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Pregnancy

GENERAL INFORMATION:

What do I need to know about pregnancy? A normal pregnancy lasts about 40 weeks from your last period. The first trimester lasts from your last period through the 13th week of pregnancy. The second trimester lasts from the 14th week of your pregnancy through the 26th week. The third trimester lasts from your 27th week of pregnancy until your baby is born. If you know the date of your last period, your caregiver can estimate your due date. You may give birth to your baby any time from 2 weeks before to 2 weeks after your due date.

What is prenatal care? Prenatal care is a series of visits with your caregiver throughout your pregnancy. Prenatal care can help prevent problems during pregnancy and childbirth. You will be weighed and your blood pressure will be checked at each prenatal visit. Your caregiver will check your baby's heartbeat and growth. You may also need the following at some visits:

  • Pelvic exam: Your caregiver uses a speculum to gently open your vagina. This lets him see your cervix (the bottom part of your uterus). Your caregiver checks the size and shape of your uterus to see how your baby is growing.

  • Blood tests: These may be done to check for gestational diabetes and anemia (low iron level). You may need other blood tests, such as blood type, Rh factor, or tests to check for birth defects.

  • Fetal ultrasound: This test uses sound waves to show pictures of your baby (fetus) inside your uterus. Jelly-like lotion is put on your abdomen, and a small handle is gently moved through the lotion. As this is done, pictures of your baby can be seen on a TV-like screen. Caregivers can learn the age of your baby, and see how fast he is growing. The movement, heart rate, and position of your baby can also be seen. Caregivers can see your placenta, and can tell if you have more than one baby.

What can I do to have a healthy pregnancy?

  • Eat a variety of healthy foods: Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if you need to be on a special diet.

  • Take prenatal vitamins as directed: These will help you get enough vitamins and minerals. Prenatal vitamins may also decrease the risk of certain birth defects.

  • Ask how much weight you should gain each month: Too much or too little weight gain can be unhealthy for you and your baby.

  • Drink plenty of liquids: Drink at least eight (8-ounce) cups of healthy liquids each day. Healthy liquids include milk, water, or juice. Avoid liquids that have caffeine in them, such as coffee, tea, and soda. Do not drink alcohol.

  • Do not smoke: If you smoke, it is never too late to quit. Smoking may be dangerous to your baby and cause him to weigh less at birth. Ask your caregiver for information if you need help quitting.

  • Ask your caregiver before you take any medicines: Many medicines may cause permanent harm to your baby if you take them when you are pregnant. Do not take any medicines, over-the-counter drugs, vitamins, herbs, or supplements without first talking to your caregiver. Never use illegal or street drugs (such as marijuana or cocaine) while you are pregnant or breastfeeding. Talk to your caregiver if you are having trouble quitting street drugs.

  • Exercise: Ask your caregiver about the best exercise plan for you. Exercise may help you feel better and make your labor and delivery easier.

What body changes should I expect during pregnancy?

  • Breast changes: Use a support bra to help decrease discomfort. You may see a thin, yellow fluid, called colostrum, leak from your nipples as early as your 10th week of pregnancy. Colostrum will change to milk about 3 days after you give birth. If your nipples are sore, wash them with warm water. Do not use soap or petroleum jelly. You may use lanolin to decrease pain.

  • Morning sickness: Eat crackers or dry toast before you get out of bed in the morning to ease morning sickness. Eat small, frequent meals throughout the day. Drink liquids between meals instead of with meals. Avoid greasy or spicy food. Avoid strong odors. Do not take medicine for nausea or vomiting without your caregiver's okay.

  • Heartburn: Pregnancy can cause stomach acid to rise into your esophagus. Eat small, frequent meals rather than 3 large meals. Avoid greasy or spicy foods. Drink liquids between meals instead of with meals. Sit upright for at least 3 hours after eating. Ask your caregiver before you take antacids for heartburn.

