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Positions for labor and childbirth

Once you're in labor, experiment to find what's most comfortable for you. Listen to your body to discover what feels good. One tip Give each new position a chance. The first few contractions may be stronger until you get used to a new position. Lying flat on your back isn't recommended for labor or childbirth. It can cause the weight of your uterus to compress major blood vessels and decrease blood flow to your uterus. Some of the positions for labor and...

Appointments with your health care provider

You've taken a home pregnancy test, and it says you're pregnant. Now's the time to set up your first appointment with the person you've chosen as your obstetrical health care provider. Whether you've chosen a family physician, obstetrician-gynecologist or nurse-midwife, that person will treat, educate and reassure you throughout your pregnancy. Developing a strong relationship with your health care provider starts now, at the very beginning of your pregnancy. Health care providers enjoy the...

Your needs while youre breastfeeding

If you're like most mothers, your attention will be focused intently on the needs of your baby. Although this commitment is completely reasonable, don't forget about your needs. If your baby is to thrive, he or she needs a healthy mother. Consider The specific amounts of foods, fluids and calories you need to support breast-feeding aren't universally agreed on, but you may need fewer calories than was previously thought. The best approach to nutrition while breastfeeding isn't unlike the best...

Breastfeeding

Some techniques may be helpful when you start breast-feeding after a Caesarean birth. You may want to try the football hold, in which you hold your baby much the way a running back tucks a football under his arm. This breast-feeding position is just as effective as any other, but it keeps your baby from putting pressure on your still-sore abdomen. To do the football hold, hold your baby at your side on your arm, with your elbow bent and your open hand firmly supporting your baby's head, near...

Working and breastfeeding

With a little planning and preparation, you can combine breast-feeding and employment. Some mothers work at home or can take their babies with them to work. Some arrange to have their babies brought to them for feedings, or they go to the babies. The mothers can continue to do most of the feedings with only occasional bottle feedings. If these aren't options for you, you may choose to have your child-care provider give your baby bottled breast milk or infant formula. For a few weeks before your...

A previous ectopic pregnancy

Your chances of having a successful pregnancy outcome are a bit lower after having had an ectopic pregnancy, but they're still good between 60 percent and 80 percent if you have both fallopian tubes. Even if one fallopian tube has been removed, you still have more than a 40 percent chance of having a successful pregnancy outcome. But your chances of having another ectopic pregnancy increase around 15 percent so your health care provider should monitor you closely the next time you conceive.

Abdomen pressure in the lower

When not accompanied by other symptoms, a feeling of pressure in the lower abdomen is probably nothing to worry about. In the first trimester, this sensation is common. Most likely, you're feeling your uterus starting to grow. You may also be feeling increased blood flow. In the second or third trimester, the pressure likely has to do with the weight of the growing uterus. In all of these cases, the bladder and rectum are compressed by the growing uterus, which provokes feelings of pressure....

Abdominal discomfort or cramping

Pain in the lower abdomen during the first and second trimesters often stems from normal pregnancy changes. As the uterus expands, the ligaments and muscles that support it stretch. This stretching may cause twinges, cramps or pulling sensations on one or both sides of your lower abdomen. You may notice the pain more when you cough, sneeze or change position. Another fairly common cause of abdominal or groin discomfort in midpregnancy is stretching of the round ligament, a cord-like muscle that...

Abdominal tenderness due to muscle separation

During pregnancy, your growing uterus stretches the muscles in your abdomen. This may cause the two large parallel bands of muscles that meet in the middle of the abdomen to separate. This separation, called diastasis, can also cause a bulge where the two muscles separate. For most women, the condition is painless. Others experience some tenderness around the bellybutton. The muscle separation can also contribute to back pain. The condition may first appear during the second trimester. It may...

Acne

Because pregnancy hormones increase oil secretion from skin glands, you may develop acne early in your pregnancy. These skin changes are temporary and will likely disappear after you give birth. Prevention and self-care for acne Most acne can be prevented or controlled with good basic skin care. Try the following techniques Wash your face as you normally would. Avoid facial scrubs, astringents and masks because they tend to irritate skin and can make acne worse. Excessive washing and scrubbing...

Alcohol use of

Don't drink alcohol during your pregnancy. No level of alcohol has been proved safe during pregnancy. Drinking alcohol during pregnancy can cause fetal alcohol syndrome, which can result in both physical and mental birth defects. If you have a drink or two before you realize you're pregnant, don't panic. It's unlikely that drinking a small amount of alcohol early in the pregnancy will do harm. However, stop drinking alcohol as soon as you suspect you're pregnant better still, quit before you...

Allergies

Many women have allergies, either seasonal or year-round, before getting pregnant. Others develop a stuffy nose during pregnancy, even if they haven't had that problem before. During pregnancy, elevated levels of estrogen appear to increase mucus production and swelling in the nose, causing congestion. In addition to a runny or stuffed nose, you may experience sneezing and itchy, watery eyes. Many of the usual remedies for these signs and symptoms should be avoided in pregnancy Antihistamines....

