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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...

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...

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...

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...

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...

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....

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...

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 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...

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...

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...

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...

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...

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...

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,...

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...

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...

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...

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...

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...

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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...

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...

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...

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...

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,...

Surgical sterilization

Either you or your partner may wish to undergo surgery to permanently prevent pregnancy. A woman may have tubal ligation, a procedure in which her tubes are tied. A man may have a vasectomy, which keeps sperm from being ejaculated. During tubal ligation, a woman's fallopian tubes are cut and tied. She is usually under general anesthesia during this procedure, and a hospital stay may or may not be required. A tubal ligation can be done immediately after delivery, about six weeks after delivery...

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...

Take your time

Be patient with yourself in these first weeks with your new baby. Remember that you and your family have undergone a tremendous change. It can be daunting, discouraging, thrilling and perplexing, all in the same hour. In time, you'll grow stronger physically. And your skills as a parent will grow, too, day by day, as you explore with this new person in your world. This month, you may also be interested in Complications Postpartum conditions, page 579 As you and your partner begin to bond with...

Taking your baby home

Finally, the moment you've been anticipating is here you're bringing home the newest member of your family You've set up the crib and nursery, bought and borrowed the cute little outfits, and stocked up on diapers, wipes, blankets and other supplies. You've been thinking about all of the changes this new baby will bring to your life and probably alternated between feeling excited and scared. Now you wonder Am I ready Are we ready Probably not and that's perfectly normal. No matter how many...

The breast or the bottle

Do you plan to feed your baby with breast milk or formula A great deal of scientific evidence supports the idea that breast milk is best for babies. And many new moms hear the message. According to the Department of Health and Human Services, 65 percent of new mothers in the United States initiate breast-feeding. At six months, almost one-third are still breast-feeding their babies. For a variety of reasons, other women choose to feed their babies with formula. Today's commercial formulas...

The choice is yours

The decision of whether to have pain relief medications during labor is largely up to you. Discuss the topic of pain relief with your health care provider long before your labor begins. Become familiar with natural pain relief methods and consider using them first, if possible, or use them in conjunction with medication. If during your labor you feel the need for medication, don't insist on it immediately. Try holding out for 15 minutes or longer and putting that time to good use, concentrating...

The importance of hormones

Hormones are the chemical messengers that regulate many aspects of your pregnancy. The hormone progesterone is produced first by your ovaries and then by your placenta. It keeps your uterus from contracting. It also promotes growth of blood vessels in the walls of your uterus, essential for your baby's nourishment. Your ovaries and placenta also produce estrogen. It causes growth and changes in your uterus, endometrium, cervix, vagina and breasts. Estrogen also influences many key body...

The premature newborn

Every parent dreams of having a healthy, full-term baby. Unfortunately, that dream isn't always the reality. Although most infants are born full-term and free of medical problems, some are born too early. Prematurity is often accompanied by medical complications. Due to medical progress, the outlook for these newborns is much more hopeful than it once was. Still, many infants experiencing problems will require special care. This section explains some of the types of problems and treatments that...

Tips for when youre feeling overwhelmed

When you bring your baby home, there will probably be times when you feel exhausted, stressed or overwhelmed. One of the most important ways to minimize stress is to take good care of yourself by continuing to eat as well as you did throughout your pregnancy, drinking plenty of fluids, staying physically active and getting as much rest as you possibly can. In addition, the following suggestions can help you survive the postpartum period Get help. Accept offers of help from friends and family...

Triple test

The triple test consists of three screening tests that can assess your risk of having a baby with certain defects. It looks at levels of three substances normally present in the bloodstream of a pregnant woman. The tests measure Maternal serum alpha-fetoprotein (MSAFP), which evaluates the levels of alpha-fetoprotein (AFP) in your blood. AFP is a protein produced by your baby's liver. Small amounts of the protein cross through the placenta and amniotic fluid and show up in your blood. Human...

Type of incision

During a Caesarean birth, your health care provider creates two incisions. One is in your abdomen, and one is in your uterus. The incision in your abdomen goes through skin, fat and muscles. From this opening, your surgeon makes the incision in your uterus. The incision in your uterus is different from the incision in your abdomen. You can't tell what kind of uterine incision you've had just by looking at your belly. Instead, to find out which type you had, check with your health care provider...

Types of health care providers

Obstetrical care is offered by family physicians, obstetricians-gynecologists, maternal-fetal medicine specialists and midwives. Family physicians provide care for the whole family through all stages of life, including pregnancy and birth. Medical school followed by at least three years in training at a hospital or another patient setting (residency). Study and work in various fields of medicine, including obstetrics, pediatrics, internal medicine, gynecology and surgery. Certification by the...

Understanding genetic carrier screening for prospective parents

Although most babies are born healthy, having a baby means taking a risk. There are no guarantees that a child will be born healthy. Some people have a genetic makeup that increases their risk of having a child with health problems. Today, tests are available that offer parents-to-be an opportunity to explore some of the risks that genetics may pose for their unborn children. These tests are called genetic carrier screening tests. They're designed to identify people who carry one copy of an...

