Everand Logo

Welcome to Everand!

  • Discover millions of ebooks, audiobooks, and so much more with a free trial

    Only $9.99/month after trial. Cancel anytime.

    Pregnancy All-in-One For Dummies
    Pregnancy All-in-One For Dummies
    Pregnancy All-in-One For Dummies
    Ebook917 pages11 hours

    Pregnancy All-in-One For Dummies

    By The Experts at Dummies

    ()

    Read preview

    About this ebook

    Your all-encompassing guide to having a happy, healthy pregnancy

    Are you an expectant parent looking for sound, expert guidance as you prepare to welcome a new addition to your family? Pregnancy All-in-One For Dummies has done the legwork for you, offering a one-stop compilation of the hottest topics and most relevant information culled from several successful For Dummies pregnancy titles. Covering everything from conception to the delivery room—and beyond—it gives moms and dads-to-be the reassuring answers they need during this very special time.

    Your pregnancy and childbirth experiences should be happy ones, but they're bound to be rife with questions—especially if you're a first-time parent, having a child later in life, or embarking on your first multiple birth. Luckily, this friendly guide is here to put your mind at ease, offering authoritative coverage of everything you can expect to encounter in the first, second, and third trimesters of pregnancy, as well as all the special considerations you may come across along the way, such as diet, exercise, labor and delivery options, breastfeeding, and so much more.

    • Make pregnancy and childbirth an enjoyable experience
    • Find out about nutrients that are critical to your baby's development
    • Get authoritative guidance on making a birth plan

    Why turn to dozens of pregnancy resources when all the helpful, down-to-earth guidance you're looking for is right here, in one convenient place?

    LanguageEnglish
    PublisherWiley
    Release dateApr 18, 2016
    ISBN9781119235514
    Pregnancy All-in-One For Dummies

    Read more from The Experts At Dummies

    Related to Pregnancy All-in-One For Dummies

    Related ebooks

    Women's Health For You

    View More
    View More

    Related podcast episodes

    Related articles

    • Article

      10 Things To Do Before You Get Pregnant

      Sep 23, 2019

      Being over- or underweight can both be issues when you’re trying to conceive, as it affects your output of hormones. This means that your diet could dramatically increase your chances of conception. Consider your weight and height, and work toward ac

      2 min read

    • Article

      Well Begun Is Half Done

      Feb 3, 2020

      Breastfeeding is a universally accepted means of optimal nutrition that promotes a baby best survival, growth and development. The World Health Organization (WHO) recommends that babies should be exclusively breastfed for the first six months of life

      4 min read

    • Article

      Do I Have To…

      Aug 1, 2022

      Do I Have To…
      4 min read

    • Article

      “Formula As ‘Medicine’ Only!”

      Oct 7, 2019

      Effath Yasmin is India’s leading International Board Certified lactation Consultant (IBCLC), Biodynamic CranioSacral Therapist, internationally certified lactation educator and the founder director of Nourish & Nurture Lactation Care & Parenting Educ

      2 min read

    • Article

      Milk for AFRICA!

      Nov 19, 2021

      Milk for AFRICA!
      4 min read

    • Article

      Q&A

      May 31, 2023

      Q&A
      4 min read

    • Article

      Tuning Into Your Fertility

      Apr 13, 2022

      Tuning Into Your Fertility
      7 min read

    • Article

      INSTANT Appointment

      Mar 10, 2022

      With Odette Abououf, midwife and founder of Mummy’s Organics (mummysorganics.co.uk) QBefore I fell pregnant, I was going to the gym every day and doing a mix of weights and high intensity cardio. I want to stay fit during my pregnancy. Can I keep thi

      2 min read

    • Article

      Mum Knows Best

      Mar 29, 2023

      Mum Knows Best
      3 min read

    • Article

      Positively Pregnant!

      Jul 22, 2019

      Positively Pregnant!
      5 min read

    • Article

      Second Time 'Round

      Nov 22, 2024

      Second Time 'Round
      5 min read

    • Article

      LOOKING AFTER Mum

      Jan 26, 2024

      LOOKING AFTER Mum
      4 min read

    • Article

      Yvonne O’Halloran

      Sep 24, 2021

      Yvonne O’Halloran
      4 min read

    • Article

      Grow, Baby, Grow

      Apr 1, 2023

      Grow, Baby, Grow
      4 min read

    • Article

      Q&A

      Apr 1, 2023

      Email your question for our experts to: [email protected] Please note that experts unfortunately cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor. DR MARISE SUBRAYAN GY

      2 min read

    • Article

      Second Time ‘Round(er)?

      Jul 27, 2020

      Second Time ‘Round(er)?
      5 min read

    • Article

      What To Expect After Birth

      Mar 15, 2024

      Once you've given birth, you will be put into the recovery room, which is usually attached to the labour ward. You and your baby will be closely monitored for about an hour. Vital signs such as pulse, temperature, blood pressure and vaginal bleeding

      4 min read

    • Article

      BREAST IS best

      Oct 1, 2022

      BREAST IS best
      2 min read

    • Article

      Q&A My HIV Has Me Worried

      Jan 19, 2024

      Ask A Doctor on the #Keready WhatsApp line 24/7 for any health-related queries: 060 019 0000 Keready hosts regular TikTok Love sessions on @keready including women’s health topics such as endometriosis, sexually transmitted infections and breast canc

      3 min read

    • Article

      26 Tips For A Better Birth

      Jul 22, 2019

      26 Tips For A Better Birth
      7 min read

    • Article

      BREAST IS best

      Sep 20, 2024

      BREAST IS best
      2 min read

    • Article

      Your Best Birth Starts Now

      Mar 12, 2021

      Your Best Birth Starts Now
      4 min read

    Related categories

    Reviews for Pregnancy All-in-One For Dummies

    0 ratings

    0 ratings0 reviews

    What did you think?