Amniocentesis

With amniocentesis, your doctor uses a thin needle inserted into your abdomen to take a small sample of amniotic fluid from the sac surrounding your baby. The two common types are genetic amniocentesis and maturity amniocentesis Genetic amniocentesis. It can give you and your doctor information about your baby's genetic makeup before your baby is born. Maturity amniocentesis. With this test, the fluid is analyzed to find out if the baby's lungs are mature enough to function normally at birth....

Analgesics and narcotics

These medications include butorphanol (Stadol), fentanyl (Sublimaze), meperidine (Demerol), nalbuphine (Nubain). Narcotics can be given anytime in labor, but they're favored in earlier labor when you're dilated less than 7 centimeters (cm) if you're a first-time mom or less than 5 cm if you've given birth before. The medications are injected into a muscle in your thigh or buttocks or injected into an IV catheter. In some instances, you may be able to control your dosage by pressing a button...

Assisted birth

If labor is prolonged or complications develop, you may require some assistance (medical intervention). For example, instruments such as forceps or a vacuum extractor may be needed to help you deliver if your cervix is fully dilated but your baby fails to make progress down the birth canal. An assisted delivery may also be necessary if your baby's head is facing the wrong direction and is wedged in your pelvis or if your baby is large. If your baby is in distress and must be delivered quickly...

Baby movement decreased

Most pregnant women get to know their baby's typical patterns of movement and are attuned to changes in the frequency or intensity of those movements. You may notice a slight decrease in your baby's activity in the last few days before birth. In late pregnancy, the number of fetal movements you perceive often declines gradually. The baby has less room to move around in the uterus, especially after his or her head drops into the pelvis. Although a baby who isn't very active in the womb may be...

Babys hiccups

Starting about midway through your pregnancy, you may occasionally notice a slight twitching or little spasms in your abdomen. Your baby probably has the hiccups. Fetal hiccups develop as early as the 15th week of gestation, even before breathing movements become common. Some fetuses get hiccups several times a day, and others never get them. After they're born, most babies have frequent bouts of hiccups. They're common after a feeding, particularly after burping. No one knows why they occur in...

Backaches and back pain

Pregnant women are prone to backaches and back pain for a number of reasons. During pregnancy, the joints and ligaments in your pelvic region begin to soften and loosen in preparation for the baby to pass through your pelvis. As your uterus grows, your abdominal organs shift, and your body weight is redistributed, changing your center of gravity. Gradually you begin to adjust your posture and the ways you move. These compensations can lead to backaches and back pain. (See also Abdominal...

Being intimate with your partner

If you're like many women, you may be more interested in sex now than you were earlier in your pregnancy. You may even be more interested in sex now than you were before you became pregnant. Enjoy this feeling while it lasts and before your baby arrives to put a significant crimp in your style. This heightened sexuality is by no means universal, and it's possible you may not feel it at all. As you enter the final months of pregnancy, you may find your desire waning again or waning even further.

Birth control pills safety of after conception

It rarely happens, but birth control pills can fail. If you get pregnant while you're taking birth control pills, stop taking them immediately. The hormones in the pills should be avoided during pregnancy. The risk is low, but there is a potential for harm. If you're planning to become pregnant, most health care providers recommend that you stop taking the pill two to three months before conception. For birth control during this time, you may want to use condoms or a diaphragm. Conceiving...

Bleeding gums

Like the rest of your body, your gums are receiving more blood flow during pregnancy. This can cause your gums to swell or become softer. As a result, they may bleed a little when you brush your teeth. Prevention and self-care for bleeding gums Don't neglect your dental care during pregnancy. Brushing, flossing and regular dental exams and cleaning are important. Make sure you're getting enough vitamin C from foods or your vitamin supplement because this vitamin helps keep your tissues strong....

Bloody show

During pregnancy, the opening to your uterus (cervix) is blocked by a thick plug of mucus. This plug forms a barrier between your cervix and vagina so that bacteria can't enter your uterus and cause an infection. A few weeks, days or hours before labor begins, this plug is sometimes discharged, and you may have what health care providers call bloody show. You may notice a small amount of blood-tinged, brownish mucus leaking from your vagina. Some women don't notice the loss of this plug. Bloody...

Blue lines or veins under skin

Veins throughout your body become larger during pregnancy to accommodate increased blood flow to the baby. These enlarged blood vessels show up as fine bluish, reddish or purplish lines under the skin, most often on the legs and ankles. Blood vessels in the skin over your breasts also become more visible and appear as blue or pink lines. These lines usually disappear after pregnancy. About one in five pregnant women develops varicose veins protruding, swollen veins, particularly in the legs....

Blurred vision

Changes in your eyes during pregnancy can cause slightly blurred vision. Because your body retains extra fluid, the outer layer of your eye (cornea) becomes about 3 percent thicker. This change may become apparent by the 10th week of pregnancy and persists until about six weeks after the baby is born. In addition, the pressure of fluid within your eyeball (intraocular pressure) decreases during pregnancy. In combination, these changes can in rare cases cause blurred vision. If you wear contact...