W

After Caesarean, 202-203 to calm babies, 228 for exercise, 18 in labor, 175, 176 wall slide exercise, 139 warfarin, 465 water, drinking quality of, 324, 386-387 recommended amount of, 29 water breaking, 149, 165, 503, 569 weight. see also body mass index (BMI) of fetus (see gestational age) gain of, in pregnancy, 6-8, 75, 85-86, 107, 150 gain of, with multiple gestations, 91 loss of, in newborns, 217 loss of, postpartum, 258-259 pregnancy risks and, 8 Wellbutrin (buproprion), 466 West Nile...

Waiting for it to be over

By this point, you're probably tired of being pregnant. You may be having trouble sleeping because you can't find a comfortable position. Once you do drift off, your bladder may be waking you up every couple of hours. Time may seem to be standing still. To deal with the boredom and discomfort, try to keep busy. Work on a hobby project, read the latest bestseller, and spend time with friends and family. Keeping your mind active will help the days move more quickly until the big day finally...

Water concerns

If your water comes from a safe municipal water supply, it's acceptable to use for preparing your baby's formula. If your home is supplied by well water, you can have the water checked by your local public health department to make sure it doesn't contain contaminants, such as nitrates, or heavy metals, such as lead. Use bottled water to prepare formula if you have any concerns about your water supply. When preparing formula, use cold water or water warmed to room temperature. Don't boil water...

Week

By week 10 the beginnings of all of your baby's vital organs have formed. The embryonic tail has disappeared completely, and fully separated fingers and toes have formed. The bones of the skeleton are now forming. Your baby's eyelids are more developed, and the eyes look closed. The outer ears are starting to assume their final form. Your baby is also starting to develop buds for teeth. Your baby's brain is now starting to grow more quickly. This week almost 250,000 new neurons are being...

Weeks 2 and 3 Ovulation fertilization and implantation

The lining of your uterus, which will nourish your baby, is developing. Your body is secreting follicle-stimulating hormone, which will cause an egg in your ovary to mature. As you ovulate and the egg is released into your fallopian tube, the hormones involved in the process estrogen and progesterone cause a slight increase in your body temperature and a change in secretions from your cervical glands. When fertilization occurs, the corpus luteum a small structure that surrounds your developing...

What parents say about bottlefeeding with formula

Parents who bottle-feed report these advantages Flexibility. Using a bottle with formula allows more than one person to feed the baby. For that reason, some mothers feel that they have more freedom when they're bottle-feeding. Fathers may like bottle-feeding because it allows them to share more easily in the feeding responsibilities. Bottle-feeding can present challenges, such as Time-consuming preparation. You have to prepare the bottle for each feeding. You've got to keep a supply of formula...

What parents say about breastfeeding

Mothers who have breast-fed their children list these advantages Convenience. Many mothers find breast-feeding to be more convenient than bottle-feeding. It can be done anywhere, at any time, whenever your baby shows signs of being hungry. No equipment is necessary. Breast milk is always available and at the right temperature. Because you don't need to prepare a bottle and you can nurse lying down, nighttime feedings may be easier. Cost savings. Breast-feeding can also save money because you...

When to call a health care professional during weeks 25 to

At this point in your pregnancy, you need to be alert to the possibility of preterm labor. Preterm labor means contractions that begin opening (dilating) your cervix before the end of the 37th week. Babies born early usually have a low birth weight, which is defined as less than 5 1 2 pounds. Their low weight and other problems associated with preterm birth put them at risk of several health problems. Be vigilant for these signs and symptoms of preterm labor Uterine contractions, possibly...

When to call a health care professional during weeks 33 to

Your pregnancy is nearly over your baby will be here before you know it. However, it's still important to know about problems that could arise and when to contact your health care provider. When in doubt, call. This month you may be interested in Decision Guide Understanding pain relief choices in childbirth, page 325 Complications Preterm labor, page 533 Complications Group B streptococcus, page 563 Here's a guide to possibly troublesome signs and symptoms and when you should notify your...

When to call a health care professional during weeks 5 to

It's always better to be safe than sorry. This month, you may also be interested in Decision Guide Managing travel during pregnancy, page 321 Complications Hyperemesis gravidarum, page 550 Here's a guide to possibly troublesome signs and symptoms and when you should notify your health care provider in the second month. When to tell your health care provider When to tell your health care provider Slight spotting that goes away within a day Any spotting or bleeding lasting...

When your baby is hospitalized

Spend time touching and talking to your newborn. Learn as much as you can about your baby's medical condition, especially what parents should watch for and how parents can care for their baby's conditions. Don't be afraid to ask questions. Medical terminology can be confusing. Have the doctor or nurse write down any key diagnoses. Ask for printed patient information sheets or recommended Web sites for further information. Take an active role in your baby's care, especially as your baby becomes...

Where to start

If you don't already have a health care provider in mind, ask for recommendations from friends or family members who have children. Find out why they like their health care provider and how that may apply to your situation. Your pregnancy health care provider may also be an excellent referral source. If you've just moved to the area or you want to do some research on your own, the following resources may be helpful Nearby general or pediatric hospitals Medical directories at your local library...

Worries and fears

During your second month of pregnancy, the excitement you felt when you learned you were pregnant may be dampened by fear. What if you might have done something to harm your baby before you knew you were pregnant What about that aspirin you took for a headache Or that glass of wine you had with dinner Or that bout of the flu It's important to realize that you can't plan or control everything about your pregnancy. But it's also important to make lifestyle choices that give you the best chance of...