2020 was a challenge!

COVID 19 challenges

A difficult year for very many - personal loss, health issues, insecurities, economic hardship and much more - didn't matter how or where one lived.

At Kushal we had our fair share. COVID catalyzed us to jump start activities in India and we had busy months between March and September despite strict lockdown. However, COVID struck and several colleagues were affected. Additionally, we had to cope with severe floods and new regulatory requirements by the government for #ngos.

Yet, the resolve, determination and passion shown by our frontline #volunteers for what we care for has been remarkable. Our digital presence continued to grow.

There are many who were beside Kushal through these challenges.

I would like to take this opportunity to thank Vasavya Mahila Mandali Bollineni Keerthi Jyoti Lahiri Divya Bajpai Peter Beeby Purba Chatterjee Tom Godfrey. A big shout out for Sophie Hurford and Niti Nadarajah who have been critical with their support. Prof Unithan University of Sussex and ST Prasad have been inspirational.

We now look forward to the New Year with the same determination and without dampened spirit.

Wish all a safe, healthy and joyous 2021!

#seasonsgreeting #hopeforthefuture

Pregnancy week 25 wellness guide

Your Body

changes in the body
What to expect
You are starting to feel uncomfortable because of simple things that you may not be able to do easily, like bending. You are also likely to get back aches and feel clumsy with movements. That is because your uterus is growing rapidly. It is the size of a football! You are likely to be puffy and swollen in your face, hands and feet and your fingers may feel numb and tingly.Your hair looks thick and lustrous – enjoy!

Baby size

Week 28 baby size
What to expect
Your baby is the size of a small Eggplant or Aubergine (roughly 32 cms and 640 gms).

Your Baby

Pregnancy weekly guide - baby size
What to expect
Baby is getting hiccups and sticking out his/her tongue! The brain, lungs and digestive system are quite developed. The first bowel movement has taken place. Kidneys are functioning and baby can pass urine!

Taking care

Pregnancy week 25 wellness guide
Tips
  • Sit up straight when you eat, eat small and healthy meals, cut back on tea or coffee to prevent indigestion problems – heart burn, nausea, distension.
  • If your vision seems blurred try not to worry too much – it will pass off after delivery.
  • Carry on doing pelvic floor exercises, have lots of water and food rich in fibre to help with constipation.
  • Maintain oral hygiene – brush your teeth at least twice a day. Periodontitis, a serious infection of gums has been linked to premature birth and increased risk of pregnancy related serious illnesses.
  • Use moisturiser or calamine lotion if your skin feels itchy.

Ask your doctor

Pregnancy weekly guide - ask your doctor
Questions
  1. My face, hands and feet feel puffy and swollen. I also get splitting headaches. Can this be due to high blood pressure in pregnancy?
  2. I get this tingling sensation and constant urge to move my legs. Could this be due to iron deficiency?
  3. My wrists hurt and I can barely move my fingers. Can acupuncture help?
  4. I often think that I don’t deserve to be happy! I think I have depression?

Your to do list

Pregnancy week 25 wellness guide
Action points
  1. Get weight checked and assessed.
  2. Have folic acid supplement and prenatal vitamins
  3. Book antenatal appointment.
  4. Ask how to prevent depression after birth.

Questions you may have

“Birth plans are personal. It is about thinking through what you would like to happen during your labour and after the birth. I planned where I wanted to give birth, what kind of pain relief I would like, discuss about caesarean section and what should I be looking out for in my newborn. I was advised to discuss my birthing plan with my husband, how he could help and to be flexible as all may not go as per plan!”

“Normal daily hair loss is suppressed by pregnancy hormones. Enjoy the look for now. After delivery you will shed quite a lot - all the hair that does not fall now!”

Pregnancy week 26 wellness guide

Your Body

changes in the body
What to expect
As the third trimester approaches you feel more tired, quite clumsy and uncoordinated – you are having to carry a lot of extra weight. You get of leg cramps and just feel like curling up throughout the day. Your belly button is likely to be protruding out now and the line downwards starting from your naval is quite dark. You just feel like snacking – avoid that!

