Pregnancy For Dummies

After you find out you're pregnant, you may wonder about the risks involved with certain medications. Maintaining good health throughout your pregnancy is a critical step in delivering a healthy baby. Many medicines — both over-the-counter and prescription — are safe to take during pregnancy. If you're taking medications essential for your health, discuss them with your physician prior to stopping them or changing your dose or regimen.

If you’ve ever had a parent-to-be show you an ultrasound picture of the baby, you know determining what you’re looking at, let alone detecting a family resemblance, isn’t always easy! But ultrasound pictures can be amazingly clear and useful — if you know what you’re looking for. Following are some of the items that doctors and sonographers try to pick out on ultrasound to find out whether the baby is growing and developing well.

Don’t worry. There's no conspiracy keeping you from knowing all there is to know about pregnancy. But your friends, sisters, cousins — whoever tells you what to expect with your pregnancy — often forget the little details, especially the more unpleasant ones. Furthermore, books often gloss over this stuff, perhaps in the interest of decorum.

Pregnancy has a certain mystique. Millions of women have been through it, yet predicting in detail what any one woman’s experience will be like is difficult. Perhaps that’s why so many myths have formed (and survived) over the centuries, most of which are designed to foresee the unknowable future. Here are 12 tales that, alas, are really nothing but nonsense: Old Heartburn Myth: If a pregnant woman frequently experiences heartburn, her baby will have a full head of hair.

Pregnant women need extra nutrition, but not empty calories, to keep themselves healthy and help their babies grow. Most pregnant women find they’re hungry throughout the day, not just at meals. With the busy schedules women have today, finding snacks that are both healthy and satisfying is difficult. Here are some recommendations for high-nutrient snacks that are easy to make and yummy.

Many kinds of professionals can help you through pregnancy and delivery. Be sure to choose a practitioner with whom you feel comfortable. Review this list of the basic five: Obstetrician/gynecologist: After completing medical school, this physician receives another four years of special training in pregnancy, delivery, and women’s health.

Everyone, young and old, seems to find joy in seeing the waving hand of a fetus inside the uterus. There’s something magical about being able to see inside the private quarters of a developing human being. But, as fascinating as it can be, we get a lot of questions about ultrasound from our patients. Patients often ask if their doctors are recommending too many ultrasounds.

To ensure the health of you and your baby, you’ll need to schedule regular visits to your doctor during your pregnancy. Use this guideline for making your appointments and understanding common procedures for each visit: Weeks Possible Tests 6–8 Blood type, rubella titer, blood counts, hepatitis screen, ultrasound.

More and more women are expressing interest in nontraditional or alternative birthing methods, and more and more possibilities are becoming available. Certainly, the following options aren’t for everyone, but knowing what’s possible can be helpful. Delivering without anesthesia Natural childbirth usually refers to giving birth without any medications or anesthesia.

Whereas systemic medications or various anesthetic techniques are aimed at eliminating the physical sensation of pain, alternative or non-pharmacologic methods are directed toward preventing the suffering associated with labor pain. These approaches to pain management emphasize labor pain as a normal side effect of the normal process of labor.

The most common forms of anesthesia used for cesarean deliveries are epidural and spinal. Both kinds of anesthesia numb you from mid-chest to toes but also allow you to remain awake so that you can experience your child’s birth. You may feel some tugging and pulling during the operation, but you don’t feel pain.

For some women, the nausea that can strike during the first trimester is worse in the mornings, maybe because the stomach is empty at that time of day. But ask anyone who’s had morning sickness, also known as nausea and vomiting of pregnancy (NVP), and she’ll tell you it can hit any time. It often starts during the fifth or sixth week (that is, three to four weeks after you miss your period) and goes away, or at least becomes much less severe, by the end of the 11th or 12th week.

A few medications can cause problems for the baby’s development. So let your doctor know about all the medications you take. If one of them is problematic, you can probably switch to something safer. Keep in mind that adjusting dosages and checking for side effects may take time. The following are some of the common medications that women should ask about before they get pregnant: Birth control pills: Women sometimes get pregnant while they’re on the Pill (because they missed or were late taking a couple of pills during the month) and then worry that their babies will have birth defects.

Cesarean section on demand (also known as a cesarean delivery on maternal request) is having a cesarean delivery just because the mom asks for it, even though no medical or obstetrical reasons for a cesarean exist. If you want to have a c-section on demand, make sure you discuss your wishes with your doctor well in advance of your delivery.

