FROM CONCEPTION TO 16 WEEKS
We only forgot the condom once. How could I be pregnant?
An egg lives for twenty-four hours after you ovulate. However, sperm can live for up to five days. If you have had unprotected sex within five days of ovulation, you can get pregnant.
I’ve done six home pregnancy tests, and all are positive. How accurate are they?
Most home pregnancy tests on the market are very sensitive and accurate. Some can detect pregnancy as early as ten days after conception. A chemical that reacts with hCG, the hormone produced in pregnancy, is used. Always follow product directions for the most accurate results.
How can I be sure I’m pregnant?
You may have symptoms of pregnancy, all caused by a combination of two hormones, progesterone and human chorionic gonadotropin (hCG). These symptoms include:
- Breast tenderness
- Breast enlargement
- Mood swings
- Frequent urination
Signs of pregnancy include:
- A missed period
- Skin changes
- Changes in your breasts
Evidence of pregnancy includes:
- A positive pregnancy test
- Increased size of the uterus
- Softening of the uterus and cervix
Can I exercise during pregnancy?
Your regular exercise program probably can be continued during your pregnancy, with some modifications. Just be sure to check with your provider first.
Here are a few helpful hints:
- You’ll probably need to cut down on the intensity of your workout, because your need for oxygen increases when you’re pregnant
- Make sure you drink plenty of water at all times
- If you’re tired, stop
- Don’t push yourself
- Always be sure to warm-up and cool-down before and after exercising
I have an excellent diet. Why should I take vitamins?
In addition to increasing your calories by 300 per day, pregnant women need additional nutrients, vitamins, minerals and trace elements to grow a healthy baby. Zinc, calcium, iron, and proper doses of vitamins A, C, and D are all essential. These are all supplied in a good prenatal vitamin.
Be sure to avoid regular or children’s multi-vitamins because they contain high levels of vitamin K, which can harm your baby. Diets don’t always give you an adequate amount of the essential nutrients.
What’s my due date?
Your expected due date is based on the date of your last menstrual period. Subtracting three months from your last menstrual period, and then adding seven days can make a close approximation. A normal human pregnancy lasts from 266 to 294 days. The average is 280 days, or forty weeks.
What can I do for morning sickness?
Morning sickness, which can occur any time of the day, usually lasts until the twelfth or thirteenth week of pregnancy. Most of what you eat is rapidly turned to glucose to feed the baby. Because of this, you can develop low blood sugar, which can cause nausea.
Sensitivity to pregnancy hormones also can cause morning sickness. The nausea of pregnancy may increase when you have an empty stomach. Some helpful things you can try are:
- Eat frequent small meals
- Eat dry crackers or dry toast before getting out of bed in the morning and between meals
- Avoid fried, spicy, or fatty foods
- Get out of bed slowly in the morning
- Avoid long periods of time between meals
If you aren’t able to keep anything down for 24 hours, you should call your provider. This may be a sign of a condition called hyperemesis gravidarum, which is severe nausea and vomiting during pregnancy. When you’re vomiting, you can quickly become dehydrated and lose electrolytes that keep your body functioning properly.
I don’t have morning sickness. Is something wrong?
You’re lucky! Some women are more sensitive to the hormone changes of pregnancy than others. If you don’t have morning sickness, this doesn’t mean there’s a problem with the pregnancy.
Can I still have sex? Will it hurt the baby?
You can have sex during pregnancy as long as it’s comfortable, there’s no bleeding, no ruptured membranes, and no history of premature labor. Changing positions as pregnancy advances may be more comfortable. Sex will not hurt the baby.
Can I go to the dentist?
Absolutely. Good dental hygiene and care are essential. Always inform the dentist that you’re pregnant and avoid unnecessary x-rays. Your provider should clear any anesthetics or medications before they’re administered. The best time for routine dental work during your pregnancy is the second trimester.
How much weight should I gain? Why so much?
A healthy weight gain in pregnancy is 25 to 35 pounds for an average-sized woman. A good approximation is: five to seven pounds during the first 13 weeks, 10 to 14 pounds during the second 13 weeks, and 10 to 14 pounds during the last 13 to 14 weeks.
What are my chances of miscarriage?
