Pregnancy All-in-One For Dummies®
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Published simultaneously in Canada
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Library of Congress Control Number: 2016934262
ISBN 978-1-119-23549-1 (pbk); ISBN 978-1-119-23551-4 (ebk); ISBN 978-1-119-23550-7 (ebk)
Prospective parents are truly curious about everything related to pregnancy, from when the baby’s heart is formed to whether eating sushi or dyeing your hair is okay. If this describes you, you’ve come to the right place. In one helpful reference guide, Pregnancy All-in-One For Dummies offers the answers to many of your pregnancy-related questions, from fetal development to workouts for moms-to-be to healthy weight gain and more.
Pregnancy should be a joy, not a worry. Yet pregnant women are, by nature, already anxious about whether anything they do or eat may hurt the baby. The source of all this anxiety? Often it’s information on pregnancy — in print, online, or from the mouths of well-meaning but clueless friends and family — that is outdated, lacks scientific basis, or is exaggerated for shock effect. The result is that many pregnant women and their partners end up incredibly worried about something they’ve read or heard.
This comprehensive, scientifically correct guide presents the facts of pregnancy based on real scientific data, and it answers many commonly asked questions — all while encouraging the humor and light-heartedness that are part of the miraculous process of having a baby. A big part of the philosophy behind this book is to reassure pregnant women instead of adding to the unnecessary worries they already have.
Prospective parents also want to know about the medical aspects of pregnancy. When are fingers developed? Which blood tests should be done, and why? What options are available for detecting various problems? This book addresses these topics, too, creating what is essentially a medical text on obstetrics for the layperson.
This book provides a lot of factual information, but it isn’t gospel. Many of the topics discussed apply to pregnancy in general, but your particular situation may have unique aspects that warrant different or extra consideration, so use this book as a companion to regular medical care.
Sidebars (boxes of text) in this book give you a more in-depth look at a certain topic. Although they further illuminate a particular point, these sidebars aren’t crucial to understanding the rest of the book. Feel free to read them or skip them. You can pass over the text that accompanies the Technical Stuff icon as well. The text associated with this icon gives some interesting details about pregnancy, but if you don’t read it, you can still come away with the information you need.
Within this book, you may note that some web addresses break across two lines of text. If you’re reading this book in print and want to visit one of these web pages, simply key in the web address exactly as it’s noted in the text, pretending the line break doesn’t exist. If you’re reading this as an e-book, you’ve got it easy — just click the web address to be taken directly to the web page.
We made some assumptions about you and what you want out of a pregnancy book:
If you fit any of these criteria, then Pregnancy All-in-One For Dummies gives you the information you’re looking for.
Like other For Dummies books, this one uses icons to guide you through the information.
In addition to the material in the print or e-book you’re reading right now, this product comes with some access-anywhere goodies on the web. Check out the free Cheat Sheet for info on what to expect when you’re admitted to the hospital, how you can avoid some of the maladies that plague pregnant women (like heartburn), and strategies that can help you find time for fitness and motherhood. To get this Cheat Sheet, simply go to www.dummies.com
and search for “Pregnancy All-in-One For Dummies Cheat Sheet” in the Search box.
If you’re the particularly thorough type, go ahead and read this book from cover to cover. 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. Dog-ear or bookmark the pages that are especially interesting or relevant to you. Add comments or write little notes in the margins. Have fun, and most of all, enjoy your pregnancy!
Book 1
Contents at a Glance
Chapter 1
IN THIS CHAPTER
Knowing what symptoms to look for
Getting the answer to that all-important question: Are you pregnant?
Knowing what to expect as your pregnancy progresses
Scheduling doctor appointments and routine tests
So you think you may be pregnant! Or maybe you’re hoping to become pregnant soon. Either way, it’s important to know what to look for so that you can find out whether you’re pregnant as early as possible. This chapter takes a look at some of the most common signals that your body sends you in the first weeks of pregnancy and offers advice for confirming your pregnancy and getting it off to a great start.
So assume it has happened: A budding embryo has nestled itself into your womb’s soft lining. How and when do you find out that you’re pregnant? Quite often, the first sign is a missed period. But your body sends many other signals — sometimes even sooner than that first missed period — that typically become more noticeable with each passing week.
Well, are you or aren’t you? These days, you don’t need to wait to get to your practitioner’s office to find out whether you’re pregnant. You can opt instead for self-testing. Home tests are urine tests that give simply a positive result (often showing two lines) or negative result (showing only one line); some use little plus (positive) and minus (negative) signs. These tests are very accurate for most people. Your practitioner, on the other hand, may perform either a urine test similar to the one you took at home or a blood test to confirm that you’re pregnant.
