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Pregnancy Week By Week

First Trimester

First Trimester
The first 12 weeks of pregnancy.
Pregnancy is measured in trimesters from the first day of your last menstrual period (LMP), totaling
40 weeks. The first trimester of pregnancy is week 1 through week 12, or about 3 months.

Early development
Your actual pregnancy begins at the time the egg is fertilized by a sperm cell. During the following
week, the fertilized egg grows into a microscopic ball of cells (blastocyst), which implants on the
wall of your uterus. This implantation triggers a series of hormonal and physical changes in your
body.
The third through eighth weeks of growth are called the embryonic stage, during which the embryo
develops most major body organs. During this process, the embryo is especially vulnerable to
damaging substances, such as alcohol, radiation, and infectious diseases.
Having reached a little more than 1 in. (2.54 cm) in length by the ninth week of growth, the embryo
is called a fetus. By now, the uterus has grown from about the size of a fist to about the size of a
grapefruit.
Early signs of pregnancy
Your first sign of pregnancy may be a missed menstrual period. Other early signs of pregnancy,
caused by hormonal changes, include:

Fatigue.
Breast tenderness.
Increased urination.

Fullness or mild aching in your lower abdomen.

Nausea with or without vomiting, also known as morning sickness.

Additional changes related to pregnancy

Throughout your pregnancy, you may notice a number of mild to severe effects,
including:

Constipation, due to hormonal changes that slow down the normal function of your
bowels. Iron in your prenatal vitamin can also cause constipation.

Mood swings, which can be caused by hormonal changes, extreme fatigue, or the
stress of expecting a new baby.

Vaginal discharge changes. A thin, milky-white discharge (leukorrhea) si normal

throughout pregnancy. Also, the tissues lining the vagina become thicker and less
sensitive during pregnancy.

Vaginal yeast infections, which are more common in pregnancy because of the
increased levels of hormones. Call your health professional if you have symptoms of
a vaginal yeast infection or bacterial vaginal infection (bacterial vaginosis).

Vaginal bleeding. Spotting in early pregnancy may go away on its own, but it can be
the start of a miscarriage. If you experience any vaginal bleeding during
pregnancy, contact your health professional.

First Trimester Pregnancy

What is it? (Overview)
The nine-month cycle of pregnancy is divided into three-month segments, called trimesters. The
first trimester starts the moment of conception, when the egg and sperm first meet, and extends
through the 12th week of pregnancy.
What changes will I experience? (Physical and Emotional Changes)
Your period will probably cease, though some women have what looks like a very light period the
first month. This light spotting, with or without a yellowish discharge, occurs when the fertilized egg
burrows down into the lining of your uterus.
Your breasts may feel swollen and tender and the skin around your nipples may darken as your
body gears up for milk production. Your uterus becomes engorged with nutrient-rich blood and
starts to expand to support your growing fetus. Since this puts pressure on your bladder, you'll feel
the urge to urinate more often.
Up to 70% of women experience nausea and vomiting during the early months of pregnancy. The
term "morning sickness" is a misnomer, since these symptoms can -- and do -- show up at any time
of day or night. For most women, nausea and vomiting wane after the first trimester.
If you feel tired, it's no surprise -- your body is working overtime to create a home for your
developing baby. Not only is the placenta (the organ that will nourish the fetus until birth) forming,
but your body is making more blood and your heart is pumping faster.
Your fatigue may also be related to stress, since your mind is working overtime, too. You may be
wondering if you're doing all the right things, if your baby will be healthy, if you'll be a good parent,
and how a newborn will affect your relationships, career, and finances.
Some women feel like they're riding an emotional roller-coaster during the first trimester. It's hard to
pinpoint the exact reason for each high or low, but hormonal fluctuations, increased stress and
anxiety, and the physical discomforts of pregnancy all play key roles in these mood swings.
What kind of medical care do I need? (Prenatal Care)
Getting prenatal care as soon as you know you're pregnant (or, if possible, before you conceive)
and seeing your provider regularly as your pregnancy progresses are vital to you and your baby's

health. During the first trimester, you'll probably have a checkup once a month. Here's what to
expect during the first prenatal visit:
After a blood or urine test confirms your pregnancy, your caregiver will give you a complete medical
exam. She'll also take a detailed medical history and asses any pregnancy risks. She'll need honest
answers about your lifestyle, too. For example:

Do you drink wine, beer, or alcohol? If so, how often and how much?
Do you smoke? How much?
Do you take any medications or illegal drugs? Which ones?
Do you exercise regularly? What kind of exercise do you do?

Having a clear, complete picture of your medical history and lifestyle helps your caregiver provide
the best care possible, so it's important not to leave out any details -- even embarrassing ones.
Next, she'll give you a blood test to determine your Rh factor. Though it's rare, having a different Rh
factor than your fetus can cause Rh disease, which may lead to serious illness or even death for
your baby. This is easily prevented if Rh incompatibility is spotted early. Your doctor will check your
blood for signs of exposure to syphilis, rubella, hepatitis B, and possibly HIV, too. Other lab work
includes urine tests for infection or diabetes and a cervical culture to check for sexually transmitted
diseases such as gonorrhea and chlamydia.
Your caregiver will also talk about nutrition during pregnancy. In addition to warning you away from
alcohol, caffeine, and tobacco, she may advise you to consume more protein, calcium, iron, and
fluids. Since it can be hard to get enough of certain nutrients, such as folic acid, she may
recommend that you take a daily prenatal vitamin to be on the safe side.
Unless a health condition prevents it, your caregiver will encourage you to exercise. Keeping fit
during pregnancy helps you maintain your aerobic capacity, muscle strength, and flexibility -- not to
mention gear up for the marathon of labor and delivery. Many women enjoy yoga, swimming, and
brisk walking throughout their pregnancies. Now is not the time to embark on a challenging new
program, though. If you haven't been exercising regularly, ask your caregiver to suggest a safe plan
that starts out slowly.
What else can I do to have a healthy pregnancy? (Self-care)
Follow your caregiver's advice regarding nutrition, exercise, and other health matters, and let her
know if frequent nausea robs your appetite or you simply can't keep anything down.
Also contact your caregiver right away if you have any worrisome symptoms, including heavy or
prolonged (more than one day) bleeding, unusual vaginal discharge, abdominal cramping, severe
or persistent headaches, dizziness, visual disturbances, fever, chills, and painful urination.
Get your caregiver's OK before taking any medication, including over-the-counter medicines or
natural remedies. Even seemingly harmless medications can cause birth defects and other
problems during pregnancy. And be sure to steer clear of alcohol, street drugs, and tobacco
(including secondhand smoke).
Finally, since high body temperatures have been linked with neural tube defects, stay out of hot
tubs and saunas while you're pregnant.

How is my baby growing? (Fetal Development)

By the end of the first trimester, the fetus is 2.5 to 3 inches long and weighs about an ounce. His
heart is beating, his respiratory system is working, his liver is making bile, his kidneys are secreting
urine, and his reproductive organs, bone cells, fingers, and toes are forming.

Frequently asked questions (FAQ)

Q: How much weight should I gain during my pregnancy?

A: If your weight was normal before you conceived, your caregiver will probably recommend that
you gain 25 to 35 pounds during pregnancy. You'll notice a little gain (about 2 pounds) during the
first trimester, but most of the necessary bulking up happens later on. If you were underweight or
overweight before getting pregnant, talk to your caregiver about how much weight to put on now.

Q: I'm having wild dreams. Is this normal?

A: Yes. Most women have much more vivid dreams during pregnancy, most likely due to the
incredible physical and emotional changes they're experiencing.

Q: Which prescription drugs can harm my baby?

A: Some common teratogenic drugs (that is, drugs that can cause birth defects and other fetal
malformations) include Accutane, an acne treatment; prednisone, a steroid; tetracycline, an
antibiotic; Coumadin and other drugs used to prevent blood clots; anti-seizure medications; and
drugs used to treat cancer. There are many more, though, so don't take any drug without your
caregiver's OK (ideally, discuss the medicines you take with her before you get pregnant). And let
anyone who prescribes medication to you (including your dentist or a doctor treating you for other
health conditions) know that you're pregnant.

Week 1

Overview of Female Pelvic Anatomy

Mother
Your last period has just started and you may be considering a pregnancy. Preconceptional health
planning is a good idea. However, if you haven't started before now, make sure that you "act
pregnant" until you know other wise. Taking a prenatal vitamin (available at most drug or grocery
stores), with .4 mg of folic acid (to help prevent neural tube defects) is a good idea. Discontinuing
any form of chemical birth control, and avoiding other chemicals such as: alcohol, tobacco (even
second hand smoke), x-rays, over the counter medications, and even discussing the prescription
medications you are currently taking with your care provider.
Baby
As the uterus sheds it's lining, the hormones are preparing another egg for release.
Dad
Many fathers-to-be also begin watching what they eat and drink. The health of dad does play an
important role in baby's health and development. Now is the ideal time to stop smoking, develop
some better eating habits and other healthful goals.

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Week 2

This is a mature follicle getting ready to release the egg...

Mother
Your uterine lining is thickening, and ovulation is getting ready to occur. Some women will actually
feel ovulation, with a one sided pain called mittleschmertz (literally meaning middle pain).
Getting to know your family's medical history is very important. About 75% of complications with
pregnancy and birth can be identified at the first visit. Also learn more about Getting pregnant and
preconceptional health.
Baby:
Almost!

Here is where sperm and egg meet.

Dad
Did you know that wearing boxers can increase your sperm count? By wearing regular or tight
underwear, even pants, you can over heat your testicles and that has an adverse effect of the
sperm.
Twin Tips
If you ovulate more than one egg, chances are you'll get pregnant with multiples! The rate of
naturally occurring twins is about 1 in 89 births.

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Week 3

These are embryos at 3 weeks.

Mother
You have ovulated and some how been exposed to sperm! When the egg implants some women
have a tiny bit of spotting called implantation bleeding, where the egg burrows into the uterine lining,
shedding a bit. This is nothing to worry about. Your body also releases an immunosuppressant
protein called Early Pregnancy Factor (EPF) to prevent your body from seeing the baby as an
invader.
Baby
Implantation will occur this week! The egg and the sperm have met in your fallopian tube and will
begin the 7-10 day journey to the uterus. Cell division begins immediately and continues throughout
this journey. Once it has implanted your baby is called a blastocyst and is about 0.1-0.2 mm in
diameter.

This is an egg five days after conception.

Dad:
You're probably blissfully unaware of what is going on at this point. Or you might be anxiously
awaiting the results of the pregnancy test. Either way continue with good habits previously started
or work towards forming new habits.
Twin Tips
If you're having fertility treatments your chances of having multiples is increased, depending one
which treatment. The rate of twins can be as many as 1 in 40 pregnancies.

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Your Baby: How Old is Your Baby?

To the surprise of many, the age of a fetus is calculated from the beginning of the last menstrual
period - not from the actual date of conception, which usually happens two weeks later. That's why
your due date is considered to be about 40 weeks after your last period, even though only 38 weeks
will have passed since you conceived.
Your Body: The ABCs of Conception
Some women have no idea they've conceived at this early date, while others can tell the exact
moment it happened. Either way, conception is a magical moment for a couple, especially a woman,
whose body is going to grow and change in ways never thought possible.
If you're curious about conception, here's what you need to know in a nutshell. During ovulation,
which usually happens mid-cycle (on day 14 of a 28-day cycle), one of your eggs is carried into the
nearest Fallopian tube. If a man's sperm makes its way to the same spot within the next 12 to 24
hours, it may fertilize that egg. You're not actually pregnant until the fertilized ovum, called a zygote,
travels the rest of the way down the Fallopian tube and attaches itself to the wall of your uterus.
The catch: The average egg lives only 24 hours and the average sperm lives for 24 to 48 hours, so
they have to get acquainted during the first few hours after sex if you're going to conceive.
The moral of the story: If your goal is to get pregnant, you should aim to make love at least every
other day during the middle of your cycle.
On That Note: Getting Graphic
The Female Reproductive System Tour shows just how far a woman's egg and a man's sperm
have to travel before they actually meet up and connect to conceive a baby.
Weekly Tip:
It might be a few more weeks until you miss a period - or notice one of the other signs of
pregnancy -- and suspect that you're with child. So have a home pregnancy test on hand,
but hold off using it until four to seven days after you would expect your period to begin.
Waiting it out will help ensure that you get the right results.

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Week 4
These are embryos at 3 weeks.

Mother
Your body is figuring out what is going on! A urine pregnancy test would probably be positive by
now. They measures the amounts of the pregnancy hormone, hCG, in your urine. Each test
measures a different level. You are probably beginning to feel tired, urinate more frequently,
experience mood swings, and possibly have tender or swollen breasts.
If you have not been avoiding environmental hazards, begin doing so now. The first trimester is the
most critical time for formation of your baby. This also includes avoiding alcohol, smoke (including
second hand smoke), street drugs, limiting or avoiding caffeine. If you have any questions please
contact your careprovider.
Baby:
The chorionic villi are fully formed by the end of this week. In one study, 100% of the transvaginal
ultrasounds showed a gestational sac. The yolk sac that helps feed your baby until the placenta is
fully functional is appearing as well.
Dad:
Do you have a plan on how you'll find out about the pregnancy? Will the test be a joint effort? Some
moms choose to have dad go and read the results. Be sure you've read the instructions and know
how to properly read the test results. The words you say will be remembered forever.
Twin Tips:
hCG levels in moms carrying multiples are often more elevated. This can often be the first sign that
you have more than one on the way! An average hCG for a singleton at 18 days post-ovulation is
about 70 mIU, a twin gestation is about 200 mIU at the same day. Though this is not a foolproof
way to detect twins.

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Your Baby: On Becoming a Blastocyst

The zygote begins to develop rapidly within a day after it is fertilized. In three days time, a cluster of
cells, called a morula, will exit the Fallopian tube and enter the uterus. Then a fluid-filled cavity will
form as the morula grows. The fertilized egg - now called a blastocyst - starts dividing into hundreds
of cells by the eighth day post-fertilization. Once safely in the uterus, it embeds itself, adhering
tightly to the top of the uterine lining.

Your Body: A Gut Feeling

Pregnancy - in all its accompanying signs and symptoms and surprises - is different for every
woman, especially in the first trimester. Some feel physically out of sorts, while others experience
emotional upsets as if they were premenstrual. For the more fortunate, the only sign of having
conceived is the absence of menstruation.
So if you think you may be pregnant, be on the lookout for any or all of these telltale signs: fatigue
and sleepiness, frequent urination, nausea and vomiting, excessive salivation, heartburn,
indigestion, bloating, food aversions and cravings, and any kind of breast changes (heaviness,
fullness, tenderness, tingling, or darkening of the areola).
On the emotional end, you may feel weepy, unstable, irrational, and all-around irritable. If you're
more prone to mood swings, you may feel joy and elation on a good day and, on a less-than-cheery
one, misgivings or fear. These feelings may set in as early as the first month of pregnancy, or they
may develop sometime in the second. And if you're really lucky, they may not affect you at all.
Note: If you have any bleeding, pelvic pain, non-stop vomiting (more than two to three times a day),
painful urination, or sudden swelling of your hands, feet, or face, you should call your doctor
immediately.

On A Different Note: Nutritious News

Planning on being pregnant or hoping you already are? If so, you need to eat accordingly. That
means getting the correct amount of the correct foods. To see what your nutrition needs are during
the next nine months.
Weekly Tip:
If you're trying to conceive or think you may be pregnant, you should start taking a prenatal
vitamin ASAP. Though there is some dispute about whether these nutritional supplements
are really necessary, research does show that they may help prevent birth defects.

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Pregnancy Month One

Physical Changes in Pregnancy

As your last period starts you are not pregnant.

After ovulation, the egg and sperm join and begin the journey to the uterus.

As you miss your first period, or even a few days before, you may begin to suspect
you are pregnant.

Take a pregnancy test.

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Week 5

Mother
If you are in your fifth week, you might not be able to stop yawning long enough to read this!
Sleeping in a jog bra can help the breast soreness. Many of your symptoms are the same as last
week. Some women may also get headaches from the rise in hormones.
There are also a lot of women who will have none of these symptoms. They will sail through early
pregnancy without vomiting or being light headed. For a lot of women this can be normal as well.
Do not panic if you do not have pregnancy symptoms, although you should contact your care
provider if you suddenly lose your pregnancy symptoms.
You And Your Body

This is the week when you will miss your scheduled period and will be able to confirm your
pregnancy officially using a test. You will also be able to calculate your due date.
Although some women sail through the early days of pregnancy, some may start feeling the
pregnancy sensations from the very start. These may include:

You may start feeling very tired even at this early stage.
Breasts may be tingling or very tender.
Nipples may start to appear darker than usual.
Veins in the breasts may become more prominent.
Strange metallic taste in the mouth.
Going off tea and coffee.
Morning (or anytime) sickness or a general feeling of nausea.
Increased urge to urinate.

All in all, your body is gearing up for the next nine months ahead!

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Baby
The heart will begin to beat this week! It's amazing how much is happening so quickly. A
transvaginal ultrasound will show about 90% of the yolk sacs. It is now possible to differentiate
between the head and the tail of the baby now. By the end of the week that folic acid will be paying
off as the neural folds begin to fuse. Your baby is now an embryo! Average length is 1.5 - 2.5 mm.
Your baby is only just visible to the naked eye and measures only about 4mm in length. The spinal
cord and brain have started to grow and the beginnings of the heart is laid down in the form of a
blood vessel.
Dad
Whether you're bursting to tell or planning to wait to spread the good news, the first few weeks of
pregnancy are weird. She's not feeling particularly pregnant or different, you're definitely not feeling
anything, and life is plain weird. It's also normal to have feelings of ambivalence, even if you've
planned the pregnancy. It's important to start talking about how you feel with your partner.
Twin Tips
Early pregnancy ultrasound can usually diagnose multiple gestational sacs, and there by you know
early on. However, early ultrasound can also miss an early multiple gestation. Some reports say
that the appearance of sacs via ultrasound can be different by up to 4 days. Early ultrasound is also
more helpful in determining how many sacs are present and whether or not your babies share the
same sac (monoamniotic). Monoamniotic sacs occur only in identical babies and places the
pregnancy at a higher risk for problems like cord entanglement.

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Your Baby: Getting the Circulation Going

Inside the uterus, the blastocyst (the rapidly dividing fertilized egg) continues to divide and develop
at great speed, growing 40 times larger during the first month. At this point, the fertilized egg, or
zygote, becomes an embryo, which measures about 1/17 inches long. The embryo divides into
three layers where organs and tissues grow. In the top layer of cells, a groove, called the neural
tube, begins to emerge. Over time, the brain, spinal cord, spinal nerves, and backbone will develop
from this area. In the middle layer, the heart and the makings of the circulatory system - blood cells,
blood and lymph vessels - are starting to form. By the end of this week, circulation will begin and
the heart will develop quickly.

Your Body: Pregnancy Pendulum

For many women, learning that they're pregnant is a mixed bag. Planned or unplanned, they may
feel ambivalent - unsure about what lies ahead, how it will transfigure their lives, if they're ready for
parenthood, and so on. While many moms-to-be are excited about conceiving and entering this new
stage in life, some are overcome by anxiety that something can go wrong or hurt the fetus. Having
conflicted feelings about your pregnancy is perfectly normal.
You may have fears about whether the baby will be healthy and how you'll adjust to motherhood.
You may be concerned about the purely practical aspects of parenthood; i.e., the added expense of
raising a child. You may question what you want to do in life - go back to work or stay at home. Or,
you may just float on a cloud for the next nine months as you accept all your bodily changes and
anxiously await your baby's arrival.

On A Different Note: Calculating Your Due Date

If you can't live another moment without knowing your due date, you can figure it out yourself. To
calculate your estimated date of delivery, just take the date of the first day or your last normal
menstrual period (LNMP) and add 7 to it. To that date, add 9 months to get your due date. Say your
last period started on September 11. Add 7 to 11, which brings you to September 18, then add 9
months. Your due date would be June 18. If you want to double check your due date, simply click
here to calculate it due date calculator.
Weekly Tip: One mother of three recommends keeping a journal of your pregnancy from the
beginning. Write down what's going on physically as well as emotionally. Make a narrative of it.
Sometimes letting it all out - even on paper - can help. And it's a great souvenir for your child later in
life.

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Week 6
Here you can see the baby, and
the yolk sac.

Mother
Your nausea may actually get worse this week as your hormone levels rise. Remember it's called
morning sickness, but it can strike at any point of the day. Your breasts may tingle, feel heavy, the
areola (dark nipple portion) may become darker.
Avoid changing cat litter for there is a risk of toxoplasmosis. Let someone else do this duty for while.
Toxoplasmosis can cause genetic defects, but most women who have cats have already had
toxoplasmosis, and just believed it to be the flu. So don't get rid of the cat, just let someone else
change the litter.
You And Your Body

If you are suffering from nausea or morning sickness, you may find that it starts to get worse. This is
due to the increased levels of the pregnancy hormone in your body now. You may also start to feel
tired and irritable.
Your skin will become either spotty or extremely dry. This is natural. Its just the hormones at work
again!

Baby
This week is another busy one for your baby. By the end of the week your baby will be 4-6 mm
Crown to Rump (CR). The larynx starts to form as does the inner ear. The lining of the placenta
begins developing but the placenta will not take over production of the hormones until about week
12.
The heart is bulging from the body and blood circulation is well established. Upper and lower limb
buds will appear this week. And the primordia of the liver, pancreas, lungs, and stomach are evident.
Transvaginal ultrasound can pick up 86% of the fetal poles with heart motion, and 100% of the yolk
sacs at this point.

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Your baby is the size of an apple pip now and measures about 6mm in length.

The heart, whose foundations were laid down last week, starts to beat and doesn't stop
for the rest of your baby's life.

Beginnings of the mouth, ears, eyes, jaw, digestive system have been laid down and
four tiny buds have developed which will develop into the arms and legs.

Your baby's movements can now be picked up on an ultrasound scan. However, these
movements are too weak to be felt by you yet.

The umbilical cord has begun to develop.

Your baby also has a distinct tail at this stage which is why your baby doesn't look quite
so human yet.

Dad
It's not easy watching the mom-to-be in your life feel ill. Be sure to ask her what you can do to help.
Sometimes a cool wash cloth for her face and neck is helpful, sometimes bringing her a snack
before she gets out of bed can help and sometimes she just wants to be alone.
Twin Tips
Nausea and vomiting may be multiplied if you're carrying more than one baby. Though the standard
remedies can still be helpful.

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Your Baby: Forming New Features

It's been four weeks since you conceived, and the embryo is now six weeks old. (Remember, the
age of a fetus is calculated from the beginning of the last menstrual period - not from the actual date
of conception, which usually happens two weeks later.) Still less than _ of an inch long (4 to 5
millimeters), it's tripled in size and is starting to look somewhat familiar. The brain is developing
distinct areas, and the eyes and ears are beginning to take shape. And at this early date, the heart
is starting to pump blood. The backbone, ribs, and muscles of the back and sides will grow out of 40
small blocks of tissue that are developing along the midline.
Your Body: Deciding on a Doctor
Nothing is more crucial to your pregnancy than getting good prenatal care. That means choosing a
compatible health-care provider, someone you can trust and can call when you have questions or
concerns - about you or your baby. In today's world, everything counts: bedside manner, philosophy,
type of practice, and medical credentials. For some people, it's the qualifications that count the most.
The Obstetrician (OB) is trained to handle every possible complication of pregnancy,

labor, and delivery.

The Maternal-Fetal Medicine Specialist, or perinatologist, is an OB who has received

special training to care for high-risk pregnancies. Women who have had a prior
complicated pregnancy, are carrying multiples, or have preexisting medical conditions,
might see this specialist for part or all of their pregnancy.
The Family Physician (FP) wears a lot of different hats - obstetrician, internist, and

pediatrician - and sees the whole family as well. Ideally, an FP will take a keen interest in
all aspects of your health and will consider pregnancy a normal part of the life cycle, not
an illness.
The Certified Nurse-Midwife (CNM) is a medical professional, trained to tend to women

with low-risk pregnancies and uncomplicated births. The focus is on you as an individual,
not on you as a patient.
Each type of medical practitioner will treat you and your pregnancy differently. So before you decide
on "the one," research each practitioner and practice as extensively as you can.
On That Note: Choosing Dr. Right
Looking for the everything-you-need-to-know-to-choose-the-perfect-doctor checklist? Then click
here to use our handy checklist that will help you determine what type of practitioner is the perfect
fit for you.
Weekly Tip:
The telltale sign of pregnancy - morning sickness - may set in this week. To ease your queasy
tummy, try keeping it full at all times. Eat small meals every two to three hours, drink lots of water,
and never leave home without a healthy snack in your bag. Some mothers' favorites include power
bars, graham crackers, plain crackers, and dried fruits and nuts. Even if you do end up vomiting, at
least you won't end up dehydrated.

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Week 7
Right in the center is a baby,
notice the arm buds.

Mother
Your face may break out due to the changes in hormones. So even though you may feel like a
teenager again, you are not alone.
There are usually early pregnancy classes that are available for you and your partner. This can help
make the transition to pregnancy more real for the partner and give you both some idea of what is
to come. Contact your local hospital, birth centers, midwives, childbirth educators for a list of current
classes.
You And Your Body

You may start to feel dizzy or faint in crowded places or if you stand for too long.

Tiredness will be a problem, so try and get as much rest as possible.

You will notice that you may start to lose interest in sex as tiredness and nausea take
over your body.

This is perfectly normal and most women feel this way during the first trimester of their
pregnancy.

Baby
The hand plates become present this week, and the baby is about 7-9 mm CRL by the end of the
week. The genital tubercle is present, but you can't distinguish girls from boys by sight at this point.
Nasal pits are forming.
Your baby will actually go through 3 sets of kidneys, very rapidly as they develop during this period.
This week the second of such sets will form. With a trans vaginal ultrasound, one study shows that
100% of the ultrasounds will be show a fetal pole with heart motion.

Your baby is now called the foetus which literally means the young one.

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Your baby's length is about 1.3cm now, roughly the size of a small grape.

Your baby has clearly visible arms and legs and the future toes and fingers can be seen
at the end of them as clefts.

Nostrils, lips, tongue and teeth are beginning to form and the embryonic lungs are also
developing.

Your baby's heart has has now started to circulate blood around the baby's body.
The spine and brain are almost fully developed.

Although not fully formed, your baby already has internal sex organs, kidneys, lungs and
intestines.

The shape of the tail can still be seen clearly

Dad
What about sex? It's definitely not a thing of the past, but libido issues are certainly big throughout
pregnancy. You might have strange feelings about having sex with a pregnant woman, but rest
assured it's perfectly fine to have sex assuming there are no problems with the pregnancy. The key
here will be that, particularly during the first trimester, there are many reasons why she may not be
interested. Don't let this cause a ruffle in the relationship. Talk to her about your feelings and
desires and be equally willing to listen to hers. Most women find a dramatic increase in their libido
as the second trimester approaches and the fatigue and ill feelings fade.
Twin Tips
Your diet is of particular importance with a multiple gestation. Some practitioners believe that the
more weight gain you do early is a better chance you have of having healthy babies, since multiples
are more likely to be born early.

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Your Baby: Looking Familiar

The embryo is about one-third of an inch or 5 to 9 millimeters long. The brain is growing more
complex as cavities and passages necessary for the circulation of spinal fluid take shape. The
lenses of the eyes are developing, and the middle part of the ears continues to grow. The outer
extremities - arms, legs, hands, and feet - are in the making. Overall, this little being is becoming
more and more recognizable.
Your Body: Off to the Office
Now that you're pregnant, you're going to have to take exceptionally good care of yourself and your
growing baby. That means getting good prenatal care - and that means going to your health-care
provider (OB/GYN, Family Practitioner, or Certified Nurse-Midwife) on a regular basis.
Ideally, you should visit your health-care provider when you are in the baby-planning phase. But if
that isn't possible, the next critical time to pay a visit is after you think you've conceived. That way
you can confirm your pregnancy and do a physical examination to make sure there aren't any
problems that require extra attention. Once you are indeed pregnant, let the visits begin.
If you are otherwise healthy and your pregnancy seems uncomplicated, you can count on going to
the doctor once a month for the first 32 weeks, at which point you'll go every two weeks until week
36, and then weekly until you deliver. The actual schedule varies, however, depending upon your
health-care provider, and if you are in a high- or low-risk category.
On A Different Note: Morning Sickness Ad Nauseam
If you're like the other 70% of pregnant women, you'll probably experience a bout of nausea and
vomiting - more commonly referred to as morning sickness- during the first 12 weeks.
Weekly Tip: You have a lot of appointments ahead of you - between the regular prenatal visits,
blood and other lab tests, as well as the ultrasounds, you'll no doubt be doing a lot of waiting in
hospital reception areas. That being the case, one seasoned mother recommends bringing a book
with you at all times so you can catch up on some reading while you wait.

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31

Week 8
This little one is waving at us!

Mother
You have probably scheduled the first office visit by now. Some practitioners do not want to see you
for your first visit until after you've missed two periods. This will decrease the numbers of false
pregnancies and miscarriages. Many things will take place at the first visit:
?
?
?
?
?
?
?

Urine Sampled (protein, hCG, etc.)

Blood Pressure (baseline)
Weight (baseline)
Pelvic Exam (size of uterus, cysts, coloring of cervix)
Pap Smear (some practitioners do this now, others wait)
Blood (Rh factor, iron levels, immunities, specifically rubella)
Family History (complications that may be predictable)

Every practitioner has a different schedule and each visit will not be as lengthy as this initial visit.
This is a good time to ask any questions that have come up or to go over the list of questions for
choosing a care provider.
You And Your Body

Although you may still not appear pregnant to the rest of the world, you will start to see
some visible changes in your body now.