Baby size

Baby size week 26
What to expect
Your baby is as big as a Sweet Papaya (roughly 34 cms long and 740 gms in weight).

Your Baby

Pregnancy weekly guide - baby size
What to expect
Baby’s eyes are opening, blinking for the first time! The brain is developing and processing information – listening and responding to sounds. Fingernails have grown. He/she might be feeling a little cramped in your womb.Baby has quite a bit of hair this week.

Taking care

Pregnancy week 26 wellness guide
Tips
  • Allow more time to do your usual activities – like when you have to walk to the bus stop.
  • Remain active as you are likely to feel like staying put and not moving.
  • Get to know your baby’s movement patterns. Learn how to track the frequency of movements.
  • Wash your hands with soap and water before and after you touch foods like raw meats, egg, poultry or fish.
  • Wash fruits and vegetables thoroughly before eating them, even the ones you will peel. Avoid raw eggs.

Ask your doctor

Pregnancy weekly guide - ask your doctor
Questions
  1. I can’t feel my baby’s movements as strongly. Is that okay?
  2. Why am I kicking in my sleep?
  3. My eyes feel dry and irritated. Is that normal?
  4. I normally get migraines. But it seems to have increased a lot in pregnancy. What medication can I take?
  5. Do I need to have a birthing plan?

Your to do list

Pregnancy week 26 wellness guide
Action points
  1. Make a daily activity plan.
  2. Practice good posture.
  3. Get your weight checked and assessed.
  4. Have your folic acid supplement and prenatal vitamins.
  5. Book Ann antenatal appointment with your doctor.

Questions you may have

“Rubbing my muscles where it hurt helped. I also made it a point to do ankle and foot exercises when I got into bed. Pulling my toes upwards also helped.”

“It’s best to talk to your doctor. Also share how you feel with your husband or your close friend. It helped me. Try to take away negative thoughts from your mind. Don't suppress positive thoughts actively.

Having thoughts like I don’t deserve to be happy suggest that postpartum depression may be likely. Your doctor will suggest if you need specialised help.”

Pregnancy week 29 wellness guide

Your Body

changes in the body
What to expect
You may be feeling excited as your due date approaches, or quite nervous! You can get breathless. Sleep is problematic because of leg cramps and needing to go to the toilet frequently. You are also prone to urinary tract infections. You may find it difficult to maintain your balance and stumble. You may also have quite leaky breasts.

Baby size

Pregnancy week 29 wellness guide
What to expect
Your baby is the size of a large Cauliflower (roughly 38 cms and 1.2 Kilos).

Your Baby

Pregnancy weekly guide - baby size
What to expect
Your baby is well formed. He/she is getting fatter and his/her organs are maturing. The bones are hardening and muscles are getting stronger. There is lots of activity and movements. He/she has begun to smile, mainly in sleep.

Taking care

Pregnancy week 29 wellness guide
Tips
  • Avoid standing or sitting for long stretches to avoid varicose veins.
  • Carry on eating high fibre foods to prevent constipation.
  • Know what infections to avoid in pregnancy.
  • Lear and know more about what happens during labour and birth. Learn what happens when you get to the hospital and how you need to be prepared.
  • Talk, talk and talk to share your emotions – you will have a range of feelings and can get quite sad and emotional about loved ones, especially those who have passed away.

Ask your doctor

Pregnancy weekly guide - ask your doctor
Questions
  1. I am very emotional most of the time. What should I do?
  2. Are my baby’s movements’ okay? What should I expect when I go to the hospital to deliver? Are there any injections I need to prevent getting infections in pregnancy?
  3. When I go to the bathroom it burns; I get lower-abdominal pain and dark foul-smelling urine. I don’t feel good. Please help.

Your to do list

Pregnancy week 29 wellness guide
Action points
  1. Find out what injections you need to prevent infections in pregnancy.
  2. Book an antenatal appointment with your doctor.
  3. Discuss and plan with your husband what happens and how to prepare for labour and birth.
  4. Speak to your mother and best friend to talk about how you feel and the emotions you are going through.

