 days.
• The religious rituals are performed on the 40 th day and these include shaving the child’s head, as a vaginal birth is considered unclean.
• This act permits, what is considered, the growth of ‘new’ and ‘clean’ hair,

This ‘seclusion’ around the time of birth also occurs in Burma and in Turkey where it is believed that postnatal women are more vulnerable to evil forces and “the grave of women who have just given birth is open for 40 days”: postnatal women are at risk and can easily die in 40 days and in that period, mother and baby are not left alone, lactating women do not go out, they and their children are not bathed,

This is in contrast to women in Nepal; where they are left alone. Purdah (female seclusion) is observed in Bangladesh lasting 5 to 9 days and there exist dietary restrictions that last up to 6 months, Similarly, among the Negev Bedouin in Israel, a 40-day postnatal period includes seclusion (homestay), followed by congratulatory visiting, the reciprocal exchange of gifts and money, and observance of a special diet,

A number of cultures have beliefs, taboos and behaviours relating to women and newborns in the postnatal period, a period lasting up to 40 days. Among Mayans the period lasted 20 days and Japanese mothers remained in a birth chamber for 3 weeks, In Chinese the postnatal period of rest is called the ‘sitting month’ or ‘doing the month’ and lasts for 30 or 40 days.

This exists, according to Chinese traditional medicine, as postpartum women are considered to be in a ‘weak’ state, and the practice is still observed with primiparous women, Keeping mothers together with their babies is medically important but also culturally: in southwest Nepal new mothers stay with their babies continuously for 6 days,

Higginbottom refers to a 40-day period after the birth in which particular foods are eaten, Cassidy also refers to “the upsitting” where bed linens would be changed and on the 10th day the mother was allowed to perform housework, and that hard labour ought to be avoided in the weeks after birth for the risk of uterine prolapse,

Burmese women also observed rest in the postpartum period, The 40-day period has often been put into practice as the ‘quarantine’ period for women, a period of rest and purification, The word “quarantine” originates from the Venetian dialect quaranta giorni, meaning ‘forty days’ for the length of isolation of ships for detection of plague symptoms,

This separation of infected people was used to prevent the spread of disease, and is recorded as far back as the Old Testament, Culturally and historically, birthing women are considered ‘unclean’, In many cultures postnatal women are believed to be dirty and weak,

Moreover, the pollution of birth is detailed; for example in Nepal, Maori (Aetoroa/New Zealand), Japan, China, Inuits in Canada, Turkey, and Bangladesh, Evidence of isolating practices can also be seen in western countries. In Europe in the recent past women were considered ‘polluted’ and dangerous to men, so new mothers were not allowed to prepare or cook food for 40 days,

The immediate period after childbirth is referred to historically as the ‘lying-in period’ in English and “Wochenbett” in German or “week bed”. Browne and Browne refer to the lying-in period as 8–10 days after labour and birth; similar to the time it takes for the stump of the umbilical cord to fall off naturally,

• Historically women in the British Isles were unclean after birth,
• Purification as a ritual is likely to have at least some physical foundation, such as notion of infection control in modern medicine.
• The 40-day period presents vulnerability in mother and child which can be targeted in this time; as a frequently described postpartum problem is infection,

In the USA, self-help books on childbirth inform new mothers and their partners that the postnatal period lasts 6 weeks, Six weeks is, of course, a different way of expressing ‘the 40-day period’. The explanation such self-help books give is that “the uterus has returned to a non-pregnant size and bleeding has abated”,

1. Similarly, one of the first UK guides for new mothers recommended that women visit their doctor at 6-weeks postpartum for a range of physiological check-ups (a period of 6–8 weeks for uterus and other pelvic structures to ‘heal’ the puerperium),,
2. Eastman and Russell also suggested that energy demanding activities such as tennis, cycling, jogging and heavy housework/lifting be postponed until the “lochia has ceased”,

In the 1960s, Browne and Browne claimed that red lochia lasted 24 days and only after that time should women resume household duties, start going out again or drive a car, whereas the shampooing of hair could be done as desired, Caring or nourishing of women during this period is seen in the literature.

