2. 10 Things That Might Surprise You About Being Pregnant
3. The Joy of Sex During Pregnancy
5. Die during Pregnancy (Eating During Pregnancy)
6. Food Cravings During Pregnancy
7. Food and Drinks to Avoid During Pregnancy
8. Exercising During Pregnancy
9. What Exercises Should You Avoid?
11. A Guide For First Time Parents
According to the Centers for Disease Control and Prevention (CDC),
almost 4 million American women give birth every year. Nearly one third of them
will have some kind of pregnancy-related complication. Those who don't get
adequate prenatal care run the risk that such complications will go undetected
or won't be dealt with soon enough. That, in turn, can lead to potentially
serious consequences for both the mother and her baby.
These statistics aren't meant to alarm you, but rather to convey the
importance of starting prenatal care as early as possible - ideally, before you
even get pregnant. Of course, this isn't always possible or practical. But the
sooner in your pregnancy you begin, the better your chances of ensuring your
own health and that of your baby.
Prenatal Care Before Getting Pregnant
Ideally, prenatal care should start before you get pregnant. If you're
planning a pregnancy, see your health care provider for a complete checkup. He
or she can do routine testing to make sure you're in good health and that you
don't have any illnesses or other conditions that could affect your pregnancy.
If you've been experiencing any unusual symptoms, this is a good time to report
them.
If you're already being treated for a chronic condition, such as diabetes,
asthma,
hypertension(high
blood pressure), a heart problem, allergies,
lupus (an inflammatory disorder that can affect several body systems), depression, or some other condition, you
should talk to your doctor about how it could affect your pregnancy. In some
cases, you may need to change or eliminate medications - especially during the
first trimester (12 weeks) - to reduce risk to the fetus. Or, you may need to
be even more vigilant about managing your condition.
For example, women with diabetes must be especially careful about
keeping their blood glucose levels under control, both before they begin trying
to conceive and during their pregnancy. Abnormal levels increase the risk of
birth defects and other complications.
This is also a good time to talk with your health care provider about
other factors that can pose a risk to your baby, such as drinking alcohol or
smoking. Ask about starting a prenatal vitamin that contains folic acid,
calcium, and iron.
It's especially important for women who are planning to become pregnant
to take vitamins with folic acid beforehand, because neural tube defects
(problems with the normal development of the spine and nervous system) happen
in the first 28 days of pregnancy, often before a woman even knows she's pregnant.
If you have or your partner has a family history of a significant
genetic disorder and you suspect either of you may be a carrier, then genetic
testing may be advisable. Talk this over with your health care
provider, who can refer you to a genetic counselor if necessary.
If you find out that you're pregnant before you do any of this, don't
worry. It's not too late to get the care that will help to ensure your health
and that of your baby.
Pregnancy is a subject that generates a lot of paper. Bookstores and
libraries devote not just shelves but entire aisles to it. At your first prenatal visit, your doctor will likely
load you down with armfuls of pamphlets that cover every test and trimester.
But despite all this information, pregnancy can take any soon-to-be parent by
surprise.
What the Doctor May Leave Out: If your doctor hasn't
mentioned the following topics during your visits, he or she isn't purposefully
omitting the information. More likely, your doctor hasn't brought them up
because pregnancy affects women in different ways. For example, some pregnant
women experience morning sickness in the morning, some feel it all day, and
some never have it. Or your doctor might not mention something because it doesn't
have a medical focus — a doctor may not have any more insight into your
increasing shoe size than your neighbor does! Also, some women may think
questions about breast size or hemorrhoids are too personal or embarrassing to
ask their doctors.
Any concerns you have about your or your baby's emotional or physical
health, regardless of how unrelated or trivial they may seem, should be
discussed with your doctor. He or she has seen many expectant parents, some
less worried and some more worried than you, and can reassure you when there is
no problem or give you more information when there is one. And if your doctor
doesn't take the time to listen to your concerns or doesn't seem to take them
seriously, you should feel free to get a second opinion.
Altered States: Pregnancy doesn't just change your body —
it affects the rest of you, too
1. The Nesting Instinct
Many pregnant women experience the nesting instinct, a powerful urge to
prepare their home for the baby by cleaning and decorating. Or perhaps you'll
want to tackle projects you haven't had time to do, like organizing your garage
or closets.
As your due date draws closer, you may find yourself cleaning cupboards
or washing walls — things you never would have imagined doing in your ninth
month of pregnancy! This desire to prepare your home can be useful because it
will give you more time to recover and nurture your baby after the birth. But
be careful not to overdo it.
2. Inability to Concentrate
In the first trimester, fatigue and morning sickness can
make many women feel worn out and mentally fuzzy. But even well-rested pregnant
women may experience an inability to concentrate and periods of forgetfulness.
A preoccupation with the baby is partially the cause, as are hormonal changes.
Everything — including work, bills, and doctor appointments — may seem less
important than the baby and the impending birth. You can combat this
forgetfulness by making lists to help you remember dates and appointments.
3. Mood Swings
Premenstrual syndrome and pregnancy are alike in many ways. Your breasts
swell and become tender, your hormones fluctuate, and you may feel moody. If
you suffer from premenstrual syndrome, you're likely to have more severe mood
swings during pregnancy. They can make you go from feeling happy one minute to
feeling like crying the next. You may be irrationally angry with your partner
one day, then a coworker may inexplicably irritate you the next.
Mood swings are incredibly common during pregnancy, although they tend
to occur more frequently in the first trimester and toward the end of the third
trimester.
About 10% of pregnant women experience depression during pregnancy. If you have
symptoms such as sleep disturbances, changes in eating habits (a complete lack
of appetite or an inability to stop eating), and exaggerated mood swings for
longer than 2 weeks, you should talk to your doctor.
Unexpected Effects of Pregnancy
4. Bra Size
An increase in breast size is one of the first signs of pregnancy.
Breasts usually become swollen and enlarged in the first trimester because of
increased levels of the hormones estrogen and progesterone. That growth in the
first trimester isn't necessarily the end, either — your breasts can continue
to grow throughout your pregnancy!
In addition to the size of your breasts, your bra size may be affected
by your rib cage. When you're pregnant, your lung capacity increases so you can
take in extra oxygen for yourself and the baby, which may result in a bigger
chest size. You may need to replace your bras several times over the course of your
pregnancy.
5. Skin
Are your friends saying you have that pregnancy glow? It's only one of
many skin changes you may experience during pregnancy due to hormonal changes
and the stretching of your skin to accommodate a larger body. Pregnant women
experience an increase in blood volume to provide extra blood flow to the
uterus and to meet the metabolic needs of the fetus. They also have increased
blood flow to their other organs, especially the kidneys. The greater volume
brings more blood to the vessels and increases oil gland secretion.
Some women develop brownish or yellowish patches called chloasma,
or the "mask of pregnancy," on their faces. And some will notice a
dark line on the midline of the lower abdomen, known as the linea nigra
(or linea negra), as well as hyperpigmentation (darkening of the skin) of the
nipples, external genitalia, and anal region. These are the result of pregnancy
hormones, which cause the body to produce more pigment. The body may not
produce this increased pigment evenly, however, so the darkened skin may appear
as splotches of color. Unfortunately, chloasma can't be prevented, but wearing
sunscreen and avoiding UV light can minimize its effects.
Acne
is common during pregnancy because the skin's sebaceous glands increase their oil production. And
newly formed pimples might not be the only evolving spots on your face or body
— moles or freckles that you had prior to pregnancy may become bigger and
darker. Even the areola, the area around the nipples, becomes darker. Except
for the darkening of the areola, which is usually permanent, these skin changes
will likely disappear after you give birth. Many women also experience heat
rash, caused by dampness and perspiration, during pregnancy.
In general, pregnancy can be an itchy time for a woman. Skin stretching
over the abdomen may cause itchiness and flaking. Your doctor can recommend
creams to soothe dry or itchy skin.
6. Hair and Nails
Many women experience changes in hair texture and growth during
pregnancy. The hormones secreted by your body will cause your hair to grow
faster and fall out less. But these hair changes usually aren't permanent; most
women lose a significant amount of hair in the postpartum period or after they
stop breastfeeding.
Some women find that they grow hair in unwanted places, such as on the
face or belly or around the nipples. Others experience changes in hair texture
that make hair drier or oilier. Some women even find their hair changing color.
Nails, like hair, can change noticeably during pregnancy. Extra hormones
can make them grow faster and become stronger. Some women, however, find that
their nails tend to split and break more easily during pregnancy. Like the
changes in hair, nail changes aren't permanent. If your nails split and tear
more easily when you're pregnant, keep them trimmed and avoid the chemicals in
nail polish and nail polish remover.
7. Shoe Size
Even though you can't fit into any of your prepregnancy clothes, you
still have your shoes, right? Maybe — but maybe not. Because of the extra fluid
in their pregnant bodies, many women experience swelling in their feet and may
even have to start wearing a larger shoe size. Wearing slip-on shoes in a
larger size will be more comfortable for many pregnant women, especially in the
summer months.
8. Joint Mobility
During pregnancy, your body produces a hormone known as relaxin,
which is believed to help prepare the pubic area and the cervix for the birth.
The relaxin loosens the ligaments in your body, making you less stable and more
prone to injury. It's easy to overstretch or strain yourself, especially the
joints in your pelvis, lower back, and knees. When exercising or lifting objects, go slowly
and avoid sudden, jerky movements.
9. Varicose Veins, Hemorrhoids, and Constipation
Varicose veins, which are usually found in the legs and genital area,
occur when blood pools in veins enlarged by the hormones of pregnancy. Varicose
veins often disappear after pregnancy, but you can lessen them by:
·
avoiding standing or sitting for long periods of
time
·
wearing loose-fitting clothing
·
wearing support hose
·
elevating your feet when you sit
Hemorrhoids — varicose veins in the rectum — frequently occur during
pregnancy as well. Because your blood volume has increased and your uterus puts
pressure on your pelvis, the veins in your rectum may enlarge into grape-like
clusters. Hemorrhoids can be extremely painful, and they may bleed, itch, or
sting, especially during or after a bowel movement. Coupled with constipation,
another common pregnancy woe, hemorrhoids can make going to the bathroom
downright unpleasant.
Constipation is common throughout pregnancy because pregnancy hormones
slow the rate of food passing through the gastrointestinal tract. During the
later stages of pregnancy, your uterus may push against your large intestine,
making it difficult for waste to be eliminated. Constipation can contribute to
hemorrhoids because straining may enlarge the veins of the rectum.
The best way to combat constipation and hemorrhoids is to prevent them. Eating a fiber-rich diet, drinking plenty
of fluids daily, and exercising regularly can help keep bowel movements
regular. Stool softeners (not laxatives) may also help. If you do have
hemorrhoids, see your doctor for a cream or ointment that can shrink them.
10. Things That Will Come Out of Your Body
So you've survived the mood swings and the hemorrhoids, and you think
your surprises are over. Guess again — the day you give birth will probably
hold the biggest surprises of all.
Only 1 in 10 mothers' water breaks before labor contractions begin. Some
women never experience it — a doctor may need to rupture the amniotic sac (if
the cervix is already dilated) when they arrive at the hospital. How much water
can you expect? For a full-term baby, there are normally about 2.1 to 5.9 cups
(500 to 1400 milliliters) of amniotic fluid. Some women may feel an intense
urge to urinate that leads to a gush of fluid when their waters break. Others
may have only a trickling sensation down their leg because the baby's head acts
like a stopper to prevent most of the fluid from leaking out. In any case,
amniotic fluid is generally sweet-smelling and pale or colorless and is
replaced by your body every three hours, so don't be surprised if you continue
to leak fluid, about a cup an hour, until delivery.
Other unexpected things may come out of your body during labor in addition to your baby, blood, and
amniotic fluid. Some women experience nausea and vomiting. Others have diarrhea
before or during labor, and flatulence (passing gas) is also common. During the
pushing phase of labor, you may lose control of your bladder or bowels. A birth plan can be especially helpful in
communicating your wishes to your health care providers about how to handle
these and other discomforts of labor and delivery.
There are lots of surprises in store for you once you become pregnant —
but none sweeter than the way you'll feel once your newborn is in your arms!
Unless your health care provider advises you
otherwise, sex during pregnancy is safe for you and your baby.
Many expectant parents worry that sex can be
harmful during pregnancy. They fear that intercourse could hurt the baby, or
even cause miscarriage. Some are afraid that the baby somehow “knows” that sex
is taking place. The partner sometimes worries that intercourse might cause
discomfort or pain for the pregnant woman. Worries like this are common and
completely normal, but most of them are unfounded.
If your pregnancy is considered to be high risk,
you may need to be more cautious than other women. Your health care provider
may advise you to avoid intercourse for all or part of your pregnancy.
The Changes of Pregnancy
Many women are not very interested in sex while
they are pregnant. Exhaustion, raging hormones, tender breasts and
self-consciousness about her growing girth can put a pregnant women’s sex drive
on hold. Take heart in the fact that most couples resume an active sex life
sometime during the first year of their baby’s life.
Many women find that pregnancy makes them want sex
more than they did before they became pregnant. This sex drive is caused by
hormonal changes. For some women, newfound voluptuousness can play a role in
making them feel sexier than ever.
Positions that work before pregnancy and early in
pregnancy can be uncomfortable or even unsafe at later stages of the baby’s
development. For example, a woman should avoid lying flat on her back after the
fourth month of pregnancy, because the weight of the growing uterus puts
pressure on major blood vessels. Fortunately, there are alternatives to the
traditional missionary position, such as lying sideways or having the woman on
top.