  • Skin changes and stretch marks: You may have red marks, called stretch marks, on your skin. There is nothing you can do to prevent stretch marks, and they will fade after pregnancy. Use lotion if your skin is dry and itchy. The skin on your face, around your nipples, and below your belly button may darken. Stay out of the sun and use sunscreen to help decrease this. Most of the time, this skin will return to its normal color after the baby is born.

What other changes should I expect during pregnancy?

  • Back pain: You may have back pain as your baby grows. Use good posture while you stand, squat, or bend. Wear shoes with good support. Sleep on a firm mattress. Use pillows for support when you lie on your side. Do not lie flat on your back because this may cause back pain and decrease blood flow to your baby. Use ice, heat packs, or massage to help decrease discomfort.

  • Constipation: Eat foods high in fiber such as fiber cereals, beans, fruits, vegetables, whole-grain breads, and prune juice. Get regular exercise and drink plenty of water to help prevent constipation. Your caregiver may also suggest fiber medicine to soften your bowel movements. Ask him before you use a stool softener or a laxative. Do not use mineral oil or enemas.

  • Hemorrhoids: These are enlarged veins in the rectal area. They may cause pain, itching, and bright red bleeding from your rectum. To decrease your risk of hemorrhoids, prevent constipation and do not strain to have a bowel movement. If you have hemorrhoids, soak in a tub of warm water to ease discomfort. Ask your caregiver before you use medicine to treat hemorrhoids.

  • Leg cramps and swelling: These may be caused by low calcium levels or the added weight of pregnancy. Rest often. Raise your legs above the level of your heart. During a leg cramp, straighten your leg and flex your toes toward your head or stand flat on your feet. Wear support pantyhose to help decrease swelling and varicose veins.

  • Urination: You may need to urinate more often. Kegel exercises may strengthen the muscles around your vagina and decrease urine leakage before and after your baby is born. Ask your caregiver if you do not know how to do kegel exercises.

  • Vaginal discharge: You may have thicker and heavier vaginal discharge.

What are some safety tips during pregnancy?

  • Avoid hot tubs and saunas: Do not use a hot tub or sauna while you are pregnant, especially during your first trimester. Hot tubs and saunas may raise your baby's temperature and increase the risk of birth defects.

  • Sex: You can have sex until your labor starts, unless there are problems with your pregnancy. Use condoms during sex if you are at risk for a sexually transmitted infection (STI). STIs can be dangerous for you and your baby. Do not have sex if you are bleeding from the vagina or having pain in your abdomen or vagina.

  • Travel safely: The most comfortable time to travel is during the second trimester (fourth to sixth months). Travel tips include the following:

    • By airplane: Ask for an aisle seat. This will make it easier to use the bathroom and to walk around every hour.

    • Places to avoid: You may need to avoid traveling to high altitudes, especially later in your pregnancy. Do not travel to areas where medical care is poor and water is untreated. Talk to your caregiver before you travel outside of the country.

  • Avoid toxoplasmosis: This is an infection caused by eating raw meat or being around infected cat feces. It can cause birth defects, miscarriages, and other problems. Wash your hands after you touch raw meat. Make sure any meat is well-cooked before you eat it. Avoid raw eggs and unpasteurized milk. Use gloves or ask someone else to clean your cat's litter box while you are pregnant.

When should I contact my caregiver? Contact your caregiver if:

  • You have chills or a fever.

  • You have vaginal itching, burning, or pain.

  • You have watery fluid leaking from your vagina.

  • You have yellow, green, curdy white, or foul-smelling vaginal discharge.

  • You have frequent headaches or headaches that will not go away.

  • You have pain or burning when you urinate, less urine than usual, or pink or bloody urine.

  • You are having frequent regular contractions.

  • You have questions or concerns about your condition or care.

When should I seek immediate care? Seek care immediately or call 911 if:

  • You have chest pain.

  • You have sharp lower back pain.

  • You have sudden swelling in your face, fingers, arms, ankles, or feet.

  • You have dizziness, fainting, or blurred or dim vision.

  • You are more than 20 weeks pregnant and you have any trauma, even if you are not hurt.

  • You feel part of the baby or the umbilical cord in your vagina.

  • You have vaginal bleeding.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.


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