Bonding with your baby

As soon as babies are born, they need and want you to hold, stroke, cuddle, touch, kiss and talk and sing to them. These everyday expressions of love and affection promote bonding and recognition. They also help your baby's brain develop. Just as an infant's body needs food to grow, his or her brain needs positive emotional, physical and intellectual experiences. Relationships with other people early in life have a vital influence on a child's development. Some parents feel an immediate...

Braxton Hicks contractions

Throughout your second and third trimesters of pregnancy, you may experience occasional, painless contractions a sensation that your uterus is tightening and relaxing. They're especially noticeable when you place your hand on your abdomen. These are called Braxton-Hicks contractions, and they're your body's way of warming up for labor. Your uterus is exercising its muscle mass to build strength for the big job ahead labor and the birth of your child. As you approach your due date, these...

Breast discharge

In the final weeks of pregnancy, you may notice a thin, yellowish or clear substance leaking from one or both nipples. This discharge is colostrum, the yellowish fluid produced by your breasts until your milk comes in. Colostrum can range in color and consistency, but such variations are normal. It may be sticky and yellow at first and become more watery as you approach your due date. The older you are and the more pregnancies you've had, the more likely it is you'll have some breast discharge....

Breast enlargement

One of the first signs of pregnancy is an increase in breast size. As early as two weeks after conception, your breasts start to grow and change in preparation for producing milk. Stimulated by estrogen and progesterone, the milk-producing glands inside your breasts get bigger, and fatty tissue increases slightly. By the end of your first trimester, your breasts and nipples will be noticeably larger, and they may keep growing throughout your pregnancy. Breast enlargement accounts for at least a...

Breast tenderness

Often the first hint of pregnancy is a change in the way your breasts feel. By a few weeks of gestation, you may notice tingling sensations in your breasts, and they may feel heavy, tender and sore. Your nipples may be more sensitive. As with breast enlargement, the primary reason for these changes is increased production of the hormones estrogen and progesterone. Breast tenderness normally disappears after the first trimester. Self-care for breast tenderness A good support bra that fits well...

Breath shortness of

Having trouble catching your breath Many pregnant women experience mild breathlessness beginning in the second trimester. This is because your expanding uterus pushes up against your diaphragm the broad, flat muscle that lies under your lungs. The diaphragm rises about 1 2 inches from its usual position during pregnancy. That may seem like a small amount, but it's enough to crowd your lungs and alter your lung capacity the amount of air your lungs are able to take in. At the same time, your...

Car travel

Avoid staying in a sitting position for more than two hours at a time. Limit total car time to six hours a day, if possible. Walking around for a few minutes every couple of hours will keep blood from pooling in your legs. This activity will reduce the risk of a blood clot forming. Wear your seat belt. Now more than ever, it's important to wear your seat belt. Trauma to the mother-to-be is the leading cause of fetal death, and vehicular accidents are to blame for...

Carpal tunnel syndrome

2nd, 3rd trimesters Carpal tunnel syndrome is most often caused by repetitive movements of the hand and wrist, such as typing. You may be surprised to learn that it's also common in pregnant women. That's because hormonal changes, swelling and weight gain can compress the nerve beneath the carpal tunnel ligament in your wrist. Symptoms of carpal tunnel syndrome include numbness, tingling, weakness, pain or a burning sensation in the hands. In pregnant women carpal tunnel syndrome often occurs...

Changing positions

Moving about freely during labor allows you to find the most comfortable positions. So, if possible, change positions frequently, experimenting to find the ones most comfortable for you. Changing positions during labor is actually a natural method of pain relief. Moving helps improve your circulation. It can also help distract you from the pain. It may even help a slow labor progress. Try a new position whenever you feel like it, and if it's possible, throughout your labor. For example, you may...

Chickenpox and shingles

Most pregnant women are immune to the viral illness chickenpox (varicella) because they had it or were vaccinated as a child. Once you've had the disease, you're immune for life. So if you had chickenpox or have been vaccinated against it, there's no need for concern if you're exposed to it during pregnancy. If you haven't had chickenpox, it poses risks to you and your fetus if you get the disease while pregnant. That's why during a preconception or prenatal visit your health care provider will...

Choosing a birthing location

You have a choice about where to have your baby. This decision is often closely tied to your choice of a health care provider and where he or she has practicing privileges. Most women in the United States around 99 percent have their babies in a hospital. Others choose to give birth at a birthing center or in their own home. Today, hospitals treat childbirth less like a medical procedure and more as a natural process. Many hospitals offer a relaxed setting in which to have your baby, with...

Circumcision

If your new baby is a boy, you may decide to have another procedure performed circumcision. When a baby boy is circumcised, a doctor surgically removes the foreskin covering the tip of the penis. The procedure exposes the end of the penis. It can be performed before you bring your baby home. There are advantages and disadvantages to circumcising your baby. You can learn more about this important decision in the decision guide titled Considering circumcision for your son on page 355.

Clothing concerns

When you're buying clothes for your newborn, choose a 3-month size or larger so that the baby doesn't immediately outgrow them. In general, look for soft, comfortable clothing that's washable. Select sleepwear that's labeled flame resistant or flame retardant, which can be either a synthetic fiber or cotton treated with flame-retardant chemicals. Avoid buttons, which are easily swallowed, and ribbons or strings, which can cause choking. Don't buy garments with drawstrings, which can catch on...