In Nepal, women can have a postnatal massage to the abdomen in order to promote blood circulation and therefore healing in the first weeks post-childbirth, Mayan women get “one or more massages” from their midwives 28 days post-partum, In Nepal, our findings were that traditional postnatal care includes baby massage with mustard oil, massaging the mother, and an emphasis on nutrition.

In higher castes (Brahmin, Chhetri, Newar and Bahun; in Nepal Tamangs are lower caste) these tasks are performed by a birth assistant, who will stay in the house for a month to wash the child’s clothes and cook for the mother. Mothers need rest and seclusion, thus there are advantages for new mothers of having a lying-in period with its associated rituals and taboos.

The historian Cressy (1993) uses the term postnatal privileges to reflect this positive notion, Women need rest after childbirth but should not be treated as ‘infected’ or ‘dirty’ during their seclusion period; research from China has found that the 40-day seclusion custom can adversely affects women’s mental health with reports of postnatal depression occuring due to the feeling of isolation,

Also adversely affecting women’s mental health are folk beliefs or traditional attitudes around stillbirth, which are slightly different in Nepal. This might reflect a lack of research on the impact of stillbirth on maternal mental health. Another concern is the issue of alcohol consumption as mentioned by some ethnic groups in Nepal, although this appeared to be a less common issue globally.

(c) Purification, naming & weaning ceremonies

The Hindu caste system and its associated behaviours have an impact on birth customs. Similar to Nepal, in India the naming ceremony takes place on the 10 th or 12 th day after birth after which the mother is considered ‘clean’ and can carry out normal household chores (e.g., cooking); furthermore male visitors can visit the nursing mother.

• A weaning ceremony at 6 months ( Annaprassana ) is believed to be necessary for the baby to become more mobile; gifts here too are given to the child and the mother may observe a fast.
• Glass bangles worn during pregnancy are gifted to the midwives.
• Mothers in India also return to their parental home for 40 days after the birth.

These customs are also practised by the Hindu diaspora and can lead to antenatal and postnatal non-attendance, The literature also demonstrates the religious importance of ritual cleansing. Traditionally the Church of England had a thanksgiving ritual welcoming new mothers back in the church after childbirth, which was also a ritual cleansing ceremonial.

The ritual referred to as ‘churching’ lasted well into the twentieth century, Similarly, historically ‘kirking’ was found in the Highlands of Scotland. Associated with the Church of Scotland, it referred to the cleansing ritual to allow the women polluted in childbirth to come back into the kirk (church),

The Greek Orthodox Archdiocese in the U.S.A. states that women may stay home for a period of 6 weeks after giving birth, The Holy Bible in Leviticus XII: 2 notes that where the woman “born a man child: then she shall be unclean seven days; according to the days of the separation for her infirmity shall she be unclean.” “And she shall then continue in the blood of her purifying three and thirty days; she shall touch no hallowed thing, nor come into the sanctuary, until the days of her purifying be fulfilled” ( The Holy Bible, Leviticus XII:4),

Similarly, Jewish women were allowed back into the temple 33 days after the birth of a son and 66 days after the birth of a daughter, The notion of purification in the 40 days also denotes the temptation of Christ when Jesus was in the wilderness “And when he had fasted forty days forty and forty nights” ( The Holy Bible, Matthew, IV: 2),

We must bear in mind that in The Bible 40 days may refer to a long period of time rather than exactly 40 days, Ceremonies frequently involve burning as part of the cleansing. In Indochina fire in the postpartum period plays a central role in ritual cleansing.

(d) Nutrition & breastfeeding

The literature discussed the role of food in the postpartum period. In Bangladesh on the first day after birth, to continue the healing of the birth passage, no food is given, and in the following days meals are nutritionally deficient consisting of rice only, as polluted women are not perceived to be hungry.