As for the baby, he or she has no idea what Mom and
Dad are doing. The baby is well protected by a cushion of fluid in the womb and
by the mom’s abdomen.
Suggestions for You and Your Partner
If you’re concerned, ask your health care provider
if it’s okay to have sex.
Talk to each other about your needs and concerns in
an open and loving way. If you work together, you can probably figure out how
to put a smile on each other’s face.
Let mutual pleasure and comfort be your guide. If
something doesn’t feel physically or emotionally right to one of you, change
what you’re doing.
Keep your sense of humor.
To avoid sexually transmitted infections, have sex
with only one person who doesn’t have any other sexual partners and/or use a
condom when having sex. Discuss HIV testing for you and your partner with your
health care provider.
If the pregnancy is high risk or if you have any
questions at all, ask for guidance from your health care provider.
After the baby is born, wait until after your
postpartum checkup before you resume intercourse.
You've survived 9 months of pregnancy. You've made it through the
excitement of labor and delivery, and now you're ready to head through the
hospital or birthing-center doors and begin your life at home with your baby.
But as those doors close behind you, you frantically realize you have no idea
what you're doing!
If you're a first-time parent, get the basics about burping, bathing,
bonding, and other baby-care concerns.
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To eat well during pregnancy you must do more than simply increase how
much you eat. You must also consider what you eat. Although you need
about 300 extra calories a day — especially later in your pregnancy, when your
baby grows quickly ? those calories should come from nutritious foods so they
can contribute to your baby's growth and development.
Why It's Important to Eat Well When You're Pregnant
Do you wonder how it's reasonable to gain 25 to 35 pounds (on average)
during your pregnancy when a newborn baby weighs only a
fraction of that? Although it varies from woman to woman, this is how those
pounds may add up:
·
7.5 pounds: average baby's weight
·
7 pounds: extra stored protein, fat, and other
nutrients
·
4 pounds: extra blood
·
4 pounds: other extra body fluids
·
2 pounds: breast enlargement
·
2 pounds: enlargement of your uterus
·
2 pounds: amniotic fluid surrounding your baby
·
1.5 pounds: the placenta
Of course, patterns of weight gain during pregnancy vary. It's
normal to gain less if you start out heavier and more if you're having twins or
triplets — or if you were underweight before becoming pregnant. More important
than how much weight you gain is what makes up those extra pounds.
When you're pregnant, what you eat and drink is the main source of
nourishment for your baby. In fact, the link between what you consume and the
health of your baby is much stronger than once thought. That's why doctors now
say, for example, that no amount of alcohol consumption should be
considered safe during pregnancy.
The extra food you eat shouldn't just be empty calories — it should
provide the nutrients your growing baby needs. For example, calcium helps make
and keep bones and teeth strong. While you're pregnant, you still need calcium
for your body, plus extra calcium for your developing baby. Similarly,
you require more of all the essential nutrients than you did before you became
pregnant.
A Nutrition Primer for Expectant Mothers
Whether or not you're pregnant, a healthy diet includes proteins,
carbohydrates, fats, vitamins, minerals, and plenty of water. The U.S.
government publishes dietary guidelines that can help you determine how many
servings of each kind of food to eat every day. Eating a variety of foods in
the proportions indicated is a good step toward staying healthy.
Food labels can tell you what kinds of
nutrients are in the foods you eat. The letters RDA, which you find on food
labeling, stand for recommended daily allowance, or the amount of a
nutrient recommended for your daily diet. When you're pregnant, the RDAs for
most nutrients are higher.
Here are some of the most common nutrients you need and the foods that
contain them:
Scientists know that your diet
can affect your baby's health — even before you become pregnant. For example,
recent research shows that folic acid helps prevent neural tube
defects (including spina bifida) from occurring during the earliest stages of
fetal development — so it's important for you to consume plenty of it before
you become pregnant and during the early weeks of your pregnancy.
Even though lots of foods, particularly breakfast cereals, are fortified
with folic acid, doctors now encourage women to take folic acid supplements
before and throughout pregnancy (especially for the first 28 days). Be sure to
ask your doctor about folic acid if you're considering becoming pregnant.
Calcium is another important nutrient for pregnant women. Because your
growing baby's calcium demands are high, you should increase your calcium
consumption to prevent a loss of calcium from your own bones. Your doctor will
also likely prescribe prenatal vitamins for you, which contain some extra
calcium.
Your best food sources of calcium are milk and other dairy products.
However, if you have lactose intolerance or dislike milk and milk products, ask
your doctor about a calcium supplement. (Signs of lactose intolerance include
diarrhea, bloating, or gas after eating milk or milk products. Taking a lactase
capsule or pill, or using lactose-free milk products may help.) Other
calcium-rich foods include sardines or salmon with bones, tofu, broccoli,
spinach, and calcium-fortified juices and foods.
Doctors don't usually recommend starting a strict vegan diet when you become pregnant. However, if you already follow a vegetarian diet, you can continue to do so during your pregnancy — but do it carefully. Be sure your doctor knows about your diet. It's challenging to get the nutrition you need if you don't eat fish and chicken, or milk, cheese, or eggs. You'll likely need supplemental protein and may also need to take vitamin B12 and D supplements. To ensure that you and your baby receive adequate nutrition, consult a registered dietitian for help with planning meals.
You've probably known women who craved specific foods during pregnancy,
or perhaps you've had such cravings yourself. Researchers have tried to
determine whether a hunger for a particular type of food indicates that a
woman's body lacks the nutrients that food contains. Although this isn't the
case, it's still unclear why these urges occur.
Some pregnant women crave chocolate, spicy foods, fruits, and comfort
foods, such as mashed potatoes, cereals, and toasted white bread. Other women
crave non-food items, such as clay and cornstarch. The craving and eating of
non-food items is known as pica. Consuming things that aren't food can
be dangerous to both you and your baby. If you have urges to eat non-food
items, notify your doctor.
But following your cravings is fine, as long as you crave foods and
these foods contribute to a healthy diet. Frequently, these cravings diminish
about 3 months into the pregnancy.
As mentioned earlier, avoid alcohol. No level of alcohol
consumption is considered safe during pregnancy. Also, check with your doctor
before you take any vitamins or herbal products. Some of these can be harmful
to the developing fetus.
And although many doctors feel that one or two 6- to 8-ounce cups per
day of coffee, tea, or soda with caffeine won't harm your baby, it's probably
wise to avoid caffeine altogether if you can. High caffeine consumption has
been linked to an increased risk of miscarriage, so limit your intake or switch
to decaffeinated products.
When you're pregnant, it's also important to avoid food-borne illnesses,
such as listeriosis and toxoplasmosis,
which can be life-threatening to an unborn baby and may cause birth
defects or miscarriage. Foods you'll want to steer clear of include:
·
soft, unpasteurized cheeses (often advertised as
"fresh") such as feta, goat, Brie, Camembert, and blue cheese
·
unpasteurized milk, juices, and apple cider
·
raw eggs or foods containing raw eggs, including
mousse and tiramisu
·
raw or undercooked meats, fish, or shellfish
·
processed meats such as hot dogs and deli meats
(these should be well-cooked)
·
fish that are high in mercury, including shark,
swordfish, king mackeral, or tilefish
If you've eaten these foods at some point during your pregnancy, try not
to worry too much about it now; just avoid them for the remainder of the
pregnancy. If you're really concerned, talk to your doctor.
About Fish. Fish and shellfish can be an extremely healthy
part of your pregnancy diet — they contain beneficial omega-3 fatty acids, and
are high in protein and low in saturated fat. But limit the types of fish you
eat while pregnant because some contain high levels of mercury, which can cause
damage to the developing nervous system of a fetus. Mercury, which occurs
naturally in the environment, is also released into the air through industrial
pollution and can accumulate in streams and oceans, where it turns into
methylmercury. The methylmercury builds up in fish, especially those that eat
other fish.
Because canned albacore (or white) tuna and tuna steaks are generally
considered to be higher in mercury than canned light tuna, the U.S. Food and
Drug Administration (FDA) recommends that you eat no more than 6 ounces a week.
A 2006 review by Consumer Reports, though, showed that some canned light tuna
can contain levels of mercury even higher than that of white tuna. But the FDA
maintains that the levels are safe if consumption of the fish is limited, and
that the current recommendations should stand.
It can be confusing when recommendations from trusted sources differ.
But since this analysis indicates that amounts of mercury in tuna may be higher
than previously reported, some women may want to eliminate tuna from their diet
while pregnant or when trying to become pregnant. Almost all fish and shellfish
contain small amounts of mercury, but you can safely eat those with
consistently low mercury levels (like salmon, shrimp, clams, and tilapia). Talk
with your doctor if you have any questions about how much — and which fish —
you can eat.
Managing Some Common Problems
Because the iron in prenatal vitamins and other factors may cause
constipation during pregnancy, try to consume more fiber than you did before
you became pregnant. Try to eat about 20 to 30 grams of fiber a day. Your best
sources are fresh fruits and vegetables and whole-grain breads, cereals, or
muffins.
Some people also use fiber tablets or drinks or other high-fiber
products available at pharmacies and grocery stores, but check with your doctor
before trying them. (Don't use laxatives while you're pregnant unless your
doctor advises you to do so. And avoid the old wives' remedy — castor oil —
because it can actually interfere with your body's ability to absorb
nutrients.)
If constipation is a problem for you, your doctor may prescribe a stool
softener. Be sure to drink plenty of fluids, especially water, when increasing
fiber intake, or you can make your constipation worse. One of the best ways to
avoid constipation is to get more exercise. You should also drink plenty of
water between meals each day to help soften your stools and move food through
your digestive system. Sometimes hot tea, soups, or broth can help. Also, keep
dried fruits handy for snacking.
Some pregnant women find that broccoli, spinach, cauliflower, and fried
foods give them heartburn or gas. You can plan a balanced diet to avoid these
foods. Carbonated drinks also cause gas or heartburn for some women, although
others find they calm the digestive system.
If you're frequently nauseated, eat small amounts of bland foods, like
toast or crackers, throughout the day. If nothing else sounds good, try cereal
with milk or a sweet piece of fruit. To help combat nausea, you can also:
·
Take your prenatal vitamin before going to bed
after you've eaten a snack — not on an empty stomach.
·
Eat a small snack when you get up to go to the
bathroom early in the morning.
·
Suck on hard candy.
How to Know If You're Eating Well During Pregnancy
The key is to eat foods from the different food groups in approximately
the recommended proportions. If nausea or lack of appetite cause you to eat
less at times, don't worry — it's unlikely to cause fetal harm because your
baby gets first crack at the nutrients you consume. And although it's generally
recommended that a woman of normal weight gain approximately 25 to 35 pounds
during pregnancy (most gain 4 to 6 pounds during the first trimester and 1
pound a week during the second and third trimesters), don't fixate on the
scale. Instead, focus on eating a good variety and balance of nutritious foods to
keep both you and your baby healthy.
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Although you may not feel like running a marathon, most women benefit
greatly from exercising throughout their pregnancies. But during that time,
you'll need to discuss your exercise plans with your doctor or other health
care provider early on and make a few adjustments to your normal exercise
routine. The level of exercise recommended will depend, in part, on your level
of prepregnancy fitness.
What Are the Benefits of Exercising During
Pregnancy?
No doubt about it, exercise is a big plus for both you and your baby (if
complications don't limit your ability to exercise throughout your pregnancy).
It can help you:
·
feel better - At a time when you wonder if
this strange body can possibly be yours, exercise can increase your sense of
control and boost your energy level. Not only does it make you feel better by
releasing endorphins (naturally occurring chemicals in your brain), appropriate
exercise can:
·
relieve backaches and improve your posture by
strengthening and toning muscles in your back, butt, and thighs
·
reduce constipation by accelerating movement in
your intestine
·
prevent wear and tear on your joints (which become
loosened during pregnancy due to normal hormonal changes) by activating the
lubricating synovial fluid in your joints
·
help you sleep better by relieving the stress and
anxiety that might make you restless at night
·
look better - Exercise increases the blood
flow to your skin, giving you a healthy glow.
·
prepare you and your body for birth -
Strong muscles and a fit heart can greatly ease labor and delivery. Gaining
control over your breathing can help you manage pain. And in the event of a
lengthy labor, increased endurance can be a real help.
·
regain your prepregnancy body more quickly -
You'll gain less fat weight during your pregnancy if you continue to exercise
(assuming you exercised before becoming pregnant). But don't expect or try to
lose weight by exercising while you're pregnant. For most women, the goal is to
maintain their fitness level throughout pregnancy.
What's a Safe Exercise Plan When You're Pregnant?
It depends on when you start and whether your pregnancy is complicated.
If you exercised regularly before becoming pregnant, continue your program,
with modifications as you need them. If you weren't fit before you became
pregnant, don't give up! Begin slowly and build gradually as you become
stronger. Whatever your fitness level, you should talk to your doctor about
exercising while you're pregnant.
Discuss any concerns you have with your doctor. You may need to limit
your exercise if you have:
·
pregnancy-induced high blood pressure
·
early contractions
·
vaginal bleeding
·
premature rupture of your membranes, also known as
your water (the fluid in the amniotic sac around the fetus) breaking early
What Kinds of Exercises Can You Do?
That depends on what interests you and what your doctor advises. Many
women enjoy dancing, swimming, water aerobics, yoga, pilates, biking, or
walking. Swimming is especially appealing, as it gives you welcome buoyancy
(floatability or the feeling of weightlessness). Try for a combination of
cardio (aerobic), strength, and flexibility exercises, and avoid bouncing.