Coloring your hair

Studies have not linked hair dyes to birth defects, and the chemicals in the dyes are not readily absorbed through the skin. Still, some experts advise pregnant women to err on the side of caution and avoid any possible risk by switching to a toxin-free hair dye or not getting hair colored during the first trimester. Your colored hair's appearance also may be a concern hormonal changes can cause your hair to react differently when you're pregnant, leaving you with an unexpected color.

Contractions

When you're about to go into labor, you'll notice an increase in contractions, the tightening and relaxing of the uterine muscles. During labor, the uterus repeatedly contracts, causing the cervix to thin (efface) and open up (dilate) so that you can push your baby out. The contractions gradually dilate the cervix until it's wide enough for the baby to pass through. During the early phase of labor, contractions can vary greatly from one woman to another. They might last 15 to 30 seconds at the...

Cramping or continuous pain

Abdominal cramping or pain and back pain often go along with the normal processes of pregnancy (see also Abdominal discomfort or cramping Backaches and back pain Pelvic pressure). However, in early pregnancy, cramping and back pain accompanied by bleeding may be signs and symptoms of miscarriage or an ectopic pregnancy. In midpregnancy and beyond, cramping and constant back pain could be warning signs of preterm labor. Sudden, constant, severe abdominal pain can be an indication of placental...

Dealing with lochia

With the birth of your baby, your hormone levels have shifted. These shifts cause a vaginal discharge called lochia a brownish to clear discharge that lasts for several weeks. Some women who've had Caesarean births are surprised at the amount of vaginal discharge they have after surgery. Even though the placenta is removed at the operation, the uterus still needs to heal and this discharge is part of the process. During your hospital stay, you'll use sanitary pads to absorb your lochia.

Dehydration after stomach flu

If you've had a stomach flu (gastroenteritis), you've probably lost a lot of fluids as you endured the misery of diarrhea and vomiting. Dehydration is the most common complication of gastroenteritis. Signs and symptoms of dehydration include Dark yellow urine or infrequent or no urination Severe weakness, dizziness or lightheadedness After a bout with gastrointestinal illness, it's essential that you take in enough fluids to replace those lost from diarrhea and vomiting. Although...

Diaper changing

To parents of young babies, life often seems to be an endless round of changing diapers. Indeed, the average child goes through 5,000 diaper changes before being toilet trained. That statistic is daunting, but it may help to think of this necessary task as an opportunity for closeness and communication with your baby. Your warm words, gentle touches and encouraging smiles help make your baby feel loved and secure, and soon your infant will be responding with gurgles and coos. Because newborns...

Difficulty learning to eat

Whether you choose to breast-feed or bottle-feed, for the first few days after your baby's birth, you may find it difficult to interest your newborn in eating. This isn't uncommon. Some babies just seem to adopt a slow-and-sleepy approach to eating. If you're concerned that your baby isn't getting enough nourishment, talk to your baby's nurse or doctor. Occasionally, pokey eaters require tube feedings to help them along for a few days. Soon they'll catch on and breast-feed or bottle-feed with...

Eating and drinking

You'll probably be allowed to have only ice chips or sips of water for the first 12 to 24 hours after your surgery. You'll receive fluids intravenously in order to prevent dehydration. Once your digestive system starts to come back on line, you'll be able to drink more fluids and probably eat some easily digested food. You'll know you're ready to start eating if you begin to pass gas. It's a sign that your digestive system is waking up and starting to again function the way it should. You...

Eating and sleeping

Two important items on a newborn's agenda are eating and sleeping. Because most of a baby's energy goes into growing, many nonsleeping hours are spent eating. During the first several weeks, most babies will be hungry six to 10 times during a 24-hour period. Their stomachs don't hold enough breast milk or formula to satisfy them for long. That means you could be feeding your baby every two or three hours, including during the night. But there's tremendous variation among infants in how often...

Emergency methods of birth control

If you had unprotected sex or a method of birth control failed during vaginal intercourse, you can use an emergency form of contraception to prevent pregnancy. Two types of pills are dedicated to emergency contraception Preven, which contains a combination of estrogen and progestin, and Plan B, which contains progestin only. An IUD also may be used as an emergency contraceptive. These emergency contraceptives prevent pregnancy by preventing ovulation, by preventing the egg from being fertilized...

Emotional and lifestyle changes

The physical changes and complaints of the postpartum period are only part of life after having a baby and, some women would say, the easy part. As you and your partner get to know your baby and begin to bond as a family, your feelings will probably be more intense and fluctuating than you expected, and the stresses may be more overwhelming than anticipated. Caring for a new baby is a demanding and exhausting job that can turn your life upside down. During the postpartum weeks, most women are...

Enjoying pregnancy

This month marks the end of the second trimester of pregnancy. Things will undoubtedly be exciting during the last three months until your baby arrives, but they'll also likely be a bit stressful. You'll be busy buying final supplies, finishing your baby's room, attending childbirth classes and making more frequent visits to your health care provider. Plus, the last three months of pregnancy will bring new physical demands on your body. Make an effort to really enjoy this month of your...