Suppose you notice some bloating or food cravings, or you miss your period by a day or two. You want to know whether you’re pregnant, but you aren’t ready to go to a doctor yet. The easiest, fastest way to find out is to go to the drugstore and pick up a home pregnancy test. These tests are basically simplified chemistry sets, designed to check for the presence of human chorionic gonadotropin (hCG, the hormone produced by the developing placenta) in your urine. Although these kits aren’t as precise as laboratory tests that look for hCG in blood, in many cases, they can provide positive results very quickly — by the day you miss your period, or about two weeks after conception.
Even if you had a positive home pregnancy test, most practitioners want to confirm this test in their office before beginning your prenatal care. Your practitioner may decide to simply repeat a urine pregnancy test or to use a blood pregnancy test instead.
A blood pregnancy test checks for hCG in your blood. This test can be either qualitative (a simple positive or negative result) or quantitative (an actual measurement of the amount of hCG in your blood). The test your practitioner chooses depends on your history and your current symptoms and on her own individual preference. Blood tests can be positive even when urine tests are negative.
Only 1 in 20 women actually delivers on her due date — most women deliver anywhere from three weeks early to two weeks late. Nonetheless, it’s important to pinpoint the due date as precisely as possible to ensure that the tests you need along the way are performed at the right times. Knowing how far along you are also makes it easier for your doctor to see that the baby is growing properly.
The average pregnancy lasts 280 days — 40 weeks — counting from the first day of the last menstrual period. This day is used to calculate your due date.
If you’re unsure of the date of conception or the date your last period started, an ultrasound exam during the first three months can give you a good idea of your due date. A first-trimester ultrasound predicts your due date more accurately than an ultrasound done in the second or third trimester.
As indicated throughout this book, pregnancy is usually referred to as a 40-week enterprise, which is a tad misleading. The pregnancy starts at conception, which — with a normal 28-day cycle — is two weeks after the first day of your last menstrual period. So if you start at conception, pregnancy is only 38 weeks, but obstetricians use 40 weeks because most women don’t know when they conceive but do remember when their last period was.
If you suspect that you’re pregnant, you’re probably both excited and anxious to find out if you truly are. The first four weeks are important because the pregnancy is getting established as the implantation process is underway.
During these initial weeks, do the following:
Check for ovulation. Some women know when they ovulate by a sensation known as mittelschmerz (German for “middle pain,” due to the mild pain that may be felt when the egg is released from the ovary, typically 14 days after your last period). Others know they’ve ovulated due to a change in the cervical mucus or a positive reading from an ovulation prediction kit.
Fertilization usually occurs within the fallopian tube. The embryo starts as one cell. During the 1st week, that cell divides many times as it moves down the fallopian tube toward the uterine cavity.
Take your first pregnancy test. As stated earlier, pregnancy tests check for a hormone called human chorionic gonadotropin (hCG), which is produced by the placenta as the embryo implants into the wall of the uterus — usually five to seven days after conception. By the time you miss a period, around ten days after conception, your pregnancy test will most likely be positive.
Don’t be too concerned if you have a little spotting around the time when you would expect your period. This is most likely due to the embryo implanting in the womb (implantation bleeding).
At the end of the 4th week, your baby measures 0.2 inches (5 mm) in length.
By this time, the pregnancy is well established, and you’re feeling the typical signs and symptoms of pregnancy, such as nausea and fatigue. During weeks 5 to 8, most of the baby’s organ systems are beginning to form. The first organ to start working is the heart. It’s amazing to realize it starts beating at just 5 weeks, although you can’t see it beating on ultrasound until 6 weeks. The baby’s arms and legs are beginning to develop at this stage. The head is the biggest part of the embryo because the brain is the fastest-growing organ at this time. (Check out Chapter 1 in Book 2 for more on what happens during the first trimester.) The placenta is rapidly growing and is now the way nutrients and oxygen get to your developing baby.
This is an important time to make any necessary lifestyle changes, if you haven’t already done so (like stopping smoking or speaking with your doctor about adjusting medications — Book 1, Chapter 2 explains the effects of certain medications, alcohol, and drugs on the developing fetus). Also during this time, begin making these necessary medical appointments:
At the end of the 8th week, your baby measures 1.2 inches (3.0 cm) in length. Your uterus is about the size of a medium orange.
Although you won’t be feeling it this early, this is the time when your baby starts to move around. If you’re having an ultrasound at this time, you may actually see these movements on the screen. Before 10 weeks, male and female embryos look the same. After 10 weeks, their external genitalia start to develop differently, although your practitioner may not be able to see this difference on ultrasound until after 16 to 20 weeks, depending on the position of the baby, the amount of abdominal tissue the sound waves have to pass through, the kinds of equipment used, and the experience of the person performing the ultrasound. By the end of the 10th week, all the organ systems have formed. The brain is unique in that it continues to develop throughout pregnancy and even into adulthood.