Twenty-five to 35 percent of all pregnancies end in miscarriage. Seventy-five to 90 percent of these occur very early in the pregnancy, sometimes even before a woman realizes that she’s pregnant. If you have any bleeding early in your pregnancy, call your provider immediately. However, bleeding does not always mean you’ll miscarry.
I’ve been having cramps. Is something wrong?
Menstrual-like cramps are not uncommon in early pregnancy. This doesn’t mean that anything is wrong. If they persist for long periods of time, become severe, or are accompanied by bleeding, you should notify your provider immediately. This could be a sign of miscarriage or ectopic pregnancy. An ectopic pregnancy is a pregnancy that occurs outside of the uterus. The most common location for this is in the fallopian tube.
Why am I tired all the time?
Increased demands on your body’s energy and the sedative effect of increased progesterone in pregnancy are two of the reasons that you may feel tired. Get as much rest as you can.
Why do I have to go to the bathroom all the time?
Frequent urination in early pregnancy is the result of increased kidney function that rids the body of waste products and toxins for both you and your baby. Avoid hot or iced teas, since tea has a mild diuretic effect. Always drink plenty of water to replace what your body has lost.
In later pregnancy, frequent urination is caused by the weight of the uterus and baby on your bladder. This doesn’t allow your bladder to fill before you feel like you have to use the bathroom again.
Can I use a microwave? A computer?
Yes, microwave ovens have safety shields built in that protect against leaks. Even if there were a leak, you would have to stand very close for a long period of time for any harm to occur.
Multiple studies have been done and have determined that video display terminals of computers do not cause birth defects or miscarriages.
I’m not a teenager anymore. Why is my face breaking out?
Skin changes are common during pregnancy. Every woman is different in her response to changes in hormone levels and in each pregnancy. There’s no way to predict how hormones will affect you. Changes that can be seen include:
- Pigmentation changes
- Spider veins
- Blotchy skin
- Increased sensitivity to cosmetics
The best way to minimize the effects is to keep your skin scrupulously clean.
Can I be in the sun?
As long as you use a good sunscreen (SPF 30 or above) liberally and avoid the sun during peak hours of the day, you can be in the sun. Keep well hydrated and don’t get overheated. Apply moisturizer liberally when you come out of the sun.
Can I dye, bleach, or perm my hair?
Metallic dyes, bleach, and permanent solutions are unpredictable during pregnancy. You should avoid the fumes of metallic dyes. Be sure to let your hairdresser know that you’re pregnant and they may be able to use natural vegetable hair products.
When will I be able to hear my baby’s heartbeat?
The baby’s heartbeat can usually be heard by the eighth week of your pregnancy.
What is CVS?
CVS, or chorionic villus sampling, is a test for chromosomal abnormalities. For women at risk, this test is usually performed between the ninth and twelfth week of pregnancy. A small amount of placental tissue is removed from the uterus using a thin plastic catheter inserted through the cervix. The tissue is then grown in a culture and the chromosomes examined for abnormalities. The advantage of CVS is that it’s performed early in pregnancy, so that a woman is alerted to any potential problems well in advance.
What can I do for constipation?
Due to the smooth muscle relaxing effects of progesterone, food travels through the digestive system at a slower pace during pregnancy. As this occurs, more water is absorbed from the contents of the colon, creating a harder stool. Iron in your prenatal vitamins also may contribute to constipation. Increasing the amount of water and fiber in your diet should help. If constipation becomes a problem, ask your provider if he or she can recommend a safe laxative or stool softener.
Can I fly during pregnancy? For how long?
You can fly without restriction on most airlines until 32 weeks. After 36 weeks, airlines may require written notice from your provider as to the safety of air travel. However, some precautions are in order:
- Get up and move around every hour
- Drink at least 32 ounces of water for every two to three hours in flight
- Keep your legs elevated, as much as possible
If you must fly after 32 weeks, you should take a copy of your medical records with you.
Will I need an amniocentesis?
If you’re going to be 35 years old when you have your baby, if you have a family history of genetic diseases, or if you have a child with a genetic problem, you may need to have an amniocentesis.
An amniocentesis is usually performed after the fifteenth week of your pregnancy. It analyzes your amniotic fluid for chromosomal abnormalities, enzyme defects, and other problems. If there’s a problem later in your pregnancy, an amniocentesis may be performed to determine the lung maturity of the baby before birth. Amniocentesis may also be used to determine the amount of bilirubin in the amniotic fluid in mothers who have Rh-isoimmunization.
