Pregnancy and Tips for Health Care

INTRODUCTION

Congratulations! The miracle of life is taking place right inside your body. Enjoy these months and take care of yourself. While every pregnancy is different, the issues covered here will more than likely be important to you at some point in your forty-week term.

FIRST TRIMESTER

In the first trimester of pregnancy you will probably be exhausted. Your body is preparing for a life to implant itself in you for forty weeks and grow until there isn’t any more room to fit.

You should expect to experience mood swings, breast changes or discomfort, a need to urinate more frequently, possible dizziness, and nausea.

During this time you should have an extensive medical checkup which will confirm your estimated due date.

In utero, the egg is fertilized, causing a missed period. By week five your embryo has a beating heart, with brain and nervous system formations. By week ten the embryo begins to develop strong bones, organs start to move into place, and muscles form. By week fourteen sex organs have formed, vocal cords are complete, and the digestive system is almost fully formed.

Choosing a Doctor

If you haven’t already, now is the time to choose your doctor. Before scouting begins, it’s best to call your insurance provider for a listing of doctors that participate in your plan. Depending on your insurance provider, that list might be very small, leaving you with little choice on who will be delivering your new child.

Some questions you should consider include:

Do you want your health-care needs placed in the hands of an obstetrician/gynecologist (ob/gyn), a midwife, or a family practitioner?

An ob/gyn has special training in neonatal and maternal health care. A midwife is usually a certified nurse who has studied midwifery at an accredited institution. Many midwives participate in home births, assist you in the birthing experience that you prefer, and work with an ob/gyn in the event that one is needed. A family practitioner has had training in obstetrics and can care for you and your baby during your pregnancy and for your growing family for years to come. This is a very personal decision, so take your time to think about what type of care you prefer.

Do you prefer to have your health care needs placed in the hands of a single person or in those of several?

If you choose a solo practitioner, he will more than likely be the only obstetrician you see during your pregnancy and will be the doctor to deliver your baby. In a group practice you will see several and possibly all of the obstetricians available and the doctor on call will deliver your baby.

Once your list has been narrowed down, you can start “interviewing” your doctors. You will first want to make sure that the doctor you have chosen is accepting new patients and your insurance plan.

Morning Sickness

Feeling a little queasy? This is common during early pregnancy and is caused by normal changes in your hormone activity. Symptoms can appear as early as the fifth week and can last through your second trimester, rarely longer.

Morning sickness can hit at any time of the day, but luckily there are measures that can be taken to prevent the discomfort. Try eating small frequent meals, possibly even waking during the night. Not only will you be well nourished, but you will also fight bouts of queasiness. Keep yourself hydrated, drinking the recommended eight to ten glasses of water a day. Stay away from spicy foods, alcohol, or other foods that generally make you nauseous.

If your morning sickness continues your doctor might prescribe medication to keep you hydrated, which will prevent the nausea.

Work Issues

Knowing exactly when to tell your employer that you are having a baby is tough. Of course if you are experiencing morning sickness, you may have shared the news before you intended. It’s a good idea to set up a meeting with your boss. Let him know what your plans are for your pregnancy and postpartum period. Know your rights and make decisions that are best for you.

Pregnancy can place atypical demands on your body, making work more difficult. Managing your time will allow you to focus on what needs to get accomplished and ensure that you are providing yourself with enough rest.

Depending on your work environment, some of your regular tasks may not be safe for you during pregnancy. Avoid exposure to hazardous substances and pollutants and lifting heavy objects as much as possible. If there are aspects of your job that make you feel uncomfortable while pregnant, it might be a topic to bring up in your discussion with your employer.

Sharing the News

Deciding with your partner when to spread the news and whom to tell first is an exciting event of early pregnancy. You can be as creative and fun as you like. While most people will be excited for your pending birth, be prepared for those who may not be as happy for you.

Keep in mind that this is a special time for you that may only happen once in your lifetime. Every moment is precious – revel in it.

A New Diet

This is the best time to reacquaint yourself with the food pyramid. I am sure you’ve heard the phrase “she’s eating for two,” which is technically incorrect. While you are feeding your child, you don’t need to eat the amount of calories that two people would consume. On average, most women gain between 25 and 35 pounds. Note that 25 pounds can be accounted for, while the rest is extra weight. The more weight you gain, the more difficult it might be for you to lose this weight after the birth of your child.

