Pregnancy

Quick look at pregnancy

Pregnancy is one of our primary services and a very important aspect in the lives of many women. In addition to providing care for pregnant women, our goal is to give them clear, comprehensive information about all aspects of pregnancy. Developing this awareness helps women be more comfortable with the changes they are experiencing, while empowering them to make the best choices about their care, before, during and after delivery.

Determining if she is pregnant is the first consideration a woman faces on the path to having a healthy baby. Knowing the specific signs of possible pregnancy is very helpful, and we’ve included those below.

Tests to determine that a woman is pregnant come next. These may begin with a home pregnancy test and then be confirmed with a visit to one of our OB-GYNs.

Being informed about the different pregnancy stages not only helps women prepare for their journey to motherhood but also gives them considerable peace of mind along the way.

Pregnancy symptoms

A woman may experience pregnancy symptoms during the first couple of weeks after conception, even before she misses a period. According to the American Association of Pregnancy, earlier signs of pregnancy are:

• Delayed or missed period (about 30 percent of pregnant women say this was their first sign)
• Nausea (first sign for about 25 percent of pregnant women)
• Change in the breasts, usually tenderness and swelling (first sign for 17 percent of women).

Each woman experiences signs of pregnancy in her own way. Some women have signs of pregnancy within a week of conception. Some don’t have any signs for a few weeks. Many will have one of the earlier signs above. The following list includes some general pregnancy symptoms that tend to present a little later into the pregnancy.

Later signs of pregnancy

• Backache
• Constipation
• Faintness and dizziness
• Fatigue
• Food aversions and/or cravings
• Headaches
• Mood swings
• Nausea with or without vomiting
• Raised basal body temperature
• Slight bleeding or cramping
• Tender, swollen breasts

It’s important to know that having any sign of pregnancy, an earlier or later sign, is not a definite indication of pregnancy. Depending on the symptom, there can be alternate causes for it that are not pregnancy related. For instance, a missed period can be due to stress or an imbalance in hormone levels. Nausea can be caused by food poisoning or another stomach issue; headaches may be due to eye strain or dehydration.

We often recommend that a woman who is experiencing one or more signs of pregnancy wait until she has missed a period before moving on to a home pregnancy test.

Home pregnancy tests and our pregnancy tests

A woman usually first takes a home pregnancy test that determines whether her body has a particular hormone, the human chorionic gonadotropin (hCG), also called the pregnancy hormone. This hormone is produced when a fertilized egg, or embryo, implants in the uterus, approximately six days after the union of the egg and sperm.

Home pregnancy tests

Home pregnancy tests are readily available and easy to use. They involve testing a specimen of the woman’s urine. Before taking the test, women should make sure that the test kit has not passed the printed expiration date and read the directions thoroughly. Most women prefer to be alone when they take the test, but some prefer their partner, a family member or friend to be with them.

A positive home pregnancy test is reason to schedule an appointment with an OB-GYN. Also, if a woman is experiencing signs and suspects she is pregnant, she can choose to see an OB-GYN without taking a home pregnancy test. If the home pregnancy test is done incorrectly or too early, it can give an inaccurate result.

Our more accurate pregnancy tests

In our office, we will perform a urine or blood test to confirm pregnancy. We will perform a clinical test if we are sure from talking with the woman that it is at least 10 days past the estimated conception date.

The urine test we perform is not necessarily more accurate than a home pregnancy test, as we will be evaluating the same hCG hormone presence. But, we will be certain to do it correctly and eliminate possible mistakes that a woman can make with a home pregnancy test.

A pregnancy test that uses the woman’s blood to test for hCG levels is more expensive than a urine pregnancy test and it also takes longer to receive the results. But a blood test can detect hCG earlier than a urine test can. There are two types of blood tests for pregnancy. A qualitative hCG test gives a yes or no answer on pregnancy.