• Burmese women and women in Turkey who adhered to traditions of food restrictions and prescriptions during the postnatal period were traditionally not given any water to drink for 2–3 days after the birth,
• There are many references in the literature to hot and cold foods ; and it is worth noting that hot in one country is not necessarily hot in another,

For instance, China has the notion of ‘Qi’ deficiency and blood loss, ‘heat’ or ‘cold’, which may cause health problems like dizziness; thus ‘cold’ foods should be avoided ‘hot’ should be encouraged, This notion of hot and cold also exists in Laos, whilst taboos include not bathing, no hair washing or teeth brushing and staying in bed between 18 h to 2 days,

• The notion of ‘hot’ and ‘cold’ is not only related to the food, but can also relate to the stage of pregnancy and birth.
• In Malaysia pregnancy is ‘hot’, in Cantonese China the pregnant mother is ‘cold’ and the foetus ‘hot’, whilst in Vietnam both the mother and foetus change from ‘cold’ in the first trimester to ‘hot’ in the last,

The notion of ‘hot’ and ‘cold’ with regards to pregnancy also exists in Laos, In the literature however there was no indication of herbal aryuvedic medicine/food being harmful, suggesting a gap in existing evidence. Dietary and breastfeeding restrictions exist; some offer women poor diets for a variety of days in Laos,

In Nepal, India and elsewhere in South Asia, colostrum is not given until a priest approves it, as it is considered to be pus, This is not unlike seventeenth century England when medical texts recommended against the feeding of colostrum, In common with Nepal, the initial breastfeeding practice in Bangladesh is poor, as colostrum is not given, as it is deemed to be ‘dirty milk’ due to its pus-like appearance.

Taboos are also evident in relation to the baby. In Bangladesh in the first 40 days breast milk is given; as is sweet water ” misri pani “. The latter is thought to have benefits. While, in richer households goat or cow milk is given after 40 days, yet in poorer houses misri pani often leads to a high incidence of diarrhoea,

• The breastfeeding diet is observed for 40 days.
• In Cairo, infants are breastfed exclusively for the first 40 days after birth,
• The majority of women in the qualitative interviews reported that they discarded their colostrum, which they felt was inadequate in nutritional value.
• Whilst this is contrary to the World Health Organization (WHO) recommendation that breastfeeding should commence in the first hour after birth ; it is significant because it indicates that women were actively expressing colostrum.

This is vital in terms of stimulating their breast-milk supply, This may be why the practice of discarding colostrum as done in South-East Asia is not as detrimental as previously thought, Although, this is less than ideal in terms of the beneficial constituents of colostrum and definitely harmful if other substances are given, such as honey, butter or unclean water.

Breastfeeding rates are high in Nepal (although not necessarily exclusively breastfeeding) when compared with UK rates at 6 weeks and 6 months, but not on the first day or two, as is common in South Asia. Some authors have suggested that women in South Asia generally do not breastfeed on the first or second day; but they do stimulate their breasts for the milk supply,

Breastfeeding statistics for the UK show reasonably high initiation rates (81 %) but at 6 to 8 weeks the prevalence is down to only 47.2 %, Breastfeeding is associated with reduced risk of infection (colostrum contains elevated concentrations of multiple antimicrobial proteins), prevention of dehydration and hypoglycaemia in babies and reduced risk of breast and ovarian cancer in mothers and increased mother-baby bonding.

Breastfeeding has short and long-term health benefits for both baby and mother, Potential long-term health benefits in children include reduced blood pressure, cholesterol concentrations, and obesity, The literature illustrates that alcohol plays an important role in both birth and the postpartum period.

In Nepal the Tamang mothers drink jad during their pregnancy and post-pregnancy, similar to the ‘god-sips’. The term ‘god-sips’ is thought to have arisen because when a woman went into labour, her ‘gossips’ were sent forth to gather for merriment and to partake in a drink at the labour,

Indeed the drinking midwife is mentioned in Shakespeare’s Twelfth Night: “like aqua vitae with a midwife”, In the Tamang community jad, an alcohol, is taken during pregnancy and post-pregnancy to celebrate the birth, and Gurung women may drink it to put the child to sleep during breastfeeding as alcohol will certainly pass into the breast-milk,

Alcohol and pregnancy are linked culturally, for instance in Africa rum was given to the Akan and Igbo child. Furthermore, the birth was celebrated with alcohol and at the naming ceremony, Drugs passing into milk as cathartics were identified by Greek physicians and Gurung women use it to put the child to sleep,

1. Alcohol is also used in the protection of children; Malaysians bathe children in stout as they believe it protects babies and to help new-borns suffering from jaundice,
2. This article has discussed that there are logical reasons for practices that are linked to the physiology of pregnancy, birth and the postpartum period.

