Click here for full explanation of what should happen at your prenatal visits.
How your due date is calculated is often confusing and different from what you expect. Pregnancy is 40 weeks or 280 days long, starting from the first day of the last menstrual period. This means that at the time of conception, a woman is already two weeks pregnant. This assumes that her menstrual cycles are 28 days apart.
Many times women do not remember the exact day of their last menstrual period, or they may not have menstrual cycles that are 28 days long, or they might've been on birth control at the time of conception. Sometimes women just ovulate a little bit late for the bleeding that they thought was there last menstrual period was actually something different, like implantation bleeding. All of these factors contribute to dating based on the last menstrual period being wrong about 40% of the time. Your doctor will compare the date derived from the last menstrual period dating to a date determined by an ultrasound, and in some cases your due date will be changed based on the ultrasound.
The first ultrasound performed that is able to give a measurement for the baby is always the most accurate for determining the due date. Sometimes, patients are confused because subsequent ultrasounds will show a baby that has a slightly different due date and they will wonder if they're due date should be changed again based on these later ultrasound. The answer is no. The later ultrasound reflect a baby that is just a little bigger or smaller than the average for that gestational age or very just because of the margin of error.
Make sure you clarify at one of your first prenatal visit what your final estimated due date is; then, don't get too fixed on that day. Only 2% of women deliver on their due date. Maybe we should've called it a due month.
Good question. The truth is, you can eat just about anything you want. Visit our page here for a full explanation. But here's the quick answer. Don't eat:
- Big fish with high levels of mercury (shark, swordfish, king mackerel, and tile fish).
- Unpasteurized milk and soft cheeses
- Raw or undercooked meats
- Unreheated meats
Finally, make sure you wash your fruits and vegetables well before eating them. The absolute risk of anything happening from eating any of these foods is incredibly low. So you shouldn't worry too much; but pregnancy isn't the time to explore strange and new foods from uncertain sources.
Normal weight women gain 25-35 lbs during their pregnancies. Underweight women may need to gain more and overweight women less. For overweight women, dieting is safe and beneficial during pregnancy. Most weight gain comes in the second half of pregnancy and often women have gained no weight or even lost weight by 20 weeks; this is healthy. We check your weight at every visit, but don’t focus on how much you gain. We are usually not worried about you gaining too little weight but instead gaining too much. Excess weight gain increases the risks of pregnancy, including the risks of preeclampsia, diabetes, fetal macrosomia, and cesarean delivery.
Many overweight women will gain no weight for the entire pregnancy or even lose weight if they're actively dieting. This is not a bad thing. Maternal weight gain when it is excessive is associated with excessive fetal size; but gaining too little weight during pregnancy will not make your baby too small if you are overweight at the start of the pregnancy.
Yes you can.
As with most things in life, moderation is the key. Scientific studies have not demonstrated any problems with caffeine consumption during pregnancy until a woman consumes over 700 mg per day. That's a lot of caffeine! To be safe, and to make sure that a woman never approaches that amount of caffeine consumption, we recommend that women limit themselves to 350 mg of caffeine per day.
Check out this list to learn how much caffeine is in common beverages. In general terms, the average cup of regular coffee and the average serving of a caffeinated soft drink. But beware: it is possible to overdo it with a large special order from Starbucks.
Pregnant women are often excessively tired in the first and third trimesters, but probably for different reasons. In the first trimester, your body undergoes rapid physiological changes accompanied by high levels of hormones that conspire to exhaust you. Couple this with food aversion or nausea and vomiting, and the result for many women is complete exhaustion.
This tends to get better by the second trimester and then in the third trimester, particularly the last few weeks of pregnancy, exhaustion returns as you sleep less at night and carry around 30 extra pounds during the day. If you have another small baby or two at home already, then the effect is even worse.
What can you do? In the first trimester, work on minimizing the effects of nausea and vomiting of pregnancy. Keep your energy up by eating several small meals or snacks throughout the day and try adding vitamin B6 if you haven't already. Naps sometimes feel like a good idea, but they often have the opposite effect then what you desire. Napping can interfere with your ability to get good rest at night and create a vicious cycle. Going for a walk for getting some exercise is probably a better idea and will improve your nighttime sleep.
Some women in the first trimester are excessively tired because they have cut caffeine completely out of their diets. Remember, you were still allowed to have up to 350 mg of caffeine today; so don't feel too badly about having that cup of coffee in the morning or maybe after lunch.
Many pregnant women need to work on maximizing their sleep habits. Make sure you have a dark room, maybe with a noisemaker, like a fan or something else that makes background noise, to minimize interruptions. Try to use your bedroom for sleep only; don't make a habit of watching TV from your bed or staring at your phone. Women in the third trimester often find every little uncomfortable spring in their mattress with their rounder bellies and hips. Try adding an extra layer of egg crate or a phone topper to your mattress and make sure you have a long pillow that you can hug with your legs.
Also, be sure to empty your bladder right before you go to sleep and if you find that you are awakening to pee several times a night, you might need to restrict water intake for 2-3 hours before going to sleep.