A quantitative hCG blood test measures the exact level of hCG and is more accurate than a qualitative hCG test or a urine test. The level can indicate approximately how far along the woman is in her pregnancy. If the level does not match up with the estimated conception date, an OB-GYN may perform the test again after an interval or conduct an ultrasound. It is not unusual for women to miscalculate the date of conception.

What to expect during pregnancy trimesters

A patient’s first prenatal visit will generally be around 10 weeks after her last menstrual period, or when she is likely around 8 weeks pregnant. At that visit the OB-GYN will ask questions about medical history, overall health, her lifestyle, diet and more.

Our OB-GYN will do a full physical exam that will include a Pap smear, pelvic examination and any recommended blood and/or urine tests. The doctor will also calculate the baby’s due date.

The first trimester

The first trimester, weeks 1-12, is paramount in the baby’s development, as the mother’s hormone levels significantly change and her body adjusts to a growing baby. During this time, the risk of miscarriage is significant. Taking prenatal vitamins and avoiding harmful substances are believed to reduce a woman’s risk of miscarriage.

The baby is fully formed by the end of the first trimester and can even open and close its fists and mouth. During the first trimester, the baby grows from about the size of a poppy seed to the size of a lime.

The second trimester

During weeks 13-28, the baby continues to develop, as eyelids, eyebrows, eyelashes, nails and hair are formed. Teeth and bones are becoming denser and the baby’s nervous system is starting to function. The mother’s fetus is beginning to develop senses, and the auditory system is intact around the 20-week mark.

At 23 weeks the baby may respond to loud noises, and the mom may experience her baby jerking or hiccupping after hearing a loud sound. An anatomy ultrasound may be performed to measure and assess parts of the baby’s body, including the heart, lungs, kidney and brain.

During this time one can hear the baby’s heartbeat, and the doctor can tell the mother the sex of the baby, if she so desires. A woman may even begin experiencing movement of the baby in her womb. By the end of this pregnancy stage, the baby is about as long as an ear of corn.

The third trimester

This final trimester is when the baby grows larger and his or her organs mature. During this trimester, we encourage the mother to educate herself about the labor and delivery process.  Many families choose to take childbirth classes at a local hospital, community center or place of worship. At around 32 weeks, the baby is beginning to practice breathing. His or her bones are hardening (with the exception of the skull, which remains soft and flexible).

Mothers often experience frequent movement during the third trimester, until the baby is too big to move around easily and settles into a head-down position in the uterus, awaiting birth. The mother’s visits to see her OB-GYN become more frequent. After 36 weeks, mothers-to-be are seen weekly until delivery.

Pregnancy Tips

Being pregnant often raises questions and concerns about unknowns, particularly if it is a woman’s first pregnancy. We’ve provided care for pregnant women for over 30 years, and we fully understand these concerns. Below you’ll find some helpful pregnancy tips and guidelines that we’ve compiled based on common concerns and frequently asked questions.

With that said, it’s important to remember that every pregnancy is different. We encourage patients to schedule an appointment or call your provider with questions and concerns.

For details regarding a typical appointment timeline and the care you can expect to receive throughout the different stages of pregnancy, please visit the page.

Pregnancy tips on lifestyle

Diet

A normal and healthy weight gain during pregnancy is 25-35 pounds. We advise that women pursue a healthy, balanced diet while avoiding processed “junk” foods. It’s also best to minimize use of sweeteners, such as NutraSweet and Splenda. A few other pregnancy tips related to diet follow.

• Caffeine: Limit use to 1-2 cups of caffeinated beverages per day.
• Alcohol: We advise that women do not drink alcohol during pregnancy. No research is available indicating how much alcohol may or may not jeopardize the fetus. Many women have inadvertently had alcohol early in pregnancy without subsequent problems for the baby. But the best policy is to not drink while attempting pregnancy and certainly to stop drinking once pregnancy is known.
• Fish: Up to 12 ounces (2 average meals) per week of fish that is low in mercury, such as salmon and shrimp, is okay. Canned light tuna has less mercury than albacore. Avoid shark, swordfish, king mackerel and tilefish.
• Cheese and meats: Avoid foods that are at a higher risk for listeria infection including hot dogs, deli meats (okay if reheated to steaming), soft cheeses, pates or meat spreads, unpasteurized milk or milk products, and raw or undercooked meats.
• Water: Stay hydrated, drinking 2-3 quarts of water daily (8-12 glasses or 64-96 ounces).