How long can I work?
You may be able to work right up until you have your baby. This will depend on the type of work you do, the rules at your company, and whether or not you have any problems with the pregnancy. Many women work until the thirty-sixth to thirty-eighth week of their pregnancy.
Why should I wear low-heeled shoes?
The curvature of your spine changes as pregnancy progresses to accommodate the increased weight you’ll carry in the front of your body. High heels can throw off your balance as your pregnancy progresses. If you wear high-heeled shoes, it’ll also add to the strain on the front of your feet. You don’t necessarily have to wear flat shoes, but low heels are recommended.
Why do my breasts hurt?
Breasts are sensitive in early pregnancy due to engorgement of the blood vessels. Blood vessel walls contain both smooth muscle and connective tissue. The smooth muscles in the veins relax, which in turn causes the valves in the veins that push the blood along, to work inefficiently. Wearing a well-fitted support bra at all times, even while sleeping, may help. Your breasts may also hurt because of an increase in size since your milk ducts are expanding.
Why do I get short of breath so easily?
Sixty to 70 percent of pregnant women experience shortness of breath. Higher progesterone levels increase the amount of oxygen you take in with each breath. However, there’s also a decrease in the total volume of air a pregnant woman’s lungs can hold due to the increased size of the uterus. The exchange of oxygen for carbon dioxide in the lungs that occurs during pregnancy allows for easier disposal of the baby’s carbon dioxide through the mother’s blood as it circulates through the lungs. All of these factors contribute to the feeling of being short of breath.
I’ve been having strange and terrible dreams about my baby. Is this normal?
Strange, terrible dreams and nightmares are normal during pregnancy. These are not dreams foreshadowing a problem with your baby. They’re simply bad dreams that may be associated with normal anxieties as you deal with major changes in your life.
FROM 16 WEEKS TO 30 WEEKS
Why does my healthcare provider test my urine at each visit?
Urine is tested for the presence of glucose and protein. Glucose in urine may be a sign of diabetes and should be evaluated further. The presence of protein could be caused by urinary tract infections, which can be treated by antibiotics. The presence of protein also may be caused by kidney disease found in pre-eclampsia, or toxemia. This is a serious disorder and can occur in later stages of pregnancy.
Can my baby hear me?
Your baby’s sense of hearing develops by 16 weeks into your pregnancy. Your baby can hear you and everything that goes on around you. If you speak to your baby every day, she’ll get used to your voice. Other family members can talk to your baby, too!
I have a dark line that runs from my navel to my pubic bone. What is it?
The dark line is called the linea nigra and is caused by increased amounts of melanocyte-stimulating hormone that your body makes when you’re pregnant. It’ll fade after your baby is born, but won’t completely disappear.
What is alpha fetoprotein, and why do I need to have it checked?
Alpha fetoprotein, or AFP, is a substance produced by your baby’s liver and is excreted through the placenta into your blood. You can have a blood test between 15 and 20 weeks of pregnancy to determine the amount of the substance present. A high amount could indicate that the baby has a neural tube defect such as spina bifida, or “open spine.” The test can be positive five percent of the time and if it is, you’ll be given further tests. A detailed sonogram, or ultrasound, should be done to determine fetal age and another blood test may be taken. The score depends on the age of your baby.
A low amount of alpha fetoprotein may indicate Down syndrome. This test however, will only detect about 20 percent of babies with Down syndrome. A newer test, called a Triple Screen, evaluates two additional hormones or enzymes. It detects up to 70 percent of Down syndrome babies.
How can I prevent stretch marks?
You can’t, so save your money on all the creams and lotions that promise to prevent stretch marks. You can use lanolin and aloe, vitamin E oil, or vitamin E-fortified lotions to help the itching and to ease the discomfort of the skin stretching. Stretch marks will usually fade to a silver color within a year after your baby is born
Why do you measure how big I am?
The size of the uterus, measured in centimeters, corresponds roughly with the number of weeks you’re pregnant. For example, if you’re 32 weeks pregnant with a single baby, you should measure approximately 32 centimeters. Doing measurements each visit will determine the growth of your baby and whether or not he’s growing well and within normal limits. A slow or overly rapid growth can alert your provider to problems before they become emergencies. Further evaluations can then be made to determine your baby’s well being.
