Pregnancy

Pregnancy is a journey of about 40 weeks from the last menstrual period to the birth of a baby. Modern antenatal care — which India's public health system provides largely free — has made pregnancy safer than ever before. But India's maternal and newborn death rates are still higher than they should be, and most of those deaths are preventable with timely care.

Antenatal care — what every pregnant woman should have

• At least 4-8 antenatal visits over pregnancy — free at government hospitals, PHCs, sub-centres.
• Blood pressure, weight, urine check, abdominal exam each visit.
• Blood tests — haemoglobin, blood group, HIV, syphilis, Hepatitis B, thyroid, sugar.
• Ultrasound — usually in the first trimester and again around 18-22 weeks.
• Tetanus toxoid (Td) vaccine — 2 doses in pregnancy, as per schedule.
• Iron-folic acid tablets — daily, from second month onwards; adding calcium from second trimester. India's anaemia prevalence in pregnant women is very high — don't skip these.
• Counselling on nutrition, birth preparedness, warning signs, breastfeeding and family planning.

Danger signs — dial 112 or go to hospital immediately

• Severe headache, blurred vision, swelling of face/hands, sudden swelling — may be pre-eclampsia.
• Convulsions (fits) — eclampsia; emergency.
• Vaginal bleeding at any stage.
• Severe abdominal pain.
• Reduced or absent baby movements after 24 weeks.
• Water breaking before term.
• High fever.
• Persistent vomiting preventing fluid intake.
• Breathlessness, chest pain, fainting.

Lifestyle

• Eat well — dal, eggs (if not vegetarian), milk, curd, green leafy vegetables, fruit, whole grains (millets, brown rice), nuts. Adequate protein matters.
• Avoid alcohol (any amount), tobacco (any form, including secondhand), unregulated herbal/ayurvedic products, raw papaya in very early pregnancy, undercooked meat/fish.
• Move gently — walking, antenatal yoga, swimming — unless advised otherwise.
• Sleep 7-9 hours; left-side sleeping is advised in later pregnancy.
• Work is usually safe; discuss with a Health Expert if it involves heavy lifting, long standing, or chemical exposure.
• Travel — generally safe in the second trimester; check with a Health Expert before air travel in later pregnancy.

India-specific legal points

• Prenatal sex determination is illegal (PCPNDT Act). A Health Expert who offers to "tell you the baby's sex" is committing a crime — report if approached.
• Legal safe abortion is available under the MTP Act — discuss with a gynaecologist if needed.
• Maternity entitlements — Maternity Benefit Act covers most employed women; states run conditional cash transfer schemes for pregnant women — ASHA workers can help navigate.