Your breasts and nipples will enlarge.

Your clothes may also begin to feel tighter around the waistline although you will still be
able to fit into your old clothes.

You will not be able to see it but the colour of vagina will change from light pink to dark
pink around this time.

What you may notice, however, will be an increase in vaginal discharge.

Baby

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Your baby will be about 8-11 mm CR by the end of the week. The baby's hind brain is clearly visible.
This week the baby's gonads will become either testes or ovaries. And spontaneous movement
begins! There are a lot of things that we do know about life before birth.
Bones and joints this week have many things going on. Elbows appear and the process of
ossification (hardening of the bones) begins. Toe rays become present, almost ready for you to
count!

Your baby is now about 2.5cm long, roughly the size of a strawberry.

It is surprising how something so small has all the major organs present already, though
not fully formed yet.

Your baby's eyes are still very wide apart on the sides of her head and it will be a while
before they settle into the correct position.

The heart is now pumping with a regular beat.

The intestines in the foetus's body are so long that they cannot fit into the body and
some of them project out into the umbilical cord.

Your baby's arms and legs are longer and although your baby is kicking with them, she
is too small for you to feel her movements.

Dad:
Looking for a way to treat her? Why not fix dinner and offer her a nap in the afternoon? The fatigue
of the first trimester is really hard on most women, particularly if they normally are very active.
Getting extra rest helps. If a nap isn't possible perhaps you could tuck other children in bed or close
the house up for the night while she runs to bed a bit earlier. Or the opposite, you can get everyone
up or fix breakfast, allowing her to sleep in for a few minutes. These will be much appreciated.

Twin Tips : Indigestion and other gastrointestinal problems can start earlier when there is more
than one baby.

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Your Baby: In a Heartbeat

It's been six weeks since conception and the embryo is just over 3/4 of an inch long or 22 to 24
millimeters. Its head is quite large compared with the rest of the body, but the body will catch up in
another couple of months. Its ears and eyelids are beginning to develop, as are its fingers and toes.
Its arms are growing and wrists and elbows are visible. Its heartbeat is fast -- about 150 a minute -twice that of an adult's.

Your Body: Think Twice

Now that you're pregnant, it's important to pay extra attention to what you do day in and day out
because much of what you do - good or bad - affects your growing baby. For most women, that
means reconsidering some simple pleasures - drinking a glass of wine at dinner, downing more
than one or two espressos, dunking in a hot tub. Like most expectant mothers, you probably
wonder which of these activities, among others, may or may not harm the new life inside you.
Without a doubt, you should give up alcohol, smoking, and using recreational drugs. For everything
else, your best bet is to check in with your health care provider and read up on the dos and don'ts
during pregnancy. Caffeine, for instance, probably won't harm your growing fetus if you keep your
intake moderate.

On That Note:
Another big question you might have is if you can take any over-the-counter or prescribed
medications.
In general and in brief, medicines should not be used unless needed. That said, there are some that
are safe - and others that are not. Consult with your doctor to see what's okay to take when.
Weekly Tip:
Pamper yourself while you can. Put your feet up, take a bath, read a book, get a manicure,
rent your favorite romantic comedy, or go away for the weekend with your spouse. A little
self-indulgence never hurt anyone!

34

Pregnancy Month Two

Physical Changes in Pregnancy

A positive pregnancy test by blood or urine is possible as soon as you miss your period.

In the beginning many women experience nausea and vomiting.

You may feel really, incredibly tired.

You may feel like you're about to start your period, even down to the mild cramping.

35

Week 9

Not only can you see the arms, but look

at the legs

Mother
You may find yourself with a stuffy nose. Nasal congestion and nose bleeds are fairly common
during pregnancy. Try using a vaporizer or humidifier to help lessen the symptoms. You continue to
feel tired, nauseated, and possibly dizzy. Making a baby is hard work!
You And Your Body

You will notice an increase in your weight.

The pregnancy hormone, hCG (Human Chorionic Gonadotrophin) is at its peak, so

anything unusual that you may be feeling can be blamed to it.

Your hair will become less oily.

Breasts may be fuller and feel lumpy or tender at times.

Hormonal changes cause your gums to become softer and thicker. Pay special attention
to oral hygiene.

Baby
We have elbows! Your baby is now approximately 13-17 mm crown to rump length, or about 0.51 0.66 inches. S/he also weighs in at 1 gram! Toe rays are present as the toes begin to form. Gonads
have become testes (for boys) or ovaries (for girls). Baby will move away if touched through the
uterine wall, and can spontaneously move as well. Ossification (hardening) of the bones may begin.

Your baby is about 3cm long now

Face is developing and the mouth and nose are clearly visible.

Arms and legs are growing rapidly.

Tail begins to shrink relative to the rest of the body.

36

Dad
Don't worry if she cries at commercial or seemingly for no reason. These are simply hormones. The
same ones that might cause her to be more irritable. And if you think it's bad being on the receiving
end, let us assure you that it's not very pleasant to feel like your body has been taken over. Again,
the good news is that as the placenta matures and begins to take over production of some of these
hormones, mom -to-be feels better.
Twin Tips
Weight gain in a multiple pregnancy is going to be a big issue. By 24 weeks Dr. Luke in her book,
When You're Expecting Twins, Triplets or Quadruplets suggests by 24 weeks that a twin mom gain
24 lbs, a triplet mom gain 36 lbs and a quadruplet mom gain 50 lbs. After that the rate of weight
gain should be about 1/2 lb per week, per baby.

37

Your Baby: Gender Differences

The growing embryo is about 1 inch long or 25.4 millimeters. As its embryonic tail disappears and
the face rounds out, the embryo is looking more human in shape. On the outside, hands and feet
that looked like paddles just a week ago are now forming fingers and toes. On the inside, the
pancreas, bile ducts, and gallbladder have formed, and the reproductive organs are starting to
develop as male or female.
Your Body: Worries, Concerns, and Fears
Most pregnant women - regardless if it's baby number 1 or baby number 9 - are anxious about the
child growing inside. Will he be healthy? Will she have 10 fingers and 10 toes? It's perfectly normal
and understandable to be concerned. After all, life takes on a new meaning when you're with child.
Some women distract themselves by diving into work or starting new projects. Others proceed with
caution and purposely don't make plans - holding off on buying furniture, choosing names, and
decorating the nursery - until the baby is born. Whatever you do to assuage your fears, you should
know that the odds of having a totally normal baby have never been better. In the United States, the
infant mortality rate is the lowest in history, down to a little over 9 per 1,000 births. Similarly, the
percentage of birth defects also appears to be declining.
Every mother-to-be worries to a certain extent. But if you're so worried that it interferes with work,
sleeping, or eating, you should take action. Try talking with your spouse, confiding in friends,
consulting your doctor, or reading up on pregnancy and parenting. If none of these provide the
comfort you need, you should consider seeking professional help.
On a Different Note:
Ever wish you could be on the outside looking in? With this interactive tool, you can take a visual
tour of the female reproductive system and better understand what's going on inside your body baby and all.
Weekly Tip:
Try to incorporate an exercise routine into your daily agenda. It might be as simple as taking
a walk around the block on your lunch break or as subtle as doing 50
kegels at your desk. Do whatever you have the time and energy for, but keep it up. In the
long run, you'll feel better and it will help your postpartum recovery.

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39

Floating around blissfully.

Week 10

Mother
You are still tired, and nauseated, hang on only a few more weeks for most of you! Your abdomen
may begin to pooch out, but it will be more from bowel distension than the uterus. Your waistline is
slowly disappearing! Remember to measure your waist and belly now! Comparing later can be a lot
of fun!

You may start to feel warmer than usual because of increased blood circulating in your
body.

Mood swings are quite common due to hormonal changes, so your partner will have a
tough time handling you.

Wear loose-fitting clothes to accomodate for your changing shape. However, you may
still be too small for maternity clothes. (try the belly belt before you start investing in
expensive maternity wear!)

Your uterus (womb) is now the size of an orange.

Baby:
The baby now enters it's fetal period. The average size is approximately 27-35 mm crown to rump
length (CRL), or 1.06-1.38 inches. S/he weighs in at 4 grams, or 4 paper clips. Tiny toes have
formed. The eyes are largely open, but the eyelids are beginning to fuse, and will stay that way until
25-27 weeks. External genitalia is beginning to differentiate. External ears are completely formed,
as well as the upper lip. The biggest accomplishment this week is the disappearance of the tail!
Click the audio file to hear a baby's heart beat at 10 weeks 2 days. It's beating at about 160 beats
per minute (BPM).

Your baby is now about 4.5 cm long and weighs about 5g or 1/4 oz

The head begins to grow rapidly to accomodate the brain which is still growing.

External ears are now visible on the head.

40

Fingers and toes, although distinct, are still webbed.

Body is elongating.

The tail disappears.

By the end of week 10, your baby is out of the danger zone for congenital abnormalities.

Dad
Is the reality of pregnancy setting in yet? Do you start worrying about things like how you'll afford
groceries if she takes maternity leave? These are normal dad worries and legitimate. Make sure
you sit down and rationalize your feelings prior to having the discussions with her. There are plenty
of answers to your questions. Finding out now about both of your maternity/paternity leave policies
will be helpful in determining what your family can handle.
Twin Tips
Try to find a time to rest each day, it's a great start on alleviating stress and lack of sleep. Even if it's
20 minutes, it's good for you and the babies! Try a body pillow as your belly grows, this can help
you make the most of your down time.

41

Your Baby: Measuring Up

It's getting increasingly difficult to measure the embryo's total length, legs included, because of the
way it's curled up in your uterus. An easier and more common measurement is from crown to rump
-- the distance from the top of the head to the buttocks - which is about 1.57 inches. The embryo's
estimated weight is about 1/2 ounce. All the major body organs have begun to form, as have the
bones of the skeleton. Its eyelids have grown and the outer ears are forming.

Your Body: Safe Sex

Almost every expectant mother wonders if it's safe to have sex during pregnancy - and the answer
is yes. There is no need to refrain from making love or having an orgasm at any time during your
pregnancy as long as it is proceeding normally and you are not at risk for premature labor.
At the beginning and end of your pregnancy, you might worry that sexual intercourse can be
dangerous for different reasons. In the first trimester, some are concerned that lovemaking could
cause a miscarriage when in fact, most miscarriages at this early date would happen regardless of
your sexual activity. They usually happen because of genetic defects unrelated to anything that
happens after conception.
In the last few weeks before delivery, some physicians may recommend holding off since orgasms
can cause uterine contractions. The majority of studies show, however, that if you have a normal
pregnancy, orgasms -- with or without intercourse -- do not lead to premature labor, premature
rupture of your membranes, or premature birth.
For many couples, it is actually very thrilling to have sex without using birth control and knowing
you're with child. So look at it this way: Enjoy it while it lasts.
On a Different Note: The Second Trimester
Just a few more weeks and you'll be in your second trimester.
Weekly Tip:
Have fun taking weekly or monthly photos of your beautifully blossoming body. By the end of
your pregnancy, you'll be able to see just how far you've come.

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43

Week 11
This baby is eleven weeks into
pregnancy.

Mother
Weight gain is a concern of a lot of women during pregnancy. By this stage of pregnancy most
women have gained very little weight. Generally we say that you will gain about 1-2 lbs. a month in
the first trimester. Some women will actually lose weight and be perfectly fine, particularly if they
were ill. Some will gain no weight whatsoever. While yet others will gain 10+ pounds. The key is a
healthy diet.
However, your focus should be on nutrition rather than weight. Despite folk lore, you are not eating
for two, but you should make everything you eat count. You will only need about 300-500 calories
extra a day while you are pregnant.
Avoid junk foods, and try to ensure that you are getting a variety of fruits and vegetables and
protein. One word about protein, even in pregnancy it does not have to come from meat. There are
a lot of successful vegetarian pregnancies.
You And Your Body

Your basal metabolic rate may rise by 25 per cent which means that you are burning
calories at a faster rate than before pregnancy.

Drink a lot of fluids as you may be perspiring more.

Baby
If you have seen pictures of babies at this stage you will notice that the head is about 1/2 of the
body size. This will change as the baby grows. The iris will begin to develop this week and finger
nails appear! Your baby weighs about 7 grams.

Your baby is now approx 5.5cm long and weighs about 10g or 1/2 oz

Most of the major organs formed.

44

Your baby is now safe from any congenital abnormalities and infections (except German
measles - Rubella).

External genitals formed (along with ovaries or testicles).

Heart is now pumping blood to all the major organs of the body.

Dad
Did you go with her to her prenatal appointment? If you didn't be sure to go to the next one, you'll
get to hear the baby's heartbeat. Attending prenatal appointments is also a great way to be involved
in the pregnancy. If one scheduled during the work day isn't convenient, ask her practitioner if they
can schedule one at the end of the day or on Saturday making it easier for you to attend.
Twin Tips
Look for a local twin club to help you through your pregnancy and new parenting. Even if you've had
children before having twins is a whole new ball game. You can look to the twin club for support
emotionally and informationally. Some clubs even have huge sales and you can grab some double
bargains.

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Your Baby: Transition Time

At nine weeks after conception, your embryo has developed enough to be called a fetus, and the
most important part of its development is over. The baby will grow a great deal at this time -- from
about 1inch long at the beginning of the week to about 2 inches by the end - with its head
measuring about half its length. The eyelids will fuse shut, and the irises will begin to form. At some
point this week or next, blood will circulate between the baby and uterus, and the placenta will begin
to function, providing oxygen and nutrients.

Your Body: Weight Watching Guidelines

Most women wonder what the ideal amount of weight gain is during pregnancy. Today, most
doctors advise a woman of average weight to gain between 25 and 35 pounds. If, however, you're
underweight at the outset, you might need to gain more and, if you're very overweight, you should
gain less. Wherever your starting weight stands, you should not go on a diet, nor should you eat for
two or more during your pregnancy. Too little and too much weight gain can lead to problems for
both you and the wee one in the months ahead.
On average, you should gain about 3 to 4 pounds during the first trimester and about a pound a
week, 12 to 14 pounds in all, during the second trimester. In the last trimester, a pound a week is
still expected up until the last month, when you might hike up to a pound or 2 - or none at all -- for a
total of 8 to 10 pounds. Keep in mind that most of the weight that you gain during pregnancy is
baby-related - not fat -- between the baby, the placenta, amniotic fluid, and the fluid that
accumulates in your body tissues.

On a Different Note: Genetics 101

Need I say that sometimes things don't always go as planned. And for whatever reason, you may
be at an increased risk of having a baby with a birth defect. If that's the case, you should see a
genetic counselor to help you better understand the consequences of a particular diagnosis, explain
the risks, the options regarding treatment, and the possibilities of the condition recurring in future
pregnancies.
Weekly Tip:
Keep up with your kegels -- one of the simplest and most important exercises you can do
from the get-go. By contracting the muscles of the pelvic floor, which support the pelvic
organs (the uterus, bladder, and bowel), you may alleviate problems that can begin during
pregnancy and last long afterward: leakage of urine and hemorrhoids. The best part about
kegels is that you can do them at any time, any place - while you're driving in the car, sitting
at the computer, or eating dinner. To begin, tighten the muscles as if you're stopping a
stream of urine. Hold for ten seconds at a time, then repeat, four or five times in a row. If
remembering things isn't your strong suit at the moment, put up a post-it on your fridge, in
your briefcase, or on your TV.

46

47

Baby is moving a lot, but you

don't feel it yet.

Week 12

Mother
You may actually start feeling better from your extreme tiredness and nausea this week. Others will
hang on to it for awhile longer. Your abdomen may start expanding, especially if this is not your first
pregnancy.
Your placenta will take over the production of hormones around this time. If you have suffered from
corpus luteum cysts they may begin to dissolve now. Your risk of miscarriage is reduced even
further.
You And Your Body

Urge to urinate may decrease as pressure fro m your bladder is lifted.

Constipation may become a problem.

Your uterus moves up into your abdomen.

You should have your first antenatal visit around this time (some hospitals offer a
routine ultrasound scan around 12 weeks).

Baby
While your baby's brain is not the same size it will be at birth, it does have the same structure. Bile
is being secreted by this time. S/he weighs about 14 grams and is approximately 3.54 inches in
total length.
Your baby has its reflexes and also practice movements in the digestive tract. All of this in
preparation for extrauterine life. If your practitioner uses a doppler, you may be able to hear your
baby's heart beat at this office visit. It will sound very fast. Some say that they hear clicking or the
sounds of horse hooves. Either way it is a joyous sound to hear!

Your baby is about 6.5cm long and weighs approx 20g or 3/4oz

48

Your baby starts to look more human although the head is still too large in proportion to
the rest of the body.

From now on, your baby only has to grow and mature.

Eyelids have developed and are closed over the eyes.

Your baby can move muscles of the mouth to frown,open or close the mouth and is
practising them all already.

Heart is beating 110-160 times a minute (about twice as fast as an adult heart).

Tiny nails begin to grow on the fingers and toes. By the time your baby is born, the nails
need trimming already Your baby is able to suck his thumb.

All the intestines now fit into your baby's abdomen and do not project out anymore.

Urine is passed which is nothing but the amniotic fluid that your baby swallows from
time to time.

Amniotic fluid is completely replaced every 24 hours.

If your baby is a male, the female reproductive organs will have degenerated by this
time.

Dad
Consider joining a support group for dads! There are plenty of online groups dedicated to the art of
fathering. These groups can be havens for you to discuss all of your feelings from the good to the
bad and every joy and frustration in between.

Twin Tips
Your uterus may begin to measure larger for dates than a singleton mom. This could also be one of
the first times that multiples are suspected.

49

Your Baby: A Work in Progress

From crown to rump, the fetus measures 2.4 to 2.75 inches or 6 to 7 centimeters long. Its tiny and
delicate fingers and toes have separated, and hair and fingernails are starting to grow. By this age,
almost all of the baby's organs and structures have formed and will continue to grow until delivery.
The intestines are developing in the abdomen and the muscles in the intestinal walls are starting to
practice peristalsis -- contractions within the intestines that digest food. As the kidneys begin to
produce and excrete urine, amniotic fluid starts to accumulate, helping your baby stay afloat.
Your Body: What's in a Craving?
One of the oldest and most enduring pregnancy-related myths is that mothers-to-be crave pickles
and ice cream. While research has found that many expectant women -- between 66% and 90% -may have a craving for at least one food, it's most often for ice cream alone or fruit. The question
then is what causes a craving?
Hormones play a big part in the case of cravings. But they aren't the only answer. Another plausible
explanation is that cravings are signs from our bodies, signaling a particular need. But what are you
to do when your body is bucking at the mere idea of broccoli and lusting for chocolate-covered
pretzels?
For the most part, you should give in to temptation and satisfy the urge as long as it doesn't put
your baby's nutritional needs in jeopardy. It goes without saying that if your craving is good for you
and your baby, then by all means, plunge in. If, on the other hand, you relish something that is
lacking in nutritional value, you should search out a substitute - as long as it fulfills the craving. So
next time you go to grab a piece of candy, reach instead for dried fruit, a fruit-juice-sweetened
muffin, or a cookie. If substitutes still don't do the trick, try distraction - exercising, knitting, reading,
or writing a letter - to take your mind off your tummy.
On That Note: Food, Glorious Food
It's never too late to alter your eating habits, increasing your fruit and vegetable intake and reducing
your processed sweets. To see what you should be eating, how many times a day, and why, check
out this RDA nutrition chart.
Weekly Tip:
One three-time pregnant woman urges others to give into an unwholesome craving first-time
around because it will only intensify if you don't. So if Peanut M&Ms are calling you, buy a
small bag. The longer you put it off, the greater the chance you'll end up devouring a
quarter-pound bag.

50

Pregnancy Month Three

Physical Changes in Pregnancy

Your pregnancy will continue to have symptoms like morning sickness, fatigue, and a
decrease in your desire for sex.

Your belly doesn't really show right now, but as you reach the end of this month your uterus
will be slightly above your pelvis.

Your breasts may increase in size, they may also feel fuller and be more tender. You may
notice that the aerola gets darker during this month.

Some symptoms of the first trimester leave you as you head towards the second trimester,
like the fatigue and morning sickness.

51

Second Trimester

52

53

Second Trimester Pregnancy

Weeks 13 to 27 of pregnancy.

Your Second Trimester

Pregnancy is measured in trimesters from the first day of your last menstrual period (LMP), totaling
40 weeks. Your second trimester begins at week 14 and ends at week 26. During this trimester,
many women begin to "look pregnant."
? Normal Changes During Pregnancy
? Prenatal Visits
? Second Trimester Checklist
? Choosing a Health Care Provider for your Baby

Normal Changes During Pregnancy

The fetus is growing rapidly. At the beginning of the second trimester, the fetus is about six inches
long. By the end of month six, the fetus resembles a small infant, except for its reddish, wrinkled
skin. It will be 12 inches long at the end of the second trimester.
You may feel the baby moving (sometimes called "quickening") in month five. This may not be more
then an infrequent fluttering feeling until month six. The fetus is protected by the amniotic sac and
floating in amniotic fluid. There is still a lot of room for the baby to move.

54

You may notice that you have more energy. You will begin to gain weight this trimester. You should
expect to gain about 25 to 35 pounds if you were an average weight before the end of the
pregnancy.
Your circulatory system expands rapidly during the second trimester. By the end of your pregnancy
you will have gained up to four pounds in increased blood volume, and an additional three pounds
in fluid volume. It is important to stand and move around more frequently in order to improve your
circulation.
Mild exercise, such as walking, will improve your general health, as well as help prevent problems.
Drink plenty of fluids. Your feet may swell later in the pregnancy. Try to put your feet up frequently
and get extra rest.
You may notice changes in your skin. You may look flushed, as if you are blushing, or you may
develop brownish markings (sometimes called "the mask of pregnancy" or chloasma) on your face.
Some women get a dark line down the middle of their abdomen (linea negra) from navel to pubic
hair. You may also notice "stretch marks" (striae gravidarum) appearing on your abdomen, thighs or
breasts. These changes are usually caused by increasing hormone levels, and will go away or fade
dramatically after the baby is born. Wear sunscreen and a hat while outdoors.
Varicose veins, or veins that appear enlarged or close to the skin, especially in the legs, may
appear in pregnancy. Get exercise (walking is great!), and don't stand for long periods without
moving. Try to prop your legs up when you sit.
Exercise is an important part of a healthy pregnancy. It will help minimize many pregnancy-related
problems, such as excess weight gain, varicose veins, problems sleeping and constipation.
Exercise will also prepare you for delivery and ensure a faster post-partum recovery.
Your breasts may begin to secrete a yellowish fluid called colostrum. Breasts require no special
preparation for breastfeeding.

55

Prenatal Visits

You will be seeing your family practice physician, nurse practitioner, certified nurse midwife or
obstetrician at weeks 16, 20, 24 and 28 (every 4 weeks). A detailed ultrasound will be performed in
our clinic Radiology Department during your 4th or 5th month. This will evaluate the placenta, fetal
size and fetal anatomy. See prenatal testing for more information about tests this trimester.

Second Trimester Checklist

Review the Expanded Alpha Feto-Protein (EAFP) Web site for screening blood tests for
birth defects. (Last accessed 4/04)

Blood tests are drawn: CBC (complete blood count) and an antibody screen

Receive a Rh immune globulin injection if advised by your health care provider.

Schedule an ultrasound with the Radiology Department.

Receive the GTT (glucose tolerance test). All pregnant mothers receive routine
screening for gestational diabetes between 24 and 28 weeks. See prenatal tests for
more information about tests this trimester.

Enroll in prenatal classes.

Complete hospital pre-admission papers.

Review your health care coverage.

Choosing a Health Care Provider for your Baby

The second trimester is a good time to choose the person who will provide health care to you
newborn. Both family medicine physicians and pediatricians are qualified to care for your newborn
at the hospital after delivery, and provide care as your child grows. PAMF has a large active group
of health care providers who are well-qualified to care for your growing family.

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Your Second Trimester

What is it? (Overview)
The nine-month cycle of pregnancy is divided into three-month segments, called trimesters. The
second trimester extends from the 13th to the 27th week of pregnancy.
What changes will I experience? (Physical and Emotional Changes)
In general, pregnant women tend to feel their best during the second trimester, since most of the
discomforts of the first trimester have abated and the aches and pains of the third trimester are still
a few months away.
The nausea and vomiting you may have experienced in previous weeks should start tapering off
now. Chances are, you have more energy and are sleeping better now, too.
By the fourth or fifth month, your belly will start to bulge, and your navel may protrude a bit. As the
muscles and ligaments that support the uterus stretch, some women feel achiness in their abdomen
or groin. To be on the safe side, report any abdominal pain to your caregiver, since it can
sometimes signal a more serious condition such as ectopic pregnancy.
You may start to feel some back pain or strain toward the end of this trimester. This often results
from the swayback stance that many pregnant women adopt to offset their belly's increasing girth.
Back pain can also flare up if abdominal muscles separate to make way for the growing uterus. If
your back hurts, talk to your caregiver about exercises, lifting tips, and sleeping positions that can
help alleviate or prevent pain.
Weight gain continues at a steady clip, and you may pack on about a pound a week. Annoying leg
cramps may also start during the second trimester. No one's sure what causes these cramps. But
they often happen at night, and may wake you from a sound sleep.
Between weeks 16 and 20, you'll probably feel your baby move for the first time. This thrilling event
is called 'quickening.' Let your caregiver know when quickening occurs, so he can better pinpoint
your baby's age.
Other common second-trimester symptoms include food cravings, blotchy skin, bleeding gums,
nasal congestion, nosebleeds, heartburn, and constipation -- all side effects of pregnancy
hormones. Although mood swings continue for some, better rest, heightened energy, and fewer
bothersome physical symptoms help create a sense of well-being for others.

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What kind of medical care do I need? (Parental Care)

During your monthly checkups, your caregiver will weigh you, check your blood pressure, and take
a urine sample to test for sugar or protein in your urine (which can signal gestational diabetes or
pregnancy-induced high blood pressure). Finally, he'll measure your abdomen to see if your baby is
growing at the expected rate.
Your caregiver may also offer you a battery of prenatal tests now, including:

Alpha-fetoprotein (AFP) or triple -marker screening - AFP is a substance produced

by the fetus. It's present in your bloodstream and can be measured with a simple
blood test. A triple-marker screening is similar to an AFP test, but provides more
specific results because it also measures the hormones estriol and hCG. Abnormal
levels of these substances can indicate an increased risk for problems such as neural
tube defects or Down syndrome. The tests do not diagnose these conditions, however.
If your screening test is abnormal, your caregiver will suggest additional tests, such as
ultrasound, to help determine why.

Ultrasound - Using high-frequency sound waves, ultrasound creates a "picture" of

your developing baby. It helps your caregiver pinpoint the fetus' age, detect multiple
fetuses, and spot conditions such as neural tube defects.

Amniocentesis - This procedure can detect or rule out disorders such as Down
syndrome and neural tube defects. Guided by ultrasound, a doctor or medical
technician inserts a long, hollow needle through your abdomen and into the amniotic
sac. He then draws out a small sample of amniotic fluid. The sample is sent to a lab,
where cells that have been sloughed off from the fetus are grown and analyzed for
chromosomal defects. This test is generally offered only to women who have an
increased risk for having a baby with genetic defects -- women over 35, for instance,
or those with a family history of inherited disorders.

Glucose tolerance testing - This test checks for signs of gestational diabetes. It's
fairly straightforward: You drink a sweetened solution, and an hour later a blood
sample is drawn and your blood sugar level is measured.

Hemoglobin testing - This test measures the amount of red blood cells in your blood.
Too few can indicate anemia, a common (and easily remedied) problem during
pregnancy.

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What else can I do to have a healthy pregnancy? (Self-care)

Continue to follow your caregiver's advice on diet, exercise, rest, and other health matters. Although
the chance of miscarriage is much lower now that the first trimester has passed, contact your doctor
immediately if you experience any worrisome symptoms, including heavy or prolonged (more than
one day) bleeding, unusual vaginal discharge, abdominal cramping, severe or persistent headaches,
dizziness, visual disturbances, fever, chills, frequent (more than twice a day) vomiting, and painful
urination.
Also be aware of the symptoms of preterm labor, and seek medical care right away if you have:

Uterine contractions, lower back pain, or pressure in your groin or upper thighs.

Fluid that leaks from your vagina in a trickle or a gush.

Spotting or vaginal bleeding.

A thick, mucousy discharge that's tinged with blood.

Some women develop yeast or other vaginal infections during pregnancy. Let your caregiver know
if you have yellowish or greenish discharge, itching, or a strong vaginal odor.
Get your caregiver's OK before taking any medication, including over-the-counter medicines,
natural remedies, and nutritional supplements. Even seemingly harmless medications can cause
birth defects and other problems during pregnancy. And be sure to steer clear of alcohol, street
drugs, and tobacco (including secondhand smoke).
Finally, since high body temperatures have been linked with neural tube defects, stay out of hot
tubs and saunas while you're pregnant.
How is my baby growing? (Fetal Development)
Your baby quadruples in size during the second trimester, growing 9 to 10 inches long and
weighing in at 1.5 to 2 pounds. By week 24, your baby hears and responds to sounds. She also
sleeps and wakes at regular times. As your pregnancy progresses, your baby becomes more and
more active, and you seem to feel every kick, nudge, and jab.

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Frequently asked questions (FAQ)

Q: Do pregnant women need more iron?