Many experts recommend walking. It's easy to vary the pace, add hills,
and add distance. If you're just starting, begin with a moderately brisk pace
for a mile, 3 days a week. Add a couple of minutes every week, pick up the pace
a bit, and eventually add hills to your route. Whether you're a pro or a
novice, go slowly for the first 5 minutes to warm up and use the last 5 minutes
to cool down.
Whatever type of exercise you and your doctor decide on, the key is to
listen to your body's warnings. Many women, for example, become dizzy early in
their pregnancy, and as the baby grows, their center of gravity changes. So it
may be easy for you to lose your balance, especially in the last trimester.
Your energy level may also vary greatly from day to day. And as your
baby grows and pushes up on your lungs, you'll notice a decreased ability to
breathe in more air (and the oxygen it contains) when you exercise. If your
body says, "Stop!" - stop!
Your body is signaling that it's had enough if you feel:
·
fatigue
·
dizziness
·
heart palpitations (your heart pounding in your
chest)
·
shortness of breath
·
pain in your back or pelvis
And if you can't talk while you're exercising, you're doing it too
strenuously. You should also keep your heart rate below 160 beats per minute.
It also isn't good for your baby if you become overheated because
temperatures greater than 102.6 degrees Fahrenheit (39 degrees Celsius) could
cause problems with the developing fetus - especially in the first trimester -
which can potentially lead to birth defects. So don't overdo exercise on hot
days.
When the weather is hot, try to avoid exercising outside during the
hottest part of the day (from about 10 AM to 3 PM) or exercise in an
air-conditioned place. Also remember that swimming makes it more difficult for
you to notice your body heating up because the water makes you feel cooler.
Most doctors recommend that pregnant women avoid weight training and
sit-ups after the first trimester, especially women who are at risk for preterm
labor.
Lifting reduces the blood flow to the kidneys and uterus, and exercises
done on your back (including sit-ups and leg lifts) cause your heart rate to
drop, also decreasing the flow of oxygenated blood to your body and the baby.
It's better to tone your abdominal muscles while on all fours, by relaxing and
then tightening your muscles as you exhale.
Unless your doctor tells you otherwise, it's also a good idea to avoid
any activities that include:
·
bouncing
·
jarring (anything that would cause a lot of up and
down movement)
·
leaping
·
a sudden change of direction
·
a risk of abdominal injury
Typical limitations include contact sports, downhill skiing, scuba
diving, and horseback riding because of the risk of injury they pose.
Although some doctors say step aerobics is acceptable if you can lower
the height of your step as your pregnancy progresses, others caution that a
changing center of gravity makes falls much more likely. If you do choose to do
aerobics, just make sure to avoid becoming extremely winded or exercising to the
point of exhaustion.
And check with your doctor if you experience any of these warning signs
during any type of exercise:
·
vaginal bleeding
·
unusual pain
·
dizziness or lightheadedness
·
unusual shortness of breath
·
racing heartbeat or chest pain
·
fluid leaking from your vagina
·
uterine contractions
What Are Kegel Exercises?
Although the effects of Kegel exercises can't be seen from the outside,
some women use them to reduce incontinence (the leakage of urine) caused by the
weight of the baby on their bladder. Kegels help to strengthen the "pelvic
floor muscles" (the muscles that aid in controlling urination).
Kegels are easy, and you can do them any time you have a few seconds -
sitting in your car, at your desk, or standing in line at the store. No one
will even know you're doing them!
To find the correct muscles, pretend you're trying to stop urinating.
Squeeze those muscles for a few seconds, then relax. You're using the correct
muscles if you feel a pull. Or place a finger inside your vagina and feel it
tighten when you squeeze. Your doctor can also help you identify the correct
muscles.
A few things to keep in mind when you're doing Kegel exercises:
·
Don't tighten other muscles (stomach or legs, for
example) at the same time. You want to focus on the muscles you're exercising.
·
Don't hold your breath while you do them because
it's important that your body and muscles continue to receive oxygen while you
do any type of exercise.
·
Don't regularly do Kegels by stopping and starting
your flow of urine while you're actually going to the bathroom, as this can
lead to incomplete emptying of your bladder, which increases the risk of urinary
tract infections.
Getting Started
Always talk to your doctor before beginning any exercise program. Once
you're ready to get going:
·
Start gradually. Even 5 minutes a day is a good
start if you've been inactive. Add 5 minutes each week until you reach 30
minutes.
·
Dress comfortably in loose-fitting clothes and wear
a supportive bra to protect your breasts.
·
Drink plenty of water to avoid overheating and
dehydration.
·
Skip your exercises if you're sick.
·
Opt for a walk in an air-conditioned mall on hot,
humid days.
·
Above all, listen to your body.
#########################################################
Folic Acid and Pregnancy:
Having a healthy baby means making sure you're healthy, too. One of the most important
things you can do to help prevent serious birth defects in your baby is to get
enough folic acid every day - especially before conception and during early pregnancy.
What Is Folic Acid?
Folic acid, sometimes called folate, is a B vitamin (B9) found mostly in
leafy green vegetables like kale and spinach, orange juice, and enriched
grains. Repeated studies have shown that women who get 400 micrograms (0.4
milligrams) daily prior to conception and during early pregnancy reduce
the risk that their baby will be born with a serious neural tube defect (a
birth defect involving incomplete development of the brain and spinal cord) by
up to 70%.
The most common neural tube defects are spina
bifida (an incomplete closure of the spinal cord and spinal column),
anencephaly (severe underdevelopment of the brain), and encephalocele (when
brain tissue protrudes out to the skin from an abnormal opening in the skull).
All of these defects occur during the first 28 days of pregnancy - usually before
a woman even knows she's pregnant.
That's why it's so important for all women of childbearing age to get
enough folic acid - not just those who are planning to become pregnant. Only
50% of pregnancies are planned, so any woman who could become pregnant should
make sure she's getting enough folic acid.
Doctors and scientists still aren't completely sure why folic acid has
such a profound effect on the prevention of neural tube defects, but they do
know that this vitamin is crucial in the development of DNA.
As a result, folic acid plays a large role in cell growth and development, as
well as tissue formation.
Getting Enough Folic Acid
The U.S. Centers for Disease Control and Prevention (CDC) recommends
that all women of childbearing age - and especially those who are planning a
pregnancy - consume about 400 micrograms (0.4 milligrams) of folic acid every
day. Adequate folic acid intake is very important 1 month before
conception and at least 3 months afterward to potentially reduce the risk
of having a fetus with a neural tube defect.
So, how can you make sure you're getting enough folic acid? In 1998, the
Food and Drug Administration mandated that folic acid be added to enriched
grain products - so you can boost your intake by looking for breakfast cereals,
breads, pastas, and rice containing 100% of the recommended daily folic acid
allowance. But for most women, eating fortified foods isn't enough. To
reach the recommended daily level, you'll probably need a vitamin supplement.
During pregnancy, you require more of all of the essential
nutrients than you did before you became pregnant. Although prenatal vitamins
shouldn't replace a well-balanced diet, taking them can give your body - and,
therefore, your baby - an added boost of vitamins and minerals. Some health
care providers even recommend taking a folic acid supplement in addition to
your regular prenatal vitamin. Talk to your doctor about your daily folic acid
intake and ask whether he or she recommends a prescription supplement, an
over-the-counter brand, or both.
Also talk to your doctor if you've already had a pregnancy that was
affected by a neural tube defect. He or she may recommend that you increase
your daily intake of folic acid (even before getting pregnant) to lower your
risk of having another occurrence.
#########################################################
If you're pregnant or even planning a pregnancy, you've probably found an abundance of information about sex before pregnancy (that is, having sex in order to conceive) and sex after childbirth (general consensus: expect a less active sex life when there's a newborn in the house).
But there's less talk about the topic of sex during pregnancy,
perhaps because of our culture's tendency to dissociate expectant mothers from
sexuality. Like many parents-to-be, you may have questions about the safety of
sex and what's normal for most couples.
Well, what's normal tends to vary widely, but you can count on the fact
that there will be changes in your sex life. Open communication will be
the key to a satisfying and safe sexual relationship during pregnancy.
Is It Safe to Have Sex During Pregnancy?
If you're having a normal pregnancy, sex is considered safe during all
stages of the pregnancy.
So what's a "normal pregnancy"? It's one that's considered
low-risk for complications such as miscarriage or pre-term labor. Talk to your
doctor, nurse-midwife, or other pregnancy health
care provider if you're uncertain about whether you fall into this category.
(The next section of this article may help, too.)
Of course, just because sex is safe during pregnancy doesn't mean you'll
necessarily want to have it! Many expectant mothers find that their desire for
sex fluctuates during certain stages in the pregnancy. Also, many women find
that sex becomes uncomfortable as their bodies get larger.
You and your partner need to keep the lines of communication open
regarding your sexual relationship. Talk about other ways to satisfy your need
for intimacy, such as kissing, caressing, and holding each other. You also may
need to experiment with other positions for sex to find those that are the most
comfortable.
Many women find that they lose their desire and motivation for sex late
in the pregnancy - not only because of their size but also because they're
preoccupied with the impending delivery and the excitement of becoming a new
parent.
When It's Not Safe
There are two types of sexual behavior that aren't safe for any
pregnant woman:
·
If you engage in oral sex, your partner should not
blow air into your vagina. Blowing air can cause an air embolism (a blockage of
a blood vessel by an air bubble), which can be potentially fatal for mother and
child.
·
You should not have sex with a partner whose
sexual history is unknown to you or who may have a sexually
transmitted disease, such as herpes,
genital
warts, chlamydia, or HIV.
If you become infected, the disease may be transmitted to your baby, with
potentially dangerous consequences.
If your doctor, nurse-midwife, or other pregnancy health care provider
anticipates or detects certain significant complications with your pregnancy,
he or she is likely to advise against sexual intercourse. The most common risk
factors include:
·
a history or threat of miscarriage
·
a history of pre-term
labor (you've previously delivered a baby before 37 weeks) or signs
indicating the risk of pre-term labor (such as premature uterine contractions)
·
unexplained vaginal bleeding, discharge, or
cramping
·
leakage of amniotic fluid (the fluid that surrounds
the baby)
·
placenta previa, a condition in which the placenta
(the blood-rich structure that nourishes the baby) is situated down so low that
it covers the cervix (the opening of the uterus)
·
incompetent cervix, a condition in which the cervix
is weakened and dilates (opens) prematurely, raising the risk for miscarriage
or premature delivery
·
multiple fetuses (you're having twins,
triplets, etc.)
Common Questions and Concerns
The following are some of the most frequently asked questions about sex
during pregnancy.
Can sex harm my baby?
No, not directly. Your baby is fully protected by the amniotic sac (a
thin-walled bag that holds the fetus and surrounding fluid) and the strong
muscles of the uterus. There's also a thick mucus plug that seals the cervix
and helps guard against infection. The penis does not come into contact
with the fetus during sex.
Can intercourse or orgasm cause miscarriage or
contractions?
In cases of normal, low-risk pregnancies, the answer is no. The
contractions that you may feel during and just after orgasm are entirely
different from the contractions associated with labor. However, you should
check with your health care provider to make sure that your pregnancy falls
into the low-risk category. Some doctors recommend that all women stop having
sex during the final weeks of pregnancy, just as a safety precaution, because
semen contains a chemical that may actually stimulate contractions. Check with
your health care provider to see what he or she thinks is best.
Is it normal for my sex drive to increase or
decrease during pregnancy?
Actually, both of these possibilities are normal (and so is everything
in between). Many pregnant women find that symptoms such as fatigue, nausea,
breast tenderness, and the increased need to urinate make sex too bothersome,
especially during the first trimester. Generally, fatigue and nausea subside
during the second trimester, and some women find that their desire for sex
increases. Also, some women find that freedom from worries about contraception,
combined with a renewed sense of closeness with their partner, makes sex more
fulfilling. Desire generally subsides again during the third trimester as the
uterus grows even larger and the reality of what's about to happen sets in.
Your partner's desire for sex is likely to increase or decrease as well.
Some men feel even closer to their pregnant partner and enjoy the changes in
their bodies. Others may experience decreased desire because of anxiety about
the burdens of parenthood, or because of concerns about the health of both the
mother and their unborn child.
Your partner may have trouble reconciling your identity as a sexual
partner with your new (and increasingly visible) identity as an expectant
mother. Again, remember that communication with your partner can be a great
help in dealing with these issues.
When to Call Your Doctor
Call your health care provider if you're unsure whether sex is safe for
you. Also, call if you notice any unusual symptoms after intercourse, such as
pain, bleeding, or discharge, or if you experience contractions that seem to
continue after sex.
Remember, "normal" is a relative term when it comes to sex
during pregnancy. You and your partner need to discuss what feels right for
both of you.
#########################################################
Many expectant parents know how hard it might be to get a good night's
sleep in the months that follow the birth of their child, but who would have
guessed that catching some ZZZs during pregnancy would prove to be so
difficult?
Actually, you may sleep more than usual during the first trimester of
your pregnancy. It's normal to feel tired as your body works to protect and
nurture the developing baby. The placenta (the organ that nourishes the fetus
until birth) is just forming, your body is making more blood, and your heart is
pumping faster.
It's usually later in pregnancy, though, that most women have trouble
getting enough deep, uninterrupted sleep.
Why Is Sleeping Sometimes Difficult During
Pregnancy?
The first and most pressing reason behind sleep problems during
pregnancy is the increasing size of the fetus, which can make it hard to find a
comfortable sleeping position. If you've always been a back or stomach sleeper,
it may be difficult to get used to sleeping on your side (as doctors
recommend). Also, shifting around in bed becomes more difficult as the pregnancy
progresses and your size increases.