In rare cases, excess fatigue might indicate another problem like a thyroid abnormality or anemia; if you feel like you are more tired than the average pregnant woman, be sure to talk to your doctor.
Most women find out the sex of their baby at the time of the anatomy ultrasound at around 18 to 20 weeks. In some cases, you might find out earlier. If you happen to have an ultrasound anytime after 14 weeks, usually the sex is visible. Ultrasounds at around 12 weeks can sometimes lead to a guess about the baby's sex, but are only about 85% accurate. Sometimes, women have genetic testing called noninvasive prenatal screening (NIPS) as early as 10 weeks gestation that can accurately reveal the baby's sex. However, finding out the baby's sex is not a good reason alone to have this test done.
Many women choose to not find out the sex of their baby until after it is born, but most women can't handle not knowing. If you're planning a gender reveal party, make sure you tell your doctor and your ultrasonographer ahead of time so that they don't give away something accidentally. They can always put the answer in a sealed envelope. If you don't want to find out until after the baby is born, make sure you tell whoever might do an ultrasound at any time that you don't want to know; if it's a later ultrasound, they will assume that you already know and they may say or show something that you don't want.
The scientific ways of determining the baby's sex are:
- Noninvasive prenatal testing
There are also some not so scientific ways that you'll read about on the Internet. None of these work:
- Fetal heart rate (under 140=boy, over 140=girl)
- Chinese gender charts
- Wedding ring test (pendulum=boy, circle=girl)
- Peeing on Draino (brown=boy, no color change=girl)
- Carrying high vs low (high=girl, low=boy)
- Morning sickness (bad=girl)
- Location of weight (hips and butt=girl, belly=boy)
- Placental location (right=boy, left=girl)
Most of these are harmless fun, but there are some products on the market that take advantage of these myths. Don't waste your money.
Nausea and vomiting during pregnancy is no one's idea of a good time. The good news is, nausea and vomiting is not associated with risk to the pregnancy; the bad news is, you aren't nauseated and throwing up.
What can you do?
- Eating several small meals per day and avoiding high fat foods may help.
- Emphasize bland foods and avoid smells that are noxious.
- Increasing protein and liquid content of your food maybe beneficial.
- Ginger ale, ginger teas, or ginger capsules may be helpful.
- Taking a vitamin B6 supplement 2 to 3 times per day alone or in combination with doxylamine at night may be beneficial.
- Your doctor may need to prescribe you an anti-nausea medicine. There are several drugs that are safe in pregnancy to choose from.
- Make sure that your acid reflux and constipation are treated as well; both can contribute to the problem.
- In bad cases, you may need to be hospitalized for IV fluids and other treatments.
Hopefully, you should feel better by the end of the first trimester. If you don't, or if the above remedies are not working, your doctor may need to investigate other causes of your nausea and vomiting apart from pregnancy. Typically, you shouldn't be concerned as long as you can maintain your bodyweight or even lose a few pounds during the first trimester and as long as you can stay hydrated.
Yes. The short answer is that exercise is a beneficial activity throughout pregnancy and virtually all pregnant women should exercise. Almost every limitation to exercise that you heard or read elsewhere on the Internet is not based in science. Women who exercise have better pregnancies in every aspect.
Almost all women have some cramping or other pains during pregnancy, particularly in the first trimester. This cramping is almost never anything to be worried about, particularly if you're not bleeding. In the first trimester, the uterus grows rapidly and most of the cramping that a woman experiences is simply growing pains. As the uterus gets bigger, it becomes top-heavy and has a tendency to pull and tug from one side to the other. This will stretch ligaments, particularly the round ligaments, and cause either cramping or sharp pains. None of these symptoms put the baby at risk.
Sometimes cramping is not related to your uterus at all. Many women become constipated during pregnancy in the cramping that they experience is actually related to their bowels slowing down. Sometimes cramping is related to the bladder and might be a sign bladder infection, but almost always there will be other symptoms like burning when you pee.
In the second and third trimesters, cramping is often what's cold Braxton-Hicks contractions. These are common and occur more often in subsequent pregnancies. They do not increase your risk of preterm labor.
Every pregnant woman at some point in her pregnancy will be given to wonder if she is in labor. Most women have a few false starts. Braxton-Hicks contractions can be confusing and can become frequent and regular, at least for a short time. Women frequently have physiologic discharge or will urinate and wonder if their water is broken. So how can you tell real labor from false labor?
The answer is time. Real labor is progressive in every way, but you won't be able to see this until some time has passed. If you're having some regular contractions, the best thing to do is to see what happens over the next two or three hours. If you are really in labor, your contractions will become more frequent (maybe going from every 6 to 7 minutes apart to every 3 to 4 minutes apart), they will last longer (going from, say, 30 seconds in length to 45 or 50 seconds in length), they will become more painful, they will become more regular and predictable, and they will persist. False labor, on the other hand, may seemingly start strong but over two or three hours will lose steam and wane.