You want to consider the following counseling and testing at this time:
Make sure you schedule your first-trimester screen for Down syndrome. Remember, the best time to screen for Down syndrome is at 11 to 12 weeks (see Book 2, Chapter 1 for detailed information about the first trimester and Down syndrome screening). This screen combines a measurement of the fluid-filled region behind the fetal neck (called a nuchal translucency), your age, and blood tests (hCG and PAPP-A) to give you a specific risk for Down syndrome as well as for Trisomy 13 and 18 (other chromosomal disorders).
Talk to your provider to see whether he thinks you’re a candidate for a newer type of screening for Down syndrome that extracts fetal genetic material from your blood. This blood sample can be drawn as early as 9 weeks.
At the end of week 12, your baby is 2.13 inches (5.4 cm) long and weighs less than half an ounce (around 14 g). Your uterus is the size of a large orange.
Congratulations! You and your baby made it through the first trimester. You’re starting to feel more like yourself — you have more energy and less nausea. After week 14, the majority of the amniotic fluid surrounding your baby is made up of the baby’s urine. By week 15, an experienced sonographer can tell by ultrasound whether you’re having a boy or a girl. By week 16, your baby starts to grow fine, soft hair (called lanugo) and fingernails.
The following considerations apply during this time period:
At the end of week 16, your baby is 4.6 inches (11.6 cm) long and weighs about 3.5 ounces (100 g). Your uterus is the size of a large grapefruit.
During weeks 17 to 20, your baby begins to put on some fat and looks more like a real baby. The baby’s skeleton, which starts out mostly as cartilage, is now transforming into bone. You may notice a little fluttering sensation in your abdomen. This could be gas, but more likely it’s early fetal movement. By 20 weeks, the top of the uterus (called the fundus) is at the level of your belly button. Twenty weeks is the halfway mark, so you should congratulate yourself. The second half usually flies by faster than the first.
You want to keep the following in mind:
Your baby now weighs about 10 ounces (300 g) and is about 10 inches (25 cm) long.
During this time, your baby’s lungs are going through a very important phase of development. The lining of the lungs is beginning to thin out enough to allow for oxygen exchange. You may be experiencing discomfort on either side of your lower abdomen (in the groin area). This discomfort is known as round ligament pain. The round ligaments are actual ligaments that attach from the top of the uterus to the labia. Many women feel an uncomfortable pulling sensation, which tends to worsen upon standing and improve upon sitting or lying down. The good news is that after 24 weeks, round ligament pain usually goes away.
At this time, your baby is regularly swallowing large amounts of amniotic fluid and excreting urine back into the amniotic cavity. The baby’s fingernails are almost fully formed, and he has started to grow eyelashes and eyebrows. The lanugo is turning from a pale color to a darker hue.
By 24 weeks, your baby is considered viable. This means survival on the outside is possible, although the baby would need a great deal of medical attention. The top of your uterus is usually at or above the level of your belly button.
There aren’t any actual tasks that you have to schedule with your provider during this time, other than your routine prenatal visits (which should be about every four weeks during this period).
At the end of this period, your baby weighs about 1 pound, 5 ounces (600 g) and measures about 12 inches (30 cm) long.
Your baby’s bones are continuing to harden, and his fingernails, toes, eyebrows, and eyelashes are fully present. Meanwhile, your baby’s skin is still fairly see-through, although it is changing from transparent to a more opaque look. You should still be seeing your provider about every four weeks during this period of pregnancy.
The following considerations are typically addressed during this time:
The top of your uterus is a couple of inches above your belly button. By 28 weeks, your baby weighs about 2 pounds, 4 ounces (1 kg). He is about 14.8 inches (38 cm) long.
Your baby’s eyes can now open. His permanent teeth have developed, and the lungs and digestive tract are nearly mature. To keep a closer eye on you and your baby, your practitioner will start to schedule your prenatal visits every two weeks.
The following steps are recommended during this time:
Pay closer attention to your baby’s movements. Although fetuses still spend most of their time sleeping, they start to develop clear sleep and wake cycles. A good general rule is that feeling about six movements in an hour is a sign of fetal well-being. You don’t have to feel these movements every hour, but if you’re ever concerned that you’re not feeling your normal fetal movement, lie down and count the movements. If you can feel six movements in an hour, you can rest assured that this is normal.