If the baby’s head is low enough in the birth canal and your practitioner feels that the baby needs to be delivered immediately or that you can’t deliver the baby vaginally without some added help, she may recommend the use of forceps or a vacuum extractor to assist. Using either of these instruments is called an operative vaginal delivery.

Most people think of newborn skin as blemish-free — the very definition of perfection — but newborns have all kinds of spots and markings. Most disappear within a matter of days or weeks. Some of the most common newborn skin conditions include Dry skin: Some babies, particularly those who are born late, have an outer layer of skin that looks shriveled like a raisin and peels off easily shortly after birth.

Backaches are a common symptom that many women experience during pregnancy. They typically occur in the latter part of pregnancy, although they can occur earlier. The shift in your center of gravity can be one cause. Another can be the change in the curvature of your spine as the baby grows and the uterus enlarges.

As you near the end of your pregnancy, you may recognize certain changes as your body prepares for the big event. You may notice all these symptoms, or you may not notice any of them. Sometimes the changes begin weeks before labor starts, and sometimes they begin only days before: Bloody show: No, the bloody show isn’t the newest horror flick by Wes Craven.

In each trimester, a few things may, in some cases, go less than smoothly. The following paragraphs describe some of the things that can happen during the first trimester of your pregnancy and what they may mean to you. Bleeding Early in pregnancy, around the time of your missed period, experiencing a little bleeding from the vagina isn’t uncommon.

Following are descriptions and symptoms of some problems that can develop during the second trimester of your pregnancy. Should you have any of these symptoms, discuss them with your practitioner. Bleeding Some women experience bleeding in the second trimester. Possible causes include a low-lying placenta (placenta previa), premature labor, cervical incompetence, or placental abruption.

Buying a car seat for your baby is one of the most important, but confusing, purchases you’ll make. You have many choices, so staying informed about what to look for is important. Basically, you can choose from two types available for newborns: Infant-only seat: Designed for babies who are under 1 year of age or weigh less than 20 pounds, this car seat is smaller and more lightweight than the alternative and should be used only in a rear-facing position.

Circumcision is the surgical removal of a male infant’s penis foreskin. Parents of boy babies must decide whether they want their son to have this procedure performed. The decision to have a circumcision may involve cultural and religious considerations, as well as personal preferences. More than half of newborn boys in the United States are circumcised, but in many other countries, circumcision is rarely performed.

Following are some common tests that may be recommended during your pregnancy. They may not be recommended for every pregnancy, but are included in the table for the sake of those who need them. Common Tests during Pregnancy TEST GESTATIONAL AGE (weeks) PURPOSE OF TEST Dating ultrasound 7–12 Confirm viability of pregnancy, establish due date, rule out multiple gestations Harmony, MaterniT21, Panorama, or Verifi 9–20 These are newly available tests for some women that use a sample of maternal blood to screen for genetic defects in the fetus.

So you know what’s going on throughout your pregnancy while at doctor’s visits, touring the hospital, and during labor and delivery, learn these medical abbreviations and what they mean. Abbreviation What It Stands For AFP Alpha-fetoprotein AMA/APA Advanced Maternal/Paternal Age CNM Certified Nurse Midwife CR

About half of all pregnant women complain of constipation. When you’re pregnant, you may become constipated because the large amount of progesterone circulating in your bloodstream slows the activity of your digestive tract. The iron in prenatal vitamins may make matters worse. Try these suggestions to deal with the problem: Eat plenty of high-fiber foods.

Hormonal shifts affect mood, as most women, especially those who suffer from premenstrual syndrome (PMS), already know. The hormonal fluctuations that support pregnancy are perhaps the most dramatic a woman experiences in her lifetime, so it’s hardly surprising that emotional ups and downs are commonplace. And the fatigue that goes along with pregnancy can easily make these ups and downs more severe.

Stretch marks are an almost inevitable part of pregnancy, though some women do manage to avoid them. Your skin stretches to accommodate the enlarging uterus and weight gain, causing the stretch marks. Some women probably also have some genetic predisposition for stretch marks. The marks typically appear as pinkish-red streaks along the abdomen and breasts, but they fade to silvery gray or white several months after delivery.

Many of the foods that have at one time or another been thought dangerous for pregnant women aren’t likely to harm you or your baby. Although you don’t have to avoid the following foods, they should be eaten in moderation, especially those that are manufactured (as opposed to natural) products: Aspartame (Equal or NutraSweet): Aspartame (a common component of low-calorie foods and beverages) is a type of amino acid, and the body is accustomed to amino acids because they’re what all proteins are made of.

