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National Domestic Violence Hotline, 8 National Nurse Practitioner Directory, 360 Center, 369 natural childbirth, 155-156, 177, 326, 332-342 natural family planning, 395-397 nausea, 472 469-471 multiple gestations and, 91 as sign of labor, 165 smells and, 487-488 neonatal intensive care unit (NICU), 219, 220 folic acid and, 11-12, 49 prenatal testing for, 291, 292, 300-301 ultrasound diagnosis of, 295 newborns, 207-224 Apgar scores of, 212 appearance of, 208-211 bathing of, 247 bonding with,...

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...

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...

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....

Anticipation

Anticipation is a normal part of making the transition to parenthood. It's a time for collecting information about how to be a good mother. It begins early in pregnancy. It has its foundations in the parenting you received as a child and your observations of other families you've encountered. The memories of how you were raised, along with your personal ideals of parenting, serve as a bank of images you can draw from as you think about what your own parenting style will be. During this time of...

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...

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.

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...

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...

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...

Colds

Most women catch a cold at least once during pregnancy. Although the signs and symptoms can make you miserable, even a bad cold isn't a hazard to your baby. Colds tend to last longer during pregnancy because of changes in your immune system. Prevention and self-care for colds To keep from catching a cold, the best strategy is to eat well, get plenty of rest, exercise regularly and avoid close contact with anyone who has the sniffles or a sore throat. If you're around family members or...

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...

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.

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...

Dreams vivid

You're being grabbed around the middle by a gorilla flying over tall buildings talking to your newborn, who is talking back Vivid dreams and nightmares are common during pregnancy. Dreams may be the mind's way of processing unconscious information. During this time of emotional and physical changes, your dreams may seem more intense and strange. You may find that you're dreaming more frequently or remembering your dreams more clearly when you wake up. Indeed, if you're regularly waking up...

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...

Eye changes

Some of the changes your body undergoes during pregnancy can affect your eyes and your vision. During pregnancy, the outer layer (cornea) of the eyes becomes a little thicker, and the pressure of fluid within your eyeballs (intraocular pressure) decreases by about 10 percent. These changes occasionally result in slightly blurred vision (see also Blurred vision). In addition to blurred vision, you may experience other changes related to your eyes Vision (refractive) changes. Changes in hormone...

Feet enlarged

If you like shopping for shoes, you'll appreciate this aspect of pregnancy. Your feet may be spreading, changing your shoe size. Hormonal changes that relax the ligaments and joints in your pelvis in preparation for delivery also relax all the other ligaments and joints in your body, including those in your feet. While these changes are normal and necessary, they can make the arch ligament of the foot (the plantar fascia) stretch under your body's extra weight. As a result, the arch may lose...

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...

Food cravings

You may not have had the classic pickles-and-ice-cream craving. But chances are you've had a strong desire for certain types of food during your pregnancy. Most expectant mothers do experience food cravings, which are likely caused by pregnancy hormones. You may wonder if a food craving is a signal from your body that you need the nutrients in that food. But such body signals are unreliable. A craving for ice cream doesn't mean your body needs the saturated fat. And even if you're not in the...

Getting started

The bottles for feeding your baby can be glass, plastic or plastic with a soft plastic liner. When your baby is old enough to hold a bottle, you may want to use plastic bottles for safety reasons. Some bottles are shaped to better fit a baby's hands. Bottles generally come in two sizes 4 ounces and 8 ounces. The amount the bottle holds isn't an indication of how much your baby needs to drink in a feeding. Your baby may need less or more for any given feeding. Many types of nipples are on the...

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...

HCG tests

Human chorionic gonadotropin (HCG) is a protein hormone produced in the placenta of a pregnant woman. The test to determine whether you're pregnant detects the presence of HCG in your urine or blood. During the early weeks of pregnancy, HCG is important in the corpus luteum, which is the mass of cells that remains in the ovary after the egg's release from a mature follicle (the sac where the egg develops in your ovary). In a normal pregnancy, production of HCG increases steadily, doubling about...

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...

Heartburn

More than half of all pregnant women get heartburn and for many, it's their first experience with it. Heartburn, also called gastroesophageal reflux disease (GERD), actually has nothing to do with your heart. It's caused by the backward flow of stomach contents passing up into the esophagus, the tube that carries food from your mouth to your stomach. When this happens, stomach acids irritate the lining of the esophagus. The resulting burning sensation at about the level of the heart gives the...