The umbilical cord if left alone typically falls off after six to ten days, whilst the lochia heal in about 40 days/6 weeks, The latter ties in with the International Classification of Diseases’ definition of maternal mortality, However, the origin of the 42 days limit is historical, i.e., in the old Anglican Church and the Jewish faith where purified women resumed attending prayers 40 days after childbirth, rather than medical.

Clinically, the relevance lies in the first menstrual bleeding in non-lactating women occurring 6 to 8 weeks after parturition. The literature finds that the 42 day limit was not based on a study of the timing of maternally related deaths, Some practices, however, clearly put women at risk; isolation may mean rest but if the woman is alone and suffers a postpartum haemorrhage, this may result in a preventable maternal death.

Also unclean tools such as a scythe used to cut the cord may lead to infection, or fasting can lead to malnutrition, and most commonly the discarding colostrum may reduce the protective effects of early breastfeeding. It is easy to forget that childbirth is a hazard for mother and child in many low-income countries; some traditional practices reduce and others increase the chance of dying.

This article highlights that cultural practices exist universally between days 3–10 and 40, and that many of these can be linked to physiology. The timing of these important events means cultural influences play a role in postnatal practices, In society, rituals develop over time to deal with the physiological and social aspects of birth and are internally consistent.

The study and literature within this article have shown that reproductive health is shaped by culture and women’s position may be influenced by social and cultural aspects rather than biological factors: The role and place of women in society is ‘lowered’ in a patriarchal society where historical social norms are maintained.

• Several studies refer to cultural sensitivity when dealing with women, focusing attention on improving the maternity services rather than on women and their cultural differences,
• As social cultural practices are passed down from senior females to younger generations, postpartum home visits may play an important role in helping women to change behaviours,

Nepalese maternity care should focus on the rural population to be more sustainable and maternity nurses/midwives can use health promotion interactions during home visits,
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When can I start walking after giving birth?

When to start – If you had an uncomplicated pregnancy and vaginal delivery, it’s generally safe to begin exercising a few days after giving birth or as soon as you feel ready. If you had a C-section, extensive vaginal repair or a complicated birth, talk to your health care provider about when to start an exercise program.
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What does it feel like when you push a baby out?

Contractions During the Pushing Stage – During the second stage of labor, the uterus continues to contract about every five minutes and each contraction lasts 45-to-90 seconds. The contractions are usually strong and forceful and may or may not be accompanied by an urge to push.

1. This can make this phase somewhat more enjoyable since you are now working with each contraction.
2. A renewed sense of energy may occur as you feel the closeness of your baby’s birth! However, sometimes after a long or difficult labor, the pushing stage can be exhausting and uncomfortable.
3. Most women will feel increased pressure in their perineum, rectum, and low back at this stage.

For many women, the rectal pressure feels the same as having a bowel movement. As the baby’s head begins to appear, you may feel a stretching or burning sensation. You may want a mirror positioned so that you can see your progress.
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Can your feet swell at 4 weeks pregnant?

– Swollen feet are a very typical part of pregnancy, as many of your fellow pregnancy buddies can probably tell you! So most of the time, swollen feet are just another sign of all the hard work your body is doing to grow that new little life. However, swollen feet can sometimes signal a more serious concern.

sudden swelling of your hands, feet, face, or around your eyesswelling that gets dramatically worsedizziness or blurred visiona severe headacheabdominal pain, especially in the upper right section of your abdomenconfusiondifficulty breathing

If you notice swelling in just one leg that is also accompanied by pain, redness, or heat, this could mean you have a deep vein thrombosis (DVT), A DVT is a blood clot, usually in your leg. It’s important to call your healthcare professional immediately if you notice these symptoms.
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Do you retain fluid in early pregnancy?

Is it normal to have water retention? – Water, or fluid retention as it is also known, is very common during pregnancy with as many as 80 per cent of women experiencing it in some form with most experiencing it from the latter part of the second trimester.
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Do you get water retention in early pregnancy?

Extra fluid builds up during pregnancy as hormones change, which helps to soften the body so it can more easily expand as the baby and uterus grow. This normal swelling is known as edema and it begins about halfway through pregnancy with the worst symptoms in the third trimester.
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