    Tap to rate

    Review must be at least 10 words

      Book preview

      Pregnancy All-in-One For Dummies - The Experts at Dummies

      Introduction

      Prospective parents are truly curious about everything related to pregnancy, from when the baby’s heart is formed to whether eating sushi or dyeing your hair is okay. If this describes you, you’ve come to the right place. In one helpful reference guide, Pregnancy All-in-One For Dummies offers the answers to many of your pregnancy-related questions, from fetal development to workouts for moms-to-be to healthy weight gain and more.

      About This Book

      Pregnancy should be a joy, not a worry. Yet pregnant women are, by nature, already anxious about whether anything they do or eat may hurt the baby. The source of all this anxiety? Often it’s information on pregnancy — in print, online, or from the mouths of well-meaning but clueless friends and family — that is outdated, lacks scientific basis, or is exaggerated for shock effect. The result is that many pregnant women and their partners end up incredibly worried about something they’ve read or heard.

      This comprehensive, scientifically correct guide presents the facts of pregnancy based on real scientific data, and it answers many commonly asked questions — all while encouraging the humor and light-heartedness that are part of the miraculous process of having a baby. A big part of the philosophy behind this book is to reassure pregnant women instead of adding to the unnecessary worries they already have.

      Prospective parents also want to know about the medical aspects of pregnancy. When are fingers developed? Which blood tests should be done, and why? What options are available for detecting various problems? This book addresses these topics, too, creating what is essentially a medical text on obstetrics for the layperson.

      This book provides a lot of factual information, but it isn’t gospel. Many of the topics discussed apply to pregnancy in general, but your particular situation may have unique aspects that warrant different or extra consideration, so use this book as a companion to regular medical care.

      Sidebars (boxes of text) in this book give you a more in-depth look at a certain topic. Although they further illuminate a particular point, these sidebars aren’t crucial to understanding the rest of the book. Feel free to read them or skip them. You can pass over the text that accompanies the Technical Stuff icon as well. The text associated with this icon gives some interesting details about pregnancy, but if you don’t read it, you can still come away with the information you need.

      Within this book, you may note that some web addresses break across two lines of text. If you’re reading this book in print and want to visit one of these web pages, simply key in the web address exactly as it’s noted in the text, pretending the line break doesn’t exist. If you’re reading this as an e-book, you’ve got it easy — just click the web address to be taken directly to the web page.

      Foolish Assumptions

      We made some assumptions about you and what you want out of a pregnancy book:

      You may be a woman who is considering pregnancy, planning to have a baby, or already pregnant.

      You may be the partner of the mother-to-be.

      You may know and love someone who is or plans to become pregnant.

      You want to find out more about pregnancy but have no interest in becoming an expert on the topic.

      You want reliable information on a variety of topics related to pregnancy, from information on the development of the fetus to how to stay fit as your body changes, whether and how to breastfeed, and more.

      If you fit any of these criteria, then Pregnancy All-in-One For Dummies gives you the information you’re looking for.

      Icons Used in This Book

      Like other For Dummies books, this one uses icons to guide you through the information.

      technicalstuff This icon signals information that delves a little deeper than usual into a medical explanation.

      remember This icon flags information that’s particularly worth keeping in mind.

      tip This icon marks bits of advice about handling minor discomforts and other challenges you encounter during pregnancy.

      warning This icon points out situations and actions that a pregnant woman clearly should avoid.

      Beyond the Book

      In addition to the material in the print or e-book you’re reading right now, this product comes with some access-anywhere goodies on the web. Check out the free Cheat Sheet for info on what to expect when you’re admitted to the hospital, how you can avoid some of the maladies that plague pregnant women (like heartburn), and strategies that can help you find time for fitness and motherhood. To get this Cheat Sheet, simply go to www.dummies.com and search for "Pregnancy All-in-One For Dummies Cheat Sheet" in the Search box.

      Where to Go from Here

      If you’re the particularly thorough type, go ahead and read this book from cover to cover. If you just want to find specific information and then close the book, take a look at the table of contents or at the index. Dog-ear or bookmark the pages that are especially interesting or relevant to you. Add comments or write little notes in the margins. Have fun, and most of all, enjoy your pregnancy!

      Book 1

      Getting Started with Your Pregnancy Preparation

      Contents at a Glance

      Chapter 1: Seeing Double (Lines): And So It Begins

      Seeing Signs — of Pregnancy, That Is

      Determining Whether You’re Pregnant

      A Week-by-Week Overview of Pregnancy

      Common Tests during Pregnancy

      Chapter 2: Practitioners, Prenatal Visits, and Maintaining Good Health

      Selecting the Right Practitioner for You

      Planning Prenatal Visits

      Keeping Your Medicines and Vaccinations in Check

      Understanding the Effects of Alcohol and Other Drugs on Your Baby

      Chapter 3: Diet, Exercise, and Expectant Moms

      Looking at Healthy Weight Gain

      Taking Stock of What You’re Taking In

      Determining Which Foods Are Safe

      Considering Special Dietary Needs

      Working Out for Two

      Chapter 4: Oh, the Changes You’ll See: Physical, Emotional, and Embarrassing Unmentionables

      Bracing for Emotional Changes

      Prepping for Physical Changes

      Looking at Lifestyle Changes

      Working during Pregnancy: A Different Type of Labor

      Chapter 5: Creating a Birth Plan

      What’s a Birth Plan? And Why Would You Want One?