Should I still wear my seat belt?
Absolutely. Seat belts do save lives. Place the lap belt across your thighs and the shoulder belt above your growing uterus. Placing the belts in this manner will protect your baby from trauma should you be involved in an accident.
Do I need an ultrasound, or sonogram? Are they safe?
Ultrasounds, which are also called sonograms, can be done at various times and for various reasons during your pregnancy. Your provider may recommend that you have an ultrasound to:
- Identify anatomic or developmental abnormalities
- Check your baby’s age
- Assist in procedures such as amniocentesis
- Locate the placenta
- Confirm your baby’s position near your due date
- Check how well your baby is doing
Ultrasound screenings are safe for you and your baby. If you’re worried about the number of ultrasounds that you’re receiving, discuss this with your provider.
What causes varicose veins?
Varicose veins are hereditary. They can occur in the lower legs, upper legs, or vulva and are usually seen after 20 weeks of pregnancy. They occasionally occur before this time. Varicose veins are caused by:
- Dilation of the blood vessels in your lower extremities, due to the progesterone-induced relaxation of the vessel walls
- Increased fluid accumulation of pregnancy
- Increased weight of the uterus as your baby grows
If you have a family history of varicose veins, you can reduce the occurrence by:
- Keeping your legs elevated as much as possible during the day
- Wearing support stockings
- Avoiding stockings that are tight around the knees or upper thighs
- Avoiding standing as much as possible
- Elevating the foot of your bed at night
Varicose veins will usually disappear after the pregnancy.
Why am I getting so many yeast infections?
Yeast infections are common in pregnancy. Your body produces more glucose to feed your baby. This changes the glucose content of your vagina. The change allows yeast to grow more easily than when you’re not pregnant. Before using any over-the-counter preparations to treat your yeast infection, check with your provider.
My vision gets blurry sometimes. My contacts don’t feel right. Why?
Water retention in pregnancy may cause your corneas to thicken. Visual changes, such as blurred vision, are not uncommon during pregnancy. This usually resolves as the pregnancy progresses. Contact lenses may not be comfortable and you may not be able to tolerate them while you’re pregnant. You may need to wear your glasses. Most of the changes will revert back to normal after your pregnancy is over.
I get a pain on the sides of my uterus when I walk. What causes this? Is it normal?
This is round ligament pain. The round ligaments are two structures, one on each side of the uterus, that attach the uterus to the pelvis. They grow along with your uterus as your pregnancy progresses. However, the round ligaments do not grow quite as fast. At about 20 weeks of pregnancy your abdominal muscles are more lax. This allows the uterus to be more mobile as you walk. The movement will stretch the round ligaments, causing pain on the sides of your lower abdomen. This is normal in pregnancy. It’s not harmful to your baby — just uncomfortable for you.
Why do I need a test for diabetes?
Studies have shown that the risk of developing diabetes in pregnancy can be from one to 15 percent. Ninety percent of pregnant diabetics are women who have developed this new onset diabetes during their pregnancy. Babies of diabetic mothers are at a risk to develop:
- Respiratory distress syndrome, which is a condition where the baby has some difficulty breathing normally
- Macrosomia, which is an abnormally large baby
- Low blood sugar
- Low calcium
Since these conditions have the potential to be serious, all women are now screened for diabetes during pregnancy. A large percentage of women who do develop diabetes during pregnancy have no family history or risk factors, such as obesity.
To screen for diabetes, a concentrated glucose drink is given and then blood is taken and tested an hour later. If the results are higher than normal, a three-hour test then follows. Approximately 15 percent of women who have an abnormal screening test will actually have gestational diabetes. Gestational diabetes can usually be controlled by diet. Occasionally, though, insulin is required to control high blood sugar levels.
FROM 30 WEEKS TO DELIVERY
Will I need a cesarean section?
There are many reasons for a cesarean section. The following gives some of the common reasons that providers suggest, or even require, that you have a cesarean section. Check the glossary to confirm the meaning of some of these terms if they’re not familiar.