Other common physical symptoms may interfere with sleep as well:
·
the frequent urge to urinate: Your
kidneys are working harder to filter the increased volume of blood (30% to 50%
more blood than you had before pregnancy) moving through your body, and this
filtering process results in more urine. Also, as your baby grows and the
uterus gets bigger, the pressure on your bladder increases. This means more
trips to the bathroom, day and night. The number of nighttime trips may be
greater if your baby is particularly active at night.
·
increased heart rate: Your
heart rate increases during pregnancy to pump more blood, and as more of your
blood supply goes to the uterus, your heart will be working harder to send
sufficient blood to the rest of your body.
·
shortness of breath:
Breathing may feel more difficult as your enlarging uterus takes up more space,
resulting in pressure against your diaphragm (the muscle just below your
lungs). At the same time, you may notice that you're breathing faster and more
deeply, mainly because of increased oxygen needs.
·
leg cramps and backaches: Pains
in your legs or back are caused by the extra weight you're carrying.
·
heartburn and constipation: Many
women experience heartburn, which occurs when the stomach
contents reflux back up into the esophagus. During pregnancy, the entire
digestive system slows down and food tends to remain in the stomach and
intestines longer, which may cause heartburn or constipation.
Your sleep problems may have other causes as well. Many pregnant women
report that their dreams become more vivid than usual, and some even experience
nightmares. Stress can interfere with sleep, too. Maybe you're worried about
your baby's health, anxious about your abilities as a parent, or feeling
nervous about the delivery itself. All of these feelings are
normal, but they may keep you (and your partner) up at night.
Finding a Good Sleeping Position
Early in your pregnancy, try to get into the habit of sleeping on your
side. Lying on your side with your knees bent is likely to be the most
comfortable position as your pregnancy progresses. It also makes your heart's
job easier because it keeps the baby's weight from applying pressure to the
large vein (called the inferior vena cava) that carries blood back to the heart
from your feet and legs.
Some doctors specifically recommend that pregnant women sleep on the left
side. Because your liver is on the right side of your abdomen, lying on your
left side helps keep the uterus off that large organ. Ask what your doctor
recommends - in most cases, lying on either side should do the trick and help
take some pressure off your back.
But don't drive yourself crazy worrying that you might roll over onto
your back during the night. Shifting positions is a natural part of sleeping
that you can't control. Most likely, during the third trimester of your
pregnancy, your body won't shift into the back-sleeping position anyway because
it will be too uncomfortable.
If you do shift onto your back and the baby's weight presses on your
inferior vena cava, the discomfort will probably wake you up. See what your
doctor recommends about this; he or she may suggest that you use a pillow to
keep yourself propped up on one side.
Try experimenting with pillows to discover a comfortable sleeping
position. Some women find that it helps to place a pillow under their abdomen
or between their legs. Also, using a bunched-up pillow or rolled-up blanket at
the small of your back may help to relieve some pressure. In fact, you'll find
that there are many "pregnancy pillows" on the market. If you're thinking
about purchasing one, talk with your doctor first about which one might work
for you.
Tips for Sleeping Success
Although they might seem appealing when you're feeling desperate to get
some ZZZs, remember that over-the-counter sleep aids, including herbal
remedies, are not recommended for pregnant women. Instead, the following
pointers may safely improve your chances of getting a good night's sleep:
·
Cut out caffeinated drinks like soda, coffee, and
tea from your diet as much as possible. Restrict any intake of them to the
morning or early afternoon.
·
Avoid drinking a lot of fluids or eating a full
meal within a few hours of going to bed at night. (But make sure that you also
get plenty of nutrients and liquids throughout the day.) Some women find it helpful
to eat more at breakfast and lunch and then have a smaller dinner. If nausea is
keeping you up, you may want to eat a few crackers before you go to bed.
·
Get into a routine of going to bed and waking up at
the same time each day.
·
Avoid rigorous exercise right before you go to bed.
Instead, do something relaxing, like soaking in a warm bath for 15 minutes or
having a warm, caffeine-free drink, such as milk with honey or a cup of herbal
tea.
·
If a leg cramp awakens you, it may help to press
your feet hard against the wall or to stand on the leg. Also, make sure that
you're getting enough calcium in your diet, which can help reduce leg cramps.
·
Take a class in yoga or learn other relaxation
techniques to help you unwind after a busy day. (Be sure to discuss any new
activity or fitness regimen with your doctor first.)
·
If fear and anxiety are keeping you awake, consider
enrolling in a childbirth or parenting class. More knowledge and the company of
other pregnant women may help to ease the fears that are keeping you awake at
night.
What to Do When You Can't Sleep
Of course, there are bound to be times when you just can't sleep.
Instead of tossing and turning, worrying that you're not asleep, and counting
the hours until your alarm clock will go off, get up and do something: read a
book, listen to music, watch TV, catch up on letters or email, or pursue some
other activity you enjoy. Eventually, you'll probably feel tired enough to get
back to sleep.
And if possible, take short naps (30 to 60 minutes) during the day to
make up for lost sleep. It won't be long before your baby will be setting the
sleep rules in your house, so you may as well get used to sleeping in spurts!
####################################################
Getting Help After Birth
You may want to recruit help from friends and family to get through this
time, which can be very hectic and overwhelming. While in the hospital, use the
expertise around you. Many hospitals have feeding specialists or lactation
consultants who can help you get started nursing
or bottle-feeding. In addition, nurses are a great resource to show
you how to hold, burp, change, and care for your baby.
For in-home help, you might want to hire a baby nurse, or a responsible
neighborhood teenager to help you for a short time after the birth. In
addition, relatives and friends can be a great resource. They may be more than
eager to help, and although you may disagree on certain things, don't dismiss
their experience. But if you don't feel up to having guests or you have other
concerns, don't feel guilty about placing restrictions on visitors.
Handling a Newborn
If you haven't spent a lot of time around newborns, their fragility may
be intimidating. Here are a few basics to remember:
·
Be careful to support your baby's head and neck. Cradle
the head when carrying your baby and support the head when carrying him or her
upright or when you lay him or her down.
·
Be careful not to shake your newborn, whether in
play or in frustration. Shaking that is vigorous can cause bleeding
in the brain and even death. If you need to wake your infant, don't shake him
or her - instead, tickle his or her feet or blow gently on his or her cheek.
·
Make sure your baby is securely fastened into the carrier,
stroller, or car seat. Limit car
rides and any other activity that would be too rough or bouncy.
·
Remember that your newborn is not ready for rough
play such as being jiggled on the knee or thrown in the air.
Bonding and Soothing Techniques
Bonding with your baby is probably one of the most pleasurable aspects
of infant care. "Bonding" is a concept that was introduced in the
late 1970's by two pediatricians, Klaus and Kennell. They suggested that there
is a sensitive time in the first hours to days after birth in which it's
important for parents to make a connection with their infant. This physical
connection promotes an emotional connection between parent and infant (bonding).
The attachment that's then formed allows the parents to make the necessary
sacrifices to be able to take care of their child.
For infants, the attachment contributes to their emotional growth, which
also impacts their development in other areas like physical growth. Another way
to think of bonding is "falling in love" with your baby. Children who
don't have a parent or adult in their life that unconditionally love them will
potentially have greater problems as they mature.
Begin bonding by cradling your baby in your lap and gently stroking him
or her in different patterns. If you and your partner both hold and touch your
infant frequently, he or she will soon come to know the difference between your
touches. Each of you should also take the opportunity to be "skin-to-skin"
with your newborn, holding him or her against your own skin when feeding or
cradling.
Babies, especially premature babies and those with medical
problems, may respond to infant massage. Research has shown
that certain types of massage can relax and increase bonding between both
infant and parent as well as help with infant digestion and growth. Infant
massage was introduced to the United States in the 1970's by Vimala Schneider
McClure from India who saw firsthand the benefits it provided. Many books and
videos cover the subject; talk to your child's doctor about which one you think
might work for you and your baby. Be careful, however - babies are not as
strong as adults, so massage your baby gently.
Babies usually love vocal sounds, such as talking, babbling, singing,
and cooing. Your baby will probably also love listening to music. Try a variety
of types to find your baby's preference. Baby rattles and musical mobiles are
other good ways to stimulate your infant's hearing. If your baby is being
fussy, try singing, reciting poetry and nursery rhymes, or reading to him or
her as you sway or rock gently in a chair.
Some babies may be unusually sensitive to touch, light, or sound. Such
babies may startle and cry easily, sleep less than you might expect, or turn
their faces away when you speak or sing to them. Keep noise and light levels
moderate.
Swaddling is another soothing technique first-time parents should learn.
Swaddling keeps your baby's arms close to his or her body and his or her legs
securely bound. Not only does this keep your baby warm, but the surrounding
pressure seems to give most newborns a sense of security and comfort. Here's
how to swaddle a baby:
·
Spread out the receiving blanket, with one corner
folded over slightly.
·
Lay the baby face up on the blanket with his or her
head at the folded corner.
·
Wrap the left corner over his or her body and tuck
it beneath him or her.
·
Bring the bottom corner up over his or her feet.
·
Wrap the right corner around him or her, leaving
only the neck and head exposed.
Diapering Dos and Don'ts
You'll probably decide before you bring your baby home whether you are
going to use cloth or disposable diapers. Whichever you use, you will need
about 10 diapers a day, or about 70 a week.
Before diapering a baby, make sure you have all supplies within reach so
you won't have to leave your baby unattended on the changing table. You'll
need:
·
a clean diaper
·
a fastener (if cloth is used)
·
diaper ointment if the baby has a rash
·
a container of warm water
·
cotton balls
·
clean washcloth or diaper wipes
After each bowel movement, or if your baby's diaper is wet, lay your
baby on his or her back and remove the dirty diaper. Use the water, cotton
balls, and washcloth or the wipes to gently wipe your baby's genital area
clean. When removing a boy's diaper, do so carefully because exposure to the
air may make him urinate. When wiping a girl, wipe her bottom from front to
back to avoid a urinary tract infection. If your baby has a
rash, apply ointment. Always remember to wash your hands thoroughly after
changing a diaper.
Diaper rash is a common concern. Typically the rash is red and bumpy and
will go away with a warm bath, some diaper cream, and a little time out of the
diaper. Most of the time rashes occur because the baby's skin is sensitive and
becomes irritated by the wet diaper. If your baby has had juice, their poop can
become acidic and give them a rash. To prevent or heal diaper rash, try these
tips:
·
Change your baby's diaper frequently, especially
soon after bowel movements.
·
After cleaning the area with mild soap and water or
a wipe, apply a diaper rash or "barrier" cream. Creams with zinc
oxide are preferable because they form a barrier against moisture.
·
If you use cloth diapers, wash them in dye- and
fragrance-free detergents.
·
Let the baby go undiapered for part of the day.
This gives their skin a chance to "air-out".
If the diaper rash continues for more than 3 days, call your child's
doctor - it may be caused by a fungal infection that requires a
prescription.
Bathing Basics
You should give your baby a sponge bath until:
·
the umbilical cord falls off (1-4 weeks)
·
the circumcision heals (1-2 weeks)
·
the naval heals completely(1-4 weeks)
A bath two or three times a week in the first year is sufficient. More
frequent bathing may be drying to the skin.
You'll need the following items before you give your baby a bath:
·
a soft, clean washcloth
·
mild, unscented baby soap and shampoo
·
a soft brush to stimulate the baby's scalp
·
towels or blankets
·
an infant tub filled with warm - not hot! - water
(to test the water temperature, feel the water with your elbow or wrist). An
infant tub is a plastic tub that can fit in the bathtub and is better fitted
for the infant and makes bath time easier to manage.
·
a clean diaper
·
clean clothes
For a sponge bath, pick a warm room and a flat surface, such as a
changing table, floor, or counter. Undress your baby down to his or her shirt
and diaper. Wipe your infant's eyes with a washcloth dampened with water only,
starting with one eye and wiping from the inner corner to the outer corner. Use
a clean corner of the washcloth to wash the other eye. Clean your baby's nose
and ears with the washcloth. Then wet the cloth again, and using soap, wash his
or her face gently and pat it dry. Next, using baby shampoo, create a lather
and gently wash your baby's head and rinse. Pay special attention to creases
under the arms, behind the ears, around the neck, and the genital area. Once
you have washed those areas, make sure they are dry and diaper and dress your
baby.
When your baby is ready for tub baths, the first baths should be gentle
and brief. If he or she becomes upset, go back to sponge baths for a week or
two, then try the bath again.
Once you've undressed your baby for the tub bath, place him or her in
the water immediately so he or she doesn't become chilled. Use one of your
hands to support the head and the other hand to guide him or her in, feet
first. Talk gently to the baby and slowly lower the rest of his or her body
until he or she is in the tub. Use a washcloth to wash his or her face and
hair. Gently massage your baby's scalp with the pads of your fingers or a soft
baby hairbrush, including the area over the fontanelles (soft spots) on the top
of the head. When you rinse the soap or shampoo from your baby's head, cup your
hand across the forehead so the suds run toward the sides and soap doesn't get
into his or her eyes. After the bath, wrap your baby in a towel immediately,
making sure to cover his or her head. Baby towels with hoods are great for
keeping a freshly washed baby warm.
While bathing your infant, never leave the baby alone. If you
need to leave the bathroom, wrap the baby in a towel and take him or her with
you.
Circumcision and Umbilical Cord Care
Immediately after circumcision, the tip of the penis is
usually covered with gauze coated with petroleum jelly to keep the wound from
sticking to the diaper. Gently wipe the tip clean with warm water after a
diaper change. Redness or irritation of the penis should heal within a few
days, but if the redness or swelling increases or if pus-filled blisters form,
infection may be present and you should call your baby's doctor immediately.