      Your Birth-Plan Options: An Overview

      Making Smart Choices When You’re Not a Doctor

      Avoiding Potential Birth-Plan Pitfalls

      Chapter 1

      Seeing Double (Lines): And So It Begins

      IN THIS CHAPTER

      Knowing what symptoms to look for

      Getting the answer to that all-important question: Are you pregnant?

      Knowing what to expect as your pregnancy progresses

      Scheduling doctor appointments and routine tests

      So you think you may be pregnant! Or maybe you’re hoping to become pregnant soon. Either way, it’s important to know what to look for so that you can find out whether you’re pregnant as early as possible. This chapter takes a look at some of the most common signals that your body sends you in the first weeks of pregnancy and offers advice for confirming your pregnancy and getting it off to a great start.

      Seeing Signs — of Pregnancy, That Is

      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.

      Honey, I’m late! You may suspect that you’re pregnant if your period hasn’t arrived as expected. By the time you notice you’re late, a pregnancy test will probably yield a positive result (see the next section for more on pregnancy tests). Sometimes, though, you may experience one or two days of light bleeding, which is known as implantation bleeding, because the embryo is attaching itself to your uterus’s lining.

      You notice new food cravings and aversions. What you’ve heard about a pregnant woman’s appetite is true. You may become ravenous for pickles, pasta, and other particular foods yet turn up your nose at foods you normally love to eat. No one knows for sure why these changes in appetite occur, but experts suspect that these changes are, at least partly, nature’s way of ensuring that you get the proper nutrients. You may find that you crave bread, potatoes, and other starchy foods, and perhaps eating those foods in the early days is actually helping you store energy for later in pregnancy, when the baby does most of its growing. As with any other time in life, though, be careful not to overeat. You may also be very thirsty early in pregnancy, and the extra water you drink is useful for increasing your body’s supply of blood and other fluids.

      Your breasts become tender and bigger. Don’t be surprised if you notice that your breasts become larger during the first portion of your pregnancy. In fact, large and tender breasts are often the first symptom of pregnancy that you feel because very early in pregnancy, levels of estrogen and progesterone rise, causing immediate changes in your breasts.

      Determining Whether You’re Pregnant

      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 result (often showing two lines) or negative result (showing only one line); some use little plus (positive) and minus (negative) signs. 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 confirm that you’re pregnant.

      Getting an answer at home

      Suppose you notice some bloating or food cravings, or you miss your period by a day or two. You want to know whether you’re pregnant, but you aren’t ready to go to a doctor yet. The easiest, fastest way to find out is to go to the drugstore and pick up a home pregnancy test. These tests are basically simplified chemistry sets, designed to check for the presence of human chorionic gonadotropin (hCG, the hormone produced by the developing placenta) in your urine. Although these kits aren’t as precise as laboratory tests that look for hCG in blood, in many cases, they can provide positive results very quickly — by the day you miss your period, or about two weeks after conception.

      remember The results of home pregnancy tests aren’t a sure thing. If your test comes out negative but you still think you’re pregnant, retest in another week or make an appointment with your doctor. A urine test is positive at a level of about 20–50 IU/L, while a blood test is positive at a level of 5–10 IU/L, depending on the test. So a blood test will be positive a little earlier than a urine test. An ultrasensitive blood test can even detect an hCG level of about 1–2 IU/L.

      Going to your practitioner for answers

      Even if you had a positive home pregnancy test, most practitioners want to confirm this test in their office before beginning your prenatal care. Your practitioner may decide to simply repeat a urine pregnancy test or to use a blood pregnancy test instead.

      A blood pregnancy test checks for hCG in your blood. This test can be either qualitative (a simple positive or negative result) or quantitative (an actual measurement of the amount of hCG in your blood). The test your practitioner chooses depends on your history and your current symptoms and on her own individual preference. Blood tests can be positive even when urine tests are negative.

      REACTING WHEN YOUR PARTNER BREAKS THE NEWS

      When your partner tells you the big news, try to mirror her reaction, at least outwardly. If her reaction is Oh … heck, you can go along in that vein also, at least for a minute or two. Remember, though, that she’s gauging your reaction to the news, and if you act like having a baby is a huge imposition in your life, she’ll be really upset, even if it is going to be a huge imposition and even if she just said the same thing five minutes before. Try to throw in a few encouraging statements about how you wanted kids eventually, how having a baby will be fun in the winter when there’s nothing else to do, or whatever encouraging babble you can come up with at a stressful time.

      Some women get very creative with their announcements, from filling the living room with balloons to baking a cake with a pair of booties inside. Just try not to choke on one, literally or figuratively. If she’s gone all out to break the news, you can safely bet that she’s really excited, so make sure to be as supportive as possible.

      Even if you’ve been trying to conceive forever, an initial reaction of fear isn’t uncommon. Remember that your partner may also be feeling some sudden doubts and fears, and allow her to express them. Under no circumstances is We spent $20,000 for fertility treatments and now you’re not sure this is the right time?! the right response to her concerns.

      Calculating your due date

      Only 1 in 20 women actually delivers on her due date — most women deliver anywhere from three weeks early to two weeks late. Nonetheless, it’s important to pinpoint the due date as precisely as possible to ensure that the tests you need along the way are performed at the right times. Knowing how far along you are also makes it easier for your doctor to see that the baby is growing properly.