Clearly, pregnant women who use alcohol put their babies at risk of fetal alcohol syndrome, which encompasses a wide variety of birth defects (including growth problems, heart defects, mental retardation, or abnormalities of the face or limbs). The controversy arises because medical science hasn’t defined an absolute safe level of alcohol intake during pregnancy.

During the month before delivery, a woman may notice that her belly feels lower and that suddenly it's easier to breathe. This feeling is because the baby has dropped, or descended lower into the pelvis. This movement is also called lightening. It typically happens two to three weeks before delivery in women who are having their first child.

You may find out at a routine prenatal visit that your practitioner thinks your uterus is measuring either too big or too small. This finding isn’t cause for immediate alarm. Often in this situation, your practitioner suggests that you have an ultrasound exam to get a better idea of how big the baby is. Ultrasound is used to measure parts of the baby — the head’s size, the abdomen’s circumference, and the thighbone’s length.

Labor puts stress on both you and the baby. Fetal heart monitoring provides a way to make sure that the baby is handling the stress. Monitoring can be done through several techniques. External monitoring Electronic fetal heart monitoring uses either two belts or a wide, elastic band placed around the abdomen. A device attached to the belt or under the band uses an ultrasound-Doppler technique to pick up the fetal heartbeat.

Now isn’t the time to shoot for that Ms. Fitness title, but that certainly doesn’t mean you can’t exercise. Because your pregnant body demands you take new precautions, choose your style of exercise carefully. Working your heart: Aerobic exercise Weight-bearing exercises like running, walking, aerobics, and using a stair-climbing machine or an elliptical trainer are great, as long as you don’t do too much.

From early on in your pregnancy, you may feel as if you’re spending your whole life in the restroom. During pregnancy, you need to urinate more frequently for a variety of reasons. At the beginning of your pregnancy, your uterus is inside your pelvis. But toward the end of your first trimester (at around 12 weeks), your uterus expands enough to rise up into your abdominal cavity.

Most people see their dentist for routine cleanings every 6 to 12 months, which means you’ll probably need to visit your dentist at least once during your pregnancy. Pregnancy itself shouldn’t affect your dental health. You don’t want to avoid the dentist because neglected cavities can become infected, which is all the more reason to see your dentist when you’re pregnant.

Just before birth, the baby’s head distends the perineum (the area between the vagina and the rectum) and stretches the skin around the vagina. As the baby’s head comes through the vagina’s opening, it may tear the tissues in the back, or posterior, part of the vaginal opening, sometimes even to the point that the tear extends into the rectum.

For most couples, having sex during pregnancy is perfectly safe. In fact, some couples find that sex during pregnancy is even better than before. However, you may have some issues to consider. In the first half of pregnancy, sex usually can continue as before because your body hasn’t changed that noticeably. You may notice that your breasts are particularly sensitive to the touch, or even tender.

Many pregnant women notice that they get headaches more often than they used to. These headaches may be the result of nausea, fatigue, hunger, the normal physiologic decrease in blood pressure that starts to occur at this time, tension, or even depression. Simple pain relievers like acetaminophen (for example, Tylenol) or ibuprofen (such as Motrin or Advil), in recommended doses, are often the best treatment for headaches, including migraines.

Heartburn — the burning sensation you feel when stomach acids rise into your esophagus — is common during pregnancy. Heartburn has two basic causes (neither of which validates the myth that heartburn means your baby will have a lot of hair). First, the high level of progesterone your body is producing can slow digestion and relax the sphincter muscle between the esophagus and the stomach, which normally prevents the upward movement of stomach acids.

No one wants to talk about them, but hemorrhoids — dilated, swollen veins around the rectum — are a common problem for pregnant women. They’re essentially varicose veins of the rectum. The enlarging uterus causes hemorrhoids by pressing on major blood vessels, which leads to pooling of blood, and ultimately makes the veins enlarge and swell.

The best way to figure out your ideal weight — and weight gain — is to look at a measurement that’s known as body mass index (BMI), a number that takes into account both height and weight. Find your body mass index by looking up your measurements on the chart. Locate your weight on the vertical line on the left-hand side of the chart and your height on the horizontal (bottom) line.

Your baby grows rapidly during the second trimester, as you can see. The fetus measures about 3 inches (8 centimeters) long at 13 weeks. By 26 weeks, it’s about 14 inches (35 centimeters) and weighs about 2-1/4 pounds (1,022 grams). Somewhere between weeks 14 and 16, the limbs begin to elongate and start to look like arms and legs.