A: Yes. You can become anemic if you don't get enough of this important mineral. Be warned,
though: Too much iron can be toxic. Ask your caregiver if you need an iron supplement, and don't
take more than the recommended amount.

Q: Is it safe to have sex during the second trimester?

A: For women with normal, healthy pregnancies, sexual intercourse is perfectly safe throughout
pregnancy. If you've had repeated miscarriages, vaginal bleeding, or are at risk for preterm labor or
other complications, ask your doctor if sex is safe for you.

Q: I've heard that cats are dangerous to pregnant women. Does this mean I have to get rid of mine?
A: No, but do let your mate handle the litter-box duty. That's because cat feces may contain the
parasite that causes toxoplasmosis, an infection that can be fatal for your baby. Avoid eating raw or
undercooked meat and unpasteurized dairy products, too, since they may also harbor the parasite.

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61

Week 13

Mother
Welcome to the second trimester! This is usually the time when mothers feel their best. They are
"over" the joys of early pregnancy and have more energy. They are also beginning to feel pregnant.
Some people have delayed spreading the good news until this point. If you are one of these people
enjoy telling now, and think of some creative ways to do it. This is also a time when fathers and
other family members start becoming more involved as the pregnancy becomes more real for them.
Encourage them to participate in your pregnancy to the extent that you feel comfortable with.
Your appointments will now consist of:
? Blood Pressure
? Baby's Heart Tones

? Weight ? Fundal Height (Growth of the Uterus)

? Urine

You And Your Body

You may start to feel better and less tired.

Irritability may begin to ease.

You may also notice the first signs of a visible bump. If this is not your first pregnancy,
you may start to look pregnant a lot earlier than this.

Nipples have become a lot darker than before.

Blue veins in the breasts become quite prominent due to increased blood supply. Infact,
they become so prominent that you start to look like the figure in your biology book's
chapter on circulatory system!

Baby
There are a lot of things going on this week! All twenty teeth have formed and are waiting (Teething
is yet to come!). Your baby approximately weighs in at 1 ounce (28.3 grams). Consider that the
placenta weighs about an ounce now as well.

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Your baby's intestines are migrating from the umbilical cord into his or her abdomen. The villi are
also forming in the intestines, these help in peristaltic movements and digestion. The pancreas of
your little one is even secreting insulin!

Your baby is approx 7.5cm long and weighs about 30g or 1.5 oz

The production of blood cells has now been taken over by the bone marrow, liver and spleen Bones
are developing.

Your baby's teeth have been laid down although they will not be visible till about 6 months after your
baby is born.

The eyelids meet and fuse together and won't open again for the next four months.

Your baby practices lip movements which are required for the sucking reflex after birth.

Dad
It's time to celebrate! You're out of the first trimester! Perhaps you've been waiting to tell family and
friends. Most people feel more confident at this point and do begin to tell their circle of friends.
Twin Tips
Consider joining some online groups to help you through pregnancy. If you wind up on bed rest
these groups can be wonderful to help you get through the days and nights to follow. Not to mention
the great friendships you can make along the way.

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Your Baby: M is for Muscles, N is for Nerves, O is for Organs

Weighing approximately 1 1/2 ounces (35.5 grams) and measuring 3 inches (almost 8 cm) long, the
fetus has plenty of room to grow inside your uterus. At this stage, its eyes and ears are easily
identifiable; the eyes start moving closer together (instead of being on the sides of the head) and
the ears begin moving to the proper place. In general, your baby's face is looking more and more
human each day. Its vocal cords are beginning to form and the arms, legs, fingers, and toes are
developing quickly. All of its tiny organs, nerves, and muscles have taken shape and are starting to
function: The intestines move farther into the baby's body, the liver begins to secrete bile, and the
pancreas begins to produce insulin. Even though your fetus can flex its arms and kick its legs, you
won't feel any movement until it grows larger around week 16 to 20. Also around week 16, you'll be
able to determine your baby's gender by looking (with an ultrasound) at the genitals, which are
present now but not yet visible to the eye.
Your Body: Second Trimester Tales
Welcome to the second trimester, which stretches from the beginning of this week to the end of
week 27. For some women, it is what is referred to as the "golden period," when the risk of
miscarriage has decreased - though not disappeared entirely - and you can feel comfortable
sharing your extraordinary news. With that, the fatigue, nausea, and other first-trimester side effects
may disappear, your sleeping should improve, and you might even enjoy a surge of energy. In
general, you might feel more like the "old" you.
Around this time, you will also notice a few baby-related changes. Being pregnant will probably feel
more real to you. Sometime around week 10 to 12, your doctor may have listened to the baby's
heartbeat using Doppler ultrasound, and, in another few weeks, you will probably start feeling little
flurries inside. Those butterfly-like sensations are the baby, making its presence felt for the first time.
Another second-trimester highlight is when you transition from feeling fat to looking pregnant -sometime during the fourth or fifth month -- and the outside world takes note. Total strangers in the
grocery store might wish you well or inquire as to which month you're in. And if you take public
transportation, something out of the ordinary may happen -- someone might actually offer you a
seat!
Keep in mind that not all second trimesters are symptom-free and sensation-less. There is, in fact, a
whole new set of aches and pains, along with potential problems and complications, that may set in.
You might suffer from back, abdomen, or leg cramps, and even experience heartburn. Your skin
may act strangely (darken, grow more moles, or skin tags), and you might experience bouts of
constipation. Look on the upside: you're 1/3 of the way there.
On That Note: Trimester Two up Close
As you enter this next stage of pregnancy, you might feel overwhelmed by the never-ending
changes in your body, as well as the vast amount of information coming at you. You might also feel
a deep-burning desire to know everything there is to know to be prepared - both mentally and
physically - for pregnancy and parenthood. To learn the who, what, when, where, and why of the
second trimester, click here for the pregnancy encyclopedia article.
Weekly Tip:
If you find yourself constantly unzipping and unbuttoning your normal-sized clothes, you might want
to bring out the maternity wear at last. But before you go on a shopping spree, take some advice
from women who've been there: Borrowing is best. Buy a few of the basics - leggings, T-shirts, and
lingerie - but ask around from friends or family who have already been pregnant for the rest. And
when their time comes next, you can lend them yours.

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65

Week 14

Baby's profile.

Mother
The hormonal changes in your body are becoming apparent. Many are in the form of skin changes.
You may have developed a dark line down the middle of your abdomen to your pubic bone called a
linea negra. The areola (dark nipple portion of your breasts) may have darkened and gotten larger
as well. Your uterus is now the size of a grapefruit.
You And Your Body
The second trimester is probably the best time in your pregnancy when you experience the
mid-pregnancy bloom and feel good about everything. Your sex life may return if it had been
lying dormant for the past three months.

Baby
The baby is now about 12.5 cms or 4.92 inches. Your baby is now producing urine and actually
urinating into the amniotic fluid. It also can practice "breathing" the amniotic fluid in and out of its
lungs.
Amniotic fluid is an amazing substance. It completely regenerates itself every three hours. We do
know that it is partially composed of urine from the baby, but where amniotic fluid in general is
made we are not sure. Modern medicine still has some surprises left.

Your baby is about 9cm long and weighs approx 60g/2oz

The chin, forehead and nose become more clearly defined on your baby's face.

Eyes come closer together and are no longer wide apart on either side of the head.

Your baby's body begins to grow fine body hair called lanugo. Lanugo is thought to have
a protective function and is also used to hold the greasy skin covering secreted by the
baby in the later months.

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Your baby can now respond to external stimulus by actually moving away when the
midwife or doctor feels your abdomen.

The heartbeat is strong and can be picked up using a special listening device - sonicaid.

Twin Tips
Amniocentesis can still be used in multiple pregnancies, be sure to talk to your practitioner if you're
interested.

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Your Baby: Practicing Breathing

The fetus weighs in at 1 1/2 ounces (45 grams) and measures almost 3 1/2 inches (8.9 centimeters)
in length. Its eyes and ears continue to develop and move to the correct position, while the neck
lengthens and the chin no longer rests on the chest. At this age, the fetus begins to practice
inhaling and exhaling and to move and use its hands. As the fetus grows, it receives all of its
nourishment from the placenta.
Your Body: Inside Out
For many expectant women, pregnancy is a time of venturing into unknown territory. Aside from
experiencing aches and pains, the entire intestinal tract is amiss. Some mothers-to-be have
heartburn or indigestion, while others fight flatulence. Still others confront constipation on a daily
basis. If you are suffering from any of these internal goings-on, you're probably wondering if any of
it will affect your baby. The answer is a resounding no - as long as it doesn't interfere with getting
good food into your system.
So, you ask, what can you do to minimize the discomfort or avoid it altogether?
Here are a few tips that may help with indigestion and heartburn:

Avoid gaining too much weight, as it puts excess pressure on your stomach.

Don't wear clothing that is tight around your abdomen and waist.

Eat lots of small meals rather than three big ones.

Eat slowly.

Don't eat any foods that cause gastrointestinal uproars: Stay away from hot and spicy
foods, fried and fatty foods, processed meats, chocolate, caffeine, alcohol or
carbonated beverages, spearmint or peppermint.

Don't smoke.

Bend with your knees, not at the waist.

Sleep with your head elevated about 6 inches.

For flatulence - otherwise known as gas - try the following measures :

Avoid constipation, which is a common cause of gas and bloating.

Eat six small meals instead of three large ones, which only add to the bloated feeling.

Chew and drink slowly so you don't ingest excess air.

Steer clear of gas-producing foods such as onions, beans, cabbage, broccoli, fried
foods, and sugary sweets.

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To combat constipation, try these:

Eat high-fiber foods such as fresh fruit and vegetables, whole-grained cereals, breads
and baked goods, and dried fruit.

Drink lots of fluids.

Exercise regularly, even if it's only a walk around the block.

Staying relaxed is another trick that can help calm your tummy and avoid some of the more
undesirable symptoms. If none of these tips help get your system back on track, you should consult
your health-care provider for more helpful hints.
On That Note: Food
It's never too late to alter your eating habits, increasing your fruit and vegetable intake and reducing
your processed sweets. To see what you should be eating, how many times a day, and why, check
out this RDA nutrition chart.
Weekly Tip: One veteran mom recommends keeping a detailed calendar chronicling your every
event during the 9 months. You can mark your doctor's appointments, general emotions, the time
you first felt your baby move, comments from friends and family, cravings, or whatever strikes your
fancy. It's a great keepsake that will help you remember all of the precious first-time moments with
which you can compare pregnancies.

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Week 15

Baby's face.

Mother
Your heart is increasing its output to supply the baby with oxygen. Your enlarged heart is pumping
about 20% more blood than prepregnancy. This volume will actually increase throughout your
pregnancy for an ending increased heart output of 30-50%.
If your clothes are getting tight, do not try to cram yourself into clothes. Either invest in some
maternity clothes, borrow them, wear your partner's clothing or unzip your pants!
The maternal blood screening for neural tube defects, often called the Alpha-fetoprotein Test (AFP)
may be offered at this point. It is a screening that is most accurate during the 15 - 17th weeks of
gestation, although this screening has a high false positive rate.
You And Your Body

It is time now to think about maternity clothes. Click here for some handy tips

Your uterus (which is your baby's home) can be felt about 3 inches below your navel.

As there is an increased amount of blood circulating in your body, the heart enlarges to
cope with this.

The heart also needs to accomodate for your baby's need of oxygen and has hence
increased its output by 20 per cent.

You may feel a lot energetic than before.

Its time to make plans for holiday between weeks 20-27.

Baby
Your baby may have developed the habit of sucking his or her thumb! The skin is very thin and you
can see the blood vessels clearly underneath.

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Your baby is about 70 grams. The scalp hair pattern is developing. And the heart is pumping about
25 quarts of blood a day. This will increase to about 300 at term.

Your baby is approx 12 cm long and weighs about 100g/3.5oz

The legs are now longer than the arms.

Eyelashes and eyebrows are present.

Hair on your baby's head is thicker.

Your baby has started to hear now although all sounds reach him through the amniotic
fluid and appear to be muffled.

Twin Tips
A high MSAFP test result might mean more babies! If you already knew that there was more than
one, be sure that they use the appropriate scale for the testing outcome.

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Your Baby: The Start of Thumb Sucking

At this stage, your fetus weighs approximately 3 1/2 ounces (99.2 grams) and measures just over 4
inches (10.2 centimeters). Hair is sprouting all over: The scalp hair pattern is developing and the
body is covered with lanugo, a very fine hair, which will continue to grow until the 26th gestational
week of pregnancy. The baby's bones are getting harder each day, while the skin is so thin, almost
gossamer, that you can see blood vessels through it. And believe it or not, your baby may have
learned to suck its little thumb. The heart is pumping about 25 quarts of blood a day, which will
increase to about 300 at full-term.
Your Body: The ABCs of the AFP

What is an AFP? The AFP is a blood test that measures the levels of alphafetoprotein in the mother's blood or serum. Called maternal-serum alpha-fetoprotein
(MSAFP), this test is part of the triple screen that measures the fetus-produced
substance, as well as two others that are present in pregnant women: human
chorionic gonadotropin (hCG), a hormone produced in the placenta and unconjugated
estriol, an estrogen produced by both the fetus and the placenta.

When is the test taken? To get the most accurate results of the AFP, the test should
be done between 16 and 18 weeks after the first day of your last menstrual period,
but can be performed by most labs at between 15 and 20 weeks.

What is the purpose of the test? The triple screen is performed to show whether your
fetus is at a greater risk for having a neural tube defect, but it can also help screen for
chromosomal defects. An elevated level of AFP can indicate spina bifida (a deformity
of the spinal column) or anencephaly (the absence of all or part of the brain).
Conversely, an abnormally low level can suggest an increased risk of Down
syndrome or other chromosomal abnormalities.

How safe is it? The blood test is like any other maternal blood test and poses no harm
to the mother or the fetus. The real risk is that a false-positive or false-negative result
may require further testing - such as an ultrasound or amniocentesis -- which could
present greater risks.

How reliable are the results? The triple test is a reliable way to identify women at
increased risk for fetal problems. Of 1,000 women who take the AFP, between 25 and
50 will have results that are higher than normal. In the end, only two of the 1,000 will
actually have a fetus with a neural tube defect. A higher- or lower-than-average result
can be attributed to an incorrect estimation of the age of the fetus, twins (both babies
produce the substance), or not taking into account your weight, race, or the presence
of diabetes.

On a Different Note: Seeing for Yourself

Depending on your circumstances -- and on your health insurance -- you might not get to see your
little one on an ultrasound until midway through your pregnancy - around week 18 to 20.
Weekly Tip: Take the Alpha-fetoprotein (AFP) test on the early side of the window in case you get a
false positive or false negative and there is a need for further testing. That way, you'll have plenty of
time to get genetic counseling, do a more in-depth ultrasound, and take the amniocentesis, if you so
choose. Click here to learn more about the AFP.

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73

Week 16

Mother
You may begin to feel the baby move around this point. This is more likely to happen now if you are
a multipara (someone who has had a previous child) or if you are very thin. Generally you will feel
the baby move about one month earlier than you did in a previous pregnancy, mainly because you
know what you are feeling. It is not uncommon for first time mothers to not recognize fetal
movements until 22-24 weeks. These first movements are called "quickening." They can also be
used in helping to determine your due date.

You And Your Body

A dark line (called Linea nigra) starts to appear down the centre of your abdomen.

You will find an increase in your appetite as the baby grows.

Blood samples for serum screening are usually taken around this time.

Baby
Your baby's nails are well formed, and some babies are even in need of having their nails trimmed
at birth. The ears have also moved from the neck to the head.
Your baby is emptying his or her bladder every 40-45 minutes. The limb movements are becoming
more coordinated. Your baby is about 3 ounces (85 grams) and 6.3 inches (16 cms). The gender
may be detectable by ultrasound.

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Your baby is now approx 16cm long and weighs about 135g/5oz

Your baby is able to squint, open his mouth and even frown.

The skin is very transparent and blood vessels can be seen underneath it.

Sex organs have developed and can be seen on an ultrasound scan to determine the baby's
sex.

If you are carrying a baby girl, her ovaries have now descended from her abdomen into the
pelvis.

Lanugo or the body hair is quite noticeable on your baby's body now.

Twin Tips
You may begin to feel movement now. Another "sign" that there are multiples is the mom who
describes fetal movement like an octopus, or "all over the place." Your practitioner may begin to
wonder if there is more than one if they can palpate more than 3 large parts (and several small
ones!) in your uterus. If you're pregnant with quadruplets or more you may be asked to stop working
at this point.
Your Baby: The First Flutters
The fetus measures 4 1/2 inches (12 centimeters) from crown to rump and weighs about 5
ounces (142 grams). Despite its growing body, your fetus has lots of room to move around
within the uterus. You might actually start to feel it move about as its bones begin to harden
and it flails about frequently. Its head is erect, its legs are now longer than its arms, and its
limb movements are becoming more coordinated. Its fingers and toenails are constantly
growing and are now well formed. If you're eager to find out the gender and you're due for
an ultrasound, you may be in luck - as long as the baby cooperates.
Your Body: All about Amnios

What is it? An amniocentesis, more often referred to as amnio, is a procedure in

which a needle is inserted into a woman's abdomen to remove a small amount of
amniotic fluid from the amniotic sac surrounding it. An ultrasound is used to guide the
needle away from the fetus. Since the fluid and the fetus are formed from the same
cells and have the same genetic makeup, the fluid undergoes genetic analysis and
biochemical tests in a lab.

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What is the purpose of the test? One of the most common uses of the amnio is to
identify genetic or chromosome abnormalities in the baby such as Down syndrome. It
can also detect other conditions, including: genetic disorders known to run in the
family, neural tube defects such as anencephaly and spina bifida, Rh disease, and
fetal lung assessment, the last two of which are done during the last half of the
pregnancy.

Who takes the test? Between 80% to 90% of all amnios are done when women are
over 35 years of age or will turn 35 before their due date. It is also performed if the
results of a screening test - MSAFP, estriol, and/or hCG - are abnormal. And it is
recommended if a couple has had a child with a chromosomal abnormality (i.e., Down
syndrome) or with a metabolic disorder (i.e., Hunter's syndrome); if a couple has had
a child or a close relative with a neural tube defect; when the mother is a carrier of an
x-linked genetic disorder (i.e., hemophilia); when both parents are carriers of an
autosomal recessive inherited disorder, such as Tay Sachs disease or sickle cell
anemia; if one parent has a condition passed on by autosomal dominant inheritance
(i.e., Huntington's chorea); or if the woman has to deliver early and the baby's lungs
have to be assessed.

When is the test taken? If the amnio is taken for chromosome analysis or molecular
DNA analysis, it is typically performed between 16 and 18 weeks of pregnancy. In
some cases, however, the test may be done up to a month earlier. If it is to assess
fetal lungs, it may be taken shortly before delivery.

How safe is it? The risk of an amnio causing a miscarriage ranges from 1 in 200 to 1
in 400. When it does happen, it is usually because of an infection in the uterus, the
water breaking, or labor being induced prematurely. While the numbers are small, the
test should be done only when the benefits outweigh the risks.

On That Note: Amnio on View

For some women, amniocentesis is just another routine pregnancy procedure - part and parcel of
the nine-month odyssey. For others, it is an unnerving exam that makes them think twice. Either
way, you can put your mind at ease with this visual presentation.

Weekly Tip:

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Many pregnant women get their best sleep during the second trimester. After all, your breasts are
no longer tender, your tummy is finally stable, and some of the first-trimester aches and pains have
dissipated. So before you really get heavy and uncomfortable next trimester, try and stock up on
some extra ZZZs now. Lounge around in bed on the weekend, or crawl into bed early and read a
few more pages than usual. Revel in repose: It might seem like an eternity before you have this
opportunity again.

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Pregnancy Month Four

Physical Changes in Pregnancy

You are enjoying feeling better than you did last month.

Because your placenta has taken over the production of the pregnancy hormones, you may
feel a bit better in the second trimester.

Some women will begin to have their bellies show at this point, though most women do not
yet need maternity clothes.

Because of the extra blood volume your body needs during pregnancy, your heart will be
beating more rapidly.

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79

Week 17

Baby's profile.

Mother
Your uterus is now about halfway between your pubic bone and navel. Your secretions all over your
body may increase, due to the increased blood volume. So if you are sweating more, have nasal
congestion, or are suffering from increased vaginal discharge this is nothing to worry about and will
go away after the birth of the baby.

You And Your Body

You may notice stretchmarks especially around the abdomen and the breasts.

Waistline will have disappeared completely.

You may experience minor nosebleeds and nasal congestion.

Bleeding gums (or 'pink toothbrush') may be a problem, so it is a good idea to make an
appointment with the dentist for your free dental check-up.

Baby
Your baby is forming brown fat deposits under his or her skin, by the end of pregnancy this will
account for 2-6% of their total body weight. This will help them maintain their body temperature
when they are born. The baby weighs in at about 5 ounces (142 grams). This means that the baby
now weighs more than the placenta. No new structures have formed.
Loud noises outside may actually cause the baby to startle.

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Your baby is approx 18cm long and weighs about 185g/6.5oz

All the limbs are fully formed now.

Your baby's taste buds are now beginning to develop.

The placenta is well established with a dense network of blood vessels and is exchanging
nutrients and waste.

Your baby shows deposition of brown fat, which plays a role in heat generation after
birth.

Twin Tips
Make sure you're getting about 120 grams of protein a day for twins, more for higher order multiples.
It's not as hard as it might seem. A quick peanut butter sandwich, or an egg can help boost those
numbers up there. Some women find that protein powders added to other meals is easier for them.

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Your Baby: More than Meets the Eye

If you saw an ultrasound of your fetus right now, you'd spot a number of recognizable features. Your
baby-to-be has thin eyebrows, hair on his scalp, and well-developed limbs. He's mastered a few
simple reflexes, too: sucking, swallowing, and blinking. Head to rump, the fetus measures 5 inches
(12.7 centimeters) long and weighs approximately 6 ounces (170 grams). Underneath the baby's
skin, fat is forming. By the end of your pregnancy, this fat will account for 2% to 6% of the baby's
weight and help maintain his body temperature at birth. At this age, your baby's hearing is pretty
sharp: He can make out your conversations and may even be startled by loud noises. Whether you
feel it or not, your baby is becoming very active, moving his head, arms, and legs, and making
breathing movements.
Your Body: What to Do About the Family Feline
If you're a cat owner or lover, you may be worried about yet another pregnancy-related malady
called toxoplasmosis. Carried by cats, the parasite that causes toxoplasmosis may also be present
in raw meat and unpasteurized milk. Though it's rare, your baby could be harmed if you contract the
infection for the first time during pregnancy.
Signs of toxoplasmosis are subtle, so you probably won't know if you've been infected. In fact, most
people show no symptoms at all. Should you feel mild malaise, have a slight fever and swollen
glands, and develop a rash after contact with cats or consuming uncooked meat or unpasteurized
milk, let your doctor know.
If you were tested for toxoplasmosis before you got pregnant and were not immune, or if you don't
know whether you're immune, a few simple steps will help you avoid infection (don't worry, they
don't involve sending your puss packing - at least not permanently):

Turn over the cat-care chores, especially litter box duty, to your partner or a friend. If
you must change the litter yourself, wear gloves and wash your hands when you
finish.

Make sure the litter box is changed daily, since the oocytes that transmit the disease
become more infectious with time.

Wear gloves when you work in the garden and stay away from soil and sand where
cats may have left feces.

Thoroughly wash raw fruits and vegetables with dish soap and/or peel or cook them
before eating.

Steer clear of steak tartare or other raw or undercooked meat or unpasteurized milk.

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On a Different Note: Ready, Set, Action

Most pregnant women are utterly amazed at the flurry of activity going on inside their belly starting
about now.
Weekly Tip:
Now that you're safely in the second trimester, it's time to start thinking about names. Try
mulling over a new one every week -or every day, if you're really rolling. If you don't know
your baby's sex and don't intend to find out, have a few of each ready. One seasoned mom
recommends narrowing it down to two boys' and two girls' names a month before your due
date. That way, you can quickly choose the one that best suits your new baby after he or
she arrives.

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Week 18

The whole baby sucking the thumb.

Mother
Sleeping may be increasingly difficult now, as your body grows. Try propping yourself with pillows to
help you find a more comfortable sleeping position. You might also try doing pelvic tilts before bed,
and always urinate before laying down.
If you haven't started yet, try playing around with baby names! Look through your family history,
read books, look at combinations for girls and boys. Remember to ensure that the initials don't spell
something rude, and never give your kids the same initials!

You And Your Body

You may be able to feel your baby move for the first time (it may be later in first time mums).
The baby's movement feels like fluttering of butterflies or even like rumbling of the stomach (similar
to a feeling of indigestion). Increase in vaginal discharge.

Baby
At 20.5 cms or 8.1 inches total length, your baby is growing rapidly. S/he weighs about 7 ounces
(198 grams). The bones are continuing the ossification process. The pads of the fingers and toes
are formed and the fingerprints are developing as well.

84

Your baby is approx 21cm long and weighs about 235g/8oz

Your baby has become more aware of the world around her and can hear sounds outside
the uterus

You may feel her jump at unexpected noises.

Wrinkled skin due to absence of fat.

Twin Tips
If you're having trouble with hemorrhoids or varicose veins, remember to drink lots of water an put
your feet up when possible. The more babies, the more pressure on the veins in the lower half of
your body.

85

Your Baby: Did You Hear a Hiccup?

At about 5 1/2 inches (14 centimeters) in length and some 7 ounces (200 grams) in weight, the
fetus is growing fast and looking more and more babyish. The pads on her fingers and toes are
formed, her eyebrows are starting to appear, and her eyes are staring straight ahead rather than
out from the sides of her head. Theres rumbling in her bowel as meconium, the baby's first BM,
accumulates there. If youre carrying a boy, his prostate gland is starting to develop now. Though
you probably wont feel them at this early date, your baby may have the hiccups, which happen
before fetal breathing movements become common. Since her trachea is still filled with fluid, these
harmless spasms are silent.

Your Body: Undergoing an Ultrasound

If youre like most women, youll have a routine ultrasound about now so your doctor can get
information on your babys health. Though this brief (five to 10 minutes) and painless test is most
often done during the second trimester, it can be performed any time between the fifth week of
gestation and delivery.
During the first trimester, an ultrasound can:

Confirm or rule out a pregnancy.

Date a pregnancy.

Determine the cause of bleeding or spotting.

Find an IUD that was in place at the time of conception.

Check the fetus condition if a problem is suspected.

During the second trimester, the test can:

Check for signs of life if the fetal heartbeat isn't heard by week 14 or if no
movement is felt by week 22.

Spot multiple fetuses.

Measure the amount of amniotic fluid (too much can cause abnormally rapid
uterine growth).

Detect cervical changes that predict preterm labor.

Determine the condition of the placenta.

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A third-trimester ultrasound can:

Confirm the fetus' age if theres a chance of preterm labor or if the pregnancy extends
much past your due date.

Gauge the fetus' well-being and track fetal activity, breathing movement, level of
amniotic fluid, and the like.

Check for breech presentation or other problematic fetal or cord positions before
delivery.

There are two types of ultrasounds: transvaginal and transabdominal. With both, you lie on your
back on an exam table while your belly or a probe is lubed up with a special gel. A transducer, a
small microphone-like device, is gently pressed on your belly or inserted into your vagina - the
method depends on how far along you are and what type of equipment is on hand. The transducer
emits sound waves, which bounce off your internal organs and form an image on a nearby
computer screen. That image, which for some is crystal clear and for others a big blur, is your baby.
Regardless, most expectant moms find this first glimpse thrilling - and over all too quickly.
On That Note: A Sneak Peek
As your next - or in some cases, your only - ultrasound draws near, you're eager to get a look at the
precious cargo youre carrying. For a sneak preview of what the test entails,
Weekly Tip:
Wear loose-fitting separates for the ultrasound exam. That way, you can easily pull the top
half up and the bottom half down. And even though youll mop up the goop on your belly
with a towel when its all over, some of it will surely wind up on your clothes. So whatever
you do, dont wear your Sunday best!

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Week 19

Baby's profile.

Mother
If you have not looked into childbirth classes, now is the time to do so. Childbirth education is a
great way of informing yourself about pregnancy, labor and birth. There are many different types of
classes available and many different types of teachers. Enroll now before the spaces are all gone!
Medical research indicates that participants in childbirth classes tend to have easier, less stressful
births.
Childbirth classes teach you a variety of things. Today's classes generally offer topics such as:
-

Making pregnancy comfortable

Labor support techniques

Breathing for Labor

Stages of labor

Pain medications in labor

Hospital policies

Birth Center policies

Home birth

Cesarean Birth

Postpartum Recovery

Life with new baby

Breastfeeding

and much more!

Find a class that best fits your schedule. Some classes meet for a few hours every week for several
weeks, while other meet for an intense period of time over one or two days.

88

You And Your Body

You may notice that you are gaining weight in specific areas like hips, thighs and abdomen.
Difficulty in finding a comfortable position to sleep due to the extra weight and bigger uterus. Tiny
veins may appear on your face (these will disappear after birth).

Baby
This is an impressive week for growth! The baby will increase in weight to 8 ounces (227 grams)! If
you are having a girl, her ovaries now contain primitive egg cells. Lanugo appears all over the
baby's body. This fine hair will remain until birth draws nearer. Sometimes you can still see some on
the baby's face and ears after birth. Permanent teeth buds are forming behind the already formed
milk teeth buds.

Your baby is approx 23cm long and weighs about 285g/10oz

Ears now stand out from the sides of the head.