Exercise

Regular exercise (at least 3 times a week) helps prevent gestational diabetes and decreases the risk of postpartum depression. Recommended activities include swimming, elliptical or stair machines and yoga. It is best to avoid high impact and abdominal exercises, as well as any activities that can cause falling or heavy contact. Scuba diving should not be attempted, but snorkeling is okay. Walking, jogging and cycling are fine, although they may become increasingly uncomfortable later in pregnancy.

After 12 weeks, women should avoid any form of exercise that requires them to lie on their back. Exercising to the point of exhaustion is not recommended. And staying hydrated and nourished is very important.

Travel

Traveling by plane is okay until around 34-36 weeks into pregnancy. Some airlines require that pregnant women provide a doctor’s note, which we are happy to provide for patients who are not in the final stages of pregnancy.

Pregnant women may travel to the mountains, but are advised to stay below 10,000 feet due to decreased oxygen at higher elevations. It is always advised to stay hydrated and use plenty of sunscreen during hikes and other outdoor activities.

Smoking

Pregnant women should not smoke. The harmful effects of smoking during pregnancy are well documented. It may lead to a small baby, premature birth, bleeding and other complications.

Other pregnancy tips on lifestyle

• Hot tubs & heat: Avoid saunas, steam baths, hot tubs and electric heating blankets.
• Cats: Avoid changing cat litter.
• Painting: Latex painting in a well-ventilated room is generally safe during pregnancy. Avoid using a sprayer and any oil- or lead-based paints.
• Hair dye: There is no evidence to suggest that hair dye causes fetal effects.

Common pregnancy side effects

Constipation

Constipation is common throughout pregnancy. It can be a result of hormonal effects and/or the pressure that the fetus exerts on the digestive system. Increasing fiber intake (fresh fruit, vegetables, whole grain breads, high fiber cereals) and drinking plenty of water often prove helpful. Pregnant women can use stool softeners (see safe OTC medications during pregnancy) but should avoid laxatives.

Additionally, it’s important to note that calcium carbonate supplements (Tums) for acid reflux can make constipation worse. Blood in the stool may be a sign of straining or hemorrhoids. If serious symptoms arise, women are advised to notify us at the next visit or give us a call.

Morning sickness

Nausea and vomiting during pregnancy are common and usually subside with time. To reduce nausea, pregnant patients should get plenty of rest and avoid bothersome smells. Eating several small meals instead of three large meals may also be beneficial. It may also help to avoid fatty or spicy foods.

Ginger may naturally reduce nausea, and patients sometimes find it helpful to incorporate ginger-containing foods or ginger capsules (200mg three times a day). Vitamin B6 supplements may also help (25mg 3 times a day). Women who are unable to keep any food or liquids down should call the office.

Fetal movement

Women can expect fetal movement around 20-24 weeks. After 28 weeks, it’s best to make a mental note of daily fetal movement. At least 12 movements should be felt every day. Patients often find that it is easy to monitor for movement at bedtime (lying on the left side) or just after a meal. If fewer than 12 movements are felt during the day, we advise our patients to call the office.

Vaginal discharge

It is normal for a woman to have thicker vaginal discharge during pregnancy. But women should not douche while pregnant. Patients are encouraged to call the office if they leak clear, watery fluid.

Side pain

Many women experience side pain during pregnancy, especially when exercising, stretching or lifting. This is usually ligament pain caused by a growing uterus pulling on the ligaments. For relief, women are advised to use heat, rest, Tylenol or massage.

Heartburn

Indigestion and heartburn are very common in pregnancy, and can be treated using approved over-the-counter medications such as Tums.