On or about the fifth day of development, the blastocyst attaches to the blood-rich lining of the uterus during a process called implantation. Part of the blastocyst grows to become the embryo (the baby in the first eight weeks of development), and the other part becomes the placenta (the organ that implants into the uterus to provide oxygen and nourishment to the fetus and eliminate its waste products).

Well, are you or aren't you? These days, you don't need to wait to get to your practitioner's office to find out whether you're pregnant. You can opt instead for self-testing. Home tests are urine tests that give simply a positive or negative result. (By the way, these tests are very accurate for most people.) Your practitioner, on the other hand, may perform either a urine test similar to the one you took at home or a blood test to find out whether you're pregnant.

Distinguishing true labor from false labor isn’t always easy. But a few general characteristics can help you determine whether the symptoms you’re experiencing mean you’re in labor. In general, you’re in false labor if your contractions Are irregular and don’t increase in frequency Disappear for any reason, but especially when you change position, walk, or rest Are not particularly uncomfortable Occur only in your lower abdomen Don’t become increasingly uncomfortable On the other hand, you’re more likely to be in actual labor if your contractions Grow steadily more frequent, intense, and uncomfortable Last approximately 40 to 60 seconds Don’t go away when you change position, walk, or rest Occur along with leakage of fluid (due to rupture of the membranes) Make normal talking difficult or impossible Stretch across your upper abdomen or are located in your back, radiating to your front Sometimes the only way you can know for sure whether you’re in labor is by seeing your practitioner or going to the hospital.

A lot happens in the few hours immediately after your baby is born. He has made a pretty significant change and has a lot to adjust to. The medical staff takes immediate action to give him the best start in life. Keeping your baby warm and dry Because body temperature drops rapidly after birth, keeping your new baby warm and dry is important.

During the last few months of pregnancy, many women find sleeping difficult. Finding a comfortable position when you’re eight months along isn’t easy. You feel a little like a beached whale. Getting up five times a night to go to the bathroom doesn’t make things any easier. However, you may find relief in the following: Drink warm milk with honey before bedtime.

Although some women think that the only food that contains caffeine is a strong cup of coffee, in fact, you can find caffeine in many of the other things you eat and drink on a daily basis: tea, many sodas, cocoa, and chocolate. No evidence suggests that caffeine causes birth defects. However, if you consume caffeine in large amounts, it may raise the risk of miscarriage.

Leg cramps are a common annoyance of pregnancy, and they’re likely to become more frequent as the months go along. They’re due to a sudden tightening of the muscles. The muscles may tighten for many different reasons, including lack of fluids, muscle strain, or staying in one position for too long. Doctors once thought that leg cramps were due to too little calcium or potassium in the diet, although that has not been shown to be true.

Skin-to-skin contact is becoming a popular and important part of the immediate post-delivery experience. Skin-to-skin contact refers to the idea that the newborn baby and mom are immediately together, with the baby naked and resting on mom’s naked chest. Some medical studies show that the baby is happy this way, with a more stable temperature, heart rate, and breathing.

A birth plan is a statement of your preferences for how you want to manage your labor and delivery. It’s about educating yourself about your options and feelings, rather than making hard and fast — “I absolutely will/won’t” decisions. A birth plan involves sorting through things like where you want to deliver, whom you want to have with you during the process, and how you want to manage any pain you may experience.

Not all the tests or procedures discussed here are performed in all pregnancies — only when a specific problem is present. When needed, they are usually performed in the second or third trimester. In fact, most of these tests are rarely done and are usually done in centers that specialize in fetal medicine. They may sound scary, but you should know what may be available if you develop a problem.

To induce labor means to cause it to begin before it starts on its own. Induction may be a necessity (due to some obstetric, medical, or fetal complications) or elective (performed for the convenience of the patient or her practitioner). Medically indicated induction An induction is indicated (is a medical necessity) when the risks of continuing the pregnancy are greater — for the mother or the baby — than the risks of early delivery.

With the explosion of genetic technology, there is a whole menu of options for detecting genetic abnormalities in your baby, and many of them can be done in the first trimester. The options fall mainly into two categories: screening tests and diagnostic tests. A screening test will take bits of information about the developing fetus that can be collected and used to estimate the probability that your baby has certain genetic abnormalities and is usually expressed as a ratio (1/100, 1/1,000, 1/10,000, and so on).

There are a few different causes for bleeding late in the pregnancy. You might be going into labor. In that case, you may experience crampy abdominal pain (like menstrual cramps or even stronger contractions) and have a bloody, mucous-like discharge known as “bloody show.” Another cause is where the placenta separates prematurely, called a placental abruption.