Questions you may have

“I was on an emotional rollercoaster! At times I felt excited. Other times I was nervous or both. I also felt sad thinking about my father who had passed away the previous year, especially knowing he would never get to meet my baby. I got advice to talk a lot. So, talk, talk, and talk. Talk to friends, family, your doctor, and discuss anything that's worrying you. That helped me a lot.”

“Chickenpox in pregnancy can be dangerous for both mother and baby. You should talk to your doctor if you never had chicken pox before. CMV is herpes like virus which is quite common especially in children and it can be dangerous for your baby. Washing your hands regularly with soap and water and not sharing food with children can help prevent CMV. There are a few other infections you can find out more about by asking your doctor.”

Training frontline workers on COVID

We have been getting requests for COVID -19 Training for frontline workers nearly everyday. That is not surprising.

Pregnant women in urban slum and rural communities are facing unexpected hardship because of COVID -19. The antenatal support provided through Government of India's Janani Sishu Suraksha Karyakram programme in Andhra Pradesh has come to a standstill as Anganwadi Centres (AWCs) have had to be closed because of the COVID - 19 related lockdown.

The closure has not only meant that services such as routine checkups, educational sessions, peer support and distribution of food has been affected. It has also compounded pregnancy related anxiety. In such circumstances, front line community health workers, that is, ASHA and AWC workers who are from the communities too feel helpless and despondent that they are not able to do more.

Most of these frontline champions have been reassigned to COVID related general awareness raising duties. However, there remains a huge gap in knowledge and information in relation to pregnancy at the time of the COVID-19 pandemic.

We keep getting requests from our frontline colleagues for information and training on pregnancy and COVID - 19. In response, we have developed a one hour training session curriculum which helps community health workers answer questions and give advice on antenatal issues in relation to COVID. The training will equip them to reach out and advice and support pregnant women with wellness and allay anxiety.

To know more about the training curriculum you can view the deck here.

Pregnancy week 39 wellness guide

Week 39

Your body

changes in the body
What to expect

You feel increased pressure in your lower abdomen and may have severe back pain. On the other hand you could also have bursts of energy. There is likely to be a lot of vaginal discharge. If there is a small blob of mucus, it is likely to be 'show'. It is natural to feel anxious - when am I going to deliver?

Baby size

Honeydew melon - Week 39 size guide
What to expect
Your baby is about the size of a large green watermelon - approximately 48 cm long and weighs 3 kilos.

Your baby

Pregnancy weekly guide - baby size
What to expect
Your baby is full term – Congratulations! Baby has acquired birth weight and length and does not grow anymore. However, the nervous system and brain continues to develop rapidly. Baby even has eyelashes!

Taking care

Pregnancy week 39 wellness guide
Tips
Look out for signs of labour, such as -
  • Breaking of water or rupture of the membranes
  • Diarrhoea or nausea, which many women experience just before the onset of labour
  • Spurts of energy or nesting instinct
  • "Show", that is, the loss of the mucous plug (which seals the opening of the uterus)
  • Bloody show - streaks of blood
At this stage -
  • Keep track of foetal movements.
  • Learn how to differentiate between Braxton Hicks and labour contractions.
  • Keep practising relaxation and breathing techniques.
  • You may be advised (very likely in India) induction of labour by your doctor. In many other countries, doctors advise this procedure after 40 weeks.

Ask your doctor

Pregnancy weekly guide - ask your doctor
Questions you may have
  1. I feel contractions. Are these labour pains? When do I need to go into hospital?
  2. What are the emergency signs I should look out for?
  3. How painful is labour!? Can I take medication for the pain?
  4. Is it okay to eat or drink during labour?
  5. Do I have to stay in the hospital? How many days will that be? Can somebody from my family be with me in the hospital?
  6. What do I need to bring to the hospital for my baby?

Your to do list

Pregnancy week 39 wellness guide
Actions
  1. Keep track of baby's movements
  2. Practice relaxation and breathing techniques
  3. Monitor contractions, foetal movements and level of pain
  4. Keep your hospital bag ready and close to the front door.
  5. Keep emergency and important phone numbers at hand.

Questions you may have

“All new mothers are offered a thorough physical examination for their baby within 72 hours of giving birth. The aim is to spot any problems early so that treatment can be started as soon as possible. Usually, nothing of concern is found. I know that my son’s eyes, heart, hips and testicles were examined.”