Expressing breast milk

You may want to remove (express) your breast milk for feeding your baby by bottle when you're unable to breast-feed. You can express your milk either with a breast pump or by hand. To help with let-down, find a quiet place to express. Relax for a few minutes before starting to express. Most breast-feeding mothers find using a breast pump is easier than expressing milk manually. There are many pumps to choose from hand, battery-operated or electric ones. The type of pump you select will depend...

Faintness and dizziness

Feeling a little faint It's common for pregnant women to experience light-headedness, faintness or dizziness. These sensations can result from circulatory changes during pregnancy, such as decreased blood flow to your upper body because of the pressure of your uterus on the blood vessels in your back and pelvis. You're particularly susceptible to this early in the second trimester, when your blood vessels have dilated in response to pregnancy hormones but your blood volume hasn't yet expanded...

Feeling your baby move

By your 20th week of pregnancy or earlier if this is at least your second pregnancy you've probably begun to feel your baby move. These early movements are called quickening, and they're a great source of amusement and reassurance for most women. These early movements remind you of the reality that your baby is a separate, unique individual, allowing you to begin imagining what your baby will be like. They're also a much more pleasant and exciting reminder of being pregnant than are nausea and...

First bowel movements

Your baby's first soiled diaper which will probably occur within 48 hours may surprise you. During these first few days, your newborn's stools will be thick and sticky a tar-like greenish black substance called meconium. After the meconium is passed, the color, frequency and consistency of your baby's stools will vary depending on how your baby is fed. In babies who breast-feed, stools will be more frequent, generally soft, watery and golden yellow. In bottle-fed babies, stools will be less...

Fontanelles

When you feel the top of your baby's head, you'll notice two soft areas. These soft spots, called fontanelles, are where your baby's skull bones haven't grown together yet. The fontanelle toward the front of the scalp is a diamond-shaped spot roughly the size of a quarter. Though it's usually flat, it may bulge when your baby cries or strains. By nine to 18 months, this fontanelle will be filled in with hard bone. The smaller, less noticeable fontanelle at the back of the head is the size of a...

Gas and bloating

Gas, bloating, flatulence more fun aspects of being pregnant Under the influence of pregnancy hormones, your digestive system slows down. Food moves more slowly through your gastrointestinal tract. This slowdown serves an important purpose It allows nutrients more time to be absorbed into your bloodstream and to reach the fetus. Unfortunately, it can also cause bloating and gas. The problem may be aggravated during the first trimester, when many women have a tendency to swallow air in response...

Guided imagery

Guided imagery is a drug-free method of pain relief that helps laboring mothers create an environment with a feeling of relaxation and well-being. Sometimes called daydreaming with a purpose, this method can be used anytime during your labor to help you relax. It involves imagining yourself in a comfortable and peaceful place. For example, you may picture yourself sitting on a warm, sandy beach or walking through a lush, green forest. Your chosen place can be real or imaginary. As you relax,...

Gum disease

An old saying has it that a woman loses one tooth with every pregnancy. While that's clearly a tale from the days before professional dental care, you are more susceptible to dental problems when you're pregnant. The oral changes of pregnancy are linked to an increased amount of plaque, the sticky, colorless film of bacteria that coats your teeth. Hormonal changes also make your gums more susceptible to the damaging effects of plaque. If plaque hardens, it turns into tartar. When plaque and...

Hair and lanugo

Your baby may be born bald, with a full head of thick hair or almost anything in between Don't fall in love with your baby's locks too quickly. The hair color your baby is born with isn't necessarily what he or she will have six months down the road. Blond newborns, for example, may become lighter or darker blond as they get older, and sometimes a reddish tinge isn't apparent at birth. You may be surprised to see that your newborn's head isn't the only place he or she has hair. Downy, fine hair...

Having an ultrasound

If you have an ultrasound exam this month, you're in for an extraordinary experience. Ultrasound allows you to see your baby's shape and form, including the tiny heart beating in the tiny chest. Most of the time, babies are completely healthy, and an ultrasound exam is an exciting and rewarding experience. For many moms-to-be, it's as thrilling as first feeling the baby move. Ultrasound also provides fathers with a more direct means of experiencing pregnancy. Invite your partner to accompany...

Health care provider

While you're shopping for cribs, baby blankets and booties, don't forget to shop around for one other essential item your baby's health care provider. It's a good idea to choose your baby's health care provider before your child is born. Often, the provider you choose will come to the hospital to check on your baby. With the provider in place, you'll know in advance where and when to bring your baby in for his or her first checkup. You'll have someone you can call with any questions regarding...

Heart rate fast heartbeat or rapid pulse

Throughout pregnancy your heart pumps more blood, faster, than it does normally. This helps meet the fetus's needs for oxygen and nutrients, which are carried in the blood through the placenta. As the heart pumps 30 percent to 50 percent more blood, your heart rate speeds up as well. Your heart beats progressively faster throughout pregnancy. By the third trimester, your heart rate may be 20 percent faster than it was before you were pregnant. Medical care for fast heart rate Because of...