Buds for your baby's permanent teeth appear, behind the ones for the milk teeth.

Twin Tips
Nursery shopping is fun, and with twins it probably needs to be done a bit earlier. You will need
about 1.5 times the clothing you'd need for one baby. Some mothers try to color code their children
to help tell them apart.

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Your Baby: Covered from Head to Toe

This week, your baby-to-be weighs in at an impressive 8 ounces (227 grams) and measures 6
inches (15.2 centimeters) in length. Lanugo - fine, downy hair - covers his skin and a white, waxy
substance called vernix caseosa protects it during its nine-month amniotic bath. Permanent teeth
buds are taking shape behind the already formed milk teeth buds, and the placenta continues to
grow and nourish the baby. If youre carrying a girl, her ovaries already contain primitive egg cells.
Your Body: What to Avoid When Youre Expecting
Pregnancy and childbirth have never been safer. Even so, there are still a few precautions you can
take to ensure that you and your unborn baby get the best possible prenatal care. For starters, take
a long and careful look around the house to see which household hazards youre aware of and
which ones you should avoid.
Cleaning products: Most ordinary household cleansers are deemed safe. And no studies have
proven that the occasional inhalation of cleaning products is detrimental to the fetus. On the flip side,
studies havent shown that frequent inhalation is totally safe either. But don't imagine that youll be
living in squalor. You can continue to keep your house clean for the rest of your pregnancy, but be
sure to follow these guidelines from here on in:

Don't breathe in any product that has a strong odor or fumes; use it in a wellventilated place or not at all.

Use pump sprays instead of aerosols.

Never mix ammonia with chlorine-based products because it produces deadly fumes.

Avoid using products such as oven cleaners and dry-cleaning fluids, which can be
toxic.

Wear rubber gloves when you clean so potentially toxic chemicals dont seep into
your skin.

Lead: Heavy exposure to this age-old mineral can put pregnant women at greater risk of developing
hypertension, even miscarriage. It can also put the fetus at risk of developing minor birth defects or
serious behavioral and neurological problems, especially if the baby is exposed in-utero and after
birth. To create a lead-free environment, check out the most common sources: your drinking water,
the paint on and around your house, and earthenware, pottery, or china that is home-crafted,
imported, antique, or simply old.

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Tap water: Some water is still not safe and drinkable. To make sure yours is potable, check with
your local health department or consult a local environmental group. If you still have some doubts,
have it tested. If your water looks or tastes odd, attach a carbon filter to your kitchen sink or use
bottled water. If it smells and/or tastes like chlorine, boil it or let it stand for 24 hours so the chemical
evaporates. Ideally, change the plumbing.

On That Note: Still More Household Hazards

Even though the world is a safer place, there are still some common household and work-related
exposures you should try to avoid during your pregnancy. To learn more about them, feast your
eyes on this article.

Weekly Tip:
Even if you aren't a gourmet cook, it's a good idea to spend some time in the kitchen during the
next few weeks. Moms we know recommend that you make and freeze a few of your favorite dishes
now, while your energy level is high and your hands are free. Then, when life gets a little more
hectic down the line, all you'll have to do to get dinner on the table is fire up the microwave!

91

Week 20

This is a 20 week ultrasound pic ture of the entire baby. Some

women will have routine ultrasound scans at this time.

Mother
POP! Your belly button may pop out and stay that way until delivery as your uterus presses
upwards. Some people will have trouble breathing as their lungs become cramped with the internal
organs. This will usually continue until the baby "drops" or engages into the pelvis. In a first
pregnancy this will generally occur 4-6 weeks before your birth and with subsequent pregnancies
not until you are in labor. There is a trade off once the baby "drops." You will have to urinate more
frequently, hard to believe, eh? Remembering to do your pelvic tilts prior to laying down will
hopefully allow you a few more minutes of rest before the next bathroom break.
You are half way through your pregnancy! Congratulations!
You And Your Body

You definitely look pregnant now.

Your waistline is no longer visible.

The top of uterus uterus is just below the navel.

Your navel may be flattened or pushed out and remain this way until after the birth.

You may experience breathlessness upon exertion.

Indigestion and heartburn as the uterus starts to push against your stomach.

Baby
Lanugo forms from sebum and skin cells to create vernix. This creamy white substance is believed
to help protect the baby inutero. It will cling to the lanugo and in the creases. This is also something

92

that can be seen sometimes after the birth. Rumor has it that nursery nurses use it for hand lotion,
because of its smooth, protect quality.
You may be aware of sleep wake cycles in your little one. The weight is now up to 10 ounces (283
grams) and the baby measures about 25 cms total length, about 9.8 inches.

Your baby is approx 25.5cm long and weighs about 340g/12oz

Vernix (waxy substance to protect your baby's skin from the amniotic fluid) is starting to
form.

Twin Tips
If you're having your first ultrasound, you might be surprised to find that there is more than one in
there!
Heartburn
What is it? Normally, the valve between the food pipe (oesophagus) and the stomach prevents
the stomach acids from passing back into the oesophagus. In pregnancy however, high levels of
the hormone progesterone causes this valve to relax. As a result, the stomach acids pass into
the oesophagus and irritate the oesophagal lining. This produces a strong burning sensation in
the centre of the chest, just where the heart is and hence the term, heartburn (although it has
nothing to do with the heart).
What to do?
If you suffer most at night, try raising the head of your bed or sleeping with extra pillows
A glass of milk before going to bed might help (as it neutralises the acidity).(Milk may bring
on nausea in some cases, so make sure it agrees with you.)
Sit up straight while eating to prevent your stomach from being sqaushed.
Eat small and frequent meals rather than three large meals.
Avoid eating or drinking very close to bedtime.
Avoid too many cups of tea or coffee.
Avoid spicy and fatty foods unless you are used to them.
Certain pregnancy safe antacids may be prescribed by the doctor. Consult a doctor or
pharmacist.

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Your Baby: How Big Is the Baby?

The fetus now weighs approximately 11 ounces (320 grams) and measures about 6.5 inches (16
centimeters) long. The soft and fine lanugo covers the babys entire body, and the vernix caseosa
clings to it. Other new developments this week include the appearance of tiny toenails, the first
signs of scalp hair, and less transparent skin.

Your Body: The Rh Factor in Full

During pregnancy one of the first blood tests you take checks for the Rh factor. Determined by
genes passed on from your parents, the Rh factor is a type of protein that may appear in red blood
cells. If you carry it, youre considered Rh-positive; if you don't, youre Rh-negative.
As 85% of women are Rh-positive, there is no cause for concern. Problems arise if youre Rhnegative and your partner is Rh-positive, which could lead to Rh incompatibility during pregnancy. If
that happens and your fetus was Rh-positive, your immune system may start producing antibodies
against the Rh factor in the fetus' blood, which it considers a foreign substance. Mild or severe
damage could occur in the fetus - even death - from Rh disease, also known as hemolytic disease
or erythroblastosis fetalis.
The key to protecting the fetus when there is Rh incompatibility is preventing the development of Rh
antibodies. If you tested negative for antibodies early in the pregnancy, you will be tested again usually at 28 or 29 weeks. If you are still negative, you will then be given a dose of Rh
immunoglobulin (RhIg) and, again, 72 hours after delivery, should the baby test Rh-positive. Thanks
to the development of RhIg, fetal Rh disease is now very rare.
The risk of Rh incompatibility is lower in a first pregnancy. Difficulties occur when the Rh factor
enters the Rh-negative mother's circulatory system during delivery (or by abortion or miscarriage),
or when the child has inherited it from the father. The pregnant womans body produces harmless
antibodies. But when pregnant again with another Rh-positive baby, these antibodies cross the
placenta and attack the fetal blood cells.
In rare cases, if your body is already producing antibodies, RhIg will not work, so the fetus will need
to be monitored closely throughout the pregnancy. If you are one of the few women who actually
has Rh antibodies, you will be tested on a regular basis throughout the second trimester to check
the level of antibodies in your blood. If the level is high, you might need to have a blood transfusion
or deliver early to protect the baby.

On That Note: Everything You Ever Wanted to Know About Rh Disease and More
What if you're Rh-negative and your mate is Rh-positive? What if you were Rh-positive in a prior
pregnancy? What if your mother lost a baby with Rh disease? To get answers to these questions and more - click on this Rh incompatibility article.

Weekly Tip:
There's nothing quite like a celebration to make something memorable. Now that you're
halfway through your pregnancy, do something special tonight with your beloved to mark the
momentous occasion. Set up a dreamy candlelight dinner, or get dressed up and hit the
town. Stamp it forever with photographs.

94

Pregnancy Month Five

Physical Changes in Pregnancy

You may begin to feel your baby move, this is called quickening.

As your uterus reaches your navel or belly button, you will begin to show more.

You are going to the bathroom more often because your kidneys work harder in pregnancy.

You are still enjoying your pregnancy at this point with few symptoms that plague you.

95

Week 21

This is an ear!

Mother
Everyone is probably telling you what sex your baby is using different myths! Some people find this
fun, other find it annoying. Using things like how you carry, the Chinese Gender Chart, or other
myths are fun, but not always accurate. Have you decided whether you want to find out the gender
of your baby? There are many things to consider before doing so, and still your baby may not
cooperate.

You And Your Body

Increase in appetite.

You may develop a craving for something unusual

You will probably be feeling energetic.

Baby
Your baby can still move all over in the amniotic fluid. Towards the end of this trimester the baby will
begin to settle, usually in a head down position (Although some babies do not turn head down until
late in the last trimester.). About 3-4% of babies will remain in a breech position. Your baby weighs
just under a pound (13 ounces or 369 grams).

96

Your baby is approx 28cm long and weighs about 390g/14oz

Your baby already has a high number of red blood cells.

White blood cells (responsible for fighting infection) are beginning to be manufactured in
your baby's body.

Twin Tips
Got back pain? While watching your posture and being careful to lift and carry properly can go a
long way, there are back braces that are made to help you carry the load. Talk to your practitioner
about writing a prescription to help insurance cover these items, or you can purchase them
separately on your own.

97

Chinese Lunar Calendar to find the gender of a baby

WOMAN'S CONCEIVING AGE
MONTH OF
CONCEPTION
January
February
March
April
May
June
July
August
September
Gctober
November
December

18

19

20

21

22

23

24

25

26

27

28

29

30

31

G
B
G
B
B
B
B
B
B
B
B
B

B
G
B
G
G
B
B
B
B
B
G
G

G
B
G
B
B
B
B
B
B
G
B
B

B
G
G
G
G
G
G
G
G
G
G
G

G
B
B
G
B
G
G
B
G
G
G
G

B
B
G
B
B
G
B
G
B
B
B
G

B
G
B
B
G
B
B
G
G
G
G
G

G
B
B
G
G
B
G
B
B
B
B
B

B
G
B
G
G
B
G
B
G
G
G
G

G
B
G
B
G
G
B
B
B
B
G
B

B
G
B
G
G
G
B
B
B
B
G
G

G
B
G
G
B
B
B
B
B
G
G
G

B
G
G
G
G
G
G
G
G
G
B
B

B
G
B
G
G
G
G
G
G
G
G
B

_____________________________________________________________________
WOMAN'S CONCEIVING AGE
MONTH OF
CONCEPTION
January
February
March
April
May
June
July
August
September
Gctober
November
December

32

33

34

35

36

37

38

39

40

41

42

43

44

45

B
G
B
G
G
G
G
G
G
G
G
B

G
B
B
B
G
G
G
B
G
G
G
B

B
G
B
G
G
G
G
G
G
G
B
B

B
B
G
B
G
G
G
B
G
G
B
B

G
B
B
G
B
G
G
G
B
B
B
B

B
G
B
B
G
B
G
B
G
B
G
B

G
B
G
B
B
G
B
G
B
G
B
G

B
G
B
B
B
G
G
B
G
B
G
G

G
B
G
B
G
B
B
G
B
G
B
G

B
G
B
G
B
G
B
B
G
B
G
B

G
B
G
B
G
B
G
B
B
G
B
G

B
G
B
G
B
G
B
G
B
B
B
B

B
B
G
B
B
B
G
B
G
B
G
G

G
B
B
G
G
G
B
G
B
G
B
B

_____________________________________________________________________

EXPLANATION
You can choose for yourself whether you want a boy or a girl by following the
chart. The woman's age from 18 to 45 (Chinese reckoning) is on the top line
while the months 1 to 12 indicate the month when the baby is conceived. By
following the chart you will be able to tell in advance whether your baby will
be a boy or a girl. Thus, you can plan to have a boy or a girl. This chart has
been taken from a Royal tomb near Peking, China. The original copy is kept in
the Institute of Science of Peking. The accuracy of the chart has been proved by
thousands of People and is believed to be 99 percent accurate. By reckoning, you
follow a line drawn from the figure representing the woman's age to a line drawn
from the month the baby is conceived. For instance, if the woman is 27 years old
and her baby is conceived in January (according to the Chinese Lunar Calendar),
then her baby will be a girl. The chart is based on the month the baby is
conceived and not on the birth of the baby, B-Male, G-Female. Remarks: A Chinese
Scientist discovered and drew this chart which was buried in a Royal tomb about
700 years ago.

98

Your Baby: Heads Up

Your fetus weighs just under a pound - 13 ounces - or 369 grams, and stands almost 7 inches
(almost 18 centimeters) tall. She still has lots of space to move around in her amniotic bubble, but
will begin to settle down toward the end of this trimester. Most babies get into a head-down position,
but some don't flip until late in the last trimester. And some turn their heads down at first, only to
summersault again later.
Your Body: Diabetes During Pregnancy
What is it? Gestational diabetes is the onset of diabetes during pregnancy in a woman who didn't
have the condition before. With this type of diabetes, your body cannot effectively use insulin, a
hormone that controls the level of sugar (glucose) in your blood. Gestational diabetes is thought to
result from metabolic changes brought about by pregnancy hormones.
What are the symptoms? Sometimes there are none, but you may experience excessive hunger
and thirst, frequent urination, recurrent vaginal yeast infections, and elevated blood pressure. Then
again, you may have some or all of these signs and not have gestational diabetes.
How is it diagnosed? Between 24 and 28 weeks of pregnancy, you'll take a glucose tolerance test
to screen for the condition. This entails slugging down a sweetened solution and getting your blood
drawn an hour later. If you're among the 15% of pregnant women whose tests reveal abnormal
blood glucose levels, you'll need a follow-up exam, called an oral glucose tolerance test. For this
one, you'll fast overnight and then drink an even sweeter solution. Your blood will then be drawn
three times over a three-hour period to measure your glucose levels.
Who's at risk? Any pregnant woman can develop this condition, but some are more prone to it than
others. This includes women over 30 (the tendency toward diabetes increases with age); women
with a family history of diabetes; women with a history of sugar in their urine during pregnancy or of
glucose intolerance outside of pregnancy; obese women; and women who were large babies
themselves (over 9 pounds) or who have delivered large babies before.
On That Note: Gestational Diabetes in Depth
If you're at risk for gestational diabetes or simply want to know more about the condition, click on
this gestational diabetes article.
Weekly Tip: Here's a surefire way to get the glucose down without making your stomach turn:
Refrigerate the sweet solution overnight so that it's cold when you drink it, and sip it slowly with a
straw over a 10-minute period. Both of these tricks tame the sickly sweet taste and make the
medicine go down in the most delightful way.

99

Week 22
A good outline of the face

Mother
You are still feeling pretty good and active in this second trimester. If you are still having aches and
pains or feel like you are slowing down you may want to look into some different remedies.
Sex is something that many pregnant couples don't really discuss at length. However, sexuality can
change a lot during pregnancy. Usually in the first trimester you are nauseated, your breasts are
sore, or you are just too tired. Finding alternate ways of expressing your sexuality without
intercourse is appropriate.
In the second trimester libido is usually increased. With the increase blood flow and secretions in
the vagina and clitoris, some women become orgasmic or multi-orgasmic for the first time. You do
not have to worry about getting pregnant, so this may be the first time in your lives where you
weren't trying to get pregnant or trying to prevent a pregnancy.
There is no way that you are going to harm the baby during intercourse, although this is a common
fear. The baby is well surrounded by the amniotic sac and blissfully unaware of your actions. Unless
you have been told by your practitioner that you should abstain from sex, it is a very healthy activity
to engage in while pregnant.
As you head into the third trimester creativity can be key. New positions will most likely take place,
but studies have shown that there are very few reasons that you can't have sex up until the birth!
Your practitioner will let you know if you should abstain from intercourse.
You And Your Body

Your growing baby and the expanding uterus push on your ribcage, which may cause you pain.
It may be a good idea to check with your doctor that you are having enough iron as it reaches its
lowest level this week.

Baby
The baby is getting bigger and continuing to practice for extrauterine life. This week your baby has
developed eyebrows! S/he weighs about 15 ounces (425 grams) and is 27.5 cms or 10.8 inches
total length!

100

Your baby is approx 29.5cm long and weighs about 410g

Your baby is learning about her body and surroundings through touch.

Fingernails are fully grown by now. They will probably need to be trimmed when born!

Your baby will frequently touch and stroke her own face.

Twin Tips
Thinking about breastfeeding your multiples? It's certainly possible. Your body will provide you as
much milk as you need, whether feeding or pumping, with only a few exceptions. Learn about
nursing your multiples from other moms who have been there. Look around your local twin club or
contact a lactation consult or La Leche Group.

Anaemia
What is it? Anaemia is a condition attributed to iron deficiency. It reduces the haemoglobin in
the red blood cells.
When? Anaemia may strike if your diet has insufficient iron. The insufficiency may also be
caused by the demands of pregnancy.
Symptoms:

extreme tiredness
lethargy
pale complexion
weakness
fainting spells (in extreme cases)

Treatment: You need an iron-rich diet which includes food like green leafy vegetables, red
meat (barring liver or liver products). If the doctor thinks that you might benefit from an iron
supplement, you may be prescribed one (some doctors routinely prescribe iron for pregnant
women). Remember to take iron tablets after or during food and preferably, with orange juice
(as this aids better absorption).

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Your Baby: The Eyes Have It

Your fetus weighs about 15 ounces (425 grams) and measures 10.8 inches (27.5 centimeters) in
length. Her body is long, slender, and well-developed. Your baby's eyelids and eyebrows are fully
formed, and her brain is entering a period of rapid growth. If you're carrying a boy, his testes have
begun to descend from his pelvis to his scrotum.
Your Body: A Is for Anemia
What is it? Anemia is a condition in which you have too few red blood cells, requiring your
body to boost its iron stores to help produce them. In your pre-pregnancy state, you needed
a daily dose of about 15 milligrams of iron. Thanks to your growing fetus, you now require
about 30.
How is it diagnosed? Your caregiver can spot anemia with a blood test, which she may
give at your first prenatal visit. Most women pass this initial check for iron deficiency with
flying colors. In fact, the majority of expectant mothers start off pregnancy with enough iron
stores to last until week 20 (after that point, blood volume expands rapidly and the fetus
needs more and more nutrients to grow). To be on the safe side, your doctor may prescribe
an iron supplement early on to prevent anemia later.
What are the symptoms? Anemia can be mild, with no noticeable signs, or more severe,
with symptoms that include extreme fatigue or weakness; pallor; breathlessness; heart
palpitations; and dizziness, light-headedness, or fainting spells. If you experience any of
these on a regular basis, let your doctor know right away.
Whos at risk? Any expectant mother can develop anemia - in fact, 20% are iron deficient
at some point during pregnancy. Some women, though, are more susceptible to the
condition than others. You may be at greater risk for anemia if youve had back-to-back
pregnancies, youre carrying multiples, youve been throwing up a lot or eating little because
of morning sickness, or you were undernourished before you conceived.
Will it harm my baby? Babies born to anemic mothers are rarely iron deficient at birth.
Thats because your fetus nutritional needs are often met before your own are. This is good
for your baby, of course, but not so good for your own health. Research does show,
however, that babies of anemic mothers who don't take iron supplements are at a slightly
higher risk of being small or premature. The moral of the story: If youre anemic, take your
iron pills to boost your strength and ensure a healthy baby.
On a Different Note: Looking Into Labor and Delivery
With 22 weeks down and 18 more to go, its time to start thinking about labor and delivery. Check
out this signs of labor article to learn the ins and outs (and dos and donts) of the birthing process.
Weekly Tip:
Iron can be tricky for your system to assimilate. To make sure your body absorbs enough of
this important mineral, take your iron pills with your morning OJ or other vitamin C-rich foods.
And be sure to steer clear of caffeine, which blocks iron absorption. If your iron supplement
makes you constipated, talk to your caregiver about safe ways to loosen things up

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Signs of Labor
If you've never given birth before, you may assume that you'll just "know" when the time has arrived to have your baby. In
reality, the onset of true labor isn't always easy to identify, and the events leading up to it can drag on for days.
Remember, too, that your due date is simply a point of reference -- it's normal for labor to start any time between three
weeks before and two weeks after this vaunted date.
So how will you know that labor is starting? First, you need to understand the birth process. In a nutshell, here's what
happens during labor: The uterus repeatedly contracts (tightens and relaxes), causing the cervix to thin (efface) and open
up (dilate) so you can push your baby into the world.

Labor may be nearing if you notice one or more of these signs:

Lightening. This happens when your baby's head "drops" down into your pelvis. Your belly will suddenly
look lower and you'll have an easier time catching your breath than you did when your baby was crowding
your lungs. The downside, though, is that he's now pressing on your bladder, increasing your need to
urinate. For first-time mothers, lightening usually occurs a few weeks before birth. For veteran moms, it
may not happen until labor has begun.

Bloody show. If you have blood-tinged or brownish vaginal discharge, it means your cervix has dilated
enough to expel the mucus plug that sealed it for the last nine months. This is a good sign, but active labor
may still be days away.

Your baby moves less. Women often notice that their baby is less active the day before labor kicks in. No
one is sure why this might be, but one theory is that the baby is simply saving his energy for the big event.

Your water breaks. When the amniotic sac ruptures, you'll feel fluid leak from your vagina in a trickle or a
gush. For most women, contractions follow shortly thereafter. But even if they don't, let your caregiver
know as soon as you think your water has broken. In about 1 in 10 women, contractions don't begin on
their own within 24 hours. If this happens, your labor may need to be induced, since the likelihood of
infection goes up once your baby's sterile bubble bursts. For other women, the amniotic sac doesn't
rupture until labor is well underway.

Diarrhea. If you feel a frequent urge to empty your bowels and your stools are looser than normal, labor
may be imminent.

Nesting. There's no scientific proof linking it to the onset of labor, but plenty of mothers -to-be are gripped
by a sudden urge to "nest" -- to vacuum the entire house at 3 a.m., say, or put those last, finishing touches
on the nursery -- right before labor begins.

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Week 23

Mother
During your appointments your practitioner may palpate your abdomen. This process is a way of
feeling the position of the baby. A tape measure will also be used to measure your fundal height.
This is the top of your uterus and is a good indicator of the continued growth of your baby. Some
people will worry if they measure a bit "too big" or "too small." However, it is completely normal to
have slight variations at this point. Be sure to ask your practitioner if you are worried.
You may actually feel Braxton Hicks contraction, or you might just happen to notice with your hand
a slight tensing of your abdomen. This is just your uterine muscle preparing for birth. The uterus
actually contracts at all phases of a woman's life, however, we rarely notice this unless our uterus is
full!
You And Your Body

You may start to feel Braxton-Hicks contractions.

Your baby can be felt through your abdominal wall now.

Baby
The baby's finger nails are almost fully formed and the lanugo darkens. Your baby continues to
grow in preparation for the journey of birth. He or she is totally unaffected by the Braxton Hicks, or
practice, contractions. Meconium, the baby's first stool, is developing. Baby weighs 1 pound 2
ounces (510 grams).

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Your baby is approx 31cm long and weighs about 440g/15.5oz

Your baby still looks red and wrinkled because although fat is being produced, skin is
being produced at a much higher

rate, causing it to hang loosely.

Your baby continues to swallow amniotic fluid and passing it back as urine.

Swallowing the amniotic fluid may give your baby hiccups, which you may be able to feel.

If your baby is a male, his scrotum is now well-developed.

If your baby is a female, her ovaries already contain millions of eggs (which continue to
decrease in number until puberty).

Twin Tips
Picking a name can be a lot of fun, picking two or more is twice the fun and the hassle. Remember
when choosing names that multiples might not always want to be a part of a set when it comes to
names. Try to pick stand-alone names as you would for any sibling.

Braxton Hicks Contractions

What are they? Also called 'rehearsal contractions', they are the painless (but uncomfortable)
contractions that are responsible for training the pregnant uterus.
When? These contractions may start around week 20 or even earlier if this is not your first
pregnancy.
How do they feel? It feels as if the uterus is tightening and then relaxing. They may last for
about 30 seconds or even longer which gives you enough time to practice your breathing
techniques.
As pregnancy progresses, Braxton Hicks contractions may become even more frequent, intense
and uncomfortable.
What to do?To relieve discomfort, try to relax or lie down. Sometimes changing your position
stops the contractions completely.

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Your Baby: The Beginning of Braxton Hicks

Your growing fetus weighs in at around 1 pound, 2 ounces (510 grams) and measures 11 inches in
length. His body is well proportioned but still slender, with little fat. He's also sporting new
developments from head to toe: The bones of his middle ear are beginning to harden; his
fingernails are almost completely developed; meconium, the baby's first bowel movement, is
forming in his intestines; and the lanugo that covers his body is darkening. You're probably feeling a
lot of movement and may even notice some early, relatively painless contractions, called Braxton
Hicks. Don't worry - these contractions don't mean you're going into labor, and your baby is
unaffected by them.
Your Body: Striations of Sorts
The majority of women - up to 90% - are forever marked by pregnancy (with stretch marks, that is).
The reddish or purplish streaks that appear on your belly, breasts, hips, and upper thighs are
harmless, but they may itch.
As the name suggests, stretch marks show up when skin is stretched, which often accompanies a
large or fast weight gain. They can also develop when you put on just a few pounds, though, - it all
depends on your genes and your skin's elasticity. Good nutrition and regular exercise may help
prevent them, but since stretch marks develop deep within the connective tissue under the skin, all
the creams, oils, and lotions in the world won't make a difference. Don't despair: Many women find
that the streaks fade to a silvery sheen after delivery.
On a Different Note: State-of-the-Art Technology
At this point, you're probably eager to get a peek at your growing baby - and all of his body parts. If
you've already had your ultrasound and want to see more, check out this about ultrasound tool,
which spotlights the fetus' head, legs and arms, genitals, size, and position, among other things.
Weekly Tip: Take a 20-minute break and treat yourself to a manicure. If pregnancy hormones are
doing their job, your nails are strong and shiny - the perfect showcase for a slick of colorful polish.
Be daring: You may not get another chance to pamper your nails for a while, so why not paint them
bright red or pastel blue?

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107

Week 24

The leg! What a great view!

Mother
Your fundus (top of the uterus) reaches just above your navel! You are now aware of your baby's
movements and may even be able to tell the sleep/wake cycles of your little one.
It is important to recognize the signs of premature labor. Premature labor is actually more common
in the summer months, thought to be caused by dehydration in some women, so continue drinking
lots of water! Call your practitioner if you have any of the following:
? Contractions or cramps, more than 5 in one hour
? Bright red blood from your vagina
? Swelling or puffiness of the face or hands, a sign of preeclampsia
? Pain during urination, possible urinary tract, bladder or kidney infection
? Sharp or prolonged pain in your stomach (preeclampsia signs)
? Acute or continuous vomiting (preeclampsia signs)
? Sudden gush of clear, watery fluid from your vagina
? Low, dull backache
? Intense pelvic pressure

You And Your Body

You may be putting on weight at the rate of about 1 lb per week.

Weight gain will start taking its toll

Backache, aching feet and general tiredness may be a problem.

Try to rest as much as possible with your feet up (above the level of the heart, if
possible).

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Baby
Your baby is almost completely formed, and is beginning to deposit brown fat on his or her body.
The purpose of the brown fat is to retain body heat. Newborns are notoriously bad at regulating
body temperature at first. This is particularly a problem for a baby born early.
Babies born at this point have some chances of survival with very special care. They will be in the
Intensive Care Unit, probably for many weeks. Usually we say that you can expect them to stay in
the NICU until their due date.
A major problem with premature babies is lung development. If preterm labor is detected early
enough a steroid shot, called Betamethasone, can sometimes be given to enhance lung
development.
S/he weighs in at 1 lb 5 ounces (595 grams) and 30 cms or 11.8 inches total length!

Your baby is approx 33cm long and weighs about 0.5 kg/1 lb

Eyes (although still closed) are close together on the front of the face.

Ears move into their final position on the sides of the head.

Your baby continues to grow hair on her scalp.

Your baby develops her own pattern of waking and resting periods.

Heartbeat can now be heard with an ordinary sthethoscope.

Your voice can be heard clearly by your baby.

Twin Tips
If your cervix measures less than 2.5 centimeters on ultrasound, you will probably be placed on bed
rest to prevent preterm labor. If you're pregnant with quadruplets your uterus may already be
measuring 40 centimeters.