Umbilical cord care in newborns is also important. To help prevent
infection, some doctors suggest swabbing the area with rubbing alcohol after
each diaper change until the cord stump dries up and falls off, usually in 10
days to 3 weeks. The infant's navel area shouldn't be submerged in water until
this happens. Until it falls off, the cord stump will change color from yellow
to brown or black - this is normal. You should consult your baby's doctor if
the navel area becomes reddened or if a foul odor or discharge develops.
Feeding and Burping Your Baby
Your first feeding decision is to choose whether you want to feed your
child with a breast or a bottle. Once you've made that
decision, you may be stumped as to how often your baby should be fed.
Generally, it's recommended that you feed your baby whenever he or she seems
hungry, which is called demand feeding. Your baby may cue you to his or
her hunger by crying, putting his or her fingers in his or her mouth, or making
sucking noises.
A newborn baby may need to be fed as often as every 2 hours or perhaps
more frequently. If you're breast-feeding, give your baby the chance to nurse
about 10 to 15 minutes at each breast. If you're feeding your infant with a
bottle, he or she will most likely take about 2 to 3 ounces of infant formula
at each feeding.
Some newborns may need to be awakened every few hours to make sure they
get enough to eat. Call your baby's doctor if you need to awaken your newborn
frequently or if your baby doesn't seem to take an interest in eating or
sucking.
If you are formula-feeding your child, you can more easily monitor if he
or she is getting enough to eat - after all, what goes in must come out.
However, if you're breast-feeding, you may wonder if your baby is eating
enough. If he or she seems satisfied, produces about six wet diapers and
several stools a day, sleeps well, and is gaining weight regularly, then your baby
is probably eating enough. Talk to your child's doctor if you have concerns
about your child's growth or feeding schedule.
Babies often swallow air during feedings, which can cause them to become
fussy. You can prevent this fussiness by burping your baby frequently. If you
are bottle-feeding, burp your baby every 2 to 3 ounces. If you are
breast-feeding, burp your baby each time he or she switches breasts with one of
the following burping strategies:
·
Hold your baby upright with his or her head on your
shoulder. Support your baby's head and back while you gently pat his or her
back with your other hand.
·
Sit your baby on your lap. Support your baby's
chest and head with one hand and gently rub his or her back with the other.
·
Lay your baby on your lap with his or her back
facing up. Support your baby's head in the crook of your arm and gently pat or
rub his or her back.
If your baby hasn't burped after several minutes, finish the feeding
you've started. Afterward, burp your baby again and keep him or her in an
upright position for 10 to 15 minutes to avoid spitting up.
Sleeping Basics
As a new parent, you may be surprised to learn that your newborn, who
seems to need you every minute of the day, actually sleeps
about 16 hours or more! Usually a newborn will sleep for periods of 3 to 4
hours. Don't expect your newborn to sleep through the night - because your
baby's digestive system is so small, he or she needs nourishment every few
hours and should be awakened if he or she hasn't been fed for 5 hours.
When can you expect your baby to sleep through the night? About 90% of
babies sleep through the night (between 6 and 8 hours) at 3 months of age, but
if your infant doesn't, it's not a cause for worry. Like adults, babies must
develop their own sleep patterns and cycles, so if your newborn is gaining
weight as your baby's doctor recommends and appears healthy, don't despair if
he or she hasn't slept through the night at 3 months.
It's important to place your infant on his or her back to sleep to
reduce the risk of sudden infant death syndrome (SIDS). In
addition, you should remove all fluffy bedding, quilts, sheepskins, stuffed
animals, and pillows from the crib to ensure that your baby doesn't get tangled
in them. You should also be sure to alternate the position of your baby's head
from night to night (first right, then left, and so on) so that he or she
doesn't develop a flat spot on one side of his or her head.
Even though you may feel anxious at handling a newborn now, in a few short weeks you'll develop a routine and will be parenting your newborn like a pro! If you have a lot of questions or concerns, call your baby's doctor - he or she can provide you with a list of possible local resources to help you and your baby grow together.
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Top
Pregnancy Precautions: FAQs
Almost as soon as you see that little pink line on the pregnancy test,
the worry seems to set in. You start thinking about the two cups of coffee you
had at work yesterday, the glass of wine you sipped at dinner last week, the
tuna steak you devoured for lunch 2 weeks ago.
No doubt about it, pregnancy is often one of the most
thrilling and most worrisome times in a woman's life. Of course, when
you're pregnant, what you don't put into your body (or expose it to) can
be almost as important as what you do. The official, scary-sounding word
for something that may cause birth defects or harm to a fetus is teratogen,
and can include drugs, medications, infections, chemicals, etc.
But stressing out about every little thing you come into contact with
can make for a long and taxing three trimesters. And beating yourself up about
things you did before you knew you were pregnant or before you found out they
could be hazardous won't do you or your baby any good.
Questions abound regarding what you can and can't do during pregnancy.
But the answers may not always come from the most reliable sources, so you
might worry unnecessarily. Some warnings from friends and other well-wishers
are worth listening to; others are popular but unproven rumors.
Knowing what could truly be harmful to your baby and what's not a real concern
is the key to keeping your sanity during these 40 weeks.
What Are the Top Pregnancy Hazards?
You should be particularly mindful of a handful of things during your
pregnancy, some of which are more harmful than others. Your doctor (or other
health care provider) will likely talk to you about — or give you information
on — which should be avoided altogether, dramatically reduced, and/or carefully
considered during pregnancy.
Hazardous or Harmless?
·
Alcohol
·
Caffeine
·
Smoking
·
Flying
·
Lead
·
Tanning
·
Sex
·
X-Rays
Alcohol
Should I avoid it? Yes! Although it may seem harmless to have
a glass of wine at dinner or a mug of beer out with friends, no one has
determined what is a "safe amount" of alcohol to drink during
pregnancy. Fetal
alcohol syndrome (FAS) is caused by the consumption of a large
amount of alcohol during pregnancy. What that amount is versus a safe amount is
really not known. Because of the uncertainty, it's always wise to err on the
side of caution and not drink any alcohol at all while you're pregnant.
What are the risks to my baby? One of the most common known
causes of mental and physical birth defects, alcohol produces more severe
abnormalities in a developing fetus than heroin, cocaine, or marijuana.
Alcohol is easily passed along to the baby, who is less able to
eliminate alcohol than the mother. That means an unborn baby tends to develop a
high concentration of alcohol, which stays in the baby's system for longer
periods than it would in the mother's. And moderate alcohol intake, as well as
periodic binge drinking, can possibly damage a baby's developing nervous system.
What can I do about it? If you had a drink or two
before you even knew you were pregnant (as many women do), don't worry too much
about it. But your best bet is to not drink any more alcohol for the rest of
your pregnancy.
If you're an alcoholic or think you may have a drinking problem, be sure
to talk to your doctor about it. He or she needs to know how much alcohol
you've consumed and when during your pregnancy to get a better idea of how your
unborn baby may have been affected. Your doctor may also be able to start you
on a path to getting the help you need to stop drinking — for your sake and
your baby's.
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Caffeine
Should I avoid and/or limit it? Yes. It's wise to cut down or
eliminate caffeine intake. Studies indicate that caffeine consumption of more
than 150 milligrams a day (about 1 1/2 cups of coffee) puts the pregnancy at
higher risk. Less than that amount is probably safe.
What are the risks to my baby? High caffeine consumption has
been linked to an increased risk of miscarriage.
What can I do about it? If you're having a hard time
cutting out coffee cold turkey, here's how you can start:
·
Cut your consumption down to one or two cups a day.
·
Gradually reduce the amount by combining
decaffeinated coffee with regular coffee.
·
Eventually cut out the regular coffee altogether.
And remember that caffeine is not limited to coffee. Green and
black tea, cola, and other soft drinks contain caffeine. Try switching to
decaffeinated products (which may still have some caffeine, but in much smaller
amounts) or caffeine-free alternatives.
If you're wondering whether chocolate, which also contains caffeine, is
a concern, the good news is that you can have some of the scrumptious
treat in moderation. Whereas a cup of brewed coffee has 95-135 milligrams of
caffeine, the average chocolate bar has between 5-30 milligrams. So, small
amounts of chocolate are fine.
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Certain Foods
Are there some I should avoid? Yes. Foods that are more
likely to be contaminated with bacteria or heavy metals are ones to try to
avoid or limit your exposure to. Those you should steer clear of altogether
during pregnancy include:
·
soft, unpasteurized cheeses (often advertised as
"fresh") such as feta, goat, Brie, Camembert, blue-veined cheeses,
and Mexican queso fresco
·
unpasteurized milk, juices, and apple cider
·
raw eggs or foods containing raw eggs, including
mousse, tiramisu, raw cookie dough, eggnog, homemade ice cream, and Caesar
dressing
·
raw or undercooked fish (sushi), shellfish, or
meats
·
paté and meat spreads
·
processed meats such as hot dogs and deli meats
(these should be very well cooked before eating)
Also, although fish and shellfish can be an extremely healthy part of
your pregnancy diet (they contain beneficial
omega-3 fatty acids and are high in protein and low in saturated fat), you
should avoid eating:
·
shark
·
swordfish
·
king mackerel
·
tilefish
·
tuna steak (limited amounts of canned, preferably
light, tuna is OK)
What are the risks to my baby? Although it's important to eat
plenty of healthy foods during pregnancy, you also need to avoid food-borne
illnesses, such as listeriosis, toxoplasmosis, and salmonella,
which can be found in the foods listed in the first set of bullets. These
infections can be life-threatening to an unborn baby and may cause birth
defects or miscarriage.
And the types of fish mentioned above may contain high levels of
mercury, which can cause damage to the developing brain of a fetus.
What can I do about it? Be sure to thoroughly wash all
fruits and vegetables, which can carry food-borne illnesses or be coated with
pesticide residue. And be mindful of what you're buying at the grocery store or
when dining out.
When you choose seafood, eat a variety of fish and shellfish and limit
the amount to about 12 ounces per week — that's about two meals. Common fish
and shellfish that are low in mercury include: canned light tuna,
catfish, pollock, salmon, and shrimp. But because albacore (or white) tuna has
more mercury than canned light tuna, it's best to eat no more than 6 ounces (or
one meal) of albacore tuna a week.
You may have to forego a few things during pregnancy that you normally
enjoy. But just think how delicious they'll taste after waiting 9 months!
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Changing the Litter Box
Should I avoid it? Yes. Pregnancy is the prime time to get
out of cleaning kitty's litter box. But that doesn't mean that you have
to keep away from Fluffy!
What are the risks to my baby? An infection called toxoplasmosis
can be spread through soiled cat litter boxes and can cause serious problems in
a fetus, including prematurity, poor growth, and severe eye
and brain damage. A pregnant woman who becomes infected often has no symptoms
but can still pass the infection on to her developing baby.
What can I do about it? Have someone else change the
litter box, making sure to clean it thoroughly and regularly, then wash his or
her hands well afterward.
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Over-the-Counter and Prescription Medications
Should I avoid them? Some — yes; others — no. There are many medications
you should steer clear of during pregnancy. Be sure to talk to your doctor
about which prescription and over-the-counter (OTC) drugs you can and
can't take, even if they seem like no big deal.
What are the risks to my baby? Even common OTC medications
that are generally safe may be considered off-limits during pregnancy because
of their potential effects on the baby. Certain prescription medications may
also cause damage to the developing fetus. (The type of harm and extent of
possible damage depends on the kind of medication.)
Also, although they may seem harmless, herbal remedies and supplements
are not regulated by the U.S. Food and Drug Administration (FDA). That
means that they don't have to follow any safety standards and, therefore, could
be harmful to your baby.
What can I do about it? To make sure you don't take
anything that could put your baby at risk talk to your doctor about:
·
any medications you're taking — prescription and
OTC — and ask which are safe to take during pregnancy
·
any concerns you have about natural remedies,
supplements, and vitamins
Also, be sure to let all of your health care providers know that you're
pregnant so that they'll keep that in mind when recommending or prescribing any
medications. If you were prescribed a medication before you became pregnant for
an illness, disease, or condition you still have, your doctor can help you
weigh the potential benefits and risks of continuing your prescription.
If you become sick (i.e., with a cold) or have symptoms that are causing
you discomfort or pain (i.e., a headache or backache), talk to your doctor
about medications you can take and alternative ways to help you feel
better without medication.
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Recreational Drugs
Should I avoid them? Yes!
What are the risks to my baby? Pregnant women who use drugs
may be placing their unborn babies at risk for:
·
premature birth
·
poor growth
·
birth defects
·
behavior and learning problems
And their babies could also be born addicted to those drugs.
What can I do about it? If you've used any drugs at
any time during your pregnancy, it's important to inform your doctor. Even if
you've quit, your unborn child could still be at risk for health problems. If
you're still using drugs, talk to your doctor for help on how to quit. Health
clinics such as Planned Parenthood also can recommend health care providers, at
little or no cost, who can help you quit your habit and have a healthier
pregnancy.
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Smoking
Should I avoid it? Yes! You wouldn't light a cigarette, put
it in your baby's mouth, and encourage your little one to puff away. As
ridiculous as this scenario seems, pregnant women who continue to smoke are
allowing their fetus to smoke too. The smoking mother passes nicotine and
carbon monoxide to her growing baby.
Likewise, you should steer clear of people who are smoking, whether
they're coworkers, friends, family members, or other diners at a restaurant (if
your state still allows smoking in public places).
