On the occasion of International Day for Maternal Health and Rights, celebrated on April 11 every year, Dr Nandita Palshetkar (President, Federation of Obstetric and Gynaecological Societies of India) speaks to Charupadma Pati on how pregnant women can ensure a healthy diet and cope with the stress and strains of the lockdown due to the COVID-19 pandemic.

We are marking National Safe Motherhood Day under a nationwide lockdown. What would be your most important tip for pregnant women under these circumstances?

I believe there are five essential things that pregnant women should take care of. The first and the most important thing is stay at home, if your job permits you. If in case they are in
essential services, it is important to maintain hand, face and respiratory hygiene, and ensure social distancing.

Hand hygiene requires washing your hands regularly for about 20 seconds with soap and water. Face hygiene is very important. It is essential not to touch your face in this vulnerable time. Thirdis respiratory hygiene, like coughing into your elbow or your sleeve. In case you cough into a tissue, you must dispose it hygienically. Four, observing social distancing is very important, in order to ensure that the virus does not spread further.

Nutrition is a key factor for both expectant women and their babies. However, given the lockdown, many –particularly in the rural areas-- may not have access to vitamin supplements and other medicines. What can they do to ensure proper nutrition and immunity?

Considering the diet of a pregnant woman, I believe there are five essential items that should be on their plates. Take for instance fruits and vegetables. Whichever fruits and vegetables theylike to eat, should be taken on an everyday basis. General food items such as chapatti, roti and rice should also be there compulsorily in the diet. Milk and milk products, such as curd, cheese and butter also form an important part of the pregnancy diet. Food items that are rich in protein such as chicken, pulses, chicken, eggs and fish are highly recommended for pregnant women.

Apart from these, items which are easily available and also healthy should be consumed. Women usually prefer to have nuts, such as almonds and peanuts in the house. Fruits such as apples and bananas are easy to get. Coming to vegetables, cauliflowers, brinjals, tomatoes and onions are very good for health. Nachni, (or ragi) which is widely available in Maharashtra, is also highly recommended as it is a good source of iron.

In rural areas, dal-chawal is easily available. They grow vegetables in their villages locally, so they definitely have access to them. They have cows in their farms, through which they procure milk. They can prepare curd for themselves, which is essential for health.

What kind a diet would you recommend for expectant women based on easily available ingredients?

Women who are expecting should take a glass of milk in the morning. Fruits such as apple can be consumed for breakfast, with some dry fruits if possible. Food items such as poha and upma, in which a lot of vegetables like carrots and peas are included are also healthy options for breakfast. Another wholesome option is whole-wheat toast or parathas.

Dry fruits, and fruits are present in everyone’s homes. Everyone keeps a stock of these items along with vegetables. Expectant mothers can also consume dry fruits around noon. Soups are also an healthy option, be it tomato soup, carrot soup, or mixed vegetable soup. Non vegetarians can have chicken soup.

Now coming to lunch, roti with dal, vegetables and a bowl of curd is a good option. Or try stuffed parathas (gobi or mooli) with vegetables and curd.

The hormonal changes during pregnancy also tend to cause mood swings and other issues, which can be heightened during stressful times like these. How does one deal with it?

During pregnancy, it is really important that the people around a pregnant woman should keep her happy. Pregnant women also themselves must realise that they have hormones which go ‘haywire’ at that particular period, and stay away from confrontational situations, which may trigger anger or resentment. Families must refrain from saying anything which could upset women who are expecting,and avoid situations that might upset them. Second, psychotherapy is also available online over the telephone. The same can be done for the pregnant women as well, if they seek help or counselling to deal with their issues. Telemedicine can also be a good way of dealing with such mental distress and other such issues.

Are pregnant women more susceptible to viral infections due to lower immunity levels?

It is known that pregnancy lowers the immunity. So yes, there is quite a possibility that women who are expecting may be susceptible to other viral infections, so why not COVID-19 then? You have
to be careful when you are pregnant because of the high susceptibility to several viruses, which is caused due to immuno- suppression associated with pregnancy.

What happens if an expectant mother is diagnosed with COVID-19 symptoms?

In our country at the moment, if a person tests positive of COVID, he or she must notify the authorities and be admitted in isolation facility. COVID in pregnancy is a notifiable disease. It is important that the patient get admitted in a COVID hospital till she recovers. Usually the disease is mild, and there is nothing much to worry as the patient can come back after 15-20 days. So far there has been a study which reveals that around 87 pregnant who contracted the coronavirus were very mild and moderate cases. The mother is the priority when it comes to treatment. There aredrugs available to treat severe infections, which cause breathing difficulties. Drugs used to treat malaria patients can be administered to pregnant women as well.

Usually when the mother is affected, the child also tends to get affected through the placenta. However, so far the studies have shown the COVID does not affect the child when it is in the
uterus. But after the delivery, there is a high possibility the baby may be affected through contact, so all necessary precautions must be taken.