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The complete guide to the purple book

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Pregnancy book

What is the purple book

The first sign that a woman may be pregnant is that she fails to have a menstrual period when one is normally due. At about the same time as the period is missed, the woman may feel unwell, unduly tired, and her breasts may become swollen and uncomfortable.A pregnant woman should not smoke because smoking adversely affects the baby's growth, and smaller babies have more problems in the early months of life. The chemicals inhaled from cigarette smoke are absorbed into the bloodstream and pass through the placenta into the baby's bloodstream, so that when the mother has a smoke, so does the baby. Alcohol should be avoided especially during the first three months of pregnancy when the vital organs of the foetus are developing. Later in pregnancy it is advisable to have no more than one drink every day with a meal. Early in the pregnancy the breasts start to prepare for the task of feeding the baby, and one of the first things the woman notices is enlarged tender breasts and a tingling in the nipples. With a first pregnancy, the skin around the nipple (the areola) will darken, and the small lubricating glands may become more prominent to create small bumps. This darkening may also occur with the oral contraceptive pill.
Hormonal changes cause the woman to urinate more frequently. This settles down after about three months, but later in pregnancy the size of the uterus puts pressure on the bladder, and frequent urination again occurs. Some women develop dark patches on the forehead and cheeks called chloasma, which are caused by hormonal changes affecting the pigment cells in the skin. This can also be a side effect of the contraceptive pill. The navel and a line down the centre of the woman's belly may also darken. These pigment changes fade somewhat after the pregnancy but will always remain darker than before.
After the pregnancy has been diagnosed, the woman should see her doctor at about ten weeks of pregnancy for the first antenatal check-up and referral to an obstetrician. At this check-up she is given a thorough examination (including an internal one), and blood and urine tests will be ordered to exclude any medical problems and to give the doctor a baseline for later comparison. Routine antenatal checks are then performed by the midwife, general practitioner or obstetrician at monthly intervals until about 34 weeks pregnant, when the frequency will increase to fortnightly or weekly. Blood pressure and weight measurement and a quick physical check are normally performed. A small ultrasound instrument may be used to listen for the baby's heart from quite an early stage. Further blood tests will be performed once or twice during this period, and a simple test will be carried out on a urine sample at every visit. An ultrasound scan is usually performed to check on the size and development of the foetus. Most women are advised to take tablets containing iron and folic acid throughout pregnancy and breastfeeding, in order to prevent both the mild anaemia that often accompanies pregnancy, and nerve developmental abnormalities in the foetus.