Pregnancy For Dummies®, 2nd Edition

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Table of Contents

Pregnancy For Dummies®, 2nd Edition


About the Authors

Dr Sarah Jarvis is a GP and GP trainer in inner city London. She is a Fellow of, and the Women’s Health spokesperson for, the Royal College of General Practitioners (RCGP). She was a founder member, and later chair, of the Women’s Taskforce at the RCGP. She was also the medical advisor/presenter of the television series, The Maternity Guide, on Channel Health. She is also a medical writer and broadcaster, and is the doctor to The One Show on BBC1 and the Radio 2 doctor, as well as appearing regularly on ITV’s Daybreak, Radio 5 Live and Sky News.

Sarah writes regularly for a variety of magazines, including Good Housekeeping, and My Weekly and in the past for Pregnancy and Baby and You. Her great passion (as far as work is concerned) is patient education, and she has written over 500 patient information leaflets, as well as two previous books, A Younger Woman’s Diagnose-It-Yourself Guide to Health and Diabetes For Dummies. Her other great passion is her family, and she loves spending time with her two children, Seth and Matilda, and their dog, Dasher.

Dr Roger Henderson was born in 1960 and raised in Whitehaven, Cumbria. He qualified as a doctor from St Bartholomew’s Hospital, London, in 1985 and as a general practitioner in 1990. He entered the media world in 1995, and is now one of the UK’s most respected media medics, writing regular columns for national newspapers and magazines. He is also a popular lecturer and after-dinner motivational speaker on a wide range of health-related topics and his medical responsibilities include being the senior partner of a six doctor general practice, running a main surgery and two busy branch surgeries. Married to a doctor, and with three teenage children, his spare time is spent thinking about how nice it would be to have some spare time.

Joanne Stone, MD, is a full-time faculty member in the internationally renowned Division of Maternal-Fetal Medicine at The Mount Sinai Medical Center in New York City. She is the director of the Perinatal Ultrasound Unit and also cares for patients with problem pregnancies. She has lectured throughout the USA, is widely published in medical journals, and has been interviewed frequently for television and magazines on topics related to pregnancy, with a special emphasis on the management of multifoetal pregnancies. She was a co-star in the critically acclaimed series Pregnancy For Dummies on the Discovery Health Channel. Away from the hospital she loves to spend time with her husband, George, and her two girls, Chloe and Sabrina.

Keith Eddleman, MD, works with Joanne at Mount Sinai. He is also a full-time faculty member and is the Director of the Division of Maternal-Fetal Medicine. He teaches medical students, residents, and fellows; lectures throughout the world; and appears often on television to discuss issues concerning the care of pregnant women. His areas of special expertise are ultrasound and reproductive genetics. He was also a co-star on the critically-acclaimed series Pregnancy For Dummies on the Discovery Health Channel. His free time, when he has any, is split between spending time with his family at their apartment in Manhattan or at their country house in upstate New York.

Mary Duenwald is a writer and editor who has for many years specialised in medicine and science journalism. She has written for The New York Times, Discover, Smithsonian, and Departures. She has been executive editor of Harper’s Bazaar, Women’s Sports & Fitness, and The Sciences magazines and a senior editor for Vogue. She is currently a contributing editor for GQ. She is also the mother of twins Nick and Claire Murray.



To Seth and Matilda, who remind me daily that pregnancy was worth it.


For Becky, Douglas, Sarah and Jack. Always.

Joanne, Keith and Mary:

To George, Chloe, Sabrina, Regina, Philip, Frank, Melba, Jack, Nick and Claire for all their love and support.

Authors’ Acknowledgments

I would like to thank my children, who have been remarkably patient as I laboured through the writing of not just one, but three For Dummies books; and my father Derek, who reminds me what bravery is all about. I would also like to acknowledge the enduring support of all my colleagues at the Richford Gate Medical Practice, and of Mr Silesh Kumar, who nurtured me through the sections on maternal-foetal medicine.