      The average pregnancy lasts 280 days — 40 weeks — counting from the first day of the last menstrual period. This day is used to calculate your due date.

      tip If your cycles are 28 days long, you can use a shortcut to determine your due date. Simply subtract three months from your last menstrual period and add seven days. If your last period started on June 3, for example, your due date would be March (subtract three months) 10 (add seven days). If your periods don’t follow 28-day cycles, don’t worry. You can establish your due date in other ways. If you’ve been tracking ovulation and can pinpoint the approximate date of conception, add 266 days to that date (the average time between the first day of your last menstrual period and ovulation is about 14 days, or 2 weeks).

      If you’re unsure of the date of conception or the date your last period started, an ultrasound exam during the first three months can give you a good idea of your due date. A first-trimester ultrasound predicts your due date more accurately than an ultrasound done in the second or third trimester.

      tip You can also use a pregnancy wheel to calculate how far along you are. To use this handy tool, line up the arrow with the date of your last menstrual period and then look for today’s date. Just below the date, you see the number of weeks and days that have gone by. (If you know the date of conception rather than your last period, there’s a line on the wheel corresponding to this, too.) You can find online wheels as well as apps that you can download to calculate your due date.

      A Week-by-Week Overview of Pregnancy

      As indicated throughout this book, pregnancy is usually referred to as a 40-week enterprise, which is a tad misleading. The pregnancy starts at conception, which — with a normal 28-day cycle — is two weeks after the first day of your last menstrual period. So if you start at conception, pregnancy is only 38 weeks, but obstetricians use 40 weeks because most women don’t know when they conceive but do remember when their last period was.

      remember Here are a few things to remember as you read this week-by-week guide:

      Many of the things discussed in a particular week may still be important at other times throughout the pregnancy. So just because the ultrasound is mentioned at 20 weeks doesn’t mean it can’t be done at any other time.

      Some things included in this chapter are optional and may not be necessary for everyone.

      The week/weeks assigned to prenatal tests or pregnancy events are an approximation. Don’t be overly alarmed if, in your pregnancy, they are off by a week or so.

      OVERCOMING YOUR FEARS OF BEING A FATHER

      You have a lot of time to get used to the idea of being a dad, so don’t worry if you have a lot of fears at first. Even if you aren’t sure you’re ready to become a father, you’ll be surprised how quickly you come around to the idea. Besides, the baby will be here before you know it, ready or not.

      It’s important, however, to use this time to confront your fears about parenting. Spend time with the male role models from your past (and present) and use them as learning tools. Ask them what they did right, what they would change, and what advice they have for you when raising your own child. You may feel like you’re the first father ever, but you don’t need to reinvent the wheel when it comes to parenting. If you admire other people’s skills, monitor and mimic their behaviors.

      Working on overcoming your fatherhood fears is doubly important if the father in your life wasn’t the best role model for the type of dad you want to be to your son or daughter. To attempt to come to terms with any wrongdoings your father may have committed, talk with a counselor or therapist, or even a trusted friend, about your relationship with your father and try to identify the mistakes you don’t want to repeat. Talking about your experience with your own father can also help heal some of the emotional wounds. Being a father is hard work, and you don’t want to wait until after the baby arrives to start overcoming your fears or past traumas.

      Weeks 0 to 4

      If you suspect that you’re pregnant, you’re probably both excited and anxious to find out if you truly are. 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. Doing so helps your provider better estimate your due date (40 weeks from your last period). Be sure to tell him if your cycles are irregular.

      Begin taking a daily prenatal vitamin if you haven’t already. Check to see that the vitamin has at least 400 micrograms of folic acid to make sure your baby is as healthy as possible.

      Check for ovulation. Some women know when they ovulate by a sensation known as mittelschmerz (German for middle pain, due to the mild pain that may be felt when the egg is released from the ovary, typically 14 days after your last period). Others know they’ve ovulated due to a change in the cervical mucus or a positive reading from an ovulation prediction kit.

      Fertilization usually occurs within the fallopian tube. The embryo starts as one cell. During the 1st week, that cell divides many times as it moves down the fallopian tube toward the uterine cavity.

      Take your first pregnancy test. As stated earlier, pregnancy tests check for a hormone called human chorionic gonadotropin (hCG), which is produced by the placenta as the embryo implants into the wall of the uterus — usually five to seven days after conception. By the time you miss a period, around ten days after conception, your pregnancy test will most likely be positive.

      Don’t be too concerned if you have a little spotting around the time when you would expect your period. This is most likely due to the embryo implanting in the womb (implantation bleeding).

      At the end of the 4th week, your baby measures 0.2 inches (5 mm) in length.

      Weeks 5 to 8

      By this time, the pregnancy is well established, and you’re feeling the typical signs and symptoms of pregnancy, such as nausea and fatigue. During weeks 5 to 8, most of the baby’s organ systems are beginning to form. The first organ to start working is the heart. It’s amazing to realize it starts beating at just 5 weeks, although you can’t see it beating on ultrasound until 6 weeks. The baby’s arms and legs are beginning to develop at this stage. The head is the biggest part of the embryo because the brain is the fastest-growing organ at this time. (Check out Chapter 1 in Book 2 for more on what happens during the first trimester.) The placenta is rapidly growing and is now the way nutrients and oxygen get to your developing baby.

      This is an important time to make any necessary lifestyle changes, if you haven’t already done so (like stopping smoking or speaking with your doctor about adjusting medications — Book 1, Chapter 2 explains the effects of certain medications, alcohol, and drugs on the developing fetus). Also during this time, begin making these necessary medical appointments:

      Call your doctor to make an appointment for your first prenatal visit. Most doctors want to see their patients before 8 to 10 weeks. Head to Book 1, Chapter 2 for advice on selecting a practitioner and what to expect during your prenatal visits.