Reasons For Cesarean Section
- Placenta previa
- Prolapsed cord
- Previous classical C-section (vertical incision)
- Abruptio placenta
- Rh iso-immunization
- Maternal risk factors/maternal disease
Relative Reasons (During Labor)
- Cephalopelvic disproportion
- Non-reassuring fetal testing
- Prolonged rupture of membranes
- Arrest of labor
- Arrest of descent
I have herpes. Will I need a C-section?
Not necessarily. If you don’t have active lesions, you can have a vaginal delivery. However, if active lesions or symptoms are present, you’ll need a C-section. If the baby passes through the vagina when active lesions are present, he could contract herpes.
Will I ever sleep again?
It may seem that you’ll never get another night’s sleep. However, sleep disturbances are common later in pregnancy. Your baby hasn’t yet learned how to tell time and he can be active day and night. This may keep you from getting to sleep or wake you from a sound sleep.
As your pregnancy advances, the weight of your baby and your uterus may make it impossible to find a comfortable sleeping position. Some things that may help are:
- A warm bath before bed
- A glass of warm milk
- The use of a body sleep pillow
- The use of a pregnancy wedge
A pregnancy wedge is a piece of foam rubber cut in a triangular shape that runs at least half the length of your body at a slight angle. You can lean back against it and still not lie on your back.
What causes bleeding during pregnancy?
Bleeding during pregnancy can be caused by the following:
- An impending or threatened miscarriage
- An ectopic pregnancy
- Inflammation of your cervix
- Placenta previa
- Abruptio placentae
Bleeding is not a reason to panic, but it’s important to call your provider immediately, so that you can be checked.
What if I don’t deliver by my due date?
You may not deliver by your due date. Remember your due date is only an estimate of when your baby is due. If you don’t deliver by 41 weeks, your provider will verify that your baby’s doing well by running some tests. As long as your baby is fine, your pregnancy will be allowed to continue.
If you don’t deliver by 42 weeks, your provider may induce labor. If your cervix is dilated, your provider may admit you to the hospital and “break your water.” About 75 percent of women will go into labor within a few hours of this.
If you don’t go into labor, your provider may use pitocin in an IV to start your labor. The amount of pitocin will be slowly increased until you have three contractions in 10 minutes, or a contraction every three minutes. In most cases, labor will continue normally from that point.
Your provider may also choose to “jump start” your labor by introducing something called a prostoglandin agent into your vagina or cervix. This should cause your cervix to dilate, and your labor to begin.
Should I breastfeed?
Breastfeeding is a personal choice and may not be the right choice for everyone. First and foremost you must be comfortable with your decision, whichever way you choose to feed your baby.
The reasons for breastfeeding include:
- Breast milk is the perfect nutrition
- Breastfeeding is free
- Breastfed babies are statistically healthier
- The iron in breast milk is completely absorbed by the baby
- Breast milk will not constipate your baby
- Breast milk passes immunities to your baby
- Breastfeeding helps to develop the palate and facial muscles
- Breastfeeding is more convenient and always available
- Breastfeeding encourages maternal closeness
- Dad can give the baby a bottle of breast milk
- Mom may return to her pre-pregnancy weight more rapidly since breastfeeding burns calories
The reasons for bottle feeding include:
- You may have less risk for breast infections
- Anyone can feed your baby with a bottle, so Dad can enjoy the same feeling of closeness that Mom gets to experience
- Some medications are passed in breast milk
- Your baby may go longer between feedings, allowing you to have more time to rest
What prenatal classes should I take?
If early prenatal classes are offered, you should consider taking them. These classes teach nutrition, exercise for pregnancy, and development of the baby. They’re also a good opportunity to interact with other pregnant couples.
Prenatal or prepared childbirth classes are an excellent idea. They’ll prepare you for labor and delivery of your child and teach you to act as a team. They teach you methods to cope with normal childbirth. This will enable you to make childbirth and delivery choices based on knowledge rather than fear. There are many different classes offered. Most prepared childbirth classes today may encompass aspects from the many philosophies and methods available. The following is a brief description of the methods used today.
Lamaze: Lamaze is focused on control and breathing. By controlling your breathing as labor progresses, you can control pain or your perception of pain. Multiple types of breathing techniques are taught for the different stages of labor. Your partner or coach’s job is to monitor and help adjust the breathing pattern.