If it's your first baby, you have plenty of time. Labor will likely last many hours and you will have plenty of time to arrive at the hospital. If it's your fourth baby, then you already know what to expect; if you are reading this anyway, your labor probably won't last that long and you should head to the hospital a little sooner.
In some cases, your doctor may ask you to come to the hospital a bit earlier; for example, if you're positive for group B strep, then you will need four hours of IV antibiotic therapy in addition to however long it takes to get to the hospital, get admitted, and get an IV started, before the baby born.
If your water breaks, you should probably head on the hospital. This may be a sign that your labor is already very advanced, since women's water tends to break at an average of about 8 cm. If your water is broken and you're not already in labor, then you should still go to the hospital because your labor likely needs to be augmented or induced.
If you have had a previous cesarean delivery, then you should come to the hospital much sooner because you do not want to risk laboring at home. A trial of labor after cesarean is a good idea for most women, but because of the risk of uterine rupture, that trial of labor should happen at the hospital as much as possible.
How can you tell if your water is truly broken? You can't always tell; but in general, once your water breaks, it keeps coming. Ruptured membranes is not just a small gush or a little bit of spotting; if you think your water has broken, clean up and see if the leakage persists. If it does or you are unsure, you probably need to be examined.
In most cases, the answer is no.
There is a whole industry that markets supplements and other products to pregnant women. Even among prenatal vitamins, for most women the only ingredient that is actually required is folate, and that folate is only necessary until the baby's neural tube is closed, which happens early in the first trimester. The truth is, prenatal vitamins are best taken beginning 2 to 3 months before pregnancy and provide little to no benefit past the first half of the first trimester. In fact, if you are beyond six weeks and prenatal vitamins are making you nauseous or constipated, there's no reason for you to not stop them.
Aside from the folate in a prenatal vitamin, the other ingredients often found in these vitamins are not science based. Don't get caught up on buying the most expensive prenatal vitamin because the company says it will make your child smarter or reduce the risks of pregnancy; this simply is not true.
In some cases, due to restrictive diets or preexisting anemia or other risk factors, your doctor might ask you to take an additional supplement or medication.
You can't always tell; but in general, once your water breaks, it keeps coming. Ruptured membranes is not just a small gush or a little bit of spotting; if you think your water has broken, clean up and see if the leakage persists. If it does or you are unsure, you probably need to be examined.
Discharge is common in pregnancy but usually never results in more leakage than would fill a small pad or pantiliner. Probably the most common reason why women believe that their water has broken is because they have peed on themselves. Most women cannot believe that they have in fact peed on themselves but in the third trimester, with the baby's head smashed right against your bladder, this is a common occurrence. If it happens on your bedsheets or in your underwear, you won't always be able to tell that it is urine by smell or color alone. Amniotic fluid has a unique odor that is like a combination of ejaculate and bleach; that may not be helpful if you've never smelled amniotic fluid before, but when you do maybe you'll recognize it.
Constipation is incredibly common during pregnancy; in the 19th century, some people called pregnancy the Disease of Constipation. The good news is on of the remedies and treatments that you might normally use for constipation are still safe in pregnancy. You should start by increasing your water and fiber intake. Many women will add daily use of MiraLAX or a generic equivalent to their diet. This is a gentle agent that is non-stimulating and safe to use during pregnancy. If it's been a few days (for a week) since you went, you may need to stimulate a bowel movement from below. Try using a Dulcolax suppository, and if this doesn't work you can repeat it in two hours or so.
If these over-the-counter remedies are not helpful, talk to your doctor.
In general, the answer is yes.
There is nothing inherently dangerous about traveling by ground, sea, or plane during pregnancy. However, you do have to consider how long you will be separated from the ability to seek medical care, and how far away that medical care might be. This is more important in the third trimester, particularly in the late third trimester when labor is more likely. For this reason, mini cruise ships will not allow you to embark after 24 weeks because they do not want any liability related to premature delivery when the baby has a chance at viability. It's not that sailing isn't safe, it's only that it is many hours away from hospital.
Planes do not often limit travel by gestational age, but you should consider how long your flight is. There is a big difference between flying from Atlanta to New York versus flying from New York to Melbourne. In general, many doctors recommend avoiding flying after 35 weeks if the length of the flight is particularly long.
Some people worry about travel by car due to the concern of increased risk of blood clots secondary to the immobilization. This is probably not a valid reason to not travel by car, particularly when you consider that pregnant women will be forcing pit stops every two or three hours anyway. When you stop for a potty break, be sure to walk around for a couple of minutes.
You've probably heard the folktale that a lot of heartburn means that your baby will have a lot of hair; this probably isn't true, but dreams of a well-coiffed baby undoubtedly doesn't make your pain any better.
Heartburn or indigestion or acid reflux is a common problem during pregnancy and likely gets worse throughout the third trimester for most women as the uterus grows and puts more pressure on the stomach. If you have occasional symptoms, then avoiding triggering foods and using some Tums may be enough; but for persistent symptoms, it is okay to use over-the-counter or prescription antacid medications, including both proton pump inhibitors and antihistamines. Click here for a list of medicines that are safe to use during pregnancy
Most itching in pregnancy is related to dry skin. A good lotion can go a long way to reducing or eliminating itching related to this problem. In some cases, itching confined to one area may be related to a reaction to something, for what is called a contact dermatitis. If you suspect this is the case, try to avoid whatever you came into contact with a consider using an antihistamine or over the counter steroid cream until you are better.