The Food Pyramid diagrams the types of foods to include in your diet as well as the servings recommended. This should be your guide during pregnancy on eating healthy for yourself and your baby.
* Breads and Carbohydrates – 6-11 servings
* Vegetables – 3-5 servings
* Fruits – 2-4 servings
* Meats – 2-3 servings
* Dairy – 2-3 servings

Your doctor may recommend that you eat more of a certain food group, depending on your health. Constipation is a common discomfort during pregnancy, and is easily remedied by adding fruits and vegetables to your diet.

If you find it difficult to plan your meals around the Food Pyramid, you might find some relief with some assistance in planning your diet. A friend, spouse, or dietitian can help if you need assistance. They can coordinate meals with you so that you eat foods that you like, but that your growing baby needs.

There are even diets designed for pregnant women that might be useful. More information can be found through your caregiver or through organizations such as Weight Watchers.

Healthy Habits

Establishing healthy habits during this time is important. If there is something that you just can’t give up, like your morning cup of coffee or your weekly glass of wine talk to your doctor about your “need.”

One absolute rule to follow during pregnancy is no smoking or illicit drugs. Smoking and drugs are extremely hazardous to your child. Children of parents who smoke have a much lower birth weight, which is dangerous to their ability to live outside of their mother’s womb. They could have damaged organs, or worst of all, not survive.

Oh, and don’t forget the water. Your baby is literally sucking all of the fluids out of you that it can. The more water that you drink, the more hydrated you will be, and the better you will feel, especially if you are pregnant during those hot summer months.

SECOND TRIMESTER

You are probably feeling much better at the onset of your second trimester and possibly are starting to look pregnant. Most women in their second trimester have much more energy and are ready to prepare mentally and physically for the arrival of their baby. Just don’t jump into anything too quickly. Pace yourself, as you can expend that energy quickly. Make adjustments to your physical activities; as your belly starts to expand, you will find yourself less stable.

During your second trimester you can expect skin and hair changes, possible dizziness, vivid dreams, and an increase in size requiring wardrobe changes. You should be able to feel your baby start to nudge you.

In utero, the fetus can make a fist, open its mouth, swallow, and possibly suck its thumb. Fat begins to form, hearing starts to develop, body parts are in proportion, organs mature, teeth appear beneath the gums, and the fetus can respond to touch.

Preparing Your Body

This is a perfect time for gathering information on birth choices, enrolling in childbirth preparation classes, and preparing your body as much as possible for birth.

Testing

Throughout your pregnancy you will have several tests performed to check the status of your health and that of your growing child. Some are as simple as urine cultures and weight measurement while others are more complex.

Routine tests include weight measurements, blood pressure, urine tests, and blood tests. With the exception of blood tests, these take place at every visit to make sure things are progressing positively.

Your caregiver will probably recommend other tests as well, including ultrasound, Alpha-Fetaprotein Screening Test, and a glucose screening.

An ultrasound is generally performed on every pregnant woman. Ultrasound is used to date the pregnancy and to monitor the growth of the baby, to assess health, and to make sure the baby is in position prior to delivery. The test is painless and quick. Now with four dimensional ultrasounds you can even see more clearly what your baby’s face will look like, in addition to the sex of the child.

The Alpha-Fetaprotein (AFP) Screening Test tests the AFP that is produced only by the fetus. This test is performed between weeks sixteen and eighteen. This protein is found in your bloodstream and is passed on to your baby. Your blood is taken to test the levels of AFP in your blood. High levels of the AF protein indicate the possibility that the baby has Spina Bifida or another spinal cord defect. If the AF results are low it could indicate that your baby might have a genetic defect such as Down’s Syndrome. Or the test could be just fine. This is usually a test that mothers decide if they would like. If the AF test is positive, further testing options are available.

Amniocentesis is performed between fifteen and eighteen weeks of pregnancy. Not every woman is required or offered this test as it comes with risks. The test will check for birth defects and is done after results from the AFP test are returned. A needle is inserted into the mother’s uterus with the assistance of ultrasound. The needle removes some of the amniotic fluid for further testing.

Chorionic Villus Sampling (CVS) is a diagnostic test that can identify or rule out birth defects and can be done earlier than the amniocentesis. It does carry the same risks as the amniocentesis – miscarriage, and other complications – but offers the benefit of choice. If the baby does test positive for defects and the mother chooses to have an abortion, it is better to do so earlier in the pregnancy than later. With the use of ultrasound, a catheter is used to extract needed cells, taking a small piece of the placenta for further testing.