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Your Baby: Body Heat

Your baby weighs 1 pound, 5 ounces (595 grams) and is 11.8 inches (30 centimeters) tall. Between
now and the end of this week, she'll gain from 6 ounces to 1 1/3 pounds, and her whole body will
begin to fill out, with her muscles, bones, organs, and tissues growing heavier by the day. Now that
she's almost completely formed, your baby will build up body fat to help her retain heat.
Your Body: The Highs and Lows of Pregnancy Lovemaking
Every expectant couple's sexual appetite, amusement, and attitude differs. For some, pregnancy is
wracked by emotional and physical upheavals, which can put a damper on desire. For others,
pregnancy is a time to rejoice and revel in the recreational act -- a welcome break after years spent
worrying about birth control and months trying to conceive.
Despite these differences, however, there is a predictable pattern of sexual interest during the three
trimesters. Not surprisingly, women often lose interest in lovemaking during the first trimester, due
to fatigue, nausea, vomiting, tender breasts, and other pregnancy-related woes. Sexual appetite
usually returns with a vengeance during the second trimester, the so-called "golden period" of
pregnancy, when women tend to feel better physically and psychologically and couples have had a
chance to adjust to the pregnant physique. As the end of pregnancy nears, desire may drop again
for obvious reasons -- a bulging belly that literally gets in the way of intimacy, amplified aches and
pains, and a focus that's turning to the future.
If you question what's normal in the realm of sex during pregnancy, here's your answer: Whatever
feels right to you. The key is understanding the many physical and emotional factors that can affect
your libido and being open-minded and flexible. Some tips to increase your pregnancy pleasure:

Make love during the day, when you're wide awake and less queasy.

Celebrate your changing shape by reminding yourself that "Big is beautiful."

Refrain from breast play if your breasts are tender or leak colostrum.

Massage scented oils onto your inner thighs to disguise less-than-delicious vaginal
odors.

If you experience bleeding, avoid deep penetration -- especially late in pregnancy.

Keep the dialogue open between you and your mate. Discuss your ambivalence
about your changing roles and relationship, your sexual fears, and other anxieties you
may be feeling about what lies ahead.

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Note: If your pregnancy is considered high-risk, talk to your doctor about which types of
sexual expression are safe for you.
On a Different Note: Cool Cervix Tool
As your due date draws nearer, thoughts, fears, and questions about labor and delivery will
increasingly occupy your thoughts. Check out this cerfical changes during labor tool to find out
about the birth process and to see how the cervix dilates during labor.
Weekly Tip: Now that you've passed the halfway point, it's time to start studying up on childbirth.
The best way to learn about the whole process - from birth education to epidurals to episiotomies -is to talk to your health-care provider, get information from the hospital or birthing center where you
plan to deliver, and quiz friends and relatives who've recently had babies.

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Pregnancy Month Six

Physical Changes in Pregnancy

Your baby's movements become easier for you to feel. You may feel your baby move more
frequently or with more regularity.

If heartburn plagues you, try smaller, more frequent meals and avoid offending foods.

Are you having practice contractions, known as Braxton Hicks contractions?

Many women tell you to really enjoy this month before the fatigue and symptoms of the third
trimester slip in...

Do you know the symptoms of premature labor?

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113

Week 25

This babe is sucking the thumb!

Mother
At this point in pregnancy you probably still feel really good! Soon you will begin to see your
practitioner more often. When this happens, many women begin to get the feeling that they are
"running out of time."
Fixing the baby's room or deciding where to let the baby sleep is one of the thing you need to work
out your feelings about now. Although, let me tell you from experience that you should reserve the
right to change your mind once the baby gets here!
Many people spend the first few months with the baby either in their bed or next to their bed in a
cradle or bassinet. This allows for easy access to night feedings and changings, and many parents
report feeling more secure about their baby. Other parents have a nursery and use a monitor to
allow their baby to waken them for night feedings, etc. Some parents feel that they need more
privacy or believe that the baby should learn to sleep alone from the beginning.
Look at all of your options before making up your mind. And again, be flexible. You may find life
with baby very different from what you had imagined. The choice is yours and it is personal, so don't
let others make you feel guilty for your choices.

You And Your Body

Your uterus is now the size of a soccer ball.

Your uterus along with your growing baby puts increased pressure on your bladder
causing you to make frequent trips to urinate.
Heartburn will be quite common now, especially after heavy meals.

Baby
Baby weighs 1 pound 9 ounces (709 grams). The bones are continuing their ossification process,
meaning that they are becoming harder.

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Your baby is approx 33cm long and weighs about 0.5 kg/1 lb

Eyes (although still closed) are close together on the front of the face.

Ears move into their final position on the sides of the head.

Your baby continues to grow hair on her scalp.

Your baby develops her own pattern of waking and resting periods.

Heartbeat can now be heard with an ordinary sthethoscope.

Your voice can be heard clearly by your baby.

Twin Tips
Starting to feel huge? If your clothes don't fit that might not make you feel any better. So mothers of
multiples suggest skipping maternity stores after a certain point in late pregnancy and just heading
to the larger sizes of clothing. There is nothing like a shirt that fits to make you feel better!

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Your Baby: Spinal News

By now, your baby weighs 1 pound 9 ounces (709 grams) and is about 11.2 to 15 inches in length.
The blood vessels of the lungs are developing and the nostrils are starting to open. The baby's
bones are hardening, or ossifying, and the intricate structures of the spine (33 rings, 150 joints, and
1000 ligaments) are taking shape.
Your Body: Childbirth Preparedness
Today, taking a childbirth education class is part and parcel of being pregnant and preparing for
your baby's arrival. It's an opportunity to involve the future father in the pregnancy, to ask questions
that come up in between prenatal visits, and to discuss fears about labor and delivery and
parenthood. It is also a wonderful way to get hands-on instruction in breathing, relaxation, coping
strategies, and coaching techniques that will help you and your spouse meet the demands of labor.
Lastly, birth education classes are a great place to meet other expectant couples -- whose children
may become your child's first friends.
On That Note: Childbirth Checklist
What's the difference between Lamaze, Bradley, and all the other approaches to childbirth? Fill out
this childbirth education class checklist to determine which method of childbirth education is right for
you.
Weekly Tip:
Hook up with some expectant moms in your area for moral and physical support. Join a
group for pregnant women or enroll in a prenatal exercise class. You never know: You or
your future baby may become bosom buddies.

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117

Week 26

They've always said two heads

were better than one...
Mother
While you have been feeling movements for awhile, those other people in your life may not have
been able to. Around this time it may become possible for them to begin feeling the baby from the
outside. It is a really neat to share the experience with others.
Finding a comfortable position for sleeping is a new task! Between night time wakings to go to the
bathroom, to get water or snacks, you need all the sleep you can get.
I highly recommend a body pillow. This will enable you to support your legs and your growing belly!
If you don't have a body pillow, try making use of several regular pillows. The main problem with
pillows is that soon there isn't much room for more than one person in bed, except the pregnant
mom.
You And Your Body

Try gentle exercise regularly as this will prepare your body for labour.

You may feel pressure on and around your pelvis.

Your baby's movements may cause you pain under the ribs.

Try to raise your hands up or lie on your side to ease the discomfort.

Baby
Veins are visible through your baby's skin, although it is quickly changing from transparent to
opaque.
Your baby can hear you and those around you. Although we assume that the uterus is a quiet place,
the baby has been surrounded by noise for a long time. Things like your heartbeat, digestion, and
other body functions are heard by the baby as well as external noises. Now you may feel the baby

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jump at a sudden noise. My daughter would always jump when I clicked the bathtub lever. It
became a game!
The uterus also allows some light to be seen. So your baby is aware of lightness and darkness.
S/he weighs 1 pound 12 ounces (794 grams) and measures 32.5 cms or 12.8 inches total length.

Your baby is approx 35cm long and weighs about 0.7kg/1lb 8oz

Your baby finally opens his eyelids.

Your baby's eyes will be blue in the womb, irrespective of the eye colour he/she develops
after birth.

Fat begins to be laid down under the skin.

Twin Tips
Do you feel funny? Perhaps you think your belly feels tight. Anything even remotely like
contractions should be reported to your practitioner. Preterm labor is much easier to stop in the
early stages and every day your baby stays inside are days it's not in the Neonatal Intensive Care
Unit (NICU). Your practitioner will probably have you go to the hospital for monitoring, you'll
probably get an IV to ensure you're well hydrated and potentially you might be given medications to
stop contractions if it is needed.

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Your Baby: Lung Development

Your baby weighs approximately 1 pound 12 ounces (794 grams) and measures 12.8 inches (32.5
cm) from crown to rump. There is active lung growth this week, as the air sacs begin to develop,
and the lungs start to secrete surfactant, which covers the sacs' inner lining, allowing the lungs to
expand normally during breathing. The brain is also busy at work: Brain wave activity for the visual
and auditory systems begins. Your baby's skin is becoming more opaque, but veins are now visible
through it. Your baby can hear you and your bodily functions - heartbeat and digestion, among
others - as well as outside noises. So if a sudden sound startles you, imagine what it does to your
baby!

Your Body: Fit to be Pregnant

Even though you're more than halfway through your pregnancy, it is now more important than ever
to stay and get in shape, if you aren't already. By getting and keeping fit now, you might have an
easier end of pregnancy and a quicker recovery after the baby.
To get and stay in shape, be sure to follow these general guidelines.

Build up slowly: If you're in week 26 and now starting to get in shape, you have to build
up to it slowly. Begin with a 10-minute warm-up followed by a 5-minute strenuous
workout then a 5-minute cool-down. If your body has adjusted after a few days, you can
increase the more rigorous activity a couple of minutes each day up to 20 to 30 minutes
or more.

Start and stop gradually: Before and after the workout - the warm up and the cool down
periods - are essential parts of any exercise program. By warming up, you will ensure
that your heart and circulation aren't taxed suddenly and reduce the chances of injury.
Conversely, stopping short traps blood in the muscles, reducing the blood supply to you
and your baby, which can lead to dizziness, faintness, extra heartbeats, or nausea. So
walk before and after you run, stretch before and after you do calisthenics or aerobics,
and swim slowly before you do laps.

Keep track of time: Do a complete workout - from warm-up to cool-down - from 30

minutes to an hour, maybe more. Too little is ineffective and too much can be detrimental.

Be consistent: The best way to get in shape is to exercise regularly - three to four times
weekly, every week. If you can't or don't have time to do the whole routine, just do the
warm-ups so your muscles stay supple.

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Think exercise: If you can't carve out special exercise time - first thing in the morning,
before or after work, on your lunch break -- then build it into your existing agenda. Walk
to work, park a block further away from your building, or take a nightly stroll in your
neighborhood after dinner.

Eat and drink up: You must replace burned-up calories and fluids lost through
perspiration so that you and your baby continue to grow. Add 100 to 200 extra calories
for every 30 minutes of rigorous exercise and drink two cups of additional fluid for each
pound lost during your workout.

Note: If you are a high-risk pregnancy, you might have to curb or eliminate exercise entirely.
Remember to consult your health care practitioner to determine what is best for your body.
On a Different Note: Fetal Development in a Flash
Creating a new life is nothing short of a miracle. With this fetal development tool, you can get an
insider's view of a baby in the making -- from conception to term. On this quick-time animation, you
will be able to watch the entire development, specify portions of the pregnancy (i.e., weeks 15-25),
or freeze the frame on a specific week.
Weekly Tip:
Before crawling into bed at night, light some candles in your bathroom and draw a bath. Put
in some aromatherapy drops or bath gel, if you have some handy, and turn off the ringer on
the phone. Once you're safely in the tub, put your feet up and let the energy drain back into
your legs. Taking a bath before bed may be a great solution to ensuring a good night's sleep.

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Week 27

The diameter of the head.

Mother
Welcome to the third trimester! The home stretch! Around this time you will begin to really put on
the weight, this will last until about week thirty-six. Although some cultures dictate otherwise, weight
gained during pregnancy is not fat or unhealthy, but rather, necessary for a healthy pregnancy and
baby.
The weight that you gain will be distributed in several places. In the beginning of pregnancy you
may have noticed that your breasts got larger. The average breast before pregnancy weighs about
7 ounces and during pregnancy each breast can weigh up to an average of 28 ounces! Some of the
weight will go to body fluids (amniotic fluid, blood volume, etc.). Remember that your blood volume
increase by 30-50% during pregnancy. And let's not forget the baby and the placenta! Add this to a
few measly pounds put on as maternal fat stores, and you average about 25-30 pounds.
The most important thing to remember is that a healthy diet is more important than what you gain.
Some women will gain more, as in the case of women who were underweight to begin with, and
those carrying multiple babies. While others will gain less. Pregnancy is not the time to go on a
reducing diet. Even if you are overweight, reducing can actually harm the baby by burning your
maternal fat stores sometimes toxins can be released that are harmful to the baby.
You And Your Body

You will become noticeably larger.

Avoid lying on your back too much- this may make you feel faint as the enlarged uterus presses
against the blood vessels.

Baby
Your baby's skin is very wrinkled from floating in water. This will stay this way until a few weeks
after birth as your newborn fills out into a baby. Although take heart in the fact that your baby's
looks are assuming the looks that they will have at birth! Baby has also hit the 2 pound mark (900
grams).

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Your baby is approx 36cm long and weighs about 0.8kg/1lb 12oz

Your unborn baby can now see light through your abdomen.

Your baby now has a very good chance of surviving if born prematurely (although special care would
be required as vital organs would not be fully functional).

Twin Tips
Be sure to check out multiples programs that offer their products at free or reduced prices. It never
hurts to ask! Your local club may have a local list and other online support groups might also have
national or international offers handy.

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Your Baby: Growing inside and out

At this point, your baby weighs roughly 2 pounds or 900 grams, and measures about 1 1/3 feet long
from head to toe. And believe it or not, he'll continue to grow over 1/2 inch this week. On the inside,
your baby's brain and lungs continue to develop and grow rapidly. On the outside, his skin looks
wrinkled from floating in water. So don't be surprised if your newborn has a crinkled, prune-like
appearance for a few weeks after birth as he fills out into a baby. Other noteworthy news: His
eyelids are beginning to open, and the retinas are starting to form.

Your Body: Travel do's and don'ts

There's no better time than the second trimester to take a vacation "with baby" as long as you've
checked in with your doctor and you've gotten the go ahead. That said, you should keep stress to a
minimum and plan a relaxing trip. To ensure that you and your wombmate are safe and comfortable
during your travels, be sure to keep these do's and don'ts in mind.
Do

Carry your doctor's name and number on you at all times in case you need to contact her
en route. Make sure you have a copy of your insurance card on you, too!

Look up a local obstetrician before leaving home. Ask your health care provider for a
name or contact the local medical association in the city you're visiting. And if all else fails
and you have an emergency, head to the nearest hospital.

Have your personal medical history on hand so that you - or anyone else - know your
blood type, vaccinations, allergies, and any other relevant data.

Prepare a pregnancy kit that includes prenatal vitamins, iron pills if you're taking them, a
few of your favorite snacks, your handy-dandy reference book, comfortable and
supportive walking shoes, support hose, and extra prescriptions for any medications you
take.

Be sure to drink plenty of water and make sure it's bottled if you're in a foreign country.

Don't:

Don't drink the water or eat raw or unpeeled produce in a foreign country unless you are
sure that it's safe.

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Don't forget to go the bathroom. The best way to steer clear of urinary tract infections and
constipation is to go to the toilet as soon as you feel the need.

Don't sit still for too long. Whether you're traveling by plane, train or by car, you should
get up and move around every hour or two. Sometimes a simple stretch of your arms and
legs can release some energy and get your circulation going.

On a Different Note: What's the deal with delivery?

If this is your first pregnancy and you can't imagine how you're going to get this baby out of you in a
few months time, then this vaginal delivery animation is a must-see. With a simple click of the
button, you'll see the whole birthing process right before your eyes in a quick-time format.

Weekly Tip:
If you know where you plan to give birth or if you are considering a few places, you and your
spouse should pay a visit. Many hospitals give tours of the labor and delivery ward so you know
exactly where to go, where to park, and what to do when the time is right. Then, once you've made
your final decision, you should pre-register and fill out all the necessary paperwork -- for the hospital
and for insurance -- ahead of time. That way, when the time comes, you'll be able to have your
baby with peace of mind.

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Third Trimester

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127

Third Trimester
Your Third Trimester

Pregnancy is measured in trimesters from the first day of your last menstrual period (LMP), totaling
40 weeks. Your third trimester begins at week 26 and ends with labor. At the end of the third
trimester, you will make the transition from being pregnant to being a parent.
? Normal Changes During Pregnancy
? Prenatal Visits
? Third Trimester Checklist
Normal Changes During Pregnancy
You may gain as much as 12 pounds this trimester. You will have to adjust your movements and
activities to accommodate your increasing size. Be sure you are maintaining healthy posture, and
get frequent, gentle exercise. You may find you need to urinate often as the growing uterus presses
on your bladder. Continue to drink lots of fluids and eat fruits and vegetables to prevent constipation
and hemorrhoids.
Mood swings, anxiety and increased irritability are common during the last three months of
pregnancy. Talk about your feelings with your loved ones. Take frequent rest periods.
The baby gains the most weight in the last 13 weeks of pregnancy. Most of the organs are
developed at the end of eight months. Tremendous brain growth occurs. At the beginning of ninth

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month, the baby settles down lower in the pelvis in preparation for labor and birth. See fetal growth
for more information.
Prenatal Visits
You will be seeing your obstetrician, nurse practitioner, certified nurse midwife or family physician
every two to three weeks starting around week 32. After 34 to 36 weeks, you will see your provider
weekly until birth. You may be seen more often, if needed.
At 35 weeks your provider will use a rectal or vaginal swab to screen for Group B Strep (GBS). Your
provider will notify you if the test results are abnormal. See prenatal testing for more information
about tests this trimester.
Third Trimester Checklist

Be sure you have signed up for classes on Birth Center Orientation, Preparing for Birth
and Breastfeeding.

Consider a lactation consultation.

Choose a doctor for your newborn.

Plan for a maternity leave from work.

Prepare for baby's arrival.

Consider birth control options for postpartum.

Frequently asked questions (FAQ)

Q: What changes to my body should I expect to notice during the third trimester?
A: All the changes of the second trimester become somewhat more exaggerated in the third
trimester. During this time, abdominal stretching can cause thin lines, and swollen veins can appear
in the legs and the vulva. More fluid retention can lead to swelling of the feet and ankles. Vaginal
discharge may increase. Urination becomes more frequent, especially with the pressure of the
baby's head descending into the pelvis. Fortunately, there is reduced pressure from the baby under
the diaphragm that allows your breathing to become easier. The baby may tend to kick only in
certain areas, which can lead to soreness.

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Q: What do I need to know about breastfeeding vs. bottle-feeding?

A: It is recommended that women attempt breast-feeding, and be as educated as possible about its
benefits. Breast milk is the ideal food for infants. It helps to protect babies until their own immune
system develops, between the 4th and 6th month. There is also evidence that babies who are
breast-fed have fewer middle ear infections, breathing and stomach problems, and are less likely to
develop colic. Breast-fed babies may also develop less allergies and asthma, and may have more
protection against certain cancers. Benefits for the mother include a close bond with the infant,
accelerated shrinking of the uterus, easier post-partum weight loss, and possibly a decreased risk
of developing breast cancer. There are some potential complications of breast-feeding. These
include nipple soreness or cracking, leaking breasts, let-down reflex, inadequate milk production,
breast engorgement, mastitis (breast infection), and drug passage (even birth control pill medication
will cross into milk). There are many reasons why women cannot or choose not to breast-feed.
Women who choose to bottle-feed have more freedom since anyone can feed your baby. Feeding
in public may be easier, and it is easier to know exactly how much food the baby receives during
each feeding. This can be very comforting for new moms. If your choice is bottle-feeding, you
should discuss the type of formula your pediatrician recommends and why. Generally it is
recommended to use an FDA approved formula with at least 4 to12 milligrams of iron. Formulas
can be more complete food than milk from mothers with nutritional deficiencies. Formulas are not
the same as breast milk and do not have all of its benefits, but there have been significant
improvements over the years. For infants allergic to regular formula, there are soy-based formulas.
Formulas should be prepared as directed on the label, and different formulas should never be
mixed.

Q: What types of tests are common during the third trimester?

A: Your health-care provider will perform the test that checks for beta-strep infection. In the third
trimester it is still common for your health-care provider to perform cervical exams if you have signs
of labor or if ruptured membranes are suspected. If it appears that the baby is not as active as
expected, or if you have any high risk factors, your baby may be watched more closely. This is
called fetal monitoring, and requires you to wear a belt that can electronically pick up the baby's
heart rate and your uterine contractions. Ultrasounds are used to determine the baby's growth, or to
detect abnormalities if they are suspected.

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Q: What is a lactation counselor, and when should I see one?

A: Lactation counselors are specially trained in breast-feeding strategies. They are useful in cases
of nipple abnormalities, milk letdown abnormalities, or if the baby has difficulty feeding. They can
help you understand the entire process of breast-feeding. One quick consultation is all that most
healthy moms and babies need. A trained counselor can detect special situations that may require
more time or visits.

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Week 28
Here are the four chambers of
the heart.

Mother
You will probably begin to see your practitioner every 2 weeks now. Some women really like the
added visits, while others feel that they are running out of time before the baby is born. If you
haven't begun discussing labor plans with your practitioner, now is the time to start!
If you have taken childbirth classes you have a good idea of the interventions and alternatives
associated in childbirth. If you haven't, please do some reading on the subject. The most common
things that people have questions about are: episiotomy, fetal monitoring, and pain relief.
Some women will want to use a birth plan to convey their wishes for their labor, birth and
postpartum. This is a terrific idea! It is also a good communication tool between you, your partner
and your practitioner.
Your breasts my leak colostrum now, although if they do not leak, this is not an indication that you
can't breastfeed. You may also find out what your blood type is. Some women, if Rh negative may
need a shot called Rhogam to prevent complications. Make sure you know your partner's blood
type, if he is also negative, then you are safe.
You And Your Body

Your breasts may begin to produce colostrum (the fluid preceding actual breast milk and
vital for baby in the first few days after birth).

Use breast pads if your breasts leak too much.

You may have already/or have this week, blood tests to determine your haemoglobin level.
See anaemia

Keep up your calcium intake to help your baby grow more bone.

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Baby
Your baby's eye lashes are developing, as subcutaneous fat is deposited. If you have a baby boy,
his testes will probably begin descending. Your baby is about 13.8 inches long (35 cms) and weighs
about 2 pounds 4 ounces (1 kilogram)!
A baby born at this time has a good chance of survival with the help of medical technology.

Your baby is approx 37cm long and weighs about 0.9kg/2lb

The heart beats at a rate of 150 beats a minute.

Your baby's brain is growing the folds and grooves of a developed brain.

The hair on the head is longer.

Fat continues to be deposited so your baby looks less skinnier.

Your baby is large enough to be able to determine its presentation (or orientation in the
womb).

Twin Tip
Many practitioners ask that you stop working and get at least 6 hours of rest a day, even if
you don't have a high stress or physically demanding job.

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Your Baby: Seeing is believing

By now, your baby is approximately 14 inches long (35 centimeters) and weighs about 2 pounds 4
ounces - just a tad over 1 kilo! You can see changes in your baby from head to toe. Up top, hair is
growing on her head, and everything relating to her eyes has formed: eyebrows, eyelashes, eyelids,
and eyes. Her lungs are capable of breathing on their own, but they are still immature and would
require help from a ventilator and other special equipment in a newborn intensive care unit in the
event of a premature birth.
If you're carrying a boy, his testicles are on the move, making their way toward the kidneys via the
groin en route to the scrotum. In a girl, you can make out the clitoris, but the labia aren't yet big
enough to cover it.
Your Body: Counting down to your due date
Welcome to the third trimester, which goes from week 28 to 40 - or until you give birth. By now, you
may be feeling a mixture of excitement and angst as you come to the end of your pregnancy. Some
women sail through the whole nine months symptom -free while others watch their bodies grow and
change in ways they never thought possible. Here's what may be in store for you - physically and
emotionally - during the home stretch:

Strong, regular, frequent fetal movement

Heartburn, indigestion, bloating, gas, constipation

Changes in vaginal discharge

Hemorrhoids

Leg cramps, especially during sleep

Protruding belly button

Difficulty sleeping

Nosebleeds and bleeding gums

Backaches

Varicose veins

Swelling in feet, ankles, hands, and face

Shortness of breath until the baby drops

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Frequent urination

Braxton Hicks contractions

Clumsiness

Leaking colostrum (premilk substance) from your breasts

Eagerness to give birth

Anxiety about labor and delivery and the baby's health

Absentmindedness

To top it off, you may have a 10-mile long to-do list that includes finding a pediatrician, buying baby
gear, preparing a birth plan, registering at the hospital and packing your bag, among others. No
matter how you feel, however, remember this is a special time for you and your spouse. So try to
enjoy as you begin the final countdown and await the day when you and your baby finally meet
face-to-face.

On a Different Note: Prenatal tests revisited

Around the 35-week mark, your health care provider might test you for Group B streptococcus,
which is a type of bacteria that may be carried by pregnant women.

Weekly Tip:
Depending on how much weight you're carrying and how flexible you are, you might be
feeling like you just can't lean down anymore. Some moms we know highly recommend
wearing strapless shoes - for example, mules, clogs or thongs - so you can slip your feet in
and out without having to bend over your belly all the time. Whatever you wear, though,
make sure that they have good support.

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Pregnancy Month Seven

Physical Changes in Pregnancy

The symptoms of the last trimester may begin to set in. This include back ache, inability to
sleep and other not so fun symptoms of late pregnancy.

Your belly is growing rapidly! It changes shape and you may even see your baby kick
through your abdomen.

As your body prepares for birth you will notice that your joints feel more loose, this is from
the release of relaxin. It makes you waddle.

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Week 29
It's getting crowded in there, you can only see a
part at a time.

Mother
As your baby is growing, so is your body. You may feel as if your internal organs are crowded. They
are. The best way to deal with the discomforts of late pregnancy are:

Good Posture

Proper Nutrition

Exercise

Rest (When you can!)

Most discomforts will occur in your back, your legs, and the amount of air you can take into your
lungs. Hang in there!
You And Your Body

You will be able to feel the baby moving around especially the bottom and feet

Your uterus is getting much bigger.

Urge to urinate more frequently because of the pressure of the growing uterus on the
internal organs.

You will need to rest more often.

Baby
Your baby is busy getting ready for the birthday! The baby is beginning to regulate his own
temperature and the bone marrow is completely in charge of production of the red blood cells. The
baby is even urinating about a half liter of urine into the amniotic fluid everyday!

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The movements that you feel will probably begin to change at this point. You once were the home
of wild gymnastic parties, now as the space becomes cramped you will notice smaller movements,
such as elbows and knees. Try monitoring the baby yourself, using fetal kick counts.
Your baby weighs in at about two pounds nine ounces (1.16 kilograms)!

Your baby is approx 38cm long and weighs about 1 kg/2lb 4oz

The head is more or less in proportion with the rest of her body.

Your baby's eyes, which can now open and close, are beginning to focus.

Twin Tips
If you're finding yourself out of breath or having trouble breathing while you sleep, try propping
yourself up on some pillows to help alleviate one other sleep stealer. Also mention this problem to
your practitioner to ensure it's not another problem unrelated to pregnancy like allergies or asthma.

Frequent Urination
Cause: In the first trimester, frequent urination is caused by an increase in the volume of body
fluids combined with increased efficiency of the kidneys. In later pregnancy, it is caused by the
pressure of the growing uterus on the bladder.
What to do? Although you can't do much except make frequent trips to the bathroom to
relieve yourself, you can try the following:

Try to empty your bladder completely. You can do this by moving forward while on the
toilet seat.
If you feel that you are getting up often at night to relieve yourself, try and limit fluid
intake in late evening. However, remember not to cut down on your fluid intake for the
day.

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Your Baby: The inside story

Your baby is growing taller and fatter by the day. This week, he measures over 14 inches tall and
weighs about 2 pounds 9 ounces (1.16 kilograms). Finally, the rest of his body has caught up with
his head and they're in proportion with each other.
Amazingly enough, your baby's organs are beginning to self-regulate. For starters, the brain can
control primitive breathing and body temperature, the eyes can move in their sockets, the bone
marrow is in charge of producing the red blood cells, and your little guy is urinating about a half liter
of urine into the amniotic fluid everyday. To top it off, he is becoming sensitive to light, sound, taste
and smell.
At this late date, you may feel a change in fetal activity as your baby's movements become smaller
due to the increasingly cramped conditions. The kind of movement isn't as important as the
frequency: You should feel your baby move at some point everyday.
Your Body: Problems sleeping?
For some women, falling - and staying - asleep at night can be a real challenge. Between the leg
cramps, the anxiety, the extra weight, and the occasional kicking, it's no wonder you feel insomniac.
But rather than lie in bed awake and fret about losing your precious z's, you might want to follow a
few of these tips to make nighttime dreamy:

Make comfort a top priority: Make sure your bedroom is the right temperature, the sheets
are clean, the mattress is firm, and that you have enough pillows to support you and your
burgeoning belly. Also, crack open a window to get some air because a stuffy room does
not make a good sleep environment.

Clear out the clutter: No doubt you have a lot on your mind, but try to air it out before
bedtime. Shift your problem-solving time to the day - talk about your worries at work or at
home with someone well before bedtime.

Get adequate exercise: Chances are if you work out during the day, you - and your tired
body - will be eager to rest at night. If you can't get to the gym until after work, just make
sure you leave yourself time to wind down before bed.

Separate your sleep space: Only spend time in your bedroom and in your bed when it's
time to sleep.

Take a bath before bed: There's nothing like a warm soak in a tub - with lights out and
candles lit - to help you relax into a sleepy state.

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Push back your bedtime: You may not need as much sleep as you think. Try going to bed
later to see if you sleep sounder.

Avoid lying down and napping during the day: If you keep yourself up - no matter how
tired you feel - and stay alert when the sun is shining, you might sleep better at night.