“I was frightened of going to the toilet at first because of the burning sensation! I then drank a lot of water and the stinging sensation I was feeling went. I was also constipated for the first few days.

There was some bleeding from my vagina. It was heavy at first and took a few weeks to decrease. The discharge turned brownish before stopping. I also got stomach cramps similar to period pains. I had a normal delivery and did not need stitches because I did not need to have an episiotomy."

Pregnancy week 31 wellness guide

My body

changes in the body
What to expect
You will have thorough antenatal check-ups like regular measuring of your BP and measuring up your stomach. Your doctor will feel your pregnant belly to work out which way up your baby is positioned. You may have felt your baby move and your belly bump shift downwards – that is baby is getting into position!You can keep enjoying your sex life.The end is in sight now! In two weeks you and your baby will go through a final growth spurt.

Your baby

Baby size week 31
What to expect
Your baby is as big as a Coconut (roughly 40 cm long and 1.4 Kilos in weight).

Your baby

Pregnancy weekly guide - baby size
What. to expect
Baby is processing information from all five senses – sight, touch, feel, taste and hearing. He/she is very active, moving around, sucking their fingers, and doing the odd somersault. But baby is also sleeping more. Physically, baby is getting plumper and looks less wrinkled.

Taking care

Pregnancy week 31 wellness guide
Tips
  • Learn about Braxton Hicks contractions. These are fake contractions that you may be getting. Your belly contracts and tightens up for 20-30 seconds and relaxes again. These are perfectly normal and harmless ‘practice contractions’.
  • Eat well – your baby needs to gain roughly 200 grams a week.
  • Do some simple stretches – this will help take away pain in your neck region.
  • You may be getting all kinds of advice from family and strangers alike – some good and some misinformation. Don’t let these comments worry you or change your mind. Make sure you get correct information from the right sources.

Ask your doctor

Pregnancy weekly guide - ask your doctor
Questions to ask
  1. I am getting contractions that are painful and coming regularly. Do I need to go to the hospital
  2. My face has swollen up suddenly. I am also getting headaches. Should I be worried?
  3. When should I go to the hospital?
  4. Is my baby’s position okay?

Your to do list

Pregnancy week 31 wellness guide
Actions
  1. Get my weight checked and assessed.
  2. Have folic acid supplement and prenatal vitamins.
  3. Monitor facial swelling.
  4. Book an antenatal appointment.
  5. Ask what to do the first few days to help with breast feeding.

Questions you may have

“You can still enjoy a healthy sex life and strong connection with your husband. Sex is safe. Try to find a position for sex that is comfortable and satisfying for you and your husband. Lying on your side is often the most comfortable. If you feel pressure on your low back, try tucking a pillow between your knees.”

“A caesarean is a major operation that carries a number of risks, so it should only be done if it's the safest option for you and your baby. Caesareans are either planned or done in case of emergencies. I was anxious about giving birth, so I discussed that with my doctor and he gave me suggestions on how to get support during my pregnancy and labour.”

Our family is growing!

We had a very busy start to the week!

56 pregnant women participated in two workshops on COViD-19 awareness and Kushal’s wellbeing programme in Vijaywada on Monday. Leela explained how to stay safe from COVID – 19, and all 56 women downloaded our app. The women also learnt in the workshop what to expect week by week, how their baby-to-be will grow, and received tips on wellbeing. Participants were given confidence to have a conversation with their doctors’ to address questions they had about their pregnancy.

It was an important day, and we proudly welcome Bharadwaj Hospital and Karuna Nursing Home (Hospital) to the Kushal family.

Dr Savitri, Gynecologist at Bharadwaj Nursing Home had to say, “The Kushal concept will be very useful for pregnant women. We will coordinate so that you can attend our OP (outpatient days) to help give knowledge about wellbeing to expecting mothers and help them to access your website and download the Kushal app.”

Dr Radha Madhavi, Gynecologist, Karuna Nursing Home reiterated “I am so impressed with the Kushal initiative. I and my health team will learn from Kushal and even on days the VMM team does not visit we will explain to pregnant women aspects of wellbeing on OP days.”