Bradley: Bradley teaches conditioning exercises and muscle relaxation in labor. A slow, deep breathing, take-your-time approach is advocated in a quiet, dimly lit environment. After she’s born, the baby is immediately placed on the mom’s breast.
Kitzinger: Using Lamaze breathing, Kitzinger advocates mental imagery to enhance relaxation. Touch, massage and visualization help to flow with the contraction, instead of fighting it.
Gamper: The key to the Gamper Method is the self-determination and confidence instilled by instructors in the ability of women to work and cooperate with the natural forces of childbirth. Classes begin in early pregnancy so the fear/tension/pain cycle can be broken. A normal, natural rate of breathing is taught.
Simkins: Couples are encouraged to use whatever means of breathing and style that helps them. An eclectic mix of techniques is taught.
Noble: This technique involves relaxation of the pelvic floor muscles and learning ways to relax them. This approach emphasizes women listening to their bodies.
LeBoyer: This method allows your baby to be born amid dim lights and soft voices. The baby is given a warm water bath and then placed on the mother’s abdomen for bonding. Because of this method and its effect on newborns, loud, harsh noises are no longer allowed in the delivery area.
Odent: Allowing women to labor and deliver in water is the newest method today. Since babies live in fluid for nine months, being born into water is not harmful at all.
You may also want to attend a C-section class if the prepared childbirth classes you choose don’t incorporate this into the lessons. This will let you know what to expect if a C-section delivery is necessary.
What is a mucus plug?
A plug of mucus is a collection of mucus that keeps your cervix impenetrable. You may pass your mucus plug up to two weeks before labor begins.
What is a bloody show?
This is mucus mixed with a small amount of blood and is usually seen during the earliest phase of labor.
Can I eat and drink if I’m in labor?
You should definitely keep yourself well hydrated. Avoid citrus and milk drinks. Good choices are water and clear fruit juices. You should eat lightly, as long as you’re not nauseous or vomiting. Toast, crackers, chicken soup, and bread are excellent choices.
How will I know when my water breaks?
Sometimes it happens just like you see in the movies and on television, with a big gush of fluid that soaks everything. Other times it may be a steady trickle of fluid that you may confuse with urine. The difference in passing urine and leaking fluid is simple. Urine will stop if you squeeze the muscle at the neck of your bladder, while amniotic fluid will continue to trickle. Many times when you rupture your membranes, you will have an initial gush of fluid, and then a steady stream of fluid will come out. This stream of fluid will usually get heavier during contractions.
Amniotic fluid should be clear and have no odor. If your amniotic fluid is colored or has noticeable odor, you should let your provider know right away.
When should I go to the hospital?
Each provider has different instructions about when she wants you to go to the hospital. Before you call your provider, you should have regular contractions. Usually, it's time to go to the hospital when your contractions are five minutes apart and last 45 to 60 seconds in length. However, you should discuss this with your provider.
What is an episiotomy? Will I need one?
An episiotomy is a cut made between your vagina and rectum, in the area called the perineum. It’s made to enlarge the vaginal opening to allow your baby to deliver more easily without tearing your perineal or vaginal tissues. Whether you need an episiotomy will depend on the amount of tissue in your perineum, the size of your baby, and your provider’s judgment on whether you’re going to tear.
How long will I be in the hospital?
The time you spend in the hospital will depend on the labor and method of delivery you have had, and on your provider. The usual time in the hospital for an uncomplicated vaginal delivery is 24 to 48 hours. A cesarean section will require more time in the hospital. This can be two to three days for an uncomplicated cesarean delivery.
How soon will my milk come in?
For the first two to three days after delivery, you’ll produce a thin opaque yellowish liquid called colostrum. After this, you’ll have milk “let down,” which means your breast milk will come in. With the milk let down, you may experience breast engorgement. You can use ice packs and acetaminophen to help ease the discomfort. Always wear a good supportive nursing bra.
If you’re bottle feeding, you should wear a tight bra immediately after delivery. You can also bind your breasts using a strip of material 10 to 12 inches wide and long enough to encircle your chest two to three times. Wrap the material around your chest and under your arms tightly. Re-wrap every few hours and wear the binding to bed. After a week to ten days, wear a good support bra 24 hours a day for several weeks or so, until your breasts are no longer producing milk.