Your positive pregnancy test marks a new beginning. The time has come to start thinking about what lies ahead. After you decide who your practitioner will be, give the office a call to find out how to proceed. Some practices want you to come in for a visit with the office nurse to give a medical history and confirm your good news with either a blood or urine test, whereas others schedule a first visit with the practitioner.

If you’re healthy, when you're pregnant you can probably confidently eat most of the foods you usually eat. Nonetheless, the following list contains some potential dangers that deserve a mention: Cheeses from unpasteurized or raw milk: Cheeses made from unpasteurized or raw milk may contain certain bacteria, such as listeria, monocytogenes, salmonella, and E.

If you think you’re in labor, call your practitioner. When a practitioner is trying to determine whether you’re in labor, he performs an internal exam to look for several things: Dilation: Your cervix is closed for most of your pregnancy but may gradually start to dilate during the last couple of weeks, especially if you’ve had a baby before.

Once you find out you’re pregnant, follow a recommended schedule of prenatal visits and review the tests you can expect for each doctor’s visit. Learning a few medical abbreviations used by your doctors and hospital staff will help you keep up with what's going on all the way through your delivery.Keeping tabs on your baby’s growth is exciting, especially when you have a helpful growth chart to follow.

Pregnant women are subject to the same rashes that nonpregnant women get. One rash is unique to pregnancy, however: Pruritic Urticarial Papules of Pregnancy, or PUPP. It sounds scary, but it’s really more of a nuisance than anything else because it can cause some intense itching. It occurs more often during a first pregnancy and in women having twins or more (the more fetuses, the greater the likelihood).

Between 28 and 36 weeks, your practitioner probably wants to see you every two to three weeks, and then weekly as you close in on delivery. She takes the usual measurements: blood pressure, weight, fetal heart rate, fundal height, and urine tests. These visits are a good time to discuss issues related to labor and delivery with your practitioner.

If you plan on breast-feeding, you may want to take steps to toughen the skin around your nipples, which can help prevent them from cracking and becoming painful and sore when you’re breast-feeding. You can try very gently rubbing or massaging your nipples between your fingers, exposing them to air, rubbing them gently with a washcloth, or wearing a nursing bra with the flaps down so that your nipples rub against your clothes.

The strict technical definition of preterm labor is when a woman begins to have contractions and changes in her cervix before she’s 37 weeks along. Many women have contractions but no cervical change — in which case it isn’t real preterm labor. However, in order to find out whether your cervix is changing, you need to be examined.

Your doctor may perform a cesarean delivery for many reasons, but all are about delivering the infant in the safest, healthiest way possible while also maintaining the mother’s well-being. A cesarean delivery can be either planned ahead of labor (elective), unplanned during labor (when the doctor determines that delivering the baby vaginally isn’t safe), or done as an emergency (if the mother’s or the baby’s health is in immediate jeopardy).

So assume it has happened: A budding embryo has nestled itself into your womb’s soft lining. How and when do you find out that you’re pregnant? Quite often, the first sign is a missed period. But your body sends many other signals — sometimes even sooner than that first missed period — that typically become more noticeable with each passing week.

Systemic medications are distributed via the bloodstream to all parts of the body. Yet most of the pain of labor and delivery is concentrated in the uterus, vagina, and rectum. So regional anesthesia is sometimes used to deliver pain medication to those specific areas. Medications used in regional anesthesia can be a local anesthetic (like lidocaine), a narcotic (such as those in the preceding section), or a combination of the two.

Using hot tubs, whirlpools, saunas, or steam rooms when you’re pregnant can be risky because of the high temperatures involved. In laboratory animals, exposure to high levels of heat during pregnancy has been known to cause birth defects or miscarriage. Studies involving humans suggest that pregnant women whose core body temperatures rise significantly during the early weeks of pregnancy may stand an increased risk of miscarriage or having babies with neural tube defects (spina bifida, for example).

The following blood tests usually yield normal results, but if yours are at all unusual, you may need further testing — an ultrasound examination, perhaps. But keep in mind that further testing doesn’t necessarily mean that anything is wrong — only that your practitioner is being careful to ensure that everything is okay.

The hormones coursing through your body at soaring levels may make strange things happen to your skin. These changes don’t occur in all women, and if they do happen to you, rest assured they usually fade away after the baby is born. Credit: Kathryn Born, MA You may notice a dark line, called the linea nigra, on your lower abdomen running from your pubic bone up to your navel.

