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PREGNANCY FAQ'S
 From the moment you found out you were expecting, it probably seems like you have many more questions than answers. We'll try to answer some of the most commonly asked questions relating to pregnancy here.
What are the first symptoms of pregnancy?
Missing a period is usually the first signal of a new pregnancy, although women with irregular periods may not initially recognize a missed period as pregnancy. During this time, many women experience a need to urinate frequently, extreme fatigue, nausea and/or vomiting, and increased breast tenderness. All or some of these symptoms are normal. Most over-the-counter pregnancy tests are sensitive 9-12 days after conception, and they are readily available at most drug stores. Performing these tests early helps to allay confusion and guesswork. A serum pregnancy test (performed in a physician's office or laboratory facility) can detect pregnancy 8-11 days after conception.
What is my "due date?"
In other words, when is the baby going to be born? Historically, the term EDC (Estimated Date of Confinement) was used. A more modern term is EDD - Estimated Date of Delivery. The most basic and oldest method to estimate this is to use Naegle's Rule. It makes the assumption that a woman has a 28-day menstrual cycle and that full term is 40 weeks by menstrual dating. It is still used as the basis for dating pregnancies. One must take the first day of the last menstrual period, subtract three months, and then add one week. That gives the EDD - estimated delivery date. Babies can be born and considered "term" as early as three weeks before the EDD to two weeks after the EDD. Ultrasound can also be used to date pregnancies. These tests are particularly helpful when the last menstrual period is not known. Ultrasound can also confirm a due date.
What is folic acid, and do I need to take it?
It is important to take enough folic acid, around 400 micrograms (400 mg or .4mg), both before and during your pregnancy to help ensure the proper development of the baby's spine. Women who don't get enough folic acid during pregnancy are more likely to have a baby with serious problems of the brain or spinal cord. It's important to take folic acid before becoming pregnant because these problems develop very early in pregnancy--only 3 to 4 weeks after conception. You can take a multivitamin or eat
I feel sick all the time, not just in the morning. Is there anything I can do to relieve morning sickness?
Morning sickness affects most pregnant women - 70 to 80 percent -- to some degree. Morning sickness is caused by hormonal changes that occur during pregnancy. Although most common in the morning, it can happen at any time of day, and can even last all day. Symptoms usually include nausea and vomiting, and normally cease around 14 to 16 weeks.
Some recommend methods for combating morning sickness:
" Eat several small meals throughout the day. One thing that triggers morning sickness is an empty stomach. You may want to keep a snack by your bed to eat right when you wake up in the morning.
" Avoid spicy, fatty or greasy foods
" Have frequent protein snacks. (Low fat meats and seafood, nuts, eggs and beans are high protein.)
" Avoid the food smells that bother you most
" Drink non-caffeinated peppermint or ginger tea to help with nausea
" Drink plenty of fluids to help prevent dehydration
" Eat more carbohydrates, such as a plain baked potato, rice, pretzels or dry toast
" Get out of bed slowly in the morning
" Take prenatal vitamins later in the day
If your morning sickness continues after the forth month of pregnancy, or totally incapacitates you, then consult your physician for further advice.
What types of foods should I choose to eat now that I'm pregnant?
Moms-to-be need to add about 300 extra calories to their daily intake. Specifically, an extra serving of milk or dairy products for the calcium benefits, and about 10 extra grams of protein for the baby's cell formation. It's important to realize pregnant women need to eat twice as well, not twice as much. Pre-natal vitamins are great to insure you get all the necessary vitamins and minerals. If morning sickness makes it difficult to eat normally, try smaller meals throughout the day. Yogurt, cheese and crackers, and fruit are excellent choices for snacks. A balanced diet, plenty of calcium and iron, and fluids are essential for moms-to-be and the healthy growth of their babies. Pregnant women who eat right and gain the recommended weight have fewer pregnancy complications, easier deliveries and lose the extra pounds faster.
Are Prenatal Vitamins Necessary?
Since it's tough to get all of the extra nutrients you need for yourself and your baby from your diet, they are usually included in the prenatal vitamins prescribed by your doctor. As with all medications, check with your doctor before taking any additional vitamins or herbal supplements to make sure they are safe for use during pregnancy. But remember, prenatal vitamins are meant to supplement your nutritional needs. Try to eat the recommended daily servings for each food group to help ensure a healthy pregnancy. It's up to you to make good food choices for you and your baby.
Is it normal to have aches and pains in my lower abdomen?
Pelvic pain comes with the territory during a pregnancy. Your body is changing to accommodate your growing baby and the resulting discomfort is usually no cause for alarm. Early in pregnancy it is normal to feel cramping as the uterus grows, as well as discomfort as the ligaments stretch.