— Sarah

Writing this book was truly a labour of love. We would like to thank everyone who played a part in the ‘birth’ of this book, and specifically the following:

Kathy Cox, Traci Cumbay, Chad Sievers, Tami Booth, Jennifer Ehrlich, Christy Beck, Elizabeth Kuball, Paula Lowell, and the other folks at Wiley, who conceived this idea and walked us through the whole process. Sophia Seidner, Carolyn Krupp, and the folks at International Management Group for connecting us with Wiley. Dr Jill Fishbane-Mayer for establishing the initial connection. Drs Jeffrey Penman, Lynn Friedman, Mary D’Alton, Richard Berkowitz, and Ramona Slupik for excellent comments and suggestions. Dr Ian Holzman for nurturing us through the newborn chapter. Kathryn Born for taking our scrap art and turning it into terrific illustrations. And to all our patients over the years whose inquisitive minds and need for accurate information inspired us to write this book.

— Joanne, Keith and Mary

Publisher’s Acknowledgements

We’re proud of this book; please send us your comments at .

Some of the people who helped bring this book to market include the following:

Commissioning, Editorial, and Media Development

Project Editor: Rachael Chilvers (Previous Edition, Daniel Mersey)

Commissioning Editor: Kerry Laundon

Assistant Editor: Ben Kemble

Proofreader: James Harrison

Production Manager: Daniel Mersey

Publisher: David Palmer

Cover Photos: © iStock / Olivier Lantzendörffer

Cartoons: Ed McLachlan

Composition Services

Project Coordinator: Kristie Rees

Layout and Graphics: Carl Byers, Lavonne Roberts, Corrie Socolovitch, Laura Westhuis

Proofreader: Lindsay Amones

Indexer: Becky Hornyak

Publishing and Editorial for Consumer Dummies

Kathleen Nebenhaus, Vice President and Executive Publisher

Kristin Ferguson-Wagstaffe, Product Development Director

Ensley Eikenburg, Associate Publisher, Travel

Kelly Regan, Editorial Director, Travel

Publishing for Technology Dummies

Andy Cummings, Vice President and Publisher

Composition Services

Debbie Stailey, Director of Composition Services


Our goal, in writing Pregnancy For Dummies, 2nd Edition, has been to write a scientifically correct, comprehensive guide to one of the most memorable experiences in anyone’s life – pregnancy. We have dozens of years of experience caring for pregnant women from all walks of life, and, equally relevant, us women authors have been pregnant, allowing us to look at this life-changing event from both sides of the coin.

About This Book

We want this book to be practical, as well as theoretically accurate – and there’s nothing like personal experience to make you realise that intellect and human nature are sometimes mutually exclusive! For example, if Sarah had been asked to talk on her radio show about the scare relating to second-hand cot mattresses and cot death in 1994, she would have dismissed it as unscientific scaremongering – as it was, she sat on a postnatal ward with her one-day-old first baby, refusing to take her son home until her husband had bought a new cot mattress! In this book, we don’t just roll out the party-line answer, or the safe answer; instead, we base our response on medical research. Sometimes, no solid evidence exists to indicate whether something is safe or unsafe, and when this is the case, we tell you.

Too often, our patients come to us incredibly worried about something they’ve read in another book (or a newspaper) that’s either outdated, lacks any real scientific basis, or is exaggerated way out of proportion. Our experience of medical scare stories in the media is that they will often give only one side of the story, in order to make more dramatic headlines. For example, a headline that shouts ‘Caffeine linked to miscarriage’ will sell more papers than ‘Women who drink large quantities of coffee may have a higher chance of miscarriage; however, there’s a significant chance that this relationship is a link, rather than a causal association, and moderate intake is unlikely to be a factor’.