      Talk to your healthcare provider about scheduling an ultrasound or obtaining a heartbeat by Doppler to confirm a healthy pregnancy. An ultrasound during this period is very accurate at establishing your due date (it is sometimes called a dating scan) and can also tell you whether you’re having one, two, or even more babies! Your due date is most accurate when it is established by an ultrasound between 8 and 12 weeks.

      If you’re taking any medications, call or see your doctor earlier than the 8 to 10 weeks mentioned. You want to make sure that these meds aren’t a problem for your developing baby. You should also discuss any over-the-counter or herbal medications you’re taking to make sure they aren’t a problem, either.

      At the end of the 8th week, your baby measures 1.2 inches (3.0 cm) in length. Your uterus is about the size of a medium orange.

      Weeks 9 to 12

      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 16 to 20 weeks, depending on the position of the baby, the amount of abdominal tissue the sound waves have to pass through, the kinds of equipment used, and the experience of the person performing the ultrasound. By the end of the 10th week, all the organ systems have formed. The brain is unique in that it continues to develop throughout pregnancy and even into adulthood.

      You want to consider the following counseling and testing at this time:

      Schedule an appointment for genetic counseling if you have a family history of genetic problems. Your doctor may also recommend it, depending on varying circumstances.

      Make sure you schedule your first-trimester screen for Down syndrome. Remember, the best time to screen for Down syndrome is at 11 to 12 weeks (see Book 2, Chapter 1 for detailed information about the first trimester and Down syndrome screening). This screen combines a measurement of the fluid-filled region behind the fetal neck (called a nuchal translucency), your age, and blood tests (hCG and PAPP-A) to give you a specific risk for Down syndrome as well as for Trisomy 13 and 18 (other chromosomal disorders).

      Talk to your provider to see whether he thinks you’re a candidate for a newer type of screening for Down syndrome that extracts fetal genetic material from your blood. This blood sample can be drawn as early as 9 weeks.

      If you’re considering having a chorionic villus sampling (CVS), weeks 10 to 12 are the best time to do this. This test can reveal chromosomal conditions as well as other genetic conditions, such as cystic fibrosis. See Book 2, Chapter 1 for more information on this test.

      At the end of week 12, your baby is 2.13 inches (5.4 cm) long and weighs less than half an ounce (around 14 g). Your uterus is the size of a large orange.

      Weeks 13 to 16

      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. By week 16, your baby starts to grow fine, soft hair (called lanugo) and fingernails.

      The following considerations apply during this time period:

      Between weeks 15 and 18, have your blood drawn to check the alpha-fetoprotein (AFP) level. This blood test helps to identify fetal abnormalities such as spina bifida. This is also the time to have the second part of your Down syndrome screening (the quad screen).

      If you’re planning on having an amniocentesis, schedule it between weeks 16 and 18. See Book 2, Chapter 2 for the reasons to consider an amniocentesis.

      Consider shopping at a maternity store. Many women start to show at this time. If you aren’t showing, don’t worry, because some body types hide pregnancy better than others.

      At the end of week 16, your baby is 4.6 inches (11.6 cm) long and weighs about 3.5 ounces (100 g). Your uterus is the size of a large grapefruit.

      Weeks 17 to 20

      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. You may notice a little fluttering sensation in your abdomen. This could be gas, but more likely it’s early fetal movement. By 20 weeks, the top of the uterus (called the fundus) is at the level of your belly button. Twenty weeks is the halfway mark, so you should congratulate yourself. The second half usually flies by faster than the first.

      You want to keep the following in mind:

      Schedule your anatomy ultrasound. This is the ultrasound where the doctor is able to check the baby’s anatomy and make sure he is growing properly and is surrounded by normal amniotic fluid.

      Pay attention to the baby’s movements. This period is when many women start to feel the baby move, which is called quickening. First-time moms, though, don’t always feel quickening this early, so don’t be alarmed if you haven’t.

      Your baby now weighs about 10 ounces (300 g) and is about 10 inches (25 cm) long.

      Weeks 21 to 24

      During this time, 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. You may be experiencing discomfort on either side of your lower abdomen (in the groin area). This discomfort is known as round ligament pain. The round ligaments are actual ligaments that attach from the top of the uterus to the labia. Many women feel an uncomfortable pulling sensation, which tends to worsen upon standing and improve upon sitting or lying down. The good news is that after 24 weeks, round ligament pain usually goes away.

      At this time, your baby is regularly swallowing large amounts of amniotic fluid and excreting urine back into the amniotic cavity. The baby’s fingernails are almost fully formed, and he has started to grow eyelashes and eyebrows. The lanugo is turning from a pale color to a darker hue.

      By 24 weeks, your baby is considered viable. This means survival on the outside is possible, although the baby would need a great deal of medical attention. The top of your uterus is usually at or above the level of your belly button.

      There aren’t any actual tasks that you have to schedule with your provider during this time, other than your routine prenatal visits (which should be about every four weeks during this period).

      At the end of this period, your baby weighs about 1 pound, 5 ounces (600 g) and measures about 12 inches (30 cm) long.

      Weeks 25 to 28

      Your baby’s bones are continuing to harden, 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.