Hip pain

It's not uncommon to feel some soreness or pain in your hips during pregnancy, especially when you're sleeping on your side at night. In preparation for the birth of your baby, the connective tissues in your body soften and loosen up. The ligaments in your hips stretch, and the joints between the pelvic bones relax. The greater flexibility makes it easier for the baby to pass through the pelvis at birth. In late pregnancy, your heavier uterus might contribute to changes in your posture, adding...

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...

Infection

A newborn's immune system isn't adequately developed to fight infection. Therefore, any type of infection can be more critical for newborns than for older children or adults. Serious bacterial infections, which occur in about two or three of 1,000 newborns, can invade any organ or the blood, urine or spinal fluid. Prompt treatment with antibiotics is necessary, but even with early diagnosis and treatment, a newborn infection can be life-threatening. For this reason, doctors are cautious when...

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...

Insomnia

You go to bed exhausted, sure you'll nod off the minute your head hits the pillow. Instead you find yourself wide awake, watching the minutes tick by. Or you wake up at four in the morning, unable to fall back asleep. Insomnia a condition in which you have problems falling asleep or staying asleep is very common during pregnancy. Considering all the changes you're going through, both physically and emotionally, it's not surprising that your sleep is affected. Although many women sleep more...

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

Before undergoing prenatal testing, think about what it can do for you. Many women choose to undergo basic ultrasounds and blood tests. But not all do. Most women don't undergo the more detailed diagnostic tests because most pregnancies don't carry a high risk of complications. Before scheduling a prenatal test, you and your partner may wish to consider these questions What will you do with the information once you have it How will it affect decisions regarding your pregnancy Most results from...

Jaundice

More than half of all newborn babies develop jaundice, a yellow tinge to the skin and eyes. Most affected babies show signs a few days after birth. Jaundice usually lasts several weeks. A baby has jaundice when bilirubin, which is produced by the breakdown of red blood cells, builds up faster than his or her liver can break it down and pass it from the body. Jaundice usually disappears on its own. It doesn't cause any discomfort to your baby. Your baby may develop jaundice for a few reasons...

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...

Lightening

As you approach your due date, you may feel that the baby has dropped, settling deeper into your pelvis in preparation for labor and delivery. This natural step in carrying a child is called lightening. Lightening may be noticeable to you. The profile of your abdomen may change your belly may seem lower and tilt more forward. You may find that it's easier to breathe, as the baby moves down and relieves pressure on your diaphragm. Eating a full meal may become more comfortable with more room in...

Linea nigra

The barely noticeable pale line that runs from your navel to your pubic bone, called the linea alba (white line), often darkens during pregnancy. Then it's referred to as the linea nigra (black line). As with so many other changes that occur during pregnancy, skin darkening is the result of hormones that cause the body to produce more pigment. You can't prevent the linea nigra, but it will fade after delivery. (See also Skin changes.)

Local anesthetics

These medications include chloroprocaine, lidocaine and other caine drugs. Local anesthetics are given shortly before or after delivery. These medications are injected directly into tissue at the opening of the vagina before a cut to enlarge the opening (episiotomy) is made or a tear is repaired. These medications numb the opening of the vagina specifically to allow a brief procedure to be done. They provide only temporary pain relief in a small area of the body. They don't lessen the pain of...

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...

Navel soreness

Along with the other aches and pains associated with your expanding uterus, your navel area may feel tender or sore. This tenderness might be most noticeable as you pass the 20th week of pregnancy and then subside as your belly grows. You may feel most uncomfortable when sitting upright. The stretching and separation of the two large bands of muscles that run along your abdomen also can cause some soreness around your belly-button. (See also Abdominal tenderness due to muscle separation.)...

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Pelvic pressure

In the last weeks of pregnancy, you may feel a sense of pressure, heaviness, soreness or tenderness in your pelvic area. This is caused by the baby pushing into the pelvis and compressing the bladder and rectum. In addition, the baby is likely to compress some veins and cause blood to pool. Finally, the bones of the pelvis are being pushed outward a bit, causing further discomfort. A feeling of pelvic pressure before the 37th week of pregnancy, however, may be a sign of preterm labor,...

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...