We don’t aim to ignore these scares – our own experience has shown us that intelligent women (and men) need informing, not patronising. So, we put facts and figures into perspective and provide you with enough information to come to a really informed decision for yourself. Pregnancy should be a joy, not a worry. A big part of our philosophy in writing this book is to reassure pregnant women (and their partners) whenever medically possible, rather than to add to the unnecessary worries they already have.

Our experience has shown us that prospective parents also want to know about the real medical aspects of pregnancy. When is the baby’s heart formed? When are fingers developed? What blood tests should be done, and why? What options are available for detecting various problems? In addressing these topics, we have attempted to write a book that is essentially a medical text on obstetrics for the layperson.

We trust that you will use this book as a companion to regular medical care. Perhaps some of the information in it will lead you to ask your practitioner questions that you may not otherwise have thought to ask. Because there isn’t always just one answer, or even a right answer, to every question, you may find that your practitioner holds a different point of view than we do in some areas. This difference of opinion is only natural, and in fact, we even occasionally disagree with each other. The bottom line is that this book provides a lot of factual information, but do not consider it ‘gospel’. Remember also that many topics we discuss apply to pregnancy in general, but your particular situation may have unique aspects to it that warrant different or extra consideration.

Conventions Used in This Book

Understanding a few conventions that we used while writing this book can help you when reading this book.

We try to be respectful of the fact that although traditional husband-wife couples still account for the majority of expectant parents, babies are born into many different circumstances.

We also realise that doctors aren’t the only health professionals who help women through pregnancy. (See Chapter 2 for specific descriptions of the many kinds of professionals who can play a major role in helping women through pregnancy and childbirth.) That is why, in many cases, we refer to your pregnancy professional as your ‘practitioner’. In some cases we do specify ‘doctor’, but usually only when we describe a situation that clearly calls for the services of an obstetrician (or sometimes your GP).

What You’re Not to Read

Any text preceded by a Technical Stuff icon contains information for the very curious and offers deeper, usually scientific or (of course) technical explanations of topics. These nuggets of information may be of interest to you, or they may not, but rest assured that you may safely skip them and still find everything you need to know about pregnancy.

Foolish Assumptions

As we wrote this book, we made some assumptions about you and what your needs may be:

check.png You may be a woman who is considering pregnancy, planning to have a baby, or already pregnant.

check.png You may be the partner of the mother-to-be.

check.png You may know and love someone who is, or plans to be, pregnant.

check.png You may want to find out more about pregnancy but have no interest in becoming an expert on the topic.

If you fit any of these criteria, then Pregnancy For Dummies, Second Edition gives you the information you’re looking for!

How This Book Is Organised

The parts and chapters of this book represent a logical flow of information about the pregnancy process. However, you don’t have to read it in order. You can pick up this book, thumb through it and read what stands out, look up specific topics in the table of contents or index, or read it cover to cover. Check out the following sections for a more detailed overview.

Part I: The Game Plan

Of course, some women get pregnant accidentally. In fact, the UK has one of the highest rates of unplanned pregnancy in Europe. But for many women pregnancy is a conscious choice. Planning ahead is a good idea – even seeing your GP before you conceive. Even if it’s already too late to plan that far ahead, this part of the book fills you in on what’s happening to your body during the first days and weeks of pregnancy. In this part, you can also find out what happens at an antenatal visit, as well as your legal entitlements. And you can find out the general scope of what your life will be like for the next 40 weeks.

Part II: Pregnancy: A Drama in Three Acts

Like all good narratives, pregnancy has a beginning, a middle and an end – called trimesters. Because pregnancy is about nine months long, the trimesters are divided into (approximately) three periods of 13 weeks – 0–12, 13–26 and 27–40. The way you feel and the kind of care you need vary with each stage. In this part, you get an idea of how each trimester unfolds.

Part III: The Big Event: Labour, Delivery and Recovery

After you’ve put in your nine months, it’s time for the flurry of activity that results in the birth of your baby. At this point, a lot is going on in a short time. Your experience depends heavily on what kind of delivery you have and how long it takes. This part covers the basic scenario of labour, delivery and recovery – plus many possible variations on the theme.