      The following considerations are typically addressed during this time:

      Get your glucose screen. This is the blood test to screen for gestational diabetes. You’re instructed to drink a 50-gram glucose drink (it tastes like flat soda), and your blood is drawn one hour later. If the glucose level is above a certain value, a definitive test called a GTT (glucose tolerance test) is needed. You’re instructed to fast the night before this test so that your fasting glucose level can be determined with the initial blood draw. You then drink a 100-gram glucose drink and have your blood drawn every hour for the next three hours. Two abnormal values are needed for a diagnosis of gestational diabetes. During the glucose screening process, your doctor may draw some additional blood to check for conditions like anemia.

      If your blood type is Rh negative (see Book 6, Chapter 2), you need to get a shot of Rh immune globulin. This shot can prevent any effects of incompatibility between you and your baby.

      The top of your uterus is a couple of inches above your belly button. By 28 weeks, your baby weighs about 2 pounds, 4 ounces (1 kg). He is about 14.8 inches (38 cm) long.

      Weeks 29 to 32

      Your baby’s eyes can now open. His permanent teeth have developed, and the lungs and digestive tract are nearly mature. To keep a closer eye on you and your baby, your practitioner will start to schedule your prenatal visits every two weeks.

      The following steps are recommended during this time:

      If you haven’t started childbirth classes, begin them now. Many alternatives are available, so check with your doctor or the hospital where you’ll deliver. Book 1, Chapter 5 discusses several options. If you’ll have help taking care of your newborn, remember that it’s a good idea for all caregivers (including you and your partner) to take an infant CPR class to be as prepared as possible for your newborn.

      Pay closer attention to your baby’s movements. Although fetuses still spend most of their time sleeping, they start to develop clear sleep and wake cycles. A good general rule is that feeling about six movements in an hour is a sign of fetal well-being. You don’t have to feel these movements every hour, but if you’re ever concerned that you’re not feeling your normal fetal movement, lie down and count the movements. If you can feel six movements in an hour, you can rest assured that this is normal.

      The nature of the fetal movements may also change. Instead of the big punches and kicks you were feeling earlier, the movements during this time may be gentler, rolling type of movements.

      Undergo a follow-up ultrasound if your practitioner orders one. This ultrasound can confirm that the baby is growing normally and has a good amount of amniotic fluid. Most practitioners also follow growth by measuring your uterine height every time you visit.

      The top of your uterus is midway between your navel and your sternum. By 32 weeks, your baby weighs from about 3 pounds, 11 ounces to 4 pounds (1.8 kg) and is 16 to 17 inches (43 cm) long.

      Weeks 33 to 36

      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. If you’re having twins, you should be well prepared for their arrival now, because on average, twins deliver at about 35 to 36 weeks.

      The following considerations come into play now:

      Get a culture taken for GBS (group B strep). Your doctor tests for these common bacteria that can be found in the vagina or rectum. If your GBS culture is positive, your doctor will place you on antibiotics during labor to prevent the baby from contracting the infection. There isn’t any point in treating it earlier, because it can just come back again.

      Continue to pay attention to the baby’s movements. Even though you’re used to feeling kicks and punches, it’s normal for the intensity of these movements to decrease during these last weeks of pregnancy. It’s the number that is important, though, rather than the intensity. See Book 2, Chapter 3 for more about fetal movements in the third trimester.

      The top of your uterus is a couple of inches below your sternum. At or just after 36 weeks, your doctor will see you at least once a week until you deliver. Your baby weighs about 5 pounds, 2 ounces (2.3 kg) and is almost 18 inches (46 cm) long.

      Weeks 37 to 40

      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 considered a full-term delivery. You may notice irregular contractions that come and go in spurts. The big event can happen at any time during this period, so be prepared — day or night.

      Do the following to ensure that you’re ready for the big day to arrive:

      Make sure that your bags are packed and you have the phone numbers of your practitioners handy! If you have other children at home, make sure you have all the arrangements set for their care, in case you go into labor.

      Watch for signs. Loss of your mucous plug, bloody show, or loose stools may happen during the days before labor to indicate that labor is coming. Unfortunately, they don’t determine when labor will happen with any certainty.

      The average baby at full-term weighs about 7.5 pounds (close to 3.5 kg), but there is a wide degree of variation in what’s considered normal. At this point in pregnancy, your baby will put on about a quarter of a pound per week until delivery. The top of your uterus should be at or just below your sternum or breastbone. Babies at 40 weeks average about 20 to 21 inches (51 to 53 cm) long.

      Weeks 40 to 42

      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 to 42 weeks. If you’re older than 35, and especially if you’re older than 40, your doctor may want to deliver you sooner. Because the risks to continuing the pregnancy really increase after 41 to 42 weeks, your baby should be delivered by then. Your doctor makes sure your baby remains healthy during this time:

      Your doctor monitors you with non-stress tests to check on fetal well-being. This is a noninvasive way to make sure the baby is tolerating the in-utero environment. (See Book 2, Chapter 3 for more information.)

      Your doctor checks the amount of amniotic fluid present to make sure it’s still adequate. The amniotic fluid volume usually tends to decrease after 36 weeks, so it isn’t uncommon for it to be low at this time. Low amniotic fluid volume is a common reason for labor induction during this period.

      Although the baby continues to grow after 40 weeks, the rate of growth slows a little, and he may not put on the quarter pound per week that he did in the few weeks before 40 weeks.

      Common Tests during Pregnancy

      Table 1-1 lists common tests that may be recommended during your pregnancy. Some of these tests may not be recommended for every pregnancy but are included for the sake of those who need them.