Pinkeye

Pinkeye (conjunctivitis) is an inflammation or infection of the conjunctiva, the moist, delicate membrane that lines the inside of the eyelids and covers the whites of the eyes. Symptoms include redness of the eyes, itchi-ness or irritation, a gritty feeling in the eyes and watery eyes. In adults, pinkeye is most often a viral or bacterial infection. It can also be caused by allergies, chemical irritants in the eyes or the use of contact lenses, particularly extended-wear lenses. If you get...

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....

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...

R

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...

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...

Rib tenderness

In the later months of pregnancy, the fetus runs out of room to stretch and may find it handy to rest his or her feet between your ribs. It's surprising how much those little toes and feet jamming into your rib cage can hurt. In addition to the pressure the baby is exerting, the shape of your chest is being altered to maintain room for your lungs while the diaphragm is pushed upward by the uterus. This reshaping pushes your ribs outward and can lead to pain between the ribs and the cartilage...

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...

Sciatica

3rd trimester Pain, tingling or numbness running down the buttock, back or thigh is called sciatica because it follows the course of the sciatic nerve. It's caused by pressure from the growing uterus, the baby or the relaxed pelvic joints on the sciatic nerve, which is a major nerve that runs from your lower back down the back of your legs to your feet. Lifting, bending and even walking may aggravate sciatica. Although sciatica is no fun, it's generally not a cause for concern. When your baby...

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...

Sight

Your newborn is nearsighted and sees best at 12 to 18 inches. That's the perfect distance for seeing the most important things to babies their parents' faces as they hold or feed them. Your baby will love to fixate on your face, and it will be the favorite entertainment for a while. Give your newborn plenty of face-to-face time to get to know you. In addition to being interested in human faces, newborns are also engaged by brightness, movement and simple, high-contrast objects. Many toy stores...

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...

Spermicide

Spermicide contains a chemical that destroys sperm cells before they can fertilize the egg. It comes in different forms, including gel, foam, cream, film, suppository and tablet. Spermicides are often used in conjunction with diaphragms or male condoms. You apply the spermicide inside your vagina near the cervix. Effectiveness Spermicides are 69 percent to 85 percent effective, meaning up to 31 out of 100 women who use this method as birth control for a year will become pregnant. Spermicides...

Squat and wall slide Why do them

If you're able to squat every few minutes or so during labor, it may help open your pelvic outlet, allowing more room for your baby to descend. Squatting during labor is tiring, so you might want to prepare by strengthening the muscles needed. Practice squatting frequently during these last months of pregnancy. An exercise called a wall slide also may be helpful. Squat. Stand with your feet about shoulder-width apart. Slowly lower into a squat position, keeping your back straight and your heels...

Stress

Besides the challenges of round-the-clock baby care, many other factors can leave you feeling stressed, overwhelmed or depressed during the postpartum weeks. Many new parents will experience some of these situations and feelings If you're used to feeling in control and organized, you may be dismayed when your orderly lifestyle flies out the window after you give birth. Rather than the serene family life you envisioned, it may be chaotic. If your baby's birth didn't go as expected for example,...

Stretch marks

Get a group of new or expecting moms together, and you're likely to hear something about stretch marks. Stretch marks are pink or purplish streaks that typically appear on the abdomen, breasts, upper arms, buttocks and thighs. About half of the pregnant women get them, especially during the last half of pregnancy. Stretch marks aren't a sign of excessive weight gain. They're caused by a stretching of the skin along with a normal increase in cortisone, a hormone produced by the adrenal glands....

Stuffy nose

Nasal stuffiness is a common problem in pregnancy, even if you don't have a cold or allergies. Nasal congestion and nosebleeds are more frequent because of the increased blood flow to the mucous membranes in your body. As the lining of your nose and airway swells, your airway shrinks. Your nasal tissue also becomes softer and more prone to bleeding. This nasal stuffiness is common in pregnancy and isn't inflammation of the mucous membranes of the nose (rhinitis). It can be annoying, however....

Tailor sitting Why do it

Tailor sitting improves your posture and strengthens and stretches the muscles in your back, thighs and pelvis. It can help keep your pelvic joints flexible, improve blood flow to your lower body and may make for an easier delivery. Sit on the floor with your back straight and bring the bottoms of your feet together, your heels in toward your groin area. Let your knees drop comfortably out to the side so that you feel a stretch in your inner thighs. Don't bounce your knees up and down. This...