What are the risks to my baby? If a pregnant woman smokes, it
could cause:
·
stillbirth
·
prematurity
·
low birth weight
·
sudden infant death syndrome (SIDS)
·
asthma and other respiratory problems
And the risks to a fetus from regular exposure to secondhand smoke
include low birth weight and slowed growth.
What can I do about it? If you smoke, having a baby may
be the motivation you need to quit. Talk to your doctor about options for
kicking the habit.
If you spend time with people who smoke, ask them nicely to do it
outside — and away from you if you're outside as well. And, of course, request
the nonsmoking area whenever you dine out.
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But What About...?
Whether you read it on an online pregnancy chat board, heard it from
your best friend's coworker's cousin, or aren't sure where that nagging doubt
came from, worries about what's OK during pregnancy abound. Here's the lowdown
on some common ones that many expectant women wonder about.
Artificial Sweeteners (Sugar Substitutes)
Should I avoid them? Although some are OK, one in particular
isn't so clear-cut.
Aspartame,
sucralose, and acesulfame-K have been found to be safe to use in moderation
during pregnancy. However, you should avoid aspartame if you or your partner
has a rare hereditary disease called phenylketonuria
(PKU), in which the body can't break down the compound
phenylalanine, which is found in aspartame. In that case, you should avoid
aspartame altogether since your baby may also be born with the disease.
But the jury still seems to be out on whether saccharin, which is found
in some foods and in the little pink packets, is safe to use during pregnancy
or not — it can cross the placenta and could stay in the fetus' tissue. (Also,
a sweetener called cyclamate was banned in the United States because of concern
about cancer.)
What are the risks, if any, to my baby?
Although some people have alleged that the artificial sweetener aspartame is
linked with birth defects and illnesses ranging from multiple sclerosis to
Parkinson's disease, government authorities and medical groups throughout the
world have evaluated aspartame and approved it as safe for human consumption,
including during pregnancy.
Research done during the 1970s suggested that saccharin caused bladder
cancer in lab rats when given in large quantities. Since then, though, those
studies have often been called into question. Also, a warning saying that it
could cause cancer was removed from all saccharin-containing products' labels
in 2000.
What can I do about it? With aspartame, sucralose, and
acesulfame-K, moderation is the key. It's OK to have an occasional diet soda or
sugar-free food with these sweeteners here and there. But if you're really
craving something sweet, it's probably better to have the real thing, as long
as it's in moderation.
If you've already consumed something with saccharin in it during your
pregnancy, don't obsess about it. It's highly unlikely that small amounts could
do any harm to your baby.
Still, it's wise to check product labels and try to avoid — or at least
limit — anything with artificial sweeteners (especially saccharin), just to be
safe. After all, this is one time in your life when you have a good reason to
avoid diet foods! And the more naturally flavored whole foods you eat during
pregnancy, the better.
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Computer Monitors (VDTs)
Should I avoid them? No. There is no evidence that
computer monitors (also called video display terminals, or VDTs) cause any
problems in unborn babies.
What are the risks, if any, to my baby?
There's been speculation since the 1980s that VDTs are unsafe for pregnant
women because of low levels of radiation (electromagnetic fields). But according
to the National Institute for Occupational Safety and Health (NIOSH), part of
the Centers for Disease Control and Prevention (CDC), computer monitors have not
been found to cause low birth weight or preterm births.
What can I do about it? You don't need to do anything.
Before you quit your office job or sit 10 feet away from the screen using a
pool stick to type, rest assured that computer monitors are OK.
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Flying
Should I avoid it? No, not unless your due date is near or
your doctor tells you that you or your baby has a medical condition that
warrants keeping you near home. You can fly up to 4 weeks before your due date
and that cut-off time is not because flying can cause problems, but because it's
just best to stay close to home and your doctor in case you deliver.
However, pregnant women who shouldn't fly include those with:
·
high blood pressure (or hypertension)
during pregnancy
·
gestational diabetes that hasn't been
well-controlled
·
abnormalities of the placenta
·
the risk of going into premature labor
What are the risks, if any, to my baby? For
women with healthy pregnancies, there are no significant risks. However, women
who have difficult pregnancies, especially involving their cardiovascular
system, could be compromised by air flight and should discuss any flying plans
with their doctor.
What can I do about it? Discuss any plans for lengthy
or distant travel with your doctor during your last trimester, just in case. If
he or she says it's OK, check with the airlines to find out what their policies
are regarding flying during pregnancy. (Most airlines will allow pregnant women
to fly up until week 36 for domestic flights and week 35 for international
travel.)
To make sure your flight is as comfortable as possible, you may want to:
·
Move your lower legs regularly and/or get out of
your seat (especially during long flights) to promote blood circulation and
help prevent blood cots.
·
Wear support stockings to further prevent clotting
in your legs.
·
Keep your seatbelt on when you're seated to keep
the jostling of turbulence to a minimum.
Hair Dyes
Should I avoid them? No. According to the American College of
Obstetricians and Gynecologists (ACOG), because very little dye is absorbed
through the skin, dying your hair is "most likely safe" during
pregnancy, despite what doctors in years past may have advised. That's good
news for many expectant women — coloring your hair can be a great little
confidence boost when everything else going on in your body feels so out of
your control.
Having said that, though, very few studies have closely examined the
many different kinds of hair treatments and their potential effects on a fetus.
What we do know indicates that hair treatments are most likely safe.
What are the risks, if any, to my baby? None
that are currently known.
What can I do about it? If you're still concerned, ask
your doctor about natural, non-chemical dyes that could give you the little
makeover you may need without the added worry. Also, having your hair
highlighted (rather than dyed) uses far less chemicals.
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High-Impact Exercise
Should I avoid it? Yes. For most pregnant women, low-impact
exercise is a great way to feel better,
look better, and help prepare the body for labor. Unless your doctor tells you
otherwise, stick to low-impact exercise. It's wise to avoid some exercises and
activities such as:
·
weight training and heavy lifting (after the first
trimester)
·
sit-ups (also after the first trimester)
·
contact sports
·
scuba diving
·
bouncing
·
jarring (anything that would cause a lot of up and
down movement, such as horseback riding)
·
leaping
·
a sudden change of direction (such as downhill
skiing)
What are the risks, if any, to my baby?
High-impact exercise can cause increased pressure on the structures within the
uterus that could lead to problems such as premature labor or bleeding.
What can I do about it? Some of the healthy ways
pregnant women can stay fit include walking, swimming, water aerobics, yoga,
and Pilates. But be sure to talk to your doctor before starting — or continuing
— any exercise routine during pregnancy.
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Household Chemicals (Cleaners, Paint, etc.)
Should I avoid them? Some — yes; others — no. While chemicals
like ammonia and chlorine may make you nauseated because of the smell, they're
not toxic, says the March of Dimes. But others, such as some paints, paint
thinners, oven cleaners, varnish removers, air fresheners, aerosols, carpet
cleaners, etc., may be.
What are the risks, if any, to my baby? It
depends on the product. Some household chemicals may have no effect, while
others in high doses could potentially be harmful.
What can I do about it? Here a few tips to help keep
household chemicals in perspective during your pregnancy:
·
Talk to your doctor about any concerns you have
with chemicals you use at home or at work.
·
Look at product labels before using any
product. If it's unsafe to use during pregnancy, the label should say that it's
toxic. Find out not only if it's safe for you to use, but if it's safe
for you to be around when being used by someone else. If the label
doesn't specify, contact the manufacturer.
·
Open windows and doors, and use rubber gloves and a
mask when cleaning with or using any chemical.
·
Wash your hands and arms, even if you wore gloves,
after using any chemical.
·
Opt for natural products like baking soda, borax,
and vinegar for cleaning.
·
Have someone else paint the baby's nursery, as much
you'd probably like to do it yourself. And definitely don't help with the
removal of paint if your home was built before 1978 as it may contain
lead-based paint. Although many paints today are considered safer than those of
the past, it's still a good idea to let someone else handle painting. You can
always take over the decorating duties after the paint dries!
Bug Sprays (Insecticides/Pesticides/Repellants)
Should I avoid them? Yes. They're considered poisons and
pregnant women should stay away from them as much as possible.
What are the risks, if any, to my baby?
Although there's no evidence that the typical occasional household use of
insecticides does any damage to a baby, it's best to err on the side of
caution. High levels of exposure may cause:
·
miscarriage
·
premature delivery
·
birth defects
As for insect repellants (which may contain DEET, or diethyltoluamide),
the risks aren't fully known. So, it's best to either not use them at all during
pregnancy or to wear gloves to place a small amount on socks, shoes, and outer
clothing instead of putting repellants directly on your skin.
What can I do about it? If you have a real problem
with pesky bugs around your home, the March of Dimes suggests the following:
·
Use safer methods of removal such as boric acid,
which you should be able to find at your local hardware store.
·
Make sure someone else applies the pesticides.
·
When pesticides are sprayed outside, close all
windows and turn off air-conditioning units and window fans to prevent the
fumes from entering your home.
·
Remove utensils, food, and dishes from areas where
the chemicals will be used.
·
Stay away from the treated area during the
application and afterward for the amount of time specified on the product
label.
·
Have someone else wash any treated area where food
is prepared or served.
·
Wear rubber gloves when gardening outside where
pesticides have been used.
·
Have your water supply tested regularly if you have
well water and use pesticides, fertilizers, and weed killers.
Lead
Should I avoid it? Yes. However, exposure to high lead levels
is rare for women in the United States.
What are the risks, if any, to my baby?
Exposure to high levels of lead can cause:
·
miscarriage
·
premature delivery
·
low birth weight
·
developmental delays
But even low levels of lead can cause subtle problems with behavior and
learning in children.
What can I do about it? If your home was built before
1978, it could have lead-based paint. But it only becomes a problem if the
paint is chipping, peeling, or being removed. Some homes also may have lead
pipes or copper piping with lead solder that can allow lead to enter the tap
water.
If you have an older home or think that you may have lead piping or
soldering and are concerned about lead exposure, you can have a professional
come out to test your water, the dust in your home, the soil outside, and/or
the paint around your home for lead.
Make sure that anyone who removes any potentially lead-based paint from
your home:
·
is a professional trained in removing lead paint
(getting rid of lead-based paint isn't a project for a do-it-yourselfer!)
·
removes it when you're not there
·
doesn't scrape, sand, or use a heat gun to remove
the paint (these methods may send lead dust into the air)
·
thoroughly cleans the area immediately afterward
To help reduce potential lead levels in your tap
water, you can run the water for 30 seconds before using it and/or buy a water
filter that specifically says on the packaging that it removes lead.
Microwaves
Should I avoid them? No. Nuke away! After all, for pregnant
women on the go, especially those with other kids, microwaves are usually a
must.
What are the risks, if any, to my baby? There
are no medically proven risks. Microwaves don't leak radiation, and any that
did would emit extremely small amounts that are virtually undetectable.
What can I do about it? If
you're still concerned, you might want to make sure your microwave is working
properly and isn't leaking or damaged. Researchers have determined that if a
microwave does leak any radiation, it diminishes exponentially with distance
from the microwave. In other words, if you have any concerns, stand a few feet
away instead of immediately in front of the oven.
Overheating (Hot Tubs, Saunas, Electric Blankets, etc.)
Should I avoid or limit it? Yes. You should limit
activities that would raise your core temperature above 102 degrees Fahrenheit
(38.9 degrees Celsius). They include:
·
using saunas or hot tubs
·
taking very hot, long baths and showers
·
using electric blankets or heating pads
·
getting a high fever
·
becoming overheated when outside in hot weather or
when exercising
What are the risks, if any, to my baby? If
your body temperature goes above 102 degrees Fahrenheit (38.9 degrees Celsius)
for more than 10 minutes, the elevated heat can cause problems with the fetus.
Overheating in the first trimester can lead to neural tube defects. Later in
the pregnancy, it can lead to dehydration.
What can I do about it? Instead of hot tubs or saunas,
take a dip in a cool pool. And it's probably a good idea to stick to warm or
slightly hot baths and showers. If you have a fever during your pregnancy, talk
to your doctor about ways to lower it. And follow your body's cues that you're
getting overheated
when exercising or enjoying the great outdoors in the warmer months.
But if you've already become overheated during your
pregnancy, don't worry too much about it. Chances are, you removed yourself
from the uncomfortable situation before any damage was done.
Self-Tanners/Sunless Tanners
Should I avoid them? Maybe. Although there's no proof that
self-tanners are harmful to an unborn baby, there haven't been many studies
done on their effects to a fetus.
What are the risks, if any, to my baby? No
risks specific to tanning have been documented.
What can I do about it? For a
summer glow, skip the self-tanner and apply some bronzer to your face, neck,
shoulders, and chest. And if you do decide to try a self-tanner, that's far
safer than lying out in the sun
and becoming potentially overheated. Overheating in the first trimester, as
discussed above, can lead to significant problems for the baby; later in the
pregnancy, it could lead to dehydration in the mother. Still, ask your doctor
before applying any "tan in a bottle."
Sex
Should I avoid it? No. Most pregnant women having a
"normal" pregnancy can continue having sex
— it's perfectly safe for both mom and the baby, even up until the delivery. Of
course, you'll probably need to modify positions for your own comfort as your
belly gets bigger.