During the second trimester, you may feel pains in the pelvis as the uterus grows, your skin stretches and the baby moves around. During the third trimester, it is common to have a backache and sciatica, shooting pains down the back of the leg and buttock. Toward the end of the third trimester, ligaments in the hips and pelvis loosen and can cause discomfort. The baby may kick nerves on the inside of the uterus causing shooting pains toward your upper abdomen or vagina. Areas of numbness may also occur on your abdomen.
If pain persists, becomes more severe, or is accompanied by spotting or bleeding, contact your physician immediately.
How much weight should I gain?
During a normal pregnancy, for most women it is advisable to put on between 24 to 35 pounds, but the amount varies considerably from one individual to another. Most of this weight is gained during the final three months. Don't try to "eat for two," but eat a balanced, healthy diet. If your weight gain is too low, your baby will have low birth weight. Being overweight brings problems like backache, pre-eclampsia or varicose veins. Also, losing all the excess weight after birth will be a major challenge for you if all the weight gain has been due to junk food. Here's a breakdown of where the pregnancy weight gain is distributed:
- Placenta - 9%
- Baby - 38%
- Blood and extra fluids - 22%
- Womb, breasts, bottoms, legs - 20%
- Amniotic fluid - 11%
Can I continue having sex during my pregnancy?
For most couples, this is a very important question. Couples can continue sexual relations until delivery, as long as there are no pregnancy complications. Certain conditions that preclude this include vaginal bleeding, whether it is due to threatened miscarriage, placenta previa or placental separation; incompetent cervix; ruptured membranes; or pre-term labor. Generally, even in the most normal pregnancies, intercourse can be very uncomfortable in the later stages of pregnancy, simply due to the size of the uterus. Therefore, if it does not hurt, it is okay. Alternate positions can also be tried to decrease the discomfort. Remember, intercourse during pregnancy can sometimes stimulate contractions due do the presence of nostaglandin in the semen.
When can I expect to feel my baby move?
You can expect to begin to feel the baby move at about 19 to 22 weeks of pregnancy. If it is not your first pregnancy, you may be able to recognize movement sooner. You may not feel regular movement until 28 weeks or later.
What is the sex of my baby? When can I have an ultrasound?
These two questions go hand-in-hand. Most women want to know the sex of the baby for a number of reasons. The ultrasound is the best non-invasive way to determine this, although it is not 100 percent specific. A good ultrasound technician and a cooperative fetus can be pretty accurate, even as early as 16 weeks. (An ultrasound can also pick up other important facts about the baby's development.) Although it is not "routine," many obstetricians will order an ultrasound during this time.
How can I avoid constipation and hemorrhoids?
These common pregnancy problems are closely related. If you can avoid constipation, you will usually avoid hemorrhoids. Constipation is defined as a hard dry stool that is difficult to pass (not infrequent stools), and diet goes a long way in preventing this. Fiber and fluids are the key! Eat at least five servings of fruits and vegetables per day, leaving skins and peels on when possible. Choose whole grain breads and cereals, and add bran somewhere. Drink at least twelve 8-ounce glasses of water or other decaffeinated fluids per day, and exercise! A daily walk will help keep things moving as they should.
Is it safe to exercise during my pregnancy?
Yes. Physical activity is recommended during pregnancy, unless your doctor specifically advises against it. Regular exercise is good for your health and sense of well being. The amount of exercise you do during pregnancy should be related to how much you did before you conceived. Pregnancy is not the time to begin a strenuous exercise program. If you were exercising regularly before pregnancy, moderate the amount of activity according to how you feel and get the advice of your doctor. Try the talk test to see if you're exercising too hard: can you easily carry on a conversation while working out? If so, you're okay. Walking and low-impact aerobics are normally the best exercises to choose. Aim for 20 - 30 minutes three times a week. Exercises that help you relax, such as yoga, and those that support your body, such as swimming, are also good choices. Make sure you don't get too hot during exercise and drink plenty of fluids. If any pain or discomfort occurs during exercise, stop immediately and consult your doctor.
Is it safe to travel during my pregnancy?
You don't need to cancel your travel plans because you are pregnant. As long as you follow a few simple guidelines and your doctor says it's safe, in most cases you can travel until close to your due date. The safety and means of travel depend on whether you have any problems that need special care, how far along you are in your pregnancy, and your comfort.
The best time to travel is mid-pregnancy (14 to 28 weeks of pregnancy). By that time many women are past the morning sickness phase of early pregnancy. During late pregnancy, it's often harder to move around or sit for a long time. There also is an increased risk of preterm labor (labor that starts before the end of the 37th week of pregnancy). Women often are most comfortable during mid-pregnancy.