Indulge in your favorite pastimes: Read a book, go to the movies, watch TV, knit, listen to
music, eat out or order in, or make love - whatever strikes your fancy as long as it's low
key and relaxing.

Drink by day to stay dry by night: Be sure to stay hydrated during the day, but limit your
fluid intake by mid-afternoon so that you don't wake up to go the bathroom all night. And
steer clear of caffeine (in coffee, tea, and chocolate) no matter what time of day.

Don't worry: A little sleep deprivation never hurt anyone. If you can't sleep, get up and
read, write a letter, or watch TV until you're ready to try again.

On a Different Note: The ins and outs of preeclampsia

Six to eight percent of all pregnant women develop a pregnancy-induced disease called
preeclampsia. If left untreated, this common condition can lead to complications - in you and your
baby. To ensure that you and your little one stay safe and healthy, learn all you need to know about
preeclampsia here.
Weekly Tip:
If a baby shower is in the making, now is the time to register for all the itty-bitty clothes and
basic baby necessities you've ever dreamed of - stroller, bouncer chair, car seat, high chair,
bathtub, play mat, and more. The best way to begin is by asking friends and family with kids
what you do and do not need and what does and doesn't work. Then simply stroll down the
aisles of a few of your favorite stores - be it the exclusive local children's boutique, Target, or
Toys 'R Us - to see the real thing and choose where you want to register.

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Week 30
Here is the heart at 30

weeks

Mother
Your posture is still very important to your comfort. Maintaining a good posture is a good way to
decrease the strain on your body as your center of gravity continues to change.
One of the things that you can do to help maintain your energy levels and to increase your stamina
for the birth is to exercise. It is important not to over do it, especially if you have not been exercising
prior to this week. Try taking walks or swimming short distances. Getting out and stretching will help
you have feel better and reduce the numbers of pregnancy related complaints.
You And Your Body

As you become large, you will start to get slower and clumsier.

It is important that you maintain good posture while sitting and standing to prevent backache.

You may experience problems in sleeping and also be unable to find a comfortable position
to sleep in. A special maternity pillow may help you get really comfortable at sleeptime.

Roll on to your side before getting up from a lying position.

You may experience little breathlessness on walking fast or climbing stairs.

Baby
The baby is very aware of the surroundings. We tend to think of the uterus as a dark place. The
uterus actually can be light and dark depending on the mother's environment. You may be able to
distinguish sleep and wake cycles in your baby. Although it usually seems as if the baby wants to
sleep while you are awake and vice versa at night. This is not indicative of a sleepless newborn.
If you are having Braxton Hicks Contractions use them to practice what you've learned in prenatal
classes, and know that they are a sign that your body is getting ready for labor. The baby notices
the contractions, but is not adversely affected by them.

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Your sweetpea weighs a whopping 3 pounds (1.36 kilograms)! S/he measures about 14.8 inches
(37.5 cms) in length.

Your baby is approx 39cm long and weighs about 1.1 kg/2lb 8oz

There is now less space for the baby to move around and he may begin to feel cramped
inside you.

Your baby continues to practice rhythmic breathing movements.

Your baby continues to get fatter and plumper and would be able to keep warm if born
prematurely.

Twin Tips
Up until this point the growth rate of your babies has been about the same of a singleton baby. Now
their growth rate will slow. This is why the early weight gain and proper diet was so important. The
majority of quadruplets will be born by now.

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Your Baby: Filling out

Your baby continues to grow taller and fill out as you near the end of your pregnancy. By now, he
weighs approximately 3 pounds (1.36 kilos) and measures about 14.8 inches (37.5 centimeters) in
length. . The fine, downy hair (called lanugo) begins to disappear and real hair starts to take its
place. The baby's eyelids can open and close, and the toenails continue to grow.
Your Body: What's better - breast or bottle?
Chances are you have a lot on your mind as you settle into the last trimester. And like most
pregnant women, you're probably pondering what's best for your baby foodwise: breast or bottle?
Truth be told, there is no one, right answer to that question. It's a personal decision that depends on
you and your baby. Some mothers choose to breastfeed exclusively, while others are convinced the
bottle is the only way to go. The most important thing is to be open minded, take cues from your
baby, and know the benefits and drawbacks of each.
Breastfeeding
Plusses

It's the perfect nutrient for newborns with the right balance of protein, carbohydrates, and fat.

It provides the baby with antibodies that protects them from certain childhood illnesses.

It's easier to digest than formula.

It's 100% cost- and hassle-free: No equipment or preparation is needed.

It speeds the process of the uterus returning to its prepregnancy size.

Minuses

You and your baby will go everywhere together (unless you pump milk).

It's physically demanding to be the only one who can feed a baby around the clock.

It dictates your eating style: You can kiss spicy food, caffeine, garlic, cabbage, and even
some dairy products goodbye.

It can affect your sex life: Between leaky breasts and a very dry vagina (caused by the
lactation hormones), you may not be in the mood.

Bottlefeeding
Plusses

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Anyone can feed your baby - any time, any place - so you can work outside the home, go on
errands, or out for the evening.

It doesn't impact your sex life in any way.

You can eat whatever you want.

You know exactly how much your baby will get at each feeding.

Minuses

It's costly.

It requires a lot of prep work and equipment - bottles, nipples, sterilized water.

It has to be at the right temperature.

On a Different Note: The inner sanction

Get a glimpse inside your swelling belly and see how babies grow and change with this ultrasound
identifier visual tool. These dynamic images will show you what a fetus looks like at 17, 19, and 30
weeks. Just roll the curser over the different body parts, and presto!
Weekly Tip:
If getting comfortable in bed at night is getting more and more difficult, bring on the pillows
and props. You can put a maternity pillow (really any pillow will do) between your legs,
under your belly, and behind your back. To relieve pressure on your hips from lying on your
side, tuck a piece of soft egg-crate foam on top of your mattress and under the sheet, and to
ease fluid retention in your legs and ankles, place a folded blanket under your feet to keep
them elevated while you sleep.

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Week 31
This baby is thirty-one weeks into
pregnancy.

Mother
Your abdomen swells and your rib cage and pelvis may be sore as the baby gets bigger and fills up
all the space you have available. While it is really great that your baby is gaining weight and
growing strong, you may be in line for different discomforts at this stage of the game.
Some women will have more heartburn as the uterus displaces the internal organs, leaving less
room for her stomach and its contents. This can be relieved by remaining upright after a meal.
Some women say that eating smaller, more frequent meals helps their heartburn. Remember to ask
your practitioner before using any medications, even over the counter products.
One of the most frequent complaints in pregnancy is back pain. This can start at almost any point of
pregnancy and can continue well into the first postpartum year. Some of this can be relieved by
maintaining good posture, exercise, and stretching. And don't forget to ask your partner for a back
rub!
The pregnant body produces a hormone called relaxin. This is what loosens the pelvis making it
mobile to help your baby be born. However, this can also cause waddling! I also refer to this as
"feeling like a Barbie with her legs pulled off." This is only temporary, and while it may be a pain
now, come birth time you'll be rather grateful!
A few women will breeze by even this phase of pregnancy without any discomforts. This does not
mean that your body isn't preparing for birth. It could be pain tolerance levels, exercise and agility
levels and many other factors. So, count your blessings if you fall into this category!

You And Your Body

Increased breathlessness - try to rest and slow down exercises to suit you

Wear a maternity/sleep bra if your breasts feel uncomfortable at night.

Inevitable backache.

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You And Your Body

Increased breathlessness - try to rest and slow down exercises to suit you

Wear a maternity/sleep bra if your breasts feel uncomfortable at night.

Inevitable backache.

Baby
You may worry that if you are breathless from walking or sometimes even just sitting that your baby
is in danger. This is not true. Your baby is getting plenty of oxygen from your placenta.
The baby's irises can now dilate and contract in response to light. Due to the deposits of white fat
underneath the skin the baby's skin is no longer red but pink, and your baby weighs about three
pounds and five ounces (1.5 kilograms). The finger nails may reach the end of the hands.

Your baby is about 40cm long and weighs about 1.4kg/3lb

The lungs are developed and if your baby was born prematurely, it would be able to take in
air into the lungs and breathe properly.

Your baby's brain is still growing.

Your baby can feel pain and will move when prodded.

Twin Tips
About 10% of twins will be born by this point, 30% of triplets, compared to 1% of singletons.

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Your Baby: Eye -opening developments

The third trimester is a time of rapid growth - for you and your baby. You might gain a great deal of
weight - and for good reason. Only 31 weeks, your baby weighs in at about 3 pounds 5 ounces or
1.5 kilos and measures over 15 inches tall. Thanks to the deposits of white fat underneath the skin,
its color is changing from red to pink. His irises dilate and contract in response to light, and his
fingernails may extend to the end of the hands.
The organs are also in a growth period. The brain continues to develop rapidly, and the lungs are
the last to develop. Don't worry: Even if your lungs (and heart) make you feel breathless when you
climb a flight of stairs or walk around the block, your womb mate is getting plenty of oxygen from
your placenta.
Your Body: Planning for the birth
Most first-time mom have mixed emotions and endless questions when it comes to labor and
delivery. You may wonder how you know when you're having a contraction? When should you go to
the hospital? Or, what can you take for the pain? One of the easiest ways to get answers and
assuage your fears is to arm yourself with knowledge: Read books on childbirth, take notes during
your childbirth education class, consult your health care practitioner, and ask friends and family to
share their experiences.
After you do some initial research, you'll be ready to create a birthing plan so that you and your
spouse can take an active part in the childbirth process. Some of the issues you may want to
include are how much you want to do on your own at home, where you give birth (birthing room,
labor room, delivery room), how you feel about enemas, shaving the pubic area, using an IV, pain
medication, external or internal fetal monitoring, being induced, forceps, Cesarean section, delivery
positions, suctioning the baby, having other family members present, using a doula or nursemidwife, holding and breastfeeding the baby right after birth, and having your spouse cut the
umbilical cord. You can also discuss postpartum topics such as rooming in, medication for you or
your baby, circumcision, how long you will stay in the hospital, and visitors.
It's easy to conjure up your ideal childbirth scenario ahead of time, but it's important to remember
that it's all theoretical. And since you and your baby's well being are your top priority, you must be
open minded and flexible when it comes to the real thing.
On a Different Note: Every bite counts
To ensure that you and your little one are strong and stay healthy, follow the guidelines of this
Nutritional Food Pyramid for Pregnancy. It will help you feel good and your baby grow great!

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Weekly Tip:
A lot of moms and dads-to-be wonder if and when they will bond with their baby. An easy
way to welcome and connect with your future arrival is to write a letter beforehand. Share
your feelings about the pregnancy and about becoming a parent. Regale him with things
friends or family have said or done, what you would do the same or differently if you could
do it all over again. You can use it as a time to reflect on the past seven plus months and to
relish the time left.

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Week 32
This is a 32 week ultrasound
picture.

Mother
As you begin to have more and more Braxton-Hicks contractions you may begin to wonder more
about labor and what it will entail for you, your family and your baby. You aren't alone in having
these thoughts.
Most women have questions about labor and birth, for example:
? Is this really labor?
? When should I go to the birth place?
? How do I time contractions?
? Who should come with me? (Partner, doula, parents, siblings, etc.)
? What should I pack?
? Will labor be really painful?
I want to address the last question specifically. About 10% of women will tell you that labor is
extremely painful, while 10% of the women will tell you that they experienced no pain. The rest,
80%, will fall someplace in the middle of the two extremes. You really need to look at the sources of
pain in labor and birth. We do know that women who have taken childbirth classes tend to report
less painful experiences and have fewer complications than women who have not taken classes.

You And Your Body

If your baby is head down, your baby's legs may reach up to your ribs and cause you
discomfort, especially if the little feet get caught in your rib cage. (avoid this by sitting up
straight always).

You may develop varicose veins, swollen feet and ankles or oedema.

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Try to spend time singing and talking to your baby.

Baby
Your baby's movements will peak this week. From now on the will change in quantity and quality.
Remember to do your Fetal Kick Counts. Most of the wrinkles are disappearing from your baby's
face, and there may be a lot of hair on their head! The weight gain has been fairly incredible
recently. Your baby has put on about 2 pounds of weight, mostly fat and muscle tissue, since last
month, bringing the total to about three pounds eleven ounces (1.7 kilograms), and measurements
to 40 cms or 15.8 inches!
Babies who are born at a younger gestation than this will most likely having difficulties sucking or
nursing. This also applies to babies who weigh less than 1500 grams at birth. A good sucking
pattern is a sign of neuromuscular maturity
.

Your baby is about 40.5cm long and weighs about 1.6kg/3lb 8oz

Your baby will become familiar with your voice and be able to recognise it immediately
after birth.

Twin Tips
The majority of triplets will be born by now. If you haven't already looked for postpartum help, now is
a good time! While the old fashioned thing to do was to have a baby nurse, now there are other
professionals designed to help new families, called a postpartum doula. A postpartum doula will
help you with all things baby related and home related, whether that be fixing meals, or learning to
breastfeed, even taking an older child for a walk. Contact local doulas as soon as you can to learn
schedules and prices. Some of these gems even spend the night!

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Your Baby: Nearing the finish line

By the eighth month, your baby is becoming her own little person. Weighing around 4 pounds (1.8
kilograms) and measuring about 16 inches long (40 plus centimeters), she is almost ready to make
an appearance. All five of your baby's senses are functional: She can suck her thumb, feel touch,
see light, hiccup, and hear sounds. You can see other spectacular developments: Her face is
almost wrinkle-free, her toenails are completely formed, and she may have a good head of hair.
Your Body: Tips and tricks to get through the workday
It's a toss up as to what wears on you more - being pregnant or working 9-5. It's no wonder that
when you put the two together, you're worn out by noon and ready for bed by 7 p.m. If your bulging
belly is affecting your ability to work, then try these tricks to take some stress off and stay on the
job :

Your body knows best so listen to its signals. If you're feeling overworked, you might need
to turn down a new project, ease up on your activities, or leave early. If your work is very
physically demanding, cut back in other areas so you don't overdo it.

Take mind and body breaks frequently. If you've been standing, sit down and put your feet
up, and if you've been sitting, get up and walk around. If you've been in meetings or
concentrating hard, take five - make a phone call, catch up with a colleague, or simply
close your eyes.

Eat small meals often to keep your body replenished. Keep healthy snacks handy and
make sure you eat what you need throughout the day no matter how many deadlines you
have to meet.

Drink up. Be sure to get eight 8-ounce glasses a day so that you and your baby stay
healthy and hydrated. Try milk, fruit and vegetable juices, soups, caffeine- and sugar-free
soft drinks, and any kind of water - bottled, tap, plain, or sparkling.

Exercise at work. If you're sitting for long periods, stretch your legs out, rotate your ankles
and flex your feet. On your lunch break, take a walk around the block. Or, give your back a
much-needed stretch as you stand facing a wall and extend your arms out 90 to make a
tabletop.

Take bathroom breaks every two hours to empty your bladder.

Wear support hose.

Adjust your body accordingly. If you spend most of your time standing, keep one foot on a
low stool with the knee bent to reduce the pressure on your back. If you sit for long
stretches, keep your legs elevated - on a stool or carton, if possible.

Work in a smoke-free zone.

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Lie on your left side. If there's a sofa or floor space at work where you can lie down for a
few minutes, try it. You'll like it!

Set the temperature to make sure it's stable - avoid too much heat or overly cool air.

On a Different Note: The ABCs of delivery

Are you anxious about labor and delivery? Are you eager to learn as much as you can about it
ahead of time? If so, this article on delivery is a great starting point, where you can read about
different positions, diagnoses, and treatments.

Weekly Tip:
With your due date fast approaching, you should start shopping around for a few infant
essentials. For starters, you'll need a car seat to transport your baby home from the hospital.
Once home, you should have a crib or a bassinet for your baby to sleep. Other immediate
must-haves include diapers - cloth or disposable - and a layette (sleepers, booties or socks,
hats, blankets, and some one-piece outfits). For the rest, keep your fingers crossed that
your family, friends, and colleagues will shower you with gifts.

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Pregnancy Month Eight

Physical Changes in Pregnancy

You may tire easily as you come down this final stretch. Some women report that they could
sleep all day but have trouble sleeping at night. Some say that this is to help prepare you for
the sleepless nights ahead. Nap whenever you can.

You may find that you are simply uncomfortable. Try yoga, swimming and light exercise to
help relieve some of the pain you experience.

As your baby drops further into your pelvis, you may need to urinate more often.

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Week 33

Face of your child

Mother
You can now probably distinguish the baby's knee from and elbow, even though the movements are
smaller. You may also notice small bumps that appear to be rhythmic in your uterus. This is
probably caused by the baby having hiccoughs and isn't cause for alarm. Continue learning all you
can about labor, birth, postpartum, and newborns!
You And Your Body

Your uterus has grown by 500 times.

You may have vivid dreams at night.

Need to urinate frequently.

Baby
Your baby has surfactant, which helps baby breathe after birth, coating the alveoli in the lungs. After
this week, if your baby is born, you have less of a chance of apnea of prematurity. S/he weighs
about four pounds (1.8 kilograms).
There are almost 2 pints of amniotic fluid in your uterus. You may have been told that you have
polyhyrdamnios, or too much amniotic fluid. The opposite of which would be oligohydramnios, often
associated with Intrauterine Growth Retardation (IUGR). However, it is important to keep in mind
that everyone has varying amounts of amniotic fluid and that simply having too much or too little
doesn't not generally indicate a problem.

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Twin Tips
Average birth weights for twins are 5 lbs 5 oz, triplets weigh in averaging 4 lbs, and quadruplets
average a bit over 3 lbs.

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Your Baby: Floating in fluid

With less than two months to go, your baby weighs about 4 pounds (1.8 kilograms) and is 16 inches
long. If you're feeling very large, it might be with good reason: There are almost two pints of
amniotic fluid in your uterus--and it's at its peak for the pregnancy.
Believe it or not, your baby's head has grown approximately 3/8 of an inch this week to
accommodate the growing brain. And, thanks to fat, which continues to accumulate under the
baby's skin, his skin color is turning from red to a rosy pink.
Your Body: Reducing the risk of preterm labor
When a woman goes into labor before week 37, it is called premature or preterm labor. No one
knows why some women experience early labor and what the precise triggers are, but there are a
few factors that seem to increase the chance of it happening, including previous preterm birth or
labor, carrying multiples, prior miscarriages or abortions, problems with the placenta, abnormalities
in the mother's uterus, problems with the amniotic fluid or amniotic sac, preeclampsia, infections or
preexisting medical conditions.
So what can you do to avoid early labor - or at least increase your chances of carrying your baby to
term? The first step is to follow these guidelines:

Stop smoking and drinking alcohol (beer, wine, and liquor) on a regular basis.

Always check with your doctor before taking any medications. Better yet, avoid taking them
altogether.

Make sure you eat a well-balanced diet and get a daily dose of zinc (research links zinc
deficiency with preterm labor).

Gain the right amount of weight for your body - between 25 and 35 pounds.

Don't spend too much time standing. If you are on your feet for a good part of the day or
doing strenuous physical labor either reduce your workload, change roles, or stop working.

Steer clear of sex if you're at risk for preterm labor. Intercourse and orgasm may stimulate
uterine contractions.

Be sure your hormones are in check. Since imbalanced hormones may cause preterm labor,
you might want to consider hormone replacement as a preventive course of action.

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On That Note: Signs from inside

Many first-time moms wonder what a real contraction feels like, and how it differs from Braxton
Hicks. Some even question how they will know when "it's time." For answers to these questions and
more, check out signs of labor article.
Weekly Tip:
When the going gets tough, go to the movies. Many pregnant women we know enjoy taking
an afternoon off and heading to a matinee. It's a great way to spend quiet time and to lose
yourself. Be sure to see something light - a romantic comedy or family feature - and avoid
the sappy or scary stuff. The last thing you want to do is end up in tears or have nightmares!

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Week 34
"I'm a boy!" says this 34 week old baby.

Mother
Your body is really getting ready and you may notice that you have more and more contractions
that seem less and less like practice! This is a great sign that your body is getting ready!
Let's go over some of the labor basics.
Labor is broken down into three major stages:
? First Stage
This begins when you start to have regular contractions that increase in frequency and
intensity. Make sure you know how to time contractions. Usually you will start off slowly,
nearly always questioning if this is really labor. Bear in mind that a lot of women have
wandered around for a bit feeling like they had the flu or were just really sleepy. The
contractions will then pick up and you will be in the active phase of the first stage of labor.
Contractions are more intense and come more frequently, usually requiring more of your
attention. Somewhere between this active phase and the next phase, transition, you will
change to your place of birth. Transition is the short but hard part of labor. Transition has
contractions coming very close together, but they never actually feel any stronger than the
contractions of the active phase. At the end of transition you will be completely dilated!
? Second Stage
This is the fun part! You begin this stage completely dilated! You will begin pushing your
baby into this world. Most women really enjoy the pushing stage, they say that they feel
more actively involved. Your contractions will get further apart and feel differently. If you
have been unmedicated you will feel the urge to push. If you have been medicated you may
or may not feel the urge to push and will be directed at how to proceed. If there is an
episiotomy done, it will be done at the end of this stage. There is quite a debate about the
need and use of episiotomies on a routine basis. The end of the second stage will be
marked by the birth of your baby!
? Third Stage
This is the anticlimax! You are holding your lovely baby and anywhere from 5 minutes to an
hour later they will want you to give a few small pushes to get the placenta out. Most women

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are so wrapped up in their babies that they always say, "I forgot about the placenta!"
Nursing your baby right away will help speed up a third stage or control any bleeding that
you are having.
You And Your Body

You will experience regular Braxton-Hicks contractions

Your blood pressure may be raised slightly.

You may notice swelling of your hands and feet (see oedema) - take things easy.

Baby
Baby is continuing to get bigger! Four pounds seven ounces (2 kilograms) and a length of 42.5 cms
or 16.8 inches. The hormones from the placenta are starting to activate the milk in your breasts. Did
you know that the baby urinates almost a pint a day! Watch out diapers here you come!

Your baby is about 43cm long and weighs about 2kg/4lb 8oz

Your baby starts to shed almost all the lanugo on her body.

Your baby is drawing calcium from you to build up her bones.

If born now, your baby is called pre-term infant and not premature.

The eyes respond to bright light and your baby is actively practicing blinking.

Twin Tips
As you look towards birth you may have the same questions any mom would have. A regular
childbirth class is perfectly appropriate for you, but you might also want to find out if any of the
hospitals in your area have a multiples class to give you a bit more information on what to expect
for more than one baby. Epidural anesthesia can still be used in multiples, just as unmedicated birth
is still an option. Be sure to discuss your desires with your practitioner. Around this point you might
have a better idea of the final positions of the baby, though it's still possible for them to change, it's
less likely.

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Your Baby: Preparing for arrival

Your baby gets bigger and bigger as each day passes. As of week 34, she weighs around 4 pounds
7 ounces (2 kilos) and is between 16 and 17 inches long (roughly 42 centimeters). There are lots of
new developments in progress: Your little one is developing immunities to fight mild infections, and
her fingernails have reached the ends of the fingertips. (Don't be surprised if she needs a manicure
during the first few days after birth.) And like a newborn, her eyes are open when awake and closed
when sleeping.
Last but not least, if you've seen or felt something drip from your breasts, you're not imagining
things. Called colostrum, this pre-milk substance is in the making, thanks to the hormones from the
placenta.

Your Body: Coping with bed rest

Sometimes, for reasons still unknown, some women end up on total or partial bed rest during their
pregnancy. They may be at high risk for preterm labor or other complication, requiring them to
reduce their activity level, stay away from stressful situations, and keep the baby inside as long as
possible. If your health care provider orders a dose of bed rest for you - whether it's for one day or
for the duration of your pregnancy - you might try these coping strategies to help accept the
restrictions and set realistic expectations.

Get all the facts. Ask your doctor to explain the problem and suggest resources to learn
more about your situation.

Take control of your care. Learn everything you can about the treatment or medication you
are taking, what side effects they might have, and how you can avoid them. If preterm labor
is a threat, know how to recognize it and how to handle it.

Seek support. Find out if there are support groups in your area for women dealing with
complicated pregnancies and check out websites that deal with pregnancy-related topics.

Focus on the baby - not you. Rather than dwelling on how much time you have left,
concentrate on your growing baby and how important it is for him to further develop inside
you.

Set short-term goals. Make up goals for you and your baby on a daily or weekly basis then
mark them off on your calendar each time you reach one.

Let people help. It may be hard to ask for or accept help from friends and family, but you
have no choice. Enlist those around you in your cause - whether it's going shopping at the

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grocery store or picking up shirts at the dry cleaners. Consider setting up a schedule so that
your household continues to run.

Allow yourself to vent. Even when pregnancy goes smoothly, women feel ambivalent and
anxious. So when real problems arise you can expect to feel angry, upset and downright
negative. Talk to your spouse, your doctor, friends, and family about your feelings. Better yet,
keep a journal where you can let it all out - for your eyes only.

Make yourself comfortable. Make sure you have everything at your hand's reach: pillows,
telephone and address book, bottle of water, books, magazines, and whatever else strikes
your fancy. You can even bring your laptop to bed!

On a Different Note: A spinal tap of sorts

Some women swear by the epidural block, an anesthesia inserted in the spine to decrease or
eliminate discomfort during labor. Others are a little more hesitant when it comes to this type of
intervention. If you're still unsure of where you stand or simply want to see how and where it's
administered, check out this 6-step epidural presentation.
Weekly Tip:
If the mere thought of an episiotomy (surgical incision in the perineum) makes you
uncomfortable, then why not do what you can to avoid it? Start now, during these last few
weeks of pregnancy, by massaging the perineum, which is the area between the vagina and
the rectum, so that by the time you're ready to give birth it might be stretched out enough for
the baby to come out without tearing or requiring an incision.

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Week 35

Mother
Your pregnancy is progressing and you may have trouble sleeping at night. Some claim that this is
mother nature's way of preparing you for life with a new baby. Others believe it is caused by
worrying about the health of your baby, labor, and/or parenting. There are also numerous physical
reasons that sleep may be difficult.
For one going the bathroom every 45 minutes isn't conducive to sleep, nor is a constant backache.
Try doing pelvic tilts before bed, limiting fluids after a certain time, and being tired when you go to
bed.
You should start putting the final touches to your knowledge base of pregnancy. There are several
items that you should know something about before labor begins.
? Inductions
? Fetal Monitoring in Labor
? Pain Relief
? Comfort Measures
? Epidurals
? Forceps
? Cesareans

You And Your Body

You will now need 200 extra calories in these last weeks.

Try to eat small, frequent meals rather than one large meal. This will prevent heartburn.

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You may begin to feel fed up about the entire affair of pregnancy and will be eager to deliver
your baby.

Baby
Your baby weighs about 4 pounds 12 ounces (2.15 kilograms) right now, although later in
pregnancy there is more room for variation than in the beginning of pregnancy. Your baby is putting
on an average of .5 pounds a week at this point. The length is reaching 18 inches from head to toe,
as opposed to the earlier measurements from crown to rump. All organ systems have been present
for a long time, now they are just putting on the final touches before birth.

Your baby is about 44.5cm long and weighs about 2.3kg/5lb

Fingernails reach the tip of the fingers and your baby may even have scratch marks on his
faces when born.

Fat deposition continues.

Your baby fills most of your uterus now and feels very cramped in the limited space.

Twin Tips
About 35% of twins will be born by this point, 80% of triplets, compared to 5% of singletons.

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Your Baby: The final touches

Nearing the ninth month, your baby weighs on average between 5 and 5 1/2 pounds (roughly 2.15
kilograms) and measures approximately 18 inches from head to toe (as opposed to crown to rump).
In fact, she is so big by now that she takes up most of the uterus and has little room to move around.
And she'll continue to grow, putting on about a half a pound per week until delivery.
Over the next few weeks, the organs, which are all present, are just putting on the final touches
before birth. In boys, their testes have completed their descent.
Your Body: Picking a pediatrician
Now that you're in your last trimester with only a few weeks to spare, you should choose a medical
caregiver for your baby-to-be (unless you go to a family physician who can provide the care). If this
is your first baby, you need to understand the importance of this decision. A good pediatrician is
more than a person to call when your baby has a fever. It is someone who will chart your child's
development, address your concerns, and answer your questions about your child's health. And it is
someone you will see regularly for sick and for well checkups.
The best place to begin looking for a pediatrician is with your family, friends, and colleagues. Ask
them for recommendations and start gathering a list of names. After you collect a few numbers,
write up some questions and call to set up interviews. When you interview a physician, you should
take into account:

Professional qualifications and reputation.

Health care philosophy toward preventive care, nutrition, and the caregiver-patient
relationship.

Availability (Does she work in a group? Do you like the other doctors in the group? What are
the office hours? Is there a nurse advice line? Is it open on weekends?).

Location (Is there free parking around? Is there more than one office?).

Office environment (Is there a nice size waiting room? Is it clean?).

Support staff (Are they friendly?).

Costs and coverage (Are they with your insurance plan?).

On a Different Note: Passing your child's first test

Immediately after you deliver your baby - and often before you actually get to see or hold her - you
will see the doctors and nurses whisk her away to weigh, measure, and bathe her. She will also
undergo her first test, called the APGAR, to assess her color, heart rate, muscle tone, respiration,

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and reflexes one and five minutes after birth. To learn more about APGAR, check out this APGAR
score article.