However, your doctor may advise against sexual intercourse if he or she
anticipates or detects certain significant complications with your pregnancy,
including:
·
a history or threat of miscarriage
·
a history of pre-term labor (you've previously
delivered a baby before 37 weeks) or signs indicating the risk of
pre-term labor (such as premature uterine contractions)
·
unexplained vaginal bleeding, discharge, or
cramping
·
leakage of amniotic fluid (the fluid that surrounds
the baby)
·
placenta previa, a condition in which the placenta
(the blood-rich structure that nourishes the baby) is situated down so low that
it covers the cervix (the opening of the uterus)
·
incompetent cervix, a condition in which the cervix
is weakened and dilates (opens) prematurely, raising the risk for miscarriage
or premature delivery
·
multiple fetuses (you're having twins,
triplets, etc.)
What are the risks, if any, to my baby? You
should not have sex with a partner whose sexual history is unknown to
you or who may have a sexually transmitted disease, such as herpes,
genital
warts, chlamydia, or HIV.
If you become infected, the disease may be transmitted to your baby, with
potentially dangerous consequences.
What can I do about it? Talk to your doctor about any
discomfort you experience during or after sex or any other concerns.
Back to List
Tap/Drinking Water
Should I avoid it? Not necessarily. Before you go out and buy
a 9-month supply of bottled water, tell your doctor where you live and whether
you have public water or well water.
It's also important to note that just because water is bottled doesn't
necessarily mean it's safer. Although bottled water (which is regulated by the
FDA) may often taste better or just different, tap water meets the same
Environmental Protection Agency (EPA) standards.
What are the risks, if any, to my baby?
Different studies show different things, according to the March of Dimes. Some
have found that the chlorine used to treat public water can turn into
chloroform when it mixes with other materials in the water, which can increase
the risk of miscarriage and poor fetal growth. But other studies have found no
such links. Also of concern to some is the potential for the water to be
contaminated by things like lead and pesticides. If you have well water you should
probably have it checked regularly, such as once a year, whether you're
pregnant or not.
What can I do about it? If you're concerned, contact
your local water supplier to get a copy of the annual water quality report. If
you're still concerned and/or have private well water, have your water tested
by a state-certified laboratory. This can cost anywhere from $15 to hundreds,
depending on the number of contaminants you want to have your water tested for.
To help ease your mind, you could also buy a water filtration system to
help reduce the levels of lead, some bacteria and viruses, and chemicals such
as chlorine. But be sure to read the product's label thoroughly, as some do
more than others.
Countertop pitcher and faucet-mounted units are fairly inexpensive (some
for under $50), whereas systems used to treat your entire home's water supply
are much pricier (up to thousands of dollars). You can also have refillable
water coolers delivered to your home, often through wholesale — or bulk items —
stores.
Back to List
Teeth Whiteners/Teeth Bleaching
Should I avoid them? Maybe. As with self-tanners, no good studies have
been done on teeth whiteners that definitively say whether they're safe to use
if you're expecting. And some makers of whitening products do caution against
using them during pregnancy. Some dentists encourage waiting until after
pregnancy to get your teeth whitened and others say that the procedures are
safe. The concern is primarily about the chemicals used in teeth whitening
products that could be swallowed and the potential effect on a fetus.
What are the risks, if any, to my baby? There's currently no evidence
that teeth whitening can harm a fetus.
What can I do about it? Talk to your doctor before
plunking down the cash on whitening products. If you'd rather wait until after
your pregnancy to try to make your teeth pearly white, simply brush regularly
with whitening toothpaste, which may give a little extra kick to your smile.
Back to List
Vaccinations
Should I avoid them? Many — yes; others — no. It's best to wait
until after your pregnancy for most vaccines, but a few are considered
safe. Your doctor may say it's OK to get a vaccine if:
·
there's a good chance that you could be exposed to
a particular disease or infection and the benefits of vaccinating you outweigh
the potential risks
·
an infection would pose a risk to you or your baby
·
the vaccine is unlikely to cause harm
However, the CDC recommends only these vaccines as safe during pregnancy
if they're truly necessary:
·
influenza (the flu) — but only the shot
made with the inactivated virus
·
rabies
What are the risks, if any, to my baby?
Live-virus vaccines — those containing a live organism — aren't recommended for
pregnant women because of the risk that the actual infection or disease the
vaccine is meant to prevent may be passed along to the unborn baby. However,
this depends on the circumstances and whether the vaccine would ultimately be safer
to receive than being exposed to the actual disease. For example, the chickenpox
vaccine may be safer to your unborn baby than getting the infection. So, it's
important to speak to your doctor if you believe that you may have been exposed
to a disease.
For the most part, though, researchers don't know what the risks of some
vaccines may be to a fetus. So, it's wise to just wait to be vaccinated unless
your doctor tells you otherwise.
What can I do about it? Be sure to talk to your doctor
before getting any vaccination during pregnancy. It's also a good idea
to inform your doctor if you became pregnant within 4 weeks of having a
vaccine. And if your workplace requires certain vaccines, be sure to let them
know you're pregnant before agreeing to be immunized.
Back to List
X-Rays
Should I avoid them? Yes and no. If your doctor thinks it's truly
necessary — for your own well-being or your baby's — to get one during your
pregnancy, then it's highly unlikely that low levels of X-ray radiation will be
harmful. However, if you can safely wait to get an X-ray until after your baby
is born, then that's probably the best way to go.
What are the risks, if any, to my baby?
According to the American Academy of Family Physicians (AAFP), X-rays are most
likely safe during pregnancy. Most diagnostic X-rays emit much less than 5
rads, which is the limit of what the FDA suggests a pregnant woman should be
exposed to.
Different imaging studies emit different amounts of radiation and the
direction of the X-ray beam also affects the possible exposure to the fetus.
Dental X-rays, for example, aren't cause for much concern because the X-ray
area is far from your uterus. However, researchers believe that a fetus is more
susceptible to damage by radiation because of the rapid rate with which their
cells are dividing.
What can I do about it? First, make sure that all of
your health care providers (including your dentist and the X-ray technician)
know about your pregnancy before you get an X-ray. Also make sure that your
stomach is covered with a lead apron.
If you're concerned and would rather not get an X-ray at all during
pregnancy, your doctor may be able to use an MRI (magnetic resonance imaging)
test during the first trimester or an ultrasound anytime.
Putting It All in Perspective
Although some things are certainly considered unsafe during pregnancy,
try not to spend too much time wondering and worrying. When in doubt, just use
common sense — if it seems like a bad idea, doesn't need to be done right now,
or might be risky, hold off at least until you've had a conversation with your
doctor about it. He or she can likely help ease your mind and may even give you
license to do something you never expected to be able to do until after your
special delivery.
Above all, make sure to follow the most important healthy pregnancy
habits — eat right; get plenty of rest; steer clear of drugs, alcohol, and
tobacco — and you'll be well on your way to keeping both you and your baby
healthy.
#########################################################
Pregnancy also can cause a number of uncomfortable, although not
necessarily serious, side effects, including:
·
nausea and vomiting, especially early in the
pregnancy
·
leg swelling
·
varicose veins in the legs and the area around the
vaginal opening
·
hemorrhoids
·
heartburn and constipation
·
backache
·
fatigue
·
sleep loss
If you experience one or more of these side effects, keep in mind that
you're not alone! Talk to your doctor about strategies for alleviating any
discomfort.
Pregnancy symptoms
During pregnancy a woman's body undergoes a number of changes to allow
the fetus to develop inside the womb. These changes can cause various symptoms,
but these are not usually serious and tend to disappear without any treatment
during pregnancy or soon after the birth.
Nausea and vomiting
Widely known as morning sickness, feeling or being sick during pregnancy
normally occurs from about the sixth until the fourteenth week of pregnancy.
However it can start as early as the first missed menstrual period and continue
until later into the pregnancy. Although the name suggests nausea and vomiting
occur only in the morning, they often occur throughout the day.
The exact cause is unknown, but it is thought to be linked to hormone
changes. It is rare for vomiting to cause a serious medical problem.
Nausea and vomiting usually stops by about week 14 of pregnancy, without
the need for any medical treatment. There is evidence that taking ginger
capsules can help. Ginger tea or ginger biscuits may also be helpful. Some
women find that eating dry crackers before getting out of bed in the morning
can be effective.
Any woman with severe sickness that does not stop should seek medical
advice. Severe vomiting can interfere with nutrition and can cause dehydration.
The medical term for it is hyperemesis gravidarum, and it may require hospital
treatment.
Urinary symptoms
In the first three months of pregnancy, many women find that they need
to pass water more often than normal. This is a result of hormonal changes, and
because the enlarging womb pushes on the bladder resulting in a smaller bladder
capacity. This frequent need to urinate is also common in the four weeks before
the birth, as the baby's head enters the pelvis and further presses on the
bladder.
During the rest of pregnancy, there is an increased risk of developing a
urinary infection. This is because hormones and the enlarging uterus can slow
the passage of urine out of the body.
To help prevent urinary infections, women should drink plenty of fluids
and not delay when they get the urge to pass water. Drinking cranberry juice
may also help.
If a urinary infection is not treated, it may spread upwards to the
kidneys and damage them, so it is important not to ignore any pain or burning
sensation on passing water. If the symptoms continue, a doctor may need to
prescribe antibiotics.
Fatigue
Extreme tiredness is very common in pregnancy, especially during the
first 12-15 weeks, because the woman's body is under extra strain.
To help cope with this, women may want to take naps whenever possible,
and try to go to bed earlier.
Extreme fatigue can sometimes be a symptom of anaemia. Any woman who is
worried about this should speak to her doctor, midwife or obstetrician.
Constipation
Constipation is common in pregnancy for several reasons. Hormone changes
slow the passage of food through the gut, while the growing uterus can put
pressure on the rectum. Iron supplements, often given to prevent or treat
anaemia in pregnancy, can also make constipation worse.
Drinking at least six to eight glasses of water per day, and eating a
diet rich in fresh fruit and wholegrain foods can help prevent or relieve
constipation. For more information on diet during pregnancy, please see the
separate factsheet on Antenatal care.
Breast soreness
Sensitive, tender or sore breasts are commonly one of the first signs of
pregnancy. This usually improves after the first trimester. Wearing a
comfortable, supportive maternity bra should help.
Itchy skin
About 20% of pregnant women get some kind of skin itchiness. When this
occurs over the abdomen, it is probably caused by the skin stretching. But it's
also common to have itchy palms and soles of the feet, which is thought to be
caused by increased hormone levels.
Itchiness can usually be relieved by applying a simple moisturiser such
as aqueous cream, which is available inexpensively from pharmacies.
In rare cases, generalised itchiness in the third trimester can be a
sign of a liver problem called obstetric cholestasis. Any woman with widespread
itching should consult her GP or obstetrician.
Backache
Backache can occur in pregnancy owing to the increasing size and weight
of the womb and the breasts, and because pregnancy hormones loosen the
ligaments that attach the spine to the pelvic bone.
Backache may be relieved by resting, having warm baths, or massage. If
pain is severe, a doctor may prescribe painkillers (such as paracetamol) that
are safe to take in pregnancy.
Leg cramps
Leg cramps can occur during pregnancy. The exact cause of these is
unknown, but doctors think they may be related to changes in the blood
circulation in the legs, and the extra weight being carried. Leg cramps are
most likely to happen in the second and third trimesters of pregnancy.
Leg cramps may be relieved by stretching, walking, warm baths and
massage.
Swollen ankles
Swelling (oedema) can affect the extremities, especially the ankles and
toes, often later in pregnancy. The swelling happens when the enlarged womb
presses on the veins that come up from the legs, leading to accumulation of
fluid around the ankles.
Swollen ankles may be relieved by elevating them when sitting, wearing
waist-high support tights and exercising.
Pins and needles
Pins and needles, especially in the hands, can be accompanied by some
pain or numbness and occasionally weakness in the fingers. Usually this is
caused by fluid build-up around the wrists, which compresses the nerves that
run to the hand muscles and skin. This is known as carpal tunnel syndrome and
tends to occur when there is also swelling in the ankles. For more information,
please see the separate BUPA factsheet on Carpal tunnel syndrome.
If finger pain or numbness is an ongoing problem, a doctor may suggest
wearing a moulded wrist splint, especially at night.
Varicose veins
These are enlarged veins, usually in the legs. They often develop or
become worse during pregnancy because the growing uterus puts extra pressure on
the veins in the pelvis and legs, and because hormones cause the walls of blood
vessels to relax.
Pregnant women can help to relieve the symptoms or reduce the risk of
getting varicose veins by getting regular gentle exercise, not crossing their
legs when sitting, putting their feet up when possible, and putting on support
tights or stockings before getting out of bed in the morning.
Varicose veins often improve or disappear after the baby is born. For
more information, see the separate factsheet on Varicose veins.
Piles
Piles (haemorrhoids) may first appear or become worse during pregnancy
and result from changes in the circulation of blood around the pregnant woman's
body. They may also develop during labour when the woman is pushing.
Women can reduce the risk of getting piles by making sure they don't
become constipated, and not ignoring the urge to open their bowels. Piles can
be relieved with over-the-counter creams, available from pharmacies. Taking
warm baths is helpful for some women.
Like varicose veins, piles often improve or disappear completely after
the baby is born, but occasionally surgery is needed. For more information,
please see the separate factsheet on Piles.
Medical problems
The symptoms described so far are common in a normal pregnancy and
generally clear-up without medical treatment. However, there are a number of
less common pregnancy-related conditions that may need medical treatment. For
more information, please see the separate factsheets on Anaemia, Pre-eclampsia,
DVT and Diabetes in pregnancy.