Holding and carrying your baby

At first you may feel a little awkward or nervous about holding and carrying your baby. But over time you'll feel more and more comfortable. And you'll soon learn what positions the baby likes all babies have their Tilt the rear-facing car safety seat back so it's reclined at the angle specified in the manufacturer's instructions, usually 45 degrees. Check to see that the harness is tight enough. You shouldn't be able to fit more than one finger width between the torso harness and the baby....

In the recovery room

Immediately after surgery, you'll be taken to a recovery room. There, your vital signs can be monitored frequently, about every 15 minutes, until the anesthesia has worn off and your condition is stable. This generally takes an hour or two, but it can take longer if you've had general anesthesia. During your time in the recovery room, you and your partner may have a few minutes alone with your baby so that you can start to get acquainted. If you've chosen to breast-feed your baby, you may be...

Initial health care for the newborn

From the moment your newborn emerges from the birth canal, he or she is the focus of much activity. Once your baby has been delivered, your health care provider or a nurse likely will quickly clean his or her face. To make sure your baby can breathe properly, the nose and mouth are cleared of fluid as soon as the head appears and again immediately after birth. While the baby's airway is being cleared, the heart rate and circulation can be checked with a stethoscope or by feeling the pulse in...

Intrauterine devices

An intrauterine device (IUD) is a small, T-shaped object that's placed inside your uterus. It prevents sperm from reaching the egg and may hinder implantation. Two types are currently available the Copper T IUD, which can stay in place for up to 10 years, and the intrauterine system (Mirena), which can stay in your uterus for up to five years. Procedure performed by your health care provider Your health care provider inserts the IUD through your cervix into your uterus. Many health care...

Introducing a bottle to a breastfed baby

During the first several weeks of your child's life, it's best to nurse exclusively to help you and your baby learn how to breast-feed and to be sure your milk supply is being established. Once your milk supply is established and you feel confident that you and your baby are doing well with breastfeeding, you may give your baby an occasional bottle of breast milk. This allows others, such as your partner or a grandparent, an opportunity to feed the baby. If your baby receives a bottle of milk,...

Is it time to go to the hospital

The decision about when to go to the hospital can be a tricky one. You may have read that you should wait until your contractions are three to five minutes apart for at least one hour. A friend may have told you that you should go to the hospital when you can no longer walk or talk through your contractions. Still another person may have told you to wait until the pain moves from low down in the front of your abdomen to higher up, above your navel. Your partner may want you to ignore all this...

Issues to consider

It's up to you to decide if you want to pursue genetic carrier screening. Consider these questions as you make that decision Is there a family history of any certain condition Are you in a racial or ethnic group that puts you at higher risk of being a carrier for a certain condition How often does the condition occur in the higher-risk population How severe is the condition likely to be Will you use the information if you find that you and your partner are carriers of the same genetic condition...

Kegel exercises Why do them

The muscles in your pelvic floor help support your uterus, bladder and bowel. Toning them by doing Kegel exercises will help ease your discomfort during the last months of your pregnancy and may help minimize two common problems that can begin during pregnancy and continue afterward leakage of urine and hemorrhoids. In fact, a recent study found that strengthening your pelvic floor muscles during pregnancy appears to reduce your risk of developing urinary incontinence, both during and after...

Leg cramps

2nd, 3rd trimesters Cramps in the lower leg muscles are fairly common in the second and third trimesters. They most frequently occur at night and may disrupt your sleep. Although the exact cause of leg cramps is unknown, slow blood return, fatigue or pressure from the uterus on nerves in your legs may cause the problem. Prevention and self-care for leg cramps Here are some tips for relieving the discomfort of leg cramps or calf tenderness Stretch the affected muscle. Try straightening your...

Mask of pregnancy

More than half of all pregnant women develop mild skin darkening on the face. Commonly called the mask of pregnancy, this brownish coloration is also known as chloasma or melasma. It can affect any woman who's pregnant, though women who are dark-haired and fair-skinned are more susceptible. Melasma usually appears on sun-exposed areas of the face, such as the forehead, temples, cheeks, chin, nose and upper lip. It tends to be matching on both sides of the face (symmetrical). Melasma is often...

Medications

When pregnant, you're still susceptible to all the usual illnesses that the general population faces. And pregnancy itself can give rise to health conditions that require treatment. But many women have concerns about using medications during pregnancy. Should you avoid all medications Which medications are safe What if you're already taking a drug to treat an ongoing health condition Should you stay on it As a general rule, it's best to use caution and avoid use of medications during pregnancy....

Meditation

A type of meditation that involves focusing on a calming object, image or word can help relax you during labor and reduce the amount of pain you experience. Focus on a single point. This can be something in the room, such as a picture you have brought along, or it can be a mental image or a word you repeat to yourself over and over. When distracting thoughts come into your consciousness, allow them to pass by, without dwelling on them, and bring your focus back to your chosen focal point.