Weekly Tip:
As you near the end of your pregnancy, you should pack your hospital bag and put it by the
front door so that you're ready to go - carefree and calm. Aside from your personal items,
make room for these must-haves: a watch with a secondhand to time the contractions, a
video recorder or camera, toiletries, and an outfit to wear home - for you and your baby. And
don't forget food and drinks for Dad (or at least small change for the vending machines)!

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Week 36
Four chamber heart at 36 weeks.

Mother
You will probably start to see your practitioner every week until you give birth.
Most babies will be in a head down position at this point. However, about 4% of the babies will be
breech. Do not panic! There are plenty of things that you can do to encourage the baby to turn,
including special exercises. If the exercises do not work, your practitioner may want to attempt an
external cephalic version (ECV). The ECV is a manual turning of the baby.
You And Your Body

Your antenatal checks will now become weekly.

The top of your uterus reaches its highest point, just below the breastbone.

You may suffer from pain in your ribcage.

Baby
The baby continues to grow and snuggle down into your pelvis. The benefit of this is that you can
breathe more easily, however, you also have to urinate more often. Your practitioner will probably
not stop your labor if you were to start having regular contractions now.
Baby weighs about five pounds two ounces (2.3 kilograms) and measures 45 cms or 17.8 inches.
Although here at the end there is a larger margin of difference among babies. Ask your practitioner
to palpate (feel through your abdomen) to guesstimate the weight. Remember it is just a guess,
although some are better than others.

Your baby is about 46cm long and weighs about 2.5kg/5lb 8oz

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Your baby may be ready to engage this week or next.

Your baby's face has filled out and looks smooth and plump.

Skull is firm but not hard.

Nervous system continues to mature.

ontinues to practice breathing, sucking and swallowing movements.

Twin Tips
Most vaginal born twins are born within an hour of each other, though this can vary from one right
after the other, to several hours. You and the babies will be monitored to ensure the process does
not need to be speeded up.

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Your Baby: Dropping into the birth canal

Your little one weighs about 5 1/2 pounds (a tad over 2 kilograms) and measures approximately 17
inches or 45 centimeters tall. He has filled out so much that fat is forming creases in the neck and
wrists and dimpling on the elbows and knees. That said, the closer you get to your due date, the
greater the size differences in babies. To get a better idea of your baby's weight, ask your doctor to
feel around your abdomen (to palpate) and approximate it.
You may have less difficulty breathing - and more of an urge to urinate - as your baby settles down
into your pelvis, getting ready to descend into the birth canal at any time.
Your Body: Changes in fetal movement
As you start your ninth month and look down at your burgeoning belly, you might notice a passing
leg or arm poke out or punch you. But sometimes, you might sense a quietness that makes you
wonder just what is going on inside. By this time, your baby has become so big and takes up so
much room in your uterus that he has little room to perform those amazing acrobatic stunts of
months gone by.
Despite the cramped conditions, it is important to monitor your baby's activity and make sure that he
is moving on a daily basis. An absence of fetal activity may indicate fetal distress, or it may not
mean anything more than a tired baby. The best way to be sure is to track your baby's goings-on
twice daily - in the morning when activity is slower and in the evening when it speeds up. Keep one
eye on the clock and the other on your belly to count movements. Any kind counts - rolls, punches,
kicks, swishes, or flutters. Stop counting when you've felt 10 movements, and note the time. Some
women will feel 10 movements within 10 minutes, but it may take longer. If you haven't felt 10
movements by the end of an hour, eat something, lie down, relax, and continue counting. If you still
don't feel those movements by the end of two hours, however, call your doctor immediately.
Note: If you do not feel your baby's movements at all or suddenly sense frantic activity, call your
doctor without delay.
On a Different Note: Checking it off your list
If you still haven't packed your bag for the hospital and wonder what you need, print out this
checklist for ideas. It's detailed and in-depth, and it even tells you what to bring for your baby, your
labor coach, and the hospital staff!

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Weekly Tip:
If you're planning on breastfeeding, now is the time to buy nursing bras. Your milk isn't in yet, but
your breasts are at their fullest and a good indication of what's to come. Ask for help from a sales
person who is knowledgeable about nursing so you are properly fitted. You might want to get one
for the day that has extra support and one to wear at night - without under wire.

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Pregnancy Month Nine

Physical Changes in Pregnancy

Can you believe how big your belly has gotten? Typically your uterus will measure about 40
centimeters from your pubic bone.

You may notice many contractions as you prepare for labor.

Your breasts make their final preparations for breastfeeding, this may include leaking.

Do you often wonder if you are in labor?

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173

Week 37

My little face is getting smashed!

Mother
You And Your Body

If your baby engages this week, you will feel a sensation called "lightening" as pressure on
your ribs and internal organs eases

Breathing and eating should become easier for you.

You will feel an even greater urge to urinate as the uterus presses even harder on your
bladder now.

You should have everything ready and packed as the baby can arrive anytime between now
and week 42.

The pregnancy is considered a "term" pregnancy at this point and nothing will be done to stop labor
in most circumstances. You should plan to take a tour of your birth facility if you have not previously.
If you are having a home birth try to invite everyone over for a quick run through of what you expect.
It will save hurt feelings in the end!
Many women wonder if they will really know when labor has begun. There are several ways to tell
the difference between real labor and prelabor. Be sure that you talk to your practitioner about
knowing the difference.
Hopefully you have given the breast/bottle debate some thought before now, but if you didn't here is
some information:

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? Breastfeeding
A lot of people haven't heard all of the benefits of breastfeeding, nor do they know the
professional organizations that back breastfeeding.
Benefits of breastfeeding are numerous, including: fewer allergies, breast cancer reduction
for mom, fewer ear infections for baby, higher IQ for baby, proper jaw alignment, reduced
risk of SIDS, and many more.
? Formula Feeding
Some people for medical or other reasons choose to formula feed their babies. And not a lot
of attention is paid on teaching people how to feed their children with bottles, this can be
dangerous. So make sure you read the instructions before mixing formula.
Baby
Your baby is practicing breathing by inhaling amniotic fluid. Sometimes the baby will even get
hiccoughs!
Remember to feel these last few weeks of kicks, believe it or not you will miss them.
Your Baby

Your baby is approx 47cm long and weighs about 2.7kg/6lb

Your baby is clinically mature and ready to be born

Fat is still being laid down by your baby so she continues to grow.

Your baby will continue practice breathing although there is no air in her lungs.

Twin Tips
If you haven't already addressed the envelopes on your birth announcements you might want to go
ahead and do that! Remember once your babies are here there will be a lot of things going on and
the birth announcements will probably be low on that list. Do everything you can before the birth of
your babies so that you can enjoy what little quiet time you'll have after you come home with your
bundles of joy.

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Welcome to Week 37
Just a few weeks before your due date, your baby averages around 6 1/2 pounds and measures
18-21 inches long. In preparation for life on the outside, he is practicing breathing movements by
inhaling amniotic fluid. Plus, his grasp is getting stronger and he turns toward light.
As anxious as you may be to meet your baby face-to-face, you still have a little time left to feel him
flutter about inside you. Each time he kicks or jabs you with an elbow, stop for a second and put
your hand on your stomach to memorize the movement and record it in your head. It's a precious
time, and who knows if and when it will happen again?
Your Body: Gearing up for delivery
As you near the end of your pregnancy, you may start noticing signs and feeling symptoms of
prelabor. They can set in one month or one day before you actually give birth - only time will tell.
The question is how will you know when it's real - and when it's not?
Only your doctor can tell if your cervix is effaced and if you're dilated, the tell-tale signs of prelabor,
but you may notice a host of other physical changes going on:

Pain and cramp-like feelings in the pelvis, rectum and lower back.

Lightening and engagement when the largest diameter of the baby's head has moved into
the midpelvis.

Weight loss or lack of weight gain.

A surge of energy or extreme fatigue.

Loss of mucus plug (bloody show) that seals the opening of the uterus dislodges as the
cervix thins out and opens up; the string-like mucus or thick discharge can be clear, pink or
tinged with blood.

Diarrhea or loose bowel movements.

Stronger, more frequent Braxton Hicks contractions that ease up when you move around.

So what's the difference between prelabor and the real thing? Suffice it to say that it's for
real when:

The contractions become regular and more intense, and don't subside by changing your
position.

The lower back pain extends down to the lower abdomen and sometimes to the legs.

Your show is pink or bloody.

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Your waters break (rupture of membranes) either in a gush or a trickle

If and when you experience these symptoms, you should check in with your health care practitioner,
who will determine what to do next. In the meantime, relax, enjoy, and good luck!
On Note: On a scale of 1 to 10
If your friends continually regale you with the details of their deliveries and you have yet to
experience it firsthand, this Cervical Changes During Labor simulator is a must-see. Dynamic and
detailed, the two images show a cross-section of female reproductive system and a frontal view of a
woman-s cervix. As you move the bar at the bottom of the scale, you will see how a cervix dilates
from 1 to 10 centimeters.

Weekly Tip:
Having a baby is one of the most intimate and private experiences for a couple. That said,
there are probably plenty of people in the waiting room or across the world who are
anxiously awaiting to hear the good news. While your mind is clear and your hands are free,
prepare a list of friends and family you want to call from the hospital so that you and your
spouse don't have to go hunting for numbers. Plus, you should start collecting change to use
in the pay phone if you can't make calls from your room.

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Week 38

Mother
You And Your Body

You will be tired of waiting, so keep yourself busy now and try to distract yourself.

You may begin to feel electrical buzzes down your legs and inside your vagina. This is caused from
the baby hitting nerves as s/he settles into your pelvis.
A lot of time and effort has been spent educating mom about the process of labor, we are going to
talk about a common fear for men this week: BEING IN THE BIRTH ROOM!
I highly encourage men to go in to watch the partners give birth. It is one of the most amazing
experiences you will ever be able to have. As a doula, I am constantly in awe of birth, even though I
see it on a routine basis.
Be assured that you will only have to watch or participate as much as you feel comfortable with. For
some men this will be little more than holding your partners hand and gazing into her eyes. Let me
assure you that this is a great thing to do! If you wish to take a more active role this may include
labor support (breathing, massage, heat and cold packs, etc.), cutting to cord, helping to catch the
baby. These are all fine, but should be discussed with your practitioner ahead of time, so that they
know your preferences.
A note about cord cutting: The umbilical cord contains no nerves, so neither the mother nor the
baby will feel the cut. The cord is also a tough, fatty substance (this protects the cord from
compression inutero) so expect to give it some effort to cut it.
Children should also be encouraged to participate as you and they feel comfortable. Again, discuss
this with your practitioner. There may be special classes for them to take, or you may have to do the

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preparation yourselves. It is very important that they are ready for whatever they may see or how
you may look/act. It is also usually encouraged that you bring a separate support person for the
child(ren) so that they may come and go during labor and you won't be concerned.

Baby

Your baby is about 48cm long and weighs about 2.9kg/6lb 8oz

The skin now has a pinkish look.

The nails have grown fully and already need cutting.

Vernix is beginning to dissolve.

The baby may be gaining as much as 1 ounce (about 28 grams) a day at this point! However, your
weight gain has slowed or stopped. Hang in there! If you haven't written a letter to your baby, now
would be a good time to do so.

Twin Tips
Some practitioners routinely wish to induce moms of multiples at this point. Be sure to discuss the
pros and cons of induction with your practitioner.

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Your Baby: Reaching full-term

During the last couple of weeks of pregnancy, your baby might gain about one ounce a day while
you might actually slow or stop gaining weight. Now considered full-term, your little one may weigh
anywhere from 6 to 9 pounds and measure 18 to 21 inches long.
Your Body: Getting into position
There is no right or wrong, best or worst position to give birth. It depends on where you're
comfortable and what's going on. Some women have to lie flat on their backs strapped to a fetal
monitor. Others are free to walk around, take a shower, and pace the hospital's hallways. Whatever
the doctor's order, you should listen to your body to find the position that works best for you and
helps labor progress. Always remember that whatever position you're in there are options:

Supine or flat on your back: May be easier for medical staff to assist you, but generally
uncomfortable. It can cause your uterus to press against the inferior vena cava blood vessel,
decreasing the placenta blood supply, and it can push against your diaphragm making it
hard to breathe. For extra comfort and support, put a pillow under your knees and bend
them slightly, or sit in a semireclining position with your head and shoulders elevated and
resting on a bunch of pillows.

Lateral or side lying: Takes pressure off your perineum and keeps the weight of your uterus
off the blood vessel called the vena cava, maximizing blood flow to your uterus and your
baby. Have your partner hold your upper leg to widen the pelvic outlet and support the
weight of the baby.

On your hands and knees: May ease back pains and give a poorly positioned baby a
chance to turn around. May help women with previous tearing or who want to avoid an
episiotomy since the baby's head presses less directly on the perineum. May help a baby
who appears to be stressed because it maximizes blood flow to the uterus and the placenta.

Upright positions

Standing or walking: Helps widen your pelvic opening and lets gravity do its job by pressing
the baby's head against your cervix. Use a wall or ask your labor coach to lean on during
contractions.

Squatting: Opens your pelvis even wider so the baby has more room to move down into the
birth canal. Use a bed with a squatting bar or two extra bodies to help support you and
sustain this position.

Sitting: Makes your uterus move forward, taking pressure off your diaphragm and improving
the blood supply to the contracting muscles. Try a birthing chair or stool if there is one handy.

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Kneeling: Lets you maintain an upright position without straining your back. Just kneel on a
pillow, lean forward against your bed, a chair, or a wall, and rest your arms and upper body
on or against the prop.

It's important to breathe through each contraction and keep an open mind. If you have to be
restricted to bed because of medical equipment, anesthesia or fetal monitoring, stay focused on
your goal: your baby. And whether you're lying down or standing up, changing positions is key.
On a Different Note: Episiotomy up close
Most first-time pregnant women feel a certain sense of panic when they think about how they're
going to get that huge baby out of that small vaginal opening. Miraculously enough, some women's
openings stretch out to accommodate the baby, while others end up with an episiotomy, or a
surgical incision in the perineum to enlarge it. To learn more about this common procedure, click on
our episiotomy article.

Weekly Tip:
Whether this is your first or your fourth baby, you could give birth any moment now. So it's crucial to
get the logistics in place. That means knowing your spouse's every move, wearing a pager, keeping
your cell phone recharged and on, sticking close to home (and the hospital), and making plans for
your other children, if you have any, for when you go into labor.

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Week 39

Some of you are already going to be new parents

Mother
You And Your Body

You will be feeling excited and apprehensive about the whole affair.

It is common to feel that you will not be able to recognise the symptoms of real labour.
Relax- you can't miss them.

Your cervix is ripening for the birth.

Your bladder is under more pressure than ever

Now that you know how to tell if you are really in labor, let's talk about some of the ways your body
prepares for labor. It is really neat to examine all of the changes that take place in your body as the
pregnancy continues.
Your baby will descend into your pelvis, sometimes called engagement or lightening, usually before
labor in first time moms and during labor in subsequent births.
Your cervix, the mouth of your uterus, will begin to soften and possibly dilate. Some practitioners
will do routine vaginal exams towards the end of pregnancy. Contrary to popular belief, you can't
predict when labor will start by the details of your cervix. Some practitioners will also strip the
membranes in an attempt to "get things going." If you feel strongly about this mention it to your
practitioner before any physical exams.
In the days before labor begins you may also experience the following, although they are not
always accurate predictors of when labor will begin:
? bloody show
? loss of mucous plug
? nesting instinct
? loose stools

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? loss of weight
? increase in appetite
Hang in there! You are almost done!
Baby

Your baby is about 49cm long and weighs about 3.1kg/7lb

Your baby is able to function on his own, although he is still getting nourishment from the
placenta.

Most of the lanugo would have gone except around the shoulders and the creases of the
chubby body.

The umbilical cord is now 1.3cm thick and may be knotted or wrapped around his neck.

Did you know that the amniotic fluid is continually replaced, even in labor, at the rate of every three
hours? Pretty amazing stuff! We really don't know where amniotic fluid comes from, although it is
partially comprised of urine, sweat and other fluids from the baby. Your baby has been practicing
breathing the amniotic fluid for many weeks in preparation for the big event!
The meconium in the baby's intestines will be shed as the first movement that the bowels make
after birth. Meconium is a black, thick, tarry substance that is hard to get off of their rear ends!
About 30% of the time, the baby will actually pass this stool before birth. This can cause problems if
the baby swallows the meconium, however, that is not likely if the proper suctioning is done at birth.
This can be done by a doctor or a midwife, even in a homebirth situation.
Twin Tips
Are you tired of answering questions about still being pregnant? Not much longer. Your weekly
check ups probably include non-stress tests to help ensure babies are growing well and that the
placentas are not aging. Remember to ask any questions you have during your visits. If you have
poor memory, write them down before you go and record the answers on the same paper!

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Your Baby: Preparing for labor

Fully developed and ready for birth, your baby will weigh somewhere between 6 and 9 pounds and
will measure between 18 and 21 inches in length. When labor starts, your baby's body shifts gears
to prepare for the journey. The fluid in the lungs is absorbed, airing out the lungs in preparation for
breathing. The fetal hormones are on the rise to help maintain blood pressure and blood sugar
levels after birth. Lastly, the baby represses his breathing movements in order to gather energy for
delivery.
Your Body: Post-delivery dealings
Regardless of how much prep work you've done beforehand, you may not know what you're in for if
this is your first baby. Immediately after birth, there are a bunch of things happening to you and your
baby. In fact, those first 24 hours after delivery are full of activities you probably never thought
about.
As soon as your baby has been delivered, you have to deliver the placenta, which had connected
the baby to the uterus for oxygen, nutrient exchange and elimination of wastes. Usually, it's only a
matter of minutes as the organ separates from the uterine wall, but it can take up to a half hour. To
help prod the placenta and to encourage the uterus to contract - which closes off blood vessels and
controls bleeding - your doctor or a birth attendant will gently massage your lower abdomen. If it still
doesn't come out, you may also have to help push it out, and in some cases, your doctor might
have to reach inside to remove it by hand. While the removal of the placenta may be painful, it is an
important part of the postpartum process. It needs to be inspected to make sure it looks normal and
intact.
Once the placenta is out, your doctor will clean you up and repair any damage that was done - an
episiotomy, tearing, laceration, or the whatnot. If you had an episiotomy, it will take 10 to 20 minutes
to close and a little longer for bigger tears. If the first anesthetic worn off, you may receive a local to
numb the area before the doctor starts stitching. You may also be given ice packs to help reduce
swelling and ease the pain.
After you are all cleaned up, you will be checked regularly and often, especially those first 24 hours
after delivery. Doctors will check to make sure your uterus is firm, massage your lower abdomen,
and monitor the amount of vaginal bleeding, temperature and blood pressure.
In the meantime, you might be overwhelmed - and that's normal. Your body has just gone through a
traumatic event, and your nine-month odyssey is finally over. Allow yourself time to heal and know
that you will feel a flurry of emotions - ups, downs, good, bad, fear, excitement, and so on. The real
adventure is just beginning!

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On That Note: What happens after birth?

By the time you reach the end of the ninth month, you might be more focused on the baby than
anything else. If your mind is racing with unanswered questions about what comes after birth, check
out the FAQ section on the postpartum period. You'll find answers to questions like what you should
expect when you bring the baby home and how long it will take for your body to heal - and more.

Weekly Tip: Chances are you feel like an oversized elephant by now. You probably can't bend
down to put on your shoes or get out of bed gracefully. Just when you think you can't stand being
pregnant one day more, do something different. Many pregnant women we know find this an
opportune time to treat themselves to a manicure and pedicure. It's a great pick-me-up that will
make your hands and feet feel great and will take your mind off your body - a welcome change.

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Week 40

A new baby is a joy for all!

Mother
Your body has been getting ready in many ways over the last few weeks. We have talked before of
the labor and what it entails. We have discussed pain relief and other aspects as well. As you know
many healthy pregnancies will still be in full gear past 40 weeks gestation. This is very normal, only
about 4% of women will actually give birth on their due date. While 98% of women, including those
who give birth on their due dates, will give birth 2 weeks before or 2 weeks after.
So, let's talk about inductions of labor for a moment. Inductions are the artificial means used to
bring about labor. Thee can be medically managed, like pitocin or amniotomy (breaking your water),
or by non-medical means. Either way, you need to really give a great deal of thought to the risks
and benefits of inductions.
And remember, no matter how your baby gets here or what you did or said in labor... You did a
great job!
You And Your Body

Try to stay calm while waiting.

Use any Braxton-Hicks or false labour to practice your relaxation and breathing techniques.

If you're worried about your waters breaking in public, you may be more confident wearing a
sanitary towel.

If you go into labour, make sure people involved in your labour know what your birth plan is
and try to be as flexible as possible.

Baby

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Your baby is probably one of the 96% of babies who is head down and deeply snuggled into your
pelvis. The immune system is still immature and the baby receives antibodies from the placenta and
after birth they will receive antibodies continually from your breast milk. Most of the lanugo has
fallen off the baby's body, although you may still find some hidden spots, particularly in the creases,
and around the shoulders or ears.
The average baby will be about 7.5 pounds (3.4 kilograms) and 20 inches o
l ng at birth. The
placenta will weight about 1/8 th the size of the baby and the umbilical cord will be about the same
length as the baby. Your baby will be judged, at birth and 5 minutes later, with an apgar score.

Your baby is approx 50cm long and weighs about 3.4kg/7lb 8oz

Your baby is all curled up, head down in the foetal position, waiting to be born.

Twin Tips
The rate of undiagnosed multiples is very slim. Finding out earlier you have multiples helps ensure
a healthier delivery for both mom and babies.

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Your Baby: Ready to roll

The average size of a full-term baby is 7 1/2 pounds (3.4 kilograms) and 20 inches long at birth.
The placenta weighs about one-eighth of the baby's size, and the umbilical cord is almost as long
as the baby.
By the end of term, your baby is fully developed. Most of the vernix (fatty substance covering the
skin) has disappeared and 15 percent of the body is fat. Similarly, most of the lanugo (downy hair)
has shed, but don't be surprised if you see some hidden spots, particularly in the creases, and
around the shoulders or ears.
Your Body: What to expect after childbirth
Your life as you knew it is about to go topsy-turvy once your baby arrives. Taking care of a baby is a
full-time job, and you're going to feel it - physically and emotionally. Some first-time moms find it
difficult to adjust to their new role, but if you know what to expect it may be easier:

Episiotomy aftermath: The healing process may take two to three weeks, but eventually your
stitches will dissolve and you will be able to sit on a normal surface again. Meanwhile, sit on
an inflatable cushion or rubber inner tube and keep a squirt bottle on hand to rinse the area
after you go to the bathroom.

Hemorrhoid care: One of the most common after effects of pushing during labor is a
hemorrhoid, or swollen blood vessels around the anus that may bleed and be painful.
Depending on the severity of the swelling, you may want to soak your bottom in a few
inches of warm water in the bath or wear a cotton pad soaked with cold witch hazel cream in
the anal area. If the pain is unbearable, you may need prescription medicine.

Uterine contractions: During the first week after birth while your uterus returns to its prebirth
state (over a six-week period), you may feel afterpains or contractions, especially during
nursing and after multiple pregnancies. To relieve the pain, you may need prescription
medicine (analgesic).

Bleeding: It is normal to bleed after birth for anywhere up to two to three weeks. But if the
bleeding remains heavy after the first week (exceeding the heaviest day of a period or flows
freely), resumes after slowing down or turns bright red after the fourth postpartum day, has
large clots, or has a foul odor (with fever and/or chills), call your doctor immediately.

Breast changes: Whether or not you are breastfeeding, you'll know when your milk comes in
because your breasts may be so full of milk that they get hard and engorged. To best
protect your breasts from engorgement pain - and from sagging - be sure to wear a wellfitted, supportive bra at all times. If you do get engorged (which may be accompanied by a

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slight fever and flu-like feelings for a day), apply cold washcloths or ice packs to reduce the
swelling.

Incontinence issues: For the first few days (and sometimes weeks) after birth, your urine and
bowel movements may be out of control. The culprit: stretching of the base of the bladder,
the stretching and weakening of the pelvic floor muscles, tearing of the perineum, and nerve
injury to the sphincter muscles around the anus. The treatment: Kegel exercises to improve
the bladder, special doctor-prescribed exercises to control your bowels, and in some cases,
surgery.

Intense fatigue: Every new mom suffers from sleep deprivation. To help manage your
fatigue, you can line up or accept offers of help from friends or family, unplug your phone
and let your answering machine take messages, ask your spouse to spell you so you can
nap, leave the housework for later and live with clutter, and simplify your daily tasks (order
take-out food, eat frozen food, use paper plates, say no to anyone who needs a volunteer).

A rollercoaster of emotions: You may feel overwhelmed, stressed out, teary, elated, or even
depressed. Some of those feelings are normal and to be expected, but if you're unable to
function or shrug off the blues you should consult a professional.

On That Note: If you're down and troubled

You may have heard or read about the baby blues, which usually lasts for the first two weeks after
childbirth, or a more serious condition a mother experiences after the first few weeks of birth called
postpartum depression

Weekly Tip:
Feeling like this baby is never going to come out? Put your fears to rest. It will happen: It's
just a matter of time. But if your due date is fast approaching and there's no changes in sight,
make it special anyhow: Go out to a romantic, candlelit dinner with your spouse to mark the
day. Who knows? It may just be your last tete-a-tete as a twosome.

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Week 41

Birth

Mother
You And Your Body

One or two weeks overdue is not a worry as long as your baby is healthy and the doctor
may do a few tests to check that.

Tests include ultrasound scan and measurement of foetal heart rate to ensure that the baby
is not in distress.

Surprise! You're still here. That's okay you aren't alone. While some moms have their babies prior
to their due dates, many moms don't have their babies until after their due dates. The majority of the
time it's simply because the due date was miscalculated...
You may see your practitioner more often. Some will want to do some testing, such as a non-stress
test to ensure baby is still doing well. usually babies are fine, it's the mommies who are tired!
Extra rest is very important, temper your bouts of energy with naps. Be leery of inductions
techniques offered by well meaning friends and family. Some are silly while others are down right
harmful.
Baby
Okay, are you surprised that the baby is still in there? You shouldn't be! He or she is tucked away,
happily, inside. The average first time mother will go more than four days past her due date.
Remember that the due date was more of a guess than anything based in science!

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Your practitioner will still be monitoring you and the baby for the proper growth, fetal movements,
and signs of labor.

Your baby is still putting on weight.

She is getting impatient just like you, waiting to be born.

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Week 42

A New Baby

Mother
You And Your Body

Nearly ten per cent of pregnancies last this long.

Discuss methods of induction of labour with your doctor.

Okay, so it's not funny anymore. Your back really hurts, the neighbors, the relatives, no one will
leave you alone. The solution: Caller ID.
While this sounds really great it can also have the opposite effect and everyone simply drives over
to your house. Pregnant woman stalking is now a very popular sport.
Seriously, continue doing all the comfort measures you need to stay comfortable. Continue
exercising, sleeping, and drinking lots of water. Remember that no one has been pregnant forever.
If you haven't had a vaginal exam yet one may be performed to see if your cervix is favorable.
Although this truly has no bearing on when you will go into labor or how long it will take, but for
some women and practitioners it's comforting information to see that her body is changing.
Remember that not all of the preparations for birth can be measured by a vaginal exam.
There may be health reasons to start looking at induction, though by the end of this week 98% of
you will be gone and off enjoying your babies. Sometimes the baby isn't growing well and would be
better off outside the uterus. Sometimes the mother has an illness, like PIH or diabetes that means
a birth sooner would be better than later. Only your practitioner can tell you if these are required for
you.

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So, settle in and enjoy the last few days of pregnancy. Read some birth stories, finish up last minute
plans, go for a walk, see a movie, and remember to enjoy those last few hours of baby movements,
it will be what you miss later!
Baby

Your baby would probably have entered the world with a cry and a surprised look on her
face.

Babies honestly don't tend to get that much bigger after 37-38 weeks. A baby who is truly postdates
(after 42 weeks) is usually characterized by the loss of weight and body fat.
Remember to do those fetal kick counts to monitor the baby's health in between visits to your
practitioner.

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Postpartum
Frequently asked questions (FAQ)

Q: What should I expect when I bring the baby home?

A: During the first week postpartum, you (and your partner) will experience many emotional
changes, which can range from elation to feelings of inadequacy to frustration. It is too bad that this
new little person doesn't come with an instruction booklet! The good news is, however, there are
numerous invaluable resources available, from experienced family and friends, to educational
books and health-care providers. Preparation is always best done in advance, so it is a good idea to
attend newborn baby classes before delivery. (While some classes are offered after delivery, it is
good if you can do this before in case you are too tired to attend after delivery or if you want to
spend the time bonding with your new family). Topics usually covered include: how to bathe, burp,
diaper, and swathe the baby; how to dress the baby; circumcision care; and eye, ear, nose, nail,
and umbilical cord care. Car seat safety is usually also discussed. During this exciting and
demanding week, you and your newborn baby will be learning a lot about each other. With practice
(and you'll get plenty) your skills, such as dressing, feeding, or diapering the baby, will improve as
will your confidence. Expect to feel like a novice at first. Whether you decide to nourish your infant
at the bottle or breast, it will be quite often and will require effort. (If breast-feeding, your baby
should nurse eight to 10 times in a 24-hour period). This wonderfully challenging week will be filled
with feedings, burping, diaper changes, sleep and then more feedings, burping, and diaper and
clothing changes. By the end of the first week, most new parents, while still feeling overwhelmed at
times, have developed a "routine" which can help immensely.

Q: How long will it take for my body to heal after I deliver?