In rare cases, itching all over the body that is not associated with a rash can be due to intrahepatic cholestasis of pregnancy or ICP. ICP is an important diagnosis to not miss and your doctor may need to check some labs to make sure you don't have this. If you do, she will prescribe medicine to improve the situation and she will likely deliver you a couple of weeks earlier than normal.
The answer to this question depends on how far along you are. If you are less than 20 weeks or so, you probably are just too early to feel any fetal movement. First time moms don't typically report feeling movements for the first time (quickening) until 20 weeks or so; women who have had children before often feel the first movements two or three weeks sooner. Even after these gestational ages, it is still common to go a few days without feeling fetal movement until about 24 weeks or so.
After 24 weeks, you should expect to feel some movement everyday but how much movement varies from pregnancy to pregnancy. You or your partner may not be able to feel the baby with a hand on the outside of your belly simply because you have an anterior placenta or the baby is turned and kicking in the other direction.
If you are concerned that you have not felt enough feeling movement, and you are after 24 weeks, then lie down on your left side and concentrate on feeling for movements. You should feel six movements of some sort in the first hour; if you have felt some movements but not six, then go another hour. You should feel a total of 10 movements or more in a two hour period and sometimes it takes a while because babies have periods of time when they are asleep. If it's been two hours and you have not felt 10 movements then you may need to go to the doctor or the hospital for evaluation.
You might have read on the Internet that you should do "Kick counts" every day. Most pregnant women do not need to do this in the practice may actually be harmful overall to the pregnancy. Only do daily kick counts if your doctor has told you to for a specific reason.
The short answer is no.
Though there are a lot of products marketed to pregnant women who are willing to spend a lot of money to prevent stretch marks, none of them have good scientific data that they work. Some products cite their own small studies, but don't waste your money on that kind of evidence. If your belly is dry and it feels good to use a nice lotion or other skin care product, go for it! But don't pretend that it will prevent any stretch marks.
Ah, the joys of pregnancy! If constipation, hemorrhoids, and heartburn weren't enough to make you feel glorious, just wait until your legs start swelling.
Most swelling or edema in pregnancy is normal. Swelling is common; about 60% of women will have significant lower extremity swelling and a large number of these women will also have swelling in their hands that make rings too tight and wrists hurt. Much of the conventional wisdom about swelling during pregnancy is related to a concern for the development of preeclampsia, but swelling is so common, that in most cases this is not really a concern at all. Your doctor checks your blood pressure at your regular visits to make sure that you're not developing preeclampsia.
Most swelling in the legs is related to the uterus blocking the return of blood that is collected by gravity in the legs. As the uterus gets bigger, it blocks the veins that drain the legs back up to the heart. Since there are no pumps in the legs, then the blood tends to pool and this leads to swelling. You may be able to make this temporarily better by elevating your legs, particularly while laying on your side. But for most women who are up and working throughout the day, there is little opportunity for this. Wearing a pair of support hose may help tremendously.
If your hands are swelling, you may have symptoms of carpal tunnel syndrome which is very common during pregnancy. Wearing an over-the-counter wrist splint at night on one or both hands will lead to significant improvement of these painful symptoms.
One common myth about swelling is that a woman should drink more water when she is swelling to make the swelling better. This is simply untrue. If you're having significant swelling in your legs, you may also find that you are lightheaded or having woozy episodes because your water content has left your blood vessels and gone into your soft tissues; in this case, drinking more water may help you not feel as woozy, but it will not affect how badly you are swollen.
Back pain in pregnancy is almost universal. The bigger the belly, the more curved the spine, and the worse the back pain. As your center of gravity moves forward with ever increasing belly size, your hips rotate forward, the curvature of your back changes, and the muscle groups that you use In your back to maintain your posture change. Because you are not used to using these muscle groups to stay upright, and because all of your muscles are doing more work than normal carrying around the extra weight, then the result is chronic muscle strain, sprain, and fatigue.
What's a girl to do?
- For starters, you can use acetaminophen to treat the pain and, if you are less than 22 weeks pregnant, you can still use nonsteroidal anti-inflammatories like ibuprofen or naprosyn. A heating pad on the back, or heat releasing patches, or a nice bath may also help a lot.
- Exercise can help tremendously. Gymnasts and ballet dancers rarely complained of back pain during pregnancy because they have well-developed back musculature and core abdominal muscles. Exercises that help strengthen the back in core abdominal muscles can provide relief and prevent worsening problems as the pregnancy goes on. This includes things like Pilates or Yoga.
- Many women benefit from wearing a back brace or pregnancy support belt. These devices tend to change your center of gravity slightly and help redistribute the load. Typically, these are most helpful in the third trimester and even though you may not have needed one in your first pregnancy, because you likely carry the baby differently in your second or third pregnancy, you might find one helpful in those subsequent pregnancies.