Mood swings

Adjusting to being pregnant and preparing for new responsibilities may leave you feeling up one day and down the next. Your emotions may range from exhilaration to exhaustion, delight to depression. Your moods can also change considerably over the course of a single day. Some of these mood swings may result from the physical stresses your growing baby is placing on your body. Some may be the result of fatigue, pure and simple. Mood changes may also be caused by the release of certain hormones...

Morning sickness

Morning sickness is one of the classic signs of early pregnancy. The majority of expectant mothers up to 70 percent experience nausea and vomiting. Although these signs and symptoms are commonly known as morning sickness, the name is misleading because nausea and vomiting can occur at any time of the day. The signs and symptoms typically first start at four to eight weeks of gestation and subside by 13 to 14 weeks. But some women have nausea and vomiting beyond the first trimester. Morning...

Nausea throughout the day

What if you don't just have morning sickness you also have afternoon, evening and night sickness Because the nausea and vomiting of pregnancy are commonly referred to as morning sickness, you may wonder if there's something wrong if you're experiencing these symptoms throughout the day. In fact, morning sickness is a misnomer because nausea can occur any time of day. In one study of 160 pregnant women, less than 2 percent had nausea only in the mornings. For most women, nausea lasted throughout...

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Perming your hair

Many women wonder if it's safe to perm, dye or use other chemical treatments on their hair when they're expecting. To date, there are no definitive answers. Studies using animals haven't identified any specific risks of birth defects or other problems. But only a few studies in humans have examined the effects of hair care chemicals or treatments on the developing fetus. Given the lack of human studies, some health care providers advise women to put off having a perm until after the first...

The facts on breastfeeding

The longer you breast-feed, the greater these benefits are to you and your baby and, in many cases, the longer they last. Ideal nutrition. Breast milk has just the right nutrients, in just the right amounts, to nourish your baby completely. It contains the fats, proteins, carbohydrates, vitamins and minerals that a baby needs for growth, digestion and brain development. Breast milk is also individualized the composition of your breast milk changes as your...

The basics of breastfeeding

Under normal circumstances, the mother's body is able to produce all the food her newborn needs. How does it work Early in your pregnancy, your milk-producing (mammary) glands prepare for nursing. By about your sixth month of pregnancy, your breasts are ready to produce milk. In some women, tiny droplets of yellowish fluid appear on the nipples at this time. This fluid is called colostrum. It's the protein-rich fluid that a breast-fed baby gets the first few...

The facts on bottlefeeding with formula

If you can't breast-feed or choose not to, you can be assured that your baby's need for nutrition can be met. A wide variety of baby (infant) formulas are on the market. The majority of them are based on cow's milk. Never use regular cow's milk as a substitute for formula. Although cow's milk is used as the foundation for formula, the milk has been changed dramatically to make it safe for babies. It's treated by heat to make the protein in it more digestible. More milk sugar (lactose) is added...

Positioning baby and bottle

The first step to bottle-feeding is to make you and your baby comfortable. Find a quiet place where you and your baby won't be distracted. Cradle your baby in one arm, hold the bottle with the other and settle into a comfortable chair, preferably one with broad, low armrests. You may want to put a pillow on your lap under the baby for support. Pull your baby in toward you snugly but not too tightly, cradled in your arm with his or her head raised slightly and resting in the bend of your elbow....

Positive affirmation

Remaining positive is important during the trials of labor and delivery. You may find it helpful and comforting to say positive, encouraging things to yourself, out loud or silently, as a means of coping with pain. You can also ask your labor coach, doula or partner to say them to you. I'm in rhythm with my body. I'm strong, and I can push my baby out. I have the energy I need to get my baby out.

Possible postCaesarean complications

In general, report these signs and symptoms to your health care provider if they occur once you're home from the hospital Fever of 100.4 F or greater Vaginal discharge (lochia) heavier than a normal period Pulling apart at your incision Redness or oozing at the incision site For more on these and other postpartum complications, see page 579.

Preparing formula

Whatever type and form of formula you choose, proper preparation and refrigeration are essential, both to ensure the appropriate amount of nutrition and to safeguard the health of your baby. Newborns have few defenses against germs. It takes a while for your baby to build up immunity especially if he or she isn't getting breast milk, which contains antibodies. Formula doesn't have them. That's why it's important to minimize the danger of bacteria contaminating your baby's formula by preparing...

Preparing to breastfeed

Before you bring your baby to your breast, find a quiet location. Have a drink of water, milk or juice at hand for yourself because it's common to feel thirsty when your milk lets down. Put the phone nearby or turn it off. Place a book, magazine or the TV remote control within reach, if you wish. Next, get into a position to nurse that's comfortable for you and your baby. Whether in your hospital bed or a chair, sit up straight. Put a pillow behind the small of your back for support. If you opt...

Pubic bone pain

Some pregnant women are troubled by pain in the pubic bone. The sensation may be mild or sharp and feel like an ache or a bruise. The pain is caused by softening and loosening of your tissues and joints. As the cartilage that connects the two pubic bones in the center of your pelvis softens, your pubic bone may feel very sore when you're moving or walking. Some pregnant women feel this more than others, and some have it only later in their pregnancy. Pubic bone pain should disappear within a...