A: Factors such as general health before and during pregnancy, type of delivery, and any
complications during delivery and the postpartum period can all influence the length of time it will
take for your body to heal after delivery. Generally, if you are in good health and had an
uncomplicated delivery, it will take approximately six weeks to recover from childbirth. Usually,
recovery from a vaginal delivery is much more rapid than the recovery period from a c-section.
Many women will feel back to their normal selves within a week of having a vaginal delivery, while

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women who have undergone c-section generally take more time to recuperate. That is not to say
that within a week women who have had a vaginal delivery can resume their regular routine. It will
still take the body approximately six weeks to get back to its pre-pregnancy state. Some general
guidelines for postpartum activities are as follows:
Vaginal Deliveries:
1 week: Resumption of driving.
2 weeks: Resumption of light exercise such as walking.
6 weeks: Postpartum exam. After medical clearance, resumption of most activities including
an exercise regimen, sexual intercourse, and work.
C-Section:
1 week: Post-operative check up.
2 weeks: Resumption of driving.
6 weeks: Postpartum exam. After medical clearance, resumption of most activities including
an exercise regimen, sexual intercourse, and most other activities.

Q: What are the signs of postpartum depression?

A: Postpartum "depression" is a complex mixture of physical, emotional, and behavioral changes
and can be divided into three categories: postpartum blues, postpartum depression, and
postpartum psychosis. POSTPARTUM BLUES: Often referred to as the "baby blues," the incidence
of postpartum blues ranges from 50% to 80%. It will usually occur within one to three days of the
delivery. Signs and symptoms usually are: difficulty sleeping; feeling tired even after sleep; lack of
energy to do even the simplest tasks; profound longing and sadness. Other symptoms can include
feeling overwhelmed, confused, and nervous. The postpartum woman with the "blues" will
frequently cry and do so for long periods of time. Patients describe having their feelings hurt rather
easily, an irritability triggered by the most minor incidents, and most troubling, a lack of feeling for
the baby. POSTPARTUM DEPRESSION (PPD): The signs and symptoms of postpartum
depression appear three to seven days after delivery, most commonly upon a woman's return home
from her postpartum hospital stay. The incidence ranges anywhere from 3% to 20%. In patients
who have had postpartum depression with a previous pregnancy, the recurrence rate ranges from
15% to 35%. There is a 15% to 25% risk of PPD in women with previous depressive reaction that
was not associated with pregnancy. Symptoms of PPD may last anywhere from a few weeks to

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several months and can include: feelings of inadequacy; inability to cope; impaired concentration or
memory; despondency or despair; thoughts of suicide; no feelings for the baby, or over-concern for
the baby's health; guilt; panic attacks; feeling "out of control" or like you are "going crazy";
headaches; chest pains; heart palpitations; or hyperventilation. POSTPARTUM PSYCHOSIS:
Although this is a relatively rare occurrence (1 in 1,000 births), the onset is usually within the first
three months of the postpartum period and tends to be severe and quick. A wide range of
symptoms include: lack of appetite, hyperactivity, confusion, fatigue, mood swings, memory loss,
and delusions or hallucinations both auditory and visual. These women are often overcome by an
overwhelming sense of shame or hopelessness. DIAGNOSIS AND TREATMENT: Your practitioner
will assess your psychological status at your postpartum checkup; unfortunately, this appointment is
usually four to six weeks after delivery when symptoms of PPD may have already developed. It is
important for you to contact your health-care provider to get professional diagnosis and treatment if
you experience any of the above symptoms or if you are concerned about your mental health.
Psychopharmacologic treatment is also available. There are numerous support and self-help
groups, which can be an invaluable resource during this difficult and confusing time. In an attempt
to prevent postpartum depression from occurring, several prenatal interventions have been
proposed. The purpose is to provide a smooth transition into parenthood. These interventions
address a wide variety of efforts to prevent the depressive episodes. They include prenatal classes
to teach parenting skills, reliance on assistance from support personnel including spouses, family
members, friends, and neighbors. Mothers-to-be are encouraged to verbalize their fears and
anxieties well before the baby arrives and to continue these discussions even after delivery. This
type of educational approach with specific attention to the psycho-social aspect of the pregnancy
holds great promise.

Q: How can I include siblings in the excitement of having a new brother or sister?
A: Preparing your child for the birth of his sibling is best done BEFORE the arrival of the new
addition. Let your child participate in discussions of how the baby will be cared for, what things he
will need, where he will sleep, etc. Let siblings get things ready for the new baby. Have your child
help you pack your suitcase for the hospital and help pick out the baby's coming home clothes. Buy
the older child a doll before you go to the hospital and encourage him to feed, diaper, and care for
"his" baby. Attend sibling classes with your child and visit the hospital with him before you deliver.
On the day that you take the baby home, bring the other child to the hospital to "help." When you
get home with the new baby:

Spend special time each day with the older child.

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Encourage your child to help with the baby in ways that are age appropriate
(singing to the baby, assisting with diaper changes, etc.).

When visitors come to see the new baby, let your older child be the tour guide. Let
him open the baby's gifts.

When you bottle- or breast-feed your baby, read a story to your older child, sing to
him, or just cuddle him.

Q: What do I need to know about reducing the risk of SIDS (sudden infant death syndrome)?
A: SIDS is the third leading cause of death in infants between the ages of 1 month and 1 year and
as of yet the cause is unknown. It is the unexpected, sudden death of an infant under age 1 in
which an autopsy does not show an explainable cause of death. Many physicians and researchers
now believe that SIDS is caused by several factors which may include problems with sleep arousal
and an inability to sense a buildup of carbon dioxide in the blood. Almost all SIDS deaths occur
without any warning or symptoms, when the infant is thought to be sleeping. Some infants are at a
higher risk than others, such as babies who: sleep on their stomachs or on soft bedding; were one
of a set of twins or other multiple births; were delivered premature; or have a sibling with SIDS. If a
mother smoked or abused substances during pregnancy, if she was very young when she gave
birth, received late prenatal care, or is of a low socioeconomic status, the baby is also at a higher
risk for SIDS. The impact of each factor on SIDS is now well defined and understood. The incidence
of SIDS has dropped by almost one-half since the American Academy of Pediatrics recommended
that parents place infants on their back or side when sleeping. Other recommendations for
preventing SIDS include:

Place your baby on a firm, tight fitting mattress, and remove all comforters and other
bulky bedding.

Do not let your baby become too hot (don't overdress).

Keep your baby in a smoke-free environment.

Do not lay your baby on pillows, beanbags, or sheepskin mattresses.

Breast-feed your baby if possible. While breast-feeding has not shown to decrease the
incidence of SIDS, it does decrease the incidence of some upper respiratory infections
which may influence the development of SIDS.

Have your baby's caretakers attend an infant CPR class.

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Q: When will the baby need his first checkup?

A: The baby's first checkup, in general, usually happens two to four weeks after birth, depending on
your baby's health and your practitioner's recommendations and style of practice.

Q: Can I take the pill if I am breast-feeding?

A: Birth control pills are usually not recommended as the first choice of contraception if you are
breast-feeding since the hormones in them can suppress lactation. However, provided that you are
a good candidate for the birth control pill, your practitioner may recommend that you use a
progestin-only pill after breast-feeding is well established.

Q: How long will it take to lose the weight I gained during pregnancy?
A: If you gained the recommended 25 to 30 pounds with pregnancy, you should be able to shed the
weight, by eating sensibly, by the end of the second month after delivery. Other factors that can
affect your weight-loss rate include: your daily caloric intake; the amount that you exercise; whether
you are breast- or bottle-feeding; and your pre-pregnancy weight. This is an area that can cause the
most anxiety for the postpartum woman. Crash or fad diets are not only ineffective, they may be
potentially harmful. To lose those extra pounds you gained during pregnancy, dedicate yourself to
sensible eating, a decreased caloric intake, and regular exercise.

Q: If I breast-feed, can I still get pregnant?

A: YES, YES, YES! Some women will find that their menstrual periods don't return while they are
nursing. This is due to hormonal changes, which suppress ovulation. However, it is IMPOSSIBLE to
predict when ovulation and menstruation will resume. In fact, some women ovulate and conceive
again before their period resumes.

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ANNEXURE

Recommended Daily Allowances Chart

When you're pregnant or breastfeeding, it's important to take a close look at your diet to make sure
that you - and your baby - are getting all of the calories and nutrients you need. What changes
should you make? To find out, look over the table below, which lists the recommended daily
allowances for various nutrients before conception, during pregnancy, and while you're nursing your
baby - and explains the importance of each.
The best way to pump up your diet is by eating a variety of healthy foods, but taking a daily prenatal
vitamin recommended by your doctor or midwife will help fill in any nutritional gaps. (If you're a
vegetarian or are on another special diet, be sure to talk to your caregiver about additional dietary
changes you may need to make.) Remember, too, that "eating for two" doesn't mean eating twice
as much. You need just 300 extra calories a day (400 while you're nursing) -equal to one glass of
milk, a banana, and 10 crackers.
NonPregnant Lactating
pregnant
Function
Women Women
Women
Kilocalories
2200
2500
2600 Provides energy for basic body functioning
Vitamin A
Aids vision; needed for growth of bones and
800
800
1300
(micrograms=mcg)
teeth
Vitamin B6
1.6
2.2
2.1
Aids in the formation of red blood cells
(milligrams=g)
Vitamin B12 (mcg)
2.0
2.2
2.6
Aids in the formation of red blood cells
Needed for wound healing, resistance to
Vitamin C * (mg)
60
70
95
infection, and collagen formation
Vitamin D (mcg)
10
10
12
Aids in the growth of bones and teeth
Needed for the formation and use of red blood
Vitamin E (mg TE)
8
10
12
cells and muscles
Prevents a rare bleeding disorder in the
Vitamin K (mcg)
55
65
65
newborn
Essential for the growth and health of bones
Calcium (mg)
1200
1200
1200
and teeth and proper muscle and nerve function
Prevents neural tube defects in the fetus;
Folate (mcg)
180
250
280
essential for blood and protein production and
cell division
Iodine (mcg)
150
200
200
Required for hormone production
Iron (mg ferrous
Essential for the production of hemoglobin, an
15
15
15
iron)
important blood protein
Nutrient

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Magnesium (mg)

280

355

355

Niacin (mg NE)

15

20

20

Phosphorous (mg) 1200

1200

1200

Protein (grams=g) 55

65

65

Riboflavin (mg)
Thiamin (mg)
Zinc (mg)

1.5
1.5
19

1.5
1.6
19

1.3
1.1
12

Needed for proper nerve and muscle function

Promotes healthy skin, nerves, and digestion;
helps the body use carbohydrates
Essential for the growth and health of bones
and teeth
Needed for overall health and growth; aids in
blood production and supplies the "building
blocks" for your baby's body
Aids in the release of energy to cells
Helps the body digest carbohydrates
Aids in the production of enzymes and insulin

These additional nutrient requirements can be taken in by choosing the right kinds of foods. For
instance, green leafy vegetables are both high in folic acid and iron and calcium can be taken in
through dairy products and also through foods such as salmon, beans, and tofu. Diary products are
helpful in getting nutrients such as phosphorous, riboflavin, vitamin A, and Vitamin D. Although
pregnancy requires additional nutrients, it doesn't require a drastic change in caloric intake, just
because you are eating for two doesn't mean that you have to double the amount of food that you
eat. Therefore, strategically planning your diet is important and supplementation by physician
recommendation should be considered. Not only is it important to choose the right kinds of foods, it
is also important to eat a variety of different foods without skipping any meals while keeping the fat
and cholesterol intake to a minimum.

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Signs of Labor

If you've never given birth before, you may assume that you'll just "know" when the time has arrived
to have your baby. In reality, the onset of true labor isn't always easy to identify, and the events
leading up to it can drag on for days. Remember, too, that your due date is simply a point of
reference -- it's normal for labor to start any time between three weeks before and two weeks after
this vaunted date.
So how will you know that labor is starting? First, you need to understand the birth process. In a
nutshell, here's what happens during labor: The uterus repeatedly contracts (tightens and relaxes),
causing the cervix to thin (efface) and open up (dilate) so you can push your baby into the world.
Labor may be nearing if you notice one or more of these signs:

Lightening. This happens when your baby's head "drops" down into your pelvis. Your belly
will suddenly look lower and you'll have an easier time catching your breath than you did
when your baby was crowding your lungs. The downside, though, is that he's now pressing
on your bladder, increasing your need to urinate. For first-time mothers, lightening usually
occurs a few weeks before birth. For veteran moms, it may not happen until labor has
begun.

Bloody show. If you have blood-tinged or brownish vaginal discharge, it means your
cervix has dilated enough to expel the mucus plug that sealed it for the last nine months.
This is a good sign, but active labor may still be days away.

Your baby moves less. Women often notice that their baby is less active the day before
labor kicks in. No one is sure why this might be, but one theory is that the baby is simply
saving his energy for the big event.

Your water breaks. When the amniotic sac ruptures, you'll feel fluid leak from your vagina
in a trickle or a gush. For most women, contractions follow shortly thereafter. But even if
they don't, let your caregiver know as soon as you think your water has broken. In about 1
in 10 women, contractions don't begin on their own within 24 hours. If this happens, your
labor may need to be induced, since the likelihood of infection goes up once your baby's
sterile bubble bursts. For other women, the amniotic sac doesn't rupture until labor is well
underway.

Diarrhea. If you feel a frequent urge to empty your bowels and your stools are looser than
normal, labor may be imminent.

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Nesting. There's no scientific proof linking it to the onset of labor, but plenty of mothers-tobe are gripped by a sudden urge to "nest" -- to vacuum the entire house at 3 a.m., say, or
put those last, finishing touches on the nursery -- right before labor begins.

False Labor
Most expectant mothers feel mild contractions before they're actually in labor. These are called
Braxton Hicks contractions. It can be hard to distinguish Braxton Hicks contractions from the real
deal, especially if you're near your due date. If contractions aren't causing your cervix to dilate,
though, it's known as "false" labor. While true labor contractions get longer, stronger, and closer
together as time goes on, false labor contractions tend to be:

Irregular. Braxton Hicks contractions are sporadic, have no predictable pattern, and
usually stop if you rest or change positions.

Felt in your belly and your groin. True labor contractions, on the other hand, usually
"wrap around" from your back to your belly. If Braxton Hicks contractions are making you
uncomfortable, take a warm bath and drink plenty of fluids to control them and ease
discomfort.

Calling Your Caregiver

Alert your caregiver if you feel increasing pelvic pressure, have vaginal bleeding or heavy discharge,
or notice a marked decrease in your baby's activity. She can talk you through these changes and
decide if you need to come in for an exam.
And, of course, let your doctor or midwife know when regular contractions begin. These may feel
like your uterus is "knotting up" and be relatively painless at first, but gradually build in intensity,
starting at the top of your uterus and radiating through your belly and lower back. Your caregiver will
want to know what other symptoms you're feeling, how far apart your contractions are, and whether
you can talk during them.
Once labor has started in earnest, when should you go to the hospital? Every situation is different,
so talk to your caregiver well ahead of delivery day about the best plan for you. In general, though,
expectant mothers should head to the hospital when their contractions last 60 seconds or more and
have been coming five minutes apart for at least an hour.
Preterm Labor
Sometimes contractions cause the cervix to efface and dilate before 37 weeks of pregnancy. This is
called preterm labor. A uterine or vaginal infection or a host of other health problems can bring on
preterm labor. For unknown reasons, some women are more prone to it than others.

The symptoms of preterm labor are similar to the symptoms of labor that begins at term. If you
notice any of the pre-labor signs listed above or feel strong, regular contractions before 37 weeks,
call your caregiver right away. After examining you to see if your cervix is effacing or dilating, she
may recommend that you avoid intercourse, exertion, and stress and get as much rest as possible
to stave off further contractions.

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Prenatal Exercise

During pregnancy your body experiences dramatic physiological changes that require a carefully
designed exercise program. These naturally occurring changes are not permanent and the benefits
of regular exercise are many. Always check with your health care provider for any limitations of your
activity before attempting any exercises.
Benefits of Exercise During Pregnancy

Improved posture and appearance

Relief of back pain

Stronger muscles in preparation for labor and support for loosened joints

Improved circulation

Increased flexibility

Increased/maintained aerobic capacity (endurance)

Increased energy level and less fatigue

Decreased muscle tension that promotes relaxation

Promotion of feelings of well-being and a positive self-image

Guidelines and Precautions for Prenatal Exercise Programs

Occasionally exercise may stimulate uterine activity or initiate other possible complications.
Before beginning the exercises, review the precautions about

premature labor.

Always maintain correct posture by tilting your pelvis and straightening your back.

Monitor your breathing and maintain the ability to walk and talk comfortably while
exercising. Stop exercising when tired and do not exercise to exhaustion.

Exercise should be done regularly; three times per week. During pregnancy, aerobic
exercises should not exceed five times per week in so your body can recover and rest
properly.

Avoid any type of exercise that may potentially cause even mild abdominal trauma.

Avoid rigorous bouncing.

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Avoid arching your back.

Do not bring your feet over your hips, i.e. candlestick or bicycling-in-air position.

Do not do sit-ups past 45 degrees.

Breathe continually while exercising; do not hold your breath. In general, exhale on
exertion. Check for separation of the

abdominal muscles

each week and take necessary

precautions if indicated.

Drink a lot of fluids before, during and after exercising to prevent dehydration.

Avoid activities that require precise balance and coordination. As your pregnancy
progresses, your coordination may be altered by your increasing weight, shifting center of
gravity, and softening and increased mobility of your joints and ligaments.

Muscles that are used in aerobic activity should be appropriately stretched before and after
the exercising.

Decrease your exercise level as your pregnancy progresses. Your increased body weight
will require a larger energy output, so you will feel more tired. If you feel tired, reduce your
exercise level and switch to simple stretching/strengthening exercises. Check with your
health care provider.

In general, continue doing any activity you enjoyed before you became pregnant as long as
it feels comfortable. If you want to begin a new aerobic program, consult your health care
provider or try a program with a trained professional.

Consider using an approved pregnancy exercise video that follows the ACOG (American
College of Obstetricians and Gynecologists) guidelines to work out at home.

How Much Exercise Should I Do?

Exercise programs during pregnancy should be directed toward muscle strengthening to minimize
the risk of joint and ligament injuries.
Frequency

Daily - stretching, strengthening, Kegels, relaxation.

Three times/week - low or non-impact aerobic activity with appropriate warm-up and cooldown.

Once a week - check for separation of abdominal muscles.

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Intensity/Duration

Stretching/strengthening

Work up to five to 10 repetitions per day.

Hold each position or stretch for 20-30 seconds

Do not stretch to extreme discomfort as joints are looser during pregnancy.

Aerobic activity:

Do not exercise beyond the point of moderately heavy perspiration.

Sustain aerobic activity for 15-20 minutes as long as you are able to talk comfortably and
are not short of breath.

Aerobic Activity During Pregnancy

Aerobic exercise can cause your body temperature to rise as your metabolism increases to provide
energy. It is important for pregnant women to exercise but not to a point of increased body
temperature. The constant movement of both arms and legs typical of most aerobic exercise
programs provides a workout that can reach high levels of intensity. It is therefore important to
participate in an aerobics program where the instructor is knowledgeable of the special needs of
pregnancy and can adjust the exercise accordingly Low or non-impact aerobics, swimming or
cycling are recommended.

Benefits of Walking

A good activity to begin during pregnancy is a walking program, three to five days/week. Walking is
an inexpensive form of exercise, as the only requirements are a suitable pair of shoes and
comfortable clothing. Also, it is an activity that can be readily integrated into daily schedules. During
pregnancy, you can improve your aerobic fitness by walking on level ground at a comfortable pace.
However, it may be necessary to use modified forms of walking to gain significant benefits. Walking
at increased speeds, walking up and down hills, and walking while carrying weights can raise the
heart rate to levels that will improve aerobic fitness.

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How to Check for Abdominal Muscle Separation

You can check for separation anytime during your pregnancy by following these instructions:

Lie on your back and bend your knees, feet flat on the floor.
Slowly put your chin to your chest. Raise your head and shoulders until your neck is 6-8 inches from the
floor. Hold one arm out in front of you.

With the other hand, check for a gap (usually present in the first few months of pregnancy or postpartum) or
a bulge (present in last 3 months of pregnancy) in the middle of your abdomen. There may just be a soft
region between the muscle, wider than two fingers' width.

If any separation is found, avoid further separation by:

Doing mild abdominal strengthening while crossing your hands over your abdominal area to support
and bring the muscles together.

Exhale as you lift your head; this decreases pressure in your abdomen and allows your abdominal
muscles to work more efficiently.

Avoid abdominal bulging by consciously contracting your abdominal muscle when lifting and avoid
straining of any kind.

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Morning Sickness
Nausea and vomiting during pregnancy.
What is it? (Overview)

If you are spending most mornings in the bathroom feeling queasy, you are not alone. As many as
90% of all pregnant women experience some symptoms of morning sickness, while one-third
actually vomit due to this condition. It usually begins four to six weeks after conception and
continues until the 14th to 16th week of gestation. The exact cause of morning sickness is unknown,
but several theories exist. Most experts believe it's triggered by hormonal changes, especially the
increase of hCG (human chorionic gonadotrophin). High levels of this pregnancy hormone are
thought to overstimulate the part of the brain that controls nausea and vomiting. Gall bladder
disease, hyperactive thyroid, molar pregnancy, or carrying more than one baby may also cause
morning sickness. Other possible culprits include the physical symptoms of pregnancy: an
enhanced sense of smell, stretching of the uterine muscles, displacement of the digestive organs,
and excess acid in the stomach. Emotional stress and a high-fat diet may also play a part.
How do I know I have it? (Symptoms and Diagnosis)

As the name suggests, most women experience morning sickness in the early hours of the day. It
can occur at any time, and for some women, it even lasts all day. It generally consists of nausea
and vomiting, but may also include dizziness and headaches.
How can I treat it? (Treatments)
There are no drugs currently approved by the FDA for the treatment of morning sickness. However, there are
several dietary, lifestyle, and alternative-medicine approaches that may help.

Diet:

Eat a diet high in protein and complex carbohydrates. Try peanut butter on apple slices or
celery; nuts; cheese and crackers; and milk, cottage cheese, and yogurt. Bland foods like
gelatin, frozen desserts, broth, ginger ale, and saltine crackers also soothe the stomach.

Avoid eating fatty foods. Recent research suggests that a high-fat diet contributes to morning
sickness.

Keep your blood sugar even by eating and drinking small portions frequently. Try to eat before
getting hungry and before nausea strikes.

Keep crackers by the bed and eat one or two before getting up for the day.

Drink plenty of liquids. Try to drink between meals rather than with meals to prevent your
stomach from getting too full.

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Lifesyle:

Take vitamin supplements at night, as the iron they contain may irritate your stomach. You may
have to try several prenatal vitamins before finding one you can tolerate.

Keep morning activities slow and calm.

Avoid staying in poorly ventilated spaces that trap food or other odors.

Avoid smoking cigarettes.

Get extra sleep and try to minimize stress as much as possible.

Alternative medicine:

Use acupressure wristbands. These apply pressure to specific points on the wrist, and are often
used to ease motion sickness. You can find them at drug stores, health-food stores, and travel
stores.

Try acupuncture. Some acupuncturists are specially trained to work with pregnant women. Talk
to your health-care provider before consulting a licensed acupuncturist.

Take 100 to 200 milligrams of vitamin B supplements daily, especially B6.

Contact your health-care provider if:

Morning sickness does not improve, despite trying home remedies.

You are vomiting blood or material that looks like coffee grounds.

You lose more than 2 pounds in a week.

There is prolonged, severe vomiting for three or more days, which can cause dehydration and
malnutrition.

Frequently asked questions (FAQ)

Q: I am now in my second trimester. Why hasn't my morning sickness stopped?
A: Unfortunately, for reasons not completely understood, some women experience morning sickness during
their entire pregnancy. This happens most often for women carrying more than one baby. If you're still having
morning sickness, make sure you inform your health-care provider to rule out other possible complications.
Q: Is the morning sickness hurting my baby in any way?
A: Luckily, no. In fact, some medical professionals believe that morning sickness is actually a sign that all is
well with you and your baby. It may signal that necessary hormonal changes are taking place.
Q: I had horrible morning sickness with my first child. Am I destined to have it again with my second?
A: No. Most women have an easier time in their second and subsequent pregnancies. This may have to do
with the body being more accustomed to the hormonal changes of pregnancy. Lower maternal stress levels
may also play a role.

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Finding Comfortable Sleeping Position

Sleeping like a baby

During my first pregnancy, as morning sickness and the reality of of the exhaustion set in, I couldn't
stay awake. I would literally get up at 9 AM, work for 2 hours, and come home and go back to sleep
until early evening. Eat dinner and hit the hay for the night.
The second trimester brought some relief to both the exhaustion and the morning sickness, but
presented new problems, namely aches and pains. However, at this stage it wasn't anything that a
few pillows couldn't cure.
At the end of my pregnancy our bed looked like a pillow factory; my husband could rarely fit in our
bed with me and the pillows, and I would lie awake at night for long periods of time.
These scenarios aren't very different for pregnant women any where, though there are different
types of problems with sleep in pregnancy.

First Trimester
At this point your mind and your body can play a tug of war with your sleep. Your body may
be forcing you into naps that you aren't used to or don't want. On the other hand your mind
may be whirring at top speed and keeping you awake, or even more likely refusing to let you
fall asleep after one of your nightly trips to the bathroom.

Second Trimester
This trimester might be your best chance for sleep! Your body isn't aching too badly yet and
your mind has settled down as the pregnancy is accepted.

Three Trimester
Many people will tell you that the lack of sleep in the third trimester is merely a way to
prepare for some of the endless nights that lie ahead. Dealing with the aches and pains,
your bladder constantly calling and the thoughts that begin to invade your mind about
parenting and labor and birth can wreck your sleeping pattern. Sometimes women will also
begin snoring during the last trimester. This is normal and will usually go away after the birth.
Finding a comfortable position is probably a big challenge right now. Back and belly
sleepers are having a particularly hard time dealing with life at night. While there are
commercial products available to aid you in sleeping on your belly, I've not talked to anyone
who has used one. There are wedges that are sold as special pillows. Although the best
thing I bought was a body length pillow, which you can find at nearly any department or
discount department store.

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Tips

Regular exercise, but not close to bed time, will help you sleep and help with energy
levels.

Avoid meals close to bed, particularly if heartburn is a problem for you.

Pillows! Use them where ever you need them: between your knees for aching hips,
under your belly for support, behind your back, and under your head.

Nap when you can, though this can be difficult with other children around. I learned to
nap on the couch while my daughter played with her blocks quietly. Enlist the help of
family if needed.

Sleep in or head to bed early.

Try relaxation before bed. A warm bath or a warm glass of milk.

If you wake up in the middle of the night or have trouble falling asleep don't just lie
there. Get up for a bit and read or do something not too stimulating.

If leg cramps wake you up at night try stretching prior to going to bed to avoid them.

Doing pelvic tilts before laying down will allow you a few extra minutes between
bathroom breaks at night.

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WELL BALANCED DIET

Your baby depends on you for its nourishment. If you eat well, your baby eats well and if you starve,
your baby starves. If you are not a person with great eating habits, use your pregnancy to inculcate
some, the benefits of which will last you all through your lifetime
What foods should I include in my daily diet?
You must aim to include the recommended servings for the following foods

Vegetables & Fruit: 5 servings a day (a glass of juice counts as one serving and frozen
vegetables are as good as fresh ones)

Bread, Cereals, Potatoes: 4-5 servings a day

Milk or dairy products: minimum 3 servings a day

Meat, fish or vegetarian alternatives: 2 servings a day

Fluids: 6-8 glasses in addition to milk (tea and coffee don't count in the daily intake and
should be reduced due to their caffeine content)

Which nutrients must my diet contain?

Your diet must contain the following nutrients:

Calories: You need enough calories to meet your energy demands.

Protein: These provide the building blocks for new tissues. Sources include meat, fish,
nuts, pulses and dairy foods.

Carbohydrates: It is wise to eat the starchy carbohydrates rather than the sugary ones.
Good sources include bread, pasta, rice, potatoes, sweet potatoes, flour products and
cereals

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Vitamins: Found in fresh fruit and vegetables. The following vitamins are essential:
Folic acid to reduce the chances of your baby being born with spina bifida or other
neural tube defect
Vitamin B12 found in meat, milk, eggs and yeast extracts like marmite
Vitamin A (necessary for healthy skin)found in eggs, margarine, dark green and yellow
vegetables, apricots and mango Excess of vitamin A can be harmful to the baby so you
must avoid any vitamin supplements (other than those prescribed by the doctor) and liver
containing foods.
Vitamin C(essential for healthy tissues) found in citrus fruits, tomatoes, peppers, broccoli
Vitamin D which helps the body to absorb calcium is found in margarine, oily fish, cereals
and can also be made in your body when you go out in the sun

Minerals: Although a number of minerals(like zinc and magnesium) are required in

small amounts, the two most important minerals include:
Iron which is essential for making red blood cells can be found in red meat, tuna fish,
spinach, dried apricots etc. Deficiency of iron can cause anaemia. small amounts, the two
most important minerals include:
Calcium is required for strong bones and teeth. It can be found in dairy products, sardines,
tofu etc.

Essential fatty acids: These cannot be made in the body and are required for the
development of the body. Best sources are corn oil, sunflower oil, oily fish (mackerel,
salmon etc.)

Fibre: Although not an essential nutrient, if added in the diet it helps to digest the food
and reduces constipation. Good sources include cereals, breads, rice, pasta, lentils,
peas, fruits etc.

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