Glucose screening will test for gestational diabetes. This test is administered between weeks twenty four and twenty eight. You will drink a sugar solution and wait about an hour before having your blood taken. If the test comes back positive, meaning your sugar levels were above average, you will discuss diet issues with your doctor to keep the problem under control.

Group B Strep Screening tests for an infection carried in the vaginal or rectal area in women. It is harmless unless passed from mother to child, which can cause deadly illnesses, such as meningitis. You will have blood taken for the test and if the test is positive will receive antibiotics before and possibly during your delivery.

Tests will assist in continuing the health of yourself and your baby. Discuss any questions you have about testing with your health care provider. He will be able to assist you in choosing which tests are necessary during your pregnancy.

THIRD TRIMESTER

There is no doubt about it; you are now pregnant and probably being stopped everywhere you go with questions, admiration, and even advice. Take everything with a grain of salt, and never be surprised at what people will ask or tell you.

Frequent urination is a time-consuming endeavor for women in their third trimester. You might find yourself constantly thirsty to keep yourself hydrated. With the addition of fluids into your system and a baby nudging your insides, the sudden need to urinate will overcome you, especially in those last weeks. Have no fear. This is normal.

Frequent urination can also be a symptom of a urinary tract infection, so if you have any pain during urination, it is important to phone your caregiver. If you have a urinary tract infection, more than likely you will be given an antibiotic.

In your third trimester, you should expect practice contractions, the addition of stretch marks, indigestion, possible breathlessness, and frequent urination.

In utero, the fetus starts to breathe amniotic fluid, brain tissue develops, and your baby can dream, eyes can open and close, the baby will sleep at regular intervals, fat continues to form, organs continue to mature, and the baby will start to pass water from its bladder.

Preparing Your Body

Exercise during pregnancy is always recommended. You will feel more energetic, in tune with your body, and generally healthy overall. Exercise will also keep your body in shape for your pending delivery. Check with your doctor before starting any strenuous type of exercise. Most activities that you already participate in are safe to continue during pregnancy.

Childbirth classes will also help you prepare for this new experience. Lamaze is the most widely known and used method of birth in the world. This birthing style emphasizes natural birth and offers a variety of relaxation methods to keep you more comfortable. The focus of this method is patterned breathing routines that will change your focus from contractions to your breathing. If the Lamaze method of breathing is practiced regularly throughout the pregnancy, the “real” event is often more relaxed.

The Bradley Method also emphasizes natural childbirth. With a healthy diet, including exercise and the understanding of pain management, labor will be less painful. Heavy abdominal breathing is used as pain management.

There are, of course, other methods of preparation; however these are the most popular.

Prepping the Baby’s Room

Time to shop! Getting together your baby’s room is always a fun event. Purchasing and bringing home special items to await your new smiling face will bring excitement to your heart and home.

If you are planning to paint the room, delegate the responsibility to someone else. You shouldn’t be exposed to the paint fumes or the possibility of a fall off of a ladder. Get assistance when putting together furniture, and use caution when lifting.

General Necessities

Shopping for a new baby tempts every purchaser. Below is a list of items that will help you feel more prepared. Of course you can add to the list.

* A car seat. You will need a car seat installed in your vehicle before taking your child home. Most stores have employees that can assist you in choosing a seat that will best fit the model of your vehicle, and some will even install it for you. If you need assistance, you can also call your local fire department in the US. They will be able to properly install your car seat.

* A stroller. Strollers are convenient for traveling with your baby. Most manufacturers offer travel systems for newborns that allow you to take your car seat and place it inside of your stroller for easier use.

* A crib. All new cribs must meet quality standards; however if you are purchasing or borrowing an older crib, make sure a soda can won’t fit through the bars. This is a general guideline to see if the crib will be safe for your baby. If the can does fit, it’s best to purchase a new crib for the safety of your baby because your baby could possibly fit his head through the bars and get stuck.

* Diapering Essentials. This may or may not include a changing table, depending on your preference. It is best to be prepared with diapers, wipes, baby powder, cream, and anything else you will use for diapering.

* Clothing. It is best to have a few outfits for nice occasions and about a dozen one-piece outfits or t-shirts as these are what your baby will practically live in around the house. You can purchase sleepers, which are long and cover your baby’s feet as an addition to your layette; however your baby might not want to stay in these very long. Socks or booties can also keep your baby’s feet warm. All other clothing purchases can be made at your discretion. If you just have to purchase clothing, it is best to buy in larger sizes so that your baby can wear them longer.