Pudendal block

These medications include chloroprocaine, lidocaine and other caine drugs. A pudendal block may be given shortly before delivery. This medication is injected into the wall of your vagina at a specific location marked by a bony landmark in your pelvis. Just as a dentist can block pain from a group of your teeth by giving an injection at a specific location, your health care provider can use an injection to block pain in the area between your vagina and anus (perineum). It provides numbness that...

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An anesthetic that numbs a segment of the body. relaxin. A hormone produced by the placenta that softens connective tissues, which allows your pelvis to open wider during childbirth. respiratory distress syndrome (RDS). Difficulty in breathing, caused by lack of surfactant in premature babies. retained placenta. Failure of the placenta to be delivered within 30 minutes after birth can cause excessive bleeding. Rh immunoglobulin (RhIg). A drug used in Rh-negative women to...

Reasons for a previous Caesarean birth

The causes behind your first Caesarean birth tend to have an influence over a trial of labor afterward If your first Caesarean was performed for a reason that may not necessarily recur, your chance of having a successful vaginal delivery is the same as that of a woman who has never had a Caesarean birth. Examples include an infection, pregnancy-induced high blood pressure (preeclampsia), placental problems and fetal distress. If you've had at least one vaginal delivery either before or after...

Recovery from Caesarean birth

After a couple of hours in the recovery room, you'll be moved to a room in the maternity unit of the hospital. Over the next 24 hours, your doctor and nurses can continue to monitor your breathing rate, heart rate, temperature and blood pressure. They'll also monitor the condition of your abdominal dressing, the amount of urine you're producing and the amount of post-pregnancy bleeding (lochia) you're experiencing. Your nurses will also periodically check your uterus, making sure that it's...

Red palms and soles

Two-thirds of pregnant women find that their palms and the soles of their feet become red. This skin change is more common in white women than in black women. The redness can appear as early as the first trimester and is the result of increased blood flow to the hands and feet. In addition to being red, these areas may itch. Like most skin changes of pregnancy, the redness fades after delivery. Self-care for red palms and soles If your hands and feet itch, moisturizing creams may help. When to...

Relieving pain

You may not like the idea of taking pain-relieving drugs after surgery, especially if you plan to breast-feed. But it's important to be medicated for pain when the anesthesia wears off so that you can stay comfortable. Also, to be successful with breast-feeding, it's important to be comfortable. Comfort is especially crucial during the first several days of your recovery, when your incision is beginning to heal. In the period immediately after your Caesarean birth, you'll likely receive...

Round ligament pain

Stretching of the round ligament can cause pain in the abdomen, pelvis or groin during the second and third trimesters. One of several ligaments that hold your uterus in place within your abdomen, the round ligament is a cord-like structure that's less than a quarter of an inch thick before pregnancy. At that time, your uterus is about the size of a pear. As the uterus grows in size and weight, the ligaments supporting it become longer, thicker and more taut, stretching and tensing like rubber...

Screening tests

Before your baby leaves the hospital, a small amount of his or her blood is taken and sent to the state health department. This sample, which may be taken from a vein in your baby's arm or a tiny cut made on the heel, is analyzed to detect the presence of rare but important medical conditions. Results should be available by your baby's first office exam. Occasionally, a baby needs to have the test repeated. Don't be alarmed if this happens to your newborn. To ensure that every newborn with any...

Selfcare for postpartum depression

If you're diagnosed with postpartum depression, start your recovery by seeking professional care. In addition, you can aid in your recovery. Try these tips Get as much rest as possible. Make a habit of resting while your baby sleeps. Eat properly. Emphasize grains, fruits and vegetables. Engage in moderate exercise. Stay connected with family and friends. Ask for occasional help with child care and household responsibilities from friends and family. Take some time for yourself. Get dressed,...

Shower or bath

Many hospitals and birthing centers have showers in their labor rooms. Some even have bathtubs or whirlpool baths to help ease the discomforts of labor, particularly those of active labor when your contractions are intensifying. The soothing, warm water helps relieve pain naturally by blocking pain impulses to your brain. Warm water is also relaxing. This is a method of pain relief you can try at home, too, before heading to the hospital or birthing center. If you use a shower, you can sit in a...

Skin blemishes and bruises

Most babies are born with some blotchiness, bruising and skin blemishes. A rounded swelling of the scalp (caput succedaneum) is usually seen on the top and back of the baby's head when a baby is born the usual way headfirst. Caput succedaneum is simply puffiness of the skin that disappears within a day or so. Pressure from your pelvis during labor can cause a bruise (cephalo-hematoma) on your baby's head. A cephalhematoma will be noticeable for several weeks, and you might feel a bump that...

Skin changes

Pregnancy hormones can spur several changes in your skin. For some lucky women, the main change is the famous healthy glow, which happens as a result of increased circulation in the tiny blood vessels just beneath the surface of your skin. But many women notice a variety of other, less desirable skin changes. Skin darkening. This is one of the most common skin changes, occurring in 90 percent of all pregnant women. The darkening can affect your cheeks, chin, nose, forehead, navel, armpits,...