      Table 1-1 Common Tests during Pregnancy

      Chapter 2

      Practitioners, Prenatal Visits, and Maintaining Good Health

      IN THIS CHAPTER

      Finding a healthcare practitioner who meets your needs

      Walking through a typical prenatal visit

      Considering medications you may be taking

      Recognizing the consequences of alcohol and drugs

      Finding the right practitioner to care for you — and your baby — is a decision you shouldn’t take lightly. Your healthcare is always important, but your new and sometimes overwhelming condition means you want a practitioner who’s in sync with your approach to pregnancy. This person should be someone you trust and feel safe with. If you’ve had a previous child, you may already have a practitioner. If not, there’s no need to feel overwhelmed. This chapter helps you make that important decision and takes you through a typical prenatal visit.

      Maintaining good health throughout your pregnancy is a critical step in delivering a healthy baby, so this chapter also includes information on risks and benefits associated with certain medicines and vaccinations, along with the consequences of alcohol and drugs.

      Selecting the Right Practitioner for You

      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. She should be board certified (or be in the process of becoming board certified) by the American Board of Obstetrics and Gynecology (or an equivalent program if you’re from a country other than the United States).

      Maternal-fetal medicine specialist: Also known as a perinatologist or high-risk obstetrician, this type of doctor has completed a two- to three-year fellowship in the care of high-risk pregnancies, in addition to the standard obstetrics residency, to become board certified in maternal-fetal medicine. Some maternal-fetal medicine specialists act only as consultants; some also deliver babies. You might seek the care of or even a consultation with a high-risk specialist if you’ve had a history of problem pregnancies (prior preterm delivery, history of preeclampsia, or multiple miscarriages), if you have underlying medical problems (like diabetes or chronic hypertension), or if your fetus has been diagnosed with a disorder.

      Family practice physician: This doctor provides general medical care for families — men, women, and children. She is board certified in family practice medicine. This kind of doctor is likely to refer you to an obstetrician or maternal-fetal medicine specialist if complications arise during your pregnancy.

      Certified nurse-midwife: A certified nurse-midwife is a registered nurse who has completed additional training to obtain a master’s degree in nursing and is also licensed to perform deliveries. A certified nurse-midwife typically practices in a setting where there is a physician available and refers patients when complications occur.

      Certified registered nurse practitioner: A certified registered nurse practitioner is a registered nurse who has completed additional training to obtain a master’s degree in nursing and is trained to provide routine prenatal care, but she typically doesn’t perform deliveries. She usually practices in conjunction with a physician; whether you see the nurse practitioner or the physician for your prenatal visits depends on the individual practice and where you are in your pregnancy. (Whether a certified registered nurse practitioner is allowed by law to deliver differs state to state.)

      Before you make a decision, you want to be thorough in your search. Make sure you know what you want out of the experience. When you’re deciding on a practitioner, ask yourself the following key questions:

      Am I comfortable with and do I have confidence in this person? You should trust and feel at ease not only with your practitioner but also with the whole constellation of people who work in the practice. Would you feel free to ask questions or express your anxieties to them? Another point to keep in mind is how your general personality fits in with the practice’s philosophy. For example, some women prefer a low-key, low-tech approach to prenatal care, while others want to have every possible diagnostic test under the sun. Does this practitioner deliver in a setting where you feel most comfortable having your baby? Your past medical and obstetrical history can also influence the approach you take to your pregnancy and the provider you choose.

      How many practitioners are involved in the practice? You may end up choosing between a practitioner who works with one or more partners and one who is in solo practice. Many group practices rotate you through appointments with each of the doctors, enabling you to get to know them all so you’ll feel comfortable having any of them deliver your baby. Some practices utilize nurse practitioners to help render prenatal care. Practically speaking, you’re likely to bond more with one or two people in the practice than with others, which is natural, given that practitioners have varied personalities. A provider who practices alone should tell you who handles deliveries when she is ill, off duty, or out of town.

      tip Ask your practitioner about her policy for after-hours problems or emergencies — including questions you may need to ask by telephone during evening or weekend hours.

      Where do I want to deliver? If your pregnancy is uncomplicated, any good hospital or birthing center will work just fine. Some women may even choose a home birth. If you’re at risk for some complications, however, you should consider a hospital delivery and ask whether the hospital you’ll be delivering in has a labor and delivery suite and a nursery equipped to handle any problems that may arise if, for example, the baby is born early. You may also want to ask the following questions:

      Is an anesthesiologist on-site 24 hours a day, or can your doctor call in an anesthesiologist quickly in case of an emergency?

      Can the hospital provide you with epidural anesthesia (a form of pain control during labor)? If epidural anesthesia isn’t readily available or you’re not interested in it, find out what other options are available for pain management.

      Are you allowed to room in — that is, keep the baby in your room as much as possible — after delivery? Also, are accommodations available for your partner to stay with you during your postpartum hospitalization?

      Can this practitioner refer me to a nearby specialist if needed? Consider whether you may need the services of a maternal-fetal medicine specialist or a neonatologist, a physician who specializes in the care of infants who are born early or who have other medical problems. Ideally, your practitioner can refer you to someone quickly if anything comes up.

      Will my insurance plan cover this practitioner? Now that managed care has become an important part of the health insurance industry, check to see whether your plan covers your practitioner of choice. Some places allow you to select an out-of-network physician if you pay part of the cost yourself.