- A good massage is nice and some women will appreciate chiropractic therapy during pregnancy as well. In some cases, your doctor might order physical therapy.
- It is unusual for back pain during pregnancy to require any testing or other treatments. However, if you have a history of chronic back pain or orthopedic abnormalities, be sure to tell your doctor.
Literally 97% of pregnant women complain of shortness of breath at some time during their pregnancies. Most of the time, this is related to some of the pulmonary physiologic changes of pregnancy that give women the sensation that they are not breathing and deeply or moving as much air with each inspiration; but their actual oxygen status remains unchanged. It is normal to feel as if you are not breathing as deeply or if your rate of respirations increase with less vigorous activity while pregnant.
Rarely, difficulty breathing is a sign of a more serious problem. If you're having trouble catching your breath even while resting or if you have symptoms of low oxygen levels, like changes in the color of your skin or confusion, then you may need to seek medical care immediately. Women who have underlying asthma may also have shortness of breath related to uncontrolled asthma during pregnancy and this would be a reason to seek immediate medical attention. Also, if you noticed that you can't sleep without propping your head up with several pillows, you may need to talk to your doctor.
Otherwise, if your shortness of breath is just with exertion and becomes improved with rest, this is likely normal.
Women who are over 35-years-old at the time of delivery are considered to be of advanced maternal age or AMA. This category was created primarily because of the increasing risk of Down syndrome, which is 1 in 270 at age 35. This cut-off was picked many years ago because it was the expected pregnancy loss rate when genetic amniocentesis was performed; at the time invasive testing like amnio was the only choice, and it made sense to only offer it to the highest risk women.
Today, we have many better tests available to screen for Down syndrome and we know that the rate of pregnancy loss with genetic amniocentesis is dramatically lower than 1 in 270.
Apart from this increased risk of Down syndrome, being over 35 may not mean much of anything. Typically, as women get older, they may gain extra pounds and extra illnesses that would tend to complicate pregnancies. Yet, a healthy woman of normal body weight above age 35 who does not have a pregnancy complicated by Down syndrome should expect to have a better and safer pregnancy than a woman 10 years her junior who is obese or has a preexisting medical condition. So your doctor should individualize what your age means for you in the context of your total health status.
Women today frequently delay childbearing until after age 35 and while this does increase their risk of miscarriage and conditions like Down syndrome, most have pregnancies whose outcomes are similar to those of younger women.
It is a myth, sometimes perpetuated by massage therapists themselves, that massages can be so relaxing that they might stimulate preterm labor. This is completely untrue. Some massage therapist may want a note from your doctor stating that a massage is safe, and I can't think of a good reason why your doctor wouldn't give you such a note.
Pregnancy is good and bad for headaches.
The good news is, migraine headaches are uncommon during pregnancy. Most chronic migraineurs thoroughly enjoy pregnancy because it is one of a few times in their lives when they don't suffer from migraine headaches.
The bad news is, other types of headaches, particularly tension type headaches, can become more common during pregnancy with the musculoskeletal strains and intentions of pregnancy and the anxieties and stresses associated with pregnancy.
You can always use acetaminophen at anytime during pregnancy for headache. If you're less than 20 weeks, you can still use Ibuprofen or Naprosyn. Other medications like Excedrin Migraine can also be used on a limited basis.
A good massage, a relaxing bath, or just a good night's rest may be the cure for a tension type headache.
Sometimes headaches have other causes, like sinus infections or allergies. If you suspect that your sinuses are the problem try and over-the-counter antihistamine and if this doesn't work talk to your doctor.
Some women in the first trimester have caffeine withdrawal headaches. If you have recently cut out all caffeine because you're pregnant these types of headaches are all too common. Remember that you can have up to 350 mg of caffeine per day. You may need to add a little bit of caffeine back in order to prevent headaches. Caffeine also is a treatment for some tension type headaches as well. Taking your acetaminophen with a serving of caffeine maybe just what the doctor ordered.
At your first visit, review on medications that you regularly take with your doctor, even over-the-counter medications in herbals and supplements.
Sometimes you'll have a problem develop during pregnancy and you'll wonder if you can take an over-the-counter medicine or remedy. Click here for a list of acceptable drugs. If you don't see what you're interested in on the list, check with your doctor.
A lot of women ask this question because they've been told to never sleep on their backs, particularly in the third trimester. Much advice on the Internet and in books about pregnancy recommends against sleeping on your back. There is no good scientific evidence that sleeping on the back increases the risk of stillbirth, and even in the third trimester. There have been studies that show that babies have some fetal heart rate changes in different sleep patterns while the mother is sleeping on her back, but these changes have not been definitively associated with an increased risk of stillbirth.
What's more, a woman has little control over her sleeping position. Women in the third trimester are unlikely to sleep on their backs in the first place due to their belly size, so they will naturally tend to sleep on one side or the other anyway. If they should sleep on their backs, there is little to do about it since women have no control over how they turn and flip about during sleep. Since there has been no definitive connection between back sleeping and stillbirth, then women should not lose too much sleep (pun intended) worrying about how they sleep.