There are so many products on the market that aren’t necessarily essentials, but will make your life easier. Purchase wisely, as the dollars spent can add up quickly.

DELIVERY AND RECOVERY

You’ve gone through the morning sickness and the testing. You’ve prepared your body and the baby’s room. Now it’s time for the big event.

Types of Delivery

Many women have their birth completely planned. In most cases, however, the reality is different than the dream. While it is a great idea to have a birth plan written and discussed with your doctor, know that there might be alterations to your strategy. Your plan should include your desire for pain medication, use (or nonuse) of extraction methods, and anything else you deem necessary.

Natural delivery is one without the use of pain medication or intravenous needle (IV). This is the technical term used to define this delivery method, however many hospitals will administer an IV to you to keep you hydrated and to be prepared in case an emergency develops. Planning and preparation are extremely important for natural deliveries. Preparation has already been described above.

A medicated childbirth is one for women who would like to dull or eliminate labor pain. There are several types of pain relief available including analgesics, anesthetics (including the epidural), and in extremely rare cases, general anesthesia. Anesthetics are pain medications that affect only the specific area where you feel pain. It is important to discuss all options with your doctor so he is prepared in advance for your delivery.

Cesarean birth or C-section is childbirth through an incision in your abdomen and uterus. Cesarean births are usually designated for those who fail to progress in labor, those who have a very large baby or a baby in a breech position, and those who have previously had a C-section. There are complications of cesarean birth as it is a major surgery.

Consult your doctor about any concerns you might have about any of the birthing options.

The Big Event

When it comes down to the last couple weeks of your pregnancy, it’s a good idea to pack your bag (if going to the hospital or birthing center) or at least get some of your things ready for your birth so you aren’t rushing at the last minute.

Among the pains that will indicate you are getting ready for labor are menstrual like cramps, feeling of heaviness or pressure on your rectum, lower back pain, change in vaginal discharge, a trickle of amniotic fluid, and contractions. These signal that your baby is preparing to make its way into the world very soon.

When real labor starts, your contractions will occur at regular intervals and come closer and closer together with an increase in intensity. Your caregiver will have told you to call when your contractions are a certain number of minutes apart. You also might feel a good deal of back pain, and your water might have broken.

There are three stages of labor. The first stage can last several days. You might pass your mucus plug or break water. The mucus plug is a collection of cervical secretions the body gives off naturally during pregnancy to ward off bacteria; the cervix releases this plug at the early stages of labor. The term breaking water refers to the leaking of amniotic fluid from your uterus. In most cases you will feel a gush of amniotic fluid. You may however feel constant dripping that will make you need to change your underclothes. This is amniotic fluid or your water breaking. The best thing to do at this point is rest. You might get hungry, but watch what you eat as your intestines slow down during labor. Eat light foods and drink plenty of water.

The second stage of labor is called active labor. During this state the cervix starts to efface, or thin out. Contractions are timely and continue to increase in intensity. This occurs to prepare your body for your new arrival. If you cervix doesn’t thin, you will not be able to push your baby out.

You will more than likely not be able to talk or walk through these contractions. This is the time when you start to use the breathing exercises of the birthing method you have chosen to assist in pain relief. This stage usually lasts from about four to six hours as the cervix dilates. Once you are fully dilated and feel the urge to push, you are ready to deliver your baby. You will push with each contraction until the baby has arrived.

Stage three of labor is the delivery of the placenta. Once your placenta is delivered, any stitches that are necessary will be administered.

Good luck and congratulations!

Recovery

While the first few days after delivery may feel a bit uncomfortable, they will be moments to remember. Get as much rest as possible. Enjoy your baby. Know that you will have emotional moments as your hormones are adjusting. “Baby blues” are normal; however if you feel that you are constantly depressed, or beyond blue, discuss the issue with your doctor.

The average postpartum recovery time is about six weeks, however every person is different. Take this time to rest up; get to know your new child. Be honest with family members and friends. If they come to visit when you are tired, ask them for help or to come another time.

Allowing your body time to recover is important. If you aren’t able to let the housework slide, ask for help or possibly hire a service. Some hospitals have information on baby-care help that includes house care options.

This time is precious, enjoy it.

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