Pregnancy

Overview

Your baby starts out as a fertilized egg, no bigger than the period at the end of this sentence. The baby will change and grow almost every single day and your body will change and grow, too. It will take 280 days (9 1/3 calendar months or 40 weeks) before the baby is fully developed and is ready to live outside your uterus (womb). Pregnancy is often divided into three periods called trimesters. Each trimester is roughly three months long.

It is important to seek medical attention as soon as you think you might be pregnant. It is best to start prenatal care before you get pregnant. By doing so, you increase the chances of having a healthy baby - your health care provider can identify problems and issues that need to be addressed prior to conception.

It is best to start prenatal care before you get pregnant

Signs of Pregnancy

The most common first sign of pregnancy is a missed menstrual period, although you may miss a period because of illness, stress, medications you are taking or a change in your lifestyle. Other signs of pregnancy include sore or tender breasts, nausea and vomiting, frequent urination, and fatigue. You may have any or all of these signs or none of them. Every woman's body is unique and so is every pregnancy. This is why it is important for you to see a doctor or nurse-midwife, or go to a clinic as soon as you suspect you might be pregnant.

Pregnancy Tests

The sooner you know you are pregnant, the sooner you can begin proper prenatal care. Therefore, it is important to have a pregnancy test as soon as possible after you miss your first period or as soon as you think you might be pregnant. Some tests can be performed as early as a few days after a single missed period. These tests use a sample of your urine to determine if you are pregnant.

You can also buy do-it-yourself (sometimes called home) pregnancy testing kits in the drug store. These tests also use a urine sample to determine pregnancy. It is a good idea to see your doctor regardless of the result of the do-it-yourself test. Another test done in the laboratory can double check your result and, if you are not pregnant, help the doctor find out why you missed a period.

Feelings

The discovery that you are pregnant is bound to produce mixed emotions in both you and the baby's father. You may be excited, happy, worried and concerned all at the same time. The father may feel proud or very uncertain. Each person is unique and therefore reacts differently.

Whatever your initial reaction, it is normal for your feelings to change many times over the course of your pregnancy. As you talk and plan and learn about pregnancy and parenting, you will be better able to deal with your concerns. Therefore, it is important to learn about pregnancy and the birth process as you are experiencing it. Join prenatal classes, share your feelings with others, and continue to do the things you enjoy. There are a number of wonderful books available dealing with the topic of pregnancy. They can help you understand what is happening to your body and assist you in maintaining a healthy pregnancy.

During the first 3 months of pregnancy, your body and your emotions will go through many changes. Your temperament will return to normal as your body adjusts to the pregnancy. However, during the last weeks of pregnancy you may feel uncomfortable, unattractive, a little nervous, and have trouble sleeping.

Nine Ways to Achieve a Positive Pregnancy

Think about nutrition and supplement with folic acid and prenatal multivitamins.

Nutrition is an important factor in your pregnancy. Studies show a direct relationship between the mother's pre-pregnant weight, the amount of pregnancy weight gain, and the weight of the newborn. The Institute of Medicine - National Academy of Science has published new guidelines that show the risk of low birth weight can be decreased if the mother gains the proper amount of weight. Underweight women should try to gain 28 to 40 pounds; normal weight women, 25 to 35 pounds; and overweight women, 15 to 25 pounds. Women carrying twins or triplets should gain 40 pounds or more.

The risk of low birthweight can be decreased if the mother gains the proper amount of weight.

Birth defects have been associated with an inadequate diet that does not include enough vitamins and minerals. Even if you are eating regular meals each day, you and your growing baby may still be inadequately nourished.

According to the U.S. Public Health Service, all women considering pregnancy should supplement their daily diet with multivitamins. To reduce the incidence of spina bifida - the number one disabling birth defect - and other neural tube defects (NTD's), take 0.4 mg of folic acid (one of the B vitamins) every day. It is recommended that folic acid supplementation be started prior to pregnancy. Nutritional considerations are part of the reason you should start prenatal care prior to conception. Such care is known as "preconception counseling".

Do not use over-the-counter and prescription medications, unless specified by your health care provider.
Avoid taking any medications unless the benefit to you outweighs any risk to your baby. The long-term effects of many drugs on the unborn child are still unknown. Several varieties of drugs have been found to cause problems and should be avoided during pregnancy. These include: amphetamines, anabolic steroids, tetracycline, streptomycin, aspirin and ibuprofen, diuretics, retin-A, LSD and marijuana, and sulfonamides. Avoid alcohol during pregnancy, as it may cause Fetal Alcohol Syndrome (FAS), an irreversible birth defect. For more information on drugs in pregnancy, click here.
Be tested for infections and diseases before becoming pregnant.
If you get certain kinds of infections, particularly during the first three months of pregnancy, it can lead to possible miscarriage, birth defects or infant death. The best way to protect against infections is to avoid exposure. When this is not possible, vaccination can often be an effective means of prevention. Discuss immunizations with your health care provider before becoming pregnant.
Infections of particular concern to pregnant women include: hepatitis A and B; rubella (German measles); influenza (flu); chlamydia (the most common sexually transmitted disease in women); gonorrhea; tuberculosis; herpes simplex; varicella (Chicken pox); toxoplasmosis; syphilis and AIDS. In most cases, a simple blood test can tell you if you have an infection.