Unless you’ve been living on Mars for the past ten years, you no doubt are aware that smoking is a health risk for you. When you smoke, you run the risk of developing lung cancer, emphysema, and heart disease, among other illnesses. During pregnancy, however, smoking poses risks to your baby as well. The carbon monoxide in cigarette smoke decreases the amount of oxygen that your growing baby receives, and nicotine cuts back on blood flow to the fetus.

Try as you may to follow all the rules of healthy nutrition, you may encounter certain problems with digestion, such as constipation or heartburn. Or you may find that you need to tailor the rules to fit your particular eating habits — for example, if you’re a vegetarian. Eating right, vegetarian-style If you’re a vegetarian, rest assured you can produce a healthy baby without eating steak.

Brace yourself: You’re probably going to be stuck with a needle and have to pee in a cup during your first prenatal visit. Here’s a look at the standard procedures, including blood and urine tests. Blood tests On your first prenatal visit, your practitioner will draw your blood for a bunch of standard tests to check your general health, as well as to make sure you are immune to certain infections.

If your diet is healthy and balanced, you get most of the vitamins and minerals you need naturally — with the exception of iron, folic acid, and calcium. To make sure you get enough of these nutrients and to guard against inadequate eating habits, your practitioner is likely to recommend prenatal vitamins. In the case of vitamins, more isn’t necessarily better; take only the prescribed number of pills each day.

The most common medications used systemically are relatives of the narcotic morphine — drugs such as meperidine (brand name Demerol), fentanyl (Sublimaze), butorphanal (Stadol), and nalbuphine (Nubain). These medications can be given every two to four hours as needed, either intravenously or intramuscularly. Any medication you take (even when you’re not pregnant) has side effects, and pain relievers used during labor are no exception, although your doctor will do what he can to reduce these side effects, often by combining medications.

Amniocentesis is a test that is performed by inserting a thin, hollow needle into the amniotic fluid and then withdrawing some of the fluid through the needle into a syringe. The amniotic fluid can then be tested in a variety of ways. Credit: Kathryn Born, MA If your practitioner performs a genetic amniocentesis — a check of fetal chromosomes — he usually conducts it at 15 to 20 weeks.

If the information from the fetal monitor raises concerns or is ambiguous, your practitioner can perform other tests to help determine how to proceed with your labor. Labor admission test This test involves performing electronic fetal heart rate monitoring for about 20–30 minutes upon admission to the labor and delivery floor.

During your first prenatal visit, your practitioner discusses with you your medical and obstetrical history. She asks about various aspects of your physical health, as well as elements of your lifestyle that may affect your pregnancy. Lifestyle Your practitioner asks about your occupation to find out whether your job is sedentary or active, whether you spend your days standing or lifting heavy objects, or whether you work nights or long shifts.

During your pregnancy, you’ll probably experience at least a headache or two and an occasional case of heartburn. The question of whether you can safely take pain relievers, antacids, and other over-the-counter medicines is bound to come up. Many women are afraid to take any medicine at all, for fear of somehow harming their babies.

The first stage of labor occurs from the onset of true labor to full dilation of the cervix. This stage is by far the longest (taking an average of 11 hours for a first child and 7 hours for subsequent births). It is divided into three phases: the early (latent) phase, the active phase, and the transition phase.

People are immune to all kinds of infections, for one of two reasons: They’ve suffered through the disease, or they’ve been vaccinated. Many vaccines are safe, and in fact recommended, while you’re pregnant. (See the table for information on several vaccines.) Safe and Unsafe Vaccines before or during Pregnancy Disease Risk of Vaccine to Baby during Pregnancy Immunization Recommendations Comments Cholera None confirmed Same as in nonpregnant women Hepatitis A (inactivated) None confirmed Okay if high risk for infection or for prevention due to recent exposure Hepatitis B None confirmed Okay if high risk for infection Used with immunoglobulins for acute exposure; newborns need vaccine Human papilloma virus None confirmed, but little data If found to be pregnant after initiating series, give remaining doses postpartum Influenza (inactivated) None confirmed Recommended Measles None confirmed No Vaccinate postpartum Mumps None confirmed No Vaccinate postpartum Plague None confirmed Selected vaccination if exposed Pneumococcus None confirmed Okay if high risk Poliomyelitis None confirmed Only if exposed Get if traveling to endemic area Rubella None confirmed No Vaccinate postpartum Rabies Unknown Indication same as for nonpregnant women Consider each case separately Smallpox Possible miscarriage No, unless emergency situation arises or fetal infection Tetanus, diphtheria, and pertussus (Tdap) None confirmed Recommended for each pregnancy between 27 and 36 weeks Typhoid None confirmed Only for close, continued exposure or travel to endemic area Varicella (chicken pox) None confirmed Immunoglobulins recommended in exposed nonimmune women; should be given to newborn if around time of delivery If nonimmune, vaccinate postpartum (second dose four to eight weeks later) Yellow fever Unknown No, unless exposure is unavoidable Here is some further information on some common vaccinations: Rubella: Your practitioner tests to see whether you’re immune to rubella (also known as German measles) by drawing a sample of blood and checking to see whether it contains antibodies to the rubella virus.