Identifying problems
Pregnant women should attend regular antenatal appointments so that any
problems with the pregnancy are picked up. The GP, midwife or obstetrician will
ask about any symptoms, and conduct a number of tests. These include:
·
monitoring blood pressure
·
monitoring weight, which can increase more than
expected if a woman retains a lot of fluid
·
taking a urine sample - a simple dipstick can
immediately indicate any sugar, protein or blood in the sample, which can help
identify an infection
·
a blood test, which is taken at the start of
pregnancy and then as required during pregnancy to check for anaemia
For more information please see the fact sheet Tests in pregnancy.
Any woman who is worried about her symptoms can seek advice from her antenatal care provider at any time.
Pregnant women are typically cared for by:
·
obstetricians (doctors who specialize in pregnancy
and childbirth)
·
obstetricians/gynecologists (OB/GYNs) (doctors who
specialize in pregnancy and childbirth, as well as women's health care)
·
family practitioners (doctors who provide a range
of services for patients of all ages - in some cases, this includes obstetrical
care - instead of specializing in one area)
·
certified nurse-midwife (an advanced
practice nurse specializing in women's health care needs, including prenatal
care, labor and delivery, and postpartum care for "normal"
pregnancies)
Any of these care providers is a good choice if you're healthy and
there's no reason to anticipate complications with your pregnancy and delivery.
However, nurse-midwives do need to have a doctor available for the delivery in
case a cesarean section has to be performed.
Your health care provider may refer you to a doctor with expertise in
high-risk pregnancies if you:
·
have a chronic condition like diabetes or heart
problems
·
have an increased risk of preterm
labor
·
are older than 35
·
have some other complicating factor that might put
you in a high-risk category
Even if your pregnancy isn't high risk, this may still be a good time to
make a change in health care providers if you're not comfortable with your
current doctor.
Your First Visit
Your first examination should take place during the first 6 to 8 weeks
of your pregnancy, or when your menstrual period is 2 to 4 weeks late. Seeing
your health care provider during this time will help him or her estimate the
duration of your pregnancy and predict your delivery date.
During your first visit, you can expect to have a full physical,
including a pelvic and rectal examination. A blood sample will be taken and
used for a series of tests:
·
a complete blood cell count (CBC)
·
blood typing and screening for Rh antibodies
(antibodies against a substance found in the red blood cells of most people)
·
for syphilis, hepatitis, gonorrhea, chlamydia, and
other sexually
transmitted diseases (STDs), including human
immunodeficiency virus (HIV)
·
for evidence of previous exposure to chickenpox
(varicella), measles (rubeola), mumps,
or German measles (rubella)
·
for cystic fibrosis (health care providers have
just recently started to routinely offer this to individuals even if there's no
family history of the disorder)
Women of African or Mediterranean descent are usually tested for sickle
cell trait or disease because they're at higher risk for having sickle
cell anemia - a chronic blood disease - or carrying the trait, which
can be passed on to their children.
During the first visit, you also can expect to provide a urine sample
for testing and to have a Pap test (or smear) for cervical cancer. To do a Pap
smear, your health care provider uses what looks like a very long mascara wand
or cotton swab to gently scrape the inside of the cervix (the opening to the
uterus that's located at the very top of the vagina). This doesn't hurt at all;
some women say they feel a little twinge, but it only lasts a second.
Routine Visits and Testing
If you're healthy and there are no complicating risk factors, you can expect
to see your health care provider:
·
every 4 weeks until the 28th week of pregnancy
·
then every 2 weeks until 36 weeks
·
then once a week until delivery
At each examination, your weight and blood pressure are usually
recorded. The size and shape of your uterus may also be measured, starting at
the 22nd week, to determine whether the fetus is growing and developing
normally.
During one or more of your visits, you'll be asked to provide a small
urine sample to be tested for sugar and protein. Protein may indicate
preeclampsia (a condition that develops in late pregnancy and is characterized
by a sudden rise in blood pressure and excessive weight gain, with fluid
retention and protein in the urine).
Screening for diabetes usually takes place at 12 weeks for women who are
at higher risk of having gestational diabetes (diabetes that occurs during
pregnancy). That includes women who:
·
have previously had a baby that weighs more than 9
pounds (4.1 kilograms)
·
have a family history of diabetes
·
are obese
·
are older than 30
All other pregnant women are tested for diabetes at 28 weeks. This test
involves drinking a sugary liquid and having a blood glucose test (which
involves having blood drawn) after an hour. If the sugar level in the blood is
high, it's tested again in 3 hours to determine if the woman has gestational
diabetes.
Many expectant parents also choose to have one or more of the following prenatal
tests, which can help predict the likelihood, or even detect the
presence, of certain developmental or chromosomal abnormalities in the fetus:
Alpha-fetoprotein screening (AFP): Between 16 and 18 weeks, the level of
alpha-fetoprotein, a protein produced by the fetus, can be measured in the woman's
blood. If the level is high, she may be carrying more than one fetus or a fetus
with spina
bifida or other neural tube defects. A high level can also indicate
that the date of conception was miscalculated. If the level is low, the fetus
may have chromosomal abnormalities, such as Down
syndrome. It's important to keep in mind that low or high results
don't automatically indicate a problem; rather, they indicate the need for
further testing, which yields normal results in many cases.
Multiple marker screening (also called a maternal serum screening,
triple screen, triple marker, quadruple screen, quad screen, quadruple marker,
or quad marker): Also between 16 and 18 weeks, your health care provider may
measure the levels of certain hormones in your blood, along with AFP. For this
screening, a sample of blood is drawn from the mother to measure the level of
AFP, as well as the levels of hCG (human chorionic gonadotropin) and estriol,
which are produced by the placenta. The levels of these three substances (which
is why the test is often called the triple screen or triple marker) in the
blood can help doctors identify a fetus at risk for certain birth
defects or chromosomal abnormalities. The test is called a quadruple
screen (or marker) when the level of an additional substance, called inhibin-A,
is also measured.
Amniocentesis (also called an amnio): In this test, a needle is
used to remove a sample of the amniotic fluid in the womb; it's generally
performed between 16 and 20 weeks. Testing the fluid can identify certain fetal
abnormalities such as Down syndrome or spina bifida. Typically, amniocentesis
is recommended only if there is reason to believe that the risk for such
conditions is higher than usual, perhaps due to maternal age (35 or older),
abnormal AFP or multiple marker screening results, or family history. Although
the test poses a small risk for causing preterm labor and inducing miscarriage,
the large majority are performed without any problem.
Chorionic villus sampling (CVS): This procedure is used during the first
trimester for the same purposes as an amniocentesis. (Women usually have one or
the other, but not both, if such testing is deemed necessary.) It involves
taking a sample of the tissue that attaches the amniotic sac (the sac around
the fetus) to the wall of the uterus. Like amniocentesis, CVS is typically done
only when there are certain risk factors; its primary advantage is that results
are available sooner. CVS also carries a slightly increased risk of miscarriage
and other complications.
Ultrasound (also called a sonogram, sonograph, echogram, or
ultrasonogram): You'll likely have at least one ultrasound examination to make
sure the pregnancy is progressing normally and to verify the expected date of
delivery. Usually, an ultrasound is performed at 18 to 20 weeks to look at the
baby's anatomy, but can be done sooner or later and sometimes more than once.
An ultrasound poses no risk to you or your baby.
Some health care providers may have the equipment and trained personnel
necessary to provide in-office ultrasounds, whereas others may have you go to a
local hospital or radiology center.
Wherever the ultrasound is done, a technician will coat your abdomen
with a gel and then run a wand-like instrument over it. High-frequency sound
waves "echo" off your body and create a picture of the fetus inside
on a computer screen.
Ultrasound scanning is used to:
·
determine whether the fetus is growing at a normal
rate
·
record fetal heartbeat or breathing movements
·
see whether you might be carrying more than one
fetus
·
identify a variety of abnormalities that might
affect the remainder of the pregnancy or delivery
There are ultrasounds that are available at shopping malls as a way to
have a "portrait" of your baby. However, the
individuals using the equipment are not necessarily trained as ultrasound
technicians. Before committing to having one of these done, it would be wise to
discuss it with your health care provider first.
Common Concerns
Some women are concerned about preexisting medical conditions, such as
diabetes, and how they could affect a pregnancy. It's important to discuss
these concerns with your health care provider. He or she may recommend a change
in medication or treatment approaches that could ease your concerns.
Whether or not you have a preexisting condition, you may be concerned
about some of the other conditions that can be associated with pregnancy
including:
·
gestational diabetes:
Roughly 2% to 3% of women develop this condition during pregnancy, usually
after the first trimester. During pregnancy, the placenta, which provides the
fetus with nutrients and oxygen, also produces hormones that change the way
insulin works. Insulin is a chemical that's made by the pancreas. It helps the
body store the sugar in food so that later it can be converted to energy.
Gestational diabetes can develop when the woman's pancreas can't make enough
extra insulin.
·
preeclampsia (also called toxemia of pregnancy): An
abnormal condition that develops after the sixth month, it causes high blood
pressure, edema (accumulation of fluid in body tissues resulting in swelling of
the hands and face), and protein in the urine.
·
Rh-negative mother/Rh-positive fetus: Rh
factor is a substance found in the red blood cells of most people (a
simple blood test can determine your Rh factor). If you don't have it, then
you're considered Rh negative. If your baby does have the factor and is Rh
positive, problems can result when the baby's blood cells enter your
bloodstream. That's because your body may react by producing antibodies that
can pass into the fetus' bloodstream and destroy red blood cells.
These conditions are serious but manageable, so it's important to
educate yourself about them and discuss them with your health care provider.
Pregnant women also frequently worry about weight gain. It's generally
recommended that a woman of normal weight gain approximately 25 to 30 pounds
during pregnancy - about 2 or 3 pounds each month. For individuals who start
their pregnancy overweight, their total weight gain should be closer to 15 to
25 pounds. And those who are underweight should gain 28 to 40 pounds.
Pregnancy is not a good time to start a diet, however, it can be a great time to
start eating healthy food if you didn't before. It's also a good time to get
regular, low-impactexercise
Controlling weight gain is more difficult later in a pregnancy, so try
to avoid gaining a lot of weight during the first few months. However, not
gaining enough weight can cause problems too, such as inadequate fetal growth
and premature labor.
Taking Care of Yourself
For your baby's sake and yours, it's important to take especially good
care of yourself during your pregnancy. Follow the basics:
·
Don't smoke, drink alcohol, or take drugs.
·
Get enough rest.
·
Eat a healthy diet.
Doctors generally recommend that women add about 300 calories to their
daily intake to provide nourishment for the developing fetus. Although protein
should supply most of these calories, your diet needs to be well-balanced,
including fresh fruits, grains, and vegetables. Your health care provider will
likely prescribe a prenatal vitamin to make sure you get enough folic acid, iron, and calcium.
Over-the-counter medications are generally considered off-limits because
of their potential effects on the fetus. Most doctors will recommend that you
don't take any over-the-counter medications at all, but they might offer a list
of those they think are safe to take. Be sure to discuss any questions about
medications, including natural remedies, supplements, and vitamins, with your
health care provider.
When you're pregnant, it's also important to avoid food-borne illnesses,
such as listeriosis and toxoplasmosis,
which can be life threatening to an unborn baby and may cause birth
defects or miscarriage. Foods you'll want to steer clear of include:
·
soft, unpasteurized cheeses (often advertised as
"fresh") such as feta, goat, Brie, Camembert, and blue cheese
·
unpasteurized milk, juices, and apple cider
·
raw eggs or foods containing raw eggs, including
mousse and tiramisu
·
raw or undercooked meats, fish, or shellfish
·
processed meats such as hot dogs and deli meats
(these should be well cooked)
You should also avoid eating shark, swordfish, king mackerel, or
tilefish, as well as limit the amount of other kinds of fish that you eat.
Although fish and shellfish can be an extremely healthy part of your pregnancy
diet (they contain beneficial omega-3 fatty acids and are high in protein and
low in saturated fat), these types of fish may contain high levels of mercury,
which can cause damage to the developing brain of a fetus.
Pregnancy also can cause a number of uncomfortable, although not
necessarily serious, side effects, including:
·
nausea and vomiting, especially early in the
pregnancy
·
leg swelling
·
varicose veins in the legs and the area around the
vaginal opening
·
hemorrhoids
·
heartburn and constipation
·
backache
·
fatigue
If you experience one or more of these side effects, keep in mind that
you're not alone! Talk to your doctor about strategies for alleviating any
discomfort.
Talking to Your Health Care Provider
When your body is going through physical changes that may be completely
new to you, it isn't always easy to talk to your health care provider. Maybe
you're wondering whether you can have sex or what to do about hemorrhoids or
constipation, or maybe you're feeling a great deal of anxiety about the delivery.
You might feel embarrassed to ask these or other questions, but it's
important to do so - your health care provider has probably heard them all
before. Keep a running list of questions between your appointments, and take
that list with you to each visit.
It's also strongly recommended that you call your health care provider
immediately if you experience:
·
heavy bleeding
·
a sudden loss of fluid
·
a marked absence of movement by the baby once he or
she has begun moving
·
more than three contractions in an hour
What you need to know:
Unless your health care provider advises you
otherwise, sex during pregnancy is safe for you and the baby. The baby is
protected by the amniotic fluid in the womb and by your abdomen.
Some women with high-risk pregnancies are advised
to avoid intercourse during pregnancy. Your health care provider will tell you
if you have a high-risk pregnancy.
What you can do:
If you are concerned, ask your health care provider
if it’s okay to have sex.
Talk to your partner about each of your needs and
concerns in an open and loving way. If you work together, you can probably
figure out how to put a smile on each other’s face.
To avoid sexually transmitted infections, have sex
with only one person who doesn’t have any other sexual partners and/or use a
condom when having sex. Discuss HIV testing for you and your partner with your
health care provider.
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