The nature of the fetal movements may also change. Instead of the big punches and kicks you were feeling earlier, the movements during this time may be gentler, rolling type of movements.
The top of your uterus is midway between your navel and your sternum. By 32 weeks, your baby weighs from about 3 pounds, 11 ounces to 4 pounds (1.8 kg) and is 16 to 17 inches (43 cm) long.
During this time, you may be feeling lots of rhythmic fetal movements, which are really the baby hiccupping — a normal occurrence. These hiccups can continue even after the baby is born. If you’re having twins, you should be well prepared for their arrival now, because on average, twins deliver at about 35 to 36 weeks.
The following considerations come into play now:
The top of your uterus is a couple of inches below your sternum. At or just after 36 weeks, your doctor will see you at least once a week until you deliver. Your baby weighs about 5 pounds, 2 ounces (2.3 kg) and is almost 18 inches (46 cm) long.
Congratulations — you are now considered term. Even though you may not yet be at your due date, any delivery that occurs at or after 37 weeks is considered a full-term delivery. You may notice irregular contractions that come and go in spurts. The big event can happen at any time during this period, so be prepared — day or night.
Do the following to ensure that you’re ready for the big day to arrive:
The average baby at full-term weighs about 7.5 pounds (close to 3.5 kg), but there is a wide degree of variation in what’s considered normal. At this point in pregnancy, your baby will put on about a quarter of a pound per week until delivery. The top of your uterus should be at or just below your sternum or breastbone. Babies at 40 weeks average about 20 to 21 inches (51 to 53 cm) long.
Don’t worry — the end really is in sight. If you haven’t gone into labor on your own, your doctor will likely schedule you for either induction or cesarean section by 41 to 42 weeks. If you’re older than 35, and especially if you’re older than 40, your doctor may want to deliver you sooner. Because the risks to continuing the pregnancy really increase after 41 to 42 weeks, your baby should be delivered by then. Your doctor makes sure your baby remains healthy during this time:
Although the baby continues to grow after 40 weeks, the rate of growth slows a little, and he may not put on the quarter pound per week that he did in the few weeks before 40 weeks.
Table 1-1 lists common tests that may be recommended during your pregnancy. Some of these tests may not be recommended for every pregnancy but are included for the sake of those who need them.
Table 1-1 Common Tests during Pregnancy
Test | Gestational Age (Weeks) | Purpose of Test |
Dating ultrasound | 7–12 | Confirms viability of pregnancy, establishes due date, rules out multiple gestations |
Harmony, MaterniT21, Panorama, or Verifi | 9–20 | Screens for genetic defects in the fetus |
Nuchal translucency test (ultrasound) | 11–12 | Part of the first-trimester screen for Down syndrome |
Chorionic villus sampling (CVS) | 10–12 | Samples the placental tissue for genetic abnormalities; recommended for some women but should be offered to all women |
AFP/quad screen | 15–18 | Screens for defects such as spina bifida and completes the second-trimester screen for Down syndrome |
Amniocentesis | 16–18 | Samples the amniotic fluid for genetic abnormalities; recommended for some women but, again, should be offered to all women |
Anatomy ultrasound | 18–22 | Looks at the baby from head to toe to make sure he is developing normally (to rule out many birth defects) |
Glucose screen | 24–28 | Tests for gestational diabetes |
Group B strep (GBS) swab | 35–37 | Sees if the birth canal is colonized with group B strep bacteria (if so, Mom will be given antibiotics during a vaginal delivery to protect the baby) |
Non-stress test (NST) | 40–42 | Tests the baby’s heart rate patterns to determine fetal well-being, despite going past his due date; often done earlier in pregnancy for other complications like high blood pressure and diabetes |
Biophysical profile (BPP) | 40–42 | Determines fetal well-being; often done earlier in pregnancy for other complications; includes an assessment of amniotic fluid volume |
Chapter 2
IN THIS CHAPTER
Finding a healthcare practitioner who meets your needs
Walking through a typical prenatal visit
Considering medications you may be taking
Recognizing the consequences of alcohol and drugs
Finding the right practitioner to care for you — and your baby — is a decision you shouldn’t take lightly. Your healthcare is always important, but your new and sometimes overwhelming condition means you want a practitioner who’s in sync with your approach to pregnancy. This person should be someone you trust and feel safe with. If you’ve had a previous child, you may already have a practitioner. If not, there’s no need to feel overwhelmed. This chapter helps you make that important decision and takes you through a typical prenatal visit.
Maintaining good health throughout your pregnancy is a critical step in delivering a healthy baby, so this chapter also includes information on risks and benefits associated with certain medicines and vaccinations, along with the consequences of alcohol and drugs.