At your first prenatal visit, your practitioner examines your head, neck, breasts, heart, lungs, abdomen, and extremities. She also performs an internal exam. During this exam, your practitioner evaluates your uterus, cervix, and ovaries, and performs, if due, a Pap test (cervix cancer and pre-cancer screening).

Caput succedaneum — more commonly called caput — refers to a circular area of swelling on the baby's head, located at the spot that pushed against the cervix's opening during delivery. The exact location of the swelling varies, depending on the position that the baby's head was in. The swollen area can range in size from only a few millimeters in diameter to several centimeters (a few inches).

The main potential problem with traveling during pregnancy is that it puts distance between you and your prenatal care provider. If you’re close to your due date or if your pregnancy is considered high-risk, you probably shouldn’t travel far from home. Your decision to travel, though, depends on what the risk factors actually are.

An ultrasound (also referred to as a sonogram) exam is an incredibly useful tool that allows you and your doctor to see the baby inside your uterus. A device called a transducer emits sound waves. The sound waves are reflected off the fetus and converted into an image that appears on a monitor. You can see almost all the structures in the fetus’s body, and you can see the fetus moving around and performing all its normal activities — kicking, waving, and so on.

Umbilical cord blood is sometimes saved because it contains stem cells, the kind of cells that can be used to treat a variety of blood disorders, such as some that may develop later in the child’s life, like severe anemia. The decision of whether to donate cord blood is a personal one and based on many factors.

Although your weight gain may follow a path all its own, your baby’s own bulking-up pattern is likely to progress slowly at first, and then pick up at about 32 weeks, only to slow again in the last weeks before birth. At 14 to 15 weeks, for example, the baby puts on weight at about 0.18 ounce (5 grams) per day, and at 32 to 34 weeks, 1.

No single food can satisfy all your nutritional needs. The USDA Choose My Plate is a general guideline that illustrates the relative proportions of servings you should eat in each group. To get some specific recommendations tailored for your pre-pregnancy weight and activity level, go to Choose My Plate and create a profile to receive a personalized “Daily Food Plan.

Most expectant mothers spend a great deal of time during the 40 weeks of pregnancy thinking ahead to the actual delivery. The most common method of delivery is, of course, a vaginal delivery. Most likely, you’ll experience what doctors call a spontaneous vaginal delivery, which means that it occurs as a result of your pushing efforts and proceeds without a great deal of intervention.

During pregnancy, your vaginal discharge normally increases substantially. Some women find that they need to wear thin panty liners every day. The discharge tends to be thin, white, and virtually odorless, technically known as leucorrhea. Vaginal douches aren’t a good idea because they may alter a woman’s natural ability to fight off vaginal infections.

You may notice that a small road map has suddenly appeared on your lower legs (and sometimes the vulvar area). These marks are dilated veins, referred to as varicose veins. The pressure of the uterus on major blood vessels — the inferior vena cava (the vein that returns blood to the heart) and the pelvic veins, in particular — causes them.

If you suspect that you’re pregnant, you’re probably excited and want to know definitively whether you are pregnant. The first four weeks are important because the pregnancy is getting established as the implantation process is underway. During these initial weeks, do the following: Record your last menstrual period (LMP).

Congratulations! You and your baby made it through the first trimester. You’re starting to feel more like yourself — you have more energy and less nausea. After week 14, the majority of the amniotic fluid surrounding your baby is made up of the baby’s urine. By week 15, an experienced sonographer can tell by ultrasound whether you’re having a boy or a girl.

During weeks 17 to 20, your baby begins to put on some fat and looks more like a real baby. The baby’s skeleton, which starts out mostly as cartilage, is now transforming into bone. Often you may notice a little fluttering sensation in your abdomen. This could be gas, but more likely it’s early fetal movement.

During this time, there aren’t any actual tasks that you have to schedule with your provider, other than your routine prenatal visits (which should be about every four weeks during this period). Your baby’s lungs are going through a very important phase of development. The lining of the lungs is beginning to thin out enough to allow for oxygen exchange.