Part IV: Special Concerns

This part is where to look for information about all kinds of special concerns that you may have as new parents – from practical challenges like how to introduce older siblings to the new baby to health problems that sometimes arise during pregnancy.

In an ideal world we would not need a section about problems that come up during pregnancy because every woman’s experience would be perfectly trouble-free. On the other hand, many of the difficulties that sometimes arise need not develop into full-blown problems if they are properly taken care of. For this reason, we offer information about how to deal with anything that can come up. This part is the one to consult if you think you’re having any kind of difficulty, from the serious to the mundane.

Part V: The Part of Tens

The Part of Tens is standard in all For Dummies books. Before we began writing the book, we weren’t sure how to make this part of our book useful. But in the end, we were very glad to have a place where we could put many aspects of pregnancy in a nutshell. Here you find out more about how the baby grows and how you can view him or her on ultrasound. We also dispel some common myths and give you some good reasons to relax and enjoy your pregnancy.


In most pregnancy books, the father of the baby is, sadly, overlooked. We think that’s a shame. Dads are, of course, welcome to read any part of the book that interests them – we include information aimed at them through the rest of the book – but we also include an insightful overview of the entire process, specifically with dads in mind, in the Appendix. Enjoy!

Icons Used in This Book

Like other For Dummies books, this one has little icons in the margins to guide you through the information and zero in on what you need to find out. The following paragraphs describe the icons and what they mean.

technicalstuff.eps This icon signals that we’re going to delve a little deeper than usual into a medical explanation. We don’t mean to suggest the information is too difficult to understand – just a little more detailed.

callthedoctor.eps Many things you may feel or notice while you’re pregnant will raise the question, ‘Is this important enough for my practitioner to know about?’ When the answer is yes, you see this icon.

caution_pregnancy.eps Throughout this book, we try to avoid being too alarmist, but there are some situations and actions that a pregnant woman clearly should avoid. When this is the case, we show you the Caution icon.

don%27tworry_pregnancy.eps We know from experience that pregnancy can bring out the instinct to worry. Feeling a little anxious from time to time is normal, but some women go overboard working themselves up over things that really aren’t a problem. We use this icon – more than any other one – to point out the countless things that you really need not fret about.

justfordads.eps We’re well aware that a dad’s perspective and a mum’s perspective can be very different. That doesn’t mean that dads are less important, or less well informed, and this icon helps dads-to-be (and their partners) to understand what’s going on.

remember.eps We flag certain pieces of information with this icon to let you know something is particularly worth keeping in mind.

tip.eps This icon marks bits of advice we can give you about handling some of the minor discomforts and other challenges you encounter during pregnancy.

Where to Go from Here

If you’re the particularly thorough type, start with Chapter 1 and end with the Appendix. If you just want to find specific information and then close the book, take a look at the table of contents or at the index.

Of course every mother, just like every pregnancy, is unique. Some women have particular risks because of their genetic make-up, their age or their past medical history. Because of this, several sections of this book may be of no relevance to some pregnant women – the ‘In this Chapter’ list at the start of each chapter will help you to decide if you can skip certain sections.

Mark the pages that are especially interesting or relevant to you. Write little notes in the margins. Have fun and – most of all – enjoy your pregnancy!

Part I

The Game Plan


In this part . . .

‘I’m not sure I’m ready for this’ is a normal reaction to finding out that you’re pregnant, no matter how long you’ve been thinking about having a baby and no matter how long you’ve been trying to conceive. Suddenly, you’re faced with the reality that your body is about to undergo some profound changes, and a baby is going to take shape inside you. Well, you may not feel ready, but preparing is easy enough. Ideally, your preparation begins with a visit to your GP a few months before you conceive. But even if you’re not that far ahead of the game, this part tells you some of the many ways you can plan ahead for the very important, very interesting next nine months (plus).