The best thing to do is follow your body's signals. How you feel is one of the best guides to your wellbeing and safety. This is true on the road and at home.
Most places are safe to visit during pregnancy. You may need to make special plans, though. If you travel to a higher altitude, you may be short of breath. It will take you a few days to adjust.
There are so many things I worry about but I don't want to pester my doctor. How do I know when its appropriate to call my doctor?
Signs and/or symptoms which should prompt you to call your doctor are:
" Spotting or bleeding from your vagina or rectum
" Nose bleeds
" Pain or burning when you urinate
" Frequent headaches or a headache that does not go away
" Swelling in your face, hands or feet
" Nausea or vomiting
" Sharp stomach or severe abdominal/uterine cramping
" Blurred vision or spots before your eyes
" Dizziness or fainting spells
" Sudden weight gain or loss
" Lack of movement from your baby
" A rash anywhere on your body that does not go away
" Muscle contractions or tightening of your abdominal/uterine area that does not go away
Always contact your doctor if you feel the need to make sure that you and your baby are healthy.
I'm in my fifth month of pregnancy, and my doctor said I may have gestational diabetes. What is that and will it affect my baby?
Thankfully, only 3% - 5% of women get gestational diabetes, a condition where the sugar level rises above normal only during pregnancy. After delivery, it goes away. It is usually detected during a routine pre-natal screening when excess sugar is discovered in the mother's urine. Her physician will usually order a more in-depth screening. If diagnosed with gestational diabetes, the mom-to-be needs to watch her diet carefully and avoid sweets. Insulin injections are not usually needed to keep the sugar level under control. Controlling it by diet is the best way. Regular, small meals will help keep the sugar level stable. Eating protein throughout the day will help. Exercise is helpful in lowering sugar levels, also. Gestational diabetes can result in an increased weight for the baby, which makes cesarean delivery a higher possibility. But, thankfully, there are no long-term negative effects for the mother or baby. Neither are more likely to develop diabetes later in life.
My doctor mentioned I may need to have a cesarean birth. What factors determine if a cesarean delivery is needed?
Cesarean deliveries, or c-section as it's commonly called, are sometimes planned ahead if the baby is believed to be quite large or if it's in a breech position. Also, if the mother has a disease or condition that would worsen from the stress of labor. Many cesarean deliveries are done on an emergency basis when problems develop with the mother or baby during labor. If either one shows signs of distress, or the labor is difficult and slow, the physician will recommend a cesarean delivery. The main objective is to protect the life of the mother and the baby, and most physicians will do everything possible to avoid surgery. If you have concerns about a cesarean delivery, talk with your doctor to understand the reasons for it and to know what options you have.
After labor starts, how will I know when to go to the hospital?
There are three major signs of labor. The first of which is the loss of your mucous plug or "blood show". The second is the rupture of your amniotic sac or "water breaking" and the third is regular or sometimes irregular rhythmic contractions. After experiencing one or all of these signs you should telephone your doctor and be prepared to be a good "labor reporter".
Have a notebook with the following facts written down:
- The time of the loss of your mucous plug or "bloody show" with a description of the discharge and approximate amount of accompanying blood loss, if any. Try to describe the amount of blood loss in terms of coins. For example, quarter, nickel or dime sized amount.
- The time your amniotic sac or "water" breaks, plus the amount of fluid loss and a description of its color. Also, describe the amount of fetal activity prior to and after the rupture occurs.
- The frequency, strength and duration of the contractual event. Timing your contraction from the beginning of one to the beginning of the next will help determine frequency. Timing your contraction from the beginning of one to its end will help determine duration or length. A description of your perceived sensation of intensity of the contraction will help determine each contraction's strength.
After providing your doctor "labor report", he or she will either instruct you to proceed immediately to the hospital or to continue to labor at home. If you are told to continue to labor at home, your healthcare provider will instruct you to call back at a predetermined time or to call back if there are any changes in your labor pattern. You may experience an increase or decrease in contractual intensity, frequency, or duration as well as in the amount of vaginal bleeding. Call your doctor after your water bag ruptures or if you have any sensation of an urge to push. If you do feel the urge to push - DO NOT DO IT!
What can I do about stretch marks?
Unfortunately, you cannot prevent them with creams or lotions. Women have a genetic tendency to get them or not; it is based on the elasticity of your skin. Pregnancy hormones cause softening and relaxing of the collagen and elastic tissue, and about half of pregnant women will experience at least a few stretch marks. They usually appear on the abdomen, breasts, hips, and upper thighs. You can help to minimize them by avoiding sudden bursts of weight gain. Eat a nutritious diet and exercise regularly. Ask your physician about taking extra Vitamin C, which assists in healthy skin and connective tissue - and pamper yourself with a rich skin lotion if you want. It feels good!
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