Your baby’s bones are continuing to harden during this time, and his fingernails, toes, eyebrows, and eyelashes are fully present. Meanwhile, your baby’s skin is still fairly see-through, although it is changing from transparent to a more opaque look. You should still be seeing your provider about every four weeks during this period of pregnancy.

During this portion of your pregnancy, your baby’s eyes can now open. His permanent teeth have developed, and the lungs and digestive tract are nearly mature. In order to keep a closer eye on you and your baby, your practitioner will start to schedule your prenatal visits every two weeks during this time. The following steps are recommended during this time: If you haven’t started childbirth classes, begin them now.

If you’re having twins, you should be well prepared for their arrival by week 33, because on average, twins deliver at about 35 to 36 weeks. During this time, you may be feeling lots of rhythmic fetal movements, which are really the baby hiccupping, a normal occurrence. These hiccups can continue even after the baby is born.

Congratulations — you are now considered “term.” Even though you may not yet be at your due date, any delivery that occurs at or after 37 weeks is called full-term. You may notice irregular contractions that come and go in spurts. The big event can happen any time during this period, so be prepared — day or night.

Don’t worry — the end really is in sight. If you haven’t gone into labor on your own, your doctor will likely schedule you for either induction or cesarean section by 41-42 weeks. If you are older than 35, and especially older than 40, your doctor may want to deliver you sooner. Because the risks to continuing the pregnancy really increase after 41–42 weeks, your baby should be delivered by that time.

By this time, the pregnancy is well established and you’re feeling the typical signs and symptoms of pregnancy, such as nausea and fatigue. It’s an important time to make any necessary lifestyle changes, if you haven’t already done so (like stopping smoking or speaking with your doctor abut adjusting medications).

Although you won’t be feeling it this early, this is the time when your baby starts to move around. If you’re having an ultrasound at this time, you may actually see these movements on the screen. Before 10 weeks, male and female embryos look the same. After 10 weeks, their external genitalia start to develop differently, although your practitioner may not be able to see this difference on ultrasound until after 14 to 15 weeks.

Without a doubt, the field of human genetics is the fastest growing field of medicine today. The Human Genome Project was sponsored by the U.S. government to sequence all 3 billion basic DNA segments (base pairs). It began around 1990 and it was anticipated that it would be done toward the end of the first decade of the new millennium.

Women may experience any and every kind of emotion after their babies are born. The spectrum of feelings is truly infinite. Most of the time, you’re completely overcome with joy when your long-awaited baby finally is born. You may be incredibly relieved to see that your baby appears healthy and obviously okay.

During your pregnancy, pack portable items you’ll need for your labor and delivery and hospital stay in a bag and keep it in a handy place or in your car. For your trip to the hospital you’ll need: Your partner/labor coach A bathrobe and nightgown Toiletries Sturdy underwear that you don’t mind soili

For the most part, use the charts of optimal weight gain as a guide, but don’t become fanatical about how much you weigh. Even if the amount you gain is somewhat off course, if your doctor says that the baby is growing normally, you have nothing to worry about. Women who gain more than average can still have healthy babies, and so can women who gain very little.

The great fitness movement hasn't left pregnant women behind. You see them jogging in parks, working out in gyms, or stretching their limbs in yoga classes. During pregnancy, exercise helps your body in many ways: It keeps your heart strong and your muscles in shape, and it relieves the basic discomforts of pregnancy — from morning sickness to constipation to achy legs and backs.

Over the last half-century, the number of women who work outside the home has steadily increased. More than 75 percent of pregnant women work during the third trimester, and more than half work up to a few weeks of delivery. Many women find that working until the end of pregnancy keeps them happy and occupied and helps them not to focus on the discomforts.

At 28 weeks, your baby measures about 14 inches (about 35 cm) and weighs about 2-1/2 pounds (about 1,135 grams). But by the end of the third trimester — at 40 weeks, your due date — it measures about 20 inches (50 cm) and weighs 6 to 8 pounds (about 2,700 to 3,600 grams) — sometimes a bit more, sometimes a bit less.

At the eighth week of pregnancy (date of last menstrual period) the embryo is now referred to as a fetus. All organs are formed and the remaining 32 weeks of pregnancy is a time for the fetus to grow and mature. Take a look at this chart to see how your baby’s body weight and length changes during your pregnancy: Weeks Pregnant (measured from LMP) Average Weight Average Length 8 0.

Be prepared for your baby’s arrival (or in case you have questions or concerns during your pregnancy) by printing this list and filling out the information. Keep this list in your purse or on the fridge for easy access Your practitioner: Name ______________________ Phone number ________