      DETERMINING WHETHER YOU’RE AT HIGH RISK

      The question of whether you and your pregnancy are at high risk has no black-and-white answer, especially at the beginning. But it helps to be aware of the kinds of conditions that can put a pregnancy at high risk:

      Diabetes

      High blood pressure

      Lupus

      Blood disorders

      Heart, kidney, or liver disorders

      Twins, triplets, or other multiple fetuses

      A premature delivery in a prior pregnancy

      A previous child with birth defects

      A history of miscarriage

      An abnormally shaped uterus

      Epilepsy

      Some infections

      Bleeding

      Advanced maternal age (35 or older by the due date)

      Remember that midwives and most family practice physicians are not equipped to handle high-risk pregnancies. If you have or develop any of these conditions, consult an obstetrician or a maternal-fetal medicine specialist.

      Planning Prenatal Visits

      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 to confirm your good news with either a blood or urine test, whereas others schedule a first visit with the practitioner. How soon your first visit will be scheduled depends in part on your history.

      tip If you didn’t have a preconception visit and you haven’t been on prenatal vitamins or other vitamins containing folic acid, let the office know. A prescription for prenatal vitamins can be called in, so you can start taking them even before your first prenatal visit. All over-the-counter adult multivitamins and prenatal vitamins should have the correct dose of folic acid (400 micrograms), so the typical patient doesn’t need a prescription for them, but ask the pharmacist if you’re not sure. Also, some insurance companies may cover prescription vitamins but not over-the-counter ones, and some women just simply prefer one particular type of vitamin.

      Some things are consistent from trimester to trimester — like checking your blood pressure and urine and checking the baby’s heartbeat — so these topics are covered in this chapter. In Chapters 1, 2, and 3 in Book 2, you can find specifics on what happens during prenatal visits for each trimester. See Table 2-1 for an overview of a typical schedule for prenatal visits.

      Table 2-1 Typical Prenatal Visit Schedule

      If you develop problems during pregnancy or if your pregnancy is considered high risk (see the risk factors described in Book 6, Chapter 1), your practitioner may suggest that you come in more frequently.

      remember This schedule of prenatal visits isn’t set in stone. If you’re planning a vacation or need to miss a prenatal visit, tell your practitioner and reschedule your appointment. If your pregnancy is going smoothly, rescheduling usually isn’t a big deal. However, because some prenatal tests have to be performed at specific times during pregnancy (see Book 1, Chapter 1 for details), just make sure that missing an appointment won’t affect any of these tests.

      Prenatal visits vary a bit according to each woman’s personal needs and each practitioner’s style. Some women need particular laboratory tests or physical examinations. However, the following procedures are standard during your prenatal visits:

      A nurse checks your weight and blood pressure. For more information on how much weight you should be gaining and when, see Book 1, Chapter 3; for details on healthy ways to manage your weight gain, head to Book 3, Chapter 1.

      You give a urine sample (usually an easy job for most pregnant women!). Your practitioner checks for the presence of protein, which may indicate preeclampsia, or glucose, which may be a sign of diabetes (see Book 6 for information on dealing with special conditions during pregnancy). Some urine tests also enable your doctor to look for any indications of a urinary tract infection.

      Starting sometime after 14 to 16 weeks, a nurse or doctor measures your fundal height. The practitioner uses either a tape measure or her hands to measure your uterus. This gives her a rough idea of how the baby is growing and whether you have an adequate amount of amniotic fluid (see Figure 2-1).

      The nurse or doctor is measuring the fundal height, the distance from the top of the pubic bone to the top of the uterus (the fundus). By 20 weeks, the fundus usually reaches the level of the navel. After 20 weeks, the height in centimeters roughly equals the number of weeks pregnant you are. (Being above or below by 2 centimeters is usually within acceptable norms as long as you’re consistent from visit to visit.)

      Note: The fundal height measurement may not be useful in women who are expecting two or more babies or in women who have large fibroids (in both cases, the uterus is much bigger than normal) or in women who are very obese (because it can be difficult to feel the top of the uterus).

      A nurse or doctor listens for and counts the baby’s heartbeats. Typically, the heartbeat ranges between 120 and 160 beats per minute. Most offices use an electronic Doppler device to check the baby’s heartbeat. With this method, the baby’s heartbeat sounds sort of like horses galloping inside the womb. Sometimes, you can hear the heartbeat as early as 8 or 9 weeks using this method, but often the heartbeat isn’t clearly discernible until 10 to 12 weeks. Prior to the availability of Doppler, a special stethoscope called a fetoscope was used to hear the baby’s heartbeat. Using this method, the doctor can hear the heartbeat around 20 weeks. A third way of checking the baby’s heartbeat is by seeing it on ultrasound. The heart beating away can frequently be seen at around 6 weeks.

      Illustration by Kathryn Born, MA

      FIGURE 2-1: Your practitioner may measure your fundal height to ensure that your baby is growing properly.

      remember In some practices, a medical assistant or nurse performs tasks such as checking your blood pressure; in other practices, a doctor may perform this task. No matter who performs the technical components of the prenatal visit, you should always have the opportunity to ask a practitioner questions before leaving the office.

      Keeping Your Medicines and Vaccinations in Check

      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. But most nonprescription drugs — and even many prescription drugs — are safe during pregnancy. During your first prenatal visit, go over with your practitioner what medications are okay to take during pregnancy — both over-the-counter medications and medications prescribed to you by another physician. If another physician is treating you for a medical condition, let her know that you’re pregnant, in case any adjustments need to be made.

      Reviewing your medications

      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. But 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.

      Exposure to the drugs and chemicals listed in Table 2-2 is considered to be safe during pregnancy.

      Table 2-2 Medications Generally Considered Safe during Pregnancy

      Medications to ask your doctor about

      The following are some of the common medications that women should ask about before they get pregnant:

      Enjoying the preview?
      Page 1 of 1