Use good hygiene. Frequent hand washing, careful handling and disposal of diapers or cat litter, and wearing gloves for gardening can reduce the risks of infection.

Beware of workplace, household, and environmental hazards, including contact with chemicals, radiation, and other harmful substances.
Steer clear of X-rays for medical or dental diagnosis, unless your abdomen is adequately shielded with a lead apron.

Only a handful of the sixty thousand chemicals used commercially are tested for their effects on pregnancy. Among those identified as causing reproductive harm are lead, mercury, iodine, ether, hydrochloride, carbon monoxide, nicotine, and ethyl alcohol.

...smoking harms more fetuses and causes more complications than any of the above listed chemicals and household products.

Do not smoke, and encourage others not to smoke in your presence. It is important to realize that smoking harms more fetuses and causes more complications than any of the above listed chemicals and household products. Smoking during pregnancy may cause prematurity, lung disease, crib death, and other complications. Therefore, if you are a smoker it is best to stop. You should also encourage others not to smoke in your presence.

Don't become overheated, through excessive temperature exposure or over-exercise.
Don't subject your body to extreme heat. The use of saunas, hot tubs, steam rooms, and sunlamps - especially during the first three months - may cause dehydration, and should be discontinued during pregnancy. Bath temperatures should be kept moderate.
Prolonged, intense exercise can raise body temperature; therefore exercise in moderation during pregnancy. This is not the best time to participate in vigorous, competitive sports, or to start a new exercise program unless specifically designed for pregnant women.

Dehydration is a common problem in pregnancy. Therefore, drink plenty of fluids, especially water. Report any elevated body temperature over 100 degrees Fahrenheit. It may indicate a fever, which should be investigated by your health care provider.
When traveling by car, practice proper positioning of your seat belt.
Always wear the shoulder strap and adjust the lower part of your safety belt to fit below your stomach, according to The American College of Obstetrics and Gynecology. Safety belts worn too loosely or too high on the stomach can cause broken ribs or injuries to you and your baby in the event of a crash. And even more serious injury may occur when seat belts are not used.
Pregnant women should avoid long periods of sitting in a car because this can increase the risk of forming a blood clot in the legs. Walking every 1-2 hours and doing isometric exercises with the legs, such as toe-lifts, are good ways of improving circulation in the lower body.
Sleep on your side, not your back during the last few months of pregnancy.
When a woman lies flat on her back, especially later in pregnancy, the combined weight of the baby, the uterus, and the placenta puts pressure on a major body vein. This can slow down the flow of blood throughout the body, contributing to abnormal swelling of the legs, varicose veins, and fatigue. The flow of oxygen to the baby can also be decreased. Therefore, it is important for a pregnant woman to avoid lying flat on her back as much as possible. This is especially true during exercise since this is a time when blood flow to the uterus is important. Lying on either side is appropriate for sleeping or resting. The best position to rest is on your left side because it is particularly helpful in promoting good circulation and improving oxygen flow to your baby. Pregnant women need more rest than usual. Use pillows for comfort and to help maintain the side position.
Use fetal "kick counts" to help assess your baby's well being.
Although the baby begins moving by seven weeks, most pregnant women do not notice until the sixteenth to the twentieth week. Usually, babies have a pattern of movement over a twenty-four hour period. Your health care provider can instruct you on how to chart your baby's movements to help in assessing your baby's well being.
If at any time, even during the last trimester of pregnancy, you detect a change in the pattern or lack of fetal movement, call your health care provider.
Be an advocate for your body and your baby.
Throughout your pregnancy, it is your right and your responsibility to be informed and involved. Ask questions. Trust your instincts. Listen to your body. And seek the help and support you need. If you have any concerns about your baby or your pregnancy, contact your health care provider.

Don't be afraid to make a change for better care. Remember that you are the most important member of the healthcare team.

Pregnancy can be a very exciting time of life - it is a time of new beginnings. Try to make the most of an occasion that can create so many fond memories. Accept the inconveniences and enjoy the precious moments, while they are here.

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Last Reviewed: May 07, 2007

Arthur T. Ollendorff, MD
Associate Professor of Obstetrics and Gynecology
Department of Obstetrics & Gynecology
College of Medicine
University of Cincinnati

Thomas A deHoop, MD
Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
Department of Obstetrics & Gynecology
College of Medicine
University of Cincinnati