Yes, please do.
Good dental hygiene is associated with good pregnancy outcomes. A severely infected tooth, on the other hand, may lead to problems for the pregnancy. There are no routine practices at the dentist's office that are unsafe during pregnancy. This includes pulling teeth and getting dental x-rays. A pregnant woman can undergo many tens of thousands of shielded dental x-rays during pregnancy without fear of delivering a harmful amount of radiation exposure to the pregnancy.
Local anesthetics, antibiotics, and pain medicines that are commonly used by dentists are all also safe during pregnancy. If your dentist has a question about a particular antibiotic or other medicine, have her ask your doctor.
Sex is safe during pregnancy and often a lot of fun. Most couples enjoy the pregnant woman's body's changes during pregnancy but sometimes women can find sex painful and problematic.
Some women find it difficult to become relaxed during pregnancy because they're worried that sex maybe harmful to the pregnancy; this is an unnecessary fear – sex is not associated with any negative outcomes during pregnancy.
Most of the time discomfort and pain during sex is just related to your changing anatomy and body shape. Familiar positions may become uncomfortable because your belly is in the way and more penetrating positions may become less desirable because your uterus has started to take space away from the upper part of your vagina. Usually, a little creativity can be both fun and problem-solving. Rear-entry positions, with the help of the few pillows or a wedge cushion, can solve several problems at once. The woman on top, as long as it's not too penetrating, can also be pleasurable for both and it can allow you to determine the angle of injury and the depth of penetration to a degree. Finally, if you lay on your side and draw your top leg upwards, this can allow your partner to straddle your bottom leg and enter at a 90° angle from the normal. This side saddle approach allows for complete control over the angle of entry and allows you to control the depth of penetration with your top leg; he is very unlikely to complain.
Unfortunately, acne tends to get worse during pregnancy. Blame your hormones and you're beautiful, oily glow of pregnancy. Still, there are a few things that you can do. It is safe to wash your face with benzoyl peroxide during pregnancy. Benzoyl peroxide is the common ingredient of most over-the-counter acne remedies. Check the label.
If you wash your face at night and then go and lay down on your pillow from last night, you may find that you have re-contaminated your face with last nights oils and bacteria. One evidence-based trick is to place a fresh clean towelette over your pillow each night that you removed in the morning. This towelette can collect the new night skin oils and bacteria and not allow them to saturate into your pillow and pillowcase. Just change it each night.
Many other acne treatments are not safe during pregnancy. Ask your doctor before trying any other remedies.
There has never been a reason for women to abstain from sex during pregnancy except in rare cases where the doctor felt that the risks outweigh the benefits. This may include certain cases of preterm labor with advanced cervical dilation; preterm, premature rupture of membranes; or placenta or vasa previa. Also, women who have had a cervical cerclage during pregnancy should probably abstain. Otherwise, have fun!
Most women find sex during pregnancy more satisfying and pleasurable than outside of pregnancy. Sex during pregnancy is not associated with an increased risk of miscarriage, preterm labor, or any other complications of pregnancy. Even in cases where penetration may be recommended against, like the situations listed above, orgasms during pregnancy are still perfectly fine. If you have a cervical cerclage and don't need penetration to orgasm, then stop reading this and get to work!
Due to some of the physiological changes of pregnancy, is common for women's resting heart rate to be about 10 to 15 bpm faster while pregnant. Pregnant women are also more likely to have bigger increases in their heart rate with exertion since they or doing more work while pregnant. This increased work starts even in the first trimester, as pregnant women have a blood volume of expansion of over 40%; but it doesn't stop there, as pregnant women also do more actual work, moving around another 35 pounds or more.
Is the uterus gets larger, the heart is actually pushed upwards and rotated to the left; this changing position of the heart allows women to become more aware of their heart beating and sometimes this is alarming because we don't normally perceive that our heart is beating in our chest. Couple this with the fact that the heart may be beating faster than normal, then this can be quite anxiety provoking. But as long as your heart rate isn't too fast it rest and you don't notice that it is irregular, don't worry too much. If you feel like that you're heart rhythm is irregular for your heart rate is staying persistently very fast, talk to your doctor.
If you failed your glucose screen and your glucose tolerance test, then you now have gestational diabetes.
Hopefully, you'll get a chance to talk to a dietitian. In the meantime, cut out all of the simple sugary items from your diet: colas, cookies, cakes, candies, and other sources of sugary carbs. Pay attention to portion size. If you're not already, and-in for or five 20 minutes walks or other cardiovascular exercise sessions per week.
You'll need to check your blood sugar several times per day, at least initially. You should check your blood sugar first thing in the morning, a fasting blood glucose, and then check it two hours after each large meal – breakfast, lunch, and dinner. You're fasting blood sugars should be below 95 and your blood sugars after meals should be below 120. If your blood sugars are running higher than this, you may need to take medicine to help lower your blood sugars.
Is also helpful in the beginning at least to track what you are eating. This can help your dietitian and your doctor decide if their are some things you should do differently in your diet. It can also help you understand why your blood sugar might spike – for example, after delicious pizza.
The Internet is full of advice recommending that you don't dye your hair while pregnant, at least in the first trimester. this is born out of ignorance and a fear of everything during the first trimester. There is no scientific data that says that dying your hair is associated with any adverse problems, even in the first trimester. If you think about it, most female beauticians and hairstylists also become pregnant at sometime, and they are exposed to the chemicals hundreds or thousands of times more that receive while getting your hair dyed. We don't recommend to those women that they changed their occupation.
Because of high-levels of mercury, pregnant women should avoid shark, swordfish, king mackerel and tilefish. Smaller fish are usually safe, such as light tuna, salmon, pollock, and catfish. Up to 12 ounces per week of these fish is considered safe.
In fact, regular consumption of fish (and their omega fats) has been associated with lower rates of preterm labor and other complications of pregnancy.
Probably. Pregnant women have more of a vaginal discharge then nonpregnant women. It is common for pregnant women to wear a panty liner while pregnant because of this discharge. Most of this discharge is physiologic and represents cervical mucus. If your discharge has a bad odor or itches or is green in color, tell your doctor to make sure it's not an infection. Otherwise, expect to have some discharge throughout pregnancy.
Nobody likes a hemorrhoid. Unfortunately, they are common during pregnancy and become more common in the third trimester. All of the normal over-the-counter remedies for hemorrhoids are perfectly fine to use while pregnant, including Preparation H and Anusol HC. Tuck's Pads, which are pads infused with Witch Hazel, are also effective. Many women will use the pads in combination with one of the creams.
Most hemorrhoids get significantly better after delivery, though they may get worse with pushing. Sitz bath's with added Witch Hazel, may be your best friend in the postpartum.
Rarely, hemorrhoids become thrombosed and need to be dealt with surgically as an emergency. You should suspect that a hemorrhoid has become thrombosed if you have new and different severe pain, preventing you from even sitting down. If you're worried about this, ask your doctor immediately.
The best way to protect your baby during pregnancy is to protect yourself. Seatbelts for the best way to do this while driving. It is a myth that seat belt and extra an unnecessary risk to your baby; on the contrary, they may save your life and your babies life.
Ha! You might. Don't worry about it. We are all used to it. We will probably lie to you about it. It's no biggie.
Yes. Especially if you've already had children, you might notice that your milk comes in early or that you have occasional leakage even in the first trimester. Even if you haven't had a baby yet, it's not uncommon at all for you to leak some milk. If this is a persistent problem (and an embarrassing one), you might need to change up your bra or wear nipple shields so that your nipples are less stimulated.
There's no reason to check your cervix unless you're having signs of labor, like regular contractions or maybe bleeding or leakage of fluid. If you're considering an early induction, checking your cervix might help determine how good an idea that might be. If your cervix isn't ready for labor (already dilated, for example), then an induction might unnecessarily increase your chances of a cesarean delivery.
Inductions happen for lots of good reasons – but also some not so good ones. Unless there's a medical reason to do so, you shouldn't be induced before 39 weeks. Even at 39 weeks, induction might not be a good idea unless your body is ready for labor. Checking your cervix can help determine this. Otherwise, it might be better to wait until 41 weeks. After 41 weeks, it's unusual that going any further makes much sense.
Sometimes you might need to be induced much earlier, but it should be because you have a medical problem like high blood pressure or some other complication.
Except in some very rare emergency cases, episiotomies should never be performed. If your doctor performs routine or frequent episiotomies, then he may not be practicing up-to-date medicine. We have known since the mid-1980s that episiotomies are harmful and unnecessary except in a handful of rare emergencies, such as severe shoulder dystocia.
This doesn't mean that you might not tear, but however badly you might tear an episiotomy would've made things worse.
Breastfeeding is not the panacea that some people make it out to be, but it is the best thing for your baby if you can pull it off. Breastfeeding is associated with less newborn infections, better maternal-infant bonding, lower cost, and greater convenience. There are very few reasons why a mother should not attempt to breastfeed (HIV is the most common), in the vast majority of women will be successful.
You're not alone. Most women struggle at some point with breastfeeding. Click here to read our primer on breastfeeding and, if you still having questions afterwards, ask your doctor or lactation consultant.
We hope not! But some women do, of course.
Cesarean delivery is definitely over-used in the United States. There are some good reasons why a woman might need one:
- If she's had a prior "Classical" cesarean delivery (where the incision on the uterus is made higher than normal)
- If she's had more than two prior regular ("low transverse") cesareans
- If she has placenta previa, where the placenta covers (or is very close to) the cervix or vase previa (where placental blood vessels cover the cervix)
- If her baby is breech or sideways (and the doctor is unable to turn the baby to be head down)
- If her baby is unable to tolerate labor (this should be unusual)
- If her baby is too big (which is more than 5,000 grams or about 11 lbs for a nondiabetic mother or more than 4,500 grams or just under 10 lbs for a diabetic mother)
- If her labor doesn't progress or she is unable to push the baby out after sufficient time (most doctors don't given women enough time for these things)
- If she has triples or quadruplets
- If she has active genital herpes or uncontrolled HIV
Those are just about all the reasons. We don't know for sure, but probably half of all cesareans done are unnecessary. Most of the unnecessary cesareans are related to impatience, and new guidelines from the American College of Obstetricians, will result in significantly fewer cesareans if doctors follow them.
This is a test question, though. You have to separate out laboring in the water and actually giving birth in water. Most of the known advantages of water birth are actually related to the process of labor in water while the known disadvantages of water birth are associated with giving birth in the water.
For example, the benefits of reduced pain during the first stage of labor (that is, the part leading up to pushing), a shorter first stage of labor, and less need for anesthesia, all occur before the birth itself takes place. At the same time, the reported disadvantages of the water birth all take place during the actual process of delivery, including newborn aspiration, drowning, infections, fatalities, hyponatremia, depressed Apgar scores, and umbilical cord rupture.
So it probably makes the most sense to labor in the water and then get out when it's time to push and have the baby on dry land.
If you think about it, nature designed the birth process to happen on dry land. One of the benefits of a vaginal delivery over a cesarean delivery is that the baby gets most of the amniotic fluid squeezed out of her lungs while traveling through the birth canal so that her first breath, once delivered, is full of nice, clean air. This doesn't always happen with a cesarean delivery and consequently babies have higher rates of respiratory problems with cesarean delivery as compared to vaginal delivery. In any event, when a baby is born vaginally underwater, the first inspiration by the baby may be underwater and therefore lead to aspiration of water with subsequent increased risk of infections, drowning, and other respiratory maladaptions.
Keep these things in mind when you read about water births being more natural than land births. In fact, water births are a rather modern invention. Currently, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend against deliveries occurring under water.
If you've had a previous cesarean delivery (or two), you may be a candidate for a trial of labor after cesarean (TOLAC). This is a complicated issue. The short answer is that most women with only one prior cesarean delivery should try to VBAC (vaginal birth after cesarean), but you should read more about it here.
Whoa! Hold your horses! Although we classically tell women to wait 6 weeks after delivery to resume sex, many do not and there isn't really any science behind this advice. The actual answer varies by woman, and likely depends on how you delivered (vaginally or cesarean), if you had problems (a bad tear or no tear), and whether you have the energy and interest.
Here are some things you should know:
- If you aren't lactating, you will probably ovulate again about 25 days after delivery. This means you could get pregnant from sex that happens as early as 3 weeks after delivery. Since the time of return to ovulation is variable, then just assume that you are fertile any time after two weeks or so postpartum
- If you are breastfeeding, you probably won't ovulate in the first 6 weeks, but you shouldn't count on this.
- If you had a vaginal delivery with a tear, you may need four weeks to heal before sex is comfortable (and sometimes much longer if the tear was severe or it's not healing well).
So when should you have sex? When you feel like and you feel healed; but make sure you use birth control or you might have two babies in the same year! Most women have sex before their 6 weeks postpartum check-up and most of those women have sex the first time at 3-4 weeks after delivery. It's really up to how you feel.
Many women are sure that they are done having children and want to know if they should get sterilized. There are many sterilization procedures, and you can get sterilized right after delivery or the next day, at the time of a cesarean delivery, or a few weeks after delivery. Women can get their tubes tied through a small incision in their belly button right after delivery, or through a laparoscopic or vaginal procedure a few weeks after delivery.
Should you get your tubes tied? For most women, the answer is no. There are two things to think about.
- First, sterilization procedures still have failure rates associated with them, and the failure rate for most sterilization methods is actually higher than the failure rates for the long-acting reversible contraceptives (LARCs), like IUDs or the Nexplanon. So if your main goal is to do the best thing to not get pregnant, you might actually be better off not getting your tubes tied and instead getting a LARC.
- Second, getting a LARC is much less risky and less costly than getting your tubes tied, plus most LARCs carry fringe-benefits, like better menstrual cycles. A simply 5 minute office procedure is definitely better than a day at the hospital and general anesthesia.
Another important issue to think about is how many children have you had and how old are you? Many women under 25, for example, might be convinced that they want no more children, but studies show that over time as many as 1 in 3 have serious regrets. So a 24 year old mother of two who gets her tubes tied and then decides at age 30 that she wants another child has very few good options, but if she had instead gotten a LARC, she would have had a lower failure rate, better menstrual cycles, and easy reversibility.
Great question. For most women, the most appropriate birth control choice is one of the long-acting, reversible contraceptives or LARCs. The LARCs include the hormonal IUDs (Mirena, Liletta, Skyla, and Kyleena), the copper IUD (ParaGard), and the implant (Nexplanon). These methods are the most effective, have the highest success rate (as much as 80 times more effective than The Pill), have the lowest side-effect profile and lowest complication rate, and the highest patient satisfaction. They also don't interfere with breastfeeding, and they will protect you for 3-10 years depending on which one you choose. All are immediately reversible if you want to get pregnant and none